Interventions with arsonists and young fire setters: A survey of the national picture in England and Wales

Objectives . Arson is a serious problem that has high costs in both financial and non‐financial terms. It is important that effective provision to intervene with arsonists and young fire setters is available. Method . A national survey was conducted of organizations delivering interventions to arsonists and young fire setters. This survey included fire and rescue services, probation areas, youth offending services, forensic mental health units, several government departments, and the National Association for the Care and Resettlement of Offenders. The survey was followed by site visits to eight organizations to conduct interviews with relevant staff. Results . The majority of interventions for children and adolescents were provided by fire and rescue services, often in conjunction with local youth offending services. Some forensic mental health units provided interventions, but no specialist provision for arsonists appeared to be available in either the prison or probation services. The site visits and interviews revealed areas of good practice across the organizations visited, and highlighted areas where developments might be made to improve services. Conclusions . The findings are discussed in light of the available literature, and recommendations made for future practice.     

论欧盟金融服务法中的母国控制原则

在欧盟金融服务法中,母国控制原则是指跨境金融服务应主要遵循母国的监管规则,相应的监管责任也主要由母国监管当局承担。母国控制原则不能适用于未经金融服务指令协调的领域。相互承认原则是母国控制原则的前提和基础,母国控制原则又是实施相互承认原则的必然要求和具体体现。这一原则的形成与欧盟金融服务市场一体化方法的转变有着密切联系,其发展也是这种新的一体化模式广泛推行的必然结果。立法和司法实践表明,母国控制原则的适用范围尚不明确,其价值没有得到充分的体现。为了消除跨境金融服务的法律壁垒,推动金融服务市场的一体化进程,欧盟金融服务立法应向协调行为规则、进一步明确划分监管责任并扩大母国控制范围的方向发展。     

Ethical, professional and legal regulation of medical practice

Moral or ethical codes of practice represent one of the oldest forms of medical regulation. Legislation such as the Medical Practice Act 1992 (NSW) enables regulatory bodies to create codes of practice for medical practitioners. Such codes can become an important aspect of disciplinary proceedings by providing the yardstick against which practitioners' conduct is evaluated. An important aspect of the New South Wales Board's Code of Professional Conduct 2005 is the obligation for doctors to report adverse events which reflect on the performance or conduct of colleagues. This is part of an increasing impetus to report adverse events in the interest of public safety. In the long- term this is a constructive development as it is likely to lead to improvements in identification of risks and hazards and thereby to result in better service provision and community health.     

Health Information Exchange in Memphis: Impact on the Physician-Patient Relationship

Health information exchanges represent one way of making medical information available to practitioners across institutional boundaries. One health information exchange in Memphis Tennessee has been operational since May of 2006 and provides information supporting care for over 1.2 million individuals. Creating such an exchange challenged traditional institutional boundaries, roles, and perceptions. Approaching these challenges required leadership, trust, sound policy, new forms of dialogue, and an incremental approach to technology. Early evidence suggests a positive impact on patient care and a change in the way providers interact with their patients and on another. Personal health records, consolidated EHR systems, and other alternative models promise to have similar impacts on the way in which providers and patients interact with one another.     

Intellectual disability and mental illness in the NSW criminal justice system

There has been increasing international, national and local recognition of the need for more appropriate responses and services for individuals who come in contact with the criminal justice system and who have an intellectual disability and mental health issues. This article provides an overview of prevalence data that indicates a significant over representation of people with intellectual disabilities in correctional facilities and reviews the problems facing this population. Findings from two specific evaluation studies undertaken by the Centre for Developmental Disability Studies are presented, along with recommendations for future provision based on these results. One of these projects trialled a case management approach to supporting offenders with an intellectual disability upon their release from prison. The 20-month follow-up found that a number of serious barriers were encountered within the overall system of provision for this population; the most serious of which related to lack of adequate accommodation upon release. The second project involved a two-stage evaluation of one model of provision for individuals with intellectual disabilities who are sex offenders, only some of whom were on parole. This service provided both residential and therapy services in a small group home located in the community. Residents were found to have high levels of emotional and behavioural difficulties, in addition to offending behaviour, that continue to require support and supervision. Critical issues, including guardianship involvement, restrictive practices and retrieval, therapy provision, and risk management issues are discussed in relation to overall clinical and lifestyle outcomes.     

Identifying and Responding to the Complex Needs of Domestic Violence Housing Practitioners at the Onset of the COVID-19 Pandemic

The social, financial, and emotional repercussions of the COVID-19 pandemic has left many organizations that support survivors of intimate partner violence questioning how to maintain core services while addressing compounding individual, organizational, and public health issues. Stay-at-home orders and other COVID-19 mitigation strategies have resulted in reduced shelter availability and increased intimate partner violence rates. Coupled with the economic impact of the pandemic, these factors have threatened financial and housing stability. To better understand these challenges and provide immediate support, The National Alliance for Safe Housing (NASH) co-hosted a peer support call to provide a virtual platform for practitioners to ask questions, discuss challenges, and share strategies for quality service provision during the COVID-19 pandemic. Over 800 practitioners from across the United States participated in the NASH call, most of whom were advocates, program directors, and managers. NASH gathered data on practitioners’ needs from a brief survey from the registration form analyzed using conventional inductive content analysis. Practitioners’ primary concerns were situated within eight questions, which we categorized into four meta-categories: (1) managing residential housing programs; (2) getting survivors materials resources; (3) keeping staff safe; and (4) maintaining organizational operations. The paper concludes with community-grounded and empirically supported practice recommendations aligned with practitioners’ expressed needs.

     

TRICARE; off-label uses of devices; partial list of examples of unproven drugs, devices, medical treatments or procedures. Final rule

The Department of Defense is publishing this final rule to revise the definition of ``unlabeled or off-label drug' to ``off-label use of a drug or device.' This provision codifies the coverage of those medically necessary indications for which there are demonstrations from medical literature, national organizations, or technology assessment bodies that the off-label use is safe and effective and in accordance with nationally accepted standards of practice in the medical community. Additionally, this rule removes the partial list of examples of unproven drugs, devices, and medical treatments or procedures proscribed in TRICARE regulations. We are removing the partial list from the regulation but will maintain the partial list in the TRICARE Policy Manual at www.tricare.mil.     

论欧盟金融服务法中的最低限度协调原则

在欧盟金融服务法中,最低限度协调原则是指共同体立法只对各成员国金融监管规则的基本要素进行协调.这一原则尊重了成员国的国家主权,有助于降低金融服务市场一体化的政策成本,并能够充分发挥市场机制的作用以促成最优的监管标准.<欧共体条约>中的特别协调条款是这一原则的直接依据,金融服务指令中的协调条款是其集中体现.最低限度协调原则只适用于符合共同利益的非歧视性限制措施.在其适用范围内,各成员国只能进行执行性立法.该原则的确立和推行是以相互承认为核心、以母国控制为表现形式的一体化模式成功运用的必然结果.晚近的立法实践表明,这一原则有被边缘化的危险.     

“Experts by Experience”: The Involvement of Service Users and Families in Designing and Implementing Innovations in Family Justice

Drawing on international research, policy, and practice, this article explores what is meant by service user involvement, how it has developed, and how it has been implemented across different areas of practice. Using examples from across the health and social care fields, it reflects on how the learning from other areas of practice in which service user involvement has been successful may be applied to the family justice field. The arguments presented highlight the value of taking a bottom‐up approach in designing and implementing innovations in family justice, which would embrace the views of family members, including children, as ‘service users.’ It is important, however, to balance both the challenges and the opportunities offered by involving those who are ‘experts by experience’ in the family justice processes, in order to lead to improved services and experiences.     

Working with personality disordered women in secure care: the challenge of gender-based service delivery

Abstract

Working with women in secure services is an infrequent subject of research and discussion in the forensic mental health literature. There are several reasons for this, which will be considered in the introduction to this paper. However, a consequence of this situation is that there remains a lack of clarity in key areas of practice in relation to working with women in secure services, and working with women with personality disorder specifically: how women with personality disorder may present in secure services compared to men, therefore, the particular skills required of the practitioners who work with women and the main design features of the services within which they are managed. The body of this paper attempts to summarise important issues in each of these areas in order to inform future debate and developments in the field.     

The European Arrest Warrant and the Sovereign State: A Marriage of Convenience?

The article aims to analyse the extent to which mutual recognition and mutual trust in the criminal law area are developing in the EU in the context of the implementation of the European Arrest Warrant (EAW). First, an overview of the decisions of the Constitutional Courts in Germany, Poland, Cyprus and Czech Republic will be given. These decisions are evidence of a tension, on the one hand, between mutual recognition and state sovereignty and, on the other hand, between the powers of the European institutions in criminal matters and the fundamental rights of the individual. Second, national case‐law in the UK, Belgium, Spain and Italy will be examined. Third, an analysis of the recent decision of the European Court of Justice of 3 May 2007 will be carried out. Finally, a global assessment of the EAW will be made. Is this instrument effectively promoting normative mutual trust among the judicial authorities in the EU? Should it be amended or is it the wrong response at the wrong time? Some suggestions will be put forward, in light of what is considered to be the nature of the EAW and the birth of this instrument as part of the mutual recognition agenda.     

Domestic violence and sexual assault service goal priorities

We investigated agency directors' perspectives about how service goals should be prioritized for domestic violence and sexual assault service subtypes, including crisis, legal advocacy, medical advocacy, counseling, support group, and shelter services. A sample of 97 (94% response rate) North Carolina domestic violence and/or sexual assault agency directors completed a survey asking participants to rank the importance of service goals. Overall, participants considered emotional support provision to be a critical service goal priority across all service types. Social support and self-care service strategies were deemed less important. However, prioritization of other service goals varied depending on the service type. Statistically significant differences on service goal prioritization based on key agency characteristics were also examined, and agency characteristics were found to relate to differences in service goal prioritization.     

中外学位学历互认协议的法律性质、效能及发展趋势

在经济全球化和高等教育国际化的背景下,高等教育学历学位相互承认问题的重要性与日俱增。中外学位学历互认协议是中国与有关国家之间实现高等教育国际合作的重要途径,从本质上讲中外学历学位互认协议应该属于国际条约法的范畴,具有促进相关主体权益的保障、提供学位学历的法律保证、提高院校质量的可靠性、促进留学市场的规范性、增加中国教育的认可度、促进国际教育服务的自由化的法律效能。未来中外学位学历互认协议的发展趋势将集中在协议内容更加细化、互认方法更加多元、互认协议更关注实施效果、互认协议与国内法的衔接更加完善等方面。     

Medicare and Medicaid programs; hospital conditions of participation: requirements for history and physical examinations; authentication of verbal orders; securing medications; and postanesthesia evaluations. Final rule

In this rule, we finalize changes to four of the current requirements (or conditions of participation (CoPs)) that hospitals must meet to participate in the Medicare and Medicaid programs. Specifically, this final rule revises and updates our CoP requirements for: Completion of the history and physical examination in the medical staff and the medical record services CoPs; authentication of verbal orders in the nursing service and the medical record services CoPs; securing medications in the pharmaceutical services CoP; and completion of the postanesthesia evaluation in the anesthesia services CoP. We also respond to timely public comments submitted on the proposed rule published in the March 25, 2005 Federal Register (70 FR 15266). The changes specified in this final rule are consistent with current medical practice and will reduce the regulatory burden on hospitals.     

Economic issues in access to medications: schizophrenia treatment in England

Mental health problems and the services to address them are currently receiving more attention in the UK than ever. Mental health care in England--indeed, across the UK--is experiencing a much needed transformation. It is therefore highly pertinent to examine the patterns of psychotropic medication use, given their intended links to recovery, rehabilitation, and reintegration, as well as to explore the economic and other factors that appear to influence those patterns. These are the aims of this paper. Our attention will be primarily focused on England. What this analysis shows is that given a higher profile by government, including additional funding (although not really benefiting differentially compared to other parts of the health service) and the first national service framework, it is possible to see changes in service patterns, access and (to a degree) outcomes. These changes are occurring at a time when new classes of psychotropic medication are being introduced in a range of therapeutic areas, contributing to the relatively rapid growth of take-up but also raising questions about appropriateness, effectiveness, cost-effectiveness and equity.     

Health and Efficiency: Community Law and National Health Systems in the Light of Müller-Fauré

In Müller-Fauré the Court of Justice has made clear that restricting patients to receiving medical services from their domestic health systems is often contrary to EC Treaty rules on the free movement of services, particularly where the treatment is not in-patient. The patient should generally be able to go abroad for treatment at the expense of their national health authority. This has structural and financial repercussions for health care systems in several Member States, including the United Kingdom, whose systems are premised upon captive patients. It also has broader implications for welfare harmonisation and provision in the European Union. Exceptions are possible, where the implications for the national health system would be very serious, but Müller-Fauré indicates that the Court will not allow national courts or authorities to rely on these too freely.     

Rural Versus Urban Victims of Violence: The Interplay of Race and Region

This paper examines individuals who were victims of domestic violence in Illinois between 1990 and 1995, comparing the traits and service needs of those who received assistance in an urban county over the 5-year period with those who were served by domestic violence programs in rural areas. Analysis focuses on the demographic characteristics of clients in each region, their relationship to the abuser, type of abuse, referral source, and need for both concrete and supportive services. In addition to looking at variations by region, analysis examines differences between African American and White clients within and across geographic areas so that the interaction of race and location is highlighted. Results indicate that apart from demographic differences related to race, there is little difference in the circumstances of abuse when victims in the urban region are compared to rural victims of violence. However, those in rural environments regardless of race, have more service needs. Differences in service needs also exist in relation to race, and for some services, both race and location are important. The implications of these findings for policy, practice, and future research are examined.     

III. Assessment,Referral and Treatment

Each court must have access to a complete range of services for effective screening, identification, assessment, evaluation, treatment, and rehabilitation. Such services may be developed within the court operation or in cooperation with related agencies or through contracted service providers. Many jurisdictions will use a combination of these basic approaches for provision of services. However they are organized, the key is that they must be in place and consistently used.     

Medicare program; durable medical equipment regional carrier service areas and related matters. Final rule

This final rule provides a mechanism for us to expeditiously make changes to the durable medical equipment regional carrier (DMERC) service area boundaries without notice and comment rulemaking. Through this mechanism, we can change the geographical boundaries served by the regional contractors that process durable medical equipment claims through issuance of a Federal Register notice and make other minor changes in the contract administration of the DMERCs. The mechanism provides a method for increasing or decreasing the number of DMERCs, changing the boundaries of DMERCs based on criteria other than the boundaries of the Common Working File sectors, and awarding new contractors to perform statistical analysis or maintain the national supplier clearinghouse. We will publish these changes and their justifications in a Federal Register notice, rather than through notice and comment rulemaking. Although we may change the number and configuration of regional carriers, we are not altering the criteria and factors that we use in awarding contracts. Through this final rule, we are improving the contracting process so that we can swiftly meet the challenges of the changing healthcare industry and address the changing needs of beneficiaries, suppliers, and the Medicare program.