Project description:While many tropical countries are experiencing rapid deforestation, some have experienced forest transition (FT) from net deforestation to net reforestation. Numerous studies have identified causative factors of FT, among which forest scarcity has been considered as a prerequisite for FT. In fact, in SE Asia, the Philippines, Thailand and Viet Nam, which experienced FT since 1990, exhibited a lower remaining forest area (30±8%) than the other five countries (68±6%, Cambodia, Indonesia, Laos, Malaysia, and Myanmar) where forest loss continues. In this study, we examined 1) the factors associated with forest scarcity, 2) the proximate and/or underlying factors that have driven forest area change, and 3) whether causative factors changed across FT phases (from deforestation to net forest gain) during 1980-2010 in the eight SE Asian countries. We used production of wood, food, and export-oriented food commodities as proximate causes and demographic, social, economic and environmental factors, as well as land-use efficiency, and wood and food trade as underlying causes that affect forest area change. Remaining forest area in 1990 was negatively correlated with population density and potential land area of lowland forests, while positively correlated with per capita wood production. This implies that countries rich in accessible and productive forests, and higher population pressures are the ones that have experienced forest scarcity, and eventually FT. Food production and agricultural input were negatively and positively correlated, respectively, with forest area change during 1980-2009. This indicates that more food production drives deforestation, but higher efficiency of agriculture is correlated with forest gain. We also found a U-shaped response of forest area change to social openness, suggesting that forest gain can be achieved in both open and closed countries, but deforestation might be accelerated in countries undergoing societal transition. These results indicate the importance of environmental, agricultural and social variables on forest area dynamics, and have important implications for predicting future tropical forest change.
Project description:The exchange of diverse ideas has been shown to be a major driver of economic growth and innovation in local labor markets across the U.S. Yet, persistently high levels of occupational gender segregation pose a barrier to such exchange between women and men workers. Consistent with this, organizational sociologists have identified multiple economic benefits to gender diversity in workplaces. Yet, it is unclear whether these trends apply to local labor markets, which constitute the ecological geographic environment for firms. In this study, I use fixed effects regression models to examine the relationship between labor market levels of segregation and economic growth from 1980 through 2010. I find that gender segregation hinders the expansion of finance and technology sectors as two industries that rely on the exchange of information and innovation. Consequently, higher levels of gender segregation are also a bane to economic productivity, as measured through hourly wages. Results from this study suggest that gender equity, manifested in lower levels of occupational segregation, is a vital ingredient in the economic development of local U.S. labor markets.
Project description:Since 1980, anthropogenic emissions of ozone precursors have decreased in developed regions, but increased in developing regions, particularly East and South Asia, redistributing emissions equatorwards1-4. Modeling studies have shown that the tropospheric ozone burden (B O3) is much more sensitive to emission changes in the tropics and Southern Hemisphere (SH) than other regions5-9. However, the effect of the spatial redistribution of emissions has not been isolated. Here we use a global chemical transport model to consider changes in anthropogenic short-lived emissions from 1980 to 2010, and separate the influence of changes in the spatial distribution of emissions from the total emission increase, on B O3 and surface ozone. We estimate that the spatial distribution change increased B O3 by slightly more than the combined influences of changes in the global emission magnitude itself and in global methane. These results are explained by the strong convection, fast reaction rates, and strong NOx sensitivity in the tropics and subtropics. Emissions increases in Southeast, East, and South Asia may be most important for the B O3 change. The spatial distribution of emissions has a dominant effect on global tropospheric ozone, suggesting that the future ozone burden will be determined mainly by emissions from the tropics and subtropics.
Project description:The balance between spending on children and spending on the elderly is important in evaluating the allocation of public welfare spending. We examine trends in public spending on social welfare programs for children and the elderly during 1980-2000. For both groups, social welfare spending as a percentage of gross domestic product changed little, even during the economic expansions of the 1990s. In constant dollars, the gap in per capita social welfare spending between children and the elderly grew 20 percent. Unlike spending for programs for the elderly, spending for children's programs suffered during recessions. Public discussion about the current imbalance in public spending is needed.
Project description:Background: U.S. nonprofit hospital community benefit recently underwent significant regulatory revisions. Starting in 2009, the Internal Revenue Service (IRS) required hospitals to submit a new Schedule H that provided greater detail on community benefit activities. In addition, the Affordable Care Act (ACA), which became law in 2010, requires hospitals to conduct community health needs assessments (CHNA) and develop community health implementation plans (CHIP) as a response to priority needs every 3 years. These new requirements have led to greater transparency and accountability and this scoping review considers what has been learned about community benefit from 2010 to 2019. Methods: This review identified peer-reviewed literature published from 2010 to 2019 using three methods. First, an OvidSP MEDLINE search using terms suggested previously by community benefit researchers. Second, a PubMed search using keywords frequently found in community benefit literature. Third, a SCOPUS search of the most frequently cited articles in this topic area. Articles were then selected based on their relevance to the research question. Articles were organized into topic areas using a qualitative strategy similar to axial coding. Results: Literature appeared around several topic areas: governance; CHNA and CHIP process, content, and impact; community programs and their evaluation; spending patterns and spending influences; population health; and policy recommendations. The plurality of literature centered on spending and needs assessments, likely because they can draw upon publicly available data. The vast majority of articles in these areas use spending data from 2009 to 2012 and the first cycle of CHNAs in 2013. Policy recommendations focus on accountability for impact, enhancing collaboration, and incentivizing action in areas other than clinical care. Discussion: There are several areas of community benefit in need of further study. Longitudinal studies on needs assessments and spending patterns would help inform whether organizations have changed and improved operations over time. Governance, program evaluation, and collaboration are some of the consequential areas about which relatively little is known. Gaps in knowledge also exist related to the operational realities that drive community benefit activities. Shaping organizational action and public policy would benefit from additional research in these and other areas.
Project description:BACKGROUND:Hypospadias is a common male birth defect that has shown widespread variation in reported prevalence estimates. Many countries have reported increasing trends over recent decades. OBJECTIVE:To analyze the prevalence and trends of hypospadias for 27 international programs over a 31-yr period. DESIGN, SETTING, AND PARTICIPANTS:The study population included live births, stillbirths, and elective terminations of pregnancy diagnosed with hypospadias during 1980-2010 from 27 surveillance programs around the world. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS:We used joinpoint regression to analyze changes over time in international total prevalence of hypospadias across programs, prevalence for each specific program, and prevalence across different degrees of severity of hypospadias. RESULTS AND LIMITATIONS:The international total prevalence of hypospadias for all years was 20.9 (95% confidence interval: 19.2-22.6) per 10000 births. The prevalence for each program ranged from 2.1 to 39.1 per 10000 births. The international total prevalence increased 1.6 times during the study period, by 0.25 cases per 10000 births per year (p<0.05). When analyzed separately, there were increasing trends for first-, second-, and third-degree hypospadias during the early 1990s to mid-2000s. The majority of programs (61.9%) had a significantly increasing trend during many of the years evaluated. Limitations include known differences in data collection methods across programs. CONCLUSIONS:Although there have been changes in clinical practice and registry ascertainment over time in some countries, the consistency in the observed increasing trends across many programs and by degrees of severity suggests that the total prevalence of hypospadias may be increasing in many countries. This observation is contrary to some previous reports that suggested that the total prevalence of hypospadias was no longer increasing in recent decades. PATIENT SUMMARY:We report on the prevalence and trends of hypospadias among 27 birth defect surveillance systems, which indicate that the prevalence of hypospadias continues to increase internationally.
Project description:The etiology, clinical manifestations, and treatment of 19 sporadic cases of Buruli ulcer (BU) in Japan are described. The cases originated in different regions of Honshu Island, with no evidence of patient contact with an aquatic environment. The majority (73.7%) of cases occurred in females, with an average age of 39.1 years for females and 56.8 years for males. All patients developed ulcers on exposed areas of the skin (e.g., face, extremities). Most ulcers were <5 cm in diameter (category I), except in one severe progressive case (category II). Pain was absent in 10 of the 19 cases. Fourteen ulcers were surgically excised, and nine patients needed skin grafting. All cases were treated with various antibiotic regimens, with no reported recurrences as of March 2011. Mycobacterium ulcerans-specific IS2404 was detected in all cases. Ten isolates had identical 16S rRNA gene sequences, which were similar to those of M. ulcerans. However, the rpoB gene showed a closer resemblance to Mycobacterium marinum or Mycobacterium pseudoshottsii. PCR identified pMUM001 in all isolates but failed to detect one marker. DNA-DNA hybridization misidentified all isolates as M. marinum. The drug susceptibility profile of the isolates also differed from that of M. ulcerans. Sequence analysis revealed "Mycobacterium ulcerans subsp. shinshuense" as the etiologic agent of BU in Japan. Clinical manifestations were comparable to those of M. ulcerans but differed as follows: (i) cases were not concentrated in a particular area; (ii) there was no suspected connection to an aquatic environment; (iii) drug susceptibility was different; and (iv) bacteriological features were different.
Project description:BackgroundSeveral studies have suggested strong associations between economic downturns and suicide mortality, but are at risk of bias due to unmeasured confounding. The rationale for our study was to provide more robust evidence by using a quasi-experimental design.MethodsWe analysed 955,561 suicides occurring in the USA from 1980 to 2010 and used a broad index of economic activity in each US state to measure economic conditions. We used a quasi-experimental, fixed-effects design and we also assessed whether the effects were heterogeneous by demographic group and during periods of official recession.ResultsAfter accounting for secular trends, seasonality and unmeasured fixed characteristics of states, we found that an economic downturn similar in magnitude to the 2007 Great Recession increased suicide mortality by 0.14 deaths per 100,000 population [95% confidence interval (CI) 0.00, 0.28] or around 350 deaths. Effects were stronger for men (0.28, 95% CI 0.07, 0.49) than women and for those with less than 12 years of education (1.22 95% CI 0.83, 1.60) compared with more than 12 years of education. The overall effect did not differ for recessionary (0.11, 95% CI -0.02, 0.25) vs non-recessionary periods (0.15, 95% CI 0.01, 0.29). The main study limitation is the potential for misclassified death certificates and we cannot definitively rule out unmeasured confounding.ConclusionsWe found limited evidence of a strong, population-wide detrimental effect of economic downturns on suicide mortality. The overall effect hides considerable heterogeneity by gender, socioeconomic position and time period.
Project description:ObjectiveTo estimate the contributions of biological aging, historical trends, and birth cohort effects on trends in pre-eclampsia in the United States.DesignPopulation based retrospective study.SettingNational hospital discharge survey datasets, 1980-2010, United States.Participants120 million women admitted to hospital for delivery.Main outcome measuresTemporal changes in rates of mild and severe pre-eclampsia in relation to maternal age, year of delivery, and birth cohorts. Poisson regression as well as multilevel age-period-cohort models with adjustment for obesity and smoking were incorporated.ResultsThe rate of pre-eclampsia was 3.4%. The age-period-cohort analysis showed a strong age effect, with women at the extremes of maternal age having the greatest risk of pre-eclampsia. In comparison with women delivering in 1980, those delivering in 2003 were at 6.7-fold (95% confidence interval 5.6-fold to 8.0-fold) increased risk of severe pre-eclampsia. Period effects declined after 2003. Trends for severe pre-eclampsia also showed a modest birth cohort effect, with women born in the 1970s at increased risk. Compared with women born in 1955, the risk ratio for women born in 1970 was 1.2 (95% confidence interval 1.1 to 1.3). Similar patterns were also evident for mild pre-eclampsia, although attenuated. Changes in the population prevalence of obesity and smoking were associated with period and cohort trends in pre-eclampsia but did not explain the trends.ConclusionsRates of severe pre-eclampsia have been increasing in the United States and age-period-cohort effects all contribute to these trends. Although smoking and obesity have driven these trends, changes in the diagnostic criteria may have also contributed to the age-period-cohort effects. Health consequences of rising obesity rates in the United States underscore that efforts to reduce obesity may be beneficial to maternal and perinatal health.