Determinantes das irregularidades na gestão pública municipal: o caso dos municípios do estado de São Paulo / Determinantes de las irregularidades en la gestión pública municipal: el caso de los municipios del estado de São Paulo / Determinants of irregularities in municipal public management: the case of municipalities in the state of São Paulo

Resumo O controle externo municipal exercido pelos Tribunais de Contas permite, por meio da divulgação dos relatórios de auditoria, conhecer as irregularidades encontradas nas contas dos governos municipais. Elas têm sido analisadas empiricamente, do ponto de vista de sua classificação em termos de gravidade, mas poucos são os estudos que visam identificar os fatores que influenciam tais falhas. Constatada essa lacuna, o principal objetivo deste estudo é identificar fatores que possam influenciar lapsos na gestão pública municipal apontados pela auditoria do Tribunal de Contas. Este artigo contribui para aprofundar a pesquisa em torno desse tema e para a melhoria da gestão nos municípios. Trata-se de uma análise exploratória, baseada em modelos econométricos para dados em painel. A amostra inclui 179 municípios paulistas, com dados relativos aos anos de 2011, 2013, 2015, 2017 e 2019. Os resultados sugerem que as recomendações e as determinações do Tribunal de Contas, bem como lacunas nos controles internos, influenciam irregularidades em municípios pequenos, médios e grandes. O volume de transferências legais e constitucionais recebidas influenciam os municípios pequenos e médios, ao passo que o produto interno bruto (PIB) municipal tem influência nos municípios médios.

Resumen El control municipal externo que ejercen los Tribunales de Cuentas permite, a través de la divulgación de informes de auditoría, conocer las irregularidades encontradas en las cuentas de los gobiernos municipales. Estas han sido analizadas empíricamente, desde el punto de vista de su clasificación en términos de gravedad, pero existen pocos estudios que tengan como objetivo identificar los factores que influyen en tales fallas. Verificada esta brecha, el objetivo principal de este estudio es identificar factores que puedan influir en las fallas en la gestión pública municipal señalados por la auditoría del Tribunal de Cuentas. Este artículo contribuye a profundizar en la investigación sobre este tema y a mejorar la gestión en los municipios. Se trata de un análisis exploratorio, basado en modelos econométricos para datos de panel. La muestra incluye 179 municipios de São Paulo, con datos de los años 2011, 2013, 2015, 2017 y 2019. Los resultados sugieren que las recomendaciones y determinaciones del Tribunal de Cuentas, así como las lagunas en los controles internos, influyen en las irregularidades en los municipios, pequeños, medianos y grandes. El volumen de transferencias legales y constitucionales recibidas influye en los municipios pequeños y medianos, mientras que el producto interno bruto (PIB) municipal influye en los municipios medianos.

Abstract The municipal external control exercised by the Courts of Accounts reveals the irregularities found in the accounts of municipal governments through the disclosure of audit reports. They have been empirically analyzed from the point of view of their classification in terms of severity, but few studies aim to identify the factors that influence such failures. Having verified this gap, the main objective of this study is to identify factors that may influence lapses in municipal public management pointed out by the audit of the Court of Accounts. This article contributes to further research on this topic and to improving management in municipalities. This is an exploratory analysis based on econometric models for panel data. The sample includes 179 municipalities in São Paulo, with data for 2011, 2013, 2015, 2017, and 2019. The results suggest that the recommendations and determinations of the Court of Accounts and gaps in internal controls influence irregularities in small, medium, and large municipalities. The volume of legal and constitutional transfers received influences small and medium-sized municipalities, while the municipal gross domestic product (GDP) influences medium-sized municipalities.

Economia compartilhada e governança pública / Economía compartida y gobernanza pública / Sharing economy and public governance

Resumo O termo economia compartilhada é empregado na literatura especializada para identificar a forma como a internet, os smartphones e os aplicativos estão modificando a dinâmica econômica mundial. Este artigo apresenta uma pesquisa documental realizada para identificar os aplicativos de compartilhamento que surgiram nas últimas décadas e o modo como estão contribuindo para a melhoria da gestão pública local. Utilizou-se a análise descritiva dos dados e uma regressão para caracterizar a adesão às novas tecnologias pelos governos locais e para identificar o modo como afetam o desempenho fiscal dos municípios, mensurado a partir do Índice FIRJAN de Gestão Fiscal (IFGF). Os resultados obtidos mostram que os aplicativos de economia compartilhada podem contribuir de diferentes formas, com destaque para: a maior cooperação e coordenação intra e entre governos locais, redução na subutilização de ativos, maior acesso e melhoria na qualidade dos serviços públicos, e maior interação e participação dos cidadãos nas decisões públicas. A regressão estimada mostra que o emprego das novas tecnologias de comunicação contribui para a melhoria no desempenho fiscal dos municípios. Contudo, essas tecnologias são pouco utilizadas, sendo necessárias iniciativas que estimulem a utilização de aplicativos de compartilhamento nas gestões públicas locais.

Resumen El término economía compartida se utiliza en la literatura especializada para identificar cómo la Internet, los smartphones y las aplicaciones están cambiando la dinámica económica mundial. Este artículo presenta una investigación documental realizada para identificar las aplicaciones de compartición que surgieron en las últimas décadas y cómo están contribuyendo a la mejora de la gestión pública local. Se utilizó el análisis descriptivo de datos y la regresión para caracterizar la adhesión a las nuevas tecnologías por parte de los gobiernos locales y para identificar cómo afectan el desempeño fiscal de los municipios, medido a partir del Índice FIRJAN de Gestión Fiscal (IFGF). Los resultados obtenidos muestran que las aplicaciones de economía compartida pueden contribuir de diferentes formas, con énfasis en: mayor cooperación y coordinación dentro y entre los gobiernos locales, reducción de la subutilización de activos, mayor acceso y mejora en la calidad de los servicios públicos y mayor interacción y participación ciudadana en las decisiones públicas. La regresión estimada muestra que el uso de nuevas tecnologías de la comunicación contribuye a mejorar el desempeño fiscal de los municipios. Sin embargo, estas tecnologías rara vez se utilizan y se necesitan iniciativas para fomentar el uso de aplicaciones de compartición en las gestiones públicas locales.

Abstract The term sharing economy is used in specialized literature to identify how the Internet, smartphones, and applications are changing the global economic dynamic. This article presents documentary research focused on private sharing applications that have emerged in recent decades, intending to contribute to the improvement of local public management. Descriptive data analysis and regression were used to characterize the local governments' adherence to new technologies and to identify how these new technologies affect the fiscal performance of municipalities measured by the FIRJAN Fiscal Management Index. The results obtained show that shared economy Apps can contribute in different ways, with emphasis on greater cooperation and coordination within and between local governments, reduction in the underutilization of assets, greater access and improvement in the quality of public services, and greater interaction and citizen participation in public decisions. The estimated regression shows that the use of new communication technologies contributes to improving the municipalities' fiscal performance. However, these technologies are little used and should be encouraged in local public administrations.

Mental health and related influencing factors among rural elderly in 14 poverty state counties of Chongqing, Southwest China: a cross-sectional study

BACKGROUND@#China has the largest elderly population in the world; little attention has been paid to the mental health of elderly in areas of extreme poverty. This is the first study to investigate the mental health of the rural elderly in poverty state counties in Chongqing and was part of the Chongqing 2018 health literacy promotion project.@*METHODS@#In 2019, a cross-sectional study was conducted to investigate the mental health status of the rural elderly in fourteen poverty state counties of Chongqing, in which a total of 1400 elderly aged ≥ 65 years were interviewed, where mental health status was measured by the ten-item Kessler10 (K10) scale. Ordered multivariate logistic regression was performed to evaluate the influencing factors related to mental health of the elderly in these areas.@*RESULTS@#The average score of K10 in 14 poverty state counties was 17.40 ± 6.31, 47.6% was labeled as good, 30.2% was moderate, 17.0% was poor, and lastly 5.1% was bad, and the mental health status of the elderly in the northeastern wing of Chongqing was better than the one in the southeastern wing of Chongqing. A worse self-rated health was the risk factor for mental health both in the northeastern and southeastern wings of Chongqing (all P < 0.001). Lower education level (OR (95% CI) = 1.45 (1.12-1.87), P = 0.004) was a risk factor in the northeastern wing, whereas older age (OR (95% CI) = 1.33 (1.13-1.56), P = 0.001) was a risk factors in the southeastern wing.@*CONCLUSIONS@#The results showed that mental health of the elderly in poverty state counties was poor, especially in the southeastern wing of Chongqing. Particular attention needs to be paid to the males who were less educated, older, and single; female with lower annual per capital income; and especially the elderly with poor self-rated health.

Assessing in-situ conservation status of threatened medicinal vascular plants in central China / 中国中药杂志

It is of great significance to carry out scientific investigation of threatened species and assess their in-situ conservation status in order to guide the conservation and management of these species within a region. In this study, we explored and assessed the biodiversity and in-situ conservation status of the threatened medicinal vascular plants(TMVPs) in central China. The results showed that there were 276 TMVPs in central China, including 18 critically endangered(CR), 77 endangered(EN), and 181 vulnerable(VU) species. Of which, 222 TMVPs were distributed in 49 national nature reserves, with an in-situ conservation rate of 80.43%. And the in-situ conservation rate of CR, EN and NR species were 83.33%, 77.92% and 81.22%, respectively. The complementary algorithm was used to select the nine national nature reserves with the highest protection and complementary contribution to the TMVPs. The cumulative protection contribution rate of these nine nature reserves was 81.98%. Fifty-four TMVPs were distributed outside of national nature reserves, while mainly distributed within 10 hotspot counties including Badong county, Hubei province, Sangzhi county, Hunan province, Jianghua Yao Autonomous county, Hunan province and so on. In general, TMVPs are well protected by the national nature reserves in central China. However, there are still some conservation gaps. It is necessary to carry out further field investigation on the species with conservation gaps and identify the gap areas, so as to provide scientific guidance for the optimization of the conservation of TMVPs in this region.

Indicadores de saneamento: uma análise de variáveis para elaboração de indicadores municipais / Indicadores de saneamiento: análisis de variables para construir indicadores municipales / Sanitation indicators: analysis of variables to construct municipality indicators

Resumo Passados nove anos da Lei do Saneamento, que define as diretrizes nacionais, verifica-se a necessidade de integrar os componentes do conceito de saneamento básico e buscar meios para monitorar os municípios. Crescentes iniciativas internacionais utilizam indicadores compostos para mensurar o desempenho das cidades, compará-las e para influenciar discussões de políticas nacionais e internacionais. Nesse sentido, o objetivo foi analisar variáveis para elaboração de indicadores de saneamento básico para os municípios paulistas a fim de gerar informações para a administração pública. O método fundamenta-se na análise de conteúdo temática de documentos para compreender os componentes e atributos do saneamento; e na análise fatorial exploratória para elaboração dos indicadores. O resultado da análise originou três indicadores que compõem um índice municipal e indica a necessidade de dados para avaliar de forma completa o saneamento.

Resumen Después de nueve años de Ley de Saneamiento, que establece las directrices nacionales, aun existe la necesidad de integrar el concepto de los componentes de saneamiento y buscar formas de controlar el saneamiento en los condados. Crecientes iniciativas internacionales utilizan indicadores compuestos para medir el desempeño de las ciudades, para compararlas y para influir en los debates de políticas nacionales e internacionales. En este sentido, el objetivo es analizar variables para la elaboración de indicadores de saneamiento para los municipios de São Paulo a fin de generar información para la administración pública. El método se basa en el análisis de contenido temático para entender los componentes y atributos del saneamiento; y análisis exploratorio factorial para elaborar indicadores. El análisis resultante arrojó tres indicadores que componen un índice municipal e indican la necesidad de datos para evaluar completamente el saneamiento.

Abstract After nine years of the Sanitation Law that defines the national guidelines in this area, it is still necessary to clarify the elements characterizing basic sanitation, and seek tools that enable monitoring sanitation in municipalities. Increasing international initiatives employ composite indicators to measure the performance of cities, compare them and use them to influence national and international political discussions. In this direction, the objective of this study is to analyze variables for the elaboration of sanitation indicators for the municipalities of São Paulo in order to generate information for the public administration. The method is based on thematic content analysis to understand the sanitation's components and attributes, and factorial exploratory analysis to elaborate indicators. The results show three indicators that compose a municipal index and indicate the need for data to fully evaluate sanitation.

Analysis on the allocation of health human resources in medical institutions and its mechanism obstacles in poverty-stricken counties of Hubei province / 中华医院管理杂志

Objective To analyze the problems and mechanism obstacles existing in the allocation of health human resources in medical institutions in poverty-stricken counties of Hubei province, and propose targeted policy recommendations. Methods The stratified random sampling method was used in an on-site investigation conducted at 5 county-level hospitals and 9 township hospitals in 3 poverty-stricken counties of Hubei province. Results The allocation of human resources in such counties showed an overall trend of improvement year by year. However, some of the counties still faced such problems as inadequate health workforce, unreasonable structure of health manpower, and great gaps of health manpower structure within the county. In most of the hospitals, the proportion of health technicians with bachelor's degree or above fell below 50% . In county hospitals, the proportion of personnel expenditure was generally less than 15% from 2013 to 2016. Conclusions The allocation of health human resources in poverty-stricken areas is facing such mechanism obstacles as limited financial input, restrictions of staffing quota, and lack of cooperative motivation by medical institutions. It is necessary to clarify the responsibility of the government and guarantee the fiscal support of personnel expenditure. It is also imperative to promote the reform of the personnel practice in the health system, strengthen the construction of the health talents guarantee mechanism at the primary level, optimize the vertical cooperation mechanism of medical institutions and promote the integrated health management of counties-township-villages.

Mode, Challenge and Strategy Integration Reform of Medical Service System in Counties and Towns / 中国卫生经济

The integration reform of medical service system in counties and towns had been an important way to sink the county health resources and to enhance the primary medical service ability.By summarizing the reform of the policy and the practical experience,it summarized the current diversification of integrated reform as decentralized help management,centralized agreement hosting,loose "medical union" integration and close "medical union" integration.After analyzing the challenges faced the integration reform,it proposed the need to establish a close "medical union",optimize the functions of government services and establish the modem hospital management system.

Geographic Variation in Fertility Measures in Sweden in (1749-1870).

We analysed geographic variation in the number of males per 100 females at birth also called the secondary sex ratio (SR), the crude birth rate (CBR), the total fertility rate (TFR) and the twinning rate (TWR). Earlier studies have noted geographic variations in the TWR and racial differences in the SR. Statistical analyses have shown that comparisons between SRs demand large data sets because random fluctuations in moderate data are marked. Consequently, reliable results presuppose national birth data. In this study, we analysed historical demographic data and investigated the geographic variations between the counties in Sweden for the SR among the live born (1749-1869), the CBR in 1751-1870, the TFR in 1860 and the TWR in 1751-1860. We built spatial models and as regressors we used geographic co-ordinates for the residences of the counties in Sweden. The influence of the CBR and TFR on the SR and TWR was examined. For all variables, we obtained spatial variations, albeit of different patterns and power. Hence, no common spatial pattern for the demographic variables SR, TFR, CBR and TWR was detected, but a better fit was noted for TFR, CBR and TWR than for SR.

The mortality of patients in a pediatric emergency department at a tertiary medical center in China: An observational study / 世界急诊医学杂志（英文）

BACKGROUND: The quality of treatment for critically ill children varies widely at different hospitals. This study aimed to analyze the characteristics of mortality in a pediatric emergency department (PED) at a tertiary children's hospital in Guangzhou, China and to investigate the risk factors associated with the mortality. METHODS: The mortality of pediatric patients at the hospital from 2011 to 2013 was retrospectively analyzed using descriptive statistics. RESULTS: Altogether 466919 patients visited the PED during the period and 43925 of them were admitted for further observation. In 230 deaths, the ratio of boys to girls was 1.4:1, and their age ranged from 2 hours to 16 years (median, 5 months). The time from admission to death ranged from 0 to 216 hours (median, 1.5 hours). There were 92 (40％) patients who died within 24 hours after admission and 104 (45.2％) patients who died on arrival. The prominent causes of the deaths were respiratory diseases, neuromuscular disorders, cardiovascular diseases, and sepsis, most of which were ascribed to severe infection. Sixty-five deaths were associated with more than one concomitant problem. The top concomitant problems were congenital malformation, low gestational age, and severe birth asphyxia. CONCLUSIONS: In our center, 40％ of the patients in the PED died of fatal acute diseases, and pneumonia was the first leading cause of the deaths. Almost half of the deaths occurred on arrival and the rest were due to end-stage malignant diseases. This study emphasized the importance of prevention of birth deficits by reducing deaths in infants and children.

Ethnic differences on nutritional status of children under 3 years old in poor counties of the western China / 中华流行病学杂志

Objective To explore the ethnic differences on nutritional status of children under three years old,in the western areas of China and to indentify the affecting factors.Methods 14 072children under the age of three years and their mothers were recruited,using the proportion population sampling method in 45 counties in the western areas of China.Height and weight were used as the measurement on nutrition of children.Results Height and weight of children with Han,Uyghur,Tibetan and Zhuang ethnicities were all lower than the WHO standards and with differences on height and weight among them.There were also ethnic differences on the status of malnutrition.Prevalence rates of stunting were 14.7％,20.3％,26.9％ and 26.5％ for Han,Uyghur,Tibetan and Zhuang ethnicities,respectively.Prevalence rates of underweight were 6.1％,10.7％,6.8％ and 15.5％ among the Han,Uyghur,Tibetan and Zhuang ethnicities,respectively.The prevalence rates of wasting were 4.2％,5.3％,2.9％,8.9％,and of under nutrition were 19.2％,25.5％,30.3％ and 36.5％ for the Han,the Uyghur,the Tibetan and the Zhuang ethnicities,respectively.When factors as family size,years of schooling of parents,family numbers,sex,age (months),mother' s height and weight,ways of feeding and sources of family income etc.were adjusted,children with Uyghur,Tibetan,Zhuang and other ethnicities were still presented more malnutrition than the children with Han ethnicity.Conclusion There were differences on malnutrition status of children under the age of three years among the studies on different ethnicities.Undemutrition was less than nutritional status,seen in children of the Han nationality than other minority ethnicites.Ethnicity seemed to be related to differences in the nutritional status of children in western China while children of the Han nationality would be better than other minorities on nutritional status if they were in same living conditionals.