High Vulnerability Index Research Articles

“Community engagement via restorative justice to build equity-oriented crisis standards of care”

The COVID-19 (SARS-CoV-2) Pandemic has revealed multiple structural inequities within the United States (US), with high social vulnerability index communities shouldering the brunt of death and disability of this pandemic. BIPOC/Latinx people have undergone hospitalizations and death at magnitudes greater than White people in the US. The untold second casualties are health care workers that are suffering from increased risk of infection, death, and mental health crisis. Many health care workers are abandoning the profession all together. Although Crisis Standards of Care (CSC) mean to guide the ethical allocation of scare resources, they frequently use scoring systems that are inherently biased. This raises concern for the application of equity in CSC. Data examining the impact of these protocols on health equity is scarce.Structural maltreatment in healthcare and inequities have led to cumulative harms, physiologic weathering and structural adversities for residents of the US. We propose the use of Restorative Justice (RJ) practices to develop CSC rooted in inclusion and equity. The RJ framework utilizes capacity building, circle process, and conferences to convene groups in a respectful environment for dialogue, healing, accountability, and action plan creation. A phased, non-faith-based facilitated RJ approach for CSC development (or revision) that fosters ethically equitable resource distribution, authentic community engagement, and accountability is shared. This opportunity for local, inclusive decision making and problem solving will both reflect the needs and give agency to community members while supporting the dismantling of structural racism and oppressive, exclusive policies.The authors are asking legislative and health system policy makers to adopt Restorative Justice practices for Crisis Standards of Care development. The US cannot afford to have additional reductions in inhabitant lifespan or the talent pool within healthcare.

Validation of a vulnerability index of exposure to chemicals of emerging concern in surface water and sediment of Great Lakes tributaries of the United States

Widespread occurrence of emerging contaminants in Great Lakes tributaries led to the development and publication of a vulnerability index (VI) to assess the potential exposure of aquatic communities to chemicals of emerging concern (CEC) in the Great Lakes basin. The robust nature of the VI was tested to evaluate the underlying statistical model and expand the spatial domain of the index. Data collected at 131 new sampling sites (Test 1) and published data from independent studies (Test 2) were used to test the model predictions. Test 1 water and sediment samples were analyzed for the same classes of CEC chemicals and compared to the predictions for the original VI. Concentrations and numbers of unique CECs detected in water and sediment samples were similar between the original data and the two test datasets, although CECs tended to have higher detection frequencies in the original dataset compared to the Test 1 and Test 2 datasets. For example, 69 CECs were detected in ≥30% of water samples in the original dataset compared with 17 CECs in the Test 1 data and 59 in the Test 2 data. Predicted vulnerability for test sites agreed with actual vulnerability 64% of the time for water and 71% of the time for sediment. Agreement percentage results were greater when individual sites were grouped by river, with 82% agreement between predictions and actual vulnerability for water and 78% agreement for sediment. For the entire dataset, the VI ranks correlated with an independent estimate of potential biological impact. Agreement percentage was the greatest for low or high vulnerability index values but highly variable for sites that are classified as having medium vulnerability. Despite the underlying variability, there is a significant correlation (R2 = 0.26; p < 0.01) between the VI ranking of tributaries and the independent ranking of potential negative biological impact.

Social vulnerability is associated with increased morbidity following colorectal surgery

IntroductionNeighborhood measures of social vulnerability encompassing multiple sociodemographic factors can be used to quantify disparities in outcomes. We hypothesize patients with high Social Vulnerability Index (SVI) are at increased risk of morbidity following colectomy. MethodsWe used local 2012–2017 National Surgical Quality Improvement Program (NSQIP) data to study colectomy patients, examining associations between SVI and postoperative outcomes. ResultsWe included 976 patients from five hospitals. High SVI (>75th percentile) was associated with increased postoperative morbidity on unadjusted analysis (OR 1.84, 95% CI 1.35–2.52, p < 0.001); this association persisted after adjusting for demographics and comorbidities (OR 1.63, 95% CI 1.15–2.31, p = 0.005). The association with SVI was not significant after adjusting for perioperative risk modifiers such as emergent presentation (OR 1.37, 95% CI 0.95–1.98, p = 0.10). ConclusionsHigh social vulnerability is associated with increased postoperative complications. This effect appears mediated by perioperative risk factors, suggesting potential to improve outcomes by facilitating timely surgical intervention.

Non-Medical risk assessment of COVID-19 in parts of Central and East Java, Indonesia

Abstract The impact of the Coronavirus disease 2019 (COVID-19) pandemic varies as each country has a different capacity to stop the virus transmission and apply social distancing. A densely populated country, such as Indonesia, tends to face challenges in implementing social distancing due to population characteristics. The Indonesian government focuses on the medical aspect as this virus is new and has been deadly with a high transmission rate. Meanwhile, the non-medical risk during the pandemic is still unclear. The main objective of this study is to assess the non-medical risk at the village level in two agglomeration cities of Central Java: Greater Surakarta and Surabaya. The methodologies use a risk index, derived from the risk reduction concept. The hazard refers to the death toll, while the vulnerability relates to parameters such as disaster, social and public facilities, health facilities, economics and demography. Further, the parameters were weighted based on expert judgement derived using analytical hierarchy process (AHP). The study found that the disaster aspect had the highest weight (0.38), followed by health facilities (0.31), economics (0.17), social-public facilities (0.11) and demography (0.04). The standard deviations of those parameters were relatively low, between 0.12 and 0.25. A low vulnerability index (0.05–0.36) was observed to be dominant in both study areas. There are 11 villages in Greater Surakarta and 30 villages in Greater Surabaya with high vulnerability index. Disaster-prone areas, low economic growth, lack of health facilities and aged demographic structure significantly added to this vulnerability. Further, a high-risk index (0.67–1.00) is observed in three villages in Greater Surabaya and one village in Greater Surakarta. These villages are relatively close to the city centre and have good accessibility. Furthermore, these four villages experienced the severest impact of the pandemic because the furniture and tourism sectors were their primary industries.

辽宁省玉米旱灾时空分布特征及综合风险评价

PDF HTML阅读 XML下载 导出引用 引用提醒 辽宁省玉米旱灾时空分布特征及综合风险评价 DOI: 10.5846/stxb202011112912 作者: 作者单位: 作者简介: 通讯作者: 中图分类号: 基金项目: 国家自然科学基金项目（52079060）；辽宁省兴辽英才项目资助；辽宁省教育厅自然科学项目（LQ2020026）；2021年大连市科技之星项目（2021RQ101） Spatio-temporal distribution characteristics and comprehensive risk assessment of maize drought disaster in Liaoning Province Author: Affiliation: Fund Project: 摘要 | 图/表 | 访问统计 | 参考文献 | 相似文献 | 引证文献 | 资源附件 | 文章评论 摘要:以辽宁省气象数据、空间数据和田间管理数据集为基础，首先，依据自然灾害风险形成理论，从危险性、脆弱性、暴露性和防灾减灾能力四因子入手，选择10个副指标，构建辽宁省玉米旱灾综合风险评价指标体系，并利用组合加权法和GIS空间分析方法，确定其权重及区域化。利用自然灾害风险指数法和加权综合评价方法，建立辽宁省玉米旱灾综合风险评价模型，并进行了辽宁省玉米旱灾时空分布特征分析及综合风险评价研究。结果表明：（1）自1960年以来，研究区干旱频率总体呈上升趋势，尤其2010年以后有明显增加态势。其中1970-1979年间干旱发生频率较低，2010-2019年间干旱频率最高。不管是月尺度、季节尺度、生长季尺度还是年际尺度，辽宁省西北部干旱频率普遍较高，而东南部干旱频率较低。干旱强度呈现从辽宁省中部地区向东西地区两个方向递减的趋势，高值出现在辽宁省中部的阜新、锦州、铁岭、辽阳、盘锦、鞍山、营口和大连等地。干旱历时从辽宁省东部向西部区域递减的趋势，其中高值出现在铁岭北部、盘锦、鞍山、营口和丹东南部等地，低值分布在朝阳西南部、葫芦岛西北部、本溪西部和丹东等地。（2）从4个因子角度来说，辽宁省朝阳西部和葫芦岛西北部玉米旱灾危险性指数较低以外其他区域玉米旱灾危险性指数均较高。然而，辽宁省西北玉米主产区玉米旱灾脆弱性指数和暴露性指数均较高，且防灾减灾能力较低。当4个因子加权综合评价时，辽宁省西北部玉米旱灾综合风险呈现较高的现象。研究结果可为保障辽宁省粮食安全及制定防灾减灾政策提供理论依据和科学指导。 Abstract:First, according to the theory of natural disaster risk formation, starting with the four factors of hazard, vulnerability, exposure and emergency response & recover capability, 10 sub-index were selected to establish the comprehensive risk evaluation index system of maize drought in Liaoning Province, based on meteorological data, spatial data and field management data. Second, the combined weighting method was used to determine the weight of each index in the evaluation index system, and each index was spatially processed according to the GIS space analysis methods. Finally, the natural disaster risk index method and weighted comprehensive evaluation method were used to establish the comprehensive risk evaluation model of maize drought in Liaoning Province. At the same time, based on the evaluation model, this paper analyzed the temporal and spatial distribution characteristics of maize drought in Liaoning Province, and further studied the comprehensive risk evaluation of maize in Liaoning Province. The results showed that:(1) The drought frequency in the study area has been increasing since 1960, especially after 2010. Among them, the frequency of drought in Liaoning Province was low from 1970 to 1979, but reached the highest from 2010 to 2019. No matter what the research scale (monthly scale, seasonal scale, growing season scale or inter annual scale) it was,the drought frequency was higher in the northwest of Liaoning Province, but lower in the southeast. The drought intensity of Liaoning Province had a decreasing trend from the middle to the East and West, and areas with high drought intensity were mainly concentrated in the middle of Liaoning Province (eg.Fuxin, Jinzhou, Tieling, Liaoyang, Panjin, Anshan, Yingkou and Dalian). The duration of drought in Liaoning province gradually decreased from east to west, and areas with high drought duration mainly appeared in the north of Tieling, Panjin, Anshan, Yingkou and the south of Dandong, while areas with low drought duration mainly appeared in the southwest of Chaoyang, the northwest of Huludao, the west of Benxi and Dandong. (2) From the perspective of four factors of drought disaster hazard, vulnerability, exposure and emergency response & recover capability, except that the drought hazard indexes of maize in the west of Chaoyang and the northwest of Huludao were low, the drought hazard indexes of maize in other regions were high in Liaoning Province. However, as the main maize producing area in Liaoning Province, the northwest of Liaoning Province had high vulnerability index and exposure index of drought disaster, but its emergency response & recover capability was relatively low. Therefore, under the weighted comprehensive evaluation of four factors, there was a high risk of drought disaster in the northwest of Liaoning Province. The research results can provide theoretical basis and scientific guidance for the formulation of policy on agricultural disaster prevention and mitigation in Liaoning Province. 参考文献 相似文献 引证文献

长江经济带旅游-经济-生态系统脆弱性时空演变及趋势预测

基于2004—2018年的面板数据, 借助脆弱性研究方法、冷热点分析法、空间变差模型和灰色预测模型探索长江经济带旅游-经济-生态系统的时空演变特征及趋势预测。研究表明：(1)2004—2018年长江经济带总体脆弱性指数在波动中上涨, 各省市脆弱性指数洼地集中于东部地区且呈平稳发展态势；峰值集中于西部地区但下降趋势显著；总体可持续发展水平呈现“东部>中部>西部”的空间分布格局, 但西部地区可持续发展水平可能将在未来超越中部地区。(2)长江经济带脆弱性指数集聚性在扩张, 冷热点时空分布变化显著, 冷点区域减少, 热点区域增多, 印证了总体区域的脆弱性数值在不断提升。(3)长江经济带脆弱性指数空间分异特征呈阶段性变化, “东散西集”的分异特征逐渐被打破, 总体指数呈均衡化发展态势。(4)通过预测计算2019—2023年长江经济带各区域脆弱性指数, 发现2019—2023年的脆弱性指数基本形成了对2014—2018年的全包围态势, 长江经济带三系统脆弱性指数较高的发展隐患逐步成为现实问题。;By selecting panel data from 2004 to 2018, this paper explores characteristics of tourism-economy-ecosystem spatio-temporal variations and trend prediction in Yangtze River Economic Belt with Vulnerability Research Method, Hot Spot Analysis, Spatial Variation Model, and Gray Prediction Model. Key research findings include: (1) from 2004 to 2018, the overall Vulnerability Index of the Yangtze River Economic Belt rose with fluctuations. Among all provinces and cities in China, the Vulnerability Index depressions are mainly in the eastern region, where the index is developing steadily; the peak value mainly occurs in the western region, with the index decreasing significantly. The spatial distribution of the overall sustainable development level from high to low is the eastern region, the central region and the western region, but the sustainable development level in the western region is likely to surpass that in the central region in the future. (2) The Vulnerability Index of the Yangtze River Economic Belt shows agglomeration expansion. The spatial and temporal distribution of hot spot analysis has changed significantly. The number of cold spots has decreased, while the number of hot spots has increased, which confirms that the value of vulnerability in the overall region is increasing. (3) The spatial differentiation characteristics of the Vulnerability Index in the Yangtze River Economic Belt have changed in different stages. The differentiation characteristics of dispersion in the east and agglomeration in the west have gradually been altered, and the overall index has presented a balanced development trend. (4) By predicting and calculating the regional Vulnerability Index of the Yangtze River Economic Belt from 2019 to 2023, it is found that the Vulnerability Index between 2019 and 2023 outperforms the index from 2014 to 2018. The development hidden danger caused by the high Vulnerability Index of the tourism-economy-ecosystem of the Yangtze River Economic Belt gradually became a realistic question which people must face to.

526. Implementation of Use of Monoclonal Antibody Therapy in a Large Academic Center for the Outpatient Treatment of Covid-19: Impact on 30 Day Hospitalization Rates, ED Visits and Death

BackgroundMonoclonal Antibody Therapy (MAbs) has been shown to reduce rates of ED visits and hospitalizations in patients at risk for severe Covid-19 infection in clinical trials. Since November, three Mabs received emergency use authorization: Bamlanivimab (Bam), Bamlanivimab/Etesevimab (Bam/Ete) and Casirivimab/Imdevimab (Casi/imdevi). We describe here the real-world effectiveness of implementing early MAb therapy in the outpatient setting for individuals with Covid-19 at high risk of progression. MethodsWe examined the records of 808 UCLA Health patients with a confirmed positive SARS-CoV2 PCR test who were either referred for outpatient Mab therapy or received Mab treatment in the emergency department (ED) between December 10, 2020, and May 3, 2021. The primary outcome of our analysis was the combined 30-day incidence of emergency department visits, hospitalizations, or death following the date of referral. SARS-CoV2 isolates of hospitalized patients who had received Mabs were sequenced to determine the presence of variants.ResultsOf 808 patients, 383 were referred for treatment but did not receive treatment, 109 received Mabs in the ED and 316 patients were treated in an outpatient setting. Composite 30-day mortality, ED visits and hospital admissions were significantly reduced in the combination therapy group (Bam/Ete or Cas/Imd) compared with monotherapy (Bam alone) or no treatment groups (aHR 0.16, 95% CI .038, .67). Significant factors associated with the composite outcome included: history of lung disease (HR 4.46, 95% CI 2.89-6.90), cardiovascular disease (HR 1.87, 95% CI 1.12-3.12), kidney disease (HR 2.04, 95% CI 1.27-3.25), and immunocompromised state (HR 3.24, 95% CI 1.02-10.26) as well as high social vulnerability index (HR 1.87, 95% CI 1.13-3.10). Over one-third of hospitalized patients who had received Mabs were confirmed to have the California variant (B.1.427/29) (Figure 1). Figure 1. Covid-19 MAB Treatment Failure LineagesConclusionOur data show that in a real-world setting, combination monoclonal antibody therapy, not monotherapy, significantly reduced ED visits and hospital admissions, likely due to the presence of the California variants. High socioeconomic vulnerability and certain medical conditions increased risk of treatment failure.Disclosures Omai Garner, PhD, D(ABMM), Beckman Coulter (Scientific Research Study Investigator)

Microzonation of Probolinggo Fault Using Microtremor as an Effort for Earthquake Disaster Mitigation

Earthquake can be caused by several things, one of which is due to an active fault. To mitigate earthquake disasters that can be caused by the Probolinggo Fault, measurement of the microtremor geophysical method is carried out to analyze seismic vulnerability. In this study, the microtremor measurements were carried out on 30 measurement points. The data obtained from measurements are then processed using EasyHVSR software to obtain natural frequency (f0) and natural amplification (A0) values. This value is then used to create a microtremor microzonation map, which is seismic vulnerability index, based on natural frequency and amplification . it founded that low natural frequency mostly founded on eastern of measurement area, caused by thick sedimentary from Lamongan volcanic. High amplification mostly founded from middle to western area, and high seismic vulnerability index founded on western of measurement area, include Maron and Krucil Sub-district. It means seismic wave can very destructive on those area.

Development of the flood vulnerability index using a multi-element approach

The problem of flood vulnerability has been reviewed in several studies, however, the reviews focused exclusively either on the social or on the physical component of the problem. The components of flood vulnerability are interdependent and each of them makes an equally important contribution to the flood vulnerability index. This study identifies and evaluates the integrated flood vulnerability index ( FVI) of an area by considering its multiple components (social, economic, and environmental). The Analytic Hierarchy Process (AHP) method was applied to evaluate the weight of each component. The evaluation was based on the judgements of experts working at local government policy- making agencies. The input data for the AHP were acquired through a questionnaire survey. Eleven indicators that delivered significant results were then selected. The FVI results show high flood vulnerability at the local scale. The FVI provides the basis for the identification of villages with high vulnerability indices. The results provide essential information about pluvial flood vulnerability at the local scale, about the area with the highest vulnerability index, and the most vulnerable villages. The results also show that the components that have a significant impact on the flood vulnerability index include environmental components (43.4%), social components (28.5%), and physical components (28.1%).

Earthquake Disaster Risk Assessment Analysis In Jailolo Coastal Region

The village, which is located in the Coastal District of Jailolo, West Halmahera, had a considerable impact from the earthquake. This is because the earthquakes that occur are influenced by tectonic earthquakes due to the movement and collision of tectonic plates on land and the seabed. If the collision causes a fault in the seabed, a tsunami can occur. The purpose of this study was to analyze the risk of earthquake disasters in supporting development planning and to produce an earthquake risk map for the coastal area of Jailolo District, West Halmahera. The analytical method used is descriptive quantitative, and the data collection model is a questionnaire with random sampling. The results obtained are in the form of a hazard value using the PGA value and produce the same PGA value, namely 0.70 gal with a high category for Bobanehena Village, Saria Village, Payo Village, Bobo Village, and Idamdehe Village. The value of vulnerability (physical, social, and economic vulnerability) shows that Bobanehena Village has a high vulnerability index value with a score of 1.9. The capacity index value for the five villages has the same score of 3 and is included in the high class. So that the value of the earthquake risk level with a high class is obtained, namely in Bobanehena Village and Bobo Village. The high level of risk in the two villages is influenced by the frequency of occurrence of earthquakes with high intensity in the area, the impact of losses due to earthquakes is quite high. Earthquake risk reduction efforts will be maximized if a comprehensive earthquake risk assessment analysis is carried out and a commitment from the Government is carried out.

Determining the Level of Vulnerability to Landslides in Banyubiru Sub-District of Semarang Regency, Central Java, Indonesia

Based on historical record, Semarang Regency in Central Java, Indonesia frequently experiences landslides. Therefore, this study was conducted in Banyubiru Sub District, Semarang Regency, Central Java. The purpose of this study is to determine the variation of field vulnerability to lanslides in the Sub District and also to establish the efforts that must be made to reduce vulnerability in order to decrease losses during the occurance of landslides. Vulnerability includes physical, social, economic and environmental variables. Each region has varying levels, types and characteristics of vulnerability. So as to be refined, the original three classes of the vulnerability index criteria were modified into five criteria i.e. very low vulnerability index criterion (1.00- &lt;1.40), low vulnerability index (1.40-&lt;1.80), moderate vulnerability index (1.80&lt;2.20), high vulnerability index (2.20-&lt;2.40) and very high vulnerability index (2,40- &lt; = 3,0). The results show that the vulnerability level of landslide is divided into 2 parts according to vulnerability indicators in Perka BNPB No.2/2012. Banyubiru sub-district has a moderate and high level of vulnerability. The average of vulnerability rate belongs to the moderate category with an index value of 2,17. The lowest rate is owned by Rowoboni Village while Sepakung village has the highest vulnerability.

A GIS based flood vulnerability modelling of Anambra State using an integrated IVFRN-DEMATEL-ANP model

Flooding is a major environmental problem facing Anambra State of Nigeria, which also threatens food security in the state. To address this issue, continual flood vulnerability mapping exploring more efficient methods is needed to facilitate flood risk management in the state. The advantages of employing spatial information technologies such as Remote Sensing (RS) and Geographic Information System (GIS) in flood vulnerability mapping has been widely documented; the limitations of employing GIS alone in effective vulnerability analysis have also been documented by researchers. To overcome these limitations, this study adopted the use of GIS and the integration of Interval Value Fuzzy Rough Number (IVFRN), Decision Making Trial and Evaluation Laboratory (DEMATEL), and Analytical Network Process (ANP) method in vulnerability assessment of flood hazard. The result of the study shows that the state is very vulnerable to flood with 73% of the total area of the state lying between Very High and Medium vulnerable zones. The most vulnerable Local Government Area (LGA) in the State is Anambra West with 95% of the total area of the LGA lying between Very High and Medium vulnerable zones. Furthermore, the obtained values of R˜−D˜ show that Rainfall Intensity factor is the major cause of flood in the study area with the highest positive value of 1.55 and Soil factor is the major effect with the highest negative value of -0.93. The IVFRN-DEMATEL-ANP assessment model was validated using AUC-ROC method; an AUC value of 0.946 was obtained, this indicates that the model has excellent prediction accuracy. This study was able to establish the feasibility of integrating the IVFRN, DEMATEL and ANP methods in flood vulnerability assessment. It is recommended that the provision of adequate drainage systems should be prioritized to areas of high flood vulnerability index; to help mitigate flood hazards in the State. Also, strategic planning of infrastructures and emergency routes for moving people and key assets from vulnerable areas especially during the rainy season should be geospatial-based and systematic.

A Quantitative Approach to Assess Seismic Vulnerability of Touristic Accommodations: Case Study in Montreal, Canada

In many places of the world, the interruption of touristic activities in the aftermath of a catastrophic earthquake is often neglected in the evaluation of seismic risks; however, these activities can account for a significant proportion of short-term and long-term economic impacts for these regions. In the last decade, several rapid visual screening techniques have been developed to define the typology of buildings and to estimate their seismic vulnerability and potential for damage. We adapted the existing screening procedures that have been developed for generic buildings to specific circumstances that are most common for tourist accommodations. The proposed approach considered six criteria related to structural and nonstructural elements of buildings, as well as local soil conditions. A score was assigned to each criterion as a function of the capacity of the elements to resist ground shaking. A vulnerability index in four levels of building vulnerability was developed combining the scores of the six criteria. The approach was tested in a pilot area of Montreal to a set of 70 typical buildings grouped in four categories based on their accommodation capacity. In Montreal, tourism is an important source of income for the city where 351,000 room-nights were booked with total stay expenditures of CAD 4.9 billion in 2019. The results indicated potential significant disruptions in activities related to tourism; 46% of the buildings investigated have a high to very high vulnerability index. Among them, 4/5 are located in the old city and 1/5 in the downtown area of the pilot zone.

Vulnerability of maize, millet, and rice yields to growing season precipitation and socio-economic proxies in Cameroon.

In sub-Saharan Africa growing season precipitation is affected by climate change. Due to this, in Cameroon, it is uncertain how some crops are vulnerable to growing season precipitation. Here, an assessment of the vulnerability of maize, millet, and rice to growing season precipitation is carried out at a national scale and validated at four sub-national scales/sites. The data collected were historical yield, precipitation, and adaptive capacity data for the period 1961-2019 for the national scale analysis and 1991-2016 for the sub-national scale analysis. The crop yield data were collected for maize, millet, and rice from FAOSTAT and the global yield gap atlas to assess the sensitivity both nationally and sub-nationally. Historical data on mean crop growing season and mean annul precipitation were collected from a collaborative database of UNDP/Oxford University and the climate portal of the World Bank to assess the exposure both nationally and sub-nationally. To assess adaptive capacity, literacy, and poverty rate proxies for both the national and regional scales were collected from KNOEMA and the African Development Bank. These data were analyzed using a vulnerability index that is based on sensitivity, exposure, and adaptive capacity. The national scale results show that millet has the lowest vulnerability index while rice has the highest. An inverse relationship between vulnerability and adaptive capacity is observed. Rice has the lowest adaptive capacity and the highest vulnerability index. Sub-nationally, this work has shown that northern maize is the most vulnerable crop followed by western highland rice. This work underscores the fact that at different scales, crops are differentially vulnerable due to variations in precipitation, temperature, soils, access to farm inputs, exposure to crop pest and variations in literacy and poverty rates. Therefore, caution should be taken when transitioning from one scale to another to avoid generalization. Despite these differences, in the sub-national scale, western highland rice is observed as the second most vulnerable crop, an observation similar to the national scale observation.

Vulnerability assessment of coastal fishing communities for building resilience and adaptation: Evidences from Tamil Nadu, India

The coastal communities are the most vulnerable to climate vagaries, which affect their habitat and livelihood alike. Vulnerability assessments undertaken using quantitative or qualitative methods at macro- or micro-level need to capture the location and context so as to be able to use them towards improving mitigation and resilience strategies at the community level, where the impact is felt. The characteristics of the marine fishing villages differ from those of other villages in any coastal block / district in a State, making a strong case for a marine village-specific vulnerability assessment as well as intervention planning. This work, capturing this grassroots reality and deriving vulnerability indicators that affect fisheries and coastal households, pilots a novel socio-economic vulnerability (SEVIPH) and cumulative vulnerability (CVIPH) framework in marine fishing villages of Thoothukudi, a coastal district of Tamil Nadu in India, and compares it with an existing framework (SEVISV) that relies on secondary data. A set of 54 indicators reflecting vulnerability components such as exposure, sensitivity (fishery and social) and adaptive capacity (economic, development drivers and alternate livelihood activity) has been developed. Primary data were collected from 1741 households residing in all the 24 marine fishing villages in Thoothukudi district to estimate various sub-indices and indices of SEVIPH, SEVISV and CVIPH. Significant differences (p < 0.01) in sensitivity index (SI) and adaptive capacity index (ACI) were observed among the fishing villages, which however, got masked at taluk and district level due to aggregation, underscoring the importance of household based village level assessment of vulnerability. Overall, 42 % of the fishing villages were socio-economically highly vulnerable, while about 71 % of the villages had high cumulative vulnerability index. While the overall social and economic status of fishing households were lower compared to non-fishing population, it could be ascertained that there was relatively less inequity among them. The study also found significant disparities and differences (p < 0.05) across the villages/taluks in terms of exposure, sensitivity as well as socio-economic capabilities to respond, adapt and develop resilience. The two dimensional decision matrix plotted against SI and ACI median threshold values presented a greater contrast and helped in identifying the key drivers (or contributing factors) and buffers (or ameliorating factors) for coastal vulnerability of marine fishing villages to aid in location-specific intervention planning. The study also highlighted the need for imparting need-based location-specific training programmes at the village and taluk level for vulnerability reduction.

Aquifer vulnerability in the Coastal Northern Part of Lombok Island Indonesia

Northern part of Lombok island has a unique geological phenomenon of submarine groundwater discharge. Submarine groundwater discharge needs to be conserved for its sustainability. This study asseses groundwater vulnerability for SGD conservation in the northern part of Lombok Island Indonesia. The assessment was conducted using aquifer vulnerability index methods. Vulnerability index value in the study area is high vulnerability index. This vulnerability index is getting higher toward the coast. The layer is tuffaceous pumice layer with a hydraulic conductivity value of 5 m/day. This layer makes the aquifer in the study area very vulnerable to contamination, especially for pollution involving vertical percolation and infiltration. Protective management is needed to prevent groundwater hazard in the research location due to groundwater pollution and heavy pumping. Anthropogenic activity at the study area should be anticipated because of the high index of aquifer susceptibility at the study area.

Family medicine provision of online medication abortion in three US states during COVID-19

ObjectiveTo examine provision of direct-to-patient medication abortion during COVID-19 by United States family physicians through a clinician-supported, asynchronous online service, Aid Access. Study DesignWe analyzed data from United States residents in New Jersey, New York, and Washington who requested medication abortion from 3 family physicians using the online service from Aid Access between April and November 2020. This study seeks to examine individual characteristics, motivations, and geographic locations of patients receiving abortion care through the Aid Access platform. ResultsOver 7 months, three family physicians using the Aid Access platform provided medication abortion care to 534 residents of New Jersey, New York, and Washington. There were no demographic differences between patients seeking care in these states. A high percentage (85%) were less than 7 weeks gestation at the time of their request for care. The reasons patients chose Aid Access for abortion services were similar regardless of state residence. The majority (71%) of Aid Access users lived in urban areas. Each family physician provided care to most counties in their respective states. Among those who received services in the three states, almost one-quarter (24%) lived in high Social Vulnerability Index (SVI) counties, with roughly one-third living in medium-high SVI counties (33%), followed by another quarter (26%) living in medium-low SVI counties. ConclusionsFamily physicians successfully provided medication abortion in three states using asynchronous online consultations and medications mailed directly to patients. ImplicationsPrimary care patients are requesting direct-to-patient first trimester abortion services online. By providing abortion care online, a single provider can serve the entire state, thus greatly increasing geographic access to medication abortion.

Association of social vulnerability with the use of high-volume and Magnet recognition hospitals for hepatopancreatic cancer surgery

BackgroundIn an effort to improve perioperative and oncologic outcomes, there have been multiple quality improvement initiatives, including regionalization of high-risk procedures and hospital accreditation designations from independent organizations. These initiatives may, however, hinder access to high-quality surgical care for certain patients living in areas with high social vulnerability who may be disproportionally affected, leading to disparities in access and worse postoperative outcomes. MethodsMedicare beneficiaries who underwent liver or pancreas resection for cancer were identified using the 100% Medicare Inpatient Standard Analytic Files. Hospitals were designated as high-volume based on Leapfrog criteria. The Centers for Disease Control and Prevention’s social vulnerability index database was used to abstract social vulnerability index information based on each beneficiary’s county of residence at the time of operation. The probability that a patient received care at a high-volume hospital stratified by the social vulnerability of the patient’s county of residence was examined. Risk-adjusted postoperative outcomes were compared across low, average, and high levels of vulnerability at both low- and high-volume hospitals. ResultsAmong 16,978 Medicare beneficiaries who underwent a pancreatectomy (n = 13,393, 78%) or a liver resection (n = 3,594, 21.2%) for cancer, the mean age was 73.3 years (standard deviation: 5.8), nearly half the cohort was female (n = 7,819, 46%), and the overwhelming majority were White (n = 15,034, 88.5%). Mean social vulnerability index was 49.8 (standard deviation 24.8) and mean Charlson comorbidity index was 4.8 (standard deviation: 3). Overall, 8,251 (48.6%) of patients had their operations at a high-volume hospital, and 3,802 patients had their operations at a hospital with Magnet recognition. Age and sex were similar within the low-, average-, and high-social vulnerability index cohorts (P > .05); however, race differed across social vulnerability index groups. White patients made up 93% (n = 3,241) of the low social vulnerability index compared with 83.9% (n = 2,706) of the high-social vulnerability index group, whereas non-Whites made up 7% (n = 244) of the low-social vulnerability index group compared with 16.1% (n = 556) of the high-social vulnerability index group (P < .001). The risk-adjusted overall probability of having surgery at a high-volume hospital decreased as social vulnerability increased (odds ratio: 0.98, 95% confidence interval: 0.97–0.99). Risk-adjusted probability of postoperative complications increased with social vulnerability index; however, among patients with high social vulnerability, risk of postoperative complications was lower at high-volume hospitals compared with low-volume hospitals. In contrast, there was no difference in postoperative complications between hospitals with and without Magnet recognition across social vulnerability index. ConclusionPatients residing in communities characterized by a high social vulnerability index were less likely to undergo high-risk cancer surgery at a high-volume hospital. Although postoperative complications and mortality increased as social vulnerability index increased, some of the risk appeared to be mitigated by having surgery at a high-volume hospital. These data highlight the importance of access to high-quality surgical care, especially among patients who may already be more vulnerable.

Drought-related vulnerability and its policy implications in Hungary

Drought phenomena have been frequent in Hungarian history. One of the most important sectors in Hungary is agriculture, so the agricultural drought is a particularly important area to be examined. The purpose of the study is to determine how vulnerable each county (NUTS-3 regions) is to the expected effects of drought. The study provides an assessment framework of drought-related vulnerabilities and the preparedness of drought policies at the NUTS-3 level in Hungary. The drought-related vulnerability of NUTS-3 regions was determined by selected exposure, sensitivity, and adaptive capacity indicators. The calculation of drought vulnerability is based on the IPCC 2007 methodology, while the input data were derived from the National Adaptation Geo-information System online data platform and Hungarian agro-statistical data sources. An assessment framework of drought-related policy performance of NUTS-3-level climate change strategies was developed. The evaluation methodology is based on a specific scorecard of evaluation criteria related to the performance of the county’s drought-related objectives and measures. According to the relationship between the county’s drought-related vulnerability and policy performance, the counties were classified into four types. The main results show that several counties fail the target by overestimating the role of drought prevention, with little vulnerability index. In contrast, many counties are not adequately prepared for the impacts of drought, despite their high vulnerability index.

Cross-national differences in the prevalence of mental illness symptoms: Evidence against the vulnerability paradox.

The vulnerability paradox refers to the observation that greater vulnerability is associated with higher prevalence of mental disorder at the individual level, but lower prevalence at the country level. The paradox is supported by studies estimating prevalence using the Composite International Diagnostic Interview and by suicide mortality data. However, cross-national studies using single-item measures of subjective well-being find no evidence of a paradox, with vulnerability being associated with lower well-being at both the individual and country levels. These findings suggest the potential usefulness of simple indicators for studying cross-national differences. In this study, we investigated the vulnerability paradox using cross-national data on the prevalence of three symptoms that indicate depression or anxiety: unhappiness, sadness and worry. The data on prevalence of unhappiness were taken from 77 countries in the World Values Survey 2017-2020 and data on prevalence of sadness and worry from 142 countries in the Gallup World Poll in 2018. Country vulnerability was measured by the Vulnerability Index and gross domestic product per capita. The data were analyzed using random-effects meta-analysis, with vulnerability measures as moderator variables. For all three symptoms, prevalence was associated with higher Vulnerability Index and lower gross domestic product per capita. When both moderators were entered in meta-regressions, there were significant associations for the Vulnerability Index, but not for gross domestic product per capita. These findings are inconsistent with the vulnerability paradox. They underscore that reducing mental disorders should be a priority in poorer nations and that further economic and social development may be an important contributor to achieving this.