Daily Expenditure Research Articles

Changes in proton pump inhibitor prescribing trend over the past decade and pharmacists\u2019 effect on prescribing practice at a tertiary hospital

BackgroundProton pump inhibitors (PPIs) remain one of the world’s most frequently prescribed medications and there is a growing number of publications on correct versus incorrect use of PPIs worldwide. The objective of this observational retrospective study was to assess changes in PPI prescribing trends over the past decade and pharmacists’ effect on optimizing PPI prescribing practice at a tertiary hospital in China.MethodsWe collected the prescriptions of PPIs in our hospital from January 2007 to December 2016. Then the rate of PPI prescribing, the defined daily doses (DDDs) and expenditures were calculated and plotted to show the change in utilization of and expenditure on PPIs. Reasons behind this change and effect of pharmacists’ intervention were evaluated by investigating the rationality of PPI use through sample surveys of patients of pre-intervention (Jul.-Dec. 2015) and post-intervention (Jul.-Dec. 2016).ResultsIn outpatient settings, the rate of PPI prescribing remained almost constant, utilization (from 135,808 DDDs to 722,943 DDDs) and expenditure (from 1.85 million CNY to 7.96 million CNY) increased for the past ten years, dominated by oral formulations and rabeprazole. In contrast, in inpatient settings, the rate of PPI prescribing (from 20.41 to 37.21%), utilization (from 132,329 DDDs to 827,747 DDDs) and expenditure (from 3.15 million CNY to 25.29 million CNY) increased from 2007 to 2015 and then decreased, dominated by injection formulations and omeprazole. Pharmacist interventions could significantly promote the rational use of PPIs (44.00% versus 26.67%), decrease PPI use and reduce patients’ charges (P < 0.05).ConclusionsThe utilization of and expenditure on PPIs grew due to the increase of patients and irrational use of PPI. Pharmacist interventions help to reduce PPI utilization and expenditure and enhance rationality for inpatients, but much work should be done to regulate injection and originator formulas, and improve the rationality in the future.

International Real Estate Review

The purpose of this paper is to estimate the impact of tenure choice on saving for Chinese households. Since housing expenditure usually accounts for a large portion of household spending, households need to consider how much they have in order to save for future housing spending when they decide on their daily expenditures, including food, clothing, transportation, education, leisure, and so on and so forth. We estimate the tenure choice behavior of Chinese households by first, applying a data set from the China Household Finance Survey and separating households into three types of tenure choice, namely, renters, owner-occupied with a mortgage, and owner-occupied without a mortgage. Then, we estimate the actual impact of tenure choice on saving by applying the Heckman two-stage model. Our estimations show two important results. First, the coefficients of the inverse Mills ratio are significant which implies that a two-stage estimation model is appropriate. Secondly, the estimated coefficients for the factors that affect saving behavior under the two-stage model are significantly different from those under a conventional model. The result shows that, without considering tenure choice, the conventional method of estimation for factors that affect saving behavior will be biased.

Treatment Delay among Pulmonary Tuberculosis Patients within the Pakistan National Tuberculosis Control Program.

Delay in diagnosis and treatment worsens the disease and clinical outcomes, which further enhances transmission of tuberculosis (TB) in the community. Therefore, this study aims to assess treatment delay and its associated factors among pulmonary TB patients in Pakistan. A cross-sectional study was conducted among 269 pulmonary TB patients in the district. Binary and multivariate logistic regressions were used to explore the factors associated with delay in TB treatment. Results reveal that most patients were from low socioeconomic backgrounds. For example, 74.7% were living in kacha houses, 54.7% were from lowest the income group (< 250 US$/month), 60.2% married, 54.3% illiterate, 62.5% rural, 56.1% had no house ownership, and 56.5% had insufficient income for daily family expenditures. Significant delays were revealed by this study: 160 patients had experienced a delay of more than 4 weeks, whereas the median delay was 5 weeks. Results show that the most important reason for patient delay was low income and poverty (42.0%) followed by unaware of TB center (41.6), stigma (felt ashamed = 38.7%), and treatment from local traditional healers. Old age (adjusted odds ratio [AOR] = 6.6; 95% confidence interval [CI] = 1.63-26.95); and rural areas patients (AOR = 2.1; 95% CI = 1.15-3.71) were more likely to have experienced delay. However, the higher income and sufficient income category (AOR = 0.5; 95% CI = 0.31-0.95) were associated factors and less likely to experience delay in patient treatment. Integrative prevention interventions, such as those involving community leaders, health extension workers such as lady health workers, and specialized TB centers, would help to reduce delay and expand access to TB-care facilities.

Prospects of Women Cut Flower Enterprise for Sustainability Approach: A Case Study

Floriculture in Nagaland has taken a big leap in the state's economy helping the growers, who for the love of flowers can now meet their daily expenditures and other needs through this venture. The demand of fresh cut flowers has brought a huge impact in the Floriculture sector providing income as well as employment especially among the home makers and unemployed youths. The present study being undertaken during the agricultural year 2014–2015 in Dimapur and Kohima districts of Nagaland for the assessment of production and marketing of cut flowers as the study comprises of 75 numbers of sample respondents by following a multi-stage stratified simple random sampling method based on the flower growers. The sample population was categorized under alstroemeria, lilium, anthurium, gerbera and orchid group of growers. The average family size were 5.56, out of which 100.00 per cent were literate, as the worker constitutes 46.66 per cent of total population, the overall total cost of cut flower growers were 46, 600.00/-per acre, as the gross income were 2, 32, 520.00/-per acre, the net return were 1, 82, 782.00/-per acre and overall benefit-cost ratio were 4.97: 1. There were three (3) marketing channels are identified for the marketing of cut flowers in both the districts, as the Producer's share in consumer's rupees were found highest on channel-I, regarding impact has enhanced by 1, 20, 131.80/-per acre to their annual income, while 23, 101.52/-was increase in their annual expenditure on food items as well as on their annual savings, also an attempt has been made to study the constraints faced by the cut flower growers during the production viz; requirement of more care was foremost followed by lack of timely availability of planting materials, while the marketing constraints include the lack of knowledge on post harvest techniques as the foremost followed by lack of storage facilities and it was least on lack of transportation facilities etc;

A Systemic Debt Payoff Policy

:The average family in the US takes on debt to buy homes, to get education, and sometimes to even pay for normal daily expenditures. Outstanding debt generates a stream of rents to creditors and has become a significant burden on many households. A policy of household debt forgiveness could increase both economic equality and individual liberty. Under what conditions might such a policy be socially acceptable and what would be the implications of such a policy? For debt forgiveness to gain social acceptance the U.S. population would have to perceive the policy as fair and believe that such a program would treat all households equally. Furthermore, any such policy would be politically impossible if it stripped asset owners of money due or would not substantially lower household debt levels. This article explores some possible parameters that a politically feasible policy would contain, and it offers an estimate of policy costs.

Risk attitude effects on Global-GAP certification decisions by smallholder French bean farmers in Kenya

Knowledge on the link between French beans farmers’ attitudes toward risks and Global-GAP compliance decisions is limited in Kenya. A social experiment (Lottery games involving real pay-offs) was implemented on 119 randomly selected farmers to solicit risk attitudes and Binary Logit Model to determine the effect of risk attitudes on compliance decisions. Majority of non-certified farmers (24 percent) were risk averse relative to certified farmers (4.3). Non-certified farmers were more averse towards losses (p=0.062|MD=0.50). Farmer’s probability weighting (p=0.046), aversion to loss (p=0.094), contract farming (p=0.000) and daily household expenditure per adult equivalent significantly and negatively affected compliance decisions while risk aversion (p=0.081), annual asset value (p=0.092) and acreage under French beans (p=0.033) significantly and positively affected compliance decisions. The results suggest that crop insurance and affordable credit is important in mitigation of potential production and marketing risks in French bean farming.

Kaliteli ve Dengeli Beslenme Açısından Kanatlı Üretiminin Etkinliği

Dünya‘da gıda eşit dağılmamaktadır. Gelişmiş ülkelerin sağlıkla ilgili sorunu obezite iken, diğer ülkeler açlık ve buna bağlı hastalıklarla karşı karşıyadır. Dünya nüfusunun 2050 yılına kadar 1/3 oranında artacağının bekleniyor olması hayvansal protein üretiminin de artırılmasını zorunlu kılıyor olacaktır. Türkiye‘de kişi başına toplam et tüketimi 35 kg, kanatlı eti ise 22 kg‘ı aşmıştır ve yumurta tüketimi 200 adet iken yaklaşık 230 lt süt tüketimi bildirilmektedir. Günlük hayvansal protein tüketimimiz 35 g civarındadır ve iletişim çağına ayak uydurabilmek bakımından 45-50 g seviyesine çıkarılması önerilmektedir. Dünyada en yüksek artış kanatlı et sektöründe ve bunu takiben yumurta tavukçuluğu sektöründe görülmektedir, bu artış ülkemiz için dünya ortalaması üzerinde iken kırmızı et üretiminde dünya ortalamasının gerisinde kalınmıştır. Görsel, yazılı ve sosyal medyada bilimsel dayanağı olmayan haberlerin oluşturduğu bilgi kirliliği tüketicilerin olumsuz yönde etkilenmesine sebep olmaktadır. Özellikle gençler başta olmak üzere tüm bireyler, biyolojik değeri yüksek olan yumurta, süt ve et ürünlerini doğal ihtiyaçları düzeyinde tüketebilmelidir. Organik ve free-range sistemlerden elde edilen ürünlere talep eden tüketiciler rahatlıkla ulaşabilmelidir. Ancak hangi sistemde üretilmiş olursa olsun, ürünlerin güvenilir kaynaklardan geldiğinden, üretim tarihi ve sağlıklı bir şekilde elde edildiğinden emin olunmalıdır. Bu derlemede, zihin ve beden gücü yüksek nesiller yetiştirilmesi bakımından son derece önemli olan hayvansal protein kaynaklarından yeterince faydalanılması için artan insan nüfusunu beslemede kanatlı üretiminin etkinliğinden bahsedilmektedir.

English

Panthera pardus is a widespread mammalian carnivore, with a very broad diet range. Therefore, it is often seen as needing less protection as compared with some other predator species. However, with a 37% reduction in historic range and some subspecies critically endangered, the leopard is a species that does indeed require certain conservation attention. In Southern Africa, there are several threats facing the leopard: habitat loss, poaching, as well as killings associated with leopard-human conflict (the latter being aggravated by poorly-stocked reserves where the animals reside). In setting aside formal protected areas for the leopard and its prey, it is important to plan and stock these reserves in such a manner so as to limit potential conflict with owners of surrounding farmlands or tribal land. Focusing on the average daily energetic consumption and expenditure of the leopard in Southern Africa, this paper seeks to determine how regular successful hunts can help maintain the animal. It was found from the study that there is a very close balance between the energy consumption and expenditure of the leopard. Depopulation of a varying intensity may result from a hunting success probability below 0.5. Leopards are unlikely to persist where hunting success is reduced to 0.1 due to prey shortage. This finding is believed to provide some preliminary guidance for leopard prey stocking rates in the future.&nbsp; &nbsp; Key words: African leopard, energy expenditure, prey stocking rate, leopard-farmer conflict, conservation, predator-prey interaction.

Analysing off-season tourist expenditure

The majority of researches deal with the issue of micro-level expenditure in the high season, leaving off-season expenditure an under-researched topic. Moreover, the relationship between tourist satisfaction and expenditure has been also rarely explored. Thus, the aim of this study is to determine the factors that influence the off-season expenditure levels of light spenders and heavy spenders. Among the set of predictors, various dimensions of satisfaction were tested as possible off-season expenditure predictors. Descriptive analysis was used for sample profiling, independent t-tests were conducted to determine significant differences between light and heavy spenders in terms of their characteristics, and Principal Components Analysis (PCA) was applied to identify the dimensions of tourist satisfaction with the destination’s offering. In the end, multiple regression analyses were made to identify the expenditure determinants of light and heavy spenders. The main findings indicate that different predictors influence the daily off-season expenditure levels of light and heavy spenders. When it comes to light spenders, among the set of other significant predictors, it was found that those who are more satisfied with the cleanliness and preserved environment tend to spend more in the destination in comparison with those who are less satisfied with this dimension. In the case of heavy spenders, the results revealed that satisfaction with safety, quality and hospitality turned out to be a statistically significant predictor of their daily off-season expenditure.

What drive students to behave more environmentally friendly towards waste?

Students’ behavior towards waste takes a crucial role to successful sustainable waste management at school level. As many scholars mentioned, a proper waste management should not only environmentally effective and economically efficient, but also socially acceptable. Therefore, it is important to know how to drive students to behave more environmental friendly. Using eco-friendly behavior survey for students as part of community engagement program titled “Creating Healthy, Fit and Productive Generation through Comprehensive Mental Revolution Model”, this paper aims to identify factors that determine students’ eco-friendly behavior. This survey was administered to 797 students from three high schools in the city of Bekasi, SMA N 1 Bekasi, SMA N 2 Bekasi and SMK Korpri. We divided three broad characteristics in determining student’s eco-friendly behavior, namely individual characteristics, household characteristics and community characteristics, as mentioned in various researches. The result shows that out of three broad characteristics, individual characteristics play significant role in determining the level of student’s eco-friendly behavior. In terms of individual characteristics, knowledge about waste and school course plays positive and significant role in determining the level. For the study course, we conclude that students in the science course have a relatively higher eco-friendly behavior level compared to social course or others. Female students are also more likely to have higher level of eco-friendly behavior rather than male students. Finally, daily expenditure significantly determines the level. On the other hand, we found that environmental concern and class rank do not have significant effect to student’s behavior. In addition, none of the household and community characteristics variables were significant in determining the behavior. This result emphasizes the importance of individual characteristics improvement, especially waste knowledge and environmental education, to drive students in dealing waste appropriately.

What drive students to behave more environmentally friendly towards waste?

Students’ behavior towards waste takes a crucial role to successful sustainable waste management at school level. As many scholars mentioned, a proper waste management should not only environmentally effective and economically efficient, but also socially acceptable. Therefore, it is important to know how to drive students to behave more environmental friendly. Using eco-friendly behavior survey for students as part of community engagement program titled “Creating Healthy, Fit and Productive Generation through Comprehensive Mental Revolution Model”, this paper aims to identify factors that determine students’ eco-friendly behavior. This survey was administered to 797 students from three high schools in the city of Bekasi, SMA N 1 Bekasi, SMA N 2 Bekasi and SMK Korpri. We divided three broad characteristics in determining student’s eco-friendly behavior, namely individual characteristics, household characteristics and community characteristics, as mentioned in various researches. The result shows that out of three broad characteristics, individual characteristics play significant role in determining the level of student’s eco-friendly behavior. In terms of individual characteristics, knowledge about waste and school course plays positive and significant role in determining the level. For the study course, we conclude that students in the science course have a relatively higher eco-friendly behavior level compared to social course or others. Female students are also more likely to have higher level of eco-friendly behavior rather than male students. Finally, daily expenditure significantly determines the level. On the other hand, we found that environmental concern and class rank do not have significant effect to student’s behavior. In addition, none of the household and community characteristics variables were significant in determining the behavior. This result emphasizes the importance of individual characteristics improvement, especially waste knowledge and environmental education, to drive students in dealing waste appropriately.

The dimensions of food insecurity and malnutrition among people living with HIV in Senegal, West Africa

ABSTRACTAn understanding of the factors contributing to food insecurity and malnutrition among people living with HIV (PLHIV) in Senegal is urgently needed in order to develop effective interventions. The goals of this study were to identify differences in the dimensions of food security among PLHIV in Dakar versus Ziguinchor, Senegal, to determine which of these dimensions are most predictive of severe food insecurity, and to identify factors associated with malnutrition.We conducted a cross-sectional study at outpatient clinics in Dakar and Ziguinchor, Senegal. Data were collected using participant interviews, anthropometry, the Household Food Insecurity Access Scale, the Individual Dietary Diversity Scale, and chart review.Interviews were conducted with ninety-five food insecure, HIV-infected subjects. Daily household income and daily food expenditure per household member were the strongest predictors of severe food insecurity. The practice of agriculture, livestock ownership, nutritional status, and HIV outcomes were not predictive of severe food insecurity. CD4 count <350/mm3 was the strongest predictor of malnutrition. Severe food insecurity, daily household income, daily food expenditure per household member, dietary diversity score, skipping meals, the practice of agriculture, livestock ownership, ART status, and adherence were not predictive of malnutrition.This is the first study to analyze the dimensions of food security among PLHIV in Senegal. We discovered important differences in food access, availability, stability, and utilization in Dakar versus Ziguinchor. We found that economic access was the strongest predictor of severe food insecurity and poorly controlled HIV was the strongest predictor of malnutrition. Our findings suggest that the interventions needed to address food insecurity differ from those necessary to target malnutrition, and that effective interventions may differ in Dakar versus Ziguinchor. Furthermore, this study highlights a need for a greater understanding of the relationship between HIV and malnutrition among individuals receiving ART in resource-limited settings.

Remittances transferred from Asian Americans to the origin country: a case study among Cambodian Americans

Southeast Asians were some of the first refugees arriving in the United States of America with federal refugee assistance after the passage of the Refugee Act of 1980. A large population from Cambodia entered the United States in the 1980s as a result of one of the greatest tragedies of the twentieth century. In this paper, I investigate the scope and motives for remittances from the United States that are transferred to Cambodia, the country of origin of the refugees. This will be done by taking a closer look at trends in remittances between 1992 and 2013, factors that contribute to the decisions to send remittances, and the characteristics of remittance recipients. The study found out that: (1) around half of the total remittances in the world transferred to Cambodia were derived from the United States, while amounts from each individual sender depended upon the economic condition of Cambodian Americans and the financial needs of their target recipient; (2) factors influencing decision-making in sending remittances included regular communication, age, amount of time for arrival to the receiving country, and closer association to Cambodian communities in the United States; and (3) remittances were primarily transferred to senior and younger family members for use in daily expenditures, health care and educational support.

Daily caloric expenditure as estimated by heart rate in lean and obese horses

Daily caloric expenditure as estimated by heart rate in lean and obese horses

Effects of Underwater Treadmill Training on Health-Related Fitness and Daily Caloric Expenditure in Adults with Type 2 Diabetes

Effects of Underwater Treadmill Training on Health-Related Fitness and Daily Caloric Expenditure in Adults with Type 2 Diabetes

Travel purpose and expenditure patterns in city tourism: evidence from the Amsterdam Metropolitan Area

This study examines the expenditure patterns of urban tourists with different trip purposes including visiting cultural heritage. Expenditure categories include museums and theatres. We use a two-step approach, in which we first analyse the total daily amount of expenditure and then the budget shares of various categories. We make use of survey data collected for the Amsterdam Metropolitan Area, a large Western European city known for its rich cultural heritage and the semi-legalized use of cannabis. The econometric analysis shows that trip purposes are associated with substantial differences in total daily expenditure as well as on budget shares. However, the results also show that the activities undertaken by tourists are not limited to their (initial) trip purposes.

Novel Tools in Determining the Physiological Demands and Nutritional Practices of Ontario FireRangers during Fire Deployments.

IntroductionThe seasonal profession of wildland fire fighting in Canada requires individuals to work in harsh environmental conditions that are physically demanding. The purpose of this study was to use novel technologies to evaluate the physiological demands and nutritional practices of Canadian FireRangers during fire deployments.MethodsParticipants (n = 21) from a northern Ontario Fire Base volunteered for this study and data collection occurred during the 2014 fire season and included Initial Attack (IA), Project Fire (P), and Fire Base (B) deployments. Deployment-specific energy demands and physiological responses were measured using heart-rate variability (HRV) monitoring devices (Zephyr BioHarness3 units). Food consumption behaviour and nutrient quantity and quality were captured using audio-video food logs on iPod Touches and analyzed by NutriBase Pro 11 software.ResultsInsufficient kilocalories were consumed relative to expenditure for all deployment types. Average daily kilocalories consumed: IA: 3758 (80% consumption rate); P: 2945±888.8; B: 2433±570.8. Average daily kilocalorie expenditure: IA: 4538±106.3; P: 4012±1164.8; B: 2842±649.9. The Average Macronutrient Distribution Range (AMDR) for protein was acceptable: 22–25% (across deployment types). Whereas the AMDR for fat and carbohydrates were high: 40–50%; and low: 27–37% respectively, across deployment types.ConclusionsThis study is the first to use the described methodology to simultaneously evaluate energy expenditures and nutritional practices in an occupational setting. The results support the use of HRV monitoring and video-food capture, in occupational field settings, to assess job demands. FireRangers expended the most energy during IA, and the least during B deployments. These results indicate the need to develop strategies centered on maintaining physical fitness and improving food practices.

Financial Burden Faced by Families due to Out-of-pocket Expenses during the Treatment of their Cancer Children: An Indian Perspective.

Context:Life-saving cancer therapy is costly and may result in financial burden for these families. Financial costs for treating childhood cancer care are traditionally assessed based on the amount spent for diagnostic tests, hospitalization, and chemotherapy. The financial costs for travel, accommodation, out-of-pocket expenses for food, phone bills, and loss of income due to reduction or termination of parental employment are hidden nonmedical expenses that are rarely accounted for. Studies on the financial implications of pediatric cancer treatment are based on the Western model of healthcare with good government/state insurance coverage and hence literature on lifestyle implications for families in developing nations with limited resources is still scarce.Aims:The aim of this study is to find out the details of out-of-pocket expenses incurred by the families during their treatment of cancer children and its implications on their quality of life. Settings and Design: This study was conducted in a tertiary care center for pediatric malignancies for over 1-year period.Subjects and Methods:About seventy families whose children were diagnosed with acute leukemia and undergoing treatment at our center were asked to fill a questionnaire detailing their out-of-pocket expenses.Results:Nonmedical expenses accounts for about 46% of their monthly household income of parents from rural areas and 22% of their household income from urban areas. On an average, a family from rural area spends four times the normal amount spent on home for their daily food expenditure. Thirty-eight percent of families have borrowed money from money lenders with an average interest rate of about 12.5% which pushes them to a state of debt for the next few years.Conclusions:Out-of-pocket expenses contribute a significant proportion to the financial burden of the families with childhood malignancies and these invisible expenses should be recognized and provide adequate support to lessen the burden of this economic impact.

La segmentación del gasto turístico: el caso de Canarias

This paper’s main objective is to analyze the behavior of tourists who come to the Canary Island regarding the different levels of average daily expenditure made in their home country. This analysis is performed using the information provided by the Tourism Expenditure Survey conducted by the Canary Institute of Statistics of the Government of the Canary Islands (ISTAC). The analysis is based on making a breakdown of the structure of tourists visiting the Canary Islands through a cluster analysis. The variable which governs segmentation is the average spending per person per day in their home country and it applies to all the tourists arriving in the Canary Islands during 2014. Furthermore, through the application of this methodology you can check the possibilities of discrimination that some variables present as opposed to others which do not provide different results.

Metabolic responses to a loaded movement training workout.

Few studies have investigated the metabolic demands of functional exercise. We determined the oxygen cost, heart rate (HR) response, and energy expenditure (EE) both during and immediately following a loaded movement training (LMT) workout. Ten participants (5 male, age 23.5±3.7 years, VO2peak 53.3±6.4 mL/kg/min) completed baseline resting metabolic rate testing, a maximal oxygen uptake (VO2) test, and a familiarization trial. After 48 hours' rest, participants completed a 19-minute LMT protocol using functional exercise equipment, consisting of 10 x 60-second work intervals followed by 60 seconds of rest. VO2, HR, respiratory exchange ratio (RER), and EE were measured during the entire LMT protocol and for 45 minutes post-exercise. Participants had a mean VO2 of 65.3±4.1% VO2peak, HR of 91.8±4.0% HRmax, RER of 1.06±0.06, EE of 13.0±3.0 kcal/min (0.176±0.021 kcal/kg/min), and rating of perceived exertion of 17.3±1.6. The mean overall caloric expenditure was 247 kcal. Post-exercise metabolic recovery data showed a mean overall excess post-exercise oxygen consumption (EPOC) of 7.89±3.78 L. EE remained elevated through 15 minutes, VO2 through 30 minutes, and HR through 45 minutes (P<0.05). RER remained depressed throughout the 45-minute collection (P<0.05). LMT meets the American College of Sports Medicine's recommendations for improving cardiovascular fitness and achieving the daily caloric expenditure from exercise. It may be used to improve cardiovascular fitness and body composition in healthy adults.