Doctors under the microscope: the birth of medical audit

In 1989 a UK government White Paper introduced medical audit as a comprehensive and statutory system of assessment and improvement in quality of care in hospitals. A considerable body of research has described the evolution of medical audit in terms of a struggle between doctors and National Health Service managers over control of quality assurance. In this paper we examine the emergence of medical audit from 1910 to the early 1950s, with a particular focus on the pioneering work of the American surgeons Codman, MacEachern and Ponton. It is contended that medical professionals initially created medical audit in order to articulate a suitable methodology for assessing individual and organisational performance. Rather than a means of protecting the medical profession from public scrutiny, medical auditing was conceived and operationalised as a managerial tool for fostering the active engagement of senior hospital managers and discharging public accountability. These early debates reveal how accounting was implicated in the development of a system for monitoring and improving the work of medical professionals, advancing the quality of hospital care, and was advocated in ways, which included rather than excluded managers

Quantitative environmental equity analysis of perceived accessibility to urban parks in Osaka Prefecture, Japan

Environmental equity (EE) has become internationally recognized as an important research field, but in Japan limited quantitative research is available. In this paper we report the results of a quantitative study that tested whether objective and perceived accessibility to parks is disproportionately distributed between the affluent and the poor in Osaka Prefecture, Japan. Perceived accessibility is considered to be a more accurate accessibility measure which reflects the socio-cultural background of people. We find inequities in both accessibility measures, and using multiple logistic regression analysis, we clarified that perceived accessibility is shaped by a range of factors (i.e., income level, objective accessibility to parks, and people’s perceptions of traffic accidents, crime, and the level of scenic beauty in the neighboring area). Our results provide some insight into remediation measures for the environmental inequity of perceived accessibility. Simply establishing a new urban park may not sufficiently increase the perceived accessibility of socioeconomically deprived groups. Identifying the underlying mechanisms that could explain how poverty-related factors undermine the perceived park accessibility or improving the quality of neighboring area are also important to ensure the effectiveness of remediation measures

Sanctus from the Missa Zimbabwe

Missa Zimbabwe hymn performed in Zulu, accompanied by the xylophone. Original composition in Ndebele

Agnus Dei from the Missa Zimbabwe

Missa Zimbabwe hymn performed in Zulu, accompanied by the xylophone. Original composition in Ndebele

Gospel Alleluia from the Missa Zimbabwe

Missa Zimbabwe hymn performed in Zulu, accompanied by the xylophone. Original composition in Ndebele

Pater Noster from the Missa Zimbabwe

Missa Zimbabwe hymn performed in Zulu, accompanied by the xylophone. Original composition in Ndebele

Gloria from the Missa Zimbabwe

Missa Zimbabwe hymn performed in Zulu, accompanied by the xylophone. Original composition in Ndebele