Pathophysiology, diagnosis, and treatment of spinal meningoceles and arachnoid cysts

Though the nomenclature regarding spinal arachnoid cysts and meningoceles is confusing and sometimes overlapping, spinal arachnoid cysts and meningoceles are distinct entities with different presentations and etiologies. Meningoceles are usually congenital lesions discovered at infancy with a high incidence of associated anomalies. Spinal arachnoid cysts are most often asymptomatic but can cause nerve root and/or cord compression. We review the presentation, pathophysiology, and management of these lesions

Preferences of Hungarian consumers for quality, access and price attributes of health care services — result of a discrete choice experiment

In 2010, a household survey was carried out in Hungary among 1037 respondents to study consumer preferences and willingness to pay for health care services. In this paper, we use the data from the discrete choice experiments included in the survey, to elicit the preferences of health care consumers about the choice of health care providers. Regression analysis is used to estimate the effect of the improvement of service attributes (quality, access, and price) on patients’ choice, as well as the differences among the socio-demographic groups. We also estimate the marginal willingness to pay for the improvement in attribute levels by calculating marginal rates of substitution. The results show that respondents from a village or the capital, with low education and bad health status are more driven by the changes in the price attribute when choosing between health care providers. Respondents value the good skills and reputation of the physician and the attitude of the personnel most, followed by modern equipment and maintenance of the office/hospital. Access attributes (travelling and waiting time) are less important. The method of discrete choice experiment is useful to reveal patients’ preferences, and might support the development of an evidence-based and sustainable health policy on patient payments

Decision for reconstructive interventions of the upper limb in individuals with tetraplegia: the effect of treatment characteristics

Objective: To determine the effect of treatment characteristics on the\ud decision for reconstructive interventions for the upper extremities (UE) in\ud subjects with tetraplegia. - \ud Setting: Seven specialized spinal cord injury centres in the Netherlands. - \ud Method: Treatment characteristics for UE reconstructive interventions were\ud determined. Conjoint analysis (CA) was used to determine the contribution\ud and the relative importance of the treatment characteristics on the decision\ud for therapy. Therefore, a number of different treatment scenarios using these\ud characteristics were established. Different pairs of scenarios were presented\ud to subjects who were asked to choose the preferred scenario of each set. - \ud Results: forty nine subjects with tetraplegia with a stable C5, C6 or C7\ud lesion were selected. All treatment characteristics significantly influenced\ud the choice for treatment. Relative importance of treatment characteristics\ud were: intervention type (surgery or surgery with FES implant) 13%, number\ud of operations 15%, in patient rehabilitation period 22%, ambulant\ud rehabilitation period 9%, complication rate 15%, improvement of elbow\ud function 10%, improvement of hand function 15%. In deciding for therapy\ud 40% of the subjects focused on one characteristic. - \ud Conclusion: CA is applicable in Spinal Cord Injury medicine to study the\ud effect of health outcomes and non-health outcomes on the decision for\ud treatment. Non-health outcomes which relate to the intensity of treatment\ud are equally important or even more important than functional outcome in the\ud decision for reconstructive UE surgery in subjects with tetraplegia

The caribbean coastal marine productivity program (CARICOMP)

CARICOMP is a regional scientific program to study land-sea interaction processes in the Caribbean coastal zone. It has been collecting data since 1992, when a Data Management Centre was established at the University of the West Indies in Jamaica. Initially it focuses on documenting the structure and productivity of major coastal communities (mangrove forests, seagrass meadows and coral reefs) at relatively undisturbed sites in diverse physical settings. Second, by regular recording of physical and biological parameters, it monitors for change, seeking to distinguish natural from anthropogenic disturbance. Third, it constitutes a regional network of observers, able to collaborate on studies of region-wide events. Examples are presented of the diverse data sets collected by the Program.Fil: Alcolado, Pedro M.. Instituto de Oceanología; CubaFil: Alleng, Gerard. No especifíca;Fil: Bonair, Kurt. No especifíca;Fil: Bone, David. Universidad Simón Bolívar; VenezuelaFil: Buchan, Kenneth. No especifíca;Fil: Bush, Phillippe G.. Protection and Conservation Unit; Islas CaimánFil: De Meyer, Kalli. No especifíca;Fil: Garcia, Jorge R.. Universidad de Puerto Rico; Puerto RicoFil: Garzón Ferreira, Jaime. Instituto de Investigaciones Marinas y Costeras; ColombiaFil: Gayle, Peter M. H.. Discovery Bay Marine Laboratory; JamaicaFil: Gerace, Donald T.. Bahamian Field Station; BahamasFil: Geraldes, Francisco X.. Universidad Autonoma de Santo Domingo.; República DominicanaFil: Dahlgren, Eric Jordán. Universidad Nacional Autónoma de México; MéxicoFil: Kjferve, Björn. University of South Carolina; Estados UnidosFil: Klein, Eduardo. Universidad Simón Bolívar; VenezuelaFil: Koltes, Karen. Smithsonian Institution; Estados UnidosFil: Laydoo, Richard S.. No especifíca;Fil: Linton, Dulcie M.. University of the West Indies ; JamaicaFil: Ogden, John C.. Florida Institute of Oceanography; Estados UnidosFil: Oxenford, Hazel A.. McGill University; BarbadosFil: Parker, Christoph. McGill University; BarbadosFil: Penchaszadeh, Pablo Enrique. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Museo Argentino de Ciencias Naturales "Bernardino Rivadavia"; ArgentinaFil: Pors, Leon P. P. J.. Universidad Simón Bolívar; VenezuelaFil: Ramírez Ramírez, Javier. Instituto Politécnico Nacional. Centro de Investigación y de Estudios Avanzados. Departamento de Física; MéxicoFil: Ruiz Rentería, Francisco. Universidad Nacional Autónoma de México; MéxicoFil: Ryan, Joseph D.. Centro de Investigación y Documentación de la Costa Atlántica; NicaraguaFil: Smith, Struan R.. Bermuda Biological Station for Research; BermudasFil: Tschirky, John. Latin American and Caribbean Division; Estados UnidosFil: Varela, Ramon. Estación de Investigaciones Marinas de Margarita; VenezuelaFil: Walker, Susan. No especifíca;Fil: Weil, Ernesto. Universidad de Puerto Rico; Puerto RicoFil: Wiebe, William J.. University of Georgia; Estados UnidosFil: Woodley, Jeremy D.. University of the West Indies; JamaicaFil: Zieman, Joseph C.. University of Virginia; Estados Unido

Vacation (after-) effects on employee health and well-being, and the role of vacation activities, experiences and sleep

Contains fulltext : 116760.pdf (publisher's version ) (Open Access)Most vacations seem to have strong, but rather short-lived effects on health and well-being (H&W). However, the recovery-potential of relatively long vacations and the underlying processes have been disregarded. Therefore, our study focused on vacations longer than 14 days and on the psychological processes associated with such a long respite from work. In the present study, we investigated (1) how health and well-being (H&W) develop during and after a long summer vacation, (2) whether changes in H&W during and after vacation relate to vacation activities and experiences and (3) whether changes in H&W during and after vacation relate to sleep. Fifty-four employees reported their H&W before, three or four times during and five times after vacation. Vacations lasted 23 days on average. Information on vacation experiences, work-related activities and sleep was collected during vacation. Vacation activities were assessed immediately after vacation. H&W increased quickly during vacation, peaked on the eighth vacation day and had rapidly returned to baseline level within the first week of work resumption. Vacation duration and most vacation activities were only weakly associated with H&W changes during and after vacation. Engagement in passive activities, savoring, pleasure derived from activities, relaxation, control and sleep showed strong relations with improved H&W during and to a lesser degree after vacation. In conclusion, H&W improved during long summer vacations, but this positive effect was short-lived. Vacation experiences, especially pleasure, relaxation, savoring and control, seem to be especially important for the strength and persistence of vacation (after-) effects

Abolition of prescription charges in Wales: the impact on medicines use in those who used to pay

OBJECTIVES: patient co-payments for prescription medicines in Wales were abolished in April 2007 and there has been much speculation on the possible effects. We analysed patient-reported use of medicines before and after abolition of the prescription charge, noting changes in the number of items prescribed, number of non-prescription medicines purchased and participants not collecting all prescribed items (primary non-adherence).METHODS: a sample of community pharmacists across Wales (n = 249) issued questionnaires to customers at the point of dispensing who were not exempt from the prescription charge. A second questionnaire was delivered by post to those who returned the first questionnaire (n = 1027) and expressed a willingness to participate further. Paired t-tests were applied to responses from those completing both questionnaires (n = 593). Further analyses were carried out according to gender, age and reported levels of household income.KEY FINDINGS: there was a statistically significant (P = 0.03) rise in the number of items prescribed, and a statistically significant fall (P = 0.02) in the number of non-prescription medicines purchased. Primary non-adherence was also found to fall between pre- and post-abolition periods. Those most affected in terms of increase in number of prescribed items prescribed were the older age group (45-59 years), and those with household income of between £15600 and £36400. The most affected in the fall in number of medicines purchased were males, those in the lower age group (25-34 years) and those with a higher household income (>£36400).CONCLUSIONS:  although the rise in number of items prescribed and fall in number of medicines purchased was generally anticipated, there appeared to be little or no effect for those on the lowest incomes