Cuban Medical Internationalism and its Role in Cuban Foreign Policy

Cuba's medical internationalism is extraordinary, and in many ways the extent of its outreach programme puts the developed world to shame. It is impossible to fit Cuba's actions into any neat theoretical box—quite simply the revolutionary process follows no established paradigm. This exceptionalism is seen both in its approach to foreign relations and in its medical internationalism policy. Indeed, even during the days when it was economically dependent upon the Soviet Union, Cuban actions showed an exceptional degree of political independence. But because Cuba is so different, it is also difficult for developed nations to understand. This is a tremendous pity, for there is much to learn from Cuba's approach to developing sustainable public health systems in poor, Third World countries. There is also a great deal that, on a moral basis, wealthy nations can also learn about Cuba's policy of internationalist solidarity.     

Virginia's Revenue Forecasting Process and Models

In Virginia, major differences between revenue forecasts and actual revenue collections raised questions from legislators about the adequacy of the state's econometric forecasting models and the forecasting process itself. Consequently, Virginia's process and models were examined by the Joint Legislative Audit and Review Commission (JLARC), a legislative watchdog agency. The review found most of the differences could be attributed to declining economic factors and not poor forecasting. However, a surprisingly large component of the forecast was based on undocumented judgmental inputs that required greater oversight. Other states in similar circumstances may wish to evaluate their own forecasting process and econometric models using the JLARC approach.     

Books in review

A former editor of theAmerican Historical Review, he has written extensively on the history of modern Great Britain and more recently has published essays on the nature of the contemporary urban university.     

Zimbabwe: continuities and changes

ABSTRACT

November 2017 will forever be etched in the minds of Zimbabweans, as the moment involving the end of Robert Mugabe’s 37-year rule and the beginning of a post-Mugabe ‘era’ under the leadership of Emmerson Mnangagwa. It also might be considered as a watershed moment in Zimbabwean history, or at least as having the potential to be so. However, identifying key moments in Zimbabwe’s history, and continuities and changes over time, involves engaging in historical periodisation. Periodising the past is never straightforward and leads to contestations at an analytical level. Further, periodisation often has a pronounced political dimension, such that Mnangagwa’s ZANU-PF is engaged in periodisation in seeking to distance itself from Mugabe’s rule. This opening article addresses these points, and it seeks to show how the following articles (mainly written, unknowingly, at the cusp of Mugabe’s endgame) facilitate reflection on continuities and changes in contemporary Zimbabwe.     

Fatal firearm wounds: a clinicopathologic study

Firearm-related injuries are a leading cause of morbidity and mortality in South Africa. This retrospective autopsy study included all firearm-related fatalities seen at a central mortuary in Durban. These cases had initially been assessed by a clinician before death, from July 1998 to June 1999.A total of 322 cases of fatal gunshot wounds were reviewed. Medical records and postmortem findings were compared by data capture onto a spreadsheet. Twenty-eight cases were excluded because of surgical alteration of the wounds, making autopsy evaluation impossible. In 50.7% of cases, the number of wounds was correctly identified and in 55.1% the position was correctly identified. In only 36.1% of cases were the entry and exit wounds correctly identified. The total number of missed wounds was 504 (48.3% of cases). The majority of missed wounds were on the upper limbs (25%), with the anterior trunk (21.8%) and lower limbs (18.5%) making up the remainder. This study demonstrates that physicians in South Africa do not adequately document and interpret gunshot wounds, which may influence the treatment of the patient and have medicolegal consequences. Emphasis should be placed on undergraduate and postgraduate teaching for physicians to correctly identify, interpret, and document firearm wounds.     

Housing Programs Fail to Deliver on Neighborhood Quality,Reexamined

This article revisits the relative performance of housing programs in terms of delivering on neighborhood quality. Newman and Schnare examined this issue in 1997, and this article updates their work more than a decade later. Both efforts examine the neighborhood characteristics surrounding assisted rental housing and assess the direction of assisted-housing policy. The analysis is performed by exploring census data at the tract level for the tenant-based Housing Choice Voucher program plus a set of project-based programs, including public housing, the Low-Income Housing Tax Credit program, and other HUD multifamily programs. We conclude that Newman and Schnare remain correct that rental housing assistance does little to improve the quality of the recipients' neighborhoods relative to those of welfare households and can make things worse. However, things have improved. The Housing Choice Voucher and Low-Income Housing Tax Credit programs have grown in importance over the intervening years and have improved their performance by moving more households into low-poverty, less distressed areas. Importantly, these active programs for assisted housing are beginning to find ways to overcome the barriers preventing entry into the suburbs, although more needs to be done.