The project described in the paper is the first attempt to provide an economic evaluation of export-crop research in PNG. The institutional framework is outlined to provide a context for understanding the methods used. Past performance of two agricultural research projects was assessed and then eleven ex ante research evaluations were performed. After reviewing the overall results, suggestions are made for institutionalising research evaluation procedures at various levels of the public administration system.
USTRACT. The roles of statutory marketing authorities (SMAs) in agricultural sectors of developing countries are increasingly coming under scrutiny. Some countries have even begun to d~smantle such institutions, or at least restrict. their operations and owers. It is timely, .therefore, to review the background and per f ormance of these auihorities, as a prelude to an assessment of their possible future role in agricultural development.A wide sample of documenta evidence is assembled containing evidence on the performance o r statutory marketing authorities in developing country agriculture. Activities of the various authorities have been examined in both the food and export cash crop markets.It is concluded that there is little evidence that SMAs have achieved significant improvement in most marketing functions, and a good deal of evidence that they have worsened marketing performance. These findings raise fundamental questions about their future status as vehicles for agricultural development.
BACKGROUND AND HISTORY
Importance: The Defense and Veterans Brain Injury Center reported 358,088 mild traumatic brain injury (mTBI) among U.S. service members worldwide between the years 2000 and 2020. Veterans with mTBI have higher rates of Post-Traumatic Stress Disorder (PTSD), depressive disorder, substance use disorder, anxiety disorder, and suicide than their healthy counterparts. Currently, there is no effective treatment for mTBI. Objective: To assess the efficacy of hyperbaric oxygen therapy (HBOT) as a treatment option for mTBI. Design, Setting, Participants: This is a case series of 39 U.S. Veterans diagnosed with mTBI and treated with HBOT. Of these participants, 36 were men and 3 women, and their ages ranged between 28 and 69. The treatment was administered by The 22 Project (a veteran-centered nonprofit organization) using monoplace hyperbaric chambers located in Delray Beach, Florida. Neuroimaging using Single Photon Emission Computer Tomography (SPECT) brain scans performed pre- and post-HBOT were made available for secondary analysis. Nilearn Python Library was utilized to visualize the corresponding neuroimaging data. A two-sided paired t-test in R was used to compare the pre- and post-treatment results. Intervention: A full treatment of HBOT involved 40 sessions. Each session consisted of the administration of 100% oxygen at 1.5 atmospheres for 90 min, twice a day, for 20 days, Mondays to Fridays only. Main Outcome and Measure: Perfusion in the brain’s Brodmann Areas (BA) comparing pre- and post-HBOT using NeuroGam software analysis from brain SPECT scan neuroimaging and multi-symptom self-reports. Results: A comparison between the pre- and post-HBOT brain scans showed significant improvement in the brain perfusion, and the difference was statistically significant (p < 0.001). Separately, participants reported reduced pain, improved mood, and better sleep, an outcome that translated into an average of about 46.6% improvement in the measured symptoms. Conclusions and Relevance: This series demonstrated that HBOT could be a useful treatment for mTBI in U.S. veterans. The participants in the study showed marked improvement in both brain perfusion measured on SPECT scan imaging and measured mTBI symptoms. This is the first study to use brain SPECT scans with quantitative numerical measurements to demonstrate improvement in brain perfusion in veterans with mild TBI treated with HBOT and measured mTBI symptoms. Future research studies are currently being done to validate these important findings.
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