No abstract

Several emergency department (ED)-based HIV screening programs have been described. However, the majority of these programs have been aimed at adults and older adolescents, and few have taken place in a dedicated pediatric ED. Given that many adolescents seek care in hospital EDs, and that the ED may be an adolescent's only contact with the health care system, we decided to implement an HIV-counseling and testing program in the ED of an urban children's hospital. The program included a dedicated health educator who provided sexual health counseling in a 30-minute session as well as optional HIV testing and test results to patients aged 14-24 years, and arranged necessary follow-up care for adolescents who tested positive for HIV. We collected aggregate data on the number of youth counseled, tested, and followed up. A total of 1287 patients were approached for potential counseling and testing during the first 3 years of the project. Of these, 643 (50.0%) agreed to meet with the health educator and were counseled. Three hundred eighteen (49.5%) of these patients agreed to HIV testing. One hundred eighty-seven (58.8%) patients returned for follow-up. Two patients (0.6%) whose previous HIV status was unknown tested positive for HIV; both of these patients were successfully linked to care. Fifty-six health care providers (17.3% of ED providers) were surveyed about their opinions of the program; although 93% were supportive of the program, several respondents were concerned about the appropriateness of HIV testing in the ED setting. This project suggests that, if appropriate resources are available, a dedicated HIV counseling and testing program can be successfully implemented in a busy, urban, pediatric ED. Providing access to these services to high-risk adolescents has the potential to significantly impact their health.

No abstract

This article offers insights into the organization of Scioto Hopewell craft production and examines the implications of this organization through the lens of ritual economy. We present a novel analysis of investigations at the North 40 site, concluding that it is a craft production site located on the outskirts of the renowned Mound City Group. High-resolution landscape-scale magnetic survey revealed a cluster of three large structures and two rows of associated pits; one of the buildings and three of the pits were sampled in excavations. Evidence from the North 40 site marks this as the best-documented Scioto Hopewell craft production site. Mica, chert, and copper were crafted here in contexts organized outside the realm of domestic household production and consumption. Other material remains from the site suggest that crafting was specialized and embedded in ceremonial contexts. This analysis of the complex organization of Scioto Hopewell craft production provides grounds for further understanding the elaborate ceremonialism practiced by Middle Woodland (AD 1–400) societies and adds to the known complexity of craft production in small-scale societies. Furthermore, this article contributes to a growing body of literature demonstrating the utility of ritual economy as a framework for approaching the sociality of small-scale societies.