An Empirical Study on the Relationship between New Energy Vehicle' Export Sophistication and Industrial Structure Upgrading in China.

Following decades of reducing greenhouse gas emissions in the transportation industry, most car companies will stop producing petrol cars and promote the development of new energy vehicles in the near future, even in China. This study is based on energy vehicle exports using China's 31 provinces' panel data from 2010 to 2020. Considering that China mainly engages in processing trade, this study analyzes the domestic energy vehicle's export sophistication after deleting intermediate goods, measuring the relationship between export sophistication and industrial upgrading with static and dynamic panel models. Then, heterogeneity tests were deployed to examine the domestic export sophistication of three major economic belts partition. The results revealed that improving export sophistication is conducive to realizing China's industrial upgrading. China's new energy vehicles industry is positively affected by export sophistication, R&D, foreign direct investment, average GDP growth rate, market factors, and human resources over the long run. Regarding regional stratification, domestic export sophistication in the eastern and western regions has more significant effects on promoting industrial upgrading than in the central region. In particular, in western regions, every increase in export sophistication by one unit will bring a significant industrial upgrading effect. Given this, China's new energy vehicles should increase export sophistication to help the country's industrial upgrading.

Assessing the willingness to pay for HIV counselling and testing service: a contingent valuation study in Lagos State, Nigeria.

HIV/AIDS is a major health issue faced by the world, generally, but particularly sub-Saharan Africa. Nigeria ranked third in the world by number of people living with HIV/AIDS in 2019. Despite prominent HIV counselling and testing (HCT) intervention programmes, Nigeria faces serious challenges, such as inadequate funding and low utilisation rates. Paucity of research into such a critical topic has restricted the capacity of policy makers to address the problem adequately. Consequently, a cross-sectional study was carried out using the contingent valuation method to assess the economic quantum of payment and determining factors associated with people's willingness to pay for HCT services. Data were collected from 768 people selected by convenience sampling of three local government areas - Alimosho, Ikorodu and Surulere in Lagos State, Nigeria. Data were analysed using descriptive statistics, chi-square, Mann-Whitney, and general linear regression model analysis. Findings show that 75% of respondents were willing to pay an average fee of N1 291 ($4.22) for HCT services. Significant determinants of willingness to pay were: income; knowledge of someone living with HIV or died of AIDS; worry about HIV infection; and fear of HIV-related stigma. The findings offer vital information germane to co-payment schemes aimed at financial sustainability of HCT and HIV/AIDS programmes in Nigeria.

Prioritizing Factors Affecting Deceased Organ Donation in Malaysia: Is a New Organ Donation System Required?

PURPOSE: The gap between the demand and the supply of human organs for transplantation is on the rise in Malaysia, despite the efforts of governments to promote donor registration. Factors affecting willingness to donate are contextual and vary from country to country. This research mainly focuses on the selection of most suitable organ donation system through factors affecting willingness to donate in Malaysia. The objectives of this study are to prioritize those factors acting as the pillars of the organ donation system and further to select the most suitable organ donation system for Malaysia. PATIENTS AND METHODS: The data were collected from 35 experts by using a bipolar questionnaire. The study applied an analytical hierarchal process (AHP) for prioritization factors contributing to willingness to donate and then selection of a suitable organ donation system based on prioritized factors. RESULTS: Based on the AHP results, it is evident that donation perception (0.36) has the highest priority in influencing organ donation rates, followed by socioeconomic status (0.32), demographic factors (0.23), and financial incentives (0.09). Further, our results challenge the existing opt-in donation system in Malaysia and present a presumptive approach as a suitable system for increasing deceased donation rate in Malaysia. Presumptive approach promotes the role of health-care professionals in securing the family consent. CONCLUSION: This approach is a person-oriented rather than process-oriented strategy and it relies on designated requesters' skills to evoke altruism among bereaved families. Based on results, the authors recommended that relevant government agencies focus on training nurses to discuss donation with bereaved families and raising public awareness.

Can financial rewards complement altruism to raise deceased organ donation rates?

BACKGROUND: Organ supply-demand in developing countries worldwide has continued to widen. Hence, using a large survey (n » 10,412), this study seeks to investigate whether human psychology could be used to inculcate philanthropy to raise deceased organ donation rates. METHODS: Three models were constructed to examine multidimensional relationships among the variables. Structural equation modeling was applied to estimate the direct and indirect influence of altruism, financial incentives, donation perception, and socioeconomic status simultaneously on willingness to donate deceased organs. ETHICAL CONSIDERATIONS: The study was approved by the University of Malaya ethics committee. RESULTS: The results show that altruism amplifies the impact of socioeconomic status and donation perception on willingness to donate. Also, the results show that financial incentives cannot complement altruism to raise organ donation rates. Hence, investing in education and public awareness enhances altruism in people, which then increases the propensity to donate. CONCLUSION: Evidence suggests that governments should allocate resources to increase public awareness about organ donation. Awareness programs about the importance of philanthropic donations and the participation of medical consultants at hospitals in the processes form the foundation of such a presumptive approach.

COP negotiations and Malaysian climate change roadmap: a comparative assessment using a dynamic environmental model.

This study critically evaluates two COP proposals on Malaysia that have been under consideration to reduce climate damage. A top-down disaggregation framework deploying an "Empirical Regional Downscaling Dynamic Integrated Model of Climate and the Economy" is used to evaluate the local government climate roadmap and Malaysia's emissions reduction agendas under COP21 and subsequently COP22 proposals. The findings show that the costs from climate damage over the period 2010-2110 under the Malaysian Optimal Climate Action scenario will amount to MYR5,483 (US$1589) billion. The commensurate climate damage costs under the COP21 and COP22 scenario would be MYR5, 264 (US$1526) billion. Thus, the effective proposal for reducing climate damage in Malaysia over the period 2010-2110 is the COP22 time-adjusted COP21 proposal but there are a number of macroeconomic cost implications for savings and consumption that policy makers must address before acting.

Climate change mitigation: comparative assessment of Malaysian and ASEAN scenarios.

This paper analyses empirically the optimal climate change mitigation policy of Malaysia with the business as usual scenario of ASEAN to compare their environmental and economic consequences over the period 2010-2110. A downscaling empirical dynamic model is constructed using a dual multidisciplinary framework combining economic, earth science, and ecological variables to analyse the long-run consequences. The model takes account of climatic variables, including carbon cycle, carbon emission, climatic damage, carbon control, carbon concentration, and temperature. The results indicate that without optimal climate policy and action, the cumulative cost of climate damage for Malaysia and ASEAN as a whole over the period 2010-2110 would be MYR40.1 trillion and MYR151.0 trillion, respectively. Under the optimal policy, the cumulative cost of climatic damage for Malaysia would fall to MYR5.3 trillion over the 100 years. Also, the additional economic output of Malaysia will rise from MYR2.1 billion in 2010 to MYR3.6 billion in 2050 and MYR5.5 billion in 2110 under the optimal climate change mitigation scenario. The additional economic output for ASEAN would fall from MYR8.1 billion in 2010 to MYR3.2 billion in 2050 before rising again slightly to MYR4.7 billion in 2110 in the business as usual ASEAN scenario.

An approach toward public hospital performance assessment.

BACKGROUND: Public hospitals have come under heavy scrutiny across the world owing to rising expenditures. However, much of the focus has been on cutting down costs to raise efficiency levels. Although not denying the importance of efficiency measures, this article targets a performance issue that is relevant to address the quality of services rendered in public hospitals. Thus, it is important to focus on the effectiveness of resource utilization in these hospitals. Consequently, this article seeks to examine the impact of average length of stay (ALOS) and bed turnover rates (BTR) on bed occupancy rates (BOR). METHODS: Public hospital inpatient utilization records during the period 2006 to 2013 were gathered from the Ministry of Health, Malaysia. A 2-step generalized method of moments (GMM) statistical method was used to analyze the data. BOR was adopted as the dependent variable, whereas BTR and ALOS were used as the explanatory variables. The logarithm of total bed count (BED), admission (ADM), and patient days (PD) was deployed as control variables. Three regression models were developed to explore the correlates of BOR as a hospital performance measure. Ethics committee approval was waived because no patients were identified in the study. RESULTS: The statistical analyses show that ALOS and BTR are inversely correlated with BOR, with both coefficients significant at 1%. The control variables of BED, ADM, and PD had the right positive signs and they were significant in both sets of equations. Hence, reducing ALOS and BTR can help raise performance of public hospitals in Malaysia. CONCLUSION: In light of the robust results obtained, this study offers implications for improving public hospital performance. It shows a need to reduce ALOS and BTR in public hospitals to improve BOR.

The impact of physical activity on cumulative cardiovascular disease risk factors among Malaysian adults.

BACKGROUND: Numerous studies have shown the importance of physical activity in reducing the morbidity and mortality rates caused by cardiovascular disease (CVD). However, most of these studies emphasise little on the cumulative effect of CVD risk factors. Hence, this study investigates the association between physical exercise and cumulative CVD risk factors among adults in three different age groups. METHODS: Using a sample of 7276 respondents drawn from community centers, the REDISCOVER team gathered information on physical activity, CVD risk factors (obesity, diabetes, hypertension, hypercholesterolemia, tobacco use) and socioeconomic and demographic variables in Malaysia. Because the study required medical examination, a convenience sampling frame was preferred in which all volunteers were included in the study. Fasting blood samples and anthropometric (height, weight and more) measurements were collected by trained staffs. Socio-demographic and physical activity variables were recorded through questionnaires. A Chi-square test was performed to identify the bivariate association between the covariates (socioeconomic variables, demographic variables and physical activity) and outcome variable. The association between the main exposure, physical activity, and the outcome variable, cumulative CVD risk factors, was assessed using an ordinal logistic regression model, controlling for socioeconomic status and demographic influences in three different age groups, 35-49, 50-64 and 65 and above. RESULTS: The mean age of participants is 51.8 (SD = 9.4). Respondents in the age groups of 35-49 (aORmoderate = 0.12; 95 % CI: 0.02 - 0.53 ) and 65 and above (aORhigh = 0.58; 95 % CI: 0.24, 0.78) showed a statistically significant inverse relationship between physical activity and cumulative CVD risk factors. However, this relationship was not significant among respondents in the 50-64 age group suggesting the possible influence of other variables, such as stress and environment. CONCLUSIONS: The statistically significant results show a negative association between physical exercise and cumulative CVD risk factors. However, the lack of a significant relationship in the 50-64 age group suggests the need to include other considerations in future studies, such as stress and environment.

Rethinking health care commercialization: evidence from Malaysia.

BACKGROUND: Against the backdrop of systemic inefficiency in the public health care system and the theoretical claims that markets result in performance and efficiency improvement, developing countries' governments have been rapidly commercializing health care delivery. This paper seeks to determine whether commercialization through an expansion in private hospitals has led to performance improvements in public hospitals. METHODS: Inpatient utilization records of all public hospitals in Peninsular Malaysia over the period 2006-2010 were used in this study. These records were obtained from the Ministry of Health. The study relied on utilization ratios, bed occupancy rates (BOR), bed turnover rates (BTR) and average length of stay (ALOS). The data were analyzed using SPSS 22 Statistical Software and the Pabon Lasso technique. RESULTS: Over 60 % of public hospitals in Malaysia are inefficient and perform sub-optimally. Average BOR among the public hospitals was 56 % in 2006 and 61 % in 2010. There was excessive BTR of 65 and 73 times within the period. Overall, the ALOS was low, falling from 3.4 days in 2006 to 3.1 days in 2010. CONCLUSIONS: This study demonstrates that commercialization has not led to performance improvements in the public health care sector in Malaysia. The evidence suggests that efforts to improve performance will require a focus directly on public hospitals.

The influence of socioeconomic and demographic variables on willingness to donate cadaveric human organs in Malaysia.

The growing shortage in human organs has raised serious concerns. To address this problem, we examine in this article the association between demographic and socioeconomic factors, and respondents' willingness to donate cadaveric organs using a large survey of Malaysian adults aged 18 years and above.A convenience sampling method was used to extract information from a total of 10,350 participants from Metropolitan Kuala Lumpur over the period of April 2, 2013 to February 29, 2014. In addition to analyzing the data using incidence of willingness to donate by demographic and socioeconomic factors, we carried out logistic regression analysis to estimate the odds ratio of respondents' willingness to become cadaveric organ donors controlling for age.About less than a third of the participants pledged to donate their organs upon death with women (35.6%) showing a higher incidence compared with men (33.2%). The Chinese (35.7%) and Malays (35.0%) pledged to contribute more than the Indians (31.6%) and the logistic regressions show that Malays (adjusted odds ration [OR] = 1.18) and Chinese (adjusted OR = 1.21) are more likely to donate than Indians (reference group). The results by religion were significant among Muslims and Hindus but not Buddhists. The likelihood of Muslims donating was the lowest (adjusted OR = 0.26). Income was also highly significant but the relationship with willingness to donate was negative. Against tertiary education, all other occupations were significant. However, the respondents with primary education enjoyed the highest adjusted OR (5.46) whereas that of secondary (0.48) and higher secondary (0.83) education was low. Among occupations (against supervisory, clerical, and direct workers), it was significant only among the unemployed and managers with adjusted OR of 1.50 and 1.58, respectively.Sex, education, ethnicity, religion, and income are important demographic and socioeconomic influences on the likelihood of Malaysians willing to become cadaveric organ donors. The Malaysian evidence suggests that awareness programs should be targeted at men, Muslims, Hindus, Malays, and the rich more than the others.

Living kidney donation: the importance of public education.

A sample of Malaysians in the Klang Valley indicating their decision on becoming unrelated living kidney donors was surveyed regarding huge amounts of financial incentives to be rewarded to them. From the 1310 respondents, 72.1% said "no" on becoming a living donor. The reason "I don't think humans can live with only one kidney" scored the highest (35.6%), and from the 27.9% of the respondents who are willing to donate their organ with the right financial incentive, most of the respondents picked the reasons "I want to do something noble in life" (50%), and monetary reason scored the lowest (6.2%), indicating that financial incentive is not a major reason guiding individuals' decision on becoming living donors. We suggest that the government should put priority at targeting public education to raise the understanding on the risk, safety and the quality of life of donation and transplantation, and improving the public trust on the donation and the surgical methods to carry out transplantation.

Cardiovascular disease risk factors and socioeconomic variables in a nation undergoing epidemiologic transition.

BACKGROUND: Cardiovascular disease (CVD) related deaths is not only the prime cause of mortality in the world, it has also continued to increase in the low and middle income countries. Hence, this study examines the relationship between CVD risk factors and socioeconomic variables in Malaysia, which is a rapidly growing middle income nation undergoing epidemiologic transition. METHODS: Using data from 11,959 adults aged 30 years and above, and living in urban and rural areas between 2007 and 2010, this study attempts to examine the prevalence of CVD risk factors, and the association between these factors, and socioeconomic and demographic variables in Malaysia. The socioeconomic and demographic, and anthropometric data was obtained with blood pressure and fasting venous blood for glucose and lipids through a community-based survey. RESULTS: The association between CVD risk factors, and education and income was mixed. There was a negative association between smoking and hypertension, and education and income. The association between diabetes, hypercholesterolemia and being overweight with education and income was not clear. More men than women smoked in all education and income groups. The remaining consistent results show that the relationship between smoking, and education and income was obvious and inverse among Malays, others, rural women, Western Peninsular Malaysia (WPM) and Eastern Peninsular Malaysia (EPM). Urban men showed higher prevalence of being overweight than rural men in all education and income categories. Except for those with no education more rural men smoked than urban men. Also, Malay men in all education and income categories showed the highest prevalence of smoking among the ethnic groups. CONCLUSIONS: The association between CVD risk factors and socioeconomic variables should be considered when formulating programmes to reduce morbidity and mortality rates in low and middle income countries. While general awareness programmes should be targeted at all, specific ones should be focused on vulnerable groups, such as, men and rural inhabitants for smoking, Malays for hypertension and hypercholesterolemia, and Indians and Malays, and respondents from EPM for diabetes.