Suchergebnisse

Networks, connectivity, and material culture / Anna Collar -- Big data and Greek archaeology: potential, hazards, and a case study from early Greece / Sarah Murray -- Biography of the Bull-Leaper: a 'Minoan' ivory figurine and collecting antiquity / Catherine L. Cooper (Kate Cooper) -- Labour organisation and energetics of early archaic architecture in Korinthos / Philip Sapirstein -- Collaborative investigations into the production of Athenian pottery / David Saunders, Karen Trentelman and Jeffrey Maish -- "Everything impossible": admiring glass in ancient Rome / Nicola Barham -- The Pylos Tablets Digital Project: prehistoric scripts in the 21st century / Dimitri Nakassis, Kevin Pluta and Julie Hruby -- Objects and things in Classical literature / Sarah Blake and Jennifer Dyer -- The soundscape of textile work in the Roman world: old sources & new methods / Magdalena Öhrman.

Background: Risk sharing schemes represent an innovative and important approach to the problems of rationing and achieving cost-effectiveness in high cost or controversial health interventions. This study aimed to assess the feasibility of risk sharing schemes, looking at long term clinical outcomes, to determine the price at which high cost treatments would be acceptable to the NHS. Methods: This case study of the first NHS risk sharing scheme, a long term prospective cohort study of beta interferon and glatiramer acetate in multiple sclerosis (MS) patients in 71 specialist MS centres in UK NHS hospitals, recruited adults with relapsing forms of MS, meeting Association of British Neurologists (ABN) criteria for disease modifying therapy. Outcome measures were: success of recruitment and follow up over the first three years, analysis of baseline and initial follow up data and the prospect of estimating the long term cost-effectiveness of these treatments. Results: Centres consented 5560 patients. Of the 4240 patients who had been in the study for a least one year, annual review data were available for 3730 (88.0%). Of the patients who had been in the study for at least two years and three years, subsequent annual review data were available for 2055 (78.5%) and 265 (71.8%) patients respectively. Baseline characteristics and a small but statistically significant progression of disease were similar to those reported in previous pivotal studies. Conclusion: Successful recruitment, follow up and early data analysis suggest that risk sharing schemes should be able to deliver their objectives. However, important issues of analysis, and political and commercial conflicts of interest still need to be addressed.

Background Demographic trends in developed countries have prompted governmental policies aimed at extending working lives. However, working beyond the traditional retirement age may not be feasible for those with major health problems of ageing, and depending on occupational and personal circumstances, might be either good or bad for health. To address these uncertainties, we have initiated a new longitudinal study. Methods/design We recruited some 8000 adults aged 50–64 years from 24 British general practices contributing to the Clinical Practice Research Datalink (CPRD). Participants have completed questionnaires about their work and home circumstances at baseline, and will do so regularly over follow-up, initially for a 5-year period. With their permission, we will access their primary care health records via the CPRD. The inter-relation of changes in employment (with reasons) and changes in health (e.g., major new illnesses, new treatments, mortality) will be examined. Discussion CPRD linkage allows cost-effective frequent capture of detailed objective health data with which to examine the impact of health on work at older ages and of work on health. Findings will inform government policy and also the design of work for older people and the measures needed to support employment in later life, especially for those with health limitations.

This report describes epidemiology, burden, and treatment of osteoporosis in each of the 27 countries of the European Union (EU27). ; Introduction: In 2010, 22 million women and 5.5 million men were estimated to have osteoporosis in the EU; and 3.5 million new fragility fractures were sustained, comprising 620,000 hip fractures, 520,000 vertebral fractures, 560,000 forearm fractures and 1,800,000 other fractures. The economic burden of incident and prior fragility fractures was estimated at € 37 billion. Previous and incident fractures also accounted for 1,180,000 quality-adjusted life years lost during 2010. The costs are expected to increase by 25 % in 2025. The majority of individuals who have sustained an osteoporosis-related fracture or who are at high risk of fracture are untreated and the number of patients on treatment is declining. The aim of this report was to characterize the burden of osteoporosis in each of the EU27 countries in 2010 and beyond. ; Methods: The data on fracture incidence and costs of fractures in the EU27 were taken from a concurrent publication in this journal (Osteoporosis in the European Union: Medical Management, Epidemiology and Economic Burden) and country specific information extracted. ; Results: The clinical and economic burden of osteoporotic fractures in 2010 is given for each of the 27 countries of the EU. The costs are expected to increase on average by 25 % in 2025. The majority of individuals who have sustained an osteoporosis-related fracture or who are at high risk of fracture are untreated and the number of patients on treatment is declining. ; Conclusions: In spite of the high cost of osteoporosis, a substantial treatment gap and projected increase of the economic burden driven by aging populations, the use of pharmacological prevention of osteoporosis has decreased in recent years, suggesting that a change in healthcare policy concerning the disease is warranted. ; peer-reviewed

Background Established in 2000, Millennium Development Goal 4 (MDG4) catalysed extraordinary political, financial, and social commitments to reduce under-5 mortality by two-thirds between 1990 and 2015. At the country level, the pace of progress in improving child survival has varied markedly, highlighting a crucial need to further examine potential drivers of accelerated or slowed decreases in child mortality. The Global Burden of Disease 2015 Study (GBD 2015) provides an analytical framework to comprehensively assess these trends for under-5 mortality, age-specific and cause-specific mortality among children under 5 years, and stillbirths by geography over time. Methods Drawing from analytical approaches developed and refined in previous iterations of the GBD study, we generated updated estimates of child mortality by age group (neonatal, post-neonatal, ages 1–4 years, and under 5) for 195 countries and territories and selected subnational geographies, from 1980–2015. We also estimated numbers and rates of stillbirths for these geographies and years. Gaussian process regression with data source adjustments for sampling and non-sampling bias was applied to synthesise input data for under-5 mortality for each geography. Age-specific mortality estimates were generated through a two-stage age–sex splitting process, and stillbirth estimates were produced with a mixed-effects model, which accounted for variable stillbirth definitions and data source-specific biases. For GBD 2015, we did a series of novel analyses to systematically quantify the drivers of trends in child mortality across geographies. First, we assessed observed and expected levels and annualised rates of decrease for under-5 mortality and stillbirths as they related to the Soci-demographic Index (SDI). Second, we examined the ratio of recorded and expected levels of child mortality, on the basis of SDI, across geographies, as well as differences in recorded and expected annualised rates of change for under-5 mortality. Third, we analysed levels and ...

Osteoarthritis is a syndrome affecting a variety of patient profiles. A European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis and the European Union Geriatric Medicine Society working meeting explored the possibility of identifying different patient profiles in osteoarthritis. The risk factors for the development of osteoarthritis include systemic factors (e.g., age, sex, obesity, genetics, race, and bone density) and local biomechanical factors (e.g., obesity, sport, joint injury, and muscle weakness); most also predict disease progression, particularly joint injury, malalignment, and synovitis/effusion. The characterization of patient profiles should help to better orientate research, facilitate trial design, and define which patients are the most likely to benefit from treatment. There are a number of profile candidates. Generalized, polyarticular osteoarthritis and local, monoarticular osteoarthritis appear to be two different profiles; the former is a feature of osteoarthritis co-morbid with inflammation or the metabolic syndrome, while the latter is more typical of post-trauma osteoarthritis, especially in cases with severe malalignment. Other biomechanical factors may also define profiles, such as joint malalignment, loss of meniscal function, and ligament injury. Early- and late-stage osteoarthritis appear as separate profiles, notably in terms of treatment response. Finally, there is evidence that there are two separate profiles related to lesions in the subchondral bone, which may determine benefit from bone-active treatments. Decisions on appropriate therapy should be made considering clinical presentation, underlying pathophysiology, and stage of disease. Identification of patient profiles may lead to more personalized healthcare, with more targeted treatment for osteoarthritis.

Prevention of fragility fractures in older people has become a public health priority, although the most appropriate and cost-effective strategy remains unclear. In the present statement, the Interest Group on Falls and Fracture Prevention of the European Union Geriatric Medicine Society (EUGMS), in collaboration with the International Association of Gerontology and Geriatrics for the European Region (IAGG-ER), the European Union of Medical Specialists (EUMS), the International Osteoporosis Foundation - European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, outlines its views on the main points in the current debate in relation to the primary and secondary prevention of falls, the diagnosis and treatment of bone fragility, and the place of combined falls and fracture liaison services for fracture prevention in older people.

Prevention of fragility fractures in older people has become a public health priority, although the most appropriate and cost-effective strategy remains unclear. In the present statement, the Interest Group on Falls and Fracture Prevention of the European Union Geriatric Medicine Society (EUGMS), in collaboration with the International Association of Gerontology and Geriatrics for the European Region (IAGG-ER), the European Union of Medical Specialists (EUMS), the International Osteoporosis Foundation - European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, outlines its views on the main points in the current debate in relation to the primary and secondary prevention of falls, the diagnosis and treatment of bone fragility, and the place of combined falls and fracture liaison services for fracture prevention in older people.

Within Latin America, about 319 volcanoes have been active in the Holocene, but 202 of these volcanoes have no seismic, deformation or gas monitoring. Following the 2012 Santorini Report on satellite Earth Observation and Geohazards, the Committee on Earth Observation Satellites (CEOS) developed a 4-year pilot project (2013-2017) to demonstrate how satellite observations can be used to monitor large numbers of volcanoes cost-effectively, particularly in areas with scarce instrumentation and/or difficult access. The pilot aims to improve disaster risk management (DRM) by working directly with the volcano observatories that are governmentally responsible for volcano monitoring as well as with the international space agencies (ESA, CSA, ASI, DLR, JAXA, NASA, CNES). The goal is to make sure that the most useful data are collected at each volcano following the guidelines of the Santorini report that observation frequency is related to volcano activity, and to communicate the results to the local institutions in a timely fashion. Here we highlight how coordinated multi-satellite observations have been used by volcano observatories to monitor volcanoes and respond to crises. Our primary tool is measurements of ground deformation made by Interferometric Synthetic Aperture Radar (InSAR), which have been used in conjunction with other observations to determine the alert level at these volcanoes, served as an independent check on ground sensors, guided the deployment of ground instruments, and aided situational awareness. During this time period, we find 26 volcanoes deforming, including 18 of the 28 volcanoes that erupted – those eruptions without deformation were less than 2 on the VEI scale. Another 7 volcanoes were restless and the volcano observatories requested satellite observations, but no deformation was detected. We describe the lessons learned about the data products and information that are most needed by the volcano observatories in the different countries using information collected by questionnaires. We ...

Within Latin America, about 319 volcanoes have been active in the Holocene, but 202 of these volcanoes have no seismic, deformation or gas monitoring. Following the 2012 Santorini Report on satellite Earth Observation and Geohazards, the Committee on Earth Observation Satellites (CEOS) developed a 4-year pilot project (2013-2017) to demonstrate how satellite observations can be used to monitor large numbers of volcanoes cost-effectively, particularly in areas with scarce instrumentation and/or difficult access. The pilot aims to improve disaster risk management (DRM) by working directly with the volcano observatories that are governmentally responsible for volcano monitoring as well as with the international space agencies (ESA, CSA, ASI, DLR, JAXA, NASA, CNES). The goal is to make sure that the most useful data are collected at each volcano following the guidelines of the Santorini report that observation frequency is related to volcano activity, and to communicate the results to the local institutions in a timely fashion. Here we highlight how coordinated multi-satellite observations have been used by volcano observatories to monitor volcanoes and respond to crises. Our primary tool is measurements of ground deformation made by Interferometric Synthetic Aperture Radar (InSAR), which have been used in conjunction with other observations to determine the alert level at these volcanoes, served as an independent check on ground sensors, guided the deployment of ground instruments, and aided situational awareness. During this time period, we find 26 volcanoes deforming, including 18 of the 28 volcanoes that erupted – those eruptions without deformation were less than 2 on the VEI scale. Another 7 volcanoes were restless and the volcano observatories requested satellite observations, but no deformation was detected. We describe the lessons learned about the data products and information that are most needed by the volcano observatories in the different countries using information collected by questionnaires. We propose a practical strategy for regional to global satellite volcano monitoring for use by volcano observatories in Latin America and elsewhere to realize the vision of the Santorini report. ; Por pares