7 research outputs found
A REAL MAP OF EUROPEAN LIFE INSURANCE MARKET â A SPATIAL APPROACH
The purpose of the current paper is to emphasize the evolution of life insurance market. In order to capture a real
picture a common proxy for insurance development was covering data from the twenty-eight European Union members.
Starting the present analysis from the idea that the effects of the financial crisis were strongly felt in this market, the
authors chose two different and representative years to show that countries such as Lithuania and Portugal have made the
greatest progress, while the lowest values are recorded for Bulgaria, Croatia and Romania. Moreover, using techniques
specific to the spatial statistics, the maps of findings support all investors to understand the similarities and differences
between countries in terms of market penetration
The nexus between the demand for life insurance and institutional factors in Europe: new evidence from a panel data approach
We investigate the influence of institutional factors upon life
insurance demand for 32 European countries, considering the sociodemographic
and economic determinants as control variables. Using a
panel data approach, we find that life insurance demand is influenced
differently by institutional indicators from the Worldwide Governance
Indicators database, in emerging and transition markets compared to
developed ones. The sound legal environment of developed countries,
where the level of the rule of law is very homogeneous and very high,
makes it non-significant for life insurance demand. For developing
countries the enforceability of contracts, the independence of justice
and the time efficiency of the judicial process positively influence
the decision of citizens to buy life insurance contracts. The effect of
income distribution over life insurance density varies across these
two categories of countries. For transition and emerging markets we
find a positive relationship between life insurance density, income
distribution and level of urbanisation. In developed countries, because
of the high levels of income, life insurance became a common good,
not a luxury one, which makes income distribution an insignificant
factor. For emerging and transition countries policymakers should
concentrate more on strengthening trust in the insurance sector for
reducing the gap with developed countries
Low Atrial Rhythm in a Large Cohort of Children from Transylvania, Romania
Low atrial rhythm (LAR) is an ectopic rhythm originating in the lower part of the right or left atrium. Prior observational studies attempted to quantify the prevalence of low atrial rhythm in the pediatric population, but the observed prevalence was highly variable with relatively small sample sizes. We aimed to characterize low atrial rhythm and determine its prevalence in a large population of 24,316 asymptomatic children from northwestern Transylvania. We found a prevalence of 0.6% (145 children) for low atrial rhythm. Children with LAR had a significantly lower heart rate (mean 78.6 ± 8.3 bpm), than the control sinus rhythm group (85.02 ± 4.5 bpm). Furthermore, a shorter PR interval was seen in children with LAR (132.7 ± 12.7 ms) than in the children from the control group (141.7 ± 5.4; p = 0.0001).There was no significant association between gender and the presence of left LAR (LLAR) or right LAR (RLAR) (p = 0.5876). The heart rate of children with LLAR was significantly higher (81.7 ± 11.6 bpm) than that of the children with LRAR (77.6 ± 11.1 bpm) (p = 0.037). Pediatric cardiologists should recognize low atrial rhythm and be aware that asymptomatic, healthy children can exhibit this pattern, which does not require therapeutic intervention
More Than 50 Percent Reduction in LDL Cholesterol in Patients With Target LDL <70 mg/dL After a Stroke
International audienceBACKGROUND: Whether a strategy to target an LDL (low-density lipoprotein) cholesterol 50% from baseline rather than 50% LDL cholesterol reduction from baseline during the trial had a higher baseline LDL cholesterol and a lower LDL cholesterol achieved as compared to patients who had 50% LDL reduction had a significant reduction in the primary outcome as compared to the higher target group (hazard ratio, 0.61 [95% CI, 0.43â0.88]; P =0.007) and patients with <50% LDL reduction from baseline had little reduction (hazard ratio, 0.96 [95% CI, 0.73â1.26]; P =0.75). CONCLUSIONS: In this post hoc analysis of the TST trial, targeting an LDL cholesterol of <70 mg/dL reduced the risk of primary outcome compared with 100±10 mg/dL provided LDL cholesterol reduction from baseline was superior to 50%, thereby suggesting that the magnitude of LDL cholesterol reduction was as important to consider as the target level to achieve. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01252875. URL: https://clinicaltrialsregister.eu ; Unique identifier: EUDRACT2009-A01280-57.gov; Unique identifier: NCT01252875. URL: https://clinicaltrialsregister.eu; Unique identifier: EUDRACT2009-A01280-57.URL: https://www
Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries
Background
Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks.
Methods
The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned.
Results
A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31).
Conclusion
Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)