Insomnia, nightmare frequency, and nightmare distress in victims of sexual abuse: the role of perceived social support and abuse characteristics

In this study of victims of sexual abuse, the aim was to investigate the role of perceived social support and abuse characteristics in self-reported insomnia, nightmare frequency, and nightmare distress. Four hundred sixty Norwegian victims of sexual abuse completed a questionnaire assessing perceived social support, abuse characteristics, insomnia, nightmare frequency, and nightmare distress. Results show that higher levels of perceived social support were related to lower scores on all symptom outcome measures. Abuse involving oral, genital, or anal penetration was related to more insomnia symptoms. Longer duration of abuse and threatening conducted by the perpetrator were related to higher nightmare frequency, while threats and abuse involving penetration were related to higher degrees of distress associated with nightmares. In conclusion, the present study provides preliminary data indicating that perceived social support may affect the nature of sleep difficulties in sexual abuse victims. Also, more severe forms of sexual abuse are related to higher levels of sleep difficulties.     

Kant, Copyright and Communicative Freedom

The rapid recent expansion of copyright law worldwide has sparked efforts to defend the ‘public domain’ of non-propertized information, often on the ground that an expansive public domain is a condition of a ‘free culture’. Yet questions remain about why the public domain is worth defending, what exactly a free culture is, and what role (if any) authors’ rights might play in relation to it. From the standard liberal perspective shared by many critics of copyright expansionism, the protection of individual expression by means of marketable property rights in authors’ works serves as an engine of progress towards a fully competitive ‘marketplace of ideas’ – though only if balanced by an extensive public domain from which users may draw in the exercise of their own expressivity. This article shows that a significantly different, and arguably richer, conception of what a free culture is and how authors’ rights underpin it emerges from a direct engagement with the philosophy of Immanuel Kant. For Kant, progress towards a fully emancipated (i.e. a ‘mature’ or ‘enlightened’) culture can only be achieved through the critical intellectual activity that public communication demands: individual expressive freedom is only a condition, not constitutive, of this ‘freedom to make public use of one’s reason in all matters’. The main thesis defended in this article is that when Kant’s writings on publicity (critical public debate) are read in relation to his writings on the legal organization of publishing, a necessary connection emerges between authors’ rights – as distinct from copyrights – and what Jürgen Habermas and others have named the public sphere. I conclude that it is the public sphere, and not the public domain as such, that should serve as the key reference point in any evaluation of copyright law’s role in relation to the possibility of a free culture.     

Homicide-suicide in the change of time

Homicide-suicide is a rare event compared to suicide and homicide alone. A comparison of the statistical figures of two studies for Hamburg (1950-1961 and 1990-2005) shows a significant development within the last 40 years: the total number of homicide-suicides committed by women has decreased considerably, probably due to a better medical and psychiatric care and greater economic independence, whereas the number of male perpetrators has remained constant. However, these perpetrators are younger now. As far as the methods are concerned, shooting is now the most common means of killing instead of poisoning by coal gas in former days.     

Medical malpractice reform and insurer claims defense: unintended effects?

In response to recent and past medical malpractice insurance crises, most states have implemented reforms meant to stabilize premiums and coverage availability. The importance of understanding whether these reforms implicitly affect the behavior and incentives of plaintiffs, attorneys, medical providers, and malpractice insurers in the intended way is crucial to policy makers, if they are to achieve their goal. This study specifically examines the effect of reforms on the claims defense efforts of insurers, given that defense expenses account for approximately 30 percent of malpractice premiums. Using state data for the period 1998-2002, we regress claims defense expenses against a variety of reform variables. These include seven tort reforms (noneconomic damage caps, punitive damage limits, attorney fee limits, modified collateral source rule, modified joint and several liability doctrine, mandatory pretrial screening, and statute of limitations) and two government-sponsored insurance mechanisms (joint underwriting associations and patient compensation funds). Claims defense expenses are found to be higher in the presence of noneconomic damage caps, punitive damage limits, and attorney fee limits--an unintended and counterproductive effect of reform--but are lower with mandatory pretrial screening and patient compensation funds.     

The evolution of program budget ideas in Canada: Does Parliament benefit from Estimates reform?

Abstract: The article examines the federal Estimates budget from the perspective of whether or not the program format enhances democratic control. It introduces the idea of the budgetary system as a control in a generic management process, and then traces reforms in the accountability side of the Canadian federal government's central management system through the past twenty years. It concludes that the implementation of this version of PPBS was an error, and that it will be difficult to correct, because the budget design is embedded in the network of central institutions, which includes the Office of the Auditor General (OAG). A distinctive kind of “meta control” is now a characteristic of the federal context, and is not clearly managed by government from one decision centre. The author argues that the system does not serve Parliament. Instead it encourages bureaucratic or silent politics at several levels: inside departments; between departments and the OAG; and in an impkit system of elite accommodation between the OAG, central agencies and the government. Sommaire: Cet article analyse le récent budget de dépenses présenté au Parlement fédéral pour voir dans quelle mesure il permet d'accroître le contrôle démocratique. Il présente le système budgétaire comme un élément de contrôle dans un processus global de gestion, pour ensuite décrire les réformes ayant trait à l'imputabilité qui ont eu lieu dans le système de gestion centrale du gouvernement fédéral canadien depuis vingt ans. En conclusion, l'auteur explique que l'implantation de cette version de la rationalisation des choix budgétaires (RCB) était une erreur et que celle-ci sera difficile à corriger, étant donné que le processus budgétaire est noyé dans le réseau des institutions centrales, dont fait partie le Bureau du Vérificateur général (BVC). Le contexte fédéral se caractérise maintenant par une forme de meta-contrôle qui ne permet pas au gouvernement de gérer avec autoritéà partir d'un centre unique de décision. L'auteur soutient que le système ne sert pas le Parlement. Il encourage plutôt les politiques bureaucratiques ou les ententes tacites à différents niveaux, que ce soit à l'intérieur des ministères, entre les ministères et le BVC ou dans le cadre d'un système implicite de services rendus entre le BVG, les organismes centraux et le gouvernement.     

Decentralization and accountability in the health sector from an international perspective: What are the choices?

This article reviews alternative decentralization policies for the health sector. It discusses the forms that decentralization can take, illustrating these with country examples. It then considers the choice of levels in a decentralization policy and the desirability of the creation of health boards or authorities. Decentralized authorities can be given differing levels of responsibility for different tasks: those considered here are revenue raising, policy-making and planning, resource allocation, funding of service provision and interagency and intersec-toral coordination. The article concludes by considering some criteria for evaluating decentralization approaches.     

Polish ‘Temporary’ Migration: The Formation and Significance of Social Networks

This article is based on in-depth interviews with migrants in different locations in Poland and the UK and explores Polish migrant decision making in both countries. In particular, we ask how migrants build networks, how this influences their decisions about the duration of their stay abroad, and the implications of network building for community cohesion. Networks exist within the sending country; between the sending and the receiving country; within diasporas; and between diasporas and the receiving community. Our article considers the first three sections of this chain.     

Book reviews

Ennio Di Nolfo (ed.), Power in Europe?II. Great Britain, France, Germany and Italy and the Origins of the EEC, 1952-1957. (Berlin and New York: Walter de Gruyter, 1992), DM238.

Simon J. Nuttall, European Political Cooperation (Oxford: Clarendon Press, 1992), 343pp. £30, ISBN 0 19 827318 5.

Michael Smith and Stephen Woolcock, The United States and the European Community in a Transformed World (London: Pinter publishers for Royal Institute for International Affairs, 1993), 120 pp., £22.50 hb, £9.95 pb. ISBN 086187 0972/086187 0980.

Richard H. Ullman, Securing Europe (London: Adamantine Press, 1991), 175pp., £12.95. ISBN 0 7449 0036 0.

Cornelia Navari (ed.), The Condition of States: A Study in International Political Theory (Milton Keynes: Open University Press, 1991), 238pp.

Francine Friedman, (comp. and ed.) Yugoslavia: A Comprehensive English-Language Bibliography (Wilmington, Delaware: Scholarly Resources, 1993), xv + 547 pp., indices, US$ 120.

Richard Dean Burns (ed.), Encyclopedia of Arms Control and Disarmament (New York: Charles Scribner's Sons, 1993), three vols., 1692 pp. inch index, US$280, ISBN 0 684 19281 0.