'Designing Better Health Care in the South': A Case Study of Unsuccessful Transformational Change in Public Sector Health Service Reform

This article presents a case study of a project known as 'Designing Better Health Care in the South' that attempted to transform four separately incorporated health services in southern Adelaide into a single regional health service. The project's efforts are examined using Kotter's (1996) model of the preconditions for transformational change in organisations and the areas in which it met or failed to meet these preconditions are analysed, using results from an evaluation that was commenced during the course of the attempted reform. The article provides valuable insights into an attempted major change by four public sector health organisations and the facilitators and barriers to such change. It also examines the way in which forces beyond the control of individual public sector agencies can significantly impact on attempts to implement organisational change in response to an identified need. This case study offers a rare glimpse into the micro detail of health care reform processes that are so widespread in contemporary health services but which are rarely systematically evaluated.     

Reciprocal Prospective Relationships Between Loneliness and Weight Status in Late Childhood and Early Adolescence

Adolescents who do not conform to weight ideals are vulnerable to disapproval and victimization from peers in school. But, missing from the literature is a prospective examination of weight status and feelings of loneliness that might come from those experiences. Using data from the Québec Longitudinal Study of Child Development, we filled that gap by examining the prospective associations between loneliness and weight status when the sample was aged 10–13 years. At ages 10, 12, and 13 years, 1042 youth (572 females; 92% from French speaking homes) reported on their loneliness and were weighed and measured. Family income sufficiency was included in our analyses given its relationship with weight status, but also its possible link with loneliness during early adolescence. The findings showed that (1) weight status and loneliness were not associated concurrently; (2) weight status predicted increases in loneliness from ages 12 to 13 years; and (3) loneliness predicted increases in weight from ages 12 to 13 years among female adolescents, but weight loss among male adolescents. The fact that loneliness was involved in weight gain for females suggests that interventions focused on reducing loneliness and increasing connection with peers during early adolescence could help in reducing obesity.     

SWAT and non-SWAT police officers and the use of force

Although many police departments use Special Weapons and Tactics (SWAT) teams, surprisingly there is very little research on them. This study examined the use of force by SWAT and non-SWAT police officers. SWAT officers may be socialized to use force as a result of the dangerous situations they frequently encounter, and thus more likely to use force in non-SWAT situations. The results of this research note, however, indicated there was a statistical nonsignificant relationship between SWAT status and the use of force. Implications of the findings of this study are discussed.     

Community violence victimization and symptoms of posttraumatic stress disorder: the moderating effects of coping and social support

This study tested the relationship of community violence (CV) victimization to severity of posttraumatic stress disorder (PTSD), and the roles of coping style and perceived social support in moderating that relationship. Three-hundred seventy-two men and women (age 18 to 22 years) self-reported on CV exposure, traumatic experiences, PTSD symptoms, perceived support from family and friends, and coping strategies. Results indicated that high CV victimization, high disengagement coping (i.e., avoidant styles), and low perceived social support from family and friends significantly predicted increased PTSD scores. Significant moderating effects indicated that the relationship between victimization and heightened PTSD severity was stronger at high levels of perceived friend support and disengagement. Thus, the protective function of friend support seemed to break down at increasing levels of victimization, whereas, as expected, avoidant styles of coping increased the risk for negative outcome. Findings are discussed in terms of event controllability, negative social reactions, and coping resources.     

Sentence disparity in the federal courts and the adoption of sentencing guidelines

Pressure in the 1970's to reform the sentencing process can be attributed to a change in perceived public sentiment regarding the utility of treatment and to the belief that sentencing disparity was a severe problem in the sentencing process. Primary reform occurred in the federal judicial system with the development and implementation of rigorous sentencing guidelines. An evaluation of sentencing patterns for one federal judicial district indicates that sentencing disparity was not severe. Most federal offenders are relatively mild and consistently receive relatively mild sentences.     

Children’s Aggression, Parenting Styles, and Distress for Hong Kong Parents

This study examined the connection between parental perceptions about their children’s reactive and proactive aggression, parenting styles, parent–child communication, and parental distress. A total of 1,485 Hong Kong parents and guardians with children 8 to 17 years old completed the Reactive and Proactive Aggression Questionnaire, Kessler Psychological Distress Scale, Adjective Checklist, and Parenting Styles and Dimensions Questionnaire. When reactive and proactive aggression responses were used to predict parental distress, a significant regression model was obtained with both predictors making a contribution. A significant model also was discovered when parenting styles and parent–child communication were used to predict parental distress. Authoritative, authoritarian, and permissive parenting contributed significantly to this model. One final regression was performed with the significant predictors from the two previous equations. This model was significant, with reactive and proactive aggression, and authoritative, authoritarian, and permissive parenting styles making significant contributions. Practice and research implications are briefly discussed.     

Validity of CO-oximetric determination of carboxyhaemoglobin in putrefying blood and body cavity fluid

Most commercial CO-oximeters pose warning flags in their measured carboxyhaemoglobin (COHb) levels when total haemoglobin (tHb) concentrations in the samples are below a certain threshold, typically about 3-4gdl. The warning flags acknowledge the fact that the haemoglobin levels are outside the ranges these instruments are designed (or validated) for. By using a parallel GC method and special sample treatment methods prior to CO-oximetric measurements, this study demonstrates that CO-oximeters could actually produce valid COHb results for samples with tHb as low as 1g/dl, and that the warning flags have no bearing to the accuracy and precision of the measurements. This study also indicates that warning flags due to high methaemoglobin (MetHb) and sulphaemoglobin (SHb), and often turbidity did not affect the validity of the CO-oximetric measurements.     

Stable Isotope Ratios of Marijuana. I. Carbon and Nitrogen Stable Isotopes Describe Growth Conditions*

Abstract: There remains significant uncertainty in illicit marijuana cultivation. We analyzed the δ¹³C and δ¹⁵N of 508 domestic samples from known U.S.A. counties, 31 seized from a single location, 5 samples grown in Mexico and Colombia, and 10 northwest border seizures. For a subset, inflorescences and leaves were analyzed separately. These data revealed a strong correspondence, with inflorescences having slightly higher δ¹³C and δ¹⁵N values than leaves. A framework for interpreting these results is introduced and evaluated. Samples identified as outdoor‐grown by δ¹³C were generally recorded as such by the Drug Enforcement Administration (DEA). DEA‐classified indoor‐grown samples had the most negative δ¹³C values, consistent with indoor cultivation, although many were also in the outdoor‐grown domain. δ¹⁵N indicated a wide range of fertilizers across the dataset. Samples seized at the single location suggested multiple sources. Northwest border δ¹³C values suggested indoor growth, whereas for the Mexican and Colombian samples they indicated outdoor growth.     

Type of counsel and the outcome of criminal appeals: A research note

Previous studies have focused on type of counsel and case outcome at trial court, but only a few have done so at the appellate level. The purpose of this research note is to provide some insight into the influence of type of counsel on the out-come of criminal appeals. Results indicate that in criminal appeals from two Florida trial courts to an intermediate appellate court type of counsel was non-significant in predicting the court’s decision. The implications of the findings are discussed.