Does fiscal decentralization improve health outcomes? - evidence from a cross-country analysis

Decentralization of fiscal responsibilities has emerged as a primary objective on the agendas of national governments, and international organizations alike. Yet there is little empirical evidence on the potential benefits of this intervention. The authors fill in some quantitative evidence. Using panel data on infant mortality rates, GDP per capita, and the share of public expenditures managed by local governments, they find greater fiscal decentralization is consistently associated with lower mortality rates. The results suggest that the benefits of fiscal decentralization are particularly important for poor countries. They suggest also that the positive effects of fiscal decentralization on infant mortality, are greater in institutional environments that promote political rights. Fiscal decentralization also appears to be a mechanism for improving health outcomes in environments with a high level of ethno-linguistic fractionalization, however, the benefits from fiscal decentralization tend to be smaller.National Governance,Health Economics&Finance,Banks&Banking Reform,Economic Theory&Research,Municipal Financial Management

Economic feasibility of organic farms and risk management strategies

Organic farmers must face different risks than conventional farmers Due to the special features of management of their productive system, and due to the specific characteristics of their cultivations. This study analyses the specific risks that organic farmers must manage as well as the different strategies that there are developing nowadays. Even if the Spanish farmers rely on the insurance system to manage their risks, today organic farmers do not have specific insurance products to manage them. The methodology and results presented in this study include a risk analysis carried out by evaluating statistical, probabilistic, and stochastic properties of the organic production data. We evaluate and discuss the aspects of our study that relate to other international studies. Productions considered in this research are olives, vineyard and cereals. Specific risk management strategies developed by organic farmers – in contrast with conventional farmers – have been identified and quantified, showing the different attitudes based on their risk perception and the potential vulnerability of their farms. Agricultural insurance tool for organic farmers in Spain has been studied and analyzed as an important risk managemen

Health manpower employment and productivity in the Philippines

The study analyzes two of the major issues which emerged in health manpower planning and development exercises in the Philippines, namely, employment and productivity of specific categories of health manpower in the country's health delivery system. The first issue involves the critical questions of supply of, and needs or requirements for, specific health manpower in the country's health care delivery system. The second issue, meanwhile, emerged because of lack of certain types of health personnel as well as the rapid increase in the cost of medical care. These two issues evolved from the nagging concern over the maldistribution of health personnel and the existence of imbalances between what and how many of specific types of health manpower are needed and available in the country. The study covers only fourtypes of health professionals: physicians, nurses, midwives and dentists. This study is organized as follows. The next section discusses the supply of health manpower in the country. This includes a discussion of the estimates of actual supply as of 1987, their employment characteristics in terms of employment settings and their regional distribution. An attempt to forecast the supply of health manpower up to the year 2000 is made. The study also examines the factors which influence the location decisions of these health workers. Additional issues on supply such as production, utilization and migration are also discussed. The third section focuses on the needs of health manpower with a discussion on how to estimate or project the needs or requirements of health manpower. The fourth section discusses estimation of the needs of health manpower using the different methodologies. These estimates are then compared with supply to identify shortages or surpluses. Adiscussion of demand for health manpower is presented in Section 5. Although no actual estimation of demand equations are made due to insufficient data, several conceptual and methodological issues are discussed. Section 6 presents various productivity issues. Finally, section 7 concludes the study with some policy recommendations

Wide-Field Multi-Parameter FLIM: Long-Term Minimal Invasive Observation of Proteins in Living Cells.

Time-domain Fluorescence Lifetime Imaging Microscopy (FLIM) is a remarkable tool to monitor the dynamics of fluorophore-tagged protein domains inside living cells. We propose a Wide-Field Multi-Parameter FLIM method (WFMP-FLIM) aimed to monitor continuously living cells under minimum light intensity at a given illumination energy dose. A powerful data analysis technique applied to the WFMP-FLIM data sets allows to optimize the estimation accuracy of physical parameters at very low fluorescence signal levels approaching the lower bound theoretical limit. We demonstrate the efficiency of WFMP-FLIM by presenting two independent and relevant long-term experiments in cell biology: 1) FRET analysis of simultaneously recorded donor and acceptor fluorescence in living HeLa cells and 2) tracking of mitochondrial transport combined with fluorescence lifetime analysis in neuronal processes

Weakening political connections by means of regulatory reform: Evidence from contracting out water services in Spain

One area of public policy where rent-seeking and favoritism is relatively common is the contracting out of public services. Private firms can improve their chances of obtaining contracts by bribing politicians or public servants and funding political parties. In the same vein, firms can gain access to policymakers by hiring influential former politicians—a practice commonly referred to as revolving-doors. In this paper, we use information from 922 privatizations of water services in Spanish municipalities between 1984 and 2016 and multinomial logistic regression techniques to study the association between specific firms securing contracts and the political parties ruling the municipalities. We find robust statistical evidence of an association between the Popular Party (Partido Popular or PP) and the firm Aqualia, part of the large Spanish holding company Fomento de Construcciones y Contratas (FCC), which is known to have funded the Popular Party. Furthermore, former PP politicians have been appointed to top positions in the FCC Board of Directors. However, this relationship weakened after the institutional reform of 2007 on public procurement and financing of political parties, which is empirically evaluated in this paper

A Robotic Solution for the Restoration of Fresco Paintings

In this paper, a service robot solution is presented for the analysis, surveying and restoration of fresco paintings. The proposed design approach integrates robot design and restoration operation. It aims to merge them into a feasible solution that can be both practical and feasible for restorers. The simulation results are reported to show a successful design solution, which has been conceived with the constraints of a low-cost user-oriented design and the consideration of cultural heritage

Efecto de la frecuencia de riego en parámetros cuantitativos y cualitativos de la Vitis vinifera cv. Syrah

La implantación generalizada de riego por goteo en cultivos leñosos nos ha motivado al estudio de la frecuencia del riego en dichos cultivos, ya que por definición el riego por goteo se ha considerado un riego de “bajo caudal y alta frecuencia”. Los cultivos leñosos presentan unas características morfológicas y estructurales muy diferentes a los cultivos herbáceos, para los que se diseñó en su origen el riego por goteo, entre los que se encuentra su sistema radicular más extenso y profundo, con una capacidad mayor de exploración del terreno. Además de ello, estudios previos [1], indican pérdidas de agua por evaporación en cada evento de riego, por lo que a priori, modificar el manejo del riego por goteo en este tipo de cultivos, reduciendo la frecuencia de riego e incrementando el número de horas del mismo, parece razonable. Es por ello que abordamos en Castilla‐La Mancha, región con clima semiárido y con cerca de 160.000 ha de viñedo para vinificación en regadío [2], el estudio que se presenta, ya que pensamos que se puede mejorar la eficiencia del agua de riego en la vid, simplemente con el manejo del mismo. El ensayo se realizó en Valdeganga (Albacete) en un cultivar de la variedad Syrah, conducido en espaldera a un marco de plantación de 3 x 1.25 m., suelo franco arcillo arenoso y sin limitaciones de profundidad. El planteamiento del ensayo se basó en un diseño de bloques al azar cuyo factor fue la “frecuencia de riego”: I1) Un riego semanal; I2) dos riegos semanales. Las programaciones de riego se ajustaron para unas necesidades hídricas de un tercio de la ETo, con balance de agua en el suelo. Durante todo el ciclo vegetativo del cultivo se ha medido semanalmente el estrés hídrico, a través de los potenciales de hoja y tallo, así como medidas de intercambio gaseoso con la finalidad de parametrizar al máximo el cultivo y poder detectar diferencias en el comportamiento fisiológico de ambos tratamientos. En cuanto al suelo, se ha medido de forma continua el contenido de agua en el mismo con sondas Sentek Drill & Drop, a 6 profundidades diferentes (5, 15, 25, 35, 45, 55 cm). En vendimia se analizó la producción, así como la madurez tecnológica y fenólica de la uva. Los resultados, tras un año de experimentación, nos muestran si es posible un manejo diferente, al que se está realizando actualmente, del riego por goteo en el cultivo de la vid

Relationship between serotypes, age, and clinical presentation of invasive pneumococcal disease in Madrid, Spain, after introduction of the 7-valent pneumococcal conjugate vaccine into the vaccination calendar

To assess invasive pneumococcal disease (IPD) clinical presentations and relationships with age and serotype in hospitalized children (<15 years) after PCV7 implementation in Madrid, Spain, a prospective 2-year (May 2007 to April 2009) laboratory-confirmed (culture and/or PCR) IPD surveillance study was performed (22 hospitals). All isolates (for serotyping) and culture-negative pleural/cerebrospinal fluids were sent to the reference laboratory for pneumolysin (ply) and autolysin (lyt) gene PCR analysis. A total of 330 IPDs were identified: 263 (79.7%) confirmed by culture and 67 (20.3%) confirmed by PCR. IPD distribution by age (months) was as follows: 23.6% (<12), 15.8% (12 to 23), 15.5% (24 to 35), 22.4% (36 to 59), and 22.7% (>59). Distribution by clinical presentation was as follows: 34.5% bacteremic pneumonia, 30.3% pediatric parapneumonic empyema (PPE), 13.6% meningitis, 13.3% primary bacteremia, and 8.2% others. Meningitis and primary bacteremia were the most frequent IPDs in children <12 months old, and bacteremic pneumonia and PPE were most frequent in those >36 months old. Frequencies of IPD-associated serotypes were as follows: 1, 26.1%; 19A, 18.8%; 5, 15.5%; 7F, 8.5%; 3, 3.9%; nontypeable/ other 30 serotypes, 27.3%. Serotype 1 was linked to respiratory-associated IPD (38.6% in bacteremic pneumonia and 38.0% in PPE) and children of >36 months (51.4% for 36 to 59 months and 40.0% for >59 months), while serotype 19A was linked to nonrespiratory IPDs (31.1% in meningitis, 27.3% in primary bacteremia, and 51.9% in others) and children of <24 months (35.9% for children of <12 months and 36.5% for those 12 to 23 months old), with high nonsusceptibility rates for penicillin, cefotaxime, and erythromycin. After PCV7 implementation, non-PCV7 serotypes caused 95.5% of IPDs. The new 13-valent conjugate vaccine would provide 79.1% coverage of serotypes responsible for IPDs in this series

Expansion of serotype coverage in the universal pediatric vaccination calendar: Short-term effects on age- and serotype-dependent incidence of invasive pneumococcal clinical presentations in Madrid, Spain

In Madrid, Spain, the 13-valent pneumococcal conjugate vaccine (PCV13) replaced PCV7 in the pediatric universal vaccination calendar in June 2010. A prospective clinical surveillance that included all children hospitalized with culture- and/or PCR-confirmed invasive pneumococcal disease (IPD) was performed in all Madrid hospitals. The incidence rates (IRs) (defined as the number of cases/100,000 inhabitants aged<15 years) in the PCV7 (May 2007 to April 2010) versus PCV13 (May 2011 to April 2012) periods were compared. There were 499 cases in the PCV7 period and 79 cases in the PCV13 period. Globally, the IR significantly decreased from 17.09 (PCV7 period) to 7.70 (PCV13 period), with significant decreases (PCV7 versus PCV13 periods) in all age groups for bacteremic pneumonia (5.51 versus 1.56), parapneumonic pneumococcal empyema (PPE) (5.72 versus 3.12), and meningitis (2.16 versus 0.97). In the PCV13 period, significant reductions (the IR in the PCV7 period versus the IR in the PCV13 period) were found in IPDs caused by PCV13 serotypes (13.49 versus 4.38), and specifically by serotypes 1 (globally [4.79 versus 2.53], for bacteremic pneumonia [2.23 versus 0.97], and for PPE [2.26 versus 1.17]), serotype 5 (globally [1.88 versus 0.00], for bacteremic pneumonia [0.89 versus 0.00], and for PPE [0.55 versus 0.00]), and serotype 19A (globally [3.77 versus 0.49], for bacteremic pneumonia [0.72 versus 0.00], for PPE [0.89 versus 0.00], and for meningitis [0.62 versus 0.00]). IPDs caused by non- PCV13 serotypes did not increase (IR, 3.60 in the PCV7 period versus 3.31 in the PCV13 period), regardless of age or presentation. No IPDs caused by the PCV13 serotypes were found in children who received 3 doses of PCV13. The number of hospitalization days and sanitary costs were significantly lower in the PCV13 period. The switch from PCV7 to PCV13 in the universal pediatric vaccination calendar provided sanitary and economical benefits without a replacement by non-PCV13 serotypesThis work was supported in part by an unrestricted grant from Pfizer S.L.U., Madrid, Spain. J.P. and J.R.-C. have received travel fees from Pfizer for attending and/or speaking at symposiums and congresses. C.M. is an employee of Pfizer S.L.U., Madrid, Spain