Eco-Efficiency for the G18: Trends and Future Outlook

Eco-efficiency is an important ecological indicator for tracking the progress of how countries’ environmental-adjusted economic activity changes over time. The objective of this research is to calculate country-level eco-efficiency for a group of 18 major countries (G18) that are part of the G20. First, the data envelope analysis (DEA) method is used to calculate eco-efficiency scores. Second, the Malmquist productivity index (MPI) is used to examine how eco-efficiency changes over time. Eco-efficiency is forecast to the year 2040 using automated forecasting methods under a business-as-usual (BAU) scenario. Over the period 1997 to 2040, eco-efficiency varies widely between these countries with some countries reporting positive growth in eco-efficiency and other countries reporting negative growth. Eco-efficiency leaders over the period 1997 to 2019 and 2019 to 2040 include Australia, Brazil, France, Germany, Great Britain, Italy, Japan, Russia, and the United States. Laggards include Canada, China, India, and Indonesia. These laggard countries recorded negative growth rates in eco-efficiency over the period 1997 to 2019 and 2019 to 2040. Negative eco-efficiency growth points to a worsening of environmental sustainability. Large variations in eco-efficiency between countries make it more difficult to negotiate international agreements on energy efficiency and climate change. For the G18 countries, the average annual change in MPI over the period 1997 to 2019 was 0.5%, while the forecasted average annual change over the period 2019 to 2040 was a 0.1% decrease. For the G18 countries, there has been little change in eco-efficiency. The G18 are an important group of developed and developing countries that need to show leadership when it comes to increasing eco-efficiency.

Tuberculosis Notification Trends and Treatment Outcomes in Penitentiary and Civilian Health Care Sectors in the WHO European Region

Setting: Tuberculosis (TB) morbidity in penitentiary sectors is one of the major barriers to ending TB in the World Health Organization (WHO) European Region. Objectives and design: a comparative analysis of TB notification rates during 2014–2018 and of treatment outcomes in the civilian and penitentiary sectors in the WHO European Region, with an assessment of risks of developing TB among people experience incarceration. Results: in the WHO European Region, incident TB rates in inmates were 4–24 times higher than in the civilian population. In 12 eastern Europe and central Asia (EECA) countries, inmates compared to civilians had higher relative risks of developing TB (RR = 25) than in the rest of the region (RR = 11), with the highest rates reported in inmates in Azerbaijan, Kazakhstan, Kyrgyzstan, Republic of Moldova, Russian Federation, and Ukraine. The average annual change in TB notification rates between 2014 and 2018 was −7.0% in the civilian sector and −10.9% in the penitentiary sector. A total of 15 countries achieved treatment success rates of over 85% for new penitentiary sector TB patients, the target for the WHO European Region. In 10 countries, there were no significant differences in treatment outcomes between civilian and penitentiary sectors. Conclusion: 42 out of 53 (79%) WHO European Region countries reported TB data for the selected time periods. Most countries in the region achieved a substantial decline in TB burden in prisons, which indicates the effectiveness of recent interventions in correctional institutions. Nevertheless, people who experience incarceration remain an at-risk population for acquiring infection, developing active disease and unfavourable treatment outcomes. Therefore, TB prevention and care practices in inmates need to be improved.

Current aboveground live tree carbon stocks and annual net change in forests of conterminous United States

Background With the introduction of the Trillion Trees Initiative and similar programs, forests’ ability to absorb carbon dioxide is increasingly in the spotlight. Many states have mandates to develop climate action plans, of which forest carbon is an important component, and planners need current information on forest carbon stocks and rates of change at relevant spatial scales. To this end, we examine rates of average annual change in live aboveground tree carbon in different forest type groups and provide state-wide and regional summaries of current live tree carbon stock and rates of change for the forests of the conterminous United States. Forest carbon summaries are presented in a format designed to meet the needs of managers, policymakers, and others requiring current estimates of aboveground live tree carbon at state and regional scales. Results Regional average aboveground live tree carbon stocks (represented on a per area basis) are generally between 40 and 75 tC/ha but range from 12.8 tC/ha in the Great Plains to 130 tC/ha in the Pacific Northwest West (west-side of Cascades). Regional average annual change in live aboveground tree carbon varies from a low of − 0.18 mtC/ha/y in the Rocky Mountain South to a high value of 1.74 mtC/ha/y in Pacific Northwest West. For individual states, carbon per unit area varies widely, from a low of 11.9 tC/ha in Nevada to a high of 96.4 tC/ha in Washington, with half the states falling between 50 and 75 tC/ha. Rates of average annual change in live aboveground tree carbon vary from a high of 1.82 tC/ha/y in Mississippi to a low of − 0.47 tC/ha/y in Colorado. Conclusions Aboveground live tree carbon stocks and rates of average annual change vary by forest type within regions. While softwood forest types currently exhibit a higher rate of increase in the amount of carbon in aboveground live tree biomass, the current standing stock of carbon per unit area does not consistently follow this pattern. For this reason, we recommend computing and considering both measures -standing stock and average annual change—of carbon storage. The relative importance of each component will depend on management and policy objectives and the time frame related to those objectives. Harvesting and natural disturbance also affect forest carbon stock and change and may need to be considered if developing projections of potential carbon storage.

Change in ankle–brachial index and mortality among individuals with chronic kidney disease: findings from the Chronic Renal Insufficiency Cohort Study

Background Patients with chronic kidney disease (CKD) have an increased risk of peripheral arterial disease (PAD). The ankle–brachial index (ABI), a noninvasive measure of PAD, is a predictor of adverse events among individuals with CKD. In general populations, changes in ABI have been associated with mortality, but this association is not well understood among patients with CKD. Methods We conducted a prospective study of 2920 participants in the Chronic Renal Insufficiency Cohort Study without lower extremity revascularization or amputation at baseline and with at least one follow-up ABI measurement (taken at annual visits) during the first 4 years of follow-up. The ABI was obtained by the standard protocol. Results In Cox proportional hazard regression analyses, we found a U-shaped association of average annual change in ABI with all-cause mortality. After adjusting for baseline ABI and other covariates, compared with participants with an average annual change in ABI of 0–<0.02, individuals with an average annual change in ABI <−0.04 or ≥0.04 had multivariable-adjusted hazard ratios (HRs) of 1.81 [95% confidence interval (CI) 1.34–2.44) and 1.42 (95% CI 1.12–1.82) for all-cause mortality, respectively. Compared with the cumulative average ABI of 1.0–<1.4, multivariable-adjusted HRs for those with a cumulative average ABI of <0.9, 0.9–<1.0 and ≥1.4 were 1.93 (95% CI 1.42–2.61), 1.20 (0.90–1.62) and 1.31 (0.94–1.82), respectively. Conclusions This study indicates both larger decreases and increases in average annual changes in ABI (>0.04/year) were associated with higher mortality risk. Monitoring changes in ABI over time may facilitate risk stratification for mortality among individuals with CKD.

Energy-dense, nutrient-poor food and beverage sales in Australia: where and when products are sold, and how sales are changing over time

Objective: To quantify sales trends for key energy-dense, nutrient-poor (EDNP) foods and beverages over 5 years in Australia. Design: The Euromonitor Global Market Information Database and linear regression models were used to estimate average annual change in sales per capita of thirteen EDNP food categories and two EDNP beverage categories (defined using Australian Dietary Guidelines) over 5 years (2012–2017 for foods and 2011–2016 for beverages). The average annual change in sales was divided by the observed sales in 2012 (foods) or 2011 (beverages) to estimate the average percentage-change in sales per capita per annum. Setting: All major retail outlets in Australia. Participants: Euromonitor Global Market Information Database sales data. Results: Between 2012 and 2017, sales per capita per annum of frozen pizza (6 %), pastries (5 %), potato chips (crisps) (5 %), tortilla chips (3 %), chocolate confectionery (2 %), frozen processed potatoes (2 %), ice cream (2 %) and sugar confectionery (0·2 %) increased. There were no changes in sales of sweet biscuits, chocolate spreads and cakes, and sales of savoury biscuits and processed meat decreased (–2 and –1 %, respectively). Between 2011 and 2016, sales per capita per annum of sports and energy drinks increased (4 %), sales of regular (sugar-sweetened) cola (–6 %) and all non-cola soft drinks (–1 %) decreased and sales of diet cola did not change. Conclusions: Sales of EDNP foods and beverages generally increased or remained stable relative to population growth. Our results demonstrate the need for public health policies to reduce sales of EDNP foods and beverages.

Trends in Total Physical Activity Time, Walking, and Vigorous Physical Activity Time in Queensland Adults From 2004–2018

Background: Health benefits of physical activity (PA) accrue with small increases in PA, with the greatest benefits for those transitioning from inactivity to any level of PA. This study examined whether self-reported PA time in Queensland adults changed between 2004 and 2018. Methods: The Queensland government conducts regular cross-sectional telephone surveys. Between 2004 and 2018, adults aged 18–75 years answered identical questions about their weekly minutes of walking, moderate PA, and vigorous PA. Hurdle regression estimated the average annual change in weekly minutes of PA overall and by activity type, focusing on sociodemographic differences in trends. Results: The sample size averaged 1764 (2004–2008) and 10,188 (2009–2018), totaling 107,171 participants aged 18–75 years. Unadjusted PA increased by 10 minutes per week per year (95% confidence interval [CI], 8.8–11.1) overall, with increases for most subgroups. Adjusted PA increased by 10.5 minutes per week per year (95% CI, 9.4–11.7). Trends differed by employment—employed adults and those not in the labor force increased by 14.3 (95% CI, 12.8–15.8) and 2.2 minutes per week per year (95% CI, 0.4–4.0), respectively, with no increase for unemployed adults. The increases were due to both an increased prevalence of doing any activity and an increased average duration among active adults. Conclusions: Since 2004, PA time has increased for Queensland adults, with substantial variability by employment status.

Determination of the original coastline on Semarang city and Demak district using remote sensing approach

Development of the coastal area without environmental consciousness is disrupting coastline equilibrium, thus triggering erosion and accretion. This results in the obscurity of the border area due to coastline change. The objective of this study is to determine the original coastline of Semarang city and Demak district. The method used is remote sensing using Landsat satellite imagery data dating from 1984 to 2018. The results showed that the length of the coastline in Semarang and Demak border coast shows a continuous increase from 48.2, 57.9, 63.7, and 73.5 km in 1984, 1992, 2000, and 2008, respectively to 92.6 km in 2018, and the average annual change rate from 1984 to 1992, 1992 to 2000, 2000 to 2008, and 2008 to 2018 is 1.2 km per year, 0.7 km per year, 1.2 km per year, and 2.1 km per year, respectively. It was concluded that the current coastline condition of Semarang city and Demak district has had an increase of 29.8 km in length and shifted inwards by 0.5-2 km in 2000 – 2018 compared to the original coastline. This shows a deviation of 5-15% from Government Regional Spatial Plan. The study recommends a sustainable coastal management and action plan to be prepared by the government, as it is vital in preserving the coastal regions.

Rainfall and runoff characteristics in a karstic basin of China

This paper examines the rainfall and runoff characteristics in a karstic basin of China. The results indicated that the inner-annual distributions of rainfall and runoff were uneven and slightly different, as the concentration period of rainfall (from April to October) was earlier; there was a delay of about a month before the runoff (from May to September), and the concentrated volume accounted for 87% of annual precipitation or annual streamflow. Interannually, rainfall changed more significantly than runoff, the wet years lasted longer than the dry years (rainfall), while the high and low flow years were equal for runoff. In addition, judging from the value of the Mann-Kendall test, the average annual change of rainfall (−2.36) was more significant than that of runoff (−2.05), and the seasonal pattern of runoff maintained an opposite tendency in autumn and winter before 1990. The changes in runoff were mainly associated with rainfall and the formation conditions in the karstic area, and the reservoir in this basin should be operated with different flood limiting water levels, and the vegetation coverage should be improved.

Trends in Kindergarten Rates of Vaccine Exemption and State-Level Policy, 2011–2016

Background Kindergarten-entry vaccination requirements have played an important role in controlling vaccine-preventable diseases in the United States. Forty-eight states and the District of Colombia offer nonmedical exemptions to vaccines, ranging in stringency. Methods We analyzed state-level exemption data from 2011 to 2012 through 2015 to 2016 school years. States were categorized by exemption ease and type of exemption allowed. We calculated nonmedical exemption rates for each year in the sample and stratified by exemption ease, type, and 2 trend categories: 2011–12 through 2012–13 and 2013–14 through 2015–16 school years. Using generalized estimating equations, we created regression models estimating (1) the average annual change in nonmedical exemption rates and (2) relative differences in rates by state classification. Results The nonmedical exemption rate was higher during the 2013–2014 through 2015–2016 period (2.25%) compared to 2011–2012 through 2012–2013 (1.75%); more importantly, the average annual change in the latter period plateaued. The nonmedical exemption rate in states allowing philosophical and religious exemptions was 2.41 times as high as in states allowing only religious exemptions (incidence rate ratio = 2.41; 95% confidence interval, 1.71–3.41). Conclusions There was an increase in nonmedical exemption rates through the 2012–2013 school year; however, rates stabilized through the 2015–2016 school year, showing an important shift in trend.