Charity Financial Reporting Regulation: a Comparison of the United Kingdom and Her Former Colony, New Zealand

Charities are becoming more highly regulated worldwide and yet they are subject to diverse, country-specific, financial reporting standards. New Zealand is a jurisdiction that has treated all sectors alike in its approach to the financial regulation of charities, whilst the United Kingdom has, for some time, separated the regulation of charities from other entities. This paper provides a comparison of the histories of the evolution of regulation for charity reporting in the United Kingdom and New Zealand. The current process of international harmonization in both jurisdictions is premised on the principle that accounting conceptual frameworks should not be jurisdiction-specific, but charities have proved to be an exception. We suggest in this study that this exception is attributed to different drivers resulting in regulatory distinctions in two otherwise similar jurisdictions. Without persisting in the maintenance of sectorneutrality, the inevitable divergence increases the load on preparers, attesters, and users and may lead to lower levels of accountability and transparency

Reticulation pattern without honeycombing on high-resolution CT is associated with the risk of disease progression in interstitial lung diseases

Background: The disease course of idiopathic pulmonary fibrosis (IPF) is progressive and occasionally, other types of interstitial lung disease (ILD) may progress similarly to IPF. This study aimed to evaluate risk factors for disease progression within 24 months in patients with various ILDs. Methods: This prospective study obtained 97 patients with a suspected ILD who underwent a transbronchial lung cryobiopsy. The extent of several high-resolution computed tomography (HRCT) patterns was assessed. Due to the inclusion criteria the study population presented a low extent of honeycombing and definite usual interstitial pneumonia (UIP) pattern on HRCT suggesting an early stage of ILD. Disease progression within 24 months despite treatment was defined as a relative decline of ≥ 10% in forced vital capacity (FVC), or a relative decline in FVC of ≥ 5% and one of the three additional criteria: (1) a decline in diffusion capacity to carbon monoxide (DLCO) ≥ 15%; (2) increased fibrosis on HRCT; (3) progressive symptoms, or progressive symptoms and increased fibrosis on HRCT. The same definition was utilized in patients with IPF and other ILDs. Risk factors for disease progression were evaluated in a multivariable logistic regression model. Results: Disease progression was revealed in 52% of the patients with ILD, 51% of the patients with IPF, and 53% of the patients with other types of ILD. A high extent of reticulation on HRCT (Odds ratio [OR] 3.11, 95% Confidence interval [CI] 1.21–7.98, P = 0.019) and never smoking (OR 3.11, CI 1.12–8.63, P = 0.029) were associated with disease progression whereas platelet count (OR 2.06 per 100 units increase, CI 0.96–4.45, P = 0.065) did not quite reach statistical significance. Conclusion: Higher extent of reticulation on HRCT and never smoking appeared to associate with the risk of disease progression within 24 months in ILD patients without honeycombing. Approximately half of the patients with ILD revealed disease progression, and similar proportions were observed in patients with IPF and in other types of ILD.publishedVersionPeer reviewe

Asbestos-related pleural and lung fibrosis in patients with retroperitoneal fibrosis

<p>Abstract</p> <p>Background</p> <p>Retroperitoneal fibrosis (RPF) is a rare fibroinflammatory disease that leads to hydronephrosis and renal failure. In a case-control study, we have recently shown that asbestos exposure was the most important risk factor for RPF in the Finnish population. The aim of this study was to evaluate the relation of asbestos exposure to radiologically confirmed lung and pleural fibrosis among patients with RPF.</p> <p>Methods</p> <p>Chest high-resolution computed tomography (HRCT) was performed on 16 unexposed and 22 asbestos-exposed RPF patients and 18 asbestos-exposed controls. Parietal pleural plaques (PPP), diffuse pleural thickening (DPT) and parenchymal fibrosis were scored separately.</p> <p>Results</p> <p>Most of the asbestos-exposed RPF patients and half of the asbestos-exposed controls had bilateral PPP, but only a few had lung fibrosis. Minor bilateral plaques were detected in two of the unexposed RPF patients, and none had lung fibrosis. DPT was most frequent and thickest in the asbestos-exposed RPF-patients. In three asbestos-exposed patients with RPF we observed exceptionally large pleural masses that were located anteriorly in the pleural space and continued into the anterior mediastinum.</p> <p>Asbestos exposure was associated with DPT in comparisons between RPF patients and controls (case-control analysis) as well as among RPF patients (case-case analysis).</p> <p>Conclusion</p> <p>The most distinctive feature of the asbestos-exposed RPF patients was a thick DPT. An asbestos-related pleural finding was common in the asbestos-exposed RPF patients, but only a few of these patients had parenchymal lung fibrosis. RPF without asbestos exposure was not associated with pleural or lung fibrosis. The findings suggest a shared etiology for RPF and pleural fibrosis and furthermore possibly a similar pathogenetic mechanisms.</p

A Survey of the European Association of Bronchology and Interventional Pulmonology (EABIP)

Publisher Copyright: © Copyright 2017 S. Karger AG, Basel. All rights reserved.Background: Airway stenting (AS) commenced in Europe circa 1987 with the first placement of a dedicated silicone airway stent. Subsequently, over the last 3 decades, AS was spread throughout Europe, using different insertion techniques and different types of stents. Objectives: This study is an international survey conducted by the European Association of Bronchology and Interventional Pulmonology (EABIP) focusing on AS practice within 26 European countries. Methods: A questionnaire was sent to all EABIP National Delegates in February 2015. National delegates were responsible for obtaining precise and objective data regarding the current AS practice in their country. The deadline for data collection was February 2016. Results: France, Germany, and the UK are the 3 leading countries in terms of number of centres performing AS. These 3 nations represent the highest ranked nations within Europe in terms of gross national income. Overall, pulmonologists perform AS exclusively in 5 countries and predominately in 12. AS is performed almost exclusively in public hospitals. AS performed under general anaesthesia is the rule for the majority of institutions, and local anaesthesia is an alternative in 9 countries. Rigid bronchoscopy techniques are predominant in 20 countries. Amongst commercially available stents, both Dumon and Ultraflex are by far the most commonly deployed. Finally, 11 countries reported that AS is an economically viable activity, while 10 claimed that it is not. Conclusion: This EABIP survey demonstrates that there is significant heterogeneity in AS practice within Europe. Therapeutic bronchoscopy training and economic issues/reimbursement for procedures are likely to be the primary reasons explaining these findings.publishersversionpublishe

Current Practice of Airway Stenting in the Adult Population in Europe: A Survey of the European Association of Bronchology and Interventional Pulmonology (EABIP)

Background: Airway stenting (AS) commenced in Europe circa 1987 with the first placement of a dedicated silicone airway stent. Subsequently, over the last 3 decades, AS was spread throughout Europe, using different insertion techniques and different types of stents. Objectives: This study is an international survey conducted by the European Association of Bronchology and Interventional Pulmonology (EABIP) focusing on AS practice within 26 European countries. Methods: A questionnaire was sent to all EABIP National Delegates in February 2015. National delegates were responsible for obtaining precise and objective data regarding the current AS practice in their country. The deadline for data collection was February 2016. Results: France, Germany, and the UK are the 3 leading countries in terms of number of centres performing AS. These 3 nations represent the highest ranked nations within Europe in terms of gross national income. Overall, pulmonologists perform AS exclusively in 5 countries and predominately in 12. AS is performed almost exclusively in public hospitals. AS performed under general anaesthesia is the rule for the majority of institutions, and local anaesthesia is an alternative in 9 countries. Rigid bronchoscopy techniques are predominant in 20 countries. Amongst commercially available stents, both Dumon and Ultraflex are by far the most commonly deployed. Finally, 11 countries reported that AS is an economically viable activity, while 10 claimed that it is not. Conclusion: This EABIP survey demonstrates that there is significant heterogeneity in AS practice within Europe. Therapeutic bronchoscopy training and economic issues/reimbursement for procedures are likely to be the primary reasons explaining these findings. (C) 2017 S. Karger AG, Base

Apolipoprotein E and A-IV polymorphisms in two Estonian ethnic groups.

Syventävä työ ei kirjastoss

Retroperitoneal Fibrosis: A new asbestos-related disease

Retroperitoneaalinen fibroosi (RPF) on harvinainen sairaus, jossa vatsakalvon takaiseen tilaan kehittyy tulehduksellinen sidekudosmassa. RPF:n taustalla olevat syyt ovat olleet valtaosassa tapauksia tuntemattomia. Muutamissa tapausselostuksissa on epäilty asbestialtistumisen ja RPF:n yhteyttä, mutta käytettävissä olevat tiedot eivät ole olleet riittäviä osoittamaan syy-yhteyttä. Tässä väitöskirjassa selvitettiin RPF:n esiintyvyyttä, sairauden taustalla olevia tekijöitä ja tyypillisesti asbestialtistumiseen liittyviä samanaikaisia keuhkomuutoksia. Kolmen yliopistosairaalapiirin alueella tehtyyn tapaus-verrokkitutkimukseen osallistui 43 RPF:a sairastavaa henkilöä ja 179 vertailuhenkilöä, joilta haastattelun avulla selvitettiin aikaisempi altistuminen asbestille ja tärkeimmät lääketieteelliset tiedot. RPF-potilaille ja asbestialtistuneille verrokeille suoritettiin asbestimuutosten selvittämiseksi keuhkojen viipalekuvaus. Erillisessä tutkimuksessa mitattiin keuhkokudoksen ja vatsan alueen imusolmukkeiden asbestikuitupitoisuutta asbestisairauden epäilyn johdosta suoritetun oikeuslääketieteellisen ruumiinavauksen yhteydessä. Tutkimuksessa todettiin selvä yhteys retroperitoneaalifibroosin ja asbestialtistumisen välillä. Yli 10 vuoden työskentely asbestipölyisessä työssä lisäsi riskin sairastua retroperitoneaaliseen fibroosiin 9-kertaiseksi. Myös vähäisempi, mutta silti selvä työperäinen asbestialtistuminen lisäsi sairastumisen riskin 5,5-kertaiseksi. Lähes joka toinen tautitapaus (44 %) johtui asbestialtituksesta. Muita riskitekijöitä olivat ergotamiinia sisältävien migreenilääkkeiden käyttö, vatsa-aortan pullistuma ja runsas tupakointi. Tunnusomaisin löydös asbestialtistuneilla RPF-potilailla oli voimakas keuhkopussin kiinnikkeisyys. Tämä viittaa sekä muutosten yhteiseen aiheuttajaan että mahdollisesti samankaltaisiin syntymekanismeihin. Valtaosalla asbestialtistuneista RPF-potilaista ja puolella asbestialtistuneista verrokeista havaittiin molemminpuolisia keuhkopussin plakkeja, mutta asbestoosia todettiin vain muutamilla. RPF ilman asbestialtistumista ei ollut yhdeydessä keuhko- tai keuhkopussifibroosiin. Asbestialtistuneiden vainajien kuitumittauksissa todettiin, että asbestikuituja voidaan havaita vatsan alueen imusolmukkeissa jo vähäisessäkin asbestialtistumisessa. Keuhkoista imunesteen mukana kulkeutuvat asbestikuidut päätyvät vatsan alueelle, jossa ne voivat aiheuttaa sekä vatsakalvon mesotelioomaa että RPF:a. Tutkimuksiemme perusteella voidaan esittää, että asbestialtistuminen on yksi RPF:n aiheuttajista. Työperäisessä asbestialtistumisessa RPF:a on käsiteltävä ammattitautiepäilynä.Background: Retroperitoneal fibrosis (RPF) is an uncommon fibroinflammatory disorder of the retroperitoneal space. The aetiology of RPF is unknown in most cases. Some reports in the literature have suggested an association between RPF and asbestos exposure. However, the data needed to assess the relationship between asbestos exposure and RPF have been missing. Aims: To clarify the possible role of asbestos exposure in the development of RPF and to determine whether patients with RPF have other asbestos-related findings and to assess the presence of asbestos in the para-aortic (PA) and mesenteric (ME) lymph nodes in deceased subjects, who had earlier been exposed to asbestos. Methods: A case-control study of 43 RPF patients treated in three university hospital districts of Finland in 1990 2001 was carried out. For every patient, five population-based matched controls were selected. Of the 215 eligible controls, 179 (83%) participated in the study. Asbestos exposure and medical history were assessed with a postal questionnaire and a personal interview. Chest high resolution-computed tomography (HRCT) was performed on 38 RPF patients and 18 asbestos-exposed controls. In a separate study, PA and ME lymph nodes and lung tissue from 17 persons who underwent medicolegal autopsy for suspicion of asbestos-related disease and from 5 controls were analysed for asbestos fibres using transmission electron microscopy. Results: Asbestos exposure was strongly associated with RPF, with odds ratios of 5.5 (95% CI 1.6-18.7) for 20 pack-years were the other significant risk factors in the conditional regression analysis. Most of the asbestos-exposed RPF patients and half of the asbestos-exposed controls had bilateral pleural plaques, but only a few had lung fibrosis. RPF without asbestos exposure was not associated with pleural or lung fibrosis. The most distinctive feature of the asbestos-exposed RPF patients was a thick diffuse pleural thickening (DPT). High concentrations of amphibole asbestos fibres were detected in several lung tissue samples and in the respective PA and ME lymph nodes among the asbestos-exposed persons. It is evident that even low-level asbestos exposure results in the presence of asbestos fibres in the abdominal lymph nodes. Conclusions Asbestos fibres, translocated by the lymph flow from the lungs, reach the abdominal and the retroperitoneal space and may induce both peritoneal mesothelioma and RPF. Persons with asbestos-related RPF frequently have asbestos-related pleural fibrosis that suggests a shared aetiology and similar pathogenetic mechanisms. The results show that occupational asbestos exposure seems to be one of the causal agents for RPF. For patients with work-related asbestos exposure, RPF should possibly be considered an occupational disease

Apolipoprotein E and A-IV polymorphisms in two Estonian ethnic groups.

Syventävä työ ei kirjastoss

Retroperitoneal Fibrosis: A new asbestos-related disease

Retroperitoneaalinen fibroosi (RPF) on harvinainen sairaus, jossa vatsakalvon takaiseen tilaan kehittyy tulehduksellinen sidekudosmassa. RPF:n taustalla olevat syyt ovat olleet valtaosassa tapauksia tuntemattomia. Muutamissa tapausselostuksissa on epäilty asbestialtistumisen ja RPF:n yhteyttä, mutta käytettävissä olevat tiedot eivät ole olleet riittäviä osoittamaan syy-yhteyttä. Tässä väitöskirjassa selvitettiin RPF:n esiintyvyyttä, sairauden taustalla olevia tekijöitä ja tyypillisesti asbestialtistumiseen liittyviä samanaikaisia keuhkomuutoksia. Kolmen yliopistosairaalapiirin alueella tehtyyn tapaus-verrokkitutkimukseen osallistui 43 RPF:a sairastavaa henkilöä ja 179 vertailuhenkilöä, joilta haastattelun avulla selvitettiin aikaisempi altistuminen asbestille ja tärkeimmät lääketieteelliset tiedot. RPF-potilaille ja asbestialtistuneille verrokeille suoritettiin asbestimuutosten selvittämiseksi keuhkojen viipalekuvaus. Erillisessä tutkimuksessa mitattiin keuhkokudoksen ja vatsan alueen imusolmukkeiden asbestikuitupitoisuutta asbestisairauden epäilyn johdosta suoritetun oikeuslääketieteellisen ruumiinavauksen yhteydessä. Tutkimuksessa todettiin selvä yhteys retroperitoneaalifibroosin ja asbestialtistumisen välillä. Yli 10 vuoden työskentely asbestipölyisessä työssä lisäsi riskin sairastua retroperitoneaaliseen fibroosiin 9-kertaiseksi. Myös vähäisempi, mutta silti selvä työperäinen asbestialtistuminen lisäsi sairastumisen riskin 5,5-kertaiseksi. Lähes joka toinen tautitapaus (44 %) johtui asbestialtituksesta. Muita riskitekijöitä olivat ergotamiinia sisältävien migreenilääkkeiden käyttö, vatsa-aortan pullistuma ja runsas tupakointi. Tunnusomaisin löydös asbestialtistuneilla RPF-potilailla oli voimakas keuhkopussin kiinnikkeisyys. Tämä viittaa sekä muutosten yhteiseen aiheuttajaan että mahdollisesti samankaltaisiin syntymekanismeihin. Valtaosalla asbestialtistuneista RPF-potilaista ja puolella asbestialtistuneista verrokeista havaittiin molemminpuolisia keuhkopussin plakkeja, mutta asbestoosia todettiin vain muutamilla. RPF ilman asbestialtistumista ei ollut yhdeydessä keuhko- tai keuhkopussifibroosiin. Asbestialtistuneiden vainajien kuitumittauksissa todettiin, että asbestikuituja voidaan havaita vatsan alueen imusolmukkeissa jo vähäisessäkin asbestialtistumisessa. Keuhkoista imunesteen mukana kulkeutuvat asbestikuidut päätyvät vatsan alueelle, jossa ne voivat aiheuttaa sekä vatsakalvon mesotelioomaa että RPF:a. Tutkimuksiemme perusteella voidaan esittää, että asbestialtistuminen on yksi RPF:n aiheuttajista. Työperäisessä asbestialtistumisessa RPF:a on käsiteltävä ammattitautiepäilynä.Background: Retroperitoneal fibrosis (RPF) is an uncommon fibroinflammatory disorder of the retroperitoneal space. The aetiology of RPF is unknown in most cases. Some reports in the literature have suggested an association between RPF and asbestos exposure. However, the data needed to assess the relationship between asbestos exposure and RPF have been missing. Aims: To clarify the possible role of asbestos exposure in the development of RPF and to determine whether patients with RPF have other asbestos-related findings and to assess the presence of asbestos in the para-aortic (PA) and mesenteric (ME) lymph nodes in deceased subjects, who had earlier been exposed to asbestos. Methods: A case-control study of 43 RPF patients treated in three university hospital districts of Finland in 1990 2001 was carried out. For every patient, five population-based matched controls were selected. Of the 215 eligible controls, 179 (83%) participated in the study. Asbestos exposure and medical history were assessed with a postal questionnaire and a personal interview. Chest high resolution-computed tomography (HRCT) was performed on 38 RPF patients and 18 asbestos-exposed controls. In a separate study, PA and ME lymph nodes and lung tissue from 17 persons who underwent medicolegal autopsy for suspicion of asbestos-related disease and from 5 controls were analysed for asbestos fibres using transmission electron microscopy. Results: Asbestos exposure was strongly associated with RPF, with odds ratios of 5.5 (95% CI 1.6-18.7) for 20 pack-years were the other significant risk factors in the conditional regression analysis. Most of the asbestos-exposed RPF patients and half of the asbestos-exposed controls had bilateral pleural plaques, but only a few had lung fibrosis. RPF without asbestos exposure was not associated with pleural or lung fibrosis. The most distinctive feature of the asbestos-exposed RPF patients was a thick diffuse pleural thickening (DPT). High concentrations of amphibole asbestos fibres were detected in several lung tissue samples and in the respective PA and ME lymph nodes among the asbestos-exposed persons. It is evident that even low-level asbestos exposure results in the presence of asbestos fibres in the abdominal lymph nodes. Conclusions Asbestos fibres, translocated by the lymph flow from the lungs, reach the abdominal and the retroperitoneal space and may induce both peritoneal mesothelioma and RPF. Persons with asbestos-related RPF frequently have asbestos-related pleural fibrosis that suggests a shared aetiology and similar pathogenetic mechanisms. The results show that occupational asbestos exposure seems to be one of the causal agents for RPF. For patients with work-related asbestos exposure, RPF should possibly be considered an occupational disease

Retroperitoneal and pleural fibrosis in an insulator working in power plants

We describe a case history of a former insulator who developed concomitant retroperitoneal and pleural fibrosis. In his work, the patient had been exposed on a daily basis to asbestos dust while demolishing and installing pipeline insulations. The heavy asbestos exposure was confirmed by a high level of asbestos content in his autopsy lung sample. We propose that both retroperitoneal fibrosis and diffuse pleural thickening were induced in our patient by an abundant amount of amphibole asbestos fibres found in his lung and retroperitoneal tissues