69 research outputs found

    After Humanitarianism: Bangladesh's Evolving Rohingya Policy

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    Since August 2017 Bangladesh has hosted 1.1 million Rohingya refugees in the world's largest refugee camp, along its restive borderlands with Myanmar. Frustrated with a stalled repatriation process, Bangladesh is moving forward with policies focused on refugee redistribution and stricter camp surveillance. Though potentially effective in the short term, such policies could complicate Bangladesh's relations with donors and worsen human rights abuses against the refugees. The Bangladeshi government wants to formally start refugee relocation to Bhashan Char - a remote, flood-prone island in the Bay of Bengal - at the end of the monsoon season (early November). The island will isolate the relocated refugee population from their kin while complicating human security issues such as aid delivery, emergency medical assistance, and support during natural disasters. The relocation could help decongest the overpopulated camps, which have seen a rise in coronavirus cases since May 2020. However, the move risks making Bangladesh unpopular with international development partners on human rights and refugee protection grounds. A comparison with the recent fatal fire accident in the Moria refugee camp on the isle of Lesbos, Greece, will be difficult to avoid. The government is further tightening surveillance in the camps after recent violent clashes between rival refugee gangs fighting for control over territory and a burgeoning illegal drug trade. For decades, Bangladesh has served as a jumping-off point for Rohingya to illegally migrate to other Muslim countries in the region. The protracted refugee situation and the COVID-19 lockdowns have compounded these clandestine efforts in recent months. Thus, the Rohingya refugee crisis could potentially turn into a regional "boat-people" crisis. In Myanmar's current hyper-nationalist political climate, the resettlement of Rohingya refugees remains highly contested, hence unlikely in the near term. Therefore, European policymakers should continue to engage with Myanmar's political regime on finding sustainable solutions for the Rohingya crisis. The EU should also conduct targeted lobbying aimed at dissuading Bangladesh from the controversial refugee relocation plan, while maintaining its financial commitments to improve security and living conditions for the refugees

    Contract Duration and the Division of Labor in Agricultural Land Leases

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    Short-term contracts provide weak incentives for durable input investment if post-contract asset transfer is difficult. Our model shows that when both agents provide inputs, optimal contract length balances weak incentives of one agent against the other. This perspective broadens the existing contract duration literature, which emphasizes the tradeoff between risk sharing and contract costs. We develop hypotheses and test them based on private grazing contracts from the Southern Great Plains. We find broad support for the implications of our model. For example, landowners provide durable land-specific inputs more often under annual versus multiyear contracts.land lease contracts, moral hazard, contract duration, division of labor

    The provision of informal care in terminal illness: An analysis of carers? needs using a discrete choice experiment

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    There is an increasing expectation that families will provide care at home for those with chronic, acute and terminal illness. There is a range of services available to support the home care of these patients. Carers of those in the terminal phase of illness face different demands and challenges than those caring for the chronically ill, disabled or aging; the patient?s health is deteriorating, often rapidly, and death is imminent. Yet the needs and requirements of this group of carers has been far less studied than those caring for people with chronic and continuing conditions. We argue that considering the reciprocal nature of relationships is important in understanding the provision of informal care. Carers? feelings for which tasks and responsibilities are most difficult are not the same as their preferences for additional support services. Carers preferences are influenced by their relationship with the patient. This study investigates carers? preferences for services to support their caregiving role. Carer preferences were investigated using a discrete choice experiment, in which 168 carers were asked first to choose between two packages of care and then between the chosen package and their current support. Data were analysed using mixed logit. The DCE results showed that the support most wanted was palliative care nursing, general nursing, and telephone advice available 24 hours. Carers providing high levels of care wanted respite care provided at home and help with the patient?s personal care. Where the care-giving need was relatively low, carers wanted help with household tasks, transport and a case co-ordinator. Overall, carers appeared to be satisfied with the support they received from palliative care services, but this varied with the personal circumstances of the carer. This study provides useful insights for those who plan and deliver palliative care in the community. It supports the view that effective support for carers must recognise the differing needs of individual carers. While our results do not provide any insight into how the pre-existing relationship between carer and recipient may affect preferences for care, it points to the need to explore further differences in preferences across respondents both in discrete choice work in general, and in designing services to support rather than replace informal carers.Informal care; carer's perspective; discrete choce experiment

    Decisions about Pap tests: What influences women and providers?

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    Despite the success internationally of cervical screening programs debate continues about optimal program design. This includes increasing participation rates among under-screened women, reducing unnecessary early re-screening, improving accuracy of and confidence in screening tests, and determining the cost-effectiveness of program parameters, such as type of screening test, screening interval and target group. For all these issues, information about consumer and provider preferences and insight into the potential impact of any change to program design on consumer and provider behaviour are essential inputs into evidence-based health policy decision making. This paper reports the results of discrete choice experiments to investigate women?s choices and providers? recommendations in relation to cervical screening in Australia. Separate experiments were conducted with women and general practitioners, with attributes selected to allow for investigation of interaction between women?s and providers? preferences and to determine how women and general practitioners differ in their preferences for common attributes. The results provide insight into the agency relationship in this context. Our results indicate a considerable commonality in preferences but the alignment was not complete. Women put relatively more weight on cost, chance of a false positive and if the recommended screening interval were changed to one year.Cervical Screening; Discrete choice experiments; Agency relationships, Consumer preferences

    Moral hazard and the division of labor in agricultural land leases

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    land lease contracts, moral hazard, contract duration, division of labor, Land Economics/Use,

    MANAGEMENT PRACTICES AND LEASE ARRANGEMENTS USED BY OKLAHOMA WHEAT, WHEAT PASTURE, AND WHEAT PASTURE LIVESTOCK PRODUCERS

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    Winter wheat is grown for three purposes in the Southern Plains, grain-only, forage-only, and as a dual-purpose forage plus grain crop. The USDA's wheat cropping practices survey does not differentiate among the three uses. Little information on actual production practices across use is available. Results of a survey are presented.Crop Production/Industries,

    Men?s preferences for treatment of early stage prostate cancer: Results from a discrete choice experiment, CHERE Working Paper 2006/14

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    Prostate cancer is the most common cancer in men in Australia; each year over 10,000 Australians are diagnosed with this disease. There are a number of treatment options for early stage prostate cancer (ESPC); radical prostatectomy, external beam radiotherapy, brachytherapy, hormonal therapy and combined therapy. Treatment can cause serious side-effects, including severe sexual and urinary dysfunction, bowel symptoms and fatigue. Furthermore, there is no evidence as yet to demonstrate that any of these treatments confers a survival gain over active surveillance (watchful waiting). While patient preferences should be important determinants in the type of treatment offered, little is known about patients? views of the relative tolerability of side effects and of the survival gains needed to justify these. To investigate this, a discrete choice experiment (DCE) was conducted in a sample of 357 men who had been treated for ESPC and 65 age-matched controls. The sample was stratified by treatment, with approximately equal numbers in each treatment group. The DCE included nine attributes: seven side-effects and two survival attributes (duration and uncertainty). An orthogonal fractional set of 108 scenarios from the full factorial was used to generate three versions of the questionnaire, with 18 scenarios per respondent. Multinomial logit (MNL) and mixed logit (MXL) models were estimated. A random intercept MXL model provided a significantly better fit to the data than the simple MNL model, and adding random coefficients for all attributes dramatically improved model fit. Each side-effect had a statistically significant mean effect on choice, as did survival duration. Most attributes had significant variance parameters, suggesting considerable heterogeneity among respondents in their preferences. To model this heterogeneity, we included men?s health-related quality of life scores following treatment as covariates to see whether their preferences were influenced by their previous treatment experience. This study demonstrate how DCEs can be used to quantify the trade-offs patients make between side-effects and survival gains. The results provide useful insights for clinicians who manage patients with ESPC, highlighting the importance of patient preferences in treatment decisions.Prostate cancer, discrete choice experiment, preferences, quality of life

    The relationship between male factor infertility and Chlamydia infection, still an undecided issue

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    Background: Seropositivity of Chlamydia trachomatis in men is suggestive of chronic and recurrent infection with this sexually transmitted organism. Most males with urogenital Chlamydia infection have serum immunoglobulin G (IgG) antibodies to C. trachomatis that persist for years. Serologic studies linking C. trachomatis to male infertility and sperm quality lead to highly variable results. The objective of the study was to examine the effect of Chlamydia infection, as determined by Chlamydia seropositivity on semen quality.Methods: One hundred men having semen analysis as part of infertility work up had anti-Chlamydia antibody test. They were grouped into those who are seropositive for Chlamydia antibody IgG and those who were not. The sperm parameters and prevalence of different semen abnormalities were compared between the two groups, Chlamydia positive and Chlamydia negative.Results: There are no significant difference in semen parameters and prevalence of different semen abnormalities between the two groups. The sonographical finding of epididymal cyst is 45.8% in Chlamydia positive compared to 12.2% in Chlamydia negative; the difference is significant.Conclusions: Seropositivity of Chlamydia infection in infertile male is not predictive of semen abnormalities. Serological screening of the male partner for Chlamydia trachomatis provides no more benefit than identifying the female partner at risk of tubal factor infertility and males at risk of epididymal obstruction

    Letrozole versus dienogest in endometrioma recurrent after surgery: a randomized controlled trial

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    Background: Letrozole is a third-generation aromatase inhibitor. As there is aberrant aromatase production by endometriotic stromal cells and the growth and regression of endometriosis is estrogen-dependent, the use of letrozole to reduce the size and symptoms of endometrioma especially in recurrent cases is a promising medical intervention. Dienogest is a fourth-generation progestin which is being used for the treatment of endometriosis due to its antiproliferative and antiangiogenic properties on endometrial tissue. The present study was conducted to compare the effects of letrozole and dienogest on endometrioma recurrent after surgery.Methods: This randomized controlled study was conducted on 38 women having recurrence of endometrioma after surgery. They were randomly assigned to receive either letrozole (2.5 mg daily) or dienogest (2 mg once daily) for 6 months. Size of the endometrioma was measured by transvaginal ultrasound and the pain (dysmenorrhoea) was measured on a visual analog scale (VAS) of 0-10, prior to treatment and after 3 and 6 months of treatment.Results: The mean size of endometrioma was reduced from a baseline of 6.06±2.40 cm to 5.23±1.37 cm and to 4.59±1.25 cm after 3 and 6 months of treatment with letrozole. While with dienogest the reduction was from a baseline of 6.67±1.31 cm to 4.83±1.50 cm and to 3.80±1.34 cm after 3 and 6 months of treatment. The difference between the two groups was not statistically significant but dienogest yielded better result in terms of effect size. Decrease in pain (dysmenorrhoea) was highly significant with both the drugs.Conclusions: In terms of reduction of the size of endometrioma, dienogest yields better results than letrozole. Both the drugs are highly effective in alleviating pain (dysmenorrhoea)
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