Wednesday, July 31, 2019
Cooperative Banks
WP/07/2 Cooperative Banks and Financial Stability Heiko Hesse and Martin Cihak à © 2007 International Monetary Fund WP/07/2 IMF Working Paper Monetary and Capital Markets Department Cooperative Banks and Financial Stability Prepared by Heiko Hesse and Martin Cihak1 Authorized for distribution by Mark W. Swinburne January 2007 Abstract This Working Paper should not be reported as representing the views of the IMF. The views expressed in this Working Paper are those of the author(s) and do not necessarily represent those of the IMF or IMF policy.Working Papers describe research in progress by the author(s) and are published to elicit comments and to further debate. Cooperative banks are an important, and growing, part of many financial systems. This paper empirically analyzes the role of cooperative banks in financial stability. Contrary to some suggestions in the literature, we find that cooperative banks are more stable than commercial banks. This finding is due to the lower volatil ity of the cooperative banksââ¬â¢ returns, which more than offsets their lower profitability and capitalization.This is most likely due to cooperative banksââ¬â¢ ability to use customer surplus as a cushion in weaker periods. We also find that in systems with a high presence of cooperative banks, weak commercial banks are less stable than they would be otherwise. The overall impact of a higher cooperative presence on bank stability is positive on average but insignificant in some specifications. JEL Classification Numbers: G21, P13 Keywords: financial sector stability, cooperative banks, commercial banks, savings banks Authorââ¬â¢s E-Mail Address: [emailà protected] org; [emailà protected] rg 1 We are indebted to Klaus Schaeck for useful discussions during the early stages of the project. We also thank the following for their comments: Edward Al-Hussainy, Thorsten Beck, Ralf Elsas, Wim Fonteyne, Francois Haas, Patrick Honohan, Plamen Iossifov, Alain Ize, Barry Johnston, Luc Laeven, Eduardo Ley, Andrea Maechler, Paul Mills, John Muellbauer, Miguel Segoviano, Mark Swinburne, Alexander Tieman, and participants in an IMF seminar and a conference entitled ââ¬Å"Public versus Private Ownership of Financial Institutionsâ⬠in Frankfurt in November 2006. Contents Page I. Motivation and Literature Overview â⬠¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦.. 3 II. Data and Methodology â⬠¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦. 6 A. Data â⬠¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦ 6 B. Measuring Bank Stabilityâ⬠¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦ C. Methodology â⬠¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦. 8 III. Resultsâ⬠¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦.. 11 A. Decomposition of Z-Scores and Correlation Analysis â⬠¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦. 11 B. Regression Analysis â⬠¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦ 14 IV.Conclusions and Topics for Further Researchâ⬠¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦. 18 Referencesâ⬠¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦.. 35 Tables 1. Summary Statistics of Bank-Specific Variables in the Sample, 1994ââ¬â2004 â⬠¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â ¬ ¦ 20 2. Decomposition of Z-Scores for the Full Sample, 1994ââ¬â2004 â⬠¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦. 21 3. Decomposition of Z-Scores for Selected Countries, 1994ââ¬â2004â⬠¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦ 2 4. Sensitivity of the Z-score Decompositionâ⬠¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦.. 23 5. Fitch: Long-Term Ratings: Distribution of the Banks in Sampleâ⬠¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦.. 24 6. Correlation Coefficients between the Z-Score and Selected Key Variables, 1994ââ¬â2004â⬠¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦. 25 7. Regression Results (Full Sample)â⬠¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦.. 6 8. OECD Regressions with Governance Variable â⬠¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦.. 27 9. Regression Results (Large Banks) â⬠¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦. 28 10. Regression Results (Small Banks) â⬠¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦. 29 11. Robust Regressionsâ⬠¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â ¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦ 30 12.Quantile Regressions (Full Sample) â⬠¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦. 31 Figure 1. Cooperative Banks: Retail Market Shares in Selected Countriesâ⬠¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦.. 3 Appendix I. Data Issuesâ⬠¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦ 32 3 I. MOTIVATION AND LITERATURE OVERVIEW Cooperative (mutual ) banks are an important part of many financial systems. 2 In a number of countries, they are among the largest financial institutions when considered as a group.Moreover, the share of cooperative banks has been increasing in recent years; in the sample of banks in advanced economies and emerging markets analyzed in this paper, the market share of cooperative banks in terms of total banking sector assets increased from about 9 percent in the mid-1990s to about 14 percent in 2004. Cooperative banks are particularly numerous and large in Europe. The five largest cooperative banks in the European Union (EU) rank among the EUââ¬â¢s top 25 banking groups in terms of consolidated equity.Reflecting the cooperative banksââ¬â¢ focus on retail banking, their market share in retail business is even more substantial: for example, five EU member countries have more than a 40 percent market share of cooperative banks in terms of branch networks (Figure 1). In non-European advanced economies and emerging markets, the share of cooperative banks is generally lower, but there are several countries where they play a non-negligible role. 3 Figure 1. Cooperative Banks: Retail Market Shares in Selected Countries 70 Percent of all branches 60 50 40 30 20 10 Netherlands Finland Germany Portugal 0 Austria France Spain Greece ItalySource: OECDââ¬â¢s Bank Profitability Report; and authorsââ¬â¢ calculations. We use the term ââ¬Å"cooperative bankâ⬠to include also credit unions. The main distinctive feature of credit unions is that their customers are identical with members. In other cooperative banks, not all customers are members. For more background on institutional history and structure of cooperative (mutual) banking, see Fonteyne (forthcoming) and Cuevas and Fischer (2006). 3 2 4 The importance of cooperative banksââ¬âand in particular the implications of their specific nature for financial stabilityââ¬âhas not yet received appropriate attention in the emp irical literature.The literature devotes disproportionately little attention to cooperative banks in comparison with commercial banks, smaller than would correspond, for example, to their market share. For example, only about 0. 1 percent of all banking-related entries in EconLit, a major database of economic research, relates to cooperative banking. 4 This contrasts with the share of cooperative banks, which account on average for about 10 percent of banking system assets in advanced economies and emerging markets, reaching as much as 30 percent in some countries in terms of assets (and even more in terms of branchesââ¬âsee Figure 1).Most of the EconLit entries devoted to cooperative banks deal with specific country cases or with issues relating to efficiency rather than those relating to financial stability. For example, Brunner and others (2004) analyze revenue and cost efficiency of cooperative banks in France, Germany, Italy, and Spain, finding that cooperative banks are no t less effective at managing revenues and costs than commercial banks. The regulatory framework, including the recent amendments, is also generally designed with commercial banks in mind.For example, the third pillar of the New Basel Capital Accord (Basel II)ââ¬âwhich relies on extensive disclosure to ensure that banks are subject to market disciplineââ¬âhas significantly reduced effectiveness in the case of cooperative banks (Fonteyne, 2007). Cooperativesââ¬â¢ disclosure practices and requirements are substantially below those of commercial banks, especially listed ones. Even if disclosure were adequate, there are rarely markets that could exert effective disciplining pressure.Shareholder pressure cannot be relied upon and cooperatives do not rely much on interbank markets or debt issuance as sources of funds. Finally, loyal and insured retail depositors are not likely to exert an effective market disciplining effect either at an early enough stage. Macroprudential work on financial systems, such as the IMFââ¬â¢s Financial System Stability Assessment reports (FSSAs), Article IV staff reports, and the Global Financial Stability Report, as well as reports on financial stability published by central banks (for a survey, see Cihak, 2006) pay relatively little attention to cooperative banks.Fonteyne (forthcoming) cites the FSSAs for France and Germany as two reports that devoted some attention to cooperative banks; however, the references to cooperative banks in those reports focused on mutual support and deposit insurance mechanisms, efficiency, and financial sector consolidation issues, rather than on financial stability implications.Several authors have noted in passing the potential of cooperative banks to increase the fragility of financial systems. For example, commenting on a finding by Barth, Caprio, and A search of the EconLit database was carried out on June 15, 2006, looking for all entries that had ââ¬Å"banksâ⬠or ââ¬Å"bankingâ⠬ among keywords or in the abstract. A search was then run for those that referred to ââ¬Å"cooperative banks,â⬠ââ¬Å"cooperative banking,â⬠or ââ¬Å"mutual financial institution(s). â⬠4 5Levine (1999) that a higher degree of government ownership of banks tends to be associated with higher fragility of financial systems, Goodhart (2004) interprets this result as perhaps indicating that the presence of any non-profit-maximizing banking entities may make financial systems more fragile. Goodhart does not elaborate on the underlying mechanism of this relationship between the presence of non-profit-maximizing entities and financial stability, but possible mechanisms are not difficult to envision in the case of cooperative banks.Cooperative banksââ¬â¢ stated objective is not to maximize profits, but rather their membersââ¬â¢ consumer surplus; this is in some cases complemented by additional objectives that seek to contribute to the well-being of stakeholders o ther than member-consumers, such as employees. 5 If a cooperative bankââ¬â¢s pursuit of objectives other than profit maximization results in very low profitability, its balance sheet risks grow faster than its capital, leading to deteriorating solvency.If cooperative banks accept lower profitability as the price to pay for delivering financial services at below-market prices to retail clients, they may pull down the profitability of the banking system, with negative repercussions for other banksââ¬â¢ soundness. The literatureââ¬â¢s verdict on cooperative banksââ¬â¢ role in financial stability is less than clear. Several papers suggest that cooperative banks may have more difficulties adjusting to adverse circumstances and changing risks.For example, Brunner and others (2004) note that the Swedish cooperative banking sector did not survive the crisis of the early 1990s in a cooperative form, as it faced high marginal costs of capitalââ¬âthe need to restore capital was a major factor in the decision to demutualize. Fonteyne (forthcoming) suggests that cooperative banks may be more vulnerable to shocks in credit quality and interest rates, because they are more focused on traditional financial intermediation than other institutions, and therefore have higher exposures to credit and interest rate risk.At the same time, several studies suggest that cooperative banks have generally lower incentives to take on risks. For example, Hansmann (1996) and Chaddad and Cook (2004) find that mutual financial institutions in the United States tend to adopt less risky strategies than demutualized ones. Whether cooperative banks have a positive or negative impact on financial stability therefore remains an empirical question. We address this question by analyzing individual bank data for major advanced economies and emerging markets. We examine two related issues:In addition, some authors have suggested that due to relatively less oversight by members, as opposed to owners in a commercial bank, managers in cooperative banks may be more likely to pursue their own goals (e. g. , ââ¬Å"empire buildingâ⬠) rather than membersââ¬â¢ interests, potentially hurting their stability. Fonteyne (forthcoming) discusses cooperative banksââ¬â¢ objective functions in more details and summarizes the relevant literature. 5 6 â⬠¢ Cooperative banksââ¬â¢ soundness and resilience to stress. We test the hypothesis that cooperative banks are relatively weaker in responding to stress because of the features of their business model.Cooperative banksââ¬â¢ impact on other banks. We test the hypothesis that the presence of cooperative banks reduces the stability of other banks. As explained, this may be, for example, because the cooperative banks use their lower average cost of capital to pursue aggressive expansion plans that may weaken other financial institutions. â⬠¢ The remainder of the paper is structured as follows. Section II introduces the data and variables used in the paper (characterized in more detail in Appendix I), and presents the estimation methodology. Section III presents the empirical results.Section IV sums up the conclusions, and suggests topics for further research. II. DATA AND METHODOLOGY A. Data Our calculations are based on individual bank data drawn from the BankScope database, provided by Bureau van Dijk. We use data on all commercial, cooperative, and savings banks in the database from 29 major advanced economies and emerging markets that are members of the Organization for Economic Cooperation and Development (OECD). 6 In total, we have data on 16,577 banks from 1994 to 2004, comprising 11,090 commercial banks, 3,072 cooperative banks, and 2,415 savings banks.Several general issues relating to the BankScope data need to be mentioned. First, the database, while being the most comprehensive commercially available database of banking sector data, is not exhaustive. Coverage varies from country to country; for most countries in our sample, the BankScope data cover 80 to 90 percent of the total banking system assets, and the coverage of cooperative banks is lower than for commercial banks (in particular, only a small number of cooperative banks is included in the United States). However, the coverage of our paper is still higher than in most banking studies (and in particular studies that focus on banks with particular features, such as large banks or banks that are listed on stock market), and even for cooperative banks our sample captures a majority in terms of total assets. We therefore believe the sample is comprehensive enough to make reliable inferences. 6 7 See Appendix I for a list of the OECD member countries.Also, our sample does not cover some specialized types of banking institutions, such as development banks or specialized investment companies (even though our analysis covers, for example, investment banking activities carried out by commercial banks on their balance sheet). 7 Second, BankScope gives the specialization (status) of a bank in the sample (commercial, cooperative, and savings) in the current year. Therefore, it is for instance likely that the commercial bank subset contains some banks that have been cooperative or savings banks in earlier periods.Where information was available, we adjusted the status of a bank accordingly. For example, France was subject to a banking reform in June 1999 in which all savings banks were converted into cooperative banks. The Alliance & Leicester (United Kingdom) as well as First National (Ireland) Building Societies were demutualized and were stock market listed in 1997 and 1998, respectively. Given the large number of banks in the sample, it was not possible to individually check potential changes in specialization over time. However, we do not think that this limitation of the BankScope dataset biases the results.Third, our analysis is based on unconsolidated bank statements. Ideally, we wou ld have opted for consolidated statements whereby the parent company integrates the statements of its subsidiaries. However, given that about 90 percent of BankScope observations for the selected countries and periods are based on unconsolidated data, we focus on results based on unconsolidated data. Nonetheless, we have also performed the same calculations with consolidated data, and obtained very similar results (available upon request). In addition to the bank-by-bank data, we also use a number of macroeconomic and other system-wide indicators.Those are described in more detail in Appendix I. B. Measuring Bank Stability Our primary dependent variable is the z-score as a measure of individual bank risk. The zscore has become a popular measure of bank soundness (see Boyd and Runkle, 1993; Maechler, Mitra, and Worrell, 2005; Beck and Laeven, 2006; Laeven and Levine, 2006; and Mercieca, Schaeck, and Wolfe, forthcoming). Its popularity stems from the fact that it is directly related t o the probability of a bankââ¬â¢s insolvency, i. e. , the probability that the value of its assets becomes lower than the value of the debt.The z-score can be summarized as z? (k+à µ)/? , where k is equity capital as percent of assets, à µ is average after-tax return as percent on assets, and ? is standard deviation of the after-tax return on assets, as a proxy for return volatility. The z-score measures the number of standard deviations a return realization has to fall in order to deplete equity, under the assumption of normality of banksââ¬â¢ returns. A higher z-score corresponds to a lower upper bound of insolvency riskââ¬âa higher z-score therefore implies a lower probability of insolvency risk. For banks listed in liquid equity markets, a popular version of the z-score is distance-to-default, which uses stock price data to estimate the volatility in the economic capital of the bank (Denmark National Bank, 2004). 8 (continuedâ⬠¦) 8 One issue relating to the use o f z-scores for analyzing cooperative banks is whether the zscores are a fair measure of soundness across different groups of institutions, in particular given that cooperative banks are much less focused on returns and profitability than commercial banks.We think that the z-score is an objective measure, as all banks (cooperative, commercial, and savings), face the same risk of insolvency in case they run out of capital. This is exactly the risk captured by the z-score, which has the same methodology for any type of bank. If an institution ââ¬Å"choosesâ⬠to have lower risk-adjusted returns, it can still have the same or higher z-score if it has a higher capitalization. C.Methodology We start by two preliminary steps: a decomposition of observed differences in z-scores into the underlying factors (capitalization, returns, and volatility of returns), and a calculation of correlation coefficients between z-scores and other variables of interest. The main part of our approach is to test the two hypotheses outlined in the introduction (Section I) using regressions of z-scores on a number of explanatory variables. We estimate a general class of panel models of the form z i , j ,t = ? + ? Bi , j ,t ? 1 + ? I j ,t ? 1 + ? ? s Ts + ? ? s Ts I j ,t ? 1 + ? ? s Ts Bi , j ,t ? 1 + ?M j ,t ? 1 + ? ? j C j + ? ? t Dt + ? i , j ,t where the dependent variable is the z-score z i , j ,t for bank i in country j and at time t; Bi , j ,t ? 1 is a vector of bank-specific variables; I jt ? 1 are time-varying banking industry-specific variables in country j; Ts , Ts I j ,t ? 1 and Ts Bi , j ,t ? 1 are the type of banks and the interaction between the type and some of the industry-specific variables as well as bank-specific variables, respectively; M j ,t , C j , and Dt are vectors of macroeconomic variables, country, and yearly dummy variables, respectively; and ? i , j ,t is the residual.To distinguish the impact of bank type on the z-score, we include two dummy variables. T he first dummy variable takes the value of 1 if the bank in question is a commercial bank, and 0 otherwise; the second one takes the value of 1 for savings banks, and 0 otherwise. If cooperative banks are relatively weaker than commercial (or savings) banks, the first (second) dummy variable would have a positive sign in the regression explaining z-scores. For most cooperative banks, however, market price data are not available. This paper therefore relies on the specification of the z-score that relies only on accounting data. At the systemic (country) level, we want to examine cooperative banksââ¬â¢ impact on other banks and the hypothesis that the presence of cooperative banks lowers systemic stability. For this reason, we have calculated the market share of cooperative banks by assets for each year and country and interacted it with the commercial bank dummy. For example, a negative sign of the sum of the coefficients of the cooperative banksââ¬â¢ market share and its inte raction with the commercial bank dummy would indicate a decrease in commercial banksââ¬â¢ stability (in their z-scores).In addition to these key variables of interest, the regression includes a number of other control variables, both on individual bank level and on country level. Appendix I provides a description of the variables. To control for bank-level differences in bank size, asset composition, and cost efficiency, we include the bankââ¬â¢s asset size in billions of U. S. dollars, loans over assets, and the cost-income ratio. Also, to control for differences in structure of banksââ¬â¢ income, we calculate a measure of income diversity that follows Laeven and Levine (forthcoming). The variable measures the degree to which banks diversify from traditional lending activities (those generating net interest income) to other activities. To further capture differences of cooperative banks in their business orientation, we interact the income diversity variable with the coope rative bank dummy. Controlling for these variables is important because there are differences in these variables between cooperative banks and the other groups. For example, commercial banks are on average larger than cooperative banks throughout the sample period.Similarly, the asset size of cooperatives is less volatile than for commercial banks but significantly more volatile than for savings banks. We want to adjust for the differences in these variables to ensure that we capture the ââ¬Å"pureâ⬠impact of the bankââ¬â¢s legal form (commercial, cooperative, or savings) on stability. 10 Table 1 shows the summary statistics of the bank-specific variables by type of bank. On the country level, we also adjust for the impact of the macroeconomic cycle by including a number of macroeconomic variables (GDP growth rate, inflation, the real long-term interest rate, and exchange rate appreciation).To account for cross-country variation in z-scores caused by differences in market concentration, we include the Herfindahl index, defined as the sum of squared market shares (in terms of total assets) of all banks in the country. 11 9 The income diversity measure is defined as 1 ? (Net interest income ? Other operating income ) . Higher values of Total operating income the variable correspond to a higher degree of diversification. 10For completeness, we have also tested whether the impact of bank-specific variables such as asset size is different for the different types of banks (by multiplying the asset size with the relevant dummy variables), but this has not led to any significantly robust results. We do not have a strong prior on the impact of the Herfindahl index, because the existing literature contains two contrasting views on the relationship between concentration and stability. For example, Allen and Gale (2004) put forth theoretical arguments why more concentrated markets are likely to be more stable, and Beck, 11 (continuedâ⬠¦) 0 In separate regres sions, we account for the quality of corporate governance in a country, using a popular indicator by Kaufmann, Kraay, and Mastruzzi (2005). The authors provide six governance measures (voice and accountability, political stability, government effectiveness, regulatory quality, rule of law, and control of corruption). We average the six measures across the available years (2004, 2002, 2000, 1998, and 1996) into one single index per country. The governance indicator should capture cross-country differences in institutional developments that might have an effect on banking risk.All bank-specific and macroeconomic variables, the Herfindahl index, and the cooperativesââ¬â¢ market share and its interaction with the commercial bank dummy are lagged to capture possible past effects of these variables on the banksââ¬â¢ risk. We also test for the robustness of the lagged effects by restricting the explanatory variables to contemporaneous effects. Across the whole sample, most observatio ns of the z-score are found in the 20ââ¬â80 range; however, there are some extreme observations, resulting in the sample range being from -81 to 14,811 with an average of 57.This leads to the question whether to eliminate observations at the extreme end of the z-score distribution. On one hand, we are interested in situations of instability, and therefore would like to include extreme observations; on the other hand, some of the extreme observations may be due to very specific, one-off events, or sometimes data errors. To assess the robustness of our results with respect to the outliers, we have done all the calculations both for the full sample and for a sample that excludes the most extreme outliers.To keep the presentation succinct, this paper presents results for a sample that eliminates the 1st and 99th percentile from the distribution of the z-score. The results for the full sample including those extreme outliers are available from the authors; the main conclusions are th e same for both approaches. To further assess the robustness of the results with respect to the selected sample, we estimate the same regression for different country samples, and different bank size samples. We start with the widest sample that includes all OECD countries (except Slovakia, for which the BankScope contains no data on cooperative banks).We then estimate the same regression for the Euro area (EU12),12 and for countries where the cooperativesââ¬â¢ market share Demirguc-Kunt, and Levine (2005) provide empirical results consistent with the view that more concentration is associated with more financial stability. Contrary to these findings, for example, Boyd and de Nicolo (forthcoming) and Mishkin (1999) suggest that too concentrated systems can be characterized by increased risktaking behavior by banks. 12 We have also carried out all the estimates for EU15 countries (EU12, Denmark, Sweden, and the United Kingdom).The results have not been substantially different from those for EU12 and are therefore not reported here. Nonetheless, they are available from authors upon request. 11 exceeds 5 percent in our sample (Coop5). 13 As regards the robustness with respect to bank size, we estimate the regressions separately for large and small banks. We also test the robustness of our results with respect to the estimation methods. We start by pooled ordinary least squares (OLS) and fixed effects estimates, followed by a robust estimation technique, and a quantile regression.The robust estimation technique assigns, through an iterative process, lower weights to observations with large residuals, thereby making the estimation less sensitive to outliers. The quantile regression allows to address the question whether the factors that cause high fragility are systematically different from the factors that cause medium or low fragility. We would like to stress that our analysis is based on individual banksââ¬â¢ z-scores. The impacts calculated from the estim ated regressions are average impacts per bank.This approach provides a baseline assessment of stability and is frequent in the literature. However, to arrive at a more complete assessment of systemic stability, one needs to look also at correlation of losses across defaults and losses given defaultââ¬âa topic for further research. III. RESULTS A. Decomposition of Z-Scores and Correlation Analysis A preliminary analysis shows that the cooperative banksââ¬â¢ z-scores are on average significantly higher than for commercial banks (and slightly, but insignificantly, higher than for savings banks), suggesting that cooperative banks are more stable than commercial banks.Interestingly, this is not because of capitalization or profitabilityââ¬âthose two are on average weaker for cooperative banks than for commercial banks. The result is driven by the fact that the cooperative banksââ¬â¢ standard deviation of returns is much lower, resulting in the high zscore (Tables 2 and 3). Why do we find the low volatility of returns over time in cooperative banks? A plausible explanation is that the cooperative banks use the customer surplus as a first line of defense in weaker times.Cooperative banks pass on an important part of their returns to customers in the form of surplus. Indeed, their stated objective is not maximization of profits, but rather maximization of the consumer surplus. This leaves the cooperative banks with relatively low average return ratios in normal years. However, in weaker years, they are able to extract some of the consumer surplus, thereby mitigating the negative impact of stress on returns. 13 The Coop 5 countries are Austria, France, Germany, Italy, Japan, Netherlands and the United Kingdom. 12We are therefore observing a lower variability of returns in cooperative banks than in commercial banks (and about the same as in savings banks). 14 In other words, our calculations suggest that the consumer surplus can be viewed as the first line of defense for cooperative banks, in a similar way as profits are the first line of defense for commercial banks. However, there are some important differences. First, consumer surplus is a very complex concept to measure. We are not able to observe consumersââ¬â¢ surplus on a consistent basis; even though we can make inferences about it from the pattern of returns.Second, while undistributed profits can be relatively easily used to replenish capital, extracting consumer surplus is one more step removed from capital and requires time. To address the idea that cooperative banks are less able to raise capital in situations of stress, we have also examined volatility in cooperative banksââ¬â¢ capitalization compared with commercial banksââ¬â¢ capitalization (even though volatility in capitalization is not a part of the z-score calculation). The results only onfirm our findings about z-scores, because cooperative banks also have a significantly lower volatility of capitalizati on. The finding that cooperative banks have higher z-scores is novel, but not inconsistent with the existing literature. The empirical papers on the subject note that cooperative banks have lower reported returns, but they find no compelling evidence that the lower returns would be due to a less effective management of revenues and costs than in commercial banks (e. g. , Brunner and others, 2004; and Altunbas, Evans, and Molyneux, 2001). 5 If the lower returns were due to inefficiencies in cooperative banksââ¬â¢ operation, then it would be difficult to argue that there are cushions that can be used in weak times. However, the finding that cooperative banks have lower returns with the same efficiency suggest that there are cushions that can be used in situation of stress, an idea that is consistent with our finding. 16 We also find no evidence for our sample that cooperative banks are less efficient than commercial banks in terms of the cost-income ratio (Table 1).To assess the ro bustness of our findings, we have also tried some alternatives to the standard definition of the z-score (Table 4). The underlying idea behind these alternative approaches (which have to our knowledge not yet been discussed in the literature) is that the standard An additional explanation of the lower volatility of returns can be the networks that cooperative banks form to provide a safety net. However, these support mechanisms are typically triggered only in extreme stress, and are therefore likely to explain only a small part of the observed difference in the volatility of returns. 5 14 The finding about lower returns is in contrast with previous observation by Valnek (1999), who finds that mutual building societies in the United Kingdom have higher returns and risk-adjusted returns on assets than commercial banks. In a recent paper, Mercieca, Schaeck, and Wolfe (forthcoming) estimate an equation for z-scores in a sample of small European banks, including small cooperative banks, but their estimated slope coefficient for a cooperative bank dummy is insignificant. 16 13 deviation underlying the z-score gives only a part of the information about the behavior of zscores.In particular, when assessing stability, we are much more interested in the downward spikes in returns on assets (ROAs) and z-scores than in the upticks. Table 3 has four panels, corresponding to four alternative variables that we have investigated, in particular: â⬠¢ We have defined downward (upward) volatility of ROA as the sample average of the difference between the bank-specific ROA per year and its mean of ROA if the ROA is below (above) the bank-specific mean. Table 4 indicates that both downward and upward volatility of ROA are higher for commercial banks than for cooperative and savings banks.Comparing the absolute values within each bank type shows that the commercial banks' downward volatility of ROA is higher than its upward volatility. This finding does not hold for cooperative and savings banks. Similarly, we have defined the downward (upward) volatility of the z-scores as the sample average of the difference between the bank-specific z-score per year and its mean of the z-score if the z-score is below (above) the bank-specific mean. We cannot observe any statistical difference in the downward (upward) volatility of the z-scores.Furthermore, the downward (upward) volatility of the capitalization is defined as the sample average of the difference between the bank-specific equity-to-assets ratio per year and its mean of the capitalization if the equity-to-assets ratio is below (above) the bankspecific mean. The downward (upward) volatility of capitalization is lower for cooperatives than for commercial and savings banks. Commercial banksââ¬â¢ z-scores have a higher frequency in the lower distribution of the zscores than cooperative and savings banks.This supports the previous results of lower average z-scores for commercial banks during the sample period . â⬠¢ â⬠¢ â⬠¢ Overall, the above robustness checks support the findings for the simple z-scores. 17 To further assess the robustness of our findings, we can also look at measures of financial soundness that are alternative to the z-scores. An obvious alternative are ratings by rating agencies. Table 5 presents a distribution of long-term credit ratings by the Fitch Ratings for cooperative banks and commercial banks in the 29 advanced economies and emerging markets.The overall conclusion is that at least on the first look there does not seem to be a major difference between the ratings for cooperative banks and commercial banks. For both groups, for example, about 90 percent of institutions have investment grade long-term credit 17 We have also calculated a modified z-score, defined as capitalization plus the ROA over the absolute value of the downward volatility of ROA. Results for this modified z-score confirm that on average, cooperative banks are more stable than comm ercial banks, reinforcing the findings from the above robustness tests.The results do not change qualitatively whether we use the absolute value of downward/upward deviation from the mean for the volatilities of the ROA, z-score and capitalization measures, or whether we use the squared downward/upward deviation from the mean. 14 rating (defined as BBB- or higher). It should be noted, however, that the distribution of ratings for cooperative banks is highly influenced by the ratings for German cooperative banks, all of which were given the same (A+) rating. This limits the usefulness of ratings for further, econometric analysis.In the next section, we will therefore focus on the z-scores. Before discussing the regression results, we provide correlation coefficients between the zscore and selected key variables in Table 6. Here, we differentiate between all the banks in the sample and large (small) banks that have assets larger (smaller) than US$1 billion. Similar to the findings fro m the decomposition of the z-score in Table 1, commercial banks tend to have lower z-scores than cooperative and savings banks in all model specifications.Also, both the cooperative bank dummy and the z-score are positively correlated across the different samples. While there is no evidence that the cooperative market share per country and year is negatively correlated with the z-scores of all commercial, cooperative and savings banks, we do find a significantly negative correlation between the z-scores and the interaction term of the share of cooperatives and commercial bank dummy in all models as hypothesized previously.A stronger cooperative sector is associated with higher commercial banksââ¬â¢ risk. Since correlation findings do not necessarily reflect causal relationships and do not account for other control factors, we now turn to the panel regressions. B. Regression Analysis Table 7 presents pooled OLS and fixed effects estimates for the z-scores in the full sample of ban ks in OECD countries, in the Euro zone (EU12), and the countries where the cooperativesââ¬â¢ market share exceeds 5 percent (Coop5). 8 All panel regressions include clustered standard errors (by bank), year and country dummy variables. Our main focus in discussing the results is on the two hypotheses outlined in the introduction, namely that cooperative banks are weaker and that their presence reduces the stability of other banks. All the pooled OLS regressions provide strong evidence that cooperative banks have higher z-scores than commercial and savings banks.The estimated signs of the commercial bank dummy and savings bank dummy are negative in all the pooled OLS and fixed effects regressions (and significant at the 10 percent level in all but one the regressions). That is, cooperative banks appear less likely to become insolvent than the other two bank types. This 18 In general, it is not possible to identify the commercial and savings bank dummies in the fixed effects regres sions since they are not time-varying. Since we have changed the status of a few banks as discussed before, we could in principle identify the bank dummies.But we do omit the commercial and savings bank dummies in the fixed effects estimations, as only a few dummies are time-varying, and therefore the coefficients and p-values might not be very meaningful. 15 is in line with the findings from the decomposition of the z-score in the previous section. It strengthens the previous findings, because the conclusion about higher z-scores in cooperative banks holds even if we adjust for other explanatory factors, such as the fact that cooperative banks are typically more retail-oriented than commercial banks.As regard the impact of a higher presence of cooperative banks on banking stability, the first approximation is provided by the estimated slope coefficient of the ââ¬Å"share of cooperativesâ⬠variable, which is positive and significant in all but one specification. Based on this estimated slope coefficient, we can say that a higher share of cooperative banks increases stability (measured by z-score) of an average bank in the same banking system. It is important to stress, however, that this is only an average effect based on all the commercial, cooperative, and savings banks in the sample. 9 To analyze in more detail the cooperative banksââ¬â¢ impact on other (e. g. , commercial) banks, one needs to analyze the sum of the coefficients of (i) the share of cooperative banks and (ii) the interaction of the share of cooperative banks with the other bank (e. g. , commercial bank) dummy. Looking again at the estimates in Table 7, and focusing on commercial banks, we find that a higher market share of cooperative banks has a significantly negative effect on commercial banksââ¬â¢ risk in the pooled OLS model for OECD countries.This would be consistent with the hypothesis that a higher presence of not-profit-maximizing cooperative banks could pull down the sou ndness of commercial banks. This could be because cooperative banks ââ¬Å"over-payâ⬠for deposits or ââ¬Å"under-chargeâ⬠for assets, or because the commercial banks get crowded out of the retail market and have to turn to markets that are more volatile. 20 However, this finding does not hold for the other model specifications. There is thus some, but limited, evidence in support of Goodhartââ¬â¢s (2004) hypothesis in the full sample. 1 The other explanatory variables have the expected signs. In particular, we find that larger banks tend to have lower z-scores, perhaps because they engage in riskier activities than smaller banks (and reflecting a relatively higher risk aversion of small banks). Also, banks with higher loan-to-asset ratios tend to be riskier (even though this result is valid only for the 19 If we measured a ââ¬Å"portfolio z-scoreâ⬠of the banking system, it would increase even more than the average zscore, due to the simple fact that a higher ma rket share of cooperative banks means a higher share of banks with higher -scores. However, our approach in this analysis is derived from individual bank z-scores. To examine the hypothesis that cooperative banks over-pay for deposits or under-charge for loans, we have calculated the implicit deposit and lending rates for the commercial and cooperative banks, defining the implicit deposit rate as total interest rate expenses over deposits and the lending rate as interest rate income over loans. Based on this calculation, there is no significant difference for deposit rates, but there is some evidence that cooperative banks charge lower lending rates than commercial banks (9. percent compared with 13. 2 percent). 21 20 For savings banks, the impact of a higher cooperative bank share is insignificant and not reported in Table 7. 16 OECD sample as a whole, but not necessarily in the EU12 and Coop5 sub-samples). Banks with higher loan portfolios on their balance sheets relative to their total assets might be more likely to experience problems with non-performing loans and thus be riskier. Finally, inefficient banks in terms of their cost-to-income ratio are less likely to cover their costs when hit by adverse shocks, so they tend to be riskier.The evidence on the effect of bank concentration on individual bank risk is mixed and unclear in the pooled OLS and fixed effects regressions. The results from the income diversity variable and its interaction with the cooperative bank dummy support the above hypothesis. Overall, an increase in diversity (which could be interpreted as less focus on the traditional lending business) tends to increase banksââ¬â¢ risk; however, cooperative banks tend to become more stable if they diversify their activities (sum of the coefficients of the income diversity variable and its interaction with the cooperative bank dummy).This result can be explained by the fact that commercial banks are about 30ââ¬â 40 percent more diversified than cooperative banks (both in the whole OECD sample and the EU12 and Coop5 sub-samplesââ¬âsee Table 1). Because of their stronger focus on the lending (retail) business, cooperative banksââ¬â¢ stability improves from an increase in diversification of their activities; in contrast, a further move away from retail business in commercial banks, which have already a relatively higher share of other (wholesale) activities, results in decreasing stability (z-scores).Table 8 presents the OECD pooled regressions with the governance indicator constructed by Kaufmann, Kraay, and Mastruzzi (2005). As expected, banks in countries with a higher level of institutional development are on average less risky than banks in countries which lack the same governance quality. From a comparison of Tables 7 and 8, the governance indicator does not have a significant impact on the estimated slope coefficients for the commercial and savings bank dummies, suggesting that cooperative banks are not mo re or less sensitive to governance problems than the other types of banks.However, this finding has to be taken with a grain of salt, because we use the overall quality of governance in the country as a proxy for corporate governance in the individual banks, on which there are unfortunately no direct cross-country data. To assess the robustness of our results, we have also estimated models for large and small banks, n addition to the full sample regressions. 22 Table 9 replicates the previous regressions on the OECD, EU12, and Coop5 countries only with large banks, defined as those that have assets larger than US$1 billion.The commercial bank dummy is significantly negative in the In addition, to account for systemic importance, we have also estimated a weighted regression, weighting the different observations by total assets. The results, which were not substantially different from those for large banks in Table 8, are available from the authors upon request. 22 17 pooled OLS estim ations (except the OECD sample). The previous result that a strong cooperative banking sector on average does not weaken the commercial banking sector is strongly supported in the regressions with large banks for all model specifications except the OLS OECD model.Table 10 gives the model findings for small banks (those with assets below US$1 billion). Small commercial banks tend to be riskier than small cooperative banks but there is no substantial evidence that an increase in the cooperative market share has a consistently and significantly negative effect on the smaller commercial banksââ¬â¢ individual risk. As a further sensitivity test, we estimated the models with the robust estimation technique, which assigns lower weights to observations with large residuals, to avoid the impact of outliers (Beck, Cull, and Jerome, 2005).The results in Table 11 support the main conclusion from the previous discussion. Finally, to address the question whether the factors that cause high fra gility are systematically different from the factors that cause medium or low fragility, we adopt quantile regression techniques. Table 12 gives the regression results at the 25th, 50th, and 75th percentiles of the OECD, EU12, and Coop5 countries. 23 The model setup is the same as for the full sample with the same variables included and the same outliers excluded (1st and 99th percentile of the distribution of the z-score).Based on the coefficients of the commercial bank dummy, the gap between the z-scores of commercial and cooperative banks tends to widen with the quantiles in the OECD, EU12, and Coop5 models, which suggests that the distribution of z-scores in cooperatives is much more skewed to the right: if one compares strong cooperative banks and strong commercial banks, the difference in z-scores is much bigger than for weak cooperative banks and weak commercial banks. A similar conclusion is valid also for the comparison of cooperative banks and savings banks, even though th e differences in their z-scores are generally smaller.Upon inspecting the sum of the coefficients of the cooperative share and its interaction with the commercial bank dummy, it appears that an increased presence of cooperative banks per country and year has a negative effect on the weakest commercial banks. In other words, commercial banks that already have low z-scores suffer more from a stronger cooperative sector than commercial banks with higher z-scores. Whereas the previous estimations did not provide any substantial evidence for a negative effect of a higher presence of cooperative 23The 50th percentile gives the median least square estimator which minimizes the median square of residuals rather than the average. In the generalized quantile regression, we estimate an equation describing a quantile other than the median. Specifically, we estimate the first quartile (25th percentile) as well as the 75th percentile. 18 banks on the average commercial bankââ¬â¢s stability, in stead there appears to be some (negative) effect on the weaker commercial banks. In all the regressions, restricting the explanatory variables to only contemporaneous effects does not change the main findings (tables available upon request).We also defined alternative z-scores as ln(1+(z/100)), but this did not affect the main conclusions. IV. CONCLUSIONS AND TOPICS FOR FURTHER RESEARCH The findings in this paper indicate that cooperative banks in advanced economies and emerging markets have higher z-scores than commercial banks and (to a smaller extent) savings banks, suggesting that cooperative banks are more stable. This finding, perhaps somewhat surprising at first, is due to much lower volatility of the cooperative banksââ¬â¢ returns, which more than offsets their relatively lower profitability and capitalization.We suggest that this observed lower variability of returns, and therefore the higher z-scores, may be caused by the fact that cooperative banks in normal times pass on most of their returns to customers, but are able to recoup that surplus in weaker periods. To some extent, this result can also reflect the mutual support mechanisms that many cooperative banks have created. The finding about the higher z-scores in cooperative banks is quite robust with respect to modifications in the measurement of volatility and z-scores.It also remains valid if one distills the ââ¬Å"pureâ⬠impact of the cooperative nature of a bank, by using regression analysis and adjusting for differences in bank size, loan to asset ratios, income diversity, and other factors with potential impact on individual bankââ¬â¢s stability. Using the regression analysis, we also find that a higher share of cooperative banks increases stability (measured by z-score) of an average bank in the same banking system. The impacts differ by the groups of banks, however.High presence of cooperative banks appears to weaken commercial banks, in particular those commercial banks that are already weak to start with. This finding is consistent with Goodhartââ¬â¢s (2004) hypothesis that the presence of non-profit-maximizing entities can pull down stability of other financial institutions. This empirical result can be explained by the fact that a higher cooperative bank presence means less space for weak commercial banks in the retail market and therefore their greater reliance on less stable revenue sources such as corporate banking or investment banking.When interpreting the results, one needs to bear in mind some caveats relating to the z-score, such as its reliance on accounting data and its focus on capital and profits rather than, say, liquidity or asset quality. As a robustness test, we have therefore tried to include some possible alternatives to the z-scores, such as ratings. The available data suggest that the ratings of cooperative banks are not substantially worse than those for commercial banks; 19 however, the dominance of observations from one cou ntry (Germany) in the ratings database does not allow for a full-fledged cross-country analysis.Several issues not addressed in this paper could be analyzed in future research. One of them is corporate governance issues. As discussed in Fonteyne (forthcoming) or Cuevas and Fischer (2006), corporate governance issues in cooperatives are often more prominent than in commercial banks. Among these issues is the presence of an owner-less endowment, since members of cooperatives are only invested with the notional value of their shares and have no right to the accumulated capital. Furthermore, there is a collective action problem that might lead to empire-building by management.BankScope and similar databases do not contain institution-specific data on the quality of the corporate governance, but with a more detailed database, perhaps on a smaller sample, it may be possible to analyze this issue. Another issue for further research is the impact of networks on cooperative banksââ¬â¢ sta bility. Cooperative banks can realize important benefits by forming networks, as it allows the pursuit of economies of scale and scope, and the provision of a safety net or mutual support mechanism. However, a more complex structure can also create new challenges for stability.For example, Desrochers and Fischer (2005), in a cross-country survey on the level of integration of cooperatives, note that lateral contracts between cooperatives involve risks that counterparts will behave opportunistically to appropriate the rent generated by the alliance. The analysis based on individual banksââ¬â¢ z-scores, presented in this paper, provides a baseline assessment of systemic stability. To arrive at a more complex assessment, one should look also at losses given default and correlation of losses across defaults (Cihak, 2007).This issue goes beyond the scope of this paper, and is an important topic for further research. Finally, we have treated the share of cooperative banks as an exogeno us variable that impacts the z-scores. When longer time series become available, it might be possible and useful to test whether the share of cooperative banks is in fact endogenous with respect to the z-scores, i. e. , whether this measure of stability affects the share of cooperatives in a system. 20 Table 1. Summary Statistics of Bank-Specific Variables in the Sample, 1994ââ¬â2004 (In percent, unless indicated otherwise) Assets (Billion USD) Mean Std. Dev.OECD Commercial Cooperative Savings EU12 Commercial Cooperative Savings Coop5 Commercial Cooperative Savings Loans to Assets Cost-Income Ratio Mean Std. Dev. Mean Std. Dev. Income Diversity Mean Std. Dev. 3. 78 1. 90 1. 90 32. 52 14. 41 6. 93 0. 57 0. 59 0. 63 0. 21 0. 14 0. 18 70. 27 72. 26 70. 03 44. 47 16. 91 32. 86 0. 33 0. 24 0. 24 0. 25 0. 19 0. 20 8. 94 1. 22 2. 65 43. 06 8. 14 6. 64 0. 43 0. 59 0. 58 0. 28 0. 14 0. 13 70. 10 71. 99 67. 09 42. 23 14. 30 13. 22 0. 39 0. 28 0. 23 0. 49 0. 19 0. 12 18. 06 1. 87 2. 02 79. 75 14. 47 4. 11 0. 50 0. 59 0. 58 0. 28 0. 14 0. 13 71. 79 72. 52 67. 55 43. 43 16. 87 10. 07 0. 34 0. 25 0. 24 0. 4 0. 18 0. 08 Source: Authors' calculation based on BankScope Data. Note: The 1st and 99th percentile of the distribution of the z-score variable is excluded. 21 Table 2. Decomposition of Z-Scores for the Full Sample 1994ââ¬â2004 Z-score Equity to Assets (percent) ROA (percent) Standard deviation of ROA (% points) All banks Commercial Cooperative Savings Large banks Commercial Cooperative Savings Small banks Commercial Cooperative Savings 50. 0 60. 8 60. 1 12. 13 7. 19 9. 29 0. 94 0. 39 0. 55 0. 59 0. 28 0. 35 29. 6 46. 6 47. 3 7. 06 5. 62 5. 91 0. 69 0. 28 0. 48 0. 71 0. 37 0. 35 46. 5 56. 9 55. 4 11. 21 6. 84 7. 99 0. 90 0. 37 0. 53 0. 65 0. 1 0. 35 Source: Authorsââ¬â¢ calculations based on BankScope data. Note: To avoid possible outliers in this sample, the 1st and 99th percentile of the distribution of each variable is excluded. Large (Small) banks are defi ned as having assets larger (smaller) than 1 billion USD. 22 Table 3. Decomposition of Z-Scores for Selected Countries, 1994ââ¬â2004 Z-score Equity to Assets (percent) ROA (percent) Standard deviation of ROA (percent) Austria Commercial Cooperative France Commercial Cooperative Germany Commercial Cooperative Italy Commercial Cooperative Japan Commercial Cooperative Netherlands Commercial Cooperative UK Commercial Cooperative 28. 70. 9 15. 95 6. 83 1. 01 0. 45 1. 708 0. 122 44. 4 82. 2 13. 31 5. 44 1. 07 0. 29 0. 471 0. 067 25. 8 33. 5 4. 47 5. 43 -0. 16 -0. 04 0. 949 1. 001 30. 7 40. 3 11. 44 12. 89 0. 43 0. 88 1. 246 0. 465 37. 3 78. 8 12. 05 5. 08 0. 48 0. 28 1. 197 0. 124 17. 8 42. 1 10. 69 6. 64 0. 39 0. 58 2. 088 0. 223 33. 8 34. 3 11. 20 6. 02 0. 70 0. 39 0. 846 0. 407 Source: Authorsââ¬â¢ calculations based on BankScope data. Note: To avoid possible outliers in this sample, the 1st and 99th percentile of the distribution of each variable is excluded. All selected count ries have a market share of cooperative banks higher than 5%. 23Table 4. Sensitivity of the Z-score Decomposition Bank type Commercial Cooperative Savings Return on assets Downward volatility (percentage points) Upward volatility (percentage points) Z-scores Downward volatility (percentage points) Upward volatility (percentage points) Equity to assets Downward volatility (percentage points) Upward volatility (percentage points) -0. 46 0. 38 -0. 19 0. 20 -0. 21 0. 21 -3. 79 3. 99 -3. 47 3. 85 -3. 78 4. 12 -1. 53 1. 69 -0. 53 0. 58 -0. 78 0. 81 Distribution of Z-scores (% of observations in banks of the same type) Less than 0 0. 37 0 to 10 13. 65 10 to 20 14. 74 20 to 30 13. 2 More than 30 57. 52 0. 62 9. 20 10. 72 13. 04 66. 42 0. 13 6. 38 9. 85 14. 80 68. 84 Source: Authors' calculation based on BankScope data. Note: To eliminate outliers, the 1st and and 99th percentiles of the distribution of the downward (upward) volatility variables were excluded. 24 Table 5. Fitch's Long-Term R atings of the Banks in Sample All Banks No. Percent 2 0. 17 16 1. 36 26 2. 21 72 6. 11 781 66. 30 77 6. 54 64 5. 43 40 3. 40 35 2. 97 29 2. 46 10 0. 85 2 0. 17 15 1. 27 4 0. 34 3 0. 25 2 0. 17 1,178 100. 00 Commercial No. Percent 2 0. 54 14 3. 75 23 6. 17 66 17. 69 53 14. 21 54 14. 48 39 10. 46 38 10. 9 28 7. 51 24 6. 43 7 1. 88 2 0. 54 14 3. 75 4 1. 07 3 0. 80 2 0. 54 373 100 Cooperative No. Percent 0 0. 00 1 0. 15 2 0. 29 2 0. 29 664 96. 37 9 1. 31 7 1. 02 0 0. 00 2 0. 29 1 0. 15 0 0. 00 0 0. 00 1 0. 15 0 0. 00 0 0. 00 0 0. 00 689 100. 00 AAA AA+ AA AAA+ A ABBB+ BBB BBBBB+ BB BBB+ B BTotal Note: All 637 cooperative banks in Germany have a Fitch rating of A+. 25 Table 6. Correlation Coefficients between the Z-Score and Selected Key Variables, 1994ââ¬â2004 Commercial Bank Dummy Cooperative Bank Dummy Savings Bank Dummy Share Coop Share Coop* Commercial Full Sample OECD -0. 060*** 0. 026*** 0. 051*** -0. 041*** -0. 38*** Large Banks OECD -0. 225*** 0. 115*** 0. 147*** 0. 100*** - 0. 168*** Small Banks OECD -0. 047*** 0. 013*** 0. 050*** -0. 034*** -0. 105*** EU12 -0. 244*** 0. 178*** 0. 041*** 0. 128*** -0. 184*** Coop5 -0. 221*** 0. 137*** 0. 066*** 0. 068*** -0. 195*** Commercial Bank Dummy Cooperative Bank Dummy Savings Bank Dummy Share Coop Share Coop* Commercial EU12 -0. 340*** 0. 115*** 0. 236*** 0. 130*** -0. 241*** Coop5 -0. 288*** 0. 091*** 0. 208*** 0. 085*** -0. 245*** Commercial Bank Dummy Cooperative Bank Dummy Savings Bank Dummy Share Coop Share Coop* Commercial EU12 -0. 179*** 0. 160*** -0. 008*** 0. 098*** -0. 144***Coop5 -0. 155*** 0. 119*** 0. 001 0. 052*** -0. 141*** Note: * significant at 10%; ** significant at 5%; *** significant at 1%. 26 Table 7. Regression Results (Full Sample) OECD (1) Assets (-1) Loans/ Assets (-1) Cost-Income Ratio (-1) Income Diversity (-1) Income Diversity* Cooperative Bank Dummy (-1) Herfindahl Index (-1) Commercial Bank Dummy Savings Bank Dummy Share of Cooperatives (-1) Share of Cooperatives * Commercial Bank Dummy (-1) GDP Growth (-1) Inflation (-1) Exchange Rate Appreciation (-1) Real Long-Term Interest Rate (-1) Constant Observations R-squared Clustered by Banks Type -0. 026 (0. 000)*** -13. 123 (0. 00)*** -0. 185 (0. 000)*** -19. 299 (0. 000)*** 23. 107 (0. 000)*** -0. 005 (0. 000)*** -4. 79 (0. 029)** -2. 547 (0. 196) -0. 094 (0. 324) -0. 386 (0. 000)*** -0. 246 (0. 037)** 0. 44 (0. 006)*** 0. 043 (0. 009)*** -0. 398 (0. 004)*** 39. 898 (0. 000)*** 78,298 0. 103 14,025 OLS (2) -0. 013 (0. 023)** -3. 225 (0. 000)*** -0. 001 (0. 572) -1. 132 (0. 004)*** 3. 67 (0. 000)*** 0. 001 (0. 002)*** (3) -0. 027 (0. 073)* 3. 802 (0. 318) -0. 044 (0. 038)** -3. 4 (0. 155) 6. 877 (0. 184) -0. 005 (0. 005)*** -22. 685 (0. 000)*** -7. 437 (0. 003)*** 0. 278 (0. 033)** -0. 027 (0. 866) -0. 081 (0. 786) -1. 901 (0. 000)*** 0. 34 (0. 096)* 0. 597 (0. 145) 55. 966 (0. 000)*** 22,665 0. 112 3,239 OLS EU12 (4) -0. 043 (0. 000)*** -1. 996 (0. 347) -0. 009 (0. 076)* -0. 742 (0. 184) 4. 534 (0. 000)*** -0. 0 004 (0. 537) (5) -0. 019 (0. 001)*** 3. 461 (0. 349) -0. 078 (0. 000)*** -4. 12 (0. 107) 13. 418 (0. 004)*** 0. 001 (0. 643) -17. 143 (0. 000)*** -4. 314 (0. 080)* 0. 086 (0. 557) -0. 003 (0. 989) 1. 002 (0. 000)*** 0. 091 (0. 789) 0. 061 (0. 015)** -0. 006 (0. 987) 22. 558 (0. 000)*** 25,241 0. 106 3,723 OLS Coop5 (6) -0. 015 (0. 028)** 0. 882 (0. 705) -0. 008 (0. 032)** -0. 858 (0. 077)* 2. 585 (0. 001)*** 0. 005 (0. 000)*** 0. 114 (0. 01)*** 0. 019 (0. 699) -0. 14 (0. 001)*** 0. 133 (0. 009)*** 0. 068 (0. 000)*** 0. 184 (0. 000)*** 46. 652 (0. 000)*** 78,298 0. 058 14,025 FE 0. 127 (0. 007)*** -0. 101 (0. 093)* 0. 012 (0. 924) -0. 427 (
Tuesday, July 30, 2019
Human Enlightenment: a Comparison of Kant and Newman Essay
The patient is a 70 years old man, admitted in Clinton Cardiology Center for repeated chest pain, fainting, hypotension, thoracic discomfort and cough, which appeared suddenly the same day. The clinical exam showed: cold, pale, sweated skin, dyspnea, tachycardia, a diastolic murmur in the third intercostal space near the sternum edge, a third degree systolic murmur above the lower sternum, and a blood pressure of 80/60 mmHg. The electrocardiogram showed signs of right ventricular overload. The patient was known with arterial hypertension form 2009, had an episode of atrialà fibrillation and deep vein thrombosis of the right calf in 2005 and had a hip replacement in 2010. An echocardiographic exam in 2006 noted an ascending aorta aneurism. He had been treated with Betaxolol 20 mg/day for hypertension, Amlodipine 5 mg/day, Indapamide 1. 5 mg/day and Trimetazidine 35 mg x 2/day. He was also treated for a severe depression (Olanzapine). The patient states having worked as an accountant at some point in his life has the occasional beer but never smoked; he doesnââ¬â¢t exercise at all and cannot stand for long period of time. The patient is a high fall risk. LEARNING STYLE English is the patientââ¬â¢s first language and he can read and write; he states having a degree in accounting. He is both an auditory and verbal learner who loves to talk and crack jokes. He speaks clearly and has no trouble communicating at all. He is however feeling discouraged, depressed and is anxious of his current situation but is not eager to learn how to manage his diet and weight as he is not able to exercise due to dyspnea; he is also partially weight bearing on his left leg and is seeing PT as a result from his hip surgery and is still non-compliant with his therapy. The doctor has put him on new medication Reteplase (Retevase) after the doctor diagnosed him with acute myocardium infarction. RETEPLASE (RETEVASE) Reteplase is a thrombolytic drug that is used to dissolve and break the blood clots that cause a heart attack. It works by activating a substance that helps to break up blood clots. Blood clots can prevent oxygen and nutrients from getting to the heart, which causes tissue death and long-term damage to the heart. Itââ¬â¢s indicated for use in the management of acute myocardial infarction (AMI) in adults for the improvement of ventricular function following AMI, the reduction of the incidence of congestive heart failure and the reduction of mortality associated with AMI. Reteplase is given by injection into a vein (IV). Generally, it is given as 10 + 10 unit double bolus injection. EACH BOLUS GIVEN OVER 2 MINUTES. WITH THE 2ND BOLUS GIVEN, AN INITIAL DOSE follows by a second dose 30 minutes later. Two 10 unit bolus injections are required for a complete treatment. CONTRAINDICATIONS â⬠¢Active internal bleeding â⬠¢Recent intracranial or intraspinal surgery or trauma. â⬠¢Severe uncontrolled hypertension â⬠¢Known bleeding diathesis ADVERSE REACTIONS â⬠¢hypersensitivity reactions, bleeding â⬠¢GI upset, hypotension, fever â⬠¢cardiogenic shock, arrhythmias, AV block, pulmonary edema â⬠¢ Heart failure, cardiac arrest, ischemia, myocardial rupture, mitral regurgitation, pericardial effusion, venous thrombosis, cholesterol embolism SIDE EFFECTS The most frequent adverse reaction associated with Retavase is bleeding. Other side effects include â⬠¢Pain, redness, or swelling at the injection site â⬠¢Nausea and vomiting â⬠¢Severe headache, eye pain or vision changes. â⬠¢Sudden numbness or weakness, especially on one side of the body â⬠¢Sudden headache, confusion, problems with speech, or balance INTERACTIONS â⬠¢Anticoagulants ââ¬Å"blood thinnersâ⬠(e. g. , warfarin or heparins) â⬠¢Antiplatelet drugs (e. g. , clopidogrel, dipyridamole, ticlopidine) â⬠¢NSAIDs (e. g. , ibuprofen, naproxen) â⬠¢Drugs that alter platelet function (such as aspirin ) may increase the risk of bleeding if administered prior to or after Retavase (reteplase) therapy DOSAGE Reteplase is for intravenous administration only. Reteplase is administered as a 10 + 10 unit double-bolus injection. Two 10 unit bolus injections are required for a complete treatment. Each bolus is administered as an intravenous injection over 2 minutes. The second bolus is given 30 minutes after initiation of the first bolus injection. Each bolus injection should be given via an intravenous line in which no other medication is being simultaneously injected or infused. No other medication should be added to the injection solution containing reteplase. There is no experience with patients receiving repeat courses of therapy with reteplase. Nursing Implications Monitor vital signs, especially blood pressure and pulse. (Decreasing blood pressure, increase in pulse may indicate internal bleeding). Protect patient from injury by maintaining limited mobility during drug therapy. Monitor all possible sites of bleeding during infusion. Ensure that cardiac rhythm is monitored during therapy. (Dysrhythmias may occur with reperfusion of myocardium). Monitor CBC during and after therapy for indications of blood loss due to internal bleeding. (Patient has increased risk of bleeding for 2-4 days post therapy. ) Lab test considerations â⬠¢Plasminogen (Administration of Retavase(reteplase) may cause decreases in plasminogen and fibrinogen â⬠¢Degradation of fibrinogen in blood samples removed for analysis NURSING PROCESS Assessment Prior to administration: â⬠¢Obtain complete health history including allergies, drug history and possible drug interactions â⬠¢Obtain a baseline ECG and electrolytes, ABG, blood urea nitrogen and cardiac enzyme levels â⬠¢Assess lab values; obtain CBC, PT, Hgb, Hct, platelet count â⬠¢Asses vital signs and neurological status â⬠¢Assess for recent surgery or trauma, bleeding disorders, or history of hemorrhagic stroke or GI bleeding Nursing Diagnoses â⬠¢Tissue perfusion, Ineffective related to adverse effects of medication â⬠¢Injury, Risk for (bleeding) related to adverse effects of medication â⬠¢Knowledge, Deficit related to drug therapy, action, and side effects Planning Patient teaching and demonstrate understanding of risks and benefits of drug therapy. Inform patient that activity will be limited during infusion and pressure dressing may be needed to prevent any active bleeding. Patient will remain free of unusual and excessive bleeding. Maintain effective tissue perfusion. Continuously monitor cardiac rhythm and explain to patient that cardiac rhythm will be monitored during treatment. Instruct patient of increased risk of bleeding, activity restriction, and frequent monitoring during this time. Teach patient regarding need for frequent vital signs. Take and record vital signs every 15minutes during infusion and for 2 hours following. Intervention Continue to monitor for adherence and compliance. At start of therapy watch for any signs of hypersensitivity, shortness of breath and a feeling of tightness and pressure in the chest. Check patient vital signs frequently andà monitor his skin color and sensory of function of extremities every hour. Evaluation Evaluate the effectiveness of drug therapy by confirming that patient goals and expected outcomes have been met. Protect patient from injury by maintaining limited mobility during drug therapy this helped to prevent any falls since heââ¬â¢s a high risk for falls. By monitoring his vital signs, especially blood pressure and pulse (Decreasing blood pressure, increase in pulse may indicate internal bleeding) this reduced risks for any internal bleeding. Patient understands the risks and benefits of the drug therapy. The teaching plan is reasonable and effective as well and if implemented today would serve to teach the patient and assist him to better manage the MI and prevent other related complications such as hypertension, embolisms, dyspnea and circulation. REFERENCES ?2009 Edition Delmarââ¬â¢s Nurseââ¬â¢s Drug Handbook By George R. Spratto, Ph. D. , Adrienne L. Woods pages 1394-1395 ?http://www. rxlist. com/retavase-drug/patient-images-side-effects. htm ?http://www. drugs. com/cons/retavase. html ?http://reference. medscape. com/drug/retavase-reteplase-342289 ?http://www. mayoclinic. com/health/drug-information/DR602387.
Monday, July 29, 2019
A Narrative Essay on the Breakfast with My Grandmother in Italy
A Narrative Essay on the Breakfast with My Grandmother in Italy Breakfast with a Side of Eye Cream With heavy arms perched high above my head, I savored the precious flow of cold water streaming down my sweaty back. At my grandmothers house, as in most Roman households in the summer, the shower is a welcome sanctuary from the unrelenting Italian sun, and it can become competitive territory to stake out in a busy home. The bittersweet smell of coffee wafted into the bathroom and invited me to join my grandmother for my favorite meal. Today was my first morning in Italy, and I knew that breakfast would mean catching my grandmother up on an entire yearââ¬â¢s worth of material. After a sip of coffee, I hooked my laptop up, and stood next to my presentation, just as I had done a few Saturdays ago in my International Fashion Marketing class at FIT. When I saw my title slide, all of the butterflies that I thought I had left in New York suddenly came fluttering into my stomach. Speaking in Italian helped to ease my nerves, and in a beautiful synergism between Italian and English, I shared my vision with my grandmother. I wanted to bring a hip active wear brand, coveted in the U.S. by yoga enthusiasts and marathon runners alike, to Italy. The sporty style of so many Italian women inspired fashion forward athletic wear, and I was excited by the prospect of bringing a new brand to a local shop in downtown Rome. After outlining my business plan and real estate forecasts, my grandmother asked me ââ¬Å"What about Paris?â ⬠I knew this was her gentle nudge for me to practice my French. After completing a brief synopsis of my presentation in French, I surrendered to the second best armchair in our lounge and dug into my bag to share my next adventure. At the end of Junior year, I decided to pursue my passion for beauty products from a new perspective. So, I traded in my summer bikini in favor of a lab coat and goggles for 40 hours a week during the first month of summer. As I unpacked a new sleeping mask that I had spent the summer experimenting with, I shared my experiences working in a Cosmetology Lab. We admired the new color I had developed, a creamy hue of golden yellow, infused with a subtle shimmer. I loved pouring the different shades of eye shadow and watching different formulations come together to yield innovative products. After breakfast, we took our first walk into the city, down the narrow cobblestone streets to our favorite grocery store. The sweet salami, paper thin slices of prosciutto, pitted olives, and smoked salmon reminded me of my favorite appetizer at Giuseppeââ¬â¢s, my familyââ¬â¢s restaurant in New Jersey. My miniature apron that I wore as a child, its pockets stained from the juice of olive pits, still hangs on the coat rack in the kitchen. I reach into my pocket and pull out a few euros, telling my grandmother that the groceries are my treat today. As we pass a vacant shop on our way home, my reflection in the dark window gives me an idea for the window display to my shop in Rome: golden tanned mannequins, with a shimmer like the one in my eye cream, clad in geometric printed ankle pants and a bright hoodie with gold accents. All this exotic art around me, the texture of the chipping bricks around the stained glass windows. My mind wanders to the history in the cities I have yet to discover.
Objection Essay Example | Topics and Well Written Essays - 1000 words
Objection - Essay Example Consequently, the paper also discusses how appellate court will rule on the objection. The outcome of the alcohol test was issued as one of the evidence (Krey & Theresa, 75). According to the judge, if Fred Friendless has a blood content of 10, they must presume that Fred Friendless is intoxicated. Therefore, obtaining a conviction for Driving while intoxicated, the prosecution will need to establish that Fred Friendless was actually operating the vehicle under the influence. This will be accomplished through circumstantial evidence or by the witness of the eyewitness. From Fred Friendless case, the court will review the Driving While Intoxication conviction where Fred Friendlessââ¬â¢ prosecution will prove that he was driving the vehicle. Evidence from the high school head teacher revealed that he measured the skid mark of the defendant and assumed the defendant was driving at least 65 miles per hour. Additionally, the defendant believes that the any person who drinks at least two beers already intoxicated. This is a direct prove that Fred was actually driving under the influence of alcohol (Dolinko,à 67). The evidence does not establish that the defendant was under the physical control of the car and hence it is not sufficient to prove that Fred was driving the vehicle. The prosecution also needs to establish the intoxication, which he did not. According to the statutes, it is noted that, intoxication normally occur due to alcohol intake of contraband ingestion. Intoxication is normally hard to articulate. In addition to submitting the blood sample, the police needs to testify the speech, appearance, or behavior and if the police detected the smell of the alcohol beverage on Fred. The factors are important and pertinent evidence of the physical impairment and mental impairment of the defendant. During Berkemer v. McCarty 468 US 420, the Supreme Court believed that the police roadside
Sunday, July 28, 2019
Illegal Immigration Essay Example | Topics and Well Written Essays - 2500 words
Illegal Immigration - Essay Example Immigrations are good sometimes for the country but as every good thing has a bad trait; the immigration gets costly for the host country. Sometimes more disasters may cause due to these immigrants. In this piece of writing, discussions on illegal immigrations in different countries, its positive and negative effects will be through. It's the dream of every mankind to live better and give best to one's family. People immigrate from one family to other not only for change in their mood; making thing adventurous for themselves but also to find better land to live and better job to earn. Few of them move to stay with their families already settled in the other country. Few immigrants need the best education in their lives and few of them need the best environment for their families to groom in. Little of them are switching their own countries coz they are tied of country's culture and tradition. Few of them needs different good opportunities in life to grow economically more rapidly. Money really makes this world's mankind crazy to run and leave their loved ones. No doubt many countries offer immigrants a good guest of honor. They serve them if they are here with their families a nice discount on their schools, on their health care etc. similarly if they are employed there, its in some countries a rule to provide a nice income to the employee, more over a nice hand on employee kids expenditures. Medications, electricity charges, Grocery stocks and traveling are few more incentives immigrants get to have. Holidays from work, Different incentives while working really gives attraction to immigrate to a nice high standard countries. America is one of the biggest countries that receive the world's biggest amount of immigrants. People run for good jobs to other countries, leaving their home and family and moreover the fame and respect from the society to earn money. People leave their official respectable job and immigrate to work day and night having number of part time jobs. And for that even they are ready to sweep, serve on petrol pumps, and providing themselves in hotels and restaurants as waiters. Most of the poor people like to go in such countries for part time opportunities as soon as possible and though instead spending money or using their education they just went by using different resources and known to be as illegal immigrants. Immigration costs the country more as its spending less than its earning to its citizens. Few years back it was easy for every one to move from this country to that; and that country to this. But this was giving tough time to host countries, as they have to spend more for sometimes their guests and sometimes who are not citizens of the country but stayed for so long that they are good to be a citizen. These kinds of few reasons make country government set few rules to join their country. Now these rules are being checked on the immigrant and then the permission to be the guest is awarded. People not fulfilling these immigration requirements use illegal ways to enter the country. Crossing Country's borders by hiding here and there, from ports hiding in luggage, etc are few ways to be in the country without immigration. Moreover, people who come once through legal immigration stays long for work even after the expiration of their Visa limit; is also an illegal immigrant. These illegal immigrants not only uses country's goods and
Saturday, July 27, 2019
Virtual lab 3 Assignment Example | Topics and Well Written Essays - 250 words
Virtual lab 3 - Assignment Example However, if they grew independently, each would utilize the readily available natural resources and develop most favorable strength, leading to both surviving. On the tenth day, the Paramecium caudatum population reached the carrying capacity of the environment when grown alone. This is given that, subsequent to counting them repeatedly the number remained the same. On the fourth day, the Paramecium aurelia population reached the carrying capacity of the environment. This is given that, subsequent to the fourth day, the Paramecium Aurelia started dying out, whereas the others remained strong. When the two Paramecium species utilize the available food resources, then one of them has the likelihood of benefiting from more of the available resources over the other one, further leaving it to scramble for the fast depleting food (survival of the fittest). In this regard, the weak Paramecium species will lose the fight and die out. This will enable the strong one to grow strong to maturity while utilizing the readily available resources. Another observation entails the existence of chemical components that may lead to the death of one of the Paramecium species. Upon mixing the paramecium population in one test tube, one started dying out gradually. The other one attained its carrying capacity, further growing steadily leading to the death of the other
Friday, July 26, 2019
Strategic Leadership and Entrepreneurship for Dr. McDougalls Right Essay
Strategic Leadership and Entrepreneurship for Dr. McDougalls Right Food Asian Entres - Essay Example The founder and owner of Dr. McDougallââ¬â¢s Right Foods, Dr. John McDougall, as the chairman of the board of directors, continues to extend the most crucial influence to the thrusts and goals of the organization. As part of the management team, oneââ¬â¢s sphere of influence encompasses ââ¬Å"responsibility for corporate governance, corporate strategy, and the interests of all the organizations stakeholdersâ⬠(Q Finance, 2009, par. 1). Through the coordination and participation of other management team members, one has relevant impact in suggesting recommendations towards the implementation of the business plan. The success of the management team is sourced from equal, fair and just collaboration and participation of all members, regardless of the diversity in responsibilities. In this regard, there is no eminent bias within the organization. With regards to anticipating hurdles, as normal as any organization operates, hurdles come in terms of external factors that are unseen, yet could influence the firmsââ¬â¢ operations. These hurdles are increases in prices of raw materials or minimum wages for employees; imposition of additional value added taxes; or stiffer competitors, An effective leadership style is that which conforms, adjusts and adapts to the demands of the situation. One would demonstrate a situational leadership style that focuses on the capabilities and resources of the organization, in conjunction with the defined goals. Any strategy that needs to be designed must focus on the achievement objectives at the most efficient and effective manner. Any potential shortcoming is perceived in terms of responding appropriately to unanticipated changes in both the internal and external environment. Oneââ¬â¢s competencies and qualifications are the strengths that would assist in designing strategies towards the accomplishment of organizational goals. Weaknesses could come in terms of responding effectively to
Thursday, July 25, 2019
Report (addressing the key issues surrounding financial and marketing Essay
Report (addressing the key issues surrounding financial and marketing applications of management information system - Essay Example MIS systems enable organisations to transform unmanageable volumes of data into formats that supports faster decision making. Faster decision making empowers organisations with the capability to survive in todayââ¬â¢s rapidly changing business environment. MIS systems also enables organisations run simulations based on raw data which allows them to answer ââ¬Ëwhat ifââ¬â¢ questions regarding their strategy. Broadly, MISà increase information utility across anà organization. Information availability is essentialà to the decision making process at all levels of the organisation: functional, operational and strategic. In this discussion we shall look at the key issues surrounding application of MIS in two major business processes, namely: marketing and finance. Marketing management information systems (MkIS) are computerized systems designed to support the availability of information required to ensure effective marketing activities of an organization. These needs of the organization can only be met by the marketing information systems if it provides the organization with operational, analytical and collaborative functionality (Harmon 2003). The operational needs aspect is addressed by the customer management applications that focus on daily customer transactions and customer service. The analytical function is done by MkIS decision support systems that enable data analysis on factors affecting the market conditions such as customers, competition and technology. The collaborative MkIS applications make it easier for managers to share information and work together virtually. Also, it assists in encouraging organizations to collaborate with their customers on product designs and preferences. Managing marketing information by means of IT has become an indispensible element of effective marketing. MkIS offer new approaches for making better the internal efficiencies of a firm especially with
Wednesday, July 24, 2019
Importance Of Agriculture Policy For European Union Essay
Importance Of Agriculture Policy For European Union - Essay Example European Union region possesses a large export market for agricultural goods. Its exports value for 2010 amounted to more than 90 billion Euros (European commission 2011). European Union has become the leading exporter of agri-products. Its agricultural exports superseded that of US in 2003. In 2003 the EU exports of agricultural products amounted to $66 billion and that of US amounted to $64billion (European commission 2007). European Union also imports agricultural products that worth many billion Euros. However its exports have been significantly higher than its import of agri-goods in the past decade. The balance of trade of EU in agricultural product has also been improved in the past decade. The following table shows the European Union Exports and Imports from 2000 to 2006. The balance of trade was negative in 2000 through 2004. It, however, improved in 2005 and amounted to $6 billion in 2006. EU exports of agricultural products amounted to $135 billion in 2010 (Wall street jou rnal 2011). European Union has Common agricultural policy (CAP). CAP came into existence in 1950ââ¬â¢s after the destruction of World War II. CAP was formulated with the vision of avoiding any possible food shortage that EU countries might face due to the massive destruction in World War II. A budget was decided to support, invest and regulate agricultural market in EU region. Initially CAP claimed around 50% of European Union Budget (Visegrad 2010). CAP aims at such regulations and action plans that ensure the safe, healthy and competitive agri-products to be consumed inside the region and exported as well. Primarily, the CAPââ¬â¢s focus has been on the subsidies given to farmers to ensure high production but now due to several factors the CAPââ¬â¢s focus, in its new proposed policy, has been on the policies for agriculture that ensure a farming that meet the standards of environmental security as well as provide competitive products to the EU region and International comm unity. Common agricultural policy takes a very high bite of the EU budget. In 2009 its budget amounted to 55 billion EUR which is about 44% of the total budget of European Union (European commission 2010). This paper will discuss the agricultural policy of European Union, its inception and primary objectives at the time of its formulation. The paper will discuss the importance of agricultural policy of European Union by referring to the important agricultural policies and discussing therein the importance of such policies. Moreover the paper will also discuss the new proposed policies for agriculture and their importance in the changing world scenario for European Union specifically and International community at large. Initial CAP and its importance In its early years, CAP adopted a policy where it provided the subsidies and had a system where the farmers were assured of high prices for their commodities. It also provided a policy for substantial financial assistance to improve and restructure farms and to implement new technological developments in the agricultural production. The underlying objective of CAP at the time of its establishment was to take such measures so as to avoid a possible food shortage in the region, to increase productivity of agricultural sector, to stabilize markets and to ensure price competitiveness of products (Stead 2010). These policies played a very important role. These helped EU region to get out of the fear
Tuesday, July 23, 2019
The relationship between narrator and a couple Essay
The relationship between narrator and a couple - Essay Example The woman turns her whole life to writing numerous letters in which she analyzes her present and past experience. Beside her terrible and irreplaceable loss she has to deal with one more problem ââ¬â her personal betrayal. On the day of the incident she was with another man called Jasper, a famous journalist. The woman cannot forgive herself this and cannot understand herself as well. It is Jasper and his girlfriend Petra who are described in the novel from rather unexpected perspective. The very situation itself in which the main heroine finds herself is bizarre- she is in the center of love triangle however, love affairs seem not to bother her anymore. So speaking about topics such popular as terrorism Chris Cleave manages to show it witty yet seriously. He reflects on the themes of loss, sin, betrayal, loneliness, atonement, and hope. He tells the story not from his point of view but from the perspective of the principal heroine: he looks with her eyes and speaks with her word s. That is why the language of the novel is far from sophisticated however it is sad and ironical at the same time. So the principal heroine is the narrator herself while the listener (which is really strange and unpredictable) is Osama Ben Laden. Obviously the relationship between the couple of Jasper and Petra and the narrator are very tense, strange and specific. First and the most noteworthy thing is the psychological state of the narrator itself. Her grief is literally felt through the words, her loss squeezes from every little sentence. It is not only that she carries this toy rabbit of her dead son with her wherever she goes, it is her eyes, her irony, and her constant and unstable self- analysis. She tries very hard not to fall apart and the only weapon she has is her natural sense of humor and her simplicity. She feels real from the very beginning of the novel and even Jasper seems to be attracted with her
Psychological Effects one can have due to Sleep Deprivation Essay Example for Free
Psychological Effects one can have due to Sleep Deprivation Essay According to Kozier et Al. (2002), sleep is the state of being conscious wherein there is a decrease of perception, and reaction to the environment of an individual (p. 953). Sleep exerts physiologic effects on both the nervous systems and other body structures and also it restores normal levels of activity and balance among parts of the nervous systems (p. 956). There are two types of sleep, NREM sleep and REM sleep, NREM sleep or non-REM sleep is a deep, restful sleep and some physiologic functions were decreased. It is also referred to as a low wave sleep because when a person sleeps the brain waves tends to slow than the alpha and beta waves of an awake person. NREM sleep is divided into four stages: stage 1- very light sleep wherein the person feels drowsy and relaxed, stage 2- light sleep that will last only from ten to fifteen minutes, stage 3- domination of parasympathetic nervous systems that slows down the heart and respiratory rates as well as other body processes and sometimes snoring may occur and the fourth stage will be the deep sleep is thought to restore the body physically, dreams and rolling of the eyes may occur in this stage. Another type of sleep is the REM sleep or the rapid eye movement sleep that constitutes 25% of sleep of a young adult and usually recurs every ninety minutes and lasts five to thirty minutes. On the other hand, dreams in REM sleep were usually remembered because it is consolidated in the memory (pp. 953-954). There are many factors that may affect sleep of an individual, quality of sleep and quantity of sleep were both affected by a number of factors. The quality of sleep is the ability of an individual to stay asleep and to get the required amount of REM and NREM sleep while the quantity of sleep is the total time the individual sleeps. Age, environment fatigue, life style, psychological stresses are just some of the factors that indeed affects the sleep of an individual (p. 956). Literature Review In an internet article, they listed six persons that have a contribution in sleep research. A French Scientist Henri Pieron authored a book entitled ââ¬Å"Le probleme physiologique du sommeil,â⬠which was the first text to examine sleep from a physiological perspective. This work is usually regarded as the beginning of the modern approach to sleep research. Dr. Nathaniel Kleitman, now known as the ââ¬Å"Father of American sleep research,â⬠he started working in Chicago in the 1920ââ¬â¢s questioning the regulation of sleep and wakefulness and of circadian rhythms. Kleitmanââ¬â¢s crucial work included studies of sleep characteristics in different populations and the effect of sleep deprivation. Another contributor is questioning the regulation of sleep and wakefulness and of circadian rhythms. Kleitmanââ¬â¢s crucial work included studies of sleep characteristics in different populations and the effect of sleep deprivation. Dr. William C. Dement extended Dr. Kleitmanââ¬â¢s path of research. Dement described the ââ¬Å"cyclicalâ⬠nature of nocturnal sleep in 1955, and in 1957 and ââ¬â¢58 established the relationship between REM sleep and dreaming. In 1958, he published a paper explaining that in a sleeping cat there is a cyclic organization existence, thus creating an explosion of fundamental research that gathers researchers from different fields of specialty. For the next 20 years, Michel Jouvet leads to an identification of REM sleep as an independent state of alertness, which he called ââ¬Å"paradoxical sleep. Another one is H. Gastaut and his colleagues discovered the presence of apnea during sleep in a subgroup of ââ¬Å"Pickwickianâ⬠patients (1965) that lead them to an outbreak of investigations of the control exercised by the ââ¬Å"sleeping brainâ⬠on the bodyââ¬â¢s vital functions. His work eventually led to the new discipline of ââ¬Å"sleep medicineâ⬠(A brief history of sleep research, ââ¬Å"n. a. â⬠). Sleep deprivation and its causes According to Kozier et Al. (2002), sleep deprivation is only one out of many common sleep disorders. They defined sleep deprivation as a syndrome of prolonged disturbance that leads the amount, quality, and consistency of sleep to decrease and thus produces a variety of physiologic and behavioral symptoms, its harshness will depend on the degree of the deprivation. Again there are two types of sleep deprivation REM and NREM deprivation, the combination of the two deprivation increases the severity of symptoms. Alcohol, barbiturates, shift work, jet lag, extended ICU hospitalization, morphine, and meperidine hydrochloride are the causes of REM deprivation, while all of the causes of REM deprivation plus diazepam flurazepam hydrochloride, hypothyroidism, depression, respiratory distress disorders, sleep apnea, and age causes NREM deprivation, and both REM and NREM deprivation is caused from the combination of both REM and NREM deprivation causes (p. 959). Another cause of sleep deprivation is from the psychological stress wherein anxiety and depression frequently disturb sleep. A person canââ¬â¢t relax adequately to get to sleep if he or she is having a personal problem. Another factor is alcohol and stimulants, people who drinks alcohol excessively has the higher rates of sleep disturbances. Alcohol disrupts REM sleep even though it fastens the onset of sleep. Diet- weight loss is accompanied with reduced total sleep time as well as broken sleep and earlier awakening. Smoking, cigarettes contains nicotine that has stimulating effects on the body and may cause in difficulty of falling asleep. Motivation, personââ¬â¢s desire to stay awake can cause a fatigue, and illness, an ill person is more prone to sleep deprivation, in their condition they need to have more sleep, but a patient in a hospital is disturb by their time to take their medicines, and respiratory conditions can also disturb sleep thus disturbing their total time of sleep a person is required to have (p. 956). Psychological and physical effects of sleep deprivationà The effects of sleep deprivation to the body is like a chain reaction, its main target is the brain, since the brain is the control unit of the body, the brain controls and is responsible for the homeostasis of the body, once the brain is affected many imbalances may occur. For REM deprivation excitability, restlessness, irritability, increased sensitivity to pain, confusion and suspiciousness, and emotional liability can possibly be the effects. For NREM deprivation one may show hyporesponsiveness, withdrawal, apathy, feeling physically uncomfortable, lack of facial expression, and speech deterioration. For both REM and NREM deprivation, inattentiveness, decreased reasoning ability and the ability to concentrate, marked fatigue manifested by blurred vision, itchy eyes, nausea, headache, difficulty in performing activities of daily living, lack of memory, mental confusion, visual or auditory hallucinations and illusions can be its primary effects to oneââ¬â¢s both psychological and physical aspect of a person. Since stress is one of the major factor affecting sleep deprivation whether itââ¬â¢s psychological or physical stress. As you think more and focuses your mind into the problem, your mind will become more fatigue (p. 959). Based on the book by Biron et Al. (2006), stress may lead to some psychological problems and may interfere with effective intrapersonal and the intrapersonal behavior of the individual. A person experiencing prolonged stressful events may suffer from feelings of helplessness and hopelessness, and consequently, undermining his self esteem. Impaired task performance is another effect of stressful mind; it interferes with our ability to successfully perform a task and responsibilities expected. And disruption of cognitive functioning, people who are under stress are likely to experience loss of concentration, disorientation, and forgetfulness (pp. 184-185). Treatment for sleep deprived persons According to the book made by Kushida (2005), pregnant women are also prone to sleep deprivation. In treating sleep deprivation for pregnant women, they recommended seven treatments to minimize maternal and fetal health risk: a) women should try to seep on the left side and avoid sleeping in supine position.à Avoiding it will ease the stress of the heart, will reduce constriction of the space available to the fetus, will reduce pressure to the inferior vena cava that carries blood back to the heart from the feet and legs, b) if symptoms of RLS are present, consider an evaluation of ferritin, hemoglobin, and folate levels and supplement when indicated, c) treat sleeping- disordered breathing with CPAP, d) avoid staying in bed when unable to seep, e) address anxiety provoking issues to reduce overall level of arousal, f) Consider regular exercise, pregnant women who exercise three times a week for at least thirty minutes have less insomnia and anxiety than pregnant women who do not exercise, and g) treat psychophysiological insomnia with empirically supported cognitive behavioral therapy for insomnia (p. 185). Another form of treatment is discussed by Greist and Jefferson (1992), psychosurgery is a rare treatment; it is not then advisable if other treatments have not been tested to a patient. Careful neurosurgical interruption of brain pathways has been shown that fifty percent of patients has been helped to this kind of treatment (pp. 79-80). Conclusion: Sleep is really a helpful in obtaining our health; it restores our bodyââ¬â¢s energy. Sleep deprivation is not really a syndrome but an effect due to some disturbances, stress, and anxiety that makes our brain to send signal to our body to be awake, an unnecessary awakening that affects our total time of sleep.à When our body is stressful or lack of average sleep needed by each individual, our brain do not work properly thus affecting our lifestyle, our ability to think and cope up with problems, and then other diseases may occur if not immediately taken to concern, because stress attacks our brain and knowing that our brain is the control center of our body. Recommendation: If sleeplessness and the listed signs and symptoms occur, it will be a clever decision if you consult a Doctor immediately prior to health concern. It is also a best way if symposiums will be conducted or seminars that discuss about Sleep deprivation to school and or universities so that students and educators will be aware to the effects of sleep deprivation that one can possibly have due to body exhaustion and abuse.
Subscribe to:
Posts (Atom)