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PP167 Cost Effectiveness Of Universal Childhood Vaccination Against Hepatitis A
- Cristina Valcarcel-Nazco, Carmen Guirado-Fuentes, Lidia García-Pérez, Renata Linertová, Javier Mar, Aurora Limia-Sánchez, Marta Soler-Soneira, Carmen Varela-Martínez, Pedro Serrano-Aguilar
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- Journal:
- International Journal of Technology Assessment in Health Care / Volume 37 / Issue S1 / December 2021
- Published online by Cambridge University Press:
- 03 December 2021, p. 24
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Introduction
Hepatitis A (HA) is a liver disease with a low mortality rate, but it can cause debilitating symptoms and fulminant hepatitis in some cases. Its incidence is greater in geographical areas with poor sanitation and hygiene. Spain is considered a low-endemicity country, so universal childhood immunization against HA is currently not financed by the National Health System. The aim of this study was to synthesize the scientific evidence on the cost effectiveness of universal childhood vaccination against HA.
MethodsFull economic evaluations, published in the English or Spanish languages, were included if they reported outcome measures related to the prevention of HA, adverse effects, or incremental cost-effectiveness ratios (ICERs). The Medline, Embase and Cochrane Library databases were searched for articles published from the beginning of the databases to April 2018.
ResultsA total of 23 economic evaluations were included: one in a country of high endemicity, nine in countries of intermediate endemicity, and 13 in countries with low endemicity. Only one Spanish study, published in 1997, was found. Studies conducted in high- and intermediate- endemicity countries concluded that a universal childhood vaccination program against HA was a cost-effective option. However, in the case of countries with low endemicity the results were heterogeneous, although most agreed that a systematic vaccination strategy would not be a cost-effective option and that the adoption of such a strategy would not be justified given the limited benefits it would offer. The results of the economic evaluations depended on parameters such as the price and duration of the vaccine effect and the program coverage.
ConclusionsIn countries with low endemicity the results were heterogeneous, although most studies concluded that the implementation of a universal vaccination strategy is not justified from the point of view of cost effectiveness.
Chapter 9 - Art to Seal the Memory: Coronation Ceremonies and the Sword as Symbol of Power (Aragon, 1200–1400)
- Edited by Flocel Sabaté
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- Book:
- Memory in the Middle Ages
- Published by:
- Amsterdam University Press
- Published online:
- 09 June 2021
- Print publication:
- 28 February 2021, pp 229-252
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Summary
MANY SCHOLARS, OF whom Adeline Rucquoi is one of the most prominent, have recommended eradicating the term “legitimation” from any discussion of monarchical institutions in the Iberian Peninsula, a conclusion to which I concur after my studies on Spanish royal symbols and insignia in material, documentary, and iconographic sources. Successors to the throne of Aragon were authorized by the right of primogeniture; so, a successor's investiture as King of Aragon was based on this principle alone. The case of James or Jaume I “the Conqueror” is illustrative because although he never took part in any coronation ceremony, in 1213 he was named King of Aragon immediately after the death of his father Peter the Great, King of Aragon, Count of Barcelona, and Lord of Montpellier.3 Nevertheless, I use this problematic term extensively throughout this chapter because the fact that James I was denied a formal coronation led him to create a series of other techniques designed to legitimize his rule. One of the strongest and most illuminating arguments in favour of this hypothesis was put forward by Bonifacio Palacios, who stated that James I invoked the “right of conquest” to justify his sovereignty over newly conquered lands. However, as we will see, James I also employed other legitimizing narratives, such as the supposed assistance that he received from St. George during his conquest of the kingdoms of Mallorca and Valencia, because, of course, the idealized image of the monarch was not limited to the military sphere alone, but had to portray other virtues such as religious legitimacy.
This chapter shows how and to what extent these legitimizing techniques, motivated by the lack of a Church-sanctioned coronation, were reflected in the iconography of Iberian kings of the Middle Ages, in particular James I (the Conqueror) and Peter the Ceremonious, and how they were used to seal into memory a set of arguments. It also determines why Peter the Ceremonious, who had to assert his potestas over the increasingly powerful estates, was so active in disseminating these techniques through texts and images and thereby fixing them in the memory of his subjects. As has been stated elsewhere, Hispanic medieval culture was, in itself, a memorial culture that sought to foster solemn recollection in which art played an indispensable role.
Diagnostic Interview for Genetic Studies (DIGS): Inter-rater and test-retest reliability and validity in a Spanish population
- Miguel Roca, Rocio Martin-Santos, Jerónimo Saiz, Jordi Obiols, Maria J. Serrano, Marta Torrens, Susana Subirà, Margalida Gili, Ricard Navinés, Angela Ibañez, Marcos Nadal, Nieves Barrantes, Francesca Cañellas
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- Journal:
- European Psychiatry / Volume 22 / Issue 1 / January 2007
- Published online by Cambridge University Press:
- 16 April 2020, pp. 44-48
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Objective
To test the reliability and validity of the DIGS in Spanish population.
MethodsInter-rater and test-retest reliability of the Spanish version of DIGS was tested in 95 inpatients and outpatients. The resultant diagnoses were compared with diagnoses obtained by the LEAD (Longitudinal Expert All Data) procedure as “gold standard”. The kappa statistic was used to measure concordance between blind inter-raters and between the diagnoses obtained by LEAD procedure and through the DIGS.
ResultsOverall kappa coefficient for inter-rater reliability was 0.956. The kappa value for individual diagnosis varied from major depression = 0.877 to schizophrenia = 1. Test-retest reliability was 0.926. Kappa for all individual target diagnoses ranged from 0.776 (major depression) to 1. Kappa between LEAD procedure and DIGS ranged from 0.704 (major depression) to 0.825 (bipolar I disorder).
ConclusionMost of the DSM-IV major psychiatric disorders can be assessed with acceptable to excellent reliability with the Spanish version of the DIGS interview. The Spanish version of DIGS showed an acceptable to excellent concurrent validity. Giving the good reliability and validity of Spanish version of DIGS it should be considered to identify psychiatric phenotypes for genetics studies.
Response of Durum Wheat (Triticum turgidum L. var. durum) Cultivars to Imazamethabenz and PP-604
- Jaime Lloveras, Jose Garcia Baudin, Josep M. Balague, Marta Serrano
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- Journal:
- Weed Technology / Volume 14 / Issue 2 / June 2000
- Published online by Cambridge University Press:
- 20 January 2017, pp. 274-278
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Field experiments were conducted in the Mediterranean conditions of the Ebro Valley, Spain during 1995 to 1996 and 1996 to 1997 to determine the effects of imazamethabenz and PP-604 on selected durum wheat Triticum turgidum var. durum cultivars grown under irrigation. Herbicides were applied at their recommended rates of 600 g ai/ha for imazamethabenz and 375 g ai/ha for PP-604 and at twice these rates. Herbicide treatment reduced the average wheat height in three of four trials. Wheat treated with imazamethabenz was almost 2 cm shorter than wheat treated with PP-604 and almost 3 cm shorter than untreated control plants. However, durum wheat yields were not significantly reduced by treatment with imazamethabenz or PP-604 in any of the four trials, and no visible plant injury was observed. These results differ from reported yield reductions under Mediterranean dryland conditions, suggesting that durum wheat can be affected by imazamethabenz and PP-604 but irrigation enhances recovery from herbicide injury.
Use of vitamin D supplements during infancy in an international feeding trial
- Eveliina Lehtonen, Anne Ormisson, Anita Nucci, David Cuthbertson, Susa Sorkio, Mila Hyytinen, Kirsi Alahuhta, Carol Berseth, Marja Salonen, Shayne Taback, Margaret Franciscus, Teba González-Frutos, Tuuli E Korhonen, Margaret L Lawson, Dorothy J Becker, Jeffrey P Krischer, Mikael Knip, Suvi M Virtanen, , Thomas Mandrup-Poulsen, Elias Arjas, Åke Lernmark, Barbara Schmidt, Jeffrey P. Krischer, Hans K. Åkerblom, Mila Hyytinen, Mikael Knip, Katriina Koski, Matti Koski, Eeva Pajakkala, Marja Salonen, David Cuthbertson, Jeffrey P. Krischer, Linda Shanker, Brenda Bradley, Hans-Michael Dosch, John Dupré, William Fraser, Margaret Lawson, Jeffrey L. Mahon, Mathew Sermer, Shayne P. Taback, Dorothy Becker, Margaret Franciscus, Anita Nucci, Jerry Palmer, Minna Pekkala, Suvi M. Virtanen, Jacki Catteau, Neville Howard, Patricia Crock, Maria Craig, Cheril L. Clarson, Lynda Bere, David Thompson, Daniel Metzger, Colleen Marshall, Jennifer Kwan, David K. Stephure, Daniele Pacaud, Wendy Schwarz, Rose Girgis, Marilyn Thompson, Shayne P. Taback, Daniel Catte, Margaret L. Lawson, Brenda Bradley, Denis Daneman, Mathew Sermer, Mary-Jean Martin, Valérie Morin, Lyne Frenette, Suzanne Ferland, Susan Sanderson, Kathy Heath, Céline Huot, Monique Gonthier, Maryse Thibeault, Laurent Legault, Diane Laforte, Elizabeth A. Cummings, Karen Scott, Tracey Bridger, Cheryl Crummell, Robyn Houlden, Adriana Breen, George Carson, Sheila Kelly, Koravangattu Sankaran, Marie Penner, Richard A. White, Nancy King, James Popkin, Laurie Robson, Eva Al Taji, Irena Aldhoon, Pavla Mendlova, Jan Vavrinec, Jan Vosahlo, Ludmila Brazdova, Jitrenka Venhacova, Petra Venhacova, Adam Cipra, Zdenka Tomsikova, Petra Krckova, Pavla Gogelova, Ülle Einberg, Mall-Anne Riikjärv, Anne Ormisson, Vallo Tillmann, Päivi Kleemola, Anna Parkkola, Heli Suomalainen, Anna-Liisa Järvenpää, Anu-Maaria Hämälainen, Hannu Haavisto, Sirpa Tenhola, Pentti Lautala, Pia Salonen, Susanna Aspholm, Heli Siljander, Carita Holm, Samuli Ylitalo, Raisa Lounamaa, Anja Nuuja, Timo Talvitie, Kaija Lindström, Hanna Huopio, Jouni Pesola, Riitta Veijola, Päivi Tapanainen, Abram Alar, Paavo Korpela, Marja-Liisa Käär, Taina Mustila, Ritva Virransalo, Päivi Nykänen, Bärbel Aschemeier, Thomas Danne, Olga Kordonouri, Dóra Krikovszky, László Madácsy, Yeganeh Manon Khazrai, Ernesto Maddaloni, Paolo Pozzilli, Carla Mannu, Marco Songini, Carine de Beaufort, Ulrike Schierloh, Jan Bruining, Margriet Bisschoff, Aleksander Basiak, Renata Wasikowa, Marta Ciechanowska, Grazyna Deja, Przemyslawa Jarosz-Chobot, Agnieszka Szadkowska, Katarzyna Cypryk, Malgorzata Zawodniak-Szalapska, Luis Castano, Teba Gonzalez Frutos, Mirentxu Oyarzabal, Manuel Serrano-Ríos, María Teresa Martínez-Larrad, Federico Gustavo Hawkins, Dolores Rodriguez Arnau, Johnny Ludvigsson, Malgorzata Smolinska Konefal, Ragnar Hanas, Bengt Lindblad, Nils-Osten Nilsson, Hans Fors, Maria Nordwall, Agne Lindh, Hans Edenwall, Jan Aman, Calle Johansson, Margrit Gadient, Eugen Schoenle, Dorothy Becker, Ashi Daftary, Margaret Franciscus, Carol Gilmour, Jerry Palmer, Rachel Taculad, Marilyn Tanner-Blasiar, Neil White, Uday Devaskar, Heather Horowitz, Lisa Rogers, Roxana Colon, Teresa Frazer, Jose Torres, Robin Goland, Ellen Greenberg, Maudene Nelson, Holly Schachner, Barney Softness, Jorma Ilonen, Massimo Trucco, Lynn Nichol, Erkki Savilahti, Taina Härkönen, Mikael Knip, Outi Vaarala, Kristiina Luopajärvi, Hans-Michael Dosch
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- Journal:
- Public Health Nutrition / Volume 17 / Issue 4 / April 2014
- Published online by Cambridge University Press:
- 24 June 2013, pp. 810-822
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Objective
To examine the use of vitamin D supplements during infancy among the participants in an international infant feeding trial.
DesignLongitudinal study.
SettingInformation about vitamin D supplementation was collected through a validated FFQ at the age of 2 weeks and monthly between the ages of 1 month and 6 months.
SubjectsInfants (n 2159) with a biological family member affected by type 1 diabetes and with increased human leucocyte antigen-conferred susceptibility to type 1 diabetes from twelve European countries, the USA, Canada and Australia.
ResultsDaily use of vitamin D supplements was common during the first 6 months of life in Northern and Central Europe (>80 % of the infants), with somewhat lower rates observed in Southern Europe (>60 %). In Canada, vitamin D supplementation was more common among exclusively breast-fed than other infants (e.g. 71 % v. 44 % at 6 months of age). Less than 2 % of infants in the USA and Australia received any vitamin D supplementation. Higher gestational age, older maternal age and longer maternal education were study-wide associated with greater use of vitamin D supplements.
ConclusionsMost of the infants received vitamin D supplements during the first 6 months of life in the European countries, whereas in Canada only half and in the USA and Australia very few were given supplementation.
Influence of Container Base Material (Fe) on SIMFUEL Leaching Behavior
- J. Quiñones, J.A. Serrano, P.P. Díaz, J.L. Rodríguez Almazán, J. Cobos, J.A. Esteban, A. Martà–nez-Esparza
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- Journal:
- MRS Online Proceedings Library Archive / Volume 663 / 2000
- Published online by Cambridge University Press:
- 21 March 2011, 435
- Print publication:
- 2000
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The chemical stability of spent fuel will be greatly influenced by the redox potential of the near field. Presence of reductants such as iron is likely to be an important factor to maintain the original integrity of spent fuel. In this work experimental data about the influence of metallic iron (container base material) on SIMFUEL leaching behavior under simulated granite and saline repository conditions is presented. In the presence of iron uranium concentration undergoes a sharp decrease. This is much more noticeable in the experiments performed under initial oxic conditions. The effect of iron on simulated fission products of SIMFUEL is very important for the elements with high redox sensitivity such us molybdenum. On the contrary, strontium remains stable during the entire tests and it seems not be affected by changes in redox potential.