With the data of administrative reform of prefecture-level cities in eight ethnic provincial regions from 1993to 2018,this study uses Sharp Regression Discontinuity（SRD）to analyze the effects of administrative reform on economic and welfare development.The findings show that the administrative reform in ethnic areas has a positive effect on economic development and people’s welfare,and this influence continues to increase over time.Compared with other regions,the administrative reform in ethnic areas has a better effect on the economy development.However,there is still a gap in its effect on people’s welfare.Ethnic areas should fully understand the value of administrative reform,stress technology empowerment and develop the modes of administrative reform that meet regional characteristics.

Since the outbreak of COVID-19, community workers’ proactive behavior has played a noteworthy role in the crisis response. Previous research has not highlighted this group and their proactive behavior. To address this important gap, drawing upon the job demands–resources (JD–R) model, this study explores how red tape affects proactive behavior and investigates the mediating role of lack of goal progress (LOGP) and the moderating role of public service motivation (PSM) in this relationship. Based on a two-wave survey with a sample of 656 community workers in China, we found a negative relationship between red tape and proactive behavior. Moreover, this study showed that LOGP mediated this relationship. Contrary to our hypothesis, PSM did not moderate the relationship between LOGP and proactive behavior. These findings have important theoretical and practical implications and can better inform community work during COVID-19.

目的 基于社区赋能理论和慢病防控相关因素构建关于"慢病相关社区效能"的评估体系,用于评估城市社区慢病防控情况,改善和提高居民健康水平.方法 应用德尔菲专家征询法,邀请来自国内外30名社区卫生、慢病管理和健康促进等领域资深专家和实践者,开展了两轮专家咨询,结合李克特五级评分制法、百分制分配法和重要性排序法进行问卷设计,并开展了专家深度访谈,对"慢病相关社区效能"评估体系进一步筛选和优化.结果 第1轮专家积极性系数为0.80,第2轮为0.85,专家权威系数均高于0.80.在第2轮德尔菲法后,得到了5个一级指标,分别是社区物质环境、慢病行为危险因素、心理与人际关系、社区卫生管理和社区组织与活动.其下属共18项二级指标和71道问题条目.绝大部分二级指标的重要性得分标准差小于10,变异系数小于0.3.结论 "慢病相关社区效能"评估体系可系统地对社区慢病防控能力进行诊断和评估,以支持社区慢病防控政策的制定和相关活动的推行.

目的 分析《学校卫生工作条例》实施以来中国学校校医队伍建设现状,为引发对中小学校医管理制度的思考提供依据.方法 在中国东、中、西部选择有代表性的省份(江苏、山东、江西、河北、青海、陕西),通过定量研究和定性访谈进行混合方法研究.结果 具有医学背景的校医占比为33.64％,部分校医(31.6％)尚未落实编制.校医在学校中地位较低,在收入、奖金分配、评优等方面较一线教师差距大,校医工资水平远低于教育行业和社会卫生保障福利业工资水平,有些地区甚至低于当地社会平均工资.薪酬水平呈现地域间不平衡,东部地区薪酬水平较高,中西部除个别地区,整体薪酬水平低.医学背景校医与非医学背景校医在最高学历、年收入水平、工作性质、是否在编、职业发展机会、收入满意度、福利待遇满意度和培训满意度之间差异均有统计学意义(x2值分别为10.73,26.64,313.44,14.13,29.14,13.22,12.97,19.44,P值均＜0.05).结论 需充分重视中小学校医队伍建设,将学校卫生纳入公共卫生管理体系,划分校医管理主体,规范校医务室工作办法,畅通校医人事薪酬及职称晋升通道.

2020年1 月31 日,英国首个新冠肺炎病例在约克郡确诊.直至2020年3月3日,英国政府才正式出台《冠状病毒行动计划》,确定应对疫情的战略是防堵、延迟、研究和减损(contain,delay,research and mitigate).

Objective: To evaluate the health impact of current and alternative patterns of rice consumption in Chinese adult men (40–79 years of age). Methods: We applied a risk–benefit assessment (RBA) model that took into account the health effects of selenium (Se), cadmium (Cd), and inorganic arsenic (i-As). The health effects included the prevention of prostate cancer associated with exposure to Se, and an increased risk of lung, bladder, and skin cancer for i-As and chronic kidney disease (CKD) for Cd. We defined the baseline scenario (BS) as the current individual mean daily consumption of rice in the population of interest and two alternative scenarios (AS): AS1 = 50 g/day and AS2 = 200 g/day. We estimated the health impact for different age groups in terms of change in Disability-Adjusted Life Years (ΔDALY). Results: The BS of rice consumption was 71.5–105.4 g/day in different age groups of adult men in China. We estimated that for AS1, the mean ΔDALY was −2.76 to 46.2/100,000 adult men of 40–79 years old. For AS2, the mean ΔDALY was 41.3 to 130.8/100,000 individuals in this population group. Conclusion: Our results showed that, based on associated exposure to selenium, cadmium, and i-As in rice, the current consumption of rice does not pose a risk to adult men in China. Also, a lower (50 g/day) or higher (200 g/day) rice consumption will not bring larger beneficial effects.

国家卫生健康委《关于推进紧密型县域医疗卫生共同体建设的通知》(2019年5月)明确了构建县域紧密型医共体(以下简称"医共体")建设的政策目标.从现有的医疗资源分配机制来看,在政策执行过程中,推动县域医共体行动者间的有效互动和协调行动才能顺利达成政策目标,并切实优化医疗资源配置,提升县域医疗服务能力.本文基于行动者中心制度主义理论框架,分析县域紧密型医共体建设相关行动者的关系,揭示县域医共体构建中不同行动者受利益诉求、动机选择等多重博弈关系的影响状况.探讨紧密型县域医共体的建构进程中,如何促成行动者之间达成利益相容和联动,最大限度满足县域人民群众获得优质高效的一体化医疗服务.

新中国成立以来,党和国家不断强化医疗卫生建设,70余年来医疗卫生政策演进呈钟摆式变迁的特征,即从公益导向的福利性医疗卫生政策摆向效率导向的市场化政策,再摆向公益为主兼顾效率的民生导向政策,在公益与效率间发生三次摆动.本文借助政策反馈理论分析医疗卫生政策钟摆式变迁的内在逻辑,发现政策变迁过程中原有政策通过资源效应、解释效应、演化效应和学习效应影响新政策的制定,使得新政策留有原政策的烙印,呈现出摆动式变迁而非剧烈或范式变迁.政策反馈理论为医疗卫生政策制定提供新视角,制定医疗卫生政策需注重原政策的历史影响力,以公共价值引领医疗医保医药政策,从多重政策反馈效应视角出发优化卫生政策的制定.

新冠肺炎疫情暴发后,有关疾控投入的问题备受关注,有观点认为,疾控没有充分发挥作用,问题主要出在投入不足上.事实上,作为公共卫生的重要部分,疾控投入与公共卫生投入直接相关,如果公共卫生投入出现问题,将对疾控产生直接影响.然而,无论从理论还是从国际经验看,财政投入规模都只是影响因素之一,另一关键因素是财政投入机制.换句话说,比起“投入多少”,“投在哪里、怎么投”可能更重要.钱投在刀刃上,效果才能如预期.