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.     

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.     

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.     

Applying a Treatment Effects Model to Investigate Public Amenity Effect on Physical Activity of the Elderly

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.     

Surprise,surprise: the New Zealand general election of 2017

ABSTRACT

This article analyses the 2017 general election in New Zealand and draws out some of its implications. The final outcome was a surprise, and its implications momentous. Events strengthened Labour under a new leader and weakened the Green and New Zealand First parties, making it possible for Labour to become a viable coalition formateur. Comparing campaign public polling results, at least some of the polls were ‘wrong’, but all added to the excitement and uncertainty. Coupled with a new Labour Party leader, that uncertainty and excitement had mobilising effects that affected the young, but not the old. Finally, this article analyses the changes to the party system, nation-wide, and in the Māori electorates, assessing the degree of two-party dominance, and draws out implications for debates about the threshold for representation.     

No Mind Reading Necessary: Conducting Evidence-Based Electronic Resource Marketing and Outreach Using Marketing Research Assessment

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.     

沙水游戏在幼儿科学教育中的运用

沙水游戏包括玩沙游戏、玩水游戏、沙水结合的游戏。沙水游戏在幼儿科学教育中的价值主要体现在激发幼儿对自然界的好奇心,培养其专注度；激发其探究欲望，培养其探究能力；积累科学经验和感性认识，促进科学认知发展；帮助建立正确的科学前概念等方面。因此，应该积极利用沙水游戏来开展幼儿科学教育。     

基于系统动力学的“互联网+健康医疗”体系模型

“互联网+健康医疗”模式已然成为我国健康医疗产业发展的一个新方向,为解决传统医疗行业中存在的诸多问题提供了新思路。在分析“互联网+健康医疗”对传统医疗的影响及其发展机制的基础上,利用存量流量图等工具构建“互联网+健康医疗”体系模型,运用Vensim软件对我国“互联网+健康医疗”发展情况进行仿真,并模拟相关政策的干预效果。结果表明:“互联网+健康医疗”在降低潜在医疗需求(PMD)、促进分级诊疗中具有重要作用,保障医疗保险能够较好地嵌入“互联网+健康医疗”就诊流程中对降低PMD最有意义,而降低整体门诊价格对于优化就医结构、促进分级诊疗最为有效。     

越南阮朝初期“京—城”政区体制的内涵与消亡（1802—1832）

富春京畿区和北城、嘉定城，共同构成了越南阮朝初期的政区区块结构制式。京畿区的设置是为了增强阮朝的中央统治能力，二城的设置则是为了加深对南北两大地区的控制。从地理平面来看，“城”属之地往往为南北两圻的中心地带;从政区层级来看，“城”乃统属数镇之地的跨高层政区，为阮朝前期地方政区的最高层级。在阮朝建立之初，“城”的设置具有代镇地方和政治缓冲区的特点，但随着时间的推移，其弊端日益暴露，明命时期分期予以废除。京、城的废止与省的建立，标志着阮朝“京—城”政治地理体制的消亡。