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Deaf and Mute patients may require minimal extra attention to establish trust and allay anxieties before minor medical maneuvers such as rectal examination. An extreme case is reported of the consequences from failure to accomplish this. A generally cooperative deaf and mute patient struggled and suffered a rectal tear and perforation during enema insertion that required emergency colorectal surgery; his nurse had failed to establish a trusting relationship before enema insertion. Ironically, the patient's physician had earlier easily performed digital rectal examination, a similar medical maneuver, with patient cooperation after establishing patient rapport. This report demonstrates the importance of treating individuals with disabilities like everyone else in addressing anxieties before medical maneuvers. The health care worker has the same responsibility of calming the patient, whether deaf or not; the sole difference is that communication between deaf and hearing requires greater skill and patience.

This study argues that a "devolution" of the presidential town hall debate as public sphere has occurred, whereby every 4 years citizens' freedom to participate in their debate—as they see fit—has been seriously restricted. The primary purpose of this study is to examine how well the town hall presidential debate, particularly in its current form, addresses issues of greatest concern to the American public. Specifically, to test how well the dialogue of a town hall debate matches the public's campaign issue agenda, as well as examine possible changes over time, analysis compares the issues discussed in both the 2004 and 1992 town hall debates to the agenda of issues that citizens claimed were most important to them. Results suggest that as candidates have gained greater control over the town hall's structure and resulting dialogue, the ability of this forum to reflect a citizen's issue agenda has greatly diminished.

This article develops a model that simultaneously considers individual turnout and vote choice while also accounting for uncertainty about candidates. The theoretical development of this model implies that the effects of uncertainty on turnout vary with the strength of individual preferences. Application of the model to individual choice in the 1996 American presidential election confirms that decreasing uncertainty about the character traits of the candidates decreases the probability of abstention for individuals with strong preferences but increases the probability of abstention for individuals with weak preferences.

In this article I use a theory of individual utility maximization to derive a unified model of electoral behavior that includes both candidate choices and turnout decisions. Compared to this new unified model, existing specifications for jointly considering turnout and vote choice are found to be theoretically or empirically lacking. I provide methods for testing my model in elections with two or three candidates, and I show that the parameters of these models can be estimated without difficulty using maximum likelihood techniques. Application of these unified models to the 1988 and 1992 American presidential elections illustrates the potential contrasts between unified models and models that consider only candidate choices.