13 research outputs found
The States on the Hill: Intergovernmental Advocacy in American Federalism
Federal lawmakers often praise the American state governments as "laboratories of democracy" conducting policy experiments from which other governments can learn. However, federalism scholarship recognizes that the federal government has strong incentives to preempt state policy and impose federal mandates in trying to achieve national policy goals. The safeguards of state power in the federal system - political, institutional, and democratic constraints - have changed and weakened over time, leaving the state governments vulnerable to the political interests of the national government. Like other interest groups, the states have developed techniques to safeguard the balance of power in the federal system as well as communicate their policy interests to national lawmakers and educate others about their unique policy developments.
Prior studies of American federalism have relied on the behavior of public official associations representing multiple state governments as the source of information about intergovernmental advocacy and state policy goals. This dissertation argues that the study of aggregate intergovernmental interests through the positions of the associations conceals variation in the advocacy activity and goals of the individual state governments. Quantitative analysis of patterns in state lobbying behavior as well as qualitative analysis of congressional hearings is conducted using a unique database of the hearing testimony by state government officials and public official associations from the 103rd-108th Congress (1993-2004). This demonstrates that the state governments are dynamic participants in federal policymaking but their influence is not constant across all policy areas. Individual states are found to have varying levels of activity in federal policymaking which are dependent on the committee placement of members from the state's congressional delegation. In some cases the states' capacity to develop policy expertise and craft innovative policy is predictive of its participation in congressional hearings but this is not as important a factor as expected. Members of Congress are most likely to invite intergovernmental witnesses based on their relationship to the state government and, less frequently, based on the state's record of distinction in policy innovation
Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures
Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo