ROAD GRANTS, INTERGOVERNMENTAL COMPETITION AND THE BENEFITS OF DUPLICATION

Abstract: This article argues that direct commonwealth involvement in road funding and road policy has benefited the states and local government. Although inefficiencies and friction are evident as a result of joint funding, the benefits of multiple accountability outweigh the costs. A competitive dynamic underlies the involvement of all three levels of government, producing outcomes that no single government dominates, but which reflect in part the responses of each to their respective constituencies. The commonwealth has been driven to more intrusive forms of intervention as existing controls failed to achieve the commonwealth's objectives, and to expanding its financial contributions to counter the diversion of funds by state governments. Its commitment to funding the road program is likely to be highest when its specific purpose grants can be identified closely with the provision of roads in particular regions and localities. In sum, joint funding of the road program produces a system that is responsive to competing conceptions and interests, and the commonwealth's "voluntary vacancy" from all but "national" roads is on balance likely to be detrimental to the program.     

The social context of adolescent self-esteem

The global self-esteem of adolescents was examined in relation to two aspects of their daily lives: (a) the perceived quality of their relationships with parents and peers; and (b) their self-evaluation in the areas of school, popularity, and athletics. The quality of relationships with parents made significant contributions to the explained variance in self-esteem of both boys and girls. The quality of peer relationships made a significant additional contribution for girls but not boys. The importance of parent and peer relationships to self-esteem did not vary as a function of age for either sex. Self-evaluation of popularity was related to girls' global self-esteem, while evaluation of school performance was more important for boys.Received her Ph.D. from George Peabody College. Research interests include adolescent stress and coping, and parent-child relationships.Received his M.D. from Medical College of Georgia. Research interests include stress, eating disorders, and pregnancy in adolescents.     

Fatal salmonella aortitis with mycotic aneurysm rupture

Salmonellae most commonly cause uncomplicated cases of gastroenteritis but have a predilection for damaged blood vessels, especially those damaged by atherosclerosis. The abdominal aorta is most frequently affected. The most serious complication of aortitis is mycotic aneurysm formation with subsequent rupture. The authors present the case of a 61-year-old man who was found unresponsive at home 3 days after discharge from the hospital for treatment of gastroenteritis with bacteremia. Postmortem examination revealed a ruptured mycotic aneurysm with a large retroperitoneal hematoma. Numerous gram-negative rods were embedded in the wall of the aorta and surrounding inflammatory infiltrate, compatible with the patient's previously isolated. Whereas abdominal aortic aneurysm rupture is most commonly associated with atherosclerosis, the isolation of from blood cultures, coupled with radiographic evidence of gas surrounding the aorta, should raise the suspicion of infectious aortitis. Whereas fatal rupture of an aortic aneurysm secondary to atherosclerosis alone or in conjunction with aortitis will not have an impact on the manner of death, infections are reportable and thus have public health implications.     

The identification of sodium fluoroacetate (compound 1080) employing NMR spectroscopy

Nuclear magnetic resonance (NMR) spectroscopy was employed for the purpose of identifying samples of materials suspected of containing sodium fluoroacetate (Compound 1080). Acquisition of routine proton (1H) and carbon (13C) NMR spectra provided a straight-forward means for determining the presence of Compound 1080 in the samples and thus afforded a simple method for analysis and identification of this compound.     

What could be achieved with greater public hospital autonomy? Comparison of public and PNFP hospitals in Uganda

The policy of hospital autonomy has been discussed for some time in Uganda. There is little evidence from Uganda or elsewhere that increased autonomy will improve hospital performance. This article compares the performance of three private not‐for‐profit (PNFP) and public hospital pairs to address this question. PNFP and public hospitals have similar management structures but PNFP hospitals had better trained managers and a church affiliated chair in the hospital management committee. Both types have problems with personnel management but these appear more pronounced in public hospitals. Drug supply management appears better in PNFP hospitals. Overall, workloads are similar, but analysis of patterns of utilisation and prices across services suggest that patient choice of facilities is influenced by relative price levels, and that willingness to pay is higher for PNFP services. PNFP hospitals are more successful at generating revenue. There are no clear differences in efficiency between PNFP and public hospitals but there is some evidence of higher quality levels in PNFP hospitals. PNFP hospitals' performance is plausibly related to three areas of managerial autonomy. First, better management of drug supply is facilitated by their freedom to purchase drugs from the open market. Second, greater success with personnel management is plausibly related to their greater autonomy over staffing. Third, higher levels of cost recovery are enabled by their freedom to set fees. However, differences in accountability and competence of hospital management, and population willingness to pay for services may also help to explain differences. Further, the use of PNFP financing strategy by public hospitals has implications for universal access to hospital services. Although there appear to be potential advantages from greater public hospital autonomy, the Ugandan government should ensure it has developed strategies to enhance public hospital management and to protect access to public hospitals before advancing further with hospital autonomy policy. Copyright © 2002 John Wiley & Sons, Ltd.     

Labor Reform and Dual Transitions in Brazil and the Southern Cone

The sequencing of transitions to democracy and to a market economy shaped the outcome of labor law reform and prospects for expanded labor rights in Argentina, Brazil, and Chile. Argentina and Brazil experienced democratic transitions before market economic reforms were consolidated in the 1990s. During the transition, unions obtained prolabor reforms and secured rights that were enshrined in labor law. In posttransition democratic governments, market reforms coincided with efforts to reverse earlier labor protections. Unable to block many harmful reforms, organized labor in Argentina and Brazil did conserve core interests linked to organizational survival and hence to future bargaining leverage. In Chile this sequence was reversed. Market economic policies and labor reform were consolidated under military dictatorship. During democratic transition, employers successfully resisted reforms that would expand labor rights. This produced a limited scope of organizational resources for Chilean unions and reduced prospects for future improvements.