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American Public (american + public)
Selected AbstractsAttitudes of the American Public toward Organ Donation after Uncontrolled (Sudden) Cardiac DeathAMERICAN JOURNAL OF TRANSPLANTATION, Issue 3 2010M. L. Volk Concerns about public support for organ donation after cardiac death have hindered expansion of this practice, particularly rapid organ recovery in the context of uncontrolled (sudden) cardiac death (uDCD). A nationally representative Internet-based panel was provided scenarios describing donation in the context of brain death, controlled cardiac death and uncontrolled cardiac death. Participants were randomized to receive questions about trust in the medical system before or after the rapid organ recovery scenario. Among 1631 panelists, 1049 (64%) completed the survey. Participants expressed slightly more willingness to donate in the context of controlled and uncontrolled cardiac death than after brain death (70% and 69% vs. 66%, respectively, p < 0.01). Eighty percent of subjects (95% CI 77,84%) would support having a rapid organ recovery program in their community, though 83% would require family consent or a signed donor card prior to invasive procedures for organ preservation. The idea of uDCD slightly decreased trust in the medical system from 59% expressing trust to 51% (p = 0.02), but did not increase belief that a signed donor card would interfere with medical care (28% vs. 32%, p = 0.37). These findings provide support for the careful expansion of uDCD, albeit with formal consent prior to organ preservation. [source] The Emergency Medical Treatment and Labor Act as a Federal Health Care Safety Net ProgramACADEMIC EMERGENCY MEDICINE, Issue 11 2001W. Wesley Fields MD Abstract Despite the greatest economic expansion in history during the 1990s, the number of uninsured U.S. residents surpassed 44 million in 1998. Although this number declined for the first time in recent years in 1999, to 42.6 million, the current economic slow-down threatens once again to increase the ranks of the uninsured. Many uninsured patients use hospital emergency departments as a vital portal of entry into an access-improverished health care system. In 1986, Congress mandated access to emergency care when it passed the Emergency Medical Treatment and Labor Act (EMTALA). The EMTALA statute has prevented the unethical denial of emergency care based on inability to pay; however, the financial implications of EMTALA have not yet been adequately appreciated or addressed by Congress or the American public. Cuts in payments from public and private payers, as well as increasing demands from a larger uninsured population, have placed unprecedented financial strains on safety net providers. This paper reviews the financial implications of EMTALA, illustrating how the statute has evolved into a federal health care safety net program. Future actions are proposed, including the pressing need for greater public safety net funding and additional actions to preserve health care access for vulnerable populations. [source] Privacy and Commercial Use of Personal Data: Policy Developments in the United StatesJOURNAL OF CONTINGENCIES AND CRISIS MANAGEMENT, Issue 1 2003Priscilla Regan In the online and offline worlds, the value of personal information , especially information about commercial purchases and preferences , has long been recognised. Exchanges and uses of personal information have also long sparked concerns about privacy. Public opinion surveys consistently indicate that overwhelming majorities of the American public are concerned that they have lost all control over information about themselves and do not trust organisations to protect the privacy of their information. Somewhat smaller majorities favour federal legislation to protect privacy. Despite public support for stronger privacy protection, the prevailing policy stance for over thirty years has been one of reluctance to legislate and a preference for self-regulation by business to protect privacy. Although some privacy legislation has been adopted, policy debates about the commercial uses of personal information have been dominated largely by business concerns about intrusive government regulation, free speech and the flow of commercial information, costs, and effectiveness. Public concerns about privacy, reflected in public opinion surveys and voiced by a number of public interest groups, are often discredited because individuals seem to behave as though privacy is not important. Although people express concern about privacy, they routinely disclose personal information because of convenience, discounts and other incentives, or a lack of understanding of the consequences. This disconnect between public opinion and public behaviour has been interpreted to support a self-regulatory approach to privacy protections with emphasis on giving individuals notice and choice about information practices. In theory the self-regulatory approach also entails some enforcement mechanism to ensure that organisations are doing what they claim, and a redress mechanism by which individuals can seek compensation if they are wronged. This article analyses the course of policy formulation over the last twenty years with particular attention on how policymakers and stakeholders have used public opinion about the commercial use of personal information in formulating policy to protect privacy. The article considers policy activities in both Congress and the Federal Trade Commission that have resulted in an emphasis on "notice and consent." The article concludes that both individual behaviour and organisational behaviour are skewed in a privacy invasive direction. People are less likely to make choices to protect their privacy unless these choices are relatively easy, obvious, and low cost. If a privacy protection choice entails additional steps, most rational people will not take those steps. This appears logically to be true and to be supported by behaviour in the physical world. Organisations are unlikely to act unilaterally to make their practices less privacy invasive because such actions will impose costs on them that are not imposed on their competitors. Overall then, the privacy level available is less than what the norms of society and the stated preferences of people require. A consent scheme that is most protective of privacy imposes the largest burden on the individual, as well as costs to the individual, while a consent scheme that is least protective of privacy imposes the least burden on the individual, as well as fewer costs to the individual. Recent experience with privacy notices that resulted from the financial privacy provisions in Gramm-Leach-Bliley supports this conclusion. Finally, the article will consider whether the terrorist attacks of 11 September have changed public opinion about privacy and what the policy implications of any changes in public opinion are likely to be. [source] Attributes of an ideal oral health care systemJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 2010DrPH, Scott L. Tomar DMD Abstract Objectives: The sense of urgency concerning the inadequacies of the current U.S. oral health care system in better preventing oral diseases, eliminating oral health disparities, and ensuring access to basic oral health services has increased in recent years. This paper sought to articulate the attributes that an ideal oral health care system would possess, which would be consistent with the principles of the leading authorities on the public's health. Methods: The authors reviewed policy statements and position papers of the World Health Organization, The Institute of Medicine, The American Public Health Association, Healthy People 2010 Objectives for the Nation, and the American Association of Public Health Dentistry. Results: Consistent with leading public health authorities, an ideal oral health care system would be have the following attributes: integration with the rest of the health care system; emphasis on health promotion and disease prevention; monitoring of population oral health status and needs; evidence-based; effective; cost-effective; sustainable; equitable; universal; comprehensive; ethical; includes continuous quality assessment and assurance; culturally competent; and empowers communities and individuals to create conditions conducive to health. Conclusions: Although there are some attributes of an ideal oral health care system on which the United States has made initial strides, it falls far short in many areas. The development of an oral health care delivery system that meets the characteristics described above is possible but would require tremendous commitment and political will on the part of the American public and its elected officials to bring it to fruition. [source] Treatment Decisions for Critically Ill Infants: The Abrogation of the Best Interests StandardJUVENILE AND FAMILY COURT JOURNAL, Issue 3 2004FRANK I. CLARK ABSTRACT The issue of withholding or withdrawing medical treatment from seriously ill newborns first gained the attention of the American public in 1982 when Baby Doe was allowed to die without surgery. Since that time, the predominant ethical, medical, and legal approach has been one that allows informed parents to make a reasonable medical treatment decision in the best interests of their infant with the concurrence of the health care providers. There has always been a minority that believes every infant should receive full medical treatment without regard to pain and suffering, until that infant dies a natural death. This viewpoint is reflected in recent judicial and legislative proceedings that have either already drastically changed the prevailing standard of care or threaten do so. This article reviews the significance of these changes. [source] Who Speaks for the People?PRESIDENTIAL STUDIES QUARTERLY, Issue 4 2008Public Opinion in the United States, The President, the Press The U.S. president, the media, and public opinion survey data all represent the American public: the U.S. president serves as the personification and symbol of the U.S. government to the press and people alike; the news and opinion publicized in the media constitute the public sphere; and public opinion polls are accepted as indicators of the public's opinions and beliefs. This article uses both existing research findings and new data to unpack the relationship between the three institutions so as to determine under which conditions each institution speaks for the public and under which it dominates or is subordinate to the others. [source] Another Lesson about Public Opinion during the Clinton-Lewinsky ScandalPRESIDENTIAL STUDIES QUARTERLY, Issue 2 2002Stephen Earl Bennett Data from Pew Research Center polls from early February 1998 through late February 1999 show that only about a third of the American public followed media accounts of the Clinton-Lewinsky scandal "very closely," which is a facet of public reaction that has been largely neglected. Levels of heed paid to media stories about the scandal affected knowledge about key personalities and facets of the imbroglio. In addition, data show that the amount of attention paid to the news about the scandal resonated with opinions about diverse aspects of the scandal. Students of public opinion need to take the public's relative inattention to the scandal into account. [source] Stigma and Self-Concept Among Adolescents Receiving Mental Health TreatmentAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 2 2009Tally Moses PhD Although studies indicate that adolescents diagnosed with mental disorders are stigmatized by the American public, we know very little about the extent to which stigma is experienced by these youth and its effects on their well-being. This cross-sectional study utilizes interviews with 60 adolescents treated in a wraparound program to examine: (a) the extent to which adolescents diagnosed and treated for psychiatric disorders experience mental illness stigma and cope by using secrecy, (b) the extent to which stigmatization is associated with self-concept (self-esteem, mastery, future outlook) and morale (depression), and (c) which clinical and demographic characteristics are associated with perceived stigma. A secondary purpose was to explore the usefulness with adolescents of stigma measures created and adapted primarily from Link's adult stigma scales (Link et al., 1991, 1997). The results support both optimistic and pessimistic interpretations regarding stigma and its effects on adolescents diagnosed and treated for mental disorders. The scales developed for this study demonstrate good internal consistency and construct validity and show promise as tools for further research on stigma as experienced by youth. [source] A Question of Morality: Artists' Values and Public Funding for the ArtsPUBLIC ADMINISTRATION REVIEW, Issue 1 2005Gregory B. Lewis In 1989, the combination of art, religion, homosexuality, ana1 public dollars set off an explosive two-year battle and a decade of skirmishes over funding for the National Endowment for the Arts. To promote artistic freedom and to avoid political controversy, federal arts policy delegates specific funding decisions to private donors and arts professionals. In an era of morality politics,hot-button issues driven by deeply held beliefs rather than by expertise,that strategy no longer works. Artists, donors, and arts audiences diverge widely from the rest of the American public in their attitudes toward religion, sexual morality, and civil liberties, as General Social Survey data show. Delegating funding decisions to them has naturally led to some subsidies of art offensive to important segments of the population. [source] A Loss of Faith: The Sources of Reduced Political Legitimacy for the American Medical ProfessionTHE MILBANK QUARTERLY, Issue 2 2002Mark Schlesinger Writing at the beginning of the 20th century, Shaw identified one of the significant contemporary transformations in industrial democracies. In part as the result of advances in science and technology, in part as a rejection of the monopolistic abuses of industrialization, and in part as a consequence of assiduous efforts by the professions themselves, this was a period in which the legitimacy and social authority of professionals increased dramatically (Brint 1994; Krause 1996; Larson 1977; Sandel 1996). Nowhere was this more evident than in medicine. Over several decades, medicine changed from an occupation with a mixed reputation and little political influence into one that would "dominate both policy and lay perceptions of health problems" (Freidson 1994, 31). In a number of countries, the professional authority and political influence of physicians also rose during this era (Coburn, Torrance, and Kaufert 1983; Krause 1996; Stone 1980), most dramatically in the United States (Starr 1982). The political legitimacy and policymaking influence of the medical profession have greatly declined in American society over the past 30 years. Despite speculation about the causes, there has been little empirical research assessing the different explanations. To address this gap, data collected in 1995 are used to compare attitudes of the American public and policy elites toward medical authority. Statistical analyses reveal that (1) elites are more hostile to professional authority than is the public; (2) the sources of declining legitimacy are different for the public than they are for policy elites; and (3) the perceptions that most threaten the legitimacy of the medical profession pertain to doubts about professional competence, physicians' perceived lack of altruism, and limited confidence in the profession's political influence. This article concludes with some speculations about the future of professional authority in American medicine. [source] Foreigners Traveling to the U.S. for Transplantation May Adversely Affect Organ Donation: A National SurveyAMERICAN JOURNAL OF TRANSPLANTATION, Issue 6 2010M. L. Volk The aims of this study were (1) to determine attitudes among the American public regarding foreigners coming to the United States for the purposes of transplantation, and (2) to investigate the impact this practice might have on the public's willingness to donate organs. A probability-based national sample of adults age ,18 was asked whether people should be allowed to travel to the United States to receive a transplant, and whether this practice would discourage the respondents from becoming an organ donor. Among 1049 participants, 30% (95% CI 25,34%) felt that people should not be allowed to travel to the United States to receive a deceased donor transplant, whereas 28% felt this would be acceptable in some cases. Thirty-eight percent (95% CI 33,42%) indicated that this practice might prevent them from becoming an organ donor. In conclusion, deceased-donor transplantation of foreigners is opposed by many Americans. Media coverage of this practice has the potential to adversely affect organ donation. [source] All Against All: How Beliefs about Human Nature Shape Foreign Policy OpinionsPOLITICAL PSYCHOLOGY, Issue 1 2002Paul R. Brewer Although the American public's increasingly cynical views about human nature have drawn considerable attention from scholars, existing research says little about how interpersonal trust shapes mass foreign policy opinions. This study analyzes survey data to test the claim that citizens use their beliefs about human nature to reason about international affairs. The results indicate that cynical citizens are more likely than trusting citizens to endorse the principle of isolationism and to oppose cooperative forms of intervention in other nations' problems. Citizens' use of interpersonal trust as an information shortcut helps them to make inferences regarding a topic about which they typically know little, but such inferences are not necessarily realistic ones. [source] | ||||||||||||||||