Testing For Financial Contagion Between Developed And Emerging Markets During The 1997 East Asian Crisis

In this paper we examine whether during the 1997 East Asian crisis there was any contagion from the four largest economies in the region (Thailand, Indonesia, Korea and Malaysia) to a number of developed countries (Japan, UK, Germany and France). Following Forbes and Rigobon (2002), we test for contagion as a significant positive shift in the correlation between asset returns, taking into account heteroscedasticity and endogeneity bias. Furthermore, we improve on earlier empirical studies by carrying out a full sample test of the stability of the system that relies on more plausible (over)identifying restrictions. The estimation results provide some evidence of contagion, in particular from Japan (the major international lender in the region), which drastically cut its credit lines to the other Asian countries in 1997

Studies to inform the methods for Cochrane systematic reviews of diagnostic accuracy in stroke medicine

Background A variety of tests are used in clinical practice to help the diagnostic process and so improve patient care. Many aspects of stroke management depend on accurate and rapid diagnosis. Brain imaging, including CT or MRI, is necessary to identify the location and extent of the cerebral lesion, and to determine the pathological type of stroke and its likely cause. Current treatments - such as thrombolysis - for ischaemic stroke have increased the need for clear evidence on which imaging test is optimal for diagnosis in the acute phase of stroke. Systematic reviews of diagnostic test accuracy may provide evidence on the best use of a diagnostic test in clinical practice and help clinicians to decide among alternative tests. The Cochrane Collaboration has recently included systematic reviews of diagnostic test accuracy within its remit. However, to prepare Cochrane systematic reviews of diagnostic test accuracy is challenging because the methods for such reviews are still in a state of flux. Materials and methods The research work undertaken for this thesis addresses four relevant methodological aspects of such reviews and, I hope, will contribute to informing the development of the methods for Cochrane systematic reviews of test accuracy: i) I assessed the quality of reporting of imaging studies in stroke medicine published between 1995 and 2008 with the current STAndards for the Reporting of Diagnostic accuracy studies (STARD) criteria; ii) I assessed the magnitude of publication bias in diagnostic accuracy studies in stroke medicine, by reviewing all diagnostic abstracts presented at two international stroke meetings between 1995 and 2004 and so evaluating the characteristics and findings of the identified abstracts; iii) I have evaluated the methods for preparing reviews of test accuracy by undertaking a pilot review according to the draft recommendations of the Cochrane Diagnostic Test Accuracy Working Group; iv) I conducted a survey to assess a) how well clinicians and health professionals interpret findings of Cochrane systematic reviews of diagnostic accuracy presented in summary documents; and b) what is the best format for summarising findings of Cochrane reviews of diagnostic accuracy. Conclusions In conclusion, methodological issues concerning the validity and reliability of findings of studies included in systematic reviews of diagnostic accuracy remain of fundamental importance. More empirical evidence is needed to address potential biases such as reporting bias and publication bias. To allow dissemination of diagnostic reviews findings in clinical practice better ways of communicating main characteristics and key results of systematic reviews of diagnostic accuracy should be considered. In the current literature, the quality of reporting and methodological quality of imaging studies for the diagnosis of stroke is less than satisfactory and leaves room for improvement. This is worrying, especially if current health imaging policies are in fact based on poor quality evidence and hence scarce health resources may not being deployed as effectively as they could be

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London