Reintegrating seriously violent and personality-disordered offenders from a supermaximum security institution into the general offender population

Offenders who have committed serious violent acts while incarcerated are often segregated and housed in supermaximum security facilities. Given the highly restricted regime under which they are detained, it is often difficult to decide if they are safe enough to be discharged. However, there is a need to reintegrate them into the general offender population in a lower security institution for humane, correctional, and financial reasons. We propose a transitional strategy to facilitate their reintegration by way of a maximum-security step-down treatment-oriented facility within which both their security requirements and treatment needs could be adequately met. The present study reports the results of such an approach. More than 80% of the offenders (n = 31) were reintegrated into a lower-security facility without relapsing and being returned to the supermaximum institutions within a follow-up period of 20 months. They also have lower institutional offense rate postreintegration compared to prereintegration.     

Ethnicity, gender, and global risk indicators in the lives of status offenders coming to the attention of the juvenile court

The present study examined the risks and needs of status offenders in comparison to an at-large juvenile court sample, with specific attention paid to factors related to gender and ethnicity. Status offenders displayed significantly higher risk scores than the comparison sample in domains associated with both family and parenting concerns and educational concerns. In addition, females displayed higher risk levels than males and White youth displayed significantly higher risk levels than minority youth across a wide variety of risk domains. Further analyses were conducted regarding the participation of African American males and females in a program designed as an alternative to detention. For both groups, successful program completion was accompanied by little or no further court involvement, whereas failure to complete the program was related to a variety of negative outcomes. However, African American females and males successfully completing program requirements displayed different risks and needs at the outset of their participation.     

Pregnancy-related maternal deaths

Pregnancy is a normal biologic process, but because of a variety of physiologic factors, it increases a woman's risk for death. Maternal deaths in pregnancy may be due to conditions unique to pregnancy, conditions associated with pregnancy, or conditions unrelated to but exacerbated by pregnancy. Death may occur during any trimester, during labor/birth, or postpartum. In this report, we present 45 cases of pregnancy-related maternal deaths that were investigated and autopsied at the Dallas County Medical Examiners office between 1977 and 1999, and we review the topic of pregnancy-related maternal death.     

The Effect of Social Conformity on Collective Voting Behavior

This article investigates the effect of social conformity onvoting behavior. Past research shows that many people vote toconform with the social norm that voting is a civic duty. Thehypothesis here is that when conformity motivates people tovote, it also stimulates conformist behavior among some voterswhen they decide which party to vote for. This produces a distinctiverelationship between voter turnout and the distribution of votesamong parties—a relationship not anticipated by rationalchoice theory. I test a mathematical model of this behaviorwith linear and nonlinear regression analyses of state-leveldata for presidential elections in the United States from 1904to 1996, longitudinal data on parliamentary elections in WesternEurope over most of the twentieth century, and cross-sectionaldata for recent elections in Western Europe, Eastern Europe,and Russia. The results generally validate the model.     

How physicians' organizations compete: protectionism and efficiency

This article develops a framework that distinguishes four types of competitive strategies that physicians' organizations can adopt in their interactions with health plans. Two types of strategies protect physicians' incomes and autonomy from incursion and control by insurers; the other two enhance the efficiency of health care markets by controlling costs and embedding physicians' caregiving in a community of professionals. The mix of strategies that each organization adopts at any given time depends on the market conditions and regulatory policies it faces, as well as its organizational capacity. The article reviews recent developments in the field that indicate that today's markets and regulations create neither the pressures nor the capacity for physicians' organizations to adopt strategies that enhance efficiency. The managed care backlash has led to a relaxation of pressures to control costs, and the lack of a business case for quality has discouraged embedded caregiving. These developments instead have encouraged and enabled physicians' organizations to adopt strategies that protect their members from the bargaining power and micromanagement of health plans. The article therefore proposes changes in purchasing and regulatory policies to alter the pressures and improve the capacity of physicians' organizations to pursue efficiency and eschew protectionism.