Inter- and intra-subject variability in ethanol pharmacokinetic parameters: effects of testing interval and dose

Calculation of a blood alcohol concentration (BAC) at the time of an offence by forward or back-extrapolation, using population average values for ethanol pharmacokinetic parameters or a single estimate of individual specific parameters, ignores the possibility of inter- and intra-subject variability. In order to estimate inter- and intra-subject variability in the elimination rate and absorption rate, BAC was measured over time in 12 male volunteers on 4 occasions. Subjects received 0.44 g kg(-1) body weight of ethanol on the first study day, and 0.70 g kg(-1) body weight on subsequent study days 1, 11 and 12 weeks later, to enable comparisons in variability over short and long time periods and when the same or different doses were administered. Evidence of both inter- and intra-subject variability was found, with inter-subject variability substantially smaller than intra-subject variability when the dose varied. Forensically important differences in pharmacokinetic parameters were observed within individuals between occasions. These findings could have an important impact on medico-legal issues related to ethanol pharmacokinetics.     

The Internal Structure of the Child Depression Inventory in Russian and UK Schoolchildren

The internal structure of a self-report rating scale for depressed mood for schoolchildren—the Child Depression Inventory (CDI)—was examined in both a Russian and a UK sample. The internal reliability and consistency of the scale was high in both samples, and factor analysis revealed that the internal structure of depressed mood was similar in both samples, and further that it was also similar for boys and girls across the two countries. The results support the use of the CDI to measure depressed mood in research with non-Western samples.     

Medicare coverage, Medicare costs, and medical technology

One possible approach to containing Medicare costs involves explicit changes in Medicare's coverage policy with respect to medical technology. This paper first describes the development and diffusion of medical technology in general and then describes how technologies are identified, assessed, and approved for payment by Medicare. Currently, cost is neither a criterion nor an explicit issue in coverage decisions, although coverage policy is an integral part of payment policy. A combination of policies to reduce the rates of adoption and use of certain technologies is needed--including cost considerations in technology assessments for coverage decisions, limiting diffusion of technology to certain providers and sites, limiting utilization to certain indications, and tightening administrative processes. Finally, the interaction between coverage policy and DRG payment needs to be explored more thoroughly.     

Vote early,vote often? Tele–democracy in European cities

This paper presents the detailed results of an empirical survey on tele–democracy in 31 European cities covering 14 states. It shows that progressive city–administrations in Europe are early adopters of tele–democracy with a diffusion rate of 72 per cent. Analysis of the survey results illustrates that cities are using tele–democracy to improve service access and the quality of services. This research shows that electronic or Internet voting is a priority for only a minority of cities. The paper suggests a typology of tele–democracy and makes wide–ranging policy suggestions. In the debate over whether information and communications technologies will have a beneficial or detrimental effect on the quality and legitimacy of local government, this paper takes an optimistic stance based on the evidence of the survey.     

美国工商界道德意识面面观

调查显示,美国有相当数量的工商界人士在本人的道德标准与企业组织要求之间进退两难。文章以准确的数据反映了美国社会工商界道德观念和行为的现状,并根据心理学家劳伦斯·科尔勃格的道德发展理论分析了经理人员不良行为产生的原因。文章分析了美国宇宙飞船“挑战者”号的失事这一案例,提出了现有的伦理道德理论和标准能否恰当地解决新技术、新形式组织和新的社会制度带来的责任问题。     

Mediation and Restorative Justice in Belgium

In this article we present, discuss and try to evaluate initiatives which were recently introduced into the Belgian criminal justice system, aimed at the development of creative answers to crime that avoid the use of traditional prison sentences. We decided to focus this analysis on the practice of mediation as it is actually considered the most innovative approach to the crime problem. Mediation as a problem-solving intervention has to be considered in direct relation to the discussion of the purpose of the criminal justice system. By putting the emphasis on the dialogue between the victim and the offender, a common solution is worked out with the help of a mediator. In this way reparation, redress and sometimes even reconciliation become core values of the penal action.     

Finkelhor's precondition model of child sexual abuse: A critique

Abstract

This paper critically discusses an extremely influential multi-factorial theory of child molestation, Finkelhor's Precondition Model. This model was one of the first comprehensive theories of the sexual abuse of children and represents a significant achievement. It provides a clear framework for approaching the study of men who have sexually abused children and has lead to both clear treatment goals and clinical innovations. It has rarely, however, been systematically critically examined and the cogency of its core constructs evaluated. Our analysis suggests that alongside its strengths, Finkelhor's Precondition Model has some conceptual problems. It suffers from vagueness; contains overlapping constructs; and a rich array of vulnerability factors that require teasing out and clarification. The model's attempts to provide a taxonomy highlight the diversity inherent in child sexual abuse, but it has not yet provided a structure to adequately inform treatment.