People with special needs and sexual behaviour problems: balancing community and client interests while ensuring effective risk management

Abstract

Deinstitutionalisation movements of the mid-1900s led to changes in policy and practice in the management of people with special needs (defined for this article as people with severe and persistent mental illness, intellectual disabilities and high levels of personality factors that interfere with treatment participation). Although the majority of clients with special needs receive care in community settings and interact more with family, friends and others in the community, some such clients require more rigorous case management. For clients who have offended, especially sexually, community-based services are scarce, and concerns regarding reoffence potential often supersede traditional understandings of diminished capacity. Recent reports suggest that jails and prisons have replaced hospitals as the institutions-of-choice for clients with special needs who engage in inappropriate conduct. This paper examines policies and practices regarding community risk management of people with special needs who have sexually offended. Vignettes are provided to illustrate how some clients and agencies have been affected, and suggestions are made to ensure best practices in risk management and public safety.     

Animal rights is a social justice issue

The literature on social justice, and social justice movements themselves, routinely ignore nonhuman animals as legitimate subjects of social justice. Yet, as with other social justice movements, the contemporary animal liberation movement has as its focus the elimination of institutional and systemic domination and oppression. In this paper, I explicate the philosophical and theoretical foundations of the contemporary animal rights movement, and situate it within the framework of social justice. I argue that those committed to social justice – to minimizing violence, exploitation, domination, objectification, and oppression – are equally obligated to consider the interests of all sentient beings, not only those of human beings.     

Sexually violent predators and civil commitment: is selection evidence based?

Sexual offenses represent an alarming proportion of crimes committed yearly. To address these concerns, several states, including South Carolina (SC), have enacted laws requiring sexually violent predators (SVPs) to be civilly committed to treatment. To date, no published study has examined sexual offenders recommended for treatment in SC. This study used a specially designed statewide database (SC-SVP research database) to determine which offender and offense characteristics were associated with increased likelihood of being recommended for civil commitment. Factors correlated with being more likely to be recommended included: being of a younger age at time of evaluation, prior sex convictions, having related and unrelated victims, a higher number of victims, frequent substance use, and a history of suicide attempts. Prior sex convictions, having both related and non-related victims, and a higher total number of victims align with characteristics associated with sexual recidivism. Frequent substance abuse and a history of suicide attempts do not mirror previous findings regarding sexual recidivism. These findings present new information regarding the civil commitment process of offenders being committed to the SC-SVP treatment program, characterize types of offenders committed to SC-SVP treatment program, and provide a foundation for using a computerized database in conducting sex offender research.     

A New Chapter in India-China Relations

<正>Prime Minister Narendra Modi has just completed a productive and positive visit to China.The three-day visit,from May14-16,was rich in symbolism and substance and has taken the relationship between India and China to new heights.Coming just eight months after the landmark visit of President Xi Jinping to India,it has opened up a new chapter     

Livelihood recovery after disaster

A lack of monitoring and evaluation on the outcomes of livelihood recovery programming has typified many post-disaster recovery initiatives. This article uses a case study of the 2006 Yogyakarta, Indonesia earthquake to analyse longer-term impacts of livelihood programming after disaster. The article includes an overview of the programming implemented in five case study villages and the perspectives of impacted populations on the livelihood interventions. Results indicate the importance of longer-term programming, early interventions, local leadership, and an integrative strategy focusing on replacing assets, providing capital and credit to jumpstart entrepreneurial activities, capacity and skills building, and developing markets and networks.     

Fatal Fentanyl Patch Misuse in a Hospitalized Patient with a Postmortem Increase in Fentanyl Blood Concentration

Opioid‐related mortality happens, even in healthcare settings. We describe serial postmortem fentanyl blood concentrations in a hospital inpatient who fatally abused transdermal fentanyl. This is a single‐patient case report. A 42‐year‐old man with lymphoma was started on transdermal fentanyl therapy while hospitalized for chronic abdominal pain. The patient was last seen awake 1.3 h prior to being found apneic and cyanotic. During the resuscitation attempt, a small square‐shaped film was removed from the patient's oropharynx. Femoral blood was collected 0.5 and 2 h postmortem, and the measured fentanyl concentration increased from 1.6 to 14 ng/mL. Study limitations include potential laboratory or collection errors and missing data. (i) Providers must be vigilant for signs of fentanyl patch abuse. (ii) Postmortem blood concentrations are not static postmortem, likely secondary to decreasing pH, increased aqueous solubility, and tissue redistribution, and are therefore unlikely to accurately represent antemortem blood concentrations.     

Comparison of the Columnar‐Thin‐Film and Vacuum‐Metal‐Deposition Techniques to Develop Sebaceous Fingermarks on Nonporous Substrates,

Both the columnar‐thin‐film (CTF) and the vacuum‐metal‐deposition (VMD) techniques for visualizing sebaceous fingermarks require the deposition of a material thereon in a vacuum chamber. Despite that similarity, there are many differences between the two techniques. The film deposited with the CTF technique has a columnar morphology, but the film deposited with the VMD technique comprises discrete islands. A split‐print methodology on a variety of fingermarked substrates was used to determine that the CTF technique is superior for developing fingermarks on clear sandwich bags and partial bloody fingermarks on stainless steel. Both techniques are similar in their ability to develop fingermarks on glass but the CTF technique yields higher contrast. The VMD technique is superior for developing fingermarks on white grocery bags and the smooth side of Gloss Finish Scotch Multitask^? tape. Neither technique worked well for fingermarks on black garbage bags.