scholarly journals Association of the global activity limitation indicator with specific measures of disability in adults aged below 65

2020 ◽  
Vol 30 (6) ◽  
pp. 1225-1230 ◽  
Author(s):  
Julio Cabrero-García ◽  
Rocío Juliá-Sanchis ◽  
Miguel Richart-Martínez
Keyword(s):  
Social Relations ◽  
Self Care ◽  
Activity Limitation ◽  
Added Value ◽  
The European Union ◽  
Domestic Life ◽  
Work Activity ◽  
Logistic Regression Models ◽  
European Health Interview Survey ◽  
Global Activity

Abstract Background Summary health measures as the global activity limitation indicator (GALI) or self-rated health (SRH) allow to quantify and monitor the health of the population. The GALI is widely used in the European Union; however, evidence of its construct validity is still limited. We examine whether the GALI reflects disability in specific living contexts such as self-care, domestic life and work activity, whether it does so consistently across gender and age and its added value concerning SRH. Methods We used the subsample of adults aged 16–64 years (N = 15 934) from the 2009 European Health Interview Survey in Spain and analyzed the data with logistic regression models using the GALI and SRH as response variables. Results The GALI was strongly and significantly associated with the three measures of disability: self-care (OR = 22.8, 95% CI: 15.9–32.7), domestic life (OR = 16.3, 95% CI: 13.6–19.5) and work activity (e.g. impossibility to work: OR = 41.9, 95% CI: 30.3–57.8; prolonged sick leave: OR = 10.7, 95% CI: 9–12.7). There were significant interactions with age on all three disability measures and with the gender on one (domestic life), although they were small. SRH was also strongly associated with all three disability measures, but to a lesser extent than the GALI. Conclusions The GALI reflects well and better than SRH, disability in self-care, domestic life and work activity. It is unknown whether the GALI performs equally in other living contexts such as social relations and community life.

scholarly journals Does the global activity limitation indicator measure participation restriction? Data from the European Health and Social Integration Survey in Spain

2021 ◽  
Author(s):  
Julio Cabrero-García ◽  
Juan Ramón Rico-Juan ◽  
Antonio Oliver-Roig
Keyword(s):  
Social Integration ◽  
Activity Limitation ◽  
Relative Importance ◽  
Participation Restriction ◽  
Domestic Life ◽  
Logistic Regression Models ◽  
European Health ◽  
And Gender ◽  
Value Decomposition ◽  
Global Activity

Abstract Purpose The global activity limitation indicator (GALI) is the only internationally agreed and harmonised participation restriction measure. We examine if GALI, as intended, is a reflective measure of the domains of participation; furthermore, we determine the relative importance of these domains. Also, we investigated the consistency of response to GALI by age and gender and compared the performance of GALI with that of self-rated health (SRH). Methods We used Spanish data from the European Health and Social Integration Survey and selected adults aged 18 and over (N = 13,568). Data analysis, based on logistic regression models and Shapley value decomposition, were also stratified by age. The predictors of the models were demographic variables and restrictions in participation domains: studies, work, mobility, leisure and social activities, domestic life, and self-care. The GALI and SRH were the response variables. Results GALI was strongly associated with all participation domains (e.g. for domestic life, adjusted OR 24.34 (95% CI 18.53–31.97) in adult under 65) and performed differentially with age (e.g. for domestic life, adjusted OR 13.33 (95% CI 10.42–17.03) in adults over 64), but not with gender. The relative importance of domains varied with age (e.g. work was the most important domain for younger and domestic life for older adults). The results with SRH were parallel to those of GALI, but the association of SRH with participation domains was lowest. Conclusions GALI reflects well restrictions in multiple participation domains and performs differently with age, probably because older people lower their standard of good functioning.

scholarly journals Analysis on the economic effect of Sino-US trade friction from the perspective of added value

2021 ◽  
Author(s):  
Zhu Zhu ◽  
Hang Zheng ◽  
Zhu Zhu
Keyword(s):  
Value Chain ◽  
Economic Effect ◽  
Added Value ◽  
The European Union ◽  
Trade Imbalance ◽  
Trade Friction ◽  
Damage Degree ◽  
The Us ◽  
The Usa ◽  
Wang Wei

AbstractBased on the theory of trade added value, this paper discusses the potential actual trade scale and benefit damage degree of the two countries under the background of big country game by measuring the real trade scale of China and the USA, simulating the economic impact of tariffs imposed by China and the USA and utilizing Wang–Wei–Zhu (WWZ) method to decompose the potential changes in Sino-US trade. The results show that: firstly, the size of China-US trade in terms of total value is significantly overestimated and China's overall trade with the USA in 2001–2014 was overestimated by an average of 3.06 percent, of which goods trade was overestimated by 8.06 percent. Secondly, although tariff increases can reduce the degree of trade imbalance between China and the USA to some extent, the adverse effects are mutual and global, and the European Union, the Association of Southeast Asian Nations (ASEAN), Japan and Canada become the main transfer countries of Sino-US trade. Thirdly, the pattern of China's final exports and the US' intermediate exports determines that China's trade interests are more damaged than those of the USA. It is proved that there is a big gap between China and the USA in the depth and breadth of China's participation in the value chain division of labor and the trade scale measured by Gross Domestic Product is more instructive than the total value.

scholarly journals Validity of the Global Activity Limitation Indicator (GALI) to evaluate severity of disability

2020 ◽  
Author(s):  
Belisa Tarazona ◽  
Jesús González-Enríquez ◽  
Javier Almazán-Isla ◽  
Enrique Alcalde-Cabero ◽  
Jesús de Pedro-Cuesta ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Gold Standard ◽  
Great Part ◽  
Activity Limitation ◽  
Item Questionnaire ◽  
Severity Of Disability ◽  
Degree Of Disability ◽  
Degree Of Severity ◽  
Global Activity ◽  
Limited Sensitivity

Abstract Our aim was to estimate the validity of the Global Activity Limitation Indicator (GALI) when measuring the severity level of disability. Data came from 153 residents of Spain, who requested an evaluation of their degree of disability. We compared disability classifications (severe vs. non-severe) from GALI against those from the 36-item questionnaire WHODAS 2.0, the current gold standard measure of disability. The sensitivity of GALI to detect severe disability was 58.3% [95% confidence interval (CI):43.2–72.4], and the specificity was 84.8% (95% CI: 76.4–91.0). Thus, the validity of GALI to accurately categorize the degree of severity of an individual’s disability is not high, this in great part due to its limited sensitivity.

From Community to Public Familiarity: Neighborhood, Sociability, and Belonging in the Neoliberal City

2021 ◽  
pp. 107808742110215
Author(s):  
Felipe Link ◽  
Andrés Señoret ◽  
Felipe Valenzuela
Keyword(s):  
Social Relations ◽  
Sense Of Belonging ◽  
Regression Models ◽  
Secondary Data ◽  
Critical Factor ◽  
Urban Morphology ◽  
Demographic Characteristics ◽  
Logistic Regression Models ◽  
Pedestrian Space

Current urban neoliberalism processes have shaped and changed contemporary cities, including the local scale’s built environment and social relations. This article aims to study how such transformations affect local sociability by analyzing the effects of neighborhoods’ morphology and socio-demographic characteristics on different forms of interactions and how they affect the sense of belonging. Taking the Metropolitan Area of Santiago, Chile, as a case study, we gathered secondary data on urban morphology and surveyed ten neighborhoods to measure sociability patterns. The results obtained from multilevel logistic regression models show that time living in the neighborhood and public pedestrian space is the most critical factor affecting neighborhood sociability. Moreover, instead of local ties, public familiarity is the form of sociability with the most substantial effects on a sense of belonging. We conclude that recent neighborhoods, formed by neoliberal urbanization, tend to discourage neighborhood sociability and a sense of belonging.

scholarly journals The politics of crisis management by regional and international organizations in fighting against a global pandemic: the member states at a crossroads

2021 ◽  
pp. 002085232098451
Author(s):  
Steven Van Hecke ◽  
Harald Fuhr ◽  
Wouter Wolfs
Keyword(s):  
Crisis Management ◽  
International Organizations ◽  
Governance Structure ◽  
Added Value ◽  
World Health ◽  
The European Union ◽  
Member States ◽  
Global Pandemic ◽  
Turbulent Times ◽  
Health Organization

Despite new challenges like climate change and digitalization, global and regional organizations recently went through turbulent times due to a lack of support from several of their member states. Next to this crisis of multilateralism, the COVID-19 pandemic now seems to question the added value of international organizations for addressing global governance issues more specifically. This article analyses this double challenge that several organizations are facing and compares their ways of managing the crisis by looking at their institutional and political context, their governance structure, and their behaviour during the pandemic until June 2020. More specifically, it will explain the different and fragmented responses of the World Health Organization, the European Union and the International Monetary Fund/World Bank. With the aim of understanding the old and new problems that these international organizations are trying to solve, this article argues that the level of autonomy vis-a-vis the member states is crucial for understanding the politics of crisis management. Points for practitioners As intergovernmental bodies, international organizations require authorization by their member states. Since they also need funding for their operations, different degrees of autonomy also matter for reacting to emerging challenges, such as the COVID-19 pandemic. The potential for international organizations is limited, though through proactive and bold initiatives, they can seize the opportunity of the crisis and partly overcome institutional and political constraints.

NCOG-18. RELATIONSHIP BETWEEN RANO-PRO WORKING GROUP STANDARDIZED PRIORITY CONSTRUCTS AND DISEASE PROGRESSION AMONG MALIGNANT GLIOMA PATIENTS AS MEASURED THROUGH CLINICAL OUTCOMES ASSESSMENTS

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi155-vi156
Author(s):  
Elizabeth Vera ◽  
Tito Mendoza ◽  
Alvina Acquaye ◽  
Nicole Briceno ◽  
Anna Choi ◽  
...  
Keyword(s):  
Malignant Glioma ◽  
Disease Progression ◽  
Clinical Outcomes ◽  
Stable Disease ◽  
Working Group ◽  
Karnofsky Performance Status ◽  
Clinical Care ◽  
Self Care ◽  
Work Activity ◽  
Core Symptoms

Abstract Recognizing the importance of clinical outcomes assessments (COA), the RANO-PRO Working Group recommends inclusion of core symptoms/functions in clinical care/research for malignant glioma patients. This study evaluated the association between the recommended symptoms (pain, perceived cognition, seizures, aphasia, treatment-specific symptoms) and functions (physical: weakness, walking; and role/social: work, usual activities) and disease progression in these patients. MDASI-Brain Tumor and EQ-5D-3L scores, Karnofsky Performance Status (KPS), and Neurologic Function Score (NFS) were evaluated in relation to disease progression by chi-square tests, independent- and paired-samples t-tests, adjusted for multiple comparisons. Our sample included 336 patients with malignant glioma; 82% white, 64% male, median age=52 (21-79). Imaging study revealed disease progression for 46% of patients. All symptoms except seizures and difficulty concentrating were worse in the group whose imaging showed disease progression versus stable disease, as well as the functions of walking, work, activity, and self-care (0.8 < difference < 1.8). Patients with disease progression were 4 times more likely to have a poor KPS (≤ 80) and worse NFS. Among patients with disease progression (n=112), all symptoms, except seizures, worsened from first assessment to time of progression. Up to 22% of patients reported worsening mobility, self-care, and usual activity; 46% and 35% had worsened KPS and NFS, respectively. Seven symptoms and functions were each individually reported by at least 10% of patients as having worsened the most. Worsening of symptoms and functions was not observed among patients with stable disease, except in difficulty understanding. Identified core symptoms/functions worsen at the time of progression demonstrating the relationship between priority constructs and a traditional tumor response measure while highlighting the importance of longitudinal collection of COA. The pattern of worsening was observed via both patient- and clinician-reported outcomes, emphasizing the utility of COA in clinical care and clinical trials.

scholarly journals A 3-State Analysis of Black–White Disparities in Diabetes Hospitalizations Among Medicaid Beneficiaries

2018 ◽  
Vol 5 ◽  
pp. 233339281878351
Author(s):  
William N. Mkanta ◽  
Michelle C. Reece ◽  
Abeer D. Alamri ◽  
Emmanuel U. Ezekekwu ◽  
Aishwarya Potluri ◽  
...  
Keyword(s):  
Primary Care ◽  
Racial Differences ◽  
Self Care ◽  
Cost Savings ◽  
Cross Sectional Study ◽  
Process Of Care ◽  
Cross Sectional ◽  
Lower Odds ◽  
Logistic Regression Models ◽  
Medicaid Beneficiaries

Introduction: Although diabetes is one of the leading chronic disease in the country, efforts in primary care and patient self-care management could prevent most of the diabetes-related hospitalizations and produce cost savings and improvements in quality of life. We used information from Medicaid beneficiaries in 3 states to predict racial differences in diabetes hospitalizations and demonstrate how they vary across states. Methods: We conducted a cross-sectional study to examine differences between black and white patients with diabetes hospitalizations. Information was obtained from the Medicaid Analytic eXtract files. We used multiple logistic regression models to assess the significance of the differences. Results: Analysis included 10 073 adult Medicaid recipients from the states of Mississippi (51%), Georgia (35%), and Michigan (14%). Blacks were more likely to experience longer hospital stays in Georgia (odds ratio [OR] = 1.040; 95% confidence interval [CI]: 1.03-1.06) and Mississippi (OR = 1.048; 95% CI: 1.03-1.07). A majority of patients in both groups were likely to be discharged to their homes for self-care. Black patients had lower odds of repeated stays in Georgia (OR = 0.670; 95% CI: 0.54-0.84), but higher odds in Michigan (OR = 1.580; 95% CI: 1.12-2.24). Similar differences occurred when patients were matched by age and sex. Blacks had lower odds of qualifying for dual Medicare–Medicaid enrollment benefit in Georgia and Mississippi. Conclusion: Racial differences in diabetes-related hospitalizations reflect possible inefficiencies in the process of care. Identification of race-specific factors for hospitalizations and implementation of primary care strategies that support effective self-management skills would aid in reducing diabetes hospitalizations and related disparities.

scholarly journals New tools and opportunities in growth and climate friendly greening for small and medium enterprises in the European Union

2015 ◽  
Vol 9 (4) ◽  
pp. 25-31
Author(s):  
Xénia Szanyi-Gyenes ◽  
György Mudri ◽  
Mária Bakosné Böröcz
Keyword(s):  
Economic Growth ◽  
Environmental Sustainability ◽  
Small And Medium Enterprises ◽  
Sustainable Growth ◽  
Added Value ◽  
Easy Access ◽  
The European Union ◽  
Access To Finance ◽  
Medium Enterprises ◽  
The Eu

The role of Small and Medium Enterprises (SMEs) is unquestionable in the European economies, while financial opportunities are still inadequate for them. The more than 20 million SMEs play a significant role in European economic growth, innovation and job creation. According to the latest EC Annual Report , SMEs are accounting for 99% of all non-financial enterprises, employing 88.8 million people and generating almost EUR 3.7 tn in added value for our economy. Despite the fact that there is plenty of EU funding available for these SMEs, for certain reasons these funds hardly reach them. But we have to see that the EU supports SMEs by various way, e.g. by grants, regulatory changes, financial instrument, direct funds. On the other hand, SMEs and decision makers realised that the environmental sustainability has to be attached to the economic growth, therefore more and more tools are available for these enterprises. Over the last few years, public institutions, the market, the financial community and non-governmental associations have explicitly demanded that firms improve their environmental performance. One of the greatest opportunities might lay in the Climate- and Energy Strategy till 2030 as 20% of the EU budget is allocated to climate-related actions, however the easy access to finance is still a key question. Does the EU recognise the actual difficulties? Is there a systemic reason behind the absorption problems? Is the EU creating a more businessfriendly environment for SMEs, facilitating access to finance, stimulates the green and sustainable growth and improving access to new markets? The paper analyses the current European situation of the SMEs and the effectiveness of some new tools, which are specially targeting SMEs. JEL classification: Q18

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