My health policy nightmare

Imagine that the United States did not have universal public education. What would the politics of extending access to education look like? It might have a nightmarish cast but also look rather familiar. Thinking about that yields some disturbing implications about the politics of health reform and, in particular, the politics of universal coverage within the broader policy discussion about "health reform."     

Rough-and-Tumble Play and the Development of Physical Aggression and Emotion Regulation: A Five-Year Follow-Up Study

This is a follow-up to a study demonstrating that rough-and-tumble play was related to physical aggression in the preschool years. Fathers reported on the frequency of father-child rough-and-tumble play interactions, and the degree to which fathers were dominant in the play dyad was observed and coded from play interactions. In this follow-up study, school-aged children’s physically aggressive behaviors and emotion regulation abilities were assessed with questionnaires 5 years later. Higher frequencies of father-child rough-and-tumble play in the preschool years were associated with more physical aggression and worse emotion regulation 5 years later for children whose fathers were less dominant, over and above the effects of physical aggression in the preschool years. Rough-and-tumble play was unrelated to these measures among children whose fathers were more dominant during play. This study shows that early rough-and-tumble play continues to be related to children’s psychosocial adjustment over time, and that the effect remains moderated by the quality of the father-child relationship during play.     

Critical incident preparedness and response on post-secondary campuses

Campus-based critical incidents received renewed focus in the aftermath of the Virginia Tech and Northern Illinois University shootings. Legislative bodies, task forces, and professional associations sought to provide campus public safety departments with a range of recommended strategies to prevent and mitigate accidental and intentional critical events. Using data from a national sample of colleges and universities, this study examined the status of critical incident preparedness and response in the spring of 2008. Results indicated a solid base of prevention and response capacity; at the same time, respondents highlighted areas lagging behind recommended practices and barriers limiting achieved changes.     

Multiple Principals and Legislative Cohesion

In many systems, legislators find themselves accountable to multiple principals. This article seeks to further answer how legislators decide between their principals and what factors condition legislators to choose one over the other. We argue that electoral uncertainty, operationalized as electoral volatility, pushes legislators towards the principal that has the greatest influence over their re‐election. Using European Parliament electoral results and roll‐call data from the second to the sixth European Parliaments (1984–2009), we show that increases in electoral volatility decreased European group cohesion and pushed legislators to side more with the positions of their national parties over their European group when the two disagreed.     

Ochronosis Presenting as Methemoglobinemia

Ochronosis is the blue‐gray discoloration of collagen‐containing tissues due to homogentisic acid (HGA) deposition, secondary to endogenous alkaptonuria or exogenous enzyme inhibition. In renal disease, accumulation of HGA in serum can cause methemoglobinemia. A 60‐year‐old woman with renal disease and anemia presented with 3 days of weakness and months of gray skin discoloration. Her hemoglobin was 8.1g/dl with 24.5% methemoglobin. Despite treatment with methylene blue, exchange transfusion, and continuous renal replacement therapy, the patient died. Autopsy revealed gray discoloration and ochronotic pigment in the ribs and cartilage. Based on these findings, the patient was diagnosed with ochronosis, suggestive of alkaptonuria, complicated by methemoglobinemia. The differential diagnosis for blue‐gray skin discoloration includes argyria, methemoglobinemia, and ochronosis. This patient's clinical and autopsy findings suggested alkaptonuria complicated by methemoglobinemia due to progressive renal dysfunction. Development of methemoglobinemia in the setting of chronic skin discoloration and renal failure should prompt consideration of alkaptonuria.