[Comparative study of the operation of two day's Hospitals in Athens].
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The present paper describes the preparation for the commencement of services by the University Mental Health Research Institute (UMHRI) Day Hospital and Eginition Day Hospital whose operation (in 1977) signifies the beginning of the Psychiatric Reform in our country. The two units' functional characteristics and the type of offered services are mentioned. Psychotherapeutic, biological and sociotherapeutic approaches are practiced on a daily basis within a framework of Therapeutic Community services. Moreover, relations, similarities and differences among the two day hospitals are pointed out. Special mention is given to the problems and difficulties that these two units faced upon their commencement, which took place at different time periods, set 32 years apart. The lack of legislative framework with regards to the operation of Day Hospitals, the bureaucratic obstacles and the skepticism towards the new treatment approach of patients, were the basic obstacles that had to be overcome in order for the first Day Hospital to become operational in 1977. Licensing and funding were the main obstacles that the creation of UMHRI's Day Hospital faced, although these two units had already been established. Emphasis was placed on the staff's training, which mainly consisted of young professionals and at the social environment's and all those services' (health-care, community etc) attitude, in the specific catchment area (6th Mental Health Sector). The study of patients' characteristics hospitalized in Eginition's Day Hospital throughout its first year of operation (1977-1978) and of patients hospitalized at UMHRI's Day Hospital, also at its first year of operation (2009-2010), showed, among other things, that in both cases, the number of hospitalized male patients is larger than the number of female patients. This constitutes an exception compared to other countries, whereby female patients outnumber male patients in Day Hospitals. Especially at UMHRI's Day Hospital, the number of men is twice the number of women and three times the number of women in the subgroup of patients with schizophrenia. In addition, at Eginition Day Hospital, the men- women ratio is 3:2 in the total number of hospitalized patients and 2:1 in the schizophrenia subgroup. The comparison between the hospitalized patients in Eginition Day Ηospital and UMHRI. Day Hospital brought out the following differences: inpatients at UMHRI's day Hospital were more often older, (x²= 29.52, p=0.0001), unemployed (x²=14.65, p=0.0001) and used public means of transportation more rarely (x²=7.38, p=0.005). No other differences were found in the rest of the sociodemographic variables such as education, marital status, insurance agency, living conditions, traveling time to the day Hospital, referral source, diagnosis of schizophrenia, past hospitalizations. To conclude, it is worth mentioning that the Day Hospital is in a position to treat patients with active psychotic symptomatology, preventing thus their hospitalization on a 24 hour basis.Keywords:
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This book examines the role of the bureaucracy, vis-a-vis the Congress and the President, in the legislative process. While it is clear that the President and the Congress are intimately involved in the legislative process, the role of the bureaucracy is not as clear. By using the Health Care Financing Administration in the Department of Health and Human Services as a case study, the author shows how the bureaucracy participates in the legislative process by: helping the President and the Congress diagnose public problems; assisting in the development of legislation; and providing essential technical assistance to the Congress and the President. Includes a foreword by Dr. Carolyne K. Davis.
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Legislative process
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The literature on consumer opinion about psychiatric day care is reviewed and a study of the views of day care attenders living in an inner city catchment area who are in prolonged contact with psychiatric services is presented. Attenders were broadly satisfied with their care. Analysis of their verbatim comments suggested that attenders perceived the value of attendance at a day unit in social rather than therapeutic terms. The implications of this finding are discussed.
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Abstract While much is known about the relationship between Congress and regulatory agencies, there has been little examination of the role state legislatures play in the activities of state regulatory bodies, particularly those activities related to timely, salient policy issues. This article explores the relationship of state legislatures to medical boards, which are increasingly becoming more policy active. We find that state legislative involvement and influence are the most important determinants of policy‐active state medical boards; institutional elements play a secondary role. Major changes in the private health care delivery system affect legislative involvement and play an indirect role in predicting policy activism. We drew our data from a 50‐state survey of executive directors of state medical boards.
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This Article makes observations about the politics of crime during major shifts in sentencing rules. One lesson to draw from the experience after _Blakely v. Washington_ and _United States v. Booker_ is that prosecutors alone do not determine the legislative outcomes on sentencing questions. Neither do the partisan affiliations of the prosecutors or the majority party in the legislature. While these factors obviously do affect the sentencing legislation that a legislature passes, partisan affiliation does not tell the entire story. Institutions matter, and their place in the political landscape matters. The long-term resources and habits of commissions and other full-time criminal justice bureaucracies can outlast the partisan agendas of the present in shaping sentencing legislation.
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Bureaucracies often provide information to legislatures in an effort to influence the agenda. This paper assesses whether data affects this influence, arguing quantitative support can increase the likelihood of legislative discussion and passage of bills related to a given topic. I also assess the impact of centralization on an agency’s ability to provide information and shape legislative agendas. I find including data in bureaucratic reports can significantly increase an agency’s influence on the legislature, but this effect is only present in a centralized setting. These results suggest centralized agencies are better equipped to marshal quantitative support for arguments to legislatures.
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An extensive literature explores the correlates of bureaucratic influence in the implementation of public policy. Considerably less work, however, has investigated the conditions under which bureaucratic actors influence legislative outcomes. In this article, we develop the argument that effectiveness should be a key determinant of bureaucratic influence in the legislative process and identify a set of institutional characteristics that may facilitate or constrain this relationship. We test these expectations in an analysis of legislator perceptions of bureaucratic influence over legislative outcomes in the 50 US states. The results suggest that the impact of bureaucratic effectiveness on the influence of the bureaucracy over legislative outcomes is greater in states with legislative term limits, united governments, and fragmented executive branches.
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