Embracing the new professionalism: self-regulation, mandatory reporting and their discontents

In response to perceived failures in medical self-regulation in Australia, first in two States (for doctors) and now under the National Registration and Accreditation Scheme (for all health practitioners), mandatory reporting of peer status or practice that poses risks to patients has been introduced. Yet now, in response to the lobbying of State and federal health ministers by the medical profession, mainly in relation to the impairment provisions, this is to be reviewed. This column argues that claims concerning the negative consequences for practitioners of mandatory reporting are illogical and lack supporting evidence. There is, however, evidence that the medical profession does not consistently act in accordance with its professed positions in the area of physician impairment and departure from accepted clinical standards. The call for a review of mandatory reporting reflects an outdated model of regulation that does not align with increasing calls for a "new professionalism". In its own interests, but primarily in the interests of patients, the medical profession should embrace new attitudes and practices that will at first appear to threaten the privilege of self-regulation, but on proper scrutiny will be seen as necessary to retain it.     

A supervisor like me: Race,representation, and the satisfaction and turnover decisions of public sector employees

Studies of race representation in public organizations illustrate the importance of bureaucrat race in determining client‐level outcomes. Building “upward” from this research, this study examines how supervisor race impacts outcomes for street‐level bureaucrats using data from a nationally representative sample of public schools. Employing multiple estimation methods, we find that, consistent with the predictions of representation theory, teachers report higher job satisfaction and turn over less often when supervised by an own‐race principal. We also find that race congruence impacts the tangible and intangible organizational benefits teachers receive, and, moreover, that race congruence impacts white and African American employees differently. Most troubling, we find evidence that black teachers earn substantially less in supplemental pay when they work for a white principal, even when compared to white teachers in the same school. © 2011 by the Association for Public Policy Analysis and Management.     

Cosmetic surgery in Australia: a risky business?

Cosmetic surgery is increasing in popularity in Australia and New Zealand, as it is across other Western countries. However, there is no systematic mechanism for gathering data about cosmetic surgery, nor about the outcomes of that surgery. This column argues that the business of cosmetic surgery in Australia has questionable marketing standards, is conducted with little scrutiny or accountability and offers patients imperfect knowledge about cosmetic procedures. It also argues that while medical practitioners debate among themselves over who should carry out cosmetic procedures, little attention has been paid to questionable advertising in the industry and even less to highlighting the real risks of undergoing cosmetic surgery. While consumers are led to believe that cosmetic surgery is accessible, affordable and safe, they are sheltered from the reality of invasive and risky surgery and from the ability to clearly discern that all cosmetic procedures carry risk. While doctors continue to undertake advertising and engage in a territorial war, they fail to address the really important issues in cosmetic surgery. These are: providing real evidence about what happens in the industry, developing stringent regulations under which the industry should operate and ensuring that all patients considering cosmetic surgery are fully informed as to the risks of that surgery.     

Visual detection of trace nitroaromatic explosive residue using photoluminescent metallole-containing polymers

The detection of trace explosives is important for forensic, military, and homeland security applications. Detection of widely used nitroaromatic explosives (trinitrotoluene [TNT], 2,4-dinitrotoluene [DNT], picric acid [PA]) was carried out using photoluminescent metallole-containing polymers. The method of detection is through the quenching of fluorescence of thin films of the polymer, prepared by spray coating organic solutions of the polymer, by the explosive analyte. Visual quenching of luminescence (lambda(em) approximately 400-510 nm) in the presence of the explosive is seen immediately upon illumination with near-UV light (lambda(ex)=360 nm). Detection limits were observed to be as low as 5 ng for TNT, 20 ng for DNT, and 5 ng for PA. In addition, experiments with normal production line explosives and their components show that this technology is also able to detect composition B, Pyrodex, and nitromethane. This method offers a convenient and sensitive method of detection of trace nitroaromatic explosive residue.     

Review article: Realising realism's role in us policy towards Europe

Adam Bronstone, European Union ‐ United States Security Relations. Transatlantic Tensions and the Theory of International Relations. Basingstoke: Macmillan, 1997. Pp.viii + 282, biblio., index. £45. ISBN 0–333–69136–9.

Robert L. Hutchings, American Diplomacy and the End of the Cold War. An Insider's Account of US Policy in Europe, 1989–1992. Baltimore: Johns Hopkins University Press, 1997. Pp.xx + 456, illus., biblio., index. £33. ISBN 0–8018–5620–5.

Thomas Risse‐Kappen, Cooperation Among Democracies. The European Influence on US Foreign Policy. Princeton: Princeton University Press 1995. Pp.x + 250, biblio., index. £30.50. ISBN 0–6910–3644–6.     

Birds of a Feather Fight Together: Status-Enhancing Violence,Social Distance and the Emergence of Homogenous Gangs

Objectives

This study proposes a theoretical framework for understanding two empirical findings from gang research: (1) gangs are generally racially homogenous, even in heterogeneous environments, and (2) gang violence tends to be intra-racial. We draw from the extensive literature on street gangs as well as from research on group formation and status-enhancing behavior to develop a theoretical model of gang formation.

Methods

Using game theory, we model the simultaneous decisions of individuals to commit status-enhancing acts of violence and to seek protection by joining a gang. We then conduct computer simulations to examine the resulting patterns of violence and gang composition.

Results

We demonstrate that as long as some social distance exists between racial groups in a community, gang violence will be intra-racial and gangs will be homogenous. We find that our results are robust to a number of simple variations of the model and allow us to generate several hypotheses about the nature of gang formation and patterns of violence.

Conclusions

When violence is motivated by socially constructed rewards, socially closer targets are likely to yield greater rewards. In such a system, individuals must reduce their likelihood of victimization by entering a social contract of non-violence (i.e. gang membership) with individuals who might view them as status-enhancing targets (i.e. socially close individuals). The result is that gangs are made up of socially close individuals interested in attacking other socially close individuals. Therefore, gangs tend to be racially homogenous and violence is overwhelmingly intra-racial.

     

Social Network Position of Gang Members in Schools: Implications for Recruitment and Gang Prevention

Schools are venues in which gang and non-gang involved youth converge. It is therefore a likely venue for gang recruitment. The extent to which this occurs depends upon the ability of gang members to connect with non-gang members. In this study, we compare the social network positions of high social status gang members who are well integrated into school networks with low status members who are not. Using network data from the Add Health study (n = 1,822), we find that not only are high status gang members strongly embedded within school networks, but that this status is driven by their ability to connect with non-gang members rather than other gang members (indicated by the high number of friendship nominations they receive from non-gang members). These gang members are potentially in optimal positions to influence others to join gangs. The implications of these results for school-based gang prevention programs are discussed.     

Further Validation of the Test of Memory Malingering (TOMM) Trial 1 Performance Validity Index: Examination of False Positives and Convergent Validity

Assessment of performance validity is an essential part of a neuropsychological evaluation, with the inclusion of two or more performance validity tests (PVTs) becoming routine practice. Considering the time to administer multiple tests, there has been some support for use of the Test of Memory Malingering (TOMM) Trial 1 (T1) as an independent, “one and done” PVT. Notably, cutoffs for TOMM T1 need further validation, with an emphasis on minimizing false-positive classifications among those with bona fide cognitive impairment. In a clinically referred sample of 127 veterans, this study examined the role of cognitive impairment in TOMM performance and the utility of a TOMM T1 as an independent PVT. Examinees were administered the TOMM and three additional PVTs as part of a comprehensive neuropsychological battery. Sixty-eight percent of examinees were classified valid (35% of valid examinees were cognitively impaired). TOMM T1?≤?40 had excellent observed sensitivity (83%) and specificity (93%) overall, with minimal false-positive classification. TOMM T1 was also significantly correlated and concordant with other memory-based PVTs. Given score ranges and failure rates for TOMM T1?≤?40 among those with neurological/neurocognitive conditions, scores in the 37–40 range may merit administration of additional TOMM trials to maximize accuracy in identifying valid-cognitively impaired versus noncredible performance. Otherwise, an abbreviated TOMM administration (i.e., only T1) using a cutoff of ≤?40—in conjunction with one or more additional PVTs—may be sufficient for detecting noncredible/invalid test performance in the absence of known or suspected neurological/neurocognitive disorders.     

Thirteenth-Century Origins of Punitive or Exemplary Damages: The Statute of Westminster I (1275) and Roman Law

This article highlights the importance of the Statute of Westminster I in the history of the concept of punitive or exemplary damages in the Anglo-American legal tradition. Maitland had long ago noted that its provisions allowing for double and triple reparation had similarities to duplum and triplum remedies in Roman law. But this tentative hypothesis has not been further explored by scholars. In this article I suggest that the antecedents for the provisions on multiple reparation in Westminster I may lie in the Roman law delicts of furtum or iniuria and their links to actions in duplum and triplum, based on conceptual similarities in the substantive nature of the wrongdoing. This article explores possible avenues for direct Roman law influence as well as indirect means of transmission, namely by non-Roman law sources of concepts analogous to Roman law.