Involuntary outpatient treatment as “desintitutionalized coercion”: The net-widening concerns

In American jurisprudence, two justifications have traditionally been put forth to support the government's social control of persons with mental illness: police power and parens patriae. As public mental hospitals became less available as loci in which to exercise these functions, governments sought alternative means to achieve the same ends. One prominent but quite controversial means is involuntary outpatient treatment (IOT). While the concerns about IOT have been myriad, one often alluded to but never documented is that of “net-widening.” That is, once IOT became available, it would be applied to an ever greater number of individuals, progressively expanding the margins of the designated population to whom it is applied, despite the formal standard for its application remaining constant. We tested the net-widening belief in a naturalistic experiment in Massachusetts. We found that net-widening did not occur, despite an environment strongly conducive to that expansion. At this time, whatever the arguments against IOT might be, net-widening should not be one of them.     

The bush administration's security strategy: Implications for transatlantic relations

There are signs of growing transatlantic estrangement over multiple international issues. An important catalyst for this estrangement is the National Security Strategy (NSS) that the Bush administration promulgated in September 2002, a document that is a detailed imperial blueprint. Despite its pretensions, however, it is not a global strategy, but instead appears to apply primarily to the 'Islamic Arc'--the territory from North Africa to the border of India. The administration's security strategy has important implications for the transatlantic relationship, since the United States is encouraging NATO to become a junior partner for missions throughout the Islamic Arc. Given the growing divergence in US and European interests and policy perspectives, the role that the Bush administration envisages for NATO is probably not sustainable. The 'West' was an artificial geostrategic concept that needed an extraordinarily threatening common adversary (the Soviet Union) to give it substance. The US and its allies will continue to drift apart strategically, and the Bush administration's security strategy may actually hasten that process. It is uncertain, however, whether the European Union will achieve the cohesion necessary to counterbalance US power. The main task facing statesmen on both sides of the Atlantic is to learn how to disagree about specific policies without becoming disagreeable.     

Accurately assessing elderly fall deaths using hospital discharge and vital statistics data

Historically, fatal injury monitoring and surveillance have relied on mortality data derived from death certificates (DC). However, problems associated with utilizing DC have been well documented. Recently, access to and utilization of hospital discharge data (HDD) have offered a new and important secondary source of data regarding in-hospital deaths. However, studies have shown that discrepancies between the HDD and the corresponding DC often exist. This discrepancy was especially evident when comparing HDD to the vital statistics data (VSD) for deaths by falls among those aged 65 and over in 19 states.This was a retrospective forensic review of elderly (age 65 and over) fall-associated fatalities (E880-E888) identified from HDD and VSD in Allegheny County, Pennsylvania, between 1997 and 1998. Seventy-seven cases were identified, with the original manner of death listed as natural (34), suicide (1), and accidental (42) on the DC. Following a forensic review of the cases, the manner of the death on the DC should have been changed from natural to accidental in 28% (n = 12) of the cases, representing an undercount in the VSD. Undercounts were due to a failure of clinicians to account for the significance of a fall event that contributed to subsequent pathology and death. In addition, in that 22% (n = 17) of the HDD fall-associated deaths, the fall did not contribute directly or sequentially to the underlying cause of death, thereby representing an overcount in the HDD.Based on these findings we recommend (1) elderly fall surveillance systems should only count HDD E-coded falls that demonstrate a serious traumatic injury which directly or subsequently results in death, (2) all in-hospital fall-associated deaths should be reported to and reviewed by coroner/Medical Examiner offices for determination of the cause and manner of death, and (3) physicians should be better educated in properly completing death certificates.     

The Transformation of the Western State: The Growth of Democracy,Autocracy, and State Power Since 1800

This article uses POLITY II, a new dataset on the authority traits of 155 countries, to assess some general historical arguments about the dynamics of political change in Europe and Latin America from 1800 to 1986. The analysis, relying mainly on graphs, focuses first on the shifting balance between democratic and autocratic patterns in each world region and identifies some of the internal and international circumstances underlying the trends, and deviations from them. Trends in three indicators of state power also are examined in the two regions: the state's capacity to direct social and economic life, the coherence of political institutions, and military manpower. The state's capacity has increased steadily in both regions; coherence has increased in the European countries but not Latin America; while military power has fluctuated widley in both regions. The article is foundational to a series of more detailed longitudinal studies of the processes of state growth. Ted Robert Gurr is a professor of government and politics at the University of Maryland and Distinguished Scholar at the University's Center for International Development and Conflict Management (Mill Building, University of Maryland, College Park, MD 20742). Among his 14 books and monographs areWhy Men Rebel (awarded the Woodrow Wilson Prize as best book in political science of 1970).Patterns of Authority: A comparative Basis for Political Inquiry (with Harry Eckstein, 1975), andViolence in America, (3d edition. 1989). He is engaged in a long-term global study of minorities' involvement in conflict and its consequences and resolution. Keith Jaggers is a Ph.D. candidate in the Department of Political Science at the University of Colorado and research assistant in the Department's Center for Comparative Politics, Campus Box 333, University of Colorado, Boulder, CO 80309. He is co-author with Will H. Moore of “Deprivation, Mobilization, and the State,” recently published in theJournal of Developing Societies, and is currently working on an empirical study of the impact of war on the growth of the state. Will H. Moore is a Ph.D. candidate in the Department of Political Science at the University of Colorado and research assistant in the Department's Center for Comparative Politics. He is also a co-author with Maro Ellena of a forthcoming article inWestern Political Quarterly on the cross-national determinants of political violence. His current research interests include the resolution of internal wars and the formation of coercive states.     

Insights from Ted Palmer: experimental criminology in a different era

Objectives  

Report insights from the career of the noted evaluation researcher, Ted Palmer, on emerging issues in correctional research and correctional treatment.