Rational planning and responsiveness: the case of the HSAs

American government in the twentieth century has been faced with a serious value conflict between the need for rational allocation of scarce resources through planning, and the need to be responsive to a diverse society. Two ideal types of planning correspond to these two values. Rational planning emphasizes the importance of the planner's expertise in achieving the "best" path to socially defined goals. Advocacy planning emphasizes the importance of responsiveness to group interests since all planning decisions are basically a matter of value choice. Citizen participation in planning often combines elements of these two models, embodying the value conflict in planning agency procedures. Health systems agencies are examined as a typical case of such planning. Their failure to build a constituency is viewed as a consequence of role conflict reduction strategies by representatives who did not know whether to play the planner or the advocate role, and how to play either.     

Pitfalls in the diagnosis of drug smuggler's abdomen

Narcotics "body packing" can be detected in abdominal X-rays by the ring shadow caused by air trapped in the packs. In a series of 82 cases admitted for abdominal X-ray in Helsinki, Finland, in 1982 through 1988, we encountered 9 (11.0%) true positives, 3 (3.6%) false positives, and 1 (1.2%) false negative. The false positives were due to the constipation often associated with the narcotics abuse. The false negative X-ray diagnosis was attributable to an inexperienced radiologist. False negatives may also be associated with packets containing marijuana, packs with few wrappings, aluminum-foil coated packs, and machine-packed narcotics. Searching for trapped air in radiographs, repeated X-raying by an experienced radiologist, use of computed tomography, or combined urinary drug screening may be applied to diminish false findings and to avoid unnecessary arrest for the purpose of fecal screening over several days.     

Rethinking the admissibility of medical treatises as evidence.

This Article examines the issues and questions which underlie the debate over the admission of "medical treatises" into evidence. The admissibility of this type of evidence is at issue most often in litigation involving complex medico-legal issues. This article outlines the evidentiary basis for admission of medical treatises and discusses the quality of medical treatises in an effort to determine what value to the fact-finder these treatises actually hold. The authors contend that there is an inherent untrustworthiness associated with medical treatises, but do not go so far as to suggest that medical treatises should never be admitted. The Article concludes that there is a need for greater caution in determining admissibility and recommends safeguards to better guarantee trustworthiness and reliability.     

Child witnesses and the confrontation clause

InMaryland v. Craig, the United States Supreme Court relied heavily on a brief prepared by a committee of the American Psychology-Law Society on behalf of the American Psychological Association (APA). The APA brief concluded that sexually abused children may be particularly vulnerable to distress in the legal process, especially when forced to confront the defendant face to face, and that such acute distress may be inconsistent with the state's interests in promotion of reliable testimony and child welfare. APA also argued that psychological theory and research provide foundations for individualized determination of the need for measures to protect children from face-to-face confrontation. *** DIRECT SUPPORT *** AFE06051 00002     

Employment and urban growth; an application of Czamanski's model to the Mexican case

The author applies the 1964 model developed by Stanislaw Czamanski, based on theories of urban growth and industrial localization, to the analysis of urban growth in Mexico. "The advantages of this model in its application as a support instrument in the process of urban planning when the information available is incomplete are...discussed...." Census data for 44 cities in Mexico are used. (SUMMARY IN ENG)     

Explaining migration: theory at the crossroads

The author presents the case that the study of migration over the past century has become too diverse. He reviews works by writers from the several disciplines covering the topic, then cites the need to develop a consistent classification of the types of migration and their origins using standardized terminology. (SUMMARY IN ENG)