Involvement of Ministries of Health in Health Service Coverage Decisions: Is England an Aberrant Case?

This article examines the involvement of ministries of health in making health service coverage decisions in Denmark, England, France and Germany. The study aims to inform debate in England about the feasibility of reducing perceived ministerial and bureaucratic ‘interference’ in decisions affecting the National Health Service, based on interviews with senior government officials and other health system stakeholders. Ministries of health differ in their involvement in health system governance and coverage decisions (‘the benefits package’), reflecting differences in institutional arrangements. In all four countries, organizations at arm's length or independent from government are either involved in providing technical advice to the ministry of health or have been mandated to take these decisions themselves. However, ministries of health occasionally intervene in the decision‐making process or ignore the advice of these organizations. The Department of Health in England is not an aberrant case, at least in relation to coverage decisions. Indeed, ministries of health in Denmark and France play a larger role in making these decisions. Public pressure, often amplified by the media, is a shared reason for ministerial and ministry involvement in all four countries. This dynamic may thus limit the feasibility of attempts to further separate the NHS from both the Department of Health and wider political pressures.     

我国农村基本公共卫生服务的均等化发展

以制度化设计为重点的均等化公共卫生服务可以减少居民消费不确定性,促进社会公平和稳定,是国外经济社会发展政策的普遍趋势。我国农村公共卫生服务从均等化发展的目标来衡量,仍面临城乡环境差距较大、卫生资源布局不合理等诸多障碍,因此,必须加大改革力度,从推进农村公共服务设施与城市衔接、加强农村基础设施投入和完善农村医疗卫生体系等重点领域进行突破,全面推进农村公共服务与城市的融合。     

Employee attitudes to work-based counselling services

Work-based counselling services have increasingly been introduced in organizational settings in the 1980s and 1990s. In this paper, a study is reported of the attitudes of 213 employees of a UK Health Authority towards an existing counselling service. Questionnaires sought information about attitudes to counselling, confidentiality, attitudes to those seeking counselling and general health. The results suggested that attitudes to work-based counselling services are predicted by employees' perceptions of those seeking counselling as trustworthy and their beliefs about the confidentiality of the service. The practical implications of these results are examined.     

新时期加强大学生心理健康教育的途径

近年来,大学生存在的心理问题日趋增多,而学生因心理疾病、精神障碍等原因伤害自己和他人的案例时有发生,且有上升趋势。由于心理问题而引发的学生休学、退学甚至自杀等恶性事件的发生,不仅给学生家庭带来了严重的心灵伤害,而且对学校和社会都产生了极大的影响,引起了社会的广泛关注和德育工作者的深刻思考。     

643例老干部健康体检患病情况分析

目的探讨影响老干部健康的主要疾病及预防策略。方法采用常规健康体检方法对我区643例老(≥60岁)干部进行全面体检及心电图、血液生化指标的检查,并以同时进行体检的1147例老年前期(50～59岁)干部作为对照。结果高脂血症、脂肪肝、高血糖、肾结石、高血压和前列腺增生为这些人群中患病率较高的前六位疾病。老年组中脂肪肝、高血压、高血糖和前列腺增生的患病率均高于老年前期组(P<0．05-0．005),高脂血症和肾结石的患病率在两组间均无显著性差异(P>0．05)。老年组心电图和超声心动图检查出现心肌缺血的改变均多于老年前期组(均P<0．005)。结论诸如高血压、高血糖等动脉硬化的高危因素在老年人中常见,定期健康体检是早期防治心血管疾病的有效方法。     

Mental load and work stress as two types of energy mobilization

A conceptual framework is presented in which mental load and stress are regarded as two distinct biobehavioural states in the work environment that differ in energy mobilization, mood and coping strategy. The framework combines two types of theory that are based on human performance research using laboratory tasks on the one hand and applied research in the work environment on the other. A high workload is regarded as an important but not a critical factor in the development of stress symptoms. Even under unfavourable conditions it is possible to work intensively and to be highly activated without feelings of strain or psychosomatic complaints. In contrast, working conditions that provide few possibilities for control and little social support or are associated with reduced well-being and increased health risks. The two states differ in activation, coping style and mood. A proper distinction is important not only for theory building but also for the reconstruction of the work environment. It may lead to recommendations that aim to enhance the work efficiency of employees while reducing the probability that stress responses will occur.     

Changes in the structure of health complaints as related to shiftwork exposure

Abstract

Factor analyses of health complaints in groups with different length of shiftwork exposure show that the structure of these complaints changes with increasing shift experience, indicating the emergence of a shift-specific pattern of health complaints. After about 15 years of shiftwork, complaints related to disturbances of circadian-controlled functions can be found in the first factor whereas other complaints have their dominant loadings on a separate factor, representing general, non-shift-specific impairments. The results indicate that in this way shift-specific components of health impairment can be separated from other non-shift related components.     

Psychophysical conditions of air traffic controllers evaluated by the standard shiftwork index

Abstract

In the ambit of a large epidemiological survey on the Italian population of air traffic controllers, an evaluation of their health conditions was carried out using the Standard Shiftwork Index (SSI). The study took into consideration 572 male air traffic controllers, aged between 23 and 59 years, of whom 301 were engaged in three large Regional Centres, 189 in thirteen Airport Towers and 82. formerly active controllers, were working in administrative offices. The former controllers showed worse health levels, in particular minor psychological disorders and chronic fatigue. Sixteen of them had been transferred to administrative jobs because of health impairment, owing to severe diseases of the nervous, gastrointestinal and cardiovascular systems. Such disorders, and musculoskeletal ones, were mostly reported by the active controllers. The controllers engaged in Regional Centres showed more sleep disturbances than those engaged in towers. Beside age, some personal characteristics appeared to influence health and well-being. Neuroticism was correlated with chronic fatigue, digestive and cardiovascular complaints, minor psychological disorders, cognitive and somatic anxiety. On the other hand, morningness was correlated negatively with sleep disturbances on morning shift, and positively with sleep duration both on morning shift and rest days.     

Talking of HRD

This paper draws upon research exploring the emergence of HRD within the British National Health Service (NHS), the aim being to investigate how HRD has been talked into being, is talked about and accomplished through talk. HRD is conceptualized as a socialand discursive construction, and as discursive action. It is argued that conceptualizing HRD as a social and discursive construction can help identify and explain changes in ways of thinking and talking about HRD. Conceptualizing HRD as discursive action can help explain and justify HRD activity, in that much of what HRD practitioners and academics ‘do’ is ‘talk’. This paper explores these concepts and introduces a typology of the discourses of training and development (T&D), HRD and strategic HRD (SHRD), labelled Tell, Sell and Gel. It is suggested that this typology is a useful analytical tool for those practising HRD, providing ameans for HRD professionals to identify and analyse, and possibly change, their practices and discourse(s). The paper introduces a way of identifying how HRD might be talked ‘about’ and theorizes how discursive activities (the talk) might be changing.     

Chinese and Americans Agree on What Is Fair,but Disagree on What Is Best in Societal Decisions Affecting Health and Safety Risks

Through surveys of students and junior professionals and interviews with business and government executives, we studied Chinese choices and fairness perceptions in risky health and safety decisions. The survey responses were compared with American responses from an earlier study by Keller and Sarin.The survey results show that the American and Chinese respondents had similar fairness perceptions, but the Chinese did not make decisions that were consistent with their fairness perceptions, whereas the Americans did. We found that the middle-age Chinese professionals tended to make choices that were more different from the Americans than were the choices of the young Chinese management students. It is likely that these discrepancies were caused by cultural differences, with the younger Chinese tending to face a stronger Western influence.The insights from the survey results were enriched by interviews that revealed fairness perceptions of Chinese business and government executives. A framework to interpret cultural influences on decision making was also proposed.