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。     

The importance of cross‐disciplinary scientific engagement in the development of quantitative procedures for aggregate safety assessments

Recent guidance on safety monitoring during drug development, issued by regulatory authorities in the United States and European Union, indicate a shift in focus towards aggregate safety monitoring and scientific evaluation of integrated safety data. The call for program‐level reviews of accumulating safety data, including from ongoing studies, provides an opportunity to leverage the scientific expertise and medical judgment of safety management teams with (a) a multidisciplinary approach, (b) quantitative frameworks to measure level of evidence, and (c) assessments that are product‐specific and driven by medical judgment. A multidisciplinary team, regularly reviewing aggregate safety data throughout the development program, is vital not only for early signal detection but also for generating a better understanding of the accumulating data and context needed for decreasing false alarms.     

When standardization becomes the lens of professional practice in child welfare services

This paper examines the relationship between professional work and standardization. There has been an increase in the use of standardized programmes in child welfare services (CWS) in Western society. Some researchers have criticized standardized programmes suggesting that they undermine professionals expertise and threaten their position, whereas others argue that such programmes strengthen professional practice. In this paper, we examine how standardized tools, in this case, a standardized parenting programme and a standardized Norwegian assessment tool, influence professional roles as experienced by child welfare workers (CWS professionals) in Norway. Semistructured individual and group interviews were conducted with 31 frontline workers in two CWS agencies. Our findings suggest that standardized tools increase the social workers experienced professional competence but challenge their professional knowledge base, reflective practice, and professional accountability. Professional and practical implications for CWS work are discussed in the light of these findings.     

Radical alternative conceptualizations of the classical welfare state? Contrasting the United Kingdom and the Netherlands with Norway

In many countries, new, broad, and normative “conceptions of society” gained prominence that represent fundamentally different discursive alternatives to the classical welfare state. We present two political projects that contain radical alternative conceptualizations of the classical welfare state, the “Big Society” in Britain and the “Participation Society” in the Netherlands, and contrast these with Norwegian developments, where no such a radical alternative conceptualization of the welfare state can be found. We show that the British and Dutch political projects were attempts to replace the welfare state, whereas there is no comparable big idea about a radical overhaul of the welfare state in Norway. Our analysis contributes to a better understanding of a fundamental shift in welfare state reform, namely a radical reconsidering of the ideational and normative foundation that defines and underpins what the welfare state is or should be.     

Welfare service privatization and opinions about service quality: The role of political ideology among local politicians and the public

In this article, we join the discussion about the potential consequences of welfare service privatization by examining the relationship between the privatization of welfare service delivery and public opinion about service quality in Sweden. Due to the politically polarized debate about welfare service privatization in Sweden, we also examine the extent to which individualsapos; ideological orientations influence this relationship in both local politicians and ordinary citizens. For local politicians, the results show that a higher municipal degree of privatization is generally associated with slightly lower levels of satisfaction overall with welfare services, although no such relationship exists for the public. Most importantly, however, the results indicate that political ideology constitutes an important moderator in the relationship between privatization and opinions about service quality. Local politicians and, to some extent, ordinary citizens who place themselves to the left on the ideological left–right scale tend to be less satisfied with services as the municipal degree of welfare service privatization increases. For local politicians who position themselves far to the right on the scale, the relationship between welfare service privatization and satisfaction is positive. These findings suggest that there is no clear-cut relationship between privatization and individualsapos; opinions about services; rather, this relationship depends on the ideological predispositions of local politicians and ordinary citizens.     

Varieties of liberalism: A comparative analysis of family policy and poverty outcomes across the 50 United States

The United States is generally recognised as an exemplar of liberal policy regime types. However, given evidence of state-level divergence in social policy, this article investigates to what extent such variation is present and relevant in state-level family policy. To this end, we pose a primary and secondary research question. Our primary question is whether varieties of liberalism exist across the 50 states in the United States. Our secondary question is whether these varieties of liberalism correspond to variety in social indicators of families' economic well-being. To answer our primary question, we first construct a family policy index that scores the relative generosity and coverage of state-administered social programmes that contribute to the (de)commodification and (de)familialisation of households with children. We then perform a cluster analysis to group states by shared decommodifying and defamilialising features. To answer our secondary question, we investigate how our family-policy clusters are associated with social indicators of families' financial security. Our findings suggest that varieties of liberalism do, indeed, exist within the United States. With the exception of Vermont, which stands out with respect to its comparatively generous family policies, we classify states into two groups: those with ‘soft’ liberal family policy in states featuring relatively generous and accessible policies and ‘hard’ liberal family policy in states achieving little of either. We find that these differences help explain state-level heterogeneity in levels of economic security among households with children, particularly single-mother households.     

Surgical Identity Play: The Anatomy Lab Revisited

The anatomy lab has been studied by sociologists interested in professional socialization since the 1950s. This is because the act of dissecting a cadaver is thought to be foundational for both the student's medical knowledge and the development of the student's professional identity. In this paper, I revisit the anatomy lab both historically and ethnographically. Drawing on theoretical insights from the laboratory ethnography tradition within science and technology studies, I show that students use material artifacts in the lab to support their “surgical identity play.” This activity is structured by the laboratory's performative architecture even while it is unsupervised by anatomy faculty. While many analyses of professional socialization focus on how students learn to interact with patients during their training, I show that the anatomy lab experience is an important form of professional socialization because here students learn to employ surgical instruments, language, and dress, and begin to relate to each other as colleagues.     

Public income transfers and wealth accumulation at the bottom: Within and between country differences in Canada and the United States

Both Canada and the United States are considered liberal welfare states, yet exhibit notable differences in income poverty attributed to social policy. While a more generous welfare system lifts many above income poverty, models of household financial behaviour suggest that more income from the state should displace private savings via a substitution effect. Using nationally representative wealth surveys from Canada and the US from 1998/1999 to 2016 we extend knowledge on the relationship between the welfare state and private wealth accumulation. Specifically, we study household asset poverty defined as financial asset levels that fall below three-month adjusted income poverty threshold. Asset poverty rates varied over time in the two countries and were higher in the less generous US welfare state. Further, income transfer share was positively related to asset poverty in Canada but not in the US. Counterfactual estimates offered evidence of the substitution effect in Canada, where higher levels of transfers may crowd out private asset accumulation. Results invite further consideration of the concept of asset poverty and its relationship to welfare state characteristics.     

Institutional evolution and abrupt change: Reforming the administration of social assistance in Finland

Historical institutionalist studies have explained institutional change as resulting from critical junctures that interrupt long periods of stability or from endogenous, incremental evolution. Building on these theories, discursive institutionalists have focused on the roles of agency, ideas and discourse as explainers of change. Combining these approaches, this article analyses Finland’s decision in 2014 to transfer the administration of basic social assistance from municipalities to the central government. This study demonstrates that institutional change can be both abrupt and evolutionary. Due to sudden, exceptional political circumstances, the decision in question was made quickly and under pressure, circumventing possible veto players. However, it was possible only because of the incremental, endogenous change that had occurred in the way in which social assistance was administered at the municipal level. It enabled a change in political discourse, which eroded the credibility of the ideational frames that policy actors had previously utilised to reject the centralised model.     

重大公共卫生事件中应如何作为:来自医学人类学哈佛学派的启示

聚焦人类学者在针对重大公共卫生事件的跨学科研究中应该有何作为这一议题,通过借鉴来自医学人类学哈佛学派的民族志洞见和研究经验,为当下2019新型冠状病毒疫情危机中所进行的田野观察和分析,以期获得灵感和启示,并探索有可行性和操作性的研究策略和方法。