Purpose To investigate the influence of ethnic origin on the incidence of keratoconus and the association of atopic diseases in patients with keratoconus. Methods Retrospective study of new patients referred to Dewsbury District General Hospital and diagnosed with keratoconus in a 6-year period between 1994 and 2000. The ethnic origin of the patient was defined as white, Asian, or other. Incidence was calculated from the catchment population of 176 774 (82% white people, 17% Asians, 1% others). t-Test, confidence intervals and v 2 tests were used to show statistical significance. Results A total of 74 cases of keratoconus were diagnosed over this period. Of these patients 29 (39%) were white and 45 (61%) were Asian. This equated to an incidence of keratoconus of 25 per 100 000 (1 in 4000) per year for Asians, compared with 3.3 per 100 000 (1 in 30 000) per year for white people (Po0.001). Asians presented significantly younger than white patients. The incidence of atopic disease was found to be significantly higher in white compared to Asian keratoconic patients. Conclusions Asians were significantly more likely to present with keratoconus. The Asian patients were mostly of Northern Pakistani origin. This community has a tradition of consanguineous, especially first-cousin marriages. The higher incidence in this population was highly suggestive of a genetic factor being significant in the aetiology. The incidence was higher than revealed by previous studies. Atopic disease was significantly less common in Asians compared to white people, supporting the theory of a different aetiology in these patients.

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A bstractIn this study, one group of respondents is offered to purchase a safety device to be installed in their cars, while another group is offered a public safety, program (improved road quality) which results in the same size risk reduction. In terms of the value of a statistical life, our results are very, reasonable. However, the WTP for the private safety device is higher than the WTP for the public safety measure. Drawing on a model developed by Jones-Lee (1991), we show that some types of altruists may, but need not, be willing to pay more for a private risk reduction than for a uniform risk reduction of the same magnitude, Still, our empirical results are surprising, and further empirical research seems warranted.

Objective To measure the willingness to pay for a severity of the symptoms and was worse than that of the sex-and age-matched general Swedish population. reduction in the number of micturitions and urinary leakages for patients with urge incontinence.The median (mean) willingness to pay per month was 240 (530) Swedish krona (SEK, £1=SEK 11.50) for Patients and methods A self-administered questionnaire with a binary willingness-to-pay question was admina 25% reduction in micturitions and leakages and SEK 470 (1030) for a 50% reduction in micturitions istered to 541 patients in Sweden with urge or mixed incontinence; 461 questionnaires were returned. The and leakages. As hypothesized, the willingness to pay was significantly related to the size of the reduction reduction in micturitions and urinary leakages valued in the willingness-to-pay question was varied in micturitions and leakages, the initial number of micturitions and leakages, and income. randomly between 25% and 50% in two diÂerent subsamples. Information was also collected about the Conclusions Patients with incontinence problems are willing to pay substantial amounts for a reduction in number of micturitions and urinary leakages, healthrelated quality of life and socio-economic characterthe number of micturitions and leakages. Keywords Incontinence, willingness to pay, quality of istics of the patients in the study. Results Quality of life was significantly related to the life, contingent valuation lation [6]. The available treatment options for this patient Introduction group include physiotherapy, bladder training, pharmacological treatment and surgery. Available pharmacoUrinary incontinence is a major clinical problem and can be a distressing, depressing and disabling condition logical treatments are of limited eÂectiveness, partly due to reduced compliance as a consequence of anticholiwith profound eÂects on quality of life and activities of daily living [1]. Reported prevalence rates vary between nergic side-eÂects [7]. In the absence of an eÂective treatment or cure, sanitary protection is widely used. As 8% and 51% depending on age and gender [2]. The prevalence increases with age and it is currently more eÂective treatments become available, it is important to compare the costs of these treatments with the estimated that half of nursing-home residents suÂer from urinary incontinence [2]. In addition, two surveys value of the health improvements (the benefits). Such economic evaluations to assess value for money are found that 30% of community-dwelling middle-aged women suÂer from urinary incontinence [3,4]. Urinary increasingly used in the healthcare field [8]. Economic evaluations are especially important for interventions in incontinence is caused by disturbances of the storage and emptying function of the bladder. fields like incontinence, that involve large patient populations and potentially large costs. Incontinence may be divided into urge incontinence (disturbance of the storage function with symptoms of The aim of this study was to es...

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