Patterns of childhood sexual abuse characteristics and their relationships to other childhood abuse and adult health

The purpose of this study was twofold: (a) to cluster women who experienced childhood sexual abuse (CSA) according to their shared patterns of CSA characteristics and (b) to examine differences across clusters on measures of other childhood abuse and adult health. Seven CSA characteristic variables were used for cluster analysis. The seven-cluster solution that emerged ranged from a noncontact extrafamilial CSA cluster that occurred without force only once to the most severe clusters in which penetration by an intrafamilial or extrafamilial abuser occurred multiple times with force. Significant differences among clusters were found for childhood emotional abuse and physical abuse, adult physical and psychosocial symptomatology, and depression. There were no significant differences for health care utilization. The results promote further understanding of which victims of CSA are more likely to have experienced other forms of childhood abuse and which victims are more at risk for poor health in adulthood.     

NGOs in a global future: marrying local delivery to worldwide leverage

This article argues that global trends are creating unprecedented opportunities for civic action at local, national and international levels. Three interconnected trends are identified: economic and cultural globalization, and the inequality and insecurity they breed; the increasing complexity of humanitarian action in response to ethnic conflict and intrastate violence; and the reform of international co‐operation to deal with the problems these trends create. In response, new forms of solidarity are emerging between citizens and authorities at different levels of the world system. It is these new relationships—expressed through partnerships, alliances and other forms of co‐operation—that provide the framework for NGO interventions, but they also require major changes in NGOs themselves. Chief among these changes are a move from ‘development‐as‐delivery’ to ‘development‐as‐leverage’; new relationships with corporations, elements of states, the military, international institutions and other groups in civil society; and new skills and capacities to mediate these linkages. These developments call for major changes in NGO roles, relationships, capacities and accountabilities. Copyright © 1999 John Wiley & Sons, Ltd.     

Food subsidy policy and democracy: A comparative study of Sri Lanka and Zambia

This article compares the political processes involved in food subsidy policies in Sri Lanka and Zambia and relates these experiences to the concept of ‘good government’ that western nations have been promoting. The Sri Lankan case illustrates the workings of the policy process in a democratic political system, albeit one that centralized considerably in the 1980s. The Zambian case illustrates the policy process in a one‐party state that returned to multi‐party democracy in 1991. Despite their very different political systems the nature of food subsidy policies show striking similarities: decades of high levels of non‐targeted consumer subsidies that placed great demands on public expenditure until radical reductions in expenditure occurred following an electorally based change of government and multilateral agency pressure. Differences in the processes of policy formulation and public accountability are explored. They reveal that neither case study functioned as democratic theory would predict. The conclusion points to the inability of the concept of ‘good government’ to model the empirical experiences reported in the article.     

Human Cutaneous Myiasis by the Australian Sheep Blowfly,Lucilia cuprina (Diptera: Calliphoridae), in Oklahoma

This case report describes an incident of myiasis in Oklahoma City, Oklahoma. Paramedics treated a 53‐year‐old man in the field when he suffered cardiac arrest. He was intubated by the paramedics and transported to an emergency room, where he received two stents and a balloon pump. He was found to have a GCS of three and remained in the hospital for 7 days before passing away. After his death, the breathing tube was removed, revealing the presence of several maggots. On closer inspection, the dipteran larvae were found in both the oral and nasal cavities. Four of these larvae were reared to adulthood and identified as Lucilia cuprina (Weidemann) (Diptera: Calliphoridae), commonly known as the Australian sheep blowfly, by the Biology Department of the University of Oklahoma. Based on the fly's life cycle and rate of development, the infestation is suspected to be hospital acquired.