Impact of Fiscal Decentralisation on Human Development: A Case Study of Pakistan

Fiscal decentralisation refers to the transfer of authority and responsibility from central government to sub-national or the local government. It is mostly pre-assumed that fiscal decentralisation can play important role in the efficient allocations of resources and improvement of the political, economic and social activities. Many studies unlock the relationship between federal government and sub-national governments or local government. Fiscal decentralisation theories mostly based on Richard Musgrave’s (1939) functions of government. He defined three roles: stabilisation, allocation and distribution whereas, only the allocation function seems to be appropriate to fiscal decentralisation theory. Because these three functions are not equally suitable for all level of governments and it is necessary for efficiency that each function is properly matched to the level. It is a step forward towards more responsive and efficient governance if the decentralisation is done properly [Oates (1972)]. The logic behind fiscal decentralisation is accountability and efficiency; the smaller organisations are more fragile for accountability than the larger ones. However, decentralisation has not always been effective in the provision of service delivery and hardly accountable due to lack of community participation. If there is no spill over effects and in the absence of diseconomies of scale it could be effective and efficient. The sub-national governments where the externalities are internalised and scale economies are acceptable fiscal responsibilities should be assigned [Rodden, et al. (2003)]. The sub-national governments are much closer to the people and they are better informed to respond according to their demands of goods and services [Hayek (1945); Qian and Weingast (1997)]. Service deliveries are highly dependent on transfers from central governments. It is necessary to increase the revenue autonomy of sub-national governments and it is linked with the service delivery in social sector [Elhiraika (2007)]. Lower level of governments is closer to the people and much aware of the preferences of localities. Service deliveries should be located at the lowest level because decentralised provision of services increases the economic welfare [Oates (1999)]

Dengue Hemorrhagic fever complicated by intercostal artery hemorrhage.

Hemorrhagic manifestations are fairly common in Dengue hemorrhagic fever and are associated with increased mortality. During last few decades there have been increasing reports of Dengue infection with unusual manifestations. Here we present a case of dengue hemorrhagic fever complicated by spontaneous rupture of an intercostal artery leading to a large hematoma which was treated successfully with angio-embolization. To the authors\u27 knowledge this is a first case of dengue hemorrhagic fever complicated by spontaneous intercostal artery hemorrhage

IMPACT OF INDUSTRY SPECIFIC VARIABLES ON THE DIVIDEND POLICY OF OIL AND GAS SECTOR IN PAKISTAN

Dividends act as a pathway to attract investments andpetroleum industry of Pakistan has remained an important element in economic progress. Therefore, this research investigates the impact of corporate tax, financial leverage and sales growth on dividend payout ratio of oil & gas sector companies in Pakistan. Secondary data of 10 companies for 12 years have been incorporated. Hypotheses have been tested using fixed effects regression technique which was confirmed through Hausman specification test. Empirical findings reveal that corporate tax and sales growth have insignificant positive impacts, whereas financial leverage has an insignificant negative impact on the dividend payout ratio. The study concludes that decisions about dividend payouts should be made by considering other variables

Death Anxiety among Hospitalized Patients: A Gender Based Comparison

Objectives: Present research purpose is to investigate and compare the level of death anxiety among male and female hospitalized patients in Balochistan. Place and duration: the research was conducted in various hospital of district Quetta and Makuran Division, Balochistan and took 6 months for completion. Sample and methods: Total sample for the study encompassed 50 hospitalized patients that includes male [n= 27, M (SD) = 51.41 (6.541)] and female [n=23, M (SD) = 49.04(6.630)] admitted in various hospitals of Balochistan. Measure:  Informed Consent Form and Death Anxiety Scales (Donald Templer, 1970) was utilized for any level of death anxiety.   Analysis: For assessing and comparing death anxiety among two gender groups. Descriptive analysis and independent sample t- test was conducted. Results:   Results indicate substantial death anxiety among hospitalized patients of Balochistan, but there were non- significant differences among male and female on the levels of death anxiety

A regulatory governance perspective on health technology assessment (HTA) in France: the contextual mediation of common functional pressures

The new regulatory governance perspective has introduced several insights to the study of health technology assessment (HTA): it has broadened the scope for the analysis of HTA; it has provided a more sophisticated account of national diversity and the potential for cross-border policy learning; and, it has dissolved the distinction between HTA assessment and appraisal processes. In this paper, we undertake a qualitative study of the French process for HTA with a view to introducing a fourth insight: that the emergence and continuing function of national agencies for HTA follows a broadly evolutionary pattern in which contextual factors play an important mediating role. We demonstrate that the French process for HTA is characterised by distinctive institutions, processes and evidential requirements. Consistent with the mediating role of this divergent policy context, we argue that even initiatives for the harmonisation of national approaches to HTA are likely to meet with divergent national policy responses

Spiniform phase-encoded metagratings entangling arbitrary rational-order orbital angular momentum

Quantum entanglements between integer-order and fractional-order orbital angular momentums (OAMs) have been previously discussed. However, the entangled nature of arbitrary rational-order OAM has long been considered a myth due to the absence of an effective strategy for generating arbitrary rational-order OAM beams. Therefore, we report a single metadevice comprising a bilaterally symmetric grating with an aperture, creating optical beams with dynamically controllable OAM values that are continuously varying over a rational range. Due to its encoded spiniform phase, this novel metagrating enables the production of an average OAM that can be increased without a theoretical limit by embracing distributed singularities, which differs significantly from the classic method of stacking phase singularities using fork gratings. This new method makes it possible to probe the unexplored niche of quantum entanglement between arbitrarily defined OAMs in light, which could lead to the complex manipulation of microparticles, high-dimensional quantum entanglement and optical communication. We show that quantum coincidence based on rational-order OAM-superposition states could give rise to low cross-talks between two different states that have no significant overlap in their spiral spectra. Additionally, future applications in quantum communication and optical micromanipulation may be found

Comparing the Effectiveness of Different Reinforcement Stimuli in a Robotic Therapy for Children With ASD

Recent research has shown reliability in robotic therapies for improvement in core impairments of autism. To improve the efficiency of communication using robots, this study evaluates the effectiveness of three different stimuli in a robotic intervention for children with autism spectrum disorder. Three different reinforcement stimuli presented in least-to-most (LTM) order introduced in this therapy using NAO robot are: visual (color variation), auditory and motion cues. The therapy was tested on 12 ASD children, 4 out of 12 children fall under mild category whereas 8 fall under the minimal category of autism. The experimentation was conducted for 2 months. Total 8 experiments were conducted with 1 trial per week. Total 12 cues were given per trial, 4 cues corresponding to each category. In total 96 cues were given per subject, 32 cues from each category. The results indicate a general trend for linking a particular autism category with the most effective stimulus for that category. It can be concluded that visual cue (color variation) is the most effective reinforcement stimulus for children with minimal autism as 8 out of 8 i.e., 100% were more responsive to visual cues whereas for children with mild autism category, 3 out of 4 i.e., 75% are more receptive towards the motion stimulus. The parameters used for assessment were joint attention and the time eye contact is maintained. Single factor ANOVA was used for the statistical analysis of results with alpha is 0.05 and p-value 0.0342, F value is 3.7456 and F critical value is 3.2834. The test was performed on 96 ( $8\times 12$ ) trails in total, therefore ensuring the significance and reliability of our results

Use of Corticosteroids in Rheumatoid Arthritis

Abstract Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disorder that may affect many tissues and organs, but principally attacks the joints producing an inflammatory synovitis that often progresses to destruction of the articular cartilage and ankylosis of the joints. Aim was to evaluate the use of corticosteroids in rheumatoid arthritis. This was a retrospective study, which was carried out in different hospitals. Method; A total 25 patients with rheumatoid arthritis were studied. These patients either presented in clinics or hospital outdoor department of Jinnah hospital, Sir Ganga Ram hospital and Services hospital Lahore between the period of 12 June 2010 to 30 July 2010. Results; From the data collected it has been found that Corticosteroids have been widely used for suppressing pain and inflammation in RA. Conclusion; Corticosteroids can improve the symptoms of patients with rheumatic diseases. They may also have a disease-modifying effect in rheumatoid arthritis. Corticosteroids have a clear role in the management of rheumatic disease. Their toxicity requires that they are used only when necessary, at the lowest dose possible and for the shortest duration of time. Consideration should be paid to the measures that can be taken to limit toxicity

Implementering av pasientbrev for nedtrapping og seponering av benzodiazepiner og benzodiazepinliknende preparater : ved Gågata legesenter

Benzodiazepiner og benzodiazepinliknende preparater (BoBLP) er de mest brukte legemidlene mot angst og søvnforstyrrelser, og medfører et betydelig misbrukspotensial samt risiko for toleranseutvikling. Avhengighet kan oppstå etter 2-4 ukers bruk innenfor terapeutiske doser. Seponering etter jevnlig bruk kan til tider gi alvorlige abstinenssymptomer. På tross av at nasjonale og internasjonale retningslinjer anbefaler korttidsbruk av BoBLP, er langtidsbruk fortsatt et utbredt fenomen. Vi ønsker i denne oppgaven å kartlegge effektive tiltak for å redusere langtidsbruk av BoBLP, og på bakgrunn av dette skissere et forbedringsprosjekt for en allmennpraksis. I eksisterende litteratur ble hovedsakelig to intervensjoner identifisert; (1) minimal intervensjon; for eksempel å gi enkle råd i form av brev, og (2) systematisk nedtrapping; behandlingsprogrammer ledet av lege eller psykolog. Det er evidens for effekt av begge de identifiserte intervensjonene. Vi valgte minimal intervensjon med utsending av brev som hovedtiltak i vårt forbedringsprosjekt. Forbedringsarbeidet går ut på å skissere et opplegg for å implementere bruk av informasjons- og motivasjonsbrev for å initiere nedtrapping og seponering av BOBLP, samt oppfordre til timebestilling for evalueringssamtale. Tiltaket skal implementeres ved hjelp av informasjonsskriv og kollegabasert terapiveiledning for de involverte allmennlegene. Vi ser for oss en prøveperiode på 6 måneder før vi, basert på våre indikatorer, evaluerer tiltaket. Vi konkluderer med at det er behov for et slikt tiltak, og at de foreslåtte intervensjonene er rimelige, lite arbeidskrevende og effektive

Obesity diagnoses in children and adolescents in Norway by immigrant background

acceptedVersio