Population Ethics and the Value of Life

Public policies often involve choices of alternatives in which the size and the composition of the population may vary. Examples are the allocation of resources to prenatal care and the design of aid packages to developing countries. In order to assess the corresponding feasible choices on normative grounds, criteria for social evaluation that are capable of performing variable-population comparisons are required. We review several important axioms for welfarist population principles and discuss the link between individual well-being and the desirability of adding a new person to a given society.

Artichoke leaf extract reduces symptoms of irritable bowel syndrome and improves quality of life in otherwise healthy volunteers suffering from concomitant dyspepsia: a subset analysis

Objectives: Does artichoke leaf extract (ALE) ameliorate symptoms of Irritable bowel syndrome (IBS) in otherwise healthy volunteers suffering concomitant dyspepsia? Methods: A subset analysis of a previous dose-ranging, open, postal study, in adults suffering dyspepsia. Two hundred and eight (208) adults were identified post hoc as suffering with IBS. IBS incidence, self-reported usual bowel pattern, and the Nepean Dyspepsia Index (NDI) were compared before and after a 2-month intervention period. Results: There was a significant fall in IBS incidence of 26.4% (p<0.001) after treatment. A significant shift in self-reported usual bowel pattern away from "alternating constipation/diarrhea" toward "normal" (p<0.001) was observed. NDI total symptom score significantly decreased by 41% (p<0.001) after treatment. Similarly, there was a significant 20% improvement in the NDI total quality-of-life (QOL) score in the subset after treatment. Conclusion: This report supports previous findings that ALE ameliorates symptoms of IBS, plus improves health-related QOL.

Fertility and the value of Life

The value of life methodology has been recently applied to a wide range of contexts as a means to evaluate welfare gains attributable to mortality reductions and health improvements. Yet, it suffers from an important methodological drawback: it does not incorporate into the analysis child mortality, individuals’ decisions regarding fertility, and their altruism towards offspring. Two interrelated dimensions of fertility choice are potentially essential in evaluating life expectancy and health related gains. First, child mortality rates can be very important in determining welfare in a context where individuals choose the number of children they have. Second, if altruism motivates fertility, life expectancy gains at any point in life have a twofold effect: they directly increase utility via increased survival probabilities, and they increase utility via increased welfare of the offspring. We develop a manageable way to deal with value of life valuations when fertility choices are endogenous and individuals are altruistic towards their offspring. We use the methodology developed in the paper to value the reductions in mortality rates experienced by the US between 1965 and 1995. The calculations show that, with a very conservative set of parameters, altruism and fertility can easily double the value of mortality reductions for a young adult, when compared to results obtained using the traditional value of life methodology.

Sleep, stress, neurocognitive profile and healthrelated quality of life in adolescents with idiopathic musculoskeletal pain

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Temporary neurological dysfunction after surgery of the thoracic aorta: a predictor of poor outcome and impaired quality of life

BACKGROUND: Transient neurological dysfunction (TND) consists of postoperative confusion, delirium and agitation. It is underestimated after surgery on the thoracic aorta and its influence on long-term quality of life (QoL) has not yet been studied. This study aimed to assess the influence of TND on short- and long-term outcome following surgery of the ascending aorta and proximal arch. METHODS: Nine hundred and seven patients undergoing surgery of the ascending aorta and the proximal aortic arch at our institution were included. Two hundred and ninety patients (31.9%) underwent surgery because of acute aortic dissection type A (AADA) and 617 patients because of aortic aneurysm. In 547 patients (60.3%) the distal anastomosis was performed using deep hypothermic circulatory arrest (DHCA). TND was defined as a Glasgow coma scale (GCS) value <13. All surviving patients had a clinical follow up and QoL was assessed with an SF-36 questionnaire. RESULTS: Overall in-hospital mortality was 8.3%. TND occurred in 89 patients (9.8%). As compared to patients without TND, those who suffered from TND were older (66.4 vs 59.9 years, p<0.01) underwent more frequently emergent procedures (53% vs 32%, p<0.05) and surgery under DHCA (84.3% vs 57.7%, p<0.05). However, duration of DHCA and extent of surgery did not influence the incidence of TND. In-hospital mortality in the group of patients with TND compared to the group without TND was similar (12.0% vs 11.4%; p=ns). Patients with TND suffered more frequently from coronary artery disease (28% vs 20.8%, p=ns) and were more frequently admitted in a compromised haemodynamic condition (23.6% vs 9.9%, p<0.05). Postoperative course revealed more pulmonary complications such as prolonged mechanical ventilation. Additional to their transient neurological dysfunction, significantly more patients had strokes with permanent neurological loss of function (14.6% vs 4.8%, p<0.05) compared to the patients without TND. ICU and hospital stay were significantly prolonged in TND patients (18+/-13 days vs 12+/-7 days, p<0.05). Over a mean follow-up interval of 27+/-14 months, patients with TND showed a significantly impaired QoL. CONCLUSION: The neurological outcome following surgery of the ascending aorta and proximal aortic arch is of paramount importance. The impact of TND on short- and long-term outcome is underestimated and negatively affects the short- and long-term outcome.

Social Work and the Quality of Life Politics - A Critical Assessment

The feature of this paper is a critical assessment of the current discourses about quality of life (QoL) and their implications for Social Work. At first it pictures some major historical backgrounds of the discussion on the improvement of life quality as an aim of societal development. In particular three crucial shifts in the politics of QoL - its 'individualisation', its 'informalisation' and its 'culturalisation' - and their implications for Social Work are critically examined theoretically and empirically referring to the results of an own community-study. The paper concludes with an alternative suggestion reflecting the idea of an 'autonomy-based' approach of democratic equality.

Regime survival strategies and the conduct of foreign policy in Egypt

エジプトではムバーラク大統領の国内政策と域内におけるエジプトの影響力低迷が引き金となって、2011年1月25日に抗議運動起こった。抗議運動はエジプト全土に拡がり、18日間の民衆的な反体制運動によってムバーラクは軍に見捨てられ、失脚に追い込まれた。この民衆蜂起によって警察は街頭から撤退し、シナイ半島の警察署は焼き放たれ、ムバーラクが率いていた国民民主党の建物や国内治安機関の本部は襲撃され、国家機関が数ヶ月にもわたって機能不全となり、ムバーラク体制の崩壊は国内的な混乱を招くこととなった。振り返れば、エジプトでの政治的大変動は社会的な革命へと展開することはできなかった。その理由は独裁体制からの移行を先導できる組織化された反体制勢力が存在しなかったためである。民衆による抗議運動は一時的に体制を転覆できても旧体制のエリートを分裂させることはできず、軍の影響下にある体制の復活を防ぐこともできなかった。2011年以降のエジプトは現在まで混乱状態に陥ったままであるが、1カ月に及ぶエジプト軍最高評議会(SCAF)の暫定統治、エジプト史上初の自由な大統領選挙によって選出された文民大統領のムルスィーによる一年余りの統治、そして2013年7月の軍事クーデターによって権力の座に就いたスィースィーの統治といった過程で、民衆蜂起がエジプトの外交関係に及ぼした影響はごく僅かであった。本稿は、現在のエジプトの外交政策が2011年の革命にほとんど影響を受けていないのはなぜか、またエジプトの統治者たちが政権の正統性、体制の強化および政治的な安定性を確保し、国内的な課題に対処するための戦略をいかに策定しているのかを説明することを試みる。本稿での主張は、ムバーラク以降のエジプトが体制の強化と保全のために外交政策を進めており、国内的な混乱によって地域内アクターへの依存度が高まっていることである。

PROFILE AND THE QUALITY OF LIFE OF LOGGERS

RESUMO – Objetivou-se com este estudo caracterizar o perfil e avaliar o nível de satisfação que reflete na qualidade de vida no trabalho (QVT) de trabalhadores da colheita de madeira de duas contratadas (C1 e C2), por duas grandes empresas do setor florestal, sendo uma do segmento de papel e celulose (PC) e, a outra, do segmento de carvão vegetal (CV). A avaliação ocorreu a partir da percepção dos trabalhadores das contratadas em questão, utilizando um modelo pré-concebido que contempla 11 blocos ou dimensões referentes a variáveis intervenientes e definidores da QVT, englobando 48 trabalhadores em três categorias funcionais: operador de motosserra (7 trabalhadores da C1 PC e 10 da C2 CV), ajudante de motosserrista (7 trabalhadores da C1 PC e 8 da C2 CV) e operador de carregador florestal (11 trabalhadores da C1 PC e 5 da C2 CV). Os dados referentes às variáveis intervenientes na QVT foram obtidos a partir de escala fechada do tipo Likert, com os escores variando de 1 a 7, em que 1 correspondeu ao nível "bastante insatisfeito" e 7, ao nível "bastante satisfeito". O perfil dos trabalhadores é de pessoa jovem, baixo nível de escolaridade e pouco tempo de serviço na empresa. Quanto ao nível de satisfação no trabalho, constatou-se que os trabalhadores da C1 PC se encontravam "satisfeitos" e os da C2 CV, "mediamente satisfeitos" com o trabalho e as condições proporcionadas pelas respectivas empresas, apesar de estatisticamente não ter sido detectada diferença entre os valores médios encontrados nas duas situações, pelo teste de Mediana (P>0,01). Os fatores que mais contribuíram para esses resultados favoráveis foram os benefícios extras oferecidos pelas prestadoras de serviços, as condições de segurança no trabalho e o contentamento com o emprego formal. ABSTRACT – The objective of this study was to characterize profile and satisfaction level, which reflects the quality of life (QOL) of forest workers of two contracts for harvest activities, one in the pulp and paper industry (PI) and another in charcoal industry (CI). The evaluation of the satisfaction indexes was carried out according to the workers perception by using a model including 11 parameters to reflect these workers QOL. The group study of 48 workers encompassed three functional categories: chainsaw operators (7 from C1 and 10 from C2), chainsaw operator's assistant (7 from C1 and 8 from C2), and log loader operators (11 from C1 and 5 from C2). Data regarding the factors involved in QOL were collected from a closed, Likert-type scale with scores ranging from 1-7, in which level 1 corresponded to "very dissatisfied" and level 7 to "very satisfied". The general profile of the group shows that most of them are young, with low level of education and employed in the companies for a short time. Overall, the employees of contractors of the paper and pulp industry are "satisfied" and those working for the charcoal company are only "moderately satisfied" with the work and policies offered by the respective companies, although no significant statistical difference was detected between the two groups, for the median test (P> 0.01). The main reasons behind these results are the general beneficts offered by the companies, the safety measurements and the overall satisfaction for been employed.

Employment and inflation goals of the Humphrey-Hawkins act and the conduct of monetary policy [microform] : hearings before the Subcommittee on Domestic Monetary Policy of the Committee on Banking, Finance, and Urban Affairs, House of Representatives, Ninety-sixth Congress, first session, March 13 and 14, 1979.

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