Search results for: per pupil expenditure

Authors: Richa Sinha, Mohammad Irfan Javed, Sanjay Singh

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Introduction: Good antimicrobial prescribing reduces length of stay in hospital, risk of adverse events, antimicrobial resistance, and unnecessary hospital expenditure. The aim of this prospective audit was to identify any problems with antimicrobial prescribing including documentation of the relevant aspects as well as appropriateness of antibiotics use. The audit was conducted on the surgical wards in a teaching hospital in the UK. Methods: Standards included the indication, duration, choice, and prescription of antibiotic should be in line with current Regional Guidelines and should be clearly documented on the prescription chart. There should be an entry in each patients’ medical record of the diagnosis and indication for each acute antibiotic prescription issued. All prescriptions should clearly document the route, frequency and dose of antibiotic. Data collection was done for 2 weeks in the month of March 2014. A proforma including all the questions above was completed for all the patients. The results were analysed using Excel. Results: 35 patients in total were selected for the audit. 85.7% of patients had indication of antibiotic documented on the prescription chart and 68.5% of patients had indication documented in the notes. The antibiotic used was in line with hospital guidelines in 45.7% of patients, however, in a further 28.5% of patients the reason for the antibiotic prescription was microbiology approved. Therefore, in total 74.2% of patients had been prescribed appropriate antibiotics. The duration of antibiotic was documented in 68.6% of patients and the antibiotic was reviewed in 37.1% of patients. The dose, frequency and route was documented clearly in 100% of patients. Conclusion: Overall, prescribing can be improved on the surgical wards in this hospital. Only 37.1% of patients had clear documentation of a review of antibiotics. It may be that antibiotics have been reviewed but this should be clearly highlighted on the prescription chart or the notes. Failure to review antibiotics can lead to poor patient care and antimicrobial resistance and therefore it is important to address this. It is also important to address the appropriateness of antibiotics as inappropriate antibiotic prescription can lead to failure of treatment as well as antimicrobial resistance. The good points from the audit was that all patients had clear documentation of dose, route and frequency which is extremely important in the administration of antibiotics. Recommendations from this audit included to emphasize good antimicrobial prescribing at induction (twice yearly), an antimicrobial handbook for junior doctors, and re-audit in 6 months time.

Keywords: prescribing, antimicrobial, indication, duration

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Authors: Pouneh Soleimaninejadian, Chengyu Yang

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In this paper, we use data on Household Income and Expenditure survey of Statistics Centre of Iran, conducted from 2005-2014, to calculate several inequality measures and to estimate the effects of Iran’s targeted subsidy reform act on consumption and income inequality. We first calculate Gini coefficients for income and consumption in order to study the relation between the two and also the effects of subsidy reform. Results show that consumption inequality has not been always mirroring changes in income inequality. However, both Gini coefficients indicate that subsidy reform caused improvement in inequality. Then we calculate Generalized Entropy Index based on consumption and income for years before and after the Subsidy Reform Act of 2010 in order to have a closer look into the changes in internal structure of inequality after subsidy reforms. We find that the improvement in income inequality is mostly caused by the decrease in inequality of lower income individuals. At the same time consumption inequality has been decreased as a result of more equal consumption in both lower and higher income groups. Moreover, the increase in Engle coefficient after the subsidy reform shows that a bigger portion of income is allocated to consumption on food which is a sign of lower living standard in general. This increase in Engle coefficient is due to rise in inflation rate and relative increase in price of food which partially is another consequence of subsidy reform. We have conducted some experiments on effect of subsidy payments and possible effects of change on distribution pattern and amount of cash subsidy payments on income inequality. Result of the effect of cash payments on income inequality shows that it leads to a definite decrease in income inequality and had a bigger share in improvement of rural areas compared to those of urban households. We also examine the possible effect of constant payments on the increasing income inequality for years after 2011. We conclude that reduction in value of payments as a result of inflation plays an important role regardless of the fact that there may be other reasons. We finally experiment with alternative allocations of transfers while keeping the total amount of cash transfers constant or make it smaller through eliminating three higher deciles from the cash payment program, the result shows that income equality would be improved significantly.

Keywords: consumption inequality, generalized entropy index, income inequality, Irans subsidy reform

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Authors: Werner Roux Uys

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The Commissioner for the South African Revenue Service (SARS) holds a high position of trust in South African society and a lack of trust by taxpayers in the Commissioner’s actions or conduct could compromise SARS’ management of public finances. Tax morality – which is implicit in the social contract between taxpayers and the state – includes distinct phenomena that can cause a breakdown if there is a perceived lack of action on the part of the Commissioner to ensure public finances are kept safe. To promote tax morality, the Commissioner must support the judiciary in the exercise of its discretion to punish fraudulent tax activities and corrupt tax practices. For several years the political meddling in the Commissioner’s actions and conduct have caused perceived abuse of power at SARS, and taxpayers believed their hard-earned income paid over to SARS would be fruitless and wasteful expenditure. The purpose of this article is to identify and analyse previous decisions held by the South African judiciary regarding the Commissioner’s actions and conduct in tax matters, as well as consider important political statements and newspaper bulletins for the purpose of this research. The study applies a qualitative research approach and exploratory case study technique. Keywords were selected and inserted in the LexisNexis electronic database to systematically identify applicable case law where the ratio decidendi of the court referred to the actions and/or conduct of the Commissioner. Specific real-life statements, including political statements and newspaper bulletins, were selected to support the topic at hand. The purpose of the study is to educate the public about the perceptions that have transformed taxpayers’ behaviour towards the Commissioner for SARS since South Africa’s fledgling constitutional democracy was inaugurated in 1994. The study adds to the literature by identifying key characteristics or distinct phenomena regarding the actions and conduct of the Commissioner affecting taxpayers’ behaviour, including discretionary decision-making. From the findings, it emerged that SARS must abide by its (own) laws and that there is a need to educate not only South African taxpayers about tax morality, but also the public in general.

Keywords: commissioner, SARS, action and conduct, judiciary, discretionry, decsion-making

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Authors: Manuela Caciula, Luis Torres, Simion Tomoiaga

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Introduction: The SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), more commonly referred to as COVID-19, has wreaked havoc on all facets of higher education since its inception in late 2019. College students, in particular, significantly reduced their daily energy expenditure and increased the time spent sitting to listen to online classes and complete their studies from home. This change, in combination with the associated COVID-19 lockdown, presumably decreased physical activity levels, increased mental health symptoms, and led to the promotion of unhealthy eating habits. Objectives: The main objective of this study was to determine the current self-reported physical activity levels, mental health symptoms, and body composition of college students after the COVID-19 lockdown in order to develop future interventions for the overall improvement of health. Methods: All participants completed pre-existing, well-validated surveys for both physical activity (International Physical Activity Questionnaire - long form) and mental health (Hospital Anxiety and Depression Scale). Body composition was assessed in person with the use of an Inbody 570 device. Results: Of the 90 American college students (M age = 22.52 ± 4.54, 50 females) who participated in this study, depressive and anxious symptom scores consistent with 58% (N = 52) heightened symptomatology, 17% (N = 15) moderate borderline symptomatology, and 25% (N = 23) asymptomatology were reported. In regard to physical activity, 79% (N = 71) of the students were highly physically active, 18% (N = 16) were moderately active, and 3% (N = 3) reported low levels of physical activity. Additionally, 46% (N = 41) of the students maintained an unhealthy body fat percentage based on World Health Organization recommendations. Strong, significant relationships were found between anxiety and depression symptomatology and body fat percentage (P = .003) and skeletal muscle mass (P = .015), with said symptomatology increasing with added body fat and decreasing with added skeletal muscle mass. Conclusions: Future health interventions for American college students should be focused on strategies to reduce stress, anxiety, and depressive characteristics, as well as nutritional information on healthy eating, regardless of self-reported physical activity levels.

Keywords: physical activity, mental health, body composition, COVID-19

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Authors: Ione Loots, Marco van Dijk, Jay Bhagwan

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Historically, South Africa had various small-scale hydropower installations in remote areas that were not incorporated in the national electricity grid. Unfortunately, in the 1960s most of these plants were decommissioned when Eskom, the national power utility, rapidly expanded its grid and capability to produce cheap, reliable, coal-fired electricity. This situation persisted until 2008, when rolling power cuts started to affect all citizens. This, together with the rising monetary and environmental cost of coal-based power generation, has sparked new interest in small-scale hydropower development, especially in remote areas or at locations (like wastewater treatment works) that could not afford to be without electricity for long periods at a time. Even though South Africa does not have the same, large-scale, hydropower potential as some other African countries, significant potential for micro- and small-scale hydropower is hidden in various places. As an example, large quantities of raw and potable water are conveyed daily under either pressurized or gravity conditions over large distances and elevations. Due to the relative water scarcity in the country, South Africa also has more than 4900 registered dams of varying capacities. However, institutional capacity and skills have not been maintained in recent years and therefore the identification of hydropower potential, as well as the development of micro- and small-scale hydropower plants has not gained significant momentum. An assessment model and decision support system for low head hydropower development has been developed to assist designers and decision makers with first-order potential analysis. As a result, various potential sites were identified and many of these sites were situated at existing infrastructure like weirs, barrages or pipelines. One reason for the specific interest in existing infrastructure is the fact that capital expenditure could be minimized and another is the reduced negative environmental impact compared to greenfield sites. This paper will explore the case study of retrofitting an unconventional and innovative hydropower plant to the outlet of a wastewater treatment works in South Africa.

Keywords: low head hydropower, retrofitting, small-scale hydropower, wastewater treatment works

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Authors: Ayanda Ndokwana, Stanley Fore

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Industrial prosperity and rapid expansion of human population in South Africa over the past two decades, have increased the use of conventional fossil fuels such as crude oil, coal and natural gas to meet the country’s energy demands. However, the inevitable depletion of fossil fuel reserves, global volatile oil price and large carbon footprint are some of the crucial reasons the South African Government needs to make a considerable investment in the development of the biofuel industry. In South Africa, this industry is still at the introductory stage with no large scale manufacturing plant that has been commissioned yet. Bioethanol is a potential replacement of gasoline which is a fossil fuel that is used in motor vehicles. Using bioethanol for the transport sector as a source of fuel will help Government to save heavy foreign exchange incurred during importation of oil and create many job opportunities in rural farming. In 2007, the South African Government developed the National Biofuels Industrial Strategy in an effort to make provision for support and attract investment in bioethanol production. However, capital investment in the production of bioethanol on a large scale, depends on the sound economic assessment of the available manufacturing technologies. The aim of this study is to evaluate the profitability of an advanced bioethanol manufacturing technology which uses maize as a feedstock in South Africa. The impact of fiber or bran fractionation in this technology causes it to possess a number of merits such as energy efficiency, low capital expenditure, and profitability compared to a conventional dry-mill bioethanol technology. Quantitative techniques will be used to collect and analyze numerical data from suitable organisations in South Africa. The dependence of three profitability indicators such as the Discounted Payback Period (DPP), Net Present Value (NPV) and Return On Investment (ROI) on plant capacity will be evaluated. Profitability analysis will be done on the following plant capacities: 100 000 ton/year, 150 000 ton/year and 200 000 ton/year. The plant capacity with the shortest Discounted Payback Period, positive Net Present Value and highest Return On Investment implies that a further consideration in terms of capital investment is warranted.

Keywords: bioethanol, economic evaluation, maize, profitability indicators

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Authors: Basma Yassa

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Evidence on cash transfers’ effectiveness in mitigating macro and idiosyncratic shocks’ impacts has been mixed and is mostly concentrated in Latin America, Sub-Saharan Africa, and South Asia with very limited evidence from the MENA region. Yet conditional cash transfers schemes have been continually used, especially in Egypt, as the main social protection tool in response to the recent socioeconomic crises and macro shocks. We use 2 panel datasets and 1 cross-sectional dataset to estimate the effectiveness of cash transfers as a shock-mitigative mechanism in the Egyptian context. In this paper, the results from the different models (Panel Fixed Effects model and the Regression Discontinuity Design (RDD) model) confirm that micro and macro shocks lead to significant decline in several household-level welfare outcomes and that Takaful cash transfers have a significant positive impact in mitigating the negative shock impacts, especially on households’ debt incidence, debt levels, and asset ownership, but not necessarily on food, and non-food expenditure levels. The results indicate large positive significant effects on decreasing household incidence of debt by up to 12.4 percent and lowered the debt size by approximately 18 percent among Takaful beneficiaries compared to non-beneficiaries’. Similar evidence is found on asset ownership levels, as the RDD model shows significant positive effects on total asset ownership and productive asset ownership, but the model failed to detect positive impacts on per capita food and non-food expenditures. Further extensions are still in progress to compare the models’ results with the DID model results when using a nationally representative ELMPS panel data (2018/2024) rounds. Finally, our initial analysis suggests that conditional cash transfers are effective in buffering the negative shock impacts on certain welfare indicators even after successive macro-economic shocks in 2022 and 2023 in the Egyptian Context.

Keywords: cash transfers, fixed effects, household welfare, household debt, micro shocks, regression discontinuity design

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Authors: Szymon Kuczynski, Krystian Liszka, Mariusz Laciak, Andrii Oliinyk, Adam Szurlej

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Compressed natural gas (CNG) represents an excellent compromise between the availability of a technology that is proven and relatively easy to use in many areas of the automotive industry and incurred costs. This fuel causes a lower corrosion effect due to the lower content of products causing the potential difference on the walls of the engine system. Natural gas powered vehicles (NGVs) do not emit any substances that can contaminate water or land. The absence of carcinogenic substances in gaseous fuel extends the life of the engine. In the longer term, it contributes positively to waste management as well as waste disposal. Popularization of propulsion systems powered by natural gas CNG positively affects the reduction of heavy duty transport. For these reasons, CNG as a fuel stimulates considerable interest around the world. Over the last few years, technologies related to use of natural gas as an engine fuel have been developed and improved. These solutions have evolved from the prototype phase to the industrial scale implementation. The widespread availability of gaseous fuels has led to the development of a technology that allows the CNG fuel to be refueled directly from the urban gas network to the vehicle tank (ie. HYGEN - CNGHRS). Home refueling installations, although they have been known for many years, are becoming increasingly important in the present day. The major obstacle in the sale of this technology was, until recently, quite high capital expenditure compared to the later benefits. Home refueling systems allow refueling vehicle tank, with full control of fuel costs and refueling time. CNG Home Refueling Stations (such as HYGEN) allow gas value chain to overcome the dogma that there is a lack of refueling infrastructure allowing companies in gas value chain to participate in transportation market. Technology is based on one stage hydraulic compressor (instead of multistage mechanical compressor technology) which provides the possibility to compress low pressure gas from distribution gas network to 200 bar for its further usage as a fuel for NGVs. This boosts revenues and profits of gas companies by expanding its presence in higher margin of energy sector.

Keywords: alternative fuels, CNG (compressed natural gas), CNG stations, NGVs (natural gas vehicles), gas value chain

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Authors: Johnson Adafin, James O. B. Rotimi, Suzanne Wilkinson, Abimbola O. Windapo

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An aspect of client expenditure management that requires attention is the level of accuracy achievable in design-stage elemental cost planning. This has been a major concern for construction clients and practitioners in New Zealand (NZ). Pre-tender estimating inaccuracies are significantly influenced by the level of risk information available to estimators. Proper cost planning activities should ensure the production of a project’s likely construction costs (initial and final), and subsequent cost control activities should prevent unpleasant consequences of cost overruns, disputes and project abandonment. If risks were properly identified and priced at the design stage, observed variance between design-stage elemental cost plans (ECPs) and final tender sums (FTS) (initial contract sums) could be reduced. This study investigates the variations between design-stage ECPs and FTS of construction projects, with a view to identifying risk factors that are responsible for the observed variance. Data were sourced through interviews, and risk factors were identified by using thematic analysis. Access was obtained to project files from the records of study participants (consultant quantity surveyors), and document analysis was employed in complementing the responses from the interviews. Study findings revealed the discrepancies between ECPs and FTS in the region of -14% and +16%. It is opined in this study that the identified risk factors were responsible for the variability observed. The values obtained from the analysis would enable greater accuracy in the forecast of FTS by Quantity Surveyors. Further, whilst inherent risks in construction project developments are observed globally, these findings have important ramifications for construction projects by expanding existing knowledge on what is needed for reasonable budgetary performance and successful delivery of construction projects. The findings contribute significantly to the study by providing quantitative confirmation to justify the theoretical conclusions generated in the literature from around the world. This therefore adds to and consolidates existing knowledge.

Keywords: accuracy, design-stage, elemental cost plan, final tender sum

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Authors: Daniel John Avutia

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Solar Photovoltaic (PV) development is reliant on the sunlight hours available in a particular region to generate electricity. A potential area is assessed through its inherent solar radiation intensity measured in watts per square meter. Solar energy development involves the feasibility, design, construction, operation and maintenance of the relevant infrastructure, but this paper will focus on the design and construction aspects. Africa and Australasia have the longest sunlight hours per day and the highest solar radiation per square meter, 7 sunlight hours/day and 5 kWh/day respectively. Solar PV support configurations consist of fixed-tilt support and tracker system structures, the differentiation being that the latter was introduced to improve the power generation efficiency of the former due to the sun tracking movement capabilities. The installation of Solar PV foundations involves rammed piles, drilling/grout piles and shallow raft reinforced concrete structures. This paper presents a case study of 2 solar PV projects in Africa and Australia, discussing the foundation design consideration and associated construction cost implications of the selected foundations systems. Solar PV foundations represent up to one fifth of the civil works costs in a project. Therefore, the selection of the most structurally sound and feasible foundation for the prevailing ground conditions is critical towards solar PV development. The design wind speed measured by anemometers govern the pile embedment depth for rammed and drill/grout foundation systems. The lateral pile deflection and vertical pull out resistance of piles increase proportionally with the embedment depth for uniform pile geometry and geology. The pile driving rate may also be used to anticipate the lateral resistance and skin friction restraining the pile. Rammed pile foundations are the most structurally suitable due to the pile skin friction and ease of installation in various geological conditions. The competitiveness of solar PV projects within the renewable energy mix is governed by lowering capital expenditure, improving power generation efficiency and power storage technological advances. The power generation reliability and efficiency are areas for further research within the renewable energy niche.

Keywords: design, foundations, piles, solar

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Authors: Emily Saurman, David Lyle

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In Australia, a well serviced rural town might have a psychiatrist visit once-a-month with more frequent visits from a psychiatric nurse, but many have no resident access to mental health specialists. Access to specialist care, would not only reduce patient distress and benefit outcomes, but facilitate the effective use of limited resources. The Mental Health Emergency Care-Rural Access Program (MHEC-RAP) was developed to improve access to specialist emergency mental health care in rural and remote communities using telehealth technologies. However, there has been no current benchmark to gauge program efficiency or capacity; to determine whether the program activity is justifiably sufficient. The evaluation of MHEC-RAP used multiple methods and applied a modified theory of access to assess the program and its aim of improved access to emergency mental health care. This was the first evaluation of a telepsychiatry service to include a time and motion study design examining program time expenditure, efficiency, and capacity. The time and motion study analysis was combined with an observational study of the program structure and function to assess the balance between program responsiveness and efficiency. Previous program studies have demonstrated that MHEC-RAP has improved access and is used and effective. The findings from the time and motion study suggest that MHEC-RAP has the capacity to manage increased activity within the current model structure without loss to responsiveness or efficiency in the provision of care. Enhancing program responsiveness and efficiency will also support a claim of the program’s value for money. MHEC-RAP is a practical telehealth solution for improving access to specialist emergency mental health care. The findings from this evaluation have already attracted the attention of other regions in Australia interested in implementing emergency telepsychiatry programs and are now informing the progressive establishment of mental health resource centres in rural New South Wales. Like MHEC-RAP, these centres will provide rapid, safe, and contextually relevant assessments and advice to support local health professionals to manage mental health emergencies in the smaller rural emergency departments. Sharing the application of this methodology and research activity may help to improve access to and future evaluations of telehealth and telepsychiatry services for others around the globe.

Keywords: access, emergency, mental health, rural, time and motion

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Authors: S. D. Kadir

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Background: Antibiotics have always been at the centrum of the revolution of modern microbiology. Micro-organisms and its pathogenicity, resistant organisms, inappropriate or over usage of various types of antibiotic agents are fuelled multidrug-resistant pathogenic organisms. Our present time review report mainly focuses on the therapeutic condition of antibiotic resistance and the possible roots behind the development of antibiotic resistance in Bangladesh in 2019. Methodology: The systemic review has progressed through a series of research analyses on various manuscripts published on Google Scholar, PubMed, Research Gate, and collected relevant information from established popular healthcare and diagnostic center and its subdivisions all over Bangladesh. Our research analysis on the possible assurance of antibiotic resistance been ensured by the selective medical reports and on random assay on the extent of individual antibiotic in 2019. Results: 5 research articles, 50 medical report summary, and around 5 patients have been interviewed while going through the estimation process. We have prioritized research articles where the research analysis been performed by the appropriate use of the Kirby-Bauer method. Kirby-Bauer technique is preferred as it provides greater efficiency, ensures lower performance expenditure, and supplies greater convenience and simplification in the application. In most of the reviews, clinical and laboratory standards institute guidelines were strictly followed. Most of our reports indicate significant resistance shown by the Beta-lactam drugs. Specifically by the derivatives of Penicillin's, Cephalosporin's (rare use of the first generation Cephalosporin and overuse of the second and third generation of Cephalosporin and misuse of the fourth generation of Cephalosporin), which are responsible for almost 67 percent of the bacterial resistance. Moreover, approximately 20 percent of the resistance was due to the fact of drug pumping from the bacterial cell by tetracycline and sulphonamides and their derivatives. Conclusion: 90 percent of the approximate antibiotic resistance is due to the usage of relative and true broad-spectrum antibiotics. The environment has been created by the following circumstances where; the excessive usage of broad-spectrum antibiotics had led to a condition where the disruption of native bacteria and a series of anti-microbial resistance causing a disturbance of the surrounding environments in medium, leading to a state of super-infection.

Keywords: antibiotics, antibiotic resistance, Kirby Bauer method, microbiology

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Authors: Estibe Dagne Mekonnen

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In recent years, the prevalence of undernourishment was 30 percent for sub-Saharan Africa, compared with 16 percent for Asia and the Pacific (Ali, 2011). In Ethiopia, almost 40 percent of the total population in the country and 57 percent of Addis Ababa population lives below the international poverty line of US$ 1.25 per day (UNICEF, 2009). This study aims to analyze the determinant of household food secrity in Addis Ababa city administration. Primary data were collected from a survey of 256 households in the selected sub-city, namely Addis Ketema, Arada, and Kolfe Keranio, in the year 2022. Both Purposive and multi-stage cluster random sampling procedures were employed to select study areas and respondents. Descriptive statistics and order logistic regression model were used to test the formulated hypotheses. The result reveals that out of the total sampled households, 25% them were food secured, 13% were mildly food insecure, 26% were moderately food insecure and 36% were severely food insecure. The study indicates that household family size, house ownership, household income, household food source, household asset possession, household awareness on inflation, household access to social protection program, household access to credit and saving and household access to training and supervision on food security have a positive and significant effect on the likelihood of household food security status. However, marital status of household head, employment sector of household head, dependency ratio and household’s nonfood expenditure has a negative and significant influence on household food security status. The study finally suggests that the government in collaboration with financial institutions and NGO should work on sustaining household food security by creating awareness, providing credit, facilitate rural-urban linkage between producer and consumer and work on urban infrastructure improvement. Moreover, the governments also work closely and monitor consumer good suppliers, if possible find a way to subsidize consumable goods to more insecure households and make them to be food secured. Last but not least, keeping this country’s peace will play a crucial role to sustain food security.

Keywords: determinants, household, food security, order logit model, Addis Ababa

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Authors: Zahra Mila Elmi, Mahsa Khanekheshi

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Almost half of the population and potential manpower in the country and rural areas are women. Manpower especially educated people, plays an important role in the production and economic growth. Also, the potential of rural areas to create employment should not be overlooked. In this research, the effects of socio-economic and demographic factors on women's economic participation in rural areas of Iran's provinces will be studied. Therefore, this study was performed by using the results of the rural households income and expenditure surveys -has been taken in 2016- in the framework of pseudo panel data. This study used the logit model and the maximum likelihood method to study the rural women's participation, with 28,265 observations. Results show the inverted U-shaped relationship between age and the probability of female participation; In other words, young women are more likely to participate in labor markets more than the other groups. Divorced and single woman has more chance of participation in comparison with who was being married. With increasing the divorce rate and singleness in Iran, economic policymakers must provide appropriate solutions for this challenge in the coming years. On the base of the results, being a student and the presence of an infant under the age of 6 in the household has a negative effect on the possibility of women's participation in the labor market. The women's education level has a U-shaped relationship with their participation rate. Illiteracy and high education have a strong positive effect on the economic participation of rural women. This shows the dual labor market for women in Iran. Illiterate women are attracted to service jobs, and educated woman are more attracted to education and health jobs. Increasing household income has a small but positive and significant effect on the probability of rural female participation. In the overlook, due to the frequency of the women population in the age group of 25 to 35 years, and more willingness of women in the age 35 to 44 years to participate in the labor market, and studying ofa significant portion of the rural women, the increase of rural female participation is expected in the years ahead. Thus, it is expected policy maker to create new job opportunities for the employment of educated women and take the necessary plan to improve the current situation for women.

Keywords: female participation rate, rural area, provincial data, pseudo-panel data method

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Authors: Esra Polat

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Partial Least Squares Discriminant Analysis (PLSDA) is a statistical method for classification and consists a classical Partial Least Squares Regression (PLSR) in which the dependent variable is a categorical one expressing the class membership of each observation. PLSDA can be applied in many cases when classical discriminant analysis cannot be applied. For example, when the number of observations is low and when the number of independent variables is high. When there are missing values, PLSDA can be applied on the data that is available. Finally, it is adapted when multicollinearity between independent variables is high. The aim of this study is to determine the economic and/or demographic indicators, which are effective in grouping the 28 European Union (EU) member countries and 7 candidate countries (including potential candidates Bosnia and Herzegovina (BiH) and Kosova) by using the data set obtained from database of the World Bank for 2014. Leaving the political issues aside, the analysis is only concerned with the economic and demographic variables that have the potential influence on country’s eligibility for EU entrance. Hence, in this study, both the performance of PLSDA method in classifying the countries correctly to their pre-defined groups (candidate or member) and the differences between the EU countries and candidate countries in terms of these indicators are analyzed. As a result of the PLSDA, the value of percentage correctness of 100 % indicates that overall of the 35 countries is classified correctly. Moreover, the most important variables that determine the statuses of member and candidate countries in terms of economic indicators are identified as 'external balance on goods and services (% GDP)', 'gross domestic savings (% GDP)' and 'gross national expenditure (% GDP)' that means for the 2014 economical structure of countries is the most important determinant of EU membership. Subsequently, the model validated to prove the predictive ability by using the data set for 2015. For prediction sample, %97,14 of the countries are correctly classified. An interesting result is obtained for only BiH, which is still a potential candidate for EU, predicted as a member of EU by using the indicators data set for 2015 as a prediction sample. Although BiH has made a significant transformation from a war-torn country to a semi-functional state, ethnic tensions, nationalistic rhetoric and political disagreements are still evident, which inhibit Bosnian progress towards the EU.

Keywords: classification, demographic indicators, economic indicators, European Union, partial least squares discriminant analysis

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Authors: Payal Bose

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The impact of music on consumers' attention and emotions at different parts of the day are rarely/never studied. Music has been widely studied in different parameters, such as in-store music and its atmospheric effects, to understand consumer arousal, in-store traffic, perceptions of visual stimuli, and actual time spent in the store. Further other parameters such as tempo, shopper's age, volume, music preference, and its usage as foreground or background music acting as a mediator and impacting consumer behavior is also well researched. However, no study has traversed the influence of music on social media advertisements and its impact on the consumer mind. Most studies have catered to the influence of music on consumers conscious. A recent study found that playing pleasant music is more effective on weekdays in enhancing supermarkets' sales than on weekends. This led to a more pertinent question about the impact of music on different parts of the day and how it impacts the attention and emotion in the consumers’ mind is an interesting question to be asked given the fact that there is a high usage of social media advertisement consumption in the recent past on a day-to-day basis. This study would help brands on social media to structure their advertisements and engage more consumers towards their products. Prior literature has examined the effects or influence of music on consumers largely in retail, brick-and-mortar format. Hence most of the outcomes are favorable for physical retail environments. However, with the rise of Web 3.0 and social media marketing, it would be interesting to see how consumers' attention and emotion can be studied with the effects of music embedded in an advertisement during different parts of the day. A smartphone is considered a personal gadget, and viewing social media advertisements on them is mostly an intimate experience. Hence in a social media advertisement, most of the viewing happens on a one-on-one basis between the consumer and the brand advertisement. To the best of our knowledge, little or no work has explored the influence of music on different parts of the day (per the circadian rhythm) in advertising research. Previous works on social media advertisement have explored the timing of social media posts, deploying Targeted Content Advertising, appropriate content, reallocation of time, and advertising expenditure. Hence, I propose studying advertisements embedded with music during different parts of the day and its influence on consumers' attention and emotions. To address the research objectives and knowledge gap, it is intended to use a neuroscientific approach using fMRI and eye-tracking. The influence of music embedded in social media advertisement during different parts of the day would be assessed.

Keywords: music, neuromarketing, circadian rhythm, social media, engagement

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Authors: Razul Ikmal Ramli

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Successful implementation of innovation is a key success formula of a great organization. Innovation will ensure competitive advantages as well as sustainability of organization in the long run. In public sector context, the role of innovation is crucial to resolve dynamic challenges of public services such as operating in economic uncertainty with limited resources, increasing operating expenditure and growing expectation among citizens towards high quality, swift and reliable public services. Acknowledging the prospect of innovation as a tool for achieving high-performance public sector, the Malaysian New Economic Model launched in the year 2011 intensified government commitment to foster innovation in the public sector. Since 2011 various initiatives have been implemented, however little is known about the performance of public sector innovation in Malaysia. Hence, by applying the national innovation system theory as a pillar, the formulated research objectives were focused on measuring the level of innovation capabilities, wider public sector condition for innovation, innovation activity, and innovation performance as well as to examine the relationship between the four constructs with innovation performance as a dependent variable. For that purpose, 1,000 sets of self-administrated survey questionnaires were distributed to heads of units and divisions of 22 Federal Ministry and Central Agencies in the administrative, security, social and economic sector. Based on 456 returned questionnaires, the descriptive analysis found that innovation capabilities, wider sector condition, innovation activities and innovation performance were rated by respondents at moderately high level. Based on Structural Equation Modelling, innovation performance was found to be influenced by innovation capability, wider sector condition for innovation and innovation activity. In addition, the analysis also found innovation activity to be the most important construct that influences innovation performance. The implication of the study concluded that the innovation policy implemented in the public sector of Malaysia sparked motivation to innovate and resulted in various forms of innovation. However, the overall achievements were not as well as they were expected to be. Thus, the study suggested for the formulation of a dedicated policy to strengthen innovation capability, wider public sector condition for innovation and innovation activity of the Malaysian public sector. Furthermore, strategic intervention needs to be focused on innovation activity as the construct plays an important role in determining the innovation performance. The success of public sector innovation implementation will not only benefit the citizens, but will also spearhead the competitiveness and sustainability of the country.

Keywords: public sector, innovation, performance, innovation policy

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Authors: Bidisha Chatterjee, Sonal Grover, Rekha Gurung

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Postpartum dissection of the internal carotid artery is a relatively rare condition and is considered as an underlying aetiology in 5% to 25% of strokes under the age of 30 to 45 years. However, 86% of these cases recover completely and 14% have mild focal neurological symptoms. Prognosis is generally good with early intervention. The risk quoted for a repeat carotid artery dissection in subsequent pregnancies is less than 2%. 36-year Caucasian primipara presented on postnatal day one of forceps delivery with tachycardia. In the intrapartum period she had a history of prolonged rupture of membranes and developed intrapartum sepsis and was treated with antibiotics. Postpartum ECG showed septal inferior T wave inversion and a troponin level of 19. Subsequently Echocardiogram ruled out post-partum cardiomyopathy. Repeat ECG showed improvement of the previous changes and in the absence of symptoms no intervention was warranted. On day 4 post-delivery, she had developed symptoms of droopy right eyelid, pain around the right eye and itching in the right ear. On examination, she had developed right sided ptosis, unequal pupils (Rt miotic pupil). Cranial nerve examination, reflexes, sensory examination and muscle power was normal. Apart from migraine, there was no medical or family history of note. In view of Horner’s on the right, she had a CT Angiogram and subsequently MR/MRA and was diagnosed with dissection of the cervical portion of the right internal carotid artery. She was discharged on a course of Aspirin 75mg. By 6 week post-natal follow up patient had recovered significantly with occasional episodes of unequal pupils and tingling of right toes which resolved spontaneously. Cervical artery dissection, including VAD and carotid artery dissection, are rare complications of pregnancy with an estimated annual incidence of 2.6–3 per 100,000 pregnancy hospitalizations. Aetiology remains unclear though trauma during straining at labour, underlying arterial disease and preeclampsia have been implicated. Hypercoagulable state during pregnancy and puerperium could also be an important factor. 60-90% cases present with severe headache and neck pain and generally precede neurological symptoms like ipsilateral Horner’s syndrome, retroorbital pain, tinnitus and cranial nerve palsy. Although rare, the consequences of delayed diagnosis and management can lead to severe and permanent neurological deficits. Patients with a strong index of suspicion should undergo an MRI or MRA of head and neck. Antithrombotic and antiplatelet therapy forms the mainstay of therapy with selected cases needing endovascular stenting. Long term prognosis is favourable with either complete resolution or minimal deficit if treatment is prompt. Patients should be counselled about the recurrence risk and possibility of stroke in future pregnancy. Coronary artery dissection is rare and treatable but needs early diagnosis and treatment. Post-partum headache and neck pain with neurological symptoms should prompt urgent imaging followed by antithrombotic and /or antiplatelet therapy. Most cases resolve completely or with minimal sequelae.

Keywords: postpartum, dissection of internal carotid artery, magnetic resonance angiogram, magnetic resonance imaging, antiplatelet, antithrombotic

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Authors: Cagdas Agirdas

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Background: The Affordable Care Act (ACA) requires non-grandfathered private insurance plans, starting with plan years on or after September 23rd, 2010, to provide certain preventive care services without any cost sharing in the form of deductibles, copayments or co-insurance. This requirement may affect racial and ethnic disparities in preventive care as it provides the largest copay reduction in preventive care. Objectives: We ask whether the ACA’s free preventive care benefits are associated with a reduction in racial and ethnic disparities in the utilization of four preventive services: cholesterol screenings, colonoscopies, mammograms, and pap smears. Methods: We use a data set of over 6,000 individuals from the 2009, 2010, and 2013 Medical Expenditure Panel Surveys (MEPS). We restrict our data set only to individuals who are old enough to be eligible for each preventive service. Our difference-in-differences logistic regression model classifies privately-insured Hispanics, African Americans, and Asians as the treatment groups and 2013 as the after-policy year. Our control group consists of non-Hispanic whites on Medicaid as this program already covered preventive care services for free or at a low cost before the ACA. Results: After controlling for income, education, marital status, preferred interview language, self-reported health status, employment, having a usual source of care, age and gender, we find that the ACA is associated with increases in the probability of the median, privately-insured Hispanic person to get a colonoscopy by 3.6% and a mammogram by 3.1%, compared to a non-Hispanic white person on Medicaid. Similarly, we find that the median, privately-insured African American person’s probability of receiving these two preventive services improved by 2.3% and 2.4% compared to a non-Hispanic white person on Medicaid. We do not find any significant improvements for any racial or ethnic group for cholesterol screenings or pap smears. Furthermore, our results do not indicate any significant changes for Asians compared to non-Hispanic whites in utilizing the four preventive services. These reductions in racial/ethnic disparities are robust to reconfigurations of time periods, previous diagnosis, and residential status. Conclusions: Early effects of the ACA’s provision of free preventive care are significant for Hispanics and African Americans. Further research is needed for the later years as more individuals became aware of these benefits.

Keywords: preventive care, Affordable Care Act, cost sharing, racial disparities

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Authors: Jemima C. A. Sumboh

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Given the urgency and consensus for countries to move towards Universal Health Coverage (UHC), health financing systems need to be accurately and consistently monitored to provide valuable data to inform policy and practice. Most of the indicators for monitoring UHC, particularly catastrophe and impoverishment, are established based on the impact of out-of-pocket health payments (OOPHP) on households’ living standards, collected through varied household surveys. These surveys, however, vary substantially in survey methods such as the length of the recall period or the number of items included in the survey questionnaire or the farming of questions, potentially influencing the level of OOPHP. Using different survey instruments can provide inaccurate, inconsistent, erroneous and misleading estimates of UHC, subsequently influencing wrong policy decisions. Using data from a household budget survey conducted by the Navrongo Health Research Center in Ghana from May 2017 to December 2018, this study intends to explore the potential implications of using surveys with varied levels of disaggregation of OOPHP data on estimates of financial risk protection. The household budget survey, structured around food and non-food expenditure, compared three OOPHP measuring instruments: Version I (existing questions used to measure OOPHP in household budget surveys), Version II (new questions developed through benchmarking the existing Classification of the Individual Consumption by Purpose (COICOP) OOPHP questions in household surveys) and Version III (existing questions used to measure OOPHP in health surveys integrated into household budget surveys- for this, the demographic and health surveillance (DHS) health survey was used). Version I, II and III contained 11, 44, and 56 health items, respectively. However, the choice of recall periods was held constant across versions. The sample size for Version I, II and III were 930, 1032 and 1068 households, respectively. Financial risk protection will be measured based on the catastrophic and impoverishment methodologies using STATA 15 and Adept Software for each version. It is expected that findings from this study will present valuable contributions to the repository of knowledge on standardizing survey instruments to obtain estimates of financial risk protection that are valid and consistent.

Keywords: Ghana, household budget surveys, measuring financial risk protection, out-of-pocket health payments, survey instruments, universal health coverage

Procedia PDF Downloads 112

Authors: Priyanka V. Janbandhu, Santosh B. Phad, Dhananjay W. Bansod

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The current changing scenario of the family is a compelling aged group not only to be alone in a nuclear family but also to join the old age institutions. The consequences of it are feeling of neglected or left alone by the children, adding a touch of helpless in the absence of lack of expected care and support. The accretion of all these feelings and unpleasant events ignite a question in their mind that – who is there for me? The efforts have taken to highlight the issues of the elderly after joining the old age home and their perception about the current life as an institutional inmate. This attempt to cover up the condition, adjustment, changed lifestyle and perspective in the association with several issues of the elderly, which have an essential effect on their well-being. The present research piece has collected the information about institutionalized elderly with the help of a semi-structured questionnaire. This study interviewed 500 respondents from 22 old age homes of Pune city of Maharashtra State, India. This data collection methodology consists of Multi-stage random sampling. In which the stratified random sampling adopted for the selection of old age homes and sample size determination, sample selection probability proportional to the size and simple random sampling techniques implemented. The study provides that around five percent of the elderly shifted to old age home along with their spouse, whereas ten percent of the elderly are staying away from their spouse. More than 71 percent of the elderly have children, and they are an involuntary inmate of the old age institution, even less than one-third of the elderly consulted to the institution before the joining it. More than sixty percent of the elderly have children, but they joined institution due to the unpleasant response of their children only. Around half of the elderly responded that there are issues while adjusting to this environment, many of them are still persistent. At least one elderly out of ten is there who is suffering from the feeling of loneliness and left out by children and other family members. In contrast, around 97 percent of the elderly are very happy or satisfied with the institutional facilities. It illustrates that the issues are associated with their children and other family members, even though they left their home before a year or more. When enquired about this loneliness feeling few of them are suffering from it before leaving their homes, it was due to lack of interaction with children, as they are too busy to have time for the aged parents. Additionally, the conflicts or fights within the family due to the presence of old persons in the family contributed to establishing another feeling of insignificance among the elderly parents. According to these elderly, have more than 70 percent of the share, the children are ready to spend money indirectly for us through these institutions, but not prepared to provide some time and very few amounts of all this expenditure directly for us.

Keywords: elderly, old age homes, life style changes and adjustment, India

Procedia PDF Downloads 114

Authors: Rutcher M. Lacaza, Stephen Jun V. Villejo

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This paper investigated the patterns of private transfers in the Philippines using the Family Income Expenditure Survey (FIES) 2009, conducted by the Philippine government’s National Statistics Office (NSO) every three years. The paper performed bivariate analysis on net transfers, using the identified determinants for a household to be either a net receiver or a net giver. The household characteristics considered are the following: age, sex, marital status, employment status and educational attainment of the household head, and also size, location, pre-transfer income and the number of employed members of the household. The variables net receiver and net giver are determined by computing the net transfer, subtracting total gifts from total receipts. The receipts are defined as the sum of cash received from abroad, cash received from domestic sources, total gifts received and inheritance. While gifts are defined as the sum of contributions and donations to church and other religious institutions, contributions and donations to other institutions, gifts and contributions to others, and gifts and assistance to private individuals outside the family. Both in kind and in cash transfers are considered in the analysis. It also performed a multiple regression analysis on transfers received and income including other household characteristics to examine the motives for giving transfers – whether altruism or exchanged. It also used the binary logistic regression to estimate the probability of being a net receiver or net giver given the household characteristics. The study revealed that receiving tends to be universal – both the non-poor and the poor benefit although the poor receive substantially less than the non-poor. Regardless of whether households are net receivers or net givers, households in the upper deciles generally give and receive more than those in the lower deciles. It also appears that private transfers may just flow within economic groups. Big amounts of transfers are, therefore, directed to the non-poor and the small amounts go to the poor. This was also supported by the increasing function of gross transfers received and the income of households – the poor receiving less and the non-poor receiving more. This is contrary to the theory that private transfers can help equalize the distribution of income. This suggested that private transfers in the Philippines are not altruistically motivated but exchanged. However, bilateral data on transfers received or given is needed to test this theory directly. The results showed that transfers are much needed by the poor and it is important to understand the nature of private transfers, to ensure that government transfer programs are properly designed and targeted so as to prevent the duplication of private safety nets already present among the non-poor.

Keywords: private transfers, net receiver, net giver, altruism, exchanged.

Procedia PDF Downloads 192

Authors: Orkide Donma, Mustafa M. Donma

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Basal metabolic rate (BMR) is widely used and an accepted measure of energy expenditure. Its principal determinant is body mass. However, this parameter is also correlated with a variety of other factors. The objective of this study is to measure BMR and compare it with the values obtained from predictive equations in adults classified according to their body mass index (BMI) values. 276 adults were included into the scope of this study. Their age, height and weight values were recorded. Five groups were designed based on their BMI values. First group (n = 85) was composed of individuals with BMI values varying between 18.5 and 24.9 kg/m². Those with BMI values varying from 25.0 to 29.9 kg/m² constituted Group 2 (n = 90). Individuals with 30.0-34.9 kg/m², 35.0-39.9 kg/m², > 40.0 kg/m² were included in Group 3 (n = 53), 4 (n = 28) and 5 (n = 20), respectively. The most commonly used equations to be compared with the measured BMR values were selected. For this purpose, the values were calculated by the use of four equations to predict BMR values, by name, introduced by Food and Agriculture Organization (FAO)/World Health Organization (WHO)/United Nations University (UNU), Harris and Benedict, Owen and Mifflin. Descriptive statistics, ANOVA, post-Hoc Tukey and Pearson’s correlation tests were performed by a statistical program designed for Windows (SPSS, version 16.0). p values smaller than 0.05 were accepted as statistically significant. Mean ± SD of groups 1, 2, 3, 4 and 5 for measured BMR in kcal were 1440.3 ± 210.0, 1618.8 ± 268.6, 1741.1 ± 345.2, 1853.1 ± 351.2 and 2028.0 ± 412.1, respectively. Upon evaluation of the comparison of means among groups, differences were highly significant between Group 1 and each of the remaining four groups. The values were increasing from Group 2 to Group 5. However, differences between Group 2 and Group 3, Group 3 and Group 4, Group 4 and Group 5 were not statistically significant. These insignificances were lost in predictive equations proposed by Harris and Benedict, FAO/WHO/UNU and Owen. For Mifflin, the insignificance was limited only to Group 4 and Group 5. Upon evaluation of the correlations of measured BMR and the estimated values computed from prediction equations, the lowest correlations between measured BMR and estimated BMR values were observed among the individuals within normal BMI range. The highest correlations were detected in individuals with BMI values varying between 30.0 and 34.9 kg/m². Correlations between measured BMR values and BMR values calculated by FAO/WHO/UNU as well as Owen were the same and the highest. In all groups, the highest correlations were observed between BMR values calculated from Mifflin and Harris and Benedict equations using age as an additional parameter. In conclusion, the unique resemblance of the FAO/WHO/UNU and Owen equations were pointed out. However, mean values obtained from FAO/WHO/UNU were much closer to the measured BMR values. Besides, the highest correlations were found between BMR calculated from FAO/WHO/UNU and measured BMR. These findings suggested that FAO/WHO/UNU was the most reliable equation, which may be used in conditions when the measured BMR values are not available.

Keywords: adult, basal metabolic rate, fao/who/unu, obesity, prediction equations

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Authors: Neha Dimri, Varsha Gupta

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Purpose: Fast Fashion trend promotes consumption of low cost high fashion garments at a rapid rate. Frequent change in fashion trend results in higher disposability of Fast Fashion products. To cater for the Fast Fashion appetite of the present day consumer, fashion giants have ramped up production of garments, thus imposing a massive strain on the planet’s natural resources. Also, ethical issues related to cheaper methods of production are of concern. India being a large consumer base has a major role to play in proliferation of the Fast Fashion trend. This paper is an attempt to study the effect of fast fashion trends on the Indian consumer’s behaviour. It also attempts to ascertain the awareness of the consumer about the detrimental effect that the fast fashion trends manifest on the environment. Design /methodology/approach: The survey was conducted using a questionnaire targeted at a set of urban Indian consumers of varied age, profession and socio economic backgrounds. Trends regarding frequency of purchase, expenditure on clothing, disposal methods and awareness about environmental issues were analyzed using the obtained data. Findings: The result of the study indicates that urban Indian consumer has a strong affinity towards fast fashion trends, but is largely unaware of its detrimental effect on the environment and strain on natural resources. Research Limitation/implications: The sample size for survey was only of a hundred consumers, and the same could be expanded for a better estimate of trends. Also, the sample consumers were mostly urban. A big chunk of Indian fashion consumers reside in small towns and the same could be included in the survey. Practical implications: As the true cost of Fast Fashion in terms of environmental and ethical aspects is getting realized worldwide, a big market like India cannot remain isolated from this phenomenon. Globally there has been an increase in demand of ethically produced clothing. It is imperative that the Indian consumer be made aware about the unsustainable nature of Fast Fashion so that he can contribute towards conservation of natural resources and ethical production of garments. Originality/value The research attempts to ascertain consumption pattern of the Indian fashion consumer and also his awareness about the true cost and consequences of Fast Fashion. The inferences may be used by fashion giants to use ‘Green Marketing’ and ‘Social Marketing’ techniques to make the Indian consumer more aware about sustainable fashion and to market their own products as ‘Sustainable, Green and Ethical’.

Keywords: consumption, disposable, fast fashion, Indian consumer

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Authors: Mohamed Abdelmongy

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Autologous Blood for Conjunctival Autograft Fixation in Primary Pterygium Surgery: A Systematic Review and Meta-analysis Hossam Zein1,2, Ammar Ismail1,3, Mohamed Abdelmongy1,4, Sherif Elsherif1,5,6, Ahmad Hassanen1,4, Basma Muhammad2, Fathy Assaf1,3, Ahmed Elsehili1,7, Ahmed Negida1,7, Shin Yamane9, Mohamed M. Abdel-Daim8,9 and Kazuaki Kadonosono9 https://www.ncbi.nlm.nih.gov/pubmed/30277146 BACKGROUND: Pterygium is a benign ocular lesion characterized by triangular fibrovascular growth of conjunctival tissue over the cornea. Patients complain of the bad cosmetic appearance, ocular surface irritation and decreased visual acuity if the pterygium is large enough to cause astigmatism or encroach on the pupil. The definitive treatment of pterygium is surgical removal. However, outcomes are compromised by recurrence . The aim of the current study is to systematically review the current literature to explore the efficacy and safety of fibrin glue, suture and autologous blood coagulum for conjunctivalautograft fixation in primary pterygium surgery. OBJECTIVES: To assess the effectiveness of fibrin glue compared to sutures and autologous blood coagulum in conjunctival autografting for the surgical treatment of pterygium. METHODS: During preparing this manuscript, we followed the steps adequately illustrated in the Cochrane Handbook for Systematic Reviews of Interventions version 5.3, and reported it according to the preferred reporting of systematic review and meta-analysis (PRISMA) statement guidelines. We searched PubMed, Ovid (both through Medline), ISI Web of Science, and Cochrane Central Register of Controlled Trials (Central) through January 2017, using the following keywords “Pterygium AND (blood OR glue OR suture)” SELECTION CRITERIA: We included all randomized controlled trials (RCTs) that met the following criteria: 1) comparing autologous blood vs fibrin glue for conjunctivalautograft fixation in primary pterygium surgery 2) comparing autologous blood vs sutures for conjunctivalautograft fixation in primary pterygium surgery DATA COLLECTION AND ANALYSIS: Two review authors independently screened the search results, assessed trial quality, and extracted data using standard methodological procedures expected by Cochrane. The extracted data included A) study design, sample size, and main findings, B) Baseline characteristics of patients included in this review including their age, sex, pterygium site and grade, and graft size. C) Study outcomes comprising 1) primary outcomes: recurrence rate 2) secondary outcomes: graft stability outcomes (graft retraction, graft displacement), operation time (min) and postoperative symptoms (pain, discomfort, foreign body sensation, tearing) MAIN RESULTS: We included 7 RCTs and The review included662eyes (Blood: 293; Glue: 198; Suture: 171). we assess the 1) primary outcomes: recurrence rate 2) secondary outcomes: graft stability outcomes (graft retraction, graft displacement), operation time (min) and postoperative symptoms (pain, discomfort, foreign body sensation, tearing) CONCLUSIONS: Autologous blood for conjunctivalautograft fixation in pterygium surgery is associated with lower graft stability than fibrin glue or sutures. It was not inferior to fibrin glue or sutures regarding recurrence rate. The overall quality of evidence is low. Further well designed RCTs are needed to fully explore the efficacy of this new technique.

Keywords: pterygium, autograft, ophthalmology, cornea

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Authors: Pallavi Kishore, Mariam Aslam

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The sharp decline in oil prices that started in 2014 affected most economies in the world either positively or negatively. In some economies, particularly the oil exporting countries, the effects were felt immediately. The Gulf Cooperation Council’s (GCC henceforth) countries are oil and gas-dependent with the largest oil reserves in the world. UAE (United Arab Emirates) has been striving to diversify away from oil and expects higher non-oil growth in 2018. These two factors, falling oil prices and the economy strategizing away from oil dependence, make a compelling case to study the financial performance of various sectors in the economy. Among other sectors, the insurance sector is widely recognized as an important indicator of the health of the economy. An expanding population, surge in construction and infrastructure, increased life expectancy, greater expenditure on automobiles and other luxury goods translate to a booming insurance sector. A slow-down of the insurance sector, on the other hand, may indicate a general slow-down in the economy. Therefore, a study on the insurance sector will help understand the general nature of the current economy. This study involves calculations and comparisons of ratios pre and post the fall in oil prices in the insurance sector in the UAE. A sample of 33 companies listed on the official stock exchanges of UAE-Dubai Financial Market and Abu Dhabi Stock Exchange were collected and empirical analysis employed to study the financial performance pre and post fall in oil prices. Ratios were calculated in 5 categories: Profitability, Liquidity, Leverage, Efficiency, and Investment. The means pre- and post-fall are compared to conclude that the profitability ratios including ROSF (Return on Shareholder Funds), ROCE (Return on Capital Employed) and NPM (Net Profit Margin) have all taken a hit. Parametric tests, including paired t-test, concludes that while the fall in profitability ratios is statistically significant, the other ratios have been quite stable in the period. The efficiency, liquidity, gearing and investment ratios have not been severely affected by the fall in oil prices. This may be due to the implementation of stronger regulatory policies and is a testimony to the diversification into the non-oil economy. The regulatory authorities can use the findings of this study to ensure transparency in revealing financial information to the public and employ policies that will help further the health of the economy. The study will also help understand which areas within the sector could benefit from more regulations.

Keywords: UAE, insurance sector, ratio analysis, oil price, profitability, liquidity, gearing, investment, efficiency

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Authors: R. O. Babatunde, O. M. Igbalajobi, F. Matambalya

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Moderate economic growth in developing and emerging countries has led to improvement in the food consumption and nutrition situation in the last two decades. Nevertheless, about 870 million people, with a quarter of them from Sub-Saharan Africa, are still suffering from hunger worldwide. As part of measures to reduce the widespread poverty and hunger, cash transfer programmes are now being implemented in many countries of the world. While nationwide cash transfer schemes are few in Sub-Saharan Africa generally, the available ones are more concentrated in East and Southern Africa. Much of the available literature on social protection had focused on the poverty impact of cash transfer schemes at the household level, with the larger proportion originating from Latin America. On the contrary, much less empirical studies have been conducted on the poverty impact of cash transfer in Sub-Saharan Africa, let alone on the food security and nutrition impact. To fill this gap in knowledge, this paper examines the impact of cash transfer on food security in Nigeria. As a case study, the paper analysed the Ekiti State Cash Transfer Scheme (ECTS). ECTS is an unconditional transfer scheme which was established in 2011 to directly provide cash transfer to elderly persons aged 65 years and above in Ekiti State of Nigeria. Using survey data collected in 2013, we analysed the impact of the scheme on food availability and dietary diversity of the beneficiary households. Descriptive and Propensity Score Matching (PSM) techniques were used to estimate the Average Treatment Effect (ATE) and Average Treatment Effect on the Treated (ATT) among the beneficiary and control groups. Thereafter, a model to test for the impact of participation in the cash transfer scheme on calorie availability and dietary diversity was estimated. The results indicate that while households in the sample are clearly vulnerable, there were statistically significant differences between the beneficiary and control groups. For instance, monthly expenditure, calorie availability and dietary diversity were significantly larger among the beneficiary and consequently, the prevalence and depth of hunger were lower in the group. Econometric results indicate that the cash transfer has a positive and significant effect on food availability and dietary diversity in the households. Expanding the coverage of the present scheme to cover all eligible households in the country and incorporating cash transfer into a comprehensive hunger reduction policy will make it to have a greater impact at improving food security among the most vulnerable households in the country.

Keywords: calorie availability, cash transfers, dietary diversity, propensity score matching

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Authors: Agnieszka H. Ludwig-Slomczynska, Michal T. Seweryn, Przemyslaw Kapusta, Ewelina Pitera, Katarzyna Cyganek, Urszula Mantaj, Lucja Dobrucka, Ewa Wender-Ozegowska, Maciej T. Malecki, Pawel Wolkow

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Obesity results from an imbalance between energy intake and its expenditure. Genome-Wide Association Study (GWAS) analyses have led to discovery of only about 100 variants influencing body mass index (BMI), which explain only a small portion of genetic variability. Analysis of gene epistasis gives a chance to discover another part. Since it was shown that interaction and communication between nuclear and mitochondrial genome are indispensable for normal cell function, we have looked for epistatic interactions between the two genomes to find their correlation with BMI. Methods: The analysis was performed on 366 T1DM patients using Illumina Infinium OmniExpressExome-8 chip and followed by imputation on Michigan Imputation Server. Only genes which influence mitochondrial functioning (listed in Human MitoCarta 2.0) were included in the analysis – variants of nuclear origin (MAF > 5%) in 1140 genes and 42 mitochondrial variants (MAF > 1%). Gene expression analysis was performed on GTex data. Association analysis between genetic variants and BMI was performed with the use of Linear Mixed Models as implemented in the package 'GENESIS' in R. Analysis of association between mRNA expression and BMI was performed with the use of linear models and standard significance tests in R. Results: Among variants involved in epistasis between mitochondria and nucleus we have identified one in mitochondrial transcription factor, TFB2M (rs6701836). It interacted with mitochondrial variants localized to MT-RNR1 (p=0.0004, MAF=15%), MT-ND2 (p=0.07, MAF=5%) and MT-ND4 (p=0.01, MAF=1.1%). Analysis of the interaction between nuclear variant rs6701836 (nuc) and rs3021088 localized to MT-ND2 mitochondrial gene (mito) has shown that the combination of the two led to BMI decrease (p=0.024). Each of the variants on its own does not correlate with higher BMI [p(nuc)=0.856, p(mito)=0.116)]. Although rs6701836 is intronic, it influences gene expression in the thyroid (p=0.000037). rs3021088 is a missense variant that leads to alanine to threonine substitution in the MT-ND2 gene which belongs to complex I of the electron transport chain. The analysis of the influence of genetic variants on gene expression has confirmed the trend explained above – the interaction of the two genes leads to BMI decrease (p=0.0308). Each of the mRNAs on its own is associated with higher BMI (p(mito)=0.0244 and p(nuc)=0.0269). Conclusıons: Our results show that nuclear-mitochondrial epistasis can influence BMI in T1DM patients. The correlation between transcription factor expression and mitochondrial genetic variants will be subject to further analysis.

Keywords: body mass index, epistasis, mitochondria, type 1 diabetes

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Authors: Vinay Kumar Vanjakula, Frank Adam, Nils Goseberg, Christian Windt

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When a structure is installed on a seabed, the presence of the structure will influence the flow field around it. The changes in the flow field include, formation of vortices, turbulence generation, waves or currents flow breaking and pressure differentials around the seabed sediment. These changes allow the local seabed sediment to be carried off and results in Scour (erosion). These are a threat to the structure's stability. In recent decades, rapid developments of research work and the knowledge of scour On fixed structures (bridges and Monopiles) in rivers and oceans has been carried out, and very limited research work on scour and liquefaction for gravity anchors, particularly for floating Tension Leg Platform (TLP) substructures. Due to its importance and need for enhancement of knowledge in scour and liquefaction around marine structures, the MarTERA funded a three-year (2020-2023) research program called NuLIMAS (Numerical Modeling of Liquefaction Around Marine Structures). It’s a group consists of European institutions (Universities, laboratories, and consulting companies). The objective of this study is to build a numerical model that replicates the reality, which indeed helps to simulate (predict) underwater flow conditions and to study different marine scour and Liquefication situations. It helps to design a heavyweight anchor for the TLP substructure and to minimize the time and expenditure on experiments. And also, the achieved results and the numerical model will be a basis for the development of other design and concepts For marine structures. The Computational Fluid Dynamics (CFD) numerical model will build in OpenFOAM. A conceptual design of heavyweight anchor for TLP substructure is designed through taking considerations of available state-of-the-art knowledge on scour and Liquefication concepts and references to Previous existing designs. These conceptual designs are validated with the available similar experimental benchmark data and also with the CFD numerical benchmark standards (CFD quality assurance study). CFD optimization model/tool is designed as to minimize the effect of fluid flow, scour, and Liquefication. A parameterized model is also developed to automate the calculation process to reduce user interactions. The parameters such as anchor Lowering Process, flow optimized outer contours, seabed interaction study, and FSSI (Fluid-Structure-Seabed Interactions) are investigated and used to carve the model as to build an optimized anchor.

Keywords: gravity anchor, liquefaction, scour, computational fluid dynamics

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Authors: Ariadna Gassiot, Raquel Camprubi, Lluis Coromina

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Creative tourism involves the participation of tourists in the co-creation of their own experiences in a tourism destination. Consequently, creative tourists move from a passive behavior to an active behavior, and tourism destinations address this type of tourism by changing the scenario and making tourists learn and participate while they travel instead of merely offering tourism products and services to them. In creative tourism experiences, tourists are in close contact with locals and their culture. In destinations where culture (i.e. food, heritage, etc.) is the basis of their offer, such as Girona, Spain, tourism stakeholders must especially consider, analyze, and further foster the co-creation of authentic tourism experiences. They should focus on discovering more about these experiences, their main attributes, visitors’ opinions, etc. Creative tourists do not only participate while they travel around the world, but they also have and active post-travel behavior. They feel free to write about tourism experiences in different channels. User-generated content becomes crucial for any tourism destination when analyzing the market, making decisions, planning strategies, and when addressing issues, such as their reputation and performance. Sentiment analysis is a methodology used to automatically analyze semantic relationships and meanings in texts, so it is a way to extract tourists’ emotions and feelings. Tourists normally express their views and opinions regarding tourism products and services. They may express positive, neutral or negative feelings towards these products or services. For example, they may express anger, love, hate, sadness or joy towards tourism services and products. They may also express feelings through verbs, nouns, adverbs, adjectives, among others. Sentiment analysis may help tourism professionals in a range of areas, from marketing to customer service. For example, sentiment analysis allows tourism stakeholders to forecast tourism expenditure and tourist arrivals, or to analyze tourists’ profile. While there is an increasing presence of creativity in tourists’ experiences, there is also an increasing need to explore tourists’ expressions about these experiences. There is a need to know how they feel about participating in specific tourism activities. Thus, the main objective of this study is to analyze the meanings, emotions and feelings that tourists express about their creative experiences in Girona, Spain. To do so, sentiment analysis methodology is used. Results show the diversity of tourists who actively participate in tourism in Girona. Their opinions refer both to tangible aspects (e.g. food, museums, etc.) and to intangible aspects (e.g. friendliness, nightlife, etc.) of tourism experiences. Tourists express love, likeliness and other sentiments towards tourism products and services in Girona. This study can help tourism stakeholders in understanding tourists’ experiences and feelings. Consequently, they can offer more customized products and services and they can efficiently make them participate in the co-creation of their own tourism experiences.

Keywords: creative tourism, sentiment analysis, text mining, user-generated content

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