Search results for: out of pocket expenditure

Authors: Sara D. Garduno-Diaz, Philippe Y. Garduno-Diaz

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To date, one of the few comprehensive indicators for the measurement of food security is the Global Food Security Index. This index is a dynamic quantitative and qualitative bench marking model, constructed from 28 unique indicators, that measures drivers of food security across both developing and developed countries. Whereas the Global Food Security Index has been calculated across a set of 109 countries, in this paper we aim to present and compare, for the Middle East and North Africa (MENA), 1) the Food Security Index scores achieved and 2) the data available on affordability, availability, and quality of food. The data for this work was taken from the latest (2014) report published by the creators of the GFSI, which in turn used information from national and international statistical sources. According to the 2014 Global Food Security Index, MENA countries rank from place 17/109 (Israel, although with resent political turmoil this is likely to have changed) to place 91/109 (Yemen) with household expenditure spent in food ranging from 15.5% (Israel) to 60% (Egypt). Lower spending on food as a share of household consumption in most countries and better food safety net programs in the MENA have contributed to a notable increase in food affordability. The region has also however experienced a decline in food availability, owing to more limited food supplies and higher volatility of agricultural production. In terms of food quality and safety the MENA has the top ranking country (Israel). The most frequent challenges faced by the countries of the MENA include public expenditure on agricultural research and development as well as volatility of agricultural production. Food security is a complex phenomenon that interacts with many other indicators of a country’s well-being; in the MENA it is slowly but markedly improving.

Keywords: diet, food insecurity, global food security index, nutrition, sustainability

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Authors: Ahmed Ghachem, Johann Colomba, Denis Prud'homme, Martin Brochu

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Background: Inactive obese postmenopausal women, are at greater risk for metabolic complications. On the other hand, high levels of cardiorespiratory fitness (CRF) are associated with a lower risk of metabolic complications. Objective: To compare inactive obese postmenopausal women displaying ‘lower’ vs ‘higher’ levels of CRF for body composition, metabolic profile, inflammatory profile and measures of energy expenditure. Methods: 132 women (age: 57.6 ± 4.8 yrs; BMI: 32.3 ± 4.6 kg/m2; Peak VO2: 17.81 ± 3.02 ml O2•kg-1•min-1) were studied. They were first divided into tertiles based on their CRF. Then, women in the first (< 16.51 ml O2•min-1•kg-1) and second tertiles (16.51 to 19.22 ml O2•min-1•kg-1) were combined (N= 88), and compared with those in the third tertile (> 19.22 ml O2•min-1•kg-1) (N= 44). Variables of interest were: Peak VO2 (stationary bike), body composition (DXA), body fat distribution (CT scan), glucose homeostasis (fasting state and euglycemic/ hyperinsulinemic clamp), fasting lipids, resting blood pressure, inflammatory profile and energy expenditure (DLW). Results: Both CRF groups (lower= 16.0 ± 2.0 ml O2•kg-1•min-1 vs higher= 21.2 ± 1.7 ml O2•kg-1•min-1; p < 0.001) were similar for age. Significant differences were observed between groups for body composition; with lower values for body weight, BMI, fat mass and visceral fat in women with higher CRF (p between 0.001 and 0.005). Also, women with higher CRF had lower values for fasting insulin (13.4 ± 4.5 vs 15.6 ± 6.6 μU/ml; p = 0.03) and CRP levels (2.31 ± 1.97 vs 3.83 ± 3.24 mg/liter; p = 0.001); and higher values for glucose disposal (6.71 ± 1.78 vs 5.92 ± 1.67 mg/kg/min; p = 0.01). However, these differences were no longer significant after controlling for visceral adipose tissue accumulations. Finally, no significant difference was observed between groups for the other variables of interest. Conclusion: Our results suggest that, among inactive overweight/obese postmenopausal women, those with higher CRF levels have a better metabolic profile; which is caused by lower visceral fat accumulations.

Keywords: cardiorespiratory fitness, metabolic profile, menopause, obesity

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Authors: Hsiang-Ru Lin

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Cholesterol plays an essential role in the regulation of the progression of numerous important diseases including atherosclerosis and Alzheimer disease so the generation of suitable cholesterol-lowering reagents is urgent to develop. Liver X receptor (LXR) is a ligand-activated transcription factor whose natural ligands are cholesterols, oxysterols and glucose. Once being activated, LXR can transactivate the transcription action of various genes including CYP7A1, ABCA1, and SREBP1c, involved in the lipid metabolism, glucose metabolism and inflammatory pathway. Essentially, the upregulation of ABCA1 facilitates cholesterol efflux from the cells and attenuates the production of beta-amyloid (ABeta) 42 in brain so LXR is a promising target to develop the cholesterol-lowering reagents and preventative treatment of Alzheimer disease. Engelhardia roxburghiana is a deciduous tree growing in India, China, and Taiwan. However, its chemical composition is only reported to exhibit antitubercular and anti-inflammatory effects. In this study, four compounds, engelheptanoxides A, C, engelhardiol A, and B isolated from the root of Engelhardia roxburghiana were evaluated for their agonistic activity against LXR by the transient transfection reporter assays in the HepG2 cells. Furthermore, their interactive modes with LXR ligand binding pocket were generated by molecular modeling programs. By using the cell-based biological assays, engelheptanoxides A, C, engelhardiol A, and B showing no cytotoxic effect against the proliferation of HepG2 cells, exerted obvious LXR agonistic effects with similar activity as T0901317, a novel synthetic LXR agonist. Further modeling studies including docking and SAR (structure-activity relationship) showed that these compounds can locate in LXR ligand binding pocket in the similar manner as T0901317. Thus, LXR is one of nuclear receptors targeted by pharmaceutical industry for developing treatments of Alzheimer and atherosclerosis diseases. Importantly, the cell-based assays, together with molecular modeling studies suggesting a plausible binding mode, demonstrate that engelheptanoxides A, C, engelhardiol A, and B function as LXR agonists. This is the first report to demonstrate that the extract of Engelhardia roxburghiana contains LXR agonists. As such, these active components of Engelhardia roxburghiana or subsequent analogs may show important therapeutic effects through selective modulation of the LXR pathway.

Keywords: Liver X receptor (LXR), Engelhardia roxburghiana, CYP7A1, ABCA1, SREBP1c, HepG2 cells

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Authors: Arbolino Roberta, Boffardi Raffaele

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Achieving the highest effectiveness for the National Plans for Recovery and Resilience (NPRR) while strengthening the objectives of cohesion and reduction of intra-EU unbalances is only possible by means of strategic, coordinated, and coherent policy planning. Therefore, the present research aims at assessing and quantifying the potential impact of NPRRs across the twenty-seven European Member States in terms of economic convergence, considering disaggregated data on industrial, construction, and service sectors. The first step of the research involves a performance analysis of the main macroeconomic indicators describing the trends of twenty-seven EU economies before the pandemic outbreak. Subsequently, in order to define the potential effect of the resources allocated, we perform an impact analysis of previous similar EU investment policies, estimating national-level sectoral elasticity associated with the expenditure of the 2007-2013 and 2014-2020 Cohesion programmes funds. These coefficients are then exploited to construct adjustment scenarios. Finally, convergence analysis is performed on the data used for constructing scenarios in order to understand whether the expenditure of funds might be useful to foster economic convergence besides driving recovery. The results of our analysis show that the allocation of resources largely mirrors the aims of the policy framework underlying the NPRR, thus reporting the largest investments in both those sectors most affected by the economic shock (services) and those considered fundamental for the digital and green transition. Notwithstanding an overall positive effect, large differences exist among European countries, while no convergence process seems to be activated or fostered by these interventions.

Keywords: NPRR, policy evaluation, cohesion policy, scenario Nalsysi

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Authors: A. Zare Javid, H. Babaee, E. Ashrafzadeh, H. Yousefimanesh, M. Zakerkish, K. Ahmadi Angali, M. Ravanbakhsh

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Introduction: Type 2 diabetes mellitus and periodontal disease hold a physiologically relationship. Periodontal disease, a common widespread chronic disease, is considered as an important complication in diabetes mellitus. The prevalence and severity of periodontal disease are increased among diabetic patients. A balanced nutrition may improve either diabetes or periodontal disease by controlling one of them. The aim of this study was to evaluate the effects of cranberry juice enriched with n-3 PUFA and their individual consumption on glycemic control and antioxidant status in diabetic patients with periodontal disease. Methods: In this randomized clinical trial 41 diabetic patients (35 – 65 y) with chronic adult periodontal disease were recruited from Endocrinology Clinic of Golestan Hospital in Ahvaz city, Iran. Subjects were randomly assigned to four groups as follow: one control group (n=12) and three intervention groups as receiving 1 g n-3 PUFA capsule (n=10), 400 ml cranberry juice (n=9), 400 ml cranberry juice enriched with 1g n-3 PUFA (n=10) for 8 weeks. Non-surgical periodontal therapy was provided for all patients during study. Fasting blood glucose, glycated hemoglobin, plasma and saliva TAOC and MDA, pocket depth and bleeding on probing were measured at baseline and post intervention. Results: There was a significant reduction in glycated hemoglobin observed in intervention groups of receiving n-3 PUFA and cranberry enriched with n-3 PUFA (11 %, P = 0.01 and 7 %, P = 0.01, respectively). The intervention group receiving n-3 PUFA had significantly lower glycated hemoglobin compared with control group. There was no significant difference found in FBS between and within groups. Furthermore, there was a significant increase in plasma TAOC only in cranberry enriched with n-3 PUFA group. Moreover, plasma MDA significantly decreased in intervention groups of receiving cranberry and cranberry enriched with n-3 PUFA. A significant increase was observed in TAOC of salvia in cranberry enriched with n-3 PUFA group compared to control group .The intervention group receiving cranberry enriched with n-3 PUFA had significantly lower MDA of salvia compared with control group. Pocket depth were significantly decreased in all groups, however, bleeding on probing didn’t significantly changed in patients post intervention. Conclusion: It is suggested that consumption of cranberry juice enriched with n-3 PUFA as a nutritional approach in adjunct with non-surgical periodontal therapy may help to improve glycosylated hemogolobin and TAOC in salvia and plasma in diabetic patients with periodontal disease.

Keywords: antioxidant, cranberry, oxidant status, periodontal disease, type 2 diabetes mellitus

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Authors: Wint Wint Thu, Htet Ko Ko Win, Myat Mon San, Zaw Lin Tun, Nandar Than Aye, Khin Nyein Myat, Hayman Nyo Oo, Nay Aung Lin, Kusum Thapa, Kyaw Htet Aung

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Background: In Myanmar, the intense political instability happened to start in Feb-2021, while the COVID-19 pandemic waves are also threatening the public health system, which subsequently led to severe health sector crisis, including difficulties in accessing maternal and newborn health care for vulnerable women and children. The Remote Pregnant and Newborn Care (RPNC) uses a telehealth approach United States Agency for International Development (USAID)-funded Essential Health Project. Implementation: The Remote Pregnant and Newborn Care (RPNC) service has adapted to the MNCH needs of vulnerable pregnant women and was implemented to mitigate the risk of limited access to essential quality MNH care in Yangon, Myanmar, under women, and the project trained 13 service providers on a telehealth care package for pregnancy and newborn developed Jhpiego to ensure understanding of evidence-based MNCH care practices. The phone numbers of the pregnant women were gathered through the preexisting and functioning community volunteers, who reach the most vulnerable pregnant women in the project's targeted area. A total of 212 pregnant women have been reached by service providers for RPNC during the implementation period. The trained service providers offer quality antenatal and postnatal care, including newborn care, via telephone calls. It includes 24/7 incoming calls and time-allotted outgoing calls to the pregnant women during antenatal and postnatal periods, including the newborn care. The required data were collected daily in time with the calls, and the quality of the medical services is made assured with the track of the calls, ensuring data privacy and patient confidentiality. Lessons learned: The key lessons are 1) cost-effectiveness: RPNC service could reduce out of pocket expenditure of pregnant women as it only costs 1.6 United States dollars (USD) per one telehealth call while it costs 8 to 10 USD per one time in-person care service at private service providers, including transportation cost, 2) network of care: telehealth call could not replace the in-person antenatal and postnatal care services, and integration of telehealth calls with in-person care by local healthcare providers with the support of the community is crucial for accessibility to essential MNH services by poor and vulnerable women, and 3) sharing information on health access points: most of the women seem to have financial barriers in accessing private health facilities while public health system collapse and telehealthcare could provide information on low-cost facilities and connect women to relevant health facilities. These key lessons are important for future efforts regarding the implementation of remote pregnancy and newborn care in Myanmar, especially during the political crisis and COVID-19 pandemic situation.

Keywords: telehealth, accessibility, maternal care, newborn care

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Authors: Fabiha Tanzeem

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BACKGROUND: Osteoporosis is a skeletal disease that is associated with a reduction in bone mass and microstructures of the bone and deterioration of bone tissue. Fragility fracture due to osteoporosis is the most significant complication of osteoporosis. The increasing prevalence of fragility fractures presents a growing burden on the global economy. There is a rapidly evolving need to improve awareness of the costs associated with these types of fractures and to review current policies and practices for the prevention and management of the disease. This systematic review will identify and describe the direct and indirect costs associated with osteoporotic fragility fractures from a global perspective from the included studies. The review will also find out whether the costs required for the treatment of fragility fractures due to osteoporosis impose an economic burden on the global healthcare system. METHODS: Four major databases were systematically searched for direct and indirect costs of osteoporotic fragility fracture studies in the English Language. PubMed, Cochrane Library, Embase and Google Scholar were searched for suitable articles published between 1990 and July 2020. RESULTS: The original search yielded 1166 papers; from these, 27 articles were selected for this review according to the inclusion and exclusion criteria. In the 27 studies, the highest direct costs were associated with the treatment of pelvic fractures, with the majority of the expenditure due to hospitalization and surgical treatments. It is also observed that most of the articles are from developed countries. CONCLUSION: This review indicates the significance of the economic burden of osteoporosis globally, although more research needs to be done in developing countries. In the treatment of fragility fractures, direct costs were the main reported expenditure in this review. The healthcare costs incurred globally can be significantly reduced by implementing measures to effectively prevent the disease. Raising awareness in children and adults by improving the quality of the information available and standardising policies and planning of services requires further research.

Keywords: systematic review, osteoporosis, cost of illness

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Authors: A. N. Moulai Khatir

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SOI-Multifin-FETs are placed to be the workhorse of the industry for the coming few generations, and thus, in a few years because their excellent transistor characteristics, ideal sub-threshold swing, low drain induced barrier lowering (DIBL) without pocket implantation, and negligible body bias dependency. The corner effect may also exist in the two lower corners; this effect is called the BOX effect, which can also occur in the direction X-Z. The electric field lines from the source and drain cross the bottom oxide and arrive in the silicon. This effect is also called DIVSB (Drain Induced Virtual Substrate Basing). The potential in the silicon film in particular near the drain is increased by the drain bias. It is similar to DIBL and result in a decrease of the threshold voltage. This work provides an understanding of the limitation of this effect by reducing the fin width for components with increased fin number.

Keywords: SOI, finFET, corner effect, dual-gate, tri-gate, BOX, multi-finFET

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Authors: Levan Tsulukidze

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The paper considers debris flow phenomena and forecasting of them in the corridor of ‘TRACECA’ on the example of river Naokhrevistkali, as well as the debris flow -type channel passing between the villages of Vale-2 and Naokhrevi. As a result of expeditionary and reconnaissance investigations, as well as using empiric dependencies, the debris flow expenditure has been estimated in case of different debris flow provisions.

Keywords: debris flow, Traceca corridor, forecasting, river Naokhrevistkali

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Authors: Callistus I. Iheme, Kenneth E. Asika, Emmanuel I. Ugwor, Chukwuka U. Ogbonna, Ugonna H. Uzoka, Nneamaka A. Chiegboka, Chinwe S. Alisi, Obinna S. Nwabueze, Amanda U. Ezirim, Judeanthony N. Ogbulie

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Antimicrobial resistance (AMR) is a major threat to the global health sector. Zinc oxide nanocomposites (ZnONCs), composed of zinc oxide nanoparticles and phytochemicals from Azadirachta indica aqueous leaf extract, were assessed for their physico-chemicals, in silico and in vitro antimicrobial properties on multidrug-resistant Escherichia coli enzymes. Gas chromatography coupled with mass spectroscope (GC-MS) analysis on the ZnONCs revealed the presence of twenty volatile phytochemical compounds, among which is scoparone. Characterization of the ZnONCs was done using ultraviolet-visible spectroscopy (UV-vis), energy dispersive spectroscopy (EDX), transmission electron microscopy (TEM), scanning electron microscopy (SEM), and x-ray diffractometer (XRD). Dehydrogenase enzyme converts colorless 2,3,5-triphenyltetrazolium chloride to the red triphenyl formazan (TPF). The rate of formazan formation in the presence of ZnONCs is proportional to the enzyme activities. The color formation is extracted and determined at 500 nm, and the percentage of enzyme activity is calculated. To determine the bioactive components of the ZnONCs, characterize their binding to enzymes, and evaluate the enzyme-ligand complex stability, respectively Discrete Fourier Transform (DFT) analysis, docking, and molecular dynamics simulations will be employed. The results showed arrays of ZnONCs nanorods with maximal absorption wavelengths of 320 nm and 350 nm and thermally stable at the temperature range of 423.77 to 889.69 ℃. In vitro study assessed the dehydrogenase inhibitory properties of the ZnONCs, conjugate of ZnONCs and ampicillin (ZnONCs-amp), the aqueous leaf extract of A. indica, and ampicillin (standard drug). The findings revealed that at the concentration of 500 μm/mL, 57.89 % of the enzyme activities were inhibited by ZnONCs compared to 33.33% and 21.05% of the standard drug (Ampicillin), and the aqueous leaf extract of the A. indica respectively. The inhibition of the enzyme activities by the ZnONCs at 500 μm/mL was further enhanced to 89.74 % by conjugating with Ampicillin. In silico study on the ZnONCs revealed scoparone as the most viable competitor of nicotinamide adenine dinucleotide (NAD⁺) for the coenzyme binding pocket on E. coli malate and histidinol dehydrogenase. From the findings, it can be concluded that the scoparone components of the nanocomposites in synergy with the zinc oxide nanoparticles inhibited E. coli malate and histidinol dehydrogenase by competitively binding to the NAD⁺ pocket and that the conjugation of the ZnONCs with ampicillin further enhanced the antimicrobial efficiency of the nanocomposite against multidrug resistant E. coli.

Keywords: antimicrobial resistance, dehydrogenase activities, E. coli, zinc oxide nanocomposites

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Authors: Joseph Bostick

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A method of decreasing the heating load of HVAC systems in a single-dwelling model of a multifamily building, by controlling movable insulation through the optimization of flux, time, surface incident solar radiation, and temperature thresholds. Simulations are completed using a co-simulation between EnergyPlus and MATLAB as an optimization tool to find optimal control thresholds. Optimization of the control thresholds leads to a significant decrease in total heating energy expenditure.

Keywords: energy plus, MATLAB, simulation, energy efficiency

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Authors: Lawong Damian Bernsah

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Neglected Tropical Diseases (NTDs) are most predominant among the poor and rural populations and are endemic in 149 countries. These diseases are the most prevalent and responsible for infecting 1.4 billion people worldwide. There are 17 neglected tropical diseases recognized by WHO that constitute the fourth largest disease health and economic burden of all communicable diseases. Five of these 17 diseases are considered for the cost analysis of this paper: lymphatic filariasis, onchocerciasis, trachoma, schistosomiasis, and soil transmitted helminth infections. WHO has proposed a roadmap for eradication and elimination by 2020 and treatments have been donated through the London Declaration by pharmaceutical manufacturers. The paper estimates the cost of NTD control programme and elimination for each NTD disease and total in Nigeria. This is necessary as it forms the bases upon which programme budget and expenditure could be based. Again, given the opportunity cost the resources for NTD face it is necessary to estimate the cost so as to provide bases for comparison. Cost of NTDs control and elimination programme is estimated using the population at risk for each NTD diseases and for the total. The population at risk is gotten from the national master plan for the 2015 - 2020, while the cost per person was gotten for similar studies conducted in similar settings and ranges from US$0.1 to US$0.5 for Mass Administration of Medicine (MAM) and between US$1 to US$1.5 for each NTD disease. The combined cost for all the NTDs was estimated to be US$634.88 million for the period 2015-2020 and US$1.9 billion for each NTD disease for the same period. For the purpose of sensitivity analysis and for robustness of the analysis the cost per person was varied and all were still high. Given that health expenditure for Nigeria (% of GDP) averages 3.5% for the period 1995-2014, it is very clear that efforts have to be made to improve allocation to the health sector in general which is hoped could trickle to NTDs control and elimination. Thus, the government and the donor partners would need to step-up budgetary allocation and also to be aware of the costs of NTD control and elimination programme since they have alternative uses. Key Words: Neglected Tropical Disease, Cost Analysis, NTD Programme Control and Elimination, Cost per Person

Keywords: Neglected Tropical Disease, Cost Analysis, Neglected Tropical Disease Programme Control and Elimination, Cost per Person

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Authors: Baikunthanath Sahoo, Santosh Kumar Sahu, Krishna Malakar

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With the essence of global environmental sustainability and green business management, the wind of business research moved towards Corporate Social Responsibility. In addition to international and national treaties, businesses have also started realising environmental protection and energy efficiency through CSR as part of business strategy in response to climate change. Considering the ambitious emission reduction target and rapid economic development of India, this study is an attempt to explore the effect of CSR on the energy efficiency management of manufacturing firms in India. By using firm-level data, the panel fixed effect model shows that the CSR dummy variable is negatively influencing the energy intensity or technically, they are energy efficient. The result demonstrates that in the presence of CSR, all the production economic variables are significant. The result also shows that doing environmental expenditure does not improve energy efficiency might be because very few firms are motivated to do such expenditure and also not common to all sectors. The interactive effect model result conforms that without considering CSR dummy as an intervening variable only Manufacturers of Chemical and Chemical products, Manufacturers of Pharmaceutical, medical chemical, and botanical products firms energy intensity low but after considering CSR in their business practices all six sub-sector firms become energy efficient. The empirical result also validate that firms are continuously engaged in CSR activities they are highly energy efficient. It is an important motivational factor for firms to become economically and environmentally sustainable in the corporate world. This analysis would help business practitioners to know how to manage today’s profitability and tomorrow’s sustainability to achieve a comparative advantage in the emerging market economy. The paper concludes that reducing energy consumption as part of their social responsibility to care for the environment, will need collaborative efforts of business society and policy bodies.

Keywords: CSR, Energy Efficiency, Indian manufacturing Sector, Business strategy

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Authors: Mohammed Sani Abdulai

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Public sector budgeting, all over the world, is underpinned by some universally accepted principles of sound budget management such as budget unity, universality, annuality, and a balanced budget. These traditional principles, though fundamental, had, in recent years, been augmented by the more modern principles of budgeting within fiscal objective, alignment with medium-term strategic plans as well as the observance of such related concepts as transparency, openness and accessibility. In this paper, we have endeavored to shed light, from literature and practice, on the meaning and purposes of such fundamental budgeting principles. We have also assessed the extent to which the Government of Ghana’s budget complies with the four traditional principles of budget unity, universality, annuality, and a balanced budget and the three out of the ten modern principles of budgetary governance of Organisation for Economic Co-operation and Development (OECD). We did so by using a qualitative method of review and analysis of existing documents and the performance assessment reports on Ghana’s Public Financial Management (PFM) measured using such frameworks as the Public Expenditure and Financial Accountability (PEFA), the Open Budget Survey (OBS) and its Index (OBI), the reports and action plans of Open Government Partnership (OGP) and the Global Initiative for Fiscal Transparency (GIFT). Other performance assessment reports that were relied on included, but not limited to, the Joint Evaluation Report of PFM in Ghana, 2001-2010, and the Joint Evaluation of Budget Support to Ghana, 2005-2015. We have, through this paper, brought to the fore the lessons that could be learned on how those budgetary principles undergird the Government of Ghana’s budget formulation, execution, accounting, control, and oversight. These lessons include, but are not limited to, the need for both scholars and practitioners in the PFM space to be aware of the impact of those principles on public sector budgeting.

Keywords: annulaity, balanced budget, budget unity, budgetary principles, OECD’s principles on budgetary governance, open budget index, public expenditure and financial accountability, universality

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Authors: Naqvi Shraddha Rathi

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During the aging process, physical frailty may develop. A more sedentary lifestyle, a reduction in metabolic cell mass and, consequently, lower energy expenditure and dietary intake are important contributors to the progression of frailty. A decline in intake is in turn associated with the risk of developing a suboptimal nutritional state or multiple micro nutrient deficiencies.The tantalizing potential of nanotechnology is to fabricate and combine nano scale approaches and building blocks to make useful tools and, ultimately, interventions for medical science, including nutritional science, at the scale of ∼1–100 nm.

Keywords: aging, cells frailty, micronutrients, biochemical reactivity

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Authors: Inayat Shah, Muhammad Omar Malik, Ghareeb Alshuwaier, Ronald H. Baxendale

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Background: The balance between angiogenesis and angiostasis is important in growth and developmental processes in the body. Angiogenic and angiostatic mediators control this balance. Endostatin is one of the prominent angiostatic mediators. The marked angiostatic effect of endostatin includes inhibiting endothelial cell migration, proliferation and apoptosis. Physical activity decreases the risk and development of many angiogenesis related health problems including atherosclerosis and numerous cancers. Physiological influences of different physical activities on plasma endostatin concentration are controversial and not completely clear. Moreover, correlation of physical characteristics and metabolic predictors during physical activity on circulating endostatin is indistinct and poorly speculated. The study aimed to determine the effects of mild, moderate and vigorous exercise on the concentration of endostatin in plasma. Methodology: 22 participants, 16 males (age = 30.6 ± 7.8 years) and 6 females (age = 26.5 ± 5 years) were recruited. Weekly session of different intensities exercise based on the predicted maximum heart of the participants [60%(low), 70% (moderate) and 80% (vigorous)] were carried out. The duration and work rate for each participant was determined through sub-maximal exercise. Standardization of the session was done on total energy expenditure of the participants per session. One pre exercise and two post exercise samples were taken at intervals of 10 and 60 minutes. Results: Pre-exercise mean endostatin was 101 ± 20 ng/dl. Low intensity exercise insignificantly decreased the endostatin concentration in plasma at 10 and 60 minutes 97 ± 20 ng/dl (p= 0.5), 98 ± 23 ng/dl (p= 0.8)). However, moderate (p= 0.022, 0.004) and vigorous intensities (p ≤ 0.001, 0.02) increased the endostatin concentrations significantly at both 10 and 60 minutes intervals respectively. The effects were not significantly influenced by gender, exercise mode (walking vs. running), components of exercise (HR, Speed, Gradients, distance, duration) or metabolism during exercise (VO₂ max, VCO₂, RER, energy expenditure, rate of carbohydrate or fats oxidation). Conclusion: Low intensity exercises did not influence endostatin concentration. However, moderate to high intensity exercises significantly increase endostatin concentration and may have potential benefits.

Keywords: angiogenesis, exercise, endostatin, physical activity

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Authors: Shailender Kumar

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Current health policy pronouncements in India advocate for insurance-based financing mechanism to achieve universal health coverage (UHC), while undermine the role of comprehensive healthcare provision system. UHC is achieved when all people receive the health services they need without suffering financial hardship. This study, using 68th & 71st NSS rounds data, examines their relative and combined strength in achieving the above objective. Health-insurance has been unsuccessful in reducing prevalence and catastrophic effects of out-of-pocket payment and even dismantle the effectiveness of traditional way of health financing system. Healthcare provision is the best way forward to enhance health and well-being of households in condition if India removes existing inadequacies and inequalities in service provision across districts/states and ensure free/low cost medicines/diagnostics to the citizens.

Keywords: health policy, demand-side financing, supply-side financing, incidence of health payment

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Authors: Zintle Sikhunyana

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Management of public finance in many countries such as South Africa is affected by political decisions and by policies around fiscal decentralization amongst the government spheres. Economic success is said to be determined by efficient management of public finance and by the policies or strategies that are implemented to support efficient public finance management. Policymakers focus on pay attention to how economic policies have been implemented and how they are directed into ensuring stable development. This will allow policymakers to address economic challenges through the usage of fiscal policy parameters that are linked to the achieved rate of economic growth and development. Efficient public finance management reduces the likelihood of corruption and corruption is said to have negative effects on economic growth and development. Corruption in public finance refers to an act of using funds for personal benefits. To achieve macroeconomic objectives, governments make use of government expenditure and government expenditure is financed through tax revenue. The main aim of this paper is to investigate the potential impact of public finance management on economic growth and development in South Africa. The secondary data obtained from the South African Reserve Bank (SARB) and World Bank for 1980- 2020 has been utilized to achieve the research objectives. To test the impact of public finance management on economic growth and development, the study will use Seeming Unrelated Regression Equation (SURE) Modelling that allows researchers to model multiple equations with interdependent variables. The advantages of using SUR are that it efficiently allows estimation of relationships between variables by combining information on different equations and SUR test restrictions that involve parameters in different equations. The findings have shown that there is a positive relationship between efficient public finance management and economic growth/development. The findings also show that efficient public finance management has an indirect positive impact on economic growth and development. Corruption has a negative impact on economic growth and development. It results in an efficient allocation of government resources and thereby improves economic growth and development. The study recommends that governments who aim to stimulate economic growth and development should target and strengthen public finance management policies or strategies.

Keywords: corruption, economic growth, economic development, public finance management, fiscal decentralization

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Authors: Jumazulhisham Abdul Shukor, Mohd. Sazali Said, Roshanizah Harun, Shuib Husin, Ahmad Razlee Ab Kadir

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This paper applies Taguchi Optimization Method in determining the best machining parameters for pocket milling process on Polypropylene (PP) using CNC milling machine where the surface roughness is considered and the Carbide inserts cutting tool are used. Three machining parameters; speed, feed rate and depth of cut are investigated along three levels; low, medium and high of each parameter (Taguchi Orthogonal Arrays). The setting of machining parameters were determined by using Taguchi Method and the Signal-to-Noise (S/N) ratio are assessed to define the optimal levels and to predict the effect of surface roughness with assigned parameters based on L9. The final experimental outcomes are presented to prove the optimization parameters recommended by manufacturer are accurate.

Keywords: inserts, milling process, signal-to-noise (S/N) ratio, surface roughness, Taguchi Optimization Method

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Authors: Mansur Ahmed Kazaure

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The emergence of sponsorship as a new marketing communication tool and a source of competitive advantage in the marketplace has changed the entire marketing communication process. Sponsorship has overtaken other marketing communication tools in terms of growth and expenditure. This paper seeks to evaluate the role of sponsorship in marketing communication tools. The study recommends that proper measures be taken before the company embarks into sponsorship programs. This is necessary because investment in sponsorship does not always guarantee sustainable competitive advantage in the marketplace.

Keywords: sponsorship, marketing communication theories, marketing communication tools

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Authors: Iris Xiaohong Quan, Sharon Qi, Kelly Tianqin Shi

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This study focuses on the critical role of insurance policies in a world grappling with increasing mental health challenges, as they significantly influence the dynamics of healthcare businesses and entrepreneurial ventures. The paper utilizes the mental health sector as a case to examine the impact of insurance policies on healthcare service providers, entrepreneurs, and individuals seeking mental health support. This paper addressed the following research questions: To what extent do changes in insurance reimbursement policies affect the accessibility and affordability of mental health services for patients, and how does this impact the overall demand for such services? What are the barriers and opportunities that mental health entrepreneurs face and what strategies and adaptations do mental health businesses employ when navigating the evolving landscape of insurance reimbursement policies? How do changes in insurance reimbursement policies, specifically related to mental health services, influence the financial viability and sustainability of mental health clinics and private practices? Employing a self-designed survey aimed at autism spectrum disorder (ASD) treatment companies, alongside two in-depth case studies and an analysis of pertinent insurance policies and documents, this research aims to elucidate the multifaceted influence of insurance policies on the mental health industry. The findings from this study reveal how insurance policies shape the landscape of mental health businesses and their operations. A total of 821 autism treatment organizations or offices were contacted by telephone between November 1, 2019, and January 31, 2020. About half of the offices (53.33%) were established in the past five years, and 80% were established in the past 15 years. There is a significant increase in the establishment of ABA service centers in the recent two decades as a result of autism insurance reform, the increasing social awareness of ASD, and the redefinition of autism. In addition, almost half of the ABA service providers we surveyed had a patient size ranging from 20 to 50 in the year when the residence state passed the legislation for autism insurance coverage. On average, an ABA service provider works with 5.3 insurance companies. This research find that insurance is the main source of revenue for most ABA service providers. However, our survey reveals that clients’ out of pocket payment has been the second main revenue sources. Despite the changes of regulations and insurance policies in all states, clients still have to pay a fraction of, if not all, the ABA treatment service fees out of pocket. This research shows that some ABA service providers seek federal and government funds and grants to support their services and businesses. Our further analysis with the in-depth case studies and other secondary data also indicate the rise of entrepreneurial startups in the mental health industry. Overall, this research sheds light on both the challenges and opportunities presented by insurance policies in the mental health sector, offering insights into the new industry landscape.

Keywords: entrepreneurship, healthcare policy, insurance policy, mental health industry

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Authors: Farzad Shidfar, Najmeh Rostami, Ziaodin Mazhari, Fatemeh Hosseini Baharanchi

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Background and Aim: The rate of failure to maintain a reduced weight has been increased. By definition, people who regain about one-third to two-thirds of their lost weight after one year from the end of the dietary treatment and return all the lost weight after 5 years it is called weight regain. This study was performed to find the causes of weight regain and its relationship with biochemical and psychological factors. Materials and Methods: This cross-sectional study was performed by reviewing the files of people who followed the dietary treatment in 1397-1398.seventy-three persons was in the weight regain group, and seventy-three people were in the weight maintenance group. Psychological factors such as depression, anxiety, quality of life, physical activity, and dietary frequency were assessed through a questionnaire, and biochemical factors such as serum insulin and fasting blood sugar were measured. The mean basal energy in the weight regain group was significantly higher than the weight maintenance group (p = 0.004). There was no significant difference between the two groups in terms of food intake and inflammatory index of food. There was no significant difference between the two groups in terms of food intake and inflammatory index of food. Mean serum insulin concentration (p = 0.023), mean fasting blood sugar (p = 0.04) and insulin resistance (p = 0.013) in the weight regain group were higher than the weight maintenance group. The weight maintenance group showed higher insulin sensitivity than the weight regain group (p = 0.005). There was no significant difference between the two groups in terms of psychological indicators. Conclusion: The only body mass index after one year from the end of the treatment period, insulin sensitivity, serum insulin concentration, fasting blood sugar, insulin resistance, selenium intake, and basal energy expenditure Specific and significant with weight regain. However, the significance of insulin resistance, basal energy expenditure, and body mass index after one year from the end of the treatment period was higher than other variables in the weight regain group.

Keywords: body weight maintenance, weight regain, insulin resistance, insulin sensitivity

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Authors: Noor F. Ilias, Mazlifah Omar, Hashbullah Ismail

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Exercise training has been shown to improve functional capacity and is recommended as a therapy for management of blood pressure. Our purpose was to establish whether different exercise capacity produces different effect size for Cardiorespiratory Fitness (CRF), systolic (SBP) and diastolic (DBP) blood pressure in patients with hypertension. Exercise characteristic is required in order to have optimal benefit from the training, but optimal exercise capacity is still unwarranted. A MEDLINE search (1985 to 2015) was conducted for exercise based rehabilitation trials in hypertensive patients. Thirty-seven studies met the selection criteria. Of these, 31 (83.7%) were aerobic exercise and 6 (16.3%) aerobic with additional resistance exercise, providing a total of 1318 exercise subjects and 819 control, the total of subjects was 2137. We calculated exercise volume and energy expenditure through the description of exercise characteristics. 4 studies (18.2%) were 451kcal - 900 kcal, 12 (54.5%) were 900 kcal – 1350 kcal and 6 (27.3%) >1351kcal per week. Peak oxygen consumption (peak VO2) increased by mean difference of 1.44 ml/kg/min (95% confidence interval [CI]: 1.08 to 1.79 ml/kg/min; p = 0.00001) with weighted mean 21.2% for aerobic exercise compare to aerobic with additional resistance exercise 4.50 ml/kg/min (95% confidence interval [CI]: 3.57 to 5.42 ml/kg/min; p = 0.00001) with weighted mean 14.5%. SBP was clinically reduce for both aerobic and aerobic with resistance training by mean difference of -4.66 mmHg (95% confidence interval [CI]: -5.68 to -3.63 mmHg; p = 0.00001) weighted mean 6% reduction and -5.06 mmHg (95% confidence interval [CI]: -7.32 to -2.8 mmHg; p = 0.0001) weighted mean 5% reduction respectively. Result for DBP was clinically reduce for aerobic by mean difference of -1.62 mmHg (95% confidence interval [CI]: -2.09 to -1.15 mmHg; p = 0.00001) weighted mean 4% reduction and aerobic with resistance training reduce by mean difference of -3.26 mmHg (95% confidence interval [CI]: -4.87 to -1.65 mmHg; p = 0.0001) weighted mean 6% reduction. Optimum exercise capacity for 451 kcal – 900 kcal showed greater improvement in peak VO2 and SBP by 2.76 ml/kg/min (95% confidence interval [CI]: 1.47 to 4.05 ml/kg/min; p = 0.0001) with weighted mean 40.6% and -16.66 mmHg (95% confidence interval [CI]: -21.72 to -11.60 mmHg; p = 0.00001) weighted mean 9.8% respectively. Our data demonstrated that aerobic exercise with total volume of 451 kcal – 900 kcal/ week energy expenditure may elicit greater changes in cardiorespiratory fitness and blood pressure in hypertensive patients. Higher exercise capacity weekly does not seem better result in management hypertensive patients.

Keywords: blood Pressure, exercise, hypertension, peak VO2

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Authors: Ching-Sung Wang, Teng-Wei Wang, Zhen-Ting Zheng

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This study mainly concerns a safety device designed for child care. When children are out of sight or the caregivers cannot always pay attention to the situation, through the functions of this device, caregivers can immediately be informed to make sure that the children do not get lost or hurt, and thus, ensure their safety. Starting from this concept, a device is produced based on the relatively low-cost Bluetooth piconet system and a three-axis gyroscope sensor. This device can transmit data to a mobile phone app through Bluetooth, in order that the user can learn the situation at any time. By simply clipping the device in a pocket or on the waist, after switching on/starting the device, it will send data to the phone to detect the child’s fall and distance. Once the child is beyond the angle or distance set by the app, it will issue a warning to inform the phone owner.

Keywords: children care, piconet system, three-axis gyroscope, distance detection, falls detection

Procedia PDF Downloads 583

Authors: Trevor R. Higgins, Ben Lopez

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Australian football fans have a tendency to indulge in foreign football clubs, often assigning a greater value to foreign clubs, in preference to the Australian National football competition; the A-League. There currently exists a gap in the knowledge available in relation to football fans in Australia, their engagement with foreign football teams and the impact that this may have with their engagement with A-League. The purpose of this study was to compare the engagement of the members of the Manchester United Supporters Club - Australia (MUSC-Aus) with Manchester United and the A-League. An online survey was implemented to gather the relevant data from members of the MUSC-Aus. Results from completed surveys were collected, and analyzed in relation to engagement levels with Manchester United and the A-League. Members of MUSC-Aus who responded to the survey were predominantly male (94%) and born in Australia (46%), England (25%), Ireland (7%), were greatly influenced in their choice of Manchester United by family (43%) and team history (16%), whereas location was the overwhelming influence in supporting the A-League (88%). Importantly, there was a reduced level of engagement in the A-League on two accounts. Firstly, only 64% of MUSC-Aus engaged with the A-League, reporting perceptions of low standard as the major reason (50%). Secondly, MUSC-Aus members who engaged in the A-League reported reduced engagement in the A-League, identified through spending patterns. MUSC-Aus members’ expenditure on Manchester United engagement was 400% greater than expenditure on A-League engagement. Furthermore, additional survey responses indicated that the level of commitment towards the A-League overall was less than Manchester United. The greatest impact on fan engagement in the A-League by MUSC-Aus can be attributed to several primary factors; family support, team history and perceptions to on-field performance and quality of players. Currently, there is little that can be done in regards to enhancing family and history as the A-League is still in its infancy. Therefore, perceptions of on-field performances and player quality should be addressed. Introducing short-term international marquee contracts to A-League rosters, across the entire competition, may provide the platform to raise the perception of the A-League player quality with minimal impact on local player development. In addition, a national marketing campaign promoting the success of A-League clubs in the ACL, as well as promoting the skill on display in the A-League may address the negative association with the standard of the A-League competition.

Keywords: engagement, football, perceptions of performance, team

Procedia PDF Downloads 271

Authors: H. Mat Kiah, Rafiziana M. Kasmani, Norazana Ibrahim, Roshafima R. Ali, Aziatul N.Sadikin

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An experimental study has been done to investigate the flame acceleration in a closed pipe. A horizontal steel pipe, 2m long and 0.1 m in diameter (L/D of 20), was used in this work. For tests with 90 degree bends, the bend had a radius of 0.1 m and thus, the pipe was lengthened 1 m (based on the centreline length of the segment). Ignition was affected one end of the vessel while the other end was closed. Only stoichiometric concentration (Ф, = 1.0) of natural gas/air mixtures will be reported in this paper. It was demonstrated that bend pipe configuration gave three times higher in maximum over-pressure (5.5 bars) compared to straight pipe (2.0 bars). From the results, the highest flame speed of 63 m s-1 was observed in a gas explosion with bent pipe, greater by a factor of ~3 as compared with straight pipe (23 m s-1). This occurs because bending acts similar to an obstacle, in which this mechanism can induce more turbulence, initiating combustion in an unburned pocket at the corner region and causing a high mass burning rate which increases the flame speed.

Keywords: bending, gas explosion, bending, flame acceleration, over-pressure

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Authors: Athira Vinod

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Under the Right to Education Act (2009), the Indian government introduced an affirmative action policy aimed at the reservation of seats in private schools at the entry-level and free primary education for children from lower socio-economic backgrounds. Using exogenous variation in the status of being in a lower social category (disadvantaged groups) and the year of starting school, this study investigates the effect of exposure to the policy on the expenditure on private education. It employs a difference-in-difference strategy with the help of repeated cross-sectional household data from the National Sample Survey (NSS) of India. It also exploits regional variation in exposure by combining the household data with administrative data on schools from the District Information System for Education (DISE). The study compares the outcome across two age cohorts of disadvantaged groups, starting school at different times, that is, before and after the policy. Regional variation in exposure is proxied with a measure of enrolment rate under the policy, calculated at the district level. The study finds that exposure to the policy led to an average reduction in annual private school fees of ₹223. Similarly, a 5% increase in the rate of enrolment under the policy in a district was associated with a reduction in annual private school fees of ₹240. Furthermore, there was a larger effect of the policy among households with a higher demand for private education. However, the effect is not due to fees waived through direct enrolment under the policy but rather an increase in the supply of low-fee private schools in India. The study finds that after the policy, 79,870 more private schools entered the market due to an increased demand for private education. The new schools, on average, charged a lower fee than existing schools and had a higher enrolment of children exposed to the policy. Additionally, the district-level variation in the enrolment under the policy was very strongly correlated with the entry of new schools, which not only charged a low fee but also had a higher enrolment under the policy. Results suggest that few disadvantaged children were admitted directly under the policy, but many were attending private schools, which were largely low-fee. This implies that disadvantaged households were willing to pay a lower fee to secure a place in a private school even if they did not receive a free place under the policy.

Keywords: affirmative action, disadvantaged groups, private schools, right to education act, school fees

Procedia PDF Downloads 103

Authors: Mariette Swanepoel, Terry Ellapen, Henriette Hammil, Juandre Williams, Timothy Qumbu

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The biomechanical consequence of pes planus is a topic seldom reviewed in regards to energy expenditure and predisposition to injury. However its comprehension in the field of foot rehabilitation, pre-and post-surgery is fundamental to successful patient management. This short communication unites the present literature to provide the reader with better insight on the consequence of pes planus, foot mechanics and its predisposition to injury at the foot and tibiofemoral joint. Further, the consideration of synergistic dominance of the foot invertors to compensate for the ineffective torque production of the fibularis longus due pes planus is presented.

Keywords: pes planus, fibularis longus, synergistic dominance, injury

Procedia PDF Downloads 273

Authors: Tigist Mekonnen Melesse

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Since rural households are basically entitled to food through own production, improving productivity might lead to enhance the welfare of rural population through higher food availability at the household level and lowering the price of agricultural products. Increasing agricultural productivity through the use of improved technology is one of the desired outcomes from sensible food security and agricultural policy. The ultimate objective of this study was to evaluate the potential impact of improved agricultural technology adoption on smallholders’ crop productivity and welfare. The study is conducted in Ethiopia covering 1500 rural households drawn from four regions and 15 rural villages based on data collected by Ethiopian Rural Household Survey. Endogenous treatment effect model is employed in order to account for the selection bias on adoption decision that is expected from the self-selection of households in technology adoption. The treatment indicator, technology adoption is a binary variable indicating whether the household used improved seeds and chemical fertilizer or not. The outcome variables were cereal crop productivity, measured in real value of production and welfare of households, measured in real per capita consumption expenditure. Results of the analysis indicate that there is positive and significant effect of improved technology use on rural households’ crop productivity and welfare in Ethiopia. Adoption of improved seeds and chemical fertilizer alone will increase the crop productivity by 7.38 and 6.32 percent per year of each. Adoption of such technologies is also found to improve households’ welfare by 1.17 and 0.25 percent per month of each. The combined effect of both technologies when adopted jointly is increasing crop productivity by 5.82 percent and improving welfare by 0.42 percent. Besides, educational level of household head, farm size, labor use, participation in extension program, expenditure for input and number of oxen positively affect crop productivity and household welfare, while large household size negatively affect welfare of households. In our estimation, the average treatment effect of technology adoption (average treatment effect on the treated, ATET) is the same as the average treatment effect (ATE). This implies that the average predicted outcome for the treatment group is similar to the average predicted outcome for the whole population.

Keywords: Endogenous treatment effect, technologies, productivity, welfare, Ethiopia

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Authors: Evelyn Nwamaka Ogbeide-Osaretin, Bright Orhewere

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This study examined the role of the population in the linkage between energy consumption and economic development in Nigeria. Time series data on energy consumption, population, and economic development were used for the period 1995 to 2020. The Autoregressive Distributed Lag -Error Correction Model (ARDL-ECM) was engaged. Economic development had a negative substantial impact on energy consumption in the long run. Population growth had a positive significant effect on energy consumption. Government expenditure was also found to impact the level of energy consumption, while energy consumption is not a function of oil price in Nigeria.

Keywords: dynamic analysis, energy consumption, population, economic development, Nigeria

Procedia PDF Downloads 166