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.     

经济赋能与社区融合—以一个西部地区的反贫困实践为例

文章基于陕西省白水县的农村反贫困实践探索,从发展性社会工作视角探讨经济赋能与社区融合干预对于残疾人脱贫发展的意义。 这一反贫困实践案例显示,贫困者的生计发展嵌入在其家庭及社区的关系性脉络中,依托于残疾人互助合作社的社区融合介入,有助于残疾人的经济与社会的双重赋能,提升残疾人生计发展的内生动力。 同时,本地社会组织在残疾人反贫困中发挥关键作用,社会组织的能动性发展促进了多主体合作参与的贫困治理,也带动了社会工作专业理念和方法在反贫困实践中的运用。     

Coalition for a Healthier Community: Lessons learned and implications for future work

The Coalition for a Healthier Community (CHC) initiative was implemented to improve the health and well-being of women and girls. Underpinning CHC is a gender-based focus that uses a network of community partners working collaboratively to generate relevant behavior change and improved health outcomes. Ten programs are trying to determine whether gender-focused system approaches are cost-effective ways to address health disparities in women and girls. Programs implemented through coalitions made up of academic institutions, public health departments, community-based organizations, and local, regional, and national organizations, are addressing health issues such as domestic violence, cardiovascular disease prevention, physical activity, and healthy eating. Although these programs are ongoing, they have made significant progress. Key factors contributing to their early success include a comprehensive needs assessment, robust coalitions, the diversity of populations targeted, programs based on findings of the needs assessments, evaluations taking into consideration the effect of gender, and strong academic–community partnerships. A noteworthy impact of these programs has been their ability to shape and impact public, social, and health policies at the state and local levels. However, there have been challenges associated with the implementation of such a complex program. Lessons learned are discussed in this paper.     

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.     

民族互嵌社区精准治理的理论向度与实践路径——以贵州省兴义市S街道社区为例

民族互嵌社区是中华民族多元一体格局空间场域延展的实践形态,是对“各民族相互嵌入式的社会结构和社区环境”这一时代命题的现实阐释。现代城市社区功能的集聚和细化为民族互嵌的再造及重释提供了场域空间,由于民族互嵌社区具有公共性、聚合性和互动性的本质特征,从而形成了立体化嵌套结构,催生出精准互嵌理论和实践的“双重愿景”:理论层面,要深刻把握民族互嵌社区精准治理的目标向度、方法向度、内容向度;实践层面,要精准识别民族互嵌社区的场域情境,以智能技术描绘民族互嵌过程的“全景图”和“晴雨表”,通过社区制度体系的精准供给,提升民族互嵌社区精准治理的效能。     

Professional blinders? The novel as an eye-opener in organizational analysis

ABSTRACT

Scholarly textbooks often follow a logic where suitable empirical cases are selected to illustrate the theoretical and analytical points that we as scholars want to make. But what would happen if we would do the opposite: build a textbook on a novel written by a novelist for such purpose and let the theories explain the actions and emotions of fictional characters? In this article, we share and reflect upon our experiences of co-authoring a textbook in organization theory together with a professional novelist. We argue that the novel can function as an eye-opener in organizational analysis, forcing us to look beyond more static and rationalistic perspectives on organizations as well as the stereotypes of such. We build and relate our experiences to the growing literature about using fiction in scholarly work and discuss the potential of such genre-bending work when we bring in flesh and blood into the analyses.     

Maternal and paternal reactions to child sadness predict children's psychosocial outcomes: A family‐centered approach

Parents' reactions to children's emotions shape their psychosocial outcomes. Extant research on emotion socialization primarily uses variable‐centered approaches. This study explores family patterns of maternal and paternal responses to children's sadness in relation to psychosocial outcomes in middle childhood. Fifty‐one families with 8‐ to 12‐year‐old children participated. Mothers and fathers reported their reactions to children's sadness and children's social competence and psychological adjustment. Cluster analyses revealed three family patterns: Supportive (high supportive and low non‐supportive reactions from both parents), Not Supportive (low supportive reactions from both parents), and Father Dominant (high paternal supportive and non‐supportive reactions, low maternal supportive and non‐supportive reactions). Supportive families had children with higher social competence and more internalizing symptoms whereas Father Dominant families had children with lower social competence and fewer internalizing symptoms. Not Supportive families had children with average social competence and fewer internalizing symptoms. Findings are discussed in relation to the “divergence model” which proposes that a diverse range of parental responses to children's sadness, rather than a uniformly supportive approach, may facilitate children's psychosocial adjustment.     

大数据背景下基于社交网络的聚类随机游走抽样算法研究

数字经济时代,社交网络作为数字化平台经济的重要载体,受到了国内外学者的广泛关注。大数据背景下,社交网络的商业应用价值巨大,但由于其网络规模空前庞大,传统的网络分析方法 因计算成本过高而不再适用。而通过网络抽样算法获取样本网络,再推断整体网络,可节约计算资源, 因此抽样算法的好坏将直接影响社交网络分析结论的准确性。现有社交网络抽样算法存在忽略网络内部拓扑结构、容易陷入局部网络、抽样效率过低等缺陷。为了弥补现有社交网络抽样算法的缺陷,本文结合大数据社交网络的社区特征,提出了一种聚类随机游走抽样算法。该方法首先使用社区聚类算法将原始网络节点进行社区划分,得到多个社区网络,然后分别对每个社区进行随机游走抽样获取样本网 络。数值模拟和案例应用的结果均表明,聚类随机游走抽样算法克服了传统网络抽样算法的缺点,能够在降低网络规模的同时较好地保留原始网络的结构特征。此外,该抽样算法还可以并行运算,有效提升抽样效率,对于大数据背景下大规模社交网络的抽样实践具有重大现实意义。     

Childbearing and Marriage: Investigating the Importance of Context for Meaning-Making of First-Time Marriage

Previous research reveals that the temporal ordering of childbearing and marriage can have an impact on the meaning of first-time marriage. This article aims to obtain a deeper understanding of meaning-making of first-time marriage in relation to childbearing. Narrative interviews with 16 brides and grooms in 8 couples in Sweden were conducted. The material was analyzed in relation to the temporal ordering of childbearing and marriage. The study reveals that the construction of meaning of marriage does not only relate to the temporal context. Social factors such as social class or family formation might also be relevant for how meaning is constructed. This article contributes to a deeper understanding of meaning-making as a relational process constructed within particular contexts.