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.     

类型化视域下自然保护地立法的制度建构

自然保护地在维持生态平衡,实现生态系统服务功能中可以发挥重要作用,但不同类型自然保护地的主导生态系统服务功能供给存在一定差异.《自然保护地法》立法工作须依赖理论上对自然保护地的类型化,并在此基础上建构对应型的规划建设、运营管理等方面的具体制度.因此,基于生态系统服务功能供给的空间差异,可以将当前相互重叠、缺乏体系的自然保护地划分为国家公园、自然保护区、自然公园、自然保护小区等四种类型,搭建"1部基础法律+4部类型化条例(或法律)"的自然保护地法律体系,并可以通过体系化公法、私法制度工具强化自然保护地的有效治理.     

高校哲学社会科学研究评价的本质要求及其制度建设

建设具有中国特色、中国风格、中国气派的哲学社会科学,一直是我国哲学社会科学繁荣发展的根本目的.提升高校哲学社会科学繁荣发展水平,离不开科学有效的哲学社会科学研究评价.坚持党的领导、"二为"方向和"双百"方针是哲学社会科学繁荣发展的根本保障,坚持"质量为本"和"创新至上"是哲学社会科学繁荣发展的必然要求,坚持科学权威和公开透明是哲学社会科学研究评价的现实需要.结合当前高校哲学社会科学研究评价中"量化评价下数量与质量的关系论辩","学术评价与科研管理评价的边界异化"和"学术权力和行政权力的制度规制"三大问题聚讼,文章建议通过强化学术成果质量保障机制、优化学术共同体工作机制、构建学术争鸣长效机制和完善学术成果转化应用机制等制度建设,推动构建科学权威、公开透明的哲学社会科学研究评价体系,以期进一步改善新时代高校哲学社会科学研究评价工作.     

随机需求环境下联产品系统价格与产量决策研究

基于固定比例生产技术和多产品随机需求的情形,研究了联产品制造商的两阶段产量和价格联合优化模型。通过反向倒推的优化求解,得到了联产品制造商的最优产量和价格决策以及变化规律。同时研究了需求服从均匀分布时,需求波动对均衡的影响。研究结果表明,在订货成本较低和一种产品的需求波动性较大时,当另外一种产品的波动增大,则该产品的最优订货量增大,同时价格下降。借助数值仿真,分析了价格敏感度和产出比例对最优决策和利润的影响。结果表明,在给定一种产品的价格敏感度时,另外一种的价格敏感度越大,那么该产品的价格就越低,制造商的订货量就下降。当一种产品的产出比例固定时,另一种产品的产出比例上升时,则该产品的价格下降,制造商的订货量下降,总利润上升。     

从主权国家的兴衰看权力博弈形态的转型

传统的国际关系理论,无论是现实主义、自由主义、建构主义还是科学行为主义理论,都是把主权国家抽象成一个统一的国际关系行为体。这一行为主体有一致的利益,也自然要有一致的对外政策目标和手段。在20世纪,尤其是在两次世界大战和冷战期间,这一概念抽象是非常准确的。但冷战结束以后,尤其是进入21世纪以后,这一概念抽象逐渐与国际关系的现实相违背。一方面,国家综合实力并不能直接转化为具体领域的竞争优势;另一方面,很多国家,包括超级大国在内,其对外政策的主要阻力可能不是所谓的竞争对手,而是其国内不同的利益集团。这导致传统的国际关系理论,从假设到概念和推理层面,都已经无法解释和预测今天的世界,而权力小博弈理论可以为认识多元复杂互动博弈时代的国际关系提供一个新的解释框架。     

农户地权诉求视角下农地制度的创新

目前我国农户的地权诉求已经发生了很大的变化，即由地权稳定、自主经营向农地资源的优化配置和高效利用转化。这一变化的内在动力是农户急切希望改变承包地过于细碎化以及改善农业生产经营基本条件。考察我国农地制度的发展史可以发现，我国农地制度变迁的基本逻辑就是农户的地权诉求决定农地制度的发展方向，这一点在当下一些地方的农地制度创新试验和经验中再次得到证明。今后我国农地制度创新必须遵循这一逻辑，根据我国农户地权诉求的变化，实施农户自愿前提下的承包地连片重划,争取国家对承包地重划制度的支持,强化农民集体民主决策制度,地方政府也要给予必要的支持。     

Inferences on the Means of Two Log-Normal Distributions: A Computational Approach Test

In this article, we propose a novel approach for testing the equality of two log-normal populations using a computational approach test (CAT) that does not require explicit knowledge of the sampling distribution of the test statistic. Simulation studies demonstrate that the proposed approach can perform hypothesis testing with satisfying actual size even at small sample sizes. Overall, it is superior to other existing methods. Also, a CAT is proposed for testing about reliability of two log-normal populations when the means are the same. Simulations show that the actual size of this new approach is close to nominal level and better than the score test. At the end, the proposed methods are illustrated using two examples.     

Testing equality of two normal covariance matrices with monotone missing data

Abstract

The problem of testing equality of two multivariate normal covariance matrices is considered. Assuming that the incomplete data are of monotone pattern, a quantity similar to the Likelihood Ratio Test Statistic is proposed. A satisfactory approximation to the distribution of the quantity is derived. Hypothesis testing based on the approximate distribution is outlined. The merits of the test are investigated using Monte Carlo simulation. Monte Carlo studies indicate that the test is very satisfactory even for moderately small samples. The proposed methods are illustrated using an example.     

疲劳裂纹扩展试验裂纹图像采集系统

针对目前金属疲劳裂纹扩展检测方法存在效率低、操作繁琐、精度不高，不能实现实时性等缺点，文章提出了基 于机器视觉的裂纹检测方法。根据金属疲劳裂纹扩展试验过程中裂纹图像的采集要求，设计了摄像头位置可自动调整 的疲劳裂纹图像采集系统，包括摄像头安装运动装置，裂纹图像采集装置以及摄像头运动控制系统。图像采集装置由高 分辨率黑白面阵CCD摄像头、光学镜头，光源照明装置和图像采集卡组成，前3者安装在摄像头支架上，与摄像头运动 装置相连。摄像头运动装置中的X，Y，，Z轴运动机构由步进电机带动滚珠导轨机构。在基于ARM技术的运动控制系统 的控制下摄像头可沿X，Y，，Z轴作高精度直线运动，实现和试件之间精确位置的调整。实验结果表明，所设计的系统可 采集到疲劳裂纹扩展试验过程中高清晰度、高分辨率的试件裂纹图像，满足下一步裂绞尺寸计算的要求；摄像头运动定 位精度可达到0. 02 mm，满足精确的系统聚焦、位置调整、跟踪采集的要求。     

Statistical testing strategies for assessing treatment efficacy and marker accuracy in phase III trials

When a candidate predictive marker is available, but evidence on its predictive ability is not sufficiently reliable, all‐comers trials with marker stratification are frequently conducted. We propose a framework for planning and evaluating prospective testing strategies in confirmatory, phase III marker‐stratified clinical trials based on a natural assumption on heterogeneity of treatment effects across marker‐defined subpopulations, where weak rather than strong control is permitted for multiple population tests. For phase III marker‐stratified trials, it is expected that treatment efficacy is established in a particular patient population, possibly in a marker‐defined subpopulation, and that the marker accuracy is assessed when the marker is used to restrict the indication or labelling of the treatment to a marker‐based subpopulation, ie, assessment of the clinical validity of the marker. In this paper, we develop statistical testing strategies based on criteria that are explicitly designated to the marker assessment, including those examining treatment effects in marker‐negative patients. As existing and developed statistical testing strategies can assert treatment efficacy for either the overall patient population or the marker‐positive subpopulation, we also develop criteria for evaluating the operating characteristics of the statistical testing strategies based on the probabilities of asserting treatment efficacy across marker subpopulations. Numerical evaluations to compare the statistical testing strategies based on the developed criteria are provided.