Defense planning in the fog of peace: the transatlantic currency conversion conundrum

ABSTRACT

Resource allocation to and within defense budgets is grand strategy. NATO and the EU coordinate defense planning and encourage fair burden-sharing among their members. We analyze the effect of agreed planning processes, namely the “NATO Defense Planning Process (NDPP)” on the conversion of political will to resources and then to capabilities development across the transatlantic security community. In a “fog of peace” featuring diverse threats, and in which allies may disagree on strategic rivals and sources of risk, national and regional political economies shape strategy, not the other way around.     

Medical liability and health care reform

We examine the impact of the Affordable Care Act (ACA) on medical liability and the controversy over whether federal medical reform including a damages cap could make a useful contribution to health care reform. By providing guaranteed access to health care insurance at community rates, the ACA could reduce the problem of under-compensation resulting from damages caps. However, it may also exacerbate the problem of under-claiming in the malpractice system, thereby reducing incentives to invest in loss prevention activities. Shifting losses from liability insurers to health insurers could further undermine the already weak deterrent effect of the medical liability system. Republicans in Congress and physician groups both pushed for the adoption of a federal damages cap as part of health care reform. Physician support for damages caps could be explained by concerns about the insurance cycle and the consequent instability of the market. Our own study presented here suggests that there is greater insurance market stability in states with caps on non-economic damages. Republicans in Congress argued that the enactment of damages caps would reduce aggregate health care costs. The Congressional Budget Office included savings from reduced health care utilization in its estimates of cost savings that would result from the enactment of a federal damages cap. But notwithstanding recent opinions offered by the CBO, it is not clear that caps will significantly reduce health care costs or that any savings will be passed on to consumers. The ACA included funding for state level demonstration projects for promising reforms such as offer and disclosure and health courts, but at this time the benefits of these reforms are also uncertain. There is a need for further studies on these issues.     

The time-dependant post-mortem redistribution of antipsychotic drugs

The post mortem redistribution of ten commonly prescribed antipsychotic drugs (APs) was investigated. Femoral blood was collected from 273 cases at admission to mortuary (AD) and at post-mortem (PM). The PM samples were collected at various times up to nine days after admission and the sample pairs analysed using LC-MS/MS. The drugs included in this study were 9OH-risperidone (paliperidone), amisulpride, chlorpromazine, clozapine, haloperidol, olanzapine, promethazine, quetiapine, risperidone, and zuclopenthixol. Haloperidol, quetiapine and risperidone showed minimal changes between AD and PM specimens, whereas the majority of drugs showed significant changes between the sample pairs collected at different time points post mortem (p<0.01) in addition to an average concentration change greater than the uncertainty of measurement of the applied method. Average increases in blood concentrations after admission to the mortuary ranged up to 112% (chlorpromazine and olanzapine) but also decreases up to -43% (9OH-risperidone) were seen. There were large standard deviations between sample pairs and substantial day-to-day unpredictable changes that highlight the difficulty in the interpretation of drug concentrations post-mortem. Based on the presented data, we recommend that specimens for toxicological analysis should to be taken as soon as possible after admission of a deceased person to the mortuary in order to minimise the effects of the PM interval on the drug concentration in blood.     

Identification of 2-hydroxymethyl-olanzapine as a novel degradation product of olanzapine

Olanzapine (OLZ) is amongst the most commonly prescribed antipsychotic drugs and is associated with substantial instability. The aim of this study was to investigate the instability of OLZ and to identify the degradants formed from its breakdown. Three experiments were conducted to monitor the degradation of OLZ and the formation of degradants in blood (1), water (2), and post-extraction at 4 °C (3). All three sample sets were analysed in duplicate and repeated in the absence (A) and presence (B) of 0.25% ascorbic acid. One degradant was identified in sample sets 2A and 3A with m/z 329 and confirmed as 2-hydroxymethyl-OLZ (2-OH-OLZ) using LC-MS techniques. The addition of 0.25% ascorbic acid slowed the degradation of OLZ down in all three experiments and inhibited the formation of 2-OH-OLZ in sample sets 2A and 3A. To investigate the influence of oxygen on the degradation of OLZ and the formation of 2-OH-OLZ in water, an additional experiment (4) was conducted. Sample sets were prepared containing different vortexing or sonication steps in order to alter the oxygen content in the samples. Statistical analysis confirmed that degradation increased significantly following vortexing for 1 min while sonication did not affect the rate of degradation of OLZ further suggesting the involvement of oxygen in the degradative processes. 2-OH-OLZ was only identified as a degradant of OLZ in aqueous solutions. It also degrades over time but its product is currently unknown and is under investigation.     

An assessment of the repeatability of pubic and ischial measurements

Forensic anthropologists frequently use measurements of the human skeleton to determine sex and ancestry. Since the establishment of the Daubert criteria of admissibility of scientific evidence to court, methodologies used by anthropologists came under severe scrutiny. It is therefore important to ensure that the osteometric standards that are used in skeletal analyses are clearly explained, repeatable and reliable. Adams and Byrd (2002) found that measurements of the pelvis that originated from a point inside the acetabulum could not be repeated accurately. The purpose of this paper was to use three different sets of pubic and ischial measurements to establish whether they can be repeated with high precision between four different observers, and also by the observers themselves. Generally, high levels of repeatability were obtained, with intra-class correlations (ICC) above 0.8. Pubic and ischial measurements using a point in the acetabulum as origin performed the worst (ICC values of 0.82 and 0.79 respectively for inter-observer repeatability), whereas other methods performed better with ICC values above 0.9. It is advised that pubic and ischial measurements should be taken using the origin of the iliac blade as landmark.     

The phenomenology and course of depressive syndromes in pre-trial detention

This study focuses on the prevalence, the phenomenology and the course of depressive syndromes in pre-trial confinement. In the course of the first examination, socio-biographic data and information pertaining to subjects' psychiatric and forensic record and their current situation in imprisonment were collected from a random sample of 105 male prisoners in a Berlin pre-trial detention center, with the help of a semi-structured interview. The Beck Depression Inventory (BDI-II) and the Hamilton Depression Rating Scale (HAMD), each a self-rating questionnaire, taken together with a clinician rating were successively performed to assess the level of depression. A further examination was conducted approximately three weeks later. The subjects in the follow-up group (n=67) were questioned in a semi-structured follow-up interview regarding their confinement conditions and were requested again to fill in the BDI-II and HAMD questionnaires. The statistical analysis compares the results from administration of the two instruments at two points in time. Individual's symptoms of depression as well as potentially aggravating or protective factors relating to the development of depressive symptoms are taken note of separately. The results of the study reveal the prevalence of mild depressive syndromes in a pre-trial prison population and a tendency to improve within the period of pre-trial confinement.     

15 years later: Post 9/11 support for increased security and criminalizing muslims

Islamophobia appears to be growing, becoming a mainstream ideology in the United States. Despite the current spike in anti-Islamic sentiment and fear of the Islamic “other,” these ideas are not new and can be traced back to the September 11, 2001, terrorist attacks. Using survey data collected only months after the attacks (N = 422), this study uses an integrated threat framework to examine predictors of public support for increased security in the United States. The results show that perceived personal threat and support for policies that criminalize Muslims predict support for security policies that compromise civil liberties. This is especially true among older individuals, conservatives, individuals less inclined towards individual freedom, and those living in the Northeast or in the South.     

Force,Stress, and Decision-Making Within the Belgian Police: the Impact of Stressful Situations on Police Decision-Making

Stress and fear are inevitable aspects of the police job and may have a large impact on police officers’ decision-making process. Many studies have explored how stress and fear may influence assessments of police officers, especially with regard to the use of force. This article aims to contribute to this research domain by reporting the findings from two empirical studies among Belgian police officers: a quantitative study of police officers’ attitudes towards and experiences with the use of force and a qualitative study on the influence of stress and emotions on officers’ decision-making and assessment abilities and accuracy of shooting. Both studies confirmed that stress and fear are often present in Belgian police practice. One of the main findings is that Belgian police officers are anxious about the consequences of their actions because they know they will be held accountable for them. The pressure that results from this accountability can make it even more difficult for police officers to react to stressful situations. Therefore, we need to look for the right balance in this difficult position, by providing tools that support police officers in making daily decisions, and help them do their job as effectively as possible.