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.     

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。     

Peer support and food security in deaf college students

Abstract

Objective: The purpose of the study was to investigate whether peer support and demographic characteristics predicted food security among deaf college students. Participants: The sample included 166 deaf college students at Gallaudet University. Methods: Participants completed a bilingual online survey in American Sign Language (ASL) and English. This survey included USDA’s 6-item food security survey, questions about peer support and socio-demographic characteristics. Results: Out of 166 students (mean age =23; SD?=?6), 60.7% were food secure. About 26.4% were at-risk for low food security and another 12.9% had very low food security. The sample included respondents who identified as people of color (54%) and women (52%). Binary logistic regression revealed that compared to people who reported always receiving peer support, people who never received peer support were 16.3 times more likely to experience food insecurity (adj OR: 16.325, 95% CI 1.824–146.107). Conclusions: This study demonstrates a strong relationship between peer support and deaf college students' food security experiences.     

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。     

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.     

Examining the Nursing Home Physical Environment Through Policy-Driven Culture Change

A critical need exists to challenge approaches to nursing home care due to rigid organizational factors and hospital-like culture. It has been argued that resident care needs to move toward a person-centered approach by addressing the organizational, social, and physical environments in nursing home facilities, a process often known as culture change. In response to this need, the Centers for Medicare & Medicaid Services (CMS) has created funding for pay for performance (P4P) nursing home incentive programs to allow nursing home providers to receive CMS reimbursements for culture change in the facilities. Through care staff interviews, site observations, and a document review, this qualitative study assesses the impact of a Midwestern state P4P incentive program in three participating nursing homes. Using an environment and behavior (E-B) policy orientation framework, this study examines culture change through a focus on policy, the physical environment, place attachment, and social and psychological processes in the study settings.     

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.     

大数据战略视野下我国信息网络安全立法分析

大数据战略视野下,很多国家纷纷制定、完善和执行着自己的信息网络安全法律,并已形成世界潮流.从国内外的大数据战略与信息网络安全立法分析来看,我国既有成绩,也有不足.对于我国信息网络安全的法律保障,目前需要完善的主要内容有:进一步明确国家信息网络安全立法的目的与宗旨;基本法层面,尽快构建完备的信息网络安全法律保障有机体系,重点包括政府信息公开法与个人信息保护法等;实施层面,加强与完善具体领域的单行法与配套法建设,增强法律规定的可操作性;完善法律框架之外的协作保障体系.     

缅北动荡局势下我国边境安全应对刍议

缅北动荡局势下，我国中缅边境地区面临传统安全与非传统安全双重威胁。从前期系列缅北冲突导致的问题处理经验看，我国中缅边境地区安全应对体系建设在预防意识的主动性、应急制度的协调性、应急体系的系统性方面仍有待进一步提升。立足中缅边境地区安全问题的特殊性，其应对可从立足跨境民族众多的实情主动应对、立足边境安全事件的复杂性系统应对、立足边疆经济的落后性持续应对等方面予以加强。     

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.