New and Notable: 24 June 2015

Here is a selection of recent papers highly recommended by our reviewers. This selection covers public health, sustinability and humanities.

Adult Psychotic Symptoms, Their Associated Risk Factors and Changes in Prevalence in Men and Women Over a Decade in a Poor Rural District of Kenya

Rachel Jenkins , Caleb Othieno, Linnet Ongeri, Bernards Ogutu, Peter Sifuna, James Kingora, David Kiima, Michael Ongecha and Raymond Omollo

There have been no repeat surveys of psychotic symptoms in Kenya or indeed subSaharan Africa. A mental health epidemiological survey was therefore conducted in a demographic surveillance site of a Kenyan household population in013 to test the hypothesis that the prevalence of psychotic symptoms would be similar to that found in an earlier sample drawn from the same sample frame in004, using the same overall methodology and instruments. This013 study found that the prevalence of one or more psychotic symptoms was3.9% with one or more symptoms and.8% with two or more symptoms, while the004 study had found that the prevalence of single psychotic symptoms in rural Kenya was% of the adult population, but only.6% had two symptoms and none had three or more psychotic symptoms. This change was accounted for by a striking increase in psychotic symptoms in women (17.8% in013 compared with.9% in004, p <.001), whereas there was no significant change in men (10.6% in013 compared with.4% in004, p =.582). Potential reasons for this increase in rate of psychotic symptoms in women are explored.

Estimating Risks of Heat Strain by Age and Sex: A Population-Level Simulation Model

Kathryn Glass,* , Peter W. Tait, Elizabeth G. Hanna and Keith Dear

Individuals living in hot climates face health risks from hyperthermia due to excessive heat. Heat strain is influenced by weather exposure and by individual characteristics such as age, sex, body size, and occupation. To explore the population-level drivers of heat strain, we developed a simulation model that scales up individual risks of heat storage (estimated using Myrup and Morgan’s man model “MANMO”) to a large population. Using Australian weather data, we identify high-risk weather conditions together with individual characteristics that increase the risk of heat stress under these conditions. The model identifies elevated risks in children and the elderly, with females aged 75 and older those most likely to experience heat strain. Risk of heat strain in males does not increase as rapidly with age, but is greatest on hot days with high solar radiation. Although cloudy days are less dangerous for the wider population, older women still have an elevated risk of heat strain on hot cloudy days or when indoors during high temperatures. Simulation models provide a valuable method for exploring population level risks of heat strain, and a tool for evaluating public health and other government policy interventions.

Unlocking the “Prisoner’s Dilemma” of Corporate Water Stewardship in South Africa—Exploring Corporate Power and Legitimacy of Engagement in Water Management and Governance

Suvi Sojamo

Corporate water stewardship, i.e., proactive water-using corporate engagement in water management and governance, has been hailed as a solution to global water challenges. However, it has also aroused criticism and skepticism, as it has been feared to lead to private securitization of resources and institutional capture especially in locations with weak public institutions and regulation. This article tackles this “prisoner’s dilemma” of corporate water stewardship by exploring when and how it is legitimate considering the private nature of corporations and their power to change water management and governance processes and their outcomes. An analytical framework is constructed based on a literature review and applied into a case-study of corporations active in water stewardship initiatives in South Africa. The case-study findings suggest that the stewardship agenda would benefit from (1) a more open acknowledgement of power asymmetries between corporations and other parties; (2) more careful and systematic evaluation and enhancement of legitimacy of corporations to engage in public good and common pool water resources in the first place; and (3) stewardship actions should support stronger public institutions and especially civil society to equally participate. The research community is called in to scrutinize and facilitate the multi-actor water governance processes, which include corporations to assist in the effort.

Fiscal Challenges in Multilayered Unions: An Overview and Case Study

Joshua Aizenman and Gunnar Gunnarsson

This paper reviews recent research dealing with fiscal discipline and revisit the issues of fiscal control in federal systems, focusing on selective case studies covering the 2000s, before and after the global financial crisis (GFC). We start by contrasting the recent fiscal history of California to that of Greece, illustrating the different ways of dealing with fiscal deficiencies in a mature union, U.S., versus a young union, Eurozone. We continue with an overview of the fiscal developments in Brazil, illustrating the challenges facing federal systems in emerging markets, and possible ways to move forward in upgrading a country’s fiscal institutions. We conclude with the fiscal history of Iceland before and after the financial crisis—a standalone small country, assessed favorably by rating agencies prior to the GFC, and now recovering from a deep financial crisis.

Querying the Call to Introduce Mental Capacity Testing to Mental Health Law: Does the Doctrine of Necessity Provide an Alternative?

Piers Gooding and Eilionóir Flynn

Trends in international human rights law have challenged States globally to rethink involuntary mental health interventions from a non-discrimination perspective. The United Nations Convention on the Rights of Persons with Disabilities (CRPD) in particular prohibits laws that discriminate on the basis of disability. However, a key criterion for compulsory mental health treatment under typical mental health legislation is a psychiatric diagnosis (in conjunction with risk of harm and other criteria). Hence, for people with mental health disabilities, rights to liberty and consent in healthcare are held to a different standard compared to other citizens. A prominent law reform option being explored by some governments and commentators for achieving non-discrimination is to replace the diagnostic criterion for triggering involuntary intervention with an assessment of mental capacity. After all, every citizen is subject to restrictions on autonomy where they are deemed to lack mental capacity, such as where concussion necessitates emergency service. However, the use of mental capacity “testing” is seen by diverse commentators as wanting in key respects. A prominent criticism comes from the United Nations Committee on the Rights of Persons with Disabilities, which considers mental capacity assessments a form of disability-based discrimination. This article queries the call to replace the diagnostic criterion in mental health law with an assessment of mental capacity in the light of jurisprudence on equality and non-discrimination in international human rights law. Instead, we examine the doctrine of necessity as an area of law, which might help identify specific thresholds for overriding autonomy in emergency circumstances that can be codified in a non-discriminatory way. We also consider the need for deliberative law reform processes to identify such measures, and we suggest interim, short-term measures for creating a “supported decision-making regime” in the mental health context. The article focuses in particular on the Australian context of mental health law reform, though the analysis can be generalised to international trends in mental health law.