Cost evaluation and comparison of three decision strategies for cardiac revascularization : results of the suspected CAD protocol of the European CMR registry

Background: The public health burden of coronary artery disease (CAD) is important. Perfusion cardiac magnetic resonance (CMR) is generally accepted to detect and monitor CAD. Few studies have so far addressed its costs and costeffectiveness. Objectives: To compare in a large CMR registry the costs of a CMR-guided strategy vs two hypothetical invasive strategies for the diagnosis and the treatment of patients with suspected CAD. Methods: In 3'647 patients with suspected CAD included prospectively in the EuroCMR Registry (59 centers; 18 countries) costs were calculated for diagnostic examinations, revascularizations as well as for complication management over a 1-year follow-up. Patients with ischemia-positive CMR underwent an invasive X-ray coronary angiography (CXA) and revascularization at the discretion of the treating physician (=CMR+CXA strategy). Ischemia was found in 20.9% of patients and 17.4% of them were revascularized. In ischemia-negative patients by CMR, cardiac death and non-fatal myocardial infarctions occurred in 0.38%/y. In a hypothetical invasive arm the costs were calculated for an initial CXA followed by FFR testing in vessels with ≥50% diameter stenoses (=CXA+FFR strategy). To model this hypothetical arm, the same proportion of ischemic patients and outcome was assumed as for the CMR+CXA strategy. The coronary stenosis - FFR relationship reported in the literature was used to derive the proportion of patients with ≥50% diameter stenoses (Psten) in the study cohort. The costs of a CXA-only strategy were also calculated. Calculations were performed from a third payer perspective for the German, UK, Swiss, and US healthcare systems.

Cost-effectivness in a DRG system for two-step exchange of infected total joint arthroplasty

The costs related to the treatment of infected total joint arthroplasties represent an ever groving burden to the society. Different patient-adapted therapeutic options like débridement and retention, 1- or 2-step exchange can be used. If a 2-step exchange is used we have to consider short (2-4 weeks) or long (>4-6 weeks) interval treatment. The Swiss DRG (Diagnose related Groups) determines the reimboursement the hopsital receives for the treatment of an infected total arthroplasty. The review assesses the cost-effectiveness of hospitalisation practices linked to surgical treatment in the two-stage exchange of a prosthetic-joint infection. The aim of this retrospectiv study is to compare the economical impact between a short (2 to 4 weeks) versus a long (6 weeks and above) interval during a two-satge procedure to determine the financial impact. Retrospectiv study of the patients with a two-stage procedure for a hip or knee prosthetic joint infection at CHUV hospital Lausanne (Switzerland) between 2012 and 2013. The review analyses the correlation between the interval length and the length of the hospital stay as well as with the costs and revenues per hospital stay. In average there is a loss of 40′000 Euro per hospitalisation for the treatment of prosthetic joint infection. Revenues never cover all the costs, even with a short interval procedure. This economical loss increases with the length of the hospital stay if a long-term intervall is choosen. The review explores potential for improvement in reimbourement practices and hospitalisation practices in the current Swiss healthcare setting. There should be alternative setups to decrease the burden of medical costs by a) increase the reimboursment for the treatment of infected total joints or by b) splitting the hospital stay with partners (rapid transfer after first operation from center hospital to level 2 hospital and retransfer for second operation to center) in order to increase revenues.

Grève des cheminots anglais, Mr Arthur Henderson [secrétaire du Labor party] quittant Caxton Hall : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 56234

Les Instituts de l'empereur Justinien. Tome 2 / , nouvellement traduits en françois, avec le latin à costé. Par M. F. Helo,... Seconde édition reveuë & corrigée

[Institutes (français-latin). 1669]

Les Instituts de l'empereur Justinien. Tome 1 / , nouvellement traduits en françois, avec le latin à costé. Par M. F. Helo,... Seconde édition reveuë & corrigée

[Institutes (français-latin). 1669]

« Recueil des actes, letres et memoires qui ont servi aux conferences tenues en Roussillon, pour les limites des royaumes de France et d'Espagne, du costé des monts Pyrenées, entre Mgrs [Pierre] de Marca, archevesque de Toulouse, et [Hyacinthe] de Serrony, evesque d'Orange, commissaires deputez par le roy [Louis XIV], d'une part, et don Miguel Çalba, lieutenant du maistre rational de la couronne d'Aragon, et don Joseph Romeu, conseiller en l'audiance royale de Barcelone, commissaires deputez par le roy d'Espagne [Philippe IV], d'autre part. Le tout ramassé et mis en ordre par Etienne Baluze, natif de Tulle en Limousin, secretaire dudit seigneur archevesque » de Toulouse. Copies.

Contient : 1 à 71 Ce recueil comprend soixante et onze pièces, dont quinze en espagnol. Les rois Louis XIV et Philippe IV, le cardinal Mazarin, Michel Le Tellier, Pierre de Marca, archevêque de Toulouse, Hyacinthe Serroni, évêque d'Orange, don Miguel Çalba, don Joseph Romeu, le marquis de Mortara, Etienne Baluze, le « docteur Pont, chanoine et archidiacre de la Seu d'Urgel, abbé nommé d'Arles », et « don Joseph de Margarit, marquis d'Aguilar, gouverneur de Catalogne », figurent ici ou comme auteurs ou comme destinataires. Les dates extrêmes sont le 26 novembre 1659 et le 12 novembre 1660

A crisis of social democracy : organized labour and the NDP in an era of neoliberalism

The NDP was founded out of the ashes of the Co-Operative Commonwealth Federation to cooperate with the Canadian Labour Congress to become the 'political arm of organized labour' in Canada. The NDP has long claimed they are the party which represents the policy goals of organized labour in Canada: that the NDP alone will fight for trade union rights, and will fight for Canadian workers. Divergent Paths is an examination of the links between the labour movement and the ND P in an era ofneo-liberalism. Provincial NDP governments have become increasingly neoliberal in their ideological orientation, and have often proved to be no friend to the labour movement when they hold office. The Federal party has never held power, nor have they ever formed the Official Opposition. This thesis charts the progress of the federal NDP as they become more neoliberal from 1988 to 2006, and shows how this trend effects the links between the NDP and labour. Divergent Paths studies each federal election from 1988 to 2006, looking at the interactions between Labour and the NDP during these elections. Elections provide critical junctions to study discourse - party platforms, speeches, and other official documents can be used to examine discourse. Extensive newspaper searches were used to follow campaign events and policy speeches. Studying the party's discourse can be used to determine the ideological orientation of the party itself: the fact that the party's discourse has become neoliberal is a sure sign that the party itself is neoliberal. The NDP continues to drive towards the centre of the political spectrum in an attempt to gain multi-class support. The NDP seems more interested in gaining seats at any cost, rather then promoting the agenda of Labour. As the party attempts to open up to more multi-class support, Labour becomes increasingly marginalised in the party. A rift which arguably started well before the 1988 election was exacerbated during that election; labour encouraged the NDP to campaign solely on the issue of Free Trade, and the NDP did not. The 1993 election saw the rift between the two grow even further as the Federal NDP suffered major blowbacks from the actions of the Ontario NDP. The 1997 and 2000 elections saw the NDP make a deliberate move to the centre of the political spectrum which increasingly marginalised labour. In the 2004 election, Jack Layton made no attempt to move the party back to the left; and in 2006 the link between labour and the NDP was perhaps irreparably damaged when the CAW endorsed the Liberal party in a strategic voting strategy, and the CLC did not endorse the NDP. The NDP is no longer a reliable ally of organized labour. The Canadian labour movement must decide wether the NDP can be 'salvaged' or if the labour movement should end their alliance with the NDP and engage in a new political project.

Examining Bullying Intervention Motivations Through a Cost/Benefit Analysis

The purpose of the present study was to examine the role of the bystander in bullying situations. A cost/benefit model was explored in researching factors adolescents consider in deciding whether to intervene when witnessing bullying. Adolescents in the present study (N = 101 (50.5% female), between the ages of 12 to 18, M = 15.37 years; SD = 1.71 years) completed self-report questionnaires, and also responded to bullying scenarios, stating how the bystander would react, while explaining potential personal costs and benefits. Adolescents were able to articulate various personal costs and benefits when making the decision to intervene. Conclusions of the present study include: 1) the evolutionary approach is quite informative in illuminating the decision process of the bystander, 2) adolescents’ beliefs about bullying and the role of bystanders are different from their teachers’, and 3) the rather explicit cost/benefit model could be used to develop more targeted anti-bullying programs.

Handwritten sheet of paper detailing the cost of transporting boxes containing the Gravatt’s level

Handwritten sheet of paper detailing the cost of transporting boxes containing the Gravatt’s level from London to St. Catharines, April 1847.

Handwritten sheet of paper detailing the cost of transporting boxes containing the Gravatt’s level

Handwritten sheet of paper detailing the cost of transporting boxes containing the Gravatt’s level from London to St. Catharines. This sheet is signed by S.D. Woodruff, Jan. 11, 1847.