19 research outputs found
Financial Dimensions of Inflationary Pressure in Developing Countries: An In-depth Analysis of Policy Mix
This study explores the relationship between inflationary pressure and policy mix in developing countries over the period of 1995 to 2022. Money supply, unemployment rate, regulatory policies, currency rate, remittances, and amount of foreign debt are explanatory factors, whereas inflationary pressure is the dependent variable. To assess the influence of these factors on inflation, panel least squares, and fixed effect models are utilized. The study's findings shed light on the complicated links between financial factors and inflationary pressures in developing nations. The study demonstrates that in developing nations, the money supply has a negative and considerable influence on inflation. The study found that unemployment had a favorable but insignificant influence on inflation pressures in emerging nations. Furthermore, the research demonstrates that regulatory measures have a negative and considerable influence on inflationary pressures. The exchange rate has been proven to have a positive and considerable impact on inflationary pressures in emerging nations, highlighting the necessity of prudent exchange rate management in mitigating the inflationary implications of currency decline. Furthermore, remittances have a negative and considerable influence on inflationary pressures, implying that increasing financial inclusion and investment possibilities for remittance-receiving families might help to stabilize inflation in developing countries. Finally, the study emphasizes that the quantity of foreign debt in emerging nations has a positive and considerable influence on inflationary pressures. According to the study, careful monitoring and control of the money supply, addressing unemployment through labor market reforms and investments, implementing effective regulatory restrictions, prudent exchange rate management, promoting financial inclusion for remittance recipients, and pursuing sustainable debt levels are all important
How Employment Brand Impacts Employees, Following A Multinational Acquistion? An Empirical Analysis
Present study explores employment brand in the contextof a multinational acquisition, particularly the implications foremployees who are currently working. Using a sample of threehundred from acquired telecom organization’s employees. Studyexamines identification predictors with the acquiring organization,discretionary effort and intention to leave. Author emphases onpredictors related to employment brand, particularly perceptionsrelated to the unique employment experiences provision, perceivedprestige, organizational identity strength, and perceptions ofwhether the acquiring organization acts with its corporate socialresponsibility claims. Findings suggest that perceptions ofcorporate social responsibility identity claims, perceivedorganizational prestige and organizational identity strength arepositively related to organizational identification and discretionaryeffort and negatively related to intention to leave. Surprisingly,unique employment experience is positively related toorganizational identification and negatively related to intention toleave but unrelated to discretionary effort. The elements ofemployment brand have varying effect on the outcomes underconsideration
Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey
Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
Abstract
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries
Development of computer software for neutron energy spectrum adjustment in research reactors
A computer program has been developed for neutron energy spectrum adjustment using the deconvolution method. The BUNKI-based algorithm has been implemented to converge quickly yielding calculated neutron energy spectrum which is in good agreement with theoretical predictions. The foil activation data have been used as an input for each unfolding technique and various activation foils including Au-197, Al-27, Ni-58, Co-59, and Mg-24 covering thermal to fast energy range have been utilized. The group cross-section values were derived from the data given in the pre-processed cross-section libraries in ENDF-6 format of IRDF-90/NMF-G. Firstly, virtual approach was used for neutron energy spectrum adjustment. In this case, the activity of foils before and after the adjustment was almost the same but the flux had the maximum error of 14%. Secondly, the experimental measured activity of the threshold foils was then used for a real system. The activity of the threshold foils before and after the neutron energy adjustment had the maximum error of 33%
by
Re ceived on De cem ber 18, 2008; ac cepted in re vised form on March 27, 2009 A com puter pro gram has been de vel oped for neu tron en ergy spec trum ad just ment us-ing the deconvolution method. The BUNKI-based al go rithm has been im ple mented to con verge quickly yield ing cal cu lated neu tron en ergy spec trum which is in good agree ment with the o ret i cal pre dic tions. The foil ac ti va tion data have been used as an in put for each un fold ing tech nique and var i ous ac ti va tion foils in clud ing Au-197
The Diagnostic Accuracy of Magnetic Resonance Imaging (MRI) For Detection of Spinal Tuberculosis (TB)
Background: Diagnosis of spinal tuberculosis is a major challenge. It is usually made using a blend of, laboratory , imaging investigations, clinical and none of these are 100% confirmatory. The objective of this study was to determine the diagnostic accuracy of magnetic resonance imaging (MRI) for detection of spinal tuberculosis (TB)
Methodology: This cross-sectional study was conducted in the department of Radiology, Lahore General Hospital, on 150 patients, with suspicion of spinal TB from January,2020 to August,2020. Patients having Backache for >6 months, loss of appetite, loss of weight >10% in previous one month, raised ESR >15 mm/hour, and positive sputum results for AFB were included. The patients underwent full spinal MRI scan. MRI was done using 1.5 Tesla MR for diagnosis of spinal TB. The diagnosis of spinal TB was then confirmed on histopathologic reporting.
Results:Mean age of study participants was 47.83±9.65 years. There was male predominance with 93 (62.0%) males and 57 (38.0%) female patients. The mean duration of spinal TB symptoms was 11.52±3.12 months. On accuracy of MRI, there were 83 (55.3%) true positive cases, 10 (6.67%) false positive, 08 (5.33%) false negative and 49 (32.67%) true negative. The sensitivity of MRI was 91.2%, specificity 83.1%, positive predictive value (PPV) 89.2% and negative predictive value (NPV) 86.0%.
Conclusion: Sensitivity of MRI was 91.2% and specificity 83.1%.MRI is an ideal non-invasive imaging modality for the diagnosis of spinal TB.
Keywords: Magnetic resonance imaging, Spinal, Tuberculosis
STUDY ON THE MORTALITY FROM TETANUS NEONATORUM IN PAKISTAN
Introduction: Neonatal tetanus (NT), caused by Clostridium tetani, is a highly fatal infection of the neonatal period. Infection occurs when the umbilical cord becomes contaminated as a result of unclean childbirth or cord-care practices. Aims and objectives: The basic aim of the study is analysis and study on the mortality from tetanus neonatorum in Pakistan. Material and methods: This study was conducted at Services Institute of medical sciences, Lahore during 2018. We conducted a community-based cross-sectional survey. To calculate the necessary sample size to estimate NNT mortality, we assumed an NNT mortality rate of 20 per 1000 live births. This assumption was based on information from the 1990–1991 Maternal and Infant Mortality Survey, Punjab, which showed a neonatal mortality rate of 66.4/1000 live births in Punjab. Results: The comparative epidemiological analysis of NT in Pakistan allowed us to evaluate the following: commonly identified risk factors for NT, their relevance to MNT elimination strategies, NT mortality levels and trends, the impact of TT immunization on NT mortality, and the role of surveillance in monitoring disease control efforts. Conclusion: It is concluded that Low immunization coverage with TT and low antenatal care suggest deficiencies of the maternal and child health services and Expanded Program on Immunization (EPI) in this area
Respiratory events associated with concomitant opioid and sedative use among Medicare beneficiaries with chronic obstructive pulmonary disease
BACKGROUND:
Opioids and sedatives are commonly prescribed in chronic obstructive pulmonary disease (COPD) patients for symptoms of dyspnoea, pain, insomnia, depression and anxiety. Older adults are advised to avoid these medications due to increased adverse events, including respiratory events. This study examines respiratory event risks associated with concomitant opioid and sedative use compared with opioid use alone in older adults with COPD.
METHODS:
A 5% nationally representative sample of Medicare beneficiaries with COPD and opioid use between 2009 and 2013 was used for this retrospective cohort study. Current and past concomitant use were identified using drug dispensed within 7 days from the censored date: at respiratory event, at death, or at 12 months post index. Concomitant opioid and sedative use were categorised into no overlap (opioid only), 1 to 10, 11 to 30, 31 to 60 and >60 days of total overlap. The primary outcome was hospitalisation or emergency department (ED) visits for respiratory events (COPD exacerbations or respiratory depression). Propensity score matching was implemented and semi-competing risk models were used to address competing risk by death.
RESULTS:
Among 48 120 eligible beneficiaries, 1810 (16.7%) concomitant users were matched with 9050 (83.3%) opioid only users. Current concomitant use of 1 to 10, 11 to 30 and 31 to 60 days was associated with increased respiratory events (HRs (95% CI): 2.8 (1.2 to 7.3), 9.3 (4.9 to 18.2) and 5.7 (2.5 to 12.5), respectively), compared with opioid only use. Current concomitant use of >60 days or past concomitant use of ≤60 days was not significantly associated with respiratory events. Consistent findings were found in sensitivity analyses, including in subgroup analysis of non-benzodiazepine sedatives. Additionally, current concomitant use significantly increased risk of death.
CONCLUSION:
Short-term and medium-term current concomitant opioid and sedative use significantly increased risk of respiratory events and death in older COPD Medicare beneficiaries. Long-term past concomitant users, however, demonstrated lower risks of these outcomes, possibly reflecting a healthy user effect or developed tolerance to the effects of these agents
Mortality and Associated Morbidities Following Traumatic Brain Injury in Older Medicare Statin Users
Objective: To assess the relationship between posttraumatic brain injury statin use and (1) mortality and (2) the incidence of associated morbidities, including stroke, depression, and Alzheimer’s disease and related dementias following injury. Setting and Participants: Nested cohort of all Medicare beneficiaries 65 years of age and older who survived a traumatic brain injury (TBI) hospitalization during 2006 through 2010. The final sample comprised 100 515 beneficiaries. Design: Retrospective cohort study of older Medicare beneficiaries. Relative risks (RR) and 95% confidence interval (CI) were obtained using discrete time analysis and generalized estimating equations. Measures: The exposure of interest included monthly atorvastatin, fluvastatin, lovastatin, pravastatin, rosuvastatin, and simvastatin use. Outcomes of interest included mortality, stroke, depression, and Alzheimer’s disease and related dementias. Results: Statin use of any kind was associated with decreased mortality following TBI hospitalization discharge. Any statin use was also associated with a decrease in any stroke (RR, 0.86; 95% confidence intervals (CI), 0.81-0.91), depression (RR, 0.85; 95% CI, 0.79-0.90), and Alzheimer’s disease and related dementias (RR, 0.77; 95% CI, 0.73-0.81). Conclusion: These findings provide valuable information for clinicians treating older adults with TBI as clinicians can consider, when appropriate, atorvastatin and simvastatin to older adults with TBI in order to decrease mortality and associated morbidities. Key words: Medicare, mortality, older adults, statins, TBI sequelae, traumatic brain injur