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New technologies with the potential to improve the health of populations are continuously being introduced. But not every technological development results in clear health gains. Health technology assessment provides evidence-based information on the coverage and usage of health technologies, enabling them to be evaluated properly and applied to health care efficaciously, promoting the most effective ones while also taking into account organizational, societal and ethical issues. This book reviews the relationship between health technology assessment and policy-making, and examines how to incr

A series of aggressive measures was launched by the Chinese government to reduce pollutant emissions from Beijing and surrounding areas during the Olympic Games. Observations at Miyun, a rural site 100 km downwind of the Beijing urban center, show significant decreases in concentrations of O 3 , CO, NO y , and SO 2 during August 2008, relative to August 2006–2007. The mean daytime mixing ratio of O 3 was lower by about 15 ppbv, reduced to 50 ppbv, in August 2008. The relative reductions in daytime SO 2 , CO, and NO y were 61%, 25%, and 21%, respectively. Changes in SO 2 and in species correlations from 2007 to 2008 indicate that emissions of SO 2 , CO, and NO x were reduced at least by 60%, 32%, and 36%, respectively, during the Olympics. Analysis of meteorological conditions and interpretation of observations using a chemical transport model suggest that although the day-to-day variability in ozone is driven mostly by meteorology, the reduction in emissions of ozone precursors associated with the Olympic Games had a significant contribution to the observed decrease in O 3 during August 2008, accounting for 80% of the O 3 reduction for the month as a whole and 45% during the Olympics Period (8–24 August). The model predicts that emission restrictions such as those implemented during the Olympics can affect O 3 far beyond the Beijing urban area, resulting in reductions in boundary layer O 3 of 2–10 ppbv over a large region of the North China Plain and Northeastern China.

A series of aggressive measures was launched by the Chinese government to reduce pollutant emissions from Beijing and surrounding areas during the Olympic Games. Observations at Miyun, a rural site 100 km downwind of the Beijing urban center, show significant decreases in concentrations of O3, CO, NOy, and SO2 during August 2008, relative to August 2006–2007. The mean daytime mixing ratio of O3 was lower by about 15 ppbv, reduced to 50 ppbv, in August 2008. The relative reductions in daytime SO2, CO, and NOy were 61%, 25%, and 21%, respectively. Changes in SO2 and in species correlations from 2007 to 2008 indicate that emissions of SO2, CO, and NOx were reduced at least by 60%, 32%, and 36%, respectively, during the Olympics. Analysis of meteorological conditions and interpretation of observations using a chemical transport model suggest that although the day-to-day variability in ozone is driven mostly by meteorology, the reduction in emissions of ozone precursors associated with the Olympic Games had a significant contribution to the observed decrease in O3 during August 2008, accounting for 80% of the O3 reduction for the month as a whole and 45% during the Olympics Period (8–24 August). The model predicts that emission restrictions such as those implemented during the Olympics can affect O3 far beyond the Beijing urban area, resulting in reductions in boundary layer O3 of 2–10 ppbv over a large region of the North China Plain and Northeastern China.

Summary: Individuals with low socio-economic status (SES) have a higher risk of dying following hip fracture compared with individuals with high SES. Evidence on social inequalities in non-hip fractures is lacking as well as evidence on the impact of SES on health-related quality of life post fracture. Introduction: Fragility fractures, especially of the hip, cause substantial excess mortality and impairment in health-related quality of life (HRQoL). This systematic review and meta-analysis aimed to investigate the association between socio-economic status (SES) and post-fracture mortality and HRQoL. Methods: PubMed, EMBASE and CINAHL databases were searched from inception to the last week of November 2018 for studies reporting an association between SES and post-fracture mortality and/or HRQoL among people aged ≥ 50 years. Risk ratios (RRs) were meta-analyzed using a standard inverse-variance-weighted random effects model. Studies using individual-level and area-based SES measures were analyzed separately. Results: A total of 24 studies from 15 different countries and involving more than one million patients with hip fractures were included. The overall risk of mortality within 1-year post-hip fracture in individuals with low SES was 24% higher than in individuals with high SES (RR 1.24, 95% CI 1.19 to 1.29) for individual-level SES measures, and 14% (RR 1.14, 95% CI 1.09 to 1.19) for area-based SES measures. The quality of the evidence for the outcome mortality was moderate. Using individual SES measures, we estimated the excess HRQoL loss to be 5% (95% CI − 1 to 10%) among hip fracture patients with low SES compared with high SES. Conclusions: We found a consistently increased risk of post-hip fracture mortality with low SES across SES measures and across countries with different political structures and different health and social care infrastructures. The impact of SES on post-fracture HRQoL remains uncertain due to sparse and low-quality evidence.

SUMMARY: Individuals with low socio-economic status (SES) have a higher risk of dying following hip fracture compared with individuals with high SES. Evidence on social inequalities in non-hip fractures is lacking as well as evidence on the impact of SES on health-related quality of life post fracture. INTRODUCTION: Fragility fractures, especially of the hip, cause substantial excess mortality and impairment in health-related quality of life (HRQoL). This systematic review and meta-analysis aimed to investigate the association between socio-economic status (SES) and post-fracture mortality and HRQoL. METHODS: PubMed, EMBASE and CINAHL databases were searched from inception to the last week of November 2018 for studies reporting an association between SES and post-fracture mortality and/or HRQoL among people aged ≥ 50 years. Risk ratios (RRs) were meta-analyzed using a standard inverse-variance-weighted random effects model. Studies using individual-level and area-based SES measures were analyzed separately. RESULTS: A total of 24 studies from 15 different countries and involving more than one million patients with hip fractures were included. The overall risk of mortality within 1-year post-hip fracture in individuals with low SES was 24% higher than in individuals with high SES (RR 1.24, 95% CI 1.19 to 1.29) for individual-level SES measures, and 14% (RR 1.14, 95% CI 1.09 to 1.19) for area-based SES measures. The quality of the evidence for the outcome mortality was moderate. Using individual SES measures, we estimated the excess HRQoL loss to be 5% (95% CI - 1 to 10%) among hip fracture patients with low SES compared with high SES. CONCLUSIONS: We found a consistently increased risk of post-hip fracture mortality with low SES across SES measures and across countries with different political structures and different health and social care infrastructures. The impact of SES on post-fracture HRQoL remains uncertain due to sparse and low-quality evidence.