Structured Assessment of Correctional Adaptation (SACA): a measure of the impact of incarceration on the mentally ill in a therapeutic setting

Clinicians have observed that psychiatric patients with correctional histories evidence attitudes and behaviors that seem adaptive in penal environments but are maladaptive in mental health settings. This study sought to assess the reliability and concurrent validity of a rating scale designed to measure correctional adaptation using a sample of 64 patients from a state psychiatric hospital. Scale ratings were obtained through structured interviews, whereas predictor variables were gleaned from chart review and self-report. The scale demonstrated good interrater reliability (ICC = .83) and acceptable internal consistency (alpha= .67). Of the variables evaluated, two were significantly correlated with Structured Assessment of Correctional Adaptation (SACA) total scores, total months sentenced to prison or jail (r = .26), and frequency of disciplinary tickets while in prison or jail (r = .31). Stepwise regression analyses revealed only the latter variable significantly predicted SACA score (R = .31), F(1, 58) = 6.27, p < .05. Clinical implications of these findings, the scale, and the construct of correctional adaptation are discussed.     

Wounding Words: Maternal Verbal Aggression and Children's Adjustment

Psychological maltreatment, including verbal aggression, has been implicated as an important contributor to children's behavioral problems. The present study looked specifically at the relationship between different forms of maternal verbal aggression and their association with children's adjustment. Mothers from Violent and Nonviolent families were compared on their use of various verbal aggression tactics, as measured by the Conflict Tactics Scale (Straus, 1979). Mothers from both groups used threats and insults with comparable frequency. In both groups, insults were predictive of children's adjustment. The relationship was particularly striking in children from violent homes. We conclude that chronic exposure to inter-parental violence may render children emotionally susceptible to maternal disparagement.     

Analysis of pilot-related equipment and archaeological strategy in the recovery of aircrew losses from the Vietnam War

Determining the location and distribution of cockpit and aircrew-related equipment within the wider debris field of a military aircraft crash site is an essential first step in planning and executing the recovery of missing aircrew members presumed still to be on the site. Understanding the spatial relationship of these materials improves the likelihood of finding and recovering the remains of the aircrew during the excavation of an aircraft crash site. Since the greater portion of these unaccounted for crewmembers were involved in aircraft with single-seat cockpits or cockpits with two or three seats in tandem, pre-analysis of the debris pattern may be more-or-less straightforward. Larger, multiple-personnel aircraft, on the other hand, create a potentially more complex analytical situation given the aircrew's greater freedom of movement within the aircraft. Nevertheless, the same fundamental principles apply and, indeed, have been successfully so for some time in the civilian arena. But older aircraft crash sites, i.e., those dating to World War II, Korea, or the Vietnam conflict, have been and still are undergoing taphonomic processes that progressively alter these relationships. The following will illustrate that exchange of information between the anthropologist/archaeologist and the life-support analyst is required to maximize the effectiveness of field recovery and demonstrates the relationship between the recovery of life-support equipment and human remains and the effect that aircraft type has on this relationship.     

A comparison of carboxyhemoglobin saturation values in postmortem heart blood and peripheral blood specimens

The following is a study conducted to determine whether there was any significant difference in carboxyhemoglobin (COHb) saturation levels between the heart blood and blood collected from a peripheral site. The average heart blood to peripheral blood COHb saturation level ratio in the 42 cases studied was 1.09. Sixty-two percent (26 of 42) of the cases had a heart blood to peripheral blood ratio between 0.9 and 1.1; 74% (31 of 42) had a ratio between 0.8 and 1.2. Eighty-three percent (35 of 42) had a ratio between 0.7 and 1.3. There were four cases where the heart blood to peripheral blood ratio was either below 0.6 or greater than 1.4. The differences between the two sites were not statistically significant.     

Total anomalous pulmonary venous drainage and sudden death in infancy.

The clinicopathologic features of four infants with undiagnosed total anomalous pulmonary venous return who died suddenly and unexpectedly are presented. Two infants were found dead in their beds and two collapsed following very non-specific episodes of mild tachypnoea and tachycardia, respectively. Pulmonary venous blood drained via a common channel to the left innominate vein, the superior vena cava, the inferior vena cava at the junction of the hepatic vein and the supradiaphragmatic portion of the inferior vena cava. All cases demonstrated right atrial and ventricular hypertrophy and in one case there was associated hypoplastic left heart syndrome. Although those mechanisms responsible for sudden infant death syndrome could not definitely be excluded in two cases, the presence of anomalous pulmonary drainage with significant right-sided cardiac cardiac hypertrophy in each patient strongly suggests a contributing role for the vascular malformation in the aetiology of sudden unexpected death. The importance of careful in situ dissection of the major vessels in all cases of paediatric sudden death is emphasised, particularly in the presence of other congenital cardiac anomalies.     

DELEGATION: A CASE STUDY

• 1 Whether to delegate or not to delegate has been an active issue in the New South Wales Public Service since 1960.
• 2 There has been considerable delegation of personnel authority to department heads during the period 1960–68, and the benefits of this programme have been significant.
• 3 The following rules seem to govern the selection of areas ripe for further delegation:

The “monopoly” rule: Where a department has a virtual monopoly over a particular occupational group in the Service, it should have authority to employ members of that group. The “rubber-stamp” rule: Where the rate of approval to departmental submissions approaches 100 per cent in any area, delegation of authority should be considered. The “guide-line” rule: Where the Board finds it possible to formulate guide-lines for the making of decisions within its own office, these guide-lines should be communicated to the departments, together with authority to make the appropriate decisions. The “no-harm” rule: Whenever authority can be exercised in a department without breaching any general or departmental limitation, delegation should be considered.

• 4 The following limitations to delegation of further personnel authority are seen to exist:

The “size” limitation: The small size of many departments limits the scope for further delegations of authority. The “geographical” limitation: The geographical dispersion of departmental staff is a factor that limits the scope for further delegations of authority. Regional decentralization, paradoxically, often leads to centralization of personnel authority. The “uniformity” limitation: The need to achieve uniformity in the Service, from one department to another, limits the scope for further delegations of authority. The ideal of uniformity, however, has probably been over-emphasized in the past because of the early history of the Public Service Board, and the centralized system of arbitration within which it operates. Other limitations: Factors unique to individual departments, such as historical influences and lack of competence in personnel administration, impose specific barriers to further delegations of authority.     

Attitudes of people with disabilities toward physician-assisted suicide legislation: broadening the dialogue

This article presents the methods, findings, and implications of a participatory action research project that attempted to shed additional light on the debate over death with dignity (DWD) or physician-assisted suicide (PAS) legislation. In-depth, qualitative interviews with forty-five physically disabled residents of the San Francisco Bay Area, conducted by others with disabilities, revealed a wide breadth of opinions about and attitudes toward such legislation. For close to half of the participants, the desire for autonomy in making end-of-life decisions was a primary concern, yet fear that PAS legislation could violate this autonomy in various ways was a deep concern as well. Also reported were widespread accounts of disability-based discrimination and frequent expressions of fear about openly discussing positions that diverge from the official, publicly held opinions of disability leaders who oppose such legislation. The findings support those of a recent Harris poll demonstrating considerable diversity of opinion about PAS legislation among people with disabilities. The findings further suggest the need for additional research on the apparent disjunction between the diversity of attitudes held by those interviewed and the more unified position taken by many disability activists. Use of the study findings to promote greater dialogue within the community and to better position people with disabilities to take their place at the policy table also is discussed. In addition, the findings are seen as reinforcing the need for the public health community to become more engaged in this central ethical debate.     

Banking on Social Change: Grameen Bank Lending to Women

The Grameen Bank in Bangladesh has become an international model for microcredit as a poverty alleviation strategy. The purpose of this paper is twofold: to evaluate the Grameen Bank as a strategy for empowering and improving the socioeconomic status of women in Bangladesh, and to identify lessons from the Grameen Bank experience that can inform development policy more generally. Arguments for and against Grameen Bank are evaluated in the light of evidence from studies of the Bank and knowledge of women and development. The conclusions that are drawn from this evaluation are that Grameen Bank is not a panacea for poverty alleviation and improving women's lives, that it has increased the income of borrowers, has led to improvements in specific aspects of their lives, and that it has potential if used in conjunction with other progressive social and economic policies to contribute to long-term, sustainable, progressive social change.