Cost effectiveness

... This gap between what we know should be provided and what is provided is the result of a poorly structured health care financing system ... applied in a host of other settings where children are served, including schools, health clin-ics, child welfare agencies, and juvenile courts. ...

ncreasingly, the explosion in scien- tific knowledge is overwhelming both researchers and practitioners in the health professions. The man- aged care pharmacist today needs a con - stant and current sense of the basic phar- maceutical sciences, clinical pharmacy, pharmacy management systems, health policy and ethics, new drug introductions, pharmacoeconomics, and pharmacoepi- demiology. Monitoring the ever-changing pharmaceutical industry is now

This study examines the relationship between a computerized neuropsychological assessment battery, the Automated Neuropsychological Assessment Metrics (ANAM) and a widely used ability measure, Woodcock-Johnson III Tests of Cognitive Ability (WJ-III). Results indicated substantial relationship between the ANAM throughput (accuracy/response time) scores and the WJ-III Cognitive Efficiency cluster. An unexpectedly strong relationship was evident between accuracy scores on the ANAM Logical Reasoning scale and the WJ-III General Intellectual Ability score, purporting to measure the g factor. The findings support the viability of the ANAM as a time- and cost-effective tool for appraisal of cognitive function.

The introduction of highly active antiretroviral therapy (also known as combination therapy) has transformed the nature of HIV infection from a severe and ultimately fatal disease to that of a manageable chronic condition. HIV drugs are highly efficacious, but their use comes at ...

Cellulose nanofibers with a size range of 5–100 nm have the potential to be a low cost renewable material that has application in a range of products. However, current chemical methods to produce crystalline nanofibers suffer from low yields and high chemical costs, while mechanical methods require high energy costs. Methods to lower the energy costs of the mechanical methods have not been well documented in the literature. A bleached softwood kraft pulp was processed using a mechanical dispersion mill and a homogenizer to produce cellulose nanofibers. Two different commercial enzymes were used to pretreat the wood fibers before the mechanical treatments. The resulting nanofibers were characterized by light microscopy, atomic force microscopy, and inverse gas chromatography. Results indicate that the dispersion mill does not affect the overall pulp fiber fibrillation, but does help prepare the sample for the homogenizer. Most fibrillation occurs after three passes through the homogenizer. The enzyme pretreatment has little effect on the size of the fibers, but does allow for higher solids to pass through the homogenizer without clogging. The dispersion component of surface energy of the resulting nanofibrils is impacted by the type of enzyme used. The measurement of acid–base properties proved to be challenging using current IGC experimental protocols.

Chronic condition management in general practice is projected to account for 50% of all consultations by 2051. General practices under present workforce conditions will be unable to meet this demand. Nurse led collaborative care models of chronic disease management have been successful overseas and are proposed as one solution. This article provides an interim report on a prospective randomised trial to investigate the acceptability, cost effectiveness and feasibility of a nurse led model of care for chronic conditions in Australian general practice. A qualitative study focused on the impact of this model of care through the perceptions of practice staff from one urban and one regional practice in Queensland, and one Victorian rural practice. Primary benefits of the collaborative care model focused on increased efficiency and communication between practice staff and patients. The increased degree of patient self responsibility was noted by all and highlights the motivational aspect ...

Malfunction of permanent vascular accesses remains a cause of frequent and costly morbidity in patients receiving chronic hemodialysis (CHD). Several recommendations for routine monitoring of these permanent vascular accesses for incipient failure have been proposed. In this study, multiple indicators of incipient vascular access dysfunction, including "venous" and "arterial" pressures at serial blood flows (200 ml/min, 300 ml/min, and 400 ml/min), percent urea recirculation, Doppler ultrasound, and access blood flow by ultrasound dilution technique were simultaneously evaluated in a total of 220 vascular accesses in 170 chronic hemodialysis patients in two separate study periods (6 months apart). The rate of thrombosis was determined within the subsequent 12 weeks of each study period to assess the short-term predictive power of access thrombosis. During the period of follow-up, there were 34 thrombotic events in 172 polytetrafluoroethylene (PTFE) grafts and only one thrombotic event in 48 arterio-venous fistulas (AVF). Therefore, the statistical analysis was limited to the PTFE grafts. When grafts with thromboses were compared to those without thrombosis by univariate analysis, access blood flow measured either by ultrasound dilution technique (875 +/- 426 ml/min with thrombosis vs. 1193 +/- 677 ml/min without thrombosis, P = 0.001) or by Doppler ultrasound (762 +/- 420 ml/min with thrombosis vs. 1171 +/- 657 ml/min without thrombosis, P = 0.001) were significantly different in the two groups. There was good correlation (r = 0.79, P = 0.0001) between the blood flows determined by both techniques. The grade of stenosis determined by ultrasound was also a statistically significant predictor (P = 0.02). "Venous" and "arterial" pressures were numerically similar and were not statistically different between the accesses that did and those that did not thrombose. When multivariate analysis was used, there was a significantly increased risk of thrombosis only with decreasing access blood flow determined by ultrasound dilution techniques after adjusting for other confounding variables. When the average blood flow of all grafts (1134 ml/min) is considered as the reference access blood flow (relative risk of 1.0), the relative risk of a PTFE thrombotic event within the subsequent 12 weeks was 1.23 at a blood flow 950 ml/min, 1.67 at a blood flow of 650 ml/min and to 2.39 at a blood flow of 300 ml/min. In summary, access blood flow measured by either Dilution or Doppler is a reliable indicator of subsequent short-term thrombosis risk. Other proposed methods of evaluating access dysfunction were not useful in our patients. If simple to use, cost-effective devices to measure dialysis access blood flow become readily available, the measurement of access blood flow will likely become the method of choice for screening of PTFE vascular access dysfunction in hemodialysis patients.

We describe the distribution and estimate densities of Grauer's gorillas (Gorilla gorilla graueri) and eastern chimpanzees (Pan troglodytes schweinfurthi) in a 12,770-km2area of lowland forest between the Lowa, Luka, Lugulu, and Oku rivers in eastern Democratic Republic of Congo, the site of the largest continuous population of Grauer's gorillas. The survey included a total of 480 km of transects completed

Virtual Reality Graded Exposure Therapy (VRGET) is an effective treatment for combat-related PTSD. We summarize the outcomes of a VRGET pilot study with 12 participants who completed one to multiple combat tours in support of the War on Terrorism and who were subsequently diagnosed with combat-related PTSD. Details of the collaborative program amongst the Virtual Reality Medical Center (VRMC), Office of Naval Research, the Naval Medical Center San Diego (NMCSD) and the Navy Hospital Camp Pendleton are discussed as is the VRGET outcomes of significant reductions in PTSD symptoms severity. We also described the estimated cost-effectiveness of VRGET for the treatment of combat-related PTSD, as contrasted to Treatment as Usual (TAU) for combat-related PTSD.

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Synthesized-reference-wave holographic techniques offer relatively simple and cost-effective measurement of antenna radiation characteristics and reconstruction of complex aperture fields using near-field intensity-pattern measurement. These methods allow utilization of advantages of methods for probe compensations for amplitude and phasing near-field measurements for the planar and cylindrical scanning including accuracy analyses. The paper analyzes periodic errors, which can be created during scanning, using both theoretical results and numerical simulations.

A membrane steady state simulator based on an open source concept is discussed. It is believe that this way of developing software will overcome weaknesses posed by available commercial membrane simulators. The application provides a cost effective state of the art tool for membrane modeling and object oriented design and its usage allows for easy incorporation of specific developments either open source or proprietary. This paper presents the components require to produce an open source membrane steady state simulator. This approach of development differs significantly from a close black-box approach. Several membrane models using the simulator will be elaborated and compared with literature results.

Advances in molecular genetics have opened opportunities to enhance strategies for genetic improvement of pigs by directly selecting on genes or chromosomal regions that harbor genes that affect traits of interest. In this paper, we review molecular technologies that have become available, the current state of the use of gene- or marker tests in pig breeding programs, and future prospects.

Cost-effectiveness analyses are important tools in efforts to prioritise interventions for obesity prevention. Modelling facilitates evaluation of multiple scenarios with varying assumptions. This study compares the cost-effectiveness of conservative scenarios for two commonly proposed policy-based interventions: front-of-pack 'traffic-light' nutrition labelling (traffic-light labelling) and a tax on unhealthy foods ('junk-food' tax). For traffic-light labelling, estimates of changes in energy intake were based on an assumed 10% shift in consumption towards healthier options in four food categories (breakfast cereals, pastries, sausages and preprepared meals) in 10% of adults. For the 'junk-food' tax, price elasticities were used to estimate a change in energy intake in response to a 10% price increase in seven food categories (including soft drinks, confectionery and snack foods). Changes in population weight and body mass index by sex were then estimated ba...

Miniaturization reduces package size, cost and board space. System on Chip (SoC) integrates a system on a common silicon substrate, however there are some shortcomings with this approach such as high manufacturing cost. Handling of different levels of voltage and current on a common silicon substrate with controller IC operating in the range of several volts and milliamps, while power