The burden of road traffic injuries in Kermanshah Province,Iran, in 2010–2011: GBD 2010 method

Deaths, injuries and disabilities resulting from road traffic injuries (RTIs) are a public health major concern. This study aims to calculate the burden of RTIs in Kermanshah Province in Iran. In this study to determine the years of life lost (YLL) related to RTIs, the National Death Registration and Forensics Medicine census data were employed. We use forensic medicine data to calculate the incidence of non-fatal injuries and years lost due to disability (YLD). The cause of death and non-fatal injuries was classified using ICD-10 codes and 23 groupes of global burden of diseases (GBD) 2010. The disability-adjusted life year (DALY) estimated on the guidelines of the GBD 2010 and age and sex structure was taken from the National Statistic Center for the year 2010. Overall, 70.8% of the subjects were males. The fatal and non-fatal injury rates of RTI were 51.3 and 283.6 per 100,000 persons, respectively. YLLs and YLDs were 46613 (24.5 per 1000) and 3405 (1.8 per 1000) in both sexes, respectively. The disability adjusted life years were 40711 in males, 9306 in females and 50018 in both sexes (42.5, 9.8 and 26.3 per 1000, respectively). More than 93% of DALY was from YLL (24.5 per 1000), with a small proportion for YLD (1.8 per 1000). Accounting for more than 50,000 DALY attributed to RTIs, traffic injuries is a major public health and socioeconomic problem in Kermanshah. Designing cost-effective interventions based on comprehensive and multi-sectoral programmes at the national and provincial levels can save many lives and resources that are lost every year. Undoubtedly, establishing a surveillance system at the sub-national level and measuring the burden of injuries, as in this study, can help policy-makers and planners in lessening the burden of RTIs.     

Employment and absenteeism in working-age persons with multiple sclerosis

Aims: To better understand the impact of the clinical course of multiple sclerosis (MS) and disability on employment, absenteeism, and related factors.

Materials and methods: This study included respondents to the North American Research Committee on Multiple Sclerosis Registry spring 2015 update survey who were US or Canadian residents, aged 18–65 years and reported having relapsing-remitting MS (RRMS), secondary progressive MS (SPMS), or primary progressive MS (PPMS). The RRMS and SPMS participants were combined to form the relapsing-onset MS (RMS) group and compared with the PPMS group regarding employment status, absenteeism, and disability. Multivariable logistic regression was used to examine the relationship between employment-related outcomes and factors that may affect these relationships.

Results: Of the 8004 survey respondents, 5887 (73.6%) were 18–65 years of age. The PPMS group (n?=?344) had a higher proportion of males and older mean age at the time of the survey and at time of diagnosis than the RMS group (n?=?4829). Female sex, age, age at diagnosis, cognitive and hand function impairment, fatigue, higher disability levels, ≥3 comorbidities, and a diagnosis of PPMS were associated with not working. After adjustment for disability, the employed PPMS sub-group reported similar levels of absenteeism to the employed RMS sub-group.

Limitations: Limitations of the study include self-report of information and the possibility that participants may not fully represent the working-age MS population.

Conclusions: In MS, employment status and absenteeism are negatively affected by disability, cognitive impairment, and fatigue. These findings underscore the need for therapies that prevent disability progression and other symptoms that negatively affect productivity in persons with MS to enable them to persist in the workforce.     

The shared environmental responsibility principle: new developments applied to the case of marine ecosystems

Estuaries provide advantageous sites for both harbors and fish habitats. In many countries, harbor expansion in estuaries contributed to the decline of fish populations with impacts at the global scale. Restoring these habitats is important to prevent a global biodiversity crisis but is costly and potentially unaffordable for polluters under the Polluter Pays Principle. Such affordability issues prompt decision-makers to reduce environmental targets of restoration programs. Harbor infrastructures destroy fish habitats but generate benefits for society and contribute to the public interest, raising some questions on who is responsible for environmental degradations and who can afford environmental restoration costs? One way to allocate restoration costs is to analyze the amount of harbor services consumed by economic sectors. This paper addresses these questions by computing burden sharing scenarios with an input–output matrix. These scenarios are simulated under the shared responsibility principle to distribute restoration costs among stakeholders in the Seine estuary, France.     

Pains and gains of environmental management system certification for the sustainable development of manufacturing companies: Heterogeneous effects of industry peer learning

Environmental sustainability is a growing global concern. Environmental management systems (EMS) could be an effective strategic tool to help firms deal with their sustainable development. However, whether EMS certification pays off financially and how it takes effect can be debated. Thus far, these questions remain largely under‐researched. In particular, the effects of EMS certification on financial performance are inconclusive, and the reasons explaining the effects are underdeveloped. This study aims to enrich the current research by exploring the mediating and moderating roles from the perspective of cost‐efficiency trade‐offs to reveal how EMS certification affects financial performance. Applying a PROCESS procedure analysis and causal mediation analysis to a sample of 1,751 Chinese listed manufacturing firms from 2008 to 2016, this study shows that the effect of EMS certification on firms' financial performance is insignificant because their operating costs burden increases while their marketing efficiency and managerial efficiency improve. For the first time, this study demonstrates the moderating role of industry peer learning, as the mediating effects decrease with the growth of industry peer learning.     

The cost of diabetes and obesity in Australia

Aims: To assess and compare the direct healthcare and non-healthcare costs and government subsidies by body weight and diabetes status.

Methods: The Australian Diabetes, Obesity and Lifestyle study collected health service utilization and health-related expenditure data at the 2011–2012 follow-up surveys. Costing data were available for 4,409 participants. Unit costs for 2016–2017 were used where available or were otherwise inflated to 2016–2017 dollars. Age- and sex-adjusted costs per person were estimated using generalized linear models.

Results: The annual total direct cost ranged from $1,998 per person with normal weight to $2,501 per person with obesity in participants without diabetes. For those with diabetes, total direct costs were $2,353 per person with normal weight, $3,263 per person with overweight, and $3,131 per person with obesity. Additional expenditure as government subsidies ranged from $5,649 per person with normal weight and no diabetes to $8,085 per person with overweight and diabetes. In general, direct costs and government subsidies were higher for overweight and obesity compared to normal weight, regardless of diabetes status, but were more noticeable in the diabetes sub-group. The annual total excess cost compared with normal weight people without diabetes was 26% for obesity alone and 46% for those with obesity and diabetes.

Limitations: Participants included in this study represented a healthier cohort than the Australian population. The relatively small sample of people with both obesity and diabetes prevented a more detailed analysis by obesity class.

Conclusion: Overweight and obesity are associated with increased costs, which are further increased in individuals who also have diabetes. Interventions to prevent overweight and obesity or reduce weight in people who are overweight or obese, and prevent diabetes, should reduce the financial burden.     

营改增背景下企业办税人员素质现状及提升路径

当前不断推进的营改增对企业税务管理工作提出了更高要求,对企业办税人员素质形成了新的考量。本文分析了营改增背景下税企双方对企业办税人员的素质要求,结合地方企业办税人员的素质现状,探究其影响因素。提出应严格企业办税人员准入制度,建立配套的职称晋升和有效的激励机制,为办税人员营造良好的职业发展空间,促进其综合素质的全面提升,为地方经济发展助力。     

增值税转型对消费型增值税全面改革的启示

消费型增值税改革不是增值税改革的终结。通过2004-2008年间的数据分析,论证了增值税转型对国家经济增长的巨大价值,并思考消费型增值税改革的可能性问题,从而提出相应对策和建议。     

我国财政收入体制特征和改革路径

本文从我国财政收入体制的实质、特征和改革路径进行了多视角、全方位剖析。指出一国财政收入的实质,是一国政府怎样去筹集收入,筹集多少,用什么形式去筹集和向谁收入等大问题。特别是从我国财政收入的总量、结构和增速三个层面,概括了我国财政收入体制具有大而失度、多而繁杂和快而失序等三大特征。进而又提出了"多用税、广用债、深减费"的改革路径和政策建议。     

公租房租金分析

公租房租金标准的核定体现了其住房保障性质,并影响保障效果。成本法与社会平均负担法是两种不同的租金核定办法,并有不同效果。通过对比,后者更有助于达到保障目标,并能通过租金标准的动态调整实现与其他保障方式的对接。无论如何核定,都需要政府强大的执行力来支持。     

我国宏观税负水平多维视角解析

判断我国宏观税负水平的高低不能脱离政府收入水平孤立研究,而且小口径宏观税负在进行国际比较时应注意选择合适的国家.评价税负的轻重必须联系国民收入分配格局以及政府为纳税人提供的公共产品和服务的数量及质量进行考查.未来5～10年我国宏观税负水平合理区间的确定受制于经济发展的水平和速度、财政职能的转变和民生财政的构建以及能否正...