SICHTWEISEN ÄLTERER MENSCHEN AUF MEDIZINISCHE VERSORGUNG AUF DEM LAND – EINE EMPIRISCHE STUDIE AUS DEUTSCHLAND

With demographic change, many rural regions in Germany face the challenge to ensure an appropriate provision of basic services, also for the increasing share of immobile population groups. Among others, the growing number of old and very old people will increase the demand for medical care. Although, on the whole health care in Germany is very good, in some rural areas its provision tends to be difficult. This paper presents findings of an empirical study on older people’s mobility options, obstacles that constrain the access to health care and related needs. In-depth interviews were conducted with elderly men and women living in Holzminden, a district in Lower Saxony already massively affected by demographic ageing and shrinking. The analysis reveals high car dependency among the elderly; those who cannot drive are highly dependent to be given a ride to all kinds of activities, including medical appointments. Satisfaction with family doctors is high but many will soon retire and might not find a successor. Access to medical specialists and emergency care turns out to be more complicated. Despite low accessibility, most appreciate the advantages of rural living and nearly none considers leaving the countryside. Yet, those who do not have family living close-by they can call on might be forced to leave rural home once not able to drive anymore.Rural health care, demographic change, accessibility, medical care, Ländliche Gesundheitsversorgung, demographischer Wandel, Erreichbarkeit, medizinische Versorgung, Environmental Economics and Policy, Farm Management, Industrial Organization, Institutional and Behavioral Economics, Land Economics/Use,

The Distribution of CAP Payments - Redistributional Injustice or Spatially Adapted policy?

This paper analyses the distributional equality of individual Scottish Government-administered payments in 2008 under CAP Pillars One (single farm payments) and Two (rural development measures) and in total, in terms of economic, social and spatial factors. The analysis shows that 94% of all payments were paid to claimants in core rural areas (94%) while only a few (5%) claimants resided in urban areas or outside of Scotland (1%). However, in both Pillars, claims made by urban residents were often higher than those made by rural dwellers. The Ordinary Least Squares spatial analysis shows that the level of payments was extremely dependent on the geographical location and natural conditions. Spatial factors describing the economic situation in the area of the claimant were significantly related to the level of the CAP amounts paid. Overall, the level of amounts paid was positively related to the natural, economic and social structures of the area of residence. The discussion tackles the question of whether the current system of farm income support by decoupled payments should be developed into a poverty payment system.Pillar One, Common Agricultural Policy, Gini-Coefficient, Rural-Urban distribution, distributional justice, Land Economics/Use, Q15, R14, R11,

Stavovi ljudi starije životne dobi o zdravstvenoj skrbi u ruralnim područjima – studija slučaja iz sjeverne Njemačke

Germany’s population is decreasing and experiencing accelerated ageing. In 2060, more than a third of the population will be aged 65 years or older. With demographic change, many rural regions are struggling to ensure supply of appropriate public infrastructure while becoming less densely populated and experiencing an increasing share of immobile population groups. One of the major issues at stake is to maintain medical infrastructure at the necessary level. Although health care in Germany is still of very high standard in international comparison, in some rural areas its provision tends to be problematic. Demographic developments aggravate this situation because of two reasons: firstly, natural decline in population and rural depopulation will lead to changes in the rural spatial structure and have impact on the provision of health care; secondly, the growing proportion of older people will simultaneously increase the demand for medical care because, with advancing age, people seek medical treatment more often than at a young age. Even so, older people’s specific needs have long been and still are neglected in health care issues. This paper presents findings of an empirical study on older people’s mobility options, obstacles that constrain the access to health care and related needs.Stanovništvo Njemačke se smanjuje i ubrzano stari. Godine 2060. više od trećine stanovnika bit će starije od 65 godina. Uz demografske promjene, mnoga ruralna područja sve teže osiguravaju adekvatnu javnu infrastrukturu, dok u isto vrijeme ta područja postaju sve rjeđe naseljene uz povećan udio prostorno slabo pokretljivih populacijskih grupa. Jedan je od glavnih problema kako održati medicinsku infrastrukturu na prikladnoj razini. Održavanje visokog standarda zdravstvene skrbi u Njemačkoj u ruralnim područjima zna biti problematično. Demografski trendovi otežavaju ovu situaciju iz dva razloga: kao prvo, prirodni pad stanovništva i ruralna depopulacija dovest će do promjena u ruralnoj prostornoj strukturi i utjecat će na pružanje zdravstvene skrbi; kao drugo, rastući udio starog stanovništva istovremeno će povećati potražnju za zdravstvenom skrbi jer stariji ljudi češće traže medicinsku pomoć. Unatoč tome, specifične potrebe ljudi starije životne dobi dugo su bile i još uvijek jesu zanemarivane po pitanju zdravstvene skrbi. Ovaj rad predstavlja saznanja dobivena iz empirijskog istraživanja o mogućnostima mobilnosti ljudi starije životne dobi, preprekama koje im ograničavaju pristup zdravstvenoj skrbi i potrebama koje se na to odnose

The relation between water use and pesticides – Some remarks on the influence of integrated farming practices

Agriculture is the main user of the world’s water resources. Due to increasing concern on water quality and quantity, there is a growing interest to use the scarce water resources in the most efficient way to feed the growing world population. By employing a meta-analysis, this paper shows that pesticide use in combination with other improved production technologies have tripled agricultural water use efficiency (WUE) in the last 30 years. Recently, the European Union banned several active substances, among these more than 20 pesticides formerly used in crop growing. By doing so the progress in WUE has been put into question. This paper argues that a sudden reduction of pesticides by 50 % would lead to a need for more than 55 million hectares of additional arable land and for more than 158 km3 of additional water. Furthermore, in such a case the global irrigated area would have to be increased by 4 %. As most studies on the worldwide potential of additional arable land show, this land does not exist. Therefore, there are strong arguments to invest even further into new water saving technologies including pesticides. Specific research is needed to clarify which countries would be affected most by a sudden restriction or even ban of pesticides.pesticides, water use efficiency, production technologies, food security, Agricultural and Food Policy, Crop Production/Industries, Farm Management, Land Economics/Use, Production Economics,

Medical Characteristics of Foreign Language Patients in Paramedic Care

Background: In this study, medical and socio-demographic characteristics of foreign language patients in prehospital emergency medical care are analyzed and compared with non-foreign language patients. Methods: We performed retrospective chart review of rescue operations in four emergency medical service stations in Northern Germany over seven months as part of the DICTUM Rescue study (DRKS00016719). We performed descriptive analyses including test statistics and used partial correlation to adjust for patients’ sex and age. Results: Patients with limited German proficiency were served in 2.2% of all 7494 covered rescue operations. On average, these patients were two decades younger than their German speaking counterparts. There were significantly more patients with limited German proficiency with gynecological and obstetric problems, especially births, as well as psychiatric disorders, especially suicide attempts. Conclusions: Our findings suggest that the existing preventive programs for pregnant women and people at risk of suicide do not sufficiently reach patients with limited German proficiency. Additionally, giving birth and psychiatric breakdowns are exceptional and sensitive situations, both for patients and the paramedic staff, where the ability to communicate safely appears to be of enormous importance to enable safe treatment

The relation between water use and pesticides – Some remarks on the influence of integrated farming practices

Agriculture is the main user of the world’s water resources. Due to increasing concern on water quality and quantity, there is a growing interest to use the scarce water resources in the most efficient way to feed the growing world population. By employing a meta-analysis, this paper shows that pesticide use in combination with other improved production technologies have tripled agricultural water use efficiency (WUE) in the last 30 years. Recently, the European Union banned several active substances, among these more than 20 pesticides formerly used in crop growing. By doing so the progress in WUE has been put into question. This paper argues that a sudden reduction of pesticides by 50 % would lead to a need for more than 55 million hectares of additional arable land and for more than 158 km3 of additional water. Furthermore, in such a case the global irrigated area would have to be increased by 4 %. As most studies on the worldwide potential of additional arable land show, this land does not exist. Therefore, there are strong arguments to invest even further into new water saving technologies including pesticides. Specific research is needed to clarify which countries would be affected most by a sudden restriction or even ban of pesticides

SICHTWEISEN ÄLTERER MENSCHEN AUF MEDIZINISCHE VERSORGUNG AUF DEM LAND – EINE EMPIRISCHE STUDIE AUS DEUTSCHLAND

With demographic change, many rural regions in Germany face the challenge to ensure an appropriate provision of basic services, also for the increasing share of immobile population groups. Among others, the growing number of old and very old people will increase the demand for medical care. Although, on the whole health care in Germany is very good, in some rural areas its provision tends to be difficult. This paper presents findings of an empirical study on older people’s mobility options, obstacles that constrain the access to health care and related needs. In-depth interviews were conducted with elderly men and women living in Holzminden, a district in Lower Saxony already massively affected by demographic ageing and shrinking. The analysis reveals high car dependency among the elderly; those who cannot drive are highly dependent to be given a ride to all kinds of activities, including medical appointments. Satisfaction with family doctors is high but many will soon retire and might not find a successor. Access to medical specialists and emergency care turns out to be more complicated. Despite low accessibility, most appreciate the advantages of rural living and nearly none considers leaving the countryside. Yet, those who do not have family living close-by they can call on might be forced to leave rural home once not able to drive anymore

Naturschutz und Erholung im Stadtwald Göttingen

Wälder bedecken fast ein Drittel der deutschen Landesfläche und erbringen zahlreiche Nutzenstiftungen für das menschliche Wohlbefinden, welche unter dem Konzept Ökosystemleistungen (ÖSL) gefasst werden. Aufgrund ihrer guten Erreichbarkeit sind insbesondere Stadtwälder bedeutsame Orte der ÖSL-Erzeugung und -Nutzung. Angesichts vielfältiger Akteursgruppen kann es zu Spannungen zwischen den Nutzungsansprüchen an den Stadtwald kommen. Im vorliegenden Artikel wird überprüft, inwiefern Konflikte durch Anwendung des Ökosystemleistungskonzeptes identifiziert und Wohlfahrtswirkungen herausgestellt werden können. Aufgrund der hohen Relevanz in Wäldern liegt besonderes Augenmerk auf der Gesundheit als Aspekt des menschlichen Wohlergehens. Am Beispiel des Stadtwaldes Göttingen werden neun Gruppendiskussionen mit Studierenden geführt. Vor dem Hintergrund des ÖSL-Konzeptes identifizieren die Diskussionsteilnehmenden vor allem kulturelle und regulierende Leistungen und heben spezifische Gesundheitsbezüge hervor. Zur Förderung dieser positiven Wirkungen des Stadtwaldes erachten sie eine Vereinbarung der Interessen von Nutzerinnen kultureller Leistungen und naturschutzfachlicher Anliegen als unerlässlich, da zwischen diesen Gruppen Bewertungskonflikte wahrgenommen werden. Für die Forstpolitik leistet das ÖSL-Konzept einen bedeutsamen Beitrag, so hilft es, die Bezüge zwischen dem natürlichen Leistungsangebot, anthropogenen Einflüssen und den individuellen Nutzwirkungen in den Fokus zu stellen