Science.gov

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. 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

  3. Smarter Spending: Reforming Federal Financial Aid for Higher Education

    ERIC Educational Resources Information Center

    Gillen, Andrew

    2011-01-01

    In higher education, three generally recognized rationales for federal involvement in financial aid exist: (1) Promoting equality of opportunity: Those from poor households are less likely to attend college for a variety of reasons; (2) Credit market imperfections: Students may not have access to the credit needed to make profitable investments in…

  4. 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

  5. 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

  6. 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…

  7. 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. PMID:25751320

  8. 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…

  9. 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. PMID:22635188

  10. 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…

  11. Physical assessment of people with AIDS.

    PubMed

    Kermode, M

    1990-01-01

    Since the Declaration of Alma-Ata in 1978, primary health care (PHC) has been acknowledged as the most effective means of achieving "health for all". Promotion of the PHC model provides nurses with an excellent opportunity for professional growth and development. The PHC role of nurse practitioner is gradually emerging within the Australian health care system and if nurses are to fulfil this role adequately they need to equip themselves with additional skills. The art of performing competent physical assessment of clients is one such skill. As the concept of the AIDS nurse practitioner is being developed locally and overseas, this paper focuses on the physical assessment of people with AIDS. While the constellation of physical signs and symptoms they experience are all too familiar to those who work in the area, they are often unusual for those who do not. PMID:2242257

  12. Smart Spending

    ERIC Educational Resources Information Center

    Kennedy, Mike

    2006-01-01

    School administrators have always labored to find ways to squeeze more value out of their limited budgets. However, in recent years, more educators and administrators have been looking at their spending decisions from a long-term perspective. Planning education facilities for the long term has led many schools and universities to adopt different…

  13. 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.

  14. What Are Institutions Spending on Assessment? Is It Worth the Cost? Occasional Paper #18

    ERIC Educational Resources Information Center

    Cooper, Tammi; Terrell, Trent

    2013-01-01

    Assessment activities have proliferated over the last decade at institutions of higher education. While assessment is useful for institutional improvement, this proliferation has in part been due to greater pressures from regional accreditors on institutions to meet assessment requirements. These higher expectations have led to new expenditures on…

  15. 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.

  16. 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

  17. 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…

  18. 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…

  19. 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)

  20. 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.

  1. "We talk of AIDS because we love life": a stakeholder assessment of HIV/AIDS organizations in Buenos Aires, Argentina.

    PubMed

    Spaulding, Alicen B; Brieger, William R

    This stakeholder assessment of HIV/AIDS service providing institutions in Argentina offers insights into the HIV/AIDS crisis in Spanish-speaking Latin America from an institutional level and makes recommendations for strengthening the work and functioning of these institutions. This stakeholder assessment was conducted to determine how HIV/AIDS prevention and management in Argentina affects and is affected by relevant HIV/AIDS institutions. Semi-structured qualitative interviews were conducted with 13 key leaders of organizations working in HIV/AIDS prevention in Buenos Aires including non-governmental, governmental, and academic institutions. Analyses of interviewee comments are presented according to four major themes: network connections, program resources, perceptions of success, and challenges. Key findings include the need for strengthening formal networks, increasing the involvement of other non-AIDS related social institutions in promoting HIV prevention, finding more sustainable funding options, working more effectively with the public sector to create policies and regulations favorable to the HIV/AIDS field, and addressing the lack of perceived susceptibility to HIV/AIDS in Argentine culture. From leaders' comments, recommendations are made for strengthening the HIV/AIDS network among key institutions including adapting the UNAIDS "Three Ones" principal to create one crosssector office responsible for coordinating HIV/AIDS work, formalizing agreements with institutions outside of Buenos Aires, increasing the role of schools in HIV/AIDS awareness, and designing programs that address lack of perceived susceptibility to HIV/AIDS among Argentines. PMID:18573753

  2. Computer-aided assessment of cardiac computed tomographic images

    NASA Astrophysics Data System (ADS)

    King, Martin; Giger, Maryellen; Suzuki, Kenji; Pan, Xiaochuan

    2007-03-01

    The accurate interpretation of cardiac CT images is commonly hindered by the presence of motion artifacts. Since motion artifacts commonly can obscure the presence of coronary lesions, physicians must spend much effort analyzing images at multiple cardiac phases in order to determine which coronary structures are assessable for potential lesions. In this study, an artificial neural network (ANN) classifier was designed to assign assessability indices to calcified plaques in individual region-of-interest (ROI) images reconstructed at multiple cardiac phases from two cardiac scans obtained at heart rates of 66 bpm and 90 bpm. Six individual features (volume, circularity, mean intensity, margin gradient, velocity, and acceleration) were used for analyzing images. Visually-assigned assessability indices were used as a continuous truth, and jack-knife analysis with four testing sets was used to evaluate the performance of the ANN classifier. In a study in which all six features were inputted into the ANN classifier, correlation coefficients of 0.962 +/- 0.006 and 0.935 +/- 0.023 between true and ANN-assigned assessability indices were obtained for databases corresponding to 66 bpm and 90 bpm, respectively.

  3. 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

  4. 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

  5. Babies' portal website hearing aid section: assessment by audiologists.

    PubMed

    Bastos, Bárbara Guimarães; Ferrari, Deborah Viviane

    2014-10-01

    Introduction The family has ultimate responsibility for decisions about the use and care during the daily routine and problem solving in the manipulation of hearing aids (HA) in infants and children. Objective The purpose of the study was to assess technical and content quality of Babies' Portal website Hearing Aid section by audiologists. Methods Letters and e-mails were sent inviting professionals to surf the website and anonymously fill out an online form with 58 questions covering demographic data as well as the website's technical (Emory questionnaire with the subscales of accuracy, authorship, updates, public, navigation, links, and structure) and content quality. Results A total of 109 professionals (tree men and 106 women) with mean age of 31.6 years participated in the study. Emory percentage scores ranged from 90.1 to 96.7%. The Hearing Aid section contents were considered good or very good. Conclusion The website was deemed to have good technical and content quality, being suitable to supplement informational counseling to parents of hearing-impaired children fitted with hearing aids. PMID:25992119

  6. 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

  7. 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.

  8. 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…

  9. 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

  10. Cognitive Aids in Medicine Assessment Tool (CMAT): preliminary validation of a novel tool for the assessment of emergency cognitive aids.

    PubMed

    Evans, D; McCahon, R; Barley, M; Norris, A; Khajuria, A; Moppett, I

    2015-08-01

    Applying human factors principles to the design of clinical emergency guidelines is important. The UK Civil Aviation Authority uses a Checklist Assessment Tool for evaluating the content and usability of emergency drills before introduction into service on aircraft. We hypothesised that this model could be used to develop a generic medical tool. A three-stage modified Delphi process was used to adapt the above tool for use in designing medical emergency guidelines. The resulting Cognitive aids in Medicine Assessment Tool was then used to score and rank seven published difficult airway guidelines; the scores were used to assess its validity and reliability. Pearson's rank coefficient between these scores and scores from independent assessors was 0.89 (p = 0.007). Internal consistency, as assessed by Cronbach's alpha, was 0.74, 0.96 and 0.72 for the tool's three constituent domains of physical characteristics, content and layout/format, respectively. Inter-rater reliability, as assessed by Cohen's kappa, ranged from 0.33 to 0.72. The adoption of our tool has the potential to improve the usability of medical emergency guidelines. PMID:25758401

  11. 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…

  12. 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…

  13. 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…

  14. 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…

  15. 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 ...

  16. 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…

  17. 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…

  18. 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

  19. 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,…

  20. 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…

  1. 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)

  2. 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…

  3. [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

  4. 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…

  5. Income Elasticity of Vaccines Spending versus General Healthcare Spending.

    PubMed

    Alfonso, Y Natalia; Ding, Guiru; Bishai, David

    2016-07-01

    Using cross-country data on gross domestic product and national expenditure on vaccines, we estimate and compare the income elasticity of vaccine expenditure and general curative healthcare expenditure. This study provides the first evidence on the national income elasticity of vaccination spending. Both fixed and random effects models are applied to data from 84 countries from 2010 to 2011. The income elasticities for healthcare expenditure and vaccine expenditure are 0.844 and 0.336, respectively. Despite vaccines' high cost-effectiveness, the national propensity to spend income on vaccines as income increases lags behind general health care. The low income elasticity of vaccine spending means that relying on economic growth alone will provide an unacceptably slow trajectory to achieving high vaccine coverage levels. Copyright © 2015 John Wiley & Sons, Ltd. PMID:26010073

  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. Levels of Spending and Resource Allocation to HIV Programs and Services in Latin America and the Caribbean

    PubMed Central

    Arán-Matero, Daniel; Amico, Peter; Arán-Fernandez, Christian; Gobet, Benjamin; Izazola-Licea, José Antonio; Avila-Figueroa, Carlos

    2011-01-01

    Background An estimated 1.86 million people are living with HIV in Latin America and the Caribbean (LAC). The region is comprised of mainly middle-income countries with steady economic growth while simultaneously there are enormous social inequalities and several concentrated AIDS epidemics. This paper describes HIV spending patterns in LAC countries including analysis of the levels and patterns of domestic HIV spending from both public and international sources. Methods and Findings We conducted an extensive analysis of the most recently available data from LAC countries using the National AIDS Spending Assessment tool. The LAC countries spent a total of US$ 1.59 billion on HIV programs and services during the latest reported year. Countries providing detailed information on spending showed that high percentages are allocated to treatment and care (75.1%) and prevention (15.0%). Domestic sources accounted for 93.6 percent of overall spending and 79 percent of domestic funds were directed to treatment and care. International funds represented 5.4 percent of total HIV funding in the region, but they supplied the majority of the effort to reach most-at-risk-populations (MARPs). However, prevalence rates among men who have sex with men (MSM) still reached over 25 percent in some countries. Conclusions Although countries in the region have increasingly sustained their response from domestic sources, still there are future challenges: 1) The growing number of new HIV infections and more people-living-with-HIV (PLWH) eligible to receive antiretroviral treatment (ART); 2) Increasing ART coverage along with high prices of antiretroviral drugs; and 3) The funding for prevention activities among MARPs rely almost exclusively on external donors. These threats call for strengthened actions by civil society and governments to protect and advance gains against HIV in LAC. PMID:21799839

  8. 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

  9. 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…

  10. Exposing variation to aid climate change risk assessment

    NASA Astrophysics Data System (ADS)

    Smith, M. J.; Purves, D. W.; Joppa, L. N.; Emmott, S.; Lyutsarev, V.; Bishop, C. M.; Palmer, P. I.; Calderhead, B.; Vanderwel, M. C.

    2015-12-01

    Considerable efforts to quantify different sources of variation in climate change projections (some might say uncertainty) have led to a welcome set of additional information on which to base confidence about what and how different futures might unfold and how different types of mediating efforts might affect the future. Quantifying the impacts of these different sources of variation on key climate change projection metrics should be used in part to guide future model development efforts. I will report on several of my team's recent research projects to better quantify and assess the importance of different sources of variation. I will show how we use inference techniques to estimate parameter uncertainty in land and marine carbon components of earth system models by comparing them with observational evidence and show how we propagate such uncertainty to better assess how such systems might respond to climate change and quantify the impact of reducing uncertainty for different applications. I will also show how we use such techniques on simulation models themselves to identify key sources of variation in their predictions: helping to pinpoint important focal areas for model improvement. Lastly, I will show a new software prototype being designed to enable any user to view climate model projections alongside historical and recent observational evidence while, importantly, also exposing some of the variation / uncertainty in the reported information.

  11. 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

  12. 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…

  13. 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…

  14. 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…

  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. Assessing College Students' Attitudes, Knowledge and Behavior Towards HIV/AIDS.

    ERIC Educational Resources Information Center

    Smith, Cheri; And Others

    The purpose of this ongoing study was to assess attitudes, knowledge and behaviors in college students toward Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS). The researchers wanted to asses students' knowledge, attitudes, and behavior for utilization in educational and skill building programs for college students.…

  17. 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…

  18. Modeling of aerosol transport as an aid to corrosivity assessment

    SciTech Connect

    Klassen, R.D.; Roberge, P.R.; Tullmin, M.A.

    1999-07-01

    In certain regimes of atmospheric corrosion, the corrosion rate is limited not by electrochemical reactions but by the rate of mass transfer of pollutants. In these cases, a mass transfer model that accounts for the transport of pollutants, such as a marine salt aerosol, provides a theoretical and predictive framework for assessing corrosivity severity. Such a model of the transport of a marine aerosol fairly near the ground and well within the planetary boundary layer was developed. The predicted aerosol concentration as a function of distance for 1500 m from a steady source was consistent with published data on steel corrosion and salinity rates near an ocean. Implications from the model regarding objects that are exposed to aerosol-containing wind include: (1) increasing wind speed increases the aerosol deposition rate and therefore the corrosion rate, (2) objects that are in the lee of prevailing winds from an aerosol source will corrode faster than objects on the windward side of an aerosol source, and (3) smaller objects can be expected to corrode faster because of a greater capture efficiency of salt aerosols.

  19. Public spending and NHS finance.

    PubMed

    Jones, T

    1992-10-01

    Reliability, the Chancellor's Autumn Statement on the country's economic prospects, and the Government's public spending plans seldom go hand in hand. Last year's statement, however, offers an insight into this year's discussions and negotiations and their effect on NHS resources. Tom Jones sets the scene. PMID:10122088

  20. 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…

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

    PubMed

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

    2010-09-01

    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 questionnaire about spending in a number of categories, including cigarettes, other addictive substances, durable goods, and disposable goods. Our preliminary results indicate that participation in a CM based program for smoking cessation did not lead to greater spending on cigarettes and other substances and may have produced more socially acceptable spending. PMID:20802850

  2. 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.

  3. 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. PMID:22678656

  4. Using a signal cancellation technique involving impulse response to assess directivity of hearing aids.

    PubMed

    Wu, Yu-Hsiang; Bentler, Ruth A

    2009-12-01

    The directional microphone systems of modern digital hearing aids are capable of changing their spatial directivity pattern and/or the microphone mode in response to changes in the properties of environmental sounds. These adaptive/automatic features make measurement of a hearing aid's directivity in a given test environment very difficult. Assessing the directivity of such systems requires a signal that can record the system's response while not changing the system's directivity. This paper proposes a method using a signal cancellation technique involving impulse responses to acoustically assess a hearing aid's directivity (referred to as the IR method). The impulse is presumed to be undetectable to the adaptive/automatic system because it contains little energy and a short response could be recorded before the system actually reacts. In the current study, the IR method was evaluated by testing five adaptive/automatic directional hearing aids in noise of various intensities. The results revealed that the IR method was an accurate and repeatable way to assess slow-acting directional systems in noise of varying intensities and fast-acting systems in noise of high intensities. PMID:20000935

  5. 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

  6. In Support of Student Aid.

    ERIC Educational Resources Information Center

    Devitt, James

    1995-01-01

    Concerns about cuts in federal student loan and grant programs are outlined, and ways in which institutions can act to influence policy are examined. Basic facts about potential cuts, their effects, federal spending on student aid, aid recipients, public opinion, and aid policy's effects on tuition are discussed. (MSE)

  7. Economic and demographic consequences of AIDS in Namibia: rapid assessment of the costs.

    PubMed

    Ojo, K; Delaney, M

    1997-01-01

    Recent announcements by the Government of Namibia to provide financial support to people living with AIDS (and their family members) have received considerable media attention. However, given the fact that government budgets are already stretched, and the need for resources to devote the prevention efforts remains, there is an urgent need to assign some values to the support the government is considering within the context of an explosive epidemic. It is against this background that this study attempts to provide a rapid assessment of the economic costs of HIV/AIDS in Namibia over the next 5 years of the First National Development Plan. The estimates include the direct and indirect costs. The direct costs are costs to the economy for inpatient and outpatient medical services, as well as the costs of support payments to people living with AIDS, their families and children orphaned by AIDS. Government and donor expenditure on national prevention and control efforts are also included. The study concludes that no sector of the Namibian economy will escape the impact of AIDS. The epidemic will definitely tax hospital, public health, private and community resources, and these substantial burdens underscore the need for coordinated long-term planning. PMID:10177418

  8. 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…

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

    PubMed Central

    Mattison, D R; Jelovsek, F R

    1987-01-01

    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. PMID:3447888

  10. 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.

  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. PMID:27568149

  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. 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.

  15. Spending money on others promotes happiness.

    PubMed

    Dunn, Elizabeth W; Aknin, Lara B; Norton, Michael I

    2008-03-21

    Although much research has examined the effect of income on happiness, we suggest that how people spend their money may be at least as important as how much money they earn. Specifically, we hypothesized that spending money on other people may have a more positive impact on happiness than spending money on oneself. Providing converging evidence for this hypothesis, we found that spending more of one's income on others predicted greater happiness both cross-sectionally (in a nationally representative survey study) and longitudinally (in a field study of windfall spending). Finally, participants who were randomly assigned to spend money on others experienced greater happiness than those assigned to spend money on themselves. PMID:18356530

  16. Bone-conduction hearing aids in an elderly population: complications and quality of life assessment.

    PubMed

    Carr, Simon D; Moraleda, Javier; Baldwin, Alice; Ray, Jaydip

    2016-03-01

    To determine whether an elderly population with hearing impairment can be adequately rehabilitated with a bone-conduction hearing aid and whether the putative relationship between the elderly and an increased complication rate is justified. The study design was a retrospective case note review with a postal and telephone questionnaire, which was carried out in a tertiary centre. All patients aged 60 or over underwent implantation with a bone-conduction aid between 2009 and 2013 for conductive, SSD or mixed hearing loss. Outcome measures were complication rates and quality of life assessment using the Glasgow Benefit Inventory. The influence of patient and surgical factors on the complication rate was assessed. Fifty-one patients were implanted. Mean age was 67 years (range 60-89 years). The mean benefit, satisfaction and global GBI scores were 70 % (range 0-100 %), 70 % (0-100 %) and 82 % (83-100 %), respectively. The residual disability was 18 % (0-25 %). The adverse skin reaction rate was 16 % and the fixture loss rate was 2 %. There was a demonstrable increase in the complication rate with the dermatome (45 %; 5 patients) compared to the Sheffield 'S' (13 %; 2 patients) or linear incision techniques (29 %; 7 patients). The bone-conduction hearing aids are ideal method of hearing rehabilitation in the elderly for all forms of hearing loss. It provides significant benefit with no increased complication rate, which is imperative if social isolation is to be avoided and cognition preserved in this growing elderly population. PMID:25736468

  17. 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.

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

    PubMed Central

    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. PMID:24624947

  19. 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…

  20. Assessing the relevance, efficiency, and sustainability of HIV/AIDS in-service training in Nigeria

    PubMed Central

    2014-01-01

    More than three million people in Nigeria are living with HIV/AIDS. In order to reduce the HIV/AIDS burden in Nigeria, the US Government (USG) has dedicated significant resources to combating the epidemic through the President’s Emergency Plan for AIDS Relief (PEPFAR). In-service training (IST) of health workers is one of the most commonly used strategies to improve the quality and coverage of HIV/AIDS services. At USAID/Nigeria’s request, the USAID-funded CapacityPlus project conducted an assessment of PEPFAR-funded IST for all cadres of health workers in Nigeria. Using the IST Improvement Framework, developed by the USAID Applying Sciences to Strengthen and Improve Systems Project (ASSIST), as a guide, the authors developed a survey tool to assess the efficiency, effectiveness and sustainability of IST provided between January 2007 and July 2012 by PEPFAR-funded implementing partners in Nigeria. The instrument was adapted to the Nigerian context and refined through a stakeholder engagement process. It was then distributed via an online platform to more than 50 PEPFAR-funded implementing partners who provided IST in Nigeria. A total of 39 implementing partners completed the survey. Our survey found that PEPFAR implementing partners have been providing a wide range of IST to a diverse group of health workers in Nigeria since 2007. Most trainings are developed using national curricula, manuals and/or other standard operating procedures. Many of the partners are conducting Training Needs Assessments to inform the planning, design and development of their training programs. However, the assessment also pointed to a number of recommendations to increase the efficiency, effectiveness and sustainability of PEPFAR-funded IST. These actions are as follows: improve collaboration and coordination among implementing partners; apply a more diverse and cost-effective set of training modalities; allocate funding specifically for the evaluation of the effectiveness of

  1. 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

  2. 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…

  3. 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

  4. Usability assessment of ASIBOT: a portable robot to aid patients with spinal cord injury.

    PubMed

    Jardón, Alberto; Gil, Ángel M; de la Peña, Ana I; Monje, Concepción A; Balaguer, Carlos

    2011-01-01

    The usability concept refers to aspects related to the use of products that are closely linked to the user's degree of satisfaction. Our goal is to present a functional evaluation methodology for assessing the usability of sophisticated technical aids, such as a portable robot for helping disabled patients with severe spinal cord injuries. The specific manipulator used for this task is ASIBOT, a personal assistance robot totally developed by RoboticsLab at the University Carlos III of Madrid. Our purpose is also to improve some aspects of the manipulator according to the user's perception. For our case study, a population of six patients with spinal cord injury is considered. These patients have been suffering spinal cord injuries for a period of time longer than 1 year before the tests are carried out. The methodology followed for the information gathering is based on the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST). Different daily functions, such as drinking, brushing one's teeth and washing one's face, are considered to assess the user's perception when using ASIBOT as a technical aid. The human factor in this procedure is the main base to establish the specific needs and tools to make the end product more suitable and usable. PMID:20969432

  5. 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.

  6. 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

  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. Distinguishing the Spending Preferences of Seniors.

    ERIC Educational Resources Information Center

    Zimmer, Zachary; Chappell, Neena L.

    1996-01-01

    The consumer spending preferences of 1,406 senior Canadians were surveyed. Age distinguished those who had product-specific preferences. Income and health status separated those interested in recreational spending from those more interested in basic needs. Diversity of health and social characteristics in this population extends to their…

  9. 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…

  10. 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…

  11. 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…

  12. 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,…

  13. Using a signal cancellation technique to assess adaptive directivity of hearing aids.

    PubMed

    Wu, Yu-Hsiang; Bentler, Ruth A

    2007-07-01

    The directivity of an adaptive directional microphone hearing aid (DMHA) cannot be assessed by the method that calls for presenting a "probe" signal from a single loudspeaker to the DMHA that moves to different angles. This method is invalid because the probe signal itself changes the polar pattern. This paper proposes a method for assessing the adaptive DMHA using a "jammer" signal, presented from a second loudspeaker rotating with the DMHA, that simulates a noise source and freezes the polar pattern. Measurement at each angle is obtained by two sequential recordings from the DMHA, one using an input of a probe and a jammer, and the other with an input of the same probe and a phase-inverted jammer. After canceling out the jammer, the remaining response to the probe signal can be used to assess the directivity. In this paper, the new method is evaluated by comparing responses from five adaptive DMHAs to different jammer intensities and locations. This method was shown to be an accurate and reliable way to assess the directivity of the adaptive DMHA in a high-intensity-jammer condition. PMID:17614507

  14. An integrated rule- and case-based approach to AIDS initial assessment.

    PubMed

    Xu, L D

    1996-01-01

    The traditional approach to the development of knowledge-based systems (KBS) has been rule-based, where heuristic knowledge is encoded in a set of production rules. A rule-based reasoning (RBR) system needs a well constructed domain theory as its reasoning basis, and it does not make substantial use of the knowledge embedded in previous cases. An RBR system performs relatively well in a knowledge-rich application environment. Although its capability may be limited when previous experiences are not a good representation of the whole population, a case-based reasoning (CBR) system is capable of using past experiences as problem solving tools, therefore, it is appropriate for an experience-rich domain. In recent years, both RBR and CBR have emerged as important and complementary reasoning methodologies in artificial intelligence. For problem solving in AIDS intervention and prevention, it is useful to integrate RBR and CBR. In this paper, a hybrid KBS which integrates a deductive RBR system and an inductive CBR system is proposed to assess AIDS-risky behaviors. PMID:8666473

  15. 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

  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. MATRIX - development and feasibility of a guide for quality assessment of patient decision aids

    PubMed Central

    Lenz, Matthias; Kasper, Jürgen

    2007-01-01

    Decision aids (DAs) are interventions designed to help people make specific and deliberative choices among options by providing information about the options and outcomes that is relevant to a person's health status. There is an ongoing discussion about the quality of DAs. The present article provides an overview on systematic approaches using various quality criteria. However, these evaluation guides are not yet implemented. Up to now quality assessment of DAs is often limited to the evidence on efficacy through controlled trials using single-outcome measures. Since DAs are multi-component interventions, single-outcome trials are not sufficient for complete quality assessment. Consideration of theoretical founding and the development process is required. In an earlier paper we proposed a novel concept of quality to meet this challenge. We introduced MATRIX a guide for quality assessment of DAs aimed at disclosing the rationale behind underpinning theories, methods, and goals of a DA. The present paper reports how the development of MATRIX progressed including results of pre-testing and a feasibility study. We present the revised version of MATRIX, explain its basic concept, and describe the way to use it. PMID:19742287

  18. 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

  19. Methodology for assessing the performance of urine absorbing aids in controlling malodour release.

    PubMed

    Sironi, S; Capelli, L; Dentoni, L; Del Rosso, R

    2013-08-01

    The aim of this study was to investigate the possibility of comparing the performance of different absorbent aids in terms of odour control by discussing a suitable methodology for product evaluation. To overcome the problems of low test reproducibility owing to biological urine variability, the first step of the work consisted of the identification and the production of artificial urine having a constant and stable composition over time, moreover preventing sensorial assessors from any risk of biological contamination. Sensorial measurements were performed to optimize the similarity between artificial and biological urine, especially as far as the composition of the volatile component and therefore of the odour properties are concerned. The assessment of absorbent articles performance to control urine malodour includes both the concentration and the hedonic tone of the odour released by the article itself loaded with synthetic urine. Analyses were run on different products, which can be grouped into two different classes: absorbing aids with or without odour control technology (OCT) respectively. Results show that, despite of the presence or absence of OCT on absorbing products, their odour concentrations are almost identical, being comprised between 10 000 and 12 000 ouE m(-3) . For this reason, it is evident that odour concentration is not suitable as the sole parameter for comparison of different absorbing products. Instead, the hedonic odour tone (odour pleasantness/unpleasantness) relevant to the different product typologies (that is products with and without OCT) should be used as an additional discriminating factor for this kind of comparative tests. PMID:23237491

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

    PubMed

    van Schoonhoven, Jelmer; 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

  1. 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

  2. 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.

  3. Public preferences for government spending in Canada.

    PubMed

    Ramji, Sabrina; Quiñonez, Carlos

    2012-01-01

    This study considers three questions: 1. What are the Canadian public's prioritization preferences for new government spending on a range of public health-related goods outside the scope of the country's national system of health insurance? 2. How homogenous or heterogeneous is the Canadian public in terms of these preferences? 3. What factors are predictive of the Canadian public's preferences for new government spending? Data were collected in 2008 from a national random sample of Canadian adults through a telephone interview survey (n=1,005). Respondents were asked to rank five spending priorities in terms of their preference for new government spending. Bivariate and multivariable logistic regression analyses were conducted. As a first priority, Canadian adults prefer spending on child care (26.2%), followed by pharmacare (23.1%), dental care (20.8%), home care (17.2%), and vision care (12.7%). Sociodemographic characteristics predict spending preferences, based on the social position and needs of respondents. Policy leaders need to give fair consideration to public preferences in priority setting approaches in order to ensure that public health-related goods are distributed in a manner that best suits population needs. PMID:23110682

  4. 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…

  5. 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…

  6. 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…

  7. 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

  8. Web-based computer-aided-diagnosis (CAD) system for bone age assessment (BAA) of children

    NASA Astrophysics Data System (ADS)

    Zhang, Aifeng; Uyeda, Joshua; Tsao, Sinchai; Ma, Kevin; Vachon, Linda A.; Liu, Brent J.; Huang, H. K.

    2008-03-01

    Bone age assessment (BAA) of children is a clinical procedure frequently performed in pediatric radiology to evaluate the stage of skeletal maturation based on a left hand and wrist radiograph. The most commonly used standard: Greulich and Pyle (G&P) Hand Atlas was developed 50 years ago and exclusively based on Caucasian population. Moreover, inter- & intra-observer discrepancies using this method create a need of an objective and automatic BAA method. A digital hand atlas (DHA) has been collected with 1,400 hand images of normal children from Asian, African American, Caucasian and Hispanic descends. Based on DHA, a fully automatic, objective computer-aided-diagnosis (CAD) method was developed and it was adapted to specific population. To bring DHA and CAD method to the clinical environment as a useful tool in assisting radiologist to achieve higher accuracy in BAA, a web-based system with direct connection to a clinical site is designed as a novel clinical implementation approach for online and real time BAA. The core of the system, a CAD server receives the image from clinical site, processes it by the CAD method and finally, generates report. A web service publishes the results and radiologists at the clinical site can review it online within minutes. This prototype can be easily extended to multiple clinical sites and will provide the foundation for broader use of the CAD system for BAA.

  9. Basic plan and assessment of an information system designed to aid patient transfer.

    PubMed

    Yamamoto, M; Sano, M

    1987-01-01

    One of the important assignments in the planning of community medical care is to find an effective way of implementing the sharing of facilities together with their coordination. In particular, the establishment of a smooth and effective system co-ordinating facilities and functions of medical organizations, comprising clinics and hospitals of various levels, and the installation of an information system, designed to provide positive assistance in information control as well as in its operation, should be undertaken urgently. In this paper, we discuss the patient-transfer system, which is one of the facility-co-ordination-system for medical organizations, from the point of view of total community medical care. Specifically we describe the purpose, features and total structure of the patient-transfer system, and discuss the basic plan for an information system designed to aid patient transfer, from information control together with an advance assessment from the system-engineering point of view. This research has been promoted by the Aichi Medical Association committee for medical care system. The proposed system is planned to be operational in the near future. PMID:3441155

  10. 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

  11. 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

  12. Assessing Employee Attitudes in a Community-Based AIDS Service Organization.

    ERIC Educational Resources Information Center

    Liou, Kuotsai Tom; Cruise, Peter L.

    1994-01-01

    Thirty-one employees of the Comprehensive Acquired Immune Deficiency Syndrome (AIDS) Program of Palm Beach County (Florida) were surveyed to explore their motives and attitudes toward their jobs, clients, and the organization. Implications for management of AIDS service organizations and program quality are discussed. (SLD)

  13. The Assessment of CS-ICIDH for Adaptation of Computer-Assisted Communication (CAS) Aids.

    ERIC Educational Resources Information Center

    Greve, J.

    1996-01-01

    This article proposes the use of a rehabilitative diagnostic approach to evaluate individuals having communication disorders in the context of the International Classification of Impairment, Disabilities and Handicaps (ICIDH). It suggests the use of computer-assisted communication aids and offers guidelines for using such aids to assess…

  14. 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

  15. Know how to maximize maintenance spending

    SciTech Connect

    Carrino, A.J.; Jones, R.B.; Platt, W.E.; Tiffany, E.D.

    2009-07-15

    Solomon has developed a methodology to determine a large optimum point where availability meets maintenance spending for Powder River Basin (PRB) coal-fired units. Using a database of sufficient size and composition across various operating ranges, Solomon generated an algorithm that predicts the relationship between maintenance spending and availability. Coupling this generalized algorithm with a unit-specific market-loss curve determines the optimum spending for a facility. The article presents the results of the analysis, how this methodology can be applied to develop optimum operating and financial targets for specific units and markets and a process to achieve those targets. It also describes how this methodology can be used for other types of fossil-fired technologies and future enhancements to the analysis. 5 figs.

  16. 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

  17. 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. PMID:25642699

  18. 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

  19. Workforce Investment Act: States' Spending Is on Track, But Better Guidance Would Improve Financial Reporting. Report to Congressional Requesters.

    ERIC Educational Resources Information Center

    General Accounting Office, Washington, DC.

    The U.S. Congress asked the Government Accounting Office (GAO) to determine the following: (1) to what extent states were spending their Workforce Investment Act (WIA) funds and whether the Department of Labor's (Labor's) data accurately reflected available funds; (2) what Labor did to assess how states were managing their WIA spending; and (3)…

  20. Workforce Investment Act: Interim Report on Status of Spending and States' Available Funds. Report to Congressional Requesters.

    ERIC Educational Resources Information Center

    Nilsen, Sigurd R.

    A study assessed whether the Department of Labor's (DOL's) information on states' Workforce Investment Act of 1998 (WIA) spending was a true reflection of states' available funds. The most recent available spending data from DOL and the 50 states were analyzed. Interviews were conducted with state workforce officials in nine states, local…

  1. 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…

  2. 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…

  3. Assessment of speech perception in children with cochlear implants and tactile aids: what should the future hold?

    PubMed

    Carney, A E

    1991-01-01

    The purpose of this paper is to propose a rationale for the future development of speech perception evaluation materials for children using either cochlear implants or vibrotactile aids as sensory prosthetic devices. It is suggested that future evaluation tools extend beyond the assessment of device efficacy. In particular, they should address issues of normal perceptual development in children, as well as the results of intervention with children using these sensory prosthetic devices. PMID:2069182

  4. 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. PMID:17453306

  5. The Employment Impact of Government Spending.

    ERIC Educational Resources Information Center

    Rumberger, Russell W.

    An analysis illustrating the direct and indirect role of government policy in generating employment begins by documenting the level and composition of government spending over the last 50 years. In 1929, federal, state, and local expenditures amounted to 10 percent of the Gross National Product (GNP); by 1980, government expenditures represented…

  6. Factors Controlling Foundation Spending in Vermont.

    ERIC Educational Resources Information Center

    Gratiot, J. Peter

    2000-01-01

    Evidence derived from data accumulated under Vermont's Foundation Plan demonstrates that school district property value is a secondary determinant of school spending level, compared with other factors: the nonresident portion of the property-tax base, resident income, and residents' perceived school-tax burden as a percent of income. (Contains 13…

  7. 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…

  8. State Spending on Colleges Bounces Back

    ERIC Educational Resources Information Center

    Fischer, Karin

    2006-01-01

    State spending for higher education in the US grew at the fastest rate during the 2005-2006 fiscal year, allowing most colleges in the nation to regain their financial balance after a series of tight budgets for five years. A new analysis by the Center for the Study of Education Policy, at Illinois State University reported that the total…

  9. 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,…

  10. 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…

  11. Consumer Socialization: Children's Saving and Spending.

    ERIC Educational Resources Information Center

    Cohen, Stewart

    1994-01-01

    Provides examples of age-appropriate saving and spending activities that teachers can encourage in students to help them develop wise consumer behaviors. Suggests that younger children can save money in piggy banks or savings accounts, and older students can utilize checking accounts and mutual funds. All students can donate unneeded possessions…

  12. 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)

  13. 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. PMID:26631494

  14. Assessing effects of a media campaign on HIV/AIDS awareness and prevention in Nigeria: results from the VISION Project

    PubMed Central

    Keating, Joseph; Meekers, Dominique; Adewuyi, Alfred

    2006-01-01

    Background In response to the growing HIV epidemic in Nigeria, the U.S. Agency for International Development (USAID) initiated the VISION Project, which aimed to increase use of family planning, child survival, and HIV/AIDS services. The VISION Project used a mass-media campaign that focused on reproductive health and HIV/AIDS prevention. This paper assesses to what extent program exposure translates into increased awareness and prevention of HIV/AIDS. Methods This analysis is based on data from the 2002 and 2004 Nigeria (Bauchi, Enugu, and Oyo) Family Planning and Reproductive Health Surveys, which were conducted among adults living in the VISION Project areas. To correct for endogeneity, two-stage logistic regression is used to investigate the effect of program exposure on 1) discussion of HIV/AIDS with a partner, 2) awareness that consistent condom use reduces HIV risk, and 3) condom use at last intercourse. Results Exposure to the VISION mass media campaign was high: 59%, 47%, and 24% were exposed to at least 1 VISION radio, printed advertisement, or TV program about reproductive health, respectively. The differences in outcome variables between 2002 baseline data and the 2004 follow-up data were small. However, those with high program exposure were almost one and a half (Odds Ratio [O.R.] = 1.47, 95% Confidence Interval [C.I.] 1.01–2.16) times more likely than those with no exposure to have discussed HIV/AIDS with a partner. Those with high program exposure were over twice (O.R. = 2.20, C.I. 1.49–3.25) as likely as those with low exposure to know that condom use can reduce risk of HIV infection. Program exposure had no effect on condom use at last sex. Conclusion The VISION Project reached a large portion of the population and exposure to mass media programs about reproductive health and HIV prevention topics can help increase HIV/AIDS awareness. Programs that target rural populations, females, and unmarried individuals, and disseminate information on

  15. 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

  16. 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…

  17. Assessment of Alternative Student Aid Delivery Systems: Preliminary Specification of the Current System with Program Antecedents.

    ERIC Educational Resources Information Center

    Advanced Technology, Inc., Reston, VA.

    Specifications of the current delivery systems of the Pell Grant program, the Guaranteed Student Loan (GSL) program, and campus-based aid programs are provided. The relationship between features of the programs and delivery systems is also examined. The campus-based programs include the Supplemental Educational Opportunity Grant (SEOG) Program,…

  18. Objective assessment of listening effort in the oscillatory EEG: comparison of different hearing aid configurations.

    PubMed

    Bernarding, Corinna; Strauss, Daniel J; Hannemann, Ronny; Seidler, Harald; Corona-Strauss, Farah I

    2014-01-01

    An objective estimate of listening effort could support the hearing aid fitting procedure. Most of the digital hearing aids have already hearing aid settings which are supposed to reduce the listening effort, but the effects of these settings on the individual's listening effort remain unclear. In this study, we propose an objective estimate of listening effort using electroencephalographic data. The new method is based on the phase distribution of the ongoing oscillatory EEG activity. We hypothesize that for a non-effortful listening environment the phase is rather uniformly distributed on the unit circle than for a demanding condition. To prove if the phase is uniformly distributed around the unit circle, the Rayleigh Test was applied to the phase of the EEG. This method was tested in 14 hearing impaired subjects (moderate hearing loss, 65.64 ±7.93 yrs, 7 female). The tested hearing aid settings were a directional microphone combined with a noise reduction algorithm in a medium and a strong setting, the noise reduction setting turned off as well as a setting using omnidirectional microphones. Noise embedded sentences (Oldenburg Sentence Test, OlSa) were used as test materials. The task of the subject was to repeat each sentence. The results indicate that the objective estimate of listening effort maps the subjectively rated effort and for a listening situation like the presented one, the strong setting of the directional microphone requires the smallest effort. PMID:25570536

  19. 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…

  20. Assessing physician/patient relationships in the presence of HIV/AIDS: an exploratory study.

    PubMed

    Taylor, S A; Madrigal, C

    1998-01-01

    The following study investigates the nature of the relationship between physicians and HIV/AIDS patients within the context of the rapidly evolving services/relationship marketing literatures. The emerging evidence suggests that service providers generally play a critical role in the development of positive consumer attitudes and behaviors, and that relationship marketing practices can contribute to the delivery of health services. However, to date, there appears little evidence supporting the efficacy of employing relationship marketing practices in relation to a target market of HIV/AIDS patients. This exploratory study contributes to the body of knowledge by more closely investigating the nature of the patient-physician relationship relative to HIV/AIDS patients' attitudes, marketing-related behaviors, and overall quality-of-life/life satisfaction judgments. The results of this study first suggest that HIV/AIDS patients use the expectancy disconfirmation model when evaluating the performance of their physician. A reliance on expectancy disconfirmation suggests the likely prevalent role of service quality perceptions and satisfaction judgments in evaluating their relationship with their physician. Second, the results appear to support the conclusion that the patient's evaluation of their physician relationship and subsequent behaviors (e.g., word-of-mouth) are directly related to the patient's general perception of received health services. Thus, the patient/physician relationship may play a particularly powerful role in determining patient (marketing related) outcomes relative to other health service settings. Third, a direct influence is supported between negative affective reactions by patients and subsequent outcome behaviors. This finding lends support for the potential efficacy of service recovery efforts when rendering treatment to HIV/AIDS patients. Finally, evidence is presented demonstrating the effect of positive perceptions of the patient

  1. 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. PMID:27131839

  2. 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…

  3. 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…

  4. The Problem With Estimating Public Health Spending.

    PubMed

    Leider, Jonathon P

    2016-01-01

    Accurate information on how much the United States spends on public health is critical. These estimates affect planning efforts; reflect the value society places on the public health enterprise; and allows for the demonstration of cost-effectiveness of programs, policies, and services aimed at increasing population health. Yet, at present, there are a limited number of sources of systematic public health finance data. Each of these sources is collected in different ways, for different reasons, and so yields strikingly different results. This article aims to compare and contrast all 4 current national public health finance data sets, including data compiled by Trust for America's Health, the Association of State and Territorial Health Officials (ASTHO), the National Association of County and City Health Officials (NACCHO), and the Census, which underlie the oft-cited National Health Expenditure Account estimates of public health activity. In FY2008, ASTHO estimates that state health agencies spent $24 billion ($94 per capita on average, median $79), while the Census estimated all state governmental agencies including state health agencies spent $60 billion on public health ($200 per capita on average, median $166). Census public health data suggest that local governments spent an average of $87 per capita (median $57), whereas NACCHO estimates that reporting LHDs spent $64 per capita on average (median $36) in FY2008. We conclude that these estimates differ because the various organizations collect data using different means, data definitions, and inclusion/exclusion criteria--most notably around whether to include spending by all agencies versus a state/local health department, and whether behavioral health, disability, and some clinical care spending are included in estimates. Alongside deeper analysis of presently underutilized Census administrative data, we see harmonization efforts and the creation of a standardized expenditure reporting system as a way to

  5. 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…

  6. A qualitative assessment of long distance truck drivers' vulnerability to HIV/AIDS in Itajaí, southern Brazil.

    PubMed

    Malta, M; Bastos, F I; Pereira-Koller, E M; Cunha, M D; Marques, C; Strathdee, S A

    2006-07-01

    Itajaí is the largest port in southern Brazil and has one of the nation's highest AIDS incidence rates. Since over 400 truck drivers enter the city daily, they may play a key role in the HIV/AIDS epidemic due to transactions with commercial sex workers (CSWs) and/or substance use. We conducted a rapid assessment to establish the context of HIV vulnerability among truckers and CSWs in Itajaí. Forty three in-depth interviews and eight focus groups were conducted with truckers and CSWs. Two truck-driving routes involving brothels, meeting places and drug-use locations were mapped and field observations were collected. Tapes and field notes were transcribed and analyzed for emerging themes. Truck drivers typically had unprotected sex with several partners, including CSWs and truckstop employees. Both truckers and CSWs had low perceived HIV risk in spite of being engaged in high-risk sex behaviors. Use of alcohol and amphetamine-like drugs was frequent among truckers and appeared to influence unsafe sex practices. Knowledge about amphetamine-related risks was low, as was access to health services and HIV/AIDS behavioral interventions. Interventions, targeting truckers, CSWs and truckstop employees, are needed that traverse cities, states and borders and take into account seasonality, spatial context and workplace conditions. PMID:16777641

  7. 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

  8. HOW DO IMMIGRANTS SPEND THEIR TIME?

    PubMed Central

    Hamermesh, Daniel S.

    2012-01-01

    Sharp differences in time use by nativity emerge when activities are distinguished by incidence and intensity in recent U.S. data. A model with daily fixed costs for assimilating activities predicts immigrants are less likely than natives to undertake such activities on a given day; but those who do will spend relatively more time on them. Activities such as purchasing, education, and market work conform to the model. Other results suggest that fixed costs for assimilating activities are higher for immigrants with poor English proficiency or who originate in less developed countries. An analysis of comparable Australian data yields similar results. PMID:24443631

  9. 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

  10. 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. PMID:26110838

  11. 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.

  12. 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

  13. 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

  14. 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

  15. 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

  16. Jurisdiction Size and Local Public Health Spending

    PubMed Central

    Santerre, Rexford E

    2009-01-01

    Objective To examine if a minimum efficient scale (MES) holds with respect to the population serviced by a local health department (LHD) given the congestability, externality, and scale/scope economy effects potentially associated with public health services. Data Sources/Study Setting A nationally representative sample of LHDs in 2005. Study Design Multiple regression analysis is used to isolate the relation between population and spending while controlling for other factors known to influence local public health costs. Data Collection Data were obtained from the 2005 National Profile of Local Public Health Agencies, a project supported through a cooperative agreement between the National Association of County and City Health Officials and the Centers for Disease Control and Prevention. Principal Findings The MES of a local public health department is approximately 100,000 people. After that size, additional population has little impact on public health spending per capita. Conclusions Seventy-seven percent of LHDs in the sample fall below the 100,000 MES. Higher levels of government may want to provide financial inducements so that smaller LHDs consolidate or enter into agreements with larger public health organizations to provide services. PMID:19656226

  17. 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

  18. 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

  19. Charter School Spending: Is There a Relationship between Spending and Student Achievement in Charter Schools?

    ERIC Educational Resources Information Center

    Phillips, Stacy R. Gill

    2010-01-01

    This study is centered on one of the prevalent concerns in urban educational settings today, the possible relationship between school spending and student achievement. Many studies have examined the relationship between these two issues to try and determine best practices when planning academically for children in urban public school settings.…

  20. Assessment of the knowledge and attitudes regarding HIV/AIDS among pre-clinical medical students in Israel

    PubMed Central

    2014-01-01

    Background Today’s medical students are the future physicians of people living with HIV/AIDS (PLWHA). It is therefore essential that medical students possess the appropriate knowledge and attitudes regarding PLWHA. This study aims to evaluate knowledge and attitudes of pre-clinical Israeli medical students and to assess whether their knowledge and attitudes change throughout their pre-clinical studies. Methods A cross-sectional study was conducted among all pre-clinical medical students from the four medical schools in Israel during the academic year of 2010/2011 (a total of 1,470 students). A self-administered questionnaire was distributed. The questionnaire sought student responses pertaining to knowledge of HIV transmission and non-transmission routes, basic knowledge of HIV/AIDS treatment and attitudes towards HIV/AIDS. Results The study’s response rate was 62.24 percent. Knowledge among pre-clinical medical students was generally high and showed a statistically significant improvement as students progressed through their pre-clinical studies. However, there were some misconceptions, mostly regarding HIV transmission via breastfeeding and knowledge of HIV prevention after exposure to the virus. Students’ attitudes were found to include stigmatizing notions. Furthermore, the majority of medical students correlated HIV with shame and fear. In addition, students’ attitudes toward HIV testing and providing confidential medical information were contradictory to health laws, protocols and guidelines. Overall, no positive changes in students’ attitudes were observed during the pre-clinical years of medical school. Conclusion The knowledge of pre-clinical medical students in Israel is generally high, although there are some knowledge inadequacies that require more emphasis in the curricula of the medical schools. Contrary to HIV-related knowledge, medical students’ attitudes are unaffected by their progression through medical school. Therefore, medical

  1. 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. PMID:21319721

  2. 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…

  3. Examining the effect of EVS spending on HCAHPS scores: a value optimization matrix for expense management.

    PubMed

    McCaughey, Deirdre; Stalley, Samantha; Williams, Eric

    2013-01-01

    Using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey the Centers for Medicare & Medicaid Services' Value-Based Purchasing program has now linked patient care experience rating to hospital revenue reimbursement, thereby establishing a key relationship between revenue cycle management and the patient experience. However, little data exist on the effect of hospital resource spending on patient HCAHPS ratings. This article examines environmental services (EVS) expenses and HCAHPS ratings on hospital cleanliness and overall patient experience ratings to determine how these variables are related. No linear relationship between EVS expense spending and HCAHPS ratings was found, but post hoc analysis identified a matrix that differentiated on hospital cleanliness ratings and overall EVS spending. A value score was calculated for each quadrant of the matrix, and it was determined that organizational value derives from management of expense spending rather than pursuit of high HCAHPS scores. A value optimization matrix is introduced, and its four quadrants are described. With increased emphasis on subjective patient experience measures attached to financial consequences, leaders in the healthcare industry must understand the link between expense management and HCAHPS performance. This study has shown that effective operations are derived from the efficient use of resources and are supported by strong leadership, strategic management, and a culture of patient-centered achievement. The capacity of healthcare organizations to identify their unique costs-to-outcomes balance through the value optimization matrix will help provide them with a means to ensure that optimal value is extracted from all expense spending. PMID:24195341

  4. Computer simulation to aid the risk assessment of wheelchair and special seating systems used in transport.

    PubMed

    Rogers, P D; Gibson, C; Wilcox, S J; Chong, A

    2009-01-01

    The crashworthiness of occupied proprietary wheelchairs, which are transported in motor vehicles, is currently assessed by physical crash testing in accordance with ISO 7176-19. If such wheelchairs are modified to meet the needs of the occupant, e.g. the addition of special seating, environmental control systems or life support equipment, then those making the modifications take on the manufacturer's responsibilities, one of these being the assessment of the modified wheelchair's ability to withstand vehicle crash forces. Destructively testing bespoke wheelchair designs is not practical so, currently, the transport-related risk is assessed using best engineering judgement. To improve this process virtual crash testing of the wheelchair and occupant was used. A modified crash criteria from ISO 7176-19 is proposed to enable assessment of the wheelchair's crashworthiness and provide the clinical engineer with an informed judgement of how both wheelchair alone and occupant and wheelchair together will behave in a crash. PMID:19848858

  5. 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

  6. The impact of health reform on health system spending.

    PubMed

    Cutler, David M; Davis, Karen; Stremikis, Kristof

    2010-05-01

    The health reform legislation passed in March 2010 will introduce a range of payment and delivery system changes designed to achieve a significant slowing of health care cost growth. Most assessments of the new reform law have focused only on the federal budgetary impact. This updated analysis projects the effect of national reform on total national health expenditures and the insurance premiums that American families would likely pay. We estimate that, on net, the combination of provisions in the new law will reduce health care spending by $590 billion over 2010-2019 and lower premiums by nearly $2,000 per family. Moreover, the annual growth rate in national health expenditures could be slowed from 6.3 percent to 5.7 percent. PMID:20491172

  7. At the intersection of HIV/AIDS and cancer: a qualitative needs assessment of community-based HIV/AIDS service organizations.

    PubMed

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

    2013-08-01

    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

  8. 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. PMID:25265389

  9. 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.

  10. Assessment of regional climate change and development of climate adaptation decision aids in the Southwestern US

    NASA Astrophysics Data System (ADS)

    Darmenova, K.; Higgins, G.; Kiley, H.; Apling, D.

    2010-12-01

    Current General Circulation Models (GCMs) provide a valuable estimate of both natural and anthropogenic climate changes and variability on global scales. At the same time, future climate projections calculated with GCMs are not of sufficient spatial resolution to address regional needs. Many climate impact models require information at scales of 50 km or less, so dynamical downscaling is often used to estimate the smaller-scale information based on larger scale GCM output. To address current deficiencies in local planning and decision making with respect to regional climate change, our research is focused on performing a dynamical downscaling with the Weather Research and Forecasting (WRF) model and developing decision aids that translate the regional climate data into actionable information for users. Our methodology involves development of climatological indices of extreme weather and heating/cooling degree days based on WRF ensemble runs initialized with the NCEP-NCAR reanalysis and the European Center/Hamburg Model (ECHAM5). Results indicate that the downscale simulations provide the necessary detailed output required by state and local governments and the private sector to develop climate adaptation plans. In addition we evaluated the WRF performance in long-term climate simulations over the Southwestern US and validated against observational datasets.

  11. 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,…

  12. 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. PMID:24880694

  13. 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.

  14. 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…

  15. 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…

  16. 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.

  17. 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…

  18. Technology as an Aid in Assessing Visual Acuity in Severely/Profoundly Retarded Children.

    ERIC Educational Resources Information Center

    Longo, Julie; And Others

    1982-01-01

    Technology has been used to measure visual acuity with the severely or profoundly mentally retarded child. The following categories of technology have been used for assessment: the recording of visual fixation within the habituation paradigm; equipment to measure eye movements and pursuits; operant techniques; and electrodiagnostic techniques…

  19. 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...

  20. 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.

  1. 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…

  2. 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…

  3. 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 ...

  4. 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

  5. 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,…

  6. 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…

  7. 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…

  8. Industry Spending Is Rising at a Faster Pace.

    ERIC Educational Resources Information Center

    Chemical and Engineering News, 1979

    1979-01-01

    Provides data on Research and Development (R&D) spending by U.S. industry, outlays by the chemical industry, basic research vs applied research vs development, spending by other industries for chemical research, pharmaceutical research, and budgets of individual companies. (Author/HM)

  9. 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,…

  10. 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. PMID:25703050

  11. Gas utility spending stays at high level

    SciTech Connect

    Not Available

    1991-12-01

    This paper reports that despite being buffeted by warmer-than-usual weather and a decline in residential construction, US gas utilities spent more than $4.15 billion in 1991 to maintain the existing distribution system and extend gas service to new customers. Next year should be a busy year for gas companies and contractors across the US, with expected expenditures of $4.4 billion and installation of more than 27,000 miles of steel and plastic mains and services. Gas utility spending should stay above the $4-billion market for several years. As new customers are added and aging, existing distribution systems are maintained, upgraded and replaced. The 3Rs---Repair, Rehabilitate, Replacement---activities accounted for 53.6% of the total 1991 gas utility construction/maintenance expenditures as gas utilities pay close attention to protecting their investment in distribution networks. However, projections for 1992 show the 3Rs maintaining only a slight edge over new construction with 50.2% of the total.

  12. 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…

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

    PubMed

    Ashbolt, Nicholas J; Schoen, Mary E; Soller, Jeffrey A; Roser, David J

    2010-09-01

    There has been an ongoing dilemma for agencies that set criteria for safe recreational waters in how to provide for a seasonal assessment of a beach site versus guidance for day-to-day management. Typically an overall 'safe' criterion level is derived from epidemiologic studies of sewage-impacted beaches. The decision criterion is based on a percentile value for a single sample or a moving median of a limited number (e.g. five per month) of routine samples, which are reported at least the day after recreator exposure has occurred. The focus of this paper is how to better undertake day-to-day recreational site monitoring and management. Internationally, good examples exist where predictive empirical regression models (based on rainfall, wind speed/direction, etc.) may provide an estimate of the target faecal indicator density for the day of exposure. However, at recreational swimming sites largely impacted by non-sewage sources of faecal indicators, there is concern that the indicator-illness associations derived from studies at sewage-impacted beaches may be inappropriate. Furthermore, some recent epidemiologic evidence supports the relationship to gastrointestinal (GI) illness with qPCR-derived measures of Bacteroidales/Bacteroides spp. as well as more traditional faecal indicators, but we understand less about the environmental fate of these molecular targets and their relationship to bather risk. Modelling pathogens and indicators within a quantitative microbial risk assessment framework is suggested as a way to explore the large diversity of scenarios for faecal contamination and hydrologic events, such as from waterfowl, agricultural animals, resuspended sediments and from the bathers themselves. Examples are provided that suggest that more site-specific targets derived by QMRA could provide insight, directly translatable to management actions. PMID:20638095

  14. Health spending growth at a historic low in 2008.

    PubMed

    Hartman, Micah; Martin, Anne; Nuccio, Olivia; Catlin, Aaron

    2010-01-01

    In 2008, U.S. health care spending growth slowed to 4.4 percent--the slowest rate of growth over the past forty-eight years. The deceleration was broadly based for nearly all payers and health care goods and services, as growth in both price and nonprice factors slowed amid the recession. Despite the slowdown, national health spending reached $2.3 trillion, or $7,681 per person, and the health care portion of gross domestic product (GDP) grew from 15.9 percent in 2007 to 16.2 percent in 2008. These developments reflect the general pattern that larger increases in the health spending share of GDP generally occur during or just after periods of economic recession. Despite the overall slowdown in national health spending growth, increases in this spending continue to outpace growth in the resources available to pay for it. PMID:20048374

  15. Assessment of quality of life in early stage HIV-infected persons: data from the AIDS Time-oriented Health Outcome Study (ATHOS).

    PubMed

    Lubeck, D P; Fries, J F

    1997-08-01

    The development of new pharmaceutical interventions for persons with human immunodeficiency virus (HIV) infection has resulted in extended survival and a need for valid, reliable and responsive instruments to assess health-related QoL (HRQoL). This paper reviews the reliability and validity of an HRQoL instrument, the AIDS Health Assessment Questionnaire (AIDS-HAQ), among persons participating in an observational database of HIV infection. The AIDS-HAQ includes nine subscales: disability, energy, general health, pain, cognitive functioning, mental health, social functioning, health distress and symptoms. Individuals complete the AIDS-HAQ quarterly. Data are reported for 440 individuals entering the study with early HIV infection. Fifty-nine progressed to symptomatic disease and 109 to AIDS after 1 year. The subscales of the instrument resulted in high internal consistency reliability (range = 0.79-0.88). Concurrent validity data reflected the ability to distinguish between patients with increasing disease severity. In all domains, except cognitive functioning, individuals who progressed to AIDS had significant decrements (p < 0.01) in HRQoL compared with symptomatic and asymptomatic patients. Significant decrements (p < 0.01) were observed for disability, general health, energy and symptoms for patients who progressed to symptomatic disease from an asymptomatic status. Individuals who had decreasing CD4+ counts also had significant declines (p < 0.001) in disability, general health, social functioning, pain and symptoms. The AIDS-HAQ is an instrument that can be used when comparing group differences and within group changes in observational databases, naturalistic studies and clinical trials. PMID:9330550

  16. Modeling error in assessment of mammographic image features for improved computer-aided mammography training: initial experience

    NASA Astrophysics Data System (ADS)

    Mazurowski, Maciej A.; Tourassi, Georgia D.

    2011-03-01

    In this study we investigate the hypothesis that there exist patterns in erroneous assessment of BI-RADS image features among radiology trainees when performing diagnostic interpretation of mammograms. We also investigate whether these error making patterns can be captured by individual user models. To test our hypothesis we propose a user modeling algorithm that uses the previous readings of a trainee to identify whether certain BI-RADS feature values (e.g. "spiculated" value for "margin" feature) are associated with higher than usual likelihood that the feature will be assessed incorrectly. In our experiments we used readings of 3 radiology residents and 7 breast imaging experts for 33 breast masses for the following BI-RADS features: parenchyma density, mass margin, mass shape and mass density. The expert readings were considered as the gold standard. Rule-based individual user models were developed and tested using the leave one-one-out crossvalidation scheme. Our experimental evaluation showed that the individual user models are accurate in identifying cases for which errors are more likely to be made. The user models captured regularities in error making for all 3 residents. This finding supports our hypothesis about existence of individual error making patterns in assessment of mammographic image features using the BI-RADS lexicon. Explicit user models identifying the weaknesses of each resident could be of great use when developing and adapting a personalized training plan to meet the resident's individual needs. Such approach fits well with the framework of adaptive computer-aided educational systems in mammography we have proposed before.

  17. 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

  18. 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.

  19. 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. PMID:27010889

  20. 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

  1. 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

  2. Prediction of grief and HIV/AIDS-related burnout in volunteers.

    PubMed

    Nesbitt, W H; Ross, M W; Sunderland, R H; Shelp, E

    1996-04-01

    Burnout in volunteer workers in the HIV/AIDS area results in the loss of dedicated personnel, consequently straining the HIV/AIDS care delivery system. By assessing the predictors of burnout and grief this study describes the role of grief in HIV/AIDS volunteer burnout. Voluntary and anonymous questionnaires were sent to members of the Foundation for Interfaith Research and Ministry (FIRM), a multi-religious organization formed to provide volunteer work in HIV/AIDS care facilities around Houston, Texas. In 174 valid responses, grief was measured against work characteristics, burnout, rewards, stressors, and the general health questionnaire (GHQ). No significant relationship was found between grief and burnout; however, burnout in volunteers may be different from that in health care professionals for the following reasons: (1) volunteers choose to work in the HIV/AIDS area; (2) they have control over the time they spend volunteering; (3) volunteers are internally motivated to work in the HIV/AIDS area; and (4) if the volunteers do not enjoy the work, they can terminate their involvement with minimal cost. The best univariate predictors of grief are time spent as a volunteer and volunteer hours per week, where those who spend the most hours volunteering experience less grief The Reward/Stress measures most significantly associated with grief include empathy/self-knowing reward, emotional support reward, and emotional overload stress. The strongest predictors of grief in the regression analysis, which account for 21% of the variance, were time as a volunteer, emotional support, emotional overload, GHQ-somatic symptoms, and GHQ social dysfunction. The data suggest that in order to reduce grief special attention should be paid te allowing volunteers freely to express problems with emotional overload and workload adjustments, and providing clear emotional support as a reward. PMID:8861413

  3. 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

  4. Lessons learned from the "Spend Less. Eat Well. Feel Better." program efficacy trial.

    PubMed

    Derrickson, Joda P; Buchanan, Chad; Asing, G Kaui; Okuma, Annette

    2003-01-01

    "Spend Less. Eat Well. Feel Better." (SLEWFB) is a 3-hour intervention designed to improve food resource management ability, health, and food security status. This program efficacy trial targeted clients seeking financial aid to prevent homelessness. A randomized controlled design using a 1-hour food safety intervention as a control group was used. Four variables were targeted over a 30-day time period: (1) food security status, (2) basic financial management, (3) average fruit and vegetable intake, and (4) goal accomplishment. Repeated-measures analysis of variance and chi-square analysis were used. Compared with control group participants (n = 47), SLEWFB graduates (n = 48) were less likely to have to choose between food and rent expenses (chi2 = 16.5, P =.00005) and improved their fruit and vegetable intake (F of time = 8.03, P <.006) regardless of financial assistance received. The findings imply that further investigation of coupling financial aid with effective life skills education is warranted. PMID:12588678

  5. 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.

  6. 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.

  7. The Real Costs of Federal Aid to Higher Education. Heritage Lectures. No. 984

    ERIC Educational Resources Information Center

    Vedder, Richard

    2007-01-01

    New federal spending on student aid is unlikely to improve college access. The increase in access in higher education in America largely came before massive federal involvement in student financial aid programs. Evidence suggests that federal subsidies for student aid may be counterproductive. Modest provision of financial assistance serves to…

  8. 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

  9. Medicare Spends Billions on Chronic Kidney Disease, Study Finds

    MedlinePlus

    ... nlm.nih.gov/medlineplus/news/fullstory_158020.html Medicare Spends Billions on Chronic Kidney Disease, Study Finds ... affects nearly 14 percent of Americans and costs Medicare billions of dollars a year, a new study ...

  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. 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.

  12. 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

  13. 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.

  14. 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

  15. 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 ...

  16. 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 medication can suppress symptoms. ...

  17. 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

  18. Towards a comprehensive estimate of national spending on prevention

    PubMed Central

    de Bekker-Grob, Esther W; Polder, Johan J; Mackenbach, Johan P; Meerding, Willem Jan

    2007-01-01

    Background Comprehensive information about national spending on prevention is crucial for health policy development and evaluation. This study provides a comprehensive overview of prevention spending in the Netherlands, including those activities beyond the national health accounts. Methods National spending on health-related primary and secondary preventive activities was examined by funding source with the use of national statistics, government reports, sector reports, and data from individual health associations and corporations, public services, occupational health services, and personal prevention. Costs were broken down by diseases, age groups and gender using population-attributable risks and other key variables. Results Total expenditures on prevention were €12.5 billion or €769 per capita in the Netherlands in 2003, of which 20% was included in the national health accounts. 82% was spent on health protection, 16% on disease prevention, and 2% on health promotion activities. Most of the spending was aimed at the prevention of infectious diseases (34%) and acute physical injuries (29%). Per capita spending on prevention increased steeply by age. Conclusion Total expenditure on health-related prevention is much higher than normally reported due to the inclusion of health protection activities beyond the national health accounts. The allocative efficiency of prevention spending, particularly the high costs of health protection and the low costs of health promotion activities, should be addressed with information on their relative cost effectiveness. PMID:17883834

  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. Money for Music Education: A District Analysis of the How, What, and Where of Spending for Music Education

    ERIC Educational Resources Information Center

    Fermanich, Mark L.

    2011-01-01

    Evidence suggests that accountability and financial pressures are causing schools across the country to reduce investments in subject areas that are not assessed for accountability purposes. However, due to the design of financial reporting systems in most states, inadequate data are available to analyze spending levels and patterns for specific…

  2. 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…

  3. 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

  4. 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

  5. Insurer Market Structure and Variation in Commercial Health Care Spending

    PubMed Central

    McKellar, Michael R; Naimer, Sivia; Landrum, Mary B; Gibson, Teresa B; Chandra, Amitabh; Chernew, Michael

    2014-01-01

    Objective To examine the relationship between insurance market structure and health care prices, utilization, and spending. Data Sources Claims for 37.6 million privately insured employees and their dependents from the Truven Health Market Scan Database in 2009. Measures of insurer market structure derived from Health Leaders Inter study data. Methods Regression models are used to estimate the association between insurance market concentration and health care spending, utilization, and price, adjusting for differences in patient characteristics and other market-level traits. Results Insurance market concentration is inversely related to prices and spending, but positively related to utilization. Our results imply that, after adjusting for input price differences, a market with two equal size insurers is associated with 3.9 percent lower medical care spending per capita (p = .002) and 5.0 percent lower prices for health care services relative to one with three equal size insurers (p < .001). Conclusion Greater fragmentation in the insurance market might lead to higher prices and higher spending for care, suggesting some of the gains from insurer competition may be absorbed by higher prices for health care. Greater attention to prices and utilization in the provider market may need to accompany procompetitive insurance market strategies. PMID:24303879

  6. Closing the Gap: How the Federal Government Can Equalize School Spending between the States.

    ERIC Educational Resources Information Center

    Rothstein, Richard

    2001-01-01

    Per-pupil expenditures in the lowest spending states are half of those in the highest-spending states. The federal government could equalize interstate spending by subsidizing spending in poorer states. The plan must consider the dollar's varying purchasing power, higher expenditures for educating disadvantaged children, and disincentives for…

  7. 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...

  8. Assessment of Alternative Student Aid Delivery Systems: Specification of the Current System. Supplement II to the Final Report.

    ERIC Educational Resources Information Center

    Advanced Technology, Inc., Reston, VA.

    Specifications of the current student financial aid system, with attention to the Pell Grant, Guaranteed Student Loan (GSL), and campus-based programs, are provided. The methodology used to develop the specifications is also described. The campus-based programs include the Supplemental Educational Opportunity Grant Program, the College Work Study…

  9. 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.…

  10. 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…

  11. 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…

  12. Spending on pharmaceuticals in Italy: macro constraints with local autonomy.

    PubMed

    Mapelli, Vittorio; Lucioni, Carlo

    2003-01-01

    Italy has a national health service (SSN) that is moving toward decentralization and empowerment of local health enterprises (LHEs)-the arms of the regions for delivering health services. Drug policy and spending decisions are both influenced by central government and local authorities. At the "macro" level, the government holds the power to decide the amount of drug expenditure, currently at 13% of total SSN expenditure; the pricing policy, price negotiation, reference price, and price cuts; criteria for reimbursement, inclusion in the positive list, and restrictive notes; and the copayments and exemptions. So far, the government concern has been predominantly on cost containment, and its approach in selecting drugs for reimbursement has been cost minimization. Italy has no centralized office for health technology assessment and this hinders the search for an efficient use of drugs. At the "micro" level, however, the LHEs are showing a great vitality in fostering a better use of drugs by general practitioners. One of the tools employed is local voluntary agreements between LHEs and general practitioners (GPs) that may be supported by economic incentives, in cash or in kind. In 2000 there were 61 agreements in place, 31% of total LHEs, which concerned the respect of drug expenditure ceilings and the local development and implementation of clinical guidelines (47% of LHEs). A traditional and widespread tool for controlling drug expenditure is providing GPs with regular reports on their drug prescriptions (59% of LHEs). Monitoring, moral suasion, and clinical guidelines are the main incentives for efficiency at local level, but focus on health outcomes is limited. The cost-containment mentality still prevails and the use of drug budget for purchasing better health is at its very early stage. PMID:12846924

  13. Undercontribution bias in health care spending account decisions.

    PubMed

    Schweitzer, M E; Hershey, J C

    1997-01-01

    Results from this work describe 239 responses to a mailed survey regarding employee benefits decisions at a large eastern university. The primary objective of this work is to test for an undercontribution bias in health care financing decisions. The results establish the existence of an undercontribution bias in both actual employee decisions and hypothetical flexible spending account contribution decisions. We describe this bias within the context of related biases including loss aversion, mental accounting, status quo and omission biases. Surprisingly, we find a significant order effect in this study and posit that preference construction in this context is an active, reference-dependent process. In addition, results from this work demonstrate the endogenous nature of health care flexible spending account expenditures. The results have important implications both for the descriptive framework of and the normative solution to the flexible spending account contribution decision. PMID:10167155

  14. Economic impact of public sector spending on health care.

    PubMed

    Hy, Ronald John

    2011-01-01

    Public sector spending on health care clearly has a positive economic impact on local communities. Not only does such spending provide residents with better health care, but it is widely recognized as an investment that returns continual dividends in the form of better jobs, higher incomes, and additional state and local tax revenues. The results of a static input/output model shows that public sector spending on health care of approximately $46 billion (in 2009 dollars) in the state of Texas yields over 588,000 jobs, $74.2 billion in total output, $26.3 billion in personal income, $22 billion in employee compensation, and $1.8 billion in state and local taxes; it clearly has a considerable positive economic impact on local economies and their quest for economic development. PMID:22106548

  15. Children with medical complexity and Medicaid: spending and cost savings.

    PubMed

    Berry, Jay G; Hall, Matt; Neff, John; Goodman, Denise; Cohen, Eyal; Agrawal, Rishi; Kuo, Dennis; Feudtner, Chris

    2014-12-01

    A small but growing population of children with medical complexity, many of whom are covered by Medicaid, accounts for a high proportion of pediatric health care spending. We first describe the expenditures for children with medical complexity insured by Medicaid across the care continuum. We report the increasingly large amount of spending on hospital care for these children, relative to the small amount of primary care and home care spending. We then present a business case that estimates how cost savings might be achieved for children with medical complexity from potential reductions in hospital and emergency department use and shows how the savings could underwrite investments in outpatient and community care. We conclude by discussing the importance of these findings in the context of Medicaid's quality of care and health care reform. PMID:25489039

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

    PubMed Central

    Bonn, Scott; Wilson, George

    2011-01-01

    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. PMID:21532926

  17. Prices don't drive regional Medicare spending variations.

    PubMed

    Gottlieb, Daniel J; Zhou, Weiping; Song, Yunjie; Andrews, Kathryn Gilman; Skinner, Jonathan S; Sutherland, Jason M

    2010-01-01

    Per capita Medicare spending is more than twice as high in New York City and Miami than in places like Salem, Oregon. How much of these differences can be explained by Medicare's paying more to compensate for the higher cost of goods and services in such areas? To answer this question, we analyzed Medicare spending after adjusting for local price differences in 306 Hospital Referral Regions. The price-adjustment analysis resulted in less variation in what Medicare pays regionally, but not much. The findings suggest that utilization-not local price differences-drives Medicare regional payment variations, along with special payments for medical education and care for the poor. PMID:20110290

  18. Health spending and ability to pay: Business, individuals, and government

    PubMed Central

    Levit, Katharine R.; Freeland, Mark S.; Waldo, Daniel R.

    1989-01-01

    Health care spending has grown almost twice as fast as has the gross national product since 1965. Various parties in the health care financing arena have been affected to different degrees by this rising health care spending. As discussed in this article, households, businesses, and government all have had to devote increasing shares of their resources to financing health care. Although businesses have been increasingly burdened, either directly or through higher insurance premiums and Medicare taxes, that burden is less than is popularly believed. PMID:10313090

  19. 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

  20. 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.

  1. Prices Don't Drive Regional Medicare Spending Variations

    PubMed Central

    Gottlieb, Daniel J.; Zhou, Weiping; Song, Yunjie; Andrews, Kathryn Gilman; Skinner, Jonathan S.; Sutherland, Jason M.

    2010-01-01

    Per capita Medicare spending is more than twice as high in New York City and Miami than in places like Salem, Oregon. How much of these differences can be explained by Medicare's paying more to compensate for the higher cost of goods and services in such areas? To answer this question, we analyzed Medicare spending after adjusting for local price differences in 306 Hospital Referral Regions. The price-adjustment analysis resulted in less variation in what Medicare pays regionally, but not much. The findings suggest that utilization—not local price differences—drives Medicare regional payment variations, along with special payments for medical education and care for the poor. PMID:20110290

  2. Effects of saving and spending patterns on holding time distribution

    NASA Astrophysics Data System (ADS)

    Ding, N.; Xi, N.; Wang, Y.

    2003-11-01

    The effects of saving and spending patterns on holding time distribution of money are investigated based on the ideal gas-like models. We show the steady-state distribution obeys an exponential law when the saving factor is set uniformly, and a power law when the saving factor is set diversely. The power distribution can also be obtained by proposing a new model where the preferential spending behavior is considered. The association of the distribution with the probability of money to be exchanged has also been discussed.

  3. A Self-Control Approach to Inefficient Spending

    ERIC Educational Resources Information Center

    Paulsen, Karen; And Others

    1977-01-01

    Student volunteers who experienced problems in impulsive overspending of money were randomly assigned to either a self-control treatment condition or to a placebo condition. Those in the self-control condition evidenced a significantly greater change (55 percent reduction in spending) than placebo control subjects, who showed a slight average…

  4. Evidence on the Efficacy of Inpatient Spending on Medicare Patients

    PubMed Central

    Kaestner, Robert; Silber, Jeffrey H

    2010-01-01

    Context: It is widely believed that a significant amount, perhaps as much as 20 to 30 percent, of health care spending in the United States is wasted, despite market forces such as managed care organizations and large, self-insured firms with a financial incentive to eliminate waste of this magnitude. Methods: This article uses Medicare claims data to study the association between inpatient spending and the thirty-day mortality of Medicare patients admitted to hospitals between 2001 and 2005 for surgery (general, orthopedic, vascular) and medical conditions (acute myocardial infarction [AMI], congestive heart failure [CHF], stroke, and gastrointestinal bleeding). Findings: Estimates from the analysis indicated that except for AMI patients, a 10 percent increase in inpatient spending was associated with a decrease of between 3.1 and 11.3 percent in thirty-day mortality, depending on the type of patient. Conclusions: Although some spending may be inefficient, the results suggest that the amount of waste is less than conventionally believed, at least for inpatient care. PMID:21166869

  5. 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…

  6. Endowment Spending--A Double-Edged Sword

    ERIC Educational Resources Information Center

    Basch, Donald L.

    2004-01-01

    The growing ability of private colleges and universities to use a high level of annual endowment spending in support of current operations has been a source of financial strength during much of the past two decades. More recently, however, declining endowments at most colleges have raised concerns about declines in the availability of …

  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. Georgia State University Spending Patterns and the Atlanta Economy.

    ERIC Educational Resources Information Center

    Salley, Charles D.

    The single but substantial economic dimension of Georgia State University's contribution to the Atlanta metropolitan area is examined in this research report. The purpose of the study was to identify successful estimating techniques developed by previous studies of the local spending impact of postsecondary educational institutions. Three direct…

  10. Does School District Spending Vary by Source of Funds?

    ERIC Educational Resources Information Center

    Fowler, William J., Jr.

    For the average school district, state funding is now higher than local funding, with unknown effects on per pupil spending. Previous studies in individual states do not agree on the direction and magnitude of the stimulative effect of state funding. This paper analyzes data from the 1989-90 United States Bureau of the Census report, "Public…

  11. 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…

  12. 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…

  13. 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…

  14. 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…

  15. 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…

  16. Saving and Spending Money: Resources for Elementary and Middle School.

    ERIC Educational Resources Information Center

    Lickteig, Mary J.

    1999-01-01

    Provides an annotated bibliography of introductory and in-depth resources, including books, software, and videocassettes, for elementary and middle school students that relate to economic principles including spending and saving money, borrowing, credit, inflation, the banking system, and the stock market. (LRW)

  17. Spending Review 2007: Securing the Future. Policy Briefing

    ERIC Educational Resources Information Center

    Universities UK, 2007

    2007-01-01

    Universities UK's submission to the Government's Spending Review in 2007 explains how additional public investment in higher education will enable the sector to make an even greater contribution to key national policy objectives. These include the major economic challenges for the UK identified by the Treasury. The need to close the productivity…

  18. 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…

  19. 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…

  20. 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)

  1. Medicare and private spending trends from 2008 to 2012 diverge in Texas.

    PubMed

    Franzini, Luisa; Taychakhoonavudh, Suthira; Parikh, Rohan; White, Chapin

    2015-02-01

    The recent relatively slow growth in health care spending masks significant differences among payers, clinical settings, and geographic areas. To better understand the spending slowdown, we focus on 2008-2012 trends in Texas among Medicare fee-for-service beneficiaries and enrollees in Blue Cross Blue Shield of Texas (BCBSTX). Spending per person for Medicare grew only 1.5% per year on average, compared with 5.2% for BCBSTX. In Medicare, utilization rates were relatively flat, while prices grew more slowly than input prices. In BCBSTX, spending growth was driven by increases in negotiated prices, in particular hospital prices. We find that geographic variation declined sharply in Medicare, due to drops in spending on post-acute care in two notoriously high-spending regions but rose slightly in BCBSTX. The aggregate spending trends mask two divergent stories: spending growth in Medicare is very slow, but price increases continue to drive unsustainable spending growth among the privately insured. PMID:25550272

  2. 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 ...

  3. Teaching Aids

    ERIC Educational Resources Information Center

    Barnard, W. Robert, Ed.

    1976-01-01

    Provides evaluations of several aids for teaching chemistry. Included are The Use of Chemical Abstracts, Practical Technical Writing, Infrared Spectroscopy Programs, and a film titled "You Can't Go Back." (RH)

  4. 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. PMID:9290837

  5. 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…

  6. Higher US branded drug prices and spending compared to other countries may stem partly from quick uptake of new drugs.

    PubMed

    Kanavos, Panos; Ferrario, Alessandra; Vandoros, Sotiris; Anderson, Gerard F

    2013-04-01

    The United States spends considerably more per capita on prescription drugs than other countries in the Organization for Economic Cooperation and Development (OECD). Drawing on the Intercontinental Medical Statistics Midas database, we examined the variation in drug prices among selected OECD countries in 2005, 2007, and 2010 to determine which country paid the highest prices for brand-name drugs, what factors led to variation in per capita drug spending, and what factors contributed to the rate of increase in drug spending. We found that depending on how prices were weighted for volume across the countries, brand-name prescription drug prices were 5-198 percent higher in the United States than in the other countries in all three study years. (A limitation is that many negotiated price discounts obtained in the United States may not be fully reflected in the results of this study.) A contributor to higher US per capita drug spending is faster uptake of new and more expensive prescription drugs in the United States relative to other countries. In contrast, the other OECD countries employed mechanisms such as health technology assessment and restrictions on patients' eligibility for new prescription drugs, and they required strict evidence of the value of new drugs. Similarly, US health care decision makers could consider requiring pharmaceutical manufacturers to provide more evidence about the value of new drugs in relation to the cost and negotiating prices accordingly. PMID:23569056

  7. 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.

  8. Plug the Leak: Align Public Spending With Public Need

    PubMed Central

    Girard, Donald E.; Brunett, Patrick; Cedfeldt, Andrea; Bower, Elizabeth A.; Flores, Christine; Rajhbeharrysingh, Uma; Choi, Dongseok

    2012-01-01

    We explore the history behind the current structure of graduate medical education funding and the problems with continuing along the current funding path. We then offer suggestions for change that could potentially manage this health care spill. Some of these changes include attracting more students into primary care, aligning federal graduate medical education spending with future workforce needs, and training physicians with skills they will require to practice in systems of the future. PMID:23997870

  9. 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.…

  10. 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

  11. 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

  12. 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. PMID:26849218

  13. Linking Consumer Debt and Consumer Expenditures: Do Borrowers Spend Money Differently?

    ERIC Educational Resources Information Center

    Fan, Jessie X.

    2000-01-01

    Data from 5,174 households were analyzed to investigate differences in spending patterns between households who borrow money and those who do not. Findings indicate that borrowers spend less money on necessities and more on luxury commodities. (JOW)

  14. The acceptability of a computer HIV/AIDS risk assessment to not-in-treatment drug users.

    PubMed

    Williams, M L; Freeman, R C; Bowen, A M; Saunders, L

    1998-12-01

    The purpose of this paper is to report the results of a study assessing the acceptability of a computer HIV risk assessment instrument administered to not-in-treatment drug users. The study asked three questions related to acceptability: (1) are drug users comfortable responding to HIV risk questions using the computer assessment; (2) do drug users feel that they possess the requisite skill to respond to questions using a computer; and (3) do drug users believe that the responses they provide using the computer assessment will remain private and confidential. This study differs from other assessments of the acceptability of computer assisted data collection in that the population of interest has only limited education and interaction with computers. Furthermore, the study was implemented under field conditions. To conduct the study, an existing HIV risk assessment instrument was adapted for use with the computer. Only slight modifications were made to the content of the instrument. To facilitate data collection with this population, audio enhancement and touch screen were used. Three scales measuring comfort, skill and perceived privacy were developed. Results of analysis showed that drug users are comfortable responding to an HIV risk assessment using computer assisted interviewing. Drug users also perceived that they possessed the requisite skill to successfully complete the interview. And, study participants reported that they believed that their responses using the computer interview would remain private and confidential. Only minor differences in scale scores based on sociodemographic characteristics were found among study participants. Implications of the findings are discussed. PMID:9924525

  15. 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…

  16. 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…

  17. 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.…

  18. 78 FR 24206 - Agency Information Collection Activities; Information Collection; USA Spending

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-24

    ... cite OMB Control Number 3090-00xx, USA Spending, in all correspondence. Dated: April 17, 2013. Casey... 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:...

  19. 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…

  20. 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

  1. 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;…

  2. 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…

  3. 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

  4. 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

  5. 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

    2016-04-01

    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. PMID:26493859

  6. Evaluation of the Computer Aided Training Evaluation and Scheduling (CATES) Decision Model for Assessing Flight Task Proficiency.

    ERIC Educational Resources Information Center

    McDaniel, William C.; And Others

    The efficacy of the CATES system for making training decisions and determining student proficiency in Naval in-flight training proposed in an earlier study (Rankin and McDaniel, 1980) is compared with the present system of instructor judgments for performance assessment. The current study used 29 newly-designated naval aviators undergoing Fleet…

  7. 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

  8. 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.

  9. 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...

  10. 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

  11. 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

  12. HOW DO IMMIGRANTS SPEND THEIR TIME?: THE PROCESS OF ASSIMILATION.

    PubMed

    Hamermesh, Daniel S; Trejo, Stephen J

    2013-04-01

    Sharp differences in time use by nativity emerge when activities are distinguished by incidence and intensity in recent U.S. data. A model with daily fixed costs for assimilating activities predicts immigrants are less likely than natives to undertake such activities on a given day; but those who do will spend relatively more time on them. Activities such as purchasing, education, and market work conform to the model. Other results suggest that fixed costs for assimilating activities are higher for immigrants with poor English proficiency or who originate in less developed countries. An analysis of comparable Australian data yields similar results. PMID:24443631

  13. Effects of Macroeconomic Trends on Social Security Spending Due to Sickness and Disability

    PubMed Central

    Khan, Jahangir; Gerdtham, Ulf-G.; Jansson, Bjarne

    2004-01-01

    Objectives. We analyzed the relationship between macroeconomic conditions, measured as unemployment rate and social security spending, from 4 social security schemes and total spending due to sickness and disability. Methods. We obtained aggregated panel data from 13 Organization for Economic Cooperation and Development member countries for 1980–1996. We used regression analysis and fixed effect models to examine spending on sickness benefits, disability pensions, occupational-injury benefits, survivor’s pensions, and total spending. Results. A decline in unemployment increased sickness benefits spending and reduced disability pension spending. These effects reversed direction after 4 years of unemployment. Inclusion of mortality rate as an additional variable in the analysis did not affect the findings. Conclusions. Macroeconomic conditions influence some reimbursements from social security schemes but not total spending. PMID:15514244

  14. Is there a budget fallacy? The role of savings goals in the prediction of personal spending.

    PubMed

    Peetz, Johanna; Buehler, Roger

    2009-12-01

    The authors extend research and theory on self prediction into the realm of personal financial behavior. Four studies examined people's ability to predict their future personal spending and the findings supported the two main hypotheses. First, participants tended to underestimate their future spending. They predicted spending substantially less money in the coming week than they actually spent or than they remembered spending in the previous week. Second, the prediction bias stemmed from people's savings goals-defined as the general desire to save money or minimize future spending-at the time of prediction. Participants who reported (Studies 2 and 3) or were induced to experience (Study 4) a stronger savings goal predicted they would spend less money. However, savings goals were not related to actual spending and thus contributed to the bias in prediction. PMID:19713568

  15. 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. PMID:24799579

  16. 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…

  17. 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

  18. 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. PMID:12349154

  19. 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.

  20. Evidence is good for your health system: policy reform to remedy catastrophic and impoverishing health spending in Mexico.

    PubMed

    Knaul, Felicia Marie; Arreola-Ornelas, Héctor; Méndez-Carniado, Oscar; Bryson-Cahn, Chloe; Barofsky, Jeremy; Maguire, Rachel; Miranda, Martha; Sesma, Sergio

    2006-11-18

    Absence of financial protection in health is a recently diagnosed "disease" of health systems. The most obvious symptom is that families face economic ruin and poverty as a consequence of financing their health care. Mexico was one of the first countries to diagnose the problem, attribute it to lack of financial protection, and propose systemic therapy through health reform. In this article we assess how Mexico turned evidence on catastrophic and impoverishing health spending into a catalyst for institutional renovation through the reform that created Seguro Popular (Popular Health Insurance). We present 15-year trends on the evolution of catastrophic and impoverishing health spending, including evidence on how the situation is improving. The results of the Mexican experience suggest an important role for the organisation and financing of the health system in reducing impoverishment and protecting households during periods of individual and collective financial crisis. PMID:17113432

  1. [Evidence is good for your health system: policy reform to remedy catastrophic and impoverishing health spending in Mexico].

    PubMed

    Knaul, Felicia Marie; Arreola-Ornelas, Héctor; Méndez-Carniado, Oscar; Bryson-Cahn, Chloe; Barofsky, Jeremy; Maguire, Rachel; Miranda, Martha; Sesma, Sergio

    2007-01-01

    Absence of financial protection in health is a recently diagnosed "disease" of health systems. The most obvious symptom is that families face economic ruin and poverty as a consequence of financing their health care. Mexico was one of the first countries to diagnose the problem, attribute it to lack of financial protection, and propose systemic therapy through health reform. In this article we assess how Mexico turned evidence on catastrophic and impoverishing health spending into a catalyst for institutional renovation through the reform that created Seguro Popular de Salud (Popular Health Insurance). We present 15-year trends on the evolution of catastrophic and impoverishing health spending, including evidence on how the situation is improving. The results of the Mexican experience suggest an important role for the organisation and financing of the health system in reducing impoverishment and protecting households during periods of individual and collective financial crisis. PMID:17469400

  2. 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. PMID:25293869

  3. 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

  4. The road against fatalities: infrastructure spending vs. regulation??

    PubMed

    Albalate, Daniel; Fernández, Laura; Yarygina, Anastasiya

    2013-10-01

    The road safety literature is typified by a high degree of compartmentalization between studies that focus on infrastructure and traffic conditions and those devoted to the evaluation of public policies and regulations. As a result, few studies adopt a unified empirical framework in their attempts at evaluating the road safety performance of public interventions, thus limiting our understanding of successful strategies in this regard. This paper considers both types of determinants in an analysis of a European country that has enjoyed considerable success in reducing road fatalities. After constructing a panel data set with road safety outcomes for all Spanish provinces between 1990 and 2009, we evaluate the role of the technical characteristics of infrastructure and recent infrastructure spending together with the main regulatory changes introduced. Our results show the importance of considering both types of determinants in a unified framework. Moreover, we highlight the importance of maintenance spending given its effectiveness in reducing fatalities and casualties in the current economic context of austerity that is having such a marked impact on investment efforts in Spain. PMID:23816806

  5. Combined robotic-aided gait training and 3D gait analysis provide objective treatment and assessment of gait in children and adolescents with Acquired Hemiplegia.

    PubMed

    Molteni, Erika; Beretta, Elena; Altomonte, Daniele; Formica, Francesca; Strazzer, Sandra

    2015-08-01

    To evaluate the feasibility of a fully objective rehabilitative and assessment process of the gait abilities in children suffering from Acquired Hemiplegia (AH), we studied the combined employment of robotic-aided gait training (RAGT) and 3D-Gait Analysis (GA). A group of 12 patients with AH underwent 20 sessions of RAGT in addition to traditional manual physical therapy (PT). All the patients were evaluated before and after the training by using the Gross Motor Function Measures (GMFM), the Functional Assessment Questionnaire (FAQ), and the 6 Minutes Walk Test. They also received GA before and after RAGT+PT. Finally, results were compared with those obtained from a control group of 3 AH children who underwent PT only. After the training, the GMFM and FAQ showed significant improvement in patients receiving RAGT+PT. GA highlighted significant improvement in stance symmetry and step length of the affected limb. Moreover, pelvic tilt increased, and hip kinematics on the sagittal plane revealed statistically significant increase in the range of motion during the hip flex-extension. Our data suggest that the combined program RAGT+PT induces improvements in functional activities and gait pattern in children with AH, and it demonstrates that the combined employment of RAGT and 3D-GA ensures a fully objective rehabilitative program. PMID:26737310

  6. A graphical judgmental aid which summarizes obtained and chance reliability data and helps assess the believability of experimental effects

    PubMed Central

    Birkimer, John C.; Brown, Joseph H.

    1979-01-01

    Interval by interval reliability has been criticized for “inflating” observer agreement when target behavior rates are very low or very high. Scored interval reliability and its converse, unscored interval reliability, however, vary as target behavior rates vary when observer disagreement rates are constant. These problems, along with the existence of “chance” values of each reliability which also vary as a function of response rate, may cause researchers and consumers difficulty in interpreting observer agreement measures. Because each of these reliabilities essentially compares observer disagreements to a different base, it is suggested that the disagreement rate itself be the first measure of agreement examined, and its magnitude relative to occurrence and to nonoccurrence agreements then be considered. This is easily done via a graphic presentation of the disagreement range as a bandwidth around reported rates of target behavior. Such a graphic presentation summarizes all the information collected during reliability assessments and permits visual determination of each of the three reliabilities. In addition, graphing the “chance” disagreement range around the bandwidth permits easy determination of whether or not true observer agreement has likely been demonstrated. Finally, the limits of the disagreement bandwidth help assess the believability of claimed experimental effects: those leaving no overlap between disagreement ranges are probably believable, others are not. PMID:16795609

  7. 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

  8. 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/ ...

  9. How the biodiversity sciences may aid biological tools and ecological engineering to assess the impact of climatic changes.

    PubMed

    Morand, S; Guégan, J-F

    2008-08-01

    This paper addresses how climate changes interact with other global changes caused by humans (habitat fragmentation, changes in land use, bioinvasions) to affect biodiversity. Changes in biodiversity at all levels (genetic, population and community) affect the functioning of ecosystems, in particular host-pathogen interactions, with major consequences in health ecology (emergence and re-emergence; the evolution of virulence and resistance). In this paper, the authors demonstrate that the biodiversity sciences, epidemiological theory and evolutionary ecology are indispensable in assessing the impact of climate changes, and also for modelling the evolution of host-pathogen interactions in a changing environment. The next step is to apply health ecology to the science of ecological engineering. PMID:18819665

  10. CYANOBACTERIA AND CYANOTOXINS IN WATER SUPPLY RESERVOIRS – TO DEVELOP AND VALIDATE A MICROARRAY TO TEST FOR CYANOBACTERIA AND CYANOTOXIN GENES IN DRINKING WATER RESERVOIRS AS AN AID TO RISK ASSESSMENT AND MANAGEMENT OF WATER SUPPLIES

    EPA Science Inventory

    The objective of this study is to develop a microarray to test for cyanobacteria and cyanotoxin genes in drinking water reservoirs as an aid to risk assessment and manages of water supplies. The microarray will include probes recognizing important freshwater cyanobacterial tax...

  11. 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

  12. Assessing the utility of an anti-malarial pharmacokinetic-pharmacodynamic model for aiding drug clinical development

    PubMed Central

    2012-01-01

    Background Mechanistic within-host models relating blood anti-malarial drug concentrations with the parasite-time profile help in assessing dosing schedules and partner drugs for new anti-malarial treatments. A comprehensive simulation study to assess the utility of a stage-specific pharmacokinetic-pharmacodynamic (PK-PD) model for predicting within-host parasite response was performed. Methods Three anti-malarial combination therapies were selected: artesunate-mefloquine, dihydroartemisinin-piperaquine, and artemether-lumefantrine. The PK-PD model included parameters to represent the concentration-time profiles of both drugs, the initial parasite burden and distribution across the parasite life cycle, and the parasite multiplication factor due to asexual reproduction. The model also included the maximal killing rate of each drug, and the blood drug concentration associated with half of that killing effect (in vivo EC50), derived from the in vitro IC50, the extent of binding to 0.5% Albumax present in the in vitro testing media, and the drugs plasma protein binding and whole blood to plasma partitioning ratio. All stochastic simulations were performed using a Latin-Hypercube-Sampling approach. Results The simulations demonstrated that the proportion of patients cured was highly sensitive to the in vivo EC50 and the maximal killing rate of the partner drug co-administered with the artemisinin derivative. The in vivo EC50 values that corresponded to on average 95% of patients cured were much higher than the adjusted values derived from the in vitro IC50. The proportion clinically cured was not strongly influenced by changes in the parameters defining the age distribution of the initial parasite burden (mean age of 4 to 16 hours) and the parasite multiplication factor every life cycle (ranging from 8 to 12 fold/cycle). The median parasite clearance times, however, lengthened as the standard deviation of the initial parasite burden increased (i.e. the infection became

  13. A GIS-Aided Assessment of the Health Hazards of Cadmium in Farm Soils in Central Taiwan

    PubMed Central

    Chiang, Po-Huang; Chan, Ta-Chien; Hsieh, Dennis P. H.

    2011-01-01

    A geostatistical method was developed to examine the correlation, or lack of it, between the levels of cadmium (Cd) detected in farm soils and those detected in the human specimens collected from residents around the contaminated areas in Changhua County where cadmium contamination of staple rice has been documented. We used the Taiwan EPA environment data in 2002 and human data which were generated by the National Health Research Institutes during 2003–2005. Kriging interpolation methods were used to determine soil Cd concentrations. A Zonal statistical function was performed to assess the individual exposure. Soil Cd levels and tissue Cd levels in residents were analyzed for contamination hotspots and other areas to determine correlation between the two variables. Three Cd contamination hotspots were identified, in which no correlation was found between soil Cd levels and tissue Cd levels in residents. Our results demonstrate how GIS spatial modeling technique can be used to estimate distribution of pollutants in an area using a limited number of data points. Results indicated no association between the soil contamination and the exposure of residents to Cd, suggesting that both the soils and the residents are receptors of Cd as a pollutant from as yet unidentified sources. PMID:22016714

  14. 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.

  15. 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.

  16. Physician spending and subsequent risk of malpractice claims: observational study

    PubMed Central

    Schoemaker, Lena; Bhattacharya, Jay; Seabury, Seth A

    2015-01-01

    Study question Is a higher use of resources by physicians associated with a reduced risk of malpractice claims? Methods Using data on nearly all admissions to acute care hospitals in Florida during 2000-09 linked to malpractice history of the attending physician, this study investigated whether physicians in seven specialties with higher average hospital charges in a year were less likely to face an allegation of malpractice in the following year, adjusting for patient characteristics, comorbidities, and diagnosis. To provide clinical context, the study focused on obstetrics, where the choice of caesarean deliveries are suggested to be influenced by defensive medicine, and whether obstetricians with higher adjusted caesarean rates in a year had fewer alleged malpractice incidents the following year. Study answer and limitations The data included 24 637 physicians, 154 725 physician years, and 18 352 391 hospital admissions; 4342 malpractice claims were made against physicians (2.8% per physician year). Across specialties, greater average spending by physicians was associated with reduced risk of incurring a malpractice claim. For example, among internists, the probability of experiencing an alleged malpractice incident in the following year ranged from 1.5% (95% confidence interval 1.2% to 1.7%) in the bottom spending fifth ($19 725 (£12 800; €17 400) per hospital admission) to 0.3% (0.2% to 0.5%) in the top fifth ($39 379 per hospital admission). In six of the specialties, a greater use of resources was associated with statistically significantly lower subsequent rates of alleged malpractice incidents. A principal limitation of this study is that information on illness severity was lacking. It is also uncertain whether higher spending is defensively motivated. What this study adds Within specialty and after adjustment for patient characteristics, higher resource use by physicians is associated with fewer malpractice claims. Funding, competing

  17. 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

  18. 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

  19. 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

  20. Soil erosion and non-point source pollution impacts assessment with the aid of multi-temporal remote sensing images.

    PubMed

    Ning, Shu-Kuang; Chang, Ni-Bin; Jeng, Kai-Yu; Tseng, Yi-Hsing

    2006-04-01

    Soil erosion associated with non-point source pollution is viewed as a process of land degradation in many terrestrial environments. Careful monitoring and assessment of land use variations with different temporal and spatial scales would reveal a fluctuating interface, punctuated by changes in rainfall and runoff, movement of people, perturbation from environmental disasters, and shifts in agricultural activities and cropping patterns. The use of multi-temporal remote sensing images in support of environmental modeling analysis in a geographic information system (GIS) environment leading to identification of a variety of long-term interactions between land, resources, and the built environment has been a highly promising approach in recent years. This paper started with a series of supervised land use classifications, using SPOT satellite imagery as a means, in the Kao-Ping River Basin, South Taiwan. Then, it was designed to differentiate the variations of eight land use patterns in the past decade, including orchard, farmland, sugarcane field, forest, grassland, barren, community, and water body. Final accuracy was confirmed based on interpretation of available aerial photographs and global positioning system (GPS) measurements. Finally, a numerical simulation model (General Watershed Loading Function, GWLF) was used to relate soil erosion to non-point source pollution impacts in the coupled land and river water systems. Research findings indicate that while the decadal increase in orchards poses a significant threat to water quality, the continual decrease in forested land exhibits a potential impact on water quality management. Non-point source pollution, contributing to part of the downstream water quality deterioration of the Kao-Ping River system in the last decade, has resulted in an irreversible impact on land integrity from a long-term perspective. PMID:16182435

  1. [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. PMID:26840813

  2. 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.

  3. 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. PMID:26732315

  4. Health spending, access, and outcomes: trends in industrialized countries.

    PubMed

    Anderson, G F; Poullier, J P

    1999-01-01

    In 1997 the United States spent $3,925 per capita on health or 13.5 percent of gross domestic product (GDP), while the median Organization for Economic Cooperation and Development (OECD) country spent $1,728 or 7.5 percent. From 1990 to 1997 U.S. health spending per capita increased 4.3 percent per year, compared with the OECD median of 3.8 percent. The United States has the lowest percentage of the population with government-assured health insurance. It also has the fewest hospital days per capita, the highest hospital expenditures per day, and substantially higher physician incomes than the other OECD countries. On the available outcome measures, the United States is generally in the bottom half, and its relative ranking has been declining since 1960. PMID:10388215

  5. The derivation and application of a risk related value of the spend for saving a statistical life.

    PubMed

    Jackson, D; Stone, D; Butler, G G; McGlynn, G

    2004-03-01

    The concept of a risk related value of the spend for saving a statistical life (VSSSL) is advanced for use in cost-benefit studies across the power generation sector, and the nuclear industry in particular. For illustrative purposes, a best estimate VSSSL is set based on HSE guidance at 2 M pounds. Above a risk of 10(-3) y(-1) it is assumed that the VSSSL may approach this maximum sustainable value. As the risk reduces so does the VSSSL. At a risk level of 10(-6) y(-1) a VSSSL of 0.5 M pounds is applied. For risks below 10(-9) y(-1) the value of further risk reduction approaches zero, although a nominal VSSSL of 10 k pounds is applied as a pragmatic way forward in this study. The implications of adopting this concept as an aid to decision making in determining the spend on radiological dose reduction measures are illustrated through a worked example with a banded approach to estimating collective dose. PMID:15080548

  6. Design of governmental policies for oil production rates and oil income spending; a long-term perspective

    SciTech Connect

    Moxnes, E.

    1983-01-01

    Norway is a small country with large oil reserves. In 1980, oil production amounted to 1 million barrels per day. Taxes and royalties to the government from this production provided 9% of the GNP. With current estimates of recoverable reserves, the 1980 production rate would last for 100 years. Because potential income is so large, decisions about oil production rates and oil income spending have tremendous impacts on society. The current debate provides a wide variety of policy suggestions. Attempts to design an appropriate oil policy are complicated by much uncertainty about total reserves, future oil prices, and complex economic responses to production and income. This report provides an integrating framework to aid government officials in their evaluation of policy options. A system dynamics model of the Norwegian national economy is developed for the analysis. The model determines endogenously the spending of oil income, GNP, consumption and investments, imports and exports, unemployment, and labor migration from exporting industries to service industries; all variables result from exogenous decisions about oil production.

  7. 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

  8. 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

  9. 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

  10. First-aid supplies for backpacking.

    PubMed Central

    Puretz, S L

    1992-01-01

    A portable first-aid kit should be carried in the backpack of campers, hikers, and anyone who expects to spend time in a remote and unoccupied area. That is the recommendation found in lay texts dealing with medical care, in backpacking books, as well as in articles appearing in popular magazines. It goes without saying that it is far better to practise safety and prevention than to have to use first aid. However, many times medical problems occur which no amount of safety and forethought could have prevented. Information in this paper indicates that hikers are generally well prepared for the health-related problems they encounter. Hikers carry diverse supplies to meet health problems but there are some basic supplies with which hikers start their long-distance sojourn. Those supplies and their usage rates are discussed, as are attitudes toward using the supplies. Images Figure 1 Figure 2 PMID:1600455

  11. Handbook of Student Financial Aid: Programs, Procedures, and Policies.

    ERIC Educational Resources Information Center

    Fenske, Robert H.; And Others

    The full range of topics relevant to student financial aid are covered in this book by a variety of experts in financial aid administration and scholarship. The volume details how to organize, implement and assess a financial aid program--including how to determine student need, deal with student bankruptcy and aid termination, and improve…

  12. 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…

  13. Tighter Link Sought between Spending, Achievement in New York

    ERIC Educational Resources Information Center

    McNeil, Michele

    2007-01-01

    As states look for ways to hold school districts accountable for how they use big increases in K-12 funding, New York's experience may offer a test case in directing the flow of that new money. Under the state's ambitious "Contracts for Excellence" program, 55 of New York's 705 districts will share $430 million in extra aid this school year, but…

  14. 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…

  15. New Software Aids in Assessment

    ERIC Educational Resources Information Center

    Carnevale, Dan

    2007-01-01

    The last time Virginia Commonwealth University had to prepare for an accreditation review, the school's officials found themselves overwhelmed with data. The university's accreditor, the Southern Association of Colleges and Schools, was asking for more information than ever before about how much students were learning: grades, test scores, written…

  16. 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.

  17. 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…

  18. 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…

  19. Is Spending More Hours in Class Better for Learning? PISA in Focus. No. 54

    ERIC Educational Resources Information Center

    OECD Publishing, 2015

    2015-01-01

    There is no real consensus on how much class time is enough when it comes to learning mathematics, science and reading. But educators and policy makers generally agree that while it's important for students to spend considerable time in school lessons to acquire new skills, spending more hours and minutes in class is not enough to ensure that…

  20. 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…

  1. 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

  2. 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

  3. 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

  4. 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...

  5. 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…

  6. State Education Trends: Academic Performance and Spending over the Past 40 Years. Policy Analysis No. 746

    ERIC Educational Resources Information Center

    Coulson, Andrew J.

    2014-01-01

    Long-term trends in academic performance and spending are valuable tools for evaluating past education policies and informing current ones. But such data have been scarce at the state level, where the most important education policy decisions are made. State spending data exist reaching back to the 1960s, but the figures have been scattered across…

  7. Break the Use It or Lose It Cycle: Six Strategies for Curbing Undisciplined Technology Spending

    ERIC Educational Resources Information Center

    McIntire, Todd

    2006-01-01

    In this article, the author presents six strategies for curbing undisciplined technology spending. These are: (1) Scrub budgets clean; (2) Track by objective, not time; (3) Reject unfocused expenditures; (4) Provide incentives to spend under budget; (5) Invest extra funds in useful materials; and (6) Contribute to fund balances. Too often one…

  8. 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…

  9. 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…

  10. Education Spending Faces Demographic and Other Pressures. State Fiscal Brief, No. 38.

    ERIC Educational Resources Information Center

    Liebschutz, David S.; Boyd, Donald J.

    State and local government spending on public elementary and secondary education grew from $40.7 billion in 1970 to an estimated $256.3 billion in 1996, a more than 6-fold increase in 25 years. Even when adjusted for inflation and changes in enrollment, real per-pupil spending still increased 86 percent. This brief examines some of the underlying…

  11. 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.

  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. PMID:23650330

  14. 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...

  15. 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...

  16. 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...

  17. 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...

  18. 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...

  19. The Connection between Macro and Micro Levels: States' Spending for Hospitals and Their Suicide Rates.

    ERIC Educational Resources Information Center

    Zimmerman, Shirley L.

    1990-01-01

    Analyzed states' spending for hospitals and suicide rates in 1960, 1970, 1980, and 1984. Found spending was not directly related to suicide rates until 1984 when it accounted for 5 percent increase in variance. Considered effects of divorce rates, and change, density, economic level, and racial composition of population. Discusses implications of…

  20. Making hard choices easier: a prospective, multicentre study to assess the efficacy of a fertility-related decision aid in young women with early-stage breast cancer

    PubMed Central

    Peate, M; Meiser, B; Cheah, B C; Saunders, C; Butow, P; Thewes, B; Hart, R; Phillips, K-A; Hickey, M; Friedlander, M

    2012-01-01

    Background: Fertility is a priority for many young women with breast cancer. Women need to be informed about interventions to retain fertility before chemotherapy so as to make good quality decisions. This study aimed to prospectively evaluate the efficacy of a fertility-related decision aid (DA). Methods: A total of 120 newly diagnosed early-stage breast cancer patients from 19 Australian oncology clinics, aged 18–40 years and desired future fertility, were assessed on decisional conflict, knowledge, decision regret, and satisfaction about fertility-related treatment decisions. These were measured at baseline, 1 and 12 months, and were examined using linear mixed effects models. Results: Compared with usual care, women who received the DA had reduced decisional conflict (β=−1.51; 95%CI: −2.54 to 0.48; P=0.004) and improved knowledge (β=0.09; 95%CI: 0.01–0.16; P=0.02), after adjusting for education, desire for children and baseline uncertainty. The DA was associated with reduced decisional regret at 1 year (β=−3.73; 95%CI: −7.12 to −0.35; P=0.031), after adjusting for education. Women who received the DA were more satisfied with the information received on the impact of cancer treatment on fertility (P<0.001), fertility options (P=0.005), and rated it more helpful (P=0.002), than those who received standard care. Conclusion: These findings support widespread use of this DA shortly after diagnosis (before chemotherapy) among younger breast cancer patients who have not completed their families. PMID:22415294

  1. Stability of ursodiol in SyrSpend SF Cherry flavored.

    PubMed

    Geiger, Christine M; Voudrie, Mark A; Sorenson, Bridget

    2012-01-01

    Ursodiol is used in the treatment and prevention of certain types of gallstones and for patients with primary biliary cirrhosis. Ursodiol is marketed for this purpose by Watson Pharma, Inc. as ACTIGALL, by Axcan Scandipharm Inc. as URSO 250 and URSO Forte, and by a number of generic manufacturers. Ursodiol is available as capsules of varying strengths. The need for other dose-form options for those patients who cannot take capsules has led compounding pharmacies to seek other alternatives, namely oral solutions and suspensions. Additionally, some patients are unable to tolerate suspending agents containing alcohol or sorbitol. The objective of this study was to determine the stability of ursodiol in SyrSpend SF Cherry Flavored which does not contain sorbitol or alcohol. The studied sample was compounded into a 3-mg/mL [corrected] suspension and stored in a low-actinic plastic bottle at temperatures between 2 degrees C and 8 degrees C. Six samples were assayed at each time point out to 66 days by a stability-indicating high-performance liquid chromatography method. The method was validated for its specificity through forced degradation studies. The sample remained within 90% to 110% of the initial concentration throughout the course of the study. The beyond-use-date of this product is at least 66 days, based on data collected when refrigerated and protected from light. PMID:23259368

  2. Public spending on health care: how are different criteria related?

    PubMed

    Musgrove, P

    1999-06-01

    At least nine different criteria are relevant for decisions about public spending for health care. These include economic efficiency criteria (public goods, externalities, catastrophic cost, and cost-effectiveness), ethical reasons (poverty, horizontal and vertical equity, and the rule of rescue), and political considerations (especially demands by the populace). Sometimes one criterion should be examined before another one is considered; that is, they are hierarchically related. Sometimes two criteria will not be compatible but will conflict, forcing difficult choices--particularly between efficiency and equity. Properly thought-out choices of which health care interventions to finance with public funds therefore depend not only on looking at all these criteria, but also on treating them in the appropriate sequence and taking account of their possible inconsistencies. Public funds should finance public and semi-public goods that are cost-effective and for which demand is inadequate; cost-effective interventions that preferentially benefit the poor; and catastrophically costly care, when contributory insurance will not work or there are good reasons to finance insurance publicly. PMID:10538919

  3. Controlling health care spending: unintended consequences of a fragmented approach.

    PubMed

    Nissenson, A R

    1996-07-01

    Health care policy decisions in Washington are being driven almost entirely by budget considerations and Presidential politics. The public programs, Medicare and Medicaid, have been targeted for drastic cuts ("decreases in growth"), which could have devastating effects on the millions of people who rely on the services provided through these programs, including patients with end-stage renal disease (ESRD). Very little is being said about the overall growth of health care spending, with private sector growth continuing to outpace general inflation. Fragmenting the approach to health care reform, focusing only on the public programs, could lead to significant unintended consequences in the system as a whole, including less affordable health insurance and increasing numbers of uninsured. For nephrology, significant reforms should be developed and promoted by health professionals to assure the viability of the ESRD program, and the continued delivery of the highest quality care to ESRD patients. These should include: management of demand for dialysis services; enactment of health insurance reform; active participation in the growth of managed care in the ESRD area, and the HCFA Demonstration Project of ESRD Capitation; reexamination of the role of home dialysis, particularly home hemodialysis; development of new care delivery paradigms, including the expanded use of physician extenders. PMID:8827197

  4. 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…

  5. 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…

  6. The Impact of Grants-in-Aid on State and Local Education Expenditures.

    ERIC Educational Resources Information Center

    Barro, Stephen M.

    This document presents a model for predicting (1) school district spending per pupil, and (2) the effect of alternative forms of school aid. Constrained maximization equations take account of (1) real expenditure per pupil; (2) real school taxes, income taxes, and nonschool property taxes per household; and (3) homeowner's proportion of property…

  7. 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

  8. 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 ...

  9. Heart attack first aid

    MedlinePlus

    First aid - heart attack; First aid - cardiopulmonary arrest; First aid - cardiac arrest ... A heart attack occurs when the blood flow that carries oxygen to the heart is blocked. The heart muscle ...

  10. 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 ...

  11. 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 ...

  12. Unconsciousness - first aid

    MedlinePlus

    Loss of consciousness - first aid; Coma - first aid; Mental status change; Altered mental status ... has a change in mental status, follow these first aid steps: Call or tell someone to call 911 . ...

  13. 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.

  14. 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

  15. 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.…

  16. 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. PMID:22081798

  17. 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

  18. 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. PMID:11362526

  19. Large increases in spending on postacute care in Medicare point to the potential for cost savings in these settings.

    PubMed

    Chandra, Amitabh; Dalton, Maurice A; Holmes, Jonathan

    2013-05-01

    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

  20. 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

  1. 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

  2. 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. PMID:27042347

  3. If slow rate of health care spending growth persists, projections may be off by $770 billion.

    PubMed

    Cutler, David M; Sahni, Nikhil R

    2013-05-01

    Despite earlier forecasts to the contrary, US health care spending growth has slowed in the past four years, continuing a trend that began in the early 2000s. In this article we attempt to identify why US health care spending growth has slowed, and we explore the spending implications if the trend continues for the next decade. We find that the 2007-09 recession, a one-time event, accounted for 37 percent of the slowdown between 2003 and 2012. A decline in private insurance coverage and cuts to some Medicare payment rates accounted for another 8 percent of the slowdown, leaving 55 percent of the spending slowdown unexplained. We conclude that a host of fundamental changes--including less rapid development of imaging technology and new pharmaceuticals, increased patient cost sharing, and greater provider efficiency--were responsible for the majority of the slowdown in spending growth. If these trends continue during 2013-22, public-sector health care spending will be as much as $770 billion less than predicted. Such lower levels of spending would have an enormous impact on the US economy and on government and household finances. PMID:23650316

  4. Traditional Medicare Versus Private Insurance: How Spending, Volume, And Price Change At Age Sixty-Five.

    PubMed

    Wallace, Jacob; Song, Zirui

    2016-05-01

    To slow the growth of Medicare spending, some policy makers have advocated raising the Medicare eligibility age from the current sixty-five years to sixty-seven years. For the majority of affected adults, this would delay entry into Medicare and increase the time they are covered by private insurance. Despite its policy importance, little is known about how such a change would affect national health care spending, which is the sum of health care spending for all consumers and payers-including governments. We examined how spending differed between Medicare and private insurance using longitudinal data on imaging and procedures for a national cohort of individuals who switched from private insurance to Medicare at age sixty-five. Using a regression discontinuity design, we found that spending fell by $38.56 per beneficiary per quarter-or 32.4 percent-upon entry into Medicare at age sixty-five. In contrast, we found no changes in the volume of services at age sixty-five. For the previously insured, entry into Medicare led to a large drop in spending driven by lower provider prices, which may reflect Medicare's purchasing power as a large insurer. These findings imply that increasing the Medicare eligibility age may raise national health care spending by replacing Medicare coverage with private insurance, which pays higher provider prices than Medicare does. PMID:27140993

  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. PMID:26975128

  6. Ten-year trends in quality and spending for depression: 1996-2005

    PubMed Central

    Fullerton, Catherine A.; Busch, Alisa B.; Normand, Sharon-Lise T.; McGuire, Thomas G.; Epstein, Arnold M.

    2016-01-01

    Context Over the past decade, the introduction of generic versions of newer antidepressants and the release of FDA-warnings regarding suicidality in children, adolescents, and young adults may have had an impact on cost and quality of depression treatment. Objectives To examine longitudinal trends in service use, spending, and treatment quality for depression. Design Observational, trend study. Setting Florida, Medicaid enrollees from July 1996 to June 2006. Subjects Annual cohorts aged 18-64 diagnosed with depression. Main Outcome Measures Mental-health spending adjusted for inflation and case mix and components of mental-health spending, including inpatient, outpatient, and medication expenditures. Quality measures included measures of medication adherence, psychotherapy, and follow-up visits. Results Mental-health spending increased from an average of $2802 per enrollee to $3610 over this time period (29% increase). This increase occurred despite a mean decrease in inpatient spending (from $641 per enrollee to $373) and was driven primarily by an increase in pharmaceutical spending (up 110%) the bulk of which was due to spending on antipsychotics (up 949%). The percentage of enrollees with depression who were hospitalized decreased from 57% to 37% and the percentage using psychotherapy decreased from 9% to 5%. Antidepressant use increased from 82% to 87%, anxiety medication use was unchanged at 64%, and antipsychotic use increased from 27% to 42%. Changes in treatment quality were mixed, with measures of antidepressant use improving slightly, measures examining follow-up visits decreasing, and measures of psychotherapy utilization fluctuating. Conclusions Over a ten-year period, we found a substantial increase in spending for enrollees with depression associated with minimal improvements in quality of care. Antipsychotic use contributed significantly to the increase in spending while contributing little to traditional measures of quality. PMID:22147841

  7. AIDS: Education's New Dilemma.

    ERIC Educational Resources Information Center

    Freeland, D. Kay; Faber, Charles F.

    The acquired immune deficiency syndrome (AIDS) is an incurable, fatal disease that is caused by a virus that eventually destroys the body's immune system. While AIDS is contagious, the risk of contracting AIDS through casual contact is said to be negligible. A review of the court cases involving students with AIDS reveals that the precedent has…

  8. It's the recipient that counts: spending money on strong social ties leads to greater happiness than spending on weak social ties.

    PubMed

    Aknin, Lara B; Sandstrom, Gillian M; Dunn, Elizabeth W; Norton, Michael I

    2011-01-01

    Previous research has shown that spending money on others (prosocial spending) increases happiness. But, do the happiness gains depend on who the money is spent on? Sociologists have distinguished between strong ties with close friends and family and weak ties--relationships characterized by less frequent contact, lower emotional intensity, and limited intimacy. We randomly assigned participants to reflect on a time when they spent money on either a strong social tie or a weak social tie. Participants reported higher levels of positive affect after recalling a time they spent on a strong tie versus a weak tie. The level of intimacy in the relationship was more important than the type of relationship; there was no significant difference in positive affect after recalling spending money on a family member instead of a friend. These results add to the growing literature examining the factors that moderate the link between prosocial behaviour and happiness. PMID:21347326

  9. 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

  10. The master hearing aid.

    PubMed

    Curran, James R; Galster, Jason A

    2013-06-01

    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

  11. 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

  12. Children, Teachers and the AIDS Curriculum.

    ERIC Educational Resources Information Center

    Silin, Jonathan G.

    For schools, acquired immune deficiency syndrome (AIDS) initially represented a policy problem requiring legal and public health experts to assess their ability to exclude students or staff infected with the human immuno-deficiency virus. As the crisis over the potential presence of people with AIDS in the schools abated and with the growing…

  13. 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…

  14. Student Financial Aid and Women. ERIC Digest.

    ERIC Educational Resources Information Center

    Moran, Mary

    The impact of student aid policies on women is assessed. Patterns of enrollment and economic profiles differ for male and female students. Women, for example, far surpass men as adult, part-time, independent, and unclassified students, the categories most likely to present barriers to participating in most financial aid programs. Gender issues in…

  15. An Assessment of Emergency School Aid Act (ESAA) Program Operations. Volume I: The Targeting of ESAA Grants and Grant Funds, and Volume II: The Focus of ESAA Projects.

    ERIC Educational Resources Information Center

    Smith, Stephen M.

    As part of a larger study, volume I of this report describes the results of analyses of the extent to which Emergency School Aid Act (ESAA) program grants and grant funds have been focused on school districts with desegregation-related needs. Also described is the extent to which the Act, regulations, and program processes influence the focusing…

  16. 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

  17. Fact File: Top 100 Institutions in Total Research-and-Development Spending, Fiscal 1990.

    ERIC Educational Resources Information Center

    Chronicle of Higher Education, 1992

    1992-01-01

    This table lists the top 100 United States academic institutions by dollar amounts and rank in spending on research and development during fiscal 1990. Research and development amounts are given in U.S. funds and total funds. (DB)

  18. Some Neglected Economic Factors behind Recent Tax and Spending Limitation Movements.

    ERIC Educational Resources Information Center

    Boskin, Michael J.

    1979-01-01

    The demand for tax and spending limitations is caused primarily by the generally unrecognized complete lack of growth in real private income since 1973. Journal availability: see EA 511 898. (Author/IRT)

  19. 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

  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. Systems GMM estimates of the health care spending and GDP relationship: a note.

    PubMed

    Kumar, Saten

    2013-06-01

    This paper utilizes the systems generalized method of moments (GMM) [Arellano and Bover (1995) J Econometrics 68:29-51; Blundell and Bond (1998) J Econometrics 87:115-143], and panel Granger causality [Hurlin and Venet (2001) Granger Causality tests in panel data models with fixed coefficients. Mime'o, University Paris IX], to investigate the health care spending and gross domestic product (GDP) relationship for organisation for economic co-operation and development countries over the period 1960-2007. The system GMM estimates confirm that the contribution of real GDP to health spending is significant and positive. The panel Granger causality tests imply that a bi-directional causality exists between health spending and GDP. To this end, policies aimed at raising health spending will eventually improve the well-being of the population in the long run. PMID:22581267

  2. The Relationship of Health Aid to Population Health Improvements

    PubMed Central

    Bendavid, Eran; Bhattacharya, Jay

    2016-01-01

    Importance Foreign aid to the health sector is an important component of all health spending in many developing countries. The relationship between health aid and changes in population health among aid recipients remains unknown. Objective To quantify the relationship between health aid and changes in life expectancy and under-5 mortality among aid recipient nations. Design Cross-country panel data analysis of the relationship between longitudinal measures of health aid, life expectancy, and under-5 mortality. Using difference models for longitudinal data with fixed effects for countries and years, we estimate the unique relationship between health aid and changes in life expectancy and under-5 mortality, controlling for gross domestic product per capita, urbanization, and total fertility rate. Setting and participants 140 aid-recipient countries between 1974 and 2010. Main Exposures and Outcomes and Measures The main exposure is the annual amount of development assistance directed to the health sector in constant 2010 US dollars; the principal outcomes are the improvements in under-5 mortality and life expectancy in in the period following aid receipt. Results We find that between 1974 and 2010, life expectancy increased by 0.24 months faster (95% CI 0.02-0.46, p=0.03) and under-5 mortality declined by 0.14 per 1,000 live births faster (95% CI 0.02-0.26, p=0.02) with each 1% increase in health aid. We also find that the association between health aid and health improvements has been strengthening over time, with the closest association between 2000 and 2010. We find that health improvements associated with health aid are measurable for 3-5 years after aid disbursement. These findings imply that an increase of $1 billion in health aid could be associated with 364,800 (95% CI 98,400-630,000) fewer under-5 deaths. Conclusions Foreign aid to the health sector is related to increasing life expectancy and declining under-5 mortality. The returns to aid appear to last

  3. Budget transparency on maternal health spending: a case study in five Latin American countries.

    PubMed

    Malajovich, Laura; Alcalde, Maria Antonieta; Castagnaro, Kelly; Barroso, Carmen

    2012-06-01

    Progress in reducing maternal mortality has been slow and uneven, including in Latin America, where 23,000 women die each year from preventable causes. This article is about the challenges civil society organizations in Latin America faced in assessing budget transparency on government spending on specific aspects of maternity care, in order to hold them accountable for reducing maternal deaths. The study was carried out by the International Planned Parenthood, Western Hemisphere Region and the International Budget Partnership in five Latin American countries--Costa Rica, El Salvador, Guatemala, Panama and Peru. It found that only in Peru was most of the information they sought available publicly (from a government website). In the other four countries, none of the information was available publicly, and although it was possible to obtain at least some data from ministry and health system sources, the search process often took a complex course. The data collected in each country were very different, depending not only on the level of budget transparency, but also on the existence and form of government data collection systems. The obstacles that these civil society organizations faced in monitoring national and local budget allocations for maternal health must be addressed through better budgeting modalities on the part of governments. Concrete guidelines are also needed for how governments can better capture data and track local and national progress. PMID:22789097

  4. Chernobyl team seeks aid for fallout cleanup studies

    SciTech Connect

    Not Available

    1993-10-18

    British nuclear experts have begun raising international aid agency interest in financing studies into cleaning up vast areas of the Ukraine still contaminated with fallout from the Chernobyl reactor explosion in April 1986. In a new 11-month investigation of the area outside an 18.6-mile radius of Chernobyl, the experts identified 80 necessary studies estimated to cost $62 million. [open quotes]That's just to get the system up and running. The total cost is much larger, but the authors don't yet know how much,[close quotes] says investigation coordinator Alan Eggleton of AEA Technology Ltd., Harwell, which led the study team. According to the report, radioactivity contaminated 19,000 sq miles of the Ukraine. The government is now spending some 12% of its income on mitigating the contamination, although most spending is for victim compensation and resettlement.

  5. Culturally sensitive AIDS education and perceived AIDS risk knowledge: reaching the "know-it-all" teenager.

    PubMed

    Stevenson, H C; Gay, K M; Josar, L

    1995-04-01

    Video education is the most popular and effective medium for informing the adolescent population. This study investigated the impact of a culturally relevant HIV/AIDS video education. One hundred and ninety-four African-American teenagers were assigned to either a culturally sensitive or culturally dissimilar video education intervention. Results indicate that both interventions were effective in increasing AIDS knowledge scores. An interaction effect was found between levels of perceived AIDS risk knowledge and participation in the culturally sensitive intervention (CSV). Only the CSV intervention was effective with adolescents who claimed to "know a lot" about AIDS (e.g., "Know-It-All" subgroup). Students in both conditions who were worried about getting AIDS demonstrated higher AIDS risk knowledge at post-assessment. This study provides further evidence of within-ethnicity diversity among African-American youth and for developing culture- and subgroup-specific HIV/AIDS education. PMID:7542465

  6. 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…

  7. 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. PMID:26539979

  8. Clinical Criteria for Physician Aid in Dying

    PubMed Central

    Pope, Thaddeus Mason; Rich, Ben A.

    2016-01-01

    Abstract 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. PMID:26539979

  9. 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.

  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. U.S., non-U.S. outlays to rise in `98, but oil price plunge clouds spending outlook

    SciTech Connect

    Beck, R.J.

    1998-03-23

    Capital spending by oil and gas companies in and outside the US will rise in 1998, but that forecast may be jeopardized by the continuing plunge in oil prices. For operations in the US, oil and gas company capital spending is expected to move up in 1998 for the fourth year in a row. If the money is spent, it will be the highest industry investment level since 1985. Strong oil and gas prices and increased volumes have boosted company cash flow and profits the last few years, fueling increased spending. However, the near-term outlook has now been clouded by economic turmoil in a number of Asian countries and the recent collapse of oil prices. The paper discusses oil and gas prices, US upstream spending, US non-exploration and production spending, capital spending in Canada, and spending outside US and Canada.

  12. HIV/AIDS

    MedlinePlus

    ... at risk for serious infections and certain cancers. AIDS stands for acquired immunodeficiency syndrome. It is the final stage of infection with HIV. Not everyone with HIV develops AIDS. HIV most often spreads through unprotected sex with ...

  13. How HIV Causes AIDS

    MedlinePlus

    ... Share this: Main Content Area How HIV Causes AIDS HIV destroys CD4 positive (CD4+) T cells, which ... and disease, ultimately resulting in the development of AIDS. Most people who are infected with HIV can ...

  14. AIDS Myths and Misunderstandings

    MedlinePlus

    ... 21, 2014 Select a Language: Fact Sheet 158 AIDS Myths and Misunderstandings WHY ARE THERE SO MANY ... support this belief. Myth: Current medications can cure AIDS. It’s no big deal if you get infected. ...

  15. HIV/AIDS

    MedlinePlus

    ... immunodeficiency virus (HIV) is the virus that causes AIDS. When a person becomes infected with HIV, the ... cancers. When that happens, the illness is called AIDS. Once a person has the virus, it stays ...

  16. Frostbite, First Aid

    MedlinePlus

    ... and rashes clinical tools newsletter | contact Share | Frostbite, First Aid A A A Severe frostbite can result in ... became frozen). Frostbite is often associated with hypothermia. First Aid Guide In the case of mild frostbite, the ...

  17. Poisoning first aid

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/007579.htm Poisoning first aid To use the sharing features on this page, ... or burns Stupor Unconsciousness Unusual breath odor Weakness First Aid Seek immediate medical help. For poisoning by swallowing: ...

  18. Head injury - first aid

    MedlinePlus

    ... medlineplus.gov/ency/article/000028.htm Head injury - first aid To use the sharing features on this page, ... a concussion can range from mild to severe. First Aid Learning to recognize a serious head injury and ...

  19. Heat Exhaustion, First Aid

    MedlinePlus

    ... rashes clinical tools newsletter | contact Share | Heat Exhaustion, First Aid A A A Heat exhaustion signs and symptoms ... specific to the other stages of heat illness. First Aid Guide Use a combination of the following measures ...

  20. Heat Cramps, First Aid

    MedlinePlus

    ... rashes clinical tools newsletter | contact Share | Heat Cramps, First Aid A A A Heat cramp signs and symptoms ... if later stages of heat illness are suspected. First Aid Guide Use a combination of the following measures, ...

  1. Heatstroke, First Aid

    MedlinePlus

    ... and rashes clinical tools newsletter | contact Share | Heatstroke, First Aid A A A Heatstroke signs and symptoms can ... specific to the earlier stages of heat illness. First Aid Guide When heatstroke is suspected, seek emergency medical ...

  2. Bruises, First Aid

    MedlinePlus

    ... and rashes clinical tools newsletter | contact Share | Bruises, First Aid A A A Bruises lighten and change color ... Bruises can be a sign of internal bleeding. First Aid Guide If there is external bleeding in addition ...

  3. Tick Bites, First Aid

    MedlinePlus

    ... rashes clinical tools newsletter | contact Share | Tick Bites, First Aid A A A It is important to inspect ... temporary paralysis in their host (called tick paralysis). First Aid Guide To remove an embedded tick: Wash your ...

  4. First Aid: Influenza (Flu)

    MedlinePlus

    ... to Know About Zika & Pregnancy First Aid: The Flu KidsHealth > For Parents > First Aid: The Flu Print ... tiredness What to Do If Your Child Has Flu Symptoms: Call your doctor. Encourage rest. Keep your ...

  5. MICROFICHE AIDS DATA

    EPA Science Inventory

    This data set contains counts of AIDS (Acquired Immune Deficiency Syndrome) cases reported to state and local health departments, by demographics; case-definition; HIV exposure group (risk factors for AIDS); Half-year of diagnosis, report, and death.

  6. Does Need-Based Student Aid Discourage Saving for College?

    ERIC Educational Resources Information Center

    Case, Karl E.; McPherson, Michael S.

    The question of whether the availability of need-based student financial aid reduces the applicant families' incentives to save and work was assessed. Changes in the need-based aid system are also suggested. Need-based aid systems compute a family's ability to pay for college from information on the family's income and assets at the time a student…

  7. Designing State Aid Formulas

    ERIC Educational Resources Information Center

    Zhao, Bo; Bradbury, Katharine

    2009-01-01

    This paper designs a new equalization-aid formula based on fiscal gaps of local communities. When states are in transition to a new local aid formula, the issue of whether and how to hold existing aid harmless poses a challenge. The authors show that some previous studies and the formulas derived from them give differential weights to existing and…

  8. Hearing-aid tester

    NASA Technical Reports Server (NTRS)

    Kessinger, R.; Polhemus, J. T.; Waring, J. G.

    1977-01-01

    Hearing aids are automatically checked by circuit that applies half-second test signal every thirty minutes. If hearing-aid output is distorted, too small, or if battery is too low, a warning lamp is activated. Test circuit is incorporated directly into hearing-aid package.

  9. HIV and AIDS

    MedlinePlus

    ... I Help a Friend Who Cuts? HIV and AIDS KidsHealth > For Teens > HIV and AIDS Print A A A Text Size What's in ... in human history. HIV causes a condition called acquired immunodeficiency syndrome — better known as AIDS . HIV destroys a type ...

  10. AIDS Education Curriculum Guide.

    ERIC Educational Resources Information Center

    Horry County Board of Education, Conway, SC.

    This curriculum guide was developed, based on sound principles of human growth and development, to present the most recently available information on AIDS (Acquired Immune Deficiency Syndrome). The curriculum presents information on the known facts about AIDS and the AIDS virus infection. It also addresses the potential for adolescents and adults…

  11. First Aid: Rashes

    MedlinePlus

    ... Story" 5 Things to Know About Zika & Pregnancy First Aid: Rashes KidsHealth > For Parents > First Aid: Rashes Print A A A Text Size Rashes ... For Kids For Parents MORE ON THIS TOPIC First Aid: Skin Infections Poison Ivy Erythema Multiforme Hives (Urticaria) ...

  12. First Aid: Burns

    MedlinePlus

    ... Story" 5 Things to Know About Zika & Pregnancy First Aid: Burns KidsHealth > For Parents > First Aid: Burns Print A A A Text Size Scald ... THIS TOPIC Kitchen: Household Safety Checklist Fireworks Safety First Aid: Sunburn Firesetting Fire Safety Burns Household Safety: Preventing ...

  13. First Aid: Croup

    MedlinePlus

    ... Story" 5 Things to Know About Zika & Pregnancy First Aid: Croup KidsHealth > For Parents > First Aid: Croup Print A A A Text Size Croup ... For Kids For Parents MORE ON THIS TOPIC First Aid: Coughing X-Ray Exam: Neck Why Is Hand ...

  14. First Aid: Falls

    MedlinePlus

    ... Story" 5 Things to Know About Zika & Pregnancy First Aid: Falls KidsHealth > For Parents > First Aid: Falls Print A A A Text Size en ... Floors, Doors & Windows, Furniture, Stairways: Household Safety Checklist First Aid: Broken Bones Head Injuries Preventing Children's Sports Injuries ...

  15. First Aid: Choking

    MedlinePlus

    ... Story" 5 Things to Know About Zika & Pregnancy First Aid: Choking KidsHealth > For Parents > First Aid: Choking Print A A A Text Size Choking ... usually are taught as part of any basic first-aid course. Reviewed by: Steven Dowshen, MD Date reviewed: ...

  16. First Aid: Dehydration

    MedlinePlus

    ... Story" 5 Things to Know About Zika & Pregnancy First Aid: Dehydration KidsHealth > For Parents > First Aid: Dehydration Print A A A Text Size Dehydration ... MORE ON THIS TOPIC Summer Safety Heat Illness First Aid: Heat Illness Sun Safety Dehydration Diarrhea Vomiting Word! ...

  17. First Aid: Animal Bites

    MedlinePlus

    ... Story" 5 Things to Know About Zika & Pregnancy First Aid: Animal Bites KidsHealth > For Parents > First Aid: Animal Bites Print A A A Text Size ... For Kids For Parents MORE ON THIS TOPIC First Aid & Safety Center Infections That Pets Carry Dealing With ...

  18. Children with AIDS.

    ERIC Educational Resources Information Center

    Jessee, Peggy O; And Others

    1993-01-01

    Discusses the prevalence of pediatric Acquired Immune Deficiency Syndrome (AIDS) cases in the United States, the quality of life of children with AIDS, and concerns that parents and the community have about the disease. Suggests some responses for educational institutions and teachers to help confront AIDS and help children with the disease. (MDM)

  19. A Teaching Aids Exhibition.

    ERIC Educational Resources Information Center

    Mahanja, Salah

    1985-01-01

    Describes an exhibition for the benefit of teachers of English in Arab Primary Schools, which was prepared by third-year students at the Teachers College for Arab Teachers. The exhibition included games, songs, audiovisual aids, crossword puzzles, vocabulary, spelling booklets, preposition aids, and worksheet and lesson planning aids. (SED)

  20. 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

  1. Relative benefits of linear analogue and advanced digital hearing aids.

    PubMed

    Wood, Sally A; Lutman, Mark E

    2004-03-01

    Speech recognition performance and self-reported benefit from linear analogue and advanced (digital) hearing aids were compared in 100 first-time hearing aid users with mild-to-moderate sensorineural hearing loss fitted monaurally with a behind-the-ear (BTE) hearing aid in a single-blind randomized crossover trial. Subjects used each aid for 5 weeks in turn, with aid order balanced across subjects. Three alternative models of digital hearing aid were assigned to subjects according to a balanced design. Aid type was disguised to keep subjects blind within practical limitations. Aided speech recognition performance in noise was measured at speech levels of 65 and 75dB at a speech-to-noise ratio (SNR) of +2dB for closed sets of single words. Self-rated benefit was measured using the Abbreviated Profile of Hearing Aid Benefit (APHAB) and the Glasgow Hearing Aid Benefit Profile (GHABP). Quality of life, hearing aid use and user preferences were also assessed. Speech recognition scores with the digital aids were significantly better at 75dB than with the analogue aids Self-reported benefit (APHAB, GHABP) and improvement in quality of life were generally not significantly different between analogue and digital aids, although aversiveness measured with the APHAB was significantly lower with digital aids, and satisfaction measured with the GHABP was greater. The digital aids were preferred significantly more often than the analogue aids, with 61 subjects choosing their digital aid, 26 choosing the analogue aid, and nine being equivocal. Overall, this study shows advantages for advanced digital over simple linear analogue aids in terms of both objective and subjective outcomes, although average differences are not large. PMID:15198378

  2. Evaluation of the Siemens Minifonator vibrotactile aid.

    PubMed

    Weisenberger, J M

    1989-03-01

    The Siemens Hearing Instruments Minifonator, a single-channel, wrist-worn vibrotactile aid, was evaluated in a laboratory setting with hearing-impaired adults. Eight subjects, with hearing loss greater than 70 dB in the better ear, were administered a test battery including sound-field detection, speech awareness threshold, environmental sound identification, syllable rhythm and stress categorization, and sentence identification subtests. Performance on each subtest was compared for hearing-aided and tactile-aided conditions. Mean performance levels for the two conditions were comparable for all but one subtest. However, closer inspection revealed that the data for the hearing-aided condition were bimodal: some subjects proved to be good hearing aid users and other performed at chance levels with their hearing aids. Performance in the tactile-aided conditions did not show such variability and mean levels fell between the hearing-aided levels for "good" and "poor" hearing aid users. The effects of training with the device were assessed for two normal-hearing subjects, who were trained in 1-hour daily sessions over a several week period on the environmental sounds and syllable rhythm and stress subtests. Results indicated substantial improvements in performance over the course of training. The implications of these results for long-term use of the device are discussed. PMID:2704198

  3. Space Derived Health Aids (AID, Heart Monitor)

    NASA Technical Reports Server (NTRS)

    1981-01-01

    CPI's spinoff from miniaturized pace circuitry is the new heart-assist device, the AID implantable automatic pulse generator. AID pulse generator monitors the heart continuously, recognizes onset of fibrillation, then administers a corrective electrical shock. A mini- computer, a power source, and two electrodes which sense heart activity are included in the unit. An associated system was also developed. It includes an external recorder to be worn by AID patients and a physician's console to display the data stored by the recorder. System provides a record of fibrillation occurrences and the ensuing defibrillation.

  4. 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…

  5. Experimental Assays to Assess the Efficacy of Vinegar and Other Topical First-Aid Approaches on Cubozoan (Alatina alata) Tentacle Firing and Venom Toxicity

    PubMed Central

    Yanagihara, Angel A.; Wilcox, Christie; King, Rebecca; Hurwitz, Kikiana; Castelfranco, Ann M.

    2016-01-01

    Despite the medical urgency presented by cubozoan envenomations, ineffective and contradictory first-aid management recommendations persist. A critical barrier to progress has been the lack of readily available and reproducible envenomation assays that (1) recapitulate live-tentacle stings; (2) allow quantitation and imaging of cnidae discharge; (3) allow primary quantitation of venom toxicity; and (4) employ rigorous controls. We report the implementation of an integrated array of three experimental approaches designed to meet the above-stated criteria. Mechanistically overlapping, yet distinct, the three approaches comprised (1) direct application of test solutions on live tentacles (termed tentacle solution assay, or TSA) with single image- and video-microscopy; (2) spontaneous stinging assay using freshly excised tentacles overlaid on substrate of live human red blood cells suspended in agarose (tentacle blood agarose assays, or TBAA); and (3) a “skin” covered adaptation of TBAA (tentacle skin blood agarose assay, or TSBAA). We report the use and results of these assays to evaluate the efficacy of topical first-aid approaches to inhibit tentacle firing and venom activity. TSA results included the potent stimulation of massive cnidae discharge by alcohols but only moderate induction by urine, freshwater, and “cola” (carbonated soft drink). Although vinegar, the 40-year field standard of first aid for the removal of adherent tentacles, completely inhibited cnidae firing in TSA and TSBAA ex vivo models, the most striking inhibition of both tentacle firing and subsequent venom-induced hemolysis was observed using newly-developed proprietary formulations (Sting No More™) containing copper gluconate, magnesium sulfate, and urea. PMID:26761033

  6. Experimental Assays to Assess the Efficacy of Vinegar and Other Topical First-Aid Approaches on Cubozoan (Alatina alata) Tentacle Firing and Venom Toxicity.

    PubMed

    Yanagihara, Angel A; Wilcox, Christie; King, Rebecca; Hurwitz, Kikiana; Castelfranco, Ann M

    2016-01-01

    Despite the medical urgency presented by cubozoan envenomations, ineffective and contradictory first-aid management recommendations persist. A critical barrier to progress has been the lack of readily available and reproducible envenomation assays that (1) recapitulate live-tentacle stings; (2) allow quantitation and imaging of cnidae discharge; (3) allow primary quantitation of venom toxicity; and (4) employ rigorous controls. We report the implementation of an integrated array of three experimental approaches designed to meet the above-stated criteria. Mechanistically overlapping, yet distinct, the three approaches comprised (1) direct application of test solutions on live tentacles (termed tentacle solution assay, or TSA) with single image- and video-microscopy; (2) spontaneous stinging assay using freshly excised tentacles overlaid on substrate of live human red blood cells suspended in agarose (tentacle blood agarose assays, or TBAA); and (3) a "skin" covered adaptation of TBAA (tentacle skin blood agarose assay, or TSBAA). We report the use and results of these assays to evaluate the efficacy of topical first-aid approaches to inhibit tentacle firing and venom activity. TSA results included the potent stimulation of massive cnidae discharge by alcohols but only moderate induction by urine, freshwater, and "cola" (carbonated soft drink). Although vinegar, the 40-year field standard of first aid for the removal of adherent tentacles, completely inhibited cnidae firing in TSA and TSBAA ex vivo models, the most striking inhibition of both tentacle firing and subsequent venom-induced hemolysis was observed using newly-developed proprietary formulations (Sting No More™) containing copper gluconate, magnesium sulfate, and urea. PMID:26761033

  7. AIDS Knowledge and HIV Stigma among Children Affected by HIV/AIDS in Rural China

    ERIC Educational Resources Information Center

    Zhao, Qun; Li, Xiaoming; Zhao, Guoxiang; Zhao, Junfeng; Fang, Xiaoyi; Lin, Xiuyun; Stanton, Bonita

    2011-01-01

    The current study was designed to assess the level of AIDS knowledge and its relationship with personal stigma toward people living with HIV/AIDS (PLWHA) among children living in communities of high HIV prevalence in rural China. The data were collected in 2009 from 118 orphanage orphans (children who had lost both of their parents to HIV and…

  8. Cancer mortality reductions were greatest among countries where cancer care spending rose the most, 1995-2007.

    PubMed

    Stevens, Warren; Philipson, Tomas J; Khan, Zeba M; MacEwan, Joanna P; Linthicum, Mark T; Goldman, Dana P

    2015-04-01

    Health care spending and health outcomes vary markedly across countries, but the association between spending and outcomes remains unclear. This inevitably raises questions as to whether continuing growth in spending is justified, especially relative to the rising cost of cancer care. We compared cancer care across sixteen countries over time, examining changes in cancer spending and two measures of cancer mortality (amenable and excess mortality). We found that compared to low-spending health systems, high-spending systems had consistently lower cancer mortality in the period 1995-2007. Similarly, we found that the countries that increased spending the most had a 17 percent decrease in amenable mortality, compared to 8 percent in the countries with the lowest growth in cancer spending. For excess mortality, the corresponding decreases were 13 percent and 9 percent. Additionally, the rate of decrease for the countries with the highest spending growth was faster than the all-country trend. These findings are consistent with the existence of a link between higher cancer spending and lower cancer mortality. However, further work is needed to investigate the mechanisms that underlie this correlation. PMID:25847637

  9. Bone Anchored Hearing Aid

    PubMed Central

    2002-01-01

    Executive Summary Objective The objective of this health technology policy assessment was to determine the effectiveness and cost-effectiveness of bone-anchored hearing aid (BAHA) in improving the hearing of people with conduction or mixed hearing loss. The Technology The (BAHA) is a bone conduction hearing device that includes a titanium fixture permanently implanted into the mastoid bone of the skull and an external percutaneous sound processor. The sound processor is attached to the fixture by means of a skin penetrating abutment. Because the device bypasses the middle ear and directly stimulates the cochlea, it has been recommended for individuals with conduction hearing loss or discharging middle ear infection. The titanium implant is expected to last a lifetime while the external sound processor is expected to last 5 years. The total initial device cost is approximately $5,300 and the external sound processor costs approximately $3,500. Review of BAHA by the Medical Advisory Secretariat The Medical Advisory Secretariat’s review is a descriptive synthesis of findings from 36 research articles published between January 1990 and May 2002. Summary of Findings No randomized controlled studies were found. The evidence was derived from level 4 case series with relative small sample sizes (ranging from 30-188). The majority of the studies have follow-up periods of eight years or longer. All except one study were based on monaural BAHA implant on the side with the best bone conduction threshold. Safety Level 4 evidence showed that BAHA has been be implanted safely in adults and children with success rates of 90% or higher in most studies. No mortality or life threatening morbidity has been reported. Revision rates for tissue reduction or resiting were generally under 10% for adults but have been reported to be as high as 25% in pediatric studies. Adverse skin reaction around the skin penetration site was the most common complication reported. Most of these

  10. One Mann against AIDS.

    PubMed

    Stocker, C

    1990-11-30

    This article features Jonathan Mann, director of the International AIDS Center of the Harvard AIDS Institute and his efforts to combat AIDS in the global context. Mann built the largest program in the history of the World Health Organization specifically in fighting AIDS. He helped originate the World AIDS Day observed annually throughout the world. As the director of the International AIDS Center at Harvard, Mann is launching a new role for himself concerning with research and ideas related to AIDS issue. According to him, AIDS pandemic offers "opportunities" to speed up research and spur people around the globe to address longstanding social problems with new energy. Mann hopes to get involved with local AIDS efforts. He foresees AIDS as an escalating problem that will continue to persist in one or two generations, which could rise as high as tenfold in the 1990s. He believes a vaccine will be available in the middle to late 1990s but to purge the virus from those positive persons is impossible. If the World AIDS Day can bring about attitude change, Mann hopes it will able be to foster a feeling of unity among people and countries. PMID:12349354

  11. Parental Spending on School-Age Children: Structural Stratification and Parental Expectation.

    PubMed

    Hao, Lingxin; Yeung, Wei-Jun Jean

    2015-06-01

    As consumption expenditures are increasingly recognized as direct measures of children's material well-being, they provide new insights into the process of intergenerational transfers from parents to children. Little is known, however, about how parents allocate financial resources to individual children. To fill this gap, we develop a conceptual framework based on stratification theory, human capital theory, and the child-development perspective; exploit unique child-level expenditure data from Child Supplements of the PSID; and employ quantile regression to model the distribution of parental spending on children. Overall, we find strong evidence supporting our hypotheses regarding the effects of socioeconomic status (SES), race, and parental expectation. Our nuanced estimates suggest that (1) parental education, occupation, and family income have differential effects on parental spending, with education being the most influential determinant; (2) net of SES, race continues to be a significant predictor of parental spending on children; and (3) parental expectation plays a crucial role in determining whether parents place a premium on child development in spending and how parents prioritize different categories of spending. PMID:25933638

  12. A comparison of global conservation prioritization models with spatial spending patterns of conservation nongovernmental organizations.

    PubMed

    Holmes, George; Scholfield, Katherine; Brockington, Dan

    2012-08-01

    In recent decades, various conservation organizations have developed models to prioritize locations for conservation. Through a survey of the spending patterns of 281 conservation nongovernmental organizations (NGOs), we examined the relation between 2 such models and spatial patterns of spending by conservation NGOs in 44 countries in sub-Saharan Africa. We tested whether, at the country level, the proportion of a country designated as a conservation priority was correlated with where NGOs spent money. For one model (the combination of Conservation International's hotspots and High Biodiversity Wilderness Areas, which are areas of high endemism with high or low levels of vegetation loss respectively), there was no relation between the proportion of a country designated as a priority and levels of NGO spending, including by the NGO associated with the model. In the second model (Global 200), the proportion of a country designated as a priority and the amount of money spent by NGOs were significantly and positively related. Less money was spent in countries in northern and western sub-Saharan Africa than countries in southern and eastern Africa, relative to the proportion of the country designated as a conservation priority. We suggest that on the basis of our results some NGOs consider increasing their spending on the areas designated as of conservation priority which are currently relatively underfunded, although there are economic, political, cultural, historical, biological, and practical reasons why current spending patterns may not align with priority sites. PMID:22809351

  13. Identification with the retail organization and customer-perceived employee similarity: effects on customer spending.

    PubMed

    Netemeyer, Richard G; Heilman, Carrie M; Maxham, James G

    2012-09-01

    Two constructs important to academicians and managers are the degree to which employees and customers identify with an organization, employee organizational identification (employee OI) and customer-company identification (customer identification), respectively. This research examines the effects of these identification constructs and the related construct of customer perceived similarity to employees on customer spending. Via a 1-year multilevel study of 12,047 customers and 1,464 store employees (sales associates) covering 212 stores of a specialty apparel retailer, our study contributes to the literature in 2 critical ways. First, we expand the theoretical network of employee OI and customer identification by examining the related construct of a customer's perceived similarity to store employees. We examine the incremental (not fully mediated) main and interaction effects of customer-perceived similarity to employees and employee OI on customer spending. Second, we examine the effect of customer identification on customer spending relative to the effect of customer satisfaction on customer spending. Thus, our study also contributes by demonstrating a potential complementary route to achieve customer spending (customer identification), a route that may be more readily affected by management than the efforts required for a sustained increase in customer satisfaction. Implications for academics and managers are offered. PMID:22663556

  14. Adding A Spending Metric To Medicare's Value-Based Purchasing Program Rewarded Low-Quality Hospitals.

    PubMed

    Das, Anup; Norton, Edward C; Miller, David C; Ryan, Andrew M; Birkmeyer, John D; Chen, Lena M

    2016-05-01

    In fiscal year 2015 the Centers for Medicare and Medicaid Services expanded its Hospital Value-Based Purchasing program by rewarding or penalizing hospitals for their performance on both spending and quality. This represented a sharp departure from the program's original efforts to incentivize hospitals for quality alone. How this change redistributed hospital bonuses and penalties was unknown. Using data from 2,679 US hospitals that participated in the program in fiscal years 2014 and 2015, we found that the new emphasis on spending rewarded not only low-spending hospitals but some low-quality hospitals as well. Thirty-eight percent of low-spending hospitals received bonuses in fiscal year 2014, compared to 100 percent in fiscal year 2015. However, low-quality hospitals also began to receive bonuses (0 percent in fiscal year 2014 compared to 17 percent in 2015). All high-quality hospitals received bonuses in both years. The Centers for Medicare and Medicaid Services should consider incorporating a minimum quality threshold into the Hospital Value-Based Purchasing program to avoid rewarding low-quality, low-spending hospitals. PMID:27140997

  15. Increased spending on health care: long-term implications for the nation.

    PubMed

    Chernew, Michael E; Hirth, Richard A; Cutler, David M

    2009-01-01

    This paper updates one we published in 2003, describing the implications of continued health care spending growth for the consumption of nonhealth goods and services. Our estimates now show that at approximately long-run average rates of excess health spending growth, 119 percent of the real increase in per capita income would be devoted to health spending over the 2007-2083 projection period. We argue that an alternative scenario, under which health spending grew just one percentage point faster than real per capita income, is "affordable," although 53.6 percent of real income growth over the period would go to health care. Moreover, even with the more favorable assumption, the nation would still face important challenges paying for care and dividing up the burden. This analysis thus supports the argument that reforms that would dramatically slow the rate of health care spending growth are necessary, especially if the nation hopes to maintain a reasonable amount of consumption of nonhealth goods and services. PMID:19738238

  16. Physician numbers as a driver of provincial government health spending in Canadian health policy.

    PubMed

    Di Matteo, Livio

    2014-03-01

    Physician spending is one of the fastest growing Canadian public sector health categories of recent years but despite their recent growth physician numbers are a relatively small contributor to the increases in total provincial government health expenditure. Regression models of the determinants of provincial government health spending are estimated and show physician numbers are a positive and significant driver of provincial government health care spending after controlling for other factors though the overall contribution is relatively small. From 1975 to 2009, the increases in physician numbers accounted for a range of 3.2-13.3 percent of the increase in real per capita total provincial government health expenditures ranging from a low of 1.9 to 7.6 percent for Manitoba to a high of 5.3 to 18.3 percent for Quebec. These are modest contributions to total health spending but vary more substantially across provinces when hospital and physician spending alone are considered particularly for Quebec and British Columbia. Nevertheless, these results suggest that physician numbers alone are a modest policy concern when it comes to restraining health costs and other factors such as utilization and fees are more important. PMID:23895879

  17. Parental Spending on School-Age Children: Structural Stratification and Parental Expectation

    PubMed Central

    Hao, Lingxin; Yeung, Wei-Jun Jean

    2015-01-01

    As consumption expenditures are increasingly recognized as direct measures of children’s material well-being, they provide new insights into the process of intergenerational transfers from parents to children. Little is known, however, about how parents allocate financial resources to individual children. To fill this gap, we develop a conceptual framework based on stratification theory, human capital theory, and the child-development perspective; exploit unique child-level expenditure data from Child Supplements of the PSID; and employ quantile regression to model the distribution of parental spending on children. Overall, we find strong evidence supporting our hypotheses regarding the effects of socioeconomic status (SES), race, and parental expectation. Our nuanced estimates suggest that (1) parental education, occupation, and family income have differential effects on parental spending, with education being the most influential determinant; (2) net of SES, race continues to be a significant predictor of parental spending on children; and (3) parental expectation plays a crucial role in determining whether parents place a premium on child development in spending and how parents prioritize different categories of spending. PMID:25933638

  18. The 'Alternative Quality Contract,' based on a global budget, lowered medical spending and improved quality.

    PubMed

    Song, Zirui; Safran, Dana Gelb; Landon, Bruce E; Landrum, Mary Beth; He, Yulei; Mechanic, Robert E; Day, Matthew P; Chernew, Michael E

    2012-08-01

    Seven provider organizations in Massachusetts entered the Blue Cross Blue Shield Alternative Quality Contract in 2009, followed by four more organizations in 2010. This contract, based on a global budget and pay-for-performance for achieving certain quality benchmarks, places providers at risk for excessive spending and rewards them for quality, similar to the new Pioneer Accountable Care Organizations in Medicare. We analyzed changes in spending and quality associated with the Alternative Quality Contract and found that the rate of increase in spending slowed compared to control groups, more so in the second year than in the first. Overall, participation in the contract over two years led to savings of 2.8 percent (1.9 percent in year 1 and 3.3 percent in year 2) compared to spending in nonparticipating groups. Savings were accounted for by lower prices achieved through shifting procedures, imaging, and tests to facilities with lower fees, as well as reduced utilization among some groups. Quality of care also improved compared to control organizations, with chronic care management, adult preventive care, and pediatric care within the contracting groups improving more in year 2 than in year 1. These results suggest that global budgets with pay-for-performance can begin to slow underlying growth in medical spending while improving quality of care. PMID:22786651

  19. Debt relief and public health spending in heavily indebted poor countries.

    PubMed Central

    Gupta, Sanjeev; Clements, Benedict; Guin-Siu, Maria Teresa; Leruth, Luc

    2002-01-01

    The Heavily Indebted Poor Countries (HIPC) Initiative, which was launched in 1996, is the first comprehensive effort by the international community to reduce the external debt of the world's poorest countries. The Initiative will generate substantial savings relative to current and past public spending on health and education in these countries. Although there is ample scope for raising public health spending in heavily indebted poor countries, it may not be advisable to spend all the savings resulting from HIPC resources for this purpose. Any comprehensive strategy for tackling poverty should also focus on improving the efficiency of public health outlays and on reallocating funds to programmes that are most beneficial to the poor. In order to ensure that debt relief increases poverty-reducing spending and benefits the poor, all such spending, not just that financed by HIPC resources, should be tracked. This requires that countries improve all aspects of their public expenditure management. In the short run, heavily indebted poor countries can take some pragmatic tracking measures based on existing public expenditure management systems, but in the longer run they should adopt a more comprehensive approach so as to strengthen their budget formulation, execution, and reporting systems. PMID:11953794

  20. Hearing Aid Assembly

    NASA Technical Reports Server (NTRS)

    Grugel, Richard N. (Inventor)

    2002-01-01

    Progress in hearing aids has come a long way. Yet despite such progress hearing aids are not the perfect answer to many hearing problems. Some adult ears cannot accommodate tightly fitting hearing aids. Mouth movements such as chewing, talking, and athletic or other active endeavors also lead to loosely fitting ear molds. It is well accepted that loosely fitting hearing aids are the cause of feedback noise. Since feedback noise is the most common complaint of hearing aid wearers it has been the subject of various patents. Herein a hearing aid assembly is provided eliminating feedback noise. The assembly includes the combination of a hearing aid with a headset developed to constrict feedback noise.

  1. HIV, AIDS, and the Future

    MedlinePlus

    ... Navigation Bar Home Current Issue Past Issues HIV / AIDS HIV, AIDS, and the Future Past Issues / Summer 2009 Table ... and your loved ones from HIV/AIDS. The AIDS Memorial Quilt In 1987, a total of 1, ...

  2. Facilitators and barriers to implementation of the AIDES initiative, a social innovation for participative assessment of children in need and for coordination of services.

    PubMed

    Dufour, Sarah; Lessard, Danielle; Chamberland, Claire

    2014-12-01

    As part of an implementation evaluation, this study aims to identify the conditions of practice that facilitated or hindered implementation of the AIDES initiative, a social innovation to support collaboration between partners involved with vulnerable children. Evaluators conducted qualitative telephone interviews with 36 respondents (19 practitioners and 17 managers) who participated in the AIDES initiative trial. Respondents were chosen to include all participating organisations (child protection services, prevention social services). Participants' comments were submitted to descriptive content analysis. Conditions facilitating or hindering implementation of the initiative included the following dimensions: (1) implementation quality; (2) organisational elements (organisational functioning, cooperation between organisations); (3) socio-political issues; and (4) personal and professional characteristics. The study highlights critical elements to consider in implementing and maintaining significant changes in practice in organisations providing assistance to vulnerable children and their families. Social innovations that do not consider such elements are likely to compromise their implementation and sustainability. We must prevent promising social changes from being considered unrealistic or inappropriate due to contextual barriers. PMID:25150926

  3. On average, physicians spend nearly 11 percent of their 40-year careers with an open, unresolved malpractice claim.

    PubMed

    Seabury, Seth A; Chandra, Amitabh; Lakdawalla, Darius N; Jena, Anupam B

    2013-01-01

    The US malpractice system is widely regarded as inefficient, in part because of the time required to resolve malpractice cases. Analyzing data from 40,916 physicians covered by a nationwide insurer, we found that the average physician spends 50.7 months-or almost 11 percent-of an assumed forty-year career with an unresolved, open malpractice claim. Although damages are a factor in how doctors perceive medical malpractice, even more distressing for the doctor and the patient may be the amount of time these claims take to be adjudicated. We conclude that this fact makes it important to assess malpractice reforms by how well they are able to reduce the time of malpractice litigation without undermining the needs of the affected patient. PMID:23297278

  4. UK research spend in 2008 and 2012: comparing stroke, cancer, coronary heart disease and dementia

    PubMed Central

    Luengo-Fernandez, Ramon; Leal, Jose; Gray, Alastair

    2015-01-01

    Objective To assess UK governmental and charity research funding in 2012 for cancer, coronary heart disease (CHD), dementia and stroke, and to make comparisons with 2008 levels. Design Analysis of research expenditure. Setting United Kingdom. Main outcome measures We identified UK governmental agencies and charities providing health research funding to determine the 2012 levels of funding for cancer, CHD, dementia and stroke. Levels of research funding were compared to burden of disease measures, including prevalence, disability adjusted life years and economic burden. Results The combined research funding into cancer, CHD, dementia and stroke by governmental and charity organisations in 2012 was £856 million, of which £544 million (64%) was devoted to cancer, £166 million (19%) to CHD, £90 million (11%) to dementia and £56 million (7%) to stroke. For every £10 of health and social care costs attributable to each disease, cancer received £1.08 in research funding, CHD £0.65, stroke £0.19 and dementia £0.08. A considerable shift in the distribution of government research funding was observed between 2008 and 2012. In 2008, 66% of governmental research funding into the four conditions under study was devoted to cancer, 21% to CHD, 9% to dementia and 4% to stroke. In 2012, the proportions devoted to dementia and stroke had increased to 21% and 12%, respectively, with cancer accounting for 45% of total research spend. Conclusions Although there has been much progress by government to increase levels of research funding for dementia and stroke, these areas remain underfunded when compared with the burden of disease. PMID:25869683

  5. Boosting beauty in an economic decline: mating, spending, and the lipstick effect.

    PubMed

    Hill, Sarah E; Rodeheffer, Christopher D; Griskevicius, Vladas; Durante, Kristina; White, Andrew Edward

    2012-08-01

    Although consumer spending typically declines in economic recessions, some observers have noted that recessions appear to increase women's spending on beauty products--the so-called lipstick effect. Using both historical spending data and rigorous experiments, the authors examine how and why economic recessions influence women's consumer behavior. Findings revealed that recessionary cues--whether naturally occurring or experimentally primed--decreased desire for most products (e.g., electronics, household items). However, these cues consistently increased women's desire for products that increase attractiveness to mates--the first experimental demonstration of the lipstick effect. Additional studies show that this effect is driven by women's desire to attract mates with resources and depends on the perceived mate attraction function served by these products. In addition to showing how and why economic recessions influence women's desire for beauty products, this research provides novel insights into women's mating psychology, consumer behavior, and the relationship between the two. PMID:22642483

  6. Is there room for containing healthcare costs? An analysis of regional spending differentials in Italy.

    PubMed

    Francese, Maura; Romanelli, Marzia

    2014-03-01

    This work aims at identifying the determinants of health spending differentials among Italian regions and at highlighting potential margins for savings. The analysis exploits a data set for the 21 Italian regions and autonomous provinces starting in the early 1990s and ending in 2006. After controlling for standard healthcare demand indicators, remaining spending differentials are found to be significant, and they appear to be associated with differences in the degree of appropriateness of treatments, health sector supply structure and social capital indicators. In general, higher regional expenditure does not appear to be associated with better reported or perceived quality in health services. In the regions that display poorer performances, inefficiencies appear not to be uniformly distributed among expenditure items. Overall, results suggest that savings could be achieved without reducing the amount of services provided to citizens. This seems particularly important given the expected rise in spending associated with the forecasted demographic developments. PMID:23512733

  7. Hong Kong's domestic health spending--financial years 1989/90 through 2004/05.

    PubMed

    Leung, G M; Tin, K Y K; Yeung, G M K; Leung, E S K; Tsui, E L H; Lam, D W S; Tsang, C S H; Fung, A Y K; Lo, S V

    2008-04-01

    This report presents the latest estimates of Hong Kong's domestic health spending between fiscal years 1989/90 and 2004/05, cross-stratified and categorised by financing source, provider and function on an annual basis. Total expenditure on health was HK$67,807 million in fiscal year 2004/05. In real terms, total expenditure on health showed positive growth averaging 7% per annum throughout the period covered in this report while gross domestic product grew at 4% per annum on average, indicating a growing percentage of health spending relative to gross domestic product, from 3.5% in 1989/90 to 5.2% in 2004/05. This increase was largely driven by the rise in public spending, which rose 9% per annum on average in real terms over the period, compared with 5% for private spending. This represents a growing share of public spending from 40% to 55% of total expenditure on health during the period. While public spending was the dominant source of health financing in 2004/05, private household out-of-pocket expenditure accounted for the second largest share of total health spending (32%). The remaining sources of health finance were employer-provided group medical benefits (8%), privately purchased insurance (5%), and other private sources (1%). Of the $67,807 million total health expenditure in 2004/05, current expenditure comprised $65,429 million (96%) while $2378 million (4%) were capital expenses (ie investment in medical facilities). Services of curative care accounted for the largest share of total health spending (67%) which were made up of ambulatory services (35%), in-patient curative care (28%), day patient hospital services (3%), and home care (1%). The next largest share of total health expenditure was spent on medical goods outside the patient care setting (10%). Analysed by health care provider, hospitals accounted for the largest share (46%) and providers of ambulatory health care the second largest share (30%) of total health spending in 2004/05. We

  8. Financial effects of pharmaceutical price regulation on R&D spending by EU versus US firms.

    PubMed

    Golec, Joseph; Vernon, John A

    2010-01-01

    EU countries closely regulate pharmaceutical prices, whereas the US does not. This paper shows how price constraints affect the profitability, stock returns and R&D spending of EU and US firms. Compared with EU firms, US firms are more profitable, earn higher stock returns and spend more on R&D. We tested the relationship between price regulation and R&D spending, and estimated the costs of tight EU price regulation. Although results show that EU consumers enjoyed much lower pharmaceutical price inflation, we estimated that price controls cost EU firms 46 fewer new medicines and 1680 fewer research jobs during our 19-year sample period. Had the US used controls similar to those used in the EU, we estimate it would have led to 117 fewer new medicines and 4368 fewer research jobs in the US. PMID:20617857

  9. Evidence links increases in public health spending to declines in preventable deaths.

    PubMed

    Mays, Glen P; Smith, Sharla A

    2011-08-01

    Public health encompasses a broad array of programs designed to prevent the occurrence of disease and injury within communities. But policy makers have little evidence to draw on when determining the value of investments in these program activities, which currently account for less than 5 percent of US health spending. We examine whether changes in spending by local public health agencies over a thirteen-year period contributed to changes in rates of community mortality from preventable causes of death, including infant mortality and deaths due to cardiovascular disease, diabetes, and cancer. We found that mortality rates fell between 1.1 percent and 6.9 percent for each 10 percent increase in local public health spending. These results suggest that increased public health investments can produce measurable improvements in health, especially in low-resource communities. However, more money by itself is unlikely to generate significant and sustainable health gains; improvements in public health practices are needed as well. PMID:21778174

  10. An assessment of felt needs and expectations of people living with HIV/AIDS seeking treatment at NGOs in Delhi, India.

    PubMed

    Singh, Megharita M; Garg, Suneela; Nath, Anita; Gupta, Vimal K

    2015-03-01

    People living with HIV/AIDS (PLHAs) continue to face stigma and discrimination in society. The felt needs of PLHAs can be met by means of a comprehensive, holistic, and integrated approach by the concerned sectors. This study included 100 PLHAs admitted at 3 care homes run by nongovernmental organizations in New Delhi. As many as 22% of the patients had been diagnosed with pulmonary Koch's. Unemployment rates were found to increase after disease onset. Majority were satisfied with the medical treatment and overall care provided at these centers. About 25% expressed that they would like the government to provide them with suitable jobs. Less than one third (30%) of the PLHAs expressed satisfaction with their family life whereas the rest yearned for love and acceptance from society. Study findings highlight the important role of nongovernmental organizations and stresses on the need for a holistic approach toward the care of these people. PMID:19443873

  11. The welfare costs of HIV/AIDS in eastern Europe: an empirical assessment using the economic value-of-life approach.

    PubMed

    Fimpel, Julia; Stolpe, Michael

    2010-06-01

    Based on the aggregation of individual willingness-to-pay for a statistical life, we calibrate an inter-temporal optimisation model to determine the aggregate welfare loss from HIV/AIDS in 25 Eastern European countries. Assuming a discount rate of 3%, we find a total welfare loss for the whole region that exceeds US $800 billion, approximately 10% of the region's annual GDP between 1995 and 2001. Although prevalence and incidence rates diverge sharply between countries-with central Europe far less affected than major countries in the Commonwealth of Independent States and the Baltics-the epidemic is likely to spread to all countries unless a coherent strategy of prevention and treatment is backed up by substantial increases in healthcare investments. The sheer size of this task and the international nature of the epidemic render this one of the most important current challenges for all of Europe. PMID:19655183

  12. The role of employee flexible spending accounts in health care financing.

    PubMed

    Schweitzer, M; Asch, D A

    1996-08-01

    Employee flexible spending accounts for health care represent one component of the current health care financing system that merits serious reform. These accounts create a system of undesirable incentives, force employees and employers to take complicated gambles, reduce tax revenues, and fail to meet their purported policy objectives. This paper describes shortcomings in these accounts from both a theoretical and an empirical perspective. Some proposed alternatives; including medical spending accounts and zero balance accounts, resolve many of these concerns but not all of them. PMID:8712264

  13. Health spending trends in the 1980's: Adjusting to financial incentives

    PubMed Central

    Arnett, Ross H.; Cowell, Carol S.; Davidoff, Lawrence M.; Freeland, Mark S.

    1985-01-01

    Health expenditure growth is projected to moderate considerably during 1983-90, reaching $660 billion in 1990 and consuming over 11 percent of the gross national product. During 1973-83, spending for health care more than tripled, increasing from $103 billion to $355 billion and moving from 7.8 percent to 10.8 percent of the gross national product. Government spending for health care is projected to reach $284 billion by 1990, with the Federal Government paying 73 percent. The Medicare Prospective Payment System, private sector initiatives, and State and local government actions are providing incentives to substantially increase competition and cost effectiveness in health care provision. PMID:10311158

  14. Health spending in the 1980's: Integration of clinical practice patterns with management

    PubMed Central

    Freeland, Mark S.; Schendler, Carol E.

    1984-01-01

    Health care spending in the United States more than tripled between 1972 and 1982, increasing from $94 billion to $322 billion. This growth substantially outpaced overall growth in the economy. National health expenditures are projected to reach approximately $690 billion in 1990 and consume roughly 12 percent of the gross national product. Government spending for health care is projected to reach $294 billion by 1990, with the Federal Government paying 72 percent. The Medicare prospective payment system and increasing competition in the health services sector are providing incentives to integrate clinical practice patterns with improved management practices. PMID:10310595

  15. 2012 National Park visitor spending effects: economic contributions to local communities, states, and the nation

    USGS Publications Warehouse

    Cullinane Thomas, Catherine; Huber, Christopher C.; Koontz, Lynne

    2014-01-01

    This 2012 analysis marks a major revision to the NPS visitor spending effects analyses, with the development of a new visitor spending effects model (VSE model) that replaces the former Money Generation Model (MGM2). Many of the hallmarks and processes of the MGM2 model are preserved in the new VSE model, but the new model makes significant strides in improving the accuracy and transparency of the analysis. Because of this change from the MGM2 model to the VSE model, estimates from this year’s analysis are not directly comparable to previous analyses.

  16. Public spending on health care in Africa: do the poor benefit?

    PubMed Central

    Castro-Leal, F.; Dayton, J.; Demery, L.; Mehra, K.

    2000-01-01

    Health care is a basic service essential in any effort to combat poverty, and is often subsidized with public funds to help achieve that aim. This paper examines public spending on curative health care in several African countries and finds that this spending favours mostly the better-off rather than the poor. It concludes that this targeting problem cannot be solved simply by adjusting the subsidy allocations. The constraints that prevent the poor from taking advantage of these services must also be addressed if the public subsidies are to be effective in reaching the poor. PMID:10686734

  17. Evidence of horizontal and vertical interactions in health care spending in the Philippines.

    PubMed

    Kelekar, Uma; Llanto, Gilberto

    2015-09-01

    This article examines whether within a decentralized system of health care spending, local government units in developing countries have any incentive to compete with one another. The existence of spatial competition, whether horizontal or vertical, is tested in the case of Philippines using local government health expenditures data. Results indicate that health spending is characterized by a strong positive interaction between municipalities, consistent with the existence of a horizontal fiscal interaction. However, the results provide less support for the existence of vertical externalities, with the interaction of municipalities with provinces being positive and marginally significant. PMID:25148843

  18. Assessment of fly ash-aided phytostabilisation of highly contaminated soils after an 8-year field trial: part 1. Influence on soil parameters and metal extractability.

    PubMed

    Lopareva-Pohu, Alena; Pourrut, Bertrand; Waterlot, Christophe; Garçon, Guillaume; Bidar, Géraldine; Pruvot, Christelle; Shirali, Pirouz; Douay, Francis

    2011-01-01

    Sustainable management of large surface areas contaminated with trace elements is a real challenge, since currently applied remediation techniques are too expensive for these areas. Aided phytostabilisation appears to be a cost efficient technique to reduce metal mobility in contaminated soils and contaminated particle spread. In this context, this study aimed at evaluating the long-term efficiency of aided phytostabilisation on former agricultural soils highly contaminated with trace elements. The influence of afforestation and fly ash amendments to reduce metal mobility was investigated. Before being planted with a tree mix, the study site was divided into three plots: a reference plot with no amendment, the second amended with silico-aluminous fly ash and the third with sulfo-calcic fly ash. After eight years, some soil physico-chemical parameters, including cadmium (Cd), lead (Pb) and zinc (Zn) extractability were modified. In particular, pH decreased on the whole site while organic carbon content increased. The alteration of these parameters influencing trace element mobility is explained by afforestation. Over time, concentrations of CaCl(2)-extractable metals increased and were correlated with the soil pH decrease. In the amended soils, extractable Cd, Pb and Zn concentrations were lower than in the reference soil. The results indicated that the two fly ashes buffered natural soil acidification due to vegetation development and limited trace element mobility and thus could limit their bioavailability. For long-term phytostabilisation, special attention should be focused on the soil pH, metal mobility and phytoavailability analysis. PMID:21106226

  19. Qualitative Assessment of the Impact of Implementing Reiki Training in a Supported Residence for People Older Than 50 Years with HIV/AIDS

    PubMed Central

    Mehl-Madrona, Lewis; Renfrew, Nita M; Mainguy, Barbara

    2011-01-01

    Introduction: Reiki is a Japanese form of energy healing that has become popular in the US. Reiki training involves three stages—levels I, II, and III—to a master practitioner level and requires both giving and receiving Reiki. We set out to implement a program to train clients of a supported residence in Brooklyn, NY. They were all older than age 50 years and had HIV/AIDS and substance-abuse and/or mental-health disorders. Methods: A qualitative, narrative-inquiry study was conducted. The Reiki master kept a journal of her 3 years of providing 90 minutes of Reiki treatment and/or training once weekly at the residence. Forty-five of 50 potential participants attended these sessions with various frequencies. Stories were collected from 35 participants regarding their experience of Reiki training. We posited success as continued involvement in the program. Results: All 35 participants reported receiving benefit from participation in Reiki. Participants first took part in training because of the offered subway tokens; however, 40 continued their involvement despite a lack of compensation. When asked why they continued, participants reported life-changing experiences, including a greater ability to cope with addictions, a greater ability to manage counseling, healing of wounds, improvement of T-cell counts, and improved skills of daily living. Conclusion: Reiki training can be successfully implemented in a supported housing facility with people with HIV/AIDS and comorbid disorders. Some people in our study population reported areas of improvement and life-changing experiences. Our study did not establish the efficacy of Reiki, but our findings support the effect of the entire gestalt of implementing a program related to spirituality and healing and supports the goal of implementing a larger randomized, controlled trial in this setting to establish the efficacy of Reiki. PMID:22058669

  20. Tracer-aided modelling using long-term and high resolution data to assess non-stationarity in stream water age

    NASA Astrophysics Data System (ADS)

    Soulsby, C.; Birkel, C.; Tetzlaff, D.

    2015-12-01

    Understanding how water and solutes move through watersheds and the associated travel times remains a key research frontier in hydrology. Here we integrate long-term data (6 years of weekly isotope measurements in rainfall and runoff) into a tracer-aided conceptual modelling approach to provide fresh insights into the complex interrelationships between catchment storage dynamics, hydrological connectivity and resulting non-stationary stream water ages. We show that in a wet Scottish upland catchment dominated by runoff generation from riparian peats (histosols) with high water storage capacity, the storage dynamics of different landscape units (e.g. hillslope vs. riparian zones) regulate both mixing processes and the strength of hydrological connectivity that govern water and solute fluxes and determine catchment travel times. We also found that the frequency and longevity of hydrological connectivity and the associated relative importance of dynamic flow paths control the contribution of younger (< 1 month) or older (>4 years) waters to the stream. Water and solute transport is mainly facilitated by overland flow from saturated histosols connected to the stream network even during smaller events. However, during prolonged dry periods, near-surface runoff "switches off" and stream water is dominated by older groundwater. The saturated riparian soils represent large mixing zones that buffer the time variance of water age and act as "isostats" damping variable inputs. These zones also integrate catchment-scale partial mixing processes. Although simulations depend on model performance, which is influenced by stochastic variation in isotope inputs, a longer-term storage analysis using this tracer-aided model allowed us to examine the sensitivity of the catchment response and transit times to extreme hydroclimatic variability. These insights were validated using a more recent high resolution dataset (3 years of daily isotope data) which also improved constraints on

  1. General Framework of Hearing Aid Fitting Management

    PubMed Central

    Oh, Soo Hee

    2016-01-01

    Hearing aids are one of the most widely used treatment options for the hearing impaired and optimal outcomes of hearing aids are supported by comprehensive hearing aid fitting protocols. Currently, the term 'hearing aid fitting' is prevalently used among service and industry sectors with its comprehensive procedures not systematically explicated. In addition, a variety of non-normalized guidelines for hearing aid fitting has led to non-uniform care, outcome variability, and dissatisfaction of the use of hearing aids. The main purpose of the present study is to suggest a general framework of standardized practice for hearing aid fitting management including its pre- and post-fitting stages. The management framework centers on its fitting process with its prior steps of assessment as well as its posterior steps of follow-up, thereby eliminating diverging interpretations and non-uniform practices. Outcomes of this study are also expected to improve potential benefits such as quality of hearing aid fitting, user satisfaction, and cost effectiveness across relevant stakeholders. PMID:27144226

  2. AIDS: acquired immunodeficiency syndrome *

    PubMed Central

    Gilmore, N.J.; Beaulieu, R.; Steben, M.; Laverdière, M.

    1992-01-01

    Acquired immunodeficiency syndrome, or AIDS, is a new illness that occurs in previously healthy individuals. It is characterized by immunodeficiency, opportunistic infections and unusual malignant diseases. Life-threatening single or multiple infections with viruses, mycobacteria, fungi or protozoa are common. A rare neoplasm, Kaposi's sarcoma, has developed in approximately one third of patients with AIDS. More than 800 cases of AIDS have been reported in North America, over 24 of them in Canada. The majority of patients are male homosexuals, although AIDS has also developed in abusers of intravenously administered drugs, Haitian immigrants, individuals with hemophilia, recipients of blood transfusions, prostitutes, and infants, spouses and partners of patients with AIDS. The cause of AIDS is unknown, but the features are consistent with an infectious process. Early diagnosis can be difficult owing to the nonspecific symptoms and signs of the infections and malignant diseases. Therefore, vigilance by physicians is of the utmost importance. PMID:1544049

  3. AIDS: the first decade.

    PubMed

    Turk, H N

    1989-01-01

    AIDS has had a profound effect on society and the workplace and has raised legal and social problems for which society was not prepared. This article will chronicle the evolution of federal, state and local law concerning AIDS and the workplace. Although there are some clear-cut answers and guidelines that address the relationship of employer and employee to the AIDS epidemic, current legislation and enforcement of those laws does not adequately address the AIDS victim as a handicapped individual. Emphasis is also placed on the problems peculiar to the health care industry, the constitutionality of present legislation, and the AIDS victim's right to privacy versus the employer's need to know. Finally, some practical solutions and guidelines will be presented that will help the employer deal with the AIDS victim and his or her co-worker. PMID:10295811

  4. National Trends In Spending On And Use Of Oral Oncologics, First Quarter 2006 Through Third Quarter 2011

    PubMed Central

    Conti, Rena M.; Fein, Adam J.; Bhatta, Sumita S.

    2015-01-01

    Oral prescription drugs are an increasingly important treatment option for cancer. Yet contemporaneous US trends in spending on anticancer drugs known as oral oncologics have not been described. Using nationally representative data, we describe trends in national spending on and use of forty-seven oral oncologics between the first quarter of 2006 and the third quarter of 2011. Average quarterly national spending on oral oncologics increased 37 percent, from $940.3 million to $1.4 billion in 2012 dollars, a significant change. Average quarterly use of oral oncologics in the same time period measured in extended units increased at a significant pace but more slowly than spending (10 percent). Within this broader trend, differences in spending among categories of oral oncologics were observed. High levels of and increases in both spending and use were concentrated among new brand-name and patent-protected oral oncologics, including second-generation tyrosine kinase inhibitors used to treat chronic myelogenous leukemia. Decreased spending but increased use was observed among oral oncologics that lost patent protection during the study period and were available in generic form, including hormonal therapies used to treat breast and prostate cancers. Spending on new and patent-protected oral oncologics and associated price increases are significant drivers of increased spending. PMID:25288415

  5. Clampdown on AIDS information in E. Africa.

    PubMed

    Hitchcock, B

    1986-01-01

    , particularly as it is known to be transmitted in heterosexual as well as homosexual relationships. Medical experts in Kenya identify the need for an AIDS Researh Foundation to be set up to encompass the whole of the East Africa region. This center would receive and collate information on AIDS from Tanzania, Uganda, and Kenya, assess it, carry out clinical research, study and experiment with anti-AIDS compounds, and formulate a public education program to be disseminated by the media. 2 points need to be known: it is difficult to contract AIDS casually; through blood and semen, carriers of the virus can transmit AIDS like wildfire creating an epidemic. PMID:12314088

  6. AIDS in South Africa.

    PubMed

    Ijsselmuiden, C; Evian, C; Matjilla, J; Steinberg, M; Schneider, H

    1993-01-01

    The National AIDS Convention in South Africa (NACOSA) in October 1992 was the first real attempt to address HIV/AIDS. In Soweto, government, the African National Congress, nongovernmental organizations, and organized industry and labor representatives worked for 2 days to develop a national plan of action, but it did not result in a united effort to fight AIDS. The highest HIV infection rates in South Africa are among the KwaZulu in Natal, yet the Inkatha Freedom Party did not attend NACOSA. This episode exemplifies the key obstacles for South Africa to prevent and control AIDS. Inequality of access to health care may explain why health workers did not diagnose the first AIDS case in blacks until 1985. Migrant labor, Bantu education, and uprooted communities affect the epidemiology of HIV infection. Further, political and social polarization between blacks and whites contributes to a mindset that AIDS is limited to the other race which only diminishes the personal and collective sense of susceptibility and the volition and aptitude to act. The Department of National Health and Population Development's voluntary register of anonymously reported cases of AIDS specifies 1517 cumulative AIDS cases (October 1992), but this number is low. Seroprevalence studies show between 400,000-450,000 HIV positive cases. Public hospitals cannot give AIDS patients AZT and DDI. Few communities provided community-based care. Not all hospitals honor confidentiality and patients' need for autonomy. Even though HIV testing is not mandatory, it is required sometimes, e.g., HIV testing of immigrants. AIDS Training, Information and Counselling Centers are in urban areas, but not in poor areas where the need is most acute. The government just recently developed in AIDS education package for schools, but too many people consider it improper, so it is not being used. The poor quality education provided blacks would make it useless anyhow. Lifting of the academic boycott will allow South African

  7. Conspiracies, contagion, and compassion: trust and public reactions to AIDS.

    PubMed

    Herek, G M; Capitanio, J P

    1994-08-01

    AIDS educational programs can be effective only to the extent that they are perceived as credible by their target audiences. In this study, public trust associated with AIDS was assessed in a national telephone survey. African-Americans were more likely than whites to express distrust of doctors and scientists concerning HIV transmission through casual contact, to believe that AIDS is being used as a form of genocide against minority groups, and to believe that information about AIDS is being withheld from the public. Individuals high in distrust did not differ from those low in distrust in their exposure to AIDS information. Higher levels of AIDS-related distrust were not related to self-reported personal risk reduction, but were related to inaccurate beliefs about HIV transmission through casual contact and greater willingness to avoid and stigmatize people with AIDS. The importance of overcoming distrust in AIDS education programs is discussed. PMID:7986656

  8. AIDS/HIV education for preservice elementary teachers.

    PubMed

    Ballard, D J; White, D M; Glascoff, M A

    1990-08-01

    Professional preparation programs should provide future elementary teachers opportunities to develop competence in dealing with school-related AIDS issues. Curriculum writers and instructors of preservice elementary teachers could be more effective if they were aware of this groups' beliefs about school-related AIDS issues. A survey was conducted to assess the beliefs and opinions of preservice elementary teachers about school-related AIDS issues. Subjects (n = 157) generally agreed they would eventually have a child with AIDS in their classroom and agreed AIDS education should be included in the elementary grades, yet a substantial number did not believe they understood the basics about AIDS. Less than one-third indicated they knew how to clean up blood or body fluids safely. About one-third indicated they would feel personally threatened to teach a student with AIDS. These results are reflected in recommended AIDS educational content and resources for preservice elementary teachers and future research in this area. PMID:2232729

  9. HIV / AIDS Network.

    PubMed

    1995-01-01

    The HIV/AIDS Network and the Philippines Department of Health (DOH) collaborated to produce the AIDS Candlelight Memorial at the Philippine International Convention Center (PICC), May 1995, and World AIDS Day activities on December 1, 1995. After the memorial, a fashion show, "Body Shots," provided a channel for information on acquired immunodeficiency syndrome (AIDS). On World AIDS Day, at the request of DOH, the Network provided speakers who lectured on human immunodeficiency virus (HIV) and AIDS in different government offices. Prior to World AIDS Day, the Network focused on strengthening its cohesiveness and building the capabilities of its member organizations through lectures and symposia during November. Network activities were coordinated by the Remedios AIDS Foundation with support from the other members of the Coordinating Council: Health Action Information Network (HAIN); Caritas; Kabalikat, Stop Trafficking of Pilopinos Foundation, Inc. (STOP);and the Library Foundation (TLF). The Coordinating Council elected for 1996 includes the Remedios AIDS Foundation, HAIN, Caritas, TLF, STOP, the Foundation for Adolescent Development (FAD), and the Salvation Army. PMID:12291699

  10. AIDS: Psychosocial Dimensions

    PubMed Central

    Stapleton, Dan

    1986-01-01

    In order to provide comprehensive care to patients who have AIDS, it is important for the family physician to understand the psychosocial elements of the disease. Homosexual men who have AIDS face particular problems, such as the disclosure of sexual orientation to family and friends. Issues discussed in this article include the reactions of the patient, family and friends to the diagnosis, the stigma of AIDS, the patient's support network, and preparations for disability and death. The facts about AIDS are discussed briefly, and the psychosocial implications of the illness for patients and their “significant others” are examined. The role of the family physician is highlighted. PMID:21267233

  11. Music and hearing aids.

    PubMed

    Madsen, Sara M K; Moore, Brian C J

    2014-01-01

    The signal processing and fitting methods used for hearing aids have mainly been designed to optimize the intelligibility of speech. Little attention has been paid to the effectiveness of hearing aids for listening to music. Perhaps as a consequence, many hearing-aid users complain that they are not satisfied with their hearing aids when listening to music. This issue inspired the Internet-based survey presented here. The survey was designed to identify the nature and prevalence of problems associated with listening to live and reproduced music with hearing aids. Responses from 523 hearing-aid users to 21 multiple-choice questions are presented and analyzed, and the relationships between responses to questions regarding music and questions concerned with information about the respondents, their hearing aids, and their hearing loss are described. Large proportions of the respondents reported that they found their hearing aids to be helpful for listening to both live and reproduced music, although less so for the former. The survey also identified problems such as distortion, acoustic feedback, insufficient or excessive gain, unbalanced frequency response, and reduced tone quality. The results indicate that the enjoyment of listening to music with hearing aids could be improved by an increase of the input and output dynamic range, extension of the low-frequency response, and improvement of feedback cancellation and automatic gain control systems. PMID:25361601

  12. Music and Hearing Aids

    PubMed Central

    Moore, Brian C. J.

    2014-01-01

    The signal processing and fitting methods used for hearing aids have mainly been designed to optimize the intelligibility of speech. Little attention has been paid to the effectiveness of hearing aids for listening to music. Perhaps as a consequence, many hearing-aid users complain that they are not satisfied with their hearing aids when listening to music. This issue inspired the Internet-based survey presented here. The survey was designed to identify the nature and prevalence of problems associated with listening to live and reproduced music with hearing aids. Responses from 523 hearing-aid users to 21 multiple-choice questions are presented and analyzed, and the relationships between responses to questions regarding music and questions concerned with information about the respondents, their hearing aids, and their hearing loss are described. Large proportions of the respondents reported that they found their hearing aids to be helpful for listening to both live and reproduced music, although less so for the former. The survey also identified problems such as distortion, acoustic feedback, insufficient or excessive gain, unbalanced frequency response, and reduced tone quality. The results indicate that the enjoyment of listening to music with hearing aids could be improved by an increase of the input and output dynamic range, extension of the low-frequency response, and improvement of feedback cancellation and automatic gain control systems. PMID:25361601

  13. The association of HIV/AIDS treatment side effects with health status, work productivity, and resource use.

    PubMed

    daCosta DiBonaventura, Marco; Gupta, Shaloo; Cho, Michelle; Mrus, Joseph

    2012-01-01

    Due to stable incidence and improved survival rates, there are an increasing number of patients living with HIV/AIDS in the USA. Although highly effective, current antiretroviral therapies are associated with a variety of side effects. The role side effects play on health outcomes has not been fully examined. The current study assessed the association of medication side effects with (1) self-assessed health status; (2) work productivity and activity impairment; and (3) healthcare resource utilization. Data were from a cross-sectional patient-reported survey fielded in the USA using a dual methodology of Internet and paper questionnaires. A total of 953 patients living with HIV/AIDS who were currently taking a medication for their condition were included in the analyses. The most frequent side effects reported by patients were fatigue (70.72%), diarrhea (62.96%), insomnia (58.97%), dizziness (52.78%), neuropathy (52.68%), joint pain (52.36%), nausea (51.63%), and abdominal pain (50.37%). The presence of each side effect was associated with reduced self-assessed health status, increased productivity loss, increased activity impairment, and increased healthcare resource use. Controlling for CD4 cell counts in regression modeling did little to diminish the impact of side effects. Although not all side effects were associated with all outcomes, every side effect was associated with worse health status, some measure of increased work productivity loss, and/or some measure of increased healthcare resource use. Patients are living longer with HIV and, therefore, spending a greater length of time on treatment. The results of the current study suggest that many of these patients are experiencing a wide array of side effects from these therapies. These side effects have demonstrated a profound association with self-assessed health, work productivity, and healthcare resource use. Improved management of these side effects or development of treatments with a better side effect

  14. A project in Zambia: talking to children about AIDS.

    PubMed

    Baker, K

    1988-09-01

    Early in 1987, it became clear to this individual that children were a high priority group for Acquired Immune Deficiency Syndrome (AIDS) education. Preparation for providing AIDS education in Zambia included reading as much as possible about AIDS and AIDS education in schools, contacting the Health Education Unit at the Ministry of Health for their permission and advice, and making posters and preparing a list of 10 basic questions about AIDS. The 1st talks were at a boys' technical school and a large girls' day school. Following an introduction of the subject, the format included: a 10-minute quiz with students writing down their answers; a 35-40 minute talk, using posters as visual aids; a 20-30 minute open question time; and a repeat of the same quiz as a form of "posttest." The students responded positively, and there was a substantial increase in the percentage of correct answers after each talk. Subsequently, talks were given in other Lusaka secondary schools. After the 1st few talks, the pretest and posttest was discontinued as it was considered preferable to spend more time answering the students' questions. The talks varied depending on the audience, but posters were always included as visual aids. Initially, this AIDS education effort was voluntary and unfunded. Subsequently, and as the work grew, NORAD funded the project, paying for duplicating and printing as well as a salary on an hourly basis. A booklet on AIDS for secondary schools has been written and duplicated and accepted by the Intersectorial Committee on AIDS Health Education with minor changes. Late in 1987, the booklet was rewritten totally and expanded, with numerous illustrations. Throughout the booklet, human immunodeficiency virus (HIV) is carefully differentiated from AIDS disease. Talks also have been initiated at the Upper Primary School level. The format has been altered somewhat for these younger children as they tend to be noisy and excited. The primary project planned for 1988 is

  15. NeuroAIDS in Africa

    PubMed Central

    Robertson, Kevin; Liner, Jeff; Hakim, James; Sankalé, Jean-Louis; Grant, Igor; Letendre, Scott; Clifford, David; Diop, Amadou Gallo; Jaye, Assan; Kanmogne, Georgette; Njamnshi, Alfred; Langford, T. Dianne; Gemechu Weyessa, Tufa; Wood, Charles; Banda, Mwanza; Hosseinipour, Mina; Sacktor, Ned; Nakasuja, Noeline; Bangirana, Paul; Paul, Robert; Joska, John; Wong, Joseph; Boivin, Michael; Holding, Penny; Kammerer, Betsy; Van Rie, Annelies; Ive, Prudence; Nath, Avindra; Lawler, Kathy; Adebamowo, Clement; Royal, Walter; Joseph, Jeymohan

    2013-01-01

    In July 2009, the Center for Mental Health Research on AIDS at the National Institute of Mental Health organized and supported the meeting “NeuroAIDS in Africa.” This meeting was held in Cape Town, South Africa, and was affiliated with the 5th IAS Conference on HIV Pathogenesis, Treatment and Prevention. Presentations began with an overview of the epidemiology of HIV in sub-Saharan Africa, the molecular epidemiology of HIV, HIV-associated neurocognitive disorders (HANDs), and HAND treatment. These introductory talks were followed by presentations on HAND research and clinical care in Botswana, Cameroon, Ethiopia, The Gambia, Kenya, Malawi, Nigeria, Senegal, South Africa, Uganda, and Zambia. Topics discussed included best practices for assessing neurocognitive disorders, patterns of central nervous system (CNS) involvement in the region, subtype-associated risk for HAND, pediatric HIV assessments and neurodevelopment, HIV-associated CNS opportunistic infections and immune reconstitution syndrome, the evolving changes in treatment implementation, and various opportunities and strategies for NeuroAIDS research and capacity building in the region. PMID:20500018

  16. The Aid Debate: Beyond the Liberal/Conservative Divide

    ERIC Educational Resources Information Center

    Kamat, Sangeeta

    2010-01-01

    Recent works that assess whether development has been well-served, or served at all, by international aid, are overwhelmingly pessimistic in their assessment and in favor of the market as the antidote to international aid (Klees, 2010). The author finds that Steve Klees' essay focuses on the neoliberal and liberal frameworks that represent the…

  17. Aid to families with dependent children: who receives more than $22 billion and why?

    PubMed

    Waldman, H B

    1996-01-01

    A general outline of the Aid to Families with Dependent Children program is provided. The $22 billion program provides financial support to 14 million persons (including more than 9 million children). The changing character of the family structure is considered in terms of efforts to control AFDC spending. Additional programs to assist children (Social Security, Supplemental Security Insurance and Food Stamps) are reviewed. PMID:8708125

  18. AIDS is your business.

    PubMed

    Rosen, Sydney; Simon, Jonathon; Vincent, Jeffrey R; MacLeod, William; Fox, Matthew; Thea, Donald M

    2003-02-01

    If your company operates in a developing country, AIDS is your business. While Africa has received the most attention, AIDS is also spreading swiftly in other parts of the world. Russia and Ukraine had the fastest-growing epidemics last year, and many experts believe China and India will suffer the next tidal wave of infection. Why should executives be concerned about AIDS? Because it is destroying the twin rationales of globalization strategy-cheap labor and fast-growing markets--in countries where people are heavily affected by the epidemic. Fortunately, investments in programs that prevent infection and provide treatment for employees who have HIV/AIDS are profitable for many businesses--that is, they lead to savings that outweigh the programs' costs. Due to the long latency period between HIV infection and the onset of AIDS symptoms, a company is not likely to see any of the costs of HIV/AIDS until five to ten years after an employee is infected. But executives can calculate the present value of epidemic-related costs by using the discount rate to weigh each cost according to its expected timing. That allows companies to think about expenses on HIV/AIDS prevention and treatment programs as investments rather than merely as costs. The authors found that the annual cost of AIDS to six corporations in South Africa and Botswana ranged from 0.4% to 5.9% of the wage bill. All six companies would have earned positive returns on their investments if they had provided employees with free treatment for HIV/AIDS in the form of highly active antiretroviral therapy (HAART), according to the mathematical model the authors used. The annual reduction in the AIDS "tax" would have been as much as 40.4%. The authors' conclusion? Fighting AIDS not only helps those infected; it also makes good business sense. PMID:12577655

  19. AIDS and student attitudes.

    PubMed

    Merrill, J M; Laux, L; Thornby, J I

    1989-04-01

    When recently polled, one half of 4,100 physicians believed they had the right not to treat patients with the acquired immunodeficiency syndrome (AIDS), and 15% said they would actually refuse to care for them. To assure medical care for the 365,000 AIDS patients projected for the US by 1992, it is imperative to know whether there is something unique about AIDS patients that produces aversion among physicians. We hypothesized that the desire to avoid AIDS patients derived from three fears: fear of contagion, homophobia, and a desire to avoid dying patients. To identify the extent to which these three fears affect the attitudes that students hold toward AIDS patients, we conducted three studies. In our first study, we discovered that students' views about a patient with a terminal illness are the same whether the illness is leukemia or AIDS. In the second study, we found that the patient's sexual preference was not the major reason students would avoid an AIDS patients. In a third study, we confirmed that fear of contagion is the principal cause of students' desire to avoid an AIDS patient. In the course of these studies, we found important differences between the attitudes of male and female students. Female students scored lower on the homophobic scale than male students, and they had less antipathy toward AIDS patients. Helping health care professionals understand their fears toward patients with AIDS will in the long run improve medical care. Since the origins of these fears are for the most part well hidden in our unconscious, dissemination of facts alone will not do the job. Interventions are needed to help health care professionals acknowledge and overcome their negative feelings about AIDS. PMID:2705068

  20. Three essays on the causes and consequences of government spending and regulatory programs

    NASA Astrophysics Data System (ADS)

    Bee, C. Adam

    Chapter 1 assesses the impact of household car ownership on individual labor supply. Various economic theories suggest one reason for low rates of employment among low-skill, inner-city residents is that their residences are spatially separated from suburban jobs. To measure this, I exploit changes in state insurance rate regulation which has been shown to suppress auto insurance prices, thereby decreasing the cost of owning a car. I find that rate regulation increases multi-car ownership among married couples with children. I find that the additional car in the household consequently encourages married mothers to decrease their labor supply while their husbands increase their labor supply. One possible explanation of this result is that second cars are stronger complements to time spent in home production (and especially childrearing) than they are to time spent in the labor market. Chapter 2 (with Shawn Moulton) tests for political budget cycles among US municipalities. According to the political budget cycle hypothesis, in election years government officials engage in opportunistic fiscal policy manipulation for electoral gains. This chapter tests that hypothesis using data on taxes and spending for a panel of 268 US cities over the period 1970-2004. While our estimates provide no evidence of altered total expenditures or taxes in election years, we do find a 0.7 percent increase in total municipal employment, including increases in police, education, and sanitation employment. Chapter 3 (with Andrew Deines, David Lodge, and Richard Jensen) assesses trade-offs between fisheries and hydropower production in a tropical floodplain fishery. We compile catch per unit effort, total harvest, and monthly-mean hydrographs from the Kafue River in Zambia for the years 1955-1996 and develop population growth models to test for effects of density, total fisheries harvest, and water regime. We find that alteration of the flood regime has reduced fish density but enhanced