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.     

When is n large enough? Looking for the right sample size to estimate proportions

The central limit theorem indicates that when the sample size goes to infinite, the sampling distribution of means tends to follow a normal distribution; it is the basis for the most usual confidence interval and sample size formulas. This study analyzes what sample size is large enough to assume that the distribution of the estimator of a proportion follows a Normal distribution. Also, we propose the use of a correction factor in sample size formulas to ensure a confidence level even when the central limit theorem does not apply for these distributions.     

Theoretical results on the discrete Weibull distribution of Nakagawa and Osaki

In this paper, we discuss some theoretical results and properties of the discrete Weibull distribution, which was introduced by Nakagawa and Osaki [The discrete Weibull distribution. IEEE Trans Reliab. 1975;24:300–301]. We study the monotonicity of the probability mass, survival and hazard functions. Moreover, reliability, moments, p-quantiles, entropies and order statistics are also studied. We consider likelihood-based methods to estimate the model parameters based on complete and censored samples, and to derive confidence intervals. We also consider two additional methods to estimate the model parameters. The uniqueness of the maximum likelihood estimate of one of the parameters that index the discrete Weibull model is discussed. Numerical evaluation of the considered model is performed by Monte Carlo simulations. For illustrative purposes, two real data sets are analyzed.     

The covariance of the backward and forward recurrence times in a renewal process: the stationary case and asymptotics for the ordinary case

In a Poisson process, it is well-known that the forward and backward recurrence times at a given time point t are independent random variables. In a renewal process, although the joint distribution of these quantities is known (asymptotically), it seems that very few results regarding their covariance function exist. In the present paper, we study this covariance and, in particular, we state both necessary and sufficient conditions for it to be positive, zero or negative in terms of reliability classifications and the coefficient of variation of the underlying inter-renewal and the associated equilibrium distribution. Our results apply either for an ordinary renewal process in the steady state or for a stationary process.     

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.     

Tempered Mittag-Leffler Lévy processes

In this article, we introduce tempered Mittag-Leffler Lévy processes (TMLLP). TMLLP is represented as tempered stable subordinator delayed by a gamma process. Its probability density function and Lévy density are obtained in terms of infinite series and Mittag-Leffler function, respectively. Asymptotic forms of the tails and moments are given. A step-by-step procedure of the parameters estimation and simulation of sample paths is given. We also provide main results available for Mittag-Leffler Lévy processes (MLLP) and some extensions which are not available in a collective way in a single article. Our results generalize and complement the results available on Mittag-Leffler distribution and MLLP in several directions. Further, the asymptotic forms of the moments of the first-exit times of the TMLLP are also discussed.     

Kumaraswamy Marshall-Olkin Exponential distribution

In this paper, a new generalization of the Kumaraswamy distribution namely, the Kumaraswamy Marshall-Olkin Exponential distribution (KwMOE) is introduced and studied. Various properties are explored. The structural analysis includes various aspects such as limiting behaviour, shape properties, moments, quantiles, mean deviation, Renyi entropy, order statistics and stochastic ordering. Some useful characterizations of the family are also obtained. The method of maximum likelihood is used to estimate the model parameters. Monte Carlo simulation study is being conducted. An application to a real data set is presented for illustrative purposes.