Altered states: state health privacy laws and the impact of the Federal Health Privacy Rule

Although the Federal Health Privacy Rule has evened out some of the inconsistencies between states' health privacy laws, gaps in protection still remain. Furthermore, the Federal Rule contains some lax standards for the disclosure of health information. State laws can play a vital role in filling these gaps and strengthening the protections afforded health information. By enacting legislation that has higher privacy-protective standards than the Federal Health Privacy Rule, states can play three important roles. First, because they can directly regulate entities that are beyond HHS's mandate, states can afford their citizens a broader degree of privacy protection than the Federal Health Privacy Rule. Second, by having state health privacy laws, states can enforce privacy protections at the local level. Finally, action by the states can positively influence health privacy policies at the federal level by raising the standard as to what constitutes sufficient privacy protection. High privacy protections imposed by states may serve as the standard for comprehensive federal legislation, if and when Congress reconsiders the issue. So far, states' reactions to the Federal Privacy Rule have been mixed. Only time will tell whether states will assume the mantle of leadership on health privacy or relinquish their role as the primary protectors of health information.     

The Peer Appearance Culture During Adolescence: Gender and Body Mass Variations

The purpose of this research was to examine gender and body mass, as factors linked to perceived experiences within the peer appearance culture. The sample included 215 girls and 200 boys who were either in 7th grade or 10th grade. Students provided self-reports on experiences in three domains: appearance culture among friends (appearance conversations and diet/muscle talk), peer evaluations (peer appearance pressure, appearance teasing, and vicarious peer teasing), and peer acceptance concerns (appearance-based acceptance, peer appearance comparison). The results indicated that although girls reported more appearance conversations, boys perceived more appearance pressure and teasing. Boys also admitted that they talked with friends about muscle building at a rate greater than girls talked about dieting. BMI showed distinct gender patterns. BMI was a key attribute that unified the experiences within the appearance culture for overweight girls. Among the boys, BMI was associated with differentiated experiences for underweight and overweight participants.Associate Professor in Educational Psychology at the University of Washington. She is a developmental psychologist specializing in the contributions of peers to body image and social-emotional well-being during adolescence. Research interests include body image during adolescence and gender differences.Doctoral student at the University of Washington in Human Development and Cognition. Her research focuses on the social-emotional development of adolescents, academic and appearance social comparisons, and issues related to gender and science. Research interests include body image during adolescence, gender differences, social comparison, and academic competence.     

Challenges for China's Reform of Government Procurement

China's reform of government procurement aims to promote greater prudence in expenditure management through introducing transparency, accountability, and competition into the procurement process. The reform can also be construed as China's effort to fulfill its commitment to the WTO. This paper examines the evolution of the reform and measures the success of the reform against three indicators: the amount of cost reduction, the coverage of procurement activities, and the degree of harmonization with the WTO Agreement of Government Procurement. This paper argues that the success of the reform has been limited by an array of factors, including the misconceptions of certain procurement officials and their malpractices in procurement processes, the poor capacities of some local governments in enforcing reform, structural deficiencies in the budget management system, and the lack of political will of both central and local authorities in spurring trade liberalization.     

Adolescents as mothers: An interdisciplinary approach to a complex problem

Pregnancy among adolescents, and especially among low-income adolescents, represents a high-risk situation from multiple points of view. When compared to data for the population at large, obstetrical outcome is worsened, subsequent educational attainment is poor, social prognosis is guarded, and repeat unwanted pregnancies are common. The surviving infants, similarly have relatively high incidences of medical and developmental problems. In recent years, comprehensive interdisciplinary programs have been organized to offer more meaningful help to these individuals. The present report describes the authors' 5-year experience with one early intensive program. Considerable medical, educational, and social successes have been noted. The results are especially striking when contrasted with the authors' current experience with an improving but still more fragmented and less successful program. Findings concerning infant development and the mother-infant interaction are also noted. Finally, issues related to the achievement of successes and the persistence of problems after provision of more adequate comprehensive services are discussed.This study was supported in part by Grant No. 03-H-000-079-03-0, Maternal and Child Health Service, H.S.M.H.A., H.E.W.While on the faculty of the State University of New York, College of Medicine at Syracuse, was a founder and the first medical director of the YMED program.Specialty is Developmental Psychology, and research interests concern infant and early child development and the effects of children on parents. While on the faculty of Cornell University, served as a consultant to the YMED program.Project director of the high-risk program.While on the faculty of the State University of New York, College of Medicine at Syracuse, was obstetrical director of the YMED program.     

A PCR multiplex and database for forensic DNA identification of dogs

Animal-derived trace evidence is a common finding at crime scenes and may provide an important link between victim(s) and suspect(s). A database of 558 dogs of pure and mixed breeds is described and analyzed with two PCR multiplexes of 17 microsatellites. Summary statistics (number of alleles, expected and observed heterozygosity and power of exclusion) are compared between breeds. Marked population substructure in dog breeds indicates significant inbreeding, and the use of a conservative theta value is recommended in likelihood calculations for determining the significance of a DNA match. Evidence is presented that the informativeness of the canine microsatellites, despite inbreeding, is comparable to the human CODIS loci. Two cases utilizing canine DNA typing, State of Washington v. Kenneth Leuluaialii and George Tuilefano and Crown v. Daniel McGowan, illustrate the potential of canine microsatellite markers for forensic investigations.     

PENDULUM--a guideline-based approach to the interpretation of STR mixtures

Several years ago, a theory to interpret mixed DNA profiles was proposed that included a consideration of peak area using the method of least squares. This method of mixture interpretation has not been widely adopted because of the complexity of the associated calculations. Most reporting officers (RO) employ an experience and judgement based approach to the interpretation of mixed DNA profiles. Here we present an approach that has formalised the thinking behind this experience and judgement. This has been written into a computer program package called PENDULUM. The program uses a least squares method to estimate the pre-amplification mixture proportion for two potential contributors. It then calculates the heterozygous balance for all of the potential sets of genotypes. A list of "possible" genotypes is generated using a set of heuristic rules. External to the programme the candidate genotypes may then be used to formulate likelihood ratios (LR) that are based on alternative casework propositions. The system does not represent a black box approach; rather it has been integrated into the method currently used by the reporting officers at the Forensic Science Service (FSS). The time saved in automating routine calculations associated with mixtures analysis is significant. In addition, the computer program assists in unifying reporting processes, thereby improving the consistency of reporting.     

The Benefit Equity Principle and Willingness to Pay for City Services

In 1991 and 1992, the City of Eugene, Oregon engaged in a citizen participation process to determine public support for a variety of spending and budget balancing alternatives. This process, called Eugene Decisions, employed an innovative combination of public forums, budget balancing exercises and representative surveys. Two of the surveys, which included questions about individual service use, are analyzed here in order to test whether the use of city services is related to willingness to pay taxes and fees. The concept of benefit equity is supported if service use is positively associated with willingness to pay.