A single fatal penetrating chest wound caused by a dagger-shaped fragment of broken door glass

A 19-year-old woman ran against a glass door, and, breaking it, was struck in the left anterior chest by a single dagger-like fragment of broken door glass. This fragment deeply penetrated her chest and wounded the anterior wall of the left ventricle of her heart. She rapidly died from loss of blood. The majority of single fatal penetrating chest wounds seen at postmortem examinations are caused by firearms and bladed weapons. While penetrating chest wounds occasionally result from fragments of glass, most severe and fatal wounds from glass result from one's falling into or through plate glass and sustaining wounds of the head, face, abdomen, or extremities. A single fatal wound from a dagger-shaped piece of glass is distinctly uncommon. To prevent such an accident from occurring, safety glass must be used in front doors of public institutions.     

Methodology for the analysis of civil commitment detention times and costs

The authors expand their methodology for quantifying and comparing civil commitment processes by developing new formulas for the determination of the average commitment detention time and cost. They also examine the effects of specific changes in commitment procedures on the average detention time and cost. Using data from Oregon's civil commitment process, the authors present several examples of the practical application of their methodology and conclude with a discussion of its major administrative and research implications.     

Human immunodeficiency virus infection in cases presenting to the Philadelphia Medical Examiner's Office.

Serum samples were available from 492 of 1,058 cadavers seen at the Philadelphia Medical Examiner's Office between August 4 and December 15, 1989. These sera were tested for the presence of antibodies to human immunodeficiency virus (HIV) by enzyme-linked immunosorbent assay (ELISA) and Western blot. The overall prevalence of HIV in the autopsy population was 2.24%. The following populations showed increased prevalence as compared to the total sampled population: blacks (3.60%, p less than 0.01), males (2.51%, n.s.), and homicide victims (3.74%, n.s.). Seroprevalence data from this study are compared with those from earlier studies of other related populations, with regard to overall prevalence and risk factor analysis.     

Empire and the business of health insurance.

I examine the development of privately provided insurance since World War II, giving special attention to Empire Blue Cross, and argue that the competition between employers and unions for the loyalty of workers after the passage of the Taft-Hartley Act helped diffuse private health insurance benefits already favored by federal policies. For-profit insurers did not challenge the privileged status of Blue Cross plans because they recognized the political benefits that the plans offered and because they did not wish to offend the plans' sponsors. A relatively easy and profitable business, health insurance has been greatly disturbed by the system inflation accompanying the introduction of Medicare and Medicaid programs. Now self-insurance and various managed-care schemes are major threats. The future may bring consolidation and the strengthening of pools, just the opposite of today's system fragmentation.     

Involuntary outpatient treatment as “desintitutionalized coercion”: The net-widening concerns

In American jurisprudence, two justifications have traditionally been put forth to support the government's social control of persons with mental illness: police power and parens patriae. As public mental hospitals became less available as loci in which to exercise these functions, governments sought alternative means to achieve the same ends. One prominent but quite controversial means is involuntary outpatient treatment (IOT). While the concerns about IOT have been myriad, one often alluded to but never documented is that of “net-widening.” That is, once IOT became available, it would be applied to an ever greater number of individuals, progressively expanding the margins of the designated population to whom it is applied, despite the formal standard for its application remaining constant. We tested the net-widening belief in a naturalistic experiment in Massachusetts. We found that net-widening did not occur, despite an environment strongly conducive to that expansion. At this time, whatever the arguments against IOT might be, net-widening should not be one of them.     

Preferential Policies and the Blurring of Ethnic Boundaries: the Case of Aboriginal Australians in the 1980s

I argue against the commonly held view that ethnically based preferential policies consistently lead to the construction of well-defined boundaries between collectivities. Using a statistical study of Australia as a case, I demonstrate that preferential programs, under certain conditions, may blur the boundaries between groups. This trend is reflected in the growing number of individuals in the early 1980s who chose to claim an Aboriginal identity in Australian states that increasingly recognized indigenous land claims.
In order to account for the sometimes-divergent effect of ethnically based preferential policies on the divisions between ethnic groups, I focus on the key factor of security. I contend that programs that favor dominant ethnic groups tend to increase the feelings of vulnerability among weaker collectivities and encourage inter-group polarization. In contrast, preferential policies for subordinate groups offer reassurances to previously threatened communities and frequently encourage the crossing of ethnic boundaries.