Who do I turn to? Resolving complaints by mental health consumers and carers

The current Australian system for handling complaints by mental health consumers and carers against service providers is complex and difficult to navigate. Complaints may be made to a range of people and organisations, including the relevant mental health service, community or official visitors, Health Services Commissioners, Chief Psychiatrists, Public Advocates, Ombudsmen and Members of Parliament. This Legal Issues column provides an overview of the law relating to complaints handling by community or official visitors, health service commissions and offices of the Chief Psychiatrist. It argues that while health service commissions may provide the best current avenue for complaints, there is a need for independent, centralised complaints bodies in Australian jurisdictions with similar powers to that of the Mental Welfare Commission for Scotland.     

What are Intoxicated Offenders Responsible for? The ��Intoxication Defense�� Re-examined

I provide a brief history of the common law governing the criminal liability of intoxicated offenders, and the codification and application of the intoxication rules in Canada. I argue that the common law and its statutory application in Canada violate a number of principles of criminal justice. I then argue that the rules cannot be saved by attempts to subsume them under principles of prior fault. I end with a modest proposal for law reform.     

Review of pathologic findings in remnant hearts following valve donation

The failure of medical examiners/coroners (ME/C) to allow heart valve donation is a major problem encountered by tissue agencies. Even though many ME/C favor tissue donation they remain responsible for determination of cause and manner of death. In 2001, the Jesse E. Edwards Registry of Cardiovascular Disease was approached by one of the nation's largest tissue procurement agencies (The American Red Cross--ARC) for the purpose of performing cardiovascular pathologic examinations following valve donation. The affiliation existed from October 2001 to January 2005. This study was undertaken to review all 593 postvalve recovery heart remnants received during that time period to tabulate the abnormalities identified and to determine whether donation interfered with the determination of cause of death. For each case, a preliminary cause of death was provided by the ARC. The decedent's body height and weight were also provided. Using the preliminary cause of death, the 593 cases were divided into natural and nonnatural manner of death groups. This division of the cases resulted in 106 cases placed in the natural manner of death group and 487 cases in the nonnatural manner of death group. For each case, all cardiac findings including significant conditions, additional findings, incidental findings, and congenital abnormalities were tabulated. Within the natural manner of death group, 15 cases had a noncardiac cause of death and 91 cases had a cause of death suspected to be cardiac related. In the 91 cases, a total of 132 significant cardiac findings were identified and there were six structurally normal hearts including two infants. In the nonnatural manner of death group, 214 significant cardiac findings were identified and 222 cases had a structurally normal heart. In both natural and nonnatural groups, the most common cardiac abnormality was atherosclerotic coronary artery disease. Other frequently encountered conditions were also identified including 11 cases with acute angle of origin of a coronary artery (five cases natural group; six cases nonnatural group). An important feature of this review was the recognition of potentially inheritable conditions that were diagnosed in both natural and nonnatural manner of death groups. There were three cases of hypertrophic cardiomyopathy (one natural; two nonnatural), three cases of arrhythmogenic right ventricular cardiomyopathy (one natural; two nonnatural), and one case of mitral valve prolapse (natural). In reviewing these cases, we did not feel that valve donation severely impaired cardiac pathologic examination. The benefits of cardiovascular pathologic examination by a cardiac pathologist include the identification of significant and incidental findings and recognition of potentially inheritable conditions.     

Ventilatory and metabolic demands during aggressive physical restraint in healthy adults

We investigated ventilatory and metabolic demands in healthy adults when placed in the prone maximal restraint position (PMRP), i.e., hogtie restraint. Maximal voluntary ventilation (MVV) was measured in seated subjects (n=30), in the PMRP, and when prone with up to 90.1 or 102.3 kg of weight on the back. MVV with the heaviest weight was 70% of the seated MVV (122+/-28 and 156+/-38 L/min, respectively; p<0.001). Also, subjects (n=27) were placed in the PMRP and struggled vigorously for 60 sec. During the restrained struggle, ventilatory function (V(E)/ MVV) was 44% of MVV in the resting PMRP. While prone with up to 90.1 or 102.3 kg on the back, the decrease in MVV was of no clinical importance in these subjects. Also, while maximally struggling in the PMRP, V(E) was still adequate to supply the ventilatory needs.     

Pilot Study of Automated Bullet Signature Identification Based on Topography Measurements and Correlations*†

Abstract: A procedure for automated bullet signature identification is described based on topography measurements using confocal microscopy and correlation calculation. Automated search and retrieval systems are widely used for comparison of firearms evidence. In this study, 48 bullets fired from six different barrel manufacturers are classified into different groups based on the width class characteristic for each land engraved area of the bullets. Then the cross‐correlation function is applied both for automatic selection of the effective correlation area, and for the extraction of a 2D bullet profile signature. Based on the cross‐correlation maximum values, a list of top ranking candidates against a ballistics signature database of bullets fired from the same model firearm is developed. The correlation results show a 9.3% higher accuracy rate compared with a currently used commercial system based on optical reflection. This suggests that correlation results can be improved using the sequence of methods described here.     

Potency Trends of Δ9‐THC and Other Cannabinoids in Confiscated Cannabis Preparations from 1993 to 2008*

Abstract: The University of Mississippi has a contract with the National Institute on Drug Abuse (NIDA) to carry out a variety of research activities dealing with cannabis, including the Potency Monitoring (PM) program, which provides analytical potency data on cannabis preparations confiscated in the United States. This report provides data on 46,211 samples seized and analyzed by gas chromatography‐flame ionization detection (GC‐FID) during 1993–2008. The data showed an upward trend in the mean Δ⁹‐tetrahydrocannabinol (Δ⁹‐THC) content of all confiscated cannabis preparations, which increased from 3.4% in 1993 to 8.8% in 2008. Hashish potencies did not increase consistently during this period; however, the mean yearly potency varied from 2.5–9.2% (1993–2003) to 12.0–29.3% (2004–2008). Hash oil potencies also varied considerably during this period (16.8 ± 16.3%). The increase in cannabis preparation potency is mainly due to the increase in the potency of nondomestic versus domestic samples.     

The total effects of boot camps that house juveniles: A systematic review of the evidence

Boot camp programs were first introduced in the 1980s, became increasingly popular as a correctional sanction, and were widely adopted and implemented throughout the United States. This study involved an examination of the prevalence of state run boot camps for juvenile delinquents and a systematic review of the existing evaluations of boot camp programs that house juveniles. In addition to the effects of boot camps on recidivism, within program effects on participants’ attitudes and perceptions of boot camp, and jurisdiction-level effects on bed space were examined. Findings revealed that boot camps are less prevalent than they were in the 1990s. Boot camps, by themselves, typically do not have an effect on participants’ odds of recidivism. Boot camps do seem to improve individuals’ attitudes and other behaviors within programs. Boot camps also appear to reduce the number of confinement beds jurisdictions require, often resulting in cost savings. These findings are discussed in terms of their implications for research and practice.     

BEST PRACTICES FOR MEDIATION TRAINING AND REGULATION: PRELIMINARY FINDINGS

This article makes recommendations as to “Best Practices” for the training of mediators in court‐connected settings. The authors’ findings cover issues including the design of training programs, the importance of experiential learning through role‐plays, teaching methods for adult learners, class size and length, training ethical mediators, suggested trainer qualifications, and recommended regulatory practices for administrators. Data comes primarily from an assessment of mediation training and regulation in Florida, but the findings hold insights for court‐connected mediation programs throughout the United States. Additionally, the authors highlight the benefits of a collaborative assessment approach involving all stakeholder groups and facilitating smooth implementation of any needed changes.     

The Role of Perceived Justice,Political Ideology,and Individual or Collective Framing in Support for Environmental Policies

Effectively addressing environmental challenges such as climate change will require adopting policy measures that have some impact on collective human behavior. The present research examined attitudes toward different environmental policies, specifically focusing on the role of perceived justice. Justice was measured in two ways: as an assessment of the fairness of a particular policy and as a general tendency to endorse statements related to environmental justice. Because justice judgments can be context specific, policies were presented in four conditions, in a 2 × 2 design manipulating the type of impact described, ecological or societal, and the level of focus, individual or collective. The roles of political ideology and environmentalism were also investigated. Results from an online sample of 162 US residents showed that non-coercive policies, overall, were rated as more acceptable. Environmental justice statements were strongly endorsed, and justice in both its specific and general forms was a determinant of policy acceptance. In particular, ratings of the fairness of specific policies were a stronger determinant of acceptability than perceived effectiveness of the policy. Type of impact had little effect, but policies tended to be rated as more acceptable when they were framed in terms of the collective rather than the individual. Although a liberal ideology was associated with acceptance of environmental policies in general and with endorsement of environmental justice, controlling for endorsement of environmental justice eliminated the effect of political ideology in most, but not all, cases. Implications for policy support are discussed.     

Bringing Community Based Participatory Research to Domestic Violence Scholarship: an Online Toolkit

In the absence of ongoing involvement in the communities that are the subjects of research, even well-intentioned researchers can develop questions that are not relevant to community needs, employ methods that hurt community members, or disseminate findings in ways that are inaccessible to those most affected. Recognizing these harms, a growing number of domestic violence (DV) researchers have embraced community-based participatory research (CBPR), an approach in which researchers and community members share power at every level of the research process, co-creating knowledge that can be applied to enhance community well-being. Despite growing interest in this approach, however, there are insufficient opportunities for interested researchers to learn how to actually engage in it, especially in the DV context. To remedy this gap, the authors of this paper collaborated to develop an online toolkit for emerging researchers interested in CPBR. This brief report frames the need for CBPR in DV research using short vignettes that come from our own research experience; introduces Power Through Partnerships: A CBPR Toolkit for Domestic Violence Researchers; and presents recommendations for developing, promoting, and disseminating future CBPR research. We chose to announce the development and availability of this toolkit in an academic journal in order to highlight its scholarly and practical relevance for researcher audiences who might be less familiar with the CBPR approach.