参加医疗保险对农村居民健康的影响——基于CHARLS 2015数据的实证分析

基于CHARLS 2015数据,采用倾向得分匹配法实证分析参加医疗保险对农村居民健康的影响。研究发现:参加医疗保险对农村居民的日常活动能力和自评健康影响不显著,参加医疗保险对农村居民认知能力具有显著的正向影响。据此提出,应进一步提升社会医疗保险保障水平、扩大社会医疗保险保障范围、促进商业医疗保险有序发展、推进"三医"高效协同联动等,以充分发挥医疗保险的健康保障功能,从而进一步提升参加医疗保险对农村居民健康的正向影响。     

孰轻孰重：市场经济下能力培育与环境建设？——基于农户绿色技术采纳行为的实证

基于湖北省1 090份农户调研数据，以有机肥施用为例，构建Binary Logistic模型探究市场能力、市场环境对农户有机肥施用行为决策的影响机制及作用大小。结果表明：市场能力中主动收集信息对有机肥施用行为产生正向影响，而销售渠道建设却表现出负向影响，市场环境中产品质量检测、要素获取便捷性与地方品牌建设均起到了正向促进作用，且根据变量贡献率大小可知市场环境作用更为显著。进一步根据市场环境的调节效应检验得出，地方品牌建设在技术推广培训、销售渠道建设与农户绿色生产技术采纳行为之间均起到正向调节作用，这说明农户市场能力作用的有效发挥需基于一定的市场环境。基于此，建议加强农户市场能力培育、发挥市场环境的规范性作用、正确认识市场能力和市场环境的作用和定位，以便调动农户有机肥施用积极性，实现农业绿色发展。     

Developing and testing a mobile application for breastfeeding support: The Milky Way application

BackgroundSupporting women to continue breastfeeding is a global challenge. The Milky Way Program is an effective face to face intervention to increase breastfeeding rates up to six months postpartum. The sustainability and access to the Milky Way Program could be enhanced by transforming it into a mobile application allowing women to access relevant information from their own place at a convenient time.AimTo explore the process of transforming the Milky Way Program into an acceptable and usable mobile health application.MethodStakeholders including multidisciplinary researchers and end-users designed the application based on the Milky Way Program by using Persuasive System Design principles. A mixed-method approach was used in the development and evaluation process. Seven women were recruited through convenience sampling to pilot test the application. The women’s feedback was collected through an online survey six weeks after birth and individual interviews at four months postpartum.FindingsWomen in the pilot study reported that the breastfeeding application was well designed, easy to use, interactive, reassuring and evidence-based with credible sources of information.ConclusionThe Persuasive System Design model combined with end-user engagement can feasibly inform the development of an acceptable and usable mobile health application for breastfeeding based on a proven clinical intervention. Further rigorous testing is required to evaluate the effectiveness of the application on breastfeeding initiation and duration.     

医疗信息共享对患者转移数量和服务质量水平影响研究

当前我国医院间存在严重的"信息孤岛"，医院参与医疗信息共享意愿不高，患者的诊疗信息被静态碎片化储存而无法充分有效地利用。考虑到医院进行医疗信息共享将降低患者转移成本，本文构建一个多阶段双寡头动态博弈模型研究医疗信息共享对医院竞争过程中患者转移数量和服务质量水平决策的影响。首先，根据是否存在转移成本，将患者分为新患者和经验性患者，借助Hotelling模型刻画患者的效用函数，分析患者就诊决策。然后，在政府价格规制和不考虑医院利他性情景下，构建了医院累积期望收益目标函数，使用动态规划方法，求解实现医院累积期望收益最大化的服务质量水平，获得了实现患者相互转移且医院在市场中共存的马尔可夫完美均衡。最后，根据医院参与医疗信息共享后患者转移成本降为零，分析与比较信息共享前后患者转移数量和服务质量水平变化。研究发现：在不同医院间本身存在患者转移背景下，医院参与信息共享后，患者转移数量增加但存在一个上限，增加的转移量与患者在医院间的转移成本呈正相关，与初始感知效用的差值范围呈负相关；医院参与信息共享后，均衡状态下的医院服务质量水平高于信息共享前的服务质量水平。因此，在不改变当前医保支付方式下，要加快推进医疗信息共享，政府部门可以根据医院的患者数量和服务质量水平变化对其进行定期补贴，以激励医院积极参与医疗信息共享，本文给出了这个补贴的量化表达。     

A Leadership Training Group for at Risk Fifth & Seventh Graders: Results from A Brief Strength-Based Group Program

ABSTRACT

An increasing number of youth are exhibiting social, emotional, and behavioral problems that hinder their ability to function at grade level. Subsequently, school mental health services have not been able to address the need for services particularly among students who are minority and poor. A mixed methodology study was conducted to determine the treatment outcomes from a brief strength-based leadership training group for primarily students who are African American and poor. Pre–post scores on three scales and focus group data revealed significant positive changes in regard to internal areas of functioning and social skills, anger management skills, and school attitude. Gender and age significantly impacted outcomes.     

‘Colour-evasiveness’ and racism without race: the disablement of asylum-seeking children at the edge of fortress Europe

This article explores discriminatory discourses articulated by Italian professionals operating in educational, health and social services for refugees in Rome, in relation to the educational and social inclusion of unaccompanied asylum-seeking and refugee children. It locates such narratives within the historical ‘concealment and invisibilisation of race and racism’ that have characterised Italy particularly since the end of the Second World War, while showing how they legitimate contemporary processes of disablement and over-representation of forced migrant children in the category of Special Educational Needs. A theoretical framework influenced by Dis/ability Critical Race Studies, Italian postcolonial studies, and Judith Butler’s notions of subjectivation and performative politics is used to discuss how a ‘colour-evasive’ racial ideology has seeped into various institutions in Italian society, and importantly into education policies and practices.     

Best practices for online Canadian prenatal health promotion: A public health approach

Background

Prenatal health promotion provides information regarding pregnancy risks, protective behaviours and clinical and community resources. Typically, women obtain prenatal health information from health care providers, prenatal classes, peers/family, media and increasingly, Internet sites and mobile apps. Barriers to prenatal health promotion and related services include language, rural/remote location, citizenship and disability. Online public health platforms represent the capacity to reach underserved women and can be customised to address the needs of a heterogeneous population of pregnant women.

疫情防控期间大学生焦虑水平及其影响因素研究

为了解大学生在新型冠状病毒肺炎疫情防控期间的焦虑状况，采用汉密顿焦虑量表（HAMA），对四川、云南、重庆三省（直辖市）的3 178名大学生进行在线问卷测试。结果发现：新冠肺炎疫情防控期间大学生焦虑水平高于常模，并且与大学生的性别、就读学历层次、就读学科、每日上网时间等存在显著相关性。其中，28.48%的大学生还可能有严重焦虑；女性、专科层次、尚不清楚就读学科的大学生群体焦虑水平更为明显；精神性焦虑是新冠肺炎疫情防控期间大学生焦虑的主要特质；每日上网时间与大学生精神性焦虑水平呈显著正相关。在公共卫生事件突发时期，应积极关注大学生的心理健康状态，采取针对性措施加以有效疏导和干预，促进其心理健康发展。     

大数据驱动下的政府治理机制研究——基于2020年后精准扶贫领域的返贫阻断分析

大数据时代已经到来，大数据驱动下的政府治理发生何种改变，目前相关研究较少。当前政府治理的考验集中在2020年实现全面脱贫后精准扶贫领域的返贫阻断。文章以该领域为切入点，探索大数据驱动下政府治理的内在机制。研究发现：大数据背景下，政府治理能力催生出新的核心能力，即数据治理能力。数据治理能力驱动下，政府治理主体多元化有利于实现政府治理资源的宽范围、精准化动员；政府治理方式实现经验式决策向数据化决策转变，有利于实现政府资源的高效率和公平配置；政府治理客体的精准识别，有利于政府资源的精准化和最优化运用。但是客观上必须具备数据治理能力，主观上必须按照大数据驱动的要求重构政府治理体系（包括治理主体、治理方式和治理客体），才能真正实现以数据治理驱动政府治理，进而提高政府治理能力的目的。而数据治理能力客观上也加速了政府治理体系的重构，进而加快了政府治理能力的提升，并最终提高政府治理绩效。在对标大数据应用不同阶段分析常规式返贫阻断和大数据返贫阻断的不足和差距的基础上，笔者提出重构政府治理体系和提升数据治理能力等针对性建议。