The incidence and health economic burden of ischemic amputation in Minnesota, 2005-2008

Critical limb ischemia (CLI) is the most severe manifestation of peripheral artery disease (PAD), is associated with high rates of myocardial infarction, stroke, and amputation, and has a high health economic cost. The objective of this study was to estimate the incidence of lower limb amputation, the most serious consequence of CLI, and to create a surveillance methodology for the incidence of ischemic amputation in Minnesota.

Social differentiation of risk: perceptions of the future in drought-prone Central Niger

A snapshot of two Tuareg-dominated 'communes rurales' in the pastoral-agricultural transition zones of Maradi and Tahoua regions, Central Niger, shows that, despite the openly shared 'inevitable natural hazard' drought discourse, risk-taking action in response to drought-related dangers is sharply polarized according to social position. On the one hand the dominant Tuareg minority perceive drought not only as danger for their herds but also as opportunity to increase their political following through the channelling of drought relief benefits to their supporters. On the other hand, the majority of commune households, living on the brink of economic viability, cultivate social links with the dominant families in order to secure access to water, land and humanitarian aid; and household members are forced into more and more frequent and distant out-migration. Certain leaders, well-informed about national land policy and practice, focus their efforts for a better future on the consolidation of community land rights through the promotion of certain sedentarization and land privatization initiatives; however the resulting increased land pressure in key locations may unwittingly expose inhabitants to even worse drought-linked crises in the future. Bibliogr., notes, sum. in English and French

[The influence of the socio-economic structure of the breeding farms of Franches-Montagnes horses on the conditions of husbandry]

The socio-economic structure of the breeding farms of Franches-Montagnes horses (FM) in Switzerland is evaluated on the basis of an investigation carried out in 2002 by the Swiss FM breeding federation. Questionnaires were sent to 3500 of its members and the results include data from 968 breeding enterprises, housing a total of 3965 FM. The quality of the husbandry of FM varies according to factors such as the altitude and the geographical situation of the farms and studs. Socio-economic parameters, such as the role of FM in the business, their use (breeding, driving, riding) and the age and level of professional education of the owners may also have an effect on standards of husbandry. The results show that the owners for whom FM represent a source of income more frequently keep their horses in standing stalls, but give them more time to exercise at liberty than the horses belonging to amateur breeders. Younger and better educated breeders are more likely to house their animals in groups.

Current state of the art in myocardial tissue engineering

Myocardial tissue engineering aims to repair, replace, and regenerate damaged cardiac tissue using tissue constructs created ex vivo. This approach may one day provide a full treatment for several cardiac disorders, including congenital diseases or ventricular dysfunction after myocardial infarction. Although the ex vivo construction of a myocardium-like tissue is faced with many challenges, it is nevertheless a pressing objective for cardiac reparative medicine. Multidisciplinary efforts have already led to the development of promising viable muscle constructs. In this article, we review the various concepts of cardiac tissue engineering and their specific challenges. We also review the different types of existing biografts and their physiological relevance. Although many investigators have favored cardiomyocytes, we discuss the potential of other clinically relevant cells, as well as the various hypotheses proposed to explain the functional benefit of cell transplantation.

Economic evaluation of varicella vaccination in Swiss children and adolescents

This study explores the effects of three different 2-dose varicella zoster virus (VZV) vaccination strategies in Switzerland. The EVITA model was used to assess clinical benefits and costs of strategies (1) vaccination of 11-15 year old adolescents with a negative or uncertain history for chickenpox, (2) universal vaccination of toddlers at age 1 to 2 years, and (3) strategy 2 plus catch-up vaccination of 11-15 year old susceptible adolescents. The cost-effectiveness analysis compares strategies 2 and 3 versus strategy 1 (current vaccination policy in Switzerland). Probabilities for clinical outcomes and medical resource utilization were derived from a real-world survey among Swiss pediatricians and general practitioners including 236 individuals with VZV infection, published information on varicella complications, and expert opinion. Costs of medical resource utilization represent official Swiss medical tariffs. The model predicts both universal childhood vaccination strategies to be more effective in reducing varicella disease burden compared to strategy 1. Economically, both universal childhood vaccination strategies with or without catch-up result in net savings from the societal perspective reflected by a benefit cost ratio (BCR) of 1.22 or 1.29, respectively. In contrast, the model predicts net costs from the payer perspective (BCR of 0.27 and 0.30, respectively). These economic findings are comparable to those reported from other similar evaluations. However, due to the recent recommendation for using a 2-dose varicella vaccination schedule, our economic results for Switzerland are somewhat less favorable than those for other country analyses in which a less expensive 1-dose vaccination regimen for toddlers has been studied.

The Contested Floodplain. Institutional Change of the Commons in the Kafue Flats, Zambia

The Contested Floodplain tells the story of institutional changes in the management of common pool resources (pasture, wildlife, and fisheries) among Ila and Balundwe agro-pastoralists and Batwa fishermen in the Kafue Flats, in southern Zambia. It explains how and why a once rich floodplain area, managed under local common property regimes, becomes a poor man’s place and a degraded resource area. Based on social anthropological field research, the book explains how well working institutions in the past, regulating communal access to resources, have turned into state property and open access or privatization. The study focuses on the historic developments taking place since pre-colonial and colonial times up to today. Haller shows how the commons had been well regulated by local institutions in the past, often embedded in religious belief systems. He then explains the transformation from common property to state property since colonial times. When the state is unable to provide well-functioning institutions due to a lack in financial income, it contributes to de facto open access and degradation of the commons. The Zambian copper-based economy has faced crisis since 1975, and many Zambians have to look for economic alternatives and find ways to profit from the lack of state control (a paradox of the present-absent state). And while the state is absent, external actors use the ideology of citizenship to justify free use of resources during conflicts with local people. Also within Zambian communities, floodplain resources are highly contested, which is illustrated through conflicts over a proposed irrigation scheme in the area.