Reconceptualizing elder abuse: treating the disease of senior community exclusion

This article focuses on the phenomenon of elder abuse, which is one of the paramount symptoms of the larger community's failure to address the social, medical, and legal needs of the senior populace. Although there have been multidisciplinary efforts to address this problem, they are not responsive to the needs of the senior population itself In response, the authors propose a model that takes into account the specific concerns of local senior communities and provides seniors and their stakeholder providers a stable infrastructure to ensure open, consistent, and effective participation and delivery of services.     

Dosage of treatment to sexual offenders: are we overprescribing?

A sample of 337 offenders who received treatment in a variety of sex offender treatment programs in the Ontario region of Correctional Service Canada between 1993 and 1998 were divided based on the highest intensity sex offender programming that they received (low, moderate, and high). The three groups were compared with reference to a variety of actuarial risk assessment measures, criminogenic factors, and the number and type of treatment programs completed. It was hypothesized that the high-intensity group would have more criminogenic risk factors, higher actuarial scores, and participate in more treatment programs than both the moderate- and low-intensity groups. The results indicate that in general, the hypotheses were supported. Nonetheless, the results suggest that the low-intensity group may be receiving too much sex offender-specific treatment.     

Does alcohol make a difference? Within-participants comparison of incidents of partner violence

Episodes of husband-to-wife violence in which the husband consumed alcohol were compared with episodes of husband-to-wife violence, reported by the same individuals, in which the husband was not drinking. Among this community sample of newlyweds, wife reports, but not husband reports, indicated that violent episodes in which the husband was drinking included more acts of violence and were more likely to involve severe violence. Both wife and husband reports indicated that wives were more likely to be physically aggressive in husband drinking episodes compared to sober episodes. However, whereas wives reported that their aggressive behavior was a response to husband aggression, husbands reported that wives were more likely to initiate violence in these episodes. Violent episodes that include alcohol may be more severe and more mutually violent than sober episodes. Discrepancies between husband and wife reports may reflect differences in recall or self-serving biases.     

Iatrogenic catheter-related cardiac tamponade: a case report of fatal hydropericardium following subcutaneous implantation of a chemotherapeutic injection port

The need to obtain dependable access to the vascular system constitutes a significant component in the treatment and management of critically ill patients. Intravenous chemotherapy administered to cancer patients over an extended period of time often results in loss of peripheral vascular access due to vein sclerosis, "exhaustion" or tissue necrosis. Medical investigators have designed and steadily upgraded a variety of devices constructed to improve venous access for long-term utilization. As with the introduction of any foreign object into the body, each of these devices has complications which may be life threatening and occasionally fatal. We present an unusual case of iatrogenic acute hydropericardium and cardiac tamponade caused by the percutaneous infusion of chemotherapeutic fluid via a right subclavian central venous implant system (Port-a-Cath). Failure to implant and monitor the device with a radiograph following placement according to manufacturer's guidelines and accepted standards of medical practice were causally related to an unusual complication, namely, perforation of the right cardiac ventricle by the catheter tip, resulting in sudden and unexpected cardiac death.     

Deregulating Federalism? The Politics of Mandate Reform in the 104th Congress

This article examines the politics and substance of mandatereform in the 104th Congress. It briefly describes the evolutionof the mandate issue, examines the process by which the issuewas placed on the national agenda, and traces the formulationof a legislative response. It analyzes in detail the politicsof enacting mandate-reform legislation, paying particular attentionto patterns of support and opposition and to changes in thesepatterns over time. It concludes by examining the prospectsfor successful implementation of the legislation and its likelyconsequences for the intergovernmental system.