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1
Sclauzero, P., G. Galli, M. Carraro, G. Barbati, and G. O. Panzetta. "Un nuovo fenotipo di pazienti in dialisi è diventato attuale. Ruolo dei componenti della fragilità sulla qualità di vita in questa popolazione: studio trasversale." Giornale di Clinica Nefrologica e Dialisi 24, no. 3 (January 26, 2018): 31–37. http://dx.doi.org/10.33393/gcnd.2012.1156.
Повний текст джерелаАнотація:
I pazienti in dialisi presentano spesso diverse componenti della fragilità: comorbidità, disabilità, dipendenza, malnutrizione, deficit cognitivo, inadeguate condizioni sociali, che incidono sulla qualità di vita (QoL). Scopo del lavoro è stato indagare questa relazione essendo la letteratura ancora non conclusiva. Ai 203 pazienti (età media 72.03+11.9 aa; età dialitica 42.6+55.6 mm; 126 m) in dialisi a Trieste l'1 agosto 2010 sono stati misurati: QoL (SF-36), disabilità (scale ADL e IADL), dipendenza (Karnofsky Index), stato nutrizionale (scala SGA) ed analizzato lo stato sociale. Il cluster componente fisica SF-36 (39.3+10.4) è risultato più compromesso di quello mentale: 48.5+8.6 (scala 0–100). I pazienti hanno presentato disabilità fisiche (ADL: 32.5%), strumentali (IADL: 38.4%), malnutrizione (34%), dipendenza (42.9%) e mediamente 3.04 comorbidità (range: 0–8). Il 31.5% vive senza supporto familiare, il 44.5% presenta ridotte relazioni sociali. La regressione lineare multipla ha dimostrato l'effetto negativo di: dipendenza (p<0.001), malnutrizione (p=0.001) e disabilità (p=0.005), escludendo comorbidità significative all'analisi univariata (dati aggiustati per genere, età, età dialitica). La vita in famiglia (p=0.002), il benessere economico (p=0.01) e soprattutto estese relazioni sociali (p<0.001) hanno avuto un ruolo positivo (test ANOVA). Pertanto una QoL soddisfacente è favorita dallo screening precoce, dalla riabilitazione funzionale-nutrizionale e dalla prevenzione dell'isolamento sociale attraverso una rete socio-sanitaria coordinata. (sian) (nursing)
2
Cerbara, Loredana, and Maria Girolama Caruso. "Fragilità e rischio di povertà educativa negli adolescenti in Italia. I dati delle indagini del CNR-IRPPS." WELFARE E ERGONOMIA, no. 1 (June 2020): 119–27. http://dx.doi.org/10.3280/we2020-001011.
Повний текст джерелаАнотація:
Se attraverso i dati ufficiali (ISTAT, MIUR e altre Istituzioni) si può analizzare dal punto di vista statistico il fenomeno della povertà educativa, costruendo graduatorie territoriali, na-zionali e internazionali, sono le indagini direttamente rivolte ai ragazzi, o anche agli educa-tori, a dare completezza al quadro complessivo del rischio di marginalizzazione a cui sono esposti i minori. Dal 2014 il CNR-IRPPS ha svolto una serie di indagini rivolte ai giovani delle scuole secondarie, sia inferiori che superiori, per approfondire la conoscenza sulla condizione giovanile. Si tratta di esperienze pratiche derivanti dalle attività di ricerca di due progetti del CNR-IRPPS, uno dedicato alla pratica dello sport come veicolo di integrazione sociale (IRPPS WPs n. 106 e 108), che è stato realizzato attraverso quattro survey distinte, e l'altro più specificamente dedicato allo studio della condizione giovanile (IRPPS WPs n. 107; Tintori e Cerbara, 2016) sia in contesti territoriali limitati che a livello nazionale. In entram-bi i progetti un team di ricercatori si è recato nelle scuole per effettuare, durante l'indagine, l'osservazione diretta del comportamento degli studenti ammessi nel campione, rivelando una serie di elementi importanti, in primo luogo per la scuola che è chiamata ad intervenire anche sulla povertà educativa, ma anche a livello di ricerca sociale più allargata. Partendo dal presupposto che la povertà educativa solo in parte coincide con la povertà eco-nomica, i dati raccolti dimostrano che, anche quando le condizioni economiche sono accetta-bili, può verificarsi la presenza di fattori di rischio di esclusione sociale che spesso si so-vrappongono, fino a determinare una vera e propria barriera che impedisce ai ragazzi di vedersi nello stesso modo dei propri pari. Vivere in una famiglia con background migratorio oppure con uno status culturale non elevato, ma anche essere donna, costituiscono elementi sufficienti perché i giovani rimangano vittime di condizionamenti sociali che impediscono lo-ro di scegliere il proprio futuro. E anche i comportamenti devianti (uso di sostanze pericolo-se, atti di violenza verbale o fisica, ecc.) possono essere determinati da situazioni di disagio correlabili con una povertà culturale che è più difficile da determinare ma che è altrettanto importante delle altre declinazioni di povertà. Alla voce degli studenti si aggiunge poi quella dei docenti che, attraverso le due indagini con-dotte dal CNR-IRPPS, hanno potuto esprimere il proprio parere sulla situazione dei giovani da un punto di osservazione particolare ed hanno dato alcune indicazioni su come la scuola potrebbe intervenire per limitare le situazioni di difficoltà nell'integrazione tra i giovani.
3
Silva, Thiago Christiano, Solange Maria Guerra, and Benjamin Miranda Tabak. "Fiscal risk and financial fragility." Emerging Markets Review 45 (December 2020): 100711. http://dx.doi.org/10.1016/j.ememar.2020.100711.
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4
Can, Cansin Kemal, and Ismail Canöz. "Testing Minsky’s Financial Fragility Hypothesis for Turkey’s Public Finances." Pénzügyi Szemle = Public Finance Quarterly 65, no. 4 (2020): 497–514. http://dx.doi.org/10.35551/pfq_2020_4_4.
Повний текст джерелаАнотація:
This paper gauges the degree of fiscal vulnerability in Turkey from a Minskian perspective. Succinctly speaking, Minsky’s financial stability hypothesis states that the government should apply hedge financing at least sporadically and pursue countercyclical fiscal policies to restore stability. We calculated two fiscal fragility indices based on Minsky’s hypothesis to examine the recent trends in Turkish public finances. According to our findings, Turkish fiscal balances are in a deteriorating trend and heading towards (ultra)Ponzi financing which is evidenced by the plummeting values of the fiscal fragility index. The results are suggestive that currently the fiscal performance in Turkey is waning gradually and current fiscal posture is not on a par with past years. Worsening fiscal balances emit a signal for a looming fiscal crisis and it is evident that this trend should promptly be reversed by the aid of appropriate expedients. Quitting the use of procyclical fiscal policies, building up public confidence by primary balance generation, implementing full-fledged tax reform, restructuring contingent liabilities, proper scrutiny of expenditures, reducing profligacy are among the policy options available for the government. Notwithstanding the abundance of alternative fiscal policies, the current Covid-19 pandemic is quite a hindrance to attaining intended outcomes regarding fiscal stability.
5
El-Shagi, Makram, and Camélia Turcu. "Monetary, financial and fiscal fragility in 2020s." Journal of International Money and Finance 117 (October 2021): 102439. http://dx.doi.org/10.1016/j.jimonfin.2021.102439.
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6
Alessandrini, Pietro, Michele Fratianni, Andrew Hughes Hallett, and Andrea F. Presbitero. "External Imbalances and Fiscal Fragility in the Euro Area." Open Economies Review 25, no. 1 (January 25, 2014): 3–34. http://dx.doi.org/10.1007/s11079-013-9305-5.
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7
Kirchner, Markus, and Sweder van Wijnbergen. "Fiscal deficits, financial fragility, and the effectiveness of government policies." Journal of Monetary Economics 80 (June 2016): 51–68. http://dx.doi.org/10.1016/j.jmoneco.2016.04.007.
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Acharya, Viral V. "Fiscal Dominance - A Theory of Everything in India." Indian Public Policy Review 1, no. 2(Nov-Dec) (November 5, 2020): 1–15. http://dx.doi.org/10.55763/ippr.2020.01.02.001.
Повний текст джерелаАнотація:
Issue: Nov-Dec 2020
This article focuses on the different channels through which fiscal dominance of the central bank affects financial stability in India, notably through its effect on bank recapitalization and regulation, default closure norms, monetary policy decisions, bond market regulations, capital flow measures and central bank balance sheet. Fiscal dominance also has other side effects on the economy, such as crowding out of private sector investment, external sector fragility of corporate sector financing, financial fragility of firms reliant on market financing, and finally, poor transmission of monetary policy. The paper ends with recommendations on the steps a central bank can take to limit being fiscally dominated. This requires a firm commitment to long-term financial stability, which must be reflected in the central bank’s objectives. The central bank must have autonomy over regulatory decisions, including for government-owned entities in the banking and financial sector. The central bank should adopt a mostly rules-based policy making approach rather than relying on excessive discretion. Finally, the central bank should be democratically accountable through transparency of actions and intent as well as an acknowledgement of limitations of its policy options.
9
Deléchat, Corinne, Ejona Fuli, Dafina Glaser, Gustavo Ramirez, and Rui Xu. "Exiting From Fragility in sub-Saharan Africa: The Role of Fiscal Policies and Fiscal Institutions." IMF Working Papers 15, no. 268 (2015): 1. http://dx.doi.org/10.5089/9781513591315.001.
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Deléchat, Corinne, Ejona Fuli, Dafina Mulaj, Gustavo Ramirez, and Rui Xu. "Exiting from Fragility in Sub-Saharan Africa: The Role of Fiscal Policies and Fiscal Institutions." South African Journal of Economics 86, no. 3 (April 27, 2018): 271–307. http://dx.doi.org/10.1111/saje.12195.
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Cavalli, A., and G. Pontoriero. "Qualità della vita dei pazienti emodializzati alla luce dello studio DOPPS." Giornale di Clinica Nefrologica e Dialisi 23, no. 4 (January 24, 2018): 60–65. http://dx.doi.org/10.33393/gcnd.2011.1503.
Повний текст джерелаАнотація:
Il DOPPS (Dialysis Outcomes and Practice Patterns Study) - ampio studio internazionale, prospettico, osservazionale – è iniziato nel 1996 per raccogliere i dati di un vasto campione di pazienti emodializzati con l'obiettivo di migliorare la terapia, la pratica dialitica ed ovviamente la loro qualità di vita. Lo studio DOPPS ha mostrato come i pazienti emodializzati presentino una qualità di vita molto inferiore rispetto ai soggetti di pari età, in tutte le sue diverse componenti (fisica, mentale e legata alla malattia renale cronica), oltre che una maggior prevalenza di sintomatologia depressiva. È inoltre emerso come alcuni fattori socioeconomici (tra cui la disoccupazione, un ridotto livello di formazione, uno scarso supporto sociale familiare e di staff dialitico) e medici (quali l'utilizzo di un catetere venoso centrale, bassi livelli di emoglobina ed albumina, una scarsa qualità del sonno) siano associati a una più bassa qualità della vita. Il DOPPS ha messo in evidenza l'associazione tra più bassi indici di qualità della vita e peggiori outcome clinici, in termini di ospedalizzazione e mortalità, permettendo pertanto di individuare i soggetti “più fragili” dal punto di vista fisico, sociale e clinico su cui intervenire in maniera specifica. Oggigiorno il DOPPS rappresenta, anche nel campo della valutazione della qualità della vita, un importante riferimento scientifico, che dimostra come uno studio osservazionale, eseguito in accordo ad adeguati criteri metodologici, possa diventare uno strumento informativo, credibile e capace di suggerire nuove ipotesi da testare in successivi studi clinici controllati.
12
Eichengreen, Barry. "Keynesian economics: can it return if it never died?" Review of Keynesian Economics 8, no. 1 (January 22, 2020): 23–25. http://dx.doi.org/10.4337/roke.2020.01.03.
Повний текст джерелаАнотація:
Appreciation of the Keynesian synthesis was enhanced by the events of the last decade. The global financial crisis highlighted the fragility of financial markets and the capriciousness of animal spirits. The depth of the downturn pointed to the value of not just automatic stabilizers but also discretionary fiscal policy as tools of macroeconomic management. Keynesian models and not their New Classical challengers provided the practical analytical framework for policy design. Models of the anti-Keynesian effects of fiscal consolidation received little support from actual consolidation experience. The secular-stagnation debate that followed the crisis lent legitimacy to the view that policy-makers with fiscal space were wise to use it.
13
Matthijs, Matthias, and Mark Blyth. "When Is It Rational to Learn the Wrong Lessons? Technocratic Authority, Social Learning, and Euro Fragility." Perspectives on Politics 16, no. 1 (September 18, 2017): 110–26. http://dx.doi.org/10.1017/s1537592717002171.
Повний текст джерелаАнотація:
Why do bad policy ideas persist over time? We trace the development of the euro’s governing ideas over fiscal and monetary policy in the face of mounting evidence that continued adherence to those ideas was economically deleterious. We argue that a specific form of social learning, framed by a retrospective recoding in 2010–2012 of Europe’s experience with fiscal rules in 2003–2005, drove European elites to pursue policies that were economically irrational but politically rational. As a result, the Eurozone’s medium-term resilience has been made possible by the European Central Bank’s unconventional and loose monetary policies, which operate in direct opposition to the tight fiscal policies of its member states’ governments. We maintain that this self-defeating macroeconomic policy mix will continue as long as the lessons learned by policymakers are driven by the need to win what we term an authority contest, rather than provide better macroeconomic outcomes.
14
Eichengreen, Barry. "Saving Europe's Automatic Stabilisers." National Institute Economic Review 159 (January 1997): 92–98. http://dx.doi.org/10.1177/002795019715900107.
Повний текст джерелаАнотація:
European policymakers have repeatedly suggested that fiscal-policy coordination and fiscal federalism will play key roles in Europe's monetary union. This paper warns that this hope is misplaced. Fiscal federalism will not be available to offset recessionary shocks for the foreseeable future. The effects of coordination designed to internalise the cross-border spillovers of fiscal policies are too weak. Freeing up fiscal policy to replace national governments' loss of monetary independence requires allowing European countries' automatic stabilisers to operate. That in turn requires a flexible application of the Excessive Deficit Procedure and the Stability Pact.The solution suggested here is that the Excessive Deficit Procedure and any fines and sanctions associated with the Stability Pact be applied to the constant-employment budget balance, not the actual deficit. Applying them to actual deficits when European countries enter EMU up against the 3 per cent limit will render fiscal policy strongly procyclical, aggravating the problem of macroeconomic fragility created by the loss of monetary autonomy. Still, countries like Germany haunted by the spectre of fiscal pro fligacy need to be reassured that member states will not abuse their fiscal discretion. Procedural and institutional reform to offset the deficit bias in national political systems is the obvious quid pro quo.
15
CAN, Cansın Kemal. "How vulnerable is the fiscal posture in Turkey?" Green Finance 3, no. 3 (2021): 319–36. http://dx.doi.org/10.3934/gf.2021016.
Повний текст джерелаАнотація:
<abstract> <p>This study gauges the degree of fiscal vulnerability in Turkey by calculating the debt stabilising primary balance level and evaluates how this variable measures up against the actual primary balance levels for the 1978–2019 period. Based on this comparison, we build up a fiscal fragility index using the methodology described in <xref ref-type="bibr" rid="b15">Stoian (2012)</xref>. In addition, the Toda-Yamamoto causality test is carried out to detect the direction of causality among these two variables. The index-based analysis reveals that the fiscal performance of Turkey was chiefly satisfactory for the estimation period. Also, the Toda-Yamamoto causality test results imply a unidirectional causality from the required primary balance to real primary balance, suggesting that the government uses the primary balance to stabilise fiscal imbalances, which is an affirmative effort by the government to restore fiscal sustainability. Nevertheless, notwithstanding the implementation of corrective fiscal actions to preserve stability, the index value is steadily moving up in recent years, indicating a mounting fiscal vulnerability risk. Back-loading fiscal adjustments involving spending cuts, full-fledged tax reform, proper scrutiny of public expenses, etc., are among the prominent policy options available to the government to alter the ongoing unfavourable trend in the fiscal vulnerability index.</p> </abstract>
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Papaioannou, Elias. "A Comment on: “ State Capacity, Reciprocity, and the Social Contract” by Timothy Besley." Econometrica 88, no. 4 (2020): 1351–58. http://dx.doi.org/10.3982/ecta18028.
Повний текст джерелаАнотація:
In this note, I discuss avenues for future research stemming from Besley's [this issue] theoretical approach on the interconnections between civicness, institutions, and state‐fiscal capacity. First, I lay down some ideas on how one could extend the framework to model fragility traps that characterize many low‐income countries and study issues related to nation‐building, conflict, and heterogeneity across space and ethnic lines in the provision of public goods. Second, I discuss the relevance of the approach for the analysis of authoritarian populism that is spreading in developed countries and emerging markets.
17
Manzo, Gerardo, and Antonio Picca. "The Impact of Sovereign Shocks." Management Science 66, no. 7 (July 2020): 3113–32. http://dx.doi.org/10.1287/mnsc.2019.3326.
Повний текст джерелаАнотація:
This paper studies the dynamic propagation mechanisms of systemic risk shocks within and across macrosystems of governments and financial institutions. We propose a novel approach to identify relevant systemic shocks and to classify them into sovereign or banking categories. We find that sovereign shocks have a significant and persistent impact on the probability of a collective banking default. We also explore channels through which these shocks propagate and identify how sovereign fiscal fragility and banking exposure are relevant mechanisms of shock transmission. This paper was accepted by Gustavo Manso, finance.
18
Dondi, Lavinia. "Ambiti rurali fragili e progetto di paesaggio: quali strategie di azione." TERRITORIO, no. 93 (January 2021): 107–15. http://dx.doi.org/10.3280/tr2020-093017.
Повний текст джерелаАнотація:
L'obiettivo del testo è quello di porre in relazione gli ambiti rurali ‘fragili' al progetto di paesaggio, inteso come un processo di rilettura e trasformazione capace di prendersi ‘cura' di determinati luoghi. Per approfondire tale interazione è stato necessario sia individuare gli elementi fisici portanti di cui si compongono gli ambiti rurali - suolo produttivo, sistema di irrigazione e trama dei percorsi - e su cui lavorano le pratiche di progetto, sia strutturare una riflessione sui possibili effetti - lacerazione o alterazione processuale - relativi ai fenomeni di indebolimento che rendono necessario l'intervento. Attraverso una selezione di casi studio individuati nello scenario rurale europeo, la volontà è quella di delineare tre modalità di azione progettuale - di trasformazione, di modificazione o di rigenerazione - che si relazionano a condizioni specifiche di disequilibrio sistemico.
19
Lane, Philip R. "The European Sovereign Debt Crisis." Journal of Economic Perspectives 26, no. 3 (August 1, 2012): 49–68. http://dx.doi.org/10.1257/jep.26.3.49.
Повний текст джерелаАнотація:
The origin and propagation of the European sovereign debt crisis can be attributed to the flawed original design of the euro. In particular, there was an incomplete understanding of the fragility of a monetary union under crisis conditions, especially in the absence of banking union and other European-level buffer mechanisms. Moreover, the inherent messiness involved in proposing and implementing incremental multicountry crisis management responses on the fly has been an important destabilizing factor throughout the crisis. After diagnosing the situation, we consider reforms that might improve the resilience of the euro area to future fiscal shocks.
20
Herzog, Alexander, and Slava Jankin Mikhaylov. "Intra-cabinet politics and fiscal governance in times of austerity." Political Science Research and Methods 8, no. 3 (September 13, 2019): 409–24. http://dx.doi.org/10.1017/psrm.2019.40.
Повний текст джерелаАнотація:
AbstractIn the context of recent economic and financial crisis in Europe, questions about the power of the core executive to control fiscal outcomes are more important than ever. Why are some governments more effective in controlling spending while others fall prey to excessive overspending by individual cabinet ministers? We approach this question by lifting the veil of collective cabinet responsibility and focusing on intra-cabinet decision-making around budgetary allocation. Using the contributions of individual cabinet members during budget debates in Ireland, we estimate their positions on a latent dimension that represents their relative levels of support or opposition to the cabinet leadership. We find some evidence that ministers who are close to the finance minister receive a larger budget share, but under worsening macro-economic conditions closeness to the prime minister is a better predictor for budget allocations. Our results highlight potential fragility of the fiscal authority delegation mechanism in adverse economic environment.
21
Angeletos, George-Marios, and Chen Lian. "Forward Guidance without Common Knowledge." American Economic Review 108, no. 9 (September 1, 2018): 2477–512. http://dx.doi.org/10.1257/aer.20161996.
Повний текст джерелаАнотація:
How does the economy respond to news about future policies or future fundamentals? Standard practice assumes that agents have common knowledge of such news and face no uncertainty about how others will respond. Relaxing this assumption attenuates the general equilibrium effects of news and rationalizes a form of myopia at the aggregate level. We establish these insights within a class of games which nests, but is not limited to, the New Keynesian model. Our results help resolve the forward-guidance puzzle, offer a rationale for the front-loading of fiscal stimuli, and illustrate more broadly the fragility of predictions that rest on long series of forward-looking feedback loops. (JEL D82, D83, D84, E12, E23, E52, E62)
22
Koehler, Gabriele, and Nicholas Mathers. "Forum Introduction: Dynamics of social protection in fragile contexts: Nepal and Myanmar." Global Social Policy 17, no. 3 (September 11, 2017): 347–52. http://dx.doi.org/10.1177/1468018117729914.
Повний текст джерелаАнотація:
This article explores some of the shared dimensions of fragility experienced by Myanmar and Nepal to illuminate the challenging contexts in which social protection policies and programmes have taken shape. Both countries have adopted a universalist, rights-based vision in their approaches to social protection, with social pensions and child benefits at the forefront of social protection programming. At the same time, both countries are employing incremental strategies to overcome political, social, and administrative obstacles, while demonstrating that fiscal space is available. The politics of social protection policy making are obvious, and consistent engagement by progressive social policy advocates in these countries will be necessary to seize opportunities, and to ensure continued investment in building inclusive, effective, and accountable social protection systems.
23
Cantelmi, Tonino, Emiliano Lambiase, Michela Pensavalli, Pasquale Laselva, and Sara Cecchetti. "COVID-19: impatto sulla salute mentale e supporto psicosociale." MODELLI DELLA MENTE, no. 1 (January 2021): 7–39. http://dx.doi.org/10.3280/mdm1-2020oa10908.
Повний текст джерелаАнотація:
Una pandemia non è solo un fenomeno medico, ma colpisce gli individui e la società e causa disagi a livello fisico, psicologico, sociale ed economico. Questo perché è un tipo di evento in grado di dimostrare, spesso in modo molto violento, la vulnerabilità e la fragilità dei nostri sistemi sociali e della nostra struttura psicologica, e quanto spesso possano essere inadeguate le nostre capacità di risposta tecnico-scientifica, sociocomunitaria e personale. In questo articolo abbiamo elaborato una rassegna della letteratura al fine di capire le possibili conseguenze psicologiche della pandemia in atto, cercando materiale da tre possibili fonti di informazione: situazioni con caratteristiche simili a quelle della pandemia in atto (es. con distanziamento sociale), eventi epidemici precedenti (es. SARS e MERS) e ricerche svolte direttamente in questo anno sulla pandemia da Sars-CoV-2. Dalle informazioni raccolte è emerso che le conseguenze psicologiche possono essere anche molto gravi (es. Depressione o Disturbo Post-Traumatico), verificarsi in tempi brevi e durare anche molto tempo dopo gli eventi che li hanno prodotti. Inoltre, è emerso come, nonostante le informazioni e la consapevolezza acquisite in situazioni passate o simili, non è stato fatto a sufficienza per prevenire e affrontare tali conseguenze psicologiche avverse.
24
Prante, Franz, Eckhard Hein, and Alessandro Bramucci. "Varieties and interdependencies of demand and growth regimes in finance-dominated capitalism: a Post-Keynesian two-country stock–flow consistent simulation approach." Review of Keynesian Economics 10, no. 2 (April 29, 2022): 264–90. http://dx.doi.org/10.4337/roke.2022.02.07.
Повний текст джерелаАнотація:
The authors outline and simulate a stylized Post-Keynesian two-country stock–flow consistent model to demonstrate the interconnection of three of the main features/outcomes of finance-dominated capitalism, namely worsening income distribution for the bottom 90 per cent of households, the rise of international imbalances, and the build-up of financial fragility. In the model, two basic regimes emerge, depending on the institutional setting of the respective model economy: the debt-led private demand boom regime and the export-led mercantilist regime. The authors demonstrate the complementarity and interdependence of these two regimes and show how this constellation transformed after a crisis into the domestic demand-led regime stabilized by government deficits, on the one hand, and export-led mercantilist regimes, on the other, depending on the required deleveraging of private household debt, distributional developments and fiscal policy.
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Graetz, Michael J. "Energy Policy: Past or Prologue?" Daedalus 141, no. 2 (April 2012): 31–44. http://dx.doi.org/10.1162/daed_a_00144.
Повний текст джерелаАнотація:
The United States was remarkably complacent about energy policy until the Arab oil embargo of 1973. Since then, we have relied on unnecessarily costly regulations and poorly designed subsidies to mandate or encourage particular forms of energy production and use. Our presidents have quested after an elusive technological “silver bullet.” Congress has elevated parochial interests and short-term political advantages over national needs. Despite the thousands of pages of energy legislation enacted over the past four decades, Congress has never demanded that Americans pay a price that reflects the full costs of the energy they consume. Given our nation's economic fragility, our difficult fiscal situation, and the daunting challenges of achieving energy security and limiting climate change, we can no longer afford second- and third-best policies. This essay discusses the failures of the past and how we might avoid repeating them.
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Sacco, Pier Luigi, Alex Arenas, and Manlio De Domenico. "The Resilience of the Multirelational Structure of Geopolitical Treaties is Critically Linked to Past Colonial World Order and Offshore Fiscal Havens." Complexity 2023 (January 7, 2023): 1–9. http://dx.doi.org/10.1155/2023/5280604.
Повний текст джерелаАнотація:
The governance of the political and economic world order builds on a complex architecture of international treaties at various geographical scales. In a historical phase of high institutional turbulence, assessing the stability of such architecture with respect to the unilateral defection of single countries and the breakdown of single treaties is important. We carry out this analysis on the whole global architecture and find that the countries with the highest disruption potential are mostly medium-small and micro countries. Political stability is highly dependent on many former colonial overseas territories that are today part of the global network of fiscal havens, as well as on emerging economies, mostly from South-East Asia. Economic stability depends on medium-sized European and African countries. Single global treaties have surprisingly less disruptive potential, with the major exception of the WTO. Our results suggest that the potential fragility of the world order seems to be more directly related to global inequality and fiscal injustice than commonly believed and that the legacy of the colonial world order is still strong in the current international relations scenario. In particular, vested interests related to tax avoidance seem to have a structural role in the political architecture of global governance.
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CASAGRANDE, Sara. "UNDERSTANDING EMU ASYMMETRIES AND THEIR ECONOMIC AND POLITICAL IMPLICATIONS." Vol 20, No 1 (2021), Vol 20, No 1 (2021) (March 2021): 69–92. http://dx.doi.org/10.35774/jee2021.01.069.
Повний текст джерелаАнотація:
The Covid-19 emergency makes the seriousness of the unsolved political and economic issues that emerged during the European sovereign debt crisis even more evident. Today more than ever it is necessary to answer questions related to the fragility of the EMU architecture: why was the EMU created with an asymmetric structure? What was the role of EMU architecture and European policies during the crisis? Do EMU asymmetries threaten the survival of the Eurozone? The European integration process took place on the basis of a permissive consensus determined by the expectation of successful economic outcomes, without a true democratic legitimacy. Under such conditions, a fiscal and political union was not possible. The EMU proved to be a competitive arena, within which economic and political asymmetries were difficult to manage. An analysis of these asymmetries allows conclusions to be drawn regarding the risks associated with further economic and institutional integration.
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Nouraei, Morteza, and Vanessa Martin. "Part II: The Karguzar and Security, the Trade Routes of Iran and Foreign Subjects 1900–1921." Journal of the Royal Asiatic Society of Great Britain & Ireland 16, no. 1 (March 15, 2006): 29–41. http://dx.doi.org/10.1017/s1356186305005638.
Повний текст джерелаАнотація:
AbstractThis, the second of our three articles on the role of the karguzar in the foreign relations of Iran, focuses on internal issues, and, in particular, the problems of security. Its main period of study is the years following the Constitutional Revolution during which Iran witnessed a gradual breakdown of social control resulting from severe government weakness. The Revolution, itself the product of financial fragility, led to the virtual bankruptcy of the country, despite the attempts of the Majlis at fiscal reform. Thus by 1910 the government did not have the means to enforce law and order. Problems of personal security placed considerable pressure on people at all levels of Iranian society. This article is, however, concerned with the experiences of the non-elite and the implications for them of financial crisis and weak government. These circumstances were also to have repercussions for Iran's relations with foreigners.
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Elkhishin, Sarah, and Mahmoud Mohieldin. "External debt vulnerability in emerging markets and developing economies during the COVID-19 shock." Review of Economics and Political Science 6, no. 1 (February 22, 2021): 24–47. http://dx.doi.org/10.1108/reps-10-2020-0155.
Повний текст джерелаАнотація:
Purpose This paper aims to assess to what extent the COVID-19 shock is expected to create a debt crisis in emerging markets and developing economies (EMDEs) through two main questions: what are the main determinants of EMDEs external vulnerability? How vulnerable are EMDEs to the current COVID-19 shock compared to the global financial crisis (GFC)? Design/methodology/approach In addition to a descriptive analysis of the determinants of EMDEs external vulnerability, this paper designs two sub-indices of overindebtedness and financial fragility that capture EMDEs’ distinct characteristics. The two sub-indices together illustrate the overall external vulnerability to the current shock. Findings EMDEs are more vulnerable compared to the GFC era. Current debt threats arise mainly from debt architecture and the domination of volatile debt forms – primarily foreign currency-denominated bonds. Excessive fear of debt-deflation spirals after the GFC prompted EMDEs to expand their growth trajectories through a pattern of cheap private lending, loose measures and unmonitored fiscal expansion. Research limitations/implications Conclusive post-crisis data are still unavailable. Practical implications EMDEs need to balance between temporary accommodative measures and a post-shock policy mix that prevent a deflation spiral without worsening indebtedness and financial fragility. Moreover, financial prudence in face of growing credit demand is crucial, particularly in light of the monetary expansion and injected liquidity. Originality/value The indices offer a framework for examining external vulnerability in EMDEs based on theoretical and historical revisions, IMF benchmarks and EMDEs specific debt characteristics. The indices components can be offered for empirical examination in separate future research once conclusive data become available.
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Whitehead, Laurence. "The Alternatives to ‘Liberal Democracy’: A Latin American Perspective." Political Studies 40, no. 1_suppl (August 1992): 146–59. http://dx.doi.org/10.1111/j.1467-9248.1992.tb01818.x.
Повний текст джерелаАнотація:
Although some conventional liberal democratic regimes are likely to become consolidated in Latin America, the dominant pattern is better understood as ‘democracy by default’, and in a few cases little more than ‘facade democracy’ is to be expected. This paper reviews the major factors accounting for the fragility, instability and policy ineffectiveness of many of these new regimes. Although current fiscal crises lend some plausibility to the ‘neo-liberal’ analyses of democratization, the paper argues that in the longer run consolidated democracies will tend to develop a range of ‘social democratic’, participatory and interventionist features that are at variance with the neo-liberal model. Latin American nation-states are relatively well integrated and contain a stock of human and social resources that should favour constitutional outcomes, so that although many of these new democracies will remain provisional and incomplete for the time being, they possess the potential for subsequent extension and entrenchment.
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Sforza, Vincenzo, and Riccardo Cimini. "Running the Obstacle Race towards Public Accounting Harmonization in EU-28: A Temporal Study." International Journal of Business and Management 12, no. 3 (February 21, 2017): 49. http://dx.doi.org/10.5539/ijbm.v12n3p49.
Повний текст джерелаАнотація:
The European Commission has recently started a project aimed at harmonizing EU public accounting systems through the development of European Public Sector Accounting Standards (EPSAS). The project is a response to the lack of coherence between primary public-sector accounts and government financial statistics, in order to strengthen the economic governance structure in the euro area. This paper aims to show that the divergences (adjustments) between the measures of surplus/deficit in governmental (working balance, WB) and national accounting (net borrowing lending, NBL) vary over time to provide future research opportunities around the factors that, affecting temporal divergences between these measures, enhance fiscal fragility within the EU public sector accounting system. By analysing the Excessive Deficit Procedure (EDP) tables issued by 28 EU countries over the period 2010-2015, the paper uses novel approaches in measuring adjustments based on network analysis and regression models, showing that they are significantly different over time.
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Soldatos, Gerasimos T., and Erotokritos Varelas. "Are Banks Too Many? A Theoretical Possibility and a Policy Issue." Journal of Economic Analysis 2, no. 1 (February 25, 2023): 37–54. http://dx.doi.org/10.58567/jea02010003.
Повний текст джерелаАнотація:
Motivated by the Blackorby-Schworm (1993) observation that market outcomes may differ from those originating in market-actor optimization, this paper claims that the number of banks in the market is larger than the number justified by bank profit maximization alone or in combination with bank depositor welfare maximization. This claim is made within the context of bilateral monopoly banks and intertemporal utility maximization by bank depositors. The basic policy implication towards bank population rationalization is a minimization of the deviation away from the optimal interest rate margin at every stage of the business cycle. It is meant to be an acyclical policy though the target of optimal bank population is attainable by active countercyclical policy as well. The nature of this policy issue makes the use of macroprudential measures imperative, jointly perhaps with a fiscal-monetary policy mix. A dynamic version of the model in a Cournot environment is akin to the modeling of Minsky's hypothesis of financial fragility.
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Teixeira, Isabela Vasconcelos, and Ricardo Carneiro. "A Política de Assistência Social Brasileira na Encruzilhada." SER Social 21, no. 45 (July 31, 2019): 301–20. http://dx.doi.org/10.26512/ser_social.v21i45.20370.
Повний текст джерелаАнотація:
O presente artigo examina o processo de implementação da política de assistência social brasileira, enfatizando o modelo de descentralização e de financiamento que lhe dá suporte. O objetivo é analisar esse modelo, que deu sustentação à implantação do Sistema Único de Assistência Social (Suas), apontando suas fragilidades e limites, a partir do resgate do seu processo de institucionalização, da análise do perfil do gasto no setor e dos constrangimentos legais colocados pelo contexto atual. Dados do gasto em assistência social nos últimos anos revelam a centralidade da corresponsabilidade federativa para sua sustentação, assim como forte priorização dos programas de transferência de renda, em detrimento dos serviços continuados, no âmbito federal. Procurou-se demonstrar que o ajuste fiscal advindo da aprovação da Emenda Constitucional n. 95 fragiliza a continuidade dos serviços e benefícios já implantados, colocando os municípios brasileiros em uma encruzilhada
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Grund, Sebastian. "The Quest for a European Safe Asset—A Comparative Legal Analysis of Sovereign Bond-Backed Securities, E-Bonds, Purple Bonds, and Coronabonds." Journal of Financial Regulation 6, no. 2 (August 13, 2020): 233–69. http://dx.doi.org/10.1093/jfr/fjaa009.
Повний текст джерелаАнотація:
Abstract The European sovereign debt crisis and, more recently, the COVID-19 pandemic have revealed the European Economic and Monetary Union’s fragility, which essentially emanates from the inherent tension between a single monetary policy and decentralized fiscal policies. To cushion economic and financial shocks and sever the sovereign-bank doom loop, different proposals to create a common public debt security have been put forward, although none of them has so far seen the light of day. Building on pertinent economic and finance scholarship, this article reviews four promising safe asset proposals from a legal perspective: Sovereign bond-backed securities (SBBS), E-bonds, Purple bonds, and Coronabonds. Rather than focusing on their feasibility under EU law or national constitutional law, this article compares the proposals from an investor perspective against the backdrop of the following formal and functional legal characteristics that render assets ‘safe’: governing law, dispute settlement forum, investor protection, and investor representation in sovereign debt restructurings. Against this backdrop, targeted recommendations on critical design elements of safe assets, with the aim of reconciling the economic policy objectives with the pertinent legal constraints, are advanced.
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Pinto, Hêider Aurélio. "Análise da mudança da Política Nacional de Atenção Básica." Saúde em Redes 4, no. 2 (December 20, 2018): 191–217. http://dx.doi.org/10.18310/2446-4813.2018v4n2p191-217.
Повний текст джерелаАнотація:
O artigo estuda as mudanças feitas na Política Nacional de Atenção Básica em 2017 dando foco àquelas com maior efeito imediato na ação dos gestores municipais como as alterações relacionadas aos agentes comunitários de saúde, regras das equipes de saúde da família, criação de incentivo para equipe não saúde da família, proposição dos padrões essencial e avançado para a atenção básica e os efeitos da mudança no financiamento federal da atenção básica. Para isso, utiliza o referencial teórico do campo de análise de políticas e, como método, faz uma revisão de literatura e análise documental de textos legais e oficiais e publicações da posição e justificativas dos principais formuladores da política além de algumas instituições e organizações que se colocaram contra. A análise aponta que a política elegeu instrumentos de política que se apresentaram insuficientes e fragiliza aqueles que mostraram ter efeito, desestimula a estratégia de saúde da família e estimula equipes que a literatura e avaliações oficiais mostraram ter piores resultados. Conclui as mudanças na PNAB-2017 não conseguem ser explicadas com base no discurso técnico-científico na medida em que atua contra as evidências e estudos disponíveis. Seu sentido latente é encontrado no papel que cumpre na agenda e política mais macro do país, formulada e levada a cabo no sistema político e voltada para o ajuste fiscal neoliberal, e conforme a correlação de forças e interesses específicos dos atores do subsistema de saúde.
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Sahu, Mrutuyanjaya. "Public policy measures for COVID-19 crisis management: lessons from the UAE." Fulbright Review of Economics and Policy 1, no. 2 (November 8, 2021): 246–65. http://dx.doi.org/10.1108/frep-09-2021-0054.
Повний текст джерелаАнотація:
PurposeThe COVID-19 pandemic has exposed the fragility of government institutions and prompted a broad range of policy measures from governments around the world. Policy responses to the pandemic have varied considerably, both in nature and in success. This paper highlights the policy capacities of the UAE in different areas that have contributed to managing the COVID-19 crisis. Specifically, the paper examines the functional capacity, analytical capacity, fiscal capacity, well-timed information-sharing capacity and political capacity of the UAE in addressing the pandemic.Design/methodology/approachThe study on which this paper was based adopted a mixed-method approach to analyze policy capacities. The trajectory and timeframe of COVID-19 from February 2020 to February 2021 were observed intensively and included in the policy capacity analysis. The secondary dataset was collected from several sources and assessed using rapid content analysis to highlight the formal and institutional policy measures implemented during the crisis. To complement the policy analysis and understand the key role of policymakers, semi-structured interviews were conducted with local officials working in various line departments that formulate and implement policy strategies for the UAE government.FindingsThe findings of the study showed that although COVID-19 has severely impacted the UAE, the nation has effectively controlled the spread of the virus and reduced its mortality rate. The UAE government has taken swift policy actions concerning coercive control and mitigation based on a centralized decision-making style, the strengthening of administrative capacity by collaboration, coordination with different departments, successful communication with residents, the allocation of adequate financial resources and a high level of trust in the government by citizens.Originality/valueThis work contributes to the existing literature by highlighting the policy capacity approach to managing the crisis. The UAE case can be used by policymakers as comparative studies of policy designs, tools and capabilities that can be implemented to manage future pandemics and other crises.
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Khasanah, Mulidati Mutya, Rizky Muliani Dwi Ujianti, Fafa Nurdyansyah, and M. Khoiron Ferdiansyah. "Karakteristik Kerupuk Ikan Bandeng (Chanos chanos) dari Variasi Jenis Pengolahan Tepung Ikan dan Pati." Jurnal Pascapanen dan Bioteknologi Kelautan dan Perikanan 15, no. 2 (December 8, 2020): 143. http://dx.doi.org/10.15578/jpbkp.v15i2.634.
Повний текст джерелаАнотація:
Kerupuk ikan bandeng (Chanos chanos) merupakan produk makanan kering yang terbuat dari campuran tepung ikan dengan tapioka atau sagu. Kerupuk ikan dapat dibuat dengan beberapa teknik pengolahan tepung ikan serta jenis pati. Kerupuk tidak akan mengembang dengan baik atau memiilki aroma yang disukai oleh konsumen, jika proses pembuatan tepung ikan atau komposisinya dengan pati tidak tepat. Oleh karena itu, penelitian ini dilakuan untuk mempelajari karakteristik fisiko-kimia dan organoleptik kerupuk ikan C. chanos yang dihasilkan dari variasi jenis proses pengolahan tepung ikan (rebus, kukus, dan presto) serta pati (tapioka dan sagu). Hasil penelitian menunjukkan bahwa kerupuk dengan komposisi 9:1 antara pati jenis tapioka dan tepung ikan hasil pengukusan adalah yang terbaik. Kerupuk ini memiliki kadar air 7,01%; daya kembang 48,41%; dan elastisitas 2,43 mm. Pengujian sensoris secara hedonik (skala 1-5) menunjukkan bahwa kerupuk matang dari komposisi tersebut dapat diterima dengan baik oleh panelis, berdasarkan parameter kerenyahan (3,90), kerapuhan (3,73), aroma (3,06), rasa (3,43), dan warna kecoklatan (3,50). ABSTRACTMilkfish cracker is a dry food product made from a mixture of milkfish meal with tapioca flour or sago flour. There are several options to choose the fish meal process and type of starches. Crackers will not expand properly and having the preferable consumers flavor, if it made from inappropriate fish meal processing and improper composition of starch. Thus, this research was conducted to study the physicochemical and sensory characteristics of fish crackers made from various types of C. chanos fish meal processing (boil, steam, and presto) and starch (tapioca and sago). The results revealed that the preferable crackers was made from 9:1 composition between tapioca starch and steamed fish flour. The crackers characterized with 7.01% moisture content, 48.41% linear expansion, and 2.43 mm elasticity. Sensory analysis (1-5 hedonic scale) showed the cracker made from described composition was preferable from several responses, which were crispiness (3.90), fragility (3.73), odor (3.06), taste (3.43), and brownish color (3.50).
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Longo, Francesco, Paola Roberta Boscolo, and Claudio Bongiorno Sottoriva. "Un framework per la digitalizzazione del territorio." MECOSAN, no. 122 (December 2022): 105–22. http://dx.doi.org/10.3280/mesa2022-122oa14872.
Повний текст джерелаАнотація:
Il Piano Nazionale di Ripresa e Resilienza (PNRR) ha previsto lo stanziamento di 191,5 miliardi di euro per l'Italia.Se da un lato si innovano le infrastrutture fisiche, "l'hardware logistico", dall'altro si dovrebbe investire nel ridisegno dei servizi per gli utenti, nella reingegnerizzazione dei processi di lavoro e nel rafforzare e modificare competenze e ruoli professionali, "il software organizzativo". La parte hard è stata ampiamente affrontata con un preciso processo di project management top-down che coinvolge l'intera filiera istituzionale, dal Ministero alle Regioni, e da queste alle aziende sanitarie pubbliche. La dimensione che riguarda la seconda variabile, ovvero la riprogettazione dei servizi, la reingegnerizzazione dei processi e delle competenze di lavoro è stata di fatto delegata alla piena autonomia delle regioni o, qualora queste siano altrettanto silenti, delle aziende sanitarie pubbliche.Il presente articolo presenta al proposito un framework di innovazione disruptive dei servizi territoriali, con un particolare focus sui processi di prevenzione, sui pazienti cronici e fragili e sulle nuove modalità di accesso e fruizione per tutti i pazienti occasionali. In particolare, si ritiene che i macroprocessi che più debbano essere sottoposti a un ridisegno siano i seguenti:" le modalità di accesso e di reclutamento dei pazienti ai servizi e ai programmi di prevenzione;" i modelli di presa in carico e di case management;" i modelli di programmazione e prenotazione delle prestazioni e dei setting di cura;" le modalità di dialogo e scambio di informazioni tra cittadino e SSN.
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Gonçalves França, Marilene, Adriana Ilha da Silva, and Francis Sodré. "O orçamento e os gastos públicos da saúde na esfera federal no capitalismo contemporâneo no Brasil." JMPHC | Journal of Management & Primary Health Care | ISSN 2179-6750 12, spec (March 16, 2021): 1–2. http://dx.doi.org/10.14295/jmphc.v12.1091.
Повний текст джерелаАнотація:
A saúde foi instituída como direito de cidadania na Constituição Federal de 1988 (CF/88) possibilitando que muitos cidadãos que não tinham acesso as ações e serviços de saúde passassem a usufruí-lo. Contudo, a garantia de recursos financeiros suficientes para assegurar esse direito constitucional tem se constituído um processo complexo, considerando a especificidade histórica, política, econômica e social de cada ente federado, atrelado a capacidade de arrecadação tributária instalada em cada estado ou município, a dependência de transferências dos recursos da União e o poder de alocação de recursos próprios na materialização das políticas de saúde. Nesse processo a apropriação do fundo público tornou-se uma disputa política entre o capital e os direitos sociais, estabelecendo uma correlação de forças na esfera política. Na consolidação do capitalismo, o fundo público tornou-se primordial, sendo os recursos públicos elementos de sustentação dos mercados financeiros, ao mesmo tempo, financiador do capital portador de juros. Já na proteção social o fundo público é o elemento principal no financiamento das políticas sociais. Nesse contexto, os direitos sociais estão sendo ameaçados e reduzidos pelas contrarreformas que o estado capitalista vem adotando nessa fase contemporânea de capitalismo financeirizado e de ajuste fiscal. O governo federal vem se apropriando das contribuições sociais destinadas à seguridade social, resultando no esvaziamento permanente do seu financiamento, deixando os recursos públicos liberados para os condutores das políticas econômicas atenderem os interesses do capital e não aos princípios de universalidade, integralidade e equidade do SUS. No decorrer dos anos, esses recursos, têm financiado as crises do capital e os ajustes fiscais têm limitado os direitos sociais, ao invés de consolidar o Estado Social – de direitos- e estruturar o financiamento da seguridade social. Para compreender as restrições impostas às políticas sociais e os cortes orçamentários, e consequentemente o (des)financimento do SUS é preciso analisar a relação do capital com o fundo público, a fim de entender os entraves para consolidação dos direitos sociais, num contexto de financeirização da economia e de captura do fundo público pelos interesses do mercado que fragiliza a implementação das políticas sociais. Busca-se neste estudo analisar a relação entre orçamento público e fundo público, por meio da análise da execução orçamentária da União no período entre 2009 a 2019, a partir de um comparativo entre o gasto público com saúde e o montante destinado ao pagamento dos juros e amortização da dívida pública brasileira. Trata-se de um estudo documental de caráter exploratório descritivo baseado nas informações obtidas pelo Relatório Resumido da Execução Orçamentária do governo federal e outros demonstrativos, disponível no portal do Tesouro Transparente, canal de disponibilização das informações consolidadas pelo Tesouro Nacional no período de 2009 a 2019. Os dados foram organizados em dois tipos de despesas: gasto público com saúde, subdivididos em gasto público com Ações e Serviços Públicos de Saúde (ASPS) e gasto público não ASPS (despesas não computadas com saúde) e o gasto com juros e amortização da dívida da União, após foram calculadas as variações percentuais por ano. Posteriormente, foi traçado a evolução do gasto público com saúde, comparando-o com o valor gasto para pagamento de juros e amortização da dívida pública. O valor foi corrigido pelo Índice Nacional de Preços ao Consumidor Amplo (IPCA) de dezembro de 2019. No período de 2009 a 2019, o gasto público com saúde da União passou de R$ 103.134.977,54 milhões em 2009, para R$ 114.066.592,01 milhões, em 2019, apresentando aumento percentual de 12,39%. Em relação ao gasto público com gasto com Ações e Serviços Públicos de Saúde (ASPS) houve um aumento de 10,59%, enquanto o gasto público com não ASPS teve crescimento de 65,21%, demonstrando que os gastos com ações que não são computadas na saúde ao longo do período apresentaram um maior crescimento. Comparando os gastos públicos com saúde com os gastos com juros e amortização da dívida da União, observa-se que ao longo dos últimos dez anos, os gastos desses últimos sempre se mantiveram acima do referente ao da saúde. No ano de 2009, a União apresentou valor de R$ 2.580.982.335,62 trilhões de reais do orçamento executado. No que tange o gasto público com saúde foi de R$ 111.342.456,33 milhões de reais (que representou 4,31% do orçamento da União - executado) enquanto o valor gasto com juros e amortização da dívida foi de R$ 470.083.614,39 milhões de reais (que representou 18,21% do orçamento executado da União). No ano de 2019, o gasto público com saúde foi de R$ 127.626.290,66 milhões de reais (que representou 4,33% do orçamento da União - executado), por sua vez o valor gasto com juros e amortização da dívida foi de R$ 482.258.160,32 milhões de reais (que representou 16,37% do orçamento executado da União). Desse modo, observa-se que um percentual maior do fundo público foi direcionado para pagamento dos juros e da amortização da dívida pública, em detrimento a política de saúde. O financiamento das políticas sociais é um reflexo da atual conjuntura política e econômica no país, na qual estão inseridos os interesses de reduzir a máquina pública por meio dos cortes dos gastos com os direitos sociais, desmontando seu aparato social e preservando a lógica do mercado. O Estado, nesse sentido, captura o fundo público para o financiamento do capital portador de juros, que transferem os recursos sociais para amortização dos juros da dívida e superávit primário, e são responsáveis pela não efetivação do orçamento público com a saúde, conforme previsto no texto constitucional, caracterizando o (des)financiamento e o desmantelamento do SUS. Assim, a política de saúde, não foi priorizada no orçamento público para a efetivação dos direitos sociais e os recursos públicos que deveriam compor o financiamento da saúde têm sido desviados pelas políticas macroeconômicas restritivas, subsidiando e financiando a acumulação capital, ao invés de financiar as políticas sociais. Essa situação vem caracterizando o desmonte do Estado e dos direitos sociais, privilegiando a rentabilidade econômica e financeira.
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Torti, Serena, Roberta Di Matteo, Antonella Giolito, Simona Arcidiacono, Tiziana Barocelli, Denise Gatti, Lorella Gambarini, Tatiana Bolgeo, and Antonio Maconi. "Nephro Walking: attivazione di un programma di attività fisica per il benessere psicofisico nel paziente dializzato e trapiantato - studio pilota." Working Paper of Public Health 10 (September 19, 2022). http://dx.doi.org/10.4081/wpph.2022.9538.
Повний текст джерелаАнотація:
Background: L’inattività fisica è un problema di particolare rilevanza nei pazienti con insufficienza renale cronica, una categoria di pazienti in cui il peggioramento sostanziale della forma fisica e della fragilità è fortemente associato a prognosi avversa e ridotta qualità della vita. Lo scopo di questo studio pilota è quello di implementare un programma di attività fisica all’interno del percorso terapeutico di pazienti adulti in trattamento sostitutivo renale (peritoneale e emodialitico) e trapiantati, al fine di incrementare la performance fisica e migliorare la qualità di vita.
Metodi: Studio pilota, interventistico non farmacologico, a singolo braccio, monocentrico, no-profit, su un campione di convenienza di almeno 10 individui affetti da nefropatia reclutati da novembre 2021 a gennaio 2022. I pazienti saranno sottoposti a un programma di camminata terapeutica costituito da 22 sedute. Verranno misurati l’indice di recupero immediato, la composizione di massa corporea, i parametri ematochimici e la qualità di vita.
Conclusioni: L’applicazione di questo studio su piccola scala, ha lo scopo di verificarne la fattibilità e l’adeguatezza per ricavare informazioni che permettano di progettare studi futuri.
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Rozzini, Renzo. "Aging clinical problems: a difficult balance between age and frailty." Monaldi Archives for Chest Disease 84, no. 1-2 (June 22, 2016). http://dx.doi.org/10.4081/monaldi.2015.727.
Повний текст джерелаАнотація:
<p>Frailty is a common geriatric syndrome that embodies an elevated risk of catastrophic declines in health and function among older adults. Frailty is a condition associated with ageing with associated weakness, slowing, decreased energy, lower activity, and, when severe, unintended weight loss. As a population ages, a central focus of geriatricians and public health practitioners is to understand, and then beneficially intervene on, the factors and processes that put elders at such risk, especially the increased vulnerability to stressors (e.g. extremes of heat and cold, infection, injury, or even changes in medication) that characterizes many older adults. The syndrome of geriatric frailty is hypothesized to reflect impairments in the regulation of multiple physiologic systems, embodying a lack of resilience to physiologic challenges and thus elevated risk for a range of deleterious endpoints. The empirical assessment of geriatric frailty in individuals seeks to capture this or related features.</p><p><strong>Riassunto</strong></p><p>Fragilità è la predisposizione alla rottura, al danno. L’etimologia della parola fragilità da "frango", rompere, rimanda alla nozione di qualche cosa che se sottoposto a una pressione, a un impatto, rischia di danneggiarsi facilmente. E’ dunque una nozione ampia e intuitiva che può avere ambiti di precisazione più diversi a seconda che se ne parli in fisica (dove esistono dei coefficienti esatti) piuttosto che nei campi della morale o del sentimento, dove la valutazione sarà sempre più "poetica" e affidata alla sensibilità individuale.</p>
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Bindi, Giulia, and Gabriele Giacomelli. "La paura nell’anziano: una ricerca intervento basata sull’osservazione partecipe." Nsc Nursing, 2021. http://dx.doi.org/10.32549/opi-nsc-49.
Повний текст джерелаАнотація:
Introduzione: La fragilità dell’anziano è fisica e psichica e su di entrambe vi è influenza degli eventi stressanti della vita. Le paure che insorgono possono essere determinate da stereotipi che spesso egli tende ad accettare e che lo portano a ritenersi incapace fino ad un lento declino intellettuale. Questa ricerca ha l'obiettivo di approfondire le conoscenze sulle paure dell’anziano ricoverato e sperimentare la “presenza dell’infermiere” come possibile intervento. Materiali e Metodi: All'interno di un Reparto “Cure Intermedie” è stata svolta una ricerca qualitativa con osservazione partecipante (studio osservazionale descrittivo tipo “serie di casi”). I dati raccolti sono stati analizzati attraverso il metodo l’analisi del contenuto. Risultati: Dalle osservazioni di 13 pazienti (9 donne e 4 uomini; età media 71 anni), sono emersi principalmente contenuti positivi come “Gioia (47)”, “Attesa (35)” e “Offerta-ricordo (33)”. Il contenuto "Paura (16)” diversamente dalla bibliografia consultata è risultato presente ma non preponderante. Discussione: Dall’analisi approfondita del materiale pare emergere che gli aspetti negativi comprendenti la “Paura” sono tra loro molto collegati ma il grosso nucleo di sofferenza viene destabilizzato dagli aspetti affettivi (speranza, aspettativa, amore) che arriva ad una prospettiva positiva (gioia, piacere, gratitudine). “Ascolto” e “disponibilità” sono stati i principali interventi attuati durante l’osservazione e coerentemente a quanto descritto in letteratura hanno permesso di registrare un impatto positivo sui pazienti. Un approfondimento è stato dedicato al concetto di “Offrire-dono” inteso come atto di riconoscimento attivo da parte del paziente verso l’operatore, con le sue implicazioni simboliche e psicologiche. Nell’analisi del materiale sono anche stati presi in considerazione aspetti legati alla psicologia positiva e allo “human caring”, come l’importanza e l’effetto del sorriso, della presenza fisica, dell’empatia nella condivisione e i risvolti nell’ambito di cura. In base agli indicatori della Diagnosi Infermieristica di Paura di Lynda Juall Carpenito-Moyet, la valutazione iniziale durante la fase di accertamento degli stati di paura del paziente, permette un'assistenza basata anche sulla pratica dell'ascolto, competenza fondamentale dell'infermiere. Nei pazienti valutati si è assistito ad una riduzione dello stato di paura nelle osservazioni successive e nelle stesse, ipotizzando un effetto efficace della “presenza”.
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Fabbri, Guest Editors: L. M., and C. Nozzoli. "Malattie croniche da ricercare attivamente e mettere in trattamento nel paziente anziano multimorbido al momento della dimissione da un reparto di Medicina Interna a seguito di un ricovero per insufficienza respiratoria acuta attribuita a riacutizzazione di BPCO." Italian Journal of Medicine, December 21, 2018, 1–97. http://dx.doi.org/10.4081/itjm.q.2018.7.
Повний текст джерелаАнотація:
IntroduzioneP. Gnerre, L.M. Fabbri, C. Nozzoli
Criteri minimi per la diagnosi, valutazione di gravità e trattamento dello scompenso cardiacoP. Gnerre
BPCO e cardiopatia ischemicaG. Vescovo
Criteri minimi per la diagnosi, valutazione di gravità e trattamento della fibrillazione atrialeD. Panuccio
Criteri minimi per la diagnosi, valutazione di gravità e trattamento dell’ipertensione arteriosaM. D’Avino, G. Caruso
Criteri minimi per la diagnosi, valutazione di gravità e trattamento di malattie croniche respiratorie concomitantiC. Nozzoli, L.M. Fabbri
Criteri minimi per la diagnosi, valutazione di gravità e trattamento delle dislipidemieG. Imperiale
Criteri minimi per la diagnosi, valutazione di gravità e trattamento del diabeteF. Costanzo, L. Magnani
Criteri minimi per la diagnosi, valutazione di gravità e trattamento del rischio tromboembolicoF. Dentali
BPCO e arteriopatiaE. Maduli, E. Zoppis
Criteri minimi per la diagnosi della vasculopatia cerebrale e delle malattie neurologiche degenerative nel paziente con BPCOI. Cova, S. Pomati, L. Pantoni
Criteri minimi per la diagnosi, valutazione di gravità e trattamento delle tireopatieM. Grandi, C. Sacchetti, S. Pederzoli
Criteri minimi per la diagnosi, valutazione di gravità e trattamento dell’osteoporosiP. Leandri, A. Cenni, S. Fiorino, G. Belmonte, R. Nardi
Criteri minimi per la diagnosi, valutazione di gravità e trattamento di eventuali malattie croniche renaliD. Manfellotto
Criteri minimi per la diagnosi, valutazione di gravità e trattamento di eventuali epatopatie cronicheL. Fontanella
Criteri minimi per la diagnosi, valutazione di gravità e trattamento di eventuali malattie infiammatorie croniche dell’intestinoA. Lonardo, S. Lugari
Criteri minimi per la diagnosi di fragilità, disabilità e multimorbilità ed interventi generali per tutti i pazienti anziani multimorbidi (vaccinazioni, attività fisica/intellettiva, dieta, ecc.)R. Antonelli Incalzi, C. Pedone
La politerapia del paziente anziano con comorbilità: problematiche in causaF. Tangianu, R. Nardi, G. Pinna, A. Sacchetta, M. Campanini
Esami di laboratorio essenziali per l’inquadramento del paziente anziano multimorbidoM. Pelloso, F. Tosato, M. Plebani
Schemi riassuntivi
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Rafanelli, Martina, and Andrea Ungar. "High blood pressure and syncope: orthostatic hypotension as a link." Monaldi Archives for Chest Disease 84, no. 1-2 (June 22, 2016). http://dx.doi.org/10.4081/monaldi.2015.729.
Повний текст джерелаАнотація:
<p>The prevalence of hypertension increases with the age. Diagnostic criteria are the same as for the young, but in older adults isolated systolic hypertension is more frequent, due to loss of vascular compliance. Blood pressure should be measured on both sides in the seated position, moreover in the supine and upright position to detect orthostatic hypotension. Ambulatory blood pressure monitoring is useful to detect white coat hypertension and masked hypertension, to tailor the treatment and search for diurnal and nocturnal blood pressure pattern abnormalities. Given that frailty can affect the relationship between blood pressure and mortality, the clinician should properly evaluate and monitor physical performance and cognitive status, throughout specific tools, as the Fried Frailty Phenotype, aiming at a systolic blood pressure target between 130 and 150 mmHg. Before starting hypotensive drugs, a careful risk and benefits’ evaluation should be performed given the high risk of hypertension and hypotension consequences and the frequent coexistence of orthostatic hypotension, which predisposes to syncope and falls.</p><p> </p><p> </p><p><strong>Riassunto</strong></p><p>La prevalenza dell’ipertensione arteriosa aumenta con l’età. I criteri diagnostici sono gli stessi previsti nel giovane, nell’anziano tuttavia si osserva più frequentemente ipertensione sistolica isolata, dovuta a perdita dell’elasticità vascolare. Ai fini diagnostici, la misurazione della pressione arteriosa bilateralmente in posizione seduta, deve essere integrata con la ricerca di ipotensione ortostatica. Il monitoraggio della pressione arteriosa nelle 24h è indicato per la conferma diagnostica, per la ricerca di “white coat hypertension” e “masked hypertension”, per monitorare la risposta terapeutica e ricercare alterazioni del ritmo circadiano. I benefici della terapia antiipertensiva sono noti, tuttavia un trattamento troppo aggressivo si è dimostrato dannoso, rendendo la gestione dell’ipertensione arteriosa nell’anziano ancora più complessa. Data l’influenza della fragilità sulla relazione tra pressione arteriosa e mortalità, il clinico dovrebbe avvalersi di adeguati strumenti per la definizione di performance fisica e cognitiva ed il monitoraggio nel tempo, mirando ad un target di pressione arteriosa sistolica compreso tra 130 e 150 mmHg. Rischi e benefici della terapia antiipertensiva dovrebbero essere attentamente valutati prima di intraprendere un trattamento, data la possibilità di eventi correlati sia all’ipertensione che all’ipotensione e la frequente coesistenza di ipotensione ortostatica, che incrementa il rischio di eventi sincopali e cadute. Nell’anziano iperteso con storia di sincope e cadute il trattamento dovrebbe quindi essere intrapreso una volta confermata la diagnosi, mirando ad un target pressorio più contenuto e con una scelta ponderata dei principi attivi.</p>
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Yildirim, Yusuf. "Measuring Fiscal Vulnerability and Fiscal Stress via Fiscal Fragility Index." SSRN Electronic Journal, 2021. http://dx.doi.org/10.2139/ssrn.3919396.
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van der Kwaak, Christiaan, and Sweder van Wijnbergen. "Financial Fragility and the Fiscal Multiplier." SSRN Electronic Journal, 2017. http://dx.doi.org/10.2139/ssrn.2375129.
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El-Shagi, Makram, and Gregor von Schweinitz. "Fiscal policy and fiscal fragility: Empirical evidence from the OECD." Journal of International Money and Finance, December 2020, 102292. http://dx.doi.org/10.1016/j.jimonfin.2020.102292.
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Kirchner, Markus, and Sweder van Wijnbergen. "Fiscal Deficits, Financial Fragility, and the Effectiveness of Government Policies." SSRN Electronic Journal, 2012. http://dx.doi.org/10.2139/ssrn.2796880.
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Kirchner, Markus, and Sweder van Wijnbergen. "Fiscal Deficits, Financial Fragility, and the Effectiveness of Government Policies." SSRN Electronic Journal, 2012. http://dx.doi.org/10.2139/ssrn.2050288.
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Dellchat, Corinne, Gustavo Ramirez, Ejona Fuli, Dafina Mulaj, and Rui Xu. "Exiting from Fragility in Sub-Saharan Africa: The Role of Fiscal Policies and Fiscal Institutions." SSRN Electronic Journal, 2015. http://dx.doi.org/10.2139/ssrn.2716248.
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