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D Stone 《Journal of health politics, policy and law》1977,2(1):32-47
This paper examines the new Professional Standards Review Organizations (PSROs) program in light of a similar program ("Economic Monitoring") that has been used in West Germany for over forty years. In the first section the PSRO program is described as government-mandated peer review by professional organizations, and is compared with that of the West Germany system. The second section argues that the PSROs are likely to strengthen the organization of established medicine, to increase the bargaining power of professional organizations, and to further insulate professional behavior from public scrutiny. The third section describes some of the effects of bureaucratic rigidities in peer review on the practice of medicine: the preservation of old technologies, the development of fixed patterns of practice, and the strengthening of the technical and interventionist biases in medical care. The final section evaluates the PSRO program as a complete delegation of congressional authority and a failure of Congress to set any rules for the development and application of norms and standards. The lack of any mechanism for accountability of the PSROs to public and choices is emphasized. 相似文献
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James Stone 《Diplomacy & Statecraft》2013,24(2):209-235
The seize mai crisis of 1877 was the occasion for last of the three war scares that punctuated Franco–German relations in the 1870s. However, it has not been given the detailed scrutiny it deserves. It was not only important for the amount of influence that Bismarck exerted during a six month period to influence the course of French domestic politics at a critical juncture. This crisis also provides a cipher for understanding the earlier crises of 1873–1874 and 1875 since the German Chancellor pursued his key objective of supporting the establishment of a republic much more openly in 1877 and his tactics are much better documented than in the earlier scares. A closer look at the events of 1877 reveals more continuity in both the means and ends used by Bismarck in his dealings with France during the mid-1870s than was previously thought. 相似文献
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In recent years, specialized nursing skills have proliferated. On the leading edge of this phenomenon are sexual assault nurse examiners (SANEs). This article, and its supporting research, examines the relationship between the SANE, the prosecutor's office, and the disposition of sexual assault cases in Texas. All prosecutors in this highly populous state were surveyed regarding their perceptions of the contributions of SANEs to the criminal justice process. Sexual assault cases present at each stage of prosecution unique obstacles to conviction, as thoroughly explored in other publications. The gauntlet of trial is intimidating to many, if not all, of the victims of this offense. Attempts to protect the victim from unnecessary and irrelevant personal attacks have been somewhat successful. SANEs, invariably volunteers with specialized forensic training, provide professional evidence collection and continuity of support for victims and are a pragmatic innovation in criminal justice. In this article, their role is examined through the lens of the prosecutors, the criminal justice officials most significant and influential in determining the ultimate resolution of complaints filed by victims of crime. The officials polled expressed great confidence in the abilities, commitment, and overall contribution of SANEs at each phase of the process, including trial. The progress and impact of this forensic specialization in gaining judicial recognition as an expert witness is also examined. 相似文献
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Glyn Stone 《Diplomacy & Statecraft》2013,24(2):237-270
For much of the nineteenth century, Canadian education-related international activities resided outside the realm of traditional diplomacy. This situation was exacerbated by Canada's colonial link with Great Britain. Obstacles that prevented educationalists from playing a more substantive role in diplomacy were local, imperial, and ecclesiastical in origin. Educational activities were also a tool in the service of governments in the era between the zenith of British Imperialism in the 1890s and the founding of the United Nations in 1945. In the post-1945 era there was greater collaboration between the federal Ministry of External Affairs and provincial ministries of education. Education also emerged in the late twentieth century as part of the new diplomacy. A flowering of new international governmental organizations dedicated to furthering creative diplomacy brought new energy to this field. 相似文献
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