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Researchers recommend a reorganization of the medical profession into larger groups with a multispecialty mix. We analyze whether there is evidence for the superiority of these models and if this organizational transformation is underway.

We summarize the evidence on scale and scope economies in physician group practice, and then review the trends in physician group size and specialty mix to conduct survivorship tests of the most efficient models.

The distribution of physician groups exhibits two interesting tails. In the lower tail, a large percentage of physicians continue to practice in small, physician-owned practices. In the upper tail, there is a small but rapidly growing percentage of large groups that have been organized primarily by non-physician owners.

While our analysis includes no original data, it does collate all known surveys of physician practice characteristics and group practice formation to provide a consistent picture of physician organization.

Our review suggests that scale and scope economies in physician practice are limited. This may explain why most physicians have retained their small practices.

Larger, multispecialty groups have been primarily organized by non-physician owners in vertically integrated arrangements. There is little evidence supporting the efficiencies of such models and some concern they may pose anticompetitive threats.

This is the first comprehensive review of the scale and scope economies of physician practice in nearly two decades. The research results do not appear to have changed much; nor has much changed in physician practice organization.

Tackling the challenges of water scarcity requires comprehensive management according to financial, environmental and social issues. This paper aims to develop a planning approach for systematic decision-making and pay attention to uncertainties in water demand management and supply investment.

This study presents a multiobjective optimization model to manage water resources based on the balance of supply and demand. The objectives of the model include economic, social and environmental (sustainable development) factors. The model achieves an optimal urban water portfolio by using a scenario tree.

The mathematical goal programming (GP) in a multiobjective optimization model is applied and solved by the branch and bound method. The results indicate the selected supply augmentation and demand management options in each stage for 20 years according to the dry, normal and wetness year scenarios.

This model is based on a real-world case and has been implemented in the city of Karaj. It can be applied for water management of other cities concerning sustainable development as well.

This paper innovates by considering the sustainable development criteria that are defined using three objective functions, including economic, social and environmental factors. The balance of supply and demand concerning uncertainty has not been investigated in any urban water portfolios. The standardized precipitation evapotranspiration index (SPEI) is incorporated to generate different scenarios. To the best of the authors’ knowledge, this approach is used for the first time.

We have repeatedly dealt with the question of the differences which are from time to time exhibited in the certificates issued by Public Analysts, when compared with those emanating from the Somerset House Laboratory in regard to the analyses of samples which purport to be representative portions of one and the same article, and we have shown that if due regard be given to the principles of evidence, it is not only wholly unjustifiable, but utterly absurd to conclude that such difference, as a matter of course, indicate error or carelessness on the part of the Public Analyst. In season and out of season we shall continue to expose the fallacies which underlie the abominably unjust assumption referred to, and to urge that in each case of the kind every possible step should be taken by those concerned on behalf of prosecuting authorities, to make all the conditions affecting the case as clear as they can be made to the lay mind.

Policymakers have focused on improving STEM outcomes for US high school students for over 50 years. Much of this focus has centered on improving the quality of STEM teachers, particularly in poor and minority schools. Few, if any, of these efforts have considered the importance of the content knowledge of those providing instructional leadership in schools – namely, principals and assistant principals. This chapter examines the percentage of school leaders with teacher certification in mathematics or science and the degree to which teacher and school leader turnover interrupts the leadership–teacher relationships. The study concludes relatively few school leaders have the content knowledge to provide deep instructional leadership. Moreover, the study finds combined teacher and school leader turnover greatly diminishes the sustained relationships between instructional leaders and teachers, particularly in lower-performing schools.

The purpose of this chapter is to examine what it means for students with extensive support needs (ESN) to have opportunities to learn (OTL), why OTL is inexplicably tied to inclusive practices, and the in-school and post-school outcomes when students have OTL. Research will be provided that supports positive in-school and post-school outcomes, when students are provided equitable learning opportunities in inclusive contexts. Given the difference in possible outcomes for students with ESN when they do and do not have OTL, excluding them from general education contexts, where they have the best access to the intended and enacted curricula, is both unethical and limiting to society as a whole.

In spite of the improved facilities which Tellier's discovery of the refrigerating process provided for the transportation of meat supplies from the great cattle raising areas of the world to the markets of Europe, a probable shortage of beef within the next dozen years is hinted at by some experts. In fact, these experts say that conditions point to a possible repetition of the crisis which confronted European statesmen, in 1866, when as a result of increased population, accompanied by increased average individual meat consumption, the margin between supplies and demand was reduced to dangerously narrow proportions. It was generally believed that Tellier's timely discovery had removed the menace of a meat famine in Europe practically for all time, but in the sanguine outlook of the moment insufficient allowance was made for the tremendous growth in the population of the New World.

Self‐inductance calculations are presented for coils of modular construction. Individual modules have a fixed winding density, so that a complete multi‐module coil will be characterized by larger inter‐turn spacing at its extremities to provide suitable insulation strength under impulse voltage conditions. Gives inductance computations using finite‐element analysis, so that empirical correction factors to take account of end‐effects and inter‐turn spacing are unnecessary. Comparison where possible with established empirical methods shows consistency. Gives an example of oscillatory high‐voltage tests.

It has been stated, and not without some cause, that no branch of our law is in a more uncertain condition than that relating to warranties under the Sale of Food and Drugs Acts, for during the past twenty‐three years various decisions have been given on what constitutes a warranty within those statutes, and at first sight it appears somewhat difficult to extract therefrom any settled principles. We propose, however, to examine shortly the leading cases on this important subject, and to see how far they are consistent with one another and lay down rules for general guidance.

THE trials of R 100 and R 101, with the consequent revival of interest in airship technical matters, makes the present time not inappropriate for reviewing the alternative methods by which such craft can be propelled.