Glioblastoma is the most common primary brain tumour. Despite advances in treatment, its prognosis remains dismal, with a mean survival time of about 14 months. Many articles have addressed direct ...costs, those associated with the diagnosis and treatment of the disease. Indirect costs, those associated with loss of productivity due to the disease, have seldom been described.
We conducted a retrospective study in patients diagnosed with glioblastoma at Hospital Universitario Donostia between January 1, 2010 and December 31, 2013. We collected demographics, data regarding the treatment received, and survival times. We calculated the indirect costs with the human capital approach, adjusting the mean salaries of comparable individuals by sex and age and obtaining mortality data for the general population from the Spanish National Statistics Institute. Past salaries were updated to 2015 euros according to the annual inflation rate and we applied a discount of 3.5% compounded yearly to future salaries.
We reviewed the records of 99 patients: 46 women (mean age 63.53) and 53 men (mean age 59.94); 29 patients underwent a biopsy and the remaining 70 underwent excisional surgery. Mean survival was 18.092 months for the whole series. The total indirect cost for the series was €11 080 762 (2015). Mean indirect cost per patient was €111 926 (2015).
Although glioblastoma is a relatively uncommon type of tumour, accounting for only 4% of all cancers, its poor prognosis and potential sequelae generate disproportionately large morbidity and mortality rates which translate to high indirect costs. Clinicians should be aware of the societal impact of glioblastoma and indirect costs should be taken into account when cost effectiveness studies are performed to better illustrate the overall consequences of this disease.
Resumen Introducción El glioblastoma es el tumor cerebral más frecuente. A pesar de los avances en su tratamiento, el pronóstico sigue siendo pobre, con una supervivencia media en torno a los 14 ...meses. Los costes directos, aquellos asociados al diagnóstico y el tratamiento de la enfermedad, han sido descritos ampliamente. Los costes indirectos, aquellos derivados de la pérdida de productividad debido a la enfermedad, han sido descritos en escasas ocasiones. Material y método Realizamos un estudio retrospectivo, incluyendo a los pacientes diagnosticados entre el 1 de enero del 2010 y el 31 de diciembre del 2013 de glioblastoma en el Hospital Universitario Donostia. Recogimos datos demográficos, relativos al tratamiento ofertado y la supervivencia. Calculamos los costes indirectos a través del método del capital humano, obteniendo datos de sujetos comparables según sexo y edad, y de mortalidad de la población general a través del Instituto Nacional de Estadística. Los salarios pasados fueron actualizados a euros de 2015 según la tasa de inflación interanual y los salarios futuros fueron descontados en un 3,5% anual en forma de interés compuesto. Resultados Revisamos a 99 pacientes, 46 mujeres (edad media 63,53 años) y 53 hombres (edad media 59,94 años). En 29 pacientes se realizó una biopsia y en los 70 restantes se realizó una cirugía resectiva. La supervivencia global media fue de 18,092 meses. Los costes indirectos totales fueron de 11.080.762 € (2015). El coste indirecto medio por paciente fue de 111.926 € (2015). Discusión A pesar de que el glioblastoma es un tipo relativamente poco frecuente de tumor, que supone el 4% de todos los tipos de cáncer, su mal pronóstico y sus posibles secuelas generan una mortalidad y morbilidad desproporcionadamente altas. Esto se traduce en unos costes indirectos muy elevados. El clínico debe ser consciente del impacto del glioblastoma en la sociedad y los costes indirectos deben ser tenidos en cuenta en los estudios de coste-efectividad para conocer las consecuencias globales de esta enfermedad.
Earthworm burrowing is essential for soil functioning in temperate climates. It is known that soil compaction hampers earthworm burrowing, but there is a lack of knowledge on how it affects the ...energy costs of earthworms. In the present study, we used respirometry and isothermal calorimetry to quantify earthworm respiration rates and heat dissipation in two endogeic species, Aporrectodea caliginosa and Aporrectodea tuberculata, in compacted and non-compacted soils. We put the measured respiration rates and heat dissipation in relation to the burrow volume and cast volume produced by the earthworms. We found that at higher compaction levels, respiration rates and dissipated heat increased for both studied species. The energy costs associated with burrowing were a significant fraction of the total energy costs. Our results indicate that energy costs per burrow volume increase due to compaction, and that the specific energy costs for burrowing (i.e., per gram earthworm) were lower for A. tuberculata than for A. caliginosa. Further studies are needed to confirm our results. We discuss the potential and current limitations of isothermal calorimetry as a method for direct quantification of energy costs of earthworms. There is a need for further studies that quantify how energy costs of burrowing are affected by various soil conditions, to better predict the implications of land use and soil management on soil processes and functions mediated by earthworm burrowing.
•Energy costs associated with burrowing were assessed using an isothermal calorimeter.•Measurements of respiration rate and heat dissipation were correlated.•Compaction increases respiration rates and heat dissipation of earthworm burrowing.•Isothermal calorimetry holds promise for its application in earthworm studies.
Glioblastoma is the most common primary brain tumour. Despite advances in treatment, its prognosis remains dismal, with a mean survival time of about 14 months. Many articles have addressed direct ...costs, those associated with the diagnosis and treatment of the disease. Indirect costs, those associated with loss of productivity due to the disease, have seldom been described.
We conducted a retrospective study in patients diagnosed with glioblastoma at Hospital Universitario Donostia between January 1, 2010 and December 31, 2013. We collected demographics, data regarding the treatment received, and survival times. We calculated the indirect costs with the human capital approach, adjusting the mean salaries of comparable individuals by sex and age and obtaining mortality data for the general population from the Spanish National Statistics Institute. Past salaries were updated to 2015 euros according to the annual inflation rate and we applied a discount of 3.5% compounded yearly to future salaries.
We reviewed the records of 99 patients: 46 women (mean age 63.53) and 53 men (mean age 59.94); 29 patients underwent a biopsy and the remaining 70 underwent excisional surgery. Mean survival was 18.092 months for the whole series. The total indirect cost for the series was €11080762 (2015). Mean indirect cost per patient was €111926 (2015).
Although glioblastoma is a relatively uncommon type of tumour, accounting for only 4% of all cancers, its poor prognosis and potential sequelae generate disproportionately large morbidity and mortality rates which translate to high indirect costs. Clinicians should be aware of the societal impact of glioblastoma and indirect costs should be taken into account when cost effectiveness studies are performed to better illustrate the overall consequences of this disease.
El glioblastoma es el tumor cerebral más frecuente. A pesar de los avances en su tratamiento, el pronóstico sigue siendo pobre, con una supervivencia media en torno a los 14 meses. Los costes directos, aquellos asociados al diagnóstico y el tratamiento de la enfermedad, han sido descritos ampliamente. Los costes indirectos, aquellos derivados de la pérdida de productividad debido a la enfermedad, han sido descritos en escasas ocasiones.
Realizamos un estudio retrospectivo, incluyendo a los pacientes diagnosticados entre el 1 de enero del 2010 y el 31 de diciembre del 2013 de glioblastoma en el Hospital Universitario Donostia. Recogimos datos demográficos, relativos al tratamiento ofertado y la supervivencia. Calculamos los costes indirectos a través del método del capital humano, obteniendo datos de sujetos comparables según sexo y edad, y de mortalidad de la población general a través del Instituto Nacional de Estadística. Los salarios pasados fueron actualizados a euros de 2015 según la tasa de inflación interanual y los salarios futuros fueron descontados en un 3,5% anual en forma de interés compuesto.
Revisamos a 99 pacientes, 46 mujeres (edad media 63,53 años) y 53 hombres (edad media 59,94 años). En 29 pacientes se realizó una biopsia y en los 70 restantes se realizó una cirugía resectiva. La supervivencia global media fue de 18,092 meses. Los costes indirectos totales fueron de 11.080.762 € (2015). El coste indirecto medio por paciente fue de 111.926 € (2015).
A pesar de que el glioblastoma es un tipo relativamente poco frecuente de tumor, que supone el 4% de todos los tipos de cáncer, su mal pronóstico y sus posibles secuelas generan una mortalidad y morbilidad desproporcionadamente altas. Esto se traduce en unos costes indirectos muy elevados. El clínico debe ser consciente del impacto del glioblastoma en la sociedad y los costes indirectos deben ser tenidos en cuenta en los estudios de coste-efectividad para conocer las consecuencias globales de esta enfermedad.
Growing interest in quantum computing for practical applications has led to a surge in the availability of programmable machines for executing quantum algorithms
. Present-day photonic quantum ...computers
have been limited either to non-deterministic operation, low photon numbers and rates, or fixed random gate sequences. Here we introduce a full-stack hardware-software system for executing many-photon quantum circuit operations using integrated nanophotonics: a programmable chip, operating at room temperature and interfaced with a fully automated control system. The system enables remote users to execute quantum algorithms that require up to eight modes of strongly squeezed vacuum initialized as two-mode squeezed states in single temporal modes, a fully general and programmable four-mode interferometer, and photon number-resolving readout on all outputs. Detection of multi-photon events with photon numbers and rates exceeding any previous programmable quantum optical demonstration is made possible by strong squeezing and high sampling rates. We verify the non-classicality of the device output, and use the platform to carry out proof-of-principle demonstrations of three quantum algorithms: Gaussian boson sampling, molecular vibronic spectra and graph similarity
. These demonstrations validate the platform as a launchpad for scaling photonic technologies for quantum information processing.
Abstract This study was carried out to assess influenza vaccination coverage among hospital personnel and the impact of health promotion campaigns, within the hospital, designed to increase ...vaccination coverage over three consecutive vaccination campaigns (2001–2002 to 2003–2004). The health promotion tool used in the 2001–2002 and 2002–2003 were informative posters distributed throughout the hospital. In the 2003–2004 season, the recommendation was also published in the internal bulletin and Web site of the hospital. In addition, a physician and a nurse from the Department of Preventive Medicine visited all departments offering vaccination in the work place. The overall vaccination coverage in the 2001–2002 campaign was 16% with coverage of 11.5% in nurses and 15% in physicians. In the 2002–2003 and 2003–2004 campaigns the overall vaccination coverage was 21% and 40%, respectively ( p < 0.01). Staff physicians and resident physicians reached 60 and 42% coverage rates in the 2003–2004 campaign, but coverage in nurses and nursing assistant remained around 30% ( p < 0.01). In summary, influenza vaccination coverage among hospital based healthcare personnel increased significantly during the last three seasons, however, it still remains low despite active attempts at promoting influenza vaccination.
Vaccination for international travelers Arrazola, M Pilar; Serrano, Almudena; López-Vélez, Rogelio
Enfermedades infecciosas y microbiologia clinica
34, Številka:
5
Journal Article
Recenzirano
Traveler's vaccination is one of the key strategies for the prevention of infectious diseases during international travel. The risk of acquiring an infectious disease is determined in each case by ...the characteristics of the traveler and the travel, so the pre-departure medical advice of the traveler must be individualized. The World Health Organization classifies travelerś vaccines into three groups. - Vaccines for routine use in national immunization programs: Haemophilus influenzae type b, hepatitis B, polio, measles-mumps-rubella, tetanus-diphtheria-whooping a cough, and chickenpox. - Vaccinations required by law in certain countries before to enter them: yellow fever, meningococcal disease and poliomyelitis. - Vaccines recommended depending on the circumstances: cholera, japanese encephalitis, tick-borne encephalitis, meningococcal disease, typhoid fever, influenza, hepatitis A, hepatitis B, rabies and BCG. This review is intended to introduce the reader to the field of international vaccination.
Background
Safety concerns have been raised about the use of adjuvanted vaccines after kidney transplantation.
Methods
We retrospectively analyzed 65 kidney transplant (KT) recipients who received ≥1 ...dose of influenza vaccine (pandemic or seasonal) during the 2009–2010 campaign. Participants were classified into 2 groups: those who received a squalene‐based AS03‐ or MF59‐adjuvanted vaccine (“adjuvanted vaccination” AV group, n = 37) and those who exclusively received non‐adjuvanted vaccines (“non‐adjuvanted vaccination” NAV group, n = 28). Primary outcomes included occurrence of biopsy‐proven acute graft rejection (BPAR) and graft function at months 6 and 12 after vaccination. Patients were followed up until graft loss, death, or October 2010.
Results
Four episodes of BPAR occurred during post‐vaccination follow‐up, with no differences between the AV and NAV groups, in terms of cumulative incidence (5.4% vs. 7.1%, respectively; P = 0.581), incidence rate (0.22 vs. 0.18 episodes per 1000 transplant‐days; P = 0.950), or occurrence of severe episodes (T‐cell‐mediated BPAR of grade ≥2a) (2.7% vs. 3.6%; P = 0.680). No between‐group differences were seen in graft function after vaccination.
Conclusion
Adjuvanted influenza vaccination in KT recipients seems to be safe regarding graft outcome.
The present article uses 25 ethnographic publications as data for a cross-national meta-ethnographic analysis of school development in rural communities. The publications come from research in four ...research projects in two countries in the past decade that were ethnographically exploring different challenges in schools in rural areas in relation to changes in State regulation from bureaucratic and professional control to market governance. Different schools in different types of rural area with different types of pedagogical and leadership challenges have been identified. Two different types of school; communitas schools and magnet schools; have emerged from the investigation as two common, different and analytically important ways of responding to market pressures. Parental co-operation and community involvement characterizes the former whilst finding ways to competitively expand and exploit resources to refine and expand recruitment characterize the other. They are both contextual developments from market governance but the latter is also recognized as a default position for school development in market conditions. Both are described as adding value for or to rural communities but in very different ways. These different ways are presented and discussed in the article and based on this discussion, the development of markets in education is described as potentially very problematic in some rural areas. Schools with greater access to resources are benefitted at the expense of other schools in ways that undermine fundamentally important rural community values.
•This article provides an important resource for thinking about rural spaces and schools.•The article demonstrates how people in local rural areas are creative and resourceful and how they develop school environments that provide meaningful opportunities for learning.•Key points in the article concern the problems of metro-centrism in educational politics. Rural schools appear in a different way to the way they appear in top-down accounts and also official policies.•They have a potential for providing educational services and good learning opportunities of better quality for everyone.•Rural schools worked best when teachers, parents, pupils and other community members were expressly committed toward ‘working together for their school’.•Competitive schools may be a default position for school development in market conditions but they do not add value for or to rural communities.•Markets in education do not work well in rural areas.
In a 2016 special issue on the relationships between ethnography of education and social, economic, and material precarity, Geoff Bright and John Smyth were critical of ethnographic researchers, for ...concentrating on discourses and discourse production only, rather than on material conditions to develop activism and processes of transformation against oppression. Instead of only identifying and critiquing precarity, and deconstructing taken-for-granted ideas to give voice to ingrained forms of oppression and marginalization, critical ethnography they wrote, should really be about changing, not only describing and analyzing, oppressive conditions. In the present article, we attempt to identify and explore cases where researchers have overcome the reluctance toward activism and transformation. Using empirical examples we will try to illustrate what characterized these efforts and what seemed to support their success.
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