Medicaid and access to child health care in Chicago.

In this article we examine how increasing the reimbursement of physicians and expanding Medicaid eligibility affect access to care for children in Cook County, Illinois, which overlies Chicago. Using Medicaid claims and other data at the zip-code level, we compare the places where Medicaid children live with the places where all the physicians who treat children and those who accept Medicaid patients have their practices. Our findings suggest that the recent changes in legislation are unlikely to benefit extremely poor children, who are more likely to live in depressed inner-city areas, where there are few physicians. "Near-poor" children whose homes are dispersed throughout the county, who are now eligible for Medicaid as a result of the recent changes, are likely to see improvements in their access to care. Further changes in policy, aimed at enhancing the capacity of institutions providing care, could improve access for the children of the inner city.     

Identification of a red "fiber": chironomid larvae

During preliminary examination of the body of a homicide victim, a peculiar red "fiber" was noticed and recovered. Initially believing this to be a carpet fiber, the item was subjected to fiber analysis. It was found to be a short coiled particle not like any known natural or synthetic fabric fiber. Subsequent examinations determined this "fiber" to be the larva of a common freshwater midge (Diptera; Chironomidae). Chironomid larvae have been observed on other bodies recovered from freshwater environments. Entomological studies of this organism have led to the conclusion that the presence of chironomid larvae indicates submersion of the body.     

Behavior of animal blood in blood typing systems. Isoelectric focusing of erythrocyte acid phosphatase and phosphoglucomutase

Isoenzyme band patterns of animal blood erythrocyte acid phosphatase (EAP) and phosphoglucomutase-1 (PGM) were studied by isoelectric focusing on ultrathin polyacrylamide gels. For blood from all animals tested (dog, cat, cow, sheep, and goat), the overall band patterns for both isoenzymes were different from those of the most common human types of these enzymes, although some animal EAP and PGM bands appeared in the human band areas. When mixtures of human and animal red blood cells were studied, it was found that misinterpretation of human types was possible only if the overall band pattern of the mixtures was ignored. For the animal blood tested, the strong PGM bands appearing outside the human band areas could be used as "markers" for the possible presence of animal blood in the samples tested.     

Self-defense injuries in homicides caused by penetrating forces

101 homicides caused by stabbing were examined for the presence of defence-injuries. 50 victims showed 174 defence-injuries on hands and forearms (133 incision wounds, 26 stab wounds and 15 cutting through). More than two thirds of lesions were found on left arm. That those lesions mostly were found on left arm is caused by the interaction between perpetrator and victim. Victims left arm is nearest to the perpetrator therefore it is used as a mean of defence first of all. The probability that defence-injuries can be seen is rising with the number of stab wounds. Localisation of a defence-injury on the extensor side ("passive") or on the flexor side ("active") is conditioned by accidentalities. Such a differentiation should be given up because no conclusions on the readiness of defence can be drawn.     

Brief for 885 law professors in support of maintaining adherence to the Roe decision

This brief opposes the overturn of "Roe v. Wade" and resists weakening "Roe's central holding" that would allow states to overturn legal abortion. The brief was written for 885 law professors. "Roe" was not a "constitutional aberration," or "an exercise of raw, judicial power." Some members of the Supreme Court seem to think that the state has "an overriding interest" in protecting fetal life. Some Court members have questioned "Roe's" trimester framework. A person's decision to abort should be done privately. If women are not free to choose abortion, they will not have equality. There is an absence of "express rights of privacy and procreational freedom" in the Constitution. "Roe" was 1 instance of the Court's recognition of constitutional rights that are not named explicitly. Historical materials are drawn on to show the link between trends in society and the "judicial recognition of unenumerated rights." The most serious questions about "Roe" deal with its trimester framework. Justice Blackmun's majority opinion said that the 1st trimester of pregnancy was personal. "Roe" said that abortions created a medical risk at the beginning of the 2nd trimester. Therefore, the government was more interested in the health of the mother at that time. The state could then regulate abortion "in ways that are reasonable related to maternal health." The start of the 3rd trimester was when the fetus was viable. The right of a woman to end her pregnancy "offends powerful moral forces." Some of "Roe's" critics had their scientific facts wrong. Medical authorities think Justice O'Connor is mistaken when she says that "Roe" is "on a collision course with itself." The 23rd to 24th week of pregnancies where the fetal organs can "sustain life outside the womb." This has not changed since "Roe" was decided in 1973, nor is it likely to in the future. Some "amici" believe that the state can never have an interest in the fetus. The state can not have an interest in the fetus distinct from the woman who will give birth to it. During previability, restricting a woman's procreational rights would not be scientifically supportable. The state does have an interest in "upholding the value of human life." "Roe" is "within the mainstream" of constitutional jurisprudence and should be reaffirmed.     

Webster and women's equality

The National Abortion Rights Action League (NARAL) and the Women's Legal Defense Fund (WLDF) co-authored an "amicus curiae" brief in "Webster." The brief was written for 77 organizations who believe in equality of women. The brief said that constitutional protection of a woman's right to choose is guaranteed by the right to privacy. The brief said that if abortions were illegal, women would not be able to take place in society equally with men. Liberty would be taken away from women. If the state interferes with abortion, the principle of bodily integrity is violated. In "Winston v. Lee," the Supreme Court found that the state could not compel a criminal to undergo an invasive surgical procedure to retrieve a bullet necessary for the state to prosecute with. 1 in 4 women have a cesarean section, which requires a larger incision in the abdomen, and has many risks. Bearing and raising children often puts a damper on women's employment opportunities. Therefore, if the Supreme Court denied women the right to bear children when and where they wanted, women would not have the right to plan their futures. If the Supreme Court were to agree that "interest in potential life outweighs" a woman's tight to procreate autonomously, states could declare all abortions illegal, investigate them to see if they were induced on purpose, and murder women who induced them. Contraceptive devices could be declared illegal. Laws could be used to force women to submit to cesarean sections and other fetal surgery. Pre-viability abortion restrictions should be rejected because they have old-fashioned notions of women's role in society. They reinforce stereotypes. Missouri's law stresses aiding "potential," rather than actual life.     

Community midwifery and state measures: the new midwifery in British Columbia

The New Midwifery, a form of community midwifery rooted in home birth and intensive prenatal and postnatal care, has attracted great controversy since its appearance in British Columbia in the early 1970s. On the one hand, this form of community midwifery has endured despite legal prohibition. Midwives derive an income from their practices, obtain necessary supplies and equipment, and are active in lobbying for recognition through the State. On the other hand, community midwifery is marginalized and illegal. Out-of-hospital births comprise less than one percent of births in British Columbia (and nationwide). Community midwives are excluded from the provincal Medical Services Plan and they lack hospital privileges if their clients are transferred to hospital. Community midwives are more likely than medical personnel to be tried for criminal negligence causing death and subject to prosecution under theMedical Practitioners Act of practicing medicine without a license.Community midwifery illustrates the structural limits placed on female birth attendants working outside the norm of professionally accredited, hospital situated childbirth. It is concluded that State measures in Canada structure power relations in a dialectical fashion. This includes measures to consolidate the monopoly status of the medical profession and the nursing profession, while temporizing about demands for independent midwifery practice. State powers are however relatively autonomous of dominant economic groups such as the Medical profession. Not all prosecutions of community midwives are successful, and contradictions in State policies surrounding monopolistic powers and civil liberties, and gender relations are evident.An earlier version of this paper was presented at the Canadian Sociology and Anthropology Association Meetings, University of Manitoba, June 1986. The author is grateful for resources provided through the Social Sciences and Humanities Research Council of Canada, the Department of Anthropology and Sociology (University of British Columbia), and the School of Criminology, Simon Fraser University. Comments from Carol Bullock, Nanette Davis, Bob Ratner, Livy Visano and the Journal referees have been helpful in revising this paper.