Multi-objective optimization in partitioning the healthcare system of Parana State in Brazil

Motivated by a proposal of the local authority for improving the existing healthcare system in the Parana State in Brazil, this article presents an optimization-based model for developing a better system for patients by aggregating various health services offered in the municipalities of Parana into some microregions. The problem is formulated as a multi-objective partitioning of the nodes of an undirected graph (or network) with the municipalities as the nodes and the roads connecting them as the edges of the graph. Maximizing the population homogeneity in the microregions, maximizing the variety of medical procedures offered in the microregions, and minimizing the inter-microregion distances to be traveled by patients are considered as three objective functions of the problem. An integer-coded multi-objective genetic algorithm is adopted as the optimization tool, which yields a significant improvement to the existing healthcare system map of the Parana State. The results obtained may have a strong impact on the healthcare system management in Parana. The model proposed here could be a useful tool to aid the decision-making in health management, as well as for better organization of any healthcare system, including those of other Brazilian States.     

民族互嵌式社区居民公共服务幸福感指标体系的构建

构建相互嵌入式社会结构和社区环境，是铸牢中华民族共同体意识，推动多民族社区治理的重要途径。由于多元文化的碰撞交融，社区内部张力扩大，民族互嵌式社区的治理在一定程度上存在着多民族融合表面化、社区共同体意识淡薄等一系列问题。论文结合社会系统论、社区治理论的相关原理，厘清民族互嵌式社区的内涵，提出民族互嵌式社区居民公共服务幸福感指标体系的构想。通过差异化选址、探索性因素分析，形成影响居民公共服务幸福感的社区融合、社区治理、社区文化建设、社会医疗、社区教育五个维度及指标体系，为有效评价民族互嵌式社区公共服务提供借鉴。     

医生的信息-情感交互模式对移动问诊服务满意度的影响——基于“激励-保健”理论的分析

移动问诊服务日益成熟，但患者满意度仍有待提高。现有研究对医患交互过程关注不足，且忽略患者不满意评价的影响因素。为此，本文引入"激励-保健"理论视角，研究医生的信息-情感交互模式对移动问诊服务满意及不满的影响机制。本文筛选国内某领先移动问诊平台中的300次医患沟通记录，采用"先定性后定量"的混合研究方法对数据进行分析。其中，定性研究旨在识别医生交互模式的细分维度，定量研究则用于提出并验证不同交互模式与患者满意及不满的关系。研究发现，医生的信息交互模式是移动问诊服务满意度的保健因素，而情感交互模式是激励因素。结论丰富了移动问诊服务患者满意度的研究框架，对改善医生行为和医疗服务APP设计提供了指导。     

国家、民族、社区——美国国家公园建设的经验及教训

美国国家公园建设过程中，以国家为主导，注重国家意识，定位服务功能，体现其教育理念，并在此过程中将管理和利用模式由开始的保护转变为现在的保护与利用并行，为全世界提供了一个成功的模板。但在其100年的发展过程中，环境的破坏，原住民权利的漠视，游客管理的混乱，是其曾遇到或正在面临的问题。建议我国在进行国家公园建设时，应扬长避短，突出国家名义，强调社区参与和游客管理先行，并注重国家公园的公益性和教育功能。     

A Literature Review of Organizational Behavior Management Interventions in Human Service Settings from 1990 to 2016

We reviewed the Journal of Applied Behavior Analysis (JABA), Journal of Organizational Behavior Management (JOBM), and Behavior Analysis in Practice (BAP) from 1990 to 2016, to identify articles that evaluated organizational behavior management interventions in a human service setting. Of those articles, 75 articles met the inclusion criteria for the review, 44 from JABA (1990 to 2016), 22 from JOBM (1990 to 2016), and 7 from BAP (2008 to 2016). We categorized each selected article by setting, employee population, client population, assessment, dependent variable, independent variable, and outcome measures. Results from the review are discussed for all three journals. Recommendations are made to broaden the scope of population and dependent variable targets, include more assessments, and include outcome data when applicable.     

The changing landscape of public service delivery systems for disabled people in China: a Shanghai case study

This article will consider the current development of an emerging contract culture for the delivery of social services and its impact on disabled people in China. The discussion is based on an original qualitative study in Shanghai. The past 30 years have seen dramatic changes in China, which in parts have led to improvements in the lives of disabled people. The China Disabled Persons’ Federation (CDPF) became a key player in delivering these changes with the government. However, the CDPF is being criticized by disabled people for being too bureaucratic and not being effective enough in its delivery of services. One of its responses is to work with newly emerging not-for-profit organizations (NPOs) of and for disabled people. The CDPF has now begun to contract the delivery of some services to such NPOs. It is hoped that this may improve their effectiveness but the development of a contract culture in the delivery of services for disabled people may also be seen to pose a threat.     

The service system challenges of work with juvenile justice involved young people in the Hunter Region,Australia

Current policies suggest that collaborative approaches are core to working effectively with juvenile justice involved young people. However, there is little research examining the workings of multi‐agency and collaborative endeavours in this field, or the experiences of the human service workers facilitating these connections. This paper reports on qualitative research that resulted from the Juvenile Justice and Education Equity in the Hunter Region project. Thirty‐eight human service workers were interviewed about their perceptions of the workings, strengths and challenges of the service system that supports young people who come into contact with the Children's Court in the Lower and Upper Hunter regions of New South Wales. Data analysis revealed three key themes related to (1) service gaps, cycles and maelstrom; (2) pursuing authentic service engagement; and (3) insider–outsider dynamics in service provision. Findings are discussed in relation to emerging practice and research agendas.     

A novel approach for evaluating programs designed to serve military veterans: Using an adapted common components analysis

Evaluators are challenged to keep pace with the vast array of Veteran support programs operating in the United States, resulting in a situation in which many programs lack any evidence of impact. Due to this lack of evidence, there is no efficient way to suggest which programs are most effective in helping Veterans in need of support. One potential solution to this dilemma is to reconceptualize program evaluation, by moving away from evaluating programs individually to evaluating what is common across programs. The Common Components Analysis (CCA) is one such technique that aggregates findings from programs that have undergone rigorous evaluation at the level of program components (e.g., content, process, barrier reduction). Given that many Veteran programs lack outcome evidence from rigorous studies, an adaptation to CCA is needed. This report examines cross-sectional data from a pilot study using an adapted CCA across five domains of well-being (i.e., employment, education, legal/financial/housing, mental/physical health, and social/personal relationships). The purpose of this preliminary study is to determine the feasibility of eliciting program nominations and program components from Veterans via an online survey. When coupled with a longitudinal research design, this adaptation to CCA will allow for stronger causal claims about the expected impact of different program components within and across a variety of domains.     

Open spaces for dialogue promoting mental health as a social work education methodology

ABSTRACT

The authors discuss service user involvement as a key approach regarding training of social workers. In many European Union countries this is a stable practice with a lengthy tradition in research and application. However, in Poland it is almost entirely absent and marginalized. This article presents the results of a participatory action research project conducted at the Institute of Sociology of the Jagiellonian University in Krakow, the objective of which was to identify and critically analyze the key substantive and formal aspects of training of social workers with the participation of individuals with experience of mental illness. This research project adopted an open approach to cognizing reality based on qualitative co-participatory methods. In the conclusion, the authors emphasize that the fundamental criterion for the success of this particular form of training is voluntary and differentiated participation of students—both in the role of people sharing their own experience and as learners—as well as shaping a culture of open dialogue, educational alliances of recognition and recovery, the foundation of which is axiological experience.