Special Education and the Risk of Becoming Less Educated in Germany and the United States. CES Germany & Europe Working Papers, No. 05.1, 13 December, 2004

Over the twentieth century, a growing group of students has been transferred into considerably expanded special education systems. These programs serve children with diagnosed impairments and disabilities and students with a variety of learning difficulties. Children and youth “with special educational needs” constitute a heterogeneous group with social, ethnic, linguistic, and physical disadvantages. An increasingly large percentage of those students at risk of leaving school without credentials participate in special education, a highly legitimated low status (and stigmatizing) school form. While most countries commit themselves to school integration or inclusive education to replace segregated schools and separate classes, cross-national and regional comparisons of special education’s diverse student bodies show considerable disparities in their (1) rates of classification, (2) provided learning opportunities, and (3) educational attainments. Analyzing special education demographics and organizational structures indicates which children and youth are most likely to grow up less educated and how educational systems distribute educational success and failure. Findings from a German-American comparison show that which students bear the greatest risk of becoming less educated depends largely on definitions of “special educational needs” and the institutionalization of special education systems.

Europe cannot afford people in bad health - Economics of health and care as a guide for investments. EPC Commentary, 4 July 2016

It is widely accepted that a new way of looking at Europe’s health sector is necessary if we are to maintain universal health coverage. Financial resources are limited, and the sustainability of Europe’s health systems is under threat. Economic growth is slow, health expenditures outpace GDP growth, public budgets are under strain and demographics – with a growing aging population – are putting pressure on the younger tax-paying generations. In an effort to ensure the sustainability of Europe’s health systems, reforms, underpinned by a new understanding of the economic value of health for individuals and society is needed.

Preferences and consumer habits related to bread in the centre of Portugal

Purpose – Bread is one of the most consumed foods in the world, and its main function is to provide nutrients and energy for the body. Thus, the purpose of this paper was to raise awareness about the consumption habits of bread and consumer preferences in the region of Viseu (centre of Portugal), assessing the extent to which the preferences and consumption habits differ based on individual variables. Design/methodology/approach – The study was conducted by means of a questionnaire by direct interviewing. The questionnaire included sections aimed at gathering information about demographics, consumption habits and preferences related to bread. The sample consisted of 500 consented respondents. Findings – The results showed significant differences between genders regarding the type of bread eaten: women consumed less wheat bread (52 per cent against 62 per cent; p 0.029) and less unsalted bread (0.3 per cent against 3 per cent; p 0.023), but more whole bread (25 per cent against 11 per cent; p 0.001) and more bread with cereal grains (23 per cent against 11 per cent; p 0.001), thus revealing a trend for a nutritionally more adequate choice. Accordingly, women valued more the composition of the bread when purchasing it (p 0.001). It was also observed a trend for a lower consumption of wheat bread among classes with more advanced studies (47 per cent on university graduates against 60 per cent on nongraduates; p 0.004). Originality/value – This work is innovative because it was the first time the preferences and consuming habits of a sample of Portuguese population regarding bread were accessed, altogether. The results hereby obtained may be of importance both to understand the nutritional importance of bread in the diet of the Portuguese and also for the industry and manufacturers to better correspond to the buying preferences.

Recurrent bacteremia with Streptococcus dysgalactiae: a case-control study.

Beta-hemolytic streptococci of groups C and G, designated as Streptococcus dysgalactiae (SD), can cause severe and recurring invasive infections. In this case-control study, we aimed to identify clinical and molecular risk factors for recurrence of SD bacteremia. Twenty-two cases of recurrent SD bacteremia were identified, and median time between episodes was 6 months. The most frequent clinical manifestation was skin and soft tissue infection. Cases and 92 controls, with single-episode SD bacteremia, showed similar demographics, had similar Charlson comorbidity scores, and had similar clinical presentations. Thirty-day fatality was 13% among controls, whereas none of 22 cases died. In 19 cases (86%), the same emm type was encountered in both episodes. SD isolates from recurrent episodes and from single episodes had a similar emm type distribution. Thus, we did not identify clinical risk factors for recurrences. The high proportion of identical emm types in recurrent episodes indicates a host-specific colonization.

Which Anesthesia Regimen Is Best to Reduce Morbidity and Mortality in Lung Surgery? A Multicenter Randomized Controlled Trial.

BACKGROUND One-lung ventilation during thoracic surgery is associated with hypoxia-reoxygenation injury in the deflated and subsequently reventilated lung. Numerous studies have reported volatile anesthesia-induced attenuation of inflammatory responses in such scenarios. If the effect also extends to clinical outcome is yet undetermined. We hypothesized that volatile anesthesia is superior to intravenous anesthesia regarding postoperative complications. METHODS Five centers in Switzerland participated in the randomized controlled trial. Patients scheduled for lung surgery with one-lung ventilation were randomly assigned to one of two parallel arms to receive either propofol or desflurane as general anesthetic. Patients and surgeons were blinded to group allocation. Time to occurrence of the first major complication according to the Clavien-Dindo score was defined as primary (during hospitalization) or secondary (6-month follow-up) endpoint. Cox regression models were used with adjustment for prestratification variables and age. RESULTS Of 767 screened patients, 460 were randomized and analyzed (n = 230 for each arm). Demographics, disease and intraoperative characteristics were comparable in both groups. Incidence of major complications during hospitalization was 16.5% in the propofol and 13.0% in the desflurane groups (hazard ratio for desflurane vs. propofol, 0.75; 95% CI, 0.46 to 1.22; P = 0.24). Incidence of major complications within 6 months from surgery was 40.4% in the propofol and 39.6% in the desflurane groups (hazard ratio for desflurane vs. propofol, 0.95; 95% CI, 0.71 to 1.28; P = 0.71). CONCLUSIONS This is the first multicenter randomized controlled trial addressing the effect of volatile versus intravenous anesthetics on major complications after lung surgery. No difference between the two anesthesia regimens was evident.

Dually Active HIV/HBV Antiretrovirals Protect Against Incident Hepatitis B Infections: Potential for Prophylaxis.

BACKGROUND  Hepatitis-B virus (HBV) has a detrimental effect on HIV natural course, and HBV vaccination is less effective in the HIV infected. We examine the protective effect of dually active antiretroviral therapy (DAART) for HIV/HBV (Tenofovir/Lamivudine/Emtricitabine) in a large cohort encompassing heterosexuals, men-who-have-sex-with-men (MSM), and intravenous drug users (IDU), who are HIV-infected yet susceptible to HBV, with comprehensive follow-up data about risky behavior and immunological profile. METHODS  We defined an incident HBV infection as the presence of any of HBV serological markers (HBsAg/AntiHBc/HBV-DNA) following a negative baseline AntiHBc test. Patients with positive AntiHBs were excluded. Cox proportional hazard models were utilized, with an incident case of HBV infection as the outcome variable. RESULTS  We analyzed 1,716 eligible patients from the Swiss HIV Cohort Study with 177 incident HBV cases. DAART was negatively associated with incident HBV infection (hazard ratio 0.4, 95%CI 0.2-0.6). This protective association was robust to adjustment (0.3, 0.2-0.5) for condomless sex, √CD4 count, drug use, and patients' demographics. Condomless sex (1.9,1.4-2.6), belonging to MSM (2.7,1.7-4.2) or IDU (3.8,2.4-6.1) were all associated with higher HBV hazard. CONCLUSIONS  Our study suggests that DAART, independently of CD4 count and risky behavior, has a potentially strong public health impact including pre-exposure prophylaxis of HBV co-infection.

Genotypic Resistance Tests Sequences Reveal the Role of Marginalized Populations in HIV-1 Transmission in Switzerland.

Targeting hard-to-reach/marginalized populations is essential for preventing HIV-transmission. A unique opportunity to identify such populations in Switzerland is provided by a database of all genotypic-resistance-tests from Switzerland, including both sequences from the Swiss HIV Cohort Study (SHCS) and non-cohort sequences. A phylogenetic tree was built using 11,127 SHCS and 2,875 Swiss non-SHCS sequences. Demographics were imputed for non-SHCS patients using a phylogenetic proximity approach. Factors associated with non-cohort outbreaks were determined using logistic regression. Non-B subtype (univariable odds-ratio (OR): 1.9; 95% confidence interval (CI): 1.8-2.1), female gender (OR: 1.6; 95% CI: 1.4-1.7), black ethnicity (OR: 1.9; 95% CI: 1.7-2.1) and heterosexual transmission group (OR:1.8; 95% CI: 1.6-2.0), were all associated with underrepresentation in the SHCS. We found 344 purely non-SHCS transmission clusters, however, these outbreaks were small (median 2, maximum 7 patients) with a strong overlap with the SHCS'. 65% of non-SHCS sequences were part of clusters composed of >= 50% SHCS sequences. Our data suggests that marginalized-populations are underrepresented in the SHCS. However, the limited size of outbreaks among non-SHCS patients in-care implies that no major HIV outbreak in Switzerland was missed by the SHCS surveillance. This study demonstrates the potential of sequence data to assess and extend the scope of infectious-disease surveillance.

First Annual IMACS Report: A global International Society for Heart and Lung Transplantation Registry for Mechanical Circulatory Support

The first annual report of the International Society for Heart and Lung Transplantation (ISHLT) Mechanically Assisted Circulatory Support (IMACS) registry provides global data on 5,942 patients from 31 countries. This initial report focuses on patient demographics, survival, device types, adverse events, competing outcomes, and a risk factor analysis.

Searching for solutions: a policy discussion series. Nationwide Personal Transportation Survey Symposium. Proceedings.

Federal Highway Administration, Office of Highway Policy Information, Washington, D.C.

Transportation for older Americans - issues and options for the decade of the 1980's. Final report.

Transportation Department, Washington, D.C.

Rail-highway crossing safety fatal crash and demographic descriptors.

National Highway Traffic Safety Administration, Office of Research and Development, Washington, D.C.

Demographic special reports: based on data from 1990 Nationwide Personal Transportation Survey (NPTS).

Federal Highway Administration, Washington, D.C.

Special reports on trip and vehicle attributes: based on data from 1990 Nationwide Personal Transportation Survey (NPTS).

Federal Highway Administration, Washington, D.C.

Understanding youthful risk taking and driving.

National Highway Traffic Safety Administration, Washington, D.C.

Special transportation services for the elderly and handicapped in Baton Rouge. Final report.

Transportation Systems Center, Cambridge, Mass.