Insurance Rationing versus Public Political Rationing: The Case of the Oregon Health Plan

This article describes the development and evolution of the Oregon experiment with public political rationing in health care. As dissatisfaction with current health care rationing has mounted, the search has accelerated for alternatives to replace the de facto rationing generated by the private health insurance marketplace. As the foremost example of public rationing, the closely-watched Oregon Health Plan is widely offered as an alternative to traditional private health insurance. Other health care rationing alternatives include health maintenance organizations (HMOs) and proposals that encourage self-rationing by individual consumers.     

Courtroom Applications of Virtual Environments, Immersive Virtual Environments, and Collaborative Virtual Environments

This article examines the possibilities and implications of employing virtual environments (VEs), immersive virtual environments (IVEs), and collaborative virtual environments (CVEs) in the courtroom. We argue that the immersive and interactive reality created by these tools adds significant value as a simulation of experience to enhance courtroom practice. The obvious boundaries between real and virtual enhance the attractiveness of these tools as technologies of rhetorical persuasion that can be used to demonstrate subjective perspective, strengthen or impeach the credibility of witnesses, and provide the trier of fact with a better understanding of each side's perception of the facts at issue. The article introduces the concepts of VEs, IVEs, and CVEs, describes the manners in which these technologies have been applied to settings other than the courts system, and review the relevant psychological and legal literature. It discusses specific applications of the technology to the court system and suggests how it could improve upon current procedures. Finally, it discusses some of the limitations and problems, and suggests legal reforms necessary to the adoption of these technologies, specifically rules of procedure that provide for all parties to be able to access, manipulate and inspect any virtual environment, the trier of fact to be able to interact with, rather than just accept the lawyer's rendition, and rules that provide for the parties to introduce at trial an inventory of all digital assets contained in the virtual environment, making those that are stipulated to and those that are in controversy.     

Long–Serving City Managers: Practical Application of the Academic Literature

The authors identified 146 city managers who have served in the same city for the past 20 years and asked them to complete a survey to determine the factors leading to their long service. As a part of the survey, the city managers were invited to express, in their own words, the reasons they had stayed in the same city for such an extended time compared to the average tenure for city managers. In the article that follows, the authors quote from the academic literature statements pertaining to practical issues of concern to city managers and the elected officials for whom they work, giving credence to the applicability of the academic literature to today's city management profession. Following the quotations from the literature, the authors present the heartfelt reflections of these senior city managers on their long careers in public service.     

Heart valve measurement at autopsy can distinguish cardiac from non-cardiac causes of death

The circumferences of the four intact cardiac valves were measured during 397 coroner's autopsies using an obturator cone to assess the value of this measurement in the postmortem diagnosis of cardiac disease. Valve sizes of cases with cardiac and noncardiac causes of death were compared using logistic regression to assess the effects of confounding variables including sex, age, height, build and the presence of chronic obstructive airways disease. Mitral valve enlargement was found to be significantly associated with cardiac death, as were build, age, and sex. Measurement of the mitral valve at autopsy can help distinguish cardiac from noncardiac causes of death.