The implications and relevance of a tax exemption for co-operatives : the case of a small European state

Purpose: To assess the relevance of the tax exemption being granted to Maltese co-operatives on their ploughed-back profits to the creation of such legal structures and to their financial performance. Design/Methodology/Approach: We do this by carrying out 21 semi-structured interviews and reviewing of the financial statements of four co-operatives over a period of five years. Findings: Results show that such a tax exemption may indeed be attracting a few applicants to form co-operatives. However, although the exemption may be serving as an incentive to encourage such start-ups, their promoters may be commonly lacking more valid reasons for choosing to set up this particular structure, which is meant to balance both commercial and social goals. The article therefore concludes that the tax exemption on its own is evidently insufficiently effective in the promotion of genuine and financially successful start-ups and recommends that a review of the tax exemption provision is likely to be beneficial. Further recommendations include (i) rendering such a provision more relevant by linking its granting to the results of a social audit for each co-operative,(ii) reviewing the legal asset-lock provision so as no longer to undermine the attractiveness of the tax exemption, and also (iii) launching vigorous education programmes on the raison d’etre of a co-operative. Practical Implications: Although there were several studies relating to Maltese co-operatives, there has not been a study specifically dealing with the tax exemption for such entities. Accordingly, this research study would prove to be useful in assessing the relevance of the tax exemption conceded to Maltese co-operatives by delving into its implications. Originality/Value: This study will identify any possible amendments that could be made to resolve the tax implications encountered.peer-reviewe

Children living with HIV in Europe: do migrants have worse treatment outcomes?

International audienceTo assess the effect of migrant status on treatment outcomes among children living with HIV in Europe

Timing of nasogastric tube insertion and the risk of postoperative pneumonia: an international, prospective cohort study

Aim: Aspiration is a common cause of pneumonia in patients with postoperative ileus. Insertion of a nasogastric tube (NGT) is often performed, but this can be distressing. The aim of this study was to determine whether the timing of NGT insertion after surgery (before versus after vomiting) was associated with reduced rates of pneumonia in patients undergoing elective colorectal surgery. Method: This was a preplanned secondary analysis of a multicentre, prospective cohort study. Patients undergoing elective colorectal surgery between January 2018 and April 2018 were eligible. Those receiving a NGT were divided into three groups, based on the timing of the insertion: routine NGT (inserted at the time of surgery), prophylactic NGT (inserted after surgery but before vomiting) and reactive NGT (inserted after surgery and after vomiting). The primary outcome was the development of pneumonia within 30 days of surgery, which was compared between the prophylactic and reactive NGT groups using multivariable regression analysis. Results: A total of 4715 patients were included in the analysis and 1536 (32.6%) received a NGT. These were classified as routine in 926 (60.3%), reactive in 461 (30.0%) and prophylactic in 149 (9.7%). Two hundred patients (4.2%) developed pneumonia (no NGT 2.7%; routine NGT 5.2%; reactive NGT 10.6%; prophylactic NGT 11.4%). After adjustment for confounding factors, no significant difference in pneumonia rates was detected between the prophylactic and reactive NGT groups (odds ratio 1.03, 95% CI 0.56\u20131.87, P = 0.932). Conclusion: In patients who required the insertion of a NGT after surgery, prophylactic insertion was not associated with fewer cases of pneumonia within 30 days of surgery compared with reactive insertion