Project USA: American competitiveness and what must be done to restore it

The United States today faces a loss of influence as a world power, a reduction in American independence as a policymaker, and a decline in the standard of living on which Americans have come to depend. History teaches that nations weaker and less productive than the United States can rise to become economic powerhouses and rapidly increase their standards of living. History also teaches that nations failing to recognize their fundamental problems will inevitably decline. American politicians must face what is abundantly clear: the United States is losing ground and must act quickly to reverse its course. This White Paper outlines what must be done. Information about the nation's current status must be analyzed and communicated. Incentives to improve the level of competence in government must be provided and maintained. The emphasis of government policy must be changed to reflect broad economic and technological interests as opposed to special interests. Savings must be encouraged and increased. Infrastructure must be improved Tax laws must be modified to help bring these changes about. Economic and technological issues must be elevated to the importance they require. American thinking must reflect the new realities: that the age of leadership through military power is over, that the requirements for success in the world of the 1990s and beyond require a sound and growing economy that is internationally competitive. The US can accomplish these goals only through foundation-shaking, comprehensive, fundamental changealong the lines we propose herein.This paper is the executive summary (with minor editing modifications) of a white paper that is available from Cornell University's Johnson Graduate School of Management.     

State Medicaid reform under Section 1115 demonstration authority

Given the complexity of federal Medicaid law and the limitations it imposes on state flexibility, it is likely that states will continue to ask the Secretary to grant waivers under Section 1115 to allow them to pursue new approaches to health care reform. The results of currently operational Section 1115 projects involving statewide managed care systems will be useful in evaluating the Medicaid reform measures currently under discussion in other states and at the federal level. In particular, the ability of the states to control Medicaid and indigent care costs and to utilize federal dollars more efficiently should prove important in evaluating a block grant approach to federal Medicaid funding. Moreover, Section 1115 project results that bear on the sufficiency of various Medicaid capitation rate methodologies will also be of value as more states expand the use of managed care arrangements for their Medicaid populations.     

The Department of Health and Human Services issues proposed regulations on physician incentive payments by hospitals

Hospitals tempted to operate their own physician incentive plans are reminded that, under OBRA 1986, they are precluded from paying physician incentives of any kind to reduce or limit Medicare or Medicaid covered services. In light of the proposed regulations and the guidance of the preamble, hospitals should review their incentive plans to determine whether physicians providing direct patient care are receiving prohibited payments. Further, supervising physicians who are receiving incentives for certain hospital departments may not influence direct care over patients served by those departments, even through other physicians. Some risk may also exist if incentives are based on a formula that considers patients of the supervising physician's medical group. Finally, it may be useful to develop a utilization and quality of care review program specifically designed to assure that patient undertreatment does not occur as a result of any supervising physician incentive program.     

Luis Alfredo Garavito Cubillos: criminal and legal aspects of serial homicide with over 200 victims

This is the first scientific report on the crimes of the homosexual paedophile sadist Luis Alfredo Garavito Cubillos, based on a research stay of the authors in Columbia, and including discussions with the investigators, and the offender. Between 1992 and 1999, Garavito killed more than 200 children in the core age span between 8 and 13 years (as an exception, 6 to 16 years). His modus operandi remained stable. During daytime, he lured children of a lower social status out of crowded parts of the city into hidden areas that were overgrown with high plants. Garavito promised either payment for easy work, or drugs, or made other socially believable offers. The children were tied up, tortured, raped, and killed by at least one cut in the lateral part of the neck, or by decapitation. During the killings, Garavito was drunk. Even after his arrest (for attempted sexual abuse under a wrong identity) it was not immediately possible to track his crimes since Garavito had frequently changed his places of stay and his jobs. He also grew different hairdos and used wrong names. During his still ongoing confessions, he directs the investigators correctly to all scenes of crime spread over large parts of Columbia. In our report, we give an overview over the course of investigations, hint to similarities in the cases of the German serial killer Denke (1920's) and homosexual paedophile serial killer Jürgen Bartsch (1960's), and give preliminary impressions on the offender's personality. Furthermore, the violent environment and juridical peculiarities in Columbia are discussed. In spite of a total penalty of 2600 years in prison, it is formally well possible that Garavito will be released out of prison within the next 10 to 20 years, i.e. even before the maximum sentence of 40 years will be over.     

Public Opinion on Federalism in Canada, Mexico, and the United States in 2003

This research reports on public opinion surveys on intergovernmentaland federal issues conducted in Canada, Mexico, and the UnitedStates in March and April 2003. In all three countries, respondentsmost often see their federal government as being the least effective,least efficient, and least trustworthy. Respondents from Canadaappear least supportive of their federal government and mostsupportive of their local governments; those from Mexico appearmost supportive of their state governments; respondents fromthe United States appear more "balanced" in their support ofthe various orders of government. Also, far greater regionaldifferences in opinion exist in Canada than in Mexico or theUnited States. Support for more decentralized federalism isfound to be strong in all these federal countries. This researchalso updates long-term trend data for the United States. Comparedwith respondents from previous years, U.S. respondents in 2003showed a measurable uplick in support for the federal government,compared with state and local governments. This support seemsto be a carryover from the terrorist attacks of 11 September2001.     

Boricuas,African Americans,and Chicanos in the “far west”: Notes on the Puerto Rican pro‐independence movement in California, 1960s‐1980s 1

Abstract

From the late 1960s through the 1980s, Puerto Ricans developed a movement in California in support of Puerto Rico's political independence that allied itself with Anglos, African Americans, Chicanos and other Latinos. These alliances were strategic in extending the influence of the movement in solidarity with Puerto Rico's struggle beyond the relatively small and geographically dispersed Puerto Rican population in California. These implicit and explicit political alliances with other sectors led to an interesting ideological and cultural exchange between radical Puerto Rican organizations and these groups. These notes initiate an exploration of this period, through the oral histories of some of the participants in this movement. The focus of the initial exploration is on those who were in positions of leadership and influence in Northern and Southern California within the radical politics of the Puerto Rican Socialist Party—at the time, the main Puerto Rican socialist organization in Puerto Rico and the US.     

Detection of cannabinoids in homicide victims and motor vehicle fatalities

A gas chromatographic/mass spectrometric (GC/MS) procedure is described for the detection and measurement of delta 9-tetrahydrocannabinol, 11-hydroxy-delta 9-tetrahydrocannabinol, and 11-nor-delta 9-tetrahydrocannabinol-9-carboxylic acid in blood, or 11-nor-delta 9-tetrahydrocannabinol-9-carboxylic acid in urine. About 50% of all homicide victims and motor vehicle drivers killed in Bexar County in 1985 were tested for the presence of cannabinoids. Of 130 homicides and 69 drivers tested, blood was analyzed primarily in all but 15 and 3 cases, respectively. In these latter cases, blood analyzed after urine was found to be positive. Of the homicide victims, 44 (34%), and of all drivers, 19 (28%), tested were positive for one or more of the cannabinoids. As a separate group, 16 motorcycle drivers tested had 38% positive as compared with 25% of the other vehicle drivers. Ethyl alcohol was present in 55% of the drivers, and in 63% of the homicide victims. Drugs other than alcohol or cannabinoids were found in 10% of the drivers, and in 12% of the homicide victims.     

Decomposition of buried bodies and methods that may aid in their location

This is the second report on an ongoing study conducted to collect data on the decompositional rates of human cadavers and the first on buried cadavers. Six unembalmed human cadavers were buried separately in unlined trenches of various depths and allowed to naturally decompose for a time period ranging from a month to a year. During the period of burial, data were collected daily on the air, soil, and cadaver temperature at each burial site. At the end of each specified burial period the cadavers were exhumed and examined for the degree of decomposition which had taken place as well as changes in the soil pH, surface vegetation, and carrion insect activity. Analysis of the data shows that the decomposition rate of buried cadavers is highly dependent on the depth of burial and environmental temperatures. The depth at which the cadaver was buried also directly affected the degree of soil and vegetational changes as well as access by carrion insects. Application of this information can contribute to a more accurate estimation of time since death of a buried corpse and may aid in the location of such corpses.     

Human Services Providers’ Perspectives on Refugee Resettlement in the United States before and after the 2016 Presidential Election

Abstract

The United States has historically accepted and resettled refugees by opening its doors to those fleeing violence, armed conflict, or persecution around the world. However, the degree of receptivity toward refugee resettlement has vacillated over time. This study examines the challenges and opportunities that Refugee Resettlement Agencies (RRAs) experienced prior to and after the 2016?U.S. Presidential election. The findings presented in this paper, based on focus groups with the RRA staff, revealed that there is a greater need for understanding the refugee resettlement process and how changing immigration policies impact state-federal funding.