The impacts of the food, fuel and financial crises on households in Nigeria. A retrospective approach for research enquiry

This paper examines the impacts of the financial, food and fuel crises on the livelihoods of low-income households Nigeria. It uses primary household level data from Nigeria to analyse the impacts of induced price variability on household welfare. Our results indicate that aggregate shocks have significant adverse effects on household consumption, human capital, and labour decisions with a degree of impact variability between northern and southern regions of the country. We find that the coping strategies adopted by the poor to deal with the short-term effects of the crises, and which include substitution for lower quality food, increasing the intensity of work, withdrawing children from school – especially girls – and engaging children in child labour, can lock households in a low-income equilibrium or poverty trap. Provided that covariate shocks exacerbate these effects, tackling the effects of covariate risks becomes central for present and future development policy

Das Eingehen auf Patienten - Entwicklung, Validierung and psychometrische Eigenschaften eines neuen Erhebungsinstruments

Introduction: It has been shown that communication skills acquired during undergraduate medical education are of great importance. Hence, many countries require teaching communication as part of their medical curricula. To assess students' learning progress, "Catering to the Patient", as an aspect of showing empathy, should be evaluated. Since there was no description of a validated instrument fitting for this purpose, one had to be developed. To describe its process of development and its psychometric properties were the aims of this study.Methods: Based on the Calgary-Cambridge Observation Guide (CCOG), items describing catering to the patient were selected and modified. Cognitive pretest interviews were conducted to check understandability. Therefore, 7 raters assessed 1 video each (R=7, V=1). In a following pilot study (R=3, V=10) first psychometric properties were evaluated and necessary corrections in the preliminary evaluation form were carried out before the final evaluation form was used to assess students' ability to cater to the patient and psychometric properties were described in detail (R=2, V=35).Results: The final assessment instrument, "catering to the patient - Marburg evaluation form", contains 11 checklist items and two global ratings (items 12 and 13). In the final evaluation the inter-rater reliability (IRR) ranged from 0 to 0.562, the median was r =0.305. Concerning item 13 (a global rating), 88.6% of the videos were scored with the maximum difference of one point. The internal consistency was very high (Cronbach's alpha: alpha=0.937 and alpha=0.962), and the correlation between the checklist items and the global rating was high (Pearson's r : r=0.856 and r =0.898).Discussion: The assessment instrument "catering to the patient" is suitable for giving feedback and for using it in formative examinations. Its use for summative examinations can be considered. Further examinations should evaluate if a three-point Likert scale could reach higher values and if item 13 can be used as a stand-alone item.Einleitung: Es konnte gezeigt werden, dass kommunikative Fähigkeiten, die während des Medizinstudiums erworben werden, von großer Wichtigkeit sind. Daher wird in vielen Ländern Kommunikation, als Teil des Curriculums des Medizinstudiums, zu lehren gefordert. Um den Lernfortschritt von Studierenden zu beurteilen, sollte das "Eingehen auf den Patienten" als ein Aspekt von Empathie evaluiert werden. Da es keine Beschreibung eines validierten Instruments gab, das für diesen Zweck genutzt werden konnte, musste ein solches entwickelt werden. Das Ziel dieser Abhandlung ist, den Entwicklungsprozess des Instruments und seine psychometrischen Eigenschaften zu beschreiben.Methoden: Basierend auf dem Calgary-Cambridge Observation Guide (CCOG), wurden Items, die das Eingehen auf den Patienten beschreiben, ausgewählt und modifiziert. Kognitive Pretest-Interviews wurden durchgeführt um die Verständlichkeit zu überprüfen. Dafür bewerteten 7 Rater jeweils 1 Video (R=7, V=1). In einer darauffolgenden Pilotstudie (R=3, V=10) wurden das erste Mal die psychometrischen Eigenschaften evaluiert und notwendige Verbesserungen am vorläufigen Bewertungsbogen durchgeführt, bevor der finale Bewertungsbogen genutzt wurde, um die Fähigkeiten von Studierenden bezüglich des Eingehens auf den Patienten zu bewerten und die psychometrischen Eigenschaften detailliert zu beschreiben (R=2, V=35).Ergebnisse: Der finale Bewertungsbogen "Eingehen auf den Patienten - Marburger Bewertungsbogen" beinhaltet 11 Checklisten-Items und zwei Globalbewertungen (Items 12 und 13). In der abschließenden Evaluation wieß die Interrater-Reliabilität (IRR) Werte zwischen 0 und 0,562 auf, der Median lag bei r =0,305. Bezüglich Item 13 (eine Globalbewertung) wurden 88,6% der Videos mit maximal einem Punkt Differenz bewertet. Die Interne Konsistenz war sehr hoch (Cronbach's alpha: alpha=0,937 und alpha=0,962); die Korrelation zwischen den Checklist-Items und der Globalbewertung war hoch (Pearson's r : r =0,856 und r =0,898).Diskussion: Der Bewertungsbogen "Eingehen auf den Patienten" ist geeignet Feedback zu geben sowie zur Nutzung in formativen Prüfungen. Der Einsatz in summativen Prüfungen kann erwogen werden. Weitere Untersuchungen sollten evaluieren, ob mit einer dreistufigen Likert-Skala höhere Kennwerte erreicht werden könnten und ob Item 13 als alleiniges Item genutzt werden könnte

Depression and heart failure associated with clinical COPD questionnaire outcome in primary care COPD patients: a cross-sectional study

Prevention, Population and Disease management (PrePoD

Depression and heart failure associated with clinical COPD questionnaire outcome in primary care COPD patients : A cross-sectional study

BACKGROUND: Improvement in health-related quality of life (HRQoL) is one of the main goals in treating chronic obstructive pulmonary disease (COPD). Impaired HRQoL in COPD is associated with increased morbidity and mortality, hospitalisations and burden on our health-care system. The Clinical COPD Questionnaire (CCQ) is a validated, reliable, short questionnaire for the evaluation of disease-specific HRQoL in patients with COPD in primary care. AIMS: To investigate factors that might be associated with CCQ outcome in COPD in a primary care setting. METHODS: In a population of COPD patients in primary care, multiple regression analyses were used to assess associations between CCQ outcome and depression, heart failure, FEV1% predicted, FEV1/FVC, age, sex, body mass index and current smoking. RESULTS: Data from 341 patients (mean age 68.1 ± 10.3, COPD GOLD class I–III) were used for analyses. Together, heart failure and depression explained 23% of the variance in CCQ total score (Po0.001, N = 93). Heart failure was most strongly associated with CCQ functional score (27% explained variance, Po0.001, N = 100), whereas depression was most strongly associated with CCQ mental score (22% explained variance, Po0.001, N = 93). CONCLUSIONS: CCQ outcomes are higher in COPD patients with heart failure and depression. These findings might imply that heart failure and depression affect HRQoL of patients with COPD, and thus emphasise the importance of a holistic approach of this complex disease, leading to a correct diagnosis of COPD and its comorbidities, to achieve better tailored treatment of chronic patients

The impacts of the food, fuel and financial crises on poor and vulnerable households in Nigeria: A retrospective approach to research inquiry

This article examines the impacts of the financial, food and fuel crises on poor and vulnerable households in two states of Nigeria: Lagos and Kano. It uses retrospective household-level data to analyze the impacts of induced price variability on household welfare. The results indicate that aggregate shocks have significant adverse effects on household consumption, schooling and child labour decisions, with a degree of impact heterogeneity across regions and rural and urban areas of the country. We find that the coping strategies adopted by the poor to deal with the short-term effects of the crises can lock households in a low-income equilibrium or poverty trap. Provided that covariate shocks exacerbate these effects, they become central for policy design

Observation of a structure in the M-p eta invariant mass distribution near 1700 MeV/c(2) in the gamma p -> p pi(0)eta reaction

The reaction gamma p -> p pi(0)eta has been studied with the CBELSA/TAPS detector at the electron stretcher accelerator ELSA in Bonn for incident photon energies from threshold up to 3.1 GeV. This paper has been motivated by the recently claimed observation of a narrow structure in the MN n invariant mass distribution at a mass of 1678 MeV/c(2). The existence of this structure cannot be confirmed in the present work. Instead, for E-gamma = 1400-1500 MeV and the cut M-P pi(0) pa(0) -> p pi(0)eta reaction