An Examination of the Information Content of Funds from Operations (FFO) Using Polynomial Regression and Response Surface Methodology

I examine the market reaction to the announcement of FFO by REITs using abnormal trading volume as a gauge of investors’ reaction. I also address the question of whether FFO provides more useful information to investors than net income. Lastly, I examine whether the quality of private information among traders prior to the announcement of FFO affects the level of abnormal trading volume. Using three different specifications, I find that even though the announcement of FFO leads to abnormal trading, there is no association between the level of abnormal trading volume and the size of the surprise contained in the FFO announcement. I also find, using abnormal returns as a measure of investor response, that FFO explains significantly more variance in abnormal returns than net income suggesting that FFO provides more useful information than net income. Lastly, I use the proportion of institutional holdings as a proxy for the number of informed traders to predict the amount of abnormal trading volume. I find no significant relation between abnormal trading volume and the proportion of institutional holdings. However, when I break down institutional ownership into two broad classifications, I find that the level of abnormal trading volume is significantly positively related to the holdings by mutual funds and investment advisors but negatively related to the holdings of other institutions (pension funds &.endowments, banks and insurance companies). This raises questions of whether the use of an aggregate measure of institutional ownership is appropriate in studies that examine the effect of institutional holdings

Modelling the Economic Growth Rate of Ghana using the Solow Model

The main objective of this study was to use the Solow growth model (Augmented Cobb-Douglas production function) as a basis to model the economic growth of Ghana during the period 1990 to 2010. Economic growth around the world has not been equal for a long time. Some economies grow faster than others. Economists have predicted that the slower growing economies will eventually converge to the faster growing economies at some point in time. In this study, we model the economic growth of Ghana using the Solow production model and applying growth differential equations. Starting from the estimates of the parameters from other studies, the growth model was simulated for the period 1990 to 2010. The recording and computation of the data was done using Matlab, SPSS and Excel. The computations were Capital, Labour force, Total Factor Productivity, and Total Production and the results from models were compared with the real GDP growth figures and variations noted. The estimations from the model were compared with the actual figures from the Ghana Statistical Service, World Bank and Bank of Ghana. The model provides a good approximation of the dynamics of the Ghanaian economy for the 1990 to 2010 periods, with respect to the dynamics of the real aggregate GDP growth and to the ratios of the main macroeconomic variables, like production per worker, capital-output ratio or capital per worker. The results showed a very close relationship between the actual and calculated growth rates over the periods 1990 to 2010. The actual average growth rate over the period was 4.5% as compared to the calculated average value of 4.21%. In conclusion, there was a correlation between the actual growth rates and the calculated but the strength was weak. Keywords: Solow growth model, Economic growth of Ghana, Real GDP growth, Macroeconomic variables, actual and calculated growth rat

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

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

An evaluation of property valuation practice in Sub-Saharan Africa

Real estate markets in Sub-Saharan Africa (SSA) are beginning to mature partly due to increased business and investment activities in the last decade and partly due to initiatives to improve transparency in market operations. Professional and ethical property valuation services are vital to the sustenance of the current real estate business and investment activities in the region as they promote transparency and support efficient operation of property markets.Serious concernsHowever, there are serious concerns over the standard of property valuations produced in the region. These concerns relate to valuation errors, in particular, wide variation in valuations.Ghana is one country in the region where real estate business and investment activities continue to increase, and there are growing concerns over high variation in valuations expressed both among real estate valuers/valuation surveyors and within the wider real estate sector. Like the rest of the Sub-Saharan Africa (SSA) region, these concerns are largely based on anecdotal evidence, and speculation that paucity of property market data is one of the main causes.Using empirical evidence from Accra, Ghana, as a case study, the aim of the research was to evaluate property valuation practice in SSA. It sought specifically to:◾estimate the extent of variations in valuations undertaken by Ghanaian valuers/valuation surveyors◾identify appropriate property market data sources in Ghana◾develop a property data collection template to support property market data collection for valuations◾outline guidelines for effective property market data collection to improve valuation practic

Sources and reliability of property market information for property valuation practice in Ghana

© 2017, © Emerald Publishing Limited. Purpose: Adequate reliable property market data are critical to the production of professional and ethical valuations as well as better real estate transaction decision-making. However, the availability of reliable property market information represents a major barrier to improving valuation practices in Ghana and it is regarded as a key challenge. The purpose of this paper is to investigate the sources and reliability of property market information for valuation practice in Ghana. The aim is to provide input into initiatives to address the availability of reliable property market data challenges. Design/methodology/approach: A mixed methods research approach is used. The study, thus, relies on a combination of a systematic identification and review of literature, a stakeholder workshop and a questionnaire survey of real estate valuers in Accra, Ghana’s capital city to obtain requisite data to address the aim. Findings: The study identifies seven property market data sources used by valuers to obtain market data for valuation practice. These are: valuers own database; public institutions; professional colleagues; property owners; estate developers; estate agents; and the media. However, access to property market information for valuations is a challenge although valuers would like to use reliable market data for their valuations. This is due to incomplete and scattered nature of data often borne out of administrative lapses; non-disclosure of details of property transactions due to confidentiality arrangements and the quest to evade taxes; data integrity concerns; and lack of requisite training and experience especially for estate agents to collect and manage market data. Although professional colleagues is the most used market data source, valuers own databases, was regarded as the most reliable source compared to the media, which was considered as the least reliable source. Research limitations/implications: Findings from the study imply a need for the development of a systematic approach to property market data collection and management. This will require practitioners to demonstrate care, consciousness and a set of data collection skills suggesting a need for valuers and estate agents to undergo regular relevant training to develop and enhance their knowledge, skills and capabilities. The establishment of a property market databank to help in the provision of reliable market data along with a suitable market data collection template to ensure effective and efficient data collection are considered essential steps. Originality/value: The study makes a significant contribution to the extant knowledge by providing empirical evidence on the frequency of use and the reliability of the various sources of market data. It also provides useful insights for regulators such as the Ghana Institution of Surveyors (GhIS), the Royal Institution of Chartered Surveyors (RICS) and other stakeholders such as the Commonwealth Association of Surveying and Land Economy (CASLE) and the Government to improve the provision of reliable property market information towards developing valuation practice not only in Ghana, but across the Sub-Saharan Africa Region. Also, based on these findings, the study proposes a new property market data collection template and guidelines towards improving the collection of effective property market data. Upon refinement, these could aid valuation practitioners to collect reliable property market data to improve valuation practice

The Integration of Mortgage and Capital Markets in Emerging Economies—Evidence from South Africa

Integration, Secondary mortgage market, Cointegration, Mortgage market, Capital market,

Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.Peer reviewe

Adaptation of the Wound Healing Questionnaire universal-reporter outcome measure for use in global surgery trials (TALON-1 study): mixed-methods study and Rasch analysis

BackgroundThe Bluebelle Wound Healing Questionnaire (WHQ) is a universal-reporter outcome measure developed in the UK for remote detection of surgical-site infection after abdominal surgery. This study aimed to explore cross-cultural equivalence, acceptability, and content validity of the WHQ for use across low- and middle-income countries, and to make recommendations for its adaptation.MethodsThis was a mixed-methods study within a trial (SWAT) embedded in an international randomized trial, conducted according to best practice guidelines, and co-produced with community and patient partners (TALON-1). Structured interviews and focus groups were used to gather data regarding cross-cultural, cross-contextual equivalence of the individual items and scale, and conduct a translatability assessment. Translation was completed into five languages in accordance with Mapi recommendations. Next, data from a prospective cohort (SWAT) were interpreted using Rasch analysis to explore scaling and measurement properties of the WHQ. Finally, qualitative and quantitative data were triangulated using a modified, exploratory, instrumental design model.ResultsIn the qualitative phase, 10 structured interviews and six focus groups took place with a total of 47 investigators across six countries. Themes related to comprehension, response mapping, retrieval, and judgement were identified with rich cross-cultural insights. In the quantitative phase, an exploratory Rasch model was fitted to data from 537 patients (369 excluding extremes). Owing to the number of extreme (floor) values, the overall level of power was low. The single WHQ scale satisfied tests of unidimensionality, indicating validity of the ordinal total WHQ score. There was significant overall model misfit of five items (5, 9, 14, 15, 16) and local dependency in 11 item pairs. The person separation index was estimated as 0.48 suggesting weak discrimination between classes, whereas Cronbach's α was high at 0.86. Triangulation of qualitative data with the Rasch analysis supported recommendations for cross-cultural adaptation of the WHQ items 1 (redness), 3 (clear fluid), 7 (deep wound opening), 10 (pain), 11 (fever), 15 (antibiotics), 16 (debridement), 18 (drainage), and 19 (reoperation). Changes to three item response categories (1, not at all; 2, a little; 3, a lot) were adopted for symptom items 1 to 10, and two categories (0, no; 1, yes) for item 11 (fever).ConclusionThis study made recommendations for cross-cultural adaptation of the WHQ for use in global surgical research and practice, using co-produced mixed-methods data from three continents. Translations are now available for implementation into remote wound assessment pathways