Climate change induced rising temperatures will pose a detrimental threat to decent health in the coming decades. Especially at risk are individuals with chronic diseases, since heat can exacerbate a ...variety of health conditions. In this article, I examine the heat‐morbidity relationship in the context of Indonesia, focusing on chronic, non‐communicable diseases, namely diabetes, cardiovascular and respiratory diseases. Using a novel dataset from the Indonesian national health insurance scheme Jaminan Kesehatan Nasional/Badan Penyelenggara Jaminan Sosial (BPJS) and linking it with meteorological data on the daily‐district level, I estimate the causal effect of high temperatures on the daily number of primary health care visits. The results show that on a hot day all‐cause visits and visits with a diagnosis of diabetes and cardiovascular diseases increase by 8%, 25% and 14%, respectively. These increases are permanent and not offset by visit displacement or 'harvesting'. Visits related to respiratory diseases seem not to be affected by high temperatures. I use several climate change scenarios to predict the increase in visits and costs by the end of the century, which all forecast a substantial financial burden for the health care system. These results might have relevance for other middle‐income countries with similar climatic conditions.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Abstract
Non-communicable diseases (NCDs), such as diabetes, cancer, cardiovascular diseases and chronic respiratory diseases, have overtaken infectious diseases as the number one cause of death ...worldwide. The rise of these diseases is especially grave in Southeast Asia, where existing research however falls short on offering guidance on how policy can best prevent and control NCDs in the region. Additionally, low- and middle-income countries in Southeast Asia cannot directly incorporate lessons drawn from interventions in richer countries, since health system capacities and human and financial resources are thoroughly different. Preventive interventions, thus, need to correspond to local capacities and require contextual solutions. In this article, we provide a systematic review of a wide scope of NCD interventions conducted in Southeast Asia to inform about existing intervention designs and to derive sound evidence of their effectiveness. Our literature search results in 51 studies from five Southeast Asian countries from which we can extract 204 estimates. We sort the studies into six intervention categories and analyse them with respect to 23 different health and behavioural outcomes. While we find positive and significant average effects across all six types of interventions, we also document evidence of substantial publication bias. Using a meta-regression approach in which we correct for the publication bias, we instead fail to confirm positive average effects for some interventions. Especially dietary and physical activity interventions fail to achieve improvements in analysed health outcomes, while programs focusing on smoking cessation, on the take-up of preventive screening activities or educating patients on how to cope with NCDs achieve sizeable effects. We also present evidence that the size of the effect differs with the participants’ characteristics as well as with design features of the intervention. For local policymakers, the results provide important knowledge on how to address the increasing NCD burden in the coming years.
The Covid-19 pandemic requires a continuous evaluation of whether current policies and measures taken are sufficient to protect vulnerable populations. One quantitative indicator of policy ...effectiveness and pandemic severity is the case fatality ratio, which relies on the lagged number of infections relative to current deaths. The appropriate length of the time lag to be used, however, is heavily debated. In this article, I contribute to this debate by determining the temporal lag between the number of infections and deaths using daily panel data from Germany’s 16 federal states. To account for the dynamic spatial spread of the virus, I rely on different spatial econometric models that allow not only to consider the infections in a given state but also spillover effects through infections in neighboring federal states. My results suggest that a wave of infections within a given state is followed by increasing death rates 12 days later. Yet, if the number of infections in other states rises, the number of death cases within that given state subsequently decreases. The results of this article contribute to the better understanding of the dynamic spatio-temporal spread of the virus in Germany, which is indispensable for the design of effective policy responses.
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EMUNI, FZAB, KILJ, MFDPS, SBMB, SBNM, UKNU, VKSCE
IntroductionNon-communicable diseases (NCDs) have surpassed infectious diseases as the leading global cause of death, with the Southeast Asian region experiencing a significant rise in NCD prevalence ...over the past decades. Despite the escalating burden, screening for NCDs remains at very low levels, resulting in undetected cases, premature mortality and high public healthcare costs. We investigate whether community-based NCD prevention and management programmes are an effective solution.MethodsIn Indonesia, we compare participants in the community-based NCD screening and management programme Pos Pembinaan Terpadu-Penyakit Tidak Menular with matched non-participants with respect to their uptake of screening activities, health-related behaviour and knowledge and metabolic risk factors. We use statistical matching to redress a possible selection bias (n=1669). In Viet Nam, we compare members of Intergenerational Self-Help Clubs, which were offered similar NCD health services, with members of other community groups, where such services were not offered. We can rely on two waves of data and use a double-difference approach to redress a possible selection bias and to measure the impacts of participation (n=1710). We discuss strengths and weaknesses of the two approaches in Indonesia and Viet Nam.ResultsIn Indonesia, participants have significantly higher uptake of screening for hypertension and diabetes (+13% from a control mean of 88% (95% CI 9% to 17%); +93% from a control mean of 48% (95% CI 79% to 108%)). In both countries, participants show a higher knowledge about risk factors, symptoms and complications of NCDs (Indonesia: +0.29 SD (0.13–0.45), Viet Nam: +0.17 SD (0.03–0.30)). Yet, the improved knowledge is only partly reflected in improved health behaviour (Viet Nam: fruit consumption +0.33 SD (0.15–0.51), vegetable consumption +0.27 SD (0.04–0.50)), body mass index (BMI) (Viet Nam: BMI −0.07 SD (−0.13 to −0.00)) or metabolic risk factors (Indonesia: systolic blood pressure: −0.13 SD (−0.26 to −0.00)).ConclusionCommunity-based NCD programmes are well suited to increase screening and to transmit health knowledge. Due to their extensive outreach within the community, they can serve as a valuable complement to the screening services provided at the primary healthcare level. Yet, limited coverage, insufficient resources and a high staff turnover remain a problem.Trial registration numberNCT05239572.
While there is a global consensus that agricultural systems need to be transformed to be more sustainable, possible pathways and challenges to this process are still debated. We analyse the ...challenges and opportunities involved in transforming smallholder farming to organic agriculture in Indonesia, where the intense application of Green Revolution technologies came at enormous environmental costs. We adopt a transdisciplinary approach to identify possible pathways towards organic agriculture, based on an analysis of farmers’ knowledge and barriers to adoption, value and belief systems, and institutional structures, including policies and regulations. We present our empirical findings as ‘system knowledge’, ‘target knowledge’ and ‘transformation knowledge’ and incorporate insights from both academics and practitioners. We draw on evidence from large-scale surveys, field experiments, in-depth interviews, participant observation and document analysis. A key insight of our research is that Indonesia does not lack initiatives towards organic farming, but that these various initiatives have different motivations, goals and strategies. This misalignment detracts from the transformational potential of organic agriculture and is responsible for the hitherto limited success of the organic transition. Our findings suggest that policy action at multiple levels is required, guided by an inclusive strategy that is drawn up in a participatory manner.
Die Krone (Verse 1-12281) Turlin, Heinrich von dem; Knapp, Fritz Peter; Niesner, Manuela
2000, 2000-01-01, Volume:
112
eBook
1852 hat G.H.F. Scholl die bisher einzige Gesamtausgabe des mittelhochdeutschen Artusromans »Die Krone« ( Diu crône ) von ca. 30.000 Versen in Lachmannscher Manier veranstaltet (Nachdruck 1966, ...vergriffen). Hier wird erstmals eine kritische Edition nach dem Leithandschriftenprinzip vorgelegt, jedoch mit Beschränkung auf die in der Wiener Handschrift Nr. 2779 fortlaufend überlieferte erste (kleinere) Hälfte (die Verse 1 bis 12281). Das einzig vertretbare Editionsprinzip ließ kaum eine andere Lösung als den Wechsel der Leithandschrift in der Mitte des Werkes zu, da der Wiener Codex (V) trotz aller Flüchtigkeitsfehler den bei weitem originalgetreueren Text bietet, andererseits eine Rückübersetzung des großteils nur in der weit jüngeren südrheinfränkischen Heidelberger Handschrift (P) cpg 374 (einer frühneuhochdeutschen Redaktion der älteren, im Original verlorenen Dichtung) erhaltenen zweiten Teils in die mittelbairische Sprache von V mehr als problematisch wäre. Die Leithandschrift V der ersten Hälfte steht dem Original nicht nur zeitlich (um mindestens 150 Jahre), sondern auch geographisch beträchtlich näher. Da sie überdies (fast) durchgehend an einer zweiten, in Ausnahmen (für 517 Verse) sogar an einer dritten Parallelüberlieferung überprüft werden kann, vermittelt der so gewonnene Text immerhin schon eine gewisse Ahnung vom - natürlich immer noch unerreichbaren - Original. Da jedoch an unzähligen Stellen die Parallelhandschriften möglicherweise den ursprünglichen Text bieten, werden ihre Lesarten im Paralleldruck geboten. Der textkritische Kommentar unter dem Text enthält die älteren Vorschläge zur Textherstellung sowie eine Rechtfertigung der eigenen Vorschläge mit Hinweisen auf Wörterbücher, Grammatiken, Parallelstellen, insbesondere aus der »Krone« selbst.
Increasing ambient temperatures will severely affect human health in the decades to come and will exacerbate a variety of chronic health conditions. In this paper, I examine the temperaturemorbidity ...relationship in the tropical climate environment of Indonesia with a focus on chronic, non-communicable diseases, namely diabetes, cardiovascular and respiratory diseases. Drawing on detailed individual level data from the Indonesian national health insurance scheme JKN and linking it with meteorological data on daily temperature realizations on a fine spatial level, I estimate the effect of high ambient temperatures on the daily number of primary health care visits. Exploiting the panel structure of the data and using a distributed lag model, I find that all-cause, diabetes and cardiovascular disease morbidity substantially increase at days with high mean temperatures. Specifically, on a day with a mean temperature above 29.5êC, the daily visits for diabetes and cardiovascular diseases increase by 29% and 19%, respectively, and these increases are permanent and not offset by visit displacement. Contrarily, I do not find any effects on respiratory disease morbidity. Heterogeneity analyses suggest that elderly and women suffer more severely from high temperatures. Back-of-the-envelope cost calculations indicate a substantial financial burden for the Indonesian health care system due to increasing temperatures.
Increasing ambient temperatures will severely affect human health in the decades to come and will exacerbate a variety of chronic health conditions. In this paper, I examine the temperature- ...morbidity relationship in the tropical climate environment of Indonesia with a focus on chronic, non-communicable diseases, namely diabetes, cardiovascular and respiratory diseases. Drawing on detailed individual level data from the Indonesian national health insurance scheme JKN and linking it with meteorological data on daily temperature realizations on a one spatial level, I estimate the e ect of high ambient temperatures on the daily number of primary health care visits. Exploiting the panel structure of the data and using a distributed lag model, I and that all-cause, diabetes and cardiovascular disease morbidity substantially increase at days with high mean temperatures. Specifically, on a day with a mean temperature above 29.5°C, the daily visits for diabetes and cardiovascular diseases increase by 29% and 19%, respectively, and these increases are permanent and not offset by visit displacement. Contrarily, I do not and any effects on respiratory disease morbidity. Heterogeneity analyses suggest that elderly and women suffer more severely from high temperatures. Back-of-the-envelope cost calculations indicate a substantial financial burden for the Indonesian health care system due to increasing temperatures.
Tutorials at The Web Conference 2023 Fionda, Valeria; Hartig, Olaf; Abdolazimi, Reyhaneh ...
Companion Proceedings of the ACM Web Conference 2023,
04/2023
Conference Proceeding
Open access
This paper summarizes the content of the 28 tutorials that have been given at The Web Conference 2023.
We assess whether social media – in particular Facebook – can serve as an efficient and cost-effective instrument to increase type 2 diabetes awareness and encourage risk screening activities in ...Indonesia, where – as in the rest of Southeast Asia – the prevalence of the disease and with it the rates of undiagnosed cases have dramatically increased in the last decade. We use Facebook’s advertisement function to randomly distribute graphical ads related to the risk and consequences of diabetes to Facebook users above the age of 35 in Jakarta and Yogyakarta. The ads differ in their message (“theme†) and graphical design, but equally invite viewers to visit an information website on which they can participate in a diabetes self-screening activity. Depending on their determined risk score, participants receive a recommendation to contact their GP and ask for an in-depth screening. We find that the ad themes that we label “information†and “shock†outperform all other themes in terms of creating link clicks and completed screening questionnaires. A follow-up survey six weeks after the online screening suggests that approximately 28% of respondents that were found to have a high risk, plan to schedule (or already have scheduled) an appointment for a professional screening. The complementary cost-effectiveness analysis shows that such an online public health campaign can be very cost-effective with a cost of approximately US$9 per newly diagnosed person with type 2 diabetes.
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