Finding audiences, changing beliefs: the structure of research use in Canadian health policy

The impact of research information depends on its ability to change beliefs or policy assumptions within the relevant audiences. As a hybrid of American and British systems, Canada's chosen decision-making structure for policy-making and its legislative framework for health insurance make these audiences unclear and not readily accessible. This factor and historical characteristics of the research community which made them only partially responsive to the values of decisionmakers provide an explanation for the limited past use of research information in Canadian health policy. More recently, improved responsiveness by researchers and an emerging definition of the audiences by legislative policymakers are bringing about a gradual increase in the potential impact of research at the levels of administrative and clinical policy. Because of continuing decision-making constraints on legislative policy, however, impact at this level is predicted to remain diffuse, with only cautious acceptance of the changes in beliefs implied by research.     

Chronic disease and disadvantage: the new politics of HIV infection

HIV infection is now perceived as the end stage of a chronic disease that is spreading most rapidly among blacks and Hispanics. The politics of the HIV epidemic in the 1980s were dominated by four interacting factors: fear and fascination; who had the disease and to whom it seemed to be spreading; the endemic problems of United States social policy; and the impact on policy of advances in scientific knowledge. This paper analyzes the political history of each of these factors and describes the dominant policies of the federal government and the states regarding HIV in the areas of surveillance, prevention, research, and financing. Four uncertainties will have a profound influence on the future politics of the HIV epidemic: how the states and the federal government will address the general problems of paying for the care of people with chronic diseases and providing access to care for the uninsured and the underinsured; the number and distribution of the sexual behaviors that transmit infection with HIV and the effectiveness of policies to persuade people to modify these behaviors; precisely who uses addictive drugs and the effectiveness of measures to change their behavior; and the natural history of the virus.     

Chinese democracy: The lessons of failure

China's experiments with democracy in this century were few in number, short in duration, and limited in their democratic characteristics. Democratic institutions malfunctioned in numerous ways. Nine sets of causes for the failure of Chinese democracy can be suggested: ideology, internal and external war, military intervention, Chinese political culture, underdevelopment, a peasant mass, flaws in the design of Chinese constitutions, moral failures by democratic politicians, or the lack of transactional benefits for military‐based elites in the process of democratic transition. Each of these factors is reviewed critically with an eye to its possible lessons.     

Sudden death in angiodysplasia of the gastroesophageal junction.

A 22-year-old Korean soldier, who had received blows to the neck and epigastrium from an officer 10 h earlier, suddenly died after massive hematemesis. He had been in relatively good health except for episodes of blood-tinged vomiting approximately 5 and 7 months prior to this event. Postmortem examination revealed angiodysplasia involving the gastroesophageal junction, and the stomach was distended with blood. No abnormal findings were present around the whole viscera, and the duodenum was free of blood. The pathologic significance of upper gastrointestinal angiodysplasia as a potential source of bleeding and a chronologic correlation between the trauma and bleeding are discussed.     

The DutchAlgemene Rekenkamer and its role in light of contemporary theory

European Journal of Law and Economics - In this article I try to find answers for three questions: Which functions are exercised by the Court of Audit in the Netherlands, and what kinds of...     

Preadolescent peer friendships: A critical contribution to adult social relatedness?

The primary aim of this paper is to review the literature on preadolescent friendships in order to examine the relationship between preadolescent friendships and social support in adulthood. Social supports are important to health, both directly and as a stress buffer. Few studies, however, have specifically examined adult social supports from the perspective of their developmental precursors and critical developmental periods. Some data indicate that the preadolescent period may be of particular importance to the development of adult social skills and ties. Observational and empirical studies of preadolescent peer relationships, and in particular best friendships, suggest unique and critical contributions to adult social relatedness. Present research is suggestive but is insufficient to validate preadolescence as a critical period in adult social relatedness. Our review has implications for better understanding the mechanisms by which preadolescent friendships effect adult social support—an important mediator of the effects of stress on health. Further longitudinal study is needed.Received Ph.D. from University of Maryland. Research interests are social supports and psychological responses to trauma and disaster.Received M.D. from Yale University. Research interests are social supports and traumatic stress.