Suchergebnisse

Despite a dramatic decline in transfusion-associated AIDS, increased safety of the national blood supply, and voluntary efforts to find alternatives to homologous blood sources, Americans remain fearful about the possibility of acquiring AIDS through a blood transfusion. Numerous states have initiated legislative efforts that would require explicit warnings about blood safety and that would direct patients to alternative sources of blood. These proposed laws—known as MANTRA bills, for "mandatory notification of transfusion alternatives"—would require physicians to advise patients of blood transfusion options prior to any surgery. Many would mandate the development of new informed consent documents and involve health departments in the implementation of new regulations regarding transfusions. This article concludes that MANTRA legislation is primarily a symbolic attempt to reassure the public about AIDS. It mandates practices that are being adopted voluntarily; it will not make the blood supply safer; it will increase the cost of health care to individuals and in the aggregate; it may diminish the number of donors to the voluntary blood supply system; and it is likely to intensify public fear about the risk of a blood transfusion.

The role of cabinet member as policy entrepreneur has received little attention in the literature of political science and public administration. Cabinet members have no formal authority or constitutional mandate. Additionally, their identification with particular agency missions has subjected cabinet secretaries to the suspicion of "going native," thus further diminishing their capacity for policy initiation. Presidential concern with controlling the executive branch perhaps reached its peak during the Reagan administration, when virtually all political appointments and policy decisions were controlled within the office of the president. This research examines the role of Cabinet Secretary Otis R. Bowen, MD in the evolution of Medicare catastrophic coverage within the Reagan administration. It demonstrates the potential of the cabinet member as policy entrepreneur, identifying weaknesses in the ability of even an ideologically cohesive administration to control fully its legislative agenda.

The life grid, has recently been acclaimed as a accurate method for collecting retrospective data from elderly respondents. Accounts of using this method, which are based upon quantitative studies, however, have not adequately captured the dynamics of grid interviewing. This is, we suggest, because it is much easier to describe technical aspects of a research method than it is to convey how that method works in practice. In this article we set out to portray some of these more 'indeterminate' aspects of the life grid interviewing, drawing on our own experiences of using this method in an qualitative study of lifecourse patterns of smoking behaviour among elderly respondents who have a smoking related illness. Focussing upon interaction between researcher and respondent the article explores the reconstruction of the life course as a mutual endeavour and the implications of this for the interview structure and data collection among this respondent group.

During the New Deal and succeeding administrations national power and authority became increasingly more centralized in the White House and Executive Office of the President. As this institutionalized presidency emerged, increasing numbers of political functions were centralized in the expanding office of the president. This paper examines the changing structural relationship between the White House and the national party with particular emphasis on the distribution of patronage appointments and staffing the executive branch. The period of analysis begins with the Eisenhower administration and concludes with the Nixon presidency. The authors note that although subsequent administrations may demonstrate the unintended effects of this concentration of authority, it is unlikely that it will be willfully reversed.