When silence threatens safety: lessons from the first Canberra Hospital neurosurgical inquiry

Despite widespread institutional and professional support, the recommendations of the Bristol Royal Infirmary Inquiry may be insufficient to reduce patient risk from impaired senior medical practitioners. Using the First Inquiry into Neurosurgical Services at the Canberra Hospital as a case study, this article argues that the Bristol-type recommendations--which emphasise reformulation of clinical governance structures, including early reporting of "sentinel events" and compulsory clinical audits--will be ineffective without a reformed institutional ethos that encourages open transparency and respect for those committed to such processes. Such reformulation may need to commence in medical education and involve new strategies including the use of portable digital technology to facilitate self-assessment of performance and immediate reporting of adverse incidents.     

To leave or to stay?: Battered women's concern for vulnerable pets

Consistent with previous research, almost half of a sample of 41 pet-owning battered women reported that their partners had threatened or actually harmed their pets, and over a fourth reported that concern for their pets had affected their decisions about leaving or staying with the batterer. Differences between rural and urban women were not significant, although higher proportions of rural than urban women reported that their partners had threatened or harmed their pets and that concern for their pets had affected their decisions. For the sample as a whole, logistic regression analyses showed that women whose pets had been threatened or harmed were significantly more likely to report that concern for their pets had affected their decisions about leaving or staying. The findings suggest that service providers should inquire about battered women's concern for their pets and should include arrangements for animals in safety planning.     

Changing Forms of Accountability in Education? A Case Study of LEAs in Wales

Political mechanisms of accountability were marginalized by Conservative government reforms during the 1980s and 1990s which sought a more market-oriented approach within the public sector in order to enhance ‘consumerism’. In education, parents were given more choice between schools and were provided with more information on school performance. The promotion of market accountability has involved a reduction in the powers of local education authorities (LEAs) which had been central to the operation of political accountability. However, whilst market-based forms of accountability were firmly enhanced in principle by the legislation, to what extent have the forms of accountability operating within LEAs changed in practice? Interviews with Chief Officers and the Chair of the Education Committee are used to identify changing perceptions and practices of accountability in LEAs in Wales. The findings indicate that although local politicians and officials have been forced to operate within the legislative framework of market accountability, they have sought to impede its successful implementation. The policy community in Wales facilitated the LEAs’ capacity to respond in this way. The market-based reforms conflicted with fundamental values held in Wales, which remain those of professional accountability.     

Reporting under International Human Rights Treaties: Perspectives from Timor Leste's Experience of the Reformed Process

This article explores Timor Leste's experience of reportingunder the reformed international human rights treaties reportingsystem during the period 2004–2007. Whilst consciousnesshas grown of the difficulties faced by states by the duplicationof treaty reporting processes and the resource burden representedby reporting, the reforms instituted to date have been comparativelyminor. Timor's experience with the new Common Core Document(CCD)/treaty-specificdocument format affirms that reporting serves useful purposes,particularly in stimulating human rights education initiatives,government/NGO collaboration and awareness of human rights gapsin practice. The reformed process highlights cross-cutting humanrights matters. Yet, significant challenges remain, particularlyfor developing, post-conflict states, before reporting willattain its desired potential of support for improved human rightspromotion and protection at the national level. The CCD itselfraises complex conceptual difficulties needing resolution. Thereremains a paucity of appropriate methodological tools to supportthe reporting process and facilitate the integration of humanrights and development goals. Further work is thus needed toshape a sustainable process for reporting.     

The impact of police charges in incidents of wife abuse

The present study addressed the impact of an urban police force laying criminal charges in cases of wife abuse. Follow-up data from battered women and from police officers were collected to identify the long-term consequences of this police policy that began in 1981, including any negative or unintended side effects. Results indicated that the policy resulted in a dramatic increase in police-laid charges (2500%), and a shift from the Family to the Criminal Division of Provincial Court. Based on interview data, victims did not decrease their requests for police service (a feared side effect) and reported a significantly higher level of satisfaction with police service in this area. A significant reduction in police calls and victim-reported violence was associated with police intervention, especially when charges were laid. Paradoxically, police officers' attitudes about the policy were more negative than the actual positive changes that they helped to produce. Considerations for future research and professional training are outlined.     

Managing Racial Diversity: Matching Internal Strategies with Environmental Needs

Although demographic diversity has been of paramount concern to researchers and practitioners in public management, studies exploring managerial strategies to capitalize on and respond to the needs of diverse client populations are scarce. This article examines strategies for managing diversity as a way to buffer environmental challenges in service delivery and performance resulting from heterogeneous client demands. Findings suggest that administrators prioritize diversity efforts when faced with higher levels of regulatory violations (a performance measure). A higher percentage of black residents is associated with lower service quality. However, the effect of managerial strategies for diversity on performance is conditioned by the racial composition of the clients: as the percentage of black nursing home residents increases, diversity management efforts are associated with a lower number of regulatory violations. Similarly, at higher levels of racial heterogeneity, diversity management efforts are associated with fewer regulatory violations.     

The Disclosure Dilemma: Nuclear Intelligence and International Organizations

Scholars have long argued that international organizations solve information problems through increased transparency. This article introduces a distinct problem that instead requires such institutions to keep information secret. We argue that states often seek to reveal intelligence about other states' violations of international rules and laws but are deterred by concerns about revealing the sources and methods used to collect it. Properly equipped international organizations, however, can mitigate these dilemmas by analyzing and acting on sensitive information while protecting it from wide dissemination. Using new data on intelligence disclosures to the International Atomic Energy Agency and an analysis of the full universe of nuclear proliferation cases, we demonstrate that strengthening the agency's intelligence protection capabilities led to greater intelligence sharing and fewer suspected nuclear facilities. However, our theory suggests that this solution gives informed states a subtle form of influence and is in tension with the normative goal of international transparency.