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In practice we do not always have clear guidance from economic theory about specifying an econometric model. At one extreme, it may be said that we should “let the data speak.” It is good to know that when they “speak” that what they say makes sense. We must be aware of a particularly important phenomenon in empirical econometrics: the spurious relationship. If you encounter a spurious relationship but do not recognize it as such, you may inadequately consider such a relationship for hypothesis testing or for the creation of forecasts. A spurious relationship appears when the model is not well specified. In this chapter, we see from a case study that people can draw strong but inappropriate conclusions if the econometric model is not well specified. We see that if you a priori hypothesize a structural break at a particular moment in time, and based on that very assumption analyze the data, then it is easy to draw inaccurate conclusions. As with influential observations, the lesson here is that one should first create an econometric model, and, given that model, investigate whether there could have been a structural break.
This chapter introduces the National Security Institutions Data Set, an original cross-national resource offering the first systematic measurement of national security decision-making and coordination bodies across the globe from 1946 to 2015. The chapter leverages these data to probe the theory quantitatively, yielding three findings that are consistent with the theory’s propositions. First, it shows that national security institutions are more malleable than previous scholarship has suggested. Second, it finds that integrated institutions tend to perform better than institutional alternatives. Third, it shows that institutional change is associated with domestic environments in which leaders have political incentives to weaken the bureaucracy.
Epidemiology studies how regularly diseases occur in different groups of people and why – hence its pivotal role in planning the distribution of resources. This chapter focuses on the epidemiology of mental illnesses in older people in acute hospitals and highlights the role of the liaison psychiatrist and other mental health professionals in bridging the gap between physical and mental disorders. By outlining the intricate connection between the two, it explains why careful consideration and a high index of suspicion are needed when assessing older persons in the acute hospital. Emphasis is placed on the importance of viewing ageing as a normal biological and social construct rather than a problematic disease process to which a figurative cut-off point can be applied. The chapter gives prominence to the mammoth social and economic burden of mental disorders, borne by all in society.
The chapter has subsections on important epidemiological terminologies, life expectancy, the prevalence of common psychiatric disorders in acute general hospitals (including emergency departments), and the influence of COVID-19 on the prevalence of mental disorders in older persons. It sounds a clarion call to challenge current practice, work synergistically with all stakeholders, and embrace change if a crisis is to be averted.
To assess trends in the dietary quality of Mexican adolescents from 2006 to 2018, both overall and by sociodemographic indicators, using adaptations of the EAT-Lancet Planetary Health (PH) recommendations, optimal intake estimated by the Global Burden of Disease (GBD) and 2015 Mexican Dietary Guidelines (MDG) in nationally representative samples.
Design:
Using dietary data from a semi-quantitative FFQ, dietary quality indexes were constructed as adaptations of three dietary intake recommendations. Trends in adherence to recommendations were evaluated with multivariate quantile regression models with survey year as the main independent variable and adjusted for age, sex, energy intake, dwelling area, geographical region, household assets condition, and student/non-student status. P values and CI were Bonferroni-corrected.
Setting:
Mexico.
Participants:
Non-pregnant or lactating adolescents aged 12–19 years (n 16 520).
Results:
Adherence to the PH index was about 40 %, GBD was nearly 35 % and MDG was about 37 %. The lowest adherences were for added sugars, sugar-sweetened beverages, nuts and seeds, red meats, processed meats, and legumes (<28 %). No 2006–2018 trends in total adherence were found in any index. Nevertheless, negative adherence trends were identified for poultry (β = –2·4), and saturated fats (β = –0·93), and positive for unsaturated oils (β = 1·23), in the PH. In MDG, relevant trends were found for plain water (β = 1·63) and foods rich in fats (β = –1·24).
Conclusions:
Mexican adolescents have demonstrated poor dietary quality by these three approaches. Therefore, this population has a high-risk profile for diet-associated chronic diseases. Further research and appropriate public policies are needed.
The prevalence of overweight and obesity in children and adults has increased worldwide. A strong environmental factor contributing to the obesity epidemic is food portion size (PS). This review evaluates the current evidence linking food PS to obesity, examines the effects of PS on energy intake (EI), and discusses the drivers of food PS selection. The leading causes of the rise in PS include globalisation, intensive farming methods, the impact of World War II, due to shortage of staple foods, and the notion of ‘waste not, want not’. Large PS of energy-dense foods may stimulate overconsumption, leading to high EI levels. However, the studies have not shown a cause-and-effect relationship, due to confounding factors. Important mechanisms explaining the attractiveness of larger PS leading to higher EI levels are value for money, portion distortion, labels on food packaging, and tableware. Consumers depend on external rather than internal PS cues to guide consumption, irrespective of satiety levels. Further research is recommended on food consumption patterns to inform policymakers and provide information and insights about changes in diet.
Psychiatric in-patients have a greatly elevated risk of suicide. We aimed to examine trends in in-patient suicide rates and determine if characteristics of in-patients who died by suicide have changed over time.
Methods
We identified all in-patients in England who died by suicide between 2009 and 2020 from the National Confidential Inquiry into Suicide and Safety in Mental Health. Suicide rates were calculated using data from Hospital Episodes Statistics.
Results
The rate of in-patient suicide per 100 000 bed days fell by 41.9% between 2009–2011 and 2018–2020. However, since 2016 the rate has remained static with no significant fall. Rates fell in men, those aged 30–59, and those with schizophrenia and other delusional disorders or personality disorder. Rates also fell for suicide by hanging (including hanging on the ward) and jumping. No falls were seen in suicide rates among women, younger and older age groups, and those with affective disorder. There was no indication of a transfer of risk to the post-discharge period or to home treatment/crisis care. More in-patients in the latter part of the study were aged under 25, were on authorised leave, and had psychiatric comorbidity.
Conclusions
In-patient suicide has significantly fallen since 2009, suggesting patient safety may have improved. The recent slowdown in the fall in rates, however, highlights that renewed preventative efforts are needed. These should include a greater focus on women, younger and older patients, and those with affective disorder. Careful reviews prior to granting leave are important to ensure a safe transition into the community.
The Conclusion summarises the sum of the individual parts of the knowledge contained across the ten chapters of this book. This is done by answering the three research questions that were posed in the Introduction of the book.
Edited by
Andreas Rasche, Copenhagen Business School,Mette Morsing, Principles for Responsible Management Education (PRME), UN GlobalCompact, United Nations,Jeremy Moon, Copenhagen Business School,Arno Kourula, Amsterdam Business School, University of Amsterdam
In the concluding chapter of the book, we reflect on the future of corporate sustainability. We summarise the key topics covered in each of the four sections – approaches, actors, processes and issues. We present past and future developments for each of these sections. We also reflect on how some of the tensions as presented in the introduction remain and become core to corporate sustainability debates. Finally, we end on a reflection of our personal roles in advancing sustainability.
The number of laws and standards regulating and protecting the welfare of animals is expanding around the world. The growing demand from policy-makers for expertise and advice on animal welfare in order to create these new regulations has been inspired by developments in both science and ethics, which are increasing our understanding of animals’ abilities and capacities.
Each year, worldwide, large numbers of wild animals are taken to rehabilitation centres for treatment, care and release. Although analysis of intake records may provide valuable insight into the threats and impacts to wildlife, there are few such published reports. Four years of intake records from a large urban rehabilitation centre in South Africa were examined for trends. Animal intake rate was high (2,701 [± 94] per annum). Most of the intake (90%) was birds, with few mammals (8%) and reptiles (2%), and most of these were of locally common species (eg doves, pigeons). This reflects the findings of other studies, namely that species living in close association with humans are the most frequently admitted to rehabilitation centres. In total, most of the animals admitted (43%) were juveniles, which were assumed to be abandoned or orphaned. The implications of then rehabilitating these juveniles, which were largely uninjured, are three-fold: should humans be interfering with nature if the cause was not human-related, can each juvenile (especially in these large numbers) be adequately prepared to survive and thrive when released into the wild, and is there space in the environment for them, without causing harm to others already in the environment. This study suggests that the large numbers of animals currently being admitted to the centre may be reduced, possibly through increased public education; in particular to leave uninjured juveniles in the wild. Furthermore, improvements in the centre's recording system may allow for use in funding requests and various research opportunities.
People often make predictions about the future based on trends they have observed in the past. Revised probabilistic forecasts can be perceived by the public as indicative of such a trend. In five studies, we describe experts who make probabilistic forecasts of various natural events (effects of climate changes, landslide and earthquake risks) at two points in time. Prognoses that have been upgraded or downgraded from T1 to T2 were in all studies expected to be updated further, in the same direction, later on (at T3). Thus, two prognoses were in these studies enough to define a trend, forming the basis for future projections. This “trend effect” implies that non-experts interpret recent forecast in light of what the expert said in the past, and think, for instance, that a “moderate” landslide risk will cause more worry if it has previously been low than if it has been high. By transcending the experts’ most recent forecasts the receivers are far from conservative, and appear to know more about the experts’ next prognoses than the experts themselves.
After nearly two decades of rising wages for those in the unskilled sectors of China's economy, in the mid-2010s employment and wages in China began to experience new polarizing trends. Using data from the National Bureau of Statistics of China, this paper examines trends in multiple sectors and subeconomies of China, revealing the substantial rise of employment in informal, low-skilled services as well as the steady decline of wage growth in the informal subeconomy. At the same time, we find that although employment growth in the formal subeconomy is relatively moderate, wage growth in high-skilled services is steadily rising. These two trends pose a challenge for China, presenting a new and uncertain period of economic change.
The vast world of biotechnology applications to human health is reviewed and the terminology used in the rest of the book is defined here. An overview of the industry, the value chains, the specific types of human health products covered in this text are presented in this chapter. A time-tested way to analyze an industry’s attractiveness for new entrants is presented here using Porter’s five forces model. Technology trends such as mobile health, artificial intelligence, 3D printing, cell and gene therapy, and robotics are presented to the reader in the context of the mission of improving human health. The overall process of development of new products in these various segments of drugs, devices and diagnostics sectors is reviewed here. The reader will leave this chapter with a 30,000-foot view of the industry dynamics and understand the context within which product commercialization is to be done.
To examine changes in the proportions of daily, weekly and occasional consumers of sugar-sweetened soda in six European countries that introduced/updated a tax between 2001–2002 and 2017–2018 and in neighbouring comparison countries (without a tax).
Design:
Repeated cross-sectional surveys.
Setting:
Health Behaviour in School-aged Children study, spanning five survey years (school years 2001–2002 to 2017–2018).
Participants:
Nationally representative samples of 13-year- and 15-year-old adolescents (n 236 623, 51·0 % girls).
Results:
Tax sizes (€0·02/l to €0·22/l) and pre-tax soda consumption were heterogeneous across countries. Prevalence of daily soda consumption reduced in the survey year following tax implementation in Latvia (from 17·9 to 11·9 %, P = 0·01), Finland (4·2 to 2·5 %, P = 0·001), Belgium (35·1 to 27·8 %, P < 0·001) and Portugal (17·4 to 14·9 %, P = 0·02), but not in Hungary (29·8 to 31·3 %, P = 0·47) or France (29·4 to 28·2 %, P = 0·27). However, reductions were similar (Finland) or smaller (Belgium, Portugal) than those in the comparison countries, except in Latvia where the reduction was larger (Pinteraction < 0·001). Prevalence of weekly soda consumption remained stable (Finland, Hungary and France) or increased (Latvia, Belgium); only Portugal experienced a decline (P < 0·001), which was larger than in the comparison country (Pinteraction < 0·001). Prevalence of occasional soda consumption (<1x/week) did not rise after implementation of the tax in Latvia, Finland, Hungary, France or Belgium, or the rise was similar to the comparison country in Portugal (Pinteraction = 0·15).
Conclusions:
Countries with a soda tax did not experience larger beneficial changes in post-tax adolescent consumption frequency of soda than comparison countries. Further studies, with different taxation types, are needed in the adolescent population.
Psychiatry is not immune to the effects of trends and fads, which are ideas that elicit short-lived enthusiasm, are quickly adopted, and abandoned when they fail to live up to expectations. Trends meet a deeply felt need to explain, or at least name, what would alternatively be unexplainable human suffering.
Objectives
The authors aim to explore the trends and fads that have occurred in psychiatric diagnostic and treatment throughout history and assess if any modern trends can be identified as well as assessing the effects or consequences of these.
Methods
The authors conducted a non-systematized literature review with focus on those articles most pertinent to the topic in question.
Results
The literature demonstrates that fads and trends not only plague fashion and diet, but also psychiatry. Trends in psychotherapeutic options can be observed by the swing from psychoanalysis to psychopharmacological focus. Overdiagnosis is one of the consequences of these trends, and can be seen from hysteria, schizophrenia, multiple personality disorder, attention-deficit and hyperactivity disorder to gender identity disorder. These trends impact the way diagnosis are made and the treatments implemented.
Conclusions
Fads in psychiatry have occurred not only on the edge, but in the very mainstream of theory and practice. A balance is called for, with caution needed in order not to fall into the temptation of the fad, however, an open mind should also be maintained when cutting-edge treatments and theories emerge. The sensible antidote to falling for fads and trends in psychiatry is commitment to evidence-based medicine.
Congenital heart defects (CHD) are the most frequent group of congenital anomalies representing a significant burden of mortality and morbidity and health service load.
Objective:
In the Northern Ireland population, served by a single paediatric cardiology centre, we determine the prevalence and trends of CHD among live births.
Methods:
This is a descriptive cross-sectional population-based study, using the paediatric cardiology database. The study included a total of 245,120 live births representing all children born in Northern Ireland 2005-2014.
Results:
A total of 11,410 children (4.65% of live births in Northern Ireland) received an echocardiogram for suspected CHD, and 3,059 children were subsequently diagnosed with a major CHD (prevalence = 12.48 per 1,000 live births (95% CI 12.04–12.93)) of whom 490 (16.02%) had genetic or chromosomal disorders including Down syndrome. The prevalence of non-genetic or chromosomal cases was 10.48 per 1,000 live births (95% CI 10.08–10.89) and did not change significantly over time (p = 0.91). The prevalence of CHD diagnosed in the first year of life was 8.46 per 1,000 live births (95% CI 8.10–8.83), which increased over time (p < 0.01). The prevalence of severe CHD was 2.02 per 1,000 live births (95% CI 1.85–2.21).
Conclusion:
Northern Ireland has a high prevalence of CHD among European countries, which may be associated with complete ascertainment of both early and late diagnosed cases recorded in the paediatric cardiology database, as well as being one of the few European countries where terminations of pregnancy for foetal anomaly was illegal during the study period.
A trite, if apt, metaphor for the American health care and insurance system is a battleship that has been sailing in a particular direction for many years, with many of us as free riders in a direction we do not prefer. That direction is characterized by spending growth that outpaces virtually any other sectoral trend in the economy, and by quality and outcome measures that, at best, improve little and, at worst, deteriorate. The battleship takes up 18 percent of gross domestic product (GDP), furnishes employment to nearly 15 percent of the workforce, and consumes a large share of federal and state governmental budgets (Figure 2.1). Even if we could figure out how to cut the power, this dreadnought would continue to coast in the same direction for the foreseeable future. The obvious conclusion is that it has been and will continue to be hard to turn the vessel to go in a different direction. As of this writing, the novel coronavirus pandemic has affected the use of care as well, putting many “normal” services on hold to accommodate sick patients. And while it is too early to conclusively confirm the effect of the pandemic on spending trends, there is likely to be an effect (although even the direction is not known). Once the pandemic stabilizes, consumption of health care services will probably not return exactly to past behaviors, but there will be a strong tendency to slide back. What might help to avoid doing so, and most importantly, what evidence can be currently offered or generated to support efforts to change course?
Many scholars have detected a decrease in political violence in recent decades, but the causes of this decline remain unclear. As a contribution to this debate, this chapter revisits the controversy over trends in conflict after the end of the Cold War. While several scholars made ominous predictions of surging ethnic warfare, Ted Robert Gurr presented evidence of a pacifying trend since the mid?1990s and predicted a further decline in ethnic conflict in an article on"ethnic warfare on the wane." Leveraging more recent data on ethnic groups and their participation in ethnic civil wars, this chapter evaluates if Gurr was right about the decline of ethnic conflict, and if he was right for the right reasons. We assess whether an increase in governments' accommodative policies toward ethnic groups can plausibly account for a decline in ethnic civil war. Our findings are largely compatible with Gurr's observations and stand in stark contrast to various pessimistic projections that were made in the early post-Cold War period. Among a number of empirical dimensions, we have found that this relatively optimistic perspective holds up well despite a surge in civil conflict in recent years. Ethnic, as opposed to non-ethnic, civil wars appear to have subsided after the mid-1990s, and this decline is at least partially attributable to an increase in governments' accommodative policies toward ethnic groups, such as the granting of group rights, regional autonomy, and inclusion through governmental power sharing, as well as democratization and peacekeeping.
To examine minimum dietary diversity (MDD) trends and determinants among children aged 6–23 months.
Design:
Secondary analysis of the Indonesia Demographic and Health Surveys (IDHS) between 2007 and 2017. The primary outcome was MDD, the consumption of at least five out of eight food groups (MDD-8). We included a total of 5015 (IDHS 2007), 5050 (IDHS 2007) and 4925 (IDHS 2017) children aged 6 to 23 months to estimate trends of MDD-8 and to identify factors associated with MDD-8. We used multiple logistic regression analysis adjusted for the complex sampling design to investigate the association between the study factors and MDD-8.
Setting:
Indonesia.
Participant:
A total of 14 990 children aged 6–23 months.
Results:
Over the 10 years, the percentage of children who consumed a diversified diet was 53·1 % in 2007, 51·7 % in 2012 and 53·7 % in 2017. Multivariate analyses showed that older age children, higher maternal education, maternal weekly access to media, paternal non-agricultural occupation, history of at least four antenatal care visits and wealthier households were associated with the increased odds of MDD-8. Children living in rural areas, Sulawesi and Eastern Indonesia, were less likely to eat a diversified diet.
Conclusions:
The proportion of children meeting MDD-8 has stagnated in the last decade. Child, parental, health care, household and community factors are associated with MDD-8. Therefore, nutrition education programmes and behaviour change communication activities should target mothers and families from socio-economically and geographically disadvantaged populations.
Chapter V applies concepts from preceding chapters to investigate the future character of war and war’s future as a human activity. The chapter begins by exploring the challenge of future forecasting and strategy development, which is compounded by the accumulation of human and environmental effects that invalidate assumptions. The chapter asserts that forecasting may be improved by considering three sets of factors: history and trends, current circumstances, and theory. Next, it explores political, technological, and doctrinal developments that could impact war’s future character, like artificial intelligence and nanotechnology, and provides strategic advice for both high and low capacity groups. The chapter’s latter half uses the history-current circumstances-theory model to assess the feasibility and desirability of ending war forever. Using evidence from archaeology, anthropology, history, trends, and war and peace theories, the chapter concludes that war’s existence is inextricably linked to humanity, i.e., eliminating either eliminates both. It wraps up by offering practical suggestions for minimizing the potential for war.