Actuarial status of the Hospital Insurance and Supplementary Medical Insurance Trust Funds

This article, adapted from a summary of the 1983 Annual Reports of the Medicare Boards of Trustees, presents the present and projected future actuarial status of the Hospital Insurance (HI) and Supplementary Medical Insurance (SMI) Trust Funds following the enactment of the Tax Equity and Fiscal Responsibility Act of 1982 and the Social Security Amendments of 1983. Although the Trustees characterize the outlook for the HI Trust Fund as slightly more optimistic than it was a year earlier, they report that the fund may be exhausted sometime between 1988 and 1996 unless benefits under the HI part of Medicare are reduced or financing is improved. The SMI Trust Fund, which is financed by premiums adjusted each year to reflect actual experience and by general revenue contributions, is characterized as actuarially sound. The Trustees note, however, the growing extent to which general revenue financing is becoming the major source of income for the SMI part of Medicare.     

FREDERICK GOULBURN: THE MAN AND HIS OFFICE

Major Frederick Goulburn's appointment in 1820 as Colonial Secretary and Registrar of the Records of New South Wales was something more than the appointment of just another colonial official. It was also a recognition by the home government, as had been the appointment of a Commissioner of Inquiry the previous year, of the changing character of the colony. Though still predominantly a penal colony, it was no longer that alone but was developing also into a colony of free British settlement with economic potential. "Considering the Importance which the Colony has attained from its rapid Increase in Wealth and Population", wrote Lord Bathurst, Secretary of State for War and Colonies, "His Majesty has thought it adviseable to take this opportunity of placing these officers [Colonial Secretary and Provost Marshall] on the Footing on which they stand in other Foreign Possessions of the Crown"; their Commissions were to be prepared for the King's signature in the usual form.     

A Fast, Easy, and Efficient Estimator for Multiparty Electoral Data

Katz and King have previously developed a model for predictingor explaining aggregate electoral results in multiparty democracies.Their model is, in principle, analogous to what least-squaresregression provides American political researchers in that two-partysystem. Katz and King applied their model to three-party electionsin England and revealed a variety of new features of incumbencyadvantage and sources of party support. Although the mathematicsof their statistical model covers any number of political parties,it is computationally demanding, and hence slow and numericallyimprecise, with more than three parties. In this paper we producean approximate method that works in practice with many partieswithout making too many theoretical compromises. Our approachis to treat the problem as one of missing data. This allowsus to use a modification of the fast EMis algorithm of King,Honaker, Joseph, and Scheve and to provide easy-to-use software,while retaining the attractive features of the Katz and Kingmodel, such as the t distribution and explicit models for uncontestedseats.     

The New Forest Suicide Prevention Initiative (NFSPI)

A retrospective suicide study revealed that the Forestry Commission car parks in the New Forest in southern England were a previously unrecognized magnet for nonlocal suicides, attracting as high a proportion of "visitors" (35/43 in 1993-97) as among suicides who jumped from the cliffs at the infamous Beachy Head (39/48 in 1993-97). Over 95% of the car park suicides died from car exhaust gas poisoning. A multiagency initiative aimed to reduce the number of suicides in the 140 New Forest car parks where restricting access was impossible, and environmental issues paramount. Signs displaying the Samaritans' national telephone number were erected in the 26 car parks in which 50% of the car park suicides had occurred. Numbers, location, and residence of all car park deaths were monitored for 3 years. Corresponding changes in other forest registration districts were also monitored. During the 3-year intervention period the number of car park suicides fell significantly from 10/year, 1988-1997, to 3.3/year. The average annual total number of suicides in the New Forest registration district also decreased. No significant changes were found in comparable forest districts. The number of suicides in the New Forest car parks remained low during the 2 years following the evaluation.     

Palliative pain therapy at the end of life and forensic medicine issues.

An 83-year-old woman with a history of Alzheimer's disease and breast cancer died at home while receiving palliative pain therapy with oral morphine from her family for metastatic breast cancer. Allegations of mistreatment were made, and this case was ultimately referred to the Office of the Chief Medical Examiner, State of Maryland. An autopsy failed to identify any injuries or residual cancer, leaving no anatomic explanation for the pain that had been presumed to be metastatic breast carcinoma involving bone. The blood free morphine concentration was 5,200 ng/ml, and the total morphine concentration was 15,000 ng/ml. This case demonstrates the challenges and difficulties in forensic medicine when faced with the interpretation of toxicologic results at the end of life.     

Sexual victimization and health-risk behaviors: a prospective analysis of college women

The present study utilizes the National College Health Risk Behavior Survey to examine the relationship between health-risk behaviors and sexual victimization among a sample of college women. A prospective design is utilized to examine the relationship between health-risk behaviors as measured at baseline and sexual victimization during a 3-month follow-up period. After controlling for age and parents' education, a history of adolescent sexual victimization was associated with the following health-risk behaviors as measured at pretest: increased likelihood of cigarette smoking, marijuana use, suicidal ideation, experience of physical violence within a dating relationship, use of diet pills and vomiting or laxatives to lose weight, multiple sexual partners, and early sexual intercourse. Prospectively, women's history of adolescent sexual victimization was the strongest predictor of sexual victimization during the 3-month follow-up. Implications of univariate associations between early sexual intercourse, suicidal ideation, and problematic weight loss behaviors and subsequent experience of sexual victimization are discussed.     

Microaggressions as Boundary Objects

What do new materialist activisms and direct theory look like? Something massively distributed yet also micro somehow in relation to persons, indeed crowd-sensible among personal storifyings, is emergent among and as microaggression and microaggressions. Literally we see, in data visualisation, this perhaps hyperobject (see the online Microaggressions Project). A mattering entanglement not simply micro or macro reframes anything personal, person-all. And the connections with movements of re-action, #Baltimore, #Ferguson, and #BlackLivesMatter, matters too along with other massive distributions: of military hardware escalating aggression in police forces, of debt peonage of whole towns, and county, regional, and national citizenry to pay to arm police, against themselves. People gathering in their person at sites of danger to confront these activating realities, as well as to enact the distributive social media and art activisms supporting them and making their actions widely available. All this at scales both intentional and not, sometimes tactical and often spontaneous, escalations fraught with danger and release, and all thoroughly neurologically entangled as mattering motivations: caring, attention, attachment, aggression. These move within and through and among bodies and infrastructural embodiments. Our holobiont/s include/s it all.