Women as patients: A problem for sex differences research

Using the feminist critique of the health care system as a starting point, this article indicates some of the relevant issues facing women as patients in general practice: lack of control over our bodies and reproductive functions, ‘psychologizing’ of women's complaints, the medicalization of social problems experienced by women as a group. Current research on women as patients is primarily of the sex-differences tradition, i.e. the differences between men and women patients are investigated. The results of this research are critically discussed. My contention is that such research, aside from being methodologically impoverished, is—from a feminist point of view—counterproductive. Some directions for alternative research in this area are given.     

Freedom to do What you are Told: Senior Management Team Autonomy in an NHS Acute Trust

Arguably, the government's aim of using the reward of 'earned autonomy' and Foundation Trust status as an incentive to improve performance in the NHS will only be effective if Trust managers view greater autonomy as both desirable and realistic. This article examines this issue by investigating the extent to which members of an NHS Trust's senior management team perceive themselves as autonomous, the factors most likely to hinder their ability to operate autonomously, and the extent to which managers want greater autonomy. In the event, autonomy was largely restricted by extensive centrally dictated targets. Entrenched professional interests and a lack of managerial skills on the part of clinician managers suggested limitations on the extent to which autonomy can be realistically devolved. Additionally, there was little belief among managers that greater autonomy would enable healthcare services to be delivered more effectively.     

Dirty diving. Sudden death of a SCUBA diver in a water treatment facility.

We report a case of a sudden death in a SCUBA diver working at a water treatment facility. The victim, an employee of the facility with a specialty in electronics, was a sport diver not qualified in commercial diving. While attempting to clean sludge from a blocked drain 25 ft under water, the diver was suddenly pinned against the drain valve when the sludge plug was broken up. We review the mechanics of the incident and the actual cause of death, asphyxia, as opposed to drowning. We believe this to be the first reported case of traumatic (pressure) asphyxia in a SCUBA diver.     

BLM,the Administrative Presidency,and Policy Shifts: Policy Tools Affecting Oil and Gas Operations

This paper addresses change in oil and gas policies pushed by the U.S. Bureau of Land Management (BLM) during the administrations of Presidents George W. Bush and Barack Obama. Administrative policy changes occurred not only because of election outcomes and the emergence of new governing coalitions but BLM's selective utilization of policy tools such as rulemaking, planning, environmental impact analyses, and the use of discretionary authority to increase or relax enforcement decisions. The data reveal that BLM put more emphasis on the use of discretionary authority to limit environmental inspections and to limit environmental reviews of proposed drilling projects under Bush while agency officials gave priority to adopting new planning procedures to allow greater stakeholder input under Obama as well as increasing the number of environmental inspections.     

This May Come As a Surprise: How Prior Knowledge of Information in a Fear Appeal is Associated with Message Outcomes

Two related studies were performed aimed at finding if and how prior knowledge of threat and efficacy information in a fear appeal message is associated with message outcomes (attitude and behavioural intentions). the extended Parallel Process model (ePPm) (Witte 1992; 1998) served as theoretical framework for one study about a chlamydia fear appeal (n = 57) and another about an alcohol abuse fear appeal (n = 59). Findings from both studies suggest that prior knowledge of threat information is hardly relevant for readers’ reactions to a fear appeal message. Prior knowledge of efficacy information, however, proved to play a more important role, most often in a positive way. Findings from both studies furthermore suggest that the ePPm may be incorrect in assuming that individual differences – in this case, in prior knowledge – may only affect fear appeal outcomes in an indirect way, that is through different perceptions of threat and efficacy.     

The effects of the (fentanyl-fueled) drug overdose epidemic on medicolegal death investigation in the United States

The evolving opioid epidemic in the United States, fueled by illicit fentanyl, has greatly increased deaths from illicit drug use. These nonnatural deaths require formal death investigation. The National Association of Medical Examiners states in its Forensic Autopsy Performance Standards that autopsy remains a necessary component for proper investigation of suspected acute overdose deaths. If a death investigation office lacks adequate resources to investigate all deaths under its jurisdiction while meeting expected standards, then that office may be forced to consider altering its protocols for investigation by changing the types of deaths investigated or the extent of its investigations. Drug death investigations take longer to complete because novel illicit drugs and mixtures of drugs complicate toxicological analyses, prolonging a family's wait for completion of a death certificate and autopsy report. Public health agencies must also wait for results, but some agencies have developed mechanisms for rapid notification of preliminary results to allow timely deployment of public health resources. The increased deaths have strained the resources of medicolegal death investigation systems throughout the United States. Given the significant workforce shortage of forensic pathologists, newly trained forensic pathologists are too few to meet the demand. Nevertheless, forensic pathologists (and all pathologists) must make time to present their work and themselves to medical students and pathology trainees to encourage an understanding of the importance of quality medicolegal death investigation and autopsy pathology and to provide a model that can encourage interest in a career in forensic pathology.     

The Role of Emotion and Cognition in Juror Perceptions of Victim Impact Statements

Recent legislation has contributed to an increasing number of victims participating in the trial process by way of providing victim impact statements (VISs). The present study evaluated jurors’ perceptions of VISs in a jury-eligible sample. Participants were 402 jury-eligible community members in the southwestern United States. Using a vignette-based method, VIS presence and content (i.e., Victim Harm versus Victim Emotion information) were examined for their influence on sentencing decisions and blame attribution. Individual differences of need for affect (NFA) and need for cognition (NFC) were featured as moderators of these relations. Notable results included significantly lengthier sentencing recommendations and decreased levels of victim blame in the presence of a VIS, regardless of content. In addition, juror NFC was significantly positively associated with perpetrator blame, while NFA moderated the relation between VIS content and sentencing length. The presence of a VIS impacted blame and sentencing, although jury panel member individual differences moderated such effects. Implications for victim rights policy, trial consultation, and social–emotional theory are discussed.     

The Effect of Previous Traumatic Injury on Homicide Risk

Research has reported that a strong risk factor for traumatic injury is having a previous injury (i.e., recidivism). To date, the only study examining the relationship between recidivism and homicide reported strong associations, but was limited by possible selection bias. The current matched case–control study utilized coroner's data from 2004 to 2008. Subjects were linked to trauma registry data to determine whether the person had a previous traumatic injury. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for the association between homicide and recidivism. Homicide risk was increased for those having a previous traumatic injury (OR 1.81, 95% CI 1.09–2.99) or a previous intentional injury (OR 2.53, 95% CI 1.24–5.17). These results suggest an association between homicide and injury recidivism, and that trauma centers may be an effective setting for screening individuals for secondary prevention efforts of homicide through violence prevention programs.     

Evolution of the Global Jihad: Female Suicide Bombers in Iraq

Female suicide bombers are increasingly seen in conflicts throughout the world; in recent years, they have become much more prevalent in religious-fundamentalist conflict. Specifically, global jihadist groups are increasingly incorporating female suicide bombers into their operations, a significant ideological and operational shift for most of these groups. Jihadist groups are using women to fill a recruiting void, to achieve tactical surprise, and for strategic purposes. Female suicide bombers are likely to emerge in jihadist conflicts throughout the world, from Nigeria to Pakistan and beyond.