“It Was Easier in Prison!” : Russian Baptist Rehab as a Therapeutic Community, Monastery, Prison, and Ministry

This chapter revisits a Foucauldian concept of “complete and austere institutions,” using the ethnographic study of therapeutic communities, monasteries, prisons, and religious ministries to draw a line between those concepts, specifically addressing a Christian ministry in the Russian Baptist interpretation. My argument is based on an ethnographic account of the Russian Baptist ministry for people suffering from addiction. I unfold the concept of an Evangelical ministry, contrasting it to the Foucauldian austere institutions in order to highlight its nature. I argue that even though a rehabilitation ministry may use methods and techniques of austere institutions, and even resemble them in their implementation, the distinctive feature of a ministry is its focus on the result, rather than the process, interpreted as serving God by serving men.Peer reviewe

Human Papillomavirus in HNSCC : A European Epidemiologic Perspective

The aim of this study was to assess incidence and survival of human papillomavirus-related and unrelated head and neck squamous cell carcinoma sites from 15 European population-based cancer registries. This analysis was performed on 29,265 adult (aged approximately 15 years) cancer patients diagnosed in the period from 1988 to 2002. The human papillomavirus-unrelated cancer sites had an age-standardized incidence higher than the human papillomavirus-related cancer cases (3.8 versus 2.5/100,000 year). Incidence rates of head and neck squamous cell carcinomas increased more for human papillomavirus-related than unrelated cancer sites. Three-year survival rates improved more in human papillomavirus-related than unrelated cancer sites, and women had better rates of survival than men

Survival for ethmoid sinus adenocarcinoma in European populations.

Abstract BACKGROUND: Adenocarcinoma of the ethmoid sinus is rare. EUROCARE data provide a good opportunity to study the survival of this rare disease in a population of continental size. PATIENTS AND METHODS: A total of 204 cases, age 15 to 99 years, diagnosed with primary ethmoid sinus adenocarcinoma between 1983 and 1994, were analyzed. The data were contributed by 22 population-based cancer registries from the nine countries participating in EUROCARE. Relative survival by sex, age, period of diagnosis, region and stage, and adjusted relative excess risk (RER) of death, were estimated. RESULTS: Survival was 83%, 58% and 46%, 1, 3 and 5 years, respectively after diagnosis. Five-year survival was best (60%) in patients of 55-64 years and worst (33%) in the oldest age group (> or =65 years). Five-year survival differ between European population: in Norway (55%, 95% confidence interval 26.4-80.9) and western Europe that includes populations from Eindhoven, Saarland, Geneva, Italy and France (56%, 95%CI 41.3-68.9) was higher than in the UK (41%, 95% CI 30.8-51.8) and eastern Europe which includes Slovakia and Slovenia, (22%, 95% CI 3.5-54.4). Five-year survival did not improve over time. Due to the rarity of the disease, all the survival differences did not reach the statistical significance. CONCLUSIONS: Since no survival improvement with time was evident from this study, efforts should be made to improve early diagnosis. GPs and ENT specialists should be alerted to the disease and encouraged to take occupational histories in people with persistent nasal symptoms, which may lead to a reasonable suspicion of malignancy. Monitoring of exposed workers may also improve early diagnosis. Patients with suspected ethmoid cancer should be referred immediately a specialized diagnosis and treatment centre

Evaluating hospital costs in type 2 diabetes care: does the choice of the model matter?

BACKGROUND: Awareness of the economic burden of diabetes has led to a number of studies on economic issues. However, comparison among cost-of-illness studies is problematic because different methods are used to arrive at a final cost estimate. OBJECTIVE: The aim of the study is to show how estimates of hospitalisation costs for diabetic patients can vary significantly in relation to the statistical method adopted in the analysis. RESEARCH DESIGN AND METHODS: The study analyses diabetic patients' costs as a function of demographic and clinical covariates, by applying the following statistical survival models: the parametric survival model assuming Weibull distribution, the Cox proportional hazard (PH) model and the Aalen additive regression for modelling costs. The Aalen approach is robust both for the non proportionality in hazard and for departures from normality. In addition it is able to easily model the effect of covariates on the extreme costs. This cost analysis is based on data collected for a retrospective observational study analysing repeated hospitalisations (N = 4816) in a cohort of 3892 diabetic patients. RESULTS: There is agreement in all models with the effects of the considered covariates (age, sex, duration of disease and presence of other pathologies). An effect of over- or under-estimation, according to the chosen model due to arguably inappropriate model fitting, was observed, being more evident for some specific profiles of the patients, and overall accounting for as much as 20% of the estimated effect. The Aalen model was able to cope with all the other models in furnishing unbiased estimates with the advantage of a greater flexibility in representing the covariates' effect on the cost process. CONCLUSIONS: An appropriate choice of the model is crucial in avoiding misinterpretation of cost determinants of type 2 diabetes care. For our data set the Aalen model proved itself to be a realistic and informative way to characterise the effect of covariates on costs