Search

The J-value is an objective method for determining when life extending measures are sen- sible, applicable to both manufacturing and service industries, including public health and healthcare. A model of human decision making based on the J-value is able to explain the shape of the Preston curve that relates life expectancy at birth and gross domestic product (GDP) per head for all the nations in the world. Making a number of reasonable assumptions, a J-value model produces a population-average life expectancy, which may be translated easily into a corresponding life expectancy at birth when life expectancy is not modified by discounting (net discount rate equals zero). The resultant values may be tested against pan-national data, showing a very good match. Thus the shape of the Preston curve has been explained and, at the same time, validation has been provided for the J-value model. A perturbation analysis shows th a t the J-value explanation for the Preston curve starts to break down as the net discount rate is increased above zero. Thus the Preston curve may be seen to validate the J-value model at a net discount rate of zero, but not at higher net discount rates. The result allows a closed-form expression to be derived for the first time for the pure time discount rate, namely the product of the rate of economic growth and the complement of risk-aversion. A further conclusion from the work is that no discernable limit is apparent before the age of 100 to the process by which people live longer as they get richer; such an intrinsic limit might be overcome by future improved medical technology. [ABSTRACT FROM AUTHOR]

Following the accident at the Chernobyl Nuclear Power Plant in 1986, the United Kingdom Government imposed restrictions on the consumption of sheep meat that became contaminated by nuclear fallout to ensure it was extremely unlikely that any consumers would receive an unacceptable dose. The international context for the restrictions is summarized and a brief review of the strategies employed by the UK is presented. An analysis using the J-value framework, including the de minimis quantum of life expectancy, is made of the cost effectiveness of the sheep meat restrictions in force until 2012, in terms of 4 categories of consumer ranging from the average to the extreme. The paper shows that the risk to the general population was very low indeed at the time the restrictions were removed in 2012. Retaining the restrictions for an extra year, would have averted the dose to the average consumer by a fraction of a microSievert, corresponding to a gain in life expectancy of 8 s. Meanwhile for the ICRP Representative Person, the gain in life expectancy from retaining the restrictions for an extra year ranged between 17 and 25 s. These gains are nugatory, as they are a factor of between 8 and 23 below the de minimis quantum of life expectancy. This new measure provides a meaningful quantitative criterion for judging when the radiation exposure of a large population is trivial in the sense used by the ICRP. The gains in life expectancy for the Field Representative Person and the Extreme Consumer were above the trivial level, but the associated J-values were 10 and 40, an order of magnitude or more above the value of unity where a case could be made for retaining the restrictions for another year. The high J-values and/or de minimis life expectancy ratios suggest that the food restrictions could almost certainly have been ended earlier. Also discussed are: the choice of the Representative Person, the role of intervention levels, the extent to which conservatisms in analysis are warranted and how socio-political factors in decision making can be taken into account in a transparent way. [ABSTRACT FROM AUTHOR]

Actions set in train shortly after the accidents at Chernobyl (1986), and Fukushima Daiichi (2011) had the aim of reducing the more immediate health effects on people living near the plants, with population relocation being especially prominent. The important topic of relocation is the subject of a companion paper, and this article will concentrate on other measures, such as soil treatment and urban decontamination, that have been put in place to reduce the radiation risks in the medium and long term to people living and farming in areas subject to some degree of radioactive contamination. The J-value method of risk assessment has been used to judge the cost-effectiveness of a range of agricultural and urban remediation actions. Many remedial measures instituted after the Chernobyl and Fukushima Daiichi accidents have been found to be highly cost-effective. [ABSTRACT FROM AUTHOR]

Objectives: To compare the current methods of appointment, qualifications and occupational experience of club doctors and physiotherapists in English professional football with (i) those outlined in a study published in 1999, and (ii) Football Association (FA) medical regulations., Design: Qualitative., Methods: Postal questionnaire survey of (head) doctors and physiotherapists at each of the clubs in the English Premiership, Championship and Football Leagues 1 and 2. Response rates of 35.8% and 45.6% respectively were obtained., Results: The majority of football club doctors are GPs who have sports medicine qualifications and relevant occupational experience. Time commitments vary from full time to a few hours per week. Most are appointed through personal contacts rather than job advertisements and/or interview. Almost all football clubs have a chartered physiotherapist, many of whom have a postgraduate qualification. They work full time and long hours. Most are appointed through personal contacts rather than job advertisements. They are frequently interviewed but not always by someone qualified to judge their professional expertise., Conclusions: Football club medical provision has become more extensive and increasingly professional over the last 10-20years, with better qualified, more career-oriented and more formally contracted staff. It is likely that clinical autonomy has subsequently increased. However recruitment procedures still need to be improved, especially in relation to advertising vacancies, interviewing candidates, and including medical personnel on interview panels. In two aspects clubs appear not to be compliant with current FA medical regulations., (Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)