Low Per-capita Income Research Articles

Novel Insights Into the Epidemiological and Clinico-Pathological Profile of Triple-Negative Breast Cancer: Dissection of an Aggressive Variant.

Objective Triple-negative breast cancer (TNBC) represents an aggressive and prognostically poor variant of breast cancer. Over the years, detailed research has been conducted and published in Western literature. However, there lacks a detailed account of TNBC cases from the perspective of a low-volume institution. This study aims to assess the clinicalfeatures of TNBC, as well as their prognostic implications in a tertiary care centre. Methods and materials This prospective observational studytook place at a tertiary health centre for two years, spanning from 2021 to 2023. The study aimed to investigate various clinicopathological and epidemiological parameters, thereby highlighting the shortcomings in the existing knowledge about the subject in the context of a low-volume centre, as well as additional contributing factors in developing countries like India.A group of 150 participants diagnosed with TNBC through biopsy and immunohistochemistry and >40 years of age were included in the study. Patients who tested positive for hormonal receptors and who refused to give consent for participation were excluded from the study. The study subjectswere categorized according to their clinical TNM (cTNM) stage and eventually segregated into two primary heads, namely pre-surgery chemotherapy with breast-conserving surgery (BCS) after a good response, or modified radical mastectomy (MRM) upfront. Important demographic details, including age, socioeconomic status, and education, were also recorded. A comprehensive follow-up assessment post-treatment was performed to detect early recurrence. After data collection, the recurrence rates were correlated with the TNBC status to establish the aggressiveness of the cancer. Statistical analysis of the data was done using the Statistical Package for Social Sciences (SPSS) -16version software. Results The average age of the 150 participants in the study was 52.21 years (SD±4.89 years). The highest recorded age was 64 years, while the lowest recorded age was 45 years. In the study, it was observed that 41% of the participants diagnosed with TNBChad stage III disease, whereas 33.5% had stage I disease, 22% had stage IV disease and 3.6% had stage II disease. A total of 27.5% of individuals with TNBCexhibited metastases in various anatomical sites, whereas the other 72.5% did not show any signs of metastasis. Conclusion Triple-negative breast cancer has earned its position as a unique subtype of breast cancer due to its unusual molecular characteristics, aggressive behavior, limited treatment options, and poor prognosis. The lower per-capita income and limited knowledge pertaining to this variant, along with the absence of more specific treatment options, contribute to the already high levels of morbidity and mortality associated with this illness. To effectively address this unique and very virulent ailment and customize our strategies, it is imperative to do further comprehensive investigations, thereby enabling us to deliver the highest quality of medical attention to individuals afflicted by this pathology.

Assessing the digital transformation in agri-food cooperatives and its determinants

The digital transformation (DT) of companies implies the emergence of new business models based on the widespread use of digital technologies. Digital transformation is necessary to improve efficiency, productivity, and market access in a context of increasing competition. In the case of the agri-food sector, DT is also required to address the challenges of food safety, food waste, and sustainability. This research aims to build a theoretical framework and a methodology to assess the global level of DT and its dimensions and factors that influence it in a specific type of agri-food company, namely agri-food cooperatives. These prominent social economy entities follow cooperative principles and play a significant role in rural development, especially in the most backward regions. An empirical analysis has been conducted to validate the methodology and meet the objectives. To this end, a Global Index of DT was built, and data was obtained from a survey of agri-food cooperatives in Andalusia, a southern Spanish region with a long-standing tradition of agri-food cooperatives, which also presents a low per-capita income in the European context. Empirical results effectively reveal that the proposed theoretical framework and methodology expediate the assessment of the global level of DT of agri-food cooperatives and the relevance of certain influential critical factors. In this way, relevant information for cooperatives and policy-makers can be collected to facilitate the implementation of DT.

Country Comparisons on the Concept of Economic Freedom: A Multi-Criteria Decision-Making Approach

Economic freedom is a broad term with numerous aspects. The aim of the study is to increase awareness of the economic freedom components and to provide an analytical approach. Entropy, TOPSIS, ARAS, SAW, Borda Count Method, Clustering, and Spearman correlation analysis were used to assess 40 nations. The countries with the greatest per capita GDP such as Hong Kong, Singapore, and Switzerland are at the top of the economic freedom ranking. On the other side, countries with low per-capita income such as Poland, Thailand, and Russian Federation rank bottom. Governments and officials in low-scoring nations must provide an environment of stability, trust, and facilitation for their residents and foreign investors in terms of trade tariffs, inflation, and account restrictions. Individuals, groups, non-governmental organizations, and institutions should persuade decision-makers and politicians to take novel action plans in terms of taxes, inflation policies, account restrictions, and decision-making in favour of greater freedom.

Is population Explosion a threat to Pakistan’s Economic Development?

Purpose: Population growth and its impact on economic development have been a subject of major concern among demographers, economists, and social scientists. Some believe that rapid population growth is a significant problem, while others consider it just a hoax. Previous studies have discovered the negative as well as the positive and profound impact of rapid population growth on economic development. The present study analyses population growth and its impact on economic development in the context of Pakistan.
 Design/Methodology/Approach: A Descriptive Methodology is found suitable to analyze the population growth and its impact on economic development in the context of Pakistan. In this regard, 50 articles from google scholar and statistical reports from World Bank are studied. The data is taken from World Bank Indicators and presented in the form of charts.
 Findings: It is found that poor family planning, high fertility, low status of women in society, and illiteracy are the main contributors to rapid population growth in Pakistan. The study concludes that rapid population growth in Pakistan contributes to higher unemployment, lower per-capita income, and depletion of natural resources.
 Implications/Originality/Value: It further recommends that rapid population growth can be addressed by educating the women, contraceptive-use campaigns or community-based programs, and investing in family planning programs.

Context matters: Unpacking decision-making, external influences and spatial factors on clean cooking transitions in Nepal

Investigations of the underlying cause of slow and varied clean cooking transitions in rural areas of developing countries have predominantly taken an intra-household approach. That is, 'who adopts or who doesn’t?’ However, this approach tends to de-emphasise the contextual domain for household decision-making. It is equally important to know factors exogenous to households; 'which technologies are appropriate and where?’. In this paper, we examine crucial exogenous influences of cooking fuel transitions in overwhelmingly understudied regions, low-income countries with heterogeneous geographic contexts, using Nepal as the case study. A two-step method is employed. First, we developed a theoretical framework to understand these external influences using an expert survey. Then, we spatially tested how these influences affect household cooking fuel use in Nepal’s sub-national regions. Our results lead to the conclusion that there exist heterogeneous exogenous factors such as climate, access to markets and geography in low-income countries with heterogeneous geographic contexts that shape the access and use of a wide array of clean cooking technologies and fuels. These factors are contextually appropriate and must be coupled with other supporting interventions if clean cooking transitions are to accelerate in countries with low per-capita income and heterogenous geographies.

Health Care for the Elderly: Policy of Japan and Recommendation for Vietnam

As a country with low per-capita income and weak social welfare network in a context of increasingly aging population, Vietnam has been facing a number of challenges in supporting the elderly with diverse needs. Japan is currently known as a super-aging society in the world. Over the past decades, Japanese government has put their efforts to protect the elderly through effective social welfare systems.
 Using desk review and analysis, this paper aims at: i) Overviewing the context of aging population in Japan and Vietnam; ii) Describing the policy system in health care for the elderly in Japan; and iii) Proposing some policy recommendations for promoting health care to the elderly in Vietnam.
 Keywords
 Social policy, health care, Elderly, Japan, Vietnam.

Policy Priorities For Improving The Quality Of Slum Settlements In Banjarmasin City, South Kalimantan Province, Indonesia

Banjarmasin city faces almost the same problems as other big cities in the world, namely slum settlements. One of the factors in the formation of slum settlements in Banjarmasin city is urbanization. The population that continues to increase due to the flow of urbanization causes urban areas to have a very urgent problem, namely the provision of housing facilities. The high price of land in the city center and low-per capita income cause people to tend to look for settlements in suburban areas with inadequate environments and supporting facilities. This research aims to identify the conditions of slum settlements in Banjarmasin City and formulate policy priorities to improve the quality of slum settlements in Banjarmasin City. To answer all these objectives, an integrated settlement management system can be implemented. Comprehensive integration between office holders, stakeholders, and residents will produce a draft policy and slum management scenario. In addition, the policy for sustainable management of slum settlements in Banjarmasin City is also designed using the AHP (Analytical Hierarchy Process) approach. The slum settlements in Banjarmasin city are generally caused by geographical location, where most of them are river and swamp areas. Slums are getting worse because of the bad sanitation system. Ecological factor is the main priority factor in improving the quality of slum settlements. This is because if the slum area is able to maintain its ecology, it will be able to overcome disturbances or pressure, maintain or regain its function and shape. Based on AHP analysis, it is also known that the policy priority in improving the quality of slum settlements is by redevelopment. This effort is the rearrangement of part or all of the area for the purpose of managing the slum settlements in Banjarmasin city.

"Puddles on the Road": Hurdles in the Pathway from Symptoms to Diagnosis and Treatment in Children with Type 1 Diabetes.

Introduction:This study was conducted to investigate the pathway from first symptoms to initiation of insulin regimen in children with new-onset Type 1 Diabetes Mellitus (T1DM) and explore the reasons behind diabetes ketoacidosis (DKA) at onset among children with T1DM.Materials and Methods:An exploratory study was conducted using a pretested questionnaire, among parents of children diagnosed with T1DM within preceding 3 months.Results:Out of the total 105 children, 56.1% were males. The median age was 7 years. The commonest reported symptoms were polydipsia (97.8%), polyuria (75.2%), and nocturia (75.2%). The mean time taken by parents from onset of symptoms to decide to visit the physician (appraisal gap) was 7.85 ± 7.95 days. The help-seeking gap (from decision-making to visiting a physician) was 3.01 ± 8.31 days, diagnostic gap (from first visit to diagnosis) was 4.19 ± 6.72 days, and the treatment gap (from diagnosis to the start of insulin) was 2.12 ± 6.87 days. The DKA at onset (was present in 39 out of 105 children 37.1%) and was higher among children with lower per-capita income (P-0.017), lack of previous experience among parents (P-0.017), longer appraisal (P-0.023), and treatment gap (P-0.009).Conclusion:Increasing awareness about the diabetes among children among the public and primary healthcare workers can help prevent DKA at onset.

Growth and Regional Disparities in Odisha: An Analysis in the Post-reform Period

The post-reform period has witnessed high economic growth in the net state domestic product (NSDP) of the state of Odisha. With a higher growth in income in the post-reform period, especially in the tertiary sector, the state witnessed high regional disparities among its districts in terms of per capita income (PCI). The regional disparities can be assessed by looking at the convergence/divergence in the PCI of the 30 districts of Odisha. The state has seen a sigma ( σ) divergence in the income of districts during the post-reform period, which points to an increase in income disparities among the districts. To know the sectoral effects of the income divergence, the PCI growths of the 30 districts, over the period from 1993–1994 to 2011–2012, are regressed with the initial PCI of the three sectors—primary, secondary and tertiary—of the 30 districts. The beta ( β) divergence shows a mixed result. The districts having a low PCI in the primary sector show a convergence, meaning these were growing at a faster rate and converged with the districts having a high PCI in the primary sector. On the other hand, the districts having a low tertiary sector PCI show a divergence, which means these were growing at a slower rate while districts having a high PCI in the tertiary sector were growing at a faster rate, causing a divergence altogether. The secondary sector PCI of the districts shows an insignificant result. Combining the growth in the sectors’ income and the disparities among the districts in terms of sectoral PCI shows that the growth in income, especially the tertiary sector income growth during the post-reform period in Odisha, caused income disparities among the districts. JEL: O47, N3, P24, P25

Epidemiological and clinical characteristics of the COVID-19 epidemic in Brazil

The first case of COVID-19 was detected in Brazil on 25 February 2020. We report and contextualize epidemiological, demographic and clinical findings for COVID-19 cases during the first 3 months of the epidemic. By 31 May 2020, 514,200 COVID-19 cases, including 29,314 deaths, had been reported in 75.3% (4,196 of 5,570) of municipalities across all five administrative regions of Brazil. The R0 value for Brazil was estimated at 3.1 (95% Bayesian credible interval = 2.4-5.5), with a higher median but overlapping credible intervals compared with some other seriously affected countries. A positive association between higher per-capita income and COVID-19 diagnosis was identified. Furthermore, the severe acute respiratory infection cases with unknown aetiology were associated with lower per-capita income. Co-circulation of six respiratory viruses was detected but at very low levels. These findings provide a comprehensive description of the ongoing COVID-19 epidemic in Brazil and may help to guide subsequent measures to control virus transmission.

Path analysis of skin cancer preventive behavior among the rural women based on protection motivation theory

BackgroundDetermining the effective factors on the adoption of preventive behaviors capable of reducing the risk of skin cancer is an important step in designing interventions to promote these behaviors. Based on the protection motivation theory, the present study is aimed to conduct a path analysis of skin cancer preventive behaviors in rural women to explore these factors.MethodsIn this cross-sectional study, 243 rural women were randomly selected from the west of Iran to receive a valid and reliable questionnaire assessing constructs from the protection motivation theory, as well as demographic information. Fully completed questionnaires were returned by 230 women and the data were analyzed by SPSS 22 and LISREL8.8.ResultsConcerning skin cancer preventive behaviors, 27.8% of women wore sun-blocking clothing when working under the sun, 21.7% used sunscreen cream, 5.7% wore a cap, and 4.8% used gloves and sunglasses. Protection motivation theory and per capita income explained 51% of motivation variance and 25% of the variance of skin cancer preventive behaviors. The response efficacy construct was the strongest predictor of the motivation of protection (ß = − 0.44, p < 0/001). Per-capita income (ß = − 0.34, p < 0/001) and motivation (ß = − 0.33, p < 0/001) were the strongest predictors of these behaviors.ConclusionsThis study showed that protection motivation theory is efficient in predicting skin cancer preventive behaviors and the interventions can be designed and implemented by this theory. Proper planning is also necessary for promoting these behaviors among people with low per-capita income.

The influence of minimum wage regulation on labor income share and overwork: evidence from China

Minimum Wage Regulation (MWR) can raise wage rate, but its relation with labor income share is in controversy. We explore the influence of raising wage rate on labor income share and overwork in China. Panel data regressions are taken mainly based on China’s Industrial Enterprise Database and the International Labor Organization Database. Our findings show that raising wage rate can increase labor income share without leading to overwork. Factors that may significantly increase overwork are a higher proportion of male workers, a larger income gap and a lower per-capita income. We point out that the neoclassical explanation for labor income share is not persuasive. We support policies of raising wage rate and believe MWR is an effective measure to increase labor income share.

Patterns in the relationship between life expectancy and gross domestic product in Russia in 2005–15: a cross-sectional analysis

SummaryBackgroundSince 2005, Russia has made substantial progress, experiencing an almost doubling of per-capita gross domestic product by purchasing power parity (GDP [PPP]) to US$24 800 and witnessing a 6-year increase in life expectancy, reaching 71·4 years by 2015. Even greater gains in GDP (PPP) were seen for Moscow, the Russian capital, reaching $43 000 in 2015 and with a life expectancy of 75·5 years. We aimed to investigate whether mortality levels now seen in Russia are consistent with what would be expected given this new level of per-capita wealth.MethodsWe used per-capita GDP (PPP) and life expectancy from 61 countries in 2014–15, plus those of Russia as a whole and its capital Moscow, to construct a Preston curve expressing the relationship between mortality and national wealth and to examine the positions of Russia and other populations relative to this curve. We adjusted life expectancy values for Moscow for underestimation of mortality at older ages. For comparison, we constructed another Preston curve based on the same set of countries for the year 2005. We used the stepwise replacement algorithm to decompose mortality differences between Russia or Moscow and comparator countries with similar incomes into age and cause-of-death components.FindingsLife expectancy in 2015 for both Russia and Moscow lay below the Preston-curve-based expectations by 6·5 years and 4·9 years, respectively. In 2015, Russia had a lower per-capita income than 36 of the comparator countries but lower life expectancy than 60 comparator countries. However, the gaps between the observed and the Preston-expected life expectancy values for Russia have diminished by about 25% since 2005, when the life expectancy gap was 8·9 years for Russia and 6·6 years for Moscow. When compared with countries with similar level of income, the largest part of the life expectancy deficit was produced by working-age mortality from external causes for Russia and cardiovascular disease at older ages for Moscow.InterpretationGiven the economic wealth of Russia, its life expectancy could be substantially higher. Sustaining the progress seen over the past decade depends on the ability of the Russian Government and society to devote adequate resources to people's health.FundingThis work was partly funded through the International Project on Cardiovascular Disease in Russia supported by a Wellcome Trust Strategic Award (100217) and was supported by the Russian Academic Excellence Project 5-100.

Analysis of the global carbon dioxide emissions from 2003 to 2015: convergence trends and regional contributions

ABSTRACTThis paper consolidates and applies statistical methods to the per-capita carbon dioxide emissions and emissions per unit of the gross domestic product (GDP) data of the World Bank member nations, and presents an analysis of the temporal and geographical sources of carbon dioxide emissions. The results indicate that during the observation period, the countries’ per-capita carbon dioxide emissions and emissions per unit of GDP both displayed evidence of convergence. The global per-capita carbon dioxide emissions are relatively stable, and are converging at a rate lower than that of the emissions per unit of GDP. In terms of per-capita income levels, the total emissions of the mid-tier countries continue to grow, and countries with mid-tier per-capita income levels exhibit higher emissions per unit of GDP than both the low and high per-capita income countries. In terms of location of low- and middle-income countries, Southeast Asia and the Pacific have relatively high emission levels, while the per-capita carbon emission levels and the emissions per unit of GDP for Latin America and the Caribbean, South Asia and sub-Saharan Africa are below the global average. The gap between emission levels across different countries, geographic regions, and income groups continues to decrease.

Exposure to indoor air pollution and its perceived impact on health of women and their children: A household survey in a slum of Kolkata, India.

One's house is believed to be the safest and the healthiest place to live in. Indoor air pollution (IAP) means the presence of unwanted substances in the indoor air at concentration toxic to health. The objective of this study is to study the presence of IAP, its associated factors and impact on health of women residing in an urban slum of Kolkata, West Bengal, India. It was a cross-sectional study done from January 2017 to March 2017 among 120 households of a slum. Data were collected using a pre-designed pre-tested schedule from the homemaker of the households. All analyses were conducted with R: A Language and Environment for Statistical Computing. About 60% households used kerosene as cooking fuel predominantly. Smoke from the neighbouring houses troubled 57.5% respondents. More than 60% houses were overcrowded and more than 70% houses were poorly ventilated. IAP-related symptoms such as irritation in the eye, suffocation, dry cough significantly correlated with the presence of IAP sources and its contributory factors. Of 120, 78 (65%) perceived the presence of IAP in their houses. Lower per capita income (PCI), ground floor, and joint family were found to have higher odds of sources of IAP. Younger age, lower PCI, and ground floor were found to be strongly associated with higher contributory factors of IAP. The present study found that the majority of the households were exposed to IAP due to kerosene, neighborhood smoke while overcrowding and ill-ventilation accentuated it. Effective intervention with intersectoral coordination is the need of the hour.

Food Insecurity Is Associated with Undernutrition but Not Overnutrition in Ecuadorian Women from Low-Income Urban Neighborhoods.

Household food insecurity (HFI) is becoming an increasingly important issue in Latin America and other regions undergoing rapid urbanization and nutrition transition. The survey investigated the association of HFI with the nutritional status of 794 adult women living in households with children in low-income neighborhoods in Quito, Ecuador. Data were collected on sociodemographic characteristics, household food security status, and nutritional status indicators (dietary intake, anthropometry, and blood hemoglobin). Data were analyzed using multivariate methods. The findings identified revealed a high HFI prevalence (81%) among the urban households that was associated with lower per capita income and maternal education; long-term neighborhood residency appeared protective. HFI was associated with lower dietary quality and diversity and an increased likelihood of anemia and short stature but not increased high-calorie food intake or generalized or abdominal obesity. Although significant progress has been made in recent years, low dietary diversity, anemia, and growth stunting/short stature in the Ecuadorian maternal-child population continue to be major public health challenges. The study findings suggest that improving urban food security may help to improve these nutritional outcomes. They also underscore the need for food security policies and targeted interventions for urban households and systematic surveillance to assess their impact.

Territorial Systems, Regional Disparities and Sustainability: Economic Structure and Soil Degradation in Italy

The present study was devoted to identify the evolutionary path of a number of local systems in a Mediterranean country vulnerable to soil degradation (SD) in the last decades. A multivariate analysis was used to evaluate the socio-ecological conditions and to estimate rapidity-of-change of local systems by considering 6 bio-physical factors predisposing soil to degradation and 23 socioeconomic indicators over fifty years (1960–2010). Results indicate that systems’ development paths diverged during the investigated time period reflecting changes in the spatial organization and in the economic base of entire regions. Interestingly, economic performance and environmental quality do not seem to follow opposite trajectories. Local systems characterized by low per-capita income, agricultural specialization and population ageing, seem not to be associated with better and more stable ecological conditions. Local systems in affluent areas, featuring a mix of socioeconomic conditions with the prevalence of services in the economy and tourism specialization, showed relatively good ecological conditions and moderate-to-low SD vulnerability. Thus, affluent local systems do not necessarily reflect a higher pressure on the environment. These findings suggest that areas with a changing socio-demographic profile and a dynamic economic structure are compatible with low and stable levels of SD vulnerability.

Diet

Diet

What do drug monopolies cost consumers in developing countries?

This paper quantifies the effects of drug monopolies and low per-capita income on pharmaceutical prices in developing economies using the example of the antiretroviral drugs (ARVs) used to treat HIV.

What Do Drug Monopolies Cost Consumers in Developing Countries?

This paper quantifies the effects of drug monopolies and low per-capita income on pharmaceutical prices in developing economies using the example of the antiretroviral drugs (ARVs) used to treat HIV.