The interplay between economic and political logics: path dependency in health care in England

The purpose of this article is to use the ideas of path dependency to understand why policies implemented by governments for health care in England were and are suboptimal in terms of the control of total costs, the equitable distribution of hospital services, and efficiency in delivery. We do this by relating the economic logic of achieving these objectives to the political logic of a state-hierarchical system in which ministers are accountable for the effects of policies and doctors largely decide the supply and demand of health care. The initial policy path of the National Health Service (NHS) controlled costs but lacked systems to achieve equity and efficiency in the funding of hospitals. Policies were introduced to achieve equity, but not efficiency, in the 1970s. The Thatcher government sought efficiency through a budgetary squeeze in the 1980s, which culminated in the NHS funding crisis of 1987 - 1988. The result was the policies of the NHS internal market, which promised efficiency by introducing a purchaser-provider split and a system of provider competition in which money would follow the patient. These promises justified an injection of extra funds for three years, but only a pallid model of the internal market was implemented. The Blair government abandoned the rhetoric of competition but maintained the purchaser-provider split and continued to constrain total NHS costs, which resulted in the funding crisis of 1998 - 1999. Current policies are to substantially increase spending on health care and reintroduce a system of provider competition in which money will follow the patient.     

The evaluation of the extent of transporting or "tracking" an identifiable ignitable liquid (gasoline) throughout fire scenes during the investigative process

Tests have determined that boots or shoes of individuals at a fire scene do not transport sufficient contaminants ("tracking") through the fire scene to produce a positive laboratory result for the presence of gasoline in a fire scene that was not present at the time of the fire. Questions about the validity of forensic laboratory results have been raised on the basis that low-level gasoline residues detected in the laboratory samples could have been the result of transporting the residue by footwear contaminated from the fire scene ("tracking"). The data collected in this study establish that "tracking" does not lead to false-positive laboratory results. Canines trained and experienced in the detection of trace ignitable liquid residues were also utilized in this study. The canine results confirmed that properly trained canines show a higher sensitivity than do standard ASTM laboratory techniques for fire debris analysis. In a few cases, canines responded to contamination, but laboratory testing (which is the definitive indicator) did not produce positive results.     

Overview of: “Crime Place and Pollution: Expanding Crime Reduction Options Through a Regulatory Approach”

Research Summary Crime reduction policy has focused almost exclusively on offenders. Recent studies and evaluations show that expanding our policy portfolio to include places may be highly productive. We show that there is considerable research showing that crime is concentrated at a relatively few locations, that high-crime places are stable, that changing places can reduce crime, that displacement is not only far from inevitable but also less likely than the diffusion of crime prevention benefits, and that owners of high-crime places can be held accountable for the criminogenic conditions of their locations. We link these findings to environmental policy, where environmental scientists, economists, and regulators have developed a broad set of regulatory options. The core of this article describes a portfolio of environmental policy instruments directly applicable to crime places. We also discuss major decisions local governments will need to make to implement various forms of regulation, and we list challenges that governments must anticipate in planning for such implementation. We argue that a regulatory approach to crime places has the potential to lower the cost to taxpayers of reducing crime by shifting costs from governments to the relatively few place owners whose actions create crime-facilitating conditions. Policy Implications Taking a regulatory approach to crime places substantially expands the crime policy options under consideration. Regulatory options may increase local governments’ effectiveness at reducing crime while reducing governments’ costs. This is because regulatory approaches have the potential to shift some portion of the financial burden for crime fighting to owners of criminogenic locations. Policy makers can select between means-based anticrime regulations that focus on how place owners manage their locations and ends-based regulations that focus on the number of crimes allowed at places. Both of these approaches contain several alternative regulatory instruments, each with its own set of advantages and disadvantages. Experimenting with various regulatory instruments could lead to the development of a range of new crime reduction policies. In addition, a regulatory approach has implications for the funding of policy research. Means-based regulatory instruments require governments to develop evidence that the means they regulate have the desired impact on crime. Ends-based regulatory instruments shift this burden to the regulated places.     

Positive Resolution of Childhood Sexual Abuse Experiences: The Role of Coping,Benefit-Finding and Meaning-Making

Resolution of the trauma of childhood sexual abuse (CSA), and the current adjustment of 60 adult female CSA survivors were explored through qualitative and quantitative analyses of their coping strategies, perceived benefits, and meaning-making attempts. While the majority of the women (87%) perceived at least some benefit resulting from coping with the CSA experience, many (29%) found it impossible to make any meaning of their trauma. Specific benefits that were associated with various aspects of positive adjustment (marital satisfaction, better physical health, less isolation) included improved relationships with others, religious or spiritual growth, and improved parenting skills. Some perceived benefits were actually associated with a negative outcome. Increased knowledge of sexual abuse was associated with more isolation and lower marital satisfaction. When positive meaning could be derived from the coping process, the women reported less isolation. Avoidant coping was strongly associated with more depressive symptoms and poorer resolution of abuse issues. Results highlight the importance of considering coping strategies and cognitive restructuring efforts in designing therapeutic interventions with this population. Portions of this paper were presented at the annual meeting of the Midwest Psychological Association, May 2004, Chicago, IL.     

New paradigms in researching police use of firearms

In the current climate of increasing violence against the police, the use of force by police officers has been the focus of much dabate, ranging from the use of non lethal incapacitant sprays to the use of lethal force^I. We review literature concerning the use of lethal force by police officers, evaluate its utility for operational contexts, consider its implications for training and propose that new technological devices can revolutionise the identification of crucial variables.     

Supreme Court Ruling Creates More Standing Room in the Already Heated Global Greenhouse Gas Movement

This article reviews the recent April 2, 2007 Supreme Court decision in the Massachusetts v. EPA, a highly important case regarding greenhouse gases. The case centered on the Court's review of EPA's denial of a petition to regulate greenhouse gas emissions from new motor vehicles. The Court required EPA to reconsider its denial. The Court found that. 1) the petitioners have standing to challenge EPA's denial of their petition; 2) the Court has the authority to review the denial of the petition; and 3) the Clean Air Act authorizes EPA to regulate greenhouse gas emissions from new motor vehicles. This article looks specifically at the Court's analysis of standing and jurisdiction by Justice Stevens, who wrote the Court's majority opinion, and two dissenting opinions by Justices Roberts and Scalia. Most interesting is how the closely divided Justices (5 to 4 decision) viewed, very differently, the issues regarding standing, the evidence that emissions from new motor vehicles are causing global warming and harm to Massachusetts, and the agency's judgment in denying the petition. Lastly, the article speculates on the impact of the decision and the current activities taking place at the state and regulated community level involving future regulation, litigation, and opportunities by various companies and coalitions to reduce greenhouse gas emissions. The article then presents five broad areas where companies that emit greenhouse gases should need to maintain or increase awareness to better position themselves in the global greenhouse gas movement.     

The Effect of a Standard to Improve Person Descriptions by Children

This study examines whether or not using a person as a standard/comparison improves the ability of a child witness to provide more accurate detail about a previously observed person. Study participants included 135 children who observed a male stranger and were then later asked to describe and answer various questions about that person using a third-person standard/comparison. Despite the fact that one-half of participants were exposed to a standard/comparison, neither participants’ gender or exposure to the standard/comparison improved recollection outcomes. However, the gender of the standard/comparisons - especially where female - did have a significant effect on the recall ability of male participants.