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.     

美国中小学的体验式学习及启示

体验式学习的内涵随着时代的发展而逐渐丰富和深化，但无论其如何演变，直接经验和反思始终是体验式学习这一概念的内核。体验式学习理念渗透于美国教育文化之中。具体表现在：小学阶段的教育以学生的真实感知为基础，注重为学生提供真实体验的机会和激发学生的学习兴趣；中学尤其是高中阶段的教育以学生的真实体验为基础，注重为学生提供在新情境中检验所学知识的机会，注重学生知识、技能的内化吸收。美国中小学体验式学习的实施经验可为我国基础教育课程改革提供如下启示：（1）进一步树立和推广体验式学习理念；（2）创设学生进行真实体验的教学环境；（3）注重实施基于学生体验式学习的表现性评价。     

An omnibus two-sample test for ranked-set sampling data

We develop an omnibus two-sample test for ranked-set sampling (RSS) data. The test statistic is the conditional probability of seeing the observed sequence of ranks in the combined sample, given the observed sequences within the separate samples. We compare the test to existing tests under perfect rankings, finding that it can outperform existing tests in terms of power, particularly when the set size is large. The test does not maintain its level under imperfect rankings. However, one can create a permutation version of the test that is comparable in power to the basic test under perfect rankings and also maintains its level under imperfect rankings. Both tests extend naturally to judgment post-stratification, unbalanced RSS, and even RSS with multiple set sizes. Interestingly, the tests have no simple random sampling analog.     

城镇职工基本养老保险税预测研究——以浙江省为例

在当前经济形势下，逐步开征基本养老保险税是实现缓解各省养老保险基金缺口、减轻企业负担以及推进养老保险全国统筹三者协调发展的重要决策。本文以浙江省为例，基于2005-2016年的历史数据，对有关参数进行线性拟合分析并加以合理设定，对税率和养老金替代率分别按高中低和高低进行假设，形成六种方案进行测算。研究发现当养老金替代率为35%，税率为14%（方案五）时，基础养老金收支平衡比较稳定；进一步研究发现浙江省未来30年内养老保险社会统筹基金的平均税率为1256%，同时基本养老保险税率降低可为正在试点中的长期护理保险制度留出发展空间。进而本文对我国养老保险税制提出相应的配套政策建议。     

我国中小学校园欺凌问题研究及薄弱环节——基于CNKI文献关键词的共词分析

随着一系列恶性事件被媒体曝光，社会各界普遍关注和担忧校园欺凌问题，如何解决这一问题，已成为社会焦点。通过共词分析法对我国中小学校园欺凌问题研究现状进行考察发现，其研究主题主要包括六大类：校园欺凌行为特征研究、校园欺凌与学校管理的关系研究、校园欺凌与人际交往的关系研究、校园欺凌的成因与对策研究、校园欺凌的预防与治理研究、校园欺凌的社会问题研究，而研究的薄弱环节则主要包括品格教育研究、学生自我保护研究以及网络欺凌问题研究。因此，校园欺凌问题研究亟待进一步深化，研究视角也需进一步拓展。首先，除欺凌者、被欺凌者之外，旁观者也应纳入研究范畴，要将欺凌者和被欺凌者实施隔离，对受欺凌者要及时给予心理疏导，引导旁观者积极主动地帮助被欺凌者；其次，建议尽快出台相关的法律法规，为学校、教师及相关部门有效处理、解决校园欺凌问题提供法律支持及保障；最后，将综合预防与治理相结合，建立由学校、教师、学生组成的反欺凌共同体。     

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。     

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.     

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.