Current Policy Context for Education Efforts to Help Young Parents Meet Their Multiple Challenges

Recent increases in the adolsecent birth rate can be in part attributable to a variety of factors including limited sex education in schools, the decline in family planning services, and rising dropout rates. This paper explores the importance of education for adolescent parents, particularly the inclusion of pregnancy prevention programs and services for young parents as part of the educational mainstream.     

The local state in Canada: theoretical perspectives

Studies of government at the local level tend to be focused on the municipalities. To understand the full range of institutions at this level, a broader conception of the “local state” is required. The latter refers to the state in so far as it is present in and concerned with the local community, and thus it encompasses local agencies of the central state as well as local governments. To conceive of the local state in this way allows for a critical assessment of competing theories of local government in Canada. The latter describe local institutions variously as the third order of government, agencies for special purposes, the local public economy, or local apparatuses of the state. All but the first draw attention to non-municipal agencies at the local level, but none give an adequate account of the structure and functions of the local state as a whole. What is required is a theory that takes the pressure for local self-government seriously, and is sensitive to both geographical variation and historical change.     

Maximizing models of legislative choice

A number of recent studies have reported estimates of single equation and simultaneous equations models of the decisions of state legislatures. These investigations have been ‘economic’ ones, in the sense that considerations of the relative costs and benefits to some self-interested person or group capable of affecting legislative outcomes have motivated the choice of explanatory variables. Thus, perhaps implicitly, these studies have assumed utility maximization by some critical agent(s) in the political marketplace. This essay draws attention to the implications of this maximizing assumption for the proper specification and estimation of the associated empirical models.     

A theoretical basis for participatory planning

Arguments are presented for the reconsideration of models which guide planning behavior and structure planning organizations. Hierarchical organizations are contrasted with reticular organizations and the latter are presented as necessary for effective citizen participation. Legitimacy is presented as a fundamental basis of justifying planning action and historical shifts in forms of legitimacy are noted. Participation, as a form of legitimacy, and several aspects of participatory planning are discussed in terms of recent systems thinking. It is argued that participatory planning increases the effectiveness and adaptivity of the planning process and contributes adaptivity and stability to the societal system. Further, it is argued that citizen participation is an essential element in making the planning process a learning system. This leads to a strengthening of the definition and role of communities in the urban system, and to an unexpected requirement of planners who would adopt a participatory planning process.     

REVIEWS

Beyond Complacency; Administrative Law (Fifth Edition). By H. W. R. Wade. Principles of Public International Law. Third Edition. By Ian Brownlie. An Introduction to the Principles of Morals and Legislation. Jeremy Bentham. Edited by J. H. Burns and H. L. A. Hart. Courts, Prosecution, and Conviction. By M. McConville and J. Baldwin. Making Good: Prisons, Punishment and Beyond. By Martin Wright.     

Accurately assessing elderly fall deaths using hospital discharge and vital statistics data

Historically, fatal injury monitoring and surveillance have relied on mortality data derived from death certificates (DC). However, problems associated with utilizing DC have been well documented. Recently, access to and utilization of hospital discharge data (HDD) have offered a new and important secondary source of data regarding in-hospital deaths. However, studies have shown that discrepancies between the HDD and the corresponding DC often exist. This discrepancy was especially evident when comparing HDD to the vital statistics data (VSD) for deaths by falls among those aged 65 and over in 19 states.This was a retrospective forensic review of elderly (age 65 and over) fall-associated fatalities (E880-E888) identified from HDD and VSD in Allegheny County, Pennsylvania, between 1997 and 1998. Seventy-seven cases were identified, with the original manner of death listed as natural (34), suicide (1), and accidental (42) on the DC. Following a forensic review of the cases, the manner of the death on the DC should have been changed from natural to accidental in 28% (n = 12) of the cases, representing an undercount in the VSD. Undercounts were due to a failure of clinicians to account for the significance of a fall event that contributed to subsequent pathology and death. In addition, in that 22% (n = 17) of the HDD fall-associated deaths, the fall did not contribute directly or sequentially to the underlying cause of death, thereby representing an overcount in the HDD.Based on these findings we recommend (1) elderly fall surveillance systems should only count HDD E-coded falls that demonstrate a serious traumatic injury which directly or subsequently results in death, (2) all in-hospital fall-associated deaths should be reported to and reviewed by coroner/Medical Examiner offices for determination of the cause and manner of death, and (3) physicians should be better educated in properly completing death certificates.