Summary
We report the proceedings of the First International new‐onset refractory status epilepticus (NORSE) and febrile infection‐related epilepsy syndrome (FIRES) Symposium. To promote awareness of ...this condition and foster research efforts, we conveyed the First International new‐onset refractory status epilepticus (NORSE) and febrile infection‐related epilepsy syndrome (FIRES) Symposium. The conference was supported by The NORSE Institute (http://www.norseinstitute.org). This article summarizes the discussions that were held during the Symposium and presents our strategy to unravel the cause of these disorders and to improve patient care. The standardized definitions for these disorders that have been developed, are required to improve communication and facilitate the development of multicenter registries and biobanks. A distinction between childhood‐ and adult‐onset forms of the syndrome is not supported by strong scientific evidence and it is argued that both should be studied together. Although the pathophysiology remains elusive, nascent evidence suggests a role for a postinfectious cytokine‐mediated mechanism, which should be further investigated. It also appears important to develop tools for their early recognition and prompt treatment. Recent evidence suggests that specific electroencephalography (EEG) features might be helpful. The optimal treatment options remain to be determined; immune therapies are usually disappointing, but the ketogenic diet has proved effective in uncontrolled trials. NORSE and FIRES represent a very delicate clinical situation with specific communication issues between physicians and with patients and families. Standardized consensus definitions and a multidisciplinary multicenter strategy will help research efforts and improve clinical care for patients with NORSE and FIRES.
This research distinguishes between the goal of maintaining status and advancing status and investigates how consumers’ political ideology triggers sensitivity to a status-maintenance (vs. ...status-advancement) goal, subsequently altering luxury consumption. Because conservative political ideology increases the preference for social stability, the authors propose that conservatives (vs. liberals) are more sensitive to status maintenance (but not status advancement) and thus exhibit a greater desire for luxury goods when the status-maintenance goal is activated. Six studies assessing status maintenance using sociodemographic characteristics (Studies 1, 2, and 3a) and controlled manipulations, including ad framing (Study 3b) and semantic priming (Studies 4 and 5), provide support for this proposition. The studies show that the effect is specific to status maintenance and does not occur (1) in the absence of a status goal or (2) when the status-advancement goal (a focus on increasing status) is activated. Overall, the findings reveal that conservatives’ desire for luxury goods stems from the goal of maintaining status and offer insights into how luxury brands can effectively tailor their communications to audiences with a conservative ideology.
Race/ethnicity and socioeconomic status (SES) are social categories that capture differential exposure to conditions of life that have health consequences. Race/ethnicity and SES are linked to each ...other, but race matters for health even after SES is considered. This commentary considers the complex ways in which race combines with SES to affect health. There is a need for greater attention to understanding how risks and resources in the social environment are systematically patterned by race, ethnicity and SES, and how they combine to influence cardiovascular disease and other health outcomes. Future research needs to examine how the levels, timing and accumulation of institutional and interpersonal racism combine with other toxic exposures, over the life-course, to influence the onset and course of illness. There is also an urgent need for research that seeks to build the science base that will identify the multilevel interventions that are likely to enhance the health of all, even while they improve the health of disadvantaged groups more rapidly than the rest of the population so that inequities in health can be reduced and ultimately eliminated. We also need sustained research attention to identifying how to build the political support to reduce the large shortfalls in health.
Many low-income countries and development organizations are calling for greater liberalization of labor immigration policies in high-income countries. At the same time, human rights organizations and ...migrant rights advocates demand more equal rights for migrant workers.The Price of Rightsshows why you cannot always have both.
Examining labor immigration policies in over forty countries, as well as policy drivers in major migrant-receiving and migrant-sending states, Martin Ruhs finds that there are trade-offs in the policies of high-income countries between openness to admitting migrant workers and some of the rights granted to migrants after admission. Insisting on greater equality of rights for migrant workers can come at the price of more restrictive admission policies, especially for lower-skilled workers. Ruhs advocates the liberalization of international labor migration through temporary migration programs that protect a universal set of core rights and account for the interests of nation-states by restricting a few specific rights that create net costs for receiving countries.
The Price of Rightsanalyzes how high-income countries restrict the rights of migrant workers as part of their labor immigration policies and discusses the implications for global debates about regulating labor migration and protecting migrants. It comprehensively looks at the tensions between human rights and citizenship rights, the agency and interests of migrants and states, and the determinants and ethics of labor immigration policy.
Summary
Objective
Super‐refractory status epilepticus (SRSE) is a severe condition in which a patient in status epilepticus (SE) for ≥24 h does not respond to first‐, second‐, or third‐line therapy. ...The economic impact of SRSE treatment remains unclear. A health insurance research database was used for a population‐based estimation of SRSE‐associated inpatient costs, length of stay, and mortality in Germany.
Methods
An algorithm using International Classification of Diseases, 10th Edition coding and treatment parameters identified and classified patients in a German statutory health insurance database covering admissions from 2008 to 2013 as having refractory SE (RSE) or SRSE. Admissions data in our study refer to these classifications. Associated patient data included costs, procedures, and demographics.
Results
The algorithm identified 2,585 (all type) SE admissions, classified as 1,655 nonrefractory SE (64%), 592 (22.9%) RSE, and 338 (13.1%) SRSE, producing database incidence rates of 15.0 in 100,000, 5.2 in 100,000, and 3.0 in 100,000 per year, respectively. Median cost per admission was €4,063 for nonrefractory SE, €4,581 (p < 0.001) for RSE, and €32,706 (p < 0.001) for SRSE. Median length of stay varied significantly between 8 days (mean = 13.6) in nonrefractory SE, 14 days in RSE, and up to 37 days in SRSE. Discharge mortality increased from 9.6% in nonrefractory SE to 15.0% (p < 0.001) in RSE and 39.9% (p < 0.001) in SRSE.
Significance
This study evaluated the hospital treatment costs associated with admissions classified by the algorithm as SRSE in Germany. SRSE represented 13% of all SE admissions, but resulted in 56% of all SE‐related costs. The lack of approved treatments and limited number of evidence‐based treatment guidelines highlight the need for further evaluations of the SRSE burden of illness and the potential for further optimization of treatments for SRSE.
Social Capital and Health Kawachi, Ichiro; Subramanian, S. V; Kim, Daniel
2007, 2008, 2007-11-15, 20080401
eBook
This text discusses social capital, a concept that originated in the social sciences, & its application to the field of public health. The editors take care to define the concept of social capital, ...describe its theoretical origins, & discuss the controversies & debates surrounding the use of the concept in public health research.
The objective of the current article was to review the literature and discuss the degree of evidence for various treatment strategies for status epilepticus (SE) in adults. We searched MEDLINE and ...EMBASE for relevant literature from 1966 to January 2005 and in the current updated version all pertinent publications from January 2005 to January 2009. Furthermore, the Cochrane Central Register of Controlled Trials (CENTRAL) was sought. Recommendations are based on this literature and on our judgement of the relevance of the references to the subject. Recommendations were reached by informative consensus approach. Where there was a lack of evidence but consensus was clear, we have stated our opinion as good practice points. The preferred treatment pathway for generalised convulsive status epilepticus (GCSE) is intravenous (i.v.) administration of 4–8 mg lorazepam or 10 mg diazepam directly followed by 18 mg/kg phenytoin. If seizures continue more than 10 min after first injection, another 4 mg lorazepam or 10 mg diazepam is recommended. Refractory GCSE is treated by anaesthetic doses of barbiturates, midazolam or propofol; the anaesthetics are titrated against an electroencephalogram burst suppression pattern for at least 24 h. The initial therapy of non‐convulsive SE depends on type and cause. Complex partial SE is initially treated in the same manner as GCSE. However, if it turns out to be refractory, further non‐anaesthetising i.v. substances such levetiracetam, phenobarbital or valproic acid should be given instead of anaesthetics. In subtle SE, in most patients, i.v. anaesthesia is required.
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This paper examines individuals’ reactions to the prospect of gaining or losing status in groups. The results of three experiments provide evidence that individuals attach greater value to status ...when recalling the risk of status loss than when recalling the potential for status gain (Experiment 1), are willing to pay more to avoid a status loss than to achieve a status gain (Experiment 1), and put forth greater effort when striving to prevent status loss than when striving to gain status (Experiment 2). Finally, individuals who risk losing status allocate more resources toward personal status concerns (and away from group interests and potential monetary gain) than do individuals who have a chance of gaining status (Experiment 3). We discuss the implications of this research both in terms of individuals’ psychological experience of their status, as well as status attainment and maintenance concerns in groups.
Studies of adults and adolescents suggest subjective socio-economic status (SES) is associated with health/well-being even after adjustment for objective SES. In adolescence, objective SES may have ...weaker relationships with health/well-being than at other life stages; school-based social status may be of greater relevance. We investigated the associations which objective SES (residential deprivation and family affluence), subjective SES and three school-based subjective social status dimensions (“SSS-peer”, “SSS-scholastic” and “SSS-sports”) had with physical symptoms, psychological distress and anger among 2503 Scottish 13–15 year-olds. Associations between objective SES and health/well-being were weak and inconsistent. Lower subjective SES was associated with increased physical symptoms and psychological distress, lower SSS-peer with increased psychological distress but reduced anger, lower SSS-scholastic with increased physical symptoms, psychological distress and anger, and lower SSS-sports with increased physical symptoms and psychological distress. Associations did not differ by gender. Objective and subjective SES had weaker associations with health/well-being than did school-based SSS dimensions. These findings underline the importance of school-based SSS in adolescence, and the need for future studies to include a range of school-based SSS dimensions and several health/well-being measures. They also highlight the need for a focus on school-based social status among those working to promote adolescent health/well-being.
•We examined associations between adolescent social status and several health measures.•Models included objective and subjective socio-economic status and school peer, scholastic and sports status.•School status had stronger associations with health than did socio-economic status.•Different school status dimensions and health measures were associated in different ways.•Studies should include a range of school status dimensions and health measures.
The Ideas of Man and Woman in Renaissance France provides the first comprehensive comparison of the printed debates in the 1500s over the superiority or inferiority of woman - the Querelle des femmes ...- and the dignity and misery of man. Analysing these writings side by side, Lyndan Warner reveals the extent to which Renaissance authors borrowed commonplaces from both traditions as they praised or blamed man or woman and habitually considered opposite and contrary points of view. In the law courts reflections on the virtues and vices of man and woman had a practical application-to win cases-and as Warner demonstrates, Parisian lawyers employed this developing rhetoric in family disputes over inheritance and marriage, and amplified it in the published versions of their pleadings. Tracing these ideas and modes of thinking from the writer's quill to the workshops and boutiques of printers and booksellers, Warner uses probate inventories to follow the books to the households of their potential male and female readers. Warner reveals the shifts in printed discussions of human nature from the 1500s to the early 1600s and shows how booksellers adapted the ways they marketed and sold new genres such as essays and lawyers' pleadings.
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