Mitochondrial DNA Validation in a State Laboratory*,†

Abstract: Because of the inception of the FBI Regional mitochondrial DNA (mtDNA) laboratories, many do not see establishing state/local mtDNA processing laboratories as a priority. Yet there is a long‐term need for mtDNA processing that will exceed the capabilities of the FBI Regional mtDNA laboratories and the few other laboratories that are currently processing mtDNA, and that need can be fulfilled by state/local laboratories. Thus, the DNA Unit of the Delaware Office of the Chief Medical Examiner (OCME‐DNA Unit) completed validation of in‐house mtDNA testing in January 2007. The validation plan for mtDNA processing included the following sections: preliminary research, sensitivity and contamination studies, ExoSAP‐IT^® optimization, BigDye^® optimization, sequencing and 310 optimization, sample preparation and extraction optimization, heteroplasmy, mixtures, and reproducibility. All sections of the validation were successfully completed, and mtDNA processing of skeletal remains, teeth, and hairs, as well as blood and buccal reference samples was adopted by the OCME‐DNA Unit.     

SLAPPs: Intent or Content?Anti-SLAPP Legislation Goes International

Due to the increasing interest in adopting anti-SLAPP legislation outside of the USA (where it was first implemented), the definition of what constitutes a SLAPP is being questioned. Some commentators have advanced the suggestion that, in order to account for jurisdictional differences, outside of the USA it is the motivation to intimidate or chill public speech that is the aspect of a SLAPP on which anti-SLAPP legislation must focus. However, defining SLAPPs by the initiator's alleged intent to intimidate can render anti-SLAPP legislation, in any jurisdiction, ineffective. SLAPPs should be defined by the involvement of public participation, rather than by the intent of the SLAPP plaintiff. Effective anti-SLAPP legislation employs procedural protections that are engaged once a threshold demonstration has been made that the case involves protected public interest communications. Generally, this approach is appropriate to adopt in any jurisdiction where the legislature desires to protect public interest communications.     

A Review of Evidence-Based Biopsychosocial Laws Governing the Treatment of Pain and Injury

The impact of scientific findings on medical, psychological, and legal concepts has led to the adoption of laws and regulations that do not easily fit into the established legal categories of medical law or mental health law. Instead, this convergence of forces has resulted in laws and regulations mandating biopsychosocial treatment guidelines, where both medical and psychological cares are integrated within the framework of a single paradigm. Laws and regulations of this type have been adopted by a number of US states and Canadian provinces, and could be considered to represent a new category, for which we offer the term “biopsychosocial law.” Biopsychosocial laws currently pertain to medical treatment guidelines for workers’ compensation, a medical treatment system noted for high costs, high levels of litigation, and psychological involvement. There are a number of examples of biopsychosocial laws, but the most noteworthy are based on guidelines developed by the Colorado Division of Workers’ Compensation, the American College of Occupational and Environmental Medicine, the Work Loss Data Institute, and The Reed Group. These guidelines differ significantly with regard to features, conditions covered, and strength of evidence basis. However, all of these guideline systems were developed with the intent of providing good care while controlling costs, are evidence based, integrate the practice of medicine and psychology, and are legally mandated in certain jurisdictions. Taken together, these guidelines represent a growing convergence of scientific evidence, professional society positions, payor policies, and legal regulations. These forces are propelling a broad societal shift away from Cartesian assumptions that the body and mind are separate, and toward a biopsychosocial paradigm for the treatment of injury and illness.     

Freedom to think – the value of multiple clinical narratives in women’s prisons†

Abstract

The merits of being multi-lingual are widely recognised. This paper considers the application of this metaphor to the conceptualisation of clinical work in a women’s prison. We suggest that sharing ‘languages’ from different theoretical orientations in open fora enables teams to build deep and nuanced understandings of clinical and systemic complexity, of particular value in secure settings. This discussion reflects the service model developed and used within HMP/YOI Holloway, a large women’s prison in London, which has recently been closed. We utilise a case example, with formulations and recommendations from several perspectives, to illustrate the value of maintaining a rich, inclusive discourse. We describe the benefits of such an approach to staff teams, to institutions and to those we serve, and consider the implications for organisation of services to maximise potential for change and recovery.     

Psychosocial concepts in juvenile law

This study was designed to clarify the types of information about juveniles and their families that are relevant for three types of juvenile court decisions: (a) the pretrial detention of juveniles; (b) their transfer for trial in criminal courts: and (c) disposition decisions after delinquency adjudication. Predominant legal standards for these decisions are described, information relevance for the decisions is defined, and why past studies have failed to clarify the information needs of juvenile court decision makers is explained. Results of a study involving a national sample of juvenile court personnel include an empirically derived domain of psychosocial and behavioral characteristics of juveniles and their families relevant for courts' interpretations of controlling legal standards; factor analysis of the domain, describing dimensions of the domain of information about juveniles and families; and an examination of the relation of these information categories to each legal standard controlling the decision areas in question. The interpretation of results may facilitate decision making by juvenile courts, evaluations by mental health professionals who assist juvenile courts, and further research by social scientists who study discretionary juvenile court decisions.This research was supported by grant No. MH-35090 from the Center for Studies of Antisocial and Violent Behavior, National Institute of Mental Health, DHHS. Portions of the study were conducted in collaboration with the National Juvenile Law Center, Inc. of St. Louis. The authors wish to acknowledge Martha Bellew-Smith, Marcia Conlin, and Robert Rust, who contributed substantially to the conduct of the study. Others who participated at various stages are Steve Bellus and Sandra Seigel     

Health insurance for Americans approaching age sixty-five: an analysis of options for incremental reform

This article provides a systematic evaluation of the options for incremental health insurance reforms aimed at older Americans nearing age sixty-five. It presents three basic arguments for giving special consideration to this age group: (1) early retirement and its effect on access to employer insurance; (2) changes in health and health care expenses associated with increasing age; (3) the vulnerability to unexpected economic or health "shocks" that will affect people throughout their retirement. The analysis of policy options begins by specifying criteria for evaluating alternative approaches to reform. The proposed criteria emphasize that reforms for this age group should be designed to fit with other financial plans and decisions made during such a transitional stage of life. Policy options should be judged according to fundamental goals such as equity and efficiency, not simply ranked according to the number of uninsured who will gain coverage. After offering a comprehensive catalog and evaluation of available options, the analysis identifies and discusses a preferred approach-which preserves choices while offering universal and subsidized access to Medicare before age sixty-five.     

Patterns of Practice in Mental Health Courts: A National Survey

Mental health courts (MHCs) represent an important new development at the interface of the criminal justice and mental health systems. MHCs are criminal courts for persons with mental illness that were in part created to divert this population from jail/prison into community treatment. MHCs are proliferating rapidly despite limited knowledge regarding their characteristics or their efficacy. We surveyed the entire population of adult MHCs in the United States, n = 90. In the past 8 years, MHCs have been created in 34 states, with an aggregate current caseload of 7,560 clients in MHCs nationally. Most courts (92%) reported using jail as a sanction for noncompliance, if only rarely. Further, jail sanction use was significantly predicted by increased judicial supervision and number of felons in the court. Implications for MHCs and social monitoring are discussed.