The main objective of this study is to examine the environmental Kuznets curve (EKC) hypothesis by utilizing the ecological footprint as an environment indicator and GDP from tourism as the economic indicator. To achieve this goal, an environmental degradation model is established during the period of 1988-2008 for 144 countries. The results from the time series generalized method of moments (GMM) and the system panel GMM revealed that the number of countries that have a negative relationship between the ecological footprint and its determinants (GDP growth from tourism, energy consumption, trade openness, and urbanization) is more existent in the upper middle- and high-income countries. Moreover, the EKC hypothesis is more present in the upper middle- and high-income countries than the other income countries. From the outcome of this research, a number of policy recommendations were provided for the investigated countries.
SETTING: Kota Kinabalu and surrounding communities in Sabah, Malaysia.
OBJECTIVES: To establish factors affecting compliance of patients with anti-tuberculosis chemotherapy, their knowledge of the disease, and views on improving the DOTS strategy.
DESIGN: Interviews with compliant patients attending clinics for DOTS treatment and with non-compliant patients in their homes, in August and September 2000.
RESULTS: A total of 63 compliant and 23 non-compliant patients were interviewed. For non-compliant patients, reaching the treatment centre entailed greater cost (P < 0.005) and travel time (P < 0.005) compared to compliant patients. Cost of transport was the reason most frequently given for non-attendance. Non-compliant patients were more likely to have completed secondary education (P < 0.05), and to be working (P < 0.01). More non-compliant patients had family members who had had the disease (P < 0.01). There was no difference between the groups for overall tuberculosis knowledge scores; however, non-compliant patients were more likely to think that treatment could be stopped once they were symptom free (P < 0.01). Most patients (73%) felt that the DOTS system could be improved by provision of more information about tuberculosis.
CONCLUSION: Compliance with DOTS in the Kota Kinabalu area is affected by travel expenses, time spent travelling to treatment centres, and having family members who have had the disease. Patients would like more information on tuberculosis.
Study site: Tuberculosis clinics, Kota Kinabalu, Malaysia