The Spousal Assault Risk Assessment (SARA) Guide: Reliability and Validity in Adult Male Offenders

We evaluated the reliability and validity of judgments concerning risk for violence made using the Spousal Assault Risk Assessment Guide (SARA; Kropp, Hart, Webster, & Eaves, 1994, 1995, 1998). We analyzed SARA ratings in six samples of adult male offenders (total N = 2681). The distribution of ratings indicated that offenders were quite heterogeneous with respect to the presence of individual risk factors and to overall perceived risk. Structural analyses of the risk factors indicated moderate levels of internal consistency and item homogeneity. Interrater reliability was high for judgments concerning the presence of individual risk factors and for overall perceived risk. SARA ratings significantly discriminated between offenders with and without a history of spousal violence in one sample, and between recidivistic and nonrecidivistic spousal assaulters in another. Finally, SARA ratings showed good convergent and discriminant validity with respect to other measures related to risk for general and violent criminality.     

Empirical evidence on the publicness of state legislative activities

Legislation would be a Samuelsonian public good if the cost of creating legislation is not a function of the number of people covered by the legislation. A straighforward test of Samuelsonian publicness is undertaken by estimating the cost of producing legislation as a function of population and other variables, using cross-sectional data from the states of the United States for the years 1965, 1975, and 1985. The empirical results indicate that while legislation does have some degree of publicness, legislation is mostly a private good, and that it has been becoming increasingly less public over time.     

Health‐care reform and the dimensions of professional autonomy

Abstract: A “managed competition” model was introduced in the Canadian province of Ontario as part of the government's reform of home care. With this model, it was assumed that competitive forces would encourage quality while driving down costs. While such reforms often achieve cost controls by constraining the incomes and practices of health‐care workers, there has been relatively little analysis of the extent to which self‐governing health‐care professionals, particularly those outside of medicine and nursing, may experience a decline in their ability to control the content and context of their professional work. In this article, the authors analyse the results of thirty‐six in‐depth interviews with representatives of Community Care Access Centres (CCACs), the organizations that purchase and coordinate the delivery of home‐care services, and rehabilitation provider agencies to examine the impact of Ontario's managed competition reform on rehabilitation professionals. Findings suggest that the impact of the reform varied across the economic, political, and clinical dimensions of professional autonomy and that, despite a general loss of autonomy under the managed competition model, market forces also served to mitigate the loss of autonomy, thus contributing to a remarkable resilience of professional autonomy. Sommaire: Un modèle de « concurrence dirigée » a été introduit récemment dans la province canadienne de l'Ontario dans le cadre de la réforme gouvernementale des soins à domicile. Avec ce modèle, il était présumé que les forces de la concurrence encourageraient la qualité tout en faisant baisser les coûts. Alors que de telles réformes parviennent souvent à maîtriser les coûts en réduisant les revenus et les pratiques des travailleurs de la santé, il y a eu relativement peu d'analyses de faites sur la mesure dans laquelle les professionnels de la santé autonomes, particulièrement ceux qui exercent en dehors de la médecine et de la profession infirmière, connaissent une perte de contrôle sur le contenu et le contexte de leur travail professionnel. Dans le présent article, les auteurs analysent les résultats de trente‐six entrevues en profondeur menées auprès de représentants des Centres d'accès aux soins communautaires (CASC), organismes qui achètent et coordonnent la prestation des services de soins à domicile, et organismes de prestation de soins de réadaptation, afin d'examiner les conséquences de la réforme de la concurrence dirigée de l'Ontario sur les professionnels de la réadaptation. Les résultats laissent entendre que l'effet de la réforme a varié en fonction des dimensions économiques, politiques et cliniques de l'autonomie professionnelle et que, malgré une perte d'autonomie générale liée au modèle de concurrence dirigée, les forces du marché ont également permis d'atténuer la perte d'autonomie, contribuant ainsi à la remarquable résilience dont font preuve ces professionnels en la matiére.