Sixteen-year Period Research Articles

Nationwide trends in blood pressure control among those with and without diabetes in England over last 2 decades: Health Survey of England 2003-2019

Abstract Diabetes and hypertension are both risk factors for cardiovascular disease (CVD), and often co-exist. Over recent decades practice guidance and health policy efforts have been made to improve population wide blood pressure (BP) control, particularly amongst those with diabetes, to reduce CVD. However, the nationwide impact of these ongoing efforts is yet to be documented comprehensively in England. We used data from 11 serial nationally representative health surveys of England between 2003 and 2019 and compared BP control and presence of untreated hypertension amongst those with and without diabetes. These cross-sectional, randomly sampled surveys included 94,100 individuals cumulatively. We applied sample weights, accounting for oversampling and survey nonresponse, and transformations mitigating for survey equipment changes during this period. We used ‘period definitions’ to define those with diabetes and quantify BP control at the time of each coinciding survey, facilitating accurate comparison of trends over the sixteen-year period, while accounting for changes in understanding, variations in definitions, and shifts in medical practices. Python and STATA were used to conduct analyses and Join Point regression software was used to develop and compare trends. In England, from 2003-2019, the prevalence of hypertension amongst those with diabetes and without diabetes decreased from 74.4% to 66.5% and from 32.6% to 27.1% (7.9% vs. 5.5%), respectively. This corresponded to reductions in population-wide mean systolic (S) and diastolic (D) BPs: compared to those without diabetes, those with diabetes had greater reduction in both SBP (7.9mmHg vs. 4.8mmHg) and DBP (2.7mmHg vs. 1.9mmHg) (Figure1). Both groups showed similar temporal improvement in BP-control amongst those with diagnosed hypertension, with those with diabetes showing better improvement in BP control compared to those without diabetes (14% vs. 12%). There was a significant difference in proportions of those with undiagnosed (unaware) hypertension amongst those with and without diabetes (11.4% vs. 30.0% respectively) (Figure2). Notably, there was no change in proportion of those with hypertension unaware about the condition (i.e. detection rate for hypertension in either of the group did not show any improvement over time). These results suggest that we have been able to improve BP control over this period amongst those with and without diabetes, however, those without diabetes (more than 90% of population) have shown significantly poorer improvement. In addition, around one third of hypertensive patients amongst the no-diabetes group are unaware of the condition, and overall, the detection rates for hypertension in both groups have not improved in the last two decades. Lessons learnt from improving BP control amongst those with diabetes should be applied across the entire population, and newer strategies need to develop to improve detection of those with hypertension and are unaware.

Seasonal Variations in Multiple Sclerosis Relapses in Oman: A Single Tertiary Centre Experience

(1) Background and Aims: The seasonal factors influencing multiple sclerosis (MS) relapses remain elusive. This study aims to investigate the seasonal variation of MS relapses in Oman and compare it globally. (2) Subject and Methods: This retrospective study was conducted on N = 183 Omani MS patients treated at Sultan Qaboos University Hospital, a tertiary hospital in Muscat, Oman, over sixteen-year period (2007–2022). Demographic and clinical data of all MS patients were juxtaposed with the monthly weather data during this period, using descriptive and inferential statistical techniques. (3) Results: Among the N = 183 MS patients studied, 508 relapses were recorded during the study period. The average number of relapses per patient was 2.8 (range: 1–15). There were significant seasonal variations in MS relapse rate, with the highest prevalence in the winter months of January and February. However, no correlation was found between MS relapses and other climatic parameters (humidity, temperature, and rainfall). (4) Conclusion: The seasonal patterns of MS relapses in Oman differ from other parts of the world, which the local clinicians should take into account while diagnosing and making management decisions. The potential impact of climate change on the anomalous changes in the seasonality of MS relapses warrants further investigation.

A Retrospective Study of Genetic Characterization in Suspected Visceral Leishmaniasis Cases in Greece, 2005 to 2020.

Leishmania infantum is considered the predominant Leishmania species responsible for visceral leishmaniasis (VL) in Greece but limited molecular-typing-based studies have been performed so far. We retrospectively analyzed data and serum samples collected from 3661 individuals suspected for VL in a sixteen-year period, from 2005 to 2020, to study the seasonality and demographic characteristics of VL cases and to define the L. infantum genotypes circulating in the country. Serum samples were tested with immunofluorescence assay and/or molecular assay. qPCR Leishmania-positive samples were subjected to genotypic analysis based on polymorphisms in 12 microsatellite regions of the internal transcribed spacers (ITSs) 1 and 2. We diagnosed 219 definite (6%, sample with a positive molecular assay and/or antibody titer ≥ 1:400) and 230 probable (6.3%, sample with antibody titer between 1:100 and 1:200) VL cases. Data analysis revealed that amongst VL-definite cases, the age group (≥65) constitutes the most affected factor, since 36.9% of the VL cases belonged to this age group. Amongst the VL definite cases, the most frequently reported symptoms were fever (83%), splenomegaly (49%), and hepatomegaly (40%), but this was not the case for immunocompromised patients that developed non-typical symptoms of leishmaniasis. Although no statistically significant differences in the overall seasonality of VL cases were observed, February and June showed a significantly higher proportion of VL cases compared to August and December. Genotyping of ITS1 and ITS2 regions revealed that all VL cases belong to ITS type A of L. infantum. Our study provides epidemiological information on VL and demonstrates for the first time, providing genotypic data, the circulation of ITS type A L. infantum in Greece.

Indolent nonprogressive multifocal choroidal lymphoid lesions with late development of systemic lymphoma

Purpose: To report a case of indolent nonprogressive multifocal choroidal lymphoid lesions with late development of pulmonary low-grade B-cell lymphoma after lymphoid lesion regression. Methods: Case report. Results: A 79-year-old male was followed with ocular and systemic surveillance over a sixteen-year period for unilateral nonprogressive choroidal lesions presumed to be a benign lymphocytic disease of the choroid. Workups for systemic lymphoma and birdshot chorioretinopathy were negative. After sixteen years of observation, the choroidal lesions had largely regressed. Recent diagnosis of atrial fibrillation led to an incidental discovery of a right lower lobe lung lesion measuring 4.5 cm. Computerized tomography-guided biopsy showed low-grade B-cell lymphoma. There was no additional systemic disease detected. The patient underwent right lower lobectomy revealing extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue. Conclusion: Patients with indolent nonprogressive multifocal choroidal lymphoid lesions should be monitored regularly for late systemic disease, which although rare, can develop even after years of follow-up.

Long-term assessment of diverse nutrient management strategies in a rice-rice cropping system: analyzing yield trends, resource use efficiency and economic viability over a sixteen-year period

In recent times, the sustainability of rice-rice cropping systems has been threatened by a yield plateau, high input cost, declining water and labor availability, and increasing food demand. Hence, the rice-based cropping systems seek more attention in relation to nutrient management. This study evaluated the impact of 16-year long-term fertilizer application on crop and water productivity, yield trend, nutrient use-efficiency, and profitability of a rice-rice system (eight treatments and four replications; randomized block design). The study showed that the integrated application NPK and FYM (BInOF) significantly increased grain yield up to (∼3949 kg ha−1) and benefit cost ratio (2.01 and 1.62) in monsoon and winter rice. Furthermore, organic manure along with inorganic fertilizers significantly increased the nutrient uptake up to (80-89 kg ha−1 N; ∼16-19 kg ha−1 P; ∼85-106 kg ha−1 K; 0.22-0.25 kg ha−1 Zn) in monsoon and winter rice. The largest N recovery was observed under BInOF plots (54.9 to 59.8%). The highest carbon sequestration (2.06 t ha−1 after 16 years of cultivation) and water productivity (3.5-4.5 kg grain ha-mm−1) was observed under BInOF system (NPK + FYM). The sustainable yield index (SYI, 0.7), an indicator of rice sustainability was highest in BInOF. This study offers valuable insights into the impacts of chemical fertilizers and organic manures on the sustainability of the rice-rice cropping system. Such findings can guide policymakers in formulating strategies for crop diversification and underscore the importance of incorporating organic matter for optimal crop performance.

Trends and patterns of antibiotics use in Serbia from 2006 to 2021: Pre-COVID-19 period versus COVID-19 pandemic

Global rise in antibiotic utilization has been strongly associated with the resistance of bacteria to antibiotics. The COVID-19 saw an increase in the use of antibiotics in some countries. The aim of this study was to evaluate antibiotic utilization from 2006 to 2021 in the Republic of Serbia. Data on antibiotic use were retrieved from the national annual reports on the official website of the Medicines and Medical Devices Agency of Serbia during the period 2006 to 2021. To evaluate trends in the use of antibiotics in Serbia, linear, and joint regression analyses were performed. The analysis of the antibiotics use over a sixteen-year period included a total of 50 antibiotics. A significant increase during the COVID-19 pandemic was observed for glycylcyclines that is, new-generationtetracyclines (tigecycline), third-generation cephalosporins (ceftazidime, ceftriaxone, and cefixime), respiratory fluoroquinolones (levofloxacin and moxifloxacin), carbapenems (ertapenem), and oxazolidinones (linezolid) utilization. Moreover, an almost negligible use of new β-lactam/β-lactamase inhibitors during the prepandemic period increased significantly during the COVID-19 pandemic period. A significant increasing trend in the use of specific antibiotics classified as the "Watch" and "Reserve" antibiotics during the pandemic period was observed.

Predicting outcomes of hematological malignancy patients admitted to critical care

BackgroundCritical care (CC) admission has traditionally been viewed as likely to result in a poor outcome for hematological malignancy (HM) patients. Such a view can have implications for decisions surrounding CC admission. Recent studies have challenged this poor prognostication, however, there still remains limited data to support CC admission and escalation decisions and to elucidate risk factors which independently predict short- and longer-term survival outcomes.MethodsWe retrospectively analyzed a large cohort of adult HM patients (n=437) admitted to CC over a sixteen-year period, with the specific aim of identifying risk factors present at CC unit admission that could help to predict outcome. We assessed all-cause mortality at CC discharge (CC mortality, primary outcome) and at further time points (hospital discharge and 12-months post-discharge from CC). Single variable and multivariate analyses were performed to identify independent predictors of outcome.ResultsCC unit and hospital mortality rates were 33.4% (146 patients) and 46.2% (202 patients) respectively. At six-month and one-year follow-up, mortality increased to 59.5% and 67.9% respectively. At single variable adjusted regression analysis, eight factors were associated with CC mortality: APACHE II score, the number of organs supported, requirement for continuous renal replacement therapy (CRRT), cardiovascular support, or respiratory support (invasive and non-invasive), the ratio between arterial partial pressure of oxygen (PaO2) and the inspired oxygen concentration (FiO2) (P/F ratio) on CC admission, and the lowest P/F ratio during CC admission. However, only three factors showed independent predictive capacity for CC outcome at multivariate logistic regression analysis; APACHE II score on admission, requirement for ventilation and lowest P/F ratio.ConclusionOne third of HM patients admitted to CC died on the unit and, following admission to CC, approximately one-third of HM patients survived over 1 year. Our data show that, while a diagnosis of HM should not preclude admission of patients who might otherwise benefit from CC support, the prognosis of those with a high APACHE II score upon admission, or those requiring IMV remains poor, despite considerable advances in IMV techniques.

Correlation between Endophthalmitis and Stroke Development in Ankylosing Spondylitis Patients: A Population-Based Cohort Study.

Background: This cohort study aimed to research the correlation between endophthalmitis and stroke development in ankylosing spondylitis (AS) patients by reviewing National Health Insurance Research Database (NHIRD) data. Methods: This study obtained data from the NHIRD over a sixteen-year period. The primary outcome was stroke development. We used Fisher’s exact test and Pearson’s chi-squared test to analyze the variables. We investigated the risk factors for disease development using Cox regression analyses. We compared the cumulative incidence of stroke using Kaplan–Meier analysis. Results: The study cohort included 549 patients with AS and endophthalmitis, while the comparison cohort included 2196 patients with AS but without endophthalmitis. The stroke development was increased in the study cohort (adjusted hazard ratio, 1.873; p ≤ 0.001). The total stroke development in the study cohort and the comparison cohort was 1724.44 per 100,000 person-years and 1085.11 per 100,000 person-years, respectively (adjusted hazard ratio, 1.873; 95% confidence interval, 1.776–2.022; p < 0.001). Our study cohort showed an increased stroke rate. Conclusions: Our studies showed that endophthalmitis increases the risk of stroke in AS patients and endophthalmitis is an independent risk factor for stroke in AS patients. Nonetheless, advanced studies that thoroughly investigate the correlation between endophthalmitis and stroke in AS patients are needed to validate our findings.

Comparison of "growth promoted" and "normally grown" dichorionic-diamniotic twins: A population-based study.

ObjectivesMacrosomia in singleton pregnancies and associated risks have been well characterized. Less is known about the outcomes of macrosomic newborns in twin pregnancy.Objective of this study was to compare maternal characteristics and perinatal outcomes of "growth promoted twins" (twin pairs with a total twin birth weight above 90th percentile) to "normally grown twins" (twin pairs with a total twin birth weight between 50th and 90th percentile).MethodsWe evaluated data (maternal characteristics and perinatal outcomes) of dichorionic–diamniotic twins born at 34 weeks of gestational age or later over a sixteen-year period (2002–2018) in two birth weight groups. We excluded twin pairs born before 34th week of gestation and discordant twin pairs. We used data from the Slovenian National Perinatal Information System.To define the percentiles, twin-specific growth curves have been used.ResultsOur study population consisted of 390 twin pregnancies with a twin total birth weight over 90th percentile and 1618 pregnancies with a total twin birth weight between 50th and 90th percentile for gestational age. Women in "growth promoted" twin group were significantly taller, heavier and more often multiparous. There was a higher incidence of gestational diabetes (10.8% vs 7.3%, OR 1.53 95% CI 1.06 – 2.22), a lower rate of caesarean births (48.2% vs 53.9%, OR 0.80 CI 0.64 – 0.99) and lower rate of assisted reproduction (21.0% vs 27.1%, OR 0.71 CI 0.55 – 0.93) in women in "growth promoted" twin group. There were no statistically significant differences in neonatal outcomes in both groups.ConclusionIn contrast to macrosomia in singletons, macrosomia in twins does not appear to increase the risk for adverse perinatal outcomes.

Punjab's Rural Economy: Temporal Shift in Employment and Income Pattern

The agricultural and non-agricultural sectors are the two most important areas of any economy. The study was done to ascertain changes in the rural economy's income and employment patterns during a sixteen-year period. The sample size of the study was 225 households. Rural populations are increasingly reliant on non-farm economies as they migrate away from farming and allied activities. However, the move to the non-farm sector has not been growth-enhancing, as the majority of non-farm sector workers remained wage earners over both periods. Diversification in the agricultural sector, as well as a shift toward the non-agricultural sector, have made no substantial improvements over the last sixteen years.

Effects of the Obesity Epidemic on Total Hip and Knee Arthroplasty Demographics

BackgroundHigher body mass index (BMI) is a well-known risk factor for the development of hip and knee osteoarthritis and predicts total hip arthroplasty (THA) and total knee arthroplasty (TKA) at an earlier age. The purpose of this study is to document the nationwide trends in age and obesity in primary THA and TKA throughout the obesity epidemic. MethodsA retrospective analysis of the National Inpatient Sample database was conducted on patients undergoing primary THA and TKA for primary OA between 2002 and 2017. Analysis of variance and chi-square tests were performed to examine changes in age and obesity percentage over time, respectively. Pearson correlations were used to assess the relationship between patient age, BMI, and year of surgery. ResultsA total of 688,371 THA and 1,556,651 TKA were identified over the sixteen-year period. Between 2002 and 2017, the proportion of obese patients increased for both THA (7.0% to 22.7%, P < .001) and TKA (10.7% to 30.4%, P < .001). Mean age significantly decreased for both THA (66.7 to 65.9 years, P < .001) and TKA (67.6 to 66.8 years; P < .001). Over time, BMI significantly increased (THA: r = 0.221 vs. TKA: r = 0.272) and patient age decreased (THA: r = -0.031 vs. TKA: r = -0.137) for both procedures (P < .001 for all). ConclusionTHA and TKA patients have become younger and increasingly more obese throughout the obesity epidemic, as obesity rates have tripled over this time period. The current investigation is the first to demonstrate significant trends in both age and obesity in the THA and TKA populations on a national level. Level of EvidenceIII.

Long-term and seasonal changes in the life-history biology of the abyssal holothurian Pseudostichopus aemulatus from the Porcupine Abyssal Plain (North-East Atlantic)

Long-term interannual variations in the benthic community structure are well-known from abyssal plains in the North Atlantic and North Pacific, where rapid responses to changes in the environment by first-order opportunists modify overall species composition. To increase our knowledge of the long-term variations of deep-sea benthic communities in the North-East Atlantic, we studied the response of a second-order opportunist echinoderm, the holothurian Pseudostichopus aemulatus, before, during and after the “Amperima Event” – a four-year episode (1996–1999) where the first-order opportunistic holothurian, Amperima rosea, increased dramatically in density. We used a collection of 14 sampling times of deep-sea community assemblage over a sixteen-year period to understand the temporal variation (i.e., interannual and seasonal) in population structure (i.e., density and individual sizes) and reproduction (i.e., mean oocyte sizes, sex ratios, gonadal indices, and fecundity) in P. aemulatus. Samples were collected from the Porcupine Abyssal Plain (PAP) in the NE Atlantic Ocean at a depth of ca. 4850 m between 1989 and 2005 with a semi-balloon otter trawl (OTSB14) and an epibenthic sledge (BN1.5/C) at varying seasons. We measured individual body size, dissected organisms to prepare histological slides of their gonads, and measured the Feret oocyte diameter in females. We found changes in the life-history biology of P. aemulatus during the “Amperima Event”. Population density increased gradually from September 1997 until April 1999, when P. aemulatus reached a peak in density coinciding with the smallest mean body size observed (1998 and 1999) suggesting recruitment of juveniles. In 1997, before these changes in population structure, mean oocyte sizes were at their largest, suggesting a strong reproductive effort with individuals either preparing to spawn or spawning. This reproductive effort was minimal in the years after 1999, when we found the largest proportions of previtellogenic oocytes in individuals that were probably allocating their energy into growth rather than reproduction given their smaller size. The presence of gametes of all sizes across seasons and a broad range of individual sizes in various sampling times suggests no seasonal reproductive patterns. We suggest that feeding guild differences between various holothurian species explain the diverse life-history responses observed among holothurians competing for resources in a food-poor environment.

Credit Risk Management and Bank Performance: With Special Reference to Specialized Banks in Sri Lanka

The adoption of credit risk management is becoming a crucial factor for every bank. The objective of this study identifies the relationship between the credit risk management determinants revealed by banking soundness index indicators CAMEL (Capital adequacy, Assets quality, Management efficiency, Earnings, Liquidity) on the performance of the License Specialize banks in Sri Lanka. This study is based on secondary data from each bank annual reports. The data were collected from six development bank among seven development banks in Sri Lanka. The sample was selected from the population based on the availability, convenience method, and reliability of data over the set period. The panel data of a sixteen-year period from 2000 to 2016 from the selected banks, were used to examine the relationship between credit risk management and performance. The Return on equity is used as a performance indicator and Capital adequacy and Asset quality were used as indicators of credit risk management. The study used multiple regression to analyze the data. With these findings, it revealed there is a strong impact of the CAMEL components on the financial performance of specialized banks in Sri Lanka. As per the findings of analysis Capital Adequacy, and Asset quality has a negative significant relationship between bank performances of ROE. This study also documented that there is a significant relationship between credit risk management by CAMEL Indicators and the financial performance of specialized banks in Sri Lanka. Therefore, this study suggests that the CAMEL model can be used as a proxy for credit risk management in the context of License Specialize banks Sri Lanka.

Earnings Management Behavior in Malaysia: The Role of Ownership Structure and External Auditing

"This paper aims to empirically investigate firms’ earnings management (EM) behaviour, representing an issue in the realm of corporate financial reporting. Specifically, it explores the strategic roles of two common governance elements of ownership (managerial, institutional and family) and external audit in shaping the firms’ EM behaviour based on the two common EM attributes of Discretionary Accruals (DA) and Real Activities EM (REM). The analyses based on 227 survived Malaysian listed firms throughout the sixteen-year period from 2001 to 2016 (3,632 firm-year observations) indicate a dynamic EM behaviour depending on the presence of different ownership structures. Whilst a high percentage of family and institutional ownership mitigates DA, it however does not hold true for REM. Further, this paper also shows that the external control mechanism of audit quality is not significant in mitigating both EM attributes. The empirical results suggest that firms facing different challenges would affect the firms’ financial reporting behaviours in their choice of EM. The paper adds to the growing body of empirical knowledge dealing with the determinants of DA and REM from the lens of an emerging economy like Malaysia. KEYWORDS: Earnings management, discretionary accruals, real earnings management, accrual earnings management, financial reporting quality."

Longitudinal Trends and Predictors of Medicaid Utilization Among Middle-Aged and Older Adults

Over fifteen million older adults in the United States rely on the means-tested Medicaid program for healthcare coverage (accounting for approximately 20% of total Medicaid beneficiaries according to the Centers for Medicare and Medicaid Services). With the older adult population growing exponentially, there has been concern that steadily rising Medicaid spending will skyrocket among this group and that there may be a need to reconfigure coverage of the program. However, few studies have longitudinally examined which factors are related to utilization of the program over time among older adults in order to better understand how any future coverage changes might impact this group. This study used the 1998 to 2014 waves of the Health and Retirement Study (N=8,162) to analyze a representative sample of those 50 and older regarding demographic, health, and economic trends associated with Medicaid utilization over a sixteen-year period. Descriptive analyses showed stable longitudinal patterns such that those who utilized Medicaid had significantly poorer health and fewer financial resources compared to those who never accessed Medicaid. Multivariate analyses further revealed those who were older, female, minority race/ethnicity, less educated, in poorer health, below the federal poverty line, and with lower net wealth had a higher proportional risk of utilizing Medicaid during the observed time period than their counterparts. The findings from this study highlight the importance of monitoring changes in the documented risk factors over time in terms of their impact on Medicaid utilization and underscore the need to consider how these factors may be interrelated.

Complementary Technology Traces in Software Practice: A Retrospective Reflection over Sixteen Years of Evolution at Ericsson

ABSTRACT To advance knowledge about evolution of practices within a software organisation, we offer a retrospective reflection based on several years of research into a software unit at Ericsson AB. Covering 16 years of evolution, we developed multiple publications from continuously expanding sources of software technology implementation data. While these publications report from specific junctures of software practice evolution at the unit, our retrospective reflection allows us to consider the impacts of the unit’s investments into two technology paradigms over the sixteen-year period: first into CMM-RUP with a focus on discipline and structured practices and years later into Agile-Lean with a focus on flexibility and responsive practices. Hence, we adopt retrospective reflection to investigate how imprints from the two paradigms, despite considerable timespan between the related technology implementations, eventually complemented each other in the unit’s software practices. Because one paradigm focuses on discipline and structured practices and the other on flexibility and responsive practices, our retrospective reflections consider how the two paradigms together impacted the software unit’s ambidextrous capability. As a result, we advance the idea that as software organisations over time invest in complementary technology paradigms they leave important technology traces with sustainable impacts on their software practices.

Medicaid Utilization among Middle-age and Older Adults: A Health and Retirement Study Longitudinal Analysis (1998 to 2014)

ABSTRACT With over fifteen million older adults in the United States relying on the means-tested Medicaid program for healthcare coverage, there has been concern over rising Medicaid costs among this rapidly growing age group. Few studies have longitudinally examined trends among older beneficiaries over time to identify factors related to Medicaid utilization and to better understand how potential coverage changes might impact this group. This study used the 1998 to 2014 waves of the Health and Retirement Study (N = 8,162) to analyze a representative sample of those aged 50 and older to ascertain demographic, health, and economic factors associated with Medicaid utilization over a sixteen-year period. The analyses showed stable probabilities of accessing the program over time and observed that the most vulnerable older adults make up the pool of Medicaid beneficiaries. There is no evidence of significant asset divestment in order to qualify for benefits. Multivariate analyses further revealed those who were older, female, minority race/ethnicity, less educated, in poorer health, below the federal poverty line, and with lower net wealth had a higher risk of utilizing Medicaid during the observed time period than their counterparts. Findings highlight the importance of monitoring changes in the documented risk factors over time in terms of their impact on Medicaid utilization and underscore the need to consider how these factors may be interrelated.

Interval regression models of a machine-building enterprise

The article discusses methods of interval regression analysis and their application in modeling. The object of the study was the reporting of the engineering company LLC Spetsstroymash (in a sixteen-year period). The results obtained are compared with traditional regression analogs such as the least squares method and the least modulus method.

An analysis of the mission drift in microfinance

ABSTRACT With the expansion in the microfinance industry and an increase in the number of microfinance institutions (MFIs), there is some apprehension that MFIs may be deviating from their mission of catering to the poor, in an effort to augment their profitability. This mission drift would typically manifest in a reduction in allocation of credit to the poor (depth of outreach) and to women. Using a sample of 1591 MFIs over a sixteen-year period, this study shows empirical evidence of a general increase in depth of outreach and no reduction in outreach to women over time, refuting claims of mission drift.

Do Differences in Corporate Governance Make a Discrepancy in Firm Value? The Case of the Shipping and Shipbuilding Industry

As Korea’s core industries, the shipping and shipbuilding industry have global competitiveness and mutually related. After the Global Financial Crisis in 2008, both industries fall into financial depression, thus progress financial re-structuring forced by the Korean government. In the process of restructuring, government policy loans concentrated on the shipbuilding industry rather than the shipping industry. Based on these facts, this study examines the impact of corporate governance on firm value in the shipping and shipbuilding industry. This study develops its research question by comparing the firm value between ownership structure and board structure using panel data set during a sixteen-year period (2000-2015). This study finds that government ownership decreases firm value in the shipbuilding industry while it positively affects firm value in the shipping industry. Specifically government ownership in the shipbuilding industry is four times higher than that of the shipping industry. This result suggests that excessive governmental ownership rather decreases firm value; Board composition in the shipping industry operates more efficiently than board composition in the shipbuilding industry. Therefore, in order to rebuild Korea