Search

The economic policy of the fourth transformation (4T) of Mexico - as the actual president Andrés Manuel López Obrador defines his mandate - is characterized by being cautious and responsible for public spending, making investment decisions more effective, and redistributing wealth to sustain domestic consumption. The internal demand has been promoted by increasing poor people's disposable income through subsidies and transfers and several policies aimed at raising minimum wages. As a framework for these direct policies to boost economic growth, the fight against corruption helped achieve these results more effectively. This work aims to analyze whether the 4T policy increased economic growth in Mexico. We applied two econometric techniques to test our hypothesis: interrupted time series analysis, controlling for robustness of the results, and breakpoint regression analysis. In both cases, we robustly showed that the 4T economic policy has positively impacted economic growth in Mexico. [ABSTRACT FROM AUTHOR]

The goal of this research is to study an economic system characterized by the coexistence of tax evading citizens with corrupt auditors (public officials), that is a system of predators-preys, i.e. corrupts and not, evaders and not. We show that citizens choose non-corrupt behavior when their utility exceeds a threshold level with respect to an optimal progressive tax rate. On the other hand, auditors choose non-corrupt behavior if their utility is higher than a certain threshold level depending on the fines and probabilities of being sanctioned. Being aware of this situation, a government or central authority must study a dynamic evolutionary economic system (a generalized predator-prey model) by analyzing all possible steady states of this economic system. The stability of the steady states depends on the crucial parameters of the model, namely: i) a socially negative impact exerted by corrupt public officials or auditors on the evolution of the economic society, ii) the impact of the social weight of the citizens who pay taxes on corrupt auditors, iii) the behavior of imitation of the agents when perceiving the possibilities of being sanctioned or not, and iv) the inertia and feedback of the corrupt system (dishonest behavior and tax evasion). We conclude by highlighting the importance of bifurcations or qualitative changes in the parameters of this economic system to fight corruption and evasion. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the risk of death after hospitalizations for diabetic foot (DF) complications, comparing two different cohorts of people with or without a prior history of DF hospitalizations across the years 2011 to 2018 in Tuscany, Italy. The DF complications were categorized by administrative source datasets such as: amputations (both major and minor), gangrene, ulcers, infections, Charcot and revascularizations. A further aim was to present the trend over time of the first ever incidents of diabetic foot hospitalizations in Tuscany. The eight-year-mortality rate was higher in the cohort with prior hospitalizations (n = 6633; 59%) compared with the cohort with first incident DF hospitalizations (n = 5028; 44%). Amputations (especially major ones) and ulcers had the worst effect on survival in people without basal history of DF hospitalizations and respectively in those with a history of prior DF hospitalizations. In both cohorts, revascularization procedures, when compared to ulcers, were associated with a significantly reduced risk of mortality. The prevalence rate of minor amputations showed a slightly rising trend over time. This result agrees with the national trend. Conversely, the progressive increase over time of revascularizations, associated with the fractional decrease in the rate of gangrene, suggests a trend for more proactive behavior by DF care teams in Tuscany. [ABSTRACT FROM AUTHOR]

Copyright of Investigación Económica is the property of Universidad Nacional Autonoma de Mexico, Facultad de Economia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of this paper is to study the effect of income inequality on the probability of democratization, in a panel of 51 transition countries during the period 1960–2008. Using a conditional fixed‐effect logit estimation, we find robust results suggesting that income inequality (measured by the Gini index of household's income inequality) has an inverse—U‐shaped relation with the probability of transition from autarchy to democracy. We show that there is a turning point at a level of household's income inequality equal to a Gini index of 40. When income inequality is below 40, then probability of transition is positively related to inequality, but when inequality is higher, a subsequent increase in inequality decreases the probability of democratization. This is consistent with Acemoglu and Robinson's theory that shows how transitions are likeliest at moderate levels of inequality, while autocracy is likelier at the lowest and highest levels of inequality. [ABSTRACT FROM AUTHOR]

In this paper, we consider a two-country and two-sector economy, where firms can choose to be innovative or not innovative, and workers to be skilled or unskilled. Using a dynamic game, we argue that exploiting the comparative advantages a country has in producing goods that use the most abundant factor of production, free mobility of capital and labor is beneficial for economic growth. However, if a country has a comparative advantage in a sector that uses intensely unskilled labor (which is the case of several underdeveloped economies), a poverty trap may arise. For this reason we argue that national Governments must ensure the technological development to improve competitiveness and therefore a social optimal use of the comparative advantages. [ABSTRACT FROM AUTHOR]

Purpose: To investigate whether the hospitalization rate for bacterial infections was modified by statin therapy in a population retrospectively followed up, over years 2011 to 2015. Methods: By using administrative databases, the 5-year hospitalization rate due to bacterial infections in population living in Tuscany, Italy exposed to statin therapy (n = 52,049) was stratified by 5 prescribed daily doses classes (0%-20%, 20%-50%, 50%-80%, 80%-100%, ≥100% of DDD) and subsequently compared with that of a population of untreated individuals (n = 3 300 ,675), matched through a propensity score accounting for all available covariates potentially able to modulate risk of infections such as age, gender, previous hospitalizations for infections, cardiovascular events, previous co-morbidities, diabetes, as well as general practitioners' proactive behaviour of care delivery according to current guidelines. Results: Unmatched individuals of each treatment-class had significantly more hospitalizations than controls, while matched treated people, apart from those in class 0% to 20%, had a decrease of hospitalizations, as large as the increase in prescribed drug. Statin effect in reducing hospitalizations translated into a number needed to treat (NNT) ranging across treatment strata from 102 to 54. Conclusions: Compliance to statin prescribed daily doses above the threshold 20% of DDD, along a 5-year follow-up, prevented hospitalizations due to infectious diseases in a large unselected population, after adjusting for covariates able to modulate baseline risk of infections. The NNTs to avoid 1 hospitalization for infections resulted on average not too dissimilar from a value lying between the 95% CI of NNTs previously found for primary prevention of 1 incident coronary ischemic event (72 to 119). [ABSTRACT FROM AUTHOR]

Objective: Women with diabetes have a greater excess risk for cardiovascular diseases (CVD) than men. This study was aimed at clarifying whether this effect is lifelong or more evident in some life-periods.Methods: The effect of diabetes and gender on the risk of first ever hospitalization for acute myocardial infarction (AMI), ischemic stroke (IS), congestive heart failure (CHF), lower extremity amputations (LEA) or any of these major cardiovascular events (MACE) have been evaluated by a Cox-hazard model, over years 2008-2012 querying administrative databases of a cohort living in Tuscany, Italy.Results: Comparing subjects with diabetes to those without it the overall age-adjusted excess risk was higher in women than in men for AMI and MACE and higher in men for LEA, with no difference for IS or CHF. In women the excess risk for AMI and MACE started earlier (46yr) and lasted until age of more than 85yr, while 'risk-windows' opened later and had a shorter duration for CHF (56-65yr) and IS (66-75yr).Conclusion: Diabetic women have a significant diabetes-associated excess of CVD risk, except for LEA, with a 'risk window' opening earlier and lasting longer for AMI and MACE, later and with a shorter duration for IS and CHF. [ABSTRACT FROM AUTHOR]

We look at two emerging economies, Brazil and China, and propose an evaluation of their recent development in terms of growth performance and the evolution of income inequality. Our analysis, therefore, is related to the literature on their recent vast growth and also to the much debated Kuznets curve and theory. However, we claim that neither the growth nor the Kuznets approach capture recent relevant phenomena characterizing such countries' dynamics: namely, the presence of at least two distinct growth models. Cointegration analysis and empirical evidence seem to corroborate our interpretation. They also offer some further insights. We surmise that while contributing to press for a further re-examination of convergence in the light of the issue of income distribution, such findings have interpretative relevance and policy implications for other less developed countries. [ABSTRACT FROM AUTHOR]

Background: Multiple Sclerosis (MS) epidemiology in Italy is mainly based on population-based prevalence studies. Administrative data are an additional source of information, when available, in prevalence studies of chronic diseases such as MS. The aim of our study is to update the prevalence rate of MS in Tuscany (central Italy) as at 2011 using a validated case-finding algorithm based on administrative data. Methods: The prevalence was calculated using an algorithm based on the following administrative data: hospital discharge records, drug-dispensing records, disease-specific exemptions from copayment to health care, home and residential long-term care and inhabitant registry. To test algorithm sensitivity, we used a true-positive reference cohort of MS patients from the Tuscan MS register. To test algorithm specificity, we used another cohort of individuals who were presumably not affected by MS. Results: As at December 31, 2011, we identified 6,890 cases (4,738 females and 2,152 males) with a prevalence of 187.9 per 100,000. The sensitivity of algorithm was 98% and the specificity was 99.99%. Conclusions: We found a prevalence higher than the rates present in literature. Our algorithm, based on administrative data, can accurately identify MS patients; moreover, the resulting cohort is suitable to monitor disease care pathways. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Low birth-weight (BW) is related to rise in blood pressure (BP) later in life. Aim of this study is investigating whether presence of overweight-obesity modifies this relationship, independently from any additional correlate of metabolic syndrome. We studied 535 (216 M/319 F) otherwise healthy overweight-obese people (body mass index≥25 kg/m²), recording systolic, diastolic and pulse BP as well as plasma glucose and lipids, additionally interviewing them about BW and weight-change after age of 18 years. The reciprocal of BW was related only to pulse pressure (PP, r=0.14; P=0.04), uniquely in men and individuals with BW≤2500 g had a higher relative risk of having PP above upper quartile (>60 mmHg), independently of sex. After adjusting for confounders each 1 kg rise in BW was associated with 2.84±0.88 (standard error) mmHg decrease in PP; P=0.0042. Moreover, again only among males, the lower BW the higher was the risk of a PP>60 mmHg [odds ratio (95% confidence interval): 2.43 (1.39-4.24); P=0.0018]. In conclusion BW was inversely related only with PP in overweight-obese subjects, uniquely in men, being such effect independent from other correlates of metabolic syndrome. Since elevated PP can be considered a proxy of vascular damage, these findings further stress the importance of inquiring about BW to better stratify the risk of vascular damage, in adult overweight-obese individuals. [ABSTRACT FROM AUTHOR]

Parkinson's disease (PD) is a major worldwide public health problem with a prevalence that is expected to increase dramatically in the coming decades. Because administrative data are useful for epidemiologic and health service studies, we aimed to define procedural algorithms to identify PD patients (on a regional basis) using these data. We built two a priori algorithms, respecting privacy laws, with increasing theoretical specificity for PD including: (1) a hospital discharge diagnosis of PD; (2) PD-specific exemption; (3) a minimum of two separate prescriptions of an antiparkinsonian drug. The two algorithms differed for drugs included. Sensitivities were tested on an opportunistic sample of 319 PD patients from the databases of 5 regional movement disorders clinics. The estimated prevalence of PD in the sample population from Tuscany was 0.49 % for algorithm 1 and 0.28 % for algorithm 2. Algorithm 1 correctly identified 291 PD patients (sensitivity 91.2 %), and algorithm 2 identified 242 PD patients (sensitivity 75.9 %). We developed two reproducible algorithms demonstrating increasing theoretical specificity with good sensitivity in identifying PD patients based on an evaluation of administrative data. This may represent a low-cost strategy to reliably follow up a large number of PD patients as a whole for evaluating the effects of therapies, disease progression and prevalence. [ABSTRACT FROM AUTHOR]

We recently investigated the prognostic impact of a Chronic Care Model (CCM)-based healthcare program applied in primary care in Tuscany Region mainly run by multidisciplinary teams composed of general practitioners (GPs) and nurses. The project included proactively planned follow-up visits for each patient, individualized counselling to optimize lifestyle modifications and adherence to appropriate diagnostic and therapeutic pathways. 1761 patients with Chronic heart failure (CHF) directly enrolled by the GPs were matched with 3522 CHF controls not involved in the project. Over a 4-year follow-up in the CCM group a higher CHF hospitalization rate was found (12.1 vs 10.3 events/100 patient-years; incidence rate ratio [IRR] 1.15, p=0.0030), whereas mortality was lower (10.8 vs 12.6 events/100 patient-years; IRR 0.82, p<0.0001). The CCM status was independently associated with a 34% increase in the risk of CHF hospitalization and a 18% reduction in the risk of death (p<0.0001 for both). The CCM status was associated with a 50% increase in the rate of planned Heart failure (HF) hospitalizations whereas the rate of 1-month CHF readmissions showed no differences. Such a divergent trend could be explained by the direct involvement of GPs in the CCM program, leading them to a better awareness of patients' clinical status, and then to a more frequent use of clinical pathways and facilities, including hospitalization. It is reasonable to argue that not all hospitalizations must necessarily be considered as a poor outcome, as they often provide additional opportunities to improve therapies, optimize patient education, or define follow-up strategies. The evidence of a divergent trend between mortality and hospitalization in our population might support the clinical importance of a multidisciplinary approach for the management of patients with HF. [ABSTRACT FROM AUTHOR]

Abstract Objective The objective of the study was to systematically assess, through the analysis of administrative data, the frequency of combinations of first-generation enzyme-inducing (EI) antiepileptic drugs (AEDs) with drugs frequently prescribed in patients with epilepsy whose metabolism is induced by EIAEDs. Methods From the population of Tuscany (a region in Italy of about 3,750,000 habitants), patients who had been treated with at least one first-generation EIAEDs (carbamazepine, phenytoin, phenobarbital, and primidone) and had received prescriptions of an inducible non-AED (NON-AED) included in a prespecified list of 103 inducible drugs were identified. Results At the index date, 9221 patients with epilepsy were treated with at least one traditional EIAED, and there were 2538 drug combinations between EIAEDs and NON-AEDs, which may result in potentially serious clinical consequences, and 3317 combinations with NON-AEDs that have their metabolism consistently increased. Conclusions Patients with epilepsy treated with traditional EIAEDs are at a very high risk of drug interactions. Highlights • Few studies have assessed potential drug interactions in outpatients with epilepsy • First generation enzyme inducers antiepileptic drugs may accelerate metabolism of thousands of drugs • More than one third of 25,996 patients with epilepsy in Tuscany (a Region of Italy) were treated with a strong enzyme inducer • There were 2538 combinations of drugs with major interactions and 3317 combinations of drugs with moderate interactions [ABSTRACT FROM AUTHOR]