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。     

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.     

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。     

Seeing the system: Systemic gender knowledge to support transformational change towards gender equality in science

Scholars agree that gender inequality is systemic and that participants in gender equality interventions need knowledge on gender inequality processes. However, a detailed view on the specific characteristics of this knowledge is as yet missing. This article aims to contribute to gender equality interventions by conceptualizing and visualizing systemic gender knowledge as an important condition for transformational change. Combining gender and participatory system dynamics literature, this article first introduces the concept of systemic gender knowledge. This concept captures two main characteristics that make gender knowledge systemic: knowledge on the interaction of gender inequality processes and endogenous thinking, here implying a focus on the organization as the relevant level of analysis. In addition to this conceptual contribution, the research contributes methodologically to the gender inequality intervention literature by designing a visualization process, translating written texts into system dynamics models which enable exploration of systemic gender knowledge. Finally, the research contributes empirically by exploring the systemic gender knowledge of participants in two science research institutes of a Dutch university, finding shifts in both characteristics of systemic gender knowledge. This enables researchers to discern whether gender equality interventions lead to increases in systemic gender knowledge, thus supporting transformational change.     

清代冕宁司法档案中的“夷兵”及其功能考察

清代冕宁县作为多民族杂居的地区，雍正年间改土归流后，国家治理开始深入基层社会，为了适应当地民族社会管理的特别需要，当地形成了一种特殊的制度——夷兵换班制。“夷兵换班制”是通过招募当地“夷民”到流官衙署中充当“夷兵”，作为地方流官处理涉及少数民族内部事务的辅助人员，保证国家在处理当地少数民族民政、治安、司法等事务时有熟悉当地“夷俗”的衙吏。由于“夷兵”实行定期轮换，所以称为“夷兵换班制”。“夷兵换班制”的核心是“夷兵”，“夷兵”从职能上看，最初是作为地方治安保安人员，但在现实中往往成为流官和夷民之间在民政、治安、司法事务管理中的中介，具有沟通官方与民间信息、促进国家法与民族习惯融合与互动、弥补外来官吏地方民族事务管理能力不足等功能。总之，“夷兵换班制”是清代地方流官衙署在西南地区治理时针对特定地区设置的一种变通制度，这种制度对于国家在少数民族地区基层社会的治理发挥着十分重要的积极作用。     

认罪认罚被告人上诉问题研究——以检察业务为视角

适用认罪认罚制度得到从宽处罚的被告人仍有部分提出上诉,其中以量刑过重为由的投机型上诉占大多数,尽管如此,认罪认罚被告人的上诉权仍应全面保留,对于因不合理上诉导致认罪认罚从宽制度效率价值无法充分发挥的问题,检察机关应当提升检察业务水平,加强沟通联系,强化释法说理工作,以减少被告人的不合理上诉,推进认罪认罚从宽制度的实施。     

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.