Middle Income Category Research Articles

Development of a protocol for using geo-trackers to identify zoonotic enteric pathogen transmission pathways in a pilot study in Kenya

Abstract Humans and animals can be exposed to fecally-transmitted pathogens in both private and public domain environments. Animals may also acquire pathogen infections from these two environments and transmit them to humans through different pathways. Evidence on how often and where interactions occur between the two environments could improve the effectiveness of public health programs for preventing zoonotic disease transmission and response to disease outbreaks. This study aimed to develop a protocol for using geo-trackers to measure the spatial-temporal movement and interaction between animals and children in households and public areas in low- and middle-income categories of urban neighbourhoods in Kenya. It also aimed to identify opportunities and challenges for the scale-up of these methods’ for surveillance of other zoonotic diseases of public health significance. One commercial geo-tracker device with the best technological performance and usability that met pre-defined criteria for the study context was identified. Community engagement meetings were then conducted to gather input on a proposed study protocol. Afterwards, infants and animals were geo-tracked in 10 households in urban informal settlements of Kibera and Jericho, Nairobi over two consecutive weeks with iterative improvements to protocols. The effectiveness of the geo-tracking exercise was evaluated through in-depth interviews with Community Health Volunteers (CHVs) and infant caregivers. Animal and infant behaviour and battery reliability of the geo-trackers were also monitored; and observed opportunities and challenges in implementing the protocol during the exercise were documented. Community members were receptive and accepted the use of geo-trackers on animals and children. In pilot testing, there was no change of behaviour from 10 infants tracked. Discomfort was observed for up to 30 min after the placement for some of the seven animals tracked, but the animals quickly adjusted. The battery for all geo-tracker devices lasted for the 24-h geo-tracking period. Some caregivers and CHVs were concerned whether the geo-trackers could record personal information. It was shown that geo-tracker devices can be successfully deployed to study animal-child interactions and movement in different categories of urban neighbourhoods. Recommendations have been made on the lessons learnt from the study to help scientists who would use geo-trackers for future community-based human and animal research. One Health impact statement Assessing human and animal risks of acquiring enteric infections from environmental contamination, or contributing to pathogen contamination of the environment requires understanding spatial-temporal patterns of human and animal movement between private households and the community. Movement of domestic animals is relevant for understanding household-community spatial patterns of pathogen transmission because animal ownership and contact with humans is common, and free-roaming animals carrying enteric pathogens can spread diverse faecal pathogens between environments. The community-based participatory research approach of this study evaluated implementation feasibility from the lens of technical usability and reliability of geo-tracking devices, as well as social acceptability and ethics related to using such devices for the community-based study of human and animal subjects in urban settings. Evidence and recommendations from this study will be useful to anyone interested in understanding human-animal-environment interactions and their contributions to infectious disease transmission.

EVALUATING THE EFFICIENCY OF COUNTRIES' DIGITALIZATION IN TERMS OF FINANCIAL INCLUSION BY USING DEA

The aim of the study is to evaluate the efficiency of countries in digitalization in terms of financial inclusion, in other words, their success in digitalization. Within the scope of the study, 117 countries were grouped as high, upper-middle, lower middle and low income and subjected to Data Envelopment Analysis. In the study conducted for the year 2021, four input variables related to the utilization and access of digital financial services were identified, along with ten corresponding output variables. Efficient countries were determined in the study based on the constant and variable return scale model for output. Digital efficiency has been identified in financial inclusion was detected in 25 countries based on variable returns and 18 countries based on constant returns in high-income countries. In upper-middle-income countries, digital efficiency in financial inclusion was identified in 12 countries based on variable returns and 9 countries based on constant returns. 16 countries in the lower middle and low income categories demonstrated digital efficiency in financial inclusion using variable returns, while 9 countries detected digital efficiency using constant returns. In the study, the comprehensive analysis of the success of digitalization in financial inclusion at the level of countries divided into income groups by using data envelopment analysis reveals the originality of the study.

Categorizing land: an account of leftover land in Patna

This paper is an account of Bihar State Housing Board (BSHB) and its role in allocating housing and land from the 1970s onwards in Patna. The housing board typifies the bureaucratic practices of property-making at its best and demonstrates how the bureaucracy strategically aligned itself with caste-driven state politics. The unstable nature of forward–backward caste-based partisan politics meant politicians made unceasing efforts to garner support to stay in power including that of the bureaucrats who had far more control and knowledge about administration rules. By creating the discretionary category of chit-put land, loosely translated as leftover or not useful for anyone, an elaborate rationale was created for land allocation. This flexibility was used for carving out new land parcels for the high-income and middle-income category in Patna. The board dexterously encroached on the land allocated for the urban poor in whose name the land acquisition was undertaken at the outset. Using minutes of the meetings of BSHB, the paper also argues for alternative approaches for drafting and mapping the spatial history of a non-metropolitan city without a master plan and maps.

Does foreign direct investment influence carbon emission-related environmental problems?Contextual evidence from developing countriesacross Sub-Saharan Africa.

Sub-Saharan African nations face multifacetedenvironmental problems, especially those associated with carbon discharges. Hence, this study calculates a composite carbon index in the context of 39 developing nations from this region and uses it as a proxy for the carbon emission-related environmental problems they have faced during the 2000-2020 period. This index is estimated by utilizing data regarding annual carbon dioxide discharges, output-based carbon productivityrates, and energy consumption-based carbon intensity levels in the concerned countries. Hence, policy takeaways from this study have critical relevance for the selected sub-Saharan African nations to help them achieve the objectives related to the Sustainable Development Goals agenda and the Paris Accord. Overall, the findings from the econometric analysesverify that morereceipt of foreign direct investment initially raises but later on reduces environmental problems. Thus, the nexus concerning these variables depicts an inverse U-shape. Besides, the results endorse that greening the energy consumption structures of the sampled sub-Saharan African countries helps to abate their environmental problems in the long runwhile financial development aggravates the extent of environmental adversitiesthat take place. Lastly, improving the quality of regulatory agencies enables the Sub-Saharan African nations to furthermitigate their environmental problems. Moreover, these aforementionedfindings are observed to be heterogeneous across low- and middle-income categories of the selected Sub-Saharan African countries. Furthermore, the heterogeneity of the findings is also confirmed by the outcomes derived from the country-specific analyses. Nevertheless, these nations should attract clean energy-embodying foreign direct investment, make their energy consumption structures greener by amplifying renewable energy adoptionrates, introduce green fundsto develop their financial sectors, and make theirenvironmental regulatory agencies more transparent with their activities.

Perceptions of Indigenous Kiboga Men on Use of LARCs by Their Partners

Worldwide, unintended pregnancies pose a significant public health concern, affecting several women in countries that are in low and middle-income categories, with an estimated annual incidence of 74 million. The African continent is responsible for around 25% of unwanted pregnancies worldwide. Unintended pregnancies may result in many health-related issues for both mothers and children including deaths. Family planning methods, especially long-acting reversible contraceptives, are some of the effective approaches in mitigating maternal mortality, especially those resulting from the effects of unplanned pregnancies. The LARCs assist women in postponing pregnancy and enable them to have extended intervals between childbirths even though their uptake in Uganda, is hindered by the lack of men’s support. This study aims at gaining insight into the perceptions of indigenous Ugandan men living in Kiboga district in NorthCentral Uganda on the utilisation of LARCs by their wives. The researchers used purposive sampling to choose a total of 20 participants for focus group interviews and 10 participants for individual interviews. The selected participants were married men or those with female sexual partners between the ages of 20 and 49 years. Semi-structured interview guides were used for both individual and focus group interviews. Data analysis was performed by transcribing the interviews, sorting the field texts, organising, and storing the data, listening to recordings, and scanning field notes for patterns related to the perceptions. The patterns were coded and categorised to build the theme emerging on the phenomenon. The study revealed that indigenous men had negative perceptions that limited their support for LARC use by their wives. These included perceived side effects, fears like malformed babies, adultery, and single mothers. The study recommended strong social behavioural change communication to educate the men on LARCs to address the negative perceptions and to strengthening service delivery for LARCs.

Self-Regulated Learning of Nursing Students: A Cross-Sectional Study

The nursing degree programme requires the students to be resilient due to the high learning burden of theoretical courses and clinical attachment requirements. The ability of the students to self-regulate their learning has been postulated for success. In this study, we aim to investigate the self-regulated learning level of nursing students at one public institution and identify the self-regulation aspects that warrant a remediation plan to be developed. A cross-sectional survey was conducted online. Active status students in one public institution’s Bachelor of Nursing programme were invited to participate in this study. The invitation was distributed online via social media and email, where they are required to self-administer the Motivated Strategies for Learning Questionnaire (MSLQ) through Google Forms. Thereafter, responses from 63 students with a response rate of 64.3% were received. Most respondents are female (76.2%), Malay (74.6%), in year 4 of their bachelor’s study (33.3%), and in the lower household income category (69.8%). Most self-regulation aspects of the students have been found to be at a satisfactory level except for specific learning strategies. Participants’ characteristics such as gender, ethnicity, study cohort, and academic achievement were determined to have a significant association with a small aspect of self-regulation. Interestingly, household income is the primary factor significantly associated with almost all self-regulation aspects. Being in the lower-income category was predominantly associated with higher motivation domains. In contrast, being in the middle-income category was predominantly associated with better learning strategies and resources. Comparatively, this study indicates that nursing students achieved the highest level in 8 of 15 self-regulation aspects than other learner populations in Malaysia. Learning strategies which exercise higher autonomy and resource management are warranted. This recommended various approaches which foster active and collaborative learning to be implemented for the students to improve their self-regulation skills. Students, especially from the highest income bracket, are the most critical and thus require attention from educators.

The psychological burden of the COVID-19 Pandemic on Arab citizens in Saudi Arabia, Sudan and Jordan

The study aimed to reveal the psychological burden in the light of Corona virus pandemic. To achieve study objectives, a scale was prepared to reveal the mental disorders. The study sample consisted of (532) individuals. The results showed that the most prevalent disorder is panic disorder with (25%), the least of which is adjustment disorder with (15%). Moreover, the results indicated that there are no differences in all mental disorders due to the gender variable, except for adjustment disorder, in favor of males. Also, the age group (15-19) years is the most affected by panic disorder, general anxiety and adjustment, the Saudi nationals were the most affected by panic disorder, severe depression and obsessive-compulsive disorder, and there were no differences in generalized anxiety disorder and adjustment due to the nationality and residence variables. In addition, the population of Saudi Arabia is the most affected by panic disorder. The results showed that individuals with chronic diseases are the most affected by all mental disorders, there are differences in panic disorder due to the economic status variable, in favor of the low-income category, and there are differences in the rest of the studied disorders, in favor of the middle-income category.

Parking Charges: Ingeniously Effective and Publicly Accepted in Riyadh?

The background of this study is relevant to parking facilities at shopping malls in the Kingdom of Saudi Arabia (KSA), where all parking services are mostly free, with very few exceptions. Demand on parking places at shopping malls and recreational areas in Saudi cities are generally very high. This is partly because most of the entertaining, shopping, and recreational areas are indoors and are typically located at shopping malls with huge parking provision. With the vast increase in car ownership and use in the country over the past few decades, a consequent increase in demand on roads and parking facilities has been observed, which has no doubt resulted in further congestion. This study aims to investigate the willingness to pay to save time searching for a parking place at shopping malls in Riyadh city in the KSA. The methodology includes interviewing shoppers in shopping mall car parks and asking about their search time for a parking space and their willingness to pay to save search time, as well as to report on their socio-economic characteristics including age, gender, employment, education, car ownership, and income. The outcome of this study shows that on average, shoppers spend about 9 min searching for a parking place for their shopping and recreational trips. The results also show that, on average, shoppers reported that they go shopping, eating out, etc., about three times per week, and the average willingness to pay to save time searching for parking space is about 10 Saudi Riyal (about 2.7 USD) per visit. The modelling results show that there is a higher willingness to pay from the middle income and car-ownership categories of the population than from the highest income and car ownership groups. This might reflect the fact that the middle-income groups are much more dependent on themselves to drive their cars and search for a parking space every time, while those of higher incomes could possibly rely on their private drivers most of the times to drive them and park their cars. This paper contributes to the literature by providing a first understanding on how demand for parking facilities is affected by various socio-economic factors and the willingness to pay to save search time at these parking locations. The implications of the outcome of this research will be of use for decision makers and city authorities in planning travel demand management policies and programs that aim at reducing demand on private cars and achieving sustainability.

Do indigenous or foreign innovation efforts matter for the middle-income economies transition to the higher-income rank? An empirical evidence

ABSTRACT This study analyzes whether indigenous or foreign innovation efforts are more important for the transition of middle-income economies to the higher-income rank. Data on 61 countries in both lower middle-income and upper middle-income categories between 1980 and 2018 are used. Discrete-time hazard models are employed. The unobserved heterogeneity is controlled in the estimations to improve the continuous-time hazard model applied in existing studies on innovation at the national level. Results show that foreign sources of innovation measured by nonresident patents and international R&D spillovers through the FDI channel are more important for the lower middle-income group to move up the income ladder. For the upper middle-income group, domestic source of innovation measured by R&D capital stock is the most important, followed by foreign innovation diffused through the import channel. Institutional quality supports the upper middle-income economies to obtain the high-income rank.

Assessing the Outreach of Targeted Development Programmes—A Case Study from a South Indian Village

This paper explores beneficiary targeting of government programmes in a village in India. The analysis is based on all 228 households of the village and focus group discussions. The results show that there is a large exclusion error in targeted programmes, which have mostly excluded the poor and the needy. Most schemes have a prerequisite of asset ownership, such as agricultural land, which benefits resource-rich farmers with large landholdings. The relationship between benefits received and income of households is best represented by an inverted ‘u’-shape curve, indicating the middle-income category benefits more than the poorest. The scope and scale of welfare programmes, especially Direct Benefit Transfers, increased during the COVID-19 pandemic. For inclusion of the poorest of the poor, welfare and development schemes need to be decoupled from landownership in rural areas.

Knowledge and Attitudes toward Autism Spectrum Disorder in Saudi Arabia.

Aims: The diagnosis of autism spectrum disorder (ASD) is not easy as there is no direct test that exists to establish such a diagnosis. Increasing community and healthcare professional knowledge of the ASD spectrum is crucial because it will encourage parents of ASD children to seek screening and diagnosis from a specialist, allowing for better early detection and treatment. This study explored the knowledge of the general population in Saudi Arabia regarding ASD and assessed variables associated with an accurate understanding of ASD. Methods: A total of 769 participants were involved in this cross-sectional study, which was conducted in Saudi Arabia between November 2021 and February 2022 using an online survey tool to explore the knowledge of the general population in Saudi Arabia regarding typical child development and ASD. A binary logistic regression analysis was used to determine factors affecting participants’ knowledge of autism. Results: Overall, the study participants showed a weak level of knowledge about autism with a mean score of 5.9 (SD: 3.1), comprising 34.7% of the total maximum obtainable score. Participants with a middle income category of 5000–7500 SR are less likely to be knowledgeable about autism compared to others (OR: 0.60 (95% CI: 0.39–0.92)) (p-value = 0.020). Conclusion: The participants in our study showed limited knowledge about autism. Government funds should be made available to facilitate educational services for ASD children. More funding and resources should be allocated by the government to provide assistance for children with special needs, and changes in public facilities are required to meet the demands of ASD patients. Through an informed educational effort, various media platforms should assist in improving the community’s understanding of ASD and their attitude toward ASD patients. Educational campaigns should focus on enhancing the public’s knowledge about ASD treatment and etiology.

Training of psychiatry and mental health in a low- and middle-income country: Experience from Thailand before and after COVID-19 outbreak.

Since the start of COVID-19 pandemic in March 2020, training of psychiatry and mental health has been impacted considerably. We illustrated the change of academic and clinical psychiatric residency training procedure at Chulalongkorn University in Bangkok, Thailand, a developing country situated in South East Asia which is categorized in the low and middle income category of countries. The training setting has set up a task force responsible to set various strategies in response to the COVID-19 measure of social and physical distancing to maintain standard of care for psychiatric patients and educational experience for psychiatric residents. The strategies include online education, service team separation, and avoidance of contact between teams, reduction of non-urgent clinical activities, and the use of telemedicine for psychiatric patients. Despite exposure to the difficulties of training during the pandemic, all senior residents were qualified and licensed at the national examination. Residents reported that pandemic did affect the academic activities and services and also the quality of living and satisfaction. Academic issues, including the inconvenience of studying online, were the most concerned problems among psychiatric residents at the time of pandemic.

The Role of FDI on Structural Transformation among Sub-Saharan African and EAP Countries Using a Panel Data Approach

In recent decades the activities of multinational corporations have increased across the globe substantially having a massive flows of foreign direct investment. This paper empirically examines the role of FDI on structural transformation among Sub-Saharan African and EAP Countries Using a Panel Data Approach. To achieve the objective the study took 31 years panel data . The study used descriptive analysis and empirical methods of analysis. The panel Autoregressive Distributed Lag model with error correction models of Pooled Mean Group technique were employed after checking the possible assumptions of our economic series. The results of Im-Pesaran-Shin test confirms our economic series are stationary at level and first difference forms. Pedroni’s cointegration tests suggests the existence of co-integration between the variables. According to the descriptive analysis, on average structural transformation index (STI) is the highest for China (30.52%) followed by South Korea (25.86), while Ethiopia (4.85) is having the lowest. On other hand, the East Asian and Pacific (EAP) countries in the higher income category are performing better than Sub-Saharan African countries. In addition,Sub-Saharan Africa countries are by far having low level of FDI inflows as compared to EAP countries. Particularly, the FDI inflows for EAP countries in the higher income category is around USD 52 Billion, and while for low and middle income category SSA countries it accounts around USD 2.2 Billion and USD 85 million, respectively. More specifically, across countries in the panel the FDI inflow is the highest for China while on average Kenya is having the lowest FDI inflows. On the other hand, according to the ARDL model of Pooled Mean Group estimation technique in the long-run financial development indicator and FDI have positive impact on the structural transformation index of nations at 1percent level of significance for the full sample in the panel. Moreover, pooled mean group regression result among the Sub-Saharan African and EAP countries FDI has a significant but having different sign for the two group in predicting structural transformation. Particularly, for EAP countries FDI has a negative effect in the long run and a positive effect in the short-run on structural transformation index which are also statistically significant. While for Sub-Saharan African countries FDI has a positive and statistically significant effect on structural transformation both in the long run and short-run. Finally, the government of developing countries like SSAs should provide different incentive packages to attract FDI inflows, among others.

Understanding Perceptions of Health Risk and Behavioral Responses to Air Pollution in the State of Utah (USA)

Poor air quality in Utah creates an array of economic, environmental, and health-related impacts that merit investigation and informed political responses. Air pollution is known to cause a variety of health problems, ranging from increased rates of asthma to cardiovascular and lung disease. Our research investigates the extent of Utahn’s understanding of the health risks associated with long-term and short-term impacts of air quality. To assess the degree to which Utahn’s perceive the health risks of air pollution, we performed an ordinal logistic regression analysis using responses to the Utah Air Quality Risk and Behavioral Action Survey, a representative panel survey administered between November 2018 and January 2020 (n = 1160), to determine how socioeconomic status impacts risk perception. Socioeconomic status is not a predictor of perceiving air’s short-term risks to health. Those with more conservative political orientation, as well as those with higher religiosity scores, were less likely than those with more liberal political orientation or those with lower religiosity scores to strongly agree that air pollution poses short-term health risks. We find that for short-term health risks from air pollution, Utahns in the middle-income category are more likely than those in the low-income category to strongly agree that air pollution poses long-term health risks. In addition, those with more conservative political orientation were less likely than those with more liberal political orientation to strongly agree that air pollution poses long-term health risks.

Costs of patient management over 18 months following a hip, clinical vertebral, distal forearm, or proximal humerus fragility fracture in France—results from the ICUROS study

This prospective observational study assessed the costs related to patient management over the 18-month period following the event of a hip, clinical vertebral, humeral, or distal forearm fracture in France. Individuals aged ≥ 50years old with the diagnosis of a fragility fracture in six French University Hospitals were enrolled in the International Costs and Utilities Related to Osteoporotic Fractures Study (ICUROS). All resources used over the defined period and related to fracture and the underlying osteoporosis management were collected by questionnaires at baseline, 4months, 12months, and 18months. Information was collected by direct or phone contact completed by patients' records and interviews of partner, family, and general practitioners. Costs were estimated from a societal perspective, including direct and indirect costs. We implemented recursive partitioning analysis (RPA), a statistical learning algorithm to identify predictors of costs. Four hundred thirty-one patients (mean age 72.5years; 84.6% women) were evaluated. Among them, 17.6% had a prior fracture in the last 5years. Approximately half of the whole group lived alone in the community, and 56.8% were from a low- or middle-income category. Over the 18-month period of evaluation, total costs (including initial fracture-related and follow-up ones) were 23 926 €, 14561 €, and 6 905 € for the hip, clinical vertebral, and distal forearm fracture, respectively. Over a year, costs related to a humeral fracture were 10 319 €. The RPA identified mobility impairment prior to fracture as a predictor of increase in costs related to fracture. Our study for the first time prospectively assessed total costs related to the four main osteoporotic fractures in France. It appears that their levels were much higher than previous estimates, raising the burden of osteoporosis-related fractures on public health expenditures.

Feelings, Behavioral Actions and Depressive Symptoms Related to COVID-19 among Undergraduates in Hail, Saudi Arabia.

The severe acute respiratory syndrome coronavirus 2 (COVID-19) outbreak has had a profound psychological impact on university undergraduates. Feelings, behavioral actions, and depressive symptoms related to COVID-19 in undergraduates in Hail, Saudi Arabia, were assessed using an online survey. Eighteen feelings and six behavioral acts were assessed. The Center for Epidemiological Studies Depression Scale was used to measure depressive symptomatology. Descriptive statistics and logistic regression techniques were used. The mean age of the participants (n = 418) was 20.2 years (standard deviation (SD) = 1.8 years), and 52.9% (n = 221) were males. Elevated levels of depressive symptoms were reported by 47.1% of male and 51.3% of female participants. Social isolation, loss of interest, obsessive monitoring of symptoms, concentration difficulties, recurrent negative thoughts, and worries about health services emerged as vital negative feelings related to COVID-19 that were expressed by the participants. Younger age (odds ratio (OR) = 0.636, 95% confidence interval (95% CI) = 0.428–0.946) and coming from the middle-income category (OR = 0.388, 95% CI = 0.151–0.994) were found to be protective factors against developing depressive symptoms. Frequent cleaning of hands, wearing masks when going out, and adherence to social distancing rules were practiced by 71.5% (95% CI = 67.2–75.8%), 78.7% (95% CI = (74.4–82.5%) and 66.0% (95% CI = (61.3–70.5%) of the participants, respectively. These behavioral acts were not associated with the development of depressive symptoms. Although the practice of COVID-19 precautionary measures by the participants was satisfactory, nearly half of the participants reported depressive symptoms. Innovative educational strategies are needed to curb concentration difficulties and social isolation experienced by undergraduates during outbreaks such as COVID-19.

Barriers to Premarital Thalassemia Screening in Asia

Thalassemia is a genetic disorder of hemoglobin synthesis. Every year 70,000 infants are born with beta thalassemia globally. Its incidence can be reduced by premarital thalassemia screening This review aims to focus on barriers to premarital thalassemia screening and to observe the current thalassemia practices in Asian countries. This study was conducted on six countries of Asia based on economic status according to World Bank criteria. High income states included Kingdom of Saudi Arabia, and Oman, Iran constituted an upper middle-income country and in lower middle-income category Sri Lanka, Pakistan and Bangladesh were considered. Search engines like PubMed, Research Gate and Google scholar were used to look for relevant articles from 2005 to 2019. A total of (89) articles were reviewed and (61) articles were finally selected to be included in this review. In Saudi Arabia, major obstacles for premarital thalassemia screening included planned weddings (43%), fear of social disgrace (21%), pressure from family (17%), and religious factors (14%). While in Oman, 4% of the people feared positive results and also considered it as an insult. Amongst the Iranian population, financial burden on couples, disease phobia, fear of positive results, difficulty in accessibility, tribal variances and sociodemographic factors were frequent hindrances to a screening program. Religious factors, financial constraint and lack of awareness cause reluctance in Pakistan and Bangladesh. Moreover, in Sri Lanka, factors like cancellation of marriage and sociocultural norms were identified as negative outcomes of the screening. In conclusion, a negative attitude and reluctant response to premarital thalassemia screening was observed in people belonging to all the countries included. Major contributing factors were religious misconceptions, social stigma, varying ethnicities, low financial status and poor accessibility to screening programs. Key words: Beta thalassemia, thalassemia screening, premarital screening, consanguineous marriage, social impact

Developing a Low-resource Approach to Trauma Patient Care - Findings from a Nigerian Trauma Registry.

Background:Trauma is a worldwide problem that results in significant morbidity and mortality in developing countries.Objective:This study looks at the demography of trauma from data abstracted from a Nigerian trauma registry and considers the peculiarities of a low-resource setting from this perspective.Methods:Trauma registry data from January 2013 to June 2014 were analyzed.Results:A total of 542 patients were included in the study. The mean age of the patients was 33.43 ± 12.79 years; the median time from injury to arrival at the hospital was 3 h (interquartile range IQR 1 – 5.1 h); three-quarters of the patients sustained their injuries on the road-tricycles were rarely involved in road traffic injuries (RTIs) (6.9% of RTIs) but were used in transporting a third of the patients whose data on means of transportation were captured. There were 15 (2.7%) deaths in the first 24 h period postinjury covered by the study – 13 (86.7%) of these patients had head-and-neck injury. About half of the assault injury (50.5%) was from persons known to the victim. The shock indices suggested that a majority of the patients were not at a high risk of mortality.Conclusion:Most of the trauma patients at our hospital were in low- to middle-income categories. The median time to arrival of injured patients was 3 h (IQR 1 – 6 h). Most injuries occurred on the road because of RTIs. The involvement of tricycles in accidents was uncommon, but they were used fairly commonly by lay responders in transporting the injured victim to hospital. A high proportion of assailants were known to the victim. The use of trauma registries provides essential data for prioritizing limited resources and can guide a contextualized approach to reducing trauma and improving trauma patient care.

The Impact of Tourism Development on Economic Growth in Sub-Saharan Africa

This study examines the dynamic impact of tourism development on economic growth in sub-Saharan Africa (SSA) using the Generalised Method of Moments and data covering the period from 2002 to 2018. The increasingly important role of tourism and the limelight the tourism sector has been enjoying of late, on the one hand, and on the other, the lack of sufficient coverage of tourism-growth nexus studies in Africa in general and in SSA in particular, motivated this study. Unlike most of the known panel data-based studies on tourism development and economic growth, this study has split the sub-Saharan African countries into low-income and middle-income categories. The results of the study show that tourism expenditure negatively affects economic growth, while tourism receipts have the opposite effect in SSA. The findings are robust to the low-income sub-sample, while only the effect of tourism expenditure is robust in the middle-income sub-sample.

COVID-19 Pandemic in Yemen

COVID-19, a global pandemic, has threatened the whole world with its devastating nature. Though, initially it has affected the developed countries, the countries in low- and middle-income category also are not spared. Yemen is a country with low-income economy and has been in an ongoing civil war. The first case of COVID-19 was reported on 10th April 2020 and there have been a total of 1619 cases along with 447 total deaths as of 21st July 2020. The preventive measures such as lockdown, social distancing, and personal hygiene are practiced, however there is still lack of adequate resources for efficient healthcare facilities. No drugs and vaccines are approved to fully rely on for the treatment of COVID-19, therefore the concept of “do not take the virus and do not give the virus” with different approaches of preventive aspects through hand-washing, social distancing, wearing masks and gloves, and making people aware in mass utilizing audio-visual media are helpful. Aids from different agencies and collaborative efforts of all the stakeholders are in need for the containment of COVID-19 cases in Yemen. By strengthening and increasing healthcare set-ups and resources, preparation of management guidelines by the government and mobilizing such resources to different parts for awareness, adequate reverse transcription-polymerase chain reaction (RT-PCR) tests, contact tracing, and safe quarantine and isolation services are essential.