Unemployment,Medicaid provisions,the mental health industry,and suicide

This study examines the association between unemployment, Medicaid provisions, the mental health industry, and adult suicides in nine US northeastern states from 1999 to 2009. Results show that increased unemployment is associated with more Medicaid beneficiaries and higher health care spending per beneficiary with no significant relationship with Medicaid mental health spending. The Medicaid beneficiary rate is positively associated with the number of mental health clinics, mental health and substance abuse social workers, mental health counselors, and psychiatrists, with no significant association with mental health physician offices or psychologists. Unemployment is also related with increasing suicide rates for the overall population and White non-Hispanics, aged 16–64, with the worst association for White non-Hispanic males. The composition of the mental health industry is also associated with suicide rates. Maintaining an appropriate mix of mental health facilities and professionals to prevent, diagnose, and treat mental health disorders remains a critical public health challenge.     

Examining Reports and Policies on Cognitive Enhancement: Approaches,Rationale, and Recommendations

The phenomenon of cognitive enhancement is attracting attention in bioethics literature and beyond, in public policy. In response, three bodies—the British Medical Association (BMA); the Commission de l'éthique de la Science et de la technologie (CEST) du Québec; the American Academy of Neurology (AAN)—have produced reports and guidance on this topic. To gain insights into different public policy approaches, rationales, and recommendations on the topic, we analyzed these reports in depth. We found convergence on the definition (with the exception of the CEST) of cognitive enhancement. However, we noted a lack of critical reflection with respect to the underlying rationale for developing these reports, i.e., that cognitive enhancement practices are rampant and represent major social changes. As it currently stands, cognitive enhancement is constituted in a way that challenges the creation of coherent and effective policy recommendations. However, policy makers should not simply wait for definitional consensus and hope that on balance the benefits turn out to be greater than the risks. Some components of cognitive enhancement could be reduced down to clearly identified policy targets to be further examined. Then, if appropriate, policy should be created that is, amongst other criteria, beneficial to the majority of the population.     

When Everyone Is an Orphan: Against Adopting a U.S.-Styled Orphan Drug Policy in Canada

Putting aside whether diseases that affect only small numbers of people (“rare diseases”) should be prioritized over diseases that are otherwise orphaned, in this article I argue that a new approach to rare, orphan diseases is needed. The current model, first signaled by the United States' Orphan Drug Act and subsequently emulated by several other jurisdictions, relies on a set of open-ended criteria and market-based incentives in order to define and encourage drug therapies for rare, orphan diseases. Given a) the biopharmaceutical industries' growing interest in orphan diseases, b) progress in the sphere of personalized medicines enabling more and more common diseases to be reclassified as rare, and c) empirical evidence suggesting that the most orphan drugs target only a limited, lucrative subset of rare diseases, I argue that Canada, which recently announced plans to develop its own “orphan drug framework” should not follow the United States' orphan drug model.     

女性教工健康状况调查——以安徽农业大学为例

随着社会的发展,女性地位的提高,女性的很多相关问题引起人们的关注。本次调查以安徽农业大学现在职的全体女性教工为研究对象。目的是通过这次调查了解安徽农业大学目前在职的女性教工的健康状况与女性以及学校对女性教工健康关注状况之间的相关性,提出相应意见以期为女性教工的事业发展搭建良好的平台。     

(Net)Working out: social capital in a private health club

In Bowling Alone Robert Putnam considers the possibility that the growth of private health clubs and the rising rates of membership to such clubs might represent a counter-trend to his thesis on the decline in social capital. In this paper I explore this idea using ethnographic data and social network analysis. I show both that and how networks form in health clubs and I discuss the ways in which these networks constitute social capital for their members. In addition, however, I explore the 'dark side' of this form of social capital. I argue that high integration amongst some members of a fitness class can generate a power differential between those members and other, less integrated members who experience this negatively. Furthermore, with an eye on Burt's (2005 ) important thesis on brokerage and closure, I argue that brokerage between relatively closed clusters of agents can lead to inter-group rivalry and conflict, which, in turn, is experienced negatively by those involved.     

Lessons from a project to create performance measures for public health

This paper uses a specific example to illustrate complications that arise in formulating and implementing performance measures. The context of this demonstration is a Centers for Disease Control and Prevention (CDC)-funded project to explore the feasibility of performance measures developed at the national level for local sexually transmitted disease (STD) prevention and control programs. Grantees provided local data and reported on their experience in eliciting the data and using the results for program development. The experience of this project suggests that measures can be made operationally feasible and programmatically useful only if terminologies are subjected to extensive definition and clarification activities. These activities must include development of common language, mapping of workflows, and clarification of spheres of influence. Finally, performance measures must be used with some caution, as they often unintentionally capture extraneous program elements.     

Using Fairness Models to Improve Equity in Health Delivery Fleet Management

Inefficiency and inequity are two challenges that plague humanitarian operations and health delivery in resource‐limited regions. Increasing capacity in humanitarian and health delivery supply chains is one option that has the potential to improve equity while maintaining efficiency. For example, the nonprofit organization Riders for Health has worked to increase capacity by providing reliable transportation to health workers in rural parts of sub‐Saharan Africa; with more motorcycle hours at their disposal, health workers can perform more outreach to outlying communities. We develop a model using a family of fairness function to quantify the efficiency and equity of health delivery as capacity is increased via development programs. We present optimal resource allocations under utilitarian, proportionally fair, and egalitarian objectives and extend the model to include dual modes of transport and diminishing returns of subsequent outreach visits. Finally, we demonstrate how to apply our model at a regional level to provide support for humanitarian decision makers such as Riders for Health. We use data from the baseline phase of our evaluation trial of Riders for Health in Zambia to quantify efficiency and equity for one real‐world scenario.     

Measuring the Contribution of Workers' Health and Psychosocial Work‐Environment on Production Efficiency

Increasingly many firms have started to implement programs intended to improve the workers' health and the psychosocial work‐environment, as well as other attributes of labor quality. Motivated by the need for evaluating to what extent the programs affect a firm's productivity performance, this study discusses a model for analyzing the contribution of labor quality attributes toward firm productivity. To assess the contribution from the labor quality attributes, we model firm productivity as the outcome of two separate processes within a firm: the physical production process and the labor quality process. Firm productivity is measured by a Malmquist‐like productivity index and is computed by Data Envelopment Analysis. Based on bootstrap methods we analyze potential statistical bias and provide bias‐corrected productivity estimates. The labor quality attributes are first modeled at an individual worker level as latent variables using Item Response Theory, and then aggregated to a firm‐level. The model is empirically validated using data from three manufacturing plants that participated in a coordinated worksite health promotion program. Over a 4‐year period (2000–2003), we observed a general improvement in efficiency of 2–5%, half of which could be attributed to an improvement in workers' health and psychosocial work‐environment. A key benefit with the model is that it is practical, easy to implement, and very fast to compute. The model also constructively contributes to the discourse on sustainability by providing a framework for deriving meaningful metrics and providing tangible measurements on the effect of sustainability‐related issues.     

关于建立标准人（Standard Person简写SP）体系的假设

人作为生物,也作为社会成员,他们具有不同的个体特征,但同时又具有共同之处,这些共同之处我们可以从人的身体素质、思想素质和科学文化素质等进行比较。标准人体系假设就是试图从这几个重要因素及其子因素对人的影响中确定一个标准人所拥有的条件,以及各因素对标准人的影响权重,也就是对人的条件进行量化,并提出本假设的目的,解决的问题和作者希望通过本假设对社会学、人口学、人类学、人口社会学等学科的研究提供一种新的视角。