参加医疗保险对农村居民健康的影响——基于CHARLS 2015数据的实证分析

基于CHARLS 2015数据,采用倾向得分匹配法实证分析参加医疗保险对农村居民健康的影响。研究发现:参加医疗保险对农村居民的日常活动能力和自评健康影响不显著,参加医疗保险对农村居民认知能力具有显著的正向影响。据此提出,应进一步提升社会医疗保险保障水平、扩大社会医疗保险保障范围、促进商业医疗保险有序发展、推进"三医"高效协同联动等,以充分发挥医疗保险的健康保障功能,从而进一步提升参加医疗保险对农村居民健康的正向影响。     

Developing and testing a mobile application for breastfeeding support: The Milky Way application

BackgroundSupporting women to continue breastfeeding is a global challenge. The Milky Way Program is an effective face to face intervention to increase breastfeeding rates up to six months postpartum. The sustainability and access to the Milky Way Program could be enhanced by transforming it into a mobile application allowing women to access relevant information from their own place at a convenient time.AimTo explore the process of transforming the Milky Way Program into an acceptable and usable mobile health application.MethodStakeholders including multidisciplinary researchers and end-users designed the application based on the Milky Way Program by using Persuasive System Design principles. A mixed-method approach was used in the development and evaluation process. Seven women were recruited through convenience sampling to pilot test the application. The women’s feedback was collected through an online survey six weeks after birth and individual interviews at four months postpartum.FindingsWomen in the pilot study reported that the breastfeeding application was well designed, easy to use, interactive, reassuring and evidence-based with credible sources of information.ConclusionThe Persuasive System Design model combined with end-user engagement can feasibly inform the development of an acceptable and usable mobile health application for breastfeeding based on a proven clinical intervention. Further rigorous testing is required to evaluate the effectiveness of the application on breastfeeding initiation and duration.     

基因编辑技术背后的伦理与人权

当前基因编辑技术发展迅速,引起各国政府、学术界和企业界的广泛关注。但从近期“基因编辑婴儿”事件来看,基因编辑技术的伦理问题仍须厘清,我国现行法律尚不完善。通过保护基因编辑婴儿隐私、切实发挥伦理委员会作用、加快相关立法工作,我们或可更好地解决基因编辑技术背后的伦理和人权问题。     

双循环发展的改革开放空间试验场——我国开发区的缘起、演进和趋势

开发区是我国改革开放进程中重要的"制度安排",在制度转型、市场机制培育、产业结构升级和带动地区经济增长等方面发挥着引领示范作用,但同时也存在政策效应边际递减、土地资源浪费、创新不足等诸多问题.梳理我国开发区过去三十多年的发展经验和不足,并展望其未来定位是一项重要的研究课题.在详细讨论我国开发区的缘起、动力机制、发展阶段、功能演变、面临问题的基础上,文章从制度安排、比较优势、产业集聚和商业环境四个方面总结了我国开发区取得的成功经验.未来,开发区的发展应实现从生产到生活、从效率到公平、从地的繁荣到人的繁荣、从外围到中心、从专业化到多样化、从高速增长到高质量发展、从对外开放到国内国际双循环等方面的转变.     

医疗信息共享对患者转移数量和服务质量水平影响研究

当前我国医院间存在严重的"信息孤岛"，医院参与医疗信息共享意愿不高，患者的诊疗信息被静态碎片化储存而无法充分有效地利用。考虑到医院进行医疗信息共享将降低患者转移成本，本文构建一个多阶段双寡头动态博弈模型研究医疗信息共享对医院竞争过程中患者转移数量和服务质量水平决策的影响。首先，根据是否存在转移成本，将患者分为新患者和经验性患者，借助Hotelling模型刻画患者的效用函数，分析患者就诊决策。然后，在政府价格规制和不考虑医院利他性情景下，构建了医院累积期望收益目标函数，使用动态规划方法，求解实现医院累积期望收益最大化的服务质量水平，获得了实现患者相互转移且医院在市场中共存的马尔可夫完美均衡。最后，根据医院参与医疗信息共享后患者转移成本降为零，分析与比较信息共享前后患者转移数量和服务质量水平变化。研究发现：在不同医院间本身存在患者转移背景下，医院参与信息共享后，患者转移数量增加但存在一个上限，增加的转移量与患者在医院间的转移成本呈正相关，与初始感知效用的差值范围呈负相关；医院参与信息共享后，均衡状态下的医院服务质量水平高于信息共享前的服务质量水平。因此，在不改变当前医保支付方式下，要加快推进医疗信息共享，政府部门可以根据医院的患者数量和服务质量水平变化对其进行定期补贴，以激励医院积极参与医疗信息共享，本文给出了这个补贴的量化表达。     

Staff and family attitudes to fences as a means of detaining people with dementia in residential aged care settings: The tension between physical and emotional safety

This study investigates staff and family attitudes towards the use of the fences that surround many aged care facilities in Australia, in the context of indefinite detention of people with dementia. This indefinite detention has been described in a report from an Australian Senate Inquiry as “a significant problem within the aged care context”, which “is often informal, unregulated and unlawful”. Five focus groups comprising direct care workers, family members, nurse unit managers and facility managers discussed the reasons for and their attitudes towards fences. The results show a tension between the provision of physical and emotional safety. This is to say that even while it is illegal to detain people with dementia against their will, and even while participants understood the negative impact of fences on the well‐being and emotional safety of people with dementia, they accepted and supported the presence of perimeter fences because they provided the perception that fences kept people with dementia physically safe. This has implications for redressing the balance between physical and emotional safety in policy and practice.     

A Leadership Training Group for at Risk Fifth & Seventh Graders: Results from A Brief Strength-Based Group Program

ABSTRACT

An increasing number of youth are exhibiting social, emotional, and behavioral problems that hinder their ability to function at grade level. Subsequently, school mental health services have not been able to address the need for services particularly among students who are minority and poor. A mixed methodology study was conducted to determine the treatment outcomes from a brief strength-based leadership training group for primarily students who are African American and poor. Pre–post scores on three scales and focus group data revealed significant positive changes in regard to internal areas of functioning and social skills, anger management skills, and school attitude. Gender and age significantly impacted outcomes.     

资本结构与员工劳动生产率

债务作为重要的公司治理手段，可以降低企业、管理层与员工之间的委托代理成本，提高员工劳动生产率.同时，债务水平上升将提高企业破产风险，对企业和员工的人力资本投入与员工劳动生产率可能产生不利影响.以我国1999年一2014年工业企业上市公司为样本，本文不同佑计方法的实证结果均表明企业的债务水平越高，员工劳动生产率越低.在其他因素不变的情况下，企业的财务困境加剧了债务对员工劳动生产率的不利影响;债务对员工劳动生产率的负作用在人力资本依赖度高的公司以及在外部就业环境好的地区更加显著.对于债务与员工劳动生产率作用的中介效应分析与分位数回归结果也说明债务上升可能导致企业人力资本投资下降，对员工劳动生产率产生不利影响.研究为我国“去杠杆”经济政策提供了微观企业层面的经验证据.     

Best practices for online Canadian prenatal health promotion: A public health approach

Background

Prenatal health promotion provides information regarding pregnancy risks, protective behaviours and clinical and community resources. Typically, women obtain prenatal health information from health care providers, prenatal classes, peers/family, media and increasingly, Internet sites and mobile apps. Barriers to prenatal health promotion and related services include language, rural/remote location, citizenship and disability. Online public health platforms represent the capacity to reach underserved women and can be customised to address the needs of a heterogeneous population of pregnant women.