The faces of death: regional differentiation in cause-specific mortality in the past

In mortality research, much attention has been paid to the strong geographical differentials in mortality levels and in modern mortality decline, as the analysis of this geographical differentiation might hold the key to explaining the determinants of mortality change. The use of historical cause-specific mortality data has proved a challenging, although very insightful, means to this end. The four contributions to this special issue focus on cause-specific mortality in the past, both to reassess older data using new insights and to challenge existing insights by using new data and methods. These papers, of which earlier versions were presented during the thirty-eighth Social Science History Association (SSHA) Meeting in Chicago, 21–24 November 2013, explore mortality at different stages of the life course, ranging from early infancy to old age. Moreover, each paper revolves around a different group of causes of death. Although the papers are in many ways rather different, together they demonstrate how different data, theoretical frameworks and methodologies can push the boundaries of research into the trends and determinants of historical mortality patterns.     

Consent in escrow

Disasters such as flash flooding, mass shootings, and train and airplane accidents involving large numbers of victims produce significant opportunity for research in the biosciences. This opportunity exists in the extreme tails of life events, however, during which decisions about life and death, valuing and foregoing, speed and patience, trust and distrust, are tested simultaneously and abundantly. The press and urgency of these scenarios may also challenge the ability of researchers to comprehensively deliver information about the purposes of a study, risks, benefits, and alternatives. Under these circumstances, we argue that acquiring consent for the immediate use of data that are not time sensitive represents a gap in the protection of human study participants. In response, we offer a two-tiered model of consent that allows for data collected in real-time to be held in escrow until the acute post-disaster window has closed. Such a model not only respects the fundamental tenet of consent in research, but also enables such research to take place in an ethically defensible manner.     

Democratic control and border security in the Western Balkans

This note focuses on the best means for achieving civilian control of border security in the Balkans. Civilian control may be achieved through societal control (as in civilian complaint reviews) but such procedures require an established political culture that does not yet exist in the region. Civilian control also requires a degree of technical expertise, which is not always available among international officials, let alone local communities.     

Examining the constitutionality of Internet filtering in public schools: a US perspective

The use of Internet filters in public classrooms in the USA has been intensely debated, both in terms of its effectiveness and legality. The debate pits concerns to protect students from indecent material against issues of unconstitutional censorship. This paper examines the legal issues addressed in various rulings by the US Supreme Court pertinent to issues raised in the debate over the constitutionality of filtering in the classroom. The rulings and opinions offer valuable insights into the legal issues raised in this debate.     

Making sense of referral fee statutes

State and federal prohibitions of referral fees have long plagued the health care sector because their broadly worded provisions threaten established and socially valuable business arrangements. Congress has recently instructed the Department of Health and Human Services to issue regulations that clarify the scope of the most threatening of these prohibitions, the Medicare and Medicaid felony referral fee statute. This article examines three possible analytical models for imposing a limiting construction on referral fee statutes by testing the models against three beneficial practices that the statute jeopardizes: physician recruitment, fee discounting, and efficiency bonuses. The article recommends primary reliance on an earned/unearned analysis that detects a prohibited referral fee by asking whether the fee is fully earned by legitimate, nonreferral services.     

FIELD NETWORK RESEARCH IN POLICY EVALUATION

The field-network evaluation studies (FNES) approach to policy evaluation research seeks to overcome deficiencies of small-sample case study method and of the large-sample survey research approach. Methodologically, FNES uses many of the familiar techniques of both these approaches interviews, data collection and analysis, limited sampling, field observation, and document analysis. The crucial difference is sample size. The FNES approach using a middle-range sample of 50 to 60 research sites has the advantages of the case study method in being able to provide an in depth account of a program and how it operates, and is sufficiently flexible to permit a shift in the analytical framework as the research proceeds thus overcoming the inflexibility of the instruments of survey research.
Seven major studies employing the FNES approach have been carried out or are underway in the United States of America. The principal components of the methodology are a network of university-based field associates and a central management group. The field associates collect the information and the data using a uniform analytical framework and reporting form. The central staff aggregates these analyses into a single report that cuts across the sample. This approach and the use of a middle-range sample make it possible to draw generalizable conclusions based on the national experience, and also provide sufficient detail to differentiate policy impacts among the sample jurisdictions.