The Long Shadow
In 2009 and 2010, China undertook a 4 trillion Yuan fiscal stimulus, roughly equivalent to 12 percent of annual GDP. The "fiscal" stimulus was largely financed by off-balance sheet companies (local financing vehicles) that borrowed and spent on behalf of local governments. The off-balance sheet financial institutions continued to grow after the stimulus program ended at the end of 2010. After the end of the stimulus program, spending by these off balance sheet companies accounted for roughly 5% of annual GDP. The off-balance spending by local governments is likely responsible for a 5 percentage point increase in the aggregate investment rate and part of the 7 to 8 percentage point decline in current account surplus. Finally, we provide suggestive evidence that local governments used their new access to financial resources to facilitate access to capital to favored private firms, which potentially worsens the overall efficiency of capital allocation. The long run effect of off-balance sheet spending by local governments may be a permanent decline in the growth rate of aggregate productivity and GDP.
The Long Shadow
Bai, Hsieh and Song note that the stimulus program was implemented by local governments and mostly financed by the relaxation of financial constraints facing local governments. Specifically, local governments were legally prohibited from borrowing or running deficits. To circumvent these rules, local governments were allowed to create off-balance sheet companies known as local financial vehicles in 2009 and 2010 to fund the stimulus spending. A typical arrangement would be that local governments would transfer ownership of land to the local financing vehicle, and the land would be used as collateral to borrow from banks and shadow banks (trust products) as well as to issue bonds.
This financing choice appears to have had long lasting effects, even 6 years after the end of the stimulus program. The authors show that after the end of the program, the off-balance sheet financial institutions continued to grow as local governments found themselves with powerful new tools to circumvent the financial controls on their budgets. By 2014, Bai, Hsieh and Song estimate that the off-balance sheet spending by local governments account for about 11 percent of GDP, with 4.6 percent of GDP spent on local infrastructure projects and 6.4 percent of GDP on essentially private commercial projects. The aggregate effect is an increase in the investment rate to what is probably the highest of any country in the world today, a worse allocation of financial resources, and a decline in the growth rate of aggregate GDP.
Pattern C is represented by countries like Italy and Iran, where waiting too long to lock down populations led to a short-term exponential growth of new cases that overwhelmed the healthcare system and resulted in a large number of deaths. In the United States, the lack of effective and universally applied social isolation mechanisms, as well as a fragmented healthcare system and a significant delay in rolling out mass virus testing, led to a replication of Pattern C, at least in densely populated places like New York City and Chicago.
To quell community spread, it then instituted a rigorous program of testing, tracking and isolation of anyone who had been exposed to the infection. It also centralized control over the distribution of personal protective equipment, while rapidly ramping up production. The result is that Taiwan has recorded less than 450 cases and only seven deaths, despite the continued arrival of infected citizens returning home from overseas. Arguably no country has performed better, and this against long odds.
What will matter going forward, as ever, is the capacity of political leadership to frame a long-term narrative and stick to it over time. Institutions and incentives can be bent to that narrative. So, of course, can the decision-making psychology of citizens. Shifting how we think about social risk and about the importance of operational competence, and maintaining those new syntheses for a long time, should be the project of this generation.
Though he was forced to part with his original team, Long Shadow finally achieved his dream when the Justice League formally inducted him into their ranks in gratitude for the courage he had shown. It is unknown how long he lived due to his cellular breakdown, but an earlier estimate by Professor Hamilton gave him as little time as a month. Presumably, he was able to live the rest of his short life as a hero among the Justice League.
Although Long Shadow was forever remembered as the Ultiman who became a hero, his name and legacy would not be entirely spotless as long as the notorious Project Cadmus continued to exist. After Long Shadow was out of the picture and presumed dead, Cadmus manufactured an army of Ultimen clones, including Long Shadow, in order to support Galatea's attack on the Justice League Watchtower. While retaining the Ultimen's powers and expertise in using them, the clones were essentially mindless, possessing no free will so as to be used only as living metahuman weapons of destruction -- a realization of what the original Ultimen feared the government really wanted. The clones served to distract the League while Galatea went after the Watchtower's reactor. However, the assault failed, as the League successfully defended their base in a massive battle.
Perry: Despite using that word all the time, the psychiatric field still debates how to define it. Is trauma an external event? Is it the way we experience that event? Is it the long-term changes in emotional and physical functioning that follow the event?
Everything is more effectively learned in rhythm. We teach kids the alphabet with a song. The military teaches soldiers to work together through marching, even though it no longer serves a functional role in combat. Some teachers have brought hip-hop into the classroom to help teach math or history. Of course, not every technique works with every child. For some, decreasing the degree of stimulation can be the right approach.
Despite years of therapy, I lived on high alert as an adult while pretending everything was fine. It took an extraordinary therapist and two marvelous healers to help me begin to unfreeze and allow the trauma in my eighty-year-old mind, body, and spirit to emerge. The body work released the trauma and the therapy helped find the words and feelings I had so long shut away.
Millions of older adults have lost loved ones or suffered declines in their health during the pandemic. Many are struggling with ongoing grief or the disabling effects of long covid. And anxiety, depression, and social isolation remain ongoing threats to mental health.
The Long Shadows is the first book to offer global perspectives on the environmental history of World War II. Based on long-term research, the selected essays represent the best available studies in different fields and countries. With contributions touching on Europe, America, Asia, and Africa, the book has a truly global approach. It considers the profound and lasting impact World War II has had on global environments, encompassing polar, temperate, and tropical ecological zones.
As nuclear weapons will persist and cast a long shadow on security in Asia and the world, it is important to reexamine and redefine "old" ideas, concepts, and strategies as well as develop "new" ones relevant to the contemporary era. In line with this, the global nuclear order should be constructed anew based on present realities.
Livestock's Long Shadow: Environmental Issues and Options is a United Nations report, released by the Food and Agriculture Organization (FAO) of the United Nations on 29 November 2006,[1] that "aims to assess the full impact of the livestock sector on environmental problems, along with potential technical and policy approaches to mitigation".[1] It stated that livestock accounts for 18% of anthropogenic greenhouse gas emissions, a figure which FAO changed to 14.5% in its 2013 study Tackling climate change through livestock.
Livestock's Long Shadow is an assessment of research, taking into account direct impacts of livestock production, along with the impacts of feed crop cultivation. The report states that the livestock sector is one of the top two or three most significant contributors to serious environmental problems. The findings of this report suggest that it should be a major policy focus when dealing with problems of land degradation, climate change and air pollution, water shortage and water pollution, and loss of biodiversity.
Here, we have used four real patient exemplars to review NBF that can interfere with the delivery of optimal AML treatment in different healthcare systems. The use of the case-based format that clinicians are familiar with, helps illustrate the extent of the challenge in a more transparent manner than is possible with quantitative analyses. Overcoming the difficulties in each narrative, all unrelated to the biology of the disease, requires significant longer-term financial and human investment, along with fundamental changes to the definition of well-being and expectation, not only from health policymakers and physicians, but also from patients and the public.
The re-calculated costs for FLAG-Ida alone, or in sequence with alloSCT in aplasia was estimated between US$ 14,300 and 35,714. Having to source this amount of money, for an estimated 20% chance of cure with the proposed treatment, was not an acceptable trade-off for the patient or his family. He expressed a desire to try an alternative, affordable treatment to prolong life and was offered treatment with subcutaneous azacitidine. However, he defaulted from follow-up less than 4 weeks into the diagnosis.
With a population approaching 1.4 billion, the Total Health Expenditure (THE) for India is estimated at US$ 70 billion (3.84% of GDP and US$ 54.40 per capita). The healthcare system is characterized by the co-existence of public and private health centers, poor public health infrastructure, high health care costs, and low insurance coverage [47]. The proportional contribution of patient-funded, out-of-pocket expenditure (OOPE) to THE is 60.6%, with smaller contributions from the government (22.8%), insurance (4.8%) and external donors including non-government organizations (11.8%) [47, 48]. Typical forms of distress financing to deal with the increased OOPE on health care include current income, savings, mortgaging and selling of assets, loans from moneylenders and financial institutions, and reduction in consumption expenditure [49, 50]. The adverse consequences of borrowing and selling assets to meet OOPE have significant short-term and longer-term consequences [51, 52]. Thus, the median age of AML patients treated in large centers in India is as low as 40 years, with less than a third of patients opting for induction chemotherapy, and standard-of-care treatments offered only to those with the potential to complete therapy [45]. 041b061a72
