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The purpose of this article is to clarify the social burden of Japan’s three major diseases including Long-term Care (LTC) burden.

A modification of the Cost of Illness (COI)—the Comprehensive-COI (C-COI) was utilized to estimate three major diseases: cancer, heart disease, and cerebrovascular diseases (CVD). The C-COI consists of five parts: medical direct cost, morbidity cost, mortality cost, formal LTC cost and informal LTC cost. The latter was calculated by two approaches: opportunity cost approach (OC) and replacement approach (RA), which assumed that informal caregivers were substituted by paid caregivers.

The C-COI of cancer, heart disease and CVD in 2017 amounted to 10.5 trillion JPY, 5.2 trillion JPY, and 6.7 trillion JPY, respectively (110 JPY= 1 US$). The mortality cost was preponderant for cancer (61 percent) and heart disease (47.9 percent); while the informal LTC cost was preponderant for CVD (27.5 percent). The informal LTC cost of the CVD in OC amounted to 1.8 trillion JPY; while the RA amounted to 3.0 trillion JPY.

The LTC burden accounted for a significant proportion of the social burden of chronic diseases. The informal care was maintained by unsustainable structures such as the elderly providing care for the elderly. This result can affect health policy decisions.

The C-COI is more appropriate for estimating the social burden of chronic diseases including the LTC burden and can be calculated using governmental statistics.

The tax burden, defined as the ratio of the collected taxes in a particular period against the total product, is commonly used to determine the effect of fiscal and tax policies on the socioeconomic structure. The purpose of this study is to examine how the changes in some macroeconomic indicators affect the tax burden.

System generalized method of moments approach is used for 34 Organisation for Economic Co-operation and Development (OECD) members in the period of 1993-2016.

Based on the research findings, variables such as income per capita, foreign trading volume, the capacity of employment, unemployment and economic share of industry sector effect tax burden in a statistically significant and positive direction. The reason that lies behind the positive effect of unemployment on tax burden is the fact that the sense of social state is not abandoned. Thus, it is predicted that the state will increase public transfer expenditures in the short term due to unemployment, this increase will impose a financial burden on the public sector both in the medium and long term and finally, there will be an increase in the tax burden.

Results in the literature suggest that there are many reasons for increasing tax burden such as socio-economic development, financial and organizational structure and the globalization process. However, according to this study, it seems that gross domestic product per capita, the size of the industry sector, openness, employment capacity and unemployment rate also have a positive and significant effect on tax burden in the long run. Ultimately, these results demonstrate that tax burden, one of the most important indicators of the public sector size in the sample of the states and period in hand, is influenced positively by all independent variables and increases slightly but surely. These results suggest that the tax state is still a determinative factor in the socioeconomic field within its taxation tools.

The purpose of this investigation is to gain insight into parents' perceptions of benefits vs burdens (value) of educational and healthcare service received for their child with ASD. Parents are the main integrators of long-term educational and healthcare service for their child with ASD.

Design/methodology/approach included (1) a sentiment analysis of discussion forum posts from an autism message board using a rule-based sentiment analysis tool that is specifically attuned to sentiments expressed in social media and (2) a qualitative content analysis of one-on-one interviews with parents of children diagnosed with ASD, complemented with interviews with experienced educators and clinicians.

Findings reveal the link between customized service integration and long-term benefits. Both parents and service providers emphasize the need to integrate healthcare and educational service to create holistic long-term care for a child with ASD. Parents highlight the benefits of varied services, but availability or cost are burdens if the service is not publicly provided, or covered by insurance. Service providers' lack of experience with ASD and people's ignorance of the challenges of ASD are burdens.

Ensuring health outcomes for a child with ASD requires an integrated service system and long-term, customer-centric service process because the scope of service covers the child's entire childhood. Customized educational and healthcare service must be allocated and budgeted early in order to reach the goal of a satisfactory service output for each child.

This is the first service research to focus on parents' challenges with obtaining services for their child with ASD. This paper provides service researchers and managers insight into parents' perceptions of educational and healthcare service value (i.e. benefits vs. burdens) received for their child with ASD. These insights into customer-centric perceptions of value may be useful to research and may help service providers to innovate and provide integrated service directly to parents, or indirectly to service providers, who serve children with ASD.

This study aims to explore the risk and protective factors of abuse on older adults by family caregivers, with a special focus on the protective role of caregiver resilience in elder abuse.

This cross-sectional survey was conducted on a purposive sample of 600 family caregivers of community-dwelling older adults in Hong Kong (mean age = 71.04 and female = 67.2%). Caregivers reported in a guided interview about elder abuse behaviours, caregiver burden, care recipients’ agitated behaviours, caregiver resilience, self-efficacy, social support and basic demographic characteristics. Hierarchical linear regression analyses were conducted to examine the predictors of different forms of elder abuse.

Caregiver resilience was predictive of lower levels of verbal abuse, physical abuse, injury and financial exploitation but not potentially harmful behaviour (PHB). Social support was independent with all forms of elder abuse, while self-efficacy predicted greater physical abuse after the adjustment of confounding variables. Caregiver burden and agitated behaviours by care recipients remained as significant risk factors in the final models when protective factors were considered.

This study extends current knowledge on the protecting role of resilience in elder abuse in family caregiving. Mixed findings revealed on social support and self-efficacy also highlight the complexity of the prediction of caregiver abuse. Further research should address this area.

The findings of this study warrant the inclusion of caregiver resilience as a key component in developing interventions to prevent elder abuse. Addressing caregiver burden and agitated behaviours have the potential in preventing elder abuse.

The findings raise awareness of the importance of supporting caregivers in the community to prevent elder abuse.

Research concerning the protective factors of elder abuse is in a preliminary stage. To the best of the authors’ knowledge, this study is among the first which successfully demonstrates the protective role of resilience in caregiver abuse on older adults. The findings shed invaluable light on the design of effective interventions.

The family caregivers play an important role in the good quality of life for the elderly, but most of them can easily have an emotional and psychological effect on caregiving. The purpose of this paper is to explore the correlation between conditions of caring for the elderly in the family and caregiver stress in a community setting, Chiang Mai Province, Thailand.

A cross-sectional exploratory descriptive research was conducted in Ban Klang Subdistrict, San Pa Tong District, Chiang Mai Province. Simple random sampling was used to collect data by using a structured interview via a questionnaire with 103 elderly caregivers. The χ² test was used to explain the conditions related to stress as being a caregiver.

Most of the caregivers were female and still in good health, but at the same time, underwent little stress. However, they did not receive any training beforehand for taking care of the elderly but mainly done by experience, relationship and gratitude. The conditions correlated with stress as being a caregiver were health status of caregivers, confidence of care, the relationship between caregiver and elderly person, and economic burden of care.

A necessary resource such as body of knowledge in elderly caregiving, long-term care system at the community level and social support from family and intimate persons will encourage confidence in taking care of the elderly in the family and also relieve caregivers’ stress.

The purpose of this study is to examine the extent of climate change awareness among the rural farmers of Northern Cross River state, investigate the gender role analyzes of some daily routine activities carried out by these rural farmers, ascertain the difference in workload burden of the impacts of climate change between men and women, identify the strategies adopted by these rural farmers to mitigate the effects of climate change in their agricultural activities and investigate the roles Environmental Education (EE) can play in helping the rural farmers to design and adopt sustainable adaptation and mitigation strategies to reduce or completely eradicate their vulnerability to climate change effects.

The research design adopted for this study is the cross-sectional survey method. Five research questions guided the study. Two sets of instruments were used for data collection, a sample of 1,258 respondents (0.1%) were selected for the study. The researchers personally administered the instruments and collected the same back, two instruments were not properly filled, so they were rejected.

The finding of the study revealed that rural farmers have some level of climate change awareness, which they got from radio, newspapers, awareness campaigns, flyers, billboards, among others. Six out of the nine strategies listed were adopted by the rural farmers to mitigate climate change effects among these rural farmers. There is a significant difference in gender workload burden between women and male in the area, the result is positively skewed toward women, implying that the burden of workload for women increased over those of men. The result also shows that EE can influence their attitude toward climate change through awareness creation, knowledge provisions and also encourage members participation in climate change effect mitigation, prevention and adaptation.

With this result, EE can be used as a tool for the creation of knowledge, awareness, attitude and encourage the participation of these rural farmers toward mitigating and prevention climate change effects among these rural farmers. It was recommended among others that deliberate policies should be designed to make EE help create the needed awareness on climate change, beginning from the causes, effects and mitigation strategies among rural farmers in their community.

Already, most Environmental Educators have been trained, the government should design and formulate practical policies to use them as extension agent on climate change effort to go to these rural communities and create the needed awareness, knowledge, skills and attitude to help them combat climate change effects including trees and cover crops planting and also re-introducing the use of irrigation agriculture in these farming communities.

With the creation of awareness, social groups and individuals can also make a social investment from these activities and also improve their social capitals, thereby reducing social burdens and improving their living conditions within the rural settings.

This research is an original research paper from the effort. the purpose is to assess the extent of climate change awareness level and how the effects of climate change increase or reduces the burden of gender workload among rural farmers and the strategies which can be used by these rural farmers to prevent, mitigate and adapt to climate change effects and the roles EE can play. This study has an original value in the sense that in the course of the study, the study hardly saw articles on these specific variables in whole research, hence the resolve to assess these variables.

The purpose of the study is to assess the differential impact of gender and cancer sites on mental burden across different types of cancer and control patients.

The paper is based on a primary survey undertaken in 2015–2016 of 600 cancer and 200 control patients across five hospitals of Nepal. The data was analyzed using propensity score matching methods and treatment effect weighting estimators.

The authors find that of all the types of patients covered under this study, cervical cancer patients suffered from a greater intensity of anxiety and lack of functional wellbeing. On an average, all other female, male cancer patients, and control patients experience significantly lower intensity of mental burden in the range of 1.83, 2.63 and 3.31, respectively when compared to patients of cervical cancer. The results are robust across all the four treatment effect estimators and through all the measures of mental burden. The implications of suffering from cervical cancer, as a unique gynecological cancer was studied in-depth. An effect size analysis pointed out to the dysfunctional familial relationship as additional causes of concern for cervical cancer patients.

An important finding that emerged is that female cancer patients especially those who have cervical cancer should be given special attention because they appear to be the most vulnerable group. Further work is needed to delineate the reasons behind a cervical cancer patient facing higher amount of stress.

Due to the different institutional pressure such as those from market, regulations and competitors, companies have implemented green supply chain management (GSCM). Unfortunately, tens of GSCM practices exist. Whether all companies should implement GSCM and how to achieve both environmental and economic performance are still not clear for many companies. The purpose of this paper is to develop models that can be helpful for companies to identify right GSCM practices and implement GSCM effectively and efficiently.

Based on about 18 years of study on GSCM with four surveys in China in 2001, 2005, 2012 and 2016, as well as numerous site visits and interviews mainly in China but also in Japan, Germany and Canada, this paper explores institutional drivers as well as opportunities and challenges using theoretical analysis and case studies. GSCM is defined considering a product life cycle. A key three-step GSCM approach is theoretically developed considering opportunities and challenges through life cycle analysis (LCA) of a product and position of a company.

All companies should implement GSCM practices to avoid risks. To effectively implement GSCM practices, a company should understand the life cycle of its product and its position in the supply chain. A key three-step LCA-based approach can help companies to identify the critical GSCM practices.

A key three-step LCA-based approach for GSCM implementation is originally developed based on theoretical analysis and eight years of study.

The estimation of the burden of a disease is one of the tasks with the longest tradition in health economics, which allows us to know the volume of resources that a country allocates to a specific health problem, and to compare countries and diseases. Although the fundamental objective of health systems is not to reduce the cost of the disease, but to improve the health of the population, the studies of burden of disease establish the economic seriousness of the problem, orienting the priorities of action.

Government-funded medical expenditure in Uruguay for the last ten years has tripled in US dollars. The increase in the prevalence of overweight and obesity has contributed to this growth. According to the World Health Organization, Uruguay has the highest growing trend in the prevalence of both overweight and obesity in South America. We have previously estimated that economic burden linked to obesity will be more than US$500 million by 2020, a figure close to 1% of the country’s GDP.

In this study, we tried to generate a measure of value to ascertain the cost of inaction in the fight against obesity and its consequences linked to several non-communicable diseases. The cost of inaction is not defined as the cost of not doing, but as the cost of not implementing the right policies (in this case health prevention policies) at the right time.

The Covid-19 pandemic has rekindled interest in sovereign debt crises amidst calls for debt relief for developing and emerging countries. But has debt relief lessened the debt burdens of emerging and developing economies? The purpose of this paper is to empirically address this question. In particular, the focus is on the implications of debt relief and institutional qualities for sovereign debt in emerging and developing economies.

The model extends the framework on the probability of default by incorporating the receipt of debt relief by a debtor country. Doing so allows to better explain movements of sovereign defaults relating to debt relief. The model is estimated via the regular probit regression.

The analysis shows that the debt relief provided, thus, far, failed to ease the debt overhang problems of developing and emerging countries and reduced investment. The current debt relief schemes may underscore the prospects of self-enforcing and self-fulfilling sovereign debt crises rather than eliminating the dilemma completely. Regarding the forms of debt relief, the analysis shows that debt forgiveness offers favourable prospects in terms of debt sustainability and economic outcomes than debt rescheduling. Perhaps, the sovereign debt crises, particularly in low-income countries, hinge on insolvency problems rather than transitory illiquidity issues.

Any debt relief mechanism should consider seriously the potential incentive effect that reinforces expectations of future debt-relief initiatives. Importantly, solving the sovereign debt problem requires a programme for sustained investment and economic growth, while not discounting the critical role of prudent debt management policies and institutions.

This study contributes a different angle to the debate on sovereign debt distress. Aside from the structural and economic factors, this study investigates the role of debt management policy in the debtor nation and the implications of debt relief benefits for sovereign risk. The framework also focuses on whether the different forms of debt relief exert distinctive impacts.