Those Who Hesitate are Lost: The Case for Setting Behavioral Health Treatment and Disability Standards, Part III

The first and second articles in this 3-part series discussed systematic issues related to multiple standardization problems and their compounding impact on the state and federal disability systems. In addition, the lack of standardization negatively influencing the behavioral health (BH) training and treatment processes may have the potential to cause harm not only to the individual receiving professional care but also to the clinician providing the treatment. In the final article of the series, I make recommendations for systemic changes for the field as well as for potentially revising previous models toward moving the Behavioral Health treatment and disability systems into more of a biopsychosocial approach. However, conclusions emphasize that successful implementation of recommendations and models require the involvement of all of the stakeholders in promoting better outcomes and in facilitating individuals; return to the workplace.     

Those Who Hesitate Are Lost: The Case for Setting Behavioral Health Treatment and Disability Standards, Part I

There are multiple factors that impede the implementation of standards into the behavioral health (BH) treatment and disability processes. The combination of physical and psychological conditions as well as the influence of psychosocial issues has consistently been identified as having negative effects on treatment and treatment outcomes. Further, the wide-spread lack of standardization causes a multitude of problems throughout both BH processes. The focus of this first article in a three-part series will examine the explosion of behavioral health claims and the major factors, such as comorbid physical conditions and psychosocial issues, associated with these types of claims. In addition, the overarching theme of lack of standardization will begin to be explored in regard to the problematic definition of disability, communication difficulties between treating professionals and disability insurers and agencies as well as the introduction of bias into the BH treatment and disability processes.     

Life, Health, and Disability Insurance: Understanding the Relationships

Communitarian values are stronger in health insurance than in life or disability insurance. This correlates with increased tolerance for insurers' use of genetic information in disability insurance underwriting, which, in turn, is relevant to the scope and content of proposals to regulate such use.     

Incarcerated Battered Women: A Comparison of Battered Women Who Killed Their Abusers and Those Incarcerated for Other Offenses

The present study compared battered women incarcerated for killing/seriously assaulting their abusers with battered women incarcerated for other offenses to explore possible similarities and differences in the characteristics and experiences of the two groups as well as to determine what factors may lead some battered women to use lethal force against their partners. Comparisons were made on a number of variables including sociodemographic factors, characteristics of the battering relationship, alcohol/drug use of battered women and their abusers, perceived social support, actions taken to end the violence, prior criminal behaviors, and childhood trauma factors. Findings revealed that women in the homicide/assault group were older, in the relationship longer and experienced a longer duration of violence in this relationship. They also experienced more frequent and severe battering, including sex assaults and sustained more injuries than those in the comparison group. Further, battered women who killed/seriously assaulted their partners were more likely to believe that their lives were in danger, were less likely to use violence against their partners, and were less likely to have a prior criminal record or to have served time previously. The implications of the findings are discussed.     

Genetic Screening and Disability Insurance: What Can We Learn From The Health Insurance Experience?

Genetic information may be used by health and disability insurance companies to deny or restrict coverage. How health insurance companies use genetic information, and how public policy has limited that use, can be illustrative for genetics and disability insurance policy.     

The Costs and Benefits of Transferring Technology Infrastructures Underlying Complex Standards: The Case of IPv6

Industry stakeholders and Internet experts generally agree that networks using Internet Protocol version 6 (IPv6), an Internet communications standard which is being promoted strongly by many parties, would be technically superior to today’s networks, which are largely based on IPv4. The improvements designed for IPv6 could provide numerous benefits to Internet users, network administrators, and applications developers; among these potential benefits are cost reductions due to improved security and increased efficiency, improvements to existing products and services, and innovations leading to new products and services. However, there is wide disagreement about the characteristics and timing of benefits associated with IPv6, and the costs associated with the transition could be substantial. In this paper, we will discuss the likely costs of a transition to IPv6 for the major stakeholders and the potential benefits. Subsequently, we will introduce the cost impact of an accelerated adoption case and discuss potential ways in which the government could become involved in the process. This paper is based on a broader study funded by the National Telecommunications and Information Administration (NTIA) and National Institute of Standards and Technology (NIST). We wish to thank Greg Tassey, Fred Lee, Tim Sloan, B. Keith Fulton, John Streck, and Baran Erkel for comments and suggestions on earlier versions of this paper.     

The Kids are Alright: Making a Case for Abolition of the Juvenile Justice System

When considering abolition of the criminal justice system, there is no greater or more impactful relevance than for juveniles that find themselves inextricably linked to the juvenile justice system. From its inception, the philosophical foundation of juvenile care was to provide individualized, compassionate assistance to young men and women perceived to be in need of emotional care and/or social control. With the establishment of the Cook County Juvenile Court in 1899, the American juvenile justice system has endured a 118-year odyssey that has produced progressively rational, largely unsympathetic, and increasingly punitive practices. With happenings such as the ‘school-to-prison pipeline’, ‘juvenile life without the possibility of parole’, ‘teen courts’, and ‘deferred prosecution probation’, current juveniles that make unassuming mistakes and errors in judgment are adjoined to a system that sustains and reinforces itself through these mistakes and errors. The charge of this article is to recommend the abolition of the contemporary juvenile justice system, with safeguards for the protection from serious offenders and a return to the compassionate care that is warranted for the majority of juveniles that currently bolster the system.     

Tattoos and tattooing. Part II: Gross pathology, histopathology, medical complications, and applications.

Tattooing involves piercing the skin with needles bearing various pigments, to cause the permanent imprint of a design. The body responds to these incursions in specific and predictable ways, with initial sloughing of the overlying epidermis, variable dermal inflammation, and gradual assimilation of the pigment into macrophages. Eventually, much of the pigment is carried to the regional draining lymph nodes, with a residue staying within macrophages localized to dermal perivascular regions. The age of tattoos may be estimated, both grossly and microscopically. Tattooing can result in a variety of relatively uncommon complications and adverse reactions to the pigment, and certain infectious diseases may be inadvertently transmitted through tattooing when the instruments are inadequately sterilized, or when poor technique is used. This article, the second of three, describes the gross and microscopic pathology of both fresh and healed tattoos, and discusses the various complications (infectious and otherwise) that can occur. Tattooing has specific applications in both dermatology and plastic and reconstructive surgery, and these are also discussed.     

Criminals' explanations of their criminal behavior, Part II: A possible role for psychopathy.

The author reviewed the literature concerning the effect of criminals' current psychopathology on their explanations about their crimes. He then studied 100 incarcerated men, examining the associations between their explanations and various historically documented aspects of psychopathy. Previously and independently documented patterns of pathological lying, lack of remorse or guilt, callousness or lack of empathy, and failure to accept responsibility for their own behavior were significantly associated with the offenders not admitting responsibility for their crimes. Further, independently described histories of pathological lying were associated with criminals' blaming their convictions on a faculty criminal-justice system, while histories of failure to accept responsibility for their behavior were associated with blaming someone else for their index crimes.     

Standards for determining coal miner's total disability or death due to pneumoconiosis; claims for benefits under Part C of Title IV of the Federal Mine Safety and Health Act, as amended--Employment Standards Administration, Labor. Notice of proposed rulemaking; request for comment

On January 1, 1982, the Black Lung Benefits Revenue Act of 1981 and the Black Lung Benefits Amendments of 1981 became effective. This legislation made numerous substantive changes in the Black Lung Benefits Act, Title IV of the Federal Mine Safety and Health Act. Those changes affect both the criteria for establishing eligibility for benefits on claims filed on and after January 1, 1982, under the Black lung Benefits Act and the procedures for the payment of such benefits. These proposed rules are intended to implement those changes in the law and to make certain technical corrections in the implementing regulations previously promulgated in 1978 and 1980.     

偏好与理性选择：保守主义人士也能接受的规制——行为经济学与“非对称父爱主义”的案例

非对称父爱主义的规制目的是帮助那些有限理性的人们避免犯成本过高的错误,同时仅对理性的人们加以很小的成本甚至不加以成本。结合了认知心理学与经济学的行为经济学表明,有时候即便有健康心智的人们在某些特定的、可预见的情形下也可能不会为他们长远的自身利益行事,很多非对称父爱主义的规制就是基于这种考虑而产生的。这些规制体现在缺省规则、对信息的提供或重组、冷却期、对消费者选择的限制等方面。非对称父爱主义并不必定是严厉的,它可能会引导产生比现有政策更温和的规则。而且新技术为将这种规制作为一种新的对规制选择的成本收益评估标准提供了新的可能性,因而值得被认真对待。