Political tolerance and stages of moral development: A conceptual and empirical alternative

The latest revisionism in the study of political tolerance has produced some of the most provocative well-designed research in the field of political science. In particular, the work by Sullivan, Piereson, and Marcus offers one of the most fully specified and rigorously executed models of public opinion formation. Yet this contemporary revisionism is flawed. This paper argues that these researchers misconceptualize tolerance, that this misconception contaminates their measurement process, that the resulting model is misspecified, and that the political conclusions offered are not supported in fact or principle. More generally this paper argues that the field of public opinion as a whole has been trapped by limited conceptions about the nature of cognitive constraint and by simplistic and inadequate methods for measuring and identifying this constraint. To remedy this, a developmental measure of cognitive moral stages is fashioned along lines suggested by Kohlberg. This measure satisfies a number of tests for both validity and reliability and appears to be one of the most powerful predictors of tolerance and intolerance — if not the most powerful single predictor.     

Death resulting from ruptured cerebral artery aneurysm: 219 cases

To characterize the demographics of ruptured cerebral artery aneurysm as a cause of death and to examine the effect of improved diagnostic and therapeutic techniques on the incidence of sudden death associated with the condition, the authors reviewed 219 autopsies performed at the Dallas County Medical Examiner's Office between 1977 and 1997 in which the cause of death was ruptured cerebral artery aneurysm. Ruptured cerebral artery aneurysms accounted for 1.5% of 15,033 natural deaths and 0.4% of all deaths (45,492) followed by autopsy during this period. The majority (56%) of cases occurred in females, with Caucasian females composing the largest group (38%). Seventy-seven percent of cases occurred in individuals between the ages of 31 and 70 years, with the highest concentration in the 41- to 50-year decade (29%). The most common location for ruptured aneurysms was the middle cerebral artery distribution (39%). Multiple aneurysms occurred in 22 (9.1%) cases. Other factors, such as medical history, coexisting disease, symptoms, activity at onset of symptoms, survival time, and toxicology results are also presented. Compared with literature reports before 1980, when ruptured cerebral artery aneurysms were reported as the cause of death in approximately 4% to 5% of sudden natural deaths, the results of this study suggest that despite improved diagnostic and therapeutic techniques during the past two decades, morbidity and mortality from ruptured aneurysms remain a significant health problem.     

Systems Ideologies and Street-Level Bureaucrats: Policy Change and Perceptions of Quality in a Behavioral Health Care System

This article examines the stability of street-level bureaucrats' negative perceptions regarding a newly implemented managed care system on quality of care and service delivery in a publicly funded behavioral health care system. Overall findings indicate that the generally negative perception of managed care did not differ between staff in the two programs, indicating a weak effect on attitudes of frontline workers. More proximal variables to the caregiver, such as service type and job title, show more influence on attitudes. The conclusion discusses the implications of these findings for practicing administrators and academic researchers.