Utilization of ADCCs and quality of life among older adults: ethno-regional disparities in Israel

Background Adult day care centers (ADCCs) are a common service provided for frail older adults in the community. We examined the influence of older adults’ utilization of ADCC’s on their quality of life (QoL), and whether ethno-regional disparities are factors in the gaps found concerning QoL in different regions and between different ethnic groups. Methods Cross sectional data were collected through structured interviews with 360 older adults attending ADCCs. Participants represented three ethnic groups and three regions in Israel. QoL was assessed by SF-36 questionnaire. Results The results revealed a positive correlation between weekly hours at the ADCC, satisfaction with attending ADCC, and QoL. Older adults living in the central region had higher QoL than those living in the southern and northern regions. Veteran Israeli Jews reported higher QoL than FSU immigrants Israeli Arabs in all regions. Connection to one’s residential area was also correlated with QoL. A significant moderating effect of the interaction (ethnicity*area of residence) on QoL was also revealed. Conclusions Attending ADCC is a vital community services to promote QoL in later life. Gaps in ADCC utilization between ethnic groups and residential region may cause disparities in QoL, specifically, in minority groups and those living in peripheral regions. Service providers should minimize the disparities by improving accessibility and availability for each person regardless of ethnicity and region of residence.

Total patient load, regional disparities and in-hospital mortality of intubated COVID-19 patients in Greece, from September 2020 to May 2021

Aims: While healthcare services have been expanding capacity during the COVID-19 pandemic, quality of care under increasing patient loads has received less attention. We examined in-hospital mortality of intubated COVID-19 patients in Greece, in relation to total intubated patient load, intensive care unit (ICU) availability and hospital region. Methods: Anonymized surveillance data were analyzed from all intubated COVID-19 patients in Greece between 1 September 2020 and 6 May 2021. Poisson regression was used to estimate the hazard of dying as a function of fixed and time-varying covariates. Results: Mortality was significantly increased above 400 patients, with an adjusted hazard ratio of 1.25 (95% confidence interval (CI): 1.03–1.51), rising progressively up to 1.57 (95% CI: 1.22–2.02) for 800+ patients. Hospitalization outside an ICU or away from the capital region of Attica were also independently associated with significantly increased mortality. Conclusions: Our results indicate that in-hospital mortality of severely ill COVID-19 patients is adversely affected by high patient load even without exceeding capacity, as well as by regional disparities. This highlights the need for more substantial strengthening of healthcare services, focusing on equity and quality of care besides just expanding capacity.

Inter- and Intra-Regional Disparities in Russia: Factors of Uneven Economic Growth

Despite the growing body of literature on the dependence of economic growth from different factors, the reasons for uneven growth remain unclear. Within the country, regions have different growth rates in their diverse parts. It is unclear why the same factor could influence municipalities differently. To reveal this reason, we used hierarchical linear modeling with spatial dependence, which allows us to decompose variation into regional and municipal scales and take into account spatial autocorrelation. We conducted our research on data for 2239 municipalities within 85 Russian regions in 2019. Our model incorporates 20 factors of economic growth, with 7 at the municipal scale. Cross-interaction estimates established that factors attributed to the regional level determined the relationship between dependent variables (growth rate of production, growth rate of social benefits, and taxable income) at the municipal level and predictors. The influence of initial level, investments in fixed assets, employment on municipal growth varies greatly depending on such regional determinants as economic structure, innovation, human capital, and inequality. This paper adds to the existing literature on uneven economic growth at a smaller scale (municipality) and at the same time helps to rethink inter- and intra-regional disparities.

EVALUASI PROGRAM PERBAIKAN JALAN LINGKUNGAN PADA KABUPATEN LOMBOK TIMUR PROVINSI NUSA TENGGARA BARAT

ABSTRAKPerbaikan jalan lingkungan di Kabupaten Lombok Timur merupakan program dari Kementerian PUPR melalui Direktorat Jenderal Cipta Karya yang ditujukan untuk mengurangi kesenjangan antar wilayah, pengentasan kemiskinan, memperbaiki tata kelola pemerintah daerah (kabupaten, kecamatan dan desa) serta memperkuat kelembagaan masyarakat di tingkat desa. Pelaksanaan program ini melibatkan Disperkim Provinsi NTB dan Dinas Cipta Karya PUPR Provinsi NTB sebagai pendamping dan pengawas teknis. Program ini dilaksanaan sejak Tahun 2017 hingga saat ini. Artikel ini bertujuan untuk mengevaluasi pelaksanaan program dan memberikan rekomendasi untuk pelaksanaan pada tahun berikutnya. Wilayah yang menjadi target evaluasi terdapat pada beberapa kecamatan meliputi Kecamatan Pringgasela, Kecamatan Sembalun, Kecamatan Aikmel, Kecamatan Pringgabaya dan Kecamatan Wanasaba. Bila dilihat secara persentase nilai capaian dari pelaksaanaan program, maka diperoleh rata-rata mencapai di atas 80%. Bahkan untuk Kecamatan Priggabaya dan Wanasaba pada Tahun 2020 mencapai 91% dan 92% berturut-turut. Selain itu Kecamatan Wanasaba memiliki persentase pencapaian tertinggi yaitu 93% di Tahun 2020. Pencapaian pelaksaaan menunjukkan persentase yang terus meningkat sehingga tercapai tujuan utama yang dinginkan. Sebagai rekomendasi untuk pelaksanaan tahun ongoing dan tahun selanjutnya maka dalam pelaksanaan sebaiknya melibatkan partisipasi dari masyarakat sehingga program dapat mencapai seluruh daerah yang ditargetkan dan menghasilkan nilai capaian sebesar 100%. Kata kunci: jalan lingkungan; perbaikan; evaluasi; capaian; lombok timur. ABSTRACTThe improvement of side roads in East Lombok Regency is a program of the Ministry of PUPR through the Direktorat Jenderal Cipta Karya which is aimed at reducing regional disparities, alleviating poverty, improving local government (district, sub-district, and village), and strengthening community institutions at the village level. The implementation of this program involves the Disperkim Provinsi NTB dan Dinas Cipta Karya PUPR as assistants and technical supervisors. This program has been implemented since 2017 until now. This article aims to evaluate the implementation of the program and provide recommendations for implementation in the following year. The evaluation target areas are located in several sub-districts including Pringgasela, Sembalun, Aikmel, Pringgabaya, and Wanasaba. According to a percentage of the achievement value of program implementation, the average achieved is above 80%. Even for the Districts of Priggabaya and Wanasaba in 2020, it reached 91% and 92%, respectively. In addition, Wanasaba District has the highest percentage of achievement, which is 93% in 2020. The achievement trend increases since the program has been initiated in 2017. As a recommendation for the implementation of the ongoing year and the following year, the implementation should involve the participation of the community. Thus the problems that have occurred so far can be avoided and are expected to reach all targeted areas to produce an achievement value of 100%. Keywords: side roads; repair; evaluation; achievement; east lombok.

Regional Disparity in Adult Obesity Prevalence, and Its Determinants

Objectives: The purpose of this study was to examine the factors affecting regional disparities in the prevalence of adult obesity.Methods: This study is an ecological study in which the unit of analysis were 229 local authorities (si = 78, gun = 82, and gu = 68). The data were obtained from database (ver 1.1) of community health outcomes and health determinants (2015-2017) and Community Health Survey data (2018-2019). Multiple regression analysis was used to identify factors related to the prevalence of obesity in 4 groups (all regions, si, gun, and gu).Results: The prevalence of regional obesity varied 23.5% to 45.15% with a mean of 34.13%. Obesity prevalence was highest in ‘gun’, and lowest in ‘gu’ area. In the overall model, sociodemographic characteristics including sex ratio (β= 0.26), household income over 3 million won (β= -0.23), and the unemployment (β= -0.18)), high-risk drinking (β= 0.18), and satisfaction with public transportation (β= -0.24) were associated with the prevalence of regional obesity. Other than those things, in ‘si’ area, population density, walking practice, in ‘gun’ area, participation in social activity were associated with the prevalence of regional obesity.Conclusions: To reduce obesity prevalence and it’s regional disparities, it is important to make intervention and prevention efforts taking into account the socioeconomic and physical environmental characteristics of the region as well as health behaviors.

Regional disparities and seasonal differences in climate risk to rice labour

The 880 million agricultural workers of the world are especially vulnerable to increasing heat stress due to climate change, affecting the health of individuals and reducing labour productivity. In this study, we focus on rice harvests across Asia and estimate the future impact on labour productivity by considering changes in climate at the time of the annual harvest. During these specific times of the year, heat stress is often high compared to the rest of the year. Examining climate simulations of the Coupled Model Intercomparison Project 6 (CMIP6), we identified that labour productivity metrics for the rice harvest, based on local wet-bulb globe temperature, are strongly correlated with global mean near-surface air temperature in the long term (p ≪ 0.01, R 2 > 0.98 in all models). Limiting global warming to 1.5 °C rather than 2.0 °C prevents a clear reduction in labour capacity of 1% across all Asia and 2% across Southeast Asia, affecting the livelihoods of around 100 million people. Due to differences in mechanization between and within countries, we find that rice labour is especially vulnerable in Indonesia, the Philippines, Bangladesh, and the Indian states of West Bengal and Kerala. Our results highlight the regional disparities and importance in considering seasonal differences in the estimation of the effect of climate change on labour productivity and occupational heat-stress.

Application Analysis of Key Macroeconomic Indicators in Terms of Regional Disparity

The purpose of the article is to study the causal links of the existence of disparities in the socio-economic development of the country's regions and identify key measures to overcome existing disparities in certain areas, taking into account systemic transformations in the modern economy. The main disparities in the regional development of Ukraine are considered and the criteria of regional disparities are defined. It is established that the largest disparities in regional development occur according to the indicators observed in the case of investment per capita. The regions-leaders and outsiders in terms of socio-economic development are selected according to the selected indicators.The division of regions of Ukraine is carried out by means of the cluster analysis. The regions are divided into groups with similar characteristics for the four analyzed macroeconomic variables. The distances between the clusters were expressed using the Euclidean distance, which is widely used in this type of analysis. To combine objects into groups, Ward's method was used to create clusters with a small number of objects.After the analysis, the following conclusions were made: across the country, the regions are characterized by large differences in the level of GRP per capita, capital investment per capita and unemployment, with smaller differences in income levels; an unfavourable phenomenon is the reduction of investment in the southern regions, which in fact leads to low economic growth and future trends; the condition for reducing regional disparities is overcoming barriers to the development of less developed regions, which may occur primarily through the consistent strengthening of their economy, improving the structure and more efficient use of investment resources aimed specifically at strengthening entrepreneurship and professional development.