Ethics committees and quality improvement: a necessary link.

As today's health care system undergoes dramatic changes, it becomes imperative that quality improvement efforts mesh with these changes to maintain quality outcomes in patient care. The confusing flurry of health care reform, cost containment, resource allocation, and advances in medical technology raises a variety of ethical issues. In the recent past ethics committees have been one strategy used to provide direction and support to care providers facing ethical dilemmas in clinical practice. The mutual goal of quality outcomes for the patient provides the rationale for linking quality improvement programs with ethics committees. As we move toward a more integrated and seamless health care system, this link may be critical to quality outcomes in caring for the patient from cradle to grave.

Funding nursing education: the Medicare dilemma. Interview by Cheryl Slagle King.

Comprehensive analysis of current Medicare funding for hospital-based diploma programs is multi-factorial, and must incorporate a market of constrained costs, impending Medicare Reform and emerging opportunities for APNs. In addition, consideration must be given to fundamental issues surrounding all aspects of nursing education. APNQ interviews Dr. Carol A. Anderson and Dr. Gail Wolf who make thought-provoking points in arguments covering a spectrum of nursing issues.

Quality mind-set overcomes barriers to success.

To remove hindrances to fiscal strength, a healthcare facility needs a long-term, organization-wide strategy. Total quality management (TQM) can offer such a solution, but it requires a revised management philosophy. Under TQM, a hospital must adopt a workable definition of quality; develop a customer orientation; form organizational teams to study and revise work processes; involve all employees in quality efforts; and strive for continuous improvements.

Temperature and aggression: effects on quarterly, yearly, and city rates of violent and nonviolent crime.

The hypothesized relation between uncomfortably hot temperatures and aggressive behavior was examined in two studies of violent and nonviolent crime. Data on rates of murder, rape, assault, robbery, burglary, larceny-theft, and motor vehicle theft were gathered from archival sources. The first three crimes listed are violent; the latter four are less violent (labeled nonviolent). On the basis of previous research and theory (Anderson & Anderson, 1984), it was predicted that violent crimes would be more prevalent in the hotter quarters of the year and in hotter years. Furthermore, it was predicted that this temperature-crime relation would be stronger for violent than for nonviolent crime. Study 1 confirmed both predictions. Also, differences among cities in violent crime were predicted to be related to the hotness of cities; this effect was expected to be stronger for violent than for nonviolent crimes. Study 2 confirmed both predictions, even when effects of a variety of social, demographic, and economic variables were statistically removed. Theoretical and practical implications are discussed.

The participation of women in education in the third world.

PIP: In this descriptive and exploratory discussion of the participation of women in education in the 3rd world, focus is only on participation in schools. The index used is years of schooling for each sex. It provides measures of utilization. The question is how far do girls go in school, compared with boys, and what do they study. Attention is directed to the following: participation versus access; literacy and primary schooling across the generations; enrollment rates and wastage around the world (overview of enrollment rates, wastage and promotion and retardation, early marriage and schooling, ambiguities of coeducation, women's schooling in Muslim and in Latin American countries); intracountry variations in schooling of girls (spatial diffusions of schooling, sex and social selection for schooling, and the assessment of progress). The availability of educational options does not ensure their utilization, and in the less developed countries (LDCs) this distinction between provision and utilization is basic for policy. Whether schooling of a daughter is considered valuable will be influenced by perceptions of the effects of schooling on jobs, on acquisition of a "better" husband, on quality of domestic life, on the daughter's personality development, and on the well-being of her children. How girls perform in school compared with boys is affected by the same factors determining initial access. The situation regarding differences in literacy and primary schooling between men and women is presented in tables to illustrate 4 distinctive patterns of change. Sex differentials in schooling among children 6-11 are negligible in European countries and in Latin America, although the rates in Latin America are lower. In these regions only small differentials occur for ages 12-17, and sex contrasts continue to be moderate at ages 18-23. In the 3rd world the situation is different. In Asian countries (excluding Japan), the rates for 6-11 year olds are 71 and 50%, respectively, and for Africa 59 and 43%; at ages 12-17, in Asia 83 and 22%, and in Africa 39 and 24%. Everywhere outside the most developed regions intercountry variations in enrollment rates are very large for both sexes, as are disparities in those rates. A country can rank quite differently at each level of school for the proportion of girls, and countries vary greatly in female shares of pupils. In countries where girls are married at ages 15-19, their enrollments at those ages are lower, but there is no simple trade-off between marriage and schooling. It appears that there are common causes for both early marriage and low school attendance. In all aspects of girls' schooling, the availability of women teachers is salient as both an instrument and a product. The proportion of girls who are in school can vary more among provinces than among countries taken as a whole. The factors affecting educational opportunities are numerous and cross cutting. Possibly the firmest generalization regarding social selectivity in the education of girls is that socioeconomic status of parents has more influence on the schooling of girls than of boys. This influence frequently is greater in rural localities or among disadvantaged ethnic groups than it is in favored segments of the population. Probit and logit models are becoming widely used in many different kinds of studies of educational participation.^ieng