UNITED STATES NAVAL STRATEGY IN THE SOUTH CHINA SEA TO ENSURE INTERNATIONAL FREEDOM OF NAVIGATION

DTIC Science & Technology

2016-02-12

Europe (FOB-E) Detachment Naples, as well as assignments on the Joint Staff as well as the OPNAV Staff in Washington DC. His hobbies include hiking ...defense, control of maritime trade, defending the regime against domestic threats, and ensuring economic benefit to the state.”9 Additionally, the...million in 7 maritime aid to its Southeast Asian allies -- including a warship for the Philippines.”33 This closer relationship could benefit not

Risks and Benefits of Salpingectomy at the Time of Sterilization.

PubMed

Castellano, Tara; Zerden, Matthew; Marsh, Laura; Boggess, Kim

2017-11-01

Bilateral salpingectomy reduces the risk ovarian cancer. The Society of Gynecologic Oncology has recommended surgeons discuss salpingectomy with patients desiring sterilization. This review summarizes current literature on the benefits and risks of bilateral salpingectomy to reduce ovarian cancer risk. Areas of insufficient evidence and directions for further research are discussed. We examined the benefits and risks of bilateral salpingectomy for female surgical sterilization, using a PubMed and EMBASE literature review. Search parameters included articles in English language and keywords "salpingectomy" or "ovarian cancer" combined with "contraception," "sterilization," or "tubal ligation." We reviewed 4 high-quality studies that investigated the increased risk reduction of bilateral salpingectomy compared with traditional sterilization. Overall, evidence shows that salpingectomy moderately decreases the risk of ovarian cancer compared with traditional sterilization. An additional 4 studies, including a meta-analysis, showed salpingectomy likely does not have significant long-term impact on ovarian reserve. Additional benefits include improved contraceptive efficacy and elimination of subsequent ectopic pregnancies. Risks include need for in vitro fertilization for patients experiencing sterilization regret, increases in operative time, and potential increases in surgical risks. Bilateral salpingectomy can reduce ovarian cancer risk compared with traditional sterilization; however, research regarding other outcomes is limited. Challenges to implementation include physician concern regarding surgical risks and patient education. Studies investigating patient-based outcomes are lacking. Bilateral salpingectomy for surgical sterilization is a reasonable option when patients are appropriately informed. Ovarian cancer risk reduction should be one of several factors considered when patients choose a surgical sterilization method.

42 CFR 417.592 - Additional benefits requirement.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 3 2012-10-01 2012-10-01 false Additional benefits requirement. 417.592 Section... PLANS, AND HEALTH CARE PREPAYMENT PLANS Medicare Payment: Risk Basis § 417.592 Additional benefits...) Additional benefits. Provide its Medicare enrollees with additional benefits in accordance with paragraph (c...

Educational Audiologists: Their Access, Benefit, and Collaborative Assistance to Speech-Language Pathologists in Schools

ERIC Educational Resources Information Center

Richburg, Cynthia McCormick; Knickelbein, Becky A.

2011-01-01

Purpose: The main goals of this study were to determine if school-based speech-language pathologists (SLPs) have access to the services of an audiologist and if those SLPs felt they obtained benefit from the audiologist's services. Additional goals included gathering information about SLPs' (a) understanding of basic audiological concepts typical…

A Qualitative Investigation of Adults' Perceived Benefits, Barriers and Strategies for Consuming Milk and Milk Products

ERIC Educational Resources Information Center

Jung, Mary E.; Mistry, Chetan; Bourne, Jessica E.; Perrier, Marie-Josee; Martin Ginis, Kathleen A.; Latimer-Cheung, Amy E.

2015-01-01

Objective: Milk and milk products provide important nutrients and have been associated with numerous health benefits in addition to bone health, including a healthy weight and a reduction of risk for certain conditions such as type 2 diabetes, hypertension, cardiovascular disease and colorectal cancer. Nonetheless, consumption of milk and milk…

A Framework for Including Family Health Spillovers in Economic Evaluation

PubMed Central

Al-Janabi, Hareth; van Exel, Job; Brouwer, Werner; Coast, Joanna

2016-01-01

Health care interventions may affect the health of patients’ family networks. It has been suggested that these “health spillovers” should be included in economic evaluation, but there is not a systematic method for doing this. In this article, we develop a framework for including health spillovers in economic evaluation. We focus on extra-welfarist economic evaluations where the objective is to maximize health benefits from a health care budget (the “health care perspective”). Our framework involves adapting the conventional cost-effectiveness decision rule to include 2 multiplier effects to internalize the spillover effects. These multiplier effects express the ratio of total health effects (for patients and their family networks) to patient health effects. One multiplier effect is specified for health benefit generated from providing a new intervention, one for health benefit displaced by funding this intervention. We show that using multiplier effects to internalize health spillovers could change the optimal funding decisions and generate additional health benefits to society. PMID:26377370

[Involvement of scientific societies in early benefit assessment: Simulated participation or valuable additional input?

PubMed

Bleß, Hans-Holger; Seidlitz, Cornelia; Ohlmeier, Christoph; de Millas, Christoph

2018-02-01

The German framework of early benefit assessment (EBA) of drugs also provides for the participation of scientific medical societies. The aim of their inclusion is to assure that care providers can critically assess all aspects of the EBA and provide insights into relevant aspects regarding the provision of care. This study systematically reviews the frequency of participation of the scientific medical societies (FGs) and the Drug Commission of the German Medical Association (AkdÄ) within the scope of the EBA. In addition, the positioning of AkdÄ/FG is compared to the Institute for Quality and Efficiency in Health Care (IQWiG) and the Federal Joint Committee (G-BA) with a focus on antidiabetic drugs and cancer drugs. A literature analysis was performed based on the comprehensive documentation of benefit assessments published by G-BA. All proceedings of antidiabetic drugs and cancer drugs were included, for which a decision was published by August 6, 2015. In addition, statements of FGs or AkdÄ were identified by an exploratory literature review and included in the analysis. The statements considered were assessed with regard to three categories: (1) additional benefit, (2) appropriate comparator (ZVT) and (3) suitability of the endpoints. For each procedure and category, it was assessed whether there was agreement or disagreement between IGWiG/G-BA and AkdÄ/FGs statements. Regarding the additional benefit, a deviating position was further differentiated according to the level of additional benefit (higher/lower). Afterwards, the proportion of favorable and unfavorable positions was calculated, stratified by FGs and AkdÄ and, separately, for proceedings of antidiabetics and cancer drugs. The literature review revealed 41 proceedings of cancer drugs and 21 proceedings of antidiabetic drugs which were included in the analyses. Statements by AkdÄ/FGs were identified in 90 % of the proceedings for antidiabetic drugs and in 98 % of the proceedings for cancer drugs. In general, the AkdÄ was more often in agreement with the IQWiG than with the FGs' positions. In addition, a different position was more frequent in the proceedings concerning antidiabetic drugs than in the proceedings concerning cancer drugs. Furthermore, the G-BA decision was more frequently in line with the AkdÄ position than with the FGs' position, and this applies to both indications. There was a high willingness to participate in the commenting procedure of the EBA. At the same time, the analyses revealed partially heterogeneous positions, both between FGs/AkdÄ and IQWiG/G-BA, as well as between FGs and AkdÄ. The results thus emphasize the need for such discussions within the framework of the EBA. Copyright © 2018. Published by Elsevier GmbH.

Is Stevia rebaudiana Bertoni a Non Cariogenic Sweetener? A Review.

PubMed

Ferrazzano, Gianmaria Fabrizio; Cantile, Tiziana; Alcidi, Brunella; Coda, Marco; Ingenito, Aniello; Zarrelli, Armando; Di Fabio, Giovanni; Pollio, Antonino

2015-12-26

Stevia rebaudiana Bertoni is a small perennial shrub of the Asteraceae (Compositae) family that is native to South America, particularly Brazil and Paraguay, where it is known as "stevia" or "honey leaf" for its powerful sweetness. Several studies have suggested that in addition to their sweetness, steviosides and their related compounds, including rebaudioside A and isosteviol, may offer additional therapeutic benefits. These benefits include anti-hyperglycaemic, anti-hypertensive, anti-inflammatory, anti-tumor, anti-diarrheal, diuretic, and immunomodulatory actions. Additionally, critical analysis of the literature supports the anti-bacterial role of steviosides on oral bacteria flora. The aim of this review is to show the emerging results regarding the anti-cariogenic properties of S. rebaudiana Bertoni. Data shown in the present paper provide evidence that stevioside extracts from S. rebaudiana are not cariogenic. Future research should be focused on in vivo studies to evaluate the effects on dental caries of regular consumption of S. rebaudiana extract-based products.

Beneficial effect of added water on sodium metal cycling in super concentrated ionic liquid sodium electrolytes

NASA Astrophysics Data System (ADS)

Basile, Andrew; Ferdousi, Shammi A.; Makhlooghiazad, Faezeh; Yunis, Ruhamah; Hilder, Matthias; Forsyth, Maria; Howlett, Patrick C.

2018-03-01

The plating and stripping performance of sodium metal in an ionic liquid electrolyte is improved when including water as an additive. Herein we report for the first time the trend of improved cycling behavior of Na0/+ in N-methyl-N-propylpyrrolidinium bis(fluorosulfonyl)imide with 500 ppm H2O. The addition of water to this ionic liquid electrolyte promotes the breakdown of the [FSI]- anion towards beneficial SEI formation. The benefits during plating and stripping of sodium is observed as lower total polarization during symmetrical cell cycling and decreased electrode/electrolyte interface impedance. Sodium metal surfaces after cycling with 500 ppm H2O are shown to be smooth in morphology in comparison to lower additive concentrations. The outcome of adventitious moisture benefiting Na0/+ cycling in an ionic liquid, contrary to conventional electrolytes, allows flexibility in ionic liquid electrolyte design to the benefit of battery manufacturers.

Social multiplier effects: academics' and practitioners' perspective on the benefits of a tuberculosis operational research capacity-building program in Indonesia.

PubMed

Probandari, Ari; Mahendradhata, Yodi; Widjanarko, Bagoes; Alisjahbana, Bachti

2017-01-01

The Tuberculosis Operational Research Group (TORG) implemented a capacity-building model involving academics and practitioners (i.e. clinicians or program staff) in an operational research (OR) team in Indonesia. This study explored academics' and practitioners' perspectives regarding the benefits of participating in a tuberculosis (TB) OR capacity-building program in Indonesia. We conducted a qualitative study involving in-depth interviews with 36 academics and 23 practitioners undertaking the TORG capacity-building program. We asked open-ended questions about their experience of the program. Data were analyzed via content analysis. The findings demonstrated the social multiplier effects of the OR capacity-building program. Both academics and practitioners reported perceived improvements in research knowledge, skills, and experience, and described additional individual- and institutional-level benefits. The individual-level benefits level included improvements in understanding of the TB program, motivation for research and self-satisfaction, the development/enhancement of individual networking, receipt of recognition, and new opportunities. The additional benefits reported at an institutional level included improvement in research curricula, in-house training, and program management and the development/enhancement of institutional partnerships. The program improved not only individuals' capacity for conducting OR but also the quality of the TB program management and public health education. OR should be included in research methodology curricula for postgraduate public health/disease control programs. The capacity-building model, in which academics and program staff collaborated within an OR team, should be promoted.

Social Security and divorce or death benefits storyboard (S(2)D(2)BS): an interactive participant learning exercise.

PubMed

Brown, Pamela Pitman

2014-01-01

Using the concept of an interactive or living storyboard, the author discusses the use of seven case narratives constructed for the sole purpose of teaching introductory gerontology or geriatric students about the distribution of Social Security benefits after spousal death. Additional information is included pertaining to Social Security benefits payable to divorced persons after the death of the former spouse, including the status of married same-sex couples. Narratives include representations of a male breadwinner model couple, a two-earner couple who have similar/dissimilar earnings prior to retirement, a divorced couple with a remarriage after a death, a gay couple with and without children, and a female primary breadwinner couple. Updated information from the Social Security Administration, as well as information on game preparation, scripts, and debriefing questions are included.

Conditional rights, benefit reform, and drug users: reducing dependency?

PubMed

Harris, Neville

2010-01-01

United Kingdom government policy to increase social security claimants' entry to the labour market through conditions attached to unemployed, sickness and incapacity benefits now includes additional measures to activate particular groups such as lone parents and drug users. The latter are a prime target because of their high level of dependency on benefits and because social security rules are seen as having the potential to modify the behaviour of individuals with a lifestyle regarded as being at odds with the moral obligations of citizenship and incompatible with the government's realization of its wider economic and social goals. There are strict procedures for the identification of drug-user claimants, enabling additional conditions to be attached to their benefit rights. This article discusses the general trend in benefit reform towards increased conditionality and evaluates the reforms affecting drug users, considering human rights and other implications. It concludes by reflecting on the status of conditional rights to social security as social rights.

Health Of Americans Who Must Work Longer To Reach Social Security Retirement Age.

PubMed

Choi, HwaJung; Schoeni, Robert F

2017-10-01

To receive full Social Security benefits, Americans born after 1937 must claim those benefits at an older age than earlier birth cohorts. Additionally, proposals to improve the fiscal position of Social Security typically include increasing the age at which workers can receive full benefits. Birth cohorts required to work longer are in worse health at ages 49-60, based on multiple measures of morbidity, than cohorts who could retire earlier. Project HOPE—The People-to-People Health Foundation, Inc.

Cost-effective conservation planning: lessons from economics.

PubMed

Duke, Joshua M; Dundas, Steven J; Messer, Kent D

2013-08-15

Economists advocate that the billions of public dollars spent on conservation be allocated to achieve the largest possible social benefit. This is "cost-effective conservation"-a process that incorporates both monetized benefits and costs. Though controversial, cost-effective conservation is poorly understood and rarely implemented by planners. Drawing from the largest publicly financed conservation programs in the United States, this paper seeks to improve the communication from economists to planners and to overcome resistance to cost-effective conservation. Fifteen practical lessons are distilled, including the negative implications of limiting selection with political constraints, using nonmonetized benefit measures or benefit indices, ignoring development risk, using incomplete cost measures, employing cost measures sequentially, and using benefit indices to capture costs. The paper highlights interrelationships between benefits and complications such as capitalization and intertemporal planning. The paper concludes by identifying the challenges at the research frontier, including incentive problems associated with adverse selection, additionality, and slippage. Copyright © 2013 Elsevier Ltd. All rights reserved.

42 CFR 417.592 - Additional benefits requirement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Additional benefits requirement. 417.592 Section... HEALTH CARE PREPAYMENT PLANS Medicare Payment: Risk Basis § 417.592 Additional benefits requirement. (a... benefits. Provide its Medicare enrollees with additional benefits in accordance with paragraph (c) of this...

Niacin for cholesterol

MedlinePlus

... cholesterol. Research now suggests that niacin does not add to the benefit of a statin alone for reducing the risk of cardiovascular events, including heart attacks and stroke. In addition, niacin ...

Game Design and Homemade PowerPoint Games: An Examination of the Justifications and a Review of the Research

ERIC Educational Resources Information Center

Siko, Jason; Barbour, Michael

2013-01-01

Research on educational games often focuses on the benefits that playing games has on student achievement. However, there is a growing body of research examining the benefits of having students design games rather than play them. Problems with game design as an instructional tool include the additional instruction on the programming language…

7 CFR 3550.54 - Calculation of income and assets.

Code of Federal Regulations, 2010 CFR

2010-01-01

... (including gifts); (6) Lump sum additions to family assets such as inheritances; capital gains; insurance... losses; and deferred periodic payments of supplemental security income and Social Security benefits... other forms of capital investments including life insurance policies and retirement plans that are...

7 CFR 3550.54 - Calculation of income and assets.

Code of Federal Regulations, 2011 CFR

2011-01-01

... (including gifts); (6) Lump sum additions to family assets such as inheritances; capital gains; insurance... losses; and deferred periodic payments of supplemental security income and Social Security benefits... other forms of capital investments including life insurance policies and retirement plans that are...

Tax Examiners, Revenue Agents, and Collectors.

ERIC Educational Resources Information Center

McCarron, Kevin M.

2001-01-01

Describes the nature of the work of tax examiners, revenue agents, and collectors. Includes employment outlook; benefits and drawbacks; qualifications, training, and advancement; and sources of additional information. (JOW)

Inclusion of the benefits of enhanced cross-protection against cervical cancer and prevention of genital warts in the cost-effectiveness analysis of human papillomavirus vaccination in the Netherlands.

PubMed

Westra, Tjalke A; Stirbu-Wagner, Irina; Dorsman, Sara; Tutuhatunewa, Eric D; de Vrij, Edwin L; Nijman, Hans W; Daemen, Toos; Wilschut, Jan C; Postma, Maarten J

2013-02-07

Infection with HPV 16 and 18, the major causative agents of cervical cancer, can be prevented through vaccination with a bivalent or quadrivalent vaccine. Both vaccines provide cross-protection against HPV-types not included in the vaccines. In particular, the bivalent vaccine provides additional protection against HPV 31, 33, and 45 and the quadrivalent vaccine against HPV31. The quadrivalent vaccine additionally protects against low-risk HPV type 6 and 11, responsible for most cases of genital warts. In this study, we made an analytical comparison of the two vaccines in terms of cost-effectiveness including the additional benefits of cross-protection and protection against genital warts in comparison with a screening-only strategy. We used a Markov model, simulating the progression from HPV infection to cervical cancer or genital warts. The model was used to estimate the difference in future costs and health effects of both HPV-vaccines separately. In a cohort of 100,000 women, use of the bivalent or quadrivalent vaccine (both at 50% vaccination coverage) reduces the cervical cancer incidence by 221 and 207 cases, corresponding to ICERs of €17,600/QALY and €18,900/QALY, respectively. It was estimated that the quadrivalent vaccine additionally prevents 4390 cases of genital warts, reducing the ICER to €16,300/QALY. Assuming a comparable willingness to pay for cancer and genital warts prevention, the difference in ICERs could justify a slightly higher price (~7% per dose) in favor of the quadrivalent vaccine. Clearly, HPV vaccination has been implemented for the prevention of cervical cancer. From this perspective, use of the bivalent HPV vaccine appears to be most effective and cost-effective. Including the benefits of prevention against genital warts, the ICER of the quadrivalent HPV vaccine was found to be slightly more favourable. However, current decision-making on the introduction of HPV is driven by the primary cervical cancer outcome. New vaccine tenders could consider the benefits of cross-protection and the benefits of genital warts, which requires more balanced decision-making.

Inclusion of the benefits of enhanced cross-protection against cervical cancer and prevention of genital warts in the cost-effectiveness analysis of human papillomavirus vaccination in the Netherlands

PubMed Central

2013-01-01

Background Infection with HPV 16 and 18, the major causative agents of cervical cancer, can be prevented through vaccination with a bivalent or quadrivalent vaccine. Both vaccines provide cross-protection against HPV-types not included in the vaccines. In particular, the bivalent vaccine provides additional protection against HPV 31, 33, and 45 and the quadrivalent vaccine against HPV31. The quadrivalent vaccine additionally protects against low-risk HPV type 6 and 11, responsible for most cases of genital warts. In this study, we made an analytical comparison of the two vaccines in terms of cost-effectiveness including the additional benefits of cross-protection and protection against genital warts in comparison with a screening-only strategy. Methods We used a Markov model, simulating the progression from HPV infection to cervical cancer or genital warts. The model was used to estimate the difference in future costs and health effects of both HPV-vaccines separately. Results In a cohort of 100,000 women, use of the bivalent or quadrivalent vaccine (both at 50% vaccination coverage) reduces the cervical cancer incidence by 221 and 207 cases, corresponding to ICERs of €17,600/QALY and €18,900/QALY, respectively. It was estimated that the quadrivalent vaccine additionally prevents 4390 cases of genital warts, reducing the ICER to €16,300/QALY. Assuming a comparable willingness to pay for cancer and genital warts prevention, the difference in ICERs could justify a slightly higher price (~7% per dose) in favor of the quadrivalent vaccine. Conclusions Clearly, HPV vaccination has been implemented for the prevention of cervical cancer. From this perspective, use of the bivalent HPV vaccine appears to be most effective and cost-effective. Including the benefits of prevention against genital warts, the ICER of the quadrivalent HPV vaccine was found to be slightly more favourable. However, current decision-making on the introduction of HPV is driven by the primary cervical cancer outcome. New vaccine tenders could consider the benefits of cross-protection and the benefits of genital warts, which requires more balanced decision-making. PMID:23390964

Monetary benefits of preventing childhood lead poisoning with lead-safe window replacement.

PubMed

Nevin, Rick; Jacobs, David E; Berg, Michael; Cohen, Jonathan

2008-03-01

Previous estimates of childhood lead poisoning prevention benefits have quantified the present value of some health benefits, but not the costs of lead paint hazard control or the benefits associated with housing and energy markets. Because older housing with lead paint constitutes the main exposure source today in the US, we quantify health benefits, costs, market value benefits, energy savings, and net economic benefits of lead-safe window replacement (which includes paint stabilization and other measures). The benefit per resident child from improved lifetime earnings alone is $21,195 in pre-1940 housing and $8685 in 1940-59 housing (in 2005 dollars). Annual energy savings are $130-486 per housing unit, with or without young resident children, with an associated increase in housing market value of $5900-14,300 per housing unit, depending on home size and number of windows replaced. Net benefits are $4490-5,629 for each housing unit built before 1940, and $491-1629 for each unit built from 1940-1959, depending on home size and number of windows replaced. Lead-safe window replacement in all pre-1960 US housing would yield net benefits of at least $67 billion, which does not include many other benefits. These other benefits, which are shown in this paper, include avoided Attention Deficit Hyperactivity Disorder, other medical costs of childhood lead exposure, avoided special education, and reduced crime and juvenile delinquency in later life. In addition, such a window replacement effort would reduce peak demand for electricity, carbon emissions from power plants, and associated long-term costs of climate change.

High-value, cost-conscious health care: concepts for clinicians to evaluate the benefits, harms, and costs of medical interventions.

PubMed

Owens, Douglas K; Qaseem, Amir; Chou, Roger; Shekelle, Paul

2011-02-01

Health care costs in the United States are increasing unsustainably, and further efforts to control costs are inevitable and essential. Efforts to control expenditures should focus on the value, in addition to the costs, of health care interventions. Whether an intervention provides high value depends on assessing whether its health benefits justify its costs. High-cost interventions may provide good value because they are highly beneficial; conversely, low-cost interventions may have little or no value if they provide little benefit. Thus, the challenge becomes determining how to slow the rate of increase in costs while preserving high-value, high-quality care. A first step is to decrease or eliminate care that provides no benefit and may even be harmful. A second step is to provide medical interventions that provide good value: medical benefits that are commensurate with their costs. This article discusses 3 key concepts for understanding how to assess the value of health care interventions. First, assessing the benefits, harms, and costs of an intervention is essential to understand whether it provides good value. Second, assessing the cost of an intervention should include not only the cost of the intervention itself but also any downstream costs that occur because the intervention was performed. Third, the incremental cost-effectiveness ratio estimates the additional cost required to obtain additional health benefits and provides a key measure of the value of a health care intervention.

Benefits of regular walking exercise in advanced pre-dialysis chronic kidney disease.

PubMed

Kosmadakis, George C; John, Stephen G; Clapp, Emma L; Viana, Joao L; Smith, Alice C; Bishop, Nicolette C; Bevington, Alan; Owen, Paul J; McIntyre, Christopher W; Feehally, John

2012-03-01

There is increasing evidence of the benefit of regular physical exercise in a number of long-term conditions including chronic kidney disease (CKD). In CKD, this evidence has mostly come from studies in end stage patients receiving regular dialysis. There is little evidence in pre-dialysis patients with CKD Stages 4 and 5. A prospective study compared the benefits of 6 months regular walking in 40 pre-dialysis patients with CKD Stages 4 and 5. Twenty of them were the exercising group and were compared to 20 patients who were continuing with usual physical activity. In addition, the 40 patients were randomized to receive additional oral sodium bicarbonate (target venous bicarbonate 29 mmol/L) or continue with previous sodium bicarbonate treatment (target 24 mmol/L). Improvements noted after 1 month were sustained to 6 months in the 18 of 20 who completed the exercise study. These included improvements in exercise tolerance (reduced exertion to achieve the same activity), weight loss, improved cardiovascular reactivity, avoiding an increase in blood pressure medication and improvements in quality of health and life and uraemic symptom scores assessed by questionnaire. Sodium bicarbonate supplementation did not produce any significant alterations. This study provides further support for the broad benefits of aerobic physical exercise in CKD. More studies are needed to understand the mechanisms of these benefits, to study whether resistance exercise will add to the benefit and to evaluate strategies to promote sustained lifestyle changes, that could ensure continued increase in habitual daily physical activity levels.

Risks and benefits of Twitter use by hematologists/oncologists in the era of digital medicine.

PubMed

Attai, Deanna J; Anderson, Patricia F; Fisch, Michael J; Graham, David L; Katz, Matthew S; Kesselheim, Jennifer; Markham, Merry Jennifer; Pennell, Nathan A; Sedrak, Mina S; Thompson, Michael A; Utengen, Audun; Dizon, Don S

2017-10-01

Twitter use by physicians, including those in the hematology-oncology field, is increasing. This microblogging platform provides a means to communicate and collaborate on a global scale. For the oncology professional, an active Twitter presence provides opportunities for continuing medical education, patient engagement and education, personal branding, and reputation management. However, because Twitter is an open, public forum, potential risks such as patient privacy violations, personal information disclosures, professionalism lapses, and time management need to be considered and managed. The authors have summarized the benefits and risks of Twitter use by the hematology-oncology physician. In addition, strategies to maximize benefit and minimize risk are discussed, and resources for additional learning are provided. Copyright © 2017 Elsevier Inc. All rights reserved.

Lipid encapsulated phenolics

USDA-ARS?s Scientific Manuscript database

Phenolic compounds have numerous health benefits when included in the human diet and have emerged as a functional food and feed additive. Current sources of phenolics include commodity grains such as corn, oat, and wheat but may also be obtained as a co-product from agricultural residues and other l...

Organizational context and taxonomy of health care databases.

PubMed

Shatin, D

2001-01-01

An understanding of the organizational context and taxonomy of health care databases is essential to appropriately use these data sources for research purposes. Characteristics of the organizational structure of the specific health care setting, including the model type, financial arrangement, and provider access, have implications for accessing and using this data effectively. Additionally, the benefit coverage environment may affect the utility of health care databases to address specific research questions. Coverage considerations that affect pharmacoepidemiologic research include eligibility, the nature of the pharmacy benefit, and regulatory aspects of the treatment under consideration.

What are true community benefits?

PubMed

Trocchio, J

1996-01-01

Not-for-profit healthcare organizations have increasingly recognized the need to document their community benefit services, but not all healthcare services should be included in a community benefits report. Some services are reasonably expected of any high-quality healthcare organization, regardless of its tax status. Others are provided as part of a commitment to the community, but they cannot or should not be quantified. A third group of services, however, can be counted and reported in an inventory of benefits. To qualify as a true community benefit, an activity must respond to a particular health problem in the community, especially one involving special populations. In addition, it must be financed through philanthropic contributions, volunteer efforts, or an endowment; generate a low or negative margin; or be a service that would be discontinued if the decision were made on a purely financial basis. Once an organization has determined that an activity is a community benefit and not a basic service or promotional program, organizational leaders must decide whether to include the service in a quantitative inventory or in a more general narrative without assignment of specific financial benefit. The community benefit services might be further broken down according to the intended recipient, whether it is the poor or the broader community.

42 CFR 440.345 - EPSDT services requirement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... the additional benefits will be provided, how access to additional benefits will be coordinated and... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Benchmark Benefit and Benchmark... plan benefits or as additional benefits provided by the State for any child under 21 years of age...

Designing a New Payment Model for Oral Care in Seniors.

PubMed

Jones, Judith A; Monopoli, Michael

2017-10-01

With 10,000 baby boomers turning 65 every day, many will be on fixed incomes and will lose dental insurance upon retirement. This article presents why a dental benefit in Medicare might save the US government money, and who would likely benefit. It details an approach to estimating costs of inclusion of a dental benefit in Medicare, and compares the proposed approach to existing proposals. Additionally, the ensuing steps needed to advance the conversation to include oral health in healthcare for the aged will be discussed.

20 CFR 10.116 - What additional evidence is needed in cases based on occupational disease?

Code of Federal Regulations, 2011 CFR

2011-04-01

... based on occupational disease? 10.116 Section 10.116 Employees' Benefits OFFICE OF WORKERS' COMPENSATION... of Proof § 10.116 What additional evidence is needed in cases based on occupational disease? (a) The... occupational diseases. The medical report should also include the information specified on the checklist for...

20 CFR 10.116 - What additional evidence is needed in cases based on occupational disease?

Code of Federal Regulations, 2010 CFR

2010-04-01

... based on occupational disease? 10.116 Section 10.116 Employees' Benefits OFFICE OF WORKERS' COMPENSATION... of Proof § 10.116 What additional evidence is needed in cases based on occupational disease? (a) The... occupational diseases. The medical report should also include the information specified on the checklist for...

20 CFR 10.116 - What additional evidence is needed in cases based on occupational disease?

Code of Federal Regulations, 2012 CFR

2012-04-01

... based on occupational disease? 10.116 Section 10.116 Employees' Benefits OFFICE OF WORKERS' COMPENSATION... of Proof § 10.116 What additional evidence is needed in cases based on occupational disease? (a) The... particular occupational diseases. The medical report should also include the information specified on the...

20 CFR 10.116 - What additional evidence is needed in cases based on occupational disease?

Code of Federal Regulations, 2013 CFR

2013-04-01

... based on occupational disease? 10.116 Section 10.116 Employees' Benefits OFFICE OF WORKERS' COMPENSATION... of Proof § 10.116 What additional evidence is needed in cases based on occupational disease? (a) The... particular occupational diseases. The medical report should also include the information specified on the...

20 CFR 10.116 - What additional evidence is needed in cases based on occupational disease?

Code of Federal Regulations, 2014 CFR

2014-04-01

... based on occupational disease? 10.116 Section 10.116 Employees' Benefits OFFICE OF WORKERS' COMPENSATION... of Proof § 10.116 What additional evidence is needed in cases based on occupational disease? (a) The... particular occupational diseases. The medical report should also include the information specified on the...

Multifunctional benefits of SuDS: techno-economic evaluation of decentralised solutions for urban water management

NASA Astrophysics Data System (ADS)

Mijic, Ana; Ossa-Moreno, Juan; Smith, Karl M.

2016-04-01

The increased frequency of extreme weather events associated with climate change poses a significant threat to the integrity and function of critical urban infrastructure - rail, road, telecommunications, power and water supply/sewerage networks. A key threat within the United Kingdom (UK) is the increased risk of pluvial flooding; the conventional approach of channeling runoff to an outfall has proven to be unsustainable during severe storm events. Green infrastructure, in the form of Sustainable Urban Drainage Systems (SuDS), has been proposed as a means of minimising the risk of pluvial flooding. However, despite their technical performance, SuDS uptake in the UK has not reached its full capacity yet, mostly due to reasons that go beyong the engineering realm. This work investigated the strategic role of SuDS retrofit in managing environmental risks to urban infrastructure in London at a catchment level, through an economic appraisal of multifunctional benefits. It was found that by including the multifunctional benefits of SuDS, the economic feasibility of the project improves considerably. The case study has also shown a mechanism towards achieving wider-scale SuDS retrofit, whereby the investments are split amongst multiple stakeholder groups by highlighting the additional benefits each group derives. Groups include water utilities and their users, local government and critical infrastructure owners. Finally, limitations to the existing cost-benefit methdology in the UK were identified, and recommendations made regarding incentives and governmental regulations to enhance the uptake of SuDS in London. The proposed methodology provides compelling and robust, cost-benefit based evidence of SUDS' effectiveness within the flood risk management planning framework, but also with regard to the additional benefits of Nature Based Solutions in urban environments.

Dual Mission Scenarios for the Human Lunar Campaign - Performance, Cost and Risk Benefits

NASA Technical Reports Server (NTRS)

Saucillo, Rudolph J.; Reeves, David M.; Chrone, Jonathan D.; Stromgren, Chel; Reeves, John D.; North, David D.

2008-01-01

Scenarios for human lunar operations with capabilities significantly beyond Constellation Program baseline missions are potentially feasible based on the concept of dual, sequential missions utilizing a common crew and a single Ares I/CEV (Crew Exploration Vehicle). For example, scenarios possible within the scope of baseline technology planning include outpost-based sortie missions and dual sortie missions. Top level cost benefits of these dual sortie scenarios may be estimated by comparison to the Constellation Program reference two-mission-per-year lunar campaign. The primary cost benefit is the accomplishment of Mission B with a "single launch solution" since no Ares I launch is required. Cumulative risk to the crew is lowered since crew exposure to launch risks and Earth return risks are reduced versus comparable Constellation Program reference two-mission-per-year scenarios. Payload-to-the-lunar-surface capability is substantially increased in the Mission B sortie as a result of additional propellant available for Lunar Lander #2 descent. This additional propellant is a result of EDS #2 transferring a smaller stack through trans-lunar injection and using remaining propellant to perform a portion of the lunar orbit insertion (LOI) maneuver. This paper describes these dual mission concepts, including cost, risk and performance benefits per lunar sortie site, and provides an initial feasibility assessment.

International Reference Ionosphere -2010

NASA Astrophysics Data System (ADS)

Bilitza, Dieter; Reinisch, Bodo

The International Reference Ionosphere 2010 includes several important improvements and ad-ditions. This presentation introduces these changes and discusses their benefits. The electron and ion density profiles for the bottomside ionosphere will be significantly improved by using more ionosonde data as well as photochemical considerations. As an additional lower iono-sphere parameter IRI-2010 will include the transition height from molecular to cluster ions. At the F2 peak Neural Net models for the peak density and the propagation factor M3000F2, which is related to the F2 peak height, are introduced as new options. At high latitudes the model will benefit from the introduction of auroral oval boundaries and their variation with magnetic activity. Regarding the electron temperature, IRI-2010 now models variations with solar activity. The homepage for the IRI project is at http://IRI.gsfc.nasa.gov/.

20 CFR 416.590 - Are there additional methods for recovery of title XVI benefit overpayments?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Are there additional methods for recovery of title XVI benefit overpayments? 416.590 Section 416.590 Employees' Benefits SOCIAL SECURITY..., and Underpayments § 416.590 Are there additional methods for recovery of title XVI benefit...

20 CFR 416.590 - Are there additional methods for recovery of title XVI benefit overpayments?

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Are there additional methods for recovery of title XVI benefit overpayments? 416.590 Section 416.590 Employees' Benefits SOCIAL SECURITY..., and Underpayments § 416.590 Are there additional methods for recovery of title XVI benefit...

20 CFR 416.590 - Are there additional methods for recovery of title XVI benefit overpayments?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Are there additional methods for recovery of title XVI benefit overpayments? 416.590 Section 416.590 Employees' Benefits SOCIAL SECURITY..., and Underpayments § 416.590 Are there additional methods for recovery of title XVI benefit...

20 CFR 416.590 - Are there additional methods for recovery of title XVI benefit overpayments?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Are there additional methods for recovery of title XVI benefit overpayments? 416.590 Section 416.590 Employees' Benefits SOCIAL SECURITY..., and Underpayments § 416.590 Are there additional methods for recovery of title XVI benefit...

Combustion Enhancement of Liquid Fuels via Nanoparticle Additions: Screening, Dispersion, and Characterization

DTIC Science & Technology

2015-06-04

These include but are not limited to aluminum, boron, boron carbide (B4C), carbon (graphene), titanium, and tungsten nano-sized particles. When...of plots displaying calculated values for aluminum, titanium, and tungsten additives are shown in Figure 1 to illustrate the potential benefits...of additive weight percent and oxidizer/fuel mixture ratio for aluminum, titanium, and tungsten . With recent improvements in the production and

Developing additional capacity for wilderness management: An international exchange program between South Africa and United States wilderness rangers

Treesearch

Pierre van den Berg; Ralph Swain

2007-01-01

Wilderness managers have limited time to initiate international exchanges. Additionally, the benefits to developing capacity for wilderness management around the globe are not significant enough to make the effort cost-effective. International assistance, including wilderness management exchange programs, is critical to protecting wild areas around the globe. Former...

Benefits of sensory garden and horticultural activities in dementia care: a modified scoping review.

PubMed

Gonzalez, Marianne T; Kirkevold, Marit

2014-10-01

To provide a review on the benefits associated with the use of sensory gardens and horticultural activities in dementia care. Maintaining quality of life is important in dementia care. Sensory gardens and horticultural activities are increasingly used in dementia care, yet their benefits are uncertain. A modified scoping review with descriptive analysis of selected empirical studies. Systematic searches in Amed, CINAHL, MEDLINE, ISI Web of Science, Embase and Scopus were used. Search terms were the free-text concepts 'healing garden', 'horticultural therapy', 'restorative garden' and 'wander garden' which were combined with dementia and Alzheimer. Sixteen studies were included with included participants ranging from eight to 129 participants. Research designs were case studies (n = 2), survey (n = 1), intervention studies with pretest/post-test design (n = 11) and randomised controlled studies (n = 2). Of these 16 studies, eight examined the benefits of sensory gardens, seven examined horticultural therapy or therapeutic horticulture and one examined the use of plants indoors. This study offers a review of the research addressing benefits of sensory gardens, therapeutic horticulture, horticultural therapy and other purposeful use of plants in dementia care. The reported findings are mainly on issues related to behaviour, affect and well-being. The findings are in general mutually supportive, however, with some contradictory findings. In addition, sleep pattern, well-being and functional level seem to improve. These types of nonpharmacological interventions may improve well-being and affect and reduce the occurrence of disruptive behaviour. Additionally, the use of psychotropic drugs, incidents of serious falls, sleep and sleep pattern also seem to improve. To further improve the use of the existing or planned gardens, an educational programme for staff that also includes skill training is recommended. © 2013 John Wiley & Sons Ltd.

Participants' Voices From Within a Healthy Lifestyle Group.

PubMed

Park, Tanya; Foster, Kim; Usher, Kim

2017-02-01

Weight gain is a serious health concern. People with mental illnesses are at increased risk of weight gain. The primary treatment is lifestyle changes such as increasing physical activity and dietary changes. This qualitative study explored the experience of people with schizophrenia who participated in a healthy lifestyle program. Four themes were identified. The findings indicate that benefits of the program were more than physical health improvements and included regular access to a health professional, gaining social relationships, and a sense of belonging. Future recommendations include retaining a group structure in lifestyle interventions to facilitate these additional benefits.

Innovative Models of Dental Care Delivery and Coverage: Patient-Centric Dental Benefits Based on Digital Oral Health Risk Assessment.

PubMed

Martin, John; Mills, Shannon; Foley, Mary E

2018-04-01

Innovative models of dental care delivery and coverage are emerging across oral health care systems causing changes to treatment and benefit plans. A novel addition to these models is digital risk assessment, which offers a promising new approach that incorporates the use of a cloud-based technology platform to assess an individual patient's risk for oral disease. Risk assessment changes treatment by including risk as a modifier of treatment and as a determinant of preventive services. Benefit plans are being developed to use risk assessment to predetermine preventive benefits for patients identified at elevated risk for oral disease. Copyright © 2017 Elsevier Inc. All rights reserved.

Patient Protection and Affordable Care Act; annual eligibility redeterminations for exchange participation and insurance affordability programs; health insurance issuer standards under the Affordable Care Act, including standards related to exchanges. Final rule.

PubMed

2014-09-05

This final rule specifies additional options for annual eligibility redeterminations and renewal and re-enrollment notice requirements for qualified health plans offered through the Exchange, beginning with annual redeterminations for coverage for benefit year 2015. This final rule provides additional flexibility for Exchanges, including the ability to propose unique approaches that meet the specific needs of their state, while streamlining the consumer experience.

A Fully Non-Metallic Gas Turbine Engine Enabled by Additive Manufacturing

NASA Technical Reports Server (NTRS)

Grady, Joseph E.

2015-01-01

The Non-Metallic Gas Turbine Engine project, funded by NASA Aeronautics Research Institute, represents the first comprehensive evaluation of emerging materials and manufacturing technologies that will enable fully nonmetallic gas turbine engines. This will be achieved by assessing the feasibility of using additive manufacturing technologies to fabricate polymer matrix composite and ceramic matrix composite turbine engine components. The benefits include: 50 weight reduction compared to metallic parts, reduced manufacturing costs, reduced part count and rapid design iterations. Two high payoff metallic components have been identified for replacement with PMCs and will be fabricated using fused deposition modeling (FDM) with high temperature polymer filaments. The CMC effort uses a binder jet process to fabricate silicon carbide test coupons and demonstration articles. Microstructural analysis and mechanical testing will be conducted on the PMC and CMC materials. System studies will assess the benefits of fully nonmetallic gas turbine engine in terms of fuel burn, emissions, reduction of part count, and cost. The research project includes a multidisciplinary, multiorganization NASA - industry team that includes experts in ceramic materials and CMCs, polymers and PMCs, structural engineering, additive manufacturing, engine design and analysis, and system analysis.

20 CFR 30.912 - Can a covered Part E employee receive benefits for additional impairment following an award of...

Code of Federal Regulations, 2010 CFR

2010-04-01

... benefits for additional impairment following an award of such benefits by OWCP? 30.912 Section 30.912... OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Impairment Benefits Under Part E of EEOICPA Ratable Impairments § 30.912 Can a covered Part E employee receive benefits for additional impairment...

25 CFR 1000.275 - Is it necessary for a self-governance AFA to include any clauses about FTCA coverage?

Code of Federal Regulations, 2012 CFR

2012-04-01

.../Consortium and its employees (including individuals performing personal services contracts with the tribe... clauses about FTCA coverage? 1000.275 Section 1000.275 Indians OFFICE OF THE ASSISTANT SECRETARY, INDIAN... salary and benefits unless the employee receives additional compensation for performing covered services...

25 CFR 1000.275 - Is it necessary for a self-governance AFA to include any clauses about FTCA coverage?

Code of Federal Regulations, 2014 CFR

2014-04-01

.../Consortium and its employees (including individuals performing personal services contracts with the tribe... clauses about FTCA coverage? 1000.275 Section 1000.275 Indians OFFICE OF THE ASSISTANT SECRETARY, INDIAN... salary and benefits unless the employee receives additional compensation for performing covered services...

25 CFR 1000.275 - Is it necessary for a self-governance AFA to include any clauses about FTCA coverage?

Code of Federal Regulations, 2011 CFR

2011-04-01

.../Consortium and its employees (including individuals performing personal services contracts with the tribe... clauses about FTCA coverage? 1000.275 Section 1000.275 Indians OFFICE OF THE ASSISTANT SECRETARY, INDIAN... salary and benefits unless the employee receives additional compensation for performing covered services...

25 CFR 1000.275 - Is it necessary for a self-governance AFA to include any clauses about FTCA coverage?

Code of Federal Regulations, 2013 CFR

2013-04-01

.../Consortium and its employees (including individuals performing personal services contracts with the tribe... clauses about FTCA coverage? 1000.275 Section 1000.275 Indians OFFICE OF THE ASSISTANT SECRETARY, INDIAN... salary and benefits unless the employee receives additional compensation for performing covered services...

Sustaining flows of crucial watershed resources

Treesearch

J. E. de Steiguer

2000-01-01

Watersheds are the source of a number of resources which are of benefit to society. These resources include water, timber, grazing, recreation, wildlife and others, often described as multiple-use resources. In addition, however, watersheds also produce a number of less tangible resources and uses, which are also socially important. These include amenity, option values...

Restoring fish ecological quality in estuaries: Implication of interactive and cumulative effects among anthropogenic stressors.

PubMed

Teichert, Nils; Borja, Angel; Chust, Guillem; Uriarte, Ainhize; Lepage, Mario

2016-01-15

Estuaries are subjected to multiple anthropogenic stressors, which have additive, antagonistic or synergistic effects. Current challenges include the use of large databases of biological monitoring surveys (e.g. the European Water Framework Directive) to help environmental managers prioritizing restoration measures. This study investigated the impact of nine stressor categories on the fish ecological status derived from 90 estuaries of the North East Atlantic countries. We used a random forest model to: 1) detect the dominant stressors and their non-linear effects; 2) evaluate the ecological benefits expected from reducing pressure from stressors; and 3) investigate the interactions among stressors. Results showed that largest restoration benefits were expected when mitigating water pollution and oxygen depletion. Non-additive effects represented half of pairwise interactions among stressors, and antagonisms were the most common. Dredged sediments, flow changes and oxygen depletion were predominantly implicated in non-additive interactions, whereas the remainder stressors often showed additive impacts. The prevalence of interactive impacts reflects a complex scenario for estuaries management; hence, we proposed a step-by-step restoration scheme focusing on the mitigation of stressors providing the maximum of restoration benefits under a multi-stress context. Copyright © 2015 Elsevier B.V. All rights reserved.

The full benefits of adult pneumococcal vaccination: A systematic review.

PubMed

Cafiero-Fonseca, Elizabeth T; Stawasz, Andrew; Johnson, Sydney T; Sato, Reiko; Bloom, David E

2017-01-01

Pneumococcal disease causes substantial morbidity and mortality, including among adults. Adult pneumococcal vaccines help to prevent these burdens, but they are underused. Accounting for the full benefits of adult pneumococcal vaccination may promote more rational resource allocation decisions with respect to adult pneumococcal vaccines. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a systematic review to assess the extent to which the literature has empirically captured (e.g., through measurement or modeling) the full benefits of adult pneumococcal vaccination. We systematically searched PubMed and Embase to identify studies published between January 1, 2010 and April 10, 2016 that examine adult pneumococcal vaccination. We included articles if they captured any health or economic benefit of an adult pneumococcal vaccine administered to adults age ≥ 50 or ≥ 18 in risk groups. Finally, we summarized the literature by categorizing the types of benefits captured, the perspective taken, and the strength of the evidence presented. Our protocol is number 42016038335 in the PROSPERO International prospective register of systematic reviews. We identified 5,857 papers and included 150 studies for analysis. While most capture health gains and healthcare cost savings, far fewer studies consider additional benefit categories, such as productivity gains. However, the studies with a broader approach still exhibit significant limitations; for example, many present only abstracts, while others offer no new measurements. Studies that examine the 13-valent pneumococcal conjugate vaccine focus more on broad economic benefits, but still have limitations. This review highlights the need for more robust empirical accounting of the full benefits of adult pneumococcal vaccination. Literature outside this realm indicates that these broad benefits may be substantial. Failing to investigate the full benefits may lead society to undervalue vaccines' contributions and therefore underinvest in their development and adoption.

Future Fuels

DTIC Science & Technology

2006-04-01

relevant to TWV is focused on permanent magnet motors , often wheel mounted. Wound rotor motors provide substantially different design and control...options than permanent magnet motors , at the expense of additional cooling requirements. Their benefits include higher peak torque and less sensitivity

Benefits of a silica-based fluoride toothpaste containing o-cymen-5-ol, zinc chloride and sodium fluoride.

PubMed

Newby, Craig S; Rowland, Joanna L; Lynch, Richard J M; Bradshaw, David J; Whitworth, Darren; Bosma, Mary Lynn

2011-08-01

Fluoride toothpastes in conjunction with tooth brushing are used to clean teeth, control plaque build-up and for anti-caries benefits. Toothpastes are designed with attractive flavours and appearances to encourage regular prolonged use to maximise these benefits. The incorporation of additional ingredients into toothpaste is a convenient way to provide supplementary protection that fits into people's everyday oral care routine. Such ingredients should not compromise the primary health benefits of toothpaste nor discourage its use. o-Cymen-5-ol and zinc chloride have been incorporated into a sodium fluoride (NaF)/silica toothpaste at 0.1%w/w and 0.6%w/w respectively to provide additional benefits. These include improved gingival health maintenance, in terms of the reduction of plaque, gingival index and bleeding, and an immediate and long lasting reduction in volatile sulfur compounds (VSCs) measured on breath. These benefits can be attributed to the antimicrobial and neutralisation actions of the toothpaste. The use of established fluoride models demonstrated no compromise in NaF bioavailability. The toothpaste was formulated without compromising product aesthetics. The combination of o-cymen-5-ol and zinc chloride in toothpaste gave superior maintenance of gingival health and reduction in malodour related VSCs without compromising the primary health benefits of the toothpaste or diminishing attributes preferred for the product's use. © 2011 FDI World Dental Federation.

A public hedonic analysis of environmental attributes in an open space preservation program

NASA Astrophysics Data System (ADS)

Nordman, Erik E.

The Town of Brookhaven, on Long Island, NY, has implemented an open space preservation program to protect natural areas, and the ecosystem services they provide, from suburban growth. I used a public hedonic model of Brookhaven's open space purchases to estimate implicit prices for various environmental attributes, locational variables and spatial metrics. I also measured the correlation between cost per acre and non-monetary environmental benefit scores and tested whether including cost data, as opposed to non-monetary environmental benefit score alone, would change the prioritization ranks of acquired properties. The mean acquisition cost per acre was 82,501. I identified the key on-site environmental and locational variables using stepwise regression for four functional forms. The log-log specification performed best ( R2adj= 0.727). I performed a second stepwise regression (log-log form) which included spatial metrics, calculated from a high-resolution land cover classification, in addition to the environmental and locational variables. This markedly improved the model's performance ( R2adj=0.866). Statistically significant variables included the property size, location in the Pine Barrens Compatible Growth Area, location in a FEMA flood zone, adjacency to public land, and several other environmental dummy variables. The single significant spatial metric, the fractal dimension of the tree cover class, had the largest elasticity of any variable. Of the dummy variables, location within the Compatible Growth Area had the largest implicit price (298,792 per acre). The priority rank for the two methods, non-monetary environmental benefit score alone and the ratio of non-monetary environmental benefit score to acquisition cost were significantly positively correlated. This suggests that, despite the lack of cost data in their ranking method, Brookhaven does not suffer from efficiency losses. The economics literature encourages using both environmental benefits and acquisition costs to ensure cost-effective conservation programs. I recommend that Brookhaven consider acquisition costs in addition to environmental benefits to avert potential efficiency losses in future open space purchases. This dissertation shows that the addition of spatial metrics can enhance the performance of hedonic models. It also provides a baseline valuation for the environmental attributes of Brookhaven' open spaces and shows that location is critical when dealing with open space preservation programs.

Benefits and environmental determinants of physical activity in children and adolescents.

PubMed

Loprinzi, Paul D; Cardinal, Bradley J; Loprinzi, Kristina L; Lee, Hyo

2012-01-01

In this review, we identify the health benefits associated with physical activity (PA); address the physical activity and sedentary guidelines issued by public health scientists as well as children's compliance to these guidelines; discuss the importance of motor skill acquisition during early childhood; and identify different settings that contribute to physical activity participation and strategies for improving PA in these settings. Results show that regular participation in PA during childhood has numerous immediate benefits, including positive changes in adiposity, skeletal health, psychological health, and cardiorespiratory fitness. Additionally, motor skill development during early childhood may have immediate health benefits as well as long-lasting effects in adulthood. Furthermore, the benefits of PA during childhood also appear to positively influence adult health outcomes, such as increased bone mineral density. Key environmental settings that have been shown to influence children's PA behavior include child care, active commuting to and from school, school recess, school physical education, after-school programs, churches, medical settings, and the home environment. Recommendations for practitioners and researchers are discussed. Copyright © 2012 S. Karger AG, Basel.

Economic analysis of measles elimination program in the Republic of Korea, 2001: a cost benefit analysis study.

PubMed

Bae, Geun-Ryang; Choe, Young June; Go, Un Yeong; Kim, Yong-Ik; Lee, Jong-Koo

2013-05-31

In this study, we modeled the cost benefit analysis for three different measles vaccination strategies based upon three different measles-containing vaccines in Korea, 2001. We employed an economic analysis model using vaccination coverage data and population-based measles surveillance data, along with available estimates of the costs for the different strategies. In addition, we have included analysis on benefit of reduction of complication by mumps and rubella. We evaluated four different strategies: strategy 1, keep-up program with a second dose measles-mumps-rubella (MMR) vaccine at 4-6 years without catch-up campaign; strategy 2, additional catch-up campaign with measles (M) vaccine; strategy 3, catch-up campaign with measles-rubella (MR) vaccine; and strategy 4, catch-up campaign with MMR vaccine. The cost of vaccination included cost for vaccines, vaccination practices and other administrative expenses. The direct benefit of estimated using data from National Health Insurance Company, a government-operated system that reimburses all medical costs spent on designated illness in Korea. With the routine one-dose MMR vaccination program, we estimated a baseline of 178,560 measles cases over the 20 years; when the catch-up campaign with M, MR or MMR vaccines was conducted, we estimated the measles cases would decrease to 5936 cases. Among all strategies, the two-dose MMR keep-up program with MR catch-up campaign showed the highest benefit-cost ratio of 1.27 with a net benefit of 51.6 billion KRW. Across different vaccination strategies, our finding suggest that MR catch-up campaign in conjunction with two-dose MMR keep-up program was the most appropriate option in terms of economic costs and public health effects associated with measles elimination strategy in Korea. Copyright © 2013 Elsevier Ltd. All rights reserved.

Comparison of patterns and knowledge of benefits and warnings of fish consumption between parents and children.

PubMed

Herdt-Losavio, Michele L; Lin, Shao; Chen, Ming; Luo, Ming; Tang, Jianzhong; Hwang, Syni-An

2014-07-01

We examined generational differences in fish consumption and knowledge of benefits/warnings of fish consumption among parents and children. This cross-sectional study gathered self-administered questionnaire data, including demographics, fish consumption behavior (including specific fish species) and knowledge of fish consumption warnings and benefits. Fish were later grouped into four categories by potential mercury contamination. Descriptive statistics were conducted for all variables comparing all adults and children. Benefit/risk knowledge variables were also descriptively analyzed among parent-child pairs only. Multivariate Poisson regression was conducted on pairs to assess risk factors for children eating higher mercury fish. 421 adults and 207 children (171 adult-child pairs) participated (family response rate: 71%). Slightly more adults (97.6%) ate fish in the last year than children (92.3%); however, there was no difference between consumption of fish by category of potential mercury contamination. Both adults (44%) and children (45%) ate high-mercury fish. In 71% of parent-child pairs, both the parent and the child knew of benefits of consuming fish; only 31% knew of warnings. Parental consumption of high or moderately-high-mercury fish was related to the child's consumption of fish in the same category. Parents and children need additional education to make better choices about fish consumption. Education should target the family and include specifics about benefits and risks.

Benefit-cost analysis of commercially available activated carbon filters for indoor ozone removal in single-family homes.

PubMed

Aldred, J R; Darling, E; Morrison, G; Siegel, J; Corsi, R L

2016-06-01

This study involved the development of a model for evaluating the potential costs and benefits of ozone control by activated carbon filtration in single-family homes. The modeling effort included the prediction of indoor ozone with and without activated carbon filtration in the HVAC system. As one application, the model was used to predict benefit-to-cost ratios for single-family homes in 12 American cities in five different climate zones. Health benefits were evaluated using disability-adjusted life-years and included city-specific age demographics for each simulation. Costs of commercially available activated carbon filters included capital cost differences when compared to conventional HVAC filters of similar particle removal efficiency, energy penalties due to additional pressure drop, and regional utility rates. The average indoor ozone removal effectiveness ranged from 4 to 20% across the 12 target cities and was largely limited by HVAC system operation time. For the parameters selected in this study, the mean predicted benefit-to-cost ratios for 1-inch filters were >1.0 in 10 of the 12 cities. The benefits of residential activated carbon filters were greatest in cities with high seasonal ozone and HVAC usage, suggesting the importance of targeting such conditions for activated carbon filter applications. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Comparison of WIC benefit redemptions in Michigan indicates higher utilization among Arab American families.

PubMed

Pooler, Jennifer; Gleason, Stacy F

2014-01-01

To assess Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) benefit use across Arab American, Hispanic, and non-Arab/non-Hispanic families participating in the Michigan WIC program using point-of-sale Electronic Benefits Transfer data. Cross-sectional analysis using administrative data obtained from the Michigan WIC program, which collects Arab American ethnicity in addition to Hispanic ethnicity and race. Michigan. Families participating in the Michigan WIC program in March, 2012 (n = 152,989). Families redeeming all WIC benefits. Bivariate frequencies and multivariate logistic regression model identified characteristics of families associated with full redemption of WIC food benefits. About 12% of WIC families fully redeemed their benefits in March, 2012. Compared with non-Arab/non-Hispanic families, Arab American WIC families were significantly more likely to use all of their monthly WIC benefits, even after controlling for family characteristics (adjusted odds ratio, 3.6; 95% confidence interval, 3.4-3.8). Rates of redemption for Hispanic families, however, were the same as for non-Arab/non-Hispanic families (adjusted odds ratio, 1.0; 95% confidence interval, 0.9-1.0). State WIC programs moving toward implementation of Electronic Benefits Transfer should consider ways to enhance systems that would allow for more opportunities to conduct targeted analyses of benefit use across participant subpopulations. Findings point to low overall WIC benefit use. Additional research is needed to explore methods to increase benefit use among all WIC populations, including whether specific factors may contribute to higher redemptions among ethnic minorities, and whether they can be translated to other subpopulations. Copyright © 2014 Society for Nutrition Education and Behavior. All rights reserved.

A framework for designing and implementing community benefit standards.

PubMed

Longo, D R; Kruse, R L; Kiely, R G

1997-01-01

Increasingly, health care professionals and the public are asking questions about the role of the hospital in meeting community need including its not-for-profit tax status. This article reviews the community benefit literature, provides a framework for understanding how a hospital community benefit program was developed, and delineates through a structured case study the lessons learned from this experience. It provides the practitioner with a context in which other hospitals may replicate the program and gives researchers a substantive case study that may be used as the basis for the empirical testing of community benefit models. The authors also outline the many difficult issues faced by a typical community hospital as it attempted to examine and develop additional responses to community need.

Evaluating the potential risks and benefits of infant rotavirus vaccination in England.

PubMed

Clark, Andy; Jit, Mark; Andrews, Nick; Atchison, Christina; Edmunds, W John; Sanderson, Colin

2014-06-17

Rotarix(®), a vaccine for the prevention of gastroenteritis in young children, was introduced in England in July 2013. At around this time, an elevated risk of intussusception (a cause of bowel obstruction) was reported among infants vaccinated in Australia and the USA. A risk-benefit analysis compared potential vaccine-related risks (additional intussusception admissions and deaths) with estimated vaccine benefits (prevented rotavirus general practitioner visits, emergency visits, admissions and deaths) in the 2012 birth cohort. Detailed data from England included the incidence of intussusception events aged <2 years by week of age, the coverage of vaccination aged <2 years by week of age, and the incidence of rotavirus gastroenteritis (RVGE) events aged <5 years by week of age. Recent estimates of vaccine-related risk from Australia were applied during the 1-21 day period after the first and second dose of vaccination. Rotarix(®) is estimated to cause one additional intussusception admission in every 18,551 vaccinated English infants (5th and 95th percentiles, 6728-93,952), equivalent to 35 (7-98) additional intussusception admissions each year. The vaccine is estimated to prevent three rotavirus deaths, 13,000 rotavirus admissions, 27,000 rotavirus emergency visits and 74,000 rotavirus GP consultations in children aged <5 years, and lead to annual savings of over £11 million, each year. We estimate 375 (136-1900) fewer RVGE admissions for every additional intussusception admission, and 88 (18-852) fewer RVGE deaths for every additional intussusception death. The estimated benefits of Rotarix(®) vaccination would greatly exceed the potential risk in England. Copyright © 2014. Published by Elsevier Ltd.

Dogs in the Workplace: A Review of the Benefits and Potential Challenges.

PubMed

Foreman, Anne M; Glenn, Margaret K; Meade, B Jean; Wirth, Oliver

2017-05-08

Pet dogs, therapy dogs, and service dogs can be seen in workplaces with increasing frequency. Although dogs may provide many benefits to employees and employers, their presence may introduce additional hazards and concerns to the work environment. Therefore, decisions to accept dogs in the workplace may include many considerations including the health, safety, and well-being of employees, legal and cultural sensitivities, and animal welfare. The present paper serves to introduce the issue of dogs in the workplace and outline the potential benefits and challenges to their presence. The legal accommodations afforded to certain types of dogs in workplace settings are discussed, and the research findings pertaining to the potential benefits of dogs on human health and well-being are summarized. The paper concludes with considerations for human resource management personnel in the areas of diversity, employee relations, ethics and corporate responsibility, organizational and employee development, safety and security, and legal considerations, as well as suggested topics for future research.

Dogs in the Workplace: A Review of the Benefits and Potential Challenges

PubMed Central

Foreman, Anne M.; Glenn, Margaret K.; Meade, B. Jean; Wirth, Oliver

2017-01-01

Pet dogs, therapy dogs, and service dogs can be seen in workplaces with increasing frequency. Although dogs may provide many benefits to employees and employers, their presence may introduce additional hazards and concerns to the work environment. Therefore, decisions to accept dogs in the workplace may include many considerations including the health, safety, and well-being of employees, legal and cultural sensitivities, and animal welfare. The present paper serves to introduce the issue of dogs in the workplace and outline the potential benefits and challenges to their presence. The legal accommodations afforded to certain types of dogs in workplace settings are discussed, and the research findings pertaining to the potential benefits of dogs on human health and well-being are summarized. The paper concludes with considerations for human resource management personnel in the areas of diversity, employee relations, ethics and corporate responsibility, organizational and employee development, safety and security, and legal considerations, as well as suggested topics for future research. PMID:28481317

20 CFR 410.535 - Reductions; effect of an additional claim for benefits.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Reductions; effect of an additional claim for benefits. 410.535 Section 410.535 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Payment of Benefits § 410.535...

20 CFR 410.535 - Reductions; effect of an additional claim for benefits.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Reductions; effect of an additional claim for benefits. 410.535 Section 410.535 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Payment of Benefits § 410.535...

Collaborative Orthopaedic Research Between and Within Institutions.

PubMed

Wolf, Brian R; Verma, Nikhil N; Spindler, Kurt P; Wright, Rick W

2017-02-15

Collaborative research is common in many medical disciplines; however, the field of orthopaedics has been relatively slow to adopt this type of research approach. Collaborative research efforts can occur between multiple institutions and, in some instances, may benefit from subspecialty society sponsorship. Collaborative research efforts between several research spheres within a single institution also can be advantageous. Collaborative research has many benefits, including a larger number of patients in studies, more power in the research, and better generalizability. In addition, collaborative research efforts allow resources to be pooled within and between institutions. The challenges of collaborative research include data management, funding, and the publication of manuscripts that have many authors.

Effect of a Bicycling Unit on the Fitness of Middle School Students

ERIC Educational Resources Information Center

Lirgg, Cathy D.; Gorman, Dean R.; Merrie, Michael D.; Hadadi, Atyh A.

2018-01-01

Many physical educators today are teaching lifetime sports, including outdoor activities such as cycling. Even though cycling is a low impact exercise that aids stamina and fitness, little is known about additional benefits in other areas including agility, balance, and explosive power. The purpose of this study was to ascertain if there are…

An Authentic Research Experience for Undergraduates on a Budget: Using Data from Simple Experiments to Develop Mini-Research Proposals

ERIC Educational Resources Information Center

Robertson, Katherine

2016-01-01

The benefits of undergraduate research are well documented, and many colleges and universities include a senior research requirement for graduation. In addition, most science curricula attempt to include discoverystyle, laboratory components to prepare students for their research experiences and to expose them to research methods in different…

The Billion-Dollar Question: Which Students Benefit?

ERIC Educational Resources Information Center

Supiano, Becky

2009-01-01

The new economic-stimulus law includes more than $29-billion in provisions directed at making college more affordable in the next two years. That includes $13.9-billion budgeted over 10 years for education-tax-credit changes in 2009 and 2010, $15-billion in additional Pell Grant support, and $200-million for the Federal Work-Study program. But…

Risk-benefit analysis and public policy: a bibliography

DOE Office of Scientific and Technical Information (OSTI.GOV)

Clark, E.M.; Van Horn, A.J.

1976-11-01

Risk-benefit analysis has been implicitly practiced whenever decision-makers are confronted with decisions involving risks to life, health, or to the environment. Various methodologies have been developed to evaluate relevant criteria and to aid in assessing the impacts of alternative projects. Among these have been cost-benefit analysis, which has been widely used for project evaluation. However, in many cases it has been difficult to assign dollar costs to those criteria involving risks and benefits which are not now assigned explicit monetary values in our economic system. Hence, risk-benefit analysis has evolved to become more than merely an extension of cost-benefit analysis,more » and many methods have been applied to examine the trade-offs between risks and benefits. In addition, new scientific and statistical techniques have been developed for assessing current and future risks. The 950 references included in this bibliography are meant to suggest the breadth of those methodologies which have been applied to decisions involving risk.« less

T'ai chi ch'uan.

PubMed

Lewis, D E

2000-11-01

The Chinese practice of t'ai chi seems to be receiving increased interest in the West. This article gives a brief overview of t'ai chi, including its origins, development, principles and potential health benefits. The function of the essential elements of t'ai chi, namely the Form and chi kung are described and their potential benefits for patients and nurses are discussed. Exponents of t'ai chi believe that it has health benefits on physical, psychological and spiritual levels, thus promoting a feeling of well-being. In addition, regular practitioners are empowered to be in greater control of themselves, their health, and situations in which they find themselves.

The commuter rail circulator network design problem : formulation, solution methods, and applications

DOT National Transportation Integrated Search

2007-08-01

Commuter rail is increasingly popular as a means to introduce rail transportation to metropolitan transportation systems. The long-term benefits of commuter rail include the addition of capacity to the transportation system, providing a quality commu...

Sun: Friend and Foe.

ERIC Educational Resources Information Center

Froschauer, Linda K.; Boudrot, Barbara

1986-01-01

Reviews the benefits and hazards that the sun provides. Describes activities which focus on the power of the sun and on the development of "Sun-sensible" behavior. Also included is a poster which contains puzzles and additional information and activities on safe sunning. (ML)

Feasibility Study and Cost Benefit Analysis of Conference Coordinating at the Naval Postgraduate School

DTIC Science & Technology

2009-06-01

such as organic and vegetarian diets at an additional cost. 14 Internet Access To Instruction...requests, including organic, vegetarian and kosher meals. All conference related activities for the Monterey Conference Center are scheduled through the

The role of oral antibiotics prophylaxis in prevention of surgical site infection in colorectal surgery.

PubMed

Koullouros, Michalis; Khan, Nadir; Aly, Emad H

2017-01-01

Surgical site infection (SSI) continues to be a challenge in colorectal surgery. Over the years, various modalities have been used in an attempt to reduce SSI risk in elective colorectal surgery, which include mechanical bowel preparation before surgery, oral antibiotics and intravenous antibiotic prophylaxis at induction of surgery. Even though IV antibiotics have become standard practice, there has been a debate on the exact role of oral antibiotics. The primary aim was to identify the role of oral antibiotics in reduction of SSI in elective colorectal surgery. The secondary aim was to explore any potential benefit in the use of mechanical bowel preparation (MBP) in relation to SSI in elective colorectal surgery. Medline, Embase and the Cochrane Library were searched. Any randomised controlled trials (RCTs) or cohort studies after 1980, which investigated the effectiveness of oral antibiotic prophylaxis and/or MBP in preventing SSIs in elective colorectal surgery were included. Twenty-three RCTs and eight cohorts were included. The results indicate a statistically significant advantage in preventing SSIs with the combined usage of oral and systemic antibiotic prophylaxis. Furthermore, our analysis of the cohort studies shows no benefits in the use of MBP in prevention of SSIs. The addition of oral antibiotics to systemic antibiotics could potentially reduce the risk of SSIs in elective colorectal surgery. Additionally, MBP does not seem to provide a clear benefit with regard to SSI prevention.

Providing Additional Support for MNA by Including Quantitative Lines of Evidence for Abiotic Degradation and Co-metabolic Oxidation of Chlorinated Ethylenes

DTIC Science & Technology

2017-02-08

cost benefit of the technology. 7.1 COST MODEL A simple cost model for the technology is presented so that a remediation professional can understand...reporting costs . The benefit of the qPCR analyses is that they allow the user to determine if aerobic cometabolism is possible. Because the PHE and...of Chlorinated Ethylenes February 2017 This document has been cleared for public release; Distribution Statement A Page Intentionally Left

The Missing Stakeholder Group: Why Patients Should be Involved in Health Economic Modelling.

PubMed

van Voorn, George A K; Vemer, Pepijn; Hamerlijnck, Dominique; Ramos, Isaac Corro; Teunissen, Geertruida J; Al, Maiwenn; Feenstra, Talitha L

2016-04-01

Evaluations of healthcare interventions, e.g. new drugs or other new treatment strategies, commonly include a cost-effectiveness analysis (CEA) that is based on the application of health economic (HE) models. As end users, patients are important stakeholders regarding the outcomes of CEAs, yet their knowledge of HE model development and application, or their involvement therein, is absent. This paper considers possible benefits and risks of patient involvement in HE model development and application for modellers and patients. An exploratory review of the literature has been performed on stakeholder-involved modelling in various disciplines. In addition, Dutch patient experts have been interviewed about their experience in, and opinion about, the application of HE models. Patients have little to no knowledge of HE models and are seldom involved in HE model development and application. Benefits of becoming involved would include a greater understanding and possible acceptance by patients of HE model application, improved model validation, and a more direct infusion of patient expertise. Risks would include patient bias and increased costs of modelling. Patient involvement in HE modelling seems to carry several benefits as well as risks. We claim that the benefits may outweigh the risks and that patients should become involved.

Benefit-finding intervention for Alzheimer caregivers: conceptual framework, implementation issues, and preliminary efficacy.

PubMed

Cheng, Sheung-Tak; Lau, Rosanna W L; Mak, Emily P M; Ng, Natalie S S; Lam, Linda C W

2014-12-01

To describe an intervention promoting benefit-finding in Alzheimer caregivers, to discuss key issues in implementation and ways to resolve them, and to examine whether the intervention reduced burden and depression in a small randomized trial. Twenty-five caregivers were randomized into benefit-finding and psychoeducation groups. Both groups had eight weekly sessions. Outcome measures including role overload, Zarit Burden Interview, and Hamilton depression scale were collected at baseline and after treatment. Results were analyzed using analysis of covariance. Additionally, the challenges of implementing such interventions, some of which related to cultural issues, were analyzed qualitatively. Controlling for pretest, the benefit-finding group had lower depression than the psychoeducation group at post-test, despite the fact that some caregivers found benefit-finding challenging. The two groups did not differ on overload and burden. However, within-group analysis suggested that both groups showed significant reductions in overload from pretest to post-test. In addition, we discussed participants' difficulties in grasping the technique of thought modification for benefit-finding, recording such exercises at home, and sharing their thoughts and experiences in groups. We described measures undertaken in the main trial to overcome these issues. Cognitive approaches focusing on benefit-finding are feasible among Chinese caregivers, with preliminary evidence suggesting an effect on alleviating depression. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

20 CFR 404.527 - Additional methods for recovery of title II benefit overpayments.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Additional methods for recovery of title II... or Recovery of Overpayments, and Liability of a Certifying Officer § 404.527 Additional methods for recovery of title II benefit overpayments. (a) General. In addition to the methods specified in §§ 404.502...

20 CFR 404.527 - Additional methods for recovery of title II benefit overpayments.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Additional methods for recovery of title II... or Recovery of Overpayments, and Liability of a Certifying Officer § 404.527 Additional methods for recovery of title II benefit overpayments. (a) General. In addition to the methods specified in §§ 404.502...

20 CFR 404.527 - Additional methods for recovery of title II benefit overpayments.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Additional methods for recovery of title II... or Recovery of Overpayments, and Liability of a Certifying Officer § 404.527 Additional methods for recovery of title II benefit overpayments. (a) General. In addition to the methods specified in §§ 404.502...

20 CFR 404.527 - Additional methods for recovery of title II benefit overpayments.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Additional methods for recovery of title II... or Recovery of Overpayments, and Liability of a Certifying Officer § 404.527 Additional methods for recovery of title II benefit overpayments. (a) General. In addition to the methods specified in §§ 404.502...

20 CFR 404.527 - Additional methods for recovery of title II benefit overpayments.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Additional methods for recovery of title II... or Recovery of Overpayments, and Liability of a Certifying Officer § 404.527 Additional methods for recovery of title II benefit overpayments. (a) General. In addition to the methods specified in §§ 404.502...

Unmanned Maritime Systems Incremental Acquisition Approach

DTIC Science & Technology

2016-12-01

We find that current UMS acquisitions are utilizing previous acquisition reforms, but could benefit from additional contractor peer competition and...peer review. Additional cost and schedule benefits could result from contractor competition during build processes in each incremental process. We...acquisitions are utilizing previous acquisition reforms, but could benefit from additional contractor peer competition and peer review. Additional

Effect of Crossover in Oncology Clinical Trials on Evidence Levels in Early Benefit Assessment in Germany.

PubMed

Isbary, Georg; Staab, Thomas R; Amelung, Volker E; Dintsios, Charalabos-Markos; Iking-Konert, Christof; Nesurini, Sonja Mariotti; Walter, Miriam; Ruof, Jörg

2018-06-01

In oncology clinical trials, crossover is used frequently but may lead to uncertainties regarding treatment effects. To investigate the handling of evidence from crossover trials by the European Medicines Agency (EMA) and the German Federal Joint Committee (G-BA). For oncology medicines with early benefit assessments before January 2015, presence of crossover, clinical data, EMA requests for additional data, and G-BA benefit ratings/evidence levels were analyzed from manufacturers' dossiers, G-BA appraisals, European Public Assessment Reports, and original publications. Eleven of 21 benefit assessments included crossover trials. Significant intergroup differences (P < 0.05) in overall survival (OS) were noted in 7 of 11 trials with and 7 of 10 without crossover. For 6 of 11 medicines with crossover, these were demonstrated before crossover. Treatment effects generally worsened with increasing proportions of crossover. The EMA requested additional data more frequently if crossover was performed, particularly if no OS data were available before crossover. The G-BA granted a considerable benefit to 73% of medicines with crossover and 40% of those without. Evidence levels were intermediate for 50% and 75%, respectively. None of the medicines received the highest evidence level. In G-BA appraisals, oncology medicines with crossover received better additional benefit ratings, but were assigned lower evidence levels, than those without. The five medicines with crossover after progression were assigned lower evidence levels than the six medicines with crossover after demonstration of superior OS, indicating that the way in which crossover is implemented may be one factor influencing the assignment of evidence levels by the G-BA. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Preschool-Based Programs for Externalizing Problems

ERIC Educational Resources Information Center

Arnold, David H.; Brown, Sharice A.; Meagher, Susan; Baker, Courtney N.; Dobbs, Jennifer; Doctoroff, Greta L.

2006-01-01

Few mental health initiatives for young children have used classroom programs. Preschool-based efforts targeting externalizing behavior could help prevent conduct disorders. Additional benefits may include improved academic achievement and reduced risk for other mental health difficulties. Pro-grams that target multiple developmental domains are…

University-Industry Strategic Partnerships. Benefits and Impediments.

ERIC Educational Resources Information Center

Gregory, Eugene H.

1997-01-01

University-industry partnership give companies opportunities to observe prospective employees and access to research innovations at lower cost. Faculty increase their familiarity with the state of the art and gain additional funding sources. Barriers include intellectual property issues, publication of proprietary information, and conflicting…

Integration of PKPD relationships into benefit-risk analysis.

PubMed

Bellanti, Francesco; van Wijk, Rob C; Danhof, Meindert; Della Pasqua, Oscar

2015-11-01

Despite the continuous endeavour to achieve high standards in medical care through effectiveness measures, a quantitative framework for the assessment of the benefit-risk balance of new medicines is lacking prior to regulatory approval. The aim of this short review is to summarise the approaches currently available for benefit-risk assessment. In addition, we propose the use of pharmacokinetic-pharmacodynamic (PKPD) modelling as the pharmacological basis for evidence synthesis and evaluation of novel therapeutic agents. A comprehensive literature search has been performed using MESH terms in PubMed, in which articles describing benefit-risk assessment and modelling and simulation were identified. In parallel, a critical review of multi-criteria decision analysis (MCDA) is presented as a tool for characterising a drug's safety and efficacy profile. A definition of benefits and risks has been proposed by the European Medicines Agency (EMA), in which qualitative and quantitative elements are included. However, in spite of the value of MCDA as a quantitative method, decisions about benefit-risk balance continue to rely on subjective expert opinion. By contrast, a model-informed approach offers the opportunity for a more comprehensive evaluation of benefit-risk balance before extensive evidence is generated in clinical practice. Benefit-risk balance should be an integral part of the risk management plan and as such considered before marketing authorisation. Modelling and simulation can be incorporated into MCDA to support the evidence synthesis as well evidence generation taking into account the underlying correlations between favourable and unfavourable effects. In addition, it represents a valuable tool for the optimization of protocol design in effectiveness trials. © 2015 The British Pharmacological Society.

Feedback: an essential element of student learning in clinical practice.

PubMed

Clynes, Mary P; Raftery, Sara E C

2008-11-01

Clinical practice is an essential component of the nursing curriculum. In order for the student to benefit fully from the experience regular performance feedback is required. Feedback should provide the student with information on current practice and offer practical advice for improved performance. The importance of feedback is widely acknowledged however it appears that there is inconsistency in its provision to students. The benefits of feedback include increased student confidence, motivation and self-esteem as well as improved clinical practice. Benefits such as enhanced interpersonal skills and a sense of personal satisfaction also accrue to the supervisor. Barriers to the feedback process are identified as inadequate supervisor training and education, unfavourable ward learning environment and insufficient time spent with students. In addition to the appropriate preparation of the supervisor effective feedback includes an appreciation of the steps of the feedback process, an understanding of the student response to feedback and effective communication skills.

Supplemental Vitamins and Minerals for CVD Prevention and Treatment.

PubMed

Jenkins, David J A; Spence, J David; Giovannucci, Edward L; Kim, Young-In; Josse, Robert; Vieth, Reinhold; Blanco Mejia, Sonia; Viguiliouk, Effie; Nishi, Stephanie; Sahye-Pudaruth, Sandhya; Paquette, Melanie; Patel, Darshna; Mitchell, Sandy; Kavanagh, Meaghan; Tsirakis, Tom; Bachiri, Lina; Maran, Atherai; Umatheva, Narmada; McKay, Taylor; Trinidad, Gelaine; Bernstein, Daniel; Chowdhury, Awad; Correa-Betanzo, Julieta; Del Principe, Gabriella; Hajizadeh, Anisa; Jayaraman, Rohit; Jenkins, Amy; Jenkins, Wendy; Kalaichandran, Ruben; Kirupaharan, Geithayini; Manisekaran, Preveena; Qutta, Tina; Shahid, Ramsha; Silver, Alexis; Villegas, Cleo; White, Jessica; Kendall, Cyril W C; Pichika, Sathish C; Sievenpiper, John L

2018-06-05

The authors identified individual randomized controlled trials from previous meta-analyses and additional searches, and then performed meta-analyses on cardiovascular disease outcomes and all-cause mortality. The authors assessed publications from 2012, both before and including the U.S. Preventive Service Task Force review. Their systematic reviews and meta-analyses showed generally moderate- or low-quality evidence for preventive benefits (folic acid for total cardiovascular disease, folic acid and B-vitamins for stroke), no effect (multivitamins, vitamins C, D, β-carotene, calcium, and selenium), or increased risk (antioxidant mixtures and niacin [with a statin] for all-cause mortality). Conclusive evidence for the benefit of any supplement across all dietary backgrounds (including deficiency and sufficiency) was not demonstrated; therefore, any benefits seen must be balanced against possible risks. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Congenitally deafblind children and cochlear implants: effects on communication.

PubMed

Dammeyer, Jesper

2009-01-01

There has been much research conducted demonstrating the positive benefits of cochlear implantation (CI) in children who are deaf. Research on CI in children who are both deaf and blind, however, is lacking. The purpose of this article is to present a study of five congenitally deafblind children who received cochlear implants between 2.2 and 4.2 years of age. Ratings of video observations were used to measure the children's early communication development with and without the use of their cochlear implants. In addition, parental interviews were used to assess the benefits parents perceived regarding their children's cochlear implants. Two examples are included in this article to illustrate the parents' perspectives about CI in their deafblind children. Benefits of CI in this cohort of children included improved attention and emotional response as well as greater use of objects in interaction with adults. The best overall outcome of CI is not spoken language but better communication.

Water resource protection in Australia: Links between land use and river health with a focus on stubble farming systems

NASA Astrophysics Data System (ADS)

Bowmer, Kathleen H.

2011-06-01

SummaryStubble farming (conservation farming, minimum tillage, zero tillage) has increased in Australia over several decades with claims of improved productivity, landscape stability and environmental benefit including ecosystem services downstream, yet recent audits show a dramatic and general decline in river health. This review explores explanations for this apparent anomaly. Many confounding factors complicate interactions between land use and river condition and may disguise or over-ride the potential benefits of adoption of stubble systems or other improvements in agricultural land use practice. These factors include climate change and variability; land use changes including an increase in bushfires, growth of farm dams and afforestation; lag times between land use change and expression of benefits in river systems; use of inappropriate scale that disguises local benefit; variations in the extent of ecosystem resilience; impacts of river regulation; and impacts of introduced species. Additionally, the value of river condition and utility is complicated by different local or regional perceptions and by contrasting rural and urban outlooks. The use of indicators, risk frameworks and biophysical modelling may help elucidate the complex relationships between land use and downstream ecosystem impact. The strengthening of local, regional and catchment scale approaches is advocated. This includes the re-integration of land management and governance with water management and planning. It is encouraging that farmers are themselves developing systems to optimise trade-offs between on-farm activities and ecosystem service benefits. This approach needs to be supported and extended.

The recent and projected public health and economic benefits of cigarette taxation in Greece.

PubMed

Alpert, Hillel R; Vardavas, Constantine I; Chaloupka, Frank J; Vozikis, Athanassios; Athanasakis, Konstantinos; Kyriopoulos, Ioannis; Bertic, Monique; Behrakis, Panagiotis K; Connolly, Gregory N

2014-09-01

Greece is in an economic crisis compounded by the costs caused by smoking. The present investigation estimates the economic and public health benefits ensuing from the recent cigarette excise tax increase in 2011 and projects the potential benefits from an additional €2.00 per pack cigarette tax increase. The effects of the recent cigarette excise tax increase were calculated on outcome measures: total price per pack, including specific excise, ad valorem tax, and value-added tax consumption; tax revenue; and per capita consumption of cigarettes. Additionally, smoking-attributable mortality, years of potential life lost, and productivity losses were estimated. Projected effects of an additional €2.00 per pack tax increase on consumption and tax revenue were also assessed. The cigarette excise tax increase in 2011 created €558 million in new tax revenue. Cigarette consumption reached a recent low of 24.9 billion sticks sold or 2197 sticks per person in 2011, indicating a 16% decrease in per capita cigarette consumption from the previous year. An additional €2.00 per pack increase in Greek cigarette taxes is projected to result in reduced cigarette sales by an additional 20% and lead to an increase in total cigarette tax revenues by nearly €1.2 billion and the prevention of 192,000 premature deaths. Nations such as Greece, should employ taxation as a crucial measure to promote public health and economic development in such dire times. International economic organisations should aggressively pursue programmes and policies that champion the economic benefits of tobacco taxation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Battery energy-storage systems — an emerging market for lead/acid batteries

NASA Astrophysics Data System (ADS)

Cole, J. F.

Although the concept of using batteries for lead levelling and peak shaving has been known for decades, only recently have these systems become commercially viable. Changes in the structure of the electric power supply industry have required these companies to seek more cost-effective ways of meeting the needs of their customers. Through experience gained, primarily in the USA, batteries have been shown to provide multiple benefits to electric utilities. Also, lower maintenance batteries, more reliable electrical systems, and the availability of methods to predict costs and benefits have made battery energy-storage systems more attractive. Technology-transfer efforts in the USA have resulted in a willingness of electric utilities to install a number of these systems for a variety of tasks, including load levelling, peak shaving, frequency regulation and spinning reserve. Additional systems are being planned for several additional locations for similar applications, plus transmission and distribution deferral and enhanced power quality. In the absence of US champions such as the US Department of Energy and the Electric Power Research Institute, ILZRO is attempting to mount a technology-transfer programme to bring the benefits of battery energy-storage to European power suppliers. As a result of these efforts, a study group on battery energy-storage systems has been established with membership primarily in Germany and Austria. Also, a two-day workshop, prepared by the Electric Power Research Institute was held in Dublin. Participants included representatives of several European power suppliers. As a result, ESB National Grid of Ireland has embarked upon a detailed analysis of the costs and benefits of a battery energy-storage system in their network. Plans for the future include continuation of this technology-transfer effort, assistance in the Irish effort, and a possible approach to the European Commission for funding.

20 CFR 10.332 - What additional medical information will OWCP require to support continuing payment of benefits?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false What additional medical information will OWCP require to support continuing payment of benefits? 10.332 Section 10.332 Employees' Benefits OFFICE OF... COMPENSATION UNDER THE FEDERAL EMPLOYEES' COMPENSATION ACT, AS AMENDED Medical and Related Benefits Medical...

20 CFR 408.808 - What happens to your SVB payments if you begin receiving additional benefit income?

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false What happens to your SVB payments if you begin receiving additional benefit income? 408.808 Section 408.808 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Suspensions and Terminations Suspension § 408...

20 CFR 408.808 - What happens to your SVB payments if you begin receiving additional benefit income?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false What happens to your SVB payments if you begin receiving additional benefit income? 408.808 Section 408.808 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Suspensions and Terminations Suspension § 408...

20 CFR 408.808 - What happens to your SVB payments if you begin receiving additional benefit income?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false What happens to your SVB payments if you begin receiving additional benefit income? 408.808 Section 408.808 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Suspensions and Terminations Suspension § 408...

20 CFR 408.808 - What happens to your SVB payments if you begin receiving additional benefit income?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false What happens to your SVB payments if you begin receiving additional benefit income? 408.808 Section 408.808 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Suspensions and Terminations Suspension § 408...

20 CFR 408.808 - What happens to your SVB payments if you begin receiving additional benefit income?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false What happens to your SVB payments if you begin receiving additional benefit income? 408.808 Section 408.808 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Suspensions and Terminations Suspension § 408...

Octogenarian and centenarian performance on the Fuld Object Memory Evaluation.

PubMed

Rahman-Filipiak, Annalise; Woodard, John L; Miller, L Stephen; Martin, Peter; Davey, Adam; Poon, Leonard W

2015-01-01

The Fuld Object Memory Evaluation (FOME) has considerable utility for cognitive assessment in older adults, but there are few normative data, particularly for the oldest old. In this study, 80 octogenarians and 244 centenarians from the Georgia Centenarian Study completed the FOME. Total and trial-to-trial performance on the storage, retrieval, repeated retrieval, and ineffective reminder indices were assessed. Additional data stratified by age group, education, and cognitive impairment are provided in the Supplemental data. Octogenarians performed significantly better than centenarians on all FOME measures. Neither age group benefitted from additional learning trials beyond Trial 3 for storage and Trial 2 for retention and retrieval. Ineffective reminders showed no change across learning trials for octogenarians, while centenarians improved only between Trials 1 and 2. This minimal improvement past Trial 2 indicates that older adults might benefit from a truncated version of the test that does not include trials three through five, with the added benefit of reducing testing burden in this population.

The full benefits of adult pneumococcal vaccination: A systematic review

PubMed Central

Stawasz, Andrew; Johnson, Sydney T.; Sato, Reiko; Bloom, David E.

2017-01-01

Background Pneumococcal disease causes substantial morbidity and mortality, including among adults. Adult pneumococcal vaccines help to prevent these burdens, but they are underused. Accounting for the full benefits of adult pneumococcal vaccination may promote more rational resource allocation decisions with respect to adult pneumococcal vaccines. Objectives Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a systematic review to assess the extent to which the literature has empirically captured (e.g., through measurement or modeling) the full benefits of adult pneumococcal vaccination. Methods We systematically searched PubMed and Embase to identify studies published between January 1, 2010 and April 10, 2016 that examine adult pneumococcal vaccination. We included articles if they captured any health or economic benefit of an adult pneumococcal vaccine administered to adults age ≥ 50 or ≥ 18 in risk groups. Finally, we summarized the literature by categorizing the types of benefits captured, the perspective taken, and the strength of the evidence presented. Our protocol is number 42016038335 in the PROSPERO International prospective register of systematic reviews. Results We identified 5,857 papers and included 150 studies for analysis. While most capture health gains and healthcare cost savings, far fewer studies consider additional benefit categories, such as productivity gains. However, the studies with a broader approach still exhibit significant limitations; for example, many present only abstracts, while others offer no new measurements. Studies that examine the 13-valent pneumococcal conjugate vaccine focus more on broad economic benefits, but still have limitations. Conclusions This review highlights the need for more robust empirical accounting of the full benefits of adult pneumococcal vaccination. Literature outside this realm indicates that these broad benefits may be substantial. Failing to investigate the full benefits may lead society to undervalue vaccines' contributions and therefore underinvest in their development and adoption. PMID:29088258

Tackling the chronic disease burden: are there co-benefits from climate policy measures?

PubMed

Vandenberghe, Désirée; Albrecht, Johan

2018-04-26

Each year, non-communicable diseases (NCDs) kill 40 million people worldwide and impose an estimated economic burden of $600 billion. Without effective policymaking, NCDs will continue to undermine health and economic systems globally. We propose that climate policy measures-such as carbon pricing-can yield significant health-related co-benefits aside from their intended greenhouse gas emission reduction. We simulate three carbon tax scenarios in the energy and food sector in Belgium and assess the resulting health-related co-benefits. These benefits originate from decreased exposure to two leading NCD risk factors: fine particulate matter and dietary regimes excessive in animal products. The carbon tax could prevent 42,300-78,800 Disability-Adjusted Life Years in Belgium, or save 0.6-1.1% of total health care expenditure and an additional 0.06-0.12% of Belgian GDP. We conclude that these health-related co-benefits should be included in the cost-benefit analysis of carbon pricing.

20 CFR 639.7 - What must the notice contain?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 639.7 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR WORKER... affected and the names of the workers currently holding affected jobs. The notice may include additional information useful to the employees such as information on available dislocated worker assistance, and, if the...

76 FR 48147 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-08

.... Respondent's Obligation: Required to obtain or retain benefits. OMB Desk Officer: Nicholas A. Fraser, e-mail... DEPARTMENT OF COMMERCE Patent and Trademark Office Submission for OMB Review; Comment Request The... obtained by: E-mail: [email protected] . Include ``0651- 0012 proposed addition copy request...

Noncaloric Sweeteners in Children: A Controversial Theme

PubMed Central

Escobar Contreras, Ma. Cristina; Rojas Gómez, Diana; de Assis Costa, Jorge

2018-01-01

Noncaloric sweeteners (NCS) are food additives used to provide sweetness without adding calories. Their consumption has become more widespread around the world in all age groups, including children. The aim of this study is to show the state of the art about the intake of noncaloric sweeteners in children, as well as their benefits and consumption risk. Scientific searchers were used (PUBMED, Scopus, and Scielo) to analyze articles that included keywords (noncaloric sweeteners/saccharin/cyclamate/acesulfame potassium/aspartame/sucralose/stevia/children) in English, Spanish, and Portuguese. Authors conclude that it is imperative that health professionals judiciously and individually evaluate the overall benefits and risks of NCS use in consumers before recommending their use. Different subgroups of the population incorporate products containing NCS in their diet with different objectives, which should be considered when recommending a diet plan for the consumer. In childhood, in earlier age groups, this type of additives should be used as a dietary alternative when other forms of prevention in obesity are not sufficient. PMID:29511682

20 CFR 725.607 - Payments in addition to compensation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... time as, but in addition to, such benefits, unless review of the order making such award is sought as... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Payments in addition to compensation. 725.607 Section 725.607 Employees' Benefits EMPLOYMENT STANDARDS ADMINISTRATION, DEPARTMENT OF LABOR FEDERAL COAL...

IPPF re-affirms its policy on sterilization: a free, informed and unpressured choice.

PubMed

1977-01-01

The IPPF has re-affirmed its policy on sterilization that individuals have the right to voluntarily choose a contraceptive method. A sterilization acceptor should understand all the implications and that the procedure should be considered irreversible, although medical techniques should be used to give the greatest chance of reversibility. An individual should know of alternative contraceptive methods and the risks and benefits involved with each. Incentives for family planning programs should ensure that benefits be in addition to the benefits and services which are entitled to everyone; likewise, any disincentives should not conflict with basic human rights. Family planning education should promote informed decisions on contraceptive use including sterilization procedures.

The 2016 HIGh Heels: Health effects And psychosexual BenefITS (HIGH HABITS) study: systematic review of reviews and additional primary studies.

PubMed

Barnish, Max; Morgan, Heather May; Barnish, Jean

2017-08-01

High-heeled shoes (high heels) are frequently worn by many women and form an important part of female gender identity. Issues of explicit and implicit compulsion to wear high heels have been noted. Previous studies and reviews have provided evidence that high heels are detrimental to health. However, the evidence base remains fragmented and no review has covered both the epidemiological and biomechanical literature. In addition, no review has considered the psychosexual benefits that offer essential context in understanding the public health challenge of high heels. We searched seven major bibliographic databases up to November 2016, in addition to supplementary searches. We initially identified all review articles of any design that assessed either the psychosexual benefits or negative musculoskeletal health effects of high heels, the latter looking at both the epidemiological and biomechanical perspectives. We additionally considered additional primary studies on areas that had not been reviewed before or in which a marked lack of evidence had been noted. Data were extracted onto standardised forms. Proportionate second review was conducted. A total of 506 unique records were identified, 27 full-text publications were screened and 20 publications (7 reviews and 13 additional studies) were included in our evidence synthesis. The most up-to-date epidemiological review provides clear evidence of an association between high heel wear and hallux valgus, musculoskeletal pain and first-party injury. The body of biomechanical reviews provides clear evidence of changes indicative of increased risk of these outcomes, as well as osteoarthritis, which is not yet evidenced by epidemiological studies. There were no reviews on psychosexual benefits, but all five identified original studies provided evidence of increased attractiveness and/or an impact on men's behaviour associated with high heel wear. With regard to second-party injury, evidence is limited to one descriptive study and eight case reports. Our evidence synthesis clearly shows that high heels bring psychosexual benefits to women but are detrimental to their health. In light of this dilemma, it is important that women's freedom of choice is respected and that any remaining issues of explicit or implicit compulsion are addressed.

Optimisation of follow-up after metabolic surgery.

PubMed

Mingrone, Geltrude; Bornstein, Stefan; Le Roux, Carel W

2018-06-01

Bariatric surgery has many benefits beyond weight loss, including improved control of glycaemia, blood pressure, and dyslipidaemia; hence, such surgery has been rebranded as metabolic surgery. The operations are, unfortunately, also associated with major surgical and medical complications. The medical complications include gastro-oesophageal reflux disease, malnutrition, and metabolic complications deriving from vitamin and mineral malabsorption. The benefits of surgery can be optimised by implementing specific protocols before and after surgery. In this Review, we discuss the assessment of the risk of major cardiac complications and severe obstructive sleep apnoea before surgery, and the provision of adequate lifelong postsurgery nutritional, vitamin, and mineral supplementation to reduce complications. Additionally, we examine the best antidiabetic medications to reduce the risk of hypoglycaemia after gastric bypass and sleeve gastrectomy, and the strategies to improve weight loss or reduce weight regain. Although optimising clinical pathways is possible to maximise metabolic benefits and reduce the risks of complications and micronutrient deficiencies, evolution of these strategies can further improve the risk-to-benefit ratio of metabolic surgery. Copyright © 2018 Elsevier Ltd. All rights reserved.

Modeling of GE Appliances: Cost Benefit Study of Smart Appliances in Wholesale Energy, Frequency Regulation, and Spinning Reserve Markets

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fuller, Jason C.; Parker, Graham B.

This report is the second in a series of three reports describing the potential of GE’s DR-enabled appliances to provide benefits to the utility grid. The first report described the modeling methodology used to represent the GE appliances in the GridLAB-D simulation environment and the estimated potential for peak demand reduction at various deployment levels. The third report will explore the technical capability of aggregated group actions to positively impact grid stability, including frequency and voltage regulation and spinning reserves, and the impacts on distribution feeder voltage regulation, including mitigation of fluctuations caused by high penetration of photovoltaic distributed generation.more » In this report, a series of analytical methods were presented to estimate the potential cost benefit of smart appliances while utilizing demand response. Previous work estimated the potential technical benefit (i.e., peak reduction) of smart appliances, while this report focuses on the monetary value of that participation. The effects on wholesale energy cost and possible additional revenue available by participating in frequency regulation and spinning reserve markets were explored.« less

Questions and answers on employee benefit issues.

PubMed

1994-06-01

This Issue Brief addresses 19 topics in the areas of pensions, health insurance, and other benefits. In addition to the topics listed below, the report includes data on the prevalence of benefits, tax incentives associated with benefits, lump-sum distributions, number of private pension plans, pension coverage rates, 401(k) plans, employer spending on group health insurance, self-insured health plans, employer initiatives to reduce health care costs, and employers' response to the retiree health benefits accounting rule, and flexible benefits plans. In 1992, U.S. employers (public and private) spent $629 billion for noncash benefits, representing nearly 18 percent of total compensation, excluding paid time off. In 1992, 71 percent of the 50.1 million individuals aged 55 and over received retirement benefits, including distributions from private and public pensions, annuities, individual retirement accounts, Keoghs, 401(k)s, and Social Security. Among the 76 percent of all private pension plan participants who participated in a single plan, 30 percent named a defined benefit plan as their pension plan type, 58 percent named a defined contribution plan as their pension plan type, and 12 percent did not know their plan type. Private and public pension funds held more than $4.6 trillion in assets at the end of 1993. The 1993 year-end assets are more than triple the asset level of 1983 (nominal terms). According to the Congressional Budget Office, U.S. expenditures on health care were expected to have reached $898 billion in 1993, up from $751.8 billion in 1991, an increase of 19.4 percent in nominal terms.

Using archived ITS data to measure the operational benefits of a system-wide adaptive ramp metering system : appendix online\\0x20106: OR\\0x2010217 NB time-space speed contour plots with meter activations.

DOT National Transportation Integrated Search

2008-12-01

Programmable logic controllers (PLCs) were installed at several key ramps with the assistance of the City of Portland and used to capture additional data about ramp operations that are not otherwise logged. The data include include the activation and...

29 CFR 516.3 - Bona fide executive, administrative, and professional employees (including academic...

Code of Federal Regulations, 2010 CFR

2010-07-01

... information and data required by § 516.2(a) except paragraphs (a) (6) through (10) and, in addition, the basis... appropriate addenda such as “plus hospitalization and insurance plan A,” “benefit package B,” “2 weeks paid...

29 CFR 516.3 - Bona fide executive, administrative, and professional employees (including academic...

Code of Federal Regulations, 2012 CFR

2012-07-01

... information and data required by § 516.2(a) except paragraphs (a) (6) through (10) and, in addition, the basis... appropriate addenda such as “plus hospitalization and insurance plan A,” “benefit package B,” “2 weeks paid...

29 CFR 516.3 - Bona fide executive, administrative, and professional employees (including academic...

Code of Federal Regulations, 2014 CFR

2014-07-01

... information and data required by § 516.2(a) except paragraphs (a) (6) through (10) and, in addition, the basis... appropriate addenda such as “plus hospitalization and insurance plan A,” “benefit package B,” “2 weeks paid...

29 CFR 516.3 - Bona fide executive, administrative, and professional employees (including academic...

Code of Federal Regulations, 2011 CFR

2011-07-01

... information and data required by § 516.2(a) except paragraphs (a) (6) through (10) and, in addition, the basis... appropriate addenda such as “plus hospitalization and insurance plan A,” “benefit package B,” “2 weeks paid...

29 CFR 516.3 - Bona fide executive, administrative, and professional employees (including academic...

Code of Federal Regulations, 2013 CFR

2013-07-01

... information and data required by § 516.2(a) except paragraphs (a) (6) through (10) and, in addition, the basis... appropriate addenda such as “plus hospitalization and insurance plan A,” “benefit package B,” “2 weeks paid...

Biological activity of peanut (Arachis hypogaea) phytoalexins and selected natural and synthetic stilbenoids

USDA-ARS?s Scientific Manuscript database

The peanut plant (Arachis hypogaea L.), when infected by a microbial pathogen, is capable of producing stilbene-derived compounds that are considered antifungal phytoalexins. In addition, the potential health benefits of other stilbenoids from peanuts, including resveratrol and pterostilbene have be...

The Effect of Heavy Drinking on Social Security Old-Age and Survivors Insurance Contributions and Benefits

PubMed Central

Ostermann, Jan; Sloan, Frank A

2004-01-01

This article estimates the effects of heavy alcohol consumption on Social Security Old-Age and Survivor Insurance (OASI) contributions and benefits. The analysis accounts for differential earnings and mortality experiences of individuals with different alcohol consumption patterns and controls for other characteristics, including smoking. Relative to moderate drinkers, heavy drinkers receive fewer OASI benefits relative to their contributions. Ironically, for each cohort of 25-year-olds, eliminating heavy drinking costs the program an additional $3 billion over the cohort's lifetime. Public health campaigns are designed to improve individual health-relevant behaviors and, in the long run, increase longevity. Therefore, if programs for the elderly are structured as longevity-independent defined benefit programs, their success will reward healthier behaviors but increase these programs’ outlays and worsen their financial condition. PMID:15330975

Evidence on global medical travel.

PubMed

Ruggeri, Kai; Záliš, Ladislav; Meurice, Christopher R; Hilton, Ian; Ly, Terry-Lisa; Zupan, Zorana; Hinrichs, Saba

2015-11-01

The potential benefits of travelling across national borders to obtain medical treatment include improved care, decreased costs and reduced waiting times. However, medical travel involves additional risks, compared to obtaining treatment domestically. We review the publicly-available evidence on medical travel. We suggest that medical travel needs to be understood in terms of its potential risks and benefits so that it can be evaluated against alternatives by patients who are seeking care. We propose three domains -quality standards, informed decision-making, economic and legal protection - in which better evidence could support the development of medical travel policies.

Cross-functional systems

NASA Technical Reports Server (NTRS)

Lee, Mark

1991-01-01

Many companies, including Xerox and Texas Instruments, are using cross functional systems to deal with the increasingly complex and competitive business environment. However, few firms within the aerospace industry appear to be aware of the significant benefits that cross functional systems can provide. Those benefits are examined and a flexible methodology is discussed that companies can use to identify and develop cross functional systems that will help improve organizational performance. In addition, some of the managerial issues are addressed that cross functional systems may raise and specific examples are used to explore networking's contributions to cross functional systems.

Cost-benefit analysis for sheltered employment service programs for people with disabilities in Taiwan - a preliminary study.

PubMed

Wang, Yun-Tung; Lin, Yi-Jiun; Shu, Ching-Hsien

2012-01-01

The aim of this study is to do a cost-benefit analysis with monetary and non-monetary benefits for sheltered employment service programs and try to provide more evidence-based information for policy makers and practitioners to understand the outcomes of sheltered employment services. This study analyzed 3 sheltered employment service programs for people with disabilities (2006-2007) implemented by Sunshine Social Welfare Foundation in Taiwan using cost-benefit analysis (including non-monetary benefits). Three groups were analyzed, including participants in the programs, taxpayers, and society (participants and taxpayers). This study found that the net social monetary benefit was $NT29,432.07 per participant per year and the benefit cost ratio was 1.43. (In 2006-2007, $US1 = $NT32.5 averagely around.) The net monetary benefit for the participants was between $NT7,890.86 and $NT91,890.86 per participant per year. On the non-monetary benefit side, the physical health (raised 7.49%), social relationship (raised 3.36%) domains, and general quality of life (raised 2.53%) improved. However, the psychological (decreased 1.51%) and working/environment (decreased 3.85%) domains backslided. In addition, the differences between pre-test and post-test average scores of all domains were not statistically significant. This study is the first to use monetary and non-monetary cost-benefit analysis methods to analyze sheltered employment service programs for people with disabilities in Taiwan. The findings indicated that sheltered employment service programs for people with disabilities could be efficient and beneficial for the whole society and sheltered employees/clients, and also helpful for raising their quality of lives.

Endogenous patient responses and the consistency principle in cost-effectiveness analysis.

PubMed

Liu, Liqun; Rettenmaier, Andrew J; Saving, Thomas R

2012-01-01

In addition to incurring direct treatment costs and generating direct health benefits that improve longevity and/or health-related quality of life, medical interventions often have further or "unrelated" financial and health impacts, raising the issue of what costs and effects should be included in calculating the cost-effectiveness ratio of an intervention. The "consistency principle" in medical cost-effectiveness analysis (CEA) requires that one include both the cost and the utility benefit of a change (in medical expenditures, consumption, or leisure) caused by an intervention or neither of them. By distinguishing between exogenous changes directly brought about by an intervention and endogenous patient responses to the exogenous changes, and within a lifetime utility maximization framework, this article addresses 2 questions related to the consistency principle: 1) how to choose among alternative internally consistent exclusion/inclusion rules, and 2) what to do with survival consumption costs and earnings. It finds that, for an endogenous change, excluding or including both the cost and the utility benefit of the change does not alter cost-effectiveness results. Further, in agreement with the consistency principle, welfare maximization implies that consumption costs and earnings during the extended life directly caused by an intervention should be included in CEA.

76 FR 59024 - Federal Government Participation in the Automated Clearing House

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-23

... Act of 2008, account-related information could be shared only for certain types of benefit [[Page... international payment transactions using a new Standard Entry Class Code and to include certain information in... Control (OFAC). In addition, the rule requires financial institutions to provide limited account-related...

28 CFR 345.65 - Inmate medical work limitation.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Inmate medical work limitation. 345.65... PRISON INDUSTRIES (FPI) INMATE WORK PROGRAMS Inmate Pay and Benefits § 345.65 Inmate medical work limitation. In addition to any prior illnesses or injuries, medical limitations also include any illness or...

28 CFR 345.65 - Inmate medical work limitation.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Inmate medical work limitation. 345.65... PRISON INDUSTRIES (FPI) INMATE WORK PROGRAMS Inmate Pay and Benefits § 345.65 Inmate medical work limitation. In addition to any prior illnesses or injuries, medical limitations also include any illness or...

Video-Based Test Questions: A Novel Means of Evaluation

ERIC Educational Resources Information Center

Hertenstein, Matthew J.; Wayand, Joseph F.

2008-01-01

Many psychology instructors present videotaped examples of behavior at least occasionally during their courses. However, few include video clips during examinations. We provide examples of video-based questions, offer guidelines for their use, and discuss their benefits and drawbacks. In addition, we provide empirical evidence to support the use…

20 CFR 416.1218 - Exclusion of the automobile.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Exclusion of the automobile. 416.1218 Section..., BLIND, AND DISABLED Resources and Exclusions § 416.1218 Exclusion of the automobile. (a) Automobile; defined. As used in this section, the term automobile includes, in addition to passenger cars, other...

20 CFR 416.1218 - Exclusion of the automobile.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Exclusion of the automobile. 416.1218 Section..., BLIND, AND DISABLED Resources and Exclusions § 416.1218 Exclusion of the automobile. (a) Automobile; defined. As used in this section, the term automobile includes, in addition to passenger cars, other...

20 CFR 416.1218 - Exclusion of the automobile.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Exclusion of the automobile. 416.1218 Section..., BLIND, AND DISABLED Resources and Exclusions § 416.1218 Exclusion of the automobile. (a) Automobile; defined. As used in this section, the term automobile includes, in addition to passenger cars, other...

20 CFR 416.1218 - Exclusion of the automobile.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Exclusion of the automobile. 416.1218 Section..., BLIND, AND DISABLED Resources and Exclusions § 416.1218 Exclusion of the automobile. (a) Automobile; defined. As used in this section, the term automobile includes, in addition to passenger cars, other...

20 CFR 416.1218 - Exclusion of the automobile.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Exclusion of the automobile. 416.1218 Section..., BLIND, AND DISABLED Resources and Exclusions § 416.1218 Exclusion of the automobile. (a) Automobile; defined. As used in this section, the term automobile includes, in addition to passenger cars, other...

Immersion and Identity: Experiences of an African American Preschool Child

ERIC Educational Resources Information Center

McCullough, Ruanda Garth; Reyes, Sharon Adelman

2010-01-01

This article explores the benefits and challenges of a Spanish language immersion preschool from the perspective of a non-Spanish speaking African American family. Data explored include the decision to enroll, reactions from peers and family, home-school communication issues, language development, and family involvement. In addition,…

Factors Influencing Student Gains from Undergraduate Research Experiences at a Hispanic-Serving Institution

ERIC Educational Resources Information Center

Daniels, Heather; Grineski, Sara E.; Collins, Timothy W.; Morales, Danielle X.; Morera, Osvaldo; Echegoyen, Lourdes

2016-01-01

Undergraduate research experiences (UREs) confer many benefits to students, including improved self-confidence, better communication skills, and an increased likelihood of pursuing science careers. Additionally, UREs may be particularly important for racial/ethnic minority students who are underrepresented in the science workforce. We examined…

Dietary Management of Attention Deficit Disorder.

ERIC Educational Resources Information Center

Dengate, Sue

1997-01-01

Claims early studies of diet and ADHD focused irrelevantly on sugar, failing to sufficiently eliminate problem-causing foods, include parental observations, and adequately rate common symptoms. Asserts that recent studies show additive-free diets alone are of little benefit, that a low-chemical elimination diet followed by challenges can identify…

[Assessing the added benefit of new ophthalmic drugs : Which additional insights can be extracted from the early benefit assessment?

PubMed

Appelrath, M; Glaeske, G

2017-12-01

Until now six ophthalmic agents have undergone the German early benefit assessment according to § 35a Social Security Code (SGB) V in a total of eleven indications. Only one agent (ocriplasmin) was recognized by the Federal Joint Committee as having an added benefit based on submitted study data for a subpopulation (indication of a considerable added benefit, limited for 5 years) and another agent, idebenone, received an added benefit due to its orphan drug designation (proof of a not quantifiable added benefit, limited for 2 years). All remaining agents (aflibercept, bromfenac, nepafenac and tafluprost/timolol) were not recognized as having an added benefit. The analysis showed that there was a lack of suitable evidence. Some reasons for the inappropriateness of the conducted trials for the usage in the early benefit assessment are the comparative therapy, the patient population included or the dosage regimens. For two agents (bromfenac and nepafenac) the pharmaceutical company did not even submit a value dossier. The examples from ophthalmology illustrate the methodological and procedural shortcomings of the assessment process and that results of an early benefit assessment should be interpreted with caution.

The Use of Economic Evaluation to Inform Newborn Screening Policy Decisions: The Washington State Experience.

PubMed

Grosse, Scott D; Thompson, John D; Ding, Yao; Glass, Michael

2016-06-01

Newborn screening not only saves lives but can also yield net societal economic benefit, in addition to benefits such as improved quality of life to affected individuals and families. Calculations of net economic benefit from newborn screening include the monetary equivalent of avoided deaths and reductions in costs of care for complications associated with late-diagnosed individuals minus the additional costs of screening, diagnosis, and treatment associated with prompt diagnosis. Since 2001 the Washington State Department of Health has successfully implemented an approach to conducting evidence-based economic evaluations of disorders proposed for addition to the state-mandated newborn screening panel. Economic evaluations can inform policy decisions on the expansion of newborn screening panels. This article documents the use of cost-benefit models in Washington State as part of the rule-making process that resulted in the implementation of screening for medium-chain acyl-CoA dehydrogenase (MCAD) deficiency and 4 other metabolic disorders in 2004, cystic fibrosis (CF) in 2006, 15 other metabolic disorders in 2008, and severe combined immune deficiency (SCID) in 2014. We reviewed Washington State Department of Health internal reports and spreadsheet models of expected net societal benefit of adding disorders to the state newborn screening panel. We summarize the assumptions and findings for 2 models (MCAD and CF) and discuss them in relation to findings in the peer-reviewed literature. The MCAD model projected a benefit-cost ratio of 3.4 to 1 based on assumptions of a 20.0 percentage point reduction in infant mortality and a 13.9 percentage point reduction in serious developmental disability. The CF model projected a benefit-cost ratio of 4.0-5.4 to 1 for a discount rate of 3%-4% and a plausible range of 1-2 percentage point reductions in deaths up to age 10 years. The Washington State cost-benefit models of newborn screening were broadly consistent with peer-reviewed literature, and their findings of net benefit appear to be robust to uncertainty in parameters. Public health newborn screening programs can develop their own capacity to project expected costs and benefits of expansion of newborn screening panels, although it would be most efficient if this capacity were shared among programs. © 2016 Milbank Memorial Fund.

Evaluation of a Placement Coaching Program for Recipients of Disability Insurance Benefits in Switzerland.

PubMed

Hagen, Tobias

2018-03-09

Purpose During 2009‒2013 a pilot project was carried out in Zurich which aimed to increase the income of disability insurance (DI) benefit recipients in order to reduce their entitlement to DI benefits. The project consisted of placement coaching carried out by a private company that specialized in this field. It was exceptional with respect to three aspects: firstly, it did not include any formal training and/or medical aid; secondly, the coaches did not have the possibility of providing additional financial incentives or sanctioning lack of effort; and thirdly due to performance bonuses, the company not only had incentives to bring the participants into (higher paid) work, but also to keep them there for 52 weeks. This paper estimates the medium-run effects of the pilot project and assesses the net benefit from the Swiss social security system. Methods Different propensity score matching estimators are applied to administrative longitudinal data in order to construct suitable control groups. Results The estimates indicate a reduction in DI benefits and an increase in income even in the medium-run. A simple cost-benefit analysis suggests that the pilot project was a profitable investment for the social security system. Conclusion Given a healthy labor market, it seems possible to enhance the employment prospects of disabled persons with a relatively inexpensive intervention, which does not include any explicit investments in human capital.

Employee health benefit redesign at the academic health center: a case study.

PubMed

Marshall, Julie; Weaver, Deirdre C; Splaine, Kevin; Hefner, David S; Kirch, Darrell G; Paz, Harold L

2013-03-01

The rapidly escalating cost of health care, including the cost of providing health care benefits, is a significant concern for many employers. In this article, the authors examine a case study of an academic health center that undertook a complete redesign of its health benefit structure to control rising costs, encourage use of its own provider network, and support employee wellness. With the implementation in 2006 of a high-deductible health plan combined with health reimbursement arrangements and wellness incentives, the Penn State Hershey Medical Center (PSHMC) was able to realize significant cost savings and increase use of its own network while maintaining a high level of employee satisfaction. By contracting with a single third-party administrator for its self-insured plan, PSHMC reduced its administrative costs and simplified benefit choices for employees. In addition, indexing employee costs to salary ensured that this change was equitable for all employees, and the shift to a consumer-driven health plan led to greater employee awareness of health care costs. The new health benefit plan's strong focus on employee wellness and preventive health has led to significant increases in the use of preventive health services, including health risk assessments, cancer screenings, and flu shots. PSHMC's experience demonstrates the importance of clear and ongoing communication with employees throughout--before, during, and even after--the process of health benefit redesign.

Resistance delaying strategies on UK sheep farms: A cost benefit analysis.

PubMed

Learmount, Jane; Glover, Mike J; Taylor, Mike A

2018-04-30

UK guidelines for the sustainable control of parasites in sheep (SCOPS) were formulated with the primary aim of delaying development of anthelmintic resistance (AR) on UK sheep farms. Promoting their use requires the engagement and commitment of stakeholders. An important driver for behavioural change in sheep farmers is evidence of economic benefits. A recent evaluation of SCOPS guidance in practice demonstrated a significant reduction in anthelmintic use, suggesting economic benefits through a direct reduction in product and labour costs. However, in order to maintain production, a range of alternative control strategies are advised, resulting in additional costs to farmers and so a full cost benefit analysis of best practice management was undertaken. We allocated financial values to the management recommendations described in the SCOPS technical manual. Benefits were calculated using data for production variables and anthelmintic use measured during studies to evaluate the effect of SCOPS recommendations on 16 UK sheep farms and from other published work. As SCOPS control is not prescriptive and a range of different diagnostics are available, best and worst case scenarios were presented, comparing the cheapest methods (e.g. egg counts without larval culture) and management situations (e.g closed flocks not requiring quarantine treatments) with the most laborious and expensive. Simulations were run for farms with a small, medium or large flock (300; 1000; 1900 ewes) as well as comparing scenarios with and without potential production benefits from using effective wormers. Analysis demonstrated a moderate cost for all farms under both scenarios when production benefits were not included. A cost benefit was demonstrated for medium and large farms when production benefits were included and the benefit could be perceived as significant in the case of the large farms for the best case scenario (>£5000 per annum). Despite a significant potential reduction in anthelmintic use by farmers employing SCOPS guidance, the very low price of the older anthelmintic classes meant that the benefit did not always outweigh the additional management/diagnostic costs unless an increase in production was also achieved. This is an important finding. Focussing research on key innovations that will improve the cost effectiveness of diagnostic assays in a diagnostic driven control strategy, as well as designing treatment options that can improve production outcomes, and presenting them in a clear and transparent way, must be high priority goals. Coupling targeted research with improvements in the delivery of messages to the end user is important in the light of increasing global concerns over drug resistance. Crown Copyright © 2018. Published by Elsevier B.V. All rights reserved.

Is There a Starling Curve for Intensive Care?

PubMed Central

2012-01-01

Large differences exist in the provision of ICU beds worldwide, with a complicated mix of risks and benefits to the population of having either too few or too many beds. Having too few beds can result in delayed admission of patients to the ICU or no admission at all, with either scenario potentially increasing mortality. Potential societal benefits of having few beds include lower costs for health care and less futile intensive care at the end of life. With added ICU beds for a population, mortality benefit should accrue, but there is still the question of whether the addition of beds always means that more lives will be saved or whether there is a point at which no additional mortality benefit is gained. With an abundance of ICU beds may come the possibility of increasing harm in the forms of unnecessary costs, poor quality of deaths (ie, excessively intensive), and iatrogenic complications. The possibility of harm may be likened to the concept of falling off a Starling curve, which is traditionally used to describe worsening heart function when overfilling occurs. This commentary examines the possible implications of having too few or too many ICU beds and proposes the concept of a family of Starling curves as a way to conceptualize the balance of societal benefits and harms associated with different availability of ICU beds for a population. PMID:22670019

Bicyclists overestimate their own night-time conspicuity and underestimate the benefits of retroreflective markers on the moveable joints.

PubMed

Wood, Joanne M; Tyrrell, Richard A; Marszalek, Ralph; Lacherez, Philippe; Carberry, Trent

2013-06-01

Conspicuity limitations make bicycling at night dangerous. This experiment quantified bicyclists' estimates of the distance at which approaching drivers would first recognize them. Twenty five participants (including 13 bicyclists who rode at least once per week, and 12 who rode once per month or less) cycled in place on a closed-road circuit at night-time and indicated when they were confident that an approaching driver would first recognize that a bicyclist was present. Participants wore black clothing alone or together with a fluorescent bicycling vest, a fluorescent bicycling vest with additional retroreflective tape, or the fluorescent retroreflective vest plus ankle and knee reflectors in a modified 'biomotion' configuration. The bicycle had a light mounted on the handlebars which was either static, flashing or off. Participants judged that black clothing made them least visible, retroreflective strips on the legs in addition to a retroreflective vest made them most visible and that adding retroreflective materials to a fluorescent vest provides no conspicuity benefits. Flashing bicycle lights were associated with higher conspicuity than static lights. Additionally, occasional bicyclists judged themselves to be more visible than did frequent bicyclists. Overall, bicyclists overestimated their conspicuity compared to previously collected recognition distances and underestimated the conspicuity benefits of retroreflective markings on their ankles and knees. Participants mistakenly judged that a fluorescent vest that did not include retroreflective material would enhance their night-time conspicuity. These findings suggest that bicyclists have dangerous misconceptions concerning the magnitude of the night-time conspicuity problem and the potential value of conspicuity treatments. Copyright © 2013 Elsevier Ltd. All rights reserved.

Recent research and development of functional food in Taiwan.

PubMed

Sun Hwang, Lucy

2007-08-01

As the living standard rises, people are more concerned with the health benefits of foods. Functional foods are, therefore, receiving increasing attention worldwide. The functional food market in Taiwan reached 1.78 billion US dollars in 2005. Only those which have been certified by the Department of Health can claim their health benefits. Until January 2007, only 88 functional foods have received the certificates. In addition to the product development in the food industry, research institutes and universities are also actively engaged in the technology development and basic research of functional foods. Many raw materials harvested in Taiwan, including edible plants, herbs, medicinal mushrooms, and sea foods, are investigated for their health benefits, bioactive components and suitable processing technologies.

Omega-3 polyunsaturated fatty acids for the prevention of cardiovascular disease: do formulation, dosage & comparator matter?

PubMed

DiNicolantonio, James J; Meier, Pascal; O'Keefe, James H

2013-01-01

Multiple trials over the past two decades testing omega-3 polyunsaturated fatty acids (PUFAs), containing eicosapentaenoic acid (EPA) and or docosahexaenoic acid (DHA), have shown substantial benefits for reducing major coronary heart disease (CHD) events, all-cause mortality, cardiovascular (CV) death, sudden cardiac death (SCD), and stroke. However, recent trials testing omega-3s have generally failed to confirm these benefits. While increased fish and fish oil intake among the general population, increased use of optimal medical therapy (including statins, aspirin, and modern antihypertensive medications) probably make it more challenging for fish oil supplementation to show additional benefits, there might be further explanations in the formulation, dosage, and comparator used in these recent omega-3 trials.

Use of cyproterone acetate/ethinylestradiol in polycystic ovary syndrome: rationale and practical aspects.

PubMed

Ruan, X; Kubba, A; Aguilar, A; Mueck, A O

2017-06-01

Polycystic ovary syndrome (PCOS) is a common, heterogeneous disorder characterised by hyperandrogenic skin symptoms, irregular menstruation and subfertility, increased risk of endometrial malignancy, and increased risk of preventable diseases associated with metabolic syndrome. Cyproterone acetate (CPA) 2 mg, combined with ethinylestradiol (EE) 35 μg, is indicated for the treatment of moderate to severe acne related to androgen-sensitivity (with or without seborrhea) and/or hirsutism, in women of reproductive age. To review the present knowledge about PCOS and summarize the role of CPA/EE in the care of patients suffering from this condition for the practitioner. Experts with clinical interest and experience in treating symptoms of androgen excess performed a non-systematic review to provide updated information regarding the use of CPA/EE in patients with PCOS. Polycystic ovary-related hyperandrogenic skin symptoms are effectively treated by CPA/EE, reducing not only the symptoms but also their negative impact on quality of life and mental health. Proven additional benefits for these patients include the treatment of menstrual irregularities and reduction in endometrial cancer risk. Possible benefits include preservation of fertility. Treatment increases the risk for venous thromboembolic complications. The nature of other metabolic and cardiovascular long-term effects i.e., whether positive or negative, are still to be investigated. Cyproterone acetate/ethinylestradiol provides effective treatment for PCO-related hyperandrogenic skin symptoms. This efficacy and additional benefits related to menstrual irregularities and endometrial cancer risk, have to be weighed against the risk of venous thromboembolic complications based on an individual benefit/risk evaluation.

Writing Assignments with a Metacognitive Component Enhance Learning in a Large Introductory Biology Course

PubMed Central

Mynlieff, Michelle; Manogaran, Anita L.; St. Maurice, Martin

2014-01-01

Writing assignments, including note taking and written recall, should enhance retention of knowledge, whereas analytical writing tasks with metacognitive aspects should enhance higher-order thinking. In this study, we assessed how certain writing-intensive “interventions,” such as written exam corrections and peer-reviewed writing assignments using Calibrated Peer Review and including a metacognitive component, improve student learning. We designed and tested the possible benefits of these approaches using control and experimental variables across and between our three-section introductory biology course. Based on assessment, students who corrected exam questions showed significant improvement on postexam assessment compared with their nonparticipating peers. Differences were also observed between students participating in written and discussion-based exercises. Students with low ACT scores benefited equally from written and discussion-based exam corrections, whereas students with midrange to high ACT scores benefited more from written than discussion-based exam corrections. Students scored higher on topics learned via peer-reviewed writing assignments relative to learning in an active classroom discussion or traditional lecture. However, students with low ACT scores (17–23) did not show the same benefit from peer-reviewed written essays as the other students. These changes offer significant student learning benefits with minimal additional effort by the instructors. PMID:26086661

Toward Value-Based Pricing to Boost Cancer Research and Innovation.

PubMed

Ocana, Alberto; Amir, Eitan; Tannock, Ian F

2016-06-01

The high market price of new anticancer agents has stimulated debate about the long-term sustainability of healthcare systems and whether these new agents can continue to be supported by public healthcare or by private insurers. In addition, some drugs have been approved with limited clinical benefit, raising concerns about setting a minimum requirement for medical benefit. Options to resolve these problems include raising the bar for approval of new drugs and/or pricing of new agents based on the medical benefit that they offer to patients. In this commentary, we suggest that new agents should be marketed in a two-step process that would include first the approval of the new drug by the regulatory agencies and second the introduction of a market price based on the medical benefit that the new intervention offers to patients. Introduction of value-based pricing would maintain the sustainability of health care systems and would improve drug development, as it would pressure pharmaceutical companies to become more innovative and avoid the development of compounds with limited benefit. Value-based pricing could also stimulate the funding of research directed to development of new anticancer drugs with novel mechanisms of action. Cancer Res; 76(11); 3127-9. ©2016 AACR. ©2016 American Association for Cancer Research.

Financial effects of health information technology: a systematic review.

PubMed

Low, Alexander F H; Phillips, Andrew B; Ancker, Jessica S; Patel, Ashwin R; Kern, Lisa M; Kaushal, Rainu

2013-11-01

Health information technology (HIT) is widely viewed as an important lever with which to improve the quality and efficiency of the healthcare system. However, there has long been debate about its financial effects. To characterize the existing data on the financial effects of HIT and to consider the implications for the effect of HIT on healthcare spending. Systematic literature review. We identified articles by (1) searching PubMed using the intersection of terms related to HIT applications and terms related to financial or economic effect; and (2) reviewing the reference lists of the included articles as well as additional policy articles and literature reviews. A total of 57 articles met our inclusion criteria, including 43 articles (75%) reporting financial benefits to a stakeholder associated with HIT. These included 26 articles (46%) reporting cost savings, 6 articles (11%) reporting revenue gains, and 11 articles (19%) reporting a mixture of cost savings and revenue gains. Among articles with experimental study designs, 22 of 34 (65%) reported financial benefits; and among articles explicitly measuring costs and benefits, 19 of 21 (90%) reported financial benefits. The most prevalent mechanisms were savings on administrative goods and/or personnel, savings on pharmaceuticals, and revenue gains through improved billing. Overall there is a dearth of articles on this topic, especially ones with strong study designs and financial analyses. HIT can have financial benefits, but more research is required, especially on HIT's effects under emerging delivery and payment reform efforts.

How are state insurance marketplaces shaping health plan design?

PubMed

Rosenbaum, Sara; Lopez, Nancy; Mehta, Devi; Dorley, Mark; Burke, Taylor; Widge, Alicia

2013-12-01

Part of states' roles in administering the new health insurance marketplaces is to certify the health plans available for purchase. This analysis focuses on how state-based and state partnership marketplaces are using their flexibility in setting certification standards to shape plan design in the individual market. It focuses on three aspects of certification: provider networks; inclusion of essential community providers; and benefit substitution, which allows plans to offer benefits that differ from a state's benchmark plan. A review of documents collected from 18 states and the District of Columbia finds that 13 states go beyond the minimum federal requirements with respect to provider network standards, four states specify additional standards for including essential community providers, and five states and Washington, D.C., bar benefit substitution. These interstate variations in plan design reflect the challenges policymakers face in balancing health care affordability, benefit coverage, and access to care through the marketplace plans.

Antiangiogenic tyrosine kinase inhibitors in colorectal cancer: is there a path to making them more effective?

PubMed

Karasic, Thomas B; Rosen, Mark A; O'Dwyer, Peter J

2017-10-01

Antiangiogenic therapy has a proven survival benefit in metastatic colorectal cancer. Inhibition of the VEGF pathway using a variety of extracellular antibody approaches has clear benefit in combination with chemotherapy, while intracellular blockade using tyrosine kinase inhibitors (TKIs) such as sorafenib and regorafenib has had more limited success. Pharmacodynamic modeling using modalities such as DCE-MRI indicates potent antiangiogenic effects of these TKIs, yet numerous combination therapies, primarily with chemotherapy, have failed to demonstrate an additive benefit. The sole comparative study of a single agent TKI against placebo showed a survival benefit of regorafenib in patients with advanced, refractory disease. Preclinical data demonstrate synergy between antiantiogenic TKIs and targeted interventions including autophagy inhibition, and together with a renewed effort to define markers of susceptibility, such combinations may be a way to improve the limited efficacy of this once-promising drug class.

The Benefits of Physician Training Programs for Rural Communities: Lessons Learned from the Teaching Health Center Graduate Medical Education Program.

PubMed

Lee, Marshala; Newton, Helen; Smith, Tracey; Crawford, Malena; Kepley, Hayden; Regenstein, Marsha; Chen, Candice

2016-01-01

Rural communities disproportionately face preventable chronic diseases and death from treatable conditions. Health workforce shortages contribute to limited health care access and health disparities. Efforts to address workforce shortages have included establishing graduate medical education programs with the goal of recruiting and retaining physicians in the communities in which they train. However, rural communities face a number of challenges in developing and maintaining successful residency programs, including concerns over financial sustainability and the integration of resident trainees into existing clinical practices. Despite these challenges, rural communities are increasingly interested in investing in residency programs; those that are successful see additional benefits in workforce recruitment, access, and quality of care that have immediate and direct impact on the health of rural communities. This commentary examines the challenges and benefits of rural residency programs, drawing from lessons learned from the Health Resources and Services Administration's Teaching Health Center Graduate Medical Education program.

Women in science, engineering and technology (SET): a report on the Indonesian experience.

PubMed

Hermawati, W; Luhulima, A S

2000-01-01

This paper presents the preliminary results of a study by the Gender Working Group, Indonesian Institute of Sciences, on women's contribution to, and benefits to women from, science, engineering and technology (SET), specifically the benefits accruing to disadvantaged women in urban and rural areas in Indonesia. Previous studies on the participation of women in SET have shown the under-representation of women in all SET activities, including decision-making and advisory positions. However, some studies have shown that if gender perspectives are included in the design and implementation of development activities, disadvantaged women in urban and rural areas could greatly benefit from SET in development projects. The two case studies in North Sulawesi and Central Lombok provinces show that the projects have enabled the expansion of employment opportunities for women and thus increased their technical skills and income. In addition, the projects have also contributed to enhancing women's self-confidence, self-reliance and communication skills.

Environmental Co-Benefit Opportunities of Solar Energy

NASA Astrophysics Data System (ADS)

Hernandez, R. R.; Armstrong, A.; Burney, J. A.; Easter, S. B.; Hoffacker, M. K.; Moore, K. A.

2015-12-01

Solar energy reduces greenhouse gas emissions by an order of magnitude when substituted for fossil fuels. Nonetheless, the strategic deployment of solar energy—from single, rooftop modules to utility-scale solar energy power plants—can confer additional environmental co-benefits beyond its immediate use as a low carbon energy source. In this study, we identify a diverse portfolio of environmental co-benefit opportunities of solar energy technologies resulting from synergistic innovations in land, food, energy, and water systems. For each opportunity, we provide a demonstrative, quantitative framework for environmental co-benefit valuation—including, equations, models, or case studies for estimating carbon dioxide equivalent (CO2-eq) and cost savings ($US) averted by environmental co-benefit opportunities of solar energy—and imminent research questions to improve certainty of valuations. As land-energy-food-water nexus issues are increasingly exigent in 21st century, we show that environmental co-benefit opportunities of solar energy are feasible in numerous environments and at a wide range of spatial scales thereby able to contribute to local and regional environmental goals and for the mitigation of climate change.

Benefit Estimates of Terminal Area Productivity Program Technologies

NASA Technical Reports Server (NTRS)

Hemm, Robert; Shapiro, Gerald; Lee, David; Gribko, Joana; Glaser, Bonnie

1999-01-01

This report documents benefit analyses for the NASA Terminal Area Technology (TAP) technology programs. Benefits are based on reductions in arrival delays at ten major airports over the 10 years from 2006 through 2015. Detailed analytic airport capacity and delay models were constructed to produce the estimates. The goal of TAP is enable good weather operations tempos in all weather conditions. The TAP program includes technologies to measure and predict runway occupancy times, reduce runway occupancy times in bad weather, accurately predict wake vortex hazards, and couple controller automation with aircraft flight management systems. The report presents and discusses the estimate results and describes the models. Three appendixes document the model algorithms and discuss the input parameters selected for the TAP technologies. The fourth appendix is the user's guide for the models. The results indicate that the combined benefits for all TAP technologies at all 10 airports range from $550 to $650 million per year (in constant 1997 dollars). Additional benefits will accrue from reductions in departure delays. Departure delay benefits are calculated by the current models.

Chocolate--guilty pleasure or healthy supplement?

PubMed

Latham, Laura S; Hensen, Zeb K; Minor, Deborah S

2014-02-01

Dark chocolate and other cocoa products are popular in the population as a whole, but their overall health benefit remains controversial. Observations from the Kuna Indian population have shown an impressive cardiovascular health benefit from cocoa. For various reasons, this benefit has not been as robust as in other populations. Additionally, several mechanisms have been proposed that might confer cocoa's possible health benefit, but no consensus has been reached on cocoa's physiologic role in promoting cardiovascular health. Flavanols, as well as theobromine, may contribute to enhancements in endothelial function and subsequent improvements in various contributors to cardiovascular disease (CVD) including hypertension, platelet aggregation and adhesion, insulin resistance, and hypercholesterolemia. While the benefits of cocoa may be altered at the various stages of growth, development, and production, it appears that for many people "healthy" dark chocolate may, indeed, provide a pleasurable role in CVD risk reduction. The objectives of this review are to discuss the associations of cocoa with decreased blood pressure and improved CVD risk, to describe the possible mechanisms for these potential benefits, and to highlight considerations for the use of cocoa as a dietary supplement.

Employment Benefit Receipt Among Ontario Public Disability Benefit Recipients with a Disability Related to a Mental Disorder.

PubMed

Dewa, Carolyn S

2016-02-01

Using administrative data from the public long-term disability support program in Ontario, Canada, this paper examines the factors related to receipt of a paid employment benefit. These analyses include only ODSP beneficiaries who were primary beneficiaries, who had active files in March 2011 and who were <65 years of age and had a disability-related primary diagnosis (n = 253,492). About 9 % of primary beneficiaries received the employment benefit. Logistic regression results suggest that compared to those who have a disability related to a physical disorder, those who have a psychotic disorder (OR 1.125), a mood disorder (OR 1.139) or a developmental disability (OR 1.618) are significantly more likely to receive the benefit while those who have a substance use disorder were significantly less likely (OR 0.540). These results indicate that a proportion of people who receives public disability benefits are employed. In addition, all things being equal, people with mental disorders are more likely to use this type of program than people with physical disorders.

The role of first formant information in simulated electro-acoustic hearing.

PubMed

Verschuur, Carl; Boland, Conor; Frost, Emily; Constable, Jack

2013-06-01

Cochlear implant (CI) recipients with residual hearing show improved performance with the addition of low-frequency acoustic stimulation (electro-acoustic stimulation, EAS). The present study sought to determine whether a synthesized first formant (F1) signal provided benefit to speech recognition in simulated EAS hearing and to compare such benefit with that from other low-frequency signals. A further aim was to determine if F1 amplitude or frequency was more important in determining benefit and if F1 benefit varied with formant bandwidth. In two experiments, sentence recordings from a male speaker were processed via a simulation of a partial insertion CI, and presented to normal hearing listeners in combination with various low-frequency signals, including a tone tracking fundamental frequency (F0), low-pass filtered speech, and signals based on F1 estimation. A simulated EAS benefit was found with F1 signals, and was similar to the benefit from F0 or low-pass filtered speech. The benefit did not differ significantly with the narrowing or widening of the F1 bandwidth. The benefit from low-frequency envelope signals was significantly less than the benefit from any low-frequency signal containing fine frequency information. Results indicate that F1 provides a benefit in simulated EAS hearing but low frequency envelope information is less important than low frequency fine structure in determining such benefit.

Health benefits of anthocyanins and molecular mechanisms: Update from recent decade.

PubMed

Li, Daotong; Wang, Pengpu; Luo, Yinghua; Zhao, Mengyao; Chen, Fang

2017-05-24

Anthocyanins are one of the most widespread families of natural pigments in the plant kingdom. Their health beneficial effects have been documented in many in vivo and in vitro studies. This review summarizes the most recent literature regarding the health benefits of anthocyanins and their molecular mechanisms. It appears that several signaling pathways, including mitogen-activated protein kinase, nuclear factor κB, AMP-activated protein kinase, and Wnt/β-catenin, as well as some crucial cellular processes, such as cell cycle, apoptosis, autophagy, and biochemical metabolism, are involved in these beneficial effects and may provide potential therapeutic targets and strategies for the improvement of a wide range of diseases in future. In addition, specific anthocyanin metabolites contributing to the observed in vivo biological activities, structure-activity relationships as well as additive and synergistic efficacy of anthocyanins are also discussed.

Cost-Effectiveness/Cost-Benefit Analysis of Newborn Screening for Severe Combined Immune Deficiency in Washington State.

PubMed

Ding, Yao; Thompson, John D; Kobrynski, Lisa; Ojodu, Jelili; Zarbalian, Guisou; Grosse, Scott D

2016-05-01

To evaluate the expected cost-effectiveness and net benefit of the recent implementation of newborn screening (NBS) for severe combined immunodeficiency (SCID) in Washington State. We constructed a decision analysis model to estimate the costs and benefits of NBS in an annual birth cohort of 86 600 infants based on projections of avoided infant deaths. Point estimates and ranges for input variables, including the birth prevalence of SCID, proportion detected asymptomatically without screening through family history, screening test characteristics, survival rates, and costs of screening, diagnosis, and treatment were derived from published estimates, expert opinion, and the Washington NBS program. We estimated treatment costs stratified by age of identification and SCID type (with or without adenosine deaminase deficiency). Economic benefit was estimated using values of $4.2 and $9.0 million per death averted. We performed sensitivity analyses to evaluate the influence of key variables on the incremental cost-effectiveness ratio (ICER) of net direct cost per life-year saved. Our model predicts an additional 1.19 newborn infants with SCID detected preclinically through screening, in addition to those who would have been detected early through family history, and 0.40 deaths averted annually. Our base-case model suggests an ICER of $35 311 per life-year saved, and a benefit-cost ratio of either 5.31 or 2.71. Sensitivity analyses found ICER values <$100 000 and positive net benefit for plausible assumptions on all variables. Our model suggests that NBS for SCID in Washington is likely to be cost-effective and to show positive net economic benefit. Published by Elsevier Inc.

Educational audiologists: their access, benefit, and collaborative assistance to speech-language pathologists in schools.

PubMed

Richburg, Cynthia McCormick; Knickelbein, Becky A

2011-10-01

The main goals of this study were to determine if school-based speech-language pathologists (SLPs) have access to the services of an audiologist and if those SLPs felt they obtained benefit from the audiologist's services. Additional goals included gathering information about SLPs' (a) understanding of basic audiological concepts typical for a school setting, (b) added job responsibilities brought about by lack of access to an audiologist, and (c) collaboration with audiologists. A 36-item survey was e-mailed to 1,000 SLPs listed with the American Speech-Language-Hearing Association as being employed in schools. Two-hundred and nine respondents from 42 states returned the survey. Seventy-six percent of the responding SLPs had access at some time to an audiologist, with 88% of them believing they received benefit from the services provided by that audiologist, primarily in the areas of hearing screenings and in-services. Thirty-eight SLPs (58%) who did not have access to an audiologist reported having additional job responsibilities. Many school-based SLPs believed they received benefit from an audiologist when they had access to one. Collaboration between these professionals was strong, yet findings indicate that audiologists could improve their collaborative efforts with SLPs and assist them in working within their scope of practice and maintaining their ethical standards.

Potential benefits of chewing gum for the delivery of oral therapeutics and its possible role in oral healthcare.

PubMed

Wessel, Stefan W; van der Mei, Henny C; Maitra, Amarnath; Dodds, Michael W J; Busscher, Henk J

2016-10-01

Over the years, chewing gum has developed from a candy towards an oral health-promoting nutraceutical. This review summarizes evidence for the oral health benefits of chewing gum, emphasizing identification of active ingredients in gum that facilitate prevention and removal of oral biofilm. Chewing of sugar-free gum yields oral health benefits that include clearance of food debris, reduction in oral dryness, increase of biofilm pH and remineralization of enamel. These basic effects of chewing gum are attributed to increased mastication and salivation. Active ingredients incorporated in chewing gums aim to expand these effects to inhibition of extrinsic tooth stain and calculus formation, enhanced enamel remineralization, reduction of the numbers of bacteria in saliva and amount of oral biofilm, neutralization of biofilm pH, and reduction of volatile sulfur compounds. Evidence for oral-health benefits of chewing gum additives is hard to obtain due to their relatively low concentrations and rapid wash-out. Clinical effects of gum additives are overshadowed by effects of increased mastication and salivation due to the chewing of gum and require daily chewing of gum for prolonged periods of time. Future studies on active ingredients should focus on specifically targeting pathogenic bacteria, whilst leaving the healthy microbiome unaffected.

Exercise for the treatment and management of overweight women with polycystic ovary syndrome: a review of the literature.

PubMed

Thomson, R L; Buckley, J D; Brinkworth, G D

2011-05-01

Polycystic ovary syndrome (PCOS) is characterized by the presence of polycystic ovaries, menstrual dysfunction, infertility and biochemical and clinical hyperandrogenism and is associated with an increased prevalence of cardiometabolic risk factors and psychological problems. Despite the well-established benefits of exercise training and its recommendation as a cornerstone of PCOS management, few well-controlled randomized studies have been conducted evaluating the benefits of exercise training and specific exercise regimes in women with PCOS. From the limited studies there appears to be a beneficial effect of exercise either alone or in combination with energy restriction has shown to improve fitness, cardiovascular, hormonal, reproductive and psychological outcomes. While the addition of regular exercise to energy restriction appears to only have additional benefits for improving body composition, these greater improvements are likely to have long-term implications. While lifestyle modification including regular exercise appears to be an effective strategy for the management of overweight PCOS women, methodological limitations in the studies limit the generalizability of the findings. Future research with rigorous study designs is needed to determine specific exercise guidelines that will provide the greatest benefit for these women. © 2010 The Authors. obesity reviews © 2010 International Association for the Study of Obesity.

College Students, Internet Use, and Protection from Online Identity Theft

ERIC Educational Resources Information Center

Norum, Pamela S.; Weagley, Robert O.

2007-01-01

The Internet has experienced phenomenal growth in higher education. In addition to many pedagogical benefits, there are potential risks to the student users, including identity theft. This study examined the extent to which selected online practices that could minimize the risk of financial identity theft are used by college students. Data were…

How Students with Hearing Impairments: Can Learn and Flourish in Your Music Classroom

ERIC Educational Resources Information Center

Butler, Maureen

2004-01-01

Activities in music class allow students, especially students with hearing impairments, to explore new means of expression and to enhance existing ones. Additional benefits may include increases in auditory awareness, cognitive ability, attention span, memory recall, and vocabulary. Students with hearing impairments can learn and flourish in music…

Perceived Effects of Community Gardening in Lower Mississippi Delta Gardening Participants

ERIC Educational Resources Information Center

Landry, Alicia S.; Chittendon, Nikki; Coker, Christine E. H.; Weiss, Caitlin

2015-01-01

This article describes the perceived physical and psychological health impacts of community gardening on participants in the Mississippi Delta. Themes identified include the use of gardening as an educational tool and as a means to increase self-efficacy and responsibility for personal and community health. Additional benefits of gardening as…

A brief history of forests and tree planting in Arkansas

Treesearch

Don C. Bragg

2012-01-01

Forests are vital to the socioeconomic well-being of Arkansas. According to one recent report, Arkansas is the eighth leading wood-producing State (Smith and others 2009), providing billions of dollars of economic contributions related to the timber industry (University of Arkansas Division of Agriculture 2009). Additional benefits of Arkansas forests include tourism,...

75 FR 30267 - Federal Long Term Care Insurance Program: Eligibility Changes

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-01

... of ``qualified relative'' is expanded to cover the same-sex domestic partners of eligible Federal and... Personnel Management (OPM) extend certain benefits that can be provided to same-sex domestic partners of... in 5 U.S.C. 9001(5)(D) to include additional individuals who are same-sex domestic partners of a...

2 CFR 1326.215 - Which nonprocurement transactions, in addition to those listed in 2 CFR 180.215, are not covered...

Code of Federal Regulations, 2010 CFR

2010-01-01

... Commerce, an incidental benefit that results from ordinary governmental operations includes: (1) Export... and Agreements Federal Agency Regulations for Grants and Agreements DEPARTMENT OF COMMERCE... of Commerce, a transaction that the Department needs to respond to a national or agency-recognized...

Effect of citrus pulp on the viability of Saccharomyces boulardii in the presence of enteric pathogens

USDA-ARS?s Scientific Manuscript database

Saccharomyces cerevisiae subtype boulardii is frequently used as a dietary supplement to promote intestinal health and reduce the impact of growth of enteric pathogens in livestock, including cattle and swine. Citrus by-products are also fed as dietary supplements that have the additional benefit o...

The Propensity of Permanently Disabled Workers to Hire Lawyers.

ERIC Educational Resources Information Center

Borba, Philip S.; Appel, David

1987-01-01

This study examined 1,060 California workers with permanent injuries to identify the factors that influence the propensity to hire an attorney for the purpose of contesting their benefit awards. These factors include (1) educational level, (2) union membership, (3) seriousness of the injury, and (4) availability of additional income sources.…

The role of insurance claims databases in drug therapy outcomes research.

PubMed

Lewis, N J; Patwell, J T; Briesacher, B A

1993-11-01

The use of insurance claims databases in drug therapy outcomes research holds great promise as a cost-effective alternative to post-marketing clinical trials. Claims databases uniquely capture information about episodes of care across healthcare services and settings. They also facilitate the examination of drug therapy effects on cohorts of patients and specific patient subpopulations. However, there are limitations to the use of insurance claims databases including incomplete diagnostic and provider identification data. The characteristics of the population included in the insurance plan, the plan benefit design, and the variables of the database itself can influence the research results. Given the current concerns regarding the completeness of insurance claims databases, and the validity of their data, outcomes research usually requires original data to validate claims data or to obtain additional information. Improvements to claims databases such as standardisation of claims information reporting, addition of pertinent clinical and economic variables, and inclusion of information relative to patient severity of illness, quality of life, and satisfaction with provided care will enhance the benefit of such databases for outcomes research.

Risk-based zoning for urbanizing floodplains.

PubMed

Porse, Erik

2014-01-01

Urban floodplain development brings economic benefits and enhanced flood risks. Rapidly growing cities must often balance the economic benefits and increased risks of floodplain settlement. Planning can provide multiple flood mitigation and environmental benefits by combining traditional structural measures such as levees, increasingly popular landscape and design features (green infrastructure), and non-structural measures such as zoning. Flexibility in both structural and non-structural options, including zoning procedures, can reduce flood risks. This paper presents a linear programming formulation to assess cost-effective urban floodplain development decisions that consider benefits and costs of development along with expected flood damages. It uses a probabilistic approach to identify combinations of land-use allocations (residential and commercial development, flood channels, distributed runoff management) and zoning regulations (development zones in channel) to maximize benefits. The model is applied to a floodplain planning analysis for an urbanizing region in the Baja Sur peninsula of Mexico. The analysis demonstrates how (1) economic benefits drive floodplain development, (2) flexible zoning can improve economic returns, and (3) cities can use landscapes, enhanced by technology and design, to manage floods. The framework can incorporate additional green infrastructure benefits, and bridges typical disciplinary gaps for planning and engineering.

The Swiss regulatory framework for paediatric health research.

PubMed

Junod, Valerie

2008-07-01

Medical research on minors entails both risks and benefits. Under Swiss law, clinical trials on children, including nontherapeutic drug trials, are permissible. However, ethics committees must systematically verify that all clinical studies have a favorable risk-benefit profile. Additional safeguards are designed to ensure that children are not unnecessarily involved in research and that proper consent is always obtained. Federal Swiss law is undergoing revision to extend these protections beyond clinical trials to a broad array of health research. The Swiss drug agency also seeks to improve the incentives for pharmaceutical firms to develop new paediatric drugs and relevant paediatric drug labels.

Evidence on global medical travel

PubMed Central

Záliš, Ladislav; Meurice, Christopher R; Hilton, Ian; Ly, Terry-Lisa; Zupan, Zorana; Hinrichs, Saba

2015-01-01

Abstract The potential benefits of travelling across national borders to obtain medical treatment include improved care, decreased costs and reduced waiting times. However, medical travel involves additional risks, compared to obtaining treatment domestically. We review the publicly-available evidence on medical travel. We suggest that medical travel needs to be understood in terms of its potential risks and benefits so that it can be evaluated against alternatives by patients who are seeking care. We propose three domains –quality standards, informed decision-making, economic and legal protection – in which better evidence could support the development of medical travel policies. PMID:26549906

Ecosystem services and economic theory: integration for policy-relevant research.

PubMed

Fisher, Brendan; Turner, Kerry; Zylstra, Matthew; Brouwer, Roy; de Groot, Rudolf; Farber, Stephen; Ferraro, Paul; Green, Rhys; Hadley, David; Harlow, Julian; Jefferiss, Paul; Kirkby, Chris; Morling, Paul; Mowatt, Shaun; Naidoo, Robin; Paavola, Jouni; Strassburg, Bernardo; Yu, Doug; Balmford, Andrew

2008-12-01

It has become essential in policy and decision-making circles to think about the economic benefits (in addition to moral and scientific motivations) humans derive from well-functioning ecosystems. The concept of ecosystem services has been developed to address this link between ecosystems and human welfare. Since policy decisions are often evaluated through cost-benefit assessments, an economic analysis can help make ecosystem service research operational. In this paper we provide some simple economic analyses to discuss key concepts involved in formalizing ecosystem service research. These include the distinction between services and benefits, understanding the importance of marginal ecosystem changes, formalizing the idea of a safe minimum standard for ecosystem service provision, and discussing how to capture the public benefits of ecosystem services. We discuss how the integration of economic concepts and ecosystem services can provide policy and decision makers with a fuller spectrum of information for making conservation-conversion trade-offs. We include the results from a survey of the literature and a questionnaire of researchers regarding how ecosystem service research can be integrated into the policy process. We feel this discussion of economic concepts will be a practical aid for ecosystem service research to become more immediately policy relevant.

A systematic review of the health benefits of Tai Chi for students in higher education.

PubMed

Webster, Craig S; Luo, Anna Y; Krägeloh, Chris; Moir, Fiona; Henning, Marcus

2016-06-01

The poor health consequences of stress are well recognized, and students in higher education may be at particular risk. Tai Chi integrates physical exercise with mindfulness techniques and seems well suited to relieve stress and related conditions. We conducted a systematic review of the health benefits of Tai Chi for students in higher education reported in the English and Chinese literature, using an evidence hierarchy approach, allowing the inclusion of studies additional to randomized controlled trials. Sixty eight reports in Chinese and 8 in English were included - a combined study sample of 9263 participants. Eighty one health outcomes were extracted from reports, and assigned evidence scores according to the evidence hierarchy. Four primary and eight secondary outcomes were found. Tai Chi is likely to benefit participants by increasing flexibility, reducing symptoms of depression, decreasing anxiety, and improving interpersonal sensitivity (primary outcomes). Secondary outcomes include improved lung capacity, balance, 800/1000m run time, quality of sleep, symptoms of compulsion, somatization and phobia, and decreased hostility. Our results show Tai Chi yields psychological and physical benefits, and should be considered by higher education institutions as a possible means to promote the physical and psychological well-being of their students.

Distribution system costs associated with the deployment of photovoltaic systems

DOE Office of Scientific and Technical Information (OSTI.GOV)

Horowitz, Kelsey A. W.; Palmintier, Bryan; Mather, Barry

The broadening of our energy system to include increasing amounts of wind and solar has led to significant debate about the total costs and benefits associated with different types of generators - with potentially far-reaching policy implications. This has included debate about the cost associated with integrating these generators onto the electric grid. For photovoltaics (PV), this encompasses costs incurred on both the bulk power and distribution systems, as well as the value provided to them. These costs and benefits, in particular those associated with integrating PV onto the distribution system, are not well understood. We seek to advance themore » state of understanding of 'grid integration costs' for the distribution system by reviewing prior literature and outlining a transparent, bottom-up approach that can be used to calculate these costs. We provide a clear delineation of costs to integrate PV in to the distribution system within the larger context of total costs and benefits associated with PV generators. We emphasize that these costs are situationally dependent, and that a single 'cost of integration' cannot be obtained. We additionally emphasize that benefits must be considered when evaluating the competitiveness of the technology in a given situation.« less

Nanocoaxes for Optical and Electronic Devices

PubMed Central

Rizal, Binod; Merlo, Juan M.; Burns, Michael J.; Chiles, Thomas C.; Naughton, Michael J.

2014-01-01

The evolution of micro/nanoelectronics technology, including the shrinking of devices and integrated circuit components, has included the miniaturization of linear and coaxial structures to micro/nanoscale dimensions. This reduction in the size of coaxial structures may offer advantages to existing technologies and benefit the exploration and development of new technologies. The reduction in the size of coaxial structures has been realized with various permutations between metals, semiconductors and dielectrics for the core, shield, and annulus. This review will focus on fabrication schemes of arrays of metal – nonmetal – metal nanocoax structures using non-template and template methods, followed by possible applications. The performance and scientific advantages associated with nanocoax-based optical devices including waveguides, negative refractive index materials, light emitting diodes, and photovoltaics are presented. In addition, benefits and challenges that accrue from the application of novel nanocoax structures in energy storage, electronic and sensing devices are summarized. PMID:25279400

Systematic review of the adjunctive use of diode and Nd:YAG lasers for nonsurgical periodontal instrumentation.

PubMed

Roncati, Marisa; Gariffo, Annalisa

2014-04-01

The aims of this study were (1) to conduct a literature search and systematically evaluate the additional therapeutic effects of pulsed Nd:YAG or diode laser use in patients with periodontitis, (2) to assess evidence supporting the additional benefit of laser-mediated periodontal treatment in conjunction with scaling and root planning (SRP) (not as monotherapy), and (3) to interpret the evidence presented in retrieved publications. Opinions about the additional use of diode lasers in the nonsurgical treatment of plaque-induced periodontal lesions are conflicting. The April 2011 American Academy of Periodontology's "Statement on the Efficacy of Lasers in the Non-Surgical Treatment of Inflammatory Periodontal Disease" asserted that the use of a laser as monotherapy or in addition to nonsurgical periodontal instrumentation conveyed no advantage. After initial screening, 23/77 potentially relevant articles and abstracts identified through electronic and manual searches of the MEDLINE(®)/PubMed database and the Cochrane Central Register of Controlled Trials (1990-2012) were included in this review. A meta-analysis could be performed. The results indicate that Nd:YAG or diode laser, used in an adjunctive capacity to SRP, may provide some additional benefit, in 6 month studies, compared with mechanical debridement. The results show the adjunctive benefits that diode laser treatment can provide when it is used as an adjunct to nonsurgical periodontal treatment in adults with chronic periodontitis. Further long-term, well-designed, parallel randomized clinical trials are needed to assess the effectiveness of the adjunctive use of the diode laser, as well as the appropriate dosimetry and laser settings.

2015 Summer Series - Kevin Reynolds - Affordable Airplanes: Modular Design and Additive Manufacturing

NASA Image and Video Library

2015-07-02

At NASA Ames, a project called FrankenEye combines salvaged, unmanned air systems parts with 3D printed materials to resurrect old aircraft. In the field of unmanned aerial vehicles for science, researchers are looking for longer flight times and increased payload capability. Benefits of the additive manufacturing approach include a decrease in development time and project costs and an increase in survivability, efficiency, capability, and endurance. Kevin Reynolds describes a technology hybrid that serves as a unique approach for optimizing flight parameters.

An Analysis of the President’s Budgetary Proposals for Fiscal Year 1979

DTIC Science & Technology

1978-01-28

1.1 billion in reforms, for a net corporate income tax reduction of $5.1 billion. These reductions are in addition to the $8.3 billion reduction that...treatment of capital gains and income from unemployment insurance benefits. The cuts in business taxes would include: o reducing the maximum corporate income tax rate...impact on business investment per dollar than the change in the corporate income tax rate. In addition, tax cuts that lower costs—such as the proposed

Alpha channeling in a rotating plasma.

PubMed

Fetterman, Abraham J; Fisch, Nathaniel J

2008-11-14

The wave-particle alpha-channeling effect is generalized to include rotating plasma. Specifically, radio frequency waves can resonate with alpha particles in a mirror machine with ExB rotation to diffuse the alpha particles along constrained paths in phase space. Of major interest is that the alpha-particle energy, in addition to amplifying the rf waves, can directly enhance the rotation energy which in turn provides additional plasma confinement in centrifugal fusion reactors. An ancillary benefit is the rapid removal of alpha particles, which increases the fusion reactivity.

Estimating the clinical benefits of vaccinating boys and girls against HPV-related diseases in Europe

PubMed Central

2013-01-01

Background HPV is related to a number of cancer types, causing a considerable burden in both genders in Europe. Female vaccination programs can substantially reduce the incidence of HPV-related diseases in women and, to some extent, men through herd immunity. The objective was to estimate the incremental benefit of vaccinating boys and girls using the quadrivalent HPV vaccine in Europe versus girls-only vaccination. Incremental benefits in terms of reduction in the incidence of HPV 6, 11, 16 and 18-related diseases (including cervical, vaginal, vulvar, anal, penile, and head and neck carcinomas and genital warts) were assessed. Methods The analysis was performed using a model constructed in Microsoft®Excel, based on a previously-published dynamic transmission model of HPV vaccination and published European epidemiological data on incidence of HPV-related diseases. The incremental benefits of vaccinating 12-year old girls and boys versus girls-only vaccination was assessed (70% vaccine coverage were assumed for both). Sensitivity analyses around vaccine coverage and duration of protection were performed. Results Compared with screening alone, girls-only vaccination led to 84% reduction in HPV 16/18-related carcinomas in females and a 61% reduction in males. Vaccination of girls and boys led to a 90% reduction in HPV 16/18-related carcinomas in females and 86% reduction in males versus screening alone. Relative to a girls-only program, vaccination of girls and boys led to a reduction in female and male HPV-related carcinomas of 40% and 65%, respectively and a reduction in the incidence of HPV 6/11-related genital warts of 58% for females and 71% for males versus girls-only vaccination. Conclusions In Europe, the vaccination of 12-year old boys and girls against HPV 6, 11, 16 and 18 would be associated with substantial additional clinical benefits in terms of reduced incidence of HPV-related genital warts and carcinomas versus girls-only vaccination. The incremental benefits of adding boys vaccination are highly dependent on coverage in girls. Therefore, further analyses should be performed taking into account the country-specific situation. In addition to clinical benefits, substantial economic benefits are also anticipated and warrant further investigation as do the social and ethical implications of including boys in vaccination programs. PMID:23298365

Estimating the clinical benefits of vaccinating boys and girls against HPV-related diseases in Europe.

PubMed

Marty, Rémi; Roze, Stéphane; Bresse, Xavier; Largeron, Nathalie; Smith-Palmer, Jayne

2013-01-08

HPV is related to a number of cancer types, causing a considerable burden in both genders in Europe. Female vaccination programs can substantially reduce the incidence of HPV-related diseases in women and, to some extent, men through herd immunity. The objective was to estimate the incremental benefit of vaccinating boys and girls using the quadrivalent HPV vaccine in Europe versus girls-only vaccination. Incremental benefits in terms of reduction in the incidence of HPV 6, 11, 16 and 18-related diseases (including cervical, vaginal, vulvar, anal, penile, and head and neck carcinomas and genital warts) were assessed. The analysis was performed using a model constructed in Microsoft(®)Excel, based on a previously-published dynamic transmission model of HPV vaccination and published European epidemiological data on incidence of HPV-related diseases. The incremental benefits of vaccinating 12-year old girls and boys versus girls-only vaccination was assessed (70% vaccine coverage were assumed for both). Sensitivity analyses around vaccine coverage and duration of protection were performed. Compared with screening alone, girls-only vaccination led to 84% reduction in HPV 16/18-related carcinomas in females and a 61% reduction in males. Vaccination of girls and boys led to a 90% reduction in HPV 16/18-related carcinomas in females and 86% reduction in males versus screening alone. Relative to a girls-only program, vaccination of girls and boys led to a reduction in female and male HPV-related carcinomas of 40% and 65%, respectively and a reduction in the incidence of HPV 6/11-related genital warts of 58% for females and 71% for males versus girls-only vaccination. In Europe, the vaccination of 12-year old boys and girls against HPV 6, 11, 16 and 18 would be associated with substantial additional clinical benefits in terms of reduced incidence of HPV-related genital warts and carcinomas versus girls-only vaccination. The incremental benefits of adding boys vaccination are highly dependent on coverage in girls. Therefore, further analyses should be performed taking into account the country-specific situation. In addition to clinical benefits, substantial economic benefits are also anticipated and warrant further investigation as do the social and ethical implications of including boys in vaccination programs.

The population benefit of evidence-based radiotherapy: 5-Year local control and overall survival benefits.

PubMed

Hanna, T P; Shafiq, J; Delaney, G P; Vinod, S K; Thompson, S R; Barton, M B

2018-02-01

To describe the population benefit of radiotherapy in a high-income setting if evidence-based guidelines were routinely followed. Australian decision tree models were utilized. Radiotherapy alone (RT) benefit was defined as the absolute proportional benefit of radiotherapy compared with no treatment for radical indications, and of radiotherapy over surgery alone for adjuvant indications. Chemoradiotherapy (CRT) benefit was the absolute incremental benefit of concurrent chemoradiotherapy over RT. Five-year local control (LC) and overall survival (OS) benefits were measured. Citation databases were systematically queried for benefit data. Meta-analysis and sensitivity analysis were performed. 48% of all cancer patients have indications for radiotherapy, 34% curative and 14% palliative. RT provides 5-year LC benefit in 10.4% of all cancer patients (95% Confidence Interval 9.3, 11.8) and 5-year OS benefit in 2.4% (2.1, 2.7). CRT provides 5-year LC benefit in an additional 0.6% of all cancer patients (0.5, 0.6), and 5-year OS benefit for an additional 0.3% (0.2, 0.4). RT benefit was greatest for head and neck (LC 32%, OS 16%), and cervix (LC 33%, OS 18%). CRT LC benefit was greatest for rectum (6%) and OS for cervix (3%) and brain (3%). Sensitivity analysis confirmed a robust model. Radiotherapy provides significant 5-year LC and OS benefits as part of evidence-based cancer care. CRT provides modest additional benefits. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

Individualized Statin Benefit for Determining Statin Eligibility in the Primary Prevention of Cardiovascular Disease.

PubMed

Thanassoulis, George; Williams, Ken; Altobelli, Kathleen Kimler; Pencina, Michael J; Cannon, Christopher P; Sniderman, Allan D

2016-04-19

Current guidelines recommend statins in the primary prevention of cardiovascular disease on the basis of predicted cardiovascular risk without directly considering the expected benefits of statin therapy based on the available randomized, controlled trial evidence. We included 2134 participants representing 71.8 million American residents potentially eligible for statins in primary prevention from the National Health and Nutrition Examination Survey for the years 2005 to 2010. We compared statin eligibilities using 2 separate approaches: a 10-year risk-based approach (≥7.5% 10-year risk) and an individualized benefit approach (ie, based on predicted absolute risk reduction over 10 years [ARR10] ≥2.3% from randomized, controlled trial data). A risk-based approach led to the eligibility of 15.0 million (95% confidence interval, 12.7-17.3 million) Americans, whereas a benefit-based approach identified 24.6 million (95% confidence interval, 21.0-28.1 million). The corresponding numbers needed to treat over 10 years were 21 (range, 9-44) and 25 (range, 9-44). The benefit-based approach identified 9.5 million lower-risk (<7.5% 10-year risk) Americans not currently eligible for statin treatment who had the same or greater expected benefit from statins (≥2.3% ARR10) compared with higher-risk individuals. This lower-risk/acceptable-benefit group includes younger individuals (mean age, 55.2 versus 62.5 years; P<0.001 for benefit based versus risk based) with higher low-density lipoprotein cholesterol (140 versus133 mg/dL; P=0.01). Statin treatment in this group would be expected to prevent an additional 266 508 cardiovascular events over 10 years. An individualized statin benefit approach can identify lower-risk individuals who have equal or greater expected benefit from statins in primary prevention compared with higher-risk individuals. This approach may help develop guideline recommendations that better identify individuals who meaningfully benefit from statin therapy. © 2016 American Heart Association, Inc.

Salute to the sun: a new dawn in yoga therapy for breast cancer.

PubMed

Galliford, Melissa; Robinson, Stephanie; Bridge, Pete; Carmichael, MaryAnn

2017-09-01

Interest in the application of yoga for health benefits in western medicine is growing rapidly, with a significant rise in publications. The purpose of this systematic review is to determine whether the inclusion of yoga therapy to the treatment of breast cancer can improve the patient's physical and psychosocial quality of life (QoL). A search of peer reviewed journal articles published between January 2009 and July 2014 was conducted. Studies were included if they had more than 15 study participants, included interventions such as mindfulness-based stress reduction (MBSR) or yoga therapy with or without comparison groups and had stated physical or psychological outcomes. Screening identified 38 appropriate articles. The most reported psychosocial benefits of yoga therapy were anxiety, emotional and social functioning, stress, depression and global QoL. The most reported physical benefits of yoga therapy were improved salivary cortisol readings, sleep quality and lymphocyte apoptosis. Benefits in these areas were linked strongly with the yoga interventions, in addition to significant improvement in overall QoL. The evidence supports the use of yoga therapy to improve the physical and psychosocial QoL for breast cancer patients with a range of benefits relevant to radiation therapy. Future studies are recommended to confirm these benefits. Evidence-based recommendations for implementation of a yoga therapy programme have been derived and included within this review. Long-term follow-up is necessary with these programmes to assess the efficacy of the yoga intervention in terms of sustainability and patient outcomes. © 2017 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.

Modulating influences of memory strength and sensitivity of the retrieval test on the detectability of the sleep consolidation effect.

PubMed

Schoch, Sarah F; Cordi, Maren J; Rasch, Björn

2017-11-01

Emotionality can increase recall probability of memories as emotional information is highly relevant for future adaptive behavior. It has been proposed that memory processes acting during sleep selectively promote the consolidation of emotional memories, so that neutral memories no longer profit from sleep consolidation after learning. This appears as a selective effect of sleep for emotional memories. However, other factors contribute to the appearance of a consolidation benefit and influence this interpretation. Here we show that the strength of the memory trace before sleep and the sensitivity of the retrieval test after sleep are critical factors contributing to the detection of the benefit of sleep on memory for emotional and neutral stimuli. 228 subjects learned emotional and neutral pictures and completed a free recall after a 12-h retention interval of either sleep or wakefulness. We manipulated memory strength by including an immediate retrieval test before the retention interval in half of the participants. In addition, we varied the sensitivity of the retrieval test by including an interference learning task before retrieval testing in half of the participants. We show that a "selective" benefit of sleep for emotional memories only occurs in the condition with high memory strength. Furthermore, this "selective" benefit disappeared when we controlled for the memory strength before the retention interval and used a highly sensitive retrieval test. Our results indicate that although sleep benefits are more robust for emotional memories, neutral memories similarly profit from sleep after learning when more sensitive indicators are used. We conclude that whether sleep benefits on memory appear depends on several factors, including emotion, memory strength and sensitivity of the retrieval test. Copyright © 2017 Elsevier Inc. All rights reserved.

Practical alternatives to chronic caloric restriction for optimizing vascular function with ageing

PubMed Central

Seals, Douglas R.

2016-01-01

Abstract Calorie restriction (CR) in the absence of malnutrition exerts a multitude of physiological benefits with ageing in model organisms and in humans including improvements in vascular function. Despite the well‐known benefits of chronic CR, long‐term energy restriction is not likely to be a feasible healthy lifestyle strategy in humans due to poor sustained adherence, and presents additional concerns if applied to normal weight older adults. This review summarizes what is known about the effects of CR on vascular function with ageing including the underlying molecular ‘energy‐ and nutrient‐sensing’ mechanisms, and discusses the limited but encouraging evidence for alternative pharmacological and lifestyle interventions that may improve vascular function with ageing by mimicking the beneficial effects of long‐term CR. PMID:27641062

Spacelab user interaction

NASA Technical Reports Server (NTRS)

1975-01-01

The results of the third and final phase of a study undertaken to define means of optimizing the Spacelab experiment data system by interactively manipulating the flow of data were presented. A number of payload applicable interactive techniques and an integrated interaction system for each of two possible payloads are described. These interaction systems have been functionally defined and are accompanied with block diagrams, hardware specifications, software sizing and speed requirements, operational procedures and cost/benefits analysis data for both onboard and ground based system elements. It is shown that accrued benefits are attributable to a reduction in data processing costs obtained by, generally, a considerable reduction in the quantity of data that might otherwise be generated without interaction. One other additional anticipated benefit includes the increased scientific value obtained by the quicker return of all useful data.

Sports-related concussions - media, science and policy.

PubMed

Mannix, Rebekah; Meehan, William P; Pascual-Leone, Alvaro

2016-08-01

Although growing awareness about the potential long-term deleterious effects of sport-related concussion has led to increased attention to the risks of collision sports, calls to ban these sports, such as American football, might be premature. Collision sports have a relatively high incidence of concussions, but participation in these sports also confers a host of benefits. In addition, the associated risks of participation, including concussion, have not been definitively shown to outweigh the benefits they provide, and the risk-benefit ratio might vary among individuals. The risks of concussion and repetitive concussions associated with collision sports are unknown in the general population and not well characterized even in elite athlete populations. In this article, we discuss current knowledge on sports-related concussion, its neurological consequences, and implications for regulation of the practice of collision sports.

The value and benefits of the International Conference on Harmonisation to drug regulatory authorities: advancing harmonization for better public health.

PubMed

Molzon, J A; Giaquinto, A; Lindstrom, L; Tominaga, T; Ward, M; Doerr, P; Hunt, L; Rago, L

2011-04-01

The International Conference on Harmonisation (ICH) is an unparalleled undertaking, which has brought together drug regulatory authorities and pharmaceutical trade associations from Europe, Japan, and the United States, to discuss the scientific and technical aspects of medical product registration. Launched in 1990, the value and benefits of ICH to regulators are being realized. ICH has harmonized submission requirements and created a harmonized submission format that is relieving both companies and regulatory authorities of the burdens of assembling and reviewing separate submissions for each region. As more countries embrace ICH guidelines, we anticipate additional benefits, including the promotion of good review practices and, ultimately, a common regulatory language that will facilitate further interactions among global drug regulatory authorities.

Additional Evidence is Needed to Recommend Acquiring a Dog to Families of Children with Autism Spectrum Disorder: A Response to Wright and Colleagues.

PubMed

Crossman, Molly K; Kazdin, Alan E

2016-01-01

Caregivers of children with autism spectrum disorder are vulnerable to overstated benefits of interventions, and such overstatements are common with interventions involving animals. This response to Wright, Hall, Hames, Hardmin, Mills, the Paws Team, and Mills' (2015) article, "Acquiring a Pet Dog Significantly Reduces Stress of Primary Careers for Children with Autism Spectrum Disorder: A Prospective Case Control Study," details why that study's conclusions are premature. Specific limitations of the study are detailed, including overstatements of the supportive literature, problems with the design, and mismatch between the findings and conclusions. The purpose is not to challenge the benefits of pet ownership, but to point out that those benefits have not yet been established.

Benefits of the fire mitigation ecosystem service in the Great Dismal Swamp National Wildlife Refuge, Virginia, USA

USGS Publications Warehouse

Parthum, Bryan M.; Pindilli, Emily J.; Hogan, Dianna

2017-01-01

 The Great Dismal Swamp (GDS) National Wildlife Refuge delivers multiple ecosystem services, including air quality and human health via fire mitigation. Our analysis estimates benefits of this service through its potential to reduce catastrophic wildfire related impacts on the health of nearby human populations. We used a combination of high-frequency satellite data, ground sensors, and air quality indices to determine periods of public exposure to dense emissions from a wildfire within the GDS. We examined emergency department (ED) visitation in seven Virginia counties during these periods, applied measures of cumulative Relative Risk to derive the effects of wildfire smoke exposure on ED visitation rates, and estimated economic losses using regional Cost of Illness values established within the US Environmental Protection Agency BenMAP framework. Our results estimated the value of one avoided catastrophic wildfire in the refuge to be \\$3.69 million (2015 USD), or \\$306 per hectare of burn. Reducing the frequency or severity of extensive, deep burning peatland wildfire events has additional benefits not included in this estimate, including avoided costs related to fire suppression during a burn, carbon dioxide emissions, impacts to wildlife, and negative outcomes associated with recreation and regional tourism. We suggest the societal value of the public health benefits alone provides a significant incentive for refuge mangers to implement strategies that will reduce the severity of catastrophic wildfires.

Benefits of the fire mitigation ecosystem service in The Great Dismal Swamp National Wildlife Refuge, Virginia, USA.

PubMed

Parthum, Bryan; Pindilli, Emily; Hogan, Dianna

2017-12-01

The Great Dismal Swamp (GDS) National Wildlife Refuge delivers multiple ecosystem services, including air quality and human health via fire mitigation. Our analysis estimates benefits of this service through its potential to reduce catastrophic wildfire related impacts on the health of nearby human populations. We used a combination of high-frequency satellite data, ground sensors, and air quality indices to determine periods of public exposure to dense emissions from a wildfire within the GDS. We examined emergency department (ED) visitation in seven Virginia counties during these periods, applied measures of cumulative Relative Risk to derive the effects of wildfire smoke exposure on ED visitation rates, and estimated economic losses using regional Cost of Illness values established within the US Environmental Protection Agency BenMAP framework. Our results estimated the value of one avoided catastrophic wildfire in the refuge to be $3.69 million (2015 USD), or $306 per hectare of burn. Reducing the frequency or severity of extensive, deep burning peatland wildfire events has additional benefits not included in this estimate, including avoided costs related to fire suppression during a burn, carbon dioxide emissions, impacts to wildlife, and negative outcomes associated with recreation and regional tourism. We suggest the societal value of the public health benefits alone provides a significant incentive for refuge mangers to implement strategies that will reduce the severity of catastrophic wildfires. Published by Elsevier Ltd.

Benchmarking DoD Use of Additive Manufacturing and Quantifying Costs

DTIC Science & Technology

2017-03-01

46 VI. Cost Benefit ...developing a cost model. The US Army Logistics Innovation Agency published a study called “Additive Manufacturing Cost - Benefit Analysis”. This...to over fifteen thousand dollars on GSA Advantage. Desktop printers do not require extensive support equipment. 47    VI. Cost Benefit

Cost-benefit analyses of supplementary measles immunisation in the highly immunized population of New Zealand.

PubMed

Hayman, D T S; Marshall, J C; French, N P; Carpenter, T E; Roberts, M G; Kiedrzynski, T

2017-09-05

As endemic measles is eliminated from countries through increased immunisation, the economic benefits of enhanced immunisation programs may come into question. New Zealand has suffered from outbreaks after measles introductions from abroad and we use it as a model system to understand the benefits of catch up immunisation in highly immunised populations. We provide cost-benefit analyses for measles supplementary immunisation in New Zealand. We model outbreaks based on estimates of the basic reproduction number in the vaccinated population (R v , the number of secondary infections in a partially immunised population), based on the number of immunologically-naïve people at district and national levels, considering both pre- and post-catch up vaccination scenarios. Our analyses suggest that measles R v often includes or exceeds one (0.18-3.92) despite high levels of population immunity. We calculate the cost of the first 187 confirmed and probable measles cases in 2014 to be over NZ$1 million (∼US$864,200) due to earnings lost, case management and hospitalization costs. The benefit-cost ratio analyses suggest additional vaccination beyond routine childhood immunisation is economically efficient. Supplemental vaccination-related costs are required to exceed approximately US$66 to US$1877 per person, depending on different scenarios, before supplemental vaccination is economically inefficient. Thus, our analysis suggests additional immunisation beyond childhood programs to target naïve individuals is economically beneficial even when childhood immunisation rates are high. Copyright © 2017 Elsevier Ltd. All rights reserved.

Evaluation of Student Injuries at the Sergeants Major Course (SMC), Fort Bliss, Texas, August 2013-May 2014

DTIC Science & Technology

2016-06-24

benefit from collection of process metrics, additional factors influencing injury incidence, and additional outcomes of interest. 15. SUBJECT TERMS...therapist at the SMC. Future evaluations would benefit from pre- and post-implementation measurement of additional factors contributing to injury...increased during the SMC. The incorporation of cross-training is likely beneficial, as noted above. Cross-training has also been shown to have benefits

Greenhouses and their humanizing synergies

NASA Astrophysics Data System (ADS)

Haeuplik-Meusburger, Sandra; Paterson, Carrie; Schubert, Daniel; Zabel, Paul

2014-03-01

Greenhouses in space will require advanced technical systems of automatic watering, soil-less cultivation, artificial lighting, and computerized observation of plants. Functions discussed for plants in space habitats include physical/health requirements and human psychology, social cohesion, as well as the complex sensorial benefits of plants for humans. The authors consider the role of plants in long-term space missions historically since 1971 (Salyut 1) and propose a set of priorities to be considered within the design requirements for greenhouses and constructed environments given a range of benefits associated with plant-human relationships. They cite recent research into the use of greenhouses in extreme environments to reveal the relative importance of greenhouses for people living in isolated locations. Additionally, they put forward hypotheses about where greenhouses might factor into several strata of human health. In a recent design-in-use study of astronauts' experiences in space habitats discussed in Architecture for Astronauts (Springer Press 2011) it was found that besides the basic advantages for life support there are clearly additional "side benefits" for habitability and physical wellbeing, and thus long-term mission success. The authors have composed several key theses regarding the need to promote plant-human relationships in space, including areas where synergy and symbiosis occur. They cite new comprehensive research into the early US Space Program to reveal where programmatic requirements could be added to space architecture to increase the less quantifiable benefits to astronauts of art, recreation, and poetic engagement with their existential condition of estrangement from the planet. Specifically in terms of the technological requirements, the authors propose the integration of a new greenhouse subsystem component into space greenhouses—the Mobile Plant Cultivation Subsystem—a portable, personal greenhouse that can be integrated functionally into future greenhouse constructions in space.

Exercise volume and intensity: a dose-response relationship with health benefits.

PubMed

Foulds, Heather J A; Bredin, Shannon S D; Charlesworth, Sarah A; Ivey, Adam C; Warburton, Darren E R

2014-08-01

The health benefits of exercise are well established. However, the relationship between exercise volume and intensity and health benefits remains unclear, particularly the benefits of low-volume and intensity exercise. The primary purpose of this investigation was, therefore, to examine the dose-response relationship between exercise volume and intensity with derived health benefits including volumes and intensity of activity well below international recommendations. Generally healthy, active participants (n = 72; age = 44 ± 13 years) were assigned randomly to control (n = 10) or one of five 13-week exercise programs: (1) 10-min brisk walking 1×/week (n = 10), (2) 10-min brisk walking 3×/week (n = 10), (3) 30-min brisk walking 3×/week (n = 18), (4) 60-min brisk walking 3×/week (n = 10), and (5) 30-min running 3×/week (n = 14), in addition to their regular physical activity. Health measures evaluated pre- and post-training including blood pressure, body composition, fasting lipids and glucose, and maximal aerobic power (VO2max). Health improvements were observed among programs at least 30 min in duration, including body composition and VO2max: 30-min walking 28.8-34.5 mL kg(-1) min(-1), 60-min walking 25.1-28.9 mL kg(-1) min(-1), and 30-min running 32.4-36.4 mL kg(-1) min(-1). The greater intensity running program also demonstrated improvements in triglycerides. In healthy active individuals, a physical activity program of at least 30 min in duration for three sessions/per week is associated with consistent improvements in health status.

Perceptual benefit and functional outcomes for children using sequential bilateral cochlear implants.

PubMed

Galvin, Karyn Louise; Mok, Mansze; Dowell, Richard C

2007-08-01

To evaluate the additional perceptual benefit provided to children through the use of two cochlear implants in comparison to one after 6 to 13 mo experience with sequential bilateral implants. A second cochlear implant was received by 11 children. The principal selection criteria were being age 4 to 15 yr with a bilateral profound hearing loss and being a consistent user of a first implant with a commitment to use of a second implant. Horizontal localization was assessed by using pink noise bursts presented from a 180 degrees , eight-loudspeaker array. Speech perception was assessed by using a four-alternative forced-choice spondee test, with speech presented from in front and adaptive background noise presented from 90 degrees to the left or right. Both tests were completed in the first implant alone and bilateral conditions. A questionnaire measured the pre- to postoperative change in the parent's ratings of the child's performance in specific listening situations. Items were related to speech perception, spatial hearing, or other qualities of hearing. Regular parental reports of device use, attitude and performance were collected. Most subjects were assessed at 6 mo after surgery, with two assessed at 13 mo. The 11 subjects demonstrated a great range of outcomes. For one subject, only anecdotal data were collected. Speech perception testing indicated that when noise was presented ipsilateral to the first implant, 8 of 10 subjects showed a benefit in the bilateral condition. None of the nine subjects tested showed a benefit when noise was contralateral to the first implant. Generally, there was no benefit to localization in the bilateral condition. For eight subjects, postoperative performance ratings were generally higher than preoperative ratings, particularly in the spatial hearing section. Anecdotal reports indicated that most subjects had a negative attitude toward, and gained limited experience with, the second implant alone. The subjects developed a range of speech perception skills, from detection to conversation level. Regarding the use of bilateral implants, attitudes were more positive and device use was consistent for eight subjects, and six parents reported some evidence of improved performance in daily life. Children over age 4 yr may gain significant additional benefit from a second implant, including improved speech perception in some noise contexts and functional advantages in daily life. There is, however, no evidence from this study to suggest that binaural listening skills, including localization, will develop during the first 6 mo. Furthermore, some children who may be committed users of a first implant may not adapt to or benefit from a second implant during the first 6 mo of device use. Although the factors influencing benefit cannot be clearly identified, limited preoperative auditory experience with the second ear, a delay of years between implants, relatively advanced age, and lack of second-implant-alone experience do not preclude benefit. Continued evaluation of these and additional subjects will clarify the factors that do contribute to benefit. Such information will be vital in helping families of implanted children to make an informed decision regarding a second implant.

The Business Case for Preconception Care: Methods and Issues

PubMed Central

Sotnikov, Sergey V.; Leatherman, Sheila; Curtis, Michele

2006-01-01

Only a limited number of economic evaluations have addressed the costs and benefits of preconception care. In order to persuade health care providers, payers, or purchasers to become actively involved in promoting preconception care, it is important to demonstrate the value of doing so through development of a “business case”. Perceived benefits in terms of organizational reputation and market share can be influential in forming a business case. In addition, it is standard to include an economic analysis of financial costs and benefits from the perspective of the provider practice, payer, or purchaser in a business case. The methods, data needs, and other issues involved with preparing an economic analysis of the likely financial return on investment in preconception care are presented here. This is accompanied by a review or case study of economic evaluations of preconception care for women with recognized diabetes. Although the data are not sufficient to draw firm conclusions, there are indications that such care may yield positive financial benefits to health care organizations through reduction in maternal and infant hospitalizations. More work is needed to establish how costs and economic benefits are distributed among different types of organizations. Also, the optimum methods of delivering preconception care for women with diabetes need to be evaluated. Similar assessments should also be conducted for other forms of preconception care, including comprehensive care. PMID:16786418

20 CFR 416.2035 - Optional supplementation: Additional State options.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Optional supplementation: Additional State options. 416.2035 Section 416.2035 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL... § 416.2035 Optional supplementation: Additional State options. (a) Residency requirement. A State or...

20 CFR 901.72 - Additional rules.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Additional rules. 901.72 Section 901.72 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF... additional rules regarding the enrollment of actuaries. [76 FR 17776, Mar. 31, 2011] ...

20 CFR 901.72 - Additional rules.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Additional rules. 901.72 Section 901.72 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF... additional rules regarding the enrollment of actuaries. [76 FR 17776, Mar. 31, 2011] ...

20 CFR 901.72 - Additional rules.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Additional rules. 901.72 Section 901.72 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF... additional rules regarding the enrollment of actuaries. [76 FR 17776, Mar. 31, 2011] ...

Investigation of enzyme formulation on pretreated switchgrass.

PubMed

Falls, Matthew; Shi, Jian; Ebrik, Mirvat A; Redmond, Tim; Yang, Bin; Wyman, Charles E; Garlock, Rebecca; Balan, Venkatesh; Dale, Bruce E; Pallapolu, V Ramesh; Lee, Y Y; Kim, Youngmi; Mosier, Nathan S; Ladisch, Michael R; Hames, Bonnie; Thomas, Steve; Donohoe, Bryon S; Vinzant, Todd B; Elander, Richard T; Warner, Ryan E; Sierra-Ramirez, Rocio; Holtzapple, Mark T

2011-12-01

This work studied the benefits of adding different enzyme cocktails (cellulase, xylanase, β-glucosidase) to pretreated switchgrass. Pretreatment methods included ammonia fiber expansion (AFEX), dilute-acid (DA), liquid hot water (LHW), lime, lime+ball-milling, soaking in aqueous ammonia (SAA), and sulfur dioxide (SO(2)). The compositions of the pretreated materials were analyzed and showed a strong correlation between initial xylan composition and the benefits of xylanase addition. Adding xylanase dramatically improved xylan yields for SAA (+8.4%) and AFEX (+6.3%), and showed negligible improvement (0-2%) for the pretreatments with low xylan content (dilute-acid, SO(2)). Xylanase addition also improved overall yields with lime+ball-milling and SO(2) achieving the highest overall yields from pretreated biomass (98.3% and 93.2%, respectively). Lime+ball-milling obtained an enzymatic yield of 92.3kg of sugar digested/kg of protein loaded. Copyright © 2011 Elsevier Ltd. All rights reserved.

An overview of zinc addition for BWR dose rate control

DOE Office of Scientific and Technical Information (OSTI.GOV)

Marble, W.J.

1995-03-01

This paper presents an overview of the BWRs employing feedwater zinc addition to reduce primary system dose rates. It identifies which BWRs are using zinc addition and reviews the mechanical injection and passive addition hardware currently being employed. The impact that zinc has on plant chemistry, including the factor of two to four reduction in reactor water Co-60 concentrations, is discussed. Dose rate results, showing the benefits of implementing zinc on either fresh piping surfaces or on pipes with existing films are reviewed. The advantages of using zinc that is isotopically enhanced by the depletion of the Zn-64 precursor tomore » Zn-65 are identified.« less

The net benefit of public expenditures on avalanche defence structures in the municipality of Davos, Switzerland

NASA Astrophysics Data System (ADS)

Fuchs, S.; McAlpin, M. C.

2005-04-01

Avalanches pose a threat to settlements as well as industrial and recreational areas in the Alps. As a counter measure, technical mitigation measures have been implemented since the 19th century, resulting in a raise in value of formerly endangered areas. This increase in value can be considered as a benefit due to prevented damage. This paper compares the total costs and benefits of technical mitigation measures in the municipality of Davos, Switzerland as a basis for evaluating their net social benefit. The benefit of avalanche defence structures is determined using two different approaches. First, the replacement value of buildings protected by mitigation measures is quantified. Second, the number of protected persons is monetarily assessed by means of a human capital approach. The quantified benefit is compared with the present value of cumulative capital expenditures on avalanche mitigation measures. In addition, distributional effects of the public expenditures on technical mitigation measures are discussed based on the average future tax revenues within protected areas. Depending on whether benefits are calculated in terms of protected buildings or protected persons, the results show a large range of cost-benefit ratios. Critical issues of cost-benefit analyses in the context of alpine natural hazards are highlighted, including problems related to the human capital approach and the sensitivity of results to how benefits are calculated. The applicability of cost-benefit analyses for evaluating avalanche mitigation measures is discussed.

Coral Reefs, Convicts, Cadavers, Coffee Shops and Couture: Customizing Experiential Learning to Increase Comfort and Engagement

ERIC Educational Resources Information Center

Grabowsky, Gail L.; Hargis, Jace; Davidson, Janet; Paynter, Allison; Suh, Junghwa; Wright, Claire

2017-01-01

Experiential learning (EL) can offer a high impact educational opportunity that benefits students from diverse backgrounds, creating an inclusive learning environment. Barriers to the generalization of EL can include a lack of institutional support, risk avoidance, time, and faculty instructional ability. As well EL require additional efforts from…

Beyond Google: The Invisible Web in the Academic Library

ERIC Educational Resources Information Center

Devine, Jane; Egger-Sider, Francine

2004-01-01

This article analyzes the concept of the Invisible Web and its implication for academic librarianship. It offers a guide to tools that can be used to mine the Invisible Web and discusses the benefits of using the Invisible Web to promote interest in library services. In addition, the article includes an expanded definition, a literature review,…

Creating Interactive Student Workbook for Primary Education Social Studies Class and Researching Its Efficiency

ERIC Educational Resources Information Center

Ulu Kalin, Özlem

2017-01-01

Student workbook is an education material including components that support learning, help ensuring knowledge and ability to students in line with the acquisitions stated in teaching programs. Students have different learning styles and necessities. Their needs should be satisfied by benefiting from some additional materials in order to make their…

The Benefits of Implementing Disability Sports in Physical Education: A Model for Success

ERIC Educational Resources Information Center

Grenier, Michelle; Kearns, Catherine

2012-01-01

The growing appeal and acceptance of disability sports within the general population makes them an attractive addition for any physical education program. When included in a general physical education program, these sports provide complementary skills to students while delivering a powerful message about what it means to be an athlete with a…

Students of Color Studying Abroad: A Qualitative Description of the Factors That Influence Participation and the Perceived Impact of Participation

ERIC Educational Resources Information Center

Perkins, Christel

2017-01-01

Research indicates that study abroad participation has many benefits, including increasing students' language proficiency, intercultural sensitivity and cross-cultural communication skills when compared with students who do not study abroad. Additionally, study abroad have been found to shape students' career paths, and academic pursuits. Despite…

78 FR 20673 - Privacy Act of 1974; Department of Homeland Security/U.S. Citizenship and Immigration Services...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-05

... additional information, and issuing decision notices and/or proofs of benefit. This notice updates this... evidence or additional information, and issuing decision notices and/or proofs of benefit. This system of... Temporary Accounts and Draft Benefit Requests), which stores draft account and case information from...

Fiber and Prebiotics: Mechanisms and Health Benefits

PubMed Central

Slavin, Joanne

2013-01-01

The health benefits of dietary fiber have long been appreciated. Higher intakes of dietary fiber are linked to less cardiovascular disease and fiber plays a role in gut health, with many effective laxatives actually isolated fiber sources. Higher intakes of fiber are linked to lower body weights. Only polysaccharides were included in dietary fiber originally, but more recent definitions have included oligosaccharides as dietary fiber, not based on their chemical measurement as dietary fiber by the accepted total dietary fiber (TDF) method, but on their physiological effects. Inulin, fructo-oligosaccharides, and other oligosaccharides are included as fiber in food labels in the US. Additionally, oligosaccharides are the best known “prebiotics”, “a selectively fermented ingredient that allows specific changes, both in the composition and/or activity in the gastrointestinal microflora that confers benefits upon host well-bring and health.” To date, all known and suspected prebiotics are carbohydrate compounds, primarily oligosaccharides, known to resist digestion in the human small intestine and reach the colon where they are fermented by the gut microflora. Studies have provided evidence that inulin and oligofructose (OF), lactulose, and resistant starch (RS) meet all aspects of the definition, including the stimulation of Bifidobacterium, a beneficial bacterial genus. Other isolated carbohydrates and carbohydrate-containing foods, including galactooligosaccharides (GOS), transgalactooligosaccharides (TOS), polydextrose, wheat dextrin, acacia gum, psyllium, banana, whole grain wheat, and whole grain corn also have prebiotic effects. PMID:23609775

Fiber and prebiotics: mechanisms and health benefits.

PubMed

Slavin, Joanne

2013-04-22

The health benefits of dietary fiber have long been appreciated. Higher intakes of dietary fiber are linked to less cardiovascular disease and fiber plays a role in gut health, with many effective laxatives actually isolated fiber sources. Higher intakes of fiber are linked to lower body weights. Only polysaccharides were included in dietary fiber originally, but more recent definitions have included oligosaccharides as dietary fiber, not based on their chemical measurement as dietary fiber by the accepted total dietary fiber (TDF) method, but on their physiological effects. Inulin, fructo-oligosaccharides, and other oligosaccharides are included as fiber in food labels in the US. Additionally, oligosaccharides are the best known "prebiotics", "a selectively fermented ingredient that allows specific changes, both in the composition and/or activity in the gastrointestinal microflora that confers benefits upon host well-bring and health." To date, all known and suspected prebiotics are carbohydrate compounds, primarily oligosaccharides, known to resist digestion in the human small intestine and reach the colon where they are fermented by the gut microflora. Studies have provided evidence that inulin and oligofructose (OF), lactulose, and resistant starch (RS) meet all aspects of the definition, including the stimulation of Bifidobacterium, a beneficial bacterial genus. Other isolated carbohydrates and carbohydrate-containing foods, including galactooligosaccharides (GOS), transgalactooligosaccharides (TOS), polydextrose, wheat dextrin, acacia gum, psyllium, banana, whole grain wheat, and whole grain corn also have prebiotic effects.

Effects of Framing Proximal Benefits of Quitting and Motivation to Quit as a Query on Communications About Tobacco Constituents.

PubMed

Kowitt, Sarah; Sheeran, Paschal; Jarman, Kristen; Ranney, Leah M; Schmidt, Allison M; Huang, Li-Ling; Goldstein, Adam O

2017-10-01

Little is known on how to communicate messages on tobacco constituents to tobacco users. This study manipulated three elements of a message in the context of a theory-based communication campaign about tobacco constituents: (1) latency of response efficacy (how soon expected health benefits would accrue), (2) self-efficacy (confidence about quitting), and (3) interrogative cue ("Ready to be tobacco-free?"). Smokers (N = 1669, 55.4% women) were recruited via an online platform, and were randomized to a 3 (Latency of response efficacy) × 2 (Self-efficacy) × 2 (Interrogative cue) factorial design. The dependent variables were believability, credibility, perceived effectiveness of the communication message, and action expectancies (likelihood of seeking additional information and help with quitting). Latency of response efficacy influenced believability, perceived effectiveness, credibility, and action expectancies. In each case, scores were higher when specific health benefits were said to accrue within 1 month, as compared to general health benefits occurring in a few hours. The interrogative cue had a marginal positive effect on perceived effectiveness. The self-efficacy manipulation had no reliable effects, and there were no significant interactions among conditions. Smokers appear less persuaded by a communication message on constituents where general health benefits accrue immediately (within a few hours) than specific benefits over a longer timeframe (1 month). Additionally, smokers appeared to be more persuaded by messages with an interrogative cue. Such findings may help design more effective communication campaigns on tobacco constituents to smokers. This paper describes, for the first time, how components of tobacco constituent messages are perceived. We now know that smokers appear to be less persuaded by communication messages where general health benefits accrue immediately (within a few hours) than specific benefits over a longer timeframe (1 month). Additionally, including an interrogative cue ("Ready to be tobacco free?") may make messages more effective, whereas the self-efficacy manipulation designed to increase confidence about quitting had no effect. While messages were universally impactful across smoker subpopulations, everyday smokers and smokers with less trust in the government may be less receptive to communication campaigns. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The Use of Economic Evaluation to Inform Newborn Screening Policy Decisions: The Washington State Experience

PubMed Central

THOMPSON, JOHN D.; DING, YAO; GLASS, MICHAEL

2016-01-01

Policy Points: Newborn screening not only saves lives but can also yield net societal economic benefit, in addition to benefits such as improved quality of life to affected individuals and families.Calculations of net economic benefit from newborn screening include the monetary equivalent of avoided deaths and reductions in costs of care for complications associated with late‐diagnosed individuals minus the additional costs of screening, diagnosis, and treatment associated with prompt diagnosis.Since 2001 the Washington State Department of Health has successfully implemented an approach to conducting evidence‐based economic evaluations of disorders proposed for addition to the state‐mandated newborn screening panel. Context Economic evaluations can inform policy decisions on the expansion of newborn screening panels. This article documents the use of cost‐benefit models in Washington State as part of the rule‐making process that resulted in the implementation of screening for medium‐chain acyl‐CoA dehydrogenase (MCAD) deficiency and 4 other metabolic disorders in 2004, cystic fibrosis (CF) in 2006, 15 other metabolic disorders in 2008, and severe combined immune deficiency (SCID) in 2014. Methods We reviewed Washington State Department of Health internal reports and spreadsheet models of expected net societal benefit of adding disorders to the state newborn screening panel. We summarize the assumptions and findings for 2 models (MCAD and CF) and discuss them in relation to findings in the peer‐reviewed literature. Findings The MCAD model projected a benefit‐cost ratio of 3.4 to 1 based on assumptions of a 20.0 percentage point reduction in infant mortality and a 13.9 percentage point reduction in serious developmental disability. The CF model projected a benefit‐cost ratio of 4.0‐5.4 to 1 for a discount rate of 3%‐4% and a plausible range of 1‐2 percentage point reductions in deaths up to age 10 years. Conclusions The Washington State cost‐benefit models of newborn screening were broadly consistent with peer‐reviewed literature, and their findings of net benefit appear to be robust to uncertainty in parameters. Public health newborn screening programs can develop their own capacity to project expected costs and benefits of expansion of newborn screening panels, although it would be most efficient if this capacity were shared among programs. PMID:27265561

User experience with a health insurance coverage and benefit-package access: implications for policy implementation towards expansion in Nigeria.

PubMed

Mohammed, Shafiu; Aji, Budi; Bermejo, Justo Lorenzo; Souares, Aurelia; Dong, Hengjin; Sauerborn, Rainer

2016-04-01

Developing countries are devising strategies and mechanisms to expand coverage and benefit-package access for their citizens through national health insurance schemes (NHIS). In Nigeria, the scheme aims to provide affordable healthcare services to insured-persons and their dependants. However, inclusion of dependants is restricted to four biological children and a spouse per user. This study assesses the progress of implementation of the NHIS in Nigeria, relating to coverage and benefit-package access, and examines individual factors associated with the implementation, according to users' perspectives. A retrospective, cross-sectional survey was done between October 2010 and March 2011 in Kaduna state and 796 users were randomly interviewed. Questions regarding coverage of immediate-family members and access to benefit-package for treatment were analysed. Indicators of coverage and benefit-package access were each further aggregated and assessed by unit-weighted composite. The additive-ordinary least square regression model was used to identify user factors that may influence coverage and benefit-package access. With respect to coverage, immediate-dependants were included for 62.3% of the users, and 49.6 rated this inclusion 'good' (49.6%). In contrast, 60.2% supported the abolishment of the policy restriction for non-inclusion of enrolees' additional children and spouses. With respect to benefit-package access, 82.7% of users had received full treatments, and 77.6% of them rated this as 'good'. Also, 14.4% of users had been refused treatments because they could not afford them. The coverage of immediate-dependants was associated with age, sex, educational status, children and enrolment duration. The benefit-package access was associated with types of providers, marital status and duration of enrolment. This study revealed that coverage of family members was relatively poor, while benefit-package access was more adequate. Non-inclusion of family members could hinder effective coverage by the scheme. Potential policy implications towards effective coverage and benefit-package access are discussed. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Which Benefits of Research Participation Count as ‘Direct’?

PubMed Central

Friedman, Alexander; Robbins, Emily; Wendler, David

2010-01-01

It is widely held that individuals who are unable to provide informed consent should be enrolled in clinical research only when the risks are low, or the research offers them the prospect of direct benefit. There is now a rich literature on when the risks of clinical research are low enough to enroll individuals who cannot consent. Much less attention has focused on which benefits of research participation count as ‘direct’, and the few existing accounts disagree over how this crucial concept should be defined. This disagreement raises concern over whether those who cannot consent, including children and adults with severe dementia, are being adequately protected. The present paper attempts to address this concern by considering first what additional protections are needed for these vulnerable individuals. This analysis suggests that the extant definitions of direct benefits either provide insufficient protection for research subjects or pose excessive obstacles to appropriate research. This analysis also points to a modified definition of direct benefits with the potential to avoid these two extremes, protecting individuals who cannot consent without blocking appropriate research. PMID:20497168

Hydration benefits to courtship feeding in crickets

PubMed Central

Ivy, T. M.; Johnson, J. C.; Sakaluk, S. K.

1999-01-01

The spermatophore transferred by male decorated crickets (Gryllodes sigillatus) at mating includes a large gelatinous spermatophylax that the female consumes after copulation. Although previous studies have shown that G. sigillatus females gain no nutritional benefits from consuming food gifts, there may be other benefits to their consumption. We examined potential hydration benefits to females by experimentally manipulating both the availability of water and the number of food gifts that females consumed, and by measuring their effect on female fitness. Analysis of the number of nymphs produced by females revealed a significant interaction between the number of spermatophylaxes consumed and water availability. When spermatophylaxes were not provided, females given water ad libitum produced significantly more nymphs than females subjected to water stress. Female longevity was significantly affected by water availability, with an increase in the availability of water corresponding to a significant increase in female longevity. These data suggest that female G. sigillatus accrue fitness benefits by consuming spermatophylaxes when alternative sources of water are unavailable. In addition, females appear to allocate water contained in spermatophylaxes towards reproduction as opposed to survival.

Comparing diagnostic tests on benefit-risk.

PubMed

Pennello, Gene; Pantoja-Galicia, Norberto; Evans, Scott

2016-01-01

Comparing diagnostic tests on accuracy alone can be inconclusive. For example, a test may have better sensitivity than another test yet worse specificity. Comparing tests on benefit risk may be more conclusive because clinical consequences of diagnostic error are considered. For benefit-risk evaluation, we propose diagnostic yield, the expected distribution of subjects with true positive, false positive, true negative, and false negative test results in a hypothetical population. We construct a table of diagnostic yield that includes the number of false positive subjects experiencing adverse consequences from unnecessary work-up. We then develop a decision theory for evaluating tests. The theory provides additional interpretation to quantities in the diagnostic yield table. It also indicates that the expected utility of a test relative to a perfect test is a weighted accuracy measure, the average of sensitivity and specificity weighted for prevalence and relative importance of false positive and false negative testing errors, also interpretable as the cost-benefit ratio of treating non-diseased and diseased subjects. We propose plots of diagnostic yield, weighted accuracy, and relative net benefit of tests as functions of prevalence or cost-benefit ratio. Concepts are illustrated with hypothetical screening tests for colorectal cancer with test positive subjects being referred to colonoscopy.

Current trends in pharmacy benefit designs: a threat to disease management in chronic complex diseases.

PubMed

Owens, Gary; Emons, Matthew F; Christian-Herman, Jennifer; Lawless, Grant

2007-04-01

With a focus on those patients who are candidates for treatment with biologic agents, we review the impact that current pharmacy benefit trends have on patients with chronic complex diseases and how they affect opportunities for disease management in this unique patient population. Dramatic increases in health care costs have led to a variety of strategies to manage cost. Many of these strategies either limit access to care or increase the patient's responsibility for choosing and paying for care, especially for medications. These strategies have a disproportionate impact on patients with chronic complex diseases, particularly those who require the use of biologic medications. A fundamental prerequisite of disease management has been coverage of disease-modifying therapies. If current pharmacy benefit trends continue, unintended consequences will likely occur including lost opportunities for disease management. Current pharmacy benefit trends could adversely impact disease management, particularly for patients requiring the use of biologic agents. Health plans should consider innovative benefit designs that reflect an appropriate level of cost sharing across all key stake-holders, ensuring appropriate access to needed therapies. Additional research is needed to clarify the value of newer approaches to therapies or benefit design changes.

The economic impact of rural family physicians practicing obstetrics.

PubMed

Avery, Daniel M; Hooper, Dwight E; McDonald, John T; Love, Michael W; Tucker, Melanie T; Parton, Jason M

2014-01-01

The economic impact of a family physician practicing family medicine in rural Alabama is $1,000,000 a year in economic benefit to the community. The economic benefit of those rural family physicians practicing obstetrics has not been studied. This study was designed to determine whether there was any added economic benefit of rural family physicians practicing obstetrics in rural, underserved Alabama. The Alabama Family Practice Rural Health Board has funded the University of Alabama Family Medicine Obstetrics Fellowship since its beginning in 1986. Family medicine obstetrics fellowship graduates who practice obstetrics in rural, underserved areas were sent questionnaires and asked to participate in the study. The questions included the most common types and average annual numbers of obstetrics/gynecological procedures they performed. Ten physicians, or 77% of the graduates asked to participate in the study, returned the questionnaire. Fourteen common obstetrics/gynecological procedures performed by the graduates were identified. A mean of 115 deliveries were performed. The full-time equivalent reduction in family medicine time to practice obstetrics was 20%. A family physician practicing obstetrics in a rural area adds an additional $488,560 in economic benefit to the community in addition to the $1,000,000 from practicing family medicine, producing a total annual benefit of $1,488,560. The investment of $616,385 from the Alabama Family Practice Rural Health Board resulted in a $399 benefit to the community for every dollar invested. The cumulative effect of fellowship graduates practicing both family medicine and obstetrics in rural, underserved areas over the 26 years studied was $246,047,120. © Copyright 2014 by the American Board of Family Medicine.

Estimating the value of volunteer-assisted community-based aging services: a case example.

PubMed

Scharlach, Andrew E

2015-01-01

This study demonstrates the use of a social return on investment (SROI) approach in estimating the financial and social value created by volunteer-assisted community-based aging services. An expanded value added statement (EVAS) analysis found that the total value of outputs produced by the Concierge Club of San Diego substantially exceeded the cost of the program, after considering likely secondary and tertiary benefits for a range of affected stakeholders-including elderly service recipients, family members, volunteers, and societal institutions. Additional research is needed regarding the direct and indirect costs and benefits of volunteer support services for vulnerable older adults and their families.

Pet dogs as promoters of wellbeing.

PubMed

While, Alison

2017-07-02

The rise in life expectancy requires strategies to enable healthy ageing and the promotion of a high quality of life in old age. Poor mental health including depression and social isolation can blight older people's lives. Despite the positive benefits of physical activity for both mental and physical health, only a minority of those over 65 years are attaining the recommended levels of physical activity. The evidence relating to the benefits of pet dogs as promoters of wellbeing is set out in this article, although meeting their care needs may place an additional strain on an older person and/or their carer who has limited resources and physical capabilities.

Including fall prevention for older adults in your trauma injury prevention program--introducing Farewell to Falls.

PubMed

Corman, Ellen

2009-01-01

With data showing that more than 50% of visits to our trauma center for older adults 65 years and older are due to falls, injury prevention programs in trauma centers should be paying more attention to the area of fall prevention for older adults. Farewell to Falls, a free, home-based program of Stanford Hospital and Clinic's trauma service, utilizes a multifaceted approach to help reduce falls. In addition to improving the lives of seniors, the program fulfills a community benefit goal and provides strong hospital marketing opportunities. This program is a benefit to hospitals and the older adults they serve.

20 CFR 901.72 - Additional rules.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Additional rules. 901.72 Section 901.72 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF... additional rules regarding the enrollment of actuaries. Effective Date Note: At 76 FR 17776, Mar. 31, 2011...

Is mini-laparoscopic cholecystectomy any better than the gold standard?: A comparative study.

PubMed

Shaikh, Haris R; Abbas, Asad; Aleem, Salik; Lakhani, Miqdad R

2017-01-01

Mini-laparoscopic cholecystectomy (MLC) has widened the horizons of modern laparoscopic surgery. Standard four port laparoscopic cholecystectomy (SLC), which has long been established as the "Gold Standard" for gall bladder diseases, is under reconsideration following the advent of further minimally-invasive procedures including MLC. Our study aims to provide a comparison between MLC and SLC and assesses whether MLC has any added benefits. Patients with symptomatic gall bladder disease undergoing MLC or SLC during the 2.5-month period were included in the study. Thirty-two patients underwent MLC while SLC was performed on 40 patients by the same surgeon. Data was collected prospectively and analysed retrospectively using a predesigned questionnaire. In our study, both the groups had similar age, body mass index (BMI) and gender distribution. No cases of MLC required insertion of additional ports. The mean operative time for MLC was 38.2 min (33-61 min), which is longer than SLC; but it was not statistically significant. There was no significant difference in mean operative blood loss, postoperative pain, analgesia requirement and mobilization. Patients who underwent MLC were able to return to normal activity earlier than patients undergoing SLC (P < 0.01). Our experience suggests that MLC can safely be used as an alternative to SLC. Compared to SLC, it has the added benefit of an early return to work along with excellent cosmetic results. Further large scale trials are required to prove any additional benefit of MLC.

Is mini-laparoscopic cholecystectomy any better than the gold standard?: A comparative study

PubMed Central

Shaikh, Haris R.; Abbas, Asad; Aleem, Salik; Lakhani, Miqdad R.

2017-01-01

BACKGROUND: Mini-laparoscopic cholecystectomy (MLC) has widened the horizons of modern laparoscopic surgery. Standard four port laparoscopic cholecystectomy (SLC), which has long been established as the “Gold Standard” for gall bladder diseases, is under reconsideration following the advent of further minimally-invasive procedures including MLC. Our study aims to provide a comparison between MLC and SLC and assesses whether MLC has any added benefits. MATERIALS AND METHODS: Patients with symptomatic gall bladder disease undergoing MLC or SLC during the 2.5-month period were included in the study. Thirty-two patients underwent MLC while SLC was performed on 40 patients by the same surgeon. Data was collected prospectively and analysed retrospectively using a predesigned questionnaire. RESULTS: In our study, both the groups had similar age, body mass index (BMI) and gender distribution. No cases of MLC required insertion of additional ports. The mean operative time for MLC was 38.2 min (33-61 min), which is longer than SLC; but it was not statistically significant. There was no significant difference in mean operative blood loss, postoperative pain, analgesia requirement and mobilization. Patients who underwent MLC were able to return to normal activity earlier than patients undergoing SLC (P < 0.01). CONCLUSION: Our experience suggests that MLC can safely be used as an alternative to SLC. Compared to SLC, it has the added benefit of an early return to work along with excellent cosmetic results. Further large scale trials are required to prove any additional benefit of MLC. PMID:27251827

Assessing the potential benefits of the motorcycle autonomous emergency braking using detailed crash reconstructions.

PubMed

Savino, Giovanni; Giovannini, Federico; Baldanzini, Niccolò; Pierini, Marco; Rizzi, Matteo

2013-01-01

The aim of this study was to assess the feasibility and quantitative potential benefits of a motorcycle autonomous emergency braking (MAEB) system in fatal rear-end crashes. A further aim was to identify possible criticalities of this safety system in the field of powered 2-wheelers (PTWs; e.g., any additional risk introduced by the system itself). Seven relevant cases from the Swedish national in-depth fatal crash database were selected. All crashes involved car-following in which a non-anti-lock braking system (ABS)-equipped motorcycle was the bullet vehicle. Those crashes were reconstructed in a virtual environment with Prescan, simulating the road scenario, the vehicles involved, their precrash trajectories, ABS, and, alternatively, MAEB. The MAEB chosen as reference for the investigation was developed within the European Commission-funded Powered Two-Wheeler Integrated Safety (PISa) project and further detailed in later studies, with the addition of the ABS functionality. The boundary conditions of each simulation varied within a range compatible with the uncertainty of the in-depth data and also included a range of possible rider behaviors including the actual one. The benefits of the MAEB were evaluated by comparing the simulated impact speed in each configuration (no ABS/MAEB, ABS only, MAEB). The MAEB proved to be beneficial in a large number of cases. When applicable, the benefits of the system were in line with the expected values. When not applicable, there was no clear evidence of an increased risk for the rider due to the system. MAEB represents an innovative safety device in the field of PTWs, and the feasibility of such a system was investigated with promising results. Nevertheless, this technology is not mature yet for PTW application. Research in the field of passenger cars does not directly apply to PTWs because the activation logic of a braking system is more challenging on PTWs. The deployment of an autonomous deceleration would affect the vehicle dynamics, thus requesting an additional control action of the rider to keep the vehicle stable. In addition, the potential effectiveness of the MAEB should be investigated on a wider set of crash scenarios in order also to avoid false triggering of the autonomous braking.

Robotics in Cardiac Surgery: Past, Present, and Future

PubMed Central

Bush, Bryan; Nifong, L. Wiley; Chitwood, W. Randolph

2013-01-01

Robotic cardiac operations evolved from minimally invasive operations and offer similar theoretical benefits, including less pain, shorter length of stay, improved cosmesis, and quicker return to preoperative level of functional activity. The additional benefits offered by robotic surgical systems include improved dexterity and degrees of freedom, tremor-free movements, ambidexterity, and the avoidance of the fulcrum effect that is intrinsic when using long-shaft endoscopic instruments. Also, optics and operative visualization are vastly improved compared with direct vision and traditional videoscopes. Robotic systems have been utilized successfully to perform complex mitral valve repairs, coronary revascularization, atrial fibrillation ablation, intracardiac tumor resections, atrial septal defect closures, and left ventricular lead implantation. The history and evolution of these procedures, as well as the present status and future directions of robotic cardiac surgery, are presented in this review. PMID:23908867

Evidence-Based Practice in Liposuction.

PubMed

Collins, Patrick S; Moyer, Kurtis E

2018-06-01

The goal of this study is to examine the existing peer reviewed literature comparing modern adjunctive techniques in liposuction including laser-assisted liposuction (LAL) and ultrasound-assisted liposuction (UAL) to standard suction-assisted liposuction (SAL). We intend to interpret these findings into a literature-based clinical application to influence practice patterns. A literature review was conducted using a keyword search in PubMed. Keyword search items included liposuction, lipoplasty, suction assisted liposuction, ultrasound assisted liposuction, laser assisted liposuction, tumescent, liposuction comparison, liposuction review, and combinations therein. Exclusion criteria included articles with a primary focus on histologic effects of energy devices, primary animal models, primary opinion papers with no reference to available data, and industry-sponsored publications. Inclusion criteria included articles with direct comparison of liposuction modalities, randomized or blinded studies, and studies with objective outcomes. Twenty-five articles that met the inclusion criteria comparing SAL to UAL or LAL out of 9972 articles identified were obtained. The selected literature was assigned into 3 categories: evidence demonstrating an advantage of 1 modality (SAL, UAL, or LAL) over another, evidence that showed no benefit of 1 modality over another, and evidence that demonstrated risks of complications of 1 modality over another. The benefits of UAL and LAL over SAL include the following: (1) UAL over SAL in the treatment of gynecomastia, (2) LAL and UAL over SAL with decreased hemoglobin/hematocrit in high-volume lipoaspirates, and (3) LAL over SAL with skin tightening in select areas specifically the submental area. Otherwise, the literature demonstrates equivocal results among the described techniques with no clear benefit to set one apart from the other. There appears to be no demonstrable added benefit to the addition of either UAL or LAL that would urge a change in practice patterns outside the exceptions listed.

Sports-related concussions — media, science and policy

PubMed Central

Mannix, Rebekah; Meehan, William P.; Pascual-Leone, Alvaro

2017-01-01

Although growing awareness about the potential long-term deleterious effects of sport-related concussion has led to increased attention to the risks of collision sports, calls to ban these sports, such as American football, might be premature. Collision sports have a relatively high incidence of concussions, but participation in these sports also confers a host of benefits. In addition, the associated risks of participation, including concussion, have not been definitively shown to outweigh the benefits they provide, and the risk–benefit ratio might vary among individuals. The risks of concussion and repetitive concussions associated with collision sports are unknown in the general population and not well characterized even in elite athlete populations. In this article, we discuss current knowledge on sports-related concussion, its neurological consequences, and implications for regulation of the practice of collision sports. PMID:27364748

Manufacturing and Security Challenges in 3D Printing

NASA Astrophysics Data System (ADS)

Zeltmann, Steven Eric; Gupta, Nikhil; Tsoutsos, Nektarios Georgios; Maniatakos, Michail; Rajendran, Jeyavijayan; Karri, Ramesh

2016-07-01

As the manufacturing time, quality, and cost associated with additive manufacturing (AM) continue to improve, more and more businesses and consumers are adopting this technology. Some of the key benefits of AM include customizing products, localizing production and reducing logistics. Due to these and numerous other benefits, AM is enabling a globally distributed manufacturing process and supply chain spanning multiple parties, and hence raises concerns about the reliability of the manufactured product. In this work, we first present a brief overview of the potential risks that exist in the cyber-physical environment of additive manufacturing. We then evaluate the risks posed by two different classes of modifications to the AM process which are representative of the challenges that are unique to AM. The risks posed are examined through mechanical testing of objects with altered printing orientation and fine internal defects. Finite element analysis and ultrasonic inspection are also used to demonstrate the potential for decreased performance and for evading detection. The results highlight several scenarios, intentional or unintentional, that can affect the product quality and pose security challenges for the additive manufacturing supply chain.

Toward full life cycle control: Adding maintenance measurement to the SEL

NASA Technical Reports Server (NTRS)

Rombach, H. Dieter; Ulery, Bradford T.; Valett, Jon D.

1992-01-01

Organization-wide measurement of software products and processes is needed to establish full life cycle control over software products. The Software Engineering Laboratory (SEL)--a joint venture between NASA GSFC, the University of Maryland, and Computer Sciences Corporation--started measurement of software development more than 15 years ago. Recently, the measurement of maintenance was added to the scope of the SEL. In this article, the maintenance measurement program is presented as an addition to the already existing and well-established SEL development measurement program and evaluated in terms of its immediate benefits and long-term improvement potential. Immediate benefits of this program for the SEL include an increased understanding of the maintenance domain, the differences and commonalities between development and maintenance, and the cause-effect relationships between development and maintenance. Initial results from a sample maintenance study are presented to substantiate these benefits. The long-term potential of this program includes the use of maintenance baselines to better plan and manage future projects and to improve development and maintenance practices for future projects wherever warranted.

Researchers’ Perceptions of the Ethical Implications of Pharmacogenomics Research with Children

PubMed Central

Avard, D.; Silverstein, T.; Sillon, G.; Joly, Y.

2009-01-01

Background This paper presents the results of an exploratory qualitative study that assesses Canadian pediatric researchers’ perceptions of a pre-selected group of ethical issues raised by pharmacogenomics research with children. Methods As a pilot study, we conducted semi-structured telephone interviews with Canadian pediatric pharmacogenomic researchers. The interviews were guided by the following themes: (1) benefits and risks of inclusion, (2) the consent/assent process, and (3) the return of research results. Results Issues about assent, consent, risks and benefits, as well as the communication of results were addressed by the respondents. Some issues, such as the unique vulnerability of children, the long term privacy concerns associated with biobanking, additional core elements that need to be discussed and included in the consent/assent forms, as well as the challenges of communicating research results in a pediatric research were not explicitly identified by the respondents. Conclusion Further consideration should be given to address the ethical challenges of including children in pharmacogenomics research. This exploratory study indicates that further guidance is needed if children are to be protected and yet benefit from such research. PMID:19204423

Hedge Funds and Asset Allocation: Investor Confidence, Diversification Benefits, and a Change in Investment Style Composition

NASA Astrophysics Data System (ADS)

Bessler, Wolfgang; Holler, Julian

Based on the belief that hedge funds are able to generate positive risk-adjusted returns (alpha) and diversification benefits in a portfolio context, many investors have included hedge funds in their asset allocation in order to optimize the risk-return trade-off of their investments. We provide evidence that more optimistic prior beliefs about expected risk-adjusted returns (alpha) lead to higher allocations into hedge funds. It appears, however, that history may not be the best guide for future fund performance and that the diversification benefits have declined over time. One reason for the lower risk-adjusted returns is a capacity effect in that previously exceptional hedge fund returns caused higher inflows to these funds and consequently a competition for alpha among investors. In our empirical analysis we provide additional evidence of other explanations for decreasing hedge fund benefits such as an increase in correlations with other asset classes and changes in the style composition of hedge funds.

Modeling relationships between various domains of hearing aid provision.

PubMed

Meister, Hartmut; Lausberg, Isabel; Kiessling, Jürgen; von Wedel, Hasso; Walger, Martin

2003-01-01

Various inventories have been developed to quantify the success of hearing aid provision. Though numerous parameters including initial measures (hearing disability, handicap) or 'outcome measures' (e.g. benefit, satisfaction and usage) are recorded, relationships and interactions among them are still unclear. A study applying a questionnaire addressing 11 domains relevant to amplification was conducted in order to generate different psychometric models with the AMOS software package for structural equation modeling. The models expose easily interpretable interactions and are helpful in understanding effects occurring with commonly used outcome measures: benefit reflects the difference between the aided and unaided condition but additionally comprises the importance of the hearing aid within a specific situation. Satisfaction is highly reliant on benefit. Usage is strongly dependent on the severity of hearing problems and therefore not appropriate in assessing the success of amplification. Moreover, the models help to predict the outcome of clinically used inventories (i.e. the Glasgow Hearing Aid Benefit Profile). Copyright 2003 S. Karger AG, Basel

Seasonal Climate Forecasts and Adoption by Agriculture

NASA Astrophysics Data System (ADS)

Garbrecht, Jurgen; Meinke, Holger; Sivakumar, Mannava V. K.; Motha, Raymond P.; Salinger, Michael J.

2005-06-01

Recent advances in atmospheric and ocean sciences and a better understanding of the global climate have led to skillful climate forecasts at seasonal to interannual timescales, even in midlatitudes. These scientific advances and forecasting capabilities have opened the door to practical applications that benefit society. The benefits include the reduction of weather/climate related risks and vulnerability, increased economic opportunities, enhanced food security, mitigation of adverse climate impacts, protection of environmental quality, and so forth. Agriculture in particular can benefit substantially from accurate long-lead seasonal climate forecasts. Indeed, agricultural production very much depends on weather, climate, and water availability, and unexpected departures from anticipated climate conditions can thwart the best laid management plans. Timely climate forecasts offer means to reduce losses in drought years, increase profitability in good years, deal more effectively with climate variability, and choose from targeted risk-management strategies. In addition to benefiting farmers, forecasts can also help marketing systems and downstream users prepare for anticipated production outcomes and associated consequences.

Satellite Power System (SPS) microwave subsystem impacts and benefits

NASA Technical Reports Server (NTRS)

Dickinson, R. M.

1977-01-01

The impacts and benefits to society of the microwave subsystem resulting from the developing, construction and operating of a space solar power to earth, electric power delivery system are presented and discussed. The primary benefit (usable energy) is conveyed mainly in the fundamental frequency portion of the RF radiation beam that is intercepted and converted to electric power output. The small fraction of the microwave and other electromagnetic energy that does not end up in the electric utility grid, yields most of the subsystem impacts. The impacts range from harmonics and noise radiated by the transmitting antenna, through potential interference with ionospheric communications and navigation caused by the power beam heating the ionosphere, to the potential large land area requirements for the rectennas and low level microwave radiation around the rectennas. Additional benefits range from a very low level of waste heat liberated and lack of atmospheric emissions including noise while operating to having no residual ionizing radiation from the rectenna when it is deactivated.

How the affordable care act and mental health parity and addiction equity act greatly expand coverage of behavioral health care.

PubMed

Beronio, Kirsten; Glied, Sherry; Frank, Richard

2014-10-01

The Patient Protection and Affordable Care Act (ACA) will expand coverage of mental health and substance use disorder benefits and federal parity protections to over 60 million Americans. The key to this expansion is the essential health benefit provision in the ACA that requires coverage of mental health and substance use disorder services at parity with general medical benefits. Other ACA provisions that should improve access to treatment include requirements on network adequacy, dependent coverage up to age 26, preventive services, and prohibitions on annual and lifetime limits and preexisting exclusions. The ACA offers states flexibility in expanding Medicaid (primarily to childless adults, not generally eligible previously) to cover supportive services needed by those with significant behavioral health conditions in addition to basic benefits at parity. Through these various new requirements, the ACA in conjunction with Mental Health Parity and Addiction Equity Act (MHPAEA) will expand coverage of behavioral health care by historic proportions.

20 CFR 416.805 - When additional evidence may be required.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false When additional evidence may be required. 416.805 Section 416.805 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Determination of Age § 416.805 When additional evidence may be...

PACS in an intensive care unit: results from a randomized controlled trial

NASA Astrophysics Data System (ADS)

Bryan, Stirling; Weatherburn, Gwyneth C.; Watkins, Jessamy; Walker, Samantha; Wright, Carl; Waters, Brian; Evans, Jeff; Buxton, Martin J.

1998-07-01

The objective of this research was to assess the costs and benefits associated with the introduction of a small PACS system into an intensive care unit (ICU) at a district general hospital in north Wales. The research design adopted for this study was a single center randomized controlled trial (RCT). Patients were randomly allocated either to a trial arm where their x-ray imaging was solely film-based or to a trial arm where their x-ray imaging was solely PACS based. Benefit measures included examination-based process measures, such as image turn-round time, radiation dose and image unavailability; and patient-related process measures, which included adverse events and length of stay. The measurement of costs focused on additional 'radiological' costs and the costs of patient management. The study recruited 600 patients. The key findings from this study were that the installation of PACS was associated with important benefits in terms of image availability, and important costs in both monetary and radiation dose terms. PACS-related improvements in terms of more timely 'clinical actions' were not found. However, the qualitative aspect of the research found that clinicians were advocates of the technology and believed that an important benefit of PACS related to improved image availability.

20 CFR 226.12 - Employee vested dual benefit.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false Employee vested dual benefit. 226.12 Section 226.12 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT... vested dual benefit. (a) General. An employee vested dual benefit is payable, in addition to tiers I and...

20 CFR 226.12 - Employee vested dual benefit.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true Employee vested dual benefit. 226.12 Section 226.12 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT... vested dual benefit. (a) General. An employee vested dual benefit is payable, in addition to tiers I and...

20 CFR 226.12 - Employee vested dual benefit.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false Employee vested dual benefit. 226.12 Section 226.12 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT... vested dual benefit. (a) General. An employee vested dual benefit is payable, in addition to tiers I and...

Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement.

PubMed

2009-11-17

Update of the 2002 U.S. Preventive Services Task Force (USPSTF) recommendation statement on screening for breast cancer in the general population. The USPSTF examined the evidence on the efficacy of 5 screening modalities in reducing mortality from breast cancer: film mammography, clinical breast examination, breast self-examination, digital mammography, and magnetic resonance imaging in order to update the 2002 recommendation. To accomplish this update, the USPSTF commissioned 2 studies: 1) a targeted systematic evidence review of 6 selected questions relating to benefits and harms of screening, and 2) a decision analysis that used population modeling techniques to compare the expected health outcomes and resource requirements of starting and ending mammography screening at different ages and using annual versus biennial screening intervals. The USPSTF recommends against routine screening mammography in women aged 40 to 49 years. The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take into account patient context, including the patient's values regarding specific benefits and harms. (Grade C recommendation) The USPSTF recommends biennial screening mammography for women between the ages of 50 and 74 years. (Grade B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of screening mammography in women 75 years or older. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of clinical breast examination beyond screening mammography in women 40 years or older. (I statement) The USPSTF recommends against clinicians teaching women how to perform breast self-examination. (Grade D recommendation) The USPSTF concludes that the current evidence is insufficient to assess additional benefits and harms of either digital mammography or magnetic resonance imaging instead of film mammography as screening modalities for breast cancer. (I statement).

The effect of anti-angiogenic agents on overall survival in metastatic oesophago-gastric cancer: A systematic review and meta-analysis

PubMed Central

Sjoquist, Katrin M.; Goldstein, David; Price, Timothy J.; Martin, Andrew J.; Bang, Yung-Jue; Kang, Yoon-Koo; Pavlakis, Nick

2017-01-01

Background Studies of anti-angiogenic agents (AAs), combined with chemotherapy (chemo) or as monotherapy in metastatic oesophago-gastric cancer (mOGC), have reported mixed outcomes. We undertook systematic review and meta-analysis to determine their overall benefits and harms. Methods Randomized controlled trials in mOGC were sought investigating the addition of AAs to standard therapy (best supportive care or chemo). The primary endpoint was overall survival (OS) with secondary endpoints progression-free survival (PFS), overall response rate (ORR) and toxicity. Estimates of treatment effect from individual trials were combined using standard techniques. Subgroup analyses were performed by line of therapy, region, age, performance status, histological type, number of metastatic sites, primary site, mechanism of action and HER2 status. Results Fifteen trials evaluating 3502 patients were included in quantitative analysis. The addition of AAs was associated with improved OS: HR 0·81 (95% CI 0·75–0·88, p<0·00001) and improved PFS: HR 0·68 (95% CI 0·63–0·74, p<0·00001). Subgroup analyses favoured greater benefit for OS in 2nd/3rd line settings (HR 0·74) compared to 1st-line settings (HR 0·91) (X2 = 6·00, p = 0·01). OS benefit was seen across all regions—Asia (HR 0·83) and rest of world (HR 0·75)—without significant subgroup interaction. Results from 8 trials evaluating 2602 patients were pooled for toxicity > = Grade 3: with OR 1·39 (95% CI 1·17–1·65). Conclusions The addition of AAs to standard therapy in mOGC improves OS. Improved efficacy was only observed in 2nd- or 3rd-line setting and not in 1st-line setting. Consistent OS benefit was present across all geographical regions. This benefit is at the expense of increased overall toxicity. PMID:28222158

[Assessing the benefits of digital health solutions in the societal reimbursement context].

PubMed

Albrecht, Urs-Vito; Kuhn, Bertolt; Land, Jörg; Amelung, Volker E; von Jan, Ute

2018-03-01

For a number of reasons, achieving reimbursability for digital health products has so far proven difficult. Demonstrating the benefits of the technology is the main hurdle in this context. The generally accepted evaluation processes, especially parallel group comparisons in randomized controlled trials (RCTs) for (clinical) benefit assessment, are primarily intended to deal with questions of (added) medical benefit. In contrast to drugs or classical medical devices, users of digital health solutions often profit from gaining autonomy, increased awareness and mindfulness, better transparency in the provision of care, and improved comfort, although there are also digital solutions with an interventional character targeting clinical outcomes (e. g. for indications such as anorexia, depression). Commonly accepted methods for evaluating (clinical) benefits primarily rely on medical outcomes, such as morbidity and mortality, but do not adequately consider additional benefits unique to digital health. The challenge is therefore to develop evaluation designs that respect the particularities of digital health without reducing the validity of the evaluations (especially with respect to safety). There is an increasing need for concepts that include both continuous feedback loops for adapting and improving an application while at the same time generate sufficient evidence for complex benefit assessments. This approach may help improve risk benefit ratio assessments of digital health when it comes to implementing digital innovations in healthcare.

Funding alternatives in EHR adoption: beyond HITECH incentives and traditional approaches.

PubMed

Wang, Tiankai; Wang, Yangmei; Biedermann, Sue

2013-05-01

The meaningful use incentives under HITECH may be inadequate to address the financial challenges many hospitals face in implementing electronic health records (EHRs). Hospitals can fill the capital gap between EHR costs and available funds by exploring other potential funding sources. These sources include additional grants, funding permissible under EHR regulations, vendor financing, and tax benefits under IRS Section 179.

Harvest Health: Translation of the Chronic Disease Self-Management Program for Older African Americans in a Senior Setting

ERIC Educational Resources Information Center

Gitlin, Laura N.; Chernett, Nancy L.; Harris, Lynn Fields; Palmer, Delores; Hopkins, Paul; Dennis, Marie P.

2008-01-01

Purpose: We describe the translation of K. R. Lorig and colleagues' Chronic Disease Self-Management Program (CDSMP) for delivery in a senior center and evaluate pre-post benefits for African American participants. Design and Methods: Modifications to the CDSMP included a name change; an additional introductory session; and course augmentations…

Room-Temperature Operation of Index-Coupled Distributed-Feedback 4.75 Micron Quantum Cascade Lasers Fabricated Without Epitaxial Regrowth

NASA Technical Reports Server (NTRS)

Briggs, Ryan M.; Frez, Clifford; Forouhar, Siamak

2013-01-01

The Mars Science Laboratory (MSL) was spin-stabilized during its cruise to Mars. We discuss the effects of spin on the radiometric data and how the orbit determination team dealt with them. Additionally, we will discuss the unplanned benefits of detailed spin modeling including attitude estimation and spacecraft clock correlation.

The Long and the Short of It: The Use of Short Films in the German Classroom

ERIC Educational Resources Information Center

Sundquist, John

2010-01-01

This article focuses on the benefits of using short film in the German classroom at the secondary or post-secondary level. The article addresses a number of characteristics of short films that lend themselves well to the classroom, including their abbreviated length, artistic innovation, and compact storytelling. In addition to discussing specific…

Scoping Studies to Evaluate the Benefits of an Advanced Dry Feed System on the Use of Low-Rank Coal

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rader, Jeff; Aguilar, Kelly; Aldred, Derek

2012-11-30

This report describes the development of the design of an advanced dry feed system that was carried out under Task 4.0 of Cooperative Agreement DE-FE0007902 with the US DOE, “Scoping Studies to Evaluate the Benefits of an Advanced Dry Feed System on the use of Low- Rank Coal.” The resulting design will be used for the advanced technology IGCC case with 90% carbon capture for sequestration to be developed under Task 5.0 of the same agreement. The scope of work covered coal preparation and feeding up through the gasifier injector. Subcomponents have been broken down into feed preparation (including grindingmore » and drying), low pressure conveyance, pressurization, high pressure conveyance, and injection. Pressurization of the coal feed is done using Posimetric1 Feeders sized for the application. In addition, a secondary feed system is described for preparing and feeding slag additive and recycle fines to the gasifier injector. This report includes information on the basis for the design, requirements for down selection of the key technologies used, the down selection methodology and the final, down selected design for the Posimetric Feed System, or PFS.« less

Determining the Ideal Strategy for Ventilator-associated Pneumonia Prevention. Cost-Benefit Analysis.

PubMed

Branch-Elliman, Westyn; Wright, Sharon B; Howell, Michael D

2015-07-01

Ventilator-associated pneumonia (VAP) is a common healthcare-associated infection with high associated cost and poor patient outcomes. Many strategies for VAP reduction have been evaluated. However, the combination of strategies with the optimal cost-benefit ratio remains unknown. To determine the preferred VAP prevention strategy, both from the hospital and societal perspectives. A cost-benefit decision model with a Markov model was constructed. Baseline probability of VAP, death, reintubation, and discharge from the intensive care unit (ICU) alive were ascertained from clinical trial data. Model inputs were obtained from the medical literature and the U.S. Department of Labor; a device cost was obtained from the manufacturer. Sensitivity analyses were completed to test the robustness of model results. Overall least expensive strategy and the strategy with the best cost-benefit ratio, up to a willingness to pay threshold of $50,000-100,000 per case of VAP averted was sought. We examined a total of 120 unique combinations of VAP prevention strategies. The preferred strategy from the hospital perspective included subglottic suction endotracheal tubes, probiotics, and the Institute for Healthcare Improvement VAP Prevention Bundle. The preferred strategy from the point of view of society also included additional prevention measures (oral care with chlorhexidine and selective oral decontamination). No preferred strategies included silver endotracheal tubes or selective gut decontamination. Despite their infrequent use, current data suggest that the use of prophylactic probiotics and subglottic endotracheal tubes are cost-effective for preventing VAP from the societal and hospital perspectives.

Addition of Rice Bran Arabinoxylan to Curcumin Therapy May Be of Benefit to Patients With Early-Stage B-Cell Lymphoid Malignancies (Monoclonal Gammopathy of Undetermined Significance, Smoldering Multiple Myeloma, or Stage 0/1 Chronic Lymphocytic Leukemia)

PubMed Central

Golombick, Terry; Diamond, Terrence H.; Manoharan, Arumugam; Ramakrishna, Rajeev

2016-01-01

Hypothesis. Prior studies on patients with early B-cell lymphoid malignancies suggest that early intervention with curcumin may lead to delay in progressive disease and prolonged survival. These patients are characterized by increased susceptibility to infections. Rice bran arabinoxylan (Ribraxx) has been shown to have immunostimulatory, anti-inflammatory, and proapoptotic effects. We postulated that addition of Ribraxx to curcumin therapy may be of benefit. Study design. Monoclonal gammopathy of undetermined significance (MGUS)/smoldering multiple myeloma (SMM) or stage 0/1 chronic lymphocytic leukemia (CLL) patients who had been on oral curcumin therapy for a period of 6 months or more were administered both curcumin (as Curcuforte) and Ribraxx. Methods. Ten MGUS/SMM patients and 10 patients with stage 0/1 CLL were administered 6 g of curcumin and 2 g Ribraxx daily. Blood samples were collected at baseline and at 2-month intervals for a period of 6 months, and various markers were monitored. MGUS/SMM patients included full blood count (FBC); paraprotein; free light chains/ratio; C-reactive protein (CRP)and erythrocyte sedimentation rate (ESR); B2 microglobulin and immunological markers. Markers monitored for stage 0/1 CLL were FBC, CRP and ESR, and immunological markers. Results. Of 10 MGUS/SMM patients,5 (50%) were neutropenic at baseline, and the Curcuforte/Ribraxx combination therapy showed an increased neutrophil count, varying between 10% and 90% among 8 of the 10 (80%) MGUS/SMM patients. An additional benefit of the combination therapy was the potent effect in reducing the raised ESR in 4 (44%) of the MGUS/SMM patients. Conclusion. Addition of Ribraxx to curcumin therapy may be of benefit to patients with early-stage B-cell lymphoid malignancies. PMID:27154182

The Added Value of a Single-photon Emission Computed Tomography-Computed Tomography in Sentinel Lymph Node Mapping in Patients with Breast Cancer and Malignant Melanoma.

PubMed

Bennie, George; Vorster, Mariza; Buscombe, John; Sathekge, Mike

2015-01-01

Single-photon emission computed tomography-computed tomography (SPECT-CT) allows for physiological and anatomical co-registration in sentinel lymph node (SLN) mapping and offers additional benefits over conventional planar imaging. However, the clinical relevance when considering added costs and radiation burden of these reported benefits remains somewhat uncertain. This study aimed to evaluate the possible added value of SPECT-CT and intra-operative gamma-probe use over planar imaging alone in the South African setting. 80 patients with breast cancer or malignant melanoma underwent both planar and SPECT-CT imaging for SLN mapping. We assessed and compared the number of nodes detected on each study, false positive and negative findings, changes in surgical approach and or patient management. In all cases where a sentinel node was identified, SPECT-CT was more accurate anatomically. There was a significant change in surgical approach in 30 cases - breast cancer (n = 13; P 0.001) and malignant melanoma (n = 17; P 0.0002). In 4 cases a node not identified on planar imaging was seen on SPECT-CT. In 16 cases additional echelon nodes were identified. False positives were excluded by SPECT-CT in 12 cases. The addition of SPECT-CT and use of intra-operative gamma-probe to planar imaging offers important benefits in patients who present with breast cancer and melanoma. These benefits include increased nodal detection, elimination of false positives and negatives and improved anatomical localization that ultimately aids and expedites surgical management. This has been demonstrated in the context of industrialized country previously and has now also been confirmed in the setting of a emerging-market nation.

Advantages and Disadvantages of Transtibial, Anteromedial Portal, and Outside-In Femoral Tunnel Drilling in Single-Bundle Anterior Cruciate Ligament Reconstruction: A Systematic Review.

PubMed

Robin, Brett N; Jani, Sunil S; Marvil, Sean C; Reid, John B; Schillhammer, Carl K; Lubowitz, James H

2015-07-01

Controversy exists regarding the best method for creating the knee anterior cruciate ligament (ACL) femoral tunnel or socket. The purpose of this study was to systematically review the risks, benefits, advantages, and disadvantages of the endoscopic transtibial (TT) technique, anteromedial portal technique, outside-in technique, and outside-in retrograde drilling technique for creating the ACL femoral tunnel. A PubMed search of English-language studies published between January 1, 2000, and February 17, 2014, was performed using the following keywords: "anterior cruciate ligament" AND "femoral tunnel." Included were studies reporting risks, benefits, advantages, and/or disadvantages of any ACL femoral technique. In addition, references of included articles were reviewed to identify potential studies missed in the original search. A total of 27 articles were identified through the search. TT technique advantages include familiarity and proven long-term outcomes; disadvantages include the risk of nonanatomic placement because of constrained (TT) drilling. Anteromedial portal technique advantages include unconstrained anatomic placement; disadvantages include technical challenges, short tunnels or sockets, and posterior-wall blowout. Outside-in technique advantages include unconstrained anatomic placement; disadvantages include the need for 2 incisions. Retrograde drilling technique advantages include unconstrained anatomic placement, as well as all-epiphyseal drilling in skeletally immature patients; disadvantages include the need for fluoroscopy for all-epiphyseal drilling. There is no one, single, established "gold-standard" technique for creation of the ACL femoral socket. Four accepted techniques show diverse and subjective advantages, disadvantages, risks, and benefits. Level V, systematic review of Level II through V evidence. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Rice bran constituents: immunomodulatory and therapeutic activities.

PubMed

Park, Ho-Young; Lee, Kwang-Won; Choi, Hee-Don

2017-03-22

Rice bran, one of the most abundant and valuable byproducts produced during the rice milling process, is of steadily growing interest in recent years due to its potential health benefits. Evidence is rapidly accumulating for the beneficial effects of nutraceuticals. However, the potential benefits of rice bran are found in several of its bioactive ingredients including oils, polysaccharides, proteins, and micronutrients. In addition, a significant advantage of rice bran is that it contains more than 100 antioxidants and several categories of bioactive phytonutrients, such as polyphenols, phytosterols, tocotrienols, γ-oryzanol, B vitamins, minerals, and trace minerals. As an immunomodulator, rice bran has beneficial constituents such as polysaccharides, proteins, and oils. Numerous studies also reported that potent antioxidants in rice bran included immune system enhancing compounds, such as phytosterols, polysaccharides, minerals and trace minerals including magnesium, selenium, zinc, vitamin E, omega-3 fatty acids and several other phytonutrients. We believe that this review will be a valuable resource for more studies on rice barn as a dietary source.

20 CFR 30.102 - In general, how does an employee file a claim for additional impairment or wage-loss under Part E...

Code of Federal Regulations, 2010 CFR

2010-04-01

... for additional impairment or wage-loss under Part E of EEOICPA? 30.102 Section 30.102 Employees... an employee file a claim for additional impairment or wage-loss under Part E of EEOICPA? (a) An employee previously awarded impairment benefits by OWCP may file a claim for additional impairment benefits...

AChE Inhibitors and NMDA Receptor Antagonists in Advanced Alzheimer's Disease.

PubMed

Glynn-Servedio, Brianna E; Ranola, Trisha Seys

2017-09-01

The objective of this article is to review the available evidence for duration of treatment with, and considerations for discontinuation of, acetylcholinesterase inhibitors and N-methyl-d-aspartate receptor antagonists in Alzheimer's disease. Literature searches of clinical trials and meta-analyses were conducted using PubMed with the search terms Alzheimer's, dementia, donepezil, galantamine, memantine, and rivastigmine. References from included trials were also used to find additional citations. 2,925 articles were initially identified. Twenty-one studies were included that looked at the use of acetylcholinesterase inhibitors and/or memantine in the treatment of moderate-to-severe Alzheimer's dementia. Several clinical trials have demonstrated small improvements in measures of cognition and activities of daily living with medications used to treat dementia. However, not all patients will benefit from treatment, and the impact of treatment on long-term outcomes, including institutionalization, remains unclear. This paper reviews the available data to support the use of acetylcholinesterase inhibitors and/or memantine in patients with advanced Alzheimer's disease, including those in nursing facilities, and reviews recommendations for consideration of therapy discontinuation. The evidence to support a specific time frame for discontinuation of Alzheimer's disease treatment is limited. It is reasonable to stop a medication if there is no noticeable benefit after the first three months of treatment or once a patient's dementia progresses to a point where there would be no meaningful benefit from continued therapy.

Systematic review on the financial return of worksite health promotion programmes aimed at improving nutrition and/or increasing physical activity.

PubMed

van Dongen, J M; Proper, K I; van Wier, M F; van der Beek, A J; Bongers, P M; van Mechelen, W; van Tulder, M W

2011-12-01

This systematic review summarizes the current evidence on the financial return of worksite health promotion programmes aimed at improving nutrition and/or increasing physical activity. Data on study characteristics and results were extracted from 18 studies published up to 14 January 2011. Two reviewers independently assessed the risk of bias of included studies. Three metrics were (re-)calculated per study: the net benefits, benefit cost ratio (BCR) and return on investment (ROI). Metrics were averaged, and a post hoc subgroup analysis was performed to compare financial return estimates between study designs. Four randomized controlled trials (RCTs), 13 non-randomized studies (NRSs) and one modelling study were included. Average financial return estimates in terms of absenteeism benefits (NRS: ROI 325%, BCR 4.25; RCT: ROI -49%, BCR 0.51), medical benefits (NRS: ROI 95%, BCR 1.95; RCT: ROI -112%, BCR -0.12) or both (NRS: ROI 387%, BCR 4.87; RCT: ROI -92%, BCR 0.08) were positive in NRSs, but negative in RCTs. Worksite health promotion programmes aimed at improving nutrition and/or increasing physical activity generate financial savings in terms of reduced absenteeism costs, medical costs or both according to NRSs, whereas they do not according to RCTs. Since these programmes are associated with additional types of benefits, conclusions about their overall profitability cannot be made. © 2011 The Authors. obesity reviews © 2011 International Association for the Study of Obesity.

Evaluation of a possible predictor for Federal Joint Committee decisions on early benefit assessments according to the German act on the reform of the market for medicinal products.

PubMed

Schwander, Björn; Banz, Kurt; Kaier, Klaus; Walzer, Stefan

2014-09-01

As of 1st January 2011 the German drug market is regulated by the act on the reform of the market for medicinal products (AMNOG). Since then the normal procedure for reimbursement of a new pharmaceutical is a benefit assessment by the joint federal committee (G-BA) which determines one of six additional benefit levels. In order to evaluate a possible predictor of G-BA decisions, the 'evaluation of pharmaceutical innovations (EVITA)' score was calculated for 40 out of 63 dossiers and compared with published G-BA appraisals. Univariate ordinary least squares (p<0.001) and ordered logit regression (p=0.008) analyses show statistically significant correlations between EVITA scores and the G-BA additional benefit levels. Moreover, for the prediction of an additional benefit level of at least 'minor', an EVITA score cutpoint of ≥3 is associated with a sensitivity of 100% and a specificity of 80%. For the prediction of an additional benefit level of at least 'considerable', an EVITA score cutpoint of ≥7.5 is associated with a sensitivity of 100% and a specificity of 93.1%. The present investigation indicates that the EVITA score may have some potential to act as a possible predictor of G-BA decisions related to AMNOG early benefit assessments. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Worth of Geophysical Data in Natural-Disaster-Insurance Rate Setting.

NASA Astrophysics Data System (ADS)

Attanasi, E. D.; Karlinger, M. R.

1982-04-01

Insurance firms that offer natural-disaster insurance base their rates on available information. The benefits from collecting additional data and incorporating this information to improve parameter estimates of probability distributions that are used to characterize natural-disaster events can be determined by computing changes in premiums as a function of additional data. Specifically, the worth of data can be measured by changes in consumer's surplus (the widely applied measure of benefits to consumers used in benefit-cost analysis) brought about when the premiums are adjusted. In this paper, a formal model of the process for setting insurance rates is hypothesized in which the insurance firm sets rates so as to trade off penalties of overestimation and underestimation of expected damages estimated from currently available hydrologic data. A Bayesian preposterior analysis is performed which permits the determination of the expected benefits of collecting additional geophysical data by examining the changes in expected premium rates as a function of the longer record before the data are actually collected. An estimate of the expected benefits associated with collecting more data for the representative consumer is computed using an assumed demand function for insurance. In addition, a sensitivity analysis of expected benefits to changes in insurance demand and firm rate-setting procedures is carried out. From these results, conclusions are drawn regarding aggregate benefits to all flood insurance purchasers.

Design of a randomized controlled trial for genomic carrier screening in healthy patients seeking preconception genetic testing.

PubMed

Kauffman, Tia L; Wilfond, Benjamin S; Jarvik, Gail P; Leo, Michael C; Lynch, Frances L; Reiss, Jacob A; Richards, C Sue; McMullen, Carmit; Nickerson, Deborah; Dorschner, Michael O; Goddard, Katrina A B

2017-02-01

Population-based carrier screening is limited to well-studied or high-impact genetic conditions for which the benefits may outweigh the associated harms and costs. As the cost of genome sequencing declines and availability increases, the balance of risks and benefits may change for a much larger number of genetic conditions, including medically actionable additional findings. We designed an RCT to evaluate genomic clinical sequencing for women and partners considering a pregnancy. All results are placed into the medical record for use by healthcare providers. Through quantitative and qualitative measures, including baseline and post result disclosure surveys, post result disclosure interviews, 1-2year follow-up interviews, and team journaling, we are obtaining data about the clinical and personal utility of genomic carrier screening in this population. Key outcomes include the number of reportable carrier and additional findings, and the comparative cost, utilization, and psychosocial impacts of usual care vs. genomic carrier screening. As the study progresses, we will compare the costs of genome sequencing and usual care as well as the cost of screening, pattern of use of genetic or mental health counseling services, number of outpatient visits, and total healthcare costs. This project includes novel investigation into human reactions and responses from would-be parents who are learning information that could both affect a future pregnancy and their own health. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Exploring participatory behaviour of disability benefit claimants from an insurance physician's perspective.

PubMed

Sjobbema, Christiaan; van der Mei, Sijrike; Cornelius, Bert; van der Klink, Jac; Brouwer, Sandra

2018-08-01

In the Dutch social security system, insurance physicians (IPs) assess participatory behaviour as part of the overall disability claim assessment. This study aims to explore the views and opinions of IPs regarding participatory behaviour as well as factors related to inadequate participatory behaviour, and to incorporate these factors in the International Classification of Functioning, Disability and Health (ICF) biopsychosocial framework. This qualitative study collected data by means of open-ended questions in 10 meetings of local peer review groups (PRGs) which included a total of 78 IPs of the Dutch Social Security Institute. In addition, a concluding discussion meeting with 8 IPs was organized. After qualitative data analyses, four major themes emerged: (1) participation as an outcome, (2) efforts of disability benefit claimants in the process of participatory behaviour, (3) beliefs of disability benefit claimants concerning participation, and (4) recovery behaviour. Identified factors of inadequate participatory behaviour covered all ICF domains, including activities, environmental, and personal factors, next to factors related to health condition and body functions or structures. Outcomes of the discussion meeting indicated the impossibility of formulating general applicable criteria for quantifying and qualifying participatory behaviour. Views of IPs on disability benefit claimants' (in)adequate participatory behaviour reflect a broad biopsychosocial perspective. IPs adopt a nuanced tailor-made approach during assessment of individual disability benefit claimants' participatory behaviour and related expected activities aimed at recovery of health and RTW. Implications for Rehabilitation Within a biopsychosocial perspective, it is not possible to formulate general criteria for the assessment of participatory behaviour for each unique case. Individual disability benefit claimant characteristics and circumstances are taken into account. To optimize the return-to-work (RTW) process, insurance physicians (IPs) assess participatory behaviour according to the International Classification of Functioning, Disability and Health, including medical, personal, and environmental factors. Some aspects within the concept of participatory behaviour extend beyond the boundaries of the domain where IPs operate because opinions in society on personal and societal responsibility influence participatory behaviour.

Medical equipment libraries: implementation, experience and user satisfaction.

PubMed

Keay, S; McCarthy, J P; Carey-Smith, B E

2015-01-01

The hospital-wide pooling and sharing of certain types of medical equipment can lead to both significant improvements in patient safety and financial advantages when compared with a department or ward-level equipment ownership system. In September 2003, a Medical Equipment Loan Service (MELS) was established, focusing initially on infusion pumps. The aims and expected benefits included; improving availability of equipment for both patients and clinical users, managing and reducing clinical risk, reducing equipment diversity, improving equipment management and reducing the overall cost of equipment provision. A user survey was carried out in 2005 and repeated in 2011. The results showed wide and continued satisfaction with the service. The process and difficulties of establishing the service and its development to include additional types of equipment are described. The benefits of managing medical equipment which is in widespread general use, through a MELS as part of a Clinical Engineering Department, are presented.

The psychological contract: enhancing productivity and its implications for long-term care.

PubMed

Flannery, Raymond B

2002-01-01

When hired, a new employee is usually given a job description and an explanation of benefits. In addition, the employee will also have a psychological contract with the organization. This contract, often unstated, reflects the main source of the employee's motivation to work hard. This is true of all groups of employees, including long-term care staff. Common examples of psychological contracts for long-term care administrative staff include autonomy, social acceptance, and being in the forefront of cutting-edge research. An awareness of these psychological contracts can result in better "fits" between employee aspirations and relevant long-term care organization tasks so that productivity is enhanced. This article outlines the steps necessary to create these good fits in ways that benefit both the organization and its employees. These recommendations are of particular relevance to administrators and supervisors in long-term carefacilities.

For two regional health foundations, returns from the Kentucky Health Issues Poll are worth the investments.

PubMed

Walsh, Sarah E; Myers, Gail; Chubinski, Jennifer; Zepeda, Susan G

2014-09-01

With finite resources to advance their missions, regional health foundations should critically evaluate the investments they make. This article reviews the costs and associated benefits of large-scale public opinion polling--specifically, the annual Kentucky Health Issues Poll, which is sponsored by the Foundation for a Healthy Kentucky and Interact for Health, formerly the Health Foundation of Greater Cincinnati. In addition to the information generated by the poll, the sponsoring foundations have benefited from increased name recognition and credibility with key stakeholders, including state policy makers and the media. Furthermore, jointly funding the poll has strengthened the relationship between the sponsoring foundations and has fostered other key collaborations. We find that the benefits from this poll more than justify its modest costs ($120,000 per year) and hope that this assessment may prove informative for other funders considering similar investments. Project HOPE—The People-to-People Health Foundation, Inc.

mtDNA ribosomal gene phylogeny of sea hares in the genus Aplysia (Gastropoda, Opisthobranchia, Anaspidea): Implications for comparative neurobiology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Medina, Monica; Collins, Timothy M.; Walsh, Patrick J.

2000-08-10

Sea hares within the genus Aplysia are important neurobiological model organisms, and as studies based on different Aplysia species appear in the literature, a phylogenetic framework has become essential. We present a phylogenetic hypothesis for this genus, based on portions of two mitochondrial genes (12S and 16S). In addition, we reconstruct the evolution of several behavioral characters of interest to neurobiologists in order to illustrate the potential benefits of a phylogeny for the genus Aplysia. These benefits include the determination of ancestral traits, the direction and timing of evolution of characters, prediction of the distribution of traits, and identification ofmore » cases of independent acquisition of traits within lineages. This last benefit may prove especially useful in understanding the linkage between behaviors and their underlying neurological basis.« less

Can research that is not intended or unlikely to be published be considered ethical?

PubMed

Barton, Christopher; Tam, Chun Wah Michael; Abbott, Penelope; Hall, Sally; Liaw, Siaw-Teng

2017-06-01

For research to be ethically acceptable, the potential benefits must justify any risks involved for participants. Dissemination of research findings through publication is one way of creating benefit, but not all researchers intend to publish their research. Other factors, such as lack of size or representativeness, generalisability or innovativeness, or negative findings mean the research is unlikely to be published in a peer-reviewed medical journal. This paper discusses ethical considerations in research where peer-reviewed publication is not intended or unlikely. Proposing research that is not intended or unlikely to be published in a peer-reviewed journal does not preclude it from being considered ethical. Additional benefits of such projects may include professional development of investigators, pilot data collection leading to more definitive studies, or developing collaborations with research users that increase relevance and improve utility of findings.

Student perceptions of writing projects in a university differential-equations course

NASA Astrophysics Data System (ADS)

Latulippe, Christine; Latulippe, Joe

2014-01-01

This qualitative study surveyed 102 differential-equations students in order to investigate how students participating in writing projects in university-level mathematics courses perceive the benefits of writing in the mathematics classroom. Based on previous literature on writing in mathematics, students were asked specifically about the benefits of writing projects as a means to explore practical uses of mathematics, deepen content knowledge, and strengthen communication. Student responses indicated an awareness of these benefits, supporting justifications commonly cited by instructors assigning writing projects. Open-ended survey responses highlighted additional themes which students associated with writing in mathematics, including using software programs and technology, working in groups, and stimulating interest in mathematics. This study provides student feedback to support the use of writing projects in mathematics, as well as student input, which can be utilized to strengthen the impact of writing projects in mathematics.

Annual incremental health benefit costs and absenteeism among employees with and without rheumatoid arthritis.

PubMed

Kleinman, Nathan L; Cifaldi, Mary A; Smeeding, James E; Shaw, James W; Brook, Richard A

2013-03-01

To assess the impact of rheumatoid arthritis (RA) on absence time, absence payments, and other health benefit costs from the perspective of US employers. Retrospective regression-controlled analysis of a database containing US employees' administrative health care and payroll data for those who were enrolled for at least 1 year in an employer-sponsored health insurance plan. Employees with RA (N = 2705) had $4687 greater average annual medical and prescription drug costs (P < 0.0001) and $525 greater (P < 0.05) indirect costs (because of sick leave, short- and long-term disability, and workers' compensation absences) than controls (N = 338,035). Compared with controls, the employees with RA used an additional 3.58 annual absence days, including 1.2 more sick leave and 1.91 more short-term disability days (both P < 0.0001). Employees with RA have greater costs across all benefits than employees without RA.

Natural antioxidants as food and feed additives to promote health benefits and quality of meat products: A review.

PubMed

Jiang, Jiang; Xiong, Youling L

2016-10-01

Fresh and processed meats offer numerous nutritional and health benefits and provide unique eating satisfaction in the lifestyle of the modern society. However, consumption of red meat including processed products is subjected to increasing scrutiny due to the health risks associated with cytotoxins that potentially could be generated during meat preparation. Evidence from recent studies suggests free radical pathways as a plausible mechanism for toxin formation, and antioxidants have shown promise to mitigate process-generated chemical hazards. The present review discusses the involvements of lipid and protein oxidation in meat quality, nutrition, safety, and organoleptic properties; animal production and meat processing strategies which incorporate natural antioxidants to enhance the nutritional and health benefits of meat; and the application of mixed or purified natural antioxidants to eliminate or minimize the formation of carcinogens for chemical safety of cooked and processed meats. Copyright © 2016. Published by Elsevier Ltd.

Framing medical tourism: an examination of appeal, risk, convalescence, accreditation, and interactivity in medical tourism web sites.

PubMed

Mason, Alicia; Wright, Kevin B

2011-02-01

This exploratory study analyzed the content of medical tourism Web sites in an attempt to examine how they convey information about benefits and risks of medical procedures, how they frame credibility, and the degree to which these Web sites include interactive features for consumers. Drawing upon framing theory, the researchers content analyzed a sample of 66 medical tourism Web sites throughout the world. The results indicated that medical tourism Web sites largely promote the benefits of medical procedures while downplaying the risks, and relatively little information regarding the credibility of these services appears. In addition, the presentation of benefits/risks, credibility, and Web site interactivity were found to differ by region and type of facility. The authors discuss the implications of these findings concerning the framing of medical tourism Web site content, future directions for research, and limitations.

Respiratory infections and pneumonia: potential benefits of switching from smoking to vaping.

PubMed

Campagna, Davide; Amaradio, Maria Domenica; Sands, Mark F; Polosa, Riccardo

2016-01-01

Abstaining from tobacco smoking is likely to lower the risk of respiratory infections and pneumonia. Unfortunately, quitting smoking is not easy. Electronic cigarettes (ECs) are emerging as an attractive long-term alternative nicotine source to conventional cigarettes and are being adopted by smokers who wish to reduce or quit cigarette consumption. Also, given that the propylene glycol in EC aerosols is a potent bactericidal agent, switching from smoking to regular vaping is likely to produce additional lung health benefits. Here, we critically address some of the concerns arising from regular EC use in relation to lung health, including respiratory infections and pneumonia. In conclusion, smokers who quit by switching to regular ECs use can reduce risk and reverse harm from tobacco smoking. Innovation in the e-vapour category is likely not only to further minimise residual health risks, but also to maximise health benefits.

Job sharing for women pharmacists in academia.

PubMed

Rogers, Kelly C; Finks, Shannon W

2009-11-12

The pharmacist shortage, increasing numbers of female pharmacy graduates, more pharmacy schools requiring faculty members, and a lower percentage of female faculty in academia are reasons to develop unique arrangements for female academic pharmacists who wish to work part-time. Job sharing is an example of a flexible alternative work arrangement that can be successful for academic pharmacists who wish to continue in a part-time capacity. Such partnerships have worked for other professionals but have not been widely adopted in pharmacy academia. Job sharing can benefit the employer through retention of experienced employees who collectively offer a wider range of skills than a single employee. Benefits to the employee include balanced work and family lives with the ability to maintain their knowledge and skills by remaining in the workforce. We discuss the additional benefits of job-sharing as well as our experience in a non-tenure track job-sharing position at the University of Tennessee College of Pharmacy.

State of the art in benefit-risk analysis: economics and marketing-finance.

PubMed

Kalogeras, N; Odekerken-Schröder, G; Pennings, J M E; Gunnlaugsdóttir, H; Holm, F; Leino, O; Luteijn, J M; Magnússon, S H; Pohjola, M V; Tijhuis, M J; Tuomisto, J T; Ueland, Ø; White, B C; Verhagen, H

2012-01-01

All market participants (e.g., investors, producers, consumers) accept a certain level of risk as necessary to achieve certain benefits. There are many types of risk including price, production, financial, institutional, and individual human risks. All these risks should be effectively managed in order to derive the utmost of benefits and avoid disruption and/or catastrophic economic consequences for the food industry. The identification, analysis, determination, and understanding of the benefit-risk trade-offs of market participants in the food markets may help policy makers, financial analysts and marketers to make well-informed and effective corporate investment strategies in order to deal with highly uncertain and risky situations. In this paper, we discuss the role that benefits and risks play in the formation of the decision-making process of market-participants, who are engaged in the upstream and downstream stages of the food supply chain. In addition, we review the most common approaches (expected utility model and psychometrics) for measuring benefit-risk trade-offs in the economics and marketing-finance literature, and different factors that may affect the economic behaviour in the light of benefit-risk analyses. Building on the findings of our review, we introduce a conceptual framework to study the benefit-risk behaviour of market participants. Specifically, we suggest the decoupling of benefits and risks into the separate components of utilitarian benefits, hedonic benefits, and risk attitude and risk perception, respectively. Predicting and explaining how market participants in the food industry form their overall attitude in light of benefit-risk trade-offs may be critical for policy-makers and managers who need to understand the drivers of the economic behaviour of market participants with respect to production, marketing and consumption of food products. Copyright © 2011 Elsevier Ltd. All rights reserved.

Volunteer motivators for participating in HIV vaccine clinical trials in Nairobi, Kenya

PubMed Central

Mutua, Gaudensia N.; Sajabi, Rose; Nyasani, Delvin; Mureithi, Marianne W.; Anzala, Omu A.

2017-01-01

Background 1.5 million Kenyans are living with HIV/AIDS as per 2015 estimates. Though there is a notable decline in new HIV infections, continued effort is still needed to develop an efficacious, accessible and affordable HIV vaccine. HIV vaccine clinical trials bear risks, hence a need to understand volunteer motivators for enrolment, retention and follow-up. Understanding the factors that motivate volunteers to participate in a clinical trial can help to strategize, refine targeting and thus increase enrolment of volunteers in future HIV vaccine clinical trials. The health belief model classifies motivators into social benefits such as ‘advancing research’ and collaboration with science, and personal benefits such as health benefits and financial interests. Method A thematic analysis was carried out on data obtained from four HIV clinical trials conducted at KAVI-Institute of Clinical Research in Nairobi Kenya from 2009 to 2015. Responses were obtained from a Questionnaire administered to the volunteers during their screening visit at the research site. Results Of the 281 healthy, HIV-uninfected volunteers participating in this study; 38% were motivated by personal benefits including, 31% motivated by health benefits and 7% motivated by possible financial gains. In addition, 62% of the volunteers were motivated by social benefits with 20% of who were seeking to help their family/society/world while 42% were interested in advancing research. Conclusion The majority of volunteers in the HIV vaccine trials at our site were motivated by social benefits, suggesting that altruism can be a major contributor to participation in HIV vaccine studies. Personal benefits were a secondary motivator for the volunteers. The motivators to volunteer in HIV clinical trials were similar across ages, education level and gender. Education on what is needed (including volunteer participation) to develop an efficacious vaccine could be the key to greater volunteer motivation to participate in HIV vaccine clinical trials. PMID:28880880

Volunteer motivators for participating in HIV vaccine clinical trials in Nairobi, Kenya.

PubMed

Nyaoke, Borna A; Mutua, Gaudensia N; Sajabi, Rose; Nyasani, Delvin; Mureithi, Marianne W; Anzala, Omu A

2017-01-01

1.5 million Kenyans are living with HIV/AIDS as per 2015 estimates. Though there is a notable decline in new HIV infections, continued effort is still needed to develop an efficacious, accessible and affordable HIV vaccine. HIV vaccine clinical trials bear risks, hence a need to understand volunteer motivators for enrolment, retention and follow-up. Understanding the factors that motivate volunteers to participate in a clinical trial can help to strategize, refine targeting and thus increase enrolment of volunteers in future HIV vaccine clinical trials. The health belief model classifies motivators into social benefits such as 'advancing research' and collaboration with science, and personal benefits such as health benefits and financial interests. A thematic analysis was carried out on data obtained from four HIV clinical trials conducted at KAVI-Institute of Clinical Research in Nairobi Kenya from 2009 to 2015. Responses were obtained from a Questionnaire administered to the volunteers during their screening visit at the research site. Of the 281 healthy, HIV-uninfected volunteers participating in this study; 38% were motivated by personal benefits including, 31% motivated by health benefits and 7% motivated by possible financial gains. In addition, 62% of the volunteers were motivated by social benefits with 20% of who were seeking to help their family/society/world while 42% were interested in advancing research. The majority of volunteers in the HIV vaccine trials at our site were motivated by social benefits, suggesting that altruism can be a major contributor to participation in HIV vaccine studies. Personal benefits were a secondary motivator for the volunteers. The motivators to volunteer in HIV clinical trials were similar across ages, education level and gender. Education on what is needed (including volunteer participation) to develop an efficacious vaccine could be the key to greater volunteer motivation to participate in HIV vaccine clinical trials.

Examination of the Open Market Corridor

DTIC Science & Technology

2003-12-01

105 D. BENEFITS OF THE PURCHASE CARD PROGRAM ..........................107 1. List of Benefits ...107 2. Additional Benefits and How OMC Can Increase the Benefits ...107 E. WEAKNESSES OF...software licenses and support services. Estimated life-cycle costs for FY 1995 through FY 2005 are $3.7 billion. Operational benefits from SPS are

42 CFR 61.37 - Stipends, allowances, and benefits.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Stipends, allowances, and benefits. 61.37 Section..., INTERNSHIPS, TRAINING FELLOWSHIPS Service Fellowships § 61.37 Stipends, allowances, and benefits. (a) Stipends... employees of the Public Health Service. (c) Benefits. In addition to other benefits provided herein, service...

Latest Developments in Probiotics

NASA Astrophysics Data System (ADS)

Leroy, Frédéric; Falony, Gwen; Vuyst, Luc De

Probiotic foods are a group of health-promoting, so-called functional foods, with large commercial interest and growing market shares (Arvanitoyannis & van Houwelingen-Koukaliaroglou, 2005). In general, their health benefits are based on the presence of selected strains of lactic acid bacteria (LAB), that, when taken up in adequate amounts, confer a health benefit on the host. They are administered mostly through the consumption of fermented milks or yoghurts (Mercenier, Pavan, & Pot, 2003). In addition to their common use in the dairy industry, probiotic LAB strains may be used in other food products too, including fermented meats (Hammes & Hertel, 1998; Incze, 1998; Kröckel, 2006; Työppönen, Petäjä,& Mattila- Sandholm, 2003).

Incremental benefit of three-dimensional transesophageal echocardiography in the assessment of left main coronary artery stent protrusion.

PubMed

Arisha, Mohammed J; Hsiung, Ming C; Ahmad, Amier; Nanda, Navin C; Elkaryoni, Ahmed; Mohamed, Ahmed H; Yin, Wei-Hsian

2017-06-01

Ostial lesions represent a challenging clinical scenario and percutaneous intervention (PCI) of left main coronary artery ostial lesions has been associated with postintervention complications, including protrusion of deployed stents into a sinus of Valsalva or aortic root. We report a case of stent protrusion into the aortic root following aorto-ostial left main coronary artery PCI, in which three-dimensional transesophageal echocardiography (3DTEE) provided incremental benefit over standard two-dimensional images. Specifically, 3DTEE confirmed the presence of stent protrusion by allowing clear visualization of the stent scaffold, in addition to characterizing the relationship between the stent and surrounding structures. © 2017, Wiley Periodicals, Inc.

Cleveland Space Odyssey

NASA Technical Reports Server (NTRS)

1980-01-01

The symposium included personal appearances by NASA astronauts, NASA exhibits, aerospace science lecture demonstrations (Spacemobile Lectures), souvenir photos for each student attending the symposium, and talks on job opportunities in aerospace and on the benefits of the Space Program. The program was directed mainly at (public, parochial and private) student groups, each of which spend three hours on the CCC campus to participate in the symposium activities. The symposium was open to the general public and consisted of the NASA exhibits, aerospace science lecture demonstrations, films, talks on the benefits of the space program, additional lectures by members of the American Institute of Aeronautics and Astronautics (AIAA), and a special tasting demonstration of space food meal systems.

Prevention Interventions of Alcohol Problems in the Workplace

PubMed Central

Ames, Genevieve M.; Bennett, Joel B.

2011-01-01

The workplace offers advantages as a setting for interventions that result in primary prevention of alcohol abuse. Such programs have the potential to reach broad audiences and populations that would otherwise not receive prevention programs and, thereby, benefit both the employee and employer. Researchers have implemented and evaluated a variety of workplace alcohol problem prevention efforts in recent years, including programs focused on health promotion, social health promotion, brief interventions, and changing the work environment. Although some studies reported significant reductions in alcohol use outcomes, additional research with a stronger and integrated methodological approach is needed. The field of workplace alcohol prevention also might benefit from a guiding framework, such as the one proposed in this article. PMID:22330216

Quantitative benefit-harm assessment for setting research priorities: the example of roflumilast for patients with COPD.

PubMed

Puhan, Milo A; Yu, Tsung; Boyd, Cynthia M; Ter Riet, Gerben

2015-07-02

When faced with uncertainties about the effects of medical interventions regulatory agencies, guideline developers, clinicians, and researchers commonly ask for more research, and in particular for more randomized trials. The conduct of additional randomized trials is, however, sometimes not the most efficient way to reduce uncertainty. Instead, approaches such as value of information analysis or other approaches should be used to prioritize research that will most likely reduce uncertainty and inform decisions. In situations where additional research for specific interventions needs to be prioritized, we propose the use of quantitative benefit-harm assessments that illustrate how the benefit-harm balance may change as a consequence of additional research. The example of roflumilast for patients with chronic obstructive pulmonary disease shows that additional research on patient preferences (e.g., how important are exacerbations relative to psychiatric harms?) or outcome risks (e.g., what is the incidence of psychiatric outcomes in patients with chronic obstructive pulmonary disease without treatment?) is sometimes more valuable than additional randomized trials. We propose that quantitative benefit-harm assessments have the potential to explore the impact of additional research and to identify research priorities Our approach may be seen as another type of value of information analysis and as a useful approach to stimulate specific new research that has the potential to change current estimates of the benefit-harm balance and decision making.

Amendments to Summary Plan Description regulations. Pension and Welfare Benefits Administration, Labor. Final rule.

PubMed

2000-11-21

This document contains a final rule amending the regulations governing the content of the Summary Plan Description (SPD) required to be furnished to employee benefit plan participants and beneficiaries under the Employee Retirement Income Security Act of 1974, as amended (ERISA). These amendments implement information disclosure recommendations of the President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry, as set forth in their November 20, 1997, report, "Consumer Bill of Rights and Responsibilities." Specifically, the amendments clarify benefit, medical provider, and other information required to be disclosed in, or as part of, the SPD of a group health plan and repeal the limited exemption with respect to SPDs of welfare plans providing benefits through qualified health maintenance organizations (HMOs). In addition, this document contains several amendments updating and clarifying provisions relating to the content of SPDs that affect both pension and welfare benefit plans. This document also adopts in final form certain regulations that were effective on an interim basis implementing amendments to ERISA enacted as part of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). This final rule will affect employee pension and welfare benefit plans, including group health plans, as well as administrators, fiduciaries, participants and beneficiaries of such plans.

Which Benefits Are Mentioned Most Often in Drug Development Publications?

PubMed

Strüver, Vanessa

2017-01-01

The aim was to identify theoretically expected as well as actually reported benefits from drug development and the importance of individual patient benefits compared to the collective benefits to society in general. Ethical guidelines require that clinical research involving humans offer the potential for benefit. A number of characteristics can be applied to define research benefit. Often benefit is categorized as being either direct or indirect. Indirect benefits can involve collective benefits for society rather than any benefits to the trial patient or subject. The purpose of this review was to examine which potential individual and societal benefits were mentioned as being expected in publications from government experts and which were mentioned in publications describing completed drug development trial results. Literature on research benefit was first identified by searching the PubMed database using several combinations of the key words benefit and clinical research . The search was limited to articles published in English. A Google search with the same combinations of key words but without any language limitation was then performed. Additionally, the reference lists of promising articles were screened for further thematically related articles. Finally, a narrative review was performed of relevant English- and German-language articles published between 1996 and 2016 to identify which of several potential benefits were either theoretically expected or which were mentioned in publications on clinical drug development trial results. The principal benefits from drug development discussed included 2 main types of benefit, namely individual benefits for the patients and collective benefits for society. Twenty-one of an overall total of 26 articles discussing theoretically expected benefits focused on individual patient benefits, whereas 17 out of 26 articles mentioned collective benefits to society. In these publications, the most commonly mentioned theoretically expected individual patient benefit was the chance to receive up-to-date care (38.1%). A general increase in knowledge about health care, treatments, or drugs (70.6%) was the most commonly mentioned theoretically expected benefit for society. In contrast, all 13 publications reporting actual benefits of clinical drug development trials focused on personal benefits and only 1 of these publications also mentioned a societal benefit. The most commonly mentioned individual benefit was an increased quality of life (53.9%), whereas the only mentioned collective benefit to society was a general gain of knowledge (100.0%). Both theoretically expected and actually reported benefits in the majority of the included publications emphasized the importance of individual patient benefits from drug development rather than the collective benefits to society in general. The authors of these publications emphasized the right of each individual patient or subject to look for and expect some personal benefit from participating in a clinical trial rather than considering societal benefit as a top priority. From an ethical point of view, the benefits each individual patient receives from his or her participation in a clinical trial might also be seen as a societal benefit, especially when the drug or device tested, if approved for marketing, would eventually be made available for other similar patients from the country in which the clinical trial was conducted.

Incentive Early Retirement Programs for Faculty: Innovative Responses to a Changing Environment. ASHE-ERIC Higher Education Report No. 1, 1987.

ERIC Educational Resources Information Center

Chronister, Jay L.; Kepple, Thomas R., Jr.

The literature on incentive early retirement for faculty members is reviewed, including the findings of studies that have assessed the effectiveness of such programs. In addition to describing different types of programs and the incentives offered, attention is directed to legal issues, costs and benefits, assessing whether a program is feasible,…

Moving Target Techniques: Leveraging Uncertainty for CyberDefense

DTIC Science & Technology

2015-12-15

cyberattacks is a continual struggle for system managers. Attackers often need only find one vulnerability (a flaw or bug that an attacker can exploit...additional parsing code itself could have security-relevant software bugs . Dynamic  Network   Techniques in the dynamic network domain change the...evaluation of MT techniques can benefit from a variety of evaluation approaches, including abstract analysis, modeling and simulation, test bed

Systems and Methods for Composable Analytics

DTIC Science & Technology

2014-04-29

simplistic module that performs a mathematical operation on two numbers. The most important method is the Execute() method. This will get called when it is...addition, an input control is also specified in the example below. In this example, the mathematical operator can only be chosen from a preconfigured...approaches. Some of the industries that could benefit from Composable Analytics include pharmaceuticals, health care, insurance, actuaries , and

Using Animal Assisted Therapy with Students with Autism Spectrum Disorder in the Art Room Setting

ERIC Educational Resources Information Center

Rosenburg, Karen L.

2016-01-01

This case study focused on the addition of a therapy dog in an Art I level class at a public high school level that included students with Autism Spectrum Disorder. The purpose of this study is to determine how Animal Assisted Therapy may benefit autism support students in the art classroom. The students participated in lessons that focused on…

Comprehension of hazard communication: effects of pictograms on safety data sheets and labels.

PubMed

Boelhouwer, Eric; Davis, Jerry; Franco-Watkins, Ana; Dorris, Nathan; Lungu, Claudiu

2013-09-01

The United Nations has proposed the Globally Harmonized System (GHS) of Classification and Labelling of Chemicals to make hazard communication more uniform and to improve comprehension. Two experiments were conducted to test whether the addition of hazard and precautionary pictograms to safety data sheets and product labels would improve the transfer of information to users compared to safety data sheets and product labels containing text only. Additionally, naïve users, workers, and experts were tested to determine any potential differences among users. The effect of adding pictograms to safety data sheets and labels was statistically significant for some conditions, but was not significant across all conditions. One benefit of the addition of pictograms was that the time to respond to the survey questions decreased when the pictograms were present for both the SDS and the labels. GHS format SDS and labels do provide benefits to users, but the system will need further enhancements and modifications to continue to improve the effectiveness of hazard communication. The final rule to modify the HCS to include the Globally Harmonized System (GHS) for the Classification and Labelling of Chemicals announced by OSHA (2012b) will change the information content of every chemical SDS and label used in commerce. This study suggests that the inclusion of GHS hazard pictograms and precautionary pictograms to SDS and labels may benefit the user. Copyright © 2013 National Safety Council and Elsevier Ltd. All rights reserved.

Human Activity Dampens the Benefits of Group Size on Vigilance in Khulan (Equus hemionus) in Western China.

PubMed

Wang, Mu-Yang; Ruckstuhl, Kathreen E; Xu, Wen-Xuan; Blank, David; Yang, Wei-Kang

2016-01-01

Animals receive anti-predator benefits from social behavior. As part of a group, individuals spend less time being vigilant, and vigilance decreases with increasing group size. This phenomenon, called "the many-eyes effect", together with the "encounter dilution effect", is considered among the most important factors determining individual vigilance behavior. However, in addition to group size, other social and environmental factors also influence the degree of vigilance, including disturbance from human activities. In our study, we examined vigilance behavior of Khulans (Equus hemionus) in the Xinjiang Province in western China to test whether and how human disturbance and group size affect vigilance. According to our results, Khulan showed a negative correlation between group size and the percentage time spent vigilant, although this negative correlation depended on the groups' disturbance level. Khulan in the more disturbed area had a dampened benefit from increases in group size, compared to those in the undisturbed core areas. Provision of continuous areas of high-quality habitat for Khulans will allow them to form larger undisturbed aggregations and to gain foraging benefits through reduced individual vigilance, as well as anti-predator benefits through increased probability of predator detection.

Human Activity Dampens the Benefits of Group Size on Vigilance in Khulan (Equus hemionus) in Western China

PubMed Central

Wang, Mu-Yang; Ruckstuhl, Kathreen E.; Xu, Wen-Xuan; Blank, David; Yang, Wei-Kang

2016-01-01

Animals receive anti-predator benefits from social behavior. As part of a group, individuals spend less time being vigilant, and vigilance decreases with increasing group size. This phenomenon, called “the many-eyes effect”, together with the “encounter dilution effect”, is considered among the most important factors determining individual vigilance behavior. However, in addition to group size, other social and environmental factors also influence the degree of vigilance, including disturbance from human activities. In our study, we examined vigilance behavior of Khulans (Equus hemionus) in the Xinjiang Province in western China to test whether and how human disturbance and group size affect vigilance. According to our results, Khulan showed a negative correlation between group size and the percentage time spent vigilant, although this negative correlation depended on the groups’ disturbance level. Khulan in the more disturbed area had a dampened benefit from increases in group size, compared to those in the undisturbed core areas. Provision of continuous areas of high-quality habitat for Khulans will allow them to form larger undisturbed aggregations and to gain foraging benefits through reduced individual vigilance, as well as anti-predator benefits through increased probability of predator detection. PMID:26756993

20 CFR 609.23 - Furnishing additional information.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Furnishing additional information. 609.23 Section 609.23 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR UNEMPLOYMENT COMPENSATION FOR FEDERAL CIVILIAN EMPLOYEES Responsibilities of Federal Agencies § 609.23...

Management of the Regional Lymph Nodes Following Breast-Conservation Therapy for Early-Stage Breast Cancer: An Evolving Paradigm

DOE Office of Scientific and Technical Information (OSTI.GOV)

Warren, Laura E.G.; Punglia, Rinaa S.; Wong, Julia S.

2014-11-15

Radiation therapy to the breast following breast conservation surgery has been the standard of care since randomized trials demonstrated equivalent survival compared to mastectomy and improved local control and survival compared to breast conservation surgery alone. Recent controversies regarding adjuvant radiation therapy have included the potential role of additional radiation to the regional lymph nodes. This review summarizes the evolution of regional nodal management focusing on 2 topics: first, the changing paradigm with regard to surgical evaluation of the axilla; second, the role for regional lymph node irradiation and optimal design of treatment fields. Contemporary data reaffirm prior studies showingmore » that complete axillary dissection may not provide additional benefit relative to sentinel lymph node biopsy in select patient populations. Preliminary data also suggest that directed nodal radiation therapy to the supraclavicular and internal mammary lymph nodes may prove beneficial; publication of several studies are awaited to confirm these results and to help define subgroups with the greatest likelihood of benefit.« less

Executive summary: the health and fitness benefits of regular participation in small-sided football games.

PubMed

Krustrup, P; Dvorak, J; Junge, A; Bangsbo, J

2010-04-01

The present special issue of Scandinavian Journal of Medicine & Science in Sports deals with health and fitness benefits of regular participation in small-sided football games. One review article and 13 original articles were the result of a 2-year multi-center study in Copenhagen and Zurich and include studies of different age groups analyzed from a physiological, medical, social and psychological perspective. The main groups investigated were middle-aged, former untrained, healthy men and women who were followed for up to 16 months. In addition, elderly, children and hypertensive patients were studied. A summary and interpretations of the main findings divided into an analysis of the physical demands during training of various groups and the effect of a period of training on performance, muscle adaptations and health profile follow. In addition, social and psychological effects on participation in recreational football are considered, the comparison of football training and endurance running is summarized and the effects of football practice on the elderly and children and youngsters are presented.

Closing the gap between knowledge and clinical application: challenges for genomic translation.

PubMed

Burke, Wylie; Korngiebel, Diane M

2015-01-01

Despite early predictions and rapid progress in research, the introduction of personal genomics into clinical practice has been slow. Several factors contribute to this translational gap between knowledge and clinical application. The evidence available to support genetic test use is often limited, and implementation of new testing programs can be challenging. In addition, the heterogeneity of genomic risk information points to the need for strategies to select and deliver the information most appropriate for particular clinical needs. Accomplishing these tasks also requires recognition that some expectations for personal genomics are unrealistic, notably expectations concerning the clinical utility of genomic risk assessment for common complex diseases. Efforts are needed to improve the body of evidence addressing clinical outcomes for genomics, apply implementation science to personal genomics, and develop realistic goals for genomic risk assessment. In addition, translational research should emphasize the broader benefits of genomic knowledge, including applications of genomic research that provide clinical benefit outside the context of personal genomic risk.

Are Soy Products Effective in DMD?

PubMed

Marston, Gemma; Winder, Steve J

2018-03-27

In addition to their nutritional value, processed soy bean extracts contain several activities with potential therapeutic benefits. These include anti-oxidants, and tyrosine kinase and protease inhibitory activity. There are also anecdotal reports of health benefits of soy products in alleviating DMD symptoms. Mdx mice were fed a control soy-free diet or the same diet containing either a proprietary soy preparation (Haelan 951), purified soy isoflavones, purified Bowman-Birk protease inhibitor or a combination of isoflavones and Bowman-Birk inhibitor. Mice were tested for their wire hanging ability at the start of the diet regimen and every 4 weeks until week 12 of treatment. The diet containing Bowman-Birk inhibitor was the only one to show a significant and sustained improvement over the 12 weeks of the study. All other dietary additions; Haelan 951, isoflavones and isoflavones with Bowman-Birk inhibitor, were not significantly different from each other or from control. The effectiveness of Bowman-Birk inhibitor in mdx mice clearly warrants further study.

The benefits of steroids versus steroids plus antivirals for treatment of Bell's palsy: a meta-analysis.

PubMed

Quant, Eudocia C; Jeste, Shafali S; Muni, Rajeev H; Cape, Alison V; Bhussar, Manveen K; Peleg, Anton Y

2009-09-07

To determine whether steroids plus antivirals provide a better degree of facial muscle recovery in patients with Bell's palsy than steroids alone. Meta-analysis. PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials were searched for studies published in all languages from 1984 to January 2009. Additional studies were identified from cited references. Selection criteria Randomised controlled trials that compared steroids with the combination of steroids and antivirals for the treatment of Bell's palsy were included in this study. At least one month of follow-up and a primary end point of at least partial facial muscle recovery, as defined by a House-Brackmann grade of at least 2 (complete palsy is designated a grade of 6) or an equivalent score on an alternative recognised scoring system, were required. Review methods Two authors independently reviewed studies for methodological quality, treatment regimens, duration of symptoms before treatment, length of follow-up, and outcomes. Odds ratios with 95% confidence intervals were calculated and pooled using a random effects model. Six trials were included, a total of 1145 patients; 574 patients received steroids alone and 571 patients received steroids and antivirals. The pooled odds ratio for facial muscle recovery showed no benefit of steroids plus antivirals compared with steroids alone (odds ratio 1.50, 95% confidence interval 0.83 to 2.69; P=0.18). A one study removed analysis showed that the highest quality studies had the greatest effect on the lack of difference between study arms shown by the odds ratio. Subgroup analyses assessing causes of heterogeneity defined a priori (time from symptom onset to treatment, length of follow-up, and type of antiviral studied) showed no benefit of antivirals in addition to that provided by steroids. Antivirals did not provide an added benefit in achieving at least partial facial muscle recovery compared with steroids alone in patients with Bell's palsy. This study does not, therefore, support the routine use of antivirals in Bell's palsy. Future studies should use improved herpes virus diagnostics and newer antivirals to assess whether combination therapy benefits patients with more severe facial paralysis at study entry.

Pomegranate extract and exercise provide additive benefits on improvement of immune function by inhibiting inflammation and oxidative stress in high-fat-diet-induced obesity in rats.

PubMed

Zhao, Fei; Pang, Wentao; Zhang, Ziyi; Zhao, Jialong; Wang, Xin; Liu, Ye; Wang, Xun; Feng, Zhihui; Zhang, Yong; Sun, Wenyan; Liu, Jiankang

2016-06-01

Obesity is reported to be associated with immune dysfunction and a state of low-grade, chronic inflammation. Either pomegranate extract (PomE) or exercise (Ex) has been shown to have antiobesity, anti-inflammatory and antioxidant effects. Nevertheless, no study has addressed the additive benefits of PomE and Ex on the restoration of obesity-induced immune defects. The present work aims to study the effect of PomE and Ex as a combined intervention on immune function and the underlying mechanism involved in inflammation and oxidative stress in rats with high-fat-diet (HFD)-induced obesity. Our results demonstrate that the combination of PomE and Ex showed additive benefits on inhibition of HFD-induced body weight increase and improvement of HFD-induced immune dysfunction, including (a) attenuating the abnormality of histomorphology of the spleen, (b) increasing the ratio of the CD4+:CD8+ T cell subpopulations in splenocytes and peripheral blood mononuclear cells (PBMC), (c) inhibition of apoptosis in splenocytes and PBMC, (d) normalizing peritoneal macrophage phenotypes and (e) restoring immunomodulating factors in serum. We also find that immune dysfunction in HFD-fed rats was associated with increased inflammatory cytokine secretion and oxidative stress biomarkers, and that the combination of PomE and Ex effectively inhibited the inflammatory response and decreased oxidative damage. The effect of PomE and Ex as a combined intervention is greater than the effect of either PomE or Ex alone, showing that PomE and Ex may be additively effective in improving immune function in HFD-fed rats by inhibiting inflammation and decreasing oxidative stress. Copyright © 2016 Elsevier Inc. All rights reserved.

Improved sensitivity high-definition interline CCD using the KODAK TRUESENSE color filter pattern

NASA Astrophysics Data System (ADS)

DiBella, James; Andreghetti, Marco; Enge, Amy; Chen, William; Stanka, Timothy; Kaser, Robert

2010-01-01

The KODAK TRUESENSE Color Filter Pattern has technology that for the first time is applied to a commercially available interline CCD. This 2/3" true-HD sensor will be described along with its performance attributes, including sensitivity improvement as compared to the Bayer CFA version of the same sensor. In addition, an overview of the system developed for demonstration and evaluation will be provided. Examples of the benefits of the new technology in specific applications including surveillance and intelligent traffic systems will be discussed.

Federal Financial Interventions and Subsidies in Energy Markets 1999: Primary Energy

EIA Publications

1999-01-01

The analysis in this report was undertaken at the request of the Office of Policy, U.S. Department of Energy. In its request, the Office of Policy asked the Energy Information Administration (EIA) to update the 1992 EIA report on Federal energy subsidies, including any additions or deletions of Federal subsidies based on Administration and Congressional action since the 1992 report was written, and to provide an estimate of the size of each current subsidy. Subsidies to be included are those through which a government or public body provides a financial benefit.

Activity of Imipenem with Relebactam against Gram-Negative Pathogens from New York City

PubMed Central

Lapuebla, Amabel; Abdallah, Marie; Olafisoye, Olawole; Cortes, Christopher; Urban, Carl; Landman, David

2015-01-01

Imipenem with relebactam was active against Escherichia coli, Klebsiella pneumoniae, and Enterobacter spp., including K. pneumoniae carbapenemase (KPC)-producing isolates. Loss of OmpK36 in KPC-producing K. pneumoniae isolates affected the susceptibility of this combination. Enhanced activity was evident against Pseudomonas aeruginosa, including isolates with depressed oprD and increased ampC expression. However, the addition of relebactam to imipenem did not provide added benefit against Acinetobacter baumannii. The combination of imipenem with relebactam demonstrated activity against KPC-producing Enterobacteriaceae and multidrug-resistant P. aeruginosa. PMID:26014931

Screening esophagus during routine ultrasound: medical and cost benefits.

PubMed

Abd Elrazek, Abd Elrazek M A; Eid, Khaled A; El-Sherif, Abd Elhalim A; Abd El Al, Usama M; El-Sherbiny, Samir M; Bilasy, Shymaa E

2015-01-01

Cost-effectiveness analysis is an approach used to determine the value of a medical care option and refers to a method used to assess the costs and health benefits of an intervention. Upon the diagnosis of liver cirrhosis, the current guidelines recommend that all cirrhotic patients have to be screened for the presence of esophageal varices by endoscopy. In addition, patients with a positive family history of esophageal cancer are screened annually. These approaches place a heavy burden on endoscopy units, and repeated testing over time may have a detrimental effect on patient compliance. Following the recommendations of a recent study entitled 'Detection of risky esophageal varices using two dimensional ultrasound: when to perform endoscopy', the intra-abdominal portion of the esophagus of 1100 patients was divided into a hepatic group, which included 650 patients, and a nonhepatic group, which included 450 patients, who presented with manifestations of liver diseases and gastrointestinal symptoms, respectively, and were examined using standard two-dimensional ultrasound (US) to evaluate cost effectiveness, standard issues, and medical benefits using conventional US. The overall effectiveness analysis of 1100 patients yielded a 41% cost standard benefit calculated to be $114,760 in a 6-month study. Two-dimensional US can play an important role in screening for esophageal abnormalities, thus saving money and time. The esophagus should be screened during routine conventional abdominal US.

The Advantages of Parental Involvement in Cognitive-Behavioral Treatment of Childhood Obsessive-Compulsive Disorder: A Single-Case Example.

PubMed

Oldham-Cooper, Rose; Glasman, David; Loades, Maria

2016-04-01

Interventions for the treatment of anxiety disorders in children have a growing evidence base. Cognitive-behavioral therapy for the treatment of specific anxiety disorders in children and adolescents, including obsessive-compulsive disorder, is now an established intervention. However, a question remains concerning the benefits of parental involvement in treatment. Some studies report limited or no benefit of including parents in treatment, whereas other studies have indicated additional advantages of parental involvement. The present case report describes the treatment of an 11-year-old girl with obsessive-compulsive disorder using cognitive-behavioral therapy derived largely from the treatment approaches outlined in Carr (2006), March and Mulle (1998), and Derisley, Heyman, Robinson, and Turner (2008). The child's mother attended all sessions and also a one-off parent-only session toward the end of treatment. The report considers the benefits of involving the child's mother in treatment and possible factors that could suggest parental involvement is indicated in future cases. Both child and mother, and the therapist, believed that parental involvement had been an important and useful element of treatment. Possible reasons for benefits of parental involvement were considered to be high parental anxiety at the outset of treatment, age of the client, and involvement of the parent in obsessions and compulsions. © 2016 Wiley Periodicals, Inc.

A net-centric system of services model for the Integrated Earth Observation System (IEOS) and the Integrated Ocean Observing System (IOOS)

NASA Astrophysics Data System (ADS)

Ardanuy, Philip; Bensman, Ed; Bergen, Bill; Chen, Bob; Griffith, Frank; Sutton, Cary; Hood, Carroll; Ritchie, Adrian; Tarro, Andre

2006-08-01

This paper considers an evolved technique for significantly enhanced enterprise-level data processing, reprocessing, archival, dissemination, and utilization. There is today a robust working paradigm established with the Advanced Weather Interactive Processing System (AWIPS)-NOAA/NWS's information integration and fusion capability. This process model extends vertically, and seamlessly, from environmental sensing through the direct delivery of societal benefit. NWS, via AWIPS, is the primary source of weather forecast and warning information in the nation. AWIPS is the tested and proven "the nerve center of operations" at all 122 NWS Weather Forecast Offices (WFOs) and 13 River Forecast Centers (RFCs). However, additional line organizations whose role in satisfying NOAA's five mission goals (ecosystems, climate, weather & water, commerce & transportation, and mission support) in multiple program areas might be facilitated through utilization of AWIPS-like functionalities, including the National Marine Fisheries Service (NMFS); National Environmental Satellite, Data, and Information Service (NESDIS); Office of Oceanic & Atmospheric Research (OAR); and the National Ocean Service (NOS). In addition to NOAA's mission goals, there are nine diverse, recommended, and important societal benefit areas in the US Integrated Earth Observation System (IEOS). This paper shows how the satisfaction of this suite of goals and benefit areas can be optimized by leveraging several key ingredients: (1) the evolution of AWIPS towards a net-centric system of services concept of operations; (2) infusion of technologies and concepts from pathfinder systems; (3) the development of new observing systems targeted at deliberate, and not just serendipitous, societal benefit; and (4) the diverse, nested local, regional, national, and international scales of the different benefits and goal areas, and their interoperability and interplay across the system of systems.

Drivers and socioeconomic impacts of tourism participation in protected areas.

PubMed

Liu, Wei; Vogt, Christine A; Luo, Junyan; He, Guangming; Frank, Kenneth A; Liu, Jianguo

2012-01-01

Nature-based tourism has the potential to enhance global biodiversity conservation by providing alternative livelihood strategies for local people, which may alleviate poverty in and around protected areas. Despite the popularity of the concept of nature-based tourism as an integrated conservation and development tool, empirical research on its actual socioeconomic benefits, on the distributional pattern of these benefits, and on its direct driving factors is lacking, because relevant long-term data are rarely available. In a multi-year study in Wolong Nature Reserve, China, we followed a representative sample of 220 local households from 1999 to 2007 to investigate the diverse benefits that these households received from recent development of nature-based tourism in the area. Within eight years, the number of households directly participating in tourism activities increased from nine to sixty. In addition, about two-thirds of the other households received indirect financial benefits from tourism. We constructed an empirical household economic model to identify the factors that led to household-level participation in tourism. The results reveal the effects of local households' livelihood assets (i.e., financial, human, natural, physical, and social capitals) on the likelihood to participate directly in tourism. In general, households with greater financial (e.g., income), physical (e.g., access to key tourism sites), human (e.g., education), and social (e.g., kinship with local government officials) capitals and less natural capital (e.g., cropland) were more likely to participate in tourism activities. We found that residents in households participating in tourism tended to perceive more non-financial benefits in addition to more negative environmental impacts of tourism compared with households not participating in tourism. These findings suggest that socioeconomic impact analysis and change monitoring should be included in nature-based tourism management systems for long-term sustainability of protected areas.

Drivers and Socioeconomic Impacts of Tourism Participation in Protected Areas

PubMed Central

Liu, Wei; Vogt, Christine A.; Luo, Junyan; He, Guangming; Frank, Kenneth A.; Liu, Jianguo

2012-01-01

Nature-based tourism has the potential to enhance global biodiversity conservation by providing alternative livelihood strategies for local people, which may alleviate poverty in and around protected areas. Despite the popularity of the concept of nature-based tourism as an integrated conservation and development tool, empirical research on its actual socioeconomic benefits, on the distributional pattern of these benefits, and on its direct driving factors is lacking, because relevant long-term data are rarely available. In a multi-year study in Wolong Nature Reserve, China, we followed a representative sample of 220 local households from 1999 to 2007 to investigate the diverse benefits that these households received from recent development of nature-based tourism in the area. Within eight years, the number of households directly participating in tourism activities increased from nine to sixty. In addition, about two-thirds of the other households received indirect financial benefits from tourism. We constructed an empirical household economic model to identify the factors that led to household-level participation in tourism. The results reveal the effects of local households' livelihood assets (i.e., financial, human, natural, physical, and social capitals) on the likelihood to participate directly in tourism. In general, households with greater financial (e.g., income), physical (e.g., access to key tourism sites), human (e.g., education), and social (e.g., kinship with local government officials) capitals and less natural capital (e.g., cropland) were more likely to participate in tourism activities. We found that residents in households participating in tourism tended to perceive more non-financial benefits in addition to more negative environmental impacts of tourism compared with households not participating in tourism. These findings suggest that socioeconomic impact analysis and change monitoring should be included in nature-based tourism management systems for long-term sustainability of protected areas. PMID:22558149

Committee Opinion No. 574: Marriage equality for same-sex couples.

PubMed

2013-09-01

Same-sex couples encounter barriers to health care that include concerns about confidentiality and disclosure, stigma and discriminatory attitudes and treatment, limited access to health care and health insurance, and often a limited understanding of their health risks. Same-sex couples and their families are adversely affected by the lack of legal recognition of their relationships, a problem with major implications for the health of same-sex couples and their families. Tangible harm has come from the lack of financial and health care protections granted to legal spouses, and children are harmed by the lack of protections afforded to families in which partners are married. However, the recent Supreme Court ruling, The United States v Windsor, which afforded equal treatment for legally married same-sex couples will provide many important health and financial benefits. Evidence suggests that marriage confers health benefits to individuals and families, yet a sizable proportion of individuals do not experience these health benefits because of their sexual orientation. Additional data suggest that same-sex couples who live in states with bans on same-sex unions experience adverse health outcomes. Civil marriage is currently available to same-sex couples in only thirteen states and the District of Columbia and honored by one state. The American College of Obstetricians and Gynecologists endorses marriage equality for same-sex couples and equal treatment for these couples and their families and applauds the Supreme Court's decision as an important step in improving access to benefits received by legally married same-sex couples. However, additional efforts are necessary to ensure that same-sex couples in every state can receive these same benefits.

Cochlear implantation in autistic children with profound sensorineural hearing loss.

PubMed

Lachowska, Magdalena; Pastuszka, Agnieszka; Łukaszewicz-Moszyńska, Zuzanna; Mikołajewska, Lidia; Niemczyk, Kazimierz

2016-11-19

Cochlear implants have become the method of choice for the treatment of severe-to-profound hearing loss in both children and adults. Its benefits are well documented in the pediatric and adult population. Also deaf children with additional needs, including autism, have been covered by this treatment. The aim of this study was to assess the benefits from cochlear implantation in deafened children with autism as the only additional disability. This study analyzes data of six children. The follow-up time was at least 43 months. The following data were analyzed: medical history, reaction to music and sound, Ling's six sounds test, onomatopoeic word test, reaction to spoken child's name, response to requests, questionnaire given to parents, sound processor fitting sessions and data. After cochlear implantation each child presented other communication skills. In some children, the symptoms of speech understanding were observed. No increased hyperactivity associated with daily use cochlear implant was observed. The study showed that in autistic children the perception is very important for a child's sense of security and makes contact with parents easier. Our study showed that oral communication is not likely to be a realistic goal in children with cochlear implants and autism. The implantation results showed benefits that varied among those children. The traditional methods of evaluating the results of cochlear implantation in children with autism are usually insufficient to fully assess the functional benefits. These benefits should be assessed in a more comprehensive manner taking into account the limitations of communication resulting from the essence of autism. It is important that we share knowledge about these complex children with cochlear implants. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Battery paste compositions and electrochemical cells for use therewith

DOEpatents

Olson, J.B.

1999-02-16

An improved battery paste composition and a lead-acid electrochemical cell which incorporates the composition are disclosed. The cell includes a positive current collector and a negative current collector which are each coated with a paste containing one or more lead-containing compositions and a paste vehicle to form a positive plate and a negative plate. An absorbent electrolyte-containing separator member may also be positioned between the positive and negative plates. The paste on the positive current collector, the negative current collector, or both further includes a special additive consisting of polyvinyl sulfonic acid or salts thereof which provides many benefits including improved battery cycle life, increased charge capacity, and enhanced overall stability. The additive also makes the pastes smoother and more adhesive, thereby improving the paste application process. The paste compositions of interest may be used in conventional flat-plate cells or in spirally wound batteries with equal effectiveness. 2 figs.

Battery paste compositions and electrochemical cells for use therewith

DOEpatents

Olson, John B.

1999-12-07

An improved battery paste composition and a lead-acid electrochemical cell which incorporates the composition. The cell includes a positive current collector and a negative current collector which are each coated with a paste containing one or more lead-containing compositions and a paste vehicle to form a positive plate and a negative plate. An absorbent electrolyte-containing separator member may also be positioned between the positive and negative plates. The paste on the positive current collector, the negative current collector, or both further includes a special additive consisting of polyvinylsulfonic acid or salts thereof which provides many benefits including improved battery cycle life, increased charge capacity, and enhanced overall stability. The additive also makes the pastes smoother and more adhesive, thereby improving the paste application process. The paste compositions of interest may be used in conventional flat-plate cells or in spirally wound batteries with equal effectiveness.

Battery paste compositions and electrochemical cells for use therewith

DOEpatents

Olson, John B.

1999-02-16

An improved battery paste composition and a lead-acid electrochemical cell which incorporates the composition. The cell includes a positive current collector and a negative current collector which are each coated with a paste containing one or more lead-containing compositions and a paste vehicle to form a positive plate and a negative plate. An absorbent electrolyte-containing separator member may also be positioned between the positive and negative plates. The paste on the positive current collector, the negative current collector, or both further includes a special additive consisting of polyvinylsulfonic acid or salts thereof which provides many benefits including improved battery cycle life, increased charge capacity, and enhanced overall stability. The additive also makes the pastes smoother and more adhesive, thereby improving the paste application process. The paste compositions of interest may be used in conventional flat-plate cells or in spirally wound batteries with equal effectiveness.

An insect with a delta-12 desaturase, the jewel wasp Nasonia vitripennis, benefits from nutritional supply with linoleic acid

NASA Astrophysics Data System (ADS)

Brandstetter, Birgit; Ruther, Joachim

2016-06-01

The availability of linoleic acid (LA; C18:2∆9,12) is pivotal for animals. While vertebrates depend on a nutritional supply, some invertebrates, including the parasitic wasp Nasonia vitripennis, are able to synthesize LA from oleic acid (OA; C18:1∆9). This raises the question as to whether these animals nevertheless benefit from the additional uptake of LA with the diet. LA plays an important role in the sexual communication of N. vitripennis because males use it as a precursor for the synthesis of an abdominal sex pheromone attracting virgin females. We reared hosts of N. vitripennis that were fed diets enriched in the availability of stearic acid (SA: C18:0), OA or LA. N. vitripennis males developing on the different host types clearly differed in both the fatty acid composition of their body fat and sex pheromone titres. Males from LA-enriched hosts had an almost fourfold higher proportion of LA and produced significantly more sex pheromone than males from SA (2.2-fold) and OA (1.4-fold) enriched hosts, respectively. Our study demonstrates that animals being able to synthesize important nutrients de novo may still benefit from an additional supply with their diet.

Generating carbon finance through avoided deforestation and its potential to create climatic, conservation and human development benefits.

PubMed

Ebeling, Johannes; Yasué, Maï

2008-05-27

Recent proposals to compensate developing countries for reducing emissions from deforestation (RED) under forthcoming climate change mitigation regimes are receiving increasing attention. Here we demonstrate that if RED credits were traded on international carbon markets, even moderate decreases in deforestation rates could generate billions of Euros annually for tropical forest conservation. We also discuss the main challenges for a RED mechanism that delivers real climatic benefits. These include providing sufficient incentives while only rewarding deforestation reductions beyond business-as-usual scenarios, addressing risks arising from forest degradation and international leakage, and ensuring permanence of emission reductions. Governance may become a formidable challenge for RED because some countries with the highest RED potentials score poorly on governance indices. In addition to climate mitigation, RED funds could help achieve substantial co-benefits for biodiversity conservation and human development. However, this will probably require targeted additional support because the highest biodiversity threats and human development needs may exist in countries that have limited income potentials from RED. In conclusion, how successfully a market-based RED mechanism can contribute to climate change mitigation, conservation and development will strongly depend on accompanying measures and carefully designed incentive structures involving governments, business, as well as the conservation and development communities.

Metronidazole stewardship initiative at Christchurch hospitals-achievable with immediate benefits.

PubMed

Gardiner, Sharon J; Metcalf, Sarah Cl; Chin, Paul Kl; Doogue, Matthew P; Dalton, Simon C; Chambers, Stephen T

2018-04-13

To evaluate an antimicrobial stewardship (AMS) initiative to change hospital prescribing practice for metronidazole. In October 2015, the Canterbury District Health Board (CDHB) AMS committee changed advice for metronidazole to promote two times daily dosing for most indications, prioritisation of the oral route and avoidance of double anaerobic cover. Adoption of the initiative was facilitated via change in prescribing guidelines, education and ongoing pharmacy support. Usage and expenditure on metronidazole for adult inpatients were compared for the five years pre- and two years post-change. Other district health boards (DHBs) were surveyed to determine their dosing recommendation for metronidazole IV. Mean annual metronidazole IV use, as defined daily doses per 1,000 occupied bed days, decreased by 43% post-initiative. Use of non-IV (oral or rectal) formulations increased by 104%. Total savings associated with the initiative were approximately $33,400 in drug costs plus $78,200 per annum in IV giving sets and post-dose flushes. Twelve of 20 (60%) DHBs (including CDHB) endorse twice daily IV dosing. In addition to financial savings, reduction in IV doses has potential benefits, including avoidance of IV catheter-associated complications such as bloodstream infections. Approaches to metronidazole dosing vary across DHBs and could benefit from national coordination.

Factors affecting nurses' decision to get the flu vaccine.

PubMed

Shahrabani, Shosh; Benzion, Uri; Yom Din, Gregory

2009-05-01

The objective of this study was to identify factors that influence the decision whether or not to get the influenza (flu) vaccine among nurses in Israel by using the health belief model (HBM). A questionnaire distributed among 299 nurses in Israel in winter 2005/2006 included (1) socio-demographic information; (2) variables based on the HBM, including susceptibility, seriousness, benefits, barriers and cues to action; and (3) knowledge about influenza and the vaccine, and health motivation. A probit model was used to analyze the data. In Israel, the significant HBM categories affecting nurses' decision to get a flu shot are the perceived benefits from vaccination and cues to action. In addition, nurses who are vaccinated have higher levels of (1) knowledge regarding the vaccine and influenza, (2) perceived seriousness of the illness, (3) perceived susceptibility, and (4) health motivation than do those who do not get the vaccine. Immunization of healthcare workers may reduce the risk of flu outbreaks in all types of healthcare facilities and reduce morbidity and mortality among high-risk patients. In order to increase vaccination rates among nurses, efforts should be made to educate them regarding the benefits of vaccination and the potential health consequences of influenza for their patients, and themselves.

A national survey of Conservation Reserve Program (CRP) participants on environmental effects, wildlife issues, and vegetation management on program lands

USGS Publications Warehouse

Allen, Arthur W.; Vandever, Mark W.

2003-01-01

A national survey of Conservation Reserve Program (CRP) contractees was completed to obtain information about Abstract environmental and social effects of the program on participants, farms, and communities. Of interest were observations concerning wildlife, attitudes about long-term management of program lands, and effectiveness of U.S. Department of Agriculture (USDA) assistance in relation to these issues. Surveys were delivered to 2,189 CRP participants with a resultant response rate of 64.5%. Retired farmers represented the largest category of respondents (52%). Enhanced control of soil erosion was the leading benefit of the CRP reported. Over 73% of respondents observed increased numbers of wildlife associated with lands enrolled in the program. The majority of respondents reported CRP benefits, including increased quality of surface and ground waters, improved air quality, control of drifting snow, and elevated opportunities to hunt or simply observe wildlife as part of daily activities. Income stability, improved scenic quality of farms and landscapes, and potential increases in property values and future incomes also were seen as program benefits. Negative aspects, reported by a smaller number of respondents, included seeing the CRP as a source of weeds, fire hazard, and attracting unwanted requests for trespass. Over 75% of respondents believed CRP benefits to wildlife were important. A majority of respondents (82%) believed the amount of assistance furnished by USDA related to planning and maintaining wildlife habitat associated with CRP lands was appropriate. Nearly 51% of respondents would accept incorporation of periodic management of vegetation into long-term management of CRP lands to maintain quality of wildlife habitats. Provision of funds to address additional costs and changes in CRP regulations would be required to maximize long-term management of program lands. Additional, on-ground assistance related to management of CRP, and other agricultural lands, to maintain wildlife habitats was commonly identified as a need by survey respondents.

The impact of genetic modification of human foods in the 21st century: a review.

PubMed

Uzogara, S G

2000-05-01

Genetic engineering of food is the science which involves deliberate modification of the genetic material of plants or animals. It is an old agricultural practice carried on by farmers since early historical times, but recently it has been improved by technology. Many foods consumed today are either genetically modified (GM) whole foods, or contain ingredients derived from gene modification technology. Billions of dollars in U.S. food exports are realized from sales of GM seeds and crops. Despite the potential benefits of genetic engineering of foods, the technology is surrounded by controversy. Critics of GM technology include consumer and health groups, grain importers from European Union (EU) countries, organic farmers, environmentalists, concerned scientists, ethicists, religious rights groups, food advocacy groups, some politicians and trade protectionists. Some of the specific fears expressed by opponents of GM technology include alteration in nutritional quality of foods, potential toxicity, possible antibiotic resistance from GM crops, potential allergenicity and carcinogenicity from consuming GM foods. In addition, some more general concerns include environmental pollution, unintentional gene transfer to wild plants, possible creation of new viruses and toxins, limited access to seeds due to patenting of GM food plants, threat to crop genetic diversity, religious, cultural and ethical concerns, as well as fear of the unknown. Supporters of GM technology include private industries, research scientists, some consumers, U.S. farmers and regulatory agencies. Benefits presented by proponents of GM technology include improvement in fruit and vegetable shelf-life and organoleptic quality, improved nutritional quality and health benefits in foods, improved protein and carbohydrate content of foods, improved fat quality, improved quality and quantity of meat, milk and livestock. Other potential benefits are: the use of GM livestock to grow organs for transplant into humans, increased crop yield, improvement in agriculture through breeding insect, pest, disease, and weather resistant crops and herbicide tolerant crops, use of GM plants as bio-factories to yield raw materials for industrial uses, use of GM organisms in drug manufacture, in recycling and/or removal of toxic industrial wastes. The potential risks and benefits of the new technology to man and the environment are reviewed. Ways of minimizing potential risks and maximizing the benefits of GM foods are suggested. Because the benefits of GM foods apparently far outweigh the risks, regulatory agencies and industries involved in GM food business should increase public awareness in this technology to enhance worldwide acceptability of GM foods. This can be achieved through openness, education, and research.

[From the licensure of vaccines to the recommendation of the Standing Committee on Vaccination in Germany : criteria for the assessment of benefits and risks].

PubMed

Pfleiderer, Michael; Wichmann, Ole

2015-03-01

Vaccines are among the most effective preventive measures in modern medicine and have led to a dramatic decline and-for a few diseases-even to the elimination of severely infectious diseases. There are some particularities of the risk-benefit assessment of vaccines compared with that of therapeutic drugs. These include the fact that vaccines are applied to healthy individuals with the aim of preventing an infectious disease, while therapeutic drugs are administered to sick people to cure them of an already acquired disease. The acceptable level of risk associated with the application of a vaccine is therefore much lower. In addition, high vaccination coverage can lead to population-level effects (e.g., the indirect protection of unvaccinated individuals) that can confer additional benefits to the population overall. When a marketing authorization application (MAA) for a novel vaccine is evaluated, conclusions are made regarding its quality, safety, and efficacy, and a benefit-risk assessment is carried out accordingly. In contrast, when deciding on the introduction of a new vaccine into a national immunization program or on a recommendation for a specific risk-group, the focus is shifted to considerations of how a licensed vaccine can be best used in a population (e.g., which immunization strategy is most effective in preventing deaths or hospitalizations, or in reducing treatment costs for the health care system). Stringent assessment criteria have been developed that require a robust safety analysis before a new vaccine is administered to humans for the first time in pre-licensure studies. Similarly, criteria are applied for calculating the benefit-risk ratio at the time of the licensure of a new vaccine in addition to during the entire post-licensure period. However, when deciding if and how a licensed vaccine can best be integrated into an existing immunization program, additional criteria are applied that are different, yet complementary to those applied for granting a marketing authorization. These decisions require-in addition to considerations of vaccine quality, vaccine efficacy and safety-conclusions regarding population-level effects combined with an integrative analysis of the local context (e.g., local epidemiology, cost-effectiveness, and acceptance by the population). To serve these objectives, national authorities such as the Standing Committee on Vaccination in Germany (STIKO) have been established to integrate globally developed vaccines into the national context of immunization strategies.

20 CFR 416.263 - No additional application needed.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false No additional application needed. 416.263 Section 416.263 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Eligibility Special Provisions for People Who Work Despite A Disabling...

20 CFR 416.263 - No additional application needed.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false No additional application needed. 416.263 Section 416.263 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Eligibility Special Provisions for People Who Work Despite A Disabling...

20 CFR 416.263 - No additional application needed.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false No additional application needed. 416.263 Section 416.263 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Eligibility Special Provisions for People Who Work Despite A Disabling...

20 CFR 416.263 - No additional application needed.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false No additional application needed. 416.263 Section 416.263 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Eligibility Special Provisions for People Who Work Despite A Disabling...

A Framework for the Evaluation of the Cost and Benefits of Microgrids

DOE Office of Scientific and Technical Information (OSTI.GOV)

Morris, Greg Young; Abbey, Chad; Joos, Geza

2011-07-15

A Microgrid is recognized as an innovative technology to help integrate renewables into distribution systems and to provide additional benefits to a variety of stakeholders, such as offsetting infrastructure investments and improving the reliability of the local system. However, these systems require additional investments for control infrastructure, and as such, additional costs and the anticipated benefits need to be quantified in order to determine whether the investment is economically feasible. This paper proposes a methodology for systematizing and representing benefits and their interrelationships based on the UML Use Case paradigm, which allows complex systems to be represented in a concise,more » elegant format. This methodology is demonstrated by determining the economic feasibility of a Microgrid and Distributed Generation installed on a typical Canadian rural distribution system model as a case study. The study attempts to minimize the cost of energy served to the community, considering the fixed costs associated with Microgrids and Distributed Generation, and suggests benefits to a variety of stakeholders.« less

A Fully Non-metallic Gas Turbine Engine Enabled by Additive Manufacturing

NASA Technical Reports Server (NTRS)

Grady, Joseph E.

2014-01-01

The Non-Metallic Gas Turbine Engine project, funded by NASA Aeronautics Research Institute (NARI), represents the first comprehensive evaluation of emerging materials and manufacturing technologies that will enable fully nonmetallic gas turbine engines. This will be achieved by assessing the feasibility of using additive manufacturing technologies for fabricating polymer matrix composite (PMC) and ceramic matrix composite (CMC) gas turbine engine components. The benefits of the proposed effort include: 50 weight reduction compared to metallic parts, reduced manufacturing costs due to less machining and no tooling requirements, reduced part count due to net shape single component fabrication, and rapid design change and production iterations. Two high payoff metallic components have been identified for replacement with PMCs and will be fabricated using fused deposition modeling (FDM) with high temperature capable polymer filaments. The first component is an acoustic panel treatment with a honeycomb structure with an integrated back sheet and perforated front sheet. The second component is a compressor inlet guide vane. The CMC effort, which is starting at a lower technology readiness level, will use a binder jet process to fabricate silicon carbide test coupons and demonstration articles. The polymer and ceramic additive manufacturing efforts will advance from monolithic materials toward silicon carbide and carbon fiber reinforced composites for improved properties. Microstructural analysis and mechanical testing will be conducted on the PMC and CMC materials. System studies will assess the benefits of fully nonmetallic gas turbine engine in terms of fuel burn, emissions, reduction of part count, and cost. The proposed effort will be focused on a small 7000 lbf gas turbine engine. However, the concepts are equally applicable to large gas turbine engines. The proposed effort includes a multidisciplinary, multiorganization NASA - industry team that includes experts in ceramic materials and CMCs, polymers and PMCs, structural engineering, additive manufacturing, engine design and analysis, and system analysis.

Improving therapeutic outcomes in autism spectrum disorders: Enhancing social communication and sensory processing through the use of interactive robots.

PubMed

Sartorato, Felippe; Przybylowski, Leon; Sarko, Diana K

2017-07-01

For children with autism spectrum disorders (ASDs), social robots are increasingly utilized as therapeutic tools in order to enhance social skills and communication. Robots have been shown to generate a number of social and behavioral benefits in children with ASD including heightened engagement, increased attention, and decreased social anxiety. Although social robots appear to be effective social reinforcement tools in assistive therapies, the perceptual mechanism underlying these benefits remains unknown. To date, social robot studies have primarily relied on expertise in fields such as engineering and clinical psychology, with measures of social robot efficacy principally limited to qualitative observational assessments of children's interactions with robots. In this review, we examine a range of socially interactive robots that currently have the most widespread use as well as the utility of these robots and their therapeutic effects. In addition, given that social interactions rely on audiovisual communication, we discuss how enhanced sensory processing and integration of robotic social cues may underlie the perceptual and behavioral benefits that social robots confer. Although overall multisensory processing (including audiovisual integration) is impaired in individuals with ASD, social robot interactions may provide therapeutic benefits by allowing audiovisual social cues to be experienced through a simplified version of a human interaction. By applying systems neuroscience tools to identify, analyze, and extend the multisensory perceptual substrates that may underlie the therapeutic benefits of social robots, future studies have the potential to strengthen the clinical utility of social robots for individuals with ASD. Copyright © 2017 Elsevier Ltd. All rights reserved.

Using archived ITS data to measure the operational benefits of a system-wide adaptive ramp metering system : appendix online\\0x20101 : I\\0x2010205 NB time\\0x2010space speed contour plots with meter activations.

DOT National Transportation Integrated Search

2008-12-01

Programmable logic controllers (PLCs) were installed at several key ramps with the assistance of the City of Portland and used to capture additional data about ramp operations that are not otherwise logged. The data include the activation and deactiv...

Mentoring of the Acquisition Workforce at Aberdeen Proving Ground, Maryland

DTIC Science & Technology

2010-04-01

of mentorship in career success was discussed along with form that mentorship took. The interview explored what elements of the mentor relationship...development that can have a significant effect on career success . Previous studies have shown that there are positive effects of mentoring beyond career ... success , including general job satisfaction and loyalty. In addition to benefits for the protégés, mentors capabilities are enhanced, and programs

Perceptions, motivations, and concerns about living organ donation among people living with HIV.

PubMed

Van Pilsum Rasmussen, Sarah E; Henderson, Macey L; Bollinger, Juli; Seaman, Shanti; Brown, Diane; Durand, Christine M; Segev, Dorry L; Sugarman, Jeremy

2018-05-03

Recent changes to United States law now permit people living with HIV (PLWH) to donate organs to HIV-infected (HIV+) recipients under research protocols. PLWH may have unique motivations for and concerns about living donation and understanding them is critical to ensuring the integrity of this novel approach to organ transplantation. We conducted in-depth interviews with PLWH from an urban HIV clinic who had previously indicated their willingness to be a living donor. Interviews elicited information on their motivations, perceived benefits, and concerns regarding living donation. Codes were identified inductively and then organized into themes and subthemes. Two coders independently analyzed the interviews and reconciled differences in coding by consensus. Thematic saturation was reached after 20 interviews. Motivations for living donation among PLWH included an altruistic desire to help others as well as HIV-specific motivations including solidarity with potential recipients and a desire to overcome HIV-related stigma. Perceived benefits of living donation included gratification from saving or improving the recipient's life and conferring a sense of normalcy for the HIV+ donor. Concerns about donation included the possibility of a prolonged recovery period, organ failure, and transmission of another strain of the virus to the recipients. PLWH had unique motivations, perceived benefits, and concerns about living donation in addition to those previously identified in the general population. These unique factors should be addressed in research protocols, informed consent processes, and the education and training of independent living donor advocates so that these endeavors are ethically sound.

Functional foods and dietary supplements for the management of dyslipidaemia.

PubMed

Hunter, Paola M; Hegele, Robert A

2017-05-01

Dyslipidaemia is characterized by increased blood levels of total or LDL cholesterol and triglycerides, or decreased HDL cholesterol levels, and is a risk factor for cardiovascular disease. Dyslipidaemia has a high worldwide prevalence, and many patients are turning to alternatives to pharmacotherapy to manage their lipid levels. Lifestyle modification should be emphasized in all patients to reduce cardiovascular risk and can be initiated before pharmacotherapy in primary prevention of cardiovascular disease. Many functional foods and natural health products have been investigated for potential lipid-lowering properties. Those with good evidence for a biochemical effect on plasma lipid levels include soy protein, green tea, plant sterols, probiotic yogurt, marine-derived omega-3 fatty acids and red yeast rice. Other products such as seaweed, berberine, hawthorn and garlic might confer some limited benefit in certain patient groups. Although none of these products can reduce lipid levels to the same extent as statins, most are safe to use in addition to other lifestyle modifications and pharmacotherapy. Natural health products marketed at individuals with dyslipidaemia, such as policosanol, guggulsterone and resveratrol, have minimal definitive evidence of a biochemical benefit. Additional research is required in this field, which should include large, high-quality randomized controlled trials with long follow-up periods to investigate associations with cardiovascular end points.

An adaptive software defined radio design based on a standard space telecommunication radio system API

NASA Astrophysics Data System (ADS)

Xiong, Wenhao; Tian, Xin; Chen, Genshe; Pham, Khanh; Blasch, Erik

2017-05-01

Software defined radio (SDR) has become a popular tool for the implementation and testing for communications performance. The advantage of the SDR approach includes: a re-configurable design, adaptive response to changing conditions, efficient development, and highly versatile implementation. In order to understand the benefits of SDR, the space telecommunication radio system (STRS) was proposed by NASA Glenn research center (GRC) along with the standard application program interface (API) structure. Each component of the system uses a well-defined API to communicate with other components. The benefit of standard API is to relax the platform limitation of each component for addition options. For example, the waveform generating process can support a field programmable gate array (FPGA), personal computer (PC), or an embedded system. As long as the API defines the requirements, the generated waveform selection will work with the complete system. In this paper, we demonstrate the design and development of adaptive SDR following the STRS and standard API protocol. We introduce step by step the SDR testbed system including the controlling graphic user interface (GUI), database, GNU radio hardware control, and universal software radio peripheral (USRP) tranceiving front end. In addition, a performance evaluation in shown on the effectiveness of the SDR approach for space telecommunication.

Conflict coaching training for nurse managers: a case study of a two-hospital health system.

PubMed

Brinkert, Ross

2011-01-01

This study evaluated the application of the Comprehensive Conflict Coaching model in a hospital environment. Conflict coaching involves a coach working with a client to improve the client's conflict understanding, interaction strategies and/or interaction skills. The training of nurse managers as conflict coaches is an innovative continuing education programme that partially addresses conflict-related concerns in nursing. Twenty nurse managers trained as conflict coaches and each coached a supervisee. Qualitative data were gathered from nurse managers, supervisees and senior nursing leaders over an 8-month period and organized using standard programme evaluation themes. Benefits included supervisor conflict coaching competency and enhanced conflict communication competency for nurse managers and supervisees facing specific conflict situations. Challenges included the management of programme tensions. Additional benefits and challenges are discussed, along with study limitations. Conflict coaching was a practical and effective means of developing the conflict communication competencies of nurse managers and supervisees. Additional research is needed. Conflict is common in nursing. Conflict coaching is a new conflict communication and supervision intervention that demonstrates initial promise. Conflict coaching seems to work best when supported by a positive conflict culture and integrated with other conflict intervention processes. © 2010 The Author. Journal compilation © 2010 Blackwell Publishing Ltd.

Use of edible coatings to preserve quality of lightly (and slightly) processed products.

PubMed

Baldwin, E A; Nisperos-Carriedo, M O; Baker, R A

1995-11-01

Lightly processed agricultural products present a special problem to the food industry and to scientists involved in postharvest and food technology research. Light or minimal processing includes cutting, slicing, coring, peeling, trimming, or sectioning of agricultural produce. These products have an active metabolism that can result in deteriorative changes, such as increased respiration and ethylene production. If not controlled, these changes can lead to rapid senescence and general deterioration of the product. In addition, the surface water activity of cut fruits and vegetables is generally quite high, inviting microbial attack, which further reduces product stability. Methods for control of these changes are numerous and can include the use of edible coatings. Also mentioned in this review are coating of nut products, and dried, dehydrated, and freeze-dried fruits. Technically, these are not considered to be minimally processed, but many of the problems and benefits of coating these products are similar to coating lightly processed products. Generally, the potential benefits of edible coatings for processed or lightly processed produce is to stabilize the product and thereby extend product shelf life. More specifically, coatings have the potential to reduce moisture loss, restrict oxygen entrance, lower respiration, retard ethylene production, seal in flavor volatiles, and carry additives that retard discoloration and microbial growth.

The effects of locomotor training in children with spinal cord injury: a systematic review.

PubMed

Donenberg, Jennifer Glenna; Fetters, Linda; Johnson, Robert

2018-06-19

Discuss the effectiveness of locomotor training (LT) in children following spinal cord injury (SCI). This intervention was assessed following an exhaustive search of the literature using the Preferred Reporting Items for Systematic Reviews and Meta- Analyses: The PRISMA Statement as a guideline. Six databases were searched including PubMed, PEDro, CINAHL, Cochrane, PsycINFO, and Web of Knowledge in January 2016 and November 2016, without date restrictions. Inclusion criteria were: studies in English and peer-reviewed and journal articles with a primary intervention of LT in children following SCI. Twelve articles, reporting eleven studies, were included. A systematic review assessing locomotor training in children with SCI published in April 2016 was also included. Participants were ages 15 months to 18 years old. Forms of LT included body-weight supported treadmill or over ground training, functional electrical stimulation, robotics, and virtual reality. Protocols differed in set-up and delivery mode, with improvements seen in ambulation for all 41 participants following LT. Children might benefit from LT to develop or restore ambulation following SCI. Age, completeness, and level of injury remain the most important prognostic factors to consider with this intervention. Additional benefits include improved bowel/ bladder management and control, bone density, cardiovascular endurance, and overall quality of life. Looking beyond the effects LT has just on ambulation is crucial because it can offer benefits to all children sustaining a SCI, even if restoration or development of walking is not the primary goal. Further rigorous research is required to determine the overall effectiveness of LT.

47 CFR 54.715 - Administrative expenses of the Administrator.

Code of Federal Regulations, 2010 CFR

2010-10-01

... employee's rate of pay exceeds Level I of the Executive Schedule does not include life insurance benefits, retirement benefits (including payments to 401(k) plans), health insurance benefits, or other similar benefits, provided that any such benefits are reasonably comparable to benefits that are provided to...

An operational system for subject switching between controlled vocabularies

NASA Technical Reports Server (NTRS)

Silvester, June P.; Klingbiel, Paul H.

1993-01-01

The NASA system of automatically converting sets of terms assigned by Department of Defense indexers to sets of NASA's authorized terms is described. This little-touted system, which has been operating successfully since 1983, matches concepts, rather than words. Subject Switching uses a translation table, known as the Lexical Dictionary, accessed by a program that determines which rules to follow in making the transition from DTIC's to NASA's authorized terms. The authors describe the four phases of development of Subject Switching, changes that have been made, evaluating the system, and benefits. Benefits to NASA include saving indexers' time, the addition of access points for documents indexed, the utilization of other government indexing, and a contribution towards the now-operational NASA, online, interactive, machine aided indexing.

Psychological and behavioral effects of genetic risk testing for obesity: a systematic review.

PubMed

Cheera, Emily K; Klarich, DawnKylee S; Hong, Mee Young

2016-05-01

Interest is growing in the use of genetic risk testing for lifestyle-related chronic diseases, including obesity, to promote health behavior change. A systematic review of the literature was conducted to determine the effects that genetic risk feedback for obesity may have on psychological and behavioral factors influencing weight. The MEDLINE/PubMed online database was searched using predefined search terms. The studies revealed that risk feedback may increase motivation to improve health behaviors, especially among individuals at higher genetic risk. Overweight and obese individuals seemed to experience additional psychological benefits when provided an external explanation for their weight status. While the psychological benefits are promising, the clinical utility of genetic risk testing for obesity remains uncertain.

Drospirenone/ethinylestradiol: a review on efficacy and noncontraceptive benefits.

PubMed

Machado, Rogério Bonassi; Pompei, Luciano de Melo; Giribela, Arícia Galvão; Giribela, Cassiana Galvão

2011-01-01

Considerable advances have been made in the field of combined oral contraceptives since their introduction 50 years ago. This ongoing evolution has been focused on reducing the estrogen dose and synthesizing new progestogens. A recently launched combination of ethinylestradiol 20 µg and drospirenone 3 mg demonstrates the advantages of a lower estrogen dose with the antimineralocorticoid activity of drospirenone that is responsible for the drug's significant antiandrogenic and antimineralocorticoid effects, reflected clinically in lower rates of adverse events including less fluid retention. In addition to the drug's contraceptive efficacy, its effects on the skin and other classic noncontraceptive benefits, the ethinylestradiol 20 µg and drospirenone 3 mg combination has demonstrated highly satisfactory results in women with premenstrual dysphoric syndrome.

Excess Benefit Plans and Other Nonqualified Deferred Compensation Palns Under ERISA

ERIC Educational Resources Information Center

Vogel, Mark A.

1977-01-01

The benefits of and restrictions imposed on qualified pension and profit-sharing plans are discussed in terms of Excess Benefit Plans (EPB), a type of deferred compensation plan. EPBs and unfunded deferred compensation plans offer flexible methods of providing additional benefits for executives and key employees. (LBH)

20 CFR 404.1919 - How benefits are recomputed.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false How benefits are recomputed. 404.1919 Section 404.1919 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY... will recompute the pro rata PIA only if the inclusion of the additional earnings results in an increase...

Cost-benefit analysis of vaccination against Mycobacterium avium ssp. paratuberculosis in dairy cattle, given its cross-reactivity with tuberculosis tests.

PubMed

Groenendaal, Huybert; Zagmutt, Francisco J; Patton, Elisabeth A; Wells, Scott J

2015-09-01

Johne's disease (JD), or paratuberculosis, is a chronic enteric disease of ruminants, caused by infection with Mycobacterium avium ssp. paratuberculosis (MAP). Johne's disease causes considerable economic losses to the US dairy industry, estimated to be over $200 million annually. Available control strategies include management measures to improve calf hygiene, test-and-cull strategies, and vaccination. Although the first 2 strategies have shown to reduce the prevalence of MAP, they require dedicated and long-term efforts from dairy producers, with often relatively slow progress. As a result, uptake of both strategies has not been as wide as expected given the economic benefits especially of improved hygiene. Vaccination has also been found to reduce the prevalence and economic losses of JD, but most economic estimates have been based on simulation of hypothetical vaccines. In addition, if an animal is vaccinated, cross-reactivity between MAP antibodies and bovine tuberculosis (BTB) antigens may occur, decreasing the specificity of BTB tests. Therefore, MAP vaccination would cause additional indirect costs to the BTB surveillance and control program. The objective of the present study was to use data from a MAP vaccine trial together with an epidemiologic and economic model to estimate the direct on-farm benefits of MAP vaccination and to estimate the indirect costs of MAP vaccination due to the cross-reactivity with BTB tests. Direct economic benefits of MAP vaccination were estimated at $8.03 (90% predictive interval: -$25.97 to $41.36) per adult animal per year, all accruing to the dairy producers. This estimate is likely an underestimation of the true direct benefits of MAP vaccination. In addition, indirect economic costs due to cross-reactivity were $2.14 per adult animal per year, making MAP vaccination economically attractive. Only in regions or states with a high frequency of BTB testing (because of, for example, Mycobacterium bovis outbreaks in a wild deer population) and areas where typically small groups of animals are BTB tested would MAP vaccination not be economically attractive. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Could Relatedness Help Explain Why Individuals Lead in Bottlenose Dolphin Groups?

PubMed Central

Lewis, Jennifer S.; Wartzok, Douglas; Heithaus, Michael; Krützen, Michael

2013-01-01

In many species, particular individuals consistently lead group travel. While benefits to followers often are relatively obvious, including access to resources, benefits to leaders are often less obvious. This is especially true for species that feed on patchy mobile resources where all group members may locate prey simultaneously and food intake likely decreases with increasing group size. Leaders in highly complex habitats, however, could provide access to foraging resources for less informed relatives, thereby gaining indirect benefits by helping kin. Recently, leadership has been documented in a population of bottlenose dolphins (Tursiops truncatus) where direct benefits to leaders appear unlikely. To test whether leaders could benefit indirectly we examined relatedness between leader-follower pairs and compared these levels to pairs who associated but did not have leader-follower relationship (neither ever led the other). We found the average relatedness value for leader-follower pairs was greater than expected based on chance. The same was not found when examining non leader-follower pairs. Additionally, relatedness for leader-follower pairs was positively correlated with association index values, but no correlation was found for this measure in non leader-follower pairs. Interestingly, haplotypes were not frequently shared between leader-follower pairs (25%). Together, these results suggest that bottlenose dolphin leaders have the opportunity to gain indirect benefits by leading relatives. These findings provide a potential mechanism for the maintenance of leadership in a highly dynamic fission-fusion population with few obvious direct benefits to leaders. PMID:23516445

Primary Care Providers’ Experiences with Urine Toxicology Tests to Manage Prescription Opioid Misuse and Substance Use Among Chronic Non-Cancer Pain Patients in Safety Net Healthcare Settings

PubMed Central

Ceasar, Rachel; Chang, Jamie; Zamora, Kara; Hurstak, Emily; Kushel, Margot; Miaskowski, Christine; Knight, Kelly

2016-01-01

Background Guideline recommendations to reduce prescription opioid misuse among patients with chronic non-cancer pain include the routine use of urine toxicology tests for high-risk patients. Yet little is known about how the implementation of urine toxicology tests among patients with co-occurring chronic non-cancer pain and substance use impacts primary care providers’ management of misuse. In this paper, we present clinicians’ perspectives on the benefits and challenges of implementing urine toxicology tests in the monitoring of opioid misuse and substance use in safety net healthcare settings. Methods We interviewed 23 primary care providers from six safety net healthcare settings whose patients had a diagnosis of co-occurring chronic non-cancer pain and substance use. We transcribed, coded, and analyzed interviews using grounded theory methodology. Results The benefits of implementing urine toxicology tests for primary care providers included less reliance on intuition to assess for misuse and the ability to identify unknown opioid misuse and/or substance use. The challenges of implementing urine toxicology tests included insufficient education and training about how to interpret and implement tests, and a lack of clarity on how and when to act on tests that indicated misuse and/or substance use. Conclusions These data suggest that primary care clinicians’ lack of education and training to interpret and implement urine toxicology tests may impact their management of patient opioid misuse and/or substance use. Clinicians may benefit from additional education and training about the clinical implementation and use of urine toxicology tests. Additional research is needed on how primary care providers implementation and use of urine toxicology tests impacts chronic non-cancer pain management in primary care and safety net healthcare settings among patients with co-occurring chronic non-cancer pain and substance use. PMID:26682471

A randomized control trial of interventions in school-aged children with auditory processing disorders.

PubMed

Sharma, Mridula; Purdy, Suzanne C; Kelly, Andrea S

2012-07-01

The primary purpose of the study was to compare intervention approaches for children with auditory processing disorder (APD): bottom-up training including activities focused on auditory perception, discrimination, and phonological awareness, and top-down training including a range of language activities. Another purpose was to determine the benefits of personal FM systems. The study is a randomized control trial where participants were allocated to groups receiving one of the two interventions, with and without personal FM, or to the no intervention group. The six-week intervention included weekly one-hour sessions with a therapist in the clinic, plus 1-2 hours per week of parent-directed homework. 55 children (7 to 13 years) with APD participated in the study. Intervention outcomes included reading, language, and auditory processing. Positive outcomes were observed for both training approaches and personal FM systems on several measures. Pre-intervention nonverbal IQ, age, and severity of APD did not influence outcomes. Performance of control group participants did not change when retested after the intervention period. Both intervention approaches were beneficial and there were additional benefits with the use of personal FM. Positive results were not limited to the areas specifically targeted by the interventions.

Reassessing the human health benefits from cleaner air.

PubMed

Cox, Louis Anthony

2012-05-01

Recent proposals to further reduce permitted levels of air pollution emissions are supported by high projected values of resulting public health benefits. For example, the Environmental Protection Agency recently estimated that the 1990 Clean Air Act Amendment (CAAA) will produce human health benefits in 2020, from reduced mortality rates, valued at nearly $2 trillion per year, compared to compliance costs of $65 billion ($0.065 trillion). However, while compliance costs can be measured, health benefits are unproved: they depend on a series of uncertain assumptions. Among these are that additional life expectancy gained by a beneficiary (with median age of about 80 years) should be valued at about $80,000 per month; that there is a 100% probability that a positive, linear, no-threshold, causal relation exists between PM(2.5) concentration and mortality risk; and that progress in medicine and disease prevention will not greatly diminish this relationship. We present an alternative uncertainty analysis that assigns a positive probability of error to each assumption. This discrete uncertainty analysis suggests (with probability >90% under plausible alternative assumptions) that the costs of CAAA exceed its benefits. Thus, instead of suggesting to policymakers that CAAA benefits are almost certainly far larger than its costs, we believe that accuracy requires acknowledging that the costs purchase a relatively uncertain, possibly much smaller, benefit. The difference between these contrasting conclusions is driven by different approaches to uncertainty analysis, that is, excluding or including discrete uncertainties about the main assumptions required for nonzero health benefits to exist at all. © 2011 Society for Risk Analysis.

"Done more for me in a fortnight than anybody done in all me life." How welfare rights advice can help people with cancer.

PubMed

Moffatt, Suzanne; Noble, Emma; Exley, Catherine

2010-09-03

In the UK many people with cancer and their carers do not have easy access to the welfare benefits to which they are entitled adding further strain to the process of dealing with cancer. It is estimated that nine out of ten cancer patients' households experience loss of income as a direct result of cancer, which, due to its socio-economic patterning disproportionately affects those most likely to be financially disadvantaged. In the UK proactive welfare rights advice services accessed via health care settings significantly increase benefit entitlement among people with health problems and this paper reports on a qualitative study examining the impact of a welfare rights advice service specifically designed for people affected by cancer and their carers in County Durham, North East England (UK). Twenty two men and women with cancer or caring for someone with cancer who were recipients of welfare rights advice aged between 35 and 83 were recruited from a variety of health care and community settings. Semi-structured interviews were undertaken and analysed using the Framework method. Most of the participants experienced financial strain following their cancer diagnosis. Participants accessed the welfare rights service in a variety of ways, but mainly through referral by other professionals. The additional income generated by successful benefit claims was used in a number of ways and included offsetting additional costs associated with cancer and lessening the impact of loss of earnings. Overall, receiving welfare rights advice eased feelings of stress over financial issues at a time when participants were concerned about dealing with the impact of cancer. Lack of knowledge about benefit entitlements was the main barrier to accessing benefits, and this outweighed attitudinal factors such as stigma and concerns about benefit fraud. Financial strain resulting from a cancer diagnosis is compounded in the UK by lack of easy access to information about benefit entitlements and assistance to claim. Proactive welfare rights advice services, working closely with health and social care professionals can assist with the practical demands that arise from dealing with the illness and should be considered an important part of a holistic approach to cancer treatment.

Fair Balance and Adequate Provision in Direct-to-Consumer Prescription Drug Online Banner Advertisements: A Content Analysis.

PubMed

Adams, Crystal

2016-02-18

The current direct-to-consumer advertising (DTCA) guidelines were developed with print, television, and radio media in mind, and there are no specific guidelines for online banner advertisements. This study evaluates how well Internet banner ads comply with existing Food and Drug Administration (FDA) guidelines for DTCA in other media. A content analysis was performed of 68 banner advertisements. A coding sheet was developed based on (1) FDA guidance documents for consumer-directed prescription drug advertisements and (2) previous DTCA content analyses. Specifically, the presence of a brief summary detailing the drug's risks and side effects or of a "major statement" identifying the drug's major risks, and the number and type of provisions made available to consumers for comprehensive information about the drug were coded. In addition, the criterion of "fair balance," the FDA's requirement that prescription drug ads balance information relating to the drug's risks with information relating to its benefits, was measured by numbering the benefit and risk facts identified in the ads and by examining the presentation of risk and benefit information. Every ad in the sample included a brief summary of risk information and at least one form of adequate provision as required by the FDA for broadcast ads that do not give audiences a brief summary of a drug's risks. No ads included a major statement. There were approximately 7.18 risk facts for every benefit fact. Most of the risks (98.85%, 1292/1307) were presented in the scroll portion of the ad, whereas most of the benefits (66.5%, 121/182) were presented in the main part of the ad. Out of 1307 risk facts, 1292 were qualitative and 15 were quantitative. Out of 182 benefit facts, 181 were qualitative and 1 was quantitative. The majority of ads showed neutral images during the disclosure of benefit and risk facts. Only 9% (6/68) of the ads displayed positive images and none displayed negative images when presenting risks facts. When benefit facts were being presented, 7% (5/68) showed only positive images. No ads showed negative images when the benefit facts were being presented. In the face of ambiguous regulatory guidelines for online banner promotion, drug companies appear to make an attempt to adapt to regulatory guidelines designed for traditional media. However, banner ads use various techniques of presentation to present the advertised drug in the best possible light. The FDA should formalize requirements that drug companies provide a brief summary and include multiple forms of adequate provision in banner ads.

Children's active play: self-reported motivators, barriers and facilitators

PubMed Central

2011-01-01

Background Physical activity has important benefits for children's physical health and mental wellbeing, but many children do not meet recommended levels. Research suggests that active play has the potential to make a valuable contribution to children's overall physical activity, whilst providing additional cognitive, social and emotional benefits. However, relatively little is known about the determinants of UK children's active play. Understanding these factors provides the critical first step in developing interventions to increase children's active play, and therefore overall physical activity. Methods Eleven focus groups were conducted with 77, 10-11 year old children from four primary schools in Bristol, UK. Focus groups examined: (i) factors which motivate children to take part in active play; (ii) factors which limit children's active play and (iii) factors which facilitate children's active play. All focus groups were audio-taped and transcribed verbatim. Data were analysed using a thematic approach. Results Children were motivated to engage in active play because they perceived it to be enjoyable, to prevent boredom, to have physical and mental health benefits and to provide freedom from adult control, rules and structure. However, children's active play was constrained by a number of factors, including rainy weather and fear of groups of teenagers in their play spaces. Some features of the physical environment facilitated children's active play, including the presence of green spaces and cul-de-sacs in the neighbourhood. Additionally, children's use of mobile phones when playing away from home was reported to help to alleviate parents' safety fears, and therefore assist children's active play. Conclusions Children express a range of motivational and environmental factors that constrain and facilitate their active play. Consideration of these factors should improve effectiveness of interventions designed to increase active play. PMID:21663605

Children's active play: self-reported motivators, barriers and facilitators.

PubMed

Brockman, Rowan; Jago, Russell; Fox, Kenneth R

2011-06-10

Physical activity has important benefits for children's physical health and mental wellbeing, but many children do not meet recommended levels. Research suggests that active play has the potential to make a valuable contribution to children's overall physical activity, whilst providing additional cognitive, social and emotional benefits. However, relatively little is known about the determinants of UK children's active play. Understanding these factors provides the critical first step in developing interventions to increase children's active play, and therefore overall physical activity. Eleven focus groups were conducted with 77, 10-11 year old children from four primary schools in Bristol, UK. Focus groups examined: (i) factors which motivate children to take part in active play; (ii) factors which limit children's active play and (iii) factors which facilitate children's active play. All focus groups were audio-taped and transcribed verbatim. Data were analysed using a thematic approach. Children were motivated to engage in active play because they perceived it to be enjoyable, to prevent boredom, to have physical and mental health benefits and to provide freedom from adult control, rules and structure. However, children's active play was constrained by a number of factors, including rainy weather and fear of groups of teenagers in their play spaces. Some features of the physical environment facilitated children's active play, including the presence of green spaces and cul-de-sacs in the neighbourhood. Additionally, children's use of mobile phones when playing away from home was reported to help to alleviate parents' safety fears, and therefore assist children's active play. Children express a range of motivational and environmental factors that constrain and facilitate their active play. Consideration of these factors should improve effectiveness of interventions designed to increase active play.

The efficacy of functional gait training in children and young adults with cerebral palsy: a systematic review and meta-analysis.

PubMed

Booth, Adam T C; Buizer, Annemieke I; Meyns, Pieter; Oude Lansink, Irene L B; Steenbrink, Frans; van der Krogt, Marjolein M

2018-03-07

The aim of this systematic review was to investigate the effects of functional gait training on walking ability in children and young adults with cerebral palsy (CP). The review was conducted using standardized methodology, searching four electronic databases (PubMed, Embase, CINAHL, Web of Science) for relevant literature published between January 1980 and January 2017. Included studies involved training with a focus on actively practising the task of walking as an intervention while reporting outcome measures relating to walking ability. Forty-one studies were identified, with 11 randomized controlled trials included. There is strong evidence that functional gait training results in clinically important benefits for children and young adults with CP, with a therapeutic goal of improved walking speed. Functional gait training was found to have a moderate positive effect on walking speed over standard physical therapy (effect size 0.79, p=0.04). Further, there is weaker yet relatively consistent evidence that functional gait training can also benefit walking endurance and gait-related gross motor function. There is promising evidence that functional gait training is a safe, feasible, and effective intervention to target improved walking ability in children and young adults with CP. The addition of virtual reality and biofeedback can increase patient engagement and magnify effects. Functional gait training is a safe, feasible, and effective intervention to improve walking ability. Functional gait training shows larger positive effects on walking speed than standard physical therapy. Walking endurance and gait-related gross motor function can also benefit from functional gait training. Addition of virtual reality and biofeedback shows promise to increase engagement and improve outcomes. © 2018 The Authors. Developmental Medicine & Child Neurology published by John Wiley & Sons Ltd on behalf of Mac Keith Press.

Modelling the Costs and Effects of Selective and Universal Hospital Admission Screening for Methicillin-Resistant Staphylococcus aureus

PubMed Central

Hubben, Gijs; Bootsma, Martin; Luteijn, Michiel; Glynn, Diarmuid; Bishai, David

2011-01-01

Background Screening at hospital admission for carriage of methicillin-resistant Staphylococcus aureus (MRSA) has been proposed as a strategy to reduce nosocomial infections. The objective of this study was to determine the long-term costs and health benefits of selective and universal screening for MRSA at hospital admission, using both PCR-based and chromogenic media-based tests in various settings. Methodology/Principal Findings A simulation model of MRSA transmission was used to determine costs and effects over 15 years from a US healthcare perspective. We compared admission screening together with isolation of identified carriers against a baseline policy without screening or isolation. Strategies included selective screening of high risk patients or universal admission screening, with PCR-based or chromogenic media-based tests, in medium (5%) or high nosocomial prevalence (15%) settings. The costs of screening and isolation per averted MRSA infection were lowest using selective chromogenic-based screening in high and medium prevalence settings, at $4,100 and $10,300, respectively. Replacing the chromogenic-based test with a PCR-based test costs $13,000 and $36,200 per additional infection averted, and subsequent extension to universal screening with PCR would cost $131,000 and $232,700 per additional infection averted, in high and medium prevalence settings respectively. Assuming $17,645 benefit per infection averted, the most cost-saving strategies in high and medium prevalence settings were selective screening with PCR and selective screening with chromogenic, respectively. Conclusions/Significance Admission screening costs $4,100–$21,200 per infection averted, depending on strategy and setting. Including financial benefits from averted infections, screening could well be cost saving. PMID:21483492

Greening Industrial Production through Waste Recovery: "Comprehensive Utilization of Resources" in China.

PubMed

Zhu, Junming; Chertow, Marian R

2016-03-01

Using nonhazardous wastes as inputs to production creates environmental benefits by avoiding disposal impacts, mitigating manufacturing impacts, and conserving virgin resources. China has incentivized reuse since the 1980s through the "Comprehensive Utilization of Resources (CUR)" policy. To test whether and to what extent environmental benefits are generated, 862 instances in Jiangsu, China are analyzed, representing eight industrial sectors and 25 products that qualified for tax relief through CUR. Benefits are determined by comparing life cycle inventories for the same product from baseline and CUR-certified production, adjusted for any difference in the use phase. More than 50 million tonnes of solid wastes were reused, equivalent to 51% of the provincial industrial total. Benefits included reduction of 161 petajoules of energy, 23 million tonnes of CO2 equivalent, 75 000 tonnes of SO2 equivalent, 33 000 tonnes of NOX, and 28 000 tonnes of PM10 equivalent, which were 2.5%-7.3% of the provincial industrial consumption and emissions. The benefits vary substantially across industries, among products within the same industry, and when comparing alternative reuse processes for the same waste. This first assessment of CUR results shows that CUR has established a firm foundation for a circular economy, but also suggest additional opportunities to refine incentives under CUR to increase environmental gain.

Active and passive surveillance of enoxaparin generics: a case study relevant to biosimilars.

PubMed

Grampp, Gustavo; Bonafede, Machaon; Felix, Thomas; Li, Edward; Malecki, Michael; Sprafka, J Michael

2015-03-01

This retrospective analysis assessed the capability of active and passive safety surveillance systems to track product-specific safety events in the USA for branded and generic enoxaparin, a complex injectable subject to immune-related and other adverse events (AEs). Analysis of heparin-induced thrombocytopenia (HIT) incidence was performed on benefit claims for commercial and Medicare supplemental-insured individuals newly treated with enoxaparin under pharmacy benefit (1 January 2009 - 30 June 2012). Additionally, spontaneous reports from the FDA AE Reporting System were reviewed to identify incidence and attribution of enoxaparin-related reports to specific manufacturers. Specific, dispensed products were identifiable from National Drug Codes only in pharmacy-benefit databases, permitting sensitive comparison of HIT incidence in nearly a third of patients treated with brand or generic enoxaparin. After originator medicine's loss of exclusivity, only 5% of spontaneous reports were processed by generic manufacturers; reports attributable to specific generics were approximately ninefold lower than expected based on market share. Claims data were useful for active surveillance of enoxaparin generics dispensed under pharmacy benefits but not for products administered under medical benefits. These findings suggest that the current spontaneous reporting system will not distinguish product-specific safety signals for products distributed by multiple manufacturers, including biosimilars.

Views of new internal medicine faculty of their preparedness and competence in physician-patient communication

PubMed Central

Mueller, Paul S; Barrier, Patricia A; Call, Timothy G; Duncan, Alan K; Hurley, Daniel L; Multari, Adamarie; Rabatin, Jeffrey T; Li, James TC

2006-01-01

Background We sought to assess self-rated importance of the medical interview to clinical practice and competence in physician-patient communication among new internal medicine faculty at an academic medical center. Methods Since 2001, new internal medicine faculty at the Mayo Clinic College of Medicine (Rochester, Minnesota) have completed a survey on physician-patient communication. The survey asks the new faculty to rate their overall competence in medical interviewing, the importance of the medical interview to their practice, their confidence and adequacy of previous training in handling eight frequently encountered challenging communication scenarios, and whether they would benefit from additional communication training. Results Between 2001 and 2004, 75 general internists and internal medicine subspecialists were appointed to the faculty, and of these, 58 (77%) completed the survey. The faculty rated (on a 10-point scale) the importance of the medical interview higher than their competence in interviewing; this difference was significant (average ± SD, 9.4 ± 1.0 vs 7.7 ± 1.2, P < .001). Similar results were obtained by sex, age, specialty, years since residency or fellowship training, and perceived benefit of training. Experienced faculty rated their competence in medical interviewing and the importance of the medical interview higher than recent graduates (ie, less than one year since training). For each challenging communication scenario, the new faculty rated the adequacy of their previous training in handling the scenario relatively low. A majority (57%) said they would benefit from additional communication training. Conclusion Although new internal medicine faculty rate high the importance of the medical interview, they rate their competence and adequacy of previous training in medical interviewing relatively low, and many indicate that they would benefit from additional communication training. These results should encourage academic medical centers to make curricula in physician-patient communication available to their faculty members because many of them not only care for patients, but also teach clinical skills, including communication skills, to trainees. PMID:16729886

Heat-pump cool storage in a clathrate of freon

NASA Astrophysics Data System (ADS)

Tomlinson, J. J.

Presented are the analytical description and assessment of a unique heat pump/storage system in which the conventional evaporator of the vapor compression cycle is replaced by a highly efficient direct contract crystallizer. The thermal storage technique requires the formation of a refrigerant gas hydrate (a clathrate) and exploits an enthalpy of reaction comparable to the heat of fusion of ice. Additional system operational benefits include cool storage at the favorable temperatures of 4 to 7 C (40 to 45 F), and highly efficient heat transfer ates afforded by he direct contact mechanism. In addition, the experimental approach underway at ORNL to study such a system is discussed.

Benefits and challenges of international clinical education from a US-based physiotherapist faculty perspective.

PubMed

Pechak, Celia; Black, Jill D

2013-12-01

The influence of internationalization on physiotherapist education in at least North American-based programmes has become more apparent. Faculty and students have been involved in various international activities. One category of activities includes international clinical education (ICE), where students earn clinical education credit for their learning activities at international sites. Although this educational strategy appears to be increasingly used in at least the United States and Canada, the related literature is limited in scope. The purpose of this portion of the present study was to investigate the benefits and challenges of ICE for US-based students, US-based physiotherapy programmes and international partners from the perspective of US-based faculty sending students for clinical education internationally. Content analysis was used for this qualitative study. Fifteen US-based faculty members who had experience in sending physiotherapist students for ICE were recruited. The primary researcher conducted semi-structured phone interviews, averaging approximately 60 minutes in length. The primary and secondary researchers completed data analysis using NVivo 8 software (QSR International Inc., Cambridge, MA). Benefits of ICE to the students included exposure to alternate health systems, broadening of student perspectives and clinical competence. Challenges consisted of funding and possible language barrier. Increased visibility, expanded global perspective and faculty collaborations were benefits to the programme. Ensuring a quality learning experience was the greatest programme challenge. Benefits to the international site included education and faculty collaborations/exchanges; challenges were language, student clinical preparation and unfamiliarity with the student evaluation tool. Because the sample was limited to 15 US-based faculty members, the results may not be relevant to all programmes inside or outside of the United States. Additionally, the study lacked perspectives from the students or international sites. The present study is an early step in the important examination of the impact of this emerging educational trend on physiotherapy education and practice. Copyright © 2013 John Wiley & Sons, Ltd.

Potential Benefits of an Integrated Electric-Acoustic Sound Processor with Children: A Preliminary Report.

PubMed

Wolfe, Jace; Neumann, Sara; Schafer, Erin; Marsh, Megan; Wood, Mark; Baker, R Stanley

2017-02-01

A number of published studies have demonstrated the benefits of electric-acoustic stimulation (EAS) over conventional electric stimulation for adults with functional low-frequency acoustic hearing and severe-to-profound high-frequency hearing loss. These benefits potentially include better speech recognition in quiet and in noise, better localization, improvements in sound quality, better music appreciation and aptitude, and better pitch recognition. There is, however, a paucity of published reports describing the potential benefits and limitations of EAS for children with functional low-frequency acoustic hearing and severe-to-profound high-frequency hearing loss. The objective of this study was to explore the potential benefits of EAS for children. A repeated measures design was used to evaluate performance differences obtained with EAS stimulation versus acoustic- and electric-only stimulation. Seven users of Cochlear Nucleus Hybrid, Nucleus 24 Freedom, CI512, and CI422 implants were included in the study. Sentence recognition (assayed using the pediatric version of the AzBio sentence recognition test) was evaluated in quiet and at three fixed signal-to-noise ratios (SNR) (0, +5, and +10 dB). Functional hearing performance was also evaluated with the use of questionnaires, including the comparative version of the Speech, Spatial, and Qualities, the Listening Inventory for Education Revised, and the Children's Home Inventory for Listening Difficulties. Speech recognition in noise was typically better with EAS compared to participants' performance with acoustic- and electric-only stimulation, particularly when evaluated at the less favorable SNR. Additionally, in real-world situations, children generally preferred to use EAS compared to electric-only stimulation. Also, the participants' classroom teachers observed better hearing performance in the classroom with the use of EAS. Use of EAS provided better speech recognition in quiet and in noise when compared to performance obtained with use of acoustic- and electric-only stimulation, and children responded favorably to the use of EAS implemented in an integrated sound processor for real-world use. American Academy of Audiology

26 CFR 53.4958-1 - Taxes on excess benefit transactions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... organization (as defined in section 4958(e) and § 53.4958-2) and a disqualified person (as defined in section... imposed is liable for an additional tax of 200 percent of the excess benefit. An organization manager (as... reasonable cause. If an organization manager also receives an excess benefit from an excess benefit...

29 CFR 4022.23 - Computation of maximum guaranteeable benefits.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Converting Temporary Additional Benefit Under Step-Down Life Annuity Age of participant 1 at the later of the... benefit payable for life commencing at age 65, the maximum guaranteeable monthly amount of such benefit... age 65 that corresponds to the later of the participant's age at the termination date or his age at...

Paid maternity and paternity leave: rights and choices.

PubMed

Jordan, Claire

2007-01-01

From April 2007 onwards, maternity leave will be raised to nine months Paid maternity leave is associated with significant health benefits for babies, including reduced infant mortality The Government proposes to increase paid maternity leave to one year and introduce additional paternity leave by around 2009 The U.K's provision for maternity leave and child care is more generous than the U.S.A. or Australia but less than in the Scandinavian countries

China’s Foreign Policy: What Does It Mean for U.S. Global Interests

DTIC Science & Technology

2008-07-18

economic competitiveness.36 The 2005 EAS meeting is part of a trend in growing Sino- ASEAN regional cooperation. In addition to being included in an...independence activism on Taiwan, and the benefits and complications accompanying China’s own rapid economic growth. As defined in a series of White...observers may CRS-15 32 Prime Minister Tony Blair, “Doctrine of the International Community,” in a

More than a score: a qualitative study of ancillary benefits of performance measurement.

PubMed

Powell, Adam A; White, Katie M; Partin, Melissa R; Halek, Krysten; Hysong, Sylvia J; Zarling, Edwin; Kirsh, Susan R; Bloomfield, Hanna E

2014-08-01

Prior research has examined clinical effects of performance measurement systems. To the extent that non-clinical effects have been researched, the focus has been on negative unintended consequences. Yet, these same systems may also have ancillary benefits for patients and providers--that is, benefits that extend beyond improvements on clinical measures. The purpose of this study is to identify and describe potential ancillary benefits of performance measures as perceived by primary care staff and facility leaders in a large US healthcare system. In-person individual semistructured interviews were conducted with 59 primary care staff and facility leaders at four Veterans Health Administration facilities. Transcribed interviews were coded and organised into thematic categories. Interviewed staff observed that local performance measurement implementation practices can result in increased patient knowledge and motivation. These effects on patients can lead to improved performance scores and additional ancillary benefits. Performance measurement implementation can also directly result in ancillary benefits for the patients and providers. Patients may experience greater satisfaction with care and psychosocial benefits associated with increased provider-patient communication. Ancillary benefits of performance measurement for providers include increased pride in individual or organisational performance and greater confidence that one's practice is grounded in evidence-based medicine. A comprehensive understanding of the effects of performance measurement systems needs to incorporate ancillary benefits as well as effects on clinical performance scores and negative unintended consequences. Although clinical performance has been the focus of most evaluations of performance measurement to date, both patient care and provider satisfaction may improve more rapidly if all three categories of effects are considered when designing and evaluating performance measurement systems. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A systematic review of occupational safety and health business cases.

PubMed

Verbeek, Jos; Pulliainen, Marjo; Kankaanpää, Eila

2009-12-01

Business cases are commonly developed as means to rationalize investment. We systematically reviewed 26 reported cases on occupational safety and health (OSH) interventions to assess if health and productivity arguments make a good business case. To be included in the review, studies had to analyze the costs and benefits, including productivity, of an OSH intervention at the enterprise level. We searched Medline and Embase for studies and used Google search in addition. Two reviewers independently selected studies and extracted data. The intervention profitability was calculated in euros (euro in 2008) as the first year's benefits minus the total intervention costs per worker. The payback period was calculated as the intervention costs divided by the first year's benefits. We found three ex-ante and 23 ex-post cases. In 20 cases, the study design was a before-after comparison without a control group. Generally a 100% reduction of injuries or sickness absence was assumed. In two cases, productivity and quality increases were very large. The main benefit was avoided sick leave. Depreciation or discounting was applied only in a minority of cases. The intervention profitability was negative in seven studies, up to euro 500 per employee in 12 studies and more than euro 500 per employee in seven studies. The payback period was less than half a year for 19 studies. Only a few studies included sensitivity analyses. Few ex-ante business cases for management decisions on OSH are reported. Guidelines for reporting and evaluation are needed. Business cases need more sound assumptions on the effectiveness of interventions and should incorporate greater uncertainty into their design. Ex-post evaluation should be based preferably on study designs that control for trends at a time different from that of the intervention.

Effectiveness of community- and workplace-based interventions to manage musculoskeletal-related sickness absence and job loss: a systematic review.

PubMed

Palmer, Keith T; Harris, Elizabeth C; Linaker, Cathy; Barker, Mary; Lawrence, Wendy; Cooper, Cyrus; Coggon, David

2012-02-01

To assess the effectiveness of interventions in community and workplace settings to reduce sickness absence and job loss in workers with musculoskeletal disorders (MSDs). Relevant randomized controlled trials (RCTs) and cohort studies, published since 1990, were identified by screening citations from 35 earlier systematic reviews and by searching MEDLINE and Embase until April 2010. Effects were estimated by intervention category and other features, including study quality. Among 42 studies (including 34 RCTs), 27 assessed return to work (RTW), 21 duration of sickness absence and 5 job loss. Interventions included exercise therapy, behavioural change techniques, workplace adaptations and provision of additional services. Studies were typically small {median sample 107 [inter-quartile range (IQR) 77-148]} and limited in quality. Most interventions appeared beneficial: the median relative risk (RR) for RTW was 1.21 (IQR 1.00-1.60) and that for avoiding MSD-related job loss was 1.25 (IQR 1.06-1.71); the median reduction in sickness absence was 1.11 (IQR 0.32-3.20) days/month. However, effects were smaller in larger and better-quality studies, suggesting publication bias. No intervention was clearly superior, although effort-intensive interventions were less effective than simple ones. No cost-benefit analyses established statistically significant net economic benefits. As benefits are small and of doubtful cost-effectiveness, employers' practice should be guided by their value judgements about the uncertainties. Expensive interventions should be implemented only with rigorous cost-benefit evaluation planned from the outset. Future research should focus on the cost-effectiveness of simple, low-cost interventions, and further explore impacts on job retention.

Job Sharing for Women Pharmacists in Academia

PubMed Central

Finks, Shannon W.

2009-01-01

The pharmacist shortage, increasing numbers of female pharmacy graduates, more pharmacy schools requiring faculty members, and a lower percentage of female faculty in academia are reasons to develop unique arrangements for female academic pharmacists who wish to work part-time. Job sharing is an example of a flexible alternative work arrangement that can be successful for academic pharmacists who wish to continue in a part-time capacity. Such partnerships have worked for other professionals but have not been widely adopted in pharmacy academia. Job sharing can benefit the employer through retention of experienced employees who collectively offer a wider range of skills than a single employee. Benefits to the employee include balanced work and family lives with the ability to maintain their knowledge and skills by remaining in the workforce. We discuss the additional benefits of job-sharing as well as our experience in a non-tenure track job-sharing position at the University of Tennessee College of Pharmacy. PMID:19960092

Efficacy of a high-resolution consultation system in gastroenterology at an Andalusian hospital center.

PubMed

Zambrana-García, José Luis; Montoro-Caba, María Isabel; Chicano-Gallardo, Maite; Monrobel-Lancho, Ana; Pérez-de-Luque, Daniel Jesús; Peña-Ojeda, José Antonio; Recio-Ramírez, José Manuel

2016-01-01

By high resolution consultation (HRC) we mean an ambulatory process of assistance fulfilled in a single day, by which treatment and diagnosis are established and recorded. To assess to which extent patients with digestive conditions may benefit from a single consultation system. A descriptive study of 179 first visit events, randomly selected as high-resolution consultations in gastroenterology. We discuss the percentage of patients who benefited from HRC and the complementary tests performed. Most common conditions included dyspepsia (16%), a family history of colon cancer (16%) and gastroesophageal reflux disease (GERD) (16%). Seventy-nine (44%) of all first visits became HRCs and 80 (45%) required a diagnostic test (100% abdominal ultrasound) that was reviewed on the same day. Performing a test on the same day significantly increased the percentage of HRCs (57% vs. 34%, p < 0.002). GERD, dyspepsia, cholelithiasis and chronic liver disease were the subjects most commonly leading to HRC. Gastroenterology consultations may largely benefit from an HRC system with only organizational changes and no additional costs.

The spectral analysis of fuel oils using terahertz radiation and chemometric methods

NASA Astrophysics Data System (ADS)

Zhan, Honglei; Zhao, Kun; Zhao, Hui; Li, Qian; Zhu, Shouming; Xiao, Lizhi

2016-10-01

The combustion characteristics of fuel oils are closely related to both engine efficiency and pollutant emissions, and the analysis of oils and their additives is thus important. These oils and additives have been found to generate distinct responses to terahertz (THz) radiation as the result of various molecular vibrational modes. In the present work, THz spectroscopy was employed to identify a number of oils, including lubricants, gasoline and diesel, with different additives. The identities of dozens of these oils could be readily established using statistical models based on principal component analysis. The THz spectra of gasoline, diesel, sulfur and methyl methacrylate (MMA) were acquired and linear fittings were obtained. By using chemometric methods, including back propagation, artificial neural network and support vector machine techniques, typical concentrations of sulfur in gasoline (ppm-grade) could be detected, together with MMA in diesel below 0.5%. The absorption characteristics of the oil additives were also assessed using 2D correlation spectroscopy, and several hidden absorption peaks were discovered. The technique discussed herein should provide a useful new means of analyzing fuel oils with various additives and impurities in a non-destructive manner and therefore will be of benefit to the field of chemical detection and identification.

Activity of Imipenem with Relebactam against Gram-Negative Pathogens from New York City.

PubMed

Lapuebla, Amabel; Abdallah, Marie; Olafisoye, Olawole; Cortes, Christopher; Urban, Carl; Landman, David; Quale, John

2015-08-01

Imipenem with relebactam was active against Escherichia coli, Klebsiella pneumoniae, and Enterobacter spp., including K. pneumoniae carbapenemase (KPC)-producing isolates. Loss of OmpK36 in KPC-producing K. pneumoniae isolates affected the susceptibility of this combination. Enhanced activity was evident against Pseudomonas aeruginosa, including isolates with depressed oprD and increased ampC expression. However, the addition of relebactam to imipenem did not provide added benefit against Acinetobacter baumannii. The combination of imipenem with relebactam demonstrated activity against KPC-producing Enterobacteriaceae and multidrug-resistant P. aeruginosa. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

26 CFR 1.509(a)-4 - Supporting organizations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... social science. The sponsoring organizations organized Y Council as a means of pooling their ideas and... benefit of new or additional publicly supported organizations of the same or a different class designated... even if they permit X to operate for the benefit of any new colleges created in State Y in addition to...

26 CFR 1.509(a)-4 - Supporting organizations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... social science. The sponsoring organizations organized Y Council as a means of pooling their ideas and... benefit of new or additional publicly supported organizations of the same or a different class designated... even if they permit X to operate for the benefit of any new colleges created in State Y in addition to...

Promoting universal financial protection: health insurance for the poor in Georgia--a case study.

PubMed

Zoidze, Akaki; Rukhazde, Natia; Chkhatarashvili, Ketevan; Gotsadze, George

2013-11-15

The present study focuses on the program "Medical Insurance for the Poor (MIP)" in Georgia. Under this program, the government purchased coverage from private insurance companies for vulnerable households identified through a means testing system, targeting up to 23% of the total population. The benefit package included outpatient and inpatient services with no co-payments, but had only limited outpatient drug benefits. This paper presents the results of the study on the impact of MIP on access to health services and financial protection of the MIP-targeted and general population. With a holistic case study design, the study employed a range of quantitative and qualitative methods. The methods included document review and secondary analysis of the data obtained through the nationwide household health expenditure and utilisation surveys 2007-2010 using the difference-in-differences method. The study findings showed that MIP had a positive impact in terms of reduced expenditure for inpatient services and total household health care costs, and there was a higher probability of receiving free outpatient benefits among the MIP-insured. However, MIP insurance had almost no effect on health services utilisation and the households' expenditure on outpatient drugs, including for those with MIP insurance, due to limited drug benefits in the package and a low claims ratio. In summary, the extended MIP coverage and increased financial access provided by the program, most likely due to the exclusion of outpatient drug coverage from the benefit package and possibly due to improper utilisation management by private insurance companies, were not able to reverse adverse effects of economic slow-down and escalating health expenditure. MIP has only cushioned the negative impact for the poorest by decreasing the poor/rich gradient in the rates of catastrophic health expenditure. The recent governmental decision on major expansion of MIP coverage and inclusion of additional drug benefit will most likely significantly enhance the overall MIP impact and its potential as a viable policy instrument for achieving universal coverage. The Georgian experience presented in this paper may be useful for other low- and middle-income countries that are contemplating ways to ensure universal coverage for their populations.

Additive Manufacturing for Affordable Rocket Engines

NASA Technical Reports Server (NTRS)

West, Brian; Robertson, Elizabeth; Osborne, Robin; Calvert, Marty

2016-01-01

Additive manufacturing (also known as 3D printing) technology has the potential to drastically reduce costs and lead times associated with the development of complex liquid rocket engine systems. NASA is using 3D printing to manufacture rocket engine components including augmented spark igniters, injectors, turbopumps, and valves. NASA is advancing the process to certify these components for flight. Success Story: MSFC has been developing rocket 3D-printing technology using the Selective Laser Melting (SLM) process. Over the last several years, NASA has built and tested several injectors and combustion chambers. Recently, MSFC has 3D printed an augmented spark igniter for potential use the RS-25 engines that will be used on the Space Launch System. The new design is expected to reduce the cost of the igniter by a factor of four. MSFC has also 3D printed and tested a liquid hydrogen turbopump for potential use on an Upper Stage Engine. Additive manufacturing of the turbopump resulted in a 45% part count reduction. To understanding how the 3D printed parts perform and to certify them for flight, MSFC built a breadboard liquid rocket engine using additive manufactured components including injectors, turbomachinery, and valves. The liquid rocket engine was tested seven times in 2016 using liquid oxygen and liquid hydrogen. In addition to exposing the hardware to harsh environments, engineers learned to design for the new manufacturing technique, taking advantage of its capabilities and gaining awareness of its limitations. Benefit: The 3D-printing technology promises reduced cost and schedule for rocket engines. Cost is a function of complexity, and the most complicated features provide the largest opportunities for cost reductions. This is especially true where brazes or welds can be eliminated. The drastic reduction in part count achievable with 3D printing creates a waterfall effect that reduces the number of processes and drawings, decreases the amount of touch labor required, and increases reliability. When certification is achieved, NASA missions will be able to realize these benefits.

Local action on outdoor air pollution to improve public health.

PubMed

Vardoulakis, Sotiris; Kettle, Rachel; Cosford, Paul; Lincoln, Paul; Holgate, Stephen; Grigg, Jonathan; Kelly, Frank; Pencheon, David

2018-06-01

The National Institute for Health and Care Excellence, jointly with Public Health England, have developed a guideline on outdoor air pollution and its links to health. The guideline makes recommendations on local interventions that can help improve air quality and prevent a range of adverse health outcomes associated with road-traffic-related air pollution. The guideline was based on a rigorous assessment of the scientific evidence by an independent advisory committee, with input from public health professionals and other professional groups. The process included systematics reviews of the literature, expert testimonies and stakeholder consultation. The guideline includes recommendations for local planning, clean air zones, measures to reduce emissions from public sector transport services, smooth driving and speed reduction, active travel, and awareness raising. The guideline recommends taking a number of actions in combination, because multiple interventions, each producing a small benefit, are likely to act cumulatively to produce significant change. These actions are likely to bring multiple public health benefits, in addition to air quality improvements.

What Bariatric Surgery Can Teach Us About Endoluminal Treatment of Obesity and Metabolic Disorders.

PubMed

Kaplan, Lee M

2017-04-01

Bariatric surgical procedures, including gastric bypass, vertical sleeve gastrectomy, and biliopancreatic diversion, are the most effective and durable treatments for obesity. In addition, These operations induce metabolic changes that provide weight-independent improvement in type 2 diabetes, fatty liver disease and other metabolic disorders. Initially thought to work by mechanical restriction of food intake or malabsorption of ingested nutrients, these procedures are now known to work through complex changes in neuroendocrine and immune signals emanating from the gut, including peptide hormones, bile acids, vagal nerve activity, and metabolites generated by the gut microbiota, all collaborating to reregulate appetite, food preference, and energy expenditure. Development of less invasive means of achieving these benefits would allow much greater dissemination of effective, gastrointestinal (GI)-targeted therapies for obesity and metabolic disorders. To reproduce the benefits of bariatric surgery, however, these endoscopic procedures and devices will need to mimic the physiological rather than the mechanical effects of these operations. Copyright © 2017 Elsevier Inc. All rights reserved.

Systematic Review of Yoga Interventions to Promote Cardiovascular Health in Older Adults.

PubMed

Barrows, Jennifer L; Fleury, Julie

2016-06-01

The benefits of physical activity are well established, yet few older adults engage in adequate physical activity to optimize health. While yoga may reduce the risk of cardiovascular disease, few studies have focused on the efficacy of yoga-based physical activity to promote cardiovascular health in older adults. The objective of this review is to provide an evaluation of yoga interventions to reduce cardiovascular risk in older adults. Four databases were searched for randomized controlled trials of yoga interventions in older adults. Studies with cardiovascular outcomes were included. Literature searches identified nine articles eligible for review. Significant health benefits were reported, including favorable changes in blood pressure, body composition, glucose, and lipids. Yoga practices, participant characteristics, and outcome measures were variable. There was limited use of theory. Yoga is safe and feasible in older adults; additional research is warranted to examine the specific components of yoga interventions essential to reducing cardiovascular risk. © The Author(s) 2015.

A tax strategy for healthcare workers. Section 403(b) plans are an alternative to weakened IRAs.

PubMed

Crain, J L; Morris, J L; Ballard, M R

1990-01-01

After the Tax Reform Act of 1986 reduced the tax-deduction benefits of investing in IRAs, many healthcare employees went looking for alternative tax-shelter investments. Several options are available. One alternative for taxpayers employed by tax-exempt organizations is Section 403(b) tax-deferred annuities (TDAs). Although the Tax Reform Act left Section 403(b) TDAs largely intact, it established a comprehensive set of nondiscrimination rules for certain statutory fringe-benefit plans--including Section 403(b) plans. The new rules are designed to restrict situations that favor participation by highly paid employees to the exclusion of other employees. Perhaps one of the harshest adjustments the 1986 law mandated is the imposition of an additional 10 percent income tax on withdrawals an investor makes from Section 403(b) plans before reaching the age of 59 years and 6 months. This excise tax had already applied to early withdrawals from an IRA, but the new law extends the penalty tax to cover all qualified plans, including TDAs.

Developing a Long-term Monitoring Program with Undergraduate Students in Marine Sciences

NASA Astrophysics Data System (ADS)

Anders, T. M.; Boryta, M. D.

2015-12-01

A goal of our growing marine geoscience program at Mt. San Antonio College is to involve our students in all stages of developing and running an undergraduate research project. During the initial planning phase, students develop and test their proposals. Instructor-set parameters were chosen carefully to help guide students toward manageable projects but to not limit their creativity. Projects should focus on long-term monitoring of a coastal area in southern California. During the second phase, incoming students will critique the initial proposals, modify as necessary and continue to develop the project. We intend for data collection opportunities to grow from geological and oceanographic bases to eventually include other STEM topics in biology, chemistry, math and GIS. Questions we will address include: What makes this a good research project for a community college? What are the costs and time commitments involved? How will the project benefit students and society? Additionally we will share our initial results, challenges, and unexpected pitfalls and benefits.

Qualitative process study to explore the perceived burdens and benefits of a digital intervention for self-managing high blood pressure in Primary Care in the UK.

PubMed

Morton, Katherine; Dennison, Laura; Bradbury, Katherine; Band, Rebecca Jane; May, Carl; Raftery, James; Little, Paul; McManus, Richard J; Yardley, Lucy

2018-05-08

Digital interventions can change patients' experiences of managing their health, either creating additional burden or improving their experience of healthcare. This qualitative study aimed to explore perceived burdens and benefits for patients using a digital self-management intervention for reducing high blood pressure. A secondary aim was to further our understanding of how best to capture burdens and benefits when evaluating health interventions. Inductive qualitative process study nested in a randomised controlled trial. Primary Care in the UK. 35 participants taking antihypertensive medication and with uncontrolled blood pressure at baseline participated in semistructured telephone interviews. Digital self-management intervention to support blood pressure self-monitoring and medication change when recommended by the healthcare professional. Data were analysed using inductive thematic analysis with techniques from grounded theory. Seven themes were developed which reflected perceived burdens and benefits of using the intervention, including worry about health, uncertainty about self-monitoring and reassurance. The analysis showed how beliefs about their condition and treatment appeared to influence participants' appraisal of the value of the intervention. This suggested that considering illness and treatment perceptions in Burden of Treatment theory could further our understanding of how individuals appraise the personal costs and benefits of self-managing their health. Patients' appraisal of the burden or benefit of using a complex self-management intervention seemed to be influenced by experiences within the intervention (such as perceived availability of support) and beliefs about their condition and treatment (such as perceived control and risk of side effects). Developing our ability to adequately capture these salient burdens and benefits for patients could help enhance evaluation of self-management interventions in the future. Many participants perceived important benefits from using the intervention, highlighting the need for theory to recognise that engaging in self-management can include positive as well as negative aspects. ISRCTN13790648; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

76 FR 52441 - Summary of Benefits and Coverage and the Uniform Glossary

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-22

... facts label that includes examples to illustrate common benefits scenarios (including pregnancy and... plan or coverage for common benefits scenarios, including pregnancy and serious or chronic medical...

A cost-benefit analysis of pre- and post-lambing anthelmintic treatments to twin-bearing ewes on commercial farms in the southern North Island of New Zealand.

PubMed

Garland, C B; Leathwick, D M

2015-07-01

To conduct a cost-benefit analysis of the administration of anthelmintics to adult ewes around lambing. Production data from comparisons of different anthelmintic treatments with no treatment were used in a cost-benefit analysis. The data were from 14 trials (part of an experiment carried out on one farm in 1 year) conducted on sheep and beef farms (eight in 2011 and six in 2012) in the Wairarapa region of New Zealand. The cost structure involved the purchase price of products and the labour cost of administration. The four key benefits identified for the calculation of economic returns, relative to untreated ewes, were: increased value of ewes sold (culled) at weaning, additional lambs weaned related to ewe liveweight at mating, increased total weight of lamb weaned per ewe, and reduced number of ewes requiring removal of soiled wool at weaning due to a lower dag score. Commercial values for these variables as at December 2013 were used, with the measured production data, to calculate a net (NZ$) benefit for every treatment-trial combination. The economic return on treating ewes around lambing with anthelmintics was highly variable and across all trials treatment resulted in a financial loss in 18/38 (47%) groups of ewes. The mean net benefit from pre-lambing administration of a controlled release capsule (CRC) containing albendazole and abamectin was 5.36 (95% CI=-2.64 to 13.35) $/ewe, but overall was not different from zero (p=0.171). A breakdown of the overall gross benefit into its various components showed that weight of lamb weaned per ewe had the largest influence (a mean benefit of $5.68/ewe), followed by ewe liveweight pre-mating ($2.45/ewe), ewe liveweight at weaning ($0.66/ewe) and reduced dag score ($0.15/ewe). Other anthelmintic treatments all showed highly variable responses amongst trials, with some negative cost-benefits. There was no significant difference between any of the treatments except a short-acting oral treatment at tail-docking had a lower net benefit than a CRC containing albendazole administered pre-lambing (p<0.05). A positive financial return resulting from the anthelmintic treatment of adult ewes around lambing is neither consistent nor predictable, and is often not achieved. Given that the additional costs of accelerating the development of anthelmintic resistance were not included in these calculations, farmers need to consider carefully the merits of administering anthelmintics to ewes around lambing.

How to successfully select and implement electronic health records (EHR) in small ambulatory practice settings.

PubMed

Lorenzi, Nancy M; Kouroubali, Angelina; Detmer, Don E; Bloomrosen, Meryl

2009-02-23

Adoption of EHRs by U.S. ambulatory practices has been slow despite the perceived benefits of their use. Most evaluations of EHR implementations in the literature apply to large practice settings. While there are similarities relating to EHR implementation in large and small practice settings, the authors argue that scale is an important differentiator. Focusing on small ambulatory practices, this paper outlines the benefits and barriers to EHR use in this setting, and provides a "field guide" for these practices to facilitate successful EHR implementation. The benefits of EHRs in ambulatory practices include improved patient care and office efficiency, and potential financial benefits. Barriers to EHRs include costs; lack of standardization of EHR products and the design of vendor systems for large practice environments; resistance to change; initial difficulty of system use leading to productivity reduction; and perceived accrual of benefits to society and payers rather than providers. The authors stress the need for developing a flexible change management strategy when introducing EHRs that is relevant to the small practice environment; the strategy should acknowledge the importance of relationship management and the role of individual staff members in helping the entire staff to manage change. Practice staff must create an actionable vision outlining realistic goals for the implementation, and all staff must buy into the project. The authors detail the process of implementing EHRs through several stages: decision, selection, pre-implementation, implementation, and post-implementation. They stress the importance of identifying a champion to serve as an advocate of the value of EHRs and provide direction and encouragement for the project. Other key activities include assessing and redesigning workflow; understanding financial issues; conducting training that is well-timed and meets the needs of practice staff; and evaluating the implementation process. The EHR implementation experience depends on a variety of factors including the technology, training, leadership, the change management process, and the individual character of each ambulatory practice environment. Sound processes must support both technical and personnel-related organizational components. Additional research is needed to further refine recommendations for the small physician practice and the nuances of specific medical specialties.

"We are part of a family". Benefits and limitations of community ART groups (CAGs) in Thyolo, Malawi: a qualitative study.

PubMed

Pellecchia, Umberto; Baert, Saar; Nundwe, Spencer; Bwanali, Andy; Zamadenga, Bote; Metcalf, Carol A; Bygrave, Helen; Daho, Sarah; Ohler, Liesbet; Chibwandira, Brown; Kanyimbo, Kennedy

2017-03-28

In 2012 Community ART Groups (CAGs), a community-based model of antiretroviral therapy (ART) delivery were piloted in Thyolo District, Malawi as a way to overcome patient barriers to accessing treatment, and to decrease healthcare workers' workload. CAGs are self-formed groups of patients on ART taking turns to collect ART refills for all group members from the health facility. We conducted a qualitative study to assess the benefits and challenges of CAGs from patients' and healthcare workers' (HCWs) perspectives. Data were collected by means of 15 focus group discussions, 15 individual in-depth interviews, and participant observation in 2 health centres. The 94 study participants included CAG members, ART patients eligible for CAGs who remained in conventional care, former CAG members who returned to conventional care and HCWs responsible for providing HIV care. Patient participants were purposively selected from ART registers, taking into account age and gender. Narratives were audio-recorded, transcribed, and translated from Chichewa to English. Data were analyzed through a thematic analysis. Patients and HCWs spoke favourably about the practical benefits of CAGs. Patient benefits included a reduced frequency of clinic visits, resulting in reduced transportation costs and time savings. HCW benefits included a reduced workload. Additionally peer support was perceived as an added value of the groups allowing not only sharing of the logistical constraints of drugs refills, but also enhanced emotional support. Identified barriers to joining a CAG included a lack of information on CAGs, unwillingness to disclose one's HIV status, change of residence and conflicts among CAG members. Participants reported that HIV-related stigma persists and CAGs were seen as an effective strategy to reduce exposure to discriminatory labelling by community members. In this setting, patients and HCWs perceived CAGs to be an acceptable model of ART delivery. Despite addressing important practical barriers to accessing ART, and providing peer support, CAGs were not well known by patients and had a limited impact on reducing HIV-related stigma. The CAG model of ART delivery should be considered in similar settings. Further measures need to be devised and implemented to address HIV-related stigma.

Clinical Teaching of Prosthodontics in Undergraduate Courses in a German Dental School: Patients, Visits, Efforts, and Incentives.

PubMed

Huettig, Fabian; Behrend, Florian

2016-01-01

It is unknown what disadvantages are faced by patients deciding for a prosthodontic treatment by inexperienced students. Commonly, the related extra effort and time are compensated by cost reduction of treatment fees. Thereby, the dental schools subsidize treatments to teach clinical prosthodontics. The aim of this study was to clarify the benefits to patients as well as the efforts of the dental school. Data collected from three courses in a dental school in Germany were patient gender, age, occupation, zip code, number of visits, scope of treatment including costs, financial discount, and remaining copayment. Travel costs were calculated based on zip code. Balance of travel costs and treatment discount was defined as financial benefit. The results showed that 185 patients (95 male) aged 32 to 82 years (median=58) were treated with fixed restorations (FR, n=110), telescopic dentures (TD, n=87), complete dentures (CD, n=17), or other (RD, n=3). The mean number of visits was 11 for FR, 12 for TD, and 9 for CD. Single distance to the clinic ranged from 0.6 to 65 miles (median=12). Total costs of prosthodontics were reduced by 19% on average. The mean financial benefit was 429 USD (median=298, min=-482, max=4025). The financial benefits were found to differ widely, including additional expenditures of patients. Participation, travel burden, and copayment did not depend on age, gender, or occupation. The financial benefit was relativized because students needed at least twice the sessions of a dentist. As a result, the financial efforts of dental schools are significant and compromise a cost-covering education.

Preliminary analysis of the benefits derived to US Air Force spacecraft from on-orbit refueling

NASA Astrophysics Data System (ADS)

Smith, Scott

1993-02-01

This analysis was undertaken during FY-91 as a preliminary step to identify potential benefits from refueling Air Force satellites on orbit. Both economic and operational benefits were included. Operational benefits were related in economic terms to allow evaluation. All economic comparisons were made using FY-91 costs. An additional purpose of the effort was to identify the preferred mission parameters, for an on-orbit refueling system. A companion study was being concurrently conducted by SSD/XRP and NASA/JPL to develop a hardware concept for an on-orbit refueling system. The mass estimates for refueling missions obtained from the companion study were used in conducting the economic analyses of this benefits study. For this study, on-orbit refueling was based on the concept developed in the companion JPL study. The concept involves launching an S/C carrying fuel that would be transferred to another 'target' S/C which is already in orbit. The two S/C would then rendezvous, dock, and transfer fuel. Another fluid, such as a cryogenic, might be included if needed by the target S/C. The hardware concept for refueling was intended to minimize costs. The re-fueler S/C was designated to be expendable and would contain only the minimal capabilities. It would be launched into the orbit plane and altitude of the target S/C(s). The re-fueler S/C would rendezvous and dock with the target S/C and the fluid transfer would occur. When the refueling mission was completed, the re-fueler S/C would be ejected from the orbit. In order to optimize launch costs, some missions involved launching two re-fueler S/C on the LV. In this case the second re-fueler S/C would be placed in a storage orbit until needed.

Preliminary analysis of the benefits derived to US Air Force spacecraft from on-orbit refueling

NASA Technical Reports Server (NTRS)

Smith, Scott

1993-01-01

This analysis was undertaken during FY-91 as a preliminary step to identify potential benefits from refueling Air Force satellites on orbit. Both economic and operational benefits were included. Operational benefits were related in economic terms to allow evaluation. All economic comparisons were made using FY-91 costs. An additional purpose of the effort was to identify the preferred mission parameters, for an on-orbit refueling system. A companion study was being concurrently conducted by SSD/XRP and NASA/JPL to develop a hardware concept for an on-orbit refueling system. The mass estimates for refueling missions obtained from the companion study were used in conducting the economic analyses of this benefits study. For this study, on-orbit refueling was based on the concept developed in the companion JPL study. The concept involves launching an S/C carrying fuel that would be transferred to another 'target' S/C which is already in orbit. The two S/C would then rendezvous, dock, and transfer fuel. Another fluid, such as a cryogenic, might be included if needed by the target S/C. The hardware concept for refueling was intended to minimize costs. The re-fueler S/C was designated to be expendable and would contain only the minimal capabilities. It would be launched into the orbit plane and altitude of the target S/C(s). The re-fueler S/C would rendezvous and dock with the target S/C and the fluid transfer would occur. When the refueling mission was completed, the re-fueler S/C would be ejected from the orbit. In order to optimize launch costs, some missions involved launching two re-fueler S/C on the LV. In this case the second re-fueler S/C would be placed in a storage orbit until needed.

Life cycle environmental impacts of substituting food wastes for traditional anaerobic digestion feedstocks.

PubMed

Pérez-Camacho, María Natividad; Curry, Robin; Cromie, Thomas

2018-03-01

In this study, life cycle assessment has been used to evaluate life cycle environmental impacts of substituting traditional anaerobic digestion (AD) feedstocks with food wastes. The results have demonstrated the avoided GHG emissions from substituting traditional AD feedstocks with food waste (avoided GHG-eq emissions of 163.33 CO 2 -eq). Additionally, the analysis has included environmental benefits of avoided landfilling of food wastes and digestate use as a substitute for synthetic fertilisers. The analysis of the GHG mitigation benefits of resource management/circular economy policies, namely, the mandating of a ban on the landfilling of food wastes, has demonstrated the very substantial GHG emission reduction that can be achieved by these policy options - 2151.04 kg CO 2 eq per MWh relative to UK Grid. In addition to the reduction in GHG emission, the utilization of food waste for AD instead of landfilling can manage the leakage of nutrients to water resources and eliminate eutrophication impacts which occur, typically as the result of field application. The results emphasise the benefits of using life-cycle thinking to underpin policy development and the implications for this are discussed with a particular focus on the analysis of policy development across the climate, renewable energy, resource management and bioeconomy nexus and recommendations made for future research priorities. Copyright © 2017 Elsevier Ltd. All rights reserved.

Vitamin supplementation benefits in master athletes.

PubMed

Brisswalter, Jeanick; Louis, Julien

2014-03-01

Master athletes are more than 35 years of age and continue to train as hard as their young counterparts despite the aging process. All life long, they are capable of accomplishing exceptional sporting performances. For these participants in endurance events, matching energy intake and expenditure is critical to maintain health and performance. The proportions of carbohydrate, fat, and protein must be optimized to provide enough calories to sustain the energy requirements of competition or training, and for recovery. In addition, endurance athletes must include adequate vitamins and minerals in their diets to maintain healthy immune function. Vitamins and minerals may be sufficient in the diets of endurance athletes, who have a high energy intake. This would make it unnecessary to use vitamin and mineral supplements. Furthermore, one major limitation for these athletes is the management of oxidative stress, which, when in excess, can be deleterious for the organism. For individuals exposed to oxidative stress, micronutritional supplementations rich in vitamins and minerals can be also an alternative strategy. Although these supplementations are increasingly used by master athletes, very few data are available on their effects on oxidative stress, muscle recovery, and physical performance. The potential benefits of supplement use in athletes are thus questionable. Some studies indicate no benefits, while others highlight potential negative side effects of vitamin supplementation. Additional studies are warranted in order to design adapted prescriptions in antioxidant vitamins and minerals.

Taurine, caffeine, and energy drinks: Reviewing the risks to the adolescent brain.

PubMed

Curran, Christine Perdan; Marczinski, Cecile A

2017-12-01

Energy drinks are emerging as a major component of the beverage market with sales projected to top $60 billion globally in the next five years. Energy drinks contain a variety of ingredients, but many of the top-selling brands include high doses of caffeine and the amino acid taurine. Energy drink consumption by children has raised concerns, due to potential caffeine toxicity. An additional risk has been noted among college-aged consumers of energy drinks who appear at higher risk of over-consumption of alcohol when the two drinks are consumed together. The differential and combinatorial effects of caffeine and taurine on the developing brain are reviewed here with an emphasis on the adolescent brain, which is still maturing. Key data from animal studies are summarized to highlight both reported benefits and adverse effects reported following acute and chronic exposures. The data suggest that age is an important factor in both caffeine and taurine toxicity. Although the aged or diseased brain might benefit from taurine or caffeine supplementation, it appears that adolescents are not likely to benefit from supplementation and may, in fact, suffer ill effects from chronic ingestion of high doses. Additional work is needed though to address gaps in our understanding of how taurine affects females, since the majority of animal studies focused exclusively on male subjects. © 2017 Wiley Periodicals, Inc.

Feasibility study of an Integrated Program for Aerospace-vehicle Design (IPAD) system. Volume 6: Implementation schedule, development costs, operational costs, benefit assessment, impact on company organization, spin-off assessment, phase 1, tasks 3 to 8

NASA Technical Reports Server (NTRS)

Garrocq, C. A.; Hurley, M. J.; Dublin, M.

1973-01-01

A baseline implementation plan, including alternative implementation approaches for critical software elements and variants to the plan, was developed. The basic philosophy was aimed at: (1) a progressive release of capability for three major computing systems, (2) an end product that was a working tool, (3) giving participation to industry, government agencies, and universities, and (4) emphasizing the development of critical elements of the IPAD framework software. The results of these tasks indicate an IPAD first release capability 45 months after go-ahead, a five year total implementation schedule, and a total developmental cost of 2027 man-months and 1074 computer hours. Several areas of operational cost increases were identified mainly due to the impact of additional equipment needed and additional computer overhead. The benefits of an IPAD system were related mainly to potential savings in engineering man-hours, reduction of design-cycle calendar time, and indirect upgrading of product quality and performance.

N-mix for fish: estimating riverine salmonid habitat selection via N-mixture models

USGS Publications Warehouse

Som, Nicholas A.; Perry, Russell W.; Jones, Edward C.; De Juilio, Kyle; Petros, Paul; Pinnix, William D.; Rupert, Derek L.

2018-01-01

Models that formulate mathematical linkages between fish use and habitat characteristics are applied for many purposes. For riverine fish, these linkages are often cast as resource selection functions with variables including depth and velocity of water and distance to nearest cover. Ecologists are now recognizing the role that detection plays in observing organisms, and failure to account for imperfect detection can lead to spurious inference. Herein, we present a flexible N-mixture model to associate habitat characteristics with the abundance of riverine salmonids that simultaneously estimates detection probability. Our formulation has the added benefits of accounting for demographics variation and can generate probabilistic statements regarding intensity of habitat use. In addition to the conceptual benefits, model application to data from the Trinity River, California, yields interesting results. Detection was estimated to vary among surveyors, but there was little spatial or temporal variation. Additionally, a weaker effect of water depth on resource selection is estimated than that reported by previous studies not accounting for detection probability. N-mixture models show great promise for applications to riverine resource selection.

Vision problems are a leading source of modifiable health expenditures.

PubMed

Rein, David B

2013-12-13

According to recent studies, visual problems represent one of the top contributors to economic health burden in the United States. This burden is divided nearly equally between direct expenditures for the care and treatment of visual problems, and the indirect costs of outcomes caused by low vision, including productivity losses, the cost of care, and incremental nursing home placements. A large amount of academic research is devoted to visual science, the biology of the visual system, and the medical treatment of visual disorders. Compared to the burden, a disproportionate share of this research is devoted to the study of retinal disorders and glaucoma. This is understandable, as research into the retina and optic nerve has the potential to unlock fundamental insights into the nature of sight and visual cognition. However, population visual health and the functionality that depends upon it also may benefit greatly from additional research into areas of prevention, rehabilitation, and adaptation. In addition, comparative research into the benefits of resource allocation across prevention, treatment, and rehabilitative resources could lead to improvements in population health.

Type 1 Diabetes TrialNet--an international collaborative clinical trials network.

PubMed

Skyler, Jay S; Greenbaum, Carla J; Lachin, John M; Leschek, Ellen; Rafkin-Mervis, Lisa; Savage, Peter; Spain, Lisa

2008-12-01

Type 1 Diabetes TrialNet is an international consortium of clinical research centers aimed at the prevention or delay of type 1 diabetes (T1D). The fundamental goal of TrialNet is to counter the T1D disease process by immune modulation and/or enhancement of beta cell proliferation and regeneration. To achieve this goal, TrialNet researchers are working to better understand the natural history of the disease, to identify persons at risk, and to clinically evaluate novel therapies that balance potential risks and benefits. The particular focus is on studies of preventive measures. In addition, TrialNet evaluates therapies in individuals with newly diagnosed T1D with preserved beta cell function to help determine the risk/benefit profile and gain an initial assessment of potential efficacy in preservation of beta cell function, so that promising agents can be studied in prevention trials. In addition, TrialNet evaluates methodologies that enhance the conduct of its clinical trials, which includes tests of outcome assessment methodology, the evaluation of surrogate markers, and mechanistic studies laying the foundation for future clinical trials.

Quantifying the indirect effects of key child survival interventions for pneumonia, diarrhoea, and measles.

PubMed

Fischer Walker, C L; Munos, M K; Black, R E

2013-01-01

To date many studies have measured the effect of key child survival interventions on the main cause of mortality while anecdotally reporting effects on all-cause mortality. We conducted a systematic literature review and abstracted cause-specific and all-cause mortality data from included studies. We then estimated the effect of the intervention on the disease of primary interest and calculated the additional deaths prevented (i.e. the indirect effect). We calculated that insecticide-treated nets have been shown to result in a 12% reduction [95% confidence interval (CI) 0·0-23] among non-malaria deaths. We found pneumonia case management to reduce non-pneumonia mortality by 20% (95% CI 8-22). For measles vaccine, seven of the 10 studies reporting an effect on all-cause mortality demonstrated an additional benefit of vaccine on all-cause mortality. These interventions may have benefits on causes of death beyond the specific cause of death they are targeted to prevent and this should be considered when evaluating the effects of implementation of interventions.

Protective Role of Dietary Berries in Cancer

PubMed Central

Kristo, Aleksandra S.; Klimis-Zacas, Dorothy; Sikalidis, Angelos K.

2016-01-01

Dietary patterns, including regular consumption of particular foods such as berries as well as bioactive compounds, may confer specific molecular and cellular protection in addition to the overall epidemiologically observed benefits of plant food consumption (lower rates of obesity and chronic disease risk), further enhancing health. Mounting evidence reports a variety of health benefits of berry fruits that are usually attributed to their non-nutritive bioactive compounds, mainly phenolic substances such as flavonoids or anthocyanins. Although it is still unclear which particular constituents are responsible for the extended health benefits, it appears that whole berry consumption generally confers some anti-oxidant and anti-inflammatory protection to humans and animals. With regards to cancer, studies have reported beneficial effects of berries or their constituents including attenuation of inflammation, inhibition of angiogenesis, protection from DNA damage, as well as effects on apoptosis or proliferation rates of malignant cells. Berries extend effects on the proliferation rates of both premalignant and malignant cells. Their effect on premalignant cells is important for their ability to cause premalignant lesions to regress both in animals and in humans. The present review focuses primarily on in vivo and human dietary studies of various berry fruits and discusses whether regular dietary intake of berries can prevent cancer initiation and delay progression in humans or ameliorate patients’ cancer status. PMID:27775562

Protective Role of Dietary Berries in Cancer.

PubMed

Kristo, Aleksandra S; Klimis-Zacas, Dorothy; Sikalidis, Angelos K

2016-10-19

Dietary patterns, including regular consumption of particular foods such as berries as well as bioactive compounds, may confer specific molecular and cellular protection in addition to the overall epidemiologically observed benefits of plant food consumption (lower rates of obesity and chronic disease risk), further enhancing health. Mounting evidence reports a variety of health benefits of berry fruits that are usually attributed to their non-nutritive bioactive compounds, mainly phenolic substances such as flavonoids or anthocyanins. Although it is still unclear which particular constituents are responsible for the extended health benefits, it appears that whole berry consumption generally confers some anti-oxidant and anti-inflammatory protection to humans and animals. With regards to cancer, studies have reported beneficial effects of berries or their constituents including attenuation of inflammation, inhibition of angiogenesis, protection from DNA damage, as well as effects on apoptosis or proliferation rates of malignant cells. Berries extend effects on the proliferation rates of both premalignant and malignant cells. Their effect on premalignant cells is important for their ability to cause premalignant lesions to regress both in animals and in humans. The present review focuses primarily on in vivo and human dietary studies of various berry fruits and discusses whether regular dietary intake of berries can prevent cancer initiation and delay progression in humans or ameliorate patients' cancer status.

Plant biology: From on-campus to on-line development and implementation

NASA Astrophysics Data System (ADS)

Bradley, Lucy K.

The lecture content of the Plant Biology class for non-majors was transformed from a traditional on-campus lecture to an asynchronous website that could be used both as a stand-alone course and as an adjunct to the on campus course sections. In addition, an interactive, on-line website with home laboratory experiments was developed and implemented by the Plant Biology Department in collaboration with design specialists from the Information Technology and Instructional Support Department of the Arizona State University. The 259-page lecture website included 134 interactive animations, as well as 11 videos. The lab website included 176 pages, with 187 graphics and 36 separate animations. Convenience was identified by most students as the key benefit of taking the course on-line. Website construction was rated highly by all of the students; however, website audio was problematic for 50% of them; video, for 71%. Students, staff, and faculty all agreed that to benefit fully from the website, adequate hardware, software, and internet connection speed were vital. Challenges with the web-based lab were either technological (inadequate equipment or skills), logistical (dissatisfaction with having to pick up home lab kits from campus), or motivational (student survey responses added to the growing literature that suggests that mature, focused, self-motivated students benefit more from distance learning).

Early Pancreatic Ductal Adenocarcinoma Survival Is Dependent on Size: Positive Implications for Future Targeted Screening.

PubMed

Hur, Chin; Tramontano, Angela C; Dowling, Emily C; Brooks, Gabriel A; Jeon, Alvin; Brugge, William R; Gazelle, G Scott; Kong, Chung Yin; Pandharipande, Pari V

2016-08-01

Pancreatic ductal adenocarcinoma (PDAC) has not experienced a meaningful mortality improvement for the past few decades. Successful screening is difficult to accomplish because most PDACs present late in their natural history, and current interventions have not provided significant benefit. Our goal was to identify determinants of survival for early PDAC to help inform future screening strategies. Early PDACs from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program database (2000-2010) were analyzed. We stratified by size and included carcinomas in situ (Tis). Overall cancer-specific survival was calculated. A Cox proportional hazards model was developed and the significance of key covariates for survival prediction was evaluated. A Kaplan-Meier plot demonstrated significant differences in survival by size at diagnosis; these survival benefits persisted after adjustment for key covariates in the Cox proportional hazards analysis. In addition, relatively weaker predictors of worse survival included older age, male sex, black race, nodal involvement, tumor location within the head of the pancreas, and no surgery or radiotherapy. For early PDAC, we found tumor size to be the strongest predictor of survival, even after adjustment for other patient characteristics. Our findings suggest that early PDAC detection can have clinical benefit, which has positive implications for future screening strategies.

Benefits and Risks of Postmenopausal Hormone Therapy When It Is Initiated Soon After Menopause

PubMed Central

Manson, JoAnn E.; Langer, Robert D.; Anderson, Garnet L.; Pettinger, Mary; Jackson, Rebecca D.; Johnson, Karen C.; Kuller, Lewis H.; Lane, Dorothy S.; Wactawski-Wende, Jean; Brzyski, Robert; Allison, Matthew; Ockene, Judith; Sarto, Gloria; Rossouw, Jacques E.

2009-01-01

The authors further analyzed results from the Women's Health Initiative randomized trials (1993–2004) of conjugated equine estrogens, with or without medroxyprogesterone acetate, focusing on health benefits versus risks among women who initiated hormone therapy soon after menopause. Data from the Women's Health Initiative observational study (1993–2004) were included in some analyses for additional precision. Results are presented here for incident coronary heart disease, stroke, venous thromboembolism, breast cancer, colorectal cancer, endometrial cancer, or hip fracture; death from other causes; a summary global index; total cancer; and total mortality. Hazard ratios for breast cancer and total cancer were comparatively higher (P < 0.05) among women who initiated hormone therapy soon after menopause, for both regimens. Among these women, use of conjugated equine estrogens appeared to produce elevations in venous thromboembolism and stroke and a reduction in hip fracture. Estrogen plus progestin results among women who initiated use soon after menopause were similar for venous thromboembolism, stroke, and hip fracture but also included evidence of longer-term elevations in breast cancer, total cancer, and the global index. These analyses provide little support for the hypothesis of favorable effects among women who initiate postmenopausal estrogen use soon after menopause, either for coronary heart disease or for health benefits versus risk indices considered. PMID:19468079

Sustaining and improving an international service-learning partnership: Evaluation of an evidence-based service delivery model.

PubMed

Hayward, Lorna M; Li, Li

2017-06-01

International service learning (ISL) is an instructional method used by physical therapist educators in the United States (US) to prepare students for rendering culturally competent care. ISL is a faculty led student learning opportunity that includes academic instruction and community service in an international context. Research exists that explores student experiences with ISL, but studies that evaluate ISL partnerships and include global stakeholder feedback are lacking. The purposes of this study were to: 1) integrate a partnership evaluation component into an existing curriculum-based ISL model and 2) through evaluation identify benefits, drawbacks, and suggestions for improving and sustaining the academic-community partnership. Community-based participatory research design using a mixed methods approach was used to evaluate a ISL partnership between a US-based physical therapy program and a service site in Ecuador. Participants were 31 staff working at the global service site. Over three years, 11 interviews were conducted and 26 surveys were administered to global partner staff. Data were analyzed using qualitative thematic content analysis and descriptive statistics. Partnership benefits included the following: continuity of ISL team leadership, targeted rehabilitative efforts, sensitivity to cultural norms, respectful communication, and interaction with local community. Drawbacks were as follows: deficits in cultural awareness, language barriers, and poor treatment carryover. Suggestions for sustaining the relationship incorporated: additional pre-trip communication, education of staff, and improved language skills. As more US teams deliver clinical services abroad, intentional evaluation approaches must include the global stakeholder in the planning, implementation, and evaluation phases to maximize partnerships benefits.

Dance movement therapy and falls prevention.

PubMed

Veronese, Nicola; Maggi, Stefania; Schofield, Patricia; Stubbs, Brendon

2017-08-01

Falls are a leading cause of morbidity, healthcare use and mortality. Dance is a popular form of physical activity among older people and previous research has suggested that it may improve various health outcomes in this population, including balance, gait and muscle performance. A systematic review of the potential benefits of dance on falls and fear of falling is lacking. Thus, we conducted a systematic review considering all randomized controls trials (RCTs) investigating if dance can reduce falls and improve fear of falling in older adults. Major databases were searched from inception until 1 March 2017 and a total of 10 RCTs were identified, which included a total of 680 people (n=356 dance, n=324 control). Overall, the mean age of the samples was 69.4 years, and 75.2% were female. Across four RCTs, dance therapy reduced falls versus usual care in only one study. Dance therapy improved fear of falling in two out of three included RCTs. There were no serious adverse events reported in the RCTs. In summary, we found a paucity of studies investigating the effect of dance on falls and fear of falling and the evidence base is preliminary and equivocal. Given the heterogeneity of the included samples and interventions, in addition to the short-term follow-up, no firm conclusions can be drawn. However, dance appears to be safe and, given its popularity and demonstrated benefits on other health/wellbeing outcomes in older adults, it is important that future research considers its potential benefits on falls/fear of falling in older age. Copyright © 2017 Elsevier B.V. All rights reserved.

Fingolimod hydrochloride for the treatment of relapsing remitting multiple sclerosis.

PubMed

Thomas, Katja; Proschmann, Undine; Ziemssen, Tjalf

2017-10-01

Fingolimod was the first oral and the first in class disease modifying treatment in multiple sclerosis that acts as sphingosine-1-phospathe receptor agonist. Since approval in 2010 there is a growing experience with fingolimod use in clinical practice, but also next-generation sphingosin-1-receptor agonists in ongoing clinical trials. Growing evidence demonstrates additional effects beyond impact on lymphocyte circulation, highlighting further promising targets in multiple sclerosis therapy. Areas covered: Here we present a systematic review using PubMed database searching and expert opinion on fingolimod use in clinical practice. Long-term data of initial clinical trials and post-marketing evaluations including long-term efficacy, safety, tolerability and management especially within growing disease modifying treatment options and pre-treatment constellation in multiple sclerosis patients are critically discussed. Furthermore novel findings in mechanism of actions and prospective on additional use in progressive forms in multiple sclerosis are presented. Expert opinion: There is an extensive long-term experience on fingolimod use in clinical practice demonstrating the favorable benefit-risk of this drug. Using a defined risk management approach experienced MS clinicians should apply fingolimod after critical choice of patients and review of clinical aspects. Further studies are essential to discuss additional benefit in progressive forms in multiple sclerosis.

Utilizing collagen membranes for guided tissue regeneration-based root coverage.

PubMed

Wang, Hom-Lay; Modarressi, Marmar; Fu, Jia-Hui

2012-06-01

Gingival recession is a common clinical problem that can result in hypersensitivity, pain, root caries and esthetic concerns. Conventional soft tissue procedures for root coverage require an additional surgical site, thereby causing additional trauma and donor site morbidity. In addition, the grafted tissues heal by repair, with formation of long junctional epithelium with some connective tissue attachment. Guided tissue regeneration-based root coverage was thus developed in an attempt to overcome these limitations while providing comparable clinical results. This paper addresses the biologic foundation of guided tissue regeneration-based root coverage, and describes the indications and contraindications for this technique, as well as the factors that influence outcomes. The step-by-step clinical techniques utilizing collagen membranes are also described. In comparison with conventional soft tissue procedures, the benefits of guided tissue regeneration-based root coverage procedures include new attachment formation, elimination of donor site morbidity, less chair-time, and unlimited availability and uniform thickness of the product. Collagen membranes, in particular, benefit from product biocompatibility with the host, while promoting chemotaxis, hemostasis, and exchange of gas and nutrients. Such characteristics lead to better wound healing by promoting primary wound coverage, angiogenesis, space creation and maintenance, and clot stability. In conclusion, collagen membranes are a reliable alternative for use in root coverage procedures. © 2012 John Wiley & Sons A/S.

The relationship between social play and developmental milestones in wild chimpanzees (Pan troglodytes schweinfurthii).

PubMed

Heintz, Matthew R; Murray, Carson M; Markham, A Catherine; Pusey, Anne E; Lonsdorf, Elizabeth V

2017-12-01

Social play is common among many group-living animals, but the benefits are not well understood. Proposed benefits include increased muscle coordination as the result of increased locomotor versatility and development, and strengthened social bonds through interactions with like-aged individuals. In this study, we used 33 years of long-term behavioral data on infant chimpanzees in Gombe National Park, Tanzania, to examine these potential benefits of social play, specifically how the percentage of time engaged in social play relates to motor and social developmental milestones. We predicted that infants who engaged in more social play would achieve motor and social milestones at younger ages. We found that individuals that spent more time engaging in social play achieved the motor milestones of riding dorsally and traveling independently at earlier ages. Additionally, we found that the amount of play was correlated with earlier ages for reaching the social milestones of spatial independence from mother, first grooming of non-maternal kin, and first observed mating attempt. This is the first study in great apes to demonstrate a relationship between play behavior and developmental milestones, supporting the hypotheses that play provides motor, and social benefits. © 2017 Wiley Periodicals, Inc.

Environmental Benefits and Burdens of Phosphorus Recovery from Municipal Wastewater.

PubMed

Bradford-Hartke, Zenah; Lane, Joe; Lant, Paul; Leslie, Gregory

2015-07-21

The environmental benefits and burdens of phosphorus recovery in four centralized and two decentralized municipal wastewater systems were compared using life cycle assessment (LCA). In centralized systems, phosphorus recovered as struvite from the solids dewatering liquid resulted in an environmental benefit except for the terrestrial ecotoxicity and freshwater eutrophication impact categories, with power and chemical use offset by operational savings and avoided fertilizer production. Chemical-based phosphorus recovery, however, generally required more resources than were offset by avoided fertilizers, resulting in a net environmental burden. In decentralized systems, phosphorus recovery via urine source separation reduced the global warming and ozone depletion potentials but increased terrestrial ecotoxicity and salinization potentials due to application of untreated urine to land. Overall, mineral depletion and eutrophication are well-documented arguments for phosphorus recovery; however, phosphorus recovery does not necessarily present a net environmental benefit. While avoided fertilizer production does reduce potential impacts, phosphorus recovery does not necessarily offset the resources consumed in the process. LCA results indicate that selection of an appropriate phosphorus recovery method should consider both local conditions and other environmental impacts, including global warming, ozone depletion, toxicity, and salinization, in addition to eutrophication and mineral depletion impacts.

Intelligibility of clear speech: effect of instruction.

PubMed

Lam, Jennifer; Tjaden, Kris

2013-10-01

The authors investigated how clear speech instructions influence sentence intelligibility. Twelve speakers produced sentences in habitual, clear, hearing impaired, and overenunciate conditions. Stimuli were amplitude normalized and mixed with multitalker babble for orthographic transcription by 40 listeners. The main analysis investigated percentage-correct intelligibility scores as a function of the 4 conditions and speaker sex. Additional analyses included listener response variability, individual speaker trends, and an alternate intelligibility measure: proportion of content words correct. Relative to the habitual condition, the overenunciate condition was associated with the greatest intelligibility benefit, followed by the hearing impaired and clear conditions. Ten speakers followed this trend. The results indicated different patterns of clear speech benefit for male and female speakers. Greater listener variability was observed for speakers with inherently low habitual intelligibility compared to speakers with inherently high habitual intelligibility. Stable proportions of content words were observed across conditions. Clear speech instructions affected the magnitude of the intelligibility benefit. The instruction to overenunciate may be most effective in clear speech training programs. The findings may help explain the range of clear speech intelligibility benefit previously reported. Listener variability analyses suggested the importance of obtaining multiple listener judgments of intelligibility, especially for speakers with inherently low habitual intelligibility.

Mississippi State University Cooling, Heating, and Power (Micro-CHP) and Bio-Fuel Center

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mago, Pedro; Newell, LeLe

2014-01-31

Between 2008 and 2014, the U.S. Department of Energy funded the MSU Micro-CHP and Bio-Fuel Center located at Mississippi State University. The overall objective of this project was to enable micro-CHP (micro-combined heat and power) utilization, to facilitate and promote the use of CHP systems and to educate architects, engineers, and agricultural producers and scientists on the benefits of CHP systems. Therefore, the work of the Center focused on the three areas: CHP system modeling and optimization, outreach, and research. In general, the results obtained from this project demonstrated that CHP systems are attractive because they can provide energy, environmental,more » and economic benefits. Some of these benefits include the potential to reduce operational cost, carbon dioxide emissions, primary energy consumption, and power reliability during electric grid disruptions. The knowledge disseminated in numerous journal and conference papers from the outcomes of this project is beneficial to engineers, architects, agricultural producers, scientists and the public in general who are interested in CHP technology and applications. In addition, more than 48 graduate students and 23 undergraduate students, benefited from the training and research performed in the MSU Micro-CHP and Bio-Fuel Center.« less

Applications and societal benefits of plastics.

PubMed

Andrady, Anthony L; Neal, Mike A

2009-07-27

This article explains the history, from 1600 BC to 2008, of materials that are today termed 'plastics'. It includes production volumes and current consumption patterns of five main commodity plastics: polypropylene, polyethylene, polyvinyl chloride, polystyrene and polyethylene terephthalate. The use of additives to modify the properties of these plastics and any associated safety, in use, issues for the resulting polymeric materials are described. A comparison is made with the thermal and barrier properties of other materials to demonstrate the versatility of plastics. Societal benefits for health, safety, energy saving and material conservation are described, and the particular advantages of plastics in society are outlined. Concerns relating to littering and trends in recycling of plastics are also described. Finally, we give predictions for some of the potential applications of plastic over the next 20 years.

Applications and societal benefits of plastics

PubMed Central

Andrady, Anthony L.; Neal, Mike A.

2009-01-01

This article explains the history, from 1600 BC to 2008, of materials that are today termed ‘plastics’. It includes production volumes and current consumption patterns of five main commodity plastics: polypropylene, polyethylene, polyvinyl chloride, polystyrene and polyethylene terephthalate. The use of additives to modify the properties of these plastics and any associated safety, in use, issues for the resulting polymeric materials are described. A comparison is made with the thermal and barrier properties of other materials to demonstrate the versatility of plastics. Societal benefits for health, safety, energy saving and material conservation are described, and the particular advantages of plastics in society are outlined. Concerns relating to littering and trends in recycling of plastics are also described. Finally, we give predictions for some of the potential applications of plastic over the next 20 years. PMID:19528050

Initiatives and resources to promote antimicrobial stewardship.

PubMed

Paño-Pardo, José Ramón; Campos, José; Natera Kindelán, Clara; Ramos, Antonio

2013-09-01

The development of an antimicrobial stewardship program (ASP) requires institutional support. However, obtaining sufficient institutional support is often a complex task that requires convincing the hospital's managers of the benefits of these programs. Additionally, in the design and implementation of an ASP, antimicrobial stewardship (AS) leaders need tools for diverse purposes, such as measuring antimicrobial consumption, education and training and designing protocols. In this review we provide useful information for AS promoters to facilitate the task of designing and implementing an ASP. First, we summarize information about various institutions that promote AS and include evidence that supports the need for and benefits of these programs. Then, several campaigns promoting AS are described. Finally, online resources for professionals dealing with AS are briefly summarized. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Toward Empirical Estimation of the Total Value of Protecting Rivers

NASA Astrophysics Data System (ADS)

Sanders, Larry D.; Walsh, Richard G.; Loomis, John B.

1990-07-01

The purpose of this paper is to develop and apply a procedure to estimate a statistical demand function for the protection of rivers in the Rocky Mountains of Colorado. Other states and nations around the world face a similar problem of estimating how much they can afford to pay for the protection of rivers. The results suggest that in addition to the direct consumption benefits of onsite recreation, total value includes offsite consumption of the flow of information about these activities and resources consumed as preservation benefits. A sample of the general population of the state reports a willingness to pay rather than forego both types of utility. We recommended that offsite values be added to the value of onsite recreation use to determine the total value of rivers to society.

TOR on the Brain

PubMed Central

Garelick, Michael G.; Kennedy, Brian K.

2012-01-01

Signaling by target of rapamycin (mTOR in mammals) has been shown to modulate lifespan in several model organisms ranging from yeast to mice. In mice, reduced mTOR signaling by chronic rapamycin treatment leads to lifespan extension, raising the possibility that rapamycin and its analogs may benefit the aging brain and serve as effective treatments of age-related neurodegenerative diseases. Here, we review mTOR signaling and how neurons utilize mTOR to regulate brain function, including regulation of feeding, synaptic plasticity and memory formation. Additionally, we discuss recent findings that evaluate the mechanisms by which reduced mTOR activity might benefit the aging brain in normal and pathological states. We will focus on recent studies investigating mTOR and Alzheimer s disease, Parkinson s disease, and polyglutamine expansion syndromes such as Huntington s disease. PMID:20849946

Emerging therapies to treat frailty syndrome in the elderly.

PubMed

Cherniack, E Paul; Florez, Hermes J; Troen, Bruce R

2007-09-01

Frailty syndrome (FS) has become increasingly recognized as a major predictor of co-morbidities and mortality in older individuals. Interventions with the potential to benefit frail elders include nutritional supplementation (vitamins D, carotenoids, creatine, dehydroepiandrosterone (DHEA), and beta-hydroxy-beta-methylbutyrate) and exercise modalities (tai chi and cobblestone walking). While these have not been explicitly tested for their impact on FS, vitamin D supplementation appears to offer significant promise in enhancing long-term health of the elderly. Exercise modalities such as tai chi and cobblestone walking, because of probable low risk and ease of participation, may also confer benefit. Additional studies are needed to investigate interventions that directly prevent, delay, and/or ameliorate frailty. Successful therapies may well involve multi-component approaches utilizing a combination of medication, nutritional supplementation, and exercise.

Reducing uncertainty in value-based pricing using evidence development agreements: the case of continuous intraduodenal infusion of levodopa/carbidopa (Duodopa®) in Sweden.

PubMed

Willis, Michael; Persson, Ulf; Zoellner, York; Gradl, Birgit

2010-01-01

Value-based pricing (VBP), whereby prices are set according to the perceived benefits offered to the consumer at a time when costs and benefits are characterized by considerable uncertainty and are then reviewed ex post, is a much discussed topic in pharmaceutical reimbursement. It is usually combined with coverage with evidence development (CED), a tool in which manufacturers are granted temporary reimbursement but are required to collect and submit additional health economic data at review. Many countries, including the UK, are signalling shifts in this direction. Several countries, including Sweden, have already adopted this approach and offer good insight into the benefits and pitfalls in actual practice. To describe VBP reimbursement decision making using CED in actual practice in Sweden. Decision making by The Dental and Pharmaceutical Benefits Agency (TLV) in Sweden was reviewed using a case study of continuous intraduodenal infusion of levodopa/carbidopa (Duodopa®) in the treatment of advanced Parkinson's disease (PD) with severe motor fluctuations. The manufacturer of Duodopa® applied for reimbursement in late 2003. While the proper economic data were not included in the submission, TLV granted reimbursement until early 2005 to provide time for the manufacturer to submit a formal economic evaluation. The re-submission with economic data was considered inadequate to judge cost effectiveness, so TLV granted an additional extension of reimbursement until August 2007, at which time conclusive data were expected. The manufacturer initiated a 3-year, prospective health economic study and a formal economic model. Data from a pre-planned interim analysis of the data were loaded into the model and the cost-effectiveness ratio was the basis of the next re-submission. TLV concluded that the data were suitable for making a definite decision and that the drug was not cost effective, deciding to discontinue reimbursement for any new patients (current patients were unaffected). The manufacturer continued to collect data and to improve the economic model and re-submitted in 2008. New data and the improved model resulted in reduced uncertainty and a lower cost-effectiveness ratio in the range of Swedish kronor (SEK)430,000 per QALY gained in the base-case analysis, ranging up to SEK900,000 in the most conservative sensitivity analysis, resulting in reimbursement being granted. The case of Duodopa® provides excellent insight into VBP reimbursement decision making in combination with CED and ex post review in actual practice. Publicly available decisions document the rigorous, time-consuming process (four iterations were required before a final decision could be reached). The data generated as part of the risk-sharing agreement proved correct the initial decision to grant limited coverage despite lack of economic data. Access was provided to 100 patients while evidence was generated. Economic appraisal differs from clinical assessment, and decision makers benefit from analysis of naturalistic, actual practice data. Despite reviewing the initial trial-based, 'piggy-back' economic analysis, TLV was uncertain of the cost effectiveness in actual practice and deferred a final decision until observational data from the DAPHNE study became available. Second, acceptance of economic modelling and use of temporary reimbursement conditional on additional evidence development provide a mechanism for risk sharing between TLV and manufacturers, which enabled patient access to a drug with proven clinical benefit while necessary evidence to support claims of cost effectiveness could be generated.

An Investigation of the Additive Benefits of Parent Dialogic Reading Techniques in Older Preschool Children

ERIC Educational Resources Information Center

Switalski, Sarah O'Neill

2012-01-01

This study examined the additive benefit of parent dialogic reading techniques in older, high-risk preschool children using multiple baseline design across participants, a single subject research design, as was as well as pre-test and post-test measures. Five preschoolers age-eligible to begin kindergarten the following school year participated.…

20 CFR 670.410 - Are there additional factors which are considered in selecting an eligible applicant for enrollment?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Are there additional factors which are considered in selecting an eligible applicant for enrollment? 670.410 Section 670.410 Employees' Benefits... INVESTMENT ACT Recruitment, Eligibility, Screening, Selection and Assignment, and Enrollment § 670.410 Are...

The benefits of steroids versus steroids plus antivirals for treatment of Bell’s palsy: a meta-analysis

PubMed Central

Quant, Eudocia C; Jeste, Shafali S; Muni, Rajeev H; Cape, Alison V; Bhussar, Manveen K

2009-01-01

Objective To determine whether steroids plus antivirals provide a better degree of facial muscle recovery in patients with Bell’s palsy than steroids alone. Design Meta-analysis. Data sources PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials were searched for studies published in all languages from 1984 to January 2009. Additional studies were identified from cited references. Selection criteria Randomised controlled trials that compared steroids with the combination of steroids and antivirals for the treatment of Bell’s palsy were included in this study. At least one month of follow-up and a primary end point of at least partial facial muscle recovery, as defined by a House-Brackmann grade of at least 2 (complete palsy is designated a grade of 6) or an equivalent score on an alternative recognised scoring system, were required. Review methods Two authors independently reviewed studies for methodological quality, treatment regimens, duration of symptoms before treatment, length of follow-up, and outcomes. Odds ratios with 95% confidence intervals were calculated and pooled using a random effects model. Results Six trials were included, a total of 1145 patients; 574 patients received steroids alone and 571 patients received steroids and antivirals. The pooled odds ratio for facial muscle recovery showed no benefit of steroids plus antivirals compared with steroids alone (odds ratio 1.50, 95% confidence interval 0.83 to 2.69; P=0.18). A one study removed analysis showed that the highest quality studies had the greatest effect on the lack of difference between study arms shown by the odds ratio. Subgroup analyses assessing causes of heterogeneity defined a priori (time from symptom onset to treatment, length of follow-up, and type of antiviral studied) showed no benefit of antivirals in addition to that provided by steroids. Conclusions Antivirals did not provide an added benefit in achieving at least partial facial muscle recovery compared with steroids alone in patients with Bell’s palsy. This study does not, therefore, support the routine use of antivirals in Bell’s palsy. Future studies should use improved herpes virus diagnostics and newer antivirals to assess whether combination therapy benefits patients with more severe facial paralysis at study entry. PMID:19736282

Career retention in the dental hygiene workforce in Texas.

PubMed

Johns, G H; Gutmann, M E; DeWald, J P; Nunn, M E

2001-01-01

The purpose of this study was to determine the factors that influence the retention and attrition of dental hygienists within the workforce in Texas. Respondents' perception of the role of employee benefits and practice of dental hygiene on career retention were explored. Demographic descriptors, including educational level, marital status, age, employment setting, and practice statuses, were also examined. A questionnaire modified from the American Dental Hygienists' Association Extension Study: Retention of Dental Hygienists in the Workforce Final Report, April 1992, was mailed to a systematic sample of licensed Texas dental hygienists in March 1999. Descriptive statistics were computed for dental hygienists currently in practice in Texas and those not in practice at the time of the survey. Differences in demographics, benefits, and attitudes between dental hygienists currently in practice in Texas and dental hygienists not in practice at the time of the survey were tested using independent t-tests for interval data and chi-squared tests for categorical data. All statistical analyses were conducted using the Statistical Package for Social Scientists (SPSS v. 9, Chicago, Illinois). A response rate of 68.1% was obtained. Results revealed the primary reasons for remaining in the practice of dental hygiene were salary, family responsibility, professional collaboration, and variety of work. The primary reasons for leaving dental hygiene practice were family responsibility, boredom, salary, and lack of benefits. Secondary and tertiary reasons stated for staying in clinical practice revealed additional factors including benefits, participation in decision-making, and a safe environment. Dental hygienists in clinical practice were more likely to be employed by a dentist in a single practice and see more patients per day, have a certificate or associate's degree, be unmarried, have fewer children, and be younger than dental hygienists not in practice. The findings suggest that dental hygienists in Texas who remain in the workforce are positively influenced primarily by salary. Dental hygienists in Texas who had left the workforce were primarily influenced to leave practice because of family responsibility. Boredom and lack of benefits were also important factors in deciding to leave clinical practice. Employers of dental hygienists need to be aware of these factors in the hiring process. In addition, dental hygiene educators should prepare students in interviewing techniques for better communication regarding retention factors.

Research Plan for Fire Signatures and Detection

NASA Technical Reports Server (NTRS)

2004-01-01

Viewgraphs on the prevention, suppression, and detection of fires aboard a spacecraft is presented. The topics include: 1) Fire Prevention, Detection, and Suppression Sub-Element Products; 2) FPDS Organizing Questions; 3) FPDS Organizing Questions; 4) Signatures, Sensors, and Simulations; 5) Quantification of Fire and Pre-Fire Signatures; 6) Smoke; 7) DAFT Hardware; 8) Additional Benefits of DAFT; 9) Development and Characterization of Sensors 10) Simulation of the Transport of Smoke and Fire Precursors; and 11) FPDS Organizing Questions.

Pediatric CT and radiation: our responsibility

NASA Astrophysics Data System (ADS)

Frush, Donald P.

2009-02-01

In order to discuss the cost-benefit ratio of CT examinations in children, one must be familiar with the reasons why CT can provide a high collective or individual dose. The reasons include increasing CT use as well as lack of attention to dose reduction strategies. While those have been substantial efforts for dose reduction, additional work is necessary to prevent unnecessary radiation exposure. This responsibility is shared between science and medicine, industry, regulatory agencies, and patients as well.

Design and rationale of a 16-week adjunctive randomized placebo-controlled trial of mitochondrial agents for the treatment of bipolar depression.

PubMed

Dean, Olivia M; Turner, Alyna; Malhi, Gin S; Ng, Chee; Cotton, Sue M; Dodd, Seetal; Sarris, Jerome; Samuni, Yuval; Tanious, Michelle; Dowling, Nathan; Waterdrinker, Astrid; Smith, Deidre; Berk, Michael

2015-01-01

Bipolar disorder places a significant burden on individuals, caregivers and family, and the broader community. Current treatments are believed to be more effective against manic symptoms, leaving a shortfall in recovery during the depressive phase of the illness. The current study draws on recent evidence suggesting that, in addition to increased oxidative load, alterations in mitochondrial function occur in bipolar disorder. This 16-week study aims to explore the potential benefits of N-acetylcysteine (NAC) alone or in combination (CT) with selected nutraceuticals believed to enhance mitochondrial function. The study includes adults diagnosed with bipolar disorder currently experiencing an episode of depression. Participants are asked to take NAC, CT, or placebo in addition to any usual treatments. A post-discontinuation visit is conducted 4 weeks following the treatment phase. The primary outcome of the study will be mean change on the Montgomery-Asberg Depression Rating Scale. Secondary outcomes include functioning, substance use, mania ratings, and quality of life. Blood samples will be collected at baseline and week 16 to explore biochemical alterations following treatment. This study may provide a novel adjunctive treatment for bipolar depression. Analysis of biological samples may assist in understanding the therapeutic benefits and the underlying etiology of bipolar depression. Australian and New Zealand Clinical Trial Registry ACTRN12612000830897.

The Middle Eastern and biblical origins of the Mediterranean diet.

PubMed

Berry, Elliot M; Arnoni, Yardena; Aviram, Michael

2011-12-01

To place the Mediterranean diet (MedDi) in the context of the cultural history of the Middle East and emphasise the health effects of some of the biblical seven species - wheat, barley, grapes, figs, pomegranates, olives and date honey. Review of the literature concerning the benefits of these foods. Middle East and Mediterranean Basin. Mediterranean populations and clinical studies utilising the MedDi. The MedDi has been associated with lower rates of CVD, and epidemiological evidence promotes the benefits of consuming fruit and vegetables. Recommended foods for optimal health include whole grain, fish, wine, pomegranates, figs, walnuts and extra virgin olive oil. The biblical traditional diet, including the seven species and additional Mediterranean fruits, has great health advantages, especially for CVD. In addition to the diet, lifestyle adaptation that involves increasing physical activity and organised meals, together with healthy food choices, is consistent with the traditional MedDi. The MedDi is a manageable, lifestyle-friendly diet that, when fortified with its biblical antecedent attributes, may prove to be even more enjoyable and considerably healthier in combating the obesogenic environment and in decreasing the risks of the non-communicable diseases of modern life than conventional, modern dietary recommendations. The biblical seven species, together with other indigenous foods from the Middle East, are now scientifically recognised as healthy foods, and further improve the many beneficial effects of the MedDi.

Chemoradiotherapy versus chemotherapy for locally advanced unresectable pancreatic cancer: A systematic review and meta-analysis.

PubMed

Ng, Ivy Weishan; Soon, Yu Yang; Chen, Desiree; Tey, Jeremy Chee Seong

2018-06-22

To determine the benefit of adding radiotherapy (RT) to chemotherapy for patients with locally advanced unresectable pancreatic cancer (LAUPC). We searched MEDLINE for comparative studies comparing chemoradiotherapy with chemotherapy for patients with LAUPC. We performed the meta-analysis with random effects model. The primary outcome was overall survival (OS); secondary outcomes include progression-free survival (PFS) and adverse events (AE). We found five randomized (RCT) and three observational studies (OBS) including 830 patients. For RCTs, the addition of radiotherapy did not improve PFS (hazard ratio [HR] 0.90; 95% confidence interval [CI], 0.74-1.10; P = 0.30; I 2   =  11%,) or OS (HR 0.87; 95% CI, 0.63-1.21; P = 0.41; I 2 = 67%,) and was associated with increased grade 3 or 4 gastrointestinal AE. In contrast, OBS reported an improvement in PFS (HR 0.58; 95% CI, 0.37-0.92; P = 0.02; I 2 = 32%) and OS (HR 0.48; 95% CI, 0.35-0.60; P < 0.0001; I 2 = 6%). The addition of radiotherapy did not improve the OS and PFS in RCTs. The divergence in results seen in OBS may be due to imbalance in baseline characteristics. Further research incorporating biomarkers may help to better select patients who will benefit from RT. © 2018 John Wiley & Sons Australia, Ltd.

Spacecraft Thermal Management

NASA Technical Reports Server (NTRS)

Hurlbert, Kathryn Miller

2009-01-01

In the 21st century, the National Aeronautics and Space Administration (NASA), the Russian Federal Space Agency, the National Space Agency of Ukraine, the China National Space Administration, and many other organizations representing spacefaring nations shall continue or newly implement robust space programs. Additionally, business corporations are pursuing commercialization of space for enabling space tourism and capital business ventures. Future space missions are likely to include orbiting satellites, orbiting platforms, space stations, interplanetary vehicles, planetary surface missions, and planetary research probes. Many of these missions will include humans to conduct research for scientific and terrestrial benefits and for space tourism, and this century will therefore establish a permanent human presence beyond Earth s confines. Other missions will not include humans, but will be autonomous (e.g., satellites, robotic exploration), and will also serve to support the goals of exploring space and providing benefits to Earth s populace. This section focuses on thermal management systems for human space exploration, although the guiding principles can be applied to unmanned space vehicles as well. All spacecraft require a thermal management system to maintain a tolerable thermal environment for the spacecraft crew and/or equipment. The requirements for human rating and the specified controlled temperature range (approximately 275 K - 310 K) for crewed spacecraft are unique, and key design criteria stem from overall vehicle and operational/programatic considerations. These criteria include high reliability, low mass, minimal power requirements, low development and operational costs, and high confidence for mission success and safety. This section describes the four major subsystems for crewed spacecraft thermal management systems, and design considerations for each. Additionally, some examples of specialized or advanced thermal system technologies are presented, which may be enabling to future space missions never before attempted like a crewed mission to Mars.

Implementation of mental health parity: lessons from california.

PubMed

Rosenbach, Margo L; Lake, Timothy K; Williams, Susan R; Buck, Jeffrey A

2009-12-01

This article reports the experiences of health plans, providers, and consumers with California's mental health parity law and discusses implications for implementation of the 2008 federal parity law. This study used a multimodal data collection approach to assess the first five years of California's parity implementation (from 2000 to 2005). Telephone interviews were conducted with 68 state-level stakeholders, and in-person interviews were conducted with 77 community-based stakeholders. Six focus groups included 52 providers, and six included 32 consumers. A semistructured interview protocol was used. Interview notes and transcripts were coded to facilitate analysis. Health plans eliminated differential benefit limits and cost-sharing requirements for certain mental disorders to comply with the law, and they used managed care to control costs. In response to concerns about access to and quality of care, the state expanded oversight of health plans, issuing access-to-care regulations and conducting focused studies. California's parity law applied to a limited list of psychiatric diagnoses. Health plan executives said they spent considerable resources clarifying which diagnoses were covered at parity levels and concluded that the limited diagnosis list was unnecessary with managed care. Providers indicated that the diagnosis list had unintended consequences, including incentives to assign a more severe diagnosis that would be covered at parity levels, rather than a less severe diagnosis that would not be covered at such levels. The lack of consumer knowledge about parity was widely acknowledged, and consumers in the focus groups requested additional information about parity. Experiences in California suggest that implementation of the 2008 federal parity law should include monitoring health plan performance related to access and quality, in addition to monitoring coverage and costs; examining the breadth of diagnoses covered by health plans; and mounting a campaign to educate consumers about their insurance benefits.

The ADDITION-Cambridge trial protocol: a cluster -- randomised controlled trial of screening for type 2 diabetes and intensive treatment for screen-detected patients.

PubMed

Echouffo-Tcheugui, Justin B; Simmons, Rebecca K; Williams, Kate M; Barling, Roslyn S; Prevost, A Toby; Kinmonth, Ann Louise; Wareham, Nicholas J; Griffin, Simon J

2009-05-12

The increasing prevalence of type 2 diabetes poses a major public health challenge. Population-based screening and early treatment for type 2 diabetes could reduce this growing burden. However, the benefits of such a strategy remain uncertain. The ADDITION-Cambridge study aims to evaluate the effectiveness and cost-effectiveness of (i) a stepwise screening strategy for type 2 diabetes; and (ii) intensive multifactorial treatment for people with screen-detected diabetes in primary care. 63 practices in the East Anglia region participated. Three undertook the pilot study, 33 were allocated to three groups: no screening (control), screening followed by intensive treatment (IT) and screening plus routine care (RC) in an unbalanced (1:3:3) randomisation. The remaining 27 practices were randomly allocated to IT and RC. A risk score incorporating routine practice data was used to identify people aged 40-69 years at high-risk of undiagnosed diabetes. In the screening practices, high-risk individuals were invited to take part in a stepwise screening programme. In the IT group, diabetes treatment is optimised through guidelines, target-led multifactorial treatment, audit, feedback, and academic detailing for practice teams, alongside provision of educational materials for newly diagnosed participants. Primary endpoints are modelled cardiovascular risk at one year, and cardiovascular mortality and morbidity at five years after diagnosis of diabetes. Secondary endpoints include all-cause mortality, development of renal and visual impairment, peripheral neuropathy, health service costs, self-reported quality of life, functional status and health utility. Impact of the screening programme at the population level is also assessed through measures of mortality, cardiovascular morbidity, health status and health service use among high-risk individuals. ADDITION-Cambridge is conducted in a defined high-risk group accessible through primary care. It addresses the feasibility of population-based screening for diabetes, as well as the benefits and costs of screening and intensive multifactorial treatment early in the disease trajectory. The intensive treatment algorithm is based on evidence from studies including individuals with clinically diagnosed diabetes and the education materials are informed by psychological theory. ADDITION-Cambridge will provide timely evidence concerning the benefits of early intensive treatment and will inform policy decisions concerning screening for type 2 diabetes. Current Controlled trials ISRCTN86769081.

The ADDITION-Cambridge trial protocol: a cluster – randomised controlled trial of screening for type 2 diabetes and intensive treatment for screen-detected patients

PubMed Central

Echouffo-Tcheugui, Justin B; Simmons, Rebecca K; Williams, Kate M; Barling, Roslyn S; Prevost, A Toby; Kinmonth, Ann Louise; Wareham, Nicholas J; Griffin, Simon J

2009-01-01

Background The increasing prevalence of type 2 diabetes poses a major public health challenge. Population-based screening and early treatment for type 2 diabetes could reduce this growing burden. However, the benefits of such a strategy remain uncertain. Methods and design The ADDITION-Cambridge study aims to evaluate the effectiveness and cost-effectiveness of (i) a stepwise screening strategy for type 2 diabetes; and (ii) intensive multifactorial treatment for people with screen-detected diabetes in primary care. 63 practices in the East Anglia region participated. Three undertook the pilot study, 33 were allocated to three groups: no screening (control), screening followed by intensive treatment (IT) and screening plus routine care (RC) in an unbalanced (1:3:3) randomisation. The remaining 27 practices were randomly allocated to IT and RC. A risk score incorporating routine practice data was used to identify people aged 40–69 years at high-risk of undiagnosed diabetes. In the screening practices, high-risk individuals were invited to take part in a stepwise screening programme. In the IT group, diabetes treatment is optimised through guidelines, target-led multifactorial treatment, audit, feedback, and academic detailing for practice teams, alongside provision of educational materials for newly diagnosed participants. Primary endpoints are modelled cardiovascular risk at one year, and cardiovascular mortality and morbidity at five years after diagnosis of diabetes. Secondary endpoints include all-cause mortality, development of renal and visual impairment, peripheral neuropathy, health service costs, self-reported quality of life, functional status and health utility. Impact of the screening programme at the population level is also assessed through measures of mortality, cardiovascular morbidity, health status and health service use among high-risk individuals. Discussion ADDITION-Cambridge is conducted in a defined high-risk group accessible through primary care. It addresses the feasibility of population-based screening for diabetes, as well as the benefits and costs of screening and intensive multifactorial treatment early in the disease trajectory. The intensive treatment algorithm is based on evidence from studies including individuals with clinically diagnosed diabetes and the education materials are informed by psychological theory. ADDITION-Cambridge will provide timely evidence concerning the benefits of early intensive treatment and will inform policy decisions concerning screening for type 2 diabetes. Trial registration Current Controlled trials ISRCTN86769081 PMID:19435491

A short guide to giving bad news.

PubMed

Mitchell, Jeffrey T

2008-01-01

Approaching an individual or a family with bad news, but without an appropriate plan to present the information in a structured manner, is almost a guarantee of greater emotional pain and disruption for the recipients of the news. Crisis interveners must develop a strategic plan for the announcement of bad news. That plan should entail a lead-up phase, a transmission phase, and a followup phase. The lead-up phase encompasses the gathering of accurate, verifiable information and the clear identification of the targets of the information. The transmission phase includes immediate preparation for the presentation of the information, the actual announcement, and the presentation of additional details as questions arise. The follow-up phase includes a range of supportive interventions to assist people in the immediate crisis reaction. It also includes a system of referrals for people who might benefit from additional professional care. This article provides practical guidelines for providing bad news to the loved ones of injured, ill, or deceased people.

COLLABORATIVE MODELING OF THE BENEFITS AND HARMS ASSOCIATED WITH DIFFERENT U.S. BREAST CANCER SCREENING STRATEGIES

PubMed Central

Mandelblatt, Jeanne S.; Stout, Natasha K.; Schechter, Clyde B.; van den Broek, Jeroen J.; Miglioretti, Diana; Krapcho, Martin; Trentham-Dietz, Amy; Munoz, Diego; Lee, Sandra J.; Berry, Donald A.; van Ravesteyn, Nicolien T.; Alagoz, Oguzhan; Kerlikowske, Karla; Tosteson, Anna N.A.; Near, Aimee M.; Hoeffken, Amanda; Chang, Yaojen; Heijnsdijk, Eveline A.; Chisholm, Gary; Huang, Xuelin; Huang, Hui; Ergun, Mehmet Ali; Gangnon, Ronald; Sprague, Brian L.; Plevritis, Sylvia; Feuer, Eric; de Koning, Harry J.; Cronin, Kathleen A.

2016-01-01

Background Controversy persists about optimal mammography screening strategies. Objective To evaluate mammography strategies considering screening and treatment advances. Design Collaboration of six simulation models. Data Sources National data on incidence, risk, breast density, digital mammography performance, treatment effects, and other-cause mortality. Target Population An average-risk cohort. Time Horizon Lifetime. Perspective Societal. Interventions Mammograms from age 40, 45 or 50 to 74 at annual or biennial intervals, or annually from 40 or 45 to 49 then biennially to 74, assuming 100% screening and treatment adherence. Outcome Measures Screening benefits (vs. no screening) include percent breast cancer mortality reduction, deaths averted, and life-years gained. Harms include number of mammograms, false-positives, benign biopsies, and overdiagnosis. Results for Average-Risk Women Biennial strategies maintain 79.8%-81.3% (range across strategies and models: 68.3–98.9%) of annual screening benefits with almost half the false-positives and fewer overdiagnoses. Screening biennially from ages 50–74 achieves a median 25.8% (range: 24.1%-31.8%) breast cancer mortality reduction; annual screening from ages 40–74 years reduces mortality an additional 12.0% (range: 5.7%-17.2%) vs. no screening, but yields 1988 more false-positives and 7 more overdiagnoses per 1000 women screened. Annual screening from ages 50–74 had similar benefits as other strategies but more harms, so would not be recommended. Sub-population Results Annual screening starting at age 40 for women who have a two- to four-fold increase in risk has a similar balance of harms and benefits as biennial screening of average-risk women from 50–74. Limitations We do not consider other imaging technologies, polygenic risk, or non-adherence. Conclusion These results suggest that biennial screening is efficient for average-risk groups, but decisions on strategies depend on the weight given to the balance of harms and benefits. Primary Funding Source National Institutes of Health PMID:26756606

Investigating the chemical changes of chlorogenic acids during coffee brewing: conjugate addition of water to the olefinic moiety of chlorogenic acids and their quinides.

PubMed

Matei, Marius Febi; Jaiswal, Rakesh; Kuhnert, Nikolai

2012-12-12

Coffee is one of the most popular and consumed beverages in the world and is associated with a series of benefits for human health. In this study we focus on the reactivity of chlorogenic acids, the most abundant secondary metabolites in coffee, during the coffee brewing process. We report on the hydroxylation of the chlorogenic acid cinnamoyl substituent by conjugate addition of water to form 3-hydroxydihydrocaffeic acid derivatives using a series of model compounds including monocaffeoyl and dicaffeoylquinic acids and quinic acid lactones. The regiochemistry of conjugate addition was established based on targeted tandem MS experiments. Following conjugate addition of water a reversible water elimination yielding cis-cinnamoyl derivatives accompanied by acyl migration products was observed in model systems. We also report the formation of all of these derivatives during the coffee brewing process.

The benefits of using bluetooth accessories with hearing aids.

PubMed

Smith, Pauline; Davis, Adrian

2014-10-01

To investigate the benefits in reported outcomes after providing bluetooth accessories for established hearing aid users. Prospective observational study using validated quantitative outcome measures and detailed patient narrative before and two months after patients were provided with bluetooth accessories. Twelve patients with bilateral NHS hearing aids participated. They had a wide range of ages and hearing loss. After two months, 10 patients reported substantial additional benefit and kept the accessories; two returned them for various reasons. Statistically significant changes were seen in two validated outcome measures: the Glasgow Hearing Aid Benefit Profile and the International Outcome Inventory - Hearing Aids, but not in the Speech, Spatial and Qualities of Hearing Scale. Two notable benefits were reported: some described hearing the emotion and mood in a voice for the first time; others were amazed to report an improved ability to hear film or to hold conversations over the telephone. The provision of bluetooth accessories can give additional reported benefit for some patients - we need better knowledge about who benefits, and whether further support/training to individuals would make a difference.

Literature review of visual representation of the results of benefit-risk assessments of medicinal products.

PubMed

Hallgreen, Christine E; Mt-Isa, Shahrul; Lieftucht, Alfons; Phillips, Lawrence D; Hughes, Diana; Talbot, Susan; Asiimwe, Alex; Downey, Gerald; Genov, Georgy; Hermann, Richard; Noel, Rebecca; Peters, Ruth; Micaleff, Alain; Tzoulaki, Ioanna; Ashby, Deborah

2016-03-01

The PROTECT Benefit-Risk group is dedicated to research in methods for continuous benefit-risk monitoring of medicines, including the presentation of the results, with a particular emphasis on graphical methods. A comprehensive review was performed to identify visuals used for medical risk and benefit-risk communication. The identified visual displays were grouped into visual types, and each visual type was appraised based on five criteria: intended audience, intended message, knowledge required to understand the visual, unintentional messages that may be derived from the visual and missing information that may be needed to understand the visual. Sixty-six examples of visual formats were identified from the literature and classified into 14 visual types. We found that there is not one single visual format that is consistently superior to others for the communication of benefit-risk information. In addition, we found that most of the drawbacks found in the visual formats could be considered general to visual communication, although some appear more relevant to specific formats and should be considered when creating visuals for different audiences depending on the exact message to be communicated. We have arrived at recommendations for the use of visual displays for benefit-risk communication. The recommendation refers to the creation of visuals. We outline four criteria to determine audience-visual compatibility and consider these to be a key task in creating any visual. Next we propose specific visual formats of interest, to be explored further for their ability to address nine different types of benefit-risk analysis information. Copyright © 2015 John Wiley & Sons, Ltd.

Evaluation of School-Based Dental Sealant Programs: An Updated Community Guide Systematic Economic Review.

PubMed

Griffin, Susan O; Naavaal, Shillpa; Scherrer, Christina; Patel, Mona; Chattopadhyay, Sajal

2017-03-01

A recently updated Community Guide systematic review of the effectiveness of school sealant programs (SSPs) still found strong evidence that SSPs reduced dental caries among schoolchildren. This follow-up systematic review updates SSP cost and benefit information from the original 2002 review. Using Community Guide economic review methods, the authors searched the literature from January 2000 to November 20, 2014. The final body of evidence included 14 studies-ten from the current search and four with cost information from the 2002 review. Nine studies had information on SSP costs; six on sealant benefit (averted treatment costs and productivity losses); four on SSP net cost (cost minus benefit); and three on net cost to Medicaid of clinically delivered sealants. The authors imputed productivity losses and discounted costs/outcomes when this information was missing. The analysis, conducted in 2015, reported all values in 2014 U.S. dollars. The median one-time SSP cost per tooth sealed was $11.64. Labor accounted for two thirds of costs, and time to provide sealants was a major cost driver. The median annual economic benefit was $6.29, suggesting that over 4 years the SSP benefit ($23.37 at a 3% discount rate) would exceed costs by $11.73 per sealed tooth. In addition, two of four economic models and all three analyses of Medicaid claims data found that SSP benefit to society exceeded SSP cost. Recent evidence indicates the benefits of SSPs exceed their costs when SSPs target schools attended by a large number of high-risk children. Published by Elsevier Inc.

Problems and Benefits Reported by Stroke Family Caregivers: Results from a Prospective Epidemiological Study

PubMed Central

Haley, William E.; Allen, Jessica Y.; Grant, Joan S.; Clay, Olivio J.; Perkins, Martinique; Roth, David L.

2009-01-01

Background and Purpose Stroke symptoms can be very stressful for family caregivers, but most knowledge about the prevalence and stressfulness of stroke-related patient problems is derived from convenience samples. In addition, little is known about perceived benefits of the stroke caregiving experience. The purpose of this study was to determine the prevalence and stressfulness of stroke-related problems, and perceived benefits of caregiving, as reported by an epidemiologically-derived sample of caregivers of stroke survivors. Methods Stroke survivors (N=75) from a prospective epidemiological study of stroke, the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, and their family caregivers were followed. Caregivers were given a comprehensive telephone interview 8 to 12 months after the stroke, using measures of stroke patient problems, caregiver appraisals of the stressfulness of these problems, and perceived benefits of caregiving. Results Caregivers rated patient problems with mood (depression, loneliness and anxiety), memory, and physical care (bowel control), as the most stressful, but reported prevalence of these problems was lower than those reported previously in studies using clinical samples. Caregivers also reported many benefits from caregiving, with over 90% reporting that caregiving enabled them to appreciate life more. Conclusions Epidemiologically based studies of stroke caregiving provide a unique picture of caregiver strains and benefits compared with clinical studies, which tend to over-represent more impaired patients. Support for caregivers should include interventions to aid their coping with highly stressful mood, physical care, and cognitive problems of stroke patients, but should also attend to perceived benefits of caregiving. PMID:19407230

Perceived harms and benefits of tobacco, marijuana, and electronic vaporizers among young adults in Colorado: implications for health education and research.

PubMed

Popova, Lucy; McDonald, Emily Anne; Sidhu, Sohrab; Barry, Rachel; Richers Maruyama, Tracey A; Sheon, Nicolas M; Ling, Pamela M

2017-10-01

To evaluate how young adults perceive and compare harms and benefits of marijuana and tobacco products in the context of a legal marijuana market in Colorado. Semi-structured qualitative interviews. Denver, CO, USA. Thirty-two young adults (aged 18-26 years) who used tobacco/marijuana/vaporizers. Semi-structured interviews addressed perceived harms and benefits of various tobacco and marijuana products and personal experiences with these products. Young adults evaluated harms and benefits using five dimensions: (1) combustion-smoking was considered more harmful than non-combustible products (e.g. e-cigarettes, vaporizers and edibles); (2) potency-edibles and marijuana concentrates were perceived as more harmful than smoking marijuana flower because of potential to receive too large a dose of tetrahydrocannabinol (THC); (3) chemicals-products containing chemical additives were seen as more harmful than 'pure' or 'natural' plant products; (4) addiction-participants recognized physiological addiction to nicotine, but talked primarily about psychological or life-style dependence on marijuana; and (5) source of knowledge-personal experiences, warning labels, campaigns, the media and opinions of product retailers and medical practitioners affected perceptions of harms and benefits. Among young adults in Colorado, USA, perceived harms and benefits of tobacco and marijuana include multiple dimensions. Health educational campaigns could benefit from addressing these dimensions, such as the potency of nicotine and cannabis concentrates and harmful chemicals present in the organic material of tobacco and marijuana. Descriptors such as 'natural' and 'pure' in the promotion or packaging of tobacco and marijuana products might be misleading. © 2017 Society for the Study of Addiction.

78 FR 68907 - Agency Information Collection (Foot (Including Flatfeet (pes planus)) Conditions Disability...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-15

... (Including Flatfeet (pes planus)) Conditions Disability Benefits Questionnaire) Under OMB Review AGENCY...)) Conditions Disability Benefits Questionnaire)'' in any correspondence. FOR FURTHER INFORMATION CONTACT...-NEW (Foot (including flatfeet (pes planus)) Conditions Disability Benefits Questionnaire...

Improving Food Safety in Meat and Poultry: Will New Regulations Benefit Consumers?

ERIC Educational Resources Information Center

Unnevehr, Laurian J.; Roberts, Tanya; Jensen, Helen H.

1997-01-01

The U.S. Department of Agriculture's Hazard Analysis and Critical Control Point System for meat and poultry processing will benefit consumers by reducing food-borne illnesses. The benefits are likely to exceed the additional costs from implementing the regulations. (SK)

77 FR 64384 - Proposed Information Collection (Supplemental Information for Change of Program or Reenrollment...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-19

... Progress) Activity: Comment Request AGENCY: Veterans Benefits Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Veterans Benefits Administration (VBA), Department of [[Page 64385... claimant's eligibility for additional educational benefits for a change of program or reenrollment after...

Risks versus benefits of medication use during pregnancy: what do women perceive?

PubMed

Mulder, Bianca; Bijlsma, Maarten J; Schuiling-Veninga, Catharina Cm; Morssink, Leonard P; van Puijenbroek, Eugene; Aarnoudse, Jan G; Hak, Eelko; de Vries, Tjalling W

2018-01-01

Understanding perception of risks and benefits is essential for informed patient choices regarding medical care. The primary aim of this study was to evaluate the perception of risks and benefits of 9 drug classes during pregnancy and associations with women's characteristics. Questionnaires were distributed to pregnant women who attended a Dutch Obstetric Care facility (first- and second-line care). Mean perceived risk and benefit scores were computed for 9 different drug classes (paracetamol, antacids, antibiotics, antifungal medication, drugs against nausea and vomiting, histamine-2 receptor antagonists/proton pump inhibitors, antidepressants, nonsteroidal anti-inflammatory drugs, and sedatives/anxiolytics). For each participant, we computed weighted risk and benefit sum scores with principal component analysis. In addition, major concerns regarding medication use were evaluated. The questionnaire was completed by 136 women (response rate 77%). Pregnant women were most concerned about having a child with a birth defect (35%), a miscarriage (35%), or their child developing an allergic disease (23%), respectively, as a result of drug use. The majority of studied drug classes were perceived relatively low in risk and high in benefit. Higher risk scores were reported if women were in their first trimesters of pregnancy ( p =0.007). Lower benefit scores were reported if women were single ( p =0.014), smoking ( p =0.028), nulliparous ( p =0.006), or did not have a family history of birth defects ( p =0.005). Pregnant women's concerns regarding potential drug adverse effects were not only focused on congenital birth defects but also included a wider range of adverse outcomes. This study showed that most of the studied drug classes were perceived relatively low in risk and high in benefit.

An evaluation of the hybrid car technology for the Mexico Mega City

NASA Astrophysics Data System (ADS)

Jazcilevich, Aron D.; Reynoso, Agustin Garcia; Grutter, Michel; Delgado, Javier; Ayala, Ulises Diego; Lastra, Manuel Suarez; Zuk, Miriam; Oropeza, Rogelio Gonzalez; Lents, Jim; Davis, Nicole

The introduction of hybrid electric vehicle (HEV) technology in the private car fleet of Mexico City is evaluated in terms of private costs, energy, public health and CO 2 emission benefits. In addition to constructing plausible scenarios for urban expansion, emission, car fleet, and fuel consumption for year 2026 and comparing them with a 2004 base case, a time series is built to obtain accumulated economic benefits. Experimental techniques were used to build a vehicle library for a car simulator that included a Prius 2002, chosen as the HEV technology representative for this work. The simulator is used to estimate the emissions and fuel consumption of the car fleet scenarios. In the context of an urban scenario for year 2026, a complex air quality model obtains the concentrations of criterion pollutants corresponding to these scenarios. Using a technology penetration model, the hybridized fleet starts unfolding in year 2009 reaching to 20% in 2026. In this year, the hybridized fleet resulted in reductions of about 10% of CO 2 emissions, and yielded reductions in daytime mean concentrations of up to 7% in ozone and 3.4% in PM 2.5 compared to the 2004 base case. These reductions are concentrated in the densely populated areas of Mexico City. By building a time series of costs and benefits it is shown that, depending on fuel prices and using a 5% return rate, positive accumulated benefits (CO 2 benefits + energy benefits + public health benefits - private costs) will start generating in year 2015 reaching between 2.8 and 4.5 billion US Dlls in 2026. Another modernized private fleet consisting exclusively of Tier I and II cars did not yield appreciable results, signaling that a change in private car technology towards HEV's is needed to obtain significant accumulated benefits.

Managing Land to Enhance Water Resources: A Hydrologic Ecosystem Services Study in Kona, Hawai'i

NASA Astrophysics Data System (ADS)

Brauman, K. A.; Daily, G. C.; Freyberg, D. L.

2010-12-01

In many water-limited environments, increasing groundwater recharge is a primary consideration in watershed management. In Kona, on the leeward side of Hawai’i Island, there are no perennial streams, and aquifers fed by rainfall on the mountain slopes are the sole source of water for coastal communities. Over 18 months, from the summer of 2006 through the winter of 2008, we measured precipitation, including rainfall and cloud interception, and meteorological drivers of evapotranspiration. Using a water balance approach, we were able to quantify the effects of land-use change on municipal water supply. Land-use change has a variety of potential impacts on aquifer level and thus on pumping expenses incurred by the downstream community. We weigh the private costs and benefits of land use change against the public costs and benefits to water supply by assessing avoided or additional cost to the water utility. One likely scenario, conversion of pasture land to plantation forest, decreases recharge and thus carries a public cost but is potentially lucrative for the landowner. The magnitudes of the public cost and the private benefit overlap, so a direct financial transaction between the utility and the landowner may be possible, improving overall welfare. A second scenario, conversion from open to dense forest, has some hydrologic benefit, but the cost to the landowner far exceeds this benefit. In this case, however, non-monetary public benefits such as carbon sequestration, habitat for biodiversity, and provision of non-timber forest goods are aligned with the hydrologic benefit. The full suite of benefits may have sufficient value to offset private cost and promote conversion to dense forest.

Part-time work or social benefits as predictors for disability pension: a prospective study of Swedish twins.

PubMed

Ropponen, Annina; Alexanderson, Kristina; Svedberg, Pia

2014-04-01

To a large extent, it is unknown whether work absences other than sickness absence (SA) covered by social benefits such as parental leave, rehabilitation, or unemployment would predict disability pension (DP). We investigated whether part-time work or having received social benefits for sick leave, rehabilitation, or parental leave would be predictors for DP taking into account familial confounding (genetics and shared environment, e.g., social background) in these associations. A sample of 17,640 same-sex Swedish twin ndividuals [corrected] was followed from 2000 to 2008 via national registries for their receipt of social benefits and DP including additional baseline questionnaire data. Cox proportional hazard ratios were estimated. Full-time work was less common (47 %) among those being granted DP during the follow-up compared to those without DP (69 %). Self-reported full-time work, part-time work (≥50 %), and self-employment and registry data of caring for a child were the direct protective factors, whereas self-reported part-time work (<50 %) and long-term SA and registry data on SA, compensation for rehabilitation, and benefits during return to work were the direct risk factors for DP, i.e., independent of familial confounding. Part-time work and social benefits play different roles in predicting DP. Thus, full-time work, part-time work (≥50 %), self-employment, and benefits for parental leave seem to protect from DP. In contrast, SA and part-time work (<50 %) carry a highly increased risk for DP. Although these associations were mainly independent from several mediating factors, some of the associations seem to be influenced by family situation, social benefits, or severity of diseases.

The importance of health co-benefits in macroeconomic assessments of UK Greenhouse Gas emission reduction strategies.

PubMed

Jensen, Henning Tarp; Keogh-Brown, Marcus R; Smith, Richard D; Chalabi, Zaid; Dangour, Alan D; Davies, Mike; Edwards, Phil; Garnett, Tara; Givoni, Moshe; Griffiths, Ulla; Hamilton, Ian; Jarrett, James; Roberts, Ian; Wilkinson, Paul; Woodcock, James; Haines, Andy

We employ a single-country dynamically-recursive Computable General Equilibrium model to make health-focussed macroeconomic assessments of three contingent UK Greenhouse Gas (GHG) mitigation strategies, designed to achieve 2030 emission targets as suggested by the UK Committee on Climate Change. In contrast to previous assessment studies, our main focus is on health co-benefits additional to those from reduced local air pollution. We employ a conservative cost-effectiveness methodology with a zero net cost threshold. Our urban transport strategy (with cleaner vehicles and increased active travel) brings important health co-benefits and is likely to be strongly cost-effective; our food and agriculture strategy (based on abatement technologies and reduction in livestock production) brings worthwhile health co-benefits, but is unlikely to eliminate net costs unless new technological measures are included; our household energy efficiency strategy is likely to breakeven only over the long term after the investment programme has ceased (beyond our 20 year time horizon). We conclude that UK policy makers will, most likely, have to adopt elements which involve initial net societal costs in order to achieve future emission targets and longer-term benefits from GHG reduction. Cost-effectiveness of GHG strategies is likely to require technological mitigation interventions and/or demand-constraining interventions with important health co-benefits and other efficiency-enhancing policies that promote internalization of externalities. Health co-benefits can play a crucial role in bringing down net costs, but our results also suggest the need for adopting holistic assessment methodologies which give proper consideration to welfare-improving health co-benefits with potentially negative economic repercussions (such as increased longevity).

Exercise prescription for the elderly: current recommendations.

PubMed

Mazzeo, R S; Tanaka, H

2001-01-01

The benefits for elderly individuals of regular participation in both cardiovascular and resistance-training programmes are great. Health benefits include a significant reduction in risk of coronary heart disease, diabetes mellitus and insulin resistance, hypertension and obesity as well as improvements in bone density, muscle mass, arterial compliance and energy metabolism. Additionally, increases in cardiovascular fitness (maximal oxygen consumption and endurance), muscle strength and overall functional capacity are forthcoming allowing elderly individuals to maintain their independence, increase levels of spontaneous physical activity and freely participate in activities associated with daily living. Taken together, these benefits associated with involvement in regular exercise can significantly improve the quality of life in elderly populations. It is noteworthy that the quality and quantity of exercise necessary to elicit important health benefits will differ from that needed to produce significant gains in fitness. This review describes the current recommendations for exercise prescriptions for the elderly for both cardiovascular and strength/resistance-training programmes. However, it must be noted that the benefits described are of little value if elderly individuals do not become involved in regular exercise regimens. Consequently, the major challenges facing healthcare professionals today concern: (i) the implementation of educational programmes designed to inform elderly individuals of the health and functional benefits associated with regular physical activity as well as how safe and effective such programmes can be; and (ii) design interventions that will both increase involvement in regular exercise as well as improve adherence and compliance to such programmes.

Economic and Social Impact of Increasing Uptake of Cardiac Rehabilitation Services--A Cost Benefit Analysis.

PubMed

De Gruyter, Elaine; Ford, Greg; Stavreski, Bill

2016-02-01

Cardiac rehabilitation can reduce mortality, improve cardiac risk factor profile and reduce readmissions; yet uptake remains low at 30%. This research aims to investigate the social and economic impact of increasing the uptake of cardiac rehabilitation in Victoria, Australia using cost benefit analysis (CBA). Cost benefit analysis has been undertaken over a 10-year period to analyse three scenarios: (1) Base Case: 30% uptake; (2) Scenario 1: 50% uptake; and (3) Scenario 2: 65% uptake. Impacts considered include cardiac rehabilitation program costs, direct inpatient costs, other healthcare costs, burden of disease, productivity losses, informal care costs and net deadweight loss. There is a net financial saving of $46.7-$86.7 million under the scenarios. Compared to the Base Case, an additional net benefit of $138.9-$227.2 million is expected. This results in a Benefit Cost Ratio of 5.6 and 6.8 for Scenarios 1 and 2 respectively. Disability Adjusted Life Years were 21,117-37,565 years lower than the Base Case. Greater uptake of cardiac rehabilitation can reduce the burden of disease, directly translating to benefits for society and the economy. This research supports the need for greater promotion, routine referral to be made standard practice and implementation of reforms to boost uptake. Copyright © 2015 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

Flexible benefits, choice, and work force diversity.

PubMed

Foley, J

1993-07-01

This Issue Brief evaluates the prevalence of flexible benefits plans and their ability to achieve cost management goals and to meet the needs of diverse employee groups. In addition, it examines flexible benefits plans' current legislative and regulatory status and typical plan design features. Sec. 125 of the Internal Revenue Code allows employers to provide employees with a choice among benefits, including moving otherwise taxable cash compensation to the pre-tax purchase of benefits, without requiring them to include the value of the noncash benefits in their adjusted gross income unless they choose taxable options. Although the percentage of full-time employees in medium and large private establishments who are eligible for cafeteria plans has not increased appreciably, the percentage of employees eligible for freestanding flexible spending accounts (FSAs) nearly tripled between 1988 and 1991. Generally, the proportion of employers sponsoring cafeteria plans or FSAs increases with employer size. Recent surveys show that 27 percent of employers with 1,000 or more employees offered choice-making plans in 1991, 48 percent of firms offered health care FSAs, and 54 percent offered dependent care FSAs, either in conjunction with cafeteria plans or as a stand-alone option. Ten percent of full-time employees in private firms employing 100 or more workers were eligible to participate in cafeteria plans in 1991. Only 5 percent of full-time employees in state and local governments and 1 percent of similar employees in small private establishments were eligible for cafeteria plans in 1990. Recent Bureau of Labor Statistics' surveys show that, among full-time employees, 27 percent in private establishments with 100 or more employees, 28 percent in state and local governments, and 6 percent in small private establishments were eligible to participate in freestanding FSAs. In 1992, 21 percent of eligible employees contributed to a health care FSA, and only 3 percent of eligible employees contributed to a dependent care FSA. Contributions to health care FSAs averaged $651, and those to dependent care FSAs averaged $2,959. National health reform could have a significant impact on these plans if the tax treatment of health benefits is changed. Taxation of health benefits in excess of a standard benefits package would fundamentally reduce the ability to use FSAs.

Screening for Prostate Cancer: US Preventive Services Task Force Recommendation Statement.

PubMed

Grossman, David C; Curry, Susan J; Owens, Douglas K; Bibbins-Domingo, Kirsten; Caughey, Aaron B; Davidson, Karina W; Doubeni, Chyke A; Ebell, Mark; Epling, John W; Kemper, Alex R; Krist, Alex H; Kubik, Martha; Landefeld, C Seth; Mangione, Carol M; Silverstein, Michael; Simon, Melissa A; Siu, Albert L; Tseng, Chien-Wen

2018-05-08

In the United States, the lifetime risk of being diagnosed with prostate cancer is approximately 13%, and the lifetime risk of dying of prostate cancer is 2.5%. The median age of death from prostate cancer is 80 years. Many men with prostate cancer never experience symptoms and, without screening, would never know they have the disease. African American men and men with a family history of prostate cancer have an increased risk of prostate cancer compared with other men. To update the 2012 US Preventive Services Task Force (USPSTF) recommendation on prostate-specific antigen (PSA)-based screening for prostate cancer. The USPSTF reviewed the evidence on the benefits and harms of PSA-based screening for prostate cancer and subsequent treatment of screen-detected prostate cancer. The USPSTF also commissioned a review of existing decision analysis models and the overdiagnosis rate of PSA-based screening. The reviews also examined the benefits and harms of PSA-based screening in patient subpopulations at higher risk of prostate cancer, including older men, African American men, and men with a family history of prostate cancer. Adequate evidence from randomized clinical trials shows that PSA-based screening programs in men aged 55 to 69 years may prevent approximately 1.3 deaths from prostate cancer over approximately 13 years per 1000 men screened. Screening programs may also prevent approximately 3 cases of metastatic prostate cancer per 1000 men screened. Potential harms of screening include frequent false-positive results and psychological harms. Harms of prostate cancer treatment include erectile dysfunction, urinary incontinence, and bowel symptoms. About 1 in 5 men who undergo radical prostatectomy develop long-term urinary incontinence, and 2 in 3 men will experience long-term erectile dysfunction. Adequate evidence shows that the harms of screening in men older than 70 years are at least moderate and greater than in younger men because of increased risk of false-positive results, diagnostic harms from biopsies, and harms from treatment. The USPSTF concludes with moderate certainty that the net benefit of PSA-based screening for prostate cancer in men aged 55 to 69 years is small for some men. How each man weighs specific benefits and harms will determine whether the overall net benefit is small. The USPSTF concludes with moderate certainty that the potential benefits of PSA-based screening for prostate cancer in men 70 years and older do not outweigh the expected harms. For men aged 55 to 69 years, the decision to undergo periodic PSA-based screening for prostate cancer should be an individual one and should include discussion of the potential benefits and harms of screening with their clinician. Screening offers a small potential benefit of reducing the chance of death from prostate cancer in some men. However, many men will experience potential harms of screening, including false-positive results that require additional testing and possible prostate biopsy; overdiagnosis and overtreatment; and treatment complications, such as incontinence and erectile dysfunction. In determining whether this service is appropriate in individual cases, patients and clinicians should consider the balance of benefits and harms on the basis of family history, race/ethnicity, comorbid medical conditions, patient values about the benefits and harms of screening and treatment-specific outcomes, and other health needs. Clinicians should not screen men who do not express a preference for screening. (C recommendation) The USPSTF recommends against PSA-based screening for prostate cancer in men 70 years and older. (D recommendation).

Space benefits: The secondary application of aerospace technology in other sectors of the economy

NASA Technical Reports Server (NTRS)

1976-01-01

A 'Benefit Briefing Notebook' was prepared for the NASA Technology Utilization Office to provide accurate, convenient, and integrated resource information on the transfer of aerospace technology to other sectors of the U.S. economy. The contents are divided into three sections: (1) transfer overview, (2) benefit cases, and (3) indexes. The transfer overview section provides a general perspective for technology transfer from NASA to other organizations. In addition to a description of the basic transfer modes, the selection criteria for notebook examples and the kinds of benefit data they contain are also presented. The benefits section is subdivided into nineteen subject areas. Each subsection presents one or more key issues of current interest, with discrete transfer cases related to each key issue. Additional transfer examples relevant to each subject area are then presented. Pertinent transfer data are given at the end of each example.

Do Generous Unemployment Benefit Programs Reduce Suicide Rates? A State Fixed-Effect Analysis Covering 1968–2008

PubMed Central

Cylus, Jonathan; Glymour, M. Maria; Avendano, Mauricio

2014-01-01

The recent economic recession has led to increases in suicide, but whether US state unemployment insurance programs ameliorate this association has not been examined. Exploiting US state variations in the generosity of benefit programs between 1968 and 2008, we tested the hypothesis that more generous unemployment benefit programs reduce the impact of economic downturns on suicide. Using state linear fixed-effect models, we found a negative additive interaction between unemployment rates and benefits among the US working-age (20–64 years) population (β = −0.57, 95% confidence interval: −0.86, −0.27; P < 0.001). The finding of a negative additive interaction was robust across multiple model specifications. Our results suggest that the impact of unemployment rates on suicide is offset by the presence of generous state unemployment benefit programs, though estimated effects are small in magnitude. PMID:24939978

The economic and clinical impact of an inpatient palliative care consultation service: a multifaceted approach.

PubMed

Ciemins, Elizabeth L; Blum, Linda; Nunley, Marsha; Lasher, Andrew; Newman, Jeffrey M

2007-12-01

While there has been a rapid increase of inpatient palliative care (PC) programs, the financial and clinical benefits have not been well established. Determine the effect of an inpatient PC consultation service on costs and clinical outcomes. Multifaceted study included: (1) interrupted time-series design utilizing mean daily costs preintervention and postintervention; (2) matched cohort analysis comparing PC to usual care patients; and (3) analysis of symptom control after consultation. Large private, not-for-profit, academic medical center in San Francisco, California, 2004-2006. Time series analysis included 282 PC patients; matched cohorts included 27 PC with 128 usual care patients; clinical outcome analysis of 48 PC patients. Mean daily patient costs and length of stay (LOS); pain, dyspnea, and secretions assessment scores. Mean daily costs were reduced 33% (p < 0.01) from preintervention to postintervention period. Mean length of stay (LOS) was reduced 30%. Mean daily costs for PC patients were 14.5% lower compared to usual care patients (p < 0.01). Pain, dyspnea, and secretions scores were reduced by 86%, 64%, and 87%, respectively. Over the study period, time to PC referral as well as overall ALOS were reduced by 50%. The large reduction in mean daily costs and LOS resulted in an estimated annual savings of $2.2 million in the study hospital. Our results extend the evidence base of financial and clinical benefits associated with inpatient PC programs. We recommend additional study of best practices for identifying patients and providing consultation services, in addition to progressive management support and reimbursement policy.

Revisiting the Dialogue on the Transition from Coteaching to Inservice Teaching: New Frameworks, Additional Benefits and Emergent Issues

ERIC Educational Resources Information Center

Wassell, Beth; LaVan, Sarah Kate

2009-01-01

In this rejoinder, we respond to the major points made by Gallo-Fox (this forum), Beers (this forum), Carambo and Stickney (this forum), and Murphy, Carlisle and Beggs (this forum). We focus primarily on the benefits and considerations that stem from employing additional theoretical frameworks for analyzing research in coteaching. We also address…

Workplace Education. Tapping Your Greatest Asset in the 1990s. A Handbook on Education in the Workplace.

ERIC Educational Resources Information Center

Braid, Mary; Macaskill, Sandra, Ed.

Workplace education (WPE) has a significant role to play in solving basic skills problems and in other training requirements. In addition to the benefit of a more able, adaptable work force, WPE leads to more contented workers, encouraged by better employment opportunities. In addition, employees benefit by being more confident both within the…

State transition model: vorapaxar added to standard antiplatelet therapy to prevent thrombosis post myocardial infarction or peripheral artery disease.

PubMed

Du, Mark; Chase, Monica; Oguz, Mustafa; Davies, Glenn

2017-09-01

To evaluate long-term health benefits and risks of adding vorapaxar (VOR) to the standard care antiplatelet therapy (SC) of aspirin and/or clopidogrel, among a population with a recent myocardial infarction (MI) and/or peripheral artery disease (PAD). In a state-transition model, patients transition between health states (event-free, recurrent MI, stroke, death), while at risk of experiencing non-transition-related revascularization and non-fatal bleeding events. Risk equations developed from the TRA 2°P-TIMI 50 trial's patient-level data were used to predict cardiovascular (CV) outcomes over longer time horizons. Additional sources, including trials and US-based observational studies, informed the inputs for short-term CV risk, non-CV death, and health-related quality of life. Survival and quality-adjusted life-years (QALYs) were estimated over a lifetime horizon, discounted at 3% per year. Within a cohort of 7361 patients with recent MI and/or PAD, VOR + SC relative to SC alone yielded 176 fewer CV events (MIs, strokes, or CV deaths), but 27 more major bleeding events. VOR + SC was associated with increased life expectancy and health benefits (19.93 undiscounted life-years [LYs], 9.57 discounted QALYs vs. 19.61 undiscounted LYs, 9.41 discounted QALYs). The results were most sensitive to scenarios varying time of vorapaxar initiation, and the assumptions in the 90 day period post-MI. Additional analyses showed that add-on vorapaxar provides consistent incremental benefits in high-risk subgroups. This study contributes to the growing literature on secondary prevention add-on therapy, as results from these modeling analyses suggest that adding vorapaxar to SC for patients at high atherothrombotic risk can provide long-term health benefits.

Adverse events in IBD: to stop or continue immune suppressant and biologic treatment.

PubMed

McLean, Leon P; Cross, Raymond K

2014-03-01

Crohn's disease and ulcerative colitis affect an increasing number of patients. A variety of medical options exist for the treatment of these diseases including immune suppressants and biologic therapies. Unfortunately, these agents are associated with adverse events ranging from mild nuisance symptoms to potentially life-threatening complications including infections and malignancies. This review discusses adverse events associated with azathioprine, mercaptopurine, and methotrexate as well as anti-TNF-α and anti-integrin antibodies. In addition, adverse events associated with combination therapy are discussed as are clinical scenarios in which it may be reasonable to discontinue or de-escalate drug therapy. It is the responsibility of the treating gastroenterologist to effectively communicate the benefits and risks of therapy with patients; this review offers strategies that may assist providers in communicating risk with patients in addition to offering our perspective on whether modification or cessation of therapy can be considered.

Adverse events in IBD: to stop or continue immune suppressant and biologic treatment

PubMed Central

McLean, Leon P; Cross, Raymond K

2014-01-01

Crohn’s disease and ulcerative colitis affect an increasing number of patients. A variety of medical options exist for the treatment of these diseases including immune suppressants and biologic therapies. Unfortunately, these agents are associated with adverse events ranging from mild nuisance symptoms to potentially life-threatening complications including infections and malignancies. This review discusses adverse events associated with azathioprine, mercaptopurine, and methotrexate as well as anti-TNF-α and anti-integrin antibodies. In addition, adverse events associated with combination therapy are discussed as are clinical scenarios in which it may be reasonable to discontinue or de-escalate drug therapy. It is the responsibility of the treating gastroenterologist to effectively communicate the benefits and risks of therapy with patients; this review offers strategies that may assist providers in communicating risk with patients in addition to offering our perspective on whether modification or cessation of therapy can be considered. PMID:24490595

Nicotine Withdrawal, Relapse of Mental Illness, or Medication Side-Effect? Implementing a Monitoring Tool for People With Mental Illness Into Quitline Counseling.

PubMed

Segan, Catherine J; Baker, Amanda L; Turner, Alyna; Williams, Jill M

2017-01-01

Smokers with mental illness and their health care providers are often concerned that smoking cessation will worsen mental health. Smokers with mental illness tend to be more nicotine-dependent and experience more severe symptoms of nicotine withdrawal, some of which are difficult to distinguish from psychiatric symptoms. In addition, smoking cessation can increase the blood levels and hence side effects of some psychotropic medications. Improved monitoring of nicotine withdrawal and medication side effects may help distinguish temporary withdrawal symptoms from psychiatric symptoms and facilitate targeted treatment to help smokers with mental illness manage the acute phase of nicotine withdrawal. The aim of this research was to examine the acceptability and feasibility to quitline counselors of implementing structured assessments of nicotine withdrawal and common medication side effects in people with mental illness who are quitting smoking using a telephone smoking cessation service. Monitoring involves administering (once pre-cessation and at each contact post-cessation) (1) the Minnesota Nicotine Withdrawal Scale, assessing eight symptoms: anger, anxiety, depression, cravings, difficulty concentrating, increased appetite, insomnia, and restlessness and (2) an adverse side effects checklist of 5 to 10 symptoms, for example, dry mouth and increased thirst. Following a 1-day update training in mental health, quitline counselors were asked to offer these assessments to callers disclosing mental illness in addition to usual counseling. Group interviews with counselors were conducted 2 months later to examine implementation barriers and benefits. Barriers included awkwardness in integrating a new structured practice into counseling, difficulty in limiting some callers to only the content of new items, and initial anxieties about how to respond to changes in some symptoms. Benefits included the ability to provide objective feedback on changes in symptoms, as this identified early benefits of quitting, provided reassurance for clients, and provided an opportunity for early intervention where symptoms worsened. Structured monitoring of withdrawal symptoms and medication side effects was able to be integrated into the quitline's counseling and was valued by counselors and clients. Given evidence of its benefits in this limited pilot study, we recommend it be considered for larger-scale adoption by quitlines.

A review of nurses' knowledge, attitudes, and ability to communicate the risks and benefits of complementary and alternative medicine.

PubMed

Chang, Hsiao-Yun; Chang, Huai-Lu

2015-06-01

This study reviewed existing literature to investigate how frequently nurses include complementary and alternative forms of medicine in their clinical practice. In so doing, we investigated nurses' knowledge of and attitudes towards complementary and alternative medicine as well as their ability to communicate the risks and benefits of these therapies with patients. Little information is available concerning nurses' knowledge and attitudes towards complementary and alternative medicine or how they incorporate these therapies into their practice. In addition, little is known about the ability of nurses to communicate the risks and benefits of complementary and alternative medicine to their patients. This study used a scoping review method to map and synthesise existing literature. Both electronic and manual searches were used to identify relevant studies published between January 2007 and January 2014. The review was conducted in five stages: (1) identification of research question(s), (2) locate studies, (3) selection of studies, (4) charting of data, and (5) collating, summarising, and reporting of results. Fifteen papers met the inclusion criteria for this review, among which 53·7% referenced how frequently nurses include complementary and alternative medicine in their practice. We found that 66·4% of nurses had positive attitudes towards complementary and alternative medicine; however, 77·4% did not possess a comprehensive understanding of the associated risks and benefits. In addition, nearly half of the respondents (47·3-67·7%) reported feeling uncomfortable discussing complementary and alternative medicine therapies with their patients. The lack of knowledge about complementary and alternative medicine among nurses is a cause for concern, particularly in light of its widespread application. Findings from this study suggest that health care professionals need to promote evidence informed decision-making in complementary and alternative medicine practice and be knowledgeable enough to discuss complementary and alternative medicine therapies. Without involvement of complementary and alternative medicine communication on the part of our profession, we may put our patients at risk of uninformed and without medical guidance. © 2015 John Wiley & Sons Ltd.

[Prescription of drugs with ASMR V in patients over 65 years in a primary care ambulatory setting. Drug prescription analysis in the Midi-Pyrénées region (France)].

PubMed

Bismuth, Serge; Chalvignac, Caroline; Bagheri, Haleh; Oustric, Stéphane

2010-12-20

In French patients over 65 years, drug intake is characterized by polytherapy, causing iatrogenic events. The general practitioner is the main actor in the follow-up and reassessment of drug prescriptions. To assess the proportion of ASMR V (Amélioration du service medical rendu - additional therapeutic benefit versus current standards) drugs [drugs producing no medical improvement] prescribed to patients over 65 years in the management of a chronic disease. In May 2009, 849 drug prescriptions were collected from 34 general practitioners in the Midi-Pyrénées region. Specialties with ASMR V were classified according to the anatomical therapeutic chemical (ATC) classification system. 58.8% of the prescriptions concerned female patients; 67.4% of the prescriptions contained at least one ASMR-V drug. Approximately 20% of the prescriptions in subjects over 65 years contained ASMR-V drugs. This study shows that older subjects are being prescribed a significant number of ASMR-V drugs. However, this classification combines several situations, including a product line extension, a fixed combination of preexisting drugs, an insufficient therapeutic benefit, the absence of additional therapeutic benefit versus a comparative drug, the absence of comparative study in some indications, or a less favorable benefit-risk ratio comparing to that of the reference drug.This classification includes as well the generic drugs prescribed using the international non proprietary names. This study did not analyze the influence of certain factors, such as treatment history, history of drug allergy or dose titration, which could influence the physician's decision. Following this study, it appears useful to extend this type of survey to other general practitioners in other French regions, and to analyze the reasons for prescribing ASMR-V drugs. These data would help increasing general practitioners' awareness of "proper drug use" to reduce the proportion of "inadequate" drugs prescribed to older subjects. One could also consider conducting a survey amongst older patients under polytherapy, to question them on the treatments taken.

76 FR 33417 - Agency Information Collection (Disability Benefits Questionnaires-Group 2) Activity Under OMB Review

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-08

.... Non-ischemic Heart Disease (including Arrhythmias and Surgery, Disability Benefits Questionnaire, VA.... Arteries and Veins Conditions (Vascular Diseases including Varicose Veins) Disability Benefits... g. Skin Diseases Disability Benefits Questionnaire, VA Form 21- 0960F-2. h. Amputations Disability...

The Association Between the Use of the Education Benefits from the G.I. Bill and Veterans' Health.

PubMed

Rumery, Zachary R; Patel, Nilam; Richard, Patrick

2018-05-01

There is limited knowledge on the impact of education on veterans' health in the United States. This study specifically examines the relationship between the education benefits from the G.I. Bill and veterans' health. This study used data from the 2010 National Survey of Veterans. The subjects for this study were 5,052 veterans who were eligible to receive G.I. Bill benefits, representing a total of about 12.7 million non-institutionalized veterans in the United States in 2010. The dependent variables included self-reported health status and smoking behavior. The key independent variable was whether veterans used the education benefits from the G.I. Bill compared with those who were eligible but did not use them. Results from multivariate regression analyses showed that those who used the education benefits from the G.I. Bill were 4% less likely to report fair/poor health (p < 0.01) and 3% less likely to report any smoking (p < 0.05) compared with those who did not use the education benefits. Additional analyses showed that using the education benefits to attend college decreased the probability of being in fair/poor health by 4% (p < 0.10) and being a smoker by 4% (p < 0.05) compared with those who did not attend college but used their benefits for non-college attainment such as business, technical, or vocational schools. More importantly, a larger association was found between the use of the education benefits from the G.I. Bill to obtain a college degree and fair/poor health (7%, p < 0.05) and smoking behavior (9%, p < 0.01) compared with those who attended college but did not obtain a college degree. This study shows that providing opportunities for service members to complete their education also has important health benefits.

Impact of trace element additives on anaerobic digestion of sewage sludge with in-situ carbon dioxide sequestration

DOE Office of Scientific and Technical Information (OSTI.GOV)

Linville, Jessica L.; Shen, Yanwen; Schoene, Robin P.

Anaerobic digestion (AD) of sludge at wastewater treatment plants can benefit from addition of essential trace metals such as iron, nickel and cobalt to increase biogas production for utilization in combined heat and power systems, fed into natural gas pipelines or as a vehicle fuel. This study evaluated the impact and benefits of Ni/Co and olivine addition to the digester at mesophilic temperatures. These additions supplement previously reported research in which iron-rich olivine (MgSiO4) was added to sequester CO2 in-situ during batch AD of sludge. Trace element addition has been shown to stimulate and stabilize biogas production and have amore » synergistic effect on the mineral carbonation process. AD with 5% w/v olivine and 1.5 mg/L Ni/Co addition had a 17.3% increase in methane volume, a 6% increase in initial exponential methane production rate and a 56% increase in methane yield (mL CH4/g CODdegraded) compared to the control due to synergistic trace element and olivine addition while maintaining 17.7% CO2 sequestration from olivine addition. Both first-order kinetic modeling and response surface methodology modeling confirmed the combined benefit of the trace elements and olivine addition. These results were significantly higher than previously reported results with olivine addition alone [1].« less

Incorporating concepts of inequality and inequity into health benefits analysis

PubMed Central

Levy, Jonathan I; Chemerynski, Susan M; Tuchmann, Jessica L

2006-01-01

Background Although environmental policy decisions are often based in part on both risk assessment information and environmental justice concerns, formalized approaches for addressing inequality or inequity when estimating the health benefits of pollution control have been lacking. Inequality indicators that fulfill basic axioms and agree with relevant definitions and concepts in health benefits analysis and environmental justice analysis can allow for quantitative examination of efficiency-equality tradeoffs in pollution control policies. Methods To develop appropriate inequality indicators for health benefits analysis, we provide relevant definitions from the fields of risk assessment and environmental justice and consider the implications. We evaluate axioms proposed in past studies of inequality indicators and develop additional axioms relevant to this context. We survey the literature on previous applications of inequality indicators and evaluate five candidate indicators in reference to our proposed axioms. We present an illustrative pollution control example to determine whether our selected indicators provide interpretable information. Results and Conclusions We conclude that an inequality indicator for health benefits analysis should not decrease when risk is transferred from a low-risk to high-risk person, and that it should decrease when risk is transferred from a high-risk to low-risk person (Pigou-Dalton transfer principle), and that it should be able to have total inequality divided into its constituent parts (subgroup decomposability). We additionally propose that an ideal indicator should avoid value judgments about the relative importance of transfers at different percentiles of the risk distribution, incorporate health risk with evidence about differential susceptibility, include baseline distributions of risk, use appropriate geographic resolution and scope, and consider multiple competing policy alternatives. Given these criteria, we select the Atkinson index as the single indicator most appropriate for health benefits analysis, with other indicators useful for sensitivity analysis. Our illustrative pollution control example demonstrates how these indices can help a policy maker determine control strategies that are dominated from an efficiency and equality standpoint, those that are dominated for some but not all societal viewpoints on inequality averseness, and those that are on the optimal efficiency-equality frontier, allowing for more informed pollution control policies. PMID:16569243

Topical anti-infective sinonasal irrigations: update and literature review.

PubMed

Lee, Jivianne T; Chiu, Alexander G

2014-01-01

Sinonasal anti-infective irrigations have emerged as a promising therapeutic modality in the comprehensive management of chronic rhinosinusitis (CRS), particularly in the context of recalcitrant disease. The purpose of this article was to delineate the current spectrum of topical anti-infective therapies available and evaluate their role in the treatment of CRS. A systematic literature review was performed on all studies investigating the use of topical antimicrobial solutions in the medical therapy of CRS. Anti-infective irrigations were stratified into topical antibacterial, antifungal, and additive preparations according to their composition and respective microbicidal properties. The use of topical antibiotic irrigations has been supported by low-level studies in the treatment of refractory CRS, with optimal results achieved in patients who have undergone prior functional endoscopic sinus surgery and received culture-directed therapy. Multiple evidence-based reviews have not established any clinical benefit with the administration of topical antifungals, and their use is not currently recommended in the management of routine CRS. Topical additives including surfactants may be beneficial as adjunctive treatment for recalcitrant CRS, but additional research is needed to investigate their efficacy in comparison with other agents and establish safety profiles. Topical anti-infective solutions are not recommended as first-line therapy for routine CRS but may be considered as a potential option for patients with refractory CRS who have failed traditional medical and surgical intervention. Additional research is necessary to determine which patient populations would derive the most benefit from each respective irrigation regimen and identify potential toxicities associated with prolonged use.

Dual-Energy CT: New Horizon in Medical Imaging

PubMed Central

Goo, Jin Mo

2017-01-01

Dual-energy CT has remained underutilized over the past decade probably due to a cumbersome workflow issue and current technical limitations. Clinical radiologists should be made aware of the potential clinical benefits of dual-energy CT over single-energy CT. To accomplish this aim, the basic principle, current acquisition methods with advantages and disadvantages, and various material-specific imaging methods as clinical applications of dual-energy CT should be addressed in detail. Current dual-energy CT acquisition methods include dual tubes with or without beam filtration, rapid voltage switching, dual-layer detector, split filter technique, and sequential scanning. Dual-energy material-specific imaging methods include virtual monoenergetic or monochromatic imaging, effective atomic number map, virtual non-contrast or unenhanced imaging, virtual non-calcium imaging, iodine map, inhaled xenon map, uric acid imaging, automatic bone removal, and lung vessels analysis. In this review, we focus on dual-energy CT imaging including related issues of radiation exposure to patients, scanning and post-processing options, and potential clinical benefits mainly to improve the understanding of clinical radiologists and thus, expand the clinical use of dual-energy CT; in addition, we briefly describe the current technical limitations of dual-energy CT and the current developments of photon-counting detector. PMID:28670151

The Effects of Acoustic Bandwidth on Simulated Bimodal Benefit in Children and Adults with Normal Hearing.

PubMed

Sheffield, Sterling W; Simha, Michelle; Jahn, Kelly N; Gifford, René H

2016-01-01

The primary purpose of this study was to examine the effect of acoustic bandwidth on bimodal benefit for speech recognition in normal-hearing children with a cochlear implant (CI) simulation in one ear and low-pass filtered stimuli in the contralateral ear. The effect of acoustic bandwidth on bimodal benefit in children was compared with the pattern of adults with normal hearing. Our hypothesis was that children would require a wider acoustic bandwidth than adults to (1) derive bimodal benefit, and (2) obtain asymptotic bimodal benefit. Nineteen children (6 to 12 years) and 10 adults with normal hearing participated in the study. Speech recognition was assessed via recorded sentences presented in a 20-talker babble. The AzBio female-talker sentences were used for the adults and the pediatric AzBio sentences (BabyBio) were used for the children. A CI simulation was presented to the right ear and low-pass filtered stimuli were presented to the left ear with the following cutoff frequencies: 250, 500, 750, 1000, and 1500 Hz. The primary findings were (1) adults achieved higher performance than children when presented with only low-pass filtered acoustic stimuli, (2) adults and children performed similarly in all the simulated CI and bimodal conditions, (3) children gained significant bimodal benefit with the addition of low-pass filtered speech at 250 Hz, and (4) unlike previous studies completed with adult bimodal patients, adults and children with normal hearing gained additional significant bimodal benefit with cutoff frequencies up to 1500 Hz with most of the additional benefit gained with energy below 750 Hz. Acoustic bandwidth effects on simulated bimodal benefit were similar in children and adults with normal hearing. Should the current results generalize to children with CIs, these results suggest pediatric CI recipients may derive significant benefit from minimal acoustic hearing (<250 Hz) in the nonimplanted ear and increasing benefit with broader bandwidth. Knowledge of the effect of acoustic bandwidth on bimodal benefit in children may help direct clinical decisions regarding a second CI, continued bimodal hearing, and even optimizing acoustic amplification for the nonimplanted ear.

Fair Balance and Adequate Provision in Direct-to-Consumer Prescription Drug Online Banner Advertisements: A Content Analysis

PubMed Central

2016-01-01

Background The current direct-to-consumer advertising (DTCA) guidelines were developed with print, television, and radio media in mind, and there are no specific guidelines for online banner advertisements. Objective This study evaluates how well Internet banner ads comply with existing Food and Drug Administration (FDA) guidelines for DTCA in other media. Methods A content analysis was performed of 68 banner advertisements. A coding sheet was developed based on (1) FDA guidance documents for consumer-directed prescription drug advertisements and (2) previous DTCA content analyses. Specifically, the presence of a brief summary detailing the drug’s risks and side effects or of a “major statement” identifying the drug’s major risks, and the number and type of provisions made available to consumers for comprehensive information about the drug were coded. In addition, the criterion of “fair balance,” the FDA’s requirement that prescription drug ads balance information relating to the drug’s risks with information relating to its benefits, was measured by numbering the benefit and risk facts identified in the ads and by examining the presentation of risk and benefit information. Results Every ad in the sample included a brief summary of risk information and at least one form of adequate provision as required by the FDA for broadcast ads that do not give audiences a brief summary of a drug’s risks. No ads included a major statement. There were approximately 7.18 risk facts for every benefit fact. Most of the risks (98.85%, 1292/1307) were presented in the scroll portion of the ad, whereas most of the benefits (66.5%, 121/182) were presented in the main part of the ad. Out of 1307 risk facts, 1292 were qualitative and 15 were quantitative. Out of 182 benefit facts, 181 were qualitative and 1 was quantitative. The majority of ads showed neutral images during the disclosure of benefit and risk facts. Only 9% (6/68) of the ads displayed positive images and none displayed negative images when presenting risks facts. When benefit facts were being presented, 7% (5/68) showed only positive images. No ads showed negative images when the benefit facts were being presented. Conclusions In the face of ambiguous regulatory guidelines for online banner promotion, drug companies appear to make an attempt to adapt to regulatory guidelines designed for traditional media. However, banner ads use various techniques of presentation to present the advertised drug in the best possible light. The FDA should formalize requirements that drug companies provide a brief summary and include multiple forms of adequate provision in banner ads. PMID:26892749

Survey of Retired Military Pharmacist's Transition to a Civilian Pharmacy Career Path.

PubMed

Bennett, David; Wellman, Greg; Mahmood, Maysaa; Freye, Ryan; Remund, Daniel; Samples, Phil L

2015-12-01

To explore variables relevant to transition to civilian pharmacy career path for retiring military pharmacists. A cross-sectional survey was designed to collect information from retired military pharmacists including demographics, military service information, postretirement employment and perceptions of transition, satisfaction, level of responsibility, work environment, rewards (level of financial compensation, opportunities for professional development and career advancement, health benefits), and level of supervisory support. The questionnaire also included additional items asking about their perception of their military experience, transition to civilian work and the impact the military career had on their personal and family life. Respondents included 140 retired pharmacists from the U.S. Army, Navy, Air Force, or Coast Guard. Factors found to be significant predictors of transition to civilian career included: bureaucracy in current job, time elapsed since retirement, extent to which an individual misses military structure and chain of command, access to military facilities and Veterans Administration benefits, and reporting little or no stress in committed long-term personal relationship while in the military. Findings suggest that the majority of retired military pharmacists perceived the transition to civilian professional sector was about what they expected or easier than expected. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.