The schizophrenia of physician extender utilization

The Patient Protection and Affordable Care Act of 2010 provides incentives for healthcare to be delivered by Affordable Care Organizations (ACOs). The public face of many, if not most, ACOs is likely to be the Patient Centered Medical Home (PCMHs), a business structure that evolved from Retail Medical Clinics, which made greater use of physician extenders (PAs). Accordingly, this paper examines the evolution and structure of PCMHs as well as how the PCMH is regulated. As neither legal or market regulatory mechanisms are ideal for policing business structures that employ PAs, this paper concludes that the tort reform most appropriate for PCMHs is the introduction of either no-fault or enterprise liability coverage.     

Situating gangs within Scotland’s illegal drugs market(s)

The Scottish government’s (2008) publication ‘The road to recovery: A new approach to tackling Scotland’s drug problem’ elaborates and outlines the Scottish National Party’s (SNP) desire to make Scotland ‘drug free’ by 2019. To achieve this objective, the Scottish Government’s (2015) ‘Serious Organised Crime Strategy’ (SSOCS) entails dismantling networks of drug supply. Yet missing from this strategic planning is a) recognition of how, if at all, different types of gangs are involved in drug supply, and b) how drug supply processes actually work. Therefore, this article seeks to extend McLean’s (J Deviant Behav, 2017) Scottish gang model, which specifies a typology of gangs in Scotland, in an effort to locate precise levels of gang involvement in the drugs market. This is achieved by drawing upon Pearson and Hobbs’ (2001) hierarchical model of the UK’s illegal drug(s) market. In-depth interviews with 35 offenders involved in criminal networks and five practitioners, indicate that recreational Youth Street Gangs are really only involved in ‘social supply’. Youth Criminal Gangs are primarily involved in commercially motivated dealing at the low- to mid-levels, including bulk-buying between the retail-to-wholesale markets. And enterprising Serious Organised Crime Gangs operate from the middle-to-apex market level. Conclusions which situate this gang typology within the illegal drug market(s) are used to put forward recommendations aimed at dismantling of drug supply networks.     

Together Forever? Explaining Exclusivity in Party–Firm Relations

Parties and firms are the key actors of representative democracy and capitalism, respectively, and the dynamic of attachment between them is a central feature of any political economy. This is the first article to analyse systematically the exclusivity of party–firm relations. We consider exclusivity at a point in time and exclusivity over time. Does a firm have a relationship with only one party at a given point in time, or is it close to more than one party? Does a firm maintain a relationship with only one party over time, or does it switch between parties? Most important, how do patterns of exclusivity impact on a firm's ability to lobby successfully? We propose a general theory, which explains patterns of party–firm relations by reference to the division of institutions and the type of party competition in a political system. A preliminary test of our theory with Polish survey data confirms our predictions, establishing a promising hypothesis for future research.     

Much ado about cloning in the public square

The dawnings of the age of human cloning and genetics is shaping lives, ideologies, and social structures. How will we--as individuals and as communities--respond to the possibilities, challenges, and changes of the clone age? This essay invites engagement in communal moral deliberation through broadening conversations about serious matters, including human cloning. A framework that includes important moral markers for significant "kitchen table talk" is offered. Clone age justice is also discussed. Attention is paid to the renewed role of religious voices in the public square.     

A comparative reliability analysis of computer-generated bitemark overlays

This study compared the reliability of two methods used to produce computer-generated bitemark overlays with Adobe Photoshop (Adobe Systems Inc., San Jose, CA). Scanned images of twelve dental casts were sent to 30 examiners with different experience levels. Examiners were instructed to produce an overlay for each cast image based on the instructions provided for the two techniques. Measurements of the area and the x-y coordinate position of the biting edges of the anterior teeth were obtained using Scion Image software program (Scion Corporation, Frederick, MD) for each overlay. The inter- and intra-reliability assessment of the measurements was performed using an analysis of variance and calculation of reliability coefficients. The assessment of the area measurements showed significant variances seen in the examiner variable for both techniques resulting in low reliability coefficients. Conversely, the results for the positional measurements showed no significant differences in the variances between examiners with exceptionally high reliability coefficients. It was concluded that both techniques were reliable methods to produce bitemark overlays in assessing tooth position.     

Forensic implications of biting behavior: a conceptually underdeveloped area of investigation

Within the context of a criminal investigation the human bitemark traditionally provides the forensic dentist with both physical and biological evidence. In recent years, however, examples exist where in addition to discussing physical and biological evidence, expert witnesses have also testified in court regarding the behavioral aspects of biting behavior. Interested in this additional source of evidence, the authors reviewed the research literature from which biting behavior could be explained. The review found a hiatus of empirical knowledge in this respect, with only two papers seemingly related to the topic. With this dearth of knowledge in mind, the authors present a framework for further analysis and tentatively suggest reasons for biting behaviors, using a range of psychological models. The article ends with a cautionary note that vague and often misleading behavioral assumptions must not be applied to bitemark testimony until further data are available.