Beyond Metropolitan Startup Rates: Regional Factors Associated with Startup Growth

Author(s):  
Yasuyuki Motoyama ◽  
Jordan Bell-Masterson
2019 ◽  
Author(s):  
Hideaki Kawaguchi ◽  
Soichi Koike ◽  
Kazuhiko Ohe

BACKGROUND The rate of adoption of electronic medical record (EMR) systems has increased internationally, and new EMR adoption is currently a major topic in Japan. However, no study has performed a detailed analysis of longitudinal data to evaluate the changes in the EMR adoption status over time. OBJECTIVE This study aimed to evaluate the changes in the EMR adoption status over time in hospitals and clinics in Japan and to examine the facility and regional factors associated with these changes. METHODS Secondary longitudinal data were created by matching data in fiscal year (FY) 2011 and FY 2014 using reference numbers. EMR adoption status was defined as “EMR adoption,” “specified adoption schedule,” or “no adoption schedule.” Data were obtained for hospitals (n=4410) and clinics (n=67,329) that had no adoption schedule in FY 2011 and for hospitals (n=1068) and clinics (n=3132) with a specified adoption schedule in FY 2011. The EMR adoption statuses of medical institutions in FY 2014 were also examined. A multinomial logistic model was used to investigate the associations between EMR adoption status in FY 2014 and facility and regional factors in FY 2011. Considering the regional variations of these models, multilevel analyses with second levels were conducted. These models were constructed separately for hospitals and clinics, resulting in four multinomial logistic models. The odds ratio (OR) and 95% Bayesian credible interval (CI) were estimated for each variable. RESULTS A total of 6.9% of hospitals and 14.82% of clinics with no EMR adoption schedules in FY 2011 had adopted EMR by FY 2014, while 10.49% of hospitals and 33.65% of clinics with specified adoption schedules in FY 2011 had cancelled the scheduled adoption by FY 2014. For hospitals with no adoption schedules in FY 2011, EMR adoption/scheduled adoption was associated with practice size characteristics, such as number of outpatients (from quantile 4 to quantile 1: OR 1.67, 95% CI 1.005-2.84 and OR 2.40, 95% CI 1.80-3.21, respectively), and number of doctors (from quantile 4 to quantile 1: OR 4.20, 95% CI 2.39-7.31 and OR 2.02, 95% CI 1.52-2.64, respectively). For clinics with specified EMR adoption schedules in FY 2011, the factors negatively associated with EMR adoption/cancellation of scheduled EMR adoption were the presence of beds (quantile 4 to quantile 1: OR 0.57, 95% CI 0.45-0.72 and OR 0.74, 95% CI 0.58-0.96, respectively) and having a private establisher (quantile 4 to quantile 1: OR 0.27, 95% CI 0.13-0.55 and OR 0.43, 95% CI 0.19-0.91, respectively). No regional factors were significantly associated with the EMR adoption status of hospitals with no EMR adoption schedules; population density was positively associated with EMR adoption in clinics with no EMR adoption schedule (quantile 4 to quantile 1: OR 1.49, 95% CI 1.32-1.69). CONCLUSIONS Different approaches are needed to promote new adoption of EMR systems in hospitals as compared to clinics. It is important to induce decision making in small- and medium-sized hospitals, and regional postdecision technical support is important to avoid cancellation of scheduled EMR adoption in clinics.


2021 ◽  
Author(s):  
Maria Virginia Riquelme ◽  
Emily Garner ◽  
Suraj Gupta ◽  
Jacob Metch ◽  
Ni Zhu ◽  
...  

Wastewater-based epidemiology (WBE) for disease monitoring is highly promising, but requires consistent methodologies that incorporate predetermined objectives, targets, and metrics. We demonstrate a comprehensive metagenomics-based approach for global surveillance of antibiotic resistance in sewage, enabling assessment of: 1) which antibiotic resistance genes (ARGs) are shared across regions/communities; 2) which ARGs are discriminatory; and 3) factors associated with overall trends including antibiotic concentrations in sewage. Across an internationally-sourced transect of sewage samples collected using a centralized, standardized protocol, ARG relative abundances (16S rRNA gene-normalized) were highest in Hong Kong and India and lowest in Sweden and Switzerland, reflecting national policy, measured antibiotic concentrations, and metal resistance genes. Asian versus European/US resistomes were distinct, with macrolide-lincosamide-streptogramin, phenicol, quinolone, and tetracycline versus multidrug resistance ARGs being discriminatory, respectively. Sales data were not predictive of antibiotics measured in sewage, emphasizing need for direct measurements. The WBE approach defined herein demonstrates multi-site comparability and sensitivity to local/regional factors.


2020 ◽  
pp. 089124242094192
Author(s):  
Shiqin Liu ◽  
Haifeng Qian ◽  
Kingsley E. Haynes

This article presents the spatial patterns of general and high-tech start-up rates and explores regional factors associated with entrepreneurship in U.S. micropolitan areas. Regression results show that general entrepreneurship in these small cities is predicted by population growth, the middle-age population group, the presence of small businesses, and natural amenities. Additionally, high-tech start-up activities are positively associated with human capital, creative knowledge (instead of technological knowledge), high-tech clustering, and proximity to a large metropolitan area. These findings are compared with the patterns in larger metropolitan areas. This research sheds light on local entrepreneurship policy in the small-city context.


2008 ◽  
Vol 65 (9) ◽  
pp. 1733-1738 ◽  
Author(s):  
Juan I. Túnez ◽  
Humberto L. Cappozzo ◽  
Marcelo H. Cassini

Abstract Túnez, J. I., Cappozzo, H. L., and Cassini, M. H. 2008. Regional factors associated with the distribution of South American fur seals along the Atlantic coast of South America. – ICES Journal of Marine Science, 65: 1733–1738. Breeding colonies of the South American fur seal (Arctocephalus australis) are not homogeneously distributed along the coast of the Atlantic Ocean, but show an unusual patchiness, with colonies located only at the northern and southern extremities of the breeding range. We used bibliographic data of censuses carried out in the mid- and late 20th century, along with a Geographic Information System, to compare the pattern of distribution of colonies during these two periods, and to identify the anthropogenic and natural factors associated with the present pattern at a regional scale, using principal components analysis. The distribution of colonies did not vary in the period analysed even when the population abundance increased tenfold. The distribution was associated with the distance to the continental shelf break, and the availability of island and protected areas. We conclude that A. australis colonies are located in places where the continental shelf is narrow and there is no human disturbance.


Author(s):  
Hilton H. Mollenhauer

Many factors (e.g., resolution of microscope, type of tissue, and preparation of sample) affect electron microscopical images and alter the amount of information that can be retrieved from a specimen. Of interest in this report are those factors associated with the evaluation of epoxy embedded tissues. In this context, informational retrieval is dependant, in part, on the ability to “see” sample detail (e.g., contrast) and, in part, on tue quality of sample preservation. Two aspects of this problem will be discussed: 1) epoxy resins and their effect on image contrast, information retrieval, and sample preservation; and 2) the interaction between some stains commonly used for enhancing contrast and information retrieval.


Sign in / Sign up

Export Citation Format

Share Document