India's “Grand Strategy” for the Indian Ocean: Mahanian Visions

This article considers how India sees the Indian Ocean, and in particular its drive to make the Indian Ocean, “India's Ocean.” Various comparisons and links are made. Firstly there is the role and application of Mahanian tenets of “sea-power,” in particular naval projection, control of sea-routes and access to bases. Second is the contrast between the earlier maritime visions of Kavalam Panikkar (1945) and Keshav Vaidya (1949) and the continental mindset evident under Nehru and his successors which saw neglect of India's maritime power. Third is the strategic vision evident since 1998 with the BJP government and maintained by the Congress administration since 2004. This has underpinned India's Naval Chief of Staff Arun Prakash's current eloquence on the possibilities opening up for India in and around the Indian Ocean. Questions of intent (strategic doctrine) and the application of “state power” (spending, bases, ships and equipment, geographical reach) are woven together.     

Forensic psychiatry and malpractice

This paper concerning the last 87 malpractice cases referred to the Department of Psychiatry and Law, Menninger Clinic, includes 57 suits against mental health practitioners and/or institutions, and 30 nonpsychiatric suits against general hospitals, surgeons, obstetricians, etc. A patient was available for interview in only 12 percent of the psychiatric cases; in 88 percent we reviewed medical records and consulted with attorneys. In the psychiatric cases the crucial question was whether a generally accepted standard of care was breached. The inherent problems of applying appropriate criteria to standards of care by practitioners and institutions are discussed. In half the psychiatric cases we found no significant deviation from acceptable clinical performance; in half we concluded that negligent practice had occurred. We did see a litigant for evaluation in 90 percent of the nonpsychiatric cases. The main issue involving them concerned harm or disability related to presumed negligence by medical personnel. How we evaluate such cases and apply disability criteria is discussed.     

Effects of positional restraint on oxygen saturation and heart rate following exercise

This report assesses the effects on peripheral oxygen saturation and heart rate that positional restraint induces when a person is prone, handcuffed, and "hog-tied." Peripheral oxygen saturation and heart rate were monitored at rest, during exercise, and during recovery from exercise for 10 adult subjects. The effects of positional restraint produced a mean recovery time that was significantly prolonged. Consequently, the physiological effects produced by positional restraint should be recognized in deaths where such measures are used.