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Background & objective: Childhood nephrotic syndrome (NS) follows a chronic course in most children. However, little has been studied about the burden of NS on the caregivers despite evidence that caregiver burden or impairment in their well-being may alter the outcome of chronic childhood illnesses. We aimed to study the multi-dimensional impact on the quality of life (QOL) of families of children with the NS to determine the significant predictors of caregiver burden and psychological distress among caregivers of children with NS in terms of Parents HRQOL (health related quality of life), Pediatrics Health-related quality of life Family Impact Module (PedsQLTM FIM) and Family Functioning Summary Score (FaF-SS). Methods: This cross-sectional analytical study was conducted over a period 6 months from October 2019 to March 2020. Parents of children with diagnosed nephrotic syndrome (frequent relapsers, steroid dependent and steroid resistant), on treatment for at least one year, attending at the Outpatient and In-patient Units of Pediatric Neprology, Dhaka Medical College & Hospital (DMCH) and Dhaka Shishu Hospital were taken as cases. A total of 40 cases and 64 controls were consecutively included in the study. The control group consisted of parents of healthy age-sex matched children attending at the immunization clinic to have their children immunized. Data were collected by face-to-face interview of the parents using questionnaire of Pediatric Quality of Life Inventory 4 (PedsQLTM), Family Impact Module (FIM). PedsQL FIM is a multi-item scale comprising of 36 questions grouped under eight domains related to physical functioning, emotional functioning, social functioning, cognitive functioning, communication, worry, daily activities and family relationships. Results: Parents HRQOL-SS was compromised with certain aspect of their demographic characteristics. Parents with debt and widows had compromised HRQOL than the parents without debt and both of the spouses are living together (p = 0.174 and p=0.027 respectively). Parents whose children responding well to treatment had a better HRQOL than those whose children were not responding to treatment (p = 0.102). As PedsQLFIM-SS was compared between the demographic characteristics of the parents, again widows and parents with debt had significantly worse PedsQLFIM-SS (p = 0.007 and p = 0.038 respectively). Parents with debt also had impact on family functioning as evidenced by commendably reduced FaF-SS (family functioning summary score) in parents with debt than those in parents without debt (p = 0.029). There was no difference between case and control groups in terms of Parents HRQOL-SS and FaF-SS (956.8 ± 195.9 vs. 970.9 ± 287.7, p = 0.786 and 404.5 ± 87.8 vs. 391.4 ± 119.1, p = 0.549 respectively) and each of the six individual domains, except emotional functioning which was significantly poor in the case group than that in the control group (p = 0.005) Physical functioning was also considerably worse in the case group than that in the control group, although the difference was not statistically significant (p = 0.130). Conclusion: The study concluded that parents of the children with NS suffer from immense financial, physical and psychological burden. Burden is significantly greater for widows or when the families are in debt due to continued effort to cope with the stresses resulting from caregiving of their compromised children. Early diagnosis and treatment of parents’ burden is of utmost need to help improve parents’ health-related quality of life. Ibrahim Card Med J 2021; 11 (1): 28-34

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Objectives In this study we compared two predictions of COVID-19 cases in the Kingdom Saudi Arabia (KSA) using pre–and post–relaxation of lockdown period data to provide an insight regarding rational exit strategies. We also applied these projections to understand economic costs versus health benefit of lockdown measures. Methods We analyzed open access data on COVID-19 cases from March 6 to January 16, 2021 in the KSA. To understand the epidemic projection during the pre- and post-lockdown period, we used two types of modeling: the SIR model, and the time series model. We also estimated the costs and benefits of lockdown- QALY gained compared to the costs of lockdown considering the payment threshold of the Government. Results Prediction using lockdown period data suggested that the epidemic might slow down significantly after 109 thousand cases and end on October 6, 2020. However, analysis with latest data after easing lockdown measures suggested that epidemic might be close to an end on October 28, 2021 with 358 thousand cases. The peak has also been shifted from May 18, 2020 to Jun 24, 2020. While earlier model predicted a steady growth in mid-June, the revised model with latest data predicted it in mid-August. In addition, we estimated that 4986 lives would have been saved if lockdown continued but the cost per life saved would be more than $378 thousand, which is way above not only the KSA threshold, but also the threshold of any other highly advanced economies such as the UK and the USA. Conclusions Our results suggest that relaxation of lockdown measures negatively impacts the epidemic. However, considering the negative impact of prolong lockdown measures on health and economy, countries must decide on the best timing and strategy to exit from such measures to safely return to normal life with minimum loss of lives and economy considering its economic and health systems’ capacity. Instead of focusing only on health, a balanced approach taking economy under consideration is recommended.

Background: When crippled with COVID-19 infection, a substantial number of countries have adopted ‘lockdown’ or similar measures to suppress the spread. This instrument is often considered as the only viable option for curbing infection spread both in developed and developing countries; however, some experts have a cynical view on its effectiveness. Exploiting cross-country lockdown information, effectiveness of lockdown on slowing the pace of COVID-19 can be elicited. Methods: The study intends to understand whether lockdown or similar measures can suppress infection growth in developing countries. In this pursuit, the study uses panel regression-based difference in difference and GMM estimation method. Results: This study finds that lockdown type measures are not as effective in developing countries as in developed nations. Nevertheless, staying at home order, income support programs, and other social distancing measures are found to be effective for both developed and developing countries. Also, the timing of the lockdown is found to be vital. One the one hand, enforcing a nationwide lockdown too early, i.e., when cases are very low, may not yield expected outcome; on the other hand, enforcing lockdown too late is also ineffective. Conclusion:Even though this study does not find strong evidence of the effectiveness of lockdown in curbing infection growth in developing countries, these findings do not necessarily suggest that lockdown should not be enforced in developing countries. Rather it indicates that lockdown should be combined with other complementary measures such as contact tracing, extensive testing, income support for the poor, effective management of informal and migrant workers to make the lockdown effective. Merely declaring lockdown, without accompanying other must-have measures, will hurt the economy without contributing much to reducing the growth of infection.JEL Codes: H2, H3, I1, I3

Though most of the countries across the world are crippled with COVID-19, there has been substantial variations in death and infection rates. While some countries are overwhelmed, a few are spared. Little is known what explains this variation. This study attempts to understand the covariates of death and infection rates of COVID-19 across countries using multivariate regression analysis and least absolute shrinkage and selection operator (LASSO) regression. The OLS estimates show that the aging population and hospital bed per capita are significantly associated with the fatality rate of COVID-19, while urbanization has a positive correlation with the inflection rate. The study suggests that an increase in health systems capacity can significantly reduce the fatality rates due to COVID-19.

BackgroundOverweight and obesity of women is a growing concern all over the world. However, an understanding on the socio-economic inequalities in overweight and obesity of women received little attention, especially in the context of Bangladesh. Therefore, the objective of this study was to measure the inequality in overweight and obesity among women of reproductive age in Bangladesh as well as to explore the effect of various socio-economic factors on this inequality.MethodsThis study used data from the Bangladesh Demographic and Health Survey 2014 which is a nationally representative data. The concentration index of overweight and obesity was applied to measure the extent of socio-economic inequality. Finally, the concertation index was decomposed in order to understand the contribution of different socio-economic variables in inequality in overweight and obesity of women.ResultsThis study included a total of 16,624 women of reproductive age. The study found that the prevalence of overweight was about 29% and the rate of obesity was approximately 11%. The value of concentration index for overweight and obesity was 0.37 (p ConclusionsThis study found notable level of overweight and obesity among the women of Bangladesh. Various socio-economic factors like wealth status, education levels of women and partners, urban settings, women watching television predominantly contributed to the inequality in overweight and obesity among women of reproductive age. Therefore, the study suggests adopting necessary interventions targeting the women of higher socio-economic status to reduce the risk of life-threatening problems caused by overweight and obesity.

The extent of tobacco cultivation remains substantially high in Bangladesh, which is the 12th largest tobacco producer in the world. Using data from a household survey of current, former, and never tobacco farmers, based on a multi-stage stratified sampling design with a mix of purposive and random sampling of households, this study estimated the financial and economic profitability per acre of land used for tobacco cultivation. The environmental effects of tobacco cultivation on land and water resources were estimated using laboratory tests of sample water and soil collected from tobacco-cultivating and non-tobacco cultivating areas. The study finds that tobacco cultivation turns into a losing concern when the opportunity costs of unpaid family labour and other owned resources, and the health effects of tobacco cultivation are included. Tobacco cultivation poses a significantly high environmental cost that causes a net loss to society. Nevertheless, the availability of unpaid family labour and the options of advanced credit as well as a buy back guarantee from the tobacco companies attract farmers to engage in and continue tobacco cultivation. Therefore, supply side interventions to curb the tobacco epidemic in Bangladesh need to address major drivers of tobacco cultivation to correct the wrong incentives and motivate tobacco farmers to switch to alternative livelihood options.

In this projection exercise, we analyzed the circumstances of the COVID-19 pandemic in Bangladesh and used multiple methods to characterize the epidemic curve. We merged several publicly available data sets for the purpose. Projections using actual Government data as of June 16, 2020 reveals that the epidemic curve for Bangladesh may be different from that of developed countries and quite similar to such curves in countries in the region. This is true, both in terms of incidence of cases (total number of cases per million population) and length of the epidemic (months to peak or flatten the epidemic curve). We find that while Bangladesh went into lockdown early, efforts to maintain lockdown at a national level was relaxed and new cases accelerated; with significant growth happening since lifting of lockdown on May 31. Our estimates indicate prevalence of COVID-19 may be between 200,000 and 600,000 towards end of the year, may take 9 months (270 days) to flatten the epidemic curve, lifting of the lockdown may have increased total cases by 60 to 100% and may have prolonged the epidemic by additional 2-3 months.

We estimate the responsiveness of state and local property, income, and sales tax revenues to state gross domestic product (GDP) changes using U.S. Census data over the period 1967–2012. Long-run a...

Introduction There has been disagreement within academia in Bangladesh on whether the global economic recession of 2008-2009 came out as a bane or a boon to their economy and for their people, particularly workers in the ready-made garments (RMG) sector; therefore, we sought to conduct a study among currently employed and recently unemployed RMG workers to examine the influence of recession on their self-reported health status. Methods This cross-sectional study was conducted among 200 workers across 20 factories and 108 recently unemployed workers from different locations of Dhaka. Workers were selected based on a systematic sampling method from 20 randomly selected factories. Unemployed respondents were selected via snowball sampling. A questionnaire was prepared to cover different socio-demographic variables, which were then explored against an outcome variable of how the respondents rate their current health status (2009) compared with their past health status during the economic recession period (2008). A simple logistic regression was conducted for each of the independent variables with the outcome variable. Finally, all independent variables were loaded against the outcome variable, and multiple logistic regression was run. Results The only statistically significant predictor of self-reported health status was age, which indicated a 4% decrease (p = 0.05; 95% confidence interval (CI), 0.9203417 to 1.000015) in improved or better health with each year increase in age, holding other variables constant. Respondent health status was unchanged or even improved after the period of recession. The employed group had 1542.061 Taka (approximately $20) more average monthly family income than the unemployed group (two-sample t-test p-value 0.007), their health status was not affected (odds ratio (OR) 0.998; p-value 0.907). Conclusion The absence of an association between self-reported health status and economic recession is not uncommon, and explanations have been proposed for this phenomenon.

Introduction: Childhood undernutrition is a crucial public health problem globally. The objective of this study is to measure the prevalence of childhood undernutrition and assess the distinct role of various factors on childhood undernutrition in Bangladesh. Methods: This study utilized the latest cross-sectional data from Bangladesh Demographic and Health Survey 2014. A total of 7256 data on children younger than 5 years old were analyzed. The undernutrition status of children was assessed by stunting (height-for-age), wasting (weight-for-height), and underweight (weight-for-age), while bivariate and multivariate analyses were performed to identify various individual-, household-, and community-level factors of childhood undernutrition. Results: The prevalence of stunting, wasting, and underweight were 36.5%, 14.6%, and 32.5%, respectively. Along with various individual- and household-level factors (eg, age, recent diarrheal disease, fever, number of under-5 children in the household, mother’s education and nutritional status, and wealth status), community index, particularly regional and geographic variation of community, had significant role for childhood undernutrition in Bangladesh. Conclusion: Childhood undernutrition is an overwhelming public health issue in Bangladesh. In order to improve the nutritional status of under-5 children, interventions should take into account the various predictors discussed in this study. Indeed, a joint effort by the government, nongovernmental organizations, and the community is necessary to improve the childhood nutritional status in Bangladesh.

We analyze the spread of use-value assessment (UVA) programs applied to agricultural and rural land for property tax purposes across the 50 states. Taxing such land on the basis of its current use in agriculture rather than its full market value can confer significant property tax reductions on owners of the land. Effects are often substantial for land near large urban areas. Using a time-to-event model, we find, as others have posited, that a driving force behind the spread of UVA has been the secular trend toward urbanization across all 50 states. We also find that models of collective action do a good job of explaining the spread of UVA. Urbanization and divergence of the values of agricultural and nonagricultural land are critical to the spread of UVA. However, other important factors include changes in average farm size and changes in agriculture's share of state income. We find that in states where average farm sizes increased more rapidly, legislatures were quicker to adopt UVA. That finding is consistent with an increased concentration of agricultural interests. We also find that states where agriculture's share of state income declined more rapidly also were quicker to adopt UVA. That finding, too, is consistent with models of collective action. As groups become smaller, the burden of subsidizing them also falls. Note that although the findings are consistent with models of interest group behavior, they are at odds with traditional voting models.

Remittance is one of the popular issues in the development economics especially for the developing countries. This paper attempted at finding the relationship between remittance flow and economic development using time series data of 1976�2007. The two modern time series econometric approachesbound testing Autoregressive Distributed Lag Models or Unrestricted Error Correction Model and EngleGranger two step procedures for cointegration testwere exand this study finds that remittance is not significant contributing factor for the GDP per capita both in the short and long run. However, the foreign direct investment is found significant factor in the short, though it is not significant factor in the long run. This study suggests adopting necessary actions to ensure that remittances work as a contributing factor of economic development.

This paper examines how people in transition countries coped with the impacts of the global economic and financial crisis of 2008-2009. The data indicate that households in these countries were hit harder than those in other regions of the world. We consider how transition country households coped with the difficult circumstances, how their government social safety nets performed, and how the experience has affected their views on redistribution. The first research question examined is the performance of public safety nets in transition countries during the global economic crisis, estimating models explaining which citizens relied on specific safety net programs, including unemployment benefits, housing support, child support, and targeted social assistance programs. We also tackle the question of whether residents of transition countries have a strong taste for income redistribution via taxation as a form of insurance. We explicitly test the whether the possibility of upward mobility (POUM) hypothesis holds. Data used in this study are from the European Bank for Reconstruction and Development (EBRD) Life in Transition Survey (LITS I and LITS II for the years 2006 and 2010, respectively).

Business operations in transition countries are subject to numerous obstacles. This study uses enterprise-level data collected by the World Bank and the European Bank for Reconstruction and Development (EBRD) to analyze which potential obstacles are the greatest impediments and how firm and/or country characteristics are related to the severity of obstacles businesses encounter. The main data employed are from the 2009 Business Environment and Enterprise Performance Survey (BEEPS), augmented with country economic and other characteristics. The biggest obstacles identified by firms are tax rates, access to finance, political instability, competition from informal market firms, inadequately trained workforce, and corruption. For each of these obstacles, both firm and country characteristics are found to influence the severity of the reported obstacle. In addition, the data permit estimation of the impact of irregular payments to government officials in reducing reported impediments. Firms are found to be more likely to make irregular payments to officials when the reported severity of obstacles is greater. Based on the empirical findings reported, policy recommendations for reducing obstacles are presented.