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.     

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.     

Comparison of Four New General Classes of Search Designs

A factor screening experiment identifies a few important factors from a large list of factors that potentially influence the response. If a list consists of m factors each at three levels, a design is a subset of all possible 3 ^m runs. This paper considers the problem of finding designs with small numbers of runs, using the search linear model introduced in Srivastava (1975). The paper presents four new general classes of these 'search designs', each with 2 m −1 runs, which permit, at most, two important factors out of m factors to be searched for and identified. The paper compares the designs for 4 ≤ m ≤ 10, using arithmetic and geometric means of the determinants, traces and maximum characteristic roots of particular matrices. Two of the designs are found to be superior in all six criteria studied. The four designs are identical for m = 3 and this design is an optimal design in the class of all search designs under the six criteria. The four designs are also identical for m = 4 under some row and column permutations.     

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。     

涂附磨具单位面积CaCO3含量分析方法的改进

以铜试剂代替氰化物作掩蔽剂 ,用EDTA容量法测定涂附磨具单位面积CaCO3 含量 ,获得了满意的效果。     

Assessing accuracy of a continuous screening test in the presence of verification bias

Summary.  In studies to assess the accuracy of a screening test, often definitive disease assessment is too invasive or expensive to be ascertained on all the study subjects. Although it may be more ethical or cost effective to ascertain the true disease status with a higher rate in study subjects where the screening test or additional information is suggestive of disease, estimates of accuracy can be biased in a study with such a design. This bias is known as verification bias. Verification bias correction methods that accommodate screening tests with binary or ordinal responses have been developed; however, no verification bias correction methods exist for tests with continuous results. We propose and compare imputation and reweighting bias-corrected estimators of true and false positive rates, receiver operating characteristic curves and area under the receiver operating characteristic curve for continuous tests. Distribution theory and simulation studies are used to compare the proposed estimators with respect to bias, relative efficiency and robustness to model misspecification. The bias correction estimators proposed are applied to data from a study of screening tests for neonatal hearing loss.     

试论心理健康教育是思想政治教育的重要组成部分

心理健康教育定位不当是思想政治教育长期效果较差的重要原因之一.文章分析了心理健康教育和思想政治教育的关系,认为现代思想政治教育应包括思想教育、政治教育、道德教育和心理教育四个方面,其中,心理教育是基础.心理健康教育是最初级、最低起点的教育,同时又是最深层次的教育.因此,心理健康教育是思想政治教育的重要组成部分.     

Three-level main-effects designs exploiting prior information about model uncertainty

To explore the projection efficiency of a design, Tsai, et al [2000. Projective three-level main effects designs robust to model uncertainty. Biometrika 87, 467–475] introduced the Q criterion to compare three-level main-effects designs for quantitative factors that allow the consideration of interactions in addition to main effects. In this paper, we extend their method and focus on the case in which experimenters have some prior knowledge, in advance of running the experiment, about the probabilities of effects being non-negligible. A criterion which incorporates experimenters’ prior beliefs about the importance of each effect is introduced to compare orthogonal, or nearly orthogonal, main effects designs with robustness to interactions as a secondary consideration. We show that this criterion, exploiting prior information about model uncertainty, can lead to more appropriate designs reflecting experimenters’ prior beliefs.     

高等教育制度改革后贫困大学生心理健康问题浅析

本文阐述了高等教育制度改革后贫困大学生的心理健康问题,分析了贫困大学生心理健康问题的原因,并提出了化解贫困大学生心理健康问题的对策。     

高校《体育与健康课程》构建与发展研究

通过对高校学生体质与健康状况资料的分析 ,认为健康教育应作为高校体育教育的首要任务 ,坚持以人为本 ,“健康第一”。并就《体育与健康课程》的内涵、课程体系的构建及发展进行了探讨和研究