Health literacy [Document électronique] : an economic perspective and data for Switzerland. Part 2, A review of health literacy measures and a cost assessment of limited health literacy

Summary : 1. Measuring health literacy in Switzerland: a review of six surveys: 1.1 Comparison of questionnaires - 1.2 Measures of health literacy in Switzerland - 1.3 Discussion of Swiss data on HL - 1.4 Description of the six surveys: 1.4.1 Current health trends and health literacy in the Swiss population (gfs-UNIVOX), 1.4.2 Nutrition, physical exercise and body weight : opinions and perceptions of the Swiss population (USI), 1.4.3 Health Literacy in Switzerland (ISPMZ), 1.4.4 Swiss Health Survey (SHS), 1.4.5 Survey of Health, Ageing and Retirement in Europe (SHARE), 1.4.6 Adult literacy and life skills survey (ALL). - 2 . Economic costs of low health literacy in Switzerland: a rough calculation. Appendix: Screenshots cost model

Ideas, Possibilities and Limitations of Sustainable Economic Policy – the Example of Ecological Economics

A mesura que el suport del creixement econòmic constitueix un objectiu fonamental de la formulació de polítiques econòmiques, cal assenyalar que aquest tipus de creixement està limitat naturalment per un planeta finit. Aquest article argumenta que, des del punt de vista de la justícia intergeneracional, la realització d'un concepte de desmaterialització i, com a efecte, d'una economia que no creix (en el sentit de dissociació absoluta del creixement econòmic i consum d'energia i materials) es pot justificar. Per tant, el creixement pot ser també entesa com la millora de la qualitat de vida sobretot en comptes d'ampliar quantitats escarpats de sortida. Per tant, una dràstica reducció del cabal de material es necessita, sobretot en els països d'alts ingressos. Després de presentar alguns crítica de les propostes, en el focus d'aquest article es dibuixen en els arguments de per què la política econòmica en el futur han de ser etiquetats com "ecològic" i, a continuació, les opcions de posar en acció les idees del teòric presentat marc en tasques manejables polítiques seran discutides. En aquest cas, s'argumentarà que l'enfocament clàssic de internalització d'efectes externs sovint seguides de decisions de política econòmica ortodoxa no és completament capaç de reflectir canvis ecològics en les estructures de preus dels mercats. Per tant, formal (industrial i l'establiment de la política de consum) i institucions informals (llars) representen punts clau de la política econòmica sostenible, assenyalant l'individu com així com la responsabilitat col · lectiva per omplir aquest buit substancial.

China’s Strategy in North Africa: New economic challenges for the Mediterranean region

El WP té com a objectiu examinar per què els països del nord d'Àfrica estan augmentant les seves importacions de Xina i per què la Xina està augmentant les seves inversions estrangeres directes a la zona. la avantatges per als països del nord d'Àfrica es troben en els actuals acords de lliure comerç, el absència de barreres aranzelàries i la seva ubicació geogràfica summament beneficiosa com Hub de la Mediterrània. El paper de la Unió per la Mediterrània és clau per identificar aspectes de la política regional, tenint en compte la participació xinesa a la zona. com conseqüència, concloem que els actors polítics han de trobar un equilibri entre sostenible desenvolupament i els interessos econòmics de la regió.

Economic structure and key sectors analysis of greenhouse gas emissions in Uruguay

This paper identifies the key sectors in greenhouse gas emissions of the Uruguayan economy through input-output analysis. This allows to precisely determine the role played by the different productive sectors and their relationship with other sectors in the relation between the Uruguayan productive structure and atmospheric pollution. In order to guide policy design for GHG reduction, we decompose sectors liability between the pollution generated through their own production processes and the pollution indirectly generated in the production processes of other sectors. The results show that all the key polluting sectors for the different contaminants considered are relevant because of their own emissions, except for the sector Motor vehicles and oil retail trade, which is relevant in CO2 emissions because of its pure, both backward and forward, linkages. Finally, the best policy channels for controlling and reducing GHGs emissions are identified, and compared with the National Climate Change Response Plan (NCCRP) lines of action.

Predictors of return to work after a knee injury in patients hospitalized in vocational rehabilitation

Introduction.- Knee injuries are frequent in a young and active population. Most of the patients resume their professional activity but few studies were interested in factors that predict a return to work. The aim of this study is to identify these predictors from a large panel of bio-psychosocial variables. We postulated that the return to work 3 months and 2 years after discharge is mostly predicted by psychosocial variables.Patients and methods.- Prospective study, patients hospitalized for a knee injury. Variables measured: the abbreviated injury score (AIS) for the gravity of the injuries, analog visual scale for the intensity of pain, INTERMED for the bio-psychosocial complexity, SF-36 for the quality of life, HADs for the anxiety/depression symptoms and IKDC score for the knee function. Univariate logistic regressions, adjusted for age and gender, were performed in order to predict return to work.Results.- One hundred and twenty-six patients hospitalized during 8 months after the accident were included into this prospective study. A total of 73 (58%) and 75 (59%) questionnaires were available after 3 months and 2 years, respectively. The SF-36 pain was the sole predictor of return to work at 3 months (odds Ratio 1.06 [1.02-1.10], P = 0.01; for a one point increase) and 2 years (odds Ratio 1.06 [1.02-1.10], P = 0.01). At three months, other factors are SF-36 (physic sub-scale), IKDC score, the presence of a work contract and the presence of litigation. The bio-psychosocial complexity, the presence of depressive symptoms predicts the return to work at two years.Discussion.- Our working hypothesis was partially confirmed: some psychosocial factors (i.e. depressive symptoms, work contract, litigation, INTERMED) predict the return to work but the physical health and the knee function, perceived by the patient, are also correlated. Pain is the sole factor isolated at both times (i.e. 3 months and 2 years) and, consequently, appears a key element in the prediction of the return to work. Some factors are accessible to the rehabilitation program but only if an interdisciplinary approach is performed.

The effect of recalled previous work environment on return to work after a rehabilitation program including vocational aspects for trauma patients.

INTRODUCTION: The aim of the present study was to assess the association between remembered previous work place environment and return to work (RTW) after hospitalisation in a rehabilitation hospital. METHODS: A cohort of 291 orthopedic trauma patients discharged from hospital between 15 December 2004 and 31 December 2005 was included in a study addressing quality of life and work-related questions. Remembered previous work environment was measured by Karasek's 31-item Job Content Questionnaire (JCQ), given to the patients during hospitalisation. Post-hospitalisation work status was assessed 3 months, 1, and 2 years after discharge, using a questionnaire sent to the ex-patients. Logistic regression models were used to test the role of four JCQ variables on RTW at each time point while controlling for relevant confounders. RESULTS: Subjects perceiving a higher physical demand were less likely to return to work 1 year after hospital discharge. Social support at work was positively associated with RTW at all time points. A high job strain appeared to be positively associated with RTW 1 year after rehabilitation, with limitations due to large confidence intervals. CONCLUSIONS: Perceptions of previous work environment may influence the probability of RTW. In a rehabilitation setting, efforts should be made to assess those perceptions and, if needed, interventions to modify them should be applied.

Litterfall and mineral return in two cork-oak forests in northeast spain

Seasonal trends in littertall and potential mineral return were studied in two cork-oak forest sites in the northeastern Iberian peninsula. The estimated average litter production was 3.9.M- gy.e1ahar for one site and 4.6 .M- gy.e1ahar for the other; these figures are similar to those reported for holm-oak (Quercus ilex) forests in the same area. Seasonal litterfall patterns were typical of Mediterranean forest ecosystems. Leaves accounted for 46 to 78% of the total dry matter. Their annual weighted-average mineral composition was low in macronutrients (N 8-9; K 4-5; Mg 0.8-1.3; Ca 9-10 and P 0.4-1 m-)g.1g and relatively high in micronutrients such as Mn (2-2.2 m-)g.1g or Fe (0.3-0.4 m)-g..1g Minimum N and P concentrations were found during the growth period. Estimates of potential mineral return for an annual cycle were N 38-52, P 2.1-5.2, K 20-28, Ca 44-53 and Mg 5.4-5.0 k-,g.1ha depending on the site biomass and fertility

Functional multidisciplinary rehabilitation versus outpatient physiotherapy for non specific low back pain: randomized controlled trial.

INTRODUCTION: In recent decades the treatment of non-specific low back pain has turned to active modalities, some of which were based on cognitive-behavioural principles. Non-randomised studies clearly favour functional multidisciplinary rehabilitation over outpatient physiotherapy. However, systematic reviews and meta-analysis provide contradictory evidence regarding the effects on return to work and functional status. The aim of the present randomised study was to compare long-term functional and work status after 3-week functional multidisciplinary rehabilitation or 18 supervised outpatient physiotherapy sessions. METHODS: 109 patients with non-specific low back pain were randomised to either a 3-week functional multidisciplinary rehabilitation programme, including physical and ergonomic training, psychological pain management, back school and information, or 18 sessions of active outpatient physiotherapy over 9 weeks. Primary outcomes were functional disability (Oswestry) and work status. Secondary outcomes were lifting capacity (Spinal Function Sort and PILE test), lumbar range-of-motion (modified-modified Schöber and fingertip-to-floor tests), trunk muscle endurance (Shirado and Biering-Sörensen tests) and aerobic capacity (modified Bruce test). RESULTS: Oswestry disability index was improved to a significantly greater extent after functional multidisciplinary rehabilitation compared to outpatient physiotherapy at follow-up of 9 weeks (P = 0.012), 9 months (P = 0.023) and 12 months (P = 0.011). Work status was significantly improved after functional multidisciplinary rehabilitation only (P = 0.012), resulting in a significant difference compared to outpatient physiotherapy at 12 months' follow-up (P = 0.012). Secondary outcome results were more contrasted. CONCLUSIONS: Functional multidisciplinary rehabilitation was better than outpatient physiotherapy in improving functional and work status. From an economic point of view, these results should be backed up by a cost-effectiveness study.

Tugan-Baranovsky on Socialism: From Utopia to the Economic Plan

Tugan-Baranovsky's ideas on socialism are reconstructed with an emphasis on the relation between political economy and utopia. Utopia enters the stage after the critique of capitalism, in the definition of the realm of possibilities in the world of ideas. With the help of ethics, the notion of ideal socialism, unreachable by definition, is defined in the sphere of utopia. Thus, the task of political economy is first to show which of these possible worlds are reachable in the real world, and second to choose the one that conforms better to ideal socialism: this is socialism in practice through the economic plan. Thus, far from considering utopia and science as contradictory, Tugan-Baranovsky saw them as complementary, and his socialism is the result of the dialogue he instituted between them.

Hypoglycémie et traitement du diabète de type 2. Le retour à une normoglycémie n'est pas nécessairement la meilleure stratégie thérapeutique [Hypoglycemia and diabetes treatment: the return to normal glucose level is not always the best therapeutic strategy].

Recent clinical trials with type 2 diabetic patients and the quest of normal glyceamic values, have revealed difficulties and limitations. These too normal glyceamic targets corresponding to the physiological standards are associated with very high rate of hypoglycemia and an increase of mortality. A too simplistic view of treatment: "the lowest, the better is in the diabetes" is no longer defensible. The knowledge from complex systems behavior invites us to search targets adapted to a new state of equilibrium due to loss of self-regulation. These targets should not aim the physiological standards but to be adapted to patient's situation. Shared decision-making and consensus are the two pillars of this new strategy supported by the new ADA-EASD guidelines.

Iowa Department of Economic Development, Agency Performance Plan

Annual Report, Agency Performance Plan

International Update, Iowa Department of Economic Development, March/April, 2003

Department Report for Economic Development