Using the Delphi process to analyze social policy implementation: A post hoc case from vocational rehabilitation

This study uses a Policy Delphi to discern differences in perspective among and within groups responsible for formulating and implementing vocational rehabilitation policy. Four groups of players were chosen for our analysis: government officials, academics, directors of rehabilitation centers, and the staff who interface with program participants. Significant differences were found between the groups regarding the relative importance of possible legislative goals. This suggests that the failure of vocational rehabilitation policy to promote a work agenda may be attributed to a lack of consensus among policy implementors. The Delphi technique could help policy planners understand the different perspectives within the implementation community, and hence craft more realistic legislation.     

State Initiatives in the Federal System: The Politics and Policy of Comparable Worth in 1984

In 1984, comparable worth came to occupy center stage amongstate and local political systems as the civil rights causeof the 1980s. Advocates of comparable worth came to see stateand local governments as being more receptive to consideringpolicy initiatives in this area than was the federal government.This article documents comparable worth events culminating in1984, describes the expansion of state and local action in thisarea, and considers the implications of these developments forthe federal system. A conceptual framework for examining theissue of comparable worth is also presented.     

Child murder committed by severely mentally III mothers: an examination of mothers found not guilty by reason of insanity. 2005 Honorable Mention/Richard Rosner Award for the best paper by a fellow in forensic psychiatry or forensic psychology

Forensic hospital records of 39 severely mentally ill mothers adjudicated Not Guilty by Reason of Insanity for filicide (child murder by parents) were analyzed to describe characteristics preceding this tragedy and to suggest prevention strategies. Almost three-quarters of the mothers (72%) had previous mental health treatment. Over two thirds (69%) of the mothers were experiencing auditory hallucinations, most frequently command hallucinations, and half (49%) were depressed at the time of the offense. Over one third (38%) of the filicides occurred during pregnancy or the postpartum period, and many had a history of postpartum psychosis. Almost three-quarters (72%) of the mothers had experienced considerable developmental stressors, such as death of their own mother or incest. Maternal motives for filicide were predominantly "altruistic" (meaning murder out of love) or "acutely psychotic" (occurring in the throes of psychosis, without rational motive). Psychiatrists should perform careful risk assessments for filicide in mothers with mental illnesses.     

The epidemiology of female rape victims who seek immediate medical care: temporal trends in the incidence of sexual assault and acquaintance rape

Women who seek medical care following sexual assault are usually evaluated and treated in an emergency department (ED). Therefore, EDs can be an important source of sexual assault surveillance data. The authors compared the incidence of sexual assault presenting for emergency care in a single county during July to November of 1974 and 1991. Participants included all female sexual assault victims aged 14 and older who presented for ED evaluation. Treating physicians prospectively collected data using standardized forms. The z statistic was used to compare sexual assault incidence. There was a 60% increase in the incidence of sexual assault victims presenting for emergency care in 1991 compared to 1974, primarily due to an increase in the incidence of women presenting to the ED after rapes by known assailants. In contrast, the annual incidence of reported stranger assaults was similar in the two study years.     

Y-chromosome STR system, Y-PLEX 12, for forensic casework: development and validation

The Y-PLEX 12 system, developed for use in human identification, enables simultaneous amplification of eleven polymorphic short tandem repeat (STR) loci, namely DYS392, DYS390, DYS385 a/b, DYS393, DYS389I, DYS391, DYS389II, DYS 19, DYS439 and DYS438, residing on the Y chromosome and Amelogenin. Amelogenin provides results for gender identification and serves as internal control for PCR. The validation studies were performed according to the DNA Advisory Board's (DAB) Quality Assurance Standards. The minimal sensitivity of the Y-PLEX 12 system was 0.1 ng of male DNA. The mean stutter values ranged between 3.76-15.72%. A full male profile was observed in mixture samples containing 0.5 ng of male DNA and up to 400 ng of female DNA. Amelogenin did not adversely affect the amplification of Y-STRs in mixture samples containing male and female DNA. The primers for the Y-STR loci present in Y-PLEX 12 are specific for human DNA and some higher primates. None of the primate samples tested provided a complete profile at all 11 Y-STR loci amplified with the Y-PLEX 12 system. Y-PLEX 12 is a sensitive, valid, reliable, and robust multiplex system for forensic analysis, and it can be used in human forensic and male lineage identification cases.     

Implementing health care reform in Israel: organizational response to perceived incentives

Devising new incentives was a main element of health care reform in Israel, which created a regulated market that embodies many principles of managed competition. This study examined sick fund directors' perceptions of the new incentives and their strategic responses to these incentives, enabling the testing of how managed competition works in practice. The methodology used was a multiple case study of Israel's four sick funds. Data were gathered through in-depth interviews with 160 senior officials, analysis of national health insurance legislation, and analysis of published and unpublished archival documents, newspaper articles, public statements of senior managers, and other published data on the sick funds' behavior. The study revealed discrepancies between planned and perceived incentives and highlighted the effect of the latter on strategy formulation. Analysis of sick fund strategies showed that their responses to managed competition incentives deviated from theoretical expectations, compromising some of the objectives of the reform. The study also shows that contextual features account for the specific model of managed competition that was implemented and for the specific strategies employed by the sick funds. The study concludes by highlighting the need to build a process that will enable policy makers to consider local contextual factors when planning and implementing reform, involving health care providers in designing incentives, continuously monitoring processes and outcomes in the reformed system, and allowing for flexibility in policy making.     

The Role of Woman's Explanations for Refusal on Men's Ability to Discriminate Unwanted Sexual Behavior in a Date Rape Scenario

This study examined the impact of types of women's verbal refusals, and the timing of her refusal, on men's discrimination of when a female wants her partner to stop making sexual advances. Male students were randomly assigned to 1 of 6 conditions (Explanations × Intimacy Levels). Before listening to an audiotape of a date rape, participants were told they would be listening to an interaction between a man and a woman who had just returned from a date. They were instructed to indicate when the woman wanted the man to stop making sexual advances by pressing a switch that synchronously stopped a timer (yielding the measure of latency). In the vignette, the woman provided an explanation for not engaging in sexual intercourse on the date either during kissing or when the man attempted to touch her breasts. She offered one of three reasons for refusing his sexual advances; fear of pregnancy, waiting until marriage, too early in the relationship. Results revealed an interaction in which participants in the too early in the relationship explanation at the level of breast contact condition displayed significantly longer latencies than individuals in the other groups. The implications of the findings are discussed.