Based on the panel data of 22 inland provinces in China from 2010 to 2020, this study constructs and measures the level of rural ecological environment in China. The impact of the financial performance of green-listed companies on the rural ecological environment and its moderating and threshold effects are analyzed. The following conclusions are drawn: (1) During 2010-2020, China\'s rural ecological environment shows a trend of \"fluctuating-decreasing-rising\" with significant regional non-equilibrium characteristics. (2) The financial performance of green-listed companies has a significantly negative impact on rural ecology. This negative impact has a crucial heterogeneous feature, with a more significant negative impact in areas with a higher rural ecological environment index and less substantial performance in regions with a lower rural ecological environment index. (3) There is a significant positive moderating effect of education level and digitalization on the relationship between the financial performance of green-listed companies on the level of rural ecological development. As moderating variables, the digitalization and education level weakens the negative impact of green-listed companies\' performance on the ecological environment. The positive impact of the financial performance of green-listed companies on the development level of the rural ecological environment is more vital in areas with higher per capita education levels and digitalization in rural areas. (4) There is a significant threshold effect on the financial performance of green-listed companies on the level of rural ecological development. When the financial performance of green-listed companies exceeds a particular threshold value, the impact of the financial performance of green-listed companies on the development level of the rural ecological environment is significantly positive. Based on the above findings, this paper puts forward corresponding countermeasure suggestions.

OBJECTIVE: As part of a national plan to govern professional and organizational development in Norwegian specialist healthcare, the country\'s hospital clinics are tasked with constructing development plans. Using the development plan as a case, the paper analyzes how managers navigate and legitimize the planning process among central actors and deals with the contingency of decisions in such strategy work.
METHODS: This study applies a qualitative research design using a case study method. The material consists of public documents, observations and single interviews, covering the process of constructing a development plan at the clinical level.
RESULTS: The findings suggest that the development plan was shaped through a multilevel translation process consisting of different contending rationalities. At the clinical level, the management had difficulties in legitimizing the process. The underlying tension between top-down and bottom-up steering challenged involvement and made it difficult to manage the contingency of decisions.
CONCLUSIONS: The findings are relevant to public sector managers working on strategy documents and policymakers identifying challenges that might hinder the fulfillment of political intentions.
CONCLUSIONS: This paper draws on a case from Norway; however, the findings are of general interest. The study contributes to the academic discussion on how to consider both the health authorities\' perspective and the organizational perspective to understand the manager\'s role in handling the contingency of decisions and managing paradoxes in the decision-making process.

For the fields of implementation science and health equity, understanding and being responsive to local contexts is of utmost importance to better inform the development, implementation, and evaluation of healthcare and public health interventions to increase their uptake and sustainment. Contexts are multi-level and include political, historical, economic, and social factors that influence health, as well as organizational characteristics, reflecting the richness of members\' views, resources, values, and needs. Poor alignment between solutions and those contextual characteristics could have an impact on inequities. The PRISM (Practical Robust Implementation and Sustainability Model) is a context-based implementation science framework that incorporates RE-AIM outcomes (Reach, Effectiveness, Adoption, Implementation, Maintenance) and offers guidance to researchers, practitioners, and their patient and community partners on how to conceptualize, assess, and address contextual domains with a focus on health equity. Drawing from systems thinking, participatory engagement, and health equity principles, this commentary expands on previous work to 1) offer a novel perspective on how to align an intervention\'s core functions and forms with the PRISM\'s contextual domains, and 2) foster an ongoing and iterative engagement process with diverse partners throughout the research and practice process using a co-creation approach. We recommend intervention-to-context alignment through iterative cycles. To that end, we present the RE-AIM Framework\'s \'outcomes cascade\' to illustrate touch points of opportunity and gaps within and across each of the five RE-AIM outcomes to illustrate \'where things go wrong\'. We present a case study to illustrate and offer recommendations for research and practice efforts to increase contextual responsiveness, and enhance alignment with context before, during, and after implementation efforts and to ensure equity is being addressed. We strive to make a conceptual contribution to advance the field of pragmatic research and implementation of evidence-based practices through the application of the contextually-based PRISM framework with a focus on health equity.

Health National Adaptation Plans were developed to increase the capacity of low- and middle-income countries (LMICs) to adapt to the impacts of climate change on the health sector. Climate and its health impacts vary locally, yet frameworks for evaluating the adaptive capacity of health systems on the subnational scale are lacking. In Kenya, counties prepare county integrated development plans (CIDPs), which contain information that might support evaluations of the extent to which counties are planning climate change adaptation for health.
To develop and apply a framework for evaluating CIDPs to assess the extent to which Kenya\'s counties are addressing the health sector\'s adaptive capacity to climate change.
CIDPs were analyzed based on the extent to which they addressed climate change in their description of county health status, whether health is noted in their descriptions of climate change, and whether they mention plans for developing climate and health programs. Based on these and other data points, composite climate and health adaptation (CHA) scores were calculated. Associations between CHA scores and poverty rates were analyzed.
CHA scores varied widely and were not associated with county-level poverty. Nearly all CIDPs noted climate change, approximately half mentioned health in the context of climate change and only 16 (34%) noted one or more specific climate-sensitive health conditions. Twelve (25%) had plans for a sub-program in both adaptive capacity and environmental health. Among the 24 counties with plans to develop climate-related programs in health programs, all specified capacity building, and 20% specified integrating health into disaster risk reduction.
Analyses of county planning documents provide insights into the extent to which the impacts of climate change on health are being addressed at the subnational level in Kenya. This approach may support governments elsewhere in evaluating climate change adaptation for health by subnational governments.

This research adds to the body of knowledge by examining the asymmetric link between rural development and pro-environmental behavior in rural China. Rural development is assessed via rural income and digital financial inclusion. We use linear and nonlinear autoregressive distributed lag (ARDL) models to assess short- and long-term effects. The linear analysis suggests that a rise in rural income and digital financial inclusion encourages long-term access to clean fuels and technologies (CFT) in rural areas, while they do not have any significant impact in the short run. On the other side, the nonlinear framework illustrates that a positive shock in rural income and digital financial inclusion encourages long-term access to CFT in rural areas. A negative shock in rural income reduces long-term access to CFT in rural areas, and a negative shock in digital financial inclusion does not significantly impact access to CFT. However, in the short run, only the estimates of rural income are significant, while the estimates attached to digital financial inclusion are insignificant, implying that a rise in rural income increases access to CFT and a fall in rural income reduces access to CFT. Thus, government should encourage collaboration between private sector and civil society organizations to promote sustainable rural development and pro-environmental behavior.

BACKGROUND: Shortages of nurses and unequal distribution of nursing staff have been huge challenges for global health services.
OBJECTIVE: The aim of our study was to evaluate the impact of the National Nursing Development Plan on nursing human resources in China.
METHODS: An interrupted time series design was used in this study. The data for this study were extracted from the National Health Statistics Yearbook from 1978 to 2021. The Ministry of Health issued the National Nursing Development Plan (2005-2010) in July 2005. Subsequently, the strategic plan was issued every 5 years: the National Nursing Development Plan (2011-2015), the National Nursing Development Plan (2016-2020), and the National Nursing Development Plan (2021-2025). This study used five indicators including 1) the number of registered nurses (RNs) in China, 2) the number of RNs per 1000 population in China, 3) the proportion of RNs in health technical personnel in China, 4) the doctor-nurse ratio and 5) the number of nurses working in primary medical institutions to evaluate the changing trend of nursing human resources in China from 1978 to 2021.
RESULTS: Interrupted time series analysis showed that after the implementation of the National Nursing Development Plan (2005-2010), the building of nurses in China was gradually strengthening, and the number of RNs in China increased by 0.198 million per year (95%CI 0.174-0.223; P < 0.001); the number of RNs per 1000 population (Coefficient = 0.139; 95%CI 0.123-0.154; P < 0.001); the proportion of RNs in the total number of health professionals in China has increased from 29.6 % to 44.6 % (Coefficient = 0.010; 95%CI 0.009-0.010; P < 0.001); in China, the doctor-nurse ratio increased by 0.024 (95%CI 0.019-0.029; P < 0.001). In 2021, the number of RNs working in primary medical institutions increased by approximately 0.86 million compared with that in 2005, and the proportion of RNs in the country increased by 1.4 %. The development of nurses is especially tilted to the primary level to meet the health and nursing needs of the primary level.
CONCLUSIONS: The implementation of the National Nursing Development Plan has greatly expanded the scale of nursing human resources in China and significantly optimized the efficiency of allocation. The implementation of the National Nursing Development Plan (2011-2015) and the National Nursing Development Plan (2016-2020) well continued the strategic plan from 2005 to 2010, further expanded the nursing workforce and further optimized the allocation efficiency.
CONCLUSIONS: The implementation of the National Nursing Development Plan has greatly expanded the scale of nursing human resources in China and significantly optimized the efficiency of allocation.

Linear infrastructure (LI) has varying effects on landscapes depending on different ecosystems\' sensitivity and threat levels. Economically developing tropical countries are particularly at risk from LI. Therefore, understanding a country\'s current LI network and planning future developments to avoid further fragmentation and disturbance is crucial. This study aimed to assess the extent of Sri Lanka\'s LI network (i.e., roads, railroads, and powerlines), given that it is both a biodiversity hotspot and an economically developing country in the tropics. First, we calculated the average normalized difference vegetation index (NDVI) and normalized difference built-up index (NDBI) indices and examined their spatial autocorrelation per divisional secretariat division. Then a multivariate cluster analysis was used to determine clusters of natural and protected areas that may receive similar impacts from different LI and their combinations. Results indicated that roads are the most widespread LI type in Sri Lanka, followed by powerlines and railroads. Over 80% of Sri Lanka\'s total land area falls within 1 km of either a national or a provincial/local road. Areas with high NDVI were primarily manmade habitats, with less than 20% contribution from protected areas. Over 50% of the total protected area of Sri Lanka is being impacted by all three types of LI. Powerlines were the most common LI type in protected areas in proportion to their total network lengths. To minimize environmental impact while achieving development goals, future LI development activities should use a landscape approach to identify development needs and strategies informed by these findings.

Recruiting and retaining public health employees and ensuring they have the skills necessary to respond are vital for meeting public health needs. As the first study examining health department (HD) workforce development plans (WDPs), this study presents gaps and strategies identified in WDPs across 201 accredited HDs (168 initial/33 reaccreditation plans).
This cross-sectional study employed qualitative review and content analysis of WDPs submitted to the Public Health Accreditation Board (PHAB) between March 2016 and November 2021.
Eight overarching workforce themes were examined: planning/coordination, leadership, organizational culture, workplace supports/retention, recruitment, planning for departmental training, delivery of departmental training, and partnership/engagement. Within each theme, related subthemes were identified. Coders indicated whether the WDP (1) identified the subtheme as a gap; (2) stated an intent to address the subtheme; and/or (3) identified a strategy for addressing the subtheme.
The most common gaps identified included prepare workforce for community engagement/partnership (34.3%, n = 69), followed by resource/fund training (24.9%, n = 50). The subtheme that had the most instances of an identified strategy to address it was assess training needs (84.1%, n = 169), followed by foster quality improvement (QI) culture/provide QI training (63.2%, n = 127). While both of these strategies were common among the majority of HDs, those subthemes were rarely identified as a gap. Secondary findings indicate that increase recruitment diversity/recruit from a more diverse applicant pool was rarely identified as a gap (6.0%, n = 12) and rarely had an identified strategy for addressing the subtheme (9.0%, n = 18).
While HDs recognized many workforce gaps, HDs did not always propose a strategy for addressing them within the WDP. Conversely, some WDPs proposed strategies for subthemes that did not reflect recognized gaps. Such discrepancies between identified gaps and strategies in WDPs may suggest areas where HDs could use additional support and guidance.

Prior research has demonstrated ways in which community events help to establish age-friendly community initiatives and strengthen their impact. We extend these insights by discussing how the design and implementation of a statewide event - the New Jersey Age-Friendly Virtual Fair - exemplifies this practice theory and extends its applicability beyond local community development toward broader state-level age-friendly ecosystems. We describe how events that are deliberately multi-organizational, multi-sectoral, and multi-level can help to further propel the Age-Friendly Movement toward systems change for aging in community.

The problem of imbalanced urban-rural development in China is becoming increasingly serious. Urban-rural integration (URI) is an inevitable way to narrow the urban-rural gap and promote rural development. The Yellow River Basin (YRB) is an important barrier to China\'s ecological security and plays a crucial role in promoting ecological protection and in high-quality development strategies. Therefore, this article constructs an evaluation index system for URI from five dimensions: economic integration, social integration, ecological integration, element integration, and spatial integration. The simulated annealing-projection pursuit model and time degree are used to analyze the dynamic urban-rural integration level (URIL) of 373 counties from 2000 to 2019. Building upon this foundation, this study classifies four types of URI zones and proposes development strategies tailored to each zone. The results indicate (1) that the URIL in the YRB continues to increase, and that there has been a significant increase in high-level integration areas since 2010. (2) The URIL exhibits a distinct spatial clustering pattern, characterized by lower levels in the upper reaches, and higher levels in the middle and lower reaches. (3) There exists a spatial disparity between economic development and the ecological environment, and it is particularly noticeable in the lower reaches regions. These results contribute to a better understanding of URI in the YRB and provide a reference for the sustainable development of URI in various regions.