Widening Gap Research Articles

Social inclusion of people with mental illness: the widening gap in the adult population in Belgium

Abstract Background Social inclusion is poor among people with mental illness (MI). In recent decades, many countries have developed policies to address this issue. It remains unclear, however, whether their social inclusion has improved over time. This study aimed to assess the evolution of the social inclusion of adults with moderate and severe MI compared to the general population without MI between 1997 and 2018 in Belgium. Methods Data on the general adult population were retrieved from the Belgian Health Interview Survey in six cross-sectional waves from 1997 to 2018. Three degrees of MI severity were compared using the 12-items General Health Questionnaire: no MI, moderate MI, and severe MI (score < 4, 4-7, and > 7). Social inclusion was measured using indicators relating to employment, income, social contacts, and partnership. Results Since 1997, the probability of being unemployed, having limited social contacts, and living on less than 60% of the median national income has been increasing among people with severe MI. Between 1997 and 2018, social inclusion increased among the general population without MI and among people with moderate MI, but decreased among people with severe MI. Conclusions The gap between the social inclusion of people with severe MI and people with moderate or no MI has widened over time, despite major reforms of mental health care and policies. Policymakers and clinical practitioners should pay more attention to supporting the social inclusion of people with more severe MI, particularly in relation to employability and social support. Key messages • In Belgium, the social inclusion of people with severe mental illness has decreased over the past two decades. • The widespread social exclusion of people with severe mental illness is in conflict with international human rights conventions.

Changing inequalities in life-expectancy by income in Finland 1997-2020

Abstract Background Previous studies show that in recent decades the changes in mortality disparities between income groups in Finland have been driven by alcohol- and smoking-related causes of death. The gap between the extreme income quintiles narrowed in 2008-14 particularly due to the declining alcohol-related mortality. We analysed the most recent changes in mortality disparities and the causes of deaths behind them. Methods We used register based individual level total population data for ages 30-95+ and yearly follow-up for mortality in 1996-2020 including information on disposable household income quintile in the previous year. Preston method was used for assessing the impact of smoking on mortality. We calculated trends in life expectancy (LE) at age 30 for three-year periods in 1997-2020 and then conducted an Arriaga cause of death decomposition of the gap between highest and lowest quintiles and changes in LE for each quintile from 2015-17 to 2018-20. Results We observed an increasing gap in LE by income due to stagnating LE in the lowest income quintile from 2015 onward among both men and women. Among men the stagnation was observed even after eliminating smoking- and alcohol-related mortality and among women the LE slightly increased after accounting for smoking and alcohol but the gap to the highest quintile increased clearly. Decomposing the change in LE from 2015-17 to 2018-2020 by causes of death showed no specific causes of death behind the stagnation and the widening gap. Among both men and women mortality due to circulatory diseases showed a substantial decline in the lowest quintile whereas in all other causes mortality increased or declined only slightly. Conclusions Inequalities in LE by income are widening again in Finland due to stagnation in the lowest income quintile. Contrary to the prior decades the increasing disparities are not attributable to smoking and alcohol-related deaths but occur in the majority of causes of death. Key messages • After nearly a decade of narrowing mortality inequalities we observed an increasing gap in life expectancy by income mainly due to stagnation in the lowest income quintile. • Contrary to the prior decades the increasing disparities and stagnation of the lowest income quintile are not explained by smoking and alcohol-related deaths but occur in majority of causes of death.

The increasing climate inequalities of urban carbon emissions: The distributional effect of low-carbon city pilot policy

The low-carbon city pilot (LCCP) policy has been implemented for >10 years in China. While previous studies have proved its effectiveness in facilitating low-carbon transformation, the distributional effects of the LCCP have not been fully explored to address the potential climate inequalities across cities. This study employs the changes-in-changes (CIC) model to explore the distributional effect of China's LCCP policy on carbon emission intensity (CEI). Our results show that the LCCP effectively reduces CEI, but its effect is uneven across cities and only lasts for the short term. In addition, the climate benefits of the LCCP diminish at higher quantiles of CEI, where urgent actions are required for CEI reduction. This unequal effect is driven by LCCP's regressive impact on productivity, leading to a widening gap among cities and undermining climate justice. This study raises the importance of equity concerns in climate policy effects. We call for policy efforts on regional coordination and fair distribution of climate responsibilities, technological transfers and financial assistance to complement climate policies.

An In-Depth Analysis of Pythonic Paradigms for Rapid Hardware Prototyping and Instrumentation

This in-depth examination review about pythonic paradigms for quick hardware prototyping and instrumentation to solve the widening gap between the fluidity of software development and the more conventional methodology used in hardware design. The proliferation of specialized hardware and accelerators has resulted in an increased necessity for development strategies that are flexible. Reconfigurable hardware, such as FPGAs and coarse-grain reconfigurable arrays, enables incremental changes in early design stages, which is a key component of agile software development. This article goes into modern agile development methods, emphasizing the integration of services, repositories, and specialized tools to meet particular users' requirements. Continuous improvement in areas such as software and hardware design, testing, analysis, and evaluation, as well as collaboration with current development tools, are all supported by an ecosystem that has been successfully integrated.

Awareness of segregation in a welfare state: a Finnish local policy perspective

Segregation is a relatively recent issue in larger Finnish cities. The existence of segregation contradicts the Nordic welfare model, and segregation has been raised to the national policy level in Finland to combat a slowly widening gap between social groups on a spatial level. Local municipalities are central actors in urban policies. Therefore, we look at segregation from a local policy perspective. Our results confirm that segregation has not been seen as a burning issue in Finland on a local level, and recognition depends on the size of the city. Where segregation is acknowledged, it is often named a problem in city strategies but does not translate into anti-segregation policies locally. In mid-size cities, ‘spatial deprivation’ rather than segregation is acknowledged, rendering systematic interventions aimed at segregation even more difficult.

A Healthcare System Looks Within to Improve Outcomes.

Healthcare organizations are facing exponential growth in change-not just to compete, but to survive. Amid the widening gap between expenses and reimbursements, hospitals must manage the adoption of expensive advanced technologies, continuous synthesis of emerging clinical knowledge, intensive regulatory readiness, and public ranking of quality outcomes. And they must handle all this as patient expectations grow. At Methodist Le Bonheur Healthcare (MLH), we have approached these challenges by nurturing an organizational mindset of transformational innovation. The ability to harness the collective brainpower of 12,000 MLH associates to find cost reductions, operational efficiencies, and better ways to provide patient care has proven invaluable when facing the demands to do more with less. Achieving this degree of engagement began with full transparency of the challenges we face as an organization, clearly articulating the need to change, and providing a structured approach to capture and respond to suggestions from the workforce. The Power of One Idea program, a platform for listening and learning, has enabled the workforce to answer that call and make an impressive impact: $17 million in cost savings and previously untapped revenues. In return, the forward-thinking associates submitting those ideas have shared in those savings and realized more than $1.5 million in extra income. The Performance Excellence Award, a program to seek out best practices in safety, efficiency, or effectiveness, also has enriched the business with at least 100 proven approaches to advance care delivery.

Declining trends in telehealth utilization in the ongoing COVID-19 pandemic.

Telehealth is an important complement to in-person healthcare, with opportunities to overcome barriers to healthcare and improve health equity. Telehealth utilization increased sharply at the onset of the COVID-19 pandemic. This study assessed trends in telehealth utilization for the years 2020 through 2022, both overall and in subgroups. We gathered data from the 2020-2022 National Health Interview Survey. The rates of telehealth utilization were calculated overall and within subgroups based on demographic factors, health conditions, healthcare utilization, challenges of ability, and social needs. Adjusted multivariable logistic regression models of telehealth utilization assessed the yearly trends. We also analyzed the ratios of subgroup utilization relative to the overall rates. A total of 69,581 patients were identified with complete information. The overall rates of telehealth utilization were 36.2% for 2020, 38.9% for 2021, and 31.3% for 2022. The reduction in telehealth utilization for 2022 was large and statistically significant (OR: 0.64 (95% CI: 0.62-0.67), p < 0.001). Subgroup analyses showed corresponding reductions in 2022 for essentially all patient subgroups. Telehealth was utilized at higher rates by patients with chronic conditions, challenges of ability, and other kinds of medical utilization. Ratio analyses showed evidence of widening disparities for patients of older age, in rural areas, and by geographic region, limited education, and of low income. The study demonstrates declining rates of telehealth utilization are occurring with widening gaps among patient subgroups. Addressing these disparities may be critical to improving equity in telehealth and healthcare overall.

Factors Predicting Intentions of Adoption and Continued Use of Artificial Intelligence Chatbots for Mental Health: Examining the Role of UTAUT Model, Stigma, Privacy Concerns, and Artificial Intelligence Hesitancy.

Background: Artificial intelligence-based chatbots (AI chatbots) can potentially improve mental health care, yet factors predicting their adoption and continued use are unclear. Methods: We conducted an online survey with a sample of U.S. adults with symptoms of depression and anxiety (N = 393) in 2021 before the release of ChatGPT. We explored factors predicting the adoption and continued use of AI chatbots, including factors of the unified theory of acceptance and use of technology model, stigma, privacy concerns, and AI hesitancy. Results: Results from the regression indicated that for nonusers, performance expectancy, price value, descriptive norm, and psychological distress are positively related to the intention of adopting AI chatbots, while AI hesitancy and effort expectancy are negatively associated with adopting AI chatbots. For those with experience in using AI chatbots for mental health, performance expectancy, price value, descriptive norm, and injunctive norm are positively related to the intention of continuing to use AI chatbots. Conclusions: Understanding the adoption and continued use of AI chatbots among adults with symptoms of depression and anxiety is essential given that there is a widening gap in the supply and demand of care. AI chatbots provide new opportunities for quality care by supporting accessible, affordable, efficient, and personalized care. This study provides insights for developing and deploying AI chatbots such as ChatGPT in the context of mental health care. Findings could be used to design innovative interventions that encourage the adoption and continued use of AI chatbots among people with symptoms of depression and anxiety and who have difficulty accessing care.

Penanggulangan Gelandangan dan Pengemis oleh Pemerintah Kabupaten Badung

One of the problems that occurs in developing countries like Indonesia is social inequality, or the increasingly widening gap in income distribution between groups, between urban and rural areas. This high poverty rate has a direct impact on the poor standard of living of people who choose to live on the streets as beggars (sprawl). As stated in regional regulations that seek to provide a deterrent effect, the Badung Regency Government continues to strive to improve supervision and control of sprawl. The government is fighting against sprawl in areas that commonly occur and disrupt public permits by carrying out efforts to prevent sprawl in Badung Regency through the Civil Service Police Unit. Based on the findings of this research, it can be said that Regional Regulation Number 7 of 2016 concerning Public Order and Community Peace is the basis for eradicating sprawl in the Badung Regency area which is very difficult to implement and is not yet functioning well. This requires support from various related parties, all levels of society in Badung Regency, as well as tourists who come to the Badung area itself.

Alleviating Poverty for Empowerment of Scheduled tribes in India: Issues and Challenges

"This paper discusses poverty alleviation for the Empowerment of Scheduled Tribes in India. Poor education, health, and poverty are grave challenges for their development. The various policies and programmes of the governments towards reducing poverty have not resulted satisfactorily. Currently, tribal people continue to be poor, and malnourished in India. Hence this study is attempted. This paper is based on secondary sources like volumes, articles, journals, and e- sources. The study reveals that the poverty ratio of STs is narrowing down in both rural and urban areas, but as compared it to the general population there is a widening gap. Hence to minimize this gap, Government should implement effective Poverty Alleviation Schemes at the grassroots and the NGOs should come forward to create awareness about Poverty Alleviation and employment creation schemes for the Empowerment of Scheduled Tribes in India."

Riding the waves of discomforts: Reflecting on the dialogue of hydrologists with society

Although there is a deep historical relationship between hydrology and society, the relationship has considerably evolved in the last three decades. Hydrologists, in particular those involved in designing of decision-support tools, are experiencing a widening gap between an academic discipline which has progressively moved away from field-based applied natural science to computational hydrology, and the multiplication of stakeholders involved in the water-related issues addressed by research. The challenge for hydrology is now to negotiate this shift and to rethink its engagement in society. This paper provides a description of a planned process designed to improve hydrology-society interactions and to foster reflexivity in socio-hydrology. Based on an interdisciplinary reflexive process undertaken in Tunisia from 2016 to 2020, we identified three types of discomforts in the dialogue with society, inviting scientists to lucidly engage with these discomforts. We formulated four key reflexive propositions to achieve a better alignment of scientific stance, research practices and discourse. The first proposition concerns the need to explain more clearly the value systems scientists engage in and with society. The second concerns the need to position hydrology in society and not outside it, by reconsidering the functions that research fulfils in society. The third is an invitation to redefine the perimeter of the research interlocutors and the way to reach them. The fourth is to revisit scientific practices to build on the strengths of the dialogue between field-based natural science and computational hydrology. The paper concludes that adopting a reflexive posture towards these four dimensions of the dialogue between hydrology and society is an effective way to overcome discomforts and to refocus research stance, practices and discourse. It is a way to renew hydrology's place in society and to contribute to the current thinking in socio-hydrology initiated by hydrologists.

Bridging the Gap or Widening the Divide? The Role of Technology in Global Economic Inequality

This article explores the relationship between technological advancements, transnational capitalism, and the growing divide in global economic inequality. It analyzes how developed nations' dominance in technology research and innovation has contributed to the disproportionate distribution of wealth, productivity, and economic development. By examining data such as G7 countries' investments in research and development, accounting for over 88% of global expenditure, and their holding of over 90% of patents filed in 2014, the article highlights the intricate links between multinational corporations, technological diffusion, and global inequality. The findings reveal that the concentration of technological advancements in a few developed countries not only fuels global capitalism but also exacerbates the economic disparities between rich and poor nations. The article calls for a more equitable approach to technological development and diffusion to bridge this widening gap.

139 The impacts of technological innovation and institutional quality on the productivity of Vietnamese manufacturing firms

This research aims to assess the pivotal role of total factor productivity (TFP) in shaping the performance of manufacturing enterprises in Vietnam. It systematically examines the influence of technological innovation and the quality of economic institutions on the TFP of these firms. Employing robust methodologies such as control function (CF) and feasible generalized least squares regression (FGLS) models, a comprehensive panel dataset of Vietnamese manufacturing companies is meticulously scrutinized. The data, meticulously sourced from the General Statistics Office of Vietnam and the Vietnam Chamber of Commerce and Industry, spans the five-year period from 2015 to 2019. The findings of this study elucidate several key insights. First, it reveals that the manufacturing landscape in Vietnam is predominantly characterized by labor-intensive operations, with an apparent trend toward increasing returns to scale. Furthermore, the study underscores that TFP's contribution to manufacturing output remains relatively modest, averaging at 1.933 over the period from 2015 to 2019. Additionally, it identifies a concerning decline in the average TFP score, along with a widening gap between firms, which tends to exacerbate during the study period. Finally, the research establishes a positive correlation between investments in production technology and the quality of economic governance within provincial governments in Vietnam, both of which significantly bolster the TFP of manufacturing firms.

The Educational Consequences of Remote and Hybrid Instruction during the Pandemic

Using testing data from over two million students in nearly 10,000 schools in 49 states (plus the District of Columbia), we investigate the role of remote and hybrid instruction in widening gaps in achievement by race and school poverty. We find that remote instruction was a primary driver of the widening gaps. Math gaps did not widen in areas that remained in person (although reading gaps did). We estimate that high-poverty districts that went remote in 2020–2021 will need to spend nearly all of their federal aid on helping students recover from pandemic-related academic achievement losses. (JEL H75, I12, I21, I24, I32, J15)

TVET Lecturer Work-Integrated Learning: Opportunities and Challenges

There is a widening gap between industry expectations and what Technical and Vocational Education and Training (TVET) lecturers teach to students. In South Africa, work-integrated learning (WIL) equips lecturers with industry skills and experience necessary for effective teaching and learning. Most TVET lecturers in South Africa lack industry experience. There is a lacuna of research as lecturers’ industry opportunities and challenges are not much researched. This study aims to explore the opportunities gained by lecturers through WIL and reflect on the challenges encountered in industry. The qualitative study adopted an interpretive paradigm and employed face-to-face semi-structured interviews to generate data from twenty-seven participants (18 lecturers and 9 industry personnel) in KwaZulu-Natal province, South Africa. Purposive sampling focused on characteristics of the lecturer population of interest, which was considered information-rich to answer the research questions. Mechanical industry personnel hosted lecturers and were considered information-rich. This study employed Kolb’s experiential learning theory, which was complemented by Shulman’s framework on domains of teacher knowledge. Data were analysed thematically from transcriptions, identifying patterns, coding, developing themes, juxtaposing the relationships amongst the different themes, and developing an interpretation of meaning. Findings revealed that lecturers acquired industry experience through exposure to the latest machines, technology processes and practices, and networking with artisans. Challenges included a lack of supervision and support from industry personnel and college, a lack of hands-on engagement with expensive machinery and weak industry induction processes. This study recommends an embedded WIL component in the training of TVET lecturers to ensure their competency. Some crucial issues are highlighted in this study which can improve TVET delivery and the livelihood of citizens.

The association of cervical cancer screening and quality of care: A systematic analysis of the Global Burden of Disease Study 2019.

Improving the quality of care is vital to enhance outcomes for cervical cancer patients. However, the inequality of cervical cancer care was seldomly assessed. We collected the data of cervical cancer burden from the Global Burden of Disease 2019 database, and constructed the Quality of Care Index (QCI) using principle component analysis. Then the disparity of QCI across regions and populations were evaluated. The association between cervical cancer screening coverage and QCI weas also explored. Quality of cervical cancer care was of disparity across regions with different development levels, with a widening gap between low-income regions and others. Cervical cancer QCI dropped rapidly after the age of 35. Cervical cancer screening coverage was positively associated with QCI, and this association was stronger in countries with low- and middle-development levels. Regions with a low development level and the middle-aged women were vulnerable in QCI improvement. Higher screening coverage was associated with better cervical cancer QCI, implying that expanding cervical cancer screening coverage may be an effective strategy to improve the quality of cervical cancer care.

Graduation is not the end, it is just the beginning: Change in perceived employability in the transition associated with graduation

Graduate employability has attracted considerable attention, unsurprisingly so: The transition associated with graduation presents a series of strong events, that is likely to produce change in employability. We focus on perceived employability (i.e., the individual's appraisal of available employment opportunities). Change in perceived employability in the transition after graduation is sometimes hinted at, yet seldom tested: Positive change is expected, based on the idea that employability-enhancement in university broadens employment opportunities. While this may be true on average, there could be heterogeneity. In response, we tested heterogeneous change in perceived employability among university graduates using a longitudinal three-wave design and among three cohorts of graduates (N2016 = 581; N2017 = 547; N2020 = 339). The pattern of results is as follows. First, perceived employability on average increased after graduation, and in the same way in the three cohorts. Second, change is heterogeneous along three change profiles: one profile perceives themselves as highly employable at the start and becomes slightly more employable (49.6 %), a second profile starts at medium levels and also becomes more employable (38.1 %), and a third profile starts at lower levels and remains stable (12.3 %), with a widening gap with the other profiles over time. Third, profiles were similar across cohorts: Our findings are not sample-specific and thus robust. Fourth, the profiles are connected to labor market outcomes (employment status, job satisfaction, education-job fit). These findings are novel to the employability field in terms of unravelling heterogeneous dynamics, and its replication attests to the robustness of the findings.

Analysis of Selected Macroeconomic Variables and Property Development in Kwara State, Nigeria: Implications on Investment Decisions

The widening gap between housing need and supply has created a void for private developers to fill in housing delivery in Nigeria. However, the uncertainty and instability of the economy across countries of the world as indicated by macroeconomic variables appears very important to be considered. Thus, the study's objective was to evaluate the effect of macroeconomic variables on private residential property development in Ilorin, Kwara state, Nigeria, for investment decision making. This study focused on three macroeconomic variables which include GDP, Interest rate and Inflation rate.&#x0D; The research utilized both primary and secondary data. The primary data were collected via structured questionnaires administered on Real Estate Development Association Practitioners (REDAN) in Ilorin, Kwara State. The secondary data which include GDP, Interest rate and Inflation rate from 2010 to 2020 was also obtained from the Central Bank of Nigeria (CBN) and Nigeria Bureau of Statistics (NBS). The information obtained were analyzed using Trend analysis and multiple regressions. Trend analysis aimed at projecting macroeconomic movement from 2010 to 2030, while the multiple regressions was used to investigate the effects of macroeconomic variables on private housing development in Ilorin Metropolis.&#x0D; The result of the analysis revealed among others that macroeconomic variables affect property development as they show significant effect on private residential property development with GDP producing positive significant effect on residential property development, while interest rate and inflation rate have negative significant effect on property development.&#x0D; Therefore, this study recommends that real estate investors in Ilorin metropolis should consider the macroeconomic environment, and evaluate their risk exposure to make informed investment decisions.

Innovative approaches to the advanced training of agricultural specialists in the system of continuing education (on the example of the Tomsk region agroindustrial complex)

Introduction. Agrarian education is currently a difficult area of the branch educational sector, at the same time departmental dissociation of branch educational institutions and professional educational institutions of the Ministry of Education and Science of the Russian Federation only complicates their interaction at all levels and stages of the process of continuous training of specialists. The growing pace of revolutionary changes in production technology in the modern economy leads to a widening gap between the requirements of employers and qualifications (primarily in terms of their practical component) of graduates of educational institutions and working citizens. In this context, the position on developing an integrated educational cluster model for quality and continuous training of specialists in Tomsk region is relevant. Purpose setting. The aim of the article is to investigate approaches to the training of agricultural specialists in Tomsk region to solve the problem of continuing education of personnel and declare to the scientific and pedagogical community, business structures and the apparatus of power about the feasibility of creating and implementing a technological system of advanced training of agricultural personnel in Tomsk region. Methodology and methods of the study. Methods of theoretical analysis of relevant scientific literature, program and official legal documents on education development, works on the problem of advanced training were used. Results. The principles of lifelong learning and advanced professional training of personnel are considered in terms of social and economic relevance. The concept of creating a regional educational ecosystem for advanced training of agricultural specialists with the competences of the XXI century as a model of integrated educational space was proposed. Developed model takes into account principles and main priorities of innovative approach to training of agricultural specialists at all levels. Conclusion. Educational ecosystem will meet the relevant needs of all participants of relations in the sphere of lifelong learning: schoolchildren, students, adults, institutions engaged in educational activities and teaching staff, employers and their associations, agrarian business institutions, local self-government bodies.

COVID-19 Vaccine Hesitancy and Implications for Economic Recovery: Evidence from Nelson Mandela Bay Municipality in South Africa.

The phenomenon of vaccine hesitancy is a growing threat to public health with far-reaching implications. The widening gap between the vaccinated and the proportion of vaccinated people needed for herd immunity raises two critical research questions that are of interest to practitioners, researchers, and policymakers: (1) What determines one's decision to be vaccinated? (2) What is the implication of COVID-19 vaccine hesitancy for economic recovery? In this study, we use empirical data in the context of South Africa to investigate factors affecting COVID-19 vaccine hesitancy and their implications for economic recovery. Findings reveal key socio-demographic and institutional drivers of COVID-19 vaccine hesitancy, which include age (the youth are more hesitant), inadequate information on the vaccine (those who perceive they have adequate information are vaccinated), trust issues in government institutions, conspiracy beliefs, vaccine-related factors, and perceived side effects associated with the vaccine. Additionally, an individual's decision to remain hesitant about COVID-19 vaccination has implications for businesses and the economy by limiting movement and trade, increasing unemployment, and causing a resurgence of new variants. Based on the findings, action plans such as information dissemination, convenience vaccination centers, consistent communications, and targeted campaign strategies are recommended for improving vaccine uptake and a positive economic recovery.