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This paper considers the clinical issue of self-harming behaviours, defined as intentional self-injury that results in tissue damage. It is distinct from a suicide attempt, as self-harm does not occur within the context of a conscious wish to die. Self-harming behaviours among children and youth is a recent area of research. To date, studies indicate that in community samples, self-harming behaviours occur in as many as 35% of youth who are sampled (Gratz, 2001). Alarmingly, very little is known about self-harming behaviours among children and youth within the child protection system. This study, drawing from data gathered through a government-mandated reporting procedure of all children and youth in care,attempted to explore self-harming behaviours of children and youth in welfare care. While analyses did not focus explicitly on Aboriginal children and youth, it does consider differences in self-harming behaviours among minority and non-minority children and youth in care of the Children's Aid Society of Toronto. Approximately half of all child welfare cases that go through the child protection system in Toronto fall under the responsibility of the Children's Aid Society of Toronto. Although minority status was not significantly related to the number of self-harming attempts or threats, results suggested that minority children and youth in care were less likely to use puncture-type behaviour (cutting, scratching, stabbing) as a means of serious self harm. Results suggest that although self- harm may be a universal phenomenon, culture may affect how children and youth in care engage in self-harming behaviours. Direction of future research should consider between-cultural effects and more importantly, how these culture-specific differences may impact on children and youth's self-harming behaviours.

The Americans With Disabilities Act poses unique challenges for public and private sector organizations. The Act requires reasonable accommodation for a variety of physical and emotional disabilities, but it does not specify what constitutes "reasonable." If organizations rely on ad hoc decisions regarding protected individuals, they risk unsystematic decisions and exposure to liability under the law. This paper describes a way to systematize decisions about A.D.A. An accommodation cost assessment system, based on a job analysis, can help guarantee that employment and promotion decisions are fair and defensible under the Act.

<b><i>Objectives:</i></b> Genomic information will increasingly be used to aid in the prevention, diagnosis, and treatment of disease. Several national initiatives are paving the way for this new reality, while also promoting new models of participant-engaged research. We compare the opinions of research participants in a cancer registry, human genetic researchers, and institutional review board (IRB) professionals about the return of individual-level genetic results (ROR). <b><i>Methods:</i></b> Online surveys were administered to participants in a cancer registry (<i>n</i> = 450) and overlapping questions were compared to our previous online national surveys of human genetic researchers (<i>n</i> = 351) and IRB professionals (<i>n</i> = 208). <b><i>Results:</i></b> The majority of respondents agreed that researchers have an obligation to return individual results when they would affect a participant's health. While 77% of registry participants favored ROR if the researcher feels the participant might be interested in the results, only 30% of the IRB professionals and 25% of the genetic researchers agreed with this statement. <b><i>Conclusions:</i></b> Significant differences emerged between the stakeholder groups in several ROR scenarios. Policies that are acceptable to participants, researchers and IRBs, and that ensure human subject protections and facilitate research are needed.

<b><i>Background:</i></b> With the arrival of large-scale population-based genomic research studies, such as the Precision Medicine Initiative (PMI), the question of how to best consent participants is significant, and in an era of patient-centered research, few studies have evaluated participants' preferences about re-consent and broad consent. Using quantitative methods, this study evaluates participants' views regarding the acceptability of re-consent and broad consent in subjects from the Participant Issues Project. <b><i>Methods:</i></b> A total of 450 participants were recruited from a cancer genetics registry, including cancer patients, their relatives, and controls. Participants completed a secure online survey. <b><i>Results:</i></b> Most participants endorsed re-consent when investigating an unrelated health condition or sharing their de-identified data with an investigator at a different institution. Notification rather than re-consent was preferred when studying a different gene but the same disease. Over 80% of respondents endorsed re-consent when parents of a child gave the original consent and the child has now reached adulthood. Preferences for some scenarios varied by history of cancer at baseline, gender, stage of cancer, or case versus control group. The large majority of participants preferred the option to select broad consent categories of research. <b><i>Conclusion:</i></b> Understanding research participants' preferences, including their views on the need for re-consent, are critical to the success of the PMI.