High prevalence of forgoing healthcare for economic reasons in Switzerland: a population-based study in a region with universal health insurance coverage.

OBJECTIVE: To investigate the determinants and the 4-year evolution of the forgoing of healthcare for economic reasons in Switzerland. METHOD: Population-based survey (2007-2010) of a representative sample aged 35-74years in the Canton of Geneva, Switzerland. Healthcare forgone, socioeconomic and insurance status, marital status, and presence of dependent children were assessed using standardized methods. RESULTS: A total of 2601 subjects were included in the analyses. Of the subjects, 13.8% (358/2601) reported having forgone healthcare for economic reasons, with the percentage varying from 3.7% in the group with a monthly income ≥13,000CHF (1CHF≈1$) to 30.9% in the group with a monthly income <3000CHF. In subjects with a monthly income <3000CHF, the percentage who had forgone healthcare increased from 22.5% in 2007/8 to 34.7% in 2010 (P trend=0.2). Forgoing healthcare for economic reasons was associated with lower income, female gender, smoking status, lower job position, having dependent children, being divorced and single, paying a higher deductible, and receiving a premium subsidy. CONCLUSION: In a Swiss region with universal health insurance coverage, the reported prevalence of forgoing healthcare for economic reasons was high and greatly dependent on socioeconomic factors. Our data suggested an increasing trend among participants with the lowest income.

Prevalence of overweight in the Seychelles: 15 year trends and association with socio-economic status.

We assessed the 15-year trends in the distribution of body mass index (BMI) and the prevalence of overweight in the Seychelles (Indian Ocean, African Region) and the relationship with socio-economic status (SES). Three population-based examination surveys were conducted in 1989, 1994 and 2004. Occupation was categorized as 'labourer', 'intermediate' or 'professional'. Education was also assessed in 1994 and 2004. Between 1989 and 2004, mean BMI increased markedly in all sex and age categories (overall: 0.16 kg m(-2) per calendar year, which corresponds to 0.46 kg per calendar year). The prevalence of overweight (including obesity, BMI >or= 25 kg m(-2)) increased from 29% to 52% in men and from 50% to 67% in women. The prevalence of obesity (BMI >or= 30 kg m(-2)) increased from 4% to 15% in men and from 23% to 34% in women. Overweight was associated inversely with occupation in women and directly in men in all surveys. In multivariate analysis, overweight was associated similarly (direction and magnitude) to occupation and education. In conclusion, the increasing prevalence of overweight and obesity over time in all age, sex and SES categories suggests large-scale changes in societal obesogenic factors. The sex-specific association of SES with overweight suggests that prevention measures should be tailored accordingly.

Interrelation among Economic Growth, Income Inequality, and Fiscal Performance: Evidence from Anglo-Saxon Countries

The interrelation among economic growth, income inequality, and fiscal performance is very complex. The paper provides the analysis of the interrelations among these variables jointly by the structural VAR methodology, examining also transmission channels among them. This approach allows exploring dynamic interactions among them and feedback effects on each other. The empirical analysis is implemented for the Anglo-Saxon countries, the UK, the USA, and Canada. We find that income inequality has negative effect on economic growth in the case of the UK. The effect is positive in the cases of the USA and Canada. The increase in income inequality worsens fiscal performance for all the countries

Federal Dynamics in Times of Economic and Financial Crisis

The global economic and financial crisis is a challenge for all governments, but particularly for federal states because divided and/or shared territorial powers make federations susceptible to coordination problems in fiscal policy making. This article explores the effects of the ongoing crisis on federal relations. Three kinds of problems that may become the cause of federal tensions and conflicts are evoked: opportunism of subgovernments, centralisation and erosion of solidarity among members of the federation. Our analysis of fiscal policies and federal conflicts of 11 federations between 2007 and the present reveals three kinds of coordination problems: shirking in the use of federal government grants, rent-seeking in equalisation payments, and over-borrowing and over-spending. Our results show that shirking remained limited to few cases and occurred only in the first part of the crisis. However, rent-seeking and over-borrowing and over-spending led to a reduction of solidarity among subgovernments and to increased regulation of the fiscal discretion of the members of the federation. Subsequently, tensions in federal relations increased - although only in one case did this challenged the federal order.

More Money, Fewer Problems? Cross-Level Effects of Economic Deprivation on Political Representation

While equal political representation of all citizens is a fundamental democratic goal, it is hampered empirically in a multitude of ways. This study examines how the societal level of economic inequality affects the representation of relatively poor citizens by parties and governments. Using CSES survey data for citizens' policy preferences and expert placements of political parties, empirical evidence is found that in economically more unequal societies, the party system represents the preferences of relatively poor citizens worse than in more equal societies. This moderating effect of economic equality is also found for policy congruence between citizens and governments, albeit slightly less clear-cut.

Comparative efficacy of chelators to remove renal cadmium burden in isolated perfused rat kidneys

Trois agents chélateurs (l?acide diéthylène triamine penta-acétique, DTPA; l?acide méso-2,3- dimercaptosucchique, DMSA; l?acide 2,3-dimercapto- 1 -propanesulfonique, DMPS) ont été comparés quant à leur efficacité à mobiliser du cadmium (Cd) accumulé dans le tissu rénal. Des reins prélevés chez des rats exposés durant 3 j au Cd (acétate de Cd , 0.75 mg/kg.j, i.p) ont été isolés et perfusés in vitro, à l?aide d?un système de reperfusion utilisant une solution de Krebs-Henseleit, pH 7.4, contenant 8 acides aminés et 6% d?albumine. Les concentrations de Cd dans le perfusat et l?urine ont été mesurées par spectrométrie d?absorption atomique. Six périodes de clearance, après une période d?équilibration de 20 min, ont ?été obtenues. Le DMSA et le DMPS ont mobilisé le Cd à partir du tissu rénal, comme l?ont montré les augmentations dose-dépendantes des concentrations de Cd dans l?urine et le perfusat. L?accumulation de Cd était nettement plus élevée dans le perfusat que dans l?urine, indiquant que l?effet des chélateurs se marquait surtout au niveau tubulaire basolatéral. Le DTPA n?induisait qu?une faible mobilisation de Cd dans l?urine et le perfusat, et son efficacité était clairement inférieure à celle des autres chélateurs. Comme prévu, la quantité de Cd présente dans le tissu rénal après perfùsion par le DMSA ou le DMPS diminuait en fonction de l?efficacité des chélateurs, jusqu?à des valeurs inférieures de 46% au taux rénal de Cd avant perfusion. Le DMPS apparaissait induire une excretion urinaire de Cd plus importante que celle induite par le DMSA, une caractéristique qui pourrait être liée à une sécrétion tubulaire du chélateur, qui a été décrite antérieurement. Un intervalle de temps prolongé (1 -2 semaines) entre le moment de l?administration du Cd et la perfusion du rein avec le DMPS induisait une augmentation de l?excrétion urinaire de Cd. Tous les chélateurs se sont montrés néphrotoxiques à concentrations élevées.

Coping with Technology: A Study on Economic Methodology and Strategic Management of Technology

There is a broad consensus among economists that technologicalchange has been a major contributor to the productivity growth and, hence, to the growth of the material welfare in western industrialized countries at least over the last century. Paradoxically, this issue has not been the focal point of theoretical economics. At the same time, we have witnessed the rise of the importance of technological issues at the strategic management level of business firms. Interestingly, the research has not accurately responded to this challenge either. The tension between the overwhelming empirical evidence of the importance of technology and its relative omission in the research offers a challenging target for a methodological endeavor. This study deals with the question of how different theories cope with technology and explain technological change. The focusis at the firm level and the analysis concentrates on metatheoretical issues, except for the last two chapters, which examine the problems of strategic management of technology. Here the aim is to build a new evolutionary-based theoreticalframework to analyze innovation processes at the firm level. The study consistsof ten chapters. Chapter 1 poses the research problem and contrasts the two basic approaches, neoclassical and evolutionary, to be analyzed. Chapter 2 introduces the methodological framework which is based on the methodology of isolation. Methodological and ontoogical commitments of the rival approaches are revealed and basic questions concerning their ways of theorizing are elaborated. Chapters 3-6 deal with the so-called substantive isolative criteria. The aim is to examine how different approaches cope with such critical issues as inherent uncertainty and complexity of innovative activities (cognitive isolations, chapter 3), theboundedness of rationality of innovating agents (behavioral isolations, chapter4), the multidimensional nature of technology (chapter 5), and governance costsrelated to technology (chapter 6). Chapters 7 and 8 put all these things together and look at the explanatory structures used by the neoclassical and evolutionary approaches in the light of substantive isolations. The last two cpahters of the study utilize the methodological framework and tools to appraise different economics-based candidates in the context of strategic management of technology. The aim is to analyze how different approaches answer the fundamental question: How can firms gain competitive advantages through innovations and how can the rents appropriated from successful innovations be sustained? The last chapter introduces a new evolutionary-based technology management framework. Also the largely omitted issues of entrepreneurship are examined.

"Sobre tenir lo Studi de Lleyda en Tortosa"

The lower medieval Catalan model of the estudi general (university) exemplified by the case of Lleida emphasises the weight achieved by the students as a body, the jurisdictional conflicts and, especially, the serious economic difficulties, that poisoned the relations with the poorly paid teaching staff and made the centre impossible to run. In that sense, the monarchy’s incapacity to provide the jurisdictional and financial bases, pushed higher education under a growing ecclesiastical weight snd municipal dependence. The local government, for its part, would have to increase the means of taxation needed to produce the necessary financing. All together, this generated difficulties that would burden the estudis generals throughout the lower Middle ages and into modern centuries, until their closure in the 18th century.

The Atherosclerosis Burden Score (ABS): a Convenient Ultrasound-Based Score of Peripheral Atherosclerosis for Coronary Artery Disease Prediction.

Ultrasonographic detection of subclinical atherosclerosis improves cardiovascular risk stratification, but uncertainty persists about the most discriminative method to apply. In this study, we found that the "atherosclerosis burden score (ABS)", a novel straightforward ultrasonographic score that sums the number of carotid and femoral arterial bifurcations with plaques, significantly outperformed common carotid intima-media thickness, carotid mean/maximal thickness, and carotid/femoral plaque scores for the detection of coronary artery disease (CAD) (receiver operating characteristic (ROC) curve area under the curve (AUC) = 0.79; P = 0.027 to <0.001 with the other five US endpoints) in 203 patients undergoing coronary angiography. ABS was also more correlated with CAD extension (R = 0.55; P < 0.001). Furthermore, in a second group of 1128 patients without cardiovascular disease, ABS was weakly correlated with the European Society of Cardiology chart risk categories (R (2) = 0.21), indicating that ABS provided information beyond usual cardiovascular risk factor-based risk stratification. Pending prospective studies on hard cardiovascular endpoints, ABS appears as a promising tool in primary prevention.

The economic relevance of climate variables in agriculture: the case of Spain

We estimate how climate variables affect price and acreage of productive farmland using the Ricardian approach. Furthermore, we use our estimations to evaluate the joint effects of possible cli- mate changes within the time horizon of 2010 and 2050. Our results show that the price of rainfed land in Spain tends to increase but rainfed acreage decreases. On the other hand, the effect on irrigated farmland price and acreage presents some mixed results, however, in the long run the dominant pattern is clearly increasing for both prices and acreage.

The economic relevance of climate variables in agriculture: The case of Spain

We estimate the impact of the different climate variables on the value of Spanish farmland. We distinguish between irrigated and non-irrigated lands and use data on temperature, precipitations, physical and socioeconomic characteristics to measure these effects on farm prices and in the number of hectares of farmland. We conclude presenting the main results of our analysis, region by region, and examining the policies that could be more effective to prevent undesired effects.

Economic evaluation of the levonorgestrel-releasing intrauterine system for the treatment of dysfunctional uterine bleeding in Spain

To compare the cost and effectiveness of the levonorgestrel-releasing intrauterine system (LNG-IUS) versus combined oral contraception (COC) and progestogens (PROG) in first-line treatment of dysfunctional uterine bleeding (DUB) in Spain. STUDY DESIGN: A cost-effectiveness and cost-utility analysis of LNG-IUS, COC and PROG was carried out using a Markov model based on clinical data from the literature and expert opinion. The population studied were women with a previous diagnosis of idiopathic heavy menstrual bleeding. The analysis was performed from the National Health System perspective, discounting both costs and future effects at 3%. In addition, a sensitivity analysis (univariate and probabilistic) was conducted. RESULTS: The results show that the greater efficacy of LNG-IUS translates into a gain of 1.92 and 3.89 symptom-free months (SFM) after six months of treatment versus COC and PROG, respectively (which represents an increase of 33% and 60% of symptom-free time). Regarding costs, LNG-IUS produces savings of 174.2-309.95 and 230.54-577.61 versus COC and PROG, respectively, after 6 months-5 years. Apart from cost savings and gains in SFM, quality-adjusted life months (QALM) are also favourable to LNG-IUS in all scenarios, with a range of gains between 1 and 2 QALM compared to COC and PROG. CONCLUSIONS: The results indicate that first-line use of the LNG-IUS is the dominant therapeutic option (less costly and more effective) in comparison with first-line use of COC or PROG for the treatment of DUB in Spain. LNG-IUS as first line is also the option that provides greatest health-related quality of life to patients.

Teollisuuden energiaverorasitus EU-maissa ja eräissä muissa maissa

Useat maat ovat 1990-luvulla ottaneet käyttöön energiaveroja. Energiaverot vaikuttavat etenkin energiavaltaisen teollisuuden toimintaan. Energiaverojen aiheuttamien kustannusten siirto hintoihin on hankalaa tuotteiden kilpaillessa maailmanmarkkinoilla. Suomen perusteollisuus on hyvin energiaintensiivistä ja sen monet tuotteet on suunnattu vientiin. Suomen lisäksi kaikkia teollisuuden käyttämiä polttoaineita verotetaan vain Alanko-maissa, Italiassa ja Tanskassa. Teollisuudelle on usein lisäksi alhaisempi verotaso kuin kotitalouksille. Energiaverotasojen tarkastelu sellaisenaan ei kerro veron todellista vaikutusta. Diplo-mityössä tarkastellaan teollisuuden maksamien energiaverojen taloudellista rasittavuutta vertaamalla maksettuja energiaveroja tuotannon jalostusarvoon. Energiaveroja ympä-ristönäkökohdista tarkastellaan vertaamalla maksettuja energiaveroja hiilidioksidipäästöihin. Diplomityössä käsitellään kolmea teollisuuden energiavaltaisinta toimialaa: metsäteollisuutta, metallien jalostusta sekä kemianteollisuutta. Vertailumaina ovat Euroopan Unionin 15 jäsenmaan lisäksi Norja, Sveitsi, Japani, Kanada ja Yhdysvallat. Sähkön kulutus- ja/tai tuotantovero on monissa maissa ja useimmilla toimialoilla merkittävin yksittäinen energiavero. Sähkön käyttö teollisuudessa on runsasta, joten sillä on muita veroja selvemmin havaittava vaikutus verorasitusten kasvuun.