Hierarchical Bayesian Small Area Estimation Using Weakly Informative Priors in Ecologically Homogeneous Areas of the Interior Western Forests

The U.S. Forest Inventory and Analysis Program (FIA) collects inventory data on and computes estimates for many forest attributes to monitor the status and trends of the nation's forests. Increasingly, FIA needs to produce estimates in small geographic and temporal regions. In this application, we implement area level hierarchical Bayesian (HB) small area estimators of several forest attributes for ecosubsections in the Interior West of the US. We use a remotely-sensed auxiliary variable, percent tree canopy cover, to predict response variables derived from ground-collected data such as basal area, biomass, tree count, and volume. We implement four area level HB estimators that borrow strength across ecological provinces and sections and consider prior information on the between-area variation of the response variables. We compare the performance of these HB estimators to the area level empirical best linear unbiased prediction (EBLUP) estimator and to the industry-standard post-stratified (PS) direct estimator. Results suggest that when borrowing strength to areas which are believed to be homogeneous (such as the ecosection level) and a weakly informative prior distribution is placed on the between-area variation parameter, we can reduce variance substantially compared the analogous EBLUP estimator and the PS estimator. Explorations of bias introduced with the HB estimators through comparison with the PS estimator indicates little to no addition of bias. These results illustrate the applicability and benefit of performing small area estimation of forest attributes in a HB framework, as they allow for more precise inference at the ecosubsection level.

Distance as explanatory factor for sexual health centre utilization: an urban population-based study in the Netherlands

Background The central sexual health centre (SHC) in the greater Rotterdam area in the Netherlands helps finding people unaware of their STI/HIV status. We aimed to determine a possible association between SHC utilization and travel distance in this urban and infrastructure-rich area. Insight in area-specific utilization helps adjust outreach policies to enhance STI testing. Methods The study population consists of all residents aged 15–45 years in the greater Rotterdam area (2015–17). We linked SHC consultation data from STI tested heterosexual clients to the population registry. The association between SHC utilization and distance was investigated by multilevel modelling, adjusting for sociodemographic and area-specific determinants. The data were also stratified by age (aged < 25 years) and migratory background (non-Western), since SHC triage may affect their utilization. We used straight-line distance between postal code area centroid and SHC address as a proxy for travel distance. Results We found large area variation in SHC utilization (range: 1.13–48.76 per 1000 residents). Both individual- and area-level determinants determine utilization. Travel distance explained most area variation and was inversely associated with SHC utilization when adjusted for other sociodemographic and area-specific determinants [odds ratio (OR) per kilometre: 0.95; 95% confidence interval (CI): 0.93–0.96]. Similar results were obtained for residents <25 years (OR: 0.95; 95% CI: 0.94–0.96), but not for non-Western residents (OR: 0.99; 95% CI: 0.99–1.00). Conclusions Living further away from a central SHC shows a distance decline effect in utilization. We recommend to enhance STI testing by offering STI testing services closer to the population.

899Stepping up: identifying small-area variation in diabetes-related lower limb amputations

Background Diabetes-related foot disease is the leading cause of lower limb amputations in Queensland. Amputations can be either minor (below the ankle joint) or major (above the ankle joint). Minor amputations may be performed to prevent major amputations prophylactically, but how these forms of amputations interrelate, and where their interrelationships are weakest and strongest, is unknown. Knowledge of small-area variation in interrelations between minor and major amputations is relevant to prevention and improved management of foot disease. Methods Data on lower limb amputations performed between 2014 and 2018 on patients aged 20+ years with diabetes were obtained from the Queensland Hospital Admitted Patient Data Collection. Rates were calculated using the number of people, rather than the number of amputation procedures. A Bayesian hierarchical spatial multivariate model was used to examine patterns over 516 populated statistical areas 2 in Queensland. Results During 2014 to 2018, 3,548 Queenslanders had at least one minor amputation, and 1,114 had at least one major amputation. Modelled amputation rates varied markedly across the State (standardised morbidity ratio (SMR) IQR: 0.67 to 1.22), with areas in far north Queensland having extremely high rates. There was consistently high area-level correlation between minor and major amputation rates. The highest SMRs for both minor and major amputations were in the Northern Peninsula. Conclusions Elevated rates of minor and major amputations in areas in Queensland, most noticeably the far north, indicate an urgent need for greater support for people with diabetes-related foot disease. Key messages Text: Large differences in minor and major amputation rates across Queensland indicate that certain regions require greater assistance in managing diabetes-related foot disease.

Small area variation in crime effects of COVID-19 policies in England and Wales

It is well established that COVID-19 policies to restrict movement induced widespread falls in many crime types internationally. Much less is known about variation between areas in how these changes occurred. This study uses k-means clustering to examine local area variation in police notifiable offences across England and Wales. It finds that crime in most areas remained stable, a small proportion of areas accounting for disproportionate change. These were typically city centers with plentiful pre-pandemic crime opportunities, dominated by theft and shoplifting offences. We explore potential implications for policy, theory and further research.

Residential area and screening venue location features associated with spatial variation in breast cancer screening invitation response rates: an observational study in Greater Sydney, Australia

ObjectivesParticipation in breast cancer screening (BCS) varies at the small-area level, which may reflect environmental influences. This study assessed small-area variation in BCS invitation response rates (IRRs) and associations between small-area BCS IRR, sociodemographic factors, BCS venue distance and venue location features in Greater Sydney, Australia.MethodsBCS IRR data for 2011–2012 were compiled for 9528 Australian Bureau of Statistics Statistical Area Level 1 (SA1) units (n=227 474 women). A geographial information system was used to extract SA1-level sociodemographic features (proportions of women speaking English at home, full-time employed and university educated, and proportion of dwellings with motor vehicles), SA1-level distance to closest venue(s) (expressed as quartiles), and closest venue(s) colocated with bus stops, train station, hospital, general practitioner and shops. Associations between area-level features, BCS venue distance, venue location features and IRR were estimated using ordinary least square-type spatial lag models including area education as a covariate.ResultsBCS IRR varied across SA1s (mean=59.8%, range: 0%–100%), with notable spatial autocorrelation (Moran’s I=0.803). BCS IRR was positively associated with greater SA1-level proportion of women speaking English at home (β=2.283, 95% CI 2.024 to 2.543), women’s education (in the model including speaking English at home β=0.454, 95% CI 0.211 to 0.697), dwellings with motor vehicles (β=1.836, 95% CI 1.594 to 2.078), greater distance to venue (eg, most distant quartile compared with closest: β=6.249, 95% CI 5.489 to 7.008), and BCS venue colocated with shops (β=0.762, 95% CI 0.273 to 1.251). Greater SA1-level women employment (β=−0.613, 95% CI −0.898 to −0.328) and venue colocated with train station (β=−1.889, 95% CI −2.376 to −1.402) or hospital (β=−0.677, 95% CI −1.164 to −0.189) were inversely related to BCS IRR.ConclusionsSmall-area variation in BCS IRR exists for Greater Sydney and is strongly related to sociodemographic factors that, together with BCS venue location features, could inform targeted attempts to improve IRR.

Analisis daya dukung daya tampung lingkungan hidup dalam pengelolaan KPHP Kampar Kiri Kabupaten Kampar Provinsi Riau

With the development of the concept of utilizing natural resources with a supporting approach and environmental capacity, knowledge of the performance of ecosystem services is needed in planning the management of the Kampar Kir Production Forest Management Unit to ensure the sustainability of ecosystems that produce various ecosystem services needed for human life. This study aims to determine the condition of the carrying capacity and the carrying capacity of the environment in the Kampar Kiri forest management unit and the management block model that is formulated with an ecosystem services approach. This research belongs to naturalistic / qualitative research and the researcher does not treat it with analytical techniques using ArcGIS software. The research was conducted from July to December 2019. The results showed that the condition of the carrying capacity and carrying capacity of the forest area in KPH Kampar Kiri currently provides services for several types of ecosystem services which are considered as services that are relevant to the function of forest areas. Modeling of management blocks with the consideration of the Ecosystem Services approach provides a reference for 2 (two) types of management blocks in primary forests and 5 (five) types of management blocks in production forests. The area of each management block that is structured using an ecosystem services approach gives a different area variation from the existing blocks that are prepared using a natural resource grouping approach.

Small area variation in child undernutrition across 640 districts and 543 parliamentary constituencies in India

In India, districts serve as central policy unit for program development, administration and implementation. The one-size-fits-all approach based on average prevalence estimates at the district level fails to capture the substantial small area variation. In addition to district average, heterogeneity within districts should be considered in policy design. The objective of this study was to quantify the extent of small area variation in child stunting, underweight and wasting across 36 states/Union Territories (UTs), 640 districts (and 543 PCs), and villages/blocks in India. We utilized the 4th round of Indian National Family Health Survey (NFHS-4) conducted in 2015–2016. The study population included 225,002 children aged 0–59 months whose height and weight information were available. Stunting was defined as height-for-age z-score below 2 SD from the World Health Organization child growth reference standards. Similarly, underweight and wasting were each defined as weight-for-age < -2 SD and weight-for-height < -2 SD from the age- and sex-specific medians. We adopted a four-level logistic regression model to partition the total variation in stunting, underweight and wasting. We computed precision-weighted prevalence of child anthropometric failures across districts and PCs as well as within-district/PC variation using standard deviation (SD) measures. For stunting, 56.4% (var: 0.237; SE: 0.008) of the total variation was attributed to villages/blocks, followed by 25.8% (var: 0.109; SE: 0.030) to states/UTs, and 17.7% (Var: 0.074; SE: 0.006) to districts. For underweight and wasting, villages/blocks accounted for 38.4% (var: 0.224; SE: 0.007) and 50% (var: 0.285; SE: 0.009), respectively, of the total contextual variance in India. Similar findings were shown in multilevel models incorporating PC as a geographical unit instead of districts. We found high positive correlations between mean prevalence and SD for stunting (r = 0.780, p < 0.001), underweight (r = 0.860, p < 0.001), and wasting (r = 0.857, p < 0.001) across all districts in India. A similar pattern of correlation was found for PCs. Within-district and within-PC variation are the primary source of variation for child malnutrition in India. Our results suggest the importance of considering heterogeneity within districts and PCs when planning and administering child nutrition policies.

The effect of diabetes on corneal endothelium: a meta-analysis

Background This research was conducted with the aim to determine the effect of diabetes mellitus on corneal endothelial cells. Methods The terms: (“diabetes mellitus” or “diabetes” or “diabetic”) and (“corneal endothelium” or “cornea” or “Corneas”) searched in Pubmed, Embase, Cochrane, and Web of science until August 2019. The included types of studies contained observational studies. The standard mean difference (SMD) which was deemed as main size effects for continuous data was calculated by means and standard deviations. The data on corneal endothelial cell density (ECD), mean cell area (MCA), cell area variation coefficient (CV) and percentage of hexagonal cells (HEX) included in the study were collected and analyzed using stata15.1. Results The final 16 cross-sectional studies and 2 case-control studies were included for the meta-analysis. Meta-analysis revealed that diabetes mellitus could reduce ECD (SMD = − 0.352, 95% CI -0.538, − 0.166) and the HEX (SMD = − 0.145, 95% CI -0.217, − 0.074), in addition to increasing CV (SMD = 0.195, 95% CI 0.123, 0.268). Nevertheless, there was no statistically significant differences observed when combining MCA (SMD = 0.078, 95% CI -0.022, 0.178). In subgroup analysis, Type 2 diabetes patients owned less corneal ECD (P < 0.05). Moreover the same results also found during the subgroup form Asia, Europe and American. The meta-regression revealed the type of diabetes mellitus might be contributing to heterogeneity. (P = 0.008). The results indicated a significant publication bias for studies, with combined CV (Begg’s test, P = 0.006; Egger’s test, P = 0.005) and merged combined HEX (Begg’s test, P = 0.113; Egger’s test, P = 0.024). Conclusions As indicated by meta-analysis, diabetes mellitus could cause a detrimental effect on corneal endothelium health. Diabetes mellitus contributed to the instability of corneal endothelium during the analysis. Therefore, further research is considered necessary to confirm our research results. Trial registration CED 42019145858.