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1.
Health Res Policy Syst ; 22(1): 25, 2024 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-38360665

RESUMO

BACKGROUND: Government purchase of social forces to participate in old age care services can release the burden of social care. Current research on performance evaluation in this field mainly focussed on the establishment of appropriate evaluation indices. However, discussion on the policy implementation deviation is scarce. This study aimed to evaluate the performance of China's local government purchase of old age care services, analyse the characteristics of related policies and explore their deviation. METHODS: The persons who participated in the Training of the Trainer (ToT) organized by the Red Cross Society were enrolled. The policy documents were obtained from the official websites. The K-means cluster was used to determine the project performance grades. We compared the project performance grades between service objects and undertakers with different characteristics utilizing the non-parametric test. Based on the framework of 'Collaborative Participation - Project Performance Objective', we analysed the content of relevant policy aiding by NVivo 12. RESULTS: Data of project performance were collected from 306 participants. The standardized mean score of the efficiency dimension was the lowest (0.70 ± 0.24). The projects were divided into four grades: poor (17.0%), average (27.5%), good (12.4%) and excellent (43.1%). There were statistically significant differences in project performance grades only between advanced ageing groups (Z = 2.429, P = 0.015). As well, the policy also mentioned that the services focus should be tilted towards the oldest old. The purchasers mainly involved the Ministry of Civil Affairs and Health management departments in the policy. Respite services were less mentioned in the responsibilities of the undertakers. The requirement for efficiency and effectiveness was mentioned in less than half of the policy documents. CONCLUSION: Policy attention is needed for the responsibilities and functions of the intermediate purchasing force, as well as more precise directions and responsibilities of undertakers. The purchasers and undertakers should improve management abilities and capacity of old age care services and focus on associated factors to achieve the best marginal benefit. In addition, the embedded performance evaluation needs to be updated periodically to bridge the deviation between policy implementation and policy formulation.


Assuntos
Governo Local , Formulação de Políticas , Humanos , Idoso de 80 Anos ou mais , Políticas , China
2.
BMC Health Serv Res ; 24(1): 81, 2024 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-38229095

RESUMO

BACKGROUND: Improvement and access to quality healthcare are a global agenda. Sustainable Development Goal (SDG-3) is committed to ensuring good health and well-being of the people by 2030. However, this commitment heavily depends on joint efforts by local authorities and the immediate service providers to communities. This paper is set to inform the status of health service provision in local authorities in Tanzania using the determinants for quality health services in Dodoma City and Bahi District. METHODS: A cross-sectional research design was employed to collect data from 400 households in the Local Government Authorities. The five-service quality (SERVQUAL) dimensions of Parasuraman were adopted to gauge the quality of service in public healthcare facilities. Descriptive statistics were used to compute the frequency and mean of the demographic information and the quality of health services, respectively. A binary logistic regression model was used to establish the influence of the demographic dimensions on the quality of health services. FINDINGS: The findings revealed that quality health services have not been realised for healthcare seekers. Further, the area of residence, education, and occupation are significantly associated with the perceived quality of health service delivery in the Local Government Authorities. CONCLUSION: The healthcare facilities under the LGAs offer services whose quality is below the healthcare seekers' expectations. The study recommends that the Local Government Authorities in Tanzania strengthen the monitoring and evaluation of health service delivery in public healthcare facilities.


Assuntos
Atenção à Saúde , Governo Local , Humanos , Tanzânia , Estudos Transversais , Serviços de Saúde
3.
J Occup Health ; 66(1)2024 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-38258943

RESUMO

OBJECTIVES: Presenteeism is a critical issue in occupational health. This study aimed to examine the association between presenteeism and subjective sleep quality, smoking status, and alcohol consumption. METHODS: Anonymous data of 777 workers in a Japanese city were retrospectively obtained from City Government Office A. They included variables like absolute presenteeism scores (measured using the Japanese version of the World Health Organization Health and Work Performance Questionnaire short form), gender, age, family status, subjective sleep quality, smoking status, and alcohol consumption. A binary logistic regression analysis was performed with gender, age, family status, subjective sleep quality, smoking status, and alcohol consumption as the independent variables, and absolute presenteeism scores equal to or below 40 as the dependent variable. A gender-stratified binary logistic regression analysis was also performed. RESULTS: The logistic regression analysis results revealed that absolute presenteeism was positively associated with poor subjective sleep quality among all respondents (odds ratio [OR], 1.70; 95% CI, 1.18-2.44) and men (OR, 1.85; 95% CI, 1.12-3.05) and with current drinkers among women (OR, 3.49; 95% CI, 1.36-8.92); it was negatively associated with age among those who were ≥50 years old (OR, 0.50; 95% CI, 0.27-0.93) and with current drinkers among men (OR, 0.43; 95% CI, 0.20-0.92). CONCLUSIONS: The factors associated with presenteeism differed between men and women office workers, suggesting that gender differences need to be considered when working toward improving workers' productivity.


Assuntos
Governo Local , Presenteísmo , Masculino , Humanos , Feminino , Pessoa de Meia-Idade , Estudos Transversais , Estudos Retrospectivos , Estilo de Vida
4.
Sci Rep ; 14(1): 1901, 2024 01 22.
Artigo em Inglês | MEDLINE | ID: mdl-38253624

RESUMO

To motivate contributions to public goods, should policy makers employ financial incentives like taxes, fines, subsidies, and rewards? While these are widely considered as the classic policy approach, a substantial academic literature suggests the impact of financial incentives is not always positive; they can sometimes fail or even backfire. To test whether policy makers are overly bullish about financial incentives, we asked county heads, mayors, and municipal government representatives of medium-to-large towns in Germany to predict the effects of a financial incentive on COVID-19 vaccination, and tested the exact same incentive in a field experiment involving all 41,548 inhabitants (clustered in 10,032 addresses) of the German town of Ravensburg. Whereas policy makers overwhelmingly predict that the financial incentive will increase vaccination-by 15.3 percentage points on average-the same financial incentive yielded a precisely estimated null effect on vaccination. We discuss when financial incentives are most likely to fail, and conclude that it is critical to educate policy makers on the potential pitfalls of employing financial incentives to promote contributions to public goods.


Assuntos
Pessoal Administrativo , Vacinas contra COVID-19 , Humanos , Alemanha , Governo Local , Políticas
5.
PLoS One ; 19(1): e0294849, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38261593

RESUMO

The San Pablo community in El Triunfo, Ecuador, is emerging as a promising community-based tourism destination. Despite its potential, the lack of knowledge about self-organization and its implementation has hindered effective tourism management. To address this challenge, a participatory approach was employed, involving the community and key stakeholders, such as the local government of El Triunfo. Through the utilization of Design Thinking and both online and in-person interviews, it was identified that an organizational structure based on networks and a culture of self-organization can drive local tourism. These aspects were incorporated into a Design Thinking-guided process, contributing to the understanding of how to forge an appropriate organizational framework for the community. Furthermore, this study aims for broader impact. The goal is not only to strengthen tourism in San Pablo, but also to inform the management of strategies and policies in other entities. The findings offer valuable insights to similar communities in Ecuador and the region. Collectively, this research enhances the comprehension of community-based tourism and proposes practical solutions for optimizing its management in emerging contexts.


Assuntos
Conhecimento , Turismo , Humanos , Equador , Governo Local , Poder Psicológico
6.
PLoS One ; 19(1): e0297360, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38271451

RESUMO

The rapid advancement and widespread implementation of digital technology have created opportunities for the e-commerce transformation of agricultural wholesale markets. The building of e-commerce platforms in this process is of utmost importance and should be approached methodically. This article analyzes the interests and behavioral choices of the agricultural wholesale markets, local government, and wholesalers by establishing a tripartite evolutionary game model. It applies replicator dynamics equations to describe the evolutionary strategies of each party. The findings of the study indicate that the behavioral choices of agricultural wholesale markets, local government, and wholesalers are influenced by their initial intentions. Furthermore, there exists a degree of alignment between the choices made by agricultural wholesale markets and wholesalers. The building of e-commerce platforms by agricultural wholesale markets can be facilitated through direct and indirect government subsidies; this also motivates wholesalers to adopt and utilize these platforms. Agricultural wholesale markets may further incentivize wholesalers to utilize their own e-commerce platforms by offering additional benefits. On the other hand, if the agricultural wholesale markets demonstrate strong initial inclinations toward using third-party e-commerce platforms. In this scenario, the local government has the potential to promote the widespread use of these platforms by providing both direct and indirect financial incentives to these markets, as well as actively encouraging wholesalers to participate in them. This study presents policy recommendations for agricultural wholesale markets and local government to support the effective implementation of e-commerce platforms in the agricultural wholesaler markets and facilitate a smooth transition to e-commerce in agricultural wholesale markets.


Assuntos
Agricultura , Comércio , Governo Local
7.
J Public Health Manag Pract ; 30(1): 66-71, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37831629

RESUMO

Indiana was one of the earliest states to conduct a comprehensive public health workforce assessment in preparation for the use of federal funds for infrastructure strengthening. Experiences from this assessment provide insights that may be useful to other public health agencies and partners. This brief summarizes key lessons and highlights opportunities for improved workforce assessments. For example, the lack of standardized job titles within local health departments (LHDs) can be mitigated by collecting the top 3 job tasks employees engage in daily and reassigning standardized titles based on nationally collected workforce data. This facilitates comparisons across LHD employees nationally. In addition, many employees felt their job tasks did not align well with the Foundational Public Health Services (FPHS) areas and capabilities, which contributed to the likely overestimation of effort. Further consideration of how to better align and/or integrate FPHS assessment within current practice is needed in addition to improved ways of assessing efforts toward FPHS.


Assuntos
Mão de Obra em Saúde , Saúde Pública , Humanos , Inquéritos e Questionários , Recursos Humanos , Indiana , Governo Local
8.
Environ Sci Pollut Res Int ; 31(3): 4864-4880, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38105333

RESUMO

The traditional view is that local governments are inclined to ease environmental regulations in response to fiscal pressure (FP) and alleviate FP by sacrificing the environment for economic development (ED). This paper takes Chinese Mainland resource-based cities (RBC) as the research sample but draws different conclusions. The research results are as follows: firstly, for RBC, although FP reduces environmental pollution (EP), it is not conducive to ED. Compared with non-resource-based cities (NRBC), the economic negative effect of FP in RBC is more obvious. Secondly, FP is detrimental to ED by reducing EP, and RBC have not sacrificed the environment to promote ED in the context of FP. This paper summarizes that the development path of RBC should be "optimizing government behavior → increasing FP → improving environmental quality → reducing ED level." Thirdly, the impact of FP on cities with slower economic growth and smaller economic gap is greater, and the impact of FP on cities with better environment is more obvious. This paper argues that facing FP, RBC in China will not trade EP for ED; at the same time, we suggest RBC in other countries in the face of the FP, not only thinking of promoting ED at the expense of the EP and ease the FP, but also the development of green ecological requirement, overall consideration of the relationship between EP and ED, and then achieve green and sustainable ED without degrading the environment as far as possible.


Assuntos
Desenvolvimento Econômico , Poluição Ambiental , Cidades , China , Governo Local
9.
Environ Sci Pollut Res Int ; 31(5): 6977-6991, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38157173

RESUMO

Currently, waste management classification is a critical topic that concerns not only environmental protection, but also the advancement of a circular economy. To address this issue within the context of a circular economy, this study develops an uncooperative triumvirate paradigm consisting of "central regulation, local promotion, and universal participation." The model analyzes the strategy choices of both the central and local governments while using an evolutionary game method to encourage residents to promote waste separation. Using numerical simulations, this study examines the variables that impact the strategy choices of the three parties over time. The results show that (1) the desire of the central government, local governments, and citizens to engage has varying effects on each of these entities; the conduct of local government is significantly influenced by the preparedness of the central government, but residents' behavior is comparatively less influenced by the central government's intention; in comparison, it is mainly affected by psychological expectations of income and expenditure; (2) the impact of the local government and residents on each other is characterized by an unbalanced relationship, with the local government being more sensitive to residents' willingness to participate and changes in policy support being more sensitive; and (3) residents show more sensitivity to incentive funds, compensation, penalties, and benefit distribution coefficients. To promote waste separation in China, it is crucial to establish a reasonable expectation of ecological civilization, establish an efficient mechanism for environmental protection supervision, refine local waste separation programs, increase local governments' responsibility for promoting them, ensure legal methods for universal participation, and improve the regulatory mechanism for universal participation to protect the environment. In addition, it is essential to improve the education system for waste separation and continue research related to waste separation.


Assuntos
Conservação dos Recursos Naturais , Gerenciamento de Resíduos , Gerenciamento de Resíduos/métodos , Governo Local , China , Gastos em Saúde , Governo
10.
Sci Rep ; 13(1): 23079, 2023 12 27.
Artigo em Inglês | MEDLINE | ID: mdl-38155194

RESUMO

Cryptosporidium is one of the most important protozoan parasitic pathogens, and it is a common cause of diarrhoea in humans, domestic animals, and wild vertebrates and has serious public health threats. A cross-sectional study was designed to determine the prevalence of Cryptosporidium oocysts in raw-eaten vegetables in Maiduguri Metropolitan Council (MMC) and Jere Local Government Areas (LGAs). A total of 400 samples were collected from four (4) different locations, namely Tashan Bama, Gomboru, and Monday Markets (n = 100), while fifty (n = 50) each from 202-Vegetable-Vendors and Unimaid Commercials. A total of 16 visits were conducted in all the sampling areas (twenty-five samples per visit). The Cryptosporidium oocysts were detected using the Modified Ziehl-Neelsen Staining Technique. The locations, sources, and types of raw-eaten vegetables were also assessed. The oocysts were confirmed (100×) as bright pink spherules. Data generated were analyzed using IBM-SPSS V23.0, and p ≤ 0.05 was considered significant. Out of the total samples (n = 400) analyzed, cabbage appeared to have the highest number of 10 (12.5%) of Cryptosporidium oocysts detected, while Tomato and garden egg had 9 (11.3%) and 1 (1.2%), respectively. There was a statistically significant association (χ2 = 12.5, P = 0.014) between the presence of Cryptosporidium oocysts in raw-eaten vegetables and vegetable types. Among the sources of the vegetables sampled, Alau had the highest number of Cryptosporidium oocysts, 15 (12.5%), followed by Kilari-Abdullahi and Zabarmari sources with 4 (10.0%) and 4 (5.0%), respectively. However, Jetete appeared to have the least number 2 (2.5%) of oocysts, and there was a statistically significant association (χ2= 10.4, P = 0.034) between the presence of Cryptosporidium oocysts and the sources of vegetables and fruits. The study concludes that the raw-eaten vegetables sampled from Maiduguri Metropolis were contaminated with Cryptosporidium oocysts. The study recommends that all raw-eaten vegetables should be from cleaned sources and washed before consumption. Consumers should be enlightened on the hygienic measures in the food chain in line with the Hazard Analysis and Critical Control Points (HACCP) principles.


Assuntos
Criptosporidiose , Cryptosporidium , Humanos , Animais , Criptosporidiose/epidemiologia , Criptosporidiose/parasitologia , Verduras/parasitologia , Oocistos , Prevalência , Nigéria/epidemiologia , Estudos Transversais , Governo Local
12.
Front Public Health ; 11: 1285152, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37954043

RESUMO

Background: Distrust in government among people of color is a response to generations of systemic racism that have produced preventable health inequities. Higher levels of trust in government are associated with better adherence to government guidelines and policies during emergencies, but factors associated with trust and potential actions to increase trust in local government are not well understood. Methods: The COVID-19 Community Recovery study sampled participants from the New York City (NYC) Department of Health and Mental Hygiene's NYC Health Panel, a probability-based survey panel who complete health surveys periodically. Participants who lived in one of three historically disinvested communities in NYC where the NYC Department of Health and Mental Hygiene has dedicated resources to reduce health inequities were included. The cross-sectional survey was fielded from September 30 to November 4, 2021 and could be self-administered online or conducted via CATI (Computer Assisted Telephone Interviewing) in English, Spanish, and Simplified Chinese (Mandarin and Cantonese by phone). Demographic data were summarized by descriptive statistics. Crude and adjusted logistic regression analyses were used to assess factors predictive of trust in local government as a source of information about COVID-19 vaccines. Open-ended responses about strengthening residents' trust in local government were coded using an iteratively generated codebook. Results: In total, 46% of respondents indicated NYC local government was a trusted source of information about COVID-19 vaccines, relatively high compared to other sources. In bivariate analyses, race/ethnicity, age group, educational attainment, length of time living in NYC, and household income were significantly associated with identifying NYC government as a trusted source of information about COVID-19 vaccines. In multivariable logistic regression, no variables remained significant predictors of selecting local government as a trusted source of information. Key recommendations for local government agencies to build residents' trust include communicating clearly and honestly, addressing socioeconomic challenges, and enhancing public COVID-19 protection measures. Conclusion: Study findings demonstrate that nearly half of residents in three historically divested NYC communities consider local government to be a trusted source of information about COVID-19 vaccines. Strategies to increase trust in local government can help reduce community transmission of COVID-19 and protect public health.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Governo Local , Vacinas contra COVID-19 , Confiança , Cidade de Nova Iorque , Estudos Transversais , Vacinação
13.
Artigo em Inglês | MEDLINE | ID: mdl-37955030

RESUMO

The Tokyo 2020 Olympic and Paralympic Games (the Games) were held from 23 July to 5 September 2021 in Tokyo, Japan, after a 1-year delay due to the coronavirus disease (COVID-19) pandemic. The Tokyo Metropolitan Government was responsible for monitoring and responding to infectious disease outbreaks other than COVID-19 during the Games. A multisource surveillance system was used from 1 July to 12 September 2021 for the early detection and rapid response to infectious diseases. This included routine notifiable disease surveillance, sentinel surveillance, syndromic surveillance, cluster surveillance, ambulance transfer surveillance and the Tokyo Infectious Alert system. Daily reports were disseminated summarizing the data collected from the multisource surveillance system. No case of infectious disease under the Tokyo Metropolitan Government system required a response during the Games. The multisource surveillance was useful for providing intelligence during the Games and, if required, could contribute to the early detection and rapid response to outbreaks during other mass gatherings. The system could be improved to overcome the challenges implied by the findings of this multisource surveillance.


Assuntos
COVID-19 , Doenças Transmissíveis , Infecções por Coronavirus , Esportes , Humanos , Tóquio/epidemiologia , Governo Local , Doenças Transmissíveis/epidemiologia , COVID-19/epidemiologia
14.
Environ Monit Assess ; 195(12): 1431, 2023 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-37940791

RESUMO

The threat of environmental pollution in Nigeria, particularly in the Niger Delta region, cannot be solely ascribed to oil spillages; rather, it also encompasses the discharge of cassava mill effluent (CME), frequently disposed off in an unregulated manner. Existing studies on CME have focused on its potential environmental consequences on soil characteristics, microbial populations, and heavy metal levels. There is limited study on the awareness of the impact of CME on the environment. Thus, this study contributes to the literature on CME by examining the awareness of its effect on the environment in Ika North East Local Government Area of Delta State, Nigeria. The study used interviews, observation, and questionnaires administered to 399 respondents for data collection. A Student t-test, ANOVA, and Pearson's correlation were employed to analyse the data in Statistical Package for the Social Sciences. Results revealed limited awareness, with 51.3% unaware of CME's environmental impact. Slight, moderate, and extreme awareness were reported by 7.5%, 17.3%, and 23.8%, respectively. Gender's influence on awareness was insignificant, but age showed a significant influence (p < 0.05), while education, occupation, and income correlated positively with awareness (p < 0.001). The source of information significantly predicted awareness (r = -0.727, p < 0.001). It indicates that gender's influence on awareness might depend on education levels. Socio-economic factors are strongly related to awareness. Reliable information sources are vital for understanding CME's environmental impact. The study underscores the need for enhanced environmental education and reliable information dissemination to promote sustainable practices.


Assuntos
Governo Local , Manihot , Nigéria , Monitoramento Ambiental , Renda
15.
PLoS One ; 18(11): e0294108, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37943771

RESUMO

Social resilience is a key factor in disaster management, but compared to resilience in other fields, research on social resilience is still limited to assessment or evaluation, and there is still a lack of dynamic and procedural research, which is also a challenge. This article constructs a causal feedback model and a system dynamics model of social resilience during the COVID-19 epidemic, so as to analyze the dynamic characteristics and improvement path of social resilience. After verifying the effectiveness of the model, model simulation is conducted and the following important conclusions are drawn: social resilience dynamically changes during the research cycle and is influenced by social entity behavior and social mechanisms; The sensitivity factors for the two variables that measure social resilience, namely panic degree and damage degree, are the real-time information acquisition of public and the epidemic awareness of local government, respectively. Therefore, the path to enhancing social resilience should be pursued from both the public and government perspectives, including improving the public's ability to access real-time information, increasing the timeline of government information disclosure, and enhancing local governments' understanding and awareness of the epidemic.


Assuntos
COVID-19 , Desastres , Epidemias , Humanos , COVID-19/epidemiologia , Epidemias/prevenção & controle , Modelos Teóricos , Governo Local
16.
West Afr J Med ; 40(11 Suppl 1): S17, 2023 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-37975800

RESUMO

Introduction: Mpox (MPX) is a viral zoonotic (a virus transmitted to humans from animals) disease caused by Mpox virus currently spreading across the world. Primary healthcare workers are fundamental in the provision of healthcare at the grassroots level. They are the front-line health managers who are expected to meet the needs of their community and prevent the spread of Mpox in Nigeria. This study aims to assess the knowledge of Mpox among Primary Health Care (PHC) Workers in Jos North Local Government Area, Plateau State. Methodology: The study is a descriptive cross-sectional study to assess the knowledge, attitude, and perception of Mpox among 152 Primary Health Care (PHC) workers in Jos North, LGA. A multistage sampling technique and a structured interviewer-administered questionnaire were used to collect data. Results: Majority of the participants, 118 (77.6%) were females, while 34 (22.4%) of the participants were males. Most of the participants 46 (30.3%) were within the age group of 31 to 40 years, Most Respondents had poor knowledge on Mpox in general 70 (46.1%), 19 (12.5%) demonstrated a good knowledge of Mpox; 63 (41.4%) had moderate knowledge in terms of clinical presentations, prevalence, and vaccine availability. Most respondents were knowledgeable with regards to Mpox being preventable (89.5%) and the knowledge of some preventive measures. Conclusion: Government and Primary Healthcare Development Agency (PHCDA) should intensify efforts to sensitize the PHC workers on Mpox infection through seminars and workshops, as well as on preventive measures already in place. The PHC workers should make a personal effort to learn more about Mpox infection, its prevention, and control.


Assuntos
Governo Local , Masculino , Feminino , Humanos , Adulto , Nigéria/epidemiologia , Estudos Transversais , Atenção Primária à Saúde , Pessoal de Saúde , Inquéritos e Questionários , Conhecimentos, Atitudes e Prática em Saúde
17.
Pan Afr Med J ; 45: 189, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38020351

RESUMO

Introduction: patient satisfaction is an attitude resulting from a person's general orientation towards the total experience of health care. The study was done with the aim of evaluating post-operative patient satisfaction level with the quality of service provided at the surgical wards; determining how much factors related to physicians, nursing, laboratory, and information provision service influence satisfaction level; and determining factors impacting patient satisfaction level. Methods: a hospital-based quantitative cross-sectional study design was conducted in six Addis Ababa City Government tertiary hospitals from November 4th to December 13th, 2022. Patients who had major operations done at the government hospitals from November 21st to December 5th, 2022, were included in the study population. A pre-tested, structured, and Amharic-version questionnaire was used to interview patients. A bivariate and multivariate logistic regression model was used to identify the variables that had an association with the dependent variable. P-values less than 0.05 were considered statistically significant. Results: a total of 287 patients participated in the research, providing a response rate of 95%. Of the total participants, 144 were males (50.8%) and 143 were females (49.5%). The overall patient satisfaction level with surgical ward service is 96.2%. The level of patient satisfaction with nursing services is 94.8%, with physician's services it is 98.6%, with the facility it is 92.3%, and with the provision of information about post-operative complications it is 69.7%. Those who have above-first-degree educational status are less satisfied (66.7%) than patients with other levels of educational status. Only the patients' residency showed a small level of association (r= 0.145, p=0.014) with overall patient satisfaction with surgical ward service among the demographic components. The two variables that are strongly correlated with patient satisfaction are the adequacy of the time ward nurses spent with patients during evaluation and treatment (r = 0.503, p = 0.000) and adequate nurses' response to patients' calls (r = 0.498, p = 0.000). Post-operative patient satisfaction with surgical ward nursing service, physician service, hospital facilities, and the provision of information about post-op complications explain about 40.9 percent of the variation in the overall patient satisfaction with post-op care provided at the surgical ward. Patient satisfaction with nursing service has more significant effect with overall patient satisfaction than the other variables (ß = 0.266, p =0.0002). Conclusion: post-operative patients at Addis Ababa City Government Tertiary Hospitals expressed a very high degree of satisfaction with the care they received in the surgical wards. The study also found that patients were generally less satisfied with the information they were given on drugs, side effects, and available treatment options. Another factor identified in the study that caused unhappiness was the unavailability of some pharmacy and laboratory services.


Assuntos
Governo Local , Satisfação do Paciente , Masculino , Feminino , Humanos , Estudos Transversais , Centros de Atenção Terciária , Etiópia
18.
PLoS One ; 18(11): e0293158, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38032928

RESUMO

The mobility of economic factors across jurisdictions has led to increased fiscal competition among decentralized subnational governments. This study examines the relationship between fiscal competition and long-term investment in innovation at the local government level. Panel data analysis, encompassing expenditures, taxes, and innovation inputs from 18 municipalities over a 10-year period, is employed using fixed effects regression. The results reveal a negative correlation between fiscal competition and expenditure on innovation, indicating that intensified competition for mobile capital diverts resources away from essential long-term investments crucial for knowledge-driven growth. Even after controlling for economic and institutional factors, a one standard deviation increase in competition corresponds to an average decline of 25% in per capita innovation investment. These findings highlight the unintended trade-off resulting from heightened competition and underscore the need for policy frameworks that promote localized flexibility while curbing uncoordinated competition that undermines innovation capacity. While fiscal decentralization aims to foster competitive governance, this study provides empirical evidence that short-term expenditure incentives often displace long-term innovation objectives without sufficient coordination. The insights contribute significant empirical evidence on the concealed costs of fiscal competition for regional development. Consequently, a re-evaluation of conventional perspectives on decentralization and competition is warranted, emphasizing the importance of developing cooperative policy solutions that strike a delicate balance between decentralized decision autonomy and strategic coordination. Adopting such an approach is essential to fully leverage the advantages of competitive governance while simultaneously nurturing innovation ecosystems.


Assuntos
Gastos em Saúde , Governo Local , Ecossistema , Políticas , Cidades , Política , China , Desenvolvimento Econômico
19.
Environ Monit Assess ; 195(12): 1470, 2023 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-37962723

RESUMO

The dynamic use of land that results from urbanization has an impact on the urban ecosystem. Yola North Local Government Area (Yola North LGA) of Adamawa state, Nigeria, has experienced tremendous changes in its land use and land cover (LULC) over the past two decades due to the influx of people from rural areas seeking for the benefits of its economic activities. The goal of this research is to develop an efficient and accurate framework for continuous monitoring of land use and land cover (LULC) change and quantify the transformation in land use and land cover pattern over a specific period (between 2002 and 2022). Land sat images of 2002, 2012, and 2022 were obtained, and the Support Vector Machine classification method was utilized to stratify the images. Land Change Modeler (LCM) tool in Idrissi Selva software was then used to analyze the LULC change. SVM produced a good classification result for all three years, with 2022 having the highest overall accuracy of 95.5%, followed by 2002 with 90% and 2012 with 87.7% which indicates the validity of the algorithm for future predictions. The results showed that severe land changes have occurred over the course of two decades in built-up (37.32%), vegetation (forest, scrubland, and grassland) (-3.27%), bare surface (-33.47%), and water bodies (-0.59%). Such changes in LULC could lead to agricultural land lost and reduced food supply. This research develops a robust framework for continuous land use monitoring, utilizing machine learning and geo-spatial data for urban planning, natural resource management, and environmental conservation. In conclusion, this study underscores the efficacy of support vector machine algorithm in analyzing complex land use and land cover changes.


Assuntos
Algoritmos , Monitoramento Ambiental , Aprendizado de Máquina , Ecossistema , Governo Local , Nigéria
20.
PLoS One ; 18(11): e0289750, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37972042

RESUMO

This paper aims to effectively reduce CO2 emissions by examining the impact of three distinct incentive and constraint policies on the quality of rating and certification information in China's green bond issuance market. To accomplish this, the government has implemented incentives, while regulators have introduced constraints to curb the spread of inflated rating and certification information. We build on the integrated rating and certification regulation mechanism by presenting a two-stage Stackelberg game model that involves four key participants: the China Securities Regulatory Commission, local governments, green evaluation and certification agencies, and credit rating agencies. We incorporate environmental effects indicators into the expected utility of rating and certification agencies to investigate the equilibrium conditions under three policy scenarios: a single financial incentive policy, a single regulatory constraint policy, and a combined incentive and constraint policy. The paper employs Stackelberg game theory to analyze how different policies mitigate the occurrence of "inflated" ratings and "greenwashing" in certifications. Numerical analysis is conducted to validate the theoretical findings. Moreover, we assess the impact of these policies on the quality of rating and evaluation information, using data from China's green bond issuance market between 2016 and 2021. Our research offers valuable management insights and regulatory recommendations for both regulators and local governments.


Assuntos
Política Fiscal , Motivação , Humanos , Políticas , Certificação , China , Governo Local
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