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.     

Myriad potential for mentoring: Understanding the process of transformational change through a gender equality intervention

This article contributes to understanding transformational change towards gender equality by examining the transformational change potential of a mentoring programme for women, a type of gender equality intervention both criticized and praised for its ability to bring about change. Drawing upon an empirical case study of a mentoring programme for women academics in a Dutch university, we explore three dimensions of transformational change: organizational members (i) discussing and reflecting upon gendered organizational norms and work practices; (ii) creating new narratives; and (iii) experimenting with new work practices. Our findings indicate five specific conditions that enable transformational change: cross‐mentoring, questioning what is taken for granted, repeating participation and individual stories, facilitating peer support networks and addressing and equipping all participants as change agents. We suggest that these conditions should be taken into account when (re)designing effective organizational gender equality interventions.     

Scrambled systems: the (im)mobilities of ‘storm Desmond’

This article examines a 3-day blackout, triggered by a ‘1-in-100-year’ rainfall event. Storms and floods account for almost three-quarters of weather-related disasters, and are typically accompanied by cascading infrastructure failures, which pattern and amplify their effects in highly significant ways. Such disruptions reveal aspects of everyday life that ordinarily remain obscure, including capacities for resilience embodied in people, cities and infrastructure. The article proposes that disruption events be understood in terms of ‘scrambles’, as they involve abrupt demobilisation and remobilisation of a range of people and materials. The article firstly examines the astonishing capacity for failure latent in ‘pervasively powered’ arrangements, as well as the many ways in which people and things were ‘scrambled’ in response. The article then proceeds to explore the ways in which vulnerabilities result in part from mobilisation in response to previous disruption events, before examining the ‘circuits’ that link far-flung places in mobile disaster geographies, global patterns of electricity dependence, the rise of data overload in the ‘cloud’ to carbon overload in the atmosphere. The article concludes by presenting further evidence in support of the thesis that disruptions and disasters are part of a ‘new normal’, and what this means for prevailing sociotechnical arrangements reliant on ‘sunk’ infrastructure.     

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.     

Examining the Nursing Home Physical Environment Through Policy-Driven Culture Change

A critical need exists to challenge approaches to nursing home care due to rigid organizational factors and hospital-like culture. It has been argued that resident care needs to move toward a person-centered approach by addressing the organizational, social, and physical environments in nursing home facilities, a process often known as culture change. In response to this need, the Centers for Medicare & Medicaid Services (CMS) has created funding for pay for performance (P4P) nursing home incentive programs to allow nursing home providers to receive CMS reimbursements for culture change in the facilities. Through care staff interviews, site observations, and a document review, this qualitative study assesses the impact of a Midwestern state P4P incentive program in three participating nursing homes. Using an environment and behavior (E-B) policy orientation framework, this study examines culture change through a focus on policy, the physical environment, place attachment, and social and psychological processes in the study settings.     

Change agent's contribution to recipients' resistance to change: A two-sided story

In the change management literature, most studies on recipients' resistance to change include only the views of agents or of recipients, thereby ignoring that these parties may have different perceptions. In this quantitative study, we include the perceptions of both parties in studying the recipients' resistance and the impact of the agent's leadership behavior. In a sample of 117 agent-recipients groupings, covering 110 different change projects in 90 organizations, we found that agents perceive higher levels of recipients' resistance than do the recipients themselves. Additionally, we found that agents who create space to enable recipients to think and act differently (by employing creating behavior) report higher levels of recipients' resistance, whereas recipients perceive their resistance to be lowered when agents facilitate an emotional connection to the change (framing behavior). The depth of the change appeared to moderate the relationship between agent's leadership behavior and recipients' resistance, indicating that agents and recipients differ in which change leadership behaviors they perceive as increasing or decreasing resistance at different levels of change depth. These findings imply to reconsider the relationship between agent and recipients and we propose some promising avenues for future studies in resistance research.     

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.     

Christian Aid and LGBTI rights: breaking the silence

In recent years Christian Aid has begun to explicitly recognise and respond to discrimination faced by LGBTI people globally. A catalyst for this shift was the re-criminalisation of homosexuality in Uganda, Nigeria, and India in 2014, as well as partner reports of rising violence towards LGBTI people in Latin America and the Caribbean. However, breaking the silence on LGBTI issues within the organisation came predominantly through the emergence of an informal staff sexuality network. This article offers a critique of Christian Aid’s journey from being initially hesitant to engage with issues of LGBTI discrimination to recognising that as a faith-based development agency it can no longer remain silent. Taking such steps, however, has not been without challenges or risks.     

Critical Reflections on the March for Science

Using MacKendrick (2017) as a springboard, this essay explores the March for Science as an example of social mobilization. I lay out some concerns regarding the use of this tactic as a response to attacks on science and suggest some ways sociology could contribute to the development of more efficacious actions to address the denigration of scientific knowledge.