Reinvigorating publicly funded medicare in Ontario: new public policy and public administration techniques

Abstract: In the increasingly complex and “horizontal” environment of Canadian governmental decision‐making, the ability of governments to advance a major new policy initiative can be compromised or impeded by the often cumbersome systems evolved to ensure both due diligence and a comprehensive approach. In Ontario, the urgent and multi‐faceted health care reform agenda has been implemented using a new set of policy‐development and program‐implementation techniques. This paper summarizes those reforms. In doing so, it outlines the degree to which the reform agenda has been implemented using techniques and processes that have been grafted onto or even short circuited existing decision‐making systems. The paper also draws conclusions about the potential utility of the Ontario experience both for health care reform and for developing new mechanisms to implement challenging, time‐limited reform agendas within parliamentary systems of government with politically neutral civil services. Sommaire: Dans le contexte de plus en plus complexe et “horizontal” de la prise de décisions gouvernementale au Canada, l'aptitude des gouvernements à promouvoir une nouvelle initiative politique majeure peut être compromise ou entravée par la lourdeur des systèmes élaborés pour assurer une diligence raisonnable et une approche exhaustive. En Ontario, le programme de réforme des soins de santé, urgent et polyvalent, a été mis en œuvre grâce à un nouvel ensemble de techniques d‘élaboration de politiques et de mise en œuvre de programmes. Le présent article résume ces réformes. Ce faisant, il souligne comment le programme de réforme a été mis en œuvre grâce à des techniques et processus qui ont été greffés, ou qui ont même court‐circuité les systèmes de prise de décisions existants. L'article tire aussi des conclusions sur l'utilité possible de l'expérience de l'Ontario en ce qui concerne la réforme des soins de santé mais aussi la mise au point de nouveaux mécanismes pour exécuter des programmes de réforme difficiles, à délai déterminé, au sein de systèmes parlementaires de gouvernement avec des fonctions civiles politiquement neutres.     

The referral decision scale with mentally disordered inmates

Correctional facilities are increasingly burdened with mentally disordered offenders and are faced with the formidable task of effectively screening inmates for major mental disorders and suicide potential. Teplin and Swartz (1989) developed the Referral Decision Scale (RDS) as a rapid screen for schizophrenia and major mood disorders in jail populations. However, more recent research by Hart, Roesch, Corrado, and Cox (1993) has called into question the effectiveness of the RDS. In this study, we examined the convergent and discriminant validity of the RDS with the Schedule of Affective Disorders and Schizophrenia—Change Version (SADS-C) and the Personality Assessment Inventory (PAI) on a sample of 108 mentally disordered inmates. The RDS provided moderate evidence of convergent validity but failed to demonstrate acceptable discriminant validity, because of high intercorrelations on RDS subscales (heterotrait-monomethod coefficients). In comparison, the SADS-C yielded similar evidence of convergent validity and excellent discriminant validity.The authors would like to thank the Research Opportunities Program, University of North Texas for its grant support and Captain James Moore for his active cooperation.Tarrant County Mental Health and Mental Retardation Services.     

Comparison of fingernail striation patterns in identical twins.

The fingernail ridge patterns of a pair of identical twins were compared to each other, their parents, and an unrelated subject. The patterns of the twins' nails showed regions of strong similarity but were distinguishable from one another. Fewer similarities were found when comparing the nails to those of the parents and the unrelated control. The twins were shown to be monozygotic by means of DNA profiling. This therefore represents the first demonstration of unique fingernail ridge patterns in subjects shown conclusively to be identical twins. When the fingernail ridge patterns were examined with a scanning electron microscope, the backscattered electron (BEI) images were found to have superior contrast when compared to the secondary electron (SEI) images.     

Regulatory Risk Management of Psychoactive Substances

Congress and the Drug Enforcement Administration have assigned certain psychoactive substances to one of five schedules, based on assumed or demonstrated abuse potential. Although formidable difficulties exist in assessing the hazards of drug use, some of these assignments do not appear consistent with empirical estimates. This mismatch of assignment and abuse potential -possibly due to "radical" political ideology - obscures significant differences in drug effects, and therefore stifles meaningful public participation in evaluating the benefits, risks, and proper use (if any) of available psychoactive substances.     

Reentry and Removal: Implications for Juvenile Confinement Facilities

An important national initiative in juvenile justice is Juvenile Offender Reentry (JOR). The renewed emphasis on offender reintegration has generated significant attention to juvenile justice practices, with the notable exception of juvenile confinement facilities. Juvenile detention and, to a lesser degree, juvenile corrections practitioners are involved but not invested in reentry, having made very few programmatic changes to accommodate JOR initiatives largely because these initiatives have been external to the institution and its staff. Yet, reentry is a powerful concept for juvenile facility practitioners, and the application of reentry principles could have a profound impact on daily operations. This article addresses a range of issues about investing juvenile institutions in reentry practices. Several reentry models are discussed along with their implications for daily operations and programs.