A Signaling Game of Family Doctors and Residents from the Perspective of Personalized Contracted Service.

The role of the family doctor contracted service system in China's medical and health system is increasing day by day. However, with the steady increase in contracting coverage, the phenomenon of "signing up but not contracting" has become common; to improve the current situation, the personalized signing service model has been strongly advocated. To promote the smooth implementation of the personalized contracted service model with family doctor competency as its core, this study used the signal game model to analyze the market equilibrium state of the signing service model. The results of this analysis reveal the following: (1) The camouflage of the number of contracts leads to distortion of the signal effect and to market failure, that is, the cost of competency camouflage is the primary factor affecting the equilibrium of contracted services. (2) The incompleteness of contracted services leads to quantity but not quality in the contracting market, that is, the payment of personalized service packages, the value-added utility of personalized services, and service gaps are the key factors that affect the decision-making behavior of the public. With this knowledge in mind, a compensation incentive mechanism that matches the competence level of the family doctor should be established, the formulation of contracted service agreements should be improved, and the participation of family doctors and residents should be encouraged, while the promotion of personalized contracted services should be enhanced and relevant supporting measures should be improved.

The Impact of COVID-19 on Job Prospects and Educational Training for Pediatric Gastroenterology Fellows.

OBJECTIVES: The COVID-19 pandemic has significantly affected graduate medical education with redistribution of trainees, altered clinical care, and decreased research. For graduating trainees, there remains concern that financial stability of health systems will affect the availability of new positions and hiring practices. This survey aims to evaluate the pandemic's impact from pediatric gastroenterology fellows' perspectives. METHODS: An anonymous survey was distributed by e-mail from June 11 to July 1, 2020 to all North American pediatric gastroenterology and advanced training fellows. The survey was tailored for the fellows' year of training including questions on education, clinical experience, research, and job outlook. RESULTS: Of the 434 pediatric gastroenterology fellows, 145 completed the survey. Of all respondents, negative impact was reported in 52% on clinical training, 46% research projects, and 41% procedural confidence. A majority (93%) of third-year respondents had a job contract signed at the time of the survey; however, 18% of those contracts were subsequently altered with 5 respondents having job contracts rescinded due to hiring freezes. Fifty-four percent of first- and second-year fellow respondents reported concern regarding finding a job with the majority being second-year fellows (78%). CONCLUSIONS: The COVID-19 pandemic continues to affect the medical system and healthcare professionals. This survey identified significant impact on job acquisition for graduating pediatric gastroenterology fellows and other critical components of training, which are likely applicable to other pediatric trainees. The survey results raise questions about potential strategies to improve medical education and job search success for graduating trainees.

Gig Workers with Disabilities: Opportunities, Challenges, and Regulatory Response.

Purpose This article examines gig work-typified by technologically-based, on-demand, independent contractor arrangements-for people with disabilities. Methods To do so, it draws upon prior and current research to describe the nature of gig work for people with disabilities, as well as the challenges and new prospects that such work presents. It also discusses recent regulatory reforms and proposes improvements, particularly in light of the current pandemic. Results Participation in the traditional employment market for people with disabilities who can and wish to work remains limited, even when workplace accommodations and individualized adjustments are possible. Increasingly, though, self-directed or independently contracted work is a way for people with disabilities to participate in the mainstream economy. The "gig economy," in particular, has provided additional opportunities for self-directed work, although the novel coronavirus pandemic has required existing approaches to be reconceived. Conclusions The gig economy provides new prospects, as well as challenges, for people with disabilities to engage in meaningful work. It also requires innovative regulatory responses to the gig work relationship, especially during the pandemic era.

[Teachers on temporary employment contracts reveal more frequent consumption of pre-prepared food]. / Professores com vínculo temporário apresentam maior frequência de consumo de alimentos pré-preparados.

The scope of this article is to analyze the eating behavior of schoolteachers according to the type of employment contract. Interviews were conducted at 20 public state schools in Londrina, State of Paraná, between 2012 and 2013. Of the 978 teachers interviewed, 672 (68.7%) had permanent employment contracts and 306 (31.3%) were on temporary employment contracts. High frequencies of recommended eating behaviors - consumption of fruit, vegetables and/or vegetables and removing visible fat from red meat - were observed in teachers with a permanent employment contract. On the other hand, teachers with temporary employment contracts revealed a high frequency of non-recommended eating behaviors with consumption of pre-prepared foods and packaged drinks or sodas. It was highlighted that a high frequency of consumption of pre-prepared foods was statistically associated with the type of employment contract irrespective of sociodemographic, lifestyle and health status factors.

O artigo tem por objetivo analisar as condutas alimentares de professores segundo os vínculos de trabalho. As entrevistas foram realizadas em 20 escolas da rede estadual de Londrina entre 2012 e 2013. Dos 978 professores entrevistados, 672 (68,7%) tinham vínculo efetivo e 306 (31,3%) temporário. Altas frequências de condutas alimentares recomendadas - consumo de frutas, verduras e/ou legumes e retirada da gordura visível da carne vermelha - foram observadas em professores com vínculo efetivo. Em contrapartida, professores com vínculo temporário apresentaram altas frequências de condutas alimentares não recomendadas - consumo de alimentos pré-preparados e de bebidas industrializadas ou refrigerantes. Destaca-se que o consumo em alta frequência de alimentos pré-preparados esteve estatisticamente associado ao tipo de vínculo independentemente de fatores sociodemográficos, de estilo de vida e da condição de saúde.

Incomplete contracts for bus service during the COVID-19 pandemic / A incompletude dos contratos de ônibus nos tempos da COVID-19 / La incompletitud de los contratos de autobús en tiempos de COVID-19

Resumo A pandemia da COVID-19 impõe sérios desafios ao setor de transporte público por ônibus. A queda da demanda em razão do isolamento social, a intensificação dos procedimentos de higienização, a aquisição de equipamentos de proteção individual e as restrições de lotação dos veículos ameaçam a viabilidade econômico-financeira do transporte coletivo brasileiro. A pandemia da COVID-19 pode ser caracterizada como um evento de força maior, ensejando reequilíbrio econômico-financeiro dos contratos de concessão de transporte público por ônibus. Entretanto, esta solução precisa ser buscada conjuntamente, pelo poder público e pelas empresas de transporte urbano, para garantir os interesses e as necessidades de ambas as partes. Este artigo sugere ações estratégicas para que o transporte coletivo continue operando durante a pandemia e os acordos de reequilíbrio econômico-financeiro estejam alinhados com o interesse público. A superação das incertezas e consequências causadas pela pandemia exige a criação de relações de confiança e apoio mútuo entre inciativa privada (operadores) e governo.

Resumen La pandemia de COVID-19 impone desafíos serios para el sector de transporte público por autobús. La caída de la demanda en función de las medidas de aislamiento social, la intensificación de los procedimientos de higiene, la adquisición del equipo de protección para los trabajadores y las restricciones en cuanto al número de pasajeros por vehículo amenazan la viabilidad económica-financiera del transporte colectivo brasileño. La pandemia de COVID-19 se puede caracterizar como acontecimiento de fuerza mayor que propicie el reequilibrio económico-financiero de contratos de concesión de transporte público por autobús. Sin embargo, esta solución debe buscarse en forma conjunta, por el gobierno y las empresas de transporte, para garantizar los intereses y las necesidades de ambas partes. Este artículo sugiere acciones estratégicas para que el transporte colectivo continúe funcionando durante la pandemia y los acuerdos de reequilibrio económico-financiero se alineen con el interés público. La superación de las incertidumbres y consecuencias de la pandemia requiere la creación de relaciones de confianza y apoyo mutuo entre la iniciativa privada (operadores) y los gobiernos.

Abstract The COVID-19 pandemic poses serious challenges for the public bus service. The fall in demand due to social distancing measures, the intensification of hygiene procedures, the acquisition of personal protective equipment, and restrictions on vehicle capacity threaten the financial viability of Brazilian public transportation. The COVID-19 pandemic may be characterized as a force majeure event, giving rise to an economic-financial balancing of public bus service contracts. However, this solution must be built by the public administration and transport companies to guarantee the interests and needs of both parties. Therefore, this article offers strategies to continue operating the service during the pandemic and to achieve economic and financial equilibrium protecting the public interest. Overcoming the uncertainties and consequences caused by the pandemic requires relationships of trust and mutual support between the private sector (operators) and government.

Is Covid-19 sowing the seeds for future litigation?

We consider various types of litigation that may follow the Covid-19 pandemic, including: claims against National Health Service (NHS) Trusts by patients who have contracted the coronavirus (or by their bereaved families), claims by NHS staff against their employer for a failure to provide any or adequate personal protective equipment or testing, commercial claims arising from the procurement of medical supplies, the potential liabilities to those who suffer adverse reactions to any vaccine and the guidance issued by the regulators in relation to subsequent disciplinary action.