Federalism and aging policy in the 1980s: implications for changing interest group roles in the 1990s

Shifts in the American political landscape during the 1980s had impacts on aging policy and on the behavior of aging interest groups through that decade. But perhaps even more important are the likely effects of those changes on aging policy and on the roles of age-related groups in the 1990s--and probably beyond. First, some of the major policy trends of the 1980s are sketched out, especially the renewed emphasis on federalism. Then, an assessment of their effects on aging policy and aging interest groups is provided. Next, a rationale for focusing on state-level policy and a discussion of current aging interest-group mobilization at the state level are presented. Last, the prospects for aging interest-group influence in the 1990s--a period in which the prior decade's emphasis on dual federalism is likely to continue--is addressed.     

The merton thesis: Oetinger and German Pietism,a significant negative case

The Merton thesis identifies two movements — English Puritanism and German Pietism — as causally significant in the development of the scientific revolution of the 17th and 18th centuries. It attributes this connection to a strong compatibility between the values of ascetic Protestantism and those associated with modern science. This article questions Merton's conclusion regarding one of these movements, German Pietism, by arguing that the Pietist ethos stood in sharp conflict with what Merton has called the normative structure of science. One manifestation of this conflict involves Friedrich Oetinger's articulation of a contending religious-mystical conception of science, which assigned a central place to feeling, intuition, the role of the divine, and a qualitative approach to nature. This conception of science, it is argued, provides the clearest indication of the conceptual and valuative distance that tended to separate Pietists from the new science of the 17th and 18th centuries.An earlier version of this article was presented at the 1990 meeting of the Society for the Scientific Study of Religion, in Virginia Beach.     

Creating customer value by streamlining business processes

Much of the strategic preoccupation of senior managers in the 1990s is focusing on the creation of customer value. Companies are seeking competitive advantage by streamlining the three processes through which they interact with their customers: product creation, order handling and service assurance. 'Micro-strategy' is a term which has been coined for the trade-offs and decisions on where and how to streamline these three processes. The article discusses micro-strategies applied by successful companies.     

Physician executives: where they are and what they do

As hospital operations become increasingly complex, so does the institution's management and organizational structure. Physician executives with titles of medical director, vice president for medical affairs, medical administrator, chief of staff, medical staff president, etc., are playing more important roles than ever before. This article will briefly review some recent literature describing physician executive profiles. The results from a survey of ten university teaching hospitals are also presented as supplementary information regarding current staffing models. Finally, several physician executive staffing-related issues will be discussed in light of the literature and the survey results.     

Eliminating smoking from the workplace

Employers are more readily realizing that a nonsmoking policy in the workplace is a more effective way to run their businesses. They are recognizing costs such as productivity losses, increased health and life insurance costs, employer liability for diseases jointly linked to smoking and occupational exposures, absenteeism, passive smoking-induced health care costs among nonsmokers, workers' compensation, and fire losses. Concomitantly, employees are supporting policies that limit smoking to achieve a clean air environment. Former Surgeon General Koop's goal of "a smokefree society by the year 2000" is being recognized by more and more segments of society.     

"The responsibility to inform, the power to act": a conference for New England college newspaper editors on the role of the campus press in addressing substance use issues.

College newspapers are a powerful but underutilized medium for educating students on health issues, including those related to drug and alcohol use on campus. Editors of these publications are in a position to wield significant influence among their readers. In addition to communicating factual information about the prevalence and impact of substance use among college students, editors can use the press to advocate changes in students' attitudes and behaviors and in college or community policies that affect substance use. A pilot conference was held to help New England college newspaper editors perceive the importance of their role in educating their peers about substance use and other health-related issues, and to offer concrete suggestions as to how they can incorporate these topics into an "activist" campus press.     

Socialization to dying: social determinants of death acknowledgement and treatment among terminally ill geriatric patients.

Although the vast majority of deaths occur among terminally ill geriatric patients, little is known about the etiology of these patients' death acknowledgement and ultimate type of treatment. Based on interviews with 76 triads composed of physicians, terminally ill patients, and primary caregivers, this study uses the socialization perspective to identify the actors and actions that most strongly affect the patient's death acknowledgment and receipt of exclusively palliative care (i.e., socialization to the dying role). Whereas patient preferences and sociodemographic characteristics do not influence significantly the patient's odds of death acknowledgment, these odds are increased if their primary caregivers accept death, their physicians are not affiliated with a teaching hospital, and the terminal prognosis is disclosed to them and disclosed "matter-of-factly." Patients who acknowledge death, whose agents value pain alleviation over life-prolongation, and whose physicians are not affiliated with a teaching hospital, are substantially more likely to receive exclusively palliative rather than curative terminal treatment.