In the case of the death of one-year-old Kelci Lewis, an eight-year-old boy is being charged with murder. No adults were present, and the case hinges on the account of six-year-old who was also in eight-year-old’s care that night. Alabama is one of 30 states with no minimum age for criminal responsibility. 

By Amanda Holpuch | The Guardian | November 15, 2015

The neat green trim on the Birmingham home matched the color of the bountiful trees hanging over its roof. There were stones plastered across the front of the residence so that children inside could imagine that they lived in a castle. A neighbor said that the sloped yard served as terrain for children to slide down on pieces of cardboard – “typical kids”, he said.

In one of the most dangerous big cities in the country, Second Avenue South is a relatively safe place during the day. But at night, a neighbor warned, “the goblins come out”.

He himself was newly out of prison and warned of neighborhood cliques who prowl the Alabama neighborhood when it is dark to defend their territory. But one night last month, the night-time horror was of a different nature and the placid-looking, green-trimmed house was the crime scene. Continue reading »

This comprehensive review article published by The New England Journal of Medicine highlights the scope and management of elder abuse, drawing from research and clinical evidence. Perhaps most strikingly, they estimate that the prevalence of elder abuse (physical, psychological, verbal, and sexual abuse, financial exploitation, and neglect) is around 10%.

By Mark S. Lachs and Karl A. Pillemer | The New England Journal of Medicine | November 12, 2015

Although it has probably existed since antiquity, elder abuse was first described in the medical literature in the 1970s.1 Many initial attempts to define the clinical spectrum of the phenomenon and to formulate effective intervention strategies were limited by their anecdotal nature or were epidemiologically flawed. The past decade, however, has seen improvements in the quality of research on elder abuse that should be of interest to clinicians who care for older adults and their families. Financial exploitation of older adults, which was explored only minimally in the initial studies, has recently been identified as a virtual epidemic and as a problem that may be detected or suspected by an alert physician.

In the field of long-term care, studies have uncovered high rates of interpersonal violence and aggression toward older adults; in particular, abuse of older residents by other residents in long-term care facilities is now recognized as a problem that is more common than physical abuse by staff.2,3 The use of interdisciplinary or interprofessional teams, also referred to as multidisciplinary teams in the context of elder abuse, has emerged as one of the intervention strategies to address the complex and multidimensional needs and problems of victims of elder abuse, and such teams are an important resource for physicians.4,5 These new developments suggest an expanded role for physicians in assessing and treating victims of elder abuse and in referring them for further care.

In this review, we summarize research and clinical evidence on the extent, assessment, and management of elder abuse, derived from our analysis of high-quality studies and recent systematic studies and reviews of the literature on elder abuse.6-10

DEFINITIONS AND ESTIMATES OF PREVALENCE

Debates about how to define elder abuse and which types of behavior to include in the definition greatly inhibited progress during the early period of research on this topic. Initial formulations were overly broad and included types of behavior that are not typically part of definitions of domestic abuse, such as crime by strangers, age discrimination, and failure to care for oneself (referred to as “self-neglect”). Over the past decade, however, consensus has arisen about the inclusion of five major types of elder abuse11-13: physical abuse, or acts carried out with the intention to cause physical pain or injury; psychological or verbal abuse, defined as acts carried out with the aim of causing emotional pain or injury; sexual abuse, defined as nonconsensual sexual contact of any kind; financial exploitation, involving the misappropriation of an older person’s money or property; and neglect, or the failure of a designated caregiver to meet the needs of a dependent older person (Table 1).

When these types of abuse have been considered together, epidemiologic surveys have shown generally similar prevalences of elder abuse over a period of 12 months, as indicated by three high-quality epidemiologic studies of community-dwelling older people (60 years of age or older). In a survey of more than 4000 older people in New York State, the rate of elder abuse was found to be 7.6%16,17; in a national survey by Laumann et al., the rate was 9%,12 and in a national telephone survey by Acierno et al.,18 the rate was 10%. It is likely that these figures are underestimates; the reliance on self-reported information from persons who are able to participate in a survey excludes patients with dementia, and studies have shown that dementia places older persons at greater risk for mistreatment.19 When the available evidence is taken into consideration, an estimated overall prevalence of elder abuse of approximately 10% appears reasonable. Thus, a busy physician caring for older adults will encounter a victim of such abuse on a frequent basis, regardless of whether the physician recognizes the abuse.

Continue reading the full journal article here.

CLBB Faculty Member Nancy Gertner appeared on WBUR to discuss her efforts to fix the system of mass incarceration that forced her to put hundreds of men and women behind bars, during her 17-year judicial career. In conversation with host Meghna Chakrabarti, Judge Gertner notes:

“The irony is, I’m going through all my sentences — hundreds of men, largely men that I sentenced — and I’m mostly dealing with mandatory minimums, because, candidly…I went as low as I could go in all of these cases. And now we’re dealing with people who just got stuck in, really, a nightmare sentencing structure.”

Listen to WBUR’s radio broadcast from November 13, 2015 here.

By Danhong Wang, Randy L Buckner, Michael D Fox, Daphne J Holt, Avram J Holmes, Sophia Stoecklein, Georg Langs, Ruiqi Pan, Tianyi Qian, Kuncheng Li, Justin T Baker, Steven M Stufflebeam, Kai Wang  Xiaomin Wang, Bo Hong, and Hesheng Liu | Nature Neuroscience | November 9, 2015

Abstract:

The capacity to identify the unique functional architecture of an individual’s brain is a crucial step toward personalized medicine and understanding the neural basis of variation in human cognition and behavior. Here we developed a cortical parcellation approach to accurately map functional organization at the individual level using resting-state functional magnetic resonance imaging (fMRI). A population-based functional atlas and a map of inter-individual variability were employed to guide the iterative search for functional networks in individual subjects. Functional networks mapped by this approach were highly reproducible within subjects and effectively captured the variability across subjects, including individual differences in brain lateralization. The algorithm performed well across different subject populations and data types, including task fMRI data. The approach was then validated by invasive cortical stimulation mapping in surgical patients, suggesting potential for use in clinical applications.

Read the full journal article here. 

CLBB Faculty Member Joshua Buckholtz is a featured contributor in the new volume, Neuroimaging Genetics: Principles and Practices, published by Oxford University Press. According to the description, “The work presented in this volume elaborates on the explosive interest from diverse research areas in psychiatry and neurology in the use of imaging genetics as a unique tool to establish and identify mechanisms of risk, establish biological significance, and extend statistical evidence of genetic associations.” Dr. Buckholtz, along with Hayley M. Dorfman, wrote a chapter entitled, “Imaging Genetics of Antisocial Behavior and Psychopathy”, under Part IV of the book.

Check out Neuroimaging Genetics: Principles and Practices today!