A system dynamics approach to food security: The case of Turkey

Predicting a sustainable food safety policy for the near future is among Turkey's priority problems. In this context, this study aims to predict Turkey's sustainable food safety policies. For this reason, the system dynamics model, which is a dynamic cycle-based method with stock and flow diagrams, is used in this paper. This study supposed the six different scenarios for 2020 and 2050. Data were selected as population, productivity rate, arable land fertility rate, and annual food consumption (per capita). The purpose of creating these scenarios; To determine the most appropriate policy to ensure food safety in Turkey. In the first scenario, we assumed that the current situation continues. In the second scenario, the average productivity rate was increased by 1.5%. The third scenario assumes that annual per capita food consumption rises to 1.2 tonnes per year. In the fourth scenario, the total fertility rate is accelerated by 2%. In the fifth scenario, we assumed that the arable land loss rate decreased by 1/3. Finally, we assumed that the sixth scenario covers all the second, third, fourth, and fifth scenarios and that 2 points reduce food losses. In conclusion, the findings show that food security responds positively in scenarios 2 and 6. However, in other scenarios, food security is negatively affected. The findings show that the sixth scenario is the best-case scenario. To ensure food security, it is necessary to reduce arable land losses and food waste. Training farmers and control of the food supply chain will be beneficial for sustainable food security in Turkey. We recommend that policymakers consider these recommendations.

Identification of Reproductive Health Monitoring Indicators in Iran

Introduction As a result of recent demographic changes, Iran has revised its reproductive health programs. To respond to the essential need for monitoring the new programs and policies, this study aimed to identify tailored, appropriate, and measurable RH indicators in the Iranian context, using available evidence and international indicators.Method This is an applied mixed-methods research, which was conducted in four phases: Identification of goals of RH policies and programs, scoping review of the RH indicators in the literature, developing and ranking the identified indicators, and finalization of indicators. Qualitative content analysis was used to analyze the textual data of the documents and policies. We analyzed the studies in the scoping review by narrative synthesis. The final indicators were selected through the consensus of experts, with a cut-off point of 75%. Result We identified 689 indicators through document analysis and scoping review. After three round of screening, a total of 37 RH indicators were finalized. The first five indicators with the highest score were: total fertility rate, population under 15 years, total population, population aged 65 years and older, and age-specific fertility rate.Conclusion: The nature and number of indicators for monitoring and evaluation of reproductive health programs might vary at different organizational levels; hence the need to develop specific indicators for each level is pivotal. In addition, the need for collection, processing and dissemination of reliable data for evaluation of these programs is essential.

Evaluation of the recurrence and fertility rate following salpingostomy in patients with tubal ectopic pregnancy

Background Ectopic pregnancy is one of the leading causes of pregnancy-related mortality; the treatment strategies associated with this condition entail complications, such as recurrence of ectopic pregnancy or infertility. The objective of this study was to evaluate the recurrence and fertility rate after salpingostomy in patients with tubal ectopic pregnancy. Methods This cross-sectional retrospective study was conducted at four referral centers of Obstetrics and Gynecology, under the supervision of Shiraz University of Medical Sciences (Iran). The medical records of 125 patients with tubal pregnancy were reviewed. These patients underwent laparoscopic salpingostomy from April 2009 to March 2016.Data on maternal age, BMI, history of previous EP, genital tract infection, IUD insertion, history of previous surgery, and infertility were further obtained. The patients were followed up for approximately 1 to 7 years. The recurrence of EP and subsequent pregnancy rate were assessed during the follow-up period. Results There was no statistically significant relationship between post-salpingostomy recurrence and maternal age, previous abdominopelvic surgery, and history of infertility(P = .425); however, the post-salpingostomy recurrence of EP was correlated with BMI (P = 0.001), previous history of EP (P = 0.001), genital tract infection (P = 0.001), and IUD insertion (P = 003). Among 95 women who had no contraception, pregnancy occurred in 51 cases (53.6%) and recurrence of EP was observed in 16 patients (12.8%). Conclusions Our results suggest that salpingostomy is a safe method with a low risk of recurrence and good fertility outcomes for women who consider future pregnancy.

Reduction in Lifetime Fertility Through MNCS in Rural Bangladesh

This study assesses the effect of a customised Maternal Neonatal and Child Survival (MNCS) intervention in the rural areas of Bangladesh. This study attempts to estimate the lifetime fertility rate and the proportion of live births ≥3, and the age-specific lifetime fertility patterns among the women of reproductive age. This quasi-experimental study used impact evaluation data from the MNCS intervention in 2013 and compared these with the baseline data collected in 2008. We used a multi-stage, cluster random sampling technique to include 6,000 and 4,800 women in 2008 and 2013, respectively. The respondents were either mothers who had alive/deceased infants or the mothers whose pregnancy was terminated or who had living children of 12–59 months without pregnancy outcomes in the preceding year of the surveys. Based on the mean difference of live births from baseline to endline year for each intervention union, and then we compared these two areas (intervention and control unions). Overall lifetime fertility rate declined significantly in high-performing intervention unions (from 2.6 to 2.2/woman, p < .001) or in control unions (from 2.4 to 2.2/woman; p < .001). The degree of reduction of fertility increased significantly with age, and such a change was most prominent in the case of women ≥35 years old. Multivariate analyses suggest that the likelihood of having live births ≥3 reduced significantly in high-performed intervention compared to control unions. In conclusion, the probability of reducing lifetime fertility over time increases with a higher level of access, degree and duration of the customised intervention.

Women's empowerment and fertility preferences of married women: analysis of demographic and health survey’2016 in Timor-Leste

<abstract> <p>A recently independent state, Timor-Leste, is progressing towards socioeconomic development, prioritizing women empowerment while its increased fertility rate (4.1) could hinder the growth due to an uncontrolled population. Currently, limited evidence shows that indicators of women's empowerment are associated with fertility preferences and rates. The objective of this study was to assess the association between women empowerment and fertility preferences of married women aged 15 to 49 years in Timor-Leste using nationally representative survey data. The study was conducted using the data of the latest Timor-Leste Demographic and Health Survey 2016. The study included 4040 rural residents and 1810 urban residents of Timor-Leste. Multinomial logistic regression has been performed to assess the strength of association between the exposures indicating women's empowerment and outcome (fertility preference). After adjusting the selected covariates, the findings showed that exposures that indicate women empowerment in DHS, namely, the employment status of women, house and land ownership, ownership of the mobile phone, and independent bank account status, contraceptive use, and the attitude of women towards negotiating sexual relations are significantly associated with fertility preferences. The study shows higher the level of education, the less likely were the women to want more children, and unemployed women were with a higher number of children. Our study also found that the attitude of violence of spouses significantly influenced women's reproductive choice. However, employment had no significant correlation with decision-making opportunities and contraceptive selection due to a lack of substantial data. Also, no meaningful data was available regarding decision-making and fertility preferences. Our findings suggest that women's empowerment governs decision-making in fertility preferences, causing a decline in the fertility rate.</p> </abstract>

Quantile Generalized Additive Model a Robust Alternative to Generalized Additive Model

Nonparametric regression is an approach used when the structure of the relationship between the response and the predictor variable is unknown. It tries to estimate the structure of this relationship since there is no predetermined form. The generalized additive model (GAM) and quantile generalized additive (QGAM) model provides an attractive framework for nonparametric regression. The QGAM focuses on the features of the response beyond the central tendency, while the GAM focuses on the mean response. The analysis was done using gam and qgam packages in R, using data set on live-births, fertility-rate and birth-rate, where, live-birth is the response with fertility-rate and birth-rate as the predictors. The spline basis function was used while selecting the smoothing parameter by marginal loss minimization technique. The result shows that the basis dimension used was sufficient. The QGAM results show the effect of the smooth functions on the response variable at 25th, 50th, 75th and 95th quantiles, while the GAM showed only the effect of the predictors on the mean response. The results also reveal that the QGAM have lower Akaike information criterion (AIC) and Generalized cross-validation (GVC) than the GAM, hence producing a better model. It was also observed that the QGAM and the GAM at the 50th quantile had the same R2adj(77%), meaning that both models were able to explain the same percentage of variation in the models, this we attribute to the fact that mean regression and median regression are approximately the same, hence the observation is in agreement with existing literature. The plots reveal that some of the residuals of the GAM were seen to fall outside the confidence band while in QGAM all the residuals fell within the confidence band producing a better smooth.

Assessment оf the Economic Potential of Change in the Population of Modern Ukraine

The influence of the macroeconomic factor on the long-term trends of reproduction the population of Ukraine since independence is considered. Based on the author’s concept of “demoeconomic niche” the results of calculation of two options for estimating the “current” (per year) economic potential of population changes in Ukraine on the criteria of conditionally autonomous consumption of population and the actual subsistence level (including necessary payments) were analyzed. The potential for population decline according to the first criterion is considered as a pessimistic (maximum) estimate (–30 million in 2019), according to the second - as an optimistic estimate (–2 million in 2019). The aim of the study was to perform a statistical analysis of the relationship between demographic and economic indicators of population reproduction in Ukraine and their relationship with certain options for assessing the economic potential of population change to determine their greater or lesser relevance to demographic and economic realities. Novelty: the assessment of the economic potential of population change is performed within the economic and demographic methodology developed and maintained by the author (based on the macroeconomic concept of “demoeconomic niche”). Research methods: to study the statistical relationship between indicators used methods of correlation and regression analysis (linear models), as well as a comparative analysis of the results of calculations with the actual dynamics of demographic and economic indicators. Calculations were made by means of PPP STATISTICA 8.0. A statistical analysis of the relationship between demographic and economic indicators and their relationship with the studied options for assessing the economic potential of Ukraine population change was performed to determine compliance with demographic and economic realities. All-time series of indicators (30 and 22 years) subjected to statistical analysis are translated into a single form of annual increments to ensure comparability, as a percentage of the value of the initial year of analysis. The direct linear relationship of GDP changes with the dynamics of the total fertility rate and average life expectancy at birth was recorded, and close feedback - with the dynamics of the migration balance. It is noticed that changes in GDP and the total fertility rate for the whole and rural population have cophase quasi cyclic fluctuations with a 3-4 year lag of reaction delay. It is shown that the assessment of the economic potential of population change by the criterion of conditionally autonomous consumption of population is closely statistically dependent on macroeconomic indicators and economic dynamics. The assessment based on the criterion of the actual subsistence level (including necessary payments) depends more closely on the indicators that directly reflect the well-being of households. It turned out that the adequacy of the assessment based on the criterion of conditionally autonomous consumption of population gradually decreases over time due to the peculiarities of the calculation algorithm, growing inaccuracy can only be neglected at intervals of +/-5 years from the base year. The adequacy of the assessment according to the criterion of the actual subsistence level (including necessary payments) depends on the correspondence to the real cost of life values for each year of the observation period, these values need to be clarified.

Multiple Perspectives on Recent Trends in Unwanted Fertility in Low- and Middle-Income Countries

The last four decades have witnessed large declines in fertility globally. This study uses data from 78 low- and middle-income countries to examine concurrent trends in unwanted fertility. Three measures of unwanted fertility are contrasted: the conventional unwanted total fertility rate, a proposed conditional unwanted fertility rate, and the percentage of births unwanted. Incidence of unwanted births and prevalence of exposure to unwanted births are both derived from answers to questions on prospective fertility preference, recognized as the most valid and reliable survey measure of preferences. Country-level trends are modeled both historically and with the decline in total fertility, with a focus on regional differentials. Results show that unwanted fertility rates—especially the conditional unwanted fertility rate—have declined substantially in recent decades. By contrast, the percentage of births unwanted has declined less, remaining stable or even increasing: from a birth cohort perspective, declines in unwanted fertility have been far more modest than the increased parental success in avoiding unwanted births. The regional patterns suggest that sub-Saharan Africa has several similarities with other major regions but also some peculiar features, including a recent stall in the decline of unwanted fertility that persists after controlling for the stage of fertility transition.