Last rights. In sickness and in health, more people are taking life's biggest decision away from doctors and into their own hands

When dying is all that awaits them, more and more people are choosing certain death now rather than uncertain life on medical support systems. But the decision seldom comes easy, as a Newsweek reporter discovers during three weeks with the doctors, nurses, patients and families in an intensive-care ward. A best-selling guide to suicide fires debate over when it is right to let life go--and who should make that choice when the patient no longer can.     

Technology transfer in the navy: The historical background

This report reviews technology transfer in light of the Stevenson-Wydler Technology Innovation Act of 1980. Following a brief introduction, a section on “Definitions” explains the several meanings that the phrase “technology transfer” now carries in policy discussions. The next section, on “Passive Technology Transfer”, reviews traditional Department of Defense scientific and technical information programs that relate to technology transfer. A section on “Military Industrial Transfer” examines technology transfer from the Defense Department to private industry, expecially to defense contractors. A section on “The Stevenson-Wydler Act and Active Technology Transfer” describes the principal provisions of the new act and why Congress passed it. The next two sections, on “NASA’s Technology Transfer Program” and “The Federal Laboratory Consortium” outline the two existing Government programs Congress relied upon in developing ideas for the new law. A section on “Implementation of the Stevenson-Wydler Act”, discusses several important issues that must be considered by Navy laboratory management as the new law is put into effect in the Navy. Finally, a brief conclusion emphasizes the major point of the report: That Congress, in passing the Stevenson-Wydler Act, did not fully consider what relationship the new technology transfer programs it was requiring in the Executive Branch should bear to existing programs with similar purposes. If the public interest is to be served, the report argues, the Navy must consciously and carefully determine the proper nature of this relationship.     

A decision support system model for technology transfer

Technology transfer is the process by which technology originating at one institutional setting is adapted for use in another. A major impediment to the implementation of new technologies to assist with mangerial decision-making problems is a lack of communication between the technology and management communities. Development of a tool designed to bridge the technology transfer gap was the goal of this research. The result is a prototype software package which may be used on an interactive computer terminal by a manager for assistance in designing a decision support system (DSS). The four primary research tasks were:

1. Develop a conceptual model of the DSS design process.
2. Select and adapt, or create, appropriate software to mechanize the model.
3. Develop a knowledge base to describe the interactiveness of various organization variables and managerial decision-making needs.
4. Collect and analyze interview data and implement resultant production rules on the model.

Tasks 1 and 2 were accomplished first to establish the feasibility of this effort. An interview instrument was developed for Task 3. And, corporate managers from several firms were interviewed to accomplish Task 4. Using this data, a prototype production rule model (called DECAIDS for DECISION AIDS) was constructed which supports managerial decision-making from the EMYCIN production rule system used at Stanford University. The purpose of this article is to introduce the need for a Decision Support System Model. A complete copy of this research can be obtained through University Microfilms International, 300 N. Zeeb Road, Ann Arbor, Michigan 48106, from the Naval Postgraduate School, Monterey, California 93940, or the Defense Technical Information Center, Cameron Station, Alexandria, Virginia 22314. The title is “An Interactive Decision Support System for Technology Transfer Pertaining to Organization and Management”, 1980.     

The influence of individual and community-level child mortality on fertility in Egypt

Child mortality was analyzed in relation to 3 dimensions of reproductive behavior: birth intervals, additional children desired, and contraceptive use. Study data were drawn from a 1978 survey conducted in 2 predominantly rural governorates, Beheira and Kafr El-Sheikh, in lower Egypt. Within each governorate, 2 districts were selected on the basis of their distance from the capital of the governorate, agricultural output by major crops, percent of the population urban, infant mortality rate, and crude birthrate. Within each of the 4 districts, villages were randomly drawn from 3 strata: villages lacking any governmental services; villages with limited services (health center or primary school); and villages served by a combined unit center providing integrated services. A random sample of household heads was selected from household registration records of the provision office of each district. 1200 interviews were obtained from 685 households. Restriction of the sample to women with 1 or more live births, and the elimination of 13 cases with incomplete or inaccurate information, yielded 1010 cases for analysis. The basic measure of actual fertility was birth intervals. For the total sample and within each age category, cumulative fertility is higher the greater the number of child deaths. The data demonstrate a strong relationship between child mortality experience and cumulative fertility. The problem lies in interpreting such results. With some exceptions, birth intervals increased as expected with increasing parity. Women without child death experience displayed longer birth intervals than women who had not lost a child. With the single exception of the 7th parity women, all differences were statistically significant. The data fail to eliminate potential biological influences on subsequent fertility. With biological influences adequately controlled, no behavioral differences remained. Women who experienced child mortality desired greater numbers of additional children than women without child death experience. 19% of respondents were ever users of contraception, with women of low parity the least likely ever to have used contraception.     

The politics of family planning in the Maghrib

This article uses a comparative case study approach to relate policy outcomes in terms of family planning to the patterns of political forces observed in the 3 Maghrib states of Algeria, Morocco, and Tunisia. It is suggested that official support for a strong family planning program may be linked to recognition of the problem of low labor absorption and to concrete steps taken to counter the problem. The article discusses different vantage points for approaching the political context of family planning and distinguishes between the use of family planning as an instrument of social policy and as an instrument of economic policy. Ideological reasons for opposition to or support of family planning are then outlined. The colonial experience of the 3 states is differentiated and a chronological account of their family planning programs is provided. The political systems and leadership of the 3 countries are separately discussed in greater detail, after which the influence of elite groups on family planning programs and activities in each country is assessed. Developments in the 3 countries since 1978 are then sketched. The author concludes that the relative importance of policies toward employment and women's status in connection with support for family planning has probably varied over time, with economics playing a greater role in the 1970s. The activities of non-regime political actors were found to be very significant in formulation of population policies in Algeria and Morocco but less so in Tunisia.