How do policy levers shape the quality of a national health system?

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.     

新乡贤重塑乡规民约:历史承继、时代价值及实现路径

当前乡村治理中乡规民约面临德治退化、自治弱化及法治虚化等现实困境。新乡贤作为乡村社会精英群体,在增强乡规民约的现代性、厚植乡规民约的乡土性及强化乡规民约的权威性等方面具有显著的时代价值,是重塑乡规民约的有益主体选择。实现新乡贤在重塑乡规民约中的时代价值,需要强化乡贤文化的敦风化俗功能、构建乡贤群体的风险防范机制及发挥乡贤组织的协商共治作用。     

论改善型民生

根据支撑基础、责任负担、保障水平以及民众需求等维度，可以把民生保障划分为托底型、基本型、改善型以及富裕型等四种类型。改善型民生是经济社会发展到一定阶段的产物，也是国家治理体系与治理能力现代化的客观要求。它是指通过各类民生项目的安排及民生待遇优化以促进民众生活得到持续改善、社会发展水平得到提升的一种制度类型，是民生项目更加齐全、内容更为完善、治理水平更高、使民众各按其分的民生模式，是人们的日常生活与服务消费支出总额持续增长以便能够提升生活水平的民生类型，是那种不断满足人的需要特别是较高层次需要的模式类型，也是更有助于形成社会结构稳定、国家长治久安的民生制度类型，因而具有综合性、完善性、激励性以及发展性等特点。这要求我们优化民生类型设计及民生投入结构，补齐改善型民生短板，营造良好社会秩序，扎实推进国家治理体系及治理能力现代化建设。     

困境与超越：扶贫工作的政治学分析

扶贫开发是国家治理的重要内容，有着丰富的政治意涵，展示着执政党执政、政府治理的基本过程和价值归属。中国的扶贫工作带有着明显的运动式、项目制、压力型的色彩，在取得巨大成效的同时，也有着走向无序化、无效化的风险。以现代国家建设和政党建设的基本理念，构筑多中心的贫困治理格局，建立现代化的扶贫开发的制度体系，走向法治化、制度化、民主化、规范化是扶贫开发的治本之策。     

太极拳与瑜伽术的传统意蕴及其文化学阐释

中、印传统体育文化蕴含了东方文明对于处世之道和养身模式的价值追求，作为东方体育文化典型代表的太极拳与瑜伽术，既是修炼身心、运动健身的重要项目，也是人们了解东方体育文化的重要媒介。跨文化比较分析表明，太极拳和瑜伽术在注重身形技法与艺术审美的结合、吐纳导引与意念游动的耦合、修身养性与天人意境的融合等方面具有共性，也有差异，体现出中、印在传统体育文化方面的异同。太极拳和瑜伽术的传承应该做到与时俱进、创新发展，其目标既不是传统竞技搏击术，也不是简单修炼养身术，而是融道德修养与身心修炼为一体的综合性运动项目。     

Perceptions of participants and staff of implementing a physical activity program in rural primary care

Addressing the lack of physical activity (PA) in rural adults is vital because of the role it plays in the risk for many chronic diseases. The purpose of the study was to explore the feasibility of conducting a 12-week intervention utilizing a Fitbit to increase PA behavior in inactive rural adults recruited from a primary care clinic. Semi-structured interviews were conducted with study participants (n=10) and a focus group was held with nurses (n=7) from the primary care clinic. Data were analyzed using the process of immersion/crystallization. Participants and nurses both felt the program had a positive impact on PA and that the program was needed in the community. Study participants most often reported their favorite part of the study was being able to track their activity as well as the goal setting. However, study participants reported barriers to continued participation in PA related to a lack of time and ability to be active in cold weather. Further, nursing staff reported barriers in regard to a lack of resources (staffing and money) These barriers need to be examined further and addressed in order to implement a sustainable PA program that can be maintained through a primary care clinic.     

制造系统生产单元碳排放核算模型

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。     

Jean Valjean Bank in Korea: an innovative approach to poor defendants sentenced to pay fines

ABSTRACT

This study aims to introduce Jean Valjean Bank in South Korea which is an innovative approach supporting poor defendants who cannot pay fines and accordingly are imprisoned. In Korea, it is reported that we have more than 40,000 Jean Valjeans annually. As a civil movement against the unfair criminal justice system, a non-governmental organisation Human Rights Solidarity (Inkwon Yondae in Korean) opened Jean Valjean Bank in 2015. Jean Valjean Bank targets poor defendants who are not able to pay fines and who are confined to prison because of non-payment of fines. As of December 2017, the Bank has loaned KRW1,024 million to 545 persons with an average loan per participant of KRW1,879,700. The Bank reported that, among the receivers, 84 persons completed redemption and 277 persons are redeeming loans to the Bank. This study concludes with implications for reforms in criminal justice system in Korea.     

Paradox of public sector capacity building: Lessons from MATT2 UK–Bangladesh co‐operation

This study focuses on the Government of Bangladesh and the UK Department for International Development (DFID) public sector capacity‐building project under collaborative public governance. It examines the efficiency and effectiveness of a foreign‐funded and multistakeholder‐led public sector capacity‐development initiative dubbed Managing at the Top Stage 2 (MATT2) project, and how it contributed to the human resource capacity development in Bangladesh. A combination of data from Government sources, in‐depth interviews, focus group discussions, participant observation and author analysis was adopted. The results showed the project to have been largely successful, despite some challenges.     

Integrating risk and performance management in quality management systems for the development of complex bespoke systems (CBSs)

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.