Avoiding HMO liability for utilization review

In this article, the author describes the potential liability of Health Maintenance Organizations for utilization review programs. Utilization review is used to determine whether certain medical treatment is necessary according to the standards of the HMO, and the HMO may decline to pay for treatments it deems unnecessary. If a doctor abstains from treatment because of this decision and the patient is harmed, the HMO may become the target of litigation. The author analyzes several recent cases and offers practical ideas for preventing and defending suits brought against HMO's for utilization review decisions.     

State-run media outlets in Central Asia: external regime legitimation through regional conflict and cooperation framing

ABSTRACT

In this article, we empirically examine how the Central Asian states apply external regime legitimation strategies to legitimize their regimes domestically. We used the Central Asia Watch Project’s data from five Central Asian state-run media outlets to examine spatial and temporal changes in regime legitimation strategies. All the Central Asian countries employed external regime legitimation strategies, but those strategies differ based on regime type. Overall, we see continuity and persistence in reporting regional cooperation but underreporting of regional conflict throughout the 2016–2017 timeframe of this study.     

Budgetary Reform in Haiti from 1996-98: A Case Study of Issues and Obstacles in Implementing Change

With the restoration of democracy and new lending agreements with the international community, the Haitian government embarked upon an ambitious program of budgetary reforms in 1996. For the next two years, Haiti's Ministry of Economy and Finance pursued administrative and legislative changes intended to address significant problems with the country's budget preparation and execution. This article examines the types of problems the Ministry faced and how it chose to address them. The author concludes that though the Ministry made important progress, the ultimate success of the reforms was impeded by weakness in the administrative capacity of the government and a persistent lack of clear political consensus and direction in the country.     

Effects of extreme heat on teeth with implications for histologic processing.

This pilot study examined teeth subjected to extreme heat under laboratory conditions, and the subsequent effect of decalcification and histologic processing. Physical and microscopic findings were evaluated in relation to temperature and duration of thermal insult. Microscopic examination following decalcification and histologic processing revealed changes including severe tissue fragmentation, vapor bubbles within dentinal tubules, altered histologic staining, charring and tissue shrinkage. Dentin appeared to be the most reliable microscopic identifier of incinerated dental tissues. Temperatures above 600 degrees C strongly predicted tooth disintegration following decalcification. This finding has implications in incineration cases where histologic evidence must be maintained and examined intact.     

Children and Young People who have Sexually Harmful Behaviours: From Fixed to Transformative Risk Assessment

Risk, risk assessment and risk management have become central to contemporary policies and practices in criminal justice, with consequences for those who apply and receive such approaches. It has been argued that risk has been the key organising principle of contemporary correctional practice and offender management, and that actuarial risk in particular has taken on a hegemonic dominance that supersedes other models of governance, such as welfare and disciplinary forms of regulation. This article focuses on the construction and deployment of two assessment frameworks for young people with sexually harmful behaviour to illustrate the epistemological differences between a clinical/actuarial guided approach and that of constructing safety. It identifies current theorising about risk/technologies as being within a neo-liberal political and governance agenda and the opportunities for moving from a fixed to a transformative risk subject.

The Impact of the Economy on Presidential Elections Throughout US History

Political Behavior - As numerous studies in the US and elsewhere document, voters often hold incumbents accountable for recent economic circumstances. However, our knowledge of the conditions that...     

Raman Microspectroscopic Mapping: A Tool for Identification of Fused Materials in Fire Debris

Examination of fire debris can provide information about the types of materials which were present at the time of the fire to give insights for fire scene reconstruction and understanding compartment fire dynamics. This paper demonstrates the ability of Raman spectroscopy for material identification postfire in complex situations, such as the production of fused masses during fire dropdown. A validated Raman spectral library is combined with Raman mapping in three fire case studies, to determine the individual materials in the fused masses formed. The case studies accessed material combinations of several common polymers. Raman mapping was carried out on a 10 μm × 10 μm square of the masses. Material identification using this technique ranged from a high of 85% match to a low of 40% match. This work demonstrated that complex masses found in the fire debris can be resolved into the individual material components for identification and spatial distribution.     

The Motivation Behind Serial Sexual Homicide: Is It Sex,Power, and Control,or Anger?*

Controversy exists in the literature and society regarding what motivates serial sexual killers to commit their crimes. Hypotheses range from the seeking of sexual gratification to the achievement of power and control to the expression of anger. The authors provide theoretical, empirical, evolutionary, and physiological support for the argument that serial sexual murderers above all commit their crimes in pursuit of sadistic pleasure. The seeking of power and control over victims is believed to serve the two secondary purposes of heightening sexual arousal and ensuring victim presence for the crime. Anger is not considered a key component of these offenders' motivation due to its inhibitory physiological effect on sexual functioning. On the contrary, criminal investigations into serial sexual killings consistently reveal erotically charged crimes, with sexual motivation expressed either overtly or symbolically. Although anger may be correlated with serial sexual homicide offenders, as it is with criminal offenders in general, it is not causative. The authors further believe serial sexual murderers should be considered sex offenders. A significant proportion of them appear to have paraphilic disorders within the spectrum of sexual sadism. "sexual sadism, homicidal type" is proposed as a diagnostic subtype of sexual sadism applicable to many of these offenders, and a suggested modification of DSM criteria is presented.