Determinantes Nacionais e Setoriais da Estrutura de Capital na América Latina

This study identified the role of the national environment (the Macroeconomy, Financial Development and Institutional Quality) and industry characteristics (Munificence, Dynamism, Concentration, Life Cycle, Technological Efficiency Dispersion, Product Quality Dispersion, Customer Bargaining Power and Supplier Bargaining Power) on debt of 612 listed companies from 7 Latin American countries (Argentina, Brazil, Chile, Colombia, Mexico, Peru and Venezuela). For comparison purposes, the analysis is also extended to 847 U.S. companies. The period of study is 1996-2009 and the analysis employed a Hierarchical Linear Model, which controls the effects according to the level of the variables (country, industry, time and firm). The results suggest that Financial Development eases access to external funds and Institutional Quality is negatively related to firm Leverage. The research also finds evidence that institutional quality can promote asymmetrical development between stock markets and credit markets

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

A New Procedure for Selecting and Ranking Ground-Motion Prediction Equations (GMPEs): The Euclidean Distance-Based Ranking (EDR) Method

We introduce a procedure for selecting and ranking of ground-motion prediction equations (GMPEs) that can be useful for regional or site-specific probabilistic seismic hazard assessment (PSHA). The methodology is called Euclidean distance-based ranking (EDR) as it modifies the Euclidean distance (DE) concept for ranking of GMPEs under a given set of observed data. DE is similar to the residual analysis concept; its modified form, as discussed in this paper, can efficiently serve for ranking the candidate GMPEs. The proposed procedure separately considers ground-motion uncertainty (i.e., aleatory variability addressed by the standard deviation) and the bias between the observed data and median estimations of candidate GMPEs (i.e., model bias). Indices computed from the consideration of aleatory variability and model bias or their combination can rank GMPEs to design GMPE logic trees that can serve for site-specific or regional PSHA studies. We discussed these features through a case study and ranked a suite of GMPEs under a specific ground-motion database. The case study indicated that separate consideration of ground-motion uncertainty (aleatory variability) and model bias or their combination can change the ranking of GMPEs, which also showed that the ground-motion models having simpler functional forms generally rank at the top of the list. We believe that the proposed method can be a useful tool to improve the decision-making process while identifying the most proper GMPEs according to the specific objectives of PSHA

A Model for Vertical-to-Horizontal Response Spectral Ratios for Europe and the Middle East

In the framework of probabilistic seismic hazard analysis, the preferred approach for obtaining the response spectrum of the vertical component of motion is to scale the horizontal spectrum by vertical-to-horizontal (V/H) spectral ratios. In order to apply these ratios to scenario or conditional mean spectra, the V/H ratios need to be defined as a function of variables such as magnitude, distance, and site classification. A new model for the prediction of V/H ratios for peak ground acceleration and spectral accelerations from 0.02 to 3.0 s is developed from the database of strong-motion accelerograms from Europe and the Middle East. A simple functional form, expressing the V/H ratios as a function of magnitude, style of faulting, distance, and site class, is found to be appropriate, and the associated aleatory variability is found to be at least as low as that obtained in other studies using more complex models. The predicted ratios from the new European model are found to be in broad agreement with recent models derived from predominantly western North America data

A model for predicting vertical component peak ground acceleration (PGA), peak ground velocity (PGV), and 5% damped pseudospectral acceleration (PSA) for Europe and the Middle East

In this study, we present a ground-motion model for the vertical component of peak ground acceleration, peak ground velocity, and 5% damped pseudo acceleration response spectra at periods ranging from 0.01 to 4 s. The vertical model is based on the ground-motion models previously developed for the horizontal component and vertical-to-horizontal ratio of ground motion by Akkar et al. (Bull Earthq Eng 12:359-387, 2014a; 517-547, 2014b) rather than on an independent regression analysis of strong-motion data available for Europe and the Middle East. The proposed ground-motion model includes formulations for the median values as well as for the aleatory within-event, between-event, and total standard deviation values of the vertical ground motion. We validate the proposed model by comparing it against the strong-motion database of Europe and the Middle East. Our vertical ground-motion model is applicable for moment magnitudes ranging from 4.0 to 8.0, for source-to-site distances ranging from 0 to 200 km, average shear-velocity down to 30 m (V-s30) values ranging from 150 to 1200 m/s and for reverse, normal and strike-slip styles of faulting as is the case for the underlying horizontal component and vertical-tohorizontal ratio ground-motion models of Akkar et al. (2014a, b). Within the scope of this study, a method to develop a vertical spectrum that is fully consistent with the corresponding horizontal uniform hazard spectrum is also proposed

A Ground-Motion Predictive Model for Iran and Turkey for Horizontal PGA, PGV, and 5% Damped Response Spectrum: Investigation of Possible Regional Effects

We present a ground-motion prediction equation (GMPE) for Turkey and Iran to investigate the possible regional effects on ground-motion amplitudes in shallow active crustal earthquakes. The proposed GMPE is developed from a subset of the recently compiled strong-motion database of the Earthquake Model of the Middle East Region project (see Data and Resources). A total of 670 Turkish and 528 Iranian accelerograms with depths down to 35 km are used to estimate peak ground acceleration, peak ground velocity, and 5% damped elastic pseudospectral acceleration ordinates of 0: 01 s <= T <= 4 s. The moment magnitude range of the model is 4 <= M-w <= 8, and the maximum Joyner-Boore distance is R-JB = 200 km. The functional form considers three major fault mechanisms (strike slip, normal, and reverse). The nonlinear soil behavior is a function of V-S30 (average shear-wave velocity in the upper 30 m of soil profile). Our observations from empirical and estimated ground-motion trends advocate regional differences in the territories covered by Iran and Turkey that originate from the differences in Q factors, kappa, and near-surface velocity profiles. These factors eventually affect the magnitude- and distance-dependent scaling of spectral amplitudes in Iran and Turkey. In essence, the ground-motion amplitudes of these two neighboring countries would draw patterns different than the ground-motion estimates of GMPEs developed from the strong-motion databases of shallow active crustal earthquakes from multiple countries

Ground-motion characterization for the probabilistic seismic hazard assessment in Turkey

This study describes the methodology implemented to establish the ground-motion logic-tree for national probabilistic seismic hazard map of Turkey for shallow active crustal regions. The presented procedure provides quantitative information to guide the hazard experts while establishing the logic tree to capture the epistemic uncertainty in ground-motion characterization. It uses non-data-driven and data-driven testing methods to identify and rank candidate ground-motion prediction equations (GMPEs) under a specific ground-motion database. The candidate GMPEs are subjected to visual inspection and are classified into center, body and range (CBR) spectral estimates for a proper consideration of epistemic uncertainty. The GMPEs classified into CBR are then used in a suite of seismic hazard sensitivity analysis to establish the most suitable GMPE logic-tree whose spectral estimates are not biased by any one of the GMPEs in the logic-tree structure. The sensitivity analysis considers normalized spectral ordinates and is not manipulated by the spectral amplitudes. The proposed procedure is inherited from the relevant studies of the Earthquake Model of the Middle East (EMME; ) regional seismic hazard project. This paper also highlights the similarities and differences in ground-motion characterization between EMME and our approach

The determinants of corporate debt maturity: evidence from UK firms

This paper investigates the empirical determinants of corporate debt maturity structure. This is done by testing several leading theoretical models of debt maturity structure using a cross-sectional data set of 321 non-financial UK firms. The evidence lends considerable support to the prediction that the impact of firm size on debt maturity is positive. The findings also provide support for the notion that firms match the maturity structure of their debt to that of their assets. The findings reveal that agency-related costs and volatility of firm value exert a negative impact on debt maturity. The empirical analysis provides no evidence that taxes affect debt maturity structure. Finally, the empirical analysis is not supportive of the signalling hypothesis that firms use their debt maturity structure to signal information to the market.