A policy critique of HIV/AIDS and demobilisation

The objective of this paper is to draw out and encourage debate on the relationship between HIV and the policy challenges that it poses for security. It explores how demobilisation programmes need to incorporate a development perspective, bringing together public health practitioners and security experts, in order to address the pandemic and the future security needs of Sub-Saharan Africa, in particular. It is hoped that integrating two very different disciplines, public policy and public health, will mark the beginning of attempts to establish some practical guidelines for policymakers and field practitioners that focus on prevention. Most important, the paper makes an urgent request for a cross-disciplinary and cross-sectoral approach to tackling such a complex problem as HIV and the military. Development practitioners once shunned any working relationship with armed forces or defence ministries, but it is impossible now to avoid these institutions in countries with high rates of HIV/AIDS in the security sector.     

The utility of histology in assessing the cause of death in medico-legal autopsies in selected trauma deaths: Suspension-, immersion-, fire-, and traffic-related

The goal of a medico-legal autopsy is primarily to determine the cause and manner of death. To this end, the pathologist often uses auxiliary analyses, including histology. However, the utility of routine histology in all medico-legal autopsies is unknown. Earlier studies on the utility of routine histology have shown inconsistent effects, with some studies recommending it and others rejecting it. To study the degree to which histology informs on the underlying cause of death, we sent autopsy reports from suspension-, immersion-, fire-, and traffic-related deaths to senior board-certified forensic pathologists and had them assess the cause of death, first without knowledge of the histological findings and then with knowledge thereof. Fifty cases were identified in each of four subgroups: fire-, immersion-, suspension-, and traffic-related deaths. The autopsy reports were anonymized, and the histological findings and conclusions were removed. Two board-certified forensic pathologists independently reviewed the reports in each subgroup and assessed the manner and underlying cause of death (including their certainty of this assessment on a five-level scale) with and without access to histological findings. The probability of changing the underlying cause of death posthistology was low in all study groups. There was a slight increase in the degree of certainty posthistology in cases where the underlying cause of death was not changed, but only when the antehistology certainty was low. Our results suggest that histology does not meaningfully inform on the underlying cause of death in suspension-, immersion-, fire-, and traffic-related deaths except when antehistology certainty is low.     

Medical negligence in drug associated deaths

According to epidemiological studies adverse drug events are one of the most frequently encountered complications during medical treatment, a leading cause of hospitalisation and frequent cause of death. However, medical malpractice claims due to medication errors seem to be relatively rare. Based on a retrospective multicentre study on medical malpractice cases with lethal outcome (n = 4450), drug related cases (n = 575) were further evaluated. In 50% of cases a causal connection between drug therapy and death could be ruled out already after autopsy. In 232 cases a causal connection between drug therapy and death could be approved (drug allergies, relative overdose, wrong application, mix-up of drugs and sepsis after injection abscess). However, within the legal context only in 70 cases a medication error was approved which was in 42 cases causal for death, in 28 not. Administration of contraindicated drugs, incorrect application and relative overdose in renal insufficiency are the prevalent mistakes. Concerning the frequency of ADE in epidemiological studies medication errors are underreported in all data sources on medical malpractice; this seems to be due to the fact that even doctors and attending physicians rarely recognize an ADE; furthermore approving the connection between drug effect and death is extremely difficult for the expert witness.     

Sovereignty at stake? The European Commission's proposal for a Defence and Security Procurement Directive

The Defence and Security Procurement Directive (DSDP) is the first supranational policy in the Common Security and Defence Policy (CSDP) and represents a departure from the standard understanding of the CSDP as intergovernmental. Whilst the member states were initially against such an initiative, the Defence Directive was eventually proposed in the Council in 2007 and accepted in July 2009. This paper examines why European Union member states changed their position on the proposal for a DSDP between 2004 and 2007. The analysis builds upon two hypotheses that aim to account for this change in position. Providing new insight into the views of the member states, the study finds that the member states accepted the Directive due to a sense of obligation to respect internal market rules, and further discusses the theoretical implications of these findings.     

Emotional Awareness in Depressive and Anxiety Symptoms in Youth: A Meta-Analytic Review

Emotion regulation is assumed to play an important role in depressive and anxiety symptoms in youth. However, the role of core components of emotion regulation, such as emotional awareness, is not well understood so far. Thus this meta-analysis aimed to examine the relationship between depressive and anxiety symptoms with emotional awareness in youth. A systematic literature search (PsycINFO, Medline, Google Scholar) identified 21 studies, from which 34 effect sizes were extracted. Results from random effects models showed that difficulties in emotional awareness were significantly correlated with a medium effect size for each, depressive and anxiety symptoms separately, and for their combined effects (overall outcome). Additionally, further analyses revealed that age was a significant moderator of the relationship between emotional awareness with depressive and anxiety symptoms, with younger samples (mean age?≤?12 years) showing a stronger association between difficulties in emotional awareness and depressive and anxiety symptoms as compared to older samples (mean age?>?12 years). The results suggest that emotional awareness may be of relevance for depressive and anxiety symptoms in youth. Future work is required to examine longitudinal developments, moderators, and mediators in multi-method approaches. Moreover, children and adolescents may benefit from interventions that aim to enhance emotional awareness.     

Altruism Born of Suffering and Prosocial Behavior Following Adverse Life Events: A Review and Conceptualization

This paper introduces the concept of “altruism born of suffering,” and provides a review and integration of relevant research and theories from various disciplines. In contrast to the well-supported notion that prosocial behavior is rooted in positive experiences, whereas violence and adversity often contribute to further violence and antisocial behavior, it is proposed that suffering may actually enhance the motivation to help other disadvantaged members of society, including outgroups. A motivational process model is presented that includes a typology of altruism born of suffering, integrates clinical and social psychological perspectives on underlying processes, and proposes potential mediators and moderators. Relevant empirical studies are reviewed that provide initial support for this model. A particular emphasis is placed on victims of group-based violence, and implications for intergroup relations and social justice.

Feasibility and Acceptability of an Impact of Crime Group Intervention with Jail Inmates

The current study evaluated the feasibility and acceptability of a manualized Impact of Crime (IOC) group intervention implemented with male inmates (N = 108) at a county jail. Facilitator adherence to the intervention and participant attendance, homework completion, and feedback were assessed. On average facilitators covered 93.7% of each manual topic. Victim speaker recruitment was a challenge—43.5% of relevant sessions lacked victim speakers. Findings suggested significant participant engagement—67.3% attended at least 75% of sessions and 93.3% of homework assignments were submitted on time. Overall, participants indicated satisfaction with the intervention. Successful strategies, challenges, and potential enhancements are discussed.