scholarly journals The impact of new evidence on regional variation in paediatric tonsillectomy and adenoidectomy: a historical review

2020 ◽  
Vol 134 (12) ◽  
pp. 1036-1043
Author(s):  
J J C M van Munster ◽  
A H Zamanipoor Najafabadi ◽  
J W Schoones ◽  
W C Peul ◽  
W B van den Hout ◽  
...  
Keyword(s):  
Regional Variation ◽  
Significant Variation ◽  
Historical Review ◽  
Practice Variation ◽  
Tonsil Surgery ◽  
The Impact ◽  
New Evidence ◽  
Over Time

AbstractBackgroundTonsillectomy and adenoidectomy have been among the most commonly performed procedures in children for approximately 100 years. These procedures were the first for which unwarranted regional variation was discovered, in 1938. Indications for these procedures have become stricter over time, which might have reduced regional practice variation.MethodsThis paper presents a historical review on practice variation in paediatric tonsillectomy and adenoidectomy rates. Data on publication year, region, level of variation, methodology and outcomes were collected.ResultsTwenty-one articles on practice variation in paediatric tonsil surgery were included, with data from 12 different countries. Significant variation was found throughout the years, although a greater than 10-fold variation was observed only in the earliest publications.ConclusionNo evidence has yet been found that better indications for tonsillectomy and adenoidectomy have reduced practice variation. International efforts are needed to reconsider why we are still unable to tackle this variation.

scholarly journals Classification of hospital and urban wastewater resistome and microbiota over time and their relationship to the eco-exposome

2019 ◽  
Author(s):  
Elena Buelow ◽  
Andreu Rico ◽  
Margaux Gaschet ◽  
José Lourenço ◽  
Sean P. Kennedy ◽  
...  
Keyword(s):  
Significant Variation ◽  
Urban Wastewater ◽  
Related Risk ◽  
Variate Analysis ◽  
One Year ◽  
The Impact ◽  
Micro Pollutants ◽  
Over Time

AbstractWastewaters (WW) are important sources for the dissemination of antimicrobial resistance (AMR) into the environment. Hospital WW (HWW) contain higher loads of micro-pollutants and AMR markers than urban WW (UWW). Little is known about the long-term dynamics of H and U WW and the impact of their joined treatment on the general burden of AMR. Here, we characterized the resistome, microbiota and eco-exposome signature of 126 H and U WW samples treated separately for three years, and then mixed, over one year. Multi-variate analysis and machine learning revealed a robust signature for each WW with no significant variation over time before mixing, and once mixed, both WW closely resembled U signatures. We demonstrated a significant impact of pharmaceuticals and surfactants on the resistome and microbiota of H and U WW. Our results present considerable targets for AMR related risk assessment of WW.

scholarly journals The decomposition of economic outcomes as a result of changes in Brazil’s male age-education structure

2018 ◽  
Author(s):  
Ernesto F. L. Amaral
Keyword(s):  
Income Inequality ◽  
Significant Influence ◽  
Regional Variation ◽  
Educational Achievement ◽  
Negative Impact ◽  
White Population ◽  
Cohort Size ◽  
Racial Differentials ◽  
The Impact ◽  
Over Time

In Brazil, the age and education compositions of the male labor force is changing with great regional variation. Based on Demographic Census microdata, results indicate that cohort size has a negative impact on earnings, but this effect is decreasing over time. In this study we consider the impact on earnings by age and education, as well as estimated income inequality reduction and racial differentials. Fertility decline and improvements regarding educational attainment had a significant influence on the decline of income inequality in the country. Moreover, the non-white population has been experiencing less success in relation to educational achievement, compared to the white population.

The Therapist’s Reaction to a Patient’s Suicide

Crisis ◽  
2011 ◽  
Vol 32 (2) ◽  
pp. 99-105 ◽  
Author(s):  
Friedrich Martin Wurst ◽  
Isabella Kunz ◽  
Gregory Skipper ◽  
Manfred Wolfersdorf ◽  
Karl H. Beine ◽  
...  
Keyword(s):  
Emotional Responses ◽  
Well Being ◽  
Emotional Reaction ◽  
Emotional Reactions ◽  
Analog Scale ◽  
General Hospitals ◽  
Item Questionnaire ◽  
Retrospective Nature ◽  
The Impact ◽  
Over Time

Background: A substantial proportion of therapists experience the loss of a patient to suicide at some point during their professional life. Aims: To assess (1) the impact of a patient’s suicide on therapists distress and well-being over time, (2) which factors contribute to the reaction, and (3) which subgroup might need special interventions in the aftermath of suicide. Methods: A 63-item questionnaire was sent to all 185 Psychiatric Clinics at General Hospitals in Germany. The emotional reaction of therapists to patient’s suicide was measured immediately, after 2 weeks, and after 6 months. Results: Three out of ten therapists suffer from severe distress after a patients’ suicide. The item “overall distress” immediately after the suicide predicts emotional reactions and changes in behavior. The emotional responses immediately after the suicide explained 43.5% of the variance of total distress in a regression analysis. Limitations: The retrospective nature of the study is its primary limitation. Conclusions: Our data suggest that identifying the severely distressed subgroup could be done using a visual analog scale for overall distress. As a consequence, more specific and intensified help could be provided to these professionals.

Should Attitudinal Views toward Innovation Development Play a Role in Policy in Peripheral EU Regions?: New Evidence from Vouchers Program in Northern Ireland

2018 ◽  
Vol 6 (2) ◽  
pp. 121-137
Author(s):  
Sean M. McDonald ◽  
Remi C. Claire ◽  
Alastair H. McPherson
Keyword(s):  
Economic Development ◽  
Northern Ireland ◽  
Policy Design ◽  
Regional Economic Development ◽  
Innovation Development ◽  
Regional Economic ◽  
Eu Regions ◽  
Future Policy ◽  
The Impact ◽  
New Evidence

The impact and effectiveness of policies to support collaboration for Research & Development (R&D) and Innovation is critical to determining the success of regional economic development. (O’Kane, 2008) The purpose of this paper is to evaluate the level of success of the Innovation Vouchers Program operated by Invest Northern Ireland (Invest NI) from 2009 to 2013 and address if attitudinal views towards innovation development should play in a role in future policy design in peripheral EU regions. 

Has Aid Helped in Pakistan?

1997 ◽  
Vol 36 (4II) ◽  
pp. 947-957 ◽  
Author(s):  
Shahrukh Rafi Khan
Keyword(s):  
Economic Growth ◽  
Negative Impact ◽  
Negative Association ◽  
Causal Impact ◽  
The Impact ◽  
Over Time

This paper has a two-fold objective: first, to examine the terms on which Pakistan receives aid and whether its debt situation is sustainable, and second, to examine the impact of aid and debt on economic growth. It is found that there is little encouraging that can be said about how the terms on which Pakistan has received aid over time have changed, and its current debt situation is not sustainable. Also reported is the analysis done elsewhere which shows that aid has a negative (Granger) causal impact on GDP, and aid has a robust negative impact on economic growth after controlling for supplyside shocks. We provide various reasons for this negative association.

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