University of Macau / Faculty of Education

University of Macau / Faculty of Social Sciences and Humanities / Department of Government and Public Administration

This business plan aims to develop a premium holistic service for girls who suffer from obesity, overweight and/or eating disorders, using new approaches to these existing problems. Our mission is to provide an innovative approach that can make a difference for young women with obesity, overweight and/or eating disorders.

健康的重要性，人人皆知，但是知易行難，現代的人忙碌，卻也創造出更多不運動的理由。近年來因為手機的普及，讓資通業者看到的是個人對身體自主健康的需求，隨著智慧手環的關鍵技術發展漸趨成熟，讓智慧穿戴裝置成為生活的必需品，許多人都相信智慧穿戴裝置將是下一個令人期待的高成長產業，而健康管理與穿戴裝置的結合又一直是此類產品發展的重點。 本論文研究的目的是希望經由分析智慧穿戴市場的基本應用與產業現況，來探討穿戴裝置業者的產品在健康管理相關領域的市場應用範圍。研究的架構是藉由分析幾個智慧穿戴業者現行的商業模式圖並輔以價值主張的設計分析探討，找出研究個案的關鍵成功因素，本研究也根據評量分析作出結論與建議，達成在這個互聯網時代，研究機構，廠家跟消費者能精準管理健康，產業成長獲利，全民健康運動的三贏目的。

全民健康保險自1995年在台灣實施以來，從設立之初面臨整合困境，到近年來因應健保財務的收支平衡及社會保險財政收入公平性規劃，而於2013年通過了改良版二代健保規劃(補充保費)，此意謂著台灣健保也面臨了一般社會保險財務沉重負擔的必然困境，同時也讓主管的衛生機關對於醫療給付的支出更限縮、管制更加嚴格。 注重醫療服務品質、衡平健保財務規劃及醫事服務機構的合理費用支付等三者平衡皆是健康保險制度能夠長久維持的重大元素。然而在總額支付制度之嚴格管制財務規劃下，雖然在名義上，健保局將醫療費用審查委託總額受託團體辦理，但受託單位角色上仍扮演行政協助角色，但健保局仍負責所有審查人員聘任、解僱、及最後審查裁量決定權，最後由健保局執行之行政程序將醫療費用支付給予醫事服務機構。 在當前醫療服務費用審查制度下，招致眾多醫療機構及醫事人員批評審查不公、惡意核刪(viciousness payment subtraction)、欠缺公民參與之黑箱審查等聲浪。細究此指摘聲浪並非空穴來風，實務上仍不免有許多謬誤醫療費用核刪、不確定法律概念(indefinite law concept)及侵犯醫事服務機構及相關醫事人員之財產權、工作權及醫療專業自主權之疑慮。 本文嘗試探討醫療費用審查之法律關係及支付制度角色，並解析目前眾多謬誤醫療費用核刪的法律明確性(principle of clarity and definiteness of law)違反、欠缺法源依據及判斷餘地瑕疵(discretion flaws)。並提出審查機制調整建議，建議將醫療費用審查制度交由公正第三人團體獨立化、專業化、減少爭議審議案件發生及爭審會行政負擔、促進公正審查(impartial review)、公開透明及避免醫療品質快速崩壞。

行政部門委員會為政府內具有公共參與特質的合議制組織，來自社會層級的利害關係人被納入決策圈，並共同決定政策內容，作者稱之為委員會參與機制。此決策模式結合了社會與政府對公共參與的期待，並在世界各國廣泛使用。行政管理者宣稱可透過社會代表性的提升，提高政策的正當性與回應性；但實務上，委員會卻遭遇密室協商、激化對立、政治操弄等質疑。對此，本研究提出以下疑問：公共參與是否真能回應社會的政策需求？該如何具體評估參與績效？ 依據委員會的決策結構特質，作者由公共參與的理論視野探討代表性和回應性的因果機制，提供一套以委員會為主體的參與評估標準。代表性在理論上有形式與實質代表性兩個層次，共包含參與制度、議事行為與會議影響力三個面向；回應性則強調利害關係人對委員會回應需求的主觀評價，又分為民主程序與實質利益的需求回應能力兩類。參與概念落實在制度賦權和議事行為，應該會同時強化兩類回應性。在研究方法上，本文以全民健康保險委員會為分析案例：首先透過跨國比較，分析台灣、日本、韓國、加拿大以及德國在類似的審議機制中，如何建構委員會代表性的制度。依此基礎，再針對第一屆健保會的運作進行分析，透過利害關係人問卷、健保會會議記錄內容分析、深度訪談與焦點團體等方法，深入探討健保會之政策回應能力。 研究結果發現：一、委員會參與的制度賦權和正當性皆來自代議機關，尚無法取而代之。台灣健保會之形式代表性，在行政單位主導下仍偏好具有政治動員能力的團體，較忽略社會連帶或保障弱勢的價值。二、健保會在民主功能和實質結果兩個回應性面向的評價皆為正面，而民主程序的評價又優於後者。然而，相互理解的功能評價再高，卻未對實質回應性產生顯著影響。三、是否具有健保會席次並不影響回應性評估；但直接與會者以及實際參與愈積極者，卻反而對委員會回應利害關係人需求的能力抱持較悲觀的看法。最後，在程序面和實質面評價上最為顯著的因素為會議影響力，會議影響力愈大的團體，其回應性也就愈高。 總結上述來回答核心問題：參與是否會提高利害關係人的回應性？在極大化個體利益的動機下，參與制度和行為都只提供爭取權益的機會，不必然導致實質利益。再加上負擔參與成本以及競爭資源的政治現實，參與者進入體制後，反而對委員會的政策回應能力持質疑的態度。是故，會議影響力為關鍵因素，只有在參與過程中獲利愈多者，其回應性才有直接的正面作用；若忽略參與途徑和結果的連結以及權力互動，就過度簡化了參與的政治本質。基於此，行政管理者掌握了決策結構與行政資源，若想取得較佳的回應性評價，就必須在制度和過程面中平衡不同的社會力量，才能使委員會發揮多元參與的功能，而不只是優勢團體的工具。 / Governmental committees are a kind of public participatory mechanism, whereby policy stakeholders are incorporated in the decision making procedure and negotiate with each other to policy outcomes. This mechanism accords with the expectations of both society and government and is frequently used by executive branches all over the world. Ideally, social representativeness can strengthen legitimacy and thereby increase responsiveness. However, in practice, there have also been some criticisms of the committee mechanism, including black box decision making, conflict enlargement, and administrative manipulation. To response this debate, my study addresses whether this type of public participation is responsive to policy demands as well as how to substantially evaluate its effectiveness. Theoretically, participation has a positive impact on policy demands, I provide more precise analysis using the concepts of representativeness and responsiveness. The former refers to how interests are presented in the decision making process, including in both the formal and substantive dimension. The latter refers to the committee’s ability to respond to procedural and substantive demands from society. To illustrate the theoretical framework, the National Health Insurance Committee (NHIC) in Taiwan is taken as my case study. The empirical section is divided into two parts, Fist, I explore original guiding values and institutional design of five committees that emerged under different political-social contexts in Japan, South Korea, Canada, Germany and Taiwan. Based on the results of this comparison, the NHIC in Taiwan is my main topic in the second part. The participatory behavior of committee members and their evaluation of the NHIC system are discussed through the various research methods, such as interviews, focus groups, stakeholder surveys, and also context analysis of meeting minutes. Four results of the study are illustrated as follows: 1. Because the legitimacy of the committee mechanism is empowered by traditional representative authority (the elected legislative or executive branch), it serves a supplementary rather than substitutive function to the existing system. Especially in Taiwan, the administration prefers the advantaged groups more capable of mobilizing social supports over the vulnerable groups which may bring the values of social solidarity and justice into the decision-making of the committee. 2. Stakeholders positively appraised the NHIC’s responsive capacity, both in the procedural and substantive dimensions, with the former appraised more highly than the latter. However, a high level of communication functions had no impact on responsiveness. 3. The institutional variable has no impact on responsiveness. However, direct participation in meetings was associated with more pessimistic views of the NHIC when compared to the non-participators. In addition, the more actors were involved in the NHIC, the more negative their evaluations were. 4. The most significant variable for responsiveness is the decision influence of stakeholders. Does participation strengthen stakeholders’ responsiveness? Under the condition that individuals are motivated by interest maximization, while institutional design and participatory behavior seek to pursue individual interest, it may not always realize substantial benefits. Furthermore, after becoming institutional insiders, the costs of participation and the political reality of power competition will make stakeholders more skeptical about the responsiveness of committee mechanisms. In other words, whether participation can increase the stakeholders’ satisfaction mainly depends on the benefit they can obtain from it. Without taking into account the link between participatory approaches and results, as well as the interaction between various stakeholders, we cannot gain a full picture of the nature of policy participation. In terms of practical reforms, to increase performance responsiveness, administrators who control the structures and resources of the NHIC should incorporate different social forces and interests on the input and process dimensions. This will enable the committee mechanism to perform the function of pluralistic participation, rather than simply serving as a political tool for advantaged groups.

本研究係對台灣天主教中等學校校長道德領導、學校組織健康與學校效能三個變項進行受訪教職員知覺調查與描述、比較不同背景變項的教職員差異是否顯著、探討校長道德領導、學校組織健康對學校效能相關性及預測性，依據研究所得結論,分別對台灣天主教中等學校董事會、學校當局、教育人員及後續研究者提出建議，以做為推展校長道德領導、精進學校組織健康及提高學校效能之參考。 本研究使用問卷調查法，以t檢訂、單因子變異數分析、皮爾森積差相關、多元迴歸等統計方法，探討台灣天主教中等學校校長道德領導、學校組織健康與學校效能之關係。 經由文獻的蒐集與探討，提出本研究的研究架構模式圖。研究對象為台灣天主教中等學校435位教職員，研究工具係組合陳浩、秦夢群、蔡玲玲三位各自編寫之「校長道德領導」、「學校組織健康」與「學校效能」問卷。 透過統計分析與討論,本研究獲得以下結論: 一、台灣天主教中等學校教職員知覺校長道德領導、學校組織健康與學校效能之現況屬中高程度。 二、台灣天主教中等學校教職員在人員背景變項對校長道德領導、學校組織健康與學校效能的知覺，大部分未達顯著差異。 三、台灣天主教中等學校校長道德領導、學校組織健康與學校效能三者間具有正向關聯性。 四、台灣天主教中等學校校長道德領導與學校組織健康對學校效能均具有正向預測力。 / This study aims to examine the relationship among the principals’ moral leadership, school organization health, and school effectiveness in Taiwan Catholic secondary schools. Through the organization status description, comparison between different teacher background variables, the correlation with the principals’ moral leadership, school organizational health to forecast school effectiveness was discussed. Finally, it proposes suggestions for Taiwan's Catholic secondary school boards, school authorities, educators and subsequent researchers for further improvement of school effectiveness. This study uses questionnaires survey, t test, one-way analysis of variance, Pearson product-moment correlation, multiple regression and other statistical methods to explore Taiwan's Catholic secondary school moral leadership, the organizational health and schools' effectiveness. Through the collection and discussion of the literature, this study proposes the study frmaework. The questionnaire interviewing 435 Taiwan Catholic secondary school faculties, is developed by the results of moral leadership, school organization and school effectiveness relationship of health from the research of Chen, Qin, and Tsai. Through statistical analysis and discussion, this study obtains the following conclusions: 1. Taiwan Catholic secondary school staff has medium-to-high perception of moral leadership, organizational status of school health and school performance. 2. Taiwan Catholic secondary school faculty staff’s background variancees show insignificant differences in surveying the principals’ moral leadership of principals, school organization and school effectiveness of health. 3. Taiwan Catholic secondary school moral leadership, school health and school performance of the organizations have a positive correlation. 4. Taiwan Catholic secondary school moral leadership and school organization health have a positive predictive power for the effectiveness of school.

目前計畫是創立一間律動瑜珈教室，交導學生熱瑜珈，交導如何放鬆身心、避免受傷，並由此獲益。 / The product of Movement Yoga Studio is Bikram yoga. Bikram Yoga is a demanding series of 26 postures and two breathing exercises, suitable for all ages and levels of ability. Each posture stretches, strengthens and prepares specific muscles, ligaments and joints for the next posture. The Bikram method also stimulates the organs, glands and nerves, moving fresh oxygenated blood to 100% of the body, restoring all systems to a healthy working order. Bikram scientifically designed this 90-minute program to deliver total health through the balancing and strengthening of every system in the body in order to prevent illness, injury, promote weight loss and limit the effects of aging. The series of postures combine skills of concentration, patience, determination and self-control which increase mental clarity and reduce stress. Bikram Yoga is practiced in a heated room at 40 °C with a humidity of 40% to warm your muscles, allow a deeper workout and cleanse the body by flushing toxins. Deep relaxation is taught in each class after completion of the postures. The intention of the instructors at Movement Yoga Studio is to assist students in the development of physical, mental, and spiritual well-being - a truly priceless health advantage. Movement Yoga Studio features well-trained, professional instructors, progressive teaching methods, a non-competitive and encouraging atmosphere, and a beautiful light-filled facility. Movement Yoga Studio also has a shop that will sell workshop clothing and yoga training aides.

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本論文旨在探討工作者之人格特質、內外控取向、工作特性、工作壓力三項變項與其工作滿足及生理、心理健康狀況之間的關係。藉由此三項變項之組合，瞭解其與工作滿足及生理、心理健康狀況之關聯性，並提出建議以供管理者於人事管理方向之參考。 本研究採立意取樣，以問卷調查一次施測方式取得資料，受試者採自新竹地區五家大型民營 之437 位現職工作者，所使用的研究工具，計有：「內外控取向量表」、「工作診斷調查表」、「工作壓力量表」、「工作滿意量表」及「生理、心理健康狀況檢查表」等。 在分析資料分法上，以因素分析法抽取研究變項之共同因素，並對各研究工具進行內部一致性信度分析，以確定研究工具為良好的工具；以簡單相關分析檢定各單變項間的關係；以三因子變異數分析探討內外控取向、工作特性、工作壓力三變項分別與工作滿足、生理、心理健康狀況間之關係有否交互作用產生，以t-Test及卡方檢定探討人員統計變項在各變項間之差異情形。 本研究結果發現：(1) 各單變項間彼此有相關情形，內外控取向、工作壓力與工作滿足變項呈負相關，而與生理、心理健康狀況呈正相關；工作特性與工作滿足變項呈正相關，而與生理、心理健康狀況呈負相關。即內控取向或工作特性佳或工作壓力低的工作者，其工作滿足感較高而生理、心理健康情形亦愈佳。(2) 三因子變異數分析之結果，只有內外控取向與工作壓力對生理健康狀況造成交互作用。主要效果結果得工作特性愈佳或工作壓力愈低的工作者，其內在、外在及整體滿足感愈高；內控取向或工作特性愈佳的工作者，其生理健康情形愈佳；內控取向或工作壓力低的工作者，其心理健康狀況較佳。 最後，根據研究結果，提出本研究之實務涵義，以供參考；並對未來研究方向及研究項目提出建議。