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261.
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This article is adapted from the 1987 Annual Reports of the Medicare Board of Trustees. It presents a summary of the current financial and actuarial status of the Hospital Insurance (HI) and Supplementary Medical Insurance (SMI) Trust Funds. The Board found that the present financing schedule for the HI program is sufficient to ensure the payment of benefits over the next 12-14 years if the intermediate (II-A and II-B) assumptions underlying the estimates are realized. Although steps have been undertaken to reduce the rate of growth in payments to hospitals, the Board urges Congress to take remedial measures to bring future HI program costs and financing into balance. The Board found the SMI program to be actuarially sound but recommends that Congress take action to curtail the rapid growth in that part of Medicare. 相似文献
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The policy sciences have advanced in the past by introspection, and there appears to be a need for a return to such self-conscious examination of the field of inquiry. A design orientation offers a useful framework for such an examination. It requires reconsideration of some of the fundamental premises of policy inquiry. This article explores what impact design might have on the conventional process framework and then proceeds to discuss the development of a design perspective. 相似文献
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Hanlon Thomas E. Bateman Richard W. Simon Betsy D. O'Grady Kevin E. Carswell Steven B. 《Journal of youth and adolescence》2002,31(6):459-471
This paper presents the results of an evaluation of an early intervention, risk-reduction strategy versus a standard intervention approach in the treatment of inner-city youth at high risk of adopting a deviant lifestyle. It examines baseline and 1-year follow-up information provided by 408 youth admitted to 2 community-based Baltimore City Youth Bureaus offering counseling services for neighborhood youth referred for delinquent and other problematic behavior. In the study, one of these bureaus served as the experimental intervention clinic and the other as the control, or standard intervention, clinic. Outcome measures involved substance abuse; sexual activity; contact with juvenile authorities; and delinquent activity, including violence-related activity. Regression analyses of outcome measures revealed significant differential results for delinquent activity, which favored the experimental intervention. Relationships between risk/protective factors and outcome are discussed. 相似文献
268.
A study of 30 cases of violence from a total sample of 199 cases of infant abductions between the years 1983 and 2000 included a subsample of six (or 20%) where the kidnapping was by cesarean section. The six cases are classified by type of crime. Four cases were classified as personal cause homicide, subtype cesarean section homicide; one case classified as personal cause, subtype domestic homicide, and one case classified as a criminal enterprise homicide. The behavioral profiles of the abductors included a confidence style approach to the victim mother, deception, and planning of the cesarean section. The forensic psychodynamics suggest a dual motive to cement a failing partner relationship and to fulfill a childbearing and delivery fantasy. Cesarean section murder suggests a new category of personal cause homicide. 相似文献
269.
The relationship between ethanol and risk of heroin overdosage was studied. Statistical processing of the results of forensic chemical analysis (460 expert evaluations) carried out in Chelyabinsk Regional Bureau of Forensic Medical Expert Evaluations in 2000 was carried out. The results of morphine and ethanol measurements in the blood and urine from corpses where deaths ensued from narcotic or ethanol poisoning, were analyzed. The concentrations of morphine in the blood and urine were measured on a gaseous chromatographer with mass-selective detector (Hewlett Packard HP 6890/HP-5972). Methods for measuring urinary and blood morphine are described. The results of statistical analysis demonstrated relationships between the age and ethanol concentrations in the blood and urine; blood ethanol and total urinary and blood morphine concentrations; blood concentration of free morphine and presence of 6-monoacetylmorphine in the blood. The authors conclude that the presence of ethanol in the blood together with morphine drastically augments the risk of rapid death from respiration arrest. It can also lead to a relatively high risk of overdosage in experienced narcomaniacs using heroin and ethanol. 相似文献
270.
A 2-month-old infant girl died suddenly as a result of torsion of the uterine adnexa. The infant was found unresponsive in bed and was pronounced dead shortly after her arrival at a hospital. There were no antecedent signs of illness. At autopsy, the right ovary and right fallopian tube were twisted and were dark purple, swollen, and necrotic. The right ovary was enlarged by a follicle cyst 4 cm in diameter, which likely precipitated the torsion. The mechanism of death was unclear but may have resulted from the release of cytokines produced in response to necrotic adnexal tissue. Fatal uterine adnexal torsion has been reported rarely in infants; in all those cases there were antecedent symptoms. Torsion of the uterine adnexa should be included in the differential diagnosis of sudden death in infancy. 相似文献