Between EU Requirements, Competitive Politics, and National Traditions: Re–creating Regions in the Accession Countries of Central and Eastern Europe

The article studies the impact of the European Union (EU) on the reforms of regional administration in Central and East European (CEE) accession countries. It analyzes the motives, process and outcomes of regional– or mesolevel administrative reforms in five countries—Bulgaria, the Czech Republic, Hungary, Poland, and Slovakia—considering whether the EU has shaped these reforms to a higher degree than in relation to its incumbent member states. The article finds that the EU Commission's interest in regional self–governments with a substantial fiscal and legal autonomy has provided an additional rationale and an incentive to re–create regional self–governments. Advocates of regional self–government and an institutionalization of regions in the accession countries have referred to European trends and (perceived) EU expectations of regionalization. Thus, the Commission and the preaccession framework have become catalysts for a process in which most CEE regions have already enhanced and will further increase their political salience. However, the trajectories and outcomes of regional–level reforms can be better explained by a combination of domestic institutional legacies, policy approaches of reformers and their adversaries, and the influence of ethnic/historical regionalism.     

New Labour and Government in Britain: Change or Continuity?

The 1997 British election marks a major change in British government. Eighteen years of Conservative rule had brought about growing inequality and social division and have generated powerful demands for new directions in public policy, especially in the areas of welfare and public administration. On welfare state reform Labour is constrained by election promises to restrain taxation and public expenditure. New Labour ministers influenced by the New Right have in any case largely rejected traditional social democratic redistributive strategies and are seeking instead new ways of reducing welfare dependency.
The virulent spread of quangos at all levels of government and a marked increase in the centralisation of power in Whitehall have given a new impetus to demands for constitutional reform. Labour's response to these demands is a major program of regional devolution, House of Lords reform and open government measures.
This article explains what 'New Labour' means and discusses New Labour policies on welfare and constitutional reform and their implications for the future of public administration in Britain.     

Social Support, Risk-Level and Safety Actions Following Acute Assessment of Suicidal Youth

The purpose of the pilot study was to examine the interrelationship between social support, risk-level, and safety actions for 2 groups of suicidal adolescents (50 attempters and 50 ideators), who had presented for an acute assessment at an outpatient mental health service. A social support model was proposed in which it was thought that information related to patients' social support would impact upon the types of risk-level and safety actions made by clinicians. Data was collected from a total of 100 patient files, utilizing the acute assessment reports (e.g., reports assessing risk of self-harm). Findings show that groups differed significantly on indices of negative support severity, positive support, and risk-level. Limited support was found for the proposed social support model. Limitations and implications for future research are discussed.     

Arterial-esophageal fistulae in patients requiring nasogastric esophageal intubation

A rare and potentially fatal cause of hematemesis is fistula formation between the esophagus and the vascular system. A case report of a 39-year-old woman with congenital aortic arch anomalies hospitalized for treatment of head injuries demonstrates the potential for iatrogenic esophageal trauma to initiate fistula formation between the esophagus and an anomalous arterial system. A literature review revealed 6 other cases of vascular-esophageal fistulae caused by nasogastric esophageal intubation. It is concluded that aortic arch anomalies increase the risk of esophageal injury and subsequent fistula formation from nasogastric esophageal intubation. In addition, the clinical features and pathologic findings of vascular-esophageal fistulae are reviewed.