Civil commitment of the mentally ill: an overview

This article discusses historical themes that led to the civil commitment reforms of the sixties and seventies. The changes in the substantive criteria for commitment are analyzed and critiqued. The author believes that the present criteria tend to focus so specifically on various external indicia of mental illness that they render commitment difficult for many seriously ill patients. An alternative commitment scheme is discussed.     

System of cities dynamics in newly industrializing nations

Rapid industrialization in such countries as Korea, Malaysia, and Taiwan suggests that the complex functional structures of cities in the periphery may appear early in development. This paper proposes a 4-stage framework for the dynamics of a system of cities in a developing country undergoing industrialization and encompassing both nonindustrial and industrial development. The synthesis is assessed with evidence from the newly industrializing Asian nations of Korea, Malaysia, and Taiwan. The 4 stages of cities' industrial change include 1) increasing primacy with industrial satellites, 2) increasing primacy with industrial satellites and nodal towns on a transport network, 3) rapidly increasing primacy with rapidly growing industrial satellites and nodal towns on the transport network, and 4) decreasing primacy with slowly growing industrial satellites and rapidly growing peripheral industrial towns. The 4-stage synthesis suggests that economic development in the periphery may occur even while the primate city maintains its hegemony over control and coordination functions. Peripheral industrial growth does not challenge this hegemony. The growth of industrial cities is, instead, part of a process of regional specialization in which the low cost labor in the periphery becomes an attraction for industry. These stages are not inevitable. Government efforts are necessary to develop rural areas in terms of social improvements (education and health), capital infrastructure (transportation and utilities), and fair payments to farmers for their outputs. These seem to be the lessons learned from the industrialization process in Korea, Malaysia, and Taiwan.     

Adjunctive use of scanning electron microscopy in bite mark analysis: a three-dimensional study

An examination of a case in which adjunctive use of scanning electron microscopy (SEM) demonstrated the presence of unusual three-dimensional characteristics in a bite mark. Despite the fact that many bite marks do not show "depth," demonstration of the presence of this third dimension can produce significant data for evidentiary purposes. In some instances, these data may transform what seem to be class characteristics of a bite mark into individual characteristics and thus impart much more uniqueness to the evidence. Because of the high level of resolution and magnification of SEM, some three-dimensional characteristics not visible to the eye can be shown quite clearly by its use. Emphasis will be given to the value of SEM as a tool of the forensic odontologist in bite mark analysis.     

Unusual hanging deaths

Four unrelated hanging deaths involving young white males, all in enlisted status in the United States military, are presented. Taken in a military context, one scene served as a suicide note equivalent with the unmistakable message of extreme defiance toward military regulations. In two cases, the elaborate attire of the decedents could have lead to the misclassification of the manner of death if investigative information had not been considered. Extensive background investigation and review of medical records in the fourth case disclosed that the victim had an eight- to ten-year history of compressing his neck to cause unconsciousness. He left an extensive suicide note in which he concluded that "hanging would be good." Each case has certain unique features, as a group, the cases all demonstrate a continuum from obvious suicide to cases where the manner of death is, at first, equivocal.     

The impact of health maintenance organizations and competition on hospitals in Minneapolis/St. Paul

The Healthcare Educational and Research Foundation (HERF) in Minneapolis undertook a two-year research project to study the effects of health maintenance organizations (HMOs) and competition on the hospital industry in Minneapolis/St. Paul. This article summarizes HERF's major findings surrounding three key questions: (1) do the HMOs in Minneapolis/St. Paul use fewer hospital resources relative to conventional payers?; (2) do recent overall community trends in inpatient use suggest evidence of hospital utilization-reducing effects attributable to HMOs?; and (3) given the highly visible competitive process among Minneapolis/St. Paul providers, do hospital cost and revenue data suggest any evidence of cost-containment? The findings (based on data through 1982) indicate that for comparable patients, Twin Cities HMOs appear to use fewer medical care resources per hospitalized patient. There was, however, no clear evidence of community-wide, utilization-reducing effects directly attributable to the "competitive effect" of HMO introduction and development in the market. In addition, there was no empirical evidence that HMOs (which had enrolled 25 percent of the consumer market by 1982), or other large buyers of inpatient services, have selected hospitals on the basis of price as hypothesized by competition advocates.     

Non-commercial, accidental water transport (boating) fatalities

A study of non-commercial accidental water transport (boating) fatalities was performed on the case files of the Office of the Medical Examiner of Metropolitan Dade County in Miami, Fla., during the years 1980-1984. A total of 23 cases were collected and analyzed as to the age, race, sex, and the cause of death of the victim along with the blood alcohol content and the Urine EMIT drug screen at autopsy. Furthermore, the type of boat involved, the geographic locale, the time of the incident, the reason or risk factor for the incident, and the scene circumstances were also noted. Commonly, one is dealing with a male population below the age of 30 years who die of drowning. In approximately half of the cases alcohol is detected. The scenario involves "small" boats or canoes in the Atlantic Ocean or in canals in the afternoon or evening. Inexperience in boating/or stupidity plays a key role. A discussion ensues concerning recommendations designed to avoid such tragedies.     

Characteristics of adolescent incest sexual perpetrators: Preliminary findings

Adolescent incest sexual perpetrators seen at an out-patient clinic were interviewed regarding demographic characteristics and occurrence of deviant and nondeviant sexual behaviors. Results indicate that subjects (1) committed more sexual crimes than they had been arrested for, (2) reported a very early onset of sexual behavior, (3) had additional DSM-III psychiatric disorders, and (4) reported previous sexual victimization. Recommendations for future research are made.     

Therapists' obligations to report their patients' criminal acts

The law governing the obligation of therapists to report their patients' previous criminal acts was reviewed. Most often, discussions of this subject fall under the general category of "misprison of a felony," that is, the presumed general obligation of all citizens to report felonies that come to their attention. Review of federal law revealed that the courts have consistently interpreted the federal misprision statute as requiring active concealment of a crime, not a mere failure to report, in order to convict for the offense. State law is more diverse. Only one state has a general misprison statute labeled as such, and several states have recently repealed such statutes. The strong trend in states without statutes is to reject misprison as a common law crime, because of its incompatibility with modern notions of justice. Most states, however, have limited reporting statutes, such as for child abuse or gunshot wounds, that impose similar obligations. Therapists' reporting of past crimes may be affected by clinical and ethical concerns, as well as by obligations to protect future victims. In almost all jurisdictions, however, the fear of prosecution for failure to report a past crime should not be a factor in deciding on a course of action.     

Economic Considerations and Reagan's New Federalism Swap Proposals

Upon coming to office, President Ronald Reagan proposed a numberof programs collectively referred to as the New Federalism.These programs were designed to alleviate some of the problemswhich the president saw as plaguing the intergovernmental systemand to accomplish Reagan's goal of decentralizing authority.One of the most highly publicized and debated— indeed,probably the most controversial—aspect of the President'sNew Federalism package was the "Big Swap" plan. Both versionsof this plan, however, were bad deals for the states and theircommunities, and it would appear that several interrelated economicconcerns played a role in the opposition of many state and localofficials to these proposals. To demonstrate just how bad theseproposals were, the article documents the effect that inflationand recession had had on the fiscal health of state and localgovernments, and the projected impact that these plans wouldhave had on state and local revenue and tax systems.