The view from below: Local government and Putin's reforms

Local government reforms in contemporary Russia are placed in the broader contexts of political reform under Putin and the historical relationship between local administration and the state. Reforms of local government thus help illuminate the architecture of contemporary state building in Russia and the degree to which contemporary Russia perpetuates political traditions. This study reviews the antecedent action in local government prior to the Putin era. It then examines the Kozak Commission and the new law on local government, assessing the strengths and weaknesses of these reforms. Finally, this study examines the challenges of implementing the reforms and what these challenges tell us about devolution and centralisation under Putin.     

A mesolevel comparative approach to maxi and mini strategies of public enterprise reform

Large-scale privatization is an unfamiliar area of public policy. The practice and study of property reforms and privatization needs to include mesolvel phenomena such as laws, regulations, institutions and standard operating procedures. There has been little comparative analysis of privatization programs around the world. The author argues that analysts should compare the most immediately relevant institutional environment of the enterprise. Conceptually, this mesolevel system is situated between the firm and the macroeconomy. This system of action is especially fruitful for cross-national comparisons of privatization programs because it is at this level that privatization strategies are designed. The problem for Eastern Europe and for less-developed countries is lack of experience with the relatively light economic regulation that characterizes industrial countries. Government leaders must also decide how much effort to devote to privatization of state-owned enterprises and how much to fostering private sector investment in new firms. Ernest J. Wilson, III is affiliated with the National Security Council, Washington, D.C.     

Proficiency testing (external quality assessment) of drug detection in oral fluid

Eighteen external quality assessment (proficiency testing) samples were prepared from client specimens collected with the Intercept^® oral fluid collection device and by spiking drug-free oral fluid. Samples were circulated in pairs at quarterly intervals to 13 UK and USA based laboratories for analysis by a panel of OraSure micro-plate Intercept^® enzyme immunoassay kits and hyphenated mass spectrophotometric techniques. During the survey, there was a single case of non-specificity in a false report for methadone. The major errors were of lack of sensitivity relative to the concentration thresholds specified for the immunoassays. The sensitivity for overall ‘present’/‘not found’ reports calculated as true positives/(true positives + false negatives) were for the amfetamine specific assay 50%, methyl-amfetamines 93%, barbiturates 64%, cannabinoids 73%, cocaine and metabolites 100%, benzodiazepines 69%, methadone 95%, opiates 79% (opiates excluding oxycodone 93%), phencyclidine 93% and human gamma-globulin 97%. A small number of the sensitivity errors were attributable to errors in chromatographic confirmation techniques.     

R&D spinoffs: Serendipity vs. a managed process

This paper describes some of the spinoff benefits that can result from R&D projects, and categorizes them in terms of the dimensions of market and technical newness. These dimensions are discussed with reference to two types of spinoffs: 1) alternative market applications, when the results of an R&D project are subsequently applied to a market or use that differs from the originally intended application, and 2) second-generation technologies, when the technology that was the subject of an R&D project is significantly altered or enhanced in unanticipated ways through subsequent R&D. Examples from the Department of Energy's Energy-Related Inventions Program are integrated into the results of literature review to illustrate key concepts, including core technologies, degrees of market and technology newness, technology robustness, and the nature of connections linking spinoffs to prior R&D investments. The paper concludes by discussing spinoffs as a managerial strategy.     

The need to know versus the right to know: privacy of patient medical data in an information-based society

"Whatever, in connection with my professional practice, or not in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret."(1) "Safeguards to privacy in individual health care information are imperative to preserve the health care delivery relationship and the integrity of the patient record."(2) As early as the fourth and fifth centuries B.C., Hippocrates contemplated the importance of medical information to the care and treatment of patients. His oath suggests that privacy of a patient's medical information creates the foundation upon which a patient reposes trust in his or her physician. While defining the earliest version of the physician-patient privilege, the oath does not envision the extent of modern day access to healthcare information. A patient's relationship with the modern healthcare delivery system often includes a team of physicians, nurses, and other clinical support personnel. This relationship extends beyond direct caregivers and may include healthcare administrators, payor organizations, and persons unfamiliar with a patient's identity, such as researchers and public health officials. Accessing a patient's medical information links these participants to the patient's healthcare delivery relationship. The Hippocratic Oath does not contemplate such broad access, nor does it contemplate the emerging privacy crisis resulting from the application of computer technology to medical record storage and retrieval. The combination of broad access, individual privacy rights, and computer technology requires a rethinking of measures designed to protect the realities of the modern medical information society.     

A review of recent developments affecting COBRA rights

Due to the high cost of health care claims and COBRA's status as remedial legislation, COBRA has generated a significant amount of litigation in recent years. While the early COBRA decisions tended to broaden the law in order to provide a remedy to an otherwise uninsured qualified beneficiary, the recent trend in the case law has been to limit the expansion of COBRA rights based on a narrower construction of the statute. Even so, COBRA still represents a legal minefield for employers. As a result, a careful employer will minimize its exposure by monitoring changes in the law and its interpretation and making appropriate modifications to its COBRA documentation and administration. This article discusses some of the more significant recent changes in the law affecting qualified beneficiaries' COBRA rights--and therefore, employers' exposure.