Burden of Influenza in Children

Background: Most children with influenza are treated as outpatients but, especially among young children, influenza-attributable illnesses often result in hospitalization. However, relatively scarce data exist on the clinical picture and the full disease burden of pediatric influenza. Prompt diagnosis of influenza could enable the institution of antiviral therapy and adequate cohorting of patients. Data are needed to help clinicians correctly suspect influenza at the time of hospital admission. Aims and methods: We conducted a prospective 2-year cohort study of respiratory infections in children aged ≤13 years to determine the incidence of influenza in outpatient children and to assess the clinical presentation of influenza in various age groups seen in primary care. We also determined the rates of different complications attributable to influenza and the absenteeism of the children and their parents due to the child’s influenza infection. We then conducted a further 16-year retrospective study of children ≤16 years of age, hospitalized with virologically confirmed influenza. We estimated the population-based rates of hospitalizations and determined the primary admission diagnoses of the hospitalized children in different age groups. Results: The average annual rate of influenza was highest (179 / 1000) among children <3 years old. In this age group, acute otitis media was diagnosed as a complication of influenza in 40% of children. High fever was the most prominent sign of influenza, and 20% of children <3 years of age had a fever ≥40oC. Most children had rhinitis already during the first days of the illness. The average annual incidence of influenzarelated hospitalization was highest (276 / 100,000) among infants <6 months of age, of whom 52% were primarily admitted due to sepsis-like illnesses. Respiratory symptoms accounted for 38% of the hospitalizations. Conclusions: Influenza causes a substantial burden of illness on outpatient children and their families. The clinical presentation of influenza is most severe in children <3 years of age. The high incidence of influenza-associated hospitalizations among infants aged <6 months calls for more effective ways to prevent influenza in this age group. The clinical manifestations of influenza vary widely in different age groups of children at the time of hospital admission. Awareness of this phenomenon is important for the early recognition of the illness and the potential initiation of effective antiviral treatment of these patients.

Transfer of Administrative HR Services to Global Service Center in Poland

Liiketoimintaa tukevien palvelujen etätuotanto edustaa uutta kansainvälistymisen muotoa. Kehittyvien markkinoiden nousu yhdistettynä yritysten arvoketjutoimintojen kansainvälistymiseen on luonut yrityksille kasvavan paineen etsiä parasta sijaintia toiminnoilleen. Monikansalliset yritykset ovat yhä useammin korvanneet paikallisia henkilöstöpalvelujaan siirtymällä globaaliin malliin jaettujen palvelujen tuotannossa. Tämä diplomityö on toteutettu tukeakseen UPM:n henkilöstöhallintoa globaalin palvelukeskuksen perustamisessa Puolaan. Tutkimuksen tavoitteena on laajentaa käsitystä henkilöstöpalvelujen tarjontamallin uudistamiseen johtaneista tekijöistä ja motiiveista. Empiirisen tutkimuksen tärkein tavoite on tukea rekrytoinnin hallinnollisten töiden siirtoa globaaliin palvelukeskukseen palvelun laadun säilyessä vähintään aikaisemmalla tasolla. Tutkimuksen tulokset painottavat strategista näkökulmaa muutokseen. Strategiset syyt UPM:n henkilöstöhallinnon globaalin palvelukeskuksen perustamiselle sisältävät ylikapasiteetin ja päällekkäisten toimintojen vähentämisen eri maissa. Muutos lisää palvelun joustavuutta sekä edesauttaa toiminnan läpinäkyvyyttä, ennustettavuutta ja kustannusten valvontaa. Onnistuneesti toteutetut jaetut palvelut voivat toimia hyvänä lähtökohtana tehokkaiden henkilöstöpalvelujen tuottamiselle.

Variability in the fecal egg count and the parasitic burden of hair sheep after grazing in nematode infected paddocks

This study aimed to evaluate the variability in the fecal egg count (FEC) and the parasitic burden of naive hair sheep after grazing in nematode infected paddocks. The research was carried out in Tabasco, Mexico, during two periods (August and December). In each period 32 lambs were grazed for one month on African star grass (Cynodon plectostachyus) contaminated with gastrointestinal parasitic nematodes. FEC, packed cell volume (PCV) and body weight (BW) were recorded. Gastrointestinal worms were recovered at necropsy. Data were analyzed with the MIXED procedure of SAS using a model of repeated measurements over time. A higher number of Haemonchus contortus worms was found in December (2814±838) than in August (1166±305). The opposite occurred with Cooperia curticei (2167±393 and 3638±441, respectively). The FEC and correlation coefficient in respect to the worm burden were higher in December (6516 ± 1599, r=0.83, respectively) than in August (4364±771, r=0.44, respectively). A high variability in resistance-susceptibility to gastrointestinal nematodes (GIN) occurred in Katahdin × Pelibuey lambs after grazing.

Coronary artery plaque burden and calcium scores in healthy men adhering to long-term wine drinking or alcohol abstinence

Observational studies suggest there are clinical benefits to moderate red wine (RW) consumption. However, the effects on coronary vasculature and overall lifestyle are unclear. We investigated whether a lifestyle of regular long-term RW consumption is associated with changes in coronary plaque burden, calcium score, carotid intima/media thickness, endothelial function, and metabolic variables, compared with alcohol abstinence. Healthy volunteers were evaluated by coronary computed tomography angiography (CTA) as well as carotid and brachial artery ultrasound. Nutritional status, psychological status, and metabolic variables were assessed. The study included 101 drinkers [aged 58.9±7.3 years (means±SD)], from wine brotherhoods, and 104 abstainers, from Anglican, Evangelical and Catholic churches both in the city of São Paulo, Brazil. No significant differences in demographics were noted. Lesion prevalence per patient assessed by coronary CTA and classified as absent (0), 1-25, 26-49, and ≥50% stenosis was similar between groups. When analyzed by individual arteries, i.e., left anterior descending, circumflex, and right coronary, prevalence was also not different. On the other hand, calcium scores were higher among drinkers than abstainers (144.4±362.2 vs 122.0±370.3; P<0.01). However, drinkers reported less history of diabetes and exercised more. RW drinkers consumed 2127.9±387.7 kcal/day while abstainers consumed 1836.0±305.0 (P<0.0001). HDL cholesterol was significantly higher among drinkers compared to abstainers (46.9±10.9 vs 39.5±9.0 mg/dL; P<0.001), while fasting plasma glucose was lower (97.6±18.2 vs 118.4±29.6 mg/dL; P<0.02). Liver enzymes were normal in both groups. In conclusion, long-term wine drinkers displayed a similar plaque burden but greater calcium score than abstainers, despite a more atherogenic diet, and the mechanisms for the increased calcium scores in the former remain speculative.

Economic Burden of Psoriasis

Psoriasis may cause a substantial economic burden to patients, health service providers, third parties, and the society as a whole. However, all of these costs may not be adequately considered when assessing the treatment costs for psoriasis. Psoriasis may negatively affect work productivity as psoriasis has a relatively high incidence in working age people that lead to possible costs because of lost productivity. The aims of this thesis were to estimate the economic burden of psoriasis particularly from patients’ and health service providers’ perspectives and to estimate the background factors (e.g., severity of psoriasis) that may have led to high costs. Another aim was to estimate the total medication costs and to estimate psoriasis’ proportion of health-related productivity losses. The patient sample was based on patients with psoriasis who visited the Department of Dermatology in Turku University Hospital during a one-year study period. These patients were sent a questionnaire. From the patients who gave consent, medication information, clinical information, and number of visits to Turku University Hospital were collected. This data was linked to the information from the questionnaire. Overall psoriasis was estimated to cause a substantial economic burden for the patient, health service provider, health insurance system, employer, and the society as a whole. The direct costs represented only a small proportion of the overall financial burden of psoriasis, whereas indirect costs were significant. The estimated annual costs for patients and employers were almost twice the costs to health service providers or the Social Insurance Institution of Finland. In conclusion, the cost contribution of patients and employers should be considered when assessing the costs of different treatments, in addition to commonly studied direct costs of medications and costs to health service providers. Methods used to assess these costs should be well justified and be described clearly to allow comparisons between studies and to evaluate the quality of the results.

Recueil périodique de législation, de doctrine et de jurisprudence en matière de procédure civile, commerciale, criminelle et administrative / publié par MM. Rodolphe Rousseau,... Laisney,...

1900 (A21).

Recueil périodique de législation, de doctrine et de jurisprudence en matière de procédure civile, commerciale, criminelle et administrative / publié par MM. Rodolphe Rousseau,... Laisney,...

1916 (A37).

Recueil périodique de législation, de doctrine et de jurisprudence en matière de procédure civile, commerciale, criminelle et administrative / publié par MM. Rodolphe Rousseau,... Laisney,...

1892 (A13).

Recueil périodique de législation, de doctrine et de jurisprudence en matière de procédure civile, commerciale, criminelle et administrative / publié par MM. Rodolphe Rousseau,... Laisney,...

1913 (A34).

Recueil périodique de législation, de doctrine et de jurisprudence en matière de procédure civile, commerciale, criminelle et administrative / publié par MM. Rodolphe Rousseau,... Laisney,...

1899 (A20).

Recueil périodique de législation, de doctrine et de jurisprudence en matière de procédure civile, commerciale, criminelle et administrative / publié par MM. Rodolphe Rousseau,... Laisney,...

1880 (A1).

Recueil périodique de législation, de doctrine et de jurisprudence en matière de procédure civile, commerciale, criminelle et administrative / publié par MM. Rodolphe Rousseau,... Laisney,...

1896 (A17).

Recueil périodique de législation, de doctrine et de jurisprudence en matière de procédure civile, commerciale, criminelle et administrative / publié par MM. Rodolphe Rousseau,... Laisney,...

1893 (A14).

Recueil périodique de législation, de doctrine et de jurisprudence en matière de procédure civile, commerciale, criminelle et administrative / publié par MM. Rodolphe Rousseau,... Laisney,...

1888 (A9).