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Sample records for aids spending assessment

  1. Why do some countries spend more for health? An assessment of sociopolitical determinants and international aid for government health expenditures.

    PubMed

    Liang, Li-Lin; Mirelman, Andrew J

    2014-08-01

    A consensus exists that rising income levels and technological development are among key drivers of total health spending. Determinants of public sector health expenditure, by contrast, are less well understood. This study examines a complex relationship across government health expenditure (GHE), sociopolitical risks, and international aid, while taking into account the impacts of national income, debt and tax financing and aging populations on health spending. We apply a fixed-effects two-stage least squares regression method to a panel dataset comprising 120 countries for the years 1995 through 2010. Our results show that democratic accountability has a diminishing positive correlation with GHE, and that levels of GHE are higher when government is more stable. Corruption is associated with less GHE in developing countries, but with higher GHE in developed countries. We also find that development assistance for health (DAH) is fungible with domestically financed government health expenditure (DGHE). For an average country, a 1% increase in DAH to government is associated with a 0.03-0.04% decrease in DGHE. Furthermore, the degree of fungibility of DAH to government is higher in countries where corruption or ethnic tensions are widespread. However, DAH to non-governmental organizations is not fungible with DGHE. PMID:24929917

  2. Why do some countries spend more for health? An assessment of sociopolitical determinants and international aid for government health expenditures.

    PubMed

    Liang, Li-Lin; Mirelman, Andrew J

    2014-08-01

    A consensus exists that rising income levels and technological development are among key drivers of total health spending. Determinants of public sector health expenditure, by contrast, are less well understood. This study examines a complex relationship across government health expenditure (GHE), sociopolitical risks, and international aid, while taking into account the impacts of national income, debt and tax financing and aging populations on health spending. We apply a fixed-effects two-stage least squares regression method to a panel dataset comprising 120 countries for the years 1995 through 2010. Our results show that democratic accountability has a diminishing positive correlation with GHE, and that levels of GHE are higher when government is more stable. Corruption is associated with less GHE in developing countries, but with higher GHE in developed countries. We also find that development assistance for health (DAH) is fungible with domestically financed government health expenditure (DGHE). For an average country, a 1% increase in DAH to government is associated with a 0.03-0.04% decrease in DGHE. Furthermore, the degree of fungibility of DAH to government is higher in countries where corruption or ethnic tensions are widespread. However, DAH to non-governmental organizations is not fungible with DGHE.

  3. Congress approves 13 percent increase in AIDS spending.

    PubMed

    1996-10-18

    A Republican Congress voted for a significant increase in AIDS-related spending for the fiscal year 1996. Increases were granted in every major program, including the Ryan White CARE Act and the once-doomed Housing Opportunities for People with AIDS (HOPWA) program. Overall, discretionary spending for Federal AIDS programs rose by 13 percent. This increase includes an additional $94 million for AIDS-related research at the National Institute's of Health (NIH). Advocates call on policy-makers to develop a long-term strategy for providing drugs to those who lack private insurance and are not qualified for Medicaid.

  4. Can we spend our way out of the AIDS epidemic? A world halting AIDS model

    PubMed Central

    2009-01-01

    Background There has been a sudden increase in the amount of money donors are willing to spend on the worldwide HIV/AIDS epidemic. Present plans are to hold most of the money in reserve and spend it slowly. However, rapid spending may be the best strategy for halting this disease. Methods We develop a mathematical model that predicts eradication or persistence of HIV/AIDS on a world scale. Dividing the world into regions (continents, countries etc), we develop a linear differential equation model of infectives which has the same eradication properties as more complex models. Results We show that, even if HIV/AIDS can be eradicated in each region independently, travel/immigration of infectives could still sustain the epidemic. We use a continent-level example to demonstrate that eradication is possible if preventive intervention methods (such as condoms or education) reduced the infection rate to two fifths of what it is currently. We show that, for HIV/AIDS to be eradicated within five years, the total cost would be ≈ $63 billion, which is within the existing $60 billion (plus interest) amount raised by the donor community. However, if this action is spread over a twenty year period, as currently planned, then eradication is no longer possible, due to population growth, and the costs would exceed $90 billion. Conclusion Eradication of AIDS is feasible, using the tools that we have currently to hand, but action needs to occur immediately. If not, then HIV/AIDS will race beyond our ability to afford it. PMID:19922685

  5. State variation in HIV/AIDS health outcomes: the effect of spending on social services and public health

    PubMed Central

    Talbert-Slagle, Kristina M.; Canavan, Maureen E.; Rogan, Erika M.; Curry, Leslie A.; Bradley, Elizabeth H.

    2016-01-01

    Objective: Despite considerable advances in the prevention and treatment of HIV/AIDS, the burden of new infections of HIV and AIDS varies substantially across the country. Previous studies have demonstrated associations between increased healthcare spending and better HIV/AIDS outcomes; however, less is known about the association between spending on social services and public health spending and HIV/AIDS outcomes. We sought to examine the association between state-level spending on social services and public health and HIV/AIDS case rates and AIDS deaths across the United States. Design: We conducted a retrospective, longitudinal study of the 50 U.S. states over 2000–2009 using a dataset of HIV/AIDS case rates and AIDS deaths per 100 000 people matched with a unique dataset of state-level spending on social services and public health per person in poverty. Methods: We estimated multivariable regression models for each HIV/AIDS outcome as a function of the social service and public health spending 1 and 5 years earlier in the state, adjusted for the log of state GDP per capita, regional and time fixed effects, Medicaid spending as % of GDP, and socio-demographic, economic, and health resource factors. Results: States with higher spending on social services and public health per person in poverty had significantly lower HIV and AIDS case rates and fewer AIDS deaths, both 1 and 5 years post expenditure (P ≤ 0.05). Conclusion: Our findings suggest that spending on social services and public health may provide a leverage point for state policymakers to reduce HIV/AIDS case rates and AIDS deaths in their state. PMID:26605512

  6. Stability Assessment of 10 Active Pharmaceutical Ingredients Compounded in SyrSpend SF.

    PubMed

    Geiger, Christine M; Sorenson, Bridget; Whaley, Paul

    2015-01-01

    The stability of 10 active pharmaceutical ingredients was studied in SyrSpend SF PH4 or SyrSpend SF Alka at room and/or refrigerated temperature (2°C to 8°C). An oral suspension of each active pharmaceutical ingredient was compounded in low actinic plastic bottles at a specific concentration in SyrSpend SF PH4 or SyrSpend SF Alka. Samples were assessed for stability immediately after preparation (day 0) followed by storage at room temperature and/or at refrigerated temperature. At set time points, the samples were removed from storage and assayed using a high-performance liquid chromatographic stability- indicating method. The active pharmaceutical ingredient was considered stable if the suspension retained 90% to 110% of the initial concentration. Furosemide was stable for at least 14 days in SyrSpend SF Alka at refrigerated conditions. Prednisolone sodium phosphate in SyrSpend SF PH4 was stable for at least 30 days at room temperature and refrigerated conditions. Ranitidine hydrochloride suspensions in SyrSpend SF PH4 at room temperature and refrigerated conditions were stable for at least 30 days and 58 days, respectively. Hydrocortisone hemisuccinate and sodium phosphate retained greater than 90% for at least 60 days at both room temperature and refrigerated samples in SyrSpend SF PH4. Amiodarone hydrochloride and nifedipine suspensions at both room temperature and refrigerated conditions retained greater than 90% of the initial concentrations for at least 90 days in SyrSpend SF PH4. Refrigerated samples of simvastatin in SyrSpend SF PH4 were stable for at least 90 days. Spironolactone in SyrSpend SF PH4 at room temperature retained more than 90% of the initial concentration for at least 90 days. Phenobarbital in SyrSpend SF PH4 retained above 90% of initial concentration for at least 154 days at room temperature. This study demonstrated the stability of a wide range of frequently used active pharmaceutical ingredients, tested in SyrSpend SF PH4 and SyrSpend

  7. Formative Assessment using Computer-Aided Assessment.

    ERIC Educational Resources Information Center

    Lawson, Duncan

    1999-01-01

    Describes how computer-aided assessment can provide a means of preserving formative assessment within the curriculum at a fraction of the time-cost involved with written work. Illustrates a variety of computer-aided assessment styles. (Author/ASK)

  8. Strength in Numbers: State Spending on K-12 Assessment Systems

    ERIC Educational Resources Information Center

    Chingos, Matthew M.

    2012-01-01

    In the coming years, states will need to make the most significant changes to their assessment systems in a decade as they implement the Common Core State Standards, a common framework for what students are expected to know that will replace existing standards in 45 states and the District of Columbia. The Common Core effort has prompted concerns…

  9. The effect of altruism on the spending behavior of elderly caregivers of family members with HIV/AIDS in South African townships.

    PubMed

    Klemz, Bruce R; Boshoff, Christo; Mazibuko, Noxolo-Eileen; Asquith, Jo Ann

    2015-01-01

    HIV/AIDS has led to an enormous demand for health care in the developing world and many governments have opted to capitalize on altruistic home-based caregivers. These caregivers are mainly poor older women and their financial survival is critically important to themselves and their families. We found that as the patient's illness progressed: (a) the altruistic cultural norm "ubuntu" led the caregiver to increase spending and (b) the social pressure (sanction) of stigma led to a very dramatic drop in direct interpersonal assistance. The impact on their spending, health care, and the related public policies are discussed.

  10. Spending Money Wisely.

    ERIC Educational Resources Information Center

    Wentworth, Donald R.; And Others

    1982-01-01

    The theme article of this issue, "Spending Money Wisely," by Donald R. Wentworth, begins with an explanation of basic strategies which aid wise spending. The article goes on to provide an introduction to economic reasoning related to consumer purchases and focusing on the role of incentives, scarcity, and alternatives. Four teaching units follow…

  11. Assessing the level of public health partner spending using the funding formula analysis tool.

    PubMed

    Bernet, Patrick M

    2012-01-01

    Public health services are delivered through a variety of organizations. Traditional accounting of public health expenditures typically captures only spending by government agencies. New Hampshire collected information from public health partners, such as community centers that host smoking cessation classes or health education done by Girls, Inc. This study compares the new data to spending by government agencies, focusing on breakdowns by fund source and service categories. Expanded funds secured by these partners account for a 42% of all local public health spending, and they spent 4 times more than government agencies on promoting healthy behavior. The funding formula analysis tool revealed that these partners spent in ways that would be politically difficult to achieve. In an era of declining budgets, an understanding of public health's partners is increasingly vital.

  12. Assessing the Impact of Regeneration Spending: Lessons from the United Kingdom and the Wider World

    ERIC Educational Resources Information Center

    Potts, David

    2008-01-01

    The government increased the funding for regional development agencies to 2.3 billion British Pounds in 2007/8, yet hard evidence on the effectiveness of the spending is difficult to find. Techniques for valuing benefits in difficult areas have existed for many years. They range from the hedonic methods and contingent valuation studies of…

  13. Assessing the binocular advantage in aided vision.

    PubMed

    Harrington, Lawrence K; McIntire, John P; Hopper, Darrel G

    2014-09-01

    Advances in microsensors, microprocessors, and microdisplays are creating new opportunities for improving vision in degraded environments through the use of head-mounted displays. Initially, the cutting-edge technology used in these new displays will be expensive. Inevitably, the cost of providing the additional sensor and processing required to support binocularity brings the value of binocularity into question. Several assessments comparing binocular, binocular, and monocular head-mounted displays for aided vision have concluded that the additional performance, if any, provided by binocular head-mounted displays does not justify the cost. The selection of a biocular [corrected] display for use in the F-35 is a current example of this recurring decision process. It is possible that the human binocularity advantage does not carry over to the aided vision application, but more likely the experimental approaches used in the past have been too coarse to measure its subtle but important benefits. Evaluating the value of binocularity in aided vision applications requires an understanding of the characteristics of both human vision and head-mounted displays. With this understanding, the value of binocularity in aided vision can be estimated and experimental evidence can be collected to confirm or reject the presumed binocular advantage, enabling improved decisions in aided vision system design. This paper describes four computational approaches-geometry of stereopsis, modulation transfer function area for stereopsis, probability summation, and binocular summation-that may be useful in quantifying the advantage of binocularity in aided vision.

  14. Assessment of the relationship of government spending on social assistance programs with Brazilian macroeconomic variables

    NASA Astrophysics Data System (ADS)

    de Senna, Viviane; Souza, Adriano Mendonça

    2016-11-01

    Since the 1988 Federal Constitution social assistance has become a duty of the State and a right to everyone, guaranteeing the population a dignified life. To ensure these rights federal government has created programs that can supply the main needs of people in extreme poverty. Among the programs that provide social assistance to the population, the best known are the "Bolsa Família" Program - PBF and the Continuous Cash Benefit - Continuous Cash Benefit - BPC. This research's main purpose is to analyze the relationship between the main macroeconomic variables and the Federal government spending on social welfare policy in the period from January 2004 to August 2014. The used methodologies are the Vector auto regression model - VAR and Error Correction Vector - VEC. The conclusion, was that there is a meaningful relationship between macroeconomic variables and social assistance programs. This indicates that if the government takes a more abrupt resolution in changing the existing programs it will result in fluctuations in the main macroeconomic variables interfering with the stability of Brazilian domestic economy up to twelve months.

  15. Adaptive Peircean decision aid project summary assessments.

    SciTech Connect

    Senglaub, Michael E.

    2007-01-01

    This efforts objective was to identify and hybridize a suite of technologies enabling the development of predictive decision aids for use principally in combat environments but also in any complex information terrain. The technologies required included formal concept analysis for knowledge representation and information operations, Peircean reasoning to support hypothesis generation, Mill's's canons to begin defining information operators that support the first two technologies and co-evolutionary game theory to provide the environment/domain to assess predictions from the reasoning engines. The intended application domain is the IED problem because of its inherent evolutionary nature. While a fully functioning integrated algorithm was not achieved the hybridization and demonstration of the technologies was accomplished and demonstration of utility provided for a number of ancillary queries.

  16. Assessment of Gasoline Prices and its Predictive Power on U.S. Consumers' Retail Spending and Savings

    NASA Astrophysics Data System (ADS)

    Alvarado-Bonilla, Joel

    The rising costs of fuels and specifically gasoline pose an economic challenge to U.S. consumers. Thus, the specific problem considered in this study was a rise in gasoline prices can reduce consumer spending, disposable income, food service traffic, and spending on healthy food, medicines, or visits to the doctor. Aligned with the problem, the purpose of this quantitative multiple correlation study was to examine the economic aspects for a rise in gasoline prices to reduce the six elements in the problem. This study consisted of a correlational design based on a retrospective longitudinal analysis (RLA) to examine gasoline prices versus the economic indexes of: (a) Retail Spending and (b) personal savings (PS). The RLA consisted on historic archival public data from 1978 to 2015. This RLA involved two separate linear multiple regression analyses to measure gasoline price's predictive power (PP) on two indexes while controlling for Unemployment Rate (UR). In summary, regression Formula 1 revealed Gasoline Price had a significant 61.1% PP on Retail Spending. In contrast, Formula 2 had Gasoline Price not having a significant PP on PS. Formula 2 yielded UR with 38.8% PP on PS. Results were significant at p<.01. Gasoline Price's PP on Retail Spending means a spending link to retail items such as: food service traffic, healthy food, medicines, and consumer spending. The UR predictive power on PS was unexpected, but logical from an economic view. Also unexpected was Gasoline Price's non-predictive power on PS, which suggests Americans may not save money when gasoline prices drop. These results shed light on the link of gasoline and UR on U.S. consumer's economy through savings and spending, which can be useful for policy design on gasoline and fuels taxing and pricing. The results serve as a basis for future study on gasoline and economics.

  17. Second assessment of NeuroAIDS in Africa

    PubMed Central

    Robertson, Kevin; Kopnisky, Kathy; Hakim, James; Merry, Concepta; Nakasujja, Noeline; Hall, Colin; Traore, Moussa; Sacktor, Ned; Clifford, David; Newton, Charles; Van Rie, Annelies; Holding, Penny; Clements, Janice; Zink, Christine; Mielke, Jens; Hosseinipour, Mina; Lalloo, Umesh; Amod, Farida; Marra, Christina; Evans, Scott; Liner, Jeff

    2009-01-01

    In July of 2006, the National Institute of Mental Health (NIMH) Center for Mental Health Research on AIDS (CMHRA) sponsored the second conference on the Assessment of NeuroAIDS in Africa, which was held in Arusha, Tanzania. The conference mission was to address the regional variations in epidemiology of HIV-related neurological disorders as well as the assessment and diagnosis of these disorders. Participants discussed and presented data regarding the relevance and translation of neuroAIDS assessment measures developed in resource intensive settings and the challenges of neuro-assessment in Africa, including the applicability of current tools, higher prevalence of confounding diseases, and the complexity of diverse cultural settings. The conference presentations summarized here highlight the need for further research on neuroAIDS in Africa and methods for assessing HIV-related neurological disorders. PMID:18370346

  18. Does Computer-Aided Formative Assessment Improve Learning Outcomes?

    ERIC Educational Resources Information Center

    Hannah, John; James, Alex; Williams, Phillipa

    2014-01-01

    Two first-year engineering mathematics courses used computer-aided assessment (CAA) to provide students with opportunities for formative assessment via a series of weekly quizzes. Most students used the assessment until they achieved very high (>90%) quiz scores. Although there is a positive correlation between these quiz marks and the final…

  19. Assessing the construct validity of the AIDS Attitude Scale.

    PubMed

    Bruce, K E; Reid, B C

    1998-02-01

    To assess the construct validity of the AIDS Attitude Scale (AAS) (Shrum, Turner, & Bruce, 1989), we administered it and related attitude scales to introductory psychology students (n = 279) and gay/lesbian support group members (n = 38). A subset of the students (n = 105) participated in a concurrent validity study; students donating items to an AIDS food pantry scored more tolerantly on the AAS than other students. AAS scores also differentiated subjects expected to have more tolerant attitudes toward people living with HIV and AIDS from other respondents, indicating known groups validity. As expected, AAS scores were positively correlated with attitudes about homosexuals and negatively correlated with authoritarian beliefs. However, AAS scores were not related to death anxiety. Attitudes about AIDS were distinguishable from related constructs using factor analysis. Together, these data provide evidence for the construct validity of the AAS. The need for valid assessment tools and uses of the AAS are discussed.

  20. eWorkbook: A Computer Aided Assessment System

    ERIC Educational Resources Information Center

    Costagliola, Gennaro; Ferrucci, Filomena; Fuccella, Vittorio; Oliveto, Rocco

    2007-01-01

    Computer aided assessment (CAA) tools are more and more widely adopted in academic environments mixed to other assessment means. In this article, we present a CAA Web application, named eWorkbook, which can be used for evaluating learner's knowledge by creating (the tutor) and taking (the learner) on-line tests based on multiple choice, multiple…

  1. An Instrument to Aid in Assessing Editorials.

    ERIC Educational Resources Information Center

    Burkhalter, Nancy

    1995-01-01

    Presents a primary-trait scoring instrument intended for journalism teachers to use in assessing students' editorials by breaking down the analysis into three essential components: claims, data, and warrants. Applies the instrument to two student essays. (SR)

  2. Assessment of Alternative Student Aid Delivery Systems. A Context Paper.

    ERIC Educational Resources Information Center

    Advanced Technology, Inc., Reston, VA.

    Background questions to support a federally-sponsored assessment of major student aid delivery system options are addressed. Attention is directed to: (1) information needed by the U.S. Secretary of Education to decide about changes to the delivery system; (2) reasons that delivery system redesign is a critical issue; (3) what can be learned from…

  3. How Effective Is Feedback in Computer-Aided Assessments?

    ERIC Educational Resources Information Center

    Gill, Mundeep; Greenhow, Martin

    2008-01-01

    Computer-Aided Assessments (CAAs) have been used increasingly at Brunel University for over 10 years to test students' mathematical abilities. Recently, we have focussed on providing very rich feedback to the students; given the work involved in designing and coding such feedback, it is important to study the impact of the interaction between…

  4. Intelligent situation assessment and response aiding in flight emergencies

    NASA Technical Reports Server (NTRS)

    Hudlicka, Eva; Corker, Kevin; Cramer, Nichael; Young, David; Baron, Sheldon

    1989-01-01

    A knowledge-based pilot aiding system which performs situation assessment and response aiding is described. The system uses a causal model of the flight domain to both simulate the effects of identified failures on flight and to derive responses during emergencies. The model represents information at two levels of abstraction: Boolean, which simply states whether a subsystem or aircraft component is normal or abnormal, and qualitative, which expresses the subsystem or component status as one of several qualitative values, such as increasing, decreasing, or stable.

  5. Women at risk: an AIDS educational needs assessment.

    PubMed

    Williams, A B

    1991-01-01

    In order to acquire the information nurses need to develop education and support programs for women at risk for Acquired Immunodeficiency Syndrome (AIDS), a qualitative needs assessment of women at risk was conducted. Interviews were conducted with 21 women who were at risk for AIDS through their own injection drug use or as the heterosexual partners of injection drug users. Results were analyzed using the variables of the Health Belief Model, including the concept of self-efficacy. The perception of AIDS as a serious and a personal health threat motivated these women to practice both "safe sex" and "safe drug use." However, they did not always believe that recommended health behaviors would be effective; and they noted significant costs associated with these behaviors. In addition, the impact of AIDS was seen to be a heightening of the isolation and mistrust which were characteristic of the injection drug using community before the epidemic. AIDS programs for women at risk should facilitate discussion of social and community issues and should emphasize hope rather than fear.

  6. Robot-aided assessment of lower extremity functions: a review.

    PubMed

    Maggioni, Serena; Melendez-Calderon, Alejandro; van Asseldonk, Edwin; Klamroth-Marganska, Verena; Lünenburger, Lars; Riener, Robert; van der Kooij, Herman

    2016-01-01

    The assessment of sensorimotor functions is extremely important to understand the health status of a patient and its change over time. Assessments are necessary to plan and adjust the therapy in order to maximize the chances of individual recovery. Nowadays, however, assessments are seldom used in clinical practice due to administrative constraints or to inadequate validity, reliability and responsiveness. In clinical trials, more sensitive and reliable measurement scales could unmask changes in physiological variables that would not be visible with existing clinical scores.In the last decades robotic devices have become available for neurorehabilitation training in clinical centers. Besides training, robotic devices can overcome some of the limitations in traditional clinical assessments by providing more objective, sensitive, reliable and time-efficient measurements. However, it is necessary to understand the clinical needs to be able to develop novel robot-aided assessment methods that can be integrated in clinical practice.This paper aims at providing researchers and developers in the field of robotic neurorehabilitation with a comprehensive review of assessment methods for the lower extremities. Among the ICF domains, we included those related to lower extremities sensorimotor functions and walking; for each chapter we present and discuss existing assessments used in routine clinical practice and contrast those to state-of-the-art instrumented and robot-aided technologies. Based on the shortcomings of current assessments, on the identified clinical needs and on the opportunities offered by robotic devices, we propose future directions for research in rehabilitation robotics. The review and recommendations provided in this paper aim to guide the design of the next generation of robot-aided functional assessments, their validation and their translation to clinical practice. PMID:27485106

  7. An assessment of global Internet-based HIV/AIDS media coverage: implications for United Nations Programme on HIV/AIDS' Global Media HIV/AIDS initiative.

    PubMed

    Anema, A; Freifeld, C C; Druyts, E; Montaner, J S G; Hogg, R S; Brownstein, J S

    2010-01-01

    No studies to date have assessed the quantity of HIV/AIDS-related media on the Internet. We assessed the quantity of language-specific HIV/AIDS Internet-based news coverage, and the correlation between country-specific HIV/AIDS news coverage and HIV/AIDS prevalence. Internet-based HIV/AIDS news articles were queried from Google News Archives for 168 countries, for the year 2007, in the nine most commonly spoken languages worldwide. English, French and Spanish sources had the greatest number of HIV/AIDS-related articles, representing 134,000 (0.70%), 11,200 (0.65%) and 24,300 (0.49%) of all news articles, respectively. A strong association between country-specific HIV/AIDS news coverage and HIV/AIDS prevalence was found, Spearman's rank correlation: 0.6 (P < 0.001). Among countries with elevated HIV/AIDS prevalence (> or =10%), the volume of HIV/AIDS-specific media was highest in Swaziland (15.9%) and Malawi (13.2%), and lowest in South Africa (4.8%) and Namibia (4.9%). Increased media attention should be placed on countries with high HIV/AIDS prevalence and limited HIV/AIDS-specific news coverage.

  8. Assessment technique for computer-aided manufactured sockets.

    PubMed

    Sanders, Joan E; Severance, Michael R

    2011-01-01

    This article presents an assessment technique for testing the quality of prosthetic socket fabrication processes at computer-aided manufacturing facilities. The assessment technique is potentially useful to both facilities making sockets and companies marketing manufacturing equipment seeking to assess and improve product quality. To execute the assessment technique, an evaluator fabricates a collection of test models and sockets using the manufacturing suite under evaluation, then measures their shapes using scanning equipment. Overall socket quality is assessed by comparing socket shapes with electronic file (e-file) shapes. To characterize carving performance, model shapes are compared with e-file shapes. To characterize forming performance, socket shapes are compared with model shapes. The mean radial error (MRE), which is the average difference in radii between the two compared shapes, provides insight into sizing quality. Interquartile range (IQR), the range of radial error for the best-matched half of the points on the compared socket surfaces, provides insight into regional shape quality. The source(s) of socket shape error may be pinpointed by separately determining MRE and IQR for carving and forming. The developed assessment technique may provide a useful tool to the prosthetics community and industry to help identify problems and limitations in computer-aided manufacturing and give insight into appropriate modifications to overcome them. PMID:21938663

  9. Assessment technique for computer-aided manufactured sockets.

    PubMed

    Sanders, Joan E; Severance, Michael R

    2011-01-01

    This article presents an assessment technique for testing the quality of prosthetic socket fabrication processes at computer-aided manufacturing facilities. The assessment technique is potentially useful to both facilities making sockets and companies marketing manufacturing equipment seeking to assess and improve product quality. To execute the assessment technique, an evaluator fabricates a collection of test models and sockets using the manufacturing suite under evaluation, then measures their shapes using scanning equipment. Overall socket quality is assessed by comparing socket shapes with electronic file (e-file) shapes. To characterize carving performance, model shapes are compared with e-file shapes. To characterize forming performance, socket shapes are compared with model shapes. The mean radial error (MRE), which is the average difference in radii between the two compared shapes, provides insight into sizing quality. Interquartile range (IQR), the range of radial error for the best-matched half of the points on the compared socket surfaces, provides insight into regional shape quality. The source(s) of socket shape error may be pinpointed by separately determining MRE and IQR for carving and forming. The developed assessment technique may provide a useful tool to the prosthetics community and industry to help identify problems and limitations in computer-aided manufacturing and give insight into appropriate modifications to overcome them.

  10. Providing Formative Feedback From a Summative Computer-aided Assessment

    PubMed Central

    Sewell, Robert D. E.

    2007-01-01

    Objectives To examine the effectiveness of providing formative feedback for summative computer-aided assessment. Design Two groups of first-year undergraduate life science students in pharmacy and neuroscience who were studying an e-learning package in a common pharmacology module were presented with a computer-based summative assessment. A sheet with individualized feedback derived from each of the 5 results sections of the assessment was provided to each student. Students were asked via a questionnaire to evaluate the form and method of feedback. Assessment The students were able to reflect on their performance and use the feedback provided to guide their future study or revision. There was no significant difference between the responses from pharmacy and neuroscience students. Students' responses on the questionnaire indicated a generally positive reaction to this form of feedback. Conclusions Findings suggest that additional formative assessment conveyed by this style and method would be appreciated and valued by students. PMID:17533442

  11. Assessing business responses to HIV / AIDS in Kenya.

    PubMed

    Roberts, M; Wangombe, J

    1995-01-01

    A consulting firm conducted interviews with managers of 16 businesses in 3 Kenyan cities, representatives of 2 trade unions, focus groups with workers at 13 companies, and an analysis of financial/labor data from 4 companies. It then did a needs assessment. The business types were light industry, manufacturing companies, tourism organizations, transport firms, agro-industrial and plantation businesses, and the service industry. Only one company followed all the workplace policy principles recommended by the World Health Organization and the International Labor Organization. Six businesses required all applicants and/or employees to undergo HIV testing. All their managers claimed that they would not discriminate against HIV-infected workers. Many workers thought that they would be fired if they were--or were suspected to be--HIV positive. Lack of a non-discrimination policy brings about worker mistrust of management. 11 companies had some type of HIV/AIDS education program. All the programs generated positive feedback. The main reasons for not providing HIV/AIDS education for the remaining 5 companies were: no employee requests, fears that it would be taboo, and assumptions that workers could receive adequate information elsewhere. More than 90% of all companies distributed condoms. 60% offered sexually transmitted disease diagnosis and treatment. About 33% offered counseling. Four companies provided volunteer HIV testing. Almost 50% of companies received financial or other external support for their programs. Most managers thought AIDS to be a problem mainly with manual staff and not with professional staff. Almost all businesses offered some medical benefits. The future impact of HIV/AIDS would be $90/employee/year (by 2005, $260) due to health care costs, absenteeism, retraining, and burial benefits. The annual costs of a comprehensive workplace HIV/AIDS prevention program varied from $18 to $54/worker at one company.

  12. Assessing business responses to HIV / AIDS in Kenya.

    PubMed

    Roberts, M; Wangombe, J

    1995-01-01

    A consulting firm conducted interviews with managers of 16 businesses in 3 Kenyan cities, representatives of 2 trade unions, focus groups with workers at 13 companies, and an analysis of financial/labor data from 4 companies. It then did a needs assessment. The business types were light industry, manufacturing companies, tourism organizations, transport firms, agro-industrial and plantation businesses, and the service industry. Only one company followed all the workplace policy principles recommended by the World Health Organization and the International Labor Organization. Six businesses required all applicants and/or employees to undergo HIV testing. All their managers claimed that they would not discriminate against HIV-infected workers. Many workers thought that they would be fired if they were--or were suspected to be--HIV positive. Lack of a non-discrimination policy brings about worker mistrust of management. 11 companies had some type of HIV/AIDS education program. All the programs generated positive feedback. The main reasons for not providing HIV/AIDS education for the remaining 5 companies were: no employee requests, fears that it would be taboo, and assumptions that workers could receive adequate information elsewhere. More than 90% of all companies distributed condoms. 60% offered sexually transmitted disease diagnosis and treatment. About 33% offered counseling. Four companies provided volunteer HIV testing. Almost 50% of companies received financial or other external support for their programs. Most managers thought AIDS to be a problem mainly with manual staff and not with professional staff. Almost all businesses offered some medical benefits. The future impact of HIV/AIDS would be $90/employee/year (by 2005, $260) due to health care costs, absenteeism, retraining, and burial benefits. The annual costs of a comprehensive workplace HIV/AIDS prevention program varied from $18 to $54/worker at one company. PMID:12289839

  13. Pattern and levels of spending allocated to HIV prevention programs in low- and middle-income countries

    PubMed Central

    2012-01-01

    Background AIDS continues to spread at an estimated 2.6 new million infections per year, making the prevention of HIV transmission a critical public health issue. The dramatic growth in global resources for AIDS has produced a steady scale-up in treatment and care that has not been equally matched by preventive services. This paper is a detailed analysis of how countries are choosing to spend these more limited prevention funds. Methods We analyzed prevention spending in 69 low- and middle-income countries with a variety of epidemic types, using data from national domestic spending reports. Spending information was from public and international sources and was analyzed based on the National AIDS Spending Assessment (NASA) methods and classifications. Results Overall, prevention received 21% of HIV resources compared to 53% of funding allocated to treatment and care. Prevention relies primarily on international donors, who accounted for 65% of all prevention resources and 93% of funding in low-income countries. For the subset of 53 countries that provided detailed spending information, we found that 60% of prevention resources were spent in five areas: communication for social and behavioral change (16%), voluntary counselling and testing (14%), prevention of mother-to-child transmission (13%), blood safety (10%) and condom programs (7%). Only 7% of funding was spent on most-at-risk populations and less than 1% on male circumcision. Spending patterns did not consistently reflect current evidence and the HIV specific transmission context of each country. Conclusions Despite recognition of its importance, countries are not allocating resources in ways that are likely to achieve the greatest impact on prevention across all epidemic types. Within prevention spending itself, a greater share of resources need to be matched with interventions that approximate the specific needs and drivers of each country's epidemic. PMID:22436141

  14. CART V: recent advancements in computer-aided camouflage assessment

    NASA Astrophysics Data System (ADS)

    Müller, Thomas; Müller, Markus

    2011-05-01

    In order to facilitate systematic, computer aided improvements of camouflage and concealment assessment methods, the software system CART (Camouflage Assessment in Real-Time) was built up for the camouflage assessment of objects in multispectral image sequences (see contributions to SPIE 2007-2010 [1], [2], [3], [4]). It comprises a semi-automatic marking of target objects (ground truth generation) including their propagation over the image sequence and the evaluation via user-defined feature extractors as well as methods to assess the object's movement conspicuity. In this fifth part in an annual series at the SPIE conference in Orlando, this paper presents the enhancements over the recent year and addresses the camouflage assessment of static and moving objects in multispectral image data that can show noise or image artefacts. The presented methods fathom the correlations between image processing and camouflage assessment. A novel algorithm is presented based on template matching to assess the structural inconspicuity of an object objectively and quantitatively. The results can easily be combined with an MTI (moving target indication) based movement conspicuity assessment function in order to explore the influence of object movement to a camouflage effect in different environments. As the results show, the presented methods contribute to a significant benefit in the field of camouflage assessment.

  15. Financial Aid and Persistence in Community Colleges: Assessing the Effectiveness of Federal and State Financial Aid Programs in Oklahoma

    ERIC Educational Resources Information Center

    Mendoza, Pilar; Mendez, Jesse P.; Malcolm, Zaria

    2009-01-01

    Using a longitudinal, state-wide dataset, this study assessed the effect of financial aid on the persistence of full-time students in associate's degree programs at the Oklahoma community colleges. Three financial-aid sources were examined: the Oklahoma Higher Learning Access Program (OHLAP), Pell grants, and Stafford loans. Results indicate that…

  16. Beyond Public Spending

    ERIC Educational Resources Information Center

    Corney, Mark

    2009-01-01

    Britain is in the longest recession since the Second World War. Mass unemployment is back. The road to recovery could be long and bumpy. On the fiscal front, the deficit could be higher than the 175 billion British Pounds forecast for 2009-10. Bringing the deficit under control will require higher taxes and lower public spending. In an effort to…

  17. School District Spending.

    ERIC Educational Resources Information Center

    Minnesota State Office of the Legislative Auditor, St. Paul. Program Evaluation Div.

    Minnesota spends more for education than most states and has increased its financial commitment steadily over the past 15 years. Because of the state's dominant role in education funding, legislators have enacted measures requiring all local school districts to follow uniform financial accounting and reporting standards (UFARS). Since 1980, the…

  18. Computer Aided Safety Assessment(CASA) Tool for ISS Payloads

    NASA Astrophysics Data System (ADS)

    Hochstein, Jason; Festa, Fabrizio

    2010-09-01

    In an effort to streamline the processes established by the partners of the International Space Station(ISS) to certify the safety of hardware and experiments destined for the Station, the European Space Agency’s(ESA) ISS System Safety Team is developing the Computer Aided Safety Assessment(CASA) tool suite. These software tools guide payload developers through the creation process of two types of standard payload hazard reports via a series of questions following a predetermined logic. The responses provided by the user are used by the CASA system to complete the majority of each hazard report requisite for payload flight safety reviews, employing consistent, approved descriptions of most hazards, hazard causes, controls and verification methods. Though some manual inputs will still be required to complete these reports, working with CASA will considerably reduce the amount of time necessary to review the documentation by agency safety authorities.

  19. Assessment of Training Needs for Arizona Student Financial Aid Practitioners. Final Report.

    ERIC Educational Resources Information Center

    Fenske, Robert H.

    The present and future training needs of financial aid practitioners (financial aid officers, counselors, and support staff personnel) at Arizona colleges and government agencies were assessed. Attention was directed to the literature on training and programs for financial aid practitioners, as well as the possibilities of developing a…

  20. Teachers' Attitudes toward HIV/AIDS: An American National Assessment.

    ERIC Educational Resources Information Center

    Brucker, Benjamin W.; Hall, Wayne H.

    1996-01-01

    Examined teachers' attitudes toward HIV/AIDS. A random sample of 1,500 teachers completed a 22-item questionnaire. Results show that respondents were opposed to the concept of testing for AIDS, although females were more positive toward the idea than were males. The majority of the respondents favored the idea of providing an HIV/AIDS awareness…

  1. Professional Growth & Support Spending Calculator

    ERIC Educational Resources Information Center

    Education Resource Strategies, 2013

    2013-01-01

    This "Professional Growth & Support Spending Calculator" helps school systems quantify all current spending aimed at improving teaching effectiveness. Part I provides worksheets to analyze total investment. Part II provides a system for evaluating investments based on purpose, target group, and delivery. In this Spending Calculator…

  2. Assessment of Lecture Strategy with Different Teaching Aids

    PubMed Central

    Kumar, Manoj; Kumar, Jayballabh; Kumar, Gaurav; Kapoor, Sangeeta

    2015-01-01

    Background and Objectives: Medical/dental colleges in Northern India cater to students with diverse backgrounds, mother tongues, levels of comprehending English, and intelligence levels. This study was conducted to identify lecture strategy and teaching aid best suited for North Indian dental and medical students. It was conducted in two parts – 1. Survey of teachers’ and students’ opinion to obtain their preferences in teaching-learning practices followed in a conventional lecture, and 2. Comparison of students’ performances after a single trial lecture with different groups of students, using different teaching aids (TAs). Materials and Methods: Opinions of 33 faculty teaching first year dental/ medical students and 506 volunteer students (320 female) were compiled. Students were divided into four groups. A single trial lecture was held with each group (on the same topic, using identical lesson plan, by the same teacher) using a different teaching aid with each group. Lecture strategy was designed according to students’ preferences (as obtained from opinion survey) regarding language of instruction and the number of mental breaks. TAs used with different groups were chalk and board (C&B), PowerPoint (PPT), overhead projector (OHP), and a combination of C&B and PPT. Pre- and post-tests using multiple choice questions were conducted with each group. Results of post-test questionnaire and feedback from faculty attending the lecture were assessed for students’ satisfaction and attentiveness in all four groups. Results: Survey results indicated that although 97.6% students believed they had good/fair proficiency in English, 83.6% preferred being taught in a combination of English and Hindi; 44.3% students preferred C&B, 40.1% preferred PPT and 15.6% preferred the use of OHP as TA. After conducting a trial lecture with different TAs with each group, more than 90% students expressed satisfaction with the TA used for that group. Significantly better

  3. Computer-aided assessment of scoliosis on posteroanterior radiographs.

    PubMed

    Zhang, Junhua; Lou, Edmond; Hill, Douglas L; Raso, James V; Wang, Yuanyuan; Le, Lawrence H; Shi, Xinling

    2010-02-01

    In order to reduce the observer variability in radiographic scoliosis assessment, a computer-aided system was developed. The system semi-automatically measured the Cobb angle and vertebral rotation on posteroanterior radiographs based on Hough transform and snake model, respectively. Both algorithms were integrated with the shape priors to improve the performance. The system was tested twice by each of three observers. The intraobserver and interobserver reliability analyses resulted in the intraclass correlation coefficients higher than 0.9 and 0.8 for Cobb measurement on 70 radiographs and rotation measurement on 156 vertebrae, respectively. Both the Cobb and rotation measurements resulted in the average intraobserver and interobserver errors less than 2 degrees and 3 degrees , respectively. There were no significant differences in the measurement variability between groups of curve location, curve magnitude, observer experience, and vertebra location. Compared with the documented results, measurement variability is reduced by using the developed system. This system can help orthopedic surgeons assess scoliosis more reliably.

  4. Computer-aided assessment of diagnostic images for epidemiological research

    PubMed Central

    2009-01-01

    Background Diagnostic images are often assessed for clinical outcomes using subjective methods, which are limited by the skill of the reviewer. Computer-aided diagnosis (CAD) algorithms that assist reviewers in their decisions concerning outcomes have been developed to increase sensitivity and specificity in the clinical setting. However, these systems have not been well utilized in research settings to improve the measurement of clinical endpoints. Reductions in bias through their use could have important implications for etiologic research. Methods Using the example of cortical cataract detection, we developed an algorithm for assisting a reviewer in evaluating digital images for the presence and severity of lesions. Available image processing and statistical methods that were easily implementable were used as the basis for the CAD algorithm. The performance of the system was compared to the subjective assessment of five reviewers using 60 simulated images. Cortical cataract severity scores from 0 to 16 were assigned to the images by the reviewers and the CAD system, with each image assessed twice to obtain a measure of variability. Image characteristics that affected reviewer bias were also assessed by systematically varying the appearance of the simulated images. Results The algorithm yielded severity scores with smaller bias on images where cataract severity was mild to moderate (approximately ≤ 6/16ths). On high severity images, the bias of the CAD system exceeded that of the reviewers. The variability of the CAD system was zero on repeated images but ranged from 0.48 to 1.22 for the reviewers. The direction and magnitude of the bias exhibited by the reviewers was a function of the number of cataract opacities, the shape and the contrast of the lesions in the simulated images. Conclusion CAD systems are feasible to implement with available software and can be valuable when medical images contain exposure or outcome information for etiologic research. Our

  5. Barriers to the Assessment of Unmet Need in Planning HIV/AIDS Prevention Programs.

    ERIC Educational Resources Information Center

    Valdiserri, Ronald O.; West, Gary R.

    1994-01-01

    Major barriers to conducting needs assessment for AIDS prevention are resource deficits, technical deficits, environmental complexity, and apprehension about expectations. Comprehensive, methodologically sound assessments conducted collaboratively by consumers and providers of prevention services are essential. (SK)

  6. Review of Multi-Criteria Decision Aid for Integrated Sustainability Assessment of Urban Water Systems - MCEARD

    EPA Science Inventory

    Integrated sustainability assessment is part of a new paradigm for urban water decision making. Multi-criteria decision aid (MCDA) is an integrative framework used in urban water sustainability assessment, which has a particular focus on utilising stakeholder participation. Here ...

  7. Assessment of AIDS Risk among Treatment Seeking Drug Abusers.

    ERIC Educational Resources Information Center

    Black, John L.; And Others

    Intravenous (IV) drug abusers are at risk for contracting transmittable diseases such as acquired immunodeficiency syndrome (AIDS) and hepatitis B. This study was conducted to investigate the prevalence of risk behaviors for acquiring and transmitting AIDS and hepatitis B among treatment-seeking drug abusers (N=168). Subjects participated in a…

  8. How College Students Spend Their Time Communicating

    ERIC Educational Resources Information Center

    Emanuel, Richard; Adams, Jim; Baker, Kim; Daufin, E. K.; Ellington, Coke; Fitts, Elizabeth; Himsel, Jonathan; Holladay, Linda; Okeowo, David

    2008-01-01

    This study sought to assess how college students spend their time communicating and what impact, if any, communications devices may be having on how that time is spent. Undergraduates (N = 696) at four southeastern colleges were surveyed. Results revealed that listening comprises 55.4% of the total average communication day followed by reading…

  9. Making health spending work.

    PubMed

    McMahon, Fred; Zelder, Martin

    2002-01-01

    Medical Savings Accounts (MSAs) are usually promoted as a demand-management tool that gives consumers incentives to economize on medical expenses. "Making Health Spending Work" takes the concept one step further and shows how MSAs can be used to design a publicly funded system that incorporates market dynamics. MSAs can bring efficiency-enhancing incentives to the supply side, creating consumer choice and empowerment with a public system that meets Medicare's key principles. Over the last few months, Canada's political leaders have begun to break away from the reform-stalling tactics of special interest groups - which profit mightily from the the current system - and to examine sensible reforms that could benefit all Canadians. By breaking free of old dogmas, Canada can turn myth into reality: we can have the best medicare system in the world, one that expands choice and creates efficiency-enhancing dynamics. PMID:12811123

  10. Federal mandatory spending caps vital for health care reform.

    PubMed

    Domenici, P V

    1992-01-01

    Rising health spending creates an increasing burden on families, businesses, and government. Federal health spending--chiefly on Medicare and Medicaid--is a major contributor to a budget deficit that threatens to exceed $400 billion. In order to control that deficit, the President and the Congress must cap mandatory spending, excluding Social Security. In turn, policymakers should adopt health reforms to fit spending within the cap including enrolling more consumers in managed care plans, resolving medical liability disputes in arbitration instead of courts, and increasing assessment of research into cost-effective new technology.

  11. Japanese Industry Boosts Pollution Spending

    ERIC Educational Resources Information Center

    McAbee, Michael K.

    1975-01-01

    In response to tightening emission standards imposed by the government, Japanese industry will increase its capital spending on pollution control equipment to account for about 20 percent of all industrial capital spending. Preferential treatment and loans from government-affiliated financial institutions are available for projects. (Author/MLH)

  12. Facilities Spending Criticized as Uneven

    ERIC Educational Resources Information Center

    Greifner, Laura

    2006-01-01

    This article features a report on states and school districts spending almost $600 billion on building and renovating schools from 1995 to 2004, an amount that far exceed earlier expectations. The report also emphasized the uneven facilities spending between minority and affluent districts. Besides receiving the least money for facilities, the…

  13. The International AIDS Questionnaire-English Version (IAQ-E): Assessing the Validity and Reliability

    ERIC Educational Resources Information Center

    Davis, Cindy; Sloan, Melissa; MacMaster, Samuel; Hughes, Leslie

    2006-01-01

    In order to address HIV infection among college students, a comprehensive measure is needed that can be used with samples from culturally diverse populations. Therefore, this paper assessed the reliability and validity of an HIV/AIDS questionnaire that measures fours dimensions of HIV/AIDS awareness--factual knowledge, prejudice, personal risk,…

  14. Assessment of optical localizer accuracy for computer aided surgery systems.

    PubMed

    Elfring, Robert; de la Fuente, Matías; Radermacher, Klaus

    2010-01-01

    The technology for localization of surgical tools with respect to the patient's reference coordinate system in three to six degrees of freedom is one of the key components in computer aided surgery. Several tracking methods are available, of which optical tracking is the most widespread in clinical use. Optical tracking technology has proven to be a reliable method for intra-operative position and orientation acquisition in many clinical applications; however, the accuracy of such localizers is still a topic of discussion. In this paper, the accuracy of three optical localizer systems, the NDI Polaris P4, the NDI Polaris Spectra (in active and passive mode) and the Stryker Navigation System II camera, is assessed and compared critically. Static tests revealed that only the Polaris P4 shows significant warm-up behavior, with a significant shift of accuracy being observed within 42 minutes of being switched on. Furthermore, the intrinsic localizer accuracy was determined for single markers as well as for tools using a volumetric measurement protocol on a coordinate measurement machine. To determine the relative distance error within the measurement volume, the Length Measurement Error (LME) was determined at 35 test lengths. As accuracy depends strongly on the marker configuration employed, the error to be expected in typical clinical setups was estimated in a simulation for different tool configurations. The two active localizer systems, the Stryker Navigation System II camera and the Polaris Spectra (active mode), showed the best results, with trueness values (mean +/- standard deviation) of 0.058 +/- 0.033 mm and 0.089 +/- 0.061 mm, respectively. The Polaris Spectra (passive mode) showed a trueness of 0.170 +/- 0.090 mm, and the Polaris P4 showed the lowest trueness at 0.272 +/- 0.394 mm with a higher number of outliers than for the other cameras. The simulation of the different tool configurations in a typical clinical setup revealed that the tracking error can

  15. Evaluation and Assessment of a Biomechanics Computer-Aided Instruction.

    ERIC Educational Resources Information Center

    Washington, N.; Parnianpour, M.; Fraser, J. M.

    1999-01-01

    Describes the Biomechanics Tutorial, a computer-aided instructional tool that was developed at Ohio State University to expedite the transition from lecture to application for undergraduate students. Reports evaluation results that used statistical analyses and student questionnaires to show improved performance on posttests as well as positive…

  16. [Patients requiring high healthcare spending].

    PubMed

    Niehaus, F

    2008-03-01

    Data from private insurance companies make it possible to analyse how healthcare spending is distributed across individuals, how it depends on the age of the people and how it changes over time. Within age groups, healthcare spending is less concentrated if recipients are older. Over the analysed period of time, a considerable levelling of expenses takes place. These findings lead to the conclusion that the ageing population will result in a greater and more evenly spread utilisation of healthcare facilities. PMID:18405231

  17. Federal Expenditures on Children: 1960-1997. Occasional Paper Number 45. Assessing the New Federalism: An Urban Institute Program To Assess Changing Social Policies.

    ERIC Educational Resources Information Center

    Clark, Rebecca L.; King, Rosalind Berkowitz; Spiro, Christopher; Steuerle, C. Eugene

    This paper examines trends in federal spending on children, assessing changes in spending between 1960-97 and classifying federal programs within eight budget categories: tax credits and exemptions (including the Earned Income Tax Credit and dependent exemption); income security (including Aid to Families with Dependent Children); nutrition…

  18. Computer-aided diagnosis in lung nodule assessment.

    PubMed

    Goldin, Jonathan G; Brown, Matthew S; Petkovska, Iva

    2008-05-01

    Computed tomography (CT) imaging is playing an increasingly important role in cancer detection, diagnosis, and lesion characterization, and it is the most sensitive test for lung nodule detection. Interpretation of lung nodules involves characterization and integration of clinical and other imaging information. Advances in lung nodule management using CT require optimization of CT data acquisition, postprocessing tools, and computer-aided diagnosis (CAD). The goal of CAD systems being developed is to both assist radiologists in the more sensitive detection of nodules and noninvasively differentiate benign from malignant lesions; the latter is important given that malignant lesions account for between 1% and 11% of pulmonary nodules. The aim of this review is to summarize the current state of the art regarding CAD techniques for the detection and characterization of solitary pulmonary nodules and their potential applications in the clinical workup of these lesions.

  19. Fit to be interviewed by the police--an aid to assessment.

    PubMed

    Norfolk, G

    2001-01-01

    The assessment of a suspect's fitness to be interviewed by the police is becoming an increasingly important part of a police surgeon's workload. This paper discusses the assessment in terms of the various factors that may render a person prone to providing an involuntary or false confession and proposes an aide memoire to assist the examining doctor. PMID:11219124

  20. Cuts to science spending spared

    NASA Astrophysics Data System (ADS)

    Federal science funding was one area spared further cuts over the next 5 years when the House rejected the Penny-Kasich Deficit Plan by a vote of 219-213 on November 22. Known for its two House cosponsors Timothy Penny (D-Minn.) and John Kasich (R-Ohio), the plan called for additional cuts of $103 billion in federal spending over 5 years. The proposal was an amendment to HR3400, Clinton's spending-reduction bill, which would cut federal spending by over $11 billion in the next 5 years. HR3400 was passed by the House during the same vote.In addition to savings from President Clinton's plan to reduce the federal work force by 252,000, the Penny-Kasich amendment offered ninety proposals to cut federal spending. One of the major policy changes called for was the merging of the Departments of Energy and Commerce, NASA, the National Science Foundation, and the Office of Science and Technology Policy into a new Department of Science. This consolidation, said the plan's sponsors, “could result in $1 billion of reduced spending due to administrative consolidation and elimination of programmatic duplication.”

  1. The DANGERTOME Personal Risk Threat Assessment Scale: An Instrument to Help Aid Immediate Threat Assessment for Counselors, Faculty, and Teachers

    ERIC Educational Resources Information Center

    Juhnke, Gerald A.

    2010-01-01

    Threats of violence are not uncommon to counselors, faculty, or teachers. Each must be taken seriously, quickly analyzed, and safety procedures implemented. Yet, there exists a paucity of brief, face-to-face, assessments designed to aid threat assessment. To address this paucity, the author created The DANGERTOME Personal Risk Threat Assessment…

  2. Computer-Aided Self Assessment: The Intelligent Answer?

    ERIC Educational Resources Information Center

    Waite, Alice; Goodman, Linda M.

    1989-01-01

    Describes the development of a computer-assisted self assessment system in the United Kingdom that was designed to explore the use of artificial intelligence techniques in the area of self assessment for training applications. The expert systems used are explained, development of a pilot prototype is outlined, and field tests are described. (eight…

  3. Computer Aided Assessment and Development of Basic Skills

    ERIC Educational Resources Information Center

    Macleod, Iain; Overheu, Don

    1977-01-01

    The advantages of applying computer techniques to assessment and development of basic skills in mildly intellectually handicapped children are discussed, and several applications of computer devices to instruction are described. (SBH)

  4. Academic Spending versus Athletic Spending: Who Wins? Issue Brief

    ERIC Educational Resources Information Center

    Desrochers, Donna M.

    2013-01-01

    Athletics are big business on many college campuses, but does this come with a price tag? This issue brief looks at academic and athletic spending in NCAA Division I public universities between 2005 and 2010. Among a host of findings, this brief shows that the athletic departments of most public colleges and universities competing in NCAA Division…

  5. HIV Spending as a Share of Total Health Expenditure: An Analysis of Regional Variation in a Multi-Country Study

    PubMed Central

    Amico, Peter; Aran, Christian; Avila, Carlos

    2010-01-01

    Background HIV has devastated numerous countries in sub-Saharan Africa and is a dominant health force in many other parts of the world. Its undeniable importance is reflected in the establishment of Millennium Development Goal No. 6. Unprecedented amounts of funding have been committed and disbursed over the past two decades. Many have argued that this enormous influx of funding has been detrimental to building stronger health systems in recipient countries. This paper examines the funding share for HIV measured against the total funding for health. Methodology/Principal Findings A descriptive analysis of HIV and health expenditures in 2007 from 65 countries was conducted. Comparable data from individual countries was used by applying a consistent definition for HIV expenditures and total health expenditures from NHAs to align them with National AIDS Assessment Reports. In 2007, the total public and international expenditure in LMICs for HIV was 1.6 percent of the total spending on health, while the share in SSA was 19.4 percent. HIV prevalence was six-fold higher in SSA than the next highest region and it is the only region whose share of HIV spending exceeded the burden of HIV DALYs. Conclusions/Significance The share of HIV spending across the 65 countries was quite moderate considering that the estimated share of deaths attributable to HIV stood at 3.8 percent and DALYs at 4.4 percent. Several high spending countries are using a large share of their total health spending for HIV health, but these countries are the exception rather than representative of the average SSA country. There is wide variation between regions, but the burden of disease also varies significantly. The percentage of HIV spending is a useful indicator for better understanding health care resources and their allocation patterns. PMID:20885986

  6. Assessing the Impact of Testing Aids on Post-Secondary Student Performance: A Meta-Analytic Investigation

    ERIC Educational Resources Information Center

    Larwin, Karen H.; Gorman, Jennifer; Larwin, David A.

    2013-01-01

    Testing aids, including student-prepared testing aids (a.k.a., cheat sheets or crib notes) and open-textbook exams, are common practice in post-secondary assessment. There is a considerable amount of published research that discusses and investigates the impact of these testing aids. However, the findings of this research are contradictory and…

  7. Economic Recovery vs. Defense Spending.

    ERIC Educational Resources Information Center

    De Grasse, Robert; Murphy, Paul

    1981-01-01

    Evaluates President Reagan's proposed military buildup in light of the cuts such expenditures would necessitate in approximately 300 domestic programs. Suggests that the dramatic proposed increase in military spending risks higher inflation and slower economic growth. Concludes with a plea for rethinking of Reagan's dramatic shift in national…

  8. School Library Journal's Spending Survey

    ERIC Educational Resources Information Center

    Farmer, Lesley; Shontz, Marilyn

    2009-01-01

    This year's "School Library Journal's" spending survey showed that, despite the recession, the vast majority of media centers around the country have retained their credentialed media specialists. For example, almost 85% of elementary schools and more than 95% of middle and high schools have a full-time certified librarian. In addition, salaries…

  9. Assessment of comprehensive HIV/AIDS knowledge level among in-school adolescents in eastern Ethiopia

    PubMed Central

    Oljira, Lemessa; Berhane, Yemane; Worku, Alemayehu

    2013-01-01

    Introduction In Ethiopia, more adolescents are in school today than ever before; however, there are no studies that have assessed their comprehensive knowledge of HIV/AIDS. Thus, this study tried to assess the level of this knowledge and the factors associated with it among in-school adolescents in eastern Ethiopia. Methods A cross-sectional school-based study was conducted using a facilitator-guided self-administered questionnaire. The respondents were students attending regular school in 14 high schools located in 14 different districts in eastern Ethiopia. The proportion of in-school adolescents with comprehensive HIV/AIDS knowledge was computed and compared by sex. The factors that were associated with the comprehensive HIV/AIDS knowledge were assessed using bivariate and multivariable logistic regression. Results Only about one in four, 677 (24.5%), in-school adolescents have comprehensive HIV/AIDS knowledge. The knowledge was better among in-school adolescents from families with a relatively middle or high wealth index (adjusted OR [95% CI]=1.39 [1.03–1.87] and 1.75 [1.24–2.48], respectively), who got HIV/AIDS information mainly from friends or mass media (adjusted OR [95% CI]=1.63 [1.17–2.27] and 1.55 [1.14–2.11], respectively) and who received education on HIV/AIDS and sexual matters at school (adjusted OR [95% CI]=1.59 [1.22–2.08]). The females were less likely to have comprehensive HIV/AIDS knowledge compared to males (adjusted OR and [95% CI]=0.60 [0.49–0.75]). Conclusions In general, only about a quarter of in-school adolescents had comprehensive HIV/AIDS knowledge. Although the female adolescents are highly vulnerable to HIV infection and its effects, they were by far less likely to have comprehensive HIV/AIDS knowledge. HIV/AIDS information, education and communication activities need to be intensified in high schools. PMID:23517715

  10. Assessment of a decision aid to assist genetic testing research participants in the informed consent process.

    PubMed

    Sorenson, J R; Lakon, C; Spinney, T; Jennings-Grant, T

    2004-01-01

    Limited attention has been given to applying decision-making theories from psychology to the content and process of informed consent in genetic testing research. Data are presented from a study that developed and assessed a psychological theory-based decision aid as part of the informed consent process. This innovative approach assisted at-risk women in assessing the consequences of participating in a research project that offered them free hemophilia A genetic carrier testing. Results suggest: (1) the decision aid can be incorporated into the consent process with few problems; (2) women of varying educational backgrounds can complete the decision aid; (3) while women consider many consequences of genetic testing, their primary focus is on the implications for their family; and (4) this is in marked contrast to the typical benefit-harm statements prepared by researchers for genetic testing.

  11. Heterogeneity in spending change at retirement

    PubMed Central

    Hurd, Michael D.; Rohwedder, Susann

    2014-01-01

    The simple one-good model of life-cycle consumption requires that consumption be continuous over retirement; yet prior research based on partial measures of consumption or on synthetic panels indicates that spending drops at retirement, a result that has been called the retirement-consumption puzzle. Using panel data on total spending, nondurable spending and food spending, we find that spending declines at small rates at retirement, rates that could be explained by mechanisms such as the cessation of work-related expenses, unexpected retirement due to a health shock or by the substitution of time for spending. We find substantial heterogeneity in spending change at retirement: in the upper half of the wealth distribution spending increased. In the low-wealth population where spending did decline at higher rates, the main explanation for the decline appears to be early retirement due to poor health, possibly augmented by a short planning horizon by a minority of the population. PMID:24524026

  12. Spending more money, saving more lives? The relationship between avoidable mortality and healthcare spending in 14 countries.

    PubMed

    Heijink, Richard; Koolman, Xander; Westert, Gert P

    2013-06-01

    Healthcare expenditures rise as a share of GDP in most countries, raising questions regarding the value of further spending increases. Against this backdrop, we assessed the value of healthcare spending growth in 14 western countries between 1996 and 2006. We estimated macro-level health production functions using avoidable mortality as outcome measure. Avoidable mortality comprises deaths from certain conditions "that should not occur in the presence of timely and effective healthcare". We investigated the relationship between total avoidable mortality and healthcare spending using descriptive analyses and multiple regression models, focussing on within-country variation and growth rates. We aimed to take into account the role of potential confounders and dynamic effects such as time lags. Additionally, we explored a method to estimate macro-level cost-effectiveness. We found an average yearly avoidable mortality decline of 2.6-5.3% across countries. Simultaneously, healthcare spending rose between 1.9 and 5.9% per year. Most countries with above-average spending growth demonstrated above-average reductions in avoidable mortality. The regression models showed a significant association between contemporaneous and lagged healthcare spending and avoidable mortality. The time-trend, representing an exogenous shift of the health production function, reduced the impact of healthcare spending. After controlling for this time-trend and other confounders, i.e. demographic and socioeconomic variables, a statistically significant relationship between healthcare spending and avoidable mortality remained. We tentatively conclude that macro-level healthcare spending increases provided value for money, at least for the disease groups, countries and years included in this study.

  13. Causal Inference and Omitted Variable Bias in Financial Aid Research: Assessing Solutions

    ERIC Educational Resources Information Center

    Riegg, Stephanie K.

    2008-01-01

    This article highlights the problem of omitted variable bias in research on the causal effect of financial aid on college-going. I first describe the problem of self-selection and the resulting bias from omitted variables. I then assess and explore the strengths and weaknesses of random assignment, multivariate regression, proxy variables, fixed…

  14. Evaluating AIDS-Related Social Skills in Anglo and Latino Adolescents: Focus on Assessment.

    ERIC Educational Resources Information Center

    Blumberg, Elaine J.; Hovell, Melbourne F.; Werner, Cynthia A.; Kelley, Norma J.; Sipan, Carol L.; Burkham, Susan M.; Hofstetter, C. Richard

    1997-01-01

    Examines the assessment of AIDS-related social skills (measured by role play) in Anglo and Latino Adolescents (N=383) and explores ethnic and gender differences on these skills. Results indicate that anxiety and nonverbal behavior are generalized response classes that transcend specific social skills, suggesting the importance of measuring…

  15. Assessing Riverside Community College Nursing Student Attitudes toward Exposure to AIDS/HIV-Positive Patients.

    ERIC Educational Resources Information Center

    Kross, Carolyn Sue

    In fall 1990, a study was conducted to assess the attitudes of nursing students who were attending Riverside Community College (RCC), in California, toward exposure to Acquired Immune Deficiency Syndrome/Human Immunodeficiency Virus (AIDS/HIV) positive patients in a hospital setting. All students enrolled in RCC's associate degree nursing program…

  16. Using a Technology-Based Case to Aid in Improving Assessment

    ERIC Educational Resources Information Center

    Zelin, Robert C., II

    2008-01-01

    This paper describes how a technology-based case using Microsoft Access can aid in the assessment process. A case was used in lieu of giving a final examination in an Accounting Information Systems course. Students worked in small groups to design a database-driven payroll system for a hypothetical company. Each group submitted its results along…

  17. Assessing Tuition and Student Aid Strategies: Using Price-Response Measures to Simulate Pricing Alternatives.

    ERIC Educational Resources Information Center

    St. John, Edward P.

    1994-01-01

    A study used price-response measures from recent national studies to assess college and university pricing (tuition and student aid) alternatives in diverse institutional settings. It is concluded that such analyses are feasible. Analysis indicated limits to "Robin Hood" pricing patterns are predominant in private colleges. Consideration of new…

  18. Lecturers' Perspectives on the Use of a Mathematics-Based Computer-Aided Assessment System

    ERIC Educational Resources Information Center

    Broughton, Stephen J.; Robinson, Carol L.; Hernandez-Martinez, Paul

    2013-01-01

    Computer-aided assessment (CAA) has been used at a university with one of the largest mathematics and engineering undergraduate cohorts in the UK for more than ten years. Lecturers teaching mathematics to first year students were asked about their current use of CAA in a questionnaire and in interviews. This article presents the issues that these…

  19. Effective Computer-Aided Assessment of Mathematics; Principles, Practice and Results

    ERIC Educational Resources Information Center

    Greenhow, Martin

    2015-01-01

    This article outlines some key issues for writing effective computer-aided assessment (CAA) questions in subjects with substantial mathematical or statistical content, especially the importance of control of random parameters and the encoding of wrong methods of solution (mal-rules) commonly used by students. The pros and cons of using CAA and…

  20. When Summative Computer-Aided Assessments Go Wrong: Disaster Recovery after a Major Failure

    ERIC Educational Resources Information Center

    Harwood, Ian

    2005-01-01

    This case study outlines the events of a recent summative computer-aided assessment (CAA) failure involving 280 first-year undergraduate students. Post-test analysis found that the central server had become unexpectedly overloaded, thereby causing the CAA to be abandoned. Practical advice on just what to do in the event of a summative CAA failure…

  1. Spending

    ERIC Educational Resources Information Center

    Lamale, Helen H.

    1977-01-01

    Unprecedented growth of the typical American family's resources since World War II have had effects upon life style, personal fulfillment, consumption of goods and services, and freedom of occupational choice. It is suggested that the time may have come for concern with nonmaterial elements that determine the quality of life. For journal…

  2. Technology-Aided Assessment of Sensorimotor Function in Early Infancy

    PubMed Central

    Allievi, Alessandro G.; Arichi, Tomoki; Gordon, Anne L.; Burdet, Etienne

    2014-01-01

    There is a pressing need for new techniques capable of providing accurate information about sensorimotor function during the first 2 years of childhood. Here, we review current clinical methods and challenges for assessing motor function in early infancy, and discuss the potential benefits of applying technology-assisted methods. We also describe how the use of these tools with neuroimaging, and in particular functional magnetic resonance imaging (fMRI), can shed new light on the intra-cerebral processes underlying neurodevelopmental impairment. This knowledge is of particular relevance in the early infant brain, which has an increased capacity for compensatory neural plasticity. Such tools could bring a wealth of knowledge about the underlying pathophysiological processes of diseases such as cerebral palsy; act as biomarkers to monitor the effects of possible therapeutic interventions; and provide clinicians with much needed early diagnostic information. PMID:25324827

  3. Wrist proprioceptive acuity: A comprehensive robot-aided assessment.

    PubMed

    Cappello, Leonardo; Contu, Sara; Konczak, Juergen; Masia, Lorenzo

    2015-08-01

    Proprioception is the sense of the body awareness. Proprioceptive deficits represent frequent consequences of several neurological conditions like stroke, Parkinson's disease and others. The assessment of such somatosensory function is crucial, although the available clinical tests are not sensitive enough. The human wrist is a crucial joint for many activities of daily living and to address the lack of its characterization in terms of proprioceptive acuity the authors in previous studies proposed a novel method that combined the use of a 3-DoF robot and a threshold haunting paradigm. Further experiments were performed to characterize the proprioceptive acuity of the dominant wrist for adduction, extension, pronation and supination by using a 2-alternative-forced-choice test. The acuity thresholds obtained from six subjects (mean values ± standard deviation of 1.65±0.39 for extension, 1.13±0.34 for adduction, 1.90±0.58 for pronation and 1.70±0.30 for supination) were finally combined with the ones harvested in the previous studies for flexion and abduction in order to build the first comprehensive database of human wrist proprioceptive acuity.

  4. Assess/Mitigate Risk through the Use of Computer-Aided Software Engineering (CASE) Tools

    NASA Technical Reports Server (NTRS)

    Aguilar, Michael L.

    2013-01-01

    The NASA Engineering and Safety Center (NESC) was requested to perform an independent assessment of the mitigation of the Constellation Program (CxP) Risk 4421 through the use of computer-aided software engineering (CASE) tools. With the cancellation of the CxP, the assessment goals were modified to capture lessons learned and best practices in the use of CASE tools. The assessment goal was to prepare the next program for the use of these CASE tools. The outcome of the assessment is contained in this document.

  5. Has Medicaid growth crowded out state educational spending?

    PubMed

    Fossett, J W; Wyckoff, J H

    1996-01-01

    Researchers have argued that the dramatic increase in Medicaid spending during the late 1980s and early 1990s "crowded out" state spending on other activities, particularly education. Medicaid growth has, at least in part, been driven by increased federal eligibility and service mandates, federal court decisions on hospital and nursing home rates, and health care inflation; and the need to respond to these outside forces has placed increasing pressure on state finances. Other evidence, however, suggests that the adverse effect of Medicaid growth on state finances has been overstated. During the late 1980s and early 1990s, states shifted many human service programs from general fund to Medicaid financing and took advantage of Medicaid rules governing the use of provider donations and assessments, such as state matching and claiming payments to disproportionate-share hospitals to increase federal reimbursement without increasing the claims on their own revenues. But the increased burden of Medicaid growth on state finances may be more apparent than real. In this article, we test the crowding-out hypothesis using a two-stage, least-squares fixed-effects model of Medicaid's impact on educational spending from 1980 to 1990. Our results indicate that Medicaid growth has had no significant effect on educational spending. Rather, educational spending has responded more to changes in states' own-source revenues than to growth in Medicaid spending.

  6. Assessment of bone ages by the Tanner-Whitehouse method using a computer-aided system.

    PubMed

    Drayer, N M; Cox, L A

    1994-12-01

    A computer-aided system to estimate bone age based on Fourier analysis was assessed by reference to the original radiographs used to produce the Tanner-Whitehouse 2 (TW2) standards for the radius, ulna and short finger bones. The computer-aided system involved matching a template of each bone to the scanned image of the radiograph. The computer then generated a stage of bone maturity, individual and total bone scores and a value for bone age. The bone ages assessed by the computer-aided system were no different from the original TW2 reference values, indicating the applicability of the system. The system was used to assess the bone ages of tall Dutch girls, and the results obtained were compared with more traditional assessments made by an experienced rater. For the radiographs from the tall girls, there was good agreement for individual bones between this method and the traditional assessment by the rater, but less agreement for the total 13-bone score and bone age.

  7. Pharmacokinetics and expert systems as aids for risk assessment in reproductive toxicology

    SciTech Connect

    Mattison, D.R.; Jelovsek, F.R.

    1987-12-01

    A minimal approach to risk assessment in reproductive toxicology involves four components: hazard identification, hazard characterization, exposure characterization, and risk characterization. In practice, risk assessment in reproductive toxicology has been reduced to arbitrary safety factors or mathematical models of the dose-response relationship. These approaches obscure biological differences across species rather than using this important and frequently accessible information. Two approaches that are formally capable of using biologically relevant information (pharmacokinetics and expert system shells) are explored as aids to risk assessment in reproductive toxicology.

  8. Obama commits to science spending

    NASA Astrophysics Data System (ADS)

    Banks, Michael

    2009-06-01

    US President Barack Obama has pledged to increase the country's spending on research and development and create an "Apollo era" push for research into renewable energy. Speaking at the 146th annual meeting of the National Academy of Sciences (NAS) in Washington, DC, at the end of April, he outlined a wide-ranging plan for science and technology, from improving teaching of science in schools to reducing carbon emissions. Obama was only the fourth US president after George Bush senior, Jimmy Carter and John F Kennedy to address an NAS annual meeting.

  9. Computer-Aided Nodule Assessment and Risk Yield Risk Management of Adenocarcinoma: The Future of Imaging?

    PubMed

    Foley, Finbar; Rajagopalan, Srinivasan; Raghunath, Sushravya M; Boland, Jennifer M; Karwoski, Ronald A; Maldonado, Fabien; Bartholmai, Brian J; Peikert, Tobias

    2016-01-01

    Increased clinical use of chest high-resolution computed tomography results in increased identification of lung adenocarcinomas and persistent subsolid opacities. However, these lesions range from very indolent to extremely aggressive tumors. Clinically relevant diagnostic tools to noninvasively risk stratify and guide individualized management of these lesions are lacking. Research efforts investigating semiquantitative measures to decrease interrater and intrarater variability are emerging, and in some cases steps have been taken to automate this process. However, many such methods currently are still suboptimal, require validation and are not yet clinically applicable. The computer-aided nodule assessment and risk yield software application represents a validated tool for the automated, quantitative, and noninvasive tool for risk stratification of adenocarcinoma lung nodules. Computer-aided nodule assessment and risk yield correlates well with consensus histology and postsurgical patient outcomes, and therefore may help to guide individualized patient management, for example, in identification of nodules amenable to radiological surveillance, or in need of adjunctive therapy. PMID:27568149

  10. Thinking about "Think Again" in Canada: assessing a social marketing HIV/AIDS prevention campaign.

    PubMed

    Lombardo, Anthony P; Léger, Yves A

    2007-06-01

    The Canadian "Think Again" social marketing HIV/AIDS prevention campaign, adapted from an American effort, encourages gay men to rethink their assumptions about their partners' HIV statuses and the risks of unsafe sex with them. To improve future efforts, existing HIV/AIDS prevention initiatives require critical reflection. While a formal evaluation of this campaign has been carried out elsewhere, here we use the campaign as a social marketing case study to illustrate its strengths and weaknesses, as a learning tool for other campaigns. After describing the campaign and its key results, we assess how it utilized central tenets of the social marketing process, such as formative research and the marketing mix. We then speak to the importance of theoretical influence in campaign design and the need to account for social-contextual factors in safer sex decision making. We conclude with a summary of the lessons learned from the assessment of this campaign.

  11. Thinking about "Think Again" in Canada: assessing a social marketing HIV/AIDS prevention campaign.

    PubMed

    Lombardo, Anthony P; Léger, Yves A

    2007-06-01

    The Canadian "Think Again" social marketing HIV/AIDS prevention campaign, adapted from an American effort, encourages gay men to rethink their assumptions about their partners' HIV statuses and the risks of unsafe sex with them. To improve future efforts, existing HIV/AIDS prevention initiatives require critical reflection. While a formal evaluation of this campaign has been carried out elsewhere, here we use the campaign as a social marketing case study to illustrate its strengths and weaknesses, as a learning tool for other campaigns. After describing the campaign and its key results, we assess how it utilized central tenets of the social marketing process, such as formative research and the marketing mix. We then speak to the importance of theoretical influence in campaign design and the need to account for social-contextual factors in safer sex decision making. We conclude with a summary of the lessons learned from the assessment of this campaign. PMID:17558789

  12. Computer-Aided Nodule Assessment and Risk Yield Risk Management of Adenocarcinoma: The Future of Imaging?

    PubMed

    Foley, Finbar; Rajagopalan, Srinivasan; Raghunath, Sushravya M; Boland, Jennifer M; Karwoski, Ronald A; Maldonado, Fabien; Bartholmai, Brian J; Peikert, Tobias

    2016-01-01

    Increased clinical use of chest high-resolution computed tomography results in increased identification of lung adenocarcinomas and persistent subsolid opacities. However, these lesions range from very indolent to extremely aggressive tumors. Clinically relevant diagnostic tools to noninvasively risk stratify and guide individualized management of these lesions are lacking. Research efforts investigating semiquantitative measures to decrease interrater and intrarater variability are emerging, and in some cases steps have been taken to automate this process. However, many such methods currently are still suboptimal, require validation and are not yet clinically applicable. The computer-aided nodule assessment and risk yield software application represents a validated tool for the automated, quantitative, and noninvasive tool for risk stratification of adenocarcinoma lung nodules. Computer-aided nodule assessment and risk yield correlates well with consensus histology and postsurgical patient outcomes, and therefore may help to guide individualized patient management, for example, in identification of nodules amenable to radiological surveillance, or in need of adjunctive therapy.

  13. Assessing the impact of international conservation aid on deforestation in sub-Saharan Africa

    NASA Astrophysics Data System (ADS)

    Bare, Matthew; Kauffman, Craig; Miller, Daniel C.

    2015-12-01

    International conservation donors have spent at least 3.4 billion to protect biodiversity and stem tropical deforestation in Africa since the early 1990s. Despite more than two decades of experience, however, there is little research on the effect of this aid at a region-wide scale. Numerous case studies exist, but show mixed results. Existing research is usually based on community perception or focused on short-term donor objectives rather than specific conservation outcomes, like deforestation rates. Thus, the impact of billions of dollars of conservation aid on deforestation rates remains an open question. This article uses an original dataset to analyze the effect of international conservation aid on deforestation rates in 42 African countries between 2000 and 2013. We first describe patterns of conservation aid across the continent and then assess its impact (with one to five-year lags), controlling for other factors that may also affect deforestation, including rural population, protected areas (PAs), governance, and other economic and commodity production variables. We find that conservation aid is associated with higher rates of forest loss after one- or two-year lags. A similar result holds for PA extent, suggesting possible displacement of deforestation from PAs. However, governance quality in high forest cover countries moderates these effects such that deforestation rates are reduced. Rural population is the most consistent factor associated with forest loss, confirming previous studies of this driver. Our results suggest that in heavily forested countries, development projects designed to support conservation work initially in conditions of good governance, but that conservation aid alone is insufficient to mitigate larger deforestation drivers.

  14. Computer-aided quantitative bone scan assessment of prostate cancer treatment response

    PubMed Central

    Brown, Matthew S.; Chu, Gregory H.; Kim, Hyun J.; Allen-Auerbach, Martin; Poon, Cheryce; Bridges, Juliette; Vidovic, Adria; Ramakrishna, Bharath; Ho, Judy; Morris, Michael J.; Larson, Steven M.; Scher, Howard I.; Goldin, Jonathan G.

    2012-01-01

    Objective The development and evaluation of a computer-aided bone scan analysis technique to quantify changes in tumor burden and assess treatment effects in prostate cancer clinical trials. Methods We have developed and report on a commercial fully automated computer-aided detection system. Using this system, scan images were intensity normalized, then lesions identified and segmented by anatomic region-specific intensity thresholding. Detected lesions were compared against expert markings to assess the accuracy of the computer-aided detection system. The metrics Bone Scan Lesion Area, Bone Scan Lesion Intensity, and Bone Scan Lesion Count were calculated from identified lesions, and their utility in assessing treatment effects was evaluated by analyzing before and after scans from metastatic castration-resistant prostate cancer patients: 10 treated and 10 untreated. In this study, patients were treated with cabozantinib, a MET/VEGF inhibitor resulting in high rates of resolution of bone scan abnormalities. Results Our automated computer-aided detection system identified bone lesion pixels with 94% sensitivity, 89% specificity, and 89% accuracy. Significant differences in changes from baseline were found between treated and untreated groups in all assessed measurements derived by our system. The most significant measure, Bone Scan Lesion Area, showed a median (interquartile range) change from baseline at week 6 of 7.13% (27.61) in the untreated group compared with −73.76% (45.38) in the cabozantinib-treated group (P = 0.0003). Conclusions Our system accurately and objectively identified and quantified metastases in bone scans, allowing for interpatient and intrapatient comparison. It demonstrates potential as an objective measurement of treatment effects, laying the foundation for validation against other clinically relevant outcome measures. PMID:22367858

  15. Assessment of Alternative Student Aid Delivery Systems. The General Assessment Model.

    ERIC Educational Resources Information Center

    Advanced Technology, Inc., Reston, VA.

    An evaluation model for the student aid delivery system is described, and extensive tables that make up the model are presented. The model can be used to evaluate the effects of specific activities and subsystems of the delivery system for major participants, as well as to estimate the likely effects of activity changes. A conceptual model for…

  16. Patients' preferences explain a small but significant share of regional variation in medicare spending.

    PubMed

    Baker, Laurence C; Bundorf, M Kate; Kessler, Daniel P

    2014-06-01

    This study assessed the extent to which differences in patients' preferences across geographic areas explained differences in traditional fee-for-service Medicare spending across Dartmouth Atlas of Health Care Hospital Referral Regions (HRRs). Preference measures were based on results of a survey that asked patients questions about their physicians, their own health status, and the care they would want in their last six months of life. We found that patients' preferences explained 5 percent of the variation across HRRs in total Medicare spending. In comparison, supply factors, such as the number of physicians, specialists, and hospital beds, explained 23 percent, and patients' health and income explained 12 percent. We also explored the relative importance of preferences in determining three components of total spending: spending at the end of life, inpatient spending, and spending on physician services. Relative to supply factors, health, and income, patients' preferences explained the largest share of variation in end-of-life spending and the smallest share of variation in spending on physician services. We conclude that variation in preferences contributes to differences across areas in Medicare spending. Medicare policy must consider both supply factors and patients' preferences in deciding how much to accommodate area variation in spending and the extent to which that variation should be subsidized by taxpayers.

  17. An Empirical Approach to Determining Advertising Spending Level.

    ERIC Educational Resources Information Center

    Sunoo, D. H.; Lin, Lynn Y. S.

    To assess the relationship between advertising and consumer promotion and to determine the optimal short-term advertising spending level for a product, a research project was undertaken by a major food manufacturer. One thousand homes subscribing to a dual-system cable television service received either no advertising exposure to the product or…

  18. Using a Multisectoral Approach to Assess HIV/AIDS Services in the Western Region of Puerto Rico

    PubMed Central

    Asencio Toro, Gloria; Burns, Patricia; Pimentel, Daniel; Sánchez Peraza, Luis Raúl; Rivera Lugo, Carmen

    2006-01-01

    The Enhancing Care Initiative of Puerto Rico assessed services available to people living with HIV/AIDS in the western region of Puerto Rico. Participants were 212 people living with HIV/AIDS and 116 employees from 6 agencies providing HIV/AIDS services in the region. Two main findings were that depression symptoms were present in 98.1% of people living with HIV/AIDS, and 7 of the 15 municipalities in the region did not provide any specific services to this population. Most urgent needs identified by people living with HIV/AIDS were economic support, housing, mental and psychological services, medicines, medical treatment, and transportation. The Enhancing Care Initiative provides an example of a successful multisectoral, multidimensional volunteer team effectively overcoming challenges while translating research into interventions to enhance HIV/AIDS care. PMID:16670220

  19. Digital hand atlas and computer-aided bone age assessment via the Web

    NASA Astrophysics Data System (ADS)

    Cao, Fei; Huang, H. K.; Pietka, Ewa; Gilsanz, Vicente

    1999-07-01

    A frequently used assessment method of bone age is atlas matching by a radiological examination of a hand image against a reference set of atlas patterns of normal standards. We are in a process of developing a digital hand atlas with a large standard set of normal hand and wrist images that reflect the skeletal maturity, race and sex difference, and current child development. The digital hand atlas will be used for a computer-aided bone age assessment via Web. We have designed and partially implemented a computer-aided diagnostic (CAD) system for Web-based bone age assessment. The system consists of a digital hand atlas, a relational image database and a Web-based user interface. The digital atlas is based on a large standard set of normal hand an wrist images with extracted bone objects and quantitative features. The image database uses a content- based indexing to organize the hand images and their attributes and present to users in a structured way. The Web-based user interface allows users to interact with the hand image database from browsers. Users can use a Web browser to push a clinical hand image to the CAD server for a bone age assessment. Quantitative features on the examined image, which reflect the skeletal maturity, will be extracted and compared with patterns from the atlas database to assess the bone age. The relevant reference imags and the final assessment report will be sent back to the user's browser via Web. The digital atlas will remove the disadvantages of the currently out-of-date one and allow the bone age assessment to be computerized and done conveniently via Web. In this paper, we present the system design and Web-based client-server model for computer-assisted bone age assessment and our initial implementation of the digital atlas database.

  20. Ten years of the International Patient Decision Aid Standards Collaboration: evolution of the core dimensions for assessing the quality of patient decision aids.

    PubMed

    Volk, Robert J; Llewellyn-Thomas, Hilary; Stacey, Dawn; Elwyn, Glyn

    2013-01-01

    In 2003, the International Patient Decision Aid Standards (IPDAS) Collaboration was established to enhance the quality and effectiveness of patient decision aids by establishing an evidence-informed framework for improving their content, development, implementation, and evaluation. Over this 10 year period, the Collaboration has established: a) the background document on 12 core dimensions to inform the original modified Delphi process to establish the IPDAS checklist (74 items); b) the valid and reliable IPDAS instrument (47 items); and c) the IPDAS qualifying (6 items), certifying (6 items + 4 items for screening), and quality criteria (28 items). The objective of this paper is to describe the evolution of the IPDAS Collaboration and discuss the standardized process used to update the background documents on the theoretical rationales, evidence and emerging issues underlying the 12 core dimensions for assessing the quality of patient decision aids.

  1. Preliminary Examination of Adolescent Spending in a Contingency Management-Based Smoking-Cessation Program

    ERIC Educational Resources Information Center

    Cavallo, Dana A.; Nich, Charla; Schepis, Ty S.; Smith, Anne E.; Liss, Thomas B.; McFetridge, Amanda K.; Krishnan-Sarin, Suchitra

    2010-01-01

    Contingency management (CM) utilizing monetary incentives is efficacious in enhancing abstinence in an adolescent smoking-cessation program, but how adolescents spend their money has not been examined. We assessed spending habits of 38 adolescent smokers in a CM-based smoking-cessation project prior to quitting and during treatment using a…

  2. Neuro-fuzzy systems for computer-aided myocardial viability assessment.

    PubMed

    Behloul, F; Lelieveldt, B P; Boudraa, A; Janier, M F; Revel, D; Reiber, J H

    2001-12-01

    This paper describes a multimodality framework for computer-aided myocardial viability assessment based on neuro-fuzzy techniques. The proposed approach distinguishes two main levels: the modality-independent inference level and the modality-dependent application level. This two-level distinction releases the hard constraint of multimodality image registration. An abstract description template is used to describe the different myocardial functions (contractile function, perfusion, metabolism). Parameters extracted from different image modalities are combined to derive a diagnostic image. The neuro-fuzzy techniques make our system transparent, adaptive and easily extendable. Its effectiveness and robustness are demonstrated in a positron emission tomography/magnetic resonance imaging data fusion application.

  3. Fiscal space for health spending in Southeast Asia.

    PubMed

    Gupta, Indrani; Mondal, Swadhin

    2013-01-01

    This article examines the availability of fiscal space in the context of health spending and the challenges and constraints in raising additional resources for health given the macroeconomic situations, in the ten countries of the South-East Asia region (SEAR) of the World Health Organization (WHO). Using a variety of secondary data, the analysis indicates that there are differences among the SEAR countries with respect to the various indicators of fiscal space. While the aid situation is under control, there are concerns regarding public debt, fiscal deficit, and revenues. Based on the findings, this article proposes ways forward for each of the countries in the coming years. PMID:24003763

  4. State Spending on Higher Education Capital Outlays

    ERIC Educational Resources Information Center

    Delaney, Jennifer A.; Doyle, William R.

    2014-01-01

    This paper explores the role that state spending on higher education capital outlays plays in state budgets by considering the functional form of the relationship between state spending on higher education capital outlays and four types of state expenditures. Three possible functional forms are tested: a linear model, a quadratic model, and the…

  5. Federal Spending for HBCUs Is Up.

    ERIC Educational Resources Information Center

    Taylor, Ronald A.

    1996-01-01

    Federal grants, training, and recruitment spending directed at historically black colleges and universities (HBCUs) jumped 21% in a 2-year period, led by sharp increases in research spending by the Central Intelligence Agency and Departments of Veterans Affairs and Commerce, and Department of Energy teaching endowments. Much of the increase is…

  6. Charter School Spending and Saving in California

    ERIC Educational Resources Information Center

    Reed, Sherrie; Rose, Heather

    2015-01-01

    Examining resource allocation practices, including savings, of charter schools is critical to understanding their financial viability and sustainability. Using 9 years of finance data from California, we find charter schools spend less on instruction and pupil support services than traditional public schools. The lower spending on instruction and…

  7. President's Budget Would Cut Education Spending

    ERIC Educational Resources Information Center

    Davis, Michelle R.

    2006-01-01

    This article discusses President Bush's budget cut on education spending. The president's blueprint for federal education spending in the next fiscal year includes a high-profile plan to boost math and science education, new money for private school vouchers, a renewed push to improve high schools--and the most drastic cut in Department of…

  8. Assessment of Chair-side Computer-Aided Design and Computer-Aided Manufacturing Restorations: A Review of the Literature

    PubMed Central

    Baroudi, Kusai; Ibraheem, Shukran Nasser

    2015-01-01

    Background: This paper aimed to evaluate the application of computer-aided design and computer-aided manufacturing (CAD-CAM) technology and the factors that affect the survival of restorations. Materials and Methods: A thorough literature search using PubMed, Medline, Embase, Science Direct, Wiley Online Library and Grey literature were performed from the year 2004 up to June 2014. Only relevant research was considered. Results: The use of chair-side CAD/CAM systems is promising in all dental branches in terms of minimizing time and effort made by dentists, technicians and patients for restoring and maintaining patient oral function and aesthetic, while providing high quality outcome. Conclusion: The way of producing and placing the restorations made with the chair-side CAD/CAM (CEREC and E4D) devices is better than restorations made by conventional laboratory procedures. PMID:25954082

  9. Evaluating social outcomes of HIV/AIDS interventions: a critical assessment of contemporary indicator frameworks

    PubMed Central

    Mannell, Jenevieve; Cornish, Flora; Russell, Jill

    2014-01-01

    Introduction Contemporary HIV-related theory and policy emphasize the importance of addressing the social drivers of HIV risk and vulnerability for a long-term response. Consequently, increasing attention is being given to social and structural interventions, and to social outcomes of HIV interventions. Appropriate indicators for social outcomes are needed in order to institutionalize the commitment to addressing social outcomes. This paper critically assesses the current state of social indicators within international HIV/AIDS monitoring and evaluation frameworks. Methods We analyzed the indicator frameworks of six international organizations involved in efforts to improve and synchronize the monitoring and evaluation of the HIV/AIDS response. Our analysis classifies the 328 unique indicators according to what they measure and assesses the degree to which they offer comprehensive measurement across three dimensions: domains of the social context, levels of change and organizational capacity. Results and discussion The majority of indicators focus on individual-level (clinical and behavioural) interventions and outcomes, neglecting structural interventions, community interventions and social outcomes (e.g. stigma reduction; community capacity building; policy-maker sensitization). The main tool used to address social aspects of HIV/AIDS is the disaggregation of data by social group. This raises three main limitations. Indicator frameworks do not provide comprehensive coverage of the diverse social drivers of the epidemic, particularly neglecting criminalization, stigma, discrimination and gender norms. There is a dearth of indicators for evaluating the social impacts of HIV interventions. Indicators of organizational capacity focus on capacity to effectively deliver and manage clinical services, neglecting capacity to respond appropriately and sustainably to complex social contexts. Conclusions Current indicator frameworks cannot adequately assess the social

  10. Assessment of a CT image of the oral cavity with use of an aid focusing on a neck examination

    NASA Astrophysics Data System (ADS)

    Lee, Hyo-Jong; Goo, Eun-Hoe; Kim, Sung-Soo; Dong, Kyung-Rae; Chung, Woon-Kwan

    2013-11-01

    The aim of this study was to provide clinical information on an oral cavity disease assessment that was conducted using a self-manufactured aid in a computed tomography (CT) oral examination. The study subjects included 30 patients, who were examined using a multi-detector CT (MDCT) 128-slice CT Scanner. Rapidia software was used for quantitative analysis, while a questionnaire and qualitative analysis were used to assess the convenience. The significance was evaluated using a Student's t-test and a Wilcoxon signed rank test. A p value < 0.05 was considered significant. The convenience was evaluated by using a multiple response frequency analysis. The means and the standard deviations, which depended on use of the aid, were 2440.41 ± 4226.26 and 57443.86 ± 12445.91 respectively, the higher values being seen in the image assessment when the aid was used (p = 0.000). In a qualitative evaluation, the means and standard deviations were 2.52 ± 0.44 and 1.62 ± 0.22, respectively, the higher values being shown in the image assessment when the aid was used (p = 0.012). According to the convenience assessment that was conducted using a questionnaire, 80% of the respondents answered that they did not have any inconvenience when using the aid because the scores were 4 points or higher on the scale. In conclusion, the contrast increased when the aid, which enabled a clear identification of the anatomical structure, was inserted to examine the oral cavity. In particular, the patients considered the use of the aid to be convenient. Overall, the aid is recommended for use in a head/neck examination.

  11. Computer aided diagnosis for severity assessment of pneumoconiosis using CT images

    NASA Astrophysics Data System (ADS)

    Suzuki, Hidenobu; Matsuhiro, Mikio; Kawata, Yoshiki; Niki, Noboru; Kato, Katsuya; Kishimoto, Takumi; Ashizawa, Kazuto

    2016-03-01

    240,000 participants have a screening for diagnosis of pneumoconiosis every year in Japan. Radiograph is used for staging of severity in pneumoconiosis worldwide. This paper presents a method for quantitative assessment of severity in pneumoconiosis using both size and frequency of lung nodules that detected by thin-section CT images. This method consists of three steps. First, thoracic organs (body, ribs, spine, trachea, bronchi, lungs, heart, and pulmonary blood vessels) are segmented. Second, lung nodules that have radius over 1.5mm are detected. These steps used functions of our developed computer aided detection system of chest CT images. Third, severity in pneumoconiosis is quantified using size and frequency of lung nodules. This method was applied to nine pneumoconiosis patients. The initial results showed that proposed method can assess severity in pneumoconiosis quantitatively. This paper demonstrates effectiveness of our method in diagnosis and prognosis of pneumoconiosis in CT screening.

  12. [A computer-aided design assessment system for recovery life support technology options].

    PubMed

    Chen, J; Wang, F; Sun, J; Shang, C

    1997-04-01

    A specific computer-aided decision support system was designed and implemented for design computation and decision assessment of environmental control and life support system of manned space station. An advanced multiobjective decision methodology and a hierarchic structure model of assessment index of recovery life support system was developed. The program incorporates a database for each technology option, metabolic design loads associated with crew activity, mission model variables to accommodate evolving mission requirements, and algorithms to produce products criteria in order to provide recommendations relative to candidate technology selection and development. A specific structure was developed for the decision system which consists of a database, a methodology base and a model base as well as their management systems. Moreover, a centre control system with friendly user interface plays a very important role in the man-computer interaction.

  13. Total HIV/AIDS Expenditures in Dehong Prefecture, Yunnan Province in 2010: The First Systematic Evaluation of Both Health and Non-Health Related HIV/AIDS Expenditures in China

    PubMed Central

    Shan, Duo; Sun, Jiangping; Yakusik, Anna; Chen, Zhongdan; Yuan, Jianhua; Li, Tao; Fu, Jeannia; Khoshnood, Kaveh; Yang, Xing; Wei, Mei; Duan, Song; Bulterys, Marc; Sante, Michael; Ye, Runhua; Xiang, Lifen; Yang, Yuecheng

    2013-01-01

    Objective We assessed HIV/AIDS expenditures in Dehong Prefecture, Yunnan Province, one of the highest prevalence regions in China, and describe funding sources and spending for different categories of HIV-related interventions and at-risk populations. Methods 2010 HIV/AIDS expenditures in Dehong Prefecture were evaluated based on UNAIDS’ National AIDS Spending Assessment methodology. Results Nearly 93% of total expenditures for HIV/AIDS was contributed by public sources. Of total expenditures, 52.7% was allocated to treatment and care, 24.5% to program management and administration and 19.8% to prevention. Spending on treatment and care was primarily allocated to the treatment of opportunistic infections. Most (40.4%) prevention spending was concentrated on most-at-risk populations, injection drug users (IDUs), sex workers, and men who have sex with men (MSM), with 5.5% allocated to voluntary counseling and testing. Prevention funding allocated for MSM, partners of people living with HIV and prisoners and other confined populations was low compared to the disproportionate burden of HIV/AIDS in these populations. Overall, people living with HIV accounted for 57.57% of total expenditures, while most-at-risk populations accounted for only 7.99%. Conclusions Our study demonstrated the applicability of NASA for tracking and assessing HIV expenditure in the context of China, it proved to be a useful tool in understanding national HIV/AIDS response from financial aspect, and to assess the extent to which HIV expenditure matches epidemic patterns. Limited funding for primary prevention and prevention for MSM, prisoners and partners of people living with HIV, signal that resource allocation to these key areas must be strengthened. Comprehensive analyses of regional and national funding strategies are needed to inform more equitable, effective and cost-effective HIV/AIDS resource allocation. PMID:23825694

  14. Self-Assessment of Hearing and Purchase of Hearing Aids by Middle-Aged and Elderly Adults

    PubMed Central

    Otavio, Andressa Colares da Costa; Coradini, Patricia Pérez; Teixeira, Adriane Ribeiro

    2015-01-01

    Introduction Presbycusis is a consequence of aging. Prescription of hearing aids is part of the treatment, although the prevalence of use by elderly people is still small. Objective To verify whether or not self-assessment of hearing is a predictor for purchase of hearing aids. Methods Quantitative, cross-sectional, descriptive, and observational study. Participants were subjects who sought a private hearing center for selection of hearing aids. During the diagnostic interview, subjects answered the following question: “On a scale of 1 to 10, with 1 being the worst and 10 the best, how would you rate your overall hearing ability?” After that, subjects underwent audiometry, selected a hearing aid, performed a home trial, and decided whether or not to purchase the hearing aid. The variables were associated and analyzed statistically. Results The sample was comprised of 32 subjects, both men and women, with a higher number of women. Mean age was 71.41 ± 12.14 years. Self-assessment of hearing ranged from 2 to 9 points. Overall, 71.9% of the subjects purchased hearing aids. There was no association between scores in the self-assessment and the purchase of hearing aids (p = 0.263). Among those who scored between 2 and 5 points, 64.7% purchased the device; between 6 and 7 points, 76.09% purchased the device; and between 8 and 9 points, 50% purchased the device, respectively. Conclusion There is evidence that low self-assessment scores lead to the purchase of hearing aids, although no significant association was observed in the sample. PMID:26722346

  15. Geography of conservation spending, biodiversity, and culture.

    PubMed

    McClanahan, T R; Rankin, P S

    2016-10-01

    We used linear and multivariate models to examine the associations between geography, biodiversity, per capita economic output, national spending on conservation, governance, and cultural traits in 55 countries. Cultural traits and social metrics of modernization correlated positively with national spending on conservation. The global distribution of this spending culture was poorly aligned with the distribution of biodiversity. Specifically, biodiversity was greater in the tropics where cultures tended to spend relatively less on conservation and tended to have higher collectivism, formalized and hierarchical leadership, and weaker governance. Consequently, nations lacking social traits frequently associated with modernization, environmentalism, and conservation spending have the largest component of Earth's biodiversity. This has significant implications for setting policies and priorities for resource management given that biological diversity is rapidly disappearing and cultural traits change slowly. Therefore, we suggest natural resource management adapt to and use characteristics of existing social organization rather than wait for or promote social values associated with conservation spending. Supporting biocultural traditions, engaging leaders to increase conservation commitments, cross-national efforts that complement attributes of cultures, and avoiding interference with nature may work best to conserve nature in collective and hierarchical societies. Spending in modernized nations may be a symbolic response to a symptom of economic development and environmental degradation, and here conservation actions need to ensure that biodiversity is not being lost.

  16. Geography of conservation spending, biodiversity, and culture.

    PubMed

    McClanahan, T R; Rankin, P S

    2016-10-01

    We used linear and multivariate models to examine the associations between geography, biodiversity, per capita economic output, national spending on conservation, governance, and cultural traits in 55 countries. Cultural traits and social metrics of modernization correlated positively with national spending on conservation. The global distribution of this spending culture was poorly aligned with the distribution of biodiversity. Specifically, biodiversity was greater in the tropics where cultures tended to spend relatively less on conservation and tended to have higher collectivism, formalized and hierarchical leadership, and weaker governance. Consequently, nations lacking social traits frequently associated with modernization, environmentalism, and conservation spending have the largest component of Earth's biodiversity. This has significant implications for setting policies and priorities for resource management given that biological diversity is rapidly disappearing and cultural traits change slowly. Therefore, we suggest natural resource management adapt to and use characteristics of existing social organization rather than wait for or promote social values associated with conservation spending. Supporting biocultural traditions, engaging leaders to increase conservation commitments, cross-national efforts that complement attributes of cultures, and avoiding interference with nature may work best to conserve nature in collective and hierarchical societies. Spending in modernized nations may be a symbolic response to a symptom of economic development and environmental degradation, and here conservation actions need to ensure that biodiversity is not being lost. PMID:26991737

  17. Accounting for health spending in developing countries.

    PubMed

    Raciborska, Dorota A; Hernández, Patricia; Glassman, Amanda

    2008-01-01

    Data on health system financing and spending, together with information on the disease prevalence and cost-effectiveness of interventions, constitute essential input into health policy. It is particularly critical in developing countries, where resources are scarce and the marginal dollar has a major impact. Yet regular monitoring of health spending tends to be absent from those countries, and the results of international efforts to stimulate estimation activities have been mixed. This paper offers a history of health spending measurement, describes alternative sources of data, and recommends improving international collaboration and advocacy with the private sector for the way forward.

  18. Computer-aided evaluation of radiologist's reproducibility and subjectivity in mammographic density assessment.

    PubMed

    Tomas, Ilijan; Kotoromanović, Zdenka; Belaj, Nenad; Margaretić, Damir; Ivezić, Zdravko; Katić, Miroslav; Zibar, Lada; Faj, Dario; Stimac, Damir; Matić, Mate

    2013-12-01

    Mammographic density is an independent risk of breast cancer. This study has evaluated the radiologists' reproducibility and subjectivity in breast density estimation and in order to decrease the radiologists' subjective errors the computer software was developed. The very good reproducibility existed in the strong correlation with the first and the second mammogram assessment after three month period for each radiologist (correlation coefficient 0.73-1, p < 0.001). The strong correlation was present in the case of all 5 radiologists when compared among themselves and compared with software aided MDEST-Mammographic Density Estimation (correlation coefficient 0.651-0.777, p < 0.001). Detected differences in glandular tissue percentage determination occurred in the case of two experienced radiologists, out of 5 (one radiologist with more than 5 year experience and one with more than 10 year experience, p < 0.01), but in the case of breast type determination (American College of Radiology-ACR I-IV), the detected difference occurred in one radiologist with the least experience (less than 5 years, p < 0.001). It can be concluded that the estimation of glandular tissue percentage in breast density is rather subjective method, especially if it is expressed with absolute percentage, but the determination of type of breast (ARCI-IV) depends on the radiologist's experience. This study showed that software aided determination of glandular tissue percentage and breast type can be of a great benefit in the case of less experienced radiologists.

  19. Financial Aid.

    ERIC Educational Resources Information Center

    Graves, Mary A.

    This workbook assists college and vocational school bound American Indian students in determining their financial needs and in locating sources of financial aid. A checklist helps students assess the state of their knowledge of financial programs; a glossary defines terms pertinent to the realm of financial aid (i.e., graduate study programs,…

  20. Retail Clinic Visits For Low-Acuity Conditions Increase Utilization And Spending.

    PubMed

    Ashwood, J Scott; Gaynor, Martin; Setodji, Claude M; Reid, Rachel O; Weber, Ellerie; Mehrotra, Ateev

    2016-03-01

    Retail clinics have been viewed by policy makers and insurers as a mechanism to decrease health care spending, by substituting less expensive clinic visits for more expensive emergency department or physician office visits. However, retail clinics may actually increase spending if they drive new health care utilization. To assess whether retail clinic visits represent new utilization or a substitute for more expensive care, we used insurance claims data from Aetna for the period 2010-12 to track utilization and spending for eleven low-acuity conditions. We found that 58 percent of retail clinic visits for low-acuity conditions represented new utilization and that retail clinic use was associated with a modest increase in spending, of $14 per person per year. These findings do not support the idea that retail clinics decrease health care spending. PMID:26953299

  1. Governmental spending for mental retardation and developmental disabilities, 1977-1984.

    PubMed

    Braddock, D; Hemp, R

    1986-07-01

    A study of public spending for mental retardation and developmental disabilities in fiscal years 1977 through 1984 reveals that combined state and federal government spending grew by 23 percent despite diminished growth in federal spending after passage of the Omnibus Budget Reconciliation Act of 1981. Combined state and federal expenditures for community services grew by 40 percent, primarily because of an unprecedented rise in state spending. Total state and federal spending for institutional services plateaued, as a 26 percent drop in state appropriations was offset by an infusion of federal dollars, mostly through the Intermediate Care Facilities for the Mentally Retarded program. Federal, state, and local expenditures in fiscal 1984, estimated to total $16.49 billion, are assessed, and future trends in the financing of institutional and community services in the U.S. are discussed.

  2. [Does the subjective assessment of roughness correlate with a computer-aided measurement of irregularity index?].

    PubMed

    Ptok, M; Iven, C; Jessen, M; Schwemmle, C

    2006-02-01

    For routine clinical purposes dysphonic voices are assessed using the GRBAS scale or analogues. An objective measurement often includes jitter measurements. Here we raised the question of whether roughness estimates correlate with a computer-aided measurement of the vocal fold cycle irregularity in 78 patients who read a standard text ("Nordwind und Sonne"). The samples were evaluated by 19 speech and voice therapy students according to the degree of roughness. The irregularity index was calculated according to the procedures suggested by Fourcin. Data were subjected to correlation analysis. A significant correlation was found between the irregularity index and the subjective roughness scaling. These data indicate that objective measurements of vibratory cycle irregularity during text reading can be used for clinical purposes in addition to subjective roughness scaling. PMID:15868131

  3. [Does the subjective assessment of roughness correlate with a computer-aided measurement of irregularity index?].

    PubMed

    Ptok, M; Iven, C; Jessen, M; Schwemmle, C

    2006-02-01

    For routine clinical purposes dysphonic voices are assessed using the GRBAS scale or analogues. An objective measurement often includes jitter measurements. Here we raised the question of whether roughness estimates correlate with a computer-aided measurement of the vocal fold cycle irregularity in 78 patients who read a standard text ("Nordwind und Sonne"). The samples were evaluated by 19 speech and voice therapy students according to the degree of roughness. The irregularity index was calculated according to the procedures suggested by Fourcin. Data were subjected to correlation analysis. A significant correlation was found between the irregularity index and the subjective roughness scaling. These data indicate that objective measurements of vibratory cycle irregularity during text reading can be used for clinical purposes in addition to subjective roughness scaling.

  4. Development and assessment of a clinically viable system for breast ultrasound computer-aided diagnosis

    NASA Astrophysics Data System (ADS)

    Gruszauskas, Nicholas Peter

    The chances of surviving a breast cancer diagnosis as well as the effectiveness of any potential treatments increase significantly with early detection of the disease. As such, a considerable amount of research is being conducted to augment the breast cancer detection and diagnosis process. One such area of research involves the investigation and application of sophisticated computer algorithms to assist clinicians in detecting and diagnosing breast cancer on medical images (termed generally as "computer-aided diagnosis" or CAD). This study investigated a previously-developed breast ultrasound CAD system with the intent of translating it into a clinically-viable system. While past studies have demonstrated that breast ultrasound CAD may be a beneficial aid during the diagnosis of breast cancer on ultrasound, there are no investigations concerning its potential clinical translation and there are currently no commercially-available implementations of such systems. This study "bridges the gap" between the laboratory-developed system and the steps necessary for clinical implementation. A novel observer study was conducted that mimicked the clinical use of the breast ultrasound CAD system in order to assess the impact it had on the diagnostic performance of the user. Several robustness studies were also performed: the sonographic features used by the system were evaluated and the databases used for calibration and testing were characterized, the effect of the user's input was assessed by evaluating the performance of the system with variations in lesion identification and image selection, and the performance of the system on different patient populations was investigated by evaluating its performance on a database consisting solely of patients with Asian ethnicity. The analyses performed here indicate that the breast ultrasound CAD system under investigation is robust and demonstrates only minor variability when subjected to "real-world" use. All of these results are

  5. Computer-aided assessment of anomalies in the scoliotic spine in 3-D MRI images.

    PubMed

    Jäger, Florian; Hornegger, Joachim; Schwab, Siegfried; Janka, Rolf

    2009-01-01

    The assessment of anomalies in the scoliotic spine using Magnetic Resonance Imaging (MRI) is an essential task during the planning phase of a patient's treatment and operations. Due to the pathologic bending of the spine, this is an extremely time consuming process as an orthogonal view onto every vertebra is required. In this article we present a system for computer-aided assessment (CAA) of anomalies in 3-D MRI images of the spine relying on curved planar reformations (CPR). We introduce all necessary steps, from the pre-processing of the data to the visualization component. As the core part of the framework is based on a segmentation of the spinal cord we focus on this. The proposed segmentation method is an iterative process. In every iteration the segmentation is updated by an energy based scheme derived from Markov random field (MRF) theory. We evaluate the segmentation results on public available clinical relevant 3-D MRI data sets of scoliosis patients. In order to assess the quality of the segmentation we use the angle between automatically computed planes through the vertebra and planes estimated by medical experts. This results in a mean angle difference of less than six degrees.

  6. Diabetes, Its Treatment, and Catastrophic Medical Spending in 35 Developing Countries

    PubMed Central

    Smith-Spangler, Crystal M.; Bhattacharya, Jay; Goldhaber-Fiebert, Jeremy D.

    2012-01-01

    OBJECTIVE To assess the individual financial impact of having diabetes in developing countries, whether diabetic individuals possess appropriate medications, and the extent to which health insurance may protect diabetic individuals by increasing medication possession or decreasing the risk of catastrophic spending. RESEARCH DESIGN AND METHODS Using 2002–2003 World Health Survey data (n = 121,051 individuals; 35 low- and middle-income countries), we examined possession of medications to treat diabetes and estimated the relationship between out-of-pocket medical spending (2005 international dollars), catastrophic medical spending, and diabetes. We assessed whether health insurance modified these relationships. RESULTS Diabetic individuals experience differentially higher out-of-pocket medical spending, particularly among individuals with high levels of spending (excess spending of $157 per year [95% CI 130–184] at the 95th percentile), and a greater chance of incurring catastrophic medical spending (17.8 vs. 13.9%; difference 3.9% [95% CI 0.2–7.7]) compared with otherwise similar individuals without diabetes. Diabetic individuals with insurance do not have significantly lower risks of catastrophic medical spending (18.6 vs. 17.7%; difference not significant), nor were they significantly more likely to possess diabetes medications (22.8 vs. 20.6%; difference not significant) than those who were otherwise similar but without insurance. These effects were more pronounced and significant in lower-income countries. CONCLUSIONS In low-income countries, despite insurance, diabetic individuals are more likely to experience catastrophic medical spending and often do not possess appropriate medications to treat diabetes. Research into why policies in these countries may not adequately protect people from catastrophic spending or enhance possession of critical medications is urgently needed. PMID:22238276

  7. A Model for Integrating a Job-Aiding, Training, and Performance Assessment System--A Preliminary Concept Paper. Final Technical Paper for Period June-August 1985.

    ERIC Educational Resources Information Center

    Kline, Charles R., Jr.; Lester, Mark

    This paper presents a model for an integrated system used for job-aiding, training, and performance assessment for persons who maintain systems of various types. The model is driven by updatable job aids, by integrated human-machine heuristics, and by an expanding matrix of maintenance activities. The model uses the job-aiding base, updated by…

  8. Aiding alternatives assessment with an uncertainty-tolerant hazard scoring method.

    PubMed

    Faludi, Jeremy; Hoang, Tina; Gorman, Patrick; Mulvihill, Martin

    2016-11-01

    This research developed a single-score system to simplify and clarify decision-making in chemical alternatives assessment, accounting for uncertainty. Today, assessing alternatives to hazardous constituent chemicals is a difficult task-rather than comparing alternatives by a single definitive score, many independent toxicological variables must be considered at once, and data gaps are rampant. Thus, most hazard assessments are only comprehensible to toxicologists, but business leaders and politicians need simple scores to make decisions. In addition, they must balance hazard against other considerations, such as product functionality, and they must be aware of the high degrees of uncertainty in chemical hazard data. This research proposes a transparent, reproducible method to translate eighteen hazard endpoints into a simple numeric score with quantified uncertainty, alongside a similar product functionality score, to aid decisions between alternative products. The scoring method uses Clean Production Action's GreenScreen as a guide, but with a different method of score aggregation. It provides finer differentiation between scores than GreenScreen's four-point scale, and it displays uncertainty quantitatively in the final score. Displaying uncertainty also illustrates which alternatives are early in product development versus well-defined commercial products. This paper tested the proposed assessment method through a case study in the building industry, assessing alternatives to spray polyurethane foam insulation containing methylene diphenyl diisocyanate (MDI). The new hazard scoring method successfully identified trade-offs between different alternatives, showing finer resolution than GreenScreen Benchmarking. Sensitivity analysis showed that different weighting schemes in hazard scores had almost no effect on alternatives ranking, compared to uncertainty from data gaps. PMID:27454102

  9. Categorization framework to aid exposure assessment of nanomaterials in consumer products.

    PubMed

    Hansen, Steffen Foss; Michelson, Evan S; Kamper, Anja; Borling, Pernille; Stuer-Lauridsen, Frank; Baun, Anders

    2008-07-01

    Exposure assessment is crucial for risk assessment for nanomaterials. We propose a framework to aid exposure assessment in consumer products. We determined the location of the nanomaterials and the chemical identify of the 580 products listed in the inventory maintained by the Woodrow Wilson International Center for Scholars, of which 37% used nanoparticles suspended in liquids, whereas <1% contained "free airborne nanoparticles". C(60) is currently only used as suspended nanoparticles in liquids and nanosilver is used more as surface bound nanoparticles than as particles suspended in liquids. Based on the location of the nanostructure we were able to further group the products into categories of: (1) expected, (2) possible, and (3) no expected exposure. Most products fall into the category of expected exposure, but we were not able to complete a quantitative exposure assessment mainly due to the lack of information on the concentration of the nanomaterial in the products--a problem that regulators and industry will have to address if we are to have realistic exposure assessment in the future. To illustrate the workability of our procedure, we applied it to four product scenarios using the best estimates available and/or worst-case assumptions. Using the best estimates available and/or worst-case assumptions we estimated the consumer exposure to be 26, 15, and 44 microg kg(-1) bw year(-1) for a facial lotion, a fluid product, and a spray product containing nanoparticles, respectively. The application of sun lotion containing 2% nanoparticles result in an exposure of 56.7 mg kg(-1) bw d(-1) for a 2-year-old child, if the amounts applied correspond to the European Commission recommendations on use of sunscreen.

  10. Aiding alternatives assessment with an uncertainty-tolerant hazard scoring method.

    PubMed

    Faludi, Jeremy; Hoang, Tina; Gorman, Patrick; Mulvihill, Martin

    2016-11-01

    This research developed a single-score system to simplify and clarify decision-making in chemical alternatives assessment, accounting for uncertainty. Today, assessing alternatives to hazardous constituent chemicals is a difficult task-rather than comparing alternatives by a single definitive score, many independent toxicological variables must be considered at once, and data gaps are rampant. Thus, most hazard assessments are only comprehensible to toxicologists, but business leaders and politicians need simple scores to make decisions. In addition, they must balance hazard against other considerations, such as product functionality, and they must be aware of the high degrees of uncertainty in chemical hazard data. This research proposes a transparent, reproducible method to translate eighteen hazard endpoints into a simple numeric score with quantified uncertainty, alongside a similar product functionality score, to aid decisions between alternative products. The scoring method uses Clean Production Action's GreenScreen as a guide, but with a different method of score aggregation. It provides finer differentiation between scores than GreenScreen's four-point scale, and it displays uncertainty quantitatively in the final score. Displaying uncertainty also illustrates which alternatives are early in product development versus well-defined commercial products. This paper tested the proposed assessment method through a case study in the building industry, assessing alternatives to spray polyurethane foam insulation containing methylene diphenyl diisocyanate (MDI). The new hazard scoring method successfully identified trade-offs between different alternatives, showing finer resolution than GreenScreen Benchmarking. Sensitivity analysis showed that different weighting schemes in hazard scores had almost no effect on alternatives ranking, compared to uncertainty from data gaps.

  11. Selecting Appropriate Tests to Assess the Benefits of Bilateral Amplification With Hearing Aids

    PubMed Central

    Schulte, Michael; Boymans, Monique; Wagener, Kirsten C.; Dreschler, Wouter A.; Kollmeier, Birger

    2016-01-01

    The aim of this study was to investigate the effect of bilateral hearing aids (HA) in subjects with mild and moderate-to-severe hearing loss. This study was designed as a within-subject feasibility study. Bilateral HA use was assessed using different laboratory tests on speech reception, listening effort, noise tolerance, and localization. All data were evaluated with bilateral and unilateral HA fittings. Forty experienced bilateral HA users were included with hearing impairment ranging from mild to moderate-to-severe. Subjects were stratified into two groups based on the degree of hearing loss. Speech reception in noise, listening effort, and localization tests showed a bilateral benefit for the moderate-to-severely hearing-impaired subjects. A bilateral benefit was also observed for listening effort in the mildly hearing-impaired group. The assessment of listening effort shows promise as a measure of bilateral HA benefit for mild hearing impairment. Localization and speech reception in noise tests provide additional value for larger losses. The next step is to compare experienced unilateral with bilateral HA users. PMID:27460871

  12. Computer-aided bone age assessment for ethnically diverse older children using integrated fuzzy logic system

    NASA Astrophysics Data System (ADS)

    Ma, Kevin; Moin, Paymann; Zhang, Aifeng; Liu, Brent

    2010-03-01

    Bone Age Assessment (BAA) of children is a clinical procedure frequently performed in pediatric radiology to evaluate the stage of skeletal maturation based on the left hand x-ray radiograph. The current BAA standard in the US is using the Greulich & Pyle (G&P) Hand Atlas, which was developed fifty years ago and was only based on Caucasian population from the Midwest US. To bring the BAA procedure up-to-date with today's population, a Digital Hand Atlas (DHA) consisting of 1400 hand images of normal children of different ethnicities, age, and gender. Based on the DHA and to solve inter- and intra-observer reading discrepancies, an automatic computer-aided bone age assessment system has been developed and tested in clinical environments. The algorithm utilizes features extracted from three regions of interests: phalanges, carpal, and radius. The features are aggregated into a fuzzy logic system, which outputs the calculated bone age. The previous BAA system only uses features from phalanges and carpal, thus BAA result for children over age of 15 is less accurate. In this project, the new radius features are incorporated into the overall BAA system. The bone age results, calculated from the new fuzzy logic system, are compared against radiologists' readings based on G&P atlas, and exhibits an improvement in reading accuracy for older children.

  13. A multicenter trial of an assess-and-fit hearing aid service using open canal fittings and comply ear tips.

    PubMed

    Smith, Pauline; Mack, Angela; Davis, Adrian

    2008-06-01

    Large potential benefits have been suggested for an assess-and-fit approach to hearing health care, particularly using open canal fittings. However, the clinical effectiveness has not previously been evaluated, nor has the efficiency of this approach in a National Health Service setting. These two outcomes were measured in a variety of clinical settings in the United Kingdom. Twelve services in England and Wales participated, and 540 people with hearing problems, not previously referred for assessment, were included. Of these, 68% (n = 369) were suitable and had hearing aids fitted to NAL NL1 during the assess-and-fit visit using either open ear tips, or Comply ear tips. The Glasgow Hearing Aid Benefit Profile was used to compare patients fitted with open ear tips with a group of patients from the English Modernization of Hearing Aid Services evaluation, who used custom earmolds. This showed a significant improvement in outcome for those with open ear tips after allowing for age and hearing loss in the analysis. In particular, the benefits of using bilateral open ear tips were significantly larger than bilateral custom earmolds. This assess-and-fit model showed a mean service efficiency gain of about 5% to 10%. The actual gain will depend on current practice, in particular on the separate appointments used, the numbers of patients failing to attend appointments, and the numbers not accepting a hearing aid solution for their problem. There are potentially further efficiency and quality gains to be made if patients are appropriately triaged before referral.

  14. Design and Evaluation of a Protocol to Assess Electronic Travel Aids for Persons Who Are Visually Impaired

    ERIC Educational Resources Information Center

    Havik, Else M.; Steyvers, Frank J. J. M.; van der Velde, Hanneke; Pinkster, J. Christiaan; Kooijman, Aart C.

    2010-01-01

    This study evaluated a protocol that was developed to assess how beneficial electronic travel aids are for persons who are visually impaired. Twenty persons with visual impairments used an electronic travel device (Trekker) for six weeks to conform to the protocol, which proved useful in identifying successful users of the device. (Contains 2…

  15. An Assessment of the Policies and Programmes of Zimbabwe in Addressing the HIV/Aids Epidemic in the Education Sector

    ERIC Educational Resources Information Center

    Rembe, Symphorosa

    2006-01-01

    This study assessed the policies, strategic plans and structures that have been put in place in Zimbabwe to address the HIV/AIDS epidemic in the education sector. It also examined the comprehensiveness of projects and programmes currently being implemented by the government in collaboration with partner organisations and NGOs. The findings show…

  16. Assessment of the Effectiveness of the Educational Environment Supported by Computer Aided Presentations at Primary School Level

    ERIC Educational Resources Information Center

    Kose, Erdogan

    2009-01-01

    The objective of this study is to assess the effectiveness of the educational environment supported by computer aided presentations at primary school. The effectiveness of the environment has been evaluated in terms of students' learning and remembering what they have learnt. In the study, we have compared experimental group and control group in…

  17. Use of the Satisfaction With Amplification in Daily Life Questionnaire to Assess Patient Satisfaction Following Remote Hearing Aid Adjustments (Telefitting)

    PubMed Central

    Bento, Ricardo Ferreira; Battistella, Linamara Rizzo

    2014-01-01

    Background Hearing loss can affect approximately 15% of the pediatric population and up to 40% of the adult population. The gold standard of treatment for hearing loss is amplification of hearing thresholds by means of a hearing aid instrument. A hearing aid is an electronic device equipped with a topology of only three major components of aggregate cost. The gold standard of hearing aid fittings is face-to-face appointments in hearing aid centers, clinics, or hospitals. Telefitting encompasses the programming and adjustments of hearing aid settings remotely. Fitting hearing aids remotely is a relatively simple procedure, using minimal computer hardware and Internet access. Objective This project aimed to examine the feasibility and outcomes of remote hearing aid adjustments (telefitting) by assessing patient satisfaction via the Portuguese version of the Satisfaction With Amplification in Daily Life (SADL) questionnaire. Methods The Brazilian Portuguese version of the SADL was used in this experimental research design. Participants were randomly selected through the Rehabilitation Clinical (Espaco Reouvir) of the Otorhinolaryngology Department Medical School University of Sao Paulo. Of the 8 participants in the study, 5 were female and 3 were male, with a mean age of 71.5 years. The design consisted of two face-to-face sessions performed within 15 working days of each other. The remote assistance took place 15 days later. Results The average scores from this study are above the mean scores from the original SADL normative data. These indicate a high level of satisfaction in participants who were fitted remotely. Conclusions The use of an evaluation questionnaire is a simple yet effective method to objectively assess the success of a remote fitting. Questionnaire outcomes can help hearing stakeholders improve the National Policy on Hearing Health Care in Brazil. The results of this project indicated that patient satisfaction levels of those fitted remotely were

  18. Age and sex structured model for assessing the demographic impact of mother-to-child transmission of HIV/AIDS.

    PubMed

    Mukandavire, Z; Garira, W

    2007-08-01

    Age and sex structured HIV/AIDS model with explicit incubation period is proposed as a system of delay differential equations. The model consists of two age groups that are children (0-14 years) and adults (15-49 years). Thus, the model considers both mother-to-child transmission (MTCT) and heterosexual transmission of HIV in a community. MTCT can occur prenatally, at labour and delivery or postnatally through breastfeeding. In the model, we consider the children age group as a one-sex formulation and divide the adult age group into a two-sex structure consisting of females and males. The important mathematical features of the model are analysed. The disease-free and endemic equilibria are found and their stabilities investigated. We use the Lyapunov functional approach to show the local stability of the endemic equilibrium. Qualitative analysis of the model including positivity and boundedness of solutions, and persistence are also presented. The basic reproductive number ([Symbol: see text](0)) for the model shows that the adult population is responsible for the spread HIV/AIDS epidemic, thus up-to-date developed HIV/AIDS models to assess intervention strategies have focused much on heterosexual transmission by the adult population and the children population has received little attention. We numerically analyse the HIV/AIDS model to assess the community benefits of using antiretroviral drugs in reducing MTCT and the effects of breastfeeding in settings with high HIV/AIDS prevalence ratio using demographic and epidemiological parameters for Zimbabwe.

  19. Public health spending in 2008: on the challenge of integrating PHSSR data sets and the need for harmonization.

    PubMed

    Leider, Jonathon P; Sellers, Katie; Shah, Gulzar; Pearsol, Jim; Jarris, Paul E

    2012-01-01

    In recent years, state and local public health department budgets have been cut, sometimes drastically. However, there is no systematic tracking of governmental public health spending that would allow researchers to assess these cuts in comparison with governmental public health spending as a whole. Furthermore, attempts to quantify the impact of public health spending are limited by the lack of good data on public health spending on state and local public health services combined. The objective of this article is to integrate self-reported state and local health department (LHD) survey data from 2 major national organizations to create state-level estimates of governmental public health spending. To create integrated estimates, we selected 1388 LHDs and 46 states that had reported requisite financial information. To account for the nonrespondent LHDs, estimates of the spending were developed by using appropriate statistical weights. Finally, funds from federal pass-through and state sources were estimated for LHDs and subtracted from the total spending by the state health agency to avoid counting these dollars in both state and local figures. On average, states spend $106 per capita on traditional public health at the state and local level, with an average of 42% of spending occurring at the local level. Considerable variation exists in state and local public health funding. The results of this analysis show a relatively low level of public health funding compared with state Medicaid spending and health care more broadly.

  20. Public health spending in 2008: on the challenge of integrating PHSSR data sets and the need for harmonization.

    PubMed

    Leider, Jonathon P; Sellers, Katie; Shah, Gulzar; Pearsol, Jim; Jarris, Paul E

    2012-01-01

    In recent years, state and local public health department budgets have been cut, sometimes drastically. However, there is no systematic tracking of governmental public health spending that would allow researchers to assess these cuts in comparison with governmental public health spending as a whole. Furthermore, attempts to quantify the impact of public health spending are limited by the lack of good data on public health spending on state and local public health services combined. The objective of this article is to integrate self-reported state and local health department (LHD) survey data from 2 major national organizations to create state-level estimates of governmental public health spending. To create integrated estimates, we selected 1388 LHDs and 46 states that had reported requisite financial information. To account for the nonrespondent LHDs, estimates of the spending were developed by using appropriate statistical weights. Finally, funds from federal pass-through and state sources were estimated for LHDs and subtracted from the total spending by the state health agency to avoid counting these dollars in both state and local figures. On average, states spend $106 per capita on traditional public health at the state and local level, with an average of 42% of spending occurring at the local level. Considerable variation exists in state and local public health funding. The results of this analysis show a relatively low level of public health funding compared with state Medicaid spending and health care more broadly. PMID:22635190

  1. Spending of HIV resources in Asia and Eastern Europe: systematic review reveals the need to shift funding allocations towards priority populations

    PubMed Central

    Craig, Andrew P; Thein, Hla-Hla; Zhang, Lei; Gray, Richard T; Henderson, Klara; Wilson, David; Gorgens, Marelize; Wilson, David P

    2014-01-01

    Introduction It is increasingly important to prioritize the most cost-effective HIV interventions. We sought to summarize the evidence on which types of interventions provide the best value for money in regions with concentrated HIV epidemics. Methods We conducted a systematic review of peer-reviewed and grey literature reporting measurements of cost-effectiveness or cost-benefit for HIV/AIDS interventions in Asia and Eastern Europe. We also collated HIV/AIDS spending assessment data from case-study countries in the region. Results We identified 91 studies for inclusion, 47 of which were from peer-reviewed journals. Generally, in concentrated settings, prevention of mother-to-child transmission programmes and prevention programmes targeting people who inject drugs and sex workers had lower incremental cost-effectiveness ratios than programmes aimed at the general population. The few studies evaluating programmes targeting men who have sex with men indicate moderate cost-effectiveness. Collation of prevention programme spending data from 12 countries in the region (none of which had generalized epidemics) indicated that resources for the general population/non-targeted was greater than 30% for eight countries and greater than 50% for five countries. Conclusions There is a misalignment between national spending on HIV/AIDS responses and the most affected populations across the region. In concentrated epidemics, scarce funding should be directed more towards most-at-risk populations. Reaching consensus on general principles of cost-effectiveness of programmes by epidemic settings is difficult due to inconsistent evaluation approaches. Adopting a standard costing, impact evaluation, benefits calculation, analysis and reporting framework would enable cross comparisons and improve HIV resource prioritization and allocation. PMID:24572053

  2. Lottery spending: a non-parametric analysis.

    PubMed

    Garibaldi, Skip; Frisoli, Kayla; Ke, Li; Lim, Melody

    2015-01-01

    We analyze the spending of individuals in the United States on lottery tickets in an average month, as reported in surveys. We view these surveys as sampling from an unknown distribution, and we use non-parametric methods to compare properties of this distribution for various demographic groups, as well as claims that some properties of this distribution are constant across surveys. We find that the observed higher spending by Hispanic lottery players can be attributed to differences in education levels, and we dispute previous claims that the top 10% of lottery players consistently account for 50% of lottery sales.

  3. Lottery Spending: A Non-Parametric Analysis

    PubMed Central

    Garibaldi, Skip; Frisoli, Kayla; Ke, Li; Lim, Melody

    2015-01-01

    We analyze the spending of individuals in the United States on lottery tickets in an average month, as reported in surveys. We view these surveys as sampling from an unknown distribution, and we use non-parametric methods to compare properties of this distribution for various demographic groups, as well as claims that some properties of this distribution are constant across surveys. We find that the observed higher spending by Hispanic lottery players can be attributed to differences in education levels, and we dispute previous claims that the top 10% of lottery players consistently account for 50% of lottery sales. PMID:25642699

  4. Comparison between computer-aided diagnosis and radiologists: assessment of pulmonary blood flow on chest radiographs.

    PubMed

    Kido, S; Arisawa, J; Kuriyama, K; Kuroda, C; Nakamura, H

    2000-01-01

    To evaluate the performance of a computer-aided diagnosis (CAD) scheme for estimating increased pulmonary blood flow on chest radiographs, we compared computerized assessment with findings by radiologists. Our CAD scheme extracts selectively linear opacities corresponding to vessels in regions of interest (ROIs) in the right upper and lower lung zones on digitized chest radiographs, and then calculates a radiographic index as a physical measure that reflects the area of the extracted opacities in selected ROIs. As a measure of increased pulmonary blood flow, the upper/lower radiographic index ratio was calculated for each patient. Seven radiologists estimated the degree of increased pulmonary blood flow for the same images of ROI sets presented on a cathode-ray tube monitor in a randomized order. Between the normal-pulmonary capillary wedge pressure (PCWP) group and increased-PCWP groups, there was no significant difference in performance between CAD and radiologists (p = 0.105). However, when the normal and mild PCWP groups were compared, the performance of CAD was superior to that of radiologists (p = 0.001). This study indicates that our CAD scheme is promising for quantitative estimation of increased pulmonary blood flow, especially in mild cases.

  5. Assessment of Alternative Student Aid Delivery Systems: Analytic Agenda for the Current System.

    ERIC Educational Resources Information Center

    Advanced Technology, Inc., Reston, VA.

    A guide for analyzing the effects of the current student aid delivery system and for estimating the effects of system alternatives is presented. Attention is directed to measures, data sources, and analysis methods needed to evaluate the effects of each delivery system activity on the various participants (e.g., lenders, financial aid applicants,…

  6. How people with HIV/AIDS manage and assess their use of complementary therapies: a qualitative analysis.

    PubMed

    Gillett, James; Pawluch, Dorothy; Cain, Roy

    2002-01-01

    The objective of this article is to provide a qualitative analysis of the practical concerns that people with HIV/AIDS have with regard to their use of complementary therapies. In-depth semistructured interviews were conducted with a diverse range of people with HIV/AIDS (N = 46). An inductive grounded approach was used to collect and analyze the data. There were five central concerns: (a) selecting which therapies to use, (b) judging which therapies work, (c) combining Western medicine with complementary therapies, (d) assessing the safety of complementary therapies, and (e) dealing with the barriers to the use of complementary therapies. A better understanding of the practical dimensions of complementary therapy use highlights the treatment and care issues that people with HIV/AIDS face and offers insights into the role that nurses might play in addressing some of these issues.

  7. An assessment of community readiness for HIV/AIDS preventive interventions in rural Bangladesh.

    PubMed

    Aboud, Frances; Huq, Nafisa Lira; Larson, Charles P; Ottisova, Livia

    2010-02-01

    Efforts to prevent HIV from becoming widespread among the youth population 15-24 years in Bangladesh are in the early stages. However, conservative religious and cultural norms may curtail the dissemination of needed information about sexuality and condoms. The community-readiness stages model was adopted as a framework for assessing the level of preparedness of community leaders to facilitate planned HIV prevention efforts. Six focus group discussions with three professional groups (teachers, businessmen, drugshop vendors) in Hobiganj district were conducted in late 2005, and a single multi-professional group made up of teachers, imams, and drugshop vendors was convened in early 2007 to assess changes. The audio recordings in Bangla were coded as were English translations. Everyone had heard of AIDS and regarded it as a potential catastrophe for the health, economy and social fabric of Bangladesh. Remarks concerning Stage 1-Vulnerability indicated that most did not believe their community to be at risk, though Bangladesh was. Remarks at Stage 2-Knowledge of Transmission were mostly vague but accurately identified sex, blood and needles as the main means of spread; however sex with sex workers was also mentioned in each group. Remarks at Stage 3-Prevention showed strong opposition to condoms for unmarried males and a preference for current means of forbidding sex outside of marriage. A few in each group recognized the importance of condoms for wayward youth. Stage 4-Planning discussions centered on raising awareness and fear, and a desire for government and media to take the lead. By 2007 participants articulated more realistic strategies that they themselves could, and had, implemented, but also raised barriers that authorities should help them overcome. The findings provide formative information on the constraints and opportunities of community groups as partners in HIV preventive interventions and strategies to help them move to a higher stage of readiness.

  8. Assessing Knowledge of, and Attitudes to, HIV/AIDS among University Students in the United Arab Emirates

    PubMed Central

    Haroun, Dalia; El Saleh, Ola; Wood, Lesley; Mechli, Rola; Al Marzouqi, Nada; Anouti, Samir

    2016-01-01

    Background The Middle East and North Africa (MENA) region is among the top two regions in the world with the fastest growing HIV epidemic. In this context, risks and vulnerability are high as the epidemic is on the rise with evidence indicating significantly increasing HIV prevalence, new HIV infections and AIDS-related deaths. Objective The aim of the survey was to assess HIV/AIDS knowledge and attitudes related to HIV/AIDS among a wide group of university students in the United Arab Emirates (UAE). Methods In a cross-sectional survey, a total sample of 2,294 students (406 male; 1,888 female) from four universities in three different Emirates in the UAE were approached to take part in the study. Students self-completed a questionnaire that was designed to measure their knowledge and attitudes to HIV/AIDS. Results The overall average knowledge score of HIV.AIDS was 61%. Non-Emirati and postgraduates demonstrated higher levels of knowledge compared to Emirati and undergraduate students respectively. No significant differences between males and females; and marital status were found. Eighty-five percent of students expressed negative attitudes towards people living with HIV, with Emirati and single students significantly holding more negative attitudes compared to non-Emiratis and those that are married respectively. Conclusions The findings provide strong evidence that there is a need to advocate for appropriate National HIV/AIDS awareness raising campaigns in universities to reduce the gaps in knowledge and decrease stigmatizing attitudes towards people living with HIV/AIDS. PMID:26913902

  9. Definition of a core set of quality indicators for the assessment of HIV/AIDS clinical care: a systematic review

    PubMed Central

    2013-01-01

    Background Several organizations and individual authors have been proposing quality indicators for the assessment of clinical care in HIV/AIDS patients. Nevertheless, the definition of a consensual core set of indicators remains controversial and its practical use is largely limited. This study aims not only to identify and characterize these indicators through a systematic literature review but also to propose a parsimonious model based on those most used. Methods MEDLINE, SCOPUS, Cochrane databases and ISI Web of Knowledge, as well as official websites of organizations dealing with HIV/AIDS care, were searched for articles and information proposing HIV/AIDS clinical care quality indicators. The ones that are on patient’s perspective and based on services set were excluded. Data extraction, using a predefined data sheet based on Cochrane recommendations, was done by one of the authors while a second author rechecked the extracted data for any inconsistency. Results A total of 360 articles were identified in our search query but only 12 of them met the inclusion criteria. We also identified one relevant site. Overall, we identified 65 quality indicators for HIV/AIDS clinical care distributed as following: outcome (n=15) and process-related (n=50) indicators; generic (n=36) and HIV/AIDS disease-specific (n=29) indicators; baseline examinations (n=19), screening (n=9), immunization (n=4), prophylaxis (n=5), HIV monitoring (n=16), and therapy (=12) indicators. Conclusions There are several studies that set up HIV clinical care indicators, with only a part of them useful to assess the HIV clinical care. More importantly, HIV/AIDS clinical care indicators need to be valid, reliable and most of all feasible. PMID:23809537

  10. Georgia State University Spending Patterns and the Atlanta Economy, 1983. Institutional Research Report No. 84-2.

    ERIC Educational Resources Information Center

    Posey, Ellen I.

    The economic impact of Georgia State University on Atlanta was assessed. The survey methodology of Salley (1976) was employed, and the differential expenditure multiplier was recomputed using local value added data. Attention was directed to: university enrollment, payroll, and spending; estimated student and staff spending; calculation of the…

  11. The Impact on Growth of Higher Efficiency of Public Spending on Schools. OECD Economics Department Working Papers No. 547

    ERIC Educational Resources Information Center

    Gonand, Frederic

    2007-01-01

    This paper assesses the impact on economic growth of increased efficiency of public spending in primary and lower-secondary education. Higher efficiency in public spending in schools can bolster growth through two main channels. On the one hand, it can allow a transfer of labour from the public sector to the business sector at unchanged…

  12. Spend Billions and They Will Come

    ERIC Educational Resources Information Center

    Fox, Bette-Lee

    2004-01-01

    People look at one billion dollars in one of two ways: if it is the result of the long, hard effort of years of fundraising, they rejoice; if it signifies an astronomical budget deficit, they cringe. How, then, should people respond as a community to reaching the $1 billion mark ($1,242,436,438, to be exact) in this year's spending for public…

  13. Funding and Spending: What Price Distance Education?

    ERIC Educational Resources Information Center

    Tate, Ormond; Hiiri, Allan

    This paper explains methods of handling information about real costs to develop a model that is then used to forecast future costs of specified distance education activities and to obtain funding for these activities. It is addressed to anyone concerned about acquiring and spending money in distance education--managers of systems and institutions,…

  14. Taxing & Spending in the Silver State.

    ERIC Educational Resources Information Center

    Nevada Public Affairs Review, 1979

    1979-01-01

    This issue of the "Nevada Public Affairs Review" focused primarily on the politics of state taxing and spending in Nevada. The articles present several aspects of this topic, including a comparison of taxation in Nevada with that in other states, an analysis of the growth of the gaming industry in Nevada, an argument for removing Nevada's tax on…

  15. Endowment Spending: Building a Stronger Policy Framework

    ERIC Educational Resources Information Center

    Sedlacek, Verne O.; Jarvis, William F.

    2010-01-01

    A large and growing body of work exists on the subject of endowment investing, but the equally important topic of endowment spending is treated less often. While the degree to which endowed institutions depend on their endowment for budgetary support varies widely, the market crisis of 2008-09 demonstrated that failure by the endowment to provide…

  16. [Assessment criteria in the choice of aids for the lifting of patients].

    PubMed

    Panciera, D; Menoni, O; Ricci, M G; Occhipinti, E

    1999-01-01

    A fundamental part of the prevention strategies aimed at reducing risk due to manual handling of patients is the use of appropriate aids. This paper defines the basic types of aids for hospital wards: patient lifting devices, aids for hygiene and minor aids; and also proposes a procedure for choice of the type of aid: the procedure uses a specific protocol and also analyzes work organization and the environmental features of the ward. The proposed criteria for choice concern in the first place the fundamental requirements of the equipment: safety for operator and patient, simplicity of use and comfort for the patient. Secondly the basic determinants for choice of the type of aid are the type of disabled patient usually present in the ward and the analysis of the movements made in handling patients. On this basis, for each type of aid, the specific features are defined which direct the choice of supply for the various wards that will be adequate and effective both in reducing risk due to manual handling of patients and in improving the comfort of the patients.

  17. Cultural adaptation of a survey to assess medical providers' knowledge of and attitudes towards HIV/AIDS in Albania.

    PubMed

    Morrison, Shane D; Rashidi, Vania; Banushi, Vilson H; Barbhaiya, Namrata J; Gashi, Valbona H; Sarnquist, Clea; Maldonado, Yvonne; Harxhi, Arjan

    2013-01-01

    Though the HIV/AIDS epidemic in Southeastern Europe is one of low reported prevalence, numerous studies have described the pervasiveness of medical providers' lack of knowledge of HIV/AIDS in the Balkans. This study sought to culturally adapt an instrument to assess medical providers' knowledge of and attitudes towards HIV/AIDS in Albania. Cultural adaptation was completed through development of a survey from previously validated instruments, translation of the survey into Albanian, blinded back translation, expert committee review of the draft instrument, focus group pre-testing with community- and University Hospital Center of Tirana-based physicians and nurses, and test-retest reliability testing. Blinded back translation of the instrument supported the initial translation with slight changes to the idiomatic and conceptual equivalences. Focus group pre-testing generally supported the instrument, yet some experiential and idiomatic changes were implemented. Based on unweighted kappa and/or prevalence adjusted bias adjusted kappa (PABAK), 20 of the 43 questions were deemed statistically significant at kappa and/or PABAK ≥0.5, while 12 others did not cross zero on the 95% confidence interval for kappa, indicating their probable significance. Subsequently, an instrument to assess medical providers' knowledge of and attitudes toward HIV/AIDS for an Albanian population was developed which can be expanded within Albania and potentially to other countries within the Balkans, which have an Albanian-speaking population.

  18. Microfinance and HIV/AIDS Prevention: Assessing its Promise and Limitations

    PubMed Central

    Dworkin, Shari L.; Blankenship, Kim

    2013-01-01

    Researchers increasingly argue that poverty and gender inequality exacerbate the spread of HIV/AIDS and that economic empowerment can therefore assist in the prevention and mitigation of the disease, particularly for women. This paper critically evaluates such claims. First, we examine the promises and limits of integrated HIV/AIDS prevention and microfinance programs by examining the available evidence base. We then propose future research agendas and next steps that may help to clear current ambiguities about the potential for economic programs to contribute to HIV/AIDS risk reduction efforts. PMID:19294500

  19. Health Spending by State of Residence, 1991–2009

    PubMed Central

    Cuckler, Gigi; Martin, Anne; Whittle, Lekha; Heffler, Stephen; Sisko, Andrea; Lassman, Dave; Benson, Joseph

    2011-01-01

    Objective Provide a detailed discussion of baseline health spending by state of residence (per capita personal health care spending, per enrollee Medicare spending, and per enrollee Medicaid spending) in 2009, over the last decade (1998–2009), as well as the differential regional and state impacts of the recent recession. Data Source State Health Expenditures by State of Residence for 1991–2009, produced by the Centers for Medicare & Medicaid Services' Office of the Actuary. Principal Findings In 2009, the 10 states where per capita spending was highest ranged from 13 to 36 percent higher than the national average, and the 10 states where per capita spending was lowest ranged from 8 to 26 percent below the national average. States with the highest per capita spending tended to have older populations and the highest per capita incomes; states with the lowest per capita spending tended to have younger populations, lower per capita incomes, and higher rates of uninsured. Over the last decade, the New England and Mideast regions exhibited the highest per capita personal health care spending, while states in the Southwest and Rocky Mountain regions had the lowest per capita spending. Variation in per enrollee Medicaid spending, however, has consistently been greater than that of total per capita personal health care spending or per enrollee Medicare spending from 1998–2009. The Great Lakes, New England, and Far West regions experienced the largest slowdown in per person health spending growth during the recent recession, largely as a result of higher unemployment rates. PMID:22340779

  20. Knowledge-based computer-aided detection of masses on digitized mammograms: a preliminary assessment.

    PubMed

    Chang, Y H; Hardesty, L A; Hakim, C M; Chang, T S; Zheng, B; Good, W F; Gur, D

    2001-04-01

    The purpose of this work was to develop and evaluate a computer-aided detection (CAD) scheme for the improvement of mass identification on digitized mammograms using a knowledge-based approach. Three hundred pathologically verified masses and 300 negative, but suspicious, regions, as initially identified by a rule-based CAD scheme, were randomly selected from a large clinical database for development purposes. In addition, 500 different positive and 500 negative regions were used to test the scheme. This suspicious region pruning scheme includes a learning process to establish a knowledge base that is then used to determine whether a previously identified suspicious region is likely to depict a true mass. This is accomplished by quantitatively characterizing the set of known masses, measuring "similarity" between a suspicious region and a "known" mass, then deriving a composite "likelihood" measure based on all "known" masses to determine the state of the suspicious region. To assess the performance of this method, receiver-operating characteristic (ROC) analyses were employed. Using a leave-one-out validation method with the development set of 600 regions, the knowledge-based CAD scheme achieved an area under the ROC curve of 0.83. Fifty-one percent of the previously identified false-positive regions were eliminated, while maintaining 90% sensitivity. During testing of the 1,000 independent regions, an area under the ROC curve as high as 0.80 was achieved. Knowledge-based approaches can yield a significant reduction in false-positive detections while maintaining reasonable sensitivity. This approach has the potential of improving the performance of other rule-based CAD schemes.

  1. Quantitative assessment of the mucosal architecture of jejunal biopsy specimens: a comparison between linear measurement, stereology, and computer aided microscopy.

    PubMed Central

    Corazza, G R; Frazzoni, M; Dixon, M F; Gasbarrini, G

    1985-01-01

    Fifty jejunal biopsy specimens obtained from normal subjects and from untreated and treated patients with coeliac disease were assessed blindly by three independent observers, each of them using different morphometric techniques-namely, linear measurement, stereology, and computer aided microscopy. In two of 26 control biopsy specimens linear measurement was not possible because of distortion of villi. Highly significant (p less than 0.001) correlation coefficients were found between the different techniques. With all methods significant differences between controls and patients with coeliac disease and between treated and untreated coeliac patients were found. Only by stereology, however, was there no overlap between results for patients and those for controls. In view of the limitations of linear measurement and the high cost and complexity of computer aided microscopy, we propose that a simple stereological technique using an eyepiece graticule is the method of choice in the quantitative assessment of mucosal architecture in jejunal biopsy specimens. Images PMID:3894431

  2. Assessing the impact of AIDS on the growth path of the Malawian economy.

    PubMed

    Cuddington, J T; Hancock, J D

    1994-04-01

    More than 1% of people of sub-Saharan Africa aged 15-49 years are infected with HIV, with over half likely to develop AIDS in the next decade. As rates of HIV infection continue to climb, there will be staggering financial consequences to bear in the years ahead in terms of high medical treatment costs and crippled macroeconomies. The authors employ a modified Solow growth model to simulate the impact of the AIDS epidemic on output capacity and other key macroeconomic aggregates in Malawi. They compare a counterfactual no-AIDS scenario to medium and extreme AIDS projections and find that average real GDP growth over the 1985-2010 period will be 0.2-0.3 percentage points lower in the medium case and 1.2-1.5% lower in the extreme case relative to the no-AIDS case. The size of the economy by 2010 will therefore be reduced from a real GDP of 5.03 billion (constant 1985) Kwacha without AIDS to 4.81-4.77 and 3.80-3.46 billion Kwacha in the medium and extreme scenarios, respectively.

  3. A Multicenter Trial of an Assess-and-Fit Hearing Aid Service Using Open Canal Fittings and Comply Ear Tips

    PubMed Central

    Smith, Pauline; Mack, Angela; Davis, Adrian

    2008-01-01

    Large potential benefits have been suggested for an assess-and-fit approach to hearing health care, particularly using open canal fittings. However, the clinical effectiveness has not previously been evaluated, nor has the efficiency of this approach in a National Health Service setting. These two outcomes were measured in a variety of clinical settings in the United Kingdom. Twelve services in England and Wales participated, and 540 people with hearing problems, not previously referred for assessment, were included. Of these, 68% (n = 369) were suitable and had hearing aids fitted to NAL NL1 during the assess-and-fit visit using either open ear tips, or Comply ear tips. The Glasgow Hearing Aid Benefit Profile was used to compare patients fitted with open ear tips with a group of patients from the English Modernization of Hearing Aid Services evaluation, who used custom earmolds. This showed a significant improvement in outcome for those with open ear tips after allowing for age and hearing loss in the analysis. In particular, the benefits of using bilateral open ear tips were significantly larger than bilateral custom ear-molds. This assess-and-fit model showed a mean service efficiency gain of about 5% to 10%. The actual gain will depend on current practice, in particular on the separate appointments used, the numbers of patients failing to attend appointments, and the numbers not accepting a hearing aid solution for their problem. There are potentially further efficiency and quality gains to be made if patients are appropriately triaged before referral. PMID:18567593

  4. Medicaid hospital spending: Effects of reimbursement and utilization control policies

    PubMed Central

    Zuckerman, Stephen

    1987-01-01

    Numerous Medicaid hospital spending policies were developed following the passage of the 1981 Omnibus Budget Reconciliation Act. The impact of reimbursement and utilization control policies on Medicaid hospital spending was measured using Medicaid program data for 1977-84. Medicaid prospective reimbursement was found to contain real hospital spending by controlling spending per recipient. However, sustained reductions in the growth in real Medicaid spending are achieved only when Medicaid is included in a broader regulatory framework, not when it is the sole regulated payer. Prior authorization for specific services reduces growth in hospital spending by reducing the growth in inpatient recipients. PMID:10312394

  5. National Health Spending In 2014: Faster Growth Driven By Coverage Expansion And Prescription Drug Spending.

    PubMed

    Martin, Anne B; Hartman, Micah; Benson, Joseph; Catlin, Aaron

    2016-01-01

    US health care spending increased 5.3 percent to $3.0 trillion in 2014. On a per capita basis, health spending was $9,523 in 2014, an increase of 4.5 percent from 2013. The share of gross domestic product devoted to health care spending was 17.5 percent, up from 17.3 percent in 2013. The faster growth in 2014 that followed five consecutive years of historically low growth was primarily due to the major coverage expansions under the Affordable Care Act, particularly for Medicaid and private health insurance, which contributed to an increase in the insured share of the population. Additionally, the introduction of new hepatitis C drugs contributed to rapid growth in retail prescription drug expenditures, which increased by 12.2 percent in 2014. Spending by the federal government grew at a faster rate in 2014 than spending by other sponsors of health care, leading to a 2-percentage-point increase in its share of total health care spending between 2013 and 2014.

  6. Capitalization and the Incidence of School Aid.

    ERIC Educational Resources Information Center

    Wyckoff, Paul Gary

    2001-01-01

    Summarizes goals of state education aid, presents a conceptual model of aid's welfare effects, and examines the literature of tax and expenditure effects. Capitalization changes the relative desirability of two goals; equalizing resources across districts becomes less important than equalizing school districts' actual spending levels. (Contains 45…

  7. Federal block grants and state spending: the Alcohol, Drug Abuse, and Mental Health block grant and state agency behavior.

    PubMed

    Jacobsen, K; McGuire, T G

    1996-01-01

    With renewed interest in block grants as a way to channel federal funds to states, several questions arise about the effect of block grants on state spending. A central question about the block grant form of intergovernmental aid is whether states spend the funds on the intended services or use budgetary strategies to appear to be in compliance with maintenance-of-effort provisions but then reallocate block grant funds from the targeted program. We studied the effect of the Alcohol, Drug Abuse and Mental Health block grant program on state substance abuse expenditures by analyzing spending data from the fifty states between fiscal years 1987 and 1992. Our findings suggest that this block grant has stimulated state spending, but this effect may be relevant only since 1990, and differs among states. PMID:8892005

  8. Slow Pace for Race to Top Spending

    ERIC Educational Resources Information Center

    McNeil, Michele

    2012-01-01

    Almost two years into the federal Race to the Top program, states are spending their shares of the $4 billion prize at a snail's pace--a reflection of the challenges the 12 winners face as they try to get ambitious education improvement plans off the ground. Through the end of March, the 11 states and the District of Columbia had spent just 14…

  9. Assessment of left ventricular wall motion abnormalities with the use of color kinesis: a valuable visual and training aid.

    PubMed

    Lau, Y S; Puryear, J V; Gan, S C; Fowler, M B; Vagelos, R H; Popp, R L; Schnittger, I

    1997-01-01

    Accurate interpretation of left ventricular segmental wall motion by echocardiography is an important yet difficult skill to learn. Color-coded left ventricular wall motion (color kinesis) is a tool that potentially could aid in the interpretation and provide semiquantification. We studied the usefulness of color kinesis in 42 patients with a history of congestive cardiomyopathy who underwent two-dimensional echocardiograms and a color kinesis study. The expert's reading of the two-dimensional wall motion served as a reference for comparison of color kinesis studies interpreted by the expert and a cardiovascular trainee. Correlation between two-dimensional echocardiography and the expert's and trainee's color coded wall motion scores were r = 0.83 and r = 0.67, respectively. Reproducibility between reviewers and between operators was also assessed. Interobserver variability for color-coded wall motion showed a correlation of r = 0.78. Correlation between operators was also good; r = 0.84. Color kinesis is reliable and appears promising as an adjunct in the assessment of wall motion abnormalities by echocardiography. It is both a valuable visual aid, as well as a training aid for the cardiovascular trainee.

  10. Women Living with HIV in Rural Areas. Implementing a Response using the HIV and AIDS Risk Assessment and Reduction Model

    PubMed Central

    Bandali, Sarah

    2014-01-01

    The global fight against HIV is progressing; however, women living in rural areas particularly in sub-Saharan Africa (SSA) continue to face the devastating consequences of HIV and AIDS. Lack of knowledge and geographical barriers to HIV services are compounded by gender norms often limiting the negotiation of safe sexual practices among women living in rural areas. This paper discusses findings from a qualitative study conducted in rural areas of Mozambique examining factors that influenced women to engage in HIV risk-reduction practices. The findings from this study led to the emergence of an HIV and AIDS risk assessment and reduction (HARAR) model, which is described in detail. The model helps in understanding gender-related factors influencing men and women to engage in risk-reduction practices, which can be used as a framework in other settings to design more nuanced and contextual policies and programs. PMID:25089093

  11. AIDS Training in the Workplace.

    ERIC Educational Resources Information Center

    Vest, Jusanne M.; And Others

    1991-01-01

    Management training regarding Acquired Immune Deficiency Syndrome (AIDS) begins with three needs assessment tools--instruments measuring fear of AIDS, knowledge of AIDS, and beliefs about the business consequences of the disease. (SK)

  12. Dynamic Analysis of School Spending Referenda. Final Report.

    ERIC Educational Resources Information Center

    Romer, Thomas; Rosenthal, Howard

    The school spending model described in this report involves institutions and information based on the following reasoning. Where education spending must be approved by referenda, the school board seeks to obtain as large a budget as possible. Voters have to approve the budget proposal or accept the "reversion" level of spending--that statutorily…

  13. Assessment of Discharge Planning Referral to Nursing Homes for People with AIDS and HIV Infection.

    ERIC Educational Resources Information Center

    Linsk, Nathan L.; Marder, Reggi E.

    This study was conducted to identify efforts by hospital discharge planners to refer clients with human immunodeficiency virus (HIV) or Acquired Immune Deficiency Syndrome (AIDS) to nursing homes; to determine the responses of the facilities contacted; and to identify gaps in services, discharge planner practices, and relationships between…

  14. Assessing Pricing and Aid Strategies: Rethinking Planning and Evaluation Practices. AIR 1994 Annual Forum Paper.

    ERIC Educational Resources Information Center

    St. John, Edward P.

    This paper explores the need for a better understanding of the influences of prices and student aid on student enrollment and college budgets. The theory of net price has not been found to adequately explain changes in enrollment. Based on a critical review of recent research on student price response, this paper develops an alternative approach…

  15. Diagnostic Accuracy of Computer-Aided Assessment of Intranodal Vascularity in Distinguishing Different Causes of Cervical Lymphadenopathy.

    PubMed

    Ying, Michael; Cheng, Sammy C H; Ahuja, Anil T

    2016-08-01

    Ultrasound is useful in assessing cervical lymphadenopathy. Advancement of computer science technology allows accurate and reliable assessment of medical images. The aim of the study described here was to evaluate the diagnostic accuracy of computer-aided assessment of the intranodal vascularity index (VI) in differentiating the various common causes of cervical lymphadenopathy. Power Doppler sonograms of 347 patients (155 with metastasis, 23 with lymphoma, 44 with tuberculous lymphadenitis, 125 reactive) with palpable cervical lymph nodes were reviewed. Ultrasound images of cervical nodes were evaluated, and the intranodal VI was quantified using a customized computer program. The diagnostic accuracy of using the intranodal VI to distinguish different disease groups was evaluated and compared. Metastatic and lymphomatous lymph nodes tend to be more vascular than tuberculous and reactive lymph nodes. The intranodal VI had the highest diagnostic accuracy in distinguishing metastatic and tuberculous nodes with a sensitivity of 80%, specificity of 73%, positive predictive value of 91%, negative predictive value of 51% and overall accuracy of 68% when a cutoff VI of 22% was used. Computer-aided assessment provides an objective and quantitative way to evaluate intranodal vascularity. The intranodal VI is a useful parameter in distinguishing certain causes of cervical lymphadenopathy and is particularly useful in differentiating metastatic and tuberculous lymph nodes. However, it has limited value in distinguishing lymphomatous nodes from metastatic and reactive nodes.

  16. At the Intersection of HIV/AIDS and Cancer: A Qualitative Needs Assessment of Community-Based HIV/AIDS Service Organizations

    ERIC Educational Resources Information Center

    Burkhalter, Jack E.; Cahill, Sean; Shuk, Elyse; Guidry, John; Corner, Geoffrey; Berk, Alexandra; Candelario, Norman; Kornegay, Mark; Lubetkin, Erica I.

    2013-01-01

    Due to advances in treatment, persons living with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) are living longer, but with aging, immune deficits, and lifestyle factors, they are at increased risk for cancer. This challenges community-based AIDS service organizations (ASOs) to address the growing cancer needs of…

  17. Reforming Student Aid: How to Simplify Tax Aid and Use Performance Metrics to Improve College Choices and Completion

    ERIC Educational Resources Information Center

    Reimherr, Patrick; Harmon, Tim; Strawn, Julie; Choitz, Vickie

    2013-01-01

    Any reform of federal student aid must address the twin challenges of college affordability and completion, which are inextricably linked. Here, CLASP has proposed ways to redirect existing federal student aid spending toward the low- and modest income families who need it most. These are the students for whom federal aid makes a difference in…

  18. National health spending trends in 1996. National Health Accounts Team.

    PubMed

    Levit, K R; Lazenby, H C; Braden, B R

    1998-01-01

    The National Health Accounts, produced annually by the Health Care Financing Administration's Office of the Actuary, present estimates for 1960-1996 of nationwide spending for health care and the sources funding that care. This year's estimates set two records: Spending topped $1 trillion for the first time, and expenditure growth slowed to the lowest rate seen in thirty-seven years of measuring health care spending--4.4 percent. The combination of decelerating health spending and a growing economy has kept national health spending as a share of the nation's gross domestic product unchanged for the fourth consecutive year.

  19. Business, Households, and Governments: Health Spending, 1991

    PubMed Central

    Cowan, Cathy A.; McDonnell, Patricia A.

    1993-01-01

    Governments have been thrust to the forefront of health care reform efforts as growth in government health care costs was faster than growth in all other sponsor sectors in 1991. In the business sector, real health care costs per worker have risen 65 times faster than real wages and salaries per worker during the past 26 years. Households continue to devote 5 percent of income after taxes to health care, the same percentage for the last 8 years. This article presents data supporting these findings, and an analysis of health care spending by each sponsor sector. PMID:10130577

  20. Food security and nutrition interventions in response to the AIDS epidemic: assessing global action and evidence.

    PubMed

    Aberman, Noora-Lisa; Rawat, Rahul; Drimie, Scott; Claros, Joan M; Kadiyala, Suneetha

    2014-10-01

    The number of people receiving antiretroviral therapy in developing countries has increased dramatically. The last decade has brought an increased understanding of the interconnectedness between HIV/AIDS, food insecurity, and undernutrition and a surge of evidence on how to address the food security and nutrition dimensions of the epidemic. We review this evidence as well as the corresponding evolution of policy support for incorporating food security and nutrition concerns into HIV programming. The available evidence, although varied in scope and methodologies, shows that nutrition supplementation and safety nets in the form of food assistance and livelihood interventions have potential in certain contexts to improve food security and nutrition outcomes in an HIV/AIDS context. In the face of funding uncertainties and competing priorities, we must maintain momentum towards effective and sustainable solutions to the epidemic through continued systematic research to inform policy and through the strengthening of monitoring systems to dynamically inform intervention development.

  1. State Tobacco Control Program Spending--United States, 2011.

    PubMed

    Huang, Jidong; Walton, Kimp; Gerzoff, Robert B; King, Brian A; Chaloupka, Frank J

    2015-06-26

    Evidence-based, statewide tobacco control programs that are comprehensive, sustained, and accountable reduce smoking rates and tobacco-related diseases and deaths. States that made larger investments in tobacco prevention and control have seen larger declines in cigarettes sales than the United States as a whole, and the prevalence of smoking has declined faster as spending for tobacco control programs has increased. CDC's Best Practices for Comprehensive Tobacco Control Programs (Best Practices) outlines the elements of an evidence-based state tobacco control program and provides recommended state funding levels to substantially reduce tobacco-related disease, disability, and death. To analyze states' spending in relation to program components outlined within Best Practices, CDC assessed state tobacco control programs' expenditures for fiscal year 2011. In 2011, states spent approximately $658 million on tobacco control and prevention, which accounts for less than 3% of the states' revenues from the sale of tobacco products and only 17.8% of the level recommended by CDC. Evidence suggests that funding tobacco prevention and control efforts at the levels recommended in Best Practices could achieve larger and more rapid reductions in tobacco use and associated morbidity and mortality.

  2. Health spending, illicit financial flows and tax incentives in Malawi.

    PubMed

    O'Hare, B; Curtis, M

    2014-12-01

    This analysis examines the gaps in health care financing in Malawi and how foregone taxes could fill these gaps. It begins with an assessment of the disease burden and government health expenditure. Then it analyses the tax revenues foregone by the government of Malawi by two main routes: Illicit financial flows (IFF) from the country, Tax incentives. We find that there are significant financing gaps in the health sector; for example, government expenditure is United States Dollars (USD) 177 million for 2013/2014 while projected donor contribution in 2013/2014 is USD 207 million and the total cost for the minimal health package is USD 535 million. Thus the funding gap between the government budget for health and the required spending to provide the minimal package for 2013/2014 is USD 358 million. On the other hand we estimate that almost USD 400 million is lost through IFF and corporate utilization of tax incentives each year. The revenues foregone plus the current government health spending would be sufficient to cover the minimal public health package for all Malawians and would help tackle Malawi's disease burden. Every effort must be made, including improving transparency and revising laws, to curtail IFF and moderate tax incentives.

  3. Health spending, illicit financial flows and tax incentives in Malawi.

    PubMed

    O'Hare, B; Curtis, M

    2014-12-01

    This analysis examines the gaps in health care financing in Malawi and how foregone taxes could fill these gaps. It begins with an assessment of the disease burden and government health expenditure. Then it analyses the tax revenues foregone by the government of Malawi by two main routes: Illicit financial flows (IFF) from the country, Tax incentives. We find that there are significant financing gaps in the health sector; for example, government expenditure is United States Dollars (USD) 177 million for 2013/2014 while projected donor contribution in 2013/2014 is USD 207 million and the total cost for the minimal health package is USD 535 million. Thus the funding gap between the government budget for health and the required spending to provide the minimal package for 2013/2014 is USD 358 million. On the other hand we estimate that almost USD 400 million is lost through IFF and corporate utilization of tax incentives each year. The revenues foregone plus the current government health spending would be sufficient to cover the minimal public health package for all Malawians and would help tackle Malawi's disease burden. Every effort must be made, including improving transparency and revising laws, to curtail IFF and moderate tax incentives. PMID:26167264

  4. The U.S. employment effects of military and domestic spending priorities.

    PubMed

    Pollin, Robert; Garrett-Peltier, Heidi

    2009-01-01

    This study focuses on the employment effects of military spending versus alternative domestic spending priorities. The authors begin by introducing the basic input-output modeling technique for considering issues such as these in a systematic way. They then present some simple alternative spending scenarios-namely, devoting $1 billion to the military versus the same amount of money spent for five alternatives: tax cuts that produce increased levels of personal consumption; health care; education; mass transit; and construction targeted at home weatherization and infrastructure repair. The first conclusion in assessing such relative employment effects is straightforward: $1 billion spent on personal consumption, health care, education, mass transit, and construction for home weatherization/infrastructure will all create more jobs in the U.S. economy than would the same $1 billion spent on the military. The authors then examine the pay level of jobs created through these alternative spending priorities and assess the overall welfare effects of the alternative employment outcomes. Combining these alternative domestic spending categories in an effective way can also generate a higher level of compensation for working people in the United States and a better average quality ofjobs.

  5. Key findings: a qualitative assessment of provider and patient perceptions of HIV/AIDS in South Africa.

    PubMed

    Ransom, James; Johnson, Anton F

    2009-01-01

    In 1997, at the Davos International Economic Forum, Nelson Mandela stated that "the poor, the vulnerable, the unschooled, the socially marginalized, the women, and the children, those who bear the burden of colonial legacy-these are the sectors of society which bear the burden of AIDS" (Richter, 2001). Nearly a decade later, that statement still holds true, especially in Mr. Mandela's home country. South Africa continues to have one of the world's highest prevalence ratios of HIV infection (UNAIDS, 2002). This paper explores the significance of perceptions, knowledge, practices, and attitudes toward HIV/AIDS in two important groups in South Africa: health care providers based in public health clinics and their patients. This paper will assess the provider-patient interaction from the perspective of members of the South African HIV/AIDS treatment and prevention community. The analysis will examine the results of in-depth interviews and focus group discussions with providers and patients, respectively, in two of South Africa's nine provinces. Between December 2002 and April 2003 in Guateng and KwaZulu-Natal provinces, we conducted (1) in-depth interviews of a spectrum of health care providers at five local public health clinics and (2) focus groups of patients who patronize those clinics. The results show that there are gaps in the HIV/AIDS knowledge of some of the health care providers and that the participants' health beliefs and practices are embedded in the social conditions in which they live and work, which has a ripple effect on their risk behaviors and trumps any intervention messages from their health care providers and larger public health intervention messages. PMID:19229772

  6. Financial protection from health spending in the Philippines: policies and progress.

    PubMed

    Bredenkamp, Caryn; Buisman, Leander R

    2016-09-01

    The objective of this article is to assess the progress of the Philippines health sector in providing financial protection to the population, as measured by estimates of health insurance coverage, out-of-pocket spending, catastrophic payments and impoverishing health expenditures. Data are drawn from eight household surveys between 2000 and 2013, including two Demographic and Health Surveys, one Family Health Survey and five Family Income and Expenditure Surveys. We find that out-of-pocket spending increased by 150% (real) from 2000 to 2012, with the sharpest increases occurring in recent years. The main driver of health spending is medicines, accounting for almost two-thirds of total health spending, and as much as three-quarters among the poor. The incidence of catastrophic payments has tripled since 2000, from 2.5% to 7.7%. The percentage of people impoverished by health spending has also increased and, in 2012, out-of-pocket spending on health added 1.5 percentage points to the poverty rate, pushing more than 1.5 million people into poverty. In light of these findings, recent policies to enhance financial risk protection-such as the expansion of government-subsidized health insurance from the poor to the near-poor, a policy of zero copayments for the poor, a deepening of the benefit package and provider payment reform aimed at cost-containment-are to be commended. Indeed, between 2008 and 2013, self-reported health insurance coverage increased across all quintiles and its distribution became more pro-poor. To speed progress toward financial protection goals, quick wins could include issuing health insurance cards to the poor to increase awareness of coverage and limiting out-of-pocket spending by clearly defining a clear copayment structure for non-poor members. An in-depth analysis of the pharmaceutical sector would help to shed light on why medicines impose such a large financial burden on households. PMID:27072948

  7. Financial protection from health spending in the Philippines: policies and progress.

    PubMed

    Bredenkamp, Caryn; Buisman, Leander R

    2016-09-01

    The objective of this article is to assess the progress of the Philippines health sector in providing financial protection to the population, as measured by estimates of health insurance coverage, out-of-pocket spending, catastrophic payments and impoverishing health expenditures. Data are drawn from eight household surveys between 2000 and 2013, including two Demographic and Health Surveys, one Family Health Survey and five Family Income and Expenditure Surveys. We find that out-of-pocket spending increased by 150% (real) from 2000 to 2012, with the sharpest increases occurring in recent years. The main driver of health spending is medicines, accounting for almost two-thirds of total health spending, and as much as three-quarters among the poor. The incidence of catastrophic payments has tripled since 2000, from 2.5% to 7.7%. The percentage of people impoverished by health spending has also increased and, in 2012, out-of-pocket spending on health added 1.5 percentage points to the poverty rate, pushing more than 1.5 million people into poverty. In light of these findings, recent policies to enhance financial risk protection-such as the expansion of government-subsidized health insurance from the poor to the near-poor, a policy of zero copayments for the poor, a deepening of the benefit package and provider payment reform aimed at cost-containment-are to be commended. Indeed, between 2008 and 2013, self-reported health insurance coverage increased across all quintiles and its distribution became more pro-poor. To speed progress toward financial protection goals, quick wins could include issuing health insurance cards to the poor to increase awareness of coverage and limiting out-of-pocket spending by clearly defining a clear copayment structure for non-poor members. An in-depth analysis of the pharmaceutical sector would help to shed light on why medicines impose such a large financial burden on households.

  8. Interactive Voice Response Self-Monitoring to Assess Risk Behaviors in Rural Substance Users Living with HIV/AIDS

    PubMed Central

    Tucker, Jalie A.; Blum, Elizabeth R.; Xie, Lili; Roth, David L.; Simpson, Cathy A.

    2011-01-01

    Community-dwelling HIV/AIDS patients in rural Alabama self-monitored (SM) daily HIV risk behaviors using an Interactive Voice Response (IVR) system, which may enhance reporting, reduce monitored behaviors, and extend the reach of care. Sexually active substance users (35 men, 19 women) engaged in IVR SM of sex, substance use, and surrounding contexts for 4–10 weeks. Baseline predictors of IVR utilization were assessed, and longitudinal IVR SM effects on risk behaviors were examined. Frequent (n = 22), infrequent (n = 22), and non-caller (n = 10) groups were analyzed. Non-callers had shorter durations of HIV medical care and lower safer sex self-efficacy and tended to be older heterosexuals. Among callers, frequent callers had lost less social support. Longitudinal logistic regression models indicated reductions in risky sex and drug use with IVR SM over time. IVR systems appear to have utility for risk assessment and reduction for rural populations living with HIV disease. PMID:21311964

  9. Computer-aided assessment of pulmonary disease in novel swine-origin H1N1 influenza on CT

    NASA Astrophysics Data System (ADS)

    Yao, Jianhua; Dwyer, Andrew J.; Summers, Ronald M.; Mollura, Daniel J.

    2011-03-01

    The 2009 pandemic is a global outbreak of novel H1N1 influenza. Radiologic images can be used to assess the presence and severity of pulmonary infection. We develop a computer-aided assessment system to analyze the CT images from Swine-Origin Influenza A virus (S-OIV) novel H1N1 cases. The technique is based on the analysis of lung texture patterns and classification using a support vector machine (SVM). Pixel-wise tissue classification is computed from the SVM value. The method was validated on four H1N1 cases and ten normal cases. We demonstrated that the technique can detect regions of pulmonary abnormality in novel H1N1 patients and differentiate these regions from visually normal lung (area under the ROC curve is 0.993). This technique can also be applied to differentiate regions infected by different pulmonary diseases.

  10. Assessment of Unconscious Decision Aids Applied to Complex Patient-Centered Medical Decisions

    PubMed Central

    Manigault, Andrew Wilhelm; Whillock, Summer Rain

    2015-01-01

    Background To improve patient health, recent research urges for medical decision aids that are designed to enhance the effectiveness of specific medically related decisions. Many such decisions involve complex information, and decision aids that independently use deliberative (analytical and slower) or intuitive (more affective and automatic) cognitive processes for such decisions result in suboptimal decisions. Unconscious thought can arguably use both intuitive and deliberative (slow and analytic) processes, and this combination may further benefit complex patient (or practitioner) decisions as medical decision aids. Indeed, mounting research demonstrates that individuals render better decisions generally if they are distracted from thinking consciously about complex information after it is presented (but can think unconsciously), relative to thinking about that information consciously or not at all. Objective The current research tested whether the benefits of unconscious thought processes can be replicated using an Internet platform for a patient medical decision involving complex information. This research also explored the possibility that judgments reported after a period of unconscious thought are actually the result of a short period of conscious deliberation occurring during the decision report phase. Methods A total of 173 participants in a Web-based experiment received information about four medical treatments, the best (worst) associated with mostly positive (negative) side-effects/attributes and the others with equal positive-negative ratios. Next, participants were either distracted for 3 minutes (unconscious thought), instructed to think about the information for 3 minutes (conscious thought), or moved directly to the decision task (immediate decision). Finally, participants reported their choice of, and attitudes toward, the treatments while experiencing high, low, or no cognitive load, which varied their ability to think consciously while

  11. Farmers as Consumers of Agricultural Education Services: Willingness to Pay and Spend Time

    ERIC Educational Resources Information Center

    Charatsari, Chrysanthi; Papadaki-Klavdianou, Afroditi; Michailidis, Anastasios

    2011-01-01

    This study assessed farmers' willingness to pay for and spend time attending an Agricultural Educational Program (AEP). Primary data on the demographic and socio-economic variables of farmers were collected from 355 farmers selected randomly from Northern Greece. Descriptive statistics and multivariate analysis methods were used in order to meet…

  12. Can Food Stamps help to reduce Medicare spending on diabetes?

    PubMed

    Nicholas, Lauren Hersch

    2011-01-01

    Diabetes is rapidly escalating amongst low-income, older adults at great cost to the Medicare program. We use longitudinal survey data from the Health and Retirement Study linked to administrative Medicare records and biomarker data to assess the relationship between Food Stamp receipt and diabetes health outcomes. We find no significant difference in Medicare spending, outpatient utilization, diabetes hospitalizations and blood sugar (HbA1c) levels between recipients and income-eligible non-recipients after controlling for a detailed set of covariates including individual fixed effects and measures of diabetes treatment compliance. As one-third of elderly Food Stamp recipients are currently diabetic, greater coordination between the Food Stamp, Medicare, and Medicaid programs may improve health outcomes for this group. PMID:21112260

  13. Health needs, budget cuts & military spending.

    PubMed

    1991-01-01

    A healthy, well-fed, educated populace is synonymous with a prospering economy. Yet, when planning their budgets, governments tend to emphasize infrastructural/industrial projects and defence rather than investing in health, education and other social programmes to eliminate the widespread poverty and high mortality of its population, which would assure a more promising future in the long-term. As citizens, nurses are responsible for initiating and supporting action to meet the health and social needs of the public. And in keeping with ICN's 1989 resolution on nuclear war, INR presents some facts on social and defence spending to show how health needs are often being deprived by emphasis on others sectors, particularly defence. The aim is "to encourage nurses to critically appraise expenditure on health and welfare at a national and global level in relation to that spent on conventional and nuclear arms and to assist nurses to develop strategies of action to contribute to international peace." PMID:2045232

  14. Health needs, budget cuts & military spending.

    PubMed

    1991-01-01

    A healthy, well-fed, educated populace is synonymous with a prospering economy. Yet, when planning their budgets, governments tend to emphasize infrastructural/industrial projects and defence rather than investing in health, education and other social programmes to eliminate the widespread poverty and high mortality of its population, which would assure a more promising future in the long-term. As citizens, nurses are responsible for initiating and supporting action to meet the health and social needs of the public. And in keeping with ICN's 1989 resolution on nuclear war, INR presents some facts on social and defence spending to show how health needs are often being deprived by emphasis on others sectors, particularly defence. The aim is "to encourage nurses to critically appraise expenditure on health and welfare at a national and global level in relation to that spent on conventional and nuclear arms and to assist nurses to develop strategies of action to contribute to international peace."

  15. Should Aid Reward Performance?

    PubMed Central

    Olken, Benjamin A.; Onishi, Junko; Wong, Susan

    2014-01-01

    We report an experiment in 3,000 villages that tested whether incentives improve aid efficacy. Villages received block grants for maternal and child health and education that incorporated relative performance incentives. Subdistricts were randomized into incentives, an otherwise identical program without incentives, or control. Incentives initially improved preventative health indicators, particularly in underdeveloped areas, and spending efficiency increased. While school enrollments improved overall, incentives had no differential impact on education, and incentive health effects diminished over time. Reductions in neonatal mortality in non-incentivized areas did not persist with incentives. We find no systematic scoring manipulation nor funding reallocation toward richer areas. PMID:25485039

  16. Computer-Aided Assessment of Tumor Grade for Breast Cancer in Ultrasound Images

    PubMed Central

    2015-01-01

    This study involved developing a computer-aided diagnosis (CAD) system for discriminating the grades of breast cancer tumors in ultrasound (US) images. Histological tumor grades of breast cancer lesions are standard prognostic indicators. Tumor grade information enables physicians to determine appropriate treatments for their patients. US imaging is a noninvasive approach to breast cancer examination. In this study, 148 3-dimensional US images of malignant breast tumors were obtained. Textural, morphological, ellipsoid fitting, and posterior acoustic features were quantified to characterize the tumor masses. A support vector machine was developed to classify breast tumor grades as either low or high. The proposed CAD system achieved an accuracy of 85.14% (126/148), a sensitivity of 79.31% (23/29), a specificity of 86.55% (103/119), and an AZ of 0.7940. PMID:25810750

  17. Assessment of a Computer-Aided Instructional Program for the Pediatric Emergency Department

    PubMed Central

    Adler, Mark D.; Duggan, Anne; Ogborn, C. Jean; Johnson, Kevin B.

    2003-01-01

    Computer aided instruction (CAI) software is becoming commonplace in medical education. Our experience with CAI programs in our pediatric ED raised concerns about the time commitment some of these programs require. We developed a just-in-time learning program, the Virtual Preceptor (VP) and evaluated this program for use in a busy clinical environment. Forty-three of 47 pediatric residents used the VP at least once. Interns used the program 2 ½ times more often than upper level residents. Of 321 topics available in 18 subject categories, 153 (48%) were selected at least once. Content was rated as appropriate by 72% of users. 95% of residents would use the program again. Although no resident felt the program itself took too long to use, 51% said they were too busy to use the VP. Time of use and level of training may be important factors in CAI use in the pediatric ED environment. PMID:14728123

  18. Computer-aided assessment of tumor grade for breast cancer in ultrasound images.

    PubMed

    Chen, Dar-Ren; Chien, Cheng-Liang; Kuo, Yan-Fu

    2015-01-01

    This study involved developing a computer-aided diagnosis (CAD) system for discriminating the grades of breast cancer tumors in ultrasound (US) images. Histological tumor grades of breast cancer lesions are standard prognostic indicators. Tumor grade information enables physicians to determine appropriate treatments for their patients. US imaging is a noninvasive approach to breast cancer examination. In this study, 148 3-dimensional US images of malignant breast tumors were obtained. Textural, morphological, ellipsoid fitting, and posterior acoustic features were quantified to characterize the tumor masses. A support vector machine was developed to classify breast tumor grades as either low or high. The proposed CAD system achieved an accuracy of 85.14% (126/148), a sensitivity of 79.31% (23/29), a specificity of 86.55% (103/119), and an A Z of 0.7940.

  19. Assessment of a computer-aided instructional program for the pediatric emergency department.

    PubMed

    Adler, Mark D; Duggan, Anne; Ogborn, C Jean; Johnson, Kevin B

    2003-01-01

    Computer aided instruction (CAI) software is becoming commonplace in medical education. Our experience with CAI programs in our pediatric ED raised concerns about the time commitment some of these programs require. We developed a just-in-time learning program, the Virtual Preceptor (VP) and evaluated this program for use in a busy clinical environment. Forty-three of 47 pediatric residents used the VP at least once. Interns used the program 2 (1/2) times more often than upper level residents. Of 321 topics available in 18 subject categories, 153 (48%) were selected at least once. Content was rated as appropriate by 72% of users. 95% of residents would use the program again. Although no resident felt the program itself took too long to use, 51% said they were too busy to use the VP. Time of use and level of training may be important factors in CAI use in the pediatric ED environment.

  20. Indices of body fat distribution for assessment of lipodysthrophy in people living with HIV/AIDS

    PubMed Central

    2012-01-01

    Background Metabolic and morphological changes associated with excessive abdominal fat, after the introduction of Antiretroviral Therapy, increase the risk of cardiovascular disease in people living with HIV/AIDS(PLWHA). Accurate methods for body composition analysis are expensive and the use of anthropometric indices is an alternative. However the investigations about this subject in PLWHA are rare, making this research very important for clinical purpose and to advance scientific knowledge. The aim of this study is to correlate results of anthropometric indices of evaluation of body fat distribution with the results obtained by Dual-energy X-Ray Absorptiometry(DEXA), in people living with HIV/AIDS. Methods The sample was of 67 PLWHA(39 male and 28 female), aged 43.6+7.9 years. Body mass index, conicity index, waist/hip ratio, waist/height ratio and waist/thigh were calculated. Separated by sex, each index/ratio was plotted in a scatter chart with linear regression fit and their respective Pearson correlation coefficients. Analyses were performed using Prism statistical program and significance was set at 5%. Results The waist/height ratio presented the highest correlation coefficient, for both male (r=0.80, p<0.001) and female (r=0.87, p <001), while the lowest were in the waist/thigh also for both: male group (r=0.58, p<0.001) and female group (r=0.03, p=0.86). The other indices also showed significant positive correlation with DEXA. Conclusion Anthropometric indices, especially waist/height ratio may be a good alternative way to be used for evaluating the distribution of fat in the abdominal region of adults living with HIV/ADIS. PMID:23031203

  1. Spending on substance abuse treatment: how much is enough?

    PubMed Central

    Meara, Ellen; Frank, Richard G.

    2006-01-01

    Aim To describe a framework that can be used to determine optimal spending on substance abuse treatment in the United States. Methods Selective review of the literature on spending for substance abuse treatment combined with an economic analysis of how to determine when spending is optimal, defining optimal spending as that which minimizes the social costs of substance use disorders. Results In 1997, only $11.9 billion of the $294 billion estimated social costs of substance abuse was spent on treatment. The discrepancy between the high indirect costs of illness relative to the level of spending on treatment of addictive disorders leads many to believe that the United States spends too little on treatment. In this paper, we argue that information on the social costs of substance abuse disorders and the level of spending on treatment is insufficient to determine whether current spending is optimal. We develop a framework that could be used to determine optimal spending on substance abuse treatment in the United States. We develop this framework in four steps. First, we provide background on the unique financial and delivery features of substance abuse treatment. Secondly, we outline the points raised by advocates of expanded substance abuse treatment: substance abuse has high social costs, yet few people receive the many effective treatments available partly because of financial barriers to treatment. Thirdly, we provide a framework that can be used to judge the additional benefits of alternative levels and types of spending on substance abuse treatment. Finally, we discuss the distinction between the potential impact of spending on substance abuse treatment and its actual impact, using productivity as an example of one significant portion of the costs of substance abuse. Conclusion To determine optimal spending on substance abuse treatment, research should describe who receives treatment, the quality of treatment received, and how treatments relate to outcomes that

  2. [Analysis methods for educational needs assessment for family caregivers of HIV positive or AIDS patients in Thailand].

    PubMed

    Girault, P; Gagnayre, R; d'Ivernois, J F

    2001-03-01

    Identification of educational needs of natural helpers for the home-based care of persons living with HIV or AIDS. Surin, Thailand. The very significant increase in the number of persons living with aids in Thailand, (1995: 20,154 notified cases; 1996: 23,309 cases; 1997: 25,064 cases), and the insufficiency of medical care for patients within Thailand's health structures, have driven Médecins Sans Frontières (MSF) to put in place since 1996 a home-based care project in Surin province (North-Eastern Thailand). In Thai culture, the sick are commonly cared for by one family member, known as the natural helper. An evaluation of the health situation showed that natural helpers who took care of a family member living with HIV or aids were not prepared for this situation. In order to better define the tasks that they ought to perform, we carried out a needs assessment in three interdependent steps: a records analysis of the activities delegated to natural helpers by nurses; an enquiry on the acceptability of natural helpers to carry out these cares and on the perceived usefulness of being trained; an expert consensus on the cares to be carried out by the natural helpers, obtained by the Delphi method. Twenty seven cares were identified as being able to be provided by natural helpers. They constitute as a list of reference for the training for natural helpers. This work has shown a social coherence between the different actors of the project. At no stage was the role of the natural helpers questioned. On the contrary, natural helpers have a privileged place within the family and in the home-based care programme. Natural helpers will allow continuity of care between the health structures and the patient's home.

  3. Assessing the Challenges of Multi-Scope Clinical Research Sites: An Example from NIH HIV/AIDS Clinical Trials Networks

    PubMed Central

    Rosas, Scott R.; Cope, Marie T.; Villa, Christie; Motevalli, Mahnaz; Utech, Jill; Schouten, Jeffrey T.

    2013-01-01

    Rationale, aims, and objectives Large-scale, multi-network clinical trials are seen as a means for efficient and effective utilization of resources with greater responsiveness to new discoveries. Formal structures instituted within the National Institutes of Health (NIH) HIV/AIDS Clinical Trials facilitate collaboration and coordination across networks and emphasize an integrated approach to HIV/AIDS vaccine, prevention, and therapeutics clinical trials. This study examines the joint usage of clinical research sites as means of gaining efficiency, extending capacity, and adding scientific value to the networks. Methods A semi-structured questionnaire covering 8 clinical management domains was administered to 74 (62% of sites) clinical site coordinators at single- and multi-network sites to identify challenges and efficiencies related to clinical trials management activities and coordination with multi-network units. Results Overall, respondents at multi-network sites did not report more challenges than single-network sites, but did report unique challenges to overcome including in the areas of study prioritization, community engagement, staff education and training, and policies and procedures. The majority of multi-network sites reported that such affiliations do allow for the consolidation and cost-sharing of research functions. Suggestions for increasing the efficiency or performance of multi-network sites included streamlining standards and requirements, consolidating protocol activation methods, using a single cross-network coordinating center, and creating common budget and payment mechanisms. Conclusions The results of this assessment provide important information to consider in the design and management of multi-network configurations for the NIH HIV/AIDS Clinical Trials Networks, as well as others contemplating and promoting the concept of multi-network settings. PMID:24219425

  4. Body image in patients with HIV/AIDS: assessment of a new psychometric measure and its medical correlates.

    PubMed

    Martinez, Shay M; Kemper, Carol A; Diamond, Catherine; Wagner, Glenn

    2005-03-01

    HIV infection and its treatment can have significant effects on physical appearance and functioning, which can affect self-perceived body image. We assessed the psychometric properties of a newly developed Body Image Scale (BIS), a subjective measure of body image perception in persons with HIV infection, as well as the scale's relationship to disease progression, symptoms, and demographic factors. HIV-positive men (n = 129) and women (n = 21) attending two outpatient HIV clinics were administered the BIS survey along with a one-page questionnaire. A subset (n = 38) were administered the survey on two occasions to assess test-retest reliability. Nearly half of the sample (46%) had AIDS and 25% had a CD4 count below 200 cells/mm(3) within the prior 3 months. The BIS had unidimensional factor structure, good internal consistency reliability (Chronbach alpha = 0.91), and good test-retest reliability (r = 0.71, p < 0.001) after controlling for the length of interval between assessments. Patients' current perception of their body image was worse then what they perceived it to be prior to HIV infection (p < 0.001), but better than their perception of how others view people with HIV (p < 0.001). The presence of symptomatic disease (p < 0.001) and a diagnosis of AIDS (p = 0.02) were associated with a less favorable body image, although laboratory markers of disease progression (CD4 count and plasma HIV viral load) were not. We conclude that the BIS has good construct validity and is a highly reproducible measure of self-perceptive of body image in HIV-infected patients. Further exploration of its relationship to psychological well being, medication adherence and other aspects of medical care is indicated.

  5. International Monetary Fund and aid displacement.

    PubMed

    Stuckler, David; Basu, Sanjay; McKee, Martin

    2011-01-01

    Several recent papers find evidence that global health aid is being diverted to reserves, education, military, or other sectors, and is displacing government spending. This is suggested to occur because ministers of finance have competing, possibly corrupt, priorities and deprive the health sector of resources. Studies have found that development assistance for health routed to governments has a negative impact on health spending and that similar assistance routed to private nongovernmental organizations has a positive impact. An alternative hypothesis is that World Bank and IMF macro-economic policies, which specifically advise governments to divert aid to reserves to cope with aid volatility and keep government spending low, could be causing the displacement of health aid. This article evaluates whether aid displacement was greater when countries undertook a new borrowing program from the IMF between 1996 and 2006. As found in existing studies, for each $1 of development assistance for health, about $0.37 is added to the health system. However, evaluating IMF-borrowing versus non-IMF-borrowing countries reveals that non-borrowers add about $0.45 whereas borrowers add less than $0.01 to the health system. On average, health system spending grew at about half the speed when countries were exposed to the IMF than when they were not. It is important to take account of the political economy of global health finance when interpreting data on financial flows.

  6. Assessing a conceptual framework of health-related quality of life in a HIV/AIDS population.

    PubMed

    Vidrine, Damon J; Amick, Benjamin C; Gritz, Ellen R; Arduino, Roberto C

    2005-05-01

    With the recognition of health-related quality of life (HRQOL) as an important outcome in the course of HIV-disease, it is important to gain a better understanding of the complex relationships among the various factors that influence it. This study assesses a conceptual framework of HRQOL, consisting of disease status, socio-economic status (SES), behavioral variables, symptom status, role-specific functional status and HRQOL, among a multiethnic, economically disadvantaged population of individuals living with HIV/AIDS. Self-report data were collected from 348 patients receiving care at a large HIV/AIDS care center, serving residents of a large metropolitan area. The relationships between the study variables were examined using structural equation modeling. Results indicated that the hypothesized framework provided a well-fitted solution to the data, chi2(44df) = 57.62], p = 0.08 and root mean square error of approximation = 0.03, 90% confidence interval 0.01; 0.05. This framework suggests that health-related variables fall along a continuum, beginning with disease status and ending in generic HRQOL. In addition, the framework suggests that behavioral factors (i.e., smoking status, alcohol consumption, and illicit drug use) and SES exert significant effects along this continuum and should be carefully considered when analyzing and interpreting HRQOL data.

  7. U.S. to begin minority AIDS initiative.

    PubMed

    1998-12-01

    President Clinton has announced a $156 million program dedicated to raising awareness of HIV and improving access to treatment programs in minority communities. The program is part of a larger $865 million increase in government spending on anti-AIDS programs. Despite the overall decline in AIDS deaths, the rate of new AIDS cases among minorities is increasing. Recently, the Black Congressional Caucus asked the administration to declare a "state of emergency" with regard to AIDS in African-American communities.

  8. At the Intersection of HIV/AIDS and Cancer: A Qualitative Needs Assessment of Community-Based HIV/AIDS Service Organizations

    PubMed Central

    Burkhalter, Jack E.; Cahill, Sean; Shuk, Elyse; Guidry, John; Corner, Geoffrey; Berk, Alexandra; Candelario, Norman; Kornegay, Mark; Lubetkin, Erica I.

    2014-01-01

    Due to advances in treatment, persons living with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) are living longer, but with aging, immune deficits, and lifestyle factors, they are at increased risk for cancer. This challenges community-based AIDS service organizations (ASOs) to address the growing cancer needs of persons living with HIV/AIDS (PLWHA). Community-based participatory research was applied to engage ASOs in exploring their capacities and needs for integrating cancer-focused programming into their services. Focus groups were conducted with a community advisory board (CAB) representing 10 community-based organizations serving PLWHA. Three 90-minute, serial focus groups were conducted with a mean number of seven participants. Topics explored CAB members’ organizational capacities and needs in cancer prevention, detection, treatment, and survivorship. Transcript analyses identified six themes: (a) agencies have limited experience with cancer-focused programs, which were not framed as cancer specific; (b) agencies need resources and collaborative partnerships to effectively incorporate cancer services; (c) staff and clients must be educated about the relevance of cancer to HIV/AIDS; (d) agencies want to know about linkages between HIV/AIDS and cancer; (e) cancer care providers should be culturally competent; and (f) agencies see opportunities to improve their services through research participation but are wary. Agency capacities were strong in relationships with clients and cultural competency, a holistic view of PLWHA health, expertise in prevention activities, and eagerness to be on the cutting edge of knowledge. Cancer education and prevention were of greatest interest and considered most feasible, suggesting that future projects develop accordingly. These findings suggest a high level of receptivity to expanding or initiating cancer-focused activities but with a clear need for education and awareness building

  9. Computer-aided design of dry powder inhalers using computational fluid dynamics to assess performance.

    PubMed

    Suwandecha, Tan; Wongpoowarak, Wibul; Srichana, Teerapol

    2016-01-01

    Dry powder inhalers (DPIs) are gaining popularity for the delivery of drugs. A cost effective and efficient delivery device is necessary. Developing new DPIs by modifying an existing device may be the simplest way to improve the performance of the devices. The aim of this research was to produce a new DPIs using computational fluid dynamics (CFD). The new DPIs took advantages of the Cyclohaler® and the Rotahaler®. We chose a combination of the capsule chamber of the Cyclohaler® and the mouthpiece and grid of the Rotahaler®. Computer-aided design models of the devices were created and evaluated using CFD. Prototype models were created and tested with the DPI dispersion experiments. The proposed model 3 device had a high turbulence with a good degree of deagglomeration in the CFD and the experiment data. The %fine particle fraction (FPF) was around 50% at 60 L/min. The mass median aerodynamic diameter was around 2.8-4 μm. The FPF were strongly correlated to the CFD-predicted turbulence and the mechanical impaction parameters. The drug retention in the capsule was only 5-7%. In summary, a simple modification of the Cyclohaler® and Rotahaler® could produce a better performing inhaler using the CFD-assisted design.

  10. Assessment of DOD and industry networks for Computer-Aided Logistics Support (CALS) telecommunications. Final report

    SciTech Connect

    DeLaura, F.L.; Sharp, S.J.; Clark, R.

    1987-06-01

    The Department of Defense is committed to applying the best in modern technology toward improving the transfer of design, engineering, and manufacturing technical information among weapon-system contractors and DoD organizations. The Military Services, the Defense Logistics Agency (DLA), the Defense Communications Agency (DCA), and industry are undertaking or planning telecommunications support for such transfer. In view of these many and diverse efforts, the Computer Aided Logistics Support (CALS) Steering Group through the CALS Communications Working Group has recognized the need for evaluating them. The report presents an evaluation of CALS-related telecommunications requirements in DoD, the major efforts for automating engineering drawing and technical data repositories, and various intelligent-gateway efforts in each of the Services. The overall direction within each Service for telecommunication support and transitioning to the OSI (Open Systems Interconnection) standards is presented, as well as the status of commercial efforts for defining and implementing the OSI standards and improving long-haul telecommunications support.

  11. Direct assessment of cryopreservation of human spermatozoa using a cryomicroscope and computer-aided sperm analysis.

    PubMed

    Mohammad, S N; Barratt, C L; Cooke, I D; Moore, H D

    1996-12-01

    Use of a cryostage has enabled direct observation of human spermatozoa as they are cryopreserved and thawed. Crystallization and recrystallization events are readily observed. In combination with computer-aided semen analysis (CASA) equipment it was possible to determine the consequence of altering the cooling, freezing and thawing rates of a temperature-rate profile on sperm motility. Increasing the cooling rate to 50 degrees C/min resulted in significantly lower pre-freeze to post-thaw ratios for average path velocity (VAP, 13%), mean straight line velocity (VSL, 35%), mean linearity (LIN, 28%) and straightness (STR, 24%), while the ratio of the number of cells crossing the field of view (NCF) significantly increased (30%) compared to a standard freeze-thaw temperature rate profile. The NCF pre-freeze to post-thaw ratio was associated with the percentage of cell recovery after cryopreservation. Faster thaw rates resulted in better survival of the cells, perhaps due to the shorter time during which recrystallization occurred. The NCF ratios were significantly higher (33 and 30% for thaw rates of 50 and 100 degrees C/min respectively) than for the standard profile samples. Previous studies on cell survival have shown a link between the cooling and thaw rates. The cryostage should prove invaluable in future studies to identify the causes of cryodamage to spermatozoa. When used in combination with CASA, changes to sperm function during cryopreservation can be accurately measured.

  12. Data on serologic inflammatory biomarkers assessed using multiplex assays and host characteristics in the Multicenter AIDS Cohort Study (MACS).

    PubMed

    McKay, Heather S; Bream, Jay H; Margolick, Joseph B; Martínez-Maza, Otoniel; Magpantay, Larry I; Phair, John P; Rinaldo, Charles R; Abraham, Alison G; Jacobson, Lisa P

    2016-12-01

    This article contains data on the associations between fixed and modifiable host characteristics and twenty-three biomarkers of inflammation and immune activation measured longitudinally in a cohort of 250 HIV-uninfected men from the Multicenter AIDS Cohort Study (1984-2009) after adjusting for age, study site, and blood draw time of day using generalized gamma regression. This article also presents associations between each biomarker and each host characteristic in a sample restricted to 2001-2009. These data are supplemental to our original research article entitled "Host factors associated with serologic inflammatory markers assessed using multiplex assays" (McKay, S. Heather, Bream, H. Jay, Margolick, B. Joseph, Martínez-Maza, Otoniel, Phair, P. John, Rinaldo, R. Charles, Abraham, G. Alison, L.P. Jacobson, 2016) [1]. PMID:27668272

  13. Data on serologic inflammatory biomarkers assessed using multiplex assays and host characteristics in the Multicenter AIDS Cohort Study (MACS).

    PubMed

    McKay, Heather S; Bream, Jay H; Margolick, Joseph B; Martínez-Maza, Otoniel; Magpantay, Larry I; Phair, John P; Rinaldo, Charles R; Abraham, Alison G; Jacobson, Lisa P

    2016-12-01

    This article contains data on the associations between fixed and modifiable host characteristics and twenty-three biomarkers of inflammation and immune activation measured longitudinally in a cohort of 250 HIV-uninfected men from the Multicenter AIDS Cohort Study (1984-2009) after adjusting for age, study site, and blood draw time of day using generalized gamma regression. This article also presents associations between each biomarker and each host characteristic in a sample restricted to 2001-2009. These data are supplemental to our original research article entitled "Host factors associated with serologic inflammatory markers assessed using multiplex assays" (McKay, S. Heather, Bream, H. Jay, Margolick, B. Joseph, Martínez-Maza, Otoniel, Phair, P. John, Rinaldo, R. Charles, Abraham, G. Alison, L.P. Jacobson, 2016) [1].

  14. "Hippocrates-mst": a prototype for computer-aided microcalcification analysis and risk assessment for breast cancer.

    PubMed

    Spyrou, George; Kapsimalakou, Smaragda; Frigas, Antonis; Koufopoulos, Konstantinos; Vassilaros, Stamatios; Ligomenides, Panos

    2006-11-01

    One of the most common cancer types among women is breast cancer. Regular mammographic examinations increase the possibility for early diagnosis and treatment and significantly improve the chance of survival for patients with breast cancer. Clustered microcalcifications have been considered as important indicators of the presence of breast cancer. We present "Hippocrates-mst", a prototype system for computer-aided risk assessment of breast cancer. Our research has been focused in developing software to locate microcalcifications on X-ray mammography images, quantify their critical features and classify them according to their probability of being cancerous. A total of 260 cases (187 benign and 73 malignant) have been examined and the performance of the prototype is presented through receiver operating characteristic (ROC) analysis. The system is showing high levels of sensitivity identifying correctly 98.63% of malignant cases.

  15. Sensory Aids for the Blind.

    ERIC Educational Resources Information Center

    National Academy of Sciences - National Research Council, Washington, DC. Committee on Prosthetics Research and Development.

    The problems of providing sensory aids for the blind are presented and a report on the present status of aids discusses direct translation and recognition reading machines as well as mobility aids. Aspects of required research considered are the following: assessment of needs; vision, audition, taction, and multimodal communication; reading aids,…

  16. Reviewing prescription spending and accessory usage.

    PubMed

    Oxenham, Julie

    This article aims to explore the role of the stoma nurse specialist in the community and how recent initiatives within the NHS have impacted on the roles in stoma care to react to the rising prescription costs in the specialty. The article will explore how the stoma care nurse conducted her prescription reviews within her own clinical commissioning group (CCG). The findings of the reviews will be highlighted by a small case history and a mini audit that reveals that some stoma patients may be using their stoma care accessories inappropriately, which may contribute to the rise in stoma prescription spending. To prevent the incorrect use of stoma appliances it may necessitate an annual review of ostomates (individuals who have a stoma), as the author's reviews revealed that inappropriate usage was particularly commonplace when a patient may have not been reviewed by a stoma care specialist for some considerable amount of time. Initial education of the ostomate and ongoing education of how stoma products work is essential to prevent the misuse of stoma appliances, particularly accessories, as the reviews revealed that often patients were not always aware of how their products worked in practice.

  17. The Flash Environmental Assessment Tool: worldwide first aid for chemical accidents response, pro action, prevention and preparedness.

    PubMed

    Posthuma, Leo; Wahlstrom, Emilia; Nijenhuis, René; Dijkens, Chris; de Zwart, Dick; van de Meent, Dik; Hollander, Anne; Brand, Ellen; den Hollander, Henri A; van Middelaar, Johan; van Dijk, Sander; Hall, E F; Hoffer, Sally

    2014-11-01

    The United Nations response mechanism to environmental emergencies requested a tool to support disaster assessment and coordination actions by United Nations Disaster Assessment and Coordination (UNDAC) teams. The tool should support on-site decision making when substantial chemical emissions affect human health directly or via the environment and should be suitable for prioritizing impact reduction management options under challenging conditions worldwide. To answer this need, the Flash Environmental Assessment Tool (FEAT) was developed and the scientific and practical underpinning and application of this tool are described in this paper. FEAT consists of a printed decision framework and lookup tables, generated by combining the scientific data on chemicals, exposure pathways and vulnerabilities with the pragmatic needs of emergency field teams. Application of the tool yields information that can help prioritize impact reduction measures. The first years of use illustrated the usefulness of the tool as well as suggesting additional uses and improvements. An additional use is application of the back-office tool (Hazard Identification Tool, HIT), the results of which aid decision-making by the authorities of affected countries and the preparation of field teams for on-site deployment. Another extra use is in disaster pro action and prevention. In this case, the application of the tool supports safe land-use planning and improved technical design of chemical facilities. UNDAC teams are trained to use the tool after large-scale sudden onset natural disasters.

  18. Computer-aided Assessment of Regional Abdominal Fat with Food Residue Removal in CT

    PubMed Central

    Makrogiannis, Sokratis; Caturegli, Giorgio; Davatzikos, Christos; Ferrucci, Luigi

    2014-01-01

    Rationale and Objectives Separate quantification of abdominal subcutaneous and visceral fat regions is essential to understand the role of regional adiposity as risk factor in epidemiological studies. Fat quantification is often based on computed tomography (CT) because fat density is distinct from other tissue densities in the abdomen. However, the presence of intestinal food residues with densities similar to fat may reduce fat quantification accuracy. We introduce an abdominal fat quantification method in CT with interest in food residue removal. Materials and Methods Total fat was identified in the feature space of Hounsfield units and divided into subcutaneous and visceral components using model-based segmentation. Regions of food residues were identified and removed from visceral fat using a machine learning method integrating intensity, texture, and spatial information. Cost-weighting and bagging techniques were investigated to address class imbalance. Results We validated our automated food residue removal technique against semimanual quantifications. Our feature selection experiments indicated that joint intensity and texture features produce the highest classification accuracy at 95%. We explored generalization capability using k-fold cross-validation and receiver operating characteristic (ROC) analysis with variable k. Losses in accuracy and area under ROC curve between maximum and minimum k were limited to 0.1% and 0.3%. We validated tissue segmentation against reference semimanual delineations. The Dice similarity scores were as high as 93.1 for subcutaneous fat and 85.6 for visceral fat. Conclusions Computer-aided regional abdominal fat quantification is a reliable computational tool for large-scale epidemiological studies. Our proposed intestinal food residue reduction scheme is an original contribution of this work. Validation experiments indicate very good accuracy and generalization capability. PMID:24119354

  19. Assessment of the relationship between lesion segmentation accuracy and computer-aided diagnosis scheme performance

    NASA Astrophysics Data System (ADS)

    Zheng, Bin; Pu, Jiantao; Park, Sang Cheol; Zuley, Margarita; Gur, David

    2008-03-01

    In this study we randomly select 250 malignant and 250 benign mass regions as a training dataset. The boundary contours of these regions were manually identified and marked. Twelve image features were computed for each region. An artificial neural network (ANN) was trained as a classifier. To select a specific testing dataset, we applied a topographic multi-layer region growth algorithm to detect boundary contours of 1,903 mass regions in an initial pool of testing regions. All processed regions are sorted based on a size difference ratio between manual and automated segmentation. We selected a testing dataset involving 250 malignant and 250 benign mass regions with larger size difference ratios. Using the area under ROC curve (A Z value) as performance index we investigated the relationship between the accuracy of mass segmentation and the performance of a computer-aided diagnosis (CAD) scheme. CAD performance degrades as the size difference ratio increases. Then, we developed and tested a hybrid region growth algorithm that combined the topographic region growth with an active contour approach. In this hybrid algorithm, the boundary contour detected by the topographic region growth is used as the initial contour of the active contour algorithm. The algorithm iteratively searches for the optimal region boundaries. A CAD likelihood score of the growth region being a true-positive mass is computed in each iteration. The region growth is automatically terminated once the first maximum CAD score is reached. This hybrid region growth algorithm reduces the size difference ratios between two areas segmented automatically and manually to less than +/-15% for all testing regions and the testing A Z value increases to from 0.63 to 0.90. The results indicate that CAD performance heavily depends on the accuracy of mass segmentation. In order to achieve robust CAD performance, reducing lesion segmentation error is important.

  20. University Leaders Weigh Downside of Huge Increase in Federal Spending

    ERIC Educational Resources Information Center

    Basken, Paul

    2009-01-01

    After a month of celebrating the largest boost in federal spending on scientific research that most of them have ever seen, university presidents are increasingly tuned to the possibility of a downside. The new money--primarily from a $21.5-billion jump in research-and-development spending in the economic-stimulus law--is certainly welcome,…

  1. Gender Differences in Saving and Spending Behaviours of Thai Students

    ERIC Educational Resources Information Center

    Sereetrakul, Wilailuk; Wongveeravuti, Siriwan; Likitapiwat, Tanakorn

    2013-01-01

    Since males and females are raised differently by their parents (Thorne, 2003), gender roles may affect the saving and spending behaviours of male and female teenagers. The objective of this research was to study the gender differences in saving and spending behaviours of Thai students. This was an exploratory study where a questionnaire was used…

  2. Federal Public Investment Spending and Economic Development in Appalachia

    ERIC Educational Resources Information Center

    Mencken, F. Carson; Tolbert, Charles M., II

    2005-01-01

    This analysis examines the relationship between federal public investment spending and economic development in the special case of Appalachia. We propose that the effects of federal public investment spending on economic development operate indirectly through private capital accumulation. We use a spatial lag regression model to test our ideas for…

  3. New Rule on Spending by States Lacks Teeth

    ERIC Educational Resources Information Center

    Kelderman, Eric

    2009-01-01

    A new federal requirement that states provide consistent spending for higher education may not yet have much effect. As state budgets sour and colleges brace for cuts, only one state seems likely to have run afoul of the new rules this year, according to a "Chronicle" analysis of available data on state higher-education spending. Under the rule,…

  4. Jernberg Industries, Inc: Forging Facility Uses Plant-Wide Assessment to Aid Conversion to Lean Manufacturing

    SciTech Connect

    2004-10-01

    Jernberg Industries conducted a plant-wide assessment while converting to lean manufacturing at a forging plant. Seven projects were identified that could yield annual savings of $791,000, 64,000 MMBtu in fuel and 6 million kWh.

  5. Predicting pathogen risks to aid beach management: the real value of quantitative microbial risk assessment (QMRA)

    EPA Science Inventory

    There has been an ongoing dilemma for agencies who set criteria for safe recreational waters in how to provide for a seasonal assessment of a beach site versus guidance for day-to-day management. Typically an overall 'safe' criterion level is derived from epidemiologic studies o...

  6. Computer-Aided Assessment Questions in Engineering Mathematics Using "MapleTA"[R

    ERIC Educational Resources Information Center

    Jones, I. S.

    2008-01-01

    The use of "MapleTA"[R] in the assessment of engineering mathematics at Liverpool John Moores University (JMU) is discussed with particular reference to the design of questions. Key aspects in the formulation and coding of questions are considered. Problems associated with the submission of symbolic answers, the use of randomly generated numbers…

  7. Self-Assessment in Autonomous Computer-Aided Second Language Writing.

    ERIC Educational Resources Information Center

    Sullivan, Kirk; Lindgren, Eva

    2002-01-01

    Presents the results of a study carried out in Sweden to investigate the promotion of self assessment and reflection in the adult second language classroom. Proposes a method in which the computer is used to record a writing session and later to replay the entire text production in retrospective peer sessions. After using the method, all writers…

  8. Incorporating Partial Credit in Computer-Aided Assessment of Mathematics in Secondary Education

    ERIC Educational Resources Information Center

    Ashton, Helen S.; Beevers, Cliff E.; Korabinski, Athol A.; Youngson, Martin A.

    2006-01-01

    In a mathematical examination on paper, partial credit is normally awarded for an answer that is not correct, but, nevertheless, contains some of the correct working. Assessment on computer normally marks an incorrect answer wrong and awards no marks. This can lead to discrepancies between marks awarded for the same examination given in the two…

  9. New Opportunities for Encouraging Higher Level Mathematical Learning by Creative Use of Emerging Computer Aided Assessment

    ERIC Educational Resources Information Center

    Sangwin, C. J.

    2003-01-01

    This article defines "higher level mathematical skills" and details an important class: that of "constructing instances" of mathematical objects satisfying certain properties. Comment is made on the frequency of higher level tasks in undergraduate work. We explain how such questions may be assessed "in practice" without the imposition on staff of…

  10. The Potential Impact of Computer-Aided Assessment Technology in Higher Education

    ERIC Educational Resources Information Center

    Tshibalo, A. E.

    2007-01-01

    Distance learning generally separates students from educators, and demands that interventions be put in place to counter the constraints that this distance poses to learners and educators. Furthermore "Increased number of students in Higher Education and the corresponding increase in time spent by staff on assessment has encouraged interest into…

  11. Manned space station environmental control and life support system computer-aided technology assessment program

    NASA Technical Reports Server (NTRS)

    Hall, J. B., Jr.; Pickett, S. J.; Sage, K. H.

    1984-01-01

    A computer program for assessing manned space station environmental control and life support systems technology is described. The methodology, mission model parameters, evaluation criteria, and data base for 17 candidate technologies for providing metabolic oxygen and water to the crew are discussed. Examples are presented which demonstrate the capability of the program to evaluate candidate technology options for evolving space station requirements.

  12. Spending on mental and substance use disorders projected to grow more slowly than all health spending through 2020.

    PubMed

    Mark, Tami L; Levit, Katharine R; Yee, Tracy; Chow, Clifton M

    2014-08-01

    Spending on mental and substance use disorders will likely grow more slowly than all health spending through 2020. We project that spending on mental and substance use disorders, as a share of all health spending, will fall from 7.4 percent in 2009 ($172 billion out of $2.3 trillion) to 6.5 percent in 2020 ($281 billion out of $4.3 trillion). This trend is the projected result of reduced spending on mental health drugs because of patent expirations, the low likelihood of innovative drugs entering the market, and a slowdown in spending growth for hospital treatment. By 2020 the expansion of coverage to previously uninsured Americans under the Affordable Care Act (ACA), combined with the projected slowdown in Medicare provider payment rates under the ACA and the Budget Control Act of 2011, are expected to add 2.7 percent to behavioral health spending, compared to spending without these changes. PMID:25092843

  13. Spending on mental and substance use disorders projected to grow more slowly than all health spending through 2020.

    PubMed

    Mark, Tami L; Levit, Katharine R; Yee, Tracy; Chow, Clifton M

    2014-08-01

    Spending on mental and substance use disorders will likely grow more slowly than all health spending through 2020. We project that spending on mental and substance use disorders, as a share of all health spending, will fall from 7.4 percent in 2009 ($172 billion out of $2.3 trillion) to 6.5 percent in 2020 ($281 billion out of $4.3 trillion). This trend is the projected result of reduced spending on mental health drugs because of patent expirations, the low likelihood of innovative drugs entering the market, and a slowdown in spending growth for hospital treatment. By 2020 the expansion of coverage to previously uninsured Americans under the Affordable Care Act (ACA), combined with the projected slowdown in Medicare provider payment rates under the ACA and the Budget Control Act of 2011, are expected to add 2.7 percent to behavioral health spending, compared to spending without these changes.

  14. How College Pricing Undermines Financial Aid

    ERIC Educational Resources Information Center

    Martin, Robert E.; Gillen, Andrew

    2011-01-01

    The primary purpose of government provided student financial aid is to increase college access by bringing the out-of-pocket price of attendance within reach of more students. The basic idea is quite straightforward. If a good or service costs $100 to buy and the government gives consumers a $50 subsidy, then consumers need only spend $50 of their…

  15. Governors Take Varied Routes in Boosting Aid

    ERIC Educational Resources Information Center

    Ujifusa, Andrew

    2013-01-01

    As states consider increases to K-12 spending amid better economic conditions, governors on opposite sides of the partisan divide are proposing significantly different plans and arguments for the best ways to use new education aid. Two prime examples: Minnesota and Ohio, a pair of Midwestern states with chief executives intent on pumping more…

  16. Relationship between regional spending on vascular care and amputation rate

    PubMed Central

    Goodney, Philip P.; Travis, Lori L.; Brooke, Benjamin S.; DeMartino, Randall R.; Goodman, David C.; Fisher, Elliott S.; Birkmeyer, John D.

    2014-01-01

    Importance While lower extremity revascularization is effective in preventing amputation, the relationship between spending on vascular care and regional amputation rates remains unclear. Objective To test the hypothesis that higher regional spending on vascular care is associated with lower amputation rates in patients with severe peripheral arterial disease (PAD). Design Retrospective cohort study. Setting United States Medicare patients, 2003-2010 Participants 18,463 patients who underwent major PAD-related amputation. Exposures Price-adjusted Medicare spending on revascularization procedures and related vascular care in the year before lower extremity amputation, across hospital referral regions. Main Outcome Measure(s) Correlation coefficient between regional spending on vascular care and regional rates of PAD-related amputation. Results Among patients ultimately subject to amputation, 64% were admitted to the hospital in the year prior to amputation for revascularization, wound-related care, or both; 36% were admitted only for their amputation. The mean cost of inpatient care in the year before amputation, including the amputation itself, was $22,405, but varied from $11,077 (Bismarck, North Dakota) to $42,613 (Salinas, California) (p<0.001). Patients in high-spending regions were more likely to undergo vascular procedures in crude analyses (12.0 procedures per 10,000 patients in the lowest quintile of spending, 20.4 procedures per 10,000 patients in the highest quintile of spending, p<0.0001), as well as in risk-adjusted analyses (adjusted OR for receiving a vascular procedure in highest quintile of spending = 3.5, 95 % CI 3.2-3.8, p<0.0001). While revascularization was associated with higher spending (R=0.38, p<0.001), higher spending was not associated with lower regional amputation rates (R=0.10, p=0.06). Regions most aggressive in the use of endovascular interventions which most likely to have high spending (R=0.42, p=0.002) and high amputation rates (R

  17. HIV / AIDS

    MedlinePlus

    ... Marketing Share this: Main Content Area Understanding HIV/AIDS AIDS was first reported in the United States in ... and has since become a major worldwide epidemic. AIDS is caused by the human immunodeficiency virus, or ...

  18. Mutagenicity assessment strategy for pharmaceutical intermediates to aid limit setting for occupational exposure.

    PubMed

    Araya, Selene; Lovsin-Barle, Ester; Glowienke, Susanne

    2015-11-01

    Pharmaceutical intermediates (IM) are used in the synthesis of active pharmaceutical ingredients. They are not intended for human administration, yet employees may be exposed to IM during the manufacturing process. In the context of occupational health, hazard assessment of IM is needed to identify potential intrinsic hazards which could cause unwanted adverse effects. In particular, a carcinogenic potential influences the protection strategy in the workplace. DNA reactive substances may, even if present at very low levels, lead to mutations and therefore, potentially cause cancer. The use of in silico methods to predict mutagenicity is increasingly acknowledged and implemented in the recently released ICH M7 guideline for the limitation of DNA reactive impurities. In this study we investigate the possibility to apply (quantitative) structure-activity-relationships ((Q)SARs) during hazard identification to reduce the number of Ames tests needed for a hazard assessment of IM while maintaining high standards of protection of employees. Ames test outcomes for 188 substances used in the pharmaceutical production were compared with their in silico predictions using two different (Q)SAR methodologies (knowledge based and statistical) complemented by expert knowledge. The results of the analysis showed that a negative prediction for mutagenicity provides a high confidence that the IM is not mutagenic in the Ames test with the negative predictive value of 97%. On the other hand the positive predictive value was only 57% and therefore considered too low to reliably consider positive predicted IM to be mutagenic. In order to avoid any unnecessary burden for occupational health purposes caused by falsely positive predicted IM, all positive predicted IM and those with insufficient coverage by the in silico systems are submitted to an Ames test to verify or reject the prediction. It is shown that the described in silico prediction approach ensures appropriate protection

  19. Mutagenicity assessment strategy for pharmaceutical intermediates to aid limit setting for occupational exposure.

    PubMed

    Araya, Selene; Lovsin-Barle, Ester; Glowienke, Susanne

    2015-11-01

    Pharmaceutical intermediates (IM) are used in the synthesis of active pharmaceutical ingredients. They are not intended for human administration, yet employees may be exposed to IM during the manufacturing process. In the context of occupational health, hazard assessment of IM is needed to identify potential intrinsic hazards which could cause unwanted adverse effects. In particular, a carcinogenic potential influences the protection strategy in the workplace. DNA reactive substances may, even if present at very low levels, lead to mutations and therefore, potentially cause cancer. The use of in silico methods to predict mutagenicity is increasingly acknowledged and implemented in the recently released ICH M7 guideline for the limitation of DNA reactive impurities. In this study we investigate the possibility to apply (quantitative) structure-activity-relationships ((Q)SARs) during hazard identification to reduce the number of Ames tests needed for a hazard assessment of IM while maintaining high standards of protection of employees. Ames test outcomes for 188 substances used in the pharmaceutical production were compared with their in silico predictions using two different (Q)SAR methodologies (knowledge based and statistical) complemented by expert knowledge. The results of the analysis showed that a negative prediction for mutagenicity provides a high confidence that the IM is not mutagenic in the Ames test with the negative predictive value of 97%. On the other hand the positive predictive value was only 57% and therefore considered too low to reliably consider positive predicted IM to be mutagenic. In order to avoid any unnecessary burden for occupational health purposes caused by falsely positive predicted IM, all positive predicted IM and those with insufficient coverage by the in silico systems are submitted to an Ames test to verify or reject the prediction. It is shown that the described in silico prediction approach ensures appropriate protection

  20. Mechanistic insights aid the search for CFC substitutes: risk assessment of HCFC-123 as an example.

    PubMed

    Jarabek, A M; Fisher, J W; Rubenstein, R; Lipscomb, J C; Williams, R J; Vinegar, A; McDougal, J N

    1994-06-01

    An international consensus on the need to reduce the use of chlorofluorocarbons (CFCs) and other ozone-depleting gases such as the halons led to the adoptions of the 1987 Montreal Protocol and Title VI of the 1990 Clean Air Act Amendments, "Protecting Stratospheric Ozone." These agreements included major provisions for reducing and eventually phasing out production and use of CFCs and halons as well as advancing the development of replacement chemicals. Because of the ubiquitous use and benefits of CFCs and halons, an expeditious search for safe replacements to meet the legislative deadlines is of critical importance. Toxicity testing and health risk assessment programs were established to evaluate the health and environmental impact of these replacement chemicals. Development and implementation of these programs as well as the structural-activity relationships significant for the development of the replacement chemicals are described below. A dose-response evaluation for the health risk assessment of the replacement chemical HCFC-123 (2,2-dichloro-1,1,1-trifluoroethane) is also presented to show an innovative use of physiologically based pharmacokinetic (PBPK) modeling. This is based on a parallelogram approach using data on the anesthetic gas halothane, a structural analog to HCFC-123. Halothane and HCFC-123 both form the same metabolite, trifluoroacetic acid (TFA), indicative of the same metabolic oxidative pathway attributed to hepatotoxicity. The parallelogram approach demonstrates the application of template model structures and shows how PBPK modeling, together with judicious experimental design, can be used to improve the accuracy of health risk assessment and to decrease the need for extensive laboratory animal testing.

  1. Assessing the Performance of a Computer-Based Policy Model of HIV and AIDS

    PubMed Central

    Rydzak, Chara E.; Cotich, Kara L.; Sax, Paul E.; Hsu, Heather E.; Wang, Bingxia; Losina, Elena; Freedberg, Kenneth A.; Weinstein, Milton C.; Goldie, Sue J.

    2010-01-01

    Background Model-based analyses, conducted within a decision analytic framework, provide a systematic way to combine information about the natural history of disease and effectiveness of clinical management strategies with demographic and epidemiological characteristics of the population. Among the challenges with disease-specific modeling include the need to identify influential assumptions and to assess the face validity and internal consistency of the model. Methods and Findings We describe a series of exercises involved in adapting a computer-based simulation model of HIV disease to the Women's Interagency HIV Study (WIHS) cohort and assess model performance as we re-parameterized the model to address policy questions in the U.S. relevant to HIV-infected women using data from the WIHS. Empiric calibration targets included 24-month survival curves stratified by treatment status and CD4 cell count. The most influential assumptions in untreated women included chronic HIV-associated mortality following an opportunistic infection, and in treated women, the ‘clinical effectiveness’ of HAART and the ability of HAART to prevent HIV complications independent of virologic suppression. Good-fitting parameter sets required reductions in the clinical effectiveness of 1st and 2nd line HAART and improvements in 3rd and 4th line regimens. Projected rates of treatment regimen switching using the calibrated cohort-specific model closely approximated independent analyses published using data from the WIHS. Conclusions The model demonstrated good internal consistency and face validity, and supported cohort heterogeneities that have been reported in the literature. Iterative assessment of model performance can provide information about the relative influence of uncertain assumptions and provide insight into heterogeneities within and between cohorts. Description of calibration exercises can enhance the transparency of disease-specific models. PMID:20844741

  2. Mechanistic insights aid the search for CFC substitutes: risk assessment of HCFC-123 as an example.

    PubMed

    Jarabek, A M; Fisher, J W; Rubenstein, R; Lipscomb, J C; Williams, R J; Vinegar, A; McDougal, J N

    1994-06-01

    An international consensus on the need to reduce the use of chlorofluorocarbons (CFCs) and other ozone-depleting gases such as the halons led to the adoptions of the 1987 Montreal Protocol and Title VI of the 1990 Clean Air Act Amendments, "Protecting Stratospheric Ozone." These agreements included major provisions for reducing and eventually phasing out production and use of CFCs and halons as well as advancing the development of replacement chemicals. Because of the ubiquitous use and benefits of CFCs and halons, an expeditious search for safe replacements to meet the legislative deadlines is of critical importance. Toxicity testing and health risk assessment programs were established to evaluate the health and environmental impact of these replacement chemicals. Development and implementation of these programs as well as the structural-activity relationships significant for the development of the replacement chemicals are described below. A dose-response evaluation for the health risk assessment of the replacement chemical HCFC-123 (2,2-dichloro-1,1,1-trifluoroethane) is also presented to show an innovative use of physiologically based pharmacokinetic (PBPK) modeling. This is based on a parallelogram approach using data on the anesthetic gas halothane, a structural analog to HCFC-123. Halothane and HCFC-123 both form the same metabolite, trifluoroacetic acid (TFA), indicative of the same metabolic oxidative pathway attributed to hepatotoxicity. The parallelogram approach demonstrates the application of template model structures and shows how PBPK modeling, together with judicious experimental design, can be used to improve the accuracy of health risk assessment and to decrease the need for extensive laboratory animal testing. PMID:8029495

  3. Assessment of the efficacy of total lymphocyte counts as predictors of AIDS defining infections in HIV-1 infected people

    PubMed Central

    Stebbing, J; Sawleshwarkar, S; Michailidis, C; Jones, R; Bower, M; Mandalia, S; Nelson, M; Gazzard, B

    2005-01-01

    Background: The CD4 count is a dominant prognostic and predictive factor in HIV infection. This study assessed the utility of the total lymphocyte count (TLC) in place of the CD4 count to predict the development of AIDS defining opportunistic infections (ADOI). Methods: The Chelsea and Westminster cohort was used to identify those people with a first episode of an ADOI. Corresponding CD4 and TLCs were recorded before diagnosis or at the time of first prescribing prophylaxis; patients without an AIDS defining opportunistic infection were defined as being at "risk" and receiver operating characteristic (ROC) curves were used to display the results of sensitivity and the false positive error rate of total lymphocyte and CD4 count groups. Results: A significant linear correlation was seen between the log10 CD4 count and log10 TLC (Pearson's correlation coefficient = 0.70, p<0.001). The finer cut off value for TLC where false positive error rate is minimum and sensitivity maximum was 1500–2000 cells/mm3. Patients with TLC 1000–1500 cells/mm3 were estimated to be at 40% increased risk of developing an ADOI. The cut off value for CD4 counts measured 200 cells/mm3 above which the risk developing an ADOI decreased. Patients with a CD4 count of 150–200 cells/mm3 were at a 34% increased risk of developing an ADOI. The area under the ROC curve for TLC was 10% lower than that for CD4 count. Conclusions: The TLC is minimally less reliable than the CD4 count as a predictor of ADOIs. In the absence of expensive equipment for CD4 measurement, the TLC is a useful test. PMID:16143689

  4. [The viability assessment of ethanol-producing yeast by computer-aided fluorescence microscopy].

    PubMed

    Puchkov, E O

    2006-01-01

    Vital staining of the ethanol-producing yeast Saccharomyces cerevisiae with ethidium bromide and DAPI allows intact and damaged cells to be differentiated by fluorescence microscopy. A computer image analysis procedure has been developed for the automatic determination of the relative number of damaged cells using ImageJ software (National Institute of Health, United States; http://rsb.info.nih.gov./ij/). A good correlation has been found between the viability rates determined by the plate count method and the relative numbers of intact cells assessed by the developed procedure in the dry-yeast preparations rehydrated under various conditions.

  5. Computer-aided lung nodule detection and assessment by using a hybrid PET/CT scanner

    NASA Astrophysics Data System (ADS)

    Franquiz, Juan; Vaddadi, Sulohita; Soler, George

    2004-04-01

    In this study we present an automatic algorithm for the detection and functional assessment of lung nodules on three-dimensional slices derived from a hybrid PET/CT scanner. In addition to differentiate malignant from benign lesions, the algorithm was mainly designed for assessing the response of lung cancer to therapy. The automated algorithm involves three major steps. First, the lung region is segmented from low resolution multislice CT images. Once the lung is segmented on CT images, a search of seed pixels with maximum activity of 18FDG is undertaken into the lung regions of the electronically registered PET images. A 3D growing algorithm identified the lesion pixels around the maximum 18FDG activity seed pixels. In the third step, the total activity (Bq), concentration (Bq/ml), metabolically active volume (ml) and standard uptake values (SUV) were calculated for lesions on PET images. A threshold and filtering method was applied to high resolution CT scans to determine the CT volume of these lesions identified on PET images. All PET images were corrected for attenuation and partial volume effect and cross calibrated with a standard activity measured in a dose calibrator. Studies were performed using a hybrid PET/CT Discovery LS (GE Medical Systems). The feasibility and robustness of the automatic algorithm was demonstrated in studies with a lung-chest phantom and by retrospective analysis of clinical studies.

  6. Shopper marketing nutrition interventions: Social norms on grocery carts increase produce spending without increasing shopper budgets☆

    PubMed Central

    Payne, Collin R.; Niculescu, Mihai; Just, David R.; Kelly, Michael P.

    2015-01-01

    Objectives We assessed the efficacy of an easy-to-implement shopper marketing nutrition intervention in a pilot and two additional studies to increase produce demand without decreasing store profitability or increasing shopper budgets. Methods We created grocery cart placards that detailed the number of produce items purchased (i.e., descriptive norm) at particular stores (i.e., provincial norm). The effect of these placards on produce spending was assessed across 971,706 individual person grocery store transactions aggregated by day. The pilot study designated a baseline period (in both control and intervention store) followed by installation of grocery cart placards (in the intervention store) for two weeks. The pilot study was conducted in Texas in 2012. In two additional stores, we designated baseline periods followed by 28 days of the same grocery cart placard intervention as in the pilot. Additional interventions were conducted in New Mexico in 2013. Results The pilot study resulted in a significant difference between average produce spending per day per person across treatment periods (i.e., intervention versus same time period in control) (16%) and the difference between average produce spending per day per person across stores in the control periods (4%); Furthermore, the same intervention in two additional stores resulted in significant produce spending increases of 12.4% and 7.5% per day per person respectively. In all stores, total spending did not change. Conclusions Descriptive and provincial social norm messages (i.e., on grocery cart placards) may be an overlooked tool to increase produce demand without decreasing store profitability and increasing shopper budgets. PMID:26844084

  7. Links between teacher assessment and child self-assessment of mental health and behavior among children affected by HIV/AIDS.

    PubMed

    Du, Hongfei; Li, Xiaoming; Weinstein, Traci L; Chi, Peilian; Zhao, Junfeng; Zhao, Guoxiang

    2015-01-01

    Teachers are considered to be one of the most important influences in the lives of students. Teachers' assessments of students may be a primary source of information on children's mental and behavioral health; however, this topic has received little attention in research. We examined this issue through linking teachers' ratings of students and mental and behavioral outcomes of children affected by HIV. The hypothesis is that teacher ratings will be predictive of specific child mental and behavioral health outcomes. A quantitative cross-sectional design with self-administered paper-and-pencil instruments was used. The sample included 1221 children (aged 6-18, grades 1-11) affected by HIV including 755 orphans who lost one or both parents to AIDS and 466 vulnerable children living with HIV-infected parents in a central province of China. The corresponding teacher sample included 185 participants. Each child completed an assessment inventory of demographic information and mental and behavioral health measures. Teachers completed a questionnaire about children's school performance. SEM analyses revealed a good model fit according to all fit indices: comparative fit index = 0.93, root mean square error of approximation = 0.07, and standardized root mean square residual = 0.04. Structural equation modeling revealed that problem ratings by teachers were positively associated with child loneliness and behavioral problems, social competence ratings by teachers were negatively related to child depression, and personal growth and social interaction ratings by teachers were negatively related to child loneliness, depression, and trauma. The current study represents a unique contribution to the field in that it recognizes that teachers can be a valuable source of information on children's psychological health. Results from this study have implications for health prevention and intervention for children and families suffering from HIV/AIDS.

  8. Readability and Test-Retest Reliability of a Psychometric Instrument Designed to Assess HIV/AIDS Attitudes, Beliefs, Behaviours and Sources of HIV Prevention Information of Young Adults

    ERIC Educational Resources Information Center

    Balogun, Joseph; Abiona, Titilayo; Lukobo-Durrell, Mainza; Adefuye, Adedeji; Amosun, Seyi; Frantz, Jose; Yakut, Yavuz

    2011-01-01

    Objective: This comparative study evaluated the readability and test-retest reliability of a questionnaire designed to assess the attitudes, beliefs behaviours and sources of information about HIV/AIDS among young adults recruited from universities in the United States of America (USA), Turkey and South Africa. Design/Setting: The instrument was…

  9. [Psychopathologic differentiation of aggressive criminals as an aid in expert assessment].

    PubMed

    Nedopil, N; Bischof, H L; Prochaska, E

    1989-05-01

    Psychiatric assessment and treatment of aggressive mentally ill offenders is one of the most difficult tasks in forensic psychiatry. Whereas psychiatric literature mostly refers to a uniform definition of aggression, different forms of aggression have been shown in animal experiments. In this study it was tested, whether a psychopathological differentiation of aggression was possible in men. In 124 individuals accused of homicide a preliminary dichotomic differentiation into undercontrolled and overcontrolled types of violent offenders (Megargee 1984) was examined. 60% of the population could be assigned to one of the two types. Undercontrolled individuals reacted violently when overburdened by situational conflicts. This form of aggression was called asthenic aggression. It was significantly more frequent in the mentally ill and led more often to the conclusion of diminished responsibility. In the undercontrolled offender aggression served mostly to achieve immediate goals. This form of violence was called sthenic aggression.

  10. Computer-aided assessment of transient ischemic attacks. A clinical evaluation.

    PubMed

    Reggia, J A; Tabb, D R; Price, T R; Banko, M; Hebel, R

    1984-12-01

    We developed and evaluated a computer-based system to assist with the difficult problem of assessing the conditions of patients with transient ischemic attacks (TIAs). The program used criteria to classify a patient's illness localize the neurologic deficit, screen for 46 causative or mimicking disorders, recommend additional tests, and suggest management steps. We evaluated this program in 103 patients with TIAs. The TIA program's localization and classification of patients generally agreed with those made by stroke specialists at our institution, demonstrating that computer programs can reproduce the decision criteria of stroke specialists. With revisions, the TIA program or similar systems could be useful for objective disease classification in clinical trials or epidemiologic studies. In contrast, the TIA program's treatment recommendations were often found to differ significantly from the actual treatments administered by non-stroke specialists.

  11. Conservation of allelic richness in wild crop relatives is aided by assessment of genetic markers.

    PubMed Central

    Schoen, D J; Brown, A H

    1993-01-01

    Wild crop relatives are an important source of genetic variation for improving domesticated species. Given limited resources, methods for maximizing the genetic diversity of collections of wild relatives are needed to help spread protection over a larger number of populations and species. Simulations were conducted to investigate the optimal strategy of sampling materials from populations of wild relatives, with the objective of maximizing the number of alleles (allelic richness) in collections of fixed size. Two methods, based on assessing populations for variation at marker loci (e.g., allozymes, restriction fragment length polymorphisms), were developed and compared with several methods that are not dependent on markers. Marker-assisted methods yielded higher overall allelic richness in the simulated collections, and they were particularly effective in conserving geographically localized alleles, the class of alleles that is most subject to loss. PMID:8248153

  12. Computer-aided dental identification: an objective method for assessment of radiographic image similarity.

    PubMed

    Flint, Diane J; Brent Dove, Stephen; Brumit, Paula C; White, Marea; Senn, David R

    2009-01-01

    A pilot study evaluated a computer-based method for comparing digital dental images, utilizing a registration algorithm to correct for variations in projection geometry between images prior to a subtraction analysis. A numerical assessment of similarity was generated for pairs of images. Using well-controlled laboratory settings, the method was evaluated as to its ability to identify the correct specimen with positive results. A subsequent clinical study examined longitudinal radiographic examinations of selected anatomical areas on 47 patients, analyzing the computer-based method in making the correct identification based upon a threshold level of similarity. The results showed that at a threshold of 0.855, there were two false negative and two false positive identifications out of 957 analyses. Based on these initial findings, 25 dental records having two sets of full mouth series of radiographs were selected. The radiographs were digitized and grouped into six anatomical regions. The more recent set of films served as postmortem images. Each postmortem image was analyzed against all other images within the region. Images were registered to correct for differences in projection geometry prior to analysis. An area of interest was selected to assess image similarity. Analysis of variance was used to determine that there was a significant difference between images from the same individual and those from different individuals. Results showed that the threshold level of concordance will vary with the anatomical region of the mouth examined. This method may provide the most objective and reliable method for postmortem dental identification using intra-oral images.

  13. Computer-aided three dimensional assessment of knee-joint cartilage with magnetic resonance imaging.

    PubMed

    Muensterer, O J; Eckstein, F; Hahn, D; Putz, R

    1996-07-01

    OBJECTIVE: An MRI-based technique for non-invasive assessment of the quantitative distribution of articular cartilage in the knee-joint was to be developed, and its accuracy and reproducibility tested. DESIGN: Three cadaveric specimens and one patient were studied and MRI measurements compared with anatomical sections or arthroscopy. BACKGROUND: Data on articular cartilage thickness is needed for the design of computer models, determination of cartilage material properties from arthroscopy and staging of osteoarthrosis. METHODS: The knees were imaged using strongly T2-weighted spin-echo and FISP-3D sequences. After digital subtraction and automatic segmentation, three-dimensional reconstruction of the cartilages was performed. Surface areas, volumes and the mean cartilage thickness were calculated, and the regional distribution displayed after trigonometric correction. RESULTS: The difference between MRI volumes and those obtained from the sections ranged from 4 to 21% with a reproducibility of +/-4 to +/-12% after repositioning. The thickness maps obtained with MRI were very similar to those from the sections. In the patient, a full-thickness defect demonstrated with MRI was verified by arthroscopy. CONCLUSIONS: Using the technique presented, the quantitative distribution of knee-joint cartilage may be analysed non-invasively, accurately, and in a very time-effective manner, in cadavers and in living subjects. RELEVANCE: To date there exists no accepted method for the accurate, fast and non-invasive assessment of articular cartilage thickness. Such a technique is, however, very helpful for generating computer models of diarthrodial joints, determination of cartilage material properties during arthroscopy, staging of joint disease, and objective control of chondroprotective treatment.

  14. Novel Fluorescein Angiography-Based Computer-Aided Algorithm for Assessment of Retinal Vessel Permeability

    PubMed Central

    Chassidim, Yoash; Parmet, Yisrael; Tomkins, Oren; Knyazer, Boris; Friedman, Alon; Levy, Jaime

    2013-01-01

    Purpose To present a novel method for quantitative assessment of retinal vessel permeability using a fluorescein angiography-based computer algorithm. Methods Twenty-one subjects (13 with diabetic retinopathy, 8 healthy volunteers) underwent fluorescein angiography (FA). Image pre-processing included removal of non-retinal and noisy images and registration to achieve spatial and temporal pixel-based analysis. Permeability was assessed for each pixel by computing intensity kinetics normalized to arterial values. A linear curve was fitted and the slope value was assigned, color-coded and displayed. The initial FA studies and the computed permeability maps were interpreted in a masked and randomized manner by three experienced ophthalmologists for statistical validation of diagnosis accuracy and efficacy. Results Permeability maps were successfully generated for all subjects. For healthy volunteers permeability values showed a normal distribution with a comparable range between subjects. Based on the mean cumulative histogram for the healthy population a threshold (99.5%) for pathological permeability was determined. Clear differences were found between patients and healthy subjects in the number and spatial distribution of pixels with pathological vascular leakage. The computed maps improved the discrimination between patients and healthy subjects, achieved sensitivity and specificity of 0.974 and 0.833 respectively, and significantly improved the consensus among raters for the localization of pathological regions. Conclusion The new algorithm allows quantification of retinal vessel permeability and provides objective, more sensitive and accurate evaluation than the present subjective clinical diagnosis. Future studies with a larger patients’ cohort and different retinal pathologies are awaited to further validate this new approach and its role in diagnosis and treatment follow-up. Successful evaluation of vasculature permeability may be used for the early

  15. Health Spending For Low-, Middle-, And High-Income Americans, 1963-2012.

    PubMed

    Dickman, Samuel L; Woolhandler, Steffie; Bor, Jacob; McCormick, Danny; Bor, David H; Himmelstein, David U

    2016-07-01

    US medical spending growth slowed between 2004 and 2013. At the same time, many Americans faced rising copayments and deductibles, which may have particularly affected lower-income people. To explore whether the health spending slowdown affected all income groups equally, we divided the population into income quintiles. We then assessed trends in health expenditures by and on behalf of people in each quintile using twenty-two national surveys carried out between 1963 and 2012. Before the 1965 passage of legislation creating Medicare and Medicaid, the lowest income quintile had the lowest expenditures, despite their worse health compared to other income groups. By 1977 the unadjusted expenditures for the lowest quintile exceeded those for all other income groups. This pattern persisted until 2004. Thereafter, expenditures fell for the lowest quintile, while rising more than 10 percent for the middle three quintiles and close to 20 percent for the highest income quintile, which had the highest expenditures in 2012. The post-2004 divergence of expenditure trends for the wealthy, middle class, and poor occurred only among the nonelderly. We conclude that the new pattern of spending post-2004, with the wealthiest quintile having the highest expenditures for health care, suggests that a redistribution of care toward wealthier Americans accompanied the health spending slowdown. PMID:27385233

  16. [Municipal public health spending in the state of Pernambuco, Brazil, from 2000 to 2007].

    PubMed

    Espírito Santo, Antônio Carlos Gomes do; Fernando, Virgínia Conceição Nascimento; Bezerra, Adriana Falangola Benjamin

    2012-04-01

    In order to assess the impact of macro-political measures implemented in the latter half of the 1990s on the increase in public spending on health and the possible reduction in allocation inequity, a descriptive, quantitative, cross-sectional study was carried out involving 184 municipalities in the state of Pernambuco, Brazil. Data from the Public Health Budget Information System was used, with the selected indicator being spending on health per inhabitant under the responsibility of the municipality. The correlations of this variable with the municipal Human Development Index, population size and value of the municipal budget per capita were analyzed. It was seen that, although the mean increase in municipal spending on health is 190.76%, the value per capita has remained relatively low - at around R$183.79 - which is below the national and macro-regional averages. Both spending on health per capita and growth percentages are distributed irregularly among health regions as well as among municipalities within a single region. In conclusion, there is marked allocation inequity among municipalities with regard to the distribution of public resources for health, despite the macro-political measures adopted to reduce this inequity.

  17. Health Spending For Low-, Middle-, And High-Income Americans, 1963-2012.

    PubMed

    Dickman, Samuel L; Woolhandler, Steffie; Bor, Jacob; McCormick, Danny; Bor, David H; Himmelstein, David U

    2016-07-01

    US medical spending growth slowed between 2004 and 2013. At the same time, many Americans faced rising copayments and deductibles, which may have particularly affected lower-income people. To explore whether the health spending slowdown affected all income groups equally, we divided the population into income quintiles. We then assessed trends in health expenditures by and on behalf of people in each quintile using twenty-two national surveys carried out between 1963 and 2012. Before the 1965 passage of legislation creating Medicare and Medicaid, the lowest income quintile had the lowest expenditures, despite their worse health compared to other income groups. By 1977 the unadjusted expenditures for the lowest quintile exceeded those for all other income groups. This pattern persisted until 2004. Thereafter, expenditures fell for the lowest quintile, while rising more than 10 percent for the middle three quintiles and close to 20 percent for the highest income quintile, which had the highest expenditures in 2012. The post-2004 divergence of expenditure trends for the wealthy, middle class, and poor occurred only among the nonelderly. We conclude that the new pattern of spending post-2004, with the wealthiest quintile having the highest expenditures for health care, suggests that a redistribution of care toward wealthier Americans accompanied the health spending slowdown.

  18. National health spending by medical condition, 1996-2005.

    PubMed

    Roehrig, Charles; Miller, George; Lake, Craig; Bryant, Jenny

    2009-01-01

    This study responds to recent calls for information about how personal health expenditures from the National Health Expenditure Accounts are distributed across medical conditions. It provides annual estimates from 1996 through 2005 for thirty-two conditions mapped into thirteen all-inclusive diagnostic categories. Circulatory system spending was highest among the diagnostic categories, accounting for 17 percent of spending in 2005. The most costly conditions were mental disorders and heart conditions. Spending growth rates were lowest for lung cancer, chronic obstructive pulmonary disease, pneumonia, coronary heart disease, and stroke, perhaps reflecting benefits of preventive care.

  19. Health care spending growth: can we avoid fiscal Armageddon?

    PubMed

    Chernew, Michael

    Both private and public payers have experienced a persistent rise in health care spending that has exceeded income growth. The issue now transcends the health care system because health care spending growth threatens the fiscal health of the nation. This paper examines the causes and consequences of health care spending growth. It notes that the determinants of spending growth may differ from the determinants of high spending at a point in time. Specifically, the evidence overwhelmingly suggests that the primary driver ofinflation-adjusted, per capita spending growth over the past decades (and thus premium growth) has been the diffusion of new medical technology. The paper argues that while new technology has provided significant clinical benefit, we can no longer afford the persistent gap between health spending and income growth. In simple terms, if the economy is growing 2%, we cannot afford persistent health care spending growth of 4%. Growth in public spending is particularly important. If not abated, high public spending will require either substantially higher taxes or debt, both of which could lead to fiscal Armageddon. Growth in private spending also threatens economic well-being by forcing more resources toward health care and away from other sectors. For example, since the cost of employer-based coverage is always borne by employees (directly or indirectly), salary increases and health care cost increases cannot continue on together. To avoid economic disaster, payers will be forced to have a greater resolve in the future. Specifically, because neither public nor private payers will be able to finance growing health care spending, the coming decade will likely experience significant changes in health care financing. Consumers may be asked to pay more out of pocket when they seek care and both public and private payers will put increasing pressure on payment rates. Furthermore, payment rates to providers are likely to rise more slowly than in the past

  20. Public spending on elders and children: the gap is growing.

    PubMed

    Pati, Susmita; Keren, Ron; Alessandri, Evaline A; Schwarz, Donald F

    2004-11-01

    Social welfare programs support the income, education, nutrition, and medical care needs of many of this country's elders and children. Over the past twenty years, however, three times as many children as elders have lived in poverty, and poverty rates for children have consistently exceeded those for the elderly. Given the continued disparity in poverty rates, it is important to track levels of public spending for each group and the generational balance in allocating limited public funds. This Issue Brief evaluates trends in social welfare spending for children and the elderly from 1980 to 2000, and the relationship of national economic trends to public spending patterns.

  1. International exchange of emergency phase information and assessments: an aid to national/international decision makers.

    PubMed

    Sullivan, Thomas J; Chino, Masamichi; Ehrhardt, Joachim; Shershakov, Vyacheslav

    2004-01-01

    This paper discusses a collaborative project (1) to demonstrate the feasibility and benefit of a system seeking early review, in a 'quasi peer review' mode, of nuclear accident plume and dose assessment predictions by four major international nuclear accident emergency response systems before release of calculations to respective national authorities followed by (2) sharing these results with responsible national/international authorities, (3) development of an affordable/accessible system to distribute results to countries without prediction capabilities and (4) utilisation for exercises and collaboration studies. The project exploits Internet browser technology and low-cost PC hardware, incorporates an Internet node, with access control, for depositing a minimal set of XML-based graphics files for presentation in an identical map format. Side-by-side viewing and televideo conferencing will permit rapid evaluation, data elaboration and recalculation (if necessary) and should produce strong consensus among decision makers. Successful completion affords easy utilisation by national/international organisations and non-nuclear states at risk of trans-boundary incursion.

  2. The Use of Mobile Devices in Aiding Dietary Assessment and Evaluation

    PubMed Central

    Zhu, Fengqing; Bosch, Marc; Woo, Insoo; Kim, SungYe; Boushey, Carol J.; Ebert, David S.; Delp, Edward J.

    2010-01-01

    There is a growing concern about chronic diseases and other health problems related to diet including obesity and cancer. The need to accurately measure diet (what foods a person consumes) becomes imperative. Dietary intake provides valuable insights for mounting intervention programs for prevention of chronic diseases. Measuring accurate dietary intake is considered to be an open research problem in the nutrition and health fields. In this paper, we describe a novel mobile telephone food record that will provide an accurate account of daily food and nutrient intake. Our approach includes the use of image analysis tools for identification and quantification of food that is consumed at a meal. Images obtained before and after foods are eaten are used to estimate the amount and type of food consumed. The mobile device provides a unique vehicle for collecting dietary information that reduces the burden on respondents that are obtained using more classical approaches for dietary assessment. We describe our approach to image analysis that includes the segmentation of food items, features used to identify foods, a method for automatic portion estimation, and our overall system architecture for collecting the food intake information. PMID:20862266

  3. PMU-Aided Voltage Security Assessment for a Wind Power Plant: Preprint

    SciTech Connect

    Jiang, H.; Zhang, Y. C.; Zhang, J. J.; Muljadi, E.

    2015-04-08

    Because wind power penetration levels in electric power systems are continuously increasing, voltage stability is a critical issue for maintaining power system security and operation. The traditional methods to analyze voltage stability can be classified into two categories: dynamic and steady-state. Dynamic analysis relies on time-domain simulations of faults at different locations; however, this method needs to exhaust faults at all locations to find the security region for voltage at a single bus. With the widely located phasor measurement units (PMUs), the Thevenin equivalent matrix can be calculated by the voltage and current information collected by the PMUs. This paper proposes a method based on a Thevenin equivalent matrix to identify system locations that will have the greatest impact on the voltage at the wind power plant’s point of interconnection. The number of dynamic voltage stability analysis runs is greatly reduced by using the proposed method. The numerical results demonstrate the feasibility, effectiveness, and robustness of the proposed approach for voltage security assessment for a wind power plant.

  4. PMU-Aided Voltage Security Assessment for a Wind Power Plant

    SciTech Connect

    Jiang, Huaiguang; Zhang, Yingchen; Zhang, Jun Jason; Muljadi, Eduard

    2015-10-05

    Because wind power penetration levels in electric power systems are continuously increasing, voltage stability is a critical issue for maintaining power system security and operation. The traditional methods to analyze voltage stability can be classified into two categories: dynamic and steady-state. Dynamic analysis relies on time-domain simulations of faults at different locations; however, this method needs to exhaust faults at all locations to find the security region for voltage at a single bus. With the widely located phasor measurement units (PMUs), the Thevenin equivalent matrix can be calculated by the voltage and current information collected by the PMUs. This paper proposes a method based on a Thevenin equivalent matrix to identify system locations that will have the greatest impact on the voltage at the wind power plant's point of interconnection. The number of dynamic voltage stability analysis runs is greatly reduced by using the proposed method. The numerical results demonstrate the feasibility, effectiveness, and robustness of the proposed approach for voltage security assessment for a wind power plant.

  5. International Exchange of Emergency Phase Information and Assessment: An Aid to Inter/National Decision Makers

    SciTech Connect

    Sullivan, T J; Chino, M; Ehrhardt, J; Shershakov, V

    2003-09-01

    This paper discusses a collaborative project whose purpose is (1) to demonstrate the technical feasibility and mutual benefit of a system seeking early review or preview, in a ''quasi peer review'' mode, of nuclear accident plume and dose assessment predictions by four major international nuclear accident emergency response systems before release of their calculations to their respective national authorities followed by (2) sharing these results with responsible international authorities. The extreme sensitivity of the general public to any nuclear accident information has been a strong motivation to seek peer review prior to public release. Another intended objective of this work is (3) the development of an affordable/accessible system for distribution of prediction results to countries having no prediction capabilities and (4) utilization of the link for exercises and collaboration studies. The project exploits the Internet as a ubiquitous communications medium, browser technology as a simple, user friendly interface, and low-cost PC level hardware. The participants are developing a web based dedicated node with ID and password access control, where the four systems can deposit a minimal set of XML-based data and graphics files, which are then displayed in a common identical map format. Side-by-side viewing and televideo conferencing will permit rapid evaluation, correction or elaboration of data, recalculation (if necessary) and should produce a strong level of consensus to assist international decision makers. Successful completion of this work could lead to easy utilization by national and international organizations, such as the IAEA and WHO, as well as by non-nuclear states at risk of a trans-boundary incursion on their territory.

  6. Validation of the facial assessment by computer evaluation (FACE) program for software-aided eyelid measurements.

    PubMed

    Choi, Catherine J; Lefebvre, Daniel R; Yoon, Michael K

    2016-06-01

    The aim of this article is to validate the accuracy of Facial Assessment by Computer Evaluation (FACE) program in eyelid measurements. Sixteen subjects between the ages of 27 and 65 were included with IRB approval. Clinical measurements of upper eyelid margin reflex distance (MRD1) and inter-palpebral fissure (IPF) were obtained. Photographs were then taken with a digital single lens reflex camera with built-in pop-up flash (dSLR-pop) and a dSLR with lens-mounted ring flash (dSLR-ring) with the cameras upright, rotated 90, 180, and 270 degrees. The images were analyzed using both the FACE and ImageJ software to measure MRD1 and IPF.Thirty-two eyes of sixteen subjects were included. Comparison of clinical measurement of MRD1 and IPF with FACE measurements of photos in upright position showed no statistically significant differences for dSLR-pop (MRD1: p = 0.0912, IPF: p = 0.334) and for dSLR-ring (MRD1: p = 0.105, IPF: p = 0.538). One-to-one comparison of MRD1 and IPF measurements in four positions obtained with FACE versus ImageJ for dSLR-pop showed moderate to substantial agreement for MRD1 (intraclass correlation coefficient = 0.534 upright, 0.731 in 90 degree rotation, 0.627 in 180 degree rotation, 0.477 in 270 degree rotation) and substantial to excellent agreement in IPF (ICC = 0.740, 0.859, 0.849, 0.805). In photos taken with dSLR-ring, there was excellent agreement of all MRD1 (ICC = 0.916, 0.932, 0.845, 0.812) and IPF (ICC = 0.937, 0.938, 0.917, 0.888) values. The FACE program is a valid method for measuring margin reflex distance and inter-palpebral fissure.

  7. Hedging Medical Spending Growth: An Adaptive Expectations Approach

    PubMed Central

    Lieberthal, Robert D.

    2016-01-01

    Long-term health insurance provides consumers with protection against persistent, negative health shocks. While the stochastic rise in medical spending growth may make some health risks harder to insure, financial assets could act as a hedge for medical spending growth risk. The purpose of this research was to determine whether such hedges exist. The results of this study were two-fold. First, the asset classes with the strongest statistical evidence as hedges were bonds, not stocks. Second, any strategy to hedge medical spending growth involved shorting assets i.e. betting against the bond or stock market. Health insurers writing long-term contracts should combine the use of hedges in the bond market with of portfolio diversification, and may benefit from health policies to moderate the uncertainty of medical spending growth. PMID:27635415

  8. The economic impact of NASA R and D spending

    NASA Technical Reports Server (NTRS)

    Evans, M. K.

    1976-01-01

    The economic impact of R and D spending, particularly NASA R and D spending, on the U. S. economy was evaluated. The crux of the methodology and hence the results revolve around the fact that it was necessary to consider both the demand effects of increased spending and the supply effects of a higher rate of technological growth and a larger total productive capacity. The demand effects are primarily short-run in nature, while the supply effects do not begin to have a significant effect on aggregate economic activity until the fifth year after increased expenditures have taken place. The short-term economic impact of alternative levels of NASA expenditures for 1975 was first examined. The long-term economic impact of increased levels of NASA R and D spending over a sustained period was then evaluated.

  9. Medicare spending by beneficiaries with various types of supplemental insurance.

    PubMed

    Khandker, R K; McCormack, L A

    1999-06-01

    The authors analyzed Medicare spending by elderly noninstitutionalized Medicare beneficiaries with and without supplemental insurance such as Medigap, employer-sponsored plans, and Medicaid. Use of a detailed survey of Medicare beneficiaries and their Medicare health insurance claims enabled the authors to control for health status, chronic conditions, functional limitations, and other factors that explain spending variations across supplemental insurance categories. The authors found that supplemental insurance was associated with a higher probability and level of Medicare spending, particularly for Part B services. Beneficiaries with both Medigap and employer plans had the highest levels of spending ceteris paribus, suggesting a possible moral hazard effect of insurance. Findings from this study are discussed in the context of the overall financing of health care for the elderly. PMID:10373721

  10. Hedging Medical Spending Growth: An Adaptive Expectations Approach

    PubMed Central

    Lieberthal, Robert D.

    2016-01-01

    Long-term health insurance provides consumers with protection against persistent, negative health shocks. While the stochastic rise in medical spending growth may make some health risks harder to insure, financial assets could act as a hedge for medical spending growth risk. The purpose of this research was to determine whether such hedges exist. The results of this study were two-fold. First, the asset classes with the strongest statistical evidence as hedges were bonds, not stocks. Second, any strategy to hedge medical spending growth involved shorting assets i.e. betting against the bond or stock market. Health insurers writing long-term contracts should combine the use of hedges in the bond market with of portfolio diversification, and may benefit from health policies to moderate the uncertainty of medical spending growth.

  11. Development and Assessment of an Integrated Computer-Aided Detection Scheme for Digital Microscopic Images of Metaphase Chromosomes

    PubMed Central

    Wang, Xingwei; Zheng, Bin; Li, Shibo; Mulvihill, John J.; Liu, Hong

    2012-01-01

    The authors developed an integrated computer-aided detection (CAD) scheme for detecting and classifying metaphase chromosomes as well as assessing its performance and robustness. This scheme includes an automatic metaphase-finding module and a karyotyping module and it was applied to a testing database with 200 digital microscopic images. The automatic metaphase-finding module detects analyzable metaphase cells using a feature-based artificial neural network (ANN). The ANN-generated outputs are analyzed by a receiver operating characteristics (ROC) method and an area under the ROC curve is 0.966. Then, the automatic karyotyping module classifies individual chromosomes of this cell into 24 types. In this module, a two-layer decision tree-based classifier with eight ANNs established in its connection nodes was optimized by a genetic algorithm. Chromosomes are first classified into seven groups by the ANN in the first layer. The chromosomes in these groups are then separately classified by seven ANNs into 24 types in the second layer. The classification accuracy is 94.5% in the first layer. Six ANNs achieved the accuracy above 95% and only one had lessened performance (80.6%) in the second layer. The overall classification accuracy is 91.5% as compared to 86.7% in the previous study using two independent datasets randomly acquired from our genetic laboratory. The results demonstrate that our automated scheme achieves high and robust performance in identification and classification of metaphase chromosomes. PMID:23087585

  12. Development and Assessment of an Integrated Computer-Aided Detection Scheme for Digital Microscopic Images of Metaphase Chromosomes.

    PubMed

    Wang, Xingwei; Zheng, Bin; Li, Shibo; Mulvihill, John J; Liu, Hong

    2008-10-01

    The authors developed an integrated computer-aided detection (CAD) scheme for detecting and classifying metaphase chromosomes as well as assessing its performance and robustness. This scheme includes an automatic metaphase-finding module and a karyotyping module and it was applied to a testing database with 200 digital microscopic images. The automatic metaphase-finding module detects analyzable metaphase cells using a feature-based artificial neural network (ANN). The ANN-generated outputs are analyzed by a receiver operating characteristics (ROC) method and an area under the ROC curve is 0.966. Then, the automatic karyotyping module classifies individual chromosomes of this cell into 24 types. In this module, a two-layer decision tree-based classifier with eight ANNs established in its connection nodes was optimized by a genetic algorithm. Chromosomes are first classified into seven groups by the ANN in the first layer. The chromosomes in these groups are then separately classified by seven ANNs into 24 types in the second layer. The classification accuracy is 94.5% in the first layer. Six ANNs achieved the accuracy above 95% and only one had lessened performance (80.6%) in the second layer. The overall classification accuracy is 91.5% as compared to 86.7% in the previous study using two independent datasets randomly acquired from our genetic laboratory. The results demonstrate that our automated scheme achieves high and robust performance in identification and classification of metaphase chromosomes.

  13. Assessment of cobalt 57 tagged bleomycin as a clinical aid in staging of head and neck carcinoma

    SciTech Connect

    Cummings, C.W.; Larson, S.M.; Dobie, R.A.; Weymuller, E.A. Jr.; Rudd, T.G.; Merello, A.

    1981-04-01

    Critical assessment of head and neck cancer with respect to staging has, on occasion, been disappointingly ineffective. The incidence of measurable uptake of cobalt 57 tagged bleomycin by primary squamous cell carcinoma and metastatic cervical lymph nodes has been correlated. Forty-six cases have been evaluated with respect to histopathological confirmation of the suspected metastatic disease. We have found that this diagnostic measure increases our acumen in staging of head and neck cancer. The relevance of the Co-Bleo scans as a diagnostic aid is reported in 46 cases. Malignant tumors greater than 2 cm in size appear to demonstrate active uptake of the imaging agent. Small tumor size and excess background radioactivity contribute to the false-negatives (17%). Inflammatory conditions or benign tumors of the salivary apparatus may result in minimal uptake, thus, a false-positive result (10%). An increase in the radioactivity of the Co-Bleo may enhance the benefits of this procedure in the search for an undiagnosed primary, as well as undiagnosed local or distant metastases.

  14. Assessment of cobalt 57 tagged bleomycin as a clinical aid in staging of head and neck carcinoma

    SciTech Connect

    Cummings, C.W.; Larson, S.M.; Dobie, R.A.; Weymuller, E.A. Jr.; Rudd, T.G.; Merello, A.

    1981-04-01

    Critical assessment of head and neck cancer with respect to staging has, on occasion, been disappointingly ineffective. We have attempted to correlate the incidence of measureable uptake of cobalt 57 tagged bleomycin by primary squamous cell carcinoma and metastatic cervical lymph nodes. Forty-six cases have been evaluated with respect to histopathological confirmation of the suspected metastatic disease. We have found that this diagnostic measure increases our acumen in staging of head and neck cancer. The relevance of the Co-Bleo scans as a diagnostic aid is reported in 46 cases. Malignant tumors greater than 2 cm in size appear to demonstrate active uptake of the imaging agent. Small tumor size and excess background radioactivity contribute to the false-negatives (17%). Inflammatory conditions or benign tumors of the salivary apparatus may result in minimal uptake, thus, a false-positive result (10%). An increase in the radioactivity of the Co-Bleo may enhance the benefits of this procedure in the search for an undiagnosed primary, as well as undiagnosed local or distant metastases.

  15. Assessment of cobalt 57 tagged bleomycin as a clinical aid in staging of head and neck carcinoma.

    PubMed

    Cummings, C W; Larson, S M; Dobie, R A; Weymuller, E A; Rudd, T G; Merello, A

    1981-04-01

    Critical assessment of head and neck cancer with respect to staging has, on occasion, been disappointingly ineffective. We have attempted to correlate the incidence of measureable uptake of cobalt 57 tagged bleomycin by primary squamous cell carcinoma and metastatic cervical lymph nodes. Forty-six cases have been evaluated with respect to histopathological confirmation of the suspected metastatic disease. We have found that this diagnostic measure increases our acumen in staging of head and neck cancer. The relevance of the Co-Bleo scans as a diagnostic aid is reported in 46 cases. Malignant tumors greater than 2 cm in size appear to demonstrate active uptake of the imaging agent. Small tumor size and excess background radioactivity contribute to the false-negatives (17%). Inflammatory conditions or benign tumors of the salivary apparatus may result in minimal uptake, thus, a false-positive result (10%). An increase in the radioactivity of the Co-Bleo may enhance the benefits of this procedure in the search for an undiagnosed primary, as well as undiagnosed local or distant metastases.

  16. Financial Incentives, Workplace Wellness Program Participation, and Utilization of Health Care Services and Spending.

    PubMed

    Fronstin, Paul; Roebuck, M Christopher

    2015-08-01

    This paper analyzes data from a large employer that enhanced financial incentives to encourage participation in its workplace wellness programs. It examines, first, the effect of financial incentives on wellness program participation, and second, it estimates the impact of wellness program participation on utilization of health care services and spending. The Patient Protection and Affordable Care Act of 2010 (PPACA) allows employers to provide financial incentives of as much as 30 percent of the total cost of coverage when tied to participation in a wellness program. Participation in health risk assessments (HRAs) increased by 50 percentage points among members of unions that bargained in the incentive, and increased 22 percentage points among non-union employees. Participation in the biometric screening program increased 55 percentage points when financial incentives were provided. Biometric screenings led to an average increase of 0.31 annual prescription drug fills, with related spending higher by $56 per member per year. Otherwise, no significant effects of participation in HRAs or biometric screenings on utilization of health care services and spending were found. The largest increase in medication utilization as a result of biometric screening was for statins, which are widely used to treat high cholesterol. This therapeutic class accounted for one-sixth of the overall increase in prescription drug utilization. Second were antidepressants, followed by ACE inhibitors (for hypertension), and thyroid hormones (for hypothyroidism). Biometric screening also led to significantly higher utilization of biologic response modifiers and immunosuppressants. These specialty medications are used to treat autoimmune diseases, such as rheumatoid arthritis and multiple sclerosis, and are relatively expensive compared with non-specialty medications. The added spending associated with the combined increase in fills of 0.02 was $27 per member per year--about one-half of the

  17. Medicaid spending on contraceptive coverage and pregnancy-related care

    PubMed Central

    2014-01-01

    Objective Up to 50% of pregnancies are unintended in the United States, and the healthcare costs associated with pregnancy are the most expensive among hospitalized conditions. The current study aims to assess Medicaid spending on various methods of contraception and on pregnancy care including unintended pregnancies. Methods We analyzed Medicaid health claims data from 2004 to 2010. Women 14–49 years of age initiating contraceptive methods and pregnant women were included as separate cohorts. Medicaid spending was summarized using mean all-cause and contraceptive healthcare payments per patient per month (PPPM) over a follow-up period of up to 12 months. Medicaid payments were also estimated in 2008 per female member of childbearing age per month (PFCPM) and per member per month (PMPM). Medicaid payments on unintended pregnancies were also evaluated PFCPM and PMPM in 2008. Results For short-acting reversible contraception (SARC) users, all-cause payments and contraceptive payments PPPM were respectively $365 and $18.3 for oral contraceptive (OC) users, $308 and $19.9 for transdermal users, $215 and $21.6 for vaginal ring users, and $410 and $8.8 for injectable users. For long-acting reversible contraception (LARC) users (follow-up of 9–10 months), corresponding payments were $194 and $36.8 for IUD users, and $237 and $29.9 for implant users. Pregnancy cohort all-cause mean healthcare payments PPPM were $610. Payments PFCPM and PMPM for contraceptives were $1.44 and $0.54, while corresponding costs of pregnancies were estimated at $39.91 and $14.81, respectively. Payments PFCPM and PMPM for contraceptives represented a small fraction at 6.56% ($1.44/$21.95) and 6.63% ($0.54/$8.15), respectively of the estimated payments for unintended pregnancy. Conclusions This study of a large sample of Medicaid beneficiaries demonstrated that, over a follow-up period of 12 months, Medicaid payments for pregnancy were considerably higher than payments for either SARC or

  18. Congress moves to set priorities for EPA research spending

    SciTech Connect

    Hanson, D.

    1993-05-31

    Research and development spending at the Environmental Protection Agency is slated to rise more than 5% in President Bill Clinton's fiscal 1994 budget. Congress is stepping in, however, and may have something to say not only about how much money is spent, but also how it is spent. For the first time in a decade, formal authorization of EPA's Office of Research and Development (ORD) is moving through Congress. The ORD authorization was approved May 20 in the House Science Committee's Subcommittee on Technology, Environment and Aviation. Introduced by subcommittee chairman Rep. Tim Valentine (D.-N.C.), the authorization bill (H.R. 1994) would provide $475 million in funding for fiscal 1994. This equals the amount proposed by Clinton, $536 million, if about $60 million earmarked for Superfund-related research is removed. The Valentine bill would set out programmatic guidelines for EPA research, requiring fundamental research in ecology, health, and risk reduction. It would also require the agency's Science Advisory Board to review these programs and submit progress reports to Congress every two years. Another part of the bill would require EPA to consolidate agency efforts to identify, compare, and assess risk to public health and the environment posed by pollution.

  19. How construction spending impacts upon utility stock prices

    SciTech Connect

    Randall, K.F.

    1984-03-15

    As utility stock price to book value ratios deviate from unity, the effect of utility capital spending changes. In this article, careful application of the discounted cash-flow model clearly reveals the relationship between investor stock pricing behavior and growth in construction spending. Upon an examination of the sometimes conflicting interests of utility shareholders and customers, the author suggests a strategy for ensuring that utility management and regulators are free to pursue construction programs best suited to customer needs.

  20. Fiscal policy dilemmas and health spending in South Africa.

    PubMed

    Hilsenrath, P

    1999-01-01

    There is broad agreement that government has an important role to play in the development of human capital, especially in health and education. Multilateral organizations, such as the World Bank, commonly call for public sector investment in human resources but the use of health spending to combat unemployment remains controversial. This article examines public sector expenditures in health and focuses on three arguments: 1) public goods; 2) investment in human capital; and 3) Keynesian spending in periods of high unemployment. PMID:10538669

  1. Fiscal policy dilemmas and health spending in South Africa.

    PubMed

    Hilsenrath, P

    1999-01-01

    There is broad agreement that government has an important role to play in the development of human capital, especially in health and education. Multilateral organizations, such as the World Bank, commonly call for public sector investment in human resources but the use of health spending to combat unemployment remains controversial. This article examines public sector expenditures in health and focuses on three arguments: 1) public goods; 2) investment in human capital; and 3) Keynesian spending in periods of high unemployment.

  2. Computer-aided global breast MR image feature analysis for prediction of tumor response to chemotherapy: performance assessment

    NASA Astrophysics Data System (ADS)

    Aghaei, Faranak; Tan, Maxine; Hollingsworth, Alan B.; Zheng, Bin; Cheng, Samuel

    2016-03-01

    Dynamic contrast-enhanced breast magnetic resonance imaging (DCE-MRI) has been used increasingly in breast cancer diagnosis and assessment of cancer treatment efficacy. In this study, we applied a computer-aided detection (CAD) scheme to automatically segment breast regions depicting on MR images and used the kinetic image features computed from the global breast MR images acquired before neoadjuvant chemotherapy to build a new quantitative model to predict response of the breast cancer patients to the chemotherapy. To assess performance and robustness of this new prediction model, an image dataset involving breast MR images acquired from 151 cancer patients before undergoing neoadjuvant chemotherapy was retrospectively assembled and used. Among them, 63 patients had "complete response" (CR) to chemotherapy in which the enhanced contrast levels inside the tumor volume (pre-treatment) was reduced to the level as the normal enhanced background parenchymal tissues (post-treatment), while 88 patients had "partially response" (PR) in which the high contrast enhancement remain in the tumor regions after treatment. We performed the studies to analyze the correlation among the 22 global kinetic image features and then select a set of 4 optimal features. Applying an artificial neural network trained with the fusion of these 4 kinetic image features, the prediction model yielded an area under ROC curve (AUC) of 0.83+/-0.04. This study demonstrated that by avoiding tumor segmentation, which is often difficult and unreliable, fusion of kinetic image features computed from global breast MR images without tumor segmentation can also generate a useful clinical marker in predicting efficacy of chemotherapy.

  3. Why prevention can increase health-care spending.

    PubMed

    Temple, Norman J

    2012-10-01

    This article examines the impact of disease prevention on health-care spending. The relationship between these two variables is more complex than what, at first glance, appears to be the case. Health-care spending would be reduced if more effective means could be found to prevent health problems that are expensive to treat but are generally not fatal, such as dementia, infectious diseases and accidents. The major focus here is on interventions designed to persuade people to quit smoking. Savings on health-care spending in early years after people stop smoking are counter-balanced (often exceeded) by higher spending at a later time. In addition, when people stop smoking there is a significant negative impact on government finances from the double effect of lost tax revenues combined with increased spending on pension payments. Arguments in favour of policies designed to prevent fatal disease, such as by reducing the prevalence of smoking, should be based on improvements to population health rather than on misleading claims that this will reduce spending on health care. PMID:21914705

  4. Why prevention can increase health-care spending.

    PubMed

    Temple, Norman J

    2012-10-01

    This article examines the impact of disease prevention on health-care spending. The relationship between these two variables is more complex than what, at first glance, appears to be the case. Health-care spending would be reduced if more effective means could be found to prevent health problems that are expensive to treat but are generally not fatal, such as dementia, infectious diseases and accidents. The major focus here is on interventions designed to persuade people to quit smoking. Savings on health-care spending in early years after people stop smoking are counter-balanced (often exceeded) by higher spending at a later time. In addition, when people stop smoking there is a significant negative impact on government finances from the double effect of lost tax revenues combined with increased spending on pension payments. Arguments in favour of policies designed to prevent fatal disease, such as by reducing the prevalence of smoking, should be based on improvements to population health rather than on misleading claims that this will reduce spending on health care.

  5. The impact of public spending on health: does money matter?

    PubMed

    Filmer, D; Pritchett, L

    1999-11-01

    We use cross-national data to examine the impact of both public spending on health and non-health factors (economic, educational, cultural) in determining child (under-5) and infant mortality. There are two striking findings. First, the impact of public spending on health is quite small, with a coefficient that is typically both numerically small and statistically insignificant at conventional levels. Independent variation in public spending explains less than one-seventh of 1% of the observed differences in mortality across countries. The estimates imply that for a developing country at average income levels the actual public spending per child death averted is $50,000-100,000. This stands in marked contrast to the typical range of estimates of the cost effectiveness of medical interventions to avert the largest causes of child mortality in developing countries, which is $10-4000. We outline three possible explanations for this divergence of the actual and apparent potential of public spending. Second, whereas health spending is not a powerful determinant of mortality, 95% of cross-national variation in mortality can be explained by a country's income per capita, inequality of income distribution, extent of female education, level of ethnic fragmentation, and predominant religion.

  6. Clinton calls for 3 percent boost in Federal AIDS programs.

    PubMed

    1996-04-19

    President Bill Clinton's fiscal 1997 budget includes a 3 percent increase in Federal funding for AIDS research, prevention, treatment, and care programs. Total discretionary spending on AIDS would approach $3 billion. Federal programs that will benefit include the Ryan White CARE Act, research conducted at the National Institutes of Health (NIH), restoration of full authority of the NIH's Office of AIDS Research, and prevention programs administered by the Centers for Disease Control and Prevention (CDC).

  7. Computer-Aided Energy Analysis for Buildings: An Assessment of Its Value for Students of Technology and Architecture.

    ERIC Educational Resources Information Center

    Ridenour, Steven

    1981-01-01

    Demonstrates that computer aided energy analysis improves students' (N=29) comprehension and prediction accuracy of energy consumption in buildings and confirms that a reasonably accurate building energy analysis computer program can be designed for student users. (Author/SK)

  8. Home and community based care program assessment for people living with HIV/AIDS in Arba Minch, Southern Ethiopia

    PubMed Central

    2012-01-01

    Background People Living with HIV/AIDS (PLWHA) require significant care and support; however, most care needs are still unmet. To our knowledge, no studies have described the activities and challenges of care services in Ethiopia. Our objective was to assess the status, shortcomings and prospects of care and support services provided to PLWHA in the town of Arba Minch, Ethiopia, and surrounding areas. Methods A cross-sectional quantitative study combined with qualitative methods was conducted in Southern Ethiopia among 226 randomly selected PLWHAs and 10 service providers who were purposively selected. Data was collected using a pre-tested structured interview questionnaire and in-depth interview guideline. Quantitative data was analyzed using SPSS windows based statistical software while qualitative data was analyzed manually using thematic framework analysis. Results A total of 226 PLWHAs were interviewed. Socio-economic support (material and income generating activities) was being received by 108 (47.8%) of the respondents, counseling services (e.g. psychological support) were being received 128(56.6%), 144 (63.7%) alleviation of stigma and discrimination as human right and legal support for study participants. Inadequate external financial support, lack of proper referral systems between different care providers were among the reasons identified for the low quality and redundancy of care and support activities. Nonetheless, many opportunities and prospects, including easily accessible care receivers (PLWHA), good political and societal will were also implicated. Conclusion Care and support services provided to PLWHAs in the study area are by far lower in terms of coverage and quantity. Strategies for improvement could be facilitated given the observed political will, social support and access to care givers. PMID:22703842

  9. Computer-aided detection of breast masses depicted on full-field digital mammograms: a performance assessment

    PubMed Central

    Zheng, B; Sumkin, J H; Zuley, M L; Lederman, D; Wang, X; Gur, D

    2012-01-01

    Objectives To investigate the feasibility of converting a computer–aided detection (CAD) scheme for digitised screen–film mammograms to full-field digital mammograms (FFDMs) and assessing CAD performance on a large database. Methods The database included 6478 FFDM images acquired on 1120 females, with 525 cancer cases and 595 negative cases. The database was divided into five case groups: (1) cancer detected during screening, (2) interval cancers, (3) “high-risk” recommended for surgical excision, (4) recalled but negative and (5) negative (not recalled). A previously developed CAD scheme for masses depicted on digitised images was converted and re-optimised for FFDM images while keeping the same image-processing structure. CAD performance was analysed on the entire database. Results The case-based sensitivity was 75.6% (397/525) for the current mammograms and 40.8% (42/103) for the prior mammograms deemed negative during clinical interpretation but “visible” during retrospective review. The region-based sensitivity was 58.1% (618/1064) for the current mammograms and 28.4% (57/201) for the prior mammograms. The CAD scheme marked 55.7% (221/397) and 35.7% (15/42) of the masses on both views of the current and the prior examinations, respectively. The overall CAD-cued false-positive rate was 0.32 per image, ranging from 0.29 to 0.51 for the five case groups. Conclusion This study indicated that (1) digitised image-based CAD can be converted for FFDMs while performing at a comparable, or better, level; (2) CAD detects a substantial fraction of cancers depicted on prior examinations, albeit most having been marked only on one view; and (3) CAD tends to mark more false-positive results on “difficult” negative cases that are more visually difficult for radiologists to interpret. PMID:21343322

  10. Manufacturing Aids

    NASA Technical Reports Server (NTRS)

    1989-01-01

    During a research program, MMTC/Textron invented a computer-aided automatic robotic system for spraying hot plasma onto a turbine blade. The need to control the thickness of the plasma deposit led to the development of advanced optical gaging techniques to monitor and control plasma spray build-up on blade surfaces. The techniques led to computerized optical gages for inspecting aircraft, industrial turbine blades, etc. MMTC offers 10 standard commercial robotic gages. The system also generates two dimensional profiles for assessing status and specifying repairs to the electromechanical cathodes used to make the parts. It is capable of accuracies to a ten-thousandth of an inch. An expanded product line is currently marketed. The gages offer multiple improvements in quality control and significant savings.

  11. The effects of national and international HIV/AIDS funding and governance mechanisms on the development of civil-society responses to HIV/AIDS in East and Southern Africa.

    PubMed

    Kelly, Kevin J; Birdsall, Karen

    2010-01-01

    The study takes stock of the exponential growth in the number of new civil-society organisations (CSOs) working in the HIV/AIDS field in East and Southern Africa during the period 1996-2004. We researched this development through a survey of 439 CSOs in six countries and case studies focused on the evolution of community responses to HIV/AIDS in specific communities in eight countries. We describe the types of CSOs that emerged, their relationships with governments and donors, and their activities, organisational characteristics and funding requirements. The data presented show that the vision of social mobilisation of HIV/AIDS responses through community-level organisations has faced strong external challenges. Evidence from survey data, national HIV/AIDS spending assessments and case studies shows that in some respects the changing international aid environment undermines the prospects for development of the civil-society sector's contributions in HIV/AIDS responses. Of particular interest is to understand how the "Three Ones" and the Paris Declaration on Aid Effectiveness have reshaped international funding for HIV/AIDS responses. There has been relatively little attention paid to the impact of the new management and funding modalities--including national performance frameworks, general budget support, joint funding arrangements and basket funds--on civil-society agencies at the forefront of community HIV/AIDS responses. Evidence is presented to show that in important respects the new modalities limit the unique contribution that CSOs can make to national HIV/AIDS responses. It is also shown that the drive to rapidly intensify the scale of HIV/AIDS responses has involved using community organisations as service providers for externally formulated programmes. We discuss this as a strong threat to the development of sustainable civil-society economies as well as to CSOs' diversity and responsiveness. The ways in which CSOs are responding to these challenges are

  12. AIDS (image)

    MedlinePlus

    AIDS (acquired immune deficiency syndrome) is caused by HIV (human immunodeficiency virus), and is a syndrome that ... life-threatening illnesses. There is no cure for AIDS, but treatment with antiviral medicine can suppress symptoms. ...

  13. Hearing Aids

    MedlinePlus

    ... more in both quiet and noisy situations. Hearing aids help people who have hearing loss from damage ... your doctor. There are different kinds of hearing aids. They differ by size, their placement on or ...

  14. Knowing Both: Towards Integrating Two Main Approaches to the Tertiary Education of Health Care Workers Involved in Caring for People Living with HIV/AIDS. A Needs Assessment of HIV/AIDS Tertiary Education for Health Care Workers in Metropolitan South Australia.

    ERIC Educational Resources Information Center

    Elsey, Barry; Mills, Patricia

    The need for continuing education about human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) was assessed for health care workers in metropolitan South Australia. Seventeen focus group discussions were held to solicit the views and experiences of various persons regarding HIV/AIDS tertiary education. Included in the…

  15. Improving Performance of Computer-Aided Detection of Masses by Incorporating Bilateral Mammographic Density Asymmetry: An Assessment

    PubMed Central

    Wang, Xingwei; Li, Lihua; Xu, Weidong; Liu, Wei; Lederman, Dror; Zheng, Bin

    2011-01-01

    Rationale and Objectives Bilateral mammographic density asymmetry is a promising indicator in assessing risk of having or developing breast cancer. This study aims to assess the performance improvement of a computer-aided detection (CAD) scheme in detecting masses by incorporating bilateral mammographic density asymmetrical information. Materials and Methods A testing dataset containing 2400 full-field digital mammograms (FFDM) acquired from 600 examination cases was established. Among them, 300 are positive cases with verified cancer associated with malignant masses and 300 are negative cases. Two computerized schemes were applied to process images of each case. The first single-image based CAD scheme detected suspicious mass regions and the second scheme computed average and difference of mammographic tissue density depicted between the left and right breast. A fusion method based on rotation of the CAD scoring projection reference axis was then applied to combine CAD-generated mass detection scores and either the computed average or difference (asymmetry) of bilateral mammographic density scores. The CAD performance levels with and without incorporating mammographic density information were evaluated and compared using a free-response receiver operating characteristic (FROC) type data analysis method. Results CAD achieved a case-based mass detection sensitivity of 0.74 and a region-based sensitivity of 0.56 at a false-positive rate of 0.25 per image. By fusing the CAD and bilateral mammographic density asymmetry scores, the case-based and region-based sensitivity levels of the CAD scheme were increased to 0.84 and 0.69, respectively, at the same false-positive rate. Fusion with average mammographic density only slightly increased CAD sensitivity to 0.75 (case-based) and 0.57 (region-based). Conclusions This study indicated that (1) bilateral mammographic density asymmetry was a stronger indicator of the case depicting suspicious masses than the average density

  16. How adolescents with substance use disorder spend research payments.

    PubMed

    Thurstone, Christian; Salomensen-Sautel, Stacy; Riggs, Paula D

    2010-10-01

    There is concern that research reimbursements to adolescents may increase substance use. However, these concerns have not been examined empirically. Participants were 70 adolescents (13-19 years) with at least one non-nicotine substance use disorder (SUD) enrolled in a 12-week clinical trial of atomoxetine/placebo for attention/deficit-hyperactivity disorder (ADHD). Adolescent participants received cash reimbursement after each study visit (maximum possible = $425 over 12 weeks). Participants reported each week how they spent the previous reimbursement. Results were tallied, and correlates of spending a payment on substances were examined. Results showed that 26 of 70 subjects reported spending at least one research payment on alcohol or drugs, and 25 of 70 subjects reported spending at least one payment on tobacco. Comparing those who did and did not spend a research payment on alcohol/drugs, those who did had more frequent baseline alcohol/drug use but did not differ in demographics (age, gender) or other clinical characteristics (ADHD severity, diagnosis of conduct disorder, number of SUD diagnoses, number of treatment sessions attended, or pre/post-change in number of days used substances in the past 28 days). Comparing those who did and did not spend a payment on tobacco, those who did were slightly older and had more frequent baseline tobacco use. In conclusion, a significant proportion of subjects used at least a portion of one research payment to buy alcohol, drugs or tobacco. However, there was little indication that research payments increased substance use. PMID:20627618

  17. Money Buys Happiness When Spending Fits Our Personality.

    PubMed

    Matz, Sandra C; Gladstone, Joe J; Stillwell, David

    2016-05-01

    In contrast to decades of research reporting surprisingly weak relationships between consumption and happiness, recent findings suggest that money can indeed increase happiness if it is spent the "right way" (e.g., on experiences or on other people). Drawing on the concept of psychological fit, we extend this research by arguing that individual differences play a central role in determining the "right" type of spending to increase well-being. In a field study using more than 76,000 bank-transaction records, we found that individuals spend more on products that match their personality, and that people whose purchases better match their personality report higher levels of life satisfaction. This effect of psychological fit on happiness was stronger than the effect of individuals' total income or the effect of their total spending. A follow-up study showed a causal effect: Personality-matched spending increased positive affect. In summary, when spending matches the buyer's personality, it appears that money can indeed buy happiness.

  18. Money Buys Happiness When Spending Fits Our Personality.

    PubMed

    Matz, Sandra C; Gladstone, Joe J; Stillwell, David

    2016-05-01

    In contrast to decades of research reporting surprisingly weak relationships between consumption and happiness, recent findings suggest that money can indeed increase happiness if it is spent the "right way" (e.g., on experiences or on other people). Drawing on the concept of psychological fit, we extend this research by arguing that individual differences play a central role in determining the "right" type of spending to increase well-being. In a field study using more than 76,000 bank-transaction records, we found that individuals spend more on products that match their personality, and that people whose purchases better match their personality report higher levels of life satisfaction. This effect of psychological fit on happiness was stronger than the effect of individuals' total income or the effect of their total spending. A follow-up study showed a causal effect: Personality-matched spending increased positive affect. In summary, when spending matches the buyer's personality, it appears that money can indeed buy happiness. PMID:27056977

  19. Hearing Aids

    MedlinePlus

    ... type and degree of loss. Are there different styles of hearing aids? Styles of hearing aids Source: NIH/NIDCD Behind-the- ... the ear canal and are available in two styles. The in-the-canal (ITC) hearing aid is ...

  20. Performance Indicators for Public Spending Efficiency in Primary and Secondary Education. OECD Economics Department Working Papers, No. 546

    ERIC Educational Resources Information Center

    Sutherland, Douglas; Price, Robert; Joumard, Isabelle, Nicq, Chantal

    2007-01-01

    This paper assesses the potential to raise public spending efficiency in the primary and secondary education sector. Resource availability per pupil has increased significantly over the past decade in a number of countries; often in attempting to exploit the link between educational attainment and growth. However, available evidence reveals only a…

  1. The Years of Big Spending in Alaska: How Good Is the Record? ISER Occasional Papers No. 20.

    ERIC Educational Resources Information Center

    Harrison, Gordon S.

    This paper is an informal assessment of Alaska state spending during the lucrative "oil years" of the early 1980s. The huge Prudhoe Bay oil field began producing in 1977 and reached a daily output of about 1.5 million barrels in 1980. From 1980 to 1986, the field helped Alaska's government to have, in relation to its population, a revenue income…

  2. How the ACA's Health Insurance Expansions Have Affected Out-of-Pocket Cost-Sharing and Spending on Premiums.

    PubMed

    Glied, Sherry; Solís-Román, Claudia; Parikh, Shivani

    2016-09-01

    One important benefit gained by the millions of Americans with health insurance through the Affordable Care Act (ACA) is protection from high out-of-pocket health spending. While Medicaid unambiguously reduces out-of-pocket premium and medical costs for low-income people, it is less certain that marketplace coverage and other types of insurance purchased to comply with the law's individual mandate also protect from high health spending. Goal: To compare out-of-pocket spending in 2014 to spending in 2013; assess how this spending changed in states where many people enrolled in the marketplaces relative to states where few people enrolled; and project the decline in the percentage of people paying high amounts out-of-pocket. Methods: Linear regression models were used to estimate whether people under age 65 spent above certain thresholds. Key findings and conclusions: The probability of incurring high out-of-pocket costs and premium expenses declined as marketplace enrollment increased. The percentage reductions were greatest among those with incomes between 250 percent and 399 percent of poverty, those who were eligible for premium subsidies, and those who previously were uninsured or had very limited nongroup coverage. These effects appear largely attributable to marketplace enrollment rather than to other ACA provisions or to economic trends.

  3. How the ACA's Health Insurance Expansions Have Affected Out-of-Pocket Cost-Sharing and Spending on Premiums.

    PubMed

    Glied, Sherry; Solís-Román, Claudia; Parikh, Shivani

    2016-09-01

    One important benefit gained by the millions of Americans with health insurance through the Affordable Care Act (ACA) is protection from high out-of-pocket health spending. While Medicaid unambiguously reduces out-of-pocket premium and medical costs for low-income people, it is less certain that marketplace coverage and other types of insurance purchased to comply with the law's individual mandate also protect from high health spending. Goal: To compare out-of-pocket spending in 2014 to spending in 2013; assess how this spending changed in states where many people enrolled in the marketplaces relative to states where few people enrolled; and project the decline in the percentage of people paying high amounts out-of-pocket. Methods: Linear regression models were used to estimate whether people under age 65 spent above certain thresholds. Key findings and conclusions: The probability of incurring high out-of-pocket costs and premium expenses declined as marketplace enrollment increased. The percentage reductions were greatest among those with incomes between 250 percent and 399 percent of poverty, those who were eligible for premium subsidies, and those who previously were uninsured or had very limited nongroup coverage. These effects appear largely attributable to marketplace enrollment rather than to other ACA provisions or to economic trends. PMID:27632806

  4. State responses to the Medicaid spending crisis: 1988 to 1992.

    PubMed

    Coughlin, T A; Ku, L; Holahan, J; Heslam, D; Winterbottom, C

    1994-01-01

    In recent years the growth of Medicaid spending has been a serious state budgetary problem. Between 1988 and 1992, state Medicaid expenditures increased at an average annual rate of 21 percent. Even when accounting for funds from special revenue programs, such as provider tax and donation programs, state Medicaid spending increased by 16 percent each year between 1988 and 1992, which is far higher than in previous years. This rapid expenditure growth occurred when states were having economic slowdowns and facing fiscal pressures in many other areas. Using a case study approach, we investigated the strategies used by nine states to address the recent surge in Medicaid spending. Despite fiscal pressures, the states generally avoided large-scale cutbacks in Medicaid. Instead they implemented a wide range of budgetary actions to reduce the effect of Medicaid growth, including increment program cutbacks, constraining other budgetary sectors, shifting program costs to the federal government, and raising state taxes. PMID:7860972

  5. DataView: Business, Households, and Government: Health Spending, 1994

    PubMed Central

    Cowan, Cathy A.; Braden, Bradley R.; McDonnell, Patricia A.; Sivarajan, Lekha

    1996-01-01

    During the 1990s, growth in health care costs slowed considerably, helping to lessen the spending strain on business, government, and households. Although cost growth has slowed, the Federal Government continues to pay an ever-increasing share of the total health care bill. This article reviews important health care spending trends, and for the first time, provides separate estimates of the employer and employee share of the premium costs for employer-sponsored private health insurance. This article also highlights some of the emerging trends in the employer-sponsored insurance market, including managed care, cost-sharing, and employment shifts. PMID:10165707

  6. Patient cost-sharing and healthcare spending growth.

    PubMed

    Baicker, Katherine; Goldman, Dana

    2011-01-01

    In this paper, we explore the role patient incentives play in slowing healthcare spending growth. Evidence suggests that while patients do indeed respond to financial incentives, cost-sharing does not uniformly improve value; rather, cost-sharing provisions must be deliberately structured and targeted to reduce care of low marginal value. Other mechanisms may be helpful in targeting particular populations or types of utilization. The spillover effects between privately insured and publicly insured populations as well as market imperfections suggest a potential role for public policy in promoting insurance design that slows spending growth while increasing the health that each dollar buys.

  7. Projected Spending on Psychotropic Medications 2013-2020.

    PubMed

    Hodgkin, Dominic; Thomas, Cindy Parks; O'Brien, Peggy L; Levit, Katharine; Richardson, John; Mark, Tami L; Malone, Kevin

    2016-07-01

    Spending on psychotropic medications has grown rapidly in recent decades. Using national data on drug expenditures, patent expirations, future drug development and expert interviews, we project that spending will grow more slowly over the period 2012-2020. The average annual increase is projected to be just 3.0 % per year, continuing the steady deceleration in recent years. The main drivers of this expected deceleration include slower development of new drugs, upcoming patent expirations which will lower prices, and payers' growing ability to manage utilization and promote generic use. The slowdown will relieve some cost pressures on payers, particularly Medicare and Medicaid. PMID:26041078

  8. Projected Spending on Psychotropic Medications 2013-2020.

    PubMed

    Hodgkin, Dominic; Thomas, Cindy Parks; O'Brien, Peggy L; Levit, Katharine; Richardson, John; Mark, Tami L; Malone, Kevin

    2016-07-01

    Spending on psychotropic medications has grown rapidly in recent decades. Using national data on drug expenditures, patent expirations, future drug development and expert interviews, we project that spending will grow more slowly over the period 2012-2020. The average annual increase is projected to be just 3.0 % per year, continuing the steady deceleration in recent years. The main drivers of this expected deceleration include slower development of new drugs, upcoming patent expirations which will lower prices, and payers' growing ability to manage utilization and promote generic use. The slowdown will relieve some cost pressures on payers, particularly Medicare and Medicaid.

  9. Differences by age groups in health care spending.

    PubMed

    Fisher, C R

    1980-01-01

    This paper presents differences by age in health care spending by type of expenditure and by source of funds through 1978. Use of health care services generally increases with age. The average health bill reached $2,026 for the aged in 1978, $764 for the intermediate age group, and $286 for the young. Biological, demographic, and policy factors determine each age group's share of health spending. Public funds financed over three-fifths of the health expenses of the aged, with Medicare and Medicaid together accounting for 58 percent. Most of the health expenses of the young age groups were paid by private sources. PMID:10309224

  10. The economic impact of NASA R and D spending Appendices

    NASA Technical Reports Server (NTRS)

    Evans, M. K.

    1976-01-01

    Seven appendices related to a previous report on the economic impact of NASA R and D spending were presented. They dealt with: (1) theoretical and empirical development of aggregate production functions, (2) the calculation of the time series for the rate of technological progress, (3) the calculation of the industry mix variable, (4) the estimation of distributed lags, (5) the estimation of the equations for gamma, (6) a ten-year forecast of the U.S. economy, (7) simulations of the macroeconomic model for increases in NASA R and D spending of $1.0, $.0.5, and 0.1 billions.

  11. Racial Prejudice and Spending on Drug Rehabilitation: The Role of Attitudes Toward Blacks and Latinos.

    PubMed

    Nielsen, Amie L; Bonn, Scott; Wilson, George

    2010-12-01

    We enhance understanding of the prejudice-induced "color coding" phenomenon among whites by determining whether racial and ethnic prejudices are associated with a previously unexplored policy outcome, spending on drug rehabilitation. We examine attitudes toward both blacks and Latinos; the latter is a group largely ignored in previous research. We assess the impact of several types of racial/ethnic views, including those that manifest modern/indirect prejudice (e.g., stereotypes about violence, individualistic causal attributions) and those that reflect social-distance-based traditional prejudice (opposition to residential proximity and to interracial marriage). These relationships are examined using data from the General Social Survey. Bivariate results support the linkage between both traditional and modern prejudice and rehabilitation spending. Logistic regression analyses also indicate that support for rehabilitation is racialized: Attributing race differences in socioeconomic outcomes to "structural" factors, namely discrimination and lack of chance for education, is associated with believing rehabilitation spending is inadequate, controlling for the effects of other racial/ethnic attitudes and background factors. The relationship between this measure of modern prejudice and the outcome is consistent with color coding. The implications of the findings are discussed, and suggestions for future research that further examine the scope of color coding are offered.

  12. Computer-aided assessment of head computed tomography (CT) studies in patients with suspected traumatic brain injury.

    PubMed

    Yuh, Esther L; Gean, Alisa D; Manley, Geoffrey T; Callen, Andrew L; Wintermark, Max

    2008-10-01

    In this study, we sought to determine the accuracy of a computer algorithm that automatically assesses head computed tomography (CT) studies in patients with suspected traumatic brain injury (TBI) for features of intracranial hemorrhage and mass effect, employing a neuroradiologist's interpretation as the gold standard. To this end, we designed a suite of computer algorithms that evaluates in a fully automated fashion the presence of intracranial blood and/or mass effect based on the following CT findings: (1) presence or absence of a subdural or epidural hematoma, (2) presence or absence of subarachnoid hemorrhage, (3) presence or absence of an intraparenchymal hematoma, (4) presence or absence of clinically significant midline shift (>or=5 mm), and (5) normal, partly effaced, or completely effaced basal cisterns. The algorithm displays abnormal findings as color overlays on the original head CT images, and calculates the volume of each type of blood collection, the midline shift, and the volume of the basal cisterns, based on the above-described features. Thresholds and parameters yielding optimal accuracy of the computer algorithm were determined using a development sample of 33 selected, nonconsecutive patients. The software was then applied to a validation sample of 250 consecutive patients evaluated for suspicion of acute TBI at our institution in 2006-2007. Software detection of the presence of at least one noncontrast CT (NCT) feature of acute TBI demonstrated high sensitivity of 98% and high negative predictive value (NPV) of 99%. There was actually only one false negative case, where a very subtle subdural hematoma, extending exclusively along the falx, was diagnosed by the neuroradiologist, while the case was considered as normal by the computer algorithm. The software was excellent at detecting the presence of mass effect and intracranial hemorrhage, but showed some disagreements with the neuroradiologist in quantifying the degree of mass effect and

  13. American Indian gay, bisexual and two-spirit men: a rapid assessment of HIV/AIDS risk factors, barriers to prevention and culturally-sensitive intervention.

    PubMed

    Burks, Derek J; Robbins, Rockey; Durtschi, Jayson P

    2011-03-01

    Epidemiological data indicate that HIV and AIDS are disproportionately affecting American Indians. Specific to American Indian men identifying as gay, bisexual, two-spirit or who have same-sex experiences, this study assessed HIV-risk behaviours and barriers to testing, prevention and treatment efforts. A rapid assessment model was utilised as an indigenous-supporting research design. Rigour and thoroughness were achieved via multiple validation procedures. Central themes surrounding barriers to HIV prevention included social discrimination, low self-esteem and substance use. Findings suggest the underutilisation of condoms due to ineffective placement and limited availability in popular locations among gay, bisexual and two-spirit individuals. Participants indicated that HIV testing is occurring less frequently and that testing was not available after hours or weekends. Barriers to treatment included a mistrust of the current healthcare system, a perceived lack of support from the Indian Health Service for AIDS care and a lack of transportation to healthcare appointments. Lastly, participants discussed and supported culturally-sensitive treatment services. This study calls attention to the value of an American Indian-specific HIV/AIDS service organisation, the presence of indigenous service providers in the community and culturally-sensitive healthcare providers. PMID:21049311

  14. Assessing the Sustainability of Japan's Foreign Aid Program: An Analysis of Development Assistance to Energy Sectors of Developing Countries

    ERIC Educational Resources Information Center

    Yamaguchi, Hideka

    2005-01-01

    This article examines the effect of Japan's official development assistance (ODA) over 10 years that proposed to facilitate environmental conservation in developing countries. Special emphasis is given to ODA disbursements in the energy sector to evaluate whether Japan's foreign aid has shifted its policy toward more environmentally sound goals.…

  15. EXTENSION OF COMPUTER-AIDED PROCESS ENGINEERING APPLICATIONS TO ENVIRONMENTAL LIFE CYCLE ASSESSMENT AND SUPPLY CHAIN MANAGEMENT

    EPA Science Inventory

    The potential of computer-aided process engineering (CAPE) tools to enable process engineers to improve the environmental performance of both their processes and across the life cycle (from cradle-to-grave) has long been proffered. However, this use of CAPE has not been fully ach...

  16. Assessing an Institutional Response of Universities to HIV/AIDS Epidemic: A Case of National Open University of Nigeria (NOUN)

    ERIC Educational Resources Information Center

    Nom, Ambe-Uva Terhemba

    2007-01-01

    Universities have come under serious attack because of their lackluster response to HIV/AIDS. The article endevours--from an institutional perspective--to what extent National Open University of Nigeria (NOUN) has responded to this challenge. This is done by first, highlighting NOUN basic structures that position it to respond better to the…

  17. Deregulating School Aid in California: How 10 Districts Responded to Fiscal Flexibility, 2009-2010. Research Report Number 2

    ERIC Educational Resources Information Center

    Fuller, Bruce; Marsh, Julie A.; Stecher, Brian M.; Timar, Tom

    2011-01-01

    In 2009, California state legislators freed local educators from the specific guidelines that previously regulated spending on 40 categorical-aid programs known as Tier 3 programs. This Tier 3 flexibility reform, which deregulates $4.5 billion in education funding, was enacted at the same time the legislature made cuts in education spending in…

  18. Factors Associated with Adolescent Saving and Spending Patterns.

    ERIC Educational Resources Information Center

    Pritchard, Mary E.; And Others

    1989-01-01

    Examined saving and spending behaviors of 1,619 employed high school seniors across the country. Found that savers were from families who saved and planned money use; necessity spenders were from families with fewer resources and greater financial difficulties; discretionary spenders felt money was important and were from families with higher…

  19. Inequalities in Parental Spending on Young Children: 1980-2010

    ERIC Educational Resources Information Center

    Kornrich, Sabino

    2016-01-01

    Using 1972-2000 data from the Consumer Expenditure Survey (CES), a nationally representative survey of spending conducted by the Bureau of Labor Statistics, this paper investigates changes in the income-based gap in monetary investments in children under the age of six, when most children typically have entered school in the United States. The…

  20. Judging Money: When Courts Decide How to Spend Taxpayer Dollars

    ERIC Educational Resources Information Center

    Dunn, Josh; Derthick, Martha

    2007-01-01

    Since the 1970s, proponents of greater spending in disadvantaged school districts have pursued their goal through litigation in state courts. They have brought suits in 45 of the 50 states. These suits began with claims of equity, which sought to redistribute revenues from rich to poor districts. Disappointed with the results, within a decade the…

  1. Should Colleges Be Required to Spend More from Their Endowments?

    ERIC Educational Resources Information Center

    Chronicle of Higher Education, 2008

    2008-01-01

    As tuitions continue to rise, Congress is looking for ways to mitigate the costs of college attendance for students and their families. Legislators are giving particular scrutiny to how colleges spend money from their endowments, which have grown significantly over the past decade. Some lawmakers have proposed that institutions with endowments of…

  2. Florida's Opinion on K-12 Public Education Spending

    ERIC Educational Resources Information Center

    Forster, Greg

    2006-01-01

    This scientifically representative poll of 1,200 Floridians finds that public opinion about K-12 public education spending is seriously misinformed. Floridians think public schools need more money, but the main reason is that they are badly mistaken about how much money the public schools actually get. Key findings of the study include: (1) Half…

  3. Communicating Spending Cuts: Lessons for Australian University Leaders

    ERIC Educational Resources Information Center

    Sharrock, Geoff

    2014-01-01

    In 2011 and 2012, two Australian university vice chancellors flagged spending cuts at their institutions to overcome financial problems. In both cases, union and staff opposition led to public protests, intense media scrutiny, delays and retreats. This article compares the two cases to see what lessons may be drawn for university leaders faced…

  4. Time Students Spend Working at Home for School

    ERIC Educational Resources Information Center

    Wagner, Petra; Schober, Barbara; Spiel, Christiane

    2008-01-01

    The paper presents three studies which deal with the time students spend working at home for school. In addition, the paper focuses on the distribution of time investment over the course of a week and on the relationship between academic achievement and time spent working at home for school. In sum, 824 students with an average age of 15 years…

  5. Online ATM Helps Youth Smarten Up about Spending

    ERIC Educational Resources Information Center

    Hibbert, Kathy; Coulson, Elizabeth

    2009-01-01

    While many high school students confess a desire to develop personal money management skills, statistics tracking the average Canadian's personal debt underscore the need to ensure the youth have the tools they need for financial success. What would it take to motivate teens to learn more about how they spend and manage their money? The authors…

  6. Do Our Engineering Students Spend Enough Time Studying?

    ERIC Educational Resources Information Center

    Kolari, S.; Savander-Ranne, C.; Viskari, E.-L.

    2006-01-01

    In higher education one of the most important learning goals is deep understanding. Achieving this goal needs time and effort. The authors discuss their observations of student time use on the basis of several case studies which they have conducted in the field of engineering education in Finland. The time that the students spend studying is…

  7. Universities UK Submission to the 2010 Spending Review

    ERIC Educational Resources Information Center

    Universities UK, 2010

    2010-01-01

    This document represents the submission of Universities UK to the 2010 Spending Review. It sets out why the authors believe universities are critical to the UK's future economic growth, what the impact of cuts to the budget for higher education would be, and the activities which universities are currently pursuing to secure national economic…

  8. Families of Working Wives Spending More on Services and Nondurables.

    ERIC Educational Resources Information Center

    Jacobs, Eva; And Others

    1989-01-01

    Data from the 1984-86 Consumer Expenditure Survey were used to examine effects of a wife's labor force participation on family income and expenditures. Findings indicate that families with employed wives spend significantly more on food away from home, child care, women's apparel, and gasoline than do families in which the wife stays at home. (CH)

  9. Review of "Spend Smart: Fix Our Broken School Funding System"

    ERIC Educational Resources Information Center

    Baker, Bruce

    2011-01-01

    ConnCAN's Spend Smart: "Fix Our Broken School Funding System" was released concurrently with a bill introduced in the Connecticut legislature, based on the principles outlined in the report. However, the report is of negligible value to the policy debate over Connecticut school finance because it provides little or no support for any of the…

  10. CP function: an alpha spending function based on conditional power.

    PubMed

    Jiang, Zhiwei; Wang, Ling; Li, Chanjuan; Xia, Jielai; Wang, William

    2014-11-20

    Alpha spending function and stochastic curtailment are two frequently used methods in group sequential design. In the stochastic curtailment approach, the actual type I error probability cannot be well controlled within the specified significance level. But conditional power (CP) in stochastic curtailment is easier to be accepted and understood by clinicians. In this paper, we develop a spending function based on the concept of conditional power, named CP function, which combines desirable features of alpha spending and stochastic curtailment. Like other two-parameter functions, CP function is flexible to fit the needs of the trial. A simulation study is conducted to explore the choice of CP boundary in CP function that maximizes the trial power. It is equivalent to, even better than, classical Pocock, O'Brien-Fleming, and quadratic spending function as long as a proper ρ0 is given, which is pre-specified CP threshold for efficacy. It also well controls the overall type I error type I error rate and overcomes the disadvantage of stochastic curtailment.

  11. Zimbabwean activist raps government on AIDS.

    PubMed

    1998-12-01

    The director of the Women and AIDS Support Network (WASN) of Zimbabwe is disappointed with the lack of government efforts to fight HIV. Priscilla Misihairabwi noted that, although a quarter of the nation's adults is HIV-positive, the government is spending its resources on the war in Congo. Her agency advocates the use of condoms, safer sex practices and education. Misihairabwi also emphasizes the impoverished and socially dependent state of women in Zimbabwe.

  12. Confronting 'scale-down': assessing Namibia's human resource strategies in the context of decreased HIV/AIDS funding.

    PubMed

    Cairney, Liita-Iyaloo; Kapilashrami, Anuj

    2014-01-01

    In Namibia, support through the Global Fund and President's Emergency Plan for AIDS Relief has facilitated an increase in access to HIV and AIDS services over the past 10 years. In collaboration with the Namibian government, these institutions have enabled the rapid scale-up of prevention, treatment and care services. Inadequate human resources capacity in the public sector was cited as a key challenge to initial scale-up; and a substantial portion of donor funding has gone towards the recruitment of new health workers. However, a recent scale-down of donor funding to the Namibian health sector has taken place, despite the country's high HIV and AIDS burden. With a specific focus on human resources, this paper examines the extent to which management processes that were adopted at scale-up have proven sustainable in the context of scale-down. Drawing on data from 43 semi-structured interviews, we argue that human resources planning and management decisions made at the onset of the country's relationship with the two institutions appear to be primarily driven by the demands of rapid scale-up and counter-productive to the sustainability of interventions.

  13. Teaching AIDS.

    ERIC Educational Resources Information Center

    Tonks, Douglas

    This book presents a curriculum to educate students about the risk of AIDS and HIV infection. The opening chapters of the book presents a discussion of: how teachers can create an environment of support for an AIDS education program; the political and educational implications of winning principal, district, and parental support for an AIDS…

  14. National health spending in 2013: growth slows, remains in step with the overall economy.

    PubMed

    Hartman, Micah; Martin, Anne B; Lassman, David; Catlin, Aaron

    2015-01-01

    In 2013 US health care spending increased 3.6 percent to $2.9 trillion, or $9,255 per person. The share of gross domestic product devoted to health care spending has remained at 17.4 percent since 2009. Health care spending decelerated 0.5 percentage point in 2013, compared to 2012, as a result of slower growth in private health insurance and Medicare spending. Slower growth in spending for hospital care, investments in medical structures and equipment, and spending for physician and clinical care also contributed to the low overall increase.

  15. Is Medicaid sustainable? Spending projections for the program's second forty years.

    PubMed

    Kronick, Richard; Rousseau, David

    2007-01-01

    We constructed long-term projections of Medicaid spending and compared projected growth in spending with that of state and federal revenues. Notwithstanding the anticipated decline in employer-sponsored insurance and the long-term care needs of the baby boomers, we project that Medicaid spending as a share of national health spending will average 16.6 percent from 2006 to 2025--roughly unchanged from 16.5 percent in 2005--and then increase slowly to 19.0 percent by 2045. Growth in government revenues is projected to be large enough to sustain both Medicaid spending increases and substantial real growth in spending for other services.

  16. Poll Finds 63 Pct. Want More Aid for Colleges.

    ERIC Educational Resources Information Center

    Evangelauf, Jean

    1984-01-01

    Members of the general public rank aid to higher education near the top of a list of federal spending priorities, according to a survey sponsored by the American Association of Community and Junior Colleges, the College Board, and the Council for Advancement and Support of Education. (MLW)

  17. Business, households, and government: health care spending, 1995.

    PubMed

    Cowan, C A; Braden, B R

    1997-01-01

    For the period 1990-95, we will present data on health care spending by business, households, and government. In addition, we will measure the relative impact of these expenditures on each sector's ability to pay. In 1994 and 1995, health care costs experienced the slowest growth in 3 decades. Combined with healthy revenue growth, slow cost growth helped ease or stabilize the financing burden faced by business, households and government.

  18. Simplifying Student Aid: The Case for an Easier, Faster, and More Accurate FAFSA

    ERIC Educational Resources Information Center

    Executive Office of the President, 2009

    2009-01-01

    Each year, more than 16 million college students and their families complete the Free Application for Federal Student Aid (FAFSA). They spend hours answering needlessly complicated and intrusive questions that undermine the fundamental goal of student aid: to help more students attend and graduate from college. In this report the Council of…

  19. Cities through the Prism of People’s Spending Behavior

    PubMed Central

    Hawelka, Bartosz; Murillo Arias, Juan; Ratti, Carlo

    2016-01-01

    Scientific studies of society increasingly rely on digital traces produced by various aspects of human activity. In this paper, we exploit a relatively unexplored source of data–anonymized records of bank card transactions collected in Spain by a big European bank, and propose a new classification scheme of cities based on the economic behavior of their residents. First, we study how individual spending behavior is qualitatively and quantitatively affected by various factors such as customer’s age, gender, and size of his/her home city. We show that, similar to other socioeconomic urban quantities, individual spending activity exhibits a statistically significant superlinear scaling with city size. With respect to the general trends, we quantify the distinctive signature of each city in terms of residents’ spending behavior, independently from the effects of scale and demographic heterogeneity. Based on the comparison of city signatures, we build a novel classification of cities across Spain in three categories. That classification exhibits a substantial stability over different city definitions and connects with a meaningful socioeconomic interpretation. Furthermore, it corresponds with the ability of cities to attract foreign visitors, which is a particularly remarkable finding given that the classification was based exclusively on the behavioral patterns of city residents. This highlights the far-reaching applicability of the presented classification approach and its ability to discover patterns that go beyond the quantities directly involved in it. PMID:26849218

  20. Cities through the Prism of People's Spending Behavior.

    PubMed

    Sobolevsky, Stanislav; Sitko, Izabela; Tachet des Combes, Remi; Hawelka, Bartosz; Murillo Arias, Juan; Ratti, Carlo

    2016-01-01

    Scientific studies of society increasingly rely on digital traces produced by various aspects of human activity. In this paper, we exploit a relatively unexplored source of data-anonymized records of bank card transactions collected in Spain by a big European bank, and propose a new classification scheme of cities based on the economic behavior of their residents. First, we study how individual spending behavior is qualitatively and quantitatively affected by various factors such as customer's age, gender, and size of his/her home city. We show that, similar to other socioeconomic urban quantities, individual spending activity exhibits a statistically significant superlinear scaling with city size. With respect to the general trends, we quantify the distinctive signature of each city in terms of residents' spending behavior, independently from the effects of scale and demographic heterogeneity. Based on the comparison of city signatures, we build a novel classification of cities across Spain in three categories. That classification exhibits a substantial stability over different city definitions and connects with a meaningful socioeconomic interpretation. Furthermore, it corresponds with the ability of cities to attract foreign visitors, which is a particularly remarkable finding given that the classification was based exclusively on the behavioral patterns of city residents. This highlights the far-reaching applicability of the presented classification approach and its ability to discover patterns that go beyond the quantities directly involved in it.

  1. Potential effects of rational prescribing on national health care spending

    PubMed Central

    Littman, Jordan; Halil, Roland

    2016-01-01

    Abstract Objective To estimate the cost savings that could result from implementation of a rational prescribing model for drug classes that are equivalent in terms of efficacy, toxicity, and convenience. Design The top 10 drug classes based on annual spending were gathered from the Canadian Institute for Health Information. They were reviewed for potential inclusion in the study based on the ability to compare intraclass medications. When equivalence in efficacy, toxicity, and convenience was determined from a literature review, annual prescribing data were gathered from the National Prescription Drug Utilization Information Systems Database. The potential cost savings were then calculated by comparing current market shares with potential future market shares. Setting Canada. Main outcome measures Estimated differences in spending produced by a rational prescribing model. Results Statins, proton pump inhibitors, angiotensin-converting enzyme inhibitors, and selective serotonin reuptake inhibitors were determined to have class equivalence for efficacy, toxicity, and convenience. Total current annual spending on these classes is $856 million through public drug programs, and an estimated $1.97 billion nationally. Through rational prescribing, annual savings could reach $222 million for public drug programs, and $521 million nationally. Conclusion Most of the potential savings are derived from deprescribing the newest patent-protected medications in each class. Avoiding prescribing the newest intraclass drug, particularly in the absence of research to support its superiority in relevant clinical outcomes, could lead to considerable savings in health care expenditures and might push the pharmaceutical industry to innovate rather than imitate. PMID:26975917

  2. Beverage alcohol spending in Singapore: an empirical update.

    PubMed

    Curry, R L

    1994-04-01

    Data on Singapore suggest strongly that consumer spending on imported and locally produced beverage alcohol was on the rise from 1986 through 1991 just as it had been from 1978 through 1986. Although not alarming in contrast to countries such as South Korea, the rise could signal an emerging problem with both public health and economic growth implications. In terms of economic growth, Singapore's continued economic success and its future plans require a highly skilled labor force, but skilled local workers are in very short supply. Continued rises in spending on beverage alcohol could pose a potential constraint to labor availability and therefore continued material progress. On the public health side, a rise in spending on beverage alcohol could lead to illness and accidents that cause chronic absenteeism, decrease on-the-job productivity, and lead to the permanent loss of valuable workers through alcohol-related motor car and other fatal accidents. A minimalist intervention strategy featuring education and rehabilitation might therefore be a reasonable policy option for government to consider pursuing, both on economic development and public health grounds.

  3. AIDS funding: competing needs and the politics of priorities.

    PubMed

    Krieger, N

    1988-01-01

    Despite the Department of Health and Human Service's 1983 claim that AIDS is the nation's "number one health priority," funding for AIDS research, prevention, and treatment remains inadequate. Worse, it is often marshaled from or juxtaposed against other necessary health allocations. Consequent AIDS-related resource crises include diverting funds for research on other diseases to AIDS investigations, propping up AIDS prevention efforts at the expense of traditional sexually transmitted disease control programs, and pitting the health needs of AIDS patients against the needs of those seeking other urgent health services, e.g., prenatal care. While this forced competition typically is blamed on fiscal constraints, examination of federal spending priorities suggests that it results principally from Reagan Administration policies. This Administration has consistently boosted military spending at the expense of social and health services, and has deliberately undermined efforts to obtain sufficient and new allocations for AIDS. In order to avert political divisions spurred by competition for currently scarce resources, AIDS and other health activists together must argue that excessive military allocations must be shifted to health research and services, and that a national health program must be implemented, if AIDS programs are to be funded appropriately without jeopardizing other necessary health initiatives. PMID:3235241

  4. Responding to climate change in New York State: the ClimAID integrated assessment for effective climate change adaptation in New York State. Final report.

    PubMed

    2011-12-01

    Climate change is already beginning to affect New York State, and these impacts are projected to grow. At the same time, the state has the ability to develop adaptation strategies to prepare for and respond to climate risks now and in the future. The ClimAID assessment provides information on climate change impacts and adaptation for eight sectors in New York State: water resources, coastal zones, ecosystems, agriculture, energy, transportation,telecommunications, and public health. Observed climate trends and future climate projections were developed for seven regions across the state. Within each of the sectors, climate risks, vulnerabilities, and adaptation strategies are identified. Integrating themes across all of the sectors are equity and environmental justice and economics.Case studies are used to examine specific vulnerabilities and potential adaptation strategies in each of the eight sectors. These case studies also illustrate the linkages among climate vulnerabilities, risks, and adaptation, and demonstrate specific monitoring needs. Stakeholder participation was critical to the ClimAID assessment process to ensure relevance to decision makers across the state.

  5. Funding bill contains extra spending on HIV care programs.

    PubMed

    1998-10-30

    Congress is working on an omnibus appropriations bill which will fund key government programs, including AIDS-related programs. The 3000 page bill increases funding for the Ryan White CARE Act, partially due to a need by AIDS Drug Assistance Programs (ADAPs). In addition, AIDS Action and the Congressional Black Caucus secured $100 million in funding for programs targeting the African-American community. Other possible changes in funding are presented.

  6. Hearing Aid

    MedlinePlus

    ... and Food and Drug Administration Staff FDA permits marketing of new laser-based hearing aid with potential ... feeds Follow FDA on Twitter Follow FDA on Facebook View FDA videos on YouTube View FDA photos ...

  7. Dynamics of knowledge and attitudes about AIDS among the educated in southern India.

    PubMed

    Ambati, B K; Ambati, J; Rao, A M

    1997-06-01

    AIDS awareness and attitudes among an educated segment of the Indian population were assessed. The study population was a total of 433 students and faculty in colleges and universities, and research & technical staff of the Public Health Service. While most knew that sexual intercourse (96%) & injection drug use (85%) could transmit HIV, and that shaking hands (95%) & mosquitoes (86%) could not, 63% did not know that breastfeeding was a mode of transmission and 71% falsely believed that they could acquire HIV by donating blood. The only variable to correlate positively with knowledge was education. Knowledge about true and false modes of transmission constituted three distinct dimensions as determined by factor analysis. An overwhelming majority (90%) harboured at least one hostile view towards persons with AIDS. Knowledge and education independently correlated with decreased hostility. There was great concern about the impact of the disease: 85% believed that AIDS is a very serious problem in India and 93% favoured increased government spending on AIDS education. These results display high levels of knowledge (with some gaps), and widespread support for increased action.

  8. 45 CFR 400.103 - Coverage of refugees who spend down to State financial eligibility standards.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 2 2014-10-01 2012-10-01 true Coverage of refugees who spend down to State... Refugee Medical Assistance § 400.103 Coverage of refugees who spend down to State financial eligibility... in § 400.101 to spend down to such standard using an appropriate method for deducting...

  9. 45 CFR 400.103 - Coverage of refugees who spend down to State financial eligibility standards.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 2 2013-10-01 2012-10-01 true Coverage of refugees who spend down to State... Refugee Medical Assistance § 400.103 Coverage of refugees who spend down to State financial eligibility... in § 400.101 to spend down to such standard using an appropriate method for deducting...

  10. 45 CFR 400.103 - Coverage of refugees who spend down to State financial eligibility standards.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 2 2012-10-01 2012-10-01 false Coverage of refugees who spend down to State... Refugee Medical Assistance § 400.103 Coverage of refugees who spend down to State financial eligibility... in § 400.101 to spend down to such standard using an appropriate method for deducting...

  11. 78 FR 24206 - Agency Information Collection Activities; Information Collection; USA Spending

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-24

    ... ADMINISTRATION Agency Information Collection Activities; Information Collection; USA Spending AGENCY: Interagency... requirement regarding USA Spending. DATES: Submit comments on or before June 24, 2013. ADDRESSES: Submit comments identified by Information Collection 3090- 00xx, USA Spending, by any of the following...

  12. Trends in Spending on Training: An Analysis of the 1982 through 2008 Training Annual Industry Reports

    ERIC Educational Resources Information Center

    Carliner, Saul; Bakir, Ingy

    2010-01-01

    This article explores long-term trends in spending using data compiled from the "Training" magazine Annual Industry Survey from 1982 through 2008. It builds on literature that proposes spending on training is an investment that yields benefits--and that offers methods for demonstrating it. After adjusting for inflation, aggregate spending on…

  13. Distribution of Public Education Spending for the Poor: The Case of Yemen

    ERIC Educational Resources Information Center

    Yuki, Takako

    2003-01-01

    This paper explores the issue of how a country for which the prioritization of public spending towards poverty reduction is a key policy concern can monitor the distributional effects of public spending. Employing standard benefit-incidence analysis, this paper empirically examines how public education spending is currently distributed in Yemen.…

  14. Equal Educational Spending across Districts--A Case Study of Taiwan

    ERIC Educational Resources Information Center

    Tao, Hung-Lin

    2010-01-01

    By specifying different goals of educational spending across districts, it is found that input (spending) equality and cost minimization improve both the Gini indexes of the college admission rate and public educational spending per student across different districts for the case of Taiwan. While complete output equality is not feasible, the…

  15. Selected Trends in Public Spending for MR/DD Services and the State Economies.

    ERIC Educational Resources Information Center

    Hemp, Richard; Rizzolo, Mary Catherine; Braddock, David

    2002-01-01

    This article summarizes mental retardation/developmental disabilities (MR/DD) spending since 1977, with emphasis on spending from 1995-2000. The change in state economic conditions, from strong growth in recent years to fiscal constraints in 2002, is addressed. Tables provide data trends in MR spending by type of placement and state and changes in…

  16. Status of Family Support Services and Spending in the United States.

    ERIC Educational Resources Information Center

    Parish, Susan L.; Braddock, David; Hemp, Richard; Rizzolo, Mary C.

    2000-01-01

    Analysis of data on family support services and spending for individuals with developmental disabilities presents information on cash subsidy payments, respite care, and other family support. A graph shows U.S. spending for family support, 1986-1998. Additional tables break down subsidy spending for family support services by state in 1998 and…

  17. Literature review: Computer-aided assessment techniques for nonpoint-source discharges. Final report, Aug-Feb 90

    SciTech Connect

    Heath, J.C.; Karr, L.A.; Canter, L.W.; Lahlou, M.; Cooper, T.A.

    1991-04-01

    Computer models and Geographic Information Systems (GISs) are valuable tools for assessing nonpoint source discharges. Because of the diffused nature and variable flow associated with storm water run-off, it is difficult to design an inexpensive sampling program to assess the impact of nonpoint source pollution. Computer modeling and GISs can help process limited data and make assessments of nonpoint source discharges from both surface water and groundwater sources. Modeling approaches range from simple loading function calculations to the use of sophisticated hydrological and water quality-oriented computer software. GISs have great potential for reducing the cost of assessing nonpoint source pollution.

  18. Assessment of aided phytostabilization of copper-contaminated soil by X-ray absorption spectroscopy and chemical extractions.

    PubMed

    Kumpiene, Jurate; Mench, Michel; Bes, Clémence M; Fitts, Jeffrey P

    2011-06-01

    Field plots were established at a timber treatment site to evaluate remediation of Cu contaminated topsoils with aided phytostabilization. Soil containing 2600 mg kg⁻¹ Cu was amended with a combination of 5 wt% compost and 2 wt% iron grit, and vegetated. Sequential extraction was combined with extended X-ray absorption fine structure (EXAFS) spectroscopy to correlate changes in Cu distribution across five fractions with changes in the predominant Cu compounds two years after treatment in parallel treated and untreated field plots. Exchangeable Cu dominated untreated soil, most likely as Cu(II) species non-specifically bound to natural organic matter. The EXAFS spectroscopic results are consistent with the sequential extraction results, which show a major shift in Cu distribution as a result of soil treatment to the fraction bound to poorly crystalline Fe oxyhydroxides forming binuclear inner-sphere complexes. PMID:21454002

  19. Assessment of Aided Phytostabilization of Copper-Contaminated Soil by X-ray Absorption Spectroscopy and Chemical Extractions

    SciTech Connect

    J Kumpiene; M Mench; C Bes; J Fitts

    2011-12-31

    Field plots were established at a timber treatment site to evaluate remediation of Cu contaminated topsoils with aided phytostabilization. Soil containing 2600 mg kg{sup -1} Cu was amended with a combination of 5 wt% compost and 2 wt% iron grit, and vegetated. Sequential extraction was combined with extended X-ray absorption fine structure (EXAFS) spectroscopy to correlate changes in Cu distribution across five fractions with changes in the predominant Cu compounds two years after treatment in parallel treated and untreated field plots. Exchangeable Cu dominated untreated soil, most likely as Cu(II) species non-specifically bound to natural organic matter. The EXAFS spectroscopic results are consistent with the sequential extraction results, which show a major shift in Cu distribution as a result of soil treatment to the fraction bound to poorly crystalline Fe oxyhydroxides forming binuclear inner-sphere complexes.

  20. AIDS lymphomas.

    PubMed

    Middleton, G W; Lau, R K

    1992-01-01

    Chronically immunosuppressed individuals are susceptible to lymphoreticular tumors. Up to 15% of patients with congenital deficiencies such as ataxia=telangiectasia may develop malignancies, mainly high-grade B cell non=Hodgkin's lymphomas (NHLs). AIDS lymphomas are comprised of NHLs including Burkitt's lymphoma (BL) and primary cerebral lymphomas (PCLs). Almost 3% of all AIDS patients (2824 of 97,258 cases) developed NHL. Epstein-Barr virus (EBV) as a co-factor in AIDS lymphomagenesis has been studied: in 12 cases of 24 AIDS lymphomas EBV by DNA in situ hybridization was found. In an analysis of 6 primary cerebral lymphomas, .5 were positive for EBV DNA by Southern blotting. In Burkitt's lymphoma the characteristic genetic alteration affects the c-myc oncogene. In 1/3 of BL p53 mutations were found but none in the 43 NHLs suggesting that p53 mutations and c-myc activation act synergistically in the pathogenesis of these tumors. Cytotoxic agents dideoxyinosine, dideoxycytosine, and zidovudine may cause secondary neoplasia. 8 of 55 AIDS patients under zidovudine treatment developed high-grade lymphoma 23.8 months subsequently; recently doses were reduced. PCL was found in 21 of 90 patients. A 5.2 months survival was associated with combined treatment with cyclophosphamide, Oncovin (vincristine), methotrexate, etoposide, and cytosine arabinoside compared with 11.3 months with chemotherapy. Colony-stimulating factors (CSFs) alleviate drug-induced myelotoxicity and zidovudine-induced neutropenia, however, l8 of 11 patients receiving granulocyte-macrophage CSF developed hematological toxicity. Interleukine-2 produced by T-helper cells enhancing tumor cells cytotoxicity has been used in AIDS-associated cryptosporidial diarrhea and in 4 patients with AIDS lymphoma with modest response, but its stimulation of the HIV-infected substrate may increase viral proliferation.

  1. Street Youth & AIDS.

    ERIC Educational Resources Information Center

    Radford, Joyce L.; And Others

    Interviews were conducted with 712 Canadian street youth (ages 15-20 years) to assess their knowledge, attitudes, and behaviors with regard to Acquired Immune Deficiency Syndrome (AIDS) and other sexually transmitted diseases (STDs). Youth were interviewed in 10 cities across Canada on the basis of 5 street culture lifestyles: prostitution, drug…

  2. Computer Aided Assessment of Mathematics for Undergraduates with Specific Learning Difficulties--Issues of Inclusion in Policy and Practice

    ERIC Educational Resources Information Center

    Perkin, Glynis; Beacham, Nigel; Croft, Anthony

    2007-01-01

    This paper opens up a debate about policy and practice in computer-assisted assessment (CAA) of mathematics for undergraduates with specific learning difficulties e.g. dyslexia. Guidelines for designing assessments for such students are emerging and some may be transferable to CAA. Whether mathematics brings with it particular issues is unclear.…

  3. Confronting AIDS.

    PubMed

    Squire, L

    1998-03-01

    By 2020, HIV/AIDS will be the leading infectious killer of young and middle-aged adults in the developing world. Past gains in life expectancy are already being eroded in some countries. Millions of lives can, however, be saved if developing country governments, the international community, and nongovernmental organizations act now. Although more than 11 million people have already died of AIDS, 2.3 billion people live in developing countries in which the disease has not yet spread beyond certain risk groups. If the spread of HIV is checked, the quality of care available to people who are infected with HIV will probably be better than it would be in the context of a full-blown AIDS epidemic. However, while governments need to respond urgently to HIV/AIDS, using resources to help people with AIDS will reduce the resources available for other investments, such as child education, providing safe drinking water, and building roads. Economics can help governments set priorities as they decide how best to allocate their available resources. Externalities, public goods, and redistribution are discussed. All countries will need to use some combination of preventive and coping measures. PMID:12293445

  4. Comparison between low-cost marker-less and high-end marker-based motion capture systems for the computer-aided assessment of working ergonomics.

    PubMed

    Patrizi, Alfredo; Pennestrì, Ettore; Valentini, Pier Paolo

    2016-01-01

    The paper deals with the comparison between a high-end marker-based acquisition system and a low-cost marker-less methodology for the assessment of the human posture during working tasks. The low-cost methodology is based on the use of a single Microsoft Kinect V1 device. The high-end acquisition system is the BTS SMART that requires the use of reflective markers to be placed on the subject's body. Three practical working activities involving object lifting and displacement have been investigated. The operational risk has been evaluated according to the lifting equation proposed by the American National Institute for Occupational Safety and Health. The results of the study show that the risk multipliers computed from the two acquisition methodologies are very close for all the analysed activities. In agreement to this outcome, the marker-less methodology based on the Microsoft Kinect V1 device seems very promising to promote the dissemination of computer-aided assessment of ergonomics while maintaining good accuracy and affordable costs. PRACTITIONER’S SUMMARY: The study is motivated by the increasing interest for on-site working ergonomics assessment. We compared a low-cost marker-less methodology with a high-end marker-based system. We tested them on three different working tasks, assessing the working risk of lifting loads. The two methodologies showed comparable precision in all the investigations.

  5. Assessment of performance and reliability of computer-aided detection scheme using content-based image retrieval approach and limited reference database.

    PubMed

    Wang, Xiao Hui; Park, Sang Cheol; Zheng, Bin

    2011-04-01

    Content-based image retrieval approach was used in our computer-aided detection (CAD) schemes for breast cancer detection with mammography. In this study, we assessed CAD performance and reliability using a reference database including 1500 positive (breast mass) regions of interest (ROIs) and 1500 normal ROIs. To test the relationship between CAD performance and the similarity level between the queried ROI and the retrieved ROIs, we applied a set of similarity thresholds to the retrieved similar ROIs selected by the CAD schemes for all queried suspicious regions, and used only the ROIs that were above the threshold for assessing CAD performance at each threshold level. Using the leave-one-out testing method, we computed areas under receiver operating characteristic (ROC) curves (A(Z)) to assess CAD performance. The experimental results showed that as threshold increase, (1) less true positive ROIs can be referenced in the database than normal ROIs and (2) the A(Z) value was monotonically increased from 0.854 ± 0.004 to 0.932 ± 0.016. This study suggests that (1) in order to more accurately detect and diagnose subtle masses, a large and diverse database is required, and (2) assessing the reliability of the decision scores based on the similarity measurement is important in application of the CBIR-based CAD schemes when the limited database is used.

  6. THE EFFECT OF TAX PREFERENCES ON HEALTH SPENDING.

    PubMed

    Cogan, John F; Hubbard, R Glenn; Kessler, Daniel P

    2011-09-01

    In this paper, we estimate the effect of the tax preference for health insurance on health care spending using data from the Medical Expenditure Panel Surveys from 1996-2005. We use the fact that Social Security taxes are only levied on earnings below a statutory threshold to identify the impact of the tax preference. Because employer-sponsored health insurance premiums are excluded from Social Security payroll taxes, workers who earn just below the Social Security tax threshold receive a larger tax preference for health insurance than workers who earn just above it. We find a significant effect of the tax preference, consistent with previous research. PMID:22500056

  7. A cross-sectional study to assess knowledge about HIV/AIDS transmission and prevention measures in company workers in Ecuador

    PubMed Central

    2013-01-01

    Background HIV/AIDS was first reported in Ecuador in 1984 and its prevalence has been increasing ever since. In 2009, the National AIDS Program reported 21,810 HIV/AIDS cases and confirmed that the worker population was amongst the most affected groups. The objective of this study was to assess knowledge about HIV transmission and prevention measures in company workers in Ecuador. Methods A cross-sectional survey based on a random sample of 115 companies (1,732 workers), stratified by three large provinces and working sectors (commerce, manufacturing and real estate) was conducted. A validated instrument developed by Family Health International was used to evaluate HIV prevention knowledge and common local misconceptions about HIV transmission. Descriptive statistics, chi square test and logistic regression analysis were performed using SAS. Results Incorrect knowledge about HIV/AIDS transmission were found in 49.1% (95% CI: 46.6–51.6) of subjects. Incorrect knowledge was higher among males (OR = 1.73 [1.39–2.15]), older subjects (OR = 1.35 [1.02–1.77]), subjects with lower education (OR = 3.72 [2.44–5.65]), manual labor workers (OR = 2.93 [1.82–4.73]) and subjects without previous exposure to HIV intervention programs (OR = 2.26 [1.79–2.86]). Incorrect knowledge about preventive measures was found among 32.9% (95%CI: 30.6–35.2) of respondents. This proportion was higher among subjects with lower education (OR = 2.28 [1.52–3.43]), married subjects (OR = 1.34 [1.07–1.68]), manual labor workers (OR = 1.80 [1.34–2.42]), and subjects not previously exposed to HIV intervention programs (OR = 1.44 [1.14–1.83]). Conclusions HIV intervention programs targeting company workers are urgently needed to improve knowledge and reduce HIV transmission in Ecuador. PMID:23410074

  8. US health spending trends by age and gender: selected years 2002-10.

    PubMed

    Lassman, David; Hartman, Micah; Washington, Benjamin; Andrews, Kimberly; Catlin, Aaron

    2014-05-01

    This article presents estimates of personal health care spending by age and gender in selected years during the period 2002-10 and an analysis of the variation in spending among children, working-age adults, and the elderly. Our research found that in this period, aggregate spending on children's health care increased at the slowest rate. However, per capita spending for children grew more rapidly than that for working-age adults and the elderly. Per capita spending for the elderly remained about five times higher than spending for children. Overall, females spent more per capita than males, but the gap had decreased by 2010. The implementation of Medicare Part D, the effects of the recent recession, and the aging of the baby boomers affected the spending trends and distributions during the period of this study.

  9. A new computer-aided detection scheme based on assessment of local bilateral mammographic feature asymmetry - a preliminary evaluation.

    PubMed

    Kelder, Adam; Zigel, Yaniv; Lederman, Dror; Zheng, Bin

    2015-01-01

    Accurate segmentation of breast lesions depicting on two-dimensional projection mammograms has been proven very difficult and unreliable. In this study we investigated a new approach of a computer-aided detection (CAD) scheme of mammograms without lesion segmentation. Our scheme was developed based on the detection and analysis of region-of-interest (ROI)-based bilateral mammographic tissue or feature asymmetry. A bilateral image registration, image feature selection process, and naïve Bayes linear classifier were implemented in CAD scheme. CAD performance predicting the likelihood of either an ROI or a subject (case) being abnormal was evaluated using 161 subjects from the mini-MIAS database and a leave-one-out testing method. The results showed that areas under receiver operating characteristic (ROC) curves were 0.87 and 0.72 on the ROI-based and case-based evaluation, respectively. The study demonstrated that using ROI-based bilateral mammographic tissue asymmetry can provide supplementary information with high discriminatory power in order to improve CAD performance.

  10. Computer-aided placement of endosseous oral implants in patients after ablative tumour surgery: assessment of accuracy.

    PubMed

    Wagner, Arne; Wanschitz, Felix; Birkfellner, Wolfgang; Zauza, Konstantin; Klug, Clemens; Schicho, Kurt; Kainberger, Franz; Czerny, Christian; Bergmann, Helmar; Ewers, Rolf

    2003-06-01

    The objective of this study was to evaluate the feasibility and accuracy of a novel surgical computer-aided navigation system for the placement of endosseous implants in patients after ablative tumour surgery. Pre-operative planning was performed by developing a prosthetic concept and modifying the implant position according to surgical requirements after high-resolution computed tomography (HRCT) scans with VISIT, a surgical planning and navigation software developed at the Vienna General Hospital. The pre-operative plan was transferred to the patients intraoperatively using surgical navigation software and optical tracking technology. The patients were HRCT-scanned again to compare the position of the implants with the pre-operative plan on reformatted CT-slices after matching of the pre- and post-operative data sets using the mutual information-technique. A total of 32 implants was evaluated. The mean deviation was 1.1 mm (range: 0-3.5 mm). The mean angular deviation of the implants was 6.4 degrees (range: 0.4 degrees - 17.4 degrees, variance: 13.3 degrees ). The results demonstrate, that adequate accuracy in placing endosseous oral implants can be delivered to patients with most difficult implantologic situations.

  11. Assessment of laboratory logistics management information system practice for HIV/AIDS and tuberculosis laboratory commodities in selected public health facilities in Addis Ababa, Ethiopia

    PubMed Central

    Desale, Adino; Taye, Bineyam; Belay, Getachew; Nigatu, Alemayehu

    2013-01-01

    Introduction Logistics management information system for health commodities remained poorly implemented in most of developing countries. To assess the status of laboratory logistics management information system for HIV/AIDS and tuberculosis laboratory commodities in public health facilities in Addis Ababa. Methods A cross-sectional descriptive study was conducted from September 2010-January 2011 at selected public health facilities. A stratified random sampling method was used to include a total of 43 facilities which, were investigated through quantitative methods using structured questionnaires interviews. Focus group discussion with the designated supply chain managers and key informant interviews were conducted for the qualitative method. Results There exists a well-designed logistics system for laboratory commodities with trained pharmacy personnel, distributed standard LMIS formats and established inventory control procedures. However, majority of laboratory professionals were not trained in LMIS. Majority of the facilities (60.5%) were stocked out for at least one ART monitoring and TB laboratory reagents and the highest stock out rate was for chemistry reagents. Expired ART monitoring laboratory commodities were found in 25 (73.5%) of facilities. Fifty percent (50%) of the assessed hospitals and 54% of health centers were currently using stock/bin cards for all HIV/AIDS and TB laboratory commodities in main pharmacy store, among these only 25% and 20.8% of them were updated with accurate information matching with the physical count done at the time of visit for hospitals and health centers respectively. Conclusion Even though there exists a well designed laboratory LMIS, keeping quality stock/bin cards and LMIS reports were very low. Key ART monitoring laboratory commodities were stock out at many facilities at the day of visit and during the past six months. Based on findings, training of laboratory personnel's managing laboratory commodities and keeping

  12. Program Spending to Increase Adherence: South African Cervical Cancer Screening

    PubMed Central

    Goldhaber-Fiebert, Jeremy D.; Denny, Lynette A.; De Souza, Michelle; Kuhn, Louise; Goldie, Sue J.

    2009-01-01

    Background Adherence is crucial for public health program effectiveness, though the benefits of increasing adherence must ultimately be weighed against the associated costs. We sought to determine the relationship between investment in community health worker (CHW) home visits and increased attendance at cervical cancer screening appointments in Cape Town, South Africa. Methodology/Principal Findings We conducted an observational study of 5,258 CHW home visits made in 2003–4 as part of a community-based screening program. We estimated the functional relationship between spending on these visits and increased appointment attendance (adherence). Increased adherence was noted after each subsequent CHW visit. The costs of making the CHW visits was based on resource use including both personnel time and vehicle-related expenses valued in 2004 Rand. The CHW program cost R194,018, with 1,576 additional appointments attended. Adherence increased from 74% to 90%; 55% to 87%; 48% to 77%; and 56% to 80% for 6-, 12-, 24-, and 36-month appointments. Average per-woman costs increased by R14–R47. The majority of this increase occurred with the first 2 CHW visits (90%, 83%, 74%, and 77%; additional cost: R12–R26). Conclusions/Significance We found that study data can be used for program planning, identifying spending levels that achieve adherence targets given budgetary constraints. The results, derived from a single disease program, are retrospective, and should be prospectively replicated. PMID:19492097

  13. Imaging of skin birefringence for human scar assessment using polarization-sensitive optical coherence tomography aided by vascular masking.

    PubMed

    Gong, Peijun; Chin, Lixin; Es'haghian, Shaghayegh; Liew, Yih Miin; Wood, Fiona M; Sampson, David D; McLaughlin, Robert A

    2014-12-01

    We demonstrate the in vivo assessment of human scars by parametric imaging of birefringence using polarization-sensitive optical coherence tomography (PS-OCT). Such in vivo assessment is subject to artifacts in the detected birefringence caused by scattering from blood vessels. To reduce these artifacts, we preprocessed the PS-OCT data using a vascular masking technique. The birefringence of the remaining tissue regions was then automatically quantified. Results from the scars and contralateral or adjacent normal skin of 13 patients show a correspondence of birefringence with scar type: the ratio of birefringence of hypertrophic scars to corresponding normal skin is 2.2 ± 0.2 (mean ± standard deviation ), while the ratio of birefringence of normotrophic scars to normal skin is 1.1 ± 0.4 . This method represents a new clinically applicable means for objective, quantitative human scar assessment. PMID:25539060

  14. Classroom Aids

    ERIC Educational Resources Information Center

    Science Activities: Classroom Projects and Curriculum Ideas, 2007

    2007-01-01

    This article describes 6 aids for science instruction, including (1) the use of fudge to represent lava; (2) the "Living by Chemistry" program, designed to make high school chemistry more accessible to a diverse pool of students without sacrificing content; (3) NOAA and NSTA's online coral reef teaching tool, a new web-based "science toolbox" for…

  15. Dietitian Aide.

    ERIC Educational Resources Information Center

    Texas Tech. Univ., Lubbock. School of Home Economics.

    This course of study for the dietitian aide is one of a series available for use by teacher-coordinators and students in Grade 11 and 12 home economics cooperative education programs. Based on job analysis interviews with health care facilities personnel, this course was prepared by teachers and Instructional Materials Center staff, field-tested,…

  16. Floriculture Aide.

    ERIC Educational Resources Information Center

    Martin, Joyce; Looney, Era

    Designed for use in a self-paced, open-entry/open-exit vocational training program for a floriculture aide, this program guide is one of six for teachers of adult women offenders from a correctional institution. Module topic outlines and sample lesson plans are presented on eleven topics: occupational opportunities in the retail florist industry;…

  17. Gay youth and AIDS.

    PubMed

    Feldman, D A

    1989-01-01

    Gay male teenagers face considerable adversity during their "coming out" process due to the AIDS epidemic. They must decide whether to be tested for HIV-1 infection, whether to postpone sexual activity, how to select a partner, and which kinds of sexual practices to engage in. Gay youth often make such decisions based upon misinformation and faulty premises. This paper reviews what is known about gay youth and AIDS, and assesses their possible risk for HIV-1 infection. It is recommended that school and community-based health education programs be developed to teach gay and bisexual youth about safe sex. Moreover, research is needed into sociocultural variations among gay youth in order to develop appropriate and effective intervention strategies for AIDS risk reduction in this diverse population.

  18. Recent Developments, Utilization, and Spending Trends for Pompe Disease Therapies

    PubMed Central

    Guo, Jing; Kelton, Christina M.L.; Guo, Jeff J.

    2012-01-01

    Background Pompe disease is a rare condition, with an incidence rate estimated to be between 1 in 40,000 and 1 in 300,000 live births worldwide. For an infant who contracts the disease, which is an inherited metabolic myopathy caused by deficiency of the acid alpha-glucosidase (GAA) enzyme in lysosomal cells, the survival rate to age 1 year is estimated to be 25.7%. Before 2006, no therapies were available for this disease. Objectives The goals of this study were to review recent developments in therapies for Pompe disease, including the US Food and Drug Administration (FDA) approval of 2 biologic drugs, and to describe the associated drug utilization and spending trends in the US Medicaid program for patients with this disease. Methods We reviewed 2 recently approved therapies for Pompe disease and compared their indications, as well as their efficacy and safety profiles. A retrospective analysis was performed using the national Medicaid pharmacy claims database. Quarterly prescriptions and reimbursement amounts were calculated for each drug from 2006 quarter 2 through 2011 quarter 2. Average per-prescription spending was calculated by dividing the drug reimbursement by the number of prescriptions written for that drug. Results Myozyme (alglucosidase alfa, recombinant human GAA) and Lumizyme (alglucosidase alfa), the first 2 enzyme replacement therapies available for Pompe disease, were approved as orphan drugs by the FDA in 2006 and in 2010, respectively. Myozyme is indicated for infantile-onset Pompe disease; Lumizyme is indicated for patients aged ≥8 years. Although both drugs have been shown to improve patient survival rates, they both also have a boxed warning, because of the possibility of life-threatening allergic reactions. Moreover, Lumizyme has a restricted distribution system to ensure it is used by the correct patient population. In 2010, Medicaid spending for Myozyme was $3.6 million. In the first 2 quarters of 2011, Medicaid spending for Lumizyme

  19. Assessment of factors impacting cervical cancer screening among low-income women living with HIV-AIDS.

    PubMed

    Ogunwale, Abayomi N; Coleman, Maame Aba; Sangi-Haghpeykar, Haleh; Valverde, Ivan; Montealegre, Jane; Jibaja-Weiss, Maria; Anderson, Matthew L

    2016-01-01

    Very little is currently known about factors impacting the prevalence of cervical cancer screening among women living with HIV-AIDS (WLHA). To better understand this issue, we surveyed low-income, medically underserved women receiving subsidized gynecologic care through an integrated HIV clinic. A self-administered questionnaire was completed by 209 women who self-identified as HIV positive. A total of 179 subjects (85.7%) reported having had a Pap test in the last three years. The majority of WLHA (95%) knew that the Pap test screens for cervical cancer. However, overall knowledge of cervical cancer risk factors, such as multiple sexual partners or sex with a man with multiple partners, was low (43% and 35%, respectively). Unscreened women were younger and more likely to be single with multiple current sexual partners. In multivariable analyses, the only factors associated with Pap testing were a woman's perception that her partner wants her to receive regular screening (aOR 4.64; 95% CI: 1.15-23.76; p = .04), number of clinic visits during the past year (aOR 1.36, 95% CI: 1.05-1.94; p = .04) and knowledge that the need for a Pap test does not depend on whether or not a woman is experiencing vaginal bleeding (aOR 6.52, 95% CI: 1.04-49.71; p = .05). We conclude that support from male partners in addition to effective contact with the health system and knowledge of cervical cancer risk factors influence Pap utilization among low-income WLHA. Future measures to improve the care for this population should increase knowledge of cervical cancer risk factors and encourage social support for cervical cancer screening among WLHA.

  20. Quality Assessment for Therapeutic Drug Monitoring in AIDS Clinical Trials Group (ACTG 5146): A Multicenter Clinical Trial

    PubMed Central

    DiFrancesco, Robin; Rosenkranz, Susan; Mukherjee, A. Lisa; Demeter, Lisa M.; Jiang, Hongyu; DiCenzo, Robert; Dykes, Carrie; Rinehart, Alex; Albrecht, Mary; Morse, Gene D.

    2010-01-01

    In a randomized trial, AIDS Clinical Trials Group (ACTG) protocol 5146 (A5146) investigated the use of TDM to adjust doses of HIV-1 protease inhibitors (PIs) in patients with prior virologic failure on PI-based therapy who were starting a new PI-based regimen. The overall percentage of “PI trough repeats”, such as rescheduled visits or redrawn PI trough specimens, increased from 2% to 5% to 10% as the process progressed from the clinical sites, the PSL, and the study team, respectively. Cumulatively, this represents a 17% rate of failure to obtain adequate PI trough sample. While targeting a turn-around of ≤ 7 days from sample receipt to a drug concentration report, 12% of the received specimens required a longer period to report concentrations. The implementation of dosing changes in the TDM arm were achieved within ≤7 days for 56% of the dose change events, and within ≤14 days for 77% of dose change events. This quality assurance analysis provides a valuable summary of the specific points in the TDM process that could be improved during a multicenter clinical trial including: [1] shortening the timeline of sample shipment from clinical site to the lab, [2] performing the collection of PI trough specimen within the targeted sampling window by careful monitoring of the last dose times and collection times by the clinicians [3] increasing patient adherence counseling to reduce the number of samples that are redrawn due to suspecting inconsistent adherence, and [4] decreasing the time to successful TDM-based dose adjustment. The application of some of these findings may also be relevant to single center studies or clinical TDM programs within a hospital. PMID:20592644

  1. Jernberg Industries, Inc.: Forging Facility Uses Plant-Wide Energy Assessment to Aid Conversion to Lean Manufacturing (Revised)

    SciTech Connect

    Not Available

    2004-10-01

    Jernberg Industries conducted a plant-wide assessment while converting to lean manufacturing at a forging plant. Seven projects were identified that could yield annual savings of $791,000, 64,000 MMBtu in fuel and 6 million kWh

  2. Development and validation of standard area diagrams to aide assessment of pecan scab symptoms on pecan fruit

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Pecan scab (Fusicladium effusum) causes losses of pecan nutmeat yield and quality in the southeastern U.S. Disease assessment relies on visual rating, which can be inaccurate, imprecise with poor inter-rater reliability. A standard area diagram (SAD) set for pecan scab on fruit valves was develope...

  3. Assessing the Value-Added by the Environmental Testing Process with the Aide of Physics/Engineering of Failure Evaluations

    NASA Technical Reports Server (NTRS)

    Cornford, S.; Gibbel, M.

    1997-01-01

    NASA's Code QT Test Effectiveness Program is funding a series of applied research activities focused on utilizing the principles of physics and engineering of failure and those of engineering economics to assess and improve the value-added by the various validation and verification activities to organizations.

  4. Novel Ergonomic Postural Assessment Method (NERPA) Using Product-Process Computer Aided Engineering for Ergonomic Workplace Design

    PubMed Central

    Sanchez-Lite, Alberto; Garcia, Manuel; Domingo, Rosario; Angel Sebastian, Miguel

    2013-01-01

    Background Musculoskeletal disorders (MSDs) that result from poor ergonomic design are one of the occupational disorders of greatest concern in the industrial sector. A key advantage in the primary design phase is to focus on a method of assessment that detects and evaluates the potential risks experienced by the operative when faced with these types of physical injuries. The method of assessment will improve the process design identifying potential ergonomic improvements from various design alternatives or activities undertaken as part of the cycle of continuous improvement throughout the differing phases of the product life cycle. Methodology/Principal Findings This paper presents a novel postural assessment method (NERPA) fit for product-process design, which was developed with the help of a digital human model together with a 3D CAD tool, which is widely used in the aeronautic and automotive industries. The power of 3D visualization and the possibility of studying the actual assembly sequence in a virtual environment can allow the functional performance of the parts to be addressed. Such tools can also provide us with an ergonomic workstation design, together with a competitive advantage in the assembly process. Conclusions The method developed was used in the design of six production lines, studying 240 manual assembly operations and improving 21 of them. This study demonstrated the proposed method’s usefulness and found statistically significant differences in the evaluations of the proposed method and the widely used Rapid Upper Limb Assessment (RULA) method. PMID:23977340

  5. MS-CANE: a computer-aided instrument for neurological evaluation of patients with multiple sclerosis: enhanced reliability of expanded disability status scale (EDSS) assessment.

    PubMed

    Cohen, Y C; Hassin-Baer, S; Olmer, L; Barishev, R; Goldhammer, Y; Freedman, L; Mozes, B

    2000-10-01

    Kurtzke's EDSS remains the most widely-used measure for clinical evaluation of MS patients. However, several studies have demonstrated the limited reliability of this tool. We introduce a computerized instrument, MS-CANE (Multiple Sclerosis Computer-Aided Neurological Examination), for clinical evaluation and follow up of patients with multiple sclerosis (MS) and to compare its reliability to that of conventional Expanded Disability Status Scale (EDSS) assessment. We developed a computerized interactive instrument, based on the following principles: structured gathering of neurological findings, reduction of compound notions to their basic components, use of precise definitions, priority setting and automated calculations of EDSS and functional systems scores. An expert panel examined the consistency of MS-CANE with Kurtzke's specifications. To determine the effect of MS-CANE on the reliability of EDSS assessment, 56 MS patients underwent paired conventional EDSS and MS-CANE-based evaluations. The inter-observer agreement in both methods was determined and compared using the kappa statistic. The expert panel judged the tool to be compatible with the basic concepts of Kurtzke's EDSS. The use of MS-CANE increased the reliability of EDSS assessment: Kappa statistic was found to be 0.42 (i.e. moderate agreement) for conventional EDSS assessment versus 0.69 (i.e. substantial agreement) for MS-CANE (P=0.002). We conclude that the use of this tool may contribute towards a standardized and reliable assessment of EDSS. Within clinical trials, this could increase the power to detect effects, thus reducing trial duration and the cohort size required. Multiple Sclerosis (2000) 6 355 - 361

  6. Financial impact of the GFC: health care spending across the OECD.

    PubMed

    Morgan, David; Astolfi, Roberto

    2015-01-01

    Since the onset of the global financial crisis (GFC), health spending has slowed markedly or fallen in many OECD countries after years of continuous growth. However, health spending patterns across the 34 countries of the OECD have been affected to varying degrees. This article examines in more detail the observed downturn in health expenditure growth, analysing which countries and which sectors of health spending have been most affected. In addition, using more recent preliminary data for a subset of countries, this article tries to shed light on the prospects for health spending trends. Given that public sources account for around three-quarters of total spending on health on average across the OECD, and, in an overall context of managing public deficits, the article focuses on the specific areas of public spending that have been most affected. This study also tries to link the observed trends with some of the main policy measures and instruments put in place by countries. The investigation finds that while nearly all OECD countries have seen health spending growth decrease since 2009, there is wide variation as to the extent of the slowdown, with some countries outside of Europe continuing to see significant growth in health spending. While all sectors of spending appear to have been affected, initial analysis appears to show the greatest decreases has been experienced in pharmaceutical spending and in areas of public health and prevention. PMID:25662194

  7. The Way the Money Goes: An Investigation of Flows of Funding and Resources for Young Children Affected by HIV/AIDS. Working Papers in Early Childhood Development. Young Children and HIV/AIDS Sub-Series, No. 37

    ERIC Educational Resources Information Center

    Dunn, Alison

    2005-01-01

    This paper discusses routes by which HIV/AIDS money is dispersed and received. It notes that capturing accurate data on actual spending patterns of large donors can be difficult, as there is no uniform tracking or reporting system and much HIV/AIDS money is spent under the broader category of sexual and reproductive health. Most of the information…

  8. Commentary: Objective aids for the assessment of ADHD - further clarification of what FDA approval for marketing means and why NEBA might help clinicians. A response to Arns et al. (2016).

    PubMed

    Stein, Mark A; Snyder, Steven M; Rugino, Thomas A; Hornig, Mady

    2016-06-01

    Neuropsychiatric EEG-Based ADHD Assessment Aid (NEBA) is an EEG-based device designed to aid in the diagnostic process for ADHD by identifying individuals less likely to have ADHD by virtue of a lower theta/beta ratio. In using NEBA as an example, the Arns et al. commentary misstates the purpose of NEBA, which is to widen the differential rather than to make the diagnosis. Arns et al. caution about missing an ADHD diagnosis, but fail to mention the impact of overdiagnosis. If we are to advance our knowledge of the etiology and pathophysiology of ADHD, as well as develop tailored treatments and ultimately improve outcomes for ADHD, then biomarkers and objective assessment aids such as NEBA are needed to improve and refine diagnostic accuracy beyond symptom description and clinical history.

  9. Commentary: Objective aids for the assessment of ADHD - further clarification of what FDA approval for marketing means and why NEBA might help clinicians. A response to Arns et al. (2016).

    PubMed

    Stein, Mark A; Snyder, Steven M; Rugino, Thomas A; Hornig, Mady

    2016-06-01

    Neuropsychiatric EEG-Based ADHD Assessment Aid (NEBA) is an EEG-based device designed to aid in the diagnostic process for ADHD by identifying individuals less likely to have ADHD by virtue of a lower theta/beta ratio. In using NEBA as an example, the Arns et al. commentary misstates the purpose of NEBA, which is to widen the differential rather than to make the diagnosis. Arns et al. caution about missing an ADHD diagnosis, but fail to mention the impact of overdiagnosis. If we are to advance our knowledge of the etiology and pathophysiology of ADHD, as well as develop tailored treatments and ultimately improve outcomes for ADHD, then biomarkers and objective assessment aids such as NEBA are needed to improve and refine diagnostic accuracy beyond symptom description and clinical history. PMID:27192956

  10. Mechanistic insights aid the search for CFC substitutes: Risk assessment of HCFC-123 as an example. [CFC (chlorofluorocarbons)

    SciTech Connect

    Jarabek, A.M. ); Fisher, J.W.; Lipscomb, J.C.; Williams, R.J.; McDougal, J.N. ); Rubenstein, R. ); Vinegar, A. )

    1994-06-01

    An international consensus on the need to reduce the use of chlorofluorocarbons (CFCs) and other ozone-depleting gases such as the halons led to the adoptions of the 1987 Montreal Protocol and Title VI of the 1990 Clean Air Act Amendments, [open quotes]Protecting Stratospheric Ozone.[close quotes] These agreements included major provisions for reducing and eventually phasing out production and use of CFCs and halons as well as advancing the development of replacement chemicals. Because of the ubiquitous use and benefits of CFCs and halons, and expeditious search for safe replacements to meet the legislative deadlines is of critical importance. Toxicity testing and health risk assessment programs were established to evaluate the health and environmental impact of these replacement chemicals. Development and implementation of these programs as well as the structural-activity relationships significant for the development of the replacement chemicals are described below. A dose-response evaluation for the health risk assessment of the replacement chemical HCFC-123 (2,2-dichloro-1,1,1-trifluoroethane) is also presented to show an innovative use of physiologically based pharmacokinetic (PBPK) modeling. This is based on a parallelogram approach using data on the anesthetic gas halothane, a structural analog to HCFC-123. Halothane and HCFC-123 both form the same metabolite, trifluoroacetic acid (TFA), indicative of the same metabolic oxidative pathway attributed to hepatotoxicity. The parallelogram approach demonstrates the application of template model structures and shows how PBPK modeling, together with judicious experimental design, can be used to improve the accuracy of health risk assessment and to decrease the need for extensive laboratory animal testing. 53 refs., 9 figs., 14 tabs.

  11. Does Increased Spending on Pharmaceutical Marketing Inhibit Pioneering Innovation?

    PubMed

    Arnold, Denis G; Troyer, Jennifer L

    2016-04-01

    The pharmaceutical industry has been criticized for developing and aggressively marketing drugs that do not provide significant health benefits relative to existing drugs but retain the benefits of patent protection. Critics argue that drug marketing increases health care expenditures and provides a disincentive for pioneering drug innovation. However, evidence that marketing expenditures have any relationship to new drug approvals has been anecdotal. We hypothesized that, at publicly traded pharmaceutical firms, increased marketing expenditures will result in a reduced volume of pioneering new drugs in comparison to less innovative new drugs. We also hypothesized that additional research and development spending will result in an increased volume of pioneering new drugs in comparison to less innovative drugs. Results confirm our hypotheses. Specific policy recommendations for altering firms' incentives for the development of pioneering drugs are provided.

  12. Research spending up slightly in Energy Department's 1994 budget

    SciTech Connect

    Hanson, D.J.

    1993-04-26

    Department of Energy (DOE) Secretary Hazel R. O'Leary says her department's proposed budget for fiscal 1994 reflects shifting priorities to meet the needs of a changing world. Thus, nuclear weapons programs, once defended as necessary to protect the nation's security, are being diminished or phased out while support for environmental programs is being increased. Caught in the middle is total R and D, which is slated to increase 2.8% to $7.4 billion in fiscal 1994. For fiscal 1994, President Bill Clinton is asking for a total of $19.6 billion for DOE, a 3% increase from fiscal 1993. According to O'Leary, DOE will place increased emphasis on developing new, clean, and renewable energy sources that meet national energy and economic requirements, and will spend more to increase energy efficiency and conservation.

  13. Educational decentralization, public spending, and social justice in Nigeria

    NASA Astrophysics Data System (ADS)

    Geo-Jaja, Macleans A.

    2007-01-01

    This study situates the process of educational decentralization in the narrower context of social justice. Its main object, however, is to analyze the implications of decentralization for strategies of equity and social justice in Nigeria. It starts from the premise that the early optimism that supported decentralization as an efficient and effective educational reform tool has been disappointed. The author maintains that decentralization — on its own — cannot improve education service delivery, the capacities of subordinate governments, or the integration of social policy in broader development goals. If the desired goals are to be met, public spending must be increased, greater tax revenues must be secured, and macro-economic stabilization must be achieved without re-instituting the welfare state.

  14. Age differences in health care spending, fiscal year 1977.

    PubMed

    Gibson, R M; Fisher, C R

    1979-01-01

    This report of health care spending in fiscal year 1977 reveals that of the $142.6 billion spent by the Nation for personal health care in fiscal year 1977, 29 percent was spent for those aged 65 or older, 59 percent for those aged 19-64, and 13 percent for those below age 19. The average health bill reached $1,745 for the aged, $661 for the intermediate age group, and $253 for the young. Public funds financed 67 percent of the health expenses of the aged, with Medicare and Medicaid together accounting for 61 percent. More than two-thirds of the health expenses of the young and 71 percent of the expenses of those aged 19-64 were paid by private sources. Third-party payments met 68 percent of the health expenditures of all those under age 65. PMID:107600

  15. HIV / AIDS and the retail sector.

    PubMed

    Michael, K

    1999-01-01

    Employing approximately 1.5 million employees and comprised of 80,000 employers, the retail and wholesale sector accounted for 16.1% of South Africa's gross domestic product in 1996. HIV/AIDS threatens the retail sector, but it is unclear whether the pandemic threatens equally every sub-sector of the industry. The 4 main sub-sectors are fast-moving consumer goods; clothing, footwear, and textiles; vehicles; and furniture and major appliances. The nature of retail infrastructure and competitive and economic trends are described. Over the next decade, AIDS may reduce the size of consumer markets through increased mortality, and will certainly slow growth in spending. The pandemic may also divert spending away from retail merchandise to health care, and threaten businesses which extend credit and offer death benefits and funeral policies to clients. AIDS morbidity and mortality could also disrupt supply chains, especially for retailers who buy their products locally. The vulnerability of retail activities is discussed, with reference to the Living Standards Measure (LSM) developed by the South African Advertising Research Foundation.

  16. High-risk behaviors among adult men and women in Botswana: Implications for HIV/AIDS prevention efforts

    PubMed Central

    Keetile, Mpho

    2014-01-01

    Abstract The government of Botswana has been spending a lot of money in the prevention, treatment, care and support for HIV/AIDS patient for decades. This paper uses data from the third Botswana AIDS Impact Survey (BAIS III) to explore high-risk behaviors of adults and how they affect government efforts to stop the spread of HIV/AIDS. The objective of this paper is to fill in the gap on the assessment of high-risk behaviors associated with HIV/AIDS and their implications on HIV/AIDS prevention efforts. A nationally representative sample of 10,159 men and women aged 20–64 years who had successfully completed the BAIS III individual questionnaire were used in the study. Both descriptive and binary logistic regression analyses were used for analysis. Crude odds ratios were obtained from gross effects model while adjusted odds ratios (AOR) were obtained from the net effects model. Statistically significant association was observed between multiple current partners and alcohol consumption (AOR = 1.5), drug abuse (AOR = 1.7), transactional sex (AOR = 2.6) and intergenerational sex (AOR = 1.07). Furthermore, statistically significant association was seen for inconsistent condom use and having tested for HIV (AOR = 1.5). These results show a worrying tendency that despite government's efforts to stop the spread of HIV/AIDS, adults in Botswana continue to indulge in high-risk behaviors. Therefore, any programs and policies on HIV/AIDS should first target these high-risk behaviors. PMID:25293869

  17. High-risk behaviors among adult men and women in Botswana: implications for HIV/AIDS prevention efforts.

    PubMed

    Keetile, Mpho

    2014-01-01

    The government of Botswana has been spending a lot of money in the prevention, treatment, care and support for HIV/AIDS patient for decades. This paper uses data from the third Botswana AIDS Impact Survey (BAIS III) to explore high-risk behaviors of adults and how they affect government efforts to stop the spread of HIV/AIDS. The objective of this paper is to fill in the gap on the assessment of high-risk behaviors associated with HIV/AIDS and their implications on HIV/AIDS prevention efforts. A nationally representative sample of 10,159 men and women aged 20-64 years who had successfully completed the BAIS III individual questionnaire were used in the study. Both descriptive and binary logistic regression analyses were used for analysis. Crude odds ratios were obtained from gross effects model while adjusted odds ratios (AOR) were obtained from the net effects model. Statistically significant association was observed between multiple current partners and alcohol consumption (AOR = 1.5), drug abuse (AOR = 1.7), transactional sex (AOR = 2.6) and intergenerational sex (AOR = 1.07). Furthermore, statistically significant association was seen for inconsistent condom use and having tested for HIV (AOR = 1.5). These results show a worrying tendency that despite government's efforts to stop the spread of HIV/AIDS, adults in Botswana continue to indulge in high-risk behaviors. Therefore, any programs and policies on HIV/AIDS should first target these high-risk behaviors.

  18. Assessment methodologies and statistical issues for computer-aided diagnosis of lung nodules in computed tomography: contemporary research topics relevant to the lung image database consortium.

    PubMed

    Dodd, Lori E; Wagner, Robert F; Armato, Samuel G; McNitt-Gray, Michael F; Beiden, Sergey; Chan, Heang-Ping; Gur, David; McLennan, Geoffrey; Metz, Charles E; Petrick, Nicholas; Sahiner, Berkman; Sayre, Jim

    2004-04-01

    Cancer of the lung and bronchus is the leading fatal malignancy in the United States. Five-year survival is low, but treatment of early stage disease considerably improves chances of survival. Advances in multidetector-row computed tomography technology provide detection of smaller lung nodules and offer a potentially effective screening tool. The large number of images per exam, however, requires considerable radiologist time for interpretation and is an impediment to clinical throughput. Thus, computer-aided diagnosis (CAD) methods are needed to assist radiologists with their decision making. To promote the development of CAD methods, the National Cancer Institute formed the Lung Image Database Consortium (LIDC). The LIDC is charged with developing the consensus and standards necessary to create an image database of multidetector-row computed tomography lung images as a resource for CAD researchers. To develop such a prospective database, its potential uses must be anticipated. The ultimate applications will influence the information that must be included along with the images, the relevant measures of algorithm performance, and the number of required images. In this article we outline assessment methodologies and statistical issues as they relate to several potential uses of the LIDC database. We review methods for performance assessment and discuss issues of defining "truth" as well as the complications that arise when truth information is not available. We also discuss issues about sizing and populating a database.

  19. Stability of omeprazole in SyrSpend SF Alka (reconstituted).

    PubMed

    Whaley, Paul A; Voudrie, Mark A; Sorenson, Bridget

    2012-01-01

    Omeprazole is used in the treatment of dyspepsia, peptic ulcer disease, gastroesophageal reflux disease, laryngopharyngeal reflux, and Zollinger-Ellison syndrome. Omeprazole is marketed by AstraZeneca under a number of names, most notably Prilosec and Losec, as well as being available from a number of generic manufacturers. Omeprazole is available in both tablet and capsule form, with varying strengths of each. The need for other administration options for those patients who cannot take tablets or capsules has led compounding pharmacies to seek other alternatives. One possible alternative is the use of a suspending agent to create an oral solution or suspension. In the past, this has been accomplished using a sodium bicarbonate solution as the vehicle. However, sodium bicarbonate/omeprazole combination imparts a bitter and unpleasant taste. SyrSpend SF Alka (reconstituted) is a vehicle for making a suspension which has a pleasant taste, thus increasing palpability and compliance. The objective of this study was to determine the stability of omeprazole in SyrSpend SF Alka (for reconstitution). The studied sample was compounded into a 2-mg/mL suspension and stored in a low-actinic plastic prescription bottle at temperatures between 2 degrees C and 8 degrees C. Six samples were assayed at each time point out to 92 days by a stability-indicating high-performance liquid chromatography method. The method was validated for its specificity through forced degradation studies. The shelf life of this product is at least 92 days, based on data collected when refrigerated and protected from light. PMID:23050328

  20. Global and local health burden trade-off through the hybridisation of quantitative microbial risk assessment and life cycle assessment to aid water management.

    PubMed

    Kobayashi, Yumi; Peters, Greg M; Ashbolt, Nicholas J; Heimersson, Sara; Svanström, Magdalena; Khan, Stuart J

    2015-08-01

    Life cycle assessment (LCA) and quantitative risk assessment (QRA) are commonly used to evaluate potential human health impacts associated with proposed or existing infrastructure and products. Each approach has a distinct objective and, consequently, their conclusions may be inconsistent or contradictory. It is proposed that the integration of elements of QRA and LCA may provide a more holistic approach to health impact assessment. Here we examine the possibility of merging LCA assessed human health impacts with quantitative microbial risk assessment (QMRA) for waterborne pathogen impacts, expressed with the common health metric, disability adjusted life years (DALYs). The example of a recent large-scale water recycling project in Sydney, Australia was used to identify and demonstrate the potential advantages and current limitations of this approach. A comparative analysis of two scenarios - with and without the development of this project - was undertaken for this purpose. LCA and QMRA were carried out independently for the two scenarios to compare human health impacts, as measured by DALYs lost per year. LCA results suggested that construction of the project would lead to an increased number of DALYs lost per year, while estimated disease burden resulting from microbial exposures indicated that it would result in the loss of fewer DALYs per year than the alternative scenario. By merging the results of the LCA and QMRA, we demonstrate the advantages in providing a more comprehensive assessment of human disease burden for the two scenarios, in particular, the importance of considering the results of both LCA and QRA in a comparative assessment of decision alternatives to avoid problem shifting. The application of DALYs as a common measure between the two approaches was found to be useful for this purpose.

  1. Global and local health burden trade-off through the hybridisation of quantitative microbial risk assessment and life cycle assessment to aid water management.

    PubMed

    Kobayashi, Yumi; Peters, Greg M; Ashbolt, Nicholas J; Heimersson, Sara; Svanström, Magdalena; Khan, Stuart J

    2015-08-01

    Life cycle assessment (LCA) and quantitative risk assessment (QRA) are commonly used to evaluate potential human health impacts associated with proposed or existing infrastructure and products. Each approach has a distinct objective and, consequently, their conclusions may be inconsistent or contradictory. It is proposed that the integration of elements of QRA and LCA may provide a more holistic approach to health impact assessment. Here we examine the possibility of merging LCA assessed human health impacts with quantitative microbial risk assessment (QMRA) for waterborne pathogen impacts, expressed with the common health metric, disability adjusted life years (DALYs). The example of a recent large-scale water recycling project in Sydney, Australia was used to identify and demonstrate the potential advantages and current limitations of this approach. A comparative analysis of two scenarios - with and without the development of this project - was undertaken for this purpose. LCA and QMRA were carried out independently for the two scenarios to compare human health impacts, as measured by DALYs lost per year. LCA results suggested that construction of the project would lead to an increased number of DALYs lost per year, while estimated disease burden resulting from microbial exposures indicated that it would result in the loss of fewer DALYs per year than the alternative scenario. By merging the results of the LCA and QMRA, we demonstrate the advantages in providing a more comprehensive assessment of human disease burden for the two scenarios, in particular, the importance of considering the results of both LCA and QRA in a comparative assessment of decision alternatives to avoid problem shifting. The application of DALYs as a common measure between the two approaches was found to be useful for this purpose. PMID:25965885

  2. [The influence of excess weight and obesity on health spending in Brazilian households].

    PubMed

    Canella, Daniela Silva; Novaes, Hillegonda Maria Dutilh; Levy, Renata Bertazzi

    2015-11-01

    The objective of this study was to evaluate the influence of excess weight and obesity on health spending in Brazilian households. Data from the Household Budget Survey 2008-2009 were used to estimate monetary health spending, corresponding to out-of-pocket spending, including purchase of medicines and payment for healthcare services, and to evaluate the nutritional status of the 55,970 household residents. Monthly spending on health and its components were analyzed according to the number of excess weight and obese individuals in households (none, one, two, or three or more individuals). The presence and increasing number of excess weight and obese individuals has resulted in greater spending on health, especially on medicines and health insurance. The results were maintained after adjusting for income, region, area, and presence of elderly and number of residents in the household. Excess weight and obesity had a direct impact on out-of-pocket health spending by Brazilian families.

  3. HIV/AIDS Basics

    MedlinePlus

    ... Enter ZIP code or city Follow Act Against AIDS Act Against AIDS @talkHIV Act Against AIDS Get Email Updates on AAA Anonymous Feedback HIV/AIDS Media Infographics Syndicated Content Podcasts Slide Sets HIV/ ...

  4. Ways of spending leisure time by the third year-students of the Faculty of Pharmacy, Medical University of Lublin.

    PubMed

    Czabak-Garbacz, Róza; Skibniewska, Agnieszka; Mazurkiewicz, Piotr; Gdula, Agnieszka

    2002-01-01

    The aim of the study was the assessment of leisure time among third-year students from the Faculty of Pharmacy of the Medical University of Lublin. It analysed quantity of time devoted to school activity and ways of spending free time. The study involved 114 students (82 women and 32 men). The study revealed that women had less free time than men, who, most probably did not attend some lectures. The most popular activities among the questioned students were: sleeping (average 6.8 hours a day), studying (average 3.6 hours a day), listening to the radio (average 2.9 hours a day), talking with friends (average 1.9 hours a day), personal hygiene (average 1.1 hours a day), watching TV (average 1.1 hours a day), housework. Students devoted the least of their free time on active rest, for example walking (women did it more often than men) or practising sport (more popular among men). Cultural life of the students consisted only of meetings with friends and going to the cinema (women did it more often). The least popular way of spending free time was going to the theatre, opera, concerts and exhibitions. Few students spent their time working. Their number increased significantly during holidays. The way of spending free time by third-year students from the Faculty of Pharmacy (both men and women) during the day was similar, differences related only to the amount of time devoted to each activity.

  5. 3 CFR 13589 - Executive Order 13589 of November 9, 2011. Promoting Efficient Spending

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... committed to cutting waste in Federal Government spending and identifying opportunities to promote efficient... Government travel, including local or technological alternatives, such as teleconferencing and...

  6. National study of public spending for mental retardation and developmental disabilities.

    PubMed

    Braddock, D; Hemp, R; Fujiura, G

    1987-09-01

    Results of a nationwide study of public mental retardation/developmental disabilities (MR/DD) spending in the states during Fiscal Years 1977 through 1986 were summarized. Trends identified included: (a) continuing growth in spending for community services, (b) contraction of total spending for institutional operations, and (c) predominance of ICF/MR support in large (16+ beds) congregate care settings. Periodic replication of the study was recommended as was additional research to identify the political and economic determinants of state MR/DD spending.

  7. Fracture risk assessment: improved evaluation of vertebral integrity among metastatic cancer patients to aid in surgical decision-making

    NASA Astrophysics Data System (ADS)

    Augustine, Kurt E.; Camp, Jon J.; Holmes, David R.; Huddleston, Paul M.; Lu, Lichun; Yaszemski, Michael J.; Robb, Richard A.

    2012-03-01

    Failure of the spine's structural integrity from metastatic disease can lead to both pain and neurologic deficit. Fractures that require treatment occur in over 30% of bony metastases. Our objective is to use computed tomography (CT) in conjunction with analytic techniques that have been previously developed to predict fracture risk in cancer patients with metastatic disease to the spine. Current clinical practice for cancer patients with spine metastasis often requires an empirical decision regarding spinal reconstructive surgery. Early image-based software systems used for CT analysis are time consuming and poorly suited for clinical application. The Biomedical Image Resource (BIR) at Mayo Clinic, Rochester has developed an image analysis computer program that calculates from CT scans, the residual load-bearing capacity in a vertebra with metastatic cancer. The Spine Cancer Assessment (SCA) program is built on a platform designed for clinical practice, with a workflow format that allows for rapid selection of patient CT exams, followed by guided image analysis tasks, resulting in a fracture risk report. The analysis features allow the surgeon to quickly isolate a single vertebra and obtain an immediate pre-surgical multiple parallel section composite beam fracture risk analysis based on algorithms developed at Mayo Clinic. The analysis software is undergoing clinical validation studies. We expect this approach will facilitate patient management and utilization of reliable guidelines for selecting among various treatment option based on fracture risk.

  8. Use of airborne remote sensing to detect riverside Brassica rapa to aid in risk assessment of transgenic crops

    NASA Astrophysics Data System (ADS)

    Elliott, Luisa M.; Mason, David C.; Allainguillaume, Joel; Wilkinson, Mike J.

    2009-11-01

    High resolution descriptions of plant distribution have utility for many ecological applications but are especially useful for predictive modeling of gene flow from transgenic crops. Difficulty lies in the extrapolation errors that occur when limited ground survey data are scaled up to the landscape or national level. This problem is epitomized by the wide confidence limits generated in a previous attempt to describe the national abundance of riverside Brassica rapa (a wild relative of cultivated rapeseed) across the United Kingdom. Here, we assess the value of airborne remote sensing to locate B. rapa over large areas and so reduce the need for extrapolation. We describe results from flights over the river Nene in England acquired using Airborne Thematic Mapper (ATM) and Compact Airborne Spectrographic Imager (CASI) imagery, together with ground truth data. It proved possible to detect 97% of flowering B. rapa on the basis of spectral profiles. This included all stands of plants that occupied >2m square (>5 plants), which were detected using single-pixel classification. It also included very small populations (<5 flowering plants, 1-2m square) that generated mixed pixels, which were detected using spectral unmixing. The high detection accuracy for flowering B. rapa was coupled with a rather large false positive rate (43%). The latter could be reduced by using the image detections to target fieldwork to confirm species identity, or by acquiring additional remote sensing data such as laser altimetry or multitemporal imagery.

  9. A computer-aided system for malignancy risk assessment of nodules in thyroid US images based on boundary features.

    PubMed

    Savelonas, Michalis; Maroulis, Dimitris; Sangriotis, Manolis

    2009-10-01

    In this paper, a novel computer-based approach is proposed for malignancy risk assessment of thyroid nodules in ultrasound images. The proposed approach is based on boundary features and is motivated by the correlation which has been addressed in medical literature between nodule boundary irregularity and malignancy risk. In addition, local echogenicity variance is utilized so as to incorporate information associated with local echogenicity distribution within nodule boundary neighborhood. Such information is valuable for the discrimination of high-risk nodules with blurred boundaries from medium-risk nodules with regular boundaries. Analysis of variance is performed, indicating that each boundary feature under study provides statistically significant information for the discrimination of thyroid nodules in ultrasound images, in terms of malignancy risk. k-nearest neighbor and support vector machine classifiers are employed for the classification tasks, utilizing feature vectors derived from all combinations of features under study. The classification results are evaluated with the use of the receiver operating characteristic. It is derived that the proposed approach is capable of discriminating between medium-risk and high-risk nodules, obtaining an area under curve, which reaches 0.95.

  10. The Productivity of Pell Grant Spending: Enrollment versus Attainment

    ERIC Educational Resources Information Center

    Martinez, Ignacio; Turner, Sarah

    2015-01-01

    The Pell grant program is the largest source of need-based federal financial aid available to low-income students, currently providing a maximum of $5500 in grants to undergraduate students. The program is a major investment of public money, and policymakers have a responsibility to ensure that the investment yields results. Because low-income…

  11. Computer-aided nanotoxicology: assessing cytotoxicity of nanoparticles under diverse experimental conditions by using a novel QSTR-perturbation approach

    NASA Astrophysics Data System (ADS)

    Luan, Feng; Kleandrova, Valeria V.; González-Díaz, Humberto; Ruso, Juan M.; Melo, André; Speck-Planche, Alejandro; Cordeiro, M. Natália D. S.

    2014-08-01

    Nowadays, the interest in the search for new nanomaterials with improved electrical, optical, catalytic and biological properties has increased. Despite the potential benefits that can be gathered from the use of nanoparticles, only little attention has been paid to their possible toxic effects that may affect human health. In this context, several assays have been carried out to evaluate the cytotoxicity of nanoparticles in mammalian cells. Owing to the cost in both resources and time involved in such toxicological assays, there has been a considerable increase in the interest towards alternative computational methods, like the application of quantitative structure-activity/toxicity relationship (QSAR/QSTR) models for risk assessment of nanoparticles. However, most QSAR/QSTR models developed so far have predicted cytotoxicity against only one cell line, and they did not provide information regarding the influence of important factors rather than composition or size. This work reports a QSTR-perturbation model aiming at simultaneously predicting the cytotoxicity of different nanoparticles against several mammalian cell lines, and also considering different times of exposure of the cell lines, as well as the chemical composition of nanoparticles, size, conditions under which the size was measured, and shape. The derived QSTR-perturbation model, using a dataset of 1681 cases (nanoparticle-nanoparticle pairs), exhibited an accuracy higher than 93% for both training and prediction sets. In order to demonstrate the practical applicability of our model, the cytotoxicity of different silica (SiO2), nickel (Ni), and nickel(ii) oxide (NiO) nanoparticles were predicted and found to be in very good agreement with experimental reports. To the best of our knowledge, this is the first attempt to simultaneously predict the cytotoxicity of nanoparticles under multiple experimental conditions by applying a single unique QSTR model.Nowadays, the interest in the search for new

  12. Computer-aided nanotoxicology: assessing cytotoxicity of nanoparticles under diverse experimental conditions by using a novel QSTR-perturbation approach.

    PubMed

    Luan, Feng; Kleandrova, Valeria V; González-Díaz, Humberto; Ruso, Juan M; Melo, André; Speck-Planche, Alejandro; Cordeiro, M Natália D S

    2014-09-21

    Nowadays, the interest in the search for new nanomaterials with improved electrical, optical, catalytic and biological properties has increased. Despite the potential benefits that can be gathered from the use of nanoparticles, only little attention has been paid to their possible toxic effects that may affect human health. In this context, several assays have been carried out to evaluate the cytotoxicity of nanoparticles in mammalian cells. Owing to the cost in both resources and time involved in such toxicological assays, there has been a considerable increase in the interest towards alternative computational methods, like the application of quantitative structure-activity/toxicity relationship (QSAR/QSTR) models for risk assessment of nanoparticles. However, most QSAR/QSTR models developed so far have predicted cytotoxicity against only one cell line, and they did not provide information regarding the influence of important factors rather than composition or size. This work reports a QSTR-perturbation model aiming at simultaneously predicting the cytotoxicity of different nanoparticles against several mammalian cell lines, and also considering different times of exposure of the cell lines, as well as the chemical composition of nanoparticles, size, conditions under which the size was measured, and shape. The derived QSTR-perturbation model, using a dataset of 1681 cases (nanoparticle-nanoparticle pairs), exhibited an accuracy higher than 93% for both training and prediction sets. In order to demonstrate the practical applicability of our model, the cytotoxicity of different silica (SiO2), nickel (Ni), and nickel(ii) oxide (NiO) nanoparticles were predicted and found to be in very good agreement with experimental reports. To the best of our knowledge, this is the first attempt to simultaneously predict the cytotoxicity of nanoparticles under multiple experimental conditions by applying a single unique QSTR model.

  13. FOCUSED ASSESSMENT WITH SONOGRAPHY AS AN AID FOR THE DIAGNOSIS OF GASTROINTESTINAL PERFORATION IN A BOBCAT ( FELIS RUFUS ).

    PubMed

    Mejia-Fava, Johanna; Mayer, Jörg; Divers, Stephen J; Cohen, Eli B; Schmiedt, Chad; Holmes, Shannon P

    2015-12-01

    A 10-yr-old female spayed bobcat (Felis rufus) presented with a 3-day history of lethargy, anorexia, and two episodes of vomiting. An emergency field visit was scheduled to perform abdominal radiography and ultrasonography. The bobcat was assessed to be approximately 5-10% dehydrated, on the basis of decreased skin turgor and tacky mucous membranes. Free peritoneal gas, reduced abdominal serosal detail, and an abnormal-appearing right-sided intestinal segment were identified in the abdominal radiographs. However, the emergency field clinicians were not knowledgeable of these abnormalities, because the radiographs could not be processed in the field. During an initial complete abdominal ultrasound evaluation, a nondependent hyperechoic interface with reverberation artifact suggestive of intestinal or free gas and focal intestinal changes indicative of marked enteritis or peritonitis were identified. Free peritoneal fluid was not present on initial examination. In a focused abdominal sonography for trauma (FAST) scan, made after subcutaneous fluid administration, a small volume of anechoic free fluid was present in the peritoneal space. With ultrasound guidance, the fluid was aspirated and appeared grossly turbid. This fluid was subsequently confirmed as septic suppurative effusion, secondary to a foreign body-associated intestinal perforation. The use of a FAST scan is well described in human medicine, and to a limited degree in veterinary literature. This case represents a novel application of FAST scanning in an emergency field setting in a nontraumatized patient. This case report illustrates the utility of the FAST scan in yielding critical clinical information after fluid resuscitation in a zoological setting.

  14. FOCUSED ASSESSMENT WITH SONOGRAPHY AS AN AID FOR THE DIAGNOSIS OF GASTROINTESTINAL PERFORATION IN A BOBCAT ( FELIS RUFUS ).

    PubMed

    Mejia-Fava, Johanna; Mayer, Jörg; Divers, Stephen J; Cohen, Eli B; Schmiedt, Chad; Holmes, Shannon P

    2015-12-01

    A 10-yr-old female spayed bobcat (Felis rufus) presented with a 3-day history of lethargy, anorexia, and two episodes of vomiting. An emergency field visit was scheduled to perform abdominal radiography and ultrasonography. The bobcat was assessed to be approximately 5-10% dehydrated, on the basis of decreased skin turgor and tacky mucous membranes. Free peritoneal gas, reduced abdominal serosal detail, and an abnormal-appearing right-sided intestinal segment were identified in the abdominal radiographs. However, the emergency field clinicians were not knowledgeable of these abnormalities, because the radiographs could not be processed in the field. During an initial complete abdominal ultrasound evaluation, a nondependent hyperechoic interface with reverberation artifact suggestive of intestinal or free gas and focal intestinal changes indicative of marked enteritis or peritonitis were identified. Free peritoneal fluid was not present on initial examination. In a focused abdominal sonography for trauma (FAST) scan, made after subcutaneous fluid administration, a small volume of anechoic free fluid was present in the peritoneal space. With ultrasound guidance, the fluid was aspirated and appeared grossly turbid. This fluid was subsequently confirmed as septic suppurative effusion, secondary to a foreign body-associated intestinal perforation. The use of a FAST scan is well described in human medicine, and to a limited degree in veterinary literature. This case represents a novel application of FAST scanning in an emergency field setting in a nontraumatized patient. This case report illustrates the utility of the FAST scan in yielding critical clinical information after fluid resuscitation in a zoological setting. PMID:26667552

  15. The effects of national and international HIV/AIDS funding and governance mechanisms on the development of civil-society responses to HIV/AIDS in East and Southern Africa.

    PubMed

    Kelly, Kevin J; Birdsall, Karen

    2010-01-01

    The study takes stock of the exponential growth in the number of new civil-society organisations (CSOs) working in the HIV/AIDS field in East and Southern Africa during the period 1996-2004. We researched this development through a survey of 439 CSOs in six countries and case studies focused on the evolution of community responses to HIV/AIDS in specific communities in eight countries. We describe the types of CSOs that emerged, their relationships with governments and donors, and their activities, organisational characteristics and funding requirements. The data presented show that the vision of social mobilisation of HIV/AIDS responses through community-level organisations has faced strong external challenges. Evidence from survey data, national HIV/AIDS spending assessments and case studies shows that in some respects the changing international aid environment undermines the prospects for development of the civil-society sector's contributions in HIV/AIDS responses. Of particular interest is to understand how the "Three Ones" and the Paris Declaration on Aid Effectiveness have reshaped international funding for HIV/AIDS responses. There has been relatively little attention paid to the impact of the new management and funding modalities--including national performance frameworks, general budget support, joint funding arrangements and basket funds--on civil-society agencies at the forefront of community HIV/AIDS responses. Evidence is presented to show that in important respects the new modalities limit the unique contribution that CSOs can make to national HIV/AIDS responses. It is also shown that the drive to rapidly intensify the scale of HIV/AIDS responses has involved using community organisations as service providers for externally formulated programmes. We discuss this as a strong threat to the development of sustainable civil-society economies as well as to CSOs' diversity and responsiveness. The ways in which CSOs are responding to these challenges are

  16. Aided phytoextraction of Cu, Pb, Zn, and As in copper-contaminated soils with tobacco and sunflower in crop rotation: Mobility and phytoavailability assessment.

    PubMed

    Hattab-Hambli, Nour; Motelica-Heino, Mikael; Mench, Michel

    2016-02-01

    Copper-contaminated soils were managed with aided phytoextraction in 31 field plots at a former wood preservation site, using a single incorporation of compost (OM) and dolomitic limestone (DL) followed by a crop rotation with tobacco and sunflower. Six amended plots, with increasing total soil Cu, and one unamended plot were selected together with a control uncontaminated plot. The mobility and phytoavailability of Cu, Zn, Cr and As were investigated after 2 and 3 years in soil samples collected in these eight plots. Total Cu, Zn, Cr and As concentrations were determined in the soil pore water (SPW) and available soil Cu and Zn fractions by DGT. The Cu, Zn, Cr and As phytoavailability was characterized by growing dwarf beans on potted soils and determining the biomass of their plant parts and their foliar ionome. Total Cu concentrations in the SPW increased with total soil Cu. Total Cu, Zn, Cr and As concentrations in the SPW decreased in year 3 as compared to year 2, likely due to annual shoot removals by the plants and the lixiviation. Available soil Cu and Zn fractions also declined in year 3. The Cu, Zn, Cr and As phytoavailability, assessed by their concentration and mineral mass in the primary leaves of beans, was reduced in year 3. PMID:26706463

  17. EXTENDING THE ASSESSMENT OF TECHNOLOGY-AIDED PROGRAMS TO SUPPORT LEISURE AND COMMUNICATION IN PEOPLE WITH ACQUIRED BRAIN INJURY AND EXTENSIVE MULTIPLE DISABILITIES.

    PubMed

    Lancioni, Giulio E; Singh, Nirbhay N; O'reilly, Mark F; Sigafoos, Jeff; Buonocunto, Francesca; D'amico, Fiora; Quaranta, Sara; Navarro, Jorge; Lanzilotti, Crocifissa; Colonna, Fabio

    2015-10-01

    Intervention programs for people with acquired brain injury and extensive motor and communication impairment need to be diversified according to their characteristics and environment. These two studies assessed two technology-aided programs for supporting leisure (i.e., access to songs and videos) and communication (i.e., expressing needs and feelings and making requests) in six of those people. The three people participating in Study 1 did not possess speech but were able to understand spoken and written sentences. Their program presented leisure and communication options through written phrases appearing on the computer screen. The three people participating in Study 2 did not possess any speech and were unable to understand spoken or written language. Their program presented leisure and communication options through pictorial images. All participants relied on a simple microswitch response to enter the options and activate songs, videos, and communication messages. The data showed that the participants of both studies learned to use the program available to them and to engage in leisure and communication independently. The importance of using programs adapted to the participants and their environment was discussed. PMID:26445152

  18. EXTENDING THE ASSESSMENT OF TECHNOLOGY-AIDED PROGRAMS TO SUPPORT LEISURE AND COMMUNICATION IN PEOPLE WITH ACQUIRED BRAIN INJURY AND EXTENSIVE MULTIPLE DISABILITIES.

    PubMed

    Lancioni, Giulio E; Singh, Nirbhay N; O'reilly, Mark F; Sigafoos, Jeff; Buonocunto, Francesca; D'amico, Fiora; Quaranta, Sara; Navarro, Jorge; Lanzilotti, Crocifissa; Colonna, Fabio

    2015-10-01

    Intervention programs for people with acquired brain injury and extensive motor and communication impairment need to be diversified according to their characteristics and environment. These two studies assessed two technology-aided programs for supporting leisure (i.e., access to songs and videos) and communication (i.e., expressing needs and feelings and making requests) in six of those people. The three people participating in Study 1 did not possess speech but were able to understand spoken and written sentences. Their program presented leisure and communication options through written phrases appearing on the computer screen. The three people participating in Study 2 did not possess any speech and were unable to understand spoken or written language. Their program presented leisure and communication options through pictorial images. All participants relied on a simple microswitch response to enter the options and activate songs, videos, and communication messages. The data showed that the participants of both studies learned to use the program available to them and to engage in leisure and communication independently. The importance of using programs adapted to the participants and their environment was discussed.

  19. Black box integration of computer-aided diagnosis into PACS deserves a second chance: results of a usability study concerning bone age assessment.

    PubMed

    Geldermann, Ina; Grouls, Christoph; Kuhl, Christiane; Deserno, Thomas M; Spreckelsen, Cord

    2013-08-01

    Usability aspects of different integration concepts for picture archiving and communication systems (PACS) and computer-aided diagnosis (CAD) were inquired on the example of BoneXpert, a program determining the skeletal age from a left hand's radiograph. CAD-PACS integration was assessed according to its levels: data, function, presentation, and context integration focusing on usability aspects. A user-based study design was selected. Statements of seven experienced radiologists using two alternative types of integration provided by BoneXpert were acquired and analyzed using a mixed-methods approach based on think-aloud records and a questionnaire. In both variants, the CAD module (BoneXpert) was easily integrated in the workflow, found comprehensible and fitting in the conceptual framework of the radiologists. Weak points of the software integration referred to data and context integration. Surprisingly, visualization of intermediate image processing states (presentation integration) was found less important as compared to efficient handling and fast computation. Seamlessly integrating CAD into the PACS without additional work steps or unnecessary interrupts and without visualizing intermediate images may considerably improve software performance and user acceptance with efforts in time.

  20. Assessment of plasma anti-elastin antibodies for use as a diagnostic aid for chronic progressive lymphoedema in Belgian Draught Horses.

    PubMed

    De Keyser, K; Berth, M; Christensen, N; Willaert, S; Janssens, S; Ducatelle, R; Goddeeris, B M; De Cock, H E V; Buys, N

    2015-01-15

    Diagnosis of chronic progressive lymphoedema (CPL) in draught horses, including the Belgian Draught Horse, is mainly based on clinical evaluation of typical lower limb lesions. A deficient perilymphatic elastic support, caused by a pathological elastin degradation in skin and subcutis, has been suggested as a contributing factor for CPL. Elastin degradation products induce the generation of anti-elastin Ab (AEAb), detectable in horse serum by ELISA. For a clinically healthy group of draught horses, a significantly lower average AEAb-level than 3 clinically affected groups (mild, moderate and severe symptoms) was demonstrated previously. To improve CPL-diagnosis, we evaluated the AEAb-ELISA as an in vitro diagnostic aid in individual horses. Test reproducibility was assessed, performing assays independently in 2 laboratories on a total of 345 horses. Possible factors associated with AEAb-levels (age, gender, pregnancy, test lab and date of blood collection) were analyzed using a mixed statistical model. Results were reproducible in both laboratories. AEAb-levels in moderately and severely affected horses were significantly higher than in healthy horses. Nevertheless, this was only demonstrated in barren mares, and, there was a very large overlap between the clinical groups. Consequently, even when a high AEAb cut-off was handled to obtain a reasonable specificity of 90%, a very low sensitivity (21%) of AEAb for CPL-diagnosis was obtained. Results on the present sample demonstrate that the described ELISA procedure is of no use as a diagnostic test for CPL in individual horses.

  1. Aided phytoextraction of Cu, Pb, Zn, and As in copper-contaminated soils with tobacco and sunflower in crop rotation: Mobility and phytoavailability assessment.

    PubMed

    Hattab-Hambli, Nour; Motelica-Heino, Mikael; Mench, Michel

    2016-02-01

    Copper-contaminated soils were managed with aided phytoextraction in 31 field plots at a former wood preservation site, using a single incorporation of compost (OM) and dolomitic limestone (DL) followed by a crop rotation with tobacco and sunflower. Six amended plots, with increasing total soil Cu, and one unamended plot were selected together with a control uncontaminated plot. The mobility and phytoavailability of Cu, Zn, Cr and As were investigated after 2 and 3 years in soil samples collected in these eight plots. Total Cu, Zn, Cr and As concentrations were determined in the soil pore water (SPW) and available soil Cu and Zn fractions by DGT. The Cu, Zn, Cr and As phytoavailability was characterized by growing dwarf beans on potted soils and determining the biomass of their plant parts and their foliar ionome. Total Cu concentrations in the SPW increased with total soil Cu. Total Cu, Zn, Cr and As concentrations in the SPW decreased in year 3 as compared to year 2, likely due to annual shoot removals by the plants and the lixiviation. Available soil Cu and Zn fractions also declined in year 3. The Cu, Zn, Cr and As phytoavailability, assessed by their concentration and mineral mass in the primary leaves of beans, was reduced in year 3.

  2. Assessment of renal volume by three-dimensional ultrasonography in pregnant bitches: an experimental study using virtual organ computer-aided analysis

    PubMed Central

    2012-01-01

    Background To assess and to compare the renal volume evolution in bitches during pregnancy by two-dimensional (2D) ultrasonography using the ellipsoid technique (volume = length x width x depth x 0.523) and three-dimensional (3D) ultrasonography using the Virtual Organ Computer-aided AnaLysis (VOCAL) method. A longitudinal prospective study was performed with 17 normal Golden Retrievers bitches during pregnancy from heat to the last third of gestation. The ultrasound scans were performed by two veterinarians. The left and right kidneys were assessed in three moments (day 0 = non-pregnant bitches; days 1st to 20th of pregnancy and days 21st to 40th of pregnancy) by three techniques (ellipsoid; VOCAL 12° and VOCAL 30°). For reproducibility calculations, we used the intraclass correlation coefficient (ICC). Results The inferential result of the volumes in ANOVA revealed the interaction effect between side and moment (p = 0.009). The 3D techniques showed, in average, the same renal volumes (p = 0.137) regardless of the side and moment. Considering the right side, the renal volume in the day 0 was smaller than the day 21st to 40th (p = 0.029). Considering the left side, the renal volume at day 0 was smaller than the day 1st to 20th (p = 0.020) and day 21st to 40th (p = 0.007). It was found good intra observer reproducibility (ICC > 0.9) and none of the three techniques showed a good inter observer reproducibility (ICC < 0.7). Conclusion The renal volume bitches by 3D ultrasonography using the VOCAL method (12° and 30°) had good correlation with the volume obtained by 2D ultrasonography method. PMID:22748096

  3. Is Health Aid Reaching the Poor? Analysis of Household Data from Aid Recipient Countries

    PubMed Central

    Bendavid, Eran

    2014-01-01

    Objective To determine the extent to which the narrowing of child mortality across wealth gradients has been related to foreign aid to the health sector in low- and middle-income countries. Methods Mortality and wealth data on 989,901 under-5 children from 957,674 households in 49 aid recipient countries in Africa, Asia, South America, and the Caribbean between 1993 and 2012 were used in the analysis. Declines in under-5 mortality in the four poorest wealth quantiles were compared to the decline among the wealthiest at varying levels of health aid per capita using fixed effects multivariable regression models and controlling for maternal education, urbanization, and domestic spending on health among recipient countries. Results Each additional dollar in total health aid per capita was associated with 5.7 fewer deaths per 10,000 child-years among children in the poorest relative to the wealthiest households (p<0.001). This was also true when measured in percent declines (1.90% faster decline in under-5 mortality among the poorest compared with the wealthiest with each dollar in total health aid, p = 0.008). The association was stronger when using health aid specifically for malaria than total health aid, 12.60% faster decline among the poorest compared with the wealthiest with each dollar in malaria aid, p = 0.001. Conclusions Foreign aid to the health sector is preferentially related to reductions in under-5 mortality among the poorest compared with the wealthiest. Health aid addressing malaria, which imposes a disproportionate burden among the poor, may explain the observed effect. PMID:24404148

  4. Disparities Within: Unequal Spending and Achievement in an Urban School District.

    ERIC Educational Resources Information Center

    Condron, Dennis J.; Roscigno, Vincent J.

    2003-01-01

    Analyzes unique within district variations in spending and achievement among urban public elementary schools (n=89). Reveals considerable disparities in spending linked to local patterns of racial and class stratification and concentration. Shows how these local driven inequalities have consequences for achievement in reading, writing,…

  5. How Federal Spending for Infrastructure and Other Public Investments Affects the Economy.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. Congressional Budget Office.

    Despite pressures for reducing the overall spending of the federal government, some policymakers and analysts have considered increasing the funding for particular areas that might be especially important to the long-term growth of the economy. Increases have been proposed in spending for highways and other types of physical infrastructure, for…

  6. Monopoly Money: The Effect of Payment Coupling and Form on Spending Behavior

    ERIC Educational Resources Information Center

    Raghubir, Priya; Srivastava, Joydeep

    2008-01-01

    This article examines consumer spending as a function of payment mode both when the modes differ in terms of payment coupling (association between purchase decision and actual parting of money) and physical form as well as when the modes differ only in terms of form. Study 1 demonstrates that consumers are willing to spend more when a credit card…

  7. 2014 National Park visitor spending effects: economic contributions to local communities, states, and the nation

    USGS Publications Warehouse

    Cullinane Thomas, Catherine; Huber, Christopher; Koontz, Lynne

    2015-01-01

    New this year, results from the Visitor Spending Effects report series are available online via an interactive tool. Users can explore current year visitor spending, jobs, labor income, value added, and output effects by sector for national, state, and local economies. This interactive tool is available via the NPS Social Science Program webpage at http://www.nature.nps.gov/socialscience/economics.cfm.

  8. Where Are State Funds Spent? The Distribution of Spending across California Regions. CRB 08-017

    ERIC Educational Resources Information Center

    Jones, Martha

    2008-01-01

    What does the geographic distribution of state spending look like? Are there regions of the state that receive more than their "fair share" of state funds? How is a region's "fair share" defined and calculated? This report examines the geographic distribution of state spending across nine regions: the San Francisco Bay Area, Central Coast, Far…

  9. Alaska's Dependence on State Spending. ISER Fiscal Policy Papers, No. 5.

    ERIC Educational Resources Information Center

    Goldsmith, Scott; And Others

    Alaska will face a large fiscal gap and growing budget deficits in the near future. The timing of such fiscal gap open hinges on the joint effect of state budget growth and the oil price change. This paper explains Alaska's dependence on state spending and offers policy options addressing the fiscal gap. State spending: (1) supports nearly one in…

  10. Report on Spending Trends Highlights Inequities in Model for Financing Colleges

    ERIC Educational Resources Information Center

    Blumenstyk, Goldie

    2009-01-01

    An analysis of spending trends that is designed to discourage policy makers' focus on finding new revenue rather than reining in spending suggests that the model for financing colleges has reinforced educational inequities and failed to increase the rate at which students graduate. According to the analysis, "serious fault lines" in the current…

  11. Analysis of capital spending and capital financing among large US nonprofit health systems.

    PubMed

    Stewart, Louis J

    2012-01-01

    This article examines the recent trends (2006 to 2009) in capital spending among 25 of the largest nonprofit health systems in the United States and analyzes the financing sources that these large nonprofit health care systems used to fund their capital spending. Total capital spending for these 25 nonprofit health entities exceeded $41 billion for the four-year period of this study. Less than 3 percent of total capital spending resulted in mergers and acquisition activities. Total annual capital spending grew at an average annual rate of 17.6 percent during the first three year of this study's period of analysis. Annual capital spending for 2009 fell by more than 22 percent over prior year's level due to the impact of widespread disruption in US tax-exempt variable rate debt markets. While cash inflow from long-term debt issues was a significant source of capital financing, this study's primary finding was that operating cash flow was the predominant source of capital spending funding. Key words: nonprofit, mergers and acquisitions (M&A), capital spending, capital financing.

  12. Examining regional variation in health care spending in British Columbia, Canada.

    PubMed

    Lavergne, Miriam Ruth; Barer, Morris; Law, Michael R; Wong, Sabrina T; Peterson, Sandra; McGrail, Kimberlyn

    2016-07-01

    Examining regional variation in health care spending may reveal opportunities for improved efficiency. Previous research has found that health care spending and service use vary substantially from place to place, and this is often not explained by differences in the health status of populations or by better outcomes in higher-spending regions, but rather by differences in intensity of service provision. Much of this research comes from the United States. Whether similar patterns are observed in other high-income countries is not clear. We use administrative data on health care use, covering the entire population of the Canadian province of British Columbia, to examine how and why health care spending varies among health regions. Pricing and insurance coverage are constant across the population, and we adjust for patient-level age, sex, and recorded diagnoses. Without adjusting for differences in population characteristics, per-capita spending is 50% higher in the highest-spending region than in the lowest. Adjusting for population characteristics as well as the very different environments for health service delivery that exist among metropolitan, non-metropolitan, and remote regions of the province, this falls to 20%. Despite modest variation in total spending, there are marked differences in mortality. In this context, it appears that policy reforms aimed at system-wide quality and efficiency improvement, rather than targeted at high-spending regions, will likely prove most promising. PMID:27131975

  13. Federal spending on behavioral health accelerated during recession as individuals lost employer insurance.

    PubMed

    Levit, Katharine R; Mark, Tami L; Coffey, Rosanna M; Frankel, Sasha; Santora, Patricia; Vandivort-Warren, Rita; Malone, Kevin

    2013-05-01

    The 2007-09 recession had a dramatic effect on behavioral health spending, with the effect most prominent for private, state, and local payers. During the recession behavioral health spending increased at a 4.6 percent average annual rate, down from 6.1 percent in 2004-07. Average annual growth in private behavioral health spending during the recession slowed to 2.7 percent from 7.2 percent in 2004-07. State and local behavioral health spending showed negative average annual growth, -1.2 percent, during the recession, compared with 3.7 percent increases in 2004-07. In contrast, federal behavioral health spending growth accelerated to 11.1 percent during the recession, up from 7.2 percent in 2004-07. These behavioral health spending trends were driven largely by increased federal spending in Medicaid, declining private insurance enrollment, and severe state budget constraints. An increased federal Medicaid match reduced the state share of Medicaid spending, which prevented more drastic cuts in state-funded behavioral health programs during the recession. Federal Medicaid served as a critical safety net for people with behavioral health treatment needs during the recession.

  14. The Influence of the Elderly on School Spending in a Median Voter Framework

    ERIC Educational Resources Information Center

    Fletcher, Deborah; Kenny, Lawrence W.

    2008-01-01

    How do the elderly influence school spending if they are a minority of the population? We estimate the determinants of school spending in a median voter model, comparing four assumptions about how the elderly influence the identity of the median voter. Using a county-level panel, we find that elderly preferences are best characterized by assuming…

  15. Supplemental coverage associated with more rapid spending growth for Medicare beneficiaries.

    PubMed

    Golberstein, Ezra; Walsh, Kayo; He, Yulei; Chernew, Michael E

    2013-05-01

    Lowering both Medicare spending and the rate of Medicare spending growth is important for the nation's fiscal health. Policy makers in search of ways to achieve these reductions have looked at the role that supplemental coverage for Medicare beneficiaries plays in Medicare spending. Supplemental coverage makes health care more affordable for beneficiaries but also makes beneficiaries insensitive to the cost of their care, thereby increasing the demand for care. Ours is the first empirical study to investigate whether supplemental Medicare coverage is associated with higher rates of spending growth over time. We found that supplemental insurance coverage was associated with significantly higher rates of overall spending growth. Specifically, employer-sponsored and self-purchased supplemental coverage were associated with annual total spending growth rates of 7.17 percent and 7.18 percent, respectively, compared to 6.08 percent annual growth for beneficiaries without supplemental coverage. Results for Medicare program spending were more equivocal, however. Our results are consistent with the belief that current trends away from generous employer-sponsored supplemental coverage and efforts to restrict the generosity of supplemental coverage may slow spending growth. PMID:23650320

  16. Variation In Accountable Care Organization Spending And Sensitivity To Risk Adjustment: Implications For Benchmarking.

    PubMed

    Rose, Sherri; Zaslavsky, Alan M; McWilliams, J Michael

    2016-03-01

    Spending targets (or benchmarks) for accountable care organizations (ACOs) participating in the Medicare Shared Savings Program must be set carefully to encourage program participation while achieving fiscal goals and minimizing unintended consequences, such as penalizing ACOs for serving sicker patients. Recently proposed regulatory changes include measures to make benchmarks more similar for ACOs in the same area with different historical spending levels. We found that ACOs vary widely in how their spending levels compare with those of other local providers after standard case-mix adjustments. Additionally adjusting for survey measures of patient health meaningfully reduced the variation in differences between ACO spending and local average fee-for-service spending, but substantial variation remained, which suggests that differences in care efficiency between ACOs and local non-ACO providers vary widely. Accordingly, measures to equilibrate benchmarks between high- and low-spending ACOs--such as setting benchmarks to risk-adjusted average fee-for-service spending in an area--should be implemented gradually to maintain participation by ACOs with high spending. Use of survey information also could help mitigate perverse incentives for risk selection and upcoding and limit unintended consequences of new benchmarking methodologies for ACOs serving sicker patients. PMID:26953298

  17. Life under the Spending Caps: The Clinton Fiscal Year 1995 Budget.

    ERIC Educational Resources Information Center

    Leonard, Paul; Greenstein, Robert

    The stage for the introduction of the Clinton Administration's fiscal year 1995 budget was largely set by the passage of the budget reconciliation bill signed into law in August 1993. In developing the budget, the Administration had to come up with enough spending cuts to meet the spending caps--as well as billions of dollars in additional cuts to…

  18. Additional reductions in Medicare spending growth will likely require shifting costs to beneficiaries.

    PubMed

    Chernew, Michael E

    2013-05-01

    Policy makers have considerable interest in reducing Medicare spending growth. Clarity in the debate on reducing Medicare spending growth requires recognition of three important distinctions: the difference between public and total spending on health, the difference between the level of health spending and rate of health spending growth, and the difference between growth per beneficiary and growth in the number of beneficiaries in Medicare. The primary policy issue facing the US health care system is the rate of spending growth in public programs, and solving that problem will probably require reforms to the entire health care sector. The Affordable Care Act created a projected trajectory for Medicare spending per beneficiary that is lower than historical growth rates. Although opportunities for one-time savings exist, any long-term savings from Medicare, beyond those already forecast, will probably require a shift in spending from taxpayers to beneficiaries via higher beneficiary premium contributions (overall or via means testing), changes in eligibility, or greater cost sharing at the point of service.

  19. 40 CFR 35.4070 - How can my group spend TAG money?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false How can my group spend TAG money? 35.4070 Section 35.4070 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL... my group spend TAG money? (a) Your group must use all or most of your funds to procure a...

  20. 50 CFR 86.73 - What if I do not spend all the money?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 50 Wildlife and Fisheries 8 2011-10-01 2011-10-01 false What if I do not spend all the money? 86.73 Section 86.73 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE... GRANT (BIG) PROGRAM How States Manage Grants § 86.73 What if I do not spend all the money? Funds...

  1. 40 CFR 35.4070 - How can my group spend TAG money?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 1 2013-07-01 2013-07-01 false How can my group spend TAG money? 35.4070 Section 35.4070 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL... my group spend TAG money? (a) Your group must use all or most of your funds to procure a...

  2. 40 CFR 35.4070 - How can my group spend TAG money?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 1 2012-07-01 2012-07-01 false How can my group spend TAG money? 35.4070 Section 35.4070 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL... my group spend TAG money? (a) Your group must use all or most of your funds to procure a...

  3. 40 CFR 35.4070 - How can my group spend TAG money?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 1 2014-07-01 2014-07-01 false How can my group spend TAG money? 35.4070 Section 35.4070 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL... my group spend TAG money? (a) Your group must use all or most of your funds to procure a...

  4. 40 CFR 35.4070 - How can my group spend TAG money?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 1 2011-07-01 2011-07-01 false How can my group spend TAG money? 35.4070 Section 35.4070 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL... my group spend TAG money? (a) Your group must use all or most of your funds to procure a...

  5. 50 CFR 86.73 - What if I do not spend all the money?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false What if I do not spend all the money? 86.73 Section 86.73 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE... GRANT (BIG) PROGRAM How States Manage Grants § 86.73 What if I do not spend all the money? Funds...

  6. Analysis of capital spending and capital financing among large US nonprofit health systems.

    PubMed

    Stewart, Louis J

    2012-01-01

    This article examines the recent trends (2006 to 2009) in capital spending among 25 of the largest nonprofit health systems in the United States and analyzes the financing sources that these large nonprofit health care systems used to fund their capital spending. Total capital spending for these 25 nonprofit health entities exceeded $41 billion for the four-year period of this study. Less than 3 percent of total capital spending resulted in mergers and acquisition activities. Total annual capital spending grew at an average annual rate of 17.6 percent during the first three year of this study's period of analysis. Annual capital spending for 2009 fell by more than 22 percent over prior year's level due to the impact of widespread disruption in US tax-exempt variable rate debt markets. While cash inflow from long-term debt issues was a significant source of capital financing, this study's primary finding was that operating cash flow was the predominant source of capital spending funding. Key words: nonprofit, mergers and acquisitions (M&A), capital spending, capital financing. PMID:22515040

  7. Why lowering health costs should be a key adjunct to slowing health spending growth.

    PubMed

    Sommers, Benjamin D

    2010-09-01

    If U.S. health care spending growth continues unchecked, the nation will have far less in the future to purchase other essentials, including education, infrastructure, and consumer goods. The point at which nonhealth spending could begin a precipitous decline was previously projected in a paper by Michael Chernew and colleagues to be 2050, unless the rate of health cost growth can be lowered (that is, "bending the curve"). This paper evaluates alternative approaches. First, it looks at the effect on health and nonhealth spending of a one-time reduction in health costs--for example, through a sharp reduction in overuse of medical services in higher-cost regions of the country. It concludes that a one-time reduction in the range of 20-35 percent would delay Chernew's projected decline in nonhealth spending by ten to twenty years. Second, it looks at the effect of combining up-front spending reductions of this size with a longer-range cut in the rate of growth of health spending from 2 percentage points to 1.5 percentage points annually. It finds that this scenario would postpone a major drop in nonhealth spending almost until the twenty-second century. The paper argues that substantial up-front reductions in health spending are therefore worth pursuing to protect the nation's long-term economic growth. PMID:20820021

  8. 42 CFR 52a.7 - For what purposes may a grantee spend grant funds?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false For what purposes may a grantee spend grant funds? 52a.7 Section 52a.7 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS NATIONAL INSTITUTES OF HEALTH CENTER GRANTS § 52a.7 For what purposes may a grantee spend...

  9. 42 CFR 52a.7 - For what purposes may a grantee spend grant funds?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false For what purposes may a grantee spend grant funds? 52a.7 Section 52a.7 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS NATIONAL INSTITUTES OF HEALTH CENTER GRANTS § 52a.7 For what purposes may a grantee spend...

  10. Review of "They Spend What? The Real Cost of Public Schools"

    ERIC Educational Resources Information Center

    Altemus, Vaughn

    2010-01-01

    The CATO Institute's Policy Analysis "They Spend WHAT? The Real Cost of Public Schools" contends that the figures most commonly associated with spending on K-12 public education do not include all relevant expenditures. It also cites survey evidence suggesting that voters underestimate the cost of education and, when presented with a higher…

  11. The US healthcare workforce and the labor market effect on healthcare spending and health outcomes.

    PubMed

    Pellegrini, Lawrence C; Rodriguez-Monguio, Rosa; Qian, Jing

    2014-06-01

    The healthcare sector was one of the few sectors of the US economy that created new positions in spite of the recent economic downturn. Economic contractions are associated with worsening morbidity and mortality, declining private health insurance coverage, and budgetary pressure on public health programs. This study examines the causes of healthcare employment growth and workforce composition in the US and evaluates the labor market's impact on healthcare spending and health outcomes. Data are collected for 50 states and the District of Columbia from 1999-2009. Labor market and healthcare workforce data are obtained from the Bureau of Labor Statistics. Mortality and health status data are collected from the Centers for Disease Control and Prevention's Vital Statistics program and Behavioral Risk Factor Surveillance System. Healthcare spending data are derived from the Centers for Medicare and Medicaid Services. Dynamic panel data regression models, with instrumental variables, are used to examine the effect of the labor market on healthcare spending, morbidity, and mortality. Regression analysis is also performed to model the effects of healthcare spending on the healthcare workforce composition. All statistical tests are based on a two-sided [Formula: see text] significance of [Formula: see text] .05. Analyses are performed with STATA and SAS. The labor force participation rate shows a more robust effect on healthcare spending, morbidity, and mortality than the unemployment rate. Study results also show that declining labor force participation negatively impacts overall health status ([Formula: see text] .01), and mortality for males ([Formula: see text] .05) and females ([Formula: see text] .001), aged 16-64. Further, the Medicaid and Medicare spending share increases as labor force participation declines ([Formula: see text] .001); whereas, the private healthcare spending share decreases ([Formula: see text] .001). Public and private healthcare spending also

  12. The US healthcare workforce and the labor market effect on healthcare spending and health outcomes.

    PubMed

    Pellegrini, Lawrence C; Rodriguez-Monguio, Rosa; Qian, Jing

    2014-06-01

    The healthcare sector was one of the few sectors of the US economy that created new positions in spite of the recent economic downturn. Economic contractions are associated with worsening morbidity and mortality, declining private health insurance coverage, and budgetary pressure on public health programs. This study examines the causes of healthcare employment growth and workforce composition in the US and evaluates the labor market's impact on healthcare spending and health outcomes. Data are collected for 50 states and the District of Columbia from 1999-2009. Labor market and healthcare workforce data are obtained from the Bureau of Labor Statistics. Mortality and health status data are collected from the Centers for Disease Control and Prevention's Vital Statistics program and Behavioral Risk Factor Surveillance System. Healthcare spending data are derived from the Centers for Medicare and Medicaid Services. Dynamic panel data regression models, with instrumental variables, are used to examine the effect of the labor market on healthcare spending, morbidity, and mortality. Regression analysis is also performed to model the effects of healthcare spending on the healthcare workforce composition. All statistical tests are based on a two-sided [Formula: see text] significance of [Formula: see text] .05. Analyses are performed with STATA and SAS. The labor force participation rate shows a more robust effect on healthcare spending, morbidity, and mortality than the unemployment rate. Study results also show that declining labor force participation negatively impacts overall health status ([Formula: see text] .01), and mortality for males ([Formula: see text] .05) and females ([Formula: see text] .001), aged 16-64. Further, the Medicaid and Medicare spending share increases as labor force participation declines ([Formula: see text] .001); whereas, the private healthcare spending share decreases ([Formula: see text] .001). Public and private healthcare spending also

  13. State unemployment in recessions during 1991-2009 was linked to faster growth in Medicare spending.

    PubMed

    McInerney, Melissa Powell; Mellor, Jennifer M

    2012-11-01

    During the US recession of 2007-09, overall health care spending growth fell, but Medicare spending growth increased. Using state-level data from the period 1991-2009, we show that these divergent trends were also observed within states. Furthermore, increases in state unemployment rates were associated with higher Medicare spending per capita and increased hospital use by Medicare beneficiaries. For example, a one-percentage-point point rise in the unemployment rate was associated with a $40 (0.7 percent) increase in Medicare spending per capita. Our results suggest that economic downturns contribute to Medicare spending and use. One of many possible explanations may be that health care providers have greater capacity, inclination, and financial incentive to treat Medicare patients during recessions as a result of slackening demand from the non-Medicare population.

  14. Returns to Local-Area Healthcare Spending: Evidence from Health Shocks to Patients Far From Home

    PubMed Central

    Doyle, Joseph J.

    2013-01-01

    Healthcare spending varies widely across markets, and previous empirical studies find little evidence that higher spending translates into better health outcomes. The main innovation in this paper exploits this cross-sectional variation in hospital spending in a new way by considering patients who are exposed to healthcare systems not designed for them: patients far from home when a health emergency strikes. Visitors to Florida who become ill in high-spending areas have significantly lower mortality rates compared to visitors in lower-spending areas. The results are robust within groups of similar visitors and within groups of destinations that appear to be close demand substitutes—areas that likely attract similar visitors. PMID:23853699

  15. State unemployment in recessions during 1991-2009 was linked to faster growth in Medicare spending.

    PubMed

    McInerney, Melissa Powell; Mellor, Jennifer M

    2012-11-01

    During the US recession of 2007-09, overall health care spending growth fell, but Medicare spending growth increased. Using state-level data from the period 1991-2009, we show that these divergent trends were also observed within states. Furthermore, increases in state unemployment rates were associated with higher Medicare spending per capita and increased hospital use by Medicare beneficiaries. For example, a one-percentage-point point rise in the unemployment rate was associated with a $40 (0.7 percent) increase in Medicare spending per capita. Our results suggest that economic downturns contribute to Medicare spending and use. One of many possible explanations may be that health care providers have greater capacity, inclination, and financial incentive to treat Medicare patients during recessions as a result of slackening demand from the non-Medicare population. PMID:23129677

  16. The economic impact of NASA R and D spending: Executive summary

    NASA Technical Reports Server (NTRS)

    Evans, M. K.

    1976-01-01

    An evaluation of the economic impact of NASA research and development programs is made. The methodology and the results revolve around the interrelationships existing between the demand and supply effects of increased research and development spending, in particular, NASA research and development spending. The INFORUM Inter-Industry Forecasing Model is used to measure the short-run economic impact of alternative levels of NASA expenditures for 1975. An aggregate production function approach is used to develop the data series necessary to measure the impact of NASA research and development spending, and other determinants of technological progress, on the rate of growth in productivity of the U. S. economy. The measured relationship between NASA research and development spending and technological progress is simulated in the Chase Macroeconometric Model to measure the immediate, intermediate, and long-run economic impact of increased NASA research and development spending over a sustained period.

  17. Changes in government spending on healthcare and population mortality in the European union, 1995–2010: a cross-sectional ecological study

    PubMed Central

    Watkins, Johnathan; Atun, Rifat; Williams, Callum; Zeltner, Thomas; Maruthappu, Mahiben

    2015-01-01

    Objective Economic measures such as unemployment and gross domestic product are correlated with changes in health outcomes. We aimed to examine the effects of changes in government healthcare spending, an increasingly important measure given constrained government budgets in several European Union countries. Design Multivariate regression analysis was used to assess the effect of changes in healthcare spending as a proportion of total government expenditure, government healthcare spending as a proportion of gross domestic product and government healthcare spending measured in purchasing power parity per capita, on five mortality indicators. Additional variables were controlled for to ensure robustness of data. One to five year lag analyses were conducted. Setting and Participants European Union countries 1995–2010. Main outcome measures Neonatal mortality, postneonatal mortality, one to five years of age mortality, under five years of age mortality, adult male mortality, adult female mortality. Results A 1% decrease in government healthcare spending was associated with significant increase in all mortality metrics: neonatal mortality (coefficient −0.1217, p = 0.0001), postneonatal mortality (coefficient −0.0499, p = 0.0018), one to five years of age mortality (coefficient −0.0185, p = 0.0002), under five years of age mortality (coefficient −0.1897, p = 0.0003), adult male mortality (coefficient −2.5398, p = 0.0000) and adult female mortality (coefficient −1.4492, p = 0.0000). One per cent decrease in healthcare spending, measured as a proportion of gross domestic product and in purchasing power parity, was both associated with significant increases (p < 0.05) in all metrics. Five years after the 1% decrease in healthcare spending, significant increases (p < 0.05) continued to be observed in all mortality metrics. Conclusions Decreased government healthcare spending is associated with increased population mortality in

  18. Miscues: Meaningful Assessment Aids Instruction

    ERIC Educational Resources Information Center

    Luft, Pamela

    2009-01-01

    LeRoy was a deaf sixth grader who used signs and his voice to communicate. Yanetta was a deaf eighth grader who had deaf parents and preferred American Sign Language (ASL). Michael was a deaf fifth grader in a suburban school who attended an oral program and used his voice exclusively to communicate. All three students struggled with reading. They…

  19. Assessment of Feasibility to Use Computer Aided Texture Analysis Based Tool for Parametric Images of Suspicious Lesions in DCE-MR Mammography

    PubMed Central

    Kale, Mehmet Cemil; Fleig, John David; İmal, Nazım

    2013-01-01

    Our aim was to analyze the feasibility of computer aided malignant tumor detection using the traditional texture analysis applied on two-compartment-based parameter pseudoimages of dynamic contrast-enhanced magnetic resonance (DCE-MR) breast image data. A major contribution of this research will be the through-plane assessment capability. Texture analysis was performed on two-compartment-based pseudo images of DCE-MRI datasets of breast data of eight subjects. The resulting texture parameter pseudo images were inputted to a feedforward neural network classification system which uses the manual segmentations of a primary radiologist as a gold standard, and each voxel was assigned as malignant or nonmalignant. The classification results were compared with the lesions manually segmented by a second radiologist. Results show that the mean true positive fraction (TPF) and false positive fraction (FPF) performance of the classifier vs. primary radiologist is statistically as good as the mean TPF and FPF performance of the second radiologist vs. primary radiologist with a confidence interval of 95% using a one-sample t-test with α = 0.05. In the experiment implemented on all of the eight subjects, all malignant tumors marked by the primary radiologist were classified to be malignant by the computer classifier. Our results have shown that neural network classification using the textural parameters for automated screening of two-compartment-based parameter pseudo images of DCE-MRI as input data can be a supportive tool for the radiologists in the preassessment stage to show the possible cancerous regions and in the postassessment stage to review the segmentations especially in analyzing complex DCE-MRI cases. PMID:23653668

  20. Assessment of feasibility to use computer aided texture analysis based tool for parametric images of suspicious lesions in DCE-MR mammography.

    PubMed

    Kale, Mehmet Cemil; Fleig, John David; Imal, Nazım

    2013-01-01

    Our aim was to analyze the feasibility of computer aided malignant tumor detection using the traditional texture analysis applied on two-compartment-based parameter pseudoimages of dynamic contrast-enhanced magnetic resonance (DCE-MR) breast image data. A major contribution of this research will be the through-plane assessment capability. Texture analysis was performed on two-compartment-based pseudo images of DCE-MRI datasets of breast data of eight subjects. The resulting texture parameter pseudo images were inputted to a feedforward neural network classification system which uses the manual segmentations of a primary radiologist as a gold standard, and each voxel was assigned as malignant or nonmalignant. The classification results were compared with the lesions manually segmented by a second radiologist. Results show that the mean true positive fraction (TPF) and false positive fraction (FPF) performance of the classifier vs. primary radiologist is statistically as good as the mean TPF and FPF performance of the second radiologist vs. primary radiologist with a confidence interval of 95% using a one-sample t-test with α = 0.05. In the experiment implemented on all of the eight subjects, all malignant tumors marked by the primary radiologist were classified to be malignant by the computer classifier. Our results have shown that neural network classification using the textural parameters for automated screening of two-compartment-based parameter pseudo images of DCE-MRI as input data can be a supportive tool for the radiologists in the preassessment stage to show the possible cancerous regions and in the postassessment stage to review the segmentations especially in analyzing complex DCE-MRI cases.

  1. Large Increases In Spending On Postacute Care In Medicare Point To The Potential For Cost Savings In These Settings

    PubMed Central

    Chandra, Amitabh; Dalton, Maurice A.; Holmes, Jonathan

    2013-01-01

    Identifying policies that will cut or constrain US health care spending and spending growth dominates reform efforts, yet little is known about whether the drivers of spending levels and of spending growth are the same. Policies that produce a one-time reduction in the level of spending, for example by making hospitals more efficient, may do little to reduce subsequent annual spending growth. To identify factors causing health care spending to grow the fastest, we focused on three conditions in the Medicare population: heart attacks, congestive heart failure, and hip fractures. We found that spending on postacute care—long-term hospital care, rehabilitation care, and skilled nursing facility care—was the fastest growing major spending category and accounted for a large portion of spending growth in 1994–2009. During that period average spending for postacute care doubled for patients with hip fractures, more than doubled for those with congestive heart failure, and more than tripled for those with heart attacks. We conclude that policies aimed at controlling acute care spending, such as bundled payments for short-term hospital spending and physician services, are likely to be more effective if they include postacute care, as is currently being tested under Medicare’s Bundled Payment for Care Improvement Initiative. PMID:23650319

  2. Crawling Aid

    NASA Technical Reports Server (NTRS)

    1982-01-01

    The Institute for the Achievement of Human Potential developed a device known as the Vehicle for Initial Crawling (VIC); the acronym is a tribute to the crawler's inventor, Hubert "Vic" Vykukal; is an effective crawling aid. The VIC is used by brain injured children who are unable to crawl due to the problems of weight-bearing and friction, caused by gravity. It is a rounded plywood frame large enough to support the child's torso, leaving arms and legs free to move. On its underside are three aluminum discs through which air is pumped to create an air-bearing surface that has less friction than a film of oil. Upper side contains the connection to the air supply and a pair of straps which restrain the child and cause the device to move with him. VIC is used with the intent to recreate the normal neurological connection between brain and muscles. Over repetitive use of the device the child develops his arm and leg muscles as well as coordination. Children are given alternating therapy, with and without the VIC until eventually the device is no longer needed.

  3. Education Funding in Massachusetts: The Effects of Aid Modifications on Vertical and Horizontal Equity

    ERIC Educational Resources Information Center

    Fahy, Colleen

    2011-01-01

    Public school funding in Massachusetts is based on foundation budget principles. However, funding formula modifications often create disparities between district foundation budgets and actual required spending levels. This study provides an in-depth look at Massachusetts' state aid formulas used between 2004 and 2009 and utilizes two approaches to…

  4. Debate Flares Regarding Aid Given to States: Unused Federal Money Is Source of Argument

    ERIC Educational Resources Information Center

    Hoff, David J.

    2004-01-01

    In this article, the author talks about the debate that flared regarding aid given to states. Officials of the Bush administration countered complaints that Republicans are inadequately financing the No Child Left Behind Act. They said the states didn't spend all of the federal K-12 money available to them in a timely manner. State officials…

  5. The uneven patterning of welfare benefits at the twilight of AFDC: assessing the influence of institutions, race, and citizen preferences.

    PubMed

    Kail, Ben Lennox; Dixon, Marc

    2011-01-01

    Scholars have been slow to test welfare state theories on the extensive subnational variation in the United States during the recent period of retrenchment. We assess institutional politics theories, literature on race and social policy, and public opinion arguments relative to levels of support in states' Aid to Families Dependent Children programs from 1982 until its elimination in 1996. Pooled time-series results demonstrate that the determinants of spending during retrenchment are mostly similar to those driving development and expansion. Pro-spending actors and professionalized state institutions limit benefit curtailment, while jurisdictions with larger African- American populations have lower benefits. Additionally, liberal citizens positively impact support and strengthen the effects of state institutions, but this effect is attenuated in states with larger African-American populations.

  6. HIV-AIDS Connection

    MedlinePlus

    ... Marketing Share this: Main Content Area The HIV-AIDS Connection AIDS was first recognized in 1981 and ... is there overwhelming scientific consensus that HIV causes AIDS? Before HIV infection became widespread in the human ...

  7. Heart attack first aid

    MedlinePlus

    First aid - heart attack; First aid - cardiopulmonary arrest; First aid - cardiac arrest ... of patients with unstable angina/non-ST-elevation myocardial infarction (updating the 2007 guideline and replacing the 2011 ...

  8. Splinter, First Aid

    MedlinePlus

    ... and rashes clinical tools newsletter | contact Share | Splinter, First Aid A A A First Aid for Splinter: View ... wet, it makes the area prone to infection. First Aid Guide Self-care measures to remove a splinter ...

  9. Recession contributes to slowest annual rate of increase in health spending in five decades.

    PubMed

    Martin, Anne; Lassman, David; Whittle, Lekha; Catlin, Aaron

    2011-01-01

    In 2009, US health care spending grew 4.0 percent--a historically low rate of annual increase--to $2.5 trillion, or $8,086 per person. Despite the slower growth, the share of the gross domestic product devoted to health spending increased to 17.6 percent in 2009 from 16.6 percent in 2008. The growth rate of health spending continued to outpace the growth of the overall economy, which experienced its largest drop since 1938. The recession contributed to slower growth in private health insurance spending and out-of-pocket spending by consumers, as well as a reduction in capital investments by health care providers. The recession also placed increased burdens on households, businesses, and governments, which meant that fewer financial resources were available to pay for health care. Declining federal revenues and strong growth in federal health spending increased the health spending share of total federal revenue from 37.6 percent in 2008 to 54.2 percent in 2009.

  10. Paying for Default: Change over Time in the Share of Federal Financial Aid Sent to Institutions with High Student Loan Default Rates

    ERIC Educational Resources Information Center

    Jaquette, Ozan; Hillman, Nicholas W.

    2015-01-01

    Both federal spending on financial aid and student loan default rates have increased over the past decade. These trends have intensified policymakers' concerns that some postsecondary institutions-- particularly in the for-profit sector--maximize revenue derived from federal financial aid without helping students to graduate or find employment.…

  11. Ergogenic aids.

    PubMed

    Coyle, E F

    1984-07-01

    The catabolism of bodily fuels provides the energy for muscular work. Work output can be limited by the size of fuel reserves, the rate of their catabolism, the build-up of by-products, or the neurologic activation of muscle. A substance that favorably affects a step that is normally limiting, and thus increases work output, can be considered an ergogenic aid. The maximal amount of muscular force generated during brief contractions can be acutely increased during hypnosis and with the ingestion of a placebo or psychomotor stimulant. This effect is most obvious in subjects under laboratory conditions and is less evident in athletes who are highly motivated prior to competition. Fatigue is associated with acidosis in the working musculature when attempts are made to maximize work output during a 4 to 15-minute period. Sodium bicarbonate ingestion may act to buffer the acid produced, provided that blood flow to the muscle is adequate. Prolonged intense exercise can be maintained for approximately two hours before carbohydrate stores become depleted. Carbohydrate feedings delay fatigue during prolonged exercise, especially in subjects who display a decline in blood glucose during exercise in the fasting state. Caffeine ingestion prior to an endurance bout has been reported to allow an individual to exercise somewhat more intensely than he or she would otherwise. Its effect may be mediated by augmenting fat metabolism or by altering the perception of effort. Amphetamines may act in a similar manner. Water ingestion during prolonged exercise that results in dehydration and hyperthermia can offset fluid losses and allow an individual to better maintain work output while substantially reducing the risk of heat-related injuries. PMID:6100848

  12. Financial aid policy: lessons from research.

    PubMed

    Dynarski, Susan; Scott-Clayton, Judith

    2013-01-01

    In the nearly fifty years since the adoption of the Higher Education Act of 1965, financial aid programs have grown in scale, expanded in scope, and multiplied in form. As a result, financial aid has become the norm among college enrollees. Aid now flows not only to traditional college students but also to part-time students, older students, and students who never graduated from high school. Today aid is available not only to low-income students but also to middle- and even high-income families, in the form of grants, subsidized loans, and tax credits. The increasing size and complexity of the nation's student aid system has generated questions about effectiveness, heightened confusion among students and parents, and raised concerns about how program rules may interact. In this article, Susan Dynarski and Judith Scott-Clayton review what is known, and just as important, what is not known, about how well various student aid programs work. The evidence, the authors write, clearly shows that lowering costs can improve college access and completion. But this general rule is not without exception. First, they note, the complexity of program eligibility and delivery appears to moderate the impact of aid on college enrollment and persistence after enrollment. Second, for students who have already decided to enroll, grants that tie financial aid to academic achievement appear to boost college outcomes such as persistence more than do grants with no strings attached. Third, compared with grant aid, relatively little rigorous research has been conducted on the effectiveness of student loans. The paucity of evidence on student loans is particularly problematic both because they represent a large share of student aid overall and because their low cost (relative to grant aid) makes them an attractive option for policy makers. Future research is likely to focus on several issues: the importance of program design and delivery, whether there are unanticipated interactions between

  13. Financial aid policy: lessons from research.

    PubMed

    Dynarski, Susan; Scott-Clayton, Judith

    2013-01-01

    In the nearly fifty years since the adoption of the Higher Education Act of 1965, financial aid programs have grown in scale, expanded in scope, and multiplied in form. As a result, financial aid has become the norm among college enrollees. Aid now flows not only to traditional college students but also to part-time students, older students, and students who never graduated from high school. Today aid is available not only to low-income students but also to middle- and even high-income families, in the form of grants, subsidized loans, and tax credits. The increasing size and complexity of the nation's student aid system has generated questions about effectiveness, heightened confusion among students and parents, and raised concerns about how program rules may interact. In this article, Susan Dynarski and Judith Scott-Clayton review what is known, and just as important, what is not known, about how well various student aid programs work. The evidence, the authors write, clearly shows that lowering costs can improve college access and completion. But this general rule is not without exception. First, they note, the complexity of program eligibility and delivery appears to moderate the impact of aid on college enrollment and persistence after enrollment. Second, for students who have already decided to enroll, grants that tie financial aid to academic achievement appear to boost college outcomes such as persistence more than do grants with no strings attached. Third, compared with grant aid, relatively little rigorous research has been conducted on the effectiveness of student loans. The paucity of evidence on student loans is particularly problematic both because they represent a large share of student aid overall and because their low cost (relative to grant aid) makes them an attractive option for policy makers. Future research is likely to focus on several issues: the importance of program design and delivery, whether there are unanticipated interactions between

  14. From Roosevelt to Reagan: federal spending for mental retardation and developmental disabilities.

    PubMed

    Braddock, D

    1986-03-01

    Results of an analysis of 50 years of federal government spending for mental retardation and developmental disabilities were summarized. Spending for services and income maintenance grew rapidly from the early 1950s through fiscal year (FY) 1981. Since FY 1981, total federal spending for mental retardation has plateaued. Federal support for research and training has declined steadily since the early 1970s. The lack of support for research and training imperils the achievement of national objectives in prevention of retardation and integration of retarded individuals into community settings.

  15. The global impact of non-communicable diseases on healthcare spending and national income: a systematic review.

    PubMed

    Muka, Taulant; Imo, David; Jaspers, Loes; Colpani, Veronica; Chaker, Layal; van der Lee, Sven J; Mendis, Shanthi; Chowdhury, Rajiv; Bramer, Wichor M; Falla, Abby; Pazoki, Raha; Franco, Oscar H

    2015-04-01

    The impact of non-communicable diseases (NCDs) in populations extends beyond ill-health and mortality with large financial consequences. To systematically review and meta-analyze studies evaluating the impact of NCDs (including coronary heart disease, stroke, type 2 diabetes mellitus, cancer (lung, colon, cervical and breast), chronic obstructive pulmonary disease and chronic kidney disease) at the macro-economic level: healthcare spending and national income. Medical databases (Medline, Embase and Google Scholar) up to November 6th 2014. For further identification of suitable studies, we searched reference lists of included studies and contacted experts in the field. We included randomized controlled trials, systematic reviews, cohorts, case-control, cross-sectional, modeling and ecological studies carried out in adults assessing the economic consequences of NCDs on healthcare spending and national income without language restrictions. All abstracts and full text selection was done by two independent reviewers. Any disagreements were resolved through consensus or consultation of a third reviewer. Data were extracted by two independent reviewers using a pre-designed data collection form. Studies evaluating the impact of at least one of the selected NCDs on at least one of the following outcome measures: healthcare expenditure, national income, hospital spending, gross domestic product (GDP), gross national product, net national income, adjusted national income, total costs, direct costs, indirect costs, inpatient costs, outpatient costs, per capita healthcare spending, aggregate economic outcome, capital loss in production levels in a country, economic growth, GDP per capita (per capita income), percentage change in GDP, intensive growth, extensive growth, employment, direct governmental expenditure and non-governmental expenditure. From 4,364 references, 153 studies met our inclusion criteria. Most of the studies were focused on healthcare related costs of NCDs

  16. World bank in AIDS prevention controversy.

    PubMed

    James, J S

    1995-06-16

    A controversial editorial review article on AIDS prevention by researchers at the Center for AIDS Prevention Studies (CAPS) of the University of California was recently published in the British journal, AIDS. The article's thesis is that in addition to individual behavior, social and economic forces have played a role in promoting the spread of HIV in developing countries, where, by the year 2000, 90 percent of HIV infection will have occurred. The researchers argue that an economic approach, called structural adjustment programs [begun and spearheaded by the International Monetary Fund (IMF) and the World Bank], may have created conditions favoring the spread of HIV infection. The article is concerned about four alleged consequences of these programs: the decline of rural subsistence economy; the development of a transportation infrastructure; migration and urbanization; and reduced spending on health and social services. The CAPS authors recommend changes in development programs which focus on the satisfaction of basic human needs and movement from paternalistic to cooperative development policy. They suggest changing the charter of the World Bank and IMF to allow rescheduling or canceling of debt. World Bank officials, in letters to AIDS, tried to persuade the journal not to publish the article, citing that it falls below the journal's current standards and that some of the information is wrong.

  17. Psychometric Limitations of the Center for Epidemiologic Studies-Depression Scale for Assessing Depressive Symptoms among Adults with HIV/AIDS: A Rasch Analysis

    PubMed Central

    Kottorp, Anders; Lee, Kathryn A.

    2016-01-01

    The Center for Epidemiological Studies-Depression (CES-D) scale is a widely used measure of depressive symptoms, but its psychometric properties have not been adequately evaluated among adults with HIV/AIDS. This study used an item response theory approach (Rasch analysis) to evaluate the CES-D's validity and reliability in relation to key demographic and clinical variables in adults with HIV/AIDS. A convenience sample of 347 adults with HIV/AIDS (231 males, 93 females, and 23 transgenders; age range 22–77 years) completed the CES-D. A Rasch model application was used to analyze the CES-D's rating scale functioning, internal scale validity, person-response validity, person-separation validity, internal consistency, differential item functioning (DIF), and differential test functioning. CES-D scores were generally high and associated with several demographic and clinical variables. The CES-D distinguished 3 distinct levels of depression and had acceptable internal consistency but lacked unidimensionality, five items demonstrated poor fit to the model, 15% of the respondents demonstrated poor fit, and eight items demonstrated DIF related to gender, race, or AIDS diagnosis. Removal of misfitting items resulted in minimal improvement in the CES-D's substantive and structural validity. CES-D scores should be interpreted with caution in adults with HIV/AIDS, particularly when comparing scores across gender and racial groups. PMID:27042347

  18. Psychometric Limitations of the Center for Epidemiologic Studies-Depression Scale for Assessing Depressive Symptoms among Adults with HIV/AIDS: A Rasch Analysis.

    PubMed

    Gay, Caryl L; Kottorp, Anders; Lerdal, Anners; Lee, Kathryn A

    2016-01-01

    The Center for Epidemiological Studies-Depression (CES-D) scale is a widely used measure of depressive symptoms, but its psychometric properties have not been adequately evaluated among adults with HIV/AIDS. This study used an item response theory approach (Rasch analysis) to evaluate the CES-D's validity and reliability in relation to key demographic and clinical variables in adults with HIV/AIDS. A convenience sample of 347 adults with HIV/AIDS (231 males, 93 females, and 23 transgenders; age range 22-77 years) completed the CES-D. A Rasch model application was used to analyze the CES-D's rating scale functioning, internal scale validity, person-response validity, person-separation validity, internal consistency, differential item functioning (DIF), and differential test functioning. CES-D scores were generally high and associated with several demographic and clinical variables. The CES-D distinguished 3 distinct levels of depression and had acceptable internal consistency but lacked unidimensionality, five items demonstrated poor fit to the model, 15% of the respondents demonstrated poor fit, and eight items demonstrated DIF related to gender, race, or AIDS diagnosis. Removal of misfitting items resulted in minimal improvement in the CES-D's substantive and structural validity. CES-D scores should be interpreted with caution in adults with HIV/AIDS, particularly when comparing scores across gender and racial groups.

  19. The Great Recession and Health Spending among Uninsured U.S. Immigrants: Implications for the Affordable Care Act Implementation

    PubMed Central

    Bustamante, Arturo Vargas; Chen, Jie

    2014-01-01

    Objective We study the association between the timing of the Great Recession (GR) and health spending among uninsured adults distinguishing by citizenship/nativity status and time of U.S. residence. Data Source Uninsured U.S. citizens and noncitizens from the 2005–2006 and 2008–2009 Medical Expenditure Panel Survey. Study Design The probability of reporting any health spending and the natural logarithm of health spending are our main dependent variables. We compare health spending across population categories before/during the GR. Subsequently, we implement two-part regression analyses of total and specific health-spending measures. We predict average health spending before/during the GR with a smearing estimation. Principal Findings The probability of reporting any spending diminished for recent immigrants compared to citizens during the GR. For those with any spending, recent immigrants reported higher spending during the GR (27 percent). Average reductions in total spending were driven by the decline in the share of the population reporting any spending among citizens and noncitizens. Conclusions Our study findings suggest that recent immigrants could be forgoing essential care, which later translates into higher spending. It portrays the vulnerability of a population that would remain exposed to income shocks, even after the Affordable Care Act (ACA) implementation. PMID:24962550

  20. Number Of Medicaid Prescriptions Grew, Drug Spending Was Steady In Medicaid Expansion States.

    PubMed

    Wen, Hefei; Borders, Tyrone F; Druss, Benjamin G

    2016-09-01

    Expansions of eligibility for Medicaid under the Affordable Care Act may have increased the number of Medicaid drug prescriptions. However, the expansions did not drive Medicaid spending on prescription drugs overall in 2014. PMID:27605639

  1. The Relationship between Commercial Health Care Prices and Medicare Spending and Utilization

    PubMed Central

    Romley, John A; Axeen, Sarah; Lakdawalla, Darius N; Chernew, Michael E; Bhattacharya, Jay; Goldman, Dana P

    2015-01-01

    Objective To explore the relationship between commercial health care prices and Medicare spending/utilization across U.S. regions. Data Sources Claims from large employers and Medicare Parts A/B/D over 2007–2009. Study Design We compared prices paid by commercial health plans to Medicare spending and utilization, adjusted for beneficiary health and the cost of care, across 301 hospital referral regions. Principal Findings A 10 percent lower commercial price (around the average level) is associated with 3.0 percent higher Medicare spending per member per year, and 4.3 percent more specialist visits (p < .01). Conclusions Commercial health care prices are negatively associated with Medicare spending across regions. Providers may respond to low commercial prices by shifting service volume into Medicare. Further investigation is needed to establish causality. PMID:25429755

  2. Microeconomics. Harnessing naturally occurring data to measure the response of spending to income.

    PubMed

    Gelman, Michael; Kariv, Shachar; Shapiro, Matthew D; Silverman, Dan; Tadelis, Steven

    2014-07-11

    This paper presents a new data infrastructure for measuring economic activity. The infrastructure records transactions and account balances, yielding measurements with scope and accuracy that have little precedent in economics. The data are drawn from a diverse population that overrepresents males and younger adults but contains large numbers of underrepresented groups. The data infrastructure permits evaluation of a benchmark theory in economics that predicts that individuals should use a combination of cash management, saving, and borrowing to make the timing of income irrelevant for the timing of spending. As in previous studies and in contrast to the predictions of the theory, there is a response of spending to the arrival of anticipated income. The data also show, however, that this apparent excess sensitivity of spending results largely from the coincident timing of regular income and regular spending. The remaining excess sensitivity is concentrated among individuals with less liquidity. PMID:25013075

  3. The Effects of Arkansas Master Settlement Spending on Disparities in Smoking

    PubMed Central

    Scharf, Deborah; Engberg, John; Schultz, Dana

    2012-01-01

    Objectives. We assessed the effect of Master Settlement Agreement (MSA) spending on smoking disparities in Arkansas, which distinguished itself from other states by investing all of its MSA funds in health-related programs. Methods. In 1996–2009 data from the Behavioral Risk Factor Surveillance System, we specified multivariate logistic models to examine gender and racial/ethnic disparities in smoking rates within Arkansas (a pre–post analysis) and between Arkansas and its 6 neighboring states. Results. Before the MSA programs started in 2001, male Arkansans smoked more than did female Arkansans (P < .05). After the programs, smoking declined significantly among men (but not women), eliminating the gender disparity by 2009. Smoking among men in Arkansas also declined more than it did in neighboring states (P < .05). Hispanics showed a greater decline in smoking than did non-Hispanic Whites in Arkansas (but not in neighboring states). In 2001, Hispanic Arkansans smoked more than did non-Hispanic Whites (P < .05); by 2009, Hispanic Arkansans smoked significantly less than did non-Hispanic Whites (P < .05). Conclusions. MSA-funded programs were more effective in some segments of the Arkansas population than in others. Policymakers should consider targeting future MSA tobacco control programs to populations most resistant to change. PMID:22095362

  4. Changes in Health Care Spending and Quality 4 Years into Global Payment

    PubMed Central

    Song, Zirui; Rose, Sherri; Safran, Dana G.; Landon, Bruce E.; Day, Matthew P.; Chernew, Michael E.

    2014-01-01

    BACKGROUND Spending and quality under global budgets remain unknown beyond 2 years. We evaluated spending and quality measures during the first 4 years of the Blue Cross Blue Shield of Massachusetts Alternative Quality Contract (AQC). METHODS We compared spending and quality among enrollees whose physician organizations entered the AQC from 2009 through 2012 with those among persons in control states. We studied spending changes according to year, category of service, site of care, experience managing risk contracts, and price versus utilization. We evaluated process and outcome quality. RESULTS In the 2009 AQC cohort, medical spending on claims grew an average of $62.21 per enrollee per quarter less than it did in the control cohort over the 4-year period (P<0.001). This amount is equivalent to a 6.8% savings when calculated as a proportion of the average post-AQC spending level in the 2009 AQC cohort. Analogously, the 2010, 2011, and 2012 cohorts had average savings of 8.8% (P<0.001), 9.1% (P<0.001), and 5.8% (P = 0.04), respectively, by the end of 2012. Claims savings were concentrated in the outpatient-facility setting and in procedures, imaging, and tests, explained by both reduced prices and reduced utilization. Claims savings were exceeded by incentive payments to providers during the period from 2009 through 2011 but exceeded incentive payments in 2012, generating net savings. Improvements in quality among AQC cohorts generally exceeded those seen elsewhere in New England and nationally. CONCLUSIONS As compared with similar populations in other states, Massachusetts AQC enrollees had lower spending growth and generally greater quality improvements after 4 years. Although other factors in Massachusetts may have contributed, particularly in the later part of the study period, global budget contracts with quality incentives may encourage changes in practice patterns that help reduce spending and improve quality. (Funded by the Commonwealth Fund and others

  5. Learning to aid learning.

    PubMed

    Richards, Jacqui

    2016-01-01

    The National Health Service (NHS) is one of the largest employers in the world and, with 1.3 million staff, the biggest employer in Europe. With over three hundred different careers on offer (NHS 2015), the acquisition of skills and qualifications, through academic and clinical training, is an integral part of day-to-day life in the health service. As such, mentoring has become a significant feature in the preparation of healthcare professionals, to support students and ensure learning needs and experiences are appropriate to competency. This article examines the mentor's role, in relation to a teaching innovation designed to address students' identified learning needs to meet the requirements of the multi-professional learning and assessment in practice course NM6156. The effectiveness of the aids to learning will be assessed through an online quiz, and its usefulness will be analysed with reference to educational theories of learning and development.

  6. Learning to aid learning.

    PubMed

    Richards, Jacqui

    2016-01-01

    The National Health Service (NHS) is one of the largest employers in the world and, with 1.3 million staff, the biggest employer in Europe. With over three hundred different careers on offer (NHS 2015), the acquisition of skills and qualifications, through academic and clinical training, is an integral part of day-to-day life in the health service. As such, mentoring has become a significant feature in the preparation of healthcare professionals, to support students and ensure learning needs and experiences are appropriate to competency. This article examines the mentor's role, in relation to a teaching innovation designed to address students' identified learning needs to meet the requirements of the multi-professional learning and assessment in practice course NM6156. The effectiveness of the aids to learning will be assessed through an online quiz, and its usefulness will be analysed with reference to educational theories of learning and development. PMID:26975128

  7. More Freedom to Spend Less Money: What Happened when California School Districts Gained Spending Flexibility and Budgets Were Cut. Research Brief

    ERIC Educational Resources Information Center

    Li, Jennifer

    2012-01-01

    In 2009-2010, California made substantial education budget cuts at the same time that it removed its spending requirements from $4.5 billion of state money. This gave districts the flexibility to use the funds in any manner approved by the local school board. Researchers found that most of the formerly earmarked money was moved into general funds…

  8. New Paradigms for Computer Aids to Invention.

    ERIC Educational Resources Information Center

    Langston, M. Diane

    Many people are interested in computer aids to rhetorical invention and want to know how to evaluate an invention aid, what the criteria are for a good one, and how to assess the trade-offs involved in buying one product or another. The frame of reference for this evaluation is an "old paradigm," which treats the computer as if it were paper, but…

  9. The Master Hearing Aid

    PubMed Central

    Curran, James R.

    2013-01-01

    As early as the 1930s the term Master Hearing Aid (MHA) described a device used in the fitting of hearing aids. In their original form, the MHA was a desktop system that allowed for simulated or actual adjustment of hearing aid components that resulted in a changed hearing aid response. Over the years the MHA saw many embodiments and contributed to a number of rationales for the fitting of hearing aids. During these same years, the MHA was viewed by many as an inappropriate means of demonstrating hearing aids; the audio quality of the desktop systems was often superior to the hearing aids themselves. These opinions and the evolution of the MHA have molded the modern perception of hearing aids and the techniques used in the fitting of hearing aids. This article reports on a history of the MHA and its influence on the fitting of hearing aids. PMID:23686682

  10. Identification Of Four Unique Spending Patterns Among Older Adults In The Last Year Of Life Challenges Standard Assumptions.

    PubMed

    Davis, Matthew Allen; Nallamothu, Brahmajee K; Banerjee, Mousumi; Bynum, Julie P W

    2016-07-01

    The assumption that health care spending skyrockets at the end of life might suggest that policy makers should target the last few months of life to control costs. However, spending patterns leading up to death have not been fully examined. We applied a new methodology to administrative claims data for older Medicare beneficiaries who died in 2012 to characterize trajectories of health care spending in the last year of life. After adjustment, we identified four unique spending trajectories among decedents: 48.7 percent had high persistent spending, 29.0 percent had moderate persistent spending, 10.2 percent had progressive spending, and 12.1 percent had late rise spending. High spending throughout the full year before death (approximately half of all decedents) was associated with having multiple chronic conditions but not any specific diseases. These findings suggest that spending at the end of life is a marker of general spending patterns often set in motion long before death. PMID:27307350

  11. Acute hospital care is the chief driver of regional spending variation in Medicare patients with advanced cancer.

    PubMed

    Brooks, Gabriel A; Li, Ling; Uno, Hajime; Hassett, Michael J; Landon, Bruce E; Schrag, Deborah

    2014-10-01

    The root causes of regional variation in medical spending are poorly understood and vary by clinical condition. To identify drivers of regional spending variation for Medicare patients with advanced cancer, we used linked Surveillance, Epidemiology, and End Results program (SEER)-Medicare data from the period 2004-10. We broke down Medicare spending into thirteen cancer-relevant service categories. We then calculated the contribution of each category to spending and regional spending variation. Acute hospital care was the largest component of spending and the chief driver of regional spending variation, accounting for 48 percent of spending and 67 percent of variation. In contrast, chemotherapy accounted for 16 percent of spending and 10 percent of variation. Hospice care constituted 5 percent of spending. However, variation in hospice spending was fully offset by opposing variation in other categories. Our analysis suggests that the strategy with the greatest potential to improve the value of care for patients with advanced cancer is to reduce reliance on acute hospital care for this patient population.

  12. Identification Of Four Unique Spending Patterns Among Older Adults In The Last Year Of Life Challenges Standard Assumptions.

    PubMed

    Davis, Matthew Allen; Nallamothu, Brahmajee K; Banerjee, Mousumi; Bynum, Julie P W

    2016-07-01

    The assumption that health care spending skyrockets at the end of life might suggest that policy makers should target the last few months of life to control costs. However, spending patterns leading up to death have not been fully examined. We applied a new methodology to administrative claims data for older Medicare beneficiaries who died in 2012 to characterize trajectories of health care spending in the last year of life. After adjustment, we identified four unique spending trajectories among decedents: 48.7 percent had high persistent spending, 29.0 percent had moderate persistent spending, 10.2 percent had progressive spending, and 12.1 percent had late rise spending. High spending throughout the full year before death (approximately half of all decedents) was associated with having multiple chronic conditions but not any specific diseases. These findings suggest that spending at the end of life is a marker of general spending patterns often set in motion long before death.

  13. Cognitive representations of AIDS: a phenomenological study.

    PubMed

    Anderson, Elizabeth H; Spencer, Margaret Hull

    2002-12-01

    Cognitive representations of illness determine behavior. How persons living with AIDS image their disease might be key to understanding medication adherence and other health behaviors. The authors' purpose was to describe AIDS patients' cognitive representations of their illness. A purposive sample of 58 men and women with AIDS were interviewed. Using Colaizzi's (1978) phenomenological method, rigor was established through application of verification, validation, and validity. From 175 significant statements, 11 themes emerged. Cognitive representations included imaging AIDS as death, bodily destruction, and just a disease. Coping focused on wiping AIDS out of the mind, hoping for the right drug, and caring for oneself. Inquiring about a patient's image of AIDS might help nurses assess coping processes and enhance nurse-patient relationships.

  14. The Impact of Spending Cuts on Missouri Student Achievement

    ERIC Educational Resources Information Center

    Kohl, Andrew Ray

    2013-01-01

    Since the Coleman Report in 1966, researchers have been analyzing educational resource inputs with respect to district, school, and student level outputs. There has been an increase in federal and state control of local school districts, as demonstrated in the adoption of the Common Core Standards and mandatory national and state assessments. In…

  15. Spending, Size, and Grade Span in K-8 Schools

    ERIC Educational Resources Information Center

    Rubenstein, Ross; Schwartz, Amy Ellen; Stiefel, Leanna; Zabel, Jeffrey

    2009-01-01

    Reorganizing primary school grade spans is a tractable and relatively inexpensive school reform. However, assessing the effects of reorganization requires also examining other organizational changes that may accompany grade span reforms. Using data on New York City public schools from 1996 to 2002 and exploiting within-school variations, we…

  16. Two-Year Impact of the Alternative Quality Contract on Pediatric Health Care Quality and Spending

    PubMed Central

    Song, Zirui; Chernew, Michael E.; Landon, Bruce E.; McNeil, Barbara J.; Safran, Dana G.; Schuster, Mark A.

    2014-01-01

    OBJECTIVE: To examine the 2-year effect of Blue Cross Blue Shield of Massachusetts’ global budget arrangement, the Alternative Quality Contract (AQC), on pediatric quality and spending for children with special health care needs (CSHCN) and non-CSHCN. METHODS: Using a difference-in-differences approach, we compared quality and spending trends for 126 975 unique 0- to 21-year-olds receiving care from AQC groups with 415 331 propensity-matched patients receiving care from non-AQC groups; 23% of enrollees were CSHCN. We compared quality and spending pre (2006–2008) and post (2009–2010) AQC implementation, adjusting analyses for age, gender, health risk score, and secular trends. Pediatric outcome measures included 4 preventive and 2 acute care measures tied to pay-for-performance (P4P), 3 asthma and 2 attention-deficit/hyperactivity disorder quality measures not tied to P4P, and average total annual medical spending. RESULTS: During the first 2 years of the AQC, pediatric care quality tied to P4P increased by +1.8% for CSHCN (P < .001) and +1.2% for non-CSHCN (P < .001) for AQC versus non-AQC groups; quality measures not tied to P4P showed no significant changes. Average total annual medical spending was ∼5 times greater for CSHCN than non-CSHCN; there was no significant impact of the AQC on spending trends for children. CONCLUSIONS: During the first 2 years of the contract, the AQC had a small but significant positive effect on pediatric preventive care quality tied to P4P; this effect was greater for CSHCN than non-CSHCN. However, it did not significantly influence (positively or negatively) CSHCN measures not tied to P4P or affect per capita spending for either group. PMID:24366988

  17. HIV/AIDS and professional freedom of expression in Japan.

    PubMed

    Matsuda, Masami

    2002-07-01

    A senior physician with a government role in Japan made a widely reported and misleading statement about Thailand's policy on HIV/AIDS patients. He claimed that in Thailand the policy is to spend public money on the prevention of HIV infection while allowing AIDS patients to die untreated. The author, a community nursing specialist in Japan with first-hand knowledge of HIV/AIDS policy in Thailand, thought that this statement would influence attitudes negatively in Japan. However, speaking out about this misrepresentation of the facts carried certain risks. Although freedom of expression is valued in Japan, in practice it is not easy to contradict senior medical professionals. The author uses his experience of this difficult professional situation to teach nurses how to approach speaking out in the public interest.

  18. Development of Bone-Conducted Ultrasonic Hearing Aid for the Profoundly Deaf: Assessments of the Modulation Type with Regard to Intelligibility and Sound Quality

    NASA Astrophysics Data System (ADS)

    Nakagawa, Seiji; Fujiyuki, Chika; Kagomiya, Takayuki

    2012-07-01

    Bone-conducted ultrasound (BCU) is perceived even by the profoundly sensorineural deaf. A novel hearing aid using the perception of amplitude-modulated BCU (BCU hearing aid: BCUHA) has been developed; however, further improvements are needed, especially in terms of articulation and sound quality. In this study, the intelligibility and sound quality of BCU speech with several types of amplitude modulation [double-sideband with transmitted carrier (DSB-TC), double-sideband with suppressed carrier (DSB-SC), and transposed modulation] were evaluated. The results showed that DSB-TC and transposed speech were more intelligible than DSB-SC speech, and transposed speech was closer than the other types of BCU speech to air-conducted speech in terms of sound quality. These results provide useful information for further development of the BCUHA.

  19. Clinical Criteria for Physician Aid in Dying.

    PubMed

    Orentlicher, David; Pope, Thaddeus Mason; Rich, Ben A

    2016-03-01

    More than 20 years ago, even before voters in Oregon had enacted the first aid in dying (AID) statute in the United States, Timothy Quill and colleagues proposed clinical criteria AID. Their proposal was carefully considered and temperate, but there were little data on the practice of AID at the time. (With AID, a physician writes a prescription for life-ending medication for a terminally ill, mentally capacitated adult.) With the passage of time, a substantial body of data on AID has developed from the states of Oregon and Washington. For more than 17 years, physicians in Oregon have been authorized to provide a prescription for AID. Accordingly, we have updated the clinical criteria of Quill, et al., based on the many years of experience with AID. With more jurisdictions authorizing AID, it is critical that physicians can turn to reliable clinical criteria. As with any medical practice, AID must be provided in a safe and effective manner. Physicians need to know (1) how to respond to a patient's inquiry about AID, (2) how to assess patient decision making capacity, and (3) how to address a range of other issues that may arise. To ensure that physicians have the guidance they need, Compassion & Choices convened the Physician Aid-in-Dying Clinical Criteria Committee, in July 2012, to create clinical criteria for physicians who are willing to provide AID to patients who request it. The committee includes experts in medicine, law, bioethics, hospice, nursing, social work, and pharmacy. Using an iterative consensus process, the Committee drafted the criteria over a one-year period.

  20. Answering the AIDS denialists: is AIDS real?

    PubMed

    Mirken, B

    2000-12-01

    This article looks at theories that say AIDS does not exist, or is not a new disease but only a collection of old ones--and explains some of the history behind earlier changes in the official definition of AIDS in the U.S., changes which caused some public confusion. PMID:12171004