Potentially Lethal Behaviors Associated With Rapid Eye Movement Sleep Behavior Disorder: Review of the Literature and Forensic Implications

Abstract:  Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by loss of the muscle atonia of REM sleep, with release of complex and violent behaviors that are often attempted dream-enactments. This study reviewed the literature on RBD with regard to potentially lethal behavior. A total of 39–41 clinical cases of RBD associated with potentially lethal behaviors to self and/or others were found, involving a child and adults of all age groups, that manifested as choking/headlock ( n  = 22–24), defenestration/near-defenestration ( n  = 7), and diving from bed ( n  = 10). A total of 80.8% ( n  = 21) were males; 19.2% ( n  = 5) were females; mean age was 65.6 ± (SD) 13.8 years (range: 27–81 years, and a child). (Gender/age data were not listed in the remaining cases.) An etiologic association of RBD with a neurologic disorder (or with pharmacotherapy of psychiatric disorders, n  = 4) was present in 21–23 patients. Thus, RBD carries well-documented, potential forensic consequences during RBD episodes that could possibly have been misinterpreted as suicidal or homicidal behavior.     

That Old-Time Religion: Efficiency, Benchmarking, and Productivity

Books Reviewed:
M. Berman, Productivity in Public and Nonprofit Organizations: Strategies and Techniques
Patricia Keehley, Steven Medlin, Sue MacBride, and Laura Longmire, Benchmarking for Best Practices in the Public Sector: Achieving Performance Breakthroughs in Federal, State and Local Agencies
David N. Ammons, Municipal Benchmarks: Assessing Local Performance and Establishing Community Standards     

Public–private partnerships (PPPs) in local services: risk-sharing and private delivery of water services in Spain

Local governments are increasingly utilising the public–private partnership (PPP) model as a means of organising service delivery in the public–private domain. This article examines the experiences with construction and operation of 131 PPP wastewater treatment plants in the region of Aragon, Spain. The study highlights how an inadequate management of construction risk and unsuitable transfer of demand and revenue risk resulted in significant time delays in execution of the PPP projects. The research also shows how the involvement of public bodies at local, regional and national level further added to the complexity of implementing the projects. The findings contribute to the literature on local service delivery and provide insights regarding risk transfer in long-term PPP contracts for the delivery of local services in general and water services in particular.     

Making the Sky Relevant to Battle Strategy: Counterinsurgency and the Prospects of Air Power in Nigeria

One of the most important roles in counterinsurgency (COIN) is to maintain adequate security presence to protect lives and properties of the affected population and restore law and order in the society. Accordingly, the state of affairs in Nigeria's COIN theater has been affected by the quantity and quality of security presence, most especially the ability of the operatives to gather timely and relevant information and mobilize for prompt response. Although the roles of the ground operatives have dominated public attention, the local air force and the complementary air powers have affected the security situations with the level of their presence or absence in the sky for intelligence, surveillance, and reconnaissance; firepower; and transportation in the theater. This study examines the relevance of security presence to achieve the objective of COIN and the prospects of air power in this arrangement in Nigeria and the Lake Chad region.     

Can bilateral programmes become learning organisations? Experiences from institutionalising participation in Keiyo Marakwet in Kenya

The concept of learning organisations is gaining prominence in the non-profit sector. Most organisations see the concept as a means of attaining organisational change for greater impact on development. While the principles of organisational learning (i.e. team learning, shared vision, common goal, and strategy) seem to have produced impressive results in the private sector and some non-profit organisations, the question is whether these principles can be adopted with similar results in complex bilateral programmes. This article explores this question in relation to a programme between the Dutch and Kenyan governments in Keiyo Marakwet, Kenya. It analyses the process of institutionalising participation as both a learning and a conflict-generating process. In the highly politicised context of bilateral programmes, learning is not necessarily carried forward from one phase to the next due to rapid changes in actors, national politics, diplomatic considerations, and the international development agenda.