Multinational Comparisons of Health Systems Data, 2014

International comparisons of health care systems offer valuable tools to health ministers, policymakers, and academics wishing to evaluate the performance of their country's system. In this chartbook, we use data collected by the Organization for Economic Cooperation and Development (OECD) to compare health care systems and performance on a range of topics, including spending, hospitals, physicians, pharmaceuticals, prevention, mortality, quality and safety, and prices. We present data across several industrialized countries: Australia, Canada, Denmark, France, Germany, Japan, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States. Whenever possible, we also present the median value of all 34 members of the OECD.The Organization for Economic Cooperation and Development (OECD) is an international organization representing 34 industrialized countries that share a commitment to democracy and a market economy. The OECD produces reports and data on a wide range of economic and social issues, including the OECD Health Data series, an annual release of data on various aspects of health and health care in the member countries. Working with statistical offices in each member country, the OECD produces the most accurate and comprehensive international health care data available on the 34 nations.This chartbook also includes data from: an analysis by Ellen Nolte and Martin McKee of amenable mortality, originally published in Health Policy; the International Federation of Health Plans on the price of diagnostic tests and hospital and physicians costs for procedures; and an analysis by Elizabeth Bradley et al. of health and social care spending, originally published in The American Health Care Paradox: Why Spending More is Getting Us Less

Sr. Anne Jones: Prayer in Action

This paper includes part of an interview with Sr. Anne Jones, a woman religious belonging an order with a history in education. This interview includes a key moment in her discernment process and her opinions on the misunderstanding that only cloistered nuns are contemplatives

Fight to Ignite: The Impacts of Climate Change on Prescribed Burning in Pine Forests

Prescribed burning is a strategy that has been used to manage the health of forest ecosystems for thousands of years. While these practices have certainly evolved over time, recent impacts of climate change are threatening the future feasibility of implementing fire in forest management altogether. This ecological process is essential to restoring and maintaining a healthy forest ecosystem as fire acts as a catalyst by returning nutrients to soil and promoting healthy regrowth. Prescribed burning prepares forestlands for reforestation by destroying weeds and other competitive species so that native and fire-dependent species can reproduce. This process also lessens the fuel load of a forest by burning excess shrubbery, mitigating wildfire risks. However, increasing impacts of climate change in recent years are creating unsuitable conditions to execute controlled burns in necessary areas. Specifically, it is necessary to consider the humidity, wind speed, and air temperature to ensure the weather conditions are within an appropriate ‘burn window.’ In this study, I examine the historical and cultural significance of prescribed fire, as well as the environmental and climatic components that are required for a burn to take place. It is imperative to understand both components with the aim of implementing thoughtful and effective solutions. Prescribed burning is a management strategy that now requires new alterations in order to remain effective as the climate changes

U.S. Health Care from a Global Perspective: Spending, Use of Services, Prices, and Health in 13 Countries

This analysis draws upon data from the Organization for Economic Cooperation and Development and other cross-national analyses to compare health care spending, supply, utilization, prices, and health outcomes across 13 high-income countries: Australia, Canada, Denmark, France, Germany, Japan, Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States. These data predate the major insurance provisions of the Affordable Care Act. In 2013, the U.S. spent far more on health care than these other countries. Higher spending appeared to be largely driven by greater use of medical technology and higher health care prices, rather than more frequent doctor visits or hospital admissions. In contrast, U.S. spending on social services made up a relatively small share of the economy relative to other countries. Despite spending more on health care, Americans had poor health outcomes, including shorter life expectancy and greater prevalence of chronic conditions

From dust to more dust: a paleoceanographic history of the East Asian Monsoon

At present, the East Asian Monsoon (EAM) influences water availability for nearly one third of the global population. The intensity and position of the EAM has varied considerably since its onset, but disagreement still exists related to the precise latitudinal and intensity shifts of the Westerly Jet and associated storm fronts, which mark the northern extent of the monsoon. Paleoclimate research can assist in improved assessment and prediction of EAM intensity, radiative forcing, and biogeochemical cycles in the Japan Sea and North Pacific, especially under the currently changing climate. My research primarily focuses on using major-, trace- and rare earth elements in sediments from International Ocean Drilling Program Expedition 346 in the Japan (Ulleung Basin) and East China Seas (Okinawa Trough) to track variability in the EAM on millennial time scales. Using geochemical and multivariate statistical techniques (Q-Mode Factor analysis and Constrained Least Squares multiple linear regressions), I differentiated compositionally similar terrigenous aluminosilicate materials (continental crust components, eolian dusts, volcanic ash) from these sediment archives. I successfully constructed a robust record of aluminosilicate provenance, which enables more precise determinations of EAM position and intensity than previously possible. Most of my research focused on the interpretation of aluminosilicate records over several different timescales from three sites from Expedition 346. In tandem with this research, I also refined values of the well-known, and widely used, Standard Reference Material (SRM) Hawaiian Volcano Observatory Basalt (BHVO-2). In the Okinawa trough (Sites U1428/U1429), I identified and tracked the increase in flux of five continental crust materials, loesses, and volcanic ashes during glacial cycles, continental shelf exposure, and the migration of paleo-rivers in the last 400 kyr. Additionally, I constructed a 12 Myr record, which identified and quantified the dust fluxes to Ulleung Basin (Site U1430), and emphasized the importance of the Taklimakan and Gobi Deserts as main sources of dust to the Japan Sea and Pacific through the Cenozoic. Collectively, these aluminosilicate flux reconstructions are first to identify multiple specific Asian source regions through the Cenozoic, and highlight the complexity of accurately reconstructing monsoons and other aspects of paleoclimate from sediment in dynamic environments

The Potential of a Stratified Approach to Drug Repurposing in Alzheimer’s Disease

Alzheimer’s disease (AD) is a complex neurodegenerative condition that is characterized by the build-up of amyloid-beta plaques and neurofibrillary tangles. While multiple theories explaining the aetiology of the disease have been suggested, the underlying cause of the disease is still unknown. Despite this, several modifiable and non-modifiable factors that increase the risk of developing AD have been identified. To date, only eight AD drugs have ever gained regulatory approval, including six symptomatic and two disease-modifying drugs. However, not all are available in all countries and high costs associated with new disease-modifying biologics prevent large proportions of the patient population from accessing them. With the current patient population expected to triple by 2050, it is imperative that new, effective, and affordable drugs become available to patients. Traditional drug development strategies have a 99% failure rate in AD, which is far higher than in other disease areas. Even when a drug does reach the market, additional barriers such as high cost and lack of accessibility prevent patients from benefiting from them. In this review, we discuss how a stratified medicine drug repurposing approach may address some of the limitations and barriers that traditional strategies face in relation to drug development in AD. We believe that novel, stratified drug repurposing studies may expedite the discovery of alternative, effective, and more affordable treatment options for a rapidly expanding patient population in comparison with traditional drug development methods

Lexical organization in deaf children who use British Sign Language: Evidence from a semantic fluency task

We adapted the semantic fluency task into British Sign Language (BSL). In Study 1, we present data from twenty-two deaf signers aged four to fifteen. We show that the same ‘cognitive signatures’ that characterize this task in spoken languages are also present in deaf children, for example, the semantic clustering of responses. In Study 2, we present data from thirteen deaf children with Specific Language Impairment (SLI) in BSL, in comparison to a subset of children from Study 1 matched for age and BSL exposure. The two groups' results were comparable in most respects. However, the group with SLI made occasional word-finding errors and gave fewer responses in the first 15 seconds. We conclude that deaf children with SLI do not differ from their controls in terms of the semantic organization of the BSL lexicon, but that they access signs less efficiently

Differences in mitochondrial efficiency explain individual variation in growth performance

The physiological causes of intraspecific differences in fitness components such as growth rate are currently a source of debate. It has been suggested that differences in energy metabolism may drive variation in growth, but it remains unclear whether covariation between growth rates and energy metabolism is: (i) a result of certain individuals acquiring and consequently allocating more resources to growth, and/or is (ii) determined by variation in the efficiency with which those resources are transformed into growth. Studies of individually housed animals under standardized nutritional conditions can help shed light on this debate. Here we quantify individual variation in metabolic efficiency in terms of the amount of adenosine triphosphate (ATP) generated per molecule of oxygen consumed by liver and muscle mitochondria and examine its effects, both on the rate of protein synthesis within these tissues and on the rate of whole-body growth of individually fed juvenile brown trout (Salmo trutta) receiving either a high or low food ration. As expected, fish on the high ration on average gained more in body mass and protein content than those maintained on the low ration. Yet, growth performance varied more than 10-fold among individuals on the same ration, resulting in some fish on low rations growing faster than others on the high ration. This variation in growth for a given ration was related to individual differences in mitochondrial properties: a high whole-body growth performance was associated with high mitochondrial efficiency of ATP production in the liver. Our results show for the first time, to our knowledge, that among-individual variation in the efficiency with which substrates are converted into ATP can help explain marked variation in growth performance, independent of food intake. This study highlights the existence of inter-individual differences in mitochondrial efficiency and its potential importance in explaining intraspecific variation in whole-animal performance

Differences in mitochondrial efficiency explain individual variation in growth performance

The physiological causes of intraspecific differences in fitness components such as growth rate are currently a source of debate. It has been suggested that differences in energy metabolism may drive variation in growth, but it remains unclear whether covariation between growth rates and energy metabolism is: (i) a result of certain individuals acquiring and consequently allocating more resources to growth, and/or is (ii) determined by variation in the efficiency with which those resources are transformed into growth. Studies of individually housed animals under standardized nutritional conditions can help shed light on this debate. Here we quantify individual variation in metabolic efficiency in terms of the amount of adenosine triphosphate (ATP) generated per molecule of oxygen consumed by liver and muscle mitochondria and examine its effects, both on the rate of protein synthesis within these tissues and on the rate of whole-body growth of individually fed juvenile brown trout (Salmo trutta) receiving either a high or low food ration. As expected, fish on the high ration on average gained more in body mass and protein content than those maintained on the low ration. Yet, growth performance varied more than 10-fold among individuals on the same ration, resulting in some fish on low rations growing faster than others on the high ration. This variation in growth for a given ration was related to individual differences in mitochondrial properties: a high whole-body growth performance was associated with high mitochondrial efficiency of ATP production in the liver. Our results show for the first time, to our knowledge, that among-individual variation in the efficiency with which substrates are converted into ATP can help explain marked variation in growth performance, independent of food intake. This study highlights the existence of inter-individual differences in mitochondrial efficiency and its potential importance in explaining intraspecific variation in whole-animal performance