INSTITUTIONAL LAYERING IN GOVERNING HEALTHCARE QUALITY

Since the 1980s, regulated markets and New Public Management have been introduced in the public sector across the world. How they have affected existing governance mechanisms such as self‐regulation and state regulation has remained largely unexplored, however. This article examines the origins and consequences of institutional layering in governing healthcare quality. Dutch health care, where a market‐based system has been introduced, is used as a case study. The results show that this market‐based system did not replace but modified existing institutional arrangements. As a result, hospitals have to deal with the fragmentation of quality demands. Using the concept of institutional layering, this study shows how different arrangements interact. As a consequence, the introduction of a certain policy reform will work out differently in different countries and policy sectors. Our ‘archaeological’ study in this layering can be seen as an example of how such incremental change can be studied in detail.     

Use of the MMPI-2 Restructured Clinical (RC) Scales in Detecting Criminal Malingering

The purpose of the present study was to assess the effects of criminal malingering on the MMPI-2 Restructured Clinical (RC) scales. Sixty undergraduate students were given the MMPI-2 twice. One administration was conducted according to the MMPI-2 manual, and the other was given with a special set of malingering instructions specific to a prison setting. The two MMPI-2 profiles for each participant were scored for both the Basic and RC scales. Eight participants were eliminated from the data analysis due to validity (VRIN or TRIN) concerns. Data from the remaining 52 participants were analyzed using a 2 × 2 repeated measures ANOVA. Results showed that, as expected, the participants achieved higher MMPI-2 scores in the malingering condition. Also, participants achieved higher scores overall on the Basic scales and a significant interaction showed that participants achieved higher scores on the Basic Scales in the malingering condition than on the RC scales in that condition. These results supported prior research, indicating that malingerers produce elevated RC profiles. However, the present results also suggest that the Basic scales may be more effective in actually detecting malingerers, mainly due to the much lower ceiling on the RC scaled scores. Further implications of these findings for research and clinical work are also discussed.     

Use of pepper spray in policing: retrospective study of situational characteristics and implications for violent situations

Pepper spray (OC) is a policing tool aimed to prevent or stop aggressive behavior by quickly and temporarily incapacitate without injuring. To date, few studies have investigated OC’s operational usefulness and limitations. OC reduced violent behavior in 93% of the 936 incidents investigated. However, the operative range was often <2 m and it took between 3 and 5 s of spraying before obtaining effect, partly owing to the difficulties of hitting a small, sometimes erratically moving target. Collateral hits were noted in 24% of the incidents, whereof 90% were other officers. Noteworthy, in 21% of incidents officers put themselves at large personal risk by using OC at close range against people armed with lethal weapons. Hence, OC emerges as a suitable tool for handling low threat situations but lacks key traits to ensure safe and efficient policing of high threat situations, e.g., handling armed assailants.     

Scanning Electron Microscopy–Energy‐Dispersive X‐Ray (SEM/EDX): A Rapid Diagnostic Tool to Aid the Identification of Burnt Bone and Contested Cremains

This study investigates the use of Scanning electron microscopy–energy‐dispersive X‐ray (SEM‐EDX) as a diagnostic tool for the determination of the osseous origin of samples subjected to different temperatures. Sheep (Ovis aries) ribs of two experimental groups (fleshed and defleshed) were burned at temperatures of between 100°C and 1100°C in 100°C increments and subsequently analyzed with the SEM‐EDX to determine the atomic percentage of present elements. Three‐factor ANOVA analysis showed that neither the exposure temperature, nor whether the burning occurred with or without soft tissue present had any significant influence on the bone's overall elemental makeup (p > 0.05). The Ca/P ratio remained in the osseous typical range of between 1.6 and 2.58 in all analyzed samples. This demonstrates that even faced with high temperatures, the overall gross elemental content and atomic percentage of elements in bone remain stable, creating a unique “fingerprint” for osseous material, even after exposure to extreme conditions.     

A new method for the recovery and evidential comparison of footwear impressions using 3D structured light scanning

Footwear impressions are one of the most common forms of evidence to be found at a crime scene, and can potentially offer the investigator a wealth of intelligence. Our aim is to highlight a new and improved technique for the recovery of footwear impressions, using three-dimensional structured light scanning. Results from this preliminary study demonstrate that this new approach is non-destructive, safe to use and is fast, reliable and accurate. Further, since this is a digital method, there is also the option of digital comparison between items of footwear and footwear impressions, and an increased ability to share recovered footwear impressions between forensic staff thus speeding up the investigation.     

论我国未成年人监护制度的完善

未成年人监护制度是监护制度的重要组成部分,它不仅关系到保护未成年人的合法权益,而且还关系到社会秩序的稳定。目前,我国监护制度中还存在着监护机构设置不合理、监护人的选任缺乏一定的标准、监护人的职责及权利不明、监护的种类不全等问题。为了更好地保护未成年人的利益,针对上述不足,提出自己的建议。