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.     

类型化视域下自然保护地立法的制度建构

自然保护地在维持生态平衡,实现生态系统服务功能中可以发挥重要作用,但不同类型自然保护地的主导生态系统服务功能供给存在一定差异.《自然保护地法》立法工作须依赖理论上对自然保护地的类型化,并在此基础上建构对应型的规划建设、运营管理等方面的具体制度.因此,基于生态系统服务功能供给的空间差异,可以将当前相互重叠、缺乏体系的自然保护地划分为国家公园、自然保护区、自然公园、自然保护小区等四种类型,搭建"1部基础法律+4部类型化条例(或法律)"的自然保护地法律体系,并可以通过体系化公法、私法制度工具强化自然保护地的有效治理.     

高校哲学社会科学研究评价的本质要求及其制度建设

建设具有中国特色、中国风格、中国气派的哲学社会科学,一直是我国哲学社会科学繁荣发展的根本目的.提升高校哲学社会科学繁荣发展水平,离不开科学有效的哲学社会科学研究评价.坚持党的领导、"二为"方向和"双百"方针是哲学社会科学繁荣发展的根本保障,坚持"质量为本"和"创新至上"是哲学社会科学繁荣发展的必然要求,坚持科学权威和公开透明是哲学社会科学研究评价的现实需要.结合当前高校哲学社会科学研究评价中"量化评价下数量与质量的关系论辩","学术评价与科研管理评价的边界异化"和"学术权力和行政权力的制度规制"三大问题聚讼,文章建议通过强化学术成果质量保障机制、优化学术共同体工作机制、构建学术争鸣长效机制和完善学术成果转化应用机制等制度建设,推动构建科学权威、公开透明的哲学社会科学研究评价体系,以期进一步改善新时代高校哲学社会科学研究评价工作.     

随机需求环境下联产品系统价格与产量决策研究

基于固定比例生产技术和多产品随机需求的情形,研究了联产品制造商的两阶段产量和价格联合优化模型。通过反向倒推的优化求解,得到了联产品制造商的最优产量和价格决策以及变化规律。同时研究了需求服从均匀分布时,需求波动对均衡的影响。研究结果表明,在订货成本较低和一种产品的需求波动性较大时,当另外一种产品的波动增大,则该产品的最优订货量增大,同时价格下降。借助数值仿真,分析了价格敏感度和产出比例对最优决策和利润的影响。结果表明,在给定一种产品的价格敏感度时,另外一种的价格敏感度越大,那么该产品的价格就越低,制造商的订货量就下降。当一种产品的产出比例固定时,另一种产品的产出比例上升时,则该产品的价格下降,制造商的订货量下降,总利润上升。     

从主权国家的兴衰看权力博弈形态的转型

传统的国际关系理论,无论是现实主义、自由主义、建构主义还是科学行为主义理论,都是把主权国家抽象成一个统一的国际关系行为体。这一行为主体有一致的利益,也自然要有一致的对外政策目标和手段。在20世纪,尤其是在两次世界大战和冷战期间,这一概念抽象是非常准确的。但冷战结束以后,尤其是进入21世纪以后,这一概念抽象逐渐与国际关系的现实相违背。一方面,国家综合实力并不能直接转化为具体领域的竞争优势;另一方面,很多国家,包括超级大国在内,其对外政策的主要阻力可能不是所谓的竞争对手,而是其国内不同的利益集团。这导致传统的国际关系理论,从假设到概念和推理层面,都已经无法解释和预测今天的世界,而权力小博弈理论可以为认识多元复杂互动博弈时代的国际关系提供一个新的解释框架。     

农户地权诉求视角下农地制度的创新

目前我国农户的地权诉求已经发生了很大的变化，即由地权稳定、自主经营向农地资源的优化配置和高效利用转化。这一变化的内在动力是农户急切希望改变承包地过于细碎化以及改善农业生产经营基本条件。考察我国农地制度的发展史可以发现，我国农地制度变迁的基本逻辑就是农户的地权诉求决定农地制度的发展方向，这一点在当下一些地方的农地制度创新试验和经验中再次得到证明。今后我国农地制度创新必须遵循这一逻辑，根据我国农户地权诉求的变化，实施农户自愿前提下的承包地连片重划,争取国家对承包地重划制度的支持,强化农民集体民主决策制度,地方政府也要给予必要的支持。     

美好抑或悲哀:旅游演艺的文化真实性研究

文化是旅游演艺的灵魂,旅游演艺即为通过对真实的地域文化进行抽离、截取、裁剪等艺术性加工所形成的具有舞台美感的旅游表演,并使真实的文化转变成舞台上的文化。由于利益诉求不同,旅游演艺相关各方对于文化真实性的关注角度存在一定差异。旅游演艺在对地域文化进行艺术加工的同时,也在对地域文化进行着解构与重构。地域文化真实性在解构与重构过程中发生改变,也使得旅游演艺相关各方对文化真实性产生了不一样的理解。尽管地域文化真实性因旅游演艺的介入而发生变化这一客观事实引起了一定的悲哀性慨叹,但总体而言旅游演艺重构或生产"新文化"这一过程既是美好的现实,更是美好的"真实",另外,这类"新文化"同样值得尊重,其是地域文化变迁过程中的真实性存在。     

Statistical testing strategies for assessing treatment efficacy and marker accuracy in phase III trials

When a candidate predictive marker is available, but evidence on its predictive ability is not sufficiently reliable, all‐comers trials with marker stratification are frequently conducted. We propose a framework for planning and evaluating prospective testing strategies in confirmatory, phase III marker‐stratified clinical trials based on a natural assumption on heterogeneity of treatment effects across marker‐defined subpopulations, where weak rather than strong control is permitted for multiple population tests. For phase III marker‐stratified trials, it is expected that treatment efficacy is established in a particular patient population, possibly in a marker‐defined subpopulation, and that the marker accuracy is assessed when the marker is used to restrict the indication or labelling of the treatment to a marker‐based subpopulation, ie, assessment of the clinical validity of the marker. In this paper, we develop statistical testing strategies based on criteria that are explicitly designated to the marker assessment, including those examining treatment effects in marker‐negative patients. As existing and developed statistical testing strategies can assert treatment efficacy for either the overall patient population or the marker‐positive subpopulation, we also develop criteria for evaluating the operating characteristics of the statistical testing strategies based on the probabilities of asserting treatment efficacy across marker subpopulations. Numerical evaluations to compare the statistical testing strategies based on the developed criteria are provided.     

司法附属行政语境下的中国古代法官地位

“司法附属行政”是中国古代司法的一个重要特征。在这一背景下，中国古代法官地位就呈现出鲜明的附属性特征，这种特征同样体现在法院的地位和司法权的地位上，这也导致中国古代法官没有专门的职业保障制度，而这一切都深深地镶嵌在当时的人治大背景之中。通过与现代法官地位的比较，可以更加深切地感受到古今法官地位以至整个司法状况的巨大差异。中国现代法官地位在独立性方面相对于古代法官有了巨大改善，但仍然不尽如人意，还需要在今后的司法改革中进行反思和重点关注。     

Depoliticising literature,politicising diversity: ethno-racial boundaries in Dutch literary professionals’ aesthetic repertoires

Although still a neglected area, over the years a growing body of sociological research on the position of ethno-racial minorities in Western artistic fields has emerged. With this article we aim to contribute to this research area by focusing on ethno-racial diversity in the Dutch literary field. Through in-depth interviews, we analyse how gatekeepers mobilise specific cultural repertoires and by doing so draw ethno-racial boundaries when discussing acquisition, assessing quality and positioning themselves in the literary field. We argue that literary publishers and other professionals (selectively) employ an ‘old school’ modernist repertoire that especially values the formal aspects of literary products, by which non-white writers and publishers concerned with diversity are often positioned in an identity politics framework. Their work is said to take in a less prestigious ‘political’/’subjective’ position rather than a ‘literary’/‘universal’ one. As such, this paper informs on how gatekeepers’ practices shape the position of non-white authors in the Dutch literary field.