The doctor-patient relationship as the business case for quality: doing well by doing right

The idea that healthcare quality in America has lagged behind optimal levels has been a central national policy issue since at least 1998. Reform efforts, however, have failed to acknowledge the critical and unique role physicians play in making quality initiatives real. This Article argues physicians are at the core of any effort to propel quality forward in a significant way and, therefore, must be taken into account directly and without apology. The Article examines the quality-accountability context present in this country. It addresses why the physician nexus on these issues is vital for real change to take place and sets forth a clear statement of what is essential to support the doctor-patient relationship in any quality agenda. Finally, it reiterates the author's previously proposed five principles for quality, as well as her unified field theory of quality, all of which are designed to advance quality in a very different way.     

Determination of sex and race from the subpubic angle in Ugandan subjects

The accurate determination of sex and race are important tools to forensic and physical anthropologists. In this study, the sex and race of 205 adult Ugandans were determined from the antero-posterior radiographs of the pelvis by measuring their subpubic angles. The angle ranged from 50 to 140 degrees with a mean of 93.86 degrees and standard deviation (SD) of 21.12 degrees for males and 75 to 155 degrees with a mean of 116.11 degrees (SD, 17.79 degrees) for females. The angle was significantly wider in women than men (P < 0.05), as indeed has previously been shown in other population groups studied. Using the demarking point method, 31.82% of Ugandan men and 10.53% of Ugandan women could be accurately sexed. However, more Malawians of both sexes previously studied had lower values for the angle and could be more accurately sexed. This study has also documented regional and racial variability of this angle among different population groups previously documented. Using the watershed subpubic angle derived from the means of this study and those of previously documented studies, 63% of Ugandans and 71% of Malawians could be accurately assigned to the black race. This method is recommended to physical and forensic anthropologists in the developing world.     

Harassment and stalking of Members of the United Kingdom Parliament: associations and consequences

A survey concerning intrusive/aggressive behaviours towards MPs was administered at Westminster, and in Queensland, New Zealand and Norway. Follow-up interviews were conducted with a sample at Westminster. This paper examines the experiences and associations of the 239 Westminster responders, of whom 81% had experienced intrusive/aggressive behaviours, 18% been subject to attack/attempted attack, and 53% stalked or harassed. Being stalked and subject to certain types of intrusive/aggressive behaviour were associated with younger age and being in the Commons five years or less, but serious incidents were more common in those who had been MPs for longer. There were no associations with brief periods of harassment. Some differences with party and constituency type emerged. Mental illness was prominent amongst perpetrators. Motives predominantly concerned personal grievances. Significant proportions of MPs suffered psychological ill-effects, necessitating inconvenient behaviour changes. Internal consistencies in these results and similarities to other sites are explored, and their implications discussed.     

Homicidal Events Among Mexican American Street Gangs: A Situational Analysis

This article examines the complexity of street gang homicides and focuses on situational factors that lead to gang members' susceptibility to this violent behavior within the context of a disadvantaged minority community. This study is based on an analysis of 28 homicides involving Mexican American gang members. The absence of immigrant youth involvement in these types of violent crimes is discussed. Findings demonstrate how locally embedded social processes associated with specific gang types, ecology, drugs, circumstances, and motives unfold into homicidal events. These findings may contribute to the development of street-based social programs focused on gang mediation, dispute resolution, and crisis intervention.     

Leading knowledge mobilization for public value: The case of the congestion charge zone (Area C) in Milan

The literature on public value creation has grown significantly in recent years. However, how such generation of public value is linked to the interaction between individual and organizational capabilities, and the role played by leadership in such interaction, is still underexplored. This analysis of the congestion charge zone (Area C) implemented by the Municipality of Milan in Italy explores this issue and highlights the role played by the knowledge orchestrator who, by assuming different leadership roles at different times, strives to create value through knowledge mobilization. Leveraging from existing resources, the knowledge orchestrator captures knowledge from the external environment and promotes collaboration among individuals and institutions, so as to generate a new reconfigured stock of knowledge. These activities nurture the capacity of public organizations to collaborate, produce innovations, and more broadly contribute to public value creation.