BACKGROUND & AIMS: :In this paper, we examine the effects of recent parental Medicaid eligibility expansions on Medicaid participation and private insurance coverage. We present a new approach for estimating these policy effects that explicitly models the particular policy instrument over which legislators have control-income eligibility thresholds. Our approach circumvents estimation problems stemming from misclassification or measurement error. Moreover, it allows us to assess how the policy effects may vary at different initial threshold levels. Using data from the Survey of Income and Program Participation, we find three main results. First, the eligibility expansions result in significant increases in Medicaid participation; a "typical" expansion increases Medicaid participation by about four percent of baseline coverage rates. Second, the participation effect is larger for lower initial thresholds and the effect decreases as Medicaid thresholds increase. Third, we find no statistically significant evidence of crowd out regardless of initial threshold level.

背景与目标： : 在本文中，我们研究了最近的父母医疗补助资格扩展对医疗补助参与和私人保险范围的影响。我们提出了一种估计这些政策效果的新方法，该方法明确建模了立法者具有控制收入资格阈值的特定政策工具。我们的方法避免了由于分类错误或测量误差引起的估计问题。此外，它使我们能够评估政策效果在不同的初始阈值水平下可能会如何变化。使用收入和计划参与调查的数据，我们发现了三个主要结果。首先，资格扩展导致医疗补助参与率显着增加; “典型” 扩展使医疗补助参与率增加了基准覆盖率的4%。其次，对于较低的初始阈值，参与效果更大，并且随着医疗补助阈值的增加，效果会降低。第三，无论初始阈值水平如何，我们都没有发现排挤的统计显着证据。

BACKGROUND & AIMS: This paper reports on a public authority's decision to "make" or "buy" mental health services. Data come from key informant interviews with California county contract or program managers. The questionnaire measures the extent of contracting and the importance of factors that are hypothesized to affect the relative costs of contracting. The percent of contracting by programs ranges from zero to 100, averaging 41%. Sixty-two percent of rural programs perceive little or no competition for public mental health contracts, and contract significantly less than urban programs. The extent of contracting is related to economic and public organizational factors.

背景与目标： 本文报告了公共机构 “制造” 或 “购买” 精神卫生服务的决定。数据来自对加利福尼亚县合同或计划经理的关键线人采访。问卷测量了合同的程度以及假设会影响合同相对成本的因素的重要性。按项目签订合同的百分比从零到100，平均41%。60 2% 的农村计划对公共精神卫生合同的竞争很少或没有竞争，并且合同明显少于城市计划。缔约的程度与经济和公共组织因素有关。

BACKGROUND & AIMS: :This participatory action research study focused on identifying community participation goals, barriers, and supports/strategies in partnership with people who have experienced a stroke. Goals demonstrate that participation is more than activity performance in context; instead, it relates to "being a part of" the community and having access to participation opportunities and supports. Results of community site audits from the first 20 participants document environmental (physical, cognitive, social) and system level barriers, as well as effective strategies for promoting participation via environmental modification and systems level changes. A consumer-directed, Web-based tool for documenting participation barriers and sharing strategies is discussed.

背景与目标： : 这项参与性行动研究的重点是与中风患者合作，确定社区参与的目标，障碍和支持/策略。目标表明，参与不仅仅是活动绩效。相反，它与 “成为社区的一部分” 并获得参与机会和支持有关。前20名参与者的社区现场审核结果记录了环境 (物理，认知，社会) 和系统级障碍，以及通过环境修改和系统级变化促进参与的有效策略。讨论了一种以消费者为导向的基于Web的工具，用于记录参与障碍和共享策略。

BACKGROUND & AIMS: :Widespread interest in global health issues is a common characteristic of students and faculty in schools of public health and schools of medicine. Building on strong university-based and community-based programs in global health, the University of Washington has created a unique Department of Global Health that is housed jointly in its School of Public Health and Community Medicine and its School of Medicine. The creation of this department has generated significant enthusiasm throughout the university and the Seattle community as a new paradigm for addressing global health education, research, and service. Placing the new Department of Global Health in two university schools and finding the appropriate niche for the department among the university's many global health initiatives presented challenges, as well as opportunities. This article describes the goals of the department, the process by which it was created, and what it expects to accomplish.

背景与目标： : 对全球卫生问题的广泛关注是公共卫生学院和医学院的学生和教职员工的共同特征。华盛顿大学以强大的基于大学和社区的全球卫生计划为基础，创建了一个独特的全球卫生部门，该部门位于其公共卫生和社区医学学院及其医学院中。这个部门的创建在整个大学和西雅图社区产生了极大的热情，成为解决全球健康教育，研究和服务的新范式。将新的全球卫生部门安置在两所大学学校中，并在大学的许多全球卫生计划中找到适合该部门的利基市场，带来了挑战和机遇。本文介绍了该部门的目标，创建该部门的过程以及预期实现的目标。

BACKGROUND & AIMS: :'Citizen participation' includes various participatory techniques and is frequently viewed as an unproblematic and important social good when used as part of the regulation of the innovation and implementation of science and technology. This is perhaps especially evident in debates around 'anticipatory governance' or 'upstream engagement'. Here, we interrogate this thesis using the example of the European Union's regulation of emerging health technologies (such as nanotechnology). In this case, citizen participation in regulatory debate is concerned with innovative objects for medical application that are considered to be emergent or not yet concrete. Through synthesising insights from law, regulatory studies, critical theory, and science and technology studies, we seek to cast new light on the promises, paradoxes, and pitfalls of citizen participation as a tool or technology of regulation in itself. As such we aim to generate a new vantage point from which to view the values and sociotechnical imaginaries that are both 'designed-in' and 'designed-out' of citizen participation. In so doing, we show not only how publics (do not) regulate technologies, but also how citizens themselves are regulated through the techniques of participation.

背景与目标： : “公民参与” 包括各种参与技术，当被用作科学技术创新和实施监管的一部分时，通常被视为毫无问题且重要的社会利益。这在围绕 “预期治理” 或 “上游参与” 的辩论中可能尤其明显。在这里，我们以欧盟对新兴卫生技术 (例如纳米技术) 的监管为例来质疑本论文。在这种情况下，公民参与监管辩论与医疗应用的创新对象有关，这些对象被认为是紧急的或尚未具体的。通过综合法律，监管研究，批判理论以及科学和技术研究的见解，我们寻求对公民参与本身作为监管工具或技术的承诺，悖论和陷阱的新认识。因此，我们的目标是产生一个新的有利位置，从中可以查看公民参与的 “设计” 和 “设计” 的价值观和社会技术想象力。在这样做的过程中，我们不仅展示了公众 (不) 如何监管技术，还展示了公民自己是如何通过参与技术来监管的。

BACKGROUND & AIMS: -2

背景与目标： -2

BACKGROUND & AIMS: BACKGROUND:Road traffic injuries contribute substantially to the disease burden in India. This paper describes the road safety issues discussed by members of the Indian Parliament, and highlights the gaps that need to be addressed to make road safety visible as a public health problem to policy-makers in India. METHODS:All questions asked to and information provided by the Ministry of Road Transport and Highways, and questions relating to accident asked to the Ministry of Health and Family Welfare of the Government of India were reviewed for the two Houses of the Indian Parliament for the years 2002 to 2004. RESULTS:Of the 1529 questions asked to the Ministry of Road Transport and Highways, only 140 (9.1%) were related to road safety, whereas 1076 (70.5%), 181 (11.8%), 51 (3.3%) and 81 (5.3%) were related to other aspects of the national highways, state roads, vehicles and other issues, respectively. Data on the magnitude of road crashes dealt only with the number of crashes and fatalities and not with the age, sex and type of road users affected by road traffic injuries. The parliamentarians were informed that human error was the main cause of road crashes in India; however, the robustness of this information is questionable. Strategies to prevent road crashes focused mainly on training of drivers with little attention to other factors that cause road crashes. The discussion on legislations also focused on drivers, ignoring other road users. Ten of the 4741 questions (0.2%) asked to Ministry of Health and Family Welfare were related to accident, the majority of which were about the setting up of trauma care services. CONCLUSION:An appropriate policy and intervention response by policy-makers is not possible with data that are presented in a manner that do not highlight the true nature of the problem, and are neither comprehensive nor robust. Majority of the proposed road safety interventions by the Ministry of Road Transport and Highways are based on the traditional view of human error as a major cause of road crashes highlighting the lack of a scientific public health approach towards prevention of road crashes. It would be useful to build the technical capacity of the Ministry of Road Transport and Highways in road safety to use the available data more effectively, and to facilitate generation of further relevant data about the magnitude, underlying causes and impact of road traffic injuries, for policy-makers to better understand the critical issues for planning effective road safety policies and interventions to reduce the high burden of mortality and morbidity due to road crashes in India.

背景与目标：

BACKGROUND & AIMS: :In a prospective cohort study of Finnish public sector employees, the authors examined the association between workplace social capital and depression. Data were obtained from 33,577 employees, who had no recent history of antidepressant treatment and who reported no history of physician-diagnosed depression at baseline in 2000-2002. Their risk of depression was measured with two indicators: recorded purchases of antidepressants until December 31, 2005, and self-reports of new-onset depression diagnosed by a physician in the follow-up survey in 2004-2005. Multilevel logistic regression analysis was used to explore whether self-reported and aggregate-level workplace social capital predicted indicators of depression at follow-up. The odds for antidepressant treatment and physician-diagnosed depression were 20-50% higher for employees with low self-reported social capital than for those reporting high social capital. These associations were not accounted for by sex, age, marital status, socioeconomic position, place of work, smoking, alcohol use, physical activity, and body mass index. The association between social capital and self-reported depression attenuated but remained significant after further adjustment for baseline psychological distress (a proxy for undiagnosed mental health problems). Aggregate-level social capital was not associated with subsequent depression.

背景与目标： : 在一项对芬兰公共部门雇员的前瞻性队列研究中，作者研究了工作场所社会资本与抑郁症之间的关联。数据来自33,577名员工，他们最近没有抗抑郁药治疗史，并且在2000-2002年的基线时没有医生诊断的抑郁症病史。通过两个指标来衡量他们的抑郁症风险: 记录到2005年12月31日之前的抗抑郁药购买量，以及2004-2005年医生在随访调查中诊断出的新发抑郁症的自我报告。使用多水平logistic回归分析来探讨自我报告和综合水平的工作场所社会资本是否可以预测随访时的抑郁指标。自我报告社会资本低的员工的抗抑郁治疗和医生诊断的抑郁症的几率比报告社会资本高的员工高20-50%。这些关联没有按性别，年龄，婚姻状况，社会经济地位，工作地点，吸烟，饮酒，体育锻炼和体重指数来解释。社会资本与自我报告的抑郁症之间的关联减弱，但在进一步调整基线心理困扰 (未诊断的精神卫生问题的代表) 后仍然显着。总水平的社会资本与随后的萧条无关。

BACKGROUND & AIMS: OBJECTIVES:To describe the US public health nutrition workforce and its future social, biological and fiscal challenges. DESIGN:Literature review primarily for the four workforce surveys conducted since 1985 by the Association of State and Territorial Public Health Nutrition Directors. SETTING:The United States. SUBJECTS:Nutrition personnel working in governmental health agencies. The 1985 and 1987 subjects were personnel in full-time budgeted positions employed in governmental health agencies providing predominantly population-based services. In 1994 and 1999 subjects were both full-time and part-time, employed in or funded by governmental health agencies, and provided both direct-care and population-based services. RESULTS:The workforce primarily focuses on direct-care services for pregnant and breast-feeding women, infants and children. The US Department of Agriculture funds 81.7 % of full-time equivalent positions, primarily through the WIC Program (Special Supplemental Nutrition Program for Women, Infants, and Children). Of those personnel working in WIC, 45 % have at least 10 years of experience compared to over 65 % of the non-WIC workforce. Continuing education needs of the WIC and non-WIC workforces differ. The workforce is increasingly more racially/ethnically diverse and with 18.2 % speaking Spanish as a second language. CONCLUSIONS:The future workforce will need to focus on increasing its diversity and cultural competence, and likely will need to address retirement within leadership positions. Little is known about the workforce's capacity to address the needs of the elderly, emergency preparedness and behavioural interventions. Fiscal challenges will require evidence-based practice demonstrating both costs and impact. Little is known about the broader public health nutrition workforce beyond governmental health agencies.

背景与目标：

BACKGROUND & AIMS: :In 1998 the Society for Academic Emergency Medicine's (SAEM's) Board of Directors asked the SAEM Public Health and Education Task Force to develop recommendations for prevention, screening, and counseling activities to be conducted in emergency departments (EDs). The Task Force's work was divided into two phases: 1) a discussion of the rationale for preventive services in the ED, along with generation of a preliminary list of prevention activities that could be studied for ED implementation; and 2) a formal evidence-based review of topics chosen from the preliminary list, along with recommendations for ED implementation and further study. This paper represents Phase I of the project. Phase II, the formal evidence-based review and recommendations, is published separately in this issue.

背景与目标： : 1998年，学术急诊医学协会 (SAEM's) 董事会要求SAEM公共卫生和教育工作组为在急诊科 (EDs) 进行的预防，筛查和咨询活动制定建议。专责小组的工作分为两个阶段: 1) 讨论在ED中提供预防服务的理由，并生成可研究用于ED实施的预防活动的初步清单; 2) 对从初步清单中选择的主题进行正式的循证审查，以及对ED实施和进一步研究的建议。本文代表了该项目的第一阶段。第二阶段，正式的循证审查和建议，在本期单独发表。

BACKGROUND & AIMS: :The aim of this study was to assess the prevalence of dental caries in the primary dentition and associated variables in low socioeconomic preschool children enrolled in public nursery schools in Juiz de Fora, Minas Gerais, Brazil. Four public institutions were selected by geographic criteria (two in the central region and two in the peripheral region). The study population comprised 338 children (181 boys; 157 girls) aged 2-6 years old. Dental caries was recorded using the decayed, missing, and filled teeth (dmf-t) index. Among the examined children, 50.6% were caries-free. The mean dmf-t index was 2.03. It was higher in the peripheral nursery schools (p<0.01). A trend towards a difference between sexes (p = 0.06) was observed. Logistic regression analysis selected a previous child's visit to dentist (p<0.001), geographic location of the public nursery school (p<0.01), and age (p<0.01) as predictive variables for the dmf-t index. The study showed the need for an oral health program for this population, including both curative and preventive measures in order to achieve the WHO/FDI goals for the year 2000, namely 50% of children free of caries at age 5-6 years.

背景与目标： : 这项研究的目的是评估在巴西米纳斯吉拉斯州Juiz de Fora的公立托儿所就读的低社会经济学龄前儿童的主要牙列中龋齿的患病率和相关变量。根据地理标准选择了四个公共机构 (两个在中部地区，两个在外围地区)。研究人群包括2-6岁的338名儿童 (181名男孩; 157名女孩)。使用腐烂，缺失和填充的牙齿 (dmf-t) 指数记录龋齿。在接受检查的儿童中，有50.6% 人没有龋齿。平均dmf-t指数为2.03。在外围托儿所中较高 (p<0.01)。观察到性别差异的趋势 (p = 0.06)。Logistic回归分析选择了以前的儿童去看牙医 (p<0.001)，公立托儿所的地理位置 (p<0.01) 和年龄 (p<0.01) 作为dmf-t指数的预测变量。该研究表明，需要为这一人群制定口腔保健方案，包括治疗和预防措施，以实现世卫组织/外国直接投资2000年的目标，即50% 5-6岁无龋齿儿童。

BACKGROUND & AIMS: :This study demonstrates a conceptual linkage between exchange theory and psychoanalytic theory of depression. The effects of diminished resources and the dynamic relationships between depression, quality of the marital relationship, and social participation were investigated with a sample of 229 community residing, married older people (Duke Longitudinal Study) using a combined structural and measurement model with linear structural relations (LISREL) analysis. Findings are that some resources have direct effects on depression, marital quality, and social participation. However, it is through the pathway of depressive moods that ill health, retirement, and stress have their negative effects on the marital relationship. Depressive moods do affect social participation, but psychosomatic symptoms of depression do not affect the amount of social participation nor the marital relationship. Recognizing depressive moods as intervening variables is important because older people tend to deny feeling depressed. Without a conceptual linkage of exchange and depression theories, this pathway would not have been identified.

背景与目标： : 这项研究证明了交换理论与抑郁症的精神分析理论之间的概念联系。资源减少的影响以及抑郁，婚姻关系质量和社会参与之间的动态关系，使用229社区居住，已婚老年人的样本 (Duke纵向研究)，使用具有线性结构关系的组合结构和测量模型 (LISREL) 分析。研究结果表明，某些资源对抑郁症，婚姻质量和社会参与有直接影响。然而，正是通过抑郁情绪的途径，健康不良，退休和压力对婚姻关系产生负面影响。抑郁情绪确实会影响社会参与，但是抑郁的心身症状不会影响社会参与的数量，也不会影响婚姻关系。将抑郁情绪作为干预变量很重要，因为老年人倾向于否认感到沮丧。如果没有交换和抑郁理论的概念联系，就不会确定这一途径。

BACKGROUND & AIMS: :South Africa has long recognized partnerships between the public and private sectors as a policy objective in health, but experience is still limited and poorly documented. The objectives of this article are to understand the factors that increase the likelihood of success of public-private interactions in South Africa, and identify and discuss opportunities for them to be scaled up. There is a strong legislative framework and a number of guidelines and tools that have been developed by the Treasury for managing partnerships. The review of literature confirmed the need for the state to have effective regulations in order to oversee quality and standards and to provide stewardship and oversight. The public sector requires sufficient capacity not only to manage relationships with the private sector but also to enable innovation and experimentation. Evaluation is an integral part of all interactions not only to learn from successes but also to identify any perverse incentives that may lead to unintended consequences. Four case studies show that the private for-profit sector is already engaged in a number of projects that are closely aligned to current health system reform priorities. Factors that increase the likelihood of interactions being successful include: increasing the government's capacity to manage public-private relationships; choosing public-private interactions that are strategically important to national goals; building a knowledge base on what works, where and why; moving from pilots to large scale initiatives; harnessing the contracting expertise in private providers; and encouraging innovation and learning.

背景与目标： : 南非长期以来一直承认公共部门和私营部门之间的伙伴关系是卫生方面的政策目标，但经验仍然有限，而且文献记载很少。本文的目的是了解增加南非公私互动成功可能性的因素，并确定和讨论扩大它们的机会。财政部为管理伙伴关系制定了强有力的立法框架和许多准则和工具。对文献的审查证实，国家需要制定有效的法规，以监督质量和标准，并提供管理和监督。公共部门不仅需要足够的能力来管理与私营部门的关系，而且还需要创新和实验。评估是所有互动的组成部分，不仅要从成功中学习，而且要确定可能导致意外后果的任何不正当激励措施。四个案例研究表明，私营营利部门已经参与了许多与当前卫生系统改革优先事项密切相关的项目。增加互动成功可能性的因素包括: 提高政府管理公私关系的能力; 选择对国家目标具有战略重要性的公私互动; 建立有效的知识基础，在何处以及为什么; 从试点转向大规模计划; 利用私人供应商的合同专业知识; 鼓励创新和学习。

BACKGROUND & AIMS: :Cooperation declines in repeated public good games because individuals behave as conditional cooperators. This is because individuals imitate the social behaviour of successful individuals when their payoff information is available. However, in human societies, individuals cooperate in many situations involving social dilemmas. We hypothesize that humans are sensitive to both success (payoffs) and how that success was obtained, by cheating (not socially sanctioned) or good behaviour (socially sanctioned and adds to prestige or reputation), when information is available about payoffs and prestige. We propose and model a repeated public good game with heterogeneous conditional cooperators where an agent's donation in a public goods game depends on comparing the number of donations in the population in the previous round and with the agent's arbitrary chosen conditional cooperative criterion. Such individuals imitate the social behaviour of role models based on their payoffs and prestige. The dependence is modelled by two population-level parameters: affinity towards payoff and affinity towards prestige. These affinities influence the degree to which agents value the payoff and prestige of role models. Agents update their conditional strategies by considering both parameters. The simulations in this study show that high levels of cooperation are established in a population consisting of heterogeneous conditional cooperators for a certain range of affinity parameters in repeated public good games. The results show that social value (prestige) is important in establishing cooperation.

背景与目标： : 合作在重复的公益游戏中下降，因为个人表现为有条件的合作者。这是因为当个人的收益信息可用时，个人会模仿成功个人的社会行为。然而，在人类社会中，个人在许多涉及社会困境的情况下进行合作。我们假设人类对成功 (收益) 和成功是如何获得的敏感，通过欺骗 (不是社会认可的) 或良好的行为 (社会认可的，并增加了声望或声誉)，当有关收益和声望的信息可用时。我们提出并建立了具有异质条件合作者的重复公共物品博弈模型，其中公共物品博弈中代理人的捐赠取决于比较上一轮人口中的捐赠数量以及代理人任意选择的条件合作标准。这些人根据他们的回报和声望来模仿榜样的社会行为。依赖关系由两个人口水平的参数建模: 对回报的亲和力和对声望的亲和力。这些亲和力会影响代理人对榜样的回报和声望的重视程度。代理通过考虑两个参数来更新其条件策略。这项研究中的模拟表明，在重复的公益游戏中，对于一定范围的亲和力参数，在由异质条件合作者组成的人群中建立了高水平的合作。结果表明，社会价值 (声望) 在建立合作中很重要。

BACKGROUND & AIMS: :With the daily number of confirmed COVID-19 cases and associated deaths rising exponentially, social fabrics on a global scale are being worn by panic, uncertainty, fear, and other consequences of the health care crisis. Comprising more than half of the global health care workforce and the highest proportion of direct patient care time than any other health professional, nurses are at the forefront of this crisis. Throughout the evolving COVID-19 pandemic, palliative nurses will increasingly exercise their expertise in symptom management, ethics, communication, and end-of-life care, among other crucial skills. The literature addressing the palliative care response to COVID-19 has surged, and yet, there is a critical gap regarding the unique contributions of palliative nurses and their essential role in mitigating the sequelae of this crisis. Thus, the primary aim herein is to provide recommendations for palliative nurses and other health care stakeholders to ensure their optimal value is realized and to promote their well-being and resilience during COVID-19 and, by extension, in anticipation of future public health crises.

背景与目标： : 新型冠状病毒肺炎病例数和相关死亡人数呈指数级增长，全球范围内的社会结构正受到恐慌、不确定性、恐惧和医疗危机的其他后果的影响。护士占全球卫生保健工作人员的一半以上，直接病人护理时间的比例比任何其他卫生专业人员都高，护士处于这场危机的最前沿。在不断发展新型冠状病毒肺炎大流行期间，姑息护士将越来越多地行使他们在症状管理、道德、沟通和临终关怀等关键技能方面的专业知识。关于新型冠状病毒肺炎的姑息治疗反应的文献激增，然而，关于姑息护士的独特贡献及其在减轻这场危机后遗症方面的重要作用存在严重差距。因此，本文的主要目的是为姑息性护士和其他医疗保健利益相关者提供建议，以确保他们的最佳价值得以实现，并在新型冠状病毒肺炎期间促进他们的福祉和复原力，进而促进对未来公共卫生危机的预期。