The competition strategy for medical care

This article reviews the so-called competition strategy for medical care. It sets out the policy goals of the strategy and the problems in the present medical and insurance system that it seeks to address. It then describes several distinct formulations of the competition strategy, showing that it is not a single, rigid, monolithic approach, but rather a flexible combination of market-oriented approaches. Finally, it briefly discusses the technical and political problems and prospects of the strategy.     

Two Decades of Change: A Ranking of Key Issues Affecting Intergovernmental Relations

This article describes the results of a 1981 survey of 1,000randomly selected scholars of American government and politicswho were asked to rank the most significant intergovernmentalevents and trends of the past twenty years. Responses were receivedfrom almost 40 percent of these scholars; no significant returnbiases were detected. These scholars ranked civil rights andvoting rights acts as the most significant events of these decades.General Revenue Sharing and the reapportionment cases were rankedsecond and third in importance. The increased flow of federaldollars to states and local governments was ranked the mostimportant trend affecting intergovernmental relations, followedby the increased public disaffection with government and thegrowing dependence of local governments on state and federalaid. The Vietnam War and the inflationary spiral it initiatedwas ranked as the most significant social event affecting thecourse of intergovernmental relations, followed closely by theenergy crisis and the beginnings of the "Great Society." Thearticle also examines the effects of party identification, age,year of degree, government experience, region, and city sizeon scholarly attitudes toward these events and trends. Whilethe overall rankings were not dramatically altered, partisanship,region, and city size all were factors found to be noticeablyrelated to scholarly rankings of these important events andtrends.     

Educational trajectory and “action orientation”: Grade and track differences

A life-span developmental perspective suggests that variations in social context will lead to differences among individuals in their action orientations. An action orientation is defined by an individual's values, control beliefs, goal orientation, and decision-making perspective. To investigate differences in the action orientations of adolescents embedded in different contexts, 83 sophomore and senior high school students on either a vocational training or college-preparatory trajectory participated in the study. A discriminant function analysis of action orientations showed that the action orientations of vocational training and college-preparatory students differed: College-preparatory students had a career preparation action orientation and vocational students had an adult preparation action orientation; also, sophomores may have had a socializing orientation. The findings are discussed in terms of the developmental tasks facing students in different grades and on different life-course trajectories. Received Ph.D. from West Virginia University. Research interests are cognitive and social cognitive development in cultural and institutional contexts.Received Ph.D. from the University of Iowa. Research interests include adult developmental and problem solving.     

Application of forensic toxicology to the problem of domestic violence.

The role of the forensic toxicologist in helping to determine causes of death or in aiding in the resolution of "driving under the influence" or similar cases is well known and clearly understood. Less clearly defined is the position of the forensic toxicologist vis-à-vis other socially significant problems. However, as the 21st century approaches, it is worth considering how forensic toxicology can help in unraveling some of these problems. The problem of violence between intimates--that is, domestic violence--is a social problem in which it has been long felt that alcohol has played a part. Until now, though, no carefully controlled toxicological studies have been conducted to substantiate this or to determine whether other drug use is associated with domestic violence. At the San Francisco Medical Examiner's Office, toxicological data from both the victim and the suspect in 20 cases of domestic violence that ended in homicide have been gathered. It was found that alcohol or other drugs or a combination of these factors was invariably present in the suspect, the victim, or both. The implications of these results and how they can be used to develop a toxicological strategy to help reduce the most serious consequences of domestic violence are presented.     

Post-mortem cooling of the human head: an infrared thermology study

The post-mortem cooling of the human head, over the first fifteen hours after death, was measured by infrared thermology. A detailed temperature map of the head and face was obtained by the use of image processing techniques and the cooling behaviour of twelve preselected facial features was observed. The two main findings of the study were a difference in cooling pattern between the upper and the lower part of the head, and a consistency in the cooling pattern of the lower part of the head in all the cases studied. A comparison of various model fits to the raw data was undertaken and the "best" bodies, models and features were determined on a statistical basis. The formula that best fitted the raw data was a novel double application of Newton's law. The features with the least error in data fitting were the chin and zygoma; that with the most error was the mouth.     

Child witnesses and the confrontation clause

InMaryland v. Craig, the United States Supreme Court relied heavily on a brief prepared by a committee of the American Psychology-Law Society on behalf of the American Psychological Association (APA). The APA brief concluded that sexually abused children may be particularly vulnerable to distress in the legal process, especially when forced to confront the defendant face to face, and that such acute distress may be inconsistent with the state's interests in promotion of reliable testimony and child welfare. APA also argued that psychological theory and research provide foundations for individualized determination of the need for measures to protect children from face-to-face confrontation. *** DIRECT SUPPORT *** AFE06051 00002     

Circumventing formal structure through commitment: Presidential influence and agenda control

Although the formal institutional structure that defines the temporal order of play in a policy game between the Congress and President ought to provide Congress with agenda power, the President is traditionally treated as the dominant player in this relationship. We show that if the President can make clear-cut commitments, presidential commitment can counter the dominance hierarchy and the complexion of equilibrium outcomes. Thus, the details of political interactions (in particular, the possibilities for commitment) may be as important as the formal specification of institutional structure.We thank Peter Aranson, David Austen-Smith, Ed Campos, Gerry Faulhaber, Art Frank, Ken Koford, William Riker, Janet Pack, the anonymous referees, and seminar participants at the University of Delaware, the University of Pennsylvania, and the University of Rochester for helpful comments, subject to the usual caveat. We also thank Joel Friedlander and Harold Dichter for research assistance.