Factors affecting cultural ecosystem services use in Vilnius (Lithuania): A participatory mapping survey approach.

Assessing preferences of recreational activities related to cultural ecosystem services (CES) in urban areas is essential for decision-making and urban green space (UGS) management. This work aims to assess the preferences and factors (based on socio-demographic and motivation variables) influencing CES-related activities in Vilnius, Lithuania, to provide scientific knowledge to support more efficient UGS design and management. Participatory mapping was reported as relevant for urban park planning and decision-making and was applied to identify spatially explicit CES. We assessed the perceived relevance of five CES-related activities groups (Social activities, Inspirational activities, Cultural activities, Spiritual activities, and Physical activities) via participatory mapping through an online survey (n = 1.114). The users selected one preferred geographic location for each CES-related activities group and attributed relevance (using a 5-point Likert scale) for a set of motivation items. The results showed that Physical and Social activities were the respondents' most important CES-related activity groups, while Spiritual activities were the less popular. Factor Analysis showed that the respondent's recreation experience preferences, or motivations, were the most relevant variables influencing all the groups except for the Social activities group. Regarding Cultural activities, preferences for understanding things & learn about history were the most relevant variables. For Inspirational activities, the variables developing knowledge & to learn were the most important. Enjoying nature's quietness & frequency was the most relevant for Physical activities. Regarding Spiritual activities, the most important variables were related to the development of spiritual activities and the reflection on personal religious values. Finally, socio-demographic variables mainly influenced social activities, namely education level, gender and age group. The spatial distribution was different between activity groups. Inspirational activities showed the highest dispersion, and Spiritual activities the highest concentration. The results of this work are relevant to municipal managers, as they allow for a better understanding of users' interactions with the territory, its multifunctionality, and potential areas of conflict between conservation and recreation.

HAAN: Learning a Hierarchical Adaptive Alignment Network for Image-Text Retrieval.

Image-text retrieval aims to search related results of one modality by querying another modality. As a fundamental and key problem in cross-modal retrieval, image-text retrieval is still a challenging problem owing to the complementary and imbalanced relationship between different modalities (i.e., Image and Text) and different granularities (i.e., Global-level and Local-level). However, existing works have not fully considered how to effectively mine and fuse the complementarities between images and texts at different granularities. Therefore, in this paper, we propose a hierarchical adaptive alignment network, whose contributions are as follows: (1) We propose a multi-level alignment network, which simultaneously mines global-level and local-level data, thereby enhancing the semantic association between images and texts. (2) We propose an adaptive weighted loss to flexibly optimize the image-text similarity with two stages in a unified framework. (3) We conduct extensive experiments on three public benchmark datasets (Corel 5K, Pascal Sentence, and Wiki) and compare them with eleven state-of-the-art methods. The experimental results thoroughly verify the effectiveness of our proposed method.

Implementation Outcomes of National Convergence Action Policy to Accelerate Stunting Prevention and Reduction at the Local Level in Indonesia: A Qualitative Study.

The study aims to explore the implementation outcome variables of Indonesia's national policy convergence action in the stunting reduction intervention at district, sub-district, and village levels. The study design was qualitative with an implementation research approach at District Cirebon, Indonesia. Data were collected through in-depth interviews, focus group discussions, study documents, and 6 months of participant observation. We recruited 172 respondents. The assessment instrument used was formed on was implementation outcomes variables. Data were analyzed through coding, categorizing and thematic content analysis based on a predetermined theme. Comparative cross district activity-site analysis was applied between sub-districts and villages. The implementation outcome variables for the convergence action policy were performed well at the district level, in line with the central government's adequate regulation, control, and budget. Meanwhile, the sub-district and village levels only performed aspects of acceptability, appropriateness, and coverage for specific interventions. The acceptability level in the village was only partially running. The barriers at the sub-district and village levels were issues of commitment, staff capacity, and poor coordination. Superficial understanding and capacity weaknesses drove the convergence of the stunting reduction responsibility back into the burden of the health sector at the forefront. Local politics also colored the implementation in the village.

Evaluation of investments in the tourism sector with a local focus.

Evaluation of investments in tourism (as a cross-section industry) is a complex issue that needs to be addressed systematically by using a combination of quantitative and qualitative methods. This article deals with the setting of an ex-post evaluation framework for the assessment of impact interventions on the tourism sector at all its levels, especially the local one. The design of an evaluation framework for the tourism sector supported by the recommended approaches and methods is the first result of this methodically focused paper. The proposal to adopt the Method for Impact Assessment of Programmes and Projects = MAPP method into the tourism sector on a local level, including indicators, measures, and outcomes would be considered as a second significant result. The proposed evaluation framework can be used by the representatives of public institutions and organizations to measure the impact of programmes financially supported from public sources on the tourism sector in an efficient way. In particular, municipalities´ government bodies can adopt the proposed approach towards sustainable planning and development in tourism.

Moving Beyond Quality-Adjusted Life-Years in Elderly Care: How Can Multicriteria Decision Analysis Complement Cost-Effectiveness Analysis in Local-Level Decision Making.

OBJECTIVES: This study aimed to investigate how multicriteria decision analysis (MCDA) could complement cost-effectiveness analysis (CEA) to support investment decisions in elderly care at local level. METHODS: We used an integrated elderly care program in The Netherlands as a case study to demonstrate the application of both methods. In a 12-month quasi-experimental study (n = 384), data on the following outcome measures were collected: quality-adjusted life-years (CEA) and physical functioning, psychological well-being, social relationships and participation, enjoyment of life, resilience, person centeredness, continuity of care, and costs (MCDA). We performed regression analysis on inversed probability weighted data and controlled for potential confounders to obtain a double robust estimate of the outcomes. Probabilistic sensitivity analyses determined uncertainty for both methods. RESULTS: The integrated elderly care program was not likely (ie, 36%) to be cost-effective according to the CEA (incremental cost-effectiveness ratios: €88 249 from a societal perspective) using the conventional Dutch willingness-to-pay threshold (ie, €50 000). The MCDA demonstrated that informal caregivers and professionals slightly preferred the intervention over usual care, driven by enjoyment of life and person centeredness. Patients did not prefer either the intervention or usual care, whereas payers and policy makers slightly preferred usual care, mainly due to higher costs of the intervention. CONCLUSIONS: MCDA could provide local-level decision makers with a broader measurement of effectiveness by including outcomes beyond health and longevity and the preferences of multiple stakeholders. This additional information could foster the acceptability and implementability of cost-effective innovations in elderly care.

Reward Expectation Differentially Modulates Global and Local Spatial Working Memory Accuracy.

Although it has been suggested that reward expectation affects the performance of spatial working memory tasks, controversial results have been found in previous experiments. Hence, it is still unclear to what extent reward expectation has an effect on working memory. To clarify this question, a memory-guided saccade task was applied, in which participants were instructed to retain and reconstruct a temporospatial sequence of four locations by moving their eyes in each trial. The global- and local-level spatial working memory accuracies were calculated to determine the reward effect on the global and local level of processing in spatial working memory tasks. Although high reward expectation enhanced the encoding of spatial information, the percentage of trials in which the cued location was correctly fixated decreased with increment of reward expectation. The reconstruction of the global temporospatial sequence was enhanced by reward expectation, whereas the local reconstruction performance was not affected by reward. Furthermore, the improvements in local representations of uncued locations and local sequences were at the cost of the representation of cued locations. The results suggest that the reward effect on spatial working memory is modulated by the level of processing, which supports the flexible resource theory during maintenance.

[The Policy and Practice of Medical Device Emergency Approval at the Local Level under the Circumstance of COVID-19 Disease].

This research analyzed Chinese emergency approval policies and practices of medical devices at the local level under the circumstance of COVID-19 disease. The legal basis and administrative system were clarified, the implementation and characteristics of emergency approval policies were investigated, the products information including total approved number, product type and license's validity period were counted. Advices as enhancing the standardization of emergency approval system, strengthening registration guidance and optimize information disclose and management were provided.

Key Indicators and Social Acceptance for Bioenergy Production Potential as Part of the Green Economy Transition Process in Local Areas of Lapland.

The aim of this article was to create key indicators for measuring the implementation potential of the green economy transition at a local level in a northernmost, natural biomass-rich environment. The case area to test the set of indicators was the village of Saija in Lapland. The work presented in this article is based on a communicative cooperative research and development project. The selection process for the appropriate indicators is based on a conceptual framework for developing local sustainability indicators and the thematic framework follows the key dimensions of the green economy (ecosystem resilience, resource efficiency and social equity). When selecting the local-level indicators, a strong emphasis was placed on the special characteristics of the local area and the availability and validity of the data. Layman villagers and data policy relevance (in this case green economy) were also taken into consideration. The key indicators developed as a result included: the increment of growing forest stock in relation to the drain on growing forest stock, the village population, the bioenergy consumption share, the utilization share of side streams, the bioenergy production potential, capital outflow, demographic dependency ratio, the ratio between employed and working age residents and the number of forest owners in relation to area households. The key indicators are targeted for use in supporting local decision-making and monitoring and assessing development activities and their effectiveness in the process of the green economy transition. The indicators measure the most critical factors for green economy transition in a local area and identify the most optimal development opportunities when moving towards green growth. In the measurement of the transition potential of the green economy, it was found that the case area's imported fossil energy consumption could be substituted with self-sufficient bioenergy production utilizing the area's own raw materials. There is extensive potential for the utilization of manure (an agricultural side stream) and forest resources (forestry side streams) at the local level, especially since forests account for 98% of Lapland's land area. In support of the change from fossil-based energy consumption towards bioenergy production, plans for a biogas plant were examined for self-sufficient bioenergy production and this appeared to be the initial key process in the path of the green economy transformation in the case village of Saija.

The Policy and Practice of Medical Device Emergency Approval at the Local Level under the Circumstance of COVID-19 Disease / 中国医疗器械杂志

This research analyzed Chinese emergency approval policies and practices of medical devices at the local level under the circumstance of COVID-19 disease. The legal basis and administrative system were clarified, the implementation and characteristics of emergency approval policies were investigated, the products information including total approved number, product type and license's validity period were counted. Advices as enhancing the standardization of emergency approval system, strengthening registration guidance and optimize information disclose and management were provided.

Assessing Urban Health Inequities through a Multidimensional and Participatory Framework: Evidence from the EURO-HEALTHY Project.

Urban health inequities often reflect and follow the geographic patterns of inequality in the social, economic and environmental conditions within a city-the so-called determinants of health. Evidence of patterns within these conditions can support decision-making by identifying where action is urgent and which policies and interventions are needed to mitigate negative impacts and enhance positive impacts. Within the scope of the EU-funded project EURO-HEALTHY (Shaping EUROpean policies to promote HEALTH equitY), the City of Lisbon was selected as a case study to apply a multidimensional and participatory assessment approach of urban health whose purpose was to inform the evaluation of policies and interventions with potential to address local health gaps. In this paper, we present the set of indicators identified as drivers of urban health inequities within the City of Lisbon, exploring the added value of using a spatial indicator framework together with a participation process to orient a place-based assessment and to inform policies aimed at reducing health inequities. Two workshops with a panel of local stakeholders from health and social care services, municipal departments (e.g. urban planning, environment, social rights and education) and non-governmental and community-based organizations were organized. The aim was to engage local stakeholders to identify locally critical situations and select indicators of health determinants from a spatial equity perspective. To support the analysis, a matrix of 46 indicators of health determinants, with data disaggregated at the city neighbourhood scale, was constructed and was complemented with maps. The panel identified critical situations for urban health equity in 28 indicators across eight intervention axes: economic conditions, social protection and security; education; demographic change; lifestyles and behaviours; physical environment; built environment; road safety and healthcare resources and performance. The geographical distribution of identified critical situations showed that all 24 city neighbourhoods presented one or more problems. A group of neighbourhoods systematically perform worse in most indicators from different intervention axes, requiring not only priority action but mainly a multi- and intersectoral policy response. The indicator matrices and maps have provided a snapshot of urban inequities across different intervention axes, making a compelling argument for boosting intersectoral work across municipal departments and local stakeholders in the City of Lisbon. This study, by integrating local evidence in combination with social elements, pinpoints the importance of a place-based approach for assessing urban health equity.

Enhancing implementation of smoke-free places: A comparative qualitative study across seven European cities.

BACKGROUND: Advocacy, resources and intersubjective reasonable arguments are known as factors that contribute to smoke-free (SF) adoption and implementation in Chinese and Anglo-Saxon places. Less is known about how the implementation of smoking bans differs across European places. The aim of this qualitative comparative study is to identify and classify the SF policy implementation processes and types undertaken at the local level in seven European cities according to the views of local bureaucrats and sub-national stakeholders. METHOD: Semi-structured expert interviews (n = 56) with local decision makers and stakeholders were conducted as qualitative part of the comparative SILNE-R project in Belgium (Namur), Finland (Tampere), Germany (Hanover), the Republic of Ireland (Dublin), the Netherlands (Amersfoort), Italy (Latina), and Portugal (Coimbra). Qualitative interviews were analyzed using the framework analysis. RESULTS: Implementation of SF environments predominantly focuses on indoor bans or youth-related settings. Progressive-hungry (Dublin), moderate-rational (Tampere), upper-saturated (Hanover, Amersfoort), and lower saturated (Namur, Coimbra, Latina) implementation types can be distinguished. These four types differ with regards to their engagement in enhancing SF places as well as along their level of perceived tobacco de-normalization and public smoking visibility. In all municipalities SF environments are adopted at national levels, but are differently implemented at the local level due national policy environments, enforcement strategies and the level of collaboration. Major mechanisms to expand SF regulations were found to be scientific evidence, public support, and the child protection frame. However, counter-mechanisms of closure occur if data on declining prevalence and new youth addiction trends trigger low prioritization. CONCLUSIONS: This study found four SF implementation types two mechanisms of progressive expansion and defensive closure. Development and enhancement of smoking bans requires a suitable national policy environment and indirect national-level support of self-governed local initiatives. Future SF policies can be enhanced by laws pertaining to places frequented by minors.

Exploring interactions in the local water-energy-food nexus (WEF-Nexus) using a simultaneous equations model.

Exploring interactions between factors is a critical step to understand, quantify and govern the WEF-Nexus. However, current research mainly focuses on mapping causal loops and the hierarchy structure; equations in interaction exploration have been largely ignored. Using the panel data of China's 30 provinces from 2005 to 2016, this paper adopts a simultaneous equations model (SEM) to evaluate intensities between related factors in the local WEF-Nexus. We define a local WEF-Nexus as containing core, peripheral and interactive sub-nexuses, and decouple the core sub-nexus from the supply, consumption and waste disposal processes. Results show that effective irrigated area, secondary industry rate and crop sown area are key positive influencing factors in the WEF subsystem, with positive impact coefficients of 1.0426, 0.6986 and 1.149, respectively. Food production (-0.303) and chemical fertilizer used per sown area unit (-0.3129) are key negative factors in the WEF subsystem. Additionally, urban green land (0.4436) and total population (0.5815) exert specific influences on the water and energy subsystems, with a 1% increase in urban green land resulting in a 0.4436% increase in water consumption. The system boundary, two positive feedback loops and seven nexus points are identified, with total groundwater pumping being the only nexus point exerting an holistic impact across the WEF equations. The results in this paper complement recent nexus modeling work, and give a better understand of interaction mechanism in China's local WEF nexus, with useful implications for future policy development.

Associating Locality-Level Characteristics With Surviving the Holocaust: A Multilevel Approach to the Odds of Being Deported and to Risk of Death Among Jews Living in Dutch Municipalities.

Characteristics of the localities in which Jews lived have received little attention in research on Holocaust-related deaths. We examined associations between locality-level and individual-level characteristics with the odds of being deported by applying multilevel mixed-effects logistic regression models to data for about 118,000 Jews in 102 Dutch municipalities listed in 1941-1942 and linked to postwar victims and returnees lists. We examined associations between individual-level characteristics and risk of death of deported Jews in multilevel mixed-effects Weibull regression models. Locality-level characteristics, per standard deviation increase, associated with higher deportation chance were more collaborating policemen (OR = 1.07, 95% CI: 1.02, 1.12), strongest segregation mentality (OR = 2.01, 95% CI: 1.15, 3.50), and less employment in agriculture (OR = 0.95, 95% CI: 0.88, 1.01). Higher percentage of Catholics (OR = 0.81, 95% CI: 0.70, 0.94) and stronger electoral support for the National Socialist Movement (OR = 0.90, 95% CI: 0.85, 0.97) unexpectedly reduced deportation chance. Individual-level characteristics associated with lower deportation chance were female sex, ages 0-5 or 15-30 years, and being immigrants, intermarried, or converts to Christianity. Deported males aged 15-30 years had reduced risk of death between July 1942 and July 1943 but increased risk thereafter, consistent with young adult men being selected for work after deportation but this selection not offering long-term protection. Holocaust survival chances were influenced by both locality-level and individual-level characteristics.

Energising the WEF nexus to enhance sustainable development at local level.

The water-energy-food (WEF) nexus is increasingly recognised as a conceptual framework able to support the efficient implementation of the Sustainable Development Goals (SDGs). Despite growing attention paid to the WEF nexus, the role that renewable energies can play in addressing trade-offs and realising synergies has received limited attention. Until now, the focus of WEF nexus discussions and applications has mainly been on national or global levels, macro-level drivers, material flows and large infrastructure developments. This overlooks the fact that major nexus challenges are faced at local level. Aiming to address these knowledge gaps, the authors conduct a systematic analysis of the linkages between small-scale energy projects in developing countries and the food and water aspects of development. The analysis is based on empirical data from continuous process and impact evaluations complemented by secondary data and relevant literature. The study provides initial insights into how to identify interconnections and the potential benefits of integrating the nexus pillars into local level projects in the global south. The study identifies the complex links which exist between sustainable energy projects and the food and water sectors and highlights that these needs are currently not systematically integrated into project design or project evaluation. A more systematic approach, integrating the water and food pillars into energy planning at local level in the global south, is recommended to avoid trade-offs and enhance the development outcomes and impacts of energy projects.

Public Health Policy and Experience of the 2009 H1N1 Influenza Pandemic in Pune, India.

BACKGROUND: Prior experience and the persisting threat of influenza pandemic indicate the need for global and local preparedness and public health response capacity. The pandemic of 2009 highlighted the importance of such planning and the value of prior efforts at all levels. Our review of the public health response to this pandemic in Pune, India, considers the challenges of integrating global and national strategies in local programmes and lessons learned for influenza pandemic preparedness. METHODS: Global, national and local pandemic preparedness and response plans have been reviewed. In-depth interviews were undertaken with district health policy-makers and administrators who coordinated the pandemic response in Pune. RESULTS: In the absence of a comprehensive district-level pandemic preparedness plan, the response had to be improvised. Media reporting of the influenza pandemic and inaccurate information that was reported at times contributed to anxiety in the general public and to widespread fear and panic. Additional challenges included inadequate public health services and reluctance of private healthcare providers to treat people with flu-like symptoms. Policy-makers developed a response strategy that they referred to as the Pune plan, which relied on powers sanctioned by the Epidemic Act of 1897 and resources made available by the union health ministry, state health department and a government diagnostic laboratory in Pune. CONCLUSION: The World Health Organization's (WHO's) global strategy for pandemic control focuses on national planning, but state-level and local experience in a large nation like India shows how national planning may be adapted and implemented. The priority of local experience and requirements does not negate the need for higher level planning. It does, however, indicate the importance of local adaptability as an essential feature of the planning process. Experience and the implicit Pune plan that emerged are relevant for pandemic preparedness and other public health emergencies.

The costs of repatriating an ill seafarer: a micro-costing approach.

Seafarers sail the high seas around the globe. In case of illness, they are protected by international regulations stating that the employers must pay all expenses in relation to repatriation, but very little is known about the cost of these repatriations. The objective of this study was to estimate the financial burden of repatriations in case of illness. We applied a local approach, a micro-costing method, with an employer perspective using four case vignettes: I) Acute myocardial infarction (AMI), II) Malignant hypertension, III) Appendicitis and IV) Malaria. Direct cost data were derived from the Danish Maritime Authority while for indirect costs estimations were applied using the friction cost approach. The average total costs of repatriation varied for the four case vignettes; AMI (98,823 EUR), Malignant hypertension (47,597 EUR), Appendicitis (58,639 EUR) and Malaria (23,792 EUR) mainly due to large variations in the average direct costs which ranged between 9560 euro in the malaria case and 77,255 in the AMI case. Repatriating an ill seafarer is a costly operation and employers have a financial interest in promoting the health of seafarers by introducing or further strengthen cost-effective prevention programs and hereby reducing the number of repatriations.

Health and equity in all policies in local government: processes and outcomes in two Norwegian municipalities.

AIMS: To identify key factors in implementing Health and Equity in All Policies (HEiAP) at the local level in two Norwegian municipalities in order to accelerate the progress of promoting health, well-being and equity in other local governments. APPROACH: This case study is presented as a narrative from policy-making processes in two Norwegian municipalities. The story is told from an insider perspective, with a focus on HEiAP policy makers in these two municipalities. RESULTS: The narrative identified key learning from implementing HEiAP at the local level, i.e. the importance of strengthening system and human capacities. System capacity is strengthened by governing HEiAP according to national legislation and a holistic governance system at the local level. Municipal plans are based on theory, evidence and local data. A 'main story' is developed to support the vision, defining joint societal goals and co-creation strategies. Policies are anchored by measuring and monitoring outcomes, sharing accountability and continuous dialogue to ensure political commitment. Human capacity is strengthened through participatory leadership, soft skills and health promotion competences across sectors. Health promotion competence at a strategic level in the organization, participation in professional networks, crowd sourcing toward common goals, and commitment through winning hearts and minds of politicians and other stakeholders are vital aspects. CONCLUSIONS: Our experience pinpoints the importance of strengthening system and human capacity in local governments. Further, we found it important to focus on the two strategic objectives in the European strategy 'Health 2020': (1) Improving health for all and reducing health inequalities; (2) improving leadership and participatory governance for health.

Analysing local-level responses to migration and urban health in Hillbrow: the Johannesburg Migrant Health Forum.

Johannesburg is home to a diverse migrant population and a range of urban health challenges. Locally informed and implemented responses to migration and health that are sensitive to the particular needs of diverse migrant groups are urgently required. In the absence of a coordinated response to migration and health in the city, the Johannesburg Migrant Health Forum (MHF) - an unfunded informal working group of civil society actors - was established in 2008. We assess the impact, contributions and challenges of the MHF on the development of local-level responses to migration and urban health in Johannesburg to date. In this Commentary, we draw on data from participant observation in MHF meetings and activities, a review of core MHF documents, and semi-structured interviews conducted with 15 MHF members.The MHF is contributing to the development of local-level migration and health responses in Johannesburg in three key ways: (1) tracking poor quality or denial of public services to migrants; (2) diverse organisational membership linking the policy process with community experiences; and (3) improving service delivery to migrant clients through participation of diverse service providers and civil society organisations in the Forum. Our findings indicate that the MHF has a vital role to play in supporting the development of appropriate local responses to migration and health in a context of continued - and increasing - migration, and against the backdrop of rising anti-immigrant sentiments.

Local peace and contemporary conflict: Constructing commonality and exclusion during war in Afghanistan.

Despite the "local turn" in international peacekeeping and the emphasis on community-centered development during the recent wars in Afghanistan and Iraq, it remains poorly understood how local actors-both foreign and indigenous-shape local-level wartime settings. This article explores the processes and consequences of one military unit's efforts to "win hearts and minds" in Afghanistan during 2012-13. The first portion of the analysis examines original textual data with a novel methodological approach depicting the unit's perceptions of commonalities between itself and local actors. The second portion explores the consequences with data from original interviews with residents of southern Afghanistan in 2014-15. The findings suggest that achieving a local peace can be undermined by military and development actors' own perception of the local community. The article concludes with a discussion of how sociological studies of micro-settings between actors can contribute to research on conflict and wartime development, as well as how the sociological study of war can further develop by disaggregating conflict settings and tracing the social construction of wartime socio-political landscapes.