ResearchPad - finance https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[Financial health as a measurable social determinant of health]]> https://www.researchpad.co/article/elastic_article_15758 Financial health, understood as one’s ability to manage expenses, prepare for and recover from financial shocks, have minimal debt, and ability to build wealth, underlies all facets of daily living such as securing food and paying for housing, yet there is inconsistency in measurement and definition of this critical concept. Most social determinants research and interventions focus on siloed solutions (housing, food, utilities) rather than on a root solution such as financial health. In light of the paucity of public health research on financial health, particularly among low-income populations, this study seeks to: 1) introduce the construct of financial health into the domain of public health as a useful root term that underlies other individual measures of economic hardship and 2) demonstrate through outcomes on financial, physical and mental health among low-income caregivers of young children that the construct of financial health belongs in the canon of social determinants of health.Materials and methodsIn order to extract features of financial health relevant to overall well-being, principal components analysis were used to assess survey data on banking and personal finances among caregivers of young children who participate in public assistance. Then, a series of logistic regressions were utilized to examine the relationship between components of financial health, depression and self-rated health.ResultsComponents aligned with other measures of financial health in the literature, and there were strong associations between financial health and health outcomes.Practice implicationsFinancial health can be conceived of and measured as a key social determinant of health. ]]> <![CDATA[Cost and logistics implications of a nationwide survey of schistosomiasis and other intestinal helminthiases in Sudan: Key activities and cost components]]> https://www.researchpad.co/article/elastic_article_15719 It is vital to share details of concrete experiences of conducting a nationwide disease survey. By doing so, the global health community could adapt previous experiences to expand geographic mapping programs, eventually contributing to the development of disease control and elimination strategies. A nationwide survey of schistosomiasis and intestinal helminthiases was conducted from December 2016 to March 2017 in Sudan. We aimed to describe details of the key activities and cost components required for the nationwide survey. We investigated which activities were necessary to prepare and conduct a nationwide survey of schistosomiasis and intestinal helminthiases, and the types and amounts of transportation, personnel, survey equipment, and consumables that were required. In addition, we estimated financial and economic costs from the perspectives of the donor and the Ministry of Health. Cash expenditures incurred to implement the survey were defined as financial costs. For economic costs, we considered the true value for society as a whole, and this category therefore accounted for the costs of all goods and services used for the project, including those that were not sold in the market and therefore had no market price (e.g., time spent by head teachers and teachers). We organized costs into capital and recurrent items. We ran one-way sensitivity and probabilistic analyses using Monte-Carlo methods with 10,000 draws to examine the robustness of the primary analysis results. A total of USD 1,465,902 and USD 1,516,238 was incurred for the financial and economic costs, respectively. The key cost drivers of the nationwide survey were personnel and transportation, for both financial and economic costs. Personnel and transportation accounted for around 64% and 18% of financial costs, respectively. If a government finds a way to mobilize existing government officials with no additional payments using the health system already in place, the cost of a nationwide survey could be remarkably reduced.

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<![CDATA[Increased financial burdens and lengths of stay in patients with healthcare-associated infections due to multidrug-resistant bacteria in intensive care units: A propensity-matched case-control study]]> https://www.researchpad.co/article/elastic_article_15718 Incidence rates of healthcare-associated infections (HAIs) depend upon infection control policy and practices, and the effectiveness of the implementation of antibiotic stewardship. Amongst intensive care unit (ICU) patients with HAIs, a substantial number of pathogens were reported to be multidrug-resistant bacteria (MDRB). However, impacts of ICU HAIs due to MDRB (MDRB-HAIs) remain understudied. Our study aimed to evaluate the negative impacts of MRDB-HAIs versus HAIs due to non-MDRB (non-MRDB-HAIs).MethodsAmong 60,317 adult patients admitted at ICUs of a 2680-bed medical centre in Taiwan between January 2010 and December 2017, 279 pairs of propensity-score matched MRDB-HAI and non-MRDB-HAI were analyzed.Principal findingsBetween the MDRB-HAI group and the non-MDRB-HAI group, significant differences were found in overall hospital costs, costs of medical and nursing services, medication, and rooms/beds, and in ICU length-of-stay (LOS). As compared with the non-MDRB-HAI group, the mean of the overall hospital costs of patients in the MDRB-HAI group was increased by 26%; for categorized expenditures, the mean of costs of medical and nursing services of patients in the MDRB-HAI group was increased by 8%, of medication by 26.9%, of rooms/beds by 10.3%. The mean ICU LOS in the MDRB-HAI group was increased by 13%. Mortality rates in both groups did not significantly differ.ConclusionsThese data clearly demonstrate more negative impacts of MDRB-HAIs in ICUs. The quantified financial burdens will be helpful for hospital/government policymakers in allocating resources to mitigate MDRB-HAIs in ICUs; in case of need for clarification/verification of the medico-economic burdens of MDRB-HAIs in different healthcare systems, this study provides a model to facilitate the evaluations. ]]> <![CDATA[Innovative machine learning approach and evaluation campaign for predicting the subjective feeling of work-life balance among employees]]> https://www.researchpad.co/article/elastic_article_14744 At present, many researchers see hope that artificial intelligence, machine learning in particular, will improve several aspects of the everyday life for individuals, cities and whole nations alike. For example, it has been speculated that the so-called machine learning could soon relieve employees of part of the duties, which may improve processes or help to find the most effective ways of performing tasks. Consequently, in the long run, it would help to enhance employees’ work-life balance. Thus, workers’ overall quality of life would improve, too. However, what would happen if machine learning as such were employed to try and find the ways of achieving work-life balance? This is why the authors of the paper decided to utilize a machine learning tool to search for the factors that influence the subjective feeling of one’s work-life balance. The possible results could help to predict and prevent the occurrence of work-life imbalance in the future. In order to do so, the data provided by an exceptionally sizeable group of 800 employees was utilised; it was one of the largest sample groups in similar studies in Poland so far. Additionally, this was one of the first studies where so many employees had been analysed using an artificial neural network. In order to enable replicability of the study, the specific setup of the study and the description of the dataset are provided. Having analysed the data and having conducted several experiments, the correlations between some factors and work-life balance have indeed been identified: it has been found that the most significant was the relation between the feeling of balance and the actual working hours; shifting it resulted in the tool predicting the switch from balance to imbalance, and vice versa. Other factors that proved significant for the predicted WLB are the amount of free time a week the employee has for themselves, working at weekends only, being self-employed and the subjective assessment of one’s financial status. In the study the dataset gets balanced, the most important features are selected with the selectKbest algorithm, an artificial neural network of 2 hidden layers with 50 and 25 neurons, ReLU and ADAM is constructed and trained on 90% of the dataset. In tests, it predicts WLB based on the prepared dataset and selected features with 81% accuracy.

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<![CDATA[The influence of spouses and their driving roles in self-regulation: A qualitative exploration of driving reduction and cessation practices amongst married older adults]]> https://www.researchpad.co/article/elastic_article_14735 There is growing evidence to suggest the importance of self-regulatory practices amongst older adults to sustain mobility. However, the decision to self-regulate driving is a complex interplay between an individual’s preference and the influence of their social networks including spouse. To our best knowledge, the influence of an older adult’s spouse on their decisions during driving transition has not been explored.Materials and methodsThis qualitative descriptive study was conducted amongst married older adults aged 60 years and above. All interview responses were transcribed verbatim and examined using thematic approach and interpretative description method.ResultsA total of 11 married couples were interviewed. Three major themes emerged: [1] Our roles in driving; [2] Challenges to continue driving; and, [3] Our driving strategies to ensure continued driving. Older couples adopted driving strategies and regulated their driving patterns to ensure they continued to drive safely. Male partners often took the active driving role as the principal drivers, while the females adopted a more passive role, including being the passenger to accompany the principal drivers or becoming the co-driver to help in navigation. Other coping strategies include sharing the driving duties as well as using public transportation or mixed mode transportation.DiscussionOur findings suggest spouse play a significant role in their partners’ decision to self-regulate driving. This underscores a need to recognise the importance of interdependency amongst couples and its impact on their driving decisions and outcomes. ]]> <![CDATA[Punishing the privileged: Selfish offers from high-status allocators elicit greater punishment from third-party arbitrators]]> https://www.researchpad.co/article/elastic_article_14606 Individuals high in socioeconomic status (SES) are often viewed as valuable members of society. However, the appeal of high-SES people exists in tension with our aversion to inequity. Little experimental work has directly examined how people rectify inequitable distributions between two individuals varying in SES. The objective of the present study was to examine how disinterested third parties adjudicate inequity in the context of concrete financial allocations between a selfish allocator and a recipient who was the victim of the allocator’s selfish offer. Specifically, this study focused on whether knowing the SES of the victim or the allocator affected the participant’s decisions to punish the selfish allocator. In two experiments (N = 999), participants completed a modified third-party Ultimatum Game in which they arbitrated inequitable exchanges between an allocator and a recipient. Although participants generally preferred to redistribute inequitable exchanges without punishing players who made unfair allocations, we observed an increased preference for punitive solutions as offers became increasingly selfish. This tendency was especially pronounced when the victim was low in SES or when the perpetrator was high in SES, suggesting a tendency to favor the disadvantaged even among participants reporting high subjective SES. Finally, punitive responses were especially likely when the context emphasized the allocator’s privileged status rather than the recipient’s underprivileged status. These findings inform our understanding of how SES biases retributive justice even in non-judicial contexts that minimize the salience of punishment.

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<![CDATA[Fear and stock price bubbles]]> https://www.researchpad.co/article/elastic_article_13818 I evaluate Alan Greenspan’s claim that stock price bubbles build up in periods of euphoria and tend to burst due to increasing fear. Indeed, there is evidence that e.g. during a crisis, triggered by increasing fear, both qualitative and quantitative measures of risk aversion increase substantially. It is argued that fear is a potential mechanism underlying financial decisions and drives the countercyclical risk aversion. Inspired by this evidence, I construct an euphoria/fear index, which is based on an economic model of time varying risk aversion. Based on US industry returns 1959–2014, my findings suggest that (1) Greenspan is correct in that the price run-up initially occurs in periods of euphoria followed by a crash due to increasing fear; (2) on average already roughly a year before an industry is crashing, euphoria is turning into fear, while the market is still bullish; (3) there is no particular euphoria-fear-pattern for price-runs in industries that do not subsequently crash. I interpret the evidence in favor of Greenspan, who was labeled “Mr. Bubble” by the New York Times, and who was accused to be a serial bubble blower.

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<![CDATA[Gender norms and mass deworming program access in Comé, Benin: A qualitative assessment of gender-associated opportunities and challenges to achieving high mass drug administration coverage]]> https://www.researchpad.co/article/N0cbc3c85-9c5e-43fe-983c-4afc7d1b8db3

The World Health Organization’s Neglected Tropical Disease Roadmap has accelerated progress towards eliminating select neglected tropical diseases (NTDs). This momentum has catalyzed research to determine the feasibility of interrupting transmission of soil-transmitted helminths (STH) using community-wide mass drug administration (MDA). This study aims to identify potential gender-specific facilitators and barriers to accessing and participating in community-wide STH MDA, with the goal of ensuring programs are equitable and maximize the probability of interrupting STH transmission. This research was conducted prior to the launch of community-wide MDA for STH in Comé, Benin. A total of 10 focus group discussions (FGDs) were conducted separately among 40 men, 38 women, and 15 community drug distributors (CDDs). Salient themes included: both men and women believe that community-wide MDA would reduce the financial burden associated with self-treatment, particularly for low income adults. Community members believe MDA should be packaged alongside water, sanitation, and other health services. Women feel past community-wide programs have been disorganized and are concerned these distributions will be similar. Women also expressed interest in increased engagement in the implementation of future community-based public health programs. Men often did not perceive themselves to be at great risk for STH infection and did not express a high demand for treatment. Finally, the barriers discussed by CDDs generally did not align with gender-specific concerns, but rather represented concerns shared by both genders. A door-to-door distribution strategy for STH MDA is preferred by women in this study, as this platform empowers women to participate as health decision makers for their family. In addition, involving women in planning and implementation of community-wide programs may help to increase treatment coverage and compliance.

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<![CDATA[Partition dependence in financial aid distribution to income categories]]> https://www.researchpad.co/article/N0611b39b-d559-4542-a5d9-a69c54a62df4

When allocating resources, people often diversify across categories even when those categories are arbitrary, such that allocations differ when identical sets of options are partitioned differently (“partition dependence”). The first goal of the present work (Experiment 1) was to replicate an experiment by Fox and colleagues in which graduate students exhibited partition dependence when asked how university financial aid should be allocated across arbitrarily partitioned income brackets. Our sample consisted of community members at a liberal arts college where financial aid practices have been recent topics of debate. Because stronger intrinsic preferences can reduce partition dependence, these participants might display little partition dependence with financial aid allocations. Alternatively, a demonstration of strong partition dependence in this population would emphasize the robustness of the effect. The second goal was to extend a “high transparency” modification to the present task context (Experiment 2) in which participants were shown both possible income partitions and randomly assigned themselves to one, to determine whether partition dependence in this paradigm would be reduced by revealing the study design (and the arbitrariness of income categories). Participants demonstrated clear partition dependence in both experiments. Results demonstrate the robustness of partition dependence in this context.

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<![CDATA[Data for understanding the risk perception of COVID-19 from Vietnamese sample]]> https://www.researchpad.co/article/Na5793820-9b52-4a6d-baed-bd8a0cad6a29

This data article describes the risk perception of COVID-190 from 391 Vietnamese respondents aged from 15 to 47 years. These data have been used in Huynh (2020). These data include the socioeconomics, media attention, and risk perception of COVID-19 in Vietnam through a survey conducted on February 1, 2020. In addition, our data might serve as a reference source for further in-depth surveys to understand the risk perception and social media communication across countries.

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<![CDATA[Mapping the coevolution, leadership and financing of research on viral vectors, RNAi, CRISPR/Cas9 and other genomic editing technologies]]> https://www.researchpad.co/article/N5b989351-f842-4a35-9237-928ff4c9c806

Genomic editing technologies are developing rapidly, promising significant developments for biomedicine, agriculture and other fields. In the present investigation, we analyzed and compared the process of innovation for six genomic technologies: viral vectors, RNAi, TALENs, meganucleases, ZFNs and CRISPR/Cas including the profile of the main research institutions and their funders, to understand how innovation evolved and what institutions influenced research trajectories. A Web of Science search of papers on viral vectors RNAi, CRISPR/Cas, TALENs, ZFNs and meganucleases was used to build a citation network of 16,746 papers. An analysis of network clustering combined with text mining was performed. For viral vectors, a long-term process of incremental innovation was identified, which was largely publicly funded in the United States and the European Union. The trajectory of RNAi research included clusters related to the study of RNAi as a biological phenomenon and its use in functional genomics, biomedicine and pest control. A British philanthropic organization and a US pharmaceutical company played a key role in the development of basic RNAi research and clinical application respectively, in addition to government and academic institutions. In the case of CRISPR/Cas research, basic science discoveries led to the technical improvements, and these two in turn provided the information required for the development of biomedical, agricultural, livestock and industrial applications. The trajectory of CRISPR/Cas research exhibits a geopolitical division of the investigation efforts between the US, as the main producer and funder of basic research and technical improvements, and Chinese research institutions increasingly leading applied research. Our results reflect a change in the model for financing science, with reduced public financing for basic science and applied research on publicly funded technological developments in the US, and the emergence of China as a scientific superpower, with implications for the development of applications of genomic technologies.

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<![CDATA[Can mutual health organisations influence the quality and the affordability of healthcare provision? The case of the Democratic Republic of Congo]]> https://www.researchpad.co/article/Nf97c5072-5c0f-45dc-b83f-09c75045dd0d

Background

In their mission to achieve better access to quality healthcare services, mutual health organisations (MHOs) are not limited to providing health insurance. As democratically controlled member organisations, MHOs aim to make people’s voices heard. At national level, they seek involvement in the design of social protection policies; at local level, they seek to improve responsiveness of healthcare services to members’ needs and expectations.

Methods

In this qualitative study, we investigated whether MHOs in the Democratic Republic of Congo (DRC) succeed in defending members’ rights by improving healthcare quality while minimising expenses. The data originate from an earlier in-depth investigation conducted in the DRC in 2016 of the performance of 13 MHOs. We re-analysed this existing dataset and more specifically investigated actions that the MHOs undertook to improve quality and affordability of healthcare provision for their members, using a framework for analysis based on Hirschman’s exit-voice theory. This framework distinguishes four mechanisms for MHO members to use in influencing providers: (1) ‘exit’ or ‘voting with the feet’; (2) ‘co-producing a long voice route’ or imposing rules through strategic purchasing; (3) ‘guarding over the long voice route of accountability’ or pressuring authorities to regulate and enforce regulations; and (4) ‘strengthening the short voice route’ by transforming the power imbalance at the provider–patient interface.

Results

All studied MHOs used these four mechanisms to improve healthcare provision. Most healthcare providers, however, did not recognise their authority to do so. In the DRC, controlling quality and affordability of healthcare is firmly seen as a role for the health authorities, but the authorities only marginally take up this role. Under current circumstances, the power of MHOs in the DRC to enhance quality and affordability of healthcare is weak.

Conclusion

On their own, mutual health organisations in the DRC do not have sufficient power to influence the practices of healthcare providers. Greater responsiveness of the health services to MHO members requires cooperation of all actors involved in healthcare delivery to create an enabling environment where voices defending people’s rights are heard.

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<![CDATA[Bridging between economy-wide activity and household-level consumption data: Matrices for European countries]]> https://www.researchpad.co/article/N195aa1ea-44cd-4794-a839-8705095d94e3

This dataset represents bridging matrices between two different data classification systems: consumption by purpose (COICOP) and products by activity (CPA). While the former classification is used in household budget and expenditure surveys, the latter represents the industry sector dimension that is typically adopted in national accounts and input–output tables. We collect input data from Eurostat on total household consumption for 35 COICOP and 63 CPA categories for the year 2015. Based on these data, we construct bridging or concordance tables for 30 European countries using recently developed matrix balancing techniques. The resulting tables enable data conversion between consumption- and production-based statistics, facilitating research that integrates macroeconomics, multi-sectoral international trade and heterogeneous agents in household-level expenditure micro-data. Although they are a necessary input in several types of research, they are often constructed on an ad hoc and region-specific basis and not shared publicly. As such, making this dataset available will be useful for computable general equilibrium and input–output models and for carbon footprint and life cycle analyses that incorporate rich consumption micro-data, for instance to shed light on distributional aspects of climate and energy policies. Furthermore, by eliminating a barrier raised by differences in statistical classifications, this dataset may foster collaboration between different research teams and may facilitate soft-linking between complementary analytical tools used for policy support.

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<![CDATA[Improved calibration estimators for the total cost of health programs and application to immunization in Brazil]]> https://www.researchpad.co/article/5c8977b1d5eed0c4847d3333

Multi-stage/level sampling designs have been widely used by survey statisticians as a means of obtaining reliable and efficient estimates at a reasonable implementation cost. This method has been particularly useful in National country-wide surveys to assess the costs of delivering public health programs, which are generally originated in different levels of service management and delivery. Unbiased and efficient estimates of costs are essential to adequately allocate resources and inform policy and planning. In recent years, the global health community has become increasingly interested in estimating the costs of immunization programs. In such programs, part of the cost correspond to vaccines and it is in most countries procured at the central level, while the rest of the costs are incurred in states, municipalities and health facilities, respectively. As such, total program cost is a result of adding these costs, and its variance should account for the relation between the totals at the different levels. An additional challenge is the missing information at the various levels. A variety of methods have been developed to compensate for this missing data. Weighting adjustments are often used to make the estimates consistent with readily-available information. For estimation of total program costs this implies adjusting the estimates at each level to comply with the characteristics of the country. In 2014, A National study to estimate the costs of the Brazilian National Immunization Program was initiated, requested by the Ministry of Health and with the support of international partners. We formulate a quick and useful way to compute the variance and deal with missing values at the various levels. Our approach involves calibrating the weights at each level using additional readily-available information such as the total number of doses administered. Taking the Brazilian immunization costing study as an example, this approach results in substantial gains in both efficiency and precision of the cost estimate.

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<![CDATA[The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana and the path to universal health coverage in India: Overcoming the challenges of stewardship and governance]]> https://www.researchpad.co/article/5c8acc3bd5eed0c48498f23f

In an Essay, Blake Angell and colleagues discuss ambitious reforms planned to expand coverage of the health system in India.

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<![CDATA[Issue framing in online voting advice applications: The effect of left-wing and right-wing headers on reported attitudes]]> https://www.researchpad.co/article/5c785013d5eed0c484007c38

Voting Advice Applications (VAAs) provide voting recommendations to millions of people. As these voting recommendations are based on users’ answers to attitude questions, the framing of these questions can have far-reaching consequences. The current study reports on a field experiment in which the framing of the header above VAA statements (N = 17) was manipulated (condition 1: no header; condition 2: a right-wing header, e.g., finance; condition 3: a left-wing header, e.g., nature and environment). Visitors of a VAA developed for Utrecht, the fourth largest municipality in the Netherlands, were randomly guided to one of the versions of the tool in which the header type was varied. Results (based on Nrespondents = 27,404) show that providing a header (left-wing or right-wing) leads to more left-wing answers as compared a condition where there is no header above the attitude statement. This effect, however, is only observed for respondents with lower levels of political sophistication.

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<![CDATA[The time-varying relationship between economic globalization and the ideological center of gravity of party systems]]> https://www.researchpad.co/article/5c803c63d5eed0c484ad8866

Does economic globalization influence the positioning of parties and, as a consequence, the ideological characteristics of party systems? Answering this question is important because we need to understand the constraints that parties face in formulating policies from which voters have to choose. In our paper, we take a systemic perspective and conceptualize a party system’s ideological center of gravity as the outcome of interest. We define the center of gravity as the weighted mean position of all parliamentary parties in a country that represents the position to which parties gravitate. We start by formulating static hypotheses on the effect of imports and exports on the center of gravity and derive their underlying mechanisms. We further derive dynamic hypotheses stipulating varying effects over time based on the premise that partisan attitudes toward globalization have undergone multiple changes over the last decades. A time-series cross-section analysis of 129 elections in 15 Western European countries from 1974 to 2015 finds evidence for opposite effects of exports and imports in the pooled data. Additionally, a moving-window analysis indicates that the relationship between globalization and the center of gravity varies over time. This is a significant finding because it suggests that economic globalization has an influence on party systems and that it is important to test for time-varying effects.

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<![CDATA[“Even if she’s really sick at home, she will pretend that everything is fine.”: Delays in seeking care and treatment for advanced HIV disease in Kinshasa, Democratic Republic of Congo]]> https://www.researchpad.co/article/5c6dc9efd5eed0c48452a55d

Introduction

HIV prevalence in the Democratic Republic of Congo (DRC) is estimated to be 1.2%, and access to HIV testing and treatment remains low across the country. Despite advances in treatment, HIV continues to be one of the main reasons for hospitalisation and death in low- and middle-income countries, including DRC, but the reasons why people delay seeking health-care when they are extremely sick remain little understood. People in Kinshasa, DRC, continue to present to health-care facilities in an advanced stage of HIV when they are close to death and needing intensive treatment.

Methods

This qualitative study was conducted in one health-care facility in Kinshasa. A total of 24 in-depth interviews with purposively selected health-care workers, patients and care-givers were conducted. Patients were currently or previously hospitalised with advanced HIV, defined as CD4 count <200 cells/μl. Patients included those who had previously started antiretroviral treatment (ART), and those who had not. Participant observation was also carried out. Interviews were audio-recorded, translated from French and Lingala into English, transcribed, coded and thematically analysed using NVivo.

Results

The main reasons for delaying access to health-care were stigmatisation, religious beliefs and limited economic resources. Stigmatisation meant that people feared disclosing their HIV status and thus did not receive support from their families. Religious leaders were reported to have encouraged people not to take ART. Patients delayed seeking treatment as they could not afford it, and health-care workers believed that staff at other facilities in Kinshasa were delaying HIV diagnoses for economic benefit.

Conclusions

Delays in accessing care and treatment linked to stigma, religious beliefs and economic factors contribute to explaining the persistence of advanced HIV within this context. Access to free HIV-testing, ART and treatment of opportunistic infections; counselling; training of health-care workers; support for care-givers and stigma reduction strategies are urgently needed to prevent unnecessary deaths.

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<![CDATA[Assessment of factors affecting diabetes management in the City Changing Diabetes (CCD) study in Tianjin]]> https://www.researchpad.co/article/5c6c758cd5eed0c4843cfe89

Objective

This study aimed to identify the local levels of vulnerability among patients with Type-II diabetes (T2DM) in Tianjin. The study was aimed at curbing the rise of T2DM in cities.

Methods

229 participants living with T2DM were purposively sampled from hospitals in Tianjin. Collected data were coded and analysed following well-established thematic analysis principles.

Results

Twelve themes involving 29 factors were associated with diabetes patients’ vulnerability: 1. Financial constraints (Low Income, Unemployment, No Medical Insurance/Low ratio reimbursement); 2. Severity of disease (Appearance of symptoms, complications, co-morbidities, high BMI, poor disease control); 3. Health literacy (No/Low/Wrong knowledge of health literacy); 4. Health beliefs (Perceived diabetes indifferently, Passively Acquire Health Knowledge, Distrust of primary health services); 5. Medical environment (Needs not met by Medical Services); 6. Life restrictions (Daily Life, Occupational Restriction); 7. Lifestyle change (Adhering to traditional or unhealthy diet, Lack of exercise, Low-quality sleep); 8. Time poverty (Healthcare-seeking behaviours were limited by work, Healthcare-seeking behaviours were limited by family issues); 9. Mental Condition (Negative emotions towards diabetes, Negative emotions towards life); 10. Levels of Support (Lack of community support, Lack of support from Friends and Family, Lack of Social Support); 11. Social integration (Low Degree of Integration, Belief in Suffering Alone); 12. Experience of transitions (Diet, Dwelling Environment).

Conclusion

Based on our findings, specific interventions targeting individual patients, family, community and society are needed to improve diabetes control, as well as patients’ mental health care and general living conditions.

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<![CDATA[Selection of the optimal trading model for stock investment in different industries]]> https://www.researchpad.co/article/5c6dc9d9d5eed0c48452a2e0

In general, the stock prices of the same industry have a similar trend, but those of different industries do not. When investing in stocks of different industries, one should select the optimal model from lots of trading models for each industry because any model may not be suitable for capturing the stock trends of all industries. However, the study has not been carried out at present. In this paper, firstly we select 424 S&P 500 index component stocks (SPICS) and 185 CSI 300 index component stocks (CSICS) as the research objects from 2010 to 2017, divide them into 9 industries such as finance and energy respectively. Secondly, we apply 12 widely used machine learning algorithms to generate stock trading signals in different industries and execute the back-testing based on the trading signals. Thirdly, we use a non-parametric statistical test to evaluate whether there are significant differences among the trading performance evaluation indicators (PEI) of different models in the same industry. Finally, we propose a series of rules to select the optimal models for stock investment of every industry. The analytical results on SPICS and CSICS show that we can find the optimal trading models for each industry based on the statistical tests and the rules. Most importantly, the PEI of the best algorithms can be significantly better than that of the benchmark index and “Buy and Hold” strategy. Therefore, the algorithms can be used for making profits from industry stock trading.

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