The need for a higher custody threshold for indigenous offenders in Victoria

Over-representation of indigenous persons in the criminal justice system has changed little since the Royal Commission into Aboriginal Deaths in Custody (RCIADIC) - claim by the Victorian Department of Justice that a key recommendation of RCIADIC had been implemented, namely that imprisonment should be a sentence of last resort for indigenous offenders - how to ensure that imprisonment is a sanction of last resort when indigenous prisoners present for sentence.

Community-based study on knowledge, attitude and practice on the mode of transmission, prevention and treatment of the Buruli ulcer in Ga West District, Ghana

Buruli ulcer disease (BUD), a devastating tropical disease caused by Mycobacterium ulcerans, occurs in more than 80% of the administrative districts of Ghana. To elucidate community perceptions and
understanding of the aetiology of BUD, attitudes towards Buruli patients and treatment-seeking behaviours, we conducted a survey with 504 heads of households and seven focus group discussions in Ga West District, Ghana. Although 67% of participants regarded BUD as a health problem, 53% did not know its cause. Sixteen per cent attributed the cause to drinking non-potable water, 8.1% mentioned poor personal hygiene or dirty surroundings, and 5.5% identified swimming or wading in ponds as a risk factor. About 5.2% thought that witchcraft and curses cause BUD, and 71.8% indicated that BU sufferers first seek treatment from herbalists and only refer to the hospital as a last resort. The main
reasons were prospects of prolonged hospital stay, cost of transport, loss of earnings and opportunity associated with parents attending their children’s hospitalization over extended period, delays in being
attended by medical staff, and not knowing the cause of the disease or required treatment. The level of acceptance of BUD sufferers was high in adults but less so in children. The challenge facing health workers is to break the vicious cycle of poor medical outcomes leading to poor attitudes to hospital treatment in the community. Because herbalists are often the first people consulted by those who contract the disease, they need to be trained in early recognition of the pre-ulcerative stage of Buruli lesions.

Is groin injecting an ethical boundary for harm reduction?

Background
Femoral vein (or groin) injecting by street drug users is an emerging public health issue in the UK. It has been proposed that groin injecting is becoming normalised among UK injecting drug users (IDUs), yet harm reduction strategies are currently piecemeal and some may be crossing the boundary of responsible provision of information. This paper discusses the interventions available to service providers dealing with groin injecting and explores the utility of ethical frameworks for informing service provider decisions.

Methods
Methods analysis of possible service provider responses using White and Popovits’ ethical decision-making framework.

Results
The use of ethical frameworks suggest that different types of groin injectors should receive different interventions. Injectors for whom the groin is a site of ‘last resort’ should be given information about how to inject there less dangerously, whereas ‘convenience’ groin injectors should be actively encouraged to inject elsewhere.

Conclusion
Groin injecting is a behaviour which represents a boundary for some harm reduction practices (such as providing ‘how to’ booklets to all injectors) as well as being an argument for more complex and environmentally appropriate harm reduction responses such as drug consumption rooms and training IDUs to maintain healthier injecting sites.

Intervention designed to reduce the use of summary execution in acute psychiatric inpatient settings

Context: Although it may seem preposterous to consider the need to reduce the use of summary executions in acute psychiatric inpatient settings because practitioners simply would not consider using such inhumane treatment, it is sobering that many mental health professionals do not hesitate to use seclusion.

Objectives: We draw attention to the assumption that underlies the thinking of many mental health professionals that seclusion is acceptable simply because it is available.

Key messages: The letter of the law (seclusion is legal) is frequently given precedence over the spirit of the law (seclusion should used as a method of last resort, if at all). The availability of seclusion as an intervention makes its use inevitable. Although sufficient checks and balances exist in society to prevent psychiatric staff from adding summary executions to their ‘‘treatment’’ paradigms, legislators need to set the bar much higher. Outside intervention, in the form of legislation, is needed because the mental health professions seem incapable of discontinuing the use seclusion despite evidence of the trauma it causes to both patients and staff and despite the lack of evidence that it achieves any desirable outcomes.

Conclusion: The use of seclusion is unacceptable and should be as impossible and unthinkable as summarily executing our patients. By the use of what would seem, at first glance, an absurd analogy between seclusion and summary execution we highlight the need for a shift in policy and legislation regarding the use of traumatising interventions.

Ethnography of housing : a conclusion

This paper is the final report of a research project spanning three years, exploring three field locations and capturing the stories of forty (plus) housing workers. Using an ethnographic research approach, this paper provides an account of how housing workers use language and stories to understand and make sense of their challenging and changing work. First hand accounts ('stories') about every day housing work frame the data in this paper, explaining how housing workers in Victoria have experienced and made sense of the shift from public housing as 'affordable housing for the working poor' to 'housing of last resort for the most vulnerable and needy members of the community'. Using a number of composite stories, this paper provides the reader with a glimpse into the work of public housing staff, transporting the leader from the relatively static world of policy and procedure to the more colorful world of tenants with 'high and complex' needs, 'wicked' problems, weary staff and the daily reality of organisational change.

A unique feature of this research is the comparison of how different workers use stories to build a range of 'socially constructed realities' around the housing work and its wicked problems. This paper compares and contrasts the socially constructed realities of frontline staff with the corresponding social realities of the managers at head office (and vice versa). This 'same problem, different perspective' approach allows the reader to better understand how the same problem is understood and approached in different ways, depending on the individual's organisational role, responsibly and authority. Using stories about 'working with problem tenants', 'collecting rental arrears from the poor and marginalised', 'maintaining old, neglected properties' and 'coping with organisational change', this paper illustrates how the shifting (and sometimes contradictory) construction of housing problems has meant that the organisation has long struggled to devise and implement sustainable remedies to these problems.

The following pages describe how the problems identified in the Housing Office Review (and experienced in the daily work of the 'modern day' housing worker) are simply a contemporary manifestation of 'age old public housing issues'. This paper describes and explains how housing staff have long used narrative to make sense of their often difficult work and ultimately, how they understand and experience a major process of operational policy change associated with the shift from 'public' housing to 'welfare' housing.

Groin injecting in injectable opioid treatment service users in South London

Femoral (or groin) injecting is an emerging public health challenge to all drug-related services within the UK. Recent work in the area has proposed that groin injecting in the UK has moved from being a ‘risk boundary’ to an ‘acceptable behaviour’. This article uses data from 10 in-depth qualitative interviews with service users from a supervised injectable opiate treatment service in South London to report on pathways to, and reasons for, groin injecting. Our findings indicate that even though groin injecting constitutes a risk boundary for some injectors, the practice is no longer heavily stigmatised and is perceived by some to be an acceptable risk. Narratives also pointed to the importance of peers in the initiation of groin injecting. Interviewees described the groin as a site of ‘last resort’ in contrast to ‘convenience’ groin injectors described in some previous research. We conclude that it might be helpful to distinguish between convenience and last resort groin injectors and support the call for innovative interventions which aim to reduce modelling of groin injection and which promote social norms supportive of using peripheral injecting sites.

Ethnography of housing

This paper is the final report of a research project spanning three years, exploring three field locations and capturing the stories of forty (plus) housing workers. Using an ethnographic research approach, this paper provides an account of how housing workers use language and stories to make sense of their challenging and changing work. First hand accounts ('stories') about everyday housing work frame the data in this paper, explaining how housing workers in Victoria have experienced and made sense of the shift from public housing as 'affordable housing for the working poor' to 'housing of last resort for the most vulnerable and needy members of the community'. Using a number of composite stories, this paper provides the reader with a glimpse into the work of public housing staff, transporting the reader from the relativley static world of policy and procedure to the more colourful world of tenants with ' high and complex' needs, 'wicked' problems, weary staff and the daily reality of organisational change.

A unique feature of this research is the comparison of how different workers use their stories to build a range of 'socially constructed realities' around the housing work and its wicked problems. With a few exceptions (Saugeres, 1999, Howe, 1998, Clapham et al., 2000, Darcy, 1999) the voices of frontline staff are largley absent from contemporary housing literature. In this paper, I use the stories of frontline staff to build a comparative case study of the socially constructed realities for frontline staff and the corresponding realities of the managers at head office (and vice versa). This 'same problem, different perspective' approach allows the reader to better understand how the same problem is understood and approached in different ways, depending on the individual's organisational role, responsibility and authority. Using stories about 'working with problem tenants', 'collecting rental arrears from the poor and marginalised', maintaining old, neglected properties' and 'coping with organisational change', this paper illustrates how the shifting (and sometimes contradictory) construction of housing problems has meant that the organisation has long struggled to devise and implement sustainable remedies to these problems.

The following pages describe how the problem identified in the Housing Office Review (and experienced in the daily work of the 'modern day' housing worker) are simply a contemporary manifestation of  'age old public housing issues'. This paper describes and explains how housing staff have long used narrative to make sense of their often difficult work and ultimately, how they understand and experience a major process of operational policy change associated with the shift from 'public' housing to 'welfare' housing.

Restrictive interventions for people with a disability exhibiting challenging behaviours : analysis of a population database

Background: People with an intellectual disability whose behaviours are perceived to be of serious harm to themselves or others are at risk of being subjected to restrictive interventions. Prevalence rates are difficult to determine, as most research is unable to draw on the results of population-level data.

Method: The current study reports on the use of chemical and mechanical restraint and seclusion in the State of Victoria, Australia, over a 12-month period.

Results: The majority of people included were subjected to chemical restraint. The use of restraint was found to be routine rather than a strategy of last resort. Consistent with findings in the UK and USA, those subjected to restrictive interventions were more likely to be young males with multiple disabilities, including autism.

Conclusions: Systemic policy and procedural developments are needed to address current use of restrictive interventions, together with a longitudinal study to evaluate the effectiveness, of alternative, non-restrictive strategies.

Bonhoeffer as Kierkegaard’s ‘single individual’ in a ‘state of exception’

This thesis interrogates the idea that violence can be justified as a ‘last resort’ through investigating the concept of ‘exception’ in the writing and action of the German theologian Dietrich Bonhoeffer, in conjunction with the writings of Soren Kierkegaard and the Nazi jurist Carl Schmitt.

Determinação de indicadores de qualidade para avaliação do processo de gestão de pequenas e médias empresas do setor de construção civil habitacional

A escolha do tema ficou circunscrita ao subsetor de construção habitacional, que é caracterizado pela presença de pequenas e médias empresas. A consolidação de grandes empresas neste ramo de atividades tende a ocorrer sobretudo em conjunturas onde através da intervenção estatal são definidos programas habitacionais de grande escala que requerem das empresas participantes de maior volume de capital e o acesso a tecnologias mais sofisticadas. A importância da pequena empresa neste ramo de atividades pode ser notada atraves da experiência dos países da Comunidade Econômica Europeia, que em 1985 de um total de mais de um milhão de empresas de construção, 90% tinham até 10 empregados. Igual situação se verifica nos Estados Unidos da América onde conforme dados de 1965, também 90 % das 875.000 empresas então existentes no país empregavam menos de 10 pessoas (ONU, 1987). De uma maneira geral a importância do tema fica evidente quando se analisa o peso do setor da construção civil na economia nacional, que se situa em torno de 5% do PIB nos países industrializados, enquanto que nos países de industrialização recente, este percentual pode atingir o índice de 7% (PNU, op.cit.). Tal constatação evidencia que a indústria da construção representa o principal item na composição dos investimentos (formação bruta de capital fixo) das contas nacionais de diversos países, apresentando uma participação relativa quase sempre superior a 55% nos países industrializados e 60% nos países de industrialização recente (ONU, op.cit.). No Brasil tal importância se confirma pelo valor adicionado do setor habitacional correspondente a 2,2% do PIB, e numa visão mais abrangente, dentro dos contornos da indústria da construção civil como um todo, representando cerca de 7,3% do PIB (FIBGE, 1988). Quanto a questão da mão-de-obra, em que pese a ausência de dados no Brasil, e bastante visível sua larga influência na economia atuando como um ramo de atividades multiplicador de alocação de pessoal, principalmente a nível de utilização intensiva de mão-de-obra menos qualificada. Enquanto nos EEUU e CEE 90% das empresas constituíam-se de organizações com menos de 10 empregados, no Brasil onde há ausência de dados oficiais a respeito, na pior das hipóteses pode-se estimar que este percentual pode variar entre 50 a 70% do total de empresas, o que não deixa de ser um dado de extrema magnitude. Foram exatamente a expressão destes números, sem considerar o déficit habitacional em torno de 10 milhões de pessoas, um terço da população, moram em condições inadequadas (Exame, 1991), que influenciaram fortemente a escolha do tema da presente proposta de Tese.

O estado como empregador de última instância: uma proposta de pleno emprego, estabilidade e condições dignas de trabalho para o Brasil

GOMES, Z. B. ; LOURENÇO, André Luís Cabral de . Atuação do Estado como empregador de última Instância: uma proposta para eliminar o desemprego estrutural do Brasil. In: Encontro Nacional de Economia Política, 13. 2008, João Pessoa/PB. Anais... João Pessoa: ENEP, 2008.

O progama empregador de última instância: Sua relevância em tempos de crises financeiras e sua aplicabilidade ao Brasil.

This dissertation aims to continue the work developed previously concerning the properties of the employer of last resort program (ELR) that would be able to promote a complete elimination of the involuntary unemployment from the economy, so much of the unemployment generated by structural problems as for problems of the conjuncture, as the present world financial crisis. Besides, it intends to deepen the study concerning the applicability of that program to the Brazilian economy, estimating their potential target population in the country and the cost with the workers' remuneration. It was presented the ELR theoretical-conceptual structure and a debate concerning their economic viability; the program properties that turn it more efficient than the onetary and fiscal policies (PMFs) in the fight against involuntary unemployment in times of financial crises; a study on its applicability to the Brazilian socioeconomic specificities and an estimate of their potential target population and of the annual wage cost in the country, as a whole, and in the specific case of the Northeast region and of the state of Rio Grande do Norte.

A proposta do estado empregador de ultima instância e o experimentalismo democrático: uma reflexão teórica sobre a compatibilidade desses dois programas

This paper aims to make a theoretical reflection on the theoretical compatibility between the program State Employer of Last Resort (ELR) and the Democratic experimentalism (ED). The ED arises in political thought as an alternative to neo-liberal and social democratic programs in order to rescue the discussion about the institutional organization of society and the market economy. About the involuntary unemployment, it proposes tax changes incidents on payroll and proposes work fronts to the most vulnerable or poorly trained. The hypothesis of this paper is that this approach is compatible with the ELR program, the post- Keynesian line. The ELR is presented as transgression of the mainstream of economic thought by proposing that the State acts as guarantor of employment, working as a stabilizing anchor for the economy. On the edge, the ELR proposes eliminate completely involuntary unemployment. The implementation of the ELR, however, requires the construction of institutions that aim to remake the market economy, as well as deepen and energize politics and democracy, goals that are part of the ED program. Thus, the ED would, in theory, an environment conducive to innovative policies guarantors of training and occupation of the individual, essential for their emancipation institutional environment. In Brazil, which has serious infrastructure problems and qualification of manpower, such a program has enormous potential benefit. However when transposed to the Northeast of Brazil through the Plan for the region based on the principles of the ED and the hypothetical coupling to the ELR could not confirm or reject the hypothesis sub-compatibility of these two theoretical frameworks. The findings point to a partial convergence between these two programs

A Cultura clerical e a folia popular

Este artigo aborda o confronto entre um catolicismo autoritário, tridentino e romanizador, que penetrou no Brasil na segunda metade do século XIX e se consolidou nas primeiras décadas do século XX, e o catolicismo tradicional vigente, de fortes raízes populares. em sua obsessão pela unanimidade, o ultramontanismo negou as outras formas de ser católico, estabelecendo as dicotomias entre o velho e o novo, o bom e o mau. Entretanto, as velhas formas de religiosidade popular resistiram, mantendo ainda hoje uma inesgotável fonte de devoção e de fé.

Treatment of root perforation by intentional reimplantation: a case report

Intentional reimplantation is defined as a procedure in which an intentional tooth extraction is performed followed by reinsertion of the extracted tooth into its own alveolus. Int his paper, intentional reimplantation is described and discussed as a treatment approach to root canal instrument separation in conjunction with root perforation. An 8-year follow-up case report is presented. The reimplanted tooth is now a fixed bridge abutment. Although successful in this case, the intentional reimplantation procedure should be considered a treatment of last resort, that is, when another treatment option is not viable for the treatment of root perforation/instrument retrieval.