Strengthening public health supply chains in Ethiopia: PEPFAR-supported expansion of access and availability

When the US President's Emergency Plan for AIDS Relief (PEPFAR)-supported Supply Chain Management System (SCMS) programme began working in Ethiopia in 2006, the estimated population of people living with HIV exceeded one million, while only 24,000 were on treatment and only 50 treatment sites were in operation. SCMS and other key partners entered into this context to support the Ethiopian government in significantly strengthening the public health supply chain system, with the aim of increasing the availability and accessibility of pharmaceutical products. The country now has 1,047 treatment sites and is nearing complete treatment coverage. This article discusses how priorities were set among many competing challenges from 2006 until 2014, and how the four-step strategy of build, operate, transfer, and optimise has resulted in a successful partnership.     

Elspeth Huxley: gender,empire and narratives of nation, 1935-64

Abstract

This article explores the impact of empire on narratives of the British nation during a period of decline of British colonial rule through a study of Elspeth Huxley's successive reworkings of such narratives between 1935 and 1964. It sets Huxley's work in the context of post-1945 anxieties about national decline and their connections with the loss of imperial power, and looks at the difficulties surrounding the articulation of national identity as virile and masculine in post-imperial Britain. Although anxieties about masculinities were often addressed through a misogynistic discourse which showed women emasculating men, Huxley's work suggests the significance of a counter-theme. It indicates not only her own attachment to an imperial identity but also the ways in which this continued to be articulated in the midtwentieth century as an identity with a wide appeal to a metropolitan audience, and one through which women could be incorporated into the story of nation. In exploring the terms of this incorporation, the article considers the opportunities open to women to claim to embody exemplary national qualities through the figure of the doughty, intrepid, imperial female pioneer, and the particular resonance and appeal this figure acquired in the context of the end of empire.     

“Absolutely Irresponsible Amateurs”: The Temporary Mixed Commission on Armaments, 1921–1924

Created in early 1921, the Temporary Mixed Commission on Armaments was a committee of eminent figures formed by the League of Nations to consider the problem of international disarmament in its widest aspects and to suggest potential initiatives, plans and solutions. What made it unique was that its members were specifically appointed as private individuals, unrestrained by formal instructions from governments. They were intended to be free to put forward ideas and opinions that seemed most likely to produce real progress but which might have created political turmoil if they had come from official representatives. To some contemporary observers this extraordinary degree of independence was tremendously appealing; to others, the lack of accountability on an issue of supreme importance to the national security of member states was desperately objectionable. In practice, much of the commission's work resolved into a battle between interventionist British members and resistant French members, led respectively by Lord Robert Cecil and Colonel Edouard Réquin, with its most prominent outcome being the failed 1923 draft Treaty of Mutual Assistance. A fascinating experiment in the possibilities of transnationalism within an international organization, the Temporary Mixed Commission on Armaments both exemplified the fluidity of the League of Nations in its early years and showed the limited results a transnational approach could achieve on as contentious an issue as disarmament.     

Preliminary evaluation of the childhood experiences of violence questionnaire short form

Despite advances in child maltreatment research, accurate measurement of exposure remains a key issue. In this study, we evaluated a short form (CEVQ-SF) of the Childhood Experiences of Violence Questionnaire (CEVQ) in a sample of adolescents involved with child protection services in an urban city in Ontario, Canada. Focusing on the two most readily defined maltreatment types, physical and sexual abuse, we evaluated the short form's comparability with the full version of the CEVQ. Both versions had good internal consistency and moderate-to-good 2-week test-retest reliability. The criterion validity of the two CEVQ versions in comparison with the Childhood Trauma Questionnaire was satisfactory. Construct validity for both versions was demonstrated: physically and sexually abused youth had higher odds of reporting clinical traumatic symptoms compared with either type alone. The CEVQ-SF is as reliable and valid as its full version. Implications for its use in large population-based surveys are discussed.     

Race and decision making within juvenile justice: The importance of context

Previous tests of the influence of race on decision making within juvenile justice proceedings have traditionally focused on case-level variables and/or macrolevel factors that characterize the jurisdictions under study. Often excluded are measures of the attitudinal context within which decision making occurs. Using a revised conflict perspective that incorporates the role of racial stereotyping, hypotheses are developed centering on racial differences in case processing decisions within four midwest jurisdictions. Attitudes of juvenile court officials toward the punitiveness of the juvenile court and perceptions regarding differences between the behavior and attitudes of whites and those of African Americans are included in additive and race interactive models of five decision-making stages. Results indicate both lenient and harsh treatment of African Americans compared to whites. Hypotheses regarding racial stereotyping in the decision-making process receive some support and the discussion focuses on how inconsistent racial effects may be a function of variation in structural “coupling” across system decision points.     

Evaluating provincial budgetary policy

Abstract: This paper reviews the period 1965-84, providing an analysis of the contribution of provincial budgets to regional stabilization and the impact of budgets on the financial position of provincial governments. The perversity hypothesis, which proposes that provincial budgetary behaviour may serve to exacerbate rather than reduce cyclical swings in local economies, is examined. An effort is made to differentiate between the automatic and discretionary components of provincial budgets, by calculating cyclically and inflation-adjusted revenues, expenditures and budget balances. A budget balance analysis arrives at the following conclusions: the behaviour of provincial budgets, including both automatic and discretionary components, was stabilizing, for the most part, during the study period; however, in most cases, discretionary budgetary policy was perverse. A regression analysis arrives at the following conclusions: in Newfoundland, New Brunswick, Manitoba and Saskatchewan, both revenue and expenditure policy demonstrated neutral cyclical behaviour during the study period; in Nova Scotia and British Columbia, destabilizing expenditure-side behaviour offset stabilizing revenue-side behaviour, while in Quebec, Ontario and Alberta, stabilizing expenditure changes may have dominated destabilizing revenue changes; in Nova Scotia and Manitoba, the long-run rate of expenditure growth exceeded the rate of revenue growth, suggesting a possible structural deficit problem, while the other provinces appear to have exercised greater financial control; and provincial expenditure policy was affected by the electoral cycle, while revenue policy appears to have been unaffected. It is expected that provincial involvement in cyclical regulation will be limited in the immediate future and that the provinces will take further steps to shore up their finances, following the stresses that were imposed on their budgets by the last recession. Sommaire: Cet article passe en revue la période 1965–1984 et analyse le rôle des budgets provinciaux dans la stabilisation régionale et leur impact sur la situation financière des gouvernements provinciaux. Les auteurs examinent l'hypothèse de l‘“effet pervers” selon lequel la politique budgétaire provinciale accentuerait les revirements cycliques de l’économie locale au lieu de les atténuer. Ils tentent de faire la distinction entre les éléments automatiques et discrétionnaires des budgets provinciaux en calculant les recettes, les dépenses et les soldes budgétaires ajustés en tenant compte de leur aspect cyclique et de l'inflation. Une analyse du solde budgétaire mène aux conclusions suivantes: les budgets provinciaux, et leurs éléments automatiques et discrétionnaires, ont eu en général un effet stabilisateur pendant la période étudiée; cependant, dans la plupart des cas, la politique budgétaire discrétionnaire a eu un effet pervers. Une analyse de régression mène aux constatations suivantes: à Terre-Neuve, au Nouveau-Brunswick, au Manitoba et en Saskatchewan, les politiques de recettes et de dépenses ont eu un effet cyclique neutre pendant la période étudiée; en Nouvelle-Écosse et en Colombie-Britannique, l'effet déstabilisateur des dépenses a annulé l'effet stabilisateur des recettes, tandis qu'au Québec, en Ontario et en Alberta, il semble que les changements stabilisateurs dans les dépenses aient dominé les changements déstabilisateurs dans les recettes; en Nouvelle-Écosse et au Manitoba, le taux de croissance à long terme des dépenses a été supérieur au taux de croissance des recettes, ce qui est peut-être le signe d'un problème de déficit structurel, bien que les autres provinces semblent exercer un plus grand contrôle financier; la politique provinciale de dépenses a subi les contrecoups du cycle électoral alors que la politique de recettes ne semble pas avoir été touchée. On prévoit que l'intervention provinciale dans la règlementation cyclique sera limitée dans un proche avenir et que les provinces prendront de nouvelles mesures pour consolider leurs finances, suite aux contraintes budgétaires que la dernière récession leur a imposée.     

HELP: an educational forensic psychiatric assessment program

This paper describes the establishment of an educational group, Health through Education in Law and Psychiatry (HELP), within an inpatient forensic psychiatric assessment service. Until recently HELP sessions have been provided twice weekly to suitable patients during their stay of some 30 days at the Metropolitan Toronto Forensic Service (METFORS). We first outline very briefly the function of METFORS, then describe the HELP project broadly, and finally discuss the rationale of the program in greater detail. Our point is that programs of this type form an added resource in assessment and in the early stages of treatment. We also argue that, along with the accepted clinical role in assessment, forensic psychiatrists and colleagues in related disciplines can serve a valuable role as teacher and therapist.     

Interpretation of the Prohibition of Torture: Making Sense of ‘Dignity’ Talk

The right not to be subjected to torture, cruel, inhuman or degrading treatment or punishment is invariably associated with ‘human dignity’. The idea of dignity plays some role in this right’s interpretation, although the content of the idea in this context, as in others, is unclear. Making sense of the dignity idea involves a number of challenges. These challenges give rise to the methodological-type question at the heart of this article: how should human rights lawyers go about articulating the content of ‘dignity’? The article proposes, and models, a methodological approach in response. Its core argument is that human rights law needs the vocabulary provided by theorizations of dignity but that these theorizations should be anchored in authoritative human rights jurisprudence. It argues that this approach can help make sense of the dignity idea in a way that facilitates a richer understanding of its influence on interpretation.     

The Changing Nature of Political Debate Consumption: Social Media,Multitasking, and Knowledge Acquisition

This study examines the influence of debate viewing-social media multitasking on campaign knowledge during the 2012 presidential election. Results from three waves of a national cross-sectional survey of U.S. adults conducted during and after the 2012 presidential election suggest that social networking site (SNS) use overall correlates with increased knowledge of campaign issues and facts above and beyond the use of other sources of news media. In addition, watching a debate with or without simultaneous social media engagement is better for knowledge generation than not viewing a debate at all, but the effect of debate viewing is dulled when simultaneously engaging in social media multitasking. The debate viewing-social media multitasking effect is moderated by candidate preference, with differential learning occurring largely for knowledge that is favorable to one’s preferred candidate.