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.     

Non-government organization study awards: enhancing successful completion of social work qualification

ABSTRACT

The current study used a sequential, exploratory mixed-method design to explore how a social work study scholarship implemented in Aotearoa New Zealand impacted on recipients’ qualification completion and their professional and practice competence. Phase one involved 13 individual interviews with past award recipients which described how the study award impacted on their qualification completion. Thematic analysis was used to extract themes. These themes were examined in the second phase through a quantitative battery completed by 107 past recipients to examine their professional and practice competence. The findings from interviews showed the award enabled recipients to complete their studies and improve their social work practice without causing undue stress or financial pressure on the recipient and their family. Quantitative analysis corroborated and extended these findings to demonstrate that the award contributed to lifting the level of social work knowledge, competence, and skills in the recipients. Accompanying the successful qualification completion, these qualified social workers were equipped with essential skills, promoting social work values and competence to contribute and safeguard the benefit of children, families, and communities. The awards offered a ‘wrap around’ support and was not limited by age or ethnicity but provided a support system to achieve qualification completion.     

English and discourses of commodification among tourism workers in the Himalayas

In this article, I investigate commodification discourses and ideologies of English from the perspective of Nepali tourism workers. Drawing data from interviews with porters and trekking guides in Nepal, I argue that English is not seen as merely a transactional means to convey meaning; it works in combination with the traditional form of labor and care in the local economy, establishing itself as a powerful tool to establish closer interpersonal relationships, enhance such interpersonal relationships for economic gains and commodify local identities and cultures in the tourism market. The interview and ethnographic details show that language learners are agentive and capable of making sense of their actions by positioning themselves variously in terms of ethnicity, economic class and job category. These workers think that tourists' linguistic and financial resources are the empowering tools that enable them to travel to locations that they want. They also want to empower themselves with English skills and translocal imaginaries to travel and see the world beyond their immediate reach. Repertoires in English are considered as instruments to mediate their imaginaries and the foreign worlds they want to be part of.     

感知风险对在线旅游产品购买意愿的影响分析

旅游电子商务发展迅猛,互联网购物平台的虚拟性和远程性强化了消费者感知风险,它也成为影响旅游电子商务发展的重要因素之一.文章聚焦消费者感知风险,运用SPSS 19.0及AMOS 21.0软件,构建以5个维度的感知风险为自变量、购买意愿为因变量、信任为调节变量的结构方程模型,探讨变量间相关关系.结果发现:感知风险对信任的影响差异较大,仅经济风险感知与信任呈显著负相关;感知风险对购买意愿总效应皆呈负相关;信任作为中介变量存在明显的调节作用,有效地降低了感知风险对购买意愿的负向影响.     

‘One MBA?’ How context impacts the development of post-MBA career outcomes

Using survey data from alumni of one of the UK's earliest and largest MBA programmes we explore how career capital, career outcomes and career satisfaction are impacted by learner context. We adopt comparative capitalisms theory to investigate whether graduates from a standardised programme marketed as ‘One MBA’ report broadly similar career outcomes irrespective of their work and study location. We find that despite the rhetoric around globalisation in management education there are differences that fit the theories of comparative capitalisms literature; thus supporting the view that, despite the global nature of MBA branding, context still plays a role in shaping learning and career outcomes as evidenced by differences reported here. Significant findings are reported in terms of the reported development of career capital ‘knowing how’; career satisfaction and perceived organisational support, however differences in terms of the achievement of objective career success (promotion and career mobility) were less pronounced.     

Quality management as a tool for job satisfaction improvement in low-level technology organizations: the case of Ethiopia

Human resources are an important determinant of operational performances as it is crucial for quality improvement. Research suggests that issues related to quality of work life of employees are often overlooked in low technology level organizations in the developing countries. This article aims to investigate the relationship between quality management (QM) practices and job satisfaction (JS) in relation with the Ethiopian manufacturing organizations. Data were collected using a structured survey questionnaire and face-to-face interviews of shop-floor workers. Exploratory and confirmatory factor analysis was used to validate the survey instrument and structural equation modelling was used for the analysis. The findings provide evidence that top management commitment, participation of employees and continuous improvement are significantly and positively associated with JS. However, customer focus has insignificant relationship and surprisingly, teamwork showed unexpected negative relationship with JS. The study provides important insights into the true worth of QM implementation in which it enforces the belief that its practices are the decisive factor in enhancing workplace satisfaction of employees.     

Schematising hospitality: Ai WeiWei’s activist artwork as a form of dark travel

The article provides a holistic appraisal of activist-artist Ai WeiWei’s work. It argues that, despite its topical innovations and evolution, it continues to be informed by narratives of ‘hospitality’ as an experiential form of engagement with variations of otherness (father, migrant, tourist and refugee). Dividing Ai’s artwork into two overlapping phases of development (national and international/global), it considers the artist’s construction of a cosmopolitan identity with uses of ‘technology’ as embodied and communal property. As Ai’s work on the refugee crisis on Lesbos attests, his (dark) artistic cosmopolitan symbolisations use geo-political imaginaries of justice and hospitality in subsequent projects.     

Leader-employee congruence of expected contributions in the employee-organization relationship

Employees' expected contributions can be incongruent with those of their leader. We examine the congruence effect of leaders' and employees' expected contributions on job satisfaction. Results of cross-level polynomial regressions on 947 employees and 224 leaders support the congruence effect. When expected contributions are congruent, employees are more satisfied with their job. Our findings suggest that employees enjoy high challenges, as long as these challenges are in harmony with the expected contributions of their leaders. Employees are less satisfied with their jobs both when their expected contributions were higher than their leaders' and when their expected contributions were lower than those of their leaders. Beyond the relevance of having high expected contributions, the findings highlight the crucial role played by the congruence of expected contributions of leaders and employees.     

Exotic Place,White Space: Racialized Volunteer Spaces in Honduras

In every year between 2004 and 2012, more than 800,000 Americans reported volunteering internationally (Lough 2013 ). These volunteers are overwhelmingly white (McBride and Lough 2008 ) and entering a largely nonwhite and developing world. This study starts by questioning how racial status informs volunteer/volunteer tourist interactions, both with locals and with other volunteers, in a global context. In‐depth interviews with 23 missionaries, teachers, and volunteers from the United States and Canada reveal that (1) international volunteering is largely motivated by romantic and exotic understandings of the Global South and (2) in spite of a stated interest in cultural immersion, participants’ notions of their whiteness guided their perceptions of Hondurans and their actions as they sought out and retreated to white spaces protected from Honduran influence. These findings further the work of those who have argued first world travelers have homogenized spaces on reserve, by demonstrating that whiteness can be the basis for the construction and maintenance of protected spaces in predominantly nonwhite countries.     

南京中山植物园游憩功能满意度评价研究

随着植物园"旅游经济"的发展,植物园在承担植物科学研究及科普功能的同时,也成为公众日常休闲的重要绿地。本文选取南京中山植物园作为研究对象,建立评价体系并运用模糊综合评价法对游客满意度进行研究,探寻影响植物园游憩功能的显著因子,为未来植物园规划设计提供参考。结果表明:游客对南京中山植物园的游憩功能达到基本满意水平。其中,植物物种多样性、景区分布、建筑景观、声景观的满意度较高,滨水景观的满意度评价值较低。通过Pearson相关系数发现植物色彩丰富度、科普场所、科普内容是影响游客满意度的显著因子。运用IPA图对16项评价因子进行重要度-满意度分析,并对各象限内的因子提出改进方向。最后基于游憩功能满意度评价结果,提出改进策略:加大对植物园休息设施、卫生设施、娱乐设施和商业服务设施的投入;更新科普方式,增添特色游憩主题园区;完善现有道路体系,增强对北部专类园的可达性;增加色叶植物的种类、提高色彩丰富度等。以期为中山植物园游憩功能的优化及其他植物园的规划设计提供借鉴。