Laurie L. McDonald

When Does the Watchdog Bark? Conditions of Aggressive Questioning in Presidential News Conferences

In theories of the journalism-state relationship, the watchdog model of journalism competes with other models emphasizing either subservient or oppositional relations. Since actual journalistic practice is circumstantially variable, this study isolates the social conditions associated with aggressive journalism. Data are drawn from presidential news conferences from 1953 to 2000, and the focus is on the aggressiveness of the questions asked therein. Through multivariate models, four sets of explanatory conditions are explored: (1) the administration life cycle, (2) presidential popularity, (3) the state of the economy, and (4) foreign affairs. Results show (1) no evidence of a firstterm honeymoon period, but significantly more aggressive questions during second terms, (2) the presidents Gallup job approval rating is not a significant independent predictor of aggressiveness, (3) both the unemployment rate and the prime interest rate are positively associated with aggressiveness, and (4) questions about foreign affairs are significantly less aggressive than questions about domestic affairs, and this differential has been stable for at least a half-century. We conclude by discussing the theoretical implications of these findings, which show that journalists modulate their conduct in complex ways that do not readily map onto any single model.

Documentation Patterns before Cataract Surgery at Ten Academic Centers

PURPOSE To determine the adequacy of documenting the preoperative evaluation for cataract surgery using criteria derived from published practice guidelines. METHODS In 1990, 1139 surgeries that were performed on 1139 patients at ten institutions of the Academic Medical Center Consortium were reviewed for completeness of documentation of the preoperative evaluation. Criteria for completeness were derived from the American Academy of Ophthalmology Preferred Practice Pattern on cataract evaluation and the Agency for Health Care Policy and Research-sponsored guidelines. RESULTS Twenty-six percent of charts lacked documentation of at least one of four basic elements of the preoperative evaluation. These four elements are (1) vision in the surgical eye; (2) vision in the fellow eye; (3) evaluation of the fundus, macula, or visual potential in the surgical eye: and (4) presence of some form (general or specific) of functional visual impairment. If, as stated in the guideline, a specific deficit in visual functioning should be identified, then 40% of charts fail to meet criteria. CONCLUSION Documentation of the ocular preoperative assessment for cataract surgery is inadequate in more than one quarter of cases. The relation between lack of documentation and incompleteness of the examination is unknown. Improved documentation is needed to better measure and enhance the quality of care.

Implementation of Residential and Nonresidential Treatment for the Dually Diagnosed Homeless

An implementation analysis conducted as part of a 2-year experimental study of residential and nonresidential treatment programs for the dually diagnosed homeless found significant differ ences in client engagement and retention, as well as unexpected variations in the treatment conditions. Fully 40% of subjects assigned to either treatmentfailed to become engaged for even one day, although a significantly higher percentage of those assigned to the residential program than the nonresidential program graduated from the first 3-month phase of treatment. The analysis revealed significant differences in the type and amount of services provided by the two treatment programs, as well as potentially important difficulties in program management. Such process data are valuable toolsfor understanding client outcomes and interpreting experimental results.