Dimensions of publicness and performance in substance abuse treatment organizations.

Changes in funding, clientele, and treatment practices of public and privately owned substance abuse treatment programs, compelled in part by increased cost containment pressures, have prompted researchers' investigations of the implications of organizational form for treatment programs. These studies primarily probe associations between ownership status, patient characteristics, and services delivered and do not empirically link organizational form or structure to treatment outcomes. Data from the National Treatment Improvement Evaluation Study (NTIES) were used to study the relationship of ownership and other dimensions of publicness identified in the public management literature to patient outcomes, controlling for patient characteristics, treatment experiences, and other program characteristics. A few effects of organizational form and structure on substance abuse treatment outcomes are statistically significant (primarily improved social functioning), although the specific contributions of measures of ownership and publicness to explaining program-level variation are generally small.     

Under the Kremlin's Thumb: Does Increased State Control in the Russian Gas Sector Endanger European Energy Security?

This article examines the effect of increased state control over the Russian gas sector and its ultimate impact on energy security in Europe. The various mechanisms by which the state has acquired ownership (or quasi-ownership) over several independent gas producers as well as the potential dangers this poses for European energy supplies are scrutinised. Due to the demonstrated inefficiency of Russian state-controlled companies, negative consequences, such as slowed production growth, are likely to result. The few remaining independent gas producers are still hampered in their development due to the government's reluctance to implement structural reforms in the Russian gas sector.     

Identität als Netzwerk

Wenn man von „Identit?t” spricht, dürfte sich im Allgemeinen das geistige Bild einer Kugel, etwas in sich Geschlossenes, einstellen. Die entsprechende „klassische” Identit?tsvorstellung ist seit dem cultural turn in eine Krise geraten, ohne dass jedoch eine befriedigende neue Vorstellung an ihre Stelle getreten w?re. Ausgehend von einer relationalen Wirklichkeitsauffassung (Cassirer, Rorty, Bourdieu) unterbreitet der vorliegende Artikel den Vorschlag, sich Identit?ten als Netzwerke von Dispositionen vorzustellen. Die Problematik wird in der Diskussion um kollektive Identit?ten sozialer Bewegungen verortet. Die Entwicklung der theoretischen Modellvorstellung nimmt ihren Ausgang bei der empirischen Untersuchung von religi?sen Bewegungen in einer Bürgerkriegssituation (Guatemala). Eine Analyse der Tiefenstruktur praktischer Operatoren der Wahrnehmung, des Urteilens und des Handelns der Akteure erlaubt die Rekonstruktion dieser Operatoren im Modell eines Netzwerks fundamentaler logischer Relationen, die den allt?glichen Wahrnehmungs-, Urteils- und Handlungsweisen zugrund liegen. Auf dieser Basis werden dann theoretische Perspektiven eines Netzwerk-Modells von Identit?t diskutiert. Dabei werden verbreitete Probleme der Identit?tstheorie im Rahmen der Bewegungstheorie aufgegriffen, wie z.B. individuelle vs. kollektive Identit?t, das Verh?ltnis von Kognition, Affekt und Leib oder die Relation von Identit?ten und gesellschaftlichen Strukturen. Diese Fragestellungen werden mit Hilfe des Netzwerk-Modells neu interpretiert.     

Formal and informal pharmaceutical economies in Third World countries: Synergetic, symbiotic or parasitical?

Informal economy functions without any formal social control for lack of a supervisory authority. Within a regulated locality the same activities would have an illegal character, but in that deviating situation those informal activities can thrive because the authorities do not intervene. Globalization of our western mixed market economy implies that also the aspect of government control takes on a global character. The fact that formal economies settle in places where an informal market is the rule leads to a combined action which, eventually, creates new market relations. In the present contribution we study the effects of a meeting between a formal and an informal market on the basis of a concrete case. An analysis of the market of medical products in Third World countries gives an idea of the new relations that arise when an informal market of natural medicines is confronted with a formal market of western medicines. We study both the situation in which there are no regulations and the situation in which the formal market is supported by economic regulations. This text illustrates how those situations can give rise to new opportunities for one group and to exploitation for another.     

Discouraging Disadvantaged Fathers’ Employment: An Unintended Consequence of Policies Designed to Support Families

Substantial declines in employment and earnings among disadvantaged men may be exacerbated by child support enforcement policies that are designed to help support families but may have the unintended consequence of discouraging fathers’ employment. Disentangling causal effects is challenging because high child support debt may be both a cause and a consequence of unemployment and low child support order compliance. We used childbirth costs charged in unmarried mothers’ Medicaid‐covered childbirths, from Wisconsin administrative records, as an exogenous source of variation to identify the impact of debt. We found that greater debt has a substantial negative effect on fathers’ formal employment and child support payments, and that this effect is mediated by fathers’ prebirth earnings histories.     

A study of ethyl glucuronide in post-mortem blood as a marker of ante-mortem ingestion of alcohol

The possibility of post-mortem production of ethanol makes correct interpretation of ethanol detection in forensic autopsy samples difficult. Even though the levels of ethanol formed post-mortem are generally low, this may be highly relevant in cases where intake of alcohol was forbidden, for instance for pilots, professional drivers and countries with low legal alcohol limits for driving. Different criteria are used to determine whether a finding of ethanol is of exogenous origin, but there is no marker for alcohol ingestion that has been studied in detail. In this study, we wanted to evaluate the sensitivity and specificity of ethyl glucuronide (EtG), a direct minor metabolite of ethanol, measured in blood, as a marker of ante-mortem alcohol ingestion. Forensic autopsy cases were divided into groups with and without ante-mortem alcohol ingestion, according to strict inclusion criteria. In 93 cases with information on ante-mortem alcohol ingestion, EtG was detected in blood in all cases, even when levels of ethanol were low. In another 53 cases where there were no indications of ante-mortem alcohol intake, EtG could not be detected in blood in a single case, also in 11 cases in which ethanol was detected and considered to be most probably formed post-mortem. In conclusion, blood EtG determination seems to be a reliable marker of ante-mortem ingestion of alcohol, and it could be considered in forensic autopsy cases when post-mortem formation of ethanol is questioned.     

A pharmacokinetic study of ethyl glucuronide in blood and urine: applications to forensic toxicology

This pharmacokinetic study investigated the kinetics of ethanol and its metabolite ethyl glucuronide (EtG) in blood and urine during the whole time course of absorption and elimination. There are few previous studies on the kinetics of EtG in blood, and we wanted to evaluate whether such knowledge could yield valuable information regarding the time of ethanol ingestion in forensic cases, such as, for instance, drunk driving. Ten male volunteers consumed ethanol at a fixed dose of 0.5 g/kg body weight in a fasted state. Blood samples were collected for 14 h and urine samples were collected for 45-50 h after the start of drinking. EtG reached its maximum concentration (C(max)) in blood after a median of 4 h (range 3.5-5), a median of 3 h (range 2-4.5) after C(max) for ethanol. The ethanol-to-EtG ratios in blood (ethanol in g/L, EtG in mg/L) were >1 only for the first median 3.5 h (range 2.5-3.5) after drinking. EtG elimination occurred with a median half-life of 2.2 h (range 1.7-3.1 h), and the renal clearance was 8.32 L/h (median, range 5.25-20.86). The concentrations of EtG were always much higher in urine than in blood. The total amount of EtG excreted in the urine was median 30 mg (range 21.5-39.7), representing 0.017% (median, range 0.013-0.022) of the ethanol given, on a molar basis. The information from the present study may be a valuable supplement to determine the time of ethanol ingestion. For this purpose, two subsequent increasing EtG values and a high ethanol-to-EtG ratio in blood would support information of recent drinking.