Over the past decade, abolitionist feminist and evangelical Christian activists have directed increasing attention toward the “traffic in women” as a dangerous manifestation of global gender inequalities. Despite renowned disagreements around the politics of sex and gender, these groups have come together to advocate for harsher penalties against traffickers, prostitutes’ customers, and nations deemed to be taking insufficient steps to stem the flow of trafficked women. In this essay, I argue that what has served to unite this coalition of "strange bedfellows" is not simply an underlying commitment to conservative ideals of sexuality, as previous commentators have offered, but an equally significant commitment to carceral paradigms of justice and to militarized humanitarianism as the preeminent mode of engagement by the state. I draw upon my ongoing ethnographic research with feminist and evangelical antitrafficking movement leaders to argue that the alliance that has been so efficacious in framing contemporary antitrafficking politics is the product of two historically unique and intersecting trends: a rightward shift on the part of many mainstream feminists and other secular liberals away from a redistributive model of justice and toward a politics of incarceration, coincident with a leftward sweep on the part of many younger evangelicals toward a globally oriented social justice theology. In the final section of this essay, I consider the resilience of these trends given a newly installed and more progressive Obama administration, positing that they are likely to continue even as the terrain of militarized humanitarian action shifts in accordance with new sets of geopolitical interests.
Objectives: Marijuana was involved in 209,563 emergency department (ED) visits in 2006, according to the Drug Abuse Warning Network. Although screening and brief intervention (SBI) has been effective in changing drinking among ED patients in a number of studies, tests of marijuana SBI in a pediatric emergency department (PED) have not yet been reported. The aim of this pilot study was to test whether SBI is effective in reducing marijuana consumption among youth and young adults presenting to a PED with a diverse range of clinical entities.Methods: A three-group randomized controlled preliminary trial was structured to test 1) differences between Intervention (Int) and standard Assessed Control (AC) groups in marijuana consumption, from baseline to 12 months, and 2) the feasibility of adding a Nonassessed Control (NAC) group to evaluate regression to the mean and assessment reactivity. Patients aged 14-21 years in an urban, academic PED were screened during 2006-2007, using standardized risk factor questions. Subjects were eligible if they used marijuana three or more times in the past 30 days, but were excluded for co-occurring high-risk alcohol use. Consented enrollees were randomized to NAC, AC, and Int groups in a two-stage process that permitted blinding to status during assessment and follow-up. NACs received a resource handout, written advice about marijuana use risks, and a 12-month follow-up appointment. ACs were assessed using standardized instruments and received resources, written advice, and 3-and 12-month follow-up appointments. The Int group received assessment, resources, written advice, 3-and 12-month appointments, a 20-minute structured conversation conducted by older peers, and a 10-day booster telephone call. A peer educator utilized a motivational style interview protocol adapted for adolescents to elicit daily life context and future goals, provide feedback, review pros and cons of marijuana use, assess readiness to change, evaluate strengths and assets, negotiate a contract for change, and make referrals to treatment and ⁄ or other resources. Measurements included demographic information; 30-day self-report of marijuana use; attempts to quit, cut back, or change conditions of use; and risk factor questions repeated at follow-up.Results: Among 7,804 PED patients screened, 325 were eligible; 210 consented and enrolled (Int, n = 68; AC, n = 71; NAC, n = 71), with a 12-month follow-up rate of 71%. For the primary objective, we compared Int to AC. At 12 months, Int participants were more likely to be abstinent for the past 30 days than ACs (odds ratio [OR] for reported abstinence = 2.89, 95% confidence interval [CI] = 1.22 to 6.84, p < 0.014). The Int group had greater reduction in days used, baseline to 12 months, controlling for baseline (Int = -7.1 vs. AC = -1.8), were less likely to have been high among those who smoked (OR = 0.39, 95% CI = 0.17 to 0.89, p < 0.05), and were more likely to receive referrals. In a linear regression model controlling for baseline use, NACs smoked 4 f...
Drawing from fieldwork and interviews with middle-class sex workers, this essay considers the relationship between the class-privileged women and men who are increasingly finding their way into sex work and more generalized patterns of economic restructuring. How has the emergence of new communications technologies transformed the meaning and experience of sexual commerce for sex workers and their customers? What is the connection between the new 'respectability' of sexual commerce and the new classes of individuals who now participate in commercial sexual transactions? This essay concludes by exploring some of the key transformations that are occurring within middle-class commercial sexual encounters, including the emergence of 'bounded authenticity' (an authentic, yet bounded, interpersonal connection) as a particularly desirable and sought-after sexual commodity.
elizabeth bernstein is Assistant Professor of Women's Studies and Sociology at Barnard College, Columbia University. She is the author of Temporarily Yours: Intimacy, Authenticity, and the Commerce of Sex (University of Chicago Press, 2007) and coeditor of Regulating Sex: The Politics of Intimacy and Identity (Routledge, 2005).
No abstract
IMPORTANCE Complete (R0) resection is the dominant prognostic factor for survival across solid tumor types. Achieving adequate tumor clearance with appropriate margins is particularly difficult in nonpalpable tumors or in situ disease. Previous methods to address this problem have proven time consumptive, impractical, or ineffective. OBJECTIVE To assess the capability of intraoperative molecular imaging (IMI), a novel technology using a fluorescent tracer targeted to malignant cells, to localize visually occult, nonpalpable tumors and quantify margin distances during resection. DESIGN, SETTING, AND PARTICIPANTSThis nonrandomized open-label trial of IMI using a folate receptor-targeted fluorescent tracer enrolled patients between May 2017 and June 2020 at a single referral center. Eligible patients included those with a small (T1) lung lesion suspicious for malignant neoplasms and with radiographic features suggestive of a nonpalpable lesion.INTERVENTIONS Patients were preoperatively infused with a folate receptor-targeted near-infrared tracer. Intraoperatively, surgeons used thoracoscopic visualization and palpation to identify lesions. IMI was performed to detect the lesion in situ, and lesions were imaged ex vivo. Margins were assessed by IMI before comparison with those reported on final histopathologic analysis. MAIN OUTCOMES AND MEASURESThe main outcomes were whether IMI could (1) localize nonpalpable lung lesions in situ and (2) quantify margin distance with comparison with final pathology as the criterion standard. Patient demographic information and lesion characteristics were prospectively recorded. RESULTSOf 40 patients, 26 (65%) were female, and the median (interquartile range) age was 66.5 (62-72) years. Conventional surgical methods localized 22 of 40 lesions (55%), while IMI localized 36 of 40 (90%). Of 18 nonpalpable lesions, 15 (83.3%) were identified by IMI. Both palpable and nonpalpable lesions demonstrated mean signal-to-background ratio more than 2. An IMI margin was able to be calculated for 39 of 40 patients (95%). IMI margins were nearly identical to margins reported on final pathology (R 2 = 0.9593), with median (interquartile range) difference of 1.3 (0.7-2.0) mm. IMI detected 2 margins in nonpalpable tumors that were clinically unacceptable and would have had a high probability of recurrence. CONCLUSIONS AND RELEVANCETo our knowledge, this study presents the first clinical use of IMI for nonpalpable tumors and provides proof of principle for the utility of IMI across the field of surgical oncology in identifying occult disease and tumor-positive margins.
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