Through the Quarantine Looking Glass: Drug-Resistant Tuberculosis and Public Health Governance, Law, and Ethics

The incident in May-June 2007 involving a U.S. citizen traveling internationally while infected with drug-resistant tuberculosis involved the U.S. federal government's application of its quarantine and isolation powers. The incident and the isolation order raised numerous important issues for public health governance, law, and ethics. This article explores many of these issues by examining how the exercise of quarantine powers provides a powerful lens through which to understand how societies respond to and attempt to govern threats posed by dangerous, contagious pathogens. The article considers historical aspects of governmental power to quarantine and isolate individuals and groups; analyzes the current state of quarantine and isolation law in the United States in light of the recent incident with drug-resistant tuberculosis; and explores global aspects of public health governance and law highlighted by this incident.     

An Investigation of a Community-based Intervention for Socially Isolated Parents with a History of Child Maltreatment

A randomized field trial was conducted to test the effectiveness of a community-based intervention to enhance the prosocial interaction and psychological well-being of urban, Head Start parents with a history of child maltreatment. One-hundred and sixteen socially isolated parents participated. Forty of these parents had a history of child maltreatment. Maltreatment and non-maltreatment parents were assigned randomly to intervention and control conditions. The intervention involved 10 group-training sessions focusing on the relationship between stress and social support. Analyses revealed a significant main effect for the intervention group with intervention parents reporting lower levels of stress and higher levels of social activity than controls. No main effects for maltreatment status or maltreatment by intervention group interactions were found. Implications for community-based treatment were discussed.     

Outsourcing Oversight: A Comparison of Monitoring for In-House and Contracted Services

The public sector contracting literature has long argued that outsourced services need to be and, in fact, are subject to a more elevated level of scrutiny compared to internally delivered services. Recently, the performance measurement and management literature has suggested that the twin themes of accountability and results have altered the management landscape at all levels of government. By focusing on performance monitoring, the implication is that monitoring levels for internally provided services should more closely approximate those for contracted services. The analysis provided here yields empirical comparisons of how governments monitor the same service provided in-house and contracted out. We find evidence that services provided internally by a government's own employees are indeed monitored intensively by the contracting government, with levels of monitoring nearly as high as those for services contracted out to for-profit providers. In contrast, however, we find strong evidence that performance monitoring by the contracting government does not extend to nonprofit and other governmental service providers, each of which is monitored much less intensively than when comparable services are provided internally. For such service providers, it appears that monitoring is either outsourced along with services, or simply reduced.     

Insurance Market for Global Warming Heats Up: Old Products and New Policies Respond to Climate Change Risks

Climate change, characterized by higher surface and water temperatures, will likely lead to more frequent and severe storms, floods, rising sea levels, wildfires, and loss of a variety of species. The monetary loss attributable to these events could be enormous, resulting in a variety of first-party insurance claims and third-party lawsuits. The availability of insurance coverage to pay these claims will depend on the nature of weather-related losses and the particular policies in force. Insurers have also begun to develop products that pay to rebuild to “greener” standards after fortuitous losses, encourage lower carbon emissions, and provide incentives for the implementation of sustainable business and personal practices.     

COMMENTARY ON WARSHAK'S "BLANKET RESTRICTIONS: OVERNIGHT CONTACT BETWEEN PARENTS AND YOUNG CHILDREN"

In a previous issue of this journal, Richard A. Warshak provided a summary of the developmental literature as it bears on overnight restrictions during custody arrangements. Here, the authors comment on points of agreement and disagreement with Warshak based on their reading of the theoretical and empirical literature on development. Particular reference is made to Warshak's interpretation of attachment theory and research. Points of agreement include the importance of fathers and all caregivers in the infant/young child's life as well as the overstatement in the literature of the significance of separation experiences and a "sensitive period" for attachment. Points of clear disagreement include what the author contends is an erroneous review of the empirical literature on overnights with other caregivers. Based on their review of the data on overnight visitation, the authors conclude on a more cautious note.