Differences In Circumstances Research Articles

Paramedic Workforce Disparities Marked by Geographical Positioning

Introduction: Effective service delivery and the wellbeing of the paramedic workforce is reliant on confounding factors and is effectuated by geographical positioning. It is important to be aware that there may be several disparities between the rural and urban workforce due to differences in circumstances. However, there is limited literature available examining these. The objective of this review was to investigate where and how these disparities exist to make recommendations in achieving equity in the paramedic workforce and thus achieve patient-centred care universally across rural and urban populations.
 Methods: The JBI approach was used to perform a scoping review to assess the availability of literature. Key words including paramedic*, EMT, urban OR metro*, rural OR remote and disparit* were inserted into the search engines MEDLINE, CINAHL Plus and Scopus. Titles and abstracts of the 282 results were screened by two authors and inclusion and exclusion criteria applied. The full text of the remaining 77 results were screened to inform the results of the review.
 Results: The search identified 282 potentially relevant articles, of which 33 informed the results of the review. The included studies identified emerging themes relevant to the objective including: (1) the skills, training availability and confidence of the workforce (2) resourcing of ambulances inclusive of both workload and case load; (3) timings of each group regarding response, scene, and transport; and (4) the health status of paramedics in each subset location.
 Conclusion: This review identified several disparities between rural and urban paramedic locations. However, it does not allow us to understand the extent at which these influence paramedics health and wellbeing and their ability to provide optimal patient-centred care which is equitable across locations. Further research is recommended to establish the extent to which these disparities are impacting the lives of paramedics and provision of emergency healthcare.

INTERDISCIPLINARY APPROACHES TO EPIDEMIOLOGY AND PREVENTION OF FALLS IN OLDER ADULTS

Abstract Prevention of falls is important to independent living and good health in older age. This symposium brings together five interdisciplinary studies on falls among community-dwelling older adults. The first presentation examines the relationship between multisite pain and fear of falling among older adults with dementia. The second discusses the differential effects of anxiety on indoor vs. outdoor falls. The cohort study found that anxiety was associated with higher rate of indoor but not outdoor falls. The third investigates racial differences in association of accelerometer measured physical activity with indoor and outdoor falls. The study found that a 30-minutes increase in moderate-to-vigorous intensity physical activity was associated with 25% lower rate of indoor falls and 42% higher rate of outdoor falls among non-White but not White participants, an interesting example of effect modification by race and location of falls. The fourth reports findings of a cross-sectional survey of older adults in Thailand which observed high prevalence of falls, and substantial differences in fear of falling, daily activities and quality of life between fallers and non-fallers, and between persons with and without fear of falling. The fifth reports rural-urban differences in circumstances and correlates of falls from the same study in Thailand. The study found higher fall rates, higher level of fear of falling and worse general health in urban than rural residents, highlighting the need for considering urban-rural differences in falls prevention. Together, these studies demonstrate the complexity and promises of interdisciplinary approaches to falls research.

Inequality of opportunity in educational achievement in Western Europe: contributors and channels

AbstractWe study the contribution of students’ circumstances to inequality of opportunity in educational achievement (IOpE) in Western Europe and explore the role of intermediate channelling variables in translating differences in circumstances into educational inequalities. Using the 2018 Programme for International Student Assessment (PISA) database, we find that differences in households’ cultural environment and in parental occupation are the most important contributing circumstances, with school’s circumstances being relevant mostly in Central Europe. Our results show that the relevant channels of IOpE in most countries are students’ educational and occupational expectations, their reading habits and skills, and grade repetition in previous years. These findings can provide policymakers with key insights to aid in designing educational interventions that effectively increase educational opportunities across European countries.

A Comparative Study of the Military Tactics of the Mongol Empire and Goguryeo Kingdom (Goryeo)

Abstract The study is conducted as a comparative study of military tactics of the powers representing different regions and time periods throughout human history. Despite the differences in circumstance and time, common success factors are identified in the military tactics of the two great powers. Based on these success factors, it is possible to compare the military tactics of these armies using the following common criteria: basic tactical unit system, strategic flexibility, tactical mobility, and strategic planning. The Mongol Empire and Goguryeo Kingdom had long been the dominant military powers in their regions. Also, during the Goryeo Dynasty, which succeeded Goguryeo, the Mongolian army invaded Goryeo and used there creative military tactics. Especially, the Mongol army was one of the greatest in human history, and through its power and military skill, led to the magnificent growth of the Mongol Empire. Thus, this study identifies the success factors of the Mongol military tactics through comparison with Goguryeo military tactics.

Personas of pregnant and parenting women with substance use and their barriers and pathways to system engagement.

Women with prenatal substance use have been identified as at-risk for the lack of engagement in perinatal services, such as medical care and home visitation programs. This issue is of particular concern in Florida (United States) where rates of fetal substance exposure have been steadily increasing. To identify pathways of and barriers to perinatal system and service engagement, journey mapping was used to compile various personas of perinatal women with substance use. A structured guide was developed to elicit maternal personas, system and service touchpoints, and system strengths and weaknesses from focus group participants with statewide stakeholders, including perinatal service administrators and community coalition members within three Florida communities. Workshop transcripts, debriefing, and member-checking sessions were transcribed verbatim and analyzed manually. Six journey-mapping workshops and two member-checking meetings with mothers in-recovery were conducted with a total of 109 participants. Four personas were identified: women who (1) have substance use on a recreational basis, (2) have prescription drug use/misuse, (3) have chronic substance dependence, and (4) are in-recovery from substance dependence. Pathways that promote and barriers that prevent perinatal women with substance use from being identified, referred, or willing to accept and engage in medical care and social services were identified. While these personas shed light on differential pathways experienced by women with OUD, they were not intended as fixed-member groups but rather fluid descriptions of circumstances in which individuals could shift over time. These personas are beneficial to understand differences in circumstances, as well as variations in pathways and barriers to service engagement. Additionally, personas may be used to identify approaches to optimize service engagement by perinatal women with substance use and to support system improvements and integrations.

Circumstances Contributing to Suicide Among U.S. Adolescents Aged 10–19 Years With and Without a Known Mental Health Condition: National Violent Death Reporting System, 2013–2018

PurposeSuicide is the second leading cause of death for adolescents in the United States; however, suicide is preventable and a better understanding of circumstances that contribute to death can inform prevention efforts. While the association between adolescent suicide and mental health is well established, multiple circumstances contribute to suicide risk. This study examines characteristics of adolescents who died by suicide and differences in circumstances between those with and without known mental health conditions at the time of death. MethodsLogistic regression models were used to estimate adjusted odds ratios and 95% confidence intervals of circumstances contributing to suicide between decedents with and without known mental health conditions using data from the 2013 to 2018 National Violent Death Reporting System (analyzed in 2021). ResultsDecedents with a known mental health condition were 1.2–1.8 times more likely to experience problematic alcohol misuse, substance misuse, family and other nonintimate relationship problems, and school problems; however, there were no significant differences between those with and without a known mental health condition for the preceding circumstances of arguments or conflicts, criminal or legal problems, or any crisis occurring within the two weeks prior to death. DiscussionA comprehensive suicide prevention approach can address not only mental health conditions as a risk factor but also life stressors and other crises experienced among adolescents without known mental health conditions.

Study on Improvement of Living SOC Complex Facilities Using Comparative Analysis on Perceptions of Users in Urban and Rural Regions

The purpose of this study is to provide improvements for satisfying consumers’ demand levels, including the selection of facilities’ locations, the improvement orientation of a facility plan and qualitative improvement of space programs, by analyzing the perceptions of users in living SOC complex facilities. It developed a structured analysis framework by reviewing literature and analyzing previous research, and secured the objectivity of it, by conducting face-to-face interviews with and administering non-contact questionnaires to the subjects. It conducted frequency, average and cross-analysis, t-test, simple regression and IPA analysis, to comparatively analyze the differences in the use level, satisfaction level and demand level, perceived by residents in urban and rural regions. The findings showed that there are differences in use level, satisfaction level and demand level, between urban and rural regions, suggesting that institutional differentiation is required depending on local characteristics, and that the customized improvement of facility plans is also needed according to differences in circumstances.

The Analysis of Green Supply Chain Management, Green Capability, and Economic Performance: A Study of Catering SMEs in the Special Region of Yogyakarta, Indonesia

The purpose of the paper is to analyze the effect of green supply chain management on economic performance in catering SMEs in the province of the Special Region of Yogyakarta, Indonesia. In the previous research, those relationships are mediated by green capability as the intervening variable. This study uses a purposive sampling technique. There are 50 catering SMEs as samples in this study. The questionnaire data were analyzed using the SEM (Structural Equation Modeling) analysis method using the SmartPLS v.3.2.7 software. The results of this study are different from the previous research. The differences may come from the highly distinct population from the prior research subjects. Therefore, some hypotheses are not accepted. Only one hypothesis is accepted, which is about the effect of green capability on economic performance. The limitation of this research is that it only conducts research in one sector, and the differences in circumstances and places of research cause research results to differ significantly from previous studies. In addition, the results of this study cannot be generalized and do not represent existing businesses in other sectors.

Inequality of opportunity in a land of equal opportunities: The impact of parents’ health and wealth on their offspring’s quality of life in Norway

BackgroundThe literature on Inequality of opportunity (IOp) in health distinguishes between circumstances that lie outside of own control vs. efforts that – to varying extents – are within one’s control. From the perspective of IOp, this paper aims to explain variations in individuals’ health-related quality of life (HRQoL) by focusing on two separate sets of variables that clearly lie outside of own control: Parents’ health is measured by their experience of somatic diseases, psychological problems and any substance abuse, while parents’ wealth is indicated by childhood financial conditions (CFC).We further include own educational attainment which may represent a circumstance, or an effort, and examine associations of IOp for different health outcomes. HRQoL are measured by EQ-5D-5L utility scores, as well as the probability of reporting limitations on specific HRQoL-dimensions (mobility, self-care, usual-activities, pain & discomfort, and anxiety and depression).MethodWe use unique survey data (N = 20,150) from the egalitarian country of Norway to investigate if differences in circumstances produce unfair inequalities in health. We estimate cross-sectional regression models which include age and sex as covariates. We estimate two model specifications. The first represents a narrow IOp by estimating the contributions of parents’ health and wealth on HRQoL, while the second includes own education and thus represents a broader IOp, alternatively it provides a comparison of the relative contributions of an effort variable and the two sets of circumstance variables.ResultsWe find strong associations between the circumstance variables and HRQoL. A more detailed examination showed particularly strong associations between parental psychological problems and respondents’ anxiety and depression. Our Shapley decomposition analysis suggests that parents’ health and wealth are each as important as own educational attainment for explaining inequalities in adult HRQoL.ConclusionWe provide evidence for the presence of the lasting effect of early life circumstances on adult health that persists even in one of the most egalitarian countries in the world. This suggests that there may be an upper limit to how much a generous welfare state can contribute to equal opportunities.

Friendship of Well-known and Undeservedly Forgotten Masters in Late 19th and Early 20th Century Russian Piano Music. The Life and Work of Medtner, Rachmaninoff, and Scriabin

"In this study, I explore the life and work of three outstanding pianists and composers in the late 19th and early 20th century: Medtner, Rachmaninoff, and Scriabin, who were not only contemporaries and colleagues but also supportive friends to each other. All three were largely influenced by their years at the Moscow Conservatory, where they became prominent pianists and first showed promise as composers. They received similar impulses and could learn from the same teachers. As a defining common element in their lives, they explored and strived to combine Russian musical traditions and Western classical music. At the same time, their different personalities are apparent from their music, so despite their common roots, their individual musical language is unmistakable. Even at the beginning of their careers, it was clear that despite the commonalities, their lives and careers took a different direction. All three tried their luck abroad, but only Scriabin returned home for the rest of his short life. In addition to their distinct life paths and musical language, their recognition is quite different. Scriabin’s name sounds familiar to many, but he does not belong to the most popular composers of our time. Rachmaninoff’s widespread popularity can be observed among professional musicians as well as the public. In contrast, it is not impossible to meet a professional for whom Medtner’s music is unknown. This is not necessarily explained by disparities in talent and abilities but rather by differences in circumstances, opportunities, and personalities. In this study, I attempt to shed light on the reasons for the three composers’ contrasting popularity from the perspective of their life and work. Keywords: Russian composers, Russian music, Late 19th, and early 20th century, Rachmaninoff, Scriabin, Medtner "

Length\u2013weight relationship of Charybdis callianassa Herbst, 1789 (Decapoda: Brachyura) in relation to sex and carapace length along the Mumbai coastal water, India

BackgroundThe present study was performed to determine carapace length–body weight relationship of Charybdis callianassa. In fisheries biology, length–weight relationships are important as they allow for the calculation, by creating a mathematical equation between the two, of the total weight of the fish in a particular group in fish. Such information is helpful for fishery scientists to research the dynamics of development and populations and for public agencies that can maintain and preserve these resources sustainably.ResultsA study on the carapace length–body weight relationship of Charybdis callianassa (Herbst, 1789) was made on the northwest coast of India for the first time. The study was based on experimental trawl fishing conducted fortnightly from August 2019 to March 2020. A total of 479 specimens, including 262 males and 217 females from fishing trawler, were examined for their carapace length and total weight. The carapace length ranged from 2.69 to 3.54 cm, and the total weight from 5.26 to 7.36 g. This analysis revealed that the crabs exhibited negative allometric development, as shown by average exponents 'b' = 2.71 for pooled data with high coefficient (r) = 0.91 and r2 = 0.83.ConclusionsThe carapace length–body weight relationship of Charybdis callianassa in relation to sex and carapace was studied in the Mumbai coastal water, India. We found major differences in the average “r2” values of species reported for males (0.89), females (0.79) and pooled data (0.83). Such kind of study is essential for fisheries biology to comprehend the differences in circumstances in small and large specimens that vary with environmental conditions and seasons.

Comparative Study of the Military Tactics of the Roman Empire and Mongol Empire

Abstract The study is conducted as a comparative study of military tactics of the two powers representing different regions and time periods throughout human history. Despite the differences in circumstance and time, common success factors are identified in the military tactics of the two great powers. Based on these success factors, it is possible to compare the military tactics of these armies using the following common criteria: basic tactical unit system, strategic flexibility, tactical mobility, and strategic planning. The Roman Empire and Mongol Empire had long been the dominant military powers in their regions. Among them, the Mongol army was one of the greatest in human history, and through its power and military skill, led to the magnificent growth of the Mongol Empire. Thus, this study identifies the success factors of the Mongol military tactics through comparisons with Roman military tactics.

Inequality of Opportunity and Support for Democracy: Evidence from Transition Countries

The linkage between income inequality and citizens’ support for democracy has widely been discussed in the literature (e.g. Acemoglu and Robinson, 2001; Andersen, 2012). However, drawing inequality can further be decomposed into two components drawing on the theory of inequality of opportunity (IOp) proposed by Roemer (1998). Inequality arising due to differences in effort is perceived as ”fair”, while inequality due to differences in circumstances (e.g. unequal starting conditions) is regarded as ”unfair”. Using multiple state-of-the-art estimation methods comparable IOp measures for 27 former communist countries (”transition countries”) and 3 Western democracies are calculated. Incorporating these IOp measures into the individual-level attitude formation process reveals that higher levels of IOp correspond to higher levels of support for the concept of democracy while overall income inequality has no statistically significant effect. This observation can be rationalized by citizens regarding democracy as a means to achieve equality of opportunity rather than simply as a vehicle for redistribution.

Inequality of Opportunity in The Labor Market: Evidence from Sudan

This paper examines the inequality of opportunity in the labor market in Sudan, using data of the Poverty Survey, 2014. A logit model is used with the dependent variable taking 1 if the person is employed and 0 otherwise. A set of circumstance variables are used as regressors, and ex-ante inequality of opportunity is calculated using the dissimilarity index and Shapley decomposition. Gender was associated with the largest share of inequality of opportunity, estimated at 73.41 percent. Gender-based inequality of opportunity in employment was assessed using Blinder-Oaxaca decomposition methods. The findings reveal that the average probability of accessing employment is 0.87 for men and 0.59 for women, yielding a gap of 0.274. The difference between the average group characteristics of males and females was reflected in the coefficient of endowment (0.008), representing 2.9 percent of the total difference. The bulk of the gap is attributed to differences in circumstances, as indicated by the difference of 0.249 in the coefficients, representing 90.8 percent of the total difference. This difference is interpreted as discrimination. The results call for substantial reforms, not only in the labor market but, more importantly, with regard to circumstance variables over which the individuals have no control.

Disentangling the Impacts of Circumstances and Efforts on Health Inequality: The Case of Luxembourg

This paper attempts to determine the contribution of circumstances, efforts (and lifestyle) and demographic variables (age and gender) to inequality in health in Luxembourg. Health is measured subjectively by self-assessed health and is considered first as a binary variable, then as an ordinal variable. The educational level of each parent, the financial situation of the family during childhood and the area of birth are considered as circumstances while effort and lifestyle variables are proxied by information on the educational level of the individual, whether he/she smoked and whether he/she had a physical activity on a regular basis. The respective impacts of the three categories of explanatory variables (circumstances, effort and demographic variables) on health inequality are derived via a Shapley decomposition of the pseudo R-square of logit regressions. Differences in circumstances and effort and lifestyle explain each around a quarter of the pseudo R-square.

ИСТОРИЈСКИ ОСЛОНАЦ ПРОГРЕСИВНОГ УМЕТНИЧКОГ ОБРАЗОВАЊА XXI ВЕКА – БЛЕК МАУНТИН КОЛЕЏ

Through theoretical analysis, the paper discusses the conceptual connection between the educational practice of Black Mountain College, an American college from the first half of the twentieth century, and contemporary practices that occur as the formation of the educational turn, artistic and cultural tendency noticeable from the mid-nineties of the twentieth century to the present. As one of the progressive art schools of the first half of last century, the Black Mountain College has developed a specific educational practice, which was specific by experimentation, practical and artistic approach to the problems and learning in the anti-hierarchical, cooperative atmosphere. Since interdisciplinary practices of educational turn put focus on the process, collaboration, and the use of different teaching methods and situations within and beyond the narrow institutional frameworks of art and art schools/academies, Black Mountain College is being established as an important historical basis in conceptual terms. However, in addition to pointing out the similarities in the ideas of the College and the educational turn, it is of great importance to point out the differences in circumstances and contexts of these types of educational practices and merely posing the questions about the significance and potential of Black Mountain for the contemporary art education.

Inequality of opportunity in health: A decomposition-based approach.

This paper presents new decomposition-based approaches to measure inequality of opportunity in health that capture Roemer's distinction between circumstances and effort and are consistent with both compensation and reward principles. Our approach is fully nonparametric in the way that it handles differences in circumstances and provides decompositions of both a rank-dependent relative (the Gini coefficient) and a rank-independent absolute inequality index (the variance). The decompositions distinguish the contribution of effort from the direct and indirect (through effort) contribution of circumstances to the total inequality. Our approach is illustrated by an empirical application that uses objectively measured biomarkers as health outcomes and as proxies for relevant effort variables. Using data from the Health Survey for England from 2003 to 2012, we find that circumstances are the leading determinant of inequality in cholesterol, glycated haemoglobin, and in a combined ill-health index whereas effort plays a substantial role in explaining inequality in fibrinogen only.

Sex Differences in the Circumstances Leading to Falls: Evidence From Real-Life Falls Captured on Video in Long-Term Care

ObjectivesFalls are a major health concern for older adults. Understanding sex differences in fall circumstances may guide the design of fall management plans specifically to men and women. In this study, analyzed real-life falls captured on video to compare scenarios leading to falls between men and women in 2 long-term care (LTC) facilities. DesignProspective cohort study. Participants/SettingA total of 529 participants residing in 2 LTC facilities in British Columbia, Canada. MeasurementsBetween 2008 and 2016, we video-captured 1738 falls experienced by 231 men and 298 women (mean age = 83 ± 9 years). Each video was analyzed to determine the causes of imbalance and the activities at time of falling. Using generalized estimating equation models, we examined how fall circumstances associated with age, sex, and health status. ResultsMen were more likely than women to fall from loss of support with an external object (odds ratio 1.37; 95% confidence interval 1.08–1.73) and less likely to fall from tripping (0.72; 0.54–0.96). Men were more likely to fall while seated (1.42; 1.07–1.87) or while rising (1.49; 1.11–1.99), and less likely to fall while walking (0.61; 0.50–0.75). After adjusting for age and health status, sex remained significantly associated with loss of support and walking. Furthermore, regardless of sex, falls from loss of support were more common among individuals who were less independent in activities of daily living, who used more medications, and who used diuretic. Individuals with independent activities of daily living and intact cognition were more likely to fall while walking, but less likely to fall while seated or while rising. ConclusionsOur results elucidate differences between older men and women in the scenarios that lead to falls, to inform sex-specific fall prevention strategies in the LTC setting.

Using the Shapley Decomposition to Disentangle the Impact of Circumstances and Efforts on Health Inequality

Following previous work on inequality in health opportunity, this paper attempts to determine the contribution of circumstances, efforts and lifestyle, and demographic variables to the overall inequality in health in Luxembourg. Health is measured via the answers given to a question on self-assessed health and is considered as an ordinal variable. The educational level of each parent, the financial situation of the family during childhood, the area of birth of the individual, and of his/her parents, and the year of immigration are considered as circumstances. Effort and lifestyle variables are proxied by information on the educational level of the individual, whether he/she smoked and whether he/she had a physical activity on a regular basis. Sex and age are considered as demographic variables. To solve the issue of correlation between circumstances and effort and lifestyle the estimation is implemented in two stages. In the first stage, each effort and lifestyle variable is regressed in a separate equation against the vector of circumstances and demographic variables and, in a second stage, the individual health status is regressed against the vector of circumstances and demographic variables along with the estimated residuals of the effort equations described previously. The respective impacts of the three categories of explanatory variables (circumstances, effort and lifestyle and demographic variables) on health inequality are derived via a Shapley decomposition of the likelihood ratio of the health ordered logit regression. It appears that differences in circumstances and effort and lifestyle explain each around a quarter of this likelihood ratio.

Assessing the ambition of post-2020 climate targets: a comprehensive framework

ABSTRACTOne of the most fundamental questions surrounding the new Paris Agreement is whether countries’ proposals to reduce GHG emissions after 2020 are equally ambitious, considering differences in circumstances between countries. We review a variety of approaches to assess the ambition of the GHG emission reduction proposals by countries. The approaches are applied illustratively to the mitigation part of the post-2020 climate proposals (nationally determined contributions, or NDCs) by China, the EU, and the US. The analysis reveals several clear trends, even though the results differ per individual assessment approach. We recommend that such a comprehensive ambition assessment framework, employing a large variety of approaches, is used in the future to capture a wide spectrum of perspectives on ambition.POLICY RELEVANCEAssessing the ambition of the national climate proposals is particularly important as the Paris Agreement asks for regular reviews of national contributions, keeping in mind that countries raise their ambition over time. Such an assessment will be an important part of the regular global stocktake that will take place every five years, starting with a ‘light’ version in 2018. However, comprehensive methods to assess the proposals are lacking. This article provides such a comprehensive assessment framework.