A Comment on Stephen Page's "What's New about the New Public Management"

The authors observe that the attacks on the new public management often show a lack of familiarity with its theoretical base, ignore that it is a recognized management tool, and imagine dramaturgy when none exists.     

Involuntary outpatient treatment as “desintitutionalized coercion”: The net-widening concerns

In American jurisprudence, two justifications have traditionally been put forth to support the government's social control of persons with mental illness: police power and parens patriae. As public mental hospitals became less available as loci in which to exercise these functions, governments sought alternative means to achieve the same ends. One prominent but quite controversial means is involuntary outpatient treatment (IOT). While the concerns about IOT have been myriad, one often alluded to but never documented is that of “net-widening.” That is, once IOT became available, it would be applied to an ever greater number of individuals, progressively expanding the margins of the designated population to whom it is applied, despite the formal standard for its application remaining constant. We tested the net-widening belief in a naturalistic experiment in Massachusetts. We found that net-widening did not occur, despite an environment strongly conducive to that expansion. At this time, whatever the arguments against IOT might be, net-widening should not be one of them.     

Does involuntary outpatient commitment lead to more intensive treatment?

Studies of involuntary outpatient commitment (OPC) among persons with severe mental illness have concluded that OPC is only effective in improving treatment outcomes when it is sustained for 6 months or longer and is combined with frequent outpatient services. This article explores factors that influence the delivery of outpatient services to subjects in a randomized trial of OPC and finds 2 general patterns. Outpatient visits were more frequent among all subjects with apparent clinical need, regardless of study assignment, and among subjects whose OPC was sustained beyond an initial court order. These results suggest that, in practice, sustained OPC represents a consensual agreement between clinicians and the court to more intensively address the complex needs of persons with severe and persistent mental illness.     

Detection of haptoglobin from concentrated urine samples by enzyme immunoassay

The detection of haptoglobin (Hp) from serum and bloodstains is utilized extensively in forensic science laboratories in order to include or exclude possible donors. There is an increasing need to make the same discriminations utilizing genetic markers from urine samples. This paper describes the use of enzyme immunoassay and Western blotting (electrophoretic) techniques to determine Hp phenotypes from concentrated urine samples. Serum and urine specimens were collected from volunteer donors. The serum sample from each donor was typed for Hp. The urine specimens were concentrated 3000-fold from the starting volume of 15 mL to a final volume of 5 microL and applied to the gradient polyacrylamide gels. This procedure allows the separation of Hp samples into the three common phenotypes as well as the other rare variants found in humans. The Western blotting electrophoretic technique was used to achieve the transfer of Hp bands from the gels to the nitrocellulose membranes. Enzyme immunoassay with goat anti-Hp antiserum and rabbit anti-goat immunoglobulin alkaline phosphatase conjugate were used to identify the Hp bands from the concentrated samples. Specimens stored for six months at -22 degrees C were also concentrated and typed successfully. Recent implementation of drug-screening policies has resulted in an increase in the submission of substituted urine specimens. The above procedure can be used to detect an additional genetic marker from urine samples and thus facilitate the identity of the donor.     

A dynamic test of the marginality hypothesis

The marginality hypothesis is an attempt to relate the voting margins of members of Congress to their subsequent legislative behavior. A major corollary of the hypothesis is that members of Congress with small victory margins will be more responsive to constituents than those with large victory margins. This has been assumed to mean that electorally secure representatives can afford to be more loyal to their congressional parties, since they have less cause to worry about their chances for reelection. Previous empirical studies have produced mixed results. We ask the question in a different way: Do changes in marginality affect party voting within Congress? If so, major shifts in the electorate potentially can have a fundamental impact on the behavior of Congress itself. We find that this is not true. Electoral margin is simply not related to party loyalty.     

The strategic inconsistency of Paretian liberalism

In this paper, the problem of the Paretian liberal is cast as a preference revelation game whose outcome function satisfies Gibbard's libertarian condition and strong Pareto optimality. Strategic consistency requires that the equilibrium of the game agree with the sincere outcome. It is shown that, whether viewed in a cooperative or non-cooperative context, the liberal social choice function is strategically inconsistent. This result suggests that, from a strategic standpoint, a different resolution of the liberal paradox is desirable.