National Priorities Research Articles

Development of Decision Support System (DSS) for surface runoff and erosion control structures planning: a case study in the Upper Citarum Watershed & towards sustainability inland waters ecosystem

The watershed ecosystem is a complex system in which there are numerous transportation and transfer mechanisms of mass and energy. To make management more effective in all national critical watersheds, there needs to be more scientific, evidence-based policymaking that is based on an understanding of the system and mechanisms of the socio-hydrological processes of the watershed. The availability of Decision Support System (DSS) technology can be the appropriate approach to this need because DSS can be an interface between scientific and practical needs (easy-to-use, easy-to-access, user-friendly). However, the availability and implementation of DSS as an important tool in the optimal design of sustainable watershed management in Indonesia are still very limited. This study aims to create a prototype DSS that practitioners and policymakers can use to identify priority areas and optimize technical solutions for controlling surface runoff and soil erosion at various scales in the internal watershed. Herein, the spatial-based numerical modeling system and process mechanism; the database and knowledge; and the Graphical User Interface (GUI) are the three main components that have been used as a framework for model-based DSS development. A distributed rainfall-runoff-erosion model (EcoHydro) is the main engine of DSS for spatially quantifying dimensions of hydrological responses, erosion rate, and sediment production according to the user’s specifications and providing design options for control measures of them. The upper Citarum river basin in West Java, which is a critical and first national priority watershed, has been selected as the case study for DSS development and to demonstrate its application. Furthermore, the resulting DSS can later be developed for use in watersheds and other nationally critical lakes.

National Security Priorities for a Sustainable Energy Transition

Relevance. Problems of the sustainability of national economic systems continue to remain relevant for a long time. States continue to interact on climate agendas and environmental topics in a tense geopolitical situation. Expanding the implementation of carbon footprint reduction technologies is becoming a prerequisite for partnerships and entry into new international markets for the supply of products and services. National priorities of states today are moving closer together due to the growing climate crisis, which dictates the need to intensify work on the implementation of ESG projects. The purpose of the study was to analyze the current state of the movement to reduce the carbon footprint and the results of the implementation of declared initiatives within the framework of international agreements. Objectives. The article set and consistently solved the following tasks: a review of the current state of climate change in the environment and the impact of declining environmental quality on the health and longevity of the population was carried out, an assessment was made of the sectoral contribution of various sectors of the economy to the formation and accumulation of greenhouse gases in the atmosphere, an assessment of modern compensation carbon impact tools. Methodology. The work used methods of logical analysis, content analysis, statistical analysis of data on emissions and inputs, graphical and horizontal analysis, generalization and systematization of data. Results. An assessment of the current state of this problem made it possible to summarize the conclusions and results of research on this topic and to identify the main national priorities related to the implementation of strategies for switching to renewable energy sources. Conclusions. The article provides an overview of the level of implementation of resource-saving technologies in various sectors of the Russian national economy. Conclusions are drawn about the need to continue the environmental modernization of the national economic system and expand interstate cooperation on climate change issues and a sustainable energy transition to resource-saving technologies.

Utilising existing data for a pilot social return on investment analysis of the family wellbeing empowerment program: A justification and framework

Demand is growing in the public, private, and philanthropic sectors for economic and quantifiable outcome data to guide decisions regarding the allocation of resources. This paper explores the challenges and opportunities in economically evaluating an Aboriginal Social and Emotional Wellbeing intervention, emphasising the value of utilising existing data. Driven by local and national Indigenous research priorities, the study involved a pilot Social Return on Investment analysis of the Aboriginal Family Wellbeing empowerment program. Underpinned by a collaborative mixed-methods approach, designed to mitigate data limitations and bolster trustworthiness, the analysis was undertaken across four stages, including a literature review to identify impacts and create a theory of change; co-design of an impacts framework; a targeted literature review to inform impact quantification and attribution; and calculation of the Social Return on Investment results. Results indicate that for every Australian dollar of investment in delivering Family Wellbeing between 2001 and 2021 in the Yarrabah Aboriginal community, A$4.60 of benefits were produced for participants and the community. The return is expected to be higher if important community and cultural impacts of the program were included in the monetisation. Data limitations and implications for future mixed methods economic evaluation of social interventions are explored.

TOPONYMIC LANDMARK IN URBANONYMY OF BELARUS AND FRANCE

The article substantiates the relevance of a comparative study of urbanonyms in Belarus and France, formed from the names of geographical objects. Both general and nationally specific thematic groups of names characteristic of the two systems
 have been established. The field structure of the subsystem of toponymic urbanonyms and the core-peripheral relations inherent in it are described; it has been demonstrated that the systems of urbanonyms of Belarus and France, formed from the names of toponymic landmarks, are characterized as typologically similar (thematic commonality of groups of names; partial coincidence of the field structure of systems and the representation of texts of culture) and nationally specific features (differences in the composition of identified groups and texts of culture realized by names, unequal quantitative ratio of groups as a reflection of differences in national nominative priorities). Extensive illustrative material shows that the system of street names in Belarusian and French cities has individual features and at the same time is an example of the sustainable embodiment of the main historical tendencies of the urbanonym nomination as a whole.

Gender perspective on the determinants of health outcomes in selected Southern African countries

Recurring global health concerns such as the COVID-19 pandemic served as perfect examples of the "health is wealth" discussion and contributed to a growing understanding of the strong relationships between multiple risks to global socioeconomic success and poor health. Another development is the inclusion of gender-specific health goals in the SDGs which have highlighted the critical role of women’s health in attaining global health and ending the cycle of poverty. This study aims at examining factors influencing women's health in two Southern African countries namely South Africa and Eswatini affected by a significant burden of disease. The regression outcomes show that female economic participation, human immunodeficiency virus (HIV), female education, teenage pregnancy, income and urbanization have varying effects on female health outcomes in both countries using gender specific socioeconomic factors within the framework of Autoregressive Distributed Lag (ARDL). This research engages policy makers and strategists in the health sector on the need to address gender disparities in formulating health policies. Moreover, policies and strategies aimed at fostering better health outcomes by solving national priority health challenges in particular the HIV/AIDS epidemic and health-risk behaviours should be prioritized.

Development of a Tool to Measure Student Perceptions of Equity and Inclusion in Medical Schools

Creating an inclusive and equitable learning environment is a national priority. Nevertheless, data reflecting medical students' perception of the climate of equity and inclusion are limited. To develop and validate an instrument to measure students' perceptions of the climate of equity and inclusion in medical school using data collected annually by the Association of American Medical Colleges (AAMC). The Promoting Diversity, Group Inclusion, and Equity tool was developed in 3 stages. A Delphi panel of 9 members identified survey items from preexisting AAMC data sources. Exploratory and confirmatory factor analysis was performed on student responses to AAMC surveys to construct the tool, which underwent rigorous psychometric validation. Participants were undergraduate medical students at Liaison Committee on Medical Education-accredited medical schools in the US who completed the 2015 to 2019 AAMC Year 2 Questionnaire (Y2Q), the administrations of 2016 to 2020 AAMC Graduation Questionnaire (GQ), or both. Data were analyzed from August 2020 to November 2023. Student race and ethnicity, sex, sexual orientation, and socioeconomic status. Development and psychometric validation of the tool, including construct validity, internal consistency, and criterion validity. Delphi panel members identified 146 survey items from the Y2Q and GQ reflecting students' perception of the climate of equity and inclusion, and responses to these survey items were obtained from 54 906 students for the Y2Q cohort (median [IQR] age, 24 [23-26] years; 29 208 [52.75%] were female, 11 389 [20.57%] were Asian, 4089 [7.39%] were multiracial, and 33 373 [60.28%] were White) and 61 998 for the GQ cohort (median [IQR] age, 27 [26-28] years; 30 793 [49.67%] were female, 13 049 [21.05%] were Asian, 4136 [6.67%] were multiracial, and 38 215 [61.64%] were White). Exploratory and confirmatory factor analyses of student responses identified 8 factors for the Y2Q model (faculty role modeling; student empowerment; student fellowship; cultural humility; faculty support for students; fostering a collaborative and safe environment; discrimination: race, ethnicity, and gender; and discrimination: sexual orientation) and 5 factors for the GQ model (faculty role modeling; student empowerment; faculty support for students; discrimination: race, ethnicity, and gender; and discrimination: sexual orientation). Confirmatory factor analysis indicated acceptable model fit (root mean square error of approximation of 0.05 [Y2Q] and 0.06 [GQ] and comparative fit indices of 0.95 [Y2Q] and 0.94 [GQ]). Cronbach α for individual factors demonstrated internal consistency ranging from 0.69 to 0.92 (Y2Q) and 0.76 to 0.95 (GQ). This study found that the new tool is a reliable and psychometrically valid measure of medical students' perceptions of equity and inclusion in the learning environment.

Cytomegalovirus infection during pregnancy: cross-sectional survey of knowledge and prevention practices of healthcare professionals in French-speaking Switzerland

BackgroundLack of Cytomegalovirus (CMV) knowledge among healthcare professionals has been proven to be the main threat to pregnant women's awareness, preventing them from reducing the risk of infection. The aims of this study were to assess the knowledge and practices of French-speaking Swiss perinatal professionals in terms of CMV prevention, as well as the sociodemographic-professional factors that influence them.MethodsThis observational study used a cross-sectional design to collect data-via an anonymous electronic questionnaire in French distributed to gynecologists-obstetricians, general practitioners and midwives via various channels: e-mails and social networks of partner centers, professional associations, and conferences. The 41-item questionnaire collected data on sociodemographic and professional characteristics, general CMV knowledge, national recommendation knowledge and prevention practices. Univariable and multivariable analyses were performed.ResultsA total of 110 gynecologist-obstetricians, 5 general practitioners and 226 midwives participated in the study. While more than 80% of practitioners were familiar with protective hygiene measures, significant gaps were highlighted concerning the transmission routes, as well as the signs of short- and long-term congenital CMV infection. Regarding practice, 63.3% of participants provided information on CMV to their patients, mainly during the first antenatal visit. Among those who did not, lack of knowledge and forgetfulness were the two main reasons cited. Concerning systematic screening, 45.7% of participants offered it to their patients, and 37.3% only offered it to “at risk” groups. The existence of national guidelines on CMV was known by 62.0% of participants. Multivariable analysis revealed that working as a gynecologist-obstetrician was independently associated with higher score of preventive practices, while performing ultrasound or preconception consultations was independently associated with a higher score of general CMV knowledge, and working in a university hospital was independently associated with a higher score of Swiss recommendation knowledge. A level of training higher than the basic medical or midwifery diploma and participation in fetal medicine symposia both promote a higher score of CMV knowledge and prevention practices in line with current recommendations.ConclusionThis study confirms the significant gaps in CMV knowledge among French-speaking Swiss caregivers along with the heterogeneity of their prevention practices. To raise awareness among pregnant women and reduce the burden of congenital CMV infections, improving professional knowledge through access to specific training and standardizing practices should be a national priority.

Public health genomics research in Italy: an overview of ongoing projects.

Public health genomics (PHG) aims to integrate advances in genomic sciences into healthcare for the benefit of the general population. As in many countries, there are various research initiatives in this field in Italy, but a clear picture of the national research portfolio has never been sketched. Thus, we aimed to provide an overview of current PHG research projects at the national or international level by consultation with Italian institutional and academic experts. We included 68 PHG projects: the majority were international projects in which Italian researchers participated (n = 43), mainly funded by the European Commission, while the remainder were national initiatives (N = 25), mainly funded by central government. Funding varied considerably, from € 50,000 to € 80,803,177. Three main research themes were identified: governance (N = 20); precision medicine (PM; N = 46); and precision public health (N = 2). We found that research activities are preferentially aimed at the clinical application of PM, while other efforts deal with the governance of the complex translation of genomic innovation into clinical and public health practice. To align such activities with national and international priorities, the development of an updated research agenda for PHG is needed.

Empathy of Bank Employees and Its Influence on Service Quality of Banks: Evidence from the Knowledge Economy of Kerala in Digital India

ICT is being aggressively promoted by the Govt. of India (GOI) as part of its ‘Digital India’ and such other policies like JAM. In this ICT-thrust era in Digital India, ‘Empathy’ aspect of service quality of banks is studied in this paper, focusing on housing finance segment-a national priority. ‘Housing for All’ is a national goal of the GOI and topmost priority is being accorded to housing sector by the State and Union Governments and also by the regulatory bodies like National Housing Bank (NHB) and Reserve Bank of India (RBI). This study is based on the feedback from 600 housing loan customers of banks in Kerala – a State that strives to turn into a ‘Knowledge Economy’ or ‘Digital Kerala’ in the context of ‘Digital India’. This paper makes an empirical study of the service quality in respect of the housing finance business of banks with a focus on the empathy of staff. It observes that even in this ICT era, a real ‘Willingness to help’ and other empathy values for the bank staff and also a ‘Human touch’ in their deals are vital for success.

Food is Medicine and implementation science: A recipe for health equity.

Diet-related chronic diseases such as Type II diabetes, cardiometabolic diseases, and cancer are among the leading causes of death in the USA. Nutrition security has emerged as a target outcome and a national priority for preventative medicine and the treatment of diet-related chronic diseases. Food is Medicine (FIM) initiatives encompass programs and interventions to meet priority population's needs across food and nutrition security continuums as a mechanism to address persistent food and nutrition inequities. In this position statement, we draw on implementation science, specifically the Exploration, Preparation, Implementation, and Sustainment (EPIS) Framework and health equity principles to provide guidance on FIM initiatives. As the FIM evidence base continues to grow, we encourage the EPIS framework be applied as one lens through which we can improve our understanding of FIM implementation among multiple contexts to understand what works, for whom, and under what circumstances. Ultimately, this position statement aims to call to action the incorporation of implementation science and equity principles into FIM efforts.

Pathways between foodways and wellbeing for first nations Australians

BackgroundSupporting the health and wellbeing of Aboriginal and Torres Strait Islander peoples (hereafter respectfully referred to as First Nations peoples) is a national priority for Australia. Despite immense losses of land, language, and governance caused by the continuing impact of colonisation, First Nations peoples have maintained strong connections with traditional food culture, while also creating new beliefs, preferences, and traditions around food, which together are termed foodways. While foodways are known to support holistic health and wellbeing for First Nations peoples, the pathways via which this occurs have received limited attention.MethodsSecondary data analysis was conducted on two national qualitative datasets exploring wellbeing, which together included the views of 531 First Nations peoples (aged 12–92). Thematic analysis, guided by an Indigenist research methodology, was conducted to identify the pathways through which foodways impact on and support wellbeing for First Nations peoples.Results and conclusionsFive pathways through which wellbeing is supported via foodways for First Nations peoples were identified as: connecting with others through food; accessing traditional foods; experiencing joy in making and sharing food; sharing information about food and nutrition; and strategies for improving food security. These findings offer constructive, nationally relevant evidence to guide and inform health and nutrition programs and services to harness the strengths and preferences of First Nations peoples to support the health and wellbeing of First Nations peoples more effectively.

The attitudes and practices of United Arab Emirates consumers towards food waste: A nationwide cross-sectional study.

Reducing global food waste is an international environmental, health, and sus-tainability priority. Although significant reductions have been achieved across the food chain, progress by UAE households and consumers remain inadequate. This study seeks to understand the association between consumer attitudes, knowledge, and awareness relating to food waste practice of residents living in the UAE. to help inform policy and action for addressing this national priority. A cross-sectional study was conducted using a validated semi-structured online questionnaire through stratified sampling (n =1052). The Spearman correlation coefficient was performed to determine the correlations. Two independent regression analysis were used to determine the association between food waste practice with: 1) knowledge and awareness and attitude subdomains, and 2) sociodemographic characteristics. Respondents (n=1072) largely reflect the socio-demographic characteristics and population distribution across the seven Emirates. As expected, a significant and negative correlation was found between food waste practice knowledge and awareness and overall attitude. The regression models showed reduced food waste practice was associated with better knowledge, personal attitude, financial attitude (first model), older age and fewer adults in the household (second model). We found a significant and negative association of personal attitude (a commitment, intention), financial attitude (cost-saving motivation), and (existing) knowledge of Food waste (FW) with practice of food waste, indicating that better knowledge about FW, personal attitude or financial attitude was associated with reduction in undesirable food waste practice. While awareness and emotional attitude (moral concerns) were positively and significantly associated with food waste practice (undesirable behaviour). Food waste poses significant challenges in the UAE, and addressing it requires a comprehensive understanding of the multifaceted factors influencing consumer behavior. By promoting knowledge, fostering positive attitudes, and considering socio-cultural factors, policymakers can develop effective strategies to reduce food waste in households and contribute to sustainable development goals.

Do gender disparities in socioeconomic status affect Teff productivity? A comparative analysis in Ethiopia

Ethiopia is one of Africa’s fastest-growing economies, and the recent political and economic reforms recognize the importance of empowering women and increasing their labour force participation. The Federal Democratic Republic of Ethiopia (FDRE) constitution of 1995 recognized women’s right to equality and provides intervened to enable women to compete and participate in all spheres of life and to exercise their rights on equal grounds with men. Gender empowerment and gender equality are given national priority and positioned at the centre of all policy, legal, and institutional frameworks. Research suggests that women remain overrepresented in lower-skilled jobs, while carrying out the bulk of unpaid care work. Women also face multiple forms of deprivation, gender-based discrimination, lack of access to productive resources, intimate partner violence, lack of education and training, and employment. Persistent inequalities in ownership and control over assets, such as land, houses, and oxen negatively affect their productivity and livelihoods. This paper aims at answering the question “Do gender disparities in socioeconomic status affect Teff productivity in Ethiopia?” Using mixed methods, the study conducted a cross-sectional household survey. Purposive sampling was used to select top Teff-producing regions, districts, Kebeles, key informants and FGD participants while a random sampling method was used to select the survey respondents. Results suggest that, although women were fully engaged in Teff production activities, due to a low level of ownership of productive resources such as land, labour, and oxen, there is a statistically significant difference in Teff production between female and male-headed households which needs the attention of the government and stakeholders. The paper contributes to understanding how gender-based disparities in socioeconomic status affect Teff production.

The Role of Big Data in Circular Supply Chain Practices and Corporate Sustainability Performance

The green industry is a national priority target, with one of the indicators being the application of a circular economy. The application of a circular economy to the entire supply chain process is an effort to extend the service life of materials so that sustainability arises. The application of circular supply chains needs to be supported by digital technology to improve processes. This study aims to analyze the effect of circular supply chain practices on corporate sustainability performance and the moderating effect of Big Data. The hypothesis testing using SEM analysis tools. The number of samples used was 140, who are currently working or have worked in companies that have implemented a circular economy. [KM1] The results of the study show that Circular Supply Chain Practices do not influence on Corporate Sustainability Performance, so the moderating effect of Big Data is not supported. Therefore, managerial parties need to implement a circular supply chain in the company's business processes. Managers need to provide technical training related to designing environmentally friendly products and educational strategies to customers regarding the application of a circular economy. Nonetheless, this study also has limitations, in that it consists of only one variable, Circular Supply Chain practices, which affect Corporate Sustainability Performance. Thus, the next researcher should add other variables that can affect Corporate Sustainability Performance, such as the purchasing realized absorptive capacity variable. [KM1]Refer in research method section for my comment.

Perspectives of community-based organizations on digital health equity interventions: a key informant interview study.

Health and healthcare are increasingly dependent on internet and digital solutions. Medically underserved communities that experience health disparities are often those who are burdened by digital disparities. While digital equity and digital health equity are national priorities, there is limited evidence about how community-based organizations (CBOs) consider and develop interventions. We conducted key informant interviews in 2022 purposively recruiting from health and welfare organizations engaged in digital equity work. Nineteen individuals from 13 organizations serving rural and/or urban communities from the local to national level participated in semi-structured interviews via Zoom regarding their perspectives on digital health equity interventions. Directed content analysis of verbatim interview transcripts was conducted to identify themes. Themes emerged at individual, organizational, and societal levels. Individual level themes included potential benefits from digital health equity, internet access challenges, and the need for access to devices and digital literacy. Organizational level themes included leveraging community assets, promising organizational practices and challenges. For the societal level, the shifting complexity of the digital equity ecosystem, policy issues, and data for needs assessment and evaluation were described. Several example case studies describing these themes were provided. Digital health equity interventions are complex, multi-level endeavors. Clear elucidation of the individual, organizational, and societal level factors that may impact digital health equity interventions are necessary to understanding if and how CBOs participate in such initiatives. This study presents unique perspectives directly from CBOs driving programs in this new arena of digital health equity.

Topic identification, selection, and prioritization for health technology assessment in selected countries: a mixed study design

BackgroundThere is limited evidence-informed guidance on TISP processes for countries where health technology assessment (HTA) is in a nascent phase. We aimed to explore the range of topic identification, selection and prioritization (TISP) processes and practices for HTA in selected countries and identify aspects relevant to emerging HTA systems.MethodsThis mixed design study included a systematic literature review, an electronic survey, and individual interviews. We conducted a systematic literature review with criteria that were developed a priori to identify countries deemed to have a recently formalized HTA system. Based on the literature review, a twenty-three item online survey was shared with the identified countries, we completed follow-up interviews with ten participants who have experience with HTA. We analyzed documents, survey responses and interview transcripts thematically to identify lessons related to TISP processes and practices.ResultsThe literature review identified 29 nine candidate countries as having a “potential” recently formalized HTA system. Twenty-one survey responses were analyzed and supplemented with ten individual interviews. We found variation in countries’ approaches to TISP — particularly between pharmaceutical and non-pharmaceutical interventions. Results indicate that TISP is heavily driven by policy makers, expert involvement, and to a lesser extent, relevant stakeholders. The use of horizon-scanning and early warning systems is uncommon. Interviewee participants provided further insight to the survey data, reporting that political awareness and an institutional framework were important to support TISP. TISP can be optimized by stronger national regulations and legislative structures, in addition to education and advocacy about HTA among politicians and decision-makers. In some settings regional networks have been useful, particularly in the development of TISP guidelines and methodologies. Additionally, the technical capacity to conduct TISP, and access to relevant local data were factors limiting TISP in national settings. Increased network collaboration and capacity building were reported as future needs.ConclusionsThis study provides current insights into a topic where there is limited published peer reviewed literature. TISP is an important first step of HTA, and topics should be selected and prioritized based on local need and relevance. The limited capacity for TISP in settings where HTA is emerging may be supported by local and international collaboration to increase capacity and knowledge. To succeed, both TISP and HTA need to be embedded within national health care priority setting and decision-making. More in-depth understanding of where countries are situtated in formalizing the TISP process may help others to overcome factors that facilitate or hinder progress.

Probabilistic modeling the protection system of spiritual and moral values. Part 1. The general approach

The protection of traditional Russian spiritual and moral values belongs to the strategic national priorities of the Russian Federation. According to the "National Security Strategy of the Russian Federation", the main goal in the implementation of national strategic priorities for the protection of traditional Russian spiritual and moral values, culture and historical memory is to strengthen the unity of peoples on the basis of all–Russian civic identity, preservation of primordial universal principles and socially significant guidelines for social development. The "Strategy ..." identifies current threats and tasks to be solved in Russia. In order to solve the tasks effectively in conditions of uncertainties and heterogeneous threats, special models and methods are required that allow not only to assess risks, but also to justify proactive measures to counter threats for the protection system of spiritual and moral values. However, today there are no such models and methods. A critical methodological contradiction has arisen between the objective needs for an effective solution of the tasks of the "Strategy ..." and the real possibilities in assessing the risks to the protection system of spiritual and moral values. This work is devoted to solving the problem of creating probabilistic models and methods (by adapting existing ones) that allow not only to predict the risks of destruction of the protection system of spiritual and moral values in conditions of uncertainties and heterogeneous threats, but also to justify proactive measures to counter threats. The main purpose of the work (in two parts) is to create a scientifically based methodological approach to the analytical predicting the risks of destruction of the protection system of spiritual and moral values in conditions of uncertainties and heterogeneous threats. The purpose of the 1st part of the work is to develop a general approach to system modeling. In the first part of the work, mathematical models and methods for predicting compound and integral risks of destruction of the protection system of spiritual and moral values in conditions of uncertainties and heterogeneous threats with the possibility of traceable analytical dependence on influencing factors are proposed. An example of a rough modeling the protection system of spiritual and moral values is given, when the essence of each element manifests itself without taking into account any additional interrelated support from the state, communities, and family. In the 2nd part, five additional examples of predicting risks are presented, illustrating the probabilistic modeling of the main essences of the protection system of spiritual and moral values as a system of systems with varying degrees of detail of eight constituent elements: element 1 – life, dignity, human rights and freedoms; 2 – patriotism, citizenship; 3 – service to the Fatherland and responsibility for its fate; 4 – high moral ideals, a strong family; 5 – creative work (including science and creativity); 6 – the priority of the spiritual over the material, humanism (including art and literature); 7 – mercy, justice, collectivism, mutual assistance and mutual respect; 8 – historical memory and continuity of generations, unity of the peoples of the country. The proposed approach to modeling the protection system of spiritual and moral values provides opportunities not only for analytical predicting of compound and integral risks in conditions of uncertainties and heterogeneous threats, but also for rationale proactive measures to counter threats.

Temporal analysis of the prevalence of congenital hypospadias in the municipality of Gela

to evaluate the risk profile of hypospadias in Gela, an Italian National Priority Contaminated Site (NPCS) located in Sicily Region (Southern Italy), characterized by a significant excess of hypospadias in newborn residents compared to data from reference on regional, national, and international basis and, until 2014, by the presence of a petrochemical plant. geographical analyses were conducted by comparing the prevalence of the Gela municipality to prevalence found in Sicily, in a territorial area bordering Gela (ALG), and in the NPCSs of Milazzo and Priolo. The geographical comparisons were conducted for the period 2010-2020, the trend within the Gela NPCS was evaluated by comparing two subperiods (2010-2014 and 2015-2020). children up to 1 year of age with hypospadias resident in the municipality of Gela in the period 2010-2020. crude odds ratios (OR) and respective 95% confidence intervals (95%CI) were used to compare the prevalence observed in Gela and that detected in the comparison areas. excess risk for hypospadias was highlighted in 2010-2020 in Gela vs Sicily (OR 4.45; 95%CI 3.45-5.75), vs ALG (OR 4.29; 95%CI 3.02-6.10), and vs the NPCSs of Milazzo (OR 2.32; 95%CI 1.32-4.07) and Priolo (OR 2.37; 95%CI 1.55-3.62). The between-period comparisons in Gela did not show an important difference between 2010-2014 and 2015-2020 (OR 1.37; 95%CI 0.83-2.24), with a prevalence of 98.9 and 72.4 per 10,000, respectively. the prevalence of hypospadias in 2015-2020 remains very high, although decreasing when compared to 2010-2014 period. The Gela data, despite the refinery being closed after 2014, suggest a complex situation in which multiple risk factors may play a role.

Abstract 139: Regional Disparities in Mechanical Thrombectomy Utilization for Treatment of Acute Ischemic Stroke in the United States

Background: A current national priority is to understand geographic disparities in mechanical thrombectomy (MT) provision for patients with acute ischemic stroke (AIS). We examine variation in rates of MT by geographic region and urban-rural areas to identify utilization disparities across the United States. Methods: The state-specific annual incidence of AIS in 2019 was determined using data from the Global Burden of Disease Collaborative Network. We determined the number of patients who were admitted with AIS due to thrombosis or embolism of anterior circulation arteries and those who received MT in a particular region/state based on the State Inpatient Database of NIS. The National Inpatient Sample data were used to create national weighted estimates of the size of subject populations, age at admission, length of stay, and discharge status. Results: In the United States, approximately 28,165 MT were performed in 2019, representing 4% of the AIS population. In large central metropolitan areas, the proportion of thrombectomies performed to the AIS patient population was significantly higher than the national estimate (4.34%, P < 0.001); small metropolitan areas and rural settings (micropolitan and noncore) had significantly lower proportions of MT-treated patients with 3.2% and 2.9%, respectively (P < 0.001), when compared with the national estimate. West region had significantly higher proportions of MT-treated patients with 4.3%, compared with the national estimate (P < 0.001), whereas South region had significantly lower proportions with 3.8% (P < 0.001). Conclusions: We found prominent regional disparities in the utilization rates of MT in acute ischemic stroke patients in the United States, which may have implications for Regional Stroke Destination Plans in Rural, Suburban, and Urban Communities.

Biodiversity for Food Security: The Giant Swamp Taro ‘Dalugha’ from Sangihe Islands, North Sulawesi, Indonesia

Biodiversity provides environmental services, foods, drugs, fibers and timbers for humans. The value of biodiversity to the Indonesian people is enormous. To feed its ever-growing population, the Indonesian government has made improving food security and food sovereignity a national priority. Achieving food security is intrinsically linked to the maintenance of biodiversity. This research was conducted in Tamako District, Sangihe Islands, North Sulawesi. One of the most serious threats to biodiversity is climate change. Small islands can be impacted by extreme weather events, rising sea levels, and the effects of climate change. Local or native crops play important role in enhancing food security. Giant swamp taro Cyrtosperma merkusii known by local people as Dalugha is one of main staple food in the Sangihe Islands, North Sulawesi, Indonesia. Prior to the introduction of rice, sago, cassava, and giant swamp taro were staple dietary sources for the Sangihe Islanders. Dalugha grows in swamps near the coast, where seawater inundates the swamp during high tide. It has a high nutritional value as a substitute food and easy to propagate. As a result, it is an essential crop for enhancing food security, especially in facing sea level rise and climate change.