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.     

Physiologically Based Liver Modeling and Risk Assessment

Because of the inherent complexity of biological systems, there is often a choice between a number of apparently equally applicable physiologically based models to describe uptake and metabolism processes in toxicology or risk assessment. These models may fit the particular data sets of interest equally well, but may give quite different parameter estimates or predictions under different (extrapolated) conditions. Such competing models can be discriminated by a number of methods, including potential refutation by means of strategic experiments, and their ability to suitably incorporate all relevant physiological processes. For illustration, three currently used models for steady-state hepatic elimination--the venous equilibration model, the parallel tube model, and the distributed sinusoidal perfusion model--are reviewed and compared with particular reference to their application in the area of risk assessment. The ability of each of the models to describe and incorporate such physiological processes as protein binding, precursor-metabolite relations and hepatic zones of elimination, capillary recruitment, capillary heterogeneity, and intrahepatic shunting is discussed. Differences between the models in hepatic parameter estimation, extrapolation to different conditions, and interspecies scaling are discussed, and criteria for choosing one model over the others are presented. In this case, the distributed model provides the most general framework for describing physiological processes taking place in the liver, and has so far not been experimentally refuted, as have the other two models. These simpler models may, however, provide useful bounds on parameter estimates and on extrapolations and risk assessments.     

Ranking Nuclear and Radiological Terrorism Scenarios: The Italian Case

A quantitative criterion for ranking the different scenarios of nuclear and radiological terrorism has been developed. The aim of the model is not to predict terroristic events but only to indicate which scenario has the higher utility from the point of view of a terroristic organization in terms of balance between factors favoring and discouraging the attack, respectively. All these factors were quantified according to a scoring system that takes into account the logarithmic relationship between perceptions and stimuli. The criterion was applied to several scenarios, each of which was modeled in a simple but not trivial way in order to estimate the expected damage in terms of probable life losses from both radiative and nonradiative effects. The outcome from the ranking method indicates that the attractive scenario appears to be the detonation of a low yield improvised nuclear device in the metropolitan area of a major city.     

浅析凤翔泥塑对现代设计的启示

中国的民间手工艺文化一直延续着中华本元文化的特征,保持了精神和物质统一的原生状态,同时包蕴了中华民族传统的自然观和思维方式,无论是其中的思想智慧还是造物工艺都为我们的现代设计在如何继承本土文化方面打开了一个可供吸收营养和借鉴的宝库。凤翔泥塑作为一种符号现象被现代设计加以运用,不能不说是民间传统手工艺术在现代的一次回归浪潮。文章探讨的是凤翔泥塑在纹饰、色彩、造型三个方面带给现代设计的启示。     

基于规则的客户关系管理系统建模方法

客户关系管理系统(CRM)是提高企业核心竞争力的有力武器。以工作流和过程建模技术为基础,研究CRM系统的建模,是CRM系统的建立和顺畅运行的关键。因此,将动态过程建模的思想引入CRM系统的建模过程中,按照逐层分解的建模方式来简化系统的复杂性,并采用事件驱动的、基于扩展业务规则的方法进行CRM系统的过程建模和系统性能评价,是针对CRM系统进行建模的有效手段。通过以上方法,可以建立出全面支持CRM系统运行、监控、仿真和性能评价的过程模型。根据该方法建立的CRM系统的模型经过仿真实验和企业实际应用,证明具有良好的应用效果。     

Leveraging middle managers’ brokerage for corporate entrepreneurship: The role of multilevel social capital configurations

Building on recent efforts to bring a socio-political perspective to social capital research, we develop and test a multilevel framework that explains why middle managers who occupy brokerage positions differ in their ability and willingness to engage in entrepreneurial behavior. More specifically, we provide a contextualized understanding of the links among middle managers' brokerage, their political-support ties, and their personal initiative. Results derived from data on 383 middle managers and 72 top managers in 34 business units indicate that political-support ties with top managers strengthen the relationship between middle managers’ brokerage and personal initiative. However, this positive effect depends on the social capital resources available in the focal business unit. It is attenuated in business units with a supportive and trusting social context and amplified in business units with high levels of internal connectedness. By uncovering these incompatibilities and complementarities, our study demonstrates the value of accounting for different social capital configurations and the interplay of their inherent social capital resources when examining the effects of brokerage on corporate entrepreneurship.     

制造业设备维护与管理的相对有效性评估

在设备维护与管理的评估中引入数据包络分析,以此为核心构建了设备维护与管理相对有效性的评估方法。该方法在系统功能建模的基础上,全面分析了设备维护与管理作为服务系统的投入与产出构成,以数据包络分析为计算模型完成了设备维护与管理有效性的评估。该方法满足了设备维护与管理评估全面性和客观性的要求,其有效性和可信度通过在某石化企业的应用得到了验证。