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1.
Comput Intell Neurosci ; 2021: 3133065, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34782831

RESUMO

With the continuous development of social economy and the intensification of social competition, human resource management plays a more and more important role in the whole resource system. How to give full play to the advantages of human resources has become the key issue of human resource management evaluation. However, the current human resource management evaluation system has some problems, such as poor timeliness, one-sidedness, and subjectivity. Therefore, this paper proposes a BP image neural network optimized based on the simulated annealing algorithm to realize enterprise human resource management evaluation and image analysis. Through the learning of different time series samples, the average weight distribution scheme of main indicators is obtained, in which the average weight proportions of c 1, c 2, c 3, and c 4 are 25.5%, 24.8%, 17.9%, and 31.9%, respectively. In the comprehensive evaluation of enterprise employees, the error between the actual output and expected output is less than 4.5%. The results show that the BP image neural network based on simulated annealing algorithm has high accuracy in the image analysis and evaluation of enterprise human resource management. The output analysis results meet the actual needs of the enterprise and the personal development of employees and provide a decision-making scheme for the evaluation of enterprise human resource management.


Assuntos
Algoritmos , Redes Neurais de Computação , Humanos , Processamento de Imagem Assistida por Computador , Recursos Humanos
2.
Comput Intell Neurosci ; 2021: 7149631, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34733325

RESUMO

The rationalization of human resource management is helpful for enterprises to efficiently train talents in the field, improve the management mode, and increase the overall resource utilization rate of enterprises. The current computational models applied in the field of human resources are usually based on statistical computation, which can no longer meet the processing needs of massive data and do not take into account the hidden characteristics of data, which can easily lead to the problem of information scarcity. The paper combines recurrent convolutional neural network and traditional human resource allocation algorithm and designs a double recurrent neural network job matching recommendation algorithm applicable to the human resource field, which can improve the traditional algorithm data training quality problem. In the experimental part of the algorithm, the arithmetic F1 value in the paper is 0.823, which is 20.1% and 7.4% higher than the other two algorithms, respectively, indicating that the algorithm can improve the hidden layer features of the data and then improve the training quality of the data and improve the job matching and recommendation accuracy.


Assuntos
Algoritmos , Redes Neurais de Computação , Simulação por Computador , Humanos , Alocação de Recursos , Recursos Humanos
3.
F1000Res ; 10: 87, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34631013

RESUMO

Background: Multiple long-term care (LTC) reports have issued similar recommendations for improvement across Canadian LTC homes. Our primary objective was to identify the most common recommendations made over the past 10 years. Our secondary objective was to estimate the total cost of studying LTC issues repeatedly from 1998 to 2020. Methods: The qualitative and cost analyses were conducted in Canada from July to October 2020. Using a list of reports, inquiries and commissions from The Royal Society of Canada Working Group on Long-Term Care, we coded recurrent recommendations in LTC reports. We contacted the sponsoring organizations for a cost estimate, including direct and indirect costs. All costs were adjusted to 2020 Canadian dollar values. Results: Of the 80 Canadian LTC reports spanning the years of 1998 to 2020, 24 (30%) were based on a national level and 56 (70%) were focused on provinces or municipalities. Report length ranged from 4 to 1491 pages and the median number of contributors was 14 (interquartile range, IQR, 5-26) per report. The most common recommendation was to increase funding to LTC to improve staffing, direct care and capacity (67% of reports). A median of 8 (IQR 3.25-18) recommendations were made per report. The total cost for all 80 reports was estimated to be $23,626,442.78. Conclusions: Problems in Canadian LTC homes and their solutions have been known for decades. Despite this, governments and non-governmental agencies continue to produce more reports at a monetary and societal cost to Canadians.


Assuntos
Assistência de Longa Duração , Canadá , Custos e Análise de Custo , Humanos , Recursos Humanos
4.
Health Res Policy Syst ; 19(Suppl 3): 107, 2021 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-34641893

RESUMO

BACKGROUND: This is the fourth of our 11-paper supplement on "Community Health Workers at the Dawn of New Era". Here, we first make the case for investing in health programmes, second for investing in human resources for health, third for investing in primary healthcare (PHC) workers, and finally for investing in community health workers (CHWs). METHODS: Searches of peer-reviewed journals and the grey literature were conducted with a focus on community health programme financing. The literature search was supplemented with a search of the grey literature for information about national health sector plans, community health strategies/policies, and costing information from databases of various countries' ministries of health, and finally a request for information from in-country partners. RESULTS: The global shortage of human resources for health is projected to rise to 18 million health workers by 2030, with more acute shortages in Africa and South Asia. CHWs have an important role to play in mitigating this shortage because of their effectiveness (when properly trained and supported) and the feasibility of their deployment. Data are limited on the costs of current CHW programmes and how they compare to government and donor expenditures for PHC and for health services more broadly. However, available data from 10 countries in Africa indicate that the median per capita cost of CHW programmes is US$ 4.77 per year and US$ 2574 per CHW, and the median monthly salary of CHWs in these same countries is US$ 35 per month. For a subset of these countries for which spending for PHC is available, governments and donors spend 7.7 times more on PHC than on CHW programming, and 15.4 times more on all health expenditures. Even though donor funding for CHW programmes is a tiny portion of health-related donor support, most countries rely on donor support for financing their CHW programmes. CONCLUSION: The financing of national CHW programmes has been a critical element that has not received sufficient emphasis in the academic literature on CHW programmes. Increasing domestic government funding for CHW programmes is a priority. In order to ensure growth in funding for CHW programmes, it will be important to measure CHW programme expenditures and their relationship to expenditures for PHC and for all health-related expenditures.


Assuntos
Agentes Comunitários de Saúde , Atenção Primária à Saúde , Política de Saúde , Promoção da Saúde , Humanos , Recursos Humanos
5.
Front Public Health ; 9: 634548, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34621714

RESUMO

Background: The undergraduate program in Public Health of Saint Catherine University is the second most popular major of the institution, drawing students from diverse racial, economic, cultural, and educational backgrounds. This has presented significant opportunities and challenges with regard to providing students and faculty with the needed academic and professional development to ensure graduates embody the skills needed for Public Health workforce of today. The objective of this study was to identify potential structured institutional supports to graduate Public Health professionals from diverse communities to advance health equity. A secondary objective was to determine whether the needed supports for Public Health students might differ from peers in other health programs, specifically Nursing. Methods: Using a mixed methods approach and a convenience sample, data were gathered from Public Health students, nursing students, faculty, and staff from November 2019 through July 2020. The survey assessed stress, grit, and demographic factors. Focus group topics included: academic resilience and professionalism, supports and gaps in the current institutional structure with respect to mitigating student stressors, and opportunities for programmatic solutions. Results: In total, 53 Public Health and 32 in Nursing students completed the survey. Nursing students tended to be farther along in their undergraduate careers, less likely to have failed a class, and more likely to have recently been laid off from a job. Public Health students reported more support from parents, but less support from friends and classmates than their Nursing peers. Most Nursing and Public Health students reported unmanaged stress, and similar average grit scores (3.51 vs. 3.41, p = 0.43), respectively. In focus groups, students described a series of stressors including working full time while attending school, family expectations, difficulty with time management, and learning how to acclimate to college norms. University staff and faculty identified financial pressures as a primary student stressor in addition to complex lives including managing family crises. Conclusions: Study findings are being used to identify or adapt professional development supports in undergraduate Public Health programs. Through supporting a diverse undergraduate student population in Public Health, a future workforce from communities most impacted by health disparities will emerge.


Assuntos
Profissionalismo , Estudantes de Enfermagem , Criança , Grupos Focais , Humanos , Universidades , Recursos Humanos
6.
Yi Chuan ; 43(10): 980-987, 2021 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-34702710

RESUMO

In the era of big data and precision medicine, large population cohort studies are one of the preferred designs for studying the etiology of chronic diseases, and cohort genetic resources have become important strategic resources of China. Promoting the standardized construction and utilization of cohort genetic resources can effectively promote the original innovation of research and technological development in the field of biomedicine, and make full use of the rich genetic resources of China. To provide a reference for the construction and utilization of genetic resources in the cohort research in China, we took the Taizhou Longitudinal Study (TZL) as an example and introduced the principles, methods, standard system, and practical experience of the collection, preservation, and shared utilization of genetic resources in the process of the cohort construction.


Assuntos
Genética Humana , China , Estudos de Coortes , Humanos , Estudos Longitudinais , Recursos Humanos
7.
Artigo em Inglês | MEDLINE | ID: mdl-34682698

RESUMO

An eco-friendly environment with green strategies can help to achieve better environmental performance. However, literature on the relationship between green human resource management practices (GHRMP) and sustainable environmental efficiency (SEF) is limited. Moreover, there is limited knowledge about the factors that could mediate the relationship between GHRMP and SEF. Therefore, the present study examines the impact of green human resource management practices mediating through green psychological climate (GPC) and green organizational culture (GOC) for better environmental efficacy. For this purpose, the primary data on variables are collected by using structured assessment tools and analyzed through regression models. Unlike previous studies, this study adopts a mediation model and unfolds not only the role of green human resource practices in psychological climate and green organizational culture but also clarifies the mediating role of GPC and GOC in sustainable environmental efficiency. The findings unfolded that ecological factors such as green psychological climate, green organizational culture, and sustainable environmental efficiency are positively affected by green human resources management. In addition, green organizational culture and green psychological climate positively mediate the relationship between GHRMP and SEF. This study recommends adopting green human resource management strategies and increasing technical innovations to improve sustainability and economic performance.


Assuntos
Cultura Organizacional , Administração de Recursos Humanos , Conservação dos Recursos Naturais , Eficiência , Humanos , Recursos Humanos
8.
BMC Med ; 19(1): 251, 2021 10 26.
Artigo em Inglês | MEDLINE | ID: mdl-34696781

RESUMO

BACKGROUND: Adaptive designs offer great promise in improving the efficiency and patient-benefit of clinical trials. An important barrier to further increased use is a lack of understanding about which additional resources are required to conduct a high-quality adaptive clinical trial, compared to a traditional fixed design. The Costing Adaptive Trials (CAT) project investigated which additional resources may be required to support adaptive trials. METHODS: We conducted a mock costing exercise amongst seven Clinical Trials Units (CTUs) in the UK. Five scenarios were developed, derived from funded clinical trials, where a non-adaptive version and an adaptive version were described. Each scenario represented a different type of adaptive design. CTU staff were asked to provide the costs and staff time they estimated would be needed to support the trial, categorised into specified areas (e.g. statistics, data management, trial management). This was calculated separately for the non-adaptive and adaptive version of the trial, allowing paired comparisons. Interviews with 10 CTU staff who had completed the costing exercise were conducted by qualitative researchers to explore reasons for similarities and differences. RESULTS: Estimated resources associated with conducting an adaptive trial were always (moderately) higher than for the non-adaptive equivalent. The median increase was between 2 and 4% for all scenarios, except for sample size re-estimation which was 26.5% (as the adaptive design could lead to a lengthened study period). The highest increase was for statistical staff, with lower increases for data management and trial management staff. The percentage increase in resources varied across different CTUs. The interviews identified possible explanations for differences, including (1) experience in adaptive trials, (2) the complexity of the non-adaptive and adaptive design, and (3) the extent of non-trial specific core infrastructure funding the CTU had. CONCLUSIONS: This work sheds light on additional resources required to adequately support a high-quality adaptive trial. The percentage increase in costs for supporting an adaptive trial was generally modest and should not be a barrier to adaptive designs being cost-effective to use in practice. Informed by the results of this research, guidance for investigators and funders will be developed on appropriately resourcing adaptive trials.


Assuntos
Projetos de Pesquisa , Pesquisadores , Análise Custo-Benefício , Humanos , Recursos Humanos
9.
Oncol Nurs Forum ; 48(6): 604-612, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34673761

RESUMO

PURPOSE: The Oncology Nursing Society (ONS) tasked a rapid response research team (RRRT) to develop priorities to increase diversity, equity, and inclusivity in oncology clinical care and workforce development. METHODS: An RRRT of experts in health disparities conducted a rapid review of the literature, consulted with oncology nurse leaders and disparities researchers, and reviewed priorities from funding agencies. RESULTS: Significant gaps in the current oncology disparities literature were identified and used to inform priority areas for future research practice and workforce development in oncology nursing. SYNTHESIS: This is the second article in a two-part series that presents findings on structural racism and health inequities in oncology nursing. In the first article, three priority areas for oncology nursing research were presented. In this article, strategies to improve diversity, equity, and inclusivity in clinical practice and the oncology workforce are described. IMPLICATIONS FOR RESEARCH: Recommendations are presented to inform research, clinical, administrative, and academic oncology nursing settings on increasing diversity, equity, and inclusivity and deconstructing structural racism.


Assuntos
Pesquisa em Enfermagem , Enfermagem Oncológica , Acesso aos Serviços de Saúde , Humanos , Sociedades de Enfermagem , Recursos Humanos
10.
BMJ Open ; 11(10): e049134, 2021 10 04.
Artigo em Inglês | MEDLINE | ID: mdl-34607860

RESUMO

OBJECTIVE: Early in the COVID-19 pandemic, US Veterans Health Administration (VHA) employee occupational health (EOH) providers were tasked with assuming a central role in coordinating employee COVID-19 screening and clearance for duty, representing entirely novel EOH responsibilities. In a rapid qualitative needs assessment, we aimed to identify learnings from the field to support the vastly expanding role of EOH providers in a national healthcare system. METHODS: We employed rapid qualitative analysis of key informant interviews in a maximal variation sample on the parameters of job type, rural versus urban and provider gender. We interviewed 21 VHA EOH providers between July and December 2020. This sample represents 15 facilities from diverse regions of the USA (large, medium and small facilities in the Mid-Atlantic; medium sites in the South; large facilities in the West and Pacific Northwest). RESULTS: Five interdependent needs included: (1) infrastructure to support employee population management, including tools that facilitate infection control measures such as contact tracing (eg, employee-facing electronic health records and coordinated databases); (2) mechanisms for information sharing across settings (eg, VHA listserv), especially for changing policy and protocols; (3) sufficiently resourced staffing using detailing to align EOH needs with human resource capital; (4) connected and resourced local and national leaders; and (5) strategies to support healthcare worker mental health.Our identified facilitators for EOH assuming new challenging and dynamically changing roles during COVID-19 included: (A) training or access to expertise; (B) existing mechanisms for information sharing; (C) flexible and responsive staffing; and (D) leveraging other institutional expertise not previously affiliated with EOH (eg, chaplains to support bereavement). CONCLUSIONS: Our needs assessment highlights local and system level barriers and facilitators of EOH assuming expanded roles during COVID-19. Integrating changes both within and across systems and with alignment of human capital will enable EOH preparedness for future challenges.


Assuntos
COVID-19 , Saúde do Trabalhador , Pessoal de Saúde , Humanos , Determinação de Necessidades de Cuidados de Saúde , Pandemias , SARS-CoV-2 , Saúde dos Veteranos , Recursos Humanos
11.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 52(5): 783-788, 2021 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-34622593

RESUMO

Objective: To understand the basic public health service (BPHS) tasks and workload of the township hospitals in Sichuan Province and to provide empirical evidence for improving the allocation of human resources (HR) and the quality of BPHS in township hospitals. Methods: Retrospective survey was conducted to collect information regarding the actual working hours per unit time of service of BPHS. Information on the service volume and unit service time of BPHS tasks for 2018 was collected in 7 township hospitals in an economically developed area and an area of moderate economic development. Estimated HR required to cover the BPHS tasks was calculated based on the survey data of actual work time. Results: The time required for the basic units of various BPHS tasks varied greatly. The top four most time-consuming services showing consistent results in the the two regions were health education, health supervision and coordination, management of children aged 0-6 and maternal care management. Institutions in the area of moderate economic development reported higher per capita service volume in the registration of children for vaccination, management of hypertension, and health supervision and coordination than those in the economically developed area, but lower service volume for other services. There is a shortage of full-time staffs in both areas. Conclusion: Differences in the service volume of BPHS exist in regions of different levels of economic development. The shortage in HR could be related to the lower quality and volume of the service. Comprehensive exploration of policies to recruit and retain competent personnel, the strengthening of grassroots professional training, and optimization of information technology will help improve the competence and quality of grassroots services.


Assuntos
Hospitais , Saúde Pública , Recursos Humanos , Carga de Trabalho , Criança , China , Humanos , Estudos Retrospectivos
12.
BMJ Open ; 11(10): e047348, 2021 10 27.
Artigo em Inglês | MEDLINE | ID: mdl-34706946

RESUMO

OBJECTIVES: Given the increased ageing population and frequent epidemic challenges, it is vital to have the nurse workforce of sufficient quantity and quality. This study aimed to demonstrate the trends, composition and distribution of nurse workforce in China. DESIGN: Secondary analysis using national public datasets in China from 2003 to 2018. SETTING/PARTICIPANTS: National population, nurse workforce and physician workforce. PRIMARY AND SECONDARY OUTCOME MEASURES: Frequency and proportion were used to demonstrate: (1) the longitudinal growth of nurse workforce; (2) the diversity of nurse workforce in gender, age, work experience and education level; and (3) the distribution of nurse workforce among provinces, rural-urban areas and hospital/community settings. The Gini coefficient and Theil L index were used to measure the inequality trends of nurse workforce. RESULTS: The total number of nurses increased from 1.3 million to 4.1 million and the density increased from 1 to 2.94 per 1000 population over 2003-2018. The nurses to physician ratio changed from 0.65:1 to 1.14:1. The majority of the nurse workforce was female, under 35 years old, with less than 30 years of work experience, with an associate's degree and employed within hospitals. Central and eastern regions had more nurses and there were 5.08 nurses per 1000 population in urban areas while less than two in rural areas in 2018. The Gini coefficient and between-provincial Theil index experienced a consistent decline. Within-province inequality accounted for overall inequality has risen from 52.38% in 2010 to 71.43% in 2018 suggested that the differences of distribution are mainly reflected in urban and rural areas. CONCLUSION: Chinese nurse workforce has been changed significantly in the past 15 years that may be associated with the reformations of policy, nursing education in China. Our study suggests current features in the nurse workforce and can be used to strengthen future health services.


Assuntos
Médicos , População Rural , Adulto , China , Feminino , Hospitais , Humanos , Recursos Humanos
13.
Artigo em Inglês | MEDLINE | ID: mdl-34501853

RESUMO

Health services quality and sustainability rely mainly on a qualified workforce. Adequately trained public health personnel protect and promote health, avert health disparities, and allow rapid response to health emergencies. Evaluations of the healthcare workforce typically focus on physicians and nurses in curative medical venues. Few have evaluated public health workforce capacity building or sought to identify gaps between the academic training of public health employees and the needs of the healthcare organizations in which they are employed. This project report describes the conceptual framework of "Sharing European Educational Experience in Public Health for Israel (SEEEPHI): harmonization, employability, leadership, and outreach"-a multinational Erasmus+ Capacity Building in Higher Education funded project. By sharing European educational experience and knowledge, the project aims to enhance professionalism and strengthen leadership aspects of the public health workforce in Israel to meet the needs of employers and the country. The project's work packages, each jointly led by an Israeli and European institution, include field qualification analysis, mapping public health academic training programs, workforce adaptation, and building leadership capacity. In the era of global health changes, it is crucial to assess the capacity building of a well-qualified and competent workforce that enables providing good health services, reaching out to minorities, preventing health inequalities, and confronting emerging health challenges. We anticipate that the methods developed and the lessons learned within the Israeli context will be adaptable and adoptable by other countries through local and cultural adjustments.


Assuntos
Mão de Obra em Saúde , Saúde Pública , Fortalecimento Institucional , Promoção da Saúde , Humanos , Saúde Pública/educação , Recursos Humanos
14.
Curr Opin Organ Transplant ; 26(5): 560-566, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34524181

RESUMO

PURPOSE OF REVIEW: This review explores trends in the United States (US) transplant surgery workforce with a focus on historical demographics, post-fellowship job market, and quality of life reported by transplant surgeons. Ongoing efforts to improve women and racial/ethnic minority representation in transplant surgery are highlighted. Future directions to create a transplant workforce that reflects the diversity of the US population are discussed. RECENT FINDINGS: Representation of women and racial and ethnic minorities among transplant surgeons is minimal. Although recent data shows an improvement in the number of Black transplant surgeons from 2% to 5.5% and an increase in women to 12%, the White to Non-White transplant workforce ratio has increased 35% from 2000 to 2013. Transplant surgeons report an average of 4.3 call nights per week and less than five leisure days a month. Transplant ranks 1st among surgical sub-specialties in the prevalence of three well-studied facets of burnout. Concerns about lifestyle may contribute to the decreasing demand for advanced training in abdominal transplantation by US graduates. SUMMARY: Minimal improvements have been made in transplant surgery workforce diversity. Sustained and intentional recruitment and promotion efforts are needed to improve the representation of women and minority physicians and advanced practice providers in the field.


Assuntos
Grupos Étnicos , Qualidade de Vida , Feminino , Humanos , Grupos Minoritários , Estados Unidos/epidemiologia , Recursos Humanos
16.
Artigo em Inglês | MEDLINE | ID: mdl-34501912

RESUMO

The COVID-19 pandemic in Germany has demanded a substantially larger public health workforce to perform contact tracing and contact management of COVID-19 cases, in line with recommendations of the World Health Organization (WHO). In response, the Robert Koch Institute (RKI) established the national "Containment Scout Initiative" (CSI) to support the local health authorities with a short-term workforce solution. It is part of a range of measures for strengthening the public health system in order to limit the spread of SARS-CoV-2 in Germany. The CSI is an example of how solutions to address critical health system capacity issues can be implemented quickly. It also demonstrates that medical or health-related backgrounds may not be necessary to support health authorities with pandemic-specific tasks and fulfil accurate contact tracing. However, it is a short-term solution and cannot compensate for the lack of existing qualified staff as well as other deficits that exist within the public health sector in Germany. This article describes the structure and process of the first phase of this initiative in order to support health policymakers, public health practitioners, and researchers considering innovative and flexible approaches for addressing urgent workforce capacity issues.


Assuntos
COVID-19 , Pandemias , Busca de Comunicante , Alemanha/epidemiologia , Mão de Obra em Saúde , Humanos , Saúde Pública , SARS-CoV-2 , Recursos Humanos
18.
Nurs Adm Q ; 45(4): 311-323, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34469389

RESUMO

The promotion of diversity, equity, and inclusion (DEI) in nursing is a topic of renewed importance, given the civil unrest following the death of George Floyd and identified disparities in health and health outcomes during the COVID-19 pandemic. Despite its progress, the nursing profession continues to struggle with recruiting and retaining a workforce that represents the cultural diversity of the patient population. The authors completed a review of the literature on DEI in nursing and found a scarcity of studies, and that a limitation exists due to the strength of the evidence examined. This article aims to provide a review of the literature on DEI in nursing, outcomes and strategies associated with organizational DEI efforts, and knowledge on how the American Nurses Credentialing Center Pathway to Excellence® Designation Program framework supports DEI initiatives. The authors further provided recommendations for nurse leaders and a checklist of proposed questions for assessing commitment, culture, and structural empowerment initiatives toward a more diverse, equitable, and inclusive organization.


Assuntos
Diversidade Cultural , Equidade em Saúde , Liderança , Enfermagem/normas , Inclusão Social , COVID-19/epidemiologia , Empoderamento , Humanos , Cultura Organizacional , Pandemias , Racismo/prevenção & controle , SARS-CoV-2 , Recursos Humanos/organização & administração
19.
PLoS One ; 16(9): e0257612, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34547050

RESUMO

BACKGROUND: The progress of green credit in China is accelerating, but its development is uneven and insufficient in different regions. And whether the issuance of green credit can effectively promote the improvement of the environment and economy is not well understood. OBJECTIVE: Previous research has found that green credit promotes economic growth through improvement of the industrial structure and green technological innovation. However, these studies have not considered the positive externality of environmental improvement even though environmental improvement and economic growth are requirements of the sustainable development concept. METHODS: We use the chain-mediated model to estimate the impact of green credit issuance on the economic growth of different provinces since the large-scale implementation of green credit in China with data from 2008 to 2016. RESULTS AND CONCLUSION: This paper shows that the issuance of green credit can improve labor supply rather than labor productivity through the improvement of air quality to achieve regional economic growth. Such a chain-mediated path is different from the economic growth caused by industrial structural adjustment and green technology innovation. At the national level, every 1% increase in green credit issuance relative to industrial loans will increase the per capita gross domestic product (GDP) by approximately 4.6 yuan, or 0.012%, through air quality and labor supply, accounting for 2.875% of the total effect. Heterogeneity analysis indicates that due to regional industrial structure differences and diminishing marginal effects, the impact of green credit is stronger in the western region than in the eastern and central regions. For every 1% increase in the proportion of green credit issuance relative to industrial loans, the per capita GDP growth achieved through the chain-mediated path is approximately 30.17 yuan in the western region, approximately 6.6 times greater than that at the national level. Within a 95% confidence interval of 5000 bootstrap samples, this path is found to be true, and the chain-mediated effect accounts for approximately 12.96% of the total indirect effect. LIMITATIONS: The limitation of this paper is the measurement of green credit. Although green credit has a large volume, it remains underdeveloped, and there is a lack of perfect indicators. Most existing studies have adopted only alternative or reverse indicators to measure the issuance of green credit. For example, this paper takes the interest expenditure of six high-energy-consuming enterprises as the reverse indicator, which may to a certain extent lead to the overestimation of the issuance of green credit and its impact on the environment and economy. Future research can accurately explore the performance of green credit on the basis of its mature development.


Assuntos
Desenvolvimento Econômico , Recursos Humanos/estatística & dados numéricos , China , Produto Interno Bruto , Modelos Teóricos
20.
Iowa Orthop J ; 41(1): 25-31, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34552400

RESUMO

Background: Sixty million rural residents have limited access to orthopedic care due to a small rural orthopedic surgery workforce. Increases in specialized training add to the challenge of attracting orthopedic surgeons to rural communities. Answering the call for research on models to meet the needs of rural orthopedic patients, we examine long-term trends in visiting consultant clinics (VCCs) in Iowa, a state with a large rural population. Methods: The Office of Statewide Clinical Education Programs (Carver College of Medicine) compiles an annual report of outreach clinic locations, frequencies and participating physicians. Trends in the total number of VCCs, days and locations (1989-2018) were analysed using joinpoint analysis. Results: Total clinic days grew rapidly from 1992-1997 (Average Percent Change: 19.7%) before a decline ending in 2009 (APC: -4.1%). A new growth period (2009-2013, APC: 7.5%) preceded another decline (APC: -3.6%) ending in 2018. The number of cities hosting a VCC grew from 56 (1989) to a peak of 90 (1999) and fell an average of 0.9% a year thereafter. More than 80% of all VCCs in the last ten years were offered 2 or more times per month. The average participation rate for Iowa-based orthopedic surgeons was 44%. The mean number of VCCs staffed by a single physician was 1.32 (std. dev. = 0.53) with a median of 1. The average number of VCC days per month for a participating physician was 3.22 (std. dev. = 2.41) with a median of 2.66. Conclusion: The VCC model of rural outreach is sustainable (30+ year history) and self-funded. Most clinics occur with sufficient frequency to allow timely follow-up care. This model of rural outreach is supported by the participation of a large segment (44%) of Iowa's orthopedic surgeons. Visiting orthopedic surgeons provide access to care in 65 of the 76 Critical Access Hospitals in Iowa offering orthopedic services compared to 8 staffed by a local orthopedic surgeon.Level of Evidence: V.


Assuntos
Cirurgiões Ortopédicos , População Rural , Instituições de Assistência Ambulatorial , Acesso aos Serviços de Saúde , Humanos , Recursos Humanos
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