Physician perceptions of medical malpractice and defensive medicine

Using judgments obtained in interviews with 33 Massachusetts physicians, the annual statewide volume of expenditures incurred for defensive medical reasons in 1982 was estimated to be $1.0 billion, 12% of all medical care expenditures. Estimates for the nation were $37 billion, 14% of expenditures. Nationally, 180,000 cesarean deliveries were thought to be performed for defensive motives. In their own institutions, respondents judged 43% of all skull x-rays following injury to be medically justified, 30% to be defensive medicine, 16% to be placebos, and 11% to be physician misjudgments. In considering the economic and noneconomic costs of medical malpractice procedures, the dollar costs of insurance were considered most serious, followed closely by defensive medicine, unfairness, and poorer relations with patients. Thirty-two percent of the responsibility for the negative aspects of malpractice processes was assigned to lawyers, 21% to physicians, 18% to legislatures and courts, 16% to patients, and 13% to insurance companies.     

The utilization of prevailing evaluation policy in the selection of performance measures

This study considers the problem of inferring a functional evaluation criterion from existing performance measure policies. The objective is to develop a rational basis by which to adaptively evaluate a current best set of performance measures from alternative sets. The analysis is based on a matrix approach for relating system characteristics to performance measures across a set of activities. A procedure for ranking measure combinations which are candidate implementation alternatives is devised using this matrix representation and cost information. An example illustrating the procedure is presented.     

未成年人犯罪对青少年价值观的诘问

分析认识青少年人生观、价值观扭曲的现实，是做好青少年思想道德教育工作的必要前提。运用了全国未成年犯调查资料，对未成年犯和中学生的价值观进行了比较。结果显示：不良的媒介偏好、偶像崇拜、闲暇意愿以及不正确的成功取向、交友倾向等方面的比例均是未成年犯明显高于中学生。研究认为应积极应对大众传媒不良信息对青少年的深层渗透，重视同伴教育在青少年价值观形成中的作用和道德实践。     

隋唐道教术数学派与传统数学关系考论

关于隋唐时期道教在传统数学领域作出的贡献,学术界已有较多的探讨,然仍显不足。要言之,隋唐道教术数学派坚信术数与数学互为表里,通过"算"、"数"之共性将术数、数学融为一体,并以兼摄数学之术数求道证道。这些思想使得其自身在传统数学(包括天文历算)的理论和实践上作出了一定的贡献,也影响了传统数学的精神气质和发展趋势。而道教术数学派在术数、数学上的研究,对道教自身的发展也有着重要的意义。     

Toward a model of school inspections in a polycentric system

Many education systems are developing towards more lateral structures where schools collaborate in networks to improve and provide (inclusive) education. These structures call for bottom-up models of network evaluation and accountability instead of the current hierarchical arrangements where single schools are evaluated by a central agency. This paper builds on available research about network effectiveness to present evolving models of network evaluation. Network effectiveness can be defined as the achievement of positive network level outcomes that cannot be attained by individual organizational participants acting alone. Models of network evaluation need to take into account the relations between network members, the structure of the network, its processes and its internal mechanism to enforce norms in order to understand the achievement and outcomes of the network and how these may evolve over time. A range of suitable evaluation models are presented in this paper, as well as a tentative school inspection framework which is inspired by these models. The final section will present examples from Inspectorates of Education in Northern Ireland and Scotland who have developed newer inspection models to evaluate the effectiveness of a range of different networks.     

Designing for “touch”, “reach” and “movement” in postwar (1946–1972) English primary and infant school environments

ABSTRACT

This article examines the use and interpretation of the terms “touch”, “reach” and “movement” in Ministry of Education (later, Department of Education) official publications known as Building Bulletins between the years 1949–1972. A close critical reading of Building Bulletins concerned primarily with school design for young children (infant and primary schools) in the English context has been carried out and the results of this exercise are discussed in the wider context of close relationships established between architects designing schools and leading progressive educationalists in Britain. The wider international context, particularly progressive educational design in the USA, is used to further understand the use and interpretation of these terms. The article contributes to a current interest among historians of education in exploring material and sensory histories of schooling.     

Estimating school effectiveness with student growth percentile and gain score models

Measuring school effectiveness using student test scores is controversial and some methods used for this can be inaccurate in some situations. The validity of two statistical models – the Student Growth Percentile (SGP) model and a multilevel gain score model – are evaluated. The SGP model conditions on previous test scores thereby unblocking a backdoor path between true school/teacher effectiveness and student test scores. When the product of the coefficients that make up this unblocked backdoor path is positive, the SGP estimates can be inaccurate. The accuracy of the multilevel gain score model was not associated with the product of this backdoor path. The gain score model appears promising in these situations where the SGP and other covariate adjusted models perform poorly.     

School context and American Indian substance use

The present study extends prior research exploring the role of school contextual factors in predicting individual adolescent substance use by examining how a school’s racial composition is associated with American Indian adolescent tobacco and marijuana use. Using a subsample of 523 American Indian students from the restricted use Add Health data, we consider both individual and school contextual factors across 99 schools. Our results suggest that a school’s racial composition is associated with individual tobacco and marijuana use among American Indian youth, but in different ways depending upon the substance. Our findings illustrate the importance of extending research on the correlates of substance use for racial and ethnic minorities beyond studies examining African-Americans and/or Hispanics.     

The limitations of using school league tables to inform school choice

Summary. In England, so-called 'league tables' based on examination results and test scores are published annually, ostensibly to inform parental choice of secondary schools. A crucial limitation of these tables is that the most recent published information is based on the current performance of a cohort of pupils who entered secondary schools several years earlier, whereas for choosing a school it is the future performance of the current cohort that is of interest. We show that there is substantial uncertainty in predicting such future performance and that incorporating this uncertainty leads to a situation where only a handful of schools' future performances can be separated from both the overall mean and from one another with an acceptable degree of precision. This suggests that school league tables, including value-added tables, have very little to offer as guides to school choice.     

论回族对国家的新贡献

为祖国作出过重大历史贡献的回族在新时期也应该而且能够为祖国作出新的贡献,这些新贡献主要包括三个方面:一是文化上结构性的贡献如义利统一、理欲平衡、公私兼顾;二是经济上的贡献如多元并举的产业理念、市场伦理;三是政治上的贡献如和谐理念和协商政治等等。