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Now Doniger paced, using Kramer as an audience of one, "We are all ruled by the past, although no on understands it. No one recognizes the power of the past" he said, with a sweep of his hand.
"But if you think about it, the past has always been more important than the present. The present is like a coral island that sticks above the water, but is built upon millions of dead corals under the surface, that no one sees. In the same way, our everyday world is built upon millions and millions of events and decisions that occurred in the past. And what we add in the present is trivial.  相似文献   
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The introduction of frontal airbags and seatbelt pretensioners for front seat occupants provided an opportunity to address injuries caused by seatbelt loading by introducing load‐limiters, which were intended to reduce belt loading while maintaining proper restraint. Investigation and forensic analysis of real‐world crashes identified that the implementation of these devices, in some circumstances, increased the potential of injury. This paper focuses on the trade‐offs of load‐limiters, that is, the reduction loading to the occupant versus the corresponding increase in seatbelt webbing and occupant movement. If the additional webbing introduced is not controlled, the risk of injury to the occupant is increased and could result in more frequent and severe injuries rather than a reduction. This paper quantifies the webbing introduced by load‐limiter activation through forensic analysis of the seatbelt involved in real‐world crashes and testing and assesses its effect on the injuries sustained by the occupant.  相似文献   
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A current debate is whether actuarial risk assessment tools predict sexual recidivism in sexual offenders with intellectual disabilities (SOIDs). Since intellectual functioning exists on a spectrum, the present study examined the predictive validity of the Static-99R across the range of intellectual functioning. The sample was comprised of 454 adult sexual offenders assessed at an outpatient clinic and followed for an average of 10 years. Offenders in the extremely low/borderline group had higher scores on the Static-99R than other offenders, largely due to their score on the detachment subscale of the Static-99R, but did not have significantly higher recidivism rates. Calibration analyses suggested that the expected and observed recidivism rates did not differ significantly. Intellectual functioning did not add incremental validity to the Static-99R. Further, there was no interaction between intellectual functioning and actuarial risk score. The results suggested that the Static-99R can be used across the range of intellectual functioning, albeit somewhat more cautiously for those at the lowest and highest end of the intellectual functioning distribution.  相似文献   
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School-based health centers (SBHCs) have proliferated rapidly nation-wide and remain politically popular. This article explores the disconnect between the evidence and the discourse on SBHCs, drawing upon the authors' evaluation of SBHCs in Newark, New Jersey, and a critical assessment of the evaluative literature and public discourse on school clinics to argue that a number of important issues are being overlooked by both research and advocacy. These issues include variations in the health needs and health care resources of different communities and the questions of whether and how SBHCs can best integrate with existing resources to fill unmet local needs. Furthermore, despite the cautions of experts that third-party reimbursement (via traditional fee-for-service insurance or participation in health maintenance organizations) cannot cover clinic expenses and is difficult to obtain, pursuit of reimbursement continues to be a goal of some SBHC sponsors, helping to promote a clinic model that in some communities is very likely not to be the best way to address student needs or to build on clinic strengths. Discussion around SBHCs should focus on diagnosing specific community needs, identifying the best approach to meeting those needs, and seeking funding sources that match the work that needs to be done.  相似文献   
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The ability to predict the timing and magnitude of future climate and temperature changes at a regional level has become increasingly important for corporate decision making and enterprise risk management. In the short term, companies could face decisions about acquisitions of water-dependent companies and natural resources or might be planning facilities or operations in communities vulnerable to erosion and flooding, changes in water supplies, and increasing health-care costs. In the intermediate term, companies need to assess these vulnerabilities to determine appropriate insurance coverage, plan for new infrastructure, implement preventative health-care programs, or protect natural resources. A technical approach needs to involve predictive tools that can provide bounding estimates at regional scales. The implications of those changes need to be translated to consequences that can affect specific businesses. Corporations must be cognizant of the uncertainties in this forecasting process and for that reason it is essential to link the likelihood of outcomes with the magnitudes of consequences. This article outlines an approach that is gaining traction as a way to address this complex matter.  相似文献   
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