Teaching Constructive Dialogue as a Social Medicine Tool for Peace

The social medicine learning communities of which we are a part comprise individuals from Uganda, Rwanda, Zimbabwe, Haiti, the United States, Canada, and Lebanon among other countries. United in an interest to understand and address the social and structural determination of health, learners have spanned a wide range of religious, ethnic, socioeconomic, and racial backgrounds. These diverse social locations have shaped lives in unique ways and given rise to profoundly divergent perspectives on sexual orientation, gender norms, reproductive health, and the role of medicine and health professionals in society among other issues. To navigate these differences and to equip our students with an integral tool for social justice and health equity, we teach constructive dialogue as a tool, amongst many others, for health professionals.     

Least restrictive practice: its role in patient independence and recovery

One of the five overarching principles of the Mental Health Act: Code of Practice is to provide patients with care and treatment which is least restrictive whilst encouraging recovery and promoting independence. However, there is limited research which explores the application of these principles within a medium secure unit. The aims of the research were to explore what are patient’s experiences of least restrictive practices and to what extent do they perceive that least restrictive practices maximise their independence and recovery. Semi-structured interviews were carried out with 12 male inpatients within a medium secure unit. Five themes were evident: Positive Changes, Perceived Lack of Transparency, Social Isolation, Institutionalisation and Normality. It was found that patient’s perceived that there was lack of shared understanding between staff and patients of what is considered least restrictive. Patient recovery was promoted through positive risk-taking, the reduction in the use of seclusion and through the promotion of meaningful activities that resembled life in the community. Nevertheless, patients perceived that there was a lack of opportunities to socialise with patients from other wards. Due to the security level of the hospital patients perceived that independence was not achievable.     

In Dependence: The Paradox of Professional Independence and Taking Seriously the Vulnerabilities of Lawyers in Large Corporate Law Firms

In this article, and drawing on the work of Martha Fineman and others, we deploy a vulnerability lens as an heuristic device to push against the concept of professional lawyer independence as enshrined in statute and promoted by legal services regulators. Using interviews with 53 senior partners and others from 20 large corporate law firms, we show how the meaning and practice of independence are profoundly mediated by the contexts, relationships, and interactions of corporate lawyers’ everyday working lives. Vulnerable to competition from other firms, the demands of clients, the shift over time from ‘trusted advisor’ to ‘service provider', regulatory requirements, pressures to make profit, and so on, these corporate lawyers appeared prone to developing and normalizing potentially risky and irresponsible practices. We therefore argue that a debate about corporate legal regulation is better based upon a richly theorized concept of interdependence that takes seriously the causes and effects of practitioner vulnerabilities in particular circumstances.     

The world at their fingertips? The mental wellbeing of online distance-based law students

In recent years there has been an increased interest in student mental wellbeing within higher education. In terms of legal education, much of this has been focused upon the United States (US) and Australia, with a lack of United Kingdom (UK)-based empirical data available. Although there is now extensive provision of online distance learning options available to UK (and other) law students, there is a notable lack of research into the possible challenges which are specific to this form of tertiary offering. This paper seeks to contribute to the development of research in this area by reporting upon, and analysing, preliminary data gathered from an empirical study of the mental wellbeing of online distance learning law students.     

Animal abuse proclivity: behavioral,personality and regulatory factors associated with varying levels of severity

ABSTRACT

To date, research into adult-perpetrated animal abuse has consisted of studies using forensic and psychiatric samples. Given that animal abuse goes largely unreported, it is unclear whether the findings from the current literature are generalizable to unapprehended, undetected abusers in the community. However, the emergence of proclivity methodologies fills this gap by examining the relationships between animal abuse propensity and factors such as empathy, attitudes towards animals and antisocial behavior. The current study aimed to extend this literature by examining further individual-level variables (i.e. personality traits) and behavioral factors as correlates of animal abuse proclivity and as a function of varying levels of animal abuse severity (e.g. neglect versus severe violence). One hundred and fifty participants took part in this correlational study. We found low extraversion, agreeableness, neuroticism, anger regulation, and illegal behavior to be significant factors related to animal abuse proclivity. We also found low extraversion, anger regulation, and illegal behavior to be significant factors across varying levels of animal abuse severity, but low neuroticism to be a unique factor related to less severe forms of animal abuse proclivity. These findings are further discussed in light of their theoretical and treatment implications.     

Fatal Complications of Aesthetic Techniques: The Gluteal Region

Cosmetic procedures are common and utilize many techniques to obtain aesthetically good outcomes for patient satisfaction with acceptable safety standards. Cosmetic procedures that involve the gluteal region are becoming increasingly popular as various procedures can target the gluteal region such as liposuction, tumescent liposuction, cosmetic filler injections, autologous fat transfer, depot drug delivery, and implants. Complications of cosmetic gluteal procedures can be localized or systemic with systemic complications being responsible for most deaths. These reported systemic complications include sepsis, thromboembolism, fat embolism with or without fat embolism syndrome, macroscopic fat embolism, anesthesia‐related and blood volume abnormalities. We herein report 10 deaths due to elective gluteal cosmetic procedures. Autologous fat transfer (fat grafting, lipoinjection) following liposuction resulted in 8 of 10 fatal outcomes of the gluteal aesthetic procedures. A comprehensive discussion of gluteal anatomy, gluteal contouring procedures, and the approach to such cases is presented along with the autopsy findings of the reported cases.     

The need for a contextual approach in identifying street-connected children for purposes of intervention

Over the years, the major challenge to the protection of street-connected children’s fundamental rights has been the homogeneous conceptualisation of categories of children who fall within the ambit of street-connected children (SCC). As such, often, states – as duty-bearers – have narrowly identified SCC. This article argues that, if the rights of these children are to be effectively guaranteed, the phenomenon of SCC will need to be contextually conceptualised. A contextual approach, it is argued, affords broader protection to all affected children because it places emphasis on children’s interaction with the street, and how it impacts on their fundamental rights. However, because of the well augmented homogeneous definitions of SCC already in place, a contextual approach warrants express delineation so that the broader obligations of duty bearers are made more apparent. Against this backdrop, since the Committee on the Rights of the Child (CRC) is in the process of developing a General Comment (GC) on SCC, this process presents the CRC with a momentous opportunity to make the contextual approach more apparent. Following a brief introduction, the article gives an overview of the varying homogeneous definitions of SCC and their limitations in affording broader protection to children. A brief discussion of the realities of children in street situations in Africa follows. Subsequently, the potential of the forthcoming GC on SCC to clearly substantiate and further the cause of a contextual approach is underscored.     

Abuse and Cruelty in Religious Bureaucracy: The Case of the Anglican Diocese of Newcastle

ABSTRACT

This paper draws on critical theories of organisations to question why child sexual abuse is a frequent correlate of male authority in institutional settings. While acknowledging the role of other risk factors, the paper suggests that the contemporary bureaucratic form is itself conducive to child sexual abuse. This argument is developed through an analysis of Case Study 42 of the Royal Commission into Institutional Responses to Child Sexual Abuse, centred on allegations of sexual abuse by the clergy and laity in the Anglican Diocese of Newcastle. The extensive allegations of abuse in the diocese illustrate how rationalised structures of governance and oversight can facilitate rather than inhibit child sexual abuse. The analysis advanced by the paper contests the assumption that institutional abuse represents the deformation or paedophilic “infiltration” of otherwise neutral organisational arrangements. Instead, the paper emphasises how rationalised institutional structures can mystify relations of domination and promulgate a milieu in which children are viewed instrumentally as the means for the fulfilment of personal drives.