In the case of every species, many different checks, acting at differ­ ent periods of life, and during different seasons or years, probably come into play; some one check or some few being the most potent, but all concurring in determining the average number or even the existence of the species. . . . When we look at the plants and bushes clothing an entangled bank, we are attempted to attribut...

In 1996, Duke Children's Hospital was in serious trouble. Its $11 million annual operating loss had forced administrators to make cutbacks. As a result, some caregivers felt that the quality of care had deteriorated. Parents' complaints were on the rise. Frustrated staff members were quitting. In this article, Jon Meliones, DCH's chief medical director, candidly describes how his debt-ridden ho...

Lucy Zammarelli: I like the way the article pulls substance abuse treatment into a standardized medical perspective. Quality of life is typically a goal in treating many diseases other than substance abuse. In the drug abuse field, it provides a broader, more encompassing gauge of success than just whether the client used a drug or how much. Dave Ross: The issue is extremely important. Quality ...

issue of WMJ describe a community-based social marketing and education campaign created in an attempt to increase immunization rates in vulnerable populations. the authors used interviews to assess how and what neighbors need to know about immunization practices and then developed a series of posters on basic themes directed toward a number of health habits. Some of these messages appeared on b...

T he Institute of Medicine’s report ‘‘Crossing the Quality Chasm’’ estimated that as many as 98,000 lives are lost each year in hospitals in the United States due to medical errors. In response, the Institute for Healthcare Improvement (IHI) has developed an ambitious ‘‘100,000 Lives’’ campaign, aimed at saving 100,000 lives each year in the US. The IHI is a non-profit organization that is seek...