Medicalization and social justice

Most social justice critiques of medical care focus upon the allocation of extant, but scarce, resources. In contrast to that focus, this article explores the preallocative arena of factors which shape the supply and availability of medical care. We identify four such factors: (1)medicalization — the tendency to regard as biologically caused various human problems which were in earlier eras ignored or attributed to other causes; (2)social inclusion — the bringing of economically deprived and socially marginal groups into participation in the medical care system; (3)biomedical transcendence — the elevation of biomedically derived concepts of human function into a social and personal world view; and (4)health absolutism — the ideology which holds individuals accountable for their own health and which, contrary to the thrust of the other factors, deemphasizes access and social equity for professionally provided medical care. While these forces all enhance the place of health as a social value, it is by no means certain that they will lead to a society which is more medically just. The article concludes with an appeal for critical analysis of the processes which shape both the medical care system and the broad social concern with medical care.     

Domestic violence between same-gender partners: recent findings and future research

Empirical literature about same-gender domestic violence was relatively nonexistent until the past 20 years, and conducting research with this population about a sensitive topic remains a daunting endeavor. Existing studies reveal similarities between opposite-and same-gender domestic violence in prevalence, types of abuse, and various dynamics, as well as dispel myths and establish a theoretical basis on which to conduct future research. Differences are evident in areas such as help-seeking behaviors and correlates, thus demanding unique assessment and intervention strategies. This article presents further explanation of the latest research, recommendations for future studies, and effective as well as problematic methodological practices about same-gender domestic violence.     

Trauma Characteristics and Posttraumatic Stress Disorder among Adolescent Survivors of Childhood Sexual Abuse

This study examined the relationship between the characteristics of childhood sexual abuse (CSA) and the severity of consequent posttraumatic stress disorder (PTSD), depression, suicidal ideation, and substance use in a sample of 83 female adolescents aged 13–18 years seeking treatment for PTSD. Nearly two-thirds of the sample (60.7 %, n?=?51) reported the perpetrator of the CSA was a relative. A large portion (40.5 %, n?=?34) of the sample reported being victimized once, while almost a quarter of the sample reported chronic victimization (23.8 %, n?=?20). PTSD and depression scores were in the clinical range, whereas reported levels of suicidal ideation and substance use were low. The frequency of victimizations was associated with suicidal ideation. Contrary to expectation, CSA characteristics including trauma type, perpetrator relationship, and duration of abuse were unrelated to PTSD severity, depressive symptoms, or substance abuse.     

Do bone elasticity and postmortem interval affect forensic fractographic analyses?

Forensic fractographic features of bone reliably establish crack propagation in perimortem injuries. We investigated if similar fracture surface features characterize postmortem fractures. Experimentally induced peri- and postmortem fractures were used to assess if fractographic features vary as bone elasticity decreases during the postmortem interval (PMI). Thirty-seven unembalmed, defleshed human femoral shafts from males and females aged 33–81 years were fractured at varying PMIs with a drop test frame using a three-point bending setup and recorded with a high-speed camera. Vital statistics, cause of death, PMI length, temperature, humidity, collagen percentage, water loss, fracture energy, and fractography scores were recorded for each sample. Results showed that fractographic features associated with perimortem fractures were expressed in PMIs up to 40,600 accumulated degree hours (ADH), or 60 warm weather days. Hackle was the most consistently expressed feature, occurring in all fractures regardless of ADH. The most variable characteristics were wake features (78.4%) and arrest ridges (70.3%). Collagen percentage did not correlate strongly with ADH (r = −0.04, p = 0.81); however, there was a strong significant correlation between ADH and water loss (r = 0.74, p < 0.001). Multinomial logistic regression showed no association between fractographic feature expression and ADH or collagen percentage. In conclusion, forensic fractographic features reliably determine initiation and directionality of crack propagation in experimentally induced PMIs up to 40,600 ADH, demonstrating the utility of this method into the recent postmortem interval. This expression of reliable fractographic features throughout the early PMI intimates these characteristics may not be useful standalone features for discerning peri- versus postmortem fractures.     

U.S. child custody outcomes in cases involving parental alienation and abuse allegations: what do the data show?

ABSTRACT

Family court and abuse professionals have long been polarized over the use of parental alienation claims to discredit a mother alleging that the father has been abusive or is unsafe for the children. This paper reports the findings from an empirical study of ten years of U.S. cases involving abuse and alienation claims. The findings confirm that mothers’ claims of abuse, especially child physical or sexual abuse, increase their risk of losing custody, and that fathers’ cross-claims of alienation virtually double that risk. Alienation’s impact is gender-specific; fathers alleging mothers are abusive are not similarly undermined when mothers cross-claim alienation. In non-abuse cases, however, the data suggest that alienation has a more gender-neutral impact. These nuanced findings may help abuse and alienation professionals find some common ground.     

Courtship Violence Among College Students: A Comparison of Verbally and Physically Abusive Couples

This study used a modified version of the Conflict Tactic Scale (Straus, 1990) to measure the expression of verbal and physical aggression among 572 college students (395 females and 177 males) involved in dating relationships over the previous year. Results indicated that 82% (n = 465) of the total sample reported having engaged in verbally aggressive behavior with a dating partner over the past year, whereas 21% (n = 116) admitted to acting in a physically aggressive manner over the same interval. No significant gender-based difference was found for verbal aggression scores; however, females were significantly more likely to report using physical force than were male students. Male and female students who used verbal aggression were characteristically similar to each. Both had experienced aggression from a parent as children and had drunk alcohol within 3 hours (before or after) an argument with a dating partner. Male and female students who admitted using physical force were dissimilar except that both had experienced parent-child aggression. For male students, having witnessed conjugal violence and their general drinking patterns were also significantly related to their using physical force, whereas for females, the use of physical force was associated with drinking alcohol within 3 hours of an argument with a dating partner.     

Preparing law graduates for a globalised world

In this article it is argued that law graduates need to be prepared for working in a global legal context. Whether working in global law firms or small, local non-global law firms, law graduates need to have the knowledge, skills and attributes that will better equip them to work within and across multiple, international legal jurisdictions. The purpose of the article is twofold: first, to report on and disseminate research on a collaborative project on internationalising the Australian law curriculum aimed at preparing law graduates for global legal practice, of which the authors were the lead researchers; and second, to discuss and demonstrate the practical application of the proposed curriculum framework to the teaching of Constitutional Law.     

Running Away From Home: A Longitudinal Study of Adolescent Risk Factors and Young Adult Outcomes

Little is known about the adolescent risk factors and young adult health-related outcomes associated with running away from home. We examined these correlates of running away using longitudinal data from 4,329 youth (48% female, 85% white) who were followed from Grade 9 to age 21. Nearly 14% of the sample reported running away in the past year at Grade 10 and/or Grade 11. Controlling for demographics and general delinquency, running away from home was predicted by lack of parental support, school disengagement, greater depressive affect, and heavier substance use at Grade 9. In turn, runaways had higher drug dependence scores and more depressive symptoms at age 21 than non-runaways, even after taking these antecedent risk factors into account. Runaway status did not predict alcohol dependence risk at age 21. Results highlight the importance of substance use and depression, both as factors propelling adolescents to run away and as important long-term consequences of running away.     

Civil Liberties and the Korean War

This article addresses the unsuccessful attempts to suppress free speech during the Korean War, and in particular explains the attempts to silence three reporters of alleged atrocities by United Nations forces. In the absence of carefully targeted legislation, the three individuals – Alan Winnington (a journalist), Monica Felton (a women's movement activist) and Jack Gaster (a solicitor) ‐ were threatened with or investigated for prosecution for treason or sedition, and Winnington was unable to renew his passport until 1968. Drawing heavily on archival sources (including MI5 files, which unusually fail to redact the identity of one of the lawyers who was reporting to Special Branch about Gaster's activities), the article explores the threat to civil liberties from the administrative as well as the legislative and the judicial power of the state. The article concludes by drawing contemporary parallels, and highlighting the continuing relevance of the writings of Winnington, Felton and Gaster.     

Early Intervention with Compensated Lower Back-Injured Workers at Risk for Work Disability: Fixed versus Flexible Approach

Low back pain (LBP), a leading cause of disability, has been linked with profound economic, personal, and social costs (Hills 2006; World Health Organization 2003). This significant effect propels research in identifying modifiable risk factors that protract LBP; these factors can be targeted in early intervention (EI) (Pransky, Journal of Occupational & Environmental Medicine, 49(3):249–251, 2007; Schultz et al., Journal of Occupational Rehabilitation, 17:327–352, 2007, Journal of Occupational Rehabilitation, 18(2), 140–151, 2008; White et al. 2013). This randomized controlled study evaluated the effectiveness of two approaches, fixed versus flexible, in delivering proactive, interdisciplinary EI with 63 workers within a workers' compensation interdisciplinary case management setting (i.e., WorkSafeBC, Canada). Off-work 4 to 10 weeks post-back injury, the workers were also at risk of protracted work disability (N?=?24 at high risk; N?=?39 at moderate risk). Fixed, protocol-driven, interdisciplinary, multimodal, clinical, occupational, and case management-based EI was compared with a flexible, individual need-driven EI with the same modalities as the fixed approach. Results showed a significant narrowing of the outcome gap between the two interventions. High-risk injured workers tended to benefit more from a fixed, protocol-driven approach, as shown in the pilot study (Schultz et al. Journal of Occupational Rehabilitation, 18(2), 140–151, 2008). The results indicated that moderate-risk workers benefitted from a more flexible, need-based, individual, and low-intensity approach as compared with a fixed approach. The flexible approach for moderate-risk workers was also less costly and consumed fewer rehabilitation and health care resources. Recommendations for future research and practice included larger sample sizes, controllability of research interventions, risk for disability-EI matching, and conditions under which a flexible delivery of multimodal EI is more efficacious than a fixed approach, and vice versa.