Substantial Regional Differences Research Articles

Exclusion, violence, and optimism: Ethnic divides in Kyrgyzstan

The nation-building projects in much of post-socialist Eurasia have been characterized by the promotion of ethnic majorities and marginalization of minority groups. In dialogue with the scholarship on nation-building, ethnic exclusion and conflict, and ethnic migration, this study examines individual views on current and future interethnic relations, assessments of prospects for own ethnicity, expectations for future economic changes, and intentions to migrate abroad in the multiethnic nation of Kyrgyzstan. I use nationally representative survey data to model differences in these outcomes across the majority-minorities divides and between regional subgroups of the nation’s ethnic majority. The results show that a native minority that experienced recent ethnic violence has the most negative assessment of current interethnic relations. However, the minority group of outside origin, which never suffered direct violence but whose size and societal preeminence have eroded rapidly, is least optimistic about the future and is most inclined to migrate. Yet, the analyses also detect substantial regional differences within the ethnic majority, underscoring the complexity of historically-rooted ethnocultural and socioeconomic cleavages as well as of more recent political experiences. I interpret these findings within the context of evolving meanings of ethnic identity and national belonging in this rapidly changing society.

Regional differences in the prevalence of sensitization to environmental allergens: Analysis on IgE antibody testing conducted at major clinical testing laboratories throughout Japan from 2002 to 2011

BackgroundIdentification of sensitized allergens for patients with respiratory allergy is an important step in disease care and environmental allergen control. The Japanese archipelago belongs to various climate categories due to its length from north to south which transverse the subarctic in the north to the subtropical in the south, suggesting substantial regional differences in dominant environmental allergens. However, few studies have assessed the regional differences in the prevalence of sensitization to environmental allergens. MethodsWe requested three major clinical testing laboratories to provide us with summarized results of antigen-specific IgE-antibody (Ab) measurements. These measurements were collected for clinical purposes throughout Japan from 2002 through 2011. The prevalence of positivity for IgE-Ab against 19 environmental allergens was calculated for each prefecture in order to evaluate regional differences. ResultsTest data on specific IgE-Ab of 19,969,753 orders were analyzed. The prevalence of positivity for house dust mites was high and the regional difference was low, whereas apparent regional differences were found for pollen, insects, and fungi. The prevalence of positivity for Japanese cedar was low in Hokkaido and Okinawa, while those to alder was highest in Hokkaido. Higher prevalence for insects was observed in southern areas (Okinawa and prefectures in Kyusyu). ConclusionsFindings of this study clearly demonstrated regional differences in the prevalence of sensitization to environmental allergens in Japan and the study also provides useful information for the clinician when deciding which allergens should preferentially be measured for IgE-Ab after considering regional difference.

Seasonal characteristics of influenza vary regionally across US.

Given substantial regional differences in absolute humidity across the US and our understanding of the relationship between absolute humidity and influenza, we may expect important differences in regional seasonal influenza activity. Here, we assessed cross-seasonal influenza activity by comparing counts of positive influenza A and B rapid test results during the influenza season versus summer baseline periods for the 2016/2017 and 2017/2018 influenza years. Our analysis indicates significant regional patterns in cross-seasonal influenza activity, with relatively fewer influenza cases during the influenza season compared to summertime baseline periods in humid areas of the US, particularly in Florida and Hawaii. The cross-seasonal ratios vary from year-to-year and influenza type, but the geographic patterning of the ratios is relatively consistent. Mixed-effects regression models indicated absolute humidity during the influenza season was the strongest predictor of cross-seasonal influenza activity, suggesting a relationship between absolute humidity and cross-seasonal influenza activity. There was also evidence that absolute humidity during the summer plays a role, as well. This analysis suggests that spatial variation in seasonal absolute humidity levels may generate important regional differences in seasonal influenza activity and dynamics in the US.

Regional differences in ischemic stroke in India (north vs. south).

India is a large country with geographically diverse populations and varying risk factors. Identification of regional differences can improve healthcare policy decisions. To study regional differences in stroke between North and South India. We analyzed data from the Indo-US Collaborative Stroke Project, a National Institute of Health-funded multicentre prospective study conducted in five academic centers in India with a US-based coordinating center. Risk factors, severity, mechanisms, management, complications, and outcomes among ischemic stroke patients were compared between North and South Indian centers. Of the 2066 patients enrolled from North (n = 1060) and South India (n = 1006), North Indian patients were significantly older with fewer men and had lower rates of diabetes (32.8% vs. 38.7%, p < 0.01), dyslipidemia (3.5% vs. 25.7%, p < 0.01), tobacco use (27% vs. 38%, p < 0.001), and alcohol use (30.1% vs. 38.6%, p < 0.01). North Indian patients had higher median National Institute of Health stroke scale scores (10 vs. 9, p < 0.01), more frequent large-artery atherosclerosis mechanism (34% vs. 25.6%, p < 0.001), intravenous thrombolysis (14.0% vs. 6.1%, p < 0.001), and lower rates of pneumonia (10.5% vs. 15.1%, p = 0.02). The three-month outcome (modified Rankin Scale score 0-2, 45.8% vs. 50.3%, p = 0.08) did not differ; however, North Indian patients had higher 90-day mortality (23.5% vs. 13.5%, p < 0.0001). The substantial regional differences in stroke risk factors and mechanisms may be partly explained by factors such as differing dietary habits and lifestyle, which can be addressed at a national level. Differences in acute and inpatient stroke care suggest a need for better adoption of national stroke management guidelines.

From Point to Area: Worldwide Assessment of the Representativeness of Monthly Surface Solar Radiation Records

AbstractThe representativeness of surface solar radiation (SSR) point observations is an important issue when using them in combination with gridded data. We conduct a comprehensive near‐global (50°S to 55°N) analysis on the representativeness of SSR point observations on the monthly mean time scale. Thereto, we apply the existing concepts of decorrelation lengths (δ), spatial sampling biases (β), and spatial sampling errors (ε) to three high‐resolution gridded monthly mean SSR data sets (CLARA, SARAH‐P, and SARAH‐E) provided by the Satellite Application Facility on Climate Monitoring. While δ quantifies the area for which a point observation is representative, β and ε are uncertainty estimates with respect to the 1‐degree reference grid (G). For this grid we find a near‐global average δG=3.4°, βG=1.4 W/m2, and εG=7.6 W/m2 with substantial regional differences. Disregarding tropical, mountainous, and some coastal regions, monthly SSR point observations can largely be considered representative of a 1‐degree grid. Since ε is an uncorrectable error the total uncertainty when combining point with 1‐degree gridded data is roughly 40% higher than the uncertainty of station‐based SSR measurements alone if a rigorous bias correction is applied. Cloud cover and terrain data can at maximum explain 50% of the patterns of the representativeness metrics. We apply our methodology to the stations of the Baseline Surface Radiation Network. Overall, this study shows that representativeness is strongly dependent on local conditions and that all three metrics (δ, β, and ε) must be considered for a comprehensive assessment of representativeness.

Regionality and Greek Ritual Norms

This article asks to what extent Greek ritual norms are homogeneous throughout the Greek world. It looks in particular at rules concerning priesthoods, purity and sacrifice. Only the first group displays a clear regional line of division: sale of priesthoods is only attested in the east Greek world, beginning at Andros. That distinction aside, some local singularities or outliers occur in all categories, and some differences that must be due to epigraphic habit. But substantial and regular regional differences at the level of actual ritual practice do not appear. Study of Greek ritual norms may therefore suggest that in some aspects there existed a Greek religion, not just a multitude of locally varying Greek religions.

Incidence of Infectious Adverse Events in Patients With Rheumatoid Arthritis and Spondyloarthritis on Biologic Drugs-Data From the Brazilian Registry for Biologics Monitoring.

BackgroundThe safety profile of biologic drugs might present substantial regional differences. Since 2009, the Brazilian Society of Rheumatology has maintained BIOBADABRASIL (Brazilian Registry for Biologic Drugs), a registry for monitoring of biologic therapies in rheumatic diseases.ObjectivesThe aim of this study was to verify the incidence rate (IR) of serious infections in rheumatoid arthritis (RA) and spondyloarthritis (SpA) patients on biologic drugs.MethodsBIOBADABRASIL prospectively included patients with rheumatic diseases who started the first biologic drug or a synthetic disease-modifying antirheumatic drug as a parallel control group. This study focuses on serious infectious adverse events (SIAEs) in RA and SpA patients on biologic drugs compared with controls, from January 2009 to June 2015. Time of exposure was set from initiation of the drug to the date of last administration or censorship. Serious infectious adverse events IR was calculated per 1000 patient/years with 95% confidence interval (CI).ResultsA total of 1698 patients (RA, 1121; SpA, 577) were included, 7119 patient/years. Serious infectious adverse events were more common among patients on tumor necrosis factor inhibitors (TNFi's) than controls (adjusted IR ratio, 2.96 [95% CI, 2.01–4.36]; p < 0.001). Subsequent TNFi was associated with a higher SIAEs incidence when compared with first TNFI (adjusted IR ratio, 1.55 [95% CI, 1.15–2.08]; p = 0.004). Serious infectious adverse events were associated with age and corticosteroids intake. Serious infectious adverse events were more frequent in the respiratory tract in all subgroups.ConclusionsIn BIOBADABRASIL, biologic drugs, especially the subsequent TNFi, were associated with a higher risk of serious infections compared with synthetic DMARDs. Corticosteroid intake and age represented risk factors for SIAEs. Constant monitoring is required to follow the safety profile of drugs in the clinical setting of rheumatic conditions in Brazil.

Regional differences between people who inject drugs in an HIV prevention trial integrating treatment and prevention (HPTN 074): a baseline analysis.

IntroductionPeople who inject drugs (PWID) experience high HIV incidence and face significant barriers to engagement in HIV care and substance use treatment. Strategies for HIV treatment as prevention and substance use treatment present unique challenges in PWID that may vary regionally. Understanding differences in the risk structure for HIV transmission and disease progression among PWID is essential in developing and effectively targeting intervention strategies of HIV treatment as prevention.MethodsWe present a baseline analysis of HIV Prevention Trials Network (HPTN) 074, a two‐arm, randomized controlled trial among PWID in Indonesia (n = 258), Ukraine (n = 457) and Vietnam (n = 439). HPTN 074 was designed to determine the feasibility, barriers and uptake of an integrated intervention combining health systems navigation and psychosocial counselling for the early engagement of antiretroviral therapy (ART) and substance use treatment for PWID living with HIV. Discordant PWID networks were enrolled, consisting of an HIV‐positive index and their HIV‐negative network injection partner(s). Among the enrolled cohort of 1154 participants (502 index participants and 652 network partners), we examine regional differences in the baseline risk structure, including sociodemographics, HIV and substance use treatment history, and injection and sexual risk behaviours.ResultsThe majority of participants were male (87%), with 82% of the enrolled females coming from Ukraine. The overall mean age was 34 (IQR: 30, 38). Most commonly injected substances included illegally manufactured methadone in Ukraine (84.2%), and heroin in Indonesia (81.8%) and Vietnam (99.5%). Injection network sizes varied by region: median number of people with whom participants self‐reported injecting drugs was 3 (IQR: 2, 5) in Indonesia, 5 (IQR: 3, 10) in Ukraine and 3 (IQR: 2, 4) in Vietnam. Hazardous alcohol use, assessed using the Alcohol Use Disorders Identification Test – Alcohol Consumption Questions (AUDIT‐C), was prominent in Ukraine (54.7%) and Vietnam (26.4%). Reported sexual risk behaviours in the past month, including having two or more sex partners and giving/receiving money or drugs in exchange for sex, were uncommon among all participants and regions.ConclusionsWhile regional differences in risk structure exist, PWID particularly in Ukraine need immediate attention for risk reduction strategies. Substantial regional differences in risk structure will require flexible, tailored treatment as prevention interventions for distinct PWID populations.

U.S. Return Migration and the Decline in Southern Black Disadvantage, 1970-2000.

This study investigates how the Return Migration altered racial inequality in poverty in the American South. I disaggregate southern poverty into its separate constituents using household data from the Integrated Public Use Microdata Series (IPUMS) for 1970 through 2000. The prevalence of poverty declined most dramatically for black southern households and the racial gap in poverty narrowed to the extent that previous substantial regional differences disappeared. A central focus is the contrast between higher poverty and inequality among migrants who returned to their birth state relative to other southern-born migrants who returned to the South. The migration experience is diverse and has conflicting consequences for racial inequality; for some, migration maintained economic vulnerability. Given the complex force of migration, I conclude that a nuanced theoretical approach to migration that gives weight to economic and noneconomic motivations is critical to understand the racial dimensions of migration and the associated changes in racial inequality.

Changes of grain production potential in farming–pastoral ecotone: a case study in West Jilin, China

AbstractGrain production potential is mainly influenced by agroclimate and land use. In the present study, substantial regional differences associated with the impact of climate change were found (i.e. the degree of climate-related impacts varied among regions). Currently, there is an urgent need for effective responses and adaptations to different agricultural districts and agricultural production modes. Therefore, the aim was to examine ecotones and explore trends and influential factors associated with grain production potential change. Using the Global Agro-ecological Zone model, the grain production potential of West Jilin, China under different conditions during various years were estimated, considering meteorological, soil, topographic, land use and other data. The results showed that total grain production potential (TGrPP) of West Jilin increased continuously from 1976 to 2013. The average annual increase in TGrPP was higher in period 1 (1976–2000) than period 2 (2000–2013). In period 1, grain production potential was influenced mainly by irrigation percentage changes, followed by land use change. The conversion of grassland to farmland was the most important land use change factor that was associated with increased grain production potential. Climate change affected grain production potential in period 1 negatively. In period 2, climate change had the largest impact and land use imparted the smallest effect on grain production potential. Finally, the decrease in irrigation percentage resulted in reduced grain production potential.

Factors associated with risky consumption of alcohol in a sample of university students.

During the university period, student wellbeing is exposed to the negative effects of many stressful factors, including the use and abuse of alcoholic beverages. The aim of this study is to estimate the risky alcohol consumption within the student population of the University of Palermo. An anonymous online questionnaire was provided to students enrolled in the mailing list of the Regional Agency for the Right to University Study (ERSU) of the University of Palermo. the first section investigated demographic and social data, while in the second section the A.U.D.I.T. C (Alcohol Use Disorders Identification Test-Consumption) test was administered. 539 subjects agreed to the informed consent and completed the questionnaire. The average age of the sample is 22.65 years (SD ± 2.95). Considering as dependent variable "students with risky consumption of alcohol", the statistically significant independent variables associated were: "age class ≤22 years old" (aOR 2.02, 95% CI 1.18-3.44, p=0.019), "don't live with own family" (aOR 3.21, 95% CI 1.81-5.69, p&0.001) and "I currently smoke" (aOR 6.44, 95% CI 3.85-10.79, p&0.001). The results of the study show that about 19% of students experience risky alcohol consumption. This percentage seems not to be gender related. Information and training campaigns focused on alcoholism and related risks are of great importance in order to educate students on the socio-economic costs of alcohol related diseases to public health; parents can play a crucial role in minimising the use of alcohol in their sons/children through dialogue if properly trained to address these issues. In fact, our study seems to show that those who no longer live in the household have a higher risk of alcohol consumption.

Public Versus Private Sector Wage Gap in Egypt: Evidence From Quantile Regression on Panel Data

This paper considers the public and private sector wage earners in Egypt and examines their wage distribution during 1998-2012 using Egyptian Labor Market Panel Survey. We estimate the public-private sector wage gap with Mincer wage equations both at the mean and at different quantiles of the wage distribution. In this process we take into account observable and unobservable characteristics of the individuals using the panel feature of the data with a fixed effects model. We address sector of employment selection issue for both males and females. We find that there is very little evidence of sample selection in our data. Therefore, we present both the selection corrected results and the results with no selection correction.We find a persistent public sector wage penalty for males and public sector wage premium for females in the face of extensive sensitivity checks. They are larger when unobserved heterogeneity is taken into account for males but insignificant for females. They are similar across the quantiles for males but, smaller at the top than at the bottom of the conditional wage distribution for females. We further examine the public sector wage gap over time and in different sub-groups according to age and education. The public sector wage penalty for males has decreased recently over time and is larger for the better educated and younger. We also find substantial regional differences in public sector wage gap for males.

Regional differences in the incidence of tuberculosis among patients with newly diagnosed diabetes mellitus.

There are regional differences in the burden of tuberculosis (TB). Although these differences might be explained by regional differences in the risk factors of TB, whether such risk factors are actually associated with the regional differences in the TB burden remains unclear. This study aimed to investigate the relationship between the risk factors of and regional differences in TB incidence. A cohort study applying nationwide claims database in Republic of Korea included patients newly diagnosed with type 2 diabetes mellitus (DM) in 2009. The main outcome was the incidence of TB defined based on the diagnostic codes combined with anti-tuberculosis treatment repeated within 90 days. Sixteen regions were categorized into 3 groups according to the age- and sex-standardized TB incidence rates. Multivariate logistic regression analysis adjusted for risk factors was performed to identify the determinants of the regional differences in TB incidence. Among 331601 participants newly diagnosed with type 2 DM and with no history of previous TB, 1216 TB cases were observed. The regional TB incidence rates ranged between 2.3 and 5.9/1000 patients. Multivariate analyses did not identify any determinants of regional differences in the TB incidence among the various risk factors, including age, sex, health care utilization, co-morbidities, medication and treatment and complications of DM. Similarly, temperature, humidity and latent TB infection rate also did not affect the results. Although substantial regional differences in the TB incidence rate were observed among patients with newly diagnosed DM, no determinants of regional difference were identified among the risk factors.

Tourism eco-efficiency of Chinese coastal cities – Analysis based on the DEA-Tobit model

Tourism eco-efficiency plays an important role in the environment due to serious environment pollution and resource consumption. An evaluation of the tourism eco-efficiency of 53 Chinese coastal cities was conducted for 2003–2013, exploring the overall efficiency levels, regional differences, eco-efficiency types and influencing factors. To achieve the objectives of the study, a data envelopment analysis (DEA)-Tobit model is applied. The major findings indicate that the overall tourism eco-efficiency of Chinese coastal cities is 0.860, which means that only a few cities are effectively efficient and that most cities still have room for improvement. This finding implies that tourism development has a more negative impact on the environment and that there are substantial regional differences in efficiency. The results also show that economic and ecological indicators have significantly positive influences on the tourism eco-efficiency of Chinese coastal cities, while the number of tourists and the use of three major pollutants in the tourism industry have a negative impact. We identify several influencing factors and propose several suggestions for increasing tourism eco-efficiency and the development quality of Chinese coastal cities.

The Oncology Care Model: Perspectives From the Centers for Medicare &amp; Medicaid Services and Participating Oncology Practices in Academia and the Community.

Cancer care delivery in the United States is often fragmented and inefficient, imposing substantial burdens on patients. Costs of cancer care are rising more rapidly than other specialties, with substantial regional differences in quality and cost. The Centers for Medicare &amp; Medicaid Services (CMS) Innovation Center (CMMIS) recently launched the Oncology Care Model (OCM), which uses payment incentives and practice redesign requirements toward the goal of improving quality while controlling costs. As of March 2017, 190 practices were participating, with approximately 3,200 oncologists providing care for approximately 150,000 unique beneficiaries per year (approximately 20% of the Medicare Fee-for-Service population receiving chemotherapy for cancer). This article provides an overview of the program from the CMS perspective, as well as perspectives from two practices implementing OCM: an academic health system (Yale Cancer Center) and a community practice (Hematology Oncology Associates of Central New York). Requirements of OCM, as well as implementation successes, challenges, financial implications, impact on quality, and future visions, are provided from each perspective.

Combining human acceptance and habitat suitability in a unified socio‐ecological suitability model: a case study of the wolf in Switzerland

Summary Habitat suitability models (HSMs) are commonly used in conservation practise to assess the potential of an area to be occupied and colonised. A major limitation of these models, however, is the omission of spatially explicit understanding of human acceptance towards the focal species. As wildlife is more and more subject to human‐dominated landscapes, ignoring the sociological component will result in misrepresentation of the observed processes and inappropriate management. We distributed 10 000 questionnaires across Switzerland and identified key socio‐demographical factors correlated with human acceptance of the wolf. We then created a spatially explicit acceptance model based on geo‐referenced socio‐demographical, social and geographical information. Finally, we combined our acceptance model with a HSM to obtain a unified socio‐ecological suitability model, which included human and ecological components. We showed that the key factors associated with human acceptance were perception of how harmful the wolf is, interest in wolf‐related issues, need for livestock protection, and fear of the wolf. Perceived harmfulness was in turn correlated with direct and indirect experience with the wolf, and level of education. Our acceptance map predicted decreasing acceptance with increasing altitude of residency and proximity to locations of confirmed wolf presence. This resulted in the overall opposition to the wolf for the Alpine region, albeit substantial regional differences. We found little spatial overlap (6% of Switzerland) between areas where the wolf was accepted and areas of suitable habitat. These areas of socio‐ecological suitability were concentrated in the Jura Mountains and in the eastern and southern Alps, and were absent in the western and central Alps. Particularly in the Jura region, which is yet to be colonised, management of human acceptance will be a crucial conservation target. Synthesis and applications. We developed an integrative, socio‐ecological approach that allowed us to accurately reproduce recent wolf recolonisation. We anticipate our framework to be a powerful tool to reliably evaluate overall suitable habitats and predict short to medium‐term range expansion for species whose distribution is also dependent on human attitudes. Because our approach is sensitive to both the ecological and human component, it is ideally suited to identify key regions where proactive and targeted socio‐ecological management plans are needed.

Pattern scaling based projections for precipitation and potential evapotranspiration: sensitivity to composition of GHGs and aerosols forcing

Pattern scaling is a computationally efficient method to generate global projections of future climate changes, such as temperature and precipitation, under various emission scenarios. In this study, we apply the pattern-scaling method to project future changes of potential evapotranspiration (PET), a metric highly relevant to hydroclimate research. While doing so, this study tests the basic assumption of pattern-scaling methods, which is that the underlying scaling pattern is largely identical across all emission scenarios. We use a pair of the large-ensemble global climate model (GCM) simulations and obtain the two separate scaling patterns, one due to greenhouse gasses (GHGs) and the other due to aerosols, which show substantial regional differences. We also derive a single combined pattern, encapsulating the effects of both forcings. Using an energy balance climate model, future changes in temperature, precipitation, and PET are projected by combining the separate GHGs and aerosols scaling patterns (“hybrid-pattern” approach) and the performance of this “hybrid-pattern” approach is compared to the conventional approach (“single-pattern”) by evaluating both approaches against the GCM direct output. We find that both approaches provide reasonably good emulations for the long-term projection (end of the twenty-first century). However, the “hybrid-pattern” approach provides better emulations for the near-term climate changes (2020–2040) when the large changes in aerosol emissions occur.

Special Demographic Zone in Poland – in search for the gist of the phenomenon

1.IntroductionNotwithstanding the fact that ageing Europe is the sole continent whose society, as a whole, undergoes an ongoing depopulation process, the European Union (EU) is still expected to increase the number of its population by 2% until 2030 [Eurostat 2016]. However, at regional and local taxonomic levels of the UE-28 the consequences of both before mentioned demographic processes - namely population ageing and population decline - are distributed unequally, leading to the substantial differences in the demographic situation of particular areas within the EU. In view of the fact that the number, structure, and quality of population on a given territory constitute prerequisite for any development strategy and the precondition for sustainable local and regional growth [Rauzinski & Szczygielski 2014; Szczygielski 2015], the changes in demographic characteristics at different levels of taxonomic analysis call for a tailored socio-economic policy at consecutive levels with the ultimate goal of alleviating the negative effects of both negative demographic processes. Thus, European and national policies require flexibility to allow regional and local implementation [OECD 2013].In the Polish context, there are also substantial regional differences in the population structure and dynamics to be noticed. There are some mesoregions and microregions in an urgent need for extraordinary political intervention. Nevertheless, the long-term demographic projections clearly show that almost all Polish regions and municipalities will have to embark on strategies to face depopulation problem, and all of them will face the population ageing problem.In 2012 one of 16 Polish voivodeships (NUTS-2 level regions in Poland) - namely Opolskie voivodeship - embarked on special policy programme, called Special Demographic Zone, which has been set up in order to fight against savage region's population demise, and to take measures to countervail the ageing process. Special Demographic Zone is to be perceived as a complex development and socio-economic policy programme that aims at alleviating the negative effect of both demographic processes in question.The objective of this paper is to place the concept of the Special Demographic Zone established in the Polish Opolskie mesoregion in the broad context of local and regional strategies of tackling demographic challenges that have been already applied in other declining and (or) ageing areas worldwide. In particular, it is in our interest to build a theoretical bridge between the consequences of ageing and depopulation processes and challenges steaming from the need to create sustainable local and regional economies.We would like to note that, if not specified otherwise, all statistical data quoted in this paper were sourced from the Eurostat database [Eurostat 2016].In the Literature review section we present a review of international literature that covers: importance of demographic issue in EU-28 member states, context, details and causes of demographic issue at country and regional level in Poland. In Methods section we describe our approach toward research sample selection and Boolean keyword and subject term research performed between 1st - 30th of September 2016. In Research findings section we provide synthesis of research performed presented in form of typology of strategies implemented to tackle negative trends at different regional levels. Our paper concludes with implications of the study for the economic and research practice.2.Literature review2.1.Demography as a strategic policy issue at country level in the EU-28Population ageing, due to successively increasing life expectancy of individuals, is the major demographic threat to be tackled throughout the EU-28 member states. However, there are some countries (and regions) within the EU equally threatened by the depopulation process and its negative consequences. Demographic issue stimulates debate on impact of income and consumption taxes, subsidies and other fiscal instruments on fertility patterns [Kudla 2013]. …

Uncovering the rising kidney failure deaths in India.

Uncovering the rising kidney failure deaths in India.

Relationship between Blood Concentrations of Persistent Organic Pollutants and Regional Difference in Risk of Type 2 Diabetes in Germany

Introduction: Although most persistent organic pollutants (POPs) are now banned in many countries, they can still be detected in the food chain and can also accumulate in adipose tissue. POPs mainly include polychlorinated biphenyls (PCBs), organochlorine pesticides, and hexachlorobenzene (HCB). We recently found substantial regional differences in the incidence of (pre-)diabetes in Germany with higher estimates in the Northeast than in the West and South, which were not fully explained by traditional risk factors. We hypothesize that differences in current diabetes risk between regions of the former German Democratic Republic and Federal Republic of Germany may partly be a result of differing exposure to POPs. Methods: We investigated the association of several POPs and the risk of type 2 diabetes (T2D) in two nested case-control studies of the cohorts CARLA in Halle (East Germany) and KORA in Augsburg (South Germany). Seventy-seven and 60 cases with incident T2D and 154 and 120 age- and sex-matched nondiabetic controls from CARLA and KORA, respectively, were included. Blood concentrations of PCBs 138, 153, 180, HCB, β-HCH and p,p’-DDE were measured using gas chromatographic high-resolution mass spectrometry. POP concentrations were categorized in tertiles among controls. Odds ratios (OR) with 95%-confidence intervals for incident T2D were estimated using conditional logistic regression adjusting for body mass index and total cholesterol. Results: In CARLA, all PCBs showed higher risks in the third tertiles compared to the lowest tertiles with the strongest association present in PCB 138 (OR: 2.74 [1.16-6.46]). Of all POPs evaluated, β-HCH showed the strongest association with incident T2D (OR: 2.78 [1.02-7.60]). Analyses for KORA are ongoing. Conclusions: POPs seem to increase the risk for T2D in CARLA, probably through endocrine disruption. Further analyses will investigate to which extent POPs might explain regional differences in T2D incidence in Germany.