CUNY School of Law

This investigation sought to understand the mental health needs of Black/African Americans during the COVID-19 pandemic and explore the church leaders’ perspectives and experiences in supporting the mental health of their communities during this time. This exploratory qualitative study uses semi-structured interviews with 21 church leaders from predominantly Black neighborhoods in Brooklyn and Harlem, New York City (NYC), which were most adversely impacted by COVID-19. Neighborhoods were selected based on COVID-19 infection and mortality data from the NYC Department of Health. Transcripts were coded and thematically analyzed using Dedoose software. Four overarching themes and one subtheme emerged: (1) The COVID-19 pandemic amplified underlying community quality of life challenges, creating a “downward cascade” of mental health, (1a) COVID-19 is a source of collective grief and trauma; (2) Faith-based leaders play a key role in providing mental health support to their community; (3) Faith-based leaders seek strategies to reduce mental health stigma, normalize conversations around mental health; and (4) Faith-based leaders often operate in isolation from citywide mental health services, disconnected from existing programs and resources. Leaders anticipate a higher demand for mental health services. On the road to emotional wellness post-pandemic, public awareness of symptoms of mental health issues must be emphasized and available resources utilized to reduce stigma and encourage help-seeking behavior. Addressing these implications requires comprehensive multi-sector community driven efforts that include collaboration with faith-based communities to support community resilience and improve mental healthcare access.

OBJECTIVE Dural sealant patches (DSPs) are a useful adjunct when closing the dura during cranial or spinal surgery to avoid cerebrospinal fluid (CSF) leakage or infection. Authors of this paper systematically review the outcomes and incidence of CSF leakage and infection with the use of a DSP versus conventional practice. METHODS The MEDLINE, Embase, Cochrane Library, and Scopus databases were searched, and clinical trials and prospective or retrospective case-control and cohort studies with a low-risk of bias and involving any solid DSP used in adults for cranial or spinal cases were included. Studies that used a DSP in combination with another method of dural sealant closure, used a DSP as a dural substitute rather than an adjunctive closure device, or used hydrogel or polymer gel (i.e., nonsolid) dural sealant "patches" were excluded. A meta-analysis of comparative studies reporting outcomes relating to CSF leakage was performed together with a subgroup analysis for each DSP type. For comparative studies reporting outcomes relating to infection, a separate meta-analysis was conducted. RESULTS Across the 7 noncomparative studies included, 669 patients received TachoComb (n = 421, 1 study), TachoSil (n = 8, 1 study), Liqoseal (n = 40, 1 study), TissuePatchDural (n = 144, 2 studies), or Hemopatch (n = 56, 2 studies). Across the 6 comparative studies included, 1013 patients received TachoSil (n = 784, 3 studies), TissuePatchDural (n = 147, 2 studies), or Hemopatch (n = 82, 1 study). When considering the rates of CSF leakage or infection, 2/6 comparative studies found DSPs to be significantly more effective than current practice, while the remaining 4/6 demonstrated noninferiority compared to current practice. All studies considered the DSPs to be safe. A meta-analysis revealed significant improvements in the incidence of CSF leakage with the use of a DSP overall, but the improvements in CSF leak rates for the TachoSil and TissuePatchDural subgroups did not reach statistical significance. The single study evaluating Hemopatch did find statistically significant improvements in CSF leak rates. There were no significant differences in infection between the DSP groups. CONCLUSIONS There was a significant improvement in the incidence of CSF leaks with the use of DSPs. Comparisons among DSP types and evaluations of outcomes relating to infection should be the focus of further research in this area.

Rapid declines in opioid analgesics dispensed in American communities since 2011 raise concerns about inadequate access to effective pain management among patients for whom opioid therapies are appropriate, especially for those living in racial/ethnic minority and socioeconomically deprived communities. Using 2011 to 2021 national data from the Automated Reports and Consolidated Ordering System and generalized linear models, this study examined quarterly per capita distribution of oxycodone, hydrocodone, and morphine (in oral morphine milligram equivalents [MMEs]) by communities' racial/ethnic and socioeconomic profiles. Communities (defined by 3-digit-zip codes areas) were classified as “majority White” (≥50% self-reported non-Hispanic White population) vs “majority non-White.” Community socioeconomic deprivation was measured by quartiles of population-weighted Social Deprivation Index. Overall, majority non-White communities had at least 40% lower mean adjusted per capita distribution than majority White communities across all levels of socioeconomic deprivation. Among the least deprived communities, the adjusted mean per capita distribution was 46.0 (95% confidence interval [CI], 40.0-52.0) for majority non-White vs 82.8 (95% CI, 78.5-87.1) MMEs for majority White communities. Among the most deprived communities, the distribution was 78.0 (95% CI, 70.8-85.1) for majority non-White vs 134.4 (95% CI, 125.4-143.4) MMEs for majority White communities. The lower distribution in majority non-White communities was statistically significant across all socioeconomic deprivation levels and over all study years. Availability of commonly prescribed opioid analgesics was substantially lower in majority non-White communities than in majority White communities across all levels of socioeconomic deprivation. Policies governing opioid analgesic availability warrant careful consideration and potential adjustments.

Plurilateral agreements among sub-sets of economies have a long history within the multilateral trading system. Plurilaterals may appear superficially less attractive than a set of non-discriminatory multilateral rules that apply to all WTO members but may, both in theory and in practice, be better suited to accommodate diversity across countries in the desire and ability to regulate certain aspects of economic activity. As long as such differences between countries do not lead to discrimination or encroachment on other countries’ rights under WTO rules, it is potentially beneficial for the trading system to permit groups of countries to pursue regulatory cooperation, even if other countries do not wish to follow suit. The alternatives to greater accommodation of plurilateral cooperation in the WTO are more preferential (discriminatory) trade agreements and club-based initiatives outside the WTO. Both options are arguably worse for non-participating developing countries than incorporating open, transparent plurilateral agreements into the WTO. Opponents of plurilateral initiatives operating under WTO auspices run the risk of inducing further erosion of the multilateral trading system.

Vitamin B12 deficiency is a significant concern among patients with end-stage renal disease undergoing dialysis. However, there hasn’t been extensive research conducted on this particular patient group. The reported incidence rates vary widely, ranging from 20% to 90%, reflecting the complexity of its diagnosis. Dialysis patients often face multiple nutritional deficiencies, including a lack of essential vitamins, due to factors such as dietary restrictions, impaired absorption, and nutrient loss during dialysis. Diagnosing vitamin B12 deficiency in these patients is challenging, and addressing it is crucial to prevent complications and improve their overall quality of life. This review paper delves into the available body of evidence on vitamin B12 deficiency in dialysis patients, examining the contributing risk factors, diagnostic challenges, potential complications, and available treatment options. It provides a well-rounded perspective on the topic, making it a valuable resource for researchers, healthcare practitioners, and policymakers interested in addressing the nutritional needs of dialysis patients.

Introduction Over 100 million displaced people rely on health services in humanitarian contexts, defined as unstable or transitory settings created in response to complex emergencies. While services are often described, there is a dearth of evidence on best practices for successful implementation to guide efforts to optimize health delivery. Implementation science is a promising but underutilized tool to address this gap. This scoping review evaluates implementation science in health services for forced migrants in humanitarian settings. Methods We conducted a scoping review according to JBI methodologies. A search of eight databases yielded 7,795 articles, after removal of duplicates, that were screened using PRISMA-ScR guidelines. Data extraction assessed study descriptors, implementation objects, barriers, facilitators, implementation strategies, and use of implementation frameworks in service delivery. Results Data from 116 studies represented 37 countries and 11 topic areas. Methods were mainly cross-sectional with low-medium evidence rigor. Mental health programs (25%) and vaccination services (16%) were the most common objects of implementation. Thirty-eight unique barriers were identified including resource limitations (30%), health worker shortages (24%), and security risks (24%). Among 29 facilitators, the most common were health worker availability (25%), pre-existing partnerships (25%), and positive perceptions towards the intervention (20%). More than 90% of studies collectively identified 35 implementation strategies, the most common being capacity building (44%), stakeholder engagement (35%), information dissemination (38%), and feedback mechanisms (25%). Only 10 studies used formal implementation models, with RE-AIM (n = 3) and Intervention mapping (n = 2) being most frequent. Conclusions In this scoping review, we found similar barriers, facilitators, and implementation strategies across diverse humanitarian migrant settings and services. However, the use of rigorous methods and formal implementation models was rare. Frameworks included RE-AIM, CFIR, and Precede-Proceed. Increased use of implementation science frameworks and methods will help humanitarians more rigorously and systematically evaluate and develop best practices for implementation of health services for migrants in humanitarian settings.

Introduction Adenoid basal cell carcinoma is a rare cervical malignancy which is indolent in nature but resembles more commonly occurring aggressive malignancies. Cases Here we describe three cases of cervical adenoid basal cell carcinoma. All patients had a history of cervical dysplasia with high-risk HPV. The first and second patient were treated with hysterectomy, and the third patient opted for surveillance after cold knife conization. All patients have no evidence of disease to date. Conclusion Cervical adenoid basal cell carcinoma is a rare malignancy that requires careful diagnostic attention due to its histologic similarities to more aggressive malignancies and the risk of misclassification. Advances in diagnostic criteria including immunohistochemistry (IHC) classification are key to distinguishing this unique pathological entity. Definitive treatment depends on accurate diagnosis. Optimal treatment involves surgical management with hysterectomy and lymph node assessment. Excisional biopsy with thorough pathologic evaluation for invasive carcinoma can be considered in patients who desire future fertility.

Footprints in Kenya show that hominin bipedalism had a complex evolutionary history

Persistently rising atmospheric greenhouse gas concentrations challenge dominant Liberal hopes that science and multilateralism might deliver rational, global climate outcomes. Emerging Realist climate approaches that take geopolitics and national interests more seriously have yet to explore Morgenthau’s concern that ‘scientism’ – exaggerated faith in scientific rationality to solve political problems – would lead to disastrous underestimations of power and irrationality. Recently, Realists have mooted ‘solar geoengineering’ designs as a ‘lesser evil’ option to deliberately cool the Earth independently of emissions reductions. However, assessments of solar geoengineering prospects barely factor in Realist concerns, focusing instead on idealised scientific modelling of bio-physical effects and Liberal governance scenarios. To explore how geoengineering techno-science would be ‘translated’ into security assessments, geopolitical logics were elicited through interviews and group discussions with (mainly Arctic-oriented) national security professionals. Security experts reframe solar geoengineering in three significant ways: (a) from a climate ‘global public good’ to a source of geopolitical leverage and disruption; (b) from a risk-reduction tool to a potential source of distrust and escalation; and (c) from a knowledge-deficit problem solvable by more research, to a potential disinformation vector. This expands Realist scholarship on climate change and identifies serious risks to ongoing scientific and commercial pursuit of such technologies.

This study examined the role of meaningfulness and motivating operations on the outcomes for equivalence-based instructions (EBI). In Experiment 1, we compared the establishment of two equivalence classes; both classes were considered as meaningful (Chemistry and Developmental Psychology contents) but only Developmental Psychology was expected to be educationally relevant to General Psychology students. Participants were assigned to two groups, in which only one content was presented. In Experiment 1, participants in the Chemistry group showed better performances compared to the Developmental Psychology group. This result suggests that, under similar conditions, equivalence classes on Chemistry contents were easier to learn. Experiment 2 assessed the effects of motivating operations in establishing equivalence classes. We systematically included instructions on whether participants would learn relations between meaningful stimuli and whether they were educationally beneficial. New participants were assigned to three groups. In the Abstract condition participants were told the stimuli were not meaningful and not educationally beneficial. The two meaningful conditions were the same as Experiment 1, with the Developmental Psychology classes being directly relevant to the course from which participants were recruited. The outcomes indicated that meaningful stimuli facilitated equivalence class formation and direct educational relevance further enhanced outcomes. These findings provide preliminary evidence of the role of motivating operations in enhancing equivalence class formation and relational frame theory’s concept of ROE-M.

This article delves into the intersection of literature and legal normativity through the lens of Ismail Kadare’s novel Broken April. It explores how literary theory enhances philosophical analysis of law by examining the novel’s portrayal of the Kanun, a set of customary laws in Albania, highlighting the complexity of legal normativity and the impact of law on individual subjectivity and social order. The core argument posits that Broken April serves not only as a reimagined narrative of Albanian customary law, but also as a device to question and reflect on the broader implications of law’s normative force, and its reliance on a plethora of aesthetically effective symbols, in constituting both human behavior and the social imaginary. Through the literariness of Broken April, this article explains how law infiltrates and molds the social and psychological dimensions of life, ultimately shaping legal experience. It argues that literature offers a unique vantage point to reassess our understanding of law’s role in society, challenging conventional and nonconventional legal theories that overlook the cultural and emotional dimensions of law.