Involuntary outpatient treatment in patients with severe mental illness: A one-year follow-up study

Introduction

Involuntary outpatient treatment (IOT) aims to ensure adherence to therapy in patients with serious mental disease who are unaware of their illness and for whom treatment discontinuation carries a high risk of relapse.

Objectives

To evaluate the effectiveness of IOT in preventing relapse among patients with serious mental disease.

Method

A retrospective observational study was carried out on all of the patients (n = 140) receiving IOT in the city of Valencia, Spain. Hospital service uses (emergency care, admissions and mean stay times) during the 12 months before and after the introduction of IOT were compared.

Results

Patients with schizophrenia, delusional disorder or schizoaffective disorder showed a significant reduction in the number of admissions and days spent in the psychiatry ward during the year of IOT. The reduction in the number of visits to the emergency department was only significant for the patients with schizophrenia.

Discussion

We conclude that involuntary outpatient treatment may be effective for patients with serious mental disease who are unaware of their illness and for whom treatment discontinuation carries a high risk of relapse.     

Poly- and Distinct- Victimization in Histories of Violence Against Women

We report results from pre-testing an Europe-wide Survey on Violence against Women. A questionnaire on women’s experiences of stalking, harassment, psychological, physical, and sexual violence by non-, ex-, and current partners was tested on 10 known victims of violence in intimate relations and 20 randomly selected women. Multiple Correspondence Analysis uncovered two profiles of victimization: women poly-victimized in multiple life ambits and women distinctly victimized in only some of them. Known-victims of intimate partner’s violence (IPV) were more likely to be poly-victimized than randomly selected women. Heterogeneity in women’s socio-economic conditions could only partly account for IPV’s over-representation among poly-victimized women. This gave more credence to an interpretation that highlights the role played by previous traumatic experiences of victimization on re-victimization.     

At the end of a fairy tale: romantic relationships in female juvenile offenders

This study explores romantic relationships among female juvenile offenders. The entire female population of a juvenile detention center at the moment of the study participated in a semi-structured interview. Using a semi-structured interview, the girls answered questions on four main topics: (a) available dating partners before entering the detention center; (b) dating partner preferences; (c) intimate relationships within the center; and (d) romantic relationships. A 34-item scale was also used to assess their dating partner preferences. Most girls depicted dysfunctional families and a reduced range of dating options, many involving male offenders. Most participants had also been precocious in their relationships and experienced victimization at the hands of their intimate partners. Implications to prevent female involvement with criminal and violent men are discussed.     

Small island developing states and international climate change negotiations: the power of moral “leadership”

Being at the frontline of climate change, small island developing states (SIDS) hold a serious stake in climate negotiations. However, these countries usually are marginalized in the international political arena, due to their lack of structural power. This paper explores the strategic influence of SIDS and its representative organization, the Alliance of Small Island States, in the negotiations leading to the Copenhagen summit of December 2009. Using the concepts of leadership and discourses, the position, strategies, and impact of SIDS are analyzed on negotiation processes and their final outcome, focusing on three core demands of small island countries at Copenhagen: a temperature rise limit of 1.5 °C above preindustrial levels, funding for adaptation, and a legally binding outcome. Results reveal that SIDS practiced entrepreneurial, intellectual, and environmental leadership strategies and especially made use of moral claims in the debate. Given their near absence of structural power, they managed to secure a surprisingly large part of “their” agenda and interests in the final Copenhagen Accord, especially through (discourse) coalitions with various other state and non-state stakeholders.     

Euvoluntariness and just market exchange: moral dilemmas from Locke’s Venditio

It is a maxim of Public Choice that voluntary exchanges should not be interfered with by the state. But what makes a voluntary market exchange truly voluntary? We suggest, contra much of the economics literature, that voluntary exchange requires consent uncoerced by threats of harm, but that this is not sufficient. In particular, a person pressured to exchange by the dire consequences of failing to exchange—e.g., dying of thirst or hunger—is still coerced, and coerced exchange cannot be voluntary. The weaker party’s desperation gives the other party unconscionable bargaining power. We argue for a distinction, based on a neologism: in the case of coercion by circumstance but not by threat, exchange is still voluntary in the conventional sense, but it is not euvoluntary (i.e., truly voluntary). We will argue that all euvoluntary exchanges are just, while non-euvoluntary exchanges may or may not be unjust; that in competitive markets all exchanges are just, even those that are not euvoluntary, while in bilateral monopolies some exchanges are neither euvoluntary nor just. We will propose a mental device, the “fictitious negotiation”, to determine the just price in non-euvoluntary market exchanges. A primitive version of these ideas can be found in a little known monograph by John Locke, which we will analyze in detail.     

On the efficiency of equilibria in a legislative bargaining model with particularistic and collective goods

Voter initiatives are important for policy making in many countries. While much research shows that the initiative process affects policy choices, almost no evidence explains how the initiative process affects policy. Initiatives might change policy directly through voters approving laws that override the legislature; or the initiative process may change policy indirectly by providing a threat that induces the legislature to change policy. This article develops an empirical strategy to measure the direct and indirect effects of the initiative based on the idea that direct effects can be inferred from states that actually pass initiatives while indirect effects can be inferred from states where the initiative is available but not used. Evidence from 50 states on nine separate issues suggests that both direct and indirect effects are important, but the direct effect is several times larger than the threat effect.     

Public affairs in Hungary today: summarized through the eyes of a practitioner

This is not an academic overview on public affairs in Hungary, as this has already been written very well by many others. I would like to share my views and experience as a practitioner and give a quick insight into how public affairs is regarded in my country and how it developed after the change of the political system in Central and Eastern Europe. I will refrain from explaining what public relations or public affairs entails as I think this is unnecessary for anyone reading this. Copyright © 2014 John Wiley & Sons, Ltd.     

Metagovernance and Control of Multi-level Governance Frameworks: The Case of the EU Structural Funds Financial Execution

Using as an empirical base the 2006–08 reform of the European Union Structural Funds financial execution, this paper explores control mechanisms of multi-level governance frameworks. The empirical evidence provides a representative case of initial metagovernance deficit and the subsequent, relatively successful, institutional response reinforcing metagovernance. The purpose is to clarify the conceptual dimensions of metagovernance, setting it in a categorical scheme that identifies forms of exercise of political power: government, governance and multi-level governance. Specifically, the paper argues for a conceptualization of metagovernance that highlights a sense of sovereignty by which governmental entities vested with legal legitimacy advance public interests.     

Population data of five STRs in three regions from Portugal

Allele and haplotype frequencies of five chromosome STR loci (CD4, TPO, FES, TH01 and VWA) were determined for unrelated males throughout Portugal. This report presents STR data for three separate regions of Portugal, being the first time that data on the south of the country is presented. This study reveals that the three regions from Portugal are not genetically homogeneous. The north of Portugal presents significant differences in the CD4 locus, when compared with the other two populations. When compared with Madeira and A?ores, the three regions show a different behavior at TPO and VWA loci.     

Y-chromosomal STR haplotypes in Berber and Arabic-speaking populations from Morocco

Twelve Y-chromosomal short tandem repeats (STRs), DYS19, DYS385, DYS389I, DYS389II, DYS390, DYS391, DYS392, DYS393, DYS388, DYS426 and DYS439 were typed in Berber-speaking (n=49) and Arabic-speaking (n=60) population samples from Morocco.