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Preprints allow researchers to make their findings available to the scientific community before they have undergone peer review. Studies on preprints within bioRxiv have been largely focused on article metadata and how often these preprints are downloaded, cited, published, and discussed online. A missing element that has yet to be examined is the language contained within the bioRxiv preprint repository. We sought to compare and contrast linguistic features within bioRxiv preprints to published biomedical text as a whole as this is an excellent opportunity to examine how peer review changes these documents. The most prevalent features that changed appear to be associated with typesetting and mentions of supporting information sections or additional files. In addition to text comparison, we created document embeddings derived from a preprint-trained word2vec model. We found that these embeddings are able to parse out different scientific approaches and concepts, link unannotated preprint–peer-reviewed article pairs, and identify journals that publish linguistically similar papers to a given preprint. We also used these embeddings to examine factors associated with the time elapsed between the posting of a first preprint and the appearance of a peer-reviewed publication. We found that preprints with more versions posted and more textual changes took longer to publish. Lastly, we constructed a web application (https://greenelab.github.io/preprint-similarity-search/) that allows users to identify which journals and articles that are most linguistically similar to a bioRxiv or medRxiv preprint as well as observe where the preprint would be positioned within a published article landscape., Preprints allow researchers to make their findings available to the scientific community before they have undergone peer review This study analyzes the full text content of the bioRxiv preprint repository, identifying field-specific patterns and changes that occur during publication, and providing a search tool that can identify the published papers that are most similar to a given bioRxiv or medRxiv preprint.

To better prevent the potential risks in Internet-based Supply Chain Financing (SCF) products, this paper optimizes and evaluates the Internet-based SCF-oriented Credit Risk Evaluation (CRE) method. Firstly, this paper summarizes 12 risk factors of SCF business, establishes a Risk Assessment Index System (RAIS) with good consistency and stability; then, the principles of Backpropagation (BP) Neural Network (NN) is expounded together with Support Vector Machines (SVM) and Genetic Algorithm (GA) model. Consequently, a CRE model is implemented by the NN tools in MATLAB based on the collection of multiple groups of SCF-oriented risk assessment samples. Subsequently, the assessment samples are trained and tested. Finally, the SCF-oriented CRE model is proposed and verified. The results show that the BP-GA model has presented high prediction consistency with the actual classification. According to the comparison of classification results of SVM, BP model, and BP-GA model, the classification accuracy of test samples of the proposed Internet-based SCF-oriented CRE system using BP-GA model reaches 97.19%; the Type I and Type II error rate of the CRE system based on BP-GA model is 7.2% and 14.21%, respectively. Therefore, a suitable SCF-oriented CRE method is put forward for China’s commercial banks along with scientific and feasible suggestions to manage SCF-oriented credit risks more reasonably and effectively.

Background & methods National protests in the summer of 2020 drew attention to the significant presence of police in marginalized communities. Recent social movements have called for substantial police reforms, including “defunding the police,” a phrase originating from a larger, historical abolition movement advocating that public investments be redirected away from the criminal justice system and into social services and health care. Although research has demonstrated the expansive role of police to respond a broad range of social problems and health emergencies, existing research has yet to fully explore the capacity for health insurance policy to influence rates of arrest in the population. To fill this gap, we examine the potential effect of Medicaid expansion under the Affordable Care Act (ACA) on arrests in 3,035 U.S. counties. We compare county-level arrests using FBI Uniform Crime Reporting (UCR) Program Data before and after Medicaid expansion in 2014–2016, relative to counties in non-expansion states. We use difference-in-differences (DID) models to estimate the change in arrests following Medicaid expansion for overall arrests, and violent, drug, and low-level arrests. Results Police arrests significantly declined following the expansion of Medicaid under the ACA. Medicaid expansion produced a 20–32% negative difference in overall arrests rates in the first three years. We observe the largest negative differences for drug arrests: we find a 25–41% negative difference in drug arrests in the three years following Medicaid expansion, compared to non-expansion counties. We observe a 19–29% negative difference in arrests for violence in the three years after Medicaid expansion, and a decrease in low-level arrests between 24–28% in expansion counties compared to non-expansion counties. Our main results for drug arrests are robust to multiple sensitivity analyses, including a state-level model. Conclusions Evidence in this paper suggests that expanded Medicaid insurance reduced police arrests, particularly drug-related arrests. Combined with research showing the harmful health consequences of chronic policing in disadvantaged communities, greater insurance coverage creates new avenues for individuals to seek care, receive treatment, and avoid criminalization. As police reform is high on the agenda at the local, state, and federal level, our paper supports the perspective that broad health policy reforms can meaningfully reduce contact with the criminal justice system under historic conditions of mass criminalization.

This study assesses the practices and views of Scottish dairy farmers relating to pasture-based and indoor systems. There are the debates about the environmental, economic and animal welfare implications of these systems. Indoor dairy farming is a contentious practice among the public. While this controversy is sometimes represented as a lack of public understanding, there is a need for more research on farmers’ views to facilitate discussion in the industry. A survey was posted to 909 dairy farmers in Scotland with questions about their grazing practices and attitudes to grazing and indoor systems. 254 surveys were completed, online and in paper form. There was a 26% response rate to the paper version of the survey. The results showed that 19% of respondents housed some or all the cows all year-round. 68% agreed or strongly agreed that cows should graze for part of the year and 51% agreed or strongly agreed that welfare was better if cows grazed for part of the year. These views coexisted with the view that management was more important than the type of system for determining profitability or welfare outcomes (83% and 82% strongly agree or agree respectively). Respondents whose system involved grazing and respondents who had spent longer in farming were moderately more likely to agree that cows should have access to pasture, and slightly less likely to agree that management was more important than system for determining welfare outcomes. The results indicate that the picture is more complicated than the public rejecting indoor dairy farming and those in the industry accepting it. The results showed that a majority preference for cows to graze co-existed with the view that management was more important than system. In terms of industry and policy recommendations, the research suggests that measures should be taken to safeguard farmers’ ability to graze through for instance research and advisory support on grazing; ensuring different systems are not penalised in the development of dairy sector environmental measures and recommendations; and potentially supply chains that financially rewards farmers for grazing.

Background Ward-Based Outreach Teams’ (WBOTs) use of mobile technologies can promote better quality and improved health services for populations in low- and middle-income countries. However, the implementation of such systems is fraught with threats to sustainability. Purpose The purpose of this study was to gain a deeper understanding of users’ views and experiences of the implementation of mHealth in a selected sub-district in North West Province, South Africa. Methods The study was qualitative, exploratory and descriptive. Data were collected from community health workers (CHWs) (n = 24) and outreach team leaders (OTLs) (n = 4) who used mobile devices loaded with the Mobenzi application through semi-structured focus group interviews, using an interview guide. Creswell’s stages of thematic analysis were used for data analysis, and codes, categories and themes were validated with the participants. Results Three themes emerged from the findings, namely the transition from a paper-based system to an electronic system; the use of the application; and reverting to paper-based documentation. The findings revealed that WBOTs considered the mHealth application as useful, easy to use, and supportive to their workflow. They experienced some technical challenges and lamented the inaccessibility of technicians. The mobile initiative’s termination caused distress among the participants, especially CHWs who had to revert to paper-based documentation to capture community health data. OTLs were concerned about the quality of health data being captured in the absence of the application. Conclusions The study concluded that community-based health care programmes that use WBOTs and mHealth technologies are essential in strengthening the health care system. WBOTs are facilitators for improving access to health care. Policy-makers and district managers will gain useful insights if they engage application users in discussions regarding future mobile health interventions for household and community-based care.

Background Work to control the gambiense form of human African trypanosomiasis (gHAT), or sleeping sickness, is now directed towards ending transmission of the parasite by 2030. In order to supplement gHAT case-finding and treatment, since 2011 tsetse control has been implemented using Tiny Targets in a number of gHAT foci. As this intervention is extended to new foci, it is vital to understand the costs involved. Costs have already been analysed for the foci of Arua in Uganda and Mandoul in Chad. This paper examines the costs of controlling Glossina palpalis palpalis in the focus of Bonon in Côte d’Ivoire from 2016 to 2017. Methodology/Principal findings Some 2000 targets were placed throughout the main gHAT transmission area of 130 km2 at a density of 14.9 per km2. The average annual cost was USD 0.5 per person protected, USD 31.6 per target deployed of which 12% was the cost of the target itself, or USD 471.2 per km2 protected. Broken down by activity, 54% was for deployment and maintenance of targets, 34% for tsetse surveys/monitoring and 12% for sensitising populations. Conclusions/Significance The cost of tsetse control per km2 of the gHAT focus protected in Bonon was more expensive than in Chad or Uganda, while the cost per km2 treated, that is the area where the targets were actually deployed, was cheaper. Per person protected, the Bonon cost fell between the two, with Uganda cheaper and Chad more expensive. In Bonon, targets were deployed throughout the protected area, because G. p. palpalis was present everywhere, whereas in Chad and Uganda G. fuscipes fuscipes was found only the riverine fringing vegetation. Thus, differences between gHAT foci, in terms of tsetse ecology and human geography, impact on the cost-effectiveness of tsetse control. It also demonstrates the need to take into account both the area treated and protected alongside other impact indicators, such as the cost per person protected., Author summary Sleeping sickness is a fatal disease in Africa caused by trypanosomes transmitted by the bite of infected tsetse flies. The World Health Organization has set the absence of new infections as a goal for 2030. To achieve this, screening and treatment of patients is supplemented by tsetse control. Tiny Targets are small insecticide-impregnated panels of blue cloth and black netting which attract and kill tsetse. To maintain the momentum in these last stages of eliminating the disease, it is important to understand the costs of vector control. This paper presents the results of two years’ cost monitoring in Bonon, an area covering 130 km2, home to 120,000 people. Since 2016, ~2,000 Tiny Targets have been deployed annually at a cost of USD 471 per km2 per year. Bonon is a degraded forested area and a relatively high number of targets was required as tsetse are present throughout. Nevertheless, the cost comes to only USD 0.5 per person protected per year. Compared to operations using Tiny Targets in Uganda and Chad, the cost was higher per km2 protected, reflecting the need to place targets throughout the area, but low per person protected compared to Chad, highlighting the need to use a range of comparators.

Background Coronavirus (COVID-19) has severely impacted lifestyles worldwide. Responses to COVID-19 have intentionally restricted the factors that encourage regular and frequent PA; opportunity, capability and motivation. However, the effects of these restrictions are likely to have differed by gender and age and different intensities of PA. This rapid review builds on previous evidence by synthesising the global impact of COVID-19 on adult PA through specific intensities and types of PA and evaluating this by gender and age. Methods A rapid systematic search of seven electronic databases (PubMed, MEDLINE, CINAHL, SPORTDiscus, Academic Search Complete, APA PsycInfo, and APA PsycArticles) was performed from December 2019 to January 2021. Studies investigating adult change in PA, exercise or sedentary behaviour due to COVID-19 were included. Results From an initial database search identifying 3,863 articles, 66 remained for synthesis after applying eligibility criteria. Results demonstrate decreases among all intensities and types of PA—walking (6 out of 7 papers), moderate-only (5 out of 6 papers), vigorous-only (5 out of 6 papers) and MVPA (4 out of 5 papers); as well as overall PA (14–72% participants reported a decrease). Reflecting that COVID-19 responses were designed to have universal effects, they also achieved whole-society decreases in PA behaviour, accented in older age groups. Conclusion There is a universal need to address the low levels of PA post-COVID-19. The consequences of decreased PA across all intensities has powerful, potentially recoverable, impacts. Universal declines have implications for public health officials and PA advocates for post-COVID-19 initiatives to promote PA.

This paper aims to identify the determinants of the length of stay (LoS) of international tourists in Norway. The paper reassesses the standard assumption related to tourists’ LoS; it refers to the travel industry’s current trends, and it postulates a more sustainable approach to analyzing tourists’ LoS at the destination level. The paper concludes with a series of recommendations. The data for this study were collected during 153 data collection days and among 5,300 travelers in Norway. The determinants of LoS were analyzed by means of an ordinary least squares (OLS) regression. The results indicate that tourists’ LoS is positively related to their age, interests (nature-based tourists), origin (German, Dutch tourists) and mode of travel organization (package tourists). A negative and significant effect on tourists’ LoS was found for tourists’ interests (urban-based tourists), spending, and origin (home market, long-haul tourists). No significant results were revealed for two covariates, namely, gender and repeat visitation.

PurposeThe aim of the paper is to identify management practices that are characteristic for SMEs that achieve market success measured by their business performance in last their years of their operation analyze the relationships between management practices applied in small and medium-sized enterprises and their success measured by their business performance drawing on the data from 2710 SMEs operating on the Polish market.Approach/Methodology/DesignA cluster analysis was used to distinguish homogenous SME groups in view of their management practices. We examined differences between groups in terms of their business performance. The HINoV algorithm allowed six variables to be selected out of 32 management practices chosen initially for testing, with these variables providing the basis for grouping. Modal values and medians were calculated for 17 business performance measures in the three clusters produced. The subsequent analysis of those findings was focused on capturing significant differences.FindingsIn the group of 2710 Polish SMEs, it was possible to verify that there existed an association between management practices in the field of modern HRM, computer systems supporting management and the company’s economic performance, as measured by an increase in net revenue and number of customers over the last three years. In clusters where the above mentioned practices were appreciated, modal and median values of the increase reported in net revenue and number of customers were significantly higher.Practical implicationsThe research has shown that at a time marked by a shortage of highly skilled personnel one should pay particular attention to building an integrated and committed team of workers and to employee empowerment. The research has also shown that SME managers monitor only a fraction of basic business performance measures, which may prove to be a major risk to SMEs.Originality/ValuePrevious studies have been largely conducted in a fragmentary manner, i.e. they were concerned with the relationships between the application of some practices (strategic management, BPR, entrepreneurial orientation, monitoring, etc.) and selected business effectiveness measures. In this paper, the research covered SME management practices from a variety of areas which were then compared with the entrepreneurs’ assessment as to whether the company’s economic condition changed over the last three years. It is also the first attempt in post-socialist economies to identify those SME management practices that are related to better economic results.

In recent years, digital finance has become a crucial part of the financial system and reshaped the mode of green finance in China. Digital finance has brought certain impact on economic growth, industrial structure, and resident income, which may affect pollution. The nexus of digital finance and environment in China is thus worth exploring. By revising the traditional Environmental Kuznets Curve model with income inequality variable, this paper decomposes the environmental effects of economic activities into income growth effect, industrial structure effect and income inequality effect, and use panel data of China’s provinces to conduct an empirical analysis. The results reveal the following: (1) the Environmental Kuznets Curve is still valid in sample, and digital finance can reduce air and water pollution (as measured through SO2 and COD emission) directly; (2) in the influence mechanism, digital finance can alleviate income inequality and promote green industrial structure, thus reducing pollution indirectly, but the scale effect of income growth outweighs the technological effect, which increases pollution indirectly; and (3) digital finance has a threshold effect on improving the environment, then an acceleration effect appears after a certain threshold value. From the regional perspective, digital finance development in eastern regions is generally ahead of central and western regions, and the effects of environmental improvement in the eastern regions are greater. According to the study, this paper suggest that digital finance can be an effective way to promote social sustainability by alleviating income inequality and environmental sustainability by reducing pollution.

This paper analyzes the dynamics of the labor market in Latin America during the COVID-19 pandemic. After a decade of a virtuous circle of growth with the creation of formal jobs, the pandemic has had an considerable impact on the region’s labor market, generating an unparalleled increase in the proportion of the inactive population, considerable reductions in informality, and, in contrast, smaller fluctuations in formal jobs. In this context, the formal sector, given its lower flexibility, became a "social safety net" that preserved the stability of employment and wages. Based on the findings presented in this paper, it is projected that, starting in 2021, informality will grow to levels higher than those of the pre-COVID-19 era–with 7.56 million additional informal jobs–as a result of the population returning to the labor market to compensate for the declines in incomes. According to the simulations presented, postponing or forgiving income tax payments and social security contributions conditional on the generation of formal jobs could reduce the growth of informality by 50 to 75 percent. Achieving educational improvements has the potential to reduce it by 50 percent.

Acknowledgements: We would like to thank Sylwia Adamus, Rachela Antosz-Rekucka, Monika Biały, Jakub Cacek, Zuzanna Garncarek, Katarzyna Hryniewiecka, and Ewa Ilczuk from Jagiellonian University who contributed to data collection., Emotion lexicons became a popular method for quantifying affect in large amounts of textual data (e.g., social media posts). There are multiple independently developed emotion lexicons which tend to correlate positively with one another but not entirely. Such differences between lexicons may not matter if they are just unsystematic noise, but if there are systematic differences this could affect conclusions of a study. The goal of this paper is to examine whether two extensively used, apparently domain-independent lexicons for emotion analysis would give the same answer to a theory-driven research question. Specifically, we use the Linguistic Inquiry and Word Count (LIWC) and NRC Word-Emotion Association Lexicon (NRC). As an example, we investigate whether older people have more positive expression through their language use. We examined nearly 5 million tweets created by 3,573 people between 18 to 78 years old and found that both methods show an increase in positive affect until age 50. After that age, however, according to LIWC, positive affect drops sharply, whereas according to NRC, the growth of positive affect increases steadily until age 65 and then levels off. Thus, using one or the other method would lead researchers to drastically different theoretical conclusions regarding affect in older age. We unpack why the two methods give inconsistent conclusions and show this was mostly due to a particular class of words: those related to politics. We conclude that using a single lexicon might lead to unreliable conclusions, so we suggest that researchers should routinely use at least two lexicons. If both lexicons come to the same conclusion then the research evidence is reliable, but if not then researchers should further examine the lexicons to find out what difference might be causing inconclusive result.

Informal learning environments provide the opportunity to study guests’ experiences as they engage with exhibits specifically designed to invoke the emotional experience of awe. The current paper presents insight gained by using both traditional survey measures and innovative mobile eye-tracking technology to examine guests’ experiences of awe in a science museum. We present results for guests’ visual attention in two exhibit spaces, one chosen for its potential to evoke positive awe and one for negative awe, and examine associations between visual attention and survey responses with regard to different facets of awe. In this exploratory study, we find relationships between how guests attend to features within an exhibit space (e.g., signage) and their feelings of awe. We discuss implications of using both methods concurrently to shed new light on exhibit design, and more generally for working in transdisciplinary multimethod teams to move scientific knowledge and application forward.

Does economic globalization influence the positioning of parties and, as a consequence, the ideological characteristics of party systems? Answering this question is important because we need to understand the constraints that parties face in formulating policies from which voters have to choose. In our paper, we take a systemic perspective and conceptualize a party system’s ideological center of gravity as the outcome of interest. We define the center of gravity as the weighted mean position of all parliamentary parties in a country that represents the position to which parties gravitate. We start by formulating static hypotheses on the effect of imports and exports on the center of gravity and derive their underlying mechanisms. We further derive dynamic hypotheses stipulating varying effects over time based on the premise that partisan attitudes toward globalization have undergone multiple changes over the last decades. A time-series cross-section analysis of 129 elections in 15 Western European countries from 1974 to 2015 finds evidence for opposite effects of exports and imports in the pooled data. Additionally, a moving-window analysis indicates that the relationship between globalization and the center of gravity varies over time. This is a significant finding because it suggests that economic globalization has an influence on party systems and that it is important to test for time-varying effects.

This paper explores the potential of combining different isotope systems from different tissues to improve resolution when reconstructing breastfeeding and weaning practices (BWP) in archaeology. Additionally, we tested whether changes in diet can be detected in deciduous teeth. Rib collagen samples from 22 infants/children from the archaeological site of Bacuranao I (Mayabeque, Cuba) were processed for nitrogen (δ15N) and carbon (δ13Cco) stable isotopes and assessed using a Bayesian model (WARN). In addition, enamel of 48 teeth from 30 infants/children were analyzed for oxygen (δ18Oen) and carbon (δ13Cen) stable isotopes. Data revealed that the timing of weaning cannot be characterized precisely by analyzing either δ18O or δ15N. While a depletion in both δ15N and δ13Cco is only evident after one year, the WARN model suggested that the weaning process started at around 3 months and ended around 1.7 years. Most teeth were enriched in δ18Oen compared to deciduous incisors, suggesting a breastfeeding signal. However, a high variability in δ18O was found between similar teeth from the same individuals. Higher enrichment in δ18Oen, and variability, was observed in tissues formed during the first six months of life. A δ13C enrichment of 1.0‰ was observed among deciduous teeth and ribs. While most individuals enriched in δ15N showed enrichment in δ13C, the δ18O values were more variable. Our data suggests that stable isotopes of deciduous teeth, especially δ13Cen, can be used to detect changes in diet during the weaning process. It is also possible that the δ18O enrichment observed in M1 is influenced by the effects of cooking techniques on weaning foods. The combination of multiple isotope systems and tissues overcome some of the limitations posed by single tissue approaches.

This paper contributes to the lack of longitudinal studies concerning online information access to corporate governance (CG) practices in the banking sector of Latin American countries. In particular, this study aims to analyze the factors that influence information transparency, both mandatory and voluntary, related to CG practices of banks that operate in Paraguay via their websites from 2016 to 2019. Findings indicate the need to improve the level of information available on websites, with disclosure of voluntary information on CG practices being more prevalent than the disclosure of mandatory information. Likewise, banks that operate in Paraguay have made scant “progress” regarding online access to their governance information over the years analyzed. Moreover, the factors “Bank size” and “listed status” positively influence the information transparency regarding CG practices of Paraguayan banks. In contrast, “leverage,” “liquidity,” “size of the audit firm,” and “credit risk rating” are factors that have a negative relation with the extent of CG disclosure.

Contains fulltext : 247205.pdf (Publisher’s version ) (Open Access) The COVID Pandemic may affect fertility behaviour and intentions in many ways. Restrictions on service provision reduce access to family planning services and increase fertility in the short term. By contrast, the economic uncertainty brought about by the pandemic and its impact on mental health and well-being may reduce fertility. These various pathways have been explored in the context of high income countries such as the United States and Western Europe, but little is known about middle income countries. In this paper we asses the impact of the COVID pandemic on fertility intentions and behaviour in the Republic of Moldova, a middle income country in Eastern Europe, using the Generations and Gender Survey. This survey was conducted partially before and partially after the onset of the pandemic in 2020, allowing for detailed comparisons of individual circumstances. The results indicate that the pandemic reduced the used of intrauterine devices, and increased the use of male condoms, but with no overall decrease in contraceptive use. Conversely individuals interviewed after the onset of the pandemic were 34.5% less likely to be trying to conceive, although medium term fertility intentions were unchanged. Indicators therefore suggest that in the medium term fertility intentions may not be affected by the pandemic but restricted access to contraception requiring medical consultation and a decrease in short-term fertility intentions could disrupt short term family planning. 16 p.

Agriculture is a very important sector of the economy that has a great influence on rural areas. Almost sixty years of the Common Agricultural Policy (CAP) in the European Union (EU) may impose a question on the impact of this policy on job creation and economic growth in rural areas. By analyzing key indicators, one should note that although there are still many problems to tackle, the CAP has been successful to some extend in increasing employment rate and Gross Domestic Product (GDP) per capita as well as decreasing poverty rate in the EU rural areas. There are also more and more households connected to the next-generation broadband network and there is still a significant number of bed places in the EU rural areas. Although, the situation in specific EU Member States and their rural regions may be different, the overall performance of the EU is satisfactory and shows positive prognostics for the current EU financial perspective of 2021–2027. This paper also provides an empirical approach which checks whether there is a connection between the employment rate and the rural development measured in GDP per capita based on the data from the Baltic States: Estonia, Latvia and Lithuania in the period of 2000–2020. This research confirms that when increasing the level of rural employment, the economic growth rises in rural areas.

This paper examines whether mega-events-initiated planning regulations improved air quality in Chinese cities and explores the driving forces of the enforcement of such regulations. Using the 2008 Beijing Olympics as an example, we find that mega-events serve as an opportunity for cities to combat air pollution. The 2008 Olympics prompted a handful of Chinese cities to cut pollution and sustain a blue sky: Cities with air quality regulated for the Olympics cut their Air Pollution Index by about 16 points during the Games, compared to non-regulated cities, and 60% of that effect remained four years after the event. These achievements are obtained through effective mobilization of city leaders by associating air quality with their political careers. This study reveals that 1) a mega-event may improve urban environmental quality beyond the host cities and the event period, and 2) successful implementation of environmental regulations hinges on incentivizing local leaders.

In the paper the costs of Polish county hospitals in 2015–2018 are studied using behavioral cost function. The set of variables combines hospitals’ characteristics which may determine their level of costs, such as the form of ownership, bed turnover rate, number of patient-days and share of beds in emergency department with environment characteristics which may influence both outsourcing costs and patients’ health. In 2017 the system of basic hospital service provision (hospital network) was introduced in Poland. Dummy variables included in the model represent the category of hospital in the system. The results show that the costs may be described using fixed effect panel model. Positive impact of percentage of emergency department patients transferred to other departments and of wages is found. Higher ratio of residents and interns to doctors is found to decrease costs. Dummy variable for the period after the introduction of hospital network assumed a negative sign with costs, but the parameter remained insignificant.

The Late Mesolithic in Southern Europe is dated to the 7th and the first part of the 6th millennia BCE and is marked by profound changes which are mostly evident in the technical know-how and tool-kit of the last hunter-fisher-gatherer societies. The significance of this phase also relates to the fact that it precedes the Early Neolithic, another period of major transformations of human societies. Nonetheless, the Late Mesolithic still remains a poorly known age in this area. A burial discovered at Mondeval de Sora (Northern Italy) in 1987, represents a unique window into this period. In this paper, we provide a detailed analysis of more than 50 lithic and osseous artifacts associated with this burial. We highlight important contextual data regarding the techno-economic dimension and the notion of personal burial possessions. Based on the association and location of some items, we propose a new interpretation of the social status of this individual and the possible impact of technological innovation on the social organization and symbolic sphere of Late Mesolithic groups.

Biocapacity of a region exhibits spatial differences owing to the limitations of regional scale and natural conditions. Based on the multi-scale perspective, we comprehensively studied and analyzed the temporal and spatial differences of the biocapacity of a region in an attempt to establish the groundwork for optimizing urban development and its utilization framework. By adopting the ecological footprint model along with multi-scale difference evaluation method, the municipal and county scales are incorporated into a unified analysis framework in this paper, thereby facilitating the exploration of the temporal and spatial differences in the biocapacity of Shenyang—a city in China—from 2005 to 2019. The results demonstrated that: 1) At the municipal scale, the biocapacity per capita fluctuated between 1.35 hm2/person and 2.22 hm2/person. It revealed an “up-down-up” trend, which appeared consistent with the Kuznets cycle; at the county scale, the biocapacity depicted spatial differences, while those of downtown and surrounding districts/counties developed a two-level ascending hierarchical structure. 2) The time series of footprint size and depth first ascended and then declined, and can be classified into four types: closed type, inverted U-type, S-type, and M-type. Among them, S-type and M-type have the phenomenon of over-utilizing the stock capital. 3) For a long time, the regional difference of biocapacity has mostly dwelt on two scales with an evident scale effect, and the biocapacity of Liaozhong District was the worst.

Cocoa is a plant with origins in northwestern South America with high relevance in the global economy. Evidence indicates that cocoa is sensitive to a dry climate, under which crop production is reduced. Projections for future climate change scenarios suggest a warmer and drier climate in the Amazon basin. In this paper, we quantify the potential effects in cocoa production due to its edaphoclimatic suitability changes to the Brazilian Amazon biome and account for regional differences in planning occupation territories. We modeled the suitability of cocoa’s geographical distribution using an ensemble of 10 correlative models that were run in the “biomod2” library and projected to two future climate scenarios (RCPs 4.5 and 8.5) by 2050. Combining information on climate and soil suitability and installed infrastructure in the macro-regions of the Brazilian Amazon. We defined a zoning system to indicate how cocoa production may respond to climate change according to the current and future suitability model. Our results suggest that a reduction in precipitation and an increase in temperature may promote a reduction in the suitability of cocoa production in the Brazilian Amazon biome. In addition of the areas suitable for cocoa plantation, we found a 37.05% and 73.15% decrease in the areas suitable for intensification and expansion zones under RCP 4.5 and 8.5, respectively, compared with the current scenario. We conclude that there may be a need to expand land to cocoa production in the future, or else it will be necessary to plant a cocoa variety resistant to new climatic conditions. Besides, we recommend procedures to combat illegal deforestation to prevent the most critical climate change scenarios from occurring.

Higher education students’ mental health has been a growing concern in recent years even before the COVID-19 pandemic. The stresses and restrictions associated with the pandemic have put university students at greater risk of developing mental health issues, which may significantly impair their academic success, social interactions and their future career and personal opportunities. This paper aimed to understand the mental health status of University students at an early stage in the pandemic and to investigate factors associated with higher levels of distress. An online survey including demographics, lifestyle/living situations, brief mental well-being history, questions relating to COVID-19 and standardised measures of depression, anxiety, resilience and quality of life was completed by 1173 students at one University in the North of England. We found high levels of anxiety and depression, with more than 50% experiencing levels above the clinical cut offs, and females scoring significantly higher than males. The survey also suggested relatively low levels of resilience which we attribute to restrictions and isolation which reduced the opportunities to engage in helpful coping strategies and activities rather than enduring personality characteristics. Higher levels of distress were associated with lower levels of exercising, higher levels of tobacco use, and a number of life events associated with the pandemic and lockdown, such as cancelled events, worsening in personal relationships and financial concerns. We discuss the importance of longer-term monitoring and mental health support for university students.

To undertake a reliable analysis of injury severity in road traffic accidents, a complete understanding of important attributes is essential. As a result of the shift from traditional statistical parametric procedures to computer-aided methods, machine learning approaches have become an important aspect in predicting the severity of road traffic injuries. The paper presents a hybrid feature selection-based machine learning classification approach for detecting significant attributes and predicting injury severity in single and multiple-vehicle accidents. To begin, we employed a Random Forests (RF) classifier in conjunction with an intrinsic wrapper-based feature selection approach called the Boruta Algorithm (BA) to find the relevant important attributes that determine injury severity. The influential attributes were then fed into a set of four classifiers to accurately predict injury severity (Naive Bayes (NB), K-Nearest Neighbor (K-NN), Binary Logistic Regression (BLR), and Extreme Gradient Boosting (XGBoost)). According to BA’s experimental investigation, the vehicle type was the most influential factor, followed by the month of the year, the driver’s age, and the alignment of the road segment. The driver’s gender, the presence of a median, and the presence of a shoulder were all found to be unimportant. According to classifier performance measures, XGBoost surpasses the other classifiers in terms of prediction performance. Using the specified attributes, the accuracy, Cohen’s Kappa, F1-Measure, and AUC-ROC values of the XGBoost were 82.10%, 0.607, 0.776, and 0.880 for single vehicle accidents and 79.52%, 0.569, 0.752, and 0.86 for multiple-vehicle accidents, respectively.

Background mHealth innovations have been proposed as an effective solution to improving adolescent access to and use of Sexual and Reproductive Health (SRH) services; particularly in regions with deeply entrenched traditional social norms. However, research demonstrating the effectiveness and theoretical basis of the interventions is lacking. Aim Our aim was to describe mHealth intervention components, assesses their effectiveness, acceptability, and cost in improving adolescent’s uptake of SRH services in Sub-Saharan Africa (SSA). Methods This paper is based on a systematic review. Twenty bibliographic databases and repositories including MEDLINE, EMBASE, and CINAHL, were searched using pre-defined search terms. Of the 10, 990 records screened, only 10 studies met the inclusion criteria. The mERA checklist was used to critically assess the transparency and completeness in reporting of mHealth intervention studies. The behaviour change components of mHealth interventions were coded using the taxonomy of Behaviour Change Techniques (BCTs). The protocol was registered in the ‘International Prospective Register for Systematic Reviews’ (PROSPERO-CRD42020179051). Results The results showed that mHealth interventions were effective and improved adolescent’s uptake of SRH services across a wide range of services. The evidence was strongest for contraceptive use. Interventions with two-way interactive functions and more behaviour change techniques embedded in the interventions improved adolescent uptake of SRH services to greater extent. Findings suggest that mHealth interventions promoting prevention or treatment adherence for HIV for individuals at risk of or living with HIV are acceptable to adolescents, and are feasible to deliver in SSA. Limited data from two studies reported interventions were inexpensive, however, none of the studies evaluated cost-effectiveness. Conclusion There is a need to develop mHealth interventions tailored for adolescents which are theoretically informed and incorporate effective behaviour change techniques. Such interventions, if low cost, have the potential to be a cost-effective means to improve the sexual and reproductive health outcomes in SSA.

The Indonesian government launched various programs to handle stunting cases, including village funds. This paper examined the effects of village fund programs and village apparatuses’ capacities to combat stunting based on aggregate data at the district level in Indonesia. Using descriptive data analysis and fixed effect panel regression, we observed that village fund programs could significantly reduce Indonesia’s stunting prevalence, especially outside Java. It also revealed that the increasing education of regional leaders does not necessarily positively impact leaders’ skills in handling stunting. At the same time, the number of village officials has a statistically significant influence on reducing stunting prevalence. It advised that the village budget fund can support national priorities in tackling the prevalence of stunting. Furthermore, it is essential to build the capacity of the village head for increasing awareness of health activities, especially early prevention of stunting, in addition to an adequate number of officials.

Made available in DSpace on 2022-04-28T19:49:42Z (GMT). No. of bitstreams: 0 Previous issue date: 2022-01-01 Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) Several studies have reported the relationship of deforestation with increased incidence of infectious diseases, mainly due to the deregulation caused in these environments. The purpose of this study was to answer the following questions: a) is increased loss of vegetation related to dengue cases in the Brazilian Cerrado? b) how do different regions of the tropical savanna biome present distinct patterns for total dengue cases and vegetation loss? c) what is the projection of a future scenario of deforestation and an increased number of dengue cases in 2030? Thus, this study aimed to assess the relationship between loss of native vegetation in the Cerrado and dengue infection. In this paper, we quantify the entire deforested area and dengue infection cases from 2001 to 2019. For data analyses, we used Poisson generalized linear model, descriptive statistics, cluster analysis, non-parametric statistics, and autoregressive integrated moving average (ARIMA) models to predict loss of vegetation and fever dengue cases for the next decade. Cluster analysis revealed the formation of four clusters among the states. Our results showed significant increases in loss of native vegetation in all states, with the exception of Piauí. As for dengue cases, there were increases in the states of Minas Gerais, São Paulo, and Mato Grosso. Based on projections for 2030, Minas Gerais will register about 4,000 dengue cases per 100,000 inhabitants, São Paulo 750 dengue cases per 100,000 inhabitants, and Mato Grosso 500 dengue cases per 100,000 inhabitants. To reduce these projections, Brazil will need to control deforestation and implement public health, environmental and social policies, requiring a joint effort from all spheres of society. Graduate Program in Agronomy–Cropping Systems São Paulo State University (Unesp), SP Graduate Program in Geography São Paulo State University (Unesp) School of Technology and Sciences, SP Federal University of Mato Grosso do Sul (UFMS), Chapadão do Sul, MS Federal University of Acre (UFAC) Graduate Program in Agronomy State University of Londrina (Uel), PR Graduate Program in Sciences—Nuclear Energy in Agriculture Centro de Energia Nuclear na Agricultura São Paulo University São Paulo State University (Unesp) Engineering School, SP Graduate Program in Geography Federal University of Mato Grosso do Sul (UFMS), Três Lagoas, MS Graduate Program in Agronomy–Cropping Systems São Paulo State University (Unesp), SP Graduate Program in Geography São Paulo State University (Unesp) School of Technology and Sciences, SP São Paulo State University (Unesp) Engineering School, SP CNPq: 303767/2020-0

BackgroundThe hospitalization of children during the COVID-19 pandemic has affected their physical and mental health. Pediatric nurses have faced challenges in providing high-quality nursing care for children and their families. However, the pediatric nursing care recommendations for COVID-19 patients in the hospital setting remain unclear. The current scoping review provides recommendations for nursing interventions for pediatric COVID-19 patients in the hospital setting.Methods and findingsThe selected articles containing management and nursing recommendations for COVID-19 that have occurred in pediatric patients ages 0–19 years old. A search strategy was developed and implemented in seven databases. We included peer-reviewed articles that reported observational or interventional studies, as well as policy papers, guides or guidelines, letters and editorials, and web articles. A total of 134 articles and other documents relevant to this review were included. We categorized the results based on The Nursing Intervention Classification (NIC) taxonomy which consists of six domains (e.g., Physiological: Basic); eleven classes (e.g., Nutrition Support); and eighteen intervention themes (e.g., Positioning, Family Presence Facilitation, Family Support, and Discharge Planning).ConclusionApart from the intervention of physical problems, there is a need to promote patient- and family-centered care, play therapy, and discharge planning to help children and families cope with their new situation.

Hemorrhagic fever with renal syndrome (HFRS) is a zoonosis characterized by clinical features of high fever, hemorrhage, and renal damage. China has the largest number of HFRS cases worldwide, accounting for over 90% of the total reported cases. In this paper, we used surveyed HFRS data and satellite imagery to conduct geostatistical analysis for investigating the associations of rapid urbanization, water bodies, and other factors on the spatiotemporal dynamics of HFRS from year 2005 to 2018 in Xi’an City, Northwest China. The results revealed an evident epidemic aggregation in the incidence of HFRS within Xi’an City with a phenomenal fluctuation in periodic time series. Rapid urbanization was found to greatly affect the HFRS incidence in two different time phases. HFRS caused by urbanization influences farmers to a lesser extent than it does to non-farmers. The association of water bodies with the HFRS incidence rate was found to be higher within the radii of 696.15 m and 1575.39 m, which represented significant thresholds. The results also showed that geomatics approaches can be used for spatiotemporally investigating the HFRS dynamic characteristics and supporting effective allocations of resources to formulate strategies for preventing epidemics., Author summary Hemorrhagic fever with renal syndrome (HFRS) is an infectious disease transmitted by the infected reservoir hosts, which chiefly include rodents, shrews, and moles. The mechanism of HFRS infection is determined by a complex interplay of various natural and socioeconomic factors. Previous studies have identified a close relationship between urbanization processes and HFRS transmission dynamics. However, the relationship involves a dual response and has not yet been quantitatively identified. This research aimed to spatiotemporally characterize how rapid urbanization affects the dynamics of HFRS. In addition, the role of water bodies, vegetation, rainfall, and occupation types in epidemic transmissions has also not been adequately investigated at the interurban scale over a long time period. Therefore, we analyzed the spatiotemporal association between the distributions of water bodies and HFRS infections and also investigated the interactions between urbanization, water body, vegetation, rainfall, and different occupation types by using multi-source data through both traditional statistical and geospatial techniques. Our work revealed biphasic associations among HFRS infection with both rapid urbanization and distribution of water bodies. Hence, it can provide useful information to formulate effective strategies for the prevention and control of HFRS.

Using microdata from the Chinese General Social Survey (CGSS 2010), this paper investigates whether there are green returns to education in China, where educational attainment promotes pro-environmental attitudes and behaviors. We establish causality by exploiting the exogenous variation induced by the implementation of the Compulsory Schooling Law (CSL) in China. We find evidence that educational attainment is associated with higher levels of pro-environmental attitudes and behaviors, and these estimates are robust to various robustness checks. Further analysis reveals that the acquisition of environmental knowledge is the channel that drives the effect of education on pro-environmental attitudes and behaviors. Finally, the effects of education are heterogeneous across individuals.

Background “Contracting Out” is a popular strategy to expand coverage and utilization of health services. Bangladesh began contracting out primary healthcare services to NGOs in urban areas through the Urban Primary Health Care Project (UPHCP) in 1998. Over the three phases of this project, retention of trained and skilled human resources, especially doctors, proved to be an intractable challenge. This paper highlights the issues influencing doctor’s retention both in managerial as well as service provision level in the contracted-out setting. Methodology In this qualitative study, 42 Key Informant Interviews were undertaken with individuals involved with UPHCP in various levels including relevant ministries, project personnel representing the City Corporations and municipalities, NGO managers and doctors. Verbatim transcripts were coded in ATLAS.ti and analyzed using the thematic analysis. Document review was done for data triangulation. Results The most cited problem was a low salary structure in contrast to public sector pay scale followed by a dearth of other financial incentives such as performance-based incentives, provident funds and gratuities. Lack of career ladder, for those in both managerial and service delivery roles, was also identified as a factor hindering staff retention. Other disincentives included inadequate opportunities for training to improve clinical skills, ineffective staffing arrangements, security issues during night shifts, abuse from community members in the context of critical patient management, and lack of job security after project completion. Conclusions An adequate, efficient and dedicated health workforce is a pre-requisite for quality service provision and patient utilization of these services. Improved career development opportunities, the provision of salaries and incentives, and a safer working environment are necessary actions to retain and motivate those serving in managerial and service delivery positions in contracting out arrangements.

Dietary adequacy and diversity during the lactation period are necessary to ensure good health and nutrition among women and children. Behavioral interventions pertaining to health and nutrition counselling during pregnancy and lactation are critical for awareness about dietary diversity. The issue assumes salience for marginalized communities because of the Covid-19 pandemic and associated economic and societal disruptions. This paper assesses the dietary patterns among 400 lactating mothers in the tribal-dominated district of Palghar in Maharashtra, India in 2020. The study is based on primary data regarding consumption of 10 food groups among women across 10 food groups based on 24-hour recall period. The primary outcome variable was binary information regarding Minimum Dietary Diversity defined as consumption from at least 5 food groups. Econometric analysis based on multilevel models and item-response theory is applied to identify food groups that were most difficult to be received by mothers during the early and late lactation period. We find that the daily diet of lactating mothers in Palghar primarily consists of grains, white roots, tubers, and pulses. In contrast, the intake of dairy, eggs, and non-vegetarian food items is much lower. Only Half of the lactating women (56.5 percent; 95% CI: 37.4; 73.8) have a minimum diversified diet (MDD). The prevalence of lactating women with MDD was higher among households with higher income (73.1 percent; 95% CI: 45.2; 89.9) than those in lower income group (50.7 percent; 95% CI: 42.3; 58.9). Lactating Women (in early phase) who received health and nutrition counseling services are more likely (OR: 2.37; 95% CI: 0.90; 6.26) to consume a diversified diet. Food groups such as fruits, meat, poultry, fish, nuts, and seeds were among the rare food items in daily diet. The dietary pattern lacking in fruits, nuts, and heme (iron) sources indicates more significant risks of micronutrient deficiencies. The findings call for improving dietary diversity among lactating mothers, particularly from the marginalized communities, and are driven by low consumption of dairy products or various fruits and vegetables. Among the different food items, the consumption of micronutrient-rich seeds and nuts is most difficult to be accessed by lactating mothers. Also, diet-centric counseling and informing lactating mothers of its benefits are necessary to increase dietary diversity for improving maternal and child nutrition.

Objective The Spanish health system is made up of seventeen regional health systems. Through the official reporting systems, some inconsistencies and differences in case fatality rates between Autonomous Communities (CC.AA.) have been observed. Therefore the objective of this paper is to compare COVID-19 case fatality rates across the Spanish CC.AA. Material and methods Observational descriptive study. The COVID-19 case fatality rate (CFR) was estimated according to the official records (CFR-PCR+), the daily mortality monitory system (MoMo) record (CFR-Mo), and the seroprevalence study ENE-COVID-19 (Estudio Nacional de sero Epidemiologia Covid-19) according to sex, age group and CC.AA. between March and June 2020. The main objective is to detect whether there are any differences in CFR between Spanish Regions using two different register systems, i. e., the official register of the Ministry of Health and the MoMo. Results Overall, the CFR-Mo was higher than the CFR-PCR+, 1.59% vs 0.98%. The differences in case fatality rate between both methods were significantly higher in Castilla La Mancha, Castilla y León, Cataluña, and Madrid. The difference between both methods was higher in persons over 74 years of age (CFR-PCR+ 7.5% vs 13.0% for the CFR-Mo) but without statistical significance. There was no correlation of the estimated prevalence of infection with CFR-PCR+, but there was with CFR-Mo (R2 = 0.33). Andalucía presented a SCFR below 1 with both methods, and Asturias had a SCFR higher than 1. Cataluña and Castilla La Mancha presented a SCFR greater than 1 in any scenario of SARS-CoV-2 infection calculated with SCFR-Mo. Conclusions The PCR+ case fatality rate underestimates the case fatality rate of the SARS-CoV- 2 virus pandemic. It is therefore preferable to consider the MoMo case fatality rate. Significant differences have been observed in the information and registration systems and in the severity of the pandemic between the Spanish CC.AA. Although the infection prevalence correlates with case fatality rate, other factors such as age, comorbidities, and the policies adopted to address the pandemic can explain the differences observed between CC.AA.

Motivated by the two-decade-long scientific debate over the existence of the ego-depletion effect, our paper contributes to exploring the scope conditions of ego-depletion theory. Specifically, in a randomized experiment, we depleted students’ self-control with a cognitively demanding task that required students’ effort. We measured the effect of depleted self-control on a subsequent task that required self-control to not engage in fraudulent cheating behavior—measured with an incentivized dice-roll task—and tested ego-depletion in a large-scale preregistered field experiment that was similar to real-life situations. We hypothesized that treated students would cheat more. The data confirms the hypothesis and provides causal evidence of the ego-depletion effect. Our results provide new insights into the scope conditions of ego-depletion theory, contribute methodological information for future research, and offer practical guidance for educational policy.

Understanding how textual information impacts financial market volatility has been one of the growing topics in financial econometric research. In this paper, we aim to examine the relationship between the volatility measure that is extracted from GARCH modelling and textual news information both publicly available and from subscription, and the performances of the two datasets are compared. We utilize a latent Dirichlet allocation method to capture the dynamic features of the textual data overtime by summarizing their statistical outputs, such as topic distributions in documents and word distributions in topics. In addition, we transform various measures representing the popularity and diversity of topics to form predictors for a rolling regression model to assess the usefulness of textual information. The proposed method captures the statistical properties of textual information over different time periods and its performance is evaluated in an out-of-sample analysis. Our results show that the topic measures are more useful for predicting our volatility proxy, the unexplained variance from the GARCH model than the simple moving average. The finding indicates that our method is helpful in extracting significant textual information to improve the prediction of stock market volatility.

The Danube is promoted as a pan-European river, what can be justified for instance by the vast range of its drainage basin, covering 19 countries on both sides of the historical border diving Eastern and Western Europe. Differentiation of imaginations of Danube course from the perspective of 7 European cities, based on research covering 1577 respondents, conducted between 2005–2007 and 2016–2018 has been presented in the paper. Maps presenting the generalized imagination of river course have been generated for each city. It has been proved that in spite of substantial political, economical and symbolical importance of this river for big part of Europe, the course of Danube remains unknown for inhabitants of its Western part, in parallel to more correct recognition of the river by students from Eastern Europe. It has been shown that the perception does not change despite the progressing integration processes.

School closures due to the COVID-19 global pandemic are likely to have a range of negative consequences spanning the domains of child development, education and health, in addition to the widening of inequalities and inequities. Research is required to improve understanding of the impact of school closures on the education, health and wellbeing of pupils and school staff, the challenges posed during reopening and importantly to identify how countries can ensure a safe return to education and to inform policy. This qualitative study aimed to reflect on the experience of primary school staff (pupils aged 3-11) in Wales regarding school closures and the initial reopening of schools and to identify recommendations for the future. A total of 208 school staff completed a national online survey through the HAPPEN primary school network, consisting of questions about school closures, the phased reopening of schools and a return to full-time education. Thematic analysis of survey responses identified five recommendations; (i) prioritise the health and wellbeing of pupils and staff. This includes more focus on wellbeing activities and less focus on attainment/assessments and protecting staff breaks to promote workplace wellbeing; (ii) focus on enabling parental engagement and support. Introduce support sessions for parents and include regular check ins during periods of home learning; (iii) improve digital competence amongst pupils, teachers and parents. Ensure the provision of equipment and training in building digital skills. Offer a combination of paper-based and digital home learning activities; (iv) consider opportunities for smaller class sizes and additional staffing. Ensure support is directed to need whilst providing pastoral care; and (v) improve the mechanism of communication between schools and families, and between government and schools. Ensure that schools receive advance notice of local or national changes in guidance.

Background With the increase in elderly population, the risk of cardiovascular diseases (CVD) among Indian older adults is also increasing. The present paper tries to assess how different anthropometric measures of obesity and physical activity affects cardiovascular disease risk among older adults in India. Methods The data from Longitudinal Ageing Study in India (LASI) has been used. The total sample size for the present study is 31,464 older adults aged 60 years and above. Chi-square test and binary logistic regression has been used to measure the association of obesity measures and CVD prevalence. Results About 35.2% (n = 11,058) of the older adults suffered from CVD. Moreover, 22.2% (n = 6,217) of the older adults were obese/overweight, 23.7% (n = 6,651) had high risk waist circumference and 77.0% (n = 21,593) had high risk waist-Hip ratio. The likelihood of CVD was 60%, 50%, and 34% significantly higher among older adults who were obese/overweight [Adjusted odds ratio (AOR): 1.60; CI: 1.48–1.72], had high risk waist circumference [AOR: 1.50; CI: 1.39–1.62] and high risk waist-Hip ratio [AOR: 1.34; CI: 1.25–1.44], respectively compared to older adults with normal BMI and those who do not have a high risk waist circumference and high risk waist hip ratio. Moreover, older adults who never did physical activity had 22 per cent higher risk of CVD than those who did frequent [AOR: 1.22; CI: 1.13–1.32] physical activity. Conclusion The burden of overweight and obesity along with physical inactivity increases the risk of CVD in older adults. These findings highlight the urgent need for framing direct and indirect strategies to control obesity in order to reduce the burden of CVD among older adults in India.

This paper is based on qualitative research carried out in a diabetic retinopathy (DR) programme in three districts of Pakistan. It analyses the organisation and delivery of DR services and the extent to which the interventions resulted in a fully functioning integrated approach to DR care and treatment. Between January and April 2019, we conducted 14 focus group discussions and 37 in-depth interviews with 144 purposively selected participants: patients, lady health workers (LHWs) and health professionals. Findings suggest that integration of services was helpful in the prevention and management of DR. Through the efforts of LHWs and general practitioners, diabetic patients in the community became aware of the eye health issues related to uncontrolled diabetes. However, a number of systemic pressure points in the continuum of care seem to have limited the impact of the integration. Some components of the intervention, such as a patient tracking system and reinforced interdepartmental links, show great promise and need to be sustained. The results of this study point to the need for action to ensure inclusion of DR on the list of local health departments’ priority conditions, greater provision of closer-to-community services, such as mobile clinics. Future interventions will need to consider the complexity of adding diabetic retinopathy to an already heavy workload for the LHWs.

Antimicrobial resistance (AMR) is a global public health crisis that is now impacted by the COVID-19 pandemic. Little is known how COVID-19 risks influence people to consume antibiotics, particularly in contexts like Bangladesh where these pharmaceuticals can be purchased without a prescription. This paper identifies the social drivers of antibiotics use among home-based patients who have tested positive with SARS-CoV-2 or have COVID-19-like symptoms. Using qualitative telephone interviews, the research was conducted in two Bangladesh cities with 40 participants who reported that they had tested positive for coronavirus (n = 20) or had COVID-19-like symptoms (n = 20). Our analysis identified five themes in antibiotic use narratives: antibiotics as ‘big’ medicine; managing anxiety; dealing with social repercussions of COVID-19 infection; lack of access to COVID-19 testing and healthcare services; and informal sources of treatment advice. Antibiotics were seen to solve physical and social aspects of COVID-19 infection, with urgent ramifications for AMR in Bangladesh and more general implications for global efforts to mitigate AMR.

Background Digital health (DH) and the benefits of related services are fairly well understood. However, it still is critical to map the digital health care landscape including the key elements that define it as an ecosystem. Particularly, knowing the perspectives of citizens on this digital transformation is an important angle to capture. In this review we aim to analyze the relevant studies to identify how DH is understood and experienced by Australian citizens and what they may require from DH platforms. Materials and methods A scoping literature review was conducted across several electronic databases (ACM Digital Library, OVID, PubMed, Scopus, IEEE, Science Direct, SAGE), as well as grey literature. Additionally, citation mining was conducted to identify further relevant studies. Identified studies were subjected to eligibility criteria and the final set of articles was independently reviewed, analyzed, discussed and interpreted by three reviewers. Results Of 3811 articles, 98 articles met the inclusion criteria with research-based articles–as opposed to review articles or white papers– comprising the largest proportion (72%) of the selected literature. The qualitative analysis of the literature revealed five key elements that capture the essence of the digital health ecosystem interventions from the viewpoint of the Australian citizens. The identified elements were “consumer/user”, “health care”, “technology”, “use and usability”, “data and information”. These elements were further found to be associated with 127 subcategories. Conclusions This study is the first of its kind to analyze and synthesize the relevant literature on DH ecosystems from the citizens’ perspective. Through the lens of two research questions, this study defines the key components that were found crucial to understanding citizens’ experiences with DH. This understanding lays a strong foundation for designing and fostering DH ecosystem. The results provide a solid ground for empirical testing.

In this paper we assess the impact of the recent European recession on stillbirth indices over the course of the 2000s and 2010s; the analysis focuses on four Southern European countries (Greece, Italy, Spain, Portugal), which were seriously affected by the sovereign debt crisis from around 2008 to 2017. We use national vital statistics and established economic indicators for the period 2000–2017; stillbirth ratios (stillbirths per 1000 livebirths) are the chosen response variable. For the purpose of the study, we employ correlation analysis and fit regression models. The overall impact of economic indicators on the stillbirth indices is sizeable and statistically robust. We find that a healthy economy is associated with low and declining levels of stillbirth measures. In contrast, economic recession appears to have an adverse effect (Greece, Italy and Spain), or an unclear impact (Portugal), on the stillbirth outcome. This study provides evidence of the adverse effect of the European sovereign debt crisis and ensuing period of austerity on a scarcely explored aspect of health.

The need for resilient health systems is recognized as important for the attainment of health outcomes, given the current shocks to health services. Resilience has been defined as the capacity to “prepare and effectively respond to crises; maintain core functions; and, informed by lessons learnt, reorganize if conditions require it”. There is however a recognized dichotomy between its conceptualization in literature, and its application in practice. We propose two mutually reinforcing categories of resilience, representing resilience targeted at potentially known shocks, and the inherent health system resilience, needed to respond to unpredictable shock events. We determined capacities for each of these categories, and explored this methodological proposition by computing country-specific scores against each capacity, for the 47 Member States of the WHO African Region. We assessed face validity of the computed index, to ensure derived values were representative of the different elements of resilience, and were predictive of health outcomes, and computed bias-corrected non-parametric confidence intervals of the emergency preparedness and response (EPR) and inherent system resilience (ISR) sub-indices, as well as the overall resilience index, using 1000 bootstrap replicates. We also explored the internal consistency and scale reliability of the index, by calculating Cronbach alphas for the various proposed capacities and their corresponding attributes. We computed overall resilience to be 48.4 out of a possible 100 in the 47 assessed countries, with generally lower levels of ISR. For ISR, the capacities were weakest for transformation capacity, followed by mobilization of resources, awareness of own capacities, self-regulation and finally diversity of services respectively. This paper aims to contribute to the growing body of empirical evidence on health systems and service resilience, which is of great importance to the functionality and performance of health systems, particularly in the context of COVID-19. It provides a methodological reflection for monitoring health system resilience, revealing areas of improvement in the provision of essential health services during shock events, and builds a case for the need for mechanisms, at country level, that address both specific and non-specific shocks to the health system, ultimately for the attainment of improved health outcomes.

With the development of recent years, the field of deep learning has made great progress. Compared with the traditional machine learning algorithm, deep learning can better find the rules in the data and achieve better fitting effect. In this paper, we propose a hybrid stock forecasting model based on Feature Selection, Convolutional Neural Network and Bidirectional Gated Recurrent Unit (FS-CNN-BGRU). Feature Selection (FS) can select the data with better performance for the results as the input data after data normalization. Convolutional Neural Network (CNN) is responsible for feature extraction. It can extract the local features of the data, pay attention to more local information, and reduce the amount of calculation. The Bidirectional Gated Recurrent Unit (BGRU) can process the data with time series, so that it can have better performance for the data with time series attributes. In the experiment, we used single CNN, LSTM and GRU models and mixed models CNN-LSTM, CNN-GRU and FS-CNN-BGRU (the model used in this manuscript). The results show that the performance of the hybrid model (FS-CNN-BGRU) is better than other single models, which has a certain reference value.

Although company ownership (local vs. foreign) has been used as a contingency variable that differentiates companies’ environmental activities and performance, the current understanding of these differences is fragmented. None of the previous studies examined the relationships between company ownership and a complex set of organizational practices which promote employees’ pro-environmental behaviors. The article fills the gap in previous research by analyzing the extent to which a total of 37 organizational practices are used. These practices are divided into technical (20 are related to environmental management) and “soft” (17 are related to HRM policies). For this study, both literature studies and a survey covering 199 companies located in Poland were used. In the theoretical part, the paper presents various typologies of factors that enhance employees’ green behavior, with the focus on organizational practices. There is also a review of studies on environmental sustainability which used company ownership as a variable. The results of the empirical research show that–although in foreign companies environmental issues are increasingly perceived as important or very important–many of the practices which are treated as crucial for developing employees’ eco-friendly behaviors are rarely used in both local and foreign companies. Moreover, company ownership was important in the context of using 88% of the “soft” practices and 50% of the technical practices discussed in the article. The article provides implications for policy and practice, as well as directions for further research.

Vehicle-tree collisions are the most common type of road crash with fixed obstacle in Czech Republic. Based on the literature review and using real world in-depth crash data, this paper aims to define factors, which significantly influence the injury severity of single vehicle-tree crashes. In-depth data provide a comprehensive view to the failure on the system infrastructure—human—vehicle related to crash, the in-depth crash database include very detailed information related to infrastructure, vehicle, human failure and crash participants characteristics and their medical condition and also crash reconstruction. Multinomial logistic regression and generalized linear mixed model were used to determine the individual effect of each predictor. The statistically significant variables were the day period, trunk diameter and impact speed. Using multinomial logistic regression shows also vehicle age as statistically significant. Obtained results can help to efficiently direct countermeasures not only on the road infrastructure—e.g. speed reduction in selected locations with specified tree character. However, the emphasis should be also focused on driver behaviour.

Men are underrepresented in family planning (FP) research, and despite the widespread promotion of FP through mass media, there is no systematic evaluation on how mass media exposure influences their FP knowledge, attitudes and behavior. Using Demographic and Health Survey (DHS) data from 31 countries in Sub-Saharan Africa (SSA), collected between 2010 and 2019, this paper examines the associations between three types of traditional mass media (radio, television and print) with FP knowledge, attitudes and method choices among reproductive age men in SSA, relative to other socio-cultural factors. Estimates to quantify the relative contribution of each type of mass media, relative to other evidence-based socio-cultural influences on FP outcomes, were derived using the Shorrocks-Shapley decomposition. Radio exposure had the largest impact on FP knowledge, attitudes and method choice, accounting for 26.1% of the variance in FP knowledge, followed by Television (21.4%) and education attainment (20.7%). Mass media exposure had relatively minimal impact on FP method choice, and between the three types of mass media, television (8%) had the largest influence on FP method choice. Print media had comparatively lesser impact on FP knowledge (8%), attitudes (6.2%) and method choice (3.2%). Findings suggest that mass media exposure has positive influences on FP knowledge, attitudes and method choice but its influence on FP knowledge, attitudes and method choice is smaller relative to other socio-cultural factors such as education, household wealth and marital status. As such, efforts to increase FP uptake in Sub-Saharan Africa should take into consideration the impact of these socio-cultural economic factors.

International openness can affect regional innovation through more export opportunities, enhanced import competition and the spillover effects of foreign direct investment. Many studies have been conducted based on different countries for capturing the determinants of regional innovation, but very little literature is available with contradictory findings for the case of China. Based on 19 years’ panel data of 31 Chinese provinces, this paper analyzes the impact of international openness on regional innovation measured by the number of patent grants. The positive effects of overall trade and a higher proportion of exports and imports to GDP are significant and robust across different model specifications, indicating that an increase in international openness can promote regional innovating activities in China. The causal relationship of all the variables depicted by path analysis matches the results of the system GMM model. Higher intellectual property protection provides each region with the opportunity to obtain economic benefits from innovation and then make a higher investment in R&D activities. Besides, the lag effect of regional innovation capability can also explain a large part of local innovating activities. In our subsample regressions, the positive effect of trade openness on innovation is majorly manifested in developed areas like eastern provinces.

In the aftermath of shock events, policy responses tend to be crafted under significant time constraints and high levels of uncertainty. The extent to which individuals comply with different policy designs can further influence how effective the policy responses are and how equitably their impacts are distributed in the population. Tools which allow policymakers to model different crisis trajectories, policy responses, and behavioral scenariosex antecan provide crucial timely support in the decision-making process. Set in the context of COVID-19 shelter in place policies, in this paper we present the COVID-19 Policy Evaluation (CoPE) tool, which is an agent-based modeling framework that enables researchers and policymakers to anticipate the relative impacts of policy decisions. Specifically, this framework illuminates the extent to which policy design features and behavioral responsiveness influence the efficacy and equity of policy responses to shock events. We show that while an early policy response can be highly effective, the impact of the timing is moderated by other aspects of policy design such as duration and targeting of the policy, as well as societal aspects such as trust and compliance among the population. More importantly, we show that even policies that are more effective overall can have disproportionate impacts on vulnerable populations. By disaggregating the impact of different policy design elements on different population groups, we provide an additional tool for policymakers to use in the design of targeted strategies for disproportionately affected populations.