Coordinated community response to family violence: the role of domestic violence service organizations

There is increasing awareness that domestic violence (DV) and child maltreatment often overlap and that there are significant negative consequences to women and children who are victims in the same families. The present study contains data from a participatory evaluation of a multisite national demonstration project on family violence (the Greenbook Initiative), funded jointly by the U.S. Departments of Health and Human Services and Justice. The goal of this initiative was to increase community capacity to assist dually victimized families. This article focuses on the DV service organizations in the demonstration with regard to collaborations with other agencies and work within the DV system to respond to dually victimized families. Findings suggest that DV agencies participated in leadership roles, cross-system collaborations, and cross-system trainings throughout the initiative. Within-agency practice changes were less apparent. Research and policy implications are discussed.     

Competition versus regulation: some empirical evidence

In response to dramatic rises in health care costs, policymakers have been debating the relative merits of regulatory and competitive strategies as a means of containing costs. One major activity espoused by proponents of competition is the growth of health maintenance organizations (HMOs) which, in their opinion, will result in the market better determining efficient levels of utilization and costs. Extending this argument, the larger the percent of the population in a market area who enroll in HMOs, the greater the market-forcing effect of HMOs in reducing overall hospital expenditures; that is, if HMOs are providing lower-cost care, then the fee-for-service system will be forced to reduce costs in order to be competitive. The authors studied the 25 largest SMSAs from 1971-1981, and controlling for environmental conditions in each market, they examined the impact of both HMO growth and regulatory activity on costs and utilization. They conclude that neither competition nor regulation had a significant impact in reducing overall hospital costs. While there may have been some impact in specific communities, no generalizable effect could be observed. However, the authors did find that increases in costs and utilization were essentially driven by supply factors such as the number of hospital beds or medical specialists in a given community.     

What attracts men who batter to their partners? An exploratory study

Men who batter, because of particular personality traits and sense of entitlement, may select partners whom they perceive will be dependent on them, meet their emotional needs, or be "objects" of physical attractiveness. During treatment intake, 181 offenders responded to the question, "What attracted you to her (your partner)?" We explored whether men who mentioned their own needs or her physical traits would engage in more frequent and severe violence and would have specific forms of personality disorder dimensions or personality traits. Six categories of attraction, including "her physical traits" and "his needs," were derived from the men's responses. The results showed that men who focused on their partners' physical attractiveness were more likely to be violent after treatment. Men who cited their own needs for their attraction had higher scores on borderline personality, alcohol abuse, and psychotic thinking and lower scores on compulsive-conforming.     

The legal role of medical professionals in decisions to withhold or withdraw life-sustaining treatment: part 2 (Queensland)

This is the second article in a series of three that examines the legal role of medical professionals in decisions to withhold or withdraw life-sustaining treatment from adults who lack capacity. This article considers the position in Queensland, including the parens patriae jurisdiction of the Supreme Court. A review of the law in this State reveals that medical professionals play significant legal roles in these decisions. However, the law is problematic in a number of respects and this is likely to impede medical professionals' legal knowledge in this area. The article examines the level of training medical professionals receive on issues such as advance health directives and substitute decision-making, and the available empirical evidence as to the state of medical professionals' knowledge of the law at the end of life. It concludes that there are gaps in legal knowledge and that law reform is needed in Queensland.