Risk Adjustment Under the Affordable Care Act: A Guide for Federal and State Regulators

Summarizes discussions from a conference about the consequences of the 2010 healthcare reform's risk adjustment provisions, design and implementation challenges, and the merits of various risk adjustment strategies. Recommends diagnostic risk measures

The Defensive Effect of Medical Practice Policies in Malpractice Litigation

The theoretical prospects for medical practice policies to reform malpractice law by giving conclusive defensive effect to medical custom were studied. A practice policy, however rigorous, is of no use if the nature of the claimed error is either incorrect performance of the treatment in question or failure to recognize the correct practice policy to employ by virtue of a falure in diagnosis

Neoliberalism and primary education: Impacts of neoliberal policy on the lived experiences of primary school communities

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.This special issue of Power and Education analyses the ways neoliberal policy agendas inflect and infect primary school communities. In recognising that ‘schools are complex and sometimes incoherent social assemblages’, this widened perspective – beyond a customary focus on just pupils and teachers – marks the particular contribution of the Special Issue. In examining how neoliberal logics thread through and organise relations between parts of primary school communities, the collection enables a critical view of the factious contemporary socio-political landscape through the lens of primary schooling. In doing so, the varied papers address what Piper and Sikes suggest are central concerns of the Power and Education journal: to interrogate ‘the general and specific imposition of crude discourses of neoliberalism and managerialism; the need to analyse carefully what is happening in particular contexts; and the possibility of constructing resistance and concrete alternatives’. Under scrutiny here is the evolution of a new educational ecosystem that reflects a re-engineering of the primary schooling terrain. This terrain might once have been characterised by the aims of nurturing children intellectually, emotionally and culturally, so that they can become socially aware, confident and critical citizens, actively able to contribute to communities that are inclusive and socially just. As these aims are re-engineered, their contested evolution can be witnessed in the tensions between: first, specific stakeholder groups like parents or teachers organising against curricula they view as dominated by metrics that damage self-actualisation; and second, policy intentions that stress the importance of security, safety and happiness. This is a crucial area of struggle, precisely because learning is increasingly governed by discourses of human capital and efficiency, where new school governance structures and tangible re-workings of teachers’ priorities have emerged to re-shape a vision of primary education. Are the proposed outcomes holistic child development with a capacity to stimulate community-oriented social justice, or productive, long-term economic activity, or something else? In this special issue, a range of authors seek to place primary educational policy in the global North in relation to the concrete experiences of teachers, senior leaders, parents, children and community members. The purpose of this is to reveal the tensions that erupt between policy drivers for productivity, human capital, efficiency, excellence and so on, in effect policy drivers for-value, against the impetus for education to frame humane values. One core terrain in which such tensions are played out is the school, and yet the school is more than a simple set of linear relationships. Such relationships emerge at the intersection of, for instance, family and caring responsibilities, educational engagements, faith-based interactions, racialized or gendered asymmetries, the public and the private, the communal and the corporate. As such, the definition and co-option of the idea of the school as a community or the school community is complex. In this collection, we seek to highlight this complexity and to demonstrate how the concrete, lived experiences of groups inside primary schools are affected by specific flavours of policy

Longing for the light: darkness, dislocation and spaces of exile

There have been many studies of light and this paper acknowledges all of the scholarship that goes before, however, this is not a study of light but a study of how light defines perceived identity and how our relationship to it in turn defines our own sense of self. I shall be examining work from different areas of the arts, literature, photography and film to develop my argument, showing how writers and artists have located both the subject and the reader/viewer to exploit this dynamic. Light, as Foucault reminds us, became the most visible symbol of those that, during the Enlightenment, sought to banish darkened spaces and create a visible society. This led eventually to Bentham’s design for the Panopticon which became a model of “‘power through transparency’, [and] subjection through ‘illumination’” which, as Foucault points out, could serve as a template for other areas of society where visibility was a necessary adjunct to other forms of more physical control (the police or the army). Light itself, defines space, sets its visible limits, reveals, creates and, as I shall show, establishes identities. Where one positions oneself, in relation to the light, depends on a number of factors and determines the limits of inclusion into what we may term civilized society. This paper sets out to look at instances where both spatial and individual identity is established through the position in which the subject is placed in relation to the light and its source

Deliberate ignorance in project risk management

The management of project risk is considered a key discipline by most organisations involved in projects. Best practice project risk management processes are claimed to be self-evidently correct. However, project risk management involves a choice between which information is utilized and which is deemed to be irrelevant and hence excluded. Little research has been carried out to ascertain the manifestation of barriers to optimal project risk management such as 'irrelevance'; the deliberate inattention of risk actors to risk. This paper presents the results of a qualitative study of IT project managers, investigating their reasons for deeming certain known risks to be irrelevant. The results both confirm and expand on Smithson's [Smithson, M., 1989. Ignorance and Uncertainty. Springer-Verlag, New York] taxonomy of ignorance and uncertainty and in particular offer further context related insights into the phenomenon of 'irrelevance' in project risk management. We suggest that coping with 'irrelevance' requires defence mechanisms, the effective management of relevance as well as the setting of, and sticking to priorities. (C) 2009 Elsevier Ltd and IPMA. All rights reserved

Safety Engineering with COTS components

Safety-critical systems are becoming more widespread, complex and reliant on software. Increasingly they are engineered through Commercial Off The Shelf (COTS) (Commercial Off The Shelf) components to alleviate the spiralling costs and development time, often in the context of complex supply chains. A parallel increased concern for safety has resulted in a variety of safety standards, with a growing consensus that a safety life cycle is needed which is fully integrated with the design and development life cycle, to ensure that safety has appropriate influence on the design decisions as system development progresses. In this article we explore the application of an integrated approach to safety engineering in which assurance drives the engineering process. The paper re- ports on the outcome of a case study on a live industrial project with a view to evaluate: its suitability for application in a real-world safety engineering setting; its benefits and limitations in counteracting some of the difficulties of safety en- gineering with COTS components across supply chains; and, its effectiveness in generating evidence which can contribute directly to the construction of safety cases

James Wilson: Presbyterian, Anglican, Thomist, or Deist?: Does it Matter? (Chapter 7 of The Founders on God and Government)

Excerpt: James Wilson is buried in America\u27s Westminster Abby-Christ Church, Philadelphia. This Anglican church is only blocks away from the First Presbyterian church in Philadelphia, where Wilson rented a pew until the end of his life. Some scholars report that Wilson joined the Anglican Communion in 1778, perhaps at the behest of one his best friends, William White, the first Anglican bishop of Philadelphia. Others claim he that never abandoned the Presbyterianism of his native Scotland. Still others pay no attention to his denominational commitments, arguing that he was actually a Thornist or a deist. Finally, some scholars say nothing about his religious identification or beliefs, apparently concluding that these things are unrelated to his political and legal accomplishments

Madison’s Memorial and Remonstrance, Jefferson’s Statute for Religious Liberty, and the Creation of the First Amendment

Jurists, scholars, and popular writers routinely assert that the men who framed and ratified the First Amendment were influenced by James Madison’s Memorial and Remonstrance (1785) and Thomas Jefferson’s Statute for Religious Liberty (1786). In this essay I demonstrate that there is little evidence to support these claims. Because these documents represent only one approach to church-state relations in the era, jurists and others who believe that the religion clauses should be interpreted in light of the founders’ views need to look well beyond these texts if they want to understand the First Amendment’s “generating history.