The validity of indices for rural health manpower needs assessment

Population-to-practitioner ratios have long been the primary index in the designation of health manpower shortage areas. This paper documents that application of the widely used population-to-dentist index results in understatement of the need for dental health manpower in rural areas. Through the analysis of utilization data collected from a statewide health screening program in Colorado, the practice of sole reliance on the population-to-dentist indices as an indicator of need was tested. Another measure, the area-(square miles) to-dentist ratio was formulated, examined, and found to be a more useful referent of the need for additional health manpower in rural areas. Utilization of dental services in sparsely settled rural counties of Colorado was unrelated to population-to-dentist ratios. A strong, statistically significant association of utilization with land area-to-dentist ratios was found. The findings of this analysis suggest a need for reevaluation of needs assessment methodologies used in the designation of health manpower shortage areas. Indices more sensitive to consumer circumstance than to the number of health care providers available must be considered.     

The Decline of marital fertility in Japan

Summary Studies concerning the demographic history of Tokuwara and Meiji Japan suggest that fertility rose substantially before declining during the twentieth century. Were the motivations and circumstances which held down natality during the feudal period similar to those which account for the modern fertility decline and the low birth rate obtaining in the Japan of to-day? The thesis of this paper is that the pre-modern situation was fundamentally different from the modern one. During the Tokugawa era infanticide and abortion were used, independently of parity, to eliminate weak offspring whose chances of survival were deemed poor. Desired natality generally exceeded natural fertility. With the rise of income per head during the Meiji period the population's need for these desparate practices vanished. To-day parity-specific control characterizes fertility. Parityspecific control was diffused throughout Japan in response to declining desired fertility. Desired fertility fell significantly below natural fertility sometime during the late nineteenth or early twentieth century and the wish to reduce actual fertility to the desired level stimulated the adoption of parity-specific control. The speed of decline in marital fertility was partially governed by official policies toward contraception and abortion, contraception and abortion.     

通过谈判争取成功砝码

回想你上次面临新的领导机遇时,出现了什么情况？不管你是受命领导团队、部门还是整个企业,你很可能通过谈判争取该职位的薪水和待遇,比如：头衔、假期及奖金,但你是否争取过在该职位上取得成功的条件呢?     

1991年诺贝尔经济学奖得主的理论贡献

学术贡献 科斯由于“发现和澄清了交易费用和产权对经济制度结构和运行的意义”而荣获诺贝尔经济学奖。科斯对于经济学的主要学术贡献包括三个方面:一是他提出了交易费用概念的雏形,并把交易费用引入经济学的分析框架之中;二是强调了交易费用、产权与经济效率的关系,构筑了产权理论的框架;三是以“科斯定理”为核心开创性地将经济理论应用到法学问题上,形成了一门新的经济学分支—法律经济学。 科斯认为市场运行是有成本的,且主要是“发现相对价格”的成本。为了进行市场交易,有必要发现准希望进行交易,有必要告诉人们交易的