More with Less? Fiscal Decentralisation,Public Health Spending and Health Sector Performance

Decentralisation is considered a panacea for deficient public sector performance by many. However, recent trends of health sector recentralisation in several OECD countries suggest the opposite. Taking on a cross‐country perspective, I examine two hypotheses, namely that decentralisation leads to an increase in public health spending (H1) and to poor health sector outcomes (H2). The evidence I present suggests that decentralising spending tends to lead to larger public health sectors and to poorer health sector outcomes. However, decentralising tax authority has no effect on the size of the health sector and may actually have a positive effect on health sector performance. The broader lesson is that while general fiscal decentralisation research tends to imply that its conclusions are valid for all policy areas in a similar way, sector‐specific insights can reveal a more nuanced view on the consequences of fiscal decentralisation.     

从国际法角度论多边贸易自由化与国内公共健康政策的冲突和协调

WTO成员以公共健康为口号发起的贸易限制措施与各国在WTO下的贸易自由化的义务存在着冲突。GATT/WTO的有关规则和实践显示出多边贸易体制对国内公共健康政策的态度从“忽视”到“有条件肯定”的演变过程。具体来说,GATT时期的规则和争端解决实践不利于国内公共健康政策的实施,而WTO时期出现了有利于国内公共健康政策实施的变化。在WTO现行体制下,各国在实施为公共健康目标的贸易措施时,应符合特定目标的合法性、目标与手段的一致性、目标与手段的相称性等一般要求和相关的具体要求。     

青年流动人口教育健康效应及群体差异研究

在“健康中国”战略背景下,如何更充分地发挥青年流动人口的健康人力资本效用,值得关注。本研究基于2014年流动人口动态监测调查社会融合专题调查数据,采用Logistic回归和OLS回归方法,就受教育程度对青年流动人口不同健康指标的影响进行了分析。研究表明：青年流动人口受教育程度由初中向高中提升能够促进正向健康自评,但高等教育加剧了健康随时间推移而变差的感知;女性、农业户籍、80后青年流动人口的健康状况更明显地受到受教育程度的影响。研究建议：通过缩小城乡教育质量差距、加强多元化心理健康支持、提高流动人口社会融合水平等举措,提升青年流动人口的人力资本质量,促进青年流动人口全面发展。     

高职学生心理健康问题分析及教育对策

目前,高职学生心理健康问题呈现递增趋势,已成为严重阻碍大学生健康成长和顺利完成学业的重要因素.如何塑造学生健康完整的人格,使学生在德育、智育、体育、心育得到全面发展,已成为教育工作者共同关注的问题.文章主要从心理健康的内涵、高职学生心理健康问题的表现特征、高职学生心理健康问题的形成因素进行分析、总结,并针对高职学生心理健康问题的现状,提出几点解决和教育的对策.     

重型犯常见的心理问题及应对策略

重型犯是指犯罪性质恶劣、情节严重以及社会危害性很大的罪犯。用症状自评量表(SCL—90)对重型犯进行了测查,发现入监初期与入监中期服刑人员相比,入监中期服刑人员在躯体化、忧郁、偏执三项因子分方面明显高于入监初期犯人,表明服刑时间较长的罪犯存在更多的心理问题。因此,综合运用各种改造手段对罪犯进行心理和行为矫正,广泛开展心理健康教育,就可以极大地提高我国特殊预防的水平。     

美与生态健康在语境性审美体验中的整合——以伊顿的审美理论为讨论中心

借鉴生态学知识与原理来重新解释审美活动及其一系列关键词是生态美学建构的重要组成部分,针对生态危机这个时代语境来重释"美"的要点则是解释它与"生态健康"的内在关联,其理论难点是将认识性的、不可感知的"生态健康"内容有机地融合到审美体验之中,从而建构出有别于传统之"美"的"生态健康之美",进而将传统的审美体验转化为生态审美...     

论劳动者安全健康权益的保障

保证生命安全是人的最基本需求。“安全发展”体现了科学发展观“以人为本”的本质特征。目前我国安全生产形势十分严峻,伤亡事故频发、职业危害严重,劳动者安全健康合法权益受到侵害。只有实现安全发展,劳动者的生命安全得到切实保障,社会才能和谐稳定,经济才能持续发展。因此,构建社会主义和谐社会,必须从保障劳动者安全健康切身利益这一现实问题入手。     

公共卫生事件风险沟通中社会信任问题研究

在风险社会中,有针对性地进行风险沟通已成为应对风险不确定性的有效手段.随着我国经济的迅速发展,具有"脱域"特质的陌生人社会逐步形成,且移动智能终端进一步普及使得生活场景向虚拟化趋势发展,社会生活现状的改变对风险沟通提出了新要求.应从风险治理、立法完善、专家系统以及公众参与等方面着手完善公共卫生事件风险沟通中的社会信任机...     

Overlooking Feigning Behavior May Result in Potential Harmful Treatment Interventions: Two Case Reports of Undetected Malingering

Clinicians tend to overestimate their ability to recognize feigning behavior in psychiatric patients, especially if it concerns patients who have been admitted for observation. Feigning can be either externally motivated (e.g., for financial compensation, known as malingering) or internally motivated (e.g., to assume the “sick role,” known as factitious disorder). Persistent presentation of severe symptoms is usually associated with the factitious disorder. We present two patients with strong external incentives who consistently and convincingly feigned severe psychiatric symptoms during a protracted period of inpatient observation in a specialized center; both were engaged in a procedure for medical asylum. The first case presented with the clinical picture of a psychotic depression with severe motor symptoms, and the second case showed symptoms of a chronic post-traumatic stress disorder with secondary psychotic symptoms. Both cases were thoroughly investigated but feigning was overlooked, and unnecessary and harmful treatment interventions were given. To prevent iatrogenic damage, we recommend a critical attitude that takes malingering as an option into account in settings where patients are often involved in high stake legal procedures. A clinical sign that might indicate feigning is therapy-resistant symptoms. To rule out feigning a comprehensive, multimethod approach is required, but an active stance toward collateral information is essential. Specialized psychological tests may be useful for preliminary screening, but for their use in culturally diverse populations as in refugee mental health more research is needed.     

Evaluating the Potential for Unintentional Occupational Exposure to Fentanyl and Fentanyl Analogues Among Medicolegal Death Investigators and Autopsy Technicians

Recent increases in deaths in the United States from synthetic opioids such as fentanyl and fentanyl analogues (fentanyls) have raised concerns about possible occupational exposures to these potent agents. Medicolegal death investigators and autopsy suite staff might perform job tasks involving exposure to fentanyls. The potential for exposure to fentanyls among medicolegal death investigators and autopsy technicians at a state medical examiner's office was evaluated through review of caseload characteristics, injury and illness logs, and procedures and policies and discussions with management and employee representatives. The evaluation showed that this medical examiner's office had low potential for work-related exposure to fentanyls; its standard operating procedures and personal protective equipment requirements should reduce the potential for occupational exposure. Medicolegal death investigation agencies can develop and implement guidance to control exposures and provide workforce education and training to reduce the potential for work-related exposure to fentanyls.