Issues in Female Inmate Health: Results From a Southeastern State

The current study examines health care services and perceptions of those services by former inmates of a women's prison in 1 southeastern state. The results indicate that many women enter prison with health issues, including hypertension, HIV/AIDS, depression, anxiety, and drug addictions, and use health services while incarcerated. Women in this study expressed overall dissatisfaction with those health services and did not perceive that their health improved while incarcerated or that they received better health care in prison than on the outside. This exploratory study points to the need for further empirical investigation into the issue of health care for the incarcerated female. The generalizability of the study's findings is possibly limited by the fact that respondents were former female inmates. Also, results from 1 southeastern state may not be generalizable to other geographic locations.     

Complex Histories and Complex Presentations: Implementation of a Manually-Guided Group Treatment for Traumatized Adolescents

It is consistently recognized that children and adolescents who have repeatedly experienced or witnessed violence are at significant risk for a multitude of lasting difficulties across many domains of functioning. Adolescents in residential settings often have extensive trauma histories and experience profound behavioral, emotional, and interpersonal difficulties. Unfortunately, there are few structured trauma-informed treatments that have been implemented in residential settings, and even fewer that have been evaluated. This article describes the core components of Structured Psychotherapy for Adolescents Responding to Chronic Stress (SPARCS), a manually-guided trauma-informed group treatment, and provides clinical examples within residential facilities for adolescents with emotional and behavioral difficulties and extensive victimization histories. Preliminary data on self-reported emotional, behavioral, and posttraumatic stress symptoms are presented.     

Interpersonal process-oriented group psychotherapy with offender populations

This article discusses the application of interpersonal process-oriented group psychotherapy to offender populations. Group psychotherapy with offenders presents problems not encountered with other populations; thus, applying the group method requires special considerations. The particular focus of this article is on the relevance of therapeutic factors in group work with offenders, group process as it applies to work with offenders, and work with difficult clients.     

State Aid To Cities: A Causal Inquiry

Path analysis is employed to identify major influences on twoforms of state aid to cities—financial and programmatic.Considerable support is found for a sequential model in whichstate resources and city need are modified by the politicalclimate and the legal/structural characteristics of the state.For financial aid, the most powerful influences are a professionalizedlegislature and a legal system under which cities are responsiblefor schools and welfare. Program support is more affected bystate resources and municipal need. In all, those states mostlikely to provide generous support have cities in need, ampleresources, professionalized legislatures, and a decentralizedstate-local structural relationship.     

Victims' Responses to traumatic life events: An unjust world or an uncaring world?

Although the psychological literature has generally equated deservingness and justice, victims' responses suggest the need to disentangle the two concepts. Victims usually feel their traumatic experience was undeserved but typically do not consider the outcome in terms of justice or fairness. Rather, their feelings about not deserving the victimization derive from a second type of moral judgment involving caring rather than justice. These two orientations are discussed in light of recent developments in work on moral reasoning. A framework for understanding the trauma of victimization is presented; the shattering of assumptions related to a caring world—in which people are protected from harm—is highlighted in this model. The crucialrole of social support and specific cognitive strategies used by victims in the aftermath of their victimization are discussed in terms of survivors' efforts to rebuild their assumptions about a caring world. Although concerns about justice are less common among survivors, an effort is made to discuss when these isues are most apt to arise.     

Suspected clozapine poisoning in the UK/Eire, 1992-2003

OBJECTIVE: Toxicological analyses are often performed to investigate suspected poisoning, but the interpretation of results may not be straightforward. We studied suspected poisoning cases 1992-2003 where blood clozapine and N-desmethylclozapine (norclozapine) were measured in order to assess the relationship of these parameters to outcome. METHODS: Samples were referred from clinicians, pathologists/coroners, or via the Clozaril Patient Monitoring Service (CPMS, Novartis). Information was gathered from clinical, post-mortem, or coroners' reports. RESULTS: There were seven fatal [five male, two female; median (range) age 28 (24-41) year] and five non-fatal [four male, one female; median age 35 (26-41) year] clozapine overdoses. The median post-mortem blood clozapine and norclozapine concentrations were 8.2 (3.7-12) and 1.9 (1.4-2.4)mg/L, respectively [median clozapine:norclozapine ratio 4.4 (2.9-5.1)]. The median plasma clozapine and norclozapine concentrations (first or only sample) were 3.9 (1.7-7.0) and 0.40 (0.30-0.70)mg/L, respectively [median clozapine:norclozapine ratio 7.6 (5.3-18)] in the remainder. These overdoses were in patients who were poorly or non-adherent to clozapine, or who had taken tablets prescribed for someone else. In 54 further people who died whilst receiving clozapine [38 male, 16 female; median age 41 (22-70) year], the median post-mortem blood clozapine and norclozapine concentrations were 1.9 (0-7.7, n = 43) and 1.4 (0-6.0, n = 39)mg/L, respectively [median clozapine:norclozapine ratio 1.5 (0.4-7.6, n = 38)]. The median post-mortem increase in blood clozapine and norclozapine as compared to the most recent ante-mortem measurement was 489 (98-5,350)% and 371 (139-831)%, respectively [median sample time before death 14 (0-30, n = 21) days]. CONCLUSION: Clozapine poisoning cannot be diagnosed on the basis of blood clozapine and norclozapine concentrations alone. The analysis of ante-mortem blood specimens collected originally for white cell count monitoring and the blood clozapine:norclozapine ratio may provide additional interpretative information.