Searching for civil society: changing patterns of governance in Britain

To understand governance, we ask who is telling the story from within which tradition. We argue there is no essentialist notion of governance but at least four conceptions each rooted in a distinctive tradition. The first section of the paper describes the relevant traditions: Tory, Liberal, Whig and Socialist. The second section describes the different notions of governance associated with each tradition; intermediate institutions, marketizing public services, reinventing the constitution and trust and negotiation. We explain these distinct conceptions of governance as responses to the dilemmas of inflation and state overload. In the conclusion, we summarize how and why traditions change, concluding, there is no such thing as governance, but only the differing constructions of the several traditions.     

Fragmented pathways to care: the experiences of suicidal men

Using qualitative methods, this study examined how, and under what circumstances, suicidal men used mental health services. In particular, the analyses focused on fragmented pathways to care. Fifteen men with a history of suicidal and aggressive behaviors and a diagnosis of borderline personality disorder and/or antisocial personality disorder participated in semistructured interviews that consisted of questions about their mental health status and experiences with mental health and addiction services. Interviews were taped and transcribed. An iterative, inductive qualitative analytic process was used. Men followed a cyclical pattern wherein negative experiences with health care providers were said to be followed by avoidance of health care settings, crisis, and then by involuntary service utilization. Men identified five health care provider and three personal practices, and two types of episodes they believed to contribute to their fragmented pathways to care. Implementation of specialized interventions, and providing patients with more information and more opportunity to participate in decisions, may improve interactions between patients and providers and improve patients' mental health status.     

Differences in HIV-related knowledge, attitudes, and behavior among psychiatric outpatients with and without a history of a sexually transmitted infection

HIV infection among the mentally ill is estimated to be at least eight times the prevalence in the general population. Psychiatric patients may also be disproportionately vulnerable to other sexually transmitted infections (STIs), but this has not been well studied. We sought to characterize the prevalence and correlates of STIs in a sample of psychiatric outpatients (N=464). Over one-third of the sample (38%) reported a lifetime history of one or more STIs. Multivariate analyses showed that, relative to those without an STI history, patients with a lifetime STI history were more knowledgeable about HIV, expressed stronger intentions to use condoms, and perceived themselves to be at greater risk for HIV. However, those with a past STI were also more likely to report sex with multiple partners and reported more frequent unprotected sex in the past 3 months. Treatment for an STI may increase HIV knowledge and risk reduction motivation, but does not necessarily lead to changes in sexual risk behavior among psychiatric patients. Findings highlight the need for STI/ HIV risk reduction interventions in psychiatric settings, particularly for patients with high-risk profiles.     

A validated SPME-GC-MS method for simultaneous quantification of club drugs in human urine

A solid-phase microextraction-gas chromatographic-mass spectrometric (SPME-GC-MS) method has been developed and validated for measuring four club drugs in human urine. These drugs include gamma-hydroxybutyrate (GHB), ketamine (KET), methamphetamine (MAMP), and methylenedioxymethamphetamine (MDMA). These drugs are referred to as 'club drugs' because of their prevalence at parties and raves. Deuterium labeled internal standards for each of the four drugs was included in the assay to aid in quantitation. The drugs were spiked into human urine and derivatized using pyridine and hexylchloroformate to make them suitable for GC-MS analysis. The SPME conditions of extraction time/temperature and desorption time/temperature were optimized to yield the highest peak area for each of the four drugs. The final SPME parameters included a 90 degrees C extraction for 20min with a 1min desorption in the GC injector at 225 degrees C using a splitless injection. All SPME work was done using a 100microm PDMS fiber by Supelco. The ratio of pyridine to hexylchloroformate for derivatization was also optimized. The GC separation was carried out on a VF-5ht column by Varian (30m, 0.25mm i.d., 0.10microm film thickness) using a temperature program of 150-270 degrees C at 10 degrees C/min. The instrument used was a ThermoFinnigan Trace GC-Polaris Q interfaced with a LEAP CombiPal autosampler. The data was collected by using extracted ion chromatograms of marker m/z values for each drug from the total ion chromatograms (TIC) (full scan mode). Calibration curves with R(2)>0.99 were generated each day using the peak area ratios (peak area drug/peak area internal standard) versus concentration. The validated method resulted in intra-day and inter-day precision (% R.S.D.) of less than 15% and a % error of less than 15% for four concentrations in the range of 0.05-20microg/mL (MAMP) and 0.10-20microg/mL (GHB, KET, and MDMA). This method has the advantage of an easy sample preparation with acceptable accuracy and precision for the simultaneous quantification of these four drugs of abuse and shows no interference from the urine matrix.     

The unintended impact of the therapeutic intentions of the New Zealand Mental Health Review Tribunal? Therapeutic jurisprudence perspectives

Mental health review bodies engage in complex decision-making that may explicitly incorporate a therapeutic philosophy. Examination of select decisions of the New Zealand Mental Health Review Tribunal offers a foundation for understanding some implications of a pro-therapeutic approach. This analysis draws upon therapeutic jurisprudence scholarship in relation to three aspects of the hearings as documented in the written decisions: advocacy, therapeutic intervention, and the dignitary potential of the proceedings. The research explores the unintended consequences of a pro-therapeutic approach and evaluates the potential application of therapeutic jurisprudence within a mental health law context.     

Text Matters: Some Reflections on the Forging of a New Constitutional Jurisprudence in South Africa

The South African Constitution establishes a constitutional democracy with a strong form of constitutional review. The Constitutional Court is required to declare invalid any legislation or conduct of the President which is inconsistent with the Constitution. The author, a former judge of the Constitutional Court, argues that the text of the Constitution has been an important determinant of the Court's jurisprudence, both in relation to the Court's jurisprudence concerning the institutional structures established by the Constitution and its Bill of Rights jurisprudence.     

Child maltreatment histories among female inmates reporting inmate on inmate sexual victimization in prison: the mediating role of emotion dysregulation

Despite data indicating that child maltreatment (CM) in various forms is associated with adult sexual victimization among community women, few studies have explicitly explored how types of CM might relate to prison sexual victimization. Because little is known about how CM might give rise to prison sexual victimization, the present study also examined emotion dysregulation emanating from early abuse experiences as a potential mediator in the link between early CM and inmate-on-inmate prison sexual victimization. Approximately 168 incarcerated women completed self-report inventories assessing various types of childhood maltreatment, emotion dysregulation, and coerced or forced sexual experiences in prison. Nearly 77% of the sample endorsed experiencing at least one form of CM, with 64% of inmates reporting that they experienced two or more forms of CM. Approximately 9% of inmates reported sexual coercion and 22% reported a forced sexual experience in prison. Each form of CM was associated with prison sexual coercion; however, fewer associations emerged between CM and forced prison sexual experiences. Emotion dysregulation was found to mediate links between CM, particularly co-occurring CM, and sexual coercion in prison, but it was unrelated to forced prison sexual experiences. Implications are discussed.     

Physical Health in Preschool Children Exposed to Intimate Partner Violence

Exposure to violence and traumatic events during childhood has long been associated with poor physical and psychological health during adulthood. Very few studies, however, have taken steps to understand the immediate relationship between exposure to intimate partner violence (IPV) and physical health problems in young children. In this study, we examined the mother-reported physical health problems of 102 preschool-age children who have been exposed to IPV. We found that children exhibiting more traumatic stress symptoms displayed fewer total health problems; however, gastrointestinal problems and asthma were related to poor psychological adjustment. We also found that preschool-age girls were more likely to display health problems than boys. Future studies of the physical health consequences of exposure to IPV in young children would benefit from examinations of specific changes in physiological processes to draw conclusions about the effects of violence on immune system functioning and physical health.     

Risky Facilities: Crime Radiators or Crime Absorbers? A Comparison of Internal and External Levels of Theft

Objectives

To undertake the first exploration of the nature of the relationship between internal crime (those that happen within facilities) and external crime (those occurring outside but in the nearby locale of facilities). The following questions are addressed. Do those localities that suffer high volumes of crime internally within their facilities also suffer high levels of crime in their immediate external environment? How is this influenced by the distribution of internal theft across facilities? What are the likely mechanisms for any relationship found?

Methods

Spatial regression is used to explore these relationships using data for 30,144 incidents of theft from a Metropolitan area of the UK arranged into small 50 × 50 m grid squares. Variables used in the analysis include counts of external and internal theft, counts of victimized and ‘risky’ facilities, indicators of land-use and a proxy for the on-street population.

Results

There is found to be a strong positive relationship between internal and external theft that appears to be strengthened by the existence of facilities suffering particularly high crime volumes. Results suggest that internal theft problems precede external ones and that the physical concentration of chronically risky facilities is a particularly strong predictor of external theft problems.

Conclusions

An argument is made that risky facilities act as crime ‘radiators’, causing crime in the immediate environment as well as internally. This has implications for crime prevention policy in terms of facility placement and management.