Has PPS increased Medicare expenditures on physicians?

We use data from 1983 and 1985 on the volume of Medicare physician services to analyze whether Medicare's Prospective Payment System (PPS), which resulted in a significant decline in hospital spending, led to a partially offsetting increase in real expenditures for physician services. We also analyze the effect of increases in assignment rates, increasing incomes of the elderly, and other factors on real expenditures during this period. Our main conclusion is that PPS has at most a small positive effect on real physician expenditures. Because people spent less time in the hospital, Medicare physician spending declined; but because of incentives to shift radiology and other services out of the hospital, some of this decline was offset. We also conclude that the sharp increase in Medicare assignment rates over this period, along with the rising incomes of the elderly during this period, contributed to the observed growth.     

A modification of the microplate method for reverse ABO typing of bloodstains and additional validation studies

The results of additional validation studies of a sensitive microplate hemagglutination assay for ABO reverse grouping of bloodstains are presented. The results of the validation study demonstrate the reliability of the microplate assay for use in routine serological casework. Based on these studies, the microplate assay has now replaced the Lattes crust test for ABO reverse grouping of bloodstains in the FBI Laboratory.     

Economic Interdependence and the Balance of Power

To account for variance in great powers responses to threats and the implications for the peacefulness of the international system since the late nineteenth century, this article elucidates a theory which refines and synthesizes economic liberal perspectives and realist balance of power theory. I argue that different patterns and levels of economic interdependence in the great power system generate societal-based economic constraints on, or incentives for, state leaders of status quo powers hoping to mobilize economic resources and political support to oppose perceived threats. This mobilization process influences strongly the preferences of status quo powers, other states beliefs about those preferences, and the interpretation of signals in balance of power politics. In this way, economic ties influence the strategies great powers pursue. Firm balancing policies conducive to peace in the international system are most likely, I then hypothesize, when there are extensive economic ties among status quo powers and few or no such links between them and perceived threatening powers. When economic interdependence is not significant between status quo powers or if status quo powers have strong economic links with threatening powers, weaker balancing postures and conciliatory policies by status quo powers, and aggression by aspiring revisionist powers, are more likely. I then illustrate how these hypotheses explain the development of the Franco-Russian alliance of the 1890s and its effectiveness as a deterrent of Germany up to 1905, British ambivalence toward Germany from 1906 to the First World War, the weakness of British, French, Soviet, and American behavior toward Germany in the 1930s and World War II, and the American and European responses to the Soviet threat, including the NATO alliance, and the "long peace" of the post-1945 era.     

Acidic and neutral drugs screen in blood with quantitation using microbore high-performance liquid chromatography–diode array detection and capillary gas chromatography–flame ionization detection

Blood previously acidified with aqueous saturated ammonium chloride solution was extracted with ethyl acetate. The dried extract was subjected to acetonitrile–hexane partition. The acetonitrile portion was analysed for the presence of acidic and neutral drugs by HPLC–DAD (200 mm×2.1 mm I.D. microbore ODS-Hypersil column) and GC–FID (25 m narrow-bore×0.25 mm I.D. HP-5 column with 0.33 μm film thickness). The protocol was found to be suitable for both clinical toxicology (including emergency toxicology) and postmortem toxicology. At least 66 drugs of interest were unequivocally identified by RRTs (HPLC) and UV spectra (DAD) match while another 12 were unequivocally identified by double RRTs match (HPLC and GC). Quantitation was facilitated by incorporating calibration blood standards in each assay batch. The five drugs most commonly encountered in clinical blood specimens (1150 cases) were: paracetamol (47.4% of the cases); chlormezanone (6.6%), theophylline (1.74%), naproxen (1.65%) and mefenamic acid (1.56%). The following drugs were detected in toxicologically significant quantities in postmortem blood specimens (245 cases): phenobarbitone (1.22% of the cases), naproxen (0.82%), chlormezanone (0.82%), theophylline (0.82%), carbamazepine (0.41%) and paracetamol (0.41%).     

Understanding Recreation and Sport as a Rehabilitative Tool Within Juvenile Justice Programs

This article discusses relevant literature on the potential benefits of sport, recreation, and leisure, and how these benefits relate to rehabilitation of juveniles. Many professionals involved in juvenile rehabilitation believe sport and recreation are beneficial adjuncts to treatment programming; however, it can be difficult to structure sport and recreation in ways that directly correspond to treatment goals. The purpose of this article is to provide insights for professionals working with juveniles on how sport and recreation programming can be an effective means of helping to achieve rehabilitation goals. Attention is given to approaches, particularly the Teaching Games for Understanding model (Bunker & Thorpe, 1982), which can be used to effectively link recreation and sport to the rehabilitation process.