突发公共卫生事件政府治理能力评价——以新冠肺炎为例

优化提升应对突发公共卫生事件时政府综合治理水平是现阶段我国面临的迫切问题。在新型冠状病毒肺炎防控背景下,结合政府治理现状和面临的新挑战,以国家、地方政府和基层为主体视角构建一套政府治理能力评价指标体系,基于模糊综合评价法对政府治理水平和质量进行科学量化,评估其应对此次公共卫生事件的管控效能,提高治理效率,可为实现新时代我国治理体系和治理能力现代化提供有力的理论支撑。     

重大突发公共卫生事件中防疫用品市场管制理路

作为一种公共干预,管制通常是对经济事件或市场失灵的特殊回应。重大突发公共卫生事件中防疫用品市场管制基础在于防疫用品的公共性和外部性。管制必须于法有据,这就需要以相应的管制立法为前提。为有效化解法律稳定性与重大突发公共卫生事件应对所要求的及时性、灵活性的矛盾,政府需要着眼于供给和需求两端,立足防疫用品生产、销售、消费三个环节,依据相关立法遵循法定程序,出台相应的管制政策。     

大数据疫情预警机制:价值分析、现实困境与实践路径

目前,我国正处于推进国家治理体系和治理能力现代化的实践探索阶段。以疫情防控为视角探讨与大数据疫情预警机制相关的问题,对于提升政府应急管理能力极具紧迫性和现实性。本文在对大数据疫情预警机制价值分析的基础上,根据数据获取渠道的不同,将现阶段大数据疫情预警机制概括为三大类:即基于网络通讯及搜索引擎的预警机制、基于电子医疗信息的预警机制和基于物联网信息采集的预警机制。针对大数据疫情预警机制面临的现实困境,提出相应的建议,以期为我国公共卫生应急管理体系的完善提供参考。     

Policy Synthesis through Regional Experimentations: Comparative Study of the New Cooperative Medical Scheme in Three Chinese Provinces

ABSTRACT

Policymakers often face difficulties in determining appropriate national policy instruments based on the results of small-scale experimentations conducted by subordinate governments due to regional disparities and the inherent characteristics of such policies. This research explores policy synthesis via regional experimentations as a novel policy experimentation model. In policy synthesis, the upper government determines instruments for each element of a national policy by communicating with and learning from the experiences of local governments and then synthesizes the policy elements by conducting large-scale experiments. This study analyzes the experimentation of the Chinese New Cooperative Medical Scheme as a case to demonstrate the feasibility of applying policy synthesis. It also compares the experimentations conducted in three provinces and reviews the strategy adopted by the central government. It is found that the Chinese central government learns the pros and cons of diverse policy instruments from regional experimentations to produce a balanced synthesized policy.     

山东省老年妇女健康与医疗保障问题研究

对2683位60岁以上老年妇女的入户问卷调查数据显示,当代老年妇女的健康状况较好.有配偶和老有所医对于老年妇女健康水平的维护有显著性保护作用;老年妇女生活自理能力差,年龄、慢性病是重要危险因素.     

Electronic health record: Wiring Europe’s healthcare

The European Commission wants to boost the digital economy by enabling all Europeans to have access to online medical records anywhere in Europe by 2020. With the newly enacted Directive 2011/24/EU on patients’ rights in cross-border healthcare due for implementation by 2013, it is inevitable that a centralised European health record system will become a reality even before 2020. However, the concept of a centralised supranational central server raises concern about storing electronic medical records in a central location. The privacy threat posed by a supranational network is a key concern. Cross-border and Interoperable electronic health record systems make confidential data more easily and rapidly accessible to a wider audience and increase the risk that personal data concerning health could be accidentally exposed or easily distributed to unauthorised parties by enabling greater access to a compilation of the personal data concerning health, from different sources, and throughout a lifetime.     

Medicolegal death investigator workplace safety hazards: A scoping review of the literature

In the United States, medicolegal death investigation practices and policies pertaining to sudden unexpected deaths are mandated by state government. Practices vary across states, which contributes to inconsistency in job prerequisites and training. In preparation for a study focused on occupational safety and health of medicolegal death investigators in their on-scene and follow-up activities, a scoping review was conducted to document known occupational safety risks and health-related conditions associated with death investigation. Searches used Boolean and subject heading operators both broad and narrow in scope, and search terms included scene responder, hazard, investigator, forensic pathology, injury, and safety. Twenty-five articles met inclusion criteria, which included seventeen survey-mixed method designs, two systematic reviews, five quasi-experimental designs, and one case study. Twelve articles addressed mental health and eleven focused on risks associated with infectious disease. One article addressed the risk of chemical exposure from cyanide among autopsy personnel (including forensic pathologists) and nine included a wide range of employees within the setting of medical examiner or coroner offices. One article, addressing burnout, included employees in a forensic science laboratory setting as well as medicolegal death investigators and two articles included forensic pathologists and medicolegal death investigators. Only one article addressed medicolegal death investigators specifically. Articles addressing occupational and environmental hazards of medicolegal death investigators associated with musculoskeletal, respiratory, cardiovascular, radiological, nuclear, electrical, or explosive threats were not identified. There is little published about safety risks inherent in conducting death investigations. Research is needed to adequately inform health promotion and injury prevention strategies.     

Legacy Contaminants of Emerging Concern: Lead (Pb), Flint (MI), and Human Health

Abstract

As a heavy metal industrially mined for millenia, lead (Pb) is a legacy contaminant. It is also a contaminant of emerging concern because of its persistence, toxicity, and recent discovery of its resurgence in drinking water serving homes and schools, recently and most notoriously in Flint, Michigan. Concern about lead, however, has reemerged beyond Flint, exemplifying adoption of bad science policy despite availability of relevant good science. Much is known about lead toxicity, and profiled here. Whereas adults chronically exposed to lead may experience peripheral neuropathy, infants and children are more susceptible. They constitute sensitive subpopulations because their blood-brain barriers are immature, making them susceptible to central nervous system effects, most notably reduced IQ, when lead penetrates to developing brains. Failure to protect disadvantaged populations in Flint and beyond despite availability of proven science and inexpensive technology also exemplifies instances of environmental injustice. Emerging concern about lead thus illustrates failure of social as well as science policy. A critical lesson to be learned is that vigilance must be maintained, as knowledge about lead exposure and toxic effects provided by science does not automatically result in consistent and evenhanded legal and regulatory protection provided by government.     

Psychotropic Medication Experiences of Incarcerated Women: A Qualitative Inquiry into Conundrums of Access and Identity

The study examines narrative data from in-depth, semi-structured interviews with 25 women in a medium security prison with the hope of deepening the knowledge base related to women’s beliefs about their mental health problems, mental health care during incarceration, and especially their experiences with psychotropic medication. The findings highlight the functional role of psychotropic medication in the lives of incarcerated women, while also emphasizing problems with limited access to prescribers, preferred medications, and other forms of mental health treatment. Trauma, substance use, and the impact of medication use on sense of self all emerged as interfacing with quality of life.     

Examining Predictors of Depression Among Older Incarcerated Women

For older women in prison, adjustments to prison life are often affected by a variety of mental and physical health symptoms. Many come to prison with specific histories of traumatic life experiences that place them at risk for high levels of depression. Using data gathered from 327 older women (mean age = 56.5), we examined the relationship between a variety of preprison conditions and prison deprivation factors as possible predictors of depression. Stepwise regression results indicated that depression was greater for those with prior abuse histories, functional health problems along with poorer perceptions of mental and physical health, safety and other prison environment concerns. Although race was not a significant predictor in the regression model, a t-test did find that whites were more depressed than African Americans in our sample. Other correlates of depression are also identified that lend insights into the high rates of depression found among elderly women in prison. With such high rates of psychiatric disorders among women offenders, more treatment interventions are needed to adequately serve this population.