Residents Of Zone Research Articles

Awareness Over Knowledge: An Exploratory Study on a Refugee Crisis Game

Background Migration crises, caused by conflicts, climate change, or economic decline, have been major drivers of social transitions in recent years, leading to significant changes in attitudes and policies toward refugees and migrants. In this context, serious games have emerged as a powerful tool for promoting awareness and understanding of the challenges faced by refugees. Objectives In this paper, we present the quantitative outcomes of a research project The People: a serious game to represent the complexity of the migration crisis on the Polish-Belarusian border. In the research, we explored how playing a serious game has impacted the affective, cognitive, and behavioural components of attitudes of 69 participants in light of the perception of the humanitarian crisis. Methods In the game, participants took on roles of migration crisis zone residents. We designed a quasi-experiment with pre-post surveys and observations of participants’ behaviour. We conducted statistical tests to confirm the effect of the simulation game on the attitudes towards asylum seekers and residents at the Polish-Belarusian border – at least at the declarative level. Results The game has improved participants’ willingness to mitigate the refugee crisis as well as the level of positive attitudes towards refugees – and knowledge regarding the situation of the inhabitants of the border area. Interestingly, the improved knowledge of refugees’ situation was not statistically significant, so despite the limited familiarity with refugees’ perspectives, the newly gained social awareness and comprehension of the migration crisis reinforced positive attitudes and agency for social change. Limitations and further research The participants were mostly from big cities and top high schools. Playing the game in rural areas, or among students without an interest in education could impact the outcomes. Creating a control group and expanding the sample is recommended to verify the role of the game per se as a transformative means.

Follow-up study on screening for early colorectal cancer in Shipai, Dongguan City, China

Objective: To examine follow-up data of different subgroups in order to further evaluate the performance and practical value of community colorectal cancer screening by detection of stool methylation syndecan-2 gene (mSDC2) among residents of Shipai Town, Dongguan City. Methods: This was an observational study. From May 2021 to February 2022, the Shipai Town government of Dongguan City completed screening for colorectal cancer by detection of stool mSDC2 in 10,708 residents from 18 villages who had met the initial screening criteria and been selected using whole population sampling. From May 2022 to February 2023, the research group conducted follow-up of participants about one year after the initial screening. Residents in the gray zone according to the initial screening were followed up by colonoscopy. Additionally, 1,000 residents with negative results on the initial screening were randomly sampled to undergo colonoscopy. Stool mSDC2 detection was performed again on residents who had had positive results on the initial screening, and colonoscopy was performed on those who again tested positive. Compliance with colonoscopy and detection of gastrointestinal lesions during follow-up were assessed in different subgroups. Results: Of the 438 residents in the gray zone on the initial screening, 155 underwent colonoscopy follow-up (colonoscopy compliance rate 35.4% [155/438]). These colonoscopies revealed that 27 (17.4%) of the participants had gastrointestinal lesions, including advanced adenomas in 22 cases (14.2%) and non-adenomatous polyps in two cases (3.2%). No colorectal carcinomas was identified. Of the 1, 000 randomly sampled residents with negative results on initial screening, 286 underwent colonoscopy follow-up (colonoscopy compliance rate 28.6% [286/1000]), These colonoscopies revealed that 11 (3.8%)of these individuals had gastrointestinal lesions, including three advanced adenomas (1.0%), five non-advanced adenomas (1.7%), one serrated adenoma or polyp (0.3%), and two non-adenomatous polyps (0.7%), but no colorectal carcinomas. Of the 821 residents who tested positive in the initial screening, 511 again underwent stool mSDC2 detection one year later (follow-up rate 62.2% [511/821]). Of these participants, 66 tested positive again (rate of 12.9% [66/511]), 39 (7.6%) of them in the gray zone, whereas 406(79.5%) tested negative. Forty-seven of the residents with positive results underwent colonoscopy (colonoscopy compliance rate 71.2% [47/66]), which revealed 36 (76.6%) gastrointestinal lesions, including 10 advanced adenomas (21.3%), nine non-advanced adenomas (19.1%) and 17 non-adenomatous polyps (36.2%). Conclusion: Stool mSDC2 detection performs well as a screening tool. In our study, colorectal cancer or precancerous lesions were extremely rare in participants who tested negative on the initial screening. However, some of the participants who tested in the gray zone on initial screening had precancerous colorectal lesions, particularly advanced adenomas, which would have been missed without follow-up colonoscopy. Of note, stool mSDC2 detection has good follow-up value in individuals who test positive on initial screening.

Public perceptions of nature-based coastal solutions in the UK

Coastal scientists are increasingly advocating for nature-based coastal solutions (NBCS) to ensure long-term coastal sustainability. Implementing NBCS will change coastal landscapes, necessitating consultation with the wider public as such changes directly affect the socio-cultural values of coastal zone residents and users. We, therefore, investigate public willingness to support, preferences for, and perceived effectiveness of coastal management solutions, nature-based and otherwise, focusing on the UK as a case study. We do this through an online survey of >500 UK residents, capturing their demographics, place of residence, and coastal management perceptions. We apply inductive coding, statistical, and geospatial techniques to analyse our survey data. While we find consensus on the need for coastal management, there are divergent coastal management preferences and perceptions: NBCS are most preferred while hard defences are considered most effective. We find that people with coastal management and/or engineering experience are more convinced by NBCS effectiveness, while coastal residents believe in hard defences. Although NBCS may have several environmental benefits (e.g., coastal protection, carbon sequestration, greater biodiversity), we find that public knowledge on their likely effectiveness is limited. Therefore, if NBCS is deemed to be the way forward for coastal sustainability, more local stakeholder engagement on NBCS will be needed, potentially through systems mapping, in order to facilitate more robust and inclusive coastal management policies.

Blue Zone Loma Linda: Assessing the Relationship Between Lifestyle and Oral Health.

Objectives: Assess the relationship between lifestyle and oral health-related quality-of-life (OHRQoL) of residents in a blue zone, Loma Linda. Methods: A cross-sectional study was conducted using a questionnaire including demographics, lifestyle, and Oral Health Impact Profile (OHIP-14). Lifestyle cumulative scores ranged from 8-32, lower scores indicating greater conformity to Power 9® lifestyle, characterized by observing Sabbath, time with friends, volunteering, exercising, eating lots of plants, eating meat in moderation, drinking a lot of water, snacking on nuts, and eating an early dinner. OHIP-14 assessed OHRQoL, with scores from 0-56. Negative binomial regression was used, with significance of alpha = 0.05. Results: A total of 350 surveys were collected. Cumulative lifestyle showed a mean of 13.9. Spending time with friends was the most adhered to activity (96%) while the least followed was having early dinners (71.2%). Asians (Mean = 14.2) had significantly higher lifestyle scores than Whites (Mean = 13.7). The mean OHIP-14 was 7.01. Whites had lower OHIP-14 scores than Asians, indicating better OHRQoL. Race, nut consumption and exercise were significant predictors for increased OHRQoL (P < 0.05, in all instances). Conclusions: Loma Linda residents adhere well to the Power 9® lifestyle. There are significant predictors such as nut consumption and exercise for increased OHRQoL.

Characteristics of the Gut Microbiota Composition of the Arctic Zone Residents in the Far Eastern Region.

Background. In many studies over the past decade, scientists have made a connection between the composition of gut microbiota and human health. A number of publications have shown that gut bacteria are involved in many metabolic and physiological processes of the organism. The composition of the gut microbiome is unique for each person and is formed under the influence of various factors associated with both the individual characteristics of the body and the characteristics of the environment. Different regional characteristics make it necessary for the body to adapt to certain conditions, including temperature fluctuations. Living in areas with low temperatures, such as the Arctic zone, dictates the need for increased energy consumption, which affects the composition of the gut microbiome. Methods. In our study, an extensive questionnaire was conducted among the participants, where many questions were included about the dietary preferences of the study participants, which allowed them us to further divide them into groups according to their diets. Stool samples were collected from participants from 3 groups: Arctic native, Arctic newcomer and the control group. The next step was the isolation of bacterial DNA and sequencing the 16S rRNA gene. The analysis of the results of the diversity of the intestinal microbiota was carried out both with and without taking into account the dietary preferences of the participants. Results. As a result of comparing the intestinal microbiota obtained from residents of the Arctic zone with the gut microbiota of residents of other regions with a milder climate, significant differences are found. These differences may be related to limited food resources and a reduction in the variety of food products characteristic of this Arctic region. t was also found that representatives of the bacterial families Christensenellaceae and Muribaculaceae dominated the control group, both with traditional nutrition and with a dairy-free diet in comparison with the Arctic groups. The control group was dominated by representatives of the Prevotellaceae, Enterobacteriaceae and Comamonadaceae families compared to the Arctic group (with a traditional diet). The results also show that the number of representatives of the families Desulfovibrionaceae (with traditional diet) and Enterobacteriaceae (with milk-free diet) is growing in the Arctic group. Conclusions. In the course of this work, bacterial families characteristic of people living in the Arc-tic zone of the Far Eastern region of the Russian Federation were identified. Poor diet, difficult climatic conditions, and problems with logistics and medical care can have a strong impact on the health of this population. The main type of diet for the inhabitants of the Arctic is the traditional type of diet. They consume a large number of low-cost products, obtainget animal protein from poultry and canned food, and also eat a small number of fresh vegetables and fruits. Such a diet is due to the social status of the study participants and the climatic and geographical features of the region (difficulties in agriculture). With such a diet, we observe a decrease in representatives of the Christensenellaceae, Muribaculaceae, Eubacteriaceae, and Prevotellaceae families and an increase in representatives of the Enterobacteriaceae and Desulfovibrionaceae families among Arctic residents. This imbalance in the futuremay cause, this population may to develop various diseases in the future, including chronic diseases such as obesity, intestinal dysbiosis, inflammatory bowel diseases, and type 2 diabetes.

Textiles from the Ust-Voikary Hillfort Site (Based on Materials from 2012–2016 Excavations)

The article describes 366 samples of clothing (some of them attributable), collected in 2012–2016 from cultural layers of the 15th to middle 18th centuries at the Ust-Voikary hillfort site in the subarctic zone of Western Siberia. We provide technological characteristics: size, state of preservation, color, properties of threads and fibers, interlacing system, technological errors, cut, and traces of repair. Both animal and plant fibers are present, and plain and twill weaving are attested. Ethnographic and zoological data provide information on the textile technologies used by residents of the polar zone of Western Siberia, and allow us to compare them with those known from other sites. We conclude that types of textiles for clothing remained virtually the same from the 15th to the 18th centuries. Fabrics, mostly woolen, were imported.

Возрастные особенности депрессии у жителей Арктической зоны

&lt;p&gt;The study aims to investigate the age-related characteristics of depression among residents of the Arctic zone, considering gender and the period of data collection. This cross-sectional study utilized data collected as part of the Cardiovascular Disease Project (N=2380). Study participants were randomly selected using stratified sampling based on age and gender. Depression was assessed using the PHQ-9 depression scale, which consists of 9 questions based on the DSM-IV diagnostic criteria for depression, asking about the patient's experiences over the past 2 weeks. In the course of studying the age-related characteristics of depression among residents of the Arctic zone, it was found that certain symptoms of depression are more prevalent in young people; however, the chance of moderate to severe depression is significantly higher in older women.&lt;/p&gt;

Health-promoting behavior and its determinants towards non-communicable diseases among adult residents of the Gedeo zone, South Ethiopia: the application of the health belief model.

Non-communicable diseases are becoming a challenge for the health care system in Ethiopia, which has suffered a double burden from infectious and rapidly increasing non-communicable diseases. However, there is little information on health-promoting behavior in the study settings. Thus, the purpose of this study was to determine health-promoting behaviors and its associated factors among adult's residents of Gedeo zone. A cross-sectional study was conducted among 705 adult residents of Gedeo zone, south Ethiopia, selected using a multi-stage sampling technique. Interviews administered through a structured questionnaire were used to collect the data. The data were entered using Kobo Collect and analyzed using Stata version 17. The baseline characteristics of the participants were summarized using descriptive statistics. The independent sample t-test and one-way ANOVA were used to compare two groups and more than two groups, respectively. Stepwise multiple linear regression analysis was used to identify the potential determinants of health-promoting behavior and its components. Statistically significant factors were declared at p-value of less than or equal to 0.05. The overall means score for health-promoting behavior was 73.88 ± 16.79. Physical activity and spiritual growth had the lowest and highest mean scores, respectively. The variables: gender, marital status, education, family history of NCDs, health insurance status, perceived health status, knowledge of NCD risk factors, risk perception of NCDs, expected outcome, cues to action, and self-efficacy showed a statistically significant difference in overall health-promoting behavior. The total health-promoting behavior score was associated with age, gender, perceived health status, marital status, family history of NCDs, health insurance, knowledge of NCD risk factors, perceived threat, expected outcome, self-efficacy, and cues to action. In the study, the mean score of health-promoting behaviors was low. Socio-demographic and economic variables, family history of NCD, perceived health status, knowledge of NCD risk factors, perceived threat, expected outcome, self-efficacy, and cues to action affect health-promoting behaviors. Therefore, the study suggests establishing health promotion programs to increase residents' awareness of health-promoting lifestyles, empower them to adopt healthy lifestyles, and improve health outcomes by increasing self-efficacy, providing education, and creating supportive environments.

Clinical Assessment of Injuries Inflicted with the Use of Firearms of Limited Destruction to Residents of the Arctic Zone of the Arkhangelsk region, 2006–2022

Clinical Assessment of Injuries Inflicted with the Use of Firearms of Limited Destruction to Residents of the Arctic Zone of the Arkhangelsk region, 2006–2022

Comparative awareness on zoonoses between residents at the Human-wildlife Interface Zone and inhabitants of the non-wildlife areas of Meru County, Kenya

Abstract Introduction: Zoonoses are infections transmitted from vertebrate animals to humans. Persons with low knowledge, exposure to wildlife or domestic animals are at risk of zoonoses. Research, surveillance and response through One Health framework is necessary for prevention. We compared the knowledge on zoonoses between residents at the wildlife-interface of Meru National Park, and non-wildlife areas of Tigania West Sub County, Meru Kenya. Methods: Data were simultaneously collected using a structured questionnaire in both zones and compared. Descriptive statistics were used to summarize the data for differences between variables in the two areas.Results: The non-wildlife zone residents of Tigania West Sub-County had statistically significantly better knowledge of zoonoses than their counterparts next to Meru National Park: χ² (1, N=525) =84.965, p&lt; .001. Conclusion: The scanty knowledge on zoonoses of residents of Igembe Central posed greater risk of zoonoses because their proximity to the wildlife conservancy. Awareness creation through one health strategy is necessary as a deterrent measure.

Domestic violence against women during COVID-19 pandemic and its associated factors among Bench Sheko zone, southwest Ethiopia

PurposeDomestic violence is an intimate relationship that causes physical, sexual or mental suffering. The ongoing coronavirus pandemic has had a ruinous effect globally, particularly in increasing the rate of domestic violence. Thus, this study aims to assess the prevalence of domestic violence against women during the COVID-19 pandemic and its associated factors.Design/methodology/approachA community-based cross-sectional study was conducted on Bench Sheko Zone residents from May to June 2021. Participants in the study were selected by multistage sampling technique. The collected data were coded, entered into EpiData 3.1 and analyzed by using SPSS version 20. Bi-variable and multiple logistic regression analysis models were fitted. Odds ratio was used at a 95% confidence level, and P-value < 0.05 was used to declare statistical significance.FindingsA total of 1,512 eligible women participated, with a 98.3% response rate. The proportion of domestic violence against women was 42.5%. The prevalence of psychological violence was 30.4%, followed by physical violence at 20.2% and sexual violence accounted for 9.6%. Variables, such as rural residency, women with no formal education, partner who had no formal education, women with monthly income of less than 25,00 Ethiopian birr and partner who was current substance user, were found to be associated with domestic violence against women.Practical implicationsDomestic violence against women is still an important public health problem in Ethiopia. Special attention should be paid to identified predictors to reduce domestic violence beyond designing prevention and control strategies along with coronavirus pandemic intervention plan.Originality/valueThe findings of this study show domestic violence against women is still an important public health problem in Ethiopia. Special attention should be paid to identified predictors to reduce domestic violence beyond designing prevention and control strategies, along with the coronavirus pandemic intervention plan.

Защита интересов резидентов Арктической зоны

The article deals with the problem of determining applicable methods and procedural forms for protecting the rights and legitimate interests of residents of the Arctic zone. It is concluded that the residents of the Arctic enter into both private and public law relations. The public law nature of disputed material legal relations is determined by the participation of public authorities in them, as well as the management company as an entity exercising public powers in relation to residents of the Arctic zone. Private law disputes involving Arctic residents can be referred to arbitration courts (arbitration). It is proposed to provide for the mandatory participation of the prosecutor in cases of a public law nature with the participation of residents of the Arctic. It is expedient to establish a mandatory pre-trial procedure for settling disputes involving residents of the Arctic.

Communities of Care Approach: Developing a Place-based Model of Care and Building Partnerships in the Communities in Central Singapore.

The population in Singapore is ageing, adding pressure to community care as the health and social needs of its residents increase. This has accelerated the pace at which Regional Health Systems adopt and deliver its population health strategies from early prevention, chronic disease management, crisis care to end-of-life care. To this end, the Central Health Integrated Care Network (ICN) began its journey to develop Communities of Care (CoCs) with other health and social care partners to meet the needs of residents in the Central Zone of Singapore. This paper describes the processes and steps taken by Central Health ICN to build partnerships with other agencies and organisations to build place-based models of care in the local neighbourhoods. The faciliating factors and the barriers faced in the implementation of CoCs were described to allow sharing of such learnings on large scale change. Strategies in overcoming some of the challenges were also presented to demonstrate the iterative processes required in building integrated place-based models of care to meet the needs of the residents in different communities.

Emergency medicine residents in the war zone: organizing humanitarian expeditions to train healthcare personnel during the conflict in Ukraine

Dear Editor, When faced with a crisis, particularly when it involves humanitarian aid, emergency medicine (EM) practitioners push themselves to question, “How can we help?” and “To the best of our knowledge and skills, what can we truly do?”. The mindset of EM personnel is presumably one of "How can I help in these situations?" and, more crucially, "How can I help the most effectively?". To answer these questions, we present our experience in Ukraine. [...]

Diversity of Fish and Decapod Fry in the Coastal Zone of Amvrakikos Gulf

Amvrakikos Gulf and its surrounding coastal lagoons are of primary importance for the local biodiversity and fishing activities. Fish species inhabited the coastal lagoons based on the seasonal ongoing migration movements of fry and adult fish individuals from the sea towards the lagoons. Information on the early stages of fish and decapod species in the Amvrakikos Gulf is limited only to the planktonic ontogenetic stages and reproduction biology, respectively. The aim of this study was to describe the spatial distribution of fry from commercially important fish and decapod species in the coastal zone of Amvrakikos Gulf. The seasonal appearance of the early stage of the most commercially important fish species caught in the coastal zone of the gulf ranged from one to four seasons, depending on the species. Individuals of all ontogenetic stages (fry, juveniles, and adults) were reported for several species (A. boyeri, A. fasciatus, S. abaster, S. tyfle, and B. ocellaris), indicating that these species may be regarded as residents in the coastal zone, providing habitats for their entire life cycle. The average relative abundance of the species/genera exhibited no differences compared to other Greek brackish waters. The species composition in the Amvrakikos Gulf at 10 cm and above was in agreement with the transitional nature of the area, with permanent and occasional species present. The present study emphasizes the importance of the coastal zone as a nursery habitat for commercially important species.

Ретроспективний аналіз каріозного ураження твердих тканин зубів у дітей з радіаційно забруднених унаслідок аварії на Чорнобильській АЕС територій України

The relevance of the study is due to the presence of significant carious lesions of the hard tissues of the teeth in children from radiation-contaminated territories as a result of the accident at the Chornobyl nuclear power plant (ChNPP). Purpose - to conduct a retrospective analysis of the intensity of dental caries in children of Ukraine, residents of radiation-contaminated territories, taking into account the general state of health at different times after the accident at the ChNPP (1993-1996, 2001-2003, 2016-2018) as a basis for the further development of a complex of therapeutic and preventive measures for this pathology. Materials and methods. The object of the study: 1852 children aged 7-15 - residents of territories contaminated with radionuclides. Assessment of caries intensity of permanent teeth in accordance with WHO recommendations (2013) included determination of caries prevalence and index assessment of caries intensity of permanent teeth (PT): «decayed, missing, filled permanent teeth» (DMFT) and «decayed, missing, filled permanent teeth surfaces» (DMFS). Statistical processing of data was carried out using methods of variational statistics (statistical package «IBM SPSS Statistics 20.0.0»). Results. In 1993-1996 irradiated children from the III zone had a very high intensity of dental caries (DMFT - 7.25±0.77, DMFS - 10.92±1.77), twice as high compared to residents of the IV zone. In children from III and IV zones in 2001-2003 the intensity of dental caries was higher in the presence of somatic pathology. In 2016-2018 compared to the period 2001-2003 there was a significant (p&lt;0.05) decrease in both indices of carious lesions, probably due to a decrease in the degree of exposure of children to radionuclides. Conclusions. During the period 1993-1996 the highest rates of dental caries intensity were determined in 15-year-old children from zone III compared to residents of zone IV. The intensity of dental caries during the periods of 2001-2003 and 2016-2018 decreased, although it remained at a high level, which requires the further development of a complex of treatment and prevention measures for this pathology. The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of the children's parents was obtained for the research. The authors declare no conflict of interests.

Implementation of the biomonitoring system in large scientific expeditions on the example of the scientific and educational project "Arctic Floating University"

Currently, biomonitoring research is actively developing in the Arctic region, despite this, groups of people who temporarily come to the Arctic remain outside the national monitoring system, unlike the local population. Participation in expeditions on ships implies special living conditions, such as limited space, sensory deprivation. The study aims to analyse the biochemical parameters of blood, the content of essential, toxic elements, persistent organic pollutants (POPs) and vitamin D in samples of the expedition group temporarily coming to work in extreme Arctic conditions. Scientists carried out a study on board the Mikhail Somov scientific expedition vessel as part of the Arctic Floating University project. The participants were 50 people: 26 men and 24 women aged 20 to 72 years. As a result of the analysis, the authors have determined: 8 biochemical blood parameters, vitamin D levels by high-performance liquid chromatography with tandem mass spectrometric detection, the content of essential (Co, Mn, Se, Cu, Zn), toxic elements (As, Cd, Hg, Pb) using an inductively coupled plasma mass spectrometer and POPs by gas chromatography-mass spectrometry. Almost 90% of the expedition participants had vitamin D concentrations below 20 ng/ml, which indicates a deficiency of this vitamin in the body. After conducting a comparative analysis between the expedition group and the permanent population of the Nenets Autonomous Okrug (NAO), it was found that the expedition group significantly reduced the content of not only toxic compounds (As, Cd, Hg, Pb, POPs), but also essential elements (Co, Mn, Se, Cu, Zn), according to compared to the local population. It is worth noting that the concentration of arsenic in the expedition group is 65 times lower (0.12 µg/L) than in permanent residents of the Arctic zone of the Russian Federation (7.29 µg/L), and the concentration of lead in the group of expedition workers was 42 times lower (0.30 µg/L) than in the local population (15.21 µg/L). The data obtained provide information about the elementary and toxic status of the urban population of the Russian Federation. One of the reasons for such differences may be the predominantly traditional lifestyle of the local NAO population and the biomagnification of toxic substances in food chains. If biomonitoring studies are carried out by specialists on an ongoing basis and the data obtained is accumulated, then a basis may appear for predicting risks of both a short-term and long-term nature. The conducted research contributes to the expansion of the biomonitoring system at the national level.

Determinants of Open Defecation Among Rural Women in Ghana: Analysis of Demographic and Health Surveys.

Open defecation continuously remains a major global sanitation challenge, contributing to an estimated 1.6 million deaths per year. Ghana ranks second in Africa for open defecation and had the fourth-lowest sanitation coverage in 2010. Evidence indicates that about 32% of the rural Ghanaian population still practice open defecation due to lack of access to basic sanitation facilities, drifting the country from achieving universal access to sanitation by 2030. Women, particularly those in rural areas, are disproportionately affected by open defecation, facing heightened health risks, harassment, and a loss of dignity. Even though previous studies on open defecation in Ghana exist, they lack national representation and neglect women in rural residents who are disproportionally affected by the repercussions of open defecation. Examining that rural women will contribute to heightening their own vulnerability to health risks by practising open defecation is essential to bridging the literature gap on open defecation practices among rural women. The study investigated determinants of open defecation among rural women in Ghana using data from the female files of the 2003, 2008 and 2014 Demographic and Health Surveys (DHS). A total of 4,284 rural women with complete information on variables of interest were included in the study. The outcome variable was 'open defecation', whilst 14 key explanatory variables (e.g., age, education, wealth status, among others) were used. Two logistic regression models were built, and the outputs were reported in odds ratio. Descriptively, 42 in every 100 women aged 15 to 49 practiced open defecation (n = 1811, 95% CI = 49-52). Open defecation (OD) significantly correlated with educational attainment, wealth status, religion, access to mass media, partner's education, and zone of residence. The likelihood of practicing open defecation reduced among those with formal education [aOR = 0.69, CI = 0.56-0.85], those whose partners had formal education [aOR = 0.64, CI = 0.52-0.80], women in the rich wealth quintile [aOR = 0.12, CI = 0.07-0.20], the traditionalist [aOR = 0.33, CI = 0.19-0.57], and those who had access to mass media [aOR = 0.70, CI = 0.57-0.85]. Residents in the Savannah zone had higher odds of openly defecating [aOR = 21.06, CI = 15.97-27.77]. The prevalence of open defecation is disproportionately pro-poor, which indicates that impoverished rural women are more likely to perform it. Public health initiatives should aim to close the rich-poor divide in OD practice among rural women.

Роль офсетных контрактов в развитии механизмов государственно-частного партнерства

An offset contract implies a government contract that assumes the existence of counter investment obligations, both on the part of the investor and on the part of the state. The investor assumes responsibility for the creation or modernization of production on the territory of the Russian Federation, and the state, in turn, creates attractive conditions for doing business. From the meaning and content of the offset contract, it can be considered as a manifestation of the mechanism of public-private partnership, which finds its expression as a result of the interaction of the subject of the Russian Federation and the supplier-investor. Offset contracts represent a promising and beneficial mechanism for both sides of interaction, which allows us to focus on long-term cooperation, which entails the creation of new production facilities on the territory of the constituent entities of the Russian Federation, as a result, jobs, and an increase in tax revenues. The urgency of a detailed study of the offset contract mechanism is conditioned by the possibility of implementing the plans of the Government of the Russian Federation to localize the production of technically complex products and increase the pace of import substitution under international sanctions. The study presents the advantages of an offset contract in comparison with other investment attraction tools and options for its adaptation in the Kursk region.&#x0D; The purpose to study the role of offset contracts in the development of public-private partnership mechanisms and summarize ideas about the future prospects of its implementation in the mechanism of attracting investment in the regions.&#x0D; Objectives: to form an idea of the concept and essence of an offset contract, to identify promising areas for the development of offset contracts, to form proposals for improving the stages of concluding an offset contract, to substantiate proposals for the further development and adaptation of this tool in the mechanism of attracting investment to the region.&#x0D; Methodology. In the process of studying the subject under consideration, such methods as analysis, synthesis, generalization, logical, as well as graphical methods of information processing were used. &#x0D; Results. The offset contract should be considered as a mechanism for the implementation of public-private partnership, since it meets the set of features inherent in it (attracting an investor on the terms of long-term interaction, the state acts as one of the parties, there is a possibility of exceeding the limits of budget allocations). The obligations of the parties are reciprocal and imply continuous interaction throughout the implementation period. The offset contract has significant advantages for both private and public parties, however, in fact offset contracts have practically not been distributed on the territory of the subjects of the Russian Federation, which is due to the similarity of offset contracts with other mechanisms of public-private partnership.&#x0D; Conclusions. It is proposed to revise the classic procedure for concluding an offset contract, consisting of the sequential execution of stages and expand them to include assistance in site selection and assistance in the implementation of the contract with the help of tax incentives, subsidies and infrastructure development. On the example of the Kursk region, the investment component was analyzed, creating the "soil", the foundation for the development of offset contracts. We have formed proposals to stimulate the conclusion of investment contracts in the region by differentiating tax benefits for residents of the special economic zone "Third Pole" who have concluded an offset contract in the Kursk region.

Development and Evaluation of a Novel Population Needs-Based Sub-Segmentation Model (NBSSM) in Singapore

Background: Population segmentation models are often used to stratify people into groups for care or services planning purposes. These are typically disease-specific or utilisation-based, and target high-risk patient groups. Singapore’s National Health Group (NHG) has developed a River of Life (RoL) segmentation approach stratifying its population into five segments, namely, Living Well, Living with Illness, Crisis and Complex Care, Living with Frailty and Leaving Well. Building on this approach, Yishun Health (YH), a Regional Population Health System under NHG caring for more than 300,000 residents in Northern Singapore, developed the Needs-Based Sub-Segmentation Model (NBSSM) to further stratify Yishun Zone residents who are living with illness and frailty using additional biological, psychological and social criteria. We evaluated the NBSSM’s ability to stratify residents into distinct risk-groups based on a set of person-centred outcomes.&#x0D; Methods: Yishun Zone residents with chronic illness and/or frailty were first identified to generate ‘Living with Illness’ and ‘Living with Frailty’ groups. These residents were further segmented into 10 sub-segments representing different needs and complexity levels, based on biological complexity i.e. number and severity of chronic diseases, as well as presence or absence of psychosocial criteria i.e. presence of mental illness and social issues.&#x0D; To evaluate the NBSSM, we studied its ability to stratify residents into distinct risk-groups using Charlson’s Comorbidity Index (CCI) scores as well as person-centred outcomes such as healthcare utilisation, and healthcare cost. Statistical distinction between NBSSM segments based on the above outcomes was also tested. Data from a Population Health Survey being conducted by YH, which included health behaviours and more detailed mental and social needs data, will next be integrated into the NBSSM to forecast the needs under each sub-segments to enable services planning for segment-specific interventions. &#x0D; Results: All 314,522 Yishun Zone residents were included for RoL segmentation, of which 53,653 residents known to YH were further sub-segmented by the NBSSM according to their biopsychosocial needs. CCI, healthcare utilisation (i.e. number of Emergency Department visits, Specialised Outpatient Clinic visits, admissions and annual bed-days), and annual total healthcare cost were found to be statistically different across the NBSSM segments (p&lt;0.05). Residents with presence of mental health and social issues had significantly higher risk of healthcare utilization and cost.&#x0D; &#x0D; Discussion &amp; Conclusion: Using only data that was readily available data in our electronic medical record system, the NBSSM was able to augment NHG RoL segmentation and effectively sub-segment the Yishun Zone resident population into mutually exclusive and collectively exhaustive groups with similar magnitude of risk of health needs and outcomes. &#x0D; NBSSM enables development of more targeted and aligned clinical governance and leadership of segment-specific interventions through clearer assignment of segment-specific accountability for population outcomes. Integrating comprehensive needs assessment data from the YH Population Health Survey will enable more coherent health system and services planning. &#x0D; In conclusion, needs-based segmentation models are more person-centred than disease-specified or utilization-only segmentation models. NBSSM enhances our health system’s system transformation and service planning capabilities to direct targeted interventions to meet needs and improve population health outcomes.&#x0D;