Essays on Debt and Heterogeneous Agent Macroeconomics

In the first essay, I build a heterogeneous agent model of housing default to study how the effectiveness of macroprudential policies changes under different income and house price specifications. When calibrated to match the observed default choices of households during the financial crisis, the model has clear implications for the kind of macroprudential policies that will be more effective in different circumstances. When income shocks are large, restrictions on the loan-to-value ratio are more effective in reducing defaults, while when house price shocks are large, the default rate is more responsive to changes in payment-to-income limits. These results are an implication, filtered through the model, of the well-known double trigger fact: In the Great Recession, defaulting households tended to be those who were both seriously underwater and had experienced a substantial shock to income. In the second essay, I study whether monetary policy has been less effective since the global financial crisis because of deteriorating household balance sheets. The paper examine the question using household data from the United States. It compares the responsiveness of household consumption to monetary policy shocks in the pre- and post-crisis periods, relating changes in monetary transmission to changes in household indebtedness and liquidity. The results show that the responsiveness of household consumption has diminished since the crisis. However, household balance sheets are not the culprit. More indebted and less liquid households are the most responsive to monetary policy, and their share in the population grew. In the third essay, I introduce new methods for efficiently solving dynamic optimization problems with both discrete and continuous choices (DC models). These methods extend the Endogenous Gridpoint Method (EGM) by including exogenous outcome probabilities, search frictions, and taste shocks to `concavify' the value function of the optimization problem. Compared to existing extensions of the EGM for DC models, the methods introduced in this paper have the added advantage of not only providing greater smoothness, but also rationalizing the smoothness into the agent's choice problem

Cooperative Networks

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Mimetic Representation of Female Characters in ‘Their Language of Love’ by Bapsi Sidhwa

Females always have been the topic of discussion under different aspects discussed in literature. From some last decades there have been some debatable titles in writing especially postcolonial literature. There are many female writers in this period of postcolonial. In Pakistan, the persons who have a name on the conversation of feminism; Bapsi Sidwa is a good name in them. Feminism is a broad topic to mentioning but it would be interested when telling about particular comparative analysis with the male author representing the society. It is very perceptible when the relation between them is like a master-slave relationship as Hegel believes, or having a balance between them. It depends upon many factors like the cultural effect of the society. Pakistani society has a patriarchal building block in it so its criteria of debate and the way the others take it, are different. This study helps to enhance the space for a female in a society described by Bapsi Sidwa.  Life depends on the thought of society and it varies the representative style of the authors. Key Words: Feminism, Societal effect, Relationships, Memetic representation DOI: 10.7176/JLLL/66-10 Publication date:March 31st 202

Assessment of potential drug–drug interactions and its associated factors in the hospitalized cardiac patients

AbstractDrug–drug interactions (DDIs) may result in the alteration of therapeutic response. Sometimes they may increase the untoward effects of many drugs. Hospitalized cardiac patients need more attention regarding drug–drug interactions due to complexity of their disease and therapeutic regimen. This research was performed to find out types, prevalence and association between various predictors of potential drug–drug interactions (pDDIs) in the Department of Cardiology and to report common interactions. This study was performed in the hospitalized cardiac patients at Ayub Teaching Hospital, Abbottabad, Pakistan. Patient charts of 2342 patients were assessed for pDDIs using Micromedex® Drug Information. Logistic regression was applied to find predictors of pDDIs. The main outcome measure in the study was the association of the potential drug–drug interactions with various factors such as age, gender, polypharmacy, and hospital stay of the patients. We identified 53 interacting-combinations that were present in total 5109 pDDIs with median number of 02 pDDIs per patient. Overall, 91.6% patients had at least one pDDI; 86.3% were having at least one major pDDI, and 84.5% patients had at least one moderate pDDI. Among 5109 identified pDDIs, most were of moderate (55%) or major severity (45%); established (24.2%), theoretical (18.8%) or probable (57%) type of scientific evidence. Top 10 common pDDIs included 3 major and 7 moderate interactions. Results obtained by multivariate logistic regression revealed a significant association of the occurrence of pDDIs in patient with age of 60years or more (p<0.001), hospital stay of 7days or longer (p<0.001) and taking 7 or more drugs (p<0.001). We found a high prevalence for pDDIs in the Department of Cardiology, most of which were of moderate severity. Older patients, patients with longer hospital stay and with elevated number of prescribed drugs were at higher risk of pDDIs

Exploring community pharmacists perception towards responsible provision of patient care services: A quantitative assessment

Purpose: To investigate the perception of community pharmacists with regard to pharmaceutical care services in Khyber Pakhtunkhwa (KPK), Pakistan.Methods: This was a cross-sectional survey carried out among the community pharmacists in seven divisions of KPK, namely, Bannu, Dera Ismail Khan, Hazara, Kohat, Malakand, Mardan, and Peshawar. The survey was conducted between July and September 2014. A total of 22 community&nbsp; pharmacists were identified and approached.Results: Eighteen community pharmacists returned the filled questionnaire showing a response rate of 81.8 %. All participants (n = 18, 100 %) were male. The majority of the participants 55.6 % (n = 10) made it clear that they had never interacted with doctors, while only 33.3 % (n = 6) reported weekly interaction. The major reasons for interaction were to discuss drug alternatives (38.9 %, n = 7) and the availability of prescribed drugs (33.3 %, n = 6). Meanwhile, about 83.3 % (n = 15) of community pharmacists were involved in educating patients, while only 38.9 % (n = 7) spend enough time on each patient. Further, a large proportion of respondents had never documented patients’ medical, allergy and family histories (83.3 %, n = 15). Only 44.4 % (n = 8) of community pharmacists sometimes checked and signed the prescription.Conclusion: Community pharmacists are few in number in the studied area. They are involved in patient counseling but face difficulties in&nbsp; counseling due to lack of time and insufficient pharmacy staff. Therefore, there is a need to significantly enhance the interaction between&nbsp; pharmacists and other healthcare professionals to facilitate inter-professional collaboration. Keywords: Community pharmacy, Pharmaceutical care, Perception, Inter-professional collaboratio

Nurses perception of pharmaceutical care practice: A qualitative approach

Purpose: To evaluate the perception of nurses regarding pharmaceutical care services in the healthcare system of Khyber Pakhtunkhwa (KPK) Province of Pakistan.Methods: This qualitative study was implemented by conducting semi-structured interviews. For data collection, interviews (face-to-face) were conducted after developing an interview guide. The interviewees were 18 nurses and were interviewed at their nursing stations in hospitals.&nbsp; Interviews were continued until the data reached a saturation point. The respondents signed a written consent form before the start of the interview.Results: From the thematic content analysis, five major themes were extracted as stated here: (a) incognizance of pharmaceutical care; (b) collaboration of nurses and pharmacists; (c) improper distribution system; (d) lack of provision of patient counseling; and (e) pharmacist’s role in reducing prescribing errors.Conclusion: Based to the findings, Pakistani nurses have poor knowledge of pharmaceutical care, thus highlighting the need for organizing pharmaceutical care awareness programs for nurses. On the other hand, nurses have a positive perception of pharmacists’ roles in the healthcare system and want to work with them. Keywords: Perception, Pharmaceutical care, Qualitative study, Nurse, Patient car

Randomized controlled trials covering pharmaceutical care and medicines management: A systematic literature review

Objective To review the effects of pharmaceutical care on hospitalizations, mortality and clinical outcomes in patients. Methods Systematic searches were conducted in MEDLINE, EMBASE and International Pharmaceutical Abstracts (IPA) databases to identify studies that were published between 2004 and January 2017. Studies included in this review were randomized controlled trials (RCTs) that spanned across both community and hospital settings. Using strict inclusion/exclusion criteria studies were included if they reported level 1 or 2 outcomes in the hierarchy of outcome measure i.e. clinical and surrogate outcomes (e.g. blood pressure (BP) control, blood glucose level, cholesterol BMI). Each study was assessed for quality using the Jadad scoring system. Results Fifty-four RCTs were included in the present review. Forty-six of these studies ranked high quality according to the Jadad scoring system. Studies were categorized into their general condition groups. Interventions in patients with diabetes, depression, respiratory disorders, cardiovascular disorders, epilepsy, osteoporosis, and interventions in older adults were identified. In the majority of studies pharmaceutical care was found to lead to significant improvements in clinical outcomes and/or hospitalizations when compared to the non-intervention group. Some conditions had a large number of RCTs, for example for cardiovascular conditions and in diabetes. Statistically significant improvements were seen in the majority of the studies included for both of these conditions, with studies indicating positive clinical outcomes and/or hospitalizations rates. Within the cardiovascular condition, a subset of studies, focusing on cardiac heart failure and coronary heart disease, had more mixed results. In other conditions the number of RCTs conducted was small and the evidence did not show improvements after pharmaceutical care, i.e. in depression, osteoporosis, and epilepsy. The majority of interventions were face to face interactions with patients, whilst a smaller number were conducted via the telephone and one via a web-based system. Patient education was a key component of most interventions, either verbal and/or written. Longitudinal data, post intervention cessation, was not collected in the majority of cases. Conclusions RCTs conducted to evaluate pharmaceutical care appear to be effective in improving patient short-term outcomes for a number of conditions including diabetes and cardiovascular conditions, however, other conditions such as depression are less well researched. Future research should attempt to evaluate the conditions where there is a lack of data, whether the positive effects of pharmaceutical care persist in patient populations after the interventions cease and what the long-term clinical outcomes would be of continued pharmaceutical care

A Compact Beam-Scanning Leaky-Wave Antenna With Improved Performance

A compact microstrip leaky-wave antenna (MLWA) with reduced sidelobe level and increased linear frequency-scanning capability is proposed in this letter. Symmetric Yagi-like elements are introduced, which reduce the sidelobe level by radiating the remaining power at the physical end of MLWA, and make the radiation plane (xz plane) symmetric. Defected ground plane is used to optimize the working of Yagi-like elements. Measured results show that the sidelobe is suppressed about 16 dB at 4.8 GHz. To further reduce the sidelobe level, improve frequency-scanning capability, and increase the gain, the leaky section of the antenna is tapered, and two slots of equal dimensions are introduced. The frequency beam scanning is improved compared with the conventional MLWAs by achieving a total beam scan of 78° (from broadside [12°] to endfire [90°]). The measurements performed on the fabricated prototype exhibit good agreement with simulations

Green Production and Structural Evaluation of Maize Starch–Fatty Acid Complexes Through High Speed Homogenization

© 2020, Springer Science+Business Media, LLC, part of Springer Nature. The current study describes the production of maize starch–fatty acid complexes through high speed homogenization, a novel field of research, without heat or any chemical treatment. The starch–fatty acid complexes were produced with three different fatty acids, i.e. stearic acid (T1), palmitic acid (T2) and lauric acid (T3). The complexes were analyzed through various techniques. The results reveal that the complexing index (CI), swelling power (SP) and solubility (S) for T1 were significantly higher compared to T2 and T3. In X-ray diffraction (XRD) studies, relatively lower crystalline (V-type pattern) structures were obtained for the samples T1–T3, where T2 showed the highest crystallinity amongst all. Fourier transformed infrared (FTIR) spectra showed characteristic bands i.e., OH, C=O, C–O and long-chain CH2 functionalities thus confirming the overall incorporation of acids into glycoside moieties. The Scanning electron microscopy (SEM) analysis showed sub-crystalline matrix structures with fewer or no spherulites indicating the overall incorporation of acids in starch. The samples showed relatively low thermal stability in the thermal gravimetric analysis (TGA) in the range of 180 to 280 °C. These results suggest that high speed homogenization had the potential for the development of green and biocompatible maize starch–fatty acid complexes