The judicial role in life-sustaining medical treatment decisions.

Although there has been speculation regarding the pervasiveness and nature of judicial decisions regarding life-sustaining medical treatment (LSMT), no attempt has been made to empirically assess their prevalence or the issues they address. An exploratory study utilizing a mail survey of a nationwide random sample (N = 905) of state trial court judges was conducted to provide initial information regarding this decision-making process. Twenty-two percent of the responding judges had heard at least one LSMT case, and judicial review did not appear endemic to particular states. The number of judges hearing LSMT cases dropped from 1975 to 1981 but has increased since then. Three major issues predominate: patient competency, appointment of a surrogate decisionmaker, and resolution of the ultimate issue of forgoing LSMT. Relatively few cases either contested a prior directive's validity or involved imposing sanctions for instituting or forgoing LSMT. Although subject to different interpretations, the results suggest the courts are having a significant impact on certain aspects of the LSMT decision-making process. However, the infrequency with which any one judge is called upon to make an LSMT decision causes concern about the judiciary's ability to respond in a timely and appropriate manner. With their potential for a profound effect on the actions of health care providers, greater attention to this decision-making process is warranted.     

Conceptualising corporate community development

Globally there is an increasing focus on the private sector as a significant development actor. One element of the private sector’s role emphasised within this new focus has been corporate social responsibility (CSR) activities, whereby the private sector claims to contribute directly to local development. There is now a substantial body of work on CSR but it is a literature that is mostly polarised, dominated by concerns from the corporate perspective, and not adequately theorised. Corporations typically do development differently from NGOs and donors, yet the nature and effects of these initiatives are both under-researched and under-conceptualised. In this paper we argue that viewing CSR initiatives through a community development lens provides new insights into their rationale and effects. Specifically we develop a conceptual framework that draws together agency and practice-centred approaches in order to illuminate the processes and relationships that underpin corporate community development initiatives.     

A Classification Tree Approach to the Development of Actuarial Violence Risk Assessment Tools

Since the 1970s, a wide body of research has suggested that the accuracy of clinical risk assessments of violence might be increased if clinicians used actuarial tools. Despite considerable progress in recent years in the development of such tools for violence risk assessment, they remain primarily research instruments, largely ignored in daily clinical practice. We argue that because most existing actuarial tools are based on a main effects regression approach, they do not adequately reflect the contingent nature of the clinical assessment processes. To enhance the use of actuarial violence risk assessment tools, we propose a classification tree rather than a main effects regression approach. In addition, we suggest that by employing two decision thresholds for identifying high- and low-risk cases--instead of the standard single threshold--the use of actuarial tools to make dichotomous risk classification decisions may be further enhanced. These claims are supported with empirical data from the MacArthur Violence Risk Assessment Study.     

Are Group Cues Necessary? How Anger Makes Ethnocentrism Among Whites a Stronger Predictor of Racial and Immigration Policy Opinions

Research shows that group conflict sets ethnocentric thinking into motion. However, when group threat is not salient, can ethnocentrism still influence people’s political decision-making? In this paper, I argue that anger, unrelated to racial and ethnic groups, can activate the attitudes of ethnocentric whites and those that score low in ethnocentrism thereby causing these attitudes to be a stronger predictor of racial and immigration policy opinions. Using an adult national experiment over two waves, I induced several emotions to elicit anger, fear, or relaxation (unrelated to racial or ethnic groups). The experimental findings show that anger increases opposition to racial and immigration policies among whites that score high in ethnocentrism and enhances support for these policies among those that score low in ethnocentrism. Using data from the American National Election Study cumulative file, I find a similar non-racial/ethnic anger effect. The survey findings also demonstrate that non-racial/ethnic fear increases opposition to immigration among whites that don’t have strong out-group attitudes.     

THE ODDS ON CASINO PAINTINGS

ABSTRACT

This article considers the role of decorative paintings in two South African casinos, namely Carnival City and Caesars Gauteng. It suggests that entertainment landscapes such as casinos are subject to subtle and elaborate mechanisms whereby the creation of seductive milieus reinforces the myth of leisure and paradigms of hedonistic consumption. The use of strategies such as themeing is examined in order to propose that entertainment is increasingly predicated on the imperative of creating exotic, fantastic, escapist or extraordinary experiences – but at a price. The contentious issue of the need for a more authentic so-called African identity in casino developments is also broached. The authors point out that within the postmodern cultural hypermarket of unlimited choices, eclecticism and pastiche, cultures and histories have the potential to be reduced to themes and stereotypes, and can be endlessly re-duplicated in simulacral fantasy landscapes. This production of escapist consumer spaces is important, because the social role of casinos in South Africa has undergone radical changes during the last few years – far from being places of adult entertainment, they now embrace diverse forms of leisure activities for families.     

The Public’s Anger: White Racial Attitudes and Opinions Toward Health Care Reform

Pundits and politicians debated whether race was implicated in the rancorous public forums and demonstrations over health care reform. Research suggests that for many white Americans, racial predispositions play a greater role in their opinions on health care than non-racial predispositions. Building on this work, I examine the extent to which anger uniquely activates white racial attitudes and increases their effect on preferences for health care reform. My theory suggests this effect occurs because anger and thoughts about race are tightly linked in memory. Using a nationally representative experiment over two waves, I induced several emotions to elicit anger, fear, enthusiasm, or relaxation. The results show that anger uniquely pushes racial conservatives to be more opposing of health care reform while it triggers more support among racial liberals. On the other hand, anger does not enhance the effect of race-neutral principles on health care reform.     

Collaborative efforts to improve system response to families who are experiencing child maltreatment and domestic violence

The Greenbook demonstration initiative provided federal funding and other support to six communities to establish collaborations to plan and implement policy and practice changes in systems that serve families who are experiencing domestic violence and child maltreatment or child exposure to domestic violence. The demonstration sites established and organized collaborative groups in accordance with the Greenbook foundational principles and recommendations, including representation from multiple levels within the primary partner systems and other organizations, as well as the community. The sites struggled with how to engage consumers of the primary systems, however, and devoted a great deal of time to understanding and addressing organizational differences among the partners. Other salient collaborative influences included leadership, resources, trust, and commitment. The stakeholders noted that the collaborative relationships required a great deal of work but were ultimately one of the main successes of the initiative.