Finland\u27s Economic Freeze

Abstract The Eurozone sovereign debt crisis has been well documented and so has Germany’s booming manufacturing economy but these events are relatively easy to explain. Greece’s troubles can easily be traced to its social security structure and lack of land registry while Germany’s success is a result of labour reforms, an undervalued currency and an emphasis on small scale businesses which form the backbone of the economy. A relatively paradoxical case has been that of Finland; ranked second for global innovation by the World Economic Forum and with over $1.8 billion being invested by the government in the country’s tech market, Finland’s lack of success presents a unique case. The European Union’s only Nordic member has suffered a stark decline of 0.6 pc in the 3rd quarter GDP growth of 2015, a figure worse than that of Greece. The implications of Finland’s lack of performance are clear cut, it is now the deadweight whose burden the EU must bear; the question lies in whether the government based in Helsinki can revive its once booming economy and at what cost. Current predictions don’t paint a rosy picture with the Finnish economy destined to be one of the worst performing economies, only second to Greece. This paper seeks to analyse the rise and fall of Finland from the perspective of Nokia, the steadily declining tech giant, and the internal changes that have occurred in the consumption patterns. The paper also uses the decline of the Russian economy as a quantitative reason for a lack of capital in the country and seeks to perform a cost benefit analysis of Finland’s participation in the single currency market as one of the obstacles to its path to recovery. The only way to thaw Finland’s frozen economy involves a series of austerity measures and structural reforms that will, at the very least, test the strength of the Eurozone’s economy

Mercurial Metastatic Merkel Cell Carcinoma: A Case of Colonic Involvement

Merkel cell carcinoma (MCC) is a neuroendocrine skin cancer that typically presents as a painless erythematous nodule on body surfaces visible to the sun. Metastatic disease is typical to the lymph nodes, liver, and lungs. There are previous case reports of patients with metastases to the gastrointestinal tract including the stomach, small intestine, and pancreas. To our knowledge, there are only rare occurrences of metastases to the colon. We report a patient with a history of MCC treated with chemotherapy who presented with hematochezia and underwent a colonoscopy that showed a partially obstructing, edematous, friable 7-cmcircumferential mass in the transverse colon. Biopsy confirmed the diagnosis of MCC that metastasized to the transverse colon.Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Institutional Responses to Pressures for Sustainable Palm Oil

As the two leading palm oil producing countries, Indonesia and Malaysia have come under external pressures to limit deforestation and greenhouse gas emissions related to land use conversion for oil palm cultivation. We examine various institutional frameworks that have emerged to mediate these pressures. These frameworks can be distinguished by their geographic scope—domestic, region, and global—as well as by the nature of control—private, non-profit, and governmental. The frameworks have taken the form of sustainability certification systems from non-profit organizations or governments, corporate sustainability policies, or the setting through global or bilateral negotiations of voluntary national targets for limiting deforestation or reducing greenhouse gas emissions. We interpret these frameworks in terms of basic theories of institutional economics, in particular the Coase theorem, which posits that the allocation of resources will be efficient if there are zero transaction costs and legal rights are well defined. Some efficiencies are certainly attainable. Certification systems can be operated by intermediary organizations with specialized capacities to monitor the sustainability practices of oil palm growers associated with various crude palm oil mills. Larger corporations similarly may be able to commit themselves more or less credibly to observance of strict sustainability standards. This does not necessarily reflect purely altruistic impulses. It will add to costs, but may also add to revenues: as consumer groups globally pressure consumer products companies to use sustainably sourced palm oil, these companies may be willing to pay more for sustainability assurance by their palm oil suppliers. Given transaction and information costs, and economic incentives of the relevant economic actors, there has been slippage in the monitoring and enforcement of certification systems and corporate policies. The quality and effectiveness of governance have also been major issues. Technological developments, particularly the increased use of satellites to monitor deforestation and fires, may offer enhanced transparency, and increased global awareness and concern over these issues should drive further progress, if the forests can last long enough

The impact of left ventricular hypertrophy on survival in candidates for liver transplantation: LVH in Cirrhosis

Left ventricular hypertrophy (LVH) occurs in 12% to 30% of patients with cirrhosis; however, its prognostic significance is not well studied. We assessed the association of LVH with survival in patients undergoing a liver transplantation (LT) evaluation. We performed a multicenter cohort study of patients undergoing an evaluation for LT. LVH was defined with transthoracic echocardiography. The outcome of interest was all-cause mortality. LVH was present in 138 of 485 patients (28%). Patients with LVH were older, more likely to be male and African American, and were more likely to have hypertension. Three hundred forty-five patients did not undergo transplantation (212 declined, and 133 were waiting): 36 of 110 patients with LVH (33%) died, whereas 57 of 235 patients without LVH (24%) died (P = 0.23). After LT, 8 of 28 patients with LVH (29%) died over the course of 3 years, whereas 9 of 112 patients without LVH (8%) died (P = 0.007). This finding was independent of conventional risk factors for LVH, and all deaths for patients with LVH occurred within 9 months of LT. No clinical or demographic characteristics were associated with mortality among LVH patients. In conclusion, the presence of LVH is associated with an early increase in mortality after LT, and this is independent of conventional risk factors for LVH. Further studies are needed to confirm these findings and identify factors associated with mortality after transplantation to improve outcomes

Cumulative effect of PM2.5 components is larger than the effect of PM2.5 mass on child health in India

Abstract While studies on ambient fine particulate matter (PM2.5) exposure effect on child health are available, the differential effects, if any, of exposure to PM2.5 species are unexplored in lower and middle-income countries. Using multiple logistic regression, we showed that for every 10 μg m−3 increase in PM2.5 exposure, anaemia, acute respiratory infection, and low birth weight prevalence increase by 10% (95% uncertainty interval, UI: 9–11), 11% (8–13), and 5% (4–6), respectively, among children in India. NO3 -, elemental carbon, and NH4 + were more associated with the three health outcomes than other PM2.5 species. We found that the total PM2.5 mass as a surrogate marker for air pollution exposure could substantially underestimate the true composite impact of different components of PM2.5. Our findings provide key indigenous evidence to prioritize control strategies for reducing exposure to more toxic species for greater child health benefits in India

Patient-reported outcomes in HCC: A scoping review by the Practice Metrics Committee of the American Association for the Study of Liver Diseases.

BACKGROUND AND AIMS: HCC is a leading cause of mortality in patients with advanced liver disease and is associated with significant morbidity. Despite multiple available curative and palliative treatments, there is a lack of systematic evaluation of patient-reported outcomes (PROs) in HCC. APPROACH AND RESULTS: The American Association for the Study of Liver Diseases Practice Metrics Committee conducted a scoping review of PROs in HCC from 1990 to 2021 to (1) synthesize the evidence on PROs in HCC and (2) provide recommendations on incorporating PROs into clinical practice and quality improvement efforts. A total of 63 studies met inclusion criteria investigating factors associated with PROs, the relationship between PROs and survival, and associations between HCC therapy and PROs. Studies recruited heterogeneous populations, and most were cross-sectional. Poor PROs were associated with worse prognosis after adjusting for clinical factors and with more advanced disease stage, although some studies showed better PROs in patients with HCC compared to those with cirrhosis. Locoregional and systemic therapies were generally associated with a high symptom burden; however, some studies showed lower symptom burden for transarterial radiotherapy and radiation therapy. Qualitative studies identified additional symptoms not routinely assessed with structured questionnaires. Gaps in the literature include lack of integration of PROs into clinical care to guide HCC treatment decisions, unknown impact of HCC on caregivers, and the effect of palliative or supportive care quality of life and health outcomes. CONCLUSION: Evidence supports assessment of PROs in HCC; however, clinical implementation and the impact of PRO measurement on quality of care and longitudinal outcomes need future investigation

Patient-reported outcomes in HCC: A scoping review by the Practice Metrics Committee of the American Association for the Study of Liver Diseases

Background and AimsHCC is a leading cause of mortality in patients with advanced liver disease and is associated with significant morbidity. Despite multiple available curative and palliative treatments, there is a lack of systematic evaluation of patient-reported outcomes (PROs) in HCC.Approach and ResultsThe American Association for the Study of Liver Diseases Practice Metrics Committee conducted a scoping review of PROs in HCC from 1990 to 2021 to (1) synthesize the evidence on PROs in HCC and (2) provide recommendations on incorporating PROs into clinical practice and quality improvement efforts. A total of 63 studies met inclusion criteria investigating factors associated with PROs, the relationship between PROs and survival, and associations between HCC therapy and PROs. Studies recruited heterogeneous populations, and most were cross-sectional. Poor PROs were associated with worse prognosis after adjusting for clinical factors and with more advanced disease stage, although some studies showed better PROs in patients with HCC compared to those with cirrhosis. Locoregional and systemic therapies were generally associated with a high symptom burden; however, some studies showed lower symptom burden for transarterial radiotherapy and radiation therapy. Qualitative studies identified additional symptoms not routinely assessed with structured questionnaires. Gaps in the literature include lack of integration of PROs into clinical care to guide HCC treatment decisions, unknown impact of HCC on caregivers, and the effect of palliative or supportive care quality of life and health outcomes.ConclusionEvidence supports assessment of PROs in HCC; however, clinical implementation and the impact of PRO measurement on quality of care and longitudinal outcomes need future investigation.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/172924/1/hep32313.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/172924/2/hep32313_am.pd