Factors moderating physical and psychological symptoms of battered women

Physical and psychological symptoms of battered women were investigated based on the theory that their ongoing victimization would produce stress-related symptoms. It was hypothesized that moderating variables (e.g., frequency and severity of abuse, predictability and controllability of abuse, social support networks) would influence the effects of abuse. Battered women (N = 234) were interviewed according to a structured format which allowed for behavioral indices of the data and categorization of the women's responses. Results indicated that frequency of abuse was a strong predictor of the number and severity of symptoms. Those women who could predict abuse experienced more symptoms. Severity of physical and psychological symptoms was predicted by a model including women with more injuries requiring medical attention, women adhering to traditional sex role values, and the presence of one type of emotional abuse. Battered women perceived their physical and emotional health as deteriorating during the relationship and during the abuse, but as getting healthier after the abuse ended. Future research needs to replicate these findings with a representative group of battered women who are still in the battering relationship.     

Fostering rational regulation of patient safety

After decades of inattention to the problem of medical injuries, patient safety is now occupying a prominent place on the health policy agenda and garnering renewed regulatory interest. Health care providers' behavior, with respect to patient safety and health care quality improvement, is now being shaped by top-down regulation through statutes and administrative agency oversight, as well as bottom-up drivers such as tort litigation and the forces of the consumer-driven health care market. Patient safety today exemplifies that eclectic mix of regulation that can occur when a new problem is exposed to the general public; it also demonstrates the difficulties of coordinating regulatory signals from multiple sources and regulating incomplete information. This article reviews the evolution of the regulatory environment for patient safety, examines some of the tensions and challenges that currently define patient safety oversight, and suggests strategies for more rational and responsive regulation.     

An Implicit Contract Theory of Intergovernmental Grants

A central puzzle in the economic analysis of intergovernmentalgrants in a federal polity is the conflict between the predictionsof the standard theory and empirical observation. Standard theoryhas no explanation for the widely observed fact that "moneysticks where it hits," that is, for the "flypaper effect" fromspecific, non-matching grants. This effect is observed whengrants that apparently are the economic equivalents of generalrevenue grants have the consequences to be expected from matchingspecific grants. We propose a resolution. Most grants are accompaniedby an implicit as well as an explicit contract between grantorand recipient. The purpose of these contracts is to influencethe behavior of the recipient, by making the size of the streamof grants conditional upon the recipient's responses to thewishes of the donor.     

Discovering Directions for Change in Higher Education Through the Experiences of Senior Women Faculty

The Women in Science and Engineering Leadership Institute (WISELI) at the University of Wisconsin–Madison, an NSF-funded ADVANCE Institutional Transformation project, employed the “discovery interviews” method to characterize the experiences of senior women faculty in science and engineering on campus. This method allowed WISELI to reach its aims of (1) gaining information from senior women that would inform the programs developed by WISELI, and (2) building relationships among the senior women and WISELI. The discovery interview process also had some unintended consequences, including creation of an expectation of advocacy that exceeded the original intent of the project. This method was well-matched to the needs of WISELI as a change agent at the UW-Madison, and has contributed a great deal to its Institutional Transformation efforts, primarily by changing WISELI’s perceptions of what leadership means to senior women faculty.