Jennifer James

Early sexual experience as a factor in prostitution

Using the literature of the early sexual histories of “normal” women and two recent studies on the sexual histories of prostitutes, this article examines the pattern of early sexual experience among prostitutes and how it differs from that common to nonprostitute women. Some significant differences found between the samples of prostitutes and the samples of “normal” women were that the prostitute samples, on the whole, learned less about sex from parents and more from personal experiences, as children experienced more sexual advances by elders, were more victimized by incest, generally initiated sexual activity at a younger age, more often had no further relationship with their first coital partner, and experienced a higher incidence of rape. The analysis of these data on early sexual history concentrates on abusive sexual experiences such as incest and rape. The authors believe that an abusive sexual self-identity relates to the development of an adult female pattern of occupational deviance such as prostitution.

Vitamin B12 deficiency in spinal cord injury: a retrospective study.

Abstract Background/Objective: Vitamin B12 (or cobalamin) deficiency is well known in geriatric patients, but not in those with spinal cord injury (SCI) . This retrospective study describes vitamin B1 2 deficiency in SCI. Methods: This study utilized a retrospective chart review of patients with SCI who had received serum vitamin B1 2 testing over the last 1 0 years. Results: Probable vitamin B1 2 deficiency was noted in 1 6 patients with SCI. Twelve patients had subnormal serum vitamin B12 levels (< 220 pg/ml), whereas 4 patients had low-normal vitamin B12 levels (< 300 pg/ml) with neurologic and/or psychiatric symptoms that improved following vitamin B1 2 replacement. Classic findings of paresthesias and numbness often were not evident; such findings likely were masked by the pre-existing sensory impairment caused by SCI. Of the 1 6 SCI patients, 7 were ambulatory; 4 of the 7 presented with deterioration of gait. In addition, 3 of the 1 6 SCI patients presented with depression and fatigue, 2 had worsening pain , 2 had worsening upper limb weakness, and 2 had memory decline. Of the 1 2 patients with subnormal serum vitamin B12 levels, 6 were asymptomatic. Classic laboratory findings of low serum vitamin B1 2 , macrocytic red blood cell indices, and megaloblastic anemia were not always present. Anem ia was identified in 7 of the 1 6 patients and macrocytic red blood cells were found in 3 of the 1 6 patients. Only 1 of the 1 6 SCI patients had a clear pathophysiologic mechanism to explain the vitamin B12 deficiency (ie, partial gastrectomy); none of the patients were vegetarian. Twelve of the SCI patients appeared to experience clinical benefits from cyanocobalamin replacement (some patients experienced more than 1 benefit), including reversal of anemia (5 patients), improved gait (4 patients), improved mood (3 patients), improved memory (2 patients), reduced pain (2 patients) , strength gain (1 patient), and reduced numbness (1 patient). Conclusion: It is recommended that physicians consider vitamin B1 2 deficiency in their patients with SCI , particularly in those with neurologic and/ or psychiatric symptoms. These symptoms often are reversible iftreatment is initiated early.

Prevalence of vitamin B12 deficiency in spinal cord injury.

OBJECTIVE To assess the prevalence of vitamin B(12) deficiency in persons with spinal cord injury (SCI) or disease (SCD). DESIGN Cross-sectional study with prospective blood collection and retrospective medical record review. SETTING Regional Veterans Affairs SCI service. PARTICIPANTS One hundred six adult men with chronic SCI or SCD and without other acute medical or surgical complications; most had SCI or SCD due to trauma or cervical spinal stenosis. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Fasting blood samples were obtained at annual evaluation for serum B(12), folic acid, methylmalonic acid (MMA), and homocysteine. Serum levels were analyzed graphically and associated with patient variables by using statistical tests. RESULTS The vitamin B(12) level was subnormal in 5.7% of subjects; of those, all had supranormal MMA levels, all were age 40 to 59, most had complete SCI, and 67% had symptoms suggestive of B(12) deficiency. Low-normal B(12) levels were associated with a high prevalence of supranormal MMA. Subjects with either subnormal B(12) or low normal B(12) with supranormal MMA, both suggestive of vitamin B(12) deficiency, comprised 13.3% of the total group of subjects. CONCLUSION Vitamin B(12) deficiency is most common in middle-aged SCI or SCD persons with complete or near-complete spinal cord involvement (ie, American Spinal Injury Association class A-C injuries). Treatment with either parenteral or oral B(12) replacement may optimize health and prevent irreversible neuropsychiatric complications in those with subnormal and low-normal B(12) levels.

A retrospective review of safety using a nursing driven protocol for autonomic dysreflexia in patients with spinal cord injuries

Objective/Background: Autonomic dysreflexia is a potentially life-threatening condition which afflicts a significant proportion of individuals with spinal cord injuries (SCI). To date, the safety and efficacy of several commonly used interventions for this condition have not been studied. Design: A retrospective chart review of the safety of a previously implemented nursing driven inpatient autonomic dysreflexia protocol. Methods: Seventy-eight male patients with SCI who experienced autonomic dysreflexia while inpatient at our Veterans Affairs SCI unit over a 3–1/2-year period were included. The safety of a nursing driven protocol utilizing conservative measures, nitroglycerin paste, and oral hydralazine was evaluated. Outcome Measures: Occurrence of adverse events and relative hypotensive events during all episodes treated with the protocol, and efficacy of attaining target blood pressure for all episodes with protocol adherence and for initial episode experienced by each patient. Results: Four hundred forty-five episodes of autonomic dysreflexia were recorded in the study period, with 92% adherence to the protocol. When the protocol was followed, target blood pressure was achieved for 97.6% of all episodes. Twenty-three total adverse events occurred (5.2% of all episodes). All adverse events were due to hypotension and only 0.9% required interventions beyond clinical monitoring. Of each patients initial autonomic dysreflexia episode, 97.3% resolved using the protocol without need for further escalation of care. Conclusion: This inpatient nursing driven-protocol for treating autonomic dysreflexia utilizing conservative measures, nitroglycerin paste and oral hydralazine achieved target blood pressure with a high success rate and a low incidence of adverse events.

Female sexual deviance: A theoretical and empirical analysis

Societal analysis of sex role typing, attribution theory in social psychology, and reaction theory in the sociology of deviance provide theoretical convergences that enable us to focus on career contingencies in the drift toward deviance. In this paper we apply these concepts to a theory of sexual labeling by identifying six early sexual experiences that are empirically shown to shape deviant sexuality in adult women. The responses to a standardized protocol were obtained for two large samples of deviant adult women. The results are based on extensive analysis that controlled for race and economic status (ES) while an adolescent. The findings reinforce previous conjectures and hypotheses about the influential factors in the drift towards female sexual deviance.

The Prostitute as a Victim

Prostitution is often referred to as a “victimless crime” or a “crime without a complainant.” These terms are used to characterize crimes, such as vagrancy, gambling, pornography, and prostitution, wherein, typically, none of the involved citizens files a complaint with the police. Because the prostitute and her customer are involved in a mutually agreed–upon relationship, neither party feels any need for the services or interference of the authorities—in contrast to the relationship between a burglar and his homeowner victim, where the latter is quite clearly an involuntary participant in the interaction. Those who refer to the prostitute as a victim do so in a nonlegal sense. She is seen as a victim because of her life–style, her “immorality,” or her “degradation.”

Perceptions of Juvenile Experience Females Involved in Prostitution Versus Property Offenses

Groups of female criminals were studied by drawing samples of prostitutes and property offenders and then further stratifying them according to race (white versus black) and juvenile economic status (low versus middle class). The eight groups were then compared on six juvenile variables: bonding/ integration, criminal activities, criminal labelling, sexual labelling, and ages of first departure from home and first criminal activity. While prostitutes were significantly more deviant than property offenders on five of these six variables, fewer differences occurred for race and economic status.