Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. Terms of use: Documents in EconStor may AbstractIncreasing labor migration and simultaneous aging of societies are two important demographic developments many poor countries face. Elderly people who are left behind may experience a decrease in welfare when their children migrate. This paper investigates the effect of migration on various dimensions of elderly health using unique data from Moldova, which has one of the highest emigration rates in the world. We find positive migration effects on the body mass index (BMI), mobility and self-reported health. No effects are found on depression and cognitive capacity. We trace these positive outcomes to an income effect which leads to improvements in diet and a reallocation of time use from subsistence farming to leisure and sleep. These positive effects seem to compensate the elderly for decreasing social contact with their migrant family members.
IntroductionThe effectiveness of Video Observed Therapy (VOT) for treating Tuberculosis (TB) has not been measured in low and middle-income countries (LMICs), where more than 95% of TB cases and deaths occur. In this study, we analyse the effectiveness, and patient cost-difference, of VOT compared to clinic-based Directly Observed Therapy (DOT) in improving medication adherence in Moldova, a LMIC in Eastern Europe.MethodsThe study was a 2-arm individually randomised trial with 197 TB patients (n=99 in DOT control group; 98 in VOT treatment group, MDR-TB cases were excluded). The primary outcome was observed medication adherence, measured by the number of days that a patient failed to be observed adhering to medication for every two-week period during the course of their treatmentResultsVOT significantly decreased non-adherence by 4 days (95% CI, 3.35 to 4.67 days; p<0.01) per two-week period: 5.24 days missed per two-week period for DOT and 1.29 days for VOT. VOT patients spent 504 Moldovan Leu (MDL) (approximately €25; 95% CI, 277 to 730 MDL; p<0.01) and 58 h (95% CI, 48 to 68 h; p<0.01) less on their treatment. VOT also increased self-reported satisfaction with treatment. We found no significant results pertaining to treatment success, patient well-being or patient employment status and some evidence of an increase in side effects.DiscussionIn this trial, Video Observed Therapy (VOT) increased observed medication adherence for tuberculosis patients in Moldova, a LMIC, when compared to clinic-based Directly Observed Therapy (DOT). VOT also significantly reduced the time and money patients spent on their treatment.
Introduction: The Republic of Moldova is among the 18 high priority countries for tuberculosis (TB) in Europe. This study compared adherence and short and long-term TB treatment outcomes for TB patients who experienced asynchronous Video Observed Treatment (aVOT) during three months of outpatient treatment versus Directly Observed Treatment (DOT) in operational conditions in 2016-2017 in Chisinau. Methodology: We used secondary data from the 2016-2017 Randomized Clinical Trial (RCT) that piloted the aVOT Strategy in Chisinau and data from the national TB register. Relative risk was selected as a measure of association in analysis of treatment strategies (aVOT and DOT under operational conditions) and short and long-term treatment outcomes. Results: From 647 TB patients included in the study, 169 followed the treatment strategy in the RCT (83 in aVOT and 86 in DOT) and 478 were on DOT in operational conditions. Those in aVOT were more likely to have favourable short-term outcome than patients with DOT in operational conditions (RR 0.07; p < 0.001). TB recurrence as an indicator for the long-term outcome, was observed in group with DOT in operational conditions (40 cases, p = 0.006). Conclusions: This study demonstrated that the aVOT treatment strategy was associated with better adherence and both short and long-term TB treatment favourable outcomes. aVOT as a new patient-centred approach supporting TB patients on improving treatment adherence and outcomes might be recommended as an alternative to DOT strategy in the Republic of Moldova.
In Indonesia, as in other countries, a large proportion of tax returns are filed at the last minute. In a population-wide randomised controlled trial (n = 11,157,069), we evaluated the impact of behavioural email prompts on the proportion of annual tax returns filed at least two weeks before the deadline; and overall filing rate. In two control conditions, taxpayers either received no email or an email used in prior years, emphasising regulatory information. The five treatments informed by behavioural science were (1) a simplified version of the existing email, emphasising early filing; (2) the simplified version with additional guidance on filing taxes; (3) the simplified version with a planning prompt and option to sign up for email reminders; (4) a version combining treatments 1, 2 and 3; and (5) an email appealing to national pride. Compared to the no-email control, all emails led to a statistically significant increase in early and overall filing rates. The planning email (3) was the most effective, increasing early filling from 34.9% to 37% (b 2.07 percentage points (pp), p < 0.001, 95% confidence interval (CI) 1.97–2.17pp), and overall filing from 65.6% to 66.7% (b 1.10pp, p < 0.001, 95% CI 0.99–1.19pp).
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