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We examine the investment performance of Chilean pension funds during their multi-fund period (2003–17). Using tradable asset class benchmarks, we extend Sharpe's (1992) return-based style analysis by explicitly considering regulatory restrictions and currency hedging. We find that despite the significant differences between pension fund manager returns, they are statistically similar to our style benchmarks for all fund types. Furthermore, accounting for currency hedging improves the accuracy of the replicating portfolios and the selection return estimates. Our results have policy implications for investment regulation of pension systems with similar characteristics to the Chilean one.
Urban slums provide suitable conditions for infestation by rats, which harbour and shed a wide diversity of zoonotic pathogens including helminths. We aimed to identify risk factors associated with the probability and intensity of infection of helminths of the digestive tract in an urban slum population of Rattus norvegicus. Among 299 rats, eleven species/groups of helminths were identified, of which Strongyloides sp., Nippostrongylus brasiliensis and, the human pathogen, Angiostrongylus cantonensis were the most frequent (97, 41 and 39%, respectively). Sex interactions highlighted behavioural differences between males and females, as eg males were more likely to be infected with N. brasiliensis where rat signs were present, and males presented more intense infections of Strongyloides sp. Moreover, rats in poor body condition had higher intensities of N. brasiliensis. We describe a high global richness of parasites in R. norvegicus, including five species known to cause disease in humans. Among these, A. cantonensis was found in high prevalence and it was ubiquitous in the study area – knowledge which is of public health importance. A variety of environmental, demographic and body condition variables were associated with helminth species infection of rats, suggesting a comparable variety of risk factors for humans.
Introduction
Opioids are the most effective treatment in patients with cancer pain (Health and Welfare, Canada, 1984; Foley, 1985). The general principles of pharmacology that are described elsewhere apply also to cancer patients. However, pain syndromes in cancer are unique in intensity and duration, so that opioids must be used at the highest doses in clinical medicine. In addition, cancer patients present with a number of devastating symptoms that require specific treatment, including nausea, delirium, asthenia, and dyspnea. These symptoms and the drugs used in their treatment influence the pattern of opioid use.
This chapter discusses some of the unique characteristics of pain syndromes and clinical situations of cancer patients and their implications for opioid management of cancer pain.
Characteristics of Patients with Cancer Pain
Approximately 80% of cancer patients develop pain before death (Health and Welfare, Canada, 1984; Foley, 1985). Pain occurs more frequently in patients with locally advanced or metastatic cancer, and in approximately 80% of cases the pain is due to the presence of the tumor (Foley, 1985). However, almost one in five advanced cancer patients experience pain as a function of the treatment (radiotherapy or surgical fibrosis, chemotherapy-induced neuropathies), general weakness (tendon retraction, pressure ulcers), or unrelated conditions. Therefore, it is crucial to establish the cause of the pain even in patients with documented disseminated cancer.
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