Stark II and physician compensation models: integrating business and legal issues

In March of 2004, the Centers for Medicare & Medicaid Services released new regulations that interpreted the Federal Physician Self Referral Act, otherwise known as Stark II. The new regulations, commonly referred to as the Phase II regulations, must be carefully considered when structuring physician compensation models. Stark II generally holds that physicians may not make a referral for designated health services to an entity with which they have a direct or indirect financial relationship. This Article outlines the provisions of Stark II that are applicable to physician compensation methodologies. In addition, the authors evaluate hypothetical transactions involving physician groups seeking viable compensation schemes and explore the validity and risks of each.     

Design of an algorithm to identify persons with mental illness in a police administrative database

North American police maintain a database to track events and information related to their involvement with the public that contain a series of electronic caution/dependency flags attached to an individual's name for internal communication. To identify persons with mental illness in a police administrative database, an algorithm was developed that was composed of (a) caution/dependency flags, (b) addresses, and (c) key search words indicative of mental illness. Based on the level of confidence of the algorithm, persons with mental illness (PMI) were then assigned to one of three categories: Definite, Probable and Possible PMI. Results for 2000 include the sociodemographic characteristics of PMI and non-PMI in the database. The mean number of contacts, types of interactions, re-involvement with a year, charges and dispositions are described. The algorithm provides a cheap, quick method to identify PMI for North American police. It enables police to monitor the effectiveness of pre-arrest diversion programs and allows researchers to analyze questions of criminalization and mental illness.     

Domestic violence and minoritisation: legal and policy barriers facing minoritized women leaving violent relationships

This article on service responses to women of African, African-Caribbean, Irish, Jewish and South Asian backgrounds facing domestic violence draws on our recently completed study based in Manchester, UK () [Batsteeler, J., Burman, E., Chantler, K., McIntosh, S.H., Pantling, K., Smailes, S., Warner, S., et al. 2002. Domestic violence minoritisation: Supporting women to indepence. Women's Studies Centre: The Manchester Metropolitan University]. We frame our analysis of domestic violence and minoritisation around the question that is frequently posed in relation to women living with domestic violence: 'why doesn't she leave?' In response, we highlight the complex and intersecting connections between domestic violence, law, mental health provision, entitlement to welfare services, which function alongside constructions of 'culture' and cultural identifications, structures of racism, class and gendered oppression. All these contribute to maintain women, particularly minoritized women, in violent relationships. Further, we illustrate how leaving violent relationships does not necessarily guarantee the safety of women and children escaping domestic violence. Despite many recent legal and social policy initiatives in the UK that have usefully brought domestic violence into the public domain, there have also been counter-measures which have made leaving violent relationships correspondingly more difficult, in particular for women from minoritized communities. We offer an analysis of how state practices, particularly facets of immigration law in the UK (although , provides an equivalent U.S. analysis), interact with domestic violence. These not only equip perpetrators with a powerful tool to oppress minoritized women further, but it also indicates how state structures thereby come to impact directly on women's distress (Chantler et al, 2001). In addition, we highlight how other aspects of state policy and practice which enter into the material well-being of survivors of domestic violence, for example, housing, levels of state benefits, and child-care also pose significant obstacles to minoritized women leaving violent relationships. Whilst women from majority/dominant groups also face many of these barriers, we illustrate how the racialized dimensions of such policies heightens their exclusionary effects. It is argued that legal and psychological strategies need to address the complexity of how public, state and institutional practices intersect with racism, class and gender oppression in order to develop more sensitive and accessible ways of supporting minoritized women and children living with domestic violence.     

Isolated peliosis of the spleen: report of 2 autopsy cases

Isolated peliosis of the spleen, characterized by the gross appearance of multiple cystlike, blood-filled cavities on cut surfaces of the organ, is a very rare pathologic entity that has been reported in 33 cases to date. We present 2 additional cases of isolated peliosis of the spleen observed at autopsy and confirmed by histology. In both cases investigated, cirrhosis of the liver was present. We hypothesize that local microcirculatory disturbances manifesting under altered local intravascular pressure conditions in the spleen may, at least to a certain degree, be responsible for the peliosis-associated vascular lesions. For the forensic pathologist, isolated peliosis of the spleen represents more than just another morphologic curiosity. The significance of peliosis lienalis lies in the potential of (1) overlooking the correct diagnosis as the cause of a spontaneous splenic rupture with intraabdominal hemorrhage, thus leading to the false conclusion of a violent death; and (2) misinterpreting the macromorphological appearance of this rare disease, also in the absence of splenic rupture, as a result of blunt force trauma.     

“Intuitive” Lie Detection of Children’s Deception by Law Enforcement Officials and University Students

Adults ability to detect childrens deception was examined. Police officers, customs officers, and university students attempted to differentiate between children who lied or told the truth about a transgression. When children were simply questioned about the event (Experiment 1), the adult groups could not distinguish between lie-tellers and truth-tellers. However, participants were more accurate when the children had participated in moral reasoning tasks (Experiment 2) or promised to tell the truth (Experiment 3) before being interviewed. Additional exposure to the children did not affect accuracy (Experiment 4). Customs officers were more certain about their judgments than other groups, but no more accurate. Overall, adults have a limited ability to identify childrens deception, regardless of their experience with lie detection.