Liang, Li-Lin; Mirelman, Andrew J
A consensus exists that rising income levels and technological development are among key drivers of total health spending. Determinants of public sector health expenditure, by contrast, are less well understood. This study examines a complex relationship across government health expenditure (GHE), sociopolitical risks, and international aid, while taking into account the impacts of national income, debt and tax financing and aging populations on health spending. We apply a fixed-effects two-stage least squares regression method to a panel dataset comprising 120 countries for the years 1995 through 2010. Our results show that democratic accountability has a diminishing positive correlation with GHE, and that levels of GHE are higher when government is more stable. Corruption is associated with less GHE in developing countries, but with higher GHE in developed countries. We also find that development assistance for health (DAH) is fungible with domestically financed government health expenditure (DGHE). For an average country, a 1% increase in DAH to government is associated with a 0.03-0.04% decrease in DGHE. Furthermore, the degree of fungibility of DAH to government is higher in countries where corruption or ethnic tensions are widespread. However, DAH to non-governmental organizations is not fungible with DGHE. PMID:24929917
Background There has been a sudden increase in the amount of money donors are willing to spend on the worldwide HIV/AIDS epidemic. Present plans are to hold most of the money in reserve and spend it slowly. However, rapid spending may be the best strategy for halting this disease. Methods We develop a mathematical model that predicts eradication or persistence of HIV/AIDS on a world scale. Dividing the world into regions (continents, countries etc), we develop a linear differential equation model of infectives which has the same eradication properties as more complex models. Results We show that, even if HIV/AIDS can be eradicated in each region independently, travel/immigration of infectives could still sustain the epidemic. We use a continent-level example to demonstrate that eradication is possible if preventive intervention methods (such as condoms or education) reduced the infection rate to two fifths of what it is currently. We show that, for HIV/AIDS to be eradicated within five years, the total cost would be ≈ $63 billion, which is within the existing $60 billion (plus interest) amount raised by the donor community. However, if this action is spread over a twenty year period, as currently planned, then eradication is no longer possible, due to population growth, and the costs would exceed $90 billion. Conclusion Eradication of AIDS is feasible, using the tools that we have currently to hand, but action needs to occur immediately. If not, then HIV/AIDS will race beyond our ability to afford it. PMID:19922685
In higher education, three generally recognized rationales for federal involvement in financial aid exist: (1) Promoting equality of opportunity: Those from poor households are less likely to attend college for a variety of reasons; (2) Credit market imperfections: Students may not have access to the credit needed to make profitable investments in…
Talbert-Slagle, Kristina M.; Canavan, Maureen E.; Rogan, Erika M.; Curry, Leslie A.; Bradley, Elizabeth H.
Objective: Despite considerable advances in the prevention and treatment of HIV/AIDS, the burden of new infections of HIV and AIDS varies substantially across the country. Previous studies have demonstrated associations between increased healthcare spending and better HIV/AIDS outcomes; however, less is known about the association between spending on social services and public health spending and HIV/AIDS outcomes. We sought to examine the association between state-level spending on social services and public health and HIV/AIDS case rates and AIDS deaths across the United States. Design: We conducted a retrospective, longitudinal study of the 50 U.S. states over 2000–2009 using a dataset of HIV/AIDS case rates and AIDS deaths per 100 000 people matched with a unique dataset of state-level spending on social services and public health per person in poverty. Methods: We estimated multivariable regression models for each HIV/AIDS outcome as a function of the social service and public health spending 1 and 5 years earlier in the state, adjusted for the log of state GDP per capita, regional and time fixed effects, Medicaid spending as % of GDP, and socio-demographic, economic, and health resource factors. Results: States with higher spending on social services and public health per person in poverty had significantly lower HIV and AIDS case rates and fewer AIDS deaths, both 1 and 5 years post expenditure (P ≤ 0.05). Conclusion: Our findings suggest that spending on social services and public health may provide a leverage point for state policymakers to reduce HIV/AIDS case rates and AIDS deaths in their state. PMID:26605512
Geiger, Christine M; Sorenson, Bridget; Whaley, Paul
The stability of 10 active pharmaceutical ingredients was studied in SyrSpend SF PH4 or SyrSpend SF Alka at room and/or refrigerated temperature (2°C to 8°C). An oral suspension of each active pharmaceutical ingredient was compounded in low actinic plastic bottles at a specific concentration in SyrSpend SF PH4 or SyrSpend SF Alka. Samples were assessed for stability immediately after preparation (day 0) followed by storage at room temperature and/or at refrigerated temperature. At set time points, the samples were removed from storage and assayed using a high-performance liquid chromatographic stability- indicating method. The active pharmaceutical ingredient was considered stable if the suspension retained 90% to 110% of the initial concentration. Furosemide was stable for at least 14 days in SyrSpend SF Alka at refrigerated conditions. Prednisolone sodium phosphate in SyrSpend SF PH4 was stable for at least 30 days at room temperature and refrigerated conditions. Ranitidine hydrochloride suspensions in SyrSpend SF PH4 at room temperature and refrigerated conditions were stable for at least 30 days and 58 days, respectively. Hydrocortisone hemisuccinate and sodium phosphate retained greater than 90% for at least 60 days at both room temperature and refrigerated samples in SyrSpend SF PH4. Amiodarone hydrochloride and nifedipine suspensions at both room temperature and refrigerated conditions retained greater than 90% of the initial concentrations for at least 90 days in SyrSpend SF PH4. Refrigerated samples of simvastatin in SyrSpend SF PH4 were stable for at least 90 days. Spironolactone in SyrSpend SF PH4 at room temperature retained more than 90% of the initial concentration for at least 90 days. Phenobarbital in SyrSpend SF PH4 retained above 90% of initial concentration for at least 154 days at room temperature. This study demonstrated the stability of a wide range of frequently used active pharmaceutical ingredients, tested in SyrSpend SF PH4 and SyrSpend
Chingos, Matthew M.
In the coming years, states will need to make the most significant changes to their assessment systems in a decade as they implement the Common Core State Standards, a common framework for what students are expected to know that will replace existing standards in 45 states and the District of Columbia. The Common Core effort has prompted concerns…
Klemz, Bruce R; Boshoff, Christo; Mazibuko, Noxolo-Eileen; Asquith, Jo Ann
HIV/AIDS has led to an enormous demand for health care in the developing world and many governments have opted to capitalize on altruistic home-based caregivers. These caregivers are mainly poor older women and their financial survival is critically important to themselves and their families. We found that as the patient's illness progressed: (a) the altruistic cultural norm "ubuntu" led the caregiver to increase spending and (b) the social pressure (sanction) of stigma led to a very dramatic drop in direct interpersonal assistance. The impact on their spending, health care, and the related public policies are discussed. PMID:25751320
Wentworth, Donald R.; And Others
The theme article of this issue, "Spending Money Wisely," by Donald R. Wentworth, begins with an explanation of basic strategies which aid wise spending. The article goes on to provide an introduction to economic reasoning related to consumer purchases and focusing on the role of incentives, scarcity, and alternatives. Four teaching units follow…
Bernet, Patrick M
Public health services are delivered through a variety of organizations. Traditional accounting of public health expenditures typically captures only spending by government agencies. New Hampshire collected information from public health partners, such as community centers that host smoking cessation classes or health education done by Girls, Inc. This study compares the new data to spending by government agencies, focusing on breakdowns by fund source and service categories. Expanded funds secured by these partners account for a 42% of all local public health spending, and they spent 4 times more than government agencies on promoting healthy behavior. The funding formula analysis tool revealed that these partners spent in ways that would be politically difficult to achieve. In an era of declining budgets, an understanding of public health's partners is increasingly vital. PMID:22635188
The government increased the funding for regional development agencies to 2.3 billion British Pounds in 2007/8, yet hard evidence on the effectiveness of the spending is difficult to find. Techniques for valuing benefits in difficult areas have existed for many years. They range from the hedonic methods and contingent valuation studies of…
Since the Declaration of Alma-Ata in 1978, primary health care (PHC) has been acknowledged as the most effective means of achieving "health for all". Promotion of the PHC model provides nurses with an excellent opportunity for professional growth and development. The PHC role of nurse practitioner is gradually emerging within the Australian health care system and if nurses are to fulfil this role adequately they need to equip themselves with additional skills. The art of performing competent physical assessment of clients is one such skill. As the concept of the AIDS nurse practitioner is being developed locally and overseas, this paper focuses on the physical assessment of people with AIDS. While the constellation of physical signs and symptoms they experience are all too familiar to those who work in the area, they are often unusual for those who do not. PMID:2242257
School administrators have always labored to find ways to squeeze more value out of their limited budgets. However, in recent years, more educators and administrators have been looking at their spending decisions from a long-term perspective. Planning education facilities for the long term has led many schools and universities to adopt different…
Senglaub, Michael E.
This efforts objective was to identify and hybridize a suite of technologies enabling the development of predictive decision aids for use principally in combat environments but also in any complex information terrain. The technologies required included formal concept analysis for knowledge representation and information operations, Peircean reasoning to support hypothesis generation, Mill's's canons to begin defining information operators that support the first two technologies and co-evolutionary game theory to provide the environment/domain to assess predictions from the reasoning engines. The intended application domain is the IED problem because of its inherent evolutionary nature. While a fully functioning integrated algorithm was not achieved the hybridization and demonstration of the technologies was accomplished and demonstration of utility provided for a number of ancillary queries.
Cooper, Tammi; Terrell, Trent
Assessment activities have proliferated over the last decade at institutions of higher education. While assessment is useful for institutional improvement, this proliferation has in part been due to greater pressures from regional accreditors on institutions to meet assessment requirements. These higher expectations have led to new expenditures on…
The rising costs of fuels and specifically gasoline pose an economic challenge to U.S. consumers. Thus, the specific problem considered in this study was a rise in gasoline prices can reduce consumer spending, disposable income, food service traffic, and spending on healthy food, medicines, or visits to the doctor. Aligned with the problem, the purpose of this quantitative multiple correlation study was to examine the economic aspects for a rise in gasoline prices to reduce the six elements in the problem. This study consisted of a correlational design based on a retrospective longitudinal analysis (RLA) to examine gasoline prices versus the economic indexes of: (a) Retail Spending and (b) personal savings (PS). The RLA consisted on historic archival public data from 1978 to 2015. This RLA involved two separate linear multiple regression analyses to measure gasoline price's predictive power (PP) on two indexes while controlling for Unemployment Rate (UR). In summary, regression Formula 1 revealed Gasoline Price had a significant 61.1% PP on Retail Spending. In contrast, Formula 2 had Gasoline Price not having a significant PP on PS. Formula 2 yielded UR with 38.8% PP on PS. Results were significant at p<.01. Gasoline Price's PP on Retail Spending means a spending link to retail items such as: food service traffic, healthy food, medicines, and consumer spending. The UR predictive power on PS was unexpected, but logical from an economic view. Also unexpected was Gasoline Price's non-predictive power on PS, which suggests Americans may not save money when gasoline prices drop. These results shed light on the link of gasoline and UR on U.S. consumer's economy through savings and spending, which can be useful for policy design on gasoline and fuels taxing and pricing. The results serve as a basis for future study on gasoline and economics.
Robertson, Kevin; Kopnisky, Kathy; Hakim, James; Merry, Concepta; Nakasujja, Noeline; Hall, Colin; Traore, Moussa; Sacktor, Ned; Clifford, David; Newton, Charles; Van Rie, Annelies; Holding, Penny; Clements, Janice; Zink, Christine; Mielke, Jens; Hosseinipour, Mina; Lalloo, Umesh; Amod, Farida; Marra, Christina; Evans, Scott; Liner, Jeff
In July of 2006, the National Institute of Mental Health (NIMH) Center for Mental Health Research on AIDS (CMHRA) sponsored the second conference on the Assessment of NeuroAIDS in Africa, which was held in Arusha, Tanzania. The conference mission was to address the regional variations in epidemiology of HIV-related neurological disorders as well as the assessment and diagnosis of these disorders. Participants discussed and presented data regarding the relevance and translation of neuroAIDS assessment measures developed in resource intensive settings and the challenges of neuro-assessment in Africa, including the applicability of current tools, higher prevalence of confounding diseases, and the complexity of diverse cultural settings. The conference presentations summarized here highlight the need for further research on neuroAIDS in Africa and methods for assessing HIV-related neurological disorders. PMID:18370346
Hannah, John; James, Alex; Williams, Phillipa
Two first-year engineering mathematics courses used computer-aided assessment (CAA) to provide students with opportunities for formative assessment via a series of weekly quizzes. Most students used the assessment until they achieved very high (>90%) quiz scores. Although there is a positive correlation between these quiz marks and the final…
Costagliola, Gennaro; Ferrucci, Filomena; Fuccella, Vittorio; Oliveto, Rocco
Computer aided assessment (CAA) tools are more and more widely adopted in academic environments mixed to other assessment means. In this article, we present a CAA Web application, named eWorkbook, which can be used for evaluating learner's knowledge by creating (the tutor) and taking (the learner) on-line tests based on multiple choice, multiple…
Presents a primary-trait scoring instrument intended for journalism teachers to use in assessing students' editorials by breaking down the analysis into three essential components: claims, data, and warrants. Applies the instrument to two student essays. (SR)
Hudlicka, Eva; Corker, Kevin; Cramer, Nichael; Young, David; Baron, Sheldon
A knowledge-based pilot aiding system which performs situation assessment and response aiding is described. The system uses a causal model of the flight domain to both simulate the effects of identified failures on flight and to derive responses during emergencies. The model represents information at two levels of abstraction: Boolean, which simply states whether a subsystem or aircraft component is normal or abnormal, and qualitative, which expresses the subsystem or component status as one of several qualitative values, such as increasing, decreasing, or stable.
Spaulding, Alicen B; Brieger, William R
This stakeholder assessment of HIV/AIDS service providing institutions in Argentina offers insights into the HIV/AIDS crisis in Spanish-speaking Latin America from an institutional level and makes recommendations for strengthening the work and functioning of these institutions. This stakeholder assessment was conducted to determine how HIV/AIDS prevention and management in Argentina affects and is affected by relevant HIV/AIDS institutions. Semi-structured qualitative interviews were conducted with 13 key leaders of organizations working in HIV/AIDS prevention in Buenos Aires including non-governmental, governmental, and academic institutions. Analyses of interviewee comments are presented according to four major themes: network connections, program resources, perceptions of success, and challenges. Key findings include the need for strengthening formal networks, increasing the involvement of other non-AIDS related social institutions in promoting HIV prevention, finding more sustainable funding options, working more effectively with the public sector to create policies and regulations favorable to the HIV/AIDS field, and addressing the lack of perceived susceptibility to HIV/AIDS in Argentine culture. From leaders' comments, recommendations are made for strengthening the HIV/AIDS network among key institutions including adapting the UNAIDS "Three Ones" principal to create one crosssector office responsible for coordinating HIV/AIDS work, formalizing agreements with institutions outside of Buenos Aires, increasing the role of schools in HIV/AIDS awareness, and designing programs that address lack of perceived susceptibility to HIV/AIDS among Argentines. PMID:18573753
King, Martin; Giger, Maryellen; Suzuki, Kenji; Pan, Xiaochuan
The accurate interpretation of cardiac CT images is commonly hindered by the presence of motion artifacts. Since motion artifacts commonly can obscure the presence of coronary lesions, physicians must spend much effort analyzing images at multiple cardiac phases in order to determine which coronary structures are assessable for potential lesions. In this study, an artificial neural network (ANN) classifier was designed to assign assessability indices to calcified plaques in individual region-of-interest (ROI) images reconstructed at multiple cardiac phases from two cardiac scans obtained at heart rates of 66 bpm and 90 bpm. Six individual features (volume, circularity, mean intensity, margin gradient, velocity, and acceleration) were used for analyzing images. Visually-assigned assessability indices were used as a continuous truth, and jack-knife analysis with four testing sets was used to evaluate the performance of the ANN classifier. In a study in which all six features were inputted into the ANN classifier, correlation coefficients of 0.962 +/- 0.006 and 0.935 +/- 0.023 between true and ANN-assigned assessability indices were obtained for databases corresponding to 66 bpm and 90 bpm, respectively.
Maggioni, Serena; Melendez-Calderon, Alejandro; van Asseldonk, Edwin; Klamroth-Marganska, Verena; Lünenburger, Lars; Riener, Robert; van der Kooij, Herman
The assessment of sensorimotor functions is extremely important to understand the health status of a patient and its change over time. Assessments are necessary to plan and adjust the therapy in order to maximize the chances of individual recovery. Nowadays, however, assessments are seldom used in clinical practice due to administrative constraints or to inadequate validity, reliability and responsiveness. In clinical trials, more sensitive and reliable measurement scales could unmask changes in physiological variables that would not be visible with existing clinical scores.In the last decades robotic devices have become available for neurorehabilitation training in clinical centers. Besides training, robotic devices can overcome some of the limitations in traditional clinical assessments by providing more objective, sensitive, reliable and time-efficient measurements. However, it is necessary to understand the clinical needs to be able to develop novel robot-aided assessment methods that can be integrated in clinical practice.This paper aims at providing researchers and developers in the field of robotic neurorehabilitation with a comprehensive review of assessment methods for the lower extremities. Among the ICF domains, we included those related to lower extremities sensorimotor functions and walking; for each chapter we present and discuss existing assessments used in routine clinical practice and contrast those to state-of-the-art instrumented and robot-aided technologies. Based on the shortcomings of current assessments, on the identified clinical needs and on the opportunities offered by robotic devices, we propose future directions for research in rehabilitation robotics. The review and recommendations provided in this paper aim to guide the design of the next generation of robot-aided functional assessments, their validation and their translation to clinical practice. PMID:27485106
Sewell, Robert D. E.
Objectives To examine the effectiveness of providing formative feedback for summative computer-aided assessment. Design Two groups of first-year undergraduate life science students in pharmacy and neuroscience who were studying an e-learning package in a common pharmacology module were presented with a computer-based summative assessment. A sheet with individualized feedback derived from each of the 5 results sections of the assessment was provided to each student. Students were asked via a questionnaire to evaluate the form and method of feedback. Assessment The students were able to reflect on their performance and use the feedback provided to guide their future study or revision. There was no significant difference between the responses from pharmacy and neuroscience students. Students' responses on the questionnaire indicated a generally positive reaction to this form of feedback. Conclusions Findings suggest that additional formative assessment conveyed by this style and method would be appreciated and valued by students. PMID:17533442
Bastos, Bárbara Guimarães; Ferrari, Deborah Viviane
Introduction The family has ultimate responsibility for decisions about the use and care during the daily routine and problem solving in the manipulation of hearing aids (HA) in infants and children. Objective The purpose of the study was to assess technical and content quality of Babies' Portal website Hearing Aid section by audiologists. Methods Letters and e-mails were sent inviting professionals to surf the website and anonymously fill out an online form with 58 questions covering demographic data as well as the website's technical (Emory questionnaire with the subscales of accuracy, authorship, updates, public, navigation, links, and structure) and content quality. Results A total of 109 professionals (tree men and 106 women) with mean age of 31.6 years participated in the study. Emory percentage scores ranged from 90.1 to 96.7%. The Hearing Aid section contents were considered good or very good. Conclusion The website was deemed to have good technical and content quality, being suitable to supplement informational counseling to parents of hearing-impaired children fitted with hearing aids. PMID:25992119
Roberts, M; Wangombe, J
A consulting firm conducted interviews with managers of 16 businesses in 3 Kenyan cities, representatives of 2 trade unions, focus groups with workers at 13 companies, and an analysis of financial/labor data from 4 companies. It then did a needs assessment. The business types were light industry, manufacturing companies, tourism organizations, transport firms, agro-industrial and plantation businesses, and the service industry. Only one company followed all the workplace policy principles recommended by the World Health Organization and the International Labor Organization. Six businesses required all applicants and/or employees to undergo HIV testing. All their managers claimed that they would not discriminate against HIV-infected workers. Many workers thought that they would be fired if they were--or were suspected to be--HIV positive. Lack of a non-discrimination policy brings about worker mistrust of management. 11 companies had some type of HIV/AIDS education program. All the programs generated positive feedback. The main reasons for not providing HIV/AIDS education for the remaining 5 companies were: no employee requests, fears that it would be taboo, and assumptions that workers could receive adequate information elsewhere. More than 90% of all companies distributed condoms. 60% offered sexually transmitted disease diagnosis and treatment. About 33% offered counseling. Four companies provided volunteer HIV testing. Almost 50% of companies received financial or other external support for their programs. Most managers thought AIDS to be a problem mainly with manual staff and not with professional staff. Almost all businesses offered some medical benefits. The future impact of HIV/AIDS would be $90/employee/year (by 2005, $260) due to health care costs, absenteeism, retraining, and burial benefits. The annual costs of a comprehensive workplace HIV/AIDS prevention program varied from $18 to $54/worker at one company. PMID:12289839
Müller, Thomas; Müller, Markus
In order to facilitate systematic, computer aided improvements of camouflage and concealment assessment methods, the software system CART (Camouflage Assessment in Real-Time) was built up for the camouflage assessment of objects in multispectral image sequences (see contributions to SPIE 2007-2010 , , , ). It comprises a semi-automatic marking of target objects (ground truth generation) including their propagation over the image sequence and the evaluation via user-defined feature extractors as well as methods to assess the object's movement conspicuity. In this fifth part in an annual series at the SPIE conference in Orlando, this paper presents the enhancements over the recent year and addresses the camouflage assessment of static and moving objects in multispectral image data that can show noise or image artefacts. The presented methods fathom the correlations between image processing and camouflage assessment. A novel algorithm is presented based on template matching to assess the structural inconspicuity of an object objectively and quantitatively. The results can easily be combined with an MTI (moving target indication) based movement conspicuity assessment function in order to explore the influence of object movement to a camouflage effect in different environments. As the results show, the presented methods contribute to a significant benefit in the field of camouflage assessment.
Mendoza, Pilar; Mendez, Jesse P.; Malcolm, Zaria
Using a longitudinal, state-wide dataset, this study assessed the effect of financial aid on the persistence of full-time students in associate's degree programs at the Oklahoma community colleges. Three financial-aid sources were examined: the Oklahoma Higher Learning Access Program (OHLAP), Pell grants, and Stafford loans. Results indicate that…
Background AIDS continues to spread at an estimated 2.6 new million infections per year, making the prevention of HIV transmission a critical public health issue. The dramatic growth in global resources for AIDS has produced a steady scale-up in treatment and care that has not been equally matched by preventive services. This paper is a detailed analysis of how countries are choosing to spend these more limited prevention funds. Methods We analyzed prevention spending in 69 low- and middle-income countries with a variety of epidemic types, using data from national domestic spending reports. Spending information was from public and international sources and was analyzed based on the National AIDS Spending Assessment (NASA) methods and classifications. Results Overall, prevention received 21% of HIV resources compared to 53% of funding allocated to treatment and care. Prevention relies primarily on international donors, who accounted for 65% of all prevention resources and 93% of funding in low-income countries. For the subset of 53 countries that provided detailed spending information, we found that 60% of prevention resources were spent in five areas: communication for social and behavioral change (16%), voluntary counselling and testing (14%), prevention of mother-to-child transmission (13%), blood safety (10%) and condom programs (7%). Only 7% of funding was spent on most-at-risk populations and less than 1% on male circumcision. Spending patterns did not consistently reflect current evidence and the HIV specific transmission context of each country. Conclusions Despite recognition of its importance, countries are not allocating resources in ways that are likely to achieve the greatest impact on prevention across all epidemic types. Within prevention spending itself, a greater share of resources need to be matched with interventions that approximate the specific needs and drivers of each country's epidemic. PMID:22436141
Evans, D; McCahon, R; Barley, M; Norris, A; Khajuria, A; Moppett, I
Applying human factors principles to the design of clinical emergency guidelines is important. The UK Civil Aviation Authority uses a Checklist Assessment Tool for evaluating the content and usability of emergency drills before introduction into service on aircraft. We hypothesised that this model could be used to develop a generic medical tool. A three-stage modified Delphi process was used to adapt the above tool for use in designing medical emergency guidelines. The resulting Cognitive aids in Medicine Assessment Tool was then used to score and rank seven published difficult airway guidelines; the scores were used to assess its validity and reliability. Pearson's rank coefficient between these scores and scores from independent assessors was 0.89 (p = 0.007). Internal consistency, as assessed by Cronbach's alpha, was 0.74, 0.96 and 0.72 for the tool's three constituent domains of physical characteristics, content and layout/format, respectively. Inter-rater reliability, as assessed by Cohen's kappa, ranged from 0.33 to 0.72. The adoption of our tool has the potential to improve the usability of medical emergency guidelines. PMID:25758401
Britain is in the longest recession since the Second World War. Mass unemployment is back. The road to recovery could be long and bumpy. On the fiscal front, the deficit could be higher than the 175 billion British Pounds forecast for 2009-10. Bringing the deficit under control will require higher taxes and lower public spending. In an effort to…
Minnesota State Office of the Legislative Auditor, St. Paul. Program Evaluation Div.
Minnesota spends more for education than most states and has increased its financial commitment steadily over the past 15 years. Because of the state's dominant role in education funding, legislators have enacted measures requiring all local school districts to follow uniform financial accounting and reporting standards (UFARS). Since 1980, the…
Brucker, Benjamin W.; Hall, Wayne H.
Examined teachers' attitudes toward HIV/AIDS. A random sample of 1,500 teachers completed a 22-item questionnaire. Results show that respondents were opposed to the concept of testing for AIDS, although females were more positive toward the idea than were males. The majority of the respondents favored the idea of providing an HIV/AIDS awareness…
Education Resource Strategies, 2013
This "Professional Growth & Support Spending Calculator" helps school systems quantify all current spending aimed at improving teaching effectiveness. Part I provides worksheets to analyze total investment. Part II provides a system for evaluating investments based on purpose, target group, and delivery. In this Spending Calculator…
Integrated sustainability assessment is part of a new paradigm for urban water decision making. Multi-criteria decision aid (MCDA) is an integrative framework used in urban water sustainability assessment, which has a particular focus on utilising stakeholder participation. Here ...
Black, John L.; And Others
Intravenous (IV) drug abusers are at risk for contracting transmittable diseases such as acquired immunodeficiency syndrome (AIDS) and hepatitis B. This study was conducted to investigate the prevalence of risk behaviors for acquiring and transmitting AIDS and hepatitis B among treatment-seeking drug abusers (N=168). Subjects participated in a…
Emanuel, Richard; Adams, Jim; Baker, Kim; Daufin, E. K.; Ellington, Coke; Fitts, Elizabeth; Himsel, Jonathan; Holladay, Linda; Okeowo, David
This study sought to assess how college students spend their time communicating and what impact, if any, communications devices may be having on how that time is spent. Undergraduates (N = 696) at four southeastern colleges were surveyed. Results revealed that listening comprises 55.4% of the total average communication day followed by reading…
McMahon, Fred; Zelder, Martin
Medical Savings Accounts (MSAs) are usually promoted as a demand-management tool that gives consumers incentives to economize on medical expenses. "Making Health Spending Work" takes the concept one step further and shows how MSAs can be used to design a publicly funded system that incorporates market dynamics. MSAs can bring efficiency-enhancing incentives to the supply side, creating consumer choice and empowerment with a public system that meets Medicare's key principles. Over the last few months, Canada's political leaders have begun to break away from the reform-stalling tactics of special interest groups - which profit mightily from the the current system - and to examine sensible reforms that could benefit all Canadians. By breaking free of old dogmas, Canada can turn myth into reality: we can have the best medicare system in the world, one that expands choice and creates efficiency-enhancing dynamics. PMID:12811123
Davis, Cindy; Sloan, Melissa; MacMaster, Samuel; Hughes, Leslie
In order to address HIV infection among college students, a comprehensive measure is needed that can be used with samples from culturally diverse populations. Therefore, this paper assessed the reliability and validity of an HIV/AIDS questionnaire that measures fours dimensions of HIV/AIDS awareness--factual knowledge, prejudice, personal risk,…
Washington, N.; Parnianpour, M.; Fraser, J. M.
Describes the Biomechanics Tutorial, a computer-aided instructional tool that was developed at Ohio State University to expedite the transition from lecture to application for undergraduate students. Reports evaluation results that used statistical analyses and student questionnaires to show improved performance on posttests as well as positive…
McAbee, Michael K.
In response to tightening emission standards imposed by the government, Japanese industry will increase its capital spending on pollution control equipment to account for about 20 percent of all industrial capital spending. Preferential treatment and loans from government-affiliated financial institutions are available for projects. (Author/MLH)
This article features a report on states and school districts spending almost $600 billion on building and renovating schools from 1995 to 2004, an amount that far exceed earlier expectations. The report also emphasized the uneven facilities spending between minority and affluent districts. Besides receiving the least money for facilities, the…
Data from private insurance companies make it possible to analyse how healthcare spending is distributed across individuals, how it depends on the age of the people and how it changes over time. Within age groups, healthcare spending is less concentrated if recipients are older. Over the analysed period of time, a considerable levelling of expenses takes place. These findings lead to the conclusion that the ageing population will result in a greater and more evenly spread utilisation of healthcare facilities. PMID:18405231
Juhnke, Gerald A.
Threats of violence are not uncommon to counselors, faculty, or teachers. Each must be taken seriously, quickly analyzed, and safety procedures implemented. Yet, there exists a paucity of brief, face-to-face, assessments designed to aid threat assessment. To address this paucity, the author created The DANGERTOME Personal Risk Threat Assessment…
Alfonso, Y Natalia; Ding, Guiru; Bishai, David
Using cross-country data on gross domestic product and national expenditure on vaccines, we estimate and compare the income elasticity of vaccine expenditure and general curative healthcare expenditure. This study provides the first evidence on the national income elasticity of vaccination spending. Both fixed and random effects models are applied to data from 84 countries from 2010 to 2011. The income elasticities for healthcare expenditure and vaccine expenditure are 0.844 and 0.336, respectively. Despite vaccines' high cost-effectiveness, the national propensity to spend income on vaccines as income increases lags behind general health care. The low income elasticity of vaccine spending means that relying on economic growth alone will provide an unacceptably slow trajectory to achieving high vaccine coverage levels. Copyright © 2015 John Wiley & Sons, Ltd. PMID:26010073
Larwin, Karen H.; Gorman, Jennifer; Larwin, David A.
Testing aids, including student-prepared testing aids (a.k.a., cheat sheets or crib notes) and open-textbook exams, are common practice in post-secondary assessment. There is a considerable amount of published research that discusses and investigates the impact of these testing aids. However, the findings of this research are contradictory and…
Arán-Matero, Daniel; Amico, Peter; Arán-Fernandez, Christian; Gobet, Benjamin; Izazola-Licea, José Antonio; Avila-Figueroa, Carlos
Background An estimated 1.86 million people are living with HIV in Latin America and the Caribbean (LAC). The region is comprised of mainly middle-income countries with steady economic growth while simultaneously there are enormous social inequalities and several concentrated AIDS epidemics. This paper describes HIV spending patterns in LAC countries including analysis of the levels and patterns of domestic HIV spending from both public and international sources. Methods and Findings We conducted an extensive analysis of the most recently available data from LAC countries using the National AIDS Spending Assessment tool. The LAC countries spent a total of US$ 1.59 billion on HIV programs and services during the latest reported year. Countries providing detailed information on spending showed that high percentages are allocated to treatment and care (75.1%) and prevention (15.0%). Domestic sources accounted for 93.6 percent of overall spending and 79 percent of domestic funds were directed to treatment and care. International funds represented 5.4 percent of total HIV funding in the region, but they supplied the majority of the effort to reach most-at-risk-populations (MARPs). However, prevalence rates among men who have sex with men (MSM) still reached over 25 percent in some countries. Conclusions Although countries in the region have increasingly sustained their response from domestic sources, still there are future challenges: 1) The growing number of new HIV infections and more people-living-with-HIV (PLWH) eligible to receive antiretroviral treatment (ART); 2) Increasing ART coverage along with high prices of antiretroviral drugs; and 3) The funding for prevention activities among MARPs rely almost exclusively on external donors. These threats call for strengthened actions by civil society and governments to protect and advance gains against HIV in LAC. PMID:21799839
Amico, Peter; Aran, Christian; Avila, Carlos
Background HIV has devastated numerous countries in sub-Saharan Africa and is a dominant health force in many other parts of the world. Its undeniable importance is reflected in the establishment of Millennium Development Goal No. 6. Unprecedented amounts of funding have been committed and disbursed over the past two decades. Many have argued that this enormous influx of funding has been detrimental to building stronger health systems in recipient countries. This paper examines the funding share for HIV measured against the total funding for health. Methodology/Principal Findings A descriptive analysis of HIV and health expenditures in 2007 from 65 countries was conducted. Comparable data from individual countries was used by applying a consistent definition for HIV expenditures and total health expenditures from NHAs to align them with National AIDS Assessment Reports. In 2007, the total public and international expenditure in LMICs for HIV was 1.6 percent of the total spending on health, while the share in SSA was 19.4 percent. HIV prevalence was six-fold higher in SSA than the next highest region and it is the only region whose share of HIV spending exceeded the burden of HIV DALYs. Conclusions/Significance The share of HIV spending across the 65 countries was quite moderate considering that the estimated share of deaths attributable to HIV stood at 3.8 percent and DALYs at 4.4 percent. Several high spending countries are using a large share of their total health spending for HIV health, but these countries are the exception rather than representative of the average SSA country. There is wide variation between regions, but the burden of disease also varies significantly. The percentage of HIV spending is a useful indicator for better understanding health care resources and their allocation patterns. PMID:20885986
Desrochers, Donna M.
Athletics are big business on many college campuses, but does this come with a price tag? This issue brief looks at academic and athletic spending in NCAA Division I public universities between 2005 and 2010. Among a host of findings, this brief shows that the athletic departments of most public colleges and universities competing in NCAA Division…
Smith, M. J.; Purves, D. W.; Joppa, L. N.; Emmott, S.; Lyutsarev, V.; Bishop, C. M.; Palmer, P. I.; Calderhead, B.; Vanderwel, M. C.
Considerable efforts to quantify different sources of variation in climate change projections (some might say uncertainty) have led to a welcome set of additional information on which to base confidence about what and how different futures might unfold and how different types of mediating efforts might affect the future. Quantifying the impacts of these different sources of variation on key climate change projection metrics should be used in part to guide future model development efforts. I will report on several of my team's recent research projects to better quantify and assess the importance of different sources of variation. I will show how we use inference techniques to estimate parameter uncertainty in land and marine carbon components of earth system models by comparing them with observational evidence and show how we propagate such uncertainty to better assess how such systems might respond to climate change and quantify the impact of reducing uncertainty for different applications. I will also show how we use such techniques on simulation models themselves to identify key sources of variation in their predictions: helping to pinpoint important focal areas for model improvement. Lastly, I will show a new software prototype being designed to enable any user to view climate model projections alongside historical and recent observational evidence while, importantly, also exposing some of the variation / uncertainty in the reported information.
Allievi, Alessandro G.; Arichi, Tomoki; Gordon, Anne L.; Burdet, Etienne
There is a pressing need for new techniques capable of providing accurate information about sensorimotor function during the first 2 years of childhood. Here, we review current clinical methods and challenges for assessing motor function in early infancy, and discuss the potential benefits of applying technology-assisted methods. We also describe how the use of these tools with neuroimaging, and in particular functional magnetic resonance imaging (fMRI), can shed new light on the intra-cerebral processes underlying neurodevelopmental impairment. This knowledge is of particular relevance in the early infant brain, which has an increased capacity for compensatory neural plasticity. Such tools could bring a wealth of knowledge about the underlying pathophysiological processes of diseases such as cerebral palsy; act as biomarkers to monitor the effects of possible therapeutic interventions; and provide clinicians with much needed early diagnostic information. PMID:25324827
This article outlines some key issues for writing effective computer-aided assessment (CAA) questions in subjects with substantial mathematical or statistical content, especially the importance of control of random parameters and the encoding of wrong methods of solution (mal-rules) commonly used by students. The pros and cons of using CAA and…
St. John, Edward P.
A study used price-response measures from recent national studies to assess college and university pricing (tuition and student aid) alternatives in diverse institutional settings. It is concluded that such analyses are feasible. Analysis indicated limits to "Robin Hood" pricing patterns are predominant in private colleges. Consideration of new…
Broughton, Stephen J.; Robinson, Carol L.; Hernandez-Martinez, Paul
Computer-aided assessment (CAA) has been used at a university with one of the largest mathematics and engineering undergraduate cohorts in the UK for more than ten years. Lecturers teaching mathematics to first year students were asked about their current use of CAA in a questionnaire and in interviews. This article presents the issues that these…
Kross, Carolyn Sue
In fall 1990, a study was conducted to assess the attitudes of nursing students who were attending Riverside Community College (RCC), in California, toward exposure to Acquired Immune Deficiency Syndrome/Human Immunodeficiency Virus (AIDS/HIV) positive patients in a hospital setting. All students enrolled in RCC's associate degree nursing program…
Smith, Cheri; And Others
The purpose of this ongoing study was to assess attitudes, knowledge and behaviors in college students toward Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS). The researchers wanted to asses students' knowledge, attitudes, and behavior for utilization in educational and skill building programs for college students.…
Zelin, Robert C., II
This paper describes how a technology-based case using Microsoft Access can aid in the assessment process. A case was used in lieu of giving a final examination in an Accounting Information Systems course. Students worked in small groups to design a database-driven payroll system for a hypothetical company. Each group submitted its results along…
Klassen, R.D.; Roberge, P.R.; Tullmin, M.A.
In certain regimes of atmospheric corrosion, the corrosion rate is limited not by electrochemical reactions but by the rate of mass transfer of pollutants. In these cases, a mass transfer model that accounts for the transport of pollutants, such as a marine salt aerosol, provides a theoretical and predictive framework for assessing corrosivity severity. Such a model of the transport of a marine aerosol fairly near the ground and well within the planetary boundary layer was developed. The predicted aerosol concentration as a function of distance for 1500 m from a steady source was consistent with published data on steel corrosion and salinity rates near an ocean. Implications from the model regarding objects that are exposed to aerosol-containing wind include: (1) increasing wind speed increases the aerosol deposition rate and therefore the corrosion rate, (2) objects that are in the lee of prevailing winds from an aerosol source will corrode faster than objects on the windward side of an aerosol source, and (3) smaller objects can be expected to corrode faster because of a greater capture efficiency of salt aerosols.
Reliability, the Chancellor's Autumn Statement on the country's economic prospects, and the Government's public spending plans seldom go hand in hand. Last year's statement, however, offers an insight into this year's discussions and negotiations and their effect on NHS resources. Tom Jones sets the scene. PMID:10122088
Farmer, Lesley; Shontz, Marilyn
This year's "School Library Journal's" spending survey showed that, despite the recession, the vast majority of media centers around the country have retained their credentialed media specialists. For example, almost 85% of elementary schools and more than 95% of middle and high schools have a full-time certified librarian. In addition, salaries…
Cavallo, Dana A; Nich, Charla; Schepis, Ty S; Smith, Anne E; Liss, Thomas B; McFetridge, Amanda K; Krishnan-Sarin, Suchitra
Contingency management (CM) utilizing monetary incentives is efficacious in enhancing abstinence in an adolescent smoking cessation program, but how adolescents spend their money has not been examined. We assessed spending habits of 38 adolescent smokers in a CM-based smoking cessation project prior to quitting and during treatment using a questionnaire about spending in a number of categories, including cigarettes, other addictive substances, durable goods, and disposable goods. Our preliminary results indicate that participation in a CM based program for smoking cessation did not lead to greater spending on cigarettes and other substances and may have produced more socially acceptable spending. PMID:20802850
Aguilar, Michael L.
The NASA Engineering and Safety Center (NESC) was requested to perform an independent assessment of the mitigation of the Constellation Program (CxP) Risk 4421 through the use of computer-aided software engineering (CASE) tools. With the cancellation of the CxP, the assessment goals were modified to capture lessons learned and best practices in the use of CASE tools. The assessment goal was to prepare the next program for the use of these CASE tools. The outcome of the assessment is contained in this document.
Heijink, Richard; Koolman, Xander; Westert, Gert P
Healthcare expenditures rise as a share of GDP in most countries, raising questions regarding the value of further spending increases. Against this backdrop, we assessed the value of healthcare spending growth in 14 western countries between 1996 and 2006. We estimated macro-level health production functions using avoidable mortality as outcome measure. Avoidable mortality comprises deaths from certain conditions "that should not occur in the presence of timely and effective healthcare". We investigated the relationship between total avoidable mortality and healthcare spending using descriptive analyses and multiple regression models, focussing on within-country variation and growth rates. We aimed to take into account the role of potential confounders and dynamic effects such as time lags. Additionally, we explored a method to estimate macro-level cost-effectiveness. We found an average yearly avoidable mortality decline of 2.6-5.3% across countries. Simultaneously, healthcare spending rose between 1.9 and 5.9% per year. Most countries with above-average spending growth demonstrated above-average reductions in avoidable mortality. The regression models showed a significant association between contemporaneous and lagged healthcare spending and avoidable mortality. The time-trend, representing an exogenous shift of the health production function, reduced the impact of healthcare spending. After controlling for this time-trend and other confounders, i.e. demographic and socioeconomic variables, a statistically significant relationship between healthcare spending and avoidable mortality remained. We tentatively conclude that macro-level healthcare spending increases provided value for money, at least for the disease groups, countries and years included in this study. PMID:22678656
Wu, Yu-Hsiang; Bentler, Ruth A
The directional microphone systems of modern digital hearing aids are capable of changing their spatial directivity pattern and/or the microphone mode in response to changes in the properties of environmental sounds. These adaptive/automatic features make measurement of a hearing aid's directivity in a given test environment very difficult. Assessing the directivity of such systems requires a signal that can record the system's response while not changing the system's directivity. This paper proposes a method using a signal cancellation technique involving impulse responses to acoustically assess a hearing aid's directivity (referred to as the IR method). The impulse is presumed to be undetectable to the adaptive/automatic system because it contains little energy and a short response could be recorded before the system actually reacts. In the current study, the IR method was evaluated by testing five adaptive/automatic directional hearing aids in noise of various intensities. The results revealed that the IR method was an accurate and repeatable way to assess slow-acting directional systems in noise of varying intensities and fast-acting systems in noise of high intensities. PMID:20000935
Hurd, Michael D.; Rohwedder, Susann
The simple one-good model of life-cycle consumption requires that consumption be continuous over retirement; yet prior research based on partial measures of consumption or on synthetic panels indicates that spending drops at retirement, a result that has been called the retirement-consumption puzzle. Using panel data on total spending, nondurable spending and food spending, we find that spending declines at small rates at retirement, rates that could be explained by mechanisms such as the cessation of work-related expenses, unexpected retirement due to a health shock or by the substitution of time for spending. We find substantial heterogeneity in spending change at retirement: in the upper half of the wealth distribution spending increased. In the low-wealth population where spending did decline at higher rates, the main explanation for the decline appears to be early retirement due to poor health, possibly augmented by a short planning horizon by a minority of the population. PMID:24524026
Concerns about cuts in federal student loan and grant programs are outlined, and ways in which institutions can act to influence policy are examined. Basic facts about potential cuts, their effects, federal spending on student aid, aid recipients, public opinion, and aid policy's effects on tuition are discussed. (MSE)
Ojo, K; Delaney, M
Recent announcements by the Government of Namibia to provide financial support to people living with AIDS (and their family members) have received considerable media attention. However, given the fact that government budgets are already stretched, and the need for resources to devote the prevention efforts remains, there is an urgent need to assign some values to the support the government is considering within the context of an explosive epidemic. It is against this background that this study attempts to provide a rapid assessment of the economic costs of HIV/AIDS in Namibia over the next 5 years of the First National Development Plan. The estimates include the direct and indirect costs. The direct costs are costs to the economy for inpatient and outpatient medical services, as well as the costs of support payments to people living with AIDS, their families and children orphaned by AIDS. Government and donor expenditure on national prevention and control efforts are also included. The study concludes that no sector of the Namibian economy will escape the impact of AIDS. The epidemic will definitely tax hospital, public health, private and community resources, and these substantial burdens underscore the need for coordinated long-term planning. PMID:10177418
Lamale, Helen H.
Unprecedented growth of the typical American family's resources since World War II have had effects upon life style, personal fulfillment, consumption of goods and services, and freedom of occupational choice. It is suggested that the time may have come for concern with nonmaterial elements that determine the quality of life. For journal…
Mattison, D R; Jelovsek, F R
A minimal approach to risk assessment in reproductive toxicology involves four components: hazard identification, hazard characterization, exposure characterization, and risk characterization. In practice, risk assessment in reproductive toxicology has been reduced to arbitrary safety factors or mathematical models of the dose-response relationship. These approaches obscure biological differences across species rather than using this important and frequently accessible information. Two approaches that are formally capable of using biologically relevant information (pharmacokinetics and expert system shells) are explored as aids to risk assessment in reproductive toxicology. PMID:3447888
Mattison, D.R.; Jelovsek, F.R.
A minimal approach to risk assessment in reproductive toxicology involves four components: hazard identification, hazard characterization, exposure characterization, and risk characterization. In practice, risk assessment in reproductive toxicology has been reduced to arbitrary safety factors or mathematical models of the dose-response relationship. These approaches obscure biological differences across species rather than using this important and frequently accessible information. Two approaches that are formally capable of using biologically relevant information (pharmacokinetics and expert system shells) are explored as aids to risk assessment in reproductive toxicology.
Lombardo, Anthony P; Léger, Yves A
The Canadian "Think Again" social marketing HIV/AIDS prevention campaign, adapted from an American effort, encourages gay men to rethink their assumptions about their partners' HIV statuses and the risks of unsafe sex with them. To improve future efforts, existing HIV/AIDS prevention initiatives require critical reflection. While a formal evaluation of this campaign has been carried out elsewhere, here we use the campaign as a social marketing case study to illustrate its strengths and weaknesses, as a learning tool for other campaigns. After describing the campaign and its key results, we assess how it utilized central tenets of the social marketing process, such as formative research and the marketing mix. We then speak to the importance of theoretical influence in campaign design and the need to account for social-contextual factors in safer sex decision making. We conclude with a summary of the lessons learned from the assessment of this campaign. PMID:17558789
Foley, Finbar; Rajagopalan, Srinivasan; Raghunath, Sushravya M; Boland, Jennifer M; Karwoski, Ronald A; Maldonado, Fabien; Bartholmai, Brian J; Peikert, Tobias
Increased clinical use of chest high-resolution computed tomography results in increased identification of lung adenocarcinomas and persistent subsolid opacities. However, these lesions range from very indolent to extremely aggressive tumors. Clinically relevant diagnostic tools to noninvasively risk stratify and guide individualized management of these lesions are lacking. Research efforts investigating semiquantitative measures to decrease interrater and intrarater variability are emerging, and in some cases steps have been taken to automate this process. However, many such methods currently are still suboptimal, require validation and are not yet clinically applicable. The computer-aided nodule assessment and risk yield software application represents a validated tool for the automated, quantitative, and noninvasive tool for risk stratification of adenocarcinoma lung nodules. Computer-aided nodule assessment and risk yield correlates well with consensus histology and postsurgical patient outcomes, and therefore may help to guide individualized patient management, for example, in identification of nodules amenable to radiological surveillance, or in need of adjunctive therapy. PMID:27568149
Bare, Matthew; Kauffman, Craig; Miller, Daniel C.
International conservation donors have spent at least 3.4 billion to protect biodiversity and stem tropical deforestation in Africa since the early 1990s. Despite more than two decades of experience, however, there is little research on the effect of this aid at a region-wide scale. Numerous case studies exist, but show mixed results. Existing research is usually based on community perception or focused on short-term donor objectives rather than specific conservation outcomes, like deforestation rates. Thus, the impact of billions of dollars of conservation aid on deforestation rates remains an open question. This article uses an original dataset to analyze the effect of international conservation aid on deforestation rates in 42 African countries between 2000 and 2013. We first describe patterns of conservation aid across the continent and then assess its impact (with one to five-year lags), controlling for other factors that may also affect deforestation, including rural population, protected areas (PAs), governance, and other economic and commodity production variables. We find that conservation aid is associated with higher rates of forest loss after one- or two-year lags. A similar result holds for PA extent, suggesting possible displacement of deforestation from PAs. However, governance quality in high forest cover countries moderates these effects such that deforestation rates are reduced. Rural population is the most consistent factor associated with forest loss, confirming previous studies of this driver. Our results suggest that in heavily forested countries, development projects designed to support conservation work initially in conditions of good governance, but that conservation aid alone is insufficient to mitigate larger deforestation drivers.
US President Barack Obama has pledged to increase the country's spending on research and development and create an "Apollo era" push for research into renewable energy. Speaking at the 146th annual meeting of the National Academy of Sciences (NAS) in Washington, DC, at the end of April, he outlined a wide-ranging plan for science and technology, from improving teaching of science in schools to reducing carbon emissions. Obama was only the fourth US president after George Bush senior, Jimmy Carter and John F Kennedy to address an NAS annual meeting.
Dunn, Elizabeth W; Aknin, Lara B; Norton, Michael I
Although much research has examined the effect of income on happiness, we suggest that how people spend their money may be at least as important as how much money they earn. Specifically, we hypothesized that spending money on other people may have a more positive impact on happiness than spending money on oneself. Providing converging evidence for this hypothesis, we found that spending more of one's income on others predicted greater happiness both cross-sectionally (in a nationally representative survey study) and longitudinally (in a field study of windfall spending). Finally, participants who were randomly assigned to spend money on others experienced greater happiness than those assigned to spend money on themselves. PMID:18356530
Carr, Simon D; Moraleda, Javier; Baldwin, Alice; Ray, Jaydip
To determine whether an elderly population with hearing impairment can be adequately rehabilitated with a bone-conduction hearing aid and whether the putative relationship between the elderly and an increased complication rate is justified. The study design was a retrospective case note review with a postal and telephone questionnaire, which was carried out in a tertiary centre. All patients aged 60 or over underwent implantation with a bone-conduction aid between 2009 and 2013 for conductive, SSD or mixed hearing loss. Outcome measures were complication rates and quality of life assessment using the Glasgow Benefit Inventory. The influence of patient and surgical factors on the complication rate was assessed. Fifty-one patients were implanted. Mean age was 67 years (range 60-89 years). The mean benefit, satisfaction and global GBI scores were 70 % (range 0-100 %), 70 % (0-100 %) and 82 % (83-100 %), respectively. The residual disability was 18 % (0-25 %). The adverse skin reaction rate was 16 % and the fixture loss rate was 2 %. There was a demonstrable increase in the complication rate with the dermatome (45 %; 5 patients) compared to the Sheffield 'S' (13 %; 2 patients) or linear incision techniques (29 %; 7 patients). The bone-conduction hearing aids are ideal method of hearing rehabilitation in the elderly for all forms of hearing loss. It provides significant benefit with no increased complication rate, which is imperative if social isolation is to be avoided and cognition preserved in this growing elderly population. PMID:25736468
Cao, Fei; Huang, H. K.; Pietka, Ewa; Gilsanz, Vicente
A frequently used assessment method of bone age is atlas matching by a radiological examination of a hand image against a reference set of atlas patterns of normal standards. We are in a process of developing a digital hand atlas with a large standard set of normal hand and wrist images that reflect the skeletal maturity, race and sex difference, and current child development. The digital hand atlas will be used for a computer-aided bone age assessment via Web. We have designed and partially implemented a computer-aided diagnostic (CAD) system for Web-based bone age assessment. The system consists of a digital hand atlas, a relational image database and a Web-based user interface. The digital atlas is based on a large standard set of normal hand an wrist images with extracted bone objects and quantitative features. The image database uses a content- based indexing to organize the hand images and their attributes and present to users in a structured way. The Web-based user interface allows users to interact with the hand image database from browsers. Users can use a Web browser to push a clinical hand image to the CAD server for a bone age assessment. Quantitative features on the examined image, which reflect the skeletal maturity, will be extracted and compared with patterns from the atlas database to assess the bone age. The relevant reference imags and the final assessment report will be sent back to the user's browser via Web. The digital atlas will remove the disadvantages of the currently out-of-date one and allow the bone age assessment to be computerized and done conveniently via Web. In this paper, we present the system design and Web-based client-server model for computer-assisted bone age assessment and our initial implementation of the digital atlas database.
In 2003, the International Patient Decision Aid Standards (IPDAS) Collaboration was established to enhance the quality and effectiveness of patient decision aids by establishing an evidence-informed framework for improving their content, development, implementation, and evaluation. Over this 10 year period, the Collaboration has established: a) the background document on 12 core dimensions to inform the original modified Delphi process to establish the IPDAS checklist (74 items); b) the valid and reliable IPDAS instrument (47 items); and c) the IPDAS qualifying (6 items), certifying (6 items + 4 items for screening), and quality criteria (28 items). The objective of this paper is to describe the evolution of the IPDAS Collaboration and discuss the standardized process used to update the background documents on the theoretical rationales, evidence and emerging issues underlying the 12 core dimensions for assessing the quality of patient decision aids. PMID:24624947
Sunoo, D. H.; Lin, Lynn Y. S.
To assess the relationship between advertising and consumer promotion and to determine the optimal short-term advertising spending level for a product, a research project was undertaken by a major food manufacturer. One thousand homes subscribing to a dual-system cable television service received either no advertising exposure to the product or…
More than three million people in Nigeria are living with HIV/AIDS. In order to reduce the HIV/AIDS burden in Nigeria, the US Government (USG) has dedicated significant resources to combating the epidemic through the President’s Emergency Plan for AIDS Relief (PEPFAR). In-service training (IST) of health workers is one of the most commonly used strategies to improve the quality and coverage of HIV/AIDS services. At USAID/Nigeria’s request, the USAID-funded CapacityPlus project conducted an assessment of PEPFAR-funded IST for all cadres of health workers in Nigeria. Using the IST Improvement Framework, developed by the USAID Applying Sciences to Strengthen and Improve Systems Project (ASSIST), as a guide, the authors developed a survey tool to assess the efficiency, effectiveness and sustainability of IST provided between January 2007 and July 2012 by PEPFAR-funded implementing partners in Nigeria. The instrument was adapted to the Nigerian context and refined through a stakeholder engagement process. It was then distributed via an online platform to more than 50 PEPFAR-funded implementing partners who provided IST in Nigeria. A total of 39 implementing partners completed the survey. Our survey found that PEPFAR implementing partners have been providing a wide range of IST to a diverse group of health workers in Nigeria since 2007. Most trainings are developed using national curricula, manuals and/or other standard operating procedures. Many of the partners are conducting Training Needs Assessments to inform the planning, design and development of their training programs. However, the assessment also pointed to a number of recommendations to increase the efficiency, effectiveness and sustainability of PEPFAR-funded IST. These actions are as follows: improve collaboration and coordination among implementing partners; apply a more diverse and cost-effective set of training modalities; allocate funding specifically for the evaluation of the effectiveness of
Baroudi, Kusai; Ibraheem, Shukran Nasser
Background: This paper aimed to evaluate the application of computer-aided design and computer-aided manufacturing (CAD-CAM) technology and the factors that affect the survival of restorations. Materials and Methods: A thorough literature search using PubMed, Medline, Embase, Science Direct, Wiley Online Library and Grey literature were performed from the year 2004 up to June 2014. Only relevant research was considered. Results: The use of chair-side CAD/CAM systems is promising in all dental branches in terms of minimizing time and effort made by dentists, technicians and patients for restoring and maintaining patient oral function and aesthetic, while providing high quality outcome. Conclusion: The way of producing and placing the restorations made with the chair-side CAD/CAM (CEREC and E4D) devices is better than restorations made by conventional laboratory procedures. PMID:25954082
Cavallo, Dana A.; Nich, Charla; Schepis, Ty S.; Smith, Anne E.; Liss, Thomas B.; McFetridge, Amanda K.; Krishnan-Sarin, Suchitra
Contingency management (CM) utilizing monetary incentives is efficacious in enhancing abstinence in an adolescent smoking-cessation program, but how adolescents spend their money has not been examined. We assessed spending habits of 38 adolescent smokers in a CM-based smoking-cessation project prior to quitting and during treatment using a…
Mannell, Jenevieve; Cornish, Flora; Russell, Jill
Introduction Contemporary HIV-related theory and policy emphasize the importance of addressing the social drivers of HIV risk and vulnerability for a long-term response. Consequently, increasing attention is being given to social and structural interventions, and to social outcomes of HIV interventions. Appropriate indicators for social outcomes are needed in order to institutionalize the commitment to addressing social outcomes. This paper critically assesses the current state of social indicators within international HIV/AIDS monitoring and evaluation frameworks. Methods We analyzed the indicator frameworks of six international organizations involved in efforts to improve and synchronize the monitoring and evaluation of the HIV/AIDS response. Our analysis classifies the 328 unique indicators according to what they measure and assesses the degree to which they offer comprehensive measurement across three dimensions: domains of the social context, levels of change and organizational capacity. Results and discussion The majority of indicators focus on individual-level (clinical and behavioural) interventions and outcomes, neglecting structural interventions, community interventions and social outcomes (e.g. stigma reduction; community capacity building; policy-maker sensitization). The main tool used to address social aspects of HIV/AIDS is the disaggregation of data by social group. This raises three main limitations. Indicator frameworks do not provide comprehensive coverage of the diverse social drivers of the epidemic, particularly neglecting criminalization, stigma, discrimination and gender norms. There is a dearth of indicators for evaluating the social impacts of HIV interventions. Indicators of organizational capacity focus on capacity to effectively deliver and manage clinical services, neglecting capacity to respond appropriately and sustainably to complex social contexts. Conclusions Current indicator frameworks cannot adequately assess the social
Jardón, Alberto; Gil, Ángel M; de la Peña, Ana I; Monje, Concepción A; Balaguer, Carlos
The usability concept refers to aspects related to the use of products that are closely linked to the user's degree of satisfaction. Our goal is to present a functional evaluation methodology for assessing the usability of sophisticated technical aids, such as a portable robot for helping disabled patients with severe spinal cord injuries. The specific manipulator used for this task is ASIBOT, a personal assistance robot totally developed by RoboticsLab at the University Carlos III of Madrid. Our purpose is also to improve some aspects of the manipulator according to the user's perception. For our case study, a population of six patients with spinal cord injury is considered. These patients have been suffering spinal cord injuries for a period of time longer than 1 year before the tests are carried out. The methodology followed for the information gathering is based on the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST). Different daily functions, such as drinking, brushing one's teeth and washing one's face, are considered to assess the user's perception when using ASIBOT as a technical aid. The human factor in this procedure is the main base to establish the specific needs and tools to make the end product more suitable and usable. PMID:20969432
Lee, Hyo-Jong; Goo, Eun-Hoe; Kim, Sung-Soo; Dong, Kyung-Rae; Chung, Woon-Kwan
The aim of this study was to provide clinical information on an oral cavity disease assessment that was conducted using a self-manufactured aid in a computed tomography (CT) oral examination. The study subjects included 30 patients, who were examined using a multi-detector CT (MDCT) 128-slice CT Scanner. Rapidia software was used for quantitative analysis, while a questionnaire and qualitative analysis were used to assess the convenience. The significance was evaluated using a Student's t-test and a Wilcoxon signed rank test. A p value < 0.05 was considered significant. The convenience was evaluated by using a multiple response frequency analysis. The means and the standard deviations, which depended on use of the aid, were 2440.41 ± 4226.26 and 57443.86 ± 12445.91 respectively, the higher values being seen in the image assessment when the aid was used (p = 0.000). In a qualitative evaluation, the means and standard deviations were 2.52 ± 0.44 and 1.62 ± 0.22, respectively, the higher values being shown in the image assessment when the aid was used (p = 0.012). According to the convenience assessment that was conducted using a questionnaire, 80% of the respondents answered that they did not have any inconvenience when using the aid because the scores were 4 points or higher on the scale. In conclusion, the contrast increased when the aid, which enabled a clear identification of the anatomical structure, was inserted to examine the oral cavity. In particular, the patients considered the use of the aid to be convenient. Overall, the aid is recommended for use in a head/neck examination.
Gupta, Indrani; Mondal, Swadhin
This article examines the availability of fiscal space in the context of health spending and the challenges and constraints in raising additional resources for health given the macroeconomic situations, in the ten countries of the South-East Asia region (SEAR) of the World Health Organization (WHO). Using a variety of secondary data, the analysis indicates that there are differences among the SEAR countries with respect to the various indicators of fiscal space. While the aid situation is under control, there are concerns regarding public debt, fiscal deficit, and revenues. Based on the findings, this article proposes ways forward for each of the countries in the coming years. PMID:24003763
Davis, Michelle R.
This article discusses President Bush's budget cut on education spending. The president's blueprint for federal education spending in the next fiscal year includes a high-profile plan to boost math and science education, new money for private school vouchers, a renewed push to improve high schools--and the most drastic cut in Department of…
Zimmer, Zachary; Chappell, Neena L.
The consumer spending preferences of 1,406 senior Canadians were surveyed. Age distinguished those who had product-specific preferences. Income and health status separated those interested in recreational spending from those more interested in basic needs. Diversity of health and social characteristics in this population extends to their…
Delaney, Jennifer A.; Doyle, William R.
This paper explores the role that state spending on higher education capital outlays plays in state budgets by considering the functional form of the relationship between state spending on higher education capital outlays and four types of state expenditures. Three possible functional forms are tested: a linear model, a quadratic model, and the…
Taylor, Ronald A.
Federal grants, training, and recruitment spending directed at historically black colleges and universities (HBCUs) jumped 21% in a 2-year period, led by sharp increases in research spending by the Central Intelligence Agency and Departments of Veterans Affairs and Commerce, and Department of Energy teaching endowments. Much of the increase is…
Reed, Sherrie; Rose, Heather
Examining resource allocation practices, including savings, of charter schools is critical to understanding their financial viability and sustainability. Using 9 years of finance data from California, we find charter schools spend less on instruction and pupil support services than traditional public schools. The lower spending on instruction and…
Graves, Mary A.
This workbook assists college and vocational school bound American Indian students in determining their financial needs and in locating sources of financial aid. A checklist helps students assess the state of their knowledge of financial programs; a glossary defines terms pertinent to the realm of financial aid (i.e., graduate study programs,…
Wu, Yu-Hsiang; Bentler, Ruth A
The directivity of an adaptive directional microphone hearing aid (DMHA) cannot be assessed by the method that calls for presenting a "probe" signal from a single loudspeaker to the DMHA that moves to different angles. This method is invalid because the probe signal itself changes the polar pattern. This paper proposes a method for assessing the adaptive DMHA using a "jammer" signal, presented from a second loudspeaker rotating with the DMHA, that simulates a noise source and freezes the polar pattern. Measurement at each angle is obtained by two sequential recordings from the DMHA, one using an input of a probe and a jammer, and the other with an input of the same probe and a phase-inverted jammer. After canceling out the jammer, the remaining response to the probe signal can be used to assess the directivity. In this paper, the new method is evaluated by comparing responses from five adaptive DMHAs to different jammer intensities and locations. This method was shown to be an accurate and reliable way to assess the directivity of the adaptive DMHA in a high-intensity-jammer condition. PMID:17614507
Xu, L D
The traditional approach to the development of knowledge-based systems (KBS) has been rule-based, where heuristic knowledge is encoded in a set of production rules. A rule-based reasoning (RBR) system needs a well constructed domain theory as its reasoning basis, and it does not make substantial use of the knowledge embedded in previous cases. An RBR system performs relatively well in a knowledge-rich application environment. Although its capability may be limited when previous experiences are not a good representation of the whole population, a case-based reasoning (CBR) system is capable of using past experiences as problem solving tools, therefore, it is appropriate for an experience-rich domain. In recent years, both RBR and CBR have emerged as important and complementary reasoning methodologies in artificial intelligence. For problem solving in AIDS intervention and prevention, it is useful to integrate RBR and CBR. In this paper, a hybrid KBS which integrates a deductive RBR system and an inductive CBR system is proposed to assess AIDS-risky behaviors. PMID:8666473
Gruszauskas, Nicholas Peter
The chances of surviving a breast cancer diagnosis as well as the effectiveness of any potential treatments increase significantly with early detection of the disease. As such, a considerable amount of research is being conducted to augment the breast cancer detection and diagnosis process. One such area of research involves the investigation and application of sophisticated computer algorithms to assist clinicians in detecting and diagnosing breast cancer on medical images (termed generally as "computer-aided diagnosis" or CAD). This study investigated a previously-developed breast ultrasound CAD system with the intent of translating it into a clinically-viable system. While past studies have demonstrated that breast ultrasound CAD may be a beneficial aid during the diagnosis of breast cancer on ultrasound, there are no investigations concerning its potential clinical translation and there are currently no commercially-available implementations of such systems. This study "bridges the gap" between the laboratory-developed system and the steps necessary for clinical implementation. A novel observer study was conducted that mimicked the clinical use of the breast ultrasound CAD system in order to assess the impact it had on the diagnostic performance of the user. Several robustness studies were also performed: the sonographic features used by the system were evaluated and the databases used for calibration and testing were characterized, the effect of the user's input was assessed by evaluating the performance of the system with variations in lesion identification and image selection, and the performance of the system on different patient populations was investigated by evaluating its performance on a database consisting solely of patients with Asian ethnicity. The analyses performed here indicate that the breast ultrasound CAD system under investigation is robust and demonstrates only minor variability when subjected to "real-world" use. All of these results are
McClanahan, T R; Rankin, P S
We used linear and multivariate models to examine the associations between geography, biodiversity, per capita economic output, national spending on conservation, governance, and cultural traits in 55 countries. Cultural traits and social metrics of modernization correlated positively with national spending on conservation. The global distribution of this spending culture was poorly aligned with the distribution of biodiversity. Specifically, biodiversity was greater in the tropics where cultures tended to spend relatively less on conservation and tended to have higher collectivism, formalized and hierarchical leadership, and weaker governance. Consequently, nations lacking social traits frequently associated with modernization, environmentalism, and conservation spending have the largest component of Earth's biodiversity. This has significant implications for setting policies and priorities for resource management given that biological diversity is rapidly disappearing and cultural traits change slowly. Therefore, we suggest natural resource management adapt to and use characteristics of existing social organization rather than wait for or promote social values associated with conservation spending. Supporting biocultural traditions, engaging leaders to increase conservation commitments, cross-national efforts that complement attributes of cultures, and avoiding interference with nature may work best to conserve nature in collective and hierarchical societies. Spending in modernized nations may be a symbolic response to a symptom of economic development and environmental degradation, and here conservation actions need to ensure that biodiversity is not being lost. PMID:26991737
Lenz, Matthias; Kasper, Jürgen
Decision aids (DAs) are interventions designed to help people make specific and deliberative choices among options by providing information about the options and outcomes that is relevant to a person's health status. There is an ongoing discussion about the quality of DAs. The present article provides an overview on systematic approaches using various quality criteria. However, these evaluation guides are not yet implemented. Up to now quality assessment of DAs is often limited to the evidence on efficacy through controlled trials using single-outcome measures. Since DAs are multi-component interventions, single-outcome trials are not sufficient for complete quality assessment. Consideration of theoretical founding and the development process is required. In an earlier paper we proposed a novel concept of quality to meet this challenge. We introduced MATRIX a guide for quality assessment of DAs aimed at disclosing the rationale behind underpinning theories, methods, and goals of a DA. The present paper reports how the development of MATRIX progressed including results of pre-testing and a feasibility study. We present the revised version of MATRIX, explain its basic concept, and describe the way to use it. PMID:19742287
Faludi, Jeremy; Hoang, Tina; Gorman, Patrick; Mulvihill, Martin
This research developed a single-score system to simplify and clarify decision-making in chemical alternatives assessment, accounting for uncertainty. Today, assessing alternatives to hazardous constituent chemicals is a difficult task-rather than comparing alternatives by a single definitive score, many independent toxicological variables must be considered at once, and data gaps are rampant. Thus, most hazard assessments are only comprehensible to toxicologists, but business leaders and politicians need simple scores to make decisions. In addition, they must balance hazard against other considerations, such as product functionality, and they must be aware of the high degrees of uncertainty in chemical hazard data. This research proposes a transparent, reproducible method to translate eighteen hazard endpoints into a simple numeric score with quantified uncertainty, alongside a similar product functionality score, to aid decisions between alternative products. The scoring method uses Clean Production Action's GreenScreen as a guide, but with a different method of score aggregation. It provides finer differentiation between scores than GreenScreen's four-point scale, and it displays uncertainty quantitatively in the final score. Displaying uncertainty also illustrates which alternatives are early in product development versus well-defined commercial products. This paper tested the proposed assessment method through a case study in the building industry, assessing alternatives to spray polyurethane foam insulation containing methylene diphenyl diisocyanate (MDI). The new hazard scoring method successfully identified trade-offs between different alternatives, showing finer resolution than GreenScreen Benchmarking. Sensitivity analysis showed that different weighting schemes in hazard scores had almost no effect on alternatives ranking, compared to uncertainty from data gaps. PMID:27454102
Sironi, S; Capelli, L; Dentoni, L; Del Rosso, R
The aim of this study was to investigate the possibility of comparing the performance of different absorbent aids in terms of odour control by discussing a suitable methodology for product evaluation. To overcome the problems of low test reproducibility owing to biological urine variability, the first step of the work consisted of the identification and the production of artificial urine having a constant and stable composition over time, moreover preventing sensorial assessors from any risk of biological contamination. Sensorial measurements were performed to optimize the similarity between artificial and biological urine, especially as far as the composition of the volatile component and therefore of the odour properties are concerned. The assessment of absorbent articles performance to control urine malodour includes both the concentration and the hedonic tone of the odour released by the article itself loaded with synthetic urine. Analyses were run on different products, which can be grouped into two different classes: absorbing aids with or without odour control technology (OCT) respectively. Results show that, despite of the presence or absence of OCT on absorbing products, their odour concentrations are almost identical, being comprised between 10 000 and 12 000 ouE m(-3) . For this reason, it is evident that odour concentration is not suitable as the sole parameter for comparison of different absorbing products. Instead, the hedonic odour tone (odour pleasantness/unpleasantness) relevant to the different product typologies (that is products with and without OCT) should be used as an additional discriminating factor for this kind of comparative tests. PMID:23237491
van Schoonhoven, Jelmer; Schulte, Michael; Boymans, Monique; Wagener, Kirsten C; Dreschler, Wouter A; Kollmeier, Birger
The aim of this study was to investigate the effect of bilateral hearing aids (HA) in subjects with mild and moderate-to-severe hearing loss. This study was designed as a within-subject feasibility study. Bilateral HA use was assessed using different laboratory tests on speech reception, listening effort, noise tolerance, and localization. All data were evaluated with bilateral and unilateral HA fittings. Forty experienced bilateral HA users were included with hearing impairment ranging from mild to moderate-to-severe. Subjects were stratified into two groups based on the degree of hearing loss. Speech reception in noise, listening effort, and localization tests showed a bilateral benefit for the moderate-to-severely hearing-impaired subjects. A bilateral benefit was also observed for listening effort in the mildly hearing-impaired group. The assessment of listening effort shows promise as a measure of bilateral HA benefit for mild hearing impairment. Localization and speech reception in noise tests provide additional value for larger losses. The next step is to compare experienced unilateral with bilateral HA users. PMID:27460871
Schulte, Michael; Boymans, Monique; Wagener, Kirsten C.; Dreschler, Wouter A.; Kollmeier, Birger
The aim of this study was to investigate the effect of bilateral hearing aids (HA) in subjects with mild and moderate-to-severe hearing loss. This study was designed as a within-subject feasibility study. Bilateral HA use was assessed using different laboratory tests on speech reception, listening effort, noise tolerance, and localization. All data were evaluated with bilateral and unilateral HA fittings. Forty experienced bilateral HA users were included with hearing impairment ranging from mild to moderate-to-severe. Subjects were stratified into two groups based on the degree of hearing loss. Speech reception in noise, listening effort, and localization tests showed a bilateral benefit for the moderate-to-severely hearing-impaired subjects. A bilateral benefit was also observed for listening effort in the mildly hearing-impaired group. The assessment of listening effort shows promise as a measure of bilateral HA benefit for mild hearing impairment. Localization and speech reception in noise tests provide additional value for larger losses. The next step is to compare experienced unilateral with bilateral HA users. PMID:27460871
Ma, Kevin; Moin, Paymann; Zhang, Aifeng; Liu, Brent
Bone Age Assessment (BAA) of children is a clinical procedure frequently performed in pediatric radiology to evaluate the stage of skeletal maturation based on the left hand x-ray radiograph. The current BAA standard in the US is using the Greulich & Pyle (G&P) Hand Atlas, which was developed fifty years ago and was only based on Caucasian population from the Midwest US. To bring the BAA procedure up-to-date with today's population, a Digital Hand Atlas (DHA) consisting of 1400 hand images of normal children of different ethnicities, age, and gender. Based on the DHA and to solve inter- and intra-observer reading discrepancies, an automatic computer-aided bone age assessment system has been developed and tested in clinical environments. The algorithm utilizes features extracted from three regions of interests: phalanges, carpal, and radius. The features are aggregated into a fuzzy logic system, which outputs the calculated bone age. The previous BAA system only uses features from phalanges and carpal, thus BAA result for children over age of 15 is less accurate. In this project, the new radius features are incorporated into the overall BAA system. The bone age results, calculated from the new fuzzy logic system, are compared against radiologists' readings based on G&P atlas, and exhibits an improvement in reading accuracy for older children.
Ramji, Sabrina; Quiñonez, Carlos
This study considers three questions: 1. What are the Canadian public's prioritization preferences for new government spending on a range of public health-related goods outside the scope of the country's national system of health insurance? 2. How homogenous or heterogeneous is the Canadian public in terms of these preferences? 3. What factors are predictive of the Canadian public's preferences for new government spending? Data were collected in 2008 from a national random sample of Canadian adults through a telephone interview survey (n=1,005). Respondents were asked to rank five spending priorities in terms of their preference for new government spending. Bivariate and multivariable logistic regression analyses were conducted. As a first priority, Canadian adults prefer spending on child care (26.2%), followed by pharmacare (23.1%), dental care (20.8%), home care (17.2%), and vision care (12.7%). Sociodemographic characteristics predict spending preferences, based on the social position and needs of respondents. Policy leaders need to give fair consideration to public preferences in priority setting approaches in order to ensure that public health-related goods are distributed in a manner that best suits population needs. PMID:23110682
The objective of this study is to assess the effectiveness of the educational environment supported by computer aided presentations at primary school. The effectiveness of the environment has been evaluated in terms of students' learning and remembering what they have learnt. In the study, we have compared experimental group and control group in…
Havik, Else M.; Steyvers, Frank J. J. M.; van der Velde, Hanneke; Pinkster, J. Christiaan; Kooijman, Aart C.
This study evaluated a protocol that was developed to assess how beneficial electronic travel aids are for persons who are visually impaired. Twenty persons with visual impairments used an electronic travel device (Trekker) for six weeks to conform to the protocol, which proved useful in identifying successful users of the device. (Contains 2…
This study assessed the policies, strategic plans and structures that have been put in place in Zimbabwe to address the HIV/AIDS epidemic in the education sector. It also examined the comprehensiveness of projects and programmes currently being implemented by the government in collaboration with partner organisations and NGOs. The findings show…
Bento, Ricardo Ferreira; Battistella, Linamara Rizzo
Background Hearing loss can affect approximately 15% of the pediatric population and up to 40% of the adult population. The gold standard of treatment for hearing loss is amplification of hearing thresholds by means of a hearing aid instrument. A hearing aid is an electronic device equipped with a topology of only three major components of aggregate cost. The gold standard of hearing aid fittings is face-to-face appointments in hearing aid centers, clinics, or hospitals. Telefitting encompasses the programming and adjustments of hearing aid settings remotely. Fitting hearing aids remotely is a relatively simple procedure, using minimal computer hardware and Internet access. Objective This project aimed to examine the feasibility and outcomes of remote hearing aid adjustments (telefitting) by assessing patient satisfaction via the Portuguese version of the Satisfaction With Amplification in Daily Life (SADL) questionnaire. Methods The Brazilian Portuguese version of the SADL was used in this experimental research design. Participants were randomly selected through the Rehabilitation Clinical (Espaco Reouvir) of the Otorhinolaryngology Department Medical School University of Sao Paulo. Of the 8 participants in the study, 5 were female and 3 were male, with a mean age of 71.5 years. The design consisted of two face-to-face sessions performed within 15 working days of each other. The remote assistance took place 15 days later. Results The average scores from this study are above the mean scores from the original SADL normative data. These indicate a high level of satisfaction in participants who were fitted remotely. Conclusions The use of an evaluation questionnaire is a simple yet effective method to objectively assess the success of a remote fitting. Questionnaire outcomes can help hearing stakeholders improve the National Policy on Hearing Health Care in Brazil. The results of this project indicated that patient satisfaction levels of those fitted remotely were
Zhang, Aifeng; Uyeda, Joshua; Tsao, Sinchai; Ma, Kevin; Vachon, Linda A.; Liu, Brent J.; Huang, H. K.
Bone age assessment (BAA) of children is a clinical procedure frequently performed in pediatric radiology to evaluate the stage of skeletal maturation based on a left hand and wrist radiograph. The most commonly used standard: Greulich and Pyle (G&P) Hand Atlas was developed 50 years ago and exclusively based on Caucasian population. Moreover, inter- & intra-observer discrepancies using this method create a need of an objective and automatic BAA method. A digital hand atlas (DHA) has been collected with 1,400 hand images of normal children from Asian, African American, Caucasian and Hispanic descends. Based on DHA, a fully automatic, objective computer-aided-diagnosis (CAD) method was developed and it was adapted to specific population. To bring DHA and CAD method to the clinical environment as a useful tool in assisting radiologist to achieve higher accuracy in BAA, a web-based system with direct connection to a clinical site is designed as a novel clinical implementation approach for online and real time BAA. The core of the system, a CAD server receives the image from clinical site, processes it by the CAD method and finally, generates report. A web service publishes the results and radiologists at the clinical site can review it online within minutes. This prototype can be easily extended to multiple clinical sites and will provide the foundation for broader use of the CAD system for BAA.
Yamamoto, M; Sano, M
One of the important assignments in the planning of community medical care is to find an effective way of implementing the sharing of facilities together with their coordination. In particular, the establishment of a smooth and effective system co-ordinating facilities and functions of medical organizations, comprising clinics and hospitals of various levels, and the installation of an information system, designed to provide positive assistance in information control as well as in its operation, should be undertaken urgently. In this paper, we discuss the patient-transfer system, which is one of the facility-co-ordination-system for medical organizations, from the point of view of total community medical care. Specifically we describe the purpose, features and total structure of the patient-transfer system, and discuss the basic plan for an information system designed to aid patient transfer, from information control together with an advance assessment from the system-engineering point of view. This research has been promoted by the Aichi Medical Association committee for medical care system. The proposed system is planned to be operational in the near future. PMID:3441155
Craig, Andrew P; Thein, Hla-Hla; Zhang, Lei; Gray, Richard T; Henderson, Klara; Wilson, David; Gorgens, Marelize; Wilson, David P
Introduction It is increasingly important to prioritize the most cost-effective HIV interventions. We sought to summarize the evidence on which types of interventions provide the best value for money in regions with concentrated HIV epidemics. Methods We conducted a systematic review of peer-reviewed and grey literature reporting measurements of cost-effectiveness or cost-benefit for HIV/AIDS interventions in Asia and Eastern Europe. We also collated HIV/AIDS spending assessment data from case-study countries in the region. Results We identified 91 studies for inclusion, 47 of which were from peer-reviewed journals. Generally, in concentrated settings, prevention of mother-to-child transmission programmes and prevention programmes targeting people who inject drugs and sex workers had lower incremental cost-effectiveness ratios than programmes aimed at the general population. The few studies evaluating programmes targeting men who have sex with men indicate moderate cost-effectiveness. Collation of prevention programme spending data from 12 countries in the region (none of which had generalized epidemics) indicated that resources for the general population/non-targeted was greater than 30% for eight countries and greater than 50% for five countries. Conclusions There is a misalignment between national spending on HIV/AIDS responses and the most affected populations across the region. In concentrated epidemics, scarce funding should be directed more towards most-at-risk populations. Reaching consensus on general principles of cost-effectiveness of programmes by epidemic settings is difficult due to inconsistent evaluation approaches. Adopting a standard costing, impact evaluation, benefits calculation, analysis and reporting framework would enable cross comparisons and improve HIV resource prioritization and allocation. PMID:24572053
Leider, Jonathon P; Sellers, Katie; Shah, Gulzar; Pearsol, Jim; Jarris, Paul E
In recent years, state and local public health department budgets have been cut, sometimes drastically. However, there is no systematic tracking of governmental public health spending that would allow researchers to assess these cuts in comparison with governmental public health spending as a whole. Furthermore, attempts to quantify the impact of public health spending are limited by the lack of good data on public health spending on state and local public health services combined. The objective of this article is to integrate self-reported state and local health department (LHD) survey data from 2 major national organizations to create state-level estimates of governmental public health spending. To create integrated estimates, we selected 1388 LHDs and 46 states that had reported requisite financial information. To account for the nonrespondent LHDs, estimates of the spending were developed by using appropriate statistical weights. Finally, funds from federal pass-through and state sources were estimated for LHDs and subtracted from the total spending by the state health agency to avoid counting these dollars in both state and local figures. On average, states spend $106 per capita on traditional public health at the state and local level, with an average of 42% of spending occurring at the local level. Considerable variation exists in state and local public health funding. The results of this analysis show a relatively low level of public health funding compared with state Medicaid spending and health care more broadly. PMID:22635190
Liou, Kuotsai Tom; Cruise, Peter L.
Thirty-one employees of the Comprehensive Acquired Immune Deficiency Syndrome (AIDS) Program of Palm Beach County (Florida) were surveyed to explore their motives and attitudes toward their jobs, clients, and the organization. Implications for management of AIDS service organizations and program quality are discussed. (SLD)
This article proposes the use of a rehabilitative diagnostic approach to evaluate individuals having communication disorders in the context of the International Classification of Impairment, Disabilities and Handicaps (ICIDH). It suggests the use of computer-assisted communication aids and offers guidelines for using such aids to assess…
Haroun, Dalia; El Saleh, Ola; Wood, Lesley; Mechli, Rola; Al Marzouqi, Nada; Anouti, Samir
Background The Middle East and North Africa (MENA) region is among the top two regions in the world with the fastest growing HIV epidemic. In this context, risks and vulnerability are high as the epidemic is on the rise with evidence indicating significantly increasing HIV prevalence, new HIV infections and AIDS-related deaths. Objective The aim of the survey was to assess HIV/AIDS knowledge and attitudes related to HIV/AIDS among a wide group of university students in the United Arab Emirates (UAE). Methods In a cross-sectional survey, a total sample of 2,294 students (406 male; 1,888 female) from four universities in three different Emirates in the UAE were approached to take part in the study. Students self-completed a questionnaire that was designed to measure their knowledge and attitudes to HIV/AIDS. Results The overall average knowledge score of HIV.AIDS was 61%. Non-Emirati and postgraduates demonstrated higher levels of knowledge compared to Emirati and undergraduate students respectively. No significant differences between males and females; and marital status were found. Eighty-five percent of students expressed negative attitudes towards people living with HIV, with Emirati and single students significantly holding more negative attitudes compared to non-Emiratis and those that are married respectively. Conclusions The findings provide strong evidence that there is a need to advocate for appropriate National HIV/AIDS awareness raising campaigns in universities to reduce the gaps in knowledge and decrease stigmatizing attitudes towards people living with HIV/AIDS. PMID:26913902
Carrino, A.J.; Jones, R.B.; Platt, W.E.; Tiffany, E.D.
Solomon has developed a methodology to determine a large optimum point where availability meets maintenance spending for Powder River Basin (PRB) coal-fired units. Using a database of sufficient size and composition across various operating ranges, Solomon generated an algorithm that predicts the relationship between maintenance spending and availability. Coupling this generalized algorithm with a unit-specific market-loss curve determines the optimum spending for a facility. The article presents the results of the analysis, how this methodology can be applied to develop optimum operating and financial targets for specific units and markets and a process to achieve those targets. It also describes how this methodology can be used for other types of fossil-fired technologies and future enhancements to the analysis. 5 figs.
Dworkin, Shari L.; Blankenship, Kim
Researchers increasingly argue that poverty and gender inequality exacerbate the spread of HIV/AIDS and that economic empowerment can therefore assist in the prevention and mitigation of the disease, particularly for women. This paper critically evaluates such claims. First, we examine the promises and limits of integrated HIV/AIDS prevention and microfinance programs by examining the available evidence base. We then propose future research agendas and next steps that may help to clear current ambiguities about the potential for economic programs to contribute to HIV/AIDS risk reduction efforts. PMID:19294500
Garibaldi, Skip; Frisoli, Kayla; Ke, Li; Lim, Melody
We analyze the spending of individuals in the United States on lottery tickets in an average month, as reported in surveys. We view these surveys as sampling from an unknown distribution, and we use non-parametric methods to compare properties of this distribution for various demographic groups, as well as claims that some properties of this distribution are constant across surveys. We find that the observed higher spending by Hispanic lottery players can be attributed to differences in education levels, and we dispute previous claims that the top 10% of lottery players consistently account for 50% of lottery sales. PMID:25642699
Garibaldi, Skip; Frisoli, Kayla; Ke, Li; Lim, Melody
We analyze the spending of individuals in the United States on lottery tickets in an average month, as reported in surveys. We view these surveys as sampling from an unknown distribution, and we use non-parametric methods to compare properties of this distribution for various demographic groups, as well as claims that some properties of this distribution are constant across surveys. We find that the observed higher spending by Hispanic lottery players can be attributed to differences in education levels, and we dispute previous claims that the top 10% of lottery players consistently account for 50% of lottery sales. PMID:25642699
General Accounting Office, Washington, DC.
The U.S. Congress asked the Government Accounting Office (GAO) to determine the following: (1) to what extent states were spending their Workforce Investment Act (WIA) funds and whether the Department of Labor's (Labor's) data accurately reflected available funds; (2) what Labor did to assess how states were managing their WIA spending; and (3)…
Nilsen, Sigurd R.
A study assessed whether the Department of Labor's (DOL's) information on states' Workforce Investment Act of 1998 (WIA) spending was a true reflection of states' available funds. The most recent available spending data from DOL and the 50 states were analyzed. Interviews were conducted with state workforce officials in nine states, local…
Posey, Ellen I.
The economic impact of Georgia State University on Atlanta was assessed. The survey methodology of Salley (1976) was employed, and the differential expenditure multiplier was recomputed using local value added data. Attention was directed to: university enrollment, payroll, and spending; estimated student and staff spending; calculation of the…
This paper assesses the impact on economic growth of increased efficiency of public spending in primary and lower-secondary education. Higher efficiency in public spending in schools can bolster growth through two main channels. On the one hand, it can allow a transfer of labour from the public sector to the business sector at unchanged…
Carney, A E
The purpose of this paper is to propose a rationale for the future development of speech perception evaluation materials for children using either cochlear implants or vibrotactile aids as sensory prosthetic devices. It is suggested that future evaluation tools extend beyond the assessment of device efficacy. In particular, they should address issues of normal perceptual development in children, as well as the results of intervention with children using these sensory prosthetic devices. PMID:2069182
Mukandavire, Z; Garira, W
Age and sex structured HIV/AIDS model with explicit incubation period is proposed as a system of delay differential equations. The model consists of two age groups that are children (0-14 years) and adults (15-49 years). Thus, the model considers both mother-to-child transmission (MTCT) and heterosexual transmission of HIV in a community. MTCT can occur prenatally, at labour and delivery or postnatally through breastfeeding. In the model, we consider the children age group as a one-sex formulation and divide the adult age group into a two-sex structure consisting of females and males. The important mathematical features of the model are analysed. The disease-free and endemic equilibria are found and their stabilities investigated. We use the Lyapunov functional approach to show the local stability of the endemic equilibrium. Qualitative analysis of the model including positivity and boundedness of solutions, and persistence are also presented. The basic reproductive number ([Symbol: see text](0)) for the model shows that the adult population is responsible for the spread HIV/AIDS epidemic, thus up-to-date developed HIV/AIDS models to assess intervention strategies have focused much on heterosexual transmission by the adult population and the children population has received little attention. We numerically analyse the HIV/AIDS model to assess the community benefits of using antiretroviral drugs in reducing MTCT and the effects of breastfeeding in settings with high HIV/AIDS prevalence ratio using demographic and epidemiological parameters for Zimbabwe. PMID:17453306
Rumberger, Russell W.
An analysis illustrating the direct and indirect role of government policy in generating employment begins by documenting the level and composition of government spending over the last 50 years. In 1929, federal, state, and local expenditures amounted to 10 percent of the Gross National Product (GNP); by 1980, government expenditures represented…
Gratiot, J. Peter
Evidence derived from data accumulated under Vermont's Foundation Plan demonstrates that school district property value is a secondary determinant of school spending level, compared with other factors: the nonresident portion of the property-tax base, resident income, and residents' perceived school-tax burden as a percent of income. (Contains 13…
Sedlacek, Verne O.; Jarvis, William F.
A large and growing body of work exists on the subject of endowment investing, but the equally important topic of endowment spending is treated less often. While the degree to which endowed institutions depend on their endowment for budgetary support varies widely, the market crisis of 2008-09 demonstrated that failure by the endowment to provide…
State spending for higher education in the US grew at the fastest rate during the 2005-2006 fiscal year, allowing most colleges in the nation to regain their financial balance after a series of tight budgets for five years. A new analysis by the Center for the Study of Education Policy, at Illinois State University reported that the total…
Tate, Ormond; Hiiri, Allan
This paper explains methods of handling information about real costs to develop a model that is then used to forecast future costs of specified distance education activities and to obtain funding for these activities. It is addressed to anyone concerned about acquiring and spending money in distance education--managers of systems and institutions,…
People look at one billion dollars in one of two ways: if it is the result of the long, hard effort of years of fundraising, they rejoice; if it signifies an astronomical budget deficit, they cringe. How, then, should people respond as a community to reaching the $1 billion mark ($1,242,436,438, to be exact) in this year's spending for public…
Provides examples of age-appropriate saving and spending activities that teachers can encourage in students to help them develop wise consumer behaviors. Suggests that younger children can save money in piggy banks or savings accounts, and older students can utilize checking accounts and mutual funds. All students can donate unneeded possessions…
Vest, Jusanne M.; And Others
Management training regarding Acquired Immune Deficiency Syndrome (AIDS) begins with three needs assessment tools--instruments measuring fear of AIDS, knowledge of AIDS, and beliefs about the business consequences of the disease. (SK)
Martin, Anne B; Hartman, Micah; Benson, Joseph; Catlin, Aaron
US health care spending increased 5.3 percent to $3.0 trillion in 2014. On a per capita basis, health spending was $9,523 in 2014, an increase of 4.5 percent from 2013. The share of gross domestic product devoted to health care spending was 17.5 percent, up from 17.3 percent in 2013. The faster growth in 2014 that followed five consecutive years of historically low growth was primarily due to the major coverage expansions under the Affordable Care Act, particularly for Medicaid and private health insurance, which contributed to an increase in the insured share of the population. Additionally, the introduction of new hepatitis C drugs contributed to rapid growth in retail prescription drug expenditures, which increased by 12.2 percent in 2014. Spending by the federal government grew at a faster rate in 2014 than spending by other sponsors of health care, leading to a 2-percentage-point increase in its share of total health care spending between 2013 and 2014. PMID:26631494
Keating, Joseph; Meekers, Dominique; Adewuyi, Alfred
Background In response to the growing HIV epidemic in Nigeria, the U.S. Agency for International Development (USAID) initiated the VISION Project, which aimed to increase use of family planning, child survival, and HIV/AIDS services. The VISION Project used a mass-media campaign that focused on reproductive health and HIV/AIDS prevention. This paper assesses to what extent program exposure translates into increased awareness and prevention of HIV/AIDS. Methods This analysis is based on data from the 2002 and 2004 Nigeria (Bauchi, Enugu, and Oyo) Family Planning and Reproductive Health Surveys, which were conducted among adults living in the VISION Project areas. To correct for endogeneity, two-stage logistic regression is used to investigate the effect of program exposure on 1) discussion of HIV/AIDS with a partner, 2) awareness that consistent condom use reduces HIV risk, and 3) condom use at last intercourse. Results Exposure to the VISION mass media campaign was high: 59%, 47%, and 24% were exposed to at least 1 VISION radio, printed advertisement, or TV program about reproductive health, respectively. The differences in outcome variables between 2002 baseline data and the 2004 follow-up data were small. However, those with high program exposure were almost one and a half (Odds Ratio [O.R.] = 1.47, 95% Confidence Interval [C.I.] 1.01–2.16) times more likely than those with no exposure to have discussed HIV/AIDS with a partner. Those with high program exposure were over twice (O.R. = 2.20, C.I. 1.49–3.25) as likely as those with low exposure to know that condom use can reduce risk of HIV infection. Program exposure had no effect on condom use at last sex. Conclusion The VISION Project reached a large portion of the population and exposure to mass media programs about reproductive health and HIV prevention topics can help increase HIV/AIDS awareness. Programs that target rural populations, females, and unmarried individuals, and disseminate information on
The global fight against HIV is progressing; however, women living in rural areas particularly in sub-Saharan Africa (SSA) continue to face the devastating consequences of HIV and AIDS. Lack of knowledge and geographical barriers to HIV services are compounded by gender norms often limiting the negotiation of safe sexual practices among women living in rural areas. This paper discusses findings from a qualitative study conducted in rural areas of Mozambique examining factors that influenced women to engage in HIV risk-reduction practices. The findings from this study led to the emergence of an HIV and AIDS risk assessment and reduction (HARAR) model, which is described in detail. The model helps in understanding gender-related factors influencing men and women to engage in risk-reduction practices, which can be used as a framework in other settings to design more nuanced and contextual policies and programs. PMID:25089093
St. John, Edward P.
This paper explores the need for a better understanding of the influences of prices and student aid on student enrollment and college budgets. The theory of net price has not been found to adequately explain changes in enrollment. Based on a critical review of recent research on student price response, this paper develops an alternative approach…
Advanced Technology, Inc., Reston, VA.
Specifications of the current delivery systems of the Pell Grant program, the Guaranteed Student Loan (GSL) program, and campus-based aid programs are provided. The relationship between features of the programs and delivery systems is also examined. The campus-based programs include the Supplemental Educational Opportunity Grant (SEOG) Program,…
Bernarding, Corinna; Strauss, Daniel J; Hannemann, Ronny; Seidler, Harald; Corona-Strauss, Farah I
An objective estimate of listening effort could support the hearing aid fitting procedure. Most of the digital hearing aids have already hearing aid settings which are supposed to reduce the listening effort, but the effects of these settings on the individual's listening effort remain unclear. In this study, we propose an objective estimate of listening effort using electroencephalographic data. The new method is based on the phase distribution of the ongoing oscillatory EEG activity. We hypothesize that for a non-effortful listening environment the phase is rather uniformly distributed on the unit circle than for a demanding condition. To prove if the phase is uniformly distributed around the unit circle, the Rayleigh Test was applied to the phase of the EEG. This method was tested in 14 hearing impaired subjects (moderate hearing loss, 65.64 ±7.93 yrs, 7 female). The tested hearing aid settings were a directional microphone combined with a noise reduction algorithm in a medium and a strong setting, the noise reduction setting turned off as well as a setting using omnidirectional microphones. Noise embedded sentences (Oldenburg Sentence Test, OlSa) were used as test materials. The task of the subject was to repeat each sentence. The results indicate that the objective estimate of listening effort maps the subjectively rated effort and for a listening situation like the presented one, the strong setting of the directional microphone requires the smallest effort. PMID:25570536
Linsk, Nathan L.; Marder, Reggi E.
This study was conducted to identify efforts by hospital discharge planners to refer clients with human immunodeficiency virus (HIV) or Acquired Immune Deficiency Syndrome (AIDS) to nursing homes; to determine the responses of the facilities contacted; and to identify gaps in services, discharge planner practices, and relationships between…
Taylor, S A; Madrigal, C
The following study investigates the nature of the relationship between physicians and HIV/AIDS patients within the context of the rapidly evolving services/relationship marketing literatures. The emerging evidence suggests that service providers generally play a critical role in the development of positive consumer attitudes and behaviors, and that relationship marketing practices can contribute to the delivery of health services. However, to date, there appears little evidence supporting the efficacy of employing relationship marketing practices in relation to a target market of HIV/AIDS patients. This exploratory study contributes to the body of knowledge by more closely investigating the nature of the patient-physician relationship relative to HIV/AIDS patients' attitudes, marketing-related behaviors, and overall quality-of-life/life satisfaction judgments. The results of this study first suggest that HIV/AIDS patients use the expectancy disconfirmation model when evaluating the performance of their physician. A reliance on expectancy disconfirmation suggests the likely prevalent role of service quality perceptions and satisfaction judgments in evaluating their relationship with their physician. Second, the results appear to support the conclusion that the patient's evaluation of their physician relationship and subsequent behaviors (e.g., word-of-mouth) are directly related to the patient's general perception of received health services. Thus, the patient/physician relationship may play a particularly powerful role in determining patient (marketing related) outcomes relative to other health service settings. Third, a direct influence is supported between negative affective reactions by patients and subsequent outcome behaviors. This finding lends support for the potential efficacy of service recovery efforts when rendering treatment to HIV/AIDS patients. Finally, evidence is presented demonstrating the effect of positive perceptions of the patient
Ying, Michael; Cheng, Sammy C H; Ahuja, Anil T
Ultrasound is useful in assessing cervical lymphadenopathy. Advancement of computer science technology allows accurate and reliable assessment of medical images. The aim of the study described here was to evaluate the diagnostic accuracy of computer-aided assessment of the intranodal vascularity index (VI) in differentiating the various common causes of cervical lymphadenopathy. Power Doppler sonograms of 347 patients (155 with metastasis, 23 with lymphoma, 44 with tuberculous lymphadenitis, 125 reactive) with palpable cervical lymph nodes were reviewed. Ultrasound images of cervical nodes were evaluated, and the intranodal VI was quantified using a customized computer program. The diagnostic accuracy of using the intranodal VI to distinguish different disease groups was evaluated and compared. Metastatic and lymphomatous lymph nodes tend to be more vascular than tuberculous and reactive lymph nodes. The intranodal VI had the highest diagnostic accuracy in distinguishing metastatic and tuberculous nodes with a sensitivity of 80%, specificity of 73%, positive predictive value of 91%, negative predictive value of 51% and overall accuracy of 68% when a cutoff VI of 22% was used. Computer-aided assessment provides an objective and quantitative way to evaluate intranodal vascularity. The intranodal VI is a useful parameter in distinguishing certain causes of cervical lymphadenopathy and is particularly useful in differentiating metastatic and tuberculous lymph nodes. However, it has limited value in distinguishing lymphomatous nodes from metastatic and reactive nodes. PMID:27131839
Burkhalter, Jack E.; Cahill, Sean; Shuk, Elyse; Guidry, John; Corner, Geoffrey; Berk, Alexandra; Candelario, Norman; Kornegay, Mark; Lubetkin, Erica I.
Due to advances in treatment, persons living with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) are living longer, but with aging, immune deficits, and lifestyle factors, they are at increased risk for cancer. This challenges community-based AIDS service organizations (ASOs) to address the growing cancer needs of…
Almost two years into the federal Race to the Top program, states are spending their shares of the $4 billion prize at a snail's pace--a reflection of the challenges the 12 winners face as they try to get ambitious education improvement plans off the ground. Through the end of March, the 11 states and the District of Columbia had spent just 14…
Leider, Jonathon P
Accurate information on how much the United States spends on public health is critical. These estimates affect planning efforts; reflect the value society places on the public health enterprise; and allows for the demonstration of cost-effectiveness of programs, policies, and services aimed at increasing population health. Yet, at present, there are a limited number of sources of systematic public health finance data. Each of these sources is collected in different ways, for different reasons, and so yields strikingly different results. This article aims to compare and contrast all 4 current national public health finance data sets, including data compiled by Trust for America's Health, the Association of State and Territorial Health Officials (ASTHO), the National Association of County and City Health Officials (NACCHO), and the Census, which underlie the oft-cited National Health Expenditure Account estimates of public health activity. In FY2008, ASTHO estimates that state health agencies spent $24 billion ($94 per capita on average, median $79), while the Census estimated all state governmental agencies including state health agencies spent $60 billion on public health ($200 per capita on average, median $166). Census public health data suggest that local governments spent an average of $87 per capita (median $57), whereas NACCHO estimates that reporting LHDs spent $64 per capita on average (median $36) in FY2008. We conclude that these estimates differ because the various organizations collect data using different means, data definitions, and inclusion/exclusion criteria--most notably around whether to include spending by all agencies versus a state/local health department, and whether behavioral health, disability, and some clinical care spending are included in estimates. Alongside deeper analysis of presently underutilized Census administrative data, we see harmonization efforts and the creation of a standardized expenditure reporting system as a way to
Reimherr, Patrick; Harmon, Tim; Strawn, Julie; Choitz, Vickie
Any reform of federal student aid must address the twin challenges of college affordability and completion, which are inextricably linked. Here, CLASP has proposed ways to redirect existing federal student aid spending toward the low- and modest income families who need it most. These are the students for whom federal aid makes a difference in…
Malta, M; Bastos, F I; Pereira-Koller, E M; Cunha, M D; Marques, C; Strathdee, S A
Itajaí is the largest port in southern Brazil and has one of the nation's highest AIDS incidence rates. Since over 400 truck drivers enter the city daily, they may play a key role in the HIV/AIDS epidemic due to transactions with commercial sex workers (CSWs) and/or substance use. We conducted a rapid assessment to establish the context of HIV vulnerability among truckers and CSWs in Itajaí. Forty three in-depth interviews and eight focus groups were conducted with truckers and CSWs. Two truck-driving routes involving brothels, meeting places and drug-use locations were mapped and field observations were collected. Tapes and field notes were transcribed and analyzed for emerging themes. Truck drivers typically had unprotected sex with several partners, including CSWs and truckstop employees. Both truckers and CSWs had low perceived HIV risk in spite of being engaged in high-risk sex behaviors. Use of alcohol and amphetamine-like drugs was frequent among truckers and appeared to influence unsafe sex practices. Knowledge about amphetamine-related risks was low, as was access to health services and HIV/AIDS behavioral interventions. Interventions, targeting truckers, CSWs and truckstop employees, are needed that traverse cities, states and borders and take into account seasonality, spatial context and workplace conditions. PMID:16777641
Ransom, James; Johnson, Anton F
In 1997, at the Davos International Economic Forum, Nelson Mandela stated that "the poor, the vulnerable, the unschooled, the socially marginalized, the women, and the children, those who bear the burden of colonial legacy-these are the sectors of society which bear the burden of AIDS" (Richter, 2001). Nearly a decade later, that statement still holds true, especially in Mr. Mandela's home country. South Africa continues to have one of the world's highest prevalence ratios of HIV infection (UNAIDS, 2002). This paper explores the significance of perceptions, knowledge, practices, and attitudes toward HIV/AIDS in two important groups in South Africa: health care providers based in public health clinics and their patients. This paper will assess the provider-patient interaction from the perspective of members of the South African HIV/AIDS treatment and prevention community. The analysis will examine the results of in-depth interviews and focus group discussions with providers and patients, respectively, in two of South Africa's nine provinces. Between December 2002 and April 2003 in Guateng and KwaZulu-Natal provinces, we conducted (1) in-depth interviews of a spectrum of health care providers at five local public health clinics and (2) focus groups of patients who patronize those clinics. The results show that there are gaps in the HIV/AIDS knowledge of some of the health care providers and that the participants' health beliefs and practices are embedded in the social conditions in which they live and work, which has a ripple effect on their risk behaviors and trumps any intervention messages from their health care providers and larger public health intervention messages. PMID:19229772
Hamermesh, Daniel S.
Sharp differences in time use by nativity emerge when activities are distinguished by incidence and intensity in recent U.S. data. A model with daily fixed costs for assimilating activities predicts immigrants are less likely than natives to undertake such activities on a given day; but those who do will spend relatively more time on them. Activities such as purchasing, education, and market work conform to the model. Other results suggest that fixed costs for assimilating activities are higher for immigrants with poor English proficiency or who originate in less developed countries. An analysis of comparable Australian data yields similar results. PMID:24443631
O'Hare, B; Curtis, M
This analysis examines the gaps in health care financing in Malawi and how foregone taxes could fill these gaps. It begins with an assessment of the disease burden and government health expenditure. Then it analyses the tax revenues foregone by the government of Malawi by two main routes: Illicit financial flows (IFF) from the country, Tax incentives. We find that there are significant financing gaps in the health sector; for example, government expenditure is United States Dollars (USD) 177 million for 2013/2014 while projected donor contribution in 2013/2014 is USD 207 million and the total cost for the minimal health package is USD 535 million. Thus the funding gap between the government budget for health and the required spending to provide the minimal package for 2013/2014 is USD 358 million. On the other hand we estimate that almost USD 400 million is lost through IFF and corporate utilization of tax incentives each year. The revenues foregone plus the current government health spending would be sufficient to cover the minimal public health package for all Malawians and would help tackle Malawi's disease burden. Every effort must be made, including improving transparency and revising laws, to curtail IFF and moderate tax incentives. PMID:26167264
Huang, Jidong; Walton, Kimp; Gerzoff, Robert B; King, Brian A; Chaloupka, Frank J
Evidence-based, statewide tobacco control programs that are comprehensive, sustained, and accountable reduce smoking rates and tobacco-related diseases and deaths. States that made larger investments in tobacco prevention and control have seen larger declines in cigarettes sales than the United States as a whole, and the prevalence of smoking has declined faster as spending for tobacco control programs has increased. CDC's Best Practices for Comprehensive Tobacco Control Programs (Best Practices) outlines the elements of an evidence-based state tobacco control program and provides recommended state funding levels to substantially reduce tobacco-related disease, disability, and death. To analyze states' spending in relation to program components outlined within Best Practices, CDC assessed state tobacco control programs' expenditures for fiscal year 2011. In 2011, states spent approximately $658 million on tobacco control and prevention, which accounts for less than 3% of the states' revenues from the sale of tobacco products and only 17.8% of the level recommended by CDC. Evidence suggests that funding tobacco prevention and control efforts at the levels recommended in Best Practices could achieve larger and more rapid reductions in tobacco use and associated morbidity and mortality. PMID:26110838
Yao, Jianhua; Dwyer, Andrew J.; Summers, Ronald M.; Mollura, Daniel J.
The 2009 pandemic is a global outbreak of novel H1N1 influenza. Radiologic images can be used to assess the presence and severity of pulmonary infection. We develop a computer-aided assessment system to analyze the CT images from Swine-Origin Influenza A virus (S-OIV) novel H1N1 cases. The technique is based on the analysis of lung texture patterns and classification using a support vector machine (SVM). Pixel-wise tissue classification is computed from the SVM value. The method was validated on four H1N1 cases and ten normal cases. We demonstrated that the technique can detect regions of pulmonary abnormality in novel H1N1 patients and differentiate these regions from visually normal lung (area under the ROC curve is 0.993). This technique can also be applied to differentiate regions infected by different pulmonary diseases.
Tucker, Jalie A.; Blum, Elizabeth R.; Xie, Lili; Roth, David L.; Simpson, Cathy A.
Community-dwelling HIV/AIDS patients in rural Alabama self-monitored (SM) daily HIV risk behaviors using an Interactive Voice Response (IVR) system, which may enhance reporting, reduce monitored behaviors, and extend the reach of care. Sexually active substance users (35 men, 19 women) engaged in IVR SM of sex, substance use, and surrounding contexts for 4–10 weeks. Baseline predictors of IVR utilization were assessed, and longitudinal IVR SM effects on risk behaviors were examined. Frequent (n = 22), infrequent (n = 22), and non-caller (n = 10) groups were analyzed. Non-callers had shorter durations of HIV medical care and lower safer sex self-efficacy and tended to be older heterosexuals. Among callers, frequent callers had lost less social support. Longitudinal logistic regression models indicated reductions in risky sex and drug use with IVR SM over time. IVR systems appear to have utility for risk assessment and reduction for rural populations living with HIV disease. PMID:21311964
Manigault, Andrew Wilhelm; Whillock, Summer Rain
Background To improve patient health, recent research urges for medical decision aids that are designed to enhance the effectiveness of specific medically related decisions. Many such decisions involve complex information, and decision aids that independently use deliberative (analytical and slower) or intuitive (more affective and automatic) cognitive processes for such decisions result in suboptimal decisions. Unconscious thought can arguably use both intuitive and deliberative (slow and analytic) processes, and this combination may further benefit complex patient (or practitioner) decisions as medical decision aids. Indeed, mounting research demonstrates that individuals render better decisions generally if they are distracted from thinking consciously about complex information after it is presented (but can think unconsciously), relative to thinking about that information consciously or not at all. Objective The current research tested whether the benefits of unconscious thought processes can be replicated using an Internet platform for a patient medical decision involving complex information. This research also explored the possibility that judgments reported after a period of unconscious thought are actually the result of a short period of conscious deliberation occurring during the decision report phase. Methods A total of 173 participants in a Web-based experiment received information about four medical treatments, the best (worst) associated with mostly positive (negative) side-effects/attributes and the others with equal positive-negative ratios. Next, participants were either distracted for 3 minutes (unconscious thought), instructed to think about the information for 3 minutes (conscious thought), or moved directly to the decision task (immediate decision). Finally, participants reported their choice of, and attitudes toward, the treatments while experiencing high, low, or no cognitive load, which varied their ability to think consciously while
Olken, Benjamin A.; Onishi, Junko; Wong, Susan
We report an experiment in 3,000 villages that tested whether incentives improve aid efficacy. Villages received block grants for maternal and child health and education that incorporated relative performance incentives. Subdistricts were randomized into incentives, an otherwise identical program without incentives, or control. Incentives initially improved preventative health indicators, particularly in underdeveloped areas, and spending efficiency increased. While school enrollments improved overall, incentives had no differential impact on education, and incentive health effects diminished over time. Reductions in neonatal mortality in non-incentivized areas did not persist with incentives. We find no systematic scoring manipulation nor funding reallocation toward richer areas. PMID:25485039
Bredenkamp, Caryn; Buisman, Leander R
The objective of this article is to assess the progress of the Philippines health sector in providing financial protection to the population, as measured by estimates of health insurance coverage, out-of-pocket spending, catastrophic payments and impoverishing health expenditures. Data are drawn from eight household surveys between 2000 and 2013, including two Demographic and Health Surveys, one Family Health Survey and five Family Income and Expenditure Surveys. We find that out-of-pocket spending increased by 150% (real) from 2000 to 2012, with the sharpest increases occurring in recent years. The main driver of health spending is medicines, accounting for almost two-thirds of total health spending, and as much as three-quarters among the poor. The incidence of catastrophic payments has tripled since 2000, from 2.5% to 7.7%. The percentage of people impoverished by health spending has also increased and, in 2012, out-of-pocket spending on health added 1.5 percentage points to the poverty rate, pushing more than 1.5 million people into poverty. In light of these findings, recent policies to enhance financial risk protection-such as the expansion of government-subsidized health insurance from the poor to the near-poor, a policy of zero copayments for the poor, a deepening of the benefit package and provider payment reform aimed at cost-containment-are to be commended. Indeed, between 2008 and 2013, self-reported health insurance coverage increased across all quintiles and its distribution became more pro-poor. To speed progress toward financial protection goals, quick wins could include issuing health insurance cards to the poor to increase awareness of coverage and limiting out-of-pocket spending by clearly defining a clear copayment structure for non-poor members. An in-depth analysis of the pharmaceutical sector would help to shed light on why medicines impose such a large financial burden on households. PMID:27072948
Santerre, Rexford E
Objective To examine if a minimum efficient scale (MES) holds with respect to the population serviced by a local health department (LHD) given the congestability, externality, and scale/scope economy effects potentially associated with public health services. Data Sources/Study Setting A nationally representative sample of LHDs in 2005. Study Design Multiple regression analysis is used to isolate the relation between population and spending while controlling for other factors known to influence local public health costs. Data Collection Data were obtained from the 2005 National Profile of Local Public Health Agencies, a project supported through a cooperative agreement between the National Association of County and City Health Officials and the Centers for Disease Control and Prevention. Principal Findings The MES of a local public health department is approximately 100,000 people. After that size, additional population has little impact on public health spending per capita. Conclusions Seventy-seven percent of LHDs in the sample fall below the 100,000 MES. Higher levels of government may want to provide financial inducements so that smaller LHDs consolidate or enter into agreements with larger public health organizations to provide services. PMID:19656226
This study involved developing a computer-aided diagnosis (CAD) system for discriminating the grades of breast cancer tumors in ultrasound (US) images. Histological tumor grades of breast cancer lesions are standard prognostic indicators. Tumor grade information enables physicians to determine appropriate treatments for their patients. US imaging is a noninvasive approach to breast cancer examination. In this study, 148 3-dimensional US images of malignant breast tumors were obtained. Textural, morphological, ellipsoid fitting, and posterior acoustic features were quantified to characterize the tumor masses. A support vector machine was developed to classify breast tumor grades as either low or high. The proposed CAD system achieved an accuracy of 85.14% (126/148), a sensitivity of 79.31% (23/29), a specificity of 86.55% (103/119), and an AZ of 0.7940. PMID:25810750
Background Metabolic and morphological changes associated with excessive abdominal fat, after the introduction of Antiretroviral Therapy, increase the risk of cardiovascular disease in people living with HIV/AIDS(PLWHA). Accurate methods for body composition analysis are expensive and the use of anthropometric indices is an alternative. However the investigations about this subject in PLWHA are rare, making this research very important for clinical purpose and to advance scientific knowledge. The aim of this study is to correlate results of anthropometric indices of evaluation of body fat distribution with the results obtained by Dual-energy X-Ray Absorptiometry(DEXA), in people living with HIV/AIDS. Methods The sample was of 67 PLWHA(39 male and 28 female), aged 43.6+7.9 years. Body mass index, conicity index, waist/hip ratio, waist/height ratio and waist/thigh were calculated. Separated by sex, each index/ratio was plotted in a scatter chart with linear regression fit and their respective Pearson correlation coefficients. Analyses were performed using Prism statistical program and significance was set at 5%. Results The waist/height ratio presented the highest correlation coefficient, for both male (r=0.80, p<0.001) and female (r=0.87, p <001), while the lowest were in the waist/thigh also for both: male group (r=0.58, p<0.001) and female group (r=0.03, p=0.86). The other indices also showed significant positive correlation with DEXA. Conclusion Anthropometric indices, especially waist/height ratio may be a good alternative way to be used for evaluating the distribution of fat in the abdominal region of adults living with HIV/ADIS. PMID:23031203
Phillips, Stacy R. Gill
This study is centered on one of the prevalent concerns in urban educational settings today, the possible relationship between school spending and student achievement. Many studies have examined the relationship between these two issues to try and determine best practices when planning academically for children in urban public school settings.…
Background Today’s medical students are the future physicians of people living with HIV/AIDS (PLWHA). It is therefore essential that medical students possess the appropriate knowledge and attitudes regarding PLWHA. This study aims to evaluate knowledge and attitudes of pre-clinical Israeli medical students and to assess whether their knowledge and attitudes change throughout their pre-clinical studies. Methods A cross-sectional study was conducted among all pre-clinical medical students from the four medical schools in Israel during the academic year of 2010/2011 (a total of 1,470 students). A self-administered questionnaire was distributed. The questionnaire sought student responses pertaining to knowledge of HIV transmission and non-transmission routes, basic knowledge of HIV/AIDS treatment and attitudes towards HIV/AIDS. Results The study’s response rate was 62.24 percent. Knowledge among pre-clinical medical students was generally high and showed a statistically significant improvement as students progressed through their pre-clinical studies. However, there were some misconceptions, mostly regarding HIV transmission via breastfeeding and knowledge of HIV prevention after exposure to the virus. Students’ attitudes were found to include stigmatizing notions. Furthermore, the majority of medical students correlated HIV with shame and fear. In addition, students’ attitudes toward HIV testing and providing confidential medical information were contradictory to health laws, protocols and guidelines. Overall, no positive changes in students’ attitudes were observed during the pre-clinical years of medical school. Conclusion The knowledge of pre-clinical medical students in Israel is generally high, although there are some knowledge inadequacies that require more emphasis in the curricula of the medical schools. Contrary to HIV-related knowledge, medical students’ attitudes are unaffected by their progression through medical school. Therefore, medical
Stuckler, David; Basu, Sanjay; McKee, Martin
Several recent papers find evidence that global health aid is being diverted to reserves, education, military, or other sectors, and is displacing government spending. This is suggested to occur because ministers of finance have competing, possibly corrupt, priorities and deprive the health sector of resources. Studies have found that development assistance for health routed to governments has a negative impact on health spending and that similar assistance routed to private nongovernmental organizations has a positive impact. An alternative hypothesis is that World Bank and IMF macro-economic policies, which specifically advise governments to divert aid to reserves to cope with aid volatility and keep government spending low, could be causing the displacement of health aid. This article evaluates whether aid displacement was greater when countries undertook a new borrowing program from the IMF between 1996 and 2006. As found in existing studies, for each $1 of development assistance for health, about $0.37 is added to the health system. However, evaluating IMF-borrowing versus non-IMF-borrowing countries reveals that non-borrowers add about $0.45 whereas borrowers add less than $0.01 to the health system. On average, health system spending grew at about half the speed when countries were exposed to the IMF than when they were not. It is important to take account of the political economy of global health finance when interpreting data on financial flows. PMID:21319721
Charatsari, Chrysanthi; Papadaki-Klavdianou, Afroditi; Michailidis, Anastasios
This study assessed farmers' willingness to pay for and spend time attending an Agricultural Educational Program (AEP). Primary data on the demographic and socio-economic variables of farmers were collected from 355 farmers selected randomly from Northern Greece. Descriptive statistics and multivariate analysis methods were used in order to meet…
McCaughey, Deirdre; Stalley, Samantha; Williams, Eric
Using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey the Centers for Medicare & Medicaid Services' Value-Based Purchasing program has now linked patient care experience rating to hospital revenue reimbursement, thereby establishing a key relationship between revenue cycle management and the patient experience. However, little data exist on the effect of hospital resource spending on patient HCAHPS ratings. This article examines environmental services (EVS) expenses and HCAHPS ratings on hospital cleanliness and overall patient experience ratings to determine how these variables are related. No linear relationship between EVS expense spending and HCAHPS ratings was found, but post hoc analysis identified a matrix that differentiated on hospital cleanliness ratings and overall EVS spending. A value score was calculated for each quadrant of the matrix, and it was determined that organizational value derives from management of expense spending rather than pursuit of high HCAHPS scores. A value optimization matrix is introduced, and its four quadrants are described. With increased emphasis on subjective patient experience measures attached to financial consequences, leaders in the healthcare industry must understand the link between expense management and HCAHPS performance. This study has shown that effective operations are derived from the efficient use of resources and are supported by strong leadership, strategic management, and a culture of patient-centered achievement. The capacity of healthcare organizations to identify their unique costs-to-outcomes balance through the value optimization matrix will help provide them with a means to ensure that optimal value is extracted from all expense spending. PMID:24195341
Rogers, P D; Gibson, C; Wilcox, S J; Chong, A
The crashworthiness of occupied proprietary wheelchairs, which are transported in motor vehicles, is currently assessed by physical crash testing in accordance with ISO 7176-19. If such wheelchairs are modified to meet the needs of the occupant, e.g. the addition of special seating, environmental control systems or life support equipment, then those making the modifications take on the manufacturer's responsibilities, one of these being the assessment of the modified wheelchair's ability to withstand vehicle crash forces. Destructively testing bespoke wheelchair designs is not practical so, currently, the transport-related risk is assessed using best engineering judgement. To improve this process virtual crash testing of the wheelchair and occupant was used. A modified crash criteria from ISO 7176-19 is proposed to enable assessment of the wheelchair's crashworthiness and provide the clinical engineer with an informed judgement of how both wheelchair alone and occupant and wheelchair together will behave in a crash. PMID:19848858
Nicholas, Lauren Hersch
Diabetes is rapidly escalating amongst low-income, older adults at great cost to the Medicare program. We use longitudinal survey data from the Health and Retirement Study linked to administrative Medicare records and biomarker data to assess the relationship between Food Stamp receipt and diabetes health outcomes. We find no significant difference in Medicare spending, outpatient utilization, diabetes hospitalizations and blood sugar (HbA1c) levels between recipients and income-eligible non-recipients after controlling for a detailed set of covariates including individual fixed effects and measures of diabetes treatment compliance. As one-third of elderly Food Stamp recipients are currently diabetic, greater coordination between the Food Stamp, Medicare, and Medicaid programs may improve health outcomes for this group. PMID:21112260
Cutler, David M; Davis, Karen; Stremikis, Kristof
The health reform legislation passed in March 2010 will introduce a range of payment and delivery system changes designed to achieve a significant slowing of health care cost growth. Most assessments of the new reform law have focused only on the federal budgetary impact. This updated analysis projects the effect of national reform on total national health expenditures and the insurance premiums that American families would likely pay. We estimate that, on net, the combination of provisions in the new law will reduce health care spending by $590 billion over 2010-2019 and lower premiums by nearly $2,000 per family. Moreover, the annual growth rate in national health expenditures could be slowed from 6.3 percent to 5.7 percent. PMID:20491172
Burkhalter, Jack E; Cahill, Sean; Shuk, Elyse; Guidry, John; Corner, Geoffrey; Berk, Alexandra; Candelario, Norman; Kornegay, Mark; Lubetkin, Erica I
Due to advances in treatment, persons living with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) are living longer, but with aging, immune deficits, and lifestyle factors, they are at increased risk for cancer. This challenges community-based AIDS service organizations (ASOs) to address the growing cancer needs of persons living with HIV/AIDS (PLWHA). Community-based participatory research was applied to engage ASOs in exploring their capacities and needs for integrating cancer-focused programming into their services. Focus groups were conducted with a community advisory board (CAB) representing 10 community-based organizations serving PLWHA. Three 90-minute, serial focus groups were conducted with a mean number of seven participants. Topics explored CAB members' organizational capacities and needs in cancer prevention, detection, treatment, and survivorship. Transcript analyses identified six themes: (a) agencies have limited experience with cancer-focused programs, which were not framed as cancer specific; (b) agencies need resources and collaborative partnerships to effectively incorporate cancer services; (c) staff and clients must be educated about the relevance of cancer to HIV/AIDS; (d) agencies want to know about linkages between HIV/AIDS and cancer; (e) cancer care providers should be culturally competent; and (f) agencies see opportunities to improve their services through research participation but are wary. Agency capacities were strong in relationships with clients and cultural competency, a holistic view of PLWHA health, expertise in prevention activities, and eagerness to be on the cutting edge of knowledge. Cancer education and prevention were of greatest interest and considered most feasible, suggesting that future projects develop accordingly. These findings suggest a high level of receptivity to expanding or initiating cancer-focused activities but with a clear need for education and awareness building
Suwandecha, Tan; Wongpoowarak, Wibul; Srichana, Teerapol
Dry powder inhalers (DPIs) are gaining popularity for the delivery of drugs. A cost effective and efficient delivery device is necessary. Developing new DPIs by modifying an existing device may be the simplest way to improve the performance of the devices. The aim of this research was to produce a new DPIs using computational fluid dynamics (CFD). The new DPIs took advantages of the Cyclohaler® and the Rotahaler®. We chose a combination of the capsule chamber of the Cyclohaler® and the mouthpiece and grid of the Rotahaler®. Computer-aided design models of the devices were created and evaluated using CFD. Prototype models were created and tested with the DPI dispersion experiments. The proposed model 3 device had a high turbulence with a good degree of deagglomeration in the CFD and the experiment data. The %fine particle fraction (FPF) was around 50% at 60 L/min. The mass median aerodynamic diameter was around 2.8-4 μm. The FPF were strongly correlated to the CFD-predicted turbulence and the mechanical impaction parameters. The drug retention in the capsule was only 5-7%. In summary, a simple modification of the Cyclohaler® and Rotahaler® could produce a better performing inhaler using the CFD-assisted design. PMID:25265389
DeLaura, F.L.; Sharp, S.J.; Clark, R.
The Department of Defense is committed to applying the best in modern technology toward improving the transfer of design, engineering, and manufacturing technical information among weapon-system contractors and DoD organizations. The Military Services, the Defense Logistics Agency (DLA), the Defense Communications Agency (DCA), and industry are undertaking or planning telecommunications support for such transfer. In view of these many and diverse efforts, the Computer Aided Logistics Support (CALS) Steering Group through the CALS Communications Working Group has recognized the need for evaluating them. The report presents an evaluation of CALS-related telecommunications requirements in DoD, the major efforts for automating engineering drawing and technical data repositories, and various intelligent-gateway efforts in each of the Services. The overall direction within each Service for telecommunication support and transitioning to the OSI (Open Systems Interconnection) standards is presented, as well as the status of commercial efforts for defining and implementing the OSI standards and improving long-haul telecommunications support.
Darmenova, K.; Higgins, G.; Kiley, H.; Apling, D.
Current General Circulation Models (GCMs) provide a valuable estimate of both natural and anthropogenic climate changes and variability on global scales. At the same time, future climate projections calculated with GCMs are not of sufficient spatial resolution to address regional needs. Many climate impact models require information at scales of 50 km or less, so dynamical downscaling is often used to estimate the smaller-scale information based on larger scale GCM output. To address current deficiencies in local planning and decision making with respect to regional climate change, our research is focused on performing a dynamical downscaling with the Weather Research and Forecasting (WRF) model and developing decision aids that translate the regional climate data into actionable information for users. Our methodology involves development of climatological indices of extreme weather and heating/cooling degree days based on WRF ensemble runs initialized with the NCEP-NCAR reanalysis and the European Center/Hamburg Model (ECHAM5). Results indicate that the downscale simulations provide the necessary detailed output required by state and local governments and the private sector to develop climate adaptation plans. In addition we evaluated the WRF performance in long-term climate simulations over the Southwestern US and validated against observational datasets.
National Academy of Sciences - National Research Council, Washington, DC. Committee on Prosthetics Research and Development.
The problems of providing sensory aids for the blind are presented and a report on the present status of aids discusses direct translation and recognition reading machines as well as mobility aids. Aspects of required research considered are the following: assessment of needs; vision, audition, taction, and multimodal communication; reading aids,…
Posthuma, Leo; Wahlstrom, Emilia; Nijenhuis, René; Dijkens, Chris; de Zwart, Dick; van de Meent, Dik; Hollander, Anne; Brand, Ellen; den Hollander, Henri A; van Middelaar, Johan; van Dijk, Sander; Hall, E F; Hoffer, Sally
The United Nations response mechanism to environmental emergencies requested a tool to support disaster assessment and coordination actions by United Nations Disaster Assessment and Coordination (UNDAC) teams. The tool should support on-site decision making when substantial chemical emissions affect human health directly or via the environment and should be suitable for prioritizing impact reduction management options under challenging conditions worldwide. To answer this need, the Flash Environmental Assessment Tool (FEAT) was developed and the scientific and practical underpinning and application of this tool are described in this paper. FEAT consists of a printed decision framework and lookup tables, generated by combining the scientific data on chemicals, exposure pathways and vulnerabilities with the pragmatic needs of emergency field teams. Application of the tool yields information that can help prioritize impact reduction measures. The first years of use illustrated the usefulness of the tool as well as suggesting additional uses and improvements. An additional use is application of the back-office tool (Hazard Identification Tool, HIT), the results of which aid decision-making by the authorities of affected countries and the preparation of field teams for on-site deployment. Another extra use is in disaster pro action and prevention. In this case, the application of the tool supports safe land-use planning and improved technical design of chemical facilities. UNDAC teams are trained to use the tool after large-scale sudden onset natural disasters. PMID:24880694
Zheng, Bin; Pu, Jiantao; Park, Sang Cheol; Zuley, Margarita; Gur, David
In this study we randomly select 250 malignant and 250 benign mass regions as a training dataset. The boundary contours of these regions were manually identified and marked. Twelve image features were computed for each region. An artificial neural network (ANN) was trained as a classifier. To select a specific testing dataset, we applied a topographic multi-layer region growth algorithm to detect boundary contours of 1,903 mass regions in an initial pool of testing regions. All processed regions are sorted based on a size difference ratio between manual and automated segmentation. We selected a testing dataset involving 250 malignant and 250 benign mass regions with larger size difference ratios. Using the area under ROC curve (A Z value) as performance index we investigated the relationship between the accuracy of mass segmentation and the performance of a computer-aided diagnosis (CAD) scheme. CAD performance degrades as the size difference ratio increases. Then, we developed and tested a hybrid region growth algorithm that combined the topographic region growth with an active contour approach. In this hybrid algorithm, the boundary contour detected by the topographic region growth is used as the initial contour of the active contour algorithm. The algorithm iteratively searches for the optimal region boundaries. A CAD likelihood score of the growth region being a true-positive mass is computed in each iteration. The region growth is automatically terminated once the first maximum CAD score is reached. This hybrid region growth algorithm reduces the size difference ratios between two areas segmented automatically and manually to less than +/-15% for all testing regions and the testing A Z value increases to from 0.63 to 0.90. The results indicate that CAD performance heavily depends on the accuracy of mass segmentation. In order to achieve robust CAD performance, reducing lesion segmentation error is important.
Tshibalo, A. E.
Distance learning generally separates students from educators, and demands that interventions be put in place to counter the constraints that this distance poses to learners and educators. Furthermore "Increased number of students in Higher Education and the corresponding increase in time spent by staff on assessment has encouraged interest into…
Jones, I. S.
The use of "MapleTA"[R] in the assessment of engineering mathematics at Liverpool John Moores University (JMU) is discussed with particular reference to the design of questions. Key aspects in the formulation and coding of questions are considered. Problems associated with the submission of symbolic answers, the use of randomly generated numbers…
Jernberg Industries conducted a plant-wide assessment while converting to lean manufacturing at a forging plant. Seven projects were identified that could yield annual savings of $791,000, 64,000 MMBtu in fuel and 6 million kWh.
Ashton, Helen S.; Beevers, Cliff E.; Korabinski, Athol A.; Youngson, Martin A.
In a mathematical examination on paper, partial credit is normally awarded for an answer that is not correct, but, nevertheless, contains some of the correct working. Assessment on computer normally marks an incorrect answer wrong and awards no marks. This can lead to discrepancies between marks awarded for the same examination given in the two…
Longo, Julie; And Others
Technology has been used to measure visual acuity with the severely or profoundly mentally retarded child. The following categories of technology have been used for assessment: the recording of visual fixation within the habituation paradigm; equipment to measure eye movements and pursuits; operant techniques; and electrodiagnostic techniques…
There has been an ongoing dilemma for agencies who set criteria for safe recreational waters in how to provide for a seasonal assessment of a beach site versus guidance for day-to-day management. Typically an overall 'safe' criterion level is derived from epidemiologic studies o...
Hall, J. B., Jr.; Pickett, S. J.; Sage, K. H.
A computer program for assessing manned space station environmental control and life support systems technology is described. The methodology, mission model parameters, evaluation criteria, and data base for 17 candidate technologies for providing metabolic oxygen and water to the crew are discussed. Examples are presented which demonstrate the capability of the program to evaluate candidate technology options for evolving space station requirements.
Martin, Robert E.; Gillen, Andrew
The primary purpose of government provided student financial aid is to increase college access by bringing the out-of-pocket price of attendance within reach of more students. The basic idea is quite straightforward. If a good or service costs $100 to buy and the government gives consumers a $50 subsidy, then consumers need only spend $50 of their…
As states consider increases to K-12 spending amid better economic conditions, governors on opposite sides of the partisan divide are proposing significantly different plans and arguments for the best ways to use new education aid. Two prime examples: Minnesota and Ohio, a pair of Midwestern states with chief executives intent on pumping more…
... Marketing Share this: Main Content Area Understanding HIV/AIDS AIDS was first reported in the United States in ... and has since become a major worldwide epidemic. AIDS is caused by the human immunodeficiency virus, or ...
Jarabek, A M; Fisher, J W; Rubenstein, R; Lipscomb, J C; Williams, R J; Vinegar, A; McDougal, J N
An international consensus on the need to reduce the use of chlorofluorocarbons (CFCs) and other ozone-depleting gases such as the halons led to the adoptions of the 1987 Montreal Protocol and Title VI of the 1990 Clean Air Act Amendments, "Protecting Stratospheric Ozone." These agreements included major provisions for reducing and eventually phasing out production and use of CFCs and halons as well as advancing the development of replacement chemicals. Because of the ubiquitous use and benefits of CFCs and halons, an expeditious search for safe replacements to meet the legislative deadlines is of critical importance. Toxicity testing and health risk assessment programs were established to evaluate the health and environmental impact of these replacement chemicals. Development and implementation of these programs as well as the structural-activity relationships significant for the development of the replacement chemicals are described below. A dose-response evaluation for the health risk assessment of the replacement chemical HCFC-123 (2,2-dichloro-1,1,1-trifluoroethane) is also presented to show an innovative use of physiologically based pharmacokinetic (PBPK) modeling. This is based on a parallelogram approach using data on the anesthetic gas halothane, a structural analog to HCFC-123. Halothane and HCFC-123 both form the same metabolite, trifluoroacetic acid (TFA), indicative of the same metabolic oxidative pathway attributed to hepatotoxicity. The parallelogram approach demonstrates the application of template model structures and shows how PBPK modeling, together with judicious experimental design, can be used to improve the accuracy of health risk assessment and to decrease the need for extensive laboratory animal testing. PMID:8029495
After a month of celebrating the largest boost in federal spending on scientific research that most of them have ever seen, university presidents are increasingly tuned to the possibility of a downside. The new money--primarily from a $21.5-billion jump in research-and-development spending in the economic-stimulus law--is certainly welcome,…
Sereetrakul, Wilailuk; Wongveeravuti, Siriwan; Likitapiwat, Tanakorn
Since males and females are raised differently by their parents (Thorne, 2003), gender roles may affect the saving and spending behaviours of male and female teenagers. The objective of this research was to study the gender differences in saving and spending behaviours of Thai students. This was an exploratory study where a questionnaire was used…
Mencken, F. Carson; Tolbert, Charles M., II
This analysis examines the relationship between federal public investment spending and economic development in the special case of Appalachia. We propose that the effects of federal public investment spending on economic development operate indirectly through private capital accumulation. We use a spatial lag regression model to test our ideas for…
Chemical and Engineering News, 1979
Provides data on Research and Development (R&D) spending by U.S. industry, outlays by the chemical industry, basic research vs applied research vs development, spending by other industries for chemical research, pharmaceutical research, and budgets of individual companies. (Author/HM)
A new federal requirement that states provide consistent spending for higher education may not yet have much effect. As state budgets sour and colleges brace for cuts, only one state seems likely to have run afoul of the new rules this year, according to a "Chronicle" analysis of available data on state higher-education spending. Under the rule,…
Du, Hongfei; Li, Xiaoming; Weinstein, Traci L; Chi, Peilian; Zhao, Junfeng; Zhao, Guoxiang
Teachers are considered to be one of the most important influences in the lives of students. Teachers' assessments of students may be a primary source of information on children's mental and behavioral health; however, this topic has received little attention in research. We examined this issue through linking teachers' ratings of students and mental and behavioral outcomes of children affected by HIV. The hypothesis is that teacher ratings will be predictive of specific child mental and behavioral health outcomes. A quantitative cross-sectional design with self-administered paper-and-pencil instruments was used. The sample included 1221 children (aged 6-18, grades 1-11) affected by HIV including 755 orphans who lost one or both parents to AIDS and 466 vulnerable children living with HIV-infected parents in a central province of China. The corresponding teacher sample included 185 participants. Each child completed an assessment inventory of demographic information and mental and behavioral health measures. Teachers completed a questionnaire about children's school performance. SEM analyses revealed a good model fit according to all fit indices: comparative fit index = 0.93, root mean square error of approximation = 0.07, and standardized root mean square residual = 0.04. Structural equation modeling revealed that problem ratings by teachers were positively associated with child loneliness and behavioral problems, social competence ratings by teachers were negatively related to child depression, and personal growth and social interaction ratings by teachers were negatively related to child loneliness, depression, and trauma. The current study represents a unique contribution to the field in that it recognizes that teachers can be a valuable source of information on children's psychological health. Results from this study have implications for health prevention and intervention for children and families suffering from HIV/AIDS. PMID:25703050
This paper reports that despite being buffeted by warmer-than-usual weather and a decline in residential construction, US gas utilities spent more than $4.15 billion in 1991 to maintain the existing distribution system and extend gas service to new customers. Next year should be a busy year for gas companies and contractors across the US, with expected expenditures of $4.4 billion and installation of more than 27,000 miles of steel and plastic mains and services. Gas utility spending should stay above the $4-billion market for several years. As new customers are added and aging, existing distribution systems are maintained, upgraded and replaced. The 3Rs---Repair, Rehabilitate, Replacement---activities accounted for 53.6% of the total 1991 gas utility construction/maintenance expenditures as gas utilities pay close attention to protecting their investment in distribution networks. However, projections for 1992 show the 3Rs maintaining only a slight edge over new construction with 50.2% of the total.
Balogun, Joseph; Abiona, Titilayo; Lukobo-Durrell, Mainza; Adefuye, Adedeji; Amosun, Seyi; Frantz, Jose; Yakut, Yavuz
Objective: This comparative study evaluated the readability and test-retest reliability of a questionnaire designed to assess the attitudes, beliefs behaviours and sources of information about HIV/AIDS among young adults recruited from universities in the United States of America (USA), Turkey and South Africa. Design/Setting: The instrument was…
Ashbolt, Nicholas J; Schoen, Mary E; Soller, Jeffrey A; Roser, David J
There has been an ongoing dilemma for agencies that set criteria for safe recreational waters in how to provide for a seasonal assessment of a beach site versus guidance for day-to-day management. Typically an overall 'safe' criterion level is derived from epidemiologic studies of sewage-impacted beaches. The decision criterion is based on a percentile value for a single sample or a moving median of a limited number (e.g. five per month) of routine samples, which are reported at least the day after recreator exposure has occurred. The focus of this paper is how to better undertake day-to-day recreational site monitoring and management. Internationally, good examples exist where predictive empirical regression models (based on rainfall, wind speed/direction, etc.) may provide an estimate of the target faecal indicator density for the day of exposure. However, at recreational swimming sites largely impacted by non-sewage sources of faecal indicators, there is concern that the indicator-illness associations derived from studies at sewage-impacted beaches may be inappropriate. Furthermore, some recent epidemiologic evidence supports the relationship to gastrointestinal (GI) illness with qPCR-derived measures of Bacteroidales/Bacteroides spp. as well as more traditional faecal indicators, but we understand less about the environmental fate of these molecular targets and their relationship to bather risk. Modelling pathogens and indicators within a quantitative microbial risk assessment framework is suggested as a way to explore the large diversity of scenarios for faecal contamination and hydrologic events, such as from waterfowl, agricultural animals, resuspended sediments and from the bathers themselves. Examples are provided that suggest that more site-specific targets derived by QMRA could provide insight, directly translatable to management actions. PMID:20638095
Hartman, Micah; Martin, Anne; Nuccio, Olivia; Catlin, Aaron
In 2008, U.S. health care spending growth slowed to 4.4 percent--the slowest rate of growth over the past forty-eight years. The deceleration was broadly based for nearly all payers and health care goods and services, as growth in both price and nonprice factors slowed amid the recession. Despite the slowdown, national health spending reached $2.3 trillion, or $7,681 per person, and the health care portion of gross domestic product (GDP) grew from 15.9 percent in 2007 to 16.2 percent in 2008. These developments reflect the general pattern that larger increases in the health spending share of GDP generally occur during or just after periods of economic recession. Despite the overall slowdown in national health spending growth, increases in this spending continue to outpace growth in the resources available to pay for it. PMID:20048374
Lubeck, D P; Fries, J F
The development of new pharmaceutical interventions for persons with human immunodeficiency virus (HIV) infection has resulted in extended survival and a need for valid, reliable and responsive instruments to assess health-related QoL (HRQoL). This paper reviews the reliability and validity of an HRQoL instrument, the AIDS Health Assessment Questionnaire (AIDS-HAQ), among persons participating in an observational database of HIV infection. The AIDS-HAQ includes nine subscales: disability, energy, general health, pain, cognitive functioning, mental health, social functioning, health distress and symptoms. Individuals complete the AIDS-HAQ quarterly. Data are reported for 440 individuals entering the study with early HIV infection. Fifty-nine progressed to symptomatic disease and 109 to AIDS after 1 year. The subscales of the instrument resulted in high internal consistency reliability (range = 0.79-0.88). Concurrent validity data reflected the ability to distinguish between patients with increasing disease severity. In all domains, except cognitive functioning, individuals who progressed to AIDS had significant decrements (p < 0.01) in HRQoL compared with symptomatic and asymptomatic patients. Significant decrements (p < 0.01) were observed for disability, general health, energy and symptoms for patients who progressed to symptomatic disease from an asymptomatic status. Individuals who had decreasing CD4+ counts also had significant declines (p < 0.001) in disability, general health, social functioning, pain and symptoms. The AIDS-HAQ is an instrument that can be used when comparing group differences and within group changes in observational databases, naturalistic studies and clinical trials. PMID:9330550
Mazurowski, Maciej A.; Tourassi, Georgia D.
In this study we investigate the hypothesis that there exist patterns in erroneous assessment of BI-RADS image features among radiology trainees when performing diagnostic interpretation of mammograms. We also investigate whether these error making patterns can be captured by individual user models. To test our hypothesis we propose a user modeling algorithm that uses the previous readings of a trainee to identify whether certain BI-RADS feature values (e.g. "spiculated" value for "margin" feature) are associated with higher than usual likelihood that the feature will be assessed incorrectly. In our experiments we used readings of 3 radiology residents and 7 breast imaging experts for 33 breast masses for the following BI-RADS features: parenchyma density, mass margin, mass shape and mass density. The expert readings were considered as the gold standard. Rule-based individual user models were developed and tested using the leave one-one-out crossvalidation scheme. Our experimental evaluation showed that the individual user models are accurate in identifying cases for which errors are more likely to be made. The user models captured regularities in error making for all 3 residents. This finding supports our hypothesis about existence of individual error making patterns in assessment of mammographic image features using the BI-RADS lexicon. Explicit user models identifying the weaknesses of each resident could be of great use when developing and adapting a personalized training plan to meet the resident's individual needs. Such approach fits well with the framework of adaptive computer-aided educational systems in mammography we have proposed before.
Zhu, Fengqing; Bosch, Marc; Woo, Insoo; Kim, SungYe; Boushey, Carol J.; Ebert, David S.; Delp, Edward J.
There is a growing concern about chronic diseases and other health problems related to diet including obesity and cancer. The need to accurately measure diet (what foods a person consumes) becomes imperative. Dietary intake provides valuable insights for mounting intervention programs for prevention of chronic diseases. Measuring accurate dietary intake is considered to be an open research problem in the nutrition and health fields. In this paper, we describe a novel mobile telephone food record that will provide an accurate account of daily food and nutrient intake. Our approach includes the use of image analysis tools for identification and quantification of food that is consumed at a meal. Images obtained before and after foods are eaten are used to estimate the amount and type of food consumed. The mobile device provides a unique vehicle for collecting dietary information that reduces the burden on respondents that are obtained using more classical approaches for dietary assessment. We describe our approach to image analysis that includes the segmentation of food items, features used to identify foods, a method for automatic portion estimation, and our overall system architecture for collecting the food intake information. PMID:20862266
Jiang, H.; Zhang, Y. C.; Zhang, J. J.; Muljadi, E.
Because wind power penetration levels in electric power systems are continuously increasing, voltage stability is a critical issue for maintaining power system security and operation. The traditional methods to analyze voltage stability can be classified into two categories: dynamic and steady-state. Dynamic analysis relies on time-domain simulations of faults at different locations; however, this method needs to exhaust faults at all locations to find the security region for voltage at a single bus. With the widely located phasor measurement units (PMUs), the Thevenin equivalent matrix can be calculated by the voltage and current information collected by the PMUs. This paper proposes a method based on a Thevenin equivalent matrix to identify system locations that will have the greatest impact on the voltage at the wind power plant’s point of interconnection. The number of dynamic voltage stability analysis runs is greatly reduced by using the proposed method. The numerical results demonstrate the feasibility, effectiveness, and robustness of the proposed approach for voltage security assessment for a wind power plant.
Choi, Catherine J; Lefebvre, Daniel R; Yoon, Michael K
The aim of this article is to validate the accuracy of Facial Assessment by Computer Evaluation (FACE) program in eyelid measurements. Sixteen subjects between the ages of 27 and 65 were included with IRB approval. Clinical measurements of upper eyelid margin reflex distance (MRD1) and inter-palpebral fissure (IPF) were obtained. Photographs were then taken with a digital single lens reflex camera with built-in pop-up flash (dSLR-pop) and a dSLR with lens-mounted ring flash (dSLR-ring) with the cameras upright, rotated 90, 180, and 270 degrees. The images were analyzed using both the FACE and ImageJ software to measure MRD1 and IPF.Thirty-two eyes of sixteen subjects were included. Comparison of clinical measurement of MRD1 and IPF with FACE measurements of photos in upright position showed no statistically significant differences for dSLR-pop (MRD1: p = 0.0912, IPF: p = 0.334) and for dSLR-ring (MRD1: p = 0.105, IPF: p = 0.538). One-to-one comparison of MRD1 and IPF measurements in four positions obtained with FACE versus ImageJ for dSLR-pop showed moderate to substantial agreement for MRD1 (intraclass correlation coefficient = 0.534 upright, 0.731 in 90 degree rotation, 0.627 in 180 degree rotation, 0.477 in 270 degree rotation) and substantial to excellent agreement in IPF (ICC = 0.740, 0.859, 0.849, 0.805). In photos taken with dSLR-ring, there was excellent agreement of all MRD1 (ICC = 0.916, 0.932, 0.845, 0.812) and IPF (ICC = 0.937, 0.938, 0.917, 0.888) values. The FACE program is a valid method for measuring margin reflex distance and inter-palpebral fissure. PMID:27010889
Goodney, Philip P.; Travis, Lori L.; Brooke, Benjamin S.; DeMartino, Randall R.; Goodman, David C.; Fisher, Elliott S.; Birkmeyer, John D.
Importance While lower extremity revascularization is effective in preventing amputation, the relationship between spending on vascular care and regional amputation rates remains unclear. Objective To test the hypothesis that higher regional spending on vascular care is associated with lower amputation rates in patients with severe peripheral arterial disease (PAD). Design Retrospective cohort study. Setting United States Medicare patients, 2003-2010 Participants 18,463 patients who underwent major PAD-related amputation. Exposures Price-adjusted Medicare spending on revascularization procedures and related vascular care in the year before lower extremity amputation, across hospital referral regions. Main Outcome Measure(s) Correlation coefficient between regional spending on vascular care and regional rates of PAD-related amputation. Results Among patients ultimately subject to amputation, 64% were admitted to the hospital in the year prior to amputation for revascularization, wound-related care, or both; 36% were admitted only for their amputation. The mean cost of inpatient care in the year before amputation, including the amputation itself, was $22,405, but varied from $11,077 (Bismarck, North Dakota) to $42,613 (Salinas, California) (p<0.001). Patients in high-spending regions were more likely to undergo vascular procedures in crude analyses (12.0 procedures per 10,000 patients in the lowest quintile of spending, 20.4 procedures per 10,000 patients in the highest quintile of spending, p<0.0001), as well as in risk-adjusted analyses (adjusted OR for receiving a vascular procedure in highest quintile of spending = 3.5, 95 % CI 3.2-3.8, p<0.0001). While revascularization was associated with higher spending (R=0.38, p<0.001), higher spending was not associated with lower regional amputation rates (R=0.10, p=0.06). Regions most aggressive in the use of endovascular interventions which most likely to have high spending (R=0.42, p=0.002) and high amputation rates (R
Payne, Collin R.; Niculescu, Mihai; Just, David R.; Kelly, Michael P.
Objectives We assessed the efficacy of an easy-to-implement shopper marketing nutrition intervention in a pilot and two additional studies to increase produce demand without decreasing store profitability or increasing shopper budgets. Methods We created grocery cart placards that detailed the number of produce items purchased (i.e., descriptive norm) at particular stores (i.e., provincial norm). The effect of these placards on produce spending was assessed across 971,706 individual person grocery store transactions aggregated by day. The pilot study designated a baseline period (in both control and intervention store) followed by installation of grocery cart placards (in the intervention store) for two weeks. The pilot study was conducted in Texas in 2012. In two additional stores, we designated baseline periods followed by 28 days of the same grocery cart placard intervention as in the pilot. Additional interventions were conducted in New Mexico in 2013. Results The pilot study resulted in a significant difference between average produce spending per day per person across treatment periods (i.e., intervention versus same time period in control) (16%) and the difference between average produce spending per day per person across stores in the control periods (4%); Furthermore, the same intervention in two additional stores resulted in significant produce spending increases of 12.4% and 7.5% per day per person respectively. In all stores, total spending did not change. Conclusions Descriptive and provincial social norm messages (i.e., on grocery cart placards) may be an overlooked tool to increase produce demand without decreasing store profitability and increasing shopper budgets. PMID:26844084
Nesbitt, W H; Ross, M W; Sunderland, R H; Shelp, E
Burnout in volunteer workers in the HIV/AIDS area results in the loss of dedicated personnel, consequently straining the HIV/AIDS care delivery system. By assessing the predictors of burnout and grief this study describes the role of grief in HIV/AIDS volunteer burnout. Voluntary and anonymous questionnaires were sent to members of the Foundation for Interfaith Research and Ministry (FIRM), a multi-religious organization formed to provide volunteer work in HIV/AIDS care facilities around Houston, Texas. In 174 valid responses, grief was measured against work characteristics, burnout, rewards, stressors, and the general health questionnaire (GHQ). No significant relationship was found between grief and burnout; however, burnout in volunteers may be different from that in health care professionals for the following reasons: (1) volunteers choose to work in the HIV/AIDS area; (2) they have control over the time they spend volunteering; (3) volunteers are internally motivated to work in the HIV/AIDS area; and (4) if the volunteers do not enjoy the work, they can terminate their involvement with minimal cost. The best univariate predictors of grief are time spent as a volunteer and volunteer hours per week, where those who spend the most hours volunteering experience less grief The Reward/Stress measures most significantly associated with grief include empathy/self-knowing reward, emotional support reward, and emotional overload stress. The strongest predictors of grief in the regression analysis, which account for 21% of the variance, were time as a volunteer, emotional support, emotional overload, GHQ-somatic symptoms, and GHQ social dysfunction. The data suggest that in order to reduce grief special attention should be paid te allowing volunteers freely to express problems with emotional overload and workload adjustments, and providing clear emotional support as a reward. PMID:8861413
Dickman, Samuel L; Woolhandler, Steffie; Bor, Jacob; McCormick, Danny; Bor, David H; Himmelstein, David U
US medical spending growth slowed between 2004 and 2013. At the same time, many Americans faced rising copayments and deductibles, which may have particularly affected lower-income people. To explore whether the health spending slowdown affected all income groups equally, we divided the population into income quintiles. We then assessed trends in health expenditures by and on behalf of people in each quintile using twenty-two national surveys carried out between 1963 and 2012. Before the 1965 passage of legislation creating Medicare and Medicaid, the lowest income quintile had the lowest expenditures, despite their worse health compared to other income groups. By 1977 the unadjusted expenditures for the lowest quintile exceeded those for all other income groups. This pattern persisted until 2004. Thereafter, expenditures fell for the lowest quintile, while rising more than 10 percent for the middle three quintiles and close to 20 percent for the highest income quintile, which had the highest expenditures in 2012. The post-2004 divergence of expenditure trends for the wealthy, middle class, and poor occurred only among the nonelderly. We conclude that the new pattern of spending post-2004, with the wealthiest quintile having the highest expenditures for health care, suggests that a redistribution of care toward wealthier Americans accompanied the health spending slowdown. PMID:27385233
Derrickson, Joda P; Buchanan, Chad; Asing, G Kaui; Okuma, Annette
"Spend Less. Eat Well. Feel Better." (SLEWFB) is a 3-hour intervention designed to improve food resource management ability, health, and food security status. This program efficacy trial targeted clients seeking financial aid to prevent homelessness. A randomized controlled design using a 1-hour food safety intervention as a control group was used. Four variables were targeted over a 30-day time period: (1) food security status, (2) basic financial management, (3) average fruit and vegetable intake, and (4) goal accomplishment. Repeated-measures analysis of variance and chi-square analysis were used. Compared with control group participants (n = 47), SLEWFB graduates (n = 48) were less likely to have to choose between food and rent expenses (chi2 = 16.5, P =.00005) and improved their fruit and vegetable intake (F of time = 8.03, P <.006) regardless of financial assistance received. The findings imply that further investigation of coupling financial aid with effective life skills education is warranted. PMID:12588678
Cummings, C.W.; Larson, S.M.; Dobie, R.A.; Weymuller, E.A. Jr.; Rudd, T.G.; Merello, A.
Critical assessment of head and neck cancer with respect to staging has, on occasion, been disappointingly ineffective. We have attempted to correlate the incidence of measureable uptake of cobalt 57 tagged bleomycin by primary squamous cell carcinoma and metastatic cervical lymph nodes. Forty-six cases have been evaluated with respect to histopathological confirmation of the suspected metastatic disease. We have found that this diagnostic measure increases our acumen in staging of head and neck cancer. The relevance of the Co-Bleo scans as a diagnostic aid is reported in 46 cases. Malignant tumors greater than 2 cm in size appear to demonstrate active uptake of the imaging agent. Small tumor size and excess background radioactivity contribute to the false-negatives (17%). Inflammatory conditions or benign tumors of the salivary apparatus may result in minimal uptake, thus, a false-positive result (10%). An increase in the radioactivity of the Co-Bleo may enhance the benefits of this procedure in the search for an undiagnosed primary, as well as undiagnosed local or distant metastases.
Cummings, C.W.; Larson, S.M.; Dobie, R.A.; Weymuller, E.A. Jr.; Rudd, T.G.; Merello, A.
Critical assessment of head and neck cancer with respect to staging has, on occasion, been disappointingly ineffective. The incidence of measurable uptake of cobalt 57 tagged bleomycin by primary squamous cell carcinoma and metastatic cervical lymph nodes has been correlated. Forty-six cases have been evaluated with respect to histopathological confirmation of the suspected metastatic disease. We have found that this diagnostic measure increases our acumen in staging of head and neck cancer. The relevance of the Co-Bleo scans as a diagnostic aid is reported in 46 cases. Malignant tumors greater than 2 cm in size appear to demonstrate active uptake of the imaging agent. Small tumor size and excess background radioactivity contribute to the false-negatives (17%). Inflammatory conditions or benign tumors of the salivary apparatus may result in minimal uptake, thus, a false-positive result (10%). An increase in the radioactivity of the Co-Bleo may enhance the benefits of this procedure in the search for an undiagnosed primary, as well as undiagnosed local or distant metastases.
New federal spending on student aid is unlikely to improve college access. The increase in access in higher education in America largely came before massive federal involvement in student financial aid programs. Evidence suggests that federal subsidies for student aid may be counterproductive. Modest provision of financial assistance serves to…
Fronstin, Paul; Roebuck, M Christopher
This paper analyzes data from a large employer that enhanced financial incentives to encourage participation in its workplace wellness programs. It examines, first, the effect of financial incentives on wellness program participation, and second, it estimates the impact of wellness program participation on utilization of health care services and spending. The Patient Protection and Affordable Care Act of 2010 (PPACA) allows employers to provide financial incentives of as much as 30 percent of the total cost of coverage when tied to participation in a wellness program. Participation in health risk assessments (HRAs) increased by 50 percentage points among members of unions that bargained in the incentive, and increased 22 percentage points among non-union employees. Participation in the biometric screening program increased 55 percentage points when financial incentives were provided. Biometric screenings led to an average increase of 0.31 annual prescription drug fills, with related spending higher by $56 per member per year. Otherwise, no significant effects of participation in HRAs or biometric screenings on utilization of health care services and spending were found. The largest increase in medication utilization as a result of biometric screening was for statins, which are widely used to treat high cholesterol. This therapeutic class accounted for one-sixth of the overall increase in prescription drug utilization. Second were antidepressants, followed by ACE inhibitors (for hypertension), and thyroid hormones (for hypothyroidism). Biometric screening also led to significantly higher utilization of biologic response modifiers and immunosuppressants. These specialty medications are used to treat autoimmune diseases, such as rheumatoid arthritis and multiple sclerosis, and are relatively expensive compared with non-specialty medications. The added spending associated with the combined increase in fills of 0.02 was $27 per member per year--about one-half of the
... nlm.nih.gov/medlineplus/news/fullstory_158020.html Medicare Spends Billions on Chronic Kidney Disease, Study Finds ... affects nearly 14 percent of Americans and costs Medicare billions of dollars a year, a new study ...
Lieberthal, Robert D.
Long-term health insurance provides consumers with protection against persistent, negative health shocks. While the stochastic rise in medical spending growth may make some health risks harder to insure, financial assets could act as a hedge for medical spending growth risk. The purpose of this research was to determine whether such hedges exist. The results of this study were two-fold. First, the asset classes with the strongest statistical evidence as hedges were bonds, not stocks. Second, any strategy to hedge medical spending growth involved shorting assets i.e. betting against the bond or stock market. Health insurers writing long-term contracts should combine the use of hedges in the bond market with of portfolio diversification, and may benefit from health policies to moderate the uncertainty of medical spending growth.
Evans, M. K.
The economic impact of R and D spending, particularly NASA R and D spending, on the U. S. economy was evaluated. The crux of the methodology and hence the results revolve around the fact that it was necessary to consider both the demand effects of increased spending and the supply effects of a higher rate of technological growth and a larger total productive capacity. The demand effects are primarily short-run in nature, while the supply effects do not begin to have a significant effect on aggregate economic activity until the fifth year after increased expenditures have taken place. The short-term economic impact of alternative levels of NASA expenditures for 1975 was first examined. The long-term economic impact of increased levels of NASA R and D spending over a sustained period was then evaluated.
Khandker, R K; McCormack, L A
The authors analyzed Medicare spending by elderly noninstitutionalized Medicare beneficiaries with and without supplemental insurance such as Medigap, employer-sponsored plans, and Medicaid. Use of a detailed survey of Medicare beneficiaries and their Medicare health insurance claims enabled the authors to control for health status, chronic conditions, functional limitations, and other factors that explain spending variations across supplemental insurance categories. The authors found that supplemental insurance was associated with a higher probability and level of Medicare spending, particularly for Part B services. Beneficiaries with both Medigap and employer plans had the highest levels of spending ceteris paribus, suggesting a possible moral hazard effect of insurance. Findings from this study are discussed in the context of the overall financing of health care for the elderly. PMID:10373721
During a research program, MMTC/Textron invented a computer-aided automatic robotic system for spraying hot plasma onto a turbine blade. The need to control the thickness of the plasma deposit led to the development of advanced optical gaging techniques to monitor and control plasma spray build-up on blade surfaces. The techniques led to computerized optical gages for inspecting aircraft, industrial turbine blades, etc. MMTC offers 10 standard commercial robotic gages. The system also generates two dimensional profiles for assessing status and specifying repairs to the electromechanical cathodes used to make the parts. It is capable of accuracies to a ten-thousandth of an inch. An expanded product line is currently marketed. The gages offer multiple improvements in quality control and significant savings.
There is broad agreement that government has an important role to play in the development of human capital, especially in health and education. Multilateral organizations, such as the World Bank, commonly call for public sector investment in human resources but the use of health spending to combat unemployment remains controversial. This article examines public sector expenditures in health and focuses on three arguments: 1) public goods; 2) investment in human capital; and 3) Keynesian spending in periods of high unemployment. PMID:10538669
... more in both quiet and noisy situations. Hearing aids help people who have hearing loss from damage ... your doctor. There are different kinds of hearing aids. They differ by size, their placement on or ...
AIDS (acquired immune deficiency syndrome) is caused by HIV (human immunodeficiency virus), and is a syndrome that ... life-threatening illnesses. There is no cure for AIDS, but treatment with antiviral medication can suppress symptoms. ...
Temple, Norman J
This article examines the impact of disease prevention on health-care spending. The relationship between these two variables is more complex than what, at first glance, appears to be the case. Health-care spending would be reduced if more effective means could be found to prevent health problems that are expensive to treat but are generally not fatal, such as dementia, infectious diseases and accidents. The major focus here is on interventions designed to persuade people to quit smoking. Savings on health-care spending in early years after people stop smoking are counter-balanced (often exceeded) by higher spending at a later time. In addition, when people stop smoking there is a significant negative impact on government finances from the double effect of lost tax revenues combined with increased spending on pension payments. Arguments in favour of policies designed to prevent fatal disease, such as by reducing the prevalence of smoking, should be based on improvements to population health rather than on misleading claims that this will reduce spending on health care. PMID:21914705
de Bekker-Grob, Esther W; Polder, Johan J; Mackenbach, Johan P; Meerding, Willem Jan
Background Comprehensive information about national spending on prevention is crucial for health policy development and evaluation. This study provides a comprehensive overview of prevention spending in the Netherlands, including those activities beyond the national health accounts. Methods National spending on health-related primary and secondary preventive activities was examined by funding source with the use of national statistics, government reports, sector reports, and data from individual health associations and corporations, public services, occupational health services, and personal prevention. Costs were broken down by diseases, age groups and gender using population-attributable risks and other key variables. Results Total expenditures on prevention were €12.5 billion or €769 per capita in the Netherlands in 2003, of which 20% was included in the national health accounts. 82% was spent on health protection, 16% on disease prevention, and 2% on health promotion activities. Most of the spending was aimed at the prevention of infectious diseases (34%) and acute physical injuries (29%). Per capita spending on prevention increased steeply by age. Conclusion Total expenditure on health-related prevention is much higher than normally reported due to the inclusion of health protection activities beyond the national health accounts. The allocative efficiency of prevention spending, particularly the high costs of health protection and the low costs of health promotion activities, should be addressed with information on their relative cost effectiveness. PMID:17883834
... type and degree of loss. Are there different styles of hearing aids? Styles of hearing aids Source: NIH/NIDCD Behind-the- ... the ear canal and are available in two styles. The in-the-canal (ITC) hearing aid is ...
Sutherland, Douglas; Price, Robert; Joumard, Isabelle, Nicq, Chantal
This paper assesses the potential to raise public spending efficiency in the primary and secondary education sector. Resource availability per pupil has increased significantly over the past decade in a number of countries; often in attempting to exploit the link between educational attainment and growth. However, available evidence reveals only a…
Fermanich, Mark L.
Evidence suggests that accountability and financial pressures are causing schools across the country to reduce investments in subject areas that are not assessed for accountability purposes. However, due to the design of financial reporting systems in most states, inadequate data are available to analyze spending levels and patterns for specific…
Harrison, Gordon S.
This paper is an informal assessment of Alaska state spending during the lucrative "oil years" of the early 1980s. The huge Prudhoe Bay oil field began producing in 1977 and reached a daily output of about 1.5 million barrels in 1980. From 1980 to 1986, the field helped Alaska's government to have, in relation to its population, a revenue income…
Matz, Sandra C; Gladstone, Joe J; Stillwell, David
In contrast to decades of research reporting surprisingly weak relationships between consumption and happiness, recent findings suggest that money can indeed increase happiness if it is spent the "right way" (e.g., on experiences or on other people). Drawing on the concept of psychological fit, we extend this research by arguing that individual differences play a central role in determining the "right" type of spending to increase well-being. In a field study using more than 76,000 bank-transaction records, we found that individuals spend more on products that match their personality, and that people whose purchases better match their personality report higher levels of life satisfaction. This effect of psychological fit on happiness was stronger than the effect of individuals' total income or the effect of their total spending. A follow-up study showed a causal effect: Personality-matched spending increased positive affect. In summary, when spending matches the buyer's personality, it appears that money can indeed buy happiness. PMID:27056977
Thurstone, Christian; Salomensen-Sautel, Stacy; Riggs, Paula D
There is concern that research reimbursements to adolescents may increase substance use. However, these concerns have not been examined empirically. Participants were 70 adolescents (13-19 years) with at least one non-nicotine substance use disorder (SUD) enrolled in a 12-week clinical trial of atomoxetine/placebo for attention/deficit-hyperactivity disorder (ADHD). Adolescent participants received cash reimbursement after each study visit (maximum possible = $425 over 12 weeks). Participants reported each week how they spent the previous reimbursement. Results were tallied, and correlates of spending a payment on substances were examined. Results showed that 26 of 70 subjects reported spending at least one research payment on alcohol or drugs, and 25 of 70 subjects reported spending at least one payment on tobacco. Comparing those who did and did not spend a research payment on alcohol/drugs, those who did had more frequent baseline alcohol/drug use but did not differ in demographics (age, gender) or other clinical characteristics (ADHD severity, diagnosis of conduct disorder, number of SUD diagnoses, number of treatment sessions attended, or pre/post-change in number of days used substances in the past 28 days). Comparing those who did and did not spend a payment on tobacco, those who did were slightly older and had more frequent baseline tobacco use. In conclusion, a significant proportion of subjects used at least a portion of one research payment to buy alcohol, drugs or tobacco. However, there was little indication that research payments increased substance use. PMID:20627618
McKellar, Michael R; Naimer, Sivia; Landrum, Mary B; Gibson, Teresa B; Chandra, Amitabh; Chernew, Michael
Objective To examine the relationship between insurance market structure and health care prices, utilization, and spending. Data Sources Claims for 37.6 million privately insured employees and their dependents from the Truven Health Market Scan Database in 2009. Measures of insurer market structure derived from Health Leaders Inter study data. Methods Regression models are used to estimate the association between insurance market concentration and health care spending, utilization, and price, adjusting for differences in patient characteristics and other market-level traits. Results Insurance market concentration is inversely related to prices and spending, but positively related to utilization. Our results imply that, after adjusting for input price differences, a market with two equal size insurers is associated with 3.9 percent lower medical care spending per capita (p = .002) and 5.0 percent lower prices for health care services relative to one with three equal size insurers (p < .001). Conclusion Greater fragmentation in the insurance market might lead to higher prices and higher spending for care, suggesting some of the gains from insurer competition may be absorbed by higher prices for health care. Greater attention to prices and utilization in the provider market may need to accompany procompetitive insurance market strategies. PMID:24303879
Per-pupil expenditures in the lowest spending states are half of those in the highest-spending states. The federal government could equalize interstate spending by subsidizing spending in poorer states. The plan must consider the dollar's varying purchasing power, higher expenditures for educating disadvantaged children, and disincentives for…
The potential of computer-aided process engineering (CAPE) tools to enable process engineers to improve the environmental performance of both their processes and across the life cycle (from cradle-to-grave) has long been proffered. However, this use of CAPE has not been fully ach...
Advanced Technology, Inc., Reston, VA.
Specifications of the current student financial aid system, with attention to the Pell Grant, Guaranteed Student Loan (GSL), and campus-based programs, are provided. The methodology used to develop the specifications is also described. The campus-based programs include the Supplemental Educational Opportunity Grant Program, the College Work Study…
This article examines the effect of Japan's official development assistance (ODA) over 10 years that proposed to facilitate environmental conservation in developing countries. Special emphasis is given to ODA disbursements in the energy sector to evaluate whether Japan's foreign aid has shifted its policy toward more environmentally sound goals.…
Nom, Ambe-Uva Terhemba
Universities have come under serious attack because of their lackluster response to HIV/AIDS. The article endevours--from an institutional perspective--to what extent National Open University of Nigeria (NOUN) has responded to this challenge. This is done by first, highlighting NOUN basic structures that position it to respond better to the…
Fuller, Bruce; Marsh, Julie A.; Stecher, Brian M.; Timar, Tom
In 2009, California state legislators freed local educators from the specific guidelines that previously regulated spending on 40 categorical-aid programs known as Tier 3 programs. This Tier 3 flexibility reform, which deregulates $4.5 billion in education funding, was enacted at the same time the legislature made cuts in education spending in…
Mapelli, Vittorio; Lucioni, Carlo
Italy has a national health service (SSN) that is moving toward decentralization and empowerment of local health enterprises (LHEs)-the arms of the regions for delivering health services. Drug policy and spending decisions are both influenced by central government and local authorities. At the "macro" level, the government holds the power to decide the amount of drug expenditure, currently at 13% of total SSN expenditure; the pricing policy, price negotiation, reference price, and price cuts; criteria for reimbursement, inclusion in the positive list, and restrictive notes; and the copayments and exemptions. So far, the government concern has been predominantly on cost containment, and its approach in selecting drugs for reimbursement has been cost minimization. Italy has no centralized office for health technology assessment and this hinders the search for an efficient use of drugs. At the "micro" level, however, the LHEs are showing a great vitality in fostering a better use of drugs by general practitioners. One of the tools employed is local voluntary agreements between LHEs and general practitioners (GPs) that may be supported by economic incentives, in cash or in kind. In 2000 there were 61 agreements in place, 31% of total LHEs, which concerned the respect of drug expenditure ceilings and the local development and implementation of clinical guidelines (47% of LHEs). A traditional and widespread tool for controlling drug expenditure is providing GPs with regular reports on their drug prescriptions (59% of LHEs). Monitoring, moral suasion, and clinical guidelines are the main incentives for efficiency at local level, but focus on health outcomes is limited. The cost-containment mentality still prevails and the use of drug budget for purchasing better health is at its very early stage. PMID:12846924
Schweitzer, M E; Hershey, J C
Results from this work describe 239 responses to a mailed survey regarding employee benefits decisions at a large eastern university. The primary objective of this work is to test for an undercontribution bias in health care financing decisions. The results establish the existence of an undercontribution bias in both actual employee decisions and hypothetical flexible spending account contribution decisions. We describe this bias within the context of related biases including loss aversion, mental accounting, status quo and omission biases. Surprisingly, we find a significant order effect in this study and posit that preference construction in this context is an active, reference-dependent process. In addition, results from this work demonstrate the endogenous nature of health care flexible spending account expenditures. The results have important implications both for the descriptive framework of and the normative solution to the flexible spending account contribution decision. PMID:10167155
Hy, Ronald John
Public sector spending on health care clearly has a positive economic impact on local communities. Not only does such spending provide residents with better health care, but it is widely recognized as an investment that returns continual dividends in the form of better jobs, higher incomes, and additional state and local tax revenues. The results of a static input/output model shows that public sector spending on health care of approximately $46 billion (in 2009 dollars) in the state of Texas yields over 588,000 jobs, $74.2 billion in total output, $26.3 billion in personal income, $22 billion in employee compensation, and $1.8 billion in state and local taxes; it clearly has a considerable positive economic impact on local economies and their quest for economic development. PMID:22106548
Berry, Jay G; Hall, Matt; Neff, John; Goodman, Denise; Cohen, Eyal; Agrawal, Rishi; Kuo, Dennis; Feudtner, Chris
A small but growing population of children with medical complexity, many of whom are covered by Medicaid, accounts for a high proportion of pediatric health care spending. We first describe the expenditures for children with medical complexity insured by Medicaid across the care continuum. We report the increasingly large amount of spending on hospital care for these children, relative to the small amount of primary care and home care spending. We then present a business case that estimates how cost savings might be achieved for children with medical complexity from potential reductions in hospital and emergency department use and shows how the savings could underwrite investments in outpatient and community care. We conclude by discussing the importance of these findings in the context of Medicaid's quality of care and health care reform. PMID:25489039
Bonn, Scott; Wilson, George
We enhance understanding of the prejudice-induced “color coding” phenomenon among whites by determining whether racial and ethnic prejudices are associated with a previously unexplored policy outcome, spending on drug rehabilitation. We examine attitudes toward both blacks and Latinos; the latter is a group largely ignored in previous research. We assess the impact of several types of racial/ethnic views, including those that manifest modern/indirect prejudice (e.g., stereotypes about violence, individualistic causal attributions) and those that reflect social-distance-based traditional prejudice (opposition to residential proximity and to interracial marriage). These relationships are examined using data from the General Social Survey. Bivariate results support the linkage between both traditional and modern prejudice and rehabilitation spending. Logistic regression analyses also indicate that support for rehabilitation is racialized: Attributing race differences in socioeconomic outcomes to “structural” factors, namely discrimination and lack of chance for education, is associated with believing rehabilitation spending is inadequate, controlling for the effects of other racial/ethnic attitudes and background factors. The relationship between this measure of modern prejudice and the outcome is consistent with color coding. The implications of the findings are discussed, and suggestions for future research that further examine the scope of color coding are offered. PMID:21532926
Gottlieb, Daniel J; Zhou, Weiping; Song, Yunjie; Andrews, Kathryn Gilman; Skinner, Jonathan S; Sutherland, Jason M
Per capita Medicare spending is more than twice as high in New York City and Miami than in places like Salem, Oregon. How much of these differences can be explained by Medicare's paying more to compensate for the higher cost of goods and services in such areas? To answer this question, we analyzed Medicare spending after adjusting for local price differences in 306 Hospital Referral Regions. The price-adjustment analysis resulted in less variation in what Medicare pays regionally, but not much. The findings suggest that utilization-not local price differences-drives Medicare regional payment variations, along with special payments for medical education and care for the poor. PMID:20110290
Levit, Katharine R.; Freeland, Mark S.; Waldo, Daniel R.
Health care spending has grown almost twice as fast as has the gross national product since 1965. Various parties in the health care financing arena have been affected to different degrees by this rising health care spending. As discussed in this article, households, businesses, and government all have had to devote increasing shares of their resources to financing health care. Although businesses have been increasingly burdened, either directly or through higher insurance premiums and Medicare taxes, that burden is less than is popularly believed. PMID:10313090
Hodgkin, Dominic; Thomas, Cindy Parks; O'Brien, Peggy L; Levit, Katharine; Richardson, John; Mark, Tami L; Malone, Kevin
Spending on psychotropic medications has grown rapidly in recent decades. Using national data on drug expenditures, patent expirations, future drug development and expert interviews, we project that spending will grow more slowly over the period 2012-2020. The average annual increase is projected to be just 3.0 % per year, continuing the steady deceleration in recent years. The main drivers of this expected deceleration include slower development of new drugs, upcoming patent expirations which will lower prices, and payers' growing ability to manage utilization and promote generic use. The slowdown will relieve some cost pressures on payers, particularly Medicare and Medicaid. PMID:26041078
Evans, M. K.
Seven appendices related to a previous report on the economic impact of NASA R and D spending were presented. They dealt with: (1) theoretical and empirical development of aggregate production functions, (2) the calculation of the time series for the rate of technological progress, (3) the calculation of the industry mix variable, (4) the estimation of distributed lags, (5) the estimation of the equations for gamma, (6) a ten-year forecast of the U.S. economy, (7) simulations of the macroeconomic model for increases in NASA R and D spending of $1.0, $.0.5, and 0.1 billions.
Gottlieb, Daniel J.; Zhou, Weiping; Song, Yunjie; Andrews, Kathryn Gilman; Skinner, Jonathan S.; Sutherland, Jason M.
Per capita Medicare spending is more than twice as high in New York City and Miami than in places like Salem, Oregon. How much of these differences can be explained by Medicare's paying more to compensate for the higher cost of goods and services in such areas? To answer this question, we analyzed Medicare spending after adjusting for local price differences in 306 Hospital Referral Regions. The price-adjustment analysis resulted in less variation in what Medicare pays regionally, but not much. The findings suggest that utilization—not local price differences—drives Medicare regional payment variations, along with special payments for medical education and care for the poor. PMID:20110290
Ding, N.; Xi, N.; Wang, Y.
The effects of saving and spending patterns on holding time distribution of money are investigated based on the ideal gas-like models. We show the steady-state distribution obeys an exponential law when the saving factor is set uniformly, and a power law when the saving factor is set diversely. The power distribution can also be obtained by proposing a new model where the preferential spending behavior is considered. The association of the distribution with the probability of money to be exchanged has also been discussed.
Paulsen, Karen; And Others
Student volunteers who experienced problems in impulsive overspending of money were randomly assigned to either a self-control treatment condition or to a placebo condition. Those in the self-control condition evidenced a significantly greater change (55 percent reduction in spending) than placebo control subjects, who showed a slight average…
Kaestner, Robert; Silber, Jeffrey H
Context: It is widely believed that a significant amount, perhaps as much as 20 to 30 percent, of health care spending in the United States is wasted, despite market forces such as managed care organizations and large, self-insured firms with a financial incentive to eliminate waste of this magnitude. Methods: This article uses Medicare claims data to study the association between inpatient spending and the thirty-day mortality of Medicare patients admitted to hospitals between 2001 and 2005 for surgery (general, orthopedic, vascular) and medical conditions (acute myocardial infarction [AMI], congestive heart failure [CHF], stroke, and gastrointestinal bleeding). Findings: Estimates from the analysis indicated that except for AMI patients, a 10 percent increase in inpatient spending was associated with a decrease of between 3.1 and 11.3 percent in thirty-day mortality, depending on the type of patient. Conclusions: Although some spending may be inefficient, the results suggest that the amount of waste is less than conventionally believed, at least for inpatient care. PMID:21166869
Kolari, S.; Savander-Ranne, C.; Viskari, E.-L.
In higher education one of the most important learning goals is deep understanding. Achieving this goal needs time and effort. The authors discuss their observations of student time use on the basis of several case studies which they have conducted in the field of engineering education in Finland. The time that the students spend studying is…
Basch, Donald L.
The growing ability of private colleges and universities to use a high level of annual endowment spending in support of current operations has been a source of financial strength during much of the past two decades. More recently, however, declining endowments at most colleges have raised concerns about declines in the availability of …
Universities UK, 2010
This document represents the submission of Universities UK to the 2010 Spending Review. It sets out why the authors believe universities are critical to the UK's future economic growth, what the impact of cuts to the budget for higher education would be, and the activities which universities are currently pursuing to secure national economic…
Jacobs, Eva; And Others
Data from the 1984-86 Consumer Expenditure Survey were used to examine effects of a wife's labor force participation on family income and expenditures. Findings indicate that families with employed wives spend significantly more on food away from home, child care, women's apparel, and gasoline than do families in which the wife stays at home. (CH)
Salley, Charles D.
The single but substantial economic dimension of Georgia State University's contribution to the Atlanta metropolitan area is examined in this research report. The purpose of the study was to identify successful estimating techniques developed by previous studies of the local spending impact of postsecondary educational institutions. Three direct…
Fowler, William J., Jr.
For the average school district, state funding is now higher than local funding, with unknown effects on per pupil spending. Previous studies in individual states do not agree on the direction and magnitude of the stimulative effect of state funding. This paper analyzes data from the 1989-90 United States Bureau of the Census report, "Public…