121 research outputs found

    Residential electricity pricing in China

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    The paper aims to evaluate the implications of the new residential pricing system in China by examining price and income elasticity of demand by different household types. We use pre-reform annual panel data for 29 provinces over a fourteen year period, from 1998 to 2011, applying feasible generalize least squares models. The price and income elasticities for household sector are -0.412, and 1.476 at nation level, -0.300 and 1.550 in urban areas and -0.522 and 1.093 in rural areas respectively. With regional effects, the price and income elasticities are -0.146 and 1.286 for urban households in coastal provinces and -0.772 and 1.259 for urban households in inland provinces respectively. The empirical results reveal that there is important heterogeneity in the responsiveness to electricity price changes according to household income level and location

    Tourism economics research: A review and assessment

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    This paper aims to provide the most up-to-date survey of tourism economics research and to summarise the key trends in its recent development. Particular attention is paid to the research progress made over the last decade in respect of approaches, methodological innovations, emerging topics, research gaps, and directions for future research. Remarkable but unbalanced developments have been observed across different sub-research areas in tourism economics. While neoclassical economics has contributed the most to the development of tourism economics, alternative schools of thought in economics have also emerged in advancing our understanding of tourism from different perspectives. As tourism studies are multi- and inter-disciplinary, integrating economics with other social science disciplines will further contribute to knowledge creation in tourism studies

    Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

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    Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

    Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

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    Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

    Condylar and ramal vertical asymmetry in adolescent patients with cleft lip and palate evaluated with cone-beam computed tomography

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    Introduction: The aims of this study were to evaluate condylar and ramal mandibular vertical asymmetry in a patient group affected by unilateral (UCLP) and bilateral (BCLP) cleft lip and palate, and to compare the findings with a well-matched control group with normal occlusion. Methods: The study groups included 20 UCLP patients (12 male, 8 female), 21 BCLP patients (12 male, 9 female), and a control group of 21 subjects with normal occlusion (10 male, 11 female). Measurements of condylar, ramal, and condylar plus ramal heights and asymmetry indexes were examined on cone-beam computed tomography images. One-way analysis of variance was used to determine potential statistical differences among the groups for condylar, ramal, and condylar plus ramal asymmetry index measurements. The post-hoc Tukey HSD test was used to determine individual differences. Results: No investigated group showed a statistically significant sex difference for any asymmetry index (P = 0.05). There was a statistically significant difference between the normal and cleft sides in the ramal height and ramal plus condylar height measurements in the UCLP group (P = 0.004 and P = 0.006, respectively). The Tukey HSD test showed a statistically significant difference between the UCLP and BCLP groups in terms of ramal asymmetry index values (P = 0.018). Conclusions: The ramal height and ramal plus condylar height measurements were significantly lower in the cleft side in the UCLP patients, and there was a statistically significant difference in ramal asymmetry index values between the patients affected by UCLP and BCLP
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