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1.
J Public Health Manag Pract ; 28(1): E256-E263, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-33729191

RESUMO

OBJECTIVE: The public health system faces major challenges in 2020, including an aging workforce, reductions in funding, and 2 simultaneous major threats to public health-the coronavirus pandemic and racial injustice. To effectively harness promising new technologies and address these and other public health challenges ahead, public health professionals must be trained on evidence-based practices for protecting and improving public health. This project sought to understand the network of health departments and organizations that provide training in order to inform strategic efforts to fill training gaps and improve access to training for local health departments (LHDs), thereby strengthening the public health system. DESIGN/SETTING/PARTICIPANTS: We conducted a Web-based survey of 501 LHDs in the 6 states constituting Region V of the Department of Health & Human Services. The survey focused on the training relationship between LHDs and state and national organizations that provide public health training, allowing for a social network analysis. We used data visualization and descriptive statistics to examine the network. RESULTS: Of 290 participating health departments (58% response rate), 248 had monthly or more frequent contact with at least 1 organization for the purpose of training. Altogether, the 248 LHDs were connected to 47 state-level organizations and 10 national-level organizations. In 5 of 6 states, more LHDs were connected to the state health department for training than to any other organization type. Universities, national nonprofits, and national membership organizations provided training to the fewest LHDs. Local health department characteristics did not have a clear relationship with its number of training connections. CONCLUSIONS: State health departments may benefit from the support of universities, national nonprofits, and national membership organizations by partnering to offer training or by recommending training from these organizations to LHDs. Additional qualitative information from local and state health departments would be useful to determine the best strategies for universities, national nonprofits, and national membership organizations to participate in training local practitioners to improve LHD capacity.


Assuntos
Governo Local , Administração em Saúde Pública , Humanos , Saúde Pública , Inquéritos e Questionários , Recursos Humanos
2.
Front Public Health ; 9: 769672, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34760866

RESUMO

This article uses data from the government work reports of 31 provinces (autonomous regions and municipalities) in China and 21 cities in Guangdong Province of China to perform a fixed effect regression. It was found that economic growth target constraints and economic growth target gaps between countries and provinces, or between provinces and cities have a significant impact on the quality of public occupational health. The non-linear relationship between economic growth target setting and the quality of public occupational health was then discussed in detail, and the reliability of basic conclusions drawn was ensured by robustness and endogeneity tests. The results show that the effect of economic growth target constraints and gaps on the quality of public occupational health shows a "U-shaped" trend at both the provincial and city levels, which initially promotes and, eventually, inhibits. This relationship is closely related to the current economic system reforms, administrative reforms, and social transformation in China. Therefore, in emphasising high-quality economic development, the government should fully consider the actual state of the development of jurisdictions in setting economic goals to improve the quality of public occupational health in an orderly manner.


Assuntos
Desenvolvimento Econômico , Saúde do Trabalhador , China , Governo Local , Reprodutibilidade dos Testes
3.
Artigo em Inglês | MEDLINE | ID: mdl-34770134

RESUMO

Based on panel data on 124 prefecture-level and above cities from 2003 to 2018, this study investigated the impact of CNSAs on tourism economic development and the moderating effect of time-limited rectification by comprehensively using the quasi-DID model, the static spatial Durbin model, and the dynamic spatial Durbin model. The results showed that the impact of CNSAs on tourism economic development has a heterogeneous characteristic in terms of tourists and revenue. In addition, the spatial spillover effect and the path dependence have effectively promoted tourism economic development. Furthermore, the effectiveness of time-limited rectification has been proved in this study, while the "beggar-thy-neighbor" effect has, to some extent, weakened the promotional effect of CNSAs on tourism economic development, especially in terms of international tourists and international tourism revenue. Finally, relevant policy implications for the superior department in charge, local governments, and the management department of CNSAs are outlined to provide a practical reference for promoting the high-quality development of the tourism economy in China.


Assuntos
Desenvolvimento Econômico , Turismo , China , Cidades , Governo Local
4.
BMC Health Serv Res ; 21(1): 1086, 2021 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-34645443

RESUMO

BACKGROUND: How health facilities are financed affects their performance and health system goals. We examined how health facilities in the public sector are financed in Kenya, within the context of a devolved health system. METHODS: We carried out a cross-sectional study in five purposely selected counties in Kenya, using a mixed methods approach. We collected data using document reviews and in-depth interviews (no = 20). In each county, we interviewed county department of health managers and health facility managers from two and one purposely selected public hospitals and health center respectively. We analyzed qualitive data using thematic analysis and conducted descriptive analysis of quantitative data. RESULTS: Planning and budgeting: Planning and budgeting processes by hospitals and health centers were not standardized across counties. Budgets were not transparent and credible, but rather were regarded as "wish lists" since they did not translate to actual resources. Sources of funds: Public hospitals relied on user fees, while health centers relied on donor funds as their main sources of funding. Funding flows: Hospitals in four of the five study counties had no financial autonomy. Health centers in all study counties had financial autonomy. Flow of funds to hospitals and health centers in all study counties was characterized by unpredictability of amounts and timing. Health facility expenditure: Staff salaries accounted for over 80% of health facility expenditure. This crowded out other expenditure and led to frequent stock outs of essential health commodities. CONCLUSION: The national and county government should consider improving health facility financing in Kenya by 1) standardizing budgeting and planning processes, 2) transitioning public facility financing away from a reliance on user fees and donor funding 3) reforming public finance management laws and carry out political engagement to facilitate direct facility financing and financial autonomy of public hospitals, and 4) assess health facility resource needs to guide appropriate levels resource allocation.


Assuntos
Financiamento da Assistência à Saúde , Governo Local , Estudos Transversais , Instalações de Saúde , Humanos , Quênia
5.
Artigo em Inglês | MEDLINE | ID: mdl-34639706

RESUMO

The objective of this research was to examine the capacity development of local self-governments in the field of disaster risk management (DRM). This quantitative research examines the degree of implementation of strategic, legislative, and institutional frameworks, as well as the capacity of local authorities to apply related policies through five analytical scopes: (1) degree of preparedness and legal framework; (2) financial framework; (3) policy aspects; (4) cooperation and partnership; (5) communication. The ability of municipalities and towns to respond to disasters was also analyzed and compared. In this paper, our initial hypothesis was that the effective implementation of the concept of DRM policy in towns of Serbia requires the continual strategic, tactical, and operational transformation of the public administration and public management system in order to strengthen the capacity of local self-governments for disaster prevention, preparation, response, and recovery. This multimethod research was conducted over the period of 2014-2017 and included the following two target groups: (a) heads of disaster sectors in local self-government units (mayor) and (b) employees of the DRM sector in local self-government units. The results of this research will enable decision makers to successfully respond to challenges and help to improve the capacity of local self-governments and public local administrations within the scope of DRM in the Republic of Serbia, based on the principles of prevention and proactive action, coordination, cooperation, partnership, and responsibility.


Assuntos
Planejamento em Desastres , Desastres , Cidades , Governo Local , Gestão de Riscos , Sérvia
6.
South Med J ; 114(9): 597-602, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34480194

RESUMO

OBJECTIVES: Coronavirus disease 2019 (COVID-19) threatens vulnerable patient populations, resulting in immense pressures at the local, regional, national, and international levels to contain the virus. Laboratory-based studies demonstrate that masks may offer benefit in reducing the spread of droplet-based illnesses, but few data are available to assess mask effects via executive order on a population basis. We assess the effects of a county-wide mask order on per-population mortality, intensive care unit (ICU) utilization, and ventilator utilization in Bexar County, Texas. METHODS: We used publicly reported county-level data to perform a mixed-methods before-and-after analysis along with other sources of public data for analyses of covariance. We used a least-squares regression analysis to adjust for confounders. A Texas state-level mask order was issued on July 3, 2020, followed by a Bexar County-level order on July 15, 2020. We defined the control period as June 2 to July 2 and the postmask order period as July 8, 2020-August 12, 2020, with a 5-day gap to account for the median incubation period for cases; longer periods of 7 and 10 days were used for hospitalization and ICU admission/death, respectively. Data are reported on a per-100,000 population basis using respective US Census Bureau-reported populations. RESULTS: From June 2, 2020 through August 12, 2020, there were 40,771 reported cases of COVID-19 within Bexar County, with 470 total deaths. The average number of new cases per day within the county was 565.4 (95% confidence interval [CI] 394.6-736.2). The average number of positive hospitalized patients was 754.1 (95% CI 657.2-851.0), in the ICU was 273.1 (95% CI 238.2-308.0), and on a ventilator was 170.5 (95% CI 146.4-194.6). The average deaths per day was 6.5 (95% CI 4.4-8.6). All of the measured outcomes were higher on average in the postmask period as were covariables included in the adjusted model. When adjusting for traffic activity, total statewide caseload, public health complaints, and mean temperature, the daily caseload, hospital bed occupancy, ICU bed occupancy, ventilator occupancy, and daily mortality remained higher in the postmask period. CONCLUSIONS: There was no reduction in per-population daily mortality, hospital bed, ICU bed, or ventilator occupancy of COVID-19-positive patients attributable to the implementation of a mask-wearing mandate.


Assuntos
COVID-19/mortalidade , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis/legislação & jurisprudência , Recursos em Saúde/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Controle de Doenças Transmissíveis/métodos , Implementação de Plano de Saúde , Política de Saúde , Humanos , Governo Local , Máscaras , SARS-CoV-2 , Texas/epidemiologia
7.
Artigo em Inglês | MEDLINE | ID: mdl-34501766

RESUMO

Over the past decades, pro-growth policies in China led to rapid economic development but overlooked the provision of health care services. Recently, increasing attention is paid to the emergence of integrated delivery systems (IDS) in China, which is envisioned to consolidate regional health care resources more effectively by facilitating patient referral among hospitals. IDS at an inter-city scale is particularly interesting because it involves both the local governments and the hospitals. Incentives among them will affect the development of an inter-city IDS. This paper thereby builds an economic model to examine both the inter-local government and inter-hospital incentives when participating in an inter-city IDS in China. The findings suggest that while inter-hospital incentives matter, inter-local government incentives should also be considered because the missing incentives at the local government level may oppose the development of inter-city IDSs.


Assuntos
Prestação Integrada de Cuidados de Saúde , China , Instalações de Saúde , Humanos , Governo Local , Motivação
8.
Health Promot Pract ; 22(6): 750-757, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34590896

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic tested the capacity of local health systems to understand and respond to changing conditions. Although data on new cases of COVID-19 were widely shared in communities, there was less information on the multisector response activities and factors associated with implementation. To address this gap, this empirical case study examined (a) the pattern of implementation of COVID-19 response activities and (b) the factors and critical events associated with both the pattern of new cases and the implementation of the local COVID-19 response. We used a participatory monitoring and evaluation system to capture, code, characterize, and communicate 580 COVID-19 response activities implemented in the city of Lawrence and Douglas County, Kansas. Collaboration across sectors including public health, medical services, city/county government, businesses, social services, public schools, and universities enabled the local public health system's response effort. Documentation results showed the varying pattern of new COVID-19 cases and response activities over time and the factors identified as enabling or impeding the response and related new cases. Similar participatory monitoring and evaluation methods can be used by local health systems to help understand and respond to the changing conditions of COVID-19 response and recovery.


Assuntos
COVID-19 , Saúde Pública , Humanos , Governo Local , Pandemias , SARS-CoV-2
9.
Artigo em Inglês | MEDLINE | ID: mdl-34574594

RESUMO

With rapid economic growth, the Chinese government expenditures at various levels have increased adequately. At the same time, the environmental quality in China has deteriorated significantly. In this study, provincial-level data for 31 Chinese provinces during 2007-2017 are used to investigate the impacts of government expenditure on the emissions of three specific measures of environmental degradation. The main objective of this study is to examine the influence of government expenditures, economic growth per capita, environment protection expenditure, and added second-sector value on environmental quality by measuring sulfur dioxide (SO2), chemical oxygen demand (COD), and ammonia nitrogen emissions (AN). Moreover, the study applied the generalized method of moments (GMM) and the fully modified least square (FMOLS) to estimate the co-integration relationship among the underlying factors. The results demonstrate a significant direct effect of government expenditure on improving environmental quality overall in the Chinese provinces, which increases with the level of economic growth. However, the results also confirmed the inverted N-shaped relationship between the pollution factor and economic growth per capita. Our key findings lead toward the manifestation and emphasis of the importance of appropriate policies for restoring government expenditure and, at the same time, strengthening the relationship between the industrial sector and environmental policy standards. Significantly, governments in developing countries should allocate larger budgets for environmental projects in their fiscal reforms for the sake of moving to greener and more inclusive economies with low-carbon activities.


Assuntos
Dióxido de Carbono , Gastos em Saúde , Dióxido de Carbono/análise , China , Desenvolvimento Econômico , Poluição Ambiental/análise , Governo Local
10.
Front Public Health ; 9: 686807, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34458221

RESUMO

Racism in the United States has been cited as a key driver of racial health inequities. Racism as a public health crisis has been in the forefront, particularly with respect to state and municipal governments that have developed legislation, resolutions, and declarations. This policy brief includes a review of resolutions and declarations across the US related to Racism as a Public Health Crisis through the end of September 2020. There were 125 resolutions reviewed for content related to the history of racism, reference to racial health equity data, content related to action steps or implementation, and any accompanying funding or resources. We found that the majority of policies name racism as critical in addressing racial inequities in health with limited details about specific actions, funding, or resources.


Assuntos
Equidade em Saúde , Racismo , Grupos de Populações Continentais , Humanos , Governo Local , Saúde Pública , Estados Unidos
11.
Sci Rep ; 11(1): 16895, 2021 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-34413337

RESUMO

Deriving effective mobility control measures is critical for the control of COVID-19 spreading. In response to the COVID-19 pandemic, many countries and regions implemented travel restrictions and quarantines to reduce human mobility and thus reduce virus transmission. But since human mobility decreased heterogeneously, we lack empirical evidence of the extent to which the reductions in mobility alter the way people from different regions of cities are connected, and what containment policies could complement mobility reductions to conquer the pandemic. Here, we examined individual movements in 21 of the most affected counties in the United States, showing that mobility reduction leads to a segregated place network and alters its relationship with pandemic spread. Our findings suggest localized area-specific policies, such as geo-fencing, as viable alternatives to city-wide lockdown for conquering the pandemic after mobility was reduced.


Assuntos
COVID-19/epidemiologia , SARS-CoV-2/fisiologia , Controle Social Formal/métodos , Controle de Doenças Transmissíveis , Humanos , Governo Local , Pandemias , Política Pública , Viagem , Estados Unidos/epidemiologia
12.
Front Public Health ; 9: 724351, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34422755

RESUMO

This study expands on the impact of local government environmental regulation on enterprise environmental protection investment. Furthermore, it analyzes the influence promotion pressure of officials has on the scale of enterprise environmental investment. The results show that the environmental protection investment of companies in China is generally insufficient. The attitude of companies toward environmental protection is passive under the policy regulation. The environmental supervision of the government is also still at a low level. Both of these observations are far from the intentions of the government. There is a U-shaped relationship between the pressure of official promotion and the scale of enterprise environmental protection investment. Only when the pressure of official promotion exceeds a certain limit can it positively stimulate enterprises to invest in environmental protection. Environmental regulation also exerts a threshold effect on the environmental protection investment by enterprises. This research provides a new way to understand the decision-making behavior of local officials and the environmental protection responsibility of enterprises. This study provides recommendations for improving the environment appraisal and government supervision system in China.


Assuntos
Conservação dos Recursos Naturais , Investimentos em Saúde , China , Governo Local , Políticas
13.
J Environ Manage ; 296: 113232, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34246901

RESUMO

Fine particulate matter (PM2.5) has become a major pressing challenge for China and remains a concern of its central government. This paper draws on a natural experiment generated by the National Ambient Air Quality Monitoring Network (NAAQMN) program in China to explore whether national air quality monitoring reduces local air pollution. In this study, we use a city-level dataset for 4200 Chinese cities covering 2001-2015 and a difference-in-differences (DID) assessment design to assess the impact of the NAAQMN program on local PM2.5 emissions in China. The results suggest that the NAAQMN program significantly reduces the local PM2.5 concentrations by 1.325 mg/m3, and each additional NAAQMN program will cause a decrease of 0.154 mg/m3 in the local PM2.5 concentrations. Furthermore, we determine the heterogeneous impacts of the NAAQMN program on local PM2.5 emission levels through the local government leaders' characteristics, PM2.5 emission levels, and economic development levels. In addition, a mediation effect is found between the NAAQMN program and local PM2.5 emissions through the efficiency of environmental governance. The Chinese government should continue to promote the implementation of the NAAQMN program by promoting the NAAQMN program to the county and rural areas as well as adding the sites of the NAAQMN program in the existing cities. Also, during the process of promoting the NAAQMN program, sufficient differentiation in policies should be developed for different cities.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Poluição do Ar/prevenção & controle , China , Cidades , Conservação dos Recursos Naturais , Monitoramento Ambiental , Política Ambiental , Governo Local , Material Particulado/análise
15.
Lancet Public Health ; 6(9): e641-e647, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34265265

RESUMO

BACKGROUND: Since 2010, large reductions in funding for local government services have been introduced in England. These reductions in funding have potentially led to reduced provision of health-promoting public services. We aimed to investigate whether areas that showed a greater decline in funding also had more adverse trends in life expectancy and premature mortality. METHODS: In this longitudinal ecological study, we linked annual data from the Ministry of Housing, Communities, and Local Government on local government revenue expenditure and financing to 147 upper-tier local authorities in England between 2013 and 2017 with data from Public Health England, on male and female life expectancy at birth, male and female life expectancy at age 65 years, and premature (younger than 75 years) all-cause mortality rate for male and female individuals. Local authorities were excluded if their populations were too small or if changes in boundaries meant consistent data were not available. Using multivariable fixed-effects panel regression models, and controlling for local socioeconomic conditions, we estimated whether changes in local funding from 2013 were associated with changes in life expectancy and premature mortality. We included a set of alternative model specifications to test the robustness of our findings. FINDINGS: Between 2013 and 2017, mean per-capita central funding to local governments decreased by 33% or £168 per person (range -£385 to £1). Each £100 reduction in annual per person funding was associated over the study period 2013-17 with an average decrease in life expectancy at birth of 1·3 months (95% CI 0·7-1·9) for male individuals and 1·2 months (0·7-1·7) for female individuals; for life expectancy at age 65 years, the results show a decrease of 0·8 months (0·3-1·3) for male individuals and 1·1 months (0·7-1·5) for female individuals. Funding reductions were greater in more deprived areas and these areas had the worst changes in life expectancy. We estimated that cuts in funding were associated with an increase in the gap in life expectancy between the most and least deprived quintiles by 3% for men and 4% for women. Overall reductions in funding during this period were associated with an additional 9600 deaths in people younger than 75 years in England (3800-15 400), an increase of 1·25%. INTERPRETATION: Our findings indicate that cuts in funding for local government might in part explain adverse trends in life expectancy. Given that more deprived areas showed greater reductions in funding, our analysis suggests that inequalities have widened. Since the pandemic, strategies to address these adverse trends in life expectancy and reduce health inequalities could prioritise reinvestment in funding for local government services, particularly within the most deprived areas of England. FUNDING: National Institute for Health Research (NIHR) School for Public Health Research, NIHR Applied Research Collaboration North East and North Cumbria, NIHR Applied Research Collaboration North West Coast and Medical Research Council.


Assuntos
Financiamento Governamental/estatística & dados numéricos , Expectativa de Vida , Governo Local , Idoso , Idoso de 80 Anos ou mais , Inglaterra/epidemiologia , Feminino , Humanos , Estudos Longitudinais , Masculino
16.
Med Care ; 59(9): 829-835, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34310456

RESUMO

BACKGROUND: Nonprofit hospitals (NFPs) are required to provide community benefits, which have been historically focused on provision of medical care, to keep their tax exemption status. To increase hospital investment in community health, the Patient Protection and Affordable Care Act required NFPs to conduct community health needs assessments and address identified needs. Some states have leveraged this provision to encourage collaboration between NFPs and local health departments (LHDs) in local health planning. OBJECTIVE: The objective of this study was to examine the association of NFP-LHD collaboration in local health planning targeting drug use, with drug-induced mortality. RESEARCH DESIGN: We conducted difference-in-differences analyses using drug-induced mortality data from 2009 to 2016, encompassing the first 3 years after NFP-LHD collaboration in local health planning specific to drug use. We evaluated drug-induced mortality in 22 counties in which collaboration was required in comparison with that in 198 control counties. We used data collected from implementation strategy reports by NFPs and combined it with data on hospital characteristics, as well as state-level and county-level factors associated with drug-induced mortality. MEASURES: The primary outcome was county-level drug-induced mortality per 100,000 population. RESULTS: Counties, in which NFP-LHD collaboration in local health planning was required and in which NFPs and LHDs jointly prioritized drug use, experienced a deceleration in drug-induced mortality of ~8 deaths per 100,000 population compared with the mortality rate they would have experienced without collaboration. CONCLUSIONS: Collaboration between NFPs and LHDs to address drug use was associated with a deceleration in drug-induced mortality. Policymakers can leverage community benefit regulation to encourage NFP-LHD collaboration in local health planning.


Assuntos
Hospitais , Organizações sem Fins Lucrativos , Transtornos Relacionados ao Uso de Substâncias/mortalidade , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Comportamento Cooperativo , Humanos , Governo Local , Determinação de Necessidades de Cuidados de Saúde , Patient Protection and Affordable Care Act , Saúde Pública
17.
Salud Colect ; 17: e3341, 2021 05 28.
Artigo em Espanhol | MEDLINE | ID: mdl-34105329

RESUMO

This article critically analyzes local governments' abilities to face the COVID-19 pandemic by examining an instance of technical-scientific cooperation between a municipality and a university located in the northern Rio de Janeiro (state) beginning in April 2020. This collaboration included: the implementation of a situation room, data processing and analysis for decision making and for public communication, a telemonitoring center, ongoing training with territorial healthcare teams, and an epidemiological study of COVID-19 in the municipality, among other actions. We situate our analysis within a conceptual framework that adopts a micropolitical view of concepts such as experience, pragmatism, "live work in action," and desire. The notion of "planning-doing" is deployed as an inventive form of planning that is only narrated a posteriori, as an imperative act, a live government in action that depends on the movement of desire oriented by life, and that only takes place in collective spaces of management practices and health care.


Assuntos
COVID-19/prevenção & controle , Planejamento em Saúde Comunitária/organização & administração , Colaboração Intersetorial , Governo Local , Pandemias/prevenção & controle , Universidades/organização & administração , Brasil/epidemiologia , COVID-19/epidemiologia , Pesquisa Participativa Baseada na Comunidade , Política de Saúde , Humanos
18.
Artigo em Inglês | MEDLINE | ID: mdl-34067068

RESUMO

Combined with the characteristics of the Chinese environmental regulation supervision system and evolutionary game theory, the spillover effect of local governments' investment behaviour has been incorporated into their payment function to study the influence of spillover on the strategy choice of local governments and enterprises. The results show that (1) the spillover effect is one of the reasons for distortions in the implementation of environmental regulations. Whether the influence of the spillover effect on the probability of local governments choosing the strategy of strict supervision is positive or negative depends on the environmental benefit of the local government's environmental protection investment. (2) Increasing the reward for the enterprise's complete green technology innovation behaviour is conducive to improving the probability of the enterprises choosing the strategy of complete green technology innovation, while it reduces the probability of local governments choosing the strategy of strict supervision. Increasing punishment for enterprises' incomplete green technology innovation behaviour is conducive to improving the probability of enterprises choosing the strategy of complete green technology innovation, but its impact on the probability of local governments choosing the strategy of strict supervision is uncertain due to the limitations of many factors. (3) Enterprises' emission reduction capacity is positively related to the probability of the enterprises choosing the strategy of complete green technology innovation and is negatively related to the probability of local governments choosing the strategy of strict supervision. The research conclusions provide a new explanation for the distorted enforcement of environmental regulations from the perspective of the spillover of local governments' investment behaviour.


Assuntos
Teoria do Jogo , Governo Local , China , Conservação dos Recursos Naturais , Invenções , Investimentos em Saúde
19.
Artigo em Inglês | PAHOIRIS | ID: phr-54152

RESUMO

[ABSTRACT]. Objective. Evaluate the sustainability of the Healthy Municipalities strategy in Guatemala in order to have solid evidence to support decision-making. Methods. A concurrent mixed-methods study was carried out in five phases: 1) theoretical-conceptual (based on a narrative review of the literature on sustainability, dimensions and categories were proposed for evaluation); 2) empirical (four municipalities were selected for convenience and 29 semi-structured interviews and four focus groups were conducted with key actors to explore sustainability; with this information, a score was assigned to each category and dimension); 3) analytical, by category and dimension (content analysis was performed for qualitative information, and totals and averages were calculated for quantitative information); 4) integrative (qualitative data were integrated into matrices by category and dimension, and quantitative data were supported by qualitative information); and 5) meta-inference (consideration was given to the context and its influence on the results). Results. Ninety-two (92) informants participated. In operational terms, progress was observed in the transfer and use of results, and in rotations in leadership. In the legal and political sphere, accountability and local planning were highlighted. In the economic sphere, progressive investment in health, water and sanitation was emphasized, as well as insufficient investment in social determinants of health. In the social sphere, few mechanisms were observed to promote and strengthen social participation. Conclusions. In the municipalities that participated in the study, a fair level of sustainability was observed in the Healthy Municipalities strategy.


[RESUMEN]. Objetivo. Evaluar la sostenibilidad de la estrategia Municipios Saludables en Guatemala, para disponer de evidencia sólida que permita apoyar la toma de decisiones. Métodos. Se realizó un estudio mixto concurrente en cinco fases: 1) teórica-conceptual, se realizó una revisión narrativa de literatura en sostenibilidad, con base en la cual se propusieron dimensiones y categorías para su evaluación; 2) empírica, se seleccionaron por conveniencia cuatro municipios y se realizaron 29 entrevistas semiestructuradas y cuatro grupos focales a actores clave para explorar la sostenibilidad; con esta información, se asignó un puntaje a cada categoría y dimensión; 3) analítica, por categoría y dimensión, se realizó el análisis del contenido para la información cualitativa y sumatorias y promedios para la información cuantitativa; 4) integrativa, los datos cualitativos se integraron en matrices por categoría y dimensión; y los datos cuantitativos se respaldaron con información cualitativa; y 5) metainferencia, se reflexionó sobre el contexto y su influencia en los resultados. Resultados. Participaron 92 informantes. En la dimensión operativa, se destacan avances en la transferencia y el uso de resultados, así como en el relevo de liderazgo. En la dimensión legal y política, se destacaron la rendición de cuentas y los planes locales. En la dimensión económica, se destacó la inversión progresiva en salud, agua y saneamiento, con deficiencia de inversiones en determinantes sociales de la salud. En la dimensión social, se observaron pocos mecanismos para impulsar y fortalecer la participación social. Conclusiones. En los municipios que participaron del estudio se observó un nivel regular de sostenibilidad de la estrategia Municipios Saludables.


[RESUMO]. Objetivo. Avaliar a sustentabilidade da estratégia de Municípios Saudáveis na Guatemala para dispor de evidências sólidas para apoiar o processo decisório. Métodos. Foi realizado um estudo de método misto concorrente em cinco fases: 1) fase teórica-conceitual em que foi feita a revisão narrativa da literatura em sustentabilidade a partir da qual foram propostas dimensões e categorias a serem avaliadas; 2) fase empírica em que foi feita a seleção por conveniência de quatro municípios, com 29 entrevistas semiestruturadas e quatro grupos de discussão com as principais partes interessadas para explorar a sustentabilidade; a partir das informações coletadas, foi dada uma pontuação a cada categoria e dimensão; 3) fase analítica, por categoria e dimensão, em que foi realizada a análise do conteúdo para os dados qualitativos e feito o cálculo de somatórias e médias para os dados quantitativos; 4) fase integrativa em que os dados qualitativos foram integrados em matrizes por categoria e dimensão e os dados quantitativos foram respaldados com a informação qualitativa e 5) metainferência em que foi analisado o contexto e sua influência nos resultados. Resultados. O estudo incluiu 92 participantes. Na dimensão operacional, destacam-se os avanços na transferência e no uso de resultados, bem como a ênfase em liderança. Na dimensão jurídico-política, destacam-se a prestação de contas e os planos locais. Na dimensão econômica, destaca-se o investimento progressivo em saúde, água e saneamento, com investimento inadequado nos determinantes sociais da saúde. Na dimensão social, observam-se poucos mecanismos para incentivar e reforçar a participação social. Conclusões. Foi observado nos municípios participantes do estudo um nível constante de sustentabilidade da estratégia de Municípios Saudáveis.


Assuntos
Estudo de Avaliação , Cidade Saudável , Promoção da Saúde , Governo Local , Guatemala , Estudo de Avaliação , Cidade Saudável , Promoção da Saúde , Governo Local , Estudo de Avaliação , Cidade Saudável , Promoção da Saúde , Governo Local
20.
PLoS One ; 16(6): e0252842, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34157034

RESUMO

The Yangtze River Delta urban agglomeration is the leading and demonstration area for the high-quality development of culture tourism (HDCT) in China. It is of great significance to study the spatiotemporal characteristics and impact mechanism of the HDCT for revealing the internal law of HDCT and promoting the collaborative innovation of culture tourism among cities. Based on the scientific construction of the evaluation system of HDCT, this paper made a quantitative analysis of 26 cities' HDCT by using coupling coordination degree model, Lisa spatiotemporal transition and spatial Durbin model (SDM). The results show that: The overall level of 26 cities' HDCT shows a fluctuating upward trend, and presents a "Z" pattern in space. More than 80% of the cities are at the medium and high level. Shanghai has obvious advantages in the primacy degree. There is a significant positive spatial autocorrelation among cities with high-quality of culture tourism development. The spatial clustering and proximity of the same kind are increasing, and the radiation effect is gradually obvious. The local spatial association patterns are mainly HH and LL agglomeration, and the characteristics of polarization are gradually prominent. The local spatial correlation structure of HDCT has strong stability, the transfer inertia between types is prominent, and the overall spatial evolution is lack of integration with obvious path dependence and lock-in effect. The spatiotemporal evolution of the HDCT is a complex process under the interaction of multiple factors, and there is a significant spatial spillover effect (0.256). The level of economic development, technological innovation, professional talent allocation are the three main factors. According to the dominant factor, it can be divided into economy stabilizing type, industry optimizing type, innovation driving type and traffic impacting type. These findings have implications for local governments and tourism management departments to achieve high-quality innovative development of cultural tourism.


Assuntos
Características Culturais , Desenvolvimento Econômico , Rios , Análise Espaço-Temporal , Turismo , Urbanização/tendências , China , Governo Local
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