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.     

民办幼儿园教师专业素养培训方式实验研究

随着现代教育的发展，提升幼儿园教师专业素养已成为促进学前教育发展的必然要求。以探究民办幼儿园教师专业素养为视角，提出通过干预行为提升教师专业素养水平的构想。实验随机选取成都市某民办幼儿园的20名教师为实验组，再选取与其办园环境、办园背景相似的另一所民办幼儿园的20名教师为对照组，对实验园教师的专业理念与师德、专业知识、专业能力3个维度进行干预。实验结果表明：与对照园相比，实验园教师的专业能力提升显著；与实验园实验前后相比，教师在专业知识、专业能力维度及专业素养总体水平方面均有提升。对教师培训的具体建议为：（1）单一与混合相结合的培训方式对提升民办幼儿园教师专业素养总体水平有现实意义；（2）民办幼儿园教师专业知识的提升需理论培训与自主学习相结合；（3）专家"现场诊断-指导式"培训方式对提升民办幼儿园教师专业能力有显著作用。综上，建议民办幼儿园在了解本园教师专业素养水平的基础上，针对教师专业素养的不同方面，分别采取不同的有效培训方式。     

Squashed dreams and rare breeds: ableism and the arbiters of life and death

The week beginning 29 June 2015 is not just historic for the closure of the Independent Living Fund in the United Kingdom, but for me was the week they decided that my life is not worth investing in; they being NHS England, NICE and, with them, the Department of Health. They chose not to support the enzyme replacement therapy that has been not only keeping me alive, but giving me a quality of life – enabling me to return to finish my Disability Studies PhD exploring how Christian leaders explain disability, where ethics have become the main topic, and to rebuild my career – or so I thought.     

论贤相伊尹的个人素质及其形成

伊尹作为中国历史上第一位贤相,其突出的个人素质表现在精于至味之理、精通耕作之道、创制治病汤液几方面,即懂得如何吃饭、种地和治病。这正是广大民众最为关心的事情,也是治理内政极其关键的因素,只有这三件事做得好,才可能完成"祀与戎"等国家大事。如此全面素质的形成,与其丰富的人生经历和勤于思索有关。     

A new financial stress index model based on support vector regression and control chart

Financial stress index (FSI) is considered to be an important risk management tool to quantify financial vulnerabilities. This paper proposes a new framework based on a hybrid classifier model that integrates rough set theory (RST), FSI, support vector regression (SVR) and a control chart to identify stressed periods. First, the RST method is applied to select variables. The outputs are used as input data for FSI–SVR computation. Empirical analysis is conducted based on monthly FSI of the Federal Reserve Bank of Saint Louis from January 1992 to June 2011. A comparison study is performed between FSI based on the principal component analysis and FSI–SVR. A control chart based on FSI–SVR and extreme value theory is proposed to identify the extremely stressed periods. Our approach identified different stressed periods including internet bubble, subprime crisis and actual financial stress episodes, along with the calmest periods, agreeing with those given by Federal Reserve System reports.     

疲劳裂纹扩展试验裂纹图像采集系统

针对目前金属疲劳裂纹扩展检测方法存在效率低、操作繁琐、精度不高，不能实现实时性等缺点，文章提出了基 于机器视觉的裂纹检测方法。根据金属疲劳裂纹扩展试验过程中裂纹图像的采集要求，设计了摄像头位置可自动调整 的疲劳裂纹图像采集系统，包括摄像头安装运动装置，裂纹图像采集装置以及摄像头运动控制系统。图像采集装置由高 分辨率黑白面阵CCD摄像头、光学镜头，光源照明装置和图像采集卡组成，前3者安装在摄像头支架上，与摄像头运动 装置相连。摄像头运动装置中的X，Y，，Z轴运动机构由步进电机带动滚珠导轨机构。在基于ARM技术的运动控制系统 的控制下摄像头可沿X，Y，，Z轴作高精度直线运动，实现和试件之间精确位置的调整。实验结果表明，所设计的系统可 采集到疲劳裂纹扩展试验过程中高清晰度、高分辨率的试件裂纹图像，满足下一步裂绞尺寸计算的要求；摄像头运动定 位精度可达到0. 02 mm，满足精确的系统聚焦、位置调整、跟踪采集的要求。     

国家级教学名师的优秀品质及其养成

通过对5位国家级教学名师的自述报告进行三级编码和主题凝练，研究发现国家级教学名师作为教师队伍的杰出代表，在其专业发展过程中养成了许多优秀品质。例如：教学方面注重实践、考虑周全，师德方面以德施教、追求卓越，科研方面以教带研、实现创新。国家级教学名师优秀品质的养成通常经历了漫长而曲折的过程，不仅需要精神与物质力量的共同推动，还需要家庭、学校和社会各环境要素的相互促进，以及社会取向养成方式和个人取向养成方式的互相配合。深入探究国家级教学名师的优秀品质及其养成之道，可以为教师专业发展提供借鉴与启示。     

Interval estimation for conformance proportions of multiple quality characteristics

A conformance proportion is an important and useful index to assess industrial quality improvement. Statistical confidence limits for a conformance proportion are usually required not only to perform statistical significance tests, but also to provide useful information for determining practical significance. In this article, we propose approaches for constructing statistical confidence limits for a conformance proportion of multiple quality characteristics. Under the assumption that the variables of interest are distributed with a multivariate normal distribution, we develop an approach based on the concept of a fiducial generalized pivotal quantity (FGPQ). Without any distribution assumption on the variables, we apply some confidence interval construction methods for the conformance proportion by treating it as the probability of a success in a binomial distribution. The performance of the proposed methods is evaluated through detailed simulation studies. The results reveal that the simulated coverage probability (cp) for the FGPQ-based method is generally larger than the claimed value. On the other hand, one of the binomial distribution-based methods, that is, the standard method suggested in classical textbooks, appears to have smaller simulated cps than the nominal level. Two alternatives to the standard method are found to maintain their simulated cps sufficiently close to the claimed level, and hence their performances are judged to be satisfactory. In addition, three examples are given to illustrate the application of the proposed methods.