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Selected AbstractsIs Vancouver Canada's supervised injection facility cost-saving?ADDICTION, Issue 8 2010Steven D. Pinkerton ABSTRACT Objective To determine whether Vancouver's Insite supervised injection facility and syringe exchange programs are cost-saving,that is, are the savings due to averted HIV-related medical care costs sufficient to offset Insite's operating costs? Methods The analyses examined the impact of Insite's programs for a single year. Mathematical models were used to calculate the number of additional HIV infections that would be expected if Insite were closed. The life-time HIV-related medical costs associated with these additional infections were compared to the annual operating costs of the Insite facility. Results If Insite were closed, the annual number of incident HIV infections among Vancouver IDU would be expected to increase from 179.3 to 262.8. These 83.5 preventable infections are associated with $17.6 million (Canadian) in life-time HIV-related medical care costs, greatly exceeding Insite's operating costs, which are approximately $3 million per year. Conclusions Insite's safe injection facility and syringe exchange program substantially reduce the incidence of HIV infection within Vancouver's IDU community. The associated savings in averted HIV-related medical care costs are more than sufficient to offset Insite's operating costs. [source] Seeking asylum in EuropeECONOMIC POLICY, Issue 38 2004Timothy J. Hatton SUMMARY Seeking asylum in Europe Over the last three decades the annual number of applications for asylum in the countries of the European Union has increased from about 15 000 to more than 300 000. This has sparked a political backlash, a revolution in policy, a lively academic debate, but very little economic analysis. Although the causes of asylum flows and the effects of policy are much discussed, they have rarely been the subject of quantitative analysis. This article examines the evolution of asylum flows and asylum policy across the EU since the early 1980s. It investigates the effects of war and conflict, economic incentives, and asylum policies on the total numbers and on the proportions going to the different countries of the EU. Special attention is given to the growth of policy restrictiveness across the EU and to the harmonization of asylum policies. Contrary to some views, policy has worked to stem the flows, but it has been overwhelmed by other forces. [source] Epidemiological study of acute encephalitis in Tottori Prefecture, JapanEUROPEAN JOURNAL OF NEUROLOGY, Issue 10 2008K. Wada-Isoe Background and purpose:, To conduct an epidemiological survey of acute encephalitis focusing on non-herpetic acute limbic encephalitis (NHALE) in Tottori Prefecture, western area of Japan. Methods:, A questionnaire survey on the annual number of patients aged 16 years or more with acute encephalitis from 2001 to 2005 was undertaken in 2006. Results:, During the study period, 49 patients were diagnosed with acute encephalitis. The subtype of acute encephalitis was as follows: 10 patients with herpes simplex encephalitis (HSE), 12 patients with NHALE, 4 patients with paraneoplastic encephalitis, 2 patients with encephalitis associated with collagen disease, one patient with viral encephalitis other than HSE, 20 patients with encephalitis with unknown causes. The service-based incidence rate of acute encephalitis was 19.0 per million person-years. The incidence rate of NHALE subtype was 4.7 per million person-years. Conclusions:, Our epidemiological survey indicated an estimated 550 patients would develop NHALE per year in Japan, suggesting that NHALE may not be a rare disorder. [source] ORIGINAL AND SECONDARY HIGH-FREQUENCY SANDSTORM ZONES IN THE LOESS PLATEAU REGION, CHINAGEOGRAFISKA ANNALER SERIES A: PHYSICAL GEOGRAPHY, Issue 2 2007JIONGXIN XU ABSTRACT. A study of sandstorms in the Loess Plateau and neighbouring areas is based on observations of sandstorms and precipitation. Through analysis of the relationship between the mean annual number of sandstorms and the mean annual precipitation, an original sandstorm zone and a secondary high-frequency zone of sandstorms have been defined. The latter is mainly formed as a result of human activities, such as vegetation destruction and waste-land cultivation, and not because of climatic change. The secondary sandstorm zone is located 350,500 km away from the original sandstorm zone, reflecting the fact that the sandstorm zone in the Loess Plateau area has shifted 350,500 km to the southeast, in response to human impact. Some abrupt change has been found in the area where the mean annual precipitation is 270 mm, where the original sandstorm zone ends and a secondary zone of high-frequency sandstorms begins. This transition area can be regarded as an abnormally unstable area. This study shows that destruction of the vegetation can cause changes in the environment similar to those attributed to climatic change. [source] Salvage laryngectomy and pharyngocutaneous fistulae after primary radiotherapy for head and neck cancer: A national survey from DAHANCAHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 9 2003Cai Grau MD, DMSc Objective. In 1998, the Danish Society for Head and Neck Oncology decided to conduct a nationwide survey at the five head and neck oncology centers with the aim of evaluating the surgical outcome of salvage laryngectomy after radiotherapy with special emphasis on identifying factors that could contribute to the development of pharyngocutaneous fistulae. Patients. A total of 472 consecutive patients undergoing postirradiation salvage laryngectomy in the period July 1, 1987,June 30, 1997 were recorded at the five head and neck oncology centers in Denmark. Age ranged from 36 to 84 years, median 63 years, 405 men and 67 women. Primary tumor site was glottic larynx (n = 242), supraglottic larynx (n = 149), other larynx (n = 45), pharynx (n = 27), and other (n = 9). All patients had received prior radiotherapy. Results. Median time between radiotherapy and laryngectomy was 10 months (range, 1,348 months). A total of 89 fistulae lasting at least 2 weeks were observed, corresponding to an overall average fistulae risk of 19%. The number of performed laryngectomies per year decreased linearly (from 58 to 37), whereas the annual number of fistulae increased slightly (from 7 to 11), which meant that the corresponding estimated fistulae risk increased significantly from 12% in 1987 to 30% in 1997. Other significant risk factors for fistulae in univariate analysis included younger patient age, primary advanced T and N stage, nonglottic primary site, resection of hyoid bone, high total radiation dose, and large radiation fields. Multiple logistic regression analysis of these parameters suggested that nonglottic tumor site, late laryngectomy period (1987,1992 vs 1993,1997), and advanced initial T stage were independent prognostic factors for fistulae risk. Surgical parameters like resection of thyroid/tongue base/trachea or radiotherapy parameters like overall treatment time or fractions per week did not influence fistulae risk. Conclusions. The risk of fistulae is especially high in patients initially treated with radiotherapy for nonglottic advanced stage tumors. A significant decrease in the number of performed salvage laryngectomies over the 10 years was seen. Over the same time period, the annual number of fistulae remained almost constant. The resulting more than doubling of fistulae rate could thus in part be explained by less surgical routine. © 2003 Wiley Periodicals, Inc. Head Neck 25: 711,716, 2003 [source] The Relationship between Hospital Volume and Mortality in Mechanical Ventilation: An Instrumental Variable AnalysisHEALTH SERVICES RESEARCH, Issue 3 2009Jeremy M. Kahn Objective. To examine the relationship between hospital volume and mortality for nonsurgical patients receiving mechanical ventilation. Data Sources. Pennsylvania state discharge records from July 1, 2004, to June 30, 2006, linked to the Pennsylvania Department of Health death records and the 2000 United States Census. Study Design. We categorized all general acute care hospitals in Pennsylvania (n=169) by the annual number of nonsurgical, mechanically ventilated discharges according to previous criteria. To estimate the relationship between annual volume and 30-day mortality, we fit linear probability models using administrative risk adjustment, clinical risk adjustment, and an instrumental variable approach. Principle Findings. Using a clinical measure of risk adjustment, we observed a significant reduction in the probability of 30-day mortality at higher volume hospitals (,300 admissions per year) compared with lower volume hospitals (<300 patients per year; absolute risk reduction: 3.4%, p=.04). No significant volume,outcome relationship was observed using only administrative risk adjustment. Using the distance from the patient's home to the nearest higher volume hospital as an instrument, the volume,outcome relationship was greater than observed using clinical risk adjustment (absolute risk reduction: 7.0%, p=.01). Conclusions. Care in higher volume hospitals is independently associated with a reduction in mortality for patients receiving mechanical ventilation. Adequate risk adjustment is essential in order to obtained unbiased estimates of the volume,outcome relationship. [source] Trends in storminess over the Netherlands, 1962,2002INTERNATIONAL JOURNAL OF CLIMATOLOGY, Issue 10 2005A. Smits Abstract Trends in the annual number of independent wind events over the Netherlands are studied for the period 1962,2002. The events are selected out of 13 hourly 10 m wind speed records that are part of a high quality dataset of near-surface wind observations at Dutch meteorological stations. Comparisons are made with trends in independent wind events selected from geostrophic wind speed records and reanalysis data. The results for moderate wind events (that occur on average 10 times per year) and strong wind events (that occur on average twice a year) indicate a decrease in storminess over the Netherlands between 5 and 10%/decade. This result is inconsistent with National Centers for Environmental Prediction,National Center for Atmospheric Research or European Centre for Medium-Range Weather Forecasts reanalysis data, which suggest increased storminess during the same 41 year period. Possible explanations are given for the discrepancy between the trends in storminess based on station data and the trends in storminess based on reanalysis data. Evaluation of trends in geostrophic wind, both from station data and reanalysis data, and evaluation of trends in vector-averaged (upscaled) 10 m wind over the Netherlands point towards inhomogeneities in the reanalysis data as the main cause of the discrepancy. We conclude that it is likely that the decrease in storminess observed in Dutch station records of near-surface wind in the past four decades is closer to reality than the increase suggested by the reanalysis data. Copyright © 2005 Royal Meteorological Society. [source] Trends in extreme daily rainfall and temperature in Southeast Asia and the South Pacific: 1961,1998INTERNATIONAL JOURNAL OF CLIMATOLOGY, Issue 3 2001M.J. Manton Abstract Trends in extreme daily temperature and rainfall have been analysed from 1961 to 1998 for Southeast Asia and the South Pacific. This 38-year period was chosen to optimize data availability across the region. Using high-quality data from 91 stations in 15 countries, significant increases were detected in the annual number of hot days and warm nights, with significant decreases in the annual number of cool days and cold nights. These trends in extreme temperatures showed considerable consistency across the region. Extreme rainfall trends were generally less spatially coherent than were those for extreme temperature. The number of rain days (with at least 2 mm of rain) has decreased significantly throughout Southeast Asia and the western and central South Pacific, but increased in the north of French Polynesia, in Fiji, and at some stations in Australia. The proportion of annual rainfall from extreme events has increased at a majority of stations. The frequency of extreme rainfall events has declined at most stations (but not significantly), although significant increases were detected in French Polynesia. Trends in the average intensity of the wettest rainfall events each year were generally weak and not significant. Copyright © 2001 Royal Meteorological Society [source] Modelling the burden of stroke in Finland until 2030INTERNATIONAL JOURNAL OF STROKE, Issue 5 2009J. Sivenius Background It is well known that increasing age is the strongest risk factor of stroke. Therefore, it has been a common belief in many countries including Finland that the numbers of stroke patients will increase considerably during the next two decades because the population is rapidly ageing. Methods The FINMONICA and FINSTROKE registers operated in Finland in the Kuopio area and city of Turku from 1983 to 1997. The results showed that the incidence, mortality and case fatality of stroke declined significantly during that period. Importantly, it was established that the trends in incidence and mortality were also declining among the elderly (>74 years). We used these results to create a model for the entire country. The model was based on the trends present in these registers from Turku and Kuopio area and age-specific population projections up to the year 2030 that were obtained from Statistics Finland. Results In the year 2000, the number of new first stroke cases was estimated to be 11 500. If the declining trend were to level off totally after the year 2000, the number of new strokes would be 20 100 in the year 2030 due to the ageing of the population. It would be 12 100 if the trend continued as favourable as during the years 1983,1997. Conclusions Ageing of the population will not inevitably increase the burden of stroke in Finland if the present declining trends are maintained, but the annual number of cases will almost double if the incidence remains at the level of the year 2000. [source] The burden of paediatric stroke and cerebrovascular disorders in CroatiaINTERNATIONAL JOURNAL OF STROKE, Issue 5 2009J. Lenicek Krleza Pediatric stroke is significantly less common than stroke in adults, but represents a major challenge to public health authorities. The aim of this retrospective study was to identify the total and annual number of children younger than 18 years with arterial ischaemic stroke and transient ischaemic attack referred to the Children's Hospital Zagreb, which is a major national centre specialised for the treatment and prevention of stroke in children. We reviewed the medical records of the Department of Neuropediatrics database at the Children's Hospital Zagreb between 1998,2005 in order to provide demographic and clinical characteristics and neuroimaging findings in children with arterial ischaemic stroke. In the 7-year period, we identified a total of 124 children from different geographic areas of Croatia with a confirmed diagnosis of transient ischaemic attack (N=77), and arterial ischaemic stroke (N=47). Perinatal and childhood arterial ischaemic stroke were equally represented (23 and 24 children, respectively). The average number of new cases identified each year was 18 cases (range: 12,21), seven arterial ischaemic stroke and 11 transient ischaemic attack cases. Male predominance was found in children with arterial ischaemic stroke with a male : female ratio of 1·76 : 1, and was slightly higher in childhood arterial ischaemic stroke compared with perinatal arterial ischaemic stroke (2 : 1 and 1·56 : 1, respectively). In contrast, transient ischaemic attack was more frequently found in girls, and more likely identified in older children compared with younger children with arterial ischaemic stroke. Obtained data will contribute to better understanding of paediatric stroke in Croatia and will provide a base for the establishment of the national referral center and national pediatric stroke registry. [source] Annual changes of the incidence and clinical characteristics of magnesium ammonium phosphate urinary stonesINTERNATIONAL JOURNAL OF UROLOGY, Issue 1 2003TAKAHIDE OGATA Abstract Background: Magnesium ammonium phosphate (MAP) urinary stones account for the majority of staghorn stones and frequently cause a non-functioning kidney. In the present study, we examined the annual changes of the number and clinical characteristics of MAP stones. Methods: The annual incidence of MAP stones was investigated in 2619 patients with urinary stones in whom composition of the stone was analysed at Chiba University Hospital between 1964 and 1999. In addition, the annual number of patients with MAP stones was examined at Funabashi Clinic. In a total of 644 patients with MAP stones, age and sex of the patients, location and size of the MAP stones, urinary cultures and etiological factors were analysed. Results: The number of MAP stones in the lower urinary tract was relatively constant. In contrast, MAP stones in the upper urinary tract had dramatically decreased since 1989, resulting in an increase in the rate of MAP stones in the lower urinary tract. Age distribution of the MAP stone patients ranged from 10 years to >,80 years, with the majority aged 30,60 years. The proportion of larger MAP stones in the upper urinary tract increased. There was no significant difference in prevalence of urine cultures. Among etiological factors for MAP stones, difficulty on urination tended to be common in recent years. Conclusion: The number of MAP stones, especially in upper urinary tract, has been decreasing during the last decade. At present, treatment of urinary tract obstruction seems important for the management of MAP stones in lower urinary tract. [source] Modelling space use and dispersal of mammals in real landscapes: a tool for conservationJOURNAL OF BIOGEOGRAPHY, Issue 4 2003David W. Macdonald Abstract Aim To explore the usefulness of Spatially Explicit Population Models (SEPMs), incorporating dispersal, as tools for animal conservation, as illustrated by the contrasting cases of four British mammals. Methods For each of the four species (American mink, Mustela vison, pine marten, Martes martes, dormouse, Muscardinus avellanarius and water vole, Arvicola terrestris) a spatial dynamics model was developed based on an integrated geographical information system (GIS) population model that linked space use to the incidence of the species. Each model had, first, a GIS, which stored environmental, habitat and animal population information, and secondly, an individual-based population dynamics module, which simulated home range formation, individual life histories and dispersal within the GIS-held landscape. Results The four models illustrated different interactions between species life-history variables and the landscape, particularly with respect to dispersal. As water voles and dormice occupy home ranges that are small relative to blocks of their habitat, they were most effectively modelled in terms of the dynamics of local populations within habitat blocks but linked by dispersal. In contrast, because the home ranges of American mink and pine marten are large relative to blocks of habitat, they were best modelled as individuals moving through a landscape of more or less useful patches of habitat. For the water vole, the most significant predictors of population size were the carrying capacity of each habitat and the annual number of litters. For the dormouse, the likelihood of catastrophe and the upper limit to dispersal movement were the key variables determining persistence. Adult mortality and home-range size were the only significant partial correlates of total population size for the American mink. Adult mortality was also a significant correlate of total population size in the pine marten, as were litter size and juvenile mortality. In neither the marten nor the mink was dispersal distance a significant factor in determining their persistence in the landscape. Main conclusions At a landscape scale it is difficult to measure animal distributions directly and yet conservation planning often necessitates knowledge of where, and in what numbers, animals are found, and how their distributions will be affected by interventions. SEPMs offer a useful tool for predicting this, and for refining conservation plans before irreversible decisions are taken in practice. [source] Evolution of avian clutch size along latitudinal gradients: do seasonality, nest predation or breeding season length matter?JOURNAL OF EVOLUTIONARY BIOLOGY, Issue 5 2010E. M. GRIEBELER Abstract Birds display a latitudinal gradient in clutch size with smaller clutches in the tropics and larger in the temperate region. Three factors have been proposed to affect this pattern: seasonality of resources (SR), nest predation and length of the breeding season (LBS). Here, we test the importance of these factors by modelling clutch size evolution within bird populations under different environmental settings. We use an individual-based ecogenetic simulation model that combines principles from population ecology and life history theory. Results suggest that increasing SR from the tropics to the poles by itself or in combination with a decreasing predation rate and LBS can generate the latitudinal gradient in clutch size. Annual fecundity increases and annual adult survival rate decreases from the tropics to the poles. We further show that the annual number of breeding attempts that (together with clutch size) determines total annual egg production is an important trait to understand latitudinal patterns in these life history characteristics. Field experiments that manipulate environmental factors have to record effects not only on clutch size, but also on annual number of breeding attempts. We use our model to predict the outcome of such experiments under different environmental settings. [source] Nationwide hospitalization costs of skin melanoma and non-melanoma skin cancer in GermanyJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 1 2008A Stang Abstract Introduction, Non-melanoma skin cancer (NMSC), in contrast to skin melanoma (MEL), is considered a negligible health problem because mortality of NMSC is low. The aim of this study was to provide insights into the burden of NMSC and MEL by analysing nationwide skin cancer hospitalization data and data from a dermatologist panel of Germany. We wanted to estimate hospitalization costs due to skin cancer in Germany. Material and methods, We analysed the most recent nationwide hospitalization data from 2003 and estimated hospitalization costs due to MEL and NMSC. We estimated the annual number of private dermatologist practice visits in Germany due to skin cancer. Results, In 2003, 20 455 melanoma-related and 41 929 NMSC-related hospitalizations occurred in Germany. Age-standardized hospitalization rates for NMSC were 2.5-fold and 1.8-fold higher among men and women than the rates for MEL, respectively. The age-specific proportions of hospitalizations for NMSC in relation to all cancer-related hospitalizations increased within the age range of 65 years and more. Among people aged 90 years and more, 14% of all cancer-related hospitalizations were due to NMSC. Estimated annual hospitalization costs for MEL were ,50 to 60 million, and those for NMSC were ,105 to 130 million. The estimated number of private dermatologist practice visits in Germany 2003 is considerably higher for NMSC than MEL Conclusions, Analyses of hospitalizations data and data from private dermatologists give NMSC higher public health relevance than can be obtained from consideration of death statistics. [source] Morphology and reproduction of Nipponomysella subtruncata (Yokoyama), a galeommatoidean bivalve commensal with the sipunculan Siphonosoma cumanense (Keferstein) in JapanJOURNAL OF ZOOLOGY, Issue 4 2001J. Lützen Abstract The shell and anatomy of Nipponomysella subtruncata is described. The bivalve is attached singly or in groups of up to nine on Siphonosoma cumanense, a burrowing intertidal sipunculan in south-west Japan. The species is a protandrous hermaphrodite. Specimens 1.4,2.5 mm long are males, which between 2.1 and 3 mm in length reverse sex and remain females. Reproduction peaks in summer and the annual number of clutches is small. Ripe oocytes, 84,88 ,m diameter, are spawned into the suprabranchial cavity where they develop into 107-,m-long straight-hinged veligers. Following a planktotrophic period of unknown duration, the c. 360-,m-long spat normally settle upon and attach to the shells of larger, predominantly female, individuals. At a length of 1,1.6 mm they detach again and live separately thereafter. Sperm are transferred in spermatophores and stored within paired, mushroom-shaped receptacles located posteriorly in the female's suprabranchial cavity. The receptacles first appear in large males or in specimens in the process of reversing sex. Stored sperm probably survive long enough to fertilize more than one clutch. The anatomy of Nipponomysella is characteristic of the Montacutidae, and is of especial interest because of the unique structure of the sperm receptacles. [source] Changing Trends in Pacemaker and Implantable Cardioverter Defibrillator Generator AdvisoriesPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 12 2002WILLIAM H. MAISEL MAISEL, W.H., et al.: Changing Trends in Pacemaker and Implantable Cardioverter Defibrillator Generator Advisories. Pacemaker and implantable cardioverter defibrillator (ICD) generator recalls and safety alerts (advisories) occur frequently, affect many patients, and are increasing in number and rate. It is unknown if advances in device technology have been accompanied by changing patterns of device advisory type. Weekly FDA Enforcement Reports from January 1991 to December 2000 were analyzed to identify all advisories involving pacemaker and ICD generators. This article represents additional analysis of previously cited advisories and does not contain additional recalls or safety alerts over those that have been previously reported. The 29 advisories (affecting 159,061 devices) from the early 1990s (1991,1995) were compared to the 23 advisories (affecting 364,084 devices) from the late 1990s (1996,2000). While the annual number of device advisories did not change significantly, ICD advisories became more frequent and a three-fold increase in the number of devices affected per advisory was observed. The number of devices affected by hardware advisories increased three-fold, due primarily to a 700-fold increase in electrical/circuitry abnormalities and a 20-fold increase in potential battery/capacitor malfunctions. Other types of hardware abnormalities (defects in the device header, hermetic seal, etc.) became less common. The number of devices recalled due to firmware (computer programming) abnormalities more than doubled. The remarkable technological advances in pacemaker and ICD therapy have been accompanied by changing patterns of device advisory type. Accurate, timely physician and patient notification systems, and routine pacemaker and ICD patient follow-up continue to be of paramount importance. [source] On Integrating Immigrants in GermanyPOPULATION AND DEVELOPMENT REVIEW, Issue 3 2006Article first published online: 8 SEP 200 Immigration to Germany in the decades following World War II made the Federal Republic the host of the largest number of immigrants in Europe. The size of the population with an immigration background is on the order of 15 million, nearly one-fifth of the total population. (Many of these are ethnic German returnees.) Although restrictive policies and a less dynamic economy in recent years slowed the annual number of immigrants and asylum seekers, the interrelated demographic influences of very low fertility, negative natural population increase, and population aging make continuing future immigration likely and, judged by influential domestic interests, desirable. Anxieties about inadequate integration of immigrants in German society are, however, apparently strongly felt by large segments of the native population. The "Grand Coalition" government that took office in November 2005 considers the formation of an effective policy of integration a high priority. On 14 July 2006 an "Integration Summit" was convened in the Chancellery with the active participation of representatives of immigrant groups. Chancellor Angela Merkel called the Summit "an almost historical event." Reproduced below in full is a non-official English translation of a government statement (entitled "Good coexistence,Clear rules") presented to the participants at the opening of the meeting. Intended as a "start of the development of a national integration plan," the statement highlights existing deficiencies of integration, especially problems with second- and third-generation immigrants: lack of mastery of the German language, weaknesses in education and training, high unemployment, lack of acceptance of the basic rules of coexistence, and violation of the law. The importance of these issues is underlined by a demographic fact noted in the statement: by 2010 it is expected that in Germany's large cities 50 percent of the population under age 40 will have an immigrant background. The statement recognizes the government's responsibility to help immigrants learn German and become better informed about the country's laws, culture, history, and political system. In turn, it demands reciprocal efforts from migrants living permanently and lawfully in Germany. The original German text of the statement is available at the Bundeskanzleramt home page: «http://www.bundesregierung.d» [source] Strategies for Establishing Organ Transplant Programs in Developing Countries: The Latin America and Caribbean ExperienceARTIFICIAL ORGANS, Issue 7 2006José Osmar Medina-Pestana Abstract:, The Latin America and Caribbean region is composed of 39 countries. It is remarkable the progress of transplantation in the region in despite of the low economic resources when compared to other regions. The criteria for brain death are well established and culturally accepted. The consent for retrieval is based on required family consent in most countries. The regulations for living donors are also well established, with restrictions to unrelated donors and prohibition of any kind of commerce. The access to transplant is limited by the model of public financing by each country, and those with public universal coverage have no financial restrictions to cover the costs for any citizen; in countries with restricted coverage, the access is restricted to the employment status. There is a progressive increment in the annual number of solid organ transplants in Latin America, reaching near 10 000 in 2004, accomplished by adequate legislation that is also concerned with the prohibition of organ commerce. [source] An estimate of the number of inmate separations from Australian prisons 2000/01 and 2005/06AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 3 2010Kristy A. Martire Abstract Objective: To estimate the annual number of inmate separations from correctional centres in Australia in 2000/01 and 2005/06. Methods: Data on separations were obtained from the websites of each State and Territory government department responsible for prisons. Data on state and national prison population were obtained from the website of the Australian Bureau of Statistics. Three different methods of estimation (multiplier, multiplier adjusted for remand separations and back-projection) were applied to State, Territory and national data on prison population and separations in Australia. Results: The median estimate (to the nearest thousand) of the number of inmate separations was 42,000 in 2000/01 and 44,000 in 2005/06 Conclusions: While the precise figures ought to be interpreted with some caution, our estimates suggest that approximately 44,500 separations from prison occurred in Australia in 2005/06. Each of these separation episodes is accompanied by an elevated risk of mortality; therefore, these figures represent a substantial public health concern. [source] Cesarean Delivery in Shantou, China: A Retrospective Analysis of 1922 WomenBIRTH, Issue 2 2000Wang-ling Wu MD Background:In China the cesarean section rate increased significantly during the past four decades. This study examined the frequency and indications of cesarean birth in Shantou, a southern city in China.Methods:An analysis was conducted of the medical records of 1922 women who had cesarean deliveries at Shantou City 2nd People's Hospital between January 1990 and December 1997. The medical records of 10,490 women who gave birth during this period were examined.Results:The average rate of cesarean delivery during the 8-year period was 19.4 ± 2.3 percent (means ± standard error). From 1990 to 1997 the cesarean delivery rates ranged from 11.05 to 29.9 percent, respectively, although during this period the total annual number of deliveries decreased significantly from 1683 to 951. The rates of the most common indications per 100 women for cesarean delivery were failure to progress (23%), premature rupture of membranes (20%), fetal distress (19.4%), breech presentation (18.1%), uterine scar (14.6%), and prolonged pregnancy (11.3%).Conclusion:The cesarean delivery rate in Shantou, China, has increased steadily and significantly between 1990 and 1997, despite a decrease in the total number of births during the same period. This study showed that on an individual basis vaginal delivery was often possible and reduction of the cesarean delivery rate could be achieved safely by paying greater heed to appropriate indications. [source] Fertility and assisted reproduction: The costs to the NHS of multiple births after IVF treatment in the UKBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 1 2006William L Ledger Objectives, To determine the cost to the NHS resulting from multiple pregnancies arising from IVF treatment in the UK, and to compare those costs with the cost to the NHS due to singleton pregnancies resulting from IVF treatment. Design, A modelling study using data from published literature and cost data from national sources in the public domain, calculating direct costs from the diagnosis of a clinical pregnancy until the end of the first year after birth. Setting, Academic Unit of Reproductive and Developmental Medicine. Population, Theoretic core modelling study using data from published literature. Methods, The analysis was based on the total annual number of births resulting from an IVF treatment in the UK. Main outcome measures total direct costs to the NHS per IVF singleton, twin or triplet family. Main outcome measures, Cost of singleton, twin and triplet IVF pregnancies in the UK. Results, Total direct costs to the NHS per IVF twin or triplet family (maternal + infant costs) are substantially higher than per IVF singleton family (singleton: £3313; twin: £9122; and triplet: £32,354). Multiple pregnancies after IVF are associated with 56% of the direct cost of IVF pregnancies, although they represent less than 1/3 of the total annual number of maternities in the UK. Conclusions, Multiple pregnancies after IVF are associated with high direct costs to the NHS. Redirection of money saved by implementation of a mandatory ,two embryo transfer' policy into increased provision of IVF treatment could double the number of NHS-funded IVF treatment cycles at no extra cost. Further savings could be made if a selective ,single embryo transfer' policy were to be adopted. [source] Trends in the curative treatment of localized prostate cancer after the introduction of prostate-specific antigen: data from the Rotterdam Cancer RegistryBJU INTERNATIONAL, Issue 4 2000S.J.J.C. Spapen Objective To investigate changes in the incidence and treatment of prostate cancer over the period in which new diagnostic tools were introduced and the attitude towards treatment was changing. Patients and methods Information on the extent of disease and treatment of patients diagnosed with prostate cancer within the Rotterdam region was retrieved from the Rotterdam Cancer Registry. Results In the period 1989,95, 4344 patients were diagnosed with prostate cancer and the age-standardized incidence increased from 62 to 125 per 100 000 men. This increase mainly comprised tumours localized to the prostate, while the incidence of advanced cancers remained stable. The proportion of poorly differentiated tumours decreased from 33% in 1989 to 24% in 1995. In the same period the number of patients receiving radiotherapy increased from 80 to 258, while the annual number of radical prostatectomies rose from 17 to 159. Radiotherapy was the preferred type of treatment in patients over 70 years of age, whereas radical prostatectomy was used more frequently in younger patients with localized tumours. Conclusion While the value of screening for prostate cancer remains in debate, incidence and treatment patterns are changing rapidly. Information on patterns of care is needed to interpret future mortality data and to plan resources for adequate health care. [source] Ronald Reagan and the Politics of Declining Union OrganizationBRITISH JOURNAL OF INDUSTRIAL RELATIONS, Issue 3 2002Henry S. Farber New union members in the United States are typically gained through workplace elections. We find that the annual number of union elections fell by 50 per cent in the early 1980s. A formal model indicates that declining union election activity may be due to an unfavourable political climate which raises the costs of unionization, even though the union win,rate remains unaffected. We relate the timing of declining election activity to the air,traffic controllers' strike of 1981, and the appointment of the Reagan Labor Board in 1983. Empirical analysis shows that the fall in election activity preceded these developments. [source] Effect of centralization of pancreaticoduodenectomy on nationwide hospital mortality and length of stayBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 11 2007B. Topal Background: Despite the persistence of large differences in operative mortality rates between centres, the value of centralization of pancreaticoduodenectomy (PD) remains under debate. This cohort study analysed the effect of centralization of PD on nationwide hospital mortality and length of hospital stay in Belgium. Methods: Data on in-hospital mortality and duration of hospital stay after PD from 2000 to 2004 were obtained from the Belgian national registry database. Analysis of mortality and hospital stay was based on 1842 PDs from all 126 hospitals. Logistic regression analysis was used to assess the effect of patient referral on the national mortality rate. Results: The national mortality rate was 8·4 per cent and the median duration of hospital stay after operation was 21·6 (range 3,117) days. There was a significant relationship between the annual number of PDs per hospital and both mortality rate (P = 0·005) and hospital stay (P = 0·027). Application of a cut-off volume of ten PDs per year per centre would necessitate 56·8 per cent of all patients being referred, resulting in an expected national mortality rate of 6·0 per cent. Conclusion: Referral of patients to more experienced centres for PD is expected to result in a significant reduction in hospital mortality rate and duration of hospital stay, regardless of the experience of the referring centre. Action towards centralization should be undertaken nationwide. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Review of 345 eye amputations carried out in the period 1996,2003, at Rigshospitalet, DenmarkACTA OPHTHALMOLOGICA, Issue 2 2010Marie Louise Roed Rasmussen Abstract. Purpose:, The aim of this study was to identify the number of eye amputations, and the causative diagnoses, indications for surgery and surgical techniques applied, and to evaluate a possible change in surgical technique in a tertiary referral centre in Denmark. Methods:, The hospital database was screened using surgery codes for patients who had undergone bulbar evisceration, enucleation or orbital exenteration in the period 1996,2003. Patient records were reviewed for gender, age, time since surgery, causative diagnosis (the disease process leading to the indication for amputation), indication for eye amputation, type of surgery and whether an implant was applied. Results:, A total of 345 patients were identified as having undergone eye amputation during the 8-year period. Indications for eye amputation were: painful blind eye (127); neoplasm (119); infection (42); recent injury (25); disfiguring blind eye (25); prevention of sympathetic ophthalmia (5), and other reasons (2). Surgical procedures included 174 eviscerations, 154 enucleations and 17 orbital exenterations. The mean number of surgeries per year was 43.1. An orbital implant was applied in 168 patients. Conclusions:, The most frequent indications for eye amputation were painful blind eye (37%) and neoplasm (34%). During the study period, the annual number of eye amputations was stable, but an increase in bulbar eviscerations was noticed. Orbital implants were used in 33% of patients in 1996 and 67% in 2003. [source] Implementation of kangaroo mother care: A randomized trial of two outreach strategiesACTA PAEDIATRICA, Issue 7 2005Robert C Pattinson Abstract Aim: To test whether a well-designed educational package on the implementation of kangaroo mother care (KMC) used on its own can be as effective in implementing KMC in a healthcare facility as the combination of a visiting facilitator used in conjunction with the package. Setting: Thirty-four hospitals in KwaZulu-Natal Province, South Africa. Method: The hospitals were paired with respect to their geographical location and annual number of births at the facility. One hospital in each pair was randomly allocated to receive either the implementation package alone (group A) or the implementation package and visits from a facilitator (group B). Hospitals in group B received three facilitation visits. All hospitals were evaluated by a site visit 8 mo after launching the process and were scored by means of a progress-monitoring tool. Outcomes: Successful implementation was regarded as demonstrating evidence of practice (score>10) during the site visit. Results: Group B scored significantly better than group A (p<0.05). All 17 hospitals in group B demonstrated evidence of practice, with the median score of the group being 15.44 (range 10.29,22.94). Twelve of the hospitals in group A demonstrated evidence of practice and the median score was 11.33 (range 1.08,21.13). Conclusion: Successful implementation was achieved in most of the hospitals irrespective of the strategy used. However, facilitation with an implementation package was clearly superior to using a package alone. Some sites do not need facilitation for successful implementation. [source] Biotechnology in the Japanese media: Comparative analysis of newspaper articles on genetic engineering in Japan and EuropeASIAN JOURNAL OF SOCIAL PSYCHOLOGY, Issue 1 2006Aiko Hibino The present study examined how the representations of biotechnology using genetic engineering have been developed in Japan relying on media analysis. Specifically, using the online database of the Asahi Shimbun, one of the major opinion-forming newspapers in Japan, the annual numbers of articles concerning biotechnology were tallied from 1985 to 2000, and an analysis was conducted of the content of 850 articles from 10 particular years. Specifically, a framework in which a biotechnological issue was presented was focused on; the changes of dominant frames and the relationships between frames and specific biotechnological applications (e.g. medicine, agrifood and cloning) were investigated. The results showed that: (i) the number of articles increased sharply in particular since 1996,1997; (ii) although general attitudes toward biotechnology were persistently positive, a frame of biotechnological article became more diverse (i.e. the prospect frames were considerably dominant in the earlier phases, but the concern frames also became prominent in the later phases); and (iii) several articles were found which reported cloned animals in a frame of emotional attachment, a frame unique to Japan. These results were compared with those of European countries and discussed from a perspective of the theory of collective symbolic coping. [source] | ||||||||||||||||||||||||||||||||||