The new politics of U.S. health policy

Following the demise of comprehensive health care reform in 1994, some reformers are seeking comfort in the successful "incremental" strategy for enacting Medicare that emerged out of President Harry Truman's failed campaign for national health insurance in 1948-50. But despite similarities between the Truman and Clinton health security efforts, overall contexts of government and politics are much less hospitable to governmentally funded reforms today than they were after Truman's defeat. Back then, market transformations and political dynamics were both pushing toward expanded access to health services and insurance coverage. Today, by contrast, both push in the opposite direction. The private insurance market is fragmenting, federal budgetary constraints stymie new programs, and the deficit dominates debate over existing programs. Equally important, a stable pro-reform coalition like that of Truman's day has yet to emerge, while a new and fiercely conservative corps of Republicans is championing coherent programmatic alternatives based on antigovernment premises. Although passage of the Kassebaum-Kennedy health insurance reform bill in 1996 unleashed a wave of enthusiasm about incremental health care reform, formidable political, fiscal, and technical obstacles continue to stand in the way of even relatively modest incremental solutions.     

Dioxins, dibenzofurans, dioxin-like PCBs, and DDE in U.S. fast food, 1995

Food, especially dairy products, meat, and fish, is the primary source of environmental exposure to dioxins in the general population. Little data exists on dioxin levels in the popular and widely consumed "fast foods". Data presented in a previously published pilot study was limited to measuring only the levels of dioxins and dibenzofurans in three types of U.S. fast food. This study adds to the previous paper by presenting data, in addition to dioxins and dibenzofurans, on the closely related dioxin-like polychlorinated biphenyls (PCBs), and the persistent metabolite of DDT, 1,1-dichloro-2,2-bis (p-chlorophenyl) ethylene (DDE), in four types of popular U.S. fast food. These include McDonald's Big Mac Hamburger, Pizza Hut's Personal Pan Pizza Supreme, Kentucky Fried Chicken (KFC) three piece original recipe mixed dark and white meat luncheon package, and H?agen-Daz chocolate-chocolate chip ice cream. Dioxin plus dibenzofuran dioxin toxic equivalents (TEQ) ranged from 0.03 to 0.28 TEQ pg/g wet or whole weight for the Big Mac, from 0.03 to 0.29 for the Pizza, from 0.01 to 0.31 for the KFC, and from 0.03 to 0.49 TEQ pg/g for the ice cream. Daily TEQ consumption per kilogram body weight (kg/BW), assuming an average 65 kg adult and a 20 kg child, from one serving of each of these fast food ranged between 0.046 and 1.556 pg/kg in adults whereas in children the values were between 0.15 and 5.05 pg/kg. Total measured PCDD/Fs in the Big Mac, Personal Pan Pizza, KFC, and the H?agen-Daz ice cream varied from 0.58 to 9.31 pg/g. Measured DDE levels in the fast foods ranged from 180 to 3170 pg/g. Total mono-ortho PCB levels ranged up to 500 pg/g or 1.28 TEQ pg/g for the KFC and for di-ortho PCBs up to 740 pg/g or 0.014 TEQ pg/g for the pizza sample. Total PCB values in the four samples ranged up to 1170 pg/g or 1.29 TEQ pg/g for the chicken sample.     

U.S. mental health policy: Doomed to fail.

Changes in the de facto system of mental health care in the last decade reflect organizational and entrepreneurial responsiveness to changes in health policy, not mental health policy. Various other actions described here reduced statutory or institutional leadership roles in mental health and increased the pace at which mental health policy was becoming dependent on health policy. In turn, US health policy in the 20th century has been inherently flawed. The short-term general hospital, the "doctors' workshop," emphasizing acute care and surgery, has been the cornerstone of US health policy throughout the 20th century. The mimicry of health services by mental health leads to demonstrably more expensive and less effective mental health care and dooms mental health policy to failure. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The past and future of U.S. prison policy. Twenty-five years after the Stanford prison experiment

In this article, the authors reflect on the lessons of their Stanford Prison Experiment, some 25 years after conducting it. They review the quarter century of change in criminal justice and correctional policies that has transpired since the Stanford Prison Experiment and then develop a series of reform-oriented proposals drawn from this and related studies on the power of social situations and institutional settings that can be applied to the current crisis in American corrections.     

U.S. mental health policy: Proactive evolution in the midst of health care reform.

Argues that it is vital that psychological and behavioral health care perspectives be explicitly recognized during the coming reform of the US health care system. Mental health policy should not be treated as a mere extension of physical health policy; to do so extends all the flaws of the physical health system into the psychological care arena, resulting in a mismatch with the actual health care needs of the nation. Furthermore, organized psychology must remind policymakers that psychologists provide health services in areas of health care beyond mental health. The challenge to psychology is to ensure the continuation of adequate and timely access to appropriate psychological and behavioral health care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differing birth weight among infants of U.S.-born blacks, African-born blacks, and U.S.-born whites

Glomerular disease often accompanies a wide variety of liver diseases, including acute or chronic hepatitis. A striking association between hepatitis B virus and glomerulonephritis particularly membranous glomerulonephritis has been reported by various authors. It is not surprising, therefore, that hepatitis C virus (HCV) infection has been recently associated with the development of various types of glomerulonephritis. The principal type of glomerulonephritis associated with HCV infection is either cryoglobulinemic or non-cryoglobulinemic membranoproliferative glomerulonephritis. However, other types of glomerular lesions were seen in the clinical course of HCV infection. We report a rare case of a 20-year-old woman who developed rapidly progressive glomerulonephritis (RPGN) during the course of the active HCV infection. Whether this case represents a true association or a coincidental association is not known.     

Deep dyslexia and the right hemisphere hypothesis: Evidence from the U.S.A. and the U.S.S.R.

Discusses the theory that asserts that the residual reading abilities seen in deep dyslexia entirely reflect the operation of an intact right hemisphere reading system rather than a partially disabled left hemisphere reading system. Evidence from an experiment with normal Ss in a report by the present author and colleagues (1983) is presented, which suggests that the right hemisphere contains no lexical entries for abbreviations that can be accessed by visual presentation. Data are presented from studies by K. E. Patterson (1980; see also PA, Vols 63:12203 and 64:10691) on 2 male deep dyslexic's understanding of printed abbreviations, along with observations of a young female deep dyslexic who was tested on understanding of abbreviations and on letter-naming abilities. Considerable sparing of the ability to obtain semantic information from printed abbreviations was evidenced in all 3 Ss. This contrast suggests that the current right hemisphere account of the residual reading abilities seen in deep dyslexia is not a sufficient one and should be modified. (French abstract) (29 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Physician migration to the U.S.--foreign aid for U.S. manpower

Data were obtained from the American Medical Association on Iranian physicians practicing in the U.S., and from the Iranian Medical Registry on U.S.-trained Iranian physicians who have returned to practice in Iran. There were 2,066 Iranian physicians practicing in the U.S. in 1972, 1,234 (60%) of whom were not undergoing any training. Only 600 of Iran's 9,535 physicians in 1972 had been trained in the United States. Thus, less than one-third of the specialists who have completed training in the U.S. have returned to practice in Iran. The specialist group with the highest rate of return is the combined surgery subspecialties (neurosurgery, thoracic surgery, orthopedic surgery, and plastic surgery). The specialist groups with the lowest rates of return were pathology, anesthesiology, and psychiatry. A comparison is made of the manpower problems Iran faces and the American problems in the area of physician manpower.     

A national survey of U.S. statutes on juvenile transfer: implications for policy and practice

The opening and closing of a single ion channel can be described as the aggregation into two sets of states, open and shut, of an underlying Markov process with a finite number of states. In this paper we consider an inhomogeneous process due to changing physical conditions, in particular a pulse of activity in which the transition rates during the pulse differ from those obtaining both before and after the pulse. Outside the pulse the chain contains an absorbing shut subset, so that no activity is observed before the pulse and almost surely, at most a finite number of openings are generated by the pulse. We consider, in particular, the probability distribution of first latency (the time to first opening) and the distribution of the total activation time. We take into account the phenomenon of time-interval omission, when short open or shut times fail to be observed.     

Congener-specific levels of dioxins and dibenzofurans in U.S. food and estimated daily dioxin toxic equivalent intake

Food, especially meat, milk, and fish, is the immediate source of almost all polychlorinated dibenzo-p-dioxins (PCDDs), dibenzofurans (PCDFs), and dioxinlike compounds in the general population. To estimate intake of these highly toxic compounds, we performed congener-specific dioxin analyses for the first time on U.S. food for 18 dairy meat, and fish samples from a supermarket in upstate New York. 2,3,7,8 Tetrachlorodibenzo-p-dioxin (TCDD, "dioxin") toxic equivalents (TEqs) on a wet weight basis for the dairy products ranged for 0.04 to 0.7 ppt, meat TEqs ranged from 0.03 to 1.5 ppt, and fish TEqs ranged from 0.02 to 0.13 ppt. Previous human breast milk and infant formula analyses were used with the current preliminary food data to estimate a range of dioxin intake for Americans. Average daily food intake of TEqs for an adult weighing 65 kg was estimated to be between 0.3 and 3.0 pg/kg body weight, for a total of 18-192 pg TEq, using 1986 American consumption rates. Due to the relatively high level of PCDDs and PCDFs commonly found in human breast milk from American women and from women in other industrial countries, a nursing infant may consume an average of 35-53 pg TEq/kg body weight/day in its first year of life. This may be compared with the current U.S. EPA virtually safe dose of 0.006 pg TCDD/kg body weight per day over a 70-year lifetime based on an upper limit cancer risk of 10(-6), or the 10 pg/kg/day used by some European government agencies.     

Development of the role of occupational health nursing in the U.S. and future perspectives in the U.S. and Japan

From 1988 to 1995, a bronchial washing was performed on 118 cases of middle lobe syndrome at the National Himeji Hospital. Twenty cases (16.9%) were positive for Mycobacterium avium complex (MAC). All cases were middle-aged (mean age 54.8), non-smoking women. Fourteen cases were asymptomatic and showed only abnormal shadow on chest X-ray film, while others complained cough, sputum or hemosputum. CT examinations were done on 13 patients, and pulmonary infiltrations were found in addition to right middle lobe or lingula in many cases. It is important to note that MAC infection might be one of causes of middle lobe syndrome.     

ISO 9000 and the U.S. Construction Industry

ISO 9000, the series of quality management standards issued by the International Organization for Standardization, is being used by organizations involved in construction all over the world. The construction industry in the United States has generally lagged behind other industries and other countries in the acceptance and implementation of ISO 9000 standards. Differing opinions surround the issue of ISO 9000 in the U.S. construction industry; it has received either the support or the criticism of experts, who weigh the effects of ISO 9000 as a matter of real improvements in quality against competitiveness and specific requirements at a domestic and international level. This paper attempts to determine the applicability and effectiveness of ISO 9000 in U.S. construction firms and the barriers that hinder its acceptance. The methodology used consists of a literature review and a survey distributed to a sample of firms that have or have not received ISO 9000 certification. After analyzing the gathered data, it was concluded that ISO 9000 is an appropriate and effective tool for construction firms in the United States, although several obstacles affect its implementation and acceptance among construction organizations.     

Smearing the opposition: Implicit and explicit stigmatization of the 2008 U.S. Presidential candidates and the current U.S. President.

Four studies investigated whether political allegiance and salience of outgroup membership contribute to the phenomenon of acceptance of false, stigmatizing information (smears) about political candidates. Studies 1–3 were conducted in the month prior to the 2008 U.S. Presidential election and together demonstrated that pre-standing opposition to John McCain or Barack Obama, as well as the situational salience of differentiating social categories (i.e., for Obama, race; for McCain, age), contributed to the implicit activation and explicit endorsement of smearing labels (i.e., Obama is Muslim; McCain is senile). The influence of salient differentiating categories on smear acceptance was particularly pronounced among politically undecided individuals. Study 4 clarified that social category differences heighten smear acceptance, even if the salient category is semantically unrelated to the smearing label, showing that, approximately 1 year after the election, the salience of race amplified belief that Obama is a socialist among undecided people and McCain supporters. Taken together, these findings suggest that, at both implicit and explicit cognitive levels, social category differences and political allegiance contribute to acceptance of smears against political candidates. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Violence and U.S. regional culture.

The US South, and western regions of the US initially settled by Southerners, are more violent than the rest of the country. Homicide rates for White Southern males are substantially higher than those for White Northern males, especially in rural areas. But only for argument-related homicides are Southern rates higher. Southerners do not endorse violence more than do Northerners when survey questions are expressed in general terms, but they are more inclined to endorse violence for protection and in response to insults. Southern Ss responded with more apparent anger to insults than did Northerners and were more likely to propose violent solutions to conflicts presented in scenarios after being insulted. The social matrix that produced this pattern may be the culture of honor characteristic of particular economic circumstances, including the herding society of the early South. Consistent with this possibility, the herding regions of the South are still the most violent. (PsycINFO Database Record (c) 2010 APA, all rights reserved)