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Agriculture in Johor
Despite decades of industrialization, Johor remains an agricultural powerhouse.
The state is Peninsular Malaysia’s largest contributor to agricultural gross domestic product, and its official agricultural productivity is Malaysia’s third highest.
Johor’s agricultural strengths lie primarily in product specialization, namely the farming of oil palms, various fruits and vegetables, poultry, pigs, cut flowers, and ornamental fish.
Johor’s production clusters have taken decades, if not centuries, to build up their regional dominance. Urbanization, often blamed for diminishing agriculture’s importance, has actually helped drive Johor’s farm growth, even until the present day.
Johor’s agricultural sector will persist for at least another decade, but may become even more specialized.
eBook
Agriculture in Johor
Despite decades of industrialization, Johor remains an agricultural powerhouse. The state is Peninsular Malaysia’s largest contributor to agricultural gross domestic product, and its official agricultural productivity is Malaysia’s third highest. Johor’s agricultural strengths lie primarily in product specialization, namely the farming of oil palms, various fruits and vegetables, poultry, pigs, cut flowers, and ornamental fish. Johor’s production clusters have taken decades, if not centuries, to build up their regional dominance. Urbanization, often blamed for diminishing agriculture’s importance, has actually helped drive Johor’s farm growth, even until the present day. Johor’s agricultural sector will persist for at least another decade, but may become even more specialized
Publication
The origins of the division of labor in pre-industrial times
This research explores the historical roots of the division of labor in pre-industrial societies. Exploiting a variety of identification strategies and a novel ethnic level dataset combining geocoded ethnographic, linguistic and genetic data, it shows that higher levels of intra-ethnic diversity were conducive to economic specialization in the pre-industrial era. The findings are robust to a host of geographical, institutional, cultural and historical confounders, and suggest that variation in intra-ethnic diversity is a key predictor of the division of labor in pre-industrial times.
Journal Article
Randomised controlled trial of the clinical and cost effectiveness of a specialist team for managing refractory unipolar depressive disorder
Background
Around 40 per cent of patients with unipolar depressive disorder who are treated in secondary care mental health services do not respond to first or second line treatments for depression. Such patients have 20 times the suicide rate of the general population and treatment response becomes harder to achieve and sustain the longer they remain depressed. Despite this there are no randomised controlled trials of community based service delivery interventions delivering both algorithm based pharmacotherapy and psychotherapy for patients with chronic depressive disorder in secondary care mental health services who remain moderately or severely depressed after six months treatment. Without such trials evidence based guidelines on services for such patients cannot be derived.
Methods/design
Single blind individually randomised controlled trial of a specialist depression disorder team (psychiatrist and psychotherapist jointly assessing and providing algorithm based drug and psychological treatment) versus usual secondary care treatment. We will recruit 174 patients with unipolar depressive disorder in secondary mental health services with a Hamilton Depression Rating Scale (HDRS) score ≥ 16 and global assessment of function (GAF) ≤ 60 after ≥ 6 months treatment. The primary outcome measures will be the HDRS and GAF supplemented by economic analysis incuding the EQ5 D and analysis of barriers to care, implementation and the process of care. Audits to benchmark both treatment arms against national standards of care will aid the interpretation of the results of the study.
Discussion
This trial will be the first to assess the effectiveness and implementation of a community based specialist depression disorder team. The study has been specially designed as part of the CLAHRC Nottinghamshire, Derbyshire and Lincolnshire joint collaboration between university, health and social care organisations to provide information of direct relevance to decisions on commissioning, service provision and implementation.
Trial registration
Clinical trials.gov identifier NCT01047124
Journal Article
Long Term Consequences of Resource-Based Specialisation
Using geological variation in oil abundance in the Southern US, I examine the long term effects of resource-based specialisation through economic channels. In 1890 oil abundant counties were similar to other nearby counties but after oil was discovered they began to specialise in its production. From 1940-90 oil abundance increased local employment per square kilometre especially in mining but also in manufacturing. Oil abundant counties had higher population growth, higher per capita income and better infrastructure.
Journal Article
The Public Health Consequences of Sport Specialization
Sport specialization was thought to affect a relatively small number of elite athletes, but it is now a common practice in youth sport culture. Recent research in the field of sport specialization has led to a better understanding of the influence this issue is having on youth (ie, younger than 19 years of age) today. This review focuses on sport specialization from a public health perspective to elucidate the effect that this practice is having within the United States. The specific goals of this review are to describe (1) the prevalence of sport specialization and the factors that may affect the decision to specialize, (2) the costs of youth sport-related injuries in the context of sport specialization, (3) the financial costs that sport specialization has for families, and (4) how sport specialization may be affecting physical literacy.
Journal Article
Disclosure of Industry Payments to Physicians: An Epidemiologic Analysis of Early Data From the Open Payments Program
The Centers for Medicare and Medicaid Services' Open Payments program implements Section 6002 of the Affordable Care Act requiring medical product manufacturers to report payments made to physicians or teaching hospitals as well as ownership or investment interests held by physicians in the manufacturer. To determine the characteristics and distribution of these industry payments by specialty, we analyzed physician payments made between August 1, 2013, and December 31, 2013, that were publicly disclosed by Open Payments. We compared payments between specialty types (medical, surgical, and other) and across specialties within each type using the Pearson χ(2) test and the Kruskal-Wallis test. The number of physicians receiving payments was compared with the total number of active physicians in each specialty in 2012. We also analyzed physician ownership interests. Allopathic and osteopathic physicians received 2.43 million payments totaling $475 million. General payments represented 90% of payments by total value ($430 million) (per-physician median, $100; interquartile range [IQR], $31-$273; mean ± SD, $1407±$23,766), with the remaining 10% ($45 million) as research payments (median, $2365; IQR, $592-$8550; mean ± SD, $12,880±$66,743). Physicians most likely to receive general payments were cardiovascular specialists (78%) and neurosurgeons (77%); those least likely were pathologists (9%). Reports of ownership interest in reporting entities included $310 million in dollar amount invested and $447 million in value of interest held by 2093 physicians. In conclusion, the distribution and characteristics of industry payments to physicians varied widely by specialty during the first half-year of Open Payments reporting.
Journal Article