Genetic screening technology: ethical issues in access to tests by employers and health insurance committees

Whereas the introduction of new technologies previously has raised the ethical question of who ought to have access to a new procedure or device, genetic testing technology raises the new ethical question of to whom access to a new technology ought to be limited. In this article we discuss the implications of employers and private health insurance companies having access to genetic testing technology. Although there may be legitimate business interests in allowing employers and insurers to conduct genetic screening, there are other valid societal interests in regulating or limiting the use of this technology by third parties. Public policy developed in the area of new genetic technology must reflect such interests.     

The administrative costs of non-profit health insurers

Interest in the efficiency or inefficiency of non-profit firms has spawned research on the administrative costs of Blue Cross and Blue Shield plans. Relying on plausible implications of the property rights theory of the firm, both Blair, Ginsburg, and Vogel (1975) and Vogel (1977) noted some evidence of inefficiency in these firms. Our analysis, however, utilizing their models and more recent data, reveals little convincing evidence for the view that Blue Shield plans are inefficient.     

A Model for Change: Legislative Advocacy to Improving Access for the Uninsured and Underinsured in New York State 1

Advocates can successfully improve access to health care for people without health insurance. This article demonstrates the success of what began as a local advocacy effort to improve access to health care on Long Island, which later grew to become a major statewide advocacy movement. It explores the process taken by local coalition members to successfully fight for monumental public health legislation—first locally then statewide—to improve access to hospital care for the medically indigent. Using New York State as a model, it includes several approaches that could facilitate the enactment of legislation in other states. The experiences of New York advocates suggest that with focused collaborative efforts it is feasible to promote significant changes to public health laws to benefit the uninsured and underinsured.     

Recent Changes in Male Income*

This paper explicitly defines two perspectives for investigating change: the longitudinal and the cross-sectional. After examining changes in male income between 1950 and 1970 by following cohorts through time, we identify a pattern of income changes with age which is quite different from that obtained in a cross-sectional analysis. On a longitudinal basis, it is evident that as men age to the retirement years that their income continually increases. A cross-sectional analysis leads to the conclusion that there is a decline in income during the latter working years. Two simple models (using change in the cost of living and productivity levels) are offered to help account for the patterns of income change. Although adjustments for varying costs of living and productivity levels slightly alter the pattern the two substantially different conclusions are not changed to any great degree. The implications of these conflicting statements are discussed.     

Foresight Study on the Risk Governance of New Technologies: The Case of Nanotechnology

Technology‐led innovation represents an important driver of European economic and industrial competitiveness and offers solutions to societal challenges. In order to facilitate responsible innovation and public acceptance, a need exists to identify and implement oversight approaches focused on the effective risk governance of emerging technologies. This article describes a foresight study on the governance of new technologies, using nanotechnology as a case example. Following a mapping of the governance landscape, four plausible foresight scenarios were developed, capturing critical uncertainties for nanotechnology governance. Key governance elements were then stress tested within these scenarios to see how well they might perform in a range of possible futures and to inform identification of the strengths, weaknesses, opportunities, and threats for nanotechnology governance in Europe. Based on the study outcomes, recommendations are proposed regarding the development of governance associated with the responsible development of new technologies.     

Attention-deficit/hyperactivity disorder–specific stimulant misuse,mood, anxiety,and stress in college-age women at high risk for or with eating disorders

ABSTRACT

Objective: To examine the misuse of attention-deficit/hyperactivity disorder (ADHD)-specific stimulants in a college population at high risk for or with clinical or subclinical eating disorders. Participants: Four hundred forty-eight college-age women aged 18–25 at high risk for or with a clinical or subclinical eating disorder. Methods: Participants completed assessments of stimulant misuse and psychopathology from September 2009 to June 2010. Results: Greater eating disorder pathology, objective binge eating, purging, eating disorder–related clinical impairment, depressive symptoms, perceived stress, and trait anxiety were associated with an increased likelihood of stimulant misuse. Subjective binge eating, excessive exercise, and dietary restraint were not associated with stimulant misuse. Conclusions: ADHD-specific stimulant misuse is associated with eating disorder and comorbid pathology among individuals at high risk for or with clinical or subclinical eating disorders. Screening for stimulant misuse and eating disorder pathology may improve identification of college-age women who may be engaging in maladaptive behaviors and inform prevention efforts.     

A functional classification of metropolitan communities

Five major approaches to the functional classification of communities have been offered. Although most of them allow the recognition of a community as specialized in more than one function, their application necessitates consideration of the several individual functions one at a time. This paper offers a method for classification that takes account of the entire configuration of selected functions. Eight industrial groups were used in determining which SMSA’s of 1960 had similar configurations of functional activity. The procedure for determining this similarity, which reduced the job to a manageable size, is described as are the distinguishing functional configurations.