Notes on the Measurement of Values
Historians frequently use values to explain behavior. Since their studies focus on the behavior, they have neglected to measure values and change in values. The current practices of historians of values will not yield conclusions usable in the history of behavior.
"Early" Fertility Decline in America: a Problem in Family History
A striking peculiarity of American demographic history is its compara tively early decline in fertility. Although some of the decrease before the Civil War may be attributed to later and less universal marriage, marital fertility also fell Past scholar ship on the subject has focused on alternative explanations and statistical approaches to cross-sectional variations in the child-woman ratio. After showing the inherent limita tions of this approach, particularly at the level of states, this article draws on the findings of historians of political behavior and women's activities to suggest that the understand ing of the early decline in marital fertility in the United States may be most profitably pursued through the study of the fertility behavior and values of the principal action- groups of antebellum America: religious, ethnic, and economic. Both the motivations for, and possibly the techniques of, family limitation were transmitted and sustained, this hypothesis contends, through membership and participation in these groups.
Study on essential drug use status and its influencing factors among cerebral infarction inpatients in county level hospitals of Anhui Province, China
Background and purpose Drug costs is one of the main components of hospitalization expenditure for cerebral infarction inpatients. In China, the National Essential Medicine System (NEMS) was created to relieve the heavy drug-cost burden for patients. The objective of this study was to investigate essential drug-use status and its influencing factors among cerebral infarction inpatients in county-level hospitals of Anhui province, China. Methods Three county-level hospitals were selected through a multi-stage cluster random sampling method. The hospitalization cost data of cerebral infarction inpatients in the three hospitals were extracted from the Anhui provincial information platform of the New Rural Cooperative Insurance System (NCMS), and whether the proportion of essential drug cost in the total drug cost reached the median value of 33.05% which was set as the evaluation index for essential drug-use status. Questionnaires for hospitals and physicians were designed and given to them to assess influencing factors. Results We retrieved the cost data of 2,189 inpatients from the NCMS platform and investigated 51 corresponding physicians in total. The drug costs accounted for 52.6% of the total hospitalization cost, and essential drug costs alone accounted for 37.0% of the total drug costs. The essential drug-cost proportion was high among physicians with a higher recognition degree on NEMS, older age, lower final academic degree, longer work experience and lower professional title. Married physicians and those with tight organizational affiliation also prescribed more essential drugs. Conclusions Increasing the proportion of essential drugs was an effective way to reduce the disease burden for cerebral infarction patients. Perfecting the NEMS, increasing government investment, reinforcing education and propaganda, and formulating relevant incentive and restrictive mechanisms were all effective ways to promote and increase the number of essential drug prescriptions written by physicians.