Professional parents’ loyalty to employer: The role of workplace social support

Professional mothers are more likely than professional fathers to leave workplaces—a phenomenon referred to as opting out. Previous research asserts that work–family challenges, including lack of access to supportive workplaces, are among the main reasons for this pattern. Despite revived interest in the study of opting out, little is known about factors shaping the loyalty to employer of those currently employed. Using data from the 2002 National Study of the Changing Workforce (N = 160 professional mothers; 114 professional fathers) we explore how three important forms of workplace social support – coworker support, supervisor support, and supportive workplace culture – are associated with professional mothers’ and fathers’ loyalty to their employees. Including fathers allows us to determine if gender dynamics are present in these patterns. The results suggest gendered patterns where supportive workplace culture relates to professional fathers’ employer loyalty and supervisor support relates to professional mothers’ employer loyalty.     

Allowing Family to be Family: End-of-Life Care in Veterans Affairs Medical Foster Homes

The Medical Foster Home program is a unique long-term care program coordinated by the Veterans Health Administration. The program pairs Veterans with private, 24-hour a day community-based caregivers who often care for Veterans until the end of life. This qualitative study explored the experiences of care coordination for Medical Foster Home Veterans at the end of life with eight Veterans’ family members, five Medical Foster Home caregivers, and seven Veterans Health Administration Home-Based Primary Care team members. A case study, qualitative content analysis identified these themes addressing care coordination and impact of the Medical Foster Home model on those involved: (a) Medical Foster Home program supports Veterans’ families; (b) Medical Foster Home program supports the caregiver as family; (c) Veterans’ needs are met socially and culturally at the end of life; and (d) the changing needs of Veterans, families, and caregivers at Veterans’ end of life are addressed. Insights into how to best support Medical Foster Home caregivers caring for Veterans at the end of life were gained including the need for more and better respite options and how caregivers are compensated in the month of the Veteran’s death, as well as suggestions to navigate end-of-life care coordination with multiple stakeholders involved.     

照护还是医疗:老年人健康支出的产出效率比较

老龄化尤其是高龄失能老人增多对我国现有的以疾病治疗为核心的健康保障体系提出了挑战。本文基于CLHLS2011年数据的结构方程模型估计结果表明,家庭的照料护理支出显著提高了老人的健康自评、健康他评、生活满意度等生活质量指标,并且还能降低老人的小病发病率、患慢性病种类数以及两年内的患重病次数;而家庭的医疗费用支出则显著降低了老人对自身健康水平和生活状况的主观评价,对降低老人患小病、重病和慢性病等也没有贡献。相比医疗支出,照护支出具有更优的健康产出效率,并且通过增进老人的身体功能和生活自理能力、提高老人主观健康评价等途径起到更积极的健康促进作用。最后建议我国应将更多的健康支出用于照料护理,建立基于家庭和社区的老人照护体系。     

Population health performance as primary healthcare governance in Australia: professionals and the politics of performance

ABSTRACT

A range of institutional and financial instruments has been used to drive population health outcomes in primary health care in Australia. However, GP sovereignty and the corporatized nature of general practice have generated major challenges. The core of government reform strategy since 1992 has been the creation and financing of Primary HealthCare Organizations (PHCOs), in various forms, to provide an organizational basis to connect GPs to population health performance, and a closer link between the state and GPs. The shift from Divisions of General Practice, the first PHCO, to Medicare Locals (MLs) in 2011 was notable. The latter constructed the object of performance as a raft of broader population health goals, which were framed in terms of accountability to communities through public reporting. Drawing on interviews with Federal government, health professional associations, ML executives and GPs, this paper examines the ways in which such performance instruments were imagined and understood, and areas of contestation. The findings show the different rationalities at play and how different actors seek control of the policy space. They also demonstrate the political precariousness of PHCOs, and the wider difficulty of steering market-based professionals in the achievement of population health objectives.     

福斯特的资本主义危机论及其中国启示

福斯特认为,当代资本主义发展正在遭遇严峻的"划时代危机"。经济维度上,当前人类尚未走出自大萧条以来最为严重的经济危机,经济垄断化、停滞化和金融化不仅在全球水平上相互作用还与全球劳动套利相勾连;社会维度上,工人阶级工作和生活的不稳定状况变为了全球性的问题,且这种不稳定相较于马恩时代甚至更为危险;生态维度上,资本主义生产的无限扩大突破了自然环境的承载限度,生态环境退化、生态失衡及其导致的全球生态不平等不断加剧。福斯特关于当代资本主义危机的研究与解读,具有鲜明的问题意识,对当前中国经济社会发展和生态文明建设具有批判性借鉴价值。     

健康传播在抖音短视频平台中的问题和提升路径

针对抖音短视频在关于健康问题传播方面存在的问题,依据对抖音短视频平台上289个健康传播账号的相关统计数据,从传播主体类型、账号认证管理、健康传播内容、短视频制作形式等4个方面,系统观察分析了抖音的健康传播现状。研究认为,抖音短视频平台的健康传播现存在以下亟待解决的4个问题:一是非专业传播主体成为平台健康传播的主力军;二是健康传播主体的账号认证名称混乱;三是短视频传播的健康信息不科学危害受众认知;四是短视频制作形式单一。为确保抖音短视频平台健康传播良性发展,应由具有较高公信力的各级政府卫生健康委员会和医疗机构主动引领短视频平台的健康传播,抖音短视频平台应加强传播主体认证管理和内容审核把关,传播主体则要坚守“内容为王”并提升制作水平。     

Barriers to Swift,Even Flow in the Internal Supply Chain of Perioperative Surgical Services Department: A Case Study*

This research analyzes the internal service supply chain of a perioperative surgical services department of a nonacademic community hospital using the theory of swift and even flow as a theoretical lens. Performance data were gathered using an in‐depth case study and it was determined that the swift and even flow constructs did affect flow speed and variance, but did not account for all the effects observed. To understand the need for departments to coordinate their efforts with each other and how this affected flow, further analysis was conducted using insights from Pagell's (2004) theory of internal integration and Gittell's (2002) research about coordinating mechanisms. The findings suggest the need to incorporate a variable measuring supply chain coordination into the theory of swift and even flow.     

Paper Versus Electronic Medical Records: The Effects of Access on Physicians' Decisions to Use Complex Information Technologies*

This study examines physicians' responses to complex information technologies (IT) in the health care supply chain. We extend individual‐level IT adoption models by incorporating a new construct: system accessibility. The main premise of the study is, when faced with a decision between alternate IT systems, individual users tend to select and make use of the technology or system that is most readily accessible. We discuss both physical and logical dimensions of accessibility as they relate to adoption of electronic medical records (EMR). Physical accessibility refers to the availability of computers that can be used to access EMR, while logical accessibility refers to the ease or difficulty of logging into the system. Using data from a survey of 199 physicians practicing in a large U.S. hospital, we show that, when deciding between the paper chart and EMR, accessibility is an important consideration in a physician's decision to use the system. Both dimensions of accessibility act as barriers to EMR use intentions through their indirect effect on physicians' perceptions of EMR usefulness and ease of use. Logical access also has a direct effect on EMR use intentions. We conclude that accessibility is an important factor that limits acceptance of complex IT such as EMR.     

天津社会工作人才队伍建设研究

社会工作是社会建设的重要组成部分,加强社会工作人才队伍建设,提升社会工作人才队伍水平,是解决社会问题、维持社会稳定、促进社会公正的重要手段。目前天津社会工作人才专业化、职业化水平不高,社会工作体制性障碍突出,为此,需要采取分领域、分地域、分时段梯次推进的措施,完善社会工作岗位设置和社会工作人才配置机制,加强天津社会工作人才队伍建设。     

关于新医疗制度改革的研究综述

在经济发展的基础上,保证人民群众公平享有公共卫生和基本医疗服务,是实现人民共享改革发展成果的重要体现。中国医药卫生体制经过多次改革和发展,取得了很多成就,但也存在一些问题,尤其是国家的经济发展进入新阶段,原有医疗体制有很多制度与经济发展阶段不符。公民的医疗卫生保障需求日益增加,如何在新形势下解决公民的医疗问题,2009年的新医改方案就是一次重要的制度再设计。