Screening for Abdominal Aortic Aneurysm among Patients Referred to the Vascular Laboratory is Cost-effective

AbstractScreening for abdominal aortic aneurysm (AAA) in high-risk groups has been recommended based on a high prevalence of disease, while being questioned due to a high frequency of co-morbidities and inferior life-expectancy. We evaluated the long-term outcome and the cost-effectiveness of selective AAA screening among patients referred to the vascular laboratory for arterial examination.MethodsA total of 5924 patients, referred to the vascular laboratory of a university hospital, were screened for AAA with ultrasound (definition: ∅≥30mm), 1993–2005. Outcome data were gathered through hospital records and the national population registry. A Markov model was used for health–economic evaluation.ResultsAn AAA was detected in 181 patients (mean age 72.8 years), of whom 21.5% underwent elective repair (perioperative mortality 5.1%) after 7.5 years of follow-up. Four of six patients diagnosed with AAA rupture were operated upon. Relative 5-year survival compared with the general Swedish population, controlled for age and sex, was 80.4% (95% confidence interval (CI): 70.8–88.8). The cost-effectiveness was robust in base-case (11 084 Euro/life year gained) and in sensitivity analyses of prevalence, cost and survival.ConclusionsPatients in whom AAA was detected at selective screening had inferior long-term survival and were operated on less frequently, compared with AAA patients described in previous studies. Yet, selective screening at the vascular laboratory was cost-effective

Racism and anti-racism in Europe: a critical analysis of concepts and frameworks

The targets and expressions of racism vary across Europe. This article discusses the relevance of different descriptions and analyses of racism despite the different terms used in different countries such as ‘ethnic minority’, ‘foreigner’ or ‘black’ and different interpretations of which differences matter. It shows the significance of a cross-national European perspective on racism. There are important convergences across European countries in the discourses and practices of racism, particularly the distinction between ‘useful’ and ‘abusive’ migrants. A cross-European perspective can be an important inspiration for anti-racist struggles

Entrepreneurship, incongruence and affect: drawing insights from a Swedish anti-racist organisation

In recent years, entrepreneurship has been reconceptualised as social change. Understood as such, entrepreneurship can be viewed to disrupt and disturb the social order. We argue in this paper that Foucault’s notion of heterotopia and Lacan’s concepts of the real and anxiety help us to conceptualize the disturbing aspect of entrepreneurship as social change, and understand why the latter may encounter social resistance. Our contribution to critical entrepreneurship literature is to first emphasise that entrepreneurship instigates social change by introducing incongruence, and second, to highlight that this process can be affective: it can create anxiety. The paper uses an illustrative historical case-example of a Swedish anti-racist commercial magazine (Gringo) to elucidate these points. We conclude by pointing out that anxiety may be necessary for the provocation of social transformation