ABSTRACT
The literature has few studies on the seasonality of tuberculosis (TB) in the southern hemisphere, entailing the fill of this knowledge gap. This study aims to analyze whether TB incidence in Brazilian capitals and the Federal District is seasonal. This is an ecological study of a time series (2001-2019) of TB cases, conducted with 26 capitals and the Federal District. The Ministry of Health database, with 516,524 TB cases, was used. Capitals and the Federal District were divided into five groups based on social indicators, disease burden, and the Koppen climate classification. The seasonal variation of TB notifications and group amplitude were evaluated. We found TB seasonality in Brazil with a 1% significance in all capital groups (Stability assumption and Krusall-Wallis tests, p < 0.01). In the combined seasonality test, capital groups A, D, and E showed seasonality, whereas groups B and C, its probability. Our findings showed that health service supply and/or demand - rather than climate - may be the most relevant underlying factor in TB seasonality. It is challenging to raise the other seasonal factors underlying TB seasonality in tropical regions in the Southern Hemisphere.
Existe uma limitação de trabalhos na literatura acerca da sazonalidade da tuberculose (TB) no hemisfério sul, o que torna necessário o preenchimento dessa lacuna de conhecimento para a região. O estudo objetiva analisar se existe sazonalidade da incidência de TB nas capitais brasileiras do Brasil e no Distrito Federal, por meio de um estudo ecológico de série temporal (2001-2019) dos casos da doença. Utilizou-se a base de 516.524 casos de TB do Ministério da Saúde. As capitais e o Distrito Federal foram distribuídos em cinco grupos, com base em indicadores sociais, carga da doença e classificação climática de Koppen. Avaliou-se a variação sazonal das notificações de TB e a amplitude sazonal por grupo. Identificou-se a presença da sazonalidade da TB no Brasil ao nível de significância de 1% em todos os grupos de capitais (teste de estabilidade assumida e Krusall-Wallis, p < 0,01) e, no teste combinado de sazonalidade, os grupos A, D e E de capitais mostraram presença de sazonalidade; e, provavelmente presentes, os grupos B e C. Os achados mostraram que é um desafio levantar os fatores sazonais subjacentes à sazonalidade da TB nas regiões tropicais do Hemisfério Sul: o clima pode não ser o fator subjacente mais relevante encontrado na sazonalidade da TB, mas sim a oferta e/ou procura por serviços de saúde.
Son limitados los estudios que tratan de la estacionalidad de la tuberculosis (TB) en el hemisferio Sur, por lo que se hace necesario llenar esta laguna. Este estudio tiene como objetivo analizar si existe una estacionalidad en la incidencia de TB en las capitales brasileñas y en el Distrito Federal, Brasil. Estudio ecológico de series de tiempo (2001-2019) de casos de TB, realizado en 26 capitales brasileñas y el Distrito Federal. Se utilizó una base de datos con 516.524 casos de TB del Ministerio de Salud. Las capitales y el Distrito Federal se dividieron en cinco grupos, con base en indicadores sociales, carga de enfermedad y clasificación climática de Koppen. Se evaluaron la variación estacional de las notificaciones de TB y la amplitud estacional por grupo. La presencia de estacionalidad de la TB en Brasil fue identificada con un nivel de significación del 1% en todos los grupos de capitales (prueba de estabilidad supuesta y Kruskal-Wallis, p < 0,01), en la prueba de estacionalidad combinada, los grupos A, D y E de las capitales tuvieron la presencia de estacionalidad; y también es probable que haya estado presente en los grupos B y C. Los hallazgos demostraron que el clima puede no ser el factor subyacente más relevante encontrado en la estacionalidad de la TB, pero sí la oferta y/o demanda de servicios de salud, lo que muestra que es un desafío plantear los demás factores estacionales subyacentes a la estacionalidad de la TB en las regiones tropicales del Hemisferio Sur.
Subject(s)
Tuberculosis , Brazil/epidemiology , Climate , Humans , Incidence , Seasons , Tuberculosis/epidemiologyABSTRACT
Existe uma limitação de trabalhos na literatura acerca da sazonalidade da tuberculose (TB) no hemisfério sul, o que torna necessário o preenchimento dessa lacuna de conhecimento para a região. O estudo objetiva analisar se existe sazonalidade da incidência de TB nas capitais brasileiras do Brasil e no Distrito Federal, por meio de um estudo ecológico de série temporal (2001-2019) dos casos da doença. Utilizou-se a base de 516.524 casos de TB do Ministério da Saúde. As capitais e o Distrito Federal foram distribuídos em cinco grupos, com base em indicadores sociais, carga da doença e classificação climática de Koppen. Avaliou-se a variação sazonal das notificações de TB e a amplitude sazonal por grupo. Identificou-se a presença da sazonalidade da TB no Brasil ao nível de significância de 1% em todos os grupos de capitais (teste de estabilidade assumida e Krusall-Wallis, p < 0,01) e, no teste combinado de sazonalidade, os grupos A, D e E de capitais mostraram presença de sazonalidade; e, provavelmente presentes, os grupos B e C. Os achados mostraram que é um desafio levantar os fatores sazonais subjacentes à sazonalidade da TB nas regiões tropicais do Hemisfério Sul: o clima pode não ser o fator subjacente mais relevante encontrado na sazonalidade da TB, mas sim a oferta e/ou procura por serviços de saúde.
The literature has few studies on the seasonality of tuberculosis (TB) in the southern hemisphere, entailing the fill of this knowledge gap. This study aims to analyze whether TB incidence in Brazilian capitals and the Federal District is seasonal. This is an ecological study of a time series (2001-2019) of TB cases, conducted with 26 capitals and the Federal District. The Ministry of Health database, with 516,524 TB cases, was used. Capitals and the Federal District were divided into five groups based on social indicators, disease burden, and the Koppen climate classification. The seasonal variation of TB notifications and group amplitude were evaluated. We found TB seasonality in Brazil with a 1% significance in all capital groups (Stability assumption and Krusall-Wallis tests, p < 0.01). In the combined seasonality test, capital groups A, D, and E showed seasonality, whereas groups B and C, its probability. Our findings showed that health service supply and/or demand - rather than climate - may be the most relevant underlying factor in TB seasonality. It is challenging to raise the other seasonal factors underlying TB seasonality in tropical regions in the Southern Hemisphere.
Son limitados los estudios que tratan de la estacionalidad de la tuberculosis (TB) en el hemisferio Sur, por lo que se hace necesario llenar esta laguna. Este estudio tiene como objetivo analizar si existe una estacionalidad en la incidencia de TB en las capitales brasileñas y en el Distrito Federal, Brasil. Estudio ecológico de series de tiempo (2001-2019) de casos de TB, realizado en 26 capitales brasileñas y el Distrito Federal. Se utilizó una base de datos con 516.524 casos de TB del Ministerio de Salud. Las capitales y el Distrito Federal se dividieron en cinco grupos, con base en indicadores sociales, carga de enfermedad y clasificación climática de Koppen. Se evaluaron la variación estacional de las notificaciones de TB y la amplitud estacional por grupo. La presencia de estacionalidad de la TB en Brasil fue identificada con un nivel de significación del 1% en todos los grupos de capitales (prueba de estabilidad supuesta y Kruskal-Wallis, p < 0,01), en la prueba de estacionalidad combinada, los grupos A, D y E de las capitales tuvieron la presencia de estacionalidad; y también es probable que haya estado presente en los grupos B y C. Los hallazgos demostraron que el clima puede no ser el factor subyacente más relevante encontrado en la estacionalidad de la TB, pero sí la oferta y/o demanda de servicios de salud, lo que muestra que es un desafío plantear los demás factores estacionales subyacentes a la estacionalidad de la TB en las regiones tropicales del Hemisferio Sur.
Subject(s)
Humans , Tuberculosis/epidemiology , Seasons , Brazil/epidemiology , Incidence , ClimateABSTRACT
Aiming to assist the environmental sustainability of the Brazilian Amazonian agriculture, this article developed an eco-efficiency index, indicating the possible limits to maximize economic and environmental objectives, taking into account the best practices in the municipalities of the region. Shadow prices of degraded areas and forest preservation were also estimated using data envelopment analysis with directional distance functions. The results indicate that, on average, the analyzed municipalities are able to expand the production and the forest areas by 38% and reduce degraded areas and their inputs in the same proportion. The shadow prices allowed the estimation of the annual opportunity cost of the degraded areas and the preservation of the forest on the farms. The first, US$ 3,131,571, represented 0.04% of the annual output value, indicating that the internalization of that cost should be a low burden for the eco-efficient producer. The second, the total cost of preserving 80% of the area of property, represented US$ 120,890,662 or 1.7% of the annual income of the biome producers studied. Therefore, the main conclusion of this work is that the internalization of negative and positive externalities of agricultural production in the Amazonian biome does not make agricultural production economically unfeasible in the region. In addition, the reimbursement of damages avoided by carbon sequestration, through the Clean Development Mechanism (CDM) established by the Kyoto Conference, should further increase the economic and environmental sustainability of agriculture in the area.
Subject(s)
Agriculture , Efficiency , Brazil , Farms , IncomeABSTRACT
Given the importance that two-stage Data Envelopment Analysis (DEA) models have attained in recent years, this paper presents a systematic review of the literature on the topic focusing on the banking industry. We discuss the two-stage terminology itself, which is not yet not consolidated. We also discuss the current state-of-the-art and present opportunities, as well as challenges, for future studies. We analyse 59 papers, divided them into ten classes that cover various perspectives of two stage DEA studies, such as the economic context, geographic region of the banking units, methodological characteristics, and type of the models, either internal or external. Additionally, we investigate several controversial points regarding two-stage DEA models, such as the variable selection approach, the technique used in the second stage, and the possible impact of non-discretionary variables on efficiency. Results of the literature review indicate the lack of a uniform or universal terminology for two-stage DEA models in the baking industry. Moreover, the main objective of most papers involves extending or improving DEA models. Radial models, with variable returns of scale, and the intermediation approach are the most frequent configurations. Finally, we identify seven gaps in the literature for both internal and external two-stage DEA models and two specific gaps to external ones. Each gap is discussed in depth in the text and can be considered opportunities for future studies.
ABSTRACT
In this paper, we verify which qualitative banking attributes can determine the level of American state-chartered Financial Institutions (FIs) and evaluate its underlying variables. The methodology followed three procedures of analysis. First, we measured banking efficiency using a two-stage SBM network data envelopment analysis (NDEA). Subsequently, we used machine learning methods to predict efficient FIs from qualitative attributes. Finally, we tested the variables related to the attributes, using a fractionated logistic regression controlled by economic-financial variables. As main results, we found that attributes linked to political-administrative localization criteria were the more important attribute in predicting if the FI was in the efficient group; we confirmed the recent findings of the literature that state that less governmental influence (freedom) is related to more efficient institutions. Besides that, we found that a population with a higher financial education have FIs with higher levels of efficiency.
