Has the erosion of the medical marketplace ended?

This paper updates tests of the validity of three models of medical price inflation: a standard model, in which changes in demand press against inelastic supply; a dynamic version of the standard model, in which high levels of insurance induce high rates of product innovation and development; and a model of increasing inefficiency, in which consumers have weak incentives to search out efficient suppliers. Earlier statistical support for the third model has weakened, which provides some evidence that the regulatory and competitive initiatives of the last decade are having their intended effects. But time series measures of medical prices upon which the statistical evidence relies have important methodological problems, so other types of evidence are useful. Trends in expenditure in other countries and in HMOs suggest that the most important explanation of medical price inflation is the dynamic version of the standard model, although the other models have some validity as well.     

The cost and value of second surgical opinion programs: a critical review of the literature

Second surgical opinion programs (SSOPs) have been used since 1972 by both public and private insurers to improve the patient's information and decision processes and to reduce operative risks and costs attributable to questionable and perhaps unnecessary operations. This article reviews the literature on SSOPs. It considers whether SSOPs are effective mechanisms for reducing health care costs, how SSOPs affect outcomes, how physician errors affect the value of SSOPs, and what nonconfirmation rates and rates of surgery indicate about the appropriateness of operations. Although the literature varies in quality, all the studies fall short in one or more of the following dimensions: an appropriate control group, a comprehensive definition of cost and outcomes, and sufficient duration and scale to measure changes and use of medical services in a general population. Thus, the value of SSOPs remains an open question.     

Chloroquine as a poison in murder. Report of fatalities after criminal or suicidal chloroquine administration

Presented is a case of murder by means of chloroquine, committed on a 36-year-old male. The wife of the deceased had confessed to have secretely administered chloroquine-containing tablets to her husband. She was lawfully sentenced to life-imprisonment. The toxicological findings of this case are compared to the results of two chloroquine suicide cases and discussed in the context of the referring literature. An additional case where chloroquine intoxication was doubtful is introduced because of the unusual circumstances under which it occurred.     

RESPONDING TO THE "CALL FOR PAPERS": Participation at A.S.C. Annual Meetings

The purpose of this study is to examine the participation of criminology and criminal justice graduate departments at the 1977-1979 American Society of Criminology meetings. Results show that institutional prestige. not productivity, is the leading predictor of meeting participation. In addition, meeting participation does not appear to be influenced by meeting site. Finally, it is suggested that criminologists focus more attention upon professional activities in order to facilitate our understanding of criminology as a science.     

Inflation,unemployment and government popularity—Dynamic models for the United States,Britain and West Germany

There has been numerous attempts to model the relationship between unemployment, inflation, other economic variables and government popularity in a variety of industrial countries. However, there is conflicting evidence about the magnitude and significance of effects both between different countries, and within the same country at different points of time. The purpose of this article is to examine the existing literature, to provide a critique of the theoretical and statistical validity of many existing studies, and to specify and estimate a dynamic model of the relationship between inflation, unemployment and government popularity in three countries over the post-war period. This model is a multivariate transfer function with an autoregressive-moving average error structure which has been developed in its general form by Box and Jenkins. The results demonstrate significant relationships between inflation, unemployment and government popularity, but relationships which are relatively weak and unstable over time.     

HIV-infection in forensic autopsy cases

Sudden and unexpected death and violent death of persons with a high risk of acquiring HIV-infections, especially homosexual males and intravenous drug abusers, have to be investigated by forensic autopsies. Therefore every forensic pathologist has to be aware of this infection and should try to make the proper diagnosis. Three typical cases are described: (1) suicide by hanging, (2) homicide by cutting the throat and (3) intravenous heroin overdose. Merely retrospectively it could be cleared up that the deceased were homosexual but did not manifestly suffer from AIDS. The morphological findings in the lymph nodes and the postmortem serological findings are described in detail.     

SELF-REPORTED DELINQUENCY AND A COMBINED DELINQUENCY SERIOUSNESS SCALE BASED ON BOYS,MOTHERS, AND TEACHERS: CONCURRENT AND PREDICTIVE VALIDITY FOR AFRICAN-AMERICANS AND CAUCASIANS*

The Pittsburgh Youth Study is a prospective longitudinal survey of three samples of Pittsburgh boys (each containing about 500 boys) initially studied in first, fourth, and seventh grades. The first two data collection waves yielded self-reported delinquency and combined delinquency seriousness scores (the combined scores based on information from boy, mother, and teacher) for the middle sample (up to an average age of 10.7 years) and oldest sample (up to an average age of 13.9 years). These scores were compared with records of petitions to the Allegheny County Juvenile Court for delinquency offenses before and up to six years after the assessments. The area under the ROC curve was used as a measure of validity. Concurrent validity was higher than predictive validity. The combined scale had similar concurrent validity but greater predictive validity than the self-report scale, and the combined scale also identified a greater number of boys as serious delinquents. Concurrent validity for admitting offenses was higher for Caucasians, but concurrent validity for admitting arrests was higher for African-Americans. There were no consistent ethnic differences in predictive validity. There was an increase in predictive validity, for both African-Americans and Caucasians, by combining self-report data with information from other sources. Afrer controlling for delinquency measures, African-Americans were more likely than Caucasians to be petitioned in the future, but not in the past. In this research, ethnic differences in official delinquency were partly attributable to ethnic differences in delinquent behavior and were not attributable to differential ethnic attrition or differential ethnic validity of measures of delinquent behavior.