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1.
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.  相似文献   
2.
Damage models for natural hazards are used for decision making on reducing and transferring risk. The damage estimates from these models depend on many variables and their complex sometimes nonlinear relationships with the damage. In recent years, data‐driven modeling techniques have been used to capture those relationships. The available data to build such models are often limited. Therefore, in practice it is usually necessary to transfer models to a different context. In this article, we show that this implies the samples used to build the model are often not fully representative for the situation where they need to be applied on, which leads to a “sample selection bias.” In this article, we enhance data‐driven damage models by applying methods, not previously applied to damage modeling, to correct for this bias before the machine learning (ML) models are trained. We demonstrate this with case studies on flooding in Europe, and typhoon wind damage in the Philippines. Two sample selection bias correction methods from the ML literature are applied and one of these methods is also adjusted to our problem. These three methods are combined with stochastic generation of synthetic damage data. We demonstrate that for both case studies, the sample selection bias correction techniques reduce model errors, especially for the mean bias error this reduction can be larger than 30%. The novel combination with stochastic data generation seems to enhance these techniques. This shows that sample selection bias correction methods are beneficial for damage model transfer.  相似文献   
3.
随着现代教育的发展,提升幼儿园教师专业素养已成为促进学前教育发展的必然要求。以探究民办幼儿园教师专业素养为视角,提出通过干预行为提升教师专业素养水平的构想。实验随机选取成都市某民办幼儿园的20名教师为实验组,再选取与其办园环境、办园背景相似的另一所民办幼儿园的20名教师为对照组,对实验园教师的专业理念与师德、专业知识、专业能力3个维度进行干预。实验结果表明:与对照园相比,实验园教师的专业能力提升显著;与实验园实验前后相比,教师在专业知识、专业能力维度及专业素养总体水平方面均有提升。对教师培训的具体建议为:(1)单一与混合相结合的培训方式对提升民办幼儿园教师专业素养总体水平有现实意义;(2)民办幼儿园教师专业知识的提升需理论培训与自主学习相结合;(3)专家"现场诊断-指导式"培训方式对提升民办幼儿园教师专业能力有显著作用。综上,建议民办幼儿园在了解本园教师专业素养水平的基础上,针对教师专业素养的不同方面,分别采取不同的有效培训方式。  相似文献   
4.
The week beginning 29 June 2015 is not just historic for the closure of the Independent Living Fund in the United Kingdom, but for me was the week they decided that my life is not worth investing in; they being NHS England, NICE and, with them, the Department of Health. They chose not to support the enzyme replacement therapy that has been not only keeping me alive, but giving me a quality of life – enabling me to return to finish my Disability Studies PhD exploring how Christian leaders explain disability, where ethics have become the main topic, and to rebuild my career – or so I thought.  相似文献   
5.
伊尹作为中国历史上第一位贤相,其突出的个人素质表现在精于至味之理、精通耕作之道、创制治病汤液几方面,即懂得如何吃饭、种地和治病。这正是广大民众最为关心的事情,也是治理内政极其关键的因素,只有这三件事做得好,才可能完成"祀与戎"等国家大事。如此全面素质的形成,与其丰富的人生经历和勤于思索有关。  相似文献   
6.
通过对5位国家级教学名师的自述报告进行三级编码和主题凝练,研究发现国家级教学名师作为教师队伍的杰出代表,在其专业发展过程中养成了许多优秀品质。例如:教学方面注重实践、考虑周全,师德方面以德施教、追求卓越,科研方面以教带研、实现创新。国家级教学名师优秀品质的养成通常经历了漫长而曲折的过程,不仅需要精神与物质力量的共同推动,还需要家庭、学校和社会各环境要素的相互促进,以及社会取向养成方式和个人取向养成方式的互相配合。深入探究国家级教学名师的优秀品质及其养成之道,可以为教师专业发展提供借鉴与启示。  相似文献   
7.
A conformance proportion is an important and useful index to assess industrial quality improvement. Statistical confidence limits for a conformance proportion are usually required not only to perform statistical significance tests, but also to provide useful information for determining practical significance. In this article, we propose approaches for constructing statistical confidence limits for a conformance proportion of multiple quality characteristics. Under the assumption that the variables of interest are distributed with a multivariate normal distribution, we develop an approach based on the concept of a fiducial generalized pivotal quantity (FGPQ). Without any distribution assumption on the variables, we apply some confidence interval construction methods for the conformance proportion by treating it as the probability of a success in a binomial distribution. The performance of the proposed methods is evaluated through detailed simulation studies. The results reveal that the simulated coverage probability (cp) for the FGPQ-based method is generally larger than the claimed value. On the other hand, one of the binomial distribution-based methods, that is, the standard method suggested in classical textbooks, appears to have smaller simulated cps than the nominal level. Two alternatives to the standard method are found to maintain their simulated cps sufficiently close to the claimed level, and hence their performances are judged to be satisfactory. In addition, three examples are given to illustrate the application of the proposed methods.  相似文献   
8.
2012年3D 版《泰坦尼克号》的华丽上映曾掀起影迷们对它的新一轮热捧。文章就同样备受中国观众喜爱的中国方言版《泰坦尼克号》为案例,结合功能目的论来探寻中国方言版字幕翻译的目的与性质,进而分析、总结英文影片字幕的中国方言版译制活动过程。  相似文献   
9.
10.
研究了多属性逆向拍卖的获胜者确定问题。考虑属性之间的两两关联,以定义在2-可加模糊测度上的Choquet积分表达拍卖人的偏好,其中模糊测度的值由拍卖人提供的偏好信息推测得出。由于一般情况下与偏好信息一致的模糊测度取值并不唯一,考虑所有一致的评分函数提出了两阶段获胜者确定方法。首先采用线性规划挑选出在任意评分函数下可能获胜的报价,再通过混合整数规划确定一个与所有一致的评分函数的评价结果最为接近的报价排序,以得分最高者为稳健获胜报价。仿真实验表明,大量的报价为不可能获胜报价,说明了在第一阶段进行筛选的必要性。与现有方法的比较表明了该方法的有效性,且在拍卖轮数较大、报价数目较多时,该方法在计算效率上更有优势。  相似文献   
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