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How accurately can you measure quality of care in health care? Recently, HMOs and other types of managed care organizations have been in the process of defining quality in quantitative terms. Physicians who utilize fewer resources and who care for more patients per-unit-of-time are valued as providing better care than colleagues who may work at a slower (more expensive?) pace. The pressure to evaluate or treat greater numbers of patients in shorter periods of time can produce adverse consequences. And numbers do not necessarily take into account the quality of the care delivered. There is clearly a middle road. Physicians must take care of a sufficient number of patients with a given problem to gain and maintain expertise and mastery. But they must also guard against the insidious pressure for the procedure to become the end in itself.  相似文献   
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"In this paper, we use simulation models to demonstrate the complexity of the relationship between the marriage selection process and the resulting RMRs [relative mortality ratios]. In particular, we show that marriage selection alone can produce a relative mortality ratio which remains large and relatively constant at ages far beyond the marriage span....Our general objective...is to determine the range of age patterns of relative mortality which could, in theory, result from marriage selection on the basis of health characteristics. We also evaluate the effects of variations in the marriage selection mechanisms on the resulting mortality patterns....We develop and apply several simple mathematical models of the marriage selection process. In order to distinguish the potential consequences of marriage selection from marriage protection, we consider hypothetical populations in which causal effects are absent....We begin by considering an extremely simple marriage selection process and subsequently explore a more realistic selection model based on recent death and marriage rates for Japan."  相似文献   
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In developing countries, children with disability lack basic services yet their voices are missing in the development agenda. This article reports on research to investigate the human rights needs and priorities of 89 children with disability aged 5–18 years in Vanuatu and Papua New Guinea. An accessible and inclusive research method was developed to enable children with diverse disabilities to communicate their own views via visual, audio and tactile means. Data were analysed in relation to the Articles of the Convention on the Rights of Persons with Disabilities, identifying a wide range of priority areas including recreation, leisure and cultural life; employment; home and family life; and education. It is proposed that policy and programme responses must take a holistic view of children and their needs, affirming but thinking beyond the importance of education, to address the complexity of the systemic disadvantage faced by children with disability.  相似文献   
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Consider k( ? 2) normal populations whose means are all known or unknown and whose variances are unknown. Let σ2[1] ? ??? ? σ[k]2 denote the ordered variances. Our goal is to select a non empty subset of the k populations whose size is at most m(1 ? m ? k ? 1) so that the population associated with the smallest variance (called the best population) is included in the selected subset with a guaranteed minimum probability P* whenever σ2[2][1]2 ? δ* > 1, where P* and δ* are specified in advance of the experiment. Based on samples of size n from each of the populations, we propose and investigate a procedure called RBCP. We also derive some asymptotic results for our procedure. Some comparisons with an earlier available procedure are presented in terms of the average subset sizes for selected slippage configurations based on simulations. The results are illustrated by an example.  相似文献   
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iDecide is a KA3 - Support for policy reform project with partners from public and private sectors- from Cyprus, Romania, Greece, Ireland and Portugal. iDecide was conceptualised with the aim of supporting school leaders and teachers in their efforts marginalised groups, and to support their learning in their everyday decision-making. The iDecide toolkit supports the decision-making processes that the majority of schools face every day in all aspects of school life (visits and excursions, school projects, parental involvement, school canteen, homework, students’ council etc). The iDecide toolkit has the capacity to provide teachers and school leaders with practical guidelines for these common decisions in straightforward, simple language. It also gives school leaders the opportunity to retrieve pupils’ and parents' opinions through online polls and forum discussions. This short paper describes the iDecide toolkit functions.  相似文献   
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This research work analyses the emotional intelligence (EI) and the social cognitive attitudes and strategies in adolescents between 12 and 17 years of age in residential care. The aim of the work is to identify those aspects that hinder their socio-emotional competence, requiring a more urgent intervention. We explore the presence of significant differences between the variables under study according to gender and age range (12–14 and 15–17) and we analyse the relationship between the dimensions of their EI and their social competence. The results show a lack of EI in these adolescents, with all three dimensions being affected: emotional attention, clarity of feelings and emotional repair. As for social competence, it can be seen that the adolescents are characterised by a lack of confidence and firmness in their interactions. Worthy of note is the impulsive cognitive style, as are the rigidity of thought and the tendency towards social mistrust and suspicion. There are many difficulties concerning the strategies for resolving social problems. This research highlights the need to design training programmes for the residential care centres that will favour their socio-emotional development.  相似文献   
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