Special report on reimbursement. HCFA enacts new enforcement remedies covering nursing facilities

While the regulations are revolutionary in their use of "substantial compliance," the interpretation and application of HCFA's new remedial scheme are still uncertain, as states are given broad discretion in defining important terms and in applying and interpreting the criteria to select remedies. Further complicating the issue is the fact that some states, including California, intend to seek waivers from HCFA to substitute their own state enforcement systems for most, if not all, of the new federal system. Based upon these uncertainties, the enforcement of nursing facility standards will likely be in a state of flux for some time to come.     

The hate that dare not speak its name: Pornography qua semi-political speech

In this essay we shall examine the contemporary jurisprudential thinking and legal precedents surrounding the issue of the sanctionability of pornography. We shall catalogue them by their logical presumptions, such as whether they view pornography as speech or act, whether they view pornography as obscenity, political hate-speech or anomalous other, whether they would scrutinize legislation governing pornography by a balancing of the harm of repression against the harm of permission, and who exactly they view as the victims.We shall take a special interest in the most recent, but unsuccessful, attempt by a subgroup of feminists to proscribe pornography by treating it as neither political speech nor sexual speech but speech which causes harm which is both political and sexual. They would like it to be considered as a special kind of odious propaganda undeserving of protection because it promulgates a mental state conducive to criminal activity, and hence is criminal in and of itself. However, the repression of propaganda, even odious propaganda, is not so easily accomplished in this country.Most anti-censors have emphasized the uncertainty of the causal connection between pornography and sexual violence. We shall contend that this is not the essential issue, and that, even if we agree with the allegations of pornography's prurient non-intellectual appeal and its tendency to excite criminal hostility, the current understanding of the Bill of Rights allows sanctioning only under the stringent requirement of the showing of a clear and present danger of specific and immediate acts.We raise the question of whether there should be a new standard for speech which is simultaneously political and sexual, and/or for speech whose harmful message is presented subliminally, on the grounds that such speech may not be adequately opposed by counter speech in the marketplace of ideas.     

Migration and social gender relations: the anthropological perspective

"This article reviews Mexican research of female migration. An analysis is made of socio-demographic and anthropological studies that cover the relations between inequality among the genders, the causes and features of migration, and the work performed by female migrants in their places of origin and destination. The paper responds to the growing interest shown in international literature [on] migration in order to determine the influence of gender identity in the motivations and features of the migration of women, as well as the consequences of spatial mobility on their social conditions and their autonomy." (SUMMARY IN ENG)     

Procreation and the succession of generations

"This article presents a complex conceptual and methodological proposal.... The study proposes an analysis similar and complementary to the abstract models of formal demography. Specifically, the article considers the practices and strategies of procreation, as well as the subjectiveness of people as constitutive elements of a succession of generations, as observed on different analytical levels." (SUMMARY IN ENG)     

Ethos,ideology, and partisanship: Exploring the paradox of conservative democrats

Despite the increasingly liberal cast of the national Democratic Party, self-identified conservatives continue to represent a significant segment of the party. At least 25 percent of Democratic identifiers considered themselves to be conservatives during the 1972–1988 period. This paper explores the puzzle of why significant numbers of political conservatives continue to identify with the Democratic Party. We argue that conservative Democrats relate to their party not because of political ideology, as do Republicans and to a lesser extent, liberal/moderate Democrats, but because of the symbolic values associated with the main groups in the party—what we refer to as party ethos. This proposition is examined by analyzing a new set of open-ended questions included in the 1988 American National Election Study probing citizens' images and assessments of the Republican and Democratic parties.The data utilized in this paper were made available by the Inter-university Consortium for Political and Social Research. The data forAmerican National Election Study 1988: Pre- and Post-Election Survey were originally collected by Warren E. Miller and the National Election Studies. Neither the collector of the original data nor the Consortium bears any responsibility for the analyses or interpretations presented here.     

The DutchAlgemene Rekenkamer and its role in light of practical experience

TheAlgemene Rekenkamer functions in the area around government and parliament. This chapter focuses on two questions: How does theRekenkamer ascertain loss of efficiency and effectiveness within government, and how does theRekenkamer restrict loss of efficiency and effectiveness within its own organization?

The goal of theRekenkamer is to provide parliament with reasonable assurances of the validity of expenses incurred and to promote the efficiency of the ministries and the effective spending of state funds. TheRekenkamer pursues a policy aimed at achieving these goals. Some central elements in this active policy are

• ? An independent position,

• ? Optimum reliability,

• ? Strategic planning,

• ? Both regularity and performance audits.

• ? The political and social relevance of research subjects, and

• ? Dialogue between parliament and theRekenkamer.

With regard to the audit theory of W.J. Van Braband, some suggestions for improvement are given.