Who Benefits from Community Mental Health Care? Using Latent Profile Analysis to Identify Differential Treatment Outcomes for Youth

Treatment effectiveness has been shown to vary across subgroups of youth based on characteristics such as comorbidity, problem severity, gender, and age. The current study aims to explore if subgroups of youth, identified by applying latent profile analysis to parent-reported symptoms, age, and gender, are better served by specific usual care services. Archival data from a community mental health center were utilized, including parent-reports of symptoms for 953 youth (44.4% female; ages 4–18) across multiple time-points, and services received. Latent profile analysis identified five subgroups including Low Risk, High Risk, Internalizing, Externalizing, and Delinquent/Depressed. The relationship between the intensity level of services and symptoms varied across subgroups. Specifically, high intensity services were related to a greater reduction in symptoms for the Internalizing, Externalizing, and High Risk subgroups. Implications for future developmental research and clinical applications are discussed.     

The Better Practice Program Funding Formula: A Neo-liberal Approach to Funding General Practice

A decade after the introduction of Medicare, various pressures had emerged in the financing of general practice. The National Health Strategy suggested these could be addressed by supplementing the Medicare benefits program with other payment systems. The Commonwealth government introduced the better practice program (BPP) in late 1994. Through the BPP, the Commonwealth makes payments to general practices calculated according to a formula. Using Medicare claims data, the formula takes into account practice size, patient loyalty to the practice and practice location. The BPP formula is oriented to the free choice of doctor by patients, and free choice of practice location by doctors. It is the exercise of these freedoms that, through the operation of the formula, determines the size of BPP payments. This arrangement is an example of a distinctively neo-liberal mode of government.     

Developing New Forms of Partnership With the ‘Market’ in the Procurement of Public Services

This article provides a conceptual framework for understanding the key differences between newly emerging ‘market’ relationships and more traditional forms of procurement by public sector organizations. It highlights how multiple relationships between service clients in the public sector and other stakeholders mean that service clients may often co‐produce welfare changes in their communities in ways which professional and commercial providers cannot easily control and may not fully understand. It highlights the very different nature of collaborations which affect single commissioners and contractors (relational contracting), multiple commissioning bodies with a unified procurement policy (partnership procurement) and multiple commissioning bodies with diverse procurement policies empowered by a single purchasing body (distributed commissioning). The article suggests that traditional conceptions of the ‘market’ and of ‘market management’ are now outdated and need to be revised to take into account the potential of collaborative relationships between multiple stakeholders in the public domain.     

Postmortem redistribution of fentanyl in the rabbit blood

Postmortem redistribution of fentanyl in the rabbit was investigated after application of the 50-μg/h Durogesic pain patch. Patches were applied for 48 hours. Two cycles of patch administration were used before characterization of the postmortem redistribution. Fentanyl showed marked redistribution into the femoral and pulmonary veins of the rabbit through 48 hours after the animals were humanely killed and the pain patches removed. The plasma concentration of 2.34 ng/mL in the femoral blood before killing the animals increased 5.6-fold by 48 hours after patch removal to 13.2 ng/mL. This postmortem concentration is approximately 3-fold the C(max) determined during antemortem pharmacokinetic analysis, 4 ng/mL, which was achieved 24 hours after the application of the second 50-μg/h Durogesic pain patch. After blood sampling for 48 hours after animal termination with patch removal compared with sampling for 48 hours from animals not terminated and with patch removal, the exposure ratios in the terminated animals were approximately 30-fold, indicating that between the postmortem redistribution of fentanyl and the cessation of hepatic clearance of fentanyl in the rabbit, the postmortem redistribution of fentanyl leads to an elevated measures of postmortem blood concentrations relative to antemortem blood concentrations.     

Predicting Phenotype from Genotype: Normal Pigmentation*

Abstract: Genetic information in forensic studies is largely limited to CODIS data and the ability to match samples and assign them to an individual. However, there are circumstances, in which a given DNA sample does not match anyone in the CODIS database, and no other information about the donor is available. In this study, we determined 75 SNPs in 24 genes (previously implicated in human or animal pigmentation studies) for the analysis of single‐ and multi‐locus associations with hair, skin, and eye color in 789 individuals of various ethnic backgrounds. Using multiple linear regression modeling, five SNPs in five genes were found to account for large proportions of pigmentation variation in hair, skin, and eyes in our across‐population analyses. Thus, these models may be of predictive value to determine an individual’s pigmentation type from a forensic sample, independent of ethnic origin.     

The Status of Forensic Anthropology in Europe and South Africa: Results of the 2016 FASE Questionnaire on Forensic Anthropology

One of the goals of the Forensic Anthropology Society of Europe (FASE) is to map the existing education and practice opportunities in the field of forensic anthropology in order to support the development of the discipline and to optimize the training courses provided by the Society. To address this goal, an online questionnaire was sent to European and South African practitioners of forensic anthropology and related disciplines in 2016. The results of the questionnaire showed that the status and roles of forensic anthropologists vary depending on the national legal systems, education, and employment status of the practitioners. Despite the fact that the expertise of forensic anthropologists has been increasingly requested in a variety of investigations and the spectrum of tasks has become broader, including identification of living persons, specialized education in forensic anthropology is still restricted to a few graduate and postgraduate programs in European countries and to annual FASE courses.