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Black and Hispanic patients infected with the HIV virus are less likely than whites to participate in clinical studies of new treatments or to receive experimental drugs, according to the first study that has used nationally representative data to examine such disparities. Moreover, underrepresentation of blacks and Hispanics in HIV treatment studies becomes a concern for the applicability of the clinical research to patients in the general population.The findings indicate that people with HIV infection overall are much more likely to get experimental treatments than are people with other diseases, such as cancer or heart disease. Because AIDS treatment is evolving rapidly and because the virus often develops resistance to approved drugs, AIDS activists have lobbied successfully to expand access to new medicines. An estimated 14 percent of the approximately 231,000 adults treated for HIV infection in 1996 participated in a clinical trial, and 24 percent had taken an experimental drug, the study found. Only 4 percent of adults with cancer who are less than 50 years old participate in clinical trials.But the results suggest marked racial and ethnic disparities in access to experimental HIV treatment. Blacks made up only 23 percent of clinical study participants but constituted 33 percent of adults receiving HIV care. Similarly, 11 percent of study participants, but 15 percent of HIV-infected patients nationally, were Hispanic. In contrast, whites made up 62 percent of participants in HIV trials, yet represented only 49 percent of adults receiving HIV care.The research team studied a nationally representative sample of 2,864 adults in the 48 contiguous United States who were receiving care for HIV infection in 1996. They interviewed participants three times between 1996 and 1998, asking about their participation in studies, their use of experimental drugs and other personal data, including such factors as their trust of doctors and desire to participate in decisions about treatment. The researchers found that, in addition to being black or Hispanic, several other factors also reduced patients" likelihood of participating in a clinical trial. They included having less than a high school education, belonging to a health maintenance organization (HMO), and living eight or more miles from a major research hospital. Patients who were white, who were highly educated or who received their health care close to a research center were more likely than others to get experimental drugs.In an editorial accompanying the study, Talmadge E. King of San Francisco General Hospital suggested that racial and ethnic disparities in access to experimental treatment may reflect "barriers at the level of the patient, the physician, the institution and the community." Doctors may harbor unconscious prejudices toward blacks or Hispanics, he suggested. Patients may be mistrustful or fear that participating in a study will threaten their autonomy. Researchers studying new treatments for drug companies may avoid enrolling members of minorities "because they believe that poor compliance is common in these groups." The word "disparities" in the first paragraph probably means "______"
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Many states have gone on prison-building sprees, yet the penal system is choked to bursting. To ease the pressure, nearly all convicted felons are released early—or not locked up at all. "About three of every four convicted criminals," says John DiIulio, a noted Princeton criminologist, "are on the streets without meaningful probation or parole supervision." And while everyone knows that amateur thugs should be deterred before they become career criminals, it is almost unheard-of for judges to send first- or second-time offenders to prison.Meanwhile, the price of keeping criminals in cages is appalling—a common estimate is $30,000 per inmate per year. (To be sure, the cost to society of turning many inmates loose would be even higher.) For tens of thousands of convicts, prison is a graduate school of criminal studies: They emerge more ruthless and savvy than when they entered. And for many offenders, there is even a certain cachet to doing time—a stint in prison becomes a sign of manhood, a status symbol.But there would be no cachet in chaining a criminal to an outdoor post and flogging him. If young punks were horsewhipped in public after their first conviction, fewer of them would harden into lifelong felons. A humiliating and painful paddling can be applied to the rear end of a crook for a lot less than $30,000—and prove a lot more educational than 10 years" worth of prison meals and lockdowns.Are we quite certain the Puritans have nothing to teach us about dealing with criminalsOf course, their crimes are not our crimes: We do not arrest blasphemers or adulterers, and only gun control fanatics would criminalize the sale of weapons to Indians. (They would criminalize the sale of weapons to anybody.) Nor would the ordeal suffered by poor Joseph Gatchell—the tongue "pierce through" with a hot poker—be regarded today as anything less than torture.But what is the objection to corporal punishment that doesn"t maim or mutilate Instead of a prison term, why not sentence at least some criminals—say, thieves and drunk drivers—to a public whipping"Too degrading," some will say. "Too brutal." But where is it written that being whipped is more degrading than being caged Why is it more brutal to flog a wrongdoer than to throw him in prison—where the risk of being beaten, raped, or murdered is terrifyingly highThe Globe reported in 1994 that more than 200,000 prison inmates are raped each year, usually to the indifference of the guards. "The horrors experienced by many young inmates, particularly those who ... are convicted of nonviolent offenses," former Supreme Court Justice Harry Blackmun has written, "border on the unimaginable." Are those horrors preferable to the short, sharp shame of corporal punishmentPerhaps the Puritans were more enlightened than we think, at least on the subject of punishment. Their sanctions were humiliating and painful, but quick and cheap. Maybe we should readopt a few. A "cachet" is ______
The mental health movement in the United States began with a period of considerable enlightenment. Dorothea Dix was shocked to find the mentally ill in jails and almshouses and crusaded for the establishment of asylums in which people could receive humane care in hospital-like environments and treatment which might help restore them to sanity. By the mid 1800s, 20 states had established asylums, but during the late 1800s and early 1900s, in the face of economic depression, legislatures were unable to appropriate sufficient funds for decent care. Asylums became overcrowded and prison-like. Additionally, patients were more resistant to treatment than the pioneers in the mental health field had anticipated, and security and restraint were needed to protect patients and others. Mental institutions became frightening and depressing places in which the rights of patients were all but forgotten.These conditions continued until after World War Ⅱ. At that time, new treatments were discovered for some major mental illnesses theretofore considered untreatable, and newspaper reports called attention to the plight of the mentally ill. Improvements were made and Dr. David Vail"s Humane Practices Program is a beacon for today. But changes were slow in coming until the early 1960s. At that time, the Civil Rights movement led lawyers to investigate America"s prisons, which were disproportionately populated by blacks, and they in turn followed prisoners into the only institutions that were worse than the prisons—the hospitals for the criminally insane. The prisons were filled with angry young men who, encouraged by legal support, were quick to demand their rights. The hospitals for the criminally insane, by contrast, were populated with people who were considered "crazy" and who were often kept obediently in their place through the use of severe bodily restraints and large doses of major tranquilizers. The young cadre of public interest lawyers liked their role in the mental hospitals. The lawyers found a population that was both passive and easy to champion. These were, after all, people who, unlike criminals, had done nothing wrong. And in many states, they were being kept in horrendous institutions, an injustice, which, once exposed, was bound to shock the public and, particularly, the judicial conscience. Patients" rights groups successfully encouraged reform by lobbying in state legislatures.Judicial interventions have had some definite positive effects, but there is growing awareness that courts cannot provide the standards and review mechanisms that assure good patient care. The details of providing day-to-day care simply cannot be mandated by a court, so it is time to take from the courts the responsibility for delivery of mental health care and assurance of patient rights and return it to the state mental health administrators to whom the mandate was originally given. Though it is a difficult task, administrators must undertake to write rules and standards and to provide the training and surveillance to assure that treatment is given and patient rights are respected. The new concerti for patients" rights is brought about mainly by ______
中国证监会自1992年10月成立以来，一直重视与境外监管机构的交流与合作，截至2008年3月，已相继与36个国家(或地区)的证券(期货)监管机构签署了39个监管合作备忘录。( )
The mental health movement in the United States began with a period of considerable enlightenment. Dorothea Dix was shocked to find the mentally ill in jails and almshouses and crusaded for the establishment of asylums in which people could receive humane care in hospital-like environments and treatment which might help restore them to sanity. By the mid 1800s, 20 states had established asylums, but during the late 1800s and early 1900s, in the face of economic depression, legislatures were unable to appropriate sufficient funds for decent care. Asylums became overcrowded and prison-like. Additionally, patients were more resistant to treatment than the pioneers in the mental health field had anticipated, and security and restraint were needed to protect patients and others. Mental institutions became frightening and depressing places in which the rights of patients were all but forgotten.These conditions continued until after World War Ⅱ. At that time, new treatments were discovered for some major mental illnesses theretofore considered untreatable, and newspaper reports called attention to the plight of the mentally ill. Improvements were made and Dr. David Vail"s Humane Practices Program is a beacon for today. But changes were slow in coming until the early 1960s. At that time, the Civil Rights movement led lawyers to investigate America"s prisons, which were disproportionately populated by blacks, and they in turn followed prisoners into the only institutions that were worse than the prisons—the hospitals for the criminally insane. The prisons were filled with angry young men who, encouraged by legal support, were quick to demand their rights. The hospitals for the criminally insane, by contrast, were populated with people who were considered "crazy" and who were often kept obediently in their place through the use of severe bodily restraints and large doses of major tranquilizers. The young cadre of public interest lawyers liked their role in the mental hospitals. The lawyers found a population that was both passive and easy to champion. These were, after all, people who, unlike criminals, had done nothing wrong. And in many states, they were being kept in horrendous institutions, an injustice, which, once exposed, was bound to shock the public and, particularly, the judicial conscience. Patients" rights groups successfully encouraged reform by lobbying in state legislatures.Judicial interventions have had some definite positive effects, but there is growing awareness that courts cannot provide the standards and review mechanisms that assure good patient care. The details of providing day-to-day care simply cannot be mandated by a court, so it is time to take from the courts the responsibility for delivery of mental health care and assurance of patient rights and return it to the state mental health administrators to whom the mandate was originally given. Though it is a difficult task, administrators must undertake to write rules and standards and to provide the training and surveillance to assure that treatment is given and patient rights are respected. All of the following contributed to the deterioration of the asylum system EXCEPT the ______
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