新农合对四川藏区的减贫效应分析

The New Rural Cooperative Medi-cal System ( hereafter NRCMS) in Tibetan areas of Sichuan was started in Wenchuan in 2005 , and by 2008 covered all of the province’s Tibetan areas. This paper studies the effects of the NRCMS on im-proving the health of and alleviating poverty for farmers and herdsmen in Tibetan area of Sichuan. Most parts of the Tibetan areas of Sichuan are located in high altitude districts. Thirty two coun-ties of these areas are classified as “National Pov-erty Counties”. Poverty and disease go hand in hand in these regions. Kashin-Beck disease and hydatid disease are the major endemics in the pas-toral and agro-pastoral areas of Sichuan. Endemic, infectious and chronic diseases are widespread in Sichuan’s Tibetan areas. More than 70% of pa-tients are workers from 20 to 60 years old. Disea-ses are more prevalent in women than in men. Kashin-Beck disease and hydatid disease are cur-rently incurable. Patients suffer from health prob-lems, which leads to a decrease in their income and the heavy burden of medical expenses. The new rural cooperative medical system alleviates the negative effects of farmers’ falling into, or back in-to poverty due to disease. However, the existing medical compensation mechanism is not sufficient to solve the problem. The greatest impact of NRCMS on the farmers and herdsmen in Sichuan’s Tibetan areas is that the system has gradually changed local people’s medi-cal behavior, as well as their underlying ideas a-bout medicine: they begin to believe in hospitals. In particular, more pregnant women are choosing to give birth in hospitals, which reduces the rate of infant mortality and postpartum diseases, and im-proves the health of women. Since the full coverage of the NRCMS in 2008 , the number of people participating in the system has reached the overall average level of Si-chuan province. By analyzing the data before and after the implementation of this system, and meas-uring the impact of the system on people’s health, it can be found that the NRCMS’s role in serving the vulnerable population, such as the elderly and infant children, is more marked. Since the implementation of the NRCMS, all administrative villages in Sichuan Tibetan areas have established village clinics, which solved the problem of a shortage of medicines and doctors in those areas. Farmers and herdsmen have conven-ient access to medical treatment, enhancing the ac-cessibility of medical service. After the implemen-tation of the NRCMS, the health of the elderly population in rural areas has improved. Infant mor-tality rates have dramatically fallen. The implementation of the NRCMS improved the medical service capacity of township hospitals and village clinics. And the NRCMS has brought the township hospitals and village clinics into its scope of compensation, which greatly promotes the utilization of primary medical services in Tibetan areas. The poverty reduction effect of the NRCMS can be analyzed from two aspects:Firstly, the im-
provement in health leads to increased income, be-cause good health can promote labor productivity. Meanwhile, the increase in income will in turn im-prove the overall level of health. Secondly, the in-patient and outpatient compensation rate is raised year by year, which reduces the medical fees of farmers, and prevents them from falling back into poverty.     

Giving time or giving money? On the relationship between charitable contributions

This paper studies philanthropic behaviour in terms of money and time contributions for charitable organisations. Using a unique dataset, which is representative of the German population, we examine the pure contributions of individuals who give either money or time as well as joint contributions of individuals who give both money and time. We find that the sequential decisions to give to charity and how much to give can be explained by different socio-economic characteristics. We report particularly pronounced gender differences among pure contributions, an interesting pattern of human capital variables such as income and education, and possible differences in the type of philanthropic goods.     

Constructing ‘disability’ in Myanmar: teachers,community stakeholders,and the complexity of disability models

This article explores Myanmar teachers’ and community stakeholders’ constructions of disability. We examine how various religious perspectives – particularly Buddhism – inform and shape understandings of impairment and how these beliefs intersect with a strongly medicalised construction of disability. However, in our discussion and exploration of the responses, we also found that the notion of two primary disability ‘models’ – namely the medical model and the social model – lack nuance, complexity, and socio-cultural consideration. Through examining teachers’ and community members’ perspectives of disability in Myanmar, we highlight the importance of socio-cultural variance in understanding local constructions of disability.     

Early Childhood Education Centre Director Perceptions of Challenging Behaviour: Promising Practices and Implications for Professional Development

Given their key role in overall programme quality, it is critical to examine how early childhood programme centre directors in the United States perceive challenging behaviour. Participants completed a survey asking which behaviours they perceive to be most problematic, the number of children dismissed or expelled from the programme during the last year, and the most commonly used strategies for addressing challenging behaviours. Results point to several promising practices and highlight the variability in access to evidence‐based practices based on programme type. Areas that warrant more targeted professional development are discussed, and findings are situated within the larger early childhood context.     

Heterogeneity in treatment effects across diverse populations

Differences in patient characteristics, including age, sex, and race influence the safety and effectiveness of drugs, biologic products, and medical devices. Here we provide a summary of the topics discussed during the opening panel at the 2018 Johns Hopkins Center for Excellence in Regulatory Science and Innovation symposium on Assessing and Communicating Heterogeneity of Treatment Effects for Patient Subpopulations: Challenges and Opportunities. The goal of this session was to provide a brief overview of FDA-regulated therapeutics, including drugs, biologics and medical devices, and some of the major sources of heterogeneity of treatment effects (HTE) related to patient demographics, such as age, sex and race. The panel discussed the US Food and Drug Administration's role in reviewing and regulating drugs, devices, and biologic products and the challenges associated with ensuring that diverse patient populations benefit from these therapeutics. Ultimately, ensuring diverse demographic inclusion in clinical trials, and designing basic and clinical research studies to account for the intended patient population's age, sex, race, and genetic factors among other characteristics, will lead to better, safer therapies for diverse patient populations.     

Trajectory of problem behaviours of Korean adopted children: using piecewise hierarchical linear growth modelling

This study examined the trajectory of problem behaviours in domestically adopted children in South Korea as they aged. This study used the Panel Study on Korean Adopted Children's longitudinal, three‐wave data (2006, 2008 and 2010). Although data were collected at three time points, our data consisted of six time points, which covered the 5–10 years age range of the adopted children at the time of survey. One hundred sixty‐four children were included in the analysis, 75 of whom contributed to one time point, 74 to two time points and 15 to three time points. The trajectory of the problem behaviours of adopted children was examined using a piecewise hierarchical linear growth model. Because the initial exploration of the data suggested non‐linear changes in behaviour problems over time, we split the growth trajectory into two time periods: Time 1 (5–7 years) and Time 2 (7–10 years). A two‐rate model was used to estimate separate slopes for the two time periods. Results showed that the externalizing and internalizing problems of adopted children have different trajectories. Internalizing problems did not show significant changes after 5 years of age, while externalizing problems increased until 7 years of age and decreased significantly thereafter.     

A reduced form of the Workplace Bullying Scale – the EAPA-T-R: A useful instrument for daily diary and experience sampling studies

The need for more longitudinal studies (i.e. daily diary and experience sampling studies) focused on counterproductive work behaviours such as bullying requires shorter scales that at the same time do not compromise their content validity. Our main objective is to develop and validate a reduced version of the Workplace Bullying Scale (Escala de Abuso Psicológico Aplicado en el Lugar de Trabajo): the EAPA-T-R. Two studies (Study 1: 1506 and Study 2: 932 employees, respectively) were conducted to evaluate its psychometric properties and to ensure the external validity of the EAPA-T-R. Correlation and regression analyses were performed to reduce the current 12-item scale to a more parsimonious 4-item scale. Moreover, the psychometric properties of potential models were compared. Subsequently, the new scale was assessed using confirmatory factor analysis. Likewise, statistically significant relationships were found between the EAPA-T-R and other dimensions evaluated, such as job characteristics, transformational leadership, engagement, job satisfaction, and subjective performance. Moreover, bullying mediated the relationship between transformational leadership and burnout. To sum up, the EAPA-T-R showed good reliability and validity across studies, supporting its use in future research. The benefits of this short scale for daily diary and experience sampling studies and when using large surveys are discussed.     

The case of vegetovascular dystonia: inventing the most common Soviet disease

ABSTRACT

The paper considers the case of vegetovascular dystonia, one of the most typical and common “Soviet” diseases. This syndrome emerged in Soviet medicine after World War II, and very quickly become a popular diagnosis among physicians. The author describes how the construct of vegetovascular dystonia was formed and developed, what changes it underwent, and what affected those changes. The concept and history of vegetovascular dystonia can provide an understanding of Soviet medicine and health science in general.     

医院青年文化品牌塑造的路径探析

青年是医院的未来,引导青年医务人员树立坚定而充沛的文化自信是激发其积极性、主动性和创造性的重要方式。常州市第一人民医院以涵养文化自信为着力点打造青年文化品牌“青之源”,通过营造学习创新氛围、建设团日活动体系、搭建阅读分享平台、探索涵养青年文化自信的品牌塑造路径等方式,动力、活力、能力三源合流,为青年成长提供正向激励和人文滋养。