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Selected Abstracts

Hungarian Agriculture at the Dawn of EU Accession

EUROCHOICES, Issue 1 2004
Imre Nemeth
Summary Hungarian AgricuIture at the Dawn of EU Accession Hungary and Hungarian agriculture nurse high hopes for EU-accession. Agriculture and rural development were of pivotal importance during the accession negotiations, in the accession referendum and the preparations for accession. The success in integrating our agriculture into the CAP and the single market will substantially influence public opinion in the post-accession years. We expect our membership to stabilise market conditions and to improve development possibilities in rural areas where there is great demand for better employment and living conditions. These benefits will emerge from our integration into the single market, our involvement in decision-making and from the backing of EU resources. But the challenges of EU membership also evoke fears amongst Hungarian farmers. The transformation of agriculture is incomplete, agricultural incomes and investments are stagnant, rural infrastructure is somewhat weak and marketing systems are rather inefficient. Hungarian farmers have difficulty accepting the relatively low levels of direct aids whereas they face full health and food safety restrictions from day one of accession. The CAP Reform of June 2003 confuses and slows down our preparatory work. Hungarian agriculture, however, is determined to respond to the challenges of accession. Our common Europe will prove stronger with Hungarian agriculture, and Hungarian agriculture has to become stronger through our EU membership. L'agriculture hongroise au temps zéro de I'accession OLa Hongrie et l'agriculture hongroise mettent de grands espoirs dans L'accession à l'Union Européenne. L'agriculture et le développement rural ont été au centre des négotiations sur l'accession, du référendum associé et des mesures préparatoires correspondantes. l'opinion publique sera grandement influenceée, dans les années qui suivront l'accession, par le succés de l'intégration de notre agriculture dans la politique agricole commune et le marché unique. De notre appartenance à l'UE, nous attendons la stabilisation des marchés et l'amélioration des perspectives de développement dans les zones rurales oú le besoin de meilleures conditions de vie et d'emploi se fait sentir avec acuité. Ces avantages devraient provenir de notre intégration dans le marché unique, de notre participation aux décisions collectives et d'un soutien à la mesure des ressources de l'Union Européenne. Cependant, les défis de l'intégration européenne ne vont pas aussi sans susciter des craintes chez les agriculteurs hongrois. La transformation de l'agriculture est incompléte, les revenus et les investissements stagnent, les infrastructures rurales sont insuffisantes et l'organisation des marchés inefficace. Les agriculteurs hongrois acceptent difficilement de ne bénéficier que d'aides directes relativement faibles, alors que, dés le premier jour de l'accession, ils seront soumis à tous les réglements communautaires en matiére de santé et de sécurité alimentaires. La réforme de la PAC en juin 2003 complique encore et ralentit les travaux préparatoires à l'accession. Néanmoins, l'agriculture hongroise est résolue à relever le défi. L'Europe commune sera plus forte avec l'agriculture hongroise et cette derniére sera renforcée par son appartenance à l' Europe Ungarische Landwirtschaft kurz vor dem EU-Beitritt Ungarn und die ungarische Landwirtschaft setzen große Hoffnungen in den EU-Beitritt. Die Landwirtschaft und die Entwicklung des ländlichen Raums waren in den Beitrittsverhandlungen, beim Volksentscheid zum Beitritt und bei den Vorbereitungen des Beitritts von entscheidender Bedeutung. Das Gelingen bei der Integration unserer Landwirtschaft in die GAP und den Binnenmarkt wird die öffendiche Meinung in den Jahren nach dem Beitritt entscheidend beeinflussen. Wir erhoffen uns von unserer Mitgliedschaft stabilere Marktbedingungen und bessere Entwicklungsmöglichkeiten im ländlichen Raum, wo Verbesserungen im Hinblick auf Beschäftigungssituation und Lebensbedingungen dringend erforderlich sind. Dies wird durch unsere Integration in den Binnenmarkt, unseren Beitrag zur Entscheidungsfindung und mit Hilfe von EU-Ressourcen erfolgen. Die Herausforderungen der EU-Mitgliedschaft rufen jedoch bei den ungarischen Landwirten auch Ängste hervor. Die Transformation der Landwirtschaft ist noch nicht abgeschlossen, die ländwirtschaftlichen Einkommen und die Investitionen stagnieren, die landliche Infrastruktur ist recht schwach entwickelt und die Vermarktung ist relativ ineffizient. Die ungarischen Landwirte können nur schwer akzeptieren, dass ab dem ersten Tag ihres Beitritts zwar alle Gesundheits- und Nahrungs-mittelsicherheitsbestimmunge n eingehalten werden müssen, aber nur geringe direkte Beihilfen gewährt werden. Die Reform der GAP vom Juni 2003 irritiert und verzögert unsere Vorbereitungen. Die ungarische Landwirtschaft ist jedoch entschlossen, sich den Herausforderungen des Beitritts zu stellen. Unser gemeinsames Europa wird mit der ungarischen Landwirtschaft noch stärker, und die ungarische Landwirtschaft muss durch unsere EU-Mitgliedschaft gestärkt werden. [source]

Using DCE and ranking data to estimate cardinal values for health states for deriving a preference-based single index from the sexual quality of life questionnaire

HEALTH ECONOMICS, Issue 11 2009
Julie Ratcliffe
Abstract There is an increasing interest in using data derived from ordinal methods, particularly data derived from discrete choice experiments (DCEs), to estimate the cardinal values for health states to calculate quality adjusted life years (QALYs). Ordinal measurement strategies such as DCE may have considerable practical advantages over more conventional cardinal measurement techniques, e.g. time trade-off (TTO), because they may not require such a high degree of abstract reasoning. However, there are a number of challenges to deriving the cardinal values for health states using ordinal data, including anchoring the values on the full health,dead scale used to calculate QALYs. This paper reports on a study that deals with these problems in the context of using two ordinal techniques, DCE and ranking, to derive the cardinal values for health states derived from a condition-specific sexual health measure. The results were compared with values generated using a commonly used cardinal valuation technique, the TTO. This study raises some important issues about the use of ordinal data to produce cardinal health state valuations. Copyright © 2009 John Wiley & Sons, Ltd. [source]

Impact of publicly sponsored interventions on musculoskeletal injury claims in nursing homes,

AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 9 2009
Robert M. Park MS
Abstract Background The rate of lost-time sprains and strains in private nursing homes is over three times the national average, and for back injuries, almost four times the national average. The Ohio Bureau of Workers' Compensation (BWC) has sponsored interventions that were preferentially promoted to nursing homes in 2000,2001, including training, consultation, and grants up to $40,000 for equipment purchases. Methods This study evaluated the impact of BWC interventions on back injury claim rates using BWC data on claims, interventions, and employer payroll for all Ohio nursing homes during 1995,2004 using Poisson regression. A subset of nursing homes was analyzed with more detailed data that allowed estimation of the impact of staffing levels and resident acuity on claim rates. Costs of interventions were compared to the associated savings in claim costs. Results A $500 equipment purchase per nursing home worker was associated with a 21% reduction in back injury rate. Assuming an equipment life of 10 years, this translates to an estimated $768 reduction in claim costs per worker, a present value of $495 with a 5% discount rate applied. Results for training courses were equivocal. Only those receiving below-median hours had a significant 19% reduction in claim rates. Injury rates did not generally decline with consultation independent of equipment purchases, although possible confounding, misclassification, and bias due to non-random management participation clouds interpretation. In nursing homes with available data, resident acuity was modestly associated with back injury risk, and the injury rate increased with resident-to-staff ratio (acting through three terms: RR,=,1.50 for each additional resident per staff member; for the ratio alone, RR,=,1.32, 95% CI,=,1.18,1.48). In these NHs, an expenditure of $908 per resident care worker (equivalent to $500 per employee in the other model) was also associated with a 21% reduction in injury rate. However, with a resident-to-staff ratio greater than 2.0, the same expenditure was associated with a $1,643 reduction in back claim costs over 10 years per employee, a present value of $1,062 with 5% discount rate. Conclusions Expenditures for ergonomic equipment in nursing homes by the Ohio BWC were associated with fewer worker injuries and reductions in claim costs that were similar in magnitude to expenditures. Un-estimated benefits and costs also need to be considered in assessing full health and financial impacts. Am. J. Ind. Med. 52:683,697, 2009. © 2009 Wiley-Liss, Inc. [source]

Health related quality of life in Crohn's proctocolitis does not differ from a general population when in remission

COLORECTAL DISEASE, Issue 1 2003
P. Andersson
Abstract Objective All treatment in Crohn's disease, although palliative, aims at restoring full health. The objective of this study was to compare health-related quality of life and psychosocial conditions in patients with Crohn's proctocolitis with a general population. Patients and methods One hundred and twenty-seven patients with Crohn's proctocolitis (median age 44 years, 44.1% men) were compared with 266 controls (median age 45 years, 50.7% men). A questionnaire consisting of the Short Form-36 (SF-36), the Psychological General Well-Being Index (PGWB) and a visual analogue scale (VAS) evaluating general health as well as questions regarding psychosocial conditions was used. Disease activity was evaluated by Best's modification of the classical Crohn's Disease Activity Index. Results Patients in remission had a health related quality of life similar to controls according to the SF-36 apart from general health where scores were lower (P < 0.01). Patients with active disease scored lower in all aspects of the SF-36 (P < 0.001 or P <,0.0001) as well as the PGWB (P < 0.0001). In a model for multiple regression including age, gender, concomitant small bowel disease, permanent stoma, previous colonic surgery, disease activity, duration, and aggressiveness, disease activity was the only variable negatively predicting all 8 domains of the SF-36 in the patient group (P < 0.001). The mean annual sick-leave for patients and controls were 33.9 and 9.5 days (P < 0.0001), respectively. Sixty-eight percent of the patients and 78.4% of the controls (P = 0.04) were married or cohabited, 67.7% and 78.0% (P = 0.04), respectively, had children. Conclusion The health related quality of life for patients with Crohn's proctocolitis in remission does not differ from the general population. The disease has, however, a negative impact on parenthood, family life and professional performance. [source]