Search results for: ottoman period
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5672

Search results for: ottoman period

4952 The Consequences of COVID-19 Crisis on Informal Workers in Brazil: An Analysis of Emergency Aid from the Government

Authors: Michele Romanello

Abstract:

COVID-19 has spread rapidly in Brazil since March 2020, making the country one of the most affected in the world by the pandemic. From an economic point of view, Brazil came from a pre-pandemic period characterized by low or negative growth, with a resulting increase in the number of unemployed and informal workers. This paper considers lockdown implementation in the situation of the large presence of informality in the economy. The objective of the paper is to analyze how the country has tried to help workers affected by economic crisis after the implementation of measures against COVID-19 and whether the emergency assistance from the government has been adequate to contain the increase of informal workers and unemployed. The methodology used in this paper is survival analysis. Through this methodology, the formality – informality, and informality – unemployment transitions are analyzed. This analysis draws data from the Continuous National Household Sample Survey (Continuous PNAD) and from the National Household Sample Survey COVID-19 (PNAD COVID-19) covering the period of January 2020 – July 2020. The results indicate that emergency aid has been not sufficient to reduce the transitions of workers from formal to informal jobs and from informal jobs to unemployment. Emergency aid has been not sufficient considering the previous situation of the country, with levels of poverty and inequality very high. In the next months, another fundamental determinant of the income trajectory in the context of the COVID-19 crisis will be the continuity of the emergency aid, especially considering the fiscal adjustment policy pursued by the government. Therefore, the current negative portrait may be even worse in the coming months.

Keywords: Brazil, COVID-19, informality, survival analysis

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4951 Effects of Music Training on Social-Emotional Development and Basic Musical Skills: Findings from a Longitudinal Study with German and Migrant Children

Authors: Stefana Francisca Lupu, Jasmin Chantah, Mara Krone, Ingo Roden, Stephan Bongard, Gunter Kreutz

Abstract:

Long-term music interventions could enhance both musical and nonmusical skills. The present study was designed to explore cognitive, socio-emotional, and musical development in a longitudinal setting. Third-graders (N = 184: 87 male, 97 female; mean age = 8.61 years; 115 native German and 69 migrant children) were randomly assigned to two intervention groups (music and maths) and a control group over a period of one school-year. At baseline, children in these groups were similar in basic cognitive skills, with a trend of advantage in the control group. Dependent measures included the culture fair intelligence test CFT 20-R; the questionnaire of emotional and social school experience for grade 3 and 4 (FEESS 3-4), the test of resources in childhood and adolescence (FRKJ 8-16), the test of language proficiency for German native and non-native primary school children (SFD 3), the reading comprehension test (ELFE 1-6), the German math test (DEMAT 3+) and the intermediate measures of music audiation (IMMA). Data were collected two times at the beginning (T1) and at the end of the school year (T2). A third measurement (T3) followed after a six months retention period. Data from baseline and post-intervention measurements are currently being analyzed. Preliminary results of all three measurements will be presented at the conference.

Keywords: musical training, primary-school German and migrant children, socio-emotional skills, transfer

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4950 The Discovery and Application of Perspective Representation in Modern Italy

Authors: Matthias Stange

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In the early modern period, a different image of man began to prevail in Europe. The focus was on the self-determined human being and his abilities. At first, these developments could be seen in Italian painting and architecture, which again oriented itself to the concepts and forms of antiquity. For example, through the discovery of perspective representation by Brunelleschi or later the orthogonal projection by Alberti, after the ancient knowledge of optics had been forgotten in the Middle Ages. The understanding of reality in the Middle Ages was not focused on the sensually perceptible world but was determined by ecclesiastical dogmas. The empirical part of this study examines the rediscovery and development of perspective. With the paradigm of antiquity, the figure of the architect was also recognised again - the cultural man trained theoretically and practically in numerous subjects, as Vitruvius describes him. In this context, the role of the architect, the influence on the painting of the Quattrocento as well as the influence on architectural representation in the Baroque period are examined. Baroque is commonly associated with the idea of illusionistic appearance as opposed to the tangible reality presented in the Renaissance. The study has shown that the central perspective projection developed by Filippo Brunelleschi enabled another understanding of seeing and the dissemination of painted images. Brunelleschi's development made it possible to understand the sight of nature as a reflection of what is presented to the viewer's eye. Alberti later shortened Brunelleschi's central perspective representation for practical use in painting. In early modern Italian architecture and painting, these developments apparently supported each other. The pictorial representation of architecture initially served the development of an art form before it became established in building practice itself.

Keywords: Alberti, Brunelleschi, central perspective projection, orthogonal projection, quattrocento, baroque

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4949 An Epidemiological Analysis of the Occurrence of Bovine Brucellosis and Adopted Control Measures in South Africa during the Period 2014 to 2019

Authors: Emily Simango, T. Chitura

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Background: Bovine brucellosis is among the most neglected zoonotic diseases in developing countries, where it is endemic and a growing challenge to public health. The development of cost-effective control measures for the disease can only be affirmed by the knowledge of the disease epidemiology and the ability to define its risk profiles. The aim of the study was to document the trend of bovine brucellosis and the control measures adopted following reported cases during the period 2014 to 2019 in South Africa. Methods: Data on confirmed cases of bovine brucellosis was retrieved from the website of the World Organisation of Animal Health (WOAH). Data was analysed using the Statistical Package for Social Sciences (IBM SPSS, 2022) version 29.0. Descriptive analysis (frequencies and percentages) and the Analysis of variance (ANOVA) were utilized for statistical significance (p<0.05). Results: The data retrieved in our study revealed an overall average bovine brucellosis prevalence of 8.48. There were statistically significant differences in bovine brucellosis prevalence across the provinces for the years 2016 and 2019 (p≥0.05), with the Eastern Cape Province having the highest prevalence in both instances. Documented control measures for the disease were limited to killing and disposal of disease cases as well as vaccination of susceptible animals. Conclusion: Bovine brucellosis is real in South Africa, with the risk profiles differing across the provinces. Information on brucellosis control measures in South Africa, as reported to the WOAH, is not comprehensive.

Keywords: zoonotic, endemic, Eastern Cape province, vaccination

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4948 Investor Psychology, Housing Prices, and Stock Market Response to Policy Decisions During the Covid-19 Recession in the United States

Authors: Ly Nguyen, Vidit Munshi

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During the Covid-19 recession, the United States government has implemented several instruments to mitigate the impacts and revitalize the economy. This paper explores the effects of the various government policy decisions on stock returns, housing prices, and investor psychology during the pandemic in the United States. A numerous previous literature studies on this subject, yet very few focus on the context similar to what we are currently experiencing. Our monthly data covering the period from January 2019 through July 2021 were collected from Datastream. Utilizing the VAR model, we document a dynamic relationship between the market and policy actions throughout the period. In particular, the movements of Unemployment, Stock returns, and Housing prices are strongly sensitive to changes in government policies. Our results also indicate that changes in production level, stock returns, and interest rates decisions influence how investors perceived future market risk and expectations. We do not find any significant nexus between monetary and fiscal policy. Our findings imply that information on government policy and stock market performance provide useful feedback to one another in order to make better decisions in the current and future pandemic. Understanding how the market responds to a shift in government practices has important implications for authorities in implementing policy to avoid assets bubbles and market overreactions. The paper also provides useful implications for investors in evaluating the effectiveness of different policies and diversifying portfolios to minimize systematic risk and maximize returns.

Keywords: Covid-19 recession, United States, government policies, investor psychology, housing prices, stock market returns

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4947 Women in Violent Conflicts and the Challenges of Food Security in Northeast Nigeria: The Case of Boko Haram Insurgency

Authors: Grace Modupe Adebo, Ayodeji Oluwamuyiwa Adedapo

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Women are key actors in ensuring food security in terms of food availability, food access, and food utilization in the developing economy, however, they suffer mostly during violent conflicts due to their feminist nature of rearing and caring for their children and relatives. The study was embarked upon to access the effects of violent conflicts posed by Boko Haram insurgency on women and food security in the Northeast of Nigeria. The study made use of secondary data. A time series data collected over a 22 years period were used. The data collected were subjected to descriptive statistics and t-test analysis. The findings of the study established a significant difference in food production (availability) before and after the Boko Haram insurgency at the 1% level of significance. The high level of Internally Displaced Person (IDP) with a high proportion of women depicts a very low level of food accessibility as the men and women has fled and uninhabited their place of abode for over a period of four to five years, thus diminishing their economic power, and the means of acquiring food which invariably endanger food stability and utilization. The study confirmed the abduction and changing roles of women as cooks, porters, spies, partners, and sex slaves to Boko Haram troop members, thus affecting their livelihoods and food security. The study recommends hands-on interventions by the governmental, non-governmental and international agencies to terminate the activities of Boko Haram in the area and restore the food production for enhanced food security.

Keywords: Boko Haram insurgency, food accessibility, food production, food utilization, women’s livelihoods

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4946 Indian Emigration to Gulf Countries: Opportunities and Challenges

Authors: Sudhaveni Naresh

Abstract:

International migration is an important subject and gaining more significance andinterest among scholars in recent years. It is defined as crossing of the boundaries of political or administrative units for a certain minimum period for reasons such as education, employment, etc.International migration is not new for India because it has a long history with the Gulf region since ancient period. India is also one of the largest migrant-sending countries after China in the world. Migration towards the Gulf region became more prominent during early 1970s due to oil boom which led to rapid increase in the demand for foreign labour. Of 25 million Indian emigrants are living across the world, about six million Indian emigrants working in the Gulf. Most of these migrants were either unskilled or semi-skilled. Both the pull and push factors behind labour emigrate to Gulf countries. India is world’s leading receiver of remittances and the flow of remittances to India has been increasing steadily since the 1970s. In 2011-12, it was about 4 percent of GDP.Emigrants play a significant role in the economic development and growth of the country via the remittances and knowledge and skill transfer. Scholars see remittances as vital tool in the development for origin country. This paper examines the recent trend and pattern of migration from India to Gulf countries and explores impact of remittances on emigrants’ families at home country. It also highlights opportunities, challenges and the need for strengthening multilateral cooperation to transform migration into an efficient, orderly and humane process.The study propose to undertake a primary survey for this purpose. Both quantitative and qualitative research methods will be used to study the above issues.

Keywords: development, international migration, remittances, unskilled labour

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4945 The Relationships between Carbon Dioxide (CO2) Emissions, Energy Consumption and GDP per capita for Oman: Time Series Analysis, 1980–2010

Authors: Jinhoa Lee

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The relationships between environmental quality, energy use and economic output have created growing attention over the past decades among researchers and policy makers. Focusing on the empirical aspects of the role of CO2 emissions and energy use in affecting the economic output, this paper is an effort to fulfil the gap in a comprehensive case study at a country level using modern econometric techniques. To achieve the goal, this country-specific study examines the short-run and long-run relationships among energy consumption, carbon dioxide (CO2) emissions and gross domestic product (GDP) for Oman using time series analysis from the year 1980-2010. To investigate the relationships between the variables, this paper employs the Augmented Dickey Fuller (ADF) test for stationary, Johansen maximum likelihood method for co-integration and a Vector Error Correction Model (VECM) for both short- and long-run causality among the research variables for the sample. All the variables in this study show very strong significant effects on GDP in the country for the long term. The long-run equilibrium in the VECM suggests positive long-run causalities from CO2 emissions to GDP. Conversely, negative impacts of energy consumption on GDP are found to be significant in Oman during the period. In the short run, there exist negative unidirectional causalities among GDP, CO2 emissions and energy consumption running from GDP to CO2 emissions and from energy consumption to CO2 emissions. Overall, the results support arguments that there are relationships among environmental quality, energy use and economic output in Oman over of period 1980-2010.

Keywords: CO2 emissions, energy consumption, GDP, Oman, time series analysis

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4944 Means of Securing Graves in the Egyptian Kingdom Era

Authors: Haitham Nabil Zaghlol Hasan

Abstract:

This research aims to study the means of securing graves in the Egyptian kingdom era, and revolves around many basic ideas used by the ancient Egyptian to protect his graves from thieves, which included architectural characteristics, which gave it importance only others. The most important of which was the choice of the place of the grave, which chose a kohl place in the desert to protect the graves, which is the valley of kings, and whether the choice of that place had an impact in protecting the grave or not, in addition to other elements followed in the architectural planning, which was in the valley of kings. The multiplicity of the tomb, the construction of the well chamber to deceive the thieves by the end of the graves suddenly, the construction of the wells of the tombs, which contained the burial chamber at the bottom of the main well and the effect of all these factors on the graves, and this shows the importance of the graves to the ancient Egyptian and his belief in resurrection and immortality. The Egyptian resorted to the elements of protection and was a religious worker by The protector gods and special texts to protect the deceased from any danger to protect the tomb. As for the human factor of securing the tomb through human guards (police) and security teams based on the guard and the words indicating the protection and the guard teams and the teams of the majai. The most important developments that arose on the cemetery from Tamit entrance, corridors, chambers, burial chamber and coffin, and the use of sand to close the well after from one cemetery to another and from time to time where it was built in the late period inside the temple campus to be under the attention of the priests and their protection, as the study dealt with an analytical study For the means of securing graves in the Egyptian kingdom period.

Keywords: Egypt, archaeology, civilization, Egyptian

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4943 Urinary Incontinence and Performance in Elite Athletes

Authors: María Barbaño Acevedo Gómez, Elena Sonsoles Rodríguez López, Sofía Olivia Calvo Moreno, Ángel Basas García, Christophe RamíRez Parenteau

Abstract:

Introduction: Urinary incontinence (UI) is defined as the involuntary leakage of urine. In persons who practice sport, its prevalence is 36.1% (95% CI 26.5% –46.8%) and varies as it seems to depend on the intensity of exercise, movements and impact on the ground. Such high impact sports are likely to generate higher intra-abdominal pressures and leading to pelvic floor muscle weakness. Although physical exercise reduces the risk of suffering from many diseases the mentality of an elite athlete is not to optimize their health, achieving their goals can put their health at risk. Furthermore, feeling or suffering from any discomfort during training seems to be normal within the elite sport demands. Objective: The main objective of the present study was to know the effects of UI in sports performance in athletes. Methods: This was an observational study conducted in 754 elite athletes. After collecting questions about pelvic floor, UI and sport-related data, participants completed the questionnaire International Consultation on Incontinence Questionnaire-UI Short- Form (ICIQ-SF) and ISI (index of incontinence severity). Results: 48.8% of the athletes declare having losses also in rest, preseason and / or competition (χ2 [3] = 3.64; p = 0.302), being the competition period (29.1%) the most frequent where suffer from urine leakage. Of the elite athletes surveyed, 33% had UI according ICIQ-SF (mean age 23.75 ± 7.74 years). Elite athletes with UI (5.31 ± 1.07 days) dedicate significantly more days per week to training [M = 0.28; 95% CI = 0.08-0.48; t (752) = 2.78; p = 0.005] than those without UI. Regarding frequency, 59.7% lose urine once a week, 25.6% lose urine more than 3 times a week, and 14.7% daily. Based on the amount, approximately 15% claim to lose a moderate and abundant. Athletes with the highest number of urine leaks during their training, the UI affects them more in their daily life (r = 0.259; p = 0.001), they present a greater number of losses in their day to day (r = 0.341; p <0.001 ) and greater severity of UI (r = 0.341; p <0.001). Conclusions: Athletes consider that UI affects them negatively in their daily routine, 30.9% affirm having a severity between moderate and severe in their daily routine, and 29.1% loss urine in competition period. An interesting fact is that more than half of the samples collected were elite athletes who compete at the highest level (Olympic Games, World and European Championship), the dedication to sport occupies a big piece in their life. The most frequent period where athletes suffers urine leakage is in competition and there are many emotions that athletes manage to get their best performance, if we add urine losses in that moments it is possible that their performance could be affected.

Keywords: athletes, performance, prevalence, sport, training, urinary incontinence

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4942 Comparative Analysis of the Third Generation of Research Data for Evaluation of Solar Energy Potential

Authors: Claudineia Brazil, Elison Eduardo Jardim Bierhals, Luciane Teresa Salvi, Rafael Haag

Abstract:

Renewable energy sources are dependent on climatic variability, so for adequate energy planning, observations of the meteorological variables are required, preferably representing long-period series. Despite the scientific and technological advances that meteorological measurement systems have undergone in the last decades, there is still a considerable lack of meteorological observations that form series of long periods. The reanalysis is a system of assimilation of data prepared using general atmospheric circulation models, based on the combination of data collected at surface stations, ocean buoys, satellites and radiosondes, allowing the production of long period data, for a wide gamma. The third generation of reanalysis data emerged in 2010, among them is the Climate Forecast System Reanalysis (CFSR) developed by the National Centers for Environmental Prediction (NCEP), these data have a spatial resolution of 0.50 x 0.50. In order to overcome these difficulties, it aims to evaluate the performance of solar radiation estimation through alternative data bases, such as data from Reanalysis and from meteorological satellites that satisfactorily meet the absence of observations of solar radiation at global and/or regional level. The results of the analysis of the solar radiation data indicated that the reanalysis data of the CFSR model presented a good performance in relation to the observed data, with determination coefficient around 0.90. Therefore, it is concluded that these data have the potential to be used as an alternative source in locations with no seasons or long series of solar radiation, important for the evaluation of solar energy potential.

Keywords: climate, reanalysis, renewable energy, solar radiation

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4941 The Effects of Changes in Accounting Standards on Loan Loss Provisions (LLP) as Earnings Management Device: Evidence from Malaysia and Nigeria Banks (Part I)

Authors: Ugbede Onalo, Mohd Lizam, Ahmad Kaseri

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In view of dearth of studies on changes in accounting standards and banks’ earnings management particularly in the context of emerging economies, and the recent Malaysia and Nigeria change from their respective local GAAP to IFRS, this study deemed it overwhelming to investigate the effects of the switch on banks’ earnings management focusing on LLP as the manipulative device. This study employed judgmental sampling to select twenty eight banks- eight Malaysia and twenty Nigeria banks as sample covering period 2008-2013. To provide an empirical research setting in pursuant of the objective of this study, the study period is further partitioned into pre (2008, 2009, 2010) and post (2011, 2012, 2013) IFRS adoption periods. This study consistent with previous studies models a LLP regression model to investigate specific discretionary accruals of banks. Findings suggest that Malaysia and Nigeria banks individually use LLP to manage reported earnings more prior to IFRS implementation. Comparative overall results evidenced that the pre IFRS adoption or domestic GAAP era for both Malaysia and Nigeria sample banks is associated with higher prevalent earnings management through LLP than the corresponding post IFRS adoption era in diverse magnitude but in favour of Malaysia banks for both periods. With results demonstrating that IFRS adoption is linked to lower earnings management via LLP, this study therefore recommends the global adoption of IFRS as reporting framework. This study also endorses that Nigeria banks embrace and borrow a leaf from Malaysia banks good corporate governance practices.

Keywords: accounting standards, IFRS, FRS, SAS, LLP, earnings management

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4940 Shelf Life of Frozen Processed Foods for Extended Durability

Authors: Manfreda Gerardo, Pasquali Frederique, Pepe Tiziana, Anastasio Aniello, Ianieri Adriana

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The aim of the research was to evaluate the shelf life of a REPFED’s product (lasagna alla bolognese), developed as a product to be marketed fresh after defrosting. Three different samples were prepared: A, B and C, which presented differences in relation to the recipe, pasteurization technique and packaging on which the trend of the shelf-life indicator parameters was evaluated during a period of prolonged shelf life. The analytical plan involved the measurement of microbiological, chemical-physical and organoleptic parameters over 7 moments of storage selected in a period of 33 days. CBT, LAB, enterobacteria, E. coli, yeasts, molds, S. coagulase positive, B. cereus, Salmonella spp and L. monocytogenes, pH, Aw, Kreiss test, peroxides, atmosphere inside the packages, and organoleptic characteristics were determined. The results demonstrated the effect of post-packaging pasteurization on the shelf life of fresh from frozen products. However, the products pasteurized at 95°C in the absence of steam showed microbiological parameters that were not appropriate for an extended shelf life of up to 60 days. On the contrary, the samples pasteurized at 98°C with steam saturation and counterpressure showed values compatible with an extended shelf life. The results of the chemical-physical analyses highlighted how recipe and packaging affect the chemical-physical and organoleptic parameters. In conclusion, this preliminary study confirmed the effectiveness of post-packaging pasteurization treatments aimed at extending the shelf life of the product, helping the food company to occupy market niches even very distant from the production sites.

Keywords: shelf life, REPFED’s product, extended durability, pasteurization

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4939 Response Analysis of a Steel Reinforced Concrete High-Rise Building during the 2011 Tohoku Earthquake

Authors: Naohiro Nakamura, Takuya Kinoshita, Hiroshi Fukuyama

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The 2011 off The Pacific Coast of Tohoku Earthquake caused considerable damage to wide areas of eastern Japan. A large number of earthquake observation records were obtained at various places. To design more earthquake-resistant buildings and improve earthquake disaster prevention, it is necessary to utilize these data to analyze and evaluate the behavior of a building during an earthquake. This paper presents an earthquake response simulation analysis (hereafter a seismic response analysis) that was conducted using data recorded during the main earthquake (hereafter the main shock) as well as the earthquakes before and after it. The data were obtained at a high-rise steel-reinforced concrete (SRC) building in the bay area of Tokyo. We first give an overview of the building, along with the characteristics of the earthquake motion and the building during the main shock. The data indicate that there was a change in the natural period before and after the earthquake. Next, we present the results of our seismic response analysis. First, the analysis model and conditions are shown, and then, the analysis result is compared with the observational records. Using the analysis result, we then study the effect of soil-structure interaction on the response of the building. By identifying the characteristics of the building during the earthquake (i.e., the 1st natural period and the 1st damping ratio) by the Auto-Regressive eXogenous (ARX) model, we compare the analysis result with the observational records so as to evaluate the accuracy of the response analysis. In this study, a lumped-mass system SR model was used to conduct a seismic response analysis using observational data as input waves. The main results of this study are as follows: 1) The observational records of the 3/11 main shock put it between a level 1 and level 2 earthquake. The result of the ground response analysis showed that the maximum shear strain in the ground was about 0.1% and that the possibility of liquefaction occurring was low. 2) During the 3/11 main shock, the observed wave showed that the eigenperiod of the building became longer; this behavior could be generally reproduced in the response analysis. This prolonged eigenperiod was due to the nonlinearity of the superstructure, and the effect of the nonlinearity of the ground seems to have been small. 3) As for the 4/11 aftershock, a continuous analysis in which the subject seismic wave was input after the 3/11 main shock was input was conducted. The analyzed values generally corresponded well with the observed values. This means that the effect of the nonlinearity of the main shock was retained by the building. It is important to consider this when conducting the response evaluation. 4) The first period and the damping ratio during a vibration were evaluated by an ARX model. Our results show that the response analysis model in this study is generally good at estimating a change in the response of the building during a vibration.

Keywords: ARX model, response analysis, SRC building, the 2011 off the Pacific Coast of Tohoku Earthquake

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4938 The Efficiency Analysis in the Health Sector: Marmara Region

Authors: Hale Kirer Silva Lecuna, Beyza Aydin

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Health is one of the main components of human capital and sustainable development, and it is very important for economic growth. Health economics, which is an indisputable part of the science of economics, has five stages in general. These are health and development, financing of health services, economic regulation in the health, allocation of resources and efficiency of health services. A well-developed and efficient health sector plays a major role by increasing the level of development of countries. The most crucial pillars of the health sector are the hospitals that are divided into public and private. The main purpose of the hospitals is to provide more efficient services. Therefore the aim is to meet patients’ satisfaction by increasing the service quality. Health-related studies in Turkey date back to the Ottoman and Seljuk Empires. In the near past, Turkey applied 'Health Sector Transformation Programs' under different titles between 2003 and 2010. Our aim in this paper is to measure how effective these transformation programs are for the health sector, to see how much they can increase the efficiency of hospitals over the years, to see the return of investments, to make comments and suggestions on the results, and to provide a new reference for the literature. Within this framework, the public and private hospitals in Balıkesir, Bilecik, Bursa, Çanakkale, Edirne, Istanbul, Kirklareli, Kocaeli, Sakarya, Tekirdağ, Yalova will be examined by using Data Envelopment Analysis (DEA) for the years between 2000 and 2019. DEA is a linear programming-based technique, which gives relatively good results in multivariate studies. DEA basically estimates an efficiency frontier and make a comparison. Constant returns to scale and variable returns to scale are two most commonly used DEA methods. Both models are divided into two as input and output-oriented. To analyze the data, the number of personnel, number of specialist physicians, number of practitioners, number of beds, number of examinations will be used as input variables; and the number of surgeries, in-patient ratio, and crude mortality rate as output variables. 11 hospitals belonging to the Marmara region were included in the study. It is seen that these hospitals worked effectively only in 7 provinces (Balıkesir, Bilecik, Bursa, Edirne, İstanbul, Kırklareli, Yalova) for the year 2001 when no transformation program was implemented. After the transformation program was implemented, for example, in 2014 and 2016, 10 hospitals (Balıkesir, Bilecik, Bursa, Çanakkale, Edirne, İstanbul, Kocaeli, Kırklareli, Tekirdağ, Yalova) were found to be effective. In 2015, ineffective results were observed for Sakarya, Tekirdağ and Yalova. However, since these values are closer to 1 after the transformation program, we can say that the transformation program has positive effects. For Sakarya alone, no effective results have been achieved in any year. When we look at the results in general, it shows that the transformation program has a positive effect on the effectiveness of hospitals.

Keywords: data envelopment analysis, efficiency, health sector, Marmara region

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4937 Risk Factors for Postoperative Recurrence in Indian Patients with Crohn’s Disease

Authors: Choppala Pratheek, Vineet Ahuja

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Background: Crohn's disease (CD) recurrence following surgery is a common challenge, and current detection methods rely on risk factors identified in Western populations. This study aimed to investigate the risk factors and rates of postoperative CD recurrence in a tuberculosis-endemic region like India. Retrospective data was collected from a structured database from a specialty IBD clinic by reviewing case files from January 2005 to December 2021. Inclusion criteria involved CD patients diagnosed based on the ECCO-ESGAR consensus guidelines, who had undergone at least one intestinal resection and had a minimum follow-up period of one year at the IBD clinic. Results: A total of 90 patients were followed up for a median period of 45 months (IQR, 20.75 - 72.00). Out of the 90 patients, 61 received ATT prior to surgery, with a mean delay in diagnosis of 2.5 years, although statistically non-significant (P=0.078). Clinical recurrence occurred in 50% of patients, with the cumulative rate increasing from 13.3% at one year to 40% at three years. Among 63 patients who underwent endoscopy, 65.7% showed evidence of endoscopic recurrence, with the cumulative rate increasing from 31.7% at one year to 55.5% at four years. Smoking was identified as a significant risk factor for early endoscopic recurrence (P=0.001) by Cox regression analysis, but no other risk factors were identified. Initiating post-operative medications prior to clinical recurrence delayed its onset (P=0.004). Subgroup analysis indicated that endoscopic monitoring aided in the early identification of recurrence (P=0.001). The findings contribute to enhancing post-operative CD management strategies in such regions where the disease burden is escalating.

Keywords: crohns, post operative, tuberculosis-endemic, risk factors

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4936 Trends in Domestic Terms of Trade of Agricultural Sector of Pakistan

Authors: Anwar Hussain, Muhammad Iqbal

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The changes in the prices of the agriculture commodities combined with changes in population and agriculture productivity affect farmers’ profitability and standard of living. This study intends to estimate various domestic terms of trade for agriculture sector and also to assess the volatility in the standard of living and profitability of farmers. The terms of trade has been estimated for Pakistan and its provinces using producer prices indices, consumer price indices, input prices indices and quantity indices using the data for the period 1990-91 to 2008-09. The domestic terms of trade of agriculture sector has been improved in terms of both approaches i.e. the ratio of producer prices indices to consumer prices indices and the real per capita income approach. However, the cross province estimates indicated that the terms of trade also improved for Khyber Pakhtunkhwa, Sindh and Punjab while Balochistan’s domestic terms of trade deteriorated drastically. In other words the standard of living of the farmers in Pakistan and its provinces except Balochistan improved. Using the input prices, the domestic terms of trade deteriorated for Pakistan as a whole and its provinces as well. This also explores that as a whole the profitability of the farmers reduced during the study period. The farmers pay more prices for inputs as compared to they receive for their produce. This further indicates that the poverty at the gross root level has been increased. Further, summing, the standard of living of the farmers improved but their profitability reduced, which indicates that the farmers do not completely rely on the farm income but also utilize some other sources of income for their livelihood. The study supports to give subsidies on farm inputs so as to improve the profitability of the farmers.

Keywords: agricultural terms of trade, farmers’ profitability, farmers’ standard of living, consumer and producer price indices, quantity indices

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4935 Prenatal Paraben Exposure Impacts Infant Overweight Development and in vitro Adipogenesis

Authors: Beate Englich, Linda Schlittenbauer, Christiane Pfeifer, Isabel Kratochvil, Michael Borte, Gabriele I. Stangl, Martin von Bergen, Thorsten Reemtsma, Irina Lehmann, Kristin M. Junge

Abstract:

The worldwide production of endocrine disrupting compounds (EDC) has risen dramatically over the last decades, as so has the prevalence for obesity. Many EDCs are believed to contribute to this obesity epidemic, by enhancing adipogenesis or disrupting relevant metabolism. This effect is most tremendous in the early prenatal period when priming effects find a highly vulnerable time window. Therefore, we investigate the impact of parabens on childhood overweight development and adipogenesis in general. Parabens are ester of 4-hydroxy-benzoic acid and part of many cosmetic products or food packing. Therefore, ubiquitous exposure can be found in the westernized world, with exposure already starting during the sensitive prenatal period. We assessed maternal cosmetic product consumption, prenatal paraben exposure and infant BMI z-scores in the prospective German LINA cohort. In detail, maternal urinary concentrations (34 weeks of gestation) of methyl paraben (MeP), ethyl paraben (EtP), n-propyl paraben (PrP) and n-butyl paraben (BuP) were quantified using UPLC-MS/MS. Body weight and height of their children was assessed during annual clinical visits. Further, we investigated the direct influence of those parabens on adipogenesis in-vitro using a human mesenchymal stem cell (MSC) differentiation assay to mimic a prenatal exposure scenario. MSC were exposed to 0.1 – 50 µM paraben during the entire differentiation period. Differentiation outcome was monitored by impedance spectrometry, real-time PCR and triglyceride staining. We found that maternal cosmetic product consumption was highly correlated with urinary paraben concentrations at pregnancy. Further, prenatal paraben exposure was linked to higher BMI Z-scores in children. Our in-vitro analysis revealed that especially the long chained paraben BuP stimulates adipogenesis by increasing the expression of adipocyte specific genes (PPARγ, ADIPOQ, LPL, etc.) and triglyceride storage. Moreover, we found that adiponectin secretion is increased whereas leptin secretion is reduced under BuP exposure in-vitro. Further mechanistic analysis for receptor binding and activation of PPARγ and other key players in adipogenesis are currently in process. We conclude that maternal cosmetic product consumption is linked to prenatal paraben exposure of children and contributes to the development of infant overweight development by triggering key pathways of adipogenesis.

Keywords: adipogenesis, endocrine disruptors, paraben, prenatal exposure

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4934 Earthquake Resistant Sustainable Steel Green Building

Authors: Arup Saha Chaudhuri

Abstract:

Structural steel is a very ductile material with high strength carrying capacity, thus it is very useful to make earthquake resistant buildings. It is a homogeneous material also. The member section and the structural system can be made very efficient for economical design. As the steel is recyclable and reused, it is a green material. The embodied energy for the efficiently designed steel structure is less than the RC structure. For sustainable green building steel is the best material nowadays. Moreover, pre-engineered and pre-fabricated faster construction methodologies help the development work to complete within the stipulated time. In this paper, the usefulness of Eccentric Bracing Frame (EBF) in steel structure over Moment Resisting Frame (MRF) and Concentric Bracing Frame (CBF) is shown. Stability of the steel structures against horizontal forces especially in seismic condition is efficiently possible by Eccentric bracing systems with economic connection details. The EBF is pin–ended, but the beam-column joints are designed for pin ended or for full connectivity. The EBF has several desirable features for seismic resistance. In comparison with CBF system, EBF system can be designed for appropriate stiffness and drift control. The link beam is supposed to yield in shear or flexure before initiation of yielding or buckling of the bracing member in tension or compression. The behavior of a 2-D steel frame is observed under seismic loading condition in the present paper. Ductility and brittleness of the frames are compared with respect to time period of vibration and dynamic base shear. It is observed that the EBF system is better than MRF system comparing the time period of vibration and base shear participation.

Keywords: steel building, green and sustainable, earthquake resistant, EBF system

Procedia PDF Downloads 347
4933 Testing the Impact of the Nature of Services Offered on Travel Sites and Links on Traffic Generated: A Longitudinal Survey

Authors: Rania S. Hussein

Abstract:

Background: This study aims to determine the evolution of service provision by Egyptian travel sites and how these services change in terms of their level of sophistication over the period of the study which is ten years. To the author’s best knowledge, this is the first longitudinal study that focuses on an extended time frame of ten years. Additionally, the study attempts to determine the popularity of these websites through the number of links to these sites. Links maybe viewed as the equivalent of a referral or word of mouth but in an online context. Both popularity and the nature of the services provided by these websites are used to determine the traffic on these sites. In examining the nature of services provided, the website itself is viewed as an overall service offering that is composed of different travel products and services. Method: This study uses content analysis in the form of a small scale survey done on 30 Egyptian travel agents’ websites to examine whether Egyptian travel websites are static or dynamic in terms of the services that they provide and whether they provide simple or sophisticated travel services. To determine the level of sophistication of these travel sites, the nature and composition of products and services offered by these sites were first examined. A framework adapted from Kotler (1997) 'Five levels of a product' was used. The target group for this study consists of companies that do inbound tourism. Four rounds of data collection were conducted over a period of 10 years. Two rounds of data collection were made in 2004 and two rounds were made in 2014. Data from the travel agents’ sites were collected over a two weeks period in each of the four rounds. Besides collecting data on features of websites, data was also collected on the popularity of these websites through a software program called Alexa that showed the traffic rank and number of links of each site. Regression analysis was used to test the effect of links and services on websites as independent variables on traffic as the dependent variable of this study. Findings: Results indicate that as companies moved from having simple websites with basic travel information to being more interactive, the number of visitors illustrated by traffic and the popularity of those sites increase as shown by the number of links. Results also show that travel companies use the web much more for promotion rather than for distribution since most travel agents are using it basically for information provision. The results of this content analysis study taps on an unexplored area and provide useful insights for marketers on how they can generate more traffic to their websites by focusing on developing a distinctive content on these sites and also by focusing on the visibility of their sites thus enhancing the popularity or links to their sites.

Keywords: levels of a product, popularity, travel, website evolution

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4932 The Role of the Urban Renewal Projects on the Reshaping of the Cities in Izmir, Turkey

Authors: Sibel Ecemis Kilic, Neslihan Karatas

Abstract:

The concept of urban renewal came up with interventions to the urban areas which have social and economic problems aimed at gaining the city. In Turkey after 2000, urban renewal has become a frequent topic on the agenda; regulations have been developed in this regard. Urban renewal project would be a focal point for the formation of the city in the near future. The future of the city is directly related to how to achieve these applications. Urban renewal policies will be decisive in the positive or negative development of the potential of the existing renewal process. Urban renewal is seen as a refreshing new planned action for reshaping unplanned and uncontrolled growth of big cities/metropolitan areas. In this context, Izmir is one of the largest metropolitan areas which came on the agenda of urban renewal application in the recent period. Izmir, which is the third largest city of Turkey, is an important trade and port city. The city, located west of Turkey, is a gate opening to Europe. In particular, continued its development rapidly after the Republican Period, it has become an important big city today. Assessment of the current situation shows that the majority of existing residential areas was formed with squatters and unplanned settlements in Izmir city center. Therefore, an important part of these areas have significant problems in terms of the quality of life, safety, and environmental quality. Legal residential areas which have had developed before 2000 is seen inadequate security in terms of an earthquake. In this study, the central policies in Turkey and local policies in İzmir about urban renewal will be considered. In addition, urban renewal projects that are being implemented or applied in Izmir were discussed and suggestions will be developed in accordance with this policy.

Keywords: urban transformation, Izmir, urban planning, urban renewal

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4931 Differential Effects of Parity, Stress and Fluoxetine Treatment on Locomotor Activity and Swimming Behavior in Rats

Authors: Nur Hidayah Kaz Abdul Aziz, Norhalida Hashim, Zurina Hassan

Abstract:

Peripartum period is a time where women are vulnerable to depression, and stress may further increase the risk of its occurrence. Use of selective serotonin reuptake inhibitors (SSRI) in the treatment of postpartum depression is a common practice. Comparison of antidepressant treatment, however, is rarely studied between gestated and nulliparous animals exposed to stress. This study was aimed to investigate the effect of parity and stress, as well as fluoxetine (an SSRI) treatment after stress exposure on the behavior of rats. Gestating and nulliparous Sprague Dawley rats were either subjected to chronic stressors or left undisturbed throughout the gestation period. After parturition, all stressors were stopped and some of the stressed rats were treated with fluoxetine (10mg/kg). Hence, the final groups formed were: 1. Non-stressed nulliparous rats, 2. Non-stressed dams, 3. Stressed nulliparous rats, 4. Stressed dams, 5. Fluoxetine-treated stressed nulliparous rats, and 6. Fluoxetine-treated stressed dams. Rats were tested in open field test (OFT), novel object recognition test (NOR) and forced swim test (FST) after weaning of pups. Gestational stress significantly reduced the locomotor activity of rats in OFT (p<0.05), while fluoxetine significantly increased the activity in nulliparous rats (p<0.001) but not the dams. While no differences were observed in NOR, stress and parity inhibited the rats from performing swimming behavior in FST. However, climbing and immobile behaviors in FST were found to have no significant differences, although there is a tendency of effect of treatment for immobility parameter (p=0.06) where fluoxetine-treated stressed dams were being the least immobile. In conclusion, the effects of parity and stress, as well as fluoxetine treatment, depended on the type of behavioral test performed.

Keywords: stress, parity, SSRI, behavioral tests

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4930 Exploring the Changes in the Publishing of Scientific Journals in the Age of Digital Transformation as the Main Measure for Scientific Communication

Authors: Arūnas Gudinavičius

Abstract:

The historiography of scholarly journals in Eastern Europe is fragmented, and so far, the development of scholarly journals in Eastern Europe has not been studied from a publishing point of view in the context of scientific communication. There are only a few general articles on the period before World War II; also, there is hardly any systematic and publicly available information about the Soviet period and the situation of scientific communication in Eastern Europe at the end of the XX century and the beginning of the XXI century. There is a lack of research data on scholarly journals in Lithuania. The existing researches focuses mostly on the specific needs of academic institutions. The publication of scientific journals and papers is analyzed as a part of the scientific communication circle. Formal science communication from the point of view that it is the results formed in the course of communication are examined, which are necessarily characterized by long-term access to a large circle of users. Improved model of scientific communication by supplementing the dissemination of research results with formal and informal communication channels is used, according to which the scientific communication system forms the essence of science, where the social, lasting value of science and the dissemination of scientific results to scientists and the public are the most important. The model covers the science communication process from research initiation to journal publication and citation. We are focusing on the publishing and dissemination stages of the model of scientific communication. The paper is to systematize and analyze the various types of scientific journal publishers from 1907 until 2020 as a means of formal documentary communication in the context of all scientific communication. The research analyses the case of a small European country and presents chronological and geographical characteristics of the publication of scientific periodicals, analyzes the publishers of scientific periodicals and their activities, publishing formats, and dissemination methods.

Keywords: scientific communication, scientific periodicals, scientific journals, publishing

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4929 Evaluation of the Urban Landscape Structures and Dynamics of Hawassa City, Using Satellite Images and Spatial Metrics Approaches, Ethiopia

Authors: Berhanu Terfa, Nengcheng C.

Abstract:

The study deals with the analysis of urban expansion and land transformation of Hawass City using remote sensing data and landscape metrics during last three decades (1987–2017). Remote sensing data from Various multi-temporal satellite images viz., TM (1987), TM (1995), ETM+ (2005) and OLI (2017) were used to examine the urban expansion, growth types, and spatial isolation within the urban landscape to develop an understanding the trends of built-up growth in Hawassa City, Ethiopia. Landscape metrics and built-up density were employed to analyze the pattern, process and overall growth status. The area under investigation was divided into concentric circles with a consecutive circle of 1 km incremental radius from the central pixel (Central Business District) for analysis. The result exhibited that the built-up area had increased by 541.32% between 1987 and 2017and an extension growth types (more than 67 %) was observed. The major growth took place in north-west direction followed by north direction in haphazard manner during 1987–1995 period, whereas predominant built-up development was observed in south and southwest direction during 1995–2017 period. Land scape metrics result revealed that the of urban patches density, total edge and edge density increased, while mean nearest neighbors’ distance decreased showing the tendency of sprawl.

Keywords: landscape metrics, spatial patterns, remote sensing, multi-temporal, urban sprawl

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4928 Means of Securing Graves in the Egyptian Kingdom Era

Authors: Mohamed Saeed Ahmed Salman

Abstract:

This research aims to study the means of securing graves in the Egyptian kingdom era, and revolves around many basic ideas used by the ancient Egyptian to protect his graves from thieves, which included architectural characteristics, which gave it importance only others. The most important of which was the choice of the place of the grave, which chose a kohl place in the desert to protect the graves, which is the valley of kings, and whether the choice of that place had an impact in protecting the grave or not, in addition to other elements followed in the architectural planning, which was in the valley of kings. The multiplicity of the tomb, the construction of the well chamber to deceive the thieves by the end of the graves suddenly, the construction of the wells of the tombs, which contained the burial chamber at the bottom of the main well and the effect of all these factors on the graves, and this shows the importance of the graves to the ancient Egyptian and his belief in resurrection and immortality. The Egyptian resorted to the elements of protection and was a religious worker by The protector gods and special texts to protect the deceased from any danger to protect the tomb. As for the human factor of securing the tomb through human guards (police) and security teams based on the guard and the words indicating the protection and the guard teams and the teams of the majai. The most important developments that arose on the cemetery from Tamit entrance, corridors, chambers, burial chamber and coffin, and the use of sand to close the well after from one cemetery to another and from time to time where it was built in the late period inside the temple campus to be under the attention of the priests and their protection, as the study dealt with an analytical study For the means of securing graves in the Egyptian kingdom period.

Keywords: Egyptian kingdom, ancient Egyptian, securing graves, Means of securing graves, Egypt, archaeology

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4927 Developments in corporate governance and economic growth in Sub Saharan Africa

Authors: Martha Matashu

Abstract:

This study examined corporate governance and economic growth trends in Sub Saharan African (SSA) countries. The need for corporate governance arise from the fact that the day to day running of the business is done by management who in accordance with the neoclassical theory and agency theory have inborn tendencies to use the resources of the company to their advantage. This prevails against a background where the endogenous economic growth theory hold the assumption that economic growth is an outcome of the overall performance of all companies within an economy. This suggest that corporate governance at firm level determine economic growth through its impact on the overall performance. Nevertheless, insight into literature suggest that efforts to promote corporate governance in countries across SSA since the 1980s to date have not yet yielded desired outcomes. The board responsibilities, shareholder rights, disclosure and transparency, protection of minority shareholder, and liability of directors were thus used as proxies of corporate governance because these are believed to be mechanisms that are believed to enhance company performance their effect on enhancing accountability and transparency. Using panel data techniques, corporate governance and economic growth data for 29 SSA countries from the period of 2008 to 2019 was analysed. The findings revealed declining economic growth trend despite an increase in corporate governance aspects such as director liability, shareholders’ rights, and protection of minority shareholder in SSA countries. These findings are in contradiction to the popularly held theoretical principles of economic growth and corporate governance. The study reached the conclusion thata nonlinearrelationship exists between corporate governance and economic growth within the selectedSSA countries during the period under investigation. This study thus recommends that measures should be taken to create conditions for corporate governance that would bolster significant positive contributions to economic growth in the region.

Keywords: corporate governance, economic growth, sub saharan Africa, agency theory, endogenous theory

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4926 Views from Shores Past: Palaeogeographic Reconstructions as an Aid for Interpreting the Movement of Early Modern Humans on and between the Islands of Wallacea

Authors: S. Kealy, J. Louys, S. O’Connor

Abstract:

The island archipelago that stretches between the continents of Sunda (Southeast Asia) and Sahul (Australia - New Guinea) and comprising much of modern-day Indonesia as well as Timor-Leste, represents the biogeographic region of Wallacea. The islands of Wallaea are significant archaeologically as they have never been connected to the mainlands of either Sunda or Sahul, and thus the colonization by early modern humans of these islands and subsequently Australia and New Guinea, would have necessitated some form of water crossings. Accurate palaeogeographic reconstructions of the Wallacean Archipelago for this time are important not only for modeling likely routes of colonization but also for reconstructing likely landscapes and hence resources available to the first colonists. Here we present five digital reconstructions of coastal outlines of Wallacea and Sahul (Australia and New Guinea) for the periods 65, 60, 55, 50, and 45,000 years ago using the latest bathometric chart and a sea-level model that is adjusted to account for the average uplift rate known from Wallacea. This data was also used to reconstructed island areal extent as well as topography for each time period. These reconstructions allowed us to determine the distance from the coast and relative elevation of the earliest archaeological sites for each island where such records exist. This enabled us to approximate how much effort exploitation of coastal resources would have taken for early colonists, and how important such resources were. These reconstructions also allowed us to estimate visibility for each island in the archipelago, and to model how intervisible each island was during the period of likely human colonisation. We demonstrate how these models provide archaeologists with an important basis for visualising this ancient landscape and interpreting how it was originally viewed, traversed and exploited by its earliest modern human inhabitants.

Keywords: Wallacea, palaeogeographic reconstructions, islands, intervisibility

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4925 Evaluation Demografical Factors for Suicide Attempts among Hazrat Abolfazl Hospital of Minab City during 1389-1390 Years

Authors: Zahra khaksari, Mahboobeh Mehrabi

Abstract:

One of the biggest health problems in communities, suicide is now one of the top ten causes of death in the world. This study aimed to investigate the risk factors of suicide attempt in Minab city over two years. This was a descriptive and cross-sectional study. Subjects of this study were cases who admitted in Hazrat Abolfazl hospital of minab city over two years Since the beginning of 1389 to end of 1390. During this period,their cases were reviewed. To analyze data, descriptive statistics was applied. During this two-year period, 275 patients who had attempted suicide, of which 65 percent are female and most of them were 15-24 years. 60% of them were single and 70 % of rural areas. 51% of suicides in 1390 and most of the suicide attempts occurred at a rate of 37 percent in summer. and the most common way of attempting suicide was medication poisoning (74%). The suicide rate leading to death was 1.5% The chi-square test showes that there were significant relationship between suicide by gender and residence status. This means that more women are committing suicide of rural areas.based on The chi-square test there were significant relation between the gender and method, gender and the result of suicide and means that more women than men commit suicide with the use of drugs. Males were more successful suicide. who had attempted with organophosphates and hanging were more successful in suicide. The finding of the current study showed that most of the suicide victims were female ,rural deweller,14-24 years old,single, serious attention must be paid to the problems of this group. It also extends the field of education professionals and health centers, and psychological therapy that focuses specifically on this topic.

Keywords: attempt to suicide, minab, risk factors, suicide

Procedia PDF Downloads 354
4924 Biochar - A Multi-Beneficial and Cost-Effective Amendment to Clay Soil for Stormwater Runoff Treatment

Authors: Mohammad Khalid, Mariya Munir, Jacelyn Rice Boyaue

Abstract:

Highways are considered a major source of pollution to storm-water, and its runoff can introduce various contaminants, including nutrients, Indicator bacteria, heavy metals, chloride, and phosphorus compounds, which can have negative impacts on receiving waters. This study assessed the ability of biochar for contaminants removal and to improve the water holding capacity of soil biochar mixture. For this, ten commercially available biochar has been strategically selected. Lab scale batch testing was done at 3% and 6% by the weight of the soil to find the preliminary estimate of contaminants removal along with hydraulic conductivity and water retention capacity. Furthermore, from the above-conducted studies, six best performing candidate and an application rate of 6% has been selected for the column studies. Soil biochar mixture was filled in 7.62 cm assembled columns up to a fixed height of 76.2 cm based on hydraulic conductivity. A total of eight column experiments have been conducted for nutrient, heavy metal, and indicator bacteria analysis over a period of one year, which includes a drying as well as a deicing period. The saturated hydraulic conductivity was greatly improved, which is attributed to the high porosity of the biochar soil mixture. Initial data from the column testing shows that biochar may have the ability to significantly remove nutrients, indicator bacteria, and heavy metals. The overall study demonstrates that biochar could be efficiently applied with clay soil to improve the soil's hydraulic characteristics as well as remove the pollutants from the stormwater runoff.

Keywords: biochar, nutrients, indicator bacteria, storm-water treatment, sustainability

Procedia PDF Downloads 119
4923 Health Reforms in Central and Eastern European Countries: Results, Dynamics, and Outcomes Measure

Authors: Piotr Romaniuk, Krzysztof Kaczmarek, Adam Szromek

Abstract:

Background: A number of approaches to assess the performance of health system have been proposed so far. Nonetheless, they lack a consensus regarding the key components of assessment procedure and criteria of evaluation. The WHO and OECD have developed methods of assessing health system to counteract the underlying issues, but they are not free of controversies and did not manage to produce a commonly accepted consensus. The aim of the study: On the basis of WHO and OECD approaches we decided to develop own methodology to assess the performance of health systems in Central and Eastern European countries. We have applied the method to compare the effects of health systems reforms in 20 countries of the region, in order to evaluate the dynamic of changes in terms of health system outcomes.Methods: Data was collected from a 25-year time period after the fall of communism, subsetted into different post-reform stages. Datasets collected from individual countries underwent one-, two- or multi-dimensional statistical analyses, and the Synthetic Measure of health system Outcomes (SMO) was calculated, on the basis of the method of zeroed unitarization. A map of dynamics of changes over time across the region was constructed. Results: When making a comparative analysis of the tested group in terms of the average SMO value throughout the analyzed period, we noticed some differences, although the gaps between individual countries were small. The countries with the highest SMO were the Czech Republic, Estonia, Poland, Hungary and Slovenia, while the lowest was in Ukraine, Russia, Moldova, Georgia, Albania, and Armenia. Countries differ in terms of the range of SMO value changes throughout the analyzed period. The dynamics of change is high in the case of Estonia and Latvia, moderate in the case of Poland, Hungary, Czech Republic, Croatia, Russia and Moldova, and small when it comes to Belarus, Ukraine, Macedonia, Lithuania, and Georgia. This information reveals fluctuation dynamics of the measured value in time, yet it does not necessarily mean that in such a dynamic range an improvement appears in a given country. In reality, some of the countries moved from on the scale with different effects. Albania decreased the level of health system outcomes while Armenia and Georgia made progress, but lost distance to leaders in the region. On the other hand, Latvia and Estonia showed the most dynamic progress in improving the outcomes. Conclusions: Countries that have decided to implement comprehensive health reform have achieved a positive result in terms of further improvements in health system efficiency levels. Besides, a higher level of efficiency during the initial transition period generally positively determined the subsequent value of the efficiency index value, but not the dynamics of change. The paths of health system outcomes improvement are highly diverse between different countries. The instrument we propose constitutes a useful tool to evaluate the effectiveness of reform processes in post-communist countries, but more studies are needed to identify factors that may determine results obtained by individual countries, as well as to eliminate the limitations of methodology we applied.

Keywords: health system outcomes, health reforms, health system assessment, health system evaluation

Procedia PDF Downloads 289