SCIENTIFIC‐BUREAUCRATIC MEDICINE AND UK HEALTH POLICY1

One prominent method for controlling health costs is to find measures for the management of demand. Various options exist for this; and many of them have been tried during the fifty years of the UK's National Health Service. Current policy now focuses on what may be called “scientific‐bureaucratic medicine.” This policy is based on the assumptions that valid medical knowledge is derived from accumulated research evidence and that such knowledge should be implemented through clinical guidelines which are enforced to some extent. This UK development has parallels with the US Agency for Health Care Policy and Research whose experience, therefore, raises some policy issues for the UK.     

MEDIATING WITH HIGH-CONFLICT COUPLES

Models of mediation based on negotiation assume that participants can think and act rationally, whereas in reality, when individuals are overwhelmed by anger and pain, their capacity for reason and logic diminishes. Family mediators need to appreciate the intensity of the irrational feelings and reactions they see in mediation and to consider their personal impact. Mediators can help to contain family crises by adapting the family crises by adapting the model and methods in this article to fit different levels and patterns of conflict. An understanding of systems theory is particularly helpful in considering the functions of conflict and varying needs to maintain conflict. This article suggests that mediators can use different kinds of nonverbal and verbal communication and surprise those who expect mediators to give them a stock response.     

Will the introduction of an emotional context affect fingerprint analysis and decision-making?

Fingerprint identification relies on an expert's ability to accurately recognise differences and similarities in friction ridge detail. The process is open to the questioning of an expert's ability to accurately analyse and interpret friction ridges. It has been suggested that the interpretation and analysis of fingermarks becomes more subjective as clarity decreases and as a consequence the expert is more vulnerable to external stimuli. An experiment involving 70 fingerprint experts was conducted to establish whether the introduction of an emotional context would alter the experts' judgement of an ambiguous or poor quality mark. The emotional context did have a perceived effect on the experts' analysis, as more stated they were affected by the information they were given. However, it did not have any actual effect on their final opinions as no difference was observed between the high- and low-emotional contexts.     

Late adolescents' perceptions of their relationships with their parents: Relationships among deidealization,autonomy, relatedness,and insecurity and implications for adolescent adjustment and ego identity status

Questionnaire data from 376 undergraduates (mean age=19.3 years) were used to test a model describing interrelationships among deidealization, relatedness, autonomy, and insecurity in late adolescents' relationships with their parents. As expected, deidealization predicted greater autonomy and less relatedness (i.e., more disengagement), greater disengagement predicted greater insecurity, and greater insecurity predicted less autonomy. However, disengagement from parents proved to be a double-edged sword in that it was linked not only to insecurity, but also to feelings of greater separateness and self-directedness in relation, to parents. Additional analyses identified significant associations between the adolescent/parent relationship variables and the adolescents' psychological health and ego identity status.Received her Ph.D. from Yale University. Major interests are in parent/child relationships during late adolescence and young adulthood.Received her B.A. from University of Virginia and M.A. from Michigan State University. Major interests are in adolescent development and pediatric psychology.Received her B.A. from Duke University and M.A. from Michigan State University. Major interests are in adult children of alcoholics and adolescent separation/individuation.     

Management standards and development practice in the South African aid chain

The article addresses how South African non‐governmental organisations (NGOs) approach the management of their development activities and the influences upon their approaches. Based on interviews, field visits and programme documents from 40 organisations working in South Africa, the article explores the extent to which NGO programme priorities and adopted management practices arise out of donor conditions, succeed in their stated aims and generate other unintended consequences. Four aspects of contemporary NGO management dynamics are explored: logical frameworks, participatory processes, impact enhancement and financial probity. While donor requirements in these four areas generally impose heavy costs on South African NGOs and poorly achieve their stated aims, the research documents cases, in which local managers were able to work effectively and learn within these constraints, found ways around the more intrusive requirements, or challenged donors to change their policies to permit more equitable donor‐recipient relationships and better development practice. However, an unintended impact of tighter funding requirements is an observable differentiation within the South African NGO sector, with smaller community‐based organisations excluded as larger professional organisations establish more enduring links with international development organisations. Copyright © 2003 John Wiley & Sons, Ltd.     

The Family of the Juvenile Delinquent

Juvenile delinquency has historically been responded to by “de-familization” of the young offender; that is, removal to a training school or other institutional setting. The trend over the past two decades toward deinstitutionalization has meant that delinquent youngsters, who are now remaining in the context of their own communities and families, have been “re-familized.” This poses a major challenge for the juvenile justice system and community, who are stuck with the family but are not sure what to do about it. Little objective and systematic information is available concerning families of delinquents, either as an aggregate group or in individual cases. It is hypothesized that the families are as heterogeneous as are delinquent youngsters, but the juvenile justice system tends to scapegoat families and assumes they are all necessarily dysfunctional. A 10-point continuum of family functioning is proposed. It is suggested that families of delinquent youngsters are found at various points on this continuum: from the extremely impaired or criminogenic family, through the family that has serious problems but has something to offer its youngster if it receives effective help with those problems, to the family of average functioning that can serve as a major rehabilitative resource for the youngster.