High Price Research Articles

Access to quality-assured artemisinin-based combination therapy and associated factors among clients of selected private drug outlets in Uganda

BackgroundMalaria treatment in sub-Saharan Africa is faced with challenges including unreliable supply of efficacious agents, substandard medicines coupled with high price of artemisinin-based combinations. This affects access to effective treatment increasing risk of malaria parasite resistance development and adverse drug events. This study investigated access to quality-assured artemisinin-based combination therapy (QAACT) medicines among clients of selected private drug-outlets in Uganda.MethodsThis was a cross sectional study where exit interviews were conducted among clients of private drug outlets in low and high malaria transmission settings in Uganda. This study adapted the World Health Organization/Health Action International (WHO/HAI) standardized criteria. Data was collected using a validated questionnaire. Data entry screen with checks was created in Epi-data ver 4.2 software and data entered in duplicate. Data was transferred to STATA ver 14.0 and cleaned prior to analysis. The analysis was done at 95% level of significance.ResultsA total of 1114 exit interviews were conducted among systematically sampled drug outlet clients. Over half, 54.9% (611/1114) of the participants were males. Majority, 97.2% (1083/1114) purchased an artemisinin-based combination anti-malarial. Most, 55.5% (618/1114) of the participants had a laboratory diagnosis of malaria. Majority, 77.9% (868/1114) of the participants obtained anti-malarial agents without a prescription. Less than a third, 27.7% (309/1114) of the participants obtained a QAACT. Of the participants who obtained QAACT, more than half 56.9% (173/309) reported finding the medicine expensive. The predictors of accessing a QAACT anti-malarial among drug outlet clients include type of drug outlet visited (aPR = 0.74; 95%CI 0.6, 0.91), not obtaining full dose (3-day treatment) of ACT (aPR = 0.49; 95%CI 0.33, 0.73), not finding the ACT expensive (aPR = 1.24; 95%CI 1.03, 1.49), post-primary education (aPR = 1.29; 95%CI 1.07,1.56), business occupation (aPR = 1.24; 95%CI 1.02,1.50) and not having a prescription (aPR = 0.76; 95%CI 0.63, 0.92).ConclusionLess than a third of the private drug outlet clients obtained a QAACT for management of malaria symptoms. Individuals who did not find artemisinin-based combinations to be expensive were more likely to obtain a QAACT anti-malarial. The Ministry of Health needs to conduct regular surveillance to monitor accessibility of QAACT anti-malarial agents under the current private sector copayment mechanism.

Peningkatan Ekonomi Paska-Pandemi Melalui Pengembangan Ulat Hongkong pada Kelompok Masyarakat Pembudidaya Ikan Air Tawar “Sumber Duren” Kabupaten Malang

Senggreng Village is one of the areas in Sumber Pucung District, Malang Regency, promising to be developed in agriculture, animal husbandry, fisheries, and agro-tourism. Abundant water resources mainly support the fisheries and agriculture potency due to its position near the Sutami Dam. One of the community groups in Senggreng Village, "Sumber Duren", is "engaged in developing a small amusement park that integrates culinary, fishing park and freshwater fish farming business, managed through a cage system. Regardless of its considerable potency, fish farming has not been carried out intensively, especially due to the high prices of commercial fish feed. Therefore, this community service team proposed a solution by initiating mealworm (Tenebrio molitor) cultivation as a cheap, high-protein, and sustainable source of fish feed to increase crop yields. Experienced mealworm practitioners also provided intensive mealworm cultivation education, training, and profitable business planning. Through this program, the community group "Sumber Duren" has been" successful in cultivating mealworms starting from the seedling phase to becoming broodstock and laying eggs. Based on the questionnaire data collection, most community group members stated that this community service activity helped provide new knowledge interested in cultivating alternative feeds, and 80% of respondents expected the activity to continue in the following years.

Community adaptation to climate-related flooding in Saskatchewan

Sustainable Development Goal 13 advances planning and resilience particularly germane for communities at the forefront of exposure to climate impacts. With the increasing intensity and frequency of climate impacts, including flood, assessing the state of preparedness of communities through review of their policies, is increasingly important. This research used a mixed methods approach to develop community resilience indicators (based on planning for extreme flood events) supplemented by two round tables and six focus groups with community leaders in Saskatchewan.Several Saskatchewan communities were identified as exposed to extreme rainfall events as well as inundation from surrounding rivers and water bodies. Focus group and roundtable participants confirmed that flood events were becoming more frequent in recent years. Cities generally scored higher in resilience, however, some northern communities also scored high. Experience of floods wasn't a necessary prerequisite of flood planning as several communities had robust plans without historical flood experience. Communities that had experienced previous flood events scored higher on indicators of flood preparedness resilience. Two communities that had never experienced floods had high indicators, providing evidence that demonstrated coping capacity is not a necessary precondition of resilience.Explanations for failure to plan included inability to address contributing farming practices, the high cost of infrastructure, climate change denial within communities, and downplaying adaptation to climate change because of its high price tag. A generational divide was identified as concerning, and especially counterproductive to the attraction of young people to rural and remote communities. Solutions identified included expanding partnerships, sharing services within a wider regional community, and supporting capacity and leadership for this. While this research suffers from limitations relating to data availability, more research on why some communities have not yet planned for floods (even though they have experienced them) and a greater geography of study would be beneficial.

A thorough investigation of the systems supporting E-vehicle charging stations and emerging trends

The percentage of electric vehicles (EVs) in the automobile industry which is increasing; yet, internal combustion engines (ICEs) remain operates a significant number of automobiles. The main barriers to EV use and environmentally friendly travel are their high price, short range, lack of battery charging infrastructure, and electricity pollution from EV chargers these barriers need to be taken down. Energy storage systems (ESS) with a substantial amount of energy are expensive, which contributes to the expensive of EVs. This article offers an analysis of EV technology, focusing on four primary areas of automobile technology. A detailed investigation is conducted into how grid architecture may be integrated with charging facilities and approaches to extend the longevity and productivity of electric vehicles. Since EVs are multienergy systems, reliable power control and management are necessary to maximize the consumption of energy. The assessment of EVs on the electric grid is concluded by an examination of various battery power management and control solutions in this paper. The review article concludes the suggested avenues for further study will be very helpful for researchers and EV users.

Effects of weather and climate on fluctuations of grain prices in southwestern Bohemia, 1725–1824 CE

Abstract. Grain prices in early modern Europe reflected the effects of weather and climate on crop yields and a complex array of societal and socio-economic factors. This study presents a newly developed series of grain prices for Sušice (southwestern Bohemia, Czech Republic) for the period 1725–1824 CE, based on various archival sources. It aims to analyse their relationships with weather and climate, represented by temperature, precipitation, and drought (self-calibrated Palmer Drought Severity Index, scPDSI) reconstructions, as well as particular weather extremes and anomalies reported in documentary evidence. Wheat, rye, barley, and oats series in Sušice showed high mutual correlations. The mean highest prices during the year typically occurred from May to July before the harvest, while prices usually declined afterwards. Wheat, rye, and barley prices were significantly negatively correlated with spring temperatures and positively correlated with scPDSI from winter to summer. This indicates that wetter winters, cooler and wetter springs, and wetter summers contributed to higher prices. The extremely high grain prices in the years 1746, 1771–1772, 1802–1806, and 1816–1817 were separately analysed with respect to weather and climate patterns and other socio-economic and political factors. The results obtained were discussed in relation to data uncertainty, factors influencing grain prices, and the broader European context.

A Study on Constraints Faced by Millet Stakeholders in Tamil Nadu, India

Millets, highly nutritious grains, are crucial for food security and nutrition due to their resilience in challenging agricultural conditions and rich nutritional content. This study investigates the constraints faced by stakeholders involved in the millet industry in Tamil Nadu, The research focuses on farmers, market intermediaries, and consumers, highlighting their challenges within the millet supply chain. A purposive sample of 90 millet-growing farmers and various market intermediaries was selected from key millet-producing districts. Data collection involved structured interviews and analysis using descriptive statistics and Garrett Ranking Technique. Results reveal significant production constraints for farmers, including price fluctuation, high seed costs, and pest and disease occurrence. Market intermediaries face challenges such as supply-demand imbalance and high transportation costs. Consumers encounter issues like limited availability and high prices of millet-based products. These findings underscore the multifaceted challenges within the millet industry, emphasizing the need for targeted interventions to address constraints and enhance the sustainability and accessibility of millets in Tamil Nadu.

New Anticancer Drugs: Reliably Assessing "Value" While Addressing High Prices.

Countries face challenges in paying for new drugs. High prices are driven in part by exploding drug development costs, which, in turn, are driven by essential but excessive regulation. Burdensome regulation also delays drug development, and this can translate into thousands of life-years lost. We need system-wide reform that will enable less expensive, faster drug development. The speed with which COVID-19 vaccines and AIDS therapies were developed indicates this is possible if governments prioritize it. Countries also differ in how they value drugs, and generally, those willing to pay more have better, faster access. Canada is used as an example to illustrate how "incremental cost-effectiveness ratios" (ICERs) based on measures such as gains in "quality-adjusted life-years" (QALYs) may be used to determine a drug's value but are often problematic, imprecise assessments. Generally, ICER/QALY estimates inadequately consider the impact of patient crossover or long post-progression survival, therapy benefits in distinct subpopulations, positive impacts of the therapy on other healthcare or societal costs, how much governments willingly might pay for other things, etc. Furthermore, a QALY value should be higher for a lethal or uncommon disease than for a common, nonlethal disease. Compared to international comparators, Canada is particularly ineffective in initiating public funding for essential new medications. Addressing these disparities demands urgent reform.

Boarding House Property Market Trends and Investor Preferences in Boarding House Development: A Comparative Study with Web Scraping

The development of the education industry and other supporting sectors scattered in the Sleman Regency - Indonesia has influenced the mushrooming of boarding houses. It is essential to use business intelligence for boarding house investors to analyze market trends to produce a boarding property business that is not inferior to its competitors. This study aims to contribute to the boarding house investors to obtain information on the characteristics, relationships, and effects of boarding house facilities on the rental prices set to remain competitive in the market. A total of 658 boarding house data from an e-commerce platform was extracted using business intelligence web scraping to determine the characteristics of the boarding house market trend in Sleman Regency. Multinomial Logistic Regression was used to find out the facilities for rooms, bathrooms, shared services and equipment, and common rooms, making the difference in rental prices for superior, exclusive, intermediate, and standard boarding house classes. The Multinomial Logistic Regression analysis results revealed that boarding houses with high rental prices were more concerned with things directly felt by tenants (everything about their room needs). Meanwhile, boarding houses with affordable rental prices prioritized things that general tenants could use/utilized.

Разработка требований к одежде для женщин в до- и послеродовой период

This article describes the basic requirements and functions of household clothing for women during pregnancy and in the postpartum period. And also what requirements are given for designing such clothes. Imported clothing before and after the period in our country is sold at a high price and our women cannot afford to buy such expensive clothes. The establishment of the production of such special clothes in our republic using local resources would make their pains cheap, which would allow the solution of problems and increase the economy of our country.

Lilitations and potentials of the school food program in the three municipalities in West Paraná

This article aims to analyze the potentialities and limitations identified in relation to the purchase of foodstuffs from family farming for school meals by the subjects involved in school meals in three municipalities in Western Paraná, through a multiple case study, using in-depth interviews individual and carrying out a collective focus group with 42 subjects (family farmers and nutritionists) during the years 2022 and 2023, gathering the results in a SWOT matrix. As results, it is evident that the potential internal and external factors, for the subjects, are related to union, diversity of production, appreciation of family farming, more natural quality foods, contribution to the health of schoolchildren, quality of life, encouragement of sustainability, income diversity, job creation and property innovation. As internal and external limitations, the lack of ATER and farmers' cooperation and adaptation, cost of adapting legislation and bureaucracy, climatic conditions, pests, difficulties in irrigation, high input prices, lack of labor and rural exodus.

Factors influencing medical expenditures in patients with unresolved facial palsy and pharmacoeconomic analysis of upper eyelid lid loading with gold and platinum weights compared to tarsorrhaphy

There are no standards in diagnostic and therapeutic approaches to eye care in incomplete eyelid closure due to unresolved facial palsy (FP). Loading of the upper eyelid (UELL) with gold weights (GWs) or platinum chains (PCs) is a highly effective procedure for the correction of lagophthalmos. Despite this, the procedure is used infrequently in our country because of the relatively high price of the implant and the lack of reimbursement. The aim of this research was to assess the factors influencing medical expenditures in this group of patients and to analyze utility costs for the UELL procedure with the use of GW and PC compared to tarsorrhaphy.Material and methods The costs of 88 surgical procedures (40 GWs, 11 PCs and 37 tarsorrhaphies) and medical expenditures before and after surgery were calculated based on reporting of materials, staff salaries and the SF-36 questionnaire. Distribution quartiles of the cost per QALY measure (dependent variable) was assessed via an ordered logistic regression model with eight explanatory variables.Results The calculated total cost of the surgery was US$209 for tarsorrhaphy, US$758 for UELL with a GW and US$1,676 for UELL with a PC. Bootstrapped costs per QALY values (CUI) in 88% of cases were below the US$100,000 cutoff. Etiology and duration of facial palsy and presence of Bell’s phenomenon were factors that significantly influenced the CUI. Patient gender and age, history of previous eyelid surgery, and presence of corneal sensation were found to be not significant (p > 0.1). Calculated ICER for GW was US$1,241.74/1QALY and ICER for PC was US$13,181.05/1QALY compared to tarsorrhaphy.Conclusions Eye protection in patients with FP should be a crucial element of health policy. Findings suggest UELL procedure with a GW or a PC to be a cost-effective procedure with GW being the most cost-effective.

When Would Owners Decide to Block Their Properties? Deciphering the Airbnb Business Decisions with Transactional Data

The sharing economy create a new model for the society to provide the properties with different status which is not be full-utilized by the host. Airbnb is a typical example, which allows the host to provide their rooms to the customers. Our work focus on the micro level to show the relation. Using the anonymous data of properties in New York City from Airbnb, we estimate the effects of properties status on market performance and supply behaviors. Our result shows that the higher daily rates would lead to higher booking numbers. However, the extra fee such as clean fee and Security Deposit will do negative effects on number of booking. Further more, Convince and information availability cause better performance. Supply behaviors will not be changed easily. However, we found that the weekend, higher price and lower annual revenues will lead to higher probability of block.

Sustainable alternative to irrigated maize monoculture in a maize-dominated cropped area: Lessons learned from a system experiment

Maize is the most-produced food crop in the world and is grown in intensive rotations or in monoculture (continuous maize) systems. As maize production has expanded massively across the world, many concerns have emerged about its local environmental and other global impacts. Agronomists have designed innovative cropping systems and assessed them using system experiments to make arable systems more sustainable. However, knowledge is still lacking on the sustainability of innovative cropping systems compared to highly intensive systems such as irrigated maize-based monoculture. Here, we present the assessment results of a nine-year system experiment in Alsace, France, developed to compare an innovative system based on a diversified rotation and innovative management practices (three-year rotation of maize/soybean/winter wheat (plus a cover crop) combined with reduced tillage) with a continuous maize reference system. The results cover a six-year assessment period following an initial three-year design period. Classic criteria, such as profitability, workload, pesticide use, fossil energy consumption and nitrate leaching, were assessed along with other less studied criteria, such as pesticide leaching risk, soil structure, soil chemical quality and soil biological activity. Sustainability – which includes environmental, social and economic dimensions – was assessed with the MASC 2.0 method. Overall sustainability was substantially enhanced in the innovative system (5 out of 7 sustainability classes) in comparison with the low level of the reference system (2 out of 7). This was due to a clear improvement in the environmental performance (from 2 out of 5 to 5 out of 5) while social performance was high in both systems (4 out of 5) and economic performance was low (2 out of 5) due to very low contribution to economic development. Nevertheless, the innovative system had a major drawback: lower profitability, especially when scenarios included high maize prices. Furthermore, herbicide use on maize was higher in the innovative system than in the reference one. Avenues for progress, such as encouraging stakeholder participation at the assessment stage or additional innovations such as multiple cropping, are suggested.

Marketing Strategy Analysis in the Digital Era Taking Pinduoduo as an Example

In this study, the researcher will assess the marketing strategy analysis of Pinduoduo, a Chinese e-commerce giant that, over the past few years, has gained prominence and increased its market share against traditional e-commerce companies such as Alibaba and JD.com. In this study, the researcher will examine the effectiveness of the evolving online marketplace, focusing on the companys unique business model and strategies such as time-limited instant kills and social media marketing to develop a better understanding of the impact and success of Pinduoduos approach. The methodological approach that the researcher will use is a comprehensive literature review and the SWOT model to understand Pinduoduos digital marketing strategies. The literature review approach will focus on the core business model of the company, while the SWOT model will be instrumental in analyzing market positioning and segmentation. The key questions in this study include: conducting an assessment of the efficacy of Pinduoduos marketing plan; understanding its digital marketing trends; and drawing insights from global success stories in the industry. Pinduoduos marketing strategies that have led the company to effectively engage users, specifically those from low-tier cities, include time-limited instant kills, daily cash rewards, and subsidies. The SWOT analysis has helped the company identify strengths, such as market differentiation, and weaknesses, such as high unit prices. In conclusion, Pinduoduos success will be based on its ability to successfully navigate the sinking market and its successful utilization of its strategic innovations, making it a formidable player in the digital era.

Efficiency and sustainability of bond market: Evidence from aftermarket trading of US corporate bond offerings

We find that for bond offerings that are non-self-marketed, there is a significantly larger proportion of institutional-sized sell trades than buy. In stark contrast, for self-marketed offerings by underwriters, immediate post-offer trading is characterized by a larger proportion of institutional-sized buy trades than sell. We also find evidence suggesting that retail investors, who are initially shut out of the offering deals, buy bonds in the secondary market at a higher price. Our evidence suggests that certain institutional investors receiving allocations of non-self-marketed offerings flip them for a quick profit. The systematic disparity in aftermarket trading immediately following self-marketed versus non-self-marketed bond offerings suggests that the offering process is inefficient, which may have implications on the sustainability of bond offering process.

Significant Communication Factors for Sustainable Products with a Focus on Czech Consumers

The aim of the study is to identify the importance of partial communication factors of sustainable products for the Czech consumer. First, the data from an online survey is interpreted in the form of descriptive statistics to establish a comprehensive overview of the attitudes and preferences of Czech consumers. Second, the global envelope method is used to evaluate reactions to packaging, certificates, ingredients, in-store placement, awareness, sales in a sustainable store, higher prices, and other factors among selected target groups. Based on the results of the 2020 questionnaire survey, significant target groups were identified by frequency analysis and their responses to communication factors were monitored for apparel, drugstore and cosmetics, and food. The test results show that clearly the most important communication factor for sustainable products is the certificate, to a large extent for two categories: males 45 – 64 years old and females who are university educated.

Robustness of business models for insect production for feed and food in Europe

Abstract Insects and their derivatives are increasingly recognised as a (more) sustainable and circular protein source for feed and food. The European insect industry is growing, but upscaling remains a challenge due to multiple uncertainties. This study analysed the robustness of three different business models for insect production for feed and food in six future scenarios. Business models and scenarios were identified through literature review and refined through expert elicitation (n = 5). The three business models comprised: (1) full-liner black soldier fly production for pet food, (2) decentralised black soldier fly production for aquafeed, and (3) mealworm processing cooperative for food. The six scenarios addressed uncertainties around the use of side streams, insect welfare, energy, and sustainability. We used the Business Model Stress Test in four focus groups with experts (n = 23) from six European countries. Heat maps for three distinct business models were presented, detailing the impacts of scenarios on business model components. Experts regarded full-liner black soldier fly production for pet food and mealworm processing cooperative for food as more robust than decentralised black soldier fly production for aquafeed. These differences were mainly related to the customer segments, value proposition, revenue structure, and cost structure. In full-liner black soldier fly production for pet food, stringent regulations were expected to have no negative impact on business model components, in contrast to liberal regulations with anticipated adverse effects. Examination of regulatory uncertainty indicated strict legislation’s advantageous expected impact on consumer trust in the pet food and food market. High energy prices were anticipated as a major challenge across all business models, while improved sustainability compliance was viewed positively. The classification in relatively more or less robust business models serves as a guide for business and policy in further developing the insect sector for feed and food in Europe.

Childhood disabilities and the cost of developmental therapies: the service provider perspective

ABSTRACT Purpose For children with neurodevelopmental disabilities (CWNDs), early diagnosis that leads to early intervention with regular targeted therapies is critical. In Qatar, private therapy centres that address this demand often have highly exclusive prices restricting families from availing them. This paper examines the challenges faced by families with CWNDs, as well as various financial and systemic obstacles, from the vantage point of these centres, all of which culminate in an extraordinarily high disability price tag for disability families in Qatar. Methods This study is based on qualitative, semi-structured, and in-depth interviews with private therapy centres and developmental paediatricians. Results Therapy centre representatives expressed common struggles in lengthy and cumbersome administration and licencing procedures, difficulty in hiring and retaining high quality staff, and expenses that need to be paid to the state. From their experience, families largely struggle with delayed diagnoses that significantly slow down intervention plans and therapies as well as staggeringly high financial costs with a dearth of funding options. Conclusions We recommend sincere engagement, dialogue, and cooperation between multiple stakeholders; a supportive ecosystem to balance and distribute the demand that includes schools and parents; as well more efficient administrative procedures and recruitment strategies.

Local food system resilience in the context of shocks and crises: vulnerabilities and responses of agroecology-based farmers in Peru, Germany, and the United States

ABSTRACT Multiple crises have disrupted food systems around the world. The shocks induced by the COVID-19 pandemic, coupled with increased energy prices and shortages of fertilizers and agricultural inputs, have affected farmers everywhere. By applying inductive, qualitative, and comparative research approaches, we investigate the impact of shocks and crises on diverse food systems. Using mixed qualitative methods, we integrate the voices of (n = 25) farmers belonging to agroecology-based local food systems in Peru, Germany, and the United States with the aims of: (i) understanding the different crisis scenarios; (ii) determining the vulnerabilities induced in farmers; and (iii) identifying the responses and coping mechanisms that farmers deploy in response to shocks. The results illustrate how farmers are affected by the combined effects of labor shortages, rising input costs, high energy prices, and climate change. Farmers’ responses to stressors are then analyzed and compared using attributes of food system resilience. Based on our results, we argue that resilience-building is determined not only by the environment in which agroecology is embedded, but also by the responsive capacities of farmers. We emphasize the need for more proactive policies aimed at promoting agroecological and localized production to enhance the resilience of food systems against recurrent shocks and crises.

Taxing ride‐sharing: Which neighborhoods pay more?

AbstractI examine the short‐run impact of taxing ride‐sharing trips on the price and usage of ride‐sharing across different neighborhoods of Chicago and investigate whether the tax had unequal effects on neighborhoods with different racial compositions. I document significant heterogeneity in price increases due to the tax across neighborhoods of departure, showing that this was correlated with their differential access to alternatives to ride‐sharing, such as public transit. Clustering neighborhoods based on their racial composition reveals that Black areas experienced particularly high price increases and reductions in usage. Overall, the burden of the tax fell more heavily on minority‐concentrated areas.