Is there a rationale for regionalizing organ transplantation services?

This paper explores issues in the designation of centers to provide organ transplantation procedures and aftercare, a decision faced increasingly by policymakers, planners, and payers. As background for consideration of the regionalization of organ transplantation services, an array of models of regionalization of health services, ranging from full-scale vertical integration to market-enhancing information provision, is described. In the United States, regionalization has mainly followed the designation model within the certificate-of-need system; vertical integration has been adopted only in limited ways. Next, the authors' review of current approaches to the regionalization of organ transplantation centers by public and private payers indicates that designation of centers is increasing, although the empirical evidence concerning the classes of hospitals upon which designation decisions rest is weak. The authors then review the literature on the relationship between volumes and outcomes on surgical services with particular reference to organ transplantation, which on the whole suggests that a relationship between volumes and outcomes exists. Original empirical analysis of data on kidney transplants that were secured from the Health Care Financing Administration is then presented. The study of the effects of hospital and surgeon volumes on graft and patient survival and of the effect of volume on charges found no systematic influence of hospital or surgeon volumes on graft or patient survival. Some evidence that charges are lower for larger centers was found. The authors conclude that the evidence implies that using volume as the provider characteristic upon which to base designation of transplantation centers is problematic, at least for kidney transplants. Steps policymakers might take to ensure quality of transplantation services is discussed in the final section.     

A suicide using a homemade carbon monoxide "death machine"

Deaths related to carbon monoxide (CO) poisoning are common. Most represent accidents and suicides, and most result from CO production via the incomplete combustion of carbon-containing substances. Suicide via CO toxicity is not uncommon and typically involves the use of motor-vehicle exhaust as a source of CO. Presented herein is a case of suicidal CO poisoning in which the CO was produced via a chemical reaction between formic acid and sulfuric acid within a homemade device.     

Large-scale land deals in Sierra Leone at the intersection of gender and lineage

There is wide engagement with large-scale land deals in sub-Saharan Africa, particularly from the perspectives of development and international political economy. Recently, scholars have increasingly pointed to a gendered lacuna in this literature. Engagement with gender tends to focus on potential differential impacts for men and women, and it also flags the need for more detailed empirical research of specific land deals. This paper draws from ethnographic data collected in Northern Sierra Leone to support the claim that the impacts of land deals are highly gendered, but it also argues that lineage in a land-owning family and patronage intersect with these gendered impacts. This data supports my claim that analysis of land deals should start from an understanding of the context-dependent, complex arrays of power and marginality. Such a starting point allows for a wider and ‘messier’ range of impacts and experiences to emerge.     

Conceiving of Telecom: The Politics of Australian Telecommunications Reform 1967–1972

This article explores the politics of telecommunications reform between 1967 and 1972, during which time Labor developed a new policy approach that included committing to reconstitute the Postmaster‐General's Department as a relatively independent statutory authority. This represented the first serious attempt to reconcile the conflicting objectives of Australian policy: to provide affordable universal services by a government department expected to operate as a “business‐like” enterprise, and ended the political consensus about how national telecommunications should be delivered. The paper contrasts Labor's policy with the Liberal‐Country government's more incremental approach; and highlights a significant public policy shift that has received insufficient attention.     

Legal developments and industry issues relevant to IT,media and telecommunications law in key jurisdictions across the Asia Pacific

This column provides a country by country analysis of the latest legal developments, cases and issues relevant to the IT, media and telecommunications' industries in key jurisdictions across the Asia Pacific region. The articles appearing in this column are intended to serve as ‘alerts’ and are not submitted as detailed analyses of cases or legal developments.     

‘The objectionable injectable’: recovering the lost history of the WLM through the Campaign Against Depo-Provera

ABSTRACT

The Women’s Liberation Movement (WLM) was one of the most important social movements of the twentieth century. Although the last few years have seen an increase in historical work exploring the movement, archival-based accounts of the diverse groups that comprised the WLM are few and far between. This article will uncover, and shed light on, the important work of the Campaign Against Depo-Provera. It will explore how women’s campaigns operated during this period, whilst also providing a lens for examining how women engaged with race and class. It will argue that we need to adopt a more nuanced understanding of how feminists engaged with identity, as an examination of the Campaign Against Depo-Provera questions many of the previously held orthodoxies in the literature.     

Convenience stores and routine activities in a summer tourist destination

In this paper we examine the effects of alcohol outlets, with particular attention to convenience stores, located in an East Coast Tourist City. Tourist City offered an opportunity to observe the interplay between convenience stores and robberies and assaults in the presence of large volumes of summer tourists. Guided by Routine Activities Theory, we focused on the convergence of potential victims, guardianship and offenders in the vicinity of convenience stores. The first part of our paper concerns the effects of convenience stores on assaults and robberies in block groups. Using grocery stores as a comparison to convenience stores, we found that the number of convenience stores was correlated with significantly higher levels of both robberies and assaults. The second part of our investigation employed small circular buffer areas focusing on the immediate area around the convenience stores. This analysis revealed that these small areas were associated with significantly higher assaults in the summer and offseason but robberies only during the offseason. In addition, we found that variation in the number of other alcohol outlets near the convenience stores increases the number of assaults within the buffer areas.