873 resultados para International Financial Reporting Standard
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Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September 2004, with methodologists, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE Statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed Explanation and Elaboration document is published separately and is freely available on the Web sites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE Statement will contribute to improving the quality of reporting of observational studies.
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As a result of debt enforcement problems, many high-productivity firms in emergingeconomies are unable to pledge enough future profits to their creditors and this constrains thefinancing they can raise. Many have argued that, by relaxing these credit constraints, reformsthat strengthen enforcement institutions would increase capital flows to emerging economies. Thisargument is based on a partial equilibrium intuition though, which does not take into account theorigin of any additional resources that flow to high-productivity firms after the reforms. We showthat some of these resources do not come from abroad, but instead from domestic low-productivityfirms that are driven out of business as a result of the reforms. Indeed, the resources released bythese low-productivity firms could exceed those absorbed by high-productivity ones so that capitalflows to emerging economies might actually decrease following successful reforms. This resultprovides a new perspective on some recent patterns of capital flows in industrial and emergingeconomies.
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The 2009 International Society of Urological Pathology Consensus Conference in Boston made recommendations regarding the standardization of pathology reporting of radical prostatectomy specimens. Issues relating to the infiltration of tumor into the seminal vesicles and regional lymph nodes were coordinated by working group 4. There was a consensus that complete blocking of the seminal vesicles was not necessary, although sampling of the junction of the seminal vesicles and prostate was mandatory. There was consensus that sampling of the vas deferens margins was not obligatory. There was also consensus that muscular wall invasion of the extraprostatic seminal vesicle only should be regarded as seminal vesicle invasion. Categorization into types of seminal vesicle spread was agreed by consensus to be not necessary. For examination of lymph nodes, there was consensus that special techniques such as frozen sectioning were of use only in high-risk cases. There was no consensus on the optimal sampling method for pelvic lymph node dissection specimens, although there was consensus that all lymph nodes should be completely blocked as a minimum. There was also a consensus that a count of the number of lymph nodes harvested should be attempted. In view of recent evidence, there was consensus that the diameter of the largest lymph node metastasis should be measured. These consensus decisions will hopefully clarify the difficult areas of pathological assessment in radical prostatectomy evaluation and improve the concordance of research series to allow more accurate assessment of patient prognosis.
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BACKGROUND: Intravenously administered antimicrobial agents have been the standard choice for the empirical management of fever in patients with cancer and granulocytopenia. If orally administered empirical therapy is as effective as intravenous therapy, it would offer advantages such as improved quality of life and lower cost. METHODS: In a prospective, open-label, multicenter trial, we randomly assigned febrile patients with cancer who had granulocytopenia that was expected to resolve within 10 days to receive empirical therapy with either oral ciprofloxacin (750 mg twice daily) plus amoxicillin-clavulanate (625 mg three times daily) or standard daily doses of intravenous ceftriaxone plus amikacin. All patients were hospitalized until their fever resolved. The primary objective of the study was to determine whether there was equivalence between the regimens, defined as an absolute difference in the rates of success of 10 percent or less. RESULTS: Equivalence was demonstrated at the second interim analysis, and the trial was terminated after the enrollment of 353 patients. In the analysis of the 312 patients who were treated according to the protocol and who could be evaluated, treatment was successful in 86 percent of the patients in the oral-therapy group (95 percent confidence interval, 80 to 91 percent) and 84 percent of those in the intravenous-therapy group (95 percent confidence interval, 78 to 90 percent; P=0.02). The results were similar in the intention-to-treat analysis (80 percent and 77 percent, respectively; P=0.03), as were the duration of fever, the time to a change in the regimen, the reasons for such a change, the duration of therapy, and survival. The types of adverse events differed slightly between the groups but were similar in frequency. CONCLUSIONS: In low-risk patients with cancer who have fever and granulocytopenia, oral therapy with ciprofloxacin plus amoxicillin-clavulanate is as effective as intravenous therapy.
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The approach to intervention programs varies depending on the methodological perspective adopted. This means that health professionals lack clear guidelines regarding how best to proceed, and it hinders the accumulation of knowledge. The aim of this paper is to set out the essential and common aspects that should be included in any program evaluation report, thereby providing a useful guide for the professional regardless of the procedural approach used. Furthermore, the paper seeks to integrate the different methodologies and illustrate their complementarity, this being a key aspect in terms of real intervention contexts, which are constantly changing. The aspects to be included are presented in relation to the main stages of the evaluation process: needs, objectives and design (prior to the intervention), implementation (during the intervention), and outcomes (after the intervention). For each of these stages the paper describes the elements on which decisions should be based, highlighting the role of empirical evidence gathered through the application of instruments to defined samples and according to a given procedure.
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Introduction: Building online courses is a highly time consuming task for teachers of a single university. Universities working alone create high-quality courses but often cannot cover all pathological fields. Moreover this often leads to duplication of contents among universities, representing a big waste of teacher time and energy. We initiated in 2011 a French university network for building mutualized online teaching pathology cases, and this network has been extended in 2012 to Quebec and Switzerland. Method: Twenty French universities (see & for details), University Laval in Quebec and University of Lausanne in Switzerland are associated to this project. One e-learning Moodle platform (http://moodle.sorbonne-paris-cite.fr/) contains texts with URL pointing toward virtual slides that are decentralized in several universities. Each university has the responsibility of its own slide scanning, slide storage and online display with virtual slide viewers. The Moodle website is hosted by PRES Sorbonne Paris Cité, and financial supports for hardware have been obtained from UNF3S (http://www.unf3s.org/) and from PRES Sorbonne Paris Cité. Financial support for international fellowships has been obtained from CFQCU (http://www.cfqcu.org/). Results: The Moodle interface has been explained to pathology teachers using web-based conferences with screen sharing. The teachers added then contents such as clinical cases, selfevaluations and other media organized in several sections by student levels and pathological fields. Contents can be used as online learning or online preparation of subsequent courses in classrooms. In autumn 2013, one resident from Quebec spent 6 weeks in France and Switzerland and created original contents in inflammatory skin pathology. These contents are currently being validated by senior teachers and will be opened to pathology residents in spring 2014. All contents of the website can be accessed for free. Most contents just require anonymous connection but some specific fields, especially those containing pictures obtained from patients who agreed for a teaching use only, require personal identification of the students. Also, students have to register to access Moodle tests. All contents are written in French but one case has been translated into English to illustrate this communication (http://moodle.sorbonne-pariscite.fr/mod/page/view.php?id=261) (use "login as a guest"). The Moodle test module allows many types of shared questions, making it easy to create personalized tests. Contents that are opened to students have been validated by an editorial committee composed of colleagues from the participating institutions. Conclusions: Future developments include other international fellowships, the next one being scheduled for one French resident from May to October 2014 in Quebec, with a study program centered on lung and breast pathology. It must be kept in mind that these e-learning programs highly depend on teachers' time, not only at these early steps but also later to update the contents. We believe that funding resident fellowships for developing online pathological teaching contents is a win-win situation, highly beneficial for the resident who will improve his knowledge and way of thinking, highly beneficial for the teachers who will less worry about access rights or image formats, and finally highly beneficial for the students who will get courses fully adapted to their practice.
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Background: Mantle cell lymphoma (MCL) is a rare subtype (3-9%) of Non Hodgkin Lymphoma (NHL) with a relatively poor prognosis (5-year survival < 40%). Although consolidation of first remission with autologous stem cell transplantation (ASCT) is regarded as "golden standard", less than half of the patients may be subjected to this intensive treatment due to advanced age and co-morbidities. Standard-dose non-myeloablative radioimmunotherapy (RIT) seems to be a very efficient approach for treatment of certain NHL. However, there are almost no data available on the efficacy and safety of RIT in MCL. Methods and Patients: In the RIT-Network, a web-based international registry collecting real observational data from RIT-treated patients, 115 MCL patients treated with ibritumomab tiuxetan were recorded. Most of the patients were elderly males with advanced stage of the disease: median age - 63 (range 31-78); males - 70.4%, stage III/IV - 92%. RIT (i.e. application of ibritumomab tiuxetan) was a part of the first line therapy in 48 pts. (43%). Further 38 pts. (33%) received ibritumomab tiuxetan after two previous chemotherapy regimens, and 33 pts. (24%) after completing 3-8 lines. In 75 cases RIT was applied as a consolidation of chemotherapy induced response; the rest of the patients received ibritumomab tiuxetan because of relapse/refractory disease. At the moment follow up data are available for 74 MCL patients. Results: After RIT the patients achieved high response rate: CR 60.8%, PR 25.7%, and SD 2.7%. Only 10.8% of the patients progressed. For survival analysis many data had to be censored since the documentation had not been completed yet. The projected 3-year overall survival (OAS, fig.1 - image 001.gif) after radioimmunotherapy was 72% for pts. subjected to RIT consolidation versus 29% for those treated in relapse/refractory disease (p=0.03). RIT was feasible for almost all patients; only 3 procedure-related deaths were reported in the whole group. The main adverse event was hematological toxicity (grade III/IV cytopenias) showing a median time of recovery of Hb, WBC and Plt of 45, 40 and 38 days respectively. Conclusion: Standard-dose non-myeloablative RIT is a feasible and safe treatment modality, even for elderly MCL pts. Consolidation radioimmunotherapy with ibritumomab tiuxetan may prolong survival of patients who achieved clinical response after chemotherapy. Therefore, this consolidation approach should be considered as a treatment strategy for those, who are not eligible for ASCT. RIT also has a potential role as a palliation therapy in relapsing/resistant cases.
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BACKGROUND: The outcome of diffuse large B-cell lymphoma has been substantially improved by the addition of the anti-CD20 monoclonal antibody rituximab to chemotherapy regimens. We aimed to assess, in patients aged 18-59 years, the potential survival benefit provided by a dose-intensive immunochemotherapy regimen plus rituximab compared with standard treatment plus rituximab. METHODS: We did an open-label randomised trial comparing dose-intensive rituximab, doxorubicin, cyclophosphamide, vindesine, bleomycin, and prednisone (R-ACVBP) with subsequent consolidation versus standard rituximab, doxorubicin, cyclophosphamide, vincristine, and prednisone (R-CHOP). Random assignment was done with a computer-assisted randomisation-allocation sequence with a block size of four. Patients were aged 18-59 years with untreated diffuse large B-cell lymphoma and an age-adjusted international prognostic index equal to 1. Our primary endpoint was event-free survival. Our analyses of efficacy and safety were of the intention-to-treat population. This study is registered with ClinicalTrials.gov, number NCT00140595. FINDINGS: One patient withdrew consent before treatment and 54 did not complete treatment. After a median follow-up of 44 months, our 3-year estimate of event-free survival was 81% (95% CI 75-86) in the R-ACVBP group and 67% (59-73) in the R-CHOP group (hazard ratio [HR] 0·56, 95% CI 0·38-0·83; p=0·0035). 3-year estimates of progression-free survival (87% [95% CI, 81-91] vs 73% [66-79]; HR 0·48 [0·30-0·76]; p=0·0015) and overall survival (92% [87-95] vs 84% [77-89]; HR 0·44 [0·28-0·81]; p=0·0071) were also increased in the R-ACVBP group. 82 (42%) of 196 patients in the R-ACVBP group experienced a serious adverse event compared with 28 (15%) of 183 in the R-CHOP group. Grade 3-4 haematological toxic effects were more common in the R-ACVBP group, with a higher proportion of patients experiencing a febrile neutropenic episode (38% [75 of 196] vs 9% [16 of 183]). INTERPRETATION: Compared with standard R-CHOP, intensified immunochemotherapy with R-ACVBP significantly improves survival of patients aged 18-59 years with diffuse large B-cell lymphoma with low-intermediate risk according to the International Prognostic Index. Haematological toxic effects of the intensive regimen were raised but manageable. FUNDING: Groupe d'Etudes des Lymphomes de l'Adulte and Amgen.
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Diplomityö liittyy case-yhtiön raportointi- ja suunnittelujärjestelmän käyttöönottoon ja kehittämiseen. Työn tavoitteena on raportoinnin toteuttaminen uudella järjestelmällä. Diplomityön teoriaosuudessa perehdytään johdon laskentatoimen rooliin johtamisen tukena, business intelligence -käsitteeseen ja raportointijärjestelmähankkeisiin liittyviin haasteisiin johdon laskentatoimen näkökulmasta. Työn empiirisessä osassa kuvataan raportoinnin toteutus uudella järjestelmällä, laaditaan raportointi- ja suunnittelujärjestelmän arkkitehtuurikuvaus, arvioidaan käyttöönottoprojektin onnistumisesta sekä esitetään jatkokehitysehdotuksia. Diplomityö on osa case-yhtiön johdon laskentatoimen kehittämistä ja jatkoa aiemmin yhtiön raportoinnin kehittämistä tutkineelle diplomityölle. Meneillään oleva raportointi- jasuunnittelujärjestelmä -projekti on osa yhtiön laajempaa IT-järjestelmien integraatioprojektia. Näin diplomityö liittyy myös yhtiön tietojärjestelmien kehittämiseen ja uudistamiseen. Diplomityössä rakennettiin case-yhtiön talouden raportointiympäristöä uuteen järjestelmään ja kehitettiin johdon laskentatoimen raportteja. Työssä kehitetty talouden raportointi täyttää raportointi- ja suunnittelujärjestelmähankkeelle asetetut tavoitteet. Raportointi on erilaiset tarpeet huomioivaa, läpinäkyvää ja antaa kokonaiskuvan tarkasteltavasta kohteesta, mutta mahdollistaa myös tapahtumien yksityiskohtaisen tarkastelun. Raportointi perustuu sähköpostin kautta jaettaviin vakioraportteihin sekä käyttäjän itse raportointiportaalissa suorittamaan raportointiin. Talouden seurannan lisäksi työssä laadittiin raportteja teknisen tiedon ja työtuntien seurantaan. Case-yhtiön nykyinen johdon laskentatoimen raportointi toteutetaan työssä esitetyllä järjestelmällä.
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Aims: The psychometric properties of the EORTC QLQ-BN20, a brain cancer-specific HRQOL questionnaire, have been previously determined in an English-speaking sample of patients. This study examined the validity and reliability of the questionnaire in a multi-national, multi-lingual study. Methods: QLQ-BN20 data were selected from two completed phase III EORTC/NCIC clinical trials in brain cancer (N=891), including 12 languages. Experimental treatments were surgery followed by radiotherapy (RT) and adjuvant PCV chemotherapy or surgery followed by concomitant RT plus temozolomide (TMZ) chemotherapy and adjuvant TMZ chemotherapy. Standard treatment consisted of surgery and postoperative RT alone. The psychometrics of the QLQ-BN20 were examined by means of multi-trait scaling analyses, reliability estimation, known groups validity testing, and responsiveness analysis. Results: All QLQ-BN20 items correlated more strongly with their own scale (r>0.70) than with other QLQ-BN20 scales. Internal consistency reliability coefficients were high (all alpha0.70). Known-groups comparisons yielded positive results, with the QLQ-BN20 distinguishing between patients with differing levels of performance status and mental functioning. Responsiveness of the questionnaire to changes over time was acceptable. Conclusion: The QLQ-BN20 demonstrates adequate psychometric properties and can be recommended for use in conjunction with the QLQ-C30 in assessing the HRQOL of brain cancer patients in international studies.
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We present a model of sovereign debt in which, contrary to conventional wisdom, government defaultsare costly because they destroy the balance sheets of domestic banks. In our model, better financial institutionsallow banks to be more leveraged, thereby making them more vulnerable to sovereign defaults.Our predictions: government defaults should lead to declines in private credit, and these declines should belarger in countries where financial institutions are more developed and banks hold more government bonds.In these same countries, government defaults should be less likely. Using a large panel of countries, we findevidence consistent with these predictions.
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Diplomityö on tehty osana InnoEnvi-hanketta, joka on Etelä-Suomen ympäristöalan verkostoitumiseen ja tietoyhteiskunnan kehittymiseen tähtäävä toimintakokonaisuus. InnoEnvi on osa Etelä-Suomen maakuntien valmistelemaa InnoElli-ohjelmaa. InnoEnvi-hankkeen päätavoitteena on kehittyvän ympäristöklusterin luominen Etelä-Suomeen. Monet suomalaiset ympäristöalalle erikoistuneet yritykset ovat vielä tänä päivänä pieniä, nuoria ja pirstaleisia, minkä vuoksi ne tarvitsevat tukea ja yhteistyötä varsinkin vientimarkkinoille pyrkiessään. Tämän työn oleellisimpana tavoitteena oli kartoittaa Etelä-Suomen jäte- ja jätehuoltoalan yritysten yhteistyön mahdollisuuksia ja etuja, sekä yhteistyön tuomaa vaikutusta koti- ja ulkomaiseen liiketoimintaan. Tutkimusongelmaa lähestyttiin kartoittamalla Suomen tämänhetkistä jäte- ja jätevesihuollon tilaa ja käytössä olevaa teknologiaa sekä ympäristöliiketoimintaan vaikuttavia ohjauskeinoja. Ympäristöalan liiketoimintakenttään syvennyttiin tutkimalla alan verkostoitumista ja uusia verkostoitumisen mahdollisuuksia. Verkostoituneita yrityksiä ja yhteistyön lisätarvetta selvitettiin InnoEnvissä tehtyjen aiempien tutkimustulosten sekä tässä tutkimuksessa tehtyjen yrityshaastattelujen avulla. Uudet EU-maat panostavat tiukentuvien ympäristösäädösten takia ympäristönsuojeluun, mikä tekee niistä houkuttelevan ympäristöteknologian vientikohteen. Tässä työssä valittiin tutkimuksen kohteiksi Latvia ja Puola, joiden ympäristöteknologian tasoa ja kehitystarpeita selvitettiin vientipotentiaalin hahmottamiseksi. Molempien maiden jätevesi- ja varsinkin jätehuollossa on paljon kehitettävää, ja maissa panostetaankin kehitystoimiin monin erilaisin valtiollisin ohjelmin. Kotimaisen ympäristöliiketoiminnan kehittämiseksi työssä käsiteltiin neljää tuote- ja palvelukonseptia, jotka valittiin InnoEnvi-hankkeessa tehdystä ajankohtaisesta ympäristöalan investointihankekartoituksesta. Valitut konseptit ovat: REF-valmistuslaitos, jätevesilietteen käsittelylaitteisto, pilaantuneiden maiden käsittelytoimet sekä kaatopaikan lopettaminen. Tuotekonseptit jaettiin osatuotteisiin ja –palveluihin, joita verkostoituneet yritykset voisivat yhdessä tuottaa. Työkaluiksi yritysten kontakteihin nähtiin InnoEnvi-hankkeessa muodostetut miniklusterit ja niiden sisällä kehittyvä toiminta sekä hankkeessa rakennettu www-pohjainen Matching-palvelu. Tutkimuksessa löydettiin uusia mahdollisuuksia yhteistyötoiminnalle. Verkostoitumisessa nähdään haastattelujen mukaan monia etuja: tiedonsaanti, taloudelliset edut, toiminnan luotettavuus sekä uudet virikkeet markkinointiin ja tuotekehitykseen. Lisäyhteistyökumppaneille on haastattelujen mukaan tarvetta. Verkostoituminen tuo vientitoimintaa aloitteleville pk-sektorin yrityksille mahdollisuuden saavuttaa kansainvälistymiseen tarvittavia resursseja. Niin koti- kuin ulkomaisessakin liiketoiminnassa verkoston tärkeimmäksi tekijäksi osoittautui veturiyritys, joka voi vastata verkostossa muun muassa markkinoinnista ja tuotekehityksestä Vientitoiminnassa kohdemaan lainsäädännön ja yleisien toimintatapojen tunteminen on tärkeää. Paikalliset kohdemaan suunnittelu- ja urakointiyritykset ovat tärkeitä yhteistyökumppaneita vientihankkeessa. Latviassa jätehuoltoteknologian kehittämisen tarve on niin yhdyskunta-, ongelma- kuin teollisuusjätteidenkin osalta merkittävä. Puolassa jätesektorin ajankohtaisia aiheita ovat muun muassa kaatopaikkojen vähentäminen ja pakkausjätteen käsittely. Molempien esimerkkimaiden kohdalla jätevesihuollossa tullaan keskittymään lietteiden käsittelyn vaatimiin teknologian tarpeisiin. Vientiosiossa tehtiin vientiyhteistyöesimerkki, jossa tutkittiin kuvitteellista rakennusjätteen käsittelylaitoksen toimittamisprojektia Puolaan. Esimerkkiin saatiin tietoja InnoEnvissä tehdystä Puolan markkinatutkimuksesta. Tulokseksi saatiin viitteitä mahdollisista suomalaisista laitetoimittajista, viisi potentiaalista puolalaista suunnitteluyritystä sekä viisi puolalaista urakoitsijaa. On tärkeää, että kotimaisella yritysryppäällä on kokemusta sujuvasta yhteistyöstä ennen vientiprojektin toteuttamista. Tuotekonseptiesimerkkeihin kartoitettiin pääosa eteläsuomalaisista tuotteiden ja palvelujen tarjoajista. Tarkasteluun otettiin mukaan myös yrityksiä, joiden tuotteet tai palvelut olivat lähellä käsiteltyä konseptia. Tehtyjen yrityslistojen avulla on tarkoitus antaa virikkeitä uusien yritysryppäiden muodostamisesta sekä uusista tuote- ja palveluideoista, joille on nähtävissä markkinapotentiaalia. InnoEnvi-hankkeessa valmisteltujen työkalujen avulla eteläsuomalaiset yhteistyöstä kiinnostuneet yritykset voivat luoda kontakteja ja kokoontua miettimään tulevien investointihankkeiden toteuttamista kotimaassa ja myöhemmin jopa ulkomailla. Työn tuloksia esitellään InnoEnvi-hankkeen toimijoiden kautta jäteminiklusterissa toimiville eteläsuomalaisille yrityksille.
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Whether or not to consolidate financial statements is dealt with in IPSAS#6. This standard is by and large based on IAS#27. It deals with the criterion according to which an entity's financial statements should be considered and which consolidation technique should be used. However, it remains silent when it comes to exposing the reason why a public sector entity should consolidate its financial statements. The literature is almost as silent as IPSAS on this issue. Which means that there is a lack of both theoretical and empirical knowledge on this subject. This paper explores the usefulness of the consolidation of financial statements (CFS) for different categories of users. It aims at investigating for which purposes consolidation is most useful and whether enlarging the scope of the consolidate group serves these purposes. Five purposes are considered: information, decision- making, accountability, risk-assessment, statistics improvement. The paper also aims at investigating if some categories of users consider CFS more useful than others. The issue is essentially empirical. Therefore it is examined in light of the results of an in-person interviews. We surveyed 25members of parliament, officials, creditors, and consultants of the Swiss central government. The results show that consolidating FS is considered especially important and useful for risk- assessment, information and accountability and to a somewhat lesser extent for decision-making and statistics improvement. Extending the scope of CFS may improve the situation when it comes to statistics but it would only marginally make CFS more relevant for decision making. Consultants and, to a lesser extent, members of the finance ministry are those respondents who deem the scope enlargement to be the most useful.