How much of cross-country income variation is explained by health?

We use development accounting techniques to assess the contribution of health to differences in income per capita among countries. Rather than rely on regressions in aggregate data, we build up estimates of the effect of health starting from microeconomic data. We examine both a particular condition, anemia, and a proxy for general health, the adult survival rate. We find that differences in anemia explain 1.3% of the log variance of income per capita, and that differences in adult survival explain 19% of the log variance of income per capita. The latter figure is almost one-third of the variation in output that is left unexplained by other measures of factor accumulation

A pragmatic harm reduction approach to manage a large outbreak of wound botulism in people who inject drugs, Scotland 2015

Abstract Background People who inject drugs (PWID) are at an increased risk of wound botulism, a potentially fatal acute paralytic illness. During the first 6 months of 2015, a large outbreak of wound botulism was confirmed among PWID in Scotland, which resulted in the largest outbreak in Europe to date. Methods A multidisciplinary Incident Management Team (IMT) was convened to conduct an outbreak investigation, which consisted of enhanced surveillance of cases in order to characterise risk factors and identify potential sources of infection. Results Between the 24th of December 2014 and the 30th of May 2015, a total of 40 cases were reported across six regions in Scotland. The majority of the cases were male, over 30 and residents in Glasgow. All epidemiological evidence suggested a contaminated batch of heroin or cutting agent as the source of the outbreak. There are significant challenges associated with managing an outbreak among PWID, given their vulnerability and complex addiction needs. Thus, a pragmatic harm reduction approach was adopted which focused on reducing the risk of infection for those who continued to inject and limited consequences for those who got infected. Conclusions The management of this outbreak highlighted the importance and need for pragmatic harm reduction interventions which support the addiction needs of PWID during an outbreak of spore-forming bacteria. Given the scale of this outbreak, the experimental learning gained during this and similar outbreaks involving spore-forming bacteria in the UK was collated into national guidance to improve the management and investigation of future outbreaks among PWID

A Stability Indicating HPLC Assay Method for Analysis of Rivastigmine Hydrogen Tartrate in Dual-Ligand Nanoparticle Formulation Matrices and Cell Transport Medium

The objective of this study was to develop and validate a method for quantitative analysis of rivastigmine hydrogen tartrate (RHT) in dual-ligand polymeric nanoparticle formulation matrices, drug release medium, and cellular transport medium. An isocratic HPLC analysis method using a reverse phase C 18 column and a simple mobile phase without buffer was developed, optimised, and fully validated. Analyses were carried out at a flow rate of 1.5 mL/min at 50°C and monitored at 214 nm. This HPLC method exhibited good linearity, accuracy, and selectivity. The recovery (accuracy) of RHT from all matrices was greater than 99.2%. The RHT peak detected in the samples of a forced degradation study, drug loading study, release study, and cellular transport study was pure and free of matrix interference. The limit of detection (LOD) and limit of quantification (LOQ) of the assay were 60 ng/mL and 201 ng/mL, respectively. The method was rugged with good intra- and interday precision. This stability indicating HPLC method was selective, accurate, and precise for analysing RHT loading and its stability in nanoparticle formulation, RHT release, and cell transport medium

Motivating bureaucrats through social recognition: External validity - A tale of two states

This is the final version. Available on open access from Elsevier via the DOI in this recordBureaucratic performance is a crucial determinant of economic growth, but little real-world evidence exists on how to improve it, especially in resource-constrained settings. We conducted a field experiment of a social recognition intervention to improve record keeping in health facilities in two Nigerian states, replicating the intervention – implemented by a single organization – on bureaucrats performing identical tasks. Social recognition improved performance in one state but had no effect in the other, highlighting both the potential benefits and also the sometimeslimited generalizability of behavioral interventions. Furthermore, differences in facility-level observables did not explain cross-state differences in impacts, suggesting that it may often be difficult to predict external validity

Failure rates and factors associated with infrazygomatic crestal orthodontic implants:A prospective study

Objective: Infrazygomatic crestal (IZC) implants have gained increased popularity over the past few years. Hardly any studies have been done to assess the rate and reasons for failure of IZCs. This prospective study was planned and designed with the primary objective of assessing the rate of failure of bone-screws (BS) placed in the infrazygomatic crest. In continuation, the secondary objective was to assess the factors that were associated with the failure. Materials and methods: The study was carried out by taking a detailed case history, (age, gender, vertical skeletal pattern, medical history), photographic records, radiographs, and clinical examination of a total of 32 randomly selected. patients of south indian origin who required infrazygomatic implants bilaterally as the choice of anchorage conservation to retract their incisors. All selected subjects were required to take a PA Cephalogram after the implant placement. The age of the patients ranged from 18 to 33 with an average age of 25 years. The patient log was maintained which included the treatment mechanics, status of oral hygiene, stability of implants, time of loading of the implant, presence of inflammation and time of failure of implant. The angulation of implant was measured on a digital PA cephalogram using Nemoceph software. These parameters were examined to evaluate independent and dependent variables using the Chi-Square test and Fischer's exact test. Result: A failure rate 28.1% for IZC placed in the infrazygomatic crest region was observed. Patients with a high mandibular plane angle, poor oral hygiene, immediately loaded implant, peri-implantitis, and severe clinical mobility showed higher failure rates. Variables such as age, gender, sagittal skeletal pattern, length of the implant, type of movement, occluso-gingival position, method of force application, and angle of placement were not significantly associated with implant failure. Conclusion: Oral hygiene and peri-screw inflammation must be controlled to minimize the failure of bone screws placed in the infrazygomatic crest region. Loading of the implant should be done after a latent period of two weeks. A higher failure rate was observed in patients with vertical growth pattern

Overcoming behavioral obstacles to escaping poverty

This is the author accepted manuscriptInternational development policy is ripe for an overhaul. Behavioral science can help policymakers to spur changes in behaviors that are difficult to explain from a conventional economic perspective and impede economic development. We focus here on two well-documented, often-coinciding psychological phenomena that have particularly wide-ranging implications for development policy: present bias (favoring immediate rewards over long-term considerations) and limited attention. We present a number of general policy recommendations that are informed by insight into these phenomena and offer concrete examples of how the recommendations can be implemented to help low-income individuals improve their lives and reach their long-term goals

Detection Efficiencies and Generalized Breakdown Probabilities for Nanosecond-Gated Near Infrared Single-Photon Avalanche Photodiodes

A rigorous model is developed for determining single-photon quantum efficiency (SPQE) of single-photon avalanche photodiodes (SPADs) with simple or heterojunction multiplication regions. The analysis assumes nanosecond gated-mode operation of the SPADs and that band-to-band tunneling of carriers is the dominant source of dark current in the multiplication region. The model is then utilized to optimize the SPQE as a function of the applied voltage, for a given operating temperature and multiplication-region structure and material. The model can be applied to SPADs with In/sub 0.52/Al/sub 0.48/As or InP multiplication regions as well as In/sub 0.52/Al/sub 0.48/As--InP heterojunction multiplication regions for wavelengths of 1.3 and 1.55 /spl mu/m. The predictions show that the SPQE generally decreases with decreasing the multiplication-region thickness. Moreover, an InP multiplication region requires a lower breakdown electric field (and, hence, offers a higher SPQE) than that required by an In/sub 0.52/Al/sub 0.48/As layer of the same width. The model also shows that the fractional width of the In/sub 0.52/Al/sub 0.48/As layer in an In/sub 0.52/Al/sub 0.48/As--InP heterojunction multiplication region can be optimized to attain a maximum SPQE that is greater than that offered by an InP multiplication region. This effect becomes more pronounced in thin multiplication regions as a result of the increased significance of dead space

Management of acute appendicitis during the COVID-19 pandemic : a retrospective cohort study

Background: The Coronavirus Disease 2019 (COVID-19) pandemic profoundly impacted delivery of health care. South Western Sydney Local Health District (SWSLHD) experienced some of the highest cases, admissions and deaths during the Delta and Omicron waves in New South Wales. This study aims to determine the impact of the pandemic on emergency surgery services for adults presenting with acute appendicitis. Methods: A retrospective review of patient records was performed of adults presenting with acute appendicitis between 1st March 2021 and 31st March 2022, which was compared to a pre-COVID control period of the same dates in 2019–2020. Patients managed operatively or conservatively were included. Results: 1556 patients were included in the operative arm; 723 and 833 respectively in the study and control groups, which were comparable at baseline. 1.66% were COVID positive. During the pandemic, patients were significantly more likely to be investigated with computered tomography (CT) scan (p ≤ 0.001), present with complicated appendicitis (p = 0.03), and require caecectomy (p = 0.005). They had higher American Society of Anaesthesiology (ASA) scores (p = 0.001) and significantly lower negative appendectomy rates (p = 0.001). Fifty-two patients were included in the conservative arm; 29 and 23 respectively in the pandemic and control groups. Patients were comparable at baseline. There were two COVID positive patients. During the pandemic, there was a significant reduction in complications (p = 0.033), readmissions (0.044) and interval appendicectomy (p = 0.0044). Conclusion: We identified higher rates of complicated appendicitis, caecectomies and greater reliance on CT imaging preoperatively during the pandemic in SWSLHD