Middle-class People Research Articles

Remedial Measures for Financial Crisis in the Light of Prophetic Teachings

A few years ago the world suffered from a financial turmoil which emerged in the United States of America, Europe and Asia. It made a large population redundant; many businesses shuttered down and reduced consumption, production, purchasing power, GDP and leading many economies into deep recession. Consequently poor and middle class people found difficult to survive. In the beginning of the financial crisis many suggestions were propounded by economists, policy makers and bankers to reduce its impact. Several policies were implemented to combat against financial crisis yet billion of people are suffering from poverty and hunger. Prophetic teaching is a complete code of life; in its guidance there is a set of teachings which govern financial issues of the society and the market. This paper aims to explore the measure suggested in the light of the Hadith and the Quran.

ANALISIS KEMAMPUAN DAN KEMAUAN MEMBAYAR PASIEN RAWAT INAP DI RS PKU MUHAMMADIYAH BANTUL

Abstract Background: The number of treatment options for making competition among hospitals increasingly stringent anyway though not the business competition. The amount of this option makes every hospital must calculate the unit cost of each so as to make the right policy in determining the hospital tariffs. PKU Muhammadiyah Bantul is one of the largest hospital in Bantul. The Muhammadiyah owned hospitals have a social mission in providing health services to the community. The social mission of making hospitals PKU Muhammadiyah Bantul in setting the rates must be in accordance with the ability of the community. This is because the target consumer PKU Muhammadiyah Bantul majority of the lower middle class people. Currently PKU Muhammadiyah Bantul is developing the building, including increasing the number of beds to 300. Increasing the number of beds will make PKU Muhammadiyah Bantul as the largest Muhammadiyah hospital in Yogyakarta. The existence of this development will be made possible due to changes in the level of rates increasing operational needs. Background of the researchers interested in studying the patient's willingness and ability to pay in PKU Muhammadiyah Hospital in Bantul. Methods: This research is analytic research. Using cross sectional study design. The sample in this study amounted to 87 respondents. Results: Based on the analysis that has been carried out showed that the patient has the ability to pay an average of 100 033. While the average willingness to pay of patients included in the high category in the amount of 71.26 percent. Conclusions: 1) The average ability to pay inpatients Rp 100 033, estimated for three days. 2.) In order to conduct the promotion of hospital managers in an appropriate manner, for example by offering affordable rates to the public. Keywords: willingness to pay, ability to pay

Consumer Behavior and Preferences of Indian Consumers towards Apparel Purchase in Retail Markets of India

The growth of Indian economy and markets has given birth to a new range of customers who is inclined towards the purchase of braded and quality products specially the apparels as the youth of the country is now exposed to various business and professional situations. The economy has resulted in to the development of markets with new jobs created in the ITES sector, Biomedical, Automotive engineering, Apparel manufacturing and Civil engineering. The growth is strongly supported by the education sector with increase in the number of students enrolling for higher education and large numbers of students graduating every year thus creating a large pool of technical and managerial manpower. The working class people segment has grown since the economic growth and it has benefited middle class and upper middle class people. Due to the increase in the number of working people and substantial raise in income, spending power has increased over the years, and particularly the young Indians in the age of 15 – 25 like to shop more. The Government of India has laid down strict rules to protect the environment and avoiding child labor but there is no legality followed by companies in providing an ethical environment in means of working time and salary. This study focuses on the consumer behavior of young Indians in the age of 15 – 25 to understand and know their perception towards spending and to show a new path for the society and the industry for a sustainable economic and social environment.

A Super Specialty Hospital: What Went Wrong?

The culture of philanthropy is as old as India itself, which has a history spanning thousands of years. One who enjoys abundance without sharing it with others is indeed a thief, says the Bhagavad Gita. According to the New Companies Act, 2013, corporations need to spend 2% of their last 3 years' average profits on CSR activities starting the current fiscal year. The case study is about a project started by a wealthy family of Kolkata to provide medical facilities to middle-class people. From a modest beginning of a polyclinic to a mega super specialty hospital and the closure of the same within a month is the gist of the case. The case highlighted the unethical and unprofessional attitude of employees, especially the doctors who were supposed to be highly qualified in the field of social work. The case study revealed why being hands-on at a job and technical expertise are a must for the success of any project. A project- social or otherwise - needs people who are sincere and hard working. The doctors and the staff appointed by the management lacked the above qualities. The doctors as well as other employees misused the infrastructure of the hospital for their personal gains, which was disapproved by the management. This led to the closure of the hospital and thus put the middle class needy people in inconvenience.

The Emerging middle class in Africa

Emerging Middle Class in Edited by Mithuli Ncube and Charles Leyeka Lufumpa. New York: Routledge, 2015. Pp. vii, 215; figures, tables, contributors, acknowledgements. $140.00 cloth, $50.95 paper.Since the turn of the century, Africa has enjoyed impressive levels of economic growth. Increasing numbers of observers have commented that consequence of this growth has been the emergence of African middle classes. In April 2011, the African Development Bank's chief economist and vice-president Mthuli Ncube, Charles Leyeka Lufumpa, director of the Statistics Department, and Steve Kayizzi-Mugerwa, director of research coauthored The Middle of the Pyramid: Dynamics of the Middle Class in Africa. This document has served as the foundation for an edited volume, Emerging Middle Class in Africa (2015). Having assembled an impressive team of international researchers, the book explores the diverse characteristics of Africa's emerging middle class.Mthuli Ncube introduces the edited volume with an operational definition of what constitutes Africa's middle class. Eight thematic chapters and conclusion follow this introduction. Ncube's introduction lays out the analytic approach that is first presented in the market brief. Like the earlier paper, the book uses an definition that includes as members of the middle those people with per capita daily consumption of $2.00 to $20.00. Ncube then disaggregates the middle classes into first the class that includes those people who consume between $2.00 and $4.00 day. Second is the lower middle class whose members spend $4.00 to $10.00 day. Finally, people in the upper middle class spend $10.00 to $20.00 day. Ncube is careful to stress that vulnerable population of 204 million people, or 63 percent of Africa's floating middle class, risk falling back into poverty. Having established the parameters for definition of what constitutes the middle class, he suggests Africa's middle reflects a robust and growing private sector (p. 3). book's eight substantive chapters employ the absolute definition to explore how the African middle classes respond to specific issues.In Chapter 1, Charles Leyeka Lufumpa, Maurice Mubila, and Mohamed Safouance Ben Aissa argue that the middle has enabled African economies to shift away from export-led growth to create dynamic domestic markets. Their essay considers how large floating middle is part of changes that might lead to sustainable socioeconomic development. In Chapter 2, Michael Lofchie provides lengthy analysis of the political economy of Africa's emerging middle class. His essay notes middle interests in political stability all the while they engage in enterprise development, comply with tax laws, accumulate savings, and make investments in the domestic economy. Lofchie's trenchant analysis describes overarching elements of the middle and its hourglass configuration; how colonial continuities shaped societies, how post-independence economic policies favored failed import-substituting industrialization policies that contributed to chronic political economic weaknesses. …

Rebel Heart: Performing Fatness Wrong Online

Rebel Heart: Performing Fatness Wrong Online

The Choice of the New Latin American Middle Classes: Sharing or Self-Caring

__Abstract__ With the growth of the middle classes throughout Latin America we also witness growing discontent and protest. The same has happened in Asia, Africa and even Europe (see the other contributions in this issue). More welfare and freedom is apparently accompanied by more demands towards governments, as well as equally more disappointments. Sassen (2013, pp. 125–126) explains this by pointing to the fact that the middle classes have been the main beneficiaries of the liberal welfare state. Now, however, ‘they are protesting against the state because the state is failing them – “austerity politics” is one important manifestation of this failure’. The question emerges: Is the increase in protests in Latin America really related to the growth of the middle classes? And if so, what would explain this dissatisfaction? For some it is an easy explanation: Middle-class people simply want a steady and ‘good’ job that allows them to build their career and that of their children, including good health and education (Banerjee and Duflo, 2008, p. 26). This perspective is increasingly under pressure now that inequalities are rising again because of the impact of the global economic crisis (Birdsall et al, 2014). Therefore, this contribution to the debate on what can be expected from the middle classes in a period of crisis focuses on some of the largest countries in Latin America in which middle classes have grown substantially over the past decade: Brazil, Argentina, Mexico and Chile. I will zoom in on Brazil, as this country by far has led middle-class growth in the region. Key questions that will be examined are: What are the implications of expanding ‘new’ middle classes in the larger Latin American societies for inclusive development strategies? How have their mobilizations and claim-making over the past few years benefited the poor? And following Wiemann’s (2015, p. 3) important question in this debate: Have the new middle classes really played a progressive role, in this case in Latin America? Below, I will address these questions by first providing a brief overview of the origins as well as the scope of the new Latin American middle classes, followed by an analysis of their changing roles and emerging contradictions, the street mobilizations of recent years, and how they perceive the limits to growth and the environment. In the concluding section I will try to answer the question whether, in the context of the current global economic crisis, it is likely that the new middle classes will be siding with the poor, or, rather, will choose to link up with the upper classes and their policies.

Same-Sex Marriage and the Future of the LGBT Movement

In this article, I respond to queer critiques of the pursuit of same-sex marriage. I first examine the issue of (homo)normalization through a consideration of the everyday lives of same-sex couples with children, a subject about which queer critics are strangely silent. Children force same-sex couples to be out in multiple areas of their lives and recent court cases explicitly challenge the idea that same-sex couples do not make fit parents. Second, I examine whether same-sex marriage will address structural inequalities or will mainly benefit white, middle-class people. Access to marriage has disparate benefits depending on people’s structural locations, but is a movement goal supported by a broad array of LGBT people. Third, I examine the relationship between marriage, regulation, and the state. I argue for a broader understanding of the relationship between the state and different types of relationships, suggesting that it is impossible to escape regulation. If we consider marriage and family forms cross-nationally, we see a variety of possibilities for state recognition of various family forms. I conclude by assessing the impact of same-sex marriage on the future of LGBT politics, arguing that achieving marriage equality may allow the space for new political possibilities to emerge.

Prevalence of T2 Diabetes Mellitus (DM) Among the Rural People of Selected villages Of Bangladesh

Objectives: This cross-sectional study was conducted to find out the prevalence of type 2 diabetes and pre-diabetes ((PD) (Impaired fasting glucose-IFG, impaired glucose tolerance-IGT)) and to see the associations with risk factors.
 Methods: Two villages were randomly selected from rural area of Mymensingh district. 125 study subjects (≥30 years) were selected with systematic procedure but 118 samples were participated in the study. Below 30 years, diagnosed case of diabetes and urban people were excluded from study. Socio-demographic data were collected on a pre-tested interview schedule through face to face interview. DM, PD were interpreted by estimating fasting blood glucose level and 2 hour after 75 gm glucose load. Obesity was assigned by BMI. SPSS program (version 11.5) used for data analysis.
 Results: Mean age of participants was 46.68 with SD ± 12.698. Female participation (66.9%) was double compare to male, literacy rate was (64.4%) with female illiteracy of 29.67%. House wives (61.9%) were more than other professions. Middle class people were nearly 73%, Poor 14.4%, sedentary life style 11% and depressives 14.4% evident in study. A 20.3% people did laborious works. 17.8% had the family history of diabetes. Smokers (53.4%) were more than the non-smokers. Majority (89.0%) of rural people eat rice thrice a day. Normal BMI 61.0%, underweight 31.4% and 7.6% overweight observed. Overall prevalence of T2 DM was 11.0% showing increase trend of diabetes compared to 8.6% estimated in 2000 and higher than several studies of home and abroad. Female showed higher prevalence (7.6%) compare to male (P>0.05). The overall prevalence of PD was 16.1% evident in this study. The prevalence of IFG and IGT were 8.5% and 7.6% respectively. Female showed higher prevalence of IFG (5.1%) and IGT (5.9%) than male (P>0.05). House wives showed higher prevalence (5.6%) of DM compare to other professions (P>0.05). Illiterates showed more PD (10.3%) and less DM (1.7%) but literates showed more (9.3%) DM (P >0.05). DM (6.7%) and PD (11.8%) more were among the middle class (P=0.018). A high prevalence of PD (13.6%) and DM (9.3%) noticed among non-sedentary lifestyle (P >0.05). Smoker showed higher DM (8.5%) and PD (11.8%). (P-0.071). Prevalence of PD and DM were high among the people with physically less active (P =0.795). Depressives showed more prevalence of DM (8.5%) and PD (13.5%), (P=0.345). increased frequency of rice eating (P=0.004), people with normal BMI (P=0.081) and family history of DM (P=0.000) showed positive association with diabetes mellitus.
 CBMJ 2015 January: Vol. 04 No. 01 P: 22-29

Why Working But Poor? A Capital Explanation and Solution

This paper responds to two of the questions posed by the 2014 AALS Poverty Law Section’s Call for Papers: (1) “What other solutions can and should be employed [to reduce poverty]?” and (2) “What can legal scholars, lawyers, law schools, legal clinics, and law students do to reduce poverty?” The answer to the first question is to democratize “capital acquisition with the earnings of capital” based on the principles of “binary economics.” This democratization requires extending to poor and middle-class people competitive access to the same government-supported institutions of corporate finance, banking, insurance, reinsurance and favorable tax and monetary policies that are presently available primarily to people and businesses to acquire capital with the future earnings of capital substantially in proportion to their existing wealth. With this democratization, participation in capital acquisition by the vast majority of poor and middle class people would no longer be limited as a practical matter to their meager or even negative net worth. This democratization would transform the existing system of corporate finance (that presently functions primarily to concentrate capital ownership) into an ownership-broadening system of corporate finance. It would require no taxes, redistribution, borrowing, or government command. Corporations would be free to continue to meet their capital requirements as before, but they would have an additional, ownership-broadening, potentially more profitable, market means to do so. This additional means could be voluntarily employed to: 1. reduce poverty, welfare dependence, and fear of poverty by substantially enhancing the earning capacity of poor and middle class people (by supplementing their labor income and any transfer payments they may receive increasingly with capital income); 2. reduce tax rates, taxes, and the need for government expenditures; 3. enhance the earning capacity of the participating companies, their shareholders, their employees, and their customers; 4. reduce unemployment, raise wages, and enhance working conditions; 5. enhance the value of equity investments and retirement plans and reduce the risk of borrowing; 6. promote more sustainable, environmentally friendly growth, and 7. (if implemented globally) enhance the creditworthiness of national governments and their ability to raise revenue.The answer to the second question is for law legal scholars, lawyers, law students, and individuals with responsibility for the curriculum of law schools and activities of legal clinics (1) first to learn and to teach (a) the underlying principles of binary economics, (b) how this democratization with the earnings of capital, based on its understanding, can be practically implemented and (c) how this democratization is a necessary part of any systemic solution to poverty and (2) then to advocate, work for, and facilitate its implementation.

Takashi Ito, London Zoo and the Victorians, 1828–1859

At the beginning of Wilkie Collins’s Heart and Science (1883), the heroine visits the London Zoological Gardens with her fiance. But the London zoo is not only a romantic site where young middle-class people flirt. If the young maiden enjoys looking at the birds, the mad scientist of the novel, Dr Benjulia, also roams the Zoological Gardens in search of animals to experiment on. Collins’s description of the London Zoological Gardens as both symbol of urban leisure and scientific knowledge is ...

POLA ADAPTASI MASYARAKAT PESISIR GENUK KOTA SEMARANG (Patterns of Community Adaptation to Environmental Degradation in Genuk Coastal Area, Semarang)

Globalization brings many consequences for Indonesian urban development and the communities. Industrialization is one of them. Globalization also brings policy transformation affecting the community’s welfare and lifestyle. One of the indicators is that local values have started to fade. The similar condition also occurs in fishermen’s and fish farmers’ settlements in Semarang, which have transformed into industrial settlements in 1980s during the industrialization period. Land conversion occurred in a short time from ponds and rice fields into factories, warehouses, and new labor’s settlements. It did not take a long time for the community’s local values to transform into the new ones influenced by the welfare level of the new community. Based on the phenomena, this study aims to understand the lifestyle of the community and its influence in managing the housing environment with Genuk coastal area of Semarang City as a case. This research has three objectives: to understand the motivation to urbanization, to comprehend the neighborhoods’ conditions, and to comprehend the influence of community’s lifestyle towards the settlement condition. In achieving the objectives, the qualitative approach supported by some quantitative data is used. The results show that there are three classes of the community influencing the environmental management. It is found that the people’s migration reasons had a big influence for the environmental management. In this case, the middle-class community is a key stakeholder to overcome the environmental problems. It becomes good initiator. On the contrary, the lower class has a less role in dealing with the environmental problems. It has even a big contribution on environmental degradation. Meanwhile, the upper class pays less attention to the environment. Only a little part of it, especially the local one, is willing to take part in the environmental management. The middle-class people consider that the problems arise due to the inappropriate planning. Unfortunately, they are not capable of dealing with the problems. On the contrary, the upper-class people consider that the issues arise from the lower class behavior that does not pay attention to the environment. As a consequence, the upper-class community is not willing to address the problems.

Segregation and Integration: Changes in the Social Diversity of Toronto’s Upper Class Suburbs, 1870s-1920s

At the beginning of its development, suburban housing in and around Toronto was viewed as a solution to the poor living standards found in Toronto’s slums, thereby attracting primarily middle and upper class families. 1 It is important to note that many early suburbs were also appealing for marginalized groups of immigrants and the working class. 2 However, the current essay will primarily explore the construction and development of upper class-dominated regions, and use the term “suburb” in reference to prestigious districts located near or in the city, such as Forest Hill, the Annex, and Parkdale, which primarily comprised of middle and upper class housing in the late 1800s. 3 By the turn of the century, these suburban neighbourhoods were undergoing significant changes associated with urban development. While some suburbs, such as Parkdale and the Annex, were modeled with the intent of housing wealthy and middle-class people, a movement of blue-collar workers and non-British immigrants to the “morally distinct” neighbourhoods of the city began in the 1890s and continued throughout the 1900s. 4 The relocation was influenced by the expansion of industries in Toronto, the housing boom that took place between 1906 and 1913, and the growing affordability of land located outside of the city’s core. This essay will argue that industrial development and housing expansion influenced the construction of class relations in Toronto’s suburbs, specifically by creating social divisions based on residents’ inner city or industry-based employment, their segregated geographical

Customer Satisfaction at Public Hospitals in Pakistan: PAKSERV Application

Research studies investigating service quality in organizations have popularized various tools. However, the usefulness of these tools in cross-cultural settings has been challenged and needs further investigation. The purpose of this study is to examine the efficacy of PAKSERV in deciphering the service quality of public sector hospitals in the Asian context of Pakistan. The study used a survey method where data was collected through a questionnaire which employed the PAKSERV dimensions of tangibility, reliability, assurance, sincerity, personalization and formality. Data was collected from 500 respondents visiting different public sector hospitals in the province of Punjab, Pakistan. The collected responses were analyzed using means, correlations and confirmatory factor analysis to interrogate the PAKSERV model’s reliability and confirmation in an entirely new context. Findings suggest some clear gaps in the quality of public hospitals in Pakistan, specifically in the ‘formality’ and ‘tangibility’ dimensions. However, all PAKSERV dimensions generated excellent results except for the ‘Formality’ dimension, which indicates a need for theoretical adjustments while investigating further the service quality of public sector health care. This research is an original contribution to the body of knowledge as PAKSERV has been used for the first time to measure service quality of public sector hospitals in Asian settings. The formality dimension is not valid in case of measuring service quality of public sector hospitals. It indicates a clear need to further investigate PAKSERV service quality with public sector organizations. The study uncovers certain areas that were not previously discussed through SERVQUAL service quality measures of public sector hospitals in an Asian setting. The findings of this study will be beneficial for health care quality assurance officials, aspiring to improve the current stature of public sector health care in countries like Pakistan. The research is limited to public health care in Pakistan as the sample consisted of middle-class people, visiting various public sector hospitals.

Revisiting ‘social tectonics’: The middle classes and social mix in gentrifying neighbourhoods

Studies of gentrification in London have shown that some groups of middle-class people have been attracted to poor and multi-ethnic areas of inner London in part because of their social and ethnic mix. However, the attraction has often not translated into everyday interaction. In an earlier account of gentrification in Brixton this de facto social segregation was typified as a process of ‘social tectonics’. In this paper we compare two ethnically and socially mixed neighbourhoods, Peckham and Brixton, that at different times have represented the ‘front line’ of gentrification in London. We examine the extent to which the gentrification of Brixton in the late 1990s is being mirrored by the gentrification that is occurring today in Peckham – a similarly mixed and counter-cultural area of South London. Whilst we identify continuities between the gentrification process in these two areas separated by a decade of boom and recession, we suggest that the Peckham example demonstrates the need for a more developed approach to the issue of social mixing than that implied by the social tectonics metaphor. Specifically, we argue that there is a need to explain how the presence of classed and ethnic ‘others’ can be central to the formation of identities within some middle-class fractions in such enclaves in the inner city, and how attitudes and neighbourhood practices can change over time.

Neighbourhood Belonging, Social Class and Social Media—Providing Ladders to the Cloud

The growth of social media over the past decade has transformed how we have interacted with the World Wide Web. This paper presents data from a research project coproduced with community organisations that had created an online archive through a Facebook site of a deprived neighbourhood in Edinburgh, Scotland. Framing the data from this site in the literature on class, place, stigma and belonging, the paper presents further evidence of the ‘we-being’ of working-class residence as opposed to the elective belonging of middle class people, and the stigma towards working-class neighbourhoods from wider society. The paper concludes by highlighting the benefits of social media in producing a natural discussion about neighbourhoods and residence and the importance of creating ladders to the cloud for working-class neighbourhoods.

조선 시대 수학과 수학자에 대한 역사 드라마

최근 한국에서는 많은 유형의 드라마들이 방송되고 있다. 특히, 역사적 배경이나 인물에 대한 역사 드라마는 높은 시청률을 보이고 있을 뿐만 아니라 한국 사회의 많은 부분에서 강한 영향력을 미치고 있다. 게다가 <대장금>과 같은 역사 드라마는 많은 아시아 국가에서 한국 문화 열풍을 불러일으켰다. 최근에는 역사드라마의 주제나 주인공이 매우 다양해지고 있다. 예를 들면, <대장금>은 궁중 요리사, <추노>는 노비와 노비추적자, <바람의 화원>은 조선 시대 유명한 화가, <마의>는 수의사에 대한 이야기이다. 이런 점에서 정부가 정한 "수학의 해"를 맞이하여 조선 시대 수학과 수학자에 대한 역사드라마를 통해 수학의 중요성을 알리는 것은 매우 의미 있는 일이다. 본 논문에서는 조선 시대의 수학과 수학자를 주제로 한 역사드라마의 제작 이유를 두 가지로 제시하였다. 첫째, 현대수학은 매우 추상화되었으며 그 결과 일부 영역을 제외하면 학생이나 일반인이 이해하기 쉽지 않다는 점이다. 둘째, 수학교육의 대중화의 측면에서 실생활과 관련된 내용을 활용하여 보다 쉽고 다양한 접근이 가능하다는 점이다. 또한, 조선시대 수학과 수학자에 대한 역사 드라마를 제작하기 위한 주인공과 소재로 홍정하의 일화, 세종시대의 수학 연구, 홍길주의 수학 연구, 남병길과 이상혁의 공동연구, 이승훈의 수학 연구와 중인 수학자들의 수학 연구에 대한 역사적 사실들을 제시하였다. Recently, various types of dramas have been broadcasted in Korea. Especially, historical dramas having backgrounds about historical events or characters have been recorded high ratings of the viewing audience, as well as a lot of influence on many parts of Korean society. Besides, the historical drama like <Daejanggeum> raised a craze for popular Korean cultures in many Asian countries. The subjects and characters of historical drama are diversifying in recent years. For example, <Daejanggeum> is a royal cook, <Chaser of slaves> is a story about running away slaves and their chaser, <Painter of Wind> is a story about a very well-known painter of the Joseon Dynasty era, and <Mayui> is a veterinarian. At this point, in celebration of the officially appointed "year of mathematics", it is very meaningful to demonstrate the importance of mathematics with a historical drama about mathematics and mathematicians of the Joseon Dynasty. In this article, the reasons for production of historical dramas about mathematics and mathematicians in the Joseon Dynasty was presented in two ways. First, modern mathematics has high level of abstractness as its nature, and therefore many students and the public can not understand what except for some areas. Second, it is possible the easier and various approaches can be used to deal with contents about real-life in the view of popularization of mathematics. Also, this article would aim to explore the main character and episodes about mathematics and mathematicians in Joseon Dynasty. For example, the anecdote of Hong Jung Ha, the works of mathematics in the King Sejong's periods, the study of Hong Gil Ju, the joint researches between Nam Byung Gil and Lee Sang Hyuk, the story of Lee Seung Hun, and the mathematics study of middle class people.

Neonatal Surgery: Demand and Survival Both are Increasing: Eight Years Experience in Dhaka Medical College Hospital, Bangladesh

Purpose: In order to achieve the Millennium Development Goal (MDG) 4 target of a two-thirds reduction in under-five mortality from 1990 to 2015, major reductions are going to be required in neonatal mortality. Congenital anomalies have become the fourth cause of neonatal deaths and most of these are curable. Dhaka Medical College Hospital is the largest public hospital of the country and serving the poor and lower middle class people where surgery and medical facilities are mostly free of cost. This study was done to see the types of neonatal surgical patients admitted in this hospital and their management out come with limited facilities and find out the ways to improve the scenario to contribute in achieving the MDG.Materials &amp; Methods: This was a retrospective study done over a period of 8 years from July 2001 to June 2009 and carried out in the Department of Pediatric Surgery, Dhaka Medical College Hospital, Dhaka. A total of 650 neonates were admitted during this period and it was the 17.99% of total number of 3612 pediatric surgical admission upto12 years of age. Data was collected from hospital records and analyzed retrospectively.Results: Out of these 650 neonates 533(80%) were admitted for Neonatal Intestinal Obstruction (NIO) and omphalocele were 59 (9.07%), ectopia vesicae are 14 (2.15% ), posterior urethral valves (PUV) were 19 (2.92%), gastroschisis were 7 (1.07%) , congenital diaphragmatic hernia (CDH) were 16 (2.46%),Tracheo-oesophageal fistula 1 (0.15%), and Conjoint twin 1 (0.15%). The most common cause of NIO was anorectal malformation (ARM) and 194 (66.43%) patients have high variety and 98(33.56%) patients have low variety ARM. Next was Hirschsprung disease and 137 (21.07%) neonates presented with this. Thirty-Five (5.38%) patients presented with septicemia and 40 (6.15%) presented with intestinal atresia, 20 (3.07%) neonates had meconium ileus and 9 (1.38%) patients presented with volvulus neonatorum. Five hundred and Fifty-nine patients (86.00%) were managed surgically. Out of 650 patients, 69 died, so mortality was 10.61% and before surgery 2.76% and after surgery was 7.84%.Conclusion: Pediatric surgeons by their skill and teamwork greatly improved the neonatal surgical service and contributing significantly in reducing infant mortality rate and to achieve MDG 4. But to improve further, neonatal intensive care unit (NICU) and other support systems are essential as well as support from UNICEF and World Health Organization (WHO) to include pediatric surgery and surgeons in their activities especially in developing countries. Due to socio-political and economic reasons of the developing countries the roll of pediatric surgeons are multidimensional.DOI: http://dx.doi.org/10.3329/jpsb.v1i1.19463

Empty Housing in America, Housing Needs, Shadow Banks and the Sharing Economy

The credit crisis has revealed economic inequalities across the world, yet it has emphasized transitions in the way middle class and working class people have handled wealth and consumption. This has mostly been focused in the press on changes in home ownership but has had dramatic effects in how and where people live as well as in their use of automobiles and their living spaces. This paper examines some of these changes in a general context of the degradation of the quality of life of Americans.

THE PREVALENCE OF MILD COGNITIVE IMPAIRMENT IN A NORTH INDIAN ELDERLY POPULATION: CORRELATION WITH DIABETES MELLITUS AND SOCIO-ECONOMIC STATUS

Improvements in health care have extended the average life expectancy which has lead to the increase in the number of individuals over 60yrs of age. Mild Cognitive Impairment (MCI) is hence emerging as a major health problem as the people with MCI are three to four times more likely to develop Alzheimer's disease (6% to 25% annually). Various studies have shown that the prevalence of MCI lies between 0.5% and 36% depending upon the diagnostic criteria used and nature of the study population. The study was conducted in the municipal area of Bikaner, Rajasthan. Individuals to be interviewed were selected by systematic random sampling method. Mini Mental Score Examination (MMSE) score was applied to screen for dementia and persons with score 20 or less were excluded. Clinical Dementia Rating (CDR) score was used to confirm and stage the cognitive status. Kolkata cognitive test battery was also applied to detect the. Overall prevalence of MCI was accountable i.e.19.26%. Prevalence of amnestic MCI (aMCI) was 7.78% and that of multiple domain MCI was 11.48%. Prevalence of both forms of MCI was more among diabetics as compared in non diabetics with statistically significant difference (p<0.01). Prevalence of both types of MCI was high in people of lower socio-economic class in comparison with higher class people (p<0.01). There was no difference in their prevalence in middle and upper class people. Diabetes and lower socio-economic status were associated with higher prevalence of MCI in elderly. These observations are particularly important in developing countries like India which is also considered as the diabetic capital of the world and hence prevalence of MCI is expected to rise in near future.