Party Politics and Economic Reform in Africa's Democracies
In: African affairs: the journal of the Royal African Society, Band 113, Heft 451, S. 321-322
ISSN: 1468-2621
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In: African affairs: the journal of the Royal African Society, Band 113, Heft 451, S. 321-322
ISSN: 1468-2621
In: African affairs: the journal of the Royal African Society, Band 103, Heft 411, S. 319-320
ISSN: 1468-2621
In: Neue politische Literatur: Berichte aus Geschichts- und Politikwissenschaft ; (NPL), Band 39, Heft 1, S. 22
ISSN: 0028-3320
In: German politics: Journal of the Association for the Study of German Politics, Band 3, Heft 2, S. 233-248
ISSN: 0964-4008
THE 1988 HEALTH REFORM WAS SUBSTANTIALLY UNDERMINED BY THE INFLUENCE OF POWERFUL PRESSURE GROUPS REPRESENTING THE INTERESTS OF THE MEDICAL PROFESSION AND THE PHARMACEUTICAL INDUSTRY AND RESISTANCE FROM THE GERMAN FEDERAL STATES. CONSEQUENTLY, IT FAILED TO ACHIEVE ITS AIM OF 'CUTTING COSTS'. THE THEORY SUPPORTING 'RESISTANCE TO REFORM WITHIN THE HEALTH CARE SYSTEM' WAS WIDELY ACCEPTED IN THE LITERATURE ON THE SUBJECT. THE 1992 REFORM APPEARED TO CONTRADICT THIS THEORY, AS THE POLITICAL LEADERSHIP SUCCEEDED IN OVERCOMING BOTH PARTY POLICY AND INTERGOVERNMENTAL DIFFERENCES, AS WELL AS MAKING CONSIDERABLE COST SAVINGS AND STRUCTURAL CHANGES IN SPITE OF RESISTANCE FROM THE OPPOSITION 'LOBBY'. THREE FACTORS WERE RESPONSIBLE FOR THIS. THEY WERE UNDER ENORMOUS PRESSURE TO ACT DUE TO THE FINANCIAL CRISIS AND THE INTERDEPENDENT COSTS WITHIN THE WELFARE STATE, THE CHANGING MOTIVES WITHIN THE HEALTH CARE SYSTEM, AND A NEW POLITICAL STRATEGY WHICH RESPONDED TO THIS. IN THE LONG TERM, PROSPECTS ARE FOR A TREND TOWARDS 'GREATER PRIVATISATION'.
In: Werkstattstechnik: wt, Band 101, Heft 11-12, S. 775-776
ISSN: 1436-4980
In: Werkstattstechnik: wt, Band 104, Heft 9, S. 535-540
ISSN: 1436-4980
As antimicrobial susceptibility of common bacterial pathogens decreases, ensuring optimal dosing may preserve the use of older antibiotics in order to limit the spread of resistance to newer agents. Beta-lactams represent the most widely prescribed antibiotic class, yet most were licensed prior to legislation changes mandating their study in children. As a result, significant heterogeneity persists in the pediatric doses used globally, along with quality of evidence used to inform dosing. This review summarizes dosing recommendations from the major pediatric reference sources and tries to answer the questions: Does beta-lactam dose heterogeneity matter? Does it impact pharmacodynamic target attainment? For three important severe clinical infections-pneumonia, sepsis, and meningitis-pharmacokinetic models were identified for common for beta-lactam antibiotics. Real-world demographics were derived from three multicenter point prevalence surveys. Simulation results were compared with minimum inhibitory concentration distributions to inform appropriateness of recommended doses in targeted and empiric treatment. While cephalosporin dosing regimens are largely adequate for target attainment, they also pose the most risk of neurotoxicity. Our review highlights aminopenicillin, piperacillin, and meropenem doses as potentially requiring review/optimization in order to preserve the use of these agents in future.
BASE
Background: The COVID-19 pandemic has disrupted routine hospital services globally. This study estimated the total number of adult elective operations that would be cancelled worldwide during the 12 weeks of peak disruption due to COVID-19. Methods: A global expert response study was conducted to elicit projections for the proportion of elective surgery that would be cancelled or postponed during the 12 weeks of peak disruption. A Bayesian β-regression model was used to estimate 12-week cancellation rates for 190 countries. Elective surgical case-mix data, stratified by specialty and indication (surgery for cancer versus benign disease), were determined. This case mix was applied to country-level surgical volumes. The 12-week cancellation rates were then applied to these figures to calculate the total number of cancelled operations. Results: The best estimate was that 28 404 603 operations would be cancelled or postponed during the peak 12 weeks of disruption due to COVID-19 (2 367 050 operations per week). Most would be operations for benign disease (90·2 per cent, 25 638 922 of 28 404 603). The overall 12-week cancellation rate would be 72·3 per cent. Globally, 81·7 per cent of operations for benign conditions (25 638 922 of 31 378 062), 37·7 per cent of cancer operations (2 324 070 of 6 162 311) and 25·4 per cent of elective caesarean sections (441 611 of 1 735 483) would be cancelled or postponed. If countries increased their normal surgical volume by 20 per cent after the pandemic, it would take a median of 45 weeks to clear the backlog of operations resulting from COVID-19 disruption. Conclusion: A very large number of operations will be cancelled or postponed owing to disruption caused by COVID-19. Governments should mitigate against this major burden on patients by developing recovery plans and implementing strategies to restore surgical activity safely.
BASE