Using spatial analysis to demonstrate the heterogeneity of the cardiovascular drug-prescribing pattern in Taiwan

<p>Abstract</p> <p>Background</p> <p>Geographic Information Systems (GIS) combined with spatial analytical methods could be helpful in examining patterns of drug use. Little attention has been paid to geographic variation of cardiovascular prescription use in Taiwan. The main objective was to use local spatial association statistics to test whether or not the cardiovascular medication-prescribing pattern is homogenous across 352 townships in Taiwan.</p> <p>Methods</p> <p>The statistical methods used were the global measures of Moran's <it>I </it>and Local Indicators of Spatial Association (LISA). While Moran's <it>I </it>provides information on the overall spatial distribution of the data, LISA provides information on types of spatial association at the local level. LISA statistics can also be used to identify influential locations in spatial association analysis. The major classes of prescription cardiovascular drugs were taken from Taiwan's National Health Insurance Research Database (NHIRD), which has a coverage rate of over 97%. The dosage of each prescription was converted into defined daily doses to measure the consumption of each class of drugs. Data were analyzed with ArcGIS and GeoDa at the township level.</p> <p>Results</p> <p>The LISA statistics showed an unusual use of cardiovascular medications in the southern townships with high local variation. Patterns of drug use also showed more low-low spatial clusters (cold spots) than high-high spatial clusters (hot spots), and those low-low associations were clustered in the rural areas.</p> <p>Conclusions</p> <p>The cardiovascular drug prescribing patterns were heterogeneous across Taiwan. In particular, a clear pattern of north-south disparity exists. Such spatial clustering helps prioritize the target areas that require better education concerning drug use.</p

Revista de la OIM sobre migraciones en América Latina

The 14 Dependent Territories governed by the United Kingdom (UK) Foreign and Commonwealth Office include in alphabetic order Anguilla, Ascension Island and Tristan da Cunha, British Antarctic Territory, Bermuda, British Indian Ocean Territory, British Virgin Islands, Cayman Islands, Falkland Islands, Gibraltar, Montserrat, Pitcairn Island, St Helena, South Georgia and South Sandwich Islands, Sovereign Base Areas on Cyprus and the Turks and Caicos Islands (Fig. 1.1). UK governance responsibilities for these territories include the strengthening of democracy, environmental protection, improvement of public services and law enforcement (Oldfield and Sheppard 1997

Role-play Simulations for Climate Change Adaptation Education and Engagement

In order to effectively adapt to climate change, public officials and other stakeholders need to rapidly enhance their understanding of local risks and ability to collaboratively and adaptively respond. We argue that science-based role-play simulation exercises, a type of ‘serious game’ involving face-to-face mock decision-making, have considerable potential as education and engagement tools for enhancing readiness to adapt. Prior research suggests role-play simulations and other serious games can foster public learning and encourage collective action in public policy-making contexts. However, the effectiveness of such exercises in the context of climate change adaptation education and engagement has heretofore been underexplored. We share results from two research projects that demonstrate the effectiveness of role-play simulations in cultivating climate change adaptation literacy, enhancing collaborative capacity, and facilitating social learning. Based on our findings, we suggest such exercises should be more widely embraced as part of adaptation professionals\u27 education and engagement tool-kits

Complex morphology of subducted lithosphere in the mantle beneath the Tonga trench

At the Tonga trench, old Pacific sea floor subducts at a rapid rate below the Indo-Australia plate, generating most of the world's deep earthquakes and producing a deep slab of former oceanic lithosphere