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Increasing expenditures on retail pharmaceuticals bring a critical challenge to the financial stability of healthcare systems worldwide. Policy makers have reacted by introducing a range of measures to control the growth of public pharmaceutical expenditure (PPE). Using panel data on European and non-European OECD member countries from 1990 to 2015, we evaluate the effectiveness of six types of demand-side expenditure control measures including physician-level behaviour measures, system-level price-control measures and substitution measures, alongside a proxy for cost-sharing and add a new dimension to the existing empirical evidence hitherto based on national-level and meta-studies. We use the weighted-average least squares regression framework adapted for estimation with panel-corrected standard errors. Our empirical analysis suggests that direct patient cost-sharing and some-but not all-demand-side measures successfully dampened PPE growth in the past. Cost-sharing schemes stand out as a powerful mechanism to curb PPE growth, but bear a high risk of adverse effects. Other demand-side measures are more limited in effect, though may be more equitable. Due to limitations inherent in the study approach and the data, the results are only explorative., (© 2022. The Author(s).)

The authors hypothesized that prospective, systematic Internet searches could identify occurrences of sudden cardiac death (SCD) in athletes and would be useful for establishing a system of active surveillance. Weekly advanced Google searches of the Internet were conducted for cases of SCD in young athletes during a 12-month period (2007-2008). Athletes ages 11-30 years who collapsed during a game, practice, or within an hour of exercise were included in the study. Individuals with known histories of cardiac issues and events occurring outside the United States were excluded. Verification of SCD was by autopsy reports and death certificates from county coroner offices and vital record agencies. Initially, 71 events were identified. Verification for the cause of death by coroner reports was possible in 45 cases, 43 (96 %) of which were confirmed to be SCDs. A total of 69 individuals 11-30 years of age (mean 17 ± 5 years) died suddenly of cardiovascular causes while participating in 15 different organized sports and a variety of nonorganized physical activities. The most common cause of death was hypertrophic cardiomyopathy (30 %), followed by coronary artery anomalies (9 %), and myocarditis (9 %). The incidence of athlete SCD, the types of sports involved, and the cardiac causes of death in our study were comparable with those of previous reports. Readily available Internet searches have the potential to be a powerful tool for identifying occurrences of athlete SCD. An active surveillance system using Google searches followed by coroner report verification can provide important epidemiologic and clinical information.

Unlabelled: Smoking prevalence in minors has increased considerably since 1986. In comparison to other European countries, smoking rates in 15-year-old students are the highest in Austria. Goal of our study was the estimation of government earnings from tobacco consumption of minors in Austria., Methods: Tobacco tax paid by adolescents aged 11 to 17 years was estimated from smoking prevalences and taxation of cigarettes., Results: In 2006 state revenues from cigarette consumption of minors in Austria amounted to 60.5 million Euro., Discussion: Up to now the fight against business interest of the tobacco industry in Austria has been mainly left to volunteers. Therefore we suggest the funding a professional agency, independent from state budget and interest groups, by a tobacco prevention fund which is financed by the revenues from cigarettes smoked by youth. The mission of this fund should be to lower smoking incidence and smoking prevalence among minors. The WHO framework convention on tobacco control, ratified by Austria in 2005, should be considered in the next amendments of the tobacco law. The efforts of the European Union to reduce tobacco consumption should be supported also by Austria. For this purpose the tobacco prevention fund - similar to the regulation in Switzerland - would give the financial background.

Many vision problems can be formulated as minimization of appropriate energy functionals. These energy functionals are usually minimized, based on the calculus of variations (Euler-Lagrange equation). Once the Euler-Lagrange equation has been determined, it needs to be discretized in order to implement it on a digital computer. This is not a trivial task and, is moreover, error-prone. In this paper, we propose a flexible alternative. We discretize the energy functional and, subsequently, apply the mathematical concept of algorithmic differentiation to directly derive algorithms that implement the energy functional's derivatives. This approach has several advantages: First, the computed derivatives are exact with respect to the implementation of the energy functional. Second, it is basically straightforward to compute second-order derivatives and, thus, the Hessian matrix of the energy functional. Third, algorithmic differentiation is a process which can be automated. We demonstrate this novel approach on three representative vision problems (namely, denoising, segmentation, and stereo) and show that state-of-the-art results are obtained with little effort.