Structural funds the challenge for sustainable development and regional disparity in the Slovak Republic

The countries of Central and Eastern Europe have undergone unprecedented political and economic changes since the fall of the Berlin Wall in 1989. The EU responded by providing political and financial support for the difficult transformation of these countries and refocused its policies towards the strategy of preparing associate countries for membership. This strategy, commonly known as the ‘pre‐accession strategy’, has three main instruments: European Agreements, structured dialogue and the PHARE programme. After a short delay in the negotiation process caused by political instability, the Slovak Republic has been offered membership in the EU, together with nine other candidates, in May 2004.

The transition process from a command‐and‐control economy to a market economy and a democratic society addressed the issue of the numerous differences in the regions in the Slovak Republic. The high disparity in economic development and low competitiveness of the regions with a resultant dramatic rise in unemployment in a number of ‘low‐income regions’ are some of the major observations. Rather than a result of its rural character alone, the main reason for regional disparity in the Slovak Republic is the deformation of historical relationships in rural areas as a result of industrialization and the intensification of agriculture in the command‐and‐control economy of the past. This led to a distortion of traditional farming habits as well as environmental damage to agricultural land and forests. In addition, the environmental infrastructure (sewerage, water treatment, etc.) is underdeveloped in these regions. Environmental protection and its infrastructure thus play a significant role in the regional disparity of the Slovak Republic and the approximation of the Slovak Republic in the environmental sector can provide double dividends for these low‐income regions. This paper analyses the above‐mentioned regional disparities and tries to identify reasons and measures particularly regarding sustainable development. It also discusses the pre‐accession period failures and successes that can be taken as a learning experience in regard to the financial opportunities of Structural Funds that will emerge upon entering the European Community in May 2004. The paper contains information available prior to February 2003.     

Ergonomics and education as a strategy for sustainable development in business

It is part of the vocabulary of organizations, and the agendas discussed the subject of "Sustainability", but there are few companies that implement practices or even know the means of implementing sustainable practices. The objective of this paper is to discuss an approach to education for sustainable development (ESD) based on the concepts and practice of ergonomics, as a consequence of this approach allows the implementation of integration initiatives focused on sustainability, such as eg. energy efficiency and consumer awareness thus allowing a means of reducing costs and operating expenses, increased competitiveness and significant contributions to corporate sustainability. There is also the inclusion of sustainability in corporate strategic planning, and their implications in the different spheres of the market.     

Biodiversity action plans as a way towards local sustainable development

Local action for biodiversity is essential to ensure better conservation status for biodiversity and maintain ecosystem services. In many places the rich biodiversity is still relatively untouched and represents an outstanding asset for local sustainable development. The loss of biodiversity occurs mainly because of rapid changes in land use, urban sprawl, infrastructure development, acidification, eutrophication, desertification, overexploitation, intensification of agriculture, tourism development and climate change. There is a clear need for a more flexible, people-oriented and visionary approach for sustainable use of biodiversity resources. This article concerns “Local Biodiversity Action Plans”, which provide a comprehensive and integrated approach to biodiversity and ecosystem services for the sustainable development of rural municipalities and their local communities. Although biodiversity action planning is not a new concept, bringing a plan to life has significant societal benefits with innovative solutions to help biodiversity conservation while entailing close interaction of science, policy and society. This approach was developed together with project partners and local communities in selected regions of the Western Balkans and it benefits from a range of stakeholders, including social and natural scientists, practitioners, elected representatives of the local communities and end users in the frame of a participatory approach. The conclusion of this article discusses the role of communication and outlines the critical success factors and the challenges ahead for the future.     

Work-life balance for sustainable human development: Cultural intelligence as enabler

It is proposed that sustainable human development can occur only when there is a reasonable work-life balance for humans. Developmental work for humans is mostly achieved through high performing organizations, and the performance of organizations, in turn, depend on the commitment and engagement of their employees. While societies organize themselves though groups which come together to form an organization, the individual continues to play a key role in success of these organizations. This article explores the impact of an individual’s work-life balance on his/her role—related engagement, thereby contributing to the sustainable human development. Since culture drives behavior for all three, that is, the individual, the organizations, and the society, it is suggested that if we create a culture that supports work-life balance, it is likely to promote sustainable human development though higher role-related engagement of individuals. Further, it is suggested that cultural intelligence plays an important role in achieving both work-life balance and sustainable human development.     

Prevention programmes for youth gambling: a review of the empirical evidence

This paper critically reviews the existing literature on the effectiveness of gambling prevention programmes for youth. Two categories of preventive strategies, all universal and most school-based, are presented: gambling-specific prevention programmes and gambling and related skills workshops. The age of the participants across the different studies varied from 9 to 20 years. Results show that programmes in both categories are generally effective in reducing misconceptions and increasing knowledge about gambling. However, a lack of long-term follow-ups and of behavioural measures makes it difficult to draw any clear conclusions about the effectiveness of such programmes. Recommendations are presented to improve the development and evaluation of future prevention programmes for youth gambling.     

Ethics of resource allocation: instruments for rational decision making in support of a sustainable health care

Objective: In all western countries health care budgets are under considerable constraint and therefore a reflection process has started on how to gain the most health benefit for the population within limited resource boundaries. The field of “ethics of resource allocation” has evolved only recently in order to bring some objectivity and rationality in the discussion. In this article it is argued that priority setting is the prerequisite of ethical resource allocation and that for purposes of operationalization, instruments such as “need assessment” and “health technology assessment (HTA)” are essential worktools for making more rational decisions. Thresholds (deduced from the need assessment and HTA) are—within this context—guiding but not binding principles. Method: Discussion of theoretical concepts of not only priority setting, need assessment and HTA complemented by practical examples for showing the challenges and the need, but also the chances of a more explicit and transparent policy of resource allocation in health care. Results: Priority setting in health care is based on the values of equity, justice and solidarity. Health packages decisions are determined from medical need (the severity of the condition) and/or the appropriateness of medical interventions (their cost-effectiveness). With growing awareness that originally effective and cost-effective services and programmes are eventually provided inappropriately, the focus is shifting towards the organisational aspects of provision and application. Therefore, need assessment is based on the distinction of health care needs from demand, supply, or actual care. Additionally HTA provides the evidence on health care interventions in a way that it becomes obvious who benefits from an intervention and who definitely does not benefit, but eventually is harmed. Conclusions: Health services research on effective and cost-effective interventions and research/monitoring of performance that the effective and cost-effective services are provided appropriately are of increasing importance for guiding the decision-making process on priority setting and need assessment. Effective healthcare for all is sustainable, if we start to put expenditures in perspective and focus health policies and research strategies on managing expectations through patient information and a more realistic notion of medical advancements and, on the other hand, on encouraging need-based and cost-effective innovations.

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Zusammenfassung Ziel: In allen Ländern des Westens ist die Haushaltslage im Gesundheitswesen heute äußerst angespannt, weshalb nun ein Reflexionsprozess begonnen hat, wie mit begrenzten Haushaltsmitteln der größtmögliche gesundheitliche Nutzen für die Bevölkerung erzielt werden kann. Erst in jüngster Zeit ist die “Ethik der Mittelzuweisung” als Arbeitsgebiet entwickelt worden, mit dem Ziel, eine gewisse Objektivität und Rationalität in die Diskussion zu bringen. In diesem Artikel argumentieren wir, dass eine ethische Mittelzuweisung Prioritätssetzungen erfordert und dass Instrumente wie Bedarfeinschätzung (Need Assessment) und Bewertung medizinischer Verfahren [Health Technology Assessment (HTA)] wesentliche Arbeitswerkzeuge zur Erzielung rationaler Entscheidungen sind. Schwellenwerte (abgeleitet aus Need Assessment und HTA) dienen in diesem Zusammenhang als leitende, jedoch nicht bindende Prinzipien. Methode: Diskussion theoretischer Begriffe der Prioritätssetzung, Bedarfeinschätzung und HTA, ergänzt durch praktische Beispiele zur Darstellung der Herausforderungen des Bedarfs nach, aber auch der Chancen für eine explizitere und transparentere Politik der Mittelzuweisung im Gesundheitswesen. Ergebnisse: Prioritätssetzung im Gesundheitswesen basiert auf den Werten Gleichheit, Gerechtigkeit und Solidarität. Entscheidungen über Versorgungspakete richten sich nach der medizinischen Bedarfslage (Schwere der Erkrankung) und/oder der Angemessenheit medizinischer Eingriffe (Kosteneffektivität). Mit der wachsenden Erkenntnis, dass ursprünglich effektive und kosteneffektive Leistungen und Programme am Ende unangemessen bereitgestellt werden, richtet sich die Aufmerksamkeit mehr auf Organisationsaspekte der Bereitstellung und Anwendung. Need Assessment basiert daher auf der Unterscheidung zwischen Bedarf im Gesundheitswesen und Nachfrage, Angebot oder tatsächlicher Versorgung. HTA fasst dann die Evidenz zu Eingriffen seitens des Gesundheitswesens zusammen, sodass offenbar wird, wem ein Eingriff nützt und wem er mit Sicherheit nicht nützt, sondern am Ende schadet. Schlussfolgerungen: Forschungen der Gesundheitsdienste zu effektiven und kosteneffektiven Eingriffen sowie die Erforschung/Erfolgskontrolle einer angemessenen Bereitstellung effektiver und kosteneffektiver Dienste sind von wachsender Bedeutung für die Information des Entscheidungsprozesses zur Prioritätssetzung und Bedarfseinschätzung. Eine effektive Gesundheitsversorgung für alle bleibt tragbar, sofern wir beginnen, Ausgaben in Perspektive zu setzen und gesundheitspolitische Entscheidungen und Forschungsstrategien darauf ausrichten, Erwartungen zu lenken, indem wir die Patienten informieren und eine realistischere Einschätzung medizinischer Fortschritte fördern, und uns zugleich auf bedarfsorientierte und kosteneffektive Innovationen konzentrieren.

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Résumé Objectif : Dans tous les pays occidentaux, les budgets de santé publique sont soumis à de fortes contraintes, ce pourquoi un processus de réflexion a commencé sur la question de savoir comment obtenir avec des moyens limités la plus grande utilité possible pour la population en termes de santé. Ce n’est que récemment que « l’éthique de l’allocation des ressources » a été développée pour apporter une certaine part d’objectivité et de rationalisme dans la discussion. Le présent article soutient que l’attribution de priorités est la condition préalable indispensable à l’allocation des ressources et que des instruments tels que l’évaluation des besoins (need assessment) et l’évaluation des technologies de la santé (ETS/HTA) sont des outils essentiels pour parvenir à des décisions plus rationnelles. Les valeurs seuils (déduites de l’évaluation des besoins et de l’ETS) servent dans ce contexte de principes directeurs, mais non contraignants. Méthode : Discussion sur les notions théoriques d’attribution de priorités, d’évaluation des besoins et d’ETS, complétée par des exemples pratiques mettant en évidence les défis et les besoins, mais aussi les chances d’une politique d’allocation des ressources de santé plus explicite et transparente. Résultats : L’attribution des priorités dans le domaine de la santé se base sur les valeurs d’équité, de justice et de solidarité. Les décisions relatives à des ensembles thérapeutiques sont déterminées par le besoin médical (gravité de la maladie) et/ou le caractère opportun des interventions médicales (efficacité des coûts). Avec la prise de conscience que des services et des programmes initialement opérationnels et efficaces en termes de coûts sont appliqués de manière inappropriée, l’attention se porte sur les aspects organisationnels de l’attribution et de l’application. L’évaluation des besoins se base par conséquent sur la distinction entre les besoins de santé provenant de la demande, de l’offre et de l’approvisionnement effectivement fourni. L’évaluation des technologies de la santé procède à une synthèse des preuves faisant apparaître qu’une intervention de santé est utile à un patient, lui est en toute certitude inutile, voire préjudiciable. Conclusions : Les recherches des services de santé sur les interventions efficaces en termes de thérapie et de coûts, de même que la recherche/le suivi des performances sur une fourniture appropriée de services efficaces en termes de thérapie et de coûts revêtent une importance croissante pour guider le processus décisionnel sur l’attribution des priorités et l’évaluation des besoins. Une couverture de santé efficace pour tous n’est viable que si nous commençons à mettre les dépenses en perspective et à concentrer les politiques de la santé et les stratégies de recherche sur la gestion des attentes, en informant les patients et en promouvant une estimation plus réaliste des progrès médicaux, et d’autre part en encourageant les innovations fondées sur les besoins et sur le rendement des coûts.

     

Children in out-of-home care as young adults: A systematic review of outcomes in the Nordic countries

BackgroundInternationally, the Nordic countries occupy top positions in child well-being. We investigated literature on the overall outcomes of young adults from the most vulnerable backgrounds in the Nordic countries, namely young adults who were placed in statutory out-of-home care (OoHC, i.e. foster care) during childhood in the Nordic countries for the protection of their safety and welfare.MethodsWe followed PRISMA guidelines and conducted literature searches manually, as well as electronically, via EBSCO's Psychology/Sociology databases and ProQuest's Social and Behavioral Sciences databases in February 2016 for quantitative studies that compared outcomes at age 18 or later between young adults placed in OoHC as children and those never placed in OoHC. Because of the heterogeneity and small number of eligible studies on each outcome, we conducted no meta-analysis but did formulate a narrative synthesis.ResultsOf 333 studies identified, 20 met the inclusion criteria. All of these studies were cohort studies that employed social and health register data. OoHC placement was studied with nine outcome categories: self-supporting problems, educational challenges, mental health problems, criminality, teenage parenthood, mortality, suicidal behavior, alcohol and drug use, and disability pension. In each of these categories, young adults with a history in OoHC faced higher risks compared with the general population, even after adjusting for various birth parents' socio-economic, demographic, and mental health–related factors.ConclusionAlthough the Nordic countries are among the world's leading nations in promoting child well-being, the Nordic welfare model has partly failed in preventing the inequality of families with children. As young adults, children placed in OoHC in the Nordic countries face an elevated risk of experiencing adversity.     

Evaluating the effectiveness of the Massachusetts workforce development system using no-shows as a nonexperimental comparison group

This article examines the effect of the Massachusetts workforce development system on the earnings of disadvantaged adults using nonexperimental data from the late 1990s. The authors construct a comparison sample for program participants using individuals who apply for and are offered services yet do not participate in a training program. They present a series of difference-in-difference estimates that make several alternative efforts to correct for selectivity bias, including econometric models that regression adjust for observable characteristics and fixed-effect models that adjust for time-invariant person effects. They also employ probabilistic matching techniques to more finely align the treatment and comparison samples. On average, program participants experienced 20% increases in annual earnings 1 year postintervention and 25% increases after 2 years. The authors uncover considerable heterogeneity in these effects, suggesting that the most difficult to serve and the most job ready benefit the least.     

Policy instruments for reducing toxic releases. The effectiveness of state information and enforcement actions

This article analyzes the extent to which different policy instruments explain toxic reductions among the states. Data from the Toxics Release Inventory (TRI) and other sources are used to assess the effect of various policy instruments, while holding economic factors constant. State TRI information programs, enforcement action, and direct regulation all matter in reducing toxic releases. Interestingly, the informational tool seems to matter more than both authoritative tools. The findings also support the idea that the interaction of policy instruments as well as the match between policy tools and policy context may account for a portion of the results.     

Towards an effective strategy to cope with housing land scarcity in the Gaza Strip as a sustainable development priority

Consistent with the global trends towards the adoption and implementation of sustainable urban planning strategies, this study discusses the problem of housing land shortage, considering the ever rapidly growing human population. Urban land is one of the most precious resources that need to be consumed and developed wisely. In this context, housing density is a widely used tool to control housing land consumption and ensure acceptable housing environments. With reference to the Gaza Strip (Palestinian Territories), the main aim of this study is to highlight the role of increasing housing density in order to face the problem of housing land scarcity. Within this scope, building legislation implemented in Gaza has been reviewed with reference to housing density. A questionnaire and a case study have been analyzed to propose recommendations related to housing planning and design. It has been concluded that rationalising urban land consumption in Gaza can be achieved by a dual strategy approach that increases housing density above the currently specified limit, and reduces the area of the typical Palestinian housing unit. This has to be done without sacrificing the limited open spaces available in the local housing environment. Thus, solutions that strike a balance between dense housing patterns and adequate urban environment, are essentially required here.     

旅游对区域经济发展贡献度研究--以秦皇岛为例

目前,旅游业已成为全球最大的产业之一,国际上许多国家和地区,国内的绝大多数省区把旅游业定位为主导或支柱产业.然而,长期以来,由于旅游有关概念的不统一,统计体系与方法、统计资料的不完善等种种原因,使得旅游业在区域社会经济发展中的地位和作用始终缺乏全面、科学、客观的量化分析和个案研究.     

Mortality rates as indicators of cross-cultural development: regional variations in the Third World

"While infant mortality and the under 5 mortality rates are widely used as measures of development, the death rate among 1-4 year olds may be a more effective measure of socioenvironmental conditions affecting mortality, since this age group is less influenced by genetic and biological factors than infants. This article looks at the relationship between infant, under 5, and 1-4 mortality rates and level of development, immunization, information, access to drinking water and health services, and literacy rates among mothers for 78 less developed countries. The evidence suggests that socioenvironmental variables have greater degrees of correlation with age group 1-4 mortality than infant or under 5 mortality, pointing to the importance of this measure in cross-cultural research."     

A stimulus for sustainable growth and development: Construing a composite index to measure overall corporate performance

Abstract

Various methods have been developed to measure sustainability. When it comes to measuring whether sustainability issues are integrated in overall corporate performance, companies broaden their reporting from economic performance to ‘sustainability performance’ and there are various frameworks around for benchmarking sustainability outcomes. A major emphasis, however, is on technical data. The main efforts have been consolidated in the Global Reporting Initiative (GRI). Each of the indicators prudently measures a well-determined set of facts. However, one major discussion point is whether the reporting frameworks do really reflect the link between sustainability and economic value, and how they would properly connect to the information used by management for running the business on a day-to-day basis. This article tries to point out that one way out of the disconnected ness might be through expanding the concept of ‘Economic Value Added’ (EVA). EVA measures overall corporate performance by claiming that shareholders gain when the return from the capital employed in a corporation is greater than the cost of that capital. From there it is a short way to proclaiming that all stakeholders gain when the value created by a corporation is greater than the cost of the capital employed in the corporation and the capital employed in whichever commonly available resources outside the corporation are used by its business. The expansion of EVA that is envisaged would be to enlarge the cost of capital by the costs that are caused by that part of ‘Public Goods’ that is available to a corporation. There is one political and one theoretical obstacle in this: the argument is quite radical and complying with it would require some leadership from ‘big corporations’; and valuing public goods is a research field that has not yet reached the stadium of generally accepted applicability, at least with regard to aggregative monetary value. However there are new initiatives under way, by the GRI, which will join forces to reach a breakthrough. The article also reflects on the effects the new indicator would stimulate for businesses, their markets and their stakeholders.     

Examining the effectiveness of health and safety committees and representatives: a review

The establishment of a health and safety committee in the workplace and/or the appointment of an elected health and safety representative is believed to foster employee participation and consultation in the workplace. Despite an emphasis within the Australian occupational health and safety legislation towards employee participation in relation to health and safety issues, there is little known about the effectiveness of the strategies used to involve workers in health and safety matters in the workplace. There is anecdotal evidence published in relation to the implementation of health and safety committees and their effectiveness in the Australian workplace. Few opinions however are substantiated by empirical evidence. Significantly more research has been conducted on the role of health and safety representatives in Australia. This paper presents the findings of a review of the literature and identifies the factors that are considered to impact on the effectiveness of workplace health and safety committees and representatives. Several factors are described as being fundamental to the effective performance of committees and representatives. These factors include management commitment, communication, training and information, union involvement, the infrastructure of an organisation, committee processes and the involvement of professional experts. It is concluded that the effectiveness of health and safety committees in Australia is unexplored and it is unknown if these committees achieve the purpose for which they were established. Recommendations are made for future research to be conducted to test the current anecdotal evidence and assumptions associated with the operation and effectiveness of health and safety committees.     

The effectiveness of health care cost management strategies: a review of the evidence

This Issue Brief discusses the evolution of the health care delivery and financing systems and its effects on health care cost management and describes the changes in the health care delivery system as they pertain to managed care. It presents empirical evidence on the effectiveness of managed care and concludes with an analysis of the potential of future health care reform to influence the evolution of the health care delivery system and affect health care costs. Between 1987 and 1993, total enrollment in health maintenance organizations (HMOs) increased from 28.6 million to 39.8 million, representing an additional 11.2 million individuals, or 4 percent of the U.S. population. At the same time, new forms of managed care organizations emerged. Enrollment in preferred provider organizations increased from 12.2 million individuals in 1987 to 58 million in 1992, and enrollment in point-of-service plans increased from virtually none in 1987 to 2.3 million individuals in 1992. In addition, the percentage of traditional fee-for-service plans with some form of utilization review increased to 95 percent in 1990 from 41 percent in 1987. Measuring the effects of the changing delivery system on the costs and quality of health care services has been a difficult task, resulting in considerable disagreement as to whether or not costs have been affected. In a recent report, the Congressional Budget Office recognizes two new major findings. First, managed care can provide cost-effective health care at a level of quality comparable with the care typically provided by a fee-for-service plan. Second, independent practice associations can be as effective as group- or staff-model HMOs under certain conditions. In the future, we are likely to see a continued movement of Americans into managed care arrangements, an increase in the number of physicians forming networks, a reduction in the number of insurers, an increase in the number of employers joining coalitions to purchase health care services for their employees, and a health care system that is generally more concentrated and vertically integrated.     

Evaluating the engagement of universities in capacity building for sustainable development in local communities

Universities have the potential to play a leading role in enabling communities to develop more sustainable ways of living and working however, sustainable communities may only emerge with facilitation, community learning and continual efforts to build their capacities. Elements of programme planning and evaluation on the one hand, and capacity building on the other, are needed. The latter entails approaches and processes that may contribute to community empowerment; universities may either lead such approaches, or be key partners in an endeavour to empower communities to address the challenges posed by the need for sustainable development. Although capacity building and the promotion of sustainable development locally, are on the agenda for universities who take seriously regional engagement, very little is published that illustrates or describes the various forms of activities that take place. Further, there is a paucity of studies that have evaluated the work performed by universities in building capacity for sustainable development at the local level. This paper is an attempt to address this need, and entails an empirical study based on a sample of universities in the United Kingdom, Germany, Portugal and Brazil. The paper examines the extent to which capacity building for sustainable development is being undertaken, suggests the forms that this might take and evaluates some of the benefits for local communities. The paper concludes by reinforcing that universities have a critical role to play in community development; that role has to prioritise the sustainability agenda.