The Affordable Care Act and Medicare

This second report in the series Medicare at 50 Years describes how the Affordable Care Act is strengthening the program for current and future beneficiaries and outlines the major challenges that policymakers have yet to confront. By starting to move Medicare away from fee-for-service payment and holding health care providers more accountable for both the quality and total cost of care, certain ACA reforms—most notably the new Center for Medicare and Medicaid Innovation—have the potential to reshape not just the Medicare program but the entire U.S. health care system, the authors say. But the rapid influx of new beneficiaries as the postwar generation retires will necessitate further changes to Medicare, as total program outlays will likely outpace growth in the economy. Another challenge is Medicare's complex and fragmented benefit package, which as currently configured is inadequate for meeting the financial and health care needs of future beneficiaries

Global Critical Shortage of Nurses: Pathway to Solution

In 2020, the first State of the World’s Nursing (SOWN) report published by the World Health Organization (WHO) revealed global nursing workforce to be at 27.9 million. SOWN estimated a current global nursing shortfall of 5.9 million. Furthermore, 17% of nurses are expected to retire in next 10 years. An estimated 5.3 million (89%) of that shortage is concentrated in low and lower-middle income countries, where the growth in the number of nurses is barely keeping pace with population growth. WHO global Strategic Directions for Nursing and Midwifery (SDNM) 2022 report has identified policy focus interventions for four major areas: education, jobs, leadership, and service delivery. Nurse advocacy groups like International Council of Nurses (ICN) are calling on governments to partner with various healthcare stakeholders to find tangible solutions in addressing global nursing shortage (NS)

The Impact of Special Economic Zones (SEZs) on Economic Growth: Where the Absorption Capacity of Domestic Labor Stands?

This study designs to assess and infer the effect of Special Economic Zones under China-Pakistan Economic Corridor on the economic growth of Pakistan through technological spillovers and the absorption capacity of domestic laborers. The present study develops a theoretical model and an empirical panel model to test whether the intervention of Special Economic Zones in the Asian developing countries has affected their economic growth through domestic Human Capital. For relevant results, we have employed the GMM model for the panel data set. The results indicate that the technological enhancement accumulates the economy through various other selected indicators rather than domestic labor productivity. The human capital remains inconsequent in this nexus. This condition gives us guidelines to follow pro-human capital policies to accumulate domestic human capital before the intervention from the foreign firms on our soil. Subsequently, much waited for dynamic or long-run benefits in terms of human capital can be attained rather than static effects.JEL Classification: C23, D24, J24How to Cite:Waqar, S., Badshah, I., Bandeali, M. S. M., & Ahmed, S. (2021). The Impact of Special Economic Zones (SEZs) on Economic Growth: Where the Absorption Capacity of Domestic Labor Stands?. Etikonomi, 20(2), xx – xx. https://doi.org/10.15408/etk.v20i2.19386

Characteristics of TIA and its management in a tertiary care hospital in Pakistan

<p>Abstract</p> <p>Background</p> <p>Transient ischemic attack (TIA) is described as a brief episode of neurological dysfunction caused by focal brain ischemia, with clinical symptoms typically lasting less than an hour, and without evidence of acute infarction. Recent studies depict TIA as a particularly unstable condition. Risk of stroke is greater than 10% in the first 90 days after an index TIA. The presentation, prognosis and intervention for TIA have not been reported in South-Asians in a developing country.</p> <p>Method</p> <p>A retrospective chart review was done for 158 patients who were admitted with the diagnosis of TIA, as defined by ICD 9 code 435, from January 2003 to December 2005 at the Aga Khan University Hospital, Karachi, Pakistan. The data was entered and analyzed in SPSS version 14.0.</p> <p>Findings</p> <p>Among 158 patients, 57.6% were male and 41.1% were female. The common presenting symptoms were motor symptoms (51.3%), speech impairment (43%), sensory impairment (34.8%) and loss of balance/vertigo (29.1%). The median delay in presenting to the hospital was 4 hours. Those with motor symptoms were found to present earlier. The study showed that only 60.8% of all the patients presenting with TIA received any immediate treatment out of which 44.7% received aspirin. Neuroimaging was used in 91.1% of the patients. Of all the TIA patients 9.1% converted to stroke with 50% doing so within the first 24 hours.</p> <p>Conclusion</p> <p>The natural history of TIA from this developing nation is comparable to international descriptions. A large percentage of patients are still not receiving any immediate treatment as recommended in available guidelines, even in a tertiary care hospital.</p

Prevalence of behavioural and psychological problems in working children

OBJECTIVE: To determine the prevalence and screen the nature and types of behavioural and psychological problems among working children in Karachi. METHODS: A cross sectional study was conducted in three urban squatter settlements of Karachi from May to June 2006, targeting working children aged 11-16 years. Behavioural Problems of these children were estimated by using the self reported Urdu version of the Strengths and Difficulty Questionnaire. The results were cross-tabulated using SPSS 13.0 with the identified risk-factors. RESULTS: Out of a total of 225 respondents, 94.2% (n = 212) males and 5.8% (n = 13) females, the prevalence of Behavioural Problems among working children was found to be 9.8%. Peer problems were most prevalent (16.9%) seconded by Conduct problems (16.7%). Adverse family environment and work environment were closely associated with Behavioural Problems in these children. CONCLUSION: Our study reinforces the need for measures to improve the environment of the children and prevent the psychological and behavioural problems associated with working children. Gradual, long-term policies are required to decrease the need for working children, though sudden abolishment would cause more detrimental effects

An Eternal ‘Child’ Turned Ally: Princely Minors and the Paternalistic British Raj at work in Hyderabad (1857-1884)

After the 1857 rebellion against British rule in India, British imperialists altered their mode of engagement with the princely states of India—from overt aggression exercised under the policy of “indirect rule” to restrained paternalism preached through a policy of “non-interference”. This paper seeks to illustrate how and why the goals of British imperialism evolved in the latter half of the 19th century. I undertake a case study of the largest princely state of India—Hyderabad—to illustrate that the Raj’s principle imperial agenda after 1857 was to domesticate and assimilate princely states within the colonial body politic. This was realized by rearticulating the tenets of ‘proper education’ for princely minors and selectively appropriating indigenous ritual idioms. In Hyderabad, I center the figure of the ‘princely minor’ Mehboob Ali Khan, the sixth Nizam of Hyderabad, whose minority from 1869-1884 became an opportune time for the British to reform and discipline him to mold him into an amenable ally. Leaving the policy of territorial conquest behind, after 1857, I argue that British imperialism had begun to envision novel ideological sites of colonialism

Novel therapies for treating familial hypercholesterolemia

Familial hypercholesterolemia is an inherited disorder associated with early accelerated atherosclerosis with morbidity and mortality resulting from premature cardiovascular disease. Affected individuals have extreme elevations in low-density lipoprotein cholesterol levels. Patients usually do not achieve target reductions in cholesterol levels with conventional antihyperlipidemic pharmacotherapy. This unmet need has resulted in the recent development and approval of novel therapies targeting different cholesterol pathways. This article briefly summarizes familial hypercholesterolemia and then discusses the newer pharmacotherapies available in the management of familial hypercholesterolemia

MedTalks: developing teaching abilities and experience in undergraduate medical students

Objectives: According to the CanMEDS’ Scholar competency, physicians are expected to facilitate the learning of colleagues, patients and other health professionals. However, most medical students are not provided with formal opportunities to gain teaching experience with objective feedback. Methods: To address this, the University’s Medical Education Interest Group (MEIG) created a pilot teaching program in January 2015 entitled ‘MedTalks’. Four 3-hour sessions were held at the University Faculty of Medicine, where first and second year medical students taught clinically oriented topics to undergraduate university students. Each extracurricular session included three 30-minute content lectures, and a 90-minute small group session on physical examination skills. Each medical student-teacher received formal feedback from undergraduate students and from faculty educators regarding teaching style, communication abilities, and professionalism. In addition, medical student-teachers self-evaluated their own teaching experience. Results: Over 50 medical students from the University participated as medical student-teachers. Based on quantitative and qualitative evaluation surveys, 100% of medical students agreed that MedTalks was a useful way to develop teaching skills and 92% gained a greater confidence in individual teaching capabilities, based largely on the opportunity to gain experience (with feedback) in teaching roles. Conclusions: A program designed to give medical students multi-source teaching experience (lecture- and small group-based) and feedback on their teaching (from learners and Faculty observers, in addition to their own self-reflection) can improve medical student confidence and enthusiasm towards teaching. Future studies will clarify if medical student self-perceived enhancements in teaching ability can be corroborated by independent (Faculty, learner) observations of future teaching activity