Subjective effect of September 11, 2001 among pregnant women: is cumulative history of interpersonal violence important?

Prior history of trauma may sensitize individuals to subsequent trauma, including terrorist attacks. Using a convenience sample of secondary, cross-sectional data, pregnant women were grouped based on lifetime interpersonal violence history. Cumulative risk theory was used to evaluate the association of lifetime interpersonal violence history and subjective impact of the September 11, 2001 (9/11) terrorists attacks. Using hierarchical linear regression, cumulative risk theory was partially supported. Women with a history of only one type of interpfersonal violence reported greater effect of 9/11 than did women without a history, but women with both types of violence did not report a greater effect of 9/11 compared to women endorsing history of one type. These data corroborate the literature in that level of exposure to terrorist-related trauma predicts subjective reaction to the attacks. Future research with a larger sample and standardized instruments is warranted.     

Law, Finance, and Politics: The Case of India

The liberalization of India's economy since 1991 has brought with it considerable development of its financial markets and supporting legal institutions. An influential body of economic scholarship asserts that a country's "legal origin"—as a civilian or common law jurisdiction—plays an important part in determining the development of its investor protection regulations, and consequently its financial development. An alternative theory claims that the determinants of investor protection are political, rather than legal. We use the case of India to test these theories. We find little support for the idea that India's legal heritage as a common law country has been influential in speeding the path of regulatory reforms and financial development. Rather, we suggest there are complementarities between (1) India's relative success in services and software; (2) the relative strength of its financial markets for outside equity, as opposed to outside debt; and (3) the relative success of stock market regulation, as opposed to reforms of creditor rights. We conclude that political economy explanations have more traction in explaining the case of India than do theories based on "legal origins."     

Gender Inequality and Patterns of Abuse Post Leaving

Drawing on Connell’s (Gender and power: Society, the person and sexual politics. California: Stanford University Press, 1987; Masculinities. Berkeley, CA: University of California Press, 1995) model of gender relations, this paper examines patterns of intimate partner violence among women who have recently left an abusive partner. In so doing, we attempt to better understand the social structural factors that shape the relations of power and control in intimate violent heterosexual unions. The data come from the first wave of a longitudinal prospective survey of 309 women who had left an abusive partner in the previous 3 years. Our data suggest that structured relations of inequality, namely relations of production, power and cathexis, shape women’s risk of abuse and harassment after leaving, and do so in ways that shape relations of coercive control. These results have implications for understanding the social context within which male violence against women occurs, and how this context constrains and/or enables women’s strategies for leaving and safety. This research was funded by the Canadian Institutes of Health Research (CIHR) New Emerging Team Grant #106054 and Institute of Gender and Health Operating Grant #15156 (Marilyn Ford-Gilboe, Principal Investigator). The authors thank the participants in the Women’s Health Effects Study. We also thank Julie McMullin, Kim Shuey, and the Health Effects research team for their helpful feedback.     

Performance characteristics of the Cozart RapiScan Oral Fluid Drug Testing System for opiates in comparison to ELISA and GC/MS following controlled codeine administration

Oral fluid is an interesting alternative matrix for drug testing in many environments, including law enforcement, workplace drug testing, and drug treatment facilities. Performance characteristics of the FDA-cleared, qualitative, Cozart RapiScan Opiate Oral Fluid Drug Testing System (Opiate Cozart RapiScan System or Opiate CRS) were compared to the semi-quantitative Cozart Microplate EIA Opiate Oral Fluid Kit (Opiate ELISA) and to gas chromatography/mass spectrometry (GC/MS). The following oral fluid opiate cutoffs were evaluated: the GC/MS limit of quantification (LOQ) of 2.5 mg/l; 15 microg/l currently used for oral fluid testing in the United Kingdom (UK); 30 microg/l (Opiate CRS cutoff); and 40 microg/l, the proposed Substance Abuse and Mental Health Services Administration (SAMHSA) cutoff. Subjects provided informed consent to participate in this IRB-approved research and resided on the closed research ward throughout the study. Three oral codeine doses of 60 mg/70 kg were administered over a 7-day period. After a 3-week break, subjects received three doses of 120 mg/70 kg within 7 days. Oral fluid specimens (N = 1273) were analyzed for codeine (COD), norcodeine (NCOD), morphine (MOR) and normorphine (NMOR) by GC/MS with an LOQ of 2.5 microg/l for all analytes. MOR and NMOR were not detected in any sample; 26.5% of the specimens were positive for COD and 13.7% for NCOD. Opiate CRS uses a preset, qualitative cutoff of 10 microg/l; this is equivalent to 30 microg/l in undiluted oral fluid as the oral fluid collection process involves a 1:3 dilution with buffer. Sensitivity, specificity, and efficiency of Opiate CRS compared to Opiate ELISA were 98.6, 98.1, and 98.2% at a 30 microg/l cutoff and 99.0, 96.2, and 96.6% at a 40 microg/l cutoff. Compared to the much lower GC/MS LOQ of 2.5 microg/l, sensitivity, specificity and efficiency were 66.8, 99.3 and 90.7%. Increasing the GC/MS cutoff to the current UK level yielded performance characteristics of 81.5% (sensitivity), 99.3% (specificity), and 95.4% (efficiency). Using a GC/MS cutoff identical to the preset Opiate CRS cutoff yielded sensitivity, specificity, and efficiency of 88.5, 99.2, and 97.5%, respectively. At the proposed SAMSHA confirmation cutoff of 40 microg/l, sensitivity increased with little change in specificity and efficiency (91.3% sensitivity, 98.9% specificity, and 97.5% efficiency). Oral fluid is a suitable matrix for detecting drugs of abuse. Opiate CRS, with a 30 microg/l cutoff, is sufficiently sensitive, specific and efficient for oral fluid opiate analysis, performing similarly to Opiate ELISA at the same cutoff, and having performance characteristics >91% when compared to GC/MS at the proposed SAMHSA cutoff.     

Risk Assessment in Environmental Policymaking

A problem in policymaking for prevention of harm to persons and the environment concerns the probability of harm occurring—that is, the measure of risk involved. Policymakers have almost always sought to calculate the risk involved in proposed courses of action. Their methods have often been irrational and their estimates erroneous. Explicit analysis of risk to society and systematic methods for estimating it emerged with the advent of science as more reliable procedures for prediction and decision-making. However, as with many other forms of analysis, the assessment of risk has carried its own risk—namely an undue reliance on logical quantitative techniques which fail to address the root causes of public concern and apprehension. Common-sense assessments of risk tell us more what risks people regard as acceptable and risks arouse anxiety and protest. Carnage from accidents on the nation's highways arouse much less apprehension than nuclear accidents even though actual risk from automobiles is much greater than injury or death from nuclear reactors. The following paper makes the case that the art and science of risk assessment will fall short of social and political realities until the psychological and cultural aspects of risk receive more adequate attention.     

Husbands who harm: Predicting spousal violence by men

Previous research on spouse abuse has frequently focused on bivariate relationships between theoretically derived variables and marital violence. This study utilizes a multivariate approach in order to explore the independent and combined effects of several variables derived from the social learning and the frustration/strain perspectives on self-reported violence by husbands against wives. Data for married and/or cohabiting males are derived from a national stratified random sample of couples in the United States. Loglinear analysis is used to identify the main and interactive effects of age, occupational status, employment status, subjective economic strain, and observation of parental violence on reports of violence toward one's wife. Results indicate that age, occupational status, parental modeling and employment status affect the likelihood of violence. Employment status more strongly increases the likelihood of violence for younger men, as opposed to older men, which supports the strain perspective. The independent effect of the observation of parental violence lends support to the social learning approach. Social policy implications are discussed.     

Violence and abuse in psychiatric in-patient institutions: a South African perspective

Institutionalisation of psychiatric patients was a prevalent treatment approach in the apartheid era of South Africa. Allegations of violence and abuse towards patients frequently arose during this time. The post-apartheid Department of Health prioritised improvements in mental health care by recommending, inter alia, deinstitutionalisation and reintegration of patients into the community. Ten years later, these interventions have proved difficult to institute and many patients are still hospitalised. The present study investigated whether currently hospitalised patients continued to experienced violence and abuse. This was an exploratory naturalistic study in which both qualitative and quantitative data were collected. Of the 127 who completed the study, more than 50% reported experiences of abuse. The main perpetrators were other patients, although violence by staff was reported. Reasons for the tardiness of implementation of deinstitutionalisation and the prevalence of ongoing violence and abuse in psychiatric hospitals are complex. Factors inherited from the pre-democratic system coupled with increased urban violence and financial constraints appear to be some of the major causes of ongoing dependency upon hospitalisation of mental health care users. The present study highlighted the urgency of implementing mental health care improvements.