A Desultory Defense of Democracy: OAS Resolution 1080 and the Inter-American Democratic Charter

This article evaluates the effectiveness of OAS mechanisms for safeguarding democracy through multilateral diplomacy, what some scholars have dubbed the interamerican defense of democracy regime. Drawing on a range of international relations theories, this study derives competing hypotheses about member states' responses to democratic crises in the Americas. It then analyzes all instances in which a collective response—that is, an application of Resolution 1080 or the Inter-American Democratic Charter—was debated in the OAS between 1991 and 2002. Patterns of state behavior suggest that domestic politics, rather than the structural or systemic traits of the interamerican system, best explain foreign policy responses to crises of democracy in the region. The OAS record in confronting such crises is uneven.     

The State of the Science in Technology Transfer: Implications for the Field of Assistive Technology

The Rehabilitation Engineering Research Center on Technology Transfer (T²RERC) hosted a “State of the Science” conference in November, 2001. The conference reviewed technology transfer work within the field of assistive technology, and summarized related work in public, private and academic sectors. Invited speakers prepared papers on various topics concerning technology transfer, and related their findings to the field of assistive technology during the ensuing discussion sessions. This paper provides an overview of the material presented by the participants, and explores the implications of their findings for one particular field of application—assistive technology for people with disabilities.     

GRANDPARENT VISITATION RIGHTS

In recent years, legislators in all fifty states have given grandparents rights to petition for visitation privileges with grandchildren that can be enforced over parental objections. Grandparent visitation rights reflect an effort to protect meaningful relationships children enjoy with nonparental caregivers, enlist the assistance of extended family when the child's nuclear family is disrupted, and defend the interests of grandparents themselves. This psycholegal analysis explores the direct and indirect consequences of grandparent visitation statutes for family functioning. Statutory provisions are summarized, and the effects of these statutes are evaluated in light of what is known about the role of grandparents in child development, how courts evaluate children's "best interests" in grandparent visitation disputes, and how these statutes can alter family functioning in informal ways. The authors conclude that there are risks as well as benefits to children and families in grandparent visitation statutes, and suggest directions for procedural and statutory reform.     

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.     

A unique case of congenital bilateral absence of parietal bones in a neonate

The remains of an unidentified female neonate were discovered in a field in central Missouri. Examination revealed bilateral absence of the parietal bones. A search of the literature describing similar defects suggests that the present case represents a unique condition, described here for the first time.     

DEVELOPMENTAL AND LIFE‐COURSE CRIMINOLOGY: KEY THEORETICAL AND EMPIRICAL ISSUES‐THE 2002 SUTHERLAND AWARD ADDRESS*

The main aim of this paper is to advance knowledge and (especially) theories about developmental and life‐course criminology (DLC). First, I review the widely accepted DLC findings that all DLC theories have been designed to explain. Second, I review more contentious and unresolved empirical DLC issues that might present challenges to DLC theories. Third, I describe my own DLC theory and specify how it addresses key empirical and theoretical questions. Fourth, I summarize five important DLC theories, by Catalano and Hawkins, Sampson and Laub, Moffitt, LeBlanc, and Thornberry and Krohn. Fifth, I identify differences in assumptions and predictions between my theory and the other five theories. Finally, I recommend a detailed comparison of the key features of all DLC theories, of their answers to key empirical and theoretical questions, and of their predictions regarding key unresolved empirical DLC issues.     

Radiographic demonstration of esophageal and tracheal fistulas at autopsy using a contrasting medium that vulcanizes at room temperature

Esophageal and tracheal fistulas, which occur in 0.05% of medicolegal autopsies, were demonstrated in three cases by a postmortem radiographic technique using silicone rubber/lead oxide as a contrasting medium that vulcanizes at room temperature. In one 83-year-old male, a tracheoesophageal fistula was detected, which had developed after surgical repair of an esophageal rupture caused by a flexible fiberoptic endoscope. In a second case, carcinoma of the esophagus in a 78-year-old male had eroded the trachea and arcus of the aorta creating a fatal tracheoesophagoaortic fistula. In a third case, 55-year-old female developed a tracheobrachicephalic artery fistula as a result of an infiltrating cystic adenocarcinoma of the trachea, resulting in a fatal hemorrhage into the trachea. The results of this study indicate that diagnostic radiologic methods using a vulcanized contrasting medium are useful in supplementing normal dissection in autopsy cases with suspected fistulas of the esophagus or trachea.     

Has PPS increased Medicare expenditures on physicians?

We use data from 1983 and 1985 on the volume of Medicare physician services to analyze whether Medicare's Prospective Payment System (PPS), which resulted in a significant decline in hospital spending, led to a partially offsetting increase in real expenditures for physician services. We also analyze the effect of increases in assignment rates, increasing incomes of the elderly, and other factors on real expenditures during this period. Our main conclusion is that PPS has at most a small positive effect on real physician expenditures. Because people spent less time in the hospital, Medicare physician spending declined; but because of incentives to shift radiology and other services out of the hospital, some of this decline was offset. We also conclude that the sharp increase in Medicare assignment rates over this period, along with the rising incomes of the elderly during this period, contributed to the observed growth.