To understand racial disproportionality in juvenile delinquency, we studied relationships between 2 possible contributors: effects of manifestations of a structural factor (racism) and psychological consequences of trauma. Informed by Carter's (2007) theory of race-based trauma, we explored the role of experiences of racial discrimination, childhood trauma, and trauma symptoms in juvenile delinquency through self-reported experiences of incarcerated African American youth. We found that childhood trauma, trauma symptoms, and racial discrimination experiences all significantly contributed to juvenile delinquency, but participants who experienced greater racial discrimination had higher posttraumatic stress symptoms and elevated delinquency rates. Considering the welldocumented effects of trauma symptoms on juvenile delinquency, race-based trauma experiences might help us understand one aspect of racial disproportionality in juvenile delinquency.

This study, guided by principles of community-based participatory research (CBPR), presents the processes, challenges, and effects of intergenerational community organizing practice of a local grassroots organization to promote community health in multiracial and historically marginalized communities. Three major lessons emerged: (1) the central role of experiential communal learning and critical analysis in collective knowledge creation, (2) development of collective efficacy through a genuine sense of connection and mutual affirmation, and 3) the importance of a co-learner stance in fostering intergenerational leadership. The interconnection between process and product is emphasized as the central tenet in both community organizing and CBPR processes.

ObjectivesTo design a cloud computing-based Healthcare Software-as-a-Service (SaaS) Platform (HSP) for delivering healthcare information services with low cost, high clinical value, and high usability.MethodsWe analyzed the architecture requirements of an HSP, including the interface, business services, cloud SaaS, quality attributes, privacy and security, and multi-lingual capacity. For cloud-based SaaS services, we focused on Clinical Decision Service (CDS) content services, basic functional services, and mobile services. Microsoft's Azure cloud computing for Infrastructure-as-a-Service (IaaS) and Platform-as-a-Service (PaaS) was used.ResultsThe functional and software views of an HSP were designed in a layered architecture. External systems can be interfaced with the HSP using SOAP and REST/JSON. The multi-tenancy model of the HSP was designed as a shared database, with a separate schema for each tenant through a single application, although healthcare data can be physically located on a cloud or in a hospital, depending on regulations. The CDS services were categorized into rule-based services for medications, alert registration services, and knowledge services.ConclusionsWe expect that cloud-based HSPs will allow small and mid-sized hospitals, in addition to large-sized hospitals, to adopt information infrastructures and health information technology with low system operation and maintenance costs.

No abstract

No abstract