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.     

基于质量意识的复杂产品质量控制激励策略

激励在复杂产品供应链中对主供协同合作关系及质量控制发挥了重要作用。本文研究基于主制造商在复杂产品生产研发前按照客户要求形成的质量意识的激励策略是否可以实现复杂产品质量控制问题。考虑具有质量意识的主制造商和其系统供应商组成的两级供应链，建立以主制造商为领导者的Stackelberg博弈模型，分别讨论无激励和存在激励时的主供生产最优决策。基于激励方式的不同，将激励策略分为根据供应商产品质量水平激励以及根据主制造商质量意识水平激励两种方式。研究结果表明激励是供应商加强协同合作、改进产品质量的内在动力，主制造商根据质量意识激励供应商可以进一步促使双方协同合作，提高产品质量，使双方获得更高的利润从而实现供应链整体利润最大化。此外用灵敏度分析发现提高主制造商质量意识水平可以增加双方协同合作努力程度，有效提升产品质量水平并实现帕累托改进。     

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.     

三级装备制造业供应链质量管理行为研究

作为我国工业化建设和国民经济发展的根本保证，供应链环境下装备制造企业的产品质量问题受到了广泛关注。本文重点考虑产品质量对供应链收益的影响，运用微分对策理论研究由单一制造商、单一部件供应商和单一零件供应商构成的三级装备制造业供应链质量管理行为的协调问题。通过对比Nash非合作博弈和Stackelberg主从博弈两种分散式决策模式及集中式决策模式下协同合作博弈的均衡结果，得到相关结论，并利用算例进行验证。研究表明，①分散式决策下，制造商的质量管理行为相同，但相比于Nash非合作博弈，Stackelberg主从博弈能够改善部件供应商和零件供应商的质量管理行为，提升供应链成员的收益水平；②集中式决策下，供应链成员的质量管理行为达到最优，系统整体收益实现最大。研究结论为装备制造业供应链成员间质量管理战略联盟的构建提供了理论依据。     

Contextualizing case reviews: A methodology for developing systemic safeguarding practices

This paper introduces a systemic methodology for reviewing professional responses to abuse between young people. The approach, “contextual case reviewing,” draws upon constructivist structuralism to assess the extent to which safeguarding practices engage with the social and public contexts of abuse. The paper conceptually compares the methodologies of contextual case review and other serious case review methods before drawing upon findings from 2 studies, which used the contextual case review methodology to explore the extrafamilial nature of peer‐on‐peer abuse and the ability of child protection practices to engage with this dynamic. Thematic findings from these studies regarding the practical interpretation of “significant harm” and “capacity to safeguard,” as well as their use within child protection assessments, are used to challenge conclusions of other case reviews, which imply that child protection procedures are sufficient for safeguarding young people. Contextual case reviews suggest that safeguarding practices, and the legislation that underpins them, are culturally, procedurally, and organisationally wedded to the context of the home, whereas insufficiently engaged with extrafamilial contexts of significant harm. The application of these issues require interrogation if social work systems are to provide sufficient mechanisms for safeguarding young people and families at risk of significant harm.     

Undercover policing and the spectre of ‘domestic extremism’: the covert surveillance of environmental activism in Britain

The spectre of environmental ‘domestic extremism’ has long been postulated by police leaders and security analysts in Britain. It is a narrative that has justified the commitment of enormous amounts of government resources towards police intelligence work directed at non-violent direct action campaigns. Most controversially, this has included the long-term infiltration of environmental (and other) activist groups by undercover police. This article provides a critical analysis of the justifications put forward in support of the covert surveillance of environmental activists in Britain. The paper proceeds by way of a single case study – a high profile, environmental direct action protest in the north of England – in order to reveal the levels of abuse, manipulation and deception at the basis of undercover protest policing. Through their court case, the activists involved with this action were able to obtain rare insights into the police authorisation documents for the undercover operation that had led to their arrests. An analysis of these documents provides us with a glimpse of the contradictory justifications given by senior police officers for infiltration – now under scrutiny by a public inquiry.     

Transition probabilities and ARL performance of Six Sigma zone control charts

In this article, Six Sigma zone control charts (SSZCCs) are proposed for world class organizations. The transition probabilities are obtained using the Markov chain approach. The Average Run Length (ARL) values are then presented. The ARL performance of the proposed SSZCCs and the standard Six Sigma control chart (SSCC) without zones or run rules is studied. The ARL performance of these charts is then compared with those of the other standard zone control charts (ZCCs), the modified ZCC and the traditional Shewhart control chart (SCC) with common run rules. As expected, it is shown that the proposed SSZCC outperforms the standard SSCC without zones or run rules for process shifts of any magnitude. When compared to the other standard ZCCs and the Shewhart chart with common run rules, it is observed that the proposed SSZCCs have much higher false alarm rates for smaller shifts and hence they prevent unwanted process disturbances. The application of the proposed SSZCC is illustrated using a real time example.     

强势开端Ⅴ：内容、特点及启示

从幼儿园过渡到小学是所有儿童必须面临的一个巨大跨越。研究表明，如果幼儿教育与小学教育之间没有良好的衔接与过渡，这些“优势”将在小学第一年消失，或将不能在小学教育阶段保持。强势开端Ⅴ聚焦幼小衔接，从组织与管理、教师专业发展衔接、课程与教学衔接、儿童发展衔接方面的举措进行研究。通过对这些举措的介绍分析，提出了启动幼小衔接专项教师培训，强调学校为儿童入学做好准备，注重多方利益主体协同共育几点借鉴思路。     

生产性服务业:发展态势、存在的问题及高质量发展政策思路

生产性服务业的改造提升和优化升级,是中国经济高质量发展的内在要求。当前,研发设计服务业“量质齐增”,已成为中国经济高质量发展的重要引擎；物流服务业发展迅猛,在企业生产和居民生活中的重要性日益凸显；金融服务业通过提供融资支持,有力促进了经济社会的良性发展；信息技术服务和电子商务飞速发展,“数字+”成为产业升级的重要实现渠道；租赁和商务服务业业态更加丰富,是促进产业转型升级的重要力量；服务外包规模持续攀升,业务覆盖范围不断扩展；职业教育方兴未艾,提升了中国人力资源的整体水平。但是,中国生产性服务业依然存在着国际竞争力羸弱、对外开放水平较低、与其他产业的融合力度不强、在全球价值链中的地位不高等问题。对此,提出了应进一步夯实生产性服务业发展的基础,对标国际标准推进服务业供给侧结构性改革,把生产性服务与制造业融合发展作为主攻方向,把提升服务贸易国际竞争力作为关键抓手,抓住机会提升生产性服务业全方位对外开放水平等政策建议。