Political corruption in the Caribbean Basin: A comparative analysis of Jamaica and Costa Rica

Political corruption in the Caribbean Basin retards state economic growth and development, undermines government legitimacy, and threatens state security. In spite of recent anti-corruption efforts of intergovernmental and nongovernmental organizations (IGO/NGOs), Caribbean political corruption problems appear to be worsening in the post-Cold War period. This dissertation discovers why IGO/NGO efforts to arrest corruption are failing by investigating the domestic and international causes of political corruption in the Caribbean. The dissertation's theoretical framework centers on an interdisciplinary model of the causes of political corruption built within the rule-oriented constructivist approach to social science. The model first employs a rational choice analysis that broadly explains the varying levels of political corruption found across the region. The constructivist theory of social rules is then used to develop the structural mechanisms that further explain the region's levels of political corruption. The dissertation advances its theory of the causes of political corruption through qualitative disciplined-configurative case studies of political corruption in Jamaica and Costa Rica. The dissertation finds that IGO/NGO sponsored anti-corruption programs are failing because they employ only technical measures (issuing anti-corruption laws and regulations, providing transparency in accounting procedures, improving freedom of the press, establishing electoral reforms, etc.). While these IGO/NGO technical measures are necessary, they are not sufficient to arrest the Caribbean's political corruption problems. This dissertation concludes that to be successful, IGO/NGO anti-corruption programs must also include social measures, e.g., building civil societies and modernizing political cultures, for there to be any hope of lowering political corruption levels and improving Caribbean social conditions. The dissertation also highlights the key role of Caribbean governing elite in constructing the political and economic structures that cause their states' political corruption problems. ^

Differences in treatment and intervention needs of girls arrested for status versus criminal offenses

The purpose of this research was to explore the differences in factors associated with girls' status and criminal arrests. This study used data from six juvenile justice programs in multiple states, which was derived from the Juvenile Assessment and Intervention System (JAIS). The sample of 908 adolescent girls (ages 13-19) was ethnically and racially diverse (41% African American, 32% white, 12% Hispanic, 11% Native American and 4% Other). A structural equation model (SEM) was analyzed which tested the potential effects of adolescent substance use, truancy, suicidal ideation/attempt, self-harm, peer legal trouble, parental criminal history and parental and non-parental abuse on type of offense (status and criminal) and whether any of these relationships varied as a function of race/ethnicity. ^ Complex relationships emerged regarding both status and more serious criminal arrests. One of the most important findings was that distinct and different patterns of factors were associated with status arrests compared to criminal arrests. For example, truancy and parental abuse were directly associated with status offenses, whereas parental criminal history was directly related to criminal arrests. However, both status and criminal arrests shared common associations, including substance use, which signifies that certain variables are influential regarding both non-criminal and more serious crimes. In addition, significant meditating influences were observed which help to explain some underlying mechanisms involved in girls' arrest patterns. Finally, race/ethnicity moderated a key relationship, which has serious implications for treatment. ^ In conclusion, the present study is an important contribution to research regarding girls' delinquency in that it overcomes limitations in the existing literature in four primary areas: (1) it utilizes a large, multi-state, ethnically and racially diverse sample of justice system-involved girls, (2) it examines numerous co-occurring factors influencing delinquency from multiple domains (family, school, peers, etc.) simultaneously, (3) it formally examines race/ethnicity as a moderator of these multivariate relationships, and (4) it looks at status and criminal arrests independently in order to highlight possible differences in the patterning of risk factors associated with each. These findings have important implications for prevention, treatment and interventions with girls involved in the juvenile justice system.^

Thioredoxin and Jab1 control estrogen- and antiestrogen-mediated progression of the cell cycle through p27 interactions

A major problem with breast cancer treatment is the prevalence of antiestrogen resistance, be it de novo or acquired after continued use. Many of the underlying mechanisms of antiestrogen resistance are not clear, although estrogen receptor-mediated actions have been identified as a pathway that is blocked by antiestrogens. Selective estrogen receptor modulators (SERMs), such as tamoxifen, are capable of producing reactive oxygen species (ROS) through metabolic activation, and these ROS, at high levels, can induce irreversible growth arrest that is similar to the growth arrest incurred by SERMs. This suggests that SERM-mediated growth arrest may also be through ROS accumulation. Breast cancer receiving long-term antiestrogen treatment appears to adapt to this increased, persistent level of ROS. This, in turn, leads to the disruption of reversible redox signaling that involves redox-sensitive phosphatases and protein kinases and transcription factors. This has downstream consequences for apoptosis, cell cycle progression, and cell metabolism. For this dissertation, we explored if altering the ROS formed by tamoxifen also alters sensitivity of the drug in resistant cells. We explored an association with a thioredoxin/Jab1/p27 pathway, and a possible role of dysregulation of thioredoxin-mediated redox regulation contributing to the development of antiestrogen resistance in breast cancer. We used standard laboratory techniques to perform proteomic assays that showed cell proliferation, protein concentrations, redox states, and protein-protein interactions. We found that increasing thioredoxin reductase levels, and thus increasing the amount of reduced thioredoxin, increased tamoxifen sensitivity in previously resistant cells, as well as altered estrogen and tamoxifen-induced ROS. We also found that decreasing levels of Jab1 protein also increased tamoxifen sensitivity, and that the downstream effects showed a decrease p27 phosphorylation in both cases. We conclude that the chronic use of tamoxifen can lead to an increase in ROS that alters cell signaling and causing cell growth in the presence of tamoxifen, and that this resistant cell growth can be reversed with an alteration to the thioredoxin/Jab1 pathway.

Anticancer activity of 4-N gemcitabine analogues

Gemcitabine (2', 2'-difluoro-2'-deoxycytidine or dFdC) has become a standard chemotherapeutic agent in the treatment of several cellular and solid tumor- related malignancies. Gemcitabine's anti-cancer activity has been attributed to its inhibitory effects on the cell's DNA synthetic machinery resulting in the induction of cell arrest and apoptosis. Despite its broad application, treatment capacity with this drug is limited due to complicated administration schedules stemming from low bioavailability and tumor resistance associated with its rampant intracellular enzymatic inactivation. The aim of this study is to characterize the anti-cancer activity of novel designed and synthesized gemcitabine analogues, that were modified with long alkyl chains at the 4-amino group of the cytosine ring. This study proposes the use of these alternative derivatives of gemcitabine that not only uphold current drug standards for potency, but additionally confer chemical stability against enzymatic inactivation. During screening conducted to identifY prospective gem-analogue candidates, I observed the potent anticancer properties ofthree 4-N modified compounds on MCF-7 breast adenocarcinoma cells. Experiments described here with these compounds referred to as LCO, LCAO, and Gvaldo, evaluate their cytotoxicity on MCF-7 cells at the concentrations of 25flM and 2.5flM, and assess their inhibitory effects on DNA synthesis and cell cycle progression using sulphorhodamine B and bromodeoxyuridine assays as well as flow cytometric analyses, respectively. Among the compounds tested, LCO was shown to be most active inhibitor of DNA synthesis (a=.05; p<.OOl) as reflected as a distinct GO/Gl versus S-phase arrest in the 25flM and 2.5flM treatments, respectively. Together, these experiments provide preliminary evidence for the clinical application of LCO-like gemcitabine derivatives as a novel treatment for breast cancer.

Test of a smock system on CPR primary emergency measures and medical errors during simulated emergencies

Rates of survival of victims of sudden cardiac arrest (SCA) using cardio pulmonary resuscitation (CPR) have shown little improvement over the past three decades. Since registered nurses (RNs) comprise the largest group of healthcare providers in U.S. hospitals, it is essential that they are competent in performing the four primary measures (compression, ventilation, medication administration, and defibrillation) of CPR in order to improve survival rates of SCA patients. The purpose of this experimental study was to test a color-coded SMOCK system on: 1) time to implement emergency patient care measures 2) technical skills performance 3) number of medical errors, and 4) team performance during simulated CPR exercises. The study sample was 260 RNs (M 40 years, SD=11.6) with work experience as an RN (M 7.25 years, SD=9.42).Nurses were allocated to a control or intervention arm consisting of 20 groups of 5-8 RNs per arm for a total of 130 RNs in each arm. Nurses in each study arm were given clinical scenarios requiring emergency CPR. Nurses in the intervention group wore different color labeled aprons (smocks) indicating their role assignment (medications, ventilation, compression, defibrillation, etc) on the code team during CPR. Findings indicated that the intervention using color-labeled smocks for pre-assigned roles had a significant effect on the time nurses started compressions (t=3.03, p=0.005), ventilations (t=2.86, p=0.004) and defibrillations (t=2.00, p=.05) when compared to the controls using the standard of care. In performing technical skills, nurses in the intervention groups performed compressions and ventilations significantly better than those in the control groups. The control groups made significantly (t=-2.61, p=0.013) more total errors (7.55 SD 1.54) than the intervention group (5.60, SD 1.90). There were no significant differences in team performance measures between the groups. Study findings indicate use of colored labeled smocks during CPR emergencies resulted in: shorter times to start emergency CPR; reduced errors; more technical skills completed successfully; and no differences in team performance.

The Sesquiterpene Lactone Dehydroleucodine Triggers Senescence and Apoptosis in Association with Accumulation of DNA Damage Markers

Sesquiterpene lactones (SLs) are plant-derived compounds that display anti-cancer effects. Some SLs derivatives have a marked killing effect on cancer cells and have therefore reached clinical trials. Little is known regarding the mechanism of action of SLs. We studied the responses of human cancer cells exposed to various concentrations of dehydroleucodine (DhL), a SL of the guaianolide group isolated and purified from Artemisia douglasiana (Besser), a medicinal herb that is commonly used in Argentina. We demonstrate for the first time that treatment of cancer cells with DhL, promotes the accumulation of DNA damage markers such as phosphorylation of ATM and focal organization of γH2AX and 53BP1. This accumulation triggers cell senescence or apoptosis depending on the concentration of the DhL delivered to cells. Transient DhL treatment also induces marked accumulation of senescent cells. Our findings help elucidate the mechanism whereby DhL triggers cell cycle arrest and cell death and provide a basis for further exploration of the effects of DhL in in vivo cancer treatment models.

Use of child safety seats among Mexican parents in a small south Dade community

The purpose of this study was to determine the use and misuse of child safety seats among Mexican parents. Data were collected via personal interview and by use of the SAFE KIDS BUCKLE UP Child Safety Seat Checklist Form. This study used a descriptive comparative design. The convenience sample consisted of 63 Mexican mothers with at least one child under the age of four (index child). The findings showed that Mexican parents tend to misuse or not use child safety seats. Most parents were not aware of the misuse, and receiving prior information on the use of child safety seats had no bearing on its correct use. Factors influencing nonuse include lack of finances, driving short distances, leaving child safety seat at home, and being unaware of the Florida child restraint law. Findings of this study have implications for how nurses need to educate mothers on car safety and help reduce childhood injuries.

Test of a Smock System on CPR Primary Emergency Measures and Medical Errors During Simulated Emergencies

Rates of survival of victims of sudden cardiac arrest (SCA) using cardio pulmonary resuscitation (CPR) have shown little improvement over the past three decades. Since registered nurses (RNs) comprise the largest group of healthcare providers in U.S. hospitals, it is essential that they are competent in performing the four primary measures (compression, ventilation, medication administration, and defibrillation) of CPR in order to improve survival rates of SCA patients. The purpose of this experimental study was to test a color-coded SMOCK system on:1) time to implement emergency patient care measures 2) technical skills performance 3) number of medical errors, and 4) team performance during simulated CPR exercises. The study sample was 260 RNs (M 40 years, SD=11.6) with work experience as an RN (M 7.25 years, SD=9.42).Nurses were allocated to a control or intervention arm consisting of 20 groups of 5-8 RNs per arm for a total of 130 RNs in each arm. Nurses in each study arm were given clinical scenarios requiring emergency CPR. Nurses in the intervention group wore different color labeled aprons (smocks) indicating their role assignment (medications, ventilation, compression, defibrillation, etc) on the code team during CPR. Findings indicated that the intervention using color-labeled smocks for pre-assigned roles had a significant effect on the time nurses started compressions (t=3.03, p=0.005), ventilations (t=2.86, p=0.004) and defibrillations (t=2.00, p=.05) when compared to the controls using the standard of care. In performing technical skills, nurses in the intervention groups performed compressions and ventilations significantly better than those in the control groups. The control groups made significantly (t=-2.61, p=0.013) more total errors (7.55 SD 1.54) than the intervention group (5.60, SD 1.90). There were no significant differences in team performance measures between the groups. Study findings indicate use of colored labeled smocks during CPR emergencies resulted in: shorter times to start emergency CPR; reduced errors; more technical skills completed successfully; and no differences in team performance.