医科与农科大学生SCL——90测查比较研究

用心理卫生自评量表(SCL———90)调查了内蒙古蒙医学院和哲里木畜牧学院两高校大学生的心理健康和差异,结果表明,两高校学生男女总体心理健康水平无明显差异,存在的心理问题各具特点,而医科学生心理问题较多,强度较大。     

扬州市邗江区乡镇预防保健体制改革两种模式的比较研究

扬州市邗江区1999年对全区21所乡镇卫生院进行了产权制度改革。改制前3年,实行“医防合一”体制,从2002年起实行“医防分设”体制。文章采用定性调查和定量调查相结合的方法,比较改革前后农村卫生体系和农村预防保键资源、组织机构、服务效率、监督执法力度、农民满意度等方面的变化。研究表明,“医防分设”是必由之路,为进一步改革和完善预防保健体系提供了依据。     

我国“放管服”改革成效评估与展望

目的/意义 近年来,“放管服”改革已成为学术界研究的热点主题,十九大的胜利召开对“放管服”改革也提出了新的要求和指导建议。因此,系统梳理和比较国内“放管服”改革研究状况,对今后“放管服”改革的理论与实践推进具有重要意义。 设计/方法 选取国内“放管服”改革研究的重要期刊文献,对比分析十九大召开前后国内“放管服”改革研究的整体发展现状及研究内容差异。 结论/发现 十九大召开前后“放管服”改革的研究热点主题存在“差异多、共性少”的特点,而研究团队则表现为“共性多、差异少”,研究内容则呈现出“大同小异”的高度一致性特点。从内涵和问题优化上看,前后阶段表现为“共性少、差异多”;而从实践模式及效果评价上看,前后阶段表现为继承与发扬的关系,后阶段研究是对前期研究的持续深入推进。最后,从强化研究团队间的沟通合作,深入推进案例和实证研究,增加定性与定量相结合的混合研究三个方面提出未来研究展望。     

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.     

Social expenditures and public administration: are local social assistance costs in Sweden a matter of organisation?

Minas R. Social expenditures and public administration: are local social assistance costs in Sweden a matter of organisation?
Int J Soc Welfare 2010: 19: 215–224 © 2009 The Author(s), Journal compilation © 2009 Blackwell Publishing Ltd and the International Journal of Social Welfare. This study examines the connection between organisational factors and local social assistance expenditures in Swedish municipalities. The organisation of social assistance units, particularly those for the intake of social assistance inquirers, and the possible implications for local social assistance costs are highlighted. The study is based on interview data from medium‐sized Swedish municipalities combined with register data covering the years from 1997 to 2001. The results show that socioeconomic factors have an overall dominant effect, but also that organisational factors co‐vary with local social assistance expenditures. The results show a cost‐reducing effect for special intake units: firstly, when these units are analysed together with other forms of specialisation and secondly, when staff resources are taken into account. Thus, specialised intake organisation by itself does not play a cost‐reducing role, but does so in combination with certain other factors that characterise the internal organisation of the social welfare office.     

Contractual audit and mental health rehabilitation: a study of formulating effectiveness in a Finnish supported housing unit

Saario S, Raitakari S. Contractual audit and mental health rehabilitation: a study of formulating effectiveness in a Finnish supported housing unit Int J Soc Welfare 2010: 19: 321–329 © 2010 The Author(s), Journal compilation © 2010 Blackwell Publishing Ltd and International Journal of Social Welfare. Mental health NGOs in Western Europe are increasingly managed by contractual audit procedures. This article concerns how contractual audit and its emphasis on effectiveness of care impact on the practices of long‐term mental health rehabilitation. To demonstrate this, a case study of a Finnish NGO that provides supported housing is presented. The study looks at how service purchasing practices, as stated in the contract between the municipality and the NGO, are reflected in the meetings among practitioners. Documentary and meeting data were utilised together with Mitchell Dean's notion of technologies of agency. It was found that practitioners actively sought to show the effectiveness of their everyday work in terms of contractual audit by demonstrating both the economic and progressive aspects of care. Thus, professional competency in mental health rehabilitation appears to entail both the skills of care interventions and the ability to perform these interventions as efficient and financially accountable activities.     

Using a mixture model for multiple imputation in the presence of outliers: the 'Healthy for life' project

Summary.  We consider the problem of obtaining population-based inference in the presence of missing data and outliers in the context of estimating the prevalence of obesity and body mass index measures from the 'Healthy for life' study. Identifying multiple outliers in a multivariate setting is problematic because of problems such as masking, in which groups of outliers inflate the covariance matrix in a fashion that prevents their identification when included, and swamping, in which outliers skew covariances in a fashion that makes non-outlying observations appear to be outliers. We develop a latent class model that assumes that each observation belongs to one of K unobserved latent classes, with each latent class having a distinct covariance matrix. We consider the latent class covariance matrix with the largest determinant to form an 'outlier class'. By separating the covariance matrix for the outliers from the covariance matrices for the remainder of the data, we avoid the problems of masking and swamping. As did Ghosh-Dastidar and Schafer, we use a multiple-imputation approach, which allows us simultaneously to conduct inference after removing cases that appear to be outliers and to promulgate uncertainty in the outlier status through the model inference. We extend the work of Ghosh-Dastidar and Schafer by embedding the outlier class in a larger mixture model, consider penalized likelihood and posterior predictive distributions to assess model choice and model fit, and develop the model in a fashion to account for the complex sample design. We also consider the repeated sampling properties of the multiple imputation removal of outliers.     

中国医疗卫生行业发展影响因素的提炼与甄别

关于卫生行业发展影响因素的现有研究多数基于定性分析，而实证研究较少。为从静态和动态两个角度将经济社会发展对卫生行业发展的制约关系进行量化与应用研究，建立多元线性回归模型和ARMA（1，1）模型将社会经济因素对卫生行业发展的影响程度和影响方向进行提炼与甄别，结果表明：人均收入水平、财政卫生支出是影响中国卫生服务业发展的两个主要因素，城乡收入比和人口老龄化对卫生行业发展的影响还不是很显著。     

The EPA Health Risk Assessment of Methylcyclopentadienyl Manganese Tricarbonyl (MMT)

This paper describes the U.S. Environmental Protection Agency's assessment of potential health risks associated with the possible widespread use of a manganese (Mn)-based fuel additive, methylcyclopentadienyl manganese tricarbonyl (MMT). This assessment was significant in several respects and may be instructive in identifying certain methodological issues of general relevance to risk assessment. A major feature of the inhalation health risk assessment was the derivation of Mn inhalation reference concentration (RfC) estimates using various statistical approaches, including benchmark dose and Bayesian analyses. The exposure assessment component used data from the Particle Total Exposure Assessment Methodology (PTEAM) study and other sources to estimate personal exposure levels of particulate Mn attributable to the permitted use of MMT in leaded gasoline in Riverside, CA, at the time of the PTEAM study; on this basis it was then possible to predict a distribution of possible future exposure levels associated with the use of MMT in all unleaded gasoline. Qualitative as well as quantitative aspects of the risk characterization are summarized, along with inherent uncertainties due to data limitations.     

关于行政机关法律责任的思考

重视国家行政机关法律责任问题的研究,对加强我国的行政法制建设具有重要意义。本文阐述了国家行政机关作为表现国家意志的机关,具有特殊法律地位;国家行政机关法律责任是国家责任的重要内容,其责任内容和责任形式取决于国家的性质、目的和任务;而国家行政机关法律责任制度是否健全,亦成为国家责任制度是否完善的重要标志。当前,我国传统的封建文化意识和现行政治体制中的缺陷是阻碍我国行政机关法律责任制度健全和发展的重要因素。社会应当关注这个问题,以促进我国社会主义民主法制的完善。