Hyperthermia: A Potential Game-Changer in the Management of Cancers in Low-Middle-Income Group Countries

Loco-regional hyperthermia at 40–44 °C is a multifaceted therapeutic modality with the distinct triple advantage of being a potent radiosensitizer, a chemosensitizer and an immunomodulator. Risk difference estimates from pairwise meta-analysis have shown that the local tumour control could be improved by 22.3% (p < 0.001), 22.1% (p < 0.001) and 25.5% (p < 0.001) in recurrent breast cancers, locally advanced cervix cancer (LACC) and locally advanced head and neck cancers, respectively by adding hyperthermia to radiotherapy over radiotherapy alone. Furthermore, thermochemoradiotherapy in LACC have shown to reduce the local failure rates by 10.1% (p = 0.03) and decrease deaths by 5.6% (95% CI: 0.6–11.8%) over chemoradiotherapy alone. As around one-third of the cancer cases in low-middle-income group countries belong to breast, cervix and head and neck regions, hyperthermia could be a potential game-changer and expected to augment the clinical outcomes of these patients in conjunction with radiotherapy and/or chemotherapy. Further, hyperthermia could also be a cost-effective therapeutic modality as the capital costs for setting up a hyperthermia facility is relatively low. Thus, the positive outcomes evident from various phase III randomized trials and meta-analysis with thermoradiotherapy or thermochemoradiotherapy justifies the integration of hyperthermia in the therapeutic armamentarium of clinical management of cancer, especially in low-middle-income group countries.

Financial Inclusion between Financial Innovation and Economic Growth A Study of Lower Middle Income Economies

Financial inclusion is a key concern that has achieved much impulsion in the last two decades internationally. It has the scope of reporting of financial scheme and institutions to the underserved community in the economy. This study examined the effect of financial innovation on economic growth with the mediation of financial inclusion. To address the relationship researchers in this study have used measures from a dataset of low and lower middle income group economies over a sample period from 2010-2017. The results of this study shows that financial innovation creates opportunities for financially excluded segment of the society which results in financial inclusion that leads to economic growth of low and lower middle economies. Therefore, financial innovation is a way for creation of financial inclusion in low and lower middle economies.

Trends and correlates of hardcore smoking in India: findings from the Global Adult Tobacco Surveys 1 & 2

Background: Data on prevalence of hardcore smoking (HCS) among different socioeconomic status (SES) groups in low- and middle-income countries are limited. We looked at the prevalence and pattern of HCS in India with the following objectives: 1) to analyse the association between SES and HCS, 2) to find trends in HCS in different SES groups and 3) to find state-wide variations in hardcore smoking. Methods: Data of individuals aged ≥25 years from the Global Adult Tobacco Survey (GATS) India 2009-10 (N= 9223) and 2016-17 (N= 7647) were used for this study. If an individual met all the following criteria: (1) current smoker, (2) smokes 10 or more cigarettes/day, (3) smokes first puff within 30 minutes after waking up, (4) no quit attempt in last 12 months, (5) no intention to quit at all or in the next 12 months, (6) lack of knowledge of harmful effect of smoking, s/he was identified as a hardcore smoker. Multiple regression analysis was done to find the factors associated with HCS. Results: Prevalence of HCS deceased from 2.5% in GATS 1 to 1.9% in GATS 2: males from 6.2% to 3.9% and females from 0.3% to 0.2%. Compared to the richest group the poorest, poor and those who belonged to the middle-income group were more likely to report HCS in GATS 1 and 2. However, only in the poorest SES group there was an increase in the proportion of hardcore smokers in GATS 2 compared to GATS 1. Other factors that were significantly associated with HCS in both surveys were male gender, working adults, those with lower education, early initiation of smoking and households without any rules for smoking inside the home. Conclusions: Tobacco control and cessation efforts need to focus on individuals of poor SES groups particularly in the high prevalence Indian states.

A STUDY ON QUALITY OF LIFE OF MIDDLE-INCOME GROUP ALONG URBAN CANAL WATERFRONTS

In most of the cases, canal network in Greater Colombo region work as the drainage system of the urban area and as the backyard of the city. Therefore, there is a lack of attention to the canal waterfronts by the government and by the public. Hence, this research was to find out and evaluate the factors, which will affect the quality of life of people along urban canal waterfronts. It has been discussed in terms of liveability through a series of carefully selected indicators. Liveability surveys were conducted along five canal waterfronts and the participants’ perceptions were taken. Every canal waterfront was assigned a rating of over 25 qualitative and quantitative factors (set of indicators) across six broad categories (dimensions): safety, comfort, health and wellbeing, mobility, environment, and socio-cultural factors. Each qualitative factor was given a rating from 1(tolerable)-5(intolerable). Qualitative factors were then combined with quantitative factors through a series of equations to form the liveability index. According to the proposed liveability index, transport dimension index is ideal (100), while the health and well-being dimension is the lowest (27). This will help for the creation of government policies, plans, rules and regulations and when implementing projects along urban canal waterfronts.

TO DEVELOP A SET OF RECOMMENDATIONS FOR PARENTS WHOSE CHILDREN ARE IN THE EARLY ADOLESCENT AGE GROUP

The present study was undertaken to assess the parenting styles of mother and father of early adolescent and its influence on personality development. The investigation took place in the municipal boundaries of Udaipur city. The total sample of the research consisted of 360 respondents who belonged to middle income group. The sample selected comprised of early adolescents (120) in the age range of 11-13 years and their father (120) and mother (120). Few recommendations for parents of early adolescent were developed which can be useful for further researches.

Diversity in food consumption: Evidences from urban Kerala

Food is fundamental to human survival and it appears to be the first item of the family budget allocation of all irrespective of class to which they belong. Kerala ranks top among the major States of India in the MPCE on food in the post liberalized era. A perusal of NSS data exhibits that, MPCE of urban Kerala is ahead of the rural for the last few decades, however, a sharp decline is noted in the last decade (2001-2011). Along with an increase in MPCE on food, an increase in food diversity is being expected. The study probe into the extent of food diversity among different income strata of urban Kerala with the unit-level data from NSS 68 consumer expenditure survey. The findings indicate that the share of expenditure on cereal in total food expenditure is high in the low-income class and low in the high-income group. The state of Kerala has high food diversity across all income classes signals a better diet quality of people. It is revealed that food diversity is low in the high and low-income groups compared to middle-income group.

A Study on the Acceptance Level of Rack Housing in Malaysia

Rack housing is one type of modular construction system which is flexible and poses a higher degree of mobility. However, the idea of rack housing is relatively new and there is no clear indication of how far is the acceptance of Malaysian citizen to this idea. Therefore, this study aims to identify the acceptance level of Malaysian towards rack housing and also serve as the basic reference for both government and private sector for the adoption fo rack house in Malaysia. In this study, the acceptance level among Malaysian factors of consumer decision to purchase rack housing and also the perspective of Malaysian especially middle income group is determined. A set of questionnaire was made by Google form which contain question about the major factor of acceptance of Malaysian citizen on rack housing with total of 208 questionnaires. The data collected from different group of Malaysian was analyzed by using Average Index (AI). The degree of importance was determined by the rating scales. The result obtained is that the acceptance level to purchase rack housing based on location, comfortability and management factors. From the result, the respondances agree to accept rack housing to implement and construct in Malaysia.

Is Greenfield Investment Greener for the Welfare of Lower-Middle Income Countries? Market based Empirical Analysis with GMM Approach

Globalization is considered as the catalyst for the progress of economic activities and economic development of lower-middle-income countries. Greenfield investment not only promotes welfare but also helps in the health and education sector of these countries. This study examined thirty-four (34) sampled countries of the lower-middle-income group from different regions for a time span of 1998-2017. Im, Pesaran and Shin (2003) test is applied for testing panel unit root and one step system GMM technique is applied for the complete data analysis. The results of the study concluded that greenfield investment has increased economic growth and helped to push the welfare activities of sampled countries. Besides the increase in economic growth and welfare, greenfield investment also brings improvement in the health and education sectors through the transfer of new and advanced technologies from the developed nation firms to the host countries. Therefore, lower-middle-income countries must approve soft and friendly economic and business policies for the attraction of foreign investors from abroad. Such policies will help in promoting and increasing economic activities and economic development of the sampled countries.

Socio-economic variations in the clinical presentation, etiology and outcome of infective endocarditis in the ESC-EORP EURO-ENDO (European Infective Endocarditis) registry: a prospective cohort study

Background Infective endocarditis (IE) is a life threatening disease associated with high mortality and morbidity worldwide. We sought to determine how socio-economic factors may influence variations in epidemiology, clinical presentation, investigation and management (and their consequence upon clinical outcomes) in a large international multi-centre registry. Methods The ESC-EORPEURO-ENDO registry comprises a prospective cohort of 3116 adult patients admitted to 156 hospitals in 40 countries with IE between January 2016 and March 2018. We analysed the complete dataset to assess potentially important determinants of variation according to World Bank economic stratification (high income (Group 1) [73.8%]; upper-middle income (Group 2) [17.1%]; lower-middle income (Group 3)[9.1%]). Results Patients in Group 3 were younger (median age [IQR]: Group 1 - 66 [54–75] years; Group 2 - 57 [40–68] years; Group 3 - 33 [26–43] years; p&lt;0.001) with a higher prevalence of smoking, intravenous drug use and human immunodeficiency virus (HIV) infection (all p&lt;0.001). Group 3 patients with IE presented later (median [IQR) days since symptom onset: Group 1 - 12 [3–35]; Group 2 - 20 [6–51]; Group 3 - 31 [12–62]; p&lt;0.001) and were more likely to develop congestive heart failure (13.6%; 11.3%; and 22.6%, respectively; p&lt;0.001), septic shock (8.3%; 11.1%; 13.4%; p=0.007), and persistent fever for greater than 7 days (9.6%; 14.4%; 27.9%; p&lt;0.001) following hospital admission. Surgery was performed less frequently in Group 3 (75.4%, 76.8% and 51.3% in Groups 1, 2 and 3, respectively; p&lt;0.001) and mortality was highest in the poorest countries (14.6%; 23.6% and 23.7%, respectively; p&lt;0.001). Conclusion Socio-economic factors influence the clinical profile of patients presenting with IE across the world. Despite being younger, patients from the poorest countries presented with more frequent complications and higher mortality associated with delayed diagnosis and less frequent use of surgery. FUNDunding Acknowledgement Type of funding sources: None.