Explaining a health care paradox

The paradox of a statistically weak linkage between physician density and measures of health based on outcome has recently received much attention because of its importance to health planning policy. It is demonstrated here that the linkage is stronger than indicated by previous studies if the statistical model is more carefully specified. A single case-type is chosen so that the impact of physician services is not filtered out by the aggregation process and a quantitative variable measuring case severity is derived. When statistical techniques are applied to correct for case-risk and for the inherent heteroscedasticity in observed mortality rates across states and time, the positive effect of physician density on health is shown to be statistically highly significant. Thus the apparently paradoxical findings in previous studies may be a result of failing to correct not only for differences in case severity but also for variations in sample errors. Also, even though the magnitude of physician impact is small compared to non-medical variables, an exploratory estimate of the impact of government programs focused on prevention suggests that present allocations between prevention and treatment may approximate optimality.The project upon which this paper is based was performed pursuant to Research Grant HS01036 from the Bureau of Health Services Research and Evaluation, U.S. Department of Health, Education and Welfare. The author wishes to acknowledge the advice and encouragement of Llad Phillips and H. E. Frech.     

Successful extraction of human genomic DNA from serum and its application to forensic identification

We report here on the successful extraction of human genomic DNA from a serum sample in a forensic case. The extracted DNA was successfully used for the identification of remains presumably immersed for more than three weeks for which the only comparison sample was a 250-microL serum aliquot kept frozen in a laboratory. The analysis made it possible to identify a second victim as the daughter of the first.     

Stealing Thunder as a Courtroom Tactic Revisited: Processes and Boundaries

Stealing thunder refers to a dissuasion tactic in which an individual reveals potentially incriminating evidence first, for the purpose of reducing its negative impact on an evaluative audience. We examined whether it was necessary to frame the negative revelation in a manner that downplayed its importance, and found that stealing thunder successfully dissuaded mock jurors even without framing. We also sought to determine the mechanism by which stealing thunder operated, and found that stealing thunder led mock jurors to change the meaning of incriminating evidence to be less damaging to the individual. We also found that stealing thunder's effectiveness did not hinge on whether or not opposing counsel also mentioned the thunder evidence, and that the stealing thunder tactic was no longer effective when opposing counsel revealed to the mock jurors that the stealing thunder tactic had been used on them.     

Bedroom rape: sequences of sexual behavior in stranger assaults

This article examines the sequential, temporal, and interactional aspects of sexual assaults using sequential analysis. Fourteen statements taken from victims of bedroom-based assaults were analyzed to provide a comprehensive account of the behavioral patterns of individuals in sexually charged conflict situations. The cases were found to vary in the sexual severity of assault, distinguishing a variety of motivations and behavioral repertoires of offender and victim. Two quite distinct styles of offense were identified: multiple and single, which may have very different implications for research into rapist taxonomies and rape prevention strategies.