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Sharma AN Nelson LS Hoffman RS 《The American journal of forensic medicine and pathology》2004,25(2):156-158
The neurologic manifestations of thallium poisoning include a severely painful ascending peripheral neuropathy, autonomic dysfunction, cranial nerve abnormalities, and a toxic encephalopathy. Although thallium has a short half-life, these neurologic manifestations commonly progress, even as the blood concentration of thallium decreases. This suggests either that thallium persists in neuronal tissues or that it initiates an injury cascade that takes time to fully manifest. As the latter mechanism is consistent with many toxin exposures, the concept of a central nervous system reservoir for thallium is often discounted. A recent case provided a unique opportunity to evaluate this possibility. A 48-year-old man was acutely and chronically thallium poisoned by his common-law wife. During his initial exposures, only gastrointestinal symptoms manifested. Following an acute ingestion, hospitalization was required. Over 3 days, his symptoms rapidly progressed from a severely painful neuropathy to slurred speech, ptosis, confusion, coma, respiratory insufficiency, and death. Because of considerations of alternative diagnoses, 2 lumbar punctures were performed, one on admission and another on the day of his death. Serum thallium concentrations obtained from stored blood samples were paired with spinal fluid concentrations from the same days. On day 1, serum and spinal fluid concentrations were 8700 mu/L and 1200 mu/L, respectively. On day 3, although the serum concentration had fallen to 7200 mu/L, the spinal fluid concentration had increased to 2100 mu/L. This case provides evidence to support the hypothesis that thallium distributes into the central nervous system more slowly than the blood compartment, and this may in part account for the progression of neurologic findings in the setting of decreasing serum concentrations. 相似文献
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Hoffman S 《Indiana law journal (Indianapolis, Ind. : 1926)》2003,78(2):659-721
Health insurers are generally guided by the principle of "actuarial fairness," according to which they distinguish among various risks on the basis of cost-related factors. Thus, insurers often limit or deny coverage for vision care, hearing aids, mental health care, and even AIDS treatment based on actuarial justifications. Furthermore, approximately forty-two million Americans have no health insurance at all, because most of these individuals cannot afford the cost of insurance. This Article argues that Americans have come to demand more than actuarial fairness from health insurers and are increasingly concerned by what I call "moral fairness." This is evidenced by the hundreds of laws that have been passed to constrain insurers' discretion with respect to particular coverage decisions. Legislative mandates are frequent, but seemingly haphazard, following no systematic methodology. This Article suggests an analytical framework that can be utilized to determine which interventions are appropriate and evaluates a variety of means by which moral fairness could be promoted in the arena of health care coverage. 相似文献
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Frank J. Hoffman 《Journal of Indian Philosophy》1987,15(4):399-412
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Merry Morash Dae-Hoon Kwak Vincent Hoffman Chang Hun Lee Sun Ho Cho Byongook Moon 《Journal of criminal justice》2008,36(3):231-239
The present article extends prior research to identify the predictors of police stress from work place problems, the resources available through social support, different strategies for coping with stress, and conditions unique to policing in South Korea. The unique conditions are perceived public perception of police and attitudes towards women working outside of the home. Seven hundred officers were asked to participate in the research, and 686 did participate (96 percent response rate). Almost half of the variance in stress could be explained. Reports of being ridiculed and “set up” in dangerous situations, and to a lesser extent, lack of support from superiors and perceived disrespect from the public, were salient predictors of stress. Coping strategies did not moderate the associations between stressors and stress. Findings were interpreted in relation to collectivist culture and possible points of intervention. 相似文献
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Understanding the relationships between youthful gambling, substance use, and other problem behaviors is of interest to researchers studying deviance and to policymakers developing improved prevention strategies. This study used first-order and second-order factor models to test the hypothesis that gambling, alcohol misuse, other drug use, and delinquency were manifestations of a single general deviance construct. Respondents were seventeen to twenty-one year-old youth who were interviewed in two separate general population studies. Contrary to the hypothesis, the second-order model with a single deviance construct did not fit as well as a model specifying only correlations among all first-order factors. A single latent variable representing general deviant behavior did not explain deviance as well as distinct types of problem behaviors. This was true for overall samples and for gender-specific subgroups. Thus, while problem behaviors were related, there also must be uncorrelated antecedents predicting distinct types of youthful problem behaviors. 相似文献
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Peter B. Hoffman 《Journal of criminal justice》1984,12(6):617-623
Empirical studies frequently have reported an association between age at release from prison and recidivism. For criminal justice decision-makers who wish to consider this knowledge in making prosecutorial, sentencing, or parole decisions, the magnitude of that association must be established while controlling for the effects of other variables known to be associated with recidivism (e.g., prior criminal record). This research addresses this issue using data from a large sample of federal prison releasees. The results indicate that recidivism rates do decline with increased age, and that the association is not diminished when statistical control is exercised for the effect of prior criminal record. 相似文献