The Physician-Patient Relationship and a National Health Information Network

The growing use of interoperable electronic health records is likely to have significant effects on the physician-patient relationship. This relationship involves two-way trust: of the physician in patients, and of the patients in their providers. Interoperable records opens up this relationship to further view, with consequences that may both enhance and undermine trust. On the one hand, physicians may learn (from additional records) that information from their patients is — or is not — to be trusted. On the other hand, patients may learn from the increased oversight made possible by electronic records that their trust in their physicians is — or is not — warranted. Release of information through new methods of surveillance may also undermine patient trust. The article concludes that because trust is fragile, attention to transparency and confidentiality in the use of interoperable electronic records is essential.     

Cranial Backspatter Pattern Production Utilizing Human Cadavers

A backspatter pattern results from blood drops that travel retrograde to an applied external force. Historically, an array of animals and nonhuman objects have been used to create and study backspatter patterns. In this study, backspatter patterns captured on foam core targets that were placed 45.72 cm (18 in) behind the impact site (occipital area of the skull) were produced by cranial gunshots to human cadavers that were reinfused with fresh defibrinated bovine blood. These patterns were compared to the backspatter patterns produced by shooting blood‐soaked sponges, a typical simulant used in controlled studies of backspatter pattern production and characteristics. The backspatter pattern produced by shooting an actual human head was found to be different than those of blood‐soaked sponges in the number of stains produced, the size and size range of the stains, and the stain dispersion patterns.     

Equality and Regional Finance in the Americas

This article explores competing definitions of equality embedded in contending visions for regional finance in the Americas. The U.S. free market–oriented project envisions extension of a NAFTA‐like regulatory framework hemispherewide, promising Latin Americans better financial services, credit, and investment in exchange for strong financial property protections and (implicitly) dramatically reduced financial policy autonomy for their governments. Venezuela's vision of “Bolivarian” finance, exported to the Caribbean and the upper Andes, promotes assertive state management of both foreign and domestic investors, populist redistribution, and increasing reliance on nonmarket financial transactions. Brazil's regional financial project would unite South America through continentwide physical infrastructure and capitalist financial markets while retaining a role for public sector banks responsive to central government priorities. Brazil's approach shares with Venezuela's an emphasis on governments' need for financial policy authority and with the U.S. approach a concern for regulatory predictability and financial deepening.     

The architecture of risk management

Abstract

Power's book examines how organizations are designed through risk-based science, law and managerial techniques. As organizations have come to think of, reform and govern themselves through the vague but powerful notion of risk, both the fortunes of the managers who conceive of these designs and the behaviour of the organizations themselves have been affected. Power develops four themes as he analyses the consequences of these moves towards risk management as governance. First, he notes the tensions that have emerged as risk management systems take in information about uncertainty in the operational environment and process it into risk, while simultaneously producing yet more uncertainty. Second, he offers an account of developments in the system of professions as the abstractions of mathematical risk analysts have lost ground to managerial approaches to the processing and uses of risk. Third, he applies neo-liberal notions of the individual to organizational behaviour in an analysis of the conflict between risk-embracing profit motives and risk-averse precautionary instincts. Fourth, he argues that the uptake of risk management techniques and discourses in organizations has fundamentally changed the way they view themselves and operate in the world. As better risk management through internal self-control has become the obvious solution to every problem, enterprise values and trust have imploded. We close our review with a critique of this implosion thesis, suggesting directions for future research for socio-legal, governance and organizational behaviour scholars.     

CPI(ML), India documents and discussion

What is meant by the term “industrialisation”? We would define the concept in the very broadest sense so that it includes not only the idea of technological change (e.g. the introduction of machine technology into agriculture, mining, manufacturing, construction and the like) but also a radical social, economic and political transformation of the societies in which it is occurring. For instance it can, but need not necessarily entail massive urbanisation. It can, but need not necessarily encompass the development of industrial capitalism and the growth of the proletariat. The specifics of each historical instance needs therefore to be treated as problematic, not taken-for-granted. Our aim in this paper is not to examine the broad sweep of social change. The notion of industrialisation as a very diverse process, however, informs our thinking, even though we focus more narrowly on change in just one sector of one society, viz manufacturing in Malaysia. In particular, we will try to establish the extent to which a capital goods sector has developed there, the form it has taken and the degree to which linkages have been formed between capital goods producing companies and the local economy.     

Assessing Children’s Risk for Homicide in the Context of Domestic Violence

Increasing evidence indicates that children are at risk of homicide in the context of domestic violence. Using a retrospective case analysis of 84 domestic homicide cases, this study sought to identify the unique factors that place a child at risk of homicide. Three groups of domestic homicide cases in which there were no children in the home (No Child in the Home, n?=?44), a child was targeted (Child Target, n?=?13), and a child was present, but not targeted (No Child Target, n?=?27) were compared. Overall, there were no significant differences amongst cases involving children (targeted or not) on major factors except for the higher number of agencies involved with couples with children. Few cases had risk assessment or safety plans completed. Despite the study limitations, the findings speak to the need for professionals to assess child risk and include children in safety planning in all cases of domestic violence.     

Introduction: The OECD and Policy Transfer: Comparative Case Studies

Abstract

The six articles in this issue examine the role of the OECD in policy transfer. Two articles (Kudrle on international tax agreements, and Legrand and Vas on Australia’s vocational and educational training policy) conclude that the OECD has been influential, albeit in a grinding and lengthy way. Two others (Clifton on the OECD’s “enhanced engagement” policy with five G-20 countries, and Eccleston and Woodward on tax transparency) find the OECD’s influence either patchier or even dysfunctional. Carroll’s article provides a novel analysis of policy transfer through accession processes, while Alasuutari explores transfer in terms of a comparative analysis of policy rationalizations that refer to the OECD as a “standard.” A common theme of all six articles is the way in which policy transfer is driven by exogenous pressures and crises, and how international governmental organizations like the OECD exploit these pressures to protect and expand their global relevance.     

Guardians at the Gate: The Backgrounds, Career Paths, and Professional Development of Private US Immigration Lawyers

This article presents findings from a qualitative study of seventy-one New York immigration lawyers who are engaged in private practice. It focuses on the lawyers' backgrounds, career paths, and early professional training and describes, inter alia, the unusual diversity of this bar, the lawyers' reasons for practicing immigration law, the ways in which they learn to practice law, and the strong sense of community within the private immigration bar. It uses the idea of communities of practice to help understand how lawyers learn from their colleagues and are influenced by them. The article identifies several factors that may contribute to the supportiveness of the bar and the strong sense of community within that practice specialty, notwithstanding its great diversity. It concludes by making some preliminary comparisons between immigration lawyers and lawyers in other practice specialties and by identifying some questions for future study.     

Maybe He's Depressed: Mental Illness as a Mitigating Factor for Drug Offender Accountability

Given the often perplexing relationship between mental illness and substance abuse among offenders, this article looks at how a juvenile drug court staff's presumptions of a youth's mental illness affect its decision-making process. Based on thirteen months of ethnographic fieldwork at a Southern California juvenile drug court, this article uses Manzo and Travers's "law in action" approach to analyze how the staff readjusts its application of normal remedies (a concept developed by Robert Emerson) designed to respond to a youth's noncompliance when it suspects mental illness may be influencing the youth's actions. In doing so, it highlights how court staff's considerations of youth mental disorders arise out of its everyday work practices. Furthermore, the article discusses how staff negotiations around a youth's mental illness create tensions for the juvenile drug court's accountability-based model of therapeutic jurisprudence, because assessments of mental illness tend to mitigate responsibility for a youth's behavior.