Non-capital Cities Research Articles

Contextual and Individual Determinants of Root Caries in Older People

The aim of this study was to identify the association of the presence of root caries in older people with contextual and individual determinants using a multilevel model. Data from the National Survey of Oral Health collected in Brazil were used. A sample of older Brazilians (aged 65-74 years) was included and selected through multistage probability cluster sampling, using probability proportional to size. Contextual variables of municipalities and individual variables of older people were included. Descriptive, bivariate, and multilevel analyses were conducted. Of the 3,926 older people included in the study, 934 (21.8%) had at least 1 tooth with root caries. There seemed to be no pattern of involvement between the anterior and posterior teeth in the dental arches. Multilevel analysis showed a higher presence of root caries among older people resident in municipalities that were noncapital cities (OR = 1.50), who were over 70 years of age (odds ratio, OR = 1.22), had nonwhite skin color (OR 1.35), had coronal caries (OR = 5.58), were dissatisfied with their teeth and mouth (OR = 1.47), and had self-perceived dental treatment needs (OR = 1.33). Contextual and individual determinants were associated with the occurrence of root caries in older people. Lesion presence demonstrated a profile of social inequality.

Effect of department climate on medical professional attitudes and behaviours of Chinese clinical physicians: a cross-sectional investigation

BackgroundAn increasing number of empirical studies on medical professionalism in clinical practice settings have been conducted since 2002. However, few of them were carried out in China, and few focused on the influence of department climate on clinical physicians' professionalism. Our study investigated Chinese clinical physicians' professional attitudes and behaviours, and evaluated the effect of department climate on their attitudes and behaviours. MethodsSelf-administered questionnaires including 20 items on professional attitude, ten items on behaviour, and 29 items on department climate were distributed to clinical physicians in four public hospitals in non-capital cities in Sichuan and Hubei Provinces, China, from Nov 29 to Dec 7, 2016. Verbal informed consent was obtained from the participants. Findings327 valid questionnaires were collected. More than 305 (94%) respondents agreed with 13 of 20 specific statements on medical professionalism. 125 (38%) respondents disagreed with reporting incompetent colleagues, 113 (35%) disagreed with recertification, and 98 (30%) disagreed with reporting medical errors. More than 294 (90%) respondents reported that they sometimes, usually, or always manifested the four positive behaviours on the questionnaire, and more than 261 (80%) reported that they never displayed the six negative behaviours. Factor analysis indicated that the department climate scale (26 items) consists of six dimensions. Regression analyses indicated that the predictors of professional attitudes were two dimensions of climate scale (serving patients [β 0·325, 95% CI 0·153–0·307] and work support [0·170, 0·036–0·161]; adjusted r2 0·174). Physicians' behaviour was significantly influenced by one dimension of climate scale (serving patients; β 0·280, 95% CI 0·112–0·254), professional attitude (0·182, 0·067–0·269), and educational background (Master's degree [0·244, 0·076–0·305] and Bachelor's degree and above [0·193, 0·032–0·238; comparison group is below Bachelor's degree]; adjusted r2 0·169). InterpretationPhysicians showed relatively positive professional attitudes and behaviours. Department climate (especially the dimension of serving patients) affected physicians' attitudes and behaviours, suggesting that improvement of department climate in the hospital is an important strategy to enhance professionalism. FundingNational Natural Science Foundation of China (71203069, 71573094), the Fundamental Research Funds for the Central Universities, HUST (2013WZ024, 2015AC027).

Primary immunodeficiency diseases in Northern Iran

IntroductionPrimary immunodeficiency diseases (PID) are a heterogeneous group of inherited disorders, characterised by recurrent severe infections, autoimmunity and lymphoproliferation. Despite impressive progress in identification of novel PID, there is an unfortunate lack of awareness among physicians in identification of patients with PID, especially in non-capital cities of countries worldwide. ResultThis study was performed in a single-centre paediatric hospital in Northern Iran during a 21-year period (1994–2015). Ninety-four patients were included in this study. The majority of cases had antibody deficiencies (37.23%), followed by well-defined syndromes with immunodeficiency in 16 (17.02%), phagocytic disorders in 15 patients (15.95%), complement deficiencies in 15 patients (15.95%), immunodeficiencies affecting cellular and humoral immunity in nine patients (9.57%), disease of immune dysregulation in three (3.19%), and defects in intrinsic and innate immunity in one (1.06%). ConclusionIt seems that there are major variations in frequency of different types of PID in different regions of a country. Therefore, reporting local data could provide better ideas to improve the local health care system strategists and quality of care of PID patients.

The role of interfirm transactions on cross border integration in East Asia: A case study of interlinkages between Busan in Korea and Fukuoka in Japan

The purpose of this article is to discuss the inter-urban linkage between the non-capital cities in Korea and Japan, focusing on the relationships between Fukuoka and Busan, as part of an empirical research on the internationalization of non-capital cities in East Asia. We attempt to subdivide international trade activities of firms and analyze foreign destinations based on cities. The linkage between Busan and Fukuoka mainly sits at the apex of the international urban system, from the perspective of the gateway of 'Physical Distribution' and 'Business Trip'; however, links to Tokyo and Osaka mostly act as 'Transaction' and functional cores such as sales channels. Fukuoka airport and Shimonoseki port have been utilized as a gateway. Fukuoka Airport has a promising evaluation concerning accessibility and convenience. Shimonoseki port has certain advantages due to the short time required for customs formalities, brevity of the shipping time and convenient daily shipping schedules.

Does lower lifetime fluoridation exposure explain why people outside capital cities have poor clinical oral health?

Australians outside state capital cities have greater caries experience than their counterparts in capital cities. We hypothesized that differing water fluoridation exposure was associated with this disparity. Data were the 2004-06 Australian National Survey of Adult Oral Health. Examiners measured participant decayed, missing and filled teeth and DMFT Index, and lifetime fluoridation exposure was quantified. Multivariable linear regression models estimated differences in caries experience between capital city residents and others, with and without adjustment for fluoridation exposure. There was greater mean lifetime fluoridation exposure in state capital cities (59.1%, 95% confidence interval = 56.9, 61.4) than outside capital cities (42.3, confidence interval = 36.9, 47.6). People located outside capital city areas had differing sociodemographic characteristics and dental visiting patterns, and a higher mean DMFT (capital cities = 12.9, non-capital cities = 14.3, p = 0.02), than people from capital cities. After adjustment for sociodemographic characteristics and dental visits, DMFT of people living in capital cities was less than non-capital city residents (regression coefficient = 0.8, p = 0.01). The disparity was no longer statistically significant (regression coefficient = 0.6, p = 0.09) after additional adjustment for fluoridation exposure.

Towards local disaster risk reduction in developing countries: Challenges from Jordan

Disasters remain one of the main challenges facing nations of the developing world, as they not only cause high mortality and suffering, but also damage local economies that are in process of formation and thwart development achievements. The Hyogo Framework for Action emphasized the significance of making disaster risk reduction a national and a local priority with a strong institutional basis for implementation. However, local governments may not have the capacity yet to address this need.Therefore, this inquiry investigates the current status of disaster risk reduction in a local Jordanian municipality to understand the current limitations facing this approach. Such an investigation will help in understanding the challenges facing local governments in non-capital cities of the region. The study provides several recommendations for initiating disaster risk reduction on the local level, stressing that the political culture and governance style in the region creates many obstacles. Further, the limited capability of local governments, the serious social and economic problems, and misleading natural disaster cognition create handicaps should the approach be implemented. The legal opaqueness in identification of jurisdictions and responsibilities compounded by the status quo of high dependency on the central government, in addition to fixation on a para-military approach to disaster management calls for reassessment of disaster management policies and related laws in Jordan.

On Individual, Household, and Community Factors Explaining Enrollment to Early Childhood Education and Care in Post-Soviet Transitional Countries

The objective of this paper is to assess the factors affecting access to early childhood education and care in post-soviet countries. We focus on enrollment in Belarus, Georgia, Kazakhstan, Kyrgyzstan, Tajikistan, Ukraine, and Uzbekistan during the late period of transition from communism to a market economy using the data from nationally-representative Multiple Indicator Cluster Surveys conducted by the United Nations Children’s Fund (UNICEF). Multilevel regression models are used to account for individual, household, and community factors explaining enrollment. Having mother with lower educational attainments, living in non-capital cities and in poorer households are associated with lower propensity of enrollment at individual and households levels. At the community level, children living in poorer communities and in communities with lower level of women education have lower propensity of enrollment. The policy measures aimed at increasing access on individual, household, and community are described and discussed.

Development of social capital in largest Russian cities

This work describes some functional economic trends in largest Russian cities. The assumption considered that low values of economic density in largest Russian cities are determined by their underdeveloped social capital. Essential imbalances have been identified in economic development, the localization of decision-making centers, and connectivity between Moscow and largest noncapital cities. These results confirm the point that the social capital in largest Russian cities is underdeveloped. Political and institutional conditions for the development of urban social capital as a largest factor of urban development are considered. Contradictions between urban-development objectives and current political and managerial practices have been identified. The reduction of democratic principles in city administration does not encourage urban social capital development and impedes formation of broad coalitions and elaboration of economic growth strategies in largest cities.

Economic place making: policy messages for European cities

The global recession, Eurozone crisis and austerity programmes have had a huge impact upon the European economy and present even greater future threats. They have sharpened debates about policies for recovery and the role that different territories can play in this. In this context in particular they have encouraged a debate about the economic contribution of capital and non-capital cities and whether countries perform better if they concentrate their investment in their capitals or spread investment across a wider set of cities. Drawing on the findings of a recently completed study of European second-tier cities and a review of the academic and policy literature on local and regional economic development, the paper argues the case for a ‘place-based’ approach to support second-tier cities across Europe. The key policy messages of this approach for policy-makers at national and European levels are highlighted.

City: Utility, Measurability, Preferability

One of the basic principles of successful place marketing and branding is the thoughtful analysis of target groups needs and preferences. Many authors show favour to the city residents as the core target group. The residents may also be segmented into the smaller groups, and in some cases successful strategies are targeted to the needs of this very specific group of citizens. One of such groups – the so-called creative class – became very popular among practitioners as a primary target group for place marketing and branding. The purpose of the paper is to compare creative and non-creative class in terms of their preferences of particular attributes, which describe a city as a whole.Design/methodology/approach: To answer research questions we describe the city in the terms of its attributes and measure preferences over these attributes (part-worths) with the help of specific conjoint analysis technique: hierarchical information integration (HII) approach, proposed by Louviere (Louviere, 1984). This technique is targeted to solve conjoint tasks with a large number of attributes. To describe the city we have chosen 4 sets of attributes (Urbanity and Diversity; City Comfort and Safety; Economic Development and Job Chances; City Facilities). Each set contains 4 attributes and each attribute has 2 or 3 levels of quality. HII approach implies building orthogonal experimental design for each set of attributes. Special bridge design is used to combine these sets. Then estimations of part-worths are calculated on the basis of linear additive model of total utility.Findings: Using the proposed analytical methodology we have measured part-worths of the above-mentioned attributes and modelled residents’ preferences as trade-offs among multiattributive alternatives on the sample of 129 respondents (61 - creative class representatives and 68 – non-creative class representatives). Simultaneously we have estimated the perceived quality level of each attribute for the city of Perm, Russia. Then we compared the preferences of different target groups using these estimations.Limitations: The results provide the evidences particularly interesting for the non-capital cities of Russia for the more effective process of city marketing, targeting and strategic development. Practical implication: The finding may be applied in the sphere of strategic planning of city development, when marketing approach is used and the core target group is the creative class.

Melanoma cutâneo: estudo epidemiológico de 30 anos em cidade do sul do Brasil, de 1980-2009

Melanoma incidence and mortality rates have increased over the past 30 years in the Caucasian population. In Brazil, data on non-capital cities are scarce, making epidemiological stu dies necessary. To evaluate the incidence of and classify cutaneous melanomas in Blumenau from 1980 to 2009. Data from 1002 histopathological examinations of individuals from Blumenau were collected, considering sex, age, primary site of involvement, histological type, level of invasion (Clark's level) and tumor thickness (Breslow's depth). The gross and adjusted coefficients of annual incidences were calculated based on the number of melanoma cases and the population estimated by the Brazilian Institute of Geography and Statistics (IBGE) between 1980 and 2009. The incidence rates of melanoma reached 22.4 cases per 100,000 inhabitants/year; 31.5 in women and 30.4 in men at the adjusted rate. The incidence rates standardized by decade, age and sex were 141 male and 103 female cases per 100,000/inhabitants aged 65 to 69 years. Superficial spreading melanoma occurred in 53% of the cases, followed by nodular melanoma (37%), and the primary site of involvement was the trunk (47%). 62.5% of the cases were diagnosed early, with Breslow < 1 mm. The incidence of malignant melanoma has increased fivefold from 1980 to 2009 and early diagnosis has increased 151% as a result of primary prevention.

Magnitude da mortalidade por câncer do colo do útero na Região Nordeste do Brasil e fatores socioeconômicos

To analyze the time trend of cervical cancer mortality based on adjusted or unadjusted mortality data and to investigate the association between these data and socioeconomic indicators in women aged 20 years or older in the Brazilian Northeast (in capitals and non-capital cities) during the period from 1996 to 2005. All deaths from cervical cancer recorded in the Brazilian Health Ministry's Mortality Data System (SIM) were included in the study. Also included were the cervical cancer deaths identified after the adjustment process. Simple linear regression was used to analyze the time trends for mortality and their correlations (Pearson) with selected socioeconomic indicators. The highest mortality coefficients with unadjusted data were observed in capitals and the lowest were observed in non-capital cities. Conversely, the highest mortality coefficients with adjusted data were observed in non-capital cities. Similarly, the lowest unadjusted mortality rates were observed in the states with the most poverty, illiteracy, fertility, and child mortality, whereas the highest unadjusted mortality rates were observed in the regions with the best social indicators. Adjusted mortality rates showed a negative association with the indicators describing better living conditions, and a positive association with the indicators describing worse living conditions. The use of unadjusted mortality data may lead to underestimation of cervical cancer rates and compromise the interpretations of comparative analyses of the magnitude, distribution, and factors associated with this disease. The magnitude of cervical cancer should be reassessed at least in the Brazilian Northeast. However, the findings show that positive results have been obtained with early detection efforts in Brazil.

Investigation on convenience in emergency rooms of 78 leading general public hospitals in China

Objective To investigate whether emergency rooms in major general public hospitals are reasonably designed and convenient for patients. Methods 78 major public hospitals were selected from all over China, except Hong Kong, Macau and Taiwan, for emergency room convenience analysis. The standards in use were the Standards of Hospitals of Joint commission International Accreditation. Results The investigation found in such hospitals the following: poor road conditions outside the clinic and insufficient guides in the clinic; long-than-expected distance (normally over 50 meters) from ER to imaging departments (such as X-ray and CT scan service); ERs in provincial capital cities are significantly more convenient than those in non-capital cities; distance from ERs to CT service is significantly shorter in hospitals in eastern China than those middle and western China. Conclusions Parameters on ER's service quality from Standards of Hospitals could serve as a guideline to emergency medicine in China. ERs in China need to improve with conspicuous ER signs, unblocked passageways, and convenient access to inspection departments. Key words: Emergency room; Convenience; Appraisal standards of hospitals; Investigation

Ports, plagues and politics: explaining Italian city growth 1300-1861

The evolution of city growth is usually studied for relatively short time periods. The rise and decline of cities is, however, typically a process that takes many decades or even centuries. In this article we study the evolution of Italian cities over the period 1300–1861. Using an existing data set, we perform panel estimations where the development of city size and urban patterns can be explained by various geographical, institutional and other determinants of city size for the period under consideration. Although large shocks such as the plague epidemics are clearly visible in the data, our baseline estimation results show that the main determinants of Italian city growth are physical geography and the predominance of capital cities. With respect to geography, being a seaport or having access to navigable waterways increases city size whereas a city's relative location, measured by its urban potential, is not significant. Being a capital city also increases city size. The estimation results reveal strong century-specific effects on city growth and these effects differ markedly between the North and South of Italy. Additional estimations show that these time effects can be linked to the political and institutional developmental changes over time in Italy. Our findings that the capital city bonus increases and non-capital cities suffer when the political power and the institutions of the state are more centralised corroborate the idea that institutions are a key factor in explaining Italian city growth.

Semantic prime inhibition and memory monitoring

The influence of semantically related primes (non-capital cities) on subsequent feeling of knowing (FOK), recall, and recognition of targets (capital cities) was examined in two studies. Subjects first rated their familiarity with 84 non-capital cities (primes). Each state had four, two or no cities presented in this task. After this, subjects rated their FOK for state capital recall, then recalled the state capitals, and finally selected the state capital from five different cities from that state. Both investigations revealed a systematic increase in FOK from the no- to the four-prime condition, coupled with a progressive decrease in retrieval performance (recall and recognition). Subjects failed to correctly assess the negative impact of semantically related information on subsequent recall, and probably relied on an evaluation of the activation level of the category for FOK assessments.

Kuwait Regional Convention for co-operation on the protection of the marine environment from pollution

Disasters remain one of the main challenges facing nations of the developing world, as they not only cause high mortality and suffering, but also damage local economies that are in process of formation and thwart development achievements. The Hyogo Framework for Action emphasized the significance of making disaster risk reduction a national and a local priority with a strong institutional basis for implementation. However, local governments may not have the capacity yet to address this need.Therefore, this inquiry investigates the current status of disaster risk reduction in a local Jordanian municipality to understand the current limitations facing this approach. Such an investigation will help in understanding the challenges facing local governments in non-capital cities of the region. The study provides several recommendations for initiating disaster risk reduction on the local level, stressing that the political culture and governance style in the region creates many obstacles. Further, the limited capability of local governments, the serious social and economic problems, and misleading natural disaster cognition create handicaps should the approach be implemented. The legal opaqueness in identification of jurisdictions and responsibilities compounded by the status quo of high dependency on the central government, in addition to fixation on a para-military approach to disaster management calls for reassessment of disaster management policies and related laws in Jordan.