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.     

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。     

中国员工企业伦理态度调查及分析

随着中国市场经济的发展,各种企业丑闻的频发引起业界广泛关注,公司治理越来越受到重视。已有的研究表明,员工企业伦理态度关乎员工承诺度和企业竞争力。本文依据个人层次研究理论,采用实证分析方法,选择国内6家企业的员工为调研对象,沿用国外企业伦理个体层次研究中广泛使用的量表"Attitude Towards Business Ethics Questionnaire"(ATBEQ)即企业伦理态度量表,考察当代中国企业员工对企业伦理态度的看法;另外,也分析了不同的工作年限,性别,学历,户口等因素下的企业员工伦理态度差异。调查结果显示:中国员工的企业伦理观存在困惑;大部分中国员工有企业利益相关者意识;教育对企业员工伦理态度存在显著影响。     

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。     

Comparison of labour and birth outcomes between nulliparous women who used epidural analgesia in labour and those who did not: A prospective cohort study

ObjectiveTo compare labour and birth outcomes between nulliparous women who used versus did not use intrapartum epidural analgesia.DesignProspective cohort study.SettingTwo maternity hospitals in Ireland.PopulationA total of 1221 nulliparous women who gave birth vaginally or by emergency caesarean section.MethodsMultinomial logistic regression was used to analyse categorical outcomes, with results presented as ratios of relative risks (RRR). For dichotomous outcomes we used logistic regression, with results presented as odds ratios (OR).Main outcome measuresMode of birth, IV syntocinon use, pyrexia (≥38 °C), antibiotic treatment, first stage labour ≥10 h, second stage labour ≥2 h, blood loss (≥500 mls, ≥1000 mls), perineal trauma. Neonatal outcomes included Apgar score ≥7 at 1 min and 5 min, admission to neonatal intensive care unit, and infant feeding method.ResultsWomen using EA were more likely to require a vacuum-assisted birth (RRR 3.35, p < 0.01) or forceps-assisted birth (RRR 11.69, p < 0.01). Exposure to EA was associated with significantly greater risk of ≥10 h first (OR 6.72, p = 0.01) and ≥2 h second (OR 2.25, p < 0.01) stage labour, increased likelihood of receiving IV syntocinon (OR 9.38, p < 0.01), antibiotics (OR 2.97, p < 0.01) and a greater probability of pyrexia (OR 10.26, p < 0.01). Women who used EA were half as likely to be breastfeeding at three months postpartum (OR 0.53, p < 0.01). No differences were observed between groups in neonatal outcomes.ConclusionsOur data shows significant associations between EA use and several intrapartum outcomes.     

关于高校中层副职干部几个基本问题的思考

高校中层副职干部具有高校干部、中层干部和副职干部的群体特征，应当具备相应的政治、思想、道德、业务、能力和身体等方面的基本素质。高校应当按照现行干部配置规制，结合内部管理体制和工作机制任用干部。高校中层副职干部的日常活动涉及到社会、学校、家庭等多个层面，必须妥善处理好各种人事关系。     

中国当代人口发展分析

以人为本的科学发展观必然要求我们在一切发展序列中首先关注人口发展,中国人口发展在中国社会发展框架中具有绝对优先的工具价值和目的意义.中国作为发展中国家与作为人口最多的国家两者之间在很大程度上具有互为因果的内在关系,充分认识中国人口发展现状具有多元化的重要意义.中国人口发展状况主要表现为人口数量多、人口质量低和人口结构不合理.中国人口现代化是中国其它现代化的强力引擎,中国人口发展的基本创新路径是城市化发展路径、市场化发展路径、民主化发展路径.     

关于高校办公室网络化管理的思考

随着科学技术和高等教育的发展,网络也广泛运用于高校办公室的管理工作,并在其中起着重要的作用。     

素质教育对化学教师素质的要求

化学教师必须具备良好的思想道德素质 ,丰富的化学专业知识和较全面的知识技能、丰富的教育理论水平以及探索创新的精神才能适应新世纪的挑战     

基于电子商务的企业管理及其创新

随着计算机网络和通讯技术的迅速发展,尤其是Internet的普及和应用,社会经济正在经历着一场巨大的变化.作为网络经济的必然产物,电子商务掀起了经济领域的一场革命,面对来势汹涌的电子商务大潮,作为社会经济环境中一个单元的企业,应将电子商务提高到战略位置上来,因为电子商务必然会渗透企业管理的各个过程,改变企业运作方式,促进企业管理创新.