The health-care economy is filled with unusual and even unique economic relationships. One of the least understood involves the peculiar roles of producer or “provider” and purchaser or “consumer” in the typical doctor-patient relationship. In most sectors of the economy, it is the seller who attempts to attract a potential buyer with various appealing factors of price, quality, and use, and it is the buyer who makes the decision. Such condition, however, is not common in most of the health-care industry.

    In the health-care industry, the doctor-patient relationship is the mirror image of the ordinary relationship between producer and consumer. Once an individual has chosen to see a physician — and even then there may be no real choice — it is the physician who usually makes all significant purchasing decisions: whether the patient should return “next Wednesday”, whether X-rays are needed, whether drugs should be prescribed, etc. It is rare that a patient will challenge such professional decisions or raise in advance questions about price, especially when the disease is regarded as serious.

    This is particularly significant in relation to hospital care. The physician must certify the need for hospitalization, determine what procedures will be performed, and announce when the patient may be discharged. The patient may be consulted about some of the decisions, but in general it is the doctor's judgments that are final. Little wonder then that in the eye of the hospital it is the physician who is the real “consumer”. As a consequence, the medical staff represents the “power center” in hospital policy and decision-making, not the administration.

    Although usually there are in this situation four identifiable participants— the physician, the hospital, the patient, and the payer (generally an insurance carrier or government)— the physician makes the essential decisions for all of them. The hospital becomes an extension of the physician; the payer generally meets most of the bills generated by the physician/hospital, and for the most part the patient plays a passive role. We estimate that about 75-80 percent of health-care choices are determined by physicians, not patients. For this reason, the economy directed at patients or the general is relatively ineffective.

    Welcome to Reading Museum's Hands – on Learning service

    Reading Museum has been offering learning opportunities to schools for over 100 years, and with your support we hope to continue this tradition for the next 100 years.

    SESSIONS AT READING MUSEUM

    Victorian Schoolroom

    The session takes place in a superb reconstruction of a schoolroom in a late nineteenth century Board School. The children will experience a range of Victorian style lessons and use slate boards and dip pens. The session leader plays the role of a Victorian teacher but will come out of the role during the session the reassure the children. We supply costume for all children.

    Victorian Toys

    Our Victorian nanny delivers this interesting session. The nanny will help children to explore the differences between rich and poor children's toys from the past. During the session the children have the opportunity to make a toy to take home.

    Victorian Christmas

    In a specially decorated room the children will find out how the Victorians introduced many of our Christmas customs. They will make a simple card or present to take home and take part in a mini pantomime.

    HOW TO BOOK AN EDUCATIONAL VISIT

    For up to date prices and session details, please visit our website www.readingmuseum.org.uk/schools/sessions/

    For all session bookings please phone us on 01189373400. We ask that you book at least 4 weeks in advance. Please be ready to tell us when you wish to come, the session(s) you wish to book and the year group of pupils.

Our sessions take place between 10:00 and 12:00 or 12:30 and 14:30.

    The maximum group size is 35 pupils. We recommend that you bring 5 adults for each group.

    As my fortieth birthday approaches, inevitable as a new hair-do, I realize how many women friends I've had over the years: Most have come and gone with the changes of life, just like the latest shoe fashions waltz in and out of my closet.

    Some of my friends, like some of my shoes, were silly mistakes. They never did fit properly, and they always felt slightly “off”, no matter how hard I tried to fit my feet into them. Others were my absolute favorite for a while, but they wore out or wore off. All style and no substance; the quality just wasn't there.

    Then there are my true friends—the ones who, like a pair of fine shoes, never go out of style or out of favor, whose appeal and value just increase with wear and time. These are friends who stay in touch and stand by me—as if they and I have never gone off to a new state, or a new job. Physical distance does not separate us; time does not change the fundamental fact of our friendship; the wear and tear of life does not stop us. The sole still support us; the colors and lines still please us; the uppers, still strong but gown son, gently bent around feet. Our connection is securely fastened, unaffected by the whirlwind of changes we've each been through, even when life carries us in different directions.

    If the comparison fits...

    Deborah is the evening shoe, elegant and lovely. She appreciates the finer things, choose only the best, and still looks polished long after the rest of us have drooped. She is a study in elegance and knows the difference between bone, and winter white. From this splendid treasure, I've come recognize my own appreciation for the finer things in life—and to the realization that I deserved them.

    Jane is pair essential, timeless pumps that I wear often and would be lost without. With this classic, my basic needs and comfort level are assured—leaving me time and energy for fun. I can move gracefully from day to night, from work to play, from jokes to discussion. My step is light; laughter comes easily and I am ready for adventure.

    Georgiana is my pair of standard white Keds—familiar, comfortable and good for all seasons. I've had them since long before. They are part of my childhood. They take me home, and I am a kid again diving into the ocean on a hot summer day. They have been up the hill and through the mud with me. They keep me moving forward, even when putting one foot in front of the other feels like the hardest thing I've ever done. I know I can slip them tomorrow and after. I am indebted to these lovely worn sneakers.

    In the shoe rack of life, these are the friends I cherish. They are the base upon which I stand. They accompany me on my chosen path, regardless of where it leads or how bumpy or how humpy or winding it gets.

    Most kinds of rose plants come from Asia. But roses are also native to other areas including northwest Africa, Europe and the United States. Some people say roses are difficult to grow. But you have a good chance of success if you start with a few suggestions from experts.

    You should plant your roses where they can get sunshine for about six hours on bright days. You can buy roses from a garden center or by mail order. You can buy potted（盆栽）roses, also known as container roses, or bare-root（裸根）plants. Each kind has its fans.

    Some gardeners say potted roses are easier to plant. They say the roots develop better. But Jeffrey Dinslage, president of Nature Hills Nursery in Omaha, Nebraska, points out that bare-root roses come without soil. So they weigh less to transport. If they arrive before you are ready to plant them, make sure the packing material is slightly wet. Keep the plants in a cool, dark place. You plant the roses while they are not active. The resting plants have no leaves but still need water.

    When growing roses, the soil should be wet. Watering should be done in the morning. That can prevent problem called black spots. But do not water too much. Jeffrey Dinslage says people often ask him about becoming discolored on rose leaves. He says the problems are usually caused by too much water. After heavy rains or too much watering, he advises pulling away mulch（覆盖物） from around the roots for a short time. This will help dry the soil. If your soil is very dry, you can add compost(堆肥), which returns nutrients（营养）to the soil.

    If you want to know more information, please click www. Planting.com.

    A picture speaks a thousand words. And with over a thousand emoji pictures to represent our words, who needs to speak or write any more? According to Professor Vyv Evans of Bangor University, emoji is the UK's fastest-growing language in history. These little electronic pictures started life in Japanese mobile phones in the 1990s and are now hugely popular. They have inspired fashion, like the real-life dress copied from the dancing lady emoji, and are even recognized as art! In New York's Museum of Modern Art you can now see the first set of the 176 original emojis.

    Why do we love them so much? They allow us to personalize text and have fun as we express ourselves, make people laugh and be creative in how we use them. UK teenagers also told us they really appreciated the fact that emojis are quick and easy.

    People have their favourite emojis. In the UK, the most used emojis are ' face with tears ofjoy', ' face blowing a kiss' and 'Iove heart'. Maybe (with emojis at least) the British are more fun and romantic than people think! Companies such as McDonalds have also tried to use people's love of emojis to make advertisement. They used a series of emojis to tell a story of a disappointing day given a happy ending by a visit to McDonalds. Unluckily for McDonalds, most people added the vomiting(呕吐) emoji to the blank space after the story.

    What is the future of emoji? Is emoji developing so rapidly that it will soon compete with English as a global language? Or is technology changing so fast that emoji will soon be forgotten when the next big thing comes along? It is hard to say and even technology and language experts are divided on the subject.

    What do you think? Keep your eyes open for new developments!

    Almost none of us have the time to read everything we'd like to read. Yet we lose countless hours to daily activities that bring us little joy like taking buses and waiting in line. What if we could turn these little blocks of unoccupied time into precious and rewarding moments for learning and thinking?

    Established in 2012, iReader, a micro-learning app on mobile phones, brings the biggest ideas from best-selling books through 15-minute audio (音频) and text. So far, more than 3,000 books have been included, ranging from psychology and parenting to management and economics, with new titles added every day.

    iReader is pioneering a new method of reading, with over 9 million users enjoying the benefits already. According to the Pew Research Center (PRC), the British read just 4 paper books a year and over 25% haven't read a single paper book this year, but reading isn't dying. There are now more ways for the British to read than ever before, due to the widespread use of e-books and audio books.

    The books in iReader are rewritten to ensure it is easy to remember the main content. The way the content is edited has been specifically designed to ensure it is useful in practice. Besides, the content is rewritten with related examples in real life, which means users are more likely to remember and apply what is helpful to them.

    Holger Seim, German co-founder of this app, declares, "iReader gives you the biggest ideas in the shortest possible time. It transforms great ideas into little packs you can listen to or read in just 15 minutes."