Is the doctor in? The evolving role of organized medicine in health policy

Until recently, physicians were viewed as the dominant player in health policy. Now, however, they compete with many other effective interest groups. This article analyzes this changing role, and specifically how organized medicine has changed its approach to influencing health policy. The essay begins with a review of the reasons for the growth and subsequent decline of physicians' influence. This is followed by a case study of physician payment reform under Medicare, which illustrates the ways in which organized medicine chooses when and when not to cooperate with government. The article concludes with a discussion of where physicians are likely to continue to be influential in future health policy reform. Three such areas are noted: payment policy, quality and clinical innovation, and medical education and training.     

Substance use,health, and mental health: problems and service utilization among incarcerated women

This article profiles self-reported substance use, health, and mental health problems among a sample of incarcerated women in Kentucky as well as lifetime service utilization. Findings indicate that a high percentage of women reported use of alcohol, cocaine, and multiple substances during the month before incarceration. In addition, participants reported common health problems such as dental, female reproductive, physical injuries, and mental health problems including depression and anxiety. Participants reported moderate use of emergency room and mental health treatment but limited substance abuse treatment utilization. Implications for criminal justice programs and linkages with community-based aftercare services for women are recommended based on findings that health and mental health problems are associated with service utilization before incarceration.     

North America's first supervised injection site opens in Vancouver

The number of injection drug users frequenting the long-awaited supervised injection site in the Downtown Eastside has steadily increased since the site opened in September 2003. However, there are concerns about the restrictions imposed by Health Canada and about the activities of the Vancouver Police.     

Supervised injection sites: Health Canada approves Vancouver pilot sites, but concerns remain

The paperwork has been processed, and Health Canada says that two pilot supervised injection sites (SISs) in Vancouver can now proceed, but operational funding for the site to be located in the Downtown Eastside has yet to be secured. Meanwhile, tired of waiting for the sanctioned SISs to open, community groups in Vancouver have begun to operate unsanctioned sites. There are also concerns that even if operational funding for the Downtown Eastside site is obtained, the pilot SIS project is too small in scope to make a major impact on public health in the area.     

The Illusion of Transparency in Negotiations

The authors examined whether negotiators are prone to an illusion of transparency, or the belief that their private thoughts and feelings are more discernible to their negotiation partners than they actually are. In Study One, negotiators who were trying to conceal their preferences thought that their preferences had leaked out more than they actually did. In Study Two, experienced negotiators who were trying to convey information about some of their preferences overestimated their partners' ability to discern them. The results of Study Three rule out the possibility that the findings are simply the result of the curse of knowledge, or the projection of one's own knowledge onto others. Discussion explores how the illusion of transparency might impede negotiators' success.     

Trends in explosive contamination

This study sought to assign a rough order of magnitude for the amount of explosive residue likely to be available in real-world searches for clandestine explosives. A variety of explosives (TNT, TATP, HMX, AN, RDX, PETN) in various forms (powder, flake, detonating cord, plastic) were carefully weighed or cut into containers, and the amount of residue inadvertently remaining on the work area, hands, or containers was quantified. This was used to evaluate the spillage potential of each explosive. The adhesion of each explosive to a glass surface was quantified from amount of explosive adhering to the inside of a glass vial into which the explosive had been placed and then removed by vigorous tapping. In powdered form, most of the explosives--TNT, PETN, RDX, HMX, and TATP--exhibited similar spillage and adhesion to glass. However, PETN as sheet explosive and plasticized RDX (C-4), showed very little potential to contaminate surfaces, either by spillage or adhesion to glass.     

An alternative method to screen for pepper spray residue

A method was developed to screen for pepper spray residue using instruments and methods other than those techniques commonly employed to analyze chemical residue (i.e.. gas chromatography mass spectrometry-GCMS or liquid chromatography mass spectrometry-LCMS). The method employed gas chromatography (GC), thin layer chromatography (TLC), and diffuse reflectance infrared Fourier transform spectroscopy (DRIFTS) to screen for dried pepper spray stains. Pepper sprays from nine different manufacturers were investigated. Capsaicin and dihydrocapsaicin were identified and unique IR reflectance spectra are presented. An additional five compounds were presumptively found. Results showed that a particular stain could be characterized as a pepper-based stain.     

Predicting mouth width from inter-canine width--a 75% rule

It has been suggested that inter-canine width plus 57% of the cumulative distance between the lateral aspect of the canines and the pupil centers can be used to estimate mouth width. Evidence also suggests that the distance between the medial irises approximates actual mouth width fairly well. However, these soft tissue prediction guidelines are limited because they rely on accurate medio-lateral positioning of the pupils within the orbits, for which no systematic empirical evidence appears to exist at this stage. It would, therefore, be more appropriate to use only known hard tissue landmarks in mouth width prediction. This study reports the results of using inter-canine width as a percentage of mouth width for its prediction. This method seems favorable in comparison to the other guidelines because it is as accurate, uses known hard tissue landmarks, and does not rely on assumptions concerning pupil location. Estimating mouth width by using the canines alone, therefore, seems the best guideline to use in facial approximation techniques, at least given knowledge existing at this stage.