富民兴盟 教育先行

沙漠戈壁绵亘境内2/3的阿拉善盟,建国初(原阿拉善旗、额济纳旗)仅有小学4所,初中一所,在校生738人,教职工33人.民族教育尤为落后,蒙古族识字者仅有270余人,占人口总数的2.1%.1990年底,全盟所辖三旗(阿拉善左旗、阿拉善右旗、额济纳旗)、两场(吉兰太、雅布赖盐场)各级种类学校已发展到132所,在校生33656人,其中蒙授6878人,教职工专任教师3449人,蒙授800人.建盟十年间,全盟基本普及初等教育,扫除了文盲.中小学全部实现"一无两有"或"一无五有".危房下降到0.84%.小学、初中、高中专任教师合格率均列全区前茅.冲破樊篱走出新路1983年,鉴于陈旧落后的教育结构、教学方法、教学内容、教育管理体制等制约着教育的发展.盟委、行署制定了《关于当前教育改革若干问题的决定》,首先     

IOM/UNFPA project on emigration dynamics in developing countries

The author briefly reviews a special section of papers in this issue of International Migration. The papers focus on aspects of a project on emigration dynamics in developing countries.     

When push comes to shove: implementing VBAC practice guidelines

The dramatic increase in U.S. cesarean sections over the past two decades has been significantly driven by repeat C-sections. In response to this trend, clinical guidelines recommending vaginal birth after cesarean-section (VBAC) have been promulgated by national organizations. Adherence to these guidelines would reduce the number of repeat C-sections, lower the overall C-section rate, and improve both the quality and the cost of health care. While these guidelines have received professional endorsement, their implementation has been clouded by issues of patient acceptance and provider payment. To examine implementation of these guidelines by health care organizations, the authors surveyed 156 members of the American College of Physician Executives to determine their policies, practices, and attitudes toward VBAC guidelines. Those surveyed generally were medical directors in HMOs, hospitals, and other practice settings. The findings indicate that the health care organizations represented by these physician executives have not consistently implemented VBAC guideline and that they are reluctant to hold physicians, their patients, or hospitals accountable for the financial, utilization, and quality impact of the elective decision ot to pursue appropriate VBACs. We conclude that, even when widely accepted, clinical practice guidelines may be ineffective in reducing the costs or improving the quality of medical care.