The Effect of Inequality and Prosperity on the European Market for Gambling Machines: A Socioeconomic Panel Analysis

This study examines the potential influence of prosperity and inequality on gambling participation in Europe. We combined data from the Eurostat database, the Global Wealth Report, and the European Casino Association and estimated fixed effects panel regression models. We show that income inequality has a negative effect on the number of gambling machines that flattens for high values, while wealth inequality has a linear negative effect. Moreover, an increase in the disposable income of the lower quintiles leads to significant increases in the number of gambling machines per country. These findings are important for future researchers who relate any kind of economic variable to gambling as well as for policy makers, as our results suggest that the lower-income groups should be given the most attention with regards to gambling regulation.

Caregiving intensity and its association with subjective views of ageing among informal caregivers with different sociodemographic background: a longitudinal analysis from Germany

We analysed whether care time, burden and range of caregiving tasks were associated with informal caregivers' subjective views of ageing (measured as attitudes towards own age (ATOA), subjective age (SA), and onset of old age (OOA)), and whether these associations differed as a function of the caregivers' age and gender. Adjusted cluster-robust fixed effects regression analyses were conducted with gender and age as moderators using data of informal caregivers (≥ 40 years) of the population-based German Ageing Survey (2014, 2017). All three aspect of care intensity were associated with changes in subjective views of ageing and this pattern was a function of the caregiver's age and gender. Care time was significantly associated with higher SA. Care tasks were significantly associated with more positive ATOA and earlier OOA. Age moderated the association between burden and ATOA, with older adults reporting more positive ATOA. Gender moderated the association between care time and ATOA; women reported less positive ATOA than men with increasing care time, but also felt subjectively younger than men with a broader range of care tasks. Age- and gender-stratified analysis indicated further differences. Our findings suggest to reduce care time, especially among older and female caregivers, to prevent a worsening of views of ageing, while being involved in a broad range of care tasks seems to (only) benefit female caregivers.

Can technological progress, renewable and nuclear energy consumption be the remedy for global climate crises? An examination of leading OECD countries

Energy is the most critical input for production and consumption. The inputs of energy cause irreversible damage to the environment. The studies carried out to reduce the environmental impact of the methods used in energy production are extremely valuable. This study aims to reveal the effects of technological development, nuclear energy consumption, and renewable energy use on environmental degradation. The patent numbers, technological development, GDP, renewable energy, and nuclear energy consumption data of 16 OECD countries covering the years 1996-2019 were used in the empirical analysis. The findings of panel FMOLS and DOLS methods reveal that technological progress, nuclear, and renewable energy consumption significantly reduce CO2 emissions. In line with these findings, critical policy implications have been suggested.

Effects of the first wave of COVID-19 pandemic on implied stock market volatility: International evidence using a google trend measure

This paper investigates the relationship between investors' attention, as measured by Google search queries, and equity implied volatility during the COVID-19 outbreak. Recent studies show that search investors' behavior data is an extremely abundant repository of predictive data, and investor-limited attention increases when the uncertainty level is high. Our study using data from thirteen countries across the globe during the first wave of the COVID-19 pandemic (January-April 2020) examines whether the search "topic and terms" for the pandemic affect market participants' expectations about future realized volatility. With the panic and uncertainty about COVID-19, our empirical findings show that increased internet searches during the pandemic caused the information to flow into the financial markets at a faster rate and thus resulting in higher implied volatility directly and via the stock return-risk relation. More specifically for the latter, the leverage effect in the VIX becomes stronger as Google search queries intensify. Both the direct and indirect effects on implied volatility, highlight a risk-aversion channel that operates during the pandemic. We also find that these effects are stronger in Europe than in the rest of the world. Moreover, in a panel vector autoregression framework, we show that a positive shock on stock returns may soothe COVID-related Google searches in Europe. Our findings suggest that Google-based attention to COVID-19 leads to elevated risk aversion in stock markets.

Effects of digital skills and other individual factors on retirement decision-making and their gender differences

Increasing the pension age as a dominant solution to population ageing does not bring desirable outcomes, if not accompanied by other essential measures in lifelong learning and fighting age discrimination. Moreover, rapid digitalisation and automation in the labour market bring additional uncertainties for the growing group of older workers. The analysis is based on the SHARE data from Waves 5, 6, and 7 and examines predictors of retirement intentions by two different estimation methods. While digital skills are positively associated with a willingness to stay in the labour market in the random-effect modelling, fixed-effects regression shows no correlation between digital skills and retirement intentions. This difference means that digital skills do not correlate with retirement intentions once we control for time-invariant individual characteristics. Thus, increasing ICT literacy among older workers can have a very limited potential for extending working lives. In contrast to this result, starting to be self-employed, health improvement, having an additional grandchild, and losing a partner increase the willingness to work longer. The study identifies the factors shaping retirement intentions, which should be reflected in any effective social policy.

Corporate Characteristics and Occupational Injuries by Industry

Background

Recent research on occupational injuries in companies has faced difficulties in obtaining representative data, leading to studies relying on surveys or case studies. Moreover, it is difficult to find studies on how a company's industry characteristics affect occupational injuries. This study aims to address these limitations.

Methods

We collected 11 years of disclosure data from 1,247 listed companies in the Korean stock market and combined it with their occupational injury histories collected by the Republic of Korea Occupational Safety and Health Agency (KOSHA) to build a dataset. We attempted to analyze a linear panel model by dividing the dataset into manufacturing, construction, and other industries.

Results

The higher proportion of full-time employees and better job skills correlate with lower occupational injuries in other industries. The wage increase reduces occupational injuries in manufacturing and other industries, but the substitution effect produces the opposite outcome in construction. Also, foreign ownership and credit ratings increase effectively reduce occupational injuries mainly in the manufacturing industry.

Conclusion

Our results suggest that in explaining the relationship between corporate characteristics and occupational injuries, it is necessary to consider the nature of the industry more closely, and in particular, employment and labor policies for preventing occupational injuries need to be selectively applied according to industry. In addition, to improve the limitations and increase the usability of the research results, further detailed studies are needed in the future.

Does renewable energy improve environmental quality? Evidence from RECAI countries

Since 1990, the ecological footprints have been increasing significantly with a continuous increase rate, which led to challenges to environmental quality. The basis for economic growth was said to be the shift of energy and environmental strategies toward a sustainable future. Indeed, it became a matter of proclaimed acceptance that environmental challenges nurtured expansion, innovation, and competitiveness. Climate change is the most pressing issue being faced by the world due to an increase in ecological footprint from 7.0 billion to 20.6 billion GHA. It indicates the seriousness of environmental degradation; therefore, nations need to ensure environmental sustainability. Keeping this in mind, the present research mainly aims to examine the impact of renewable energy utilization on the ecological footprints of RECAI economies, spanning the period from 1990 to 2020. To significantly achieve the research objective, we utilized panel econometric methods for empirical analysis. The results of long-run elasticities indicate that both renewable energy utilization as well as trade openness significantly controls the ecological footprints, while higher conventional energy utilization and economic growth significantly impede environmental sustainability. The empirical findings provide new insights for policymakers on renewable energy for the betterment of environmental quality in RECAI countries.

Quantifying an influence of green credit on digital technology innovation: financial perspective of a China's case study

This paper examines the impact of green credit (GC) on digital technology innovation based on Chinese enterprises using panel data from 1990 to 2016. The study collected panel data from the 40 Chinese firms listed on the Beijing and Wuhan stock markets. Manufacturing companies were selected because they mainly contribute to green credit from pre- and post-policy periods. First, in the "two high and one surplus" sectors, the application of China's Green Credit 2012 could significantly increase total factor digital technology innovation by 1.21%. Results show a considerable drop in the variable values of digital technology innovation, 61.3%; green credit policy, 10.45%; leverage, 21.0%; and green innovation, 85.4%. The results of the absolute value of standard error after matching is much lower than 20.0%, demonstrating that the variable features of the two sets of samples are similar. In conclusion, GC's impact on the FDI of capital was asymmetrical, reflecting various impacts on businesses with various types of property rights and sizes.

The effect of geopolitical risk on environmental stress: evidence from a panel analysis

The current paper concentrates on whether geopolitical risk can create environmental stress or not. It empirically explores the geopolitical risk effect on energy and carbon intensities of human well-being. Our paper postulates that geopolitical risk's impacts change over time because of the continuous amendments in the decision process through the geopolitical events' reoccurrence and the interaction with unobserved variables or the time-specific disturbances. Thus, our paper uses the two-way fixed Prais-Winsten regression approach to measure this dynamic relationship period yearly. It extracts evidence from 18 countries worldwide during the period (1992-2018). It finds that the effect of geopolitical risk on environmental stress is changing between positive and negative signs. The results show that geopolitical risk is biased toward reducing environmental stress or supporting environmental sustainability. From a policy implication side, policymakers and scholars should pay more attention to understand how geopolitical risk effects evolve on the country and the international levels and how to manage the geopolitical events to encourage their positive impacts on the environment.

Studying the Interrelationship between Telecommuting during COVID-19, residential local accessibility, and active travel: a panel study in Montréal, Canada

The COVID-19 pandemic led to a substantial increase in the number of people working from home (telecommuting), in turn leading to unprecedented changes in mobility patterns worldwide. Due to the changing context of the pandemic, there is still a significant gap in knowledge regarding the effects of working from home on workers' travel patterns. The main goal of this work is to unravel the interrelationship between telecommuting during the COVID-19 pandemic, the frequency of active travel for non-work utilitarian purposes, and local accessibility levels around workers' homes. This study uses a longitudinal approach by analyzing travel and telecommuting behavior data from a two-wave survey administered in Montreal in 2019, pre-pandemic, and 2021, during COVID-19 (n = 452). Through a set of weighted multi-level linear regressions, we study the effects of telecommuting on the frequency of active travel for non-work utilitarian purposes, mediated by local accessibility around the household. Results show that the effect of telecommuting on non-work active travel for utilitarian purposes is highly dependent on local accessibility levels around the person's household. For workers living in high local accessibility areas, an increase in telecommuting during the pandemic has induced an increase in active trips for non-work utilitarian purposes. On the other hand, for workers residing in low local accessibility neighborhoods, the effect is the opposite. This research provides insights into the effects of telecommuting on non-work active travel, an area that is currently of interest to policy-makers and practitioners working towards increasing the level of physical activity among individuals through travel.

Is the Effect of Environmental Attitudes on Behavior Driven Solely by Unobserved Heterogeneity?

A large body of research exists investigating the link between environmental attitudes and behavior. Many empirical studies have found modest positive effects, suggesting that attitudes toward the environment might indeed influence environmental behavior. However, most of the previous empirical work is cross-sectional and correlational in nature. This means that the issue of the causal effect of environmental attitudes on behavior is far from settled, and that the relationships observed in the past may be due to unobserved confounders. In a panel study using six waves of the GESIS Panel Survey, we examine the individual-level effect of changes in one's attitudes on changes in different forms of environmental behavior. We use fixed effects panel regression within the structural equation modeling framework to control for unobserved time-invariant confounders, while also tackling other methodological challenges. We find that environmental attitudes have no effect on behavior after controlling for unobserved confounders. However, there is a robust effect of attitudes on willingness to sacrifice. This suggests that creating more positive attitudes might make individuals more willing to accept sacrifices for environmental protection.

Investigating the potential role of innovation and clean energy in mitigating the ecological footprint in N11 countries

This paper seeks to explore the potential function of technological innovation and clean power in mitigating the ecological footprint in the N-11 nations during the phase 1992-2015 by applying panel cointegration analysis. The outcomes of the panel cointegration test signify the occurrence of a long-run relation among the clean energy (CE) variable, the ecological footprint (EF) variable, the per capita GDP (Y) variable, the financial development (FIN) variable, and technological innovation (TI) variable. The outcomes of the VECM signify a long-run causal relation from the ecological footprint (EF) variable to the clean energy (CE) variable, the GDP per capita (Y) variable, and technological innovation (TI) variable. This implies that the environmental degradation faced by the N-11 countries leads to shifting toward clean energy sources and technological innovation in the long run. Thus, the N-11 countries are in need to design policies that enhance shifting toward environmentally friendly energy sources.

Investigating marginal effect of economic growth on environmental quality based on six environmental indicators: does financial development have a determinative role in strengthening or weakening this effect?

Given the complexity of the correlation of economic growth with financial development, and their interactive impacts on environmental quality, this study attempted to present new insights into indecisive outcomes from the contribution of financial development in determining the impressionability of environmental indicators under economic growth conditions. Previous studies only employed a single environmental indicator for analyzing the correlation between economic factors and environmental quality. However, six environmental indicators are adopted in this study to evaluate environmental quality and to reach major goals of this research. To this end, using 2-stage system generalized technique of moment estimator, the association of economic growth, energy consumption, financial development, environmental indicators, and trade openness is determined in selected OPEC countries for years 2010 to 2019. Findings indicated that accompanied by the effects of economic growth on any EFI, ANS, PN, and EPI variables, the financial development enhances such effect. This is while, the financial development would weaken the economic growth effect on the ESI variable. Regarding EVI, no significant association was observed. Regarding to ESI, EPI, and PN, trade openness applies a significantly positive impact on environmental quality; on the other hand, it has positive role in environmental degradation based on EFI and ANS. This is while, according to the EVI variable, trade openness has not meaningful impact on environmental status. Finally, energy use has significant and positive effects on environmental degradation in each of environmental indicators. However, this variable has not shown significant impact on EPI and ANS. Alternatively, findings indicated that financial development can be considered an important and key variable in improvement of the environmental quality due to the moderating role it plays relative to the negative economic growth effect on the environmental quality. At the end of this paper, some limitations are presented, and some suggestions for further studies are provided as well.

From income inequality to social inequity: impact on health levels in an international efficiency comparison panel

BACKGROUND

Health equity, although addressed in several publications dealing with health efficiency analysis, is not easily translated into the operationalization of variables, mainly due to technical difficulties. Some studies provide evidence that it does not influence health outcomes; others demonstrate that its effect is an indirect one, with the hegemony of material living conditions over its social connotation. The aim of this article is to evaluate the role of health equity in determining health outcomes, in an international comparative analysis of the effectiveness and efficiency of health systems.

METHOD

Fixed Effects Model Panel and Data Envelopment Analysis, a dynamic and network model, in addition to comparative analysis between methods and health impacts. The effect variables considered in the study were life expectancy at birth and infant mortality, in 2010 and 2015, according to the sociocultural regions of the selected countries. Inequity was assessed both economically and socially. The following dimensions were considered: physical and financial resources, health production (access, coverage and prevention) and intersectoral variables: demographic, socioeconomic, governance and health risks.

RESULTS

Both methods demonstrated that countries with higher inequity levels (regarding income, education and health dimensions), associated or not with poverty, are the least efficient, not reaching the potential for effective health outcomes. The outcome life expectancy at birth exhibited, in the final model, the following variables: social inequity and per capita health expenditure. The outcome infant mortality comprehended the level of education variable, in association with the following healthcare variabels: care seeking due to diarrhea in children under five, births attended by skilled health professionals and the reduction in the incidence of HIV.

CONCLUSION

The dissociation between the distribution of health outcomes and the overall level of health of the population characterizes a devastating political choice for society, as it is associated with high levels of segregation, disrespect and violence from within. Countries should prioritize health equity, adding value to its resources, since health inequties affect society altogether, generating mistrust and reduced social cohesion.

Faculty and programmatic influences on the percentage of graduates of color from professional physical therapy programs in the United States

The physical therapy profession in the United States suffers from a shortage of providers of color. This is unlikely to change with newly graduating students, as 2.6% of 2017 graduates were African American and 5.7% were Hispanic or Latino. Faculty mentorship has a more profound influence on the retention of underrepresented minority students as compared with students from privileged backgrounds, according to undergraduate literature. The influences of faculty characteristics on physical therapy graduates of color are unknown. The purpose of this study was to determine faculty and programmatic characteristics that could influence the percentage of physical therapy graduates of color. This study implemented the theory of academic capitalism to inform the results of a retrospective panel analysis, which used accreditation data from 2008 to 2017. Data from 231 programs was used to create fixed effects and random effects models to estimate the effects that faculty and program characteristics had on the percentage of graduates of color that a program produced. There was a statistically significant positive relationship between faculty of color and graduates of color (p < 0.001), but faculty must be sufficiently diverse before a program can expect a meaningful change in their percentage of graduates of color. Academic capitalist principles suggest that competition between programs for resources could negatively influence the proportion of graduates of color. Cause and effect associations between variables cannot be established. The authors concluded that professional physical therapy programs appeared to have increases in the percentages of graduates of color when they had more core faculty members of color.

Characteristics of Professional Physical Therapist Faculty and Doctor of Physical Therapy Programs, 2008-2017: Influences on Graduation Rates and First-Time National Physical Therapy Examination Pass Rates

OBJECTIVE

Graduation rates and first-time National Physical Therapy Examination (NPTE) pass rates among Doctor of Physical Therapy (DPT) programs have ranged from 30% to 100% and 0% to 100% between 2008 and 2017, respectively. Prior studies on predictors of graduation rates and NPTE pass rates from DPT programs have used cross-sectional data and have not studied faculty data. This study sought to understand how trends in DPT faculty and program characteristics correlated with graduation rates and first-time NPTE pass rates.

METHODS

This study was a retrospective panel analysis of yearly data from 231 programs between 2008 and 2017. Random effects models estimated the correlations between faculty and program characteristics regarding graduation rates and first-time NPTE pass rates.

RESULTS

Graduation rates peaked when programs devoted 25% of faculty time, on average, to scholarship. The number of peer-reviewed publications was positively correlated with graduation rates; however, the trend was logarithmic, indicating a diminishing rise in graduation rates as the number of publications exceeded 1 per faculty full-time equivalent. Tenure-track status, faculty of color, and part-time faculty were all negatively correlated with first-time NPTE pass rates. However, these 3 trends are likely not meaningful, because the predicted rates of decline in pass rates were minimal.

CONCLUSIONS

Faculty engagement in scholarly activities can positively influence graduation rates, but only up to a certain level of faculty time devoted to scholarship.

IMPACT

This is the first study to provide data on the influence of faculty on DPT student outcomes and will help education programs develop strategies to improve those outcomes.

Is perception of inability to procreate a temporal phenomenon?: A longitudinal exploration of changes and determinants among women and men of reproductive age in Germany

Continued postponement of births and increasing use of reproductive medicine enhance the relevance of infertility and related perceptions for fertility research. Fertility researchers tend to assume that an existing perception of inability to procreate is a stable trait among persons of reproductive age. This assumption is questionable from a life course perspective and has not been thoroughly investigated. Therefore we investigate the prevalence, stability, and correlates of perceived inability to procreate. We apply between-within logit models to annual panel data (2008-2015) to study variation in perceived inability to procreate within individuals over time and between individuals. We find that approximately every 20th person of reproductive age is affected. There is considerable instability among those who ever perceive an inability to procreate: On average, 39 % of women and 48 % of men who perceive an inability in one year change to not perceiving an inability in the next year. Multivariate analysis shows that increases in age and perception of one's partner as unable to procreate are associated with higher odds of perceiving an inability to procreate. Not using contraception is associated with higher odds of perceiving an inability to procreate. Perceived procreative ability further differs by parity, level of education, immigration background, and religious denomination. In summary, perception of inability to procreate is a temporal phenomenon that is shaped by lifecourse contexts and social group differences.

Environmental Kuznets curve hypothesis: asymmetry analysis and robust estimation under cross-section dependence

In this paper, we revisit the environmental Kuznets curve (EKC) hypothesis by using estimations that account for cross-sectional dependency (CSD) and asymmetry effect in 76 countries for the period 1971-2014. Our results lend moderate support to the EKC hypothesis. The country-specific results unfold that a total of 16 out of 76 countries support the EKC hypothesis using CCEMG estimator. Results from AMG reveal that the EKC hypothesis holds in 24 out of 76 countries. It is worth highlighting that 11 countries (Australia, China, Congo Dem. Rep., Costa Rica, Gabon, Hong Kong, India, Korea, Myanmar, Turkey, and Uruguay) exhibit an inverted U-shaped curve regardless of whether CCEMG or AMG is used. The asymmetry analysis using PMG is also able to support the EKC hypothesis. We conclude that the EKC hypothesis does not fit all countries. Policy implication and recommendation in designing appropriate energy and economic policies are provided.

Toward a sustainable mitigation approach of energy efficiency to greenhouse gas emissions in the European countries

The efficient use of energy contributes to less energy consumption and the reduction of greenhouse gases released to nature, thus improving environmental sustainability. For this reason, many countries pioneered by the developed nations are trying to develop policies for energy efficiency. In this context, the relationship between energy efficiency and greenhouse gas emissions was tested by panel co-integration, panel causality, and FMOLS and DOLS analysis. Given that the study used the datasets of 29 European countries over the period 1995–2016, there result suggests that there is a long-term relationship between energy efficiency and greenhouse gas emissions and that the quantity of greenhouse gas emission decreases as energy efficiency increases. Finally, the robustness and novelty by employing the Emirmahmutoglu & Kose (2011) Testing for Granger causality in heterogeneous mixed panels. Economic Modelling, 28(3), 870–876 approach, the findings illustrated that there is a causal relationship between energy efficiency and greenhouse gas emissions for many European countries. Overall, the current study presents a relevant policy direction for the European bloc countries.

What do housing wealth and tenure have to do with it? Changes in wellbeing of men and women after divorce using Australian panel data

Homeownership, as a way to build up housing wealth, is believed to play an increasingly important role in terms of providing welfare to citizens. However, homeownership does not always act as a nest-egg; it can be a source of financial anxiety as well. In this paper we investigate how homeownership and housing wealth impact on the relationship between divorce and subjective wellbeing (life satisfaction, happiness, financial satisfaction). Using longitudinal data for Australia we find that homeowners are more negatively affected with respect to wellbeing by divorce than tenants, amongst others because the owned house becomes a financial burden. We further find that gender moderates the impact of homeownership and tenure change upon divorce on wellbeing. When women move from an owned to a rented house, divorce has a smaller negative effect on happiness and financial satisfaction than when women stay in the owned house. For men, staying in the owned house or moving within the owner-occupied sector increases happiness, but moving to the rental sector from the owned house increases financial satisfaction. Furthermore, for men, housing wealth mitigates financial stress when remaining in an owner-occupied house after divorce. We conclude that the potential role of homeownership as a welfare resource - in this case for subjective well-being - seems rather limited to those who already possess other resources (e.g. financial security) and therefore cannot be expected to substitute more traditional forms of welfare.

Assessing factors that influence waste management financial sustainability

This article examines the financial sustainability of waste management activities to understand whether and how choices oriented toward environmental protection and contextual factors influence waste management companies' revenues and costs, which, in turn, affect their financial sustainability and, thus, their ongoing viability. To achieve this purpose, a three-year empirical analysis on 880 Italian municipalities was conducted. Financial sustainability was evaluated with reference to waste management companies working in these territories, and a set of quantitative and qualitative data was considered to investigate possible influencing factors. The results show that separate waste collection may positively influence companies' financial performance, while municipalities' territorial extension negatively impacts profitability. Lastly, there is no evidence of a relationship between companies' financial sustainability and the potential presence of waste disposal plants or the geographical areas in which they operate. For the analyzed companies, thus, it seems that it would be more convenient to expand business by boosting separate waste collection activities than by enlarging the territories served. These findings can support firms' decisions regarding environmental and financial issues, both of which are crucial for long-term sustainability. It can also help policy makers detect appropriate tools to support companies in implementing European Union waste management targets.

Assessing physician productivity following Norwegian hospital reform: A panel and data envelopment analysis

BACKGROUND

Although health care reforms may improve efficiency at the macro level, less is known regarding their effects on the utilization of health care personnel. Following the 2002 Norwegian hospital reform, we studied the productivity of the physician workforce and the effect of personnel mix on this measure in all nineteen Norwegian hospitals from 2001 to 2013.

METHODS

We used panel analysis and non-parametric data envelopment analysis (DEA) to study physician productivity defined as patient treatments per full-time equivalent (FTE) physician. Resource variables were FTE and salary costs of physicians, nurses, secretaries, and other personnel. Patient metrics were number of patients treated by hospitalization, daycare, and outpatient treatments, as well as corresponding diagnosis-related group (DRG) scores accounting for differences in patient mix. Research publications and the fraction of residents/FTE physicians were used as proxies for research and physician training.

RESULTS

The number of patients treated increased by 47% and the DRG scores by 35%, but there were no significant increases in any of the activity measures per FTE physician. Total DRG per FTE physician declined by 6% (p < 0.05). In the panel analysis, more nurses and secretaries per FTE physician correlated positively with physician productivity, whereas physician salary was neutral. In 2013, there was a 12%-80% difference between the hospitals with the highest and lowest physician productivity in the differing treatment modalities. In the DEA, cost efficiency did not change in the study period, but allocative efficiency decreased significantly. Bootstrapped estimates indicated that the use of physicians was too high and the use of auxiliary nurses and secretaries was too low.

CONCLUSIONS

Our measures of physician productivity declined from 2001 to 2013. More support staff was a significant variable for predicting physician productivity. Personnel mix developments in the study period were unfavorable with respect to physician productivity.

Poverty dynamics in Germany: Evidence on the relationship between persistent poverty and health behavior

Previous studies have found poverty to be related to lower levels of health due to poor health behavior such as unhealthy eating, smoking or less physical activity. Longer periods of poverty seem to be especially harmful for individual health behavior. Studies have shown that poverty has a dynamic character. Moreover, poverty is increasingly regarded as being a multidimensional construct and one that considers more aspects than income alone. Against this background this paper analyzes the relationship between health behavior and persistent spells of income poverty as well as a combined poverty indicator using data of the German Socio-Economic Panel (2000-2010). Next to cross-sectional logistic regression models we estimate fixed-effects models to analyze the effect of persistent poverty on dietary behavior, tobacco consumption, and physical activity. Cross-sectional results suggest that persistent poverty is related to poor health behavior, particularly regarding tobacco consumption and physical activity. Results also show that multidimensional and dynamic aspects of poverty matter. Complementary panel analyses reveal negative effects for the combined poverty indicator only for dietary behavior in the total sample. However, by analyzing the sample by gender we identify further effects of persistent poverty on health behavior. The analyses show that not only do individuals in poverty but also those in precarious situations show health-damaging behavior more often.

Does Sexual Satisfaction Change With Relationship Duration?

Despite a large body of empirical literature on sexual satisfaction, its development over the course of a relationship is still unclear. Only a small number of studies, most of which have relied on cross-sectional data of convenience samples, have explicitly focused on relationship duration, and empirical evidence is mixed. We analyzed how sexual satisfaction changes over the course of a relationship using three waves of the German Family Panel study (pairfam). We concentrated our analyses on young and middle-aged heterosexual individuals in committed relationships (N = 2,814) and applied fixed effects regression models, which have the advantage of estimations based on changes within individuals over time. We found a positive development of sexual satisfaction in the first year of a relationship, followed by a steady decline. This pattern persisted even when controlling for the frequency of intercourse, although the effects were, in part, mediated by intercourse frequency. We explained the non-linear effect of relationship duration on sexual satisfaction with an initial learning effect regarding partner-specific sexual skills, which is then outweighed by a decline in passion at later stages of a relationship. Moreover, we found significant effects for the control variables of health status, intimacy in couple communication, and conflict style, as expected. In contrast to past research, however, cohabitation and marriage were not found to play a role for sexual satisfaction in our data. Further research is required to deepen the understanding of the reasons why sexual satisfaction changes with relationship duration.

Effects of relationship duration, cohabitation, and marriage on the frequency of intercourse in couples: Findings from German panel data

Research into the changes in the frequency of sexual intercourse is (with few exceptions) limited to cross-sectional analyses of marital duration. We investigate the frequency of intercourse while taking into account relationship duration as well as the duration of cohabitation and marriage, effects of parenthood, and relationship quality. For the analysis we apply fixed effects regression models using data from the German Family Panel (pairfam), a nationwide randomly sampled German panel survey. Our findings imply that the drop in sex frequency occurs early in the relationship, whereas neither cohabitation nor marriage affects the frequency of intercourse to a significant extent. Sex frequency is reduced during pregnancy and as long as the couple has small children, but becomes revived later on. Relationship quality is found to play a role as well. These results are contrary to the honeymoon effect found in earlier research, but indicate that in times of postponed marriage an analogous effect may be at work in the initial period of the relationship.

The effect of medical cannabis laws on juvenile cannabis use

BACKGROUND

A number of states in the United States legally allow the use of cannabis as a medical therapy to treat an illness or to alleviate symptoms. Concern persists as to whether these types of laws are increasing juvenile recreational cannabis use. It is also plausible that medical cannabis laws engender an escalation of illicit non-cannabis drug use among juveniles because cannabis is frequently considered to be a gateway drug.

METHODS

This study uses longitudinal data drawn from the National Survey on Drug Use and Health for the 50 U.S. states and a cross-sectional pooled-time series research design to investigate the effect of medical cannabis laws on juvenile cannabis use and on juvenile non-cannabis illicit drug use. Our study period encompasses five measurement periods calibrated in two-year intervals (2002-2003 to 2010-2011). This research design is advantageous in that it affords us the ability not only to assess the effect of the implementation of medical cannabis laws on juvenile drug use, but also to consider other state-specific factors that may explain variation in drug use that cannot be accounted for using a single time series.

RESULTS

Findings show that medical cannabis laws amplify recreational juvenile cannabis use. Other salient predictors of juvenile cannabis use at the state-level of analysis include perceived availability of cannabis, percent of juveniles skipping school, severity of perceived punishment for cannabis possession, alcohol consumption, percent of respondents with a father residing in household, and percent of families in the state receiving public assistance. There is little empirical evidence to support the view that medical cannabis laws affect juveniles' use of illicit non-cannabis drugs.

CONCLUSION

Based on our findings, it seems reasonable to speculate that medical cannabis laws amplify juveniles' use of cannabis by allaying the social stigma associated with recreational cannabis use and by placating the fear that cannabis use could potentially result in a negative health outcome.

Air pollution, avoidance behaviour and children's respiratory health: evidence from England

Despite progress in air pollution control, concerns remain over the health impact of poor air quality. Governments increasingly issue air quality information to enable vulnerable groups to avoid exposure. Avoidance behaviour potentially biases estimates of the health effects of air pollutants. But avoidance behaviour imposes a cost on individuals and therefore may not be taken in all circumstances. This paper exploits panel data at the English local authority level to estimate the relationship between children's daily hospital emergency admissions for respiratory diseases and common air pollutants, while allowing for avoidance behaviour in response to air pollution warnings. A 1% increase in nitrogen dioxide or ozone concentrations increases hospital admissions by 0.1%. For the subset of asthma admissions - where avoidance is less costly - there is evidence of avoidance behaviour. Ignoring avoidance behaviour, however, does not result in statistically significant underestimation of the health effect of air pollution.