Litigating the science of breast cancer treatment

Beginning in the late 1980s, many health insurers refused to cover high-dose chemotherapy with autologous bone marrow transplant (HDC/ABMT) for high-risk and metastatic breast cancer patients. Insurers denied coverage because there was no persuasive evidence of clinical effectiveness. In response, many women sued to compel coverage. After years of litigation and the expenditure of approximately $3 billion, randomized clinical trials (RCTs) showed that the procedure was no more effective and possibly more harmful than conventional therapy. To understand whether and how litigation contributed to the diffusion of the procedure, we conducted a series of case studies that examine the litigation tactics and strategies used by defense and plaintiffs' counsel. Despite the fact that HDC/ABMT lacked proven scientific effectiveness, insurance defense attorneys were unable to stop the procedure's diffusion. Plaintiffs' attorneys had a much easier and more sympathetic story to tell and were able to exploit vulnerabilities facing the defense.     

Why criminal harms matter: Plato’s abiding insight in the Laws

Commentators have contested the role of resulting harm in criminal law since the time of Plato. Unfortunately, they have neglected what may be not only the best discussion of the issue, but also the first—namely, Plato’s one-paragraph discussion in the Laws. Plato’s discussion succeeds in reconciling two, seemingly irreconcilable viewpoints that till now have been in stalemate. Thus, Plato reconciles the view, that an offender’s desert is solely a function of his subjective willingness to act in disregard of the legitimate interests of others, with the view that criminal sentences can appropriately be made to depend upon how indignant, angry, and upset society is at an offender based upon the results of his culpable conduct. In doing so, Plato casts light on retributive theories of punishment by suggesting that an adjudicator can be committed to retribution and yet rightly believe that it is inappropriate to give an offender the full punishment he deserves. He also lays a basis for the view that causation, rather being predicates for the just punishment of offenders toward whom the public is intuitively angry for harm, is the consequence of the public’s being intuitively angry at offenders for harm.

Streiflichter zum Verhältnis von Parlamentsakten und EMRK

Dieser Beitrag untersucht die Beziehung zwischen Parlamentsakten und der Europäischen Menschenrechtskonvention. Dabei wird beleuchtet, wie verschiedene Parlamentsakte in ein Spannungsverhältnis zu den Vorgaben der Europäischen Menschenrechtskonvention treten können. Die vorliegende Arbeit behandelt die maßgebliche Rechtslage hinsichtlich der österreichischen Parlamente bzw deren Mitglieder auf Bundes- sowie Landesebene.     

The Role of Peer Contacts in the Relationship Between Parental Knowledge and Adolescents' Externalizing Behaviors: A Latent Growth Curve Modeling Approach

The purpose of the present study was to examine the direct and indirect effects (through peer contacts) of parental knowledge on adolescents’ delinquent and aggressive problem behavior, using latent growth curve modeling. A sample of 457 13- to 14-year old adolescents at first measurement wave (M=13.27; SD=0.45 years) filled out questionnaires about their parents, peers, and problem behavior three times with 1-year intervals in between. Regarding initial levels of behavior, both direct and indirect effects of parental knowledge were found on aggressive as well as on delinquent behavior. When the rate of change in behaviors was considered, only direct effects were found for both types of problem behavior, whereas indirect effects were absent. Gender differences were also found, with stronger effects of parenting on both aggressive and delinquent problem behavior for boys and stronger effects of peer contacts on aggressive behavior for girls. The present study shows that different behaviors of the externalizing spectrum have different trajectories and diverse relations with parenting and should not be treated as identical.

The Intergenerational Cycle of Criminality—Association with Psychopathy*

Abstract: Preventive interventions early in life are likely to lower the risk of intergenerational transmission of criminal behavior. We investigated if psychopathy among homicidal offenders is associated with criminal offending among the offenders’ offspring. The basic sample consisted of consecutive Finnish homicide offenders (during 1995–2004) who had been subjected to a forensic psychiatric examination and rated for a file‐based PCL‐R, and their offspring. Criminal behavior among both genders of the offspring was more common than in the general population. In general, the offspring’s crimes against others (e.g., threat, intimidation, deprivation of freedom, breach of domicile) were associated with their parent’s psychopathy. A grandfather’s major mental disorder was associated with a high rate of crime committed by the offspring. Especially, the sons of male psychopathic homicidal offenders had the highest rate of committing crimes, which was often expressed as vandalism. However, both genders of offspring seem to require special preventive programs to ameliorate these problems.     

Discrimination of Falls and Blows in Blunt Head Trauma: A Multi‐Criteria Approach

Abstract: In the discrimination of falls versus blows, the hat brim line (HBL) rule is mentioned in several textbooks as the most useful single criterion. Recent studies, however, have found that the HBL rule is only moderately valid and that its use on its own is not recommended. The purpose of this 6‐year retrospective study was to find additional individually useful criteria in the distinction of falls from blows. Overall, the following criteria were found to point toward blows: more than three lacerations, laceration length of 7 cm or more, comminuted or depressed calvarial fractures, lacerations or fractures located above the HBL, left‐side lateralization of lacerations or fractures, more than four facial contusions or lacerations, presence of ear lacerations, presence of facial fractures, and presence of postcranial osseous and/or visceral trauma. Based on the most discriminating criteria, a decision tree was constructed to be potentially applicable to future cases.     

Using Gas Chromatography with Ion Mobility Spectrometry to Resolve Explosive Compounds in the Presence of Interferents*

Abstract: Ion mobility spectrometry (IMS) is a valued field detection technology because of its speed and high sensitivity, but IMS cannot easily resolve analytes of interest within mixtures. Coupling gas chromatography (GC) to IMS adds a separation capability to resolve complex matrices. A GC‐IONSCAN^® operated in IMS and GC/IMS modes was evaluated with combinations of five explosives and four interferents. In 100 explosive/interferent combinations, IMS yielded 21 false positives while GC/IMS substantially reduced the occurrence of false positives to one. In addition, the results indicate that through redesign or modification of the preconcentrator there would be significant advantages to using GC/IMS, such as enhancement of the linear dynamic range (LDR) in some situations. By balancing sensitivity with LDR, GC/IMS could prove to be a very advantageous tool when addressing real world complex mixture situations.