Prioritizing the 'worse off' under attainability constraints: An indeterminacy problem for distributive fairness

Numerous theories of distributive fairness promote the idea that we ought to give extra weight to benefits to the worse off and can thereby be seen as promoting gap closures. This paper underlines the relevance of making a distinction between attainable and ideal target levels for individuals in populations affected by distributive fairness and show that in cases of scarce resources, theories that promote aggregate gap closures and prioritization of the worse off can in view of this distinction be interpreted in three mutually inconsistent ways

Emerging Trends in Classroom Management Research

While classroom management continues to be a serious concern for teachers because of its important contribution in providing quality education to students, little is known about the reappearing trends that correlate with it. For instance, bullying in schools has become very prevalent in today’s society, however not very much is known about the relationship between classroom management and bullying in the classrooms. Allen (2010) reported that effective classroom management could help the prevention of bullying. This literature review addresses the effects classroom management have on students’ academic success and a teacher’s career, as well as ways to help improve students’ and teachers’ success in the classroom through effective classroom techniques. Additionally, future research should consider an investigation of the need for pre-service and in-service teacher education programs to value the teaching of classroom management practices in preparing teachers to meet the challenges of K-12 classrooms (Ferber & Nillas, 2010)

Clinical decision support system (CDSS) – effects on care quality

Purpose – Despite their efficacy, some recommended therapies are underused. The purpose of this paper is to describe clinical decision support system (CDSS) development and its impact on clinical guideline adherence. Design/methodology/approach - A new CDSS was developed and introduced in a cardiac intensive care unit (CICU) in 2003, which provided physicians with patient-tailored reminders and permitted data export from electronic patient records into a national quality registry. To evaluate CDSS effects in the CICU, process indicators were compared to a control group using registry data. All CICUs were in the same region and only patients with acute coronary syndrome were included. Findings – CDSS introduction was associated with increases in guideline adherence, which ranged from 16 to 35 per cent, depending on the therapy. Statistically significant associations between guideline adherence and CDSS use remained over the five-year period after its introduction. During the same period, no relapses occurred in the intervention CICU. Practical implications – Guideline adherence and healthcare quality can be enhanced using CDSS. This study suggests that practitioners should turn to CDSS to improve healthcare quality. Originality/value – This paper describes and evaluates an intervention that successfully increased guideline adherence, which improved healthcare quality when the intervention CICU was compared to the control group

The changing face of cognitive gender differences in Europe

Cognitive gender differences and the reasons for their origins have fascinated researchers for decades. Using nationally representative data to investigate gender differences in cognitive performance in middle-aged and older populations across Europe, we show that the magnitude of these differences varies systematically across cognitive tasks, birth cohorts, and regions, but also that the living conditions and educational opportunities individuals are exposed to during their formative years are related to their later cognitive performance. Specifically, we demonstrate that improved living conditions and less gender-restricted educational opportunities are associated with increased gender differences favoring women in some cognitive functions (i.e., episodic memory) and decreases (i.e., numeracy) or elimination of differences in other cognitive abilities (i.e., category fluency). Our results suggest that these changes take place due to a general increase in women's cognitive performance over time, associated with societal improvements in living conditions and educational opportunities

Country differences in the diagnosis and management of coronary heart disease : a comparison between the US, the UK and Germany

Background The way patients with coronary heart disease (CHD) are treated is partly determined by non-medical factors. There is a solid body of evidence that patient and physician characteristics influence doctors' management decisions. Relatively little is known about the role of structural issues in the decision making process. This study focuses on the question whether doctors' diagnostic and therapeutic decisions are influenced by the health care system in which they take place. This non-medical determinant of medical decision-making was investigated in an international research project in the US, the UK and Germany. Methods Videotaped patients within an experimental study design were used. Experienced actors played the role of patients with symptoms of CHD. Several alternative versions were taped featuring the same script with patients of different sex, age and social status. The videotapes were shown to 384 randomly selected primary care physicians in the three countries under study. The sample was stratified on gender and duration of professional experience. Physicians were asked how they would diagnose and manage the patient after watching the video vignette using a questionnaire with standardised and open-ended questions. Results Results show only small differences in decision making between British and American physicians in essential aspects of care. About 90% of the UK and US doctors identified CHD as one of the possible diagnoses. Further similarities were found in test ordering and lifestyle advice. Some differences between the US and UK were found in the certainty of the diagnoses, prescribed medications and referral behaviour. There are numerous significant differences between Germany and the other two countries. German physicians would ask fewer questions, they would order fewer tests, prescribe fewer medications and give less lifestyle advice. Conclusion Although all physicians in the three countries under study were presented exactly the same patient, some disparities in the diagnostic and patient management decisions were evident. Since other possible influences on doctors treatment decisions are controlled within the experimental design, characteristics of the health care system seem to be a crucial factor within the decision making process

Gender and sexual orientation differences in cognition across adulthood : age is kinder to women than to men regardless of sexual orientation

Despite some evidence of greater age-related deterioration of the brain in males than in females, gender differences in rates of cognitive aging have proved inconsistent. The present study employed web-based methodology to collect data from people aged 20-65 years (109,612 men; 88,509 women). As expected, men outperformed women on tests of mental rotation and line angle judgment, whereas women outperformed men on tests of category fluency and object location memory. Performance on all tests declined with age but significantly more so for men than for women. Heterosexuals of each gender generally outperformed bisexuals and homosexuals on tests where that gender was superior; however, there were no clear interactions between age and sexual orientation for either gender. At least for these particular tests from young adulthood to retirement, age is kinder to women than to men, but treats heterosexuals, bisexuals, and homosexuals just the same

Withdrawal of antihypertensive medication: a systematic review

Although antihypertensive medication is usually continued indefinitely, observations during wash-out phases in hypertension trials have shown that withdrawal of antihypertensive medication might be well tolerated to do in a considerable proportion of people. A systematic review was completed to determine the proportion of people remaining normotensive for 6 months or longer after cessation of antihypertensive therapy and to investigate the safety of withdrawal. The mean proportion adjusted for sample size of people remaining below each study's threshold for hypertension treatment was 0.38 at 6 months [95% confidence interval (CI) 0.37–0.49; 912 participants], 0.40 at 1 year (95% CI 0.40–0.40; 2640 participants) and 0.26 at 2 years or longer (95% CI 0.26–0.27; 1262 participants). Monotherapy, lower blood pressure before withdrawal and body weight were reported as predictors for successful withdrawal. Adverse events were more common in those who withdrew but were minor and included headache, joint pain, palpitations, oedema and a general feeling of being unwell. Prescribers should consider offering patients with well controlled hypertension a trial of withdrawal of antihypertensive treatment with subsequent regular blood pressure monitoring