Determining utility values related to malaria and malaria chemoprophylaxis

<p>Abstract</p> <p>Background</p> <p>Chemoprophylaxis for travellers' malaria is problematic. Decision modeling may help determine optimal prevention strategies for travellers' malaria. Such models can fully assess effect of drug use and disease on quality of life, and help travellers make informed values based decisions. Such models require utility values reflecting societal preferences over different health states of relevance. To date, there are no published utility values relating to clinical malaria or chemoprophylaxis adverse events.</p> <p>Methods</p> <p>Utility estimates for health states related to falciparum malaria, sequelae and drug-related adverse events were obtained using a self-administered visual analogue scale in 20 individuals. Utility values for health states related to clinical malaria were obtained from a survey of 11 malaria experts questioned about length of hospital stay or equivalent disability with simple and severe travellers' malaria.</p> <p>Results</p> <p>The general public (potential travellers), were more tolerant of taking prophylaxis if associated with no or mild AEs and least tolerant of mild sequelae from malaria and severe drug related events. The rating value reported for taking no prophylaxis was quite variable. Tropical medicine specialists estimated a mean hospital stay 3.23 days (range 0.5-4.5 days) for simple and 6.36 days (range 4.5 - 7 days) for severe malaria.</p> <p>Conclusions</p> <p>This study provides a benchmark for important utility value estimates for modeling malaria and drug-related outcomes in non-immune travellers.</p

The prospects for the water management framework in the Douro, Portugal

The implementation of the Water Framework Directive (WFD) has represented a unique opportunity to enhance the regulatory capacity of public agencies and restore the ecological condition of water bodies in the European Union. This paper examines the experience of translating the new Directive into practical policy-making in the Douro River Catchment in the north of Portugal. Regional development and the evolution of water management are initially described, which then inform the assessment of the achievements and failures of the new regulatory regime. The higher level of concern for environmental impacts and the integration of responses that follow the WFD can be identified as positive steps in the direction of resolving lasting water management problems. However, the translation of the Directive into national legislation has also reinforced techno-bureaucratic practices and politico-economic centralisation, as well as led to various forms of contestation and protest. It is suggested that two main reasons account for those difficulties: the sociospatial rigidity (i.e. the fragmented and static understanding of ecological and social interactions) and the monotonic categorisation of water management issues (i.e. upfront decisions with limited scope for innovation and creativity at the local level). Overall, the success of the WFD seems to fundamentally depend on the ability to perceive the broader socionatural complexity of water management and on the pursuit of more effective forms of negotiation and social inclusion

Tourism growth and regional resilience: the "beach disease' and the consequences of the global crisis of 2007

As a consequence of the international financial crisis in 2007, the region of Algarve, where tourism plays an important economic and social role, suffered a decrease in tourism demand, while unemployment increased sharply. Although tourism activities registered a quick recovery, unemployment levels continued to grow. This article examines the impacts of tourism activities on the sectorial structure of the regional economy, using a Bayesian vector autoregressive model. The results reveal that tourism growth did not automatically create the expected positive impacts on the economic performance of the other sectors, as was expressed by the objectives defined in the regional development strategies over the last two decades. The positive impacts of tourism were concentrated in the production of non-tradable goods and the construction sector, leading to a significant reduction of the weight of the tradable sector within the regional economy, similar to a process of deindustrialization described as the Dutch disease'. The decline of construction activities after 2007 has led to a significant increase of regional unemployment, although tourism growth has returned to pre-crisis' levels, revealing the lack of regional resilience

Personal Communication Ties and Organizational Collaborations in Networks of Science, Education, and Business

The literature suggests that the success of innovation clusters is based on personal networks that connect members of scientific, educational, and business organizations, stimulating more formalized cross-boundary collaborations between the three sectors. But it is still unclear if such organizational collaborations actually correspond with these personal ties and which aspects of personal communication are most strongly associated with organizational collaborations. To investigate these issues, the authors applied network analysis to study an innovation cluster in Algarve, Portugal. They found that cross-boundary organizational collaborations corresponded with personal ties. Moreover, they found that collaborations appeared to correlate most strongly with emotional attachments between individuals