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The ESRD Quality Incentive Program (QIP) is the first mandatory federal pay for performance program launched on January 1, 2012. The QIP is tied to the ESRD prospective payment system and mandated by the Medicare Improvements for Patients and Providers Act of 2008, which directed the Centers for Medicare and Medicaid Services to expand the payment bundle for renal dialysis services and legislated that payment be tied to quality measures. The QIP links 2% of the payment that a dialysis facility receives for Medicare patients on dialysis to the facility's performance on quality of care measures. Quality measures are evaluated annually for inclusion on the basis of importance, validity, and performance gap. Other quality assessment programs overlap with the QIP; all have substantial effects on provision of care as clinicians, patients, regulators, and dialysis organizations scramble to keep up with the frequent release of wide-ranging regulations. In this review, we provide an overview of quality assessment and quality measures, focusing on the ESRD QIP, its effect on care, and its potential future directions. We conclude that a patient-centered, individualized, and parsimonious approach to quality assessment needs to be maintained to allow the nephrology community to further bridge the quality chasm in dialysis care.

This report is a summary of the specialist meeting of NCGIA Initiative 19: 'The Social Implications of How People, Space, and Environment are Represented in GIS'. The meeting brought together researchers and graduate students from the US and Europe and represented a spectrum of the Geography discipline. Deliberations began in an opening plenary session where the steering committee identified three core conceptual issues: 1) epistemologies of GIS; 2) GIS, spatial data institutions, and access to information; and 3) developing alternative GISs. Subsequent small group and plenary discussions generated the following seven research focus areas:GIS 2 and virtual geographies; GIS social practice and intellectual history; Environmental justice and political ecology; GIS in the community: local knowledge and multiple realities; Data access, privacy and geodemographics; Gender and representation; and Geographic Information (and Systems) and the human dimensions of global environmental change.

New right and neo‐liberal 'development' discourses have heavily impacted on the politics of agrarian restructuring in South Africa. Mechanisms for resolving agrarian contradictions are being discussed and presented as abstract planning decisions to be made by agricultural and rural development experts. This legitimation of 'neo‐classicism', if unchallenged, will reproduce and support current neo‐apartheid forms of restructuring.
In this article, we argue for a process of agrarian transformation where rural political mobilisation and the establishment of viable agricultural production systems are complementary. The paper is not an exercise in proposing specific (top‐down) 'solutions' or 'models', which has become a recent pre‐occupation in South Africa. Rather, we write with the objective of supporting a process whereby democratic transformation in rural South Africa remains possible.

Advocates a popular democratic process of transformation involving rural political mobilization and the establishment of viable production systems. African National Congress of South Africa (ANC) policy.

Der Artikel diskutiert, wie die Landfrage und die Frage landwirtschaftlicher Entwicklung im Südafrika nach der Apartheid gelöst werden kann. Ohne damit eine Lösung anbieten zu wollen, favorisieren die Autoren einen Prozeß landwirtschaftlicher Transformation, in dem die politische Mobilisierung der ländlichen Bevölkerung und die Schaffung lebensfähiger agrarischer Produktionssysteme komplementär sind. Die Widersprüche des Agrarsystems könnten nicht durch abstrakte Planungsentscheidungen von Entwicklungsexperten gelöst werden. (DÜI-Sbd)

This Specialist Meeting (Santa Barbara, CA, 15-17 Oct. 1998) brought together individuals with deep experience with public participation GIS to share experiences about alternative GIS designs and applications to better reflect community interests and involve and empower its members. The meeting also explored the unintended consequences of PPGIS in marginalizing people and communities. The participants presented case studies in a diversity of social contexts. Key themes of the meeting included: identifying community information needs and how PPGIS might contribute to those needs; the multiple ways in which PPGIS are being designed and implemented; the impacts on communities arising from differential access to GIS hardware, software, data, and expertise; the nature of GIS knowledge distortion and the ways in which socially differentiated communities and their local knowledge might be represented within a PPGIS; changes in local politics and power relationships arising from the use of PPGIS in decision making; unintended outcomes of PPGIS implementation, including red-lining, local surveillance, and breaches of confidentiality and privacy; and the potential of PPGIS to empower people and communities. Extended abstracts of papers from 38 participants, discussion summaries, and meeting recommendations are provided in this report.

ABSTRACTZimbabwe's 1992 food crisis revealed both spatial and social contradictions associated with post‐independence agricultural growth. Zimbabwe's pattern of agricultural restructuring demonstrates the need for agrarian reform programs that are more socially and environmentally sustainable. This paper examines one aspect of agricultural sustainability—the use of energy. Post‐independence patterns of agricultural energy consumption are analyzed and traced historically, and the social relations of agricultural energy utilization are investigated. The energetic efficiencies of the primary farming systems are calculated as are the macro‐flows of energy to agriculture generally. The data and historical analysis point to the need for a restructuring of agriculture that involves greater reliance on local renewable energy in all farming systems, and the continued resettlement of black smallholders onto former white‐settler estates.