Drugs, Thugs, and the Diablos Rojos: Perils and Progress in Panama
In many ways, Panama has come into its own. Its running of the Panama Canal is indisputably successful, its post-Noriega elections appear to be relatively corruption free, the multibillion dollar expansion of the Canal and the modernization of its transportation system are in full swing—all ostensibly signs of a developed country, but appearances can be deceiving. Dig deeper, and perils emerge: an increase in gangs and drug trafficking, a huge disparity between the wealthy and the poor, and an emerging threat to democracy. Examining these perils and progress demonstrates that Panamanians do not yet enjoy full citizenship; instead, “client-ship” still dominates.
Procedural Justice and the Discursive Construction of Narratives at Trial
The structure and practices of justice systems in many parts of the world are undergoing what can be seen as a kind of revolution – and one not merely of professional interest to lawyers and judges. What we are seeing in nation after nation is a move from inquisitorial models of legal adjudication toward adversarial models. The discourses of adjudication in these contrasting types of trials are changing the ways in which lawyers, judges, and witnesses come to see their role in the process. The change has implications that extend far beyond the courtrooms in which trials play out, however. Because the shift from inquisitorial to adversarial justice models determines how legal narratives are created and deployed in trials, this change has the potential to impact popular perceptions of legal legitimacy, which in turn has implications for the relationship of citizens to their government and justice systems. This article will detail the global character of this change in the nature of the discourse used in legal adjudication and will explore its potential ramifications for legal professionals and for society more generally.
Study on essential drug use status and its influencing factors among cerebral infarction inpatients in county level hospitals of Anhui Province, China
Background and purpose Drug costs is one of the main components of hospitalization expenditure for cerebral infarction inpatients. In China, the National Essential Medicine System (NEMS) was created to relieve the heavy drug-cost burden for patients. The objective of this study was to investigate essential drug-use status and its influencing factors among cerebral infarction inpatients in county-level hospitals of Anhui province, China. Methods Three county-level hospitals were selected through a multi-stage cluster random sampling method. The hospitalization cost data of cerebral infarction inpatients in the three hospitals were extracted from the Anhui provincial information platform of the New Rural Cooperative Insurance System (NCMS), and whether the proportion of essential drug cost in the total drug cost reached the median value of 33.05% which was set as the evaluation index for essential drug-use status. Questionnaires for hospitals and physicians were designed and given to them to assess influencing factors. Results We retrieved the cost data of 2,189 inpatients from the NCMS platform and investigated 51 corresponding physicians in total. The drug costs accounted for 52.6% of the total hospitalization cost, and essential drug costs alone accounted for 37.0% of the total drug costs. The essential drug-cost proportion was high among physicians with a higher recognition degree on NEMS, older age, lower final academic degree, longer work experience and lower professional title. Married physicians and those with tight organizational affiliation also prescribed more essential drugs. Conclusions Increasing the proportion of essential drugs was an effective way to reduce the disease burden for cerebral infarction patients. Perfecting the NEMS, increasing government investment, reinforcing education and propaganda, and formulating relevant incentive and restrictive mechanisms were all effective ways to promote and increase the number of essential drug prescriptions written by physicians.