The stages of managed care regulation: developing better rules

The managed care industry is at a crossroads. Belief in the ability of market forces alone to create an environment fostering quality health care at lower cost is eroding. Regulators across the country are confronted with a growing consumer backlash against managed care. As a result, states have passed managed care reform legislation at unprecedented rates. In doing so, states are confronted with a patchwork of federal intervention and preemption. We examine the stages of these recent state and federal developments and evaluate them in terms of the traditional objectives of a reasonably functioning health care system: quality care, access, and cost containment.     

工具理性与中国传统文化的现代化

构成西方现代性主要内涵的工具理性,促发了科学与技术的繁荣和昌盛。当前中国现代化最主要的也是最急需的就是科学与技术的大发展,这一点在文化层面上就表现为工具理性的缺失和弘扬,中国传统文化的现代化必须工具理性化。     

Financing War or Facilitating Peace? The Impact of Rebel Drug Trafficking on Peace Negotiations in Colombia and Myanmar

Rebel involvement in drug trafficking is broadly found to prolong and intensify civil wars. Being an illicit good with strong demand, high profit margins, limited barriers to entry, and few interdiction opportunities, narcotic drugs disproportionately benefit rebel groups as a source of funding in civil wars. Furthermore, drug trafficking is believed to prolong civil wars by creating war economies that benefit rebel groups, making them reluctant to engage in peace negotiations. However, recent peace agreements suggest that drug trafficking can in some cases be used to “buy off” rebel leaders, whereas other insurgents willingly relinquish this source of funding. This article compares attempts at conflict resolution in Colombia and Myanmar, focusing on the impact drug trafficking by Fuerzas Armadas Revolucionarias de Colombia (Revolutionary Armed Forces of Colombia) and United Wa State Army has on contemporary peace negotiations.     

Failed states: temporary obstacles to democratic diffusion or fundamental holes in the world political map?

In parts of the developing world the fundamental requisite of democracy—stateness—is in recession. This paper engages the literature on failed states with regard to the implications for global democratic diffusion. The heart of the paper summarises and analyses the four main frameworks for assessing and responding to failed states. The status quo framework regards failed states as sick patients that can be revived. This state revival framework has a mixed track record, however, and many critics. The ‘shared sovereignty’ framework advocates quasi-permanent intervention in the most difficult cases of state failure. A third approach argues for the recognition of de facto sovereignty and the restructuring of de jure international boundaries when necessary. A fourth framework insists on a historically grounded analysis of modern statehood as a failed global project. The article's final section surveys the stateness – democracy nexus in sub-Saharan Africa.     

Differentiating patterns of substance misuse by subtypes of antisocial traits in male offenders

Among criminal offenders, two subtypes of antisocial traits, psychopathy and externalizing-only, are associated with an especially elevated risk for substance use disorders (SUDs). The present study examined the associations of these traits with patterns of substance misuse. In a sample of 1410 male offenders, we used diagnoses for alcohol, cannabis, opioids, and stimulants to examine the association between antisocial traits and SUD severity, as well as, age at substance use initiation. Results indicated that externalizing-only, but not psychopathic, traits predicted greater severity of SUDs (i.e. increased likelihood of dependence) across all substances. By contrast, psychopathic, but not externalizing-only, traits predicted earlier initiation of use across all substances. These differential patterns of substance misuse may be a reflection of distinct psychobiological processes. Ultimately, parsing the patterns of substance use across a continuum of clinically heterogeneous samples, rather than within circumscribed diagnostic categories, might help to refine the phenotype and improve the prediction of substance-related problems.     

Guns,Southernness, and gun control

Southerners have been found to have higher levels of gun ownership than persons who reside elsewhere. This may be due to cultural factors peculiar to the Southern region. If so, this would have interesting implications for gun control initiatives. Although the differential in gun ownership has been linked to varying support or opposition to gun control, the relationship between this variable and specific types of gun control has not been examined. With this in mind, we investigate how specific types of gun ownership interact with Southernness, controlling for the effects of other variables, to determine preferences for three different types of gun control. We use 1975 data collected by DMI on a stratified random sample of 1538 noninstitutionalized adults in the United States. An analysis of several logistic regression equations indicates that a cultural component, related to Southernness, affects attitudes toward gun control. Southerners, in general, were the most opposed to permits and handgun bans. Southern shotgun owners, in particular, were found to be the most opposed to gun registration. These findings point to the need to consider region, culture, and gun type when addressing the issue of gun control.We would be happy to supply the interested reader with an electronic copy of the data set.