The Liberal Peace at Home and Abroad: Northern Ireland and Liberal Internationalism

Northern Ireland, we are told, holds positive lessons for other societies emerging from violent conflict. As Britain is one of the leading proponents of liberal internationalism, this article considers whether the liberal internationalism pushed with so much enthusiasm abroad through British foreign policy has been applied with diligence at home—in the Northern Ireland peace process. The findings suggest that Northern Ireland is by no means a poster child for liberal internationalism. Instead, British government handling of the Northern Ireland peace process shows serious deviations from the liberal internationalist canon. This article argues that liberal peace-lite has been tolerated and facilitated at home, while a stricter variant is often expected in overseas contexts.     

Mediation in disputes between municipal governments

Emerging forms of intergovernmental management include roles for neutrals in a range of problem solving and conflict management situations. Third party intergovernmental mediation has been used to settle adversarial municipal boundary disputes in Virginia since 1980. Settlements fashioned through mediated negotiations are responsive to local officialst concerns. This paper reports on this innovation.     

Reducing criminal recidivism: evaluation of Citizenship, an evidence-based probation supervision process

‘Citizenship’ is a structured probation supervision program based on ‘what works’ principles, designed for offenders on community orders or licenses supervised within the UK National Probation Service. The program was evaluated using survival analysis comparing the reconvictions of a cohort of all offenders in one probation area eligible for Citizenship over a 2-year period (n = 3,819) with those of a retrospective cohort of all eligible offenders in the same probation area receiving ‘traditional’ probation supervision (n = 2,110), controlling for risk related factors. At the 2-year stage, 50% of offenders in the comparison group had reoffended compared to 41% in the experimental group, and the difference between the survival curves was statistically significant. The hazard ratio was 0.69, which represents a 31% reduction in reconvictions in the experimental group over the proportion in the comparison group at any given time. Time to violation of a supervision order or post custody license was also statistically significantly longer in the experimental group. A key element of the program, promoting contact with community support agencies, was statistically significantly related to reduced reoffending in the Citizenship group. The overall effects remained after controlling for differences in risk scores although effectiveness varied by risk level. Contrary to other ‘what works’ research findings, the program was found to be most effective across the low–medium and medium–high risk thresholds, and was not effective with the highest risk group. This difference can be explained and is discussed in terms of risk, need, and responsivity principles. The Citizenship program was found to be cost-beneficial.     

Sudden death as a complication of bacterial endocarditis

Three cases are reported to demonstrate the range of possible lesions and wide variation in lethal mechanisms that may be found in cases of unexpected death subsequently shown to be due to bacterial endocarditis. Case 1: A 36-year-old man was found dead on his bedroom floor surrounded by drug paraphernalia. At autopsy, acute myocardial ischemia was present caused by coronary artery ostial occlusion complicating acute bacterial endocarditis of the aortic valve. Case 2: A 54-year-old man with chronic renal failure was found dead in bed at home. At autopsy, a left middle cerebral artery territory cerebral infarct was present due to septic embolization from bacterial endocarditis involving the aortic valve. Case 3: A 23-year-old man was found collapsed in a pool of blood. At autopsy, upper airway hemorrhage from an arteriobronchial fistula was present caused by septic pulmonary infarction from previous endocarditis of a congenital ventricular septal defect. This report demonstrates that bacterial endocarditis may still be a cause of sudden and unexpected death presenting to forensic mortuaries and that the underlying mechanisms may involve complex sequences of pathological changes that compromise vascular function.     

Competitive pricing and the challenge of cost control in medicare

The Medicare program faces a serious challenge: it must find ways to control costs but must do so through a system of congressional oversight that necessarily limits its choices. We look at one approach to prudent purchasing - competitive pricing - that Medicare has attempted many times and in various ways since the beginning of the program, and in all but one case unsuccessfully due to the politics of provider opposition working through Congress and the courts. We look at some related efforts to change Medicare pricing to explore when the program has been successful in making dramatic changes in how it pays for health care. A set of recommendations emerges for ways to respond to the impediments of law and politics that have obstructed change to more efficient payment methods. Except in unusual cases, competitive pricing threatens too many stakeholders in too many ways for key political actors to support it. But an unusual case may arise in the coming Medicare fiscal crisis, a crisis related in part to the prices Medicare pays. At that point, competitive pricing may look less like a problem and more like a solution coming at a time when the system badly needs one.     

Recent trends in suicides utilizing helium

Retrospective review of cases of suicide involving helium inhalation was undertaken at Forensic Science South Australia over a 25-year period from 1985 to 2009. No cases of helium-related suicides were identified in the first 15 years of the study, with one case between 2000 and 2004 and eight cases between 2005 and 2009. Australian data were also reviewed from 2001 to 2009 that showed 30 cases between January 2001 and June 2005, compared to 79 cases between July 2005 and December 2009, an increase of 163%. A review of Swedish data between 2001 and 2009 showed no cases between January 2001 and June 2005, compared to seven cases between July 2005 and December 2009. Thus, all three areas showed recent and striking increases in cases of suicide involving helium inhalation. Given the availability of helium and the recent promotion of this method of suicide, it is quite possible that this may represent a newly emerging trend in suicide deaths.