Is the doctor in? The evolving role of organized medicine in health policy

Until recently, physicians were viewed as the dominant player in health policy. Now, however, they compete with many other effective interest groups. This article analyzes this changing role, and specifically how organized medicine has changed its approach to influencing health policy. The essay begins with a review of the reasons for the growth and subsequent decline of physicians' influence. This is followed by a case study of physician payment reform under Medicare, which illustrates the ways in which organized medicine chooses when and when not to cooperate with government. The article concludes with a discussion of where physicians are likely to continue to be influential in future health policy reform. Three such areas are noted: payment policy, quality and clinical innovation, and medical education and training.     

North America's first supervised injection site opens in Vancouver

The number of injection drug users frequenting the long-awaited supervised injection site in the Downtown Eastside has steadily increased since the site opened in September 2003. However, there are concerns about the restrictions imposed by Health Canada and about the activities of the Vancouver Police.     

Supervised injection sites: Health Canada approves Vancouver pilot sites, but concerns remain

The paperwork has been processed, and Health Canada says that two pilot supervised injection sites (SISs) in Vancouver can now proceed, but operational funding for the site to be located in the Downtown Eastside has yet to be secured. Meanwhile, tired of waiting for the sanctioned SISs to open, community groups in Vancouver have begun to operate unsanctioned sites. There are also concerns that even if operational funding for the Downtown Eastside site is obtained, the pilot SIS project is too small in scope to make a major impact on public health in the area.     

The Illusion of Transparency in Negotiations

The authors examined whether negotiators are prone to an illusion of transparency, or the belief that their private thoughts and feelings are more discernible to their negotiation partners than they actually are. In Study One, negotiators who were trying to conceal their preferences thought that their preferences had leaked out more than they actually did. In Study Two, experienced negotiators who were trying to convey information about some of their preferences overestimated their partners' ability to discern them. The results of Study Three rule out the possibility that the findings are simply the result of the curse of knowledge, or the projection of one's own knowledge onto others. Discussion explores how the illusion of transparency might impede negotiators' success.     

Trends in explosive contamination

This study sought to assign a rough order of magnitude for the amount of explosive residue likely to be available in real-world searches for clandestine explosives. A variety of explosives (TNT, TATP, HMX, AN, RDX, PETN) in various forms (powder, flake, detonating cord, plastic) were carefully weighed or cut into containers, and the amount of residue inadvertently remaining on the work area, hands, or containers was quantified. This was used to evaluate the spillage potential of each explosive. The adhesion of each explosive to a glass surface was quantified from amount of explosive adhering to the inside of a glass vial into which the explosive had been placed and then removed by vigorous tapping. In powdered form, most of the explosives--TNT, PETN, RDX, HMX, and TATP--exhibited similar spillage and adhesion to glass. However, PETN as sheet explosive and plasticized RDX (C-4), showed very little potential to contaminate surfaces, either by spillage or adhesion to glass.     

An alternative method to screen for pepper spray residue

A method was developed to screen for pepper spray residue using instruments and methods other than those techniques commonly employed to analyze chemical residue (i.e.. gas chromatography mass spectrometry-GCMS or liquid chromatography mass spectrometry-LCMS). The method employed gas chromatography (GC), thin layer chromatography (TLC), and diffuse reflectance infrared Fourier transform spectroscopy (DRIFTS) to screen for dried pepper spray stains. Pepper sprays from nine different manufacturers were investigated. Capsaicin and dihydrocapsaicin were identified and unique IR reflectance spectra are presented. An additional five compounds were presumptively found. Results showed that a particular stain could be characterized as a pepper-based stain.     

Virtopsy-postmortem multislice computed tomography (MSCT) and magnetic resonance imaging (MRI) in a fatal scuba diving incident

The body of a 44-year-old scuba diver was examined using postmortem multislice computed tomography (MSCT) and magnetic resonance imaging (MRI), and findings were verified by subsequent autopsy. The goal was to find out whether the important pathomorphological findings for the reconstruction of events and the identification of cause and manner of death could be identified using modem digital cross-sectioning techniques. The findings of a massive vital decompression with pulmonary barotrauma and lethal gas embolism were identified in the radiological images. MSCT and MRI were superior to autopsy in the demonstration of the extent and distribution of gas accumulation in intraparenchymal blood vessels of internal organs as well as in areas of the body inaccessible by standard autopsy.