The impact of COVID-19 on tourists’ length of stay and daily expenditures

This study evaluates the effect of the COVID-19 pandemic on tourists’ length of stay and daily expenditures at a destination. The paper compares detailed microdata for visitors to a Northern Spanish region in the summer periods of 2019 (pre-pandemic) and 2020 (after the pandemic outbreak). We estimate the pandemic-induced impacts on the length of stay and expenditures per person for several categories using regression adjustment, inverse probability weighting regression and propensity score matching. We find clear evidence of a drop in the length of stay of around 1.26 nights, representing a 23.8% decline. We also show that, although total expenditures per person and day have remained constant, there has been a change in the allocations for categories in the tourism budget.

Enhancing psychological resilience at the cusp of older ages: the role of social networks

Prior research has established a positive association between social support and psychological resilience. In this study, we seek to examine whether and to what extent aspects of individuals’ social network – specifically size (how many relatives and friends one has) and strength (how often did one communicate with close network members and at the time of important decisions) – are related to greater psychological resilience. We use data pertaining to 1,609 respondents from the Panel on Ageing and Transitions in Health Survey (PATHS), 2016–2017, a national study of 1,654 older midlife adults, aged 50–59, in Singapore. We estimate the relationship between social networks and psychological resilience, using inverse probability weighted regression adjustment to account for the possibility of a selection bias whereby individuals with larger or stronger social networks may be more resilient at the outset. We find that strong social networks are associated with greater psychological resilience among older midlife adults, regardless of the size of the network. Having a large social network is associated with greater resilience only if it is also a strong network. Maintaining stronger, even if small, social networks may enable individuals at the cusp of older ages to be better prepared to deal with stressful life events and challenges associated with older midlife.

Advanced Placement Course Credit and Undergraduate Student Success in Gateway Science Courses

Approximately two million students take Advanced Placement (AP) examinations annually. However, departmental policies that allow students to replace introductory courses with AP credit greatly vary within and across universities, even across relatively similar universities. This study examines the impact of AP credit policies on subsequent course success in Biology, Chemistry, and Physics at six large public research universities (N = 48,230 students). Examining average treatment effects for students skipping college courses using inverse-probability weights with regression adjustment, we found that students who skipped actually performed similarly well or better in subsequent courses than students who did not skip, even in contexts where lower AP scores were accepted. We also discovered wide variation in percentage of students who chose to skip when meeting their local policies. Therefore, to reduce unnecessary coursework that is burdensome for both students and universities, we suggest that departments consider modifying AP credit policies and that advisors consider encouraging students to skip when they have eligible AP scores.

How robust is the association between youth unemployment and later mental health? An analysis of longitudinal data from English schoolchildren

BackgroundSeveral studies show that youth unemployment is associated with worse mental health later in life. However, existing studies report results for only one model, or a few models, and use regression adjustment to support causal claims. We use two novel methods to address these gaps in the literature.MethodsWe use data from Next Steps, a cohort study of English schoolchildren who entered the labour market in the aftermath of the 2008–2009 global financial crisis, and measure mental health using the 12-item General Health Questionnaire (GHQ-12) at age 25. We use specification curve analysis and a negative control outcome design (a form of placebo test) to test whether associations between youth unemployment and later GHQ-12 scores are sensitive to model specification or are likely to be confounded by unobserved factors.ResultsWe find that the association between unemployment and later GHQ-12 is qualitatively similar across 99.96% of the 120 000 models we run. Statistically significant associations with two placebo outcomes, height and patience, are not present when regression adjustments are made.ConclusionsThere is clear evidence that youth unemployment is related to later mental health, and some evidence that this cannot be easily explained by unobserved confounding.

The Livelihoods Impacts of Irrigation in Western Africa: The Ghana Experience

Although agriculture remains the mainstay of the African economy, it is currently going through stress because of a multitude of factors including climate change. Thus, many countries in their efforts to transform their agricultural sectors are employing climate-smart initiatives including the provision of water harvesting technologies for irrigated crop production during the dry season. This paper examines the role of irrigation in the drive towards a transformation of smallholder agriculture in Africa. Focus group discussions, key informant interviews and individual questionnaires were employed for the data collection. The data were analyzed using the regression adjustment (RA) technique. The results indicate that irrigation has significant and positive impacts on farm incomes, employment, consumption, food security and non-farm businesses, all of which are necessary conditions for a successful transformation of smallholder agriculture in Africa. The impacts of irrigation on health and environmental sustainability are mixed—the positive being the ability of irrigators to pay for improved healthcare for their families and the negatives include the outbreak of waterborne diseases associated with irrigation water. Construction of irrigation facilities causes destruction to the environment but improves provisioning ecosystem services. It is generally concluded that access to irrigation is associated with higher farm incomes, employment, consumption, food security and engagement in non-farm business activities. The key policy implication of these findings is that African governments must formulate strategic policies that will accelerate investments in the provision of irrigation facilities to better promote the agenda to transform smallholder agriculture in the continent.

Age- and gender-dependent association of SLC11A1 polymorphisms with tuberculosis susceptibility

Background: Tuberculosis (TB) is an important health issue in our world. It is reported that various factors may effect on its pathogenesis. In this current study, we aimed to investigate the association between SLC11A1 polymorphism and the risk of TB among 510 TB patients and 508 healthy controls.Methods: Agena MassARRAY platform was conducted for genotyping. Odds ratios (ORs) and 95% confidence intervals (CIs) were analyzed through unconditional logistic regression adjustment confound factors, such as age and gender.Results: The results suggested that the allele and genotype frequencies of polymorphisms in SLC11A1 were not observed associated with TB risk. Subsequently, stratified analysis by age and gender confirmed that rs7608307 “A/A” and “C/T-T/T” genotypes were related with increased TB risk in age ≤ 41 group (p = 0.021) and males (p = 0.013), respectively. Besides, rs13062 “A/A” genotype was reduced TB risk in age > 41 group (p = 0.043). In addition, we observed that the “C/C” genotype of rs4674301 was noteworthy correlated with increased TB risk in females (p = 0.043). Conclusion: Our results demonstrated the relationship between SLC11A1 polymorphism and TB risk and confirmed for the first time that the correlation was restricted to age and gender in northwest Chinese population.

Examining the effectiveness of telemonitoring with routinely acquired blood pressure data in primary care: challenges in the statistical analysis

Background Scale-up BP was a quasi-experimental implementation study, following a successful randomised controlled trial of the roll-out of telemonitoring in primary care across Lothian, Scotland. Our primary objective was to assess the effect of telemonitoring on blood pressure (BP) control using routinely collected data. Telemonitored systolic and diastolic BP were compared with surgery BP measurements from patients not using telemonitoring (comparator patients). The statistical analysis and interpretation of findings was challenging due to the broad range of biases potentially influencing the results, including differences in the frequency of readings, ‘white coat effect’, end digit preference, and missing data. Methods Four different statistical methods were employed in order to minimise the impact of these biases on the comparison between telemonitoring and comparator groups. These methods were “standardisation with stratification”, “standardisation with matching”, “regression adjustment for propensity score” and “random coefficient modelling”. The first three methods standardised the groups so that all participants provided exactly two measurements at baseline and 6–12 months follow-up prior to analysis. The fourth analysis used linear mixed modelling based on all available data. Results The standardisation with stratification analysis showed a significantly lower systolic BP in telemonitoring patients at 6–12 months follow-up (-4.06, 95% CI -6.30 to -1.82, p < 0.001) for patients with systolic BP below 135 at baseline. For the standardisation with matching and regression adjustment for propensity score analyses, systolic BP was significantly lower overall (− 5.96, 95% CI -8.36 to − 3.55 , p < 0.001) and (− 3.73, 95% CI− 5.34 to − 2.13, p < 0.001) respectively, even after assuming that − 5 of the difference was due to ‘white coat effect’. For the random coefficient modelling, the improvement in systolic BP was estimated to be -3.37 (95% CI -5.41 to -1.33 , p < 0.001) after 1 year. Conclusions The four analyses provide additional evidence for the effectiveness of telemonitoring in controlling BP in routine primary care. The random coefficient analysis is particularly recommended due to its ability to utilise all available data. However, adjusting for the complex array of biases was difficult. Researchers should appreciate the potential for bias in implementation studies and seek to acquire a detailed understanding of the study context in order to design appropriate analytical approaches.

Association between admission blood fibrinogen-to-albumin ratio and clinical outcomes after acute lacunar stroke

Aim: We aimed to investigate the influence of admission fibrinogen-to-albumin ratio (FAR) on 3-month outcomes after acute lacunar stroke. Materials & methods: Consecutive patients with acute lacunar stroke were included and classified into two groups according to an optimized FAR cut-off value determined by receiver operating characteristic curve analysis. Results: Compared with those with low FAR (<0.077), patients from the high FAR group (≥0.077) had significantly higher risk for 3-month disability and the composite outcome of death/disability. After logistic regression adjustment, high FAR was still significantly associated with 3-month disability and death/disability. Conclusion: FAR ≥0.077 on admission might be an independent predictor of disability and death/disability at 3 months after lacunar stroke, which needs to be verified in future studies.