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1.
Poor quality of care may have a detrimental effect on access and take-up and can become a serious barrier to the universality of health services. This consideration is of particular interest in view of the fact that health systems in many countries must address a growing public-sector deficit and respond to increasing pressures due to COVID-19 and aging population, among other factors. In line with a rapidly emerging literature, we focus on patient satisfaction as a proxy for quality of health care. Drawing on rich longitudinal and cross-sectional data for Spain and multilevel estimation techniques, we show that in addition to individual level differences, policy levers (such as public health spending and the patient-doctor ratio, in particular) exert a considerable influence on the quality of a health care system. Our results suggest that policymakers seeking to enhance the quality of care should be cautious when compromising the level of health resources, and in particular, health personnel, as a response to economic downturns in a sector that traditionally had insufficient human resources in many countries, which have become even more evident in the light of the current health crisis. Additionally, we provide evidence that the increasing reliance on the private health sector may be indicative of inefficiencies in the public system and/or the existence of features of private insurance which are deemed important by patients.  相似文献   
2.
ABSTRACT

Women fare less well than men across all academic disciplines: they are less likely to be promoted, they earn less, and many more professors are men. There has, however, been little analysis to date of the experience of women in social work education, a discipline that has historically had higher representation of female staff and students. This study set out to explore women in the social work academy through a case-study of social work education in Scotland. A mixed-methods approach was used, including a review of relevant literature; an online survey of women and men academics in social work education; and semi-structured interviews with female social work leaders, past and present. The study found that women in the social work academy faced the same pressures as other women in higher education; some of these pressures were also shared by men. Most significant, however, was the extent to which women in social work academia experienced twin challenges, firstly, as female academics and secondly, as female social work academics in a discipline that struggles for recognition in the academy. We conclude that this makes for a contradictory and, at times, ambiguous experience for women as they navigate the gendered academy.  相似文献   
3.
迄今,为解决多属性偏好关联决策属性集容量判断指数复杂性难题所提出的λ模糊测度模式与k-可加模糊测度模式,以及建构在它们之上的属性集容量确定的推算模型,尚存在着适用性差的技术不足。为此,以平衡容量判断的可操作性和容量推算的准确性为视角,提出了一种新容量测度模式,即关于容量判断与推算的夹挤式测度模式,并在此基础上通过引入决策者较易判断给出的容量序信息构建了相应的容量推算模型。基于数值模拟的对比分析表明:新模式不仅在应用可行性上高于k-可加模糊测度模式,而且从容量推算的准确性上看也明显优于λ模糊测度模式和k-可加模糊测度模式,因而对实际决策具有更强的适用性。  相似文献   
4.
制造业是我国国民经济的支柱产业,但也是环境污染物排放的主要来源、能源消耗主体和温室气体排放大户。制造系统高能耗、高物耗、高碳排放的加工过程是造成制造业碳排放量大的重要原因。生产单元作为制造系统的加工的主体,其碳排放量的核算是确定整个制造系统乃至制造业碳排放总量的关键。本文首先对生产单元的原材料、电能、辅助物料及废屑处理所引起的碳排放进行分析,确定生产单元的碳排放源;其次,产品合格率的不同会造成生产单元输入及输出的成品/半成品数量的差异,进而影响生产单元单位产品的碳排放量,在此基础上,综合考虑了原材料、电能、辅助物料及废屑处理的碳排放情况,构建了给定工艺流程下生产单元碳排放核算模型。最后,结合一汽车排气装置加工实例,分别核算加工过程中九个生产单元的碳排放量,验证了模型的可行性。  相似文献   
5.
Abstract

Risk and performance management are at the core of complex bespoke systems (CBSs). CBSs are developed to customer–specified requirements in terms of structure, functionality and conformance. This article examines how risk and performance management are integrated as essential systems in the successful development of projects across multi-organizational functions in complex bespoke system (CBS) organizations. The article argues for the development of a quality management system that consists of two sub-processes: quality control and quality development. Using three case studies from engineering companies, we provide evidence and insights of the way change control, quality development and quality performance are developed in innovating business solutions.  相似文献   
6.
当代知识论越来越重视认知价值的研究,但从认知价值角度去重新思考传统怀疑主义问题的研究却很少。历史上的怀疑主义者既认为我们无法拥有任何知识,又主张我们应该悬置判断。因此,他们不仅预设了一个高的知识标准,而且预设了一个价值标准:任何达不到知识标准的认知状态都是没有认知价值的。但这个价值标准是错误的,所以我们即使无法达到怀疑主义者所设定的知识标准,也不必悬置判断。假设怀疑主义者认为我们无法拥有任何知识,同时认可“有些达不到知识标准的认知状态也有认知价值”,那么怀疑主义就没有很大的威胁性,因为即使我们无法获取知识,也可以获得具有认知价值的东西,取得认知进步。此外,摩尔主义、语境主义、溯因主义这几种对怀疑主义的主要回应是否成功,最终都依赖于对认知价值的讨论。  相似文献   
7.

Background

The rates of breastfeeding worldwide are slowly improving since 1996. Europe is still trailing behind the global breastfeeding incidence and prevalence rates. Thus, breastfeeding promotion, protection, prolongation and support have become an important challenge as breastfeeding sharply decreases in the first six months of life.

Objectives

The aim of this project is to determine, assess and identify the real impact of breastfeeding support networks in Murcia (Spain).

Methods

After searching unsuccessfully for a validated questionnaire, a specific one was developed and validated for measuring the impact of formal and informal support networks through five dimensions: satisfaction, consultation, experience, problems and support. The questionnaire was provided to 500 mothers with experience in breastfeeding, who brought their children to baby paediatricians between 2 June and 27 November 2014. Upon completion of the survey and fieldwork, a detailed statistical analysis was conducted.

Results

The degree of satisfaction perceived by the users of the services of support breastfeeding networks is remarkable. In addition, mothers who clarified their doubts and discussed their problems with health professionals and/or breastfeeding support networks were more likely to breastfeed for a longer duration compared to those who did not (p = 0.005). Furthermore, mothers who sought support in breastfeeding are more likely to breastfeed for more than 6 months (p < 0.0005).

Conclusion

Based on this information, we conclude that breastfeeding support networks have a positive influence in the duration of a women’s decision to breastfeed.  相似文献   
8.
The increasing elderly population puts significant health, economic, and social burdens on society. Physical activity is one of the most cost-effective ways to maintain the health of the elderly. This study adopts a treatment effects model to investigate the causal relationship between environment attributes and physical activity among the elderly, while taking endogeneity into account. The data were collected from 274 participants by face-to-face interviews in Taichung, Taiwan. Performing physical activity regularly in parks is the most important measure of the amount of physical activity by the elderly. Providing sufficient and accessible parks in metropolitan residential neighborhoods could be one of the most cost-effective ways to promote physical activity for the elderly living in midsize Asian cities.  相似文献   
9.
Abstract

In her presentation entitled “No Mind Reading Necessary: Conducting Evidence-Based Electronic Resource Marketing and Outreach” at the North Carolina Serials Conference April 2019, Kate Hill discussed marketing research strategies and outreach tools used to increase online users’ access to electronic resources and primary resources. In an effort to connect users to seldom-used resources, Jackson Library collaborated with university partners to develop surveys to identify the information-seeking behavior of its users and apply the gathered marketing research to strategically plan outreach activities.  相似文献   
10.
As numbers of families with same-sex parents increase in the United States, children are more likely to encounter diverse family structures. Given that young children can demonstrate in-group bias, prejudicial attitudes, and social exclusion, it is important to understand how children perceive their peers in diverse families. To our knowledge, no studies have assessed elementary-school-age children's attitudes about same-sex parent families. Here, 131 elementary school students (Mage = 7.79 years; 61 girls) viewed images of same-sex (female and male) and other-sex couples with a child and then were asked about their perceptions of these families, particularly the children. Results indicated participants' preferences toward children with other-sex versus same-sex parents. Developmental and practical implications about children's attitudes toward sexual minority parent families are discussed.  相似文献   
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