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.     

严复的能力观及其对当代公共管理创新的启示——对史华兹《寻求富强:严复与西方》的一种解读

对美国著名汉学家史华兹的代表作<寻求富强:严复与西方>进行文本解读发现:该著所反映出的严复能力观对当代公共管理的创新发展具有重要的启示意义.严复认为中西方的关键性差别在于能力,而隐含其中的是以能力为导向的主体意识和公共意识方面的差距."-3代公共管理的创新发展有必要吸收严复能力观中的思想精髓,以国家能力建构为着力点,以公民启蒙为社会基石,以突显公正为其内在灵魂.对正处于社会转型期的国家而言,努力实现国家能力与公民自由问的平衡是达致善治的关键.     

从人道主义向自然主义迈进的福克纳——读《我弥留之际》

美国南方流派的代表作家威廉·福克纳是一位实验性的作家,在他的文学生涯中,他做过多种尝试,他的早期长篇小说《我弥留之际》是其中非常重要的一次。这部作品的创作思想显示福克纳在上世纪30年代从人道主义向自然主义迈进。     

“我怀疑故我在”与“我思故我在”之区别

奥古斯丁的“我怀疑故我在”与笛卡尔的“我思故我在”这两个命题的共同之处是无需质疑的，但是它们之间的区别也是确实存在的。二者的区别主要表现在：论证的出发点、“我”的含义和论证的目的三个方面。明确这三个方面的区别将有助于我们掌握奥古斯丁教父哲学和笛卡尔哲学思想的实质。     

六经注我,我注六经--简述陆九渊的经学思想

南宋心学创始人陆九渊对传统经学采取尊重与怀疑的辩证态度,这是由他立学的宗旨和问学的态度决定的。他主张自立、自得、独立思考、大胆疑问,也因此形成了“六经注我,我注六经”的精神,创立了心学一系。象山经学可说是传统经学的心学化。其心学开一代学风,对推动中国学术的向前发展具有重要意义和价值。     

理查兹的作者心理经验论

理查兹(1893—1981)是本世纪初英国著名的文学批评家。本文旨在考查他的作者心理经验论。理查兹倡导了后来美国的新批评派所极力推崇的“细读”式批评。他认为作品只不过是读者进入作者心灵的窗口。由于读者文学水准的高低不一,所以,读者的看法不能作为评价文学的标准。理查兹把作者的心理经验看成是衡量读者“期待视野”的标尺。理查兹对绝对标准的关注,使其理论带有明显的客观主义和实证主义的色彩;同时他对心理因素的兴趣也使他的理论具有人文主义和心理主义的内涵。     

论盖斯凯尔女性哥特小说中的幽灵、暴君和母亲

英国维多利亚时代女作家伊丽莎白·盖斯凯尔以当时流行的哥特文体，创作了短篇小说《老保姆的故事》《克拉雷会苦行修女》和《灰发女郎》等作品，塑造了痛苦的幽灵、专制的暴君和焦虑的母亲几种不同的人物形象，表达了她对女性命运的关注与思考。从女性哥特研究视角解读这些人物形象，可以清楚地看到：这几部一直未引起评论家重视的小说在人物塑造上很大程度反映了盖斯凯尔对男权社会的批判和对女性主义的坚持。     

Accelerated life test sampling plans for the Weibull distribution under Type I progressive interval censoring with random removals

This paper considers the design of accelerated life test (ALT) sampling plans under Type I progressive interval censoring with random removals. We assume that the lifetime of products follows a Weibull distribution. Two levels of constant stress higher than the use condition are used. The sample size and the acceptability constant that satisfy given levels of producer's risk and consumer's risk are found. In particular, the optimal stress level and the allocation proportion are obtained by minimizing the generalized asymptotic variance of the maximum likelihood estimators of the model parameters. Furthermore, for validation purposes, a Monte Carlo simulation is conducted to assess the true probability of acceptance for the derived sampling plans.     

A goodness of fit test for the multilevel proportional odds model

It is essential to test the goodness of fit of the model before making inferences based on it. Multilevel modeling of ordinal categorical responses is not as developed as for continuous responses. Assessing model adequacy in terms of the goodness of fit with ordinal categorical responses is still being developed and no satisfactory tests are available so far. As a consequence of that, this study concentrates on developing such a goodness of fit test for Multilevel Proportional Odds models and to study the properties of the test.     

Sex, self-interest and health care priorities

In this questionnaire study, individuals were asked to prioritise publicly provided preventive health care services, one of which would be unavailable to them by virtue of their sex. The aim was to establish whether men and women would exhibit different degrees of self-interest when making a constrained choice. Around 1800 subjects from east-central England prioritised three different types of cancer screening. Most also provided written explanations for their rankings and these were classified into explanatory themes. Logistic regressions using socio-demographic and attitude data predicted the type of screening chosen as first priority. The analysis revealed that many men and women did indeed assign similar priorities to the different types of screening and, even when the priorities differed, these were often justified by similar arguments relating to technical aspects of the interventions and to self-interest. However, women were far more likely than men to prioritise a type of screening from which they themselves would benefit directly and the variations in preferences and explanations between the sexes occurred primarily because of differences in other-regarding attitudes. The bias towards screening of females was driven by women's greater worries about the disease in question and by men's “benevolent sexism” with respect to women's wellbeing.