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.     

民办幼儿园教师专业素养培训方式实验研究

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。     

Mentorship experiences during registrar training: reflections of Black African specialists in the Western Cape

In order to meet the significant staffing challenges to health care provision in South Africa, the need to support the training and retention of Black medical specialists has been identified. This small qualitative study aimed to explore experiences of mentorship among a group of Black medical specialists in hopes of understanding the value and potential challenges that these relationships raise. Ten Black medical specialists were interviewed about their experiences of being mentored during their registrar training. The interview data was analysed using discourse analysis, and the results comprise of three main themes, namely: Difficulty accessing mentorship, a lack of Black and/or female role models and finally, experiences of feeling excluded from soft networks. The experiences explored in this study indicate the need for open dialogue within the mentorship dyad regarding certain taken-for-granted assumptions surrounding race, so as to aid the provision of more effective and satisfying mentorship outcomes.     

The relationship between lifetime health trajectories and socioeconomic attainment in middle age

A large literature demonstrates the direct and indirect influence of health on socioeconomic attainment, and reveals the ways in which health and socioeconomic background simultaneously and dynamically affect opportunities for attainment and mobility. Despite an increasing understanding of the effects of health on social processes, research to date remains limited in its conceptualization and measurement of the temporal dimensions of health, especially in the presence of socioeconomic circumstances that covary with health over time. Guided by life course theory, we use data from the British National Child Development Study, an ongoing panel study of a cohort born in 1958, to examine the association between lifetime health trajectories and socioeconomic attainment in middle age. We apply finite mixture modeling to identify distinct trajectories of health that simultaneously account for timing, duration and stability. Moreover, we employ propensity score weighting models to account for the presence of time-varying socioeconomic factors in estimating the impact of health trajectories. We find that, when poor health is limited to the childhood years, the disadvantage in socioeconomic attainment relative to being continuously healthy is either insignificant or largely explained by time-varying socioeconomic confounders. The socioeconomic impact of continuously deteriorating health over the life course is more persistent, however. Our results suggest that accounting for the timing, duration and stability of poor health throughout both childhood and adulthood is important for understanding how health works to produce social stratification. In addition, the findings highlight the importance of distinguishing between confounding and mediating effects of time-varying socioeconomic circumstances.     

师德建设在学风建设中的作用

高等学校加强师德建设和学风建设是全面贯彻党的教育方针的根本保证,是适应新时期发展的需要,是高等学校自身发展的需要,是学生成长和成才的需要。建设优良的学风关键在于建设一支优秀的教师队伍,而建设一支优秀的教师队伍的关键在于提高教师的道德水平。     

张之洞实业教育观之我见

实业教育观是张之洞教育思想的重要组成部分 ,它是张之洞与外洋抗争思想的直接结果之一。它以创办实业学堂、派遣留学生及倡导理论与实践相结合的教学方法为主旨 ;以培养近代农、工、商业人才 ,推动经济发展为目的 ,在中国近代历史上影响较为深远。     

法的分类与现代化

世界上所有国家的法按照其与政治、宗教和道德的关系的密切程度来划分,可以分为专业性法、政治性法、宗教性法和道德性法四大类型,其中宗教性法和道德性法属于传统法的范畴,专业性法和政治性法属于现代法的范畴。世界各国法不可避免地发生汇合,现代法正在影响传统法。对于第三世界和其他非西方国家来说,法的现代化是这些国家法律制度改革的方向.     

制约学校体育实施健康教育的诸因素分析

本文主要对影响学校体育实施健康教育的因素进行了分类研究 ,为学校体育实施健康教育提供科学的参考依据。     

与时俱进 应势而变——浅议入世后我国高等职业教育发展的趋势

入世以后,必将对我国高等职业教育提出新的要求。高等职业教育必须顺应时代发展的趋势,与时俱进、应势而变,才能与时代同步。本文遵循以下思路展开:入世以后,对我国高等职业教育的发展趋势作一些前瞻性的探讨,在此基础上提出应对的措施。有利于我国高等职业教育主动地适应新形势发展的要求。     

论教师的职业信念

树立坚定的职业信念是对教师第一位的要求 ,教师的职业信念是教师献身于教育工作的根本动力 ,也是形成教师职业道德的必要条件之一。目前我国教师中有相当一部分人职业信念问题没有解决好 ,广大教师应采取各种方式努力铸就自己的职业信念