Regional differences of outpatient physician supply as a theoretical economic and empirical generalized linear model

BACKGROUND: Regional differences in physician supply can be found in many health care systems, regardless of their organizational and financial structure. A theoretical model is developed for the physicians' decision on office allocation, covering demand-side factors and a consumption time function. METHODS: To test the propositions following the theoretical model, generalized linear models were estimated to explain differences in 412 German districts. Various factors found in the literature were included to control for physicians' regional preferences. RESULTS: Evidence in favor of the first three propositions of the theoretical model could be found. Specialists show a stronger association to higher populated districts than GPs. Although indicators for regional preferences are significantly correlated with physician density, their coefficients are not as high as population density. CONCLUSIONS: If regional disparities should be addressed by political actions, the focus should be to counteract those parameters representing physicians' preferences in over- and undersupplied regions.

Future Bloom and Blossom Frost Risk for Malus domestica Considering Climate Model and Impact Model Uncertainties

The future bloom and risk of blossom frosts for Malus domestica were projected using regional climate realizations and phenological (= impact) models. As climate impact projections are susceptible to uncertainties of climate and impact models and model concatenation, the significant horizon of the climate impact signal was analyzed by applying 7 impact models, including two new developments, on 13 climate realizations of the IPCC emission scenario A1B. Advancement of phenophases and a decrease in blossom frost risk for Lower Saxony (Germany) for early and late ripeners was determined by six out of seven phenological models. Single model/single grid point time series of bloom showed significant trends by 2021-2050 compared to 1971-2000, whereas the joint signal of all climate and impact models did not stabilize until 2043. Regarding blossom frost risk, joint projection variability exceeded the projected signal. Thus, blossom frost risk cannot be stated to be lower by the end of the 21st century despite a negative trend. As a consequence it is however unlikely to increase. Uncertainty of temperature, blooming date and blossom frost risk projection reached a minimum at 2078-2087. The projected phenophases advanced by 5.5 d K-1, showing partial compensation of delayed fulfillment of the winter chill requirement and faster completion of the following forcing phase in spring. Finally, phenological model performance was improved by considering the length of day.

Environmental factors affecting soil metals near outlet roads in Poznan, Poland: impact of grain size, soil depth, and wind dispersal

We determined the Cd, Cr, Cu, Ni, Pb, and Zn concentrations in soil samples collected along the eight main outlet roads of Poznan. Samples were collected at distances of 1, 5, and 10 m from the roadway edges at depth intervals of 0-20 and 40-60 cm. The metal content was determined in seven grain size fractions. The highest metal concentrations were observed in the smallest fraction (<0.063 mm), which were up to four times higher than those in sand fractions. Soil Pb, Cu, and Zn (and to a lesser extent Ni, Cr, and Cd) all increased in relation to the geochemical background. At most sampling sites, metal concentrations decreased with increasing distance from roadway edges and increasing depth. In some locations, the accumulation of metals in soils appears to be strongly influenced by wind direction. Our survey findings should contribute in predicting the behavior of metals along outlet road, which is important by assessing sources for further migration of heavy metals into the groundwater, plants, and humans.