59 research outputs found

    Are waiting times for hospital admissions affected by patients' choices and mobility?

    Get PDF
    Background Waiting times for elective care have been considered a serious problem in many health care systems. A topic of particular concern has been how administrative boundaries act as barriers to efficient patient flows. In Norway, a policy combining patient's choice of hospital and removal of restriction on referrals was introduced in 2001, thereby creating a nationwide competitive referral system for elective hospital treatment. The article aims to analyse if patient choice and an increased opportunity for geographical mobility has reduced waiting times for individual elective patients. Methods A survey conducted among Norwegian somatic patients in 2004 gave information about whether the choice of hospital was made by the individual patient or by others. Survey data was then merged with administrative data on which hospital that actually performed the treatment. The administrative data also gave individual waiting time for hospital admission. Demographics, socio-economic position, and medical need were controlled for to determine the effect of choice and mobility upon waiting time. Several statistical models, including one with instrument variables for choice and mobility, were run. Results Patients who had neither chosen hospital individually nor bypassed the local hospital for other reasons faced the longest waiting times. Next were patients who individually had chosen the local hospital, followed by patients who had not made an individual choice, but had bypassed the local hospital for other reasons. Patients who had made a choice to bypass the local hospitals waited on average 11 weeks less than the first group. Conclusion The analysis indicates that a policy combining increased opportunity for hospital choice with the removal of rules restricting referrals can reduce waiting times for individual elective patients. Results were robust over different model specifications

    Michael Gove’s war on professional historical expertise : conservative curriculum reform, extreme Whig history and the place of imperial heroes in modern multicultural Britain

    Get PDF
    Six years of continuously baiting his opponents within the history profession eventually amounted to little where it mattered most. UK Secretary of State for Education, Michael Gove, finally backtracked in 2013 on his plans to impose a curriculum for English schools based on a linear chronology of the achievements of British national heroes. His ‘history as celebration’ curriculum was designed to instil pride amongst students in a supposedly shared national past, but would merely have accentuated how many students in modern multicultural Britain fail to recognise themselves in what is taught in school history lessons. Now that the dust has settled on Gove’s tenure as Secretary of State, the time is right for retrospective analysis of how his plans for the history curriculum made it quite so far. How did he construct an ‘ideological’ conception of expertise which allowed him to go toe-to-toe for so long with the ‘professional’ expertise of academic historians and history teachers? What does the content of this ideological expertise tell us about the politics of race within Conservative Party curriculum reforms? This article answers these questions to characterise Gove as a ‘whig historian’ of a wilfully extreme nature in his attachment to imperial heroes as the best way to teach national history in modern multicultural Britain

    Determining the influence of spray deposition and coverage inside soybean canopies: Part 2. Open design with field experiments

    No full text
    Field studies were established in north central Ohio to determine the effect of different application strategies on targeting of foliar pesticides in narrow-row (18 cm) soybeans. Several different application factors were tested, including spray quality, nozzle type, air-assistance, and spray volume. In 2005, the spray mix included a fungicide. In 2006, in addition to the fungicide, an insecticide was included. Plant samples were removed from each test plot, and stems and leaves from the bottom third and middle third of the plant were separated for analysis. Overall, there was significantly less active ingredient found in the lower third of the canopies than the middle third, and significantly less pesticide residue was found on stems than leaves from the same canopy location. Significantly more fungicide residue was found on lower leaves treated by the medium-quality XR8004 flat-fan nozzle in 2005 than the coarse-quality XR8005 flat-fan nozzle. There were no differences in fungicide residue found on middle canopy leaves between the fine, medium, and coarse quality flat-fan nozzles. The twin-fan pattern nozzles (Turbo Duo and TwinJet) produced the lowest amounts Of fungicide residue on the lower leaves in 2005. The mechanical canopy opener produced significantly higher fungicide residues on middle canopy leaves than all other treatments. The Jacto air-assist sprayer using JA3 hollow-cone nozzles produced the highest fungicide residues on lower canopy leaves in 2005. There were some statistical differences between the amounts of fungicide and insecticide residue found oil plant tissue in 2006 because of the high amount of variability in the sample data. Overall in 2006, the higher volume XR8004 treatment (187 L ha(-1)) and the twin-fan TTJ60-11003 treatment at 145 L ha(-1) performed similar to the Jacto sprayer making applications at 145 L ha(-1) using either flat-fan or hollow-cone nozzles. In general, higher volume applications produced higher amounts of fungicide and insecticide residue on leaves from the middle of the canopy for conventional flat-fan and air-assist applications. Spray volume had less affect on residues measured on leaves from the lower canopy area. Across two years of different canopies at the same spray volume (145 L ha(-1)), the Jacto sprayer using JA3 hollow-cone nozzles produced more fungicide residue on middle canopy stems and lower canopy leaves than the medium-quality XR8004 flat-fan nozzle
    • …
    corecore