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.     

不同冷链服务模式下生鲜农产品供应链决策

基于单物流服务商、单供应商和单零售商构成的生鲜农产品供应链，构建3种冷链服务模式：承诺模式、提前要求模式与延后要求模式，探讨不同冷链服务模式对定价与冷链服务水平、企业绩效的影响。研究发现：某种冷链服务模式是否有利于消减数量与质量损耗依赖于产品易腐性、冷链服务成本及其分担比例。供应链成员无法在承诺模式与提前要求模式下形成统一的模式偏好。当物流服务商承担的冷链服务成本比例较低时，相比于提前要求模式，供应商偏好承诺模式，否则，偏好提前要求模式。承诺模式比提前要求模式更有利于物流服务商，然而对于零售商，结果正好相反。数值实验表明，虽然供应链成员无法对冷链服务模式形成整体的一致性偏好，但仍可实现局部的一致性偏好。     

Institutional evolution and abrupt change: Reforming the administration of social assistance in Finland

Historical institutionalist studies have explained institutional change as resulting from critical junctures that interrupt long periods of stability or from endogenous, incremental evolution. Building on these theories, discursive institutionalists have focused on the roles of agency, ideas and discourse as explainers of change. Combining these approaches, this article analyses Finland’s decision in 2014 to transfer the administration of basic social assistance from municipalities to the central government. This study demonstrates that institutional change can be both abrupt and evolutionary. Due to sudden, exceptional political circumstances, the decision in question was made quickly and under pressure, circumventing possible veto players. However, it was possible only because of the incremental, endogenous change that had occurred in the way in which social assistance was administered at the municipal level. It enabled a change in political discourse, which eroded the credibility of the ideational frames that policy actors had previously utilised to reject the centralised model.     

Middle School Children's Perceptions on Welfare and Poverty: An Exploratory, Qualitative Study

This study was undertaken to determine how middle school children assess the effects of welfare reform on their daily lives. The study consisted of thirty interviews with children and their mothers recruited from a middle school in a large, metropolitan area. From the children's perspective, multiple jobs and evening/night hours interfered with the child-parent relationship. Other consequences included grades going down and not getting to school on time. All the children stated that mothers should work, but most children felt mothers should only work when their children are in school. Welfare and poverty were issues about which children were teased at school.     

The University: An Agent of Social Change?

Can universities be agents of progressive social change? How would we know if a university was acting as an agent of social change? Drawing on four case studies, I raise a number of questions to problematize our understanding of the university as an agent of social change. I outline a number of contributing factors that appear to explain successful cases. I conclude by arguing the relevancy of these cases for larger, and more traditional, sociological projects.     

Open Road or Blind Alley? Welfare Reform, Mothers, and Children with Disabilities

Welfare reform was examined for 39 Michigan families whose children have significant health or intellectual and behavioral disabilities. As a group, these families received little specialized assistance or services to address their unique needs. Family-cited barriers to self-sufficiency included poorly trained welfare caseworkers, limited public transportation, and inadequate child care. Having an older child was the only discriminating variable between working and non-working mothers. However, working mothers only had temporary positions with no benefits and low pay. All families, whether employed or not, lived below the poverty line.     

Challenges to Connecting Sociology and Service Learning

Service-learning programs are not free from challenges brought about by lack of financial support, lack of widespread commitment from professors, community agencies, and recipients of service, and lack of knowledge and insight in students directly involved in such programs. While service-learning initiatives and programs serve positive functions for organizations and individuals, rhetorical accolades for service learning can distort or omit the realities of program implementation and sustained delivery. This paper specifically explores the following challenges connected to service-learning programs: (1) pedagogical difficulties; (2) student limitations; (3) time constraints; and (4) community cooperation.     

服务台可修的多水平优先权排队(二)

文献[1]讨论了服务台可修的多水平优先权排队的排队指标。本文讨论该系统的可靠性指标。利用文献[3]中的随机序,获得了这些可靠性指标的界值。     

对林业税费的经济学分析

该文运用经济学的基本工具———供给和需求曲线 ,以商品林为研究对象 ,探讨了林业税费的作用机理和内涵。该文认为商品林生产具有正的外部性 ,市场失灵使生产者将不能提供社会真正所需要的商品林数量。在封闭的市场条件下 ,林业税费会直接成为价格的一部分 ,商品林生产者应当能够获得正常利润 ,与税费高低无关 ,但会使一部分林地退出生产。林业补贴是一种负的林业税收。在开放市场经济条件下 ,国内商品林供应量低于没有林业税收时的商品林供应量 ,更低于考虑社会生态需求时的商品林供应量 ,造成巨大的社会福利损失 ,应减免林业税费、增加林业扶持、取消价格管制。该文进一步研究了与林业税费密切相关的森林采伐限额政策 ,认为对商品林应该完全取消采伐限额政策     

陶渊明的诗化人格

作家的人格是其作品风格的内在因素 ,往往决定着其作品的风格。我们在研究作品风格的时候 ,不能不关注作家的人格。只有对作家的人格进行全面深入的审视 ,才能更准确地理解和把握其作品的风格。探讨陶渊明的人格魅力及其特征 ,是深入研究陶渊明作品风格的至关重要的途径。从陶渊明的作品中 ,从他的言行中 ,我们可以领悟到他的情趣和胸襟 ,领悟到一种具体的人格。陶渊明自然率真平和旷达的个性特征构筑了他的诗化人格 ,即未经世俗异化的高尚贞洁的人格。这种人格的内在思想根源是自然化迁的宇宙观和委运自然的人生观。这种人格的外在表现形式是他任真自得和固穷守节的行为方式。他的作品中常见的酒与菊、孤松、孤云与归鸟等艺术形象组成了陶渊明诗化人格的象征系列