The effect of cash transfers on mental health – New evidence from South Africa

Mental health and poverty are strongly interlinked. There is a gap in the literature on the effects of poverty alleviation programmes on mental health. We aim to fill this gap by studying the effect of an exogenous income shock generated by the Child Support Grant, South Africa’s largest Unconditional Cash Transfer (UCT) programme, on mental health. We use biennial data on 10,925 individuals from the National Income Dynamics Study between 2008 and 2014. We exploit the programme’s eligibility criteria to estimate instrumental variable Fixed Effects models. We find that receiving the Child Support Grant improves adult mental health by 0.822 points (on a 0-30 scale), 4.1% of the sample mean. Our findings show that UCT programmes have strong mental health benefits for the poor adult population

The effect of cash transfers on mental health – New evidence from South Africa

Background Mental health and poverty are strongly interlinked. There is a gap in the literature on the effects of poverty alleviation programmes on mental health. We aim to fill this gap by studying the effect of an exogenous income shock generated by the Child Support Grant, South Africa’s largest Unconditional Cash Transfer (UCT) programme, on mental health. Methods We use biennial data on 10,925 individuals from the National Income Dynamics Study between 2008 and 2014. We exploit the programme’s eligibility criteria to estimate instrumental variable Fixed Effects models. Results We find that receiving the Child Support Grant improves adult mental health by 0.822 points (on a 0–30 scale), 4.1% of the sample mean. Conclusion Our findings show that UCT programmes have strong mental health benefits for the poor adult population

Weekend mortality in an Italian hospital: immediate versus delayed bedside critical care treatment

Background: a number of studies highlighted increased mortality associated with hospital admissions during weekends and holidays, the so-call "weekend effect". In this retrospective study of mortality in an acute care public hospital in Italy between 2009 and 2015, we compared inpatient mortality before and after a major organizational change in 2012. The new model (Model 2) implied that the intensivist was available on call from outside the hospital during nighttime, weekends, and holidays. The previous model (Model 1) ensured the presence of the intensivist coordinating a Medical Emergency Team (MET) inside the hospital 24 h a day, 7 days a week. Methods: life status at discharge after 9298 and 8223 hospital admissions that occurred during two consecutive periods of 1185 days each (organizational Model 1 and 2), respectively, were classified into "discharged alive", "deceased during nighttime-weekends-holidays" and "deceased during daytime-weekdays". We estimated Relative Risk Ratios (RRR) for the associations between the organizational model and life status at discharge using multinomial logistic regression models adjusted for demographic and case-mix indicators, and timing of admission (nighttime-weekends-holidays vs. daytime-weekdays). Results: there were 802 and 840 deaths under Models 1 and 2, respectively. Total mortality was higher for hospital admissions under Model 2 compared to Model 1. Model 2 was associated with a significantly higher risk of death during nighttime-weekends-holidays (IRR: 1.38, 95% CI 1.20-1.59) compared to daytime-weekdays (RRR: 1.12, 95% CI 0.97-1.31) (p = 0.04). Respiratory diagnoses, in particular, acute and chronic respiratory failure (ICD 9 codes 510-519) were the leading causes of the mortality excess under Model 2. Conclusions: our data suggest that the immediate availability of an intensivist coordinating a MET 24 h, 7 days a week can result in a better prognosis of in-hospital emergencies compared to delayed consultation

Litter in alien species of possible commercial interest: The blue crab (Callinectes sapidus Rathbun, 1896) as case study

Marine litter levels were measured in the stomach contents, hepatopancreas, and gonad tissues of crustacea decapod (Callinectes sapidus Rathbun, 1896; n\ua0=\ua06), a widespread alien species affecting the Lesina lagoon. Results highlight a mean of 2.5 (SD\ua0=\ua01.6) items/animal and indicate the presence of metals fragments (13%) and plastics (13% PE; 6.7% PET) in the stomach contents of collected individuals. No microplastic particles were detected in the hepatopancreas or in muscle tissue, while microplastic fibres (nylon, rayon, polyester) were found present in female specimen gonads. The presence of synthetic fibres in the investigated species reflects the relative contamination level in this habitat type and suggests that the blue crab could be considered a model organism for evaluating the contamination status of the study area

Pay for performance at a crossroads:Lessons from taking a global perspective

Purpose: The use of pay for performance (P4P) as an instrument to incentivise quality improvements in health care is at a crossroads in high-income countries but has remained a commonly used tool in low- and middle-income countries. The authors aimed to take stock of the evidence on effectiveness and design from across income settings to reveal insights for the future design of performance payment across income contexts. Design/methodology/approach: The authors identified Cochrane literature reviews of the use of P4P in health care in any income setting, tracked the development in the quantity and quality of evidence over time, and compared the incentive design features used across high-income countries compared to low- and middle-income countries. Findings: The quantity and quality of the evidence base have grown over time but can still be improved. Scheme design varies across income settings, and although some design choices may reflect differences in context, the authors find that incentive designers in both income settings can learn from practices used in the other setting. Originality/value: The research and literature on P4P in high-, low- and middle-income countries largely operate in silos. By taking stock of the evidence on P4P from across income settings, the authors are able to draw out key insights between these settings, which remain underexplored in the literature

Pay for performance at a crossroads: lessons from taking a global perspective

Purpose: The use of pay for performance (P4P) as an instrument to incentivise quality improvements in health care is at a crossroads in high-income countries but has remained a commonly used tool in low- and middle-income countries. The authors aimed to take stock of the evidence on effectiveness and design from across income settings to reveal insights for the future design of performance payment across income contexts. Design/methodology/approach: The authors identified Cochrane literature reviews of the use of P4P in health care in any income setting, tracked the development in the quantity and quality of evidence over time, and compared the incentive design features used across high-income countries compared to low- and middle-income countries. Findings: The quantity and quality of the evidence base have grown over time but can still be improved. Scheme design varies across income settings, and although some design choices may reflect differences in context, the authors find that incentive designers in both income settings can learn from practices used in the other setting. Originality/value: The research and literature on P4P in high-, low- and middle-income countries largely operate in silos. By taking stock of the evidence on P4P from across income settings, the authors are able to draw out key insights between these settings, which remain underexplored in the literature

A translational signature for nucleosome positioning in vivo

In vivo nucleosomes often occupy well-defined preferred positions on genomic DNA. An important question is to what extent these preferred positions are directly encoded by the DNA sequence itself. We derive here from in vivo positions, accurately mapped by partial micrococcal nuclease digestion, a translational positioning signal that identifies the approximate midpoint of DNA bound by a histone octamer. This midpoint is, on average, highly A/T rich (∼73%) and, in particular, the dinucleotide TpA occurs preferentially at this and other outward-facing minor grooves. We conclude that in this set of sequences the sequence code for DNA bending and nucleosome positioning differs from the other described sets and we suggest that the enrichment of AT-containing dinucleotides at the centre is required for local untwisting. We show that this signature is preferentially associated with nucleosomes flanking promoter regions and suggest that it contributes to the establishment of gene-specific nucleosome arrays

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

The worse the better? Quantile treatment effects of a conditional cash transfer programme on mental health

Poor mental health is a pressing global health problem, with high prevalence among poor populations from low-income countries. Existing studies of conditional cash transfer (CCT) effects on mental health have found positive effects. However, there is a gap in the literature on population-wide effects of cash transfers on mental health and if and how these vary by the severity of mental illness. We use the Malawian Longitudinal Study of Family and Health containing 790 adult participants in the Malawi Incentive Programme, a year-long randomized controlled trial. We estimate average and distributional quantile treatment effects and we examine how these effects vary by gender, HIV status and usage of the cash transfer. We find that the cash transfer improves mental health on average by 0.1 of a standard deviation. The effect varies strongly along the mental health distribution, with a positive effect for individuals with worst mental health of about four times the size of the average effect. These improvements in mental health are associated with increases in consumption expenditures and expenditures related to economic productivity. Our results show that CCTs can improve adult mental health for the poor living in low-income countries, particularly those with the worst mental health

Remote sensing analysis of Mediterranean ecosystem canopies and upscaling studies

This study analysed a natural site located in Central Italy which is a part of the Circeo National Park. An integrated approach was developed to correlate Remote Sensing TM data with field measurements of leaf Area Index (LAI). Six vegetation types were discriminated by a supervised classification of the Circeo forest. Approximately 80% of the surface of the territory analysed is dominated by natural mixed oak woody communities. Pine reforested areas are also present, LAI field measurements were correlated with normalised difference vegetation index (NDVI) obtaining a high correlation (y=15.587x(2.2967); r(2)=0.88). An estimation of LAI for the entire forest was performed and an LAI map created. The correlation between the measured and the estimated LAI was also high (r(2)=0.91). The study shows the potential of spatial scale integration to analyse and to monitor plant coenosis in Mediterranean areas