Toward an agenda for reform of justice and mental health systems interactions

This article presents an agenda for reform of the justice and mental health systems interactions, which includes policy, management, and research strategies related to the systemic and interorganizational issues facing the two systems. The strategies are divided into six major categories: (a) base decisions, procedures, and policies on empirical data; (b) improve communications between system; (c) ensure dignity and respect are afforded all individuals involved in both systems; (d) ensure the availability and delivery of mental health services and treatment prorams; (e) inform others about issues related to the intereactions of the justice and mental health systems; and (f) periodically review and reformulate policies, management strategies, and research efforts for improving systems interactions. The article also presents a summary of the problems and possible goals associated with mental health and justice systems interactions. The summaries as well as the agenda are based on the results of a symposiuum attended by practitioners and scholars in the justice and mental health fields.     

Tardieu's spots and asphyxia--a literature study

Subpleural, epicardial and pericranial ecchymoses have been described in cases of suffocation since the 18th century. In the 19th century, great diagnostic importance was attributed to ecchymoses. Tardieu was the most determined defender of the specificity of ecchymoses for suffocations. He thought that he could diagnose violent suffocation by means of ecchymoses and claimed that he was able to differentiate violent suffocation from other unnatural causes of death (hanging, choking, strangulation, and drowning). Other physicians, among them numerous German medical examiners, proved Tardieu's opinions wrong by means of observations and animal studies. The most dedicated disputant against Tardieu's false doctrines was Liman. According to today's knowledge of pathophysiology, the haemorrhages concerned cannot have a specificity for suffocation or even a specific form of suffocation. Therefore, the confusing term of "suffocation haemorrages" should be avoided.     

Toward Disorganized Governance in Public Service Provision? The Case of German Sickness Funds

Over many years now, the concept of “network” or “new governance” pervades the literature on public administration. It suggests a growing role for network-based governance downgrading both command-and-control bureaucracy and, if more implicitly, New Public Management (NPM). Challenging this reading, the article explores the relationship between network-based and (quasi-)market governance by investigating the policies of German health care insurance organizations, the so-called sickness funds, epitomizing the international movement towards focal agencies run at arm's length of Government. These policies reflect new forms of hybrid coordination in public service provision, leading into what can be coined disorganized governance and be characterized as a regime of hybrid coordination shaped by a nervous interplay of partnership-building and disruptive segregation, with important repercussions on the overall outcomes in the provision of health care.