AIM: To estimate the burden of undiagnosed celiac disease (CD) in the Mediterranean area in terms of morbidity, mortality and health cost. METHODS: For statistics regarding the population of each country in the Medite...AIM: To estimate the burden of undiagnosed celiac disease (CD) in the Mediterranean area in terms of morbidity, mortality and health cost. METHODS: For statistics regarding the population of each country in the Mediterranean area, we accessed authoritative international sources (World Bank, World Health Organization and United Nations). The prevalence of CD was obtained for most countries from published reports. An overall prevalence rate of 1% cases/total population was finally estimated to represent the frequency of the disease in the area, since none of the available conf idence intervals of the reported rates significantly excluded this rate. The distribution of symptoms and complications was obtained from reliable reports in the same cohort. A standardized mortality rate of 1.8 was obtained from recent reports. Crude health cost was estimated for the years between symptoms and diagnosis for adults and children, and was standardized for purchasing power parity to account for the different economic prof iles amongst Mediterranean countries. RESULTS: In the next 10 years, the Mediterranean area will have about half a billion inhabitants, of which 120 million will be children. The projected number of CD diagnoses in 2020 is 5 million cases (1 million celiac children), with a relative increase of 11% compared to 2010. Based on the 2010 rate, there will be about 550 000 symptomatic adults and about 240 000 sick children: 85% of the symptomatic patients will suffer from gastrointestinal complaints, 40% are likely to have anemia, 30% will likely have osteopenia, 20% of children will have short stature, and 10% will have abnormal liver enzymes. The estimated standardized medical costs for symptomatic celiac patients during the delay between symptom onset and diagnosis (mean 6 years for adults, 2 years for children) will be about €4 billion (€387 million for children) over the next 10 years. A delay in diagnosis is expected to increase mortality: about 600 000 celiac patients will die in the next 10 years, with an excess of 44.4% vs age-and sexmatched controls. CONCLUSION: In the near future, the burden of CD will increase tremendously. Few Mediterranean countries are able to face this expanding epidemic alone.展开更多
Japan experienced the retrenchment of the welfare state. The purpose of this study was to deepen the understanding of the impact these policy changes had on citizens’ organized activities. It focused on the 2016 revi...Japan experienced the retrenchment of the welfare state. The purpose of this study was to deepen the understanding of the impact these policy changes had on citizens’ organized activities. It focused on the 2016 revision of Long-Term Care Insurance (LTCI) system, which urged citizens to organize activities to support the frail seniors in their communities. Researchers conducted interviews in the Tokyo from February-March 2016. The subjects were six local officers in charge of LTCI implementation and 10 community members who led the voluntary activities organized as a response to the 2016 systemic revision. This study found that those leading voluntary activities were primarily baby boomers, who were born between 1947 and 1949. They were actively involved in “new voluntary activity movements” in the 1980s, as interacting with a wide range of citizens. However, as they reached the age of 65 or older, they became more focused on developing a comfortable space and collaborating with those similar to them: those who were college graduates, middle- to upper-class, and held white-collar jobs. The disparity based on income level seemed to be emphasized also because the way the 2016 revision of LTCI system was designed.展开更多
It is of great significance to enhance collaborative community policing for crime prevention and better community-police relationships. Understanding the relational structure of collaborative community policing is nec...It is of great significance to enhance collaborative community policing for crime prevention and better community-police relationships. Understanding the relational structure of collaborative community policing is necessary to pinpoint the pattern of interactions among key actors involved in community policing and improve the effectiveness of network governance. Based on 234 surveys of citizens of S Community in Beijing from April 2017 to May 2017, this paper empirically examines the characteristics of formal network and informal network of citizen participation in the collaborative community policing. Beijing is widely known for its active involvement of neighborhood volunteers in different types of community policing. We focused on four different types of interpersonal work relationships in this study: workflow, problem solving, mentoring and friendship, among resident committees, neighborhood administrative offices, media, police station, business security personnel, neighborhood volunteers, and security activists. The nature of relationships between individuals in networks can be treated as from instrumental ties to expressive ties. Expressive ties cover relationships that involve the exchange of friendship, trust, and socio-emotional support. We extended this intra-organizational insight into a community policing inter-organizational context. The collaborative network showed the trend of the distributed network. The clustering analysis showed that in the workflow network, we should make thll use of the close interaction between the citizens and activists in the community. Meanwhile, in the problem-solving network, mentoring network and friendship network, interactions between citizens and neighborhood committee are weak.展开更多
基金Supported by European Laboratory for Food Induced Diseases, Federico Ⅱ University of Naples
文摘AIM: To estimate the burden of undiagnosed celiac disease (CD) in the Mediterranean area in terms of morbidity, mortality and health cost. METHODS: For statistics regarding the population of each country in the Mediterranean area, we accessed authoritative international sources (World Bank, World Health Organization and United Nations). The prevalence of CD was obtained for most countries from published reports. An overall prevalence rate of 1% cases/total population was finally estimated to represent the frequency of the disease in the area, since none of the available conf idence intervals of the reported rates significantly excluded this rate. The distribution of symptoms and complications was obtained from reliable reports in the same cohort. A standardized mortality rate of 1.8 was obtained from recent reports. Crude health cost was estimated for the years between symptoms and diagnosis for adults and children, and was standardized for purchasing power parity to account for the different economic prof iles amongst Mediterranean countries. RESULTS: In the next 10 years, the Mediterranean area will have about half a billion inhabitants, of which 120 million will be children. The projected number of CD diagnoses in 2020 is 5 million cases (1 million celiac children), with a relative increase of 11% compared to 2010. Based on the 2010 rate, there will be about 550 000 symptomatic adults and about 240 000 sick children: 85% of the symptomatic patients will suffer from gastrointestinal complaints, 40% are likely to have anemia, 30% will likely have osteopenia, 20% of children will have short stature, and 10% will have abnormal liver enzymes. The estimated standardized medical costs for symptomatic celiac patients during the delay between symptom onset and diagnosis (mean 6 years for adults, 2 years for children) will be about €4 billion (€387 million for children) over the next 10 years. A delay in diagnosis is expected to increase mortality: about 600 000 celiac patients will die in the next 10 years, with an excess of 44.4% vs age-and sexmatched controls. CONCLUSION: In the near future, the burden of CD will increase tremendously. Few Mediterranean countries are able to face this expanding epidemic alone.
文摘Japan experienced the retrenchment of the welfare state. The purpose of this study was to deepen the understanding of the impact these policy changes had on citizens’ organized activities. It focused on the 2016 revision of Long-Term Care Insurance (LTCI) system, which urged citizens to organize activities to support the frail seniors in their communities. Researchers conducted interviews in the Tokyo from February-March 2016. The subjects were six local officers in charge of LTCI implementation and 10 community members who led the voluntary activities organized as a response to the 2016 systemic revision. This study found that those leading voluntary activities were primarily baby boomers, who were born between 1947 and 1949. They were actively involved in “new voluntary activity movements” in the 1980s, as interacting with a wide range of citizens. However, as they reached the age of 65 or older, they became more focused on developing a comfortable space and collaborating with those similar to them: those who were college graduates, middle- to upper-class, and held white-collar jobs. The disparity based on income level seemed to be emphasized also because the way the 2016 revision of LTCI system was designed.
文摘It is of great significance to enhance collaborative community policing for crime prevention and better community-police relationships. Understanding the relational structure of collaborative community policing is necessary to pinpoint the pattern of interactions among key actors involved in community policing and improve the effectiveness of network governance. Based on 234 surveys of citizens of S Community in Beijing from April 2017 to May 2017, this paper empirically examines the characteristics of formal network and informal network of citizen participation in the collaborative community policing. Beijing is widely known for its active involvement of neighborhood volunteers in different types of community policing. We focused on four different types of interpersonal work relationships in this study: workflow, problem solving, mentoring and friendship, among resident committees, neighborhood administrative offices, media, police station, business security personnel, neighborhood volunteers, and security activists. The nature of relationships between individuals in networks can be treated as from instrumental ties to expressive ties. Expressive ties cover relationships that involve the exchange of friendship, trust, and socio-emotional support. We extended this intra-organizational insight into a community policing inter-organizational context. The collaborative network showed the trend of the distributed network. The clustering analysis showed that in the workflow network, we should make thll use of the close interaction between the citizens and activists in the community. Meanwhile, in the problem-solving network, mentoring network and friendship network, interactions between citizens and neighborhood committee are weak.