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Page 1 of 2

  • Pandemic Effect on Healthcare Use and Death in Adults with Epilepsy: A Population Study

  • Maria Espinoza Vargas, Andrea S. Gershon, Michael Pugliese, Ryan Jason Gotfrit, Douglas Manuel, Mohsen Sadatsafavi, Therese A. Stukel, Teresa To, Claire E. Kendall, Kednapa Thavorn, Rebecca Robillard, Tetyana Kendzerska
  • Journal:
    Canadian Journal of Neurological Sciences / Volume 51 / Issue 5 / September 2024
    Published online by Cambridge University Press:
    20 December 2023, pp. 616-626
    • Article
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  • Objectives:

    We conducted a population-based study using Ontario health administrative data to describe trends in healthcare utilization and mortality in adults with epilepsy during the first pandemic year (March 2020–March 2021) compared to historical data (2016–2019). We also investigated if changes in outpatient visits and diagnostic testing during the first pandemic year were associated with increased risk for hospitalizations, emergency department (ED) visits, or death.

    Methods:

    Projected monthly visit rates (per 100,000 people) for outpatient visits, electroencephalography, magnetic resonance, computed tomography, all-cause ED visits, hospitalizations, and mortality were calculated based on historical data by fitting monthly time series autoregressive integrated moving-average models. Two-way interactions were calculated using Quasi-Poisson models.

    Results:

    In adults with epilepsy during the first quarter of the pandemic, we demonstrated a reduction in all-cause outpatient visits, diagnostic testing, ED visits and hospitalizations, and a temporary increase in mortality (observed rates of 355.8 vs projected 308.8, 95% CI: 276.3–345.1). By the end of the year, outpatient visits increased (85,535.4 vs 76,620.6, 95% CI: 71,546.9–82,059.4), and most of the diagnostic test rates returned to the projected. The increase in the rate of all-cause mortality during the pandemic, compared to pre-pandemic, was greater during months with the lower frequency of diagnostic tests than months with higher frequency (interaction p-values <.0001).

    Conclusion:

    We described the impact of the pandemic on healthcare utilization and mortality in adults with epilepsy during the first year. We demonstrated that access to relevant diagnostic testing is likely important for this population while planning restrictions on non-urgent health services.

  • 1 - Introduction

  • Edited by Marc Weller, University of Cambridge, Mark Retter, University of Cambridge, Andrea Varga, University of Cambridge
  • Book:
    International Law and Peace Settlements
    Published online:
    14 January 2021
    Print publication:
    04 February 2021, pp 1-28

  • Summary

    This introductory chapter identifies the key questions and themes for the International Law and Peace Settlements volume, and provides a framework and conceptual map for analysing the relationship between international law and peace settlement practice. In particular, it examines the concepts of peace and war, and their relation to law, before developing a working lexicon for peace agreements and settlements. The chapter then critically examines the legal character of peace agreements and settlement commitments as ‘legal tools’ for peace-making. This analysis provides essential foundations to map out the ways in which peace settlements and international law can interact. Those forms of interaction become key focal points for the various contributions in the remainder of the volume. The thematic rationale and structure of the volume is explained to orientate the reader in light of its key themes and questions.

  • 10 - Witnesses and Guarantors

  • from Part III - Key Actors and the Role of International Law
  • Edited by Marc Weller, University of Cambridge, Mark Retter, University of Cambridge, Andrea Varga, University of Cambridge
  • Book:
    International Law and Peace Settlements
    Published online:
    14 January 2021
    Print publication:
    04 February 2021, pp 211-236

  • Summary

    While third states and international organisations often co-sign peace agreements in the capacity of witnesses or guarantors, little is understood of the legal consequences flowing from these roles. The chapter aims to fill this gap. First, it highlights that the mere designation of witness or guarantor leads to few consequences. Second, it analyses how specific third-party rights and obligations are established and conceptualised under VCLT rules, extended by analogy to intra-state peace agreements. Third, it provides a brief illustration of common third-party rights and obligations in peace agreements. Finally, it examines whether the involvement of third parties can internationalise an intra-state peace agreement, i.e. render it to be governed by international law. Bringing together views from the literature, jurisprudence and the preceding analysis on the structure of third-party rights and obligations, the chapter concludes that such rights and obligations can be internationalised, in a manner that can only extend to the agreement as a whole when inseparable from the rest of the agreement.

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