Analyzing the Socio-economic Impacts of Mining with Propensity Score Matching (PSM): Insights for Responsible Mining in Caraga Region, Philippines

Propensity-score matching (PSM) is an estimation procedure used in this study to address selection bias and endogeneity to obtain robust results in determining the impacts of mining on the socio-economic condition of the people in the mining areas of Caraga Region, Philippines. This study has used it with three matching methods (nearest neighbor, kernel and radius matching) to come up with implications on the socio-economic underpinnings of responsible mining for the region. The impacts of mining in this study are signified by the significance of average treatment effects on the treated (ATT) for each of the socio-economic parameters of the households under study. Consistently, the results demonstrate increased borrowing in the mining areas of the region.  Results of radius matching have indicated increase in investment for human capital buildup, as implied by the increase in food and education expenditures. There are also manifestations of in-migration and efforts on the part of mining to participate in the improvement of accessibility condition through the provision of paved roads. Yet, the results signify that there is yet a need to work for the improvement of the quality of life as perceived by the households in the mining areas.  This study has recommended intensified efforts towards human development, entrepreneurship and pollution control, especially that responsible mining is to build the resilience of people to natural hazards for sustainable development in Caraga Region, Philippines. Keywords: propensity-score matching, nearest neighbor, kernel and radius matching, AT

Floristic Inventory of The Proposed Site for Tarsier Tourism Center in Villa Aurora, Bilar, Bohol, Philippines

The study assessed the present vegetation composition of the Proposed Site for the Tarsier Tourism Center (PTTC) at Villa Aurora, Bilar, Bohol and performed a comparative analysis with the existing Tarsier Sanctuary (TS) at Canapnapan, Corella, Bohol. The basis for comparison was the computed importance values, species richness, species dominance, and percent distribution of plants according to self-defined DBH classes. Results showed that both sites had very high species richness and evenness values. Common overstorey and understorey plant species found in both areas were katagpo (Psychotria sp.), sagimsim (Syzygium brevistylum [C. B. Rob]Merr.) and bagauak (Clerodendrum minahassae Teijsm. & Binn.). Apart from sagimsim (Syzygium brevistylum [C.B.Rob.] Merr.), selaginella (Selaginella cuppresina Lin.), and lunas (Lunasia amara Blanco) were also common in the ground vegetation of both areas. Percent distribution of trees according to self-defined DBH classes revealed that PTTC had 87.55% of the total recorded plants with DBH measurements of 20 cm. Percent distribution of trees on these DBH ranges (especially on DBH class >20 cm) indicated the presence of medium and large trees. The largest DBH measured in the PTTC was 70 cm while in TS was only 22 cm. The proposed 10-ha site in Villa Aurora, Bilar, is suited to be utilized as Tarsier Tourism Center. In case the proposed project is to be pursued, enclosure similar to what has been constructed in Canapnapan, Corella, Bohol, Philippines should also be established to prevent stray animals from predating the captive tarsiers.Keywords: floristic inventory, Philippine tarsier, Bohol, primate conservation, tourism. Inventarisasi flora dari Situs Usulan untuk Sentra Wisata Tarsier di Villa Aurora, Bilar, Bohol, FilipinaAbstractPenelitian ini ditujukan untuk melakukan penilaian komposisi vegetasi dari Usulan Lokasi Pusat Wisata Tarsius (ULPWT) di Villa Aurora, Bilar, Bohol dan melakukan analisis perbandingan antara Tarsier Sanctuary (TS) yang ada di Canapnapan, Corella, Bohol. Dasar perbandingan yang digunakan yaitu dengan menghitung nilai penting, kekayaan spesies, dominansi spesies, dan prosentase distribusi dari tumbuhan berdasarkan kelas diameter yang telah ditentukan. Hasil penelitian menunjukkan bahwa kedua tempat memiliki kekayaan spesies dan nilai evenness/ kemerataan yang sangat tinggi. Spesies tumbuhan yang umum ditemukan di overstorey dan understorey di kedua area adalah katagpo (Psychotria sp.), sagimsim (Syzygium brevistylum [C. B. Rob]Merr.), dan bagauak (Clerodendrum minahassae Teijsm. & Binn.). Selain itu, sagimsim (Syzygium brevistylum [C.B.Rob.] Merr.), selaginella (Selaginella cuppresina Lin.), dan lunas (Lunasia amara Blanco) juga umum ditemukan di lantai hutan di kedua tempat. Prosentase distribusi dari tumbuhan berdasarkan kelas diameter yang telah ditentukan menunjukkan bahwa ULPWT memiliki 87.55% dari keseluruhan tumbuhan yang tercatat dengan ukuran diameter 20 cm. Prosentase distribusi dari pohon pada kisaran ini (khususnya pada diameter >20 cm) menunjukkan adanya kehadiran pohon berukuran medium dan besar. Diameter terbesar yang terukur di ULPWT adalah 70 cm sementara di TS hanya sebesar 22 cm. Lokasi seluas 10 ha di Villa Aurora, Bilar, sesuai untuk digunakan sebagai Pusat Wisata Tarsius. Apabila akan didirikan, maka kandang yang dibangun diharapkan mirip dengan yang telah dibangun di Canapnapan, Corella, Bohol, Pilipina, agar mencegah pemangsaan oleh satwa yang lepas.

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research