Assessment of unfavorable outcomes of dental care provoked by the patient

Some causes of ineffective dental care because of the patient's negligence were analyzed. In 16 cases the patients ignored recommendations of the dentist and missed visits to the doctor. As a result, the patients developed complications leading to esthetic dissatisfaction, prolonged treatment, repeated prosthetic management.     

Family Representative Payeeship and Violence Risk in Severe Mental Illness

Although representative payeeship is prevalent among people with mental illness and shows promise to positively influence clinically relevant outcomes, research also suggests this legal mechanism could be implemented in ways that are problematic. The current study examined whether family representative payeeship was associated with elevated risk of family violence perpetrated by persons with severe mental illness (SMI). Data were collected every 4 months for 1 year in structured interviews with N = 245 persons with SMI who received disability benefits. Multivariate analyses showed that substance abuse, history of violence, frequency of family contact, and family representative payeeship were associated with elevated odds of family violence. Analyses also showed family contact and family representative payeeship had a cumulative effect on increasing the predicted probability of family violence (controlling for covariates such as violence history and substance abuse). The data shed light on the potential for family representative payeeship to be associated with increased risk of interpersonal conflict and violence in SMI.     

The Decline and Decay of European Refugee Policy

This article challenges the view, implicit in much current researchon EU migration and asylum policy, that supranationalizationis a self-evident antidote to the exclusionary and securitizedmigration policy that has been enacted through inter-governmentalcooperation. It does so by treating supranationalization asan open question in need of empirical scrutiny. To develop thisthesis, it undertakes not only a critique of the current developmentstowards supranational policies, but also of the inter-governmentalpolicy-making system, pursuing a broad brush historical assessmentup to and beyond Amsterdam, with the aim of bringing fresh andfurther insights into the future development of EU asylum policy.It concludes that the current aims are less to do with the establishmentof a common European asylum system and more to do with reducingimmigration pressure and compensating for the perceived lossesof internal security in the wake of full freedom of movementinside the Union. Communitarization will not necessarily occursimply because the European Union is intent upon institutingever stricter immigration controls. Communitarization is doggedby the legacy of intensive trans-governmentalism. In particular,the British, Danish and Irish governments have only been preparedto support communitarization so long as they could have separateprotocols that legitimized their non-participation. The UK andIreland have opted into all proposals on asylum, illegal migrationand civil law but have opted out of practically all proposalsconcerning visas, borders, and legal migration. The securitarianframe still predominates and trans-governmentalism refuses todie. In January 2005, following the agreement on The Hague programme,there was change in decision-making rules from unanimous votingto Qualified Majority Vote (QMV) in the European Council andco-decision with the European Parliament. Yet, there is no guaranteethis will bring about more liberal asylum rules, as is clearfrom the ‘Schengen Borders Code’ which was agreedin June 2005. This is because European migration policy hasalways been fraught with internal contradictions, which haveyet to be resolved. Accordingly, the emergence of a rights-respectingmodel of asylum law based on the Geneva Convention 1951 remainsa distant dream.     

Federal employees health benefits program; revision of contract cost principles and procedures, and miscellaneous changes. Final rule

The U.S. Office of Personnel Management (OPM) is issuing a final regulation amending the Federal Employees Health Benefits (FEHB) Acquisition Regulation (FEHBAR). This regulation provides additional contract cost principles and procedures for FEHB Program experience-rated contracts and is intended to clarify our requirements and enhance our oversight of FEHB carriers.     

Rural and urban differences in the commission of animal cruelty

Despite the recent surge in society's interest in human violence, relatively few studies have been conducted examining the closely related phenomenon of animal cruelty. Although several researchers have begun to identify some of the correlates of animal cruelty, few have attempted to understand how differences in the backgrounds of rural and urban residents have led to their abuse of animals. Using survey data from 261 inmates, the authors investigate how demographic, familial differences and species type have contributed to the frequency of acts of animal cruelty. In general, early exposure to animal abuse is a strong predictor of the subsequent behavior. However, rural inmates learned to be cruel by watching family members exclusively, whereas urban inmates learned from family members and friends. Moreover, urban inmates chose dogs, cats, and wild animals as their target animals; however, rural inmates chose only cats.     

The who, what, and why of risk adjustment: a technology on the cusp of adoption

Risk adjustment (RA) consists of a series of techniques that account for the health status of patients when predicting or explaining costs of health care for defined populations or for evaluating retrospectively the performance of providers who care for them. Although the federal government seems to have settled on an approach to RA for Medicare Advantage programs, adoption and implementation of RA techniques elsewhere have proceeded much more slowly than was anticipated. This article examines factors affecting the adoption and use of RA outside the Medicare program using case studies in six U.S. health care markets (Baltimore, Seattle, Denver, Cleveland, Phoenix, and Atlanta) as of 2001. We found that for purchasing decisions, RA was used exclusively by public agencies. In the private sector, use of risk adjustment was uncommon and scattered and assumed informal and unexpected forms. The most common private sector use of RA was by health plans, which occasionally employed RA in negotiations with purchasers or to allocate resources internally among providers. The article uses classic technology diffusion theory to explain the adoption and use of RA in these six markets and derives lessons for health policy generally and for the future of RA in particular. For health policy generally, the differing experiences of public and private actors with RA serve as markers of the divergent paths that public and private health care sectors are pursuing with respect to managed care and risk sharing. For the future of RA in particular, its history suggests the need for health service researchers to consider barriers to use adoption and new analytic technologies as they develop them.     

Carbon monoxide-related deaths in a metropolitan county in the USA: an 11-year study

Carbon monoxide (CO) poisoning as a cause of death is well documented in industrialized countries. The objective of this study was to compare demographic data in deaths due to accidents (in fires) and suicides in the same population between 1988 and 1998. Furthermore, the potential effect of a community wide education effort regarding safety in the home was assessed. Postmortem reports were reviewed for all deaths examined at the Office of the Cuyahoga County Coroner in Cleveland, OH, USA. During the study period, there were 209 accidental deaths due to fires in the home (6.5% of all accidents in the home) and 182 CO deaths by suicide (9.8% of all suicides). Demographic characteristics of the two groups differed: while males represented the majority of cases in both groups (55% of accidents, 70% suicides), race specific death rates were higher for whites than blacks (18/100,000 white, 3/100,000 black) in suicides compared with 29/100,000 deaths for blacks and 11/100,000 for whites in accidental cases. Fire deaths were prevalent in the young (0-9 years) and old (>60) whereas in the suicide group the age specific death rate was highest for those over 70 years. The majority of fire deaths occurred in the city of Cleveland but suicides were prevalent in the suburbs. More fire deaths occurred in December than any other month whereas more suicides occurred in April. In 1992, there was a community wide effort to provide free smoke detectors to residents in Cleveland. In 1992, there were 4.2/100,000 fire deaths in the city. This decreased to 0.6/100,000 in 1996, increased to 1.2/100,000 in 1997 followed by a decrease to 0.8/100,000 in 1998. This suggested that the program may have aided in decreasing these types of deaths. Deaths due to fires in the suburbs were <1/100,000 throughout the study period.     

Learning to be cruel?: exploring the onset and frequency of animal cruelty

Few studies have examined how animal cruelty is learned within a specific social context among incarcerated individuals. Using data from 261 inmates, this study specifically addressed how demographic characteristics and childhood experiences with animal abuse may have affected the recurrence and onset of childhood and adolescent cruelty as a learned behavior. Multiple regression analyses revealed that inmates who experienced animal cruelty at a younger age were more likely to demonstrate recurrent animal cruelty themselves. In addition, respondents who observed a friend abuse animals were more likely to hurt or kill animals more frequently. Finally, inmates who were younger when they first witnessed animal cruelty also hurt or killed animals at a younger age.     

Social isolation and delayed discovery of bodies in houses: the value of forensic pathology, anthropology, odontology and entomology in the medico-legal investigation

The bodies of socially isolated people may remain undiscovered in their own houses for prolonged periods. Occasionally the body is in situ for sufficient time to become skeletonised, or partially so. Medico-legal investigation of these cases is complicated by degradation and contamination of evidence. Thus, a multidisciplinary forensic investigation is recommended. The potential contributions of forensic pathology, anthropology, odontology and entomology are outlined here with reference to two cases that occurred in Victoria, Australia, in 2003. Forensic pathologists are often unable to determine the cause of death in skeletonised bodies, however, they may find evidence to support either a natural or unnatural mode of death, and they may describe skeletal pathology or trauma, and identify skeletal features to support radiological identification of the deceased. Anthropologists can provide supplementary evidence of skeletal trauma. Additionally, they can assess age, sex, stature and racial affiliation from skeletal remains. Odontologists can identify individuals through comparison with ante-mortem dental records; however, potential difficulties exist in identifying the treating dentist of a socially isolated person. Odontologists may also examine the teeth and oro-facial skeleton for trauma. Entomologists may estimate minimum death time and/or season of death. Entomological examination of insect remains may also confirm that a body has lain in situ for a considerable period.