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Little is known about patterns of participation in social activities among adolescents with an autism spectrum disorder (ASD). The objectives were to report nationally representative (U.S.) estimates of participation in social activities among adolescents with an ASD, to compare these estimates to other groups of adolescents with disabilities, and examine correlates of limited social participation. We analyzed data from wave 1 of the National Longitudinal Transition Study 2, a large cohort study of adolescents enrolled in special education. Three comparison groups included adolescents with learning disabilities, mental retardation, and speech/language impairments. Adolescents with an ASD were significantly more likely never to see friends out of school (43.3%), never to get called by friends (54.4%), and never to be invited to social activities (50.4%) when compared with adolescents from all the other groups. Correlates of limited social participation included low family income and having impairments in conversational ability, social communication, and functional cognitive skills. Compared with prior research, our study significantly expands inquiry in this area by broadening the range of social participation indicators examined, increasing the external validity of findings, focusing on the under-studied developmental stage of adolescence, and taking an ecological approach that included many potential correlates of social participation. There were notable differences in social participation by income, a dimension of social context seldom examined in research on ASDs.

Anecdotal reports indicate that individuals with autism spectrum disorders (ASD) are often preoccupied with television, computers, and video games (screen-based media). However, few studies have examined this issue. The current study examined screen-based media use among a large, nationally representative sample of youths participating in the National Longitudinal Transition Study—2 (NLTS2). The majority of youths with ASD (64.2%) spent most of their free time using non-social media (television, video games), while only 13.2% spent time on social media (email, internet chatting). Compared with other disability groups (speech/language impairments, learning disabilities, intellectual disabilities), rates of non-social media use were higher among the ASD group, and rates of social media use were lower. Demographic and symptom-specific correlates were also examined.

Investigating social participation of young adults with an autism spectrum disorder (ASD) is important given the increasing number of youth aging into young adulthood. Social participation is an indicator of life quality and overall functioning. Using data from the National Longitudinal Transition Study 2, we examined rates of participation in social activities among young adults who received special education services for autism (ASD group), compared to young adults who received special education for intellectual disability, emotional/behavioral disability, or a learning disability. Young adults with an ASD were significantly more likely to never see friends, never get called by friends, never be invited to activities, and be socially isolated. Among those with an ASD, lower conversation ability, lower functional skills, and living with a parent were predictors of less social participation.

IntroductionFirearm injuries are the leading cause of death among young people in the USA and disproportionately impact communities of colour and those experiencing socioeconomic distress. Understanding the personal goals of violently injured patients is essential to identifying protective factors and developing interventions that promote them. However, limited research characterising these personal goals exists.ObjectiveThe objective of this study was to use qualitative thematic analysis to analyse and describe the personal goals of young people who enrolled in a region-wide hospital-based violence intervention programme after surviving a violent injury.MethodsA qualitative coding framework was developed, evaluated, and implemented using data from Life Outside of Violence, the St. Louis Area Hospital-Based Violence Intervention Programme. Chart abstraction procedures were used to compile qualitative data on Life Outside of Violence participants’ personal goals documented by clinical case managers during individual treatment planning sessions with participants (n=168). Descriptive analyses are reported and implications for practice are discussed.ResultsKey findings reveal that (1) violent injury survivors have unmet therapeutic and resource needs, indicating the importance of having service providers with both clinical and case management skills, (2) anger management is a common clinical goal, and (3) employment opportunities are a common resource need.ConclusionsFindings from this study inform the implementation of the Life Outside of Violence programme and offer a roadmap to other hospital-based violence intervention programmes operating nation-wide. Our results provide insight into participants’ needs, desires, and motivations, allowing unique opportunities for improved participant engagement and service delivery.

IntroductionFirearm injuries are a public health crisis in the US. The National Death Index (NDI) is a well-established, comprehensive database managed by the National Center for Health Statistics at the CDC. In this methodology paper we describe our experience accessing and linking data from the NDI to our regional, hospital-based violent injury database to identify out-of-hospital deaths from firearms.MethodsWe outline the key steps of our submission to the NDI. Data were collected from research team meeting notes, team member emails with NDI staff, and information provided from the NDI website and supplementary guides. Few of our collaborators or university partner investigators had accessed or used data from the NDI. We discuss the online NDI Processing Portal data request, data preparation and receipt from the NDI, troubleshooting tips, and a timeline of events.ResultsOur query to the NDI returned 12 034 records of 12 219 firearm-injured patient records from 2010 and 2019. The record match rate was 98.5%.DiscussionLinking hospital-based data sets with NDI data can provide valuable information on out-of-hospital deaths. This has the potential to improve the quality of longitudinal morbidity and mortality calculations in hospital-based patient cohorts. We encountered logistic and administrative challenges in completing the online NDI Processing Portal and in preparing and receiving data from the NDI. It is our hope that the lessons learnt presented herein will help facilitate easy and streamlined acquisition of valuable NDI data for other clinical researchers.What this study adds:- A step-by-step guide for clinical researchers of how to apply to access data from the National Death Index (NDI).- Advice and lessons learned on how to efficiently and effectively access data from the NDI.- A well-described methodology to improve the quality of longitudinal morbdity and mortality calculations in hospital-based cohorts of firearm injured patients.What is already known on this subject:- There is a need for robust, longitudinal data sources that reliably track morbidity and mortality among firearm injured patients in the United States.- The NDI is a well-established, comprehensive database that holds death records for all 50 states, which provides valuable mortality data to the public health and medical research community.

Background: Many youths with an autism spectrum disorder (ASD) benefit from psychotropic medication treatment of co-morbid symptom patterns consistent with attention-deficit/hyperactivity disorder (ADHD). The lack of clear indications and algorithms to direct clinical practice has led to a very poor understanding of overall medication use for these youths. The present study examined the prevalence of psychotropic medication use compared across individuals with an ASD without a caregiver-reported ADHD diagnosis (ASD-only), ADHD without ASD (ADHD-only), and an ASD with co-morbid ADHD (ASD+ADHD). Correlates of medication use were also examined. Methods: Data on psychotropic medication from the first wave of the National Longitudinal Transition Study 2, a nationally representative study of adolescents ages 13–17 in special education, were used to compare the prevalence of medication use across the three groups, overall and by class. Separate logistic regression models were constructed for each group to examine the correlates of psychotropic medication use. Poisson regression models were used to examine correlates of the number of medications. Results: Youths with ASD+ADHD had the highest rates of use (58.2%), followed by youths with ADHD-only (49.0%) and youths with ASD-only (34.3%). Youths with an ASD, both ASD-only and ASD+ADHD, used medications across a variety of medication classes, whereas stimulants were dominant among youths with ADHD-only. African American youths with ASD-only and with ASD+ADHD were less likely to receive medication than white youths, whereas race was not associated with medication use in the ADHD-only group. Conclusions: Clearer practice parameters for ADHD have likely contributed to more consistency in treatment, whereas treatment for ASD reflects a trial and error approach based on associated symptom patterns. Additional studies examining the treatment of core and associated ASD symptoms are needed to guide pharmacologic treatment of these youths. Interventions targeting African American youths with ASD and the physicians who serve them are also warranted.

The federal Healthy Start program began 20 years ago, yet outcome evaluations lack sufficient rigor to draw conclusions on program impact. We evaluated the impact of the Healthy Start program on birth outcomes, prenatal care, and public services utilization. Birth record data for the St. Louis Healthy Start Program (SLHS) and non-SLHS controls (matched using a propensity score technique) were assessed for differences. Propensity score matching techniques matched SLHS to non-SLHS clients on potentially confounding variables for births from years 2006 to 2008. Traditional multivariable logistic regression on the full, unmatched sample was also conducted for comparison. Matching eliminated any prior statistical differences between groups on covariates. 168 controls and 84 SLHS participants remained in the final matched analysis group. Both analysis techniques were similar on all outcomes, revealing significant group differences for low birth weight (matched OR = 0.28, p  = 0.023) and prematurity (matched OR = 0.25, p  = 0.012) but not for prenatal care (matched OR = 0.76, p  = 0.414), or public services utilization (matched OR = 3.31, p  = 0.121). Early results for this Healthy Start project are positive in key areas directly impacting infant mortality. However, continued analysis of this program for sustained impact in these areas and ultimately, a reduction in infant mortality is needed. Additionally, more rigorous experimental and quasi-experimental evaluation designs are needed to assess the impact of other Healthy Start programs around the country.

The number of youth on the autism spectrum approaching young adulthood and attending college is growing. Very little is known about the subjective experience of these college students. Disability identification and self-efficacy are two subjective factors that are critical for the developmental and logistical tasks associated with emerging adulthood. This study uses data from the National Longitudinal Transition Study 2 to examine the prevalence and correlates of disability identification and self-efficacy among college students on the autism spectrum. Results indicate nearly one-third of these students do not report seeing themselves as disabled or having a special need. Black race was associated with lower likelihood of both disability identification and self-efficacy.

In Simmons v. South Carolina (1994), the Supreme Court held that when the prosecutor rests his case for the death penalty on the defendant's future dangerousness, and where the defendant is ineligible for parole, due process requires that the jury be informed that the defendant is ineligible for parole, even though state law otherwise prevents the jury from considering parole eligibility. A prosecutor must not be able to mislead jurors into believing that the defendant, who will never be eligible for parole, will one day pose a danger to society if not sentenced to death. While the Supreme Court faced a rather easy decision in Simmons, lower courts have confronted a much more difficult task in addressing the dozens of Simmons claims that have subsequently come before them. These claims come in 2 varieties: 1. Defendants whose convictions were not final at the time of the Simmons decision seek the benefit of the Simmons ruling on direct appeal. 2. Defendants whose convictions were final at the time of Simmons seek to use it to make a collateral attack on their death sentences.

Because of this \"user friendly\" rule, the burden imposed on all interested parties - law students, law schools and legal service providers - will be relatively small and certainly smaller than critics have suggested. Most applicants will fulfill the pro bono requirement at their law school, and law schools already provide ample pro bono opportunities for students to do so. Indeed, as part of the accreditation process, the ABA requires law schools to \"offer substantial opportunities for live-client or other real-life practice experiences appropriately supervised\" and \"student pro bono opportunities.\"14 In recent years, law schools have expanded their clinical and pro bono programs. According to the ABA, more than 85% of law schools now \"regularly offer[] in-house live-client clinical opportunities,\"15 and about the same number (176 law schools out of approximately 200) have a formal pro bono program.16 Thirty-nine schools make pro bono service a requirement for graduation.17 In other words, almost all students already have sufficient opportunities to fulfill New York's pro bono requirement in law school, and, in fact, for the significant number of students who are already required to do pro bono service in law school, the new requirement will change nothing.18 Third, if lawyers do pro bono work in law school, they may be more likely to do pro bono work as lawyers. Professor [Deborah L Rhode] refers to this as the \"trickle up\" effect.29 Although some have raised concerns that forcing lawyers to engage in pro bono service tends to reduce the overall number of hours donated by lawyers,30 when it comes to mandatory pro bono requirements for law students (as opposed to lawyers), some research indicates that such a program will have the opposite effect and actually cause lawyers to do more pro bono work in the future. \"In surveys at several schools with required programs, most students report that participation has increased their willingness to provide pro bono contributions after graduation.\"31 Further, lawyers who do pro bono work in law school will be more prepared to do pro bono work once they are in practice. Imagine a junior associate in the corporate department of a large New York firm. He may want to represent a tenant in a dispute with a landlord or help a battered woman get a temporary restraining order to protect her from her husband, but if he has not been exposed to that kind of work in law school, it is unlikely that he will know how to do it. As a result, the junior associate may not do a very good job on the case, or he may not take the case at all. At the end of the day, New York's rule is worth a try. It would be preferable if we could rely on lawyers to volunteer their time but \"the best available data indicates that the average pro bono contribution for lawyers is still less than half a dollar per day and half an hour per week.\"37 New York's new rule should impose relatively little burden on anybody while providing at least some benefit to the poor and to students seeking practical opportunities in law school. We can hope, moreover, that the experience of doing pro bono work in law school will \"trickle up\" and increase pro bono service by lawyers in practice. The rule is by no means a panacea, but viewed as a first and partial step toward reform (rather than a definitive and final answer to access-to-justice issues), it starts to look better. Once the program is in place, it will be easier to require a similar program for licensed lawyers or to suggest other innovations aimed at increasing access to justice. And if the program proves unworkable, it can always be improved, replaced, or terminated. As the reaction to the plan demonstrates, it is easy to be a critic, but it is much harder to propose concrete solutions. Chief Judge [Jonathan Lippman] has offered one. It is not perfect, but those who are waiting for a perfect solution will never find it. 30. Susan Hackett, Mandatory Pro Bono: Not Only an Oxymoron, But at Cross-Purposes with its Goal, Legal Executive Leadership (May 3, 2012), http://www.legalexecutiveleadership.com/2012/ ny-mandatory-pro-bono-rule (\"I respectfully push back on this rule, based on my work with top pro bono groups, such as the Pro Bono Institute, which don't like mandatory pro bono for a very important reason: the end result is a net \"lowering\" of the number of hours donated by lawyers. It's proven from looking at the experience in states with mandatory systems.\").