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PubMed1994

Civil protection orders: a viable justice system tool for deterring domestic violence.

The prevalence and severity of domestic violence have illuminated the need for effective justice system responses to this pernicious phenomenon. A remedy that all states now provide is the civil protection order, but the forms of relief available, duration of orders, and processes for obtaining them vary from state to state. Examples of types of relief include prohibitions against further abuse and contact with the protected person; eviction from the residence; and temporary custody of children. Studies of civil protection orders suggest that they can be an effective form of relief if the justice system takes affirmative steps to increase their power, including screening petitioners to identify those who need more elaborate safety plans; provision of specific and comprehensive orders and low cost and effective service of them; stringent enforcement of orders by law enforcement and the court; and linkages from the court to advocacy services, shelters, legal representation, and other services.

Adult↗
PubMedDate not supplied

The impact of the April 1992 civil unrest on the Los Angeles REI WIC program and its participants.

This paper discusses the findings of a study conducted in south central Los Angeles in August 1992 among women in the Special Supplemental Food Program for Women, Infants, and Children. The goals of the study were to determine the current demographics of WIC participants; examine the financial hardship, need for relief services, and extent of hunger resulting from the civil unrest of April 1992; look at the effects of the unrest on different ethnic groups; determine the unmet need for WIC services; and evaluate the State and local WIC responses to the unrest. The 1,189 respondents were approximately 77 percent Latina, 20 percent African American, and 3 percent white. Half or more were recent immigrants, 19 percent were pregnant and parenting adolescents, 74 percent were school dropouts, and 56 percent were single mothers. Only 1 percent had any problems using WIC vouchers after the unrest, although more than half of their grocery stores had closed. Thirty-five percent experienced food deficits in their households, and 33 percent of those who applied for emergency food stamps had trouble getting them. Four percent said their children had gone to bed hungry in the last week, and 9 percent said they, the respondents, had as well. Only 2 percent needed shelter, and 1 percent became homeless, but 6 percent had family members who lost jobs due to the unrest. This study suggests that the chronically substandard conditions under which many families in south central Los Angeles live affect them more profoundly than did the dramatic consequences of the civil unrest.

Adolescent↗
PubMedDate not supplied

[The crisis in psychiatry and the protection of the civil rights of mentally ill patients].

In Poland a basic opinion of the mental health care system is that it considers that mental disorders are illnesses and that an ill person is weaker (worse) and less useful in the social distribution of roles and tasks. Consequently, the ill are excluded from the main-stream of social life: they are deprived of jobs by an easy and early recognition of disability, and the granting of disability pensions, by civil law prohibition of marriage, criminal law ban on sexual contacts etc. A person has little chance for a just life if he/she is deprived of the possibility of working, founding a family, if he/she receives an inadequate pension, remains sexually isolated and on the margin of public life. This medical model of care includes a lot of discriminatory features in the area of human and civil rights of the mentally ill. The discussion concentrated on selected features of the crisis in world psychiatry as well as the practical, ideological, clinical, institutional and organizational difficulties of Polish psychiatry. The main goal of this paper is the raising of psychiatry's awareness of its faults, in order to induce the creation of a new system of mental health care, free of the discriminatory stigmas of the ill and more adequately adapted the ideas of a contemporary democratic state.

Civil Rights↗
PubMed1993

AIDS and social work: the ethics and civil liberties agenda.

Social workers are becoming increasingly involved in casework and social policy debate related to the acquired immune deficiency syndrome (AIDS) crisis. To enhance their delivery of services and contribution to policy formulation, social workers need to be familiar with a wide range of ethical and civil liberties issues that have been generated by the AIDS epidemic. This article provides an overview of six major ethical and civil liberties issues pertaining to social work practice related to AIDS: (1) mandatory screening and testing of clients for the human immunodeficiency virus (HIV), (2) client access to health insurance, (3) professionals' duty to treat HIV-infected clients, (4) privacy and confidentiality, (5) client involvement in AIDS research, and (6) relevant legal issues. Implications for social work practice are highlighted, particularly with respect to protecting clients' rights and formulating a social action agenda.

AIDS Serodiagnosis↗
PubMed1996

[Medical expert assessment in civil rights from the legal viewpoint].

This paper gives an overview over the basics and fundamentals of the medical expert assessment during civil action. Beginning with the character of the expert assessment as evidence in a lawsuit, the task distribution between physician and judges is discussed: Physicians are knowledgeable advisors, judges decide and determine direction and subject of the discussion and get the evidence necessary for them. The goal of the medical expert assessment is not treatment but guide the development of a decision about contentious claims. An offense against the evidence "assessment' during a lawsuit sometimes becomes a personal offense against the expert witness himself Regarding his response, he has to take into account that the expert witness as well as the judge may be refused due to bias, and to avoid the impression of prejudice especially in cases of medical liability. The appointed expert is always the expert witness independent of drafts by senior physicians or assistance by residents. Many civil lawsuits might not be decided without the teamwork between judges and physicians.

Civil Rights↗
PubMed1997

Beyond the black letter of the law: an empirical study of an individual judge's decision process for civil commitment hearings.

To study the role of parens patriae and "police powers" considerations in an individual judge's civil commitment decisions, the judge's reports of the impact of various characteristics of the patient were analyzed. The validity of this methodology was tested by comparing it to an alternative technique based on objective statistical analysis of the dependence of the judge's decisions upon patient characteristics. A probate court judge filled out a questionnaire after each civil commitment hearing over which he presided during a seven-month study. For each of 26 decisions, the judge rated the patient on 26 features and indicated the impact of each feature on the decision. The judge's responses were analyzed to measure the role of various statutory and nonstatutory considerations (expressed as patient characteristics) in the judge's decisions. Results using self-reported impacts are compared with an objective, statistical characterization of the judge's decision-making policy. As in previous studies, the parens patriae model more closely described the individual judge's decision process than the "police powers" model. Contextual variables (e.g., the patient's family favoring commitment) also were influential. Results with the two methods were similar. The methodology developed here can be used not only in further research on judicial commitment decisions but also to educate judges and other decision-makers individually faced with potentially tragic choices as to their personal implicit decision-making strategies.

Civil Rights↗
PubMed1998

Violence against women during the Liberian civil conflict.

CONTEXT: Civilians were often the casualties of fighting during the recent Liberian civil conflict. Liberian health care workers played a crucial role in documenting violence against women by soldiers and fighters during the war. OBJECTIVE: To document women's experiences of violence, including rape and sexual coercion, from a soldier or fighter during 5 years of the Liberian civil war from 1989 through 1994. DESIGN: Interview and survey. SETTING: High schools, markets, displaced persons camps, and urban communities in Monrovia, Liberia, in 1994. PARTICIPANTS: A random sample of 205 women and girls between the ages of 15 and 70 years (88% participation rate). RESULTS: One hundred (49%) of 205 participants reported experiencing at least 1 act of physical or sexual violence by a soldier or fighter. Survey participants reported being beaten, tied up, or detained in a room under armed guard (17%); strip-searched 1 or more times (32%); and raped, subjected to attempted rape, or sexually coerced (15%). Women who were accused of belonging to a particular ethnic group or fighting faction or who were forced to cook for a soldier or fighter were at increased risk for physical and sexual violence. Of the 106 women and girls accused of belonging to an ethnic group or faction, 65 (61%) reported that they were beaten, locked up, strip-searched, or subjected to attempted rape, compared with 27 (27%) of the 99 women who were not accused (P< or =.02, .07, .001, and .06, respectively). Women and girls who were forced to cook for a soldier or fighter were more likely to report experiencing rape, attempted rape, or sexual coercion than those who were not forced to cook (55% vs 10%; P< or =.001, .06, and .001, respectively). Young women (those younger than 25 years) were more likely than women 25 years or older to report experiencing attempted rape and sexual coercion (18% vs 4%, P=.02 and .04, respectively). CONCLUSIONS: This collaborative research allowed Liberian women to document wartime violence against women in their own communities and to develop a unique program to address violence against women in Liberia.

Adolescent↗
PubMed2003

Factors associated with poor mental health among Guatemalan refugees living in Mexico 20 years after civil conflict.

CONTEXT: From 1981 to 2001, 46 000 refugees who fled the 36-year civil conflict in Guatemala for Chiapas, Mexico were under the protection of the United Nations High Commissioner for Refugees. OBJECTIVES: To estimate the prevalence of mental illness and factors associated with poor mental health of underserved Guatemalan refugee communities located in Chiapas, Mexico, since 1981 and to assess need for mental health services. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional survey of 183 households in 5 Mayan refugee camps in Chiapas representing an estimated 1546 residents (adults and children) conducted November-December 2000. MAIN OUTCOME MEASURES: Symptom criteria of Posttraumatic Stress Disorder (PTSD), anxiety, and depression as measured by the Harvard Trauma Questionnaire and Hopkins Symptom Checklist-25 (Hopkins-25). RESULTS: One adult (aged > or =16 years) per household (n = 170 respondents) who agreed to participate was included in the analysis, representing an estimated 93% of households. All respondents reported experiencing at least 1 traumatic event with a mean of 8.3 traumatic events per individual. Of the respondents, 20 (11.8%) had all symptom criteria for PTSD. Of the 160 who completed the Hopkins Symptom Checklist-25, 87 (54.4%) had anxiety symptoms and 62 (38.8%) had symptoms of depression. Witnessing the disappearance of family members (adjusted odds ratio [AOR], 4.58; 95% confidence interval [CI], 1.35-15.50), being close to death (AOR, 4.19, 95% CI, 1.03-17.00), or living with 9 to 15 persons in the same home (AOR, 3.69; 95% CI, 1.19-11.39) were associated with symptoms of PTSD. There was a protective factor found for lacking sufficient food (AOR, 0.08; 95% CI, 0.01-0.59). Elevated anxiety symptoms were associated with witnessing a massacre (AOR, 10.63; 95% CI, 4.31-26.22), being wounded (AOR, 3.22; 95% CI, 0.95-10.89), and experiencing 7 to 12 traumatic events (AOR, 2.67; 95% CI, 1.14-6.27) and 13 to 19 traumatic events (AOR, 2.26; 95% CI, 0.65-7.89). Elevated symptoms of depression were associated with being a woman (AOR, 3.64; 95% CI, 1.47-9.04), being widowed (AOR, 27.55; 95% CI, 2.54-299.27), being married (AOR, 1.93; 95% CI, 0.59-6.33), witnessing disappearances (AOR, 2.68; 95% CI, 1.16-6.19), experiencing 7 to 12 traumatic events (AOR, 1.57; 95% CI, 0.64-3.88), or experiencing 13 to 19 traumatic events (AOR, 7.44; 95% CI, 2.18-25.37). CONCLUSION: Psychiatric morbidity related to human rights violations, traumatic events, and refugee status was common among Guatemalan refugees surveyed 20 years after the Guatemalan civil conflict.

Adult↗
PubMed1997

Persistence is not always a virtue: tort reform, civil liability for health care, and the lack of empirical evidence.

The efficacy of reforms in the civil system, including professional liability in the health care arena, depends upon the accuracy with which problems are defined. A growing empirical literature argues that the description of the civil justice system underlying the movement for tort reform in the health care arena is not an accurate one. Regardless, that description continues to be used successfully as the basis for a variety of enacted reforms. The interesting question now posed by some researchers is why that description persists despite its lack of empirical verification. This article summarizes the reformers' description; provides an overview of relevant empirical findings; and then draws on a theoretical literature in political science dealing with agenda-setting in the public policy process to answer that interesting question. The article concludes that the image persists because it is successful in a political, not rational, process in which appeals to emotion overshadow reasoned argument.

Causality↗
PubMed2000

Psychopathy, criminal responsibility, and civil commitment as a sexual predator.

Recent judicial decisions regarding commitment under sexual predator statutes and commentary addressing the legal significance of psychopathy provide an interesting opportunity to reflect upon the exculpatory significance of psychopathy and the appropriate relationship between criminal conviction and police power civil commitment. This paper examines the legal significance of psychopathy for the purposes of criminal responsibility and of civil commitment under sexual predator statutes. By examining the significance of psychopathy for each of these legal institutions, it clarifies our understanding of the legal significance of psychopathy and of the relationship between these institutions. This process illuminates the defensible functions and boundaries of each institution and clarifies the nature of the impairment that should qualify an individual for confinement by each. This analysis interprets criminal conviction and police power commitment, including sexual predator commitment, as integrated institutions of social control intended to provide a coherent approach to psychopaths as well as to others who require state intervention under the police power.

Adult↗
PubMed1995

Predicting the present: expert testimony and civil commitment.

This article uses the Supreme Court's decision in Daubert as an opportunity to address a chronic concern regarding the disparity between mental health law as officially enunciated and the practical application of that law. After Daubert, admissibility of expert evidence under the federal rules requires a qualified expert, a reliable basis for the testimony, and relevance to the legal issue. Ongoing psychological research pursues empirical data that expands the scope of psychological expertise and clarifies its limits. This article addresses the requirement of relevance by examining the logical relationship between the psychologist's actuarial and clinical expertise and the legal issues addressed by the court in civil commitment proceedings. Ideally, Daubert might stimulate a process of cooperative analysis in which psychologists and lawyers clarify the proper roles of psychological experts and of the courts with which those experts interact. This article begins that project by clarifying the legal determination required in civil commitment proceedings and by explicating the relationship between the responsibilities of experts and those of courts.

Commitment of Persons with Psychiatric Disorders↗
PubMed1996

Aspects of bioenergetics and civilization.

By means of an allometric relation between the oxygen consumption rate and the body mass of an animal a metabolic coefficient is derived that can be used as a measure of standard metabolism in different animal species. This coefficient increased in the course of evolution corresponding to the time of appearance of each class of animal. It reached its highest values in Primates and passerine birds. A further increase across an energetic threshold was only possible with human civilization. A similar approach to evolution is performed through an encephalization coefficient showing that in all phases of evolution, species existed with a much larger relative brain volume than the other members of their class. These species might have established a non-human civilization on Earth if evolution would have taken another path. Finally, social activities of insects and the use of external energy sources by animals are discussed to show further implications of this bioenergetic approach to evolution.

Animals↗
PubMedDate not supplied

Civil commitment reform: context and consequences.

Laws and policies governing the care and treatment of the mentally ill are in part shaped by the sociopolitical climate in which they are formulated, and their outcomes are similarly shaped by the context in which they occur. Civil commitment laws were narrowed in a liberal era but later broadened in response both to the outcome of the initial reform and the trend toward social and fiscal conservatism which emerged in the late 1970s and 1980s. This study, which reports on the evolution of commitment law in the state of Washington, indicates that while recent changes in these laws mandate greater use of state hospitals, the retention of the procedural safeguards set in place by the initial reform coupled with limitations on resources available to state mental health systems will prevent a return to the state hospital as it appeared prior to the deinstitutionalization movement. These factors may promote the search for non-institutional alternatives, such as efforts underway in Washington and elsewhere to implement civil commitment of community-based services.

Commitment of Persons with Psychiatric Disorders↗
PubMed1986

The relationship between both sodium and potassium intake and blood pressure in London Civil Servants. A report from the Whitehall Department of Environment Study.

The relationship was examined in 459 male London Civil Servants between the casual lying systolic and diastolic (phase V) blood pressures measured in the clinic, and 24-hr urinary sodium and potassium excretion collected an average of 6 weeks later. Systolic and diastolic pressures, after adjusting for age and weight, were both negatively associated with the 24 hr potassium excretion (r = -0.17 [p less than 0.001, 95% confidence limits -0.07, -0.27) and r = -0.11 (p less than 0.05, 95% CL 0.00, -0.21) for systolic and diastolic pressure respectively]. Adjusted systolic but not diastolic pressure was also negatively associated with plasma potassium estimated at the time of blood pressure measurement (r = -0.15, p less than 0.001, 95% CL -0.06, -0.24). In 159 female London Civil Servants both systolic and diastolic pressures were negatively correlated with plasma potassium. However, there was no evidence for a negative relationship between urinary potassium excretion and blood pressure in women. Urinary sodium excretion was not related to blood pressure either in men or women. Blood pressure was also measured by the subjects at home over a one week period during which time the urine collection was made. There was no evidence for an association between blood pressure measured at home 6 weeks after the time of drawing blood, and plasma sodium. On the other hand, in men, the negative relationship between blood pressure and urinary potassium excretion was consistent and independent of the time and place of measuring blood pressure. This is consistent with a true effect of diet, a low potassium intake being associated with an increased blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Factors associated with hypertension in Nigerian civil servants.

BACKGROUND: Study of hypertension in segments of West African populations in transition toward Westernization may lead to better understanding of the high risk for hypertension among Westernized blacks. METHODS: Five hundred fifty-nine urban civil servants, ages 25-54, were recruited from six ministries of Bendel State, Nigeria. Blood pressure, physical measurements, urinary protein and glucose, fasting blood glucose, and demographic data were collected at the workplace. Subjects were classified as senior staff (professionals or administrators) or junior staff (non-administrators). RESULTS: Among 172 male senior staff, the age-adjusted rate of hypertension (diastolic blood pressure > or = 90 mm Hg, systolic blood pressure > or = 140 mm Hg, or on an antihypertensive medication) was 43% and occurrence rose dramatically from 21 to 63% across age groups 25-34 to 45-54, respectively. Among 266 male junior staff, the age-adjusted rate of hypertension was 23%, and occurrence did not rise with age. Logistic regression showed that body mass index (kg/m2), age, alcohol drinking, and being senior staff were all independently related to hypertension in men. On the other hand, the age-adjusted rate of hypertension in 121 women was 20% and was significantly related only to body mass index. CONCLUSION: Male urban civil servants appeared to have a risk for hypertension similar to that of U.S. black males. Age, body mass index, alcohol drinking, and other unidentified factors related to higher socioeconomic status were strong determinants of hypertension in this population.

Adult↗
PubMed1991

Health inequalities among British civil servants: the Whitehall II study.

The Whitehall study of British civil servants begun in 1967, showed a steep inverse association between social class, as assessed by grade of employment, and mortality from a wide range of diseases. Between 1985 and 1988 we investigated the degree and causes of the social gradient in morbidity in a new cohort of 10,314 civil servants (6900 men, 3414 women) aged 35-55 (the Whitehall II study). Participants were asked to answer a self-administered questionnaire and attend a screening examination. In the 20 years separating the two studies there has been no diminution in social class difference in morbidity: we found an inverse association between employment grade and prevalence of angina, electrocardiogram evidence of ischaemia, and symptoms of chronic bronchitis. Self-perceived health status and symptoms were worse in subjects in lower status jobs. There were clear employment-grade differences in health-risk behaviours including smoking, diet, and exercise, in economic circumstances, in possible effects of early-life environment as reflected by height, in social circumstances at work (eg, monotonous work characterised by low control and low satisfaction), and in social supports. Healthy behaviours should be encouraged across the whole of society; more attention should be paid to the social environments, job design, and the consequences of income inequality.

Adult↗
PubMed1995

Incidence of pulmonary tuberculosis in Korean civil servants.

SETTING: Longitudinal epidemiological study based on civil servants in Korea. OBJECTIVE: To estimate the incidence of pulmonary tuberculosis (PTB) for the general population from a reliable sample. DESIGN: New active PTB developing between 1988 and 1990 in civil servants has been determined from (1) the findings of biennial medical examinations and (2) perusal of the medical records of those claiming health insurance for tuberculosis (TB). RESULTS: A total of 790,204 subjects was available for investigation. Active PTB was diagnosed in 5107 patients over the 2 years of the study. Bacteriological examination of 3847 patients yielded 575 (14.9%) positive smears and 350 (9.1%) smear-negative positive cultures from them. Applying these rates to the 1260 whose sputum was not examined, 702 were smear-positive, and 431 were culture-positive. Overall PTB incidence was 393 per 10(5), with 84 and 53 per 10(5) smear- and culture-positive. Incidence was high in males, and in the age group 20-29 years in both sexes. CONCLUSION: Such high PTB incidence, particularly in the age group 20-29, clearly indicates that TB in Korea remains a serious health problem.

Adolescent↗
PubMed2004

The major infectious epidemic diseases of Civil War soldiers.

Two thirds of the 600,000 deaths of Civil War soldiers were caused by disease. Physicians during the war kept detailed records and reports, which were tabulated, discussed in detail, and published after the war. These records include case histories, autopsy descriptions, photographs, and photomicrographs; they are the best records of the medical experiences of any of America's wars, even those in the twentieth century. Because the Civil War occurred just before the discoveries of bacteriology, these records are of particular historical interest.

Communicable Diseases↗