Capita Ratio Research Articles

Persistence in sovereign debt during the past two centuries: Evidence for the US and the largest European economies

This paper analyzes the persistence of the sovereign debt / GDP and sovereign debt / GDP per capita series for the five largest European economies and the US using fractional integration. We use historical data starting in 1800 for the US and the UK, in 1861 for Italy and in 1880 for Germany, France and Spain. The results indicate high degrees of persistence of debt-to-GDP and debt per capita ratios with clear evidence of no mean reversion in both debt indicators. We also find evidence of correlation with the primary deficit, supporting the idea that one of the causes of this debt persistence is precisely the primary deficit persistence. Empirical results support the need for a better coordination between fiscal and monetary policies to enhance debt control in the countries under examination.

OECD 고등교육 재정의 국제 비교

In this article we compare the higher education finance of advanced countries using OECD’s “Education at a Glance” data from 1998~2018. We first investigate the relationship among input side variables such as relative size of number of college students, relative size of per student expenditure, the portion of public expenditure in higher education finance. We find fundamental trade-off between the quality and quantity, as captured by the negative correlation between the per student expenditure-GDP per capita ratio and the number of college students compared to the total population. We also investigate the relationship between the input and outputs of higher education. The major findings are that the higher the portion of public expenditure in higher education finance, the lower the chance of having world’s top research universities. Meanwhile, the youth unemployment tends to be lower in countries that governments’ portion of higher education finance are large.

The anti-politics of impact investment: Financial self-regulation, market competition and over-indebtedness in Cambodia

Social impact investors claim to promote sustainable development by mobilizing private finance capital to solve pressing global challenges like poverty alleviation. In this paper, I interrogate this claim through an examination of microfinance in Cambodia, a major destination for impact investment. In the past decade, Cambodia has received nearly 10% of global investments from microfinance-specific funds. It now has the largest microfinance-debt per capita ratio of any country in the world. Based on qualitative research between 2021 and 2023, I argue that impact investment functions as an anti-politics of development that reinforces finance as a political technology of neoliberal governance. Over the past two decades, impact investors have poured capital into the country’s microfinance industry to expand access to credit without acknowledging structural political-economic conditions that have produced rising over-indebtedness among microfinance borrowers. Instead, they have argued that the problems created by the microfinance industry are best resolved through a self-regulation model that uses a voluntary code of conduct based on global standards of responsible finance. Thus, impact investors have been integral in broader transformations that have extended financial logics, technologies and accumulation imperatives into people’s daily lives. This paper contributes to economic geography and critical development studies by explaining how impact investment deepens neoliberal financialization.

The fallacy of global comparisons based on per capita measures.

Media, social scientists and public health researchers often present comparisons across countries, and policy makers use such comparisons to take evidence-based action. For a meaningful comparison among countries, one often needs to normalize the measure for differences in population size. To address this issue, the first choice is usually to calculate per capita ratios. Such ratios, however, normalize the measure for differences in population size directly only under the highly restrictive assumption of a proportional increase of the measure with population size. Violation of this assumption frequently leads to misleading conclusions. We compare per capita ratios with an approach based on regression, a widely used statistical procedure that eliminates many of the problems with ratios and allows for straightforward data interpretation. It turns out that the per capita measures in three global datasets (gross domestic product, COVID-19-related mortality and CO2 production) systematically overestimate values in countries with small populations, while countries with large populations tend to have misleadingly low per capita ratios owing to the large denominators. Unfortunately, despite their biases, comparisons based on per capita ratios are still ubiquitous, and they are used for influential recommendations by various global institutions. Their continued use can cause significant damage when employed as evidence for policy actions and should therefore be replaced by a more scientifically substantiated and informative method, such as a regression-based approach.

Relationship between pesticide research output and GDP: a socio-economic analysis

Purpose The focus of this study was to evaluate the relationship between research publications in the pesticide field, a country’s gross domestic product (GDP) and GDP per capita. The study aims to analyze pesticide use in association with a country’s population and research publications. The purpose of this study is to uncover the country’s contribution to pesticide research and assess the financial resources allocated to it as a percentage of their GDP by exploring these factors. Design/methodology/approach The Web of Science database was used to retrieve data for the period of 2001–2020. The use of scientometric indicators allowed for the analysis of the collaborative patterns and active performance of countries in pesticide research. Socio-economic analysis was used to determine the contribution of countries toward pesticide research. Findings This study demonstrated a strong association (0.952%) between a country’s GDP and its research publications in the field of pesticide research. Countries, such as Denmark, Belgium and Australia, have benefited from global collaboration, which has enhanced their research efforts. Despite ranking lower in pesticide utilization, India focused on pesticide research, as indicated by its high publication/GDP per capita ratio (0.26). Originality/value Research on pesticides directly impacts agricultural practices, which, in turn, influence the economic production of the agricultural sector. Changes in pesticide usage can have inference for crop yields, food price and, eventually, the GDP. Comparative analysis can assist in evaluating the efficiency of regulatory policies in balancing ecological concerns with economic interests. Changes in regulations may impact both pesticide usage and economic outcomes.

Oral health in emerging countries and suggestions for adjusted care strategies

Objective: Investigation into the oral health status of selected emerging countries from different regions of the world, so as to capture a broad spectrum of oral health reality prevailing in fast-growing middle-income countries, the aim being to present helpful steps towards adjusted strategies that improve the dental health of the entire population. Method: Using a composite indicator, the Dental Health Index, the oral health of entire populations is measured and compared with the aid of these quantifiable results. The study relies on existing data, where possible, from national representative surveys. Results: The best performer is the upper middle-income country of China. It is followed by India and Vietnam, two lower middle-income states, which placed second and third, although the two latter populations are largely untouched by professional dental activities. This finding is scientifically challenging to explain and needs further investigation. The relative wealthiest country, Malaysia, ranks in the sixth place while Brazil, with one of the highest dentist per capita ratios in the world, places only eighth, just ahead of the Philippines which ranks last in the study. Conclusion: Over the last decade, the awareness and the willingness shown by all countries to improve their precarious oral care situations resulted in the successful implementation of dental care strategies. However, the main obstacles - the widespread shortage of dentists and the poor oral health awareness among the population, particularly those living in poor and/or rural areas - can only be overcome by development-stage adjusted strategies. The broad use of teledentistry (TD) and priority education and training of mid-level dental professionals could be promising instruments for solving these shortcomings in a manageable period of time and under limited financial resources. To attract additional financial and technical resources and expertise, public/private partnerships should also be encouraged.

Severity of vehicle-to-vehicle accidents in the UAE: An exploratory analysis using machine learning algorithms

The World Health Organization (WHO) identifies road traffic injuries as a global health problem. The Eastern-Mediterranean region is particularly suffering from low traffic safety levels, recording the third highest death per capita ratio in the world. It is critical to evaluate and understand the causes of crashes and their severity levels as a first step to devising policies that aim to reduce these causes. Previous studies examining the frequency or severity of crashes present important limitations that motivate the need for the current work. While these studies have investigated the relation of contributing factors to severity of crashes, not until recently the importance of these factors are bring investigated. Even then, less research have explored various Machine Learning models and none in the middle-eastern region. This is critical because the WHO report concludes that the chances of dying in a traffic crash in this region are second only to Africa per 100000 population.This is a first study analyzing the severity of vehicle-to-vehicle crashes among drivers in the United Arab Emirates. Traffic Crash Data was obtained from the Abu Dhabi Police, which consisted of 11,400 observations during the period 2014–2017. Machine learning algorithms, including gradient boosting (GB), support vector machines (SVM), and random forest (RF), were trained and tested to predict crash severity and extract (using feature analysis) its determinants. The models were evaluated using two performance metrics: prediction accuracy and F1-scores.The RF model outperformed both GB and SVM, with the confusion matrix of RF reporting a better prediction for all four crash severity classes. The feature importance analysis indicates that the age of car, age of the injured, and the age of the initiator have the highest effect on severity, which is an important finding as the listed factors were rarely considered in previous studies. Vehicle and road characteristics such as vehicle class, crash type, and lighting are slightly associated with the severity. Consistent with other studies, gender was the least essential predictor of severity. Recommendations are finally provided to the Abu Dhabi Department of Municipalities and Transport (AD-DMT) authority to guide the development of road safety policies and countermeasures to mitigate the occurrence and severity of crashes.

Lessons From the Delta.

Lessons From the Delta.

(454) Variations in Practice Patterns of Xiaflex Providers Throughout the United States

Abstract Introduction Intralesional Collagenase Clostridium Histolyticum (CCH; Xiaflex; Endo Pharmaceuticals, Dublin, Ireland) is the only FDA-approved intralesional therapy to treat bothersome penile curvature in men with Peyronie’s Disease (PD). Clinicians who administer CCH must be certified through a risk evaluation and management strategy (REMS) program. However, provider availability is highly dependent on geography and many patients must travel great distances to undergo evaluation and treatment with CCH by an experienced injector. Objective The goal of the current study is to describe the landscape of certified CCH injectors with respect to location and clinical background/training. Methods Patients are currently able to use an online “locate a specialist” tool through Endo Pharmaceuticals to identify clinicians in their local geographic area who are certified to administer CCH. Using this tool, a list of all providers who offer CCH injections was compiled throughout the continental United States. Pertinent information that was gathered included geographic location, type of provider or level of training [Medical Doctor (MD), Doctor of Osteopathic Medicine (DO), Physician Assistant (PA), Nurse Practitioner (NP), and Registered Nurse (RN)], and gender of providers. This information was compared to state population data (United State Census Bureau) to determine per capita coverage. Results A total of 1947 Xiaflex providers were identified: 1749 Doctors of Medicine (MD; 90%), 115 Doctor of Osteopathic Medicine (DO; 6%), 60 Physician Assistants (PA; 3%), 21 Nurse Practitioners (NP; 1%), and 1 Registered Nurse (RN; 0.05%). Out of the 1947 providers, only 95 (4.9%) were women. Most women administering Xiaflex were MDs (73%), followed by PAs (12%), NP and DOs (7%), and RN (1%). Xiaflex providers were available in all states except for Hawaii and Alaska. Providers were distributed throughout the United States with the average provider per capita ratio of 230,240. Wyoming, Washington D.C., Rhode Island, and Georgia had the best provider per capita at <10,000 while New Mexico had the worst provider per capita ratio at 2,117,522. Conclusions Our results show significant variation in certified CCH injector availability for patients across the United States. < 5% of all certified clinicians are female and 4% were advanced practice providers. Further work is needed to characterize and remedy gender disparities amongst providers, and ensure greater access for patients who desire an FDA-approved non-surgical treatment for their PD-associated curvature. Disclosure No

Bangkok’s existing mixed fruit orchards are tree diversity hotspots for city greening

Bangkok’s Inner Orchard (BIO), located in the west peri-urban area of the city, provides both fresh products and ecological benefits to its inhabitants. Although this unique forest-like cultivation of mixed fruit trees growing on dikes has the potential to become an urban forest, it has never been thoroughly investigated. Urban expansion is a threat to this orchard. Sustainable cities must maintain a balance between development and the environment. In this study, six orchards were surveyed by collecting data on tree species, plant height, crown width, and location and analyzed to identify the orchard areas covered by forest canopy and clarify the forest structure and tree species diversity in the orchards. Overall, 98.64% of the forest canopy within the orchard area was evaluated using cover analysis. Analysis of the forest structure of the BIO revealed that the average tree height was greater than that of common orchard trees. Tree diversity analysis showed an average Shannon index value of 2.53, indicating mid-range diversity. Older orchards showed a greater diversity of fruit tree species, whereas newer orchards, replanted after major flood and drought events, showed a lesser diversity of fruit tree species. In order to protect BIO on the long-term, it is essential to identify and apply appropriate conservation strategies. Including BIO areas in the Bangkok greening scheme would cause rapid increases in the green area per capita ratio. Both urban food forest and urban agriculture concepts could be applied to existing BIO orchards, which represent new urban green area types. BIO thus has the potential to act as an urban forest and tree diversity hotspot for Bangkok.

On leaving: Coloniality and physician migration in Puerto Rico

Puerto Rico (PR) has a growing physician migration problem. As of 2009, the medical workforce was composed of 14,500 physicians and by 2020 the number had been reduced to 9,000. If this migration pattern continues, the Island will not be able to meet the recommended physicians per capita ratio proposed by the World Health Organization (WHO). Existing research has focused on the personal motivations for movement to, or permanence in, a particular setting, and social variables that encourage physicians to migrate (e.g., economic conditions). Few studies have addressed the role of coloniality in fostering physician migration. In this article we examine the role of coloniality and its impact on PR's physician migration problem. The data presented in this paper stem from an NIH-funded study (1R01MD014188) that aimed to document the factors associated with physician migration from PR to the US mainland and its impact on the Island's healthcare system. The research team used qualitative interviews, surveys, and ethnographic observations. This paper focuses on the data from the qualitative interviews with 26 physicians who had migrated to the USA and ethnographic observations, which were collected and analyzed between September 2020 and December 2022. The results evidence that participants understand physician migration as a consequence of three factors: 1) the historical and multidimensional deterioration of PR, 2) the idea that the current healthcare system is rigged by politicians and insurance companies, and 3) the specific challenges faced by physicians in training on the Island. We discuss the role of coloniality in fostering these factors and how it serves as the backdrop for the problem faced by the Island.

Regional Differentiation of GDP at the NUTS-3 Level in Selected European Countries after their Accession to the European Union

The issue of regional development is gaining importance due to the disproportions in its socio-economic aspects. The study aims to identify changes in economic development of selected countries which joined the European Union (EU) in 2004. The study examines small NUTS-3 (Nomenclature of territorial units for statistics) regions, which are territories determined for statistical purpose, that are less often analysed in the literature. Moreover, it focuses on spatial aspects, also considering rarely examined urban-rural typology of regions. The value and dynamics of gross domestic product (GDP) changes were presented using the Eurostat data for 2004–2019 on GDP per capita ratio (PPS) and GDP per capita (in % in relation to the EU-28 average). The analysis uses basic statistical and convergence measures; regional disparities were presented on graphs and maps. It was found that the examined EU countries are internally different in terms of economic development. The growth of GDP per capita was most dynamic in the Baltic States, Slovakia and Poland. The dynamics of GDP per capita in relation to the EU average was higher in regions — regardless of the type — where the value of GDP per capita was lower at the time of accession to the EU. In rural regions, the dynamics of development changes was smaller in relation to other types of regions. Convergence (both beta and sigma) is occurring at a very low level. Further research may focus on the reasons for enclosed disparities and factors of the ongoing changes.

Trends in the Neurosurgical Workforce and Implications in Providing for an Aging Population

The United States is projected to face increasing physician-workforce shortages. However, the shortage in the neurosurgical workforce has not yet been characterized. In the present study, we outlined the current state of the neurosurgical workforce by quantifying the divide between the number of practicing neurosurgeons and the U.S. The Medicare Physician National Medicare database was queried from 2014 to 2019 to obtain the numbers of practicing neurosurgeons, which were compared with the population counts from the U.S. Census data. From 2014 to 2019, the total increase in neurosurgeons per capita was 9.4%. The Northeast neurosurgeons per capita rate (NPCR) increased by 17.1%, the South NPCR by 3.4%, the Midwest NPCR by 13.3%, and the West NPCR by 12.5%. In all regions, except for the West, the surgeon per capita ratio had decreased from 2017 to 2019. The greatest increase in the number of surgeons was 2018 to 2019 (n= 214). In 2014, the states with the lowest NPCRs were Vermont, Arkansas, and New Mexico. In 2019, these included Nevada, New Mexico, and Vermont. As of 2020, 56.6% of the neurosurgeons had practiced for >20 years. Although the national NPCR has slowly increased during the past 5 years, a more recent decrease occurred within the last 3 years. Additionally, with almost 57% of surgeons having been practicing for >20 years, concern exists regarding whether current practices can sustain increasing patient needs. The results from the present study indicate that further investigation is warranted regarding the factors contributing to this shortage and the steps that can be taken to increase the production of well-trained neurosurgeons.

Determining the impact of information technology greenhouse gas abatement at the Royal Borough of Kingston and Sutton Council

Personal computing generates 1% of global greenhouse gas emissions created by the production, use and end of life treatment of devices such as desktop computers and notebooks. Consequently, legislation exists to encourage organisations to procure computers with a low total carbon footprint. The rationale being that both scope 2 use-phase and scope 3 supply chain emissions can be reduced in the long term to contribute to wider reaching abatement targets. However, research finds that current computer product carbon footprint information is both insufficiently available and inconsistent to enable such a strategy. Further research determines barriers including associated incremental cost and perceived impact also prevent the diffusion of sustainable computing strategies. As such, the case study objective is to examine the impact of overcoming such limitations and barriers within an organisation subject to both the new legislation and a holistic climate emergency. By doing so the research question, 'Can meaningful representation of end user computing carbon footprint data drive human behavioural changes to abate greenhouse gas emissions?' is answered. Conducted over 3-years using newly developed methodologies, end user computer related emissions are quantified within a Greater London Council. Presented in a format reflecting the triple bottom line of corporate and social responsibility accounting, values for planet, people and profit are defined using standard emissions units, environmental equivalents, a per capita ratio and monetary savings. Subsequent behavioural changes driven by access to the new information are fourfold. Firstly, adoption of low energy devices reduces annual scope 2 emissions by 15,841 kgCO2e. Secondly, extended device retention periods displaces 515,190 kgCO2e of supply chain emissions. Thirdly, a new technology enabled remote working scheme is justified and adopted, avoiding 4,516,584 kgCO2e of commuting emissions. Finally, new computer procurement assessment practices are adopted to ensure ongoing abatement is maximised and compliance with legislation exceeded. Consequently, the council responds to the climate emergency strategy via the newly proven sustainable end user computing strategy by reducing energy consumption, waste and contributing to sustainable transport. In total, related emissions are reduced by 39% per year whilst saving £228,418 annually. As such, it is proven that the barriers of cost and perceived impact are surmountable and significant emissions abatement achievable when presented with meaningful information that drives behavioural change.

Territorial Conflict, Domestic Crisis, and the Covid-19 Pandemic in the South Caucasus. Explaining Variegated EU Responses.

Territorial Conflict, Domestic Crisis, and the Covid-19 Pandemic in the South Caucasus. Explaining Variegated EU Responses.

The Application of a Hospital Medical Surge Preparedness Index to Assess National Pandemic and Other Mass Casualty Readiness.

This article describes the use and findings of the Hospital Medical Surge Preparedness Index (HMSPI) tool to improve the understanding of hospitals' ability to respond to mass casualty events such as the COVID-19 pandemic. For this investigation, data from the U.S. Census Bureau, the Dartmouth Atlas Project, and the 2005 to 2014 annual surveys of the American Hospital Association (AHA) were analyzed. The HMSPI tool uses variables from the AHA survey and the other two sources to allow facility, county, and referral area index calculations. Using the three data sets, the HMSPI also allows for an index calculation for per capita ratios and by political (state or county) boundaries. In this use case, the results demonstrated increases in county and state HMSPI scores through the period of analysis; however, no statistically significant difference was found in HMSPI scores between 2013 and 2014. The HMSPI builds on the limited scientific foundation of medical surge preparedness and could serve as an objective and standardized measure to assess the nation's medical readiness for crises such as the COVID-19 pandemic and other large-scale emergencies such as mass shootings. Future studies are encouraged to refine the score, assess the validity of the HMSPI, and evaluate its relevance in response to future legislative and executive policies that affect preparedness measures.

Assessing Public Open Spaces: A Case of City Nagpur, India

Major Indian cities have a lower public open space (POS)-capita ratio and do not meet national and international standards. Moreover, factors such as lack of design guidelines for POSs, limited funding, and lack of public participation have affected these limitedly available POSs and made them ineffective and incapable of meeting the contemporary needs of a diverse range of users. Therefore, it is essential to make them not only inclusive, user-friendly, attractive, and efficient, but also socially, economically, and environmentally sustainable in order to serve the various facilities and services at their optimum level. This study includes the assessment of two POSs to identify strengths and deficiencies that affect their character and use. These POSs are public parks, provide free access to users and are located in the city of Nagpur. For assessment, the study proposed the Public Open Space Index (POSI) that combines five aspects: Individual well-being, Inclusiveness, Engagement, Sustainable spaces, and Management.A mixed methods approach was considered for data collection, including a self-administered questionnaire survey and observations.According to the results, POSs have strengths in that they facilitate social cohesion, engagement, and basic facilities. POSs do not encourage equitable access and sustainable practices, which are considered deficiencies.The study helps planners, designers, and parenting authority to develop initiatives to make these limited POSs inclusive, functional, and sustainable.

Imatinib Efficacy, Safety and Resistance in Iranian Patients with Chronic Myeloid Leukemia: A Review of Literature.

Background: Imatinib is the gold standard in the treatment of chronic myeloid leukemia (CML) patients. Resistance to imatinib is interfering with patients’ responses and their survivals.Materials and Methods: We designed a systematic search to find relevant studies by applying appropriate keywords in PubMed, Web of science, Scopus, Ovid, ProQuest, Science direct and Google scholar for English studies. We also investigated the aforementioned terms’ correspondence in Magiran, Scientific information database (SID) and Google scholar for Persian articles. Results: 25 studies were selected for final analysis. Reported hematologic responses from adult studies ranged 86-99% and major molecular responses were estimated in 38.84% of our patients within 12 months of treatment. The most frequent reported adverse drug reactions (ADRs) were edema (n=5 studies, 100%) and fatigue and nausea (n=4 studies, 80%); ADR per capita ratio was 1.46. Only one study informed ADRs in pediatrics demonstrating 93% of patients experienced ADRs after receiving imatinib. Most of the Studies (n=4, 67% from 7 studies) considered BCR/ABL point mutation as main reason of imatinib resistance. Drug-binding site and P-loop regions were two common sites for BCR/ABL point mutation.Conclusion: Imatinib as the first line treatment for CML has been associated with proper and durable responses in Iranian adults and children CML patients. Moreover, Imatinib life-threatening adverse effects were reported uncommon. Various responses to modified regimens have been reported in resistant patients; therefore, individualized treatment based on mutation type could be recommended.

Southern and Northern Italy in the Great Divergence: New Perspectives from the Occupational Structure

Structural transformation is a key indicator of economic development. This paper reconstructs and examines spatial patterns of the occupational structure in pre-unification Italy, combining direct observations and urbanization rates. In 1861, the agricultural labour share was higher in Southern Italy than in the Centre and North. During the Risorgimento, provincial wages converged within the Centre-North. The predicted Centre-North/South GDP per capita ratio declined in the fifteenth and sixteenth centuries, as the Centre-North stagnated and the South grew slowly. Southern Italy forged ahead of China after, and fell behind Britain before, the Centre-North did, but by pre-modern standards it nonetheless emerged as a middle-high income area.

Lower COVID-19 mortality in Italian forested areas suggests immunoprotection by Mediterranean plants.

The COVID-19 pandemic has induced dramatic effects on the population of the industrialized north of Italy, whereas it has not heavily affected inhabitants of the southern regions. This might be explained in part by human exposure to high levels of fine particulate matter (PM) in the air of northern Italy, thus exacerbating the mortality. Since trees mitigate air pollution by intercepting PM onto plant surfaces and bolster the human immune system by emitting bioactive volatile organic compounds (VOCs), we hypothesize a protective role of evergreen forested areas in southern Italy. We compared the mortality rate due to COVID-19, the death number, the positivity rate and the forest coverage per capita in various Italian regions. Hectares of forest per capita and prevalence of deciduous versus evergreen forestal species were also estimated. In silico docking studies of potentially protective compounds found in Laurus nobilis L., a typical Mediterranean plant, were performed to search for potential antivirals. We found that the pandemic’s severity was generally lower in southern regions, especially those with more than 0.3 hectares of forest per capita. The lowest mortality rates were found in southern Italy, mainly in regions like Molise (0.007%) and Basilicata (0.005%) where the forest per capita ratio is higher than 0.5 Ha/person. Our findings suggest that evergreen Mediterranean forests and shrubland plants could have protected the southern population by emission of immuno-modulating VOCs and provision of dietary sources of bioactive compounds. Moreover, in silico studies revealed a potential anti-COVID-19 activity in laurusides, which are unexplored glycosides from bay laurel. Overall, our results highlight the importance of nature conservation and applications to the search for natural antivirals.Electronic supplementary materialThe online version of this article (10.1007/s10311-020-01063-0) contains supplementary material, which is available to authorized users.