ABSTRACT Objective: To examine the associations between individual chronic diseases and multidimensional frailty comprising physical, psychological, and social frailty. Methods: Dutch individuals (N = 47,768) age ≥ 65 years completed a general health questionnaire sent by the Public Health Services (response rate of 58.5 %), including data concerning self-reported chronic diseases, multidimensional frailty, and sociodemographic characteristics. Multidimensional frailty was assessed with the Tilburg Frailty Indicator (TFI). Total frailty and each frailty domain were regressed onto background characteristics and the six most prevalent chronic diseases: diabetes mellitus, cancer, hypertension, arthrosis, urinary incontinence, and severe back disorder. Multimorbidity was defined as the presence of combinations of these six diseases. Results: The six chronic diseases had medium and strong associations with total ((f2 = 0.122) and physical frailty (f2 = 0.170), respectively, and weak associations with psychological (f2 = 0.023) and social frailty (f2 = 0.008). The effects of the six diseases on the frailty variables differed strongly across diseases, with urinary incontinence and severe back disorder impairing frailty most. No synergetic effects were found; the effects of a disease on frailty did not get noteworthy stronger in the presence of another disease. Conclusions: Chronic diseases, in particular urinary incontinence and severe back disorder, were associated with frailty. We thus recommend assigning different weights to individual chronic diseases in a measure of multimorbidity that aims to examine effects of multimorbidity on multidimensional frailty. Because there were no synergetic effects of chronic diseases, the measure does not need to include interactions between diseases.
This study is the first to systematically and quantitatively explore the factors that determine the length of charging sessions at public charging stations for electric vehicles in urban areas, with particular emphasis placed on the combined parking- and charging-related determinants of connection times. We use a unique and large data set – containing information concerning 3.7 million charging sessions of 84,000 (i.e., 70% of) Dutch EV-users – in which both private users and taxi and car sharing vehicles are included; thus representing a large variation in charging duration behavior. Using multinomial logistic regression techniques, we identify key factors explaining heterogeneity in charging duration behavior across charging stations. We show how these explanatory variables can be used to predict EV-charging behavior in urban areas and we derive preliminary implications for policy-makers and planners who aim to optimize types and size of charging infrastructure.
There has been a rapidly growing number of studies of the geographical aspects of happiness and well-being. Many of these studies have been highlighting the role of space and place and of individual and spatial contextual determinants of happiness. However, most of the studies to date do not explicitly consider spatial clustering and possible spatial spillover effects of happiness and well-being. The few studies that do consider spatial clustering and spillovers conduct the analysis at a relatively coarse geographical scale of country or region. This article analyses such effects at a much smaller geographical unit: community areas. These are small area level geographies at the intra-urban level. In particular, the article presents a spatial econometric approach to the analysis of life satisfaction data aggregated to 1,215 communities in Canada and examines spatial clustering and spatial spillovers. Communities are suitable given that they form a small geographical reference point for households. We find that communities’ life satisfaction is spatially clustered while regression results show that it is associated to the life satisfaction of neighbouring communities as well as to the latter's average household income and unemployment rate. We consider the role of shared cultural traits and institutions that may explain such spillovers of life satisfaction. The findings highlight the importance of neighbouring characteristics when discussing policies to improve the well-being of a (small area) place.
