Does Tobacco Affect Economy?

OBJECTIVE: The still debatable contribution of tobacco to the economy demands further discussion as tobacco remains controversial commodity due to its adverse health impacts. This paper aims to investigate the relationship between tobacco and the economy using macroeconomics indicators such as unemployment, inflation, and GDP growth. As a comparison, we include the tobacco price bands in USA because the sector is one of dominant affecting the economy and the price in some main areas in America is incredibly competitive. METHODS: This paper use tobacco data and Macroeconomics Indicators from Euromonitor International and World Bank Data. We extend linear regression models by controlling both the serial correlation and endogeneity bias problems. We also observe the properties in the ARMA(2,2) data generating process. RESULTS: We document that tobacco tends to affect the USA's future economy but not Indonesia. In our robustness check, we conduct a SUR analysis to control the contemporaneous correlations among Asian markets. We further document that tobacco variables tend not to affect the economy in the Asian markets. CONCLUSION: Our results show that the contribution of tobacco commodity to the economy is overstated. Therefore, the comprehensive and massive tobacco control implementations should be undertaken hence is relevant to put into actions.

Structured training in the management of emergencies in mothers, babies and children in a poorly resourced health system: logbooks to document skill use.

OBJECTIVE: To evaluate the use of a structured training programme in emergency care in Pakistan through the completion of logbooks documenting actual resuscitation attempts. DESIGN: Cross-sectional survey. SETTING: All tiers of health care settings across all regions of Pakistan. PARTICIPANTS: 120 health workers, trained in the skills for managing maternal, neonatal and childhood emergencies as part of a system development programme called "Essential Surgical Skills-Emergency Maternal and Child Healthcare (ESS-EMCH). METHODS: Following a series of 6 five-day training courses developed as part of the ESS-EMCH programme between January and December 2006, participants were provided with logbooks to document the actual use of their newly acquired skills during the resuscitation of mothers, infants and children. RESULTS: 1123 resuscitation attempts were documented and received from 63 of the 120 participants (response rate 53%; number of forms 4-22 per participant). Seventy-six percent (858/1123) of documented cases were received from doctors and 24% (265) from nurses. The patients receiving resuscitation were neonates 31% (n=349), infants and children 38% (n=426), pregnant mothers 21% (n=233) and other adults 10% (n=111). The commonest emergencies treated in neonates were resuscitation at birth, sepsis, shock and difficulty in breathing. Haemorrhage was the commonest obstetric emergency (52%, n=52/101), followed by eclampsia and shoulder dystocia. Skills used to secure the airway; breathing (use of oxygen and bag valve mask ventilation) and circulation were used in 58%, 82% and 73% of resuscitated patients. Oxygen was used in 87% of neonates and in 62% of pregnant mothers. The overall survival rate in the cases reported was 89%. CONCLUSIONS: Resuscitation logbooks can be used to assess which skills are used in emergency care. This analysis provides some evidence that the skills taught during the ESS-EMCH programme are used by the trained health workers. Individually held and completed logbooks should continue to act as a feedback and audit mechanism to measure outcomes, in conjunction with other methods of evaluating the impact of the training component of this programme.

Emergency maternal and child health training courses and advocacy to achieve millennium development goals in a poorly resourced country; challenges and opportunities.

Our three years' experience of Essential Surgical Skills-Emergency Maternal and Child Health (ESS-EMCH) Programme in Pakistan suggests that despite a compromised healthcare delivery system, a tangible improvement in the management of emergencies in pregnancy, the neonate and children can be achieved by adopting a novel but robust mechanism of effective advocacy along with provision of innovative, evidence based and high quality training for healthcare staff.

Evidence for improvement in the quality of care given during emergencies in pregnancy, infancy and childhood following training in life-saving skills: a postal survey.

OBJECTIVES: To assess the motivational level and use of skills amongst the graduates of training courses on maternal and newborn healthcare in emergency settings. METHODS: Postal survey involving Doctors and Nurses from public sector hospitals who attended training courses on Essential Surgical Skills with emphasis on Emergency Maternal and Child Health. RESULTS: Ninety percent of respondents reported the use of acquired skills and the structured Airway, Breathing, Circulation (ABC) approach in handling emergencies. Instances were described where this approach helped to improve practice, simplify treatment and save lives in all age groups, especially mothers and newborns. Lack of equipment and lack of support from higher levels were the common barriers yet many graduates managed to obtain equipment and 81% of respondents reported that these training courses had resulted in better availability or use of supplies at their facilities. Efforts were made by the graduates for institutionalizing the trainings and discussions (88%) were found to be the most common mode followed by formal teaching of the skills (66%). Hand washing was the most commonly used skill followed by the use of bag valve and mask resuscitation in the newborn at birth. Those catering for neonates expressed their confidence in obstetric procedures, while obstetricians described themselves as being self-assured now in neonatal resuscitation. CONCLUSIONS: The introduction of a structured training programme in a resource-constrained healthcare system has improved the emergency management of patients. ESS-EMCH trainings should be incorporated into the district health systems to enhance emergency care handling capacities of healthcare staff, to help them contribute to achieve the MDGs and also for sustainable improvement in maternal, neonatal and child healthcare.

Adherence of private practitioners with the National Tuberculosis Treatment Guidelines in Pakistan: a survey report.

OBJECTIVE: In Pakistan, over 80% of the patients suffering from TB consult a private practitioner for the initial evaluation. A cross-sectional survey was conducted in seven thickly populated urban communities of Rawalpindi district to evaluate the adherence of private practitioners with TB treatment guidelines as laid down by National Tuberculosis Control Programme (NTP) in Pakistan. The data was collected over 30 days. METHODS: A young lean man was simulated to act as a TB patient and was provided with a chest X-ray suggestive of TB and two Acid-Fast Bacilli (AFB) positive sputum reports. Only those prescriptions were included for analysis which either had recognized the patient having TB or had any TB drug written in the prescription. RESULTS: A total of 77 practitioners were visited. Prescriptions of 53 general practitioners fulfilled the inclusion criteria and were analyzed. Only 2 (3.7%) prescriptions out of 53 met the required standard for TB patients as laid down by NTP. Eighty three percent (n = 44) favored a combination drug for the treatment while the rest preferred individual preparations. CONCLUSIONS: The study reflects the lack of knowledge about standardized TB treatment protocols amongst the private practitioners in Pakistan. Public Private Partnerships between government public health departments and non-governmental organizations working in public health can be a valuable tool in generating mass awareness campaigns.

Measuring Secondhand Smoke in Muscat, Oman.

OBJECTIVES: This study aimed to measure exposure to secondhand smoke (SHS) and assess venue compliance with the municipal Law against smoking indoors in public places in Muscat, Oman. METHODS: Following the selection of 30 public indoor venues within the Muscat governorate, the concentration of suspended SHS particulate matter (PM2.5) in the venues' indoor air was measured throughout July and August 2010. RESULTS: Almost all of the venues were found to be compliant with the smoke-free municipal, with the exception of a café that served waterpipes for smoking indoors. The concentration of PM2.5 in this venue showed an average level of 256 µg/m(3) which was 64 times the level of that found in the non-smoking venues. CONCLUSION: Aside from one café, the majority of the assessed indoor public venues abided by the smoke-free municipal law. However, the enforcement of policies banning smoking in indoor public recreational venues should be re-examined in order to protect member of the public in Oman from exposure to SHS.