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

PubMed

Uzogara, S G

2000-05-01

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

Benefits and drawbacks of electronic health record systems

PubMed Central

Menachemi, Nir; Collum, Taleah H

2011-01-01

The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 that was signed into law as part of the “stimulus package” represents the largest US initiative to date that is designed to encourage widespread use of electronic health records (EHRs). In light of the changes anticipated from this policy initiative, the purpose of this paper is to review and summarize the literature on the benefits and drawbacks of EHR systems. Much of the literature has focused on key EHR functionalities, including clinical decision support systems, computerized order entry systems, and health information exchange. Our paper describes the potential benefits of EHRs that include clinical outcomes (eg, improved quality, reduced medical errors), organizational outcomes (eg, financial and operational benefits), and societal outcomes (eg, improved ability to conduct research, improved population health, reduced costs). Despite these benefits, studies in the literature highlight drawbacks associated with EHRs, which include the high upfront acquisition costs, ongoing maintenance costs, and disruptions to workflows that contribute to temporary losses in productivity that are the result of learning a new system. Moreover, EHRs are associated with potential perceived privacy concerns among patients, which are further addressed legislatively in the HITECH Act. Overall, experts and policymakers believe that significant benefits to patients and society can be realized when EHRs are widely adopted and used in a “meaningful” way. PMID:22312227

Why System Safety Professionals Should Read Accident Reports

NASA Technical Reports Server (NTRS)

Holloway, C. M.; Johnson, C. W.

2006-01-01

System safety professionals, both researchers and practitioners, who regularly read accident reports reap important benefits. These benefits include an improved ability to separate myths from reality, including both myths about specific accidents and ones concerning accidents in general; an increased understanding of the consequences of unlikely events, which can help inform future designs; a greater recognition of the limits of mathematical models; and guidance on potentially relevant research directions that may contribute to safety improvements in future systems.

Lake Powell management alternatives and values: CVM estimates of recreation benefits

USGS Publications Warehouse

Douglas, A.J.; Harpman, D.A.

2004-01-01

This paper presents data analyses based on information gathered from a recreation survey distributed during the spring of 1997 at Lake Powell. Recreation-linked management issues are the foci of the survey and this discussion. Survey responses to contingent valuation method (CVM) queries included in the questionnaire quantify visitor recreation values. The CVM estimates of the benefits provided by potential resource improvements are compared with the costs of the improvements in a benefit-cost analysis. The CVM questions covered three resources management issues including water quality improvement, sport fish harvest enhancement, and archeological site protection and restoration. The estimated benefits are remarkably high relative to the costs and range from $6 to $60 million per year. The dichotomous choice format was used in each of three resource CVM question scenarios. There were two levels of enhancement for each resource. There are, therefore, several consistency requirements—some of them unique to the dichotomous choice format—that the data and benefit estimates must satisfy. These consistency tests are presented in detail in the ensuing analysis.

Improving Rural Teachers' Attitudes towards Acceleration

ERIC Educational Resources Information Center

Olthouse, Jill M.

2015-01-01

Gifted students see both educational benefits and barriers as a result of living in rural communities. Benefits include increased individual attention and community engagement; barriers include limited curricular options (Lawrence, 2009). Acceleration is an option that has positive academic outcomes but is underused, especially in rural areas.…

Northeast community tree guide: benefits, costs, and strategic planting

Treesearch

E. Gregory McPherson; James R. Simpson; Paula J. Peper; Shelley L. Gardner; Kelaine E. Vargas; Qingfu Xiao

2007-01-01

Trees make our cities more attractive and provide many ecosystem services, including air quality improvement, energy conservation, stormwater interception, and atmospheric carbon dioxide reduction. These benefits must be weighed against the costs of maintaining trees, including planting, pruning, irrigation, administration, pest control, liability, cleanup, and removal...

Maximizing Societal Benefits Associated With Alternative Fuel Subsidies: The Case of Plug-in Hybrid Electric Vehicles

NASA Astrophysics Data System (ADS)

Nazir, Samir M.

Government seeks to improve the welfare of its citizenry and intervenes in marketplaces to maximize benefits when externalities are not captured. By analyzing how welfare changes from area to area across the country in response to the same intervention informs where government should act. This thesis analyzes the case of plug-in hybrid electric vehicles (PHEVs). PHEVs have many societal benefits, including improving national security, economic, environmental, and health advantages. The magnitude and distribution of these benefits depends on where PHEVs are deployed. This thesis develops and applies a methodology to determine if the benefits from PHEV deployment vary across the country and for ranking regions where positive PHEV consequences are likely to be maximized. The metrics in this method are proxies of key variables which predict the level of benefits in a county from the deployment of a PHEV there; they include population, health benefits from reduced ozone concentration, vehicle miles traveled per capita, existence of non-federal policies, and CO 2 intensity of electricity. By shedding light on how benefits from PHEV deployment vary across counties, this thesis seeks to better inform where to enact government interventions to maximize the benefits of this technology.

Central Florida community tree guide: benefits, costs, and strategic planting

Treesearch

Paula J. Peper; E. Gregory McPherson; James R. Simpson; Shannon N. Albers; Qingfu Xiao

2010-01-01

Trees make our cities more attractive and provide many ecosystem services, including air quality improvement, energy conservation, stormwater interception, and atmospheric carbon dioxide reduction. These benefits must be weighed against the costs of maintaining trees, including planting, pruning, irrigation, administration, pest control, liability, cleanup, and removal...

Interior West community tree guide: benefits, costs, and strategic planting

Treesearch

Kelaine E. Vargas; Gregory E. McPherson; James R. Simpson; Paula J. Peper; Shelley L. Gardner; Qingfu Xiao

2007-01-01

Even as they increase the beauty of our surroundings, trees provide us with a great many ecosystem services, including air quality improvement, energy conservation, stormwater interception, and atmospheric carbon dioxide reduction. These benefits must be weighed against the costs of maintaining trees, including planting, pruning, irrigation, administration, pest...

Tropical community tree guide: benefits, costs, and strategic planting

Treesearch

Kelaine E. Vargas; Gregory E. McPherson; James R. Simpson; Paula J. Peper; Shelley L. Gardner; Qingfu Xiao

2008-01-01

Even as they increase the beauty of our surroundings, trees provide us with a great many ecosystem services, including air quality improvement, energy conservation, stormwater interception, and atmospheric carbon dioxide reduction. These benefits must be weighed against the costs of maintaining trees, including planting, pruning, irrigation, administration, pest...

Northern California coast community tree guide: benefits, costs, and strategic planting

Treesearch

E. Gregory McPherson; James R. Simpson; Paula. J. Peper; Aaron M.N. Crowell; Qingfu Xiao

2010-01-01

Trees make our cities more attractive and provide many ecosystem services, including air quality improvement, energy conservation, stormwater interception, and atmospheric carbon dioxide reduction. These benefits must be weighed against the costs of maintaining trees, including planting, pruning, irrigation, administration, pest control, liability, cleanup, and removal...

Temperate Interior West community tree guide: benefits, costs, and strategic planting

Treesearch

Kelaine E. Vargas; E. Gregory McPherson; James R. Simpson; Paula J. Peper; Shelley L. Gardner; Qingfu Xiao

2007-01-01

Even as they increase the beauty of our surroundings, trees provide us with a great many ecosystem services, including air quality improvement, energy conservation, stormwater interception, and atmospheric carbon dioxide reduction. These benefits must be weighed against the costs of maintaining trees, including planting, pruning, irrigation, administration, pest...

Lower Midwest community tree guide: benefits, costs, and strategic planting

Treesearch

Paula J. Peper; E. Gregory McPherson; James R. Simpson; Kelaine E. Vargas; Qingfu Xiao

2009-01-01

Even as they increase the beauty of our surroundings, trees provide us with a great many ecosystem services, including air quality improvement, energy conservation, stormwater interception, and atmospheric carbon dioxide reduction. These benefits must be weighed against the costs of maintaining trees, including planting, pruning, irrigation, administration, pest...

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

PubMed

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

2017-01-01

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

Veterans' Employment and Education. Hearing on S. 2515, Veterans' Employment and Training Act of 1992 and S. 2647, Veterans' Readjustment Benefits Improvement Act of 1992 before the Committee on Veterans' Affairs. United States Senate, One Hundred Second Congress, Second Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on Veteran's Affairs.

This document records the oral and written testimony of witnesses who testified concerning the Veterans' Employment and Training Act of 1992 and the Veterans' Readjustment Benefits Improvement Act of 1992. It also includes the texts of the bills. Witnesses included representatives of veterans' organizations, disabled veterans' groups, the U.S.…

Who Benefits from Pension Enhancements?

ERIC Educational Resources Information Center

Koedel, Cory; Ni, Shawn; Podgursky, Michael

2014-01-01

During the late 1990s public pension funds across the United States accrued large actuarial surpluses. The seemingly flush conditions of the pension funds led legislators in most states to substantially improve retirement benefits for public workers, including teachers. In this study we examine the benefit enhancements to the teacher pension…

Who Benefits from Pension Enhancements? Working Paper 76

ERIC Educational Resources Information Center

Koedel, Cory; Ni, Shawn; Podgursky, Michael

2012-01-01

During the late 1990s public pension funds across the United States accrued large actuarial surpluses. The seemingly flush conditions of the pension funds led legislators in most states to substantially improve retirement benefits for public workers, including teachers. In this study we examine the benefit enhancements to the teacher pension…

Air Starters for Transit Buses

DOT National Transportation Integrated Search

1983-05-01

This study was conducted to familiarize transit agencies with the potential benefits gained by utilizing air starting systems as an alternative to electrical starting systems. The potential benefits include improved starting reliability under hot and...

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

PubMed

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

2017-09-01

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

Community benefit: what it is and isn't.

PubMed

Dean, Natalie; Trocchio, Julie

2005-01-01

"Community benefit" is the measurable contribtution made by Catholic and other tax-exempt organizations to support the health needs of disadvantaged persons and to improve the overall health and well-being of local communities. Community benefit activities include outreach to low-income and other vulnerable persons; charity care for people unable to afford services; health education and illness prevention; special health care initiatives for at-risk school children; free or low-cost clinics; and efforts to improve and revitalize communities. These activities are often provided in collaboration with community members and other community organizations to improve local health and quality of life for everyone. Since 1989, the Catholic health ministry has utilized a systematic approach to plan, monitor, report, and evaluate the community benefit activities and services it provides to its communities. This approach, first described in CHA's Social Accountability Budget, was updated in the recent Community Benefit Reporting: Guidelines and Standard Definitions for the Community Benefit Inventory for Social Accountability. By using credible and consistent information, health care organizations can improve their strategic response to demands for information that demonstrates their worth.

Exercise in the healthy older adult.

PubMed

Karani, R; McLaughlin, M A; Cassel, C K

2001-01-01

Habitual exercise provides numerous health benefits to the older adult. While dynamic aerobic activities increase stamina and lung capacity, isometric or resistance training improves muscle strength and endurance. Long-term benefits of continued exercise include a decreased risk of death from heart disease, enhanced balance and mobility, a decreased risk of diabetes, and an improvement in depressive symptoms. While the hazards of exercise relate predominantly to extremes of intensity and duration, all older adults should consult with a physician before beginning a new activity program. A prescription for exercise should include both aerobic and resistance training components, and frequent follow-up to improve adherence is highly recommended. (c)2001 CVRR, Inc.

Economic evaluation of distribution system smart grid investments

DOE PAGES

Onen, Ahmet; Cheng, Danling; Broadwater, Robert P.; ...

2014-12-31

This paper investigates economic benefits of smart grid automation investments. A system consisting of 7 substations and 14 feeders is used in the evaluation. Here benefits that can be quantified in terms of dollar savings are considered, termed “hard dollar” benefits. Smart Grid investment evaluations to be considered include investments in improved efficiency, more cost effective use of existing system capacity with automated switches, and coordinated control of capacitor banks and voltage regulators. These Smart Grid evaluations are sequentially ordered, resulting in a series of incremental hard dollar benefits. Hard dollar benefits come from improved efficiency, delaying large capital equipmentmore » investments, shortened storm restoration times, and reduced customer energy use. Analyses used in the evaluation involve hourly power flow analysis over multiple years and Monte Carlo simulations of switching operations during storms using a reconfiguration for restoration algorithm. The economic analysis uses the time varying value of the Locational Marginal Price. Algorithms used include reconfiguration for restoration involving either manual or automated switches and coordinated control involving two modes of control. Field validations of phase balancing and capacitor design results are presented. The evaluation shows that investments in automation can improve performance while at the same time lowering costs.« less

Long-term effects of recombinant human growth hormone therapy in children with Prader-Willi syndrome.

PubMed

Wolfgram, Peter M; Carrel, Aaron L; Allen, David B

2013-08-01

Recombinant human growth hormone (hGH) therapy in children with Prader-Willi syndrome (PWS) improves linear growth, body composition, physical strength and agility, and other metabolic parameters. These benefits must be weighed against potential adverse effects, including rare occurrences of sudden death. This review summarizes recent evidence important to a benefit-risk analysis of hGH use in children with PWS. Studies consistently show that hGH improves stature, body composition, fat percentage and distribution, and other metabolic markers in children with PWS. Preliminary reports of improved cognitive development during hGH have also emerged. Scoliosis progression is influenced by growth rate, but frequency of occurrence and severity are not increased by hGH exposure. PWS genotype does not appear to affect response to hGH. Concerns about hGH-associated sudden death persist, but recent studies show either absence of change in sleep-disordered breathing or improved sleep cardiovascular function during hGH therapy. Recent studies confirm and expand reported benefits of hGH therapy in children with PWS, including a possible salutary role in cognitive development. These findings support previous assertions that hGH can reduce morbidity and improve function in children with PWS, and suggest that potential risks of such treatment are favorably balanced by its benefits.

Workshop: Valuation for Environmental Policy: Ecological Benefits (2007)

EPA Pesticide Factsheets

Two-day workshop includes research examining There were presentations on the estimation of values for ecological goods and services such as water quality, wetlands, riparian habitat, and aquatic resources, improved methods for benefits transfer.

Evaluating projects for improving fish and wildlife habitat on National Forests.

Treesearch

Fred H. Everest; Daniel R. Talhelm

1982-01-01

Recent legislation (PL. 93-452; P.L. 94-588) has emphasized improvement of fish and wildlife habitat on lands of the National Forest System. A sequential procedure has been developed for screening potential projects to identify those producing the greatest fishery benefits. The procedure—which includes program planning, project planning, and intensive benefit/cost...

Why do kids eat healthful food? Perceived benefits of and barriers to healthful eating and physical activity among children and adolescents.

PubMed

O'dea, Jennifer A

2003-04-01

The goal was to have children and adolescents identify and rank the major perceived benefits of and barriers to healthful eating and physical activity and to suggest strategies for overcoming barriers. Semistructured, in-depth focus groups were undertaken using standardized questions and prompts. Students in grades 2 through 11(ages 7 through 17; N=213) from 34 randomly selected schools participated in 38 focus groups. Major benefits of healthful eating included improvements to cognitive and physical performance, fitness, endurance, psychological benefits, physical sensation (feeling good physically), and production of energy. Barriers included convenience, taste, and social factors. Benefits of physical activity included social benefits, enhancement of psychological status, physical sensation, and sports performance. Barriers included a preference for indoor activities, lack of energy and motivation, time constraints, and social factors. Suggested strategies for overcoming barriers included support from parents and school staff, better planning, time management, self-motivation, education, restructuring the physical environment, and greater variety of physical activities.

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

PubMed

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

2012-03-01

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

Economic Benefits of Improved Information on Worldwide Crop Production: An Optimal Decision Model of Production and Distribution with Application to Wheat, Corn, and Soybeans

NASA Technical Reports Server (NTRS)

Andrews, J.

1977-01-01

An optimal decision model of crop production, trade, and storage was developed for use in estimating the economic consequences of improved forecasts and estimates of worldwide crop production. The model extends earlier distribution benefits models to include production effects as well. Application to improved information systems meeting the goals set in the large area crop inventory experiment (LACIE) indicates annual benefits to the United States of $200 to $250 million for wheat, $50 to $100 million for corn, and $6 to $11 million for soybeans, using conservative assumptions on expected LANDSAT system performance.

Thermal barrier coating on high temperature industrial gas turbine engines

NASA Technical Reports Server (NTRS)

Carlson, N.; Stoner, B. L.

1977-01-01

The thermal barrier coating used was a yttria stabilized zirconia material with a NiCrAlY undercoat, and the base engine used to establish improvements was the P&WA FT50A-4 industrial gas turbine engine. The design benefits of thermal barrier coatings include simplified cooling schemes and the use of conventional alloys in the engine hot section. Cooling flow reductions and improved heating rates achieved with thermal barrier coating result in improved performance. Economic benefits include reduced power production costs and reduced fuel consumption. Over the 30,000 hour life of the thermal barrier coated parts, fuel savings equivalent to $5 million are projected and specific power (megawatts/mass of engine airflow) improvements on the order of 13% are estimated.

The economic value of remote sensing of earth resources from space: An ERTS overview and the value of continuity of service. Volume 3: Intensive use of living resources: Agriculture. Part 1: Overview

NASA Technical Reports Server (NTRS)

Kornhauser, A. L.; Wilson, L. B.

1974-01-01

Potential economic benefits obtainable from a state-of-the-art ERS system in the resource area of intensive use of living resources, agriculture, are studied. A spectrum of equal capability (cost saving), increased capability, and new capability benefits are quantified. These benefits are estimated via ECON developed models of the agricultural marketplace and include benefits of improved production and distribution of agricultural crops. It is shown that increased capability benefits and new capability benefits result from a reduction of losses due to disease and insect infestation given ERS's capability to distinguish crop vigor and from the improvement in world trade negotiations given ERS's worldwide surveying capability.

Optimisation of follow-up after metabolic surgery.

PubMed

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

2018-06-01

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

Exergames for Physical Education Courses: Physical, Social, and Cognitive Benefits.

PubMed

Staiano, Amanda E; Calvert, Sandra L

2011-06-01

Digital games combining exercise with game play, known as exergames, can improve youths' health status and provide social and academic benefits. Exergame play increases caloric expenditure, heart rate, and coordination. Psychosocial and cognitive impacts of exergame play may include increased self-esteem, social interaction, motivation, attention, and visual-spatial skills. This article summarizes the literature on exergames, with a special emphasis on physical education courses and the potential of exergames to improve students' physical health, as well as transfer effects that may benefit related physical, social, and academic outcomes.

Exergames for Physical Education Courses: Physical, Social, and Cognitive Benefits

PubMed Central

Staiano, Amanda E.; Calvert, Sandra L.

2012-01-01

Digital games combining exercise with game play, known as exergames, can improve youths’ health status and provide social and academic benefits. Exergame play increases caloric expenditure, heart rate, and coordination. Psychosocial and cognitive impacts of exergame play may include increased self-esteem, social interaction, motivation, attention, and visual–spatial skills. This article summarizes the literature on exergames, with a special emphasis on physical education courses and the potential of exergames to improve students’ physical health, as well as transfer effects that may benefit related physical, social, and academic outcomes. PMID:22563349

The benefits of integrating cost-benefit analysis and risk assessment

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

Fisher, K.; Clarke-Whistler, K.

1995-12-31

It has increasingly been recognized that knowledge of risks in the absence of benefits and costs cannot dictate appropriate public policy choices. Recent evidence of this recognition includes the proposed EPA Risk Assessment and Cost-Benefit Analysis Act of 1995, a number of legislative changes in Canada and the US, and the increasing demand for field studies combining measures of impacts, risks, costs and benefits. Failure to consider relative environmental and human health risks, benefits, and costs in making public policy decisions has resulted in allocating scarce resources away from areas offering the highest levels of risk reduction and improvements inmore » health and safety. The authors discuss the implications of not taking costs and benefits into account in addressing environmental risks, drawing on examples from both Canada and the US. The authors also present the results of their recent field work demonstrating the advantages of considering costs and benefits in making public policy and site remediation decisions, including a study on the benefits and costs of prevention, remediation and monitoring techniques applied to groundwater contamination; the benefits and costs of banning the use of chlorine; and the benefits and costs of Canada`s concept of disposing of high-level nuclear waste. The authors conclude that a properly conducted Cost-Benefit Analysis can provide critical input to a Risk Assessment and can ensure that risk management decisions are efficient, cost-effective and maximize improvement to environmental and human health.« less

Let the Professionals Do It.

ERIC Educational Resources Information Center

Hoover, James P.; Main, Ron

2003-01-01

Describes benefits of West Allegheny (Pennsylvania) School District's decision to outsource the management of its technology services. Benefits include improved efficiency, increased technical expertise, cost-effectiveness, personnel stability, and organizational focus. Lists important points to consider when selecting an outsourcing firm. (PKP)

Mobile Health Devices as Tools for Worldwide Cardiovascular Risk Reduction and Disease Management

PubMed Central

Piette, John D.; List, Justin; Rana, Gurpreet K.; Townsend, Whitney; Striplin, Dana; Heisler, Michele

2015-01-01

We examined evidence on whether mobile health (mHealth) tools, including Interactive Voice Response (IVR) calls, short message service (SMS) or text messaging, and smartphones, can improve lifestyle behaviors and management related to cardiovascular diseases throughout the world. We conducted a state-of-the-art review and literature synthesis of peer-reviewed and grey literature published since 2004. The review prioritized randomized trials and studies focused on cardiovascular diseases and risk factors, but included other reports when they represented the best available evidence. The search emphasized reports on the potential benefits of mHealth interventions implemented in low- and middle-income countries (LMICs). IVR and SMS interventions can improve cardiovascular preventive care in developed countries by addressing risk factors including weight, smoking, and physical activity. IVR and SMS-based interventions for cardiovascular disease management also have shown benefits with respect to hypertension management, hospital readmissions, and diabetic glycemic control. Multi-modal interventions including web-based communication with clinicians and mHealth-enabled clinical monitoring with feedback also have shown benefits. The evidence regarding the potential benefits of interventions using smartphones and social media is still developing. Studies of mHealth interventions have been conducted in more than 30 LMICs, and evidence to date suggests that programs are feasible and may improve medication adherence and disease outcomes. Emerging evidence suggests that mHealth interventions may improve cardiovascular-related lifestyle behaviors and disease management. Next generation mHealth programs developed worldwide should be based on evidence-based behavioral theories and incorporate advances in artificial intelligence for adapting systems automatically to patients’ unique and changing needs. PMID:25690685

Mobile Health Devices as Tools for Worldwide Cardiovascular Risk Reduction and Disease Management

PubMed Central

Piette, John D.; List, Justin; Rana, Gurpreet K.; Townsend, Whitney; Striplin, Dana; Heisler, Michele

2016-01-01

We examined evidence on whether mobile health (mHealth) tools, including Interactive Voice Response (IVR) calls, short message service (SMS) or text messaging, and smartphones, can improve lifestyle behaviors and management related to cardiovascular diseases throughout the world. We conducted a state-of-the-art review and literature synthesis of peer-reviewed and grey literature published since 2004. The review prioritized randomized trials and studies focused on cardiovascular diseases and risk factors, but included other reports when they represented the best available evidence. The search emphasized reports on the potential benefits of mHealth interventions implemented in low- and middle-income countries (LMICs). IVR and SMS interventions can improve cardiovascular preventive care in developed countries by addressing risk factors including weight, smoking, and physical activity. IVR and SMS-based interventions for cardiovascular disease management also have shown benefits with respect to hypertension management, hospital readmissions, and diabetic glycemic control. Multi-modal interventions including web-based communication with clinicians and mHealth-enabled clinical monitoring with feedback also have shown benefits. The evidence regarding the potential benefits of interventions using smartphones and social media is still developing. Studies of mHealth interventions have been conducted in more than 30 LMICs, and evidence to date suggests that programs are feasible and may improve medication adherence and disease outcomes. Emerging evidence suggests that mHealth interventions may improve cardiovascular-related lifestyle behaviors and disease management. Next generation mHealth programs developed worldwide should be based on evidence-based behavioral theories and incorporate advances in artificial intelligence for adapting systems automatically to patients’ unique and changing needs. PMID:26596977

Effects of mental health benefits legislation: a community guide systematic review.

PubMed

Sipe, Theresa Ann; Finnie, Ramona K C; Knopf, John A; Qu, Shuli; Reynolds, Jeffrey A; Thota, Anilkrishna B; Hahn, Robert A; Goetzel, Ron Z; Hennessy, Kevin D; McKnight-Eily, Lela R; Chapman, Daniel P; Anderson, Clinton W; Azrin, Susan; Abraido-Lanza, Ana F; Gelenberg, Alan J; Vernon-Smiley, Mary E; Nease, Donald E

2015-06-01

Health insurance benefits for mental health services typically have paid less than benefits for physical health services, resulting in potential underutilization or financial burden for people with mental health conditions. Mental health benefits legislation was introduced to improve financial protection (i.e., decrease financial burden) and to increase access to, and use of, mental health services. This systematic review was conducted to determine the effectiveness of mental health benefits legislation, including executive orders, in improving mental health. Methods developed for the Guide to Community Preventive Services were used to identify, evaluate, and analyze available evidence. The evidence included studies published or reported from 1965 to March 2011 with at least one of the following outcomes: access to care, financial protection, appropriate utilization, quality of care, diagnosis of mental illness, morbidity and mortality, and quality of life. Analyses were conducted in 2012. Thirty eligible studies were identified in 37 papers. Implementation of mental health benefits legislation was associated with financial protection (decreased out-of-pocket costs) and appropriate utilization of services. Among studies examining the impact of legislation strength, most found larger positive effects for comprehensive parity legislation or policies than for less-comprehensive ones. Few studies assessed other mental health outcomes. Evidence indicates that mental health benefits legislation, particularly comprehensive parity legislation, is effective in improving financial protection and increasing appropriate utilization of mental health services for people with mental health conditions. Evidence was limited for other mental health outcomes. Published by Elsevier Inc.

Effects of Mental Health Benefits Legislation

PubMed Central

Sipe, Theresa Ann; Finnie, Ramona K.C.; Knopf, John A.; Qu, Shuli; Reynolds, Jeffrey A.; Thota, Anilkrishna B.; Hahn, Robert A.; Goetzel, Ron Z.; Hennessy, Kevin D.; McKnight-Eily, Lela R.; Chapman, Daniel P.; Anderson, Clinton W.; Azrin, Susan; Abraido-Lanza, Ana F.; Gelenberg, Alan J.; Vernon-Smiley, Mary E.; Nease, Donald E.

2015-01-01

Context Health insurance benefits for mental health services typically have paid less than benefits for physical health services, resulting in potential underutilization or financial burden for people with mental health conditions. Mental health benefits legislation was introduced to improve financial protection (i.e., decrease financial burden) and to increase access to, and use of, mental health services. This systematic review was conducted to determine the effectiveness of mental health benefits legislation, including executive orders, in improving mental health. Evidence acquisition Methods developed for the Guide to Community Preventive Services were used to identify, evaluate, and analyze available evidence. The evidence included studies published or reported from 1965 to March 2011 with at least one of the following outcomes: access to care, financial protection, appropriate utilization, quality of care, diagnosis of mental illness, morbidity and mortality, and quality of life. Analyses were conducted in 2012. Evidence synthesis Thirty eligible studies were identified in 37 papers. Implementation of mental health benefits legislation was associated with financial protection (decreased out-of-pocket costs) and appropriate utilization of services. Among studies examining the impact of legislation strength, most found larger positive effects for comprehensive parity legislation or policies than for less-comprehensive ones. Few studies assessed other mental health outcomes. Conclusions Evidence indicates that mental health benefits legislation, particularly comprehensive parity legislation, is effective in improving financial protection and increasing appropriate utilization of mental health services for people with mental health conditions. Evidence is limited for other mental health outcomes. PMID:25998926

Effects of Subsidies and Prohibitions on Nutrition in a Food Benefit Program

PubMed Central

Harnack, Lisa; Oakes, J. Michael; Elbel, Brian; Beatty, Timothy; Rydell, Sarah; French, Simone

2018-01-01

IMPORTANCE Strategies to improve the nutritional status of those participating in the Supplemental Nutrition Assistance Program (SNAP) are of interest to policymakers. OBJECTIVE To evaluate whether the proposed policy of incentivizing the purchase of fruits and vegetables and prohibiting the purchase of less nutritious foods in a food benefit program improves the nutritional quality of participants’ diets. DESIGN, SETTING, AND PARTICIPANTS Lower income participants (n = 279) not currently enrolled in SNAP were randomized to 1 of 4 experimental financial food benefit conditions: (1) incentive (30% financial incentive for fruits and vegetables purchased using food benefits); (2) restriction (not allowed to buy sugar sweetened beverages, sweet baked goods, or candies with food benefits); (3) incentive plus restriction (30% financial incentive on fruits and vegetables and restriction of purchase of sugar sweetened beverages, sweet baked goods, or candy with food benefits); or (4) control (no incentive or restrictions on foods purchased with food benefits). Participants in all conditions were given a study-specific debit card where funds were added every 4 weeks for a 12-week period. Outcome measures were collected at baseline and in the final 4 weeks of the experimental period. MAIN OUTCOMES AND MEASURES Primary outcomes (from 24-hour dietary recalls) included intake of energy, discretionary calories, and overall diet quality. RESULTS A number of favorable changes were observed in the incentive plus restriction condition that were significantly different from changes in the control condition. These included (1) reduced intake of energy (−96 kcal/d, standard error [SE], 59.9); (2) reduced intake of discretionary calories (−64 kcal/d, SE 26.3); (3) reduced intake of sugar sweetened beverages, sweet baked goods, and candies (−0.6 servings/d, SE 0.2); (4) increased intake of solid fruit (0.2 servings/d, SE 0.1); and (5) improved Healthy Eating Index score (4.1 points, SE 1.4). Fewer improvements were observed in the incentive only and restriction only arms. CONCLUSIONS AND RELEVANCE A food benefit program that pairs incentives for purchasing more fruits and vegetables with restrictions on the purchase of less nutritious foods may reduce energy intake and improve the nutritional quality of the diet of participants compared with a program that does not include incentives or restrictions. CLINICAL TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT02643576 PMID:27653735

Effects of Subsidies and Prohibitions on Nutrition in a Food Benefit Program: A Randomized Clinical Trial.

PubMed

Harnack, Lisa; Oakes, J Michael; Elbel, Brian; Beatty, Timothy; Rydell, Sarah; French, Simone

2016-11-01

Strategies to improve the nutritional status of those participating in the Supplemental Nutrition Assistance Program (SNAP) are of interest to policymakers. To evaluate whether the proposed policy of incentivizing the purchase of fruits and vegetables and prohibiting the purchase of less nutritious foods in a food benefit program improves the nutritional quality of participants' diets. Lower income participants (n = 279) not currently enrolled in SNAP were randomized to 1 of 4 experimental financial food benefit conditions: (1) incentive (30% financial incentive for fruits and vegetables purchased using food benefits); (2) restriction (not allowed to buy sugar sweetened beverages, sweet baked goods, or candies with food benefits); (3) incentive plus restriction (30% financial incentive on fruits and vegetables and restriction of purchase of sugar sweetened beverages, sweet baked goods, or candy with food benefits); or (4) control (no incentive or restrictions on foods purchased with food benefits). Participants in all conditions were given a study-specific debit card where funds were added every 4 weeks for a 12-week period. Outcome measures were collected at baseline and in the final 4 weeks of the experimental period. Primary outcomes (from 24-hour dietary recalls) included intake of energy, discretionary calories, and overall diet quality. A number of favorable changes were observed in the incentive plus restriction condition that were significantly different from changes in the control condition. These included (1) reduced intake of energy (-96 kcal/d, standard error [SE], 59.9); (2) reduced intake of discretionary calories (-64 kcal/d, SE 26.3); (3) reduced intake of sugar sweetened beverages, sweet baked goods, and candies (-0.6 servings/d, SE 0.2); (4) increased intake of solid fruit (0.2 servings/d, SE 0.1); and (5) improved Healthy Eating Index score (4.1 points, SE 1.4). Fewer improvements were observed in the incentive only and restriction only arms. A food benefit program that pairs incentives for purchasing more fruits and vegetables with restrictions on the purchase of less nutritious foods may reduce energy intake and improve the nutritional quality of the diet of participants compared with a program that does not include incentives or restrictions. clinicaltrials.gov Identifier: NCT02643576.

Beyond Strength: Participant Perspectives on the Benefits of an Older Adult Exercise Program.

PubMed

Kohn, Marlana; Belza, Basia; Petrescu-Prahova, Miruna; Miyawaki, Christina E

2016-06-01

This study examines the expected and experienced benefits among participants in Enhance®Fitness (EF), an evidence-based group physical activity program for older adults. We also describe the implications for program dissemination (reach, implementation, and maintenance) within the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework. Twenty semistructured interviews were conducted with EF participants enrolled from 2005 to 2012. Interviews were digitally recorded, professionally transcribed, and analyzed using a deductive approach. Participants were motivated to join EF for expected physical benefits and the social environment of a group-based class. Actualized benefits of participation included physical, social, functional, and improved self-image/sense of well-being. Participants valued the practical application of class exercises to daily activities that support independent living, such as lifting objects and completing household chores. Organizations looking to implement EF or improve existing EF classes can improve program reach, implementation, and maintenance by incorporating participants' expressed motivations and valued benefits in program marketing and by improving organizational support to meet participant needs. EF class instructors can tailor their classes to engage participants based on their motivations. Understanding participants' motivations and valued benefits can improve EF dissemination by meeting participant needs with tailored class offerings and organizational needs informed by participant insights that aid program sustainability. © 2015 Society for Public Health Education.

Benefits of community-based education to the community in South African health science facilities

PubMed Central

Flack, Penny

2013-01-01

Abstract Background Community-based education (CBE) is utilised by health science faculties worldwide to provide a relevant primary care experience for students and a service to underserved communities and, hopefully, to affect student career choices. The benefits to training institutions and students are well documented, but it may well be that communities, too, will be able to benefit from a more balanced partnership, where they are consulted in the planning of such training programmes. Method An exploratory qualitative study was undertaken by three South African universities in the provinces of Limpopo, KwaZulu-Natal and the Western Cape. Focus group interviews were conducted in their local languages with groups of community leaders, patients and supervisors at community sites involved in CBE training. A thematic analysis of their views was undertaken with the aid of NVivo (version 9). Ethics approval was obtained from the respective universities and health care training sites. Results Benefits to the community could be categorised into short-term and long-term benefits. Short-term benefits included improved service delivery, reduction in hospital referrals, home visits and community orientated primary health care, improved communication with patients and enhanced professionalism of the health care practitioner. Long-term benefits included improved teaching through a relationship with an academic institution and student familiarity with the health care system. Students also became involved in community upliftment projects, thereby acting as agents of change in these communities. Conclusion Communities can certainly benefit from well-planned CBE programmes involving a training site - community site partnership.

Research Review: Harnessing the power of individual participant data in a meta-analysis of the benefits and harms of the Incredible Years parenting program.

PubMed

Leijten, Patty; Gardner, Frances; Landau, Sabine; Harris, Victoria; Mann, Joanna; Hutchings, Judy; Beecham, Jennifer; Bonin, Eva-Maria; Scott, Stephen

2018-02-01

Parenting programs aim to reduce children's conduct problems through improvement of family dynamics. To date, research on the precise benefits and possible harms of parenting programs on family well-being has been unsystematic and likely to be subject to selective outcome reporting and publication bias. Better understanding of program benefits and harms requires full disclosure by researchers of all included measures, and large enough numbers of participants to be able to detect small effects and estimate them precisely. We obtained individual participant data for 14 of 15 randomized controlled trials on the Incredible Years parenting program in Europe (total N = 1,799). We used multilevel modeling to estimate program effects on 13 parent-reported outcomes, including parenting practices, children's mental health, and parental mental health. Parental use of praise, corporal punishment, threats, and shouting improved, while parental use of tangible rewards, monitoring, or laxness did not. Children's conduct problems and attention deficit hyperactivity disorder (ADHD) symptoms improved, while emotional problems did not. Parental mental health (depressive symptoms, self-efficacy, and stress) did not improve. There was no evidence of harmful effects. The Incredible Years parenting program improves the aspects of family well-being that it is primarily designed to improve: parenting and children's conduct problems. It also improves parent-reported ADHD symptoms in children. Wider benefits are limited: the program does not improve children's emotional problems or parental mental health. There are no signs of harm on any of the target outcomes. © 2017 Association for Child and Adolescent Mental Health.

Benefit transfer protocol for long-term health risk valuation: A case of surface water contamination

NASA Astrophysics Data System (ADS)

Kask, Susan B.; Shogren, Jason F.

1994-10-01

In response to scarce financial resources, economists have promoted the concept of benefit transfer as a cost-effective alternative to new nonmarket valuation studies. Recent discussion on benefit transfer for improved water quality has focused on recreational benefits. While useful, the discussion must now be expanded to include another key benefit from improved water quality: the reduction in risk to public health. This paper develops a protocol for benefit transfer of long-term health risk reduction and presents a case study for surface water contamination. Challenges such as the multiple sources of risk, the mortality and morbidity effects indicated by a variety of symptoms, the long latency period between cause and effect, and an individual's ability to privately or collectively reduce the probability or severity of the risk are discussed.

The benefits of health information exchange: an updated systematic review.

PubMed

Menachemi, Nir; Rahurkar, Saurabh; Harle, Christopher A; Vest, Joshua R

2018-04-28

Widespread health information exchange (HIE) is a national objective motivated by the promise of improved care and a reduction in costs. Previous reviews have found little rigorous evidence that HIE positively affects these anticipated benefits. However, early studies of HIE were methodologically limited. The purpose of the current study is to review the recent literature on the impact of HIE. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to conduct our systematic review. PubMed and Scopus databases were used to identify empirical articles that evaluated HIE in the context of a health care outcome. Our search strategy identified 24 articles that included 63 individual analyses. The majority of the studies were from the United States representing 9 states; and about 40% of the included analyses occurred in a handful of HIEs from the state of New York. Seven of the 24 studies used designs suitable for causal inference and all reported some beneficial effect from HIE; none reported adverse effects. The current systematic review found that studies with more rigorous designs all reported benefits from HIE. Such benefits include fewer duplicated procedures, reduced imaging, lower costs, and improved patient safety. We also found that studies evaluating community HIEs were more likely to find benefits than studies that evaluated enterprise HIEs or vendor-mediated exchanges. Overall, these finding bode well for the HIEs ability to deliver on anticipated improvements in care delivery and reduction in costs.

Taiji for individuals with Parkinson disease and their support partners: a program evaluation.

PubMed

Klein, Penelope J; Rivers, Lynn

2006-03-01

Exercise is advocated in the management of Parkinson disease (PD), however, little is known regarding the potential benefits of complementary mind/body exercise for this clinical population. The purpose of this pilot program evaluation was to gain insight into participant and instructor perceptions of the perceived benefits and potential utility of a taiji exercise program. Program participants (N=15) included 8 individuals with PD and 7 support partners with no history of PD. Group taiji instruction was offered in 45-minute weekly sessions, for 12 weeks at a community facility. Post-program evaluation included administration of a survey questionnaire, thematic analysis of a focus group discussion, instructor reflections, and review of attendance records. Benefits were perceived by participants in physical, psychological, and social domains. Thirteen of the survey respondents, including 6 of the 8 respondents with PD reported perceiving a physical benefit attributed to taiji practice. Improved balance was reported most frequently. Instructor observations and participant testimony suggest movement capability for individuals with Parkinsons may also be improved by performing taiji. This preliminary research provides support for further Taiji Buddy program examination and application.

The HPT Value Proposition in the Larger Improvement Arena.

ERIC Educational Resources Information Center

Wallace, Guy W.

2003-01-01

Discussion of human performance technology (HPT) emphasizes the key variable, which is the human variable. Highlights include the Ishikawa Diagram; human performance as one variable of process performance; collaborating with other improvement approaches; value propositions; and benefits to stakeholders, including real return on investments. (LRW)

Economic Benefits of Improved Water Quality: Public Perceptions of Option and Preservation Values

NASA Astrophysics Data System (ADS)

Bouwes, Nicolaas W., Sr.

The primary objective of this book is to report the authors‧ research approach to the estimation of benefits of water quality improvements in the South Platte River of northeastern Colorado. Benefits included a “consumer surplus” from enhanced enjoyment of water-based recreation, an “option value” of assured choice of future recreation use, and a “preservation value” of the ecosystem and its bequest to future generations. Concepts such as preservation and option value benefits have been often mentioned but seldom estimated in natural resources research. The authors have met their objective by providing the reader with a detailed description of their research without being tedious.

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

PubMed

Gonzalez, Marianne T; Kirkevold, Marit

2014-10-01

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

Mapping benefits from updated ifsar data in Alaska: improved source data enables better maps

USGS Publications Warehouse

Craun, Kari J.

2015-08-06

The U.S. Geological Survey (USGS) and partners in other Federal and State agencies are working collaboratively toward Statewide coverage of interferometric synthetic aperture radar (ifsar) elevation data in Alaska. These data will provide many benefits to a wide range of stakeholders and users. Some applications include development of more accurate and highly detailed topographic maps; improvement of surface water information included in the National Hydrography (NHD) and Watershed Boundary Datasets (WBDs); and use in scientific modeling applications such as calculating glacier surface elevation differences over time and estimating tsunami inundation areas.

The Benefits and Costs of the Section 8 Housing Subsidy Program: A Framework and Estimates of First-Year Effects

ERIC Educational Resources Information Center

Carlson, Deven; Haveman, Robert; Kaplan, Thomas; Wolfe, Barbara

2011-01-01

This paper provides estimates for a comprehensive set of social benefits and costs associated with the federal Housing Choice Voucher (Section 8) program. The impact categories for which we provide empirical estimates include the value of the voucher to recipients; additional services and public benefits induced by voucher receipt; improvements in…

The use of process mapping in healthcare quality improvement projects.

PubMed

Antonacci, Grazia; Reed, Julie E; Lennox, Laura; Barlow, James

2018-05-01

Introduction Process mapping provides insight into systems and processes in which improvement interventions are introduced and is seen as useful in healthcare quality improvement projects. There is little empirical evidence on the use of process mapping in healthcare practice. This study advances understanding of the benefits and success factors of process mapping within quality improvement projects. Methods Eight quality improvement projects were purposively selected from different healthcare settings within the UK's National Health Service. Data were gathered from multiple data-sources, including interviews exploring participants' experience of using process mapping in their projects and perceptions of benefits and challenges related to its use. These were analysed using inductive analysis. Results Eight key benefits related to process mapping use were reported by participants (gathering a shared understanding of the reality; identifying improvement opportunities; engaging stakeholders in the project; defining project's objectives; monitoring project progress; learning; increased empathy; simplicity of the method) and five factors related to successful process mapping exercises (simple and appropriate visual representation, information gathered from multiple stakeholders, facilitator's experience and soft skills, basic training, iterative use of process mapping throughout the project). Conclusions Findings highlight benefits and versatility of process mapping and provide practical suggestions to improve its use in practice.

Providing Better University Personnel through Job Sharing.

ERIC Educational Resources Information Center

Hutton, Clifford E.; McFarlin, Joy Simon

1982-01-01

Universities could benefit by offering more flexible part-time job opportunities such as job-sharing, following an apparent national trend in accommodating social and economic needs. Institutions have many options in scheduling and allocating tasks. Possible benefits include improved employee attitude and productivity. (MSE)

Self-Reported Benefits and Adverse Outcomes of Hot Yoga Participation.

PubMed

Mace, Casey; Eggleston, Brandon

2016-01-01

There is little to no scientific data about the health benefits or risks to participating in hot yoga, in particular distinguishing it from the practice of non-hot yoga. This study aims to provide some preliminary evidence about the risks and benefits of participating in hot yoga. Future studies will be able to build off the findings herein. This study utilized online survey software (Qualtrics) and recruited participants through convenience sampling (n = 157) by targeting yoga websites and online forums. As there is currently no known questionnaire that has been developed to assess the risks and benefits of hot yoga participation, an exploratory measure was designed to gain more detailed responses from participants. Descriptive epidemiological analyses we re conducted. Participants of hot yoga had a number of pre-existing health conditions. Both benefits and adverse outcomes were reported. The most frequently reported health benefits of hot yoga in this sample included increased flexibility (63%), improved mood (58%), increased fitness (43%), and improved stamina (42%). Just over half of the participants reported some sort of adverse event during a hot yoga session (n = 82). The most commonly reported adverse events included dizziness (60%), feeling light headed (61%), nausea (35%), and dehydration (34%), amongst others. Further study on the risks and benefits of hot yoga participation is required.

Self-Reported Benefits and Adverse Outcomes of Hot Yoga Participation.

PubMed

Mace, Casey; Eggleston, Brandon

2016-08-15

There is little to no scientific data about the health benefits or risks to participating in hot yoga, in particular distinguishing it from the practice of non-hot yoga. This study aims to provide some preliminary evidence about the risks and benefits of participating in hot yoga. Future studies will be able to build off the findings herein. This study utilized online survey software (Qualtrics) and recruited participants through convenience sampling (n = 157) by targeting yoga websites and online forums. As there is currently no known questionnaire that has been developed to assess the risks and benefits of hot yoga participation, an exploratory measure was designed to gain more detailed responses from participants. Descriptive epidemiological analyses we re conducted. Participants of hot yoga had a number of pre-existing health conditions. Both benefits and adverse outcomes were reported. The most frequently reported health benefits of hot yoga in this sample included increased flexibility (63%), improved mood (58%), increased fitness (43%), and improved stamina (42%). Just over half of the participants reported some sort of adverse event during a hot yoga session (n = 82). The most commonly reported adverse events included dizziness (60%), feeling light headed (61%), nausea (35%), and dehydration (34%), amongst others. Further study on the risks and benefits of hot yoga participation is required.

Mobile Health Devices as Tools for Worldwide Cardiovascular Risk Reduction and Disease Management.

PubMed

Piette, John D; List, Justin; Rana, Gurpreet K; Townsend, Whitney; Striplin, Dana; Heisler, Michele

2015-11-24

We examined evidence on whether mobile health (mHealth) tools, including interactive voice response calls, short message service, or text messaging, and smartphones, can improve lifestyle behaviors and management related to cardiovascular diseases throughout the world. We conducted a state-of-the-art review and literature synthesis of peer-reviewed and gray literature published since 2004. The review prioritized randomized trials and studies focused on cardiovascular diseases and risk factors, but included other reports when they represented the best available evidence. The search emphasized reports on the potential benefits of mHealth interventions implemented in low- and middle-income countries. Interactive voice response and short message service interventions can improve cardiovascular preventive care in developed countries by addressing risk factors including weight, smoking, and physical activity. Interactive voice response and short message service-based interventions for cardiovascular disease management also have shown benefits with respect to hypertension management, hospital readmissions, and diabetic glycemic control. Multimodal interventions including Web-based communication with clinicians and mHealth-enabled clinical monitoring with feedback also have shown benefits. The evidence regarding the potential benefits of interventions using smartphones and social media is still developing. Studies of mHealth interventions have been conducted in >30 low- and middle-income countries, and evidence to date suggests that programs are feasible and may improve medication adherence and disease outcomes. Emerging evidence suggests that mHealth interventions may improve cardiovascular-related lifestyle behaviors and disease management. Next-generation mHealth programs developed worldwide should be based on evidence-based behavioral theories and incorporate advances in artificial intelligence for adapting systems automatically to patients' unique and changing needs. © 2015 American Heart Association, Inc.

Reporting transparency: making the ethical mandate explicit.

PubMed

Nicholls, Stuart G; Langan, Sinéad M; Benchimol, Eric I; Moher, David

2016-03-16

Improving the transparency and quality of reporting in biomedical research is considered ethically important; yet, this is often based on practical reasons such as the facilitation of peer review. Surprisingly, there has been little explicit discussion regarding the ethical obligations that underpin reporting guidelines. In this commentary, we suggest a number of ethical drivers for the improved reporting of research. These ethical drivers relate to researcher integrity as well as to the benefits derived from improved reporting such as the fair use of resources, minimizing risk of harms, and maximizing benefits. Despite their undoubted benefit to reporting completeness, questions remain regarding the extent to which reporting guidelines can influence processes beyond publication, including researcher integrity or the uptake of scientific research findings into policy or practice. Thus, we consider investigation on the effects of reporting guidelines an important step in providing evidence of their benefits.

Benefits of Conducting Research.

ERIC Educational Resources Information Center

Anderson, Frances E.

2001-01-01

Metaphors for researchers, such as a crusader; a traveler; an explorer; a miner; an astronaut; a biblical Daniel; a Samurai; and an archaeologist are discussed. Benefits of conducting research are enumerated, including building the knowledge base for art therapy; increasing professional opportunities; improving client care; and advancing the…

Barriers and benefits to using mobile health technology after operation: A qualitative study.

PubMed

Abelson, Jonathan S; Kaufman, Elinore; Symer, Matthew; Peters, Alexander; Charlson, Mary; Yeo, Heather

2017-09-01

Recently, mobile health technology has emerged as a promising avenue for improving physician-patient communication and patient outcomes. The objective of our study was to determine the public's perception of barriers and benefits to using mobile health technology technologies to enhance recovery after operation. We used the Empire State Poll to ask 2 open-ended questions to 800 participants assessing their perceptions of benefits and barriers to use mobile health technology after operation. All responses were coded independently, and any discrepancies were resolved by consensus. We used grounded theory to allow themes to arise from the codes. Interrater reliability was calculated using Cohen's Kappa. Participants identified a range of possible barriers to using mobile health technology apps after operation including: protecting personal health information, technology effectiveness and failure, preference for face-to-face interaction with their surgeon, level of effort required, and ability of the older adults to navigate mobile health technology. Participants identified multiple possible benefits including: better monitoring, improved communication with their surgeon, minimizing follow-up visits, improved convenience, and increased patient knowledge. In the study, 15% of all respondents stated there were no barriers whereas 6% stated there were no benefits. Participants were receptive to the many potential benefits of this technology to enhance not only their relationships with providers and the convenience of access, but also their health outcomes. We must address participants concerns about data security and their fears of losing a personal relationship with their doctor. Copyright © 2017 Elsevier Inc. All rights reserved.

Sleep benefit in Parkinson's disease: time to revive an enigma?

PubMed

van Gilst, Merel M; Louter, Maartje; Baumann, Christian R; Bloem, Bastiaan R; Overeem, Sebastiaan

2012-01-01

Some patients with Parkinson's disease (PD) reportedly experience 'sleep benefit': an improved motor functioning upon awaking in the morning. In this questionnaire study, 114 out of 243 consecutive outpatients with PD (46.9%) subjectively experienced sleep benefit. Among those patients that regularly took an afternoon nap, 33.7% experienced sleep benefit after the nap as well. Between patients with and without sleep benefit, there were no differences in demographic or clinical variables, including age, disease duration, dopaminergic treatment, and nocturnal sleep quality. Sleep benefit remains an intriguing but elusive phenomenon, which deserves renewed attention and further research.

A discrete choice experiment to explore patients' willingness to risk disease relapse from treatment withdrawal in psoriatic arthritis.

PubMed

Rothery, Claire; Bojke, Laura; Richardson, Gerry; Bojke, Chris; Moverley, Anna; Coates, Laura; Thorp, Liz; Waxman, Robin; Helliwell, Philip

2016-12-01

The objective of this study is to assess patient preferences for treatment-related benefits and risk of disease relapse in the management of low disease states of psoriatic arthritis (PsA). Focus groups with patients and a literature review were undertaken to determine the characteristics of treatment and symptoms of PsA important to patients. Patient preferences were assessed using a discrete choice experiment which compared hypothetical treatment profiles of the risk and benefits of treatment withdrawal. The risk outcome included increased risk of disease relapse, while benefit outcomes included reduced sickness/nausea from medication and changes in health-related quality of life. Each patient completed 12 choice sets comparing treatment profiles. Preference weights were estimated using a logic regression model, and the maximum acceptable risk in disease relapse for a given improvement in benefit outcomes was elicited. Final sample included 136 patients. Respondents attached the greatest importance to eliminating severe side effects of sickness/nausea and the least importance to a change in risk of relapse. Respondents were willing to accept an increase in the risk of relapse of 32.6 % in order to eliminate the side effects of sickness/nausea. For improvements in health status, the maximum acceptable risk in relapse was comparable to a movement from some to no sickness/nausea. The study suggests that patients in low disease states of PsA are willing to accept greater risks of relapse for improvements in side effects of sickness/nausea and overall health status, with the most important benefit attribute being the elimination of severe sickness or nausea.

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

PubMed

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

2014-08-01

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

Economic Insights into Providing Access to Improved Groundwater Sources in Remote, Low-Resource Areas

NASA Astrophysics Data System (ADS)

Abramson, A.; Lazarovitch, N.; Adar, E.

2013-12-01

Groundwater is often the most or only feasible drinking water source in remote, low-resource areas. Yet the economics of its development have not been systematically outlined. We applied CBARWI (Cost-Benefit Analysis for Remote Water Improvements), a recently developed Decision Support System, to investigate the economic, physical and management factors related to the costs and benefits of non-networked groundwater supply in remote areas. Synthetic profiles of community water services (n = 17,962), defined across 14 parameters' values and ranges relevant to remote areas, were imputed into the decision framework, and the parameter effects on economic outcomes were investigated through regression analysis (Table 1). Several approaches were included for financing the improvements, after Abramson et al, 2011: willingness-to -pay (WTP), -borrow (WTB) and -work (WTW) in community irrigation (';water-for-work'). We found that low-cost groundwater development approaches are almost 7 times more cost-effective than conventional boreholes fitted with handpumps. The costs of electric, submersible borehole pumps are comparable only when providing expanded water supplies, and off-grid communities pay significantly more for such expansions. In our model, new source construction is less cost-effective than improvement of existing wells, but necessary for expanding access to isolated households. The financing approach significantly impacts the feasibility of demand-driven cost recovery; in our investigation, benefit exceeds cost in 16, 32 and 48% of water service configurations financed by WTP, WTB and WTW, respectively. Regressions of total cost (R2 = 0.723) and net benefit under WTW (R2 = 0.829) along with analysis of output distributions indicate that parameters determining the profitability of irrigation are different from those determining costs and other measures of net benefit. These findings suggest that the cost-benefit outcomes associated with groundwater-based water supply improvements vary considerably by many parameters. Thus, a wide variety of factors should be included to inform water development strategies. Abramson, A. et al (2011), Willingness to pay, borrow and work for water service improvements in developing countries, Water Resour Res, 47Table 1: Descriptions, investigated values and regression coefficients of parameters included in our analysis. Rank of standardized β indicates relative importance. Regression dependent variables are in [($ household-1) y-1]. * Parameters relevant to water-for-work program only.† p <.0001‡ p <.05

Qigong and the Older Adult

ERIC Educational Resources Information Center

Mittelstaedt, Robin D.; Hinton, Jennifer; Rana, Sharon; Cade, Dennis; Xue, Steve

2005-01-01

Qigong is a traditional Chinese exercise that is used to enhance health, vitality, and well-being. Some of the health benefits attributed to qigong include improved circulation, coordination, muscle tone, and flexibility. Scientists and researchers in the Eastern world have documented numerous medical benefits. While fewer Western medical studies…

Fall cover crops boost soil arbuscular mycorrhizal fungi which can lead to reduced inputs

USDA-ARS?s Scientific Manuscript database

Fall cover crops provide multiple benefits to producers. These benefits include pathogen and pest protection, drought protection, weed control, reduced soil erosion, nutrient acquisition and retention, increased soil organic matter, and conservation of soil water by improvement of soil structure th...

Can reducing tillage and increasing crop diversity benefit grain and forage production?

USDA-ARS?s Scientific Manuscript database

Benefits of reduced tillage and diverse rotation cropping systems include reversing soil C loss, mitigating greenhouse gas production, and improving soil health. However, adoption of these strategies is lagging, particularly in the upper Midwest, due to a perception that reduced tillage reduces cro...

Estimating the Health Effects of Greenhouse Gas Mitigation Strategies: Addressing Parametric, Model, and Valuation Challenges

PubMed Central

Hess, Jeremy J.; Ebi, Kristie L.; Markandya, Anil; Balbus, John M.; Wilkinson, Paul; Haines, Andy; Chalabi, Zaid

2014-01-01

Background: Policy decisions regarding climate change mitigation are increasingly incorporating the beneficial and adverse health impacts of greenhouse gas emission reduction strategies. Studies of such co-benefits and co-harms involve modeling approaches requiring a range of analytic decisions that affect the model output. Objective: Our objective was to assess analytic decisions regarding model framework, structure, choice of parameters, and handling of uncertainty when modeling health co-benefits, and to make recommendations for improvements that could increase policy uptake. Methods: We describe the assumptions and analytic decisions underlying models of mitigation co-benefits, examining their effects on modeling outputs, and consider tools for quantifying uncertainty. Discussion: There is considerable variation in approaches to valuation metrics, discounting methods, uncertainty characterization and propagation, and assessment of low-probability/high-impact events. There is also variable inclusion of adverse impacts of mitigation policies, and limited extension of modeling domains to include implementation considerations. Going forward, co-benefits modeling efforts should be carried out in collaboration with policy makers; these efforts should include the full range of positive and negative impacts and critical uncertainties, as well as a range of discount rates, and should explicitly characterize uncertainty. We make recommendations to improve the rigor and consistency of modeling of health co-benefits. Conclusion: Modeling health co-benefits requires systematic consideration of the suitability of model assumptions, of what should be included and excluded from the model framework, and how uncertainty should be treated. Increased attention to these and other analytic decisions has the potential to increase the policy relevance and application of co-benefits modeling studies, potentially helping policy makers to maximize mitigation potential while simultaneously improving health. Citation: Remais JV, Hess JJ, Ebi KL, Markandya A, Balbus JM, Wilkinson P, Haines A, Chalabi Z. 2014. Estimating the health effects of greenhouse gas mitigation strategies: addressing parametric, model, and valuation challenges. Environ Health Perspect 122:447–455; http://dx.doi.org/10.1289/ehp.1306744 PMID:24583270

The need to include animal protection in public health policies.

PubMed

Akhtar, Aysha

2013-11-01

Many critical public health issues require non-traditional approaches. Although many novel strategies are used, one approach not widely applied involves improving the treatment of animals. Emerging infectious diseases are pressing public health challenges that could benefit from improving the treatment of animals. Other human health issues, that overlap with animal treatment issues, and that warrant further exploration, are medical research and domestic violence. The diverse nature of these health issues and their connection with animal treatment suggest that there may be other similar intersections. Public health would benefit by including the treatment of animals as a topic of study and policy development.

High-precision radiometric tracking for planetary approach and encounter in the inner solar system

NASA Technical Reports Server (NTRS)

Christensen, C. S.; Thurman, S. W.; Davidson, J. M.; Finger, M. H.; Folkner, W. M.

1989-01-01

The benefits of improved radiometric tracking data have been studied for planetary approach within the inner Solar System using the Mars Rover Sample Return trajectory as a model. It was found that the benefit of improved data to approach and encounter navigation was highly dependent on the a priori uncertainties assumed for several non-estimated parameters, including those for frame-tie, Earth orientation, troposphere delay, and station locations. With these errors at their current levels, navigational performance was found to be insensitive to enhancements in data accuracy. However, when expected improvements in these errors are modeled, performance with current-accuracy data significantly improves, with substantial further improvements possible with enhancements in data accuracy.

Improving Wellbeing and Environmental Stewardship Through Volunteering in Nature.

PubMed

Molsher, Robyn; Townsend, Mardie

2016-03-01

Environmental volunteering (EV) can provide a unique way to optimise the wellbeing of participants while fostering environmental stewardship. However, the potential of EV to create human health benefits remains an under-researched area. This study provides evidence for improved wellbeing and mood state for 32 participants from diverse backgrounds undertaking EV activities. Most participants also reported improved environmental stewardship with a greatly improved understanding of the environment and the need to conserve it. Other benefits included: 31% of those seeking work obtained it; and 50% joined a volunteer group at program completion. EV provides a unique mechanism to enhance the wellbeing of the participants, while conserving the environment.

Program Manager: The Journal of the Defense Systems Management College, Volume 15, Number 2, March-April 1986.

DTIC Science & Technology

1986-04-01

benefits to the user, and economic benefits to the host country. Figure 2 shows the develop- ment of the NATO Infrastructure Pro- grams since 1951. FH...generalized benefits of stream- classified programs work with less dollar expenditures based solely on the lined specialized management include: than one-third...for contractors to demon- significant cost and schedule benefits on-site visits by the SPO are strate their management integrity, and new improvements

Project Career: Perceived benefits of iPad apps among college students with Traumatic Brain Injury (TBI).

PubMed

Jacobs, K; Leopold, A; Hendricks, D J; Sampson, E; Nardone, A; Lopez, K B; Rumrill, P; Stauffer, C; Elias, E; Scherer, M; Dembe, J

2017-09-14

Project Career is an interprofessional five-year development project designed to improve academic and employment success of undergraduate students with a traumatic brain injury (TBI) at two- and four-year colleges and universities. Students receive technology in the form of iPad applications ("apps") to support them in and out of the classroom. To assess participants' perspectives on technology at baseline and perceived benefit of apps after 6 and 12 months of use. This article address a component of a larger study. Participants included 50 college-aged students with traumatic brain injuries. Statistical analysis included data from two Matching Person and Technology (MPT) assessment forms, including the Survey of Technology Use at baseline and the Assistive Technology Use Follow-Up Survey: Apps Currently Using, administered at 6- and 12-months re-evaluation. Analyses included frequencies and descriptives. Average scores at baseline indicated positive perspectives on technology. At 6 months, quality of life (67%) and academics (76%) improved moderately or more from the use of iPad apps. At 12 months, quality of life (65%) and academics (82%) improved moderately or more from the use of iPad apps. Students with a TBI have positive perspectives on technology use. The results on perceived benefit of apps indicated that students with a TBI (including civilians and veterans) report that the apps help them perform in daily life and academic settings.

Comprehensive sector-wide strategies to prevent and control obesity: what are the potential health and broader societal benefits? A case study from Australia.

PubMed

Kite, James; Hector, Debra J; St George, Alexis; Pedisic, Zeljko; Phongsavan, Philayrath; Bauman, Adrian; Mitchell, Jo; Bellew, Bill

2015-09-30

Several countries have recently established multistakeholder strategies to prevent or control overweight and obesity; however, studies have not yet been done on their effectiveness and likely impact. This study's objectives were to (i) explore sector-wide benefits and impacts likely to accrue from implementing an obesity prevention strategy in the Australian state of New South Wales; (ii) discuss the wider implications of the findings for research and practice; and (iii) strengthen the case for sustained implementation of a comprehensive, intersectoral approach. A case study approach, including evidence reviews and illustrative epidemiological models, was used to show potential benefits from meeting selected targets and objectives specified in the strategy. For adults, improved health outcomes potentially include reductions in all-cause mortality, cardiovascular disease, type 2 diabetes, various cancers, osteoarthritis, infant mortality and healthcare costs. Potential benefits beyond the health sector involve disability payments, absenteeism, worker productivity, workplace injuries and insurance claims. For children and adolescents, improved health outcomes potentially include metabolic risk factors, dental health, prehypertension/hypertension, cardiovascular disease risk factors, depression, rates of mortality in hospitalised children, bullying and otitis media. Sector-wide health, social and economic benefits from successful implementation of multisector obesity prevention strategies are likely to be substantial if specified targets are achieved. Epidemiological modelling described in this paper for selected examples provides illustrative rather than comprehensive evidence for potential benefits. Process evaluation of the extent of implementation of these multisectoral strategies, together with the accumulated data on intervention effectiveness, will determine their potential population health benefit. Quantifying the health and social benefits that are likely to accrue if comprehensive sector-wide obesity prevention and control strategies are established can strengthen advocacy for their sustained implementation.

Transforming School Grounds into Natural Learning Environments.

ERIC Educational Resources Information Center

Keetch, Tammy

1996-01-01

Discusses the benefits as well as the concerns of changing traditional asphalt and turf grass grounds into educational resources. Benefits include an opportunity for hands-on learning, a softer and more creative area for play, a reduction in school ground violence among students, an ecologically improved landscape, and a reduction in maintenance…

Electrification of the freight train network from the Ports of Los Angeles and Long Beach to the Inland Empire.

DOT National Transportation Integrated Search

2008-05-01

The goal of this project was to evaluate the benefits of electrifying the freight railroads connecting the Ports of Los Angeles and Long Beach with the Inland Empire. These benefits include significant reduction in air pollution, and improvements in ...

Discovering Nature: The Benefits of Teaching Outside of the Classroom

ERIC Educational Resources Information Center

Jacobi-Vessels, Jill L.

2013-01-01

Nature play can be an effective teaching strategy across the curriculum and may provide children and teachers with lasting memories. Research shows that experiences in natural settings provide multiple benefits to young children, including increased physical activity, reduced obesity, improved concentration, and enhanced social skills. Early…

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

NASA Astrophysics Data System (ADS)

Bowmer, Kathleen H.

2011-06-01

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

The Association of Benefit Finding to Psychosocial and Health Behavior Adaptation Among HIV+ Men and Women

PubMed Central

Littlewood, Rae A.; Vanable, Peter A.; Carey, Michael P.; Blair, Donald C.

2008-01-01

Psychological and behavioral adaptation to HIV is integral to long-term survival. Although most research on coping with HIV has focused on factors associated with poor adaptation, recent research has expanded to include positive concomitants of adaptation, such as benefit finding. This study examined the occurrence of benefit finding among HIV+ men and women and evaluated the potential relevance of benefit finding to positive health behavior and psychosocial adaptation. HIV+ participants (N = 221) recruited during outpatient care completed self-report assessments of benefit finding, social support, depression, HAART adherence, substance use, and physical activity. In a series of multivariate analyses that controlled for demographic and health status variables, benefit finding was associated with lower depression scores, greater social support, and more physical activity, but showed no association to HAART adherence or substance use. The association of benefit finding to depression was partially mediated by differences in social support. Thus, benefit finding may improve psychological adjustment by motivating patients who experience stress-related growth to seek improved social support. PMID:18157689

Shared Opportunities on Institutional Lands: On-Site Food Production, Its Benefits, Barriers, and Opportunities.

PubMed

Knezevic, Irena; Mount, Phil; Clement, Chantal

2016-10-01

This article outlines preliminary findings of a 3-year project that explored on-site food production on institutional properties, primarily healthcare facilities. There are growing pressures on healthcare facilities to improve their food offerings and incorporate food gardens into their health programs. While several healthcare facilities produce food on-site, there are few studies that explore opportunities, capacities, and institutional barriers related to on-site food production. The study employed mixed methods including historical review, case studies, surveys, interviews, pilot garden projects, and Geographic Information System mapping. The number of participating institutions varied by method. Benefits associated with on-site food production can be health, economic, environmental, and social. There are also institutional barriers including administrative roadblocks, perceived obstacles, and the difficulty in quantitatively, measuring the qualitatively documented benefits. The benefits of food gardens far outweigh the challenges. On-site food production has tremendous potential to improve nutrition for staff and patients, offer healing spaces, better connect institutions with the communities in which they are located, and provide the long-professed benefits of gardening for all involved-from therapeutic benefits and outdoor physical activities to developing skills and social relationships in ways that few other activities do. © The Author(s) 2016.

Bioactives from probiotics for dermal health: functions and benefits.

PubMed

Lew, L-C; Liong, M-T

2013-05-01

Probiotics have been extensively reviewed for decades, emphasizing on improving general gut health. Recently, more studies showed that probiotics may exert other health-promoting effects beyond gut well-being, attributed to the rise of the gut-brain axis correlations. Some of these new benefits include skin health such as improving atopic eczema, atopic dermatitis, healing of burn and scars, skin-rejuvenating properties and improving skin innate immunity. Increasing evidence has also showed that bacterial compounds such as cell wall fragments, their metabolites and dead bacteria can elicit certain immune responses on the skin and improve skin barrier functions. This review aimed to underline the mechanisms or the exact compounds underlying the benefits of bacterial extract on the skin based on evidences from in vivo and in vitro studies. This review could be of help in screening of probiotic strains with potential dermal enhancing properties for topical applications. © 2013 The Society for Applied Microbiology.

State Health Agencies' Perceptions of the Benefits of Accreditation.

PubMed

Kittle, Alannah; Liss-Levinson, Rivka

The national voluntary accreditation program serves to encourage health agencies to seek departmental accreditation as a mechanism for continuous quality improvement. This study utilizes data from the 2016 Association of State and Territorial Health Officials Profile Survey to examine the perceived benefits of accreditation among state health agencies. Respondents answered questions on topics such as agency structure, workforce, and quality improvement activities. Frequencies and cross tabulations were conducted using IBM SPSS (version 21) statistical software. Results indicate that among accredited agencies, the most commonly endorsed benefits of accreditation include stimulating quality and performance improvement opportunities (95%), strengthening the culture of quality improvement (90%), and stimulating greater collaboration across departments/units within the agency (90%). Policy and practice implications, such as how these data can be used to promote accreditation within health agencies, as well as how accreditation strengthens governmental public health systems, are also discussed.

Ecosystem Services and Environmental Markets in ...

EPA Pesticide Factsheets

This report contains two separate analyses, both of which make use of an optimization framework previously developed to evaluate trade-offs in alternative restoration strategies to achieve the Chesapeake Bay Total Maximum Daily Load (TMDL). The first analysis expands on model applications that examine how incorporating selected co-benefits of nutrient reductions into the optimization framework alters the optimal distribution of nutrient reductions in the watershed (U.S. EPA, 2011). In previous applications, the analyzed co-benefits included carbon sequestration and recreational hunting benefits from certain agricultural best management practices (BMPs). In this report we expand the optimization framework to also include benefits from water quality improvements in freshwater river and streams. We find that these nontidal water quality co-benefits are larger than the other co-benefits combined and would result in greater nutrient control efforts in upstream portions of the watershed. Compared to cost-minimization results that do not account for co-benefits, including all co-benefits in the optimization would increase annual nutrient control costs by $16 million in the Susquehanna River Basin in Pennsylvania; however, the co-benefits would increase by $31 million, for a net gain of $15 million per year. In the James River Basin in Virginia, considering monetized co-benefits results in an estimated increase in nutrient control costs of $17 million but an increase in

45 CFR 158.170 - Allocation of expenses.

Code of Federal Regulations, 2012 CFR

2012-10-01

... reported, including but not limited to those that are for or benefit self-funded plans, must be reported on..., including incurred claims, quality improvement expenses, Federal and State taxes and licensing or regulatory...

45 CFR 158.170 - Allocation of expenses.

Code of Federal Regulations, 2013 CFR

2013-10-01

... reported, including but not limited to those that are for or benefit self-funded plans, must be reported on..., including incurred claims, quality improvement expenses, Federal and State taxes and licensing or regulatory...

45 CFR 158.170 - Allocation of expenses.

Code of Federal Regulations, 2011 CFR

2011-10-01

... reported, including but not limited to those that are for or benefit self-funded plans, must be reported on..., including incurred claims, quality improvement expenses, Federal and State taxes and licensing or regulatory...

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

PubMed

Clynes, Mary P; Raftery, Sara E C

2008-11-01

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

A Systematic Review of the Benefits of Hiring People with Disabilities.

PubMed

Lindsay, Sally; Cagliostro, Elaine; Albarico, Mikhaela; Mortaji, Neda; Karon, Leora

2018-02-01

Purpose We reviewed literature on the benefits of hiring people with disabilities. Increasing attention is being paid to the role of people with disabilities in the workplace. Although most research focuses on employers' concerns, many companies are now beginning to share their successes. However, there is no synthesis of the peer-reviewed literature on the benefits of hiring people with disabilities. Methods Our team conducted a systematic review, completing comprehensive searches of seven databases from 1997 to May 2017. We selected articles for inclusion that were peer-reviewed publications, had a sample involving people with disabilities, conducted an empirical study with at least one outcome focusing on the benefits of hiring people with disabilities, and focused on competitive employment. Two reviewers independently applied the inclusion criteria, extracted the data, and rated the study quality. Results Of the 6176 studies identified in our search, 39 articles met our inclusion criteria. Findings show that benefits of hiring people with disabilities included improvements in profitability (e.g., profits and cost-effectiveness, turnover and retention, reliability and punctuality, employee loyalty, company image), competitive advantage (e.g., diverse customers, customer loyalty and satisfaction, innovation, productivity, work ethic, safety), inclusive work culture, and ability awareness. Secondary benefits for people with disabilities included improved quality of life and income, enhanced self-confidence, expanded social network, and a sense of community. Conclusions There are several benefits to hiring people with disabilities. Further research is needed to explore how benefits may vary by type of disability, industry, and job type.

Current Emergency Locator Transmitter (ELT) deficiencies and potential improvements utilizing TSO-C91a ELTs

NASA Technical Reports Server (NTRS)

Trudell, Bernard J.; Dreibelbis, Ryland R.

1990-01-01

An analysis was conducted of current ELT problems and potential improvements that could be made by employing the TSO-C91a ELTs to replace the current TSO-C91 ELTs. The scope of the study included the following: (1) validate the problems; (2) determine specific failure causes; (3) determine false alarm causes; (4) estimate improvements from TSO-C91a; (5) estimate benefits from replacement of the current ELTs; and (6) determine need and benefits for improved ELT inspection and maintenance. A detailed comparison between the two requirements documents (TSO-C91 and -91a) was made to assess improved performance of the ELT in each category of failure cause and each cause of false alarms. The comparison and analysis resulted in projecting a success of operation rate approximately 3 times the current rate and a reduction in false alarms to 0.25 of those generated by TSO-C91 ELTs. These improvements led to a projection of benefits of approximately 25 additional lives to be saved each year with TSO-C91a ELTs and an improved inspection and maintenance program.

QUANTIFYING THE CLIMATE, AIR QUALITY AND HEALTH BENEFITS OF IMPROVED COOKSTOVES: AN INTEGRATED LABORATORY, FIELD AND MODELING STUDY

EPA Science Inventory

Expected results and outputs include: extensive dataset of in-field and laboratory emissions data for traditional and improved cookstoves; parameterization to predict cookstove emissions from drive cycle data; indoor and personal exposure data for traditional and improved cook...

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

PubMed

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

2018-03-01

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

Symptomatic improvement reported after receiving Reiki at a cancer infusion center.

PubMed

Marcus, Dawn A; Blazek-O'Neill, Betsy; Kopar, Jennifer L

2013-03-01

To evaluate patient-perceived benefits from receiving Reiki at a cancer infusion center. During a 6-month period, adults at a university hospital receiving Reiki through volunteer services were invited to complete a survey asking about perceived changes after Reiki. Changes in pain, mood, distress, sleep, and appetite were rated on a 5-point scale from no benefit to great benefit. Surveys were distributed after completing treatment and were returned in postage-paid envelops. A total of 145 surveys were completed (34.5% response rate), with 47 participants seen in the cancer infusion center and 98 in other areas of the hospital. Reiki was rated as a positive experience by 94% at the cancer center and 93% of others, with 92% at the cancer center and 86% of others interested in receiving additional Reiki sessions. Symptomatic improvement was similar for people at the cancer center and others, respectively, with much to great improvement for 89% and 86% for relaxation, 75% and 75% for anxiety/worry, 81% and 78% for improved mood, 43% and 35% for improved sleep, 45% and 49% for reduced pain, 38% and 43% for reduced isolation/loneliness, 75% and 63% for improved attitude, and 30% and 30% for improved appetite. Response was unaffected by previous exposure to Reiki, massage, or other touch therapy. Reiki results in a broad range of symptomatic benefits, including improvements in common cancer-related symptoms.

The benefits of being a near-peer teacher.

PubMed

Hall, Samuel; Harrison, Charlotte H; Stephens, Jonny; Andrade, Matheus Gesteria; Seaby, Eleanor G; Parton, William; McElligott, Simon; Myers, Matthew A; Elmansouri, Ahmed; Ahn, Michael; Parrott, Rachel; Smith, Claire F; Border, Scott

2018-03-23

Near-peer teaching is used in anatomy education because of its benefits to the learner, teacher and faculty members. Despite the range of reports focusing on the learner, the advantages for the teacher, which are thought to include communication skills, subject knowledge and employability, are only beginning to be explored. A questionnaire was distributed to the teachers involved in anatomy near-peer teaching at the University of Southampton and Brighton and Sussex Medical School (BSMS). This questionnaire was designed using a rating scale of 0-10 to assess teacher perspectives on their level of knowledge, teaching skills and enjoyment of teaching. Free-text responses determined the teachers' motivation and perceived benefits from the teaching. Twenty-eight questionnaires were gathered (54.9% response rate), including 20 from Southampton and eight from BSMS. Long-term knowledge retention and better understanding of the material were rated 8.1 and 7.9 out of 10, respectively. Eight responses were from currently practising doctors, who rated how much they now use their teaching skills as doctors as 8.9 out of 10. Of the eight doctors, seven gained points for their foundation programme applications as a direct result of near-peer teaching. The most common motivator for engaging in teaching was to improve subject matter knowledge and the most common benefit was improved communication skills. There are numerous advantages to being a near-peer teacher in medical school DISCUSSION: There are numerous advantages to being a near-peer teacher in medical school, which include knowledge improvement, transferrable professional skills and employability. These initial results support the hypothesised benefits to the teachers and provide a foundation for further longitudinal studies. © 2018 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Group visits for chronic illness management: implementation challenges and recommendations.

PubMed

Jones, Katherine R; Kaewluang, Napatsawan; Lekhak, Nirmala

2014-01-01

The group visit approach to improve chronic illness self-management appears promising in terms of selected outcomes, but little information is available about best ways to organize and implement group visits. This literature review of 84 articles identified group visit implementation challenges, including lack of a group visit billing code, inadequate administrative support and resources, difficult participant recruitment and retention, and logistical issues such as space and scheduling. Recommendations for future implementation initiatives were also abstracted from the literature. Patients and providers can benefit from well-planned and well-conducted group visits. These benefits include greater patient and provider satisfaction, reduced overall utilization, improved clinical outcomes, and greater provider efficiency and productivity.

Improving Students' Study Habits by Demonstrating the Mnemonic Benefits of Semantic Processing

ERIC Educational Resources Information Center

Bugg, Julie M.; DeLosh, Edward L.; McDaniel, Mark A.

2008-01-01

This article describes an in-class exercise that illustrates the advantage of semantic over nonsemantic study habits. The exercise includes a survey of students' current study strategies, followed by the presentation of an abbreviated version of Craik and Tulving's(1975) classic levels-of-processing experiment. We observed significant benefits of…

Towards a no-till no-spray future? Introduction to a symposium on nonchemical weed management for reduced-tillage cropping systems

USDA-ARS?s Scientific Manuscript database

Reduced-tillage systems including no-tillage and strip tillage have well-known benefits for conserving and improving soils, protecting vulnerable crops from extreme weather events, and reducing labor and fuel costs associated with full-width inversion tillage. Despite these benefits, reduced-tillage...

Examining the Benefits and Barriers of Instructional Gardening Programs to Increase Fruit and Vegetable Intake among Preschool-Age Children

PubMed Central

Davis, Kristen L.

2017-01-01

Research exists on using instructional gardening programs with school age children as a means of improving dietary quality and for obesity prevention. This article examines the potential use of instructional gardens in childcare settings to improving fruit and vegetable intake in young children. A qualitative study was conducted with childcare providers. Participants (n = 20) were recruited via e-mails, letters, and follow-up phone calls. Interviews were recorded, transcribed, and coded to identify themes within two areas (1) childcare providers perceptions of children's fruit and vegetable consumption and (2) components necessary to initiate or improve instructional gardening programs. Themes associated with provider's perceptions of child fruit and vegetable consumption included benefits of consumption, willingness to try fruits and vegetables, meeting recommendations, and influence of the home and childcare environments on child eating. Benefits, barriers, and resources needed were identified as themes related to starting or improving instructional gardening programs. Benefits to gardening with preschoolers are consistent with those found in school-age populations. While several barriers exist, resources are available to childcare providers to address these barriers. Increased knowledge and awareness of resources are necessary to improve the success of gardening programs in the childcare setting with the goal of improving child diet quality. PMID:28607563

Examining the Benefits and Barriers of Instructional Gardening Programs to Increase Fruit and Vegetable Intake among Preschool-Age Children.

PubMed

Davis, Kristen L; Brann, Lynn S

2017-01-01

Research exists on using instructional gardening programs with school age children as a means of improving dietary quality and for obesity prevention. This article examines the potential use of instructional gardens in childcare settings to improving fruit and vegetable intake in young children. A qualitative study was conducted with childcare providers. Participants ( n = 20) were recruited via e-mails, letters, and follow-up phone calls. Interviews were recorded, transcribed, and coded to identify themes within two areas (1) childcare providers perceptions of children's fruit and vegetable consumption and (2) components necessary to initiate or improve instructional gardening programs. Themes associated with provider's perceptions of child fruit and vegetable consumption included benefits of consumption, willingness to try fruits and vegetables, meeting recommendations, and influence of the home and childcare environments on child eating. Benefits, barriers, and resources needed were identified as themes related to starting or improving instructional gardening programs. Benefits to gardening with preschoolers are consistent with those found in school-age populations. While several barriers exist, resources are available to childcare providers to address these barriers. Increased knowledge and awareness of resources are necessary to improve the success of gardening programs in the childcare setting with the goal of improving child diet quality.

Intellectual property rights, benefit-sharing and development of "improved traditional medicines": A new approach.

PubMed

Willcox, Merlin; Diallo, Drissa; Sanogo, Rokia; Giani, Sergio; Graz, Bertrand; Falquet, Jacques; Bodeker, Gerard

2015-12-24

Protection of intellectual property rights and benefit-sharing are key issues for all ethnopharmacological research. The International Society of Ethnobiology has produced helpful guidelines on access and benefit-sharing which are widely viewed as a "gold standard" but the question remains how best to apply these guidelines in practice. Difficult questions include ownership of traditional knowledge, making appropriate agreements, and how appropriately to share benefits. We present the case study of the development of an "improved traditional medicine" for malaria in Mali and we report how benefit-sharing was applied in this case. The knowledge about the selected plant came independently from several families and traditional healers. The IPR approach was to recognise that this traditional knowledge belongs to the people of Mali and was used for their benefit in developing a new "improved traditional medicine" (ITM). The traditional healer whose method of preparation was used, and who collaborated in clinical trials, did not request any financial reward but asked for the ITM to be named after him. The most sustainable benefit for the community was sharing the results of which preparation of which medicinal plant seemed to be the most effective for treating malaria. Attempts at providing a health centre and training a health worker for the village did not prove to be sustainable. Respect for intellectual property rights and benefit-sharing are possible even in a context where the knowledge is not owned by a clearly identified person or group of people. The most sustainable benefits are intangible rather than material: namely recognition, improved knowledge about which traditional treatment is the best and how to prepare and take it. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The effect of exercise training on cutaneous microvascular reactivity: A systematic review and meta-analysis.

PubMed

Lanting, Sean M; Johnson, Nathan A; Baker, Michael K; Caterson, Ian D; Chuter, Vivienne H

2017-02-01

This study aimed to review the efficacy of exercise training for improving cutaneous microvascular reactivity in response to local stimulus in human adults. Systematic review with meta-analysis. A systematic search of Medline, Cinahl, AMED, Web of Science, Scopus, and Embase was conducted up to June 2015. Included studies were controlled trials assessing the effect of an exercise training intervention on cutaneous microvascular reactivity as instigated by local stimulus such as local heating, iontophoresis and post-occlusive reactive hyperaemia. Studies where the control was only measured at baseline or which included participants with vasospastic disorders were excluded. Two authors independently reviewed and selected relevant controlled trials and extracted data. Quality was assessed using the Downs and Black checklist. Seven trials were included, with six showing a benefit of exercise training but only two reaching statistical significance with effect size ranging from -0.14 to 1.03. The meta-analysis revealed that aerobic exercise had a moderate statistically significant effect on improving cutaneous microvascular reactivity (effect size (ES)=0.43, 95% CI: 0.08-0.78, p=0.015). Individual studies employing an exercise training intervention have tended to have small sample sizes and hence lacked sufficient power to detect clinically meaningful benefits to cutaneous microvascular reactivity. Pooled analysis revealed a clear benefit of exercise training on improving cutaneous microvascular reactivity in older and previously inactive adult cohorts. Exercise training may provide a cost-effective option for improving cutaneous microvascular reactivity in adults and may be of benefit to those with cardiovascular disease and metabolic disorders such as diabetes. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Exercise and Education Program After Breast Cancer: Benefits on Quality of Life and Symptoms at 3, 6, 12, and 24 Months' Follow-up.

PubMed

Leclerc, Anne-France; Slomian, Justine; Jerusalem, Guy; Coucke, Philippe; Bury, Thierry; Deflandre, Dorian; Devos, Martine; Bruyère, Olivier; Foidart-Dessalle, Marguerite; Kaux, Jean-François; Crielaard, Jean-Michel; Maquet, Didier

2018-05-19

Various clinical trials have demonstrated the benefits of physical training offered during and/or after breast cancer treatments. However, given the variety of adverse events that may be encountered, physical training could be combined with psychologic, relational, and social guidance. This kind of multidisciplinary program, as well as its long-term effects, have been little studied so far. Therefore, the objective of our study was to determine the benefits at 3, 6, 12, and 24 months of a 3-month exercise and education program among women after breast cancer treatment. Two hundred nine outpatients treated for primary breast carcinoma were divided into a control group (n = 106) and an experimental group (n = 103) which underwent a 3-month rehabilitation program including physical training and psychoeducational sessions. The assessments, performed before the program and at 3, 6, 12, and 24 months after inclusion, included validated questionnaires on quality of life and symptoms. The analyses revealed an improvement in quality of life and symptoms after the exercise and education program within the experimental group and a maintenance of these improvements during the 2 years of follow-up. These improvements were significantly better than those in the control group, clearly demonstrating that the program has benefits. This trial identified the benefits of a well-detailed 3-month exercise and education program over 24 months' follow-up among women after breast cancer treatment. Copyright © 2018 Elsevier Inc. All rights reserved.

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

PubMed

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

2011-12-01

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

EHR strategy: top down, bottom up or middle out?

PubMed

Bowden, Thomas C

2011-01-01

Around the world a number of countries have made a concerted effort to embed Information and Communications Technology (ICT) within their health systems. It is widely acknowledged that the successful application of ICT to health systems can bring about significant benefits. A number of areas commonly singled out for improvement include: coordination of care; improved medication management; and streamlining the transfer of a patient's care from one healthcare provider to another. There are also perceived cost-benefits including reduced duplication of services and improved service utilization. Countries across the world have chosen many and varied paths to automating their health systems. Health systems are intrinsically very complicated and changing rapidly. Because they represent a high proportion of government expenditure, it is important to understand what is being achieved by each of the broad approaches that are being taken.

Robotics in Cardiac Surgery: Past, Present, and Future

PubMed Central

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

2013-01-01

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

Psychological Factors and Cardiac Risk And Impact of Exercise Training Programs—A Review of Ochsner Studies

PubMed Central

Lavie, Carl J.; Milani, Richard V.; Artham, Surya M.; Gilliland, Yvonne

2007-01-01

Although under-emphasized, substantial evidence indicates that psychological distress, especially depression, hostility, and anxiety, are risk factors for coronary heart disease (CHD) and affect recovery following major coronary heart disease events. We review several major studies from Ochsner Medical Center demonstrating the high prevalence of psychological distress in CHD patients and the marked benefits that occur following formal cardiac rehabilitation and exercise training programs. These benefits include reductions in psychological stress, improvements in CHD risk factors that accompany high stress, and reduced all-cause mortality. These data support the benefits of exercise training and increased levels of fitness to improve psychological stress and subsequent prognosis. PMID:21603539

Beyond privacy: benefits and burdens of e-health technologies in primary care.

PubMed

Aultman, Julie M; Dean, Erin

2014-01-01

In this mixed methods study we identify and assess ethical and pragmatic issues and dilemmas surrounding e-health technologies in the context of primary care, including what is already in the literature. We describe how primary healthcare professionals can access reliable and accurate data, improve the quality of care for patients, and lower costs while following institutional guidelines to protect patients. Using qualitative and quantitative methodologies we identify several underlying ethical and pragmatic burdens and benefits of e-health technologies.The 41 study participants reported more burdens than benefits, and were generally ambivalent about their level of satisfaction with their institutions' e-health technologies, their general knowledge about the technologies, and whether e-health can improve team-based communication and collaboration. Participants provided recommendations to improve e-health technologies in primary care settings.

Benefits for employees with children with ADHD: findings from the Collaborative Employee Benefit Study.

PubMed

Perrin, James M; Fluet, Chris; Kuhlthau, Karen A; Anderson, Betsy; Wells, Nora; Epstein, Susan; Allen, Debby; Tobias, Carol

2005-02-01

Parents of most children with attention-deficit hyperactivity disorder (ADHD) are employed. Employers have interest in decreasing employee absenteeism and improving workplace productivity, partly through employee benefits. The authors interviewed employers to (1) determine how they view the needs of employees with children with ADHD and (2) identify benefits that might help employees with children with ADHD. The authors carried out a systematic interview study of mainly family-friendly, large employers in four U.S. urban markets (Boston, Cleveland, Miami, Seattle). Multidisciplinary interview teams used a protocol to gather basic company information, benefit philosophy, current insurance and other employee benefits, and knowledge of ADHD and its impacts on employees. Initially, the interview team and then the larger project team reviewed all protocols for common themes. The authors interviewed staff of 41 employers (human resource managers, work/life program directors, benefits directors). Only 15 of 41 interviewees knew about ADHD, its prevalence, or its effects on parents. They had little knowledge of how differences in managed behavioral health may affect families' access to diagnostic and treatment services for ADHD, although most had experience with primary care management of depression among employees. Employers offer a variety of other benefits, including work/life and employee assistance programs, occasionally providing employees help with caring for a child with a mental health condition, on-site parent training programs, or assistance with child care. Other potentially useful employee benefits include flexible work and leave policies and information and referral services that can link parents with community programs. Although employers have limited awareness of ADHD and its potential effect on employees' work, this study identified opportunities to improve both health insurance and other benefits for employees with children with ADHD.

Data warehousing in disease management programs.

PubMed

Ramick, D C

2001-01-01

Disease management programs offer the benefits of lower disease occurrence, improved patient care, and lower healthcare costs. In such programs, the key mechanism used to identify individuals at risk for targeted diseases is the data warehouse. This article surveys recent warehousing techniques from HMOs to map out critical issues relating to the preparation, design, and implementation of a successful data warehouse. Discussions of scope, data cleansing, and storage management are included in depicting warehouse preparation and design; data implementation options are contrasted. Examples are provided of data warehouse execution in disease management programs that identify members with preexisting illnesses, as well as those exhibiting high-risk conditions. The proper deployment of successful data warehouses in disease management programs benefits both the organization and the member. Organizations benefit from decreased medical costs; members benefit through an improved quality of life through disease-specific care.

Mentorship in anesthesia.

PubMed

Flexman, Alana M; Gelb, Adrian W

2011-12-01

This article will provide a review of mentorship in academic medicine. The review will include definitions and an overview of the evidence supporting the benefits, barriers, and structure of mentorship programmes in academic medicine and anesthesia. Finally, we will identify areas of further research. Mentorship in medicine has been increasingly recognized as a core component of training and career advancement in academic medicine. Mentoring provides many benefits to both mentor and mentee and facilitates the growth of academic departments by improving research productivity, faculty career satisfaction, recruitment, and educational performance. Mentorship programmes may be formal or informal and should include some form of mentor education. There are several barriers to successful mentorship including time constraints, limited availability of mentors, gender, minority status, and generational differences. These barriers may be overcome with improved awareness and sensitivity. Further investigation into the prevalence of mentorship and specific needs in our specialty are urgently required. Mentorship has been demonstrated to be an integral part of training and career development in academic medicine and benefits both mentees and mentors. Despite the promotion of mentorship in many academic anesthesia departments, little is published in the available literature supporting mentorship in anesthesia.

[Which rehabilitation for which low back pain?].

PubMed

Poiraudeau, S; Lefèvre-Colau, M M; Mayoux-Benhamou, M A; Revel, M

2000-10-15

Many rehabilitation technics for low back pain are available. Their aims are short time pain decrease, muscular strengthening in flexion or extension, increased hip and lumbar spine mobility, improved lumbar and pelvic proprioceptive sensibility, improved general fitness. During the past ten years, studies meeting widely accepted validity and applicability for therapeutic trials have addressed the clinical efficacy of rehabilitation in low back pain patients. Most studies assessing the back school approach have found no benefit. Spinal extension and flexion programs have yielded short-time improvements, without difference between the two methods. There is now strong evidence that functional restoration programs provide long-term benefits including better social and occupational outcomes.

Disease management programs: barriers and benefits.

PubMed

Magnezi, Racheli; Kaufman, Galit; Ziv, Arnona; Kalter-Leibovici, Ofra; Reuveni, Haim

2013-04-01

The healthcare system in Israel faces difficulties similar to those of most industrialized countries, including limited resources, a growing chronically ill population, and demand for high quality care. Disease management programs (DMPs) for patients with a chronic illness aim to alleviate some of these problems, primarily by improving patient self-management skills and quality of care. This study surveyed the opinions of senior healthcare administrators regarding barriers, benefits, and support for implementing DMPs. Cross-sectional survey. A 21-item questionnaire was self-completed by 87 of 105 (83%) healthcare administrators included in the study. Participants were 65.5% male and 47% physicians, 25.3% nurses, 17.3% administrators, and 10.3% other healthcare professionals. The main perceived benefit of DMPs among all respondents was improving quality of care. Other benefits noted were better contact with patients (81.6%) and better compliance with treatment (75.9%). Efficient long-term utilization of system resources was perceived as a benefit by only 58.6%. The main perceived barriers to implementing DMPs were lack of budgetary resources (69%) and increased time required versus financial compensation received (63.2%). The benefits of DMPs were patient oriented; barriers were perceived as financial and limiting professional autonomy. Information regarding long-term benefits (better patient outcomes) that ultimately provide better value for the system versus short-term barriers (increased costs and expenditures of time without compensation) might encourage the implementation of DMPs in countries faced with a growing population of patients with at least 1 chronic illness.

Transgenic perennial biofuel feedstocks and strategies for bioconfinement

EPA Science Inventory

The use of transgenic tools for the improvement of plant feedstocks will be required to realize the full economic and environmental benefits of cellulosic and other biofuels, particularly from perennial plants. Traits that are targets for improvement of biofuels crops include he...

Effect of dietary tea supplementation on growth performance, fat content, and muscle fatty acid profile of rainbow trout

USDA-ARS?s Scientific Manuscript database

Green tea is cultivated and consumed predominantly in Asia. Yet, recent reports of its health benefits have increased popularity outside of Asia, including in North America. Of these health benefits, improved fat metabolism and weight loss have garnered the most attention in recent years. Salmonid f...

Exploring the Impact of Undergraduate Intramural Sports on Undergraduate Students' Perceived Sense of Community: A Multiple Regression Analysis

ERIC Educational Resources Information Center

Penland, Nathan Paul

2017-01-01

Research has shown benefits to the student experience for college students when they participate in intramural sports on university campuses. These benefits include improved physical and social health as well as academic performance. This non-experimental, predictive correlational study sought to understand if a relationship exists between the…

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

PubMed Central

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

2014-01-01

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

Benefits of a holistic breathing technique in patients on hemodialysis.

PubMed

Stanley, Ruth; Leither, Thomas W; Sindelir, Cathy

2011-01-01

Health-related quality of life and heart rate variability are often depressed in patients on hemodialysis. This pilot program used a simple holistic, self-directed breathing technique designed to improve heart rate variability, with the hypothesis that improving heart rate variability would subsequently enhance health-related quality of life. Patient self-reported benefits included reductions in anxiety, fatigue, insomnia, and pain. Using holistic physiologic techniques may offer a unique and alternative tool for nurses to help increase health-related quality of life in patients on hemodialysis.

Implantable cardiac devices: the utility of remote monitoring in a paediatric and CHD population.

PubMed

Olen, Melissa M; Dechert-Crooks, Brynn

2017-01-01

Remote monitoring in the modern era has improved outcomes for patients with cardiac implantable electronic devices. There are many advantages to remote monitoring, including improved quality of life for patients, decreased need for in-office interrogation, and secondary reduced costs. Patient safety and enhanced survival remain the most significant benefit. With most of the published literature on this topic being focussed on adults, paediatric outcomes continue to be defined. This is a review of the benefits of remote monitoring in paediatrics and in patients with CHD.

A model to estimate the cost effectiveness of the indoorenvironment improvements in office work

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

Seppanen, Olli; Fisk, William J.

2004-06-01

Deteriorated indoor climate is commonly related to increases in sick building syndrome symptoms, respiratory illnesses, sick leave, reduced comfort and losses in productivity. The cost of deteriorated indoor climate for the society is high. Some calculations show that the cost is higher than the heating energy costs of the same buildings. Also building-level calculations have shown that many measures taken to improve indoor air quality and climate are cost-effective when the potential monetary savings resulting from an improved indoor climate are included as benefits gained. As an initial step towards systemizing these building level calculations we have developed a conceptualmore » model to estimate the cost-effectiveness of various measures. The model shows the links between the improvements in the indoor environment and the following potential financial benefits: reduced medical care cost, reduced sick leave, better performance of work, lower turn over of employees, and lower cost of building maintenance due to fewer complaints about indoor air quality and climate. The pathways to these potential benefits from changes in building technology and practices go via several human responses to the indoor environment such as infectious diseases, allergies and asthma, sick building syndrome symptoms, perceived air quality, and thermal environment. The model also includes the annual cost of investments, operation costs, and cost savings of improved indoor climate. The conceptual model illustrates how various factors are linked to each other. SBS symptoms are probably the most commonly assessed health responses in IEQ studies and have been linked to several characteristics of buildings and IEQ. While the available evidence indicates that SBS symptoms can affect these outcomes and suspects that such a linkage exists, at present we can not quantify the relationships sufficiently for cost-benefit modeling. New research and analyses of existing data to quantify the financial importance of SBS symptoms would enable more widespread consideration of the effects of IEQ in cost benefit calculations.« less

Financial effects of health information technology: a systematic review.

PubMed

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

2013-11-01

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

The Queensland experience of participation in a national drug use evaluation project, Community-acquired pneumonia – towards improving outcomes nationally (CAPTION)

PubMed Central

Pulver, Lisa K; Tett, Susan E; Coombes, Judith

2009-01-01

Background Multicentre drug use evaluations are described in the literature infrequently and usually publish only the results. The purpose of this paper is to describe the experience of Queensland hospitals participating in the Community-Acquired Pneumonia Towards Improving Outcomes Nationally (CAPTION) project, specifically evaluating the implementation of this project, detailing benefits and drawbacks of involvement in a national drug use evaluation program. Methods Emergency departments from nine hospitals in Queensland, Australia, participated in CAPTION, a national quality improvement project, conducted in 37 Australian hospitals. CAPTION was aimed at optimising prescribing in the management of Community-Acquired Pneumonia according to the recommendations of the Australian Therapeutic Guidelines: Antibiotic 12th edition. The project involved data collection, and evaluation, feedback of results and a suite of targeted educational interventions including audit and feedback, group presentations and academic detailing. A baseline audit and two drug use evaluation cycles were conducted during the 2-year project. The implementation of the project was evaluated using feedback forms after each phase of the project (audit or intervention). At completion a group meeting with the hospital coordinators identified positive and negative elements of the project. Results Evaluation by hospitals of their participation in CAPTION demonstrated both benefits and drawbacks. The benefits were grouped into the impact on the hospital dynamic such as; improved interdisciplinary working relationships (e.g. between pharmacist and doctor), recognition of the educational/academic role of the pharmacist, creation of ED Pharmacist positions and enhanced involvement with the National Prescribing Service, and personal benefits. Personal benefits included academic detailing training for participants, improved communication skills and opportunities to present at conferences. The principal drawback of participation was the extra burden on already busy staff members. Conclusion A national multicentre drug use evaluation project such as CAPTION allows hospitals which would otherwise not undertake such projects the opportunity to participate. The Queensland arm of CAPTION demonstrated benefits to both the individual participants and their hospitals, highlighting the additional value of participating in a multicentre project of this type. PMID:19646287

Targeting Alertness to Improve Cognition in Older Adults: A Preliminary Report of Benefits in Executive Function and Skill Acquisition

PubMed Central

Van Vleet, Thomas M.; DeGutis, Joseph M.; Merzenich, Michael M.; Simpson, Gregory V.; Zomet, Ativ; Dabit, Sawsan

2016-01-01

Efficient self-regulation of alertness declines with age exacerbating normal declines in performance across multiple cognitive domains, including learning and skill acquisition. Previous cognitive intervention studies have shown that it is possible to enhance alertness in patients with acquired brain injury and marked attention impairments, and that this benefit generalizes to improvements in more global cognitive functions. In the current preliminary studies, we sought to test whether this approach, that targets both tonic (over a period of minutes) and phasic (moment-to-moment) alertness, can improve key executive functioning declines in older adults, and enhance the rate of skill acquisition. The results of both experiments 1 and 2 demonstrate that, compared to active control training, alertness training significantly enhanced performance in several validated executive function measures. In experiment 2, alertness training significantly improved skill acquisition compared to active control training in a well-characterized speed of processing task, with the largest benefits shown in the most challenging speed of processing blocks. The results of the current study suggest that targeting intrinsic alertness in cognitive training provides a novel approach to improve executive functions in older adults and may be a useful adjunct treatment to enhance benefits gained in other clinically validated treatments. PMID:27372902

Biotechnological advances in the genetic improvement of Prunus domestica

USDA-ARS?s Scientific Manuscript database

Plum producers world-wide are facing multiple challenges including climate change, reductions in available labor, the need for reduced chemical inputs, the spread of native and exotic pests and pathogens, and consumer demands for improved fruit quality and health benefits. Meeting these challenges ...

Reengineering the laboratory: strategic process and systems innovation to improve performance. Recreating our role on the health-care team.

PubMed

Johnson, E

1995-01-01

The author describes reengineering efforts in the laboratory of a 550-bed hospital. Key benefits include reduced costs, improved turnaround time, and redirection of staff into new roles in information management and outreach.

Medical equipment libraries: implementation, experience and user satisfaction.

PubMed

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

2015-01-01

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

The Measurable Benefits of a Workplace Wellness Program in Canada: Results After One Year.

PubMed

Lowensteyn, Ilka; Berberian, Violette; Belisle, Patrick; DaCosta, Deborah; Joseph, Lawrence; Grover, Steven A

2018-03-01

The aim of this study was to evaluate the impact of an employee wellness program in Canada. A comprehensive program including web-based lifestyle challenges was evaluated with annual health screenings. Among 730 eligible employees, 688 (94%) registered for the program, 571 (78%) completed a health screening at baseline, and 314 (43%) at 1 year. Most (66%) employees tracked their activity for more than 6 weeks. At 1-year follow-up, there were significant clinical improvements in systolic blood pressure -3.4 mm Hg, and reductions in poor sleep quality (33% to 28%), high emotional stress (21% to 15%), and fatigue (11% to 6%). A positive dose-response was noted where the greatest improvements were observed among those who participated the most. The program had high employee engagement. After 1 year, the benefits included clinically important improvements in physical and mental health.

Functional fitness improvements after a worksite-based yoga initiative.

PubMed

Cowen, Virginia S

2010-01-01

This study explored the benefits of yoga on functional fitness, flexibility, and perceived stress. A quasi-experimental design was used to measure benefits of yoga in sample of firefighters from a major metropolitan fire department. Yoga classes were conducted on-shift, in the fire stations over the period of 6 weeks. The classes included pranayama (breathing), asana (postures), and savasana (relaxation); 108 firefighters enrolled in the study, most were physically active but had no prior experience with yoga. Baseline and post-yoga assessments were completed by 77 participants. Paired t-tests revealed significant improvements in the Functional Movement Screen, a seven item test that measures functional fitness. Improvements were also noted in trunk flexibility and perceived stress. Participants also reported favorable perceptions of yoga: feeling more focused and less musculoskeletal pain. These findings - along with the retention of the majority of the participants - indicate that participants benefited from yoga.

Cost-effective conservation planning: lessons from economics.

PubMed

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

2013-08-15

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

Team approach to care in labor and delivery.

PubMed

Mann, Susan; Pratt, Stephen D

2008-12-01

Changing to a teamwork culture in labor and delivery requires a real commitment. The skills involved can be taught to all healthcare providers. The benefits of a teamwork culture may include improved patient outcomes, less medical errors, and improved patient and staff satisfaction. Malpractice claim reduction may possibly occur through these improved outcomes and better communication with our patients.

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

PubMed

Choi, HwaJung; Schoeni, Robert F

2017-10-01

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

Analysis of hospital community benefit expenditures' alignment with community health needs: evidence from a national investigation of tax-exempt hospitals.

PubMed

Singh, Simone R; Young, Gary J; Daniel Lee, Shoou-Yih; Song, Paula H; Alexander, Jeffrey A

2015-05-01

We investigated whether federally tax-exempt hospitals consider community health needs when deciding how much and what types of community benefits to provide. Using 2009 data from hospital tax filings to the Internal Revenue Service and the 2010 County Health Rankings, we employed both univariate and multivariate analyses to examine the relationship between community health needs and the types and levels of hospitals' community benefit expenditures. The study sample included 1522 private, tax-exempt hospitals throughout the United States. We found some patterns between community health needs and hospitals' expenditures on community benefits. Hospitals located in communities with greater health needs spent more as a percentage of their operating budgets on benefits directly related to patient care. By contrast, spending on community health improvement initiatives was unrelated to community health needs. Important opportunities exist for tax-exempt hospitals to improve the alignment between their community benefit activities and the health needs of the community they serve. The Affordable Care Act requirement that hospitals conduct periodic community health needs assessments may be a first step in this direction.

Chocolate--guilty pleasure or healthy supplement?

PubMed

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

2014-02-01

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

Psychiatrists' judgments about antipsychotic benefit and risk outcomes and formulation in schizophrenia treatment.

PubMed

Markowitz, Michael A; Levitan, Bennett S; Mohamed, Ateesha F; Johnson, F R; Bridges, John F P; Alphs, Larry; Citrome, Leslie

2014-09-01

The objectives were to quantify psychiatrists' judgments of the benefits and risks of antipsychotic treatments of patients with schizophrenia and to evaluate how patient adherence history affects these judgments. Weights assigned by respondents to risks, benefits, and alternative drug formulations in the treatment of schizophrenia were assessed via a Web-based survey by using a discrete-choice experiment. Respondents in the United States and the United Kingdom chose among alternative scenarios characterized by various levels of improvement in positive symptoms, negative symptoms, social functioning, weight gain, extrapyramidal symptoms (EPS), hyperprolactinemia, and hyperglycemia and by formulation. The effect of patient adherence history on respondents' judgments was also assessed. Random-parameters logit and bivariate probit models were estimated. The sample included 394 psychiatrists. Improvement in positive symptoms from "no improvement" to "very much improved" was the most preferred outcome over the range of improvements included and was assigned a relative importance score of 10. Other outcomes, in decreasing order of importance, were improvement in negative symptoms from "no improvement" to "very much improved" (5.2; 95% confidence interval [CI]=4.2-6.2), social functioning from "severe problems" to "mild problems" (4.6, CI=3.8-5.4), no hyperglycemia (1.9, CI=1.5-2.4), <15% weight gain (1.5, CI=.9-2.0), no hyperprolactinemia (1.3, CI=.8-1.6), and no EPS (1.1, CI=.7-1.5). As adherence decreased, formulation became more important than modest efficacy changes and injections were preferred to daily pills (p<.05). Psychiatrists favored treatments that primarily improve positive symptoms. Choice of formulation became more important as likely adherence declined.

Patients opting for breast reconstruction following mastectomy: an analysis of uptake rates and benefit

PubMed Central

Howard-McNatt, Marissa M

2013-01-01

For women with breast cancer who undergo a mastectomy, breast reconstruction offers improved psychological and cosmetic outcomes. We analyzed the rates of breast reconstruction and potential benefits to these women. The review was based on a PubMed search using the terms “reconstruction,” “mastectomy,” “rates,” “benefits,” and “breast cancer.” Breast-reconstruction rates have continued to rise in recent years; however, there are definite barriers to widespread use of this procedure. These barriers include age, ethnicity, income, tumor characteristics, and the need for adjuvant radiation therapy. There are notable psychological advantages to women who receive breast reconstruction. These women also express an improved quality of life. Breast reconstruction is an acceptable technique for women undergoing mastectomy. It should be offered to all women in an immediate or delayed fashion, with guidance from their physician about the benefits and risks. PMID:24648753

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

Barr, Jonathan L.; Taira, Randal Y.; Orr, Heather M.

The purpose of this document is to describe the operating concepts, capabilities, and benefits of RAMS including descriptions of how the system implementations can improve emergency response, damage assessment, task prioritization, and situation awareness. This CONOPS provides general information on operational processes and procedures required to utilize RAMS, and expected performance benefits of the system. The primary audiences for this document are the end users of RAMS (including flight operators and incident commanders) and the RAMS management team. Other audiences include interested offices within the Department of Homeland Security (DHS), and officials from other state and local jurisdictions who wantmore » to implement similar systems.« less

Mutual benefits in academic-service partnership: An integrative review.

PubMed

Sadeghnezhad, Maliheh; Heshmati Nabavi, Fatemeh; Najafi, Fereshteh; Kareshki, Hossein; Esmaily, Habibollah

2018-05-30

Academic and service institutions involve with many challenges. Partnership programs are a golden opportunity to achieve mutual benefits to overcome these challenges. Identifying mutual benefits is the cornerstone of forming a successful partnership and guarantee to its continuity. There are definitions and instances of mutual benefits in the literature related to partnership programs, but there is no coherent evidence and clear picture of these benefits. This study is conducted to identify mutual benefits in academic-service partnership by analyzing the definitions and instances of it in the literature. An integrative review of key papers regarding mutual benefits in academic-service partnership was undertaken. This review was guided by the framework described by Whittemore and Knafl. Search of the following databases was conducted: MEDLINE, ERIC, Google Scholar, Emerald Insight and Science Direct. The search terms were mutual benefits, mutual gains, mutual interest, mutual expectations, mutual goals, mutual demand, partnership, collaboration, academic-service partnership and academic service collaboration. Cooper's five-stage integrative review method was used. Quality evaluation of articles was conducted. Data were abstracted from included articles. The analysis was conducted based on the qualitative content analysis of the literature suggested by Zhang and Wildemuth. 28 articles were included in this review. Mutual benefits are described in four categories include: synergy in training and empowerment of human resources, education improvement, access to shared resources, facilitate production and application of beneficial knowledge into practice. Mutual benefits in the academic-service partnership include a range of goals, interests, expectations, and needs of partner organizations that is achievable and measurable through joint planning and collaboration. We suggest academic and service policymakers to consider these benefits in the planning and evaluating partnership programs. Copyright © 2018 Elsevier Ltd. All rights reserved.

The Drug Facts Box: Improving the communication of prescription drug information.

PubMed

Schwartz, Lisa M; Woloshin, Steven

2013-08-20

Communication about prescription drugs ought to be a paragon of public science communication. Unfortunately, it is not. Consumers see $4 billion of direct-to-consumer advertising annually, which typically fails to present data about how well drugs work. The professional label--the Food and Drug Administration's (FDA) mechanism to get physicians information needed for appropriate prescribing--may also fail to present benefit data. FDA labeling guidance, in fact, suggests that industry omit benefit data for new drugs in an existing class and for drugs approved on the basis of unfamiliar outcomes (such as depression rating scales). The medical literature is also problematic: there is selective reporting of favorable trials, favorable outcomes within trials, and "spinning" unfavorable results to maximize benefit and minimize harm. In contrast, publicly available FDA reviews always include the phase 3 trial data on benefit and harm, which are the basis of drug approval. However, these reviews are practically inaccessible: lengthy, poorly organized, and weakly summarized. To improve accessibility, we developed the Drug Facts Box: a one-page summary of benefit and harm data for each indication of a drug. A series of studies--including national randomized trials--demonstrates that most consumers understand the Drug Facts Box and that it improves decision-making. Despite calls from their own Risk Communication Advisory Committee and Congress (in the Affordable Care Act) to consider implementing boxes, the FDA announced it needs at least 3-5 y more to make a decision. Given its potential public health impact, physicians and the public should not have to wait that long for better drug information.

The Drug Facts Box: Improving the communication of prescription drug information

PubMed Central

Schwartz, Lisa M.; Woloshin, Steven

2013-01-01

Communication about prescription drugs ought to be a paragon of public science communication. Unfortunately, it is not. Consumers see $4 billion of direct-to-consumer advertising annually, which typically fails to present data about how well drugs work. The professional label—the Food and Drug Administration's (FDA) mechanism to get physicians information needed for appropriate prescribing—may also fail to present benefit data. FDA labeling guidance, in fact, suggests that industry omit benefit data for new drugs in an existing class and for drugs approved on the basis of unfamiliar outcomes (such as depression rating scales). The medical literature is also problematic: there is selective reporting of favorable trials, favorable outcomes within trials, and “spinning” unfavorable results to maximize benefit and minimize harm. In contrast, publicly available FDA reviews always include the phase 3 trial data on benefit and harm, which are the basis of drug approval. However, these reviews are practically inaccessible: lengthy, poorly organized, and weakly summarized. To improve accessibility, we developed the Drug Facts Box: a one-page summary of benefit and harm data for each indication of a drug. A series of studies—including national randomized trials—demonstrates that most consumers understand the Drug Facts Box and that it improves decision-making. Despite calls from their own Risk Communication Advisory Committee and Congress (in the Affordable Care Act) to consider implementing boxes, the FDA announced it needs at least 3–5 y more to make a decision. Given its potential public health impact, physicians and the public should not have to wait that long for better drug information. PMID:23942130

The impact of parity on major depression treatment quality in the Federal Employees' Health Benefits Program after parity implementation.

PubMed

Busch, Alisa B; Huskamp, Haiden A; Normand, Sharon-Lise T; Young, Alexander S; Goldman, Howard; Frank, Richard G

2006-06-01

Since the 1990s, parity laws have been implemented to reduce inequities in mental health coverage compared with that for general medical conditions. It is unclear if parity under managed care is associated with improvements in mental health treatment quality. Major depressive disorder (MDD) is a prevalent but often undetected and undertreated and thus could potentially benefit from parity implementation. The objective of this study was to examine the association between parity implementation and changes in MDD treatment quality in the Federal Employees' Health Benefits (FEHB) Program. We conducted retrospective analyses of insurance claims data. Logistic regression models estimated quality changes for MDD-diagnosed enrollees from pre- to postparity. Subjects included MDD-diagnosed FEHB insured enrollees, aged 18-64, across multiple states and 6 FEHB plans before (1999-2000) and after (2001-2002) parity implementation. Measures included receipt of any antidepressant or psychotherapy within a given calendar year of diagnosis; receipt of appropriate psychotherapy frequency/intensity and duration; and pharmacotherapy duration during acute-phase treatment episodes. Postparity, several plans improved significantly in the likelihood of receiving antidepressant medication. In the acute-phase episodes, the greatest improvement was seen in the likelihood of follow up >or=4 months. Few or no other changes were observed in the acute-phase treatment intensity or duration quality measures. Parity under managed care was associated with modest improvements. The observed improvements were consistent with secular trends in MDD treatment. Whereas mental health parity is an important policy goal, these results highlight its limitations: improving the financing of care may not be sufficient to improve quality.

Mental Health Consultation in Early Childhood Classrooms

ERIC Educational Resources Information Center

Bernzweig, Jane; Ramler, Malia; Alkon, Abbey

2009-01-01

Early childhood mental health consultation is a relationship-based intervention that promotes children's social and emotional development. Benefits include improved childhood behaviors, improved staff self-efficacy, and lowered parental stress. Child care center directors are more likely to be satisfied with consultation when they are involved in…

Through a Child's Eyes: A Parents' Guide to Improving Youth Sports

ERIC Educational Resources Information Center

National Association for Sport and Physical Education, 2006

2006-01-01

Parents are the key to improving youth sports for everyone. This self-test is provided to see if they are doing all they can to keep their children active in sports and receiving the benefits of sports participation. A list of resources is included.

Advances in the genetic improvement of Prunus domestica utilizing genetic engineering

USDA-ARS?s Scientific Manuscript database

Plum producers world-wide are facing multiple challenges including climate change, reductions in available labor, the need for reduced chemical inputs, the spread of native and exotic pests and pathogens, and consumer demands for improved fruit quality and health benefits. Meeting these challenges ...

Application of space benefits to education

NASA Technical Reports Server (NTRS)

Dannenberg, K. K.; Ordway, F. I., III

1972-01-01

Information on the conducting of a teacher workshop is presented. This educational pilot project updated instruction material, used improved teaching techniques, and increased student motivation. The NASA/MSFC industrial facilities, and the displays at the Alabama Space and Rocket Center (ASRC) were key elements of the program, including a permanent exhibit, at the latter, on selected benefits accruing from the space program.

Electronic medical record systems in critical access hospitals: leadership perspectives on anticipated and realized benefits.

PubMed

Mills, Troy R; Vavroch, Jared; Bahensky, James A; Ward, Marcia M

2010-04-01

The growth of electronic medical records (EMRs) is driven by the belief that EMRs will significantly improve healthcare providers' performance and reduce healthcare costs. Evidence supporting these beliefs is limited, especially for small rural hospitals. A survey that focused on health information technology (HIT) capacity was administered to all hospitals in Iowa. Structured interviews were conducted with the leadership at 15 critical access hospitals (CAHs) that had implemented EMRs in order to assess the perceived benefits of operational EMRs. The results indicate that most of the hospitals implemented EMRs to improve efficiency, timely access, and quality. Many CAH leaders also viewed EMR implementation as a necessary business strategy to remain viable and improve financial performance. While some reasons reflect external influences, such as perceived future federal mandates, other reasons suggest that the decision was driven by internal forces, including the hospital's culture and the desires of key leaders to embrace HIT. Anticipated benefits were consistent with goals; however, realized benefits were rarely obvious in terms of quantifiable results. These findings expand the limited research on the rationale for implementing EMRs in critical access hospitals.

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

PubMed

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

2016-06-01

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

Determining the composition and benefit of the pre-hospital medical response team in the conflict setting.

PubMed

Davis, P R; Rickards, A C; Ollerton, J E

2007-12-01

To determine the optimal composition o f the pre-hospital medical response team (MERT) and the value of pre-hospital critical care interventions in a military setting, and specifically to determine both the benefit of including a doctor in the pre-hospital response team and the relevance of the time and distance to definitive care. A comprehensive review of the literature incorporating a range of electronic search engines and hand searches of key journals. There was no level 1 evidence on which to base conclusions. The 15 most relevant articles were analysed in detail. There was one randomized controlled trial (level 2 evidence) that supports the inclusion of a doctor on MERT. Several cohort studies were identified that analysed the benefits of specific critical care interventions in the pre-hospital setting. A doctor with critical care skills deployed on the MERT is associated with improved survival in victims of major trauma. Specific critical care interventions including emergency endotracheal intubation and ventilation, and intercostal drainage are associated with improved survival and functional recovery in certain patients. These benefits appear to be more easily demonstrated for the rural and remote setting than for the urban setting.

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

PubMed

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

2008-03-01

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

The psychology behind doping in sport.

PubMed

Ehrnborg, Christer; Rosén, Thord

2009-08-01

Drugs and methods to improve physical performance among athletes have been used since the beginning of sport history, but the use of performance enhancing drugs has not always been regarded as cheating. In short, the motives for doping are improving and maintaining physical functioning, coping with the social/psychological pressures and striving for social and psychological goals, including economic benefits. Factors such as, "doping dilemma", "win at all costs", cost versus benefit, and the specificity of some specific doping agents, also play major roles. It seems that action on the athletes' attitude about the achievement of physical improvement and creating effective methods to reveal the drug abuse, are two main ways in winning the struggle against doping.

Systemic Therapy in Men With Metastatic Castration-Resistant Prostate Cancer: American Society of Clinical Oncology and Cancer Care Ontario Clinical Practice Guideline

PubMed Central

Basch, Ethan; Loblaw, D. Andrew; Oliver, Thomas K.; Carducci, Michael; Chen, Ronald C.; Frame, James N.; Garrels, Kristina; Hotte, Sebastien; Kattan, Michael W.; Raghavan, Derek; Saad, Fred; Taplin, Mary-Ellen; Walker-Dilks, Cindy; Williams, James; Winquist, Eric; Bennett, Charles L.; Wootton, Ted; Rumble, R. Bryan; Dusetzina, Stacie B.; Virgo, Katherine S.

2014-01-01

Purpose To provide treatment recommendations for men with metastatic castration-resistant prostate cancer (CRPC). Methods The American Society of Clinical Oncology and Cancer Care Ontario convened an expert panel to develop evidence-based recommendations informed by a systematic review of the literature. Results When added to androgen deprivation, therapies demonstrating improved survival, improved quality of life (QOL), and favorable benefit-harm balance include abiraterone acetate/prednisone, enzalutamide, and radium-223 (223Ra; for men with predominantly bone metastases). Improved survival and QOL with moderate toxicity risk are associated with docetaxel/prednisone. For asymptomatic/minimally symptomatic men, improved survival with unclear QOL impact and low toxicity are associated with sipuleucel-T. For men who previously received docetaxel, improved survival, unclear QOL impact, and moderate to high toxicity risk are associated with cabazitaxel/prednisone. Modest QOL benefit (without survival benefit) and high toxicity risk are associated with mitoxantrone/prednisone after docetaxel. No benefit and excess toxicity are observed with bevacizumab, estramustine, and sunitinib. Recommendations Continue androgen deprivation (pharmaceutical or surgical) indefinitely. Abiraterone acetate/prednisone, enzalutamide, or 223Ra should be offered; docetaxel/prednisone should also be offered, accompanied by discussion of toxicity risk. Sipuleucel-T may be offered to asymptomatic/minimally symptomatic men. For men who have experienced progression with docetaxel, cabazitaxel may be offered, accompanied by discussion of toxicity risk. Mitoxantrone may be offered, accompanied by discussion of limited clinical benefit and toxicity risk. Ketoconazole or antiandrogens (eg, bicalutamide, flutamide, nilutamide) may be offered, accompanied by discussion of limited known clinical benefit. Bevacizumab, estramustine, and sunitinib should not be offered. There is insufficient evidence to evaluate optimal sequences or combinations of therapies. Palliative care should be offered to all patients. PMID:25199761

Expanded Benefits for Humanity from the International Space Station

NASA Technical Reports Server (NTRS)

Rai, Amelia; Robinson, Julie A.; Tate-Brown, Judy; Buckley, Nicole; Zell, Martin; Tasaki, Kazuyuki; Karabadzhak, Georgy; Sorokin, Igor V.; Pignataro, Salvatore

2016-01-01

In 2012, the International Space Station (ISS) partnership published the updated International Space Station Benefits for Humanity, 2nd edition, a compilation of stories about the many benefits being realized in the areas of human health, Earth observations and disaster response, and global education. This compilation has recently been revised to include updated statistics on the impacts of the benefits, and new benefits that have developed since the first publication. Two new sections have also been added to the book, economic development of space and innovative technology. This paper will summarize the updates on behalf of the ISS Program Science Forum, made up of senior science representatives across the international partnership. The new section on "Economic Development of Space" highlights case studies from public-private partnerships that are leading to a new economy in low earth orbit (LEO). Businesses provide both transportation to the ISS as well as some research facilities and services. These relationships promote a paradigm shift of government-funded, contractor-provided goods and services to commercially-provided goods purchased by government agencies. Other examples include commercial firms spending research and development dollars to conduct investigations on ISS and commercial service providers selling services directly to ISS users. This section provides examples of ISS as a test bed for new business relationships, and illustrates successful partnerships. The second new section, Innovative Technology, merges technology demonstration and physical science findings that promise to return Earth benefits through continued research. Robotic refueling concepts for life extensions of costly satellites in geo-synchronous orbit have applications to robotics in industry on Earth. Flame behavior experiments reveal insight into how fuel burns in microgravity leading to the possibility of improving engine efficiency on Earth. Nanostructures and smart fluids are examples of materials improvements that are being developed using data from ISS. The publication also expands the benefits of research results in human health, environmental change and disaster response and in education activities developed to capture student imaginations in support of science, technology, engineering and mathematics, or STEM, education internationally. Applications to human health of the knowledge gained on ISS continues to grow and improve healthcare technologies and our understanding of human physiology. Distinct benefits return to Earth from the only orbiting multi-disciplinary laboratory of its kind. The ISS is a stepping stone for future space exploration by providing findings that develop LEO and improve life on our planet.

Expanded benefits for humanity from the International Space Station

NASA Astrophysics Data System (ADS)

Rai, Amelia; Robinson, Julie A.; Tate-Brown, Judy; Buckley, Nicole; Zell, Martin; Tasaki, Kazuyuki; Karabadzhak, Georgy; Sorokin, Igor V.; Pignataro, Salvatore

2016-09-01

In 2012, the International Space Station (ISS) (Fig. 1) partnership published the updated International Space Station Benefits for Humanity[1], a compilation of stories about the many benefits being realized in the areas of human health, Earth observations and disaster response, and global education. This compilation has recently been revised to include updated statistics on the impacts of the benefits, and new benefits that have developed since the first publication. Two new sections have also been added to the book, economic development of space and innovative technology. This paper will summarize the updates on behalf of the ISS Program Science Forum, made up of senior science representatives across the international partnership. The new section on "Economic Development of Space" highlights case studies from public-private partnerships that are leading to a new economy in low earth orbit (LEO). Businesses provide both transportation to the ISS as well as some research facilities and services. These relationships promote a paradigm shift of government-funded, contractor-provided goods and services to commercially-provided goods purchased by government agencies. Other examples include commercial firms spending research and development dollars to conduct investigations on ISS and commercial service providers selling services directly to ISS users. This section provides examples of ISS as a test bed for new business relationships, and illustrates successful partnerships. The second new section, "Innovative Technology," merges technology demonstration and physical science findings that promise to return Earth benefits through continued research. Robotic refueling concepts for life extensions of costly satellites in geo-synchronous orbit have applications to robotics in industry on Earth. Flame behavior experiments reveal insight into how fuel burns in microgravity leading to the possibility of improving engine efficiency on Earth. Nanostructures and smart fluids are examples of materials improvements that are being developed using data from ISS. The publication also expands the benefits of research results in human health, environmental change and disaster response and in education activities developed to capture student imaginations in support of science, technology, engineering and mathematics, or STEM, education internationally. Applications to human health of the knowledge gained on ISS continue to grow and improve healthcare technologies and our understanding of human physiology. Distinct benefits return to Earth from the only orbiting multi-disciplinary laboratory of its kind. The ISS is a stepping stone for future space exploration by providing findings that develop LEO and improve life on our planet.

United States benefits of improved worldwide wheat crop information from a LANDSAT system

NASA Technical Reports Server (NTRS)

Heiss, K. P.; Sand, F.; Seidel, A.; Warner, D.; Sheflin, N.; Bhattacharyya, R.; Andrews, J.

1975-01-01

The value of worldwide information improvements on wheat crops, promised by LANDSAT, is measured in the context of world wheat markets. These benefits are based on current LANDSAT technical goals and assume that information is made available to all (United States and other countries) at the same time. A detailed empirical sample demonstration of the effect of improved information is given; the history of wheat commodity prices for 1971-72 is reconstructed and the price changes from improved vs. historical information are compared. The improved crop forecasting from a LANDSAT system assumed include wheat crop estimates of 90 percent accuracy for each major wheat producing region. Accurate, objective worldwide wheat crop information using space systems may have a very stabilizing influence on world commodity markets, in part making possible the establishment of long-term, stable trade relationships.

Rehabilitation of low back pain patients. A review.

PubMed

Revel, M

1995-01-01

Numerous methods have been developed for the rehabilitation of low back pain patients, including spinal flexion and extension exercises, lumbar spine locking in an intermediate position, enhancement of spinal and pelvic proprioceptive sensibility, swimming pool therapy, back schools, and functional restoration. Each seeks to achieve a goal assumed to be central to the prevention of a first or recurrent episode of low back pain. Goals include short-term pain relief, an improved ability to achieve self-sedation, abdominal and lumbar muscle strengthening, increased hip and lumbar spine mobility, improved lumbar and pelvic proprioceptive sensibility, intervertebral joint stabilization, lumbar posture modification and improved general fitness. Less than 30 studies meeting widely accepted validity and applicability criteria for therapeutic trials have addressed the clinical efficacy of rehabilitation in low back pain patients. Most studies of the back school approach have found no benefit. Spinal flexion and extension exercise programs have yielded short-lived improvements, with no differences across methods. There is evidence that functional restoration programs based on graded activity may provide long-term benefits including better social and occupational outcomes. We have evaluated the physical therapy methods most commonly taught to and used by physical therapists in France.

Does Surgical Repair of Moderate Ischemic Mitral Regurgitation Improve Survival? A Systematic Review.

PubMed

Chatterjee, Saurav; Tripathi, Byomesh; Virk, Hafeez Ul Hassan; Ahmed, Mohammed; Bavishi, Chirag; Krishnamoorthy, Parasuram; Sardar, Partha; Giri, Jay; Omidvari, Karan; Chikwe, Joanna

2016-03-01

Mitral regurgitation (MR) is one of the common complications in myocardial infarction (MI) patients. Almost half of the post MI patients have MR (ischemic MR)(17) which is moderate to severe (grade II-IV). Whether there is a mortality benefit of performing mitral valve repair (MVR) along with coronary artery bypass grafting (CABG) in patients with post MI moderate MR remains inconclusive. Literature search was done from PubMed, Google scholar, Ovid, and Medline databases. Studies which included post MI patients with moderate ischemic MR and reported mortality outcomes of performing CABG and MVR were chosen for the systematic review. Our preliminary literature search identified 194 studies, of which 11 studies met our inclusion criteria. Nine studies showed no survival benefit of performing simultaneous MVR and CABG. One study demonstrated survival benefit of performing CABG plus MVR only in the New York Heart Association (NYHA) class III-IV, and one study suggested survival benefit of performing CABG plus MVR as compared to CABG alone in patient with ischemic MR irrespective of preoperative NYHA functional class. Review of current literature showed mixed results in terms of improvement in functional status but failed to show any survival benefit of performing MVR along with CABG. Limitations of studies include small sample size, difference in baseline demographic variables, and short follow-up period which might influence the outcome of the study. Prospective randomized studies are required to establish clear benefit of performing MVR simultaneously with CABG.

Developing a PPO: challenges and benefits.

PubMed

Range, R P

1984-12-01

When deciding upon which kind of alternative delivery system to develop, Saint Vincent Charity Hospital and Health Center, Cleveland, selected the preferred provider organization (PPO) mode because of four basic advantages: (1) the health care consumer's freedom to choose providers; (2) effective cost containment; (3) coordination of services among allied providers; and (4) health promotion programs. More specifically, the Ohio Health Choice Plan (OHCP) benefits hospitals by assisting to maintain or increase market share, facilitating prompt claims payments, and improving financial mix. Physicians benefit not only because they receive prompt payment and are not a risk but also because the fee-for-service system is retained and their market shares can also be preserved or enhanced. Employers' advantages include savings through controlled utilization, positive employee relations, and improved management information. Employees' benefits include lower out-of-pocket costs and freedom of choice. As a full-service PPO, the organization provides benefits plans designed to meet each employer's needs as well as actuary services, claims screening and processing, benefits coordination, utilization control, management reporting, health promotion activities, and networking capabilities. Four major challenges do confront PPOs: 1. Start-up and operating costs can be significant; 2. The administrative skills required are different from those used in traditional health care systems; 3. The commitment in implementing and operating a PPO; and 4. All participating providers must genuinely accept the PPO. A PPO's success also can be measured in three ways: the development of a strong network; size of enrollment; and effectiveness in utilization control.(ABSTRACT TRUNCATED AT 250 WORDS)

Improved Steam Turbine Leakage Control with a Brush Seal Design

NASA Astrophysics Data System (ADS)

Turnquist, Norman; Chupp, Raymond E.; Pastrana, Ryan; Wolfe, Chris; Burnett, Mark

2002-10-01

This paper presents an improved steam turbine leakage control system with a brush seal design. The contents include: 1) Typical Design Characteristics; 2) Typical Brush Seal Locations; 3) Reduced Leakage Rates; 4) Performance Benefits; 5) System Considerations; 6) Rotor Dynamics; 7) Laboratory Tests and 8) Field Experience.

Improving city forests through assessment, modelling and monitoring

Treesearch

D.J. Nowak

2018-01-01

Urban and peri-urban forests produce numerous benefits for society. These include moderating the climate; reducing energy use in buildings; sequestering atmospheric carbon dioxide; improving air and water quality; mitigating rainfall run-off and flooding; providing an aesthetic environment and recreational opportunities; enhancing human health and social well-being;...

The Practical Considerations of Opening School Facilities to Lifelong Learning.

ERIC Educational Resources Information Center

Odell, John H.

1997-01-01

There are many reasons why a school should plan for extending its facilities' hours of use and making them available to the community. Benefits include improving cost effectiveness in using limited resources, improving security, promoting the school, enhancing staff's potential to offer industry-related training and expertise, and enriching…

Coal flow aids reduce coke plant operating costs and improve production rates

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

Bedard, R.A.; Bradacs, D.J.; Kluck, R.W.

2005-06-01

Chemical coal flow aids can provide many benefits to coke plants, including improved production rates, reduced maintenance and lower cleaning costs. This article discusses the mechanisms by which coal flow aids function and analyzes several successful case histories. 2 refs., 10 figs., 1 tab.

Toward Improved Security and Privacy in Modern Healthcare

ERIC Educational Resources Information Center

Pagano, Matthew Wallach

2013-01-01

The conversion of paper-based medical records into electronic formats is set to bring many benefits to healthcare. This includes creating a more seamless exchange of electronic health records (EHRs) between providers, improving healthcare while lowering its costs, and providing patients with increased access to their EHRs. As more medical…

Tai Chi research review.

PubMed

Field, Tiffany

2011-08-01

This review briefly summarizes recent Tai Chi research on physical benefits including balance and muscle strength and psychological benefits including attentiveness, sleep and anxiety. Cardiovascular changes following Tai Chi include decreased heart rate and blood pressure, increased vagal activity and decreased cholesterol. Pain syndromes that have been affected include fibromyalgia, osteoarthritis and rheumatoid arthritis. Autoimmune and immune conditions recently researched and reviewed here include osteoporosis, diabetes and HIV. Methodological problems with this research include the variability in forms (series of postures) used across studies as well as the intensity of the Tai Chi schedule. Further, most of the studies are based on within group changes rather than attention control group comparisons. Nonetheless, significant clinical improvements have been noted. Copyright © 2010 Elsevier Ltd. All rights reserved.

Making our offices universally accessible: guidelines for physicians

PubMed Central

Jones, K E; Tamari, I E

1997-01-01

OBJECTIVE: To develop recommendations for office-based physicians who wish to make their offices accessible to all patients. OPTIONS: Include taking steps to make offices more accessible, or not; offices may be accessible to varying degrees. OUTCOMES: Outcomes of accessibility involve patient-care, economic, ethical and legal issues. Stakeholders in these outcomes include patients, physicians, government and society. EVIDENCE: Data were obtained from a series of searches of MEDLINE, CINAHL and Healthstar (previously Health) databases for articles on disability and family medicine, primary (health) care and family practice, and on access and offices, and health services accessibility, and from a telephone survey of 50 stakeholders. VALUES: A high value was placed on services to persons with disabilities and on stakeholder input. Universal accessibility was valued as an overall goal; improved accessibility was also highly valued. BENEFITS, HARMS AND COSTS: Benefits to patients include improved access to care as guaranteed by the Canada Health Act and in keeping with provincial Human Rights Codes. Benefits to physicians include contact with a broader patient population and freedom from fear of litigation. Costs of improved accessibility vary depending on individual circumstances and on whether an office is being built or renovated; some improvement costs are minimal. RECOMMENDATIONS: All physicians should take measures to improve practice accessibility. Improved access should be considered in each of the following areas: transportation and entrance to the facility, entrance to the office, waiting rooms, rest rooms, examination rooms, general building features and other features. VALIDATION: No similar guidelines exist. To assess the content validity of these guidelines, the authors had a draft document reviewed by 18 stakeholders. All specific recommendations met the minimum criterion of adherence to current legislation, including national and provincial building codes. The specific recommendations are endorsed by the Canadian Paraplegic Association (national and Ontario offices), the DisAbled Women's Network (Ontario) and the Centre for Independent Living (Toronto). SPONSORS: Development of these guidelines was supported in part by the Department of Family and Community Medicine, Toronto Hospital, Toronto, Ont. PMID:9068570

Improving information technology adoption and implementation through the identification of appropriate benefits: creating IMPROVE-IT.

PubMed

Leonard, Kevin J; Sittig, Dean F

2007-05-04

This paper describes the objectives of a collaborative initiative that attempts to provide the evidence that increased information technology (IT) capabilities, availability, and use lead directly to improved clinical quality, safety, and effectiveness within the inpatient hospital setting. This collaborative network has defined specific measurement indicators in an attempt to examine the existence, timing, and level of improvements in health outcomes that can be derived from IT investment. These indicators are in three areas: (1) IT costs (which includes both initial and ongoing investment), (2) IT infusion (ie, system availability, adoption, and deployment), and (3) health performance (eg, clinical efficacy, efficiency, quality, and effectiveness). Herein, we outline the theoretical framework, the methodology employed to create the metrics, and the benefits that can be obtained.

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

PubMed Central

Seals, Douglas R.

2016-01-01

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

Beyond monetary benefits of restoring sight in Vietnam: Evaluating well-being gains from cataract surgery.

PubMed

Feeny, Simon; Posso, Alberto; McDonald, Lachlan; Chuyen, Truong Thi Kim; Tung, Son Thanh

2018-01-01

A more holistic understanding of the benefits of sight-restoring cataract surgery requires a focus that goes beyond income and employment, to include a wider array of well-being measures. The objective of this study is to examine the monetary and non-monetary benefits of cataract surgery on both patients as well as their caregivers in Vietnam. Participants were randomly recruited from a Ho-Chi-Minh City Hospital. A total of 82 cataract patients and 83 caregivers participated in the survey conducted for this study. Paired t-tests, Wilcoxon Signed Rank tests, and regression analysis are used to detect any statistically significant differences in various measures of well-being for patients and caregivers before and after surgery. There are statistically significant improvements in monetary and non-monetary measures of well-being for both patients and caregivers approximately three months after undergoing cataract surgery, compared with baseline assessments collected prior to surgery. Non-monetary measures of well-being include self-assessments of overall health, mental health, hope, self-efficacy, happiness and life satisfaction. For patients, the benefits included statistically significant improvements in earnings, mobility, self-care, the ability to undertake daily activities, self-assessed health and mental health, life satisfaction, hope, and self-efficacy (p<0.01). For caregivers, attendance at work improved alongside overall health, mental health, hope, self-efficacy, happiness and life satisfaction, three months post-surgery (p<0.01). Restoring sight has positive impacts for those suffering from cataracts and their caregivers. Sometimes the benefits are almost equal in their magnitude. The study has also demonstrated that many of these impacts are non-monetary in nature. It is clear that estimates of the rate of return to restoring sight that focus only on financial gains will underestimate the true returns to society of restoring sight from cataract surgeries.

The benefits associated with volunteering among seniors: a critical review and recommendations for future research.

PubMed

Anderson, Nicole D; Damianakis, Thecla; Kröger, Edeltraut; Wagner, Laura M; Dawson, Deirdre R; Binns, Malcolm A; Bernstein, Syrelle; Caspi, Eilon; Cook, Suzanne L

2014-11-01

There is an urgent need to identify lifestyle activities that reduce functional decline and dementia associated with population aging. The goals of this article are to review critically the evidence on the benefits associated with formal volunteering among older adults, propose a theoretical model of how volunteering may reduce functional limitations and dementia risk, and offer recommendations for future research. Database searches identified 113 papers on volunteering benefits in older adults, of which 73 were included. Data from descriptive, cross-sectional, and prospective cohort studies, along with 1 randomized controlled trial, most consistently reveal that volunteering is associated with reduced symptoms of depression, better self-reported health, fewer functional limitations, and lower mortality. The extant evidence provides the basis for a model proposing that volunteering increases social, physical, and cognitive activity (to varying degrees depending on characteristics of the volunteer placement) which, through biological and psychological mechanisms, leads to improved functioning; we further propose that these volunteering-related functional improvements should be associated with reduced dementia risk. Recommendations for future research are that studies (a) include more objective measures of psychosocial, physical, and cognitive functioning; (b) integrate qualitative and quantitative methods in prospective study designs; (c) explore further individual differences in the benefits associated with volunteering; (d) include occupational analyses of volunteers' specific jobs in order to identify their social, physical, and cognitive complexity; (e) investigate the independent versus interactive health benefits associated with volunteering relative to engagement in other forms of activity; and (f) examine the relationship between volunteering and dementia risk. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

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

PubMed

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

2014-08-01

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

Action Video Game Training for Healthy Adults: A Meta-Analytic Study

PubMed Central

Wang, Ping; Liu, Han-Hui; Zhu, Xing-Ting; Meng, Tian; Li, Hui-Jie; Zuo, Xi-Nian

2016-01-01

Action video game (AVG) has attracted increasing attention from both the public and from researchers. More and more studies found video game training improved a variety of cognitive functions. However, it remains controversial whether healthy adults can benefit from AVG training, and whether young and older adults benefit similarly from AVG training. In the present study, we aimed to quantitatively assess the AVG training effect on the cognitive ability of adults and to compare the training effects on young and older adults by conducting a meta-analysis on previous findings. We systematically searched video game training studies published between January 1986 and July 2015. Twenty studies were included in the present meta-analysis, for a total of 313 participants included in the training group and 323 participants in the control group. The results demonstrate that healthy adults achieve moderate benefit from AVG training in overall cognitive ability and moderate to small benefit in specific cognitive domains. In contrast, young adults gain more benefits from AVG training than older adults in both overall cognition and specific cognitive domains. Age, education, and some methodological factors, such as the session duration, session number, total training duration, and control group type, modulated the training effects. These meta-analytic findings provide evidence that AVG training may serve as an efficient way to improve the cognitive performance of healthy adults. We also discussed several directions for future AVG training studies. PMID:27378996

Action Video Game Training for Healthy Adults: A Meta-Analytic Study.

PubMed

Wang, Ping; Liu, Han-Hui; Zhu, Xing-Ting; Meng, Tian; Li, Hui-Jie; Zuo, Xi-Nian

2016-01-01

Action video game (AVG) has attracted increasing attention from both the public and from researchers. More and more studies found video game training improved a variety of cognitive functions. However, it remains controversial whether healthy adults can benefit from AVG training, and whether young and older adults benefit similarly from AVG training. In the present study, we aimed to quantitatively assess the AVG training effect on the cognitive ability of adults and to compare the training effects on young and older adults by conducting a meta-analysis on previous findings. We systematically searched video game training studies published between January 1986 and July 2015. Twenty studies were included in the present meta-analysis, for a total of 313 participants included in the training group and 323 participants in the control group. The results demonstrate that healthy adults achieve moderate benefit from AVG training in overall cognitive ability and moderate to small benefit in specific cognitive domains. In contrast, young adults gain more benefits from AVG training than older adults in both overall cognition and specific cognitive domains. Age, education, and some methodological factors, such as the session duration, session number, total training duration, and control group type, modulated the training effects. These meta-analytic findings provide evidence that AVG training may serve as an efficient way to improve the cognitive performance of healthy adults. We also discussed several directions for future AVG training studies.

A multiple biomarker risk score for guiding clinical decisions using a decision curve approach.

PubMed

Hughes, Maria F; Saarela, Olli; Blankenberg, Stefan; Zeller, Tanja; Havulinna, Aki S; Kuulasmaa, Kari; Yarnell, John; Schnabel, Renate B; Tiret, Laurence; Salomaa, Veikko; Evans, Alun; Kee, Frank

2012-08-01

We assessed whether a cardiovascular risk model based on classic risk factors (e.g. cholesterol, blood pressure) could refine disease prediction if it included novel biomarkers (C-reactive protein, N-terminal pro-B-type natriuretic peptide, troponin I) using a decision curve approach which can incorporate clinical consequences. We evaluated whether a model including biomarkers and classic risk factors could improve prediction of 10 year risk of cardiovascular disease (CVD; chronic heart disease and ischaemic stroke) against a classic risk factor model using a decision curve approach in two prospective MORGAM cohorts. This included 7739 men and women with 457 CVD cases from the FINRISK97 cohort; and 2524 men with 259 CVD cases from PRIME Belfast. The biomarker model improved disease prediction in FINRISK across the high-risk group (20-40%) but not in the intermediate risk group, at the 23% risk threshold net benefit was 0.0033 (95% CI 0.0013-0.0052). However, in PRIME Belfast the net benefit of decisions guided by the decision curve was improved across intermediate risk thresholds (10-20%). At p(t) = 10% in PRIME, the net benefit was 0.0059 (95% CI 0.0007-0.0112) with a net increase in 6 true positive cases per 1000 people screened and net decrease of 53 false positive cases per 1000 potentially leading to 5% fewer treatments in patients not destined for an event. The biomarker model improves 10-year CVD prediction at intermediate and high-risk thresholds and in particular, could be clinically useful at advising middle-aged European males of their CVD risk.

Change in Environmental Benefits of Urban Land Use and Its Drivers in Chinese Cities, 2000–2010

PubMed Central

Song, Xiaoqing; Chang, Kang-tsung; Yang, Liang; Scheffran, Jürgen

2016-01-01

Driven by rising income and urban population growth, China has experienced rapid urban expansion since the 1980s. Urbanization can have positive effects on the urban environment; however, improvement of urban environment quality, especially its divergence between relatively developed and undeveloped cities in China, is currently a rather rudimentary and subjective issue. This study analyzed urban environmental benefits among China’s prefectural cities based on their structure of urban land use in 2000 and 2010. First, we divided 347 prefectural cities into two groups, 81 coastal and capital cities in the relatively developed group (RD) and 266 other prefectural cities in the undeveloped group (RP). Then, we defined three areas of urban environmental benefits, including green infrastructure, industrial upgrade, and environmental management, and developed an assessment index system. Results showed that all prefectural cities saw improvement in urban environmental quality in 2000–2010. Although the RD cities had higher income and more population growth, they had less improvement than the RP cities during the same period. We also found that demographic and urban land agglomeration among RD cities restrained green infrastructure expansion, making green infrastructure unsuitable as a permanent solution to environmental improvement. It is therefore urgent for China to promote balanced improvement among the three areas of urban environmental benefits and between the RD and RP cities through regional differentiation policies. PMID:27240386

Change in Environmental Benefits of Urban Land Use and Its Drivers in Chinese Cities, 2000-2010.

PubMed

Song, Xiaoqing; Chang, Kang-Tsung; Yang, Liang; Scheffran, Jürgen

2016-05-26

Driven by rising income and urban population growth, China has experienced rapid urban expansion since the 1980s. Urbanization can have positive effects on the urban environment; however, improvement of urban environment quality, especially its divergence between relatively developed and undeveloped cities in China, is currently a rather rudimentary and subjective issue. This study analyzed urban environmental benefits among China's prefectural cities based on their structure of urban land use in 2000 and 2010. First, we divided 347 prefectural cities into two groups, 81 coastal and capital cities in the relatively developed group (RD) and 266 other prefectural cities in the undeveloped group (RP). Then, we defined three areas of urban environmental benefits, including green infrastructure, industrial upgrade, and environmental management, and developed an assessment index system. Results showed that all prefectural cities saw improvement in urban environmental quality in 2000-2010. Although the RD cities had higher income and more population growth, they had less improvement than the RP cities during the same period. We also found that demographic and urban land agglomeration among RD cities restrained green infrastructure expansion, making green infrastructure unsuitable as a permanent solution to environmental improvement. It is therefore urgent for China to promote balanced improvement among the three areas of urban environmental benefits and between the RD and RP cities through regional differentiation policies.

Novel model of direct and indirect cost-benefit analysis of mechanical embolectomy over IV tPA for large vessel occlusions: a real-world dollar analysis based on improvements in mRS.

PubMed

Mangla, Sundeep; O'Connell, Keara; Kumari, Divya; Shahrzad, Maryam

2016-01-20

Ischemic strokes result in significant healthcare expenditures (direct costs) and loss of quality-adjusted life years (QALYs) (indirect costs). Interventional therapy has demonstrated improved functional outcomes in patients with large vessel occlusions (LVOs), which are likely to reduce the economic burden of strokes. To develop a novel real-world dollar model to assess the direct and indirect cost-benefit of mechanical embolectomy compared with medical treatment with intravenous tissue plasminogen activator (IV tPA) based on shifts in modified Rankin scores (mRS). A cost model was developed including multiple parameters to account for both direct and indirect stroke costs. These were adjusted based upon functional outcome (mRS). The model compared IV tPA with mechanical embolectomy to assess the costs and benefits of both therapies. Direct stroke-related costs included hospitalization, inpatient and outpatient rehabilitation, home care, skilled nursing facilities, and long-term care facility costs. Indirect costs included years of life expectancy lost and lost QALYs. Values for the model cost parameters were derived from numerous resources and functional outcomes were derived from the MR CLEAN study as a reflective sample of LVOs. Direct and indirect costs and benefits for the two treatments were assessed using Microsoft Excel 2013. This cost-benefit model found a cost-benefit of mechanical embolectomy over IV tPA of $163 624.27 per patient and the cost benefit for 50 000 patients on an annual basis is $8 181 213 653.77. If applied widely within the USA, mechanical embolectomy will significantly reduce the direct and indirect financial burden of stroke ($8 billion/50 000 patients). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Environmental regulations and energy for home heating

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

Cohen, A.S.; Fishelson, G.; Gardner, J.L.

1975-01-01

A cost/benefit study of environmental policies supports banning coal as an urban fuel. In an analysis of the Chicago area a coal ban resulted in costs exceeding benefits in only 16 of 172 square miles. In 54 areas benefits were double costs. Benefits include improved air quality, health, and savings on cleaning supplies, and showed no income or racial preferences. As coal use declines, natural gas and oil will increase in demand and price. Two methods for increasing natural gas price would be Federal deregulation of wellhead gas and a fuel policy allowing price increases in response to local shortages.more » (DCK)« less

Resistant starch can improve insulin sensitivity independently of the gut microbiota.

PubMed

Bindels, Laure B; Segura Munoz, Rafael R; Gomes-Neto, João Carlos; Mutemberezi, Valentin; Martínez, Inés; Salazar, Nuria; Cody, Elizabeth A; Quintero-Villegas, Maria I; Kittana, Hatem; de Los Reyes-Gavilán, Clara G; Schmaltz, Robert J; Muccioli, Giulio G; Walter, Jens; Ramer-Tait, Amanda E

2017-02-07

Obesity-related diseases, including type 2 diabetes and cardiovascular disease, have reached epidemic proportions in industrialized nations, and dietary interventions for their prevention are therefore important. Resistant starches (RS) improve insulin sensitivity in clinical trials, but the mechanisms underlying this health benefit remain poorly understood. Because RS fermentation by the gut microbiota results in the formation of physiologically active metabolites, we chose to specifically determine the role of the gut microbiota in mediating the metabolic benefits of RS. To achieve this goal, we determined the effects of RS when added to a Western diet on host metabolism in mice with and without a microbiota. RS feeding of conventionalized mice improved insulin sensitivity and redressed some of the Western diet-induced changes in microbiome composition. However, parallel experiments in germ-free littermates revealed that RS-mediated improvements in insulin levels also occurred in the absence of a microbiota. RS reduced gene expression of adipose tissue macrophage markers and altered cecal concentrations of several bile acids in both germ-free and conventionalized mice; these effects were strongly correlated with the metabolic benefits, providing a potential microbiota-independent mechanism to explain the physiological effects of RS. This study demonstrated that some metabolic benefits exerted by dietary RS, especially improvements in insulin levels, occur independently of the microbiota and could involve alterations in the bile acid cycle and adipose tissue immune modulation. This work also sets a precedent for future mechanistic studies aimed at establishing the causative role of the gut microbiota in mediating the benefits of bioactive compounds and functional foods.

A survey of cannabis (marijuana) use and self-reported benefit in men with chronic prostatitis/chronic pelvic pain syndrome.

PubMed

Tripp, Dean A; Nickel, J Curtis; Katz, Laura; Krsmanovic, Adrijana; Ware, Mark A; Santor, Darcy

2014-11-01

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a chronic pelvic pain condition largely refractory to treatment. Cannabis (marijuana) use has been reported for a wide variety of chronic pain conditions, but no study has examined prevalence of cannabis use, symptom benefit or side effects, or frequency in CP/CPPS. Participants were recruited from an outpatient CP/CPPS urology clinic (n = 98) and online through the Prostatitis Foundation website (n = 244). Participants completed questionnaires (demographics, CP/CPPS, depression, cannabis). The clinic sample included Canadian patients and the online sample included primarily American patients. Due to differences, groups were examined separately. Almost 50% of respondents reported using cannabis (clinic n = 49; online n = 89). Of the cannabis users, 36.8% of clinic and 75% of online respondents reported that it improved their symptoms. Most of the respondents (from the clinic and online groups) reported that cannabis improved their mood, pain, muscle spasms, and sleep. However, they did not note any improvements for weakness, fatigue, numbness, ambulation, and urination. Overall, the effectiveness of cannabis for CP/CPPS was "somewhat/very effective" (57% clinic; 63% online). There were no differences between side effects or choice of consumption and most reported using cannabis rarely. These are the first estimates in men suffering from CP/CPPS and suggest that while cannabis use is prevalent, its medical use and benefit are unknown. This is an understudied area and the benefit or hazard for cannabis use awaits further study.

Environmental cost-effectiveness analysis in intertemporal natural resource policy: evaluation of selective fishing gear.

PubMed

Kronbak, Lone Grønbæk; Vestergaard, Niels

2013-12-15

In most decision-making involving natural resources, the achievements of a given policy (e.g., improved ecosystem or biodiversity) are rather difficult to measure in monetary units. To address this problem, the current paper develops an environmental cost-effectiveness analysis (ECEA) to include intangible benefits in intertemporal natural resource problems. This approach can assist managers in prioritizing management actions as least cost solutions to achieve quantitative policy targets. The ECEA framework is applied to a selective gear policy case in Danish mixed trawl fisheries in Kattegat and Skagerrak. The empirical analysis demonstrates how a policy with large negative net benefits might be justified if the intangible benefits are included. Copyright © 2013 Elsevier Ltd. All rights reserved.

The New, Improved 2016 SmartWay Truck Carrier Tool

EPA Pesticide Factsheets

This EPA presentation provides information on the SmartWay Transport Partnership Program, including key information about EPA, Partners' roles, benefits, tools, partner recognition, awards, and brand value. Transcript available

24 CFR 964.15 - HUD policy on resident management.

Code of Federal Regulations, 2010 CFR

2010-04-01

... corporation. Potential benefits of resident-managed entities include improved quality of life, experiencing the dignity of meaningful work, enabling residents to choose where they want to live, and meaningful...

Captive insurance: is it the right choice for your insurance exposures?

PubMed

Frese, Richard C

2015-12-01

Potential benefits of a captive insurance company include: Broader coverage Improved cash flow and stability. Direct access to reinsurance markets. Tax advantages. Better handling and control of risk management and claims. Potential drawbacks and challenges include: Startup capitalization. Underwriting losses. Administration and commitment.

A new emphasis on root traits for perennial grass and legume varieties with environmental and ecological benefits.

PubMed

Marshall, Athole H; Collins, Rosemary P; Humphreys, Mike W; Scullion, John

2016-02-01

Grasslands cover a significant proportion of the agricultural land within the UK and across the EU, providing a relatively cheap source of feed for ruminants and supporting the production of meat, wool and milk from grazing animals. Delivering efficient animal production from grassland systems has traditionally been the primary focus of grassland-based research. But there is increasing recognition of the ecological and environmental benefits of these grassland systems and the importance of the interaction between their component plants and a host of other biological organisms in the soil and in adjoining habitats. Many of the ecological and environmental benefits provided by grasslands emanate from the interactions between the roots of plant species and the soil in which they grow. We review current knowledge on the role of grassland ecosystems in delivering ecological and environmental benefits. We will consider how improved grassland can deliver these benefits, and the potential opportunities for plant breeding to improve specific traits that will enhance these benefits whilst maintaining forage production for livestock consumption. Opportunities for exploiting new plant breeding approaches, including high throughput phenotyping, and for introducing traits from closely related species are discussed.

Evidence based exercise - clinical benefits of high intensity interval training.

PubMed

Shiraev, Tim; Barclay, Gabriella

2012-12-01

Aerobic exercise has a marked impact on cardiovascular disease risk. Benefits include improved serum lipid profiles, blood pressure and inflammatory markers as well as reduced risk of stroke, acute coronary syndrome and overall cardiovascular mortality. Most exercise programs prescribed for fat reduction involve continuous, moderate aerobic exercise, as per Australian Heart Foundation clinical guidelines. This article describes the benefits of exercise for patients with cardiovascular and metabolic disease and details the numerous benefits of high intensity interval training (HIIT) in particular. Aerobic exercise has numerous benefits for high-risk populations and such benefits, especially weight loss, are amplified with HIIT. High intensity interval training involves repeatedly exercising at a high intensity for 30 seconds to several minutes, separated by 1-5 minutes of recovery (either no or low intensity exercise). HIT is associated with increased patient compliance and improved cardiovascular and metabolic outcomes and is suitable for implementation in both healthy and 'at risk' populations. Importantly, as some types of exercise are contraindicated in certain patient populations and HIIT is a complex concept for those unfamiliar to exercise, some patients may require specific assessment or instruction before commencing a HIIT program.

Analysis of Hospital Community Benefit Expenditures’ Alignment With Community Health Needs: Evidence From a National Investigation of Tax-Exempt Hospitals

PubMed Central

Young, Gary J.; Daniel Lee, Shoou-Yih; Song, Paula H.; Alexander, Jeffrey A.

2015-01-01

Objectives. We investigated whether federally tax-exempt hospitals consider community health needs when deciding how much and what types of community benefits to provide. Methods. Using 2009 data from hospital tax filings to the Internal Revenue Service and the 2010 County Health Rankings, we employed both univariate and multivariate analyses to examine the relationship between community health needs and the types and levels of hospitals’ community benefit expenditures. The study sample included 1522 private, tax-exempt hospitals throughout the United States. Results. We found some patterns between community health needs and hospitals’ expenditures on community benefits. Hospitals located in communities with greater health needs spent more as a percentage of their operating budgets on benefits directly related to patient care. By contrast, spending on community health improvement initiatives was unrelated to community health needs. Conclusions. Important opportunities exist for tax-exempt hospitals to improve the alignment between their community benefit activities and the health needs of the community they serve. The Affordable Care Act requirement that hospitals conduct periodic community health needs assessments may be a first step in this direction. PMID:25790412

Effects of the Pulmonary Hypertension Manual (PulHMan) on Awareness of Exercise in Patients with Pulmonary Hypertension.

PubMed

Babu, Abraham Samuel; Ramachandran, Padmakumar; Maiya, Arun G

2016-01-01

Patient education is an important part of holistic care for patients with chronic diseases. With the success of the Heart Manual, it was felt there is a strong need to develop such a manual for those with pulmonary hypertension (PH) - the Pulmonary Hypertension Manual (PulHMan). This was developed through a qualitative methodology in order to ensure the needs of the patients were being met. The impact of the PulHMan on awareness about exercise-related benefits and PH are not known. Therefore the aim of this study was to assess the effects of the PulHMan on improving awareness among individuals with PH. A repeat cross sectional study was carried out on 30 patients with PH to assess the effects of using the PulHMan on awareness of exercise-related benefits in PH. Awareness was assessed from a self-developed and validated questionnaire that included components of PH and exercise related components. Thirty patients with PH (mean right ventricular systolic pressure and six minute walk distance of 89.2±4.1mm Hg and 322.8±102m respectively) were included in the study. At baseline, it was seen that there was a low awareness regarding the benefits of exercise for PH. However, they were aware of the general health benefits of walking. After three months, it was seen that the PulHMan improved awareness on the benefits of exercising. Despite a low number willing to exercise (2/30) and participate in a home-based program (2/30), after using the PulHMan for three months, there was an improvement in those willing to exercise and participate in a home-based program (22/30 and 25/30 respectively). The PulHMan was seen to improve awareness regarding the exercise-related benefits among patients with PH. More studies are needed to determine if this change in awareness translates into a behavioural change for those with PH. Copyright © 2015 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

Benefits of advanced propulsion technology for the advanced supersonic transport

NASA Technical Reports Server (NTRS)

Hines, R. W.; Sabatella, J. A.

1973-01-01

Future supersonic transports will have to provide improvement in the areas of economics, range, and emissions relative to the present generation of supersonic transports, as well as meeting or improving upon FAR 36 noise goals. This paper covers the promising propulsion systems including variable-cycle engine concepts for long-range supersonic commercial transport application. The benefits of applying advanced propulsion technology to solve the economic and environmental problems are reviewed. The advanced propulsion technologies covered are in the areas of structures, materials, cooling techniques, aerodynamics, variable engine geometry, jet noise suppressors, acoustic treatment, and low-emission burners. The results of applying the advanced propulsion technology are presented in terms of improvement in overall system takeoff gross weight and return on investment.

Swimming and Children with Attention-Deficit Hyperactive Disorder: A Winning Combination

ERIC Educational Resources Information Center

Dail, Teresa; Smith, Caroline

2016-01-01

The benefits of swimming for children with disabilities include improved motor skills, physical fitness, executive brain function and improved social skills. Swimming can also be an activity that provides a positive environment for children suffering from attention-deficit hyperactive disorder (ADHD). This article provides an overview of ADHD and…

Sustaining and improving an international service-learning partnership: Evaluation of an evidence-based service delivery model.

PubMed

Hayward, Lorna M; Li, Li

2017-06-01

International service learning (ISL) is an instructional method used by physical therapist educators in the United States (US) to prepare students for rendering culturally competent care. ISL is a faculty led student learning opportunity that includes academic instruction and community service in an international context. Research exists that explores student experiences with ISL, but studies that evaluate ISL partnerships and include global stakeholder feedback are lacking. The purposes of this study were to: 1) integrate a partnership evaluation component into an existing curriculum-based ISL model and 2) through evaluation identify benefits, drawbacks, and suggestions for improving and sustaining the academic-community partnership. Community-based participatory research design using a mixed methods approach was used to evaluate a ISL partnership between a US-based physical therapy program and a service site in Ecuador. Participants were 31 staff working at the global service site. Over three years, 11 interviews were conducted and 26 surveys were administered to global partner staff. Data were analyzed using qualitative thematic content analysis and descriptive statistics. Partnership benefits included the following: continuity of ISL team leadership, targeted rehabilitative efforts, sensitivity to cultural norms, respectful communication, and interaction with local community. Drawbacks were as follows: deficits in cultural awareness, language barriers, and poor treatment carryover. Suggestions for sustaining the relationship incorporated: additional pre-trip communication, education of staff, and improved language skills. As more US teams deliver clinical services abroad, intentional evaluation approaches must include the global stakeholder in the planning, implementation, and evaluation phases to maximize partnerships benefits.

Dance movement therapy and falls prevention.

PubMed

Veronese, Nicola; Maggi, Stefania; Schofield, Patricia; Stubbs, Brendon

2017-08-01

Falls are a leading cause of morbidity, healthcare use and mortality. Dance is a popular form of physical activity among older people and previous research has suggested that it may improve various health outcomes in this population, including balance, gait and muscle performance. A systematic review of the potential benefits of dance on falls and fear of falling is lacking. Thus, we conducted a systematic review considering all randomized controls trials (RCTs) investigating if dance can reduce falls and improve fear of falling in older adults. Major databases were searched from inception until 1 March 2017 and a total of 10 RCTs were identified, which included a total of 680 people (n=356 dance, n=324 control). Overall, the mean age of the samples was 69.4 years, and 75.2% were female. Across four RCTs, dance therapy reduced falls versus usual care in only one study. Dance therapy improved fear of falling in two out of three included RCTs. There were no serious adverse events reported in the RCTs. In summary, we found a paucity of studies investigating the effect of dance on falls and fear of falling and the evidence base is preliminary and equivocal. Given the heterogeneity of the included samples and interventions, in addition to the short-term follow-up, no firm conclusions can be drawn. However, dance appears to be safe and, given its popularity and demonstrated benefits on other health/wellbeing outcomes in older adults, it is important that future research considers its potential benefits on falls/fear of falling in older age. Copyright © 2017 Elsevier B.V. All rights reserved.

International Space Station Research Benefits for Humanity

NASA Technical Reports Server (NTRS)

Thumm, Tracy; Robinson, Julie A.; Johnson-Green, Perry; Buckley, Nicole; Karabadzhak, George; Nakamura, Tai; Kamigaichi, Shigeki; Sorokin, Igor V.; Zell, Martin; Fuglesang, Christer;

International Space Station Benefits for Humanity

NASA Technical Reports Server (NTRS)

Thumm, Tracy L.; Robinson, Julie A.; Buckley, Nicole; Johnson-Green, Perry; Kamigaichi, Shigeki; Karabadzhak, George; Nakamura, Tai; Sabbagh, Jean; Sorokin, Igor; Zell, Martin

2012-01-01

The ISS partnership has seen a substantial increase in research accomplished, crew efforts devoted to research, and results of ongoing research and technology development. The ISS laboratory is providing a unique environment for research and international collaboration that benefits humankind. Benefits come from the engineering development, the international partnership, and from the research results. Benefits can be of three different types: scientific discovery, applications to life on Earth, and applications to future exploration. Working across all ISS partners, we identified key themes where the activities on the ISS improve the lives of people on Earth--not only within the partner nations, but also in other nations of the world. Three major themes of benefits to life on earth emerged from our review: benefits to human health, education, and Earth observation and disaster response. Other themes are growing as use of the ISS continues. Benefits to human health range from advancements in surgical technology, improved telemedicine, and new treatments for disease. Earth observations from the ISS provide a wide range of observations that include: marine vessel tracking, disaster monitoring and climate change. The ISS participates in a number of educational activities aimed to inspire students of all ages to learn about science, technology, engineering and mathematics. To date over 63 countries have directly participated in some aspect of ISS research or education. In summarizing these benefits and accomplishments, ISS partners are also identifying ways to further extend the benefits to people in developing countries for the benefits of humankind.

What are the health benefits of physical activity in type 1 diabetes mellitus? A literature review.

PubMed

Chimen, M; Kennedy, A; Nirantharakumar, K; Pang, T T; Andrews, R; Narendran, P

2012-03-01

Physical activity improves well-being and reduces the risk of heart disease, cancer and type 2 diabetes mellitus in the general population. In individuals with established type 2 diabetes, physical activity improves glucose and lipid levels, reduces weight and improves insulin resistance. In type 1 diabetes mellitus, however, the benefits of physical activity are less clear. There is poor evidence for a beneficial effect of physical activity on glycaemic control and microvascular complications, and significant risk of harm through hypoglycaemia. Here we review the literature relating to physical activity and health in type 1 diabetes. We examine its effect on a number of outcomes, including glycaemic control, lipids, blood pressure, diabetic complications, well-being and overall mortality. We conclude that whilst there is sufficient evidence to recommend physical activity in the management of type 1 diabetes, it is still unclear as to what form, duration and intensity should be recommended and whether there is benefit for many of the outcomes examined.

Terminal Area Productivity Airport Wind Analysis and Chicago O'Hare Model Description

NASA Technical Reports Server (NTRS)

Hemm, Robert; Shapiro, Gerald

1998-01-01

This paper describes two results from a continuing effort to provide accurate cost-benefit analyses of the NASA Terminal Area Productivity (TAP) program technologies. Previous tasks have developed airport capacity and delay models and completed preliminary cost benefit estimates for TAP technologies at 10 U.S. airports. This task covers two improvements to the capacity and delay models. The first improvement is the completion of a detailed model set for the Chicago O'Hare (ORD) airport. Previous analyses used a more general model to estimate the benefits for ORD. This paper contains a description of the model details with results corresponding to current conditions. The second improvement is the development of specific wind speed and direction criteria for use in the delay models to predict when the Aircraft Vortex Spacing System (AVOSS) will allow use of reduced landing separations. This paper includes a description of the criteria and an estimate of AVOSS utility for 10 airports based on analysis of 35 years of weather data.

MEDNET: Telemedicine via Satellite Combining Improved Access to Health-Care Services with Enhanced Social Cohesion in Rural Peru

NASA Astrophysics Data System (ADS)

Panopoulos, Dimitrios; Sachpazidis, Ilias; Rizou, Despoina; Menary, Wayne; Cardenas, Jose; Psarras, John

Peru, officially classified as a middle-income country, has benefited from sustained economic growth in recent years. However, the benefits have not been seen by the vast majority of the population, particularly Peru's rural population. Virtually all of the nation's rural health-care centres are cut off from the rest of the country, so access to care for most people is not only difficult but also costly. MEDNET attempts to redress this issue by developing a medical health network with the help of the collaboration medical application based on TeleConsult & @HOME medical database for vital signs. The expected benefits include improved support for medics in the field, reduction of patient referrals, reduction in number of emergency interventions and improved times for medical diagnosis. An important caveat is the emphasis on exploiting the proposed infrastructure for education and social enterprise initiatives. The project has the full support of regional political and health authorities and, importantly, full local community support.

Medicaid and Children's Health Insurance Programs: essential health benefits in alternative benefit plans, eligibility notices, fair hearing and appeal processes, and premiums and cost sharing; exchanges: eligibility and enrollment. Final rule.

PubMed

2013-07-15

This final rule implements provisions of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act. This final rule finalizes new Medicaid eligibility provisions; finalizes changes related to electronic Medicaid and the Children's Health Insurance Program (CHIP) eligibility notices and delegation of appeals; modernizes and streamlines existing Medicaid eligibility rules; revises CHIP rules relating to the substitution of coverage to improve the coordination of CHIP coverage with other coverage; and amends requirements for benchmark and benchmark-equivalent benefit packages consistent with sections 1937 of the Social Security Act (which we refer to as ``alternative benefit plans'') to ensure that these benefit packages include essential health benefits and meet certain other minimum standards. This rule also implements specific provisions including those related to authorized representatives, notices, and verification of eligibility for qualifying coverage in an eligible employer-sponsored plan for Affordable Insurance Exchanges. This rule also updates and simplifies the complex Medicaid premium and cost sharing requirements, to promote the most effective use of services, and to assist states in identifying cost sharing flexibilities. It includes transition policies for 2014 as applicable.

Exploring the energy benefits of advanced water metering

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

Berger, Michael A.; Hans, Liesel; Piscopo, Kate

Recent improvements to advanced water metering and communications technologies have the potential to improve the management of water resources and utility infrastructure, benefiting both utilities and ratepayers. The highly granular, near-real-time data and opportunity for automated control provided by these advanced systems may yield operational benefits similar to those afforded by similar technologies in the energy sector. While significant progress has been made in quantifying the water-related benefits of these technologies, the research on quantifying the energy benefits of improved water metering is underdeveloped. Some studies have quantified the embedded energy in water in California, however these findings are basedmore » on data more than a decade old, and unanimously assert that more research is needed to further explore how topography, climate, water source, and other factors impact their findings. In this report, we show how water-related advanced metering systems may present a broader and more significant set of energy-related benefits. We review the open literature of water-related advanced metering technologies and their applications, discuss common themes with a series of water and energy experts, and perform a preliminary scoping analysis of advanced water metering deployment and use in California. We find that the open literature provides very little discussion of the energy savings potential of advanced water metering, despite the substantial energy necessary for water’s extraction, conveyance, treatment, distribution, and eventual end use. We also find that water AMI has the potential to provide water-energy co-efficiencies through improved water systems management, with benefits including improved customer education, automated leak detection, water measurement and verification, optimized system operation, and inherent water and energy conservation. Our findings also suggest that the adoption of these technologies in the water sector has been slow, due to structural economic and regulatory barriers. In California, we see examples of deployed advanced metering systems with demonstrated embedded energy savings through water conservation and leak detection. Finally, we also see substantial untapped opportunity in the agricultural sector for enabling electric demand response for both traditional peak shaving and more complex flexible and ancillary services through improved water tracking and farm automation.« less

Local action on outdoor air pollution to improve public health.

PubMed

Vardoulakis, Sotiris; Kettle, Rachel; Cosford, Paul; Lincoln, Paul; Holgate, Stephen; Grigg, Jonathan; Kelly, Frank; Pencheon, David

2018-06-01

The National Institute for Health and Care Excellence, jointly with Public Health England, have developed a guideline on outdoor air pollution and its links to health. The guideline makes recommendations on local interventions that can help improve air quality and prevent a range of adverse health outcomes associated with road-traffic-related air pollution. The guideline was based on a rigorous assessment of the scientific evidence by an independent advisory committee, with input from public health professionals and other professional groups. The process included systematics reviews of the literature, expert testimonies and stakeholder consultation. The guideline includes recommendations for local planning, clean air zones, measures to reduce emissions from public sector transport services, smooth driving and speed reduction, active travel, and awareness raising. The guideline recommends taking a number of actions in combination, because multiple interventions, each producing a small benefit, are likely to act cumulatively to produce significant change. These actions are likely to bring multiple public health benefits, in addition to air quality improvements.

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

NASA Technical Reports Server (NTRS)

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

1992-01-01

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

Rehabilitation that incorporates virtual reality is more effective than standard rehabilitation for improving walking speed, balance and mobility after stroke: a systematic review.

PubMed

Corbetta, Davide; Imeri, Federico; Gatti, Roberto

2015-07-01

In people after stroke, does virtual reality based rehabilitation (VRBR) improve walking speed, balance and mobility more than the same duration of standard rehabilitation? In people after stroke, does adding extra VRBR to standard rehabilitation improve the effects on gait, balance and mobility? Systematic review with meta-analysis of randomised trials. Adults with a clinical diagnosis of stroke. Eligible trials had to include one these comparisons: VRBR replacing some or all of standard rehabilitation or VRBR used as extra rehabilitation time added to a standard rehabilitation regimen. Walking speed, balance, mobility and adverse events. In total, 15 trials involving 341 participants were included. When VRBR replaced some or all of the standard rehabilitation, there were statistically significant benefits in walking speed (MD 0.15 m/s, 95% CI 0.10 to 0.19), balance (MD 2.1 points on the Berg Balance Scale, 95% CI 1.8 to 2.5) and mobility (MD 2.3 seconds on the Timed Up and Go test, 95% CI 1.2 to 3.4). When VRBR was added to standard rehabilitation, mobility showed a significant benefit (0.7 seconds on the Timed Up and Go test, 95% CI 0.4 to 1.1), but insufficient evidence was found to comment about walking speed (one trial) and balance (high heterogeneity). Substituting some or all of a standard rehabilitation regimen with VRBR elicits greater benefits in walking speed, balance and mobility in people with stroke. Although the benefits are small, the extra cost of applying virtual reality to standard rehabilitation is also small, especially when spread over many patients in a clinic. Adding extra VRBR time to standard rehabilitation also has some benefits; further research is needed to determine if these benefits are clinically worthwhile. Copyright © 2015 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

Serious and actionable risks, plus disclosure: Investigating an alternative approach for presenting risk information in prescription drug television advertisements.

PubMed

Betts, Kevin R; Boudewyns, Vanessa; Aikin, Kathryn J; Squire, Claudia; Dolina, Suzanne; Hayes, Jennifer J; Southwell, Brian G

2017-08-02

Broadcast direct-to-consumer (DTC) prescription drug ads that present product claims are required to also present the product's major risks. Debate exists regarding how much information should be included in these major risk statements. Some argue that such statements expose people to unnecessary amounts of information, while others argue that they leave out important information. Examine the impact of type of risk statement (unedited versus serious and actionable risks only) and a disclosure indicating that not all risks are presented on consumers' ability to remember the important risks and benefits of a drug following exposure to a DTC television advertisement (ad). Risk and benefit perceptions, ad-prompted actions, recognition of the disclosure statement, and evaluations of both the disclosure and risk statement were also examined. A web-based experiment was conducted in which US adults who self-reported as having depression (N = 500), insomnia (N = 500), or high cholesterol (N = 500) were randomly assigned to view one of four versions of the television ad, and then complete a questionnaire. The type of risk statement had a significant effect on risk recall and recognition, benefit recognition, perceived risk severity (depression condition only), and perceived benefit magnitude (high cholesterol condition only). Disclosure recognition (using bias-corrected scores) ranged from 63% to 70% across the three illness samples. The revised risk statement improved overall processing of the television ad, as evidenced by improved risk recall and recognition and improved benefit recognition. Further, the presence of the disclosure did not adversely affect consumers' processing of drug risk and benefit information. Therefore, limiting the risks presented in DTC television ads and including a disclosure alerting consumers that not all risks are presented may be an effective strategy for communicating product risks. Published by Elsevier Inc.

Rapid Deployment of Optimal Control for Building HVAC Systems Using Innovative Software Tools and a Hybrid Heuristic/Model Based Control Approach

DTIC Science & Technology

2017-03-21

for public release; distribution is unlimited 13. SUPPLEMENTARY NOTES None 14. ABSTRACT ESTCP project EW-201409 aimed at demonstrating the benefits ...of innovative software technology for building HV AC systems. These benefits included reduced system energy use and cost as wetl as improved...Control Approach March 2017 This document has been cleared for public release; Distribution Statement A

RMS active damping augmentation

NASA Technical Reports Server (NTRS)

Gilbert, Michael G.; Scott, Michael A.; Demeo, Martha E.

1992-01-01

The topics are presented in viewgraph form and include: RMS active damping augmentation; potential space station assembly benefits to CSI; LaRC/JSC bridge program; control law design process; draper RMS simulator; MIMO acceleration control laws improve damping; potential load reduction benefit; DRS modified to model distributed accelerations; accelerometer location; Space Shuttle aft cockpit simulator; simulated shuttle video displays; SES test goals and objectives; and SES modifications to support RMS active damping augmentation.

The Returns to the Brain Drain and Brain Circulation in Sub-Saharan Africa: Some Computations Using Data from Ghana. NBER Working Paper No. 16813

ERIC Educational Resources Information Center

Nyarko, Yaw

2011-01-01

We look at the decision of the government or "central planner" in the allocation of scarce governmental resources for tertiary education, as well as that for the individual. We provide estimates of the net present values, or cost and benefits. These include costs of tertiary education; the benefits of improved skills of those who remain…

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

NASA Astrophysics Data System (ADS)

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

1998-07-01

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

Exploring the benefits of a stroke telemedicine programme: An organisational and societal perspective.

PubMed

Bagot, Kathleen L; Bladin, Christopher F; Vu, Michelle; Kim, Joosup; Hand, Peter J; Campbell, Bruce; Walker, Alison; Donnan, Geoffrey A; Dewey, Helen M; Cadilhac, Dominique A

2016-12-01

We undertook a qualitative analysis to identify the broader benefits of a state-wide acute stroke telemedicine service beyond the patient-clinician consultation. Since 2010, the Victorian Stroke Telemedicine (VST) programme has provided a clinical service for regional hospitals in Victoria, Australia. The benefits of the Victorian Stroke Telemedicine programme were identified through document analysis of governance activities, including communications logs and reports from hospital co-ordinators of the programme. Discussions with the Victorian Stroke Telemedicine management were undertaken and field notes were also reviewed. Several benefits of telemedicine were identified within and across participating hospitals, as well as for the state government and community. For hospitals, standardisation of clinical processes was reported, including improved stroke care co-ordination. Capacity building occurred through professional development and educational workshops. Enhanced networking, and resource sharing across hospitals was achieved between hospitals and organisations. Governments leveraged the Victorian Stroke Telemedicine programme infrastructure to provide immediate access to new treatments for acute stroke care in regional areas. Standardised data collection allowed routine quality of care monitoring. Community awareness of stroke symptoms occurred with media reports on the novel technology and improved patient outcomes. The value of telemedicine services extends beyond those involved in the clinical consultation to healthcare funders and the community. © The Author(s) 2016.

A National Strategy for Civic Networking: A Vision of Change.

ERIC Educational Resources Information Center

Civille, Richard

1993-01-01

Presents a vision and a national strategy for civic networking based on the development of the National Information Infrastructure. Topics addressed include a public interest communications policy; benefits of civic networking, including improving services and reducing government costs, reducing poverty and health care costs, and improving…

24 CFR 570.500 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... portion of a public improvement. (2) Program income does not include income earned (except for interest... public services activities to be paid for with CDBG funds. (4) Program income does not include: (i) Any... a loan guaranteed under section 108 of the Act and meet one or more of the public benefit criteria...

Regret causes ego-depletion and finding benefits in the regrettable events alleviates ego-depletion.

PubMed

Gao, Hongmei; Zhang, Yan; Wang, Fang; Xu, Yan; Hong, Ying-Yi; Jiang, Jiang

2014-01-01

This study tested the hypotheses that experiencing regret would result in ego-depletion, while finding benefits (i.e., "silver linings") in the regret-eliciting events counteracted the ego-depletion effect. Using a modified gambling paradigm (Experiments 1, 2, and 4) and a retrospective method (Experiments 3 and 5), five experiments were conducted to induce regret. Results revealed that experiencing regret undermined performance on subsequent tasks, including a paper-and-pencil calculation task (Experiment 1), a Stroop task (Experiment 2), and a mental arithmetic task (Experiment 3). Furthermore, finding benefits in the regret-eliciting events improved subsequent performance (Experiments 4 and 5), and this improvement was mediated by participants' perceived vitality (Experiment 4). This study extended the depletion model of self-regulation by considering emotions with self-conscious components (in our case, regret). Moreover, it provided a comprehensive understanding of how people felt and performed after experiencing regret and after finding benefits in the events that caused the regret.

78 FR 42159 - Medicaid and Children's Health Insurance Programs: Essential Health Benefits in Alternative...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-15

...This final rule implements provisions of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act. This final rule finalizes new Medicaid eligibility provisions; finalizes changes related to electronic Medicaid and the Children's Health Insurance Program (CHIP) eligibility notices and delegation of appeals; modernizes and streamlines existing Medicaid eligibility rules; revises CHIP rules relating to the substitution of coverage to improve the coordination of CHIP coverage with other coverage; and amends requirements for benchmark and benchmark- equivalent benefit packages consistent with sections 1937 of the Social Security Act (which we refer to as ``alternative benefit plans'') to ensure that these benefit packages include essential health benefits and meet certain other minimum standards. This rule also implements specific provisions including those related to authorized representatives, notices, and verification of eligibility for qualifying coverage in an eligible employer-sponsored plan for Affordable Insurance Exchanges. This rule also updates and simplifies the complex Medicaid premium and cost sharing requirements, to promote the most effective use of services, and to assist states in identifying cost sharing flexibilities. It includes transition policies for 2014 as applicable.

International Reference Ionosphere -2010

NASA Astrophysics Data System (ADS)

Bilitza, Dieter; Reinisch, Bodo

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

Atomic bomb health benefits.

PubMed

Luckey, T D

2008-01-01

Media reports of deaths and devastation produced by atomic bombs convinced people around the world that all ionizing radiation is harmful. This concentrated attention on fear of miniscule doses of radiation. Soon the linear no threshold (LNT) paradigm was converted into laws. Scientifically valid information about the health benefits from low dose irradiation was ignored. Here are studies which show increased health in Japanese survivors of atomic bombs. Parameters include decreased mutation, leukemia and solid tissue cancer mortality rates, and increased average lifespan. Each study exhibits a threshold that repudiates the LNT dogma. The average threshold for acute exposures to atomic bombs is about 100 cSv. Conclusions from these studies of atomic bomb survivors are: One burst of low dose irradiation elicits a lifetime of improved health.Improved health from low dose irradiation negates the LNT paradigm.Effective triage should include radiation hormesis for survivor treatment.

Exercise prescription for the elderly: current recommendations.

PubMed

Mazzeo, R S; Tanaka, H

2001-01-01

The benefits for elderly individuals of regular participation in both cardiovascular and resistance-training programmes are great. Health benefits include a significant reduction in risk of coronary heart disease, diabetes mellitus and insulin resistance, hypertension and obesity as well as improvements in bone density, muscle mass, arterial compliance and energy metabolism. Additionally, increases in cardiovascular fitness (maximal oxygen consumption and endurance), muscle strength and overall functional capacity are forthcoming allowing elderly individuals to maintain their independence, increase levels of spontaneous physical activity and freely participate in activities associated with daily living. Taken together, these benefits associated with involvement in regular exercise can significantly improve the quality of life in elderly populations. It is noteworthy that the quality and quantity of exercise necessary to elicit important health benefits will differ from that needed to produce significant gains in fitness. This review describes the current recommendations for exercise prescriptions for the elderly for both cardiovascular and strength/resistance-training programmes. However, it must be noted that the benefits described are of little value if elderly individuals do not become involved in regular exercise regimens. Consequently, the major challenges facing healthcare professionals today concern: (i) the implementation of educational programmes designed to inform elderly individuals of the health and functional benefits associated with regular physical activity as well as how safe and effective such programmes can be; and (ii) design interventions that will both increase involvement in regular exercise as well as improve adherence and compliance to such programmes.

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

PubMed

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

2018-04-30

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

Systematic review of systematic reviews for medical cannabinoids: Pain, nausea and vomiting, spasticity, and harms.

PubMed

Allan, G Michael; Finley, Caitlin R; Ton, Joey; Perry, Danielle; Ramji, Jamil; Crawford, Karyn; Lindblad, Adrienne J; Korownyk, Christina; Kolber, Michael R

2018-02-01

To determine the effects of medical cannabinoids on pain, spasticity, and nausea and vomiting, and to identify adverse events. MEDLINE, the Cochrane Database, and the references of included studies were searched. Systematic reviews with 2 or more randomized controlled trials (RCTs) that focused on medical cannabinoids for pain, spasticity, or nausea and vomiting were included. For adverse events, any meta-analysis for the conditions listed or of adverse events of cannabinoids was included. From 1085 articles, 31 relevant systematic reviews were identified including 23 for pain, 5 for spasticity, 6 for nausea and vomiting, and 12 for adverse events. Meta-analysis of 15 RCTs found more patients taking cannabinoids attained at least a 30% pain reduction: risk ratio (RR) of 1.37 (95% CI 1.14 to 1.64), number needed to treat (NNT) of 11. Sensitivity analysis found study size and duration affected findings (subgroup differences, P ≤ .03), with larger and longer RCTs finding no benefit. Meta-analysis of 4 RCTs found a positive global impression of change in spasticity (RR = 1.45, 95% CI 1.08 to 1.95, NNT = 7). Other results were not consistently statistically significant, but when positive, a 30% or more improvement in spasticity had an NNT of 10. Meta-analysis of 7 RCTs for control of nausea and vomiting after chemotherapy found an RR of 3.60 (95% CI 2.55 to 5.09) with an NNT of 3. Adverse effects caused more patients to stop treatment (number needed to harm [NNH] of 8 to 22). Individual adverse events were very common, including dizziness (NNH = 5), sedation (NNH = 5), confusion (NNH = 15), and dissociation (NNH = 20). "Feeling high" was reported in 35% to 70% of users. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) evaluation reduced evidence ratings of benefit to low or very low. There is reasonable evidence that cannabinoids improve nausea and vomiting after chemotherapy. They might improve spasticity (primarily in multiple sclerosis). There is some uncertainty about whether cannabinoids improve pain, but if they do, it is neuropathic pain and the benefit is likely small. Adverse effects are very common, meaning benefits would need to be considerable to warrant trials of therapy. Copyright© the College of Family Physicians of Canada.

Insights from the design and implementation of a single-entry model of referral for total joint replacement surgery: Critical success factors and unanticipated consequences.

PubMed

Damani, Zaheed; MacKean, Gail; Bohm, Eric; Noseworthy, Tom; Wang, Jenney Meng Han; DeMone, Brie; Wright, Brock; Marshall, Deborah A

2018-02-01

Single-entry models (SEMs) in healthcare allow patients to see the next-available provider and have been shown to improve waiting times, access and patient flow for preference-sensitive, scheduled services. The Winnipeg Central Intake Service (WCIS) for hip and knee replacement surgery was implemented to improve access in the Winnipeg Regional Health Authority. This paper describes the system's design/implementation; successes, challenges, and unanticipated consequences. On two occasions, during and following implementation, we interviewed all members of the WCIS project team, including processing engineers, waiting list coordinators, administrators and policy-makers regarding their experiences. We used semi-structured telephone interviews to collect data and qualitative thematic analysis to analyze and interpret the findings. Respondents indicated that the overarching objectives of the WCIS were being met. Benefits included streamlined processes, greater patient access, improved measurement and monitoring of outcomes. Challenges included low awareness, change readiness, and initial participation among stakeholders. Unanticipated consequences included workload increases, confusion around stakeholder expectations and under-reporting of data by surgeons' offices. Critical success factors for implementation included a requirement for clear communication, robust data collection, physician leadership and patience by all, especially implementation teams. Although successfully implemented, key lessons and critical success factors were learned related to change management, which if considered and applied, can reduce unanticipated consequences, improve uptake and benefit new models of care. Copyright © 2017 Elsevier B.V. All rights reserved.

Participants' Voices From Within a Healthy Lifestyle Group.

PubMed

Park, Tanya; Foster, Kim; Usher, Kim

2017-02-01

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

The Importance of Muscular Strength: Training Considerations.

PubMed

Suchomel, Timothy J; Nimphius, Sophia; Bellon, Christopher R; Stone, Michael H

2018-04-01

This review covers underlying physiological characteristics and training considerations that may affect muscular strength including improving maximal force expression and time-limited force expression. Strength is underpinned by a combination of morphological and neural factors including muscle cross-sectional area and architecture, musculotendinous stiffness, motor unit recruitment, rate coding, motor unit synchronization, and neuromuscular inhibition. Although single- and multi-targeted block periodization models may produce the greatest strength-power benefits, concepts within each model must be considered within the limitations of the sport, athletes, and schedules. Bilateral training, eccentric training and accentuated eccentric loading, and variable resistance training may produce the greatest comprehensive strength adaptations. Bodyweight exercise, isolation exercises, plyometric exercise, unilateral exercise, and kettlebell training may be limited in their potential to improve maximal strength but are still relevant to strength development by challenging time-limited force expression and differentially challenging motor demands. Training to failure may not be necessary to improve maximum muscular strength and is likely not necessary for maximum gains in strength. Indeed, programming that combines heavy and light loads may improve strength and underpin other strength-power characteristics. Multiple sets appear to produce superior training benefits compared to single sets; however, an athlete's training status and the dose-response relationship must be considered. While 2- to 5-min interset rest intervals may produce the greatest strength-power benefits, rest interval length may vary based an athlete's training age, fiber type, and genetics. Weaker athletes should focus on developing strength before emphasizing power-type training. Stronger athletes may begin to emphasize power-type training while maintaining/improving their strength. Future research should investigate how best to implement accentuated eccentric loading and variable resistance training and examine how initial strength affects an athlete's ability to improve their performance following various training methods.

Performance Based Logistics: A Readiness Strategy Tailor Made for Austere Times

DTIC Science & Technology

2015-06-01

reducing cost and improving support performance to conclude that if it is effectively implemented and managed, PBL yields significant benefits. Key...These include outcomes that facilitate both product and process improvements to drive out cost and drive up readiness as well as outcomes that... improvements , and proactive obsolescence and the mitigation of Diminishing Manufacturing Sources and Material Shortages (DMSMS). In short, we are looking for

The Unforgettables: a chorus for people with dementia with their family members and friends.

PubMed

Mittelman, Mary Sherman; Papayannopoulou, Panayiota Maria

2018-01-29

Summary/Abstract Our experience evaluating a museum program for people with dementia together with their family members demonstrated benefits for all participants. We hypothesized that participation in a chorus would also have positive effects, giving them an opportunity to share a stimulating and social activity that could improve their quality of life. We inaugurated a chorus for people with dementia and their family caregivers in 2011, which rehearses and performs regularly. Each person with dementia must be accompanied by a friend or family member and must commit to attending all rehearsals and the concert that ensues. A pilot study included a structured assessment, take home questionnaires and focus groups. Analyses of pre-post scores were conducted; effect size was quantified using Cohen's d. Results showed that quality of life and communication with the other member of the dyad improved (Effect size: Cohen's d between 0.32 and 0.72) for people with dementia; quality of life, social support, communication and self-esteem improved (d between 0.29 and 0.68) for caregivers. Most participants stated that benefits included belonging to a group, having a normal activity together and learning new skills. Participants attended rehearsals in spite of harsh weather conditions. The chorus has been rehearsing and performing together for more than 6 years and contributing to its costs. Results of this pilot study suggest that people in the early to middle stage of dementia and their family members and friends can enjoy and learn from rehearsing and performing in concerts that also engage the wider community. It is essential to conduct additional larger studies of the benefits of participating in a chorus, which may include improved quality of life and social support for all, and reduced cognitive decline among people with dementia.

Efficacy of rivastigmine for cognitive symptoms in Parkinson disease with dementia.

PubMed

Almaraz, Amy C; Driver-Dunckley, Erika D; Woodruff, Bryan K; Wellik, Kay E; Caselli, Richard J; Demaerschalk, Bart M; Adler, Charles H; Caviness, John N; Wingerchuk, Dean M

2009-07-01

Impairment of multiple neurotransmitter networks, including acetylcholine, may contribute to the cognitive impairment in patients with Parkinson disease with dementia (PDD). Therefore, cholinesterase inhibitors might improve cognitive function in PDD. On the other hand, enhancing cholinergic function could plausibly worsen features of parkinsonism. To determine if oral cholinesterase inhibitors improve measures of cognitive outcome and are tolerated by people with PDD. We addressed the question through the development of a critically appraised topic. Participants included consultant and resident neurologists, clinical epidemiologists, a medical librarian, and behavioral neurology and movement disorder specialists. Participants began with a structured clinical question, devised search strategies, compiled the best evidence, performed a critical appraisal, summarized the evidence, provided commentary, and declared bottom-line conclusions. A randomized controlled trial (n = 541) showed that, compared with placebo, rivastigmine (mean, 8.6 mg/d) significantly improved scores on 2 coprimary cognitive outcome scales in PDD, including the Alzheimer disease Cooperative Study-Clinician's Global Impression of Change. When dichotomized to evaluate clinically significant benefit (moderate or marked improvement), this outcome was not significant (risk difference = 5.3%; 95% confidence interval (CI) = -1.6 to 12.1). The number needed to treat (NNT) to avoid clinically significant worsening of cognition was 10 (95% CI = 6-28). The NNT for the combined outcome of either achieving clinically significant benefit or avoiding significant worsening was 7. The numbers needed to harm for cholinergic side effects were 9 (95% CI = 5-24) for parkinsonian symptoms and 11 (95% CI = 6-32) for rivastigmine discontinuation due to any side effect. Rivastigmine therapy for PDD is associated with significant tradeoffs in efficacy and adverse effects. Carefully monitored trials of rivastigmine may provide meaningful benefits for a minority of PDD patients.

Positive effects of afforestation efforts on the health of urban soils

Treesearch

Emily E. Oldfield; Alexander J. Felson; Stephen A. Wood; Richard A. Hallett; Michael S. Strickland; Mark A. Bradford

2014-01-01

Large-scale tree planting projects in cities are increasingly implemented as a strategy to improve the urban environment. Trees provide multiple benefits in cities, including reduction of urban temperatures, improved air quality, mitigation of storm-water run-off, and provision of wildlife habitat. How urban afforestation affects the properties and functions of urban...

A Great Place to Work: Improving Conditions for Staff in Young Children's Programs.

ERIC Educational Resources Information Center

Jorde-Bloom, Paula

This book discusses important issues of the day care profession. Topics include evaluation of the work place and the improvement of the day care environment for the benefit of staff, parents, and children. Organizational climate is considered in terms of the different types of early childhood programs and their relationship to current knowledge…

Social science to improve fuels management: a synthesis of research on collaboration.

Treesearch

Victoria Sturtevant; Margaret Ann Moote; Pamela Jakes; Anthony S. Cheng

2005-01-01

A series of syntheses were commissioned by the USDA Forest Service to aid in fuels mitigation project planning. This synthesis focuses on collaboration research, and offers knowledge and tools to improve collaboration in the planning and implementation of wildland fire and fuels management projects. It covers a variety of topics including benefits of collaboration,...

Informing Writing: The Benefits of Formative Assessment. A Report from Carnegie Corporation of New York

ERIC Educational Resources Information Center

Graham, Steve; Harris, Karen; Hebert, Michael

2011-01-01

During this decade there have been numerous efforts to identify instructional practices that improve students' writing. These include "Reading Next" (Biancarosa and Snow, 2004), which provided a set of instructional recommendations for improving writing, and "Writing Next" (Graham and Perin, 2007) and "Writing to Read" (Graham and Hebert, 2010),…

Financial risk management of pharmacy benefits.

PubMed

Saikami, D

1997-10-01

Financial risk management of pharmacy benefits in integrated health systems is explained. A managed care organization should assume financial risk for pharmacy benefits only if it can manage the risk. Horizontally integrated organizations often do not have much control over the management of drug utilization and costs. Vertically integrated organizations have the greatest ability to manage pharmacy financial risk; virtual integration may also be compatible. Contracts can be established in which the provider is incentivized or placed at partial or full risk. The main concerns that health plans have with respect to pharmacy capitation are formulary management and the question of who should receive rebates from manufacturers. The components needed to managed pharmacy financial risk depend on the type of contract negotiated. Health-system pharmacists are uniquely positioned to take advantage of opportunities opening up through pharmacy risk contracting. Functions most organizations must provide when assuming pharmacy financial risk can be divided into internal and external categories. Internally performed functions include formulary management, clinical pharmacy services and utilization management, and utilization reports for physicians. Functions that can be outsourced include claims processing and administration, provider- and customer support services, and rebates. Organizations that integrate the pharmacy benefit across the health care continuum will be more effective in controlling costs and improving outcomes than organizations that handle this benefit as separate from others. Patient care should not focus on payment mechanisms and unit costs but on developing superior processes and systems that improve health care.

Guidelines for software inspections

NASA Technical Reports Server (NTRS)

1983-01-01

Quality control inspections are software problem finding procedures which provide defect removal as well as improvements in software functionality, maintenance, quality, and development and testing methodology is discussed. The many side benefits include education, documentation, training, and scheduling.

Benefits of nurse prescribing for patients in pain: nurses' views.

PubMed

Stenner, Karen; Courtenay, Molly

2008-07-01

This paper is a report of a study to explore nurses' views on the benefits of adopting the role of prescribing for patients with acute and chronic pain. It was envisioned that the advent of nurse prescribing would be beneficial to the efficiency and effectiveness of the United Kingdom National Health Service. Research to date does indeed indicate that nurse prescribing can be beneficial to patients, nurses and the health service in general. Despite the expansion of nurse prescribing, there is little evidence of its impact according to nurses working in specialist areas, such as with patients in acute and chronic pain. Interviews were conducted during 2006 and 2007 with 26 nurses qualified to prescribe medicines for patients in acute and chronic pain. This was a qualitative study and a thematic analysis was conducted. Nurses reported a number of benefits, including faster access to treatment, improved quality of care, more appropriate prescribing of medication, improved safety, improved relations and communication with patients, greater efficiency and cost effectiveness. Nurses benefited from increased job satisfaction, credibility with patients and healthcare professionals and also gained knowledge through prescribing. There is potential for the benefits of nurse prescribing to be expanded beyond the United Kingdom in settings where nurses hold similar roles in the treatment of pain, although further research using a wider range of research methods is recommended to substantiate these findings.

Benefits and risks of antimicrobial use in food-producing animals

PubMed Central

Hao, Haihong; Cheng, Guyue; Iqbal, Zahid; Ai, Xiaohui; Hussain, Hafiz I.; Huang, Lingli; Dai, Menghong; Wang, Yulian; Liu, Zhenli; Yuan, Zonghui

2014-01-01

Benefits and risks of antimicrobial drugs, used in food-producing animals, continue to be complex and controversial issues. This review comprehensively presents the benefits of antimicrobials drugs regarding control of animal diseases, protection of public health, enhancement of animal production, improvement of environment, and effects of the drugs on biogas production and public health associated with antimicrobial resistance. The positive and negative impacts, due to ban issue of antimicrobial agents used in food-producing animals, are also included in the discussion. As a double-edged sword, use of these drugs in food-animals persists as a great challenge. PMID:24971079

Policy analysis for prenatal genetic diagnosis.

PubMed

Thompson, M; Milunsky, A

1979-01-01

Consideration of the analytic difficulties faced in estimating the benefits and costs of prenatal genetic diagnosis, coupled with a brief review of existing benefit-cost studies, leads to the conclusion that public subsidy of prenatal testing can yield benefits substantially in excess of costs. The practical obstacles to such programs include the attitudes of prospective parents, a lack of knowledge, monetary barriers, inadequately organized medical resources, and the political issue of abortion. Policy analysis can now nevertheless formulate principles and guide immediate actions to improve present utilization of prenatal testing and to facilitate possible future expansion of these diagnostic techniques.

Exploring the perceived health benefits of singing in a choir: an international cross-sectional mixed-methods study.

PubMed

Moss, Hilary; Lynch, Julie; O'Donoghue, Jessica

2018-05-01

This mixed-methods exploratory study investigates the perceived health benefits of singing in a choir from an international sample of choristers. An online questionnaire including demographic information, 28 quantitative statements and two qualitative questions relating to the perceived health benefits of singing in a choir was distributed via email and social media over a period of 4 months to a sample of 1,779 choristers. Basic descriptives and comparisons between subgroups of the sample are presented along with thematic analysis of qualitative comments. Basic descriptives suggest an overwhelmingly positive response. Females scored significantly higher than males on physical benefits, social benefits and emotional benefits. Professional singers reported significantly more physical, social and spiritual benefits than amateur singers. Bias may be present in these findings as the results were entirely self-reported by people who already sing in choirs. Qualitative thematic analysis identified six key themes which may counter this bias by providing deeper understanding of the perceived benefits for choir singers. These include social connection, physical and physiological benefits (specifically respiratory health), cognitive stimulation, mental health, enjoyment and transcendence. Choral singing elicits a positive response in the chorister across a plethora of domains. This research confirms previous findings on the health benefits of singing but offers evidence from the largest sample of singers to date. However, results are based on self-perceptions of choristers, and findings are, therefore, limited. Results may be used as a base on which to develop further research in this area. It also provides confirmatory evidence to support choral singing as a means of improving wellbeing in many populations, including but not limited to workplaces, schools, nursing homes, communities and churches.

Payer view of personalized medicine.

PubMed

Pezalla, Edmund J

2016-12-01

The process and methods used by payers when evaluating coverage of personalized medicine testing are described. Personalized medicine encompasses a number of diagnostic tools that measure drug metabolism, genetic risk for disease development, and tumor type or markers that can guide oncology treatments. However, whole genome testing, tumor marker testing, and testing for drug metabolism are additional costs to the healthcare system. In order to justify these costs, payers and health technology assessment bodies must evaluate the individual tests or groups of tests on their own merits. In order for a test to be covered by payers, test developers must demonstrate clinical utility as measured by improved outcomes or well-informed decision-making. In the United States, payers generally focus on clinical benefit to individual patients and benefits to the healthcare system. Clinical benefits include improved outcomes. Benefits to the healthcare system are generally considered to be cost offsets, which may be due to reductions in the use of unnecessary interventions or to more efficient use of resources. Provider organizations have been assuming more responsibility and liability for healthcare costs through various risk arrangements, including accountable care organizations and patient-centered medical homes. Diagnostic tests that increase efficiency, reduce unnecessary interventions, and improve outcomes will be chosen by specialists in provider organizations. For personalized medicine approaches to be adopted and covered by health plans, the methods must be shown to be analytically and clinically valid and provide clinical utility at a reasonable level of cost-effectiveness to payers. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

A cost-efficiency and health benefit approach to improve urban air quality.

PubMed

Miranda, A I; Ferreira, J; Silveira, C; Relvas, H; Duque, L; Roebeling, P; Lopes, M; Costa, S; Monteiro, A; Gama, C; Sá, E; Borrego, C; Teixeira, J P

2016-11-01

When ambient air quality standards established in the EU Directive 2008/50/EC are exceeded, Member States are obliged to develop and implement Air Quality Plans (AQP) to improve air quality and health. Notwithstanding the achievements in emission reductions and air quality improvement, additional efforts need to be undertaken to improve air quality in a sustainable way - i.e. through a cost-efficiency approach. This work was developed in the scope of the recently concluded MAPLIA project "Moving from Air Pollution to Local Integrated Assessment", and focuses on the definition and assessment of emission abatement measures and their associated costs, air quality and health impacts and benefits by means of air quality modelling tools, health impact functions and cost-efficiency analysis. The MAPLIA system was applied to the Grande Porto urban area (Portugal), addressing PM10 and NOx as the most important pollutants in the region. Four different measures to reduce PM10 and NOx emissions were defined and characterized in terms of emissions and implementation costs, and combined into 15 emission scenarios, simulated by the TAPM air quality modelling tool. Air pollutant concentration fields were then used to estimate health benefits in terms of avoided costs (external costs), using dose-response health impact functions. Results revealed that, among the 15 scenarios analysed, the scenario including all 4 measures lead to a total net benefit of 0.3M€·y(-1). The largest net benefit is obtained for the scenario considering the conversion of 50% of open fire places into heat recovery wood stoves. Although the implementation costs of this measure are high, the benefits outweigh the costs. Research outcomes confirm that the MAPLIA system is useful for policy decision support on air quality improvement strategies, and could be applied to other urban areas where AQP need to be implemented and monitored. Copyright © 2016. Published by Elsevier B.V.

Process evaluation of knowledge transfer across industries: Leveraging Coca-Cola's supply chain expertise for medicine availability in Tanzania.

PubMed

Linnander, Erika; Yuan, Christina T; Ahmed, Shirin; Cherlin, Emily; Talbert-Slagle, Kristina; Curry, Leslie A

2017-01-01

Persistent gaps in the availability of essential medicines have slowed the achievement of global health targets. Despite the supply chain knowledge and expertise that ministries of health might glean from other industries, limited empirical research has examined the process of knowledge transfer from other industries into global public health. We examined a partnership designed to improve the availability of medical supplies in Tanzania by transferring knowledge from The Coca-Cola system to Tanzania's Medical Stores Department (MSD). We conducted a process evaluation including in-depth interviews with 70 participants between July 2011 and May 2014, corresponding to each phase of the partnership, with focus on challenges and strategies to address them, as well as benefits perceived by partners. Partners faced challenges in (1) identifying relevant knowledge to transfer, (2) translating operational solutions from Coca-Cola to MSD, and (3) maintaining momentum between project phases. Strategies to respond to these challenges emerged through real-time problem solving and included (1) leveraging the receptivity of MSD leadership, (2) engaging a boundary spanner to identify knowledge to transfer, (3) promoting local recognition of commonalities across industries, (4) engaging external technical experts to manage translation activities, (5) developing tools with visible benefits for MSD, (6) investing in local relationships, and (7) providing time and space for the partnership model to evolve. Benefits of the partnership perceived by MSD staff included enhanced collaboration and communication, more proactive orientations in managing operations, and greater attention to performance management. Benefits perceived by Coca-Cola staff included strengthened knowledge transfer capability and enhanced job satisfaction. Linking theoretical constructs with practical experiences from the field, we highlight the challenges, emergent strategies, and perceived benefits of a partnership across industry boundaries that may be useful to others seeking to promote the transfer of knowledge to improve global health.

Process evaluation of knowledge transfer across industries: Leveraging Coca-Cola’s supply chain expertise for medicine availability in Tanzania

PubMed Central

Yuan, Christina T.; Ahmed, Shirin; Cherlin, Emily; Talbert-Slagle, Kristina; Curry, Leslie A.

2017-01-01

Persistent gaps in the availability of essential medicines have slowed the achievement of global health targets. Despite the supply chain knowledge and expertise that ministries of health might glean from other industries, limited empirical research has examined the process of knowledge transfer from other industries into global public health. We examined a partnership designed to improve the availability of medical supplies in Tanzania by transferring knowledge from The Coca-Cola system to Tanzania’s Medical Stores Department (MSD). We conducted a process evaluation including in-depth interviews with 70 participants between July 2011 and May 2014, corresponding to each phase of the partnership, with focus on challenges and strategies to address them, as well as benefits perceived by partners. Partners faced challenges in (1) identifying relevant knowledge to transfer, (2) translating operational solutions from Coca-Cola to MSD, and (3) maintaining momentum between project phases. Strategies to respond to these challenges emerged through real-time problem solving and included (1) leveraging the receptivity of MSD leadership, (2) engaging a boundary spanner to identify knowledge to transfer, (3) promoting local recognition of commonalities across industries, (4) engaging external technical experts to manage translation activities, (5) developing tools with visible benefits for MSD, (6) investing in local relationships, and (7) providing time and space for the partnership model to evolve. Benefits of the partnership perceived by MSD staff included enhanced collaboration and communication, more proactive orientations in managing operations, and greater attention to performance management. Benefits perceived by Coca-Cola staff included strengthened knowledge transfer capability and enhanced job satisfaction. Linking theoretical constructs with practical experiences from the field, we highlight the challenges, emergent strategies, and perceived benefits of a partnership across industry boundaries that may be useful to others seeking to promote the transfer of knowledge to improve global health. PMID:29121051

Instructional Basics: Oppelt Standard Method of Therapeutic and Recreational Ice Skating.

ERIC Educational Resources Information Center

Oppelt, Kurt

Detailed in the booklet is the standard ice skating method and considered are the benefits of therapeutic ice skating for the handicapped and aged. Values for the mentally retarded and physically handicapped are seen to include physiological (such as increased flexibility and improved posture), psychological (including satifaction and enhanced…

Can Parent-Teacher Groups Work for All Students?

ERIC Educational Resources Information Center

Woyshner, Christine; Cucchiara, Maia

2017-01-01

Who benefits from parent-teacher organizations in schools? Which parents are included, and which are excluded? How can school leaders work with them? In this article, an historian and a sociologist review the complex history of parent-teacher organizing and examine current issues in parental efforts to improve schools, including concerns about…

Implementation and impact of ICD-10 (Part II).

PubMed

Rahmathulla, Gazanfar; Deen, H Gordon; Dokken, Judith A; Pirris, Stephen M; Pichelmann, Mark A; Nottmeier, Eric W; Reimer, Ronald; Wharen, Robert E

2014-01-01

The transition from the International Classification of Disease-9(th) clinical modification to the new ICD-10 was all set to occur on 1 October 2015. The American Medical Association has previously been successful in delaying the transition by over 10 years and has been able to further postpone its introduction to 2015. The new system will overcome many of the limitations present in the older version, thus paving the way to more accurate capture of clinical information. The benefits of the new ICD-10 system include improved quality of care, potential cost savings, reduction of unpaid claims, and improved tracking of healthcare data. The areas where challenges will be evident include planning and implementation, the cost to transition, a shortage of qualified coders, training and education of the healthcare workforce, and a loss of productivity when this occurs. The impacts include substantial costs to the healthcare system, but the projected long-term savings and benefits will be significant. Improved fraud detection, accurate data entry, ability to analyze cost benefits with procedures, and enhanced quality outcome measures are the most significant beneficial factors with this change. The present Current Procedural Terminology and Healthcare Common Procedure Coding System code sets will be used for reporting ambulatory procedures in the same manner as they have been. ICD-10-PCS will replace ICD-9 procedure codes for inpatient hospital services. The ICD-10-CM will replace the clinical code sets. Our article will focus on the challenges to execution of an ICD change and strategies to minimize risk while transitioning to the new system. With the implementation deadline gradually approaching, spine surgery practices that include multidisciplinary health specialists have to anticipate and prepare for the ICD change in order to mitigate risk. Education and communication is the key to this process in spine practices.

Influence of control group therapy on the benefit from dose-dense chemotherapy in early breast cancer: a systemic review and meta-analysis.

PubMed

Goldvaser, Hadar; Majeed, Habeeb; Ribnikar, Domen; Šeruga, Boštjan; Ocaña, Alberto; Cescon, David W; Amir, Eitan

2018-06-01

Results from clinical trials of adjuvant dose-dense chemotherapy in patients with breast cancer are inconsistent. A systematic search of MEDLINE identified studies comparing the efficacy of dose-dense adjuvant chemotherapy to a standard treatment. The primary analysis included studies that used identical regimens in the experimental and control groups, but varied only dose density. A secondary analysis included studies that used either different drugs or doses in the experimental and the control groups. Hazard ratios (HRs) and 95% confidence intervals were computed for disease-free survival (DFS) and overall survival (OS) and pooled in a meta-analysis. Subgroup analyses and meta-regression explored drug schedules utilized in control groups and the influence of clinicopathologic variables on benefit from dose-dense therapy. The primary analysis included 5 studies comprising 9819 patients while the secondary analysis included 6 studies comprising 9679 patients. Dose-dense treatment significantly improved DFS (HR 0.85, p < 0.001) and OS (HR 0.86, p = 0.008) in the primary analysis. Similar results were observed in the secondary analysis. Dose-dense schedule was important primarily in studies utilizing paclitaxel every 3 weeks as the control group (interaction p = 0.04 for DFS interaction p = 0.001 for OS). A significantly greater relative magnitude of benefit was observed in pre-menopausal women and those with nodal involvement, but there was no influence of hormone receptor status on results. Adjuvant dose-dense regimens improve breast cancer outcomes. It remains uncertain whether the observed benefit reflects the impact of dose density or the inferiority of paclitaxel every 3 weeks as a control group.

Can active music making promote health and well-being in older citizens? Findings of the music for life project.

PubMed

Hallam, Susan; Creech, Andrea

2016-01-01

Although there is now an accepted need for initiatives that support older people's well-being, little attention has been paid to the potential for music making to effect a significant contribution to the quality of life of older people. The research summarised here explored the role of music in older people's lives and how participation in community music making can enhance their social, emotional and cognitive well-being. The research comprised three UK case study sites, each offering a variety of musical activities. At each site, a sample of people aged 50+ (total N  = 398), some of whom had recently begun musical activities and others who were more experienced, were recruited to complete questionnaires that assessed quality of life. A control group ( N  = 102) completed the same measures. In-depth interviews were carried out with a representative sample, followed by observations of musical activities, focus groups and interviews with the facilitators of the activities. Higher scores on the quality of life measures were found consistently among the music participants, in comparison with the control group with ongoing benefits into the 4th age. Analysis of the qualitative data demonstrated: (1) cognitive benefits including challenge, the acquisition of new skills, a sense of achievement, and improvements in concentration and memory; (2) health benefits including increased vitality, improved mental health and mobility and feelings of rejuvenation; and (3) emotional benefits including protection against stress, protection against depression, support following bereavement, a sense of purpose, positive feelings, confidence and opportunities for creativity. Participants also identified a number of barriers to participation including lack of information about opportunities for making music. Ways that GP surgeries might support participation in music making are considered.

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

PubMed

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

2012-01-01

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

Economic impacts of lock usage and unavailability : August 18, 2014 - June 30, 2016 : final research report.

DOT National Transportation Integrated Search

2016-07-30

Freight statistics should provide an objective baseline for transportation policy : decisions, and national economic benefits of maritime transport necessitate : improving inland waterways infrastructure. Proposed work included consolidating : and le...

Valuing preferences over stormwater management outcomes including improved hydrologic function

NASA Astrophysics Data System (ADS)

LondoñO Cadavid, Catalina; Ando, Amy W.

2013-07-01

Stormwater runoff causes environmental problems such as flooding, soil erosion, and water pollution. Conventional stormwater management has focused primarily on flood reduction, while a new generation of decentralized stormwater solutions yields ancillary benefits such as healthier aquatic habitat, improved surface water quality, and increased water table recharge. Previous research has estimated values for flood reduction from stormwater management, but no estimates exist for the willingness to pay (WTP) for some of the other environmental benefits of alternative approaches to stormwater control. This paper uses a choice experiment survey of households in Champaign-Urbana, Illinois, to estimate the values of several attributes of stormwater management outcomes. We analyzed data from 131 surveyed households in randomly selected neighborhoods. We find that people value reduced basement flooding more than reductions in yard or street flooding, but WTP for basement flood reduction in the area only exists if individuals are currently experiencing significant flooding themselves. Citizens value both improved water quality and improved hydrologic function and aquatic habitat from runoff reduction. Thus, widespread investment in low impact development stormwater solutions could have very large total benefits, and stormwater managers should be wary of policies and infrastructure plans that reduce flooding at the expense of water quality and aquatic habitat.

The impact of self-efficacy, expectations, and readiness on hearing aid outcomes.

PubMed

Ferguson, Melanie A; Woolley, Annie; Munro, Kevin J

2016-07-01

To examine the impact of self-efficacy and expectations for hearing aids, and readiness to improve hearing, on hearing aid outcome measures in first-time adult hearing aid users Design: A prospective, single centre design. Predictor variables measured at the hearing assessment included measures of self-efficacy, expectations and readiness to improve hearing. Outcome measures obtained at six-week follow-up were the Glasgow Hearing Aid Benefit Profile and Satisfaction with Amplification in Daily Life. A sample of 30 first-time adult hearing aid users were recruited through a public-sector funded audiology clinic. When measured prior to hearing aid fitting, self-efficacy for hearing aids predicted satisfaction with hearing aids but was not related to other hearing aid outcomes. Expectations of hearing aids, in particular positive expectations, and readiness to improve hearing predicted outcomes for hearing aid satisfaction and benefit, although not hearing aid use. Hearing sensitivity was not correlated with hearing aid outcomes. These results suggest that assessment of expectations of hearing aids, and readiness to improve hearing, may be useful to help identify individuals attending audiology clinics who would most likely benefit from hearing aid provision.

The Efficacy of Equine-Assisted Activities and Therapies on Improving Physical Function.

PubMed

Rigby, B Rhett; Grandjean, Peter W

2016-01-01

To summarize the physical benefits of therapeutic horseback riding and hippotherapy and suggest directions for future research. Review of databases for peer-reviewed articles related to equine-assisted activities and therapies. Databases included MEDLINE via EBSCO, Web of Science, PubMed, Google Scholar, and Academic Search Complete. Articles were limited to those with full-text access published in English since 1987. Acute and residual improvements in physical benefits, such as gross motor function (e.g., walking, running, jumping), spasticity, muscle symmetry, posture, balance, and gait occur in adults and children with varying disabilities. The benefits appear to be greatest following multiweek interventions with one or more sessions per week. Modest acute cardiovascular responses are observed during equine-assisted activities and therapies with little or no evidence for training improvements in heart rate or blood pressure at rest or during riding. The present body of literature provides evidence that equine-assisted activities and therapies are an effective means of improving many measures of physical health. However, more controlled trials are urgently needed to strengthen the current knowledge base, establish dose-response characteristics of equine-assisted activities and therapies, and explore the physiologic basis for the promising results suggested from the literature.

Atomic Bomb Health Benefits

PubMed Central

Luckey, T. D.

2008-01-01

Media reports of deaths and devastation produced by atomic bombs convinced people around the world that all ionizing radiation is harmful. This concentrated attention on fear of miniscule doses of radiation. Soon the linear no threshold (LNT) paradigm was converted into laws. Scientifically valid information about the health benefits from low dose irradiation was ignored. Here are studies which show increased health in Japanese survivors of atomic bombs. Parameters include decreased mutation, leukemia and solid tissue cancer mortality rates, and increased average lifespan. Each study exhibits a threshold that repudiates the LNT dogma. The average threshold for acute exposures to atomic bombs is about 100 cSv. Conclusions from these studies of atomic bomb survivors are: One burst of low dose irradiation elicits a lifetime of improved health.Improved health from low dose irradiation negates the LNT paradigm.Effective triage should include radiation hormesis for survivor treatment. PMID:19088902

Modular Chemical Process Intensification: A Review.

PubMed

Kim, Yong-Ha; Park, Lydia K; Yiacoumi, Sotira; Tsouris, Costas

2017-06-07

Modular chemical process intensification can dramatically improve energy and process efficiencies of chemical processes through enhanced mass and heat transfer, application of external force fields, enhanced driving forces, and combinations of different unit operations, such as reaction and separation, in single-process equipment. These dramatic improvements lead to several benefits such as compactness or small footprint, energy and cost savings, enhanced safety, less waste production, and higher product quality. Because of these benefits, process intensification can play a major role in industrial and manufacturing sectors, including chemical, pulp and paper, energy, critical materials, and water treatment, among others. This article provides an overview of process intensification, including definitions, principles, tools, and possible applications, with the objective to contribute to the future development and potential applications of modular chemical process intensification in industrial and manufacturing sectors. Drivers and barriers contributing to the advancement of process intensification technologies are discussed.

Modular Chemical Process Intensification: A Review

DOE PAGES

Kim, Yong-ha; Park, Lydia K.; Yiacoumi, Sotira; ...

2016-06-24

Modular chemical process intensification can dramatically improve energy and process efficiencies of chemical processes through enhanced mass and heat transfer, application of external force fields, enhanced driving forces, and combinations of different unit operations, such as reaction and separation, in single-process equipment. Dramatic improvements such as these lead to several benefits such as compactness or small footprint, energy and cost savings, enhanced safety, less waste production, and higher product quality. Because of these benefits, process intensification can play a major role in industrial and manufacturing sectors, including chemical, pulp and paper, energy, critical materials, and water treatment, among others. Thismore » article provides an overview of process intensification, including definitions, principles, tools, and possible applications, with the objective to contribute to the future development and potential applications of modular chemical process intensification in industrial and manufacturing sectors. Drivers and barriers contributing to the advancement of process intensification technologies are discussed.« less

Civil helicopter propulsion system reliability and engine monitoring technology assessments

NASA Technical Reports Server (NTRS)

Murphy, J. A.; Zuk, J.

1982-01-01

A study to reduce operating costs of helicopters, particularly directed at the maintenance of the propulsion subsystem, is presented. The tasks of the study consisted of problem definition refinement, technology solutions, diagnostic system concepts, and emergency power augmentation. Quantifiable benefits (reduced fuel consumption, on-condition engine maintenance, extended drive system overhaul periods, and longer oil change intervals) would increase the initial cost by $43,000, but the benefit of $24.46 per hour would result in breakeven at 1758 hours. Other benefits not capable of being quantified but perhaps more important include improved aircraft avilability due to reduced maintenance time, potential for increased operating limits due to continuous automatic monitoring of gages, and less time and fuel required to make engine power checks. The most important improvement is the on-condition maintenance program, which will require the development of algorithms, equipment, and procedures compatible with all operating environments.

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

NASA Astrophysics Data System (ADS)

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

2018-03-01

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

Lipid Lowering with Soluble Dietary Fiber.

PubMed

Surampudi, Prasanth; Enkhmaa, Byambaa; Anuurad, Erdembileg; Berglund, Lars

2016-12-01

Consumption of dietary soluble fibers has been associated with health benefits such as reduced lipid levels, lower blood pressure, improved blood glucose control, weight loss, improved immune function, and reduced inflammation. Many of these health benefits relate to a reduced risk of developing cardiovascular disease. In this paper, we have reviewed recent studies on the hypocholesterolemic effects of dietary soluble fibers as well as fiber-rich foods. Findings include the following: (a) consumption of water-soluble, viscous-forming fibers can reduce total and low-density lipoprotein cholesterol levels by about 5-10 %; (b) minimal changes of high-density lipoprotein cholesterol or triglyceride levels were observed; (c) cholesterol-lowering properties of soluble fibers depend on their physical and chemical properties; and (d) medium to high molecular weight fibers are more effective in reducing lipid levels. Hypocholesterolemic benefits were also observed with some fiber-rich foods, such as whole oats, whole barley, legumes, peas, beans, flax seeds, apples, and citrus foods.

Implementing the Affordable Care Act: Revisiting the ACA's Essential Health Benefits Requirements.

PubMed

Giovannelli, Justin; Lucia, Kevin W; Corlette, Sabrina

2014-10-01

The Affordable Care Act broadens and strengthens the health insurance benefits available to consumers by requiring insurers to provide coverage of a minimum set of medical services known as "essential health benefits." Federal officials implemented this reform using transitional policies that left many important decisions to the states, while pledging to reassess that approach in time for the 2016 coverage year. This issue brief examines how states have exercised their options under the initial federal essential health benefits framework. We find significant variation in how states have developed their essential health benefits packages, including their approaches to benefit substitution and coverage of habilitative services. Federal regulators should use insurance company data describing enrollees' experiences with their coverage--information called for under the law's delayed transparency requirements--to determine whether states' differing strategies are producing the coverage improvements promised by reform.

Strategies for optimizing maternal nutrition to promote infant development.

PubMed

Hambidge, K Michael; Krebs, Nancy F

2018-06-22

The growing appreciation of the multi-faceted importance of optimal maternal nutrition to the health and development of the infant and young child is tempered by incompletely resolved strategies for combatting challenges. To review the importance of maternal nutrition and strategies being employed to optimize outcomes. Selected data from recent literature with special focus on rationale for and currently published results of maternal nutrition supplements, including lipid based nutrition supplements. 1) An impelling rationale for improving the maternal and in utero environment of low resource populations has emerged to achieve improved fetal and post-natal growth and development. 2) Based partly on population increases in adult height over one-two generations, much can be achieved by reducing poverty. 3) Maternal, newborn and infant characteristics associated with low resource environments include evidence of undernutrition, manifested by underweight and impaired linear growth. 4) Apart from broad public health and educational initiatives, to date, most specific efforts to improve fetal growth and development have included maternal nutrition interventions during gestation. 5) The relatively limited but real benefits of both iron/folic acid (IFA) and multiple micronutrient (MMN) maternal supplements during gestation have now been reasonably defined. 6) Recent investigations of a maternal lipid-based primarily micronutrient supplement (LNS) have not demonstrated a consistent benefit beyond MMN alone. 7) However, effects of both MMN and LNS appear to be enhanced by commencing early in gestation. Poor maternal nutritional status is one of a very few specific factors in the human that not only contributes to impaired fetal and early post-natal growth but for which maternal interventions have demonstrated improved in utero development, documented primarily by both improvements in low birth weights and by partial corrections of impaired birth length. A clearer definition of the benefits achievable by interventions specifically focused on correcting maternal nutrition deficits should not be limited to improvements in the quality of maternal nutrition supplements, but on the cumulative quantity and timing of interventions (also recognizing the heterogeneity between populations). Finally, in an ideal world these steps are only a prelude to improvements in the total environment in which optimal nutrition and other health determinants can be achieved.

Traffic-related air pollution and health co-benefits of alternative transport in Adelaide, South Australia.

PubMed

Xia, Ting; Nitschke, Monika; Zhang, Ying; Shah, Pushan; Crabb, Shona; Hansen, Alana

2015-01-01

Motor vehicle emissions contribute nearly a quarter of the world's energy-related greenhouse gases and cause non-negligible air pollution, primarily in urban areas. Changing people's travel behaviour towards alternative transport is an efficient approach to mitigate harmful environmental impacts caused by a large number of vehicles. Such a strategy also provides an opportunity to gain health co-benefits of improved air quality and enhanced physical activities. This study aimed at quantifying co-benefit effects of alternative transport use in Adelaide, South Australia. We made projections for a business-as-usual scenario for 2030 with alternative transport scenarios. Separate models including air pollution models and comparative risk assessment health models were developed to link alternative transport scenarios with possible environmental and health benefits. In the study region with an estimated population of 1.4 million in 2030, by shifting 40% of vehicle kilometres travelled (VKT) by passenger vehicles to alternative transport, annual average urban PM2.5 would decline by approximately 0.4μg/m(3) compared to business-as-usual, resulting in net health benefits of an estimated 13deaths/year prevented and 118 disability-adjusted life years (DALYs) prevented per year due to improved air quality. Further health benefits would be obtained from improved physical fitness through active transport (508deaths/year prevented, 6569DALYs/year prevented), and changes in traffic injuries (21 deaths and, 960 DALYs prevented). Although uncertainties remain, our findings suggest that significant environmental and health benefits are possible if alternative transport replaces even a relatively small portion of car trips. The results may provide assistance to various government organisations and relevant service providers and promote collaboration in policy-making, city planning and infrastructure establishment. Copyright © 2014 Elsevier Ltd. All rights reserved.

Substantial air quality and climate co-benefits achievable now with sectoral mitigation strategies in China.

PubMed

Peng, Wei; Yang, Junnan; Wagner, Fabian; Mauzerall, Denise L

2017-11-15

China is the world's top carbon emitter and suffers from severe air pollution. We examine near-term air quality and CO 2 co-benefits of various current sector-based policies in China. Using a 2015 base case, we evaluate the potential benefits of four sectoral mitigation strategies. All scenarios include a 20% increase in conventional air pollution controls as well as the following sector-specific fuel switching or technology upgrade strategies. Power sector (POW): 80% replacement of small coal power plants with larger more efficient ones; Industry sector (IND): 10% improvement in energy efficiency; Transport sector (TRA): replacement of high emitters with average vehicle fleet emissions; and Residential sector (RES): replacement of 20% of coal-based stoves with stoves using liquefied petroleum gas (LPG). Conducting an integrated assessment using the regional air pollution model WRF-Chem, we find that the IND scenario reduces national air-pollution-related deaths the most of the four scenarios examined (27,000, 24,000, 13,000 and 23,000 deaths reduced annually in IND, POW, TRA and RES, respectively). In addition, the IND scenario reduces CO 2 emissions more than 8times as much as any other scenario (440, 53, 0 and 52Mt CO 2 reduced in IND, POW, TRA and RES, respectively). We also examine the benefits of an industrial efficiency improvement of just 5%. We find the resulting air quality and health benefits are still among the largest of the sectoral scenarios, while the carbon mitigation benefits remain more than 3 times larger than any other scenario. Our analysis hence highlights the importance of even modest industrial energy efficiency improvements and air pollution control technology upgrades for air quality, health and climate benefits in China. Copyright © 2017 Elsevier B.V. All rights reserved.

Effectiveness and cost of reducing particle-related mortality with particle filtration

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

Fisk, W. J.; Chan, W. R.

This study evaluates the mortality-related benefits and costs of improvements in particle filtration in U.S. homes and commercial buildings based on models with empirical inputs. The models account for time spent in various environments as well as activity levels and associated breathing rates. The scenarios evaluated include improvements in filter efficiencies in both forced-air heating and cooling systems of homes and heating, ventilating, and air conditioning systems of workplaces as well as use of portable air cleaners in homes. The predicted reductions in mortality range from approximately 0.25 to 2.4 per 10 000 population. The largest reductions in mortality were frommore » interventions with continuously operating portable air cleaners in homes because, given our scenarios, these portable air cleaners with HEPA filters most reduced particle exposures. For some interventions, predicted annual mortality-related economic benefits exceed $1000 per person. Economic benefits always exceed costs with benefit-to-cost ratios ranging from approximately 3.9 to 133. In conclusion, restricting interventions to homes of the elderly further increases the mortality reductions per unit population and the benefit-to-cost ratios.« less

On the socioeconomic benefits of family planning work.

PubMed

Yang, D

1991-01-01

The focus of this article is on 1) the intended socioeconomic benefit of Chinese family planning (FP) versus the benefit of the maternal production sector, 2) the estimated costs of FP work, 3) and the principal ways to lower FP costs. Marxian population theory, which is ascribed to in socialist China, states that population and socioeconomic development are interconnected and must adapt to each other and that an excessively large or small population will upset the balance and retard development. Malthusians believe that large populations reduce income, and Adam Smith believed that more people meant a larger market and more income. It is believed that FP will bring socioeconomic benefits to China. The socioeconomic benefit of material production is the linkage between labor consumption and the amount of labor usage with the fruits and benefits of labor. FP invests in human, material, and financial resources to reduce the birth rate and the absolute number of births. The investment is recouped in population. The increased national income generated from a small outlay to produce an ideal population would be used to improve material and cultural lives. FP brings economic benefits and accelerates social development (ecological balances women's emancipation and improvement in the physical and mental health of women and children, improvement in cultural learning and employment, cultivation of socialist morality and new practices, and stability). In computing FP cost, consideration is given to total cost and unit cost. Cost is dependent on the state budget allocation, which was 445.76 million yuan in 1982 and was doubled by 1989. World Bank figures for 1984 affixed the FP budget in China at 979.6 million US dollars, of which 80% was provided by China. Per person, this means 21 cents for central, provincial, prefecture, and country spending, 34 cents for rural collective set-ups, 25 cents for child awards, and various subsidies, 15 cents for sterilization, and 5 cents for rural medical services, or 1 US dollar/person. Unit costs are the costs to reduce the population of one and include direct and indirect costs. The unit cost between 1970-82 was 35.5 yuan, but if outlays for families and industrial units are included, the cost was 70-100 yuan. Population growth, however, must be balanced so that aging does not cancel out the benefits from FP gains. Lower costs can be achieved by better FP administration.

Guidelines on the irritable bowel syndrome: mechanisms and practical management

PubMed Central

Spiller, R; Aziz, Q; Creed, F; Emmanuel, A; Houghton, L; Hungin, P; Jones, R; Kumar, D; Rubin, G; Trudgill, N; Whorwell, P

2007-01-01

Background IBS affects 5–11% of the population of most countries. Prevalence peaks in the third and fourth decades, with a female predominance. Aim To provide a guide for the assessment and management of adult patients with irritable bowel syndrome. Methods Members of the Clinical Services Committee of The British Society of Gastroenterology were allocated particular areas to produce review documents. Literature searching included systematic searches using electronic databases such as Pubmed, EMBASE, MEDLINE, Web of Science, and Cochrane databases and extensive personal reference databases. Results Patients can usefully be classified by predominant bowel habit. Few investigations are needed except when diarrhoea is a prominent feature. Alarm features may warrant further investigation. Adverse psychological features and somatisation are often present. Ascertaining the patients' concerns and explaining symptoms in simple terms improves outcome. IBS is a heterogeneous condition with a range of treatments, each of which benefits a small proportion of patients. Treatment of associated anxiety and depression often improves bowel and other symptoms. Randomised placebo controlled trials show benefit as follows: cognitive behavioural therapy and psychodynamic interpersonal therapy improve coping; hypnotherapy benefits global symptoms in otherwise refractory patients; antispasmodics and tricyclic antidepressants improve pain; ispaghula improves pain and bowel habit; 5‐HT3 antagonists improve global symptoms, diarrhoea, and pain but may rarely cause unexplained colitis; 5‐HT4 agonists improve global symptoms, constipation, and bloating; selective serotonin reuptake inhibitors improve global symptoms. Conclusions Better ways of identifying which patients will respond to specific treatments are urgently needed. PMID:17488783

Patterns and Perceived Benefits of Utilizing Seven Major Complementary Health Approaches in U.S. Older Adults.

PubMed

Rhee, Taeho Greg; Marottoli, Richard A; Van Ness, Peter H; Tinetti, Mary E

2018-04-28

To examine patterns and perceived benefits of seven major complementary health approaches (CHA) among older adults in the U.S. Data from the 2012 National Health Interview Survey (NHIS), which represents non-institutionalized adults ages 65 or older (n=7,116 unweighted), were used. We elicited seven most common CHA used in older adults, which are: acupuncture, herbal therapies, chiropractic, massage, meditation, Tai Chi, and yoga. Survey participants were asked to self-report perceived benefits (e.g., maintaining health and stress reduction) in their CHA used. We estimated prevalence and perceived benefits of CHA use. We also investigated socio-demographic and clinical factors associated with the use of any of these seven CHA. Overall, 29.2% of older adults used any of seven CHA in the past year. Most commonly used CHA included herbal therapies (18.1%), chiropractic (8.4%), and massage (5.7%). More than 60% of older CHA users reported that CHA were important for maintaining health and well-being. Other perceived benefits included improving overall health and feeling better (52.3%), giving a better sense of control over health (27.4%), and making it easier to cope with health problems (24.7%). Older adults with higher education and income levels, ≥2 chronic conditions, and functional limitations had greater odds of using CHA (p<0.01, respectively). A substantial number of older CHA users reported CHA-related benefits. CHA may play a crucial role in improving health status among older adults. At the population level, further research on the effects of CHA use on bio-psycho-social outcomes is needed to promote healthy aging in older adults.

Valuing vaccines using value of statistical life measures.

PubMed

Laxminarayan, Ramanan; Jamison, Dean T; Krupnick, Alan J; Norheim, Ole F

2014-09-03

Vaccines are effective tools to improve human health, but resources to pursue all vaccine-related investments are lacking. Benefit-cost and cost-effectiveness analysis are the two major methodological approaches used to assess the impact, efficiency, and distributional consequences of disease interventions, including those related to vaccinations. Childhood vaccinations can have important non-health consequences for productivity and economic well-being through multiple channels, including school attendance, physical growth, and cognitive ability. Benefit-cost analysis would capture such non-health benefits; cost-effectiveness analysis does not. Standard cost-effectiveness analysis may grossly underestimate the benefits of vaccines. A specific willingness-to-pay measure is based on the notion of the value of a statistical life (VSL), derived from trade-offs people are willing to make between fatality risk and wealth. Such methods have been used widely in the environmental and health literature to capture the broader economic benefits of improving health, but reservations remain about their acceptability. These reservations remain mainly because the methods may reflect ability to pay, and hence be discriminatory against the poor. However, willingness-to-pay methods can be made sensitive to income distribution by using appropriate income-sensitive distributional weights. Here, we describe the pros and cons of these methods and how they compare against standard cost-effectiveness analysis using pure health metrics, such as quality-adjusted life years (QALYs) and disability-adjusted life years (DALYs), in the context of vaccine priorities. We conclude that if appropriately used, willingness-to-pay methods will not discriminate against the poor, and they can capture important non-health benefits such as financial risk protection, productivity gains, and economic wellbeing. Copyright © 2014 Elsevier Ltd. All rights reserved.

Energy manager design for microgrids

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

Firestone, Ryan; Marnay, Chris

2005-01-01

On-site energy production, known as distributed energy resources (DER), offers consumers many benefits, such as bill savings and predictability, improved system efficiency, improved reliability, control over power quality, and in many cases, greener electricity. Additionally, DER systems can benefit electric utilities by reducing congestion on the grid, reducing the need for new generation and transmission capacity, and offering ancillary services such as voltage support and emergency demand response. Local aggregations of distributed energy resources (DER) that may include active control of on-site end-use energy devices can be called microgrids. Microgrids require control to ensure safe operation and to make dispatchmore » decisions that achieve system objectives such as cost minimization, reliability, efficiency and emissions requirements, while abiding by system constraints and regulatory rules. This control is performed by an energy manager (EM). Preferably, an EM will achieve operation reasonably close to the attainable optimum, it will do this by means robust to deviations from expected conditions, and it will not itself incur insupportable capital or operation and maintenance costs. Also, microgrids can include supervision over end-uses, such as curtailing or rescheduling certain loads. By viewing a unified microgrid as a system of supply and demand, rather than simply a system of on-site generation devices, the benefits of integrated supply and demand control can be exploited, such as economic savings and improved system energy efficiency.« less

Qualitative evaluation of just-in-time simulation-based learning: the learners' perspective.

PubMed

Kamdar, Gunjan; Kessler, David O; Tilt, Lindsey; Srivastava, Geetanjali; Khanna, Kajal; Chang, Todd P; Balmer, Dorene; Auerbach, Marc

2013-02-01

Just-in-time training (JITT) is an educational strategy where training occurs in close temporal proximity to a clinical encounter. A multicenter study evaluated the impact of simulation-based JITT on interns' infant lumbar puncture (LP) success rates. Concurrent with this multicenter study, we conducted a qualitative evaluation to describe learner perceptions of this modality of skills training. Eleven interns from a single institution participated in a face-to-face semistructured interview exploring their JITT experience. Interviews were audio-recorded and transcribed. Two investigators reviewed the transcripts, assigned codes to the data, and categorized the codes. Categories were modified by 4 emergency physicians. As a means of data triangulation, we performed focus groups at a second institution. Benefits of JITT included review of anatomic landmarks, procedural rehearsal, and an opportunity to ask questions. These perceived benefits improved confidence with infant LP. Deficits of the training included lack of mannequin fidelity and unrealistic context when compared with an actual LP. An unexpected category, which emerged from our analysis, was that of barriers to JITT performance. Barriers included lack of time in a busy clinical setting and various instructor factors. The focus group findings confirmed and elaborated the benefits and deficits of JITT and the barriers to JITT performance. Just-in-time training improved procedural confidence with infant LP, but work place busyness and instructor lack of support or unawareness were barriers to JITT performance. Optimal LP JITT would occur with improved contextual fidelity. More research is needed to determine optimal training strategies that are effective for the learner and maximize clinical outcomes for the patient.

U.S. Assistance to Yemen: Actions Needed to Improve Oversight of Emergency Food Aid and Assess Security Assistance

DTIC Science & Technology

2013-03-01

annual targets between fiscal years 2008 and 2011 for the number of individuals in Yemen benefiting from food donations. However, reports to Congress...annual performance targets three times for the number of individuals in Yemen benefiting from food donations, reports to Congress about the program...security to several hundred locally employed staff. However, the embassy has deemed other steps proposed by locally employed staff, including telework and

Flight-determined benefits of integrated flight-propulsion control systems

NASA Technical Reports Server (NTRS)

Stewart, James F.; Burcham, Frank W., Jr.; Gatlin, Donald H.

1992-01-01

Over the last two decades, NASA has conducted several experiments in integrated flight-propulsion control. Benefits have included improved maneuverability; increased thrust, range, and survivability; reduced fuel consumption; and reduced maintenance. This paper presents the basic concepts for control integration, examples of implementation, and benefits. The F-111E experiment integrated the engine and inlet control systems. The YF-12C incorporated an integral control system involving the inlet, autopilot, autothrottle, airdata, navigation, and stability augmentation systems. The F-15 research involved integration of the engine, flight, and inlet control systems. Further extension of the integration included real-time, onboard optimization of engine, inlet, and flight control variables; a self-repairing flight control system; and an engines-only control concept for emergency control. The F-18A aircraft incorporated thrust vectoring integrated with the flight control system to provide enhanced maneuvering at high angles of attack. The flight research programs and the resulting benefits of each program are described.

Quality of Life and Sexual Function Benefits of Long-Term Testosterone Treatment: Longitudinal Results From the Registry of Hypogonadism in Men (RHYME).

PubMed

Rosen, Raymond C; Wu, Frederick; Behre, Hermann M; Porst, Hartmut; Meuleman, Eric J H; Maggi, Mario; Romero-Otero, Javier; Martinez-Salamanca, Juan I; Jones, Thomas Hugh; Debruyne, Frans M J; Kurth, Karl-Heinz; Hackett, Geoff I; Quinton, Richard; Stroberg, Peter; Reisman, Yacov; Pescatori, Edoardo S; Morales, Antonio; Bassas, Lluis; Cruz, Natalio; Cunningham, Glenn R; Wheaton, Olivia A

2017-09-01

The benefits and risks of long-term testosterone administration have been a topic of much scientific and regulatory interest in recent years. To assess long-term quality of life (QOL) and sexual function benefits of testosterone replacement therapy (TRT) prospectively in a diverse, multinational cohort of men with hypogonadism. A multinational patient registry was used to assess long-term changes associated with TRT in middle-age and older men with hypogonadism. Comprehensive evaluations were conducted at 6, 12, 24, and 36 months after enrollment into the registry. QOL and sexual function were evaluated by validated measures, including the Aging Males' Symptom (AMS) Scale and the International Index of Erectile Function (IIEF). A total of 999 previously untreated men with hypogonadism were enrolled at 25 European centers, 750 of whom received TRT at at least one visit during the period of observation. Patients on TRT reported rapid and sustained improvements in QOL, with fewer sexual, psychological, and somatic symptoms. Modest improvements in QOL and sexual function, including erectile function, also were noted in RHYME patients not on TRT, although treated patients showed consistently greater benefit over time in all symptom domains compared with untreated patients. AMS total scores for patients on TRT were 32.8 (95% confidence interval = 31.3-34.4) compared with 36.6 (95% confidence interval = 34.8-38.5) for untreated patients (P < .001). Small but significant improvements in IIEF scores over time also were noted with TRT. Approximately 25% of treated and untreated men also used phosphodiesterase type 5 inhibitors, with notable differences in the frequency of phosphodiesterase type 5 inhibitor prescription use according to physician specialty and geographic site location. TRT-related benefits in QOL and sexual function are well maintained for up to 36 months after initiation of treatment. The major strengths are the large, diverse patient population being treated in multidisciplinary clinical settings. The major limitation is the frequency of switching from one formulation to another. Overall, we confirmed the broad and sustained benefits of TRT across major QOL dimensions, including sexual, somatic, and psychological health, which were sustained over 36 months in our treatment cohort. Rosen RC, Wu F, Behre H, et al. Quality of Life and Sexual Function Benefits Effects of Long-Term Testosterone Treatment: Longitudinal Results From the Registry of Hypogonadism in Men (RHYME). J Sex Med 2017;14:1104-1115. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Vitrectomy for vitreous floaters: analysis of the benefits and risks.

PubMed

Sommerville, Drew N

2015-05-01

To review the pros and cons of small-gauge vitrectomy for symptomatic floaters. Current treatment options for floaters include Nd:YAG vitreolysis and pars plana vitrectomy. There are risks and benefits associated with vitrectomy for floaters. However, small-gauge vitrectomy is a minimally invasive way of removing the floaters. The current literature demonstrates vitrectomy has some risk, but is highly effective at improving vision, symptoms, contrast sensitivity, and quality of life. Small-gauge vitrectomy for floaters is a well tolerated and effective procedure to remove the symptomatic floaters. Symptomatic patients are willing to take some risk to have their troublesome vitreous floaters removed, often resulting in an improvement in their vision and quality of life.

Probiotic Bacillus coagulans GBI-30, 6086 Improves Protein Absorption and Utilization.

PubMed

Jäger, Ralf; Purpura, Martin; Farmer, Sean; Cash, Howard A; Keller, David

2017-12-01

Probiotics offer numerous health benefits, including digestive and immune health. Improved digestive health is linked to a more efficient absorption of important nutrients from our diet. This review focused on the rationale of using the probiotic Bacillus coagulans GBI-30, 6086 to aid protein absorption and utilization. B. coagulans GBI-30, 6086 can withstand the acidic environment of the stomach to reach the intestine where it germinates. Once active in the small intestine after germination, it has been shown to aid the digestion of carbohydrates and proteins. Co-administration of B. coagulans GBI-30, 6086 with protein has been shown to increase protein absorption and to maximize the health benefits associated with protein supplementation.

Do Prescription Drug Ads Tell Consumers Enough About Benefits and Side Effects? Results From the Health Information National Trends Survey, Fourth Administration.

PubMed

Sullivan, Helen W; Campbell, Miriam

2015-01-01

Direct-to-consumer prescription drug advertising (DTCA) is a major source of consumer information about prescription drugs. The present study updates 2002 U.S. Food and Drug Administration phone survey questions that found that 44% and 61% of consumers thought that DTCA did not include enough information about benefits and risks, respectively. The present study was administered by mail using a nationally representative sample, and provides a more in-depth understanding of how these beliefs relate to demographic and health characteristics. Data collected from 3,959 respondents to the National Cancer Institute's 2011 Health Information National Trends Survey find results similar to the 2002 survey: 46% and 52% of respondents thought that DCTA did not include enough information about benefits and risks, respectively. Respondents fell into four groups: 23% agreed that DTCA tells enough about drug benefits and risks, 41% disagreed, 18% expressed no opinion, and 18% had discordant beliefs. DTCA attitudes were negatively associated with education, income, and whether respondents purchase prescription drugs; attitudes were positively associated with whether respondents understand prescription drug information. This study confirms that a plurality of Americans believe that DTCA does not include enough information about benefits and risks, suggesting that the educational effect of DTCA could be improved.

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

PubMed

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

2011-05-01

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

Broad-based visual benefits from training with an integrated perceptual-learning video game.

PubMed

Deveau, Jenni; Lovcik, Gary; Seitz, Aaron R

2014-06-01

Perception is the window through which we understand all information about our environment, and therefore deficits in perception due to disease, injury, stroke or aging can have significant negative impacts on individuals' lives. Research in the field of perceptual learning has demonstrated that vision can be improved in both normally seeing and visually impaired individuals, however, a limitation of most perceptual learning approaches is their emphasis on isolating particular mechanisms. In the current study, we adopted an integrative approach where the goal is not to achieve highly specific learning but instead to achieve general improvements to vision. We combined multiple perceptual learning approaches that have individually contributed to increasing the speed, magnitude and generality of learning into a perceptual-learning based video-game. Our results demonstrate broad-based benefits of vision in a healthy adult population. Transfer from the game includes; improvements in acuity (measured with self-paced standard eye-charts), improvement along the full contrast sensitivity function, and improvements in peripheral acuity and contrast thresholds. The use of this type of this custom video game framework built up from psychophysical approaches takes advantage of the benefits found from video game training while maintaining a tight link to psychophysical designs that enable understanding of mechanisms of perceptual learning and has great potential both as a scientific tool and as therapy to help improve vision. Copyright © 2014 Elsevier B.V. All rights reserved.

Healthcare professionals' views of group structured education for people with newly diagnosed Type 2 diabetes.

PubMed

Winkley, K; Upsher, R; Keij, S M; Chamley, M; Ismail, K; Forbes, A

2018-04-06

To determine healthcare professionals' (HCP) views of group structured education for people with newly diagnosed Type 2 diabetes. This was a qualitative study using semi-structured interviews to ascertain primary care HCPs' views and experiences of education for people with newly diagnosed Type 2 diabetes. A thematic framework method was applied to analyse the data. Participants were HCPs (N = 22) from 15 general practices in three south London boroughs. All but one HCP viewed diabetes education favourably and all identified that low attendance was a problem. Three key themes emerged from the qualitative data: (1) benefits of diabetes education, including the group mode of delivery, improved patient interactions, saving HCPs' time and improved patient outcomes; (2) factors limiting uptake of education, including patient-level problems such as access and the appropriateness of the programme for certain groups, and difficulties communicating the benefits to patients and integration of education management plans into ongoing diabetes care; and (3) suggestions for improvement, including strategies to improve attendance at education with more localized and targeted marketing and enhanced programme content including follow-up sessions and support for people with pre-existing psychological issues. Most HCPs valued diabetes education and all highlighted the lack of provision for people with different levels of health literacy. Because there was wide variation in terms of the level of knowledge regarding the education on offer, future studies may want to focus on how to help HCPs encourage their patients to attend. © 2018 Diabetes UK.

Unfractionated or low-molecular weight heparin for induction of remission in ulcerative colitis.

PubMed

Chande, Nilesh; McDonald, John Wd; Macdonald, John K; Wang, Josh J

2010-10-06

There are a limited number of treatment options for patients with ulcerative colitis (UC). An increased risk of thrombosis in UC coupled with an observation that UC patients being treated with anticoagulant therapy for thrombotic events had an improvement in their bowel symptoms led to trials examining the use of unfractionated heparin (UFH) and low molecular weight heparins (LMWH) in patients with active UC. To review randomized trials examining the efficacy of unfractionated heparin (UFH) or low molecular weight heparins (LMWH) for remission induction in patients with ulcerative colitis. The MEDLINE (PUBMED), and EMBASE databases, The Cochrane Central Register of Controlled Trials, the Cochrane IBD/FBD group specialized trials register, review papers on ulcerative colitis, and references from identified papers were searched up to June 2010 in an effort to identify all randomized trials studying UFH or LMWH use in patients with ulcerative colitis. Abstracts from major gastroenterological meetings were searched to identify research published in abstract form only. Each author independently reviewed potentially relevant trials to determine their eligibility for inclusion based on the criteria identified above. The Cochrane Risk of Bias tool was used to assess study quality. Studies published in abstract form only were included if the authors could be contacted for further information. A data extraction form was developed and used to extract data from included studies. At least 2 authors independently extracted data. Any disagreements were resolved by consensus. Data were analyzed on an intention-to-treat basis. The primary outcome was induction of remission, as defined by the studies. Data were combined for analysis if they assessed the same treatments (UFH or LMWH versus placebo or other therapy). LMWH administered subcutaneously showed no benefit over placebo for any outcome, including clinical remission, and clinical, endoscopic, or histological improvement. High dose LMWH administered via an extended colon-release tablet demonstrated benefit over placebo for clinical remission (OR 2.73; 95% CI 1.32 to 5.67; P = 0.007), clinical improvement (OR 2.99; 95% CI 1.30 to 6.87; P = 0.01), and endoscopic improvement (OR 2.25; 95%CI 1.01 to 5.01; P = 0.05) but not endoscopic remission or histologic improvement. LMWH was not beneficial when added to standard therapy for clinical remission, clinical improvement, endoscopic remission or endoscopic improvement. LMWH was well-tolerated but provided no significant benefit for quality of life. One study examining UFH versus corticosteroids for the treatment of severe UC demonstrated the inferiority of UFH for clinical improvement. More patients assigned to UFH had rectal hemorrhage as an adverse event. There is evidence to suggest that LMWH may be effective for the treatment of active UC. When administered by extended colon-release tablets, LMWH was more effective than placebo for treating outpatients with mild to moderate disease. This benefit needs to be confirmed by further randomized controlled studies. The same benefits were not seen when LMWH was administered subcutaneously at lower doses. There is no evidence to support the use of UFH for the treatment of active UC. A further trial of UFH in patients with mild disease may also be justified. Any benefit found would need to be weighed against a possible increased risk of rectal bleeding in patients with active UC.

Employer benefits from making workplace accommodations.

PubMed

Solovieva, Tatiana I; Dowler, Denetta L; Walls, Richard T

2011-01-01

This study explored workplace disability accommodations and their benefits. The participants were employers and human resource professionals who had not used the services of the Job Accommodation Network (JAN). The companies included large businesses (more than 499 employees) and small businesses (fewer than 500 employees). The intent of this investigation was to assess the disability accommodations and benefits for the employers. The study used responses to online survey from194 employers to discuss disability-related accommodations for an employee or potential employee. The survey included 128 employers who reported having had a person with a disability who requested an accommodation. As reported by the employers, the most frequently mentioned direct benefits from implementing workplace accommodations were (a) retained a qualified employee, (b) increased worker productivity, and (c) eliminated the cost of training a new employee. The most frequently mentioned indirect benefits from accommodations were (a) improved interactions with coworkers, (b) increased overall company morale, and (c) increased overall company productivity. The most frequently reported types of implemented accommodations were buying equipment and changing work schedules. Most of the respondents estimated the direct benefits of having made an accommodation at more than $1000. The findings heighten awareness of benefits associated with making accommodations for people with disabilities in the workplace. These benefits signify value for business, coworkers, and individuals with disabilities for whom accommodations are critical for successful employment. Published by Elsevier Inc.

The Significance of Benefit Perceptions for the Ethics of HIV Research Involving Adolescents in Kenya.

PubMed

Rennie, Stuart; Groves, Allison K; Hallfors, Denise Dion; Iritani, Bonita J; Odongo, Fredrick S; Luseno, Winnie K

2017-10-01

Assessment of benefits is traditionally regarded as crucial to the ethical evaluation of research involving human participants. We conducted focus group discussions (FGDs) with health and other professionals engaged with adolescents, caregivers/parents, and adolescents in Siaya County, Kenya, to solicit opinions about appropriate ways of conducting HIV research with adolescents. Our data revealed that many focus group participants have a profoundly positive conception of participation in health research, including studies conferring seemingly few benefits. In this article, we identify and analyze five different but interrelated types of benefits as perceived by Kenyan adolescent and adult stakeholders in HIV research, and discuss their ethical significance. Our findings suggest that future empirical and conceptual research should concentrate on factors that may trigger researcher obligations to improve benefit perceptions among research participants.

The impact on health of employment and welfare transitions for those receiving out-of-work disability benefits in the UK.

PubMed

Curnock, Esther; Leyland, Alastair H; Popham, Frank

2016-08-01

Employment status has a dynamic relationship with health and disability. There has been a striking increase in the working age population receiving out-of-work disability benefits in many countries, including the UK. In response, recent UK welfare reforms have tightened eligibility criteria and introduced new conditions for benefit receipt linked to participation in return-to-work activities. Positive and negative impacts have been suggested but there is a lack of high quality evidence of the health impact when those receiving disability benefits move towards labour market participation. Using four waves of the UK's Understanding Society panel survey (2009-2013) three different types of employment and welfare transition were analysed in order to identify their impact on health. A difference-in-difference approach was used to compare change between treatment and control groups in mental and physical health using the SF-12. To strengthen causal inference, sensitivity checks for common trends used pre-baseline data and propensity score matching. Transitions from disability benefits to employment (n = 124) were associated on average with an improvement in the SF12 mental health score of 5.94 points (95% CI = 3.52-8.36), and an improvement in the physical health score of 2.83 points (95% CI = 0.85-4.81) compared with those remaining on disability benefits (n = 1545). Transitions to unemployed status (n = 153) were associated with a significant improvement in mental health (3.14, 95% CI = 1.17-5.11) but not physical health. No health differences were detected for those who moved on to the new out-of-work disability benefit. It remains rare for disability benefit recipients to return to the labour market, but our results indicate that for those that do, such transitions may improve health, particularly mental health. Understanding the mechanisms behind this relationship will be important for informing policies to ensure both work and welfare are 'good for health' for this group. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Improving cereal grain carbohydrates for diet and health

PubMed Central

Lafiandra, Domenico; Riccardi, Gabriele; Shewry, Peter R.

2014-01-01

Starch and cell wall polysaccharides (dietary fibre) of cereal grains contribute to the health benefits associated with the consumption of whole grain cereal products, including reduced risk of obesity, type 2 diabetes, cardiovascular disease and colorectal cancer. The physiological bases for these effects are reviewed in relation to the structures and physical properties of the polysaccharides and their behaviour (including digestion and fermentation) in the gastro-intestinal tract. Strategies for modifying the content and composition of grain polysaccharides to increase their health benefits are discussed, including exploiting natural variation and using mutagenesis and transgenesis to generate further variation. These studies will facilitate the development of new types of cereals and cereal products to face the major health challenges of the 21st century. PMID:24966450

The effect of a bidirectional exchange on faculty and institutional development in a global health collaboration.

PubMed

Bodnar, Benjamin E; Claassen, Cassidy W; Solomon, Julie; Mayanja-Kizza, Harriet; Rastegar, Asghar

2015-01-01

The MUYU Collaboration is a partnership between Mulago Hospital-Makerere University College of Health Sciences (M-MakCHS), in Kampala, Uganda, and the Yale University School of Medicine. The program allows Ugandan junior faculty to receive up to 1 year of subspecialty training within the Yale hospital system. The authors performed a qualitative study to assess the effects of this program on participants, as well as on M-MakCHS as an institution. Data was collected via semi-structured interviews with exchange participants. Eight participants (67% of those eligible as of 4/2012) completed interviews. Study authors performed data analysis using standard qualitative data analysis techniques. Analysis revealed themes addressing the benefits, difficulties, and opportunities for improvement of the program. Interviewees described the main benefit of the program as its effect on their fund of knowledge. Participants also described positive effects on their clinical practice and on medical education at M-MakCHS. Most respondents cited financial issues as the primary difficulty of participation. Post-participation difficulties included resource limitations and confronting longstanding institutional and cultural habits. Suggestions for programmatic improvement included expansion of the program, ensuring appropriate management of pre-departure expectations, and refinement of program mentoring structures. Participants also voiced interest in expanding post-exchange programming to ensure both the use of and the maintenance of new capacity. The MUYU Collaboration has benefitted both program participants and M-MakCHS, though these benefits remain difficult to quantify. This study supports the assertion that resource-poor to resource-rich exchanges have the potential to provide significant benefits to the resource-poor partner.

Perceived Risks and Benefits in a Text Message Study of Substance Abuse and Sexual Behavior.

PubMed

Bonar, Erin E; Koocher, Gerald P; Benoit, Matthew F; Collins, R Lorraine; Cranford, James A; Walton, Maureen A

2018-01-01

To inform ethical procedures for human subjects research using mobile health (mHealth), we examined perceived risks and benefits of study participation among emerging adults ( N =54) with drug use who completed text message assessments of substance use and sexual behaviors. Most participants reported comfort with participation and some reported perceived benefits, such as improved relationships. Perceived risks were infrequently reported, including negative emotions, and legal or financial concerns. In conclusion, participants from a vulnerable population reported few perceived harms of participation in longitudinal mHealth assessments of sensitive behaviors. Researchers should continue characterizing participants' perspectives on ethical aspects of mHealth research.

Adapted recreational and sports programs for children with disabilities: A decade of experience.

PubMed

Moberg-Wolff, Elizabeth; Kiesling, Sarah

2008-01-01

To identify and describe community based adapted sports and recreational programs (SARPs) for children with physically disabilities, documenting program types, benefits, challenges, growth and/or decline, and lessons they have learned over a 10-year period. In 1996, a total of 277 children's hospitals and freestanding rehabilitation hospitals stating that they provided pediatric rehabilitation services were contacted and asked to provide information regarding adapted recreational and sports programs in their region. Seventy-nine SARPs were identified, contacted, and survyed about programming, benefits and challenges they faced. They were then re-surveyed in 2006 for comparison data. Ten years ago, the average SARP served 25 or fewer clients and was led by a therapeutic recreation specialist with assistance from volunteers. Most programs had been in place for 5 years or more, met weekly for 2-3 hours, and were recreational in orientation. Activities varied, with basketball, aquatics, horseback riding and snow skiing being most common. Fund-raisers and grants supported most programs, and securing funding was their greatest challenge. Participant benefits noted by programs included improved socialization, enhanced physical fitness, increased self esteem, improved therapeutic skills (ADL's, transfers, etc.), enhanced cognition, expanded client independence, improved community relations, and enhanced leisure skills. Ten years later, the majority of SARPs noted similar benefits, and reported an increase in number of participants despite continued challenges with funding and staffing. Leadership and mentorship by those with disabilities was still very low, but community awareness of the abilities of those with disabilities had increased. Adapted sports and recreation programs surveyed in 1996 and again in 2006, report overall that their health is good, and many have retained the same programming, financial support mechanisms, leadership and participant mix over the years. Many have increased athlete participation despite financial challenges being a predominant concern. They report that their staying power is dependent on many factors, including leadership, participant referrals, an ample supply of volunteers, and consistent community and financial support. They feel that their success is important to the physical and psychological well-being of individuals with disabilities and that an increased focus on corporate sponsorship, participation and mentorship by those with disabilities may assist with future growth. Increased school involvement, development of more competitive vs. recreational programs, and improved research documenting the physical and psychological benefits of adapted sports programs were also recommended to improve future SARP stability.

Benefits of information technology-enabled diabetes management.

PubMed

Bu, Davis; Pan, Eric; Walker, Janice; Adler-Milstein, Julia; Kendrick, David; Hook, Julie M; Cusack, Caitlin M; Bates, David W; Middleton, Blackford

2007-05-01

To determine the financial and clinical benefits of implementing information technology (IT)-enabled disease management systems. A computer model was created to project the impact of IT-enabled disease management on care processes, clinical outcomes, and medical costs for patients with type 2 diabetes aged >25 years in the U.S. Several ITs were modeled (e.g., diabetes registries, computerized decision support, remote monitoring, patient self-management systems, and payer-based systems). Estimates of care process improvements were derived from published literature. Simulations projected outcomes for both payer and provider organizations, scaled to the national level. The primary outcome was medical cost savings, in 2004 U.S. dollars discounted at 5%. Secondary measures include reduction of cardiovascular, cerebrovascular, neuropathy, nephropathy, and retinopathy clinical outcomes. All forms of IT-enabled disease management improved the health of patients with diabetes and reduced health care expenditures. Over 10 years, diabetes registries saved $14.5 billion, computerized decision support saved $10.7 billion, payer-centered technologies saved $7.10 billion, remote monitoring saved $326 million, self-management saved $285 million, and integrated provider-patient systems saved $16.9 billion. IT-enabled diabetes management has the potential to improve care processes, delay diabetes complications, and save health care dollars. Of existing systems, provider-centered technologies such as diabetes registries currently show the most potential for benefit. Fully integrated provider-patient systems would have even greater potential for benefit. These benefits must be weighed against the implementation costs.

Improving Employee Benefits: Doing the Right Thing.

ERIC Educational Resources Information Center

Perreault, Joe

1990-01-01

With some exceptions, child care workers receive fewer employee benefits than workers in other occupations. The employer's and the employee's point of view on employee benefits are discussed. Also considers availability of benefits in child care and the obstacles to improved benefits for workers. (DG)

Cost-effectiveness of a complex workplace dietary intervention: an economic evaluation of the Food Choice at Work study

PubMed Central

Fitzgerald, Sarah; Murphy, Aileen; Kirby, Ann; Geaney, Fiona; Perry, Ivan J

2018-01-01

Objective To evaluate the costs, benefits and cost-effectiveness of complex workplace dietary interventions, involving nutrition education and system-level dietary modification, from the perspective of healthcare providers and employers. Design Single-study economic evaluation of a cluster-controlled trial (Food Choice at Work (FCW) study) with 1-year follow-up. Setting Four multinational manufacturing workplaces in Cork, Ireland. Participants 517 randomly selected employees (18–65 years) from four workplaces. Interventions Cost data were obtained from the FCW study. Nutrition education included individual nutrition consultations, nutrition information (traffic light menu labelling, posters, leaflets and emails) and presentations. System-level dietary modification included menu modification (restriction of fat, sugar and salt), increase in fibre, fruit discounts, strategic positioning of healthier alternatives and portion size control. The combined intervention included nutrition education and system-level dietary modification. No intervention was implemented in the control. Outcomes The primary outcome was an improvement in health-related quality of life, measured using the EuroQoL 5 Dimensions 5 Levels questionnaire. The secondary outcome measure was reduction in absenteeism, which is measured in monetary amounts. Probabilistic sensitivity analysis (Monte Carlo simulation) assessed parameter uncertainty. Results The system-level intervention dominated the education and combined interventions. When compared with the control, the incremental cost-effectiveness ratio (€101.37/quality-adjusted life-year) is less than the nationally accepted ceiling ratio, so the system-level intervention can be considered cost-effective. The cost-effectiveness acceptability curve indicates there is some decision uncertainty surrounding this, arising from uncertainty surrounding the differences in effectiveness. These results are reiterated when the secondary outcome measure is considered in a cost–benefit analysis, whereby the system-level intervention yields the highest net benefit (€56.56 per employee). Conclusions System-level dietary modification alone offers the most value per improving employee health-related quality of life and generating net benefit for employers by reducing absenteeism. While system-level dietary modification strategies are potentially sustainable obesity prevention interventions, future research should include long-term outcomes to determine if improvements in outcomes persist. Trial registration number ISRCTN35108237; Post-results. PMID:29502090

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

PubMed

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

2018-06-19

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

Evaluating Digital Health Interventions: Key Questions and Approaches.

PubMed

Murray, Elizabeth; Hekler, Eric B; Andersson, Gerhard; Collins, Linda M; Doherty, Aiden; Hollis, Chris; Rivera, Daniel E; West, Robert; Wyatt, Jeremy C

2016-11-01

Digital health interventions have enormous potential as scalable tools to improve health and healthcare delivery by improving effectiveness, efficiency, accessibility, safety, and personalization. Achieving these improvements requires a cumulative knowledge base to inform development and deployment of digital health interventions. However, evaluations of digital health interventions present special challenges. This paper aims to examine these challenges and outline an evaluation strategy in terms of the research questions needed to appraise such interventions. As they are at the intersection of biomedical, behavioral, computing, and engineering research, methods drawn from all of these disciplines are required. Relevant research questions include defining the problem and the likely benefit of the digital health intervention, which in turn requires establishing the likely reach and uptake of the intervention, the causal model describing how the intervention will achieve its intended benefit, key components, and how they interact with one another, and estimating overall benefit in terms of effectiveness, cost effectiveness, and harms. Although RCTs are important for evaluation of effectiveness and cost effectiveness, they are best undertaken only when: (1) the intervention and its delivery package are stable; (2) these can be implemented with high fidelity; and (3) there is a reasonable likelihood that the overall benefits will be clinically meaningful (improved outcomes or equivalent outcomes at lower cost). Broadening the portfolio of research questions and evaluation methods will help with developing the necessary knowledge base to inform decisions on policy, practice, and research. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Assessment of health benefits related to air quality improvement strategies in urban areas: An Impact Pathway Approach.

PubMed

Silveira, Carlos; Roebeling, Peter; Lopes, Myriam; Ferreira, Joana; Costa, Solange; Teixeira, João P; Borrego, Carlos; Miranda, Ana I

2016-12-01

Air pollution is, increasingly, a concern to our society given the threats to human health and the environment. Concerted actions to improve air quality have been taken at different levels, such as through the development of Air Quality Plans (AQPs). However, air quality impacts associated with the implementation of abatement measures included in AQPs are often neglected. In order to identify the major gaps and strengths in current knowledge, a literature review has been performed on existing methodologies to estimate air pollution-related health impacts and subsequent external costs. Based on this review, the Impact Pathway Approach was adopted and applied within the context of the MAPLIA research project to assess the health impacts and benefits (or avoided external costs) derived from improvements in air quality. Seven emission abatement scenarios, based on individual and combined abatement measures, were tested for the major activity sectors (traffic, residential and industrial combustion and production processes) of a Portuguese urban area (Grande Porto) with severe particular matter (PM10) air pollution problems. Results revealed a strong positive correlation between population density and health benefits obtained from the assessed reduction scenarios. As a consequence, potential health benefits from reduction scenarios are largest in densely populated areas with high anthropic activity and, thus, where air pollution problems are most alarming. Implementation of all measures resulted in a reduction in PM10 emissions by almost 8%, improving air quality by about 1% and contributing to a benefit of 8.8 million €/year for the entire study domain. The introduction of PM10 reduction technologies in industrial units was the most beneficial abatement measure. This study intends to contribute to policy support for decision-making on air quality management. Copyright © 2016 Elsevier Ltd. All rights reserved.

Frequent Questions about the Hazardous Waste Generator Improvements Final Rule

EPA Pesticide Factsheets

FAQs including What are the benefits of these revisions to the generator regulations? What changed in the final regulations since proposal? How and why will the hazardous waste generator regulations be reorganized? When will this rule become effective?

Year-Round Education: Learning More for Less.

ERIC Educational Resources Information Center

Ballinger, Charles

1990-01-01

Advantages and examples of year-round education are discussed in this publication. Advantages include instructional benefits, relief from overcrowding, savings on operational and capital costs, increased teacher flexibility, improved attendance, and reduced vandalism. Guidelines for implementation, calendar design, and descriptions of various…

Use of reinforced soil foundation (RSF) to support shallow foundation.

DOT National Transportation Integrated Search

2008-11-01

This research study aims at investigating the potential benefits of using reinforced soil foundations to improve the bearing capacity and reduce the settlement of shallow foundations on soils. To implement this objective, a total of 117 tests, includ...

Use of humic products for production of berry crops

USDA-ARS?s Scientific Manuscript database

Many berry growers in the United States and elsewhere are incorporating humic acid products into their fertilizer programs. Proclaimed benefits of these substances include improved soil properties and structure, greater bioavailability of soil nutrients, increased microbial populations, and plant ho...

OPTIMIZING GREEN ROOF TECHNOLOGIES IN THE MIDWEST

EPA Science Inventory

Green roofs, while extensively used in Europe, are an emerging technology in the U.S. They have an array of potential benefits (including improved storm water management, increased energy conservation of buildings, reduced urban heat island effects, and extended roof life) ...

Use of reinforced soil foundation (RSF) to support shallow foundation.

DOT National Transportation Integrated Search

2008-11-01

The main objective of this research study is to investigate potential benefits of using the reinforced soil foundations to improve the bearing capacity and to reduce the settlement of shallow foundations on soils. This includes examining influences o...

Safe, High-Performance, Sustainable Precast School Design

ERIC Educational Resources Information Center

Finsen, Peter I.

2011-01-01

School design utilizing integrated architectural and structural precast and prestressed concrete components has gained greater acceptance recently for numerous reasons, including increasingly sophisticated owners and improved learning environments based on material benefits such as: sustainability, energy efficiency, indoor air quality, storm…

'Tis the Season.

ERIC Educational Resources Information Center

Fullan, Michael; Hargreaves, Andy

1997-01-01

Suggestions are offered for teachers in moving schools toward collaboration: reflect on values and teaching; become risk takers; learn to trust processes and people; appreciate colleagues; commit to ongoing improvement; seek variety; redefine roles; balance work and life; include administrators; and acknowledge benefits of collaboration to…

National requirements for improved elevation data

USGS Publications Warehouse

Snyder, Gregory I.; Sugarbaker, Larry J.; Jason, Allyson L.; Maune, David F.

2014-01-01

This report presents the results of surveys, structured interviews, and workshops conducted to identify key national requirements for improved elevation data for the United States and its territories, including coastlines. Organizations also identified and reported the expected economic benefits that would be realized if their requirements for improved elevation were met (appendixes 1–3). This report describes the data collection methodology and summarizes the findings. Participating organizations included 34 Federal agencies, 50 States and two territories, and a sampling of local governments, tribes, and nongovernmental orgnizations. The nongovernmental organizations included The Nature Conservancy and a sampling of private sector businesses. These data were collected in 2010-2011 as part of the National Enhanced Elevation Assessment (NEEA), a study to identify program alternatives for better meeting the Nation’s elevation data needs. NEEA tasks included the collection of national elevation requirements; analysis of the benefits and costs of meeting these requirements; assessment of emerging elevation technologies, lifecycle data management needs, and costs for managing and distributing a national-scale dataset and derived products; and candidate national elevation program alternatives that balance costs and benefits in meeting the Nation’s elevation requirements. The NEEA was sponsored by the National Digital Elevation Program (NDEP), a government coordination body with the U.S. Geological Survey (USGS) as managing partner that includes the National Geospatial-Intelligence Agency (NGA), the Federal Emergency Management Agency (FEMA), the Natural Resources Conservation Service (NRCS), the U.S. Army Corps of Engineers (USACE), and the National Oceanic and Atmospheric Administration (NOAA), among the more than a dozen agencies and organizations. The term enhanced elevation data as used in this report refers broadly to three-dimensional measurements of land or submerged topography, built features, vegetation structure, and other landscape detail. Additional information about NEEA and its later use in the development of a 3D Elevation Program (3DEP) can be found at http://nationalmap.gov/3DEP/index.html.

Potential benefits of propulsion and flight control integration for supersonic cruise vehicles

NASA Technical Reports Server (NTRS)

Berry, D. T.; Schweikhard, W. G.

1976-01-01

Typical airframe/propulsion interactions such as Mach/altitude excursions and inlet unstarts are reviewed. The improvements in airplane performance and flight control that can be achieved by improving the interfaces between propulsion and flight control are estimated. A research program to determine the feasibility of integrating propulsion and flight control is described. This program includes analytical studies and YF-12 flight tests.

The Added Value of Collecting Information on Pain Experience When Predicting Time on Benefits for Injured Workers with Back Pain.

PubMed

Steenstra, Ivan A; Franche, Renée-Louise; Furlan, Andrea D; Amick, Ben; Hogg-Johnson, Sheilah

2016-06-01

Objectives Some injured workers with work-related, compensated back pain experience a troubling course in return to work. A prediction tool was developed in an earlier study, using administrative data only. This study explored the added value of worker reported data in identifying those workers with back pain at higher risk of being on benefits for a longer period of time. Methods This was a cohort study of workers with compensated back pain in 2005 in Ontario. Workplace Safety and Insurance Board (WSIB) data was used. As well, we examined the added value of patient-reported prognostic factors obtained from a prospective cohort study. Improvement of model fit was determined by comparing area under the curve (AUC) statistics. The outcome measure was time on benefits during a first workers' compensation claim for back pain. Follow-up was 2 years. Results Among 1442 workers with WSIB data still on full benefits at 4 weeks, 113 were also part of the prospective cohort study. Model fit of an established rule in the smaller dataset of 113 workers was comparable to the fit previously established in the larger dataset. Adding worker rating of pain at baseline improved the rule substantially (AUC = 0.80, 95 % CI 0.68, 0.91 compared to benefit status at 180 days, AUC = 0.88, 95 % CI 0.74, 1.00 compared to benefits status at 360 days). Conclusion Although data routinely collected by workers' compensation boards show some ability to predict prolonged time on benefits, adding information on experienced pain reported by the worker improves the predictive ability of the model from 'fairly good' to 'good'. In this study, a combination of prognostic factors, reported by multiple stakeholders, including the worker, could identify those at high risk of extended duration on disability benefits and in potentially in need of additional support at the individual level.

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

NASA Astrophysics Data System (ADS)

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

2010-01-01

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

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

PubMed

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

2016-04-01

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

A Conceptual Framework for Assessment of the Benefits of a Global Earth Observation System of Systems

NASA Astrophysics Data System (ADS)

Fritz, S.; Scholes, R. J.; Obersteiner, M.; Bouma, J.

2007-12-01

The aim of the Global Earth Observation System of Systems (GEOSS) is to contribute to human wellbeing though improving the information available to decision-makers at all levels relating to human health and safety, protection of the global environment, the reduction of losses from natural disasters, and achieving sustainable development. Specifically, GEOSS proposes that better international co-operation in the collection, interpretation and sharing of Earth Observation information is an important and cost-effective mechanism for achieving this aim. While there is a widespread intuition that this proposition is correct, at some point the following question needs to be answered: how much additional investment in Earth Observation (and specifically, in its international integration) is enough? This leads directly to some challenging subsidiary questions, such as how can the benefits of Earth Observation be assessed? What are the incremental costs of GEOSS? Are there societal benefit areas where the return on investment is higher than in others? The Geo-Bene project has developed a `benefit chain' concept as a framework for addressing these questions. The basic idea is that an incremental improvement in the observing system (including its data collection, interpretation and information-sharing aspects) will result in an improvement in the quality of decisions based on that information. This will in turn lead to better societal outcomes, which have a value. This incremental value must be judged against the incremental cost of the improved observation system. Since in many cases there will be large uncertainties in the estimation of both the costs and the benefits, and it may not be possible to express one or both of them in monetary terms, we show how order-of-magnitude approaches and a qualitative understanding of the shape of the cost-benefit curves can help guide rational investment decision in Earth Observation systems.

One bout of open skill exercise improves cross-modal perception and immediate memory in healthy older adults who habitually exercise.

PubMed

O'Brien, Jessica; Ottoboni, Giovanni; Tessari, Alessia; Setti, Annalisa

2017-01-01

One single bout of exercise can be associated with positive effects on cognition, due to physiological changes associated with muscular activity, increased arousal, and training of cognitive skills during exercise. While the positive effects of life-long physical activity on cognitive ageing are well demonstrated, it is not well established whether one bout of exercise is sufficient to register such benefits in older adults. The aim of this study was to test the effect of one bout of exercise on two cognitive processes essential to daily life and known to decline with ageing: audio-visual perception and immediate memory. Fifty-eight older adults took part in a quasi-experimental design study and were divided into three groups based on their habitual activity (open skill exercise (mean age = 69.65, SD = 5.64), closed skill exercise, N = 18, 94% female; sedentary activity-control group, N = 21, 62% female). They were then tested before and after their activity (duration between 60 and 80 minutes). Results showed improvement in sensitivity in audio-visual perception in the open skill group and improvements in one of the measures of immediate memory in both exercise groups, after controlling for baseline differences including global cognition and health. These findings indicate that immediate benefits for cross-modal perception and memory can be obtained after open skill exercise. However, improvements after closed skill exercise may be limited to memory benefits. Perceptual benefits are likely to be associated with arousal, while memory benefits may be due to the training effects provided by task requirements during exercise. The respective role of qualitative and quantitative differences between these activities in terms of immediate cognitive benefits should be further investigated. Importantly, the present results present the first evidence for a modulation of cross-modal perception by exercise, providing a plausible avenue for rehabilitation of cross-modal perception deficits, which are emerging as a significant contributor to functional decline in ageing.

Yoga and quality-of-life improvement in patients with breast cancer: a literature review.

PubMed

Levine, Alison Spatz; Balk, Judith L

2012-01-01

Women undergoing treatment for breast cancer often turn to complementary and alternative medicine (CAM), including yoga, for improvement of mood, quality of life (QOL), sleep, and treatment-related side effects. The extant literature was reviewed to examine the clinical effects of yoga practice on QOL for patients with breast cancer. QOL was defined as physical well-being, social functioning, emotional health, and function-al adaptation. Seven databases, including PubMed, Ovid MEDLINE, CINAHL, Embase, PsycINFO, Cochrane Library, and Web of Science were used to search for studies of patients with breast cancer that included a yoga intervention and QOL assessment. Attention was paid to assessing study population, outcome variables, the type of yoga intervention used, and methodological strengths and limitations. Seventy-one articles were identified that fit the search criteria. Although the literature provided evidence of QOL benefits of yoga for patients with breast cancer, no specific aspect of yoga was identified as being most advantageous. Although participation in yoga programs appeared to benefit patients with breast cancer, greater methodological rigor is required to understand the mechanisms that contribute to their effectiveness.

Aromatherapy as an adjuvant treatment in cancer care--a descriptive systematic review.

PubMed

Boehm, Katja; Büssing, Arndt; Ostermann, Thomas

2012-01-01

Claims of benefits of aromatherapy for cancer patients include reduced anxiety levels and relief of emotional stress, pain, muscular tension and fatigue. The objective of this paper is to provide an updated descriptive, systematic review of evidence from pre-clinical and clinical trials assessing the benefits and safety of aromatherapy for cancer patients. Literature databases such as Medline (via Ovid), the Cochrane database of systematic reviews, Cochrane Central were searched from their inception until October 2010. Only studies on cancer cells or cancer patients were included. There is no long lasting effect of aromatherapy massage, while short term improvements were reported for general well being, anxiety and depression up to 8 weeks after treatment. The reviewed studies indicate short-term effects of aromatherapy on depression, anxiety and overall wellbeing. Specifically, some clinical trials found an increase in patient-identified symptom relief, psychological wellbeing and improved sleep. Furthermore, some found a short-term improvement (up to 2 weeks after treatment) in anxiety and depression scores and better pain control. Although essential oils have generally shown minimal adverse effects, potential risks include ingesting large amounts (intentional misuse); local skin irritation, especially with prolonged skin contact; allergic contact dermatitis; and phototoxicity from reaction to sunlight (some oils). Repeated topical administration of lavender and tea tree oil was associated with reversible prepubertal gynecomastia.

Improvement of the cost-benefit analysis algorithm for high-rise construction projects

NASA Astrophysics Data System (ADS)

Gafurov, Andrey; Skotarenko, Oksana; Plotnikov, Vladimir

2018-03-01

The specific nature of high-rise investment projects entailing long-term construction, high risks, etc. implies a need to improve the standard algorithm of cost-benefit analysis. An improved algorithm is described in the article. For development of the improved algorithm of cost-benefit analysis for high-rise construction projects, the following methods were used: weighted average cost of capital, dynamic cost-benefit analysis of investment projects, risk mapping, scenario analysis, sensitivity analysis of critical ratios, etc. This comprehensive approach helped to adapt the original algorithm to feasibility objectives in high-rise construction. The authors put together the algorithm of cost-benefit analysis for high-rise construction projects on the basis of risk mapping and sensitivity analysis of critical ratios. The suggested project risk management algorithms greatly expand the standard algorithm of cost-benefit analysis in investment projects, namely: the "Project analysis scenario" flowchart, improving quality and reliability of forecasting reports in investment projects; the main stages of cash flow adjustment based on risk mapping for better cost-benefit project analysis provided the broad range of risks in high-rise construction; analysis of dynamic cost-benefit values considering project sensitivity to crucial variables, improving flexibility in implementation of high-rise projects.

Personality disorders: review and clinical application in daily practice.

PubMed

Angstman, Kurt B; Rasmussen, Norman H

2011-12-01

Personality disorders have been documented in approximately 9 percent of the general U.S. population. Psychotherapy, pharmacotherapy, and brief interventions designed for use by family physicians can improve the health of patients with these disorders. Personality disorders are classified into clusters A, B, and C. Cluster A includes schizoid, schizotypal, and paranoid personality disorders. Cluster B includes borderline, histrionic, antisocial, and narcissistic personality disorders. Cluster C disorders are more prevalent and include avoidant, dependent, and obsessive-compulsive personality disorders. Many patients with personality disorders can be treated by family physicians. Patients with borderline personality disorder may benefit from the use of omega-3 fatty acids, second-generation antipsychotics, and mood stabilizers. Patients with antisocial personality disorder may benefit from the use of mood stabilizers, antipsychotics, and antidepressants. Other therapeutic interventions include motivational interviewing and solution-based problem solving.

The Long-Term Public Health Benefits of Breastfeeding.

PubMed

Binns, Colin; Lee, MiKyung; Low, Wah Yun

2016-01-01

Breastfeeding has many health benefits, both in the short term and the longer term, to infants and their mothers. There is an increasing number of studies that report on associations between breastfeeding and long-term protection against chronic disease. Recent research evidence is reviewed in this study, building on previous authoritative reviews. The recent World Health Organization reviews of the short- and long-term benefits of breastfeeding concluded that there was strong evidence for many public health benefits of breastfeeding. Cognitive development is improved by breastfeeding, and infants who are breastfed and mothers who breastfeed have lower rates of obesity. Other chronic diseases that are reduced by breastfeeding include diabetes (both type 1 and type 2), obesity, hypertension, cardiovascular disease, hyperlipidemia, and some types of cancer. © 2015 APJPH.

Do the benefits outweigh the side effects of colorectal cancer surveillance? A systematic review.

PubMed

Augestad, Knut Magne; Rose, Johnie; Crawshaw, Benjamin; Cooper, Gregory; Delaney, Conor

2014-05-15

Most patients treated with curative intent for colorectal cancer (CRC) are included in a follow-up program involving periodic evaluations. The survival benefits of a follow-up program are well delineated, and previous meta-analyses have suggested an overall survival improvement of 5%-10% by intensive follow-up. However, in a recent randomized trial, there was no survival benefit when a minimal vs an intensive follow-up program was compared. Less is known about the potential side effects of follow-up. Well-known side effects of preventive programs are those of somatic complications caused by testing, negative psychological consequences of follow-up itself, and the downstream impact of false positive or false negative tests. Accordingly, the potential survival benefits of CRC follow-up must be weighed against these potential negatives. The present review compares the benefits and side effects of CRC follow-up, and we propose future areas for research.

Congenitally deafblind children and cochlear implants: effects on communication.

PubMed

Dammeyer, Jesper

2009-01-01

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

Forecasting the Economic Impact of Future Space Station Operations

NASA Technical Reports Server (NTRS)

Summer, R. A.; Smolensky, S. M.; Muir, A. H.

1967-01-01

Recent manned and unmanned Earth-orbital operations have suggested great promise of improved knowledge and of substantial economic and associated benefits to be derived from services offered by a space station. Proposed application areas include agriculture, forestry, hydrology, public health, oceanography, natural disaster warning, and search/rescue operations. The need for reliable estimates of economic and related Earth-oriented benefits to be realized from Earth-orbital operations is discussed and recent work in this area is reviewed. Emphasis is given to those services based on remote sensing. Requirements for a uniform, comprehensive and flexible methodology are discussed. A brief review of the suggested methodology is presented. This methodology will be exercised through five case studies which were chosen from a gross inventory of almost 400 user candidates. The relationship of case study results to benefits in broader application areas is discussed, Some management implications of possible future program implementation are included.

Benefits of Delay Tolerant Networking for Earth Science Missions

NASA Technical Reports Server (NTRS)

Davis, Faith; Marquart, Jane; Menke, Greg

2012-01-01

To date there has been much discussion about the value of Delay Tolerant Networking (DTN) for space missions. Claims of various benefits, based on paper analysis, are good; however a benefits statement with empirical evidence to support is even better. This paper presents potential and actual advantages of using DTN for Earth science missions based on results from multiple demonstrations, conducted by the Communications, Standards, and Technology Laboratory (CSTL) at NASA Goddard Space Flight Center (GSFC). Demonstrations included two flight demonstrations using the Earth Observing Mission 1 (EO-1) and the Near Earth Network (NEN), a ground based demonstration over satellite links to the Internet Router in Space (IRIS) payload on Intelsat-14, and others using the NASA Tracking Data Relay Satellite System (TDRSS). Real and potential findings include increased flexibility and efficiency in science campaigns, reduced latency in a collaborative science scenario, and improved scientist-instrument communication and control.

Survey of risks and benefits communication strategies by research nurses.

PubMed

Nusbaum, Lika; Douglas, Brenda; Estrella-Luna, Neenah; Paasche-Orlow, Michael; Damus, Karla

2017-01-01

An ethical, informed consent process requires that potential participants understand the study, their rights, and the risks and benefits. Yet, despite strategies to improve communication, many participants still lack understanding of potential risks and benefits. Investigating attitudes and practices of research nurses can identify ways to improve the informed consent process. What are the attitudes, practices, and preparedness of nurses involved in the informed consent process regarding communication of risks and benefits? A survey was developed and administered online to a national purposive sample of 107 research nurses with experience obtaining informed consent for clinical trials. Survey responses stratified by selected work-related characteristics were analyzed. Ethical considerations: Participants were instructed they need not answer each question and could stop at any time. They consented by clicking "accept" on the email which linked to the survey. The study was approved by the Northeastern University Institutional Review Board, Boston, Massachusetts (NU-IRB Protocol #: 13-06-17). Most research nurses (87%) used a teach-back method to assess participant comprehension, while 72% relied on their intuition. About one-third did not feel prepared to communicate related statistics. About 20% did not feel prepared to tailor information, and half did not feel competent using supplemental materials to enhance risks and benefits comprehension. Only 70% had received training in the informed consent process which included in-person training (84%), case studies (69%), online courses (57%), feedback during practice sessions (54%), and simulation, such as role playing (49%) and viewing videos (45%). Perceived preparedness was significantly associated with greater informed consent experience and training. Research nurses may have inadequate training to encourage, support, and reinforce communication of risks and benefits during the informed consent process. Relevant purposeful education and training should help to improve and standardize the ethical informed consent process.

Use of reinforced soil foundation (RSF) to support shallow foundation : summary report, November 2008.

DOT National Transportation Integrated Search

2008-05-01

This research study investigates the potential benefits of using reinforced soil foundations to improve the bearing : capacity and reduce the settlement of shallow foundations on soils. To implement this objective, a total of 117 : tests, including 3...

Lighting levels for isolated intersections : leading to safety improvements : final report.

DOT National Transportation Integrated Search

2015-01-01

A number of studies have linked the benefits of roadway lighting to a reduction in crash rates at night for a variety : of roadway types including rural intersections. Assessing the effectiveness of intersection lighting has primarily : relied upon c...

Preschool-Based Programs for Externalizing Problems

ERIC Educational Resources Information Center

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

2006-01-01

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

Use of reinforced soil foundation (RSF) to support shallow foundation : summary report.

DOT National Transportation Integrated Search

2008-05-01

This research study investigates the potential benefits of using reinforced soil foundations to improve the bearing capacity and reduce the settlement of shallow foundations on soils. To implement this objective, a total of 117 tests, including 38 la...

Designing, producing, and constructing fine-graded hot mix asphalt on Illinois roadways.

DOT National Transportation Integrated Search

2015-04-01

Fine-graded (F-G) asphalt concrete mixtures are composed of an aggregate structure in which the fine fraction controls the : load-carrying capacity of the mix. Other states have reported benefits in using F-G mixtures, including improved compaction, ...

Developing scientific information to support decisions for sustainable reef ecosystem services

EPA Science Inventory

The U.S. Environmental Protection Agency (EPA) has recently realigned its research enterprise around the concept of sustainability, including improving understanding of benefits derived from ecosystems. We provide an example of how EPA is applying structured decision-making (SDM)...

20 CFR 438.605 - Inspector General report.

Code of Federal Regulations, 2010 CFR

2010-04-01

....605 Employees' Benefits SOCIAL SECURITY ADMINISTRATION RESTRICTIONS ON LOBBYING Agency Reports § 438.605 Inspector General report. (a) The Inspector General of Social Security, or other official as... include any recommended changes that may be necessary to strengthen or improve the requirements. (b) The...

Putting ultrasound to use in food processing

USDA-ARS?s Scientific Manuscript database

Ultrasound has been applied to a wide range of food processing operations, both in research laboratories and commercially. This emerging technology has received a good deal of interest due to its green nature and nonthermal benefits, which include increased throughput, reduced cost, improved final ...

Engineered Structured Sorbents for the Adsorption of Carbon Dioxide and Water Vapor from Manned Spacecraft Atmospheres: Applications and Testing 2008/2009

NASA Technical Reports Server (NTRS)

Howard, David F.; Perry, Jay L.; Knox, James C.; Junaedi, Christian

2009-01-01

This paper describes efforts to improve on typical packed beds of sorbent pellets by making use of structured sorbents and alternate bed configurations to improve system efficiency and reliability. The benefits of the alternate configurations include increased structural stability gained by eliminating clay bound zeolite pellets that tend to fluidize and erode, and better thermal control during sorption to increase process efficiency. Test results that demonstrate such improvements are described and presented.

The Path to NGATS

NASA Technical Reports Server (NTRS)

Scardina, John

2006-01-01

NGATS operational Improvements and benefits include: 1) Broad area and precision navigation to access and capacity; 2) Airspace access and management to capacity; 3) 4D trajectory based ATM to capacity and efficiency; 4) Reduced separation between aircraft to capacity; 5) Flight deck situational awareness and delegation to capacity and safety; 6) ATM decision support to capacity; 7) Improved weather data and dissemination to capacity and safety; 8) Reduced cost to deliver ATM services to cost; 9) Greatly expanded airport network and improved terminals to capacity.

Does the expectation or perception of noncontraceptive benefits lead to higher rates of short-acting reversible contraceptive continuation for adolescents and young adult women?

PubMed

Lazorwitz, Aaron; Sheeder, Jeanelle; Teal, Stephanie; Guiahi, Maryam

2015-05-01

Continuation rates of short-acting contraception among young women are low; we attempted to determine if continuation is higher when women expect noncontraceptive benefits at initiation or perceive benefits 6 months later. A total of 243 young women ages 13-24 years initiating short-acting methods in an adolescent-only family planning clinic completed post-visit surveys that included directed and open-ended questions about anticipated noncontraceptive benefits. The study participants were contacted 6 months later. We compared contraceptive continuation between those who expected noncontraceptive benefits and those who did not and between those who reported experiencing benefits and those who did not. We examined the concordance between expectations and reported experiences. Six months after initiation, 69.3% of women were using the same method. Baseline expectation of noncontraceptive benefits was not associated with 6-month continuation. The experience of any benefit listed by the patient (odds ratio=2.69, 95% confidence interval 1.1, 6.0) was associated with greater continuation. Concordance between expectation and perception of noncontraceptive benefits was low (Kappa=0.2). Women who experienced noncontraceptive benefits at 6 months of use were more likely to continue short-acting contraception. Women who expected benefits when initiating were not more likely to report experiencing them, and many women who did not expect benefits reported them and were more likely to continue. These findings imply that building expectations of noncontraceptive benefits, e.g., through counseling, may not improve continuation and that new contraceptive development should include consideration of tangible noncontraceptive benefits. Although adolescents and young women who perceive noncontraceptive benefits after 6 months of use are more likely to continue, the expectation of such benefits does not correlate with continuation. Copyright © 2015 Elsevier Inc. All rights reserved.

Adjuvant and induction chemotherapy in non-small cell lung cancer.

PubMed

Pirker, R; Malayeri, R; Huber, H

1999-01-01

About 25%-30% of patients with non-small cell lung cancer can be resected with curative intent. However, systemic relapses occur in up to 70% of these patients. Thus, postoperative adjuvant chemotherapy was evaluated in several randomised trials but the results of these trials were inconclusive with a survival benefit only in some trials. Shortcomings of these trials included low number of patients, poor patient compliance and inadequate chemotherapy protocols. A recent meta-analysis suggested an absolute survival benefit of 5% at five years for postoperative cisplatin-based chemotherapy as compared to surgery alone. Thus adjuvant chemotherapy with both improved chemotherapy protocols and improved anti-emetics is currently re-evaluated in several randomised trials on large patient populations.

Tai Chi exercise and the improvement of health and well-being in older adults.

PubMed

Yau, Matthew Kwai-sang

2008-01-01

Activity participation has a positive impact on both quantity and quality of life (QOL). Regular participations in physical, social, and cultural activities are associated with successful aging. There is considerable evidence that Tai Chi has positive health benefits; physical, psychosocial and therapeutic. Furthermore, Tai Chi does not only consist of a physical component, but also sociocultural, meditative components that are believed to contribute to overall well-being. This chapter describes the benefits of Tai Chi exercise for the older adults, particularly in terms of the psychosocial aspect. The perceived meanings, associated values and well-being, as well as the impact on QOL, of Tai Chi practice among the older adults in Hong Kong are also discussed. Tai Chi exercise is chosen by the elderly participants for its gentle and soft movements. Besides the physical aspect, the benefits they describe include lifestyle issues, as well as psychological and social benefits. Evidence points out that the improvements in physical and mental health through the practice of Tai Chi among the older adults are related to their perceived level of QOL. Findings from numerous studies support the belief that the practice of Tai Chi has multiple benefits to practitioners that are not only physical in nature. It is recommended as a strategy to promote successful aging.

Benefits, barriers and opinions on multidisciplinary team meetings: a survey in Swedish cancer care.

PubMed

Rosell, Linn; Alexandersson, Nathalie; Hagberg, Oskar; Nilbert, Mef

2018-04-05

Case review and discussion at multidisciplinary team meetings (MDTMs) have evolved into standard practice in cancer care with the aim to provide evidence-based treatment recommendations. As a basis for work to optimize the MDTMs, we investigated participants' views on the meeting function, including perceived benefits and barriers. In a cross-sectional study design, 244 health professionals from south Sweden rated MDTM meeting structure and function, benefits from these meetings and barriers to reach a treatment recommendation. The top-ranked advantages from MDTMs were support for patient management and competence development. Low ratings applied to monitoring patients for clinical trial inclusion and structured work to improve the MDTM. Nurses and cancer care coordinators did less often than physicians report involvement in the case discussions. Major benefits from MDTM were reported to be more accurate treatment recommendations, multidisciplinary evaluation and adherence to clinical guidelines. Major barriers to a joint treatment recommendation were reported to be need for supplementary investigations and insufficient pathology reports. Health professionals' report multiple benefits from MDTMs, but also define areas for improvement, e.g. access to complete information and clarified roles for the different health professions. The emerging picture suggests that structures for regular MDTM evaluations and increased focus on patient-related perspectives should be developed and implemented.

Emphasizing the Health Benefits of Vitamin D for Those with Neurodevelopmental Disorders and Intellectual Disabilities

PubMed Central

Grant, William B.; Wimalawansa, Sunil J.; Holick, Michael F.; Cannell, John J.; Pludowski, Pawel; Lappe, Joan M.; Pittaway, Mary; May, Philip

2015-01-01

People with neurodevelopmental disorders and intellectual disabilities have much greater health care needs. Mainly staying indoors, such people generally have low 25-hydroxyvitamin D (25(OH)D) concentrations. The Vitamin D Task Force of the American Academy of Developmental Medicine and Dentistry (AADMD) reviewed the evidence of 25(OH)D concentrations that benefit the health of persons with developmental disabilities. Maintaining recommended optimal serum 25(OH)D concentrations year long will benefit skeletal development in infants, children, and adolescents, and benefit musculoskeletal health and neuromuscular coordination in adult patients, and decrease risk of falls. Maintaining optimal concentrations decreases risks and severities of autoimmune diseases, cardiovascular disease, many types of cancer, dementia, types 1 and 2 diabetes mellitus, and respiratory tract infections. Other benefits include improved dental and oral health and improved physical performance. The Task Force recommends that 25(OH)D concentrations for optimal health to be in the range of 75 to 125 nmol/L, which can be achieved using between 800 and 4000 IU/day vitamin D3 and sensible exposure to solar UVB radiation. The paper also discusses the potential risks of higher 25(OH)D concentrations, the evidence from and limitations of randomized controlled trials, and the recommendations by various groups and agencies. PMID:25734565

Five-year trends in women veterans' use of VA maternity benefits, 2008-2012.

PubMed

Mattocks, Kristin M; Frayne, Susan; Phibbs, Ciaran S; Yano, Elizabeth M; Zephyrin, Laurie; Shryock, Holly; Haskell, Sally; Katon, Jodie; Sullivan, J Cherry; Weinreb, Linda; Ulbricht, Christine; Bastian, Lori A

2014-01-01

An increasing number of young women veterans are returning from war and military service and are seeking reproductive health care from the Veterans Health Administration (VHA). Many of these women seek maternity benefits from the VHA, and yet little is known regarding the number of women veterans utilizing VHA maternity benefits nor the characteristics of pregnant veterans using these benefits. In May 2010, VHA maternity benefits were expanded to include 7 days of infant care, which may serve to entice more women to use VHA maternity benefits. Understanding the changing trends in women veterans seeking maternity benefits will help the VHA to improve the quality of reproductive care over time. The goal of this study was to examine the trends in delivery claims among women veterans receiving VHA maternity benefits over a 5-year period and the characteristics of pregnant veterans utilizing VHA benefits. We undertook a retrospective, national cohort study of pregnant veterans enrolled in VHA care with inpatient deliveries between fiscal years (FY) 2008 and 2012. We included pregnant veterans using VHA maternity benefits for delivery. Measures included annualized numbers and rates of inpatient deliveries and delivery-related costs, as well as cesarean section rates as a quality indicator. During the 5-year study period, there was a significant increase in the number of deliveries to women veterans using VHA maternity benefits. The overall delivery rate increased by 44% over the study period from 12.4 to 17.8 deliveries per 1,000 women veterans. A majority of women using VHA maternity benefits were age 30 or older and had a service-connected disability. From FY 2008 to 2012, the VHA paid more than $46 million in delivery claims to community providers for deliveries to women veterans ($4,993/veteran). Over a 5-year period, the volume of women veterans using VHA maternity benefits increased by 44%. Given this sizeable increase, the VHA must increase its capacity to care for pregnant veterans and ensure care coordination systems are in place to address the needs of pregnant veterans with service-connected disabilities. Published by Elsevier Inc.

The acceptability and potential benefits of mindfulness-based interventions in improving psychological well-being for adults with advanced cancer: A systematic review.

PubMed

Zimmermann, Fernanda F; Burrell, Beverley; Jordan, Jennifer

2018-02-01

In spite of supportive care for people affected by cancer being well recognized as a priority for research, there is little solid evidence of the effectiveness of psychological interventions using mindfulness for those with advanced cancer. This systematic review aims to describe, evaluate and synthesize the acceptability and potential benefits of mindfulness-based interventions (MBIs) for the psychological well-being of people with advanced cancers. Eight databases were searched and terms related to advanced stages of cancer and mindfulness were combined systematically to identify relevant published literature. Inclusion criteria were studies with adults only and all types of cancer at stages III and IV. There was considerable variety in the MBI treatment packages including in the extent and centrality of mindfulness in the interventions. Of 312 identified studies, only 8 included MBIs for people with advanced cancer rather than their families or carers. Results from these studies suggests that MBIs are acceptable and beneficial to the advanced cancer population, improving quality of life, use of mindfulness skills, acceptance of their cancer situation and reduction in depression and anxiety. Some adaptations were recommended however regarding delivery, simplified briefer MBIs, abbreviated session time, flexibility concerning locality of treatment and a minimized questionnaire burden for this group. MBI packages reviewed in this study had evidence of acceptability and of effectiveness, indicating potential benefit for this population. Individualized, including home-based interventions may be optimal to allow critically ill patients to participate in treatment. In future, MBIs adapted to the needs of various advanced cancer patients are recommended to address the gap in the field and improve health care. Copyright © 2017 Elsevier Ltd. All rights reserved.

The influence of age, hearing, and working memory on the speech comprehension benefit derived from an automatic speech recognition system.

PubMed

Zekveld, Adriana A; Kramer, Sophia E; Kessens, Judith M; Vlaming, Marcel S M G; Houtgast, Tammo

2009-04-01

The aim of the current study was to examine whether partly incorrect subtitles that are automatically generated by an Automatic Speech Recognition (ASR) system, improve speech comprehension by listeners with hearing impairment. In an earlier study (Zekveld et al. 2008), we showed that speech comprehension in noise by young listeners with normal hearing improves when presenting partly incorrect, automatically generated subtitles. The current study focused on the effects of age, hearing loss, visual working memory capacity, and linguistic skills on the benefit obtained from automatically generated subtitles during listening to speech in noise. In order to investigate the effects of age and hearing loss, three groups of participants were included: 22 young persons with normal hearing (YNH, mean age = 21 years), 22 middle-aged adults with normal hearing (MA-NH, mean age = 55 years) and 30 middle-aged adults with hearing impairment (MA-HI, mean age = 57 years). The benefit from automatic subtitling was measured by Speech Reception Threshold (SRT) tests (Plomp & Mimpen, 1979). Both unimodal auditory and bimodal audiovisual SRT tests were performed. In the audiovisual tests, the subtitles were presented simultaneously with the speech, whereas in the auditory test, only speech was presented. The difference between the auditory and audiovisual SRT was defined as the audiovisual benefit. Participants additionally rated the listening effort. We examined the influences of ASR accuracy level and text delay on the audiovisual benefit and the listening effort using a repeated measures General Linear Model analysis. In a correlation analysis, we evaluated the relationships between age, auditory SRT, visual working memory capacity and the audiovisual benefit and listening effort. The automatically generated subtitles improved speech comprehension in noise for all ASR accuracies and delays covered by the current study. Higher ASR accuracy levels resulted in more benefit obtained from the subtitles. Speech comprehension improved even for relatively low ASR accuracy levels; for example, participants obtained about 2 dB SNR audiovisual benefit for ASR accuracies around 74%. Delaying the presentation of the text reduced the benefit and increased the listening effort. Participants with relatively low unimodal speech comprehension obtained greater benefit from the subtitles than participants with better unimodal speech comprehension. We observed an age-related decline in the working-memory capacity of the listeners with normal hearing. A higher age and a lower working memory capacity were associated with increased effort required to use the subtitles to improve speech comprehension. Participants were able to use partly incorrect and delayed subtitles to increase their comprehension of speech in noise, regardless of age and hearing loss. This supports the further development and evaluation of an assistive listening system that displays automatically recognized speech to aid speech comprehension by listeners with hearing impairment.

Effectiveness of a video-based aging services technology education program for health care professionals.

PubMed

Weakley, Alyssa; Tam, Joyce W; Van Son, Catherine; Schmitter-Edgecombe, Maureen

2017-01-19

Health care professionals (HCPs) are a critical source of recommendations for older adults. Aging services technologies (ASTs), which include devices to support the health-care needs of older adults, are underutilized despite evidence for improving functional outcomes and safety and reducing caregiver burden and health costs. This study evaluated a video-based educational program aimed at improving HCP awareness of ASTs. Sixty-five HCPs viewed AST videos related to medication management, daily living, and memory. Following the program, participants' objective and perceived AST knowledge improved, as did self-efficacy and anticipated AST engagement. About 95% of participants stated they were more likely to recommend ASTs postprogram. Participants benefitted equally regardless of years of experience or previous AST familiarity. Furthermore, change in self-efficacy and perceived knowledge were significant predictors of engagement change. Overall, the educational program was effective in improving HCPs' awareness of ASTs and appeared to benefit all participants regardless of experience and prior knowledge.

A Systematic Review of Nutritional Supplementation in HIV-Infected Children in Resource-Limited Settings.

PubMed

McHenry, Megan S; Dixit, Avika; Vreeman, Rachel C

2015-01-01

In resource-limited settings, malnutrition is the major cause of death in young children, but the precise benefits of nutritional supplementation for HIV-infected children are not well understood. Two researchers reviewed studies conducted in low- or middle-income countries that involved macro- and micronutrient supplementation in HIV-infected individuals ≤18 years. Fifteen studies focused on micronutrients, including vitamin A, zinc, multivitamins, and multiple-micronutrient supplementation. The 8 macronutrient studies focused on ready-to-use foods (4 studies), spirulina, whey protein, general food rations, and F75 and F100 starter formulas. Vitamin A was associated with improved mortality rates, ranging from 28% to 63%. Multiple-micronutrient supplementations were not associated with improvement of measured health outcomes. Ready-to-use foods were associated with improvement in certain anthropometrics. Periodic vitamin A supplementation is associated with reduced mortality. Macronutrient supplementation is linked to improved anthropometrics. More research is needed to determine how nutritional supplementation benefits this particularly vulnerable population. © The Author(s) 2014.

Potential crashworthiness benefits to general aviation from Indianapolis Motor Speedway technology.

PubMed

Jennings, R T; Mohler, S R

1988-01-01

General aviation crashworthiness can potentially benefit from certain advances being accomplished by the automobile industry. Progressive improvements in crash protection technology, as documented by a dramatic reduction in crash injuries and fatalities at the Indianapolis Motor Speedway, reflect improved crashworthiness. The speeds of survivable general aviation aircraft impacts are in the range of the Indianapolis Motor Speedway crashes (200-220 mph). This paper relates the declining crash death rates at Indy by decade versus the increase in speeds. The continuous rise in speeds has prompted the development of new crashworthy designs and driver protection equipment. Crashworthiness improvements include crushable surrounding structures, high-grade restraint systems, protective head gear, fire resistant clothing, break-away structural components, and a "protective cocoon" concept. Adaptation of selected advances in crashworthiness design and operations accomplished at the Indianapolis Motor Speedway to the next generation of general aviation aircraft should provide significant dividends in survival of air crashes.

Improving lives using multidisciplinary education: partnering to benefit community, innovation, health, and technology.

PubMed

McClelland, Molly; Kleinke, Darrell

2013-07-01

University students are trained in specific disciplines, which can benefit disabled individuals in a variety of ways, including education, health promotion, assistive technologies, logistics, or design improvement. However, collaboration with other disciplines can have a greater impact on improving the health of disabled individuals than can training in one discipline alone. The University of Detroit Mercy Colleges of Engineering and Nursing have partnered to develop and provide assistive devices to disabled individuals while teaching innovation, technology, and collaboration to students. After 4 years of developing and implementing our multidisciplinary program, numerous unique and helpful assistive devices have been designed, created, and delivered to individuals in our community. More nursing schools should initiate multidisciplinary programs to train and prepare students for workplaces where such innovative, collaborative skills are increasingly sought. Nurses need to be at the forefront of such collaborative work. Copyright 2013, SLACK Incorporated.

An analysis of landing rates and separations at the Dallas/Fort Worth International Airport

NASA Technical Reports Server (NTRS)

Ballin, Mark G.; Erzberger, Heinz

1996-01-01

Advanced air traffic management systems such as the Center/TRACON Automation System (CTAS) should yield a wide range of benefits, including reduced aircraft delays and controller workload. To determine the traffic-flow benefits achievable from future terminal airspace automation, live radar information was used to perform an analysis of current aircraft landing rates and separations at the Dallas/Fort Worth International Airport. Separation statistics that result when controllers balance complex control procedural constraints in order to maintain high landing rates are presented. In addition, the analysis estimates the potential for airport capacity improvements by determining the unused landing opportunities that occur during rush traffic periods. Results suggest a large potential for improving the accuracy and consistency of spacing between arrivals on final approach, and they support earlier simulation findings that improved air traffic management would increase capacity and reduce delays.

Investigation of enzyme formulation on pretreated switchgrass.

PubMed

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

2011-12-01

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

Standardized rendering from IR surveillance motion imagery

NASA Astrophysics Data System (ADS)

Prokoski, F. J.

2014-06-01

Government agencies, including defense and law enforcement, increasingly make use of video from surveillance systems and camera phones owned by non-government entities.Making advanced and standardized motion imaging technology available to private and commercial users at cost-effective prices would benefit all parties. In particular, incorporating thermal infrared into commercial surveillance systems offers substantial benefits beyond night vision capability. Face rendering is a process to facilitate exploitation of thermal infrared surveillance imagery from the general area of a crime scene, to assist investigations with and without cooperating eyewitnesses. Face rendering automatically generates greyscale representations similar to police artist sketches for faces in surveillance imagery collected from proximate locations and times to a crime under investigation. Near-realtime generation of face renderings can provide law enforcement with an investigation tool to assess witness memory and credibility, and integrate reports from multiple eyewitnesses, Renderings can be quickly disseminated through social media to warn of a person who may pose an immediate threat, and to solicit the public's help in identifying possible suspects and witnesses. Renderings are pose-standardized so as to not divulge the presence and location of eyewitnesses and surveillance cameras. Incorporation of thermal infrared imaging into commercial surveillance systems will significantly improve system performance, and reduce manual review times, at an incremental cost that will continue to decrease. Benefits to criminal justice would include improved reliability of eyewitness testimony and improved accuracy of distinguishing among minority groups in eyewitness and surveillance identifications.

Quality of life of patients who underwent aesthetic rhinoplasty: 100 cases assessed with the Glascow Benefit Inventory.

PubMed

Kotzampasakis, Dimitrios; Piniara, Anastasia; Themelis, Sotirios; Kotzampasakis, Stylianos; Gabriel, Eustratios; Maroudias, Nikos; Nikolopoulos, Thomas

2017-09-01

The aim of the present study is to assess the long-term effect of classic rhinoplasty on patients' quality of life. Outcomes research. The study included 100 operated patients; there were 34 males and 66 females. The ages ranged between 23 and 57 years old, with a mean of 36.4 years. A minimum of 3 years between the operation and the study was selected to assess the long-term effect of the operation on the patients' quality of life and exclude any short-term impressions. The time elapsed between surgery and the time of the study ranged from 3 to 13 years, with a mean of 6.8 years. Patients were assessed using the Glasgow Benefit Inventory, which has been proven valid and reliable in ear, nose, and throat interventions. From the 100 patients included in the study, 92 reported improvement in their quality of life due to the operation and only eight worsening. In the social support subscale, 97 patients reported better quality of life, and only three patients reported worse quality of life. The patients' overall life markedly improved, reaching a mean of 80% in the Glasgow Benefit Inventory. The present long-term study using a validated and reliable instrument concludes that rhinoplasty improves the quality of life of patients in all sectors. 2c Laryngoscope, 127:2017-2025, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Metro nature, environmental health, and economic value.

PubMed

Wolf, Kathleen L; Robbins, Alicia S T

2015-05-01

Nearly 40 years of research provides an extensive body of evidence about human health, well-being, and improved function benefits associated with experiences of nearby nature in cities. We demonstrate the numerous opportunities for future research efforts that link metro nature, human health and well-being outcomes, and economic values. We reviewed the literature on urban nature-based health and well-being benefits. In this review, we provide a classification schematic and propose potential economic values associated with metro nature services. Economic valuation of benefits derived from urban green systems has largely been undertaken in the fields of environmental and natural resource economics, but studies have not typically addressed health outcomes. Urban trees, parks, gardens, open spaces, and other nearby nature elements-collectively termed metro nature-generate many positive externalities that have been largely overlooked in urban economics and policy. Here, we present a range of health benefits, including benefit context and beneficiaries. Although the understanding of these benefits is not yet consistently expressed, and although it is likely that attempts to link urban ecosystem services and economic values will not include all expressions of cultural or social value, the development of new interdisciplinary approaches that integrate environmental health and economic disciplines are greatly needed. Metro nature provides diverse and substantial benefits to human populations in cities. In this review, we begin to address the need for development of valuation methodologies and new approaches to understanding the potential economic outcomes of these benefits.

Swedish Massage: A Systematic Review of its Physical and Psychological Benefits.

PubMed

Barreto, Débora M; Batista, Marcus V A

2017-01-01

Context • Swedish massage is the systematic application of manual pressure and the movement of soft tissue, with rhythmical pressure and stroking to obtain or maintain health. Studies have revealed its many benefits. Objective • The aim of the current study was to determine the results of past studies that evaluated the benefits of Swedish massage for various populations and to highlight its relevance as an alternative medical practice in health promotion and disease prevention. Methods • The research team performed a review of the literature using the key terms massage, relaxation, and benefits of massage. Original case reports and literature reviews of manual therapy published from 2004 to 2014 were included in the current review. The search was conducted using the SciELO, PubMed, and Medline databases. Setting • The study was performed at the Central Library of the Federal University of Sergipe, in São Cristóvão, Sergipe, Brazil. Participants • Participants in the reviewed studies included varied populations, such as nurses in hospitals, infants and older children, pregnant women, older adults, and cancer patients. Results • A total of 4516 articles were identified for consideration through the electronic database searches. After screening, 117 potentially relevant articles were identified for full review, and 11 studies met the inclusion criteria. The studies showed beneficial results in most cases, including improved nasal breathing and cleanliness in children, reduced lower-back pain for nurses, and improved adrenocortical function in infants. Massage is not completely risk free, however, and should be done by a professional very cautiously. Conclusions • Swedish massage has shown beneficial effects for multiple populations and can be used as a therapy. Its use in disease prevention is highly recommended.

Targeting Nicotine Addiction in a Substance Abuse Program

PubMed Central

Sharp, James R.; Schwartz, Steven; Nightingale, Thomas; Novak, Steven

2003-01-01

The potential benefits of addressing nicotine addiction as part of substance dependency treatment may include improved response to interventions for other addictions and, over the long term, reduced tobacco-related morbidity and mortality. The authors recount the experiences of three inpatient programs that instituted nicotine addiction interventions and a tobacco-free policy for both facilities and patients. After making adjustments to counter temporary adverse effects of the policy, two of the programs are achieving higher overall treatment completion rates than prior to implementation. Outstanding research issues include quantifying the costs and benefits of the antinicotine interventions, determining the long-term impact of tobacco-free treatment, and tailoring treatment to various patient groups. PMID:18552720

Assessing health and economic outcomes of interventions to reduce pregnancy-related mortality in Nigeria.

PubMed

Erim, Daniel O; Resch, Stephen C; Goldie, Sue J

2012-09-14

Women in Nigeria face some of the highest maternal mortality risks in the world. We explore the benefits and cost-effectiveness of individual and integrated packages of interventions to prevent pregnancy-related deaths. We adapt a previously validated maternal mortality model to Nigeria. Model outcomes included clinical events, population measures, costs, and cost-effectiveness ratios. Separate models were adapted to Southwest and Northeast zones using survey-based data. Strategies consisted of improving coverage of effective interventions, and could include improved logistics. Increasing family planning was the most effective individual intervention to reduce pregnancy-related mortality, was cost saving in the Southwest zone and cost-effective elsewhere, and prevented nearly 1 in 5 abortion-related deaths. However, with a singular focus on family planning and safe abortion, mortality reduction would plateau below MDG 5. Strategies that could prevent 4 out of 5 maternal deaths included an integrated and stepwise approach that includes increased skilled deliveries, facility births, access to antenatal/postpartum care, improved recognition of referral need, transport, and availability quality of EmOC in addition to family planning and safe abortion. The economic benefits of these strategies ranged from being cost-saving to having incremental cost-effectiveness ratios less than $500 per YLS, well below Nigeria's per capita GDP. Early intensive efforts to improve family planning and control of fertility choices, accompanied by a stepwise effort to scale-up capacity for integrated maternal health services over several years, will save lives and provide equal or greater value than many public health interventions we consider among the most cost-effective (e.g., childhood immunization).

Improved Storm Monitoring and Prediction for the San Francisco Bay Area

NASA Astrophysics Data System (ADS)

Cifelli, R.; Chandrasekar, V.; Anderson, M.; Davis, G.

2017-12-01

The Advanced Quantitative Precipitation Information (AQPI) System is a multi-faceted project to improve precipitation and hydrologic monitoring, prediction, and decision support for the San Francisco Bay Area. The Bay Area faces a multitude of threats from extreme events, including disrupted transportation from flooded roads and railroad lines, water management challenges related to storm water, river and reservoir management and storm-related damage demanding emergency response. The threats occur on spatial scales ranging from local communities to the entire region and time scales ranging from hours to days. These challenges will be exacerbated by future sea level rise, more extreme weather events and increased vulnerabilities. AQPI is a collaboration of federal, state and local governments with assistance from the research community. Led by NOAA's Earth System Research Laboratory, in partnership with the Cooperative Institute for Research in the Atmosphere, USGS, and Scripps, AQPI is a four-year effort funded in part by a grant from the California Department of Water Resource's Integrated Regional Water Management Program. The Sonoma County Water Agency is serving as the local sponsor of the project. Other local participants include the Santa Clara Valley Water District, San Francisco Public Utilities Commission, and the Bay Area Flood Protection Agencies Association. AQPI will provide both improved observing capabilities and a suite of numerical forecast models to produce accurate and timely information for benefit of flood management, emergency response, water quality, ecosystem services, water supply and transportation management for the Bay Area. The resulting information will support decision making to mitigate flood risks, secure water supplies, minimize water quality impacts to the Bay from combined sewer overflows, and have improved lead-time on coastal and Bay inundation from extreme storms like Atmospheric Rivers (ARs). The project is expected to provide benefits exceeding costs at a reasonable level. This presentation will provide an overview of AQPI, including example products and anticipated benefits to the Bay area.

Cochlear implantation with hearing preservation yields significant benefit for speech recognition in complex listening environments.

PubMed

Gifford, René H; Dorman, Michael F; Skarzynski, Henryk; Lorens, Artur; Polak, Marek; Driscoll, Colin L W; Roland, Peter; Buchman, Craig A

2013-01-01

The aim of this study was to assess the benefit of having preserved acoustic hearing in the implanted ear for speech recognition in complex listening environments. The present study included a within-subjects, repeated-measures design including 21 English-speaking and 17 Polish-speaking cochlear implant (CI) recipients with preserved acoustic hearing in the implanted ear. The patients were implanted with electrodes that varied in insertion depth from 10 to 31 mm. Mean preoperative low-frequency thresholds (average of 125, 250, and 500 Hz) in the implanted ear were 39.3 and 23.4 dB HL for the English- and Polish-speaking participants, respectively. In one condition, speech perception was assessed in an eight-loudspeaker environment in which the speech signals were presented from one loudspeaker and restaurant noise was presented from all loudspeakers. In another condition, the signals were presented in a simulation of a reverberant environment with a reverberation time of 0.6 sec. The response measures included speech reception thresholds (SRTs) and percent correct sentence understanding for two test conditions: CI plus low-frequency hearing in the contralateral ear (bimodal condition) and CI plus low-frequency hearing in both ears (best-aided condition). A subset of six English-speaking listeners were also assessed on measures of interaural time difference thresholds for a 250-Hz signal. Small, but significant, improvements in performance (1.7-2.1 dB and 6-10 percentage points) were found for the best-aided condition versus the bimodal condition. Postoperative thresholds in the implanted ear were correlated with the degree of electric and acoustic stimulation (EAS) benefit for speech recognition in diffuse noise. There was no reliable relationship among measures of audiometric threshold in the implanted ear nor elevation in threshold after surgery and improvement in speech understanding in reverberation. There was a significant correlation between interaural time difference threshold at 250 Hz and EAS-related benefit for the adaptive speech reception threshold. The findings of this study suggest that (1) preserved low-frequency hearing improves speech understanding for CI recipients, (2) testing in complex listening environments, in which binaural timing cues differ for signal and noise, may best demonstrate the value of having two ears with low-frequency acoustic hearing, and (3) preservation of binaural timing cues, although poorer than observed for individuals with normal hearing, is possible after unilateral cochlear implantation with hearing preservation and is associated with EAS benefit. The results of this study demonstrate significant communicative benefit for hearing preservation in the implanted ear and provide support for the expansion of CI criteria to include individuals with low-frequency thresholds in even the normal to near-normal range.

Cochlear implantation with hearing preservation yields significant benefit for speech recognition in complex listening environments

PubMed Central

Gifford, René H.; Dorman, Michael F.; Skarzynski, Henryk; Lorens, Artur; Polak, Marek; Driscoll, Colin L. W.; Roland, Peter; Buchman, Craig A.

2012-01-01

Objective The aim of this study was to assess the benefit of having preserved acoustic hearing in the implanted ear for speech recognition in complex listening environments. Design The current study included a within subjects, repeated-measures design including 21 English speaking and 17 Polish speaking cochlear implant recipients with preserved acoustic hearing in the implanted ear. The patients were implanted with electrodes that varied in insertion depth from 10 to 31 mm. Mean preoperative low-frequency thresholds (average of 125, 250 and 500 Hz) in the implanted ear were 39.3 and 23.4 dB HL for the English- and Polish-speaking participants, respectively. In one condition, speech perception was assessed in an 8-loudspeaker environment in which the speech signals were presented from one loudspeaker and restaurant noise was presented from all loudspeakers. In another condition, the signals were presented in a simulation of a reverberant environment with a reverberation time of 0.6 sec. The response measures included speech reception thresholds (SRTs) and percent correct sentence understanding for two test conditions: cochlear implant (CI) plus low-frequency hearing in the contralateral ear (bimodal condition) and CI plus low-frequency hearing in both ears (best aided condition). A subset of 6 English-speaking listeners were also assessed on measures of interaural time difference (ITD) thresholds for a 250-Hz signal. Results Small, but significant, improvements in performance (1.7 – 2.1 dB and 6 – 10 percentage points) were found for the best-aided condition vs. the bimodal condition. Postoperative thresholds in the implanted ear were correlated with the degree of EAS benefit for speech recognition in diffuse noise. There was no reliable relationship among measures of audiometric threshold in the implanted ear nor elevation in threshold following surgery and improvement in speech understanding in reverberation. There was a significant correlation between ITD threshold at 250 Hz and EAS-related benefit for the adaptive SRT. Conclusions Our results suggest that (i) preserved low-frequency hearing improves speech understanding for CI recipients (ii) testing in complex listening environments, in which binaural timing cues differ for signal and noise, may best demonstrate the value of having two ears with low-frequency acoustic hearing and (iii) preservation of binaural timing cues, albeit poorer than observed for individuals with normal hearing, is possible following unilateral cochlear implantation with hearing preservation and is associated with EAS benefit. Our results demonstrate significant communicative benefit for hearing preservation in the implanted ear and provide support for the expansion of cochlear implant criteria to include individuals with low-frequency thresholds in even the normal to near-normal range. PMID:23446225

Two randomized, controlled, comparative studies of the stratum corneum integrity benefits of two cosmetic niacinamide/glycerin body moisturizers vs. conventional body moisturizers.

PubMed

Christman, Jeremy C; Fix, Deborah K; Lucus, Sawanna C; Watson, Debrah; Desmier, Emma; Wilkerson, Rolanda J Johnson; Fixler, Charles

2012-01-01

Despite numerous body moisturizers being available, cosmetic xerosis continues to be a leading skin problem for consumers. We performed two 35-day studies to evaluate the ability of a variety of body moisturizers containing various levels of oils/lipids, humectants, as well as other ingredients (e.g., niacinamide) to improve stratum corneum integrity. 63 and 58 female subjects were enrolled and randomized in an incomplete block design to six of nine products (eight moisturizers or no treatment control) in studies 1 and 2, respectively. The primary endpoints included visual dryness by a qualified skin grader, skin hydration as measured by Corneometer, and barrier integrity as measured by transepidermal water loss (TEWL). The primary comparisons for the two niacinamide/glycerin moisturizers were to the other six moisturizers and to the no treatment control for each endpoint. The two niacinamide/glycerin moisturizers demonstrated an overall better solution towards rapid and prolonged improvement of cosmetic xerosis due to functional improvement of stratum corneum barrier function compared to no treatment and the other moisturizers tested. These studies establish the benefit of including niacinamide in a body moisturizer to improve the integrity of the stratum corneum and thus reduce cosmetic xerosis over time.

[Cost-effectiveness and cost-benefit analysis on the integrated schistosomiasis control strategies with emphasis on infection source in Poyang Lake region].

PubMed

Lin, Dan-Dan; Zeng, Xiao-Jun; Chen, Hong-Gen; Hong, Xian-Lin; Tao, Bo; Li, Yi-Feng; Xiong, Ji-Jie; Zhou, Xiao-Nong

2009-08-01

To evaluate the cost-effectiveness and cost-benefit on the integrated schistosomiasis control strategies with emphasis on infection source, and provide scientific basis for the improvement of schistosomiasis control strategy. Aiguo and Xinhe villages in Jinxian County were selected as intervention group where the new comprehensive strategy was implemented, while Ximiao and Zuxi villages in Xinzi County served as control where routine control program was implemented. New strategy of interventions included removing cattle from snail-infested grasslands and providing farmers with farm machinery, improving sanitation by supplying tap water and building lavatories and methane gas tanks, and implementing an intensive health education program. Routine interventions were carried out in the control villages including diagnosis and treatment for human and cattle, health education, and focal mollusciciding. Data were collected from retrospective investigation and field survey for the analysis and comparison of cost-effectiveness and cost-benefit between intervention and control groups. The control effect of the intervention group was better than that of the control. The cost for 1% decrease of infection rate per 100 people, 100 cattle, and 100 snails in intervention group was 480.01, 6 851.24, and 683.63 Yuan, respectively, which were about 2.70, 4.37 and 20.25 times as those in the control respectively. The total cost/benefit ratio (BCR) was lower than 1 (0.94 in intervention group and 0.08 in the control). But the total benefit of intervention group was higher than that of the control from 2005 to 2008. The forecasting analysis indicated that the total BCR in intervention group would be 1.13 at the 4th year and all cost could be recalled. Sensitivity analysis revealed that the BCR in intervention group changed in the range around 1.0 and that of the control ranged blow 0.5. The cost-benefit of intervention group was evidently higher than that of the control. The integrated control strategy focusing on infection source control brings about triplex benefits in schistosomiasis control, social development (and ecological protection) and economic efficacy, and shows better effects and benefits than the conventional control strategy.

Octogenarian and centenarian performance on the Fuld Object Memory Evaluation.

PubMed

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

2015-01-01

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

Improved Throughput with Cooperating Futuristic Airspace Management Components

NASA Technical Reports Server (NTRS)

Glaab, Patricia C.

2013-01-01

An experiment was conducted to integrate airspace management tools that would typically be confined to either the en route or the terminal airspace to explore the potential benefits of their communication to improve arrival capacity. A NAS-wide simulation was configured with a new concept component that used the information to reconfigure the terminal airspace to the capacity benefit of the airport. Reconfiguration included a dynamically expanding and contracting TRACON area and a varying number of active arrival runways, both automatically selected to accommodate predicted volume of traffic. ATL and DFW were selected for the study. Results showed significant throughput increase for scenarios that are considered to be over-capacity for current day airport configurations. During periods of sustained demand for ATL 2018, throughput increased by 26 operations per hour (30%) and average delay was reduced from 18 minutes to 8 minutes per flight when using the dynamic TRACON. Similar results were obtained for DFW with 2018 traffic levels and for ATL with 2006 traffic levels, but with lower benefits due to lower demand.

Greenbelt Homes Pilot Program: Summary of Building Envelope Retrofits, Planned HVAC Equipment Upgrades, and Energy Savings

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

Wiehagen, J.; Del Bianco, M.; Mallay, D.

2015-05-01

In the fall of 2010, a multiyear pilot energy efficiency retrofit project was undertaken by Greenbelt Homes, Inc, (GHI) a 1,566 home cooperative of circa 1930 and 1940 homes in Greenbelt, Maryland. GHI established this pilot project to serve as a basis for decision making for the rollout of a decade-long community-wide upgrade program that will incorporate energy efficiency improvements to the building envelope and mechanical equipment. It presents a unique opportunity to evaluate and prioritize the wide-range of benefits of high-performance retrofits based on member experience with and acceptance of the retrofit measures implemented during the pilot project. Addressingmore » the complex interactions between benefits, trade-offs, construction methods, project management implications, realistic upfront costs, financing, and other considerations, serves as a case study for energy retrofit projects to include high-performance technologies based on the long-term value to the homeowner. The pilot project focused on identifying the added costs and energy savings benefits of improvements.« less

Benefits of music training are widespread and lifelong: a bibliographic review of their non-musical effects.

PubMed

Dawson, William J

2014-06-01

Recent publications indicate that musical training has effects on non-musical activities, some of which are lifelong. This study reviews recent publications collected from the Performing Arts Medicine Association bibliography. Music training, whether instrumental or vocal, produces beneficial and long-lasting changes in brain anatomy and function. Anatomic changes occur in brain areas devoted to hearing, speech, hand movements, and coordination between both sides of the brain. Functional benefits include improved sound processing and motor skills, especially in the upper extremities. Training benefits extend beyond music skills, resulting in higher IQs and school grades, greater specialized sensory and auditory memory/recall, better language memory and processing, heightened bilateral hand motor functioning, and improved integration and synchronization of sensory and motor functions. These changes last long after music training ends and can minimize or prevent age-related loss of brain cells and some mental functions. Early institution of music training and prolonged duration of training both appear to contribute to these positive changes.

Economic benefits of improved meteorological forecasts - The construction industry

NASA Technical Reports Server (NTRS)

Bhattacharyya, R. K.; Greenberg, J. S.

1976-01-01

Estimates are made of the potential economic benefits accruing to particular industries from timely utilization of satellite-derived six-hour weather forecasts, and of economic penalties resulting from failure to utilize such forecasts in day-to-day planning. The cost estimate study is centered on the U.S. construction industry, with results simplified to yes/no 6-hr forecasts on thunderstorm activity and work/no work decisions. Effects of weather elements (thunderstorms, snow and sleet) on various construction operations are indicated. Potential dollar benefits for other industries, including air transportation and other forms of transportation, are diagrammed for comparison. Geosynchronous satellites such as STORMSAT, SEOS, and SMS/GOES are considered as sources of the forecast data.

Compression of CCD raw images for digital still cameras

NASA Astrophysics Data System (ADS)

Sriram, Parthasarathy; Sudharsanan, Subramania

2005-03-01

Lossless compression of raw CCD images captured using color filter arrays has several benefits. The benefits include improved storage capacity, reduced memory bandwidth, and lower power consumption for digital still camera processors. The paper discusses the benefits in detail and proposes the use of a computationally efficient block adaptive scheme for lossless compression. Experimental results are provided that indicate that the scheme performs well for CCD raw images attaining compression factors of more than two. The block adaptive method also compares favorably with JPEG-LS. A discussion is provided indicating how the proposed lossless coding scheme can be incorporated into digital still camera processors enabling lower memory bandwidth and storage requirements.

Use of reinforced soil foundation (RSF) to support shallow foundation : final report, November 2008.

DOT National Transportation Integrated Search

2008-11-01

This research study aims at investigating the potential benefits of using reinforced soil foundations to improve the bearing capacity and reduce the settlement of shallow foundations on soils. To implement this objective, a total of 117 tests, includ...

Evaluation of Environmental Education in Schools.

ERIC Educational Resources Information Center

Connect, 1984

1984-01-01

This newsletter discusses the evaluation of environmental education (EE) in schools, highlighting an introductory chapter of a proposed Unesco-United Nations environmental program guide on evaluating such programs. The benefits of evaluating an EE program (including program improvement, growth in student learning, better environment, and program…

Impact of cover crops on soil nitrate, crop yield and quality

USDA-ARS?s Scientific Manuscript database

There are multiple benefits of incorporating cover crops into current production systems including decreasing erosion, improving water infiltration, increasing soil organic matter and biological activity but in water limited areas caution should be utilized. A field study was established in the fal...

Multi-scale monitoring for improved nutrient management

USDA-ARS?s Scientific Manuscript database

In many watersheds, monitoring at the outlet of small watersheds has not been able to demonstrate that conservation efforts have had any impact on stream water quality. Reasons are multiple including legacy issues, time for the conservation practices to have any benefit, temporal variability of weat...

Energy 101: Electric Vehicles

ScienceCinema

None

2018-03-02

This edition of Energy 101 highlights the benefits of electric vehicles, including improved fuel efficiency, reduced emissions, and lower maintenance costs. For more information on electric vehicles from the Office of Energy Efficiency and Renewable Energy, visit the Vehicle Technologies Program website: http://www1.eere.energy.gov/vehiclesandfuels/

This Good-Health Regimen Keeps Employes Fit--And School Budgets Trim.

ERIC Educational Resources Information Center

Collingwood, Thomas R.

1984-01-01

The Dallas Independent School District's staff stress reduction and health awareness program is described. The program features medical screening, fitness assessment, goal setting, exercise and nutrition prescriptions, health education, exercise classes, motivation, and feedback. Benefits reported include significantly improved health and attitude…

Using Stan for Item Response Theory Models

ERIC Educational Resources Information Center

Ames, Allison J.; Au, Chi Hang

2018-01-01

Stan is a flexible probabilistic programming language providing full Bayesian inference through Hamiltonian Monte Carlo algorithms. The benefits of Hamiltonian Monte Carlo include improved efficiency and faster inference, when compared to other MCMC software implementations. Users can interface with Stan through a variety of computing…

Innovations in surgery simulation: a review of past, current and future techniques

PubMed Central

Burtt, Karen; Solorzano, Carlos A.; Carey, Joseph N.

2016-01-01

As a result of recent work-hours limitations and concerns for patient safety, innovations in extraclinical surgical simulation have become a desired part of residency education. Current simulation models, including cadaveric, animal, bench-top, virtual reality (VR) and robotic simulators are increasingly used in surgical training programs. Advances in telesurgery, three-dimensional (3D) printing, and the incorporation of patient-specific anatomy are paving the way for simulators to become integral components of medical training in the future. Evidence from the literature highlights the benefits of including simulations in surgical training; skills acquired through simulations translate into improvements in operating room performance. Moreover, simulations are rapidly incorporating new medical technologies and offer increasingly high-fidelity recreations of procedures. As a result, both novice and expert surgeons are able to benefit from their use. As dedicated, structured curricula are developed that incorporate simulations into daily resident training, simulated surgeries will strengthen the surgeon’s skill set, decrease hospital costs, and improve patient outcomes. PMID:28090509

Emerging Trends in Healthcare Adoption of Wireless Body Area Networks.

PubMed

Rangarajan, Anuradha

2016-01-01

Real-time personal health monitoring is gaining new ground with advances in wireless communications. Wireless body area networks (WBANs) provide a means for low-powered sensors, affixed either on the human body or in vivo, to communicate with each other and with external telecommunication networks. The healthcare benefits of WBANs include continuous monitoring of patient vitals, measuring postacute rehabilitation time, and improving quality of medical care provided in medical emergencies. This study sought to examine emerging trends in WBAN adoption in healthcare. To that end, a systematic literature survey was undertaken against the PubMed database. The search criteria focused on peer-reviewed articles that contained the keywords "wireless body area network" and "healthcare" or "wireless body area network" and "health care." A comprehensive review of these articles was performed to identify adoption dimensions, including underlying technology framework, healthcare subdomain, and applicable lessons-learned. This article benefits healthcare technology professionals by identifying gaps in implementation of current technology and highlighting opportunities for improving products and services.

Innovations in surgery simulation: a review of past, current and future techniques.

PubMed

Badash, Ido; Burtt, Karen; Solorzano, Carlos A; Carey, Joseph N

2016-12-01

As a result of recent work-hours limitations and concerns for patient safety, innovations in extraclinical surgical simulation have become a desired part of residency education. Current simulation models, including cadaveric, animal, bench-top, virtual reality (VR) and robotic simulators are increasingly used in surgical training programs. Advances in telesurgery, three-dimensional (3D) printing, and the incorporation of patient-specific anatomy are paving the way for simulators to become integral components of medical training in the future. Evidence from the literature highlights the benefits of including simulations in surgical training; skills acquired through simulations translate into improvements in operating room performance. Moreover, simulations are rapidly incorporating new medical technologies and offer increasingly high-fidelity recreations of procedures. As a result, both novice and expert surgeons are able to benefit from their use. As dedicated, structured curricula are developed that incorporate simulations into daily resident training, simulated surgeries will strengthen the surgeon's skill set, decrease hospital costs, and improve patient outcomes.

Patient and partner perspectives on patient-delivered partner screening: acceptability, benefits, and barriers.

PubMed

McBride, Kimberly R; Goldsworthy, Richard C; Fortenberry, J Dennis

2010-10-01

The study examined willingness to engage in patient-delivered partner screening (PDPS) and preferences for expedited partner services (EPS). Forty urban U.S. sexually transmitted infection (STI) clinic patients participated in individual mixed-methods interviews exploring EPS preferences and PDPS willingness. Most participants selected PDPS and PDPT together and uptake varied by patient–partner relationship closeness. For PDPS, several potentially important barriers and benefits were identified. Perceived benefits included improved sexual health for patients and their sexual partner(s) as well as convenience, privacy, and the potential to enhance trust between sexual partners. Perceived barriers included concerns about PDPS processes (e.g., time it would take to receive the result, risk of sample contamination), the accuracy of results, STI stigma and associated blame, lack of trust for a sexual partner, and the packaging/appearance of the screening kit. PDPS affords benefits and may overcome treatment barriers in some situations; however, it shares common PDPT barriers and has its own unique challenges. There are also concerns regarding how the offer of PDPS may interact with PDPT utilization.

Computerized clinical decision support systems for drug prescribing and management: a decision-maker-researcher partnership systematic review.

PubMed

Hemens, Brian J; Holbrook, Anne; Tonkin, Marita; Mackay, Jean A; Weise-Kelly, Lorraine; Navarro, Tamara; Wilczynski, Nancy L; Haynes, R Brian

2011-08-03

Computerized clinical decision support systems (CCDSSs) for drug therapy management are designed to promote safe and effective medication use. Evidence documenting the effectiveness of CCDSSs for improving drug therapy is necessary for informed adoption decisions. The objective of this review was to systematically review randomized controlled trials assessing the effects of CCDSSs for drug therapy management on process of care and patient outcomes. We also sought to identify system and study characteristics that predicted benefit. We conducted a decision-maker-researcher partnership systematic review. We updated our earlier reviews (1998, 2005) by searching MEDLINE, EMBASE, EBM Reviews, Inspec, and other databases, and consulting reference lists through January 2010. Authors of 82% of included studies confirmed or supplemented extracted data. We included only randomized controlled trials that evaluated the effect on process of care or patient outcomes of a CCDSS for drug therapy management compared to care provided without a CCDSS. A study was considered to have a positive effect (i.e., CCDSS showed improvement) if at least 50% of the relevant study outcomes were statistically significantly positive. Sixty-five studies met our inclusion criteria, including 41 new studies since our previous review. Methodological quality was generally high and unchanged with time. CCDSSs improved process of care performance in 37 of the 59 studies assessing this type of outcome (64%, 57% of all studies). Twenty-nine trials assessed patient outcomes, of which six trials (21%, 9% of all trials) reported improvements. CCDSSs inconsistently improved process of care measures and seldomly improved patient outcomes. Lack of clear patient benefit and lack of data on harms and costs preclude a recommendation to adopt CCDSSs for drug therapy management.

Slum Upgrading and Health Equity.

PubMed

Corburn, Jason; Sverdlik, Alice

2017-03-24

Informal settlement upgrading is widely recognized for enhancing shelter and promoting economic development, yet its potential to improve health equity is usually overlooked. Almost one in seven people on the planet are expected to reside in urban informal settlements, or slums, by 2030. Slum upgrading is the process of delivering place-based environmental and social improvements to the urban poor, including land tenure, housing, infrastructure, employment, health services and political and social inclusion. The processes and products of slum upgrading can address multiple environmental determinants of health. This paper reviewed urban slum upgrading evaluations from cities across Asia, Africa and Latin America and found that few captured the multiple health benefits of upgrading. With the Sustainable Development Goals (SDGs) focused on improving well-being for billions of city-dwellers, slum upgrading should be viewed as a key strategy to promote health, equitable development and reduce climate change vulnerabilities. We conclude with suggestions for how slum upgrading might more explicitly capture its health benefits, such as through the use of health impact assessment (HIA) and adopting an urban health in all policies (HiAP) framework. Urban slum upgrading must be more explicitly designed, implemented and evaluated to capture its multiple global environmental health benefits.

Slum Upgrading and Health Equity

PubMed Central

Corburn, Jason; Sverdlik, Alice

2017-01-01

Informal settlement upgrading is widely recognized for enhancing shelter and promoting economic development, yet its potential to improve health equity is usually overlooked. Almost one in seven people on the planet are expected to reside in urban informal settlements, or slums, by 2030. Slum upgrading is the process of delivering place-based environmental and social improvements to the urban poor, including land tenure, housing, infrastructure, employment, health services and political and social inclusion. The processes and products of slum upgrading can address multiple environmental determinants of health. This paper reviewed urban slum upgrading evaluations from cities across Asia, Africa and Latin America and found that few captured the multiple health benefits of upgrading. With the Sustainable Development Goals (SDGs) focused on improving well-being for billions of city-dwellers, slum upgrading should be viewed as a key strategy to promote health, equitable development and reduce climate change vulnerabilities. We conclude with suggestions for how slum upgrading might more explicitly capture its health benefits, such as through the use of health impact assessment (HIA) and adopting an urban health in all policies (HiAP) framework. Urban slum upgrading must be more explicitly designed, implemented and evaluated to capture its multiple global environmental health benefits. PMID:28338613

Community pharmacy patient perceptions of a pharmacy-initiated mobile technology app to improve adherence.

PubMed

DiDonato, Kristen L; Liu, Yifei; Lindsey, Cameron C; Hartwig, David Matthew; Stoner, Steven C

2015-10-01

To determine patient perceptions of using a demonstration application (app) of mobile technology to improve medication adherence and to identify desired features to assist in the management of medications. A qualitative study using key informant interviews was conducted in a community pharmacy chain for patients aged 50 and older, on statin therapy and owning a smart device. Three main themes emerged from 24 interviews at four pharmacy locations, which included benefits, barriers and desired features of the app. Benefits such as accessibility, privacy, pros of appearance and beneficiaries were more likely to lead to usage of the app. Barriers that might prevent usage of the app were related to concerns of appearance, the burden it might cause for others, cost, privacy, motivation and reliability. Specific features patients desired were categorized under appearance, customization, communication, functionality, input and the app platform. Patients provided opinions about using a mobile app to improve medication adherence and assist with managing medications. Patients envisioned the app within their lifestyle and expressed important considerations, identifying benefits to using this technology and voicing relevant concerns. App developers can use patient perceptions to guide development of a mobile app addressing patient medication-related needs. © 2015 Royal Pharmaceutical Society.

The Road to ICD-10-CM/PCS Implementation: Forecasting the Transition for Providers, Payers, and Other Healthcare Organizations

PubMed Central

Sanders, Tekla B; Bowens, Felicia M; Pierce, William; Stasher-Booker, Bridgette; Thompson, Erica Q; Jones, Warren A

2012-01-01

This article will examine the benefits and challenges of the US healthcare system's upcoming conversion to use of the International Classification of Diseases, Tenth Revision, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS) and will review the cost implications of the transition. Benefits including improved quality of care, potential cost savings from increased accuracy of payments and reduction of unpaid claims, and improved tracking of healthcare data related to public health and bioterrorism events are discussed. Challenges are noted in the areas of planning and implementation, the financial cost of the transition, a shortage of qualified coders, the need for further training and education of the healthcare workforce, and the loss of productivity during the transition. Although the transition will require substantial implementation and conversion costs, potential benefits can be achieved in the areas of data integrity, fraud detection, enhanced cost analysis capabilities, and improved monitoring of patients’ health outcomes that will yield greater cost savings over time. The discussion concludes with recommendations to healthcare organizations of ways in which technological advances and workforce training and development opportunities can ease the transition to the new coding system. PMID:22548024

[Assessing environmental and economical benefits of integrated sewage treatment systems].

PubMed

Li, Jin-rong; Zhang, Xiao-hong; Zhang, Hang-bin; Pan, Heng-yu; Liu, Qiang

2015-08-01

Sewage treatment, treated water treatment and sludge treatment are three basic units of an integrated sewage treatment system. This work assessed the influence of reusing or discharge of treated water and sludge landfill or compost on the sustainability of an integrated sewage treatment system using emergy analysis and newly proposed emergy indicators. This system's value included its environmental benefits and the products. Environmental benefits were the differences of the environmental service values before and after sewage treatment. Due to unavailability of data of the exchanged substance and energy in the internal system, products' values were attained by newly proposed substitution values. The results showed that the combination of sewage treatment, treated water reuse and sludge landfill had the strongest competitiveness, while the combination of sewage treatment, treated water reuse and earthworm compost was the most sustainable. Moreover, treated water reuse and earthworm compost were helpful for improving the sustainability of the integrated sewage treatment system. The quality of treated water and local conditions should be also considered when implementing the treated water reuse or discharge. The resources efficiency of earthworm compost unit needed to be further improved. Improved emergy indices were more suitable for integrated sewage treatment systems.

Impact of fatty acid status on immune function of children in low-income countries.

PubMed

Prentice, Andrew M; van der Merwe, Liandré

2011-04-01

In vitro and animal studies point to numerous mechanisms by which fatty acids, especially long-chain polyunsaturated fatty acids (LCPUFA), can modulate the innate and adaptive arms of the immune system. These data strongly suggest that improving the fatty acid supply of young children in low-income countries might have immune benefits. Unfortunately, there have been virtually no studies of fatty acid/immune interactions in such settings. Clinical trial registers list over 150 randomized controlled trials (RCTs) involving PUFAs, only one in a low-income setting (the Gambia). We summarize those results here. There was evidence for improved growth and nutritional status, but the primary end point of chronic environmental enteropathy showed no benefit, possibly because the infants were still substantially breastfed. In high-income settings, there have been RCTs with fatty acids (usually LCPUFAs) in relation to 18 disease end points, for some of which there have been numerous trials (asthma, inflammatory bowel disease and rheumatoid arthritis). For these diseases, the evidence is judged reasonable for risk reduction for childhood asthma (but not in adults), as yielding possible benefit in Crohn's disease (insufficient evidence in ulcerative colitis) and for convincing evidence for rheumatoid arthritis at sufficient dose levels, though formal meta-analyses are not yet available. This analysis suggests that fatty acid interventions could yield immune benefits in children in poor settings, especially in non-breastfed children and in relation to inflammatory conditions such as persistent enteropathy. Benefits might include improved responses to enteric vaccines, which frequently perform poorly in low-income settings, and these questions merit randomized trials. © 2011 Blackwell Publishing Ltd.

Recent developments in persufflation for organ preservation.

PubMed

Min, Catherine G; Papas, Klearchos K

2018-06-01

To summarize current literature and recent findings on the potential of humidified oxygenated gas perfusion (persufflation) as an alternative method for improved organ preservation. Although there are some conflicting data, the majority of the evidence suggests that persufflation, by enhancing oxygenation, can improve preservation and even rescue organs, including organs with prior exposure to warm ischemia. In some cases, persufflation produced better results than hypothermic machine perfusion. The timing of persufflation is of importance; benefits of persufflation appear to increase as the timing of its administration postprocurement decreases. This may be particularly true for tissues that are more sensitive to ischemia, such as the pancreas prior to islet isolation. Combining oxygen persufflation with nitric oxide and addition of pulsatile flow may provide further benefits and amplify its effects on improving transplant outcomes. Persufflation is a promising, relatively simple, preservation technique that enables improved oxygenation, which provides protection and improvement in the graft condition during preservation and prior to transplantation. More detailed studies are needed to optimize persufflation and evaluate its short and long-term effects in vivo.

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

Trifiletti, Daniel M.; Swisher-McClure, Samuel; Showalter, Timothy N.

Purpose: To review the National Cancer Database (NCDB) to evaluate postoperative high-risk cervical cancer patients for factors associated with a benefit from chemoradiation therapy (CRT) over external beam radiation therapy alone (EBRT). Methods and Materials: The National Cancer Database was queried for women with cervical cancer treated with hysterectomy and adjuvant EBRT from 2002 to 2012. Only patients with pathologic lymph node involvement (LN+), positive surgical margins, and/or parametrial invasion were included in our analysis (on the basis of Peter's criteria). Univariable and multivariable analyses (MVA) were performed, and hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated to investigatemore » for factors associated with of CRT utilization and overall survival (OS). Results: A total of 3053 patients met inclusion criteria, and 2479 received adjuvant CRT (81%), whereas 574 (19%) received EBRT alone. Factors associated with increased CRT utilization on MVA included age <69 years, year of diagnosis ≥2008, non-adenocarcinoma histology, and LN+. Use of CRT improved OS among the entire cohort on MVA (HR 0.76, CI 0.601-0.962; P=.022). On MVA, CRT improved OS in patients with LN+ as their sole Peter's criteria (HR 0.58, CI 0.413-0.814; P=.002). Chemoradiation therapy did not improve OS in patients with only positive margins (P=.73), only parametrial invasion (P=.95), or any combination of these 2 factors without LN+ (P=.63). Conclusions: The use of adjuvant CRT after hysterectomy improves OS in patients with high-risk cervical cancer compared with EBRT alone, but this benefit seems to be restricted to patients with LN+. The benefits of adjuvant CRT over EBRT alone in patients with parametrial invasion and/or positive margins (without nodal involvement) are unknown.« less

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

PubMed

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

2018-03-07

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

Capacity building in emerging space nations: Experiences, challenges and benefits

NASA Astrophysics Data System (ADS)

Jason, Susan; da Silva Curiel, Alex; Liddle, Doug; Chizea, Francis; Leloglu, Ugur Murat; Helvaci, Mustafa; Bekhti, Mohammed; Benachir, Djouad; Boland, Lee; Gomes, Luis; Sweeting, Martin

2010-09-01

This paper focuses on ways in which space is being used to build capacity in science and technology in order to: Offer increasing support for national and global solutions to current and emerging problems including: how to improve food security; resource management; understanding the impacts of climate change and how to deal with them; improving disaster mitigation, management and response. Support sustainable economic development. We present some of the experiences, lessons learned and benefits gained in capacity building projects undertaken by Surrey Satellite Technology Ltd. and our partners from developing and mature space nations. We focus on the Turkish, Algerian and Nigerian know-how and technology transfer programmes which form part of the first Disaster Monitoring Constellation (DMC) in orbit. From the lessons learned on Surrey's know-how and technology transfer partnership programmes, it is clear that space technology needs to be implemented responsibly as part of a long-term capacity building plan to be a sustainable one. It needs to be supported with appropriate policy and legal frameworks, institutional development, including community participation, human resources development and strengthening of managerial systems. In taking this on board, DMC has resulted in a strong international partnership combining national objectives, humanitarian aid and commerce. The benefits include: Ownership of space-based and supporting ground assets with low capital expenditure that is in line with national budgets of developing nations. Ownership of data and control over data acquisition. More for the money via collaborative consortium. Space related capacity building in organisations and nations with the goal of sustainable development. Opportunities for international collaboration, including disaster management and relief.

The role of satisfaction and emotional response in the choice mechanisms of suburban natural-areas users.

PubMed

Lopez-Mosquera, Natalia; Sanchez, Mercedes

2012-01-01

The unique observations and experiences of users of suburban natural areas lead them to perceive their surroundings in a manner associated with their personal values. It follows that every individual has a unique cognitive decision-making structure. This paper examines users' affective and cognitive evaluation of a particular suburban natural area by applying the means-end chain method to reveal the cognitive mechanism by which users link the attributes and benefits of an environmental public good with their own personal values. Analysis of a survey conducted of visitors to a Spanish suburban natural area (park) reveals the main attributes to be the opportunity to practice sports and proximity of the park and the main potential benefits to be the improvement of physical and psychological well-being. The desired personal values include fun, quality of life and self-fulfillment at the individual level and improved social relationships at the collective level. The paper also tests for cross-group, cognitive-structure differences in visitor groups, segmented by level of satisfaction and reported range of emotions, and finds that perceived physical and psychological health improvements and individual and social awareness increase with higher levels of satisfaction and emotional response. Therefore, the recommendations for natural area management suggested by these findings include enhancing the scenic beauty and peacefulness of suburban natural areas in order to improve the affective state of visitors because this could contribute to reducing social costs (including health care) within the area of influence of the natural area.

The Role of Satisfaction and Emotional Response in the Choice Mechanisms of Suburban Natural-Areas Users

NASA Astrophysics Data System (ADS)

Lopez-Mosquera, Natalia; Sanchez, Mercedes

2012-01-01

The unique observations and experiences of users of suburban natural areas lead them to perceive their surroundings in a manner associated with their personal values. It follows that every individual has a unique cognitive decision-making structure. This paper examines users' affective and cognitive evaluation of a particular suburban natural area by applying the means-end chain method to reveal the cognitive mechanism by which users link the attributes and benefits of an environmental public good with their own personal values. Analysis of a survey conducted of visitors to a Spanish suburban natural area (park) reveals the main attributes to be the opportunity to practice sports and proximity of the park and the main potential benefits to be the improvement of physical and psychological well-being. The desired personal values include fun, quality of life and self-fulfillment at the individual level and improved social relationships at the collective level. The paper also tests for cross-group, cognitive-structure differences in visitor groups, segmented by level of satisfaction and reported range of emotions, and finds that perceived physical and psychological health improvements and individual and social awareness increase with higher levels of satisfaction and emotional response. Therefore, the recommendations for natural area management suggested by these findings include enhancing the scenic beauty and peacefulness of suburban natural areas in order to improve the affective state of visitors because this could contribute to reducing social costs (including health care) within the area of influence of the natural area.

The impact of commercial rapid respiratory virus diagnostic tests on patient outcomes and health system utilization.

PubMed

Ko, Fiona; Drews, Steven J

2017-10-01

Acute respiratory tract infections due to influenza A/B and respiratory syncytial virus (RSV) are major causes of morbidity and mortality globally. Rapid tests for detection of these pathogens include antigen detection point of care tests (POC) and newer easy to use molecular tests. From experience, these assays improve both laboratory workflow and assay interpretation issues. However, the question of the benefits of using rapid test technology compared to routine laboratory testing for respiratory viral pathogens is still often asked. Areas covered: Specifically, this review aims to; 1) identify clinical/patient indicators that can be measured prior to and following the implementation of rapid diagnostic test for influenza and RSV, 2) provide multiple perspectives on the extent of impact of a rapid diagnostic test, including direct and indirect outcomes, and 3) identify the technological advancements in the development of rapid testing, demonstrating a timeline that transitions from antigen-based assays to molecular assays. Expert commentary: Key benefits to the use of either antigen-based or molecular rapid tests for patient care, patient flow within institutions, as well as laboratory utilization are identified. Due to improved test characteristics, the authors feel that rapid molecular tests have greater benefits than antigen-based detection methods.

The psychosocial effects of the Li-Fraumeni Education and Early Detection (LEAD) program on individuals with Li-Fraumeni syndrome.

PubMed

Ross, Jessica; Bojadzieva, Jasmina; Peterson, Susan; Noblin, Sarah Jane; Yzquierdo, Rebecca; Askins, Martha; Strong, Louise

2017-09-01

In the past 5 years, new screening protocols have been developed that provide improved cancer screening options for individuals with Li-Fraumeni syndrome (LFS). Very little has been published on the psychosocial impact of these screening protocols. The goals of this study were to determine how participation in screening impacts individuals psychosocially, to examine the benefits and drawbacks of screening, and to evaluate possible barriers to continued screening. We performed a qualitative study consisting of semistructured phone interviews conducted from December 2015 to February 2016 with 20 individuals attending the LFS screening program at MD Anderson Cancer Center. Data analysis showed that benefits of screening include early detection, peace of mind, centralized screening, knowledge providing power, and screening making LFS seem more livable. Perceived drawbacks included logistical issues, difficulty navigating the system, screening being draining, and significant negative emotional reactions such as anxiety, fear, and skepticism. Regardless of the emotions that were present, 100% of participants planned on continuing screening in the program. Our data indicate that the perceived benefits of screening outweigh the drawbacks of screening. Individuals in this screening program appeared to have improved psychosocial well-being because of their access to the screening program.Genet Med advance online publication 16 March 2017.

International Experiences with Quantifying the Co-Benefits of Energy-Efficiency and Greenhouse-Gas Mitigation Programs and Policies

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

Williams, Christopher; Hasanbeigi, Ali; Price, Lynn

Improving the efficiency of energy production and consumption and switching to lower carbon energy sources can significantly decrease carbon dioxide (CO2) emissions and reduce climate change impacts. A growing body of research has found that these measures can also directly mitigate many non-climate change related human health hazards and environmental damage. Positive impacts of policies and programs that occur in addition to the intended primary policy goal are called co-benefits. Policy analysis relies on forecasting and comparing the costs of policy and program implementation and the benefits that accrue to society from implementation. GHG reduction and energy efficiency policies andmore » programs face political resistance in part because of the difficulty of quantifying their benefits. On the one hand, climate change mitigation policy benefits are often global, long-term, and subject to large uncertainties, and subsidized energy pricing can reduce the direct monetary benefits of energy efficiency policies to below their cost. On the other hand, the co-benefits that accrue from these efforts’ resultant reductions in conventional air pollution (such as improved health, agricultural productivity, reduced damage to infrastructure, and local ecosystem improvements) are generally near term, local, and more certain than climate change mitigation benefits and larger than the monetary value of energy savings. The incorporation of co-benefits into energy efficiency and climate mitigation policy and program analysis therefore might significantly increase the uptake of these policies. Faster policy uptake is especially important in developing countries because ongoing development efforts that do not consider co-benefits may lock in suboptimal technologies and infrastructure and result in high costs in future years. Over the past two decades, studies have repeatedly documented that non-climate change related benefits of energy efficiency and fuel conversion efforts, as a part of GHG mitigation strategies, can be from between 30% to over 100% of the costs of such policies and programs strategies. Policy makers around the world are increasingly interested in including both GHG and non-GHG impacts in analyses of energy efficiency and fuel switching policies and programs and a set of methodologies has matured from the efforts of early moving jurisdictions such as the European Union, the United States, and Japan.« less

[Efficacy and patient benefit of treatment of irritated skin with ointments containing dexpanthenol: health services research (observational study) on self-medication in a pharmaceutical network].

PubMed

Radtke, M A; Lee-Seifert, C; Rustenbach, S J; Schäfer, I; Augustin, M

2009-05-01

Products containing dexpanthenol are used to treat irritated and inflamed skin. So far there is a lack of data for the evidence of patient-relevant benefits. Assessment of the patient-relevant benefit of ointments containing dexpanthenol in the self-medicated therapy of irritated skin. Prospective, observational study in a network of 392 pharmacies. Consecutive recruitment of n=1,886 patients with symptoms of irritated skin, including non-inflammatory intervals of atopic eczema, other xerotic skin conditions and impairment of skin barrier. The patient-relevant benefit was ascertained prior to and 7-10 days after treatment through the patient-benefit index (PBI). The PBI showed that 91.5% of the patients experienced a relevant benefit from treatment. 94.7% directly indicated to have had achieved successful therapeutic results. All symptoms of irritated skin (e.g. xerosis, erythema, desquamation) significantly improved (p

Improving Societal Benefit Areas from Applications Enhanced by the Joint Polar Satellite System

NASA Astrophysics Data System (ADS)

Goldberg, M.

2016-12-01

Applications of satellite data are paramount to transform science and technology to product and services which are used in critical decision making for societal benefits. For the satellite community, good representations of technology are the satellite sensors, while science provides the instrument calibration and derived geophysical parameters. Weather forecasting is an application of the science and technology provided by remote sensing satellites. The Joint Polar Satellite System, which includes the Suomi National Polar-orbiting Partnership (S-NPP) provides formidable science and technology to support many applications and includes support to 1) weather forecasting - data from the JPSS Cross-track Infrared Sounder (CrIS) and the Advanced Technology Microwave Sounder (ATMS) are used to forecast weather events out to 7 days - nearly 85% of all data used in weather forecasting are from polar orbiting satellites; 2) environmental monitoring -data from the JPSS Visible Infrared Imager Radiometer Suite (VIIRS) are used to monitor the environment including the health of coastal ecosystems, drought conditions, fire, smoke, dust, snow and ice, and the state of oceans, including sea surface temperature and ocean color; and 3) climate monitoring - data from JPSS instruments, including OMPS and CERES will provide continuity to climate data records established using NOAA POES and NASA Earth Observing System (EOS) satellite observations. To bridge the gap between products and applications, the JPSS Program has established a proving ground program to optimize the use of JPSS data with other data sources to improve key products and services. A number of operational and research applications will be presented along with how the data and applications support a large number of societal benefit areas of the Global Earth Observation Systems of Systems (GEOSS).

Improving Sedative-Hypnotic Prescribing in Older Hospitalized Patients: Provider-Perceived Benefits and Barriers of a Computer-Based Reminder

PubMed Central

Concato, John; Inouye, Sharon K.

2007-01-01

Background Older adults are commonly prescribed sedative-hypnotic (SH) medications when hospitalized, yet these drugs are associated with important adverse effects such as falls and delirium. Objective To identify provider-perceived benefits or barriers of a computer-based reminder regarding appropriate use of SH medications. Design Qualitative study using semi-structured interviews. Participants and setting Thirty-six house staff physicians at a university hospital. Measurements Information was collected regarding the experiences of prescribing an SH using a computer order entry system with a reminder intervention. Clinicians were asked about their perceptions of the reminder and what they found most and least useful about it. Responses were analyzed using grounded theory methodology. Results The 36 participants (including 29 interns) had prescribed an SH medication for a hospitalized patient over age 65 years. Three themes associated with benefits of a computer reminder were identified: increasing awareness of safety, including risk of delirium, falls, and general patient safety risks; usefulness of information technology; and the value of the educational content, including geriatric pharmacology review and nonpharmacologic treatment options. Barriers included the demands of the reminder with regard to time needed to read the reminder, the role of clinician experience with regard to preserving clinical autonomy, and the information content of the reminder, including its being too basic or not relevant for a particular patient. The mean satisfaction rating for the reminder was 8.5 (±0.9 SD), with 10 indicating high satisfaction. Conclusions Improving decision support systems involves an understanding of how clinicians respond to real-time strategies encouraging better prescribing. PMID:18095041

Evidence supporting contemporary post-operative radiation therapy (PORT) using linear accelerators in N2 lung cancer.

PubMed

Patel, Suchit H; Ma, Yan; Wernicke, A Gabriella; Nori, Dattatreyudu; Chao, K S C; Parashar, Bhupesh

2014-05-01

Post-operative radiotherapy (PORT) treatment for lung cancer declined since a meta-analysis failed to show benefit in patients with N2 disease. Because several included studies employed outmoded radiation planning and delivery techniques, we sought to determine whether PORT with modern technology benefits patients with N2 disease. We conducted searches of the published literature. For inclusion, studies must have included patients with stage III-N2 lung cancer treated with PORT using only linear accelerators, used a control group that did not receive PORT, and reported outcome data for overall survival (OS). Prospective and retrospective analyses were included. Exclusion criteria were the use of cobalt devices or orthovoltage radiation. Data were evaluated with random-effects models. Three prospective and eight retrospective studies were included. The PORT and no-PORT groups included 1368 and 1360 patients, respectively. The PORT group had significantly improved OS over the no-PORT group (hazard ratio [HR] = 0.77, 95% confidence interval [CI] 0.62-0.96, P = 0.020). Locoregional recurrence-free survival (LRFS) in 10 studies for which data was available was also improved in the PORT group (HR = 0.51, CI 0.41-0.65, P < 0.001). PORT was associated with significantly lower risk of death and locoregional recurrence in patients with N2 lung cancer. Our study was limited by lack of access to individual patient data, which would have enabled more detailed analyses. Regardless, data thus far suggest PORT may be associated with a survival benefit. Given a lack of large-scale prospective data, clinical trials evaluating PORT with modern technology are warranted. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

[Assessment of actual benefits of new drugs by the Transparency Committee].

PubMed

Le Jeunne, C

2008-01-01

When a drug has been granted a marketing authorization, if the pharmaceutical company wants it to be covered by the National Health Insurance, the company has to submit a file with all the studies concerning the drug, especially drug-drug comparative studies, to be assessed by the Transparency Committee. Drugs are assessed on two criteria: actual or expected benefit (AB) and improvement in actual benefit (IAB). Actual benefit mainly takes into account the severity of the disease concerned, the level of efficacy relative to known side effects (risk-benefit ratio), and the place the drug is intended to take in the therapeutic strategy. At the end of the assessment, AB is considered as important, moderate, poor or insufficient (to justify inclusion of the drug on the list of products to be reimbursed). After actual benefit is determined, improvement of actual benefit is assessed, comparing the estimated benefit of this drug with one of drugs with the same indication that is already reimbursed, to assess whether this drug will improve the patient's disease. This can be assessed by direct comparison (two drugs compared in the same clinical trial) or by indirect comparison (separate studies with the same design). There are four levels of added value, from I (major improvement) to IV (minor improvement). Level V represents no improvement. This second assessment is always relative to another drug. It never provides an absolute score. However, IAB is very important for pharmaceutical companies, because it is a fundamental criterion to determine the price of the drug, which is discussed with the Economic Committee of Health Products in a final phase. Actual benefit and improvement in actual benefit are allocated for each indication of a drug.

"Meaningful use" of EHR in dental school clinics: how to benefit from the U.S. HITECH Act's financial and quality improvement incentives.

PubMed

Kalenderian, Elsbeth; Walji, Muhammad; Ramoni, Rachel B

2013-04-01

Through the 2009 HITECH (Health Information Technology for Economic and Clinical Health) Act, the U.S. government committed $27 billion to incentivize the adoption and "meaningful use" of certified electronic health records (EHRs) by providers, including dentists. Given their patient profiles, dental school clinics are in a position to benefit from this time-delimited commitment to support the adoption and use of certified EHR technology under the Medicaid-based incentive. The benefits are not merely financial: rather, the meaningful use objectives and clinical quality measures can drive quality improvement initiatives within dental practices and help develop a community of medical and dental professionals focused on quality. This article describes how dentists can qualify as eligible providers and the set of activities that must be undertaken and attested to in order to obtain this incentive. Two case studies describe the approaches that can be used to meet the Medicaid threshold necessary to be eligible for the incentive. Dentists can and have successfully applied for meaningful use incentive payments. Given the diverse set of patients who are treated at dental schools, these dental practices are among those most likely to benefit from the incentive programs.

Evaluating the multiple benefits of marine water quality improvements: how important are health risk reductions?

PubMed

Machado, Fernando S; Mourato, Susana

2002-07-01

Marine water pollution affects many recreational sites around the world. It has impacts not only on recreational activities but also on health risks for those who come into direct contact with the water. Few economic studies have explicitly considered the health risks of bathing in polluted marine waters and none have attempted to separate health benefits from other benefits of marine water quality improvements. This paper uses stated preference techniques to separately evaluate the multiple benefits of improving the quality of marine recreational waters at the Estoril Coast in Portugal. The results indicate that health risk reductions are only a small fraction of the total social benefits of water quality improvements.

Implementation and impact of ICD-10 (Part II)

PubMed Central

Rahmathulla, Gazanfar; Deen, H. Gordon; Dokken, Judith A.; Pirris, Stephen M.; Pichelmann, Mark A.; Nottmeier, Eric W.; Reimer, Ronald; Wharen, Robert E.

2014-01-01

Background: The transition from the International Classification of Disease-9th clinical modification to the new ICD-10 was all set to occur on 1 October 2015. The American Medical Association has previously been successful in delaying the transition by over 10 years and has been able to further postpone its introduction to 2015. The new system will overcome many of the limitations present in the older version, thus paving the way to more accurate capture of clinical information. Methods: The benefits of the new ICD-10 system include improved quality of care, potential cost savings, reduction of unpaid claims, and improved tracking of healthcare data. The areas where challenges will be evident include planning and implementation, the cost to transition, a shortage of qualified coders, training and education of the healthcare workforce, and a loss of productivity when this occurs. The impacts include substantial costs to the healthcare system, but the projected long-term savings and benefits will be significant. Improved fraud detection, accurate data entry, ability to analyze cost benefits with procedures, and enhanced quality outcome measures are the most significant beneficial factors with this change. Results: The present Current Procedural Terminology and Healthcare Common Procedure Coding System code sets will be used for reporting ambulatory procedures in the same manner as they have been. ICD-10-PCS will replace ICD-9 procedure codes for inpatient hospital services. The ICD-10-CM will replace the clinical code sets. Our article will focus on the challenges to execution of an ICD change and strategies to minimize risk while transitioning to the new system. Conclusion: With the implementation deadline gradually approaching, spine surgery practices that include multidisciplinary health specialists have to anticipate and prepare for the ICD change in order to mitigate risk. Education and communication is the key to this process in spine practices. PMID:25184098

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

PubMed

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

2012-01-01

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

Cardiovascular Benefits of Dark Chocolate?

PubMed

Higginbotham, Erin; Taub, Pam R

2015-12-01

The use of cacao for health benefits dates back at least 3000 years. Our understanding of cacao has evolved with modern science. It is now felt based on extensive research the main health benefits of cacao stem from epicatechin, a flavanol found in cacao. The process of manufacturing dark chocolate retains epicatechin, whereas milk chocolate does not contain significant amounts of epicatechin. Thus, most of the current research studies are focused on dark chocolate. Both epidemiological and clinical studies suggest a beneficial effect of dark chocolate on blood pressure, lipids, and inflammation. Proposed mechanisms underlying these benefits include enhanced nitric oxide bioavailability and improved mitochondrial structure/function. Ultimately, further studies of this promising compound are needed to elucidate its potential for prevention and treatment of cardiovascular and metabolic diseases as well as other diseases that have underlying mechanisms of mitochondrial dysfunction and nitric oxide deficiency.

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

PubMed Central

Ostermann, Jan; Sloan, Frank A

2004-01-01

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

Industrial benefits and future expectations in materials and processes resulting from space technology

NASA Technical Reports Server (NTRS)

Meyer, J. D.

1977-01-01

Space technology transfer is discussed as applied to the field of materials science. Advances made in processing include improved computer techniques, and structural analysis. Technology transfer is shown to have an important impact potential in the overall productivity of the United States.

A report on participant sampling and recruitment for travel and physical activity data collection : final technical report, July 2009.

DOT National Transportation Integrated Search

2009-07-01

The substantial investments now being made in transit yield benefits that go beyond managing traffic congestion relief, : and include improved environmental quality and potential gains in human health due to increased physical activity. Past : resear...

Generation of induced pluripotent stem cells from the pig

USDA-ARS?s Scientific Manuscript database

The value of stem cells has become increasingly evident in recent years with the advent of genetic engineering tools that allow site-specific modifications to the genome. The use of stem cells to induce modifications has several potential benefits for the livestock industry including improving anim...

Citizen Science: Is It Worth Your Time?

ERIC Educational Resources Information Center

Smith, Michael Chadwick

2015-01-01

This dissertation investigated citizen science, a tool that connects the public to the scientific community through research-based projects and education campaigns. Benefits include volunteers adding data to long-term data sets and improved scientific literacy among the public. Oftentimes, there is trepidation among scientists, managers, and…

The Four-Day Week--What Are the Advantages for Schools?

ERIC Educational Resources Information Center

Richburg, Robert W.; Sjogren, Douglas D.

1983-01-01

Experience in 12 Colorado school districts suggests that implementation of a four-day school week can offer several benefits, including savings in fuel costs, decreased absenteeism, improved efficiency in activity-oriented classes, increased staff development time, and a flexible "fifth day" for extracurricular activities. (PGD)

Benchmark for Strategic Performance Improvement.

ERIC Educational Resources Information Center

Gohlke, Annette

1997-01-01

Explains benchmarking, a total quality management tool used to measure and compare the work processes in a library with those in other libraries to increase library performance. Topics include the main groups of upper management, clients, and staff; critical success factors for each group; and benefits of benchmarking. (Author/LRW)

Toward more diverse forests: helping trees "get along" in a new organization

Treesearch

Noreen Parks; Timothy Harrington; Warren. Devine

2010-01-01

Interactions among plant species and their growth patterns help shape a forest. Various management practices can enhance forest complexity and in return yield benefits that include enhanced growth of desired species, slowing the spread of root disease, and improved wildlife habitat.Based on...

Penicillin for Education: How Cognitive Science Can Contribute to Education.

ERIC Educational Resources Information Center

Bruer, John T.

1995-01-01

Education can benefit from knowledge derived from cognitive and developmental psychology. Family demographics have actually improved between 1970 and 90 and so have NAEP scores. Three innovative programs demonstrating cognitive science applications include the Teaching Number Sense elementary math program, reciprocal teaching (reading strategy),…

Tides and Trends in Higher Education.

ERIC Educational Resources Information Center

Fincher, Cameron

This paper examines changes in American higher education, using the metaphor of ocean tides. The tides of change in the 1980s included public demands for assessment and accountability; fairness and credibility in advantages and benefits; improved quality of education; effectiveness and efficiency; assurance that college graduates were personally…

Military Enlisted Aides: DOD’s Report Met Most Statutory Requirements, but Aide Allocation Could Be Improved

DTIC Science & Technology

2016-02-01

purposes. Personal services performed solely for the benefit of family members or unofficial guests, including driving, shopping , running private...housing (Army). Maintaining accountability of, and ensuring care of, all government- owned furnishings, antiques , and memorabilia (Marine Corps

Evidence on global medical travel.

PubMed

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

2015-11-01

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

Cross-functional systems

NASA Technical Reports Server (NTRS)

Lee, Mark

1991-01-01

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

A scoping review of the experiences, benefits, and challenges involved in volunteer work among youth and young adults with a disability.

PubMed

Lindsay, Sally

2016-08-01

To develop a better understanding of the experiences of volunteer work among youth with disabilities. A scoping review was undertaken to assess the benefits and challenges of volunteering among youth with disabilities. Comprehensive searches using six international databases were conducted. Eligible articles included: (a) youth aged 30 or younger, with a disability; (b) empirical research on the benefits or challenges of volunteering; (c) published in a peer-reviewed journal between 1980 and 2014. Of the 1558 articles identified, 20 articles - involving 1409 participants, aged 12-30, across five countries - met the inclusion criteria. Studies linked volunteering to the development of human capital (i.e. practical experience, improved self-determination, self-confidence, coping), enhanced social capital (i.e. social and communication skills, social inclusion) and improved cultural capital (i.e. helping others, contributing to community). Many youth with disabilities also encountered challenges - including lack of accessible volunteer opportunities, difficulties arranging transportation, and negative attitudes from potential supervisors. Young people with disabilities are willing and able to volunteer, and they report benefits of volunteering; however, they face many challenges in finding suitable volunteer positions. More rigorous research is needed to understand the health and social benefits of volunteering and how it can help youth develop career pathways. Implications for Rehabilitation Clinicians, educators and parents should discuss the benefits of volunteering with youth with disabilities and assist them in finding placements that match their interests and abilities. Managers and clinicians should consider incorporating volunteering into vocational rehabilitation programming (i.e. addressing how to find placements and connecting youth to organisations). Clinicians should encourage youth to take part in social and extracurricular activities to help build their social skills and networks where they can learn about volunteer opportunities. Clinicians and educators should advocate on behalf of youth with disabilities among community organisations to help break down barriers and reduce misconceptions and negative attitudes by showcasing the abilities that youth with disabilities have to offer.

Software Reuse Methods to Improve Technological Infrastructure for e-Science

NASA Technical Reports Server (NTRS)

Marshall, James J.; Downs, Robert R.; Mattmann, Chris A.

2011-01-01

Social computing has the potential to contribute to scientific research. Ongoing developments in information and communications technology improve capabilities for enabling scientific research, including research fostered by social computing capabilities. The recent emergence of e-Science practices has demonstrated the benefits from improvements in the technological infrastructure, or cyber-infrastructure, that has been developed to support science. Cloud computing is one example of this e-Science trend. Our own work in the area of software reuse offers methods that can be used to improve new technological development, including cloud computing capabilities, to support scientific research practices. In this paper, we focus on software reuse and its potential to contribute to the development and evaluation of information systems and related services designed to support new capabilities for conducting scientific research.

Technology to promote safe mobility in the elderly.

PubMed

Nelson, Audrey; Powell-Cope, Gail; Gavin-Dreschnack, Deborah; Quigley, Pat; Bulat, Tatjana; Baptiste, Andrea S; Applegarth, Shawn; Friedman, Yvonne

2004-09-01

New technologies designed to help prevent adverse events related to the mobility of geriatric patients (ie, patient falls, bed-rail entrapment, patient handling, and wandering) are described. Technology offers the potential to eliminate or mitigate preventable adverse events that interfere with treatment, delay rehabilitation, potentiate impairment, and compromise patient safety. Unchecked, these adverse events can have a negative impact on patient health, functional status, and quality of life. It is not surprising that the elderly constitute the population at highest risk for adverse events, based on poor health, chronic conditions, long hospitalizations, and institutional care. Patient falls are a high-risk, high-volume, and high-cost adverse event. Key technologies to prevent falls and fall-related injuries include hip protectors, wheelchair/scooter safety features, intelligent walkers, fall alarms, and environmental aids. Bed-rail entrapment is a serious adverse event, which includes patients being trapped, entangled, or strangled in beds. New technologies to prevent bed-rail entrapment include new hospital bed designs, height-adjustable low beds, devices to close gaps in legacy beds, and bedside floor mats. Patients with mobility impairments necessitate physical assistance in transfers and other patient-handling tasks, which increases risk for the caregiver and the patient. Featured technologies to prevent patient handling injuries include innovations in floor-based lifts, new ceiling-mounted patient lifts, and improvements in powered standing lifts, new friction-reducing devices, and new patient transport technology. Wandering affects 39% of cognitively impaired nursing home residents and up to 70% of community-residing elderly persons with cognitive impairments. New technologies to prevent adverse events associated with wandering include door alarms and signal-transmitting devices. Nurses in geriatric settings would benefit from exposure to technologies that could improve patient and caregiver safety. To maximize the benefits of technology, it is critical that front-line nursing staff be involved in the testing and selection of devices that will be used in their practice. Further, to reap the full benefits of technology, a careful plan for implementation needs to be developed that would include integrating the new technology with existing infrastructure. Training needs to be provided for all staff who will be using the technology, and efforts to ensure competency over time is needed. A major barrier to widespread use of new technology is cost. Further research is needed to demonstrate the cost effectiveness of these devices. Results from these studies will help to build a business case, demonstrating that initial capital investments will result in cost savings, improved quality of care, and other benefits.

Risks and Benefits of Salpingectomy at the Time of Sterilization.

PubMed

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

2017-11-01

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

Human health benefits from livestock vaccination for brucellosis: case study.

PubMed Central

Roth, Felix; Zinsstag, Jakob; Orkhon, Dontor; Chimed-Ochir, G.; Hutton, Guy; Cosivi, Ottorino; Carrin, Guy; Otte, Joachim

2003-01-01

OBJECTIVE: To estimate the economic benefit, cost-effectiveness, and distribution of benefit of improving human health in Mongolia through the control of brucellosis by mass vaccination of livestock. METHODS: Cost-effectiveness and economic benefit for human society and the agricultural sector of mass vaccination against brucellosis was modelled. The intervention consisted of a planned 10-year livestock mass vaccination campaign using Rev-1 livestock vaccine for small ruminants and S19 livestock vaccine for cattle. Cost-effectiveness, expressed as cost per disability-adjusted life year (DALY) averted, was the primary outcome. FINDINGS: In a scenario of 52% reduction of brucellosis transmission between animals achieved by mass vaccination, a total of 49,027 DALYs could be averted. Estimated intervention costs were US$ 8.3 million, and the overall benefit was US$ 26.6 million. This results in a net present value of US$ 18.3 million and an average benefit-cost ratio for society of 3.2 (2.27-4.37). If the costs of the intervention were shared between the sectors in proportion to the benefit to each, the public health sector would contribute 11%, which gives a cost-effectiveness of US$ 19.1 per DALY averted (95% confidence interval 5.3-486.8). If private economic gain because of improved human health was included, the health sector should contribute 42% to the intervention costs and the cost-effectiveness would decrease to US$ 71.4 per DALY averted. CONCLUSION: If the costs of vaccination of livestock against brucellosis were allocated to all sectors in proportion to the benefits, the intervention might be profitable and cost effective for the agricultural and health sectors. PMID:14997239

Points to consider for prioritizing clinical genetic testing services: a European consensus process oriented at accountability for reasonableness

PubMed Central

Severin, Franziska; Borry, Pascal; Cornel, Martina C; Daniels, Norman; Fellmann, Florence; Victoria Hodgson, Shirley; Howard, Heidi C; John, Jürgen; Kääriäinen, Helena; Kayserili, Hülya; Kent, Alastair; Koerber, Florian; Kristoffersson, Ulf; Kroese, Mark; Lewis, Celine; Marckmann, Georg; Meyer, Peter; Pfeufer, Arne; Schmidtke, Jörg; Skirton, Heather; Tranebjærg, Lisbeth; Rogowski, Wolf H

2015-01-01

Given the cost constraints of the European health-care systems, criteria are needed to decide which genetic services to fund from the public budgets, if not all can be covered. To ensure that high-priority services are available equitably within and across the European countries, a shared set of prioritization criteria would be desirable. A decision process following the accountability for reasonableness framework was undertaken, including a multidisciplinary EuroGentest/PPPC-ESHG workshop to develop shared prioritization criteria. Resources are currently too limited to fund all the beneficial genetic testing services available in the next decade. Ethically and economically reflected prioritization criteria are needed. Prioritization should be based on considerations of medical benefit, health need and costs. Medical benefit includes evidence of benefit in terms of clinical benefit, benefit of information for important life decisions, benefit for other people apart from the person tested and the patient-specific likelihood of being affected by the condition tested for. It may be subject to a finite time window. Health need includes the severity of the condition tested for and its progression at the time of testing. Further discussion and better evidence is needed before clearly defined recommendations can be made or a prioritization algorithm proposed. To our knowledge, this is the first time a clinical society has initiated a decision process about health-care prioritization on a European level, following the principles of accountability for reasonableness. We provide points to consider to stimulate this debate across the EU and to serve as a reference for improving patient management. PMID:25248395

Points to consider for prioritizing clinical genetic testing services: a European consensus process oriented at accountability for reasonableness.

PubMed

Severin, Franziska; Borry, Pascal; Cornel, Martina C; Daniels, Norman; Fellmann, Florence; Victoria Hodgson, Shirley; Howard, Heidi C; John, Jürgen; Kääriäinen, Helena; Kayserili, Hülya; Kent, Alastair; Koerber, Florian; Kristoffersson, Ulf; Kroese, Mark; Lewis, Celine; Marckmann, Georg; Meyer, Peter; Pfeufer, Arne; Schmidtke, Jörg; Skirton, Heather; Tranebjærg, Lisbeth; Rogowski, Wolf H

2015-06-01

Given the cost constraints of the European health-care systems, criteria are needed to decide which genetic services to fund from the public budgets, if not all can be covered. To ensure that high-priority services are available equitably within and across the European countries, a shared set of prioritization criteria would be desirable. A decision process following the accountability for reasonableness framework was undertaken, including a multidisciplinary EuroGentest/PPPC-ESHG workshop to develop shared prioritization criteria. Resources are currently too limited to fund all the beneficial genetic testing services available in the next decade. Ethically and economically reflected prioritization criteria are needed. Prioritization should be based on considerations of medical benefit, health need and costs. Medical benefit includes evidence of benefit in terms of clinical benefit, benefit of information for important life decisions, benefit for other people apart from the person tested and the patient-specific likelihood of being affected by the condition tested for. It may be subject to a finite time window. Health need includes the severity of the condition tested for and its progression at the time of testing. Further discussion and better evidence is needed before clearly defined recommendations can be made or a prioritization algorithm proposed. To our knowledge, this is the first time a clinical society has initiated a decision process about health-care prioritization on a European level, following the principles of accountability for reasonableness. We provide points to consider to stimulate this debate across the EU and to serve as a reference for improving patient management.

Optimal integral force feedback for active vibration control

NASA Astrophysics Data System (ADS)

Teo, Yik R.; Fleming, Andrew J.

2015-11-01

This paper proposes an improvement to Integral Force Feedback (IFF), which is a popular method for active vibration control of structures and mechanical systems. Benefits of IFF include robustness, guaranteed stability and simplicity. However, the maximum damping performance is dependent on the stiffness of the system; hence, some systems cannot be adequately controlled. In this paper, an improvement to the classical force feedback control scheme is proposed. The improved method achieves arbitrary damping for any mechanical system by introducing a feed-through term. The proposed improvement is experimentally demonstrated by actively damping an objective lens assembly for a high-speed confocal microscope.

Dual n-back training increases the capacity of the focus of attention.

PubMed

Lilienthal, Lindsey; Tamez, Elaine; Shelton, Jill Talley; Myerson, Joel; Hale, Sandra

2013-02-01

Working memory (WM) training has been reported to benefit abilities as diverse as fluid intelligence (Jaeggi et al., Proceedings of the National Academy of Sciences of the United States of America, 105:6829-6833, 2008) and reading comprehension (Chein & Morrison, Psychonomic Bulletin & Review, 17:193-199, 2010), but transfer is not always observed (for reviews, see Morrison & Chein, Psychonomics Bulletin & Review, 18:46-60, 2011; Shipstead et al., Psychological Bulletin, 138:628-654, 2012). In contrast, recent WM training studies have consistently reported improvement on the trained tasks. The basis for these training benefits has received little attention, however, and it is not known which WM components and/or processes are being improved. Therefore, the goal of the present study was to investigate five possible mechanisms underlying the effects of adaptive dual n-back training on working memory (i.e., improvements in executive attention, updating, and focus switching, as well as increases in the capacity of the focus of attention and short-term memory). In addition to a no-contact control group, the present study also included an active control group whose members received nonadaptive training on the same task. All three groups showed significant improvements on the n-back task from pretest to posttest, but adaptive training produced larger improvements than did nonadaptive training, which in turn produced larger improvements than simply retesting. Adaptive, but not nonadaptive, training also resulted in improvements on an untrained running span task that measured the capacity of the focus of attention. No other differential improvements were observed, suggesting that increases in the capacity of the focus of attention underlie the benefits of adaptive dual n-back training.

A One Health approach to antimicrobial resistance surveillance: is there a business case for it?

PubMed

Queenan, Kevin; Häsler, Barbara; Rushton, Jonathan

2016-10-01

Antimicrobial resistance is a global problem of complex epidemiology, suited to a broad, integrated One Health approach. Resistant organisms exist in humans, animals, food and the environment, and the main driver of this resistance is antimicrobial usage. A One Health conceptual framework for surveillance is presented to include all of these aspects. Global and European (regional and national) surveillance systems are described, highlighting shortcomings compared with the framework. Policy decisions rely on economic and scientific evidence, so the business case for a fully integrated system is presented. The costs of integrated surveillance are offset by the costs of unchecked resistance and the benefits arising from interventions and outcomes. Current estimates focus on costs and benefits of human health outcomes. A One Health assessment includes wider societal costs of lost labour, changes in health-seeking behaviour, impacts on animal health and welfare, higher costs of animal-origin food production, and reduced consumer confidence in safety and international trade of such food. Benefits of surveillance may take years to realise and are dependent on effective and accepted interventions. Benefits, including the less tangible, such as improved synergies and efficiencies in service delivery and more timely and accurate risk identification, should also be recognised. By including these less tangible benefits to society, animal welfare, ecosystem health and resilience, together with the savings and efficiencies through shared resources and social capital-building, a stronger business case for a One Health approach to surveillance can be made. Copyright © 2016 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

Systems Engineering Methodology for Fuel Efficiency and its Application to the TARDEC Fuel Efficient Demonstrator (FED) Program

DTIC Science & Technology

2010-08-19

highlight the benefits of regenerative braking . Parameters within the drive cycle may include vehicle speed, elevation/grade changes, road surface...assist to downsize the engine due to infinite maximum speed requirements • Drive cycle less suited to regenerative braking improvement compared to...will be cycle dependent. A high speed drive cycle may for example drive a focus on aerodynamic improvements, while high frequency of braking will

Modular avionics packaging standardization

NASA Astrophysics Data System (ADS)

Austin, M.; McNichols, J. K.

The Modular Avionics Packaging (MAP) Program for packaging future military avionics systems with the objective of improving reliability, maintainability, and supportability, and reducing equipment life cycle costs is addressed. The basic MAP packaging concepts called the Standard Avionics Module, the Standard Enclosure, and the Integrated Rack are summarized, and the benefits of modular avionics packaging, including low risk design, technology independence with common functions, improved maintainability and life cycle costs are discussed. Progress made in MAP is briefly reviewed.

Potentially improved glasses from space environment

NASA Technical Reports Server (NTRS)

Nichols, R.

1977-01-01

The benefits of processing glasses in a low-gravity space environment are examined. Containerless processing, the absence of gravity driven convection, and lack of sedimentation are seen as potential advantages. Potential applications include the formation of glass-ceramics with a high content of active elements for ferromagnetic devices, the production of ultrapure chalcogenide glasses for laser windows and IR fiber optics, and improved glass products for use in optical systems and laser fusion targets.

Health Benefits of Fasting and Caloric Restriction.

PubMed

Golbidi, Saeid; Daiber, Andreas; Korac, Bato; Li, Huige; Essop, M Faadiel; Laher, Ismail

2017-10-23

Obesity and obesity-related diseases, largely resulting from urbanization and behavioral changes, are now of global importance. Energy restriction, though, is associated with health improvements and increased longevity. We review some important mechanisms related to calorie limitation aimed at controlling of metabolic diseases, particularly diabetes. Calorie restriction triggers a complex series of intricate events, including activation of cellular stress response elements, improved autophagy, modification of apoptosis, and alteration in hormonal balance. Intermittent fasting is not only more acceptable to patients, but it also prevents some of the adverse effects of chronic calorie restriction, especially malnutrition. There are many somatic and potentially psychologic benefits of fasting or intermittent calorie restriction. However, some behavioral modifications related to abstinence of binge eating following a fasting period are crucial in maintaining the desired favorable outcomes.

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

PubMed

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

2012-01-01

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

Kaizen: a process improvement model for the business of health care and perioperative nursing professionals.

PubMed

Tetteh, Hassan A

2012-01-01

Kaizen is a proven management technique that has a practical application for health care in the context of health care reform and the 2010 Institute of Medicine landmark report on the future of nursing. Compounded productivity is the unique benefit of kaizen, and its principles are change, efficiency, performance of key essential steps, and the elimination of waste through small and continuous process improvements. The kaizen model offers specific instruction for perioperative nurses to achieve process improvement in a five-step framework that includes teamwork, personal discipline, improved morale, quality circles, and suggestions for improvement. Published by Elsevier Inc.

Improving Outcome of Psychosocial Treatments by Enhancing Memory and Learning

PubMed Central

Harvey, Allison G.; Lee, Jason; Williams, Joseph; Hollon, Steven D.; Walker, Matthew P.; Thompson, Monique A.; Smith, Rita

2014-01-01

Mental disorders are prevalent and lead to significant impairment. Progress toward establishing treatments has been good. However, effect sizes are small to moderate, gains may not persist, and many patients derive no benefit. Our goal is to highlight the potential for empirically-supported psychosocial treatments to be improved by incorporating insights from cognitive psychology and research on education. Our central question is: If it were possible to improve memory for content of sessions of psychosocial treatments, would outcome substantially improve? This question arises from five lines of evidence: (a) mental illness is often characterized by memory impairment, (b) memory impairment is modifiable, (c) psychosocial treatments often involve the activation of emotion, (d) emotion can bias memory and (e) memory for psychosocial treatment sessions is poor. Insights from scientific knowledge on learning and memory are leveraged to derive strategies for a transdiagnostic and transtreatment cognitive support intervention. These strategies can be applied within and between sessions and to interventions delivered via computer, the internet and text message. Additional novel pathways to improving memory include improving sleep, engaging in exercise and imagery. Given that memory processes change across the lifespan, services to children and older adults may benefit from cognitive support. PMID:25544856

The benefits of improved technologies in agricultural aviation

NASA Technical Reports Server (NTRS)

Lietzke, K.; Abram, P.; Braen, C.; Givens, S.; Hazelrigg, G. A., Jr.; Fish, R.; Clyne, F.; Sand, F.

1977-01-01

The results are present for a study of the economic benefits attributed to a variety of potential technological improvements in agricultural aviation. Part 1 gives a general description of the ag-air industry and discusses the information used in the data base to estimate the potential benefits from technological improvements. Part 2 presents the benefit estimates and provides a quantitative basis for the estimates in each area study. Part 3 is a bibliography of references relating to this study.

Many shades of gray—The context-dependent performance of organic agriculture

PubMed Central

Seufert, Verena; Ramankutty, Navin

2017-01-01

Organic agriculture is often proposed as a more sustainable alternative to current conventional agriculture. We assess the current understanding of the costs and benefits of organic agriculture across multiple production, environmental, producer, and consumer dimensions. Organic agriculture shows many potential benefits (including higher biodiversity and improved soil and water quality per unit area, enhanced profitability, and higher nutritional value) as well as many potential costs including lower yields and higher consumer prices. However, numerous important dimensions have high uncertainty, particularly the environmental performance when controlling for lower organic yields, but also yield stability, soil erosion, water use, and labor conditions. We identify conditions that influence the relative performance of organic systems, highlighting areas for increased research and policy support. PMID:28345054

The role of early childhood education programmes in the promotion of child and adolescent mental health in low- and middle-income countries.

PubMed

Baker-Henningham, Helen

2014-04-01

There is growing evidence that early childhood education (ECE) interventions can reduce the loss of developmental potential of disadvantaged children in low- and middle-income countries (LAMIC). Less attention has been paid to the potential of these programmes to prevent child mental health problems and promote child well-being. Peer-reviewed journal articles describing controlled evaluations of ECE interventions in LAMIC were reviewed to identify studies with child mental health outcomes. Studies with proximal outcomes for child mental health including caregiver practices and caregiver mental health were also reviewed. Of 63 studies identified, 21 (33.33%) included child mental health outcomes; 12 of 16 studies with short-term measures showed benefits; 6 studies included a longer-term follow-up and all found benefits; 25 studies included caregiver outcomes: consistent benefits were found for caregiver practices (21 studies) and 6 of 9 studies that measured caregiver mental health reported benefits. Gains to child mental health may be most likely when ECE interventions include three main elements: (i) activities to increase child skills including cognition, language, self-regulation and social-emotional competence; (ii) training caregivers in the skills required to provide a cognitively stimulating and emotionally supportive environment; and (iii) attention to the caregivers' mental health, motivation and self-efficacy. Recommendations for the design and implementation of programmes are provided. ECE interventions are an important component of mental health prevention and promotion in LAMIC, and promoting child and caregiver well-being is a fundamental aspect of interventions to improve child development.

[Cost-benefit analysis of primary prevention programs for mental health at the workplace in Japan].

PubMed

Yoshimura, Kensuke; Kawakami, Norito; Tsusumi, Akizumi; Inoue, Akiomi; Kobayashi, Yuka; Takeuchi, Ayano; Fukuda, Takashi

2013-01-01

To determine the cost-benefits of primary prevention programs for mental health at the workplace, we conducted a meta-analysis of published studies in Japan. We searched the literature, published as of 16 November 2011, using the Pubmed database and relevant key words. The inclusion criteria were: conducted in the workplace in Japan; primary prevention focus; quasi-experimental studies or controlled trials; and outcomes including absenteeism or presenteeism. Four studies were identified: one participatory work environment improvement, one individual-oriented stress management, and two supervisor education programs. Costs and benefits in yen were estimated for each program, based on the description of the programs in the literature, and additional information from the authors. The benefits were estimated based on each program's effect on work performance (measured using the WHO Health and Work Performance Questionnaire in all studies), as well as sick leave days, if available. The estimated relative increase in work performance (%) in the intervention group compared to the control group was converted into labor cost using the average bonus (18% of the total annual salary) awarded to employees in Japan as a base. Sensitive analyses were conducted using different models of time-trend of intervention effects and 95% confidence limits of the relative increase in work performance. For the participatory work environment improvement program, the cost was estimated as 7,660 yen per employee, and the benefit was 15,200-22,800 yen per employee. For the individual-oriented stress management program, the cost was 9,708 yen per employee, and the benefit was 15,200-22,920 yen per employee. For supervisor education programs, the costs and benefits were respectively 5,209 and 4,400-6,600 yen per employee, in one study, 2,949 and zero yen per employee in the other study. The 95% confidence intervals were wide for all these studies. For the point estimates based on these cases, the participatory work environment improvement program and the individual-oriented stress management program showed better cost-benefits. For the supervisor education programs, the costs were almost equal to or greater than the benefits. The results of the present study suggest these primary prevention programs for mental health at the workplace are economically advantageous to employers. Because the 95% confidence intervals were wide, further research is needed to clarify if these interventions yield statistically significant cost-benefits.

The Management Development Program: A Competency-Based Model for Preparing Hospitality Leaders.

ERIC Educational Resources Information Center

Brownell, Judi; Chung, Beth G.

2001-01-01

The master of management program at Cornell University focused on competency-based development of skills for the hospitality industry through core courses, minicourses, skill benchmarking, and continuous improvement. Benefits include a shift in the teacher role to advocate/coach, increased information sharing, student satisfaction, and clear…

Biosurveillance at the United States Meat Animal Research Center

USDA-ARS?s Scientific Manuscript database

The mission of the 50 scientists and 165 support staff at the U.S. Meat Animal Research Center (USMARC) is to develop new technologies to increase the efficiency of livestock production and improve meat safety, quality, and animal health to benefit consumers worldwide. The facilities include 35,000 ...

The School Leader's Guide to Social Media

ERIC Educational Resources Information Center

Williamson, Ronald; Johnston, J. Howard

2012-01-01

Social media has exploded onto American culture--including our schools--giving educators a unique opportunity to shape this phenomenon into a powerful tool for improving educational leadership practices. With real-world examples and practical tips, this essential guide shows school leaders how to address both the potential benefits and common…

Nothing's Free: Calculating the Cost of Volunteers

ERIC Educational Resources Information Center

Ingle, W. Kyle

2010-01-01

Most school district administrators recognize the benefits of using parent and community volunteers, including improved school-community relations. But volunteers are not cost free. At their best, volunteers can be a valuable resource for schools and districts. At their worst, volunteers can consume already limited resources. However, their use…

How Course Portfolios Can Advance the Scholarship and Practice of Management Teaching

ERIC Educational Resources Information Center

New, J. Randolph; Clawson, James G.; Coughlan, Richard S.; Hoyle, Joe Ben

2008-01-01

The authors believe the development, peer review, and sharing of course portfolios can significantly improve the scholarship and teaching of management. To make this case, they provide background information about course portfolios, including origins, defining features, purposes, and potential benefits. They then identify actual portfolio projects…

"A Desire for Growth": Online Full-Time Faculty's Perceptions of Evaluation Processes

ERIC Educational Resources Information Center

DeCosta, Meredith; Bergquist, Emily; Holbeck, Rick

2015-01-01

Post-secondary educational institutions use various means to evaluate the teaching performance of faculty members. There are benefits to effective faculty evaluation, including advancing the scholarship of teaching and learning, as well as improving the functionality and innovation of courses, curriculum, departments, and ultimately the broader…

Recommendations for improved assessment of noise impacts on wildlife

Treesearch

Larry L. Pater; Teryl G. Grubb; David K. Delaney

2009-01-01

Research to determine noise impacts on animals benefits from methodology that adequately describes the acoustical stimulus as well as the resulting biological responses. We present acoustical considerations and research techniques that we have found to be useful. These include acoustical definitions and noise measurement techniques that conform to standardized...

Enhancing Professional Learning for Rural Educators by Rethinking Connectedness

ERIC Educational Resources Information Center

Broadley, Tania

2012-01-01

Impending changes in Australian education brings forth the expected transformation of teachers working in schools. Three key points for transforming Australian schools has been identified by Gillard (2008a) including the improvement of quality teaching, ensuring every child benefits and mandating transparency and accountability. A number of…

The Relations between "Babysigning", Child Vocabulary and Maternal Mind-Mindedness

ERIC Educational Resources Information Center

Zammit, Maria; Atkinson, Susan

2017-01-01

Babysign classes are increasingly popular across the UK. Benefits are said to include increasing child vocabulary, reducing frustration, and improving parent-child relations. A further relationship between the use of babysign and maternal mind-mindedness (MM) has been suggested. It was hypothesized here that parents choosing babysign classes would…

Shared Decision Making in Cancer Care

ERIC Educational Resources Information Center

Butow, Phyllis; Tattersall, Martin

2005-01-01

Cancer treatment outcomes have improved over the past 20 years, but treatment decision making in this context remains complex. There are often a number of reasonable treatment alternatives, including no treatment in some circumstances. Patients and doctors often have to weigh up uncertain benefits against uncertain costs. Shared decision making…

Decreasing nitrate-N loads to coastal ecosystems with innovative drainage management strategies in agricultural landscapes: An experimental approach

USDA-ARS?s Scientific Manuscript database

Controlled drainage in agricultural ditches contributes to a drainage management strategy with potential environmental and production benefits. Innovative drainage strategies including spatially orientated low-grade weirs show promise to significantly improve nutrient (e.g. nitrate-N) reductions by...

Harnessing Linguistic Variation to Improve Education. Rethinking Education. Volume 5

ERIC Educational Resources Information Center

Yiakoumetti, Androula, Ed.

2012-01-01

This volume brings together research carried out in a variety of geographic and linguistic contexts including Africa, Asia, Australia, Canada, the Caribbean, Europe and the United States and explores efforts to incorporate linguistic diversity into education and to "harness" this diversity for learners' benefit. It challenges the largely…

"You're a Grounded Theorist for the Day": Teaching Students the Grounded Theory Approach

ERIC Educational Resources Information Center

Docan-Morgan, Tony

2010-01-01

Undergraduate research experience offers students a host of benefits including: (a) improving interpersonal and technical skills; (b) fostering independent learning and analytical abilities; and (c) creating close personal connections with faculty members. However, Rodrick and Dickmeyer (2002) suggest that, "although communication educators…

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

ERIC Educational Resources Information Center

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

2016-01-01

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

The Writer's Hotline: Outreach and the Urban English Department.

ERIC Educational Resources Information Center

Willson, Robert F., Jr.

1980-01-01

Describes a "writer's hotline" telephone program operated at the University of Missouri, Kansas City, in which English faculty address community members' writing problems. Benefits have included increased publicity for the department, improved relationships with the community, and gains in expertise in handling questions of English usage. (DF)

Improving Business-IT Alignment through Business Architecture

ERIC Educational Resources Information Center

Li, Chingmei

2010-01-01

The business and Information Technology (IT) alignment issue has become one of the Top-10 IT management issues since 1980. IT has continually strived to achieve alignment with business goals and objectives. These IT efforts include ERP implementation to benefit from the best practices; data center consolidation and server virtualization to keep…

School Yard Environmental Projects: A Planning Primer.

ERIC Educational Resources Information Center

Megalos, Mark A.; And Others

This guide describes how to establish successful trails, outdoor classrooms, or other environmental education improvements on rural and urban school grounds. Teachers are encouraged to promote the environmental project as a solution to an existing problem and to include all parties and stakeholders that can benefit from a coordinated environmental…

Caveats to quantifying ecosystem services: fruit abortion blurs benefits from crop pollination.

PubMed

Bos, Merijn M; Veddeler, Dorthe; Bogdanski, Anne K; Klein, Alexandra-Maria; Tscharntke, Teja; Steffan-Dewenter, Ingolf; Tylianakis, Jason M

2007-09-01

The recent trend to place monetary values on ecosystem services has led to studies on the economic importance of pollinators for agricultural crops. Several recent studies indicate regional, long-term pollinator declines, and economic consequences have been derived from declining pollination efficiencies. However, use of pollinator services as economic incentives for conservation must consider environmental factors such as drought, pests, and diseases, which can also limit yields. Moreover, "flower excess" is a well-known reproductive strategy of plants as insurance against unpredictable, external factors that limit reproduction. With three case studies on the importance of pollination levels for amounts of harvested fruits of three tropical crops (passion fruit in Brazil, coffee in Ecuador, and cacao in Indonesia) we illustrate how reproductive strategies and environmental stress can obscure initial benefits from improved pollination. By interpreting these results with findings from evolutionary sciences, agronomy, and studies on wild-plant populations, we argue that studies on economic benefits from pollinators should include the total of ecosystem processes that (1) lead to successful pollination and (2) mobilize nutrients and improve plant quality to the extent that crop yields indeed benefit from enhanced pollinator services. Conservation incentives that use quantifications of nature's services to human welfare will benefit from approaches at the ecosystem level that take into account the broad spectrum of biological processes that limit or deliver the service.

The impact of continuous versus intermittent vital signs monitoring in hospitals: A systematic review and narrative synthesis.

PubMed

Downey, C L; Chapman, S; Randell, R; Brown, J M; Jayne, D G

2018-08-01

Continuous vital signs monitoring on general hospital wards may allow earlier detection of patient deterioration and improve patient outcomes. This systematic review will assess if continuous monitoring is practical outside of the critical care setting, and whether it confers any clinical benefit to patients. MEDLINE ® , MEDLINE ® In-Process, EMBASE, CINAHL and The Cochrane Library were searched for articles that evaluated the clinical or non-clinical outcomes of continuous vital signs monitoring in adults outside of the critical care setting. The protocol was registered with PROSPERO (CRD42017058098). Twenty-four studies met the inclusion criteria and reported outcomes on a total of 40,274 patients and 59 ward staff in nine countries. The majority of studies showed benefits in terms of critical care use and length of hospital stay. Larger studies were more likely to demonstrate clinical benefit, particularly critical care use and length of hospital stay. Three studies showed cost-effectiveness. Barriers to implementation included nursing and patient satisfaction and the burden of false alerts. Continuous vital signs monitoring outside the critical care setting is feasible and may provide a benefit in terms of improved patient outcomes and cost efficiency. Large, well-controlled studies in high-risk populations are required to evaluate the clinical benefit of continuous monitoring systems. Copyright © 2018 Elsevier Ltd. All rights reserved.

Managing the water-energy-food nexus: Opportunities in Central Asia

NASA Astrophysics Data System (ADS)

Jalilov, Shokhrukh-Mirzo; Amer, Saud A.; Ward, Frank A.

2018-02-01

This article examines impacts of infrastructure development and climate variability on economic outcomes for the Amu Darya Basin in Central Asia. It aims to identify the most economically productive mix of expanded reservoir storage for economic benefit sharing to occur, in which economic welfare of all riparians is improved. Policies examined include four combinations of storage infrastructure for each of two climate futures. An empirical optimization model is developed and applied to identify opportunities for improving the welfare of Tajikistan, Uzbekistan, Afghanistan, and Turkmenistan. The analysis 1) characterizes politically constrained and economically optimized water-use patterns for these combinations of expanded reservoir storage capacity, 2) describes Pareto-Improving packages of expanded storage capacity that could raise economic welfare for all four riparians, and accounts for impacts for each of two climate scenarios. Results indicate that a combination of targeted water storage infrastructure and efficient water allocation could produce outcomes for which the discounted net present value of benefits are favorable for each riparian. Results identify a framework to provide economic motivation for all riparians to cooperate through development of water storage infrastructure. Our findings illustrate the principle that development of water infrastructure can expand the negotiation space by which all communities can gain economic benefits in the face of limited water supply. Still, despite our optimistic findings, patient and deliberate negotiation will be required to transform potential improvements into actual gains.

Quality assessments for cancer centers in the European Union.

PubMed

Wind, Anke; Rajan, Abinaya; van Harten, Wim H

2016-09-07

Cancer centers are pressured to deliver high-quality services that can be measured and improved, which has led to an increase of assessments in many countries. A critical area of quality improvement is to improve patient outcome. An overview of existing assessments can help stakeholders (e.g., healthcare professionals, managers and policy makers) improve the quality of cancer research and care and lead to patient benefits. This paper presents key aspects of assessments undertaken by European cancer centers, such as: are assessments mandatory or voluntary? Do they focus on evaluating research, care or both? And are they international or national? A survey was sent to 33 cancer centers in 28 European Union member states. Participants were asked to score the specifics for each assessment that they listed. Based on the responses from 19 cancer centers from 18 member states, we found 109 assessments. The numbers have steadily increased from 1990's till 2015. Although, a majority of assessments are on patient-care aspects (n = 45), it is unclear how many of those include assessing patient benefits. Only few assessments cover basic research. There is an increasing trend towards mixed assessments (i.e., combining research and patient-care aspects) The need for assessments in cancer centers is increasing. To improve efforts in the quality of research and patient care and to prevent new assessments that "reinvent the wheel", it is advised to start comparative research into the assessments that are likely to bring patient benefits and improve patient outcome. Do assessments provide consistent and reliable information that create added value for all key stakeholders?

Implementation and impact of an online tool used in primary care to improve access to financial benefits for patients: a study protocol.

PubMed

Aery, Anjana; Rucchetto, Anne; Singer, Alexander; Halas, Gayle; Bloch, Gary; Goel, Ritika; Raza, Danyaal; Upshur, Ross E G; Bellaire, Jackie; Katz, Alan; Pinto, Andrew David

2017-10-22

Addressing the social determinants of health has been identified as crucial to reducing health inequities. However, few evidence-based interventions exist. This study emerges from an ongoing collaboration between physicians, researchers and a financial literacy organisation. Our study will answer the following: Is an online tool that improves access to financial benefits feasible and acceptable? Can such a tool be integrated into clinical workflow? What are patient perspectives on the tool and what is the short-term impact on access to benefits? An advisory group made up of patients living on low incomes and representatives from community agencies supports this study. We will recruit three primary care sites in Toronto, Ontario and three in Winnipeg, Manitoba that serve low-income communities. We will introduce clinicians to screening for poverty and how benefits can increase income. Health providers will be encouraged to use the tool with any patient seen. The health provider and patient will complete the online tool together, generating a tailored list of benefits and resources to assist with obtaining these benefits. A brief survey on this experience will be administered to patients after they complete the tool, as well as a request to contact them in 1 month. Those who agree to be contacted will be interviewed on whether the intervention improved access to financial benefits. We will also administer an online survey to providers and conduct focus groups at each site. Key ethical concerns include that patients may feel discomfort when being asked about their financial situation, may feel obliged to complete the tool and may have their expectations falsely raised about receiving benefits. Providers will be trained to address each of these concerns. We will share our findings with providers and policy-makers interested in addressing the social determinants of health within healthcare settings. Clinicaltrials.gov: NCT02959866. Registered 7 November 2016. Retrospectively registered. Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Cost-effectiveness of a complex workplace dietary intervention: an economic evaluation of the Food Choice at Work study.

PubMed

Fitzgerald, Sarah; Murphy, Aileen; Kirby, Ann; Geaney, Fiona; Perry, Ivan J

2018-03-03

To evaluate the costs, benefits and cost-effectiveness of complex workplace dietary interventions, involving nutrition education and system-level dietary modification, from the perspective of healthcare providers and employers. Single-study economic evaluation of a cluster-controlled trial (Food Choice at Work (FCW) study) with 1-year follow-up. Four multinational manufacturing workplaces in Cork, Ireland. 517 randomly selected employees (18-65 years) from four workplaces. Cost data were obtained from the FCW study. Nutrition education included individual nutrition consultations, nutrition information (traffic light menu labelling, posters, leaflets and emails) and presentations. System-level dietary modification included menu modification (restriction of fat, sugar and salt), increase in fibre, fruit discounts, strategic positioning of healthier alternatives and portion size control. The combined intervention included nutrition education and system-level dietary modification. No intervention was implemented in the control. The primary outcome was an improvement in health-related quality of life, measured using the EuroQoL 5 Dimensions 5 Levels questionnaire. The secondary outcome measure was reduction in absenteeism, which is measured in monetary amounts. Probabilistic sensitivity analysis (Monte Carlo simulation) assessed parameter uncertainty. The system-level intervention dominated the education and combined interventions. When compared with the control, the incremental cost-effectiveness ratio (€101.37/quality-adjusted life-year) is less than the nationally accepted ceiling ratio, so the system-level intervention can be considered cost-effective. The cost-effectiveness acceptability curve indicates there is some decision uncertainty surrounding this, arising from uncertainty surrounding the differences in effectiveness. These results are reiterated when the secondary outcome measure is considered in a cost-benefit analysis, whereby the system-level intervention yields the highest net benefit (€56.56 per employee). System-level dietary modification alone offers the most value per improving employee health-related quality of life and generating net benefit for employers by reducing absenteeism. While system-level dietary modification strategies are potentially sustainable obesity prevention interventions, future research should include long-term outcomes to determine if improvements in outcomes persist. ISRCTN35108237; Post-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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

PubMed

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

2016-06-01

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

A cost-benefit analysis of music therapy in a home hospice.

PubMed

Romo, Rafael; Gifford, Lisa

2007-01-01

Medicare's fixed daily rates create an absolute cost constraint on hospices; consequently, the growth in hospice brings financial pressures. The patient efficacy of music therapy has been demonstrated in the literature and includes improving pain, agitation, disruptive behaviors, communication, depression, and quality of life. Music therapy is well suited to hospice as it addresses the four domains of palliative care (physiological, emotional, social, and spiritual care). In this small study, the total cost of patients in music therapy was $10,659 and $13,643 for standard care patients, resulting in a cost savings of $2984. The music therapy program cost $3615, yielding a cost benefit ratio of 0.83. When using cost per patient day, the cost benefit ratio is 0.95.

Adequate nutrient intake can reduce cardiovascular disease risk in African Americans.

PubMed

Reusser, Molly E; DiRienzo, Douglas B; Miller, Gregory D; McCarron, David A

2003-03-01

Cardiovascular disease kills nearly as many Americans each year as the next seven leading causes of death combined. The prevalence of cardiovascular disease and most of its associated risk factors is markedly higher and increasing more rapidly among African Americans than in any other racial or ethnic group. Improving these statistics may be simply a matter of improving diet quality. In recent years, a substantial and growing body of evidence has revealed that dietary patterns complete in all food groups, including nutrient-rich dairy products, are essential for preventing and reducing cardiovascular disease and the conditions that contribute to it. Several cardiovascular risk factors, including hypertension, insulin resistance syndrome, and obesity, have been shown to be positively influenced by dietary patterns that include adequate intake of dairy products. The benefits of nutrient-rich dietary patterns have been specifically tested in randomized, controlled trials emphasizing African American populations. These studies demonstrated proportionally greater benefits for African Americans without evidence of adverse effects such as symptoms of lactose intolerance. As currently promoted for the prevention of certain cancers and osteoporosis, regular consumption of diets that meet recommended nutrient intake levels might also be the most effective approach for reducing cardiovascular disease risk in African Americans.

Closing the (service) gap: exploring partnerships between Aboriginal and mainstream health services.

PubMed

Taylor, Kate P; Thompson, Sandra C

2011-08-01

Although effective partnerships between Aboriginal and mainstream health services are critical to improve Aboriginal health outcomes, many factors can cause these partnerships to be tenuous and unproductive. Understanding the elements of best practice for successful partnerships is essential. A literature review was conducted in 2009 using keyword searches of electronic databases. Sourced literature was assessed for relevance regarding the benefits, challenges, lessons learnt and factors contributing to successful Aboriginal and mainstream partnerships. Key themes were collated. Although there is much literature regarding general partnerships generally, few specifically examine Aboriginal and mainstream health service partnerships. Twenty-four sources were reviewed in detail. Benefits include broadening service capacity and improving the cultural security of healthcare. Challenges include the legacy of Australia's colonial history, different approaches to servicing clients and resource limitations. Recommendations for success include workshopping tensions early, building trust and leadership. Although successful partnerships are crucial to optimise Aboriginal health outcomes, failed collaborations risk inflaming sensitive Aboriginal-non-Aboriginal relationships. Factors supporting successful partnerships remind us to develop genuine, trusting relationships that are tangibly linked to the Aboriginal community. Failure to invest in this relational process and push forward with 'business as usual' can ultimately have negative ramifications on client outcomes.

PEGylated nanomedicines: recent progress and remaining concerns.

PubMed

Vllasaliu, Driton; Fowler, Robyn; Stolnik, Snow

2014-01-01

Recent biopharma deals related to nanocarrier drug delivery technologies highlight the emergence of nanomedicine. This is perhaps an expected culmination of many years of research demonstrating the potential of nanomedicine as the next generation of therapeutics with improved performance. PEGylated nanocarriers play a key role within this field. The drug delivery advantages of nanomedicines in general are discussed, focusing on nanocarriers and PEGylated nanomedicines, including products under current development/clinical evaluation. Well-established drug delivery benefits of PEGylation (e.g., prolonged circulation) are only briefly covered. Instead, attention is deliberately made to less commonly reported advantages of PEGylation, including mucosal delivery of nanomedicines. Finally, some of the issues related to the safety of PEGylated nanomedicines in clinical application are discussed. The advent of nanomedicine providing therapeutic options of refined performance continues. Although PEGylation as a tool to improve the pharmacokinetics of nanomedicines is well established and is used clinically, other benefits of 'PEGnology', including enhancement of physicochemical properties and/or biocompatibility of actives and/or drug carriers, as well as mucosal delivery, have attracted less attention. While concerns regarding the clinical use of PEGylated nanomedicines remain, evidence suggests that at least some safety issues may be controlled by adequate designs of nanosystems.

Benefits of simulation based training for neonatal resuscitation education: a systematic review.

PubMed

Rakshasbhuvankar, A A; Patole, S K

2014-10-01

Simulation-based training (SBT) is being more frequently recommended for neonatal resuscitation education (NRE). It is important to assess if SBT improves clinical outcomes as neonatal resuscitation aims to improve survival without long-term neurodevelopmental impairment. We aimed to assess the evidence supporting benefits of SBT in NRE. A systematic review was conducted using the Cochrane methodology. PubMed, Embase, PsycInfo and Cochrane databases were searched. Related abstracts were scanned and full texts of the potentially relevant articles were studied. Randomised controlled trials (RCT) and quasi-experimental studies with controls (non-RCT) assessing SBT for NRE were eligible for inclusion in the review. Four small studies [three RCT (n=126) and one non-RCT (n=60)] evaluated SBT for NRE. Participants included medical students (one RCT and one non-RCT), residents (one RCT) and nursing staff (one RCT). Outcomes included performance in a simulation scenario, theoretical knowledge, and confidence in leading a resuscitation scenario. One RCT favoured simulation [improved resuscitation score (p=0.016), 2.31 more number of critical actions (p=0.017) and decreased time to achieve resuscitation steps (p=<0.001)]. The remaining two RCTs and the non-RCT did not find any difference between SBT and alternate methods of instruction. None of the four studies reported clinical outcomes. Evidence regarding benefits of SBT for NRE is limited. There are no data on clinical outcomes following SBT for NRE. Large RCTs assessing clinically important outcomes are required before SBT can be recommended widely for NRE. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Service-learning in Higher Education Relevant to the Promotion of Physical Activity, Healthful Eating, and Prevention of Obesity

PubMed Central

Rosenkranz, Richard R

2012-01-01

Service-learning is a type of experiential teaching and learning strategy combining classroom instruction and meaningful community service and guided activities for reflection. This educational approach has been used frequently in higher education settings, including an array of disciplines such as medicine, theology, public health, physical education, nutrition, psychology, anthropology, and sociology. The purpose of the present review paper was to provide guidance on the use of service-learning within higher education, relevant to the preventive medicine and public health topics of healthful eating, physical activity, and obesity prevention. In service-learning, coursework is structured to address community needs, and to benefit students through the real-world application of knowledge. The benefits for students include positive impacts on social skills, empathy, awareness, understanding, and concern regarding community issues, plus greater confidence and skills to work with diverse populations, increased awareness of community resources, improved motivation, and enhanced knowledge. Educational institutions may also benefit through improved “town and gown” relations, as strong ties, partnerships, and mutually beneficial activities take place. The present literature review describes several service-learning applications such as nutrition education for kids, dietary improvement for seniors, foodservice recipe modification on a college campus, an intergenerational physical activity program for nursing home residents, motor skill development in kindergarteners, organized elementary school recess physical activities, health education, and obesity prevention in children. From this review, service-learning appears to have great potential as a flexible component of academic coursework in the areas of preventive medicine and public health. PMID:23112892

Mental illness in Bwindi, Uganda: Understanding stakeholder perceptions of benefits and barriers to developing a community-based mental health programme.

PubMed

Sessions, Kristen L; Wheeler, Lydia; Shah, Arya; Farrell, Deenah; Agaba, Edwin; Kuule, Yusufu; Merry, Stephen P

2017-11-30

Mental illness has been increasingly recognised as a source of morbidity in low- and middle-income countries and significant treatment gaps exist worldwide. Studies have demonstrated the effectiveness of task sharing through community-based treatment models for addressing international mental health issues. This paper aims to evaluate the perceptions of a wide range of mental health stakeholders in a Ugandan community regarding the benefits and barriers to developing a community-based mental health programme. Bwindi Community Hospital (BCH) in south-west Uganda provides services through a team of community health workers to people in the Kanungu District. Thematic analysis of 13 semi-structured interviews and 6 focus group discussions involving 54 community members and 13 mental health stakeholders within the BCH catchment area. Stakeholders perceived benefits to a community-based compared to a hospital-based programme, including improved patient care, lower costs to patients and improved community understanding of mental illness. They also cited barriers including cost, insufficient workforce and a lack of community readiness. Stakeholders express interest in developing community-based mental health programmes, as they feel that it will address mental health needs in the community and improve community awareness of mental illness. However, they also report that cost is a significant barrier to programme development that will have to be addressed prior to being able to successfully establish such programming. Additionally, many community members expressed unique sociocultural beliefs regarding the nature of mental illness and those suffering from a psychiatric disease.

Service-learning in Higher Education Relevant to the Promotion of Physical Activity, Healthful Eating, and Prevention of Obesity.

PubMed

Rosenkranz, Richard R

2012-10-01

Service-learning is a type of experiential teaching and learning strategy combining classroom instruction and meaningful community service and guided activities for reflection. This educational approach has been used frequently in higher education settings, including an array of disciplines such as medicine, theology, public health, physical education, nutrition, psychology, anthropology, and sociology. The purpose of the present review paper was to provide guidance on the use of service-learning within higher education, relevant to the preventive medicine and public health topics of healthful eating, physical activity, and obesity prevention. In service-learning, coursework is structured to address community needs, and to benefit students through the real-world application of knowledge. The benefits for students include positive impacts on social skills, empathy, awareness, understanding, and concern regarding community issues, plus greater confidence and skills to work with diverse populations, increased awareness of community resources, improved motivation, and enhanced knowledge. Educational institutions may also benefit through improved "town and gown" relations, as strong ties, partnerships, and mutually beneficial activities take place. The present literature review describes several service-learning applications such as nutrition education for kids, dietary improvement for seniors, foodservice recipe modification on a college campus, an intergenerational physical activity program for nursing home residents, motor skill development in kindergarteners, organized elementary school recess physical activities, health education, and obesity prevention in children. From this review, service-learning appears to have great potential as a flexible component of academic coursework in the areas of preventive medicine and public health.

Valuation of Green Walls and Green Roofs as Soundscape Measures: Including Monetised Amenity Values Together with Noise-attenuation Values in a Cost-benefit Analysis of a Green Wall Affecting Courtyards

PubMed Central

Veisten, Knut; Smyrnova, Yuliya; Klæboe, Ronny; Hornikx, Maarten; Mosslemi, Marjan; Kang, Jian

2012-01-01

Economic unit values of soundscape/acoustic effects have been based on changes in the number of annoyed persons or on decibel changes. The normal procedure has been the application of these unit values to noise-attenuation measures affecting the noisier façade of a dwelling. Novel modular vegetation-based soundscape measures, so-called green walls, might be relevant for both noisy and quieter areas. Moreover, their benefits will comprise noise attenuation as well as non-acoustic amenity effects. One challenge is to integrate the results of some decades of non-acoustic research on the amenity value of urban greenery into design of the urban sound environment, and incorporate these non-acoustic properties in the overall economic assessment of noise control and overall sound environment improvement measures. Monetised unit values for green walls have been included in two alternative cases, or demonstration projects, of covering the entrances to blocks of flats with a green wall. Since these measures improve the noise environment on the quiet side of the dwellings and courtyards, not the most exposed façade, adjustment factors to the nominal quiet side decibel reductions to arrive at an estimate of the equivalent overall acoustic improvement have been applied. A cost-benefit analysis of the green wall case indicates that this measure is economically promising, when valuing the noise attenuation in the quieter area and adding the amenity/aesthetic value of the green wall. PMID:23202816

Cost-benefit and cost-savings analyses of antiarrhythmic medication monitoring.

PubMed

Snider, Melissa; Carnes, Cynthia; Grover, Janel; Davis, Rich; Kalbfleisch, Steven

2012-09-15

The economic impact of pharmacist-managed antiarrhythmic drug therapy monitoring on an academic medical center's electrophysiology (EP) program was investigated. Data were collected for the initial two years of patient visits (n = 816) to a pharmacist-run clinic for antiarrhythmic drug therapy monitoring. A retrospective cost analysis was conducted to assess the direct costs associated with three appointment models: (1) a clinic office visit only, (2) a clinic visit involving electrocardiography and basic laboratory tests, and (3) a clinic visit including pulmonary function testing and chest x-rays in addition to electrocardiography and laboratory testing. A subset of patient cases (n = 18) were included in a crossover analysis comparing pharmacist clinic care and usual care in an EP physician clinic. The primary endpoints were the cost benefits and cost savings associated with pharmacy-clinic care versus usual care. A secondary endpoint was improvement of overall EP program efficiency. The payer mix was 61.6% (n = 498) Medicare, 33.2% (n = 268) managed care, and 5.2% (n = 42) other. Positive contribution margins were demonstrated for all appointment models. The pharmacist-managed clinic also yielded cost savings by reducing overall patient care charges by 21% relative to usual care. By the second year, the pharmacy clinic improved EP program efficiency by scheduling an average of 24 patients per week, in effect freeing up one day per week of EP physician time to spend on other clinical activities. Pharmacist monitoring of antiarrhythmic drug therapy in an out-patient clinic provided cost benefits, cost savings, and improved overall EP program efficiency.

Presentation of Benefits and Harms in US Cancer Screening and Prevention Guidelines: Systematic Review

PubMed Central

Hayward, Rodney A.; Reamer, Elyse; Zikmund-Fisher, Brian J.; Connochie, Daniel; Heisler, Michele; Fagerlin, Angela

2016-01-01

Background: Cancer prevention and screening guidelines are ideally suited to the task of providing high-quality benefit-harm information that informs clinical practice. We systematically examined how US guidelines present benefits and harms for recommended cancer prevention and screening interventions. Methods: We included cancer screening and prevention recommendations from: 1) the United States Preventive Services Task Force, 2) the American Cancer Society, 3) the American College of Physicians, 4) the National Comprehensive Cancer Network, and 5) other US guidelines within the National Guidelines Clearinghouse. Searches took place November 20, 2013, and January 1, 2014, and updates were reviewed through July 1, 2015. Two coders used an abstraction form to code information about benefits and harms presented anywhere within a guideline document, including appendices. The primary outcome was each recommendation’s benefit-harm “comparability” rating, based on how benefits and harms were presented. Recommendations presenting absolute effects for both benefits and harms received a “comparable” rating. Other recommendations received an incomplete rating or an asymmetric rating based on prespecified criteria. Results: Fifty-five recommendations for using interventions to prevent or detect breast, prostate, colon, cervical, and lung cancer were identified among 32 guidelines. Thirty point nine percent (n = 17) received a comparable rating, 14.5% (n = 8) received an incomplete rating, and 54.5% (n = 30) received an asymmetric rating. Conclusions: Sixty-nine percent of cancer prevention and screening recommendation statements either did not quantify benefits and harms or presented them in an asymmetric manner. Improved presentation of benefits and harms in guidelines would better ensure that clinicians and patients have access to the information required for making informed decisions. PMID:26917630

Intelligent Sensors for Integrated Systems Health Management (ISHM)

NASA Technical Reports Server (NTRS)

Schmalzel, John L.

2008-01-01

IEEE 1451 Smart Sensors contribute to a number of ISHM goals including cost reduction achieved through: a) Improved configuration management (TEDS); and b) Plug-and-play re-configuration. Intelligent Sensors are adaptation of Smart Sensors to include ISHM algorithms; this offers further benefits: a) Sensor validation. b) Confidence assessment of measurement, and c) Distributed ISHM processing. Space-qualified intelligent sensors are possible a) Size, mass, power constraints. b) Bus structure/protocol.

Health Co-Benefits of Green Building Design Strategies and Community Resilience to Urban Flooding: A Systematic Review of the Evidence.

PubMed

Houghton, Adele; Castillo-Salgado, Carlos

2017-12-06

Climate change is increasingly exacerbating existing population health hazards, as well as resulting in new negative health effects. Flooding is one particularly deadly example of its amplifying and expanding effect on public health. This systematic review considered evidence linking green building strategies in the Leadership in Energy and Environmental Design ® (LEED) Rating System with the potential to reduce negative health outcomes following exposure to urban flooding events. Queries evaluated links between LEED credit requirements and risk of exposure to urban flooding, environmental determinants of health, co-benefits to public health outcomes, and co-benefits to built environment outcomes. Public health co-benefits to leveraging green building design to enhance flooding resilience included: improving the interface between humans and wildlife and reducing the risk of waterborne disease, flood-related morbidity and mortality, and psychological harm. We conclude that collaborations among the public health, climate change, civil society, and green building sectors to enhance community resilience to urban flooding could benefit population health.

Does Carbohydrate Intake During Endurance Running Improve Performance? A Critical Review.

PubMed

Wilson, Patrick B

2016-12-01

Wilson, PB. Does carbohydrate intake during endurance running improve performance? A critical review. J Strength Cond Res 30(12): 3539-3559, 2016-Previous review articles assessing the effects of carbohydrate ingestion during prolonged exercise have not focused on running. Given the popularity of distance running and the widespread use of carbohydrate supplements, this article reviewed the evidence for carbohydrate ingestion during endurance running. The criteria for inclusion were (a) experimental studies reported in English language including a performance task, (b) moderate-to-high intensity exercise >60 minutes (intermittent excluded), and (c) carbohydrate ingestion (mouth rinsing excluded). Thirty studies were identified with 76 women and 505 men. Thirteen of the 17 studies comparing a carbohydrate beverage(s) with water or a placebo found a between-condition performance benefit with carbohydrate, although heterogeneity in protocols precludes clear generalizations about the expected effect sizes. Additional evidence suggests that (a) performance benefits are most likely to occur during events >2 hours, although several studies showed benefits for tasks lasting 90-120 minutes; (b) consuming carbohydrate beverages above ad libitum levels increases gastrointestinal discomfort without improving performance; (c) carbohydrate gels do not influence performance for events lasting 16-21 km; and (d) multiple saccharides may benefit events >2 hours if intake is ≥1.3 g·min Given that most participants were fasted young men, inferences regarding women, adolescents, older runners, and those competing in fed conditions are hampered. Future studies should address these limitations to further elucidate the role of carbohydrate ingestion during endurance running.

Clinical Pharmacology in Sleep Medicine

PubMed Central

Proctor, Ashley; Bianchi, Matt T.

2012-01-01

The basic treatment goals of pharmacological therapies in sleep medicine are to improve waking function by either improving sleep or by increasing energy during wakefulness. Stimulants to improve waking function include amphetamine derivatives, modafinil, and caffeine. Sleep aids encompass several classes, from benzodiazepine hypnotics to over-the-counter antihistamines. Other medications used in sleep medicine include those initially used in other disorders, such as epilepsy, Parkinson's disease, and psychiatric disorders. As these medications are prescribed or encountered by providers in diverse fields of medicine, it is important to recognize the distribution of adverse effects, drug interaction profiles, metabolism, and cytochrome substrate activity. In this paper, we review the pharmacological armamentarium in the field of sleep medicine to provide a framework for risk-benefit considerations in clinical practice. PMID:23213564

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

PubMed Central

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

2017-01-01

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

Measuring economic value for tourism destination using contingent valuation method: The Sangiran Sites, Central Java Province, Indonesia

NASA Astrophysics Data System (ADS)

Subanti, S.; Zukhronah, E.; Handajani, S. S.; Irawan, BRM B.; Hakim, A. R.

2018-03-01

This purpose of study aims to estimate the economic value for quality improvement in Sangiran, Indonesia. This paper used contingent valuation method. The study was found significant factors affecting the probability of individuals to be willing to pay for quality improvement are the nominal amount bid, gender, and income. The economic value of Sangiran sites tourism was estimated between Rp 2.219 billion per year until Rp 2.756 billion per year. This value can be a guidance for management of the Sangiran as a basic reason for Sangiran’s improvement. The improvement includes to add the collection, to build supporting infrastructure in Sangiran, to increase services, to arrange training for Sangiran staff, and others. The suggestion from this paper, we must support the local government for Sangiran improvement, because it can be profitable and it can give benefits from many aspects includes economic, historical, and education.

Effects of non-invasive ventilation on survival and quality of life in patients with amyotrophic lateral sclerosis: a randomised controlled trial.

PubMed

Bourke, Stephen C; Tomlinson, Mark; Williams, Tim L; Bullock, Robert E; Shaw, Pamela J; Gibson, G John

2006-02-01

Few patients with amyotrophic lateral sclerosis currently receive non-invasive ventilation (NIV), reflecting clinical uncertainty about the role of this intervention. We aimed to assess the effect of NIV on quality of life and survival in amyotrophic lateral sclerosis in a randomised controlled trial. 92 of 102 eligible patients participated. They were assessed every 2 months and randomly assigned to NIV (n=22) or standard care (n=19) when they developed either orthopnoea with maximum inspiratory pressure less than 60% of that predicted or symptomatic hypercapnia. Primary validated quality-of-life outcome measures were the short form 36 mental component summary (MCS) and the sleep apnoea quality-of-life index symptoms domain (sym). Both time maintained above 75% of baseline (T(i)MCS and T(i)sym) and mean improvement (microMCS and microsym) were measured. NIV improved T(i)MCS, T(i)sym, microMCS, microsym, and survival in all patients and in the subgroup with better bulbar function (n=20). This subgroup showed improvement in several measures of quality of life and a median survival benefit of 205 days (p=0.006) with maintained quality of life for most of this period. NIV improved some quality-of-life indices in those with poor bulbar function, including microsym (p=0.018), but conferred no survival benefit. In patients with amyotrophic lateral sclerosis without severe bulbar dysfunction, NIV improves survival with maintenance of, and improvement in, quality of life. The survival benefit from NIV in this group is much greater than that from currently available neuroprotective therapy. In patients with severe bulbar impairment, NIV improves sleep-related symptoms, but is unlikely to confer a large survival advantage.

Incorporating Exercise Into the Cancer Treatment Paradigm.

PubMed

Haas, Barbara K; Hermanns, Melinda; Kimmel, Gary

2016-12-01

The benefits of exercise for patients with cancer are well documented. However, exercise is still not a standard of care for this population. Several factors contribute to the lack of exercise prescriptions for patients with cancer, including challenges posed by treatment-related side effects, lack of knowledge among healthcare providers and the laypeople, and inadequate resources. This article reviews the benefits of exercise in general and specifically to patients with cancer, discusses the specific challenges and considerations required in recommending exercise to this population, and provides specific recommendations for healthcare providers to incorporate exercise into treatment plans. Using a case study exemplar, this article discusses the benefits and challenges to exercise while undergoing treatment for cancer and proposes specific solutions and recommendations. Oncology practitioners can provide the opportunity for patients to safely engage in exercise with the appropriate resources and trained personnel using a successful model of delivering exercise to patients undergoing treatment for cancer. Exercise improves quality of life in all patients, including those with advanced-stage cancers and those actively receiving treatment.

Value of Adaptive Drought Forecasting and Management for the ACF River Basin in the Southeast U.S.

NASA Astrophysics Data System (ADS)

Georgakakos, A. P.; Kistenmacher, M.

2016-12-01

In recent times, severe droughts in the southeast U.S. occur every 6 to 10 years and last for up to 4 years. During such drought episodes, the ACF River Basin supplies decline by up to 50 % of their normal levels, and water stresses increase rather markedly, exacerbating stakeholder anxiety and conflicts. As part of the ACF Stakeholder planning process, GWRI has developed new tools and carried out comprehensive assessments to provide quantitative answers to several important questions related to drought prediction and management: (i) Can dry and wet climatic periods be reliably anticipated with sufficiently long lead times? What drought indices can support reliable, skillful, and long-lead forecasts? (ii) What management objectives can seasonal climate forecasts benefit? How should benefits/impacts be shared? (iii) What operational adjustments are likely to mitigate stakeholder impacts or increase benefits consistent with stakeholder expectations? Regarding drought prediction, a large number of indices were defined and tested at different basin locations and lag times. These included local/cumulative unimpaired flows (UIFs) at 10 river nodes; Mean Areal Precipitation (MAP); Standard Precipitation Index (SPI); Palmer Drought Severity Index; Palmer Modified Drought Index; Palmer Z-Index; Palmer Hydrologic Drought Severity Index; and Soil Moisture—GWRI watershed model. Our findings show that all ACF sub-basins exhibit good forecast skill throughout the year and with sufficient lead time. Index variables with high explanatory value include: previous UIFs, soil moisture states (generated by the GWRI watershed model), and PDSI. Regarding drought management, assessments with coupled forecast-management schemes demonstrate that the use of adaptive forecast-management procedures improves reservoir operations and meets basin demands more reliably. Such improvements can support better management of lake levels, higher environmental and navigation flows, higher dependable power generation hours, and better management of consumptive uses without adverse impacts on other stakeholder interests. However, realizing these improvements requires (1) usage of adaptive reservoir management procedures (incorporating forecasts), and (2) stakeholder agreement on equitable benefit sharing.

Methodological Challenges to Economic Evaluations of Vaccines: Is a Common Approach Still Possible?

PubMed

Jit, Mark; Hutubessy, Raymond

2016-06-01

Economic evaluation of vaccination is a key tool to inform effective spending on vaccines. However, many evaluations have been criticised for failing to capture features of vaccines which are relevant to decision makers. These include broader societal benefits (such as improved educational achievement, economic growth and political stability), reduced health disparities, medical innovation, reduced hospital beds pressures, greater peace of mind and synergies in economic benefits with non-vaccine interventions. Also, the fiscal implications of vaccination programmes are not always made explicit. Alternative methodological frameworks have been proposed to better capture these benefits. However, any broadening of the methodology for economic evaluation must also involve evaluations of non-vaccine interventions, and hence may not always benefit vaccines given a fixed health-care budget. The scope of an economic evaluation must consider the budget from which vaccines are funded, and the decision-maker's stated aims for that spending to achieve.

Health benefits of dietary fiber.

PubMed

Anderson, James W; Baird, Pat; Davis, Richard H; Ferreri, Stefanie; Knudtson, Mary; Koraym, Ashraf; Waters, Valerie; Williams, Christine L

2009-04-01

Dietary fiber intake provides many health benefits. However, average fiber intakes for US children and adults are less than half of the recommended levels. Individuals with high intakes of dietary fiber appear to be at significantly lower risk for developing coronary heart disease, stroke, hypertension, diabetes, obesity, and certain gastrointestinal diseases. Increasing fiber intake lowers blood pressure and serum cholesterol levels. Increased intake of soluble fiber improves glycemia and insulin sensitivity in non-diabetic and diabetic individuals. Fiber supplementation in obese individuals significantly enhances weight loss. Increased fiber intake benefits a number of gastrointestinal disorders including the following: gastroesophageal reflux disease, duodenal ulcer, diverticulitis, constipation, and hemorrhoids. Prebiotic fibers appear to enhance immune function. Dietary fiber intake provides similar benefits for children as for adults. The recommended dietary fiber intakes for children and adults are 14 g/1000 kcal. More effective communication and consumer education is required to enhance fiber consumption from foods or supplements.

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

PubMed

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

2017-10-01

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

Potential benefits of satiety to the consumer: scientific considerations.

PubMed

Hetherington, M M; Cunningham, K; Dye, L; Gibson, E L; Gregersen, N T; Halford, J C G; Lawton, C L; Lluch, A; Mela, D J; Van Trijp, H C M

2013-06-01

Foods and dietary patterns that enhance satiety may provide benefit to consumers. The aim of the present review was to describe, consider and evaluate research on potential benefits of enhanced satiety. The proposal that enhanced satiety could only benefit consumers by a direct effect on food intake should be rejected. Instead, it is proposed that there is a variety of routes through which enhanced satiety could (indirectly) benefit dietary control or weight-management goals. The review highlights specific potential benefits of satiety, including: providing appetite control strategies for consumers generally and for those who are highly responsive to food cues; offering pleasure and satisfaction associated with low-energy/healthier versions of foods without feeling 'deprived'; reducing dysphoric mood associated with hunger especially during energy restriction; and improved compliance with healthy eating or weight-management efforts. There is convincing evidence of short-term satiety benefits, but only probable evidence for longer-term benefits to hunger management, possible evidence of benefits to mood and cognition, inadequate evidence that satiety enhancement can promote weight loss, and no evidence on which consumers would benefit most from satiety enhancement. The appetite-reducing effects of specific foods or diets will be much more subtle than those of pharmaceutical compounds in managing hunger; nevertheless, the experience of pharmacology in producing weight loss via effects on appetite suggests that there is potential benefit of satiety enhancement from foods incorporated into the diet to the consumer.

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

PubMed

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

2013-06-01

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

Environmental Co-Benefit Opportunities of Solar Energy

NASA Astrophysics Data System (ADS)

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

2015-12-01

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

Surgical process improvement tools: defining quality gaps and priority areas in gastrointestinal cancer surgery.

PubMed

Wei, A C; Devitt, K S; Wiebe, M; Bathe, O F; McLeod, R S; Urbach, D R

2014-04-01

Surgery is a cornerstone of cancer treatment, but significant differences in the quality of surgery have been reported. Surgical process improvement tools (spits) modify the processes of care as a means to quality improvement (qi). We were interested in developing spits in the area of gastrointestinal (gi) cancer surgery. We report the recommendations of an expert panel held to define quality gaps and establish priority areas that would benefit from spits. The present study used the knowledge-to-action cycle was as a framework. Canadian experts in qi and in gi cancer surgery were assembled in a nominal group workshop. Participants evaluated the merits of spits, described gaps in current knowledge, and identified and ranked processes of care that would benefit from qi. A qualitative analysis of the workshop deliberations using modified grounded theory methods identified major themes. The expert panel consisted of 22 participants. Experts confirmed that spits were an important strategy for qi. The top-rated spits included clinical pathways, electronic information technology, and patient safety tools. The preferred settings for use of spits included preoperative and intraoperative settings and multidisciplinary contexts. Outcomes of interest were cancer-related outcomes, process, and the technical quality of surgery measures. Surgical process improvement tools were confirmed as an important strategy. Expert panel recommendations will be used to guide future research efforts for spits in gi cancer surgery.

Rapid response systems.

PubMed

Lyons, Patrick G; Edelson, Dana P; Churpek, Matthew M

2018-07-01

Rapid response systems are commonly employed by hospitals to identify and respond to deteriorating patients outside of the intensive care unit. Controversy exists about the benefits of rapid response systems. We aimed to review the current state of the rapid response literature, including evolving aspects of afferent (risk detection) and efferent (intervention) arms, outcome measurement, process improvement, and implementation. Articles written in English and published in PubMed. Rapid response systems are heterogeneous, with important differences among afferent and efferent arms. Clinically meaningful outcomes may include unexpected mortality, in-hospital cardiac arrest, length of stay, cost, and processes of care at end of life. Both positive and negative interventional studies have been published, although the two largest randomized trials involving rapid response systems - the Medical Early Response and Intervention Trial (MERIT) and the Effect of a Pediatric Early Warning System on All-Cause Mortality in Hospitalized Pediatric Patients (EPOCH) trial - did not find a mortality benefit with these systems, albeit with important limitations. Advances in monitoring technologies, risk assessment strategies, and behavioral ergonomics may offer opportunities for improvement. Rapid responses may improve some meaningful outcomes, although these findings remain controversial. These systems may also improve care for patients at the end of life. Rapid response systems are expected to continue evolving with novel developments in monitoring technologies, risk prediction informatics, and work in human factors. Copyright © 2018 Elsevier B.V. All rights reserved.

Clinical benefit using sperm hyaluronic acid binding technique in ICSI cycles: a systematic review and meta-analysis.

PubMed

Beck-Fruchter, Ronit; Shalev, Eliezer; Weiss, Amir

2016-03-01

The human oocyte is surrounded by hyaluronic acid, which acts as a natural selector of spermatozoa. Human sperm that express hyaluronic acid receptors and bind to hyaluronic acid have normal shape, minimal DNA fragmentation and low frequency of chromosomal aneuploidies. Use of hyaluronic acid binding assays in intracytoplasmic sperm injection (ICSI) cycles to improve clinical outcomes has been studied, although none of these studies had sufficient statistical power. In this systematic review and meta-analysis, electronic databases were searched up to June 2015 to identify studies of ICSI cycles in which spermatozoa able to bind hyaluronic acid was selected. The main outcomes were fertilization rate and clinical pregnancy rate. Secondary outcomes included cleavage rate, embryo quality, implantation rate, spontaneous abortion and live birth rate. Seven studies and 1437 cycles were included. Use of hyaluronic acid binding sperm selection technique yielded no improvement in fertilization and pregnancy rates. A meta-analysis of all available studies showed an improvement in embryo quality and implantation rate; an analysis of prospective studies only showed an improvement in embryo quality. Evidence does not support routine use of hyaluronic acid binding assays in all ICSI cycles. Identification of patients that might benefit from this technique needs further study. Copyright © 2015 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Surgical process improvement tools: defining quality gaps and priority areas in gastrointestinal cancer surgery

PubMed Central

Wei, A.C.; Devitt, K.S.; Wiebe, M.; Bathe, O.F.; McLeod, R.S.; Urbach, D.R.

2014-01-01

Background Surgery is a cornerstone of cancer treatment, but significant differences in the quality of surgery have been reported. Surgical process improvement tools (spits) modify the processes of care as a means to quality improvement (qi). We were interested in developing spits in the area of gastrointestinal (gi) cancer surgery. We report the recommendations of an expert panel held to define quality gaps and establish priority areas that would benefit from spits. Methods The present study used the knowledge-to-action cycle was as a framework. Canadian experts in qi and in gi cancer surgery were assembled in a nominal group workshop. Participants evaluated the merits of spits, described gaps in current knowledge, and identified and ranked processes of care that would benefit from qi. A qualitative analysis of the workshop deliberations using modified grounded theory methods identified major themes. Results The expert panel consisted of 22 participants. Experts confirmed that spits were an important strategy for qi. The top-rated spits included clinical pathways, electronic information technology, and patient safety tools. The preferred settings for use of spits included preoperative and intraoperative settings and multidisciplinary contexts. Outcomes of interest were cancer-related outcomes, process, and the technical quality of surgery measures. Conclusions Surgical process improvement tools were confirmed as an important strategy. Expert panel recommendations will be used to guide future research efforts for spits in gi cancer surgery. PMID:24764704

Initial Development of a Spatially Separated Speech-in-Noise and Localization Training Program

PubMed Central

Tyler, Richard S.; Witt, Shelley A.; Dunn, Camille C.; Wang, Wenjun

2010-01-01

Objective This article describes the initial development of a novel approach for training hearing-impaired listeners to improve their ability to understand speech in the presence of background noise and to also improve their ability to localize sounds. Design Most people with hearing loss, even those well fit with hearing devices, still experience significant problems understanding speech in noise. Prior research suggests that at least some subjects can experience improved speech understanding with training. However, all training systems that we are aware of have one basic, critical limitation. They do not provide spatial separation of the speech and noise, therefore ignoring the potential benefits of training binaural hearing. In this paper we describe our initial experience with a home-based training system that includes spatially separated speech-in-noise and localization training. Results Throughout the development of this system patient input, training and preliminary pilot data from individuals with bilateral cochlear implants were utilized. Positive feedback from subjective reports indicated that some individuals were engaged in the treatment, and formal testing showed benefit. Feedback and practical issues resulted from the reduction of an eight-loudspeaker to a two-loudspeaker system. Conclusions These preliminary findings suggest we have successfully developed a viable spatial hearing training system that can improve binaural hearing in noise and localization. Applications include, but are not limited to, hearing with hearing aids and cochlear implants. PMID:20701836

Audiologic and subjective evaluation of Baha® Attract device.

PubMed

Pérez-Carbonell, Tomàs; Pla-Gil, Ignacio; Redondo-Martínez, Jaume; Morant-Ventura, Antonio; García-Callejo, Francisco Javier; Marco-Algarra, Jaime

We included 9 patients implanted with Baha ® Attract. All our patients were evaluated by free field tonal audiometry, free field verbal audiometry and free field verbal audiometry with background noise, all the tests were performed with and without the device. To evaluate the subjective component of the implantation, we used the Glasgow Benefit Inventory (GBI) and Abbreviated Profile of Hearing Aid Benefit (APHAB). The auditive assessment with the device showed average auditive thresholds of 35.8dB with improvements of 25.8dB over the previous situation. Speech reception thresholds were 37dB with Baha ® Attract, showing improvements of 23dB. Maximum discrimination thresholds showed an average gain of 60dB with the device. Baha ® Attract achieves auditive improvements in patients for whom it is correctly indicated, with a consequent positive subjective evaluation. This study shows the attenuation effect in transcutaneous transmission, that prevents the device achieving greater improvements. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

Research Contributing to Improvements in Controlling Florida's Mosquitoes and Mosquito-borne Diseases.

PubMed

Tabachnick, Walter J

2016-09-28

Research on mosquitoes and mosquito-borne diseases has contributed to improvements in providing effective, efficient, and environmentally proper mosquito control. Florida has benefitted from several research accomplishments that have increased the state's mosquito control capabilities. Research with Florida's mosquitoes has resulted in the development of ecologically sound management of mosquito impoundments on Florida's east coast. This strategy, called Rotational Impoundment Management (RIM), has improved the ability to target the delivery of pesticides and has helped to reduce non-target effects and environmental damage. Research has led to the development of an arbovirus surveillance system which includes sentinel chicken surveillance, real time use of environmental contributing factors like meteorology and hydrology to target mosquito control, as well as public health efforts to mitigate disease outbreaks to areas with risk of disease. These research driven improvements have provided substantial benefits to all of Florida. More research is needed to meet the future challenges to reduce emerging pathogens like Zika virus and the consequences of environmental changes like global climate change that are likely to influence the effects of mosquito-borne pathogens on human health and well-being.

Variation in Response to a Home Intervention to Support Daily Function by Age, Race, Sex, and Education

PubMed Central

Gitlin, Laura N.; Winter, Laraine; Dennis, Marie P.; Hauck, Walter W.

2009-01-01

Background Functional difficulty is associated with increased frailty and poor life quality, with the oldest old, women, African Americans and less educated at greatest risk of disablement. This study examines whether these at-risk groups benefit differentially from an in-home intervention previously found to effectively reduce functional difficulties. Methods 319 community-living functionally vulnerable adults 70 years or older were randomized to usual care or an intervention involving occupational and physical therapy home instruction in problem-solving, device use, energy conservation, safety, fall recovery, balance and muscle strengthening instruction. Outcome measures at six and 12 months included difficulty level in ambulation, instrumental (IADLs) and activities of daily living (ADLs), self-efficacy, and fear of falling. Results At six-months, for ADLs, individuals ≥80 years (p=.022), women (p=.036), and less educated (p=.028) intervention participants improved compared to their control group counterparts. For mobility, women (p=.048) and the oldest (p=.001) intervention participants improved relative to their counterparts. For self-efficacy, women (p=.036) and less educated (p=.016) intervention participants benefited more. For fear of falling, those less educated improved more (p=.001). A similar pattern was found at 12 months. For IADLs, Whites improved more than non-Whites at 12 months. Conclusions Treatment benefits varied by specific participant characteristics, with individuals at greatest disability riskbeing most responsive to the intervention. Both White and non-White participants benefited similarly except in IADL functioning. Future research should control for participant characteristics, identify underlying mechanisms for variation in treatment effects, and tailor treatment to patient characteristics and desired outcomes. PMID:18693230

Effectiveness of befriending interventions: a systematic review and meta-analysis

PubMed Central

Siette, Joyce; Cassidy, Megan; Priebe, Stefan

2017-01-01

Objective Befriending is an emotional supportive relationship in which one-to-one companionship is provided on a regular basis by a volunteer. It is commonly and increasingly offered by the voluntary sector for individuals with distressing physical and mental conditions. However, the effectiveness of this intervention on health outcomes is largely unknown. We aim to conduct a systematic review of the benefits of befriending. Design Systematic review. Methods A systematic search of electronic databases was conducted to identify randomised controlled trials and quasi-experimental trials of befriending for a range of physical and mental health indications including depression, anxiety, mental illness, cancer, physical illness and dementia. Main outcomes included patient-relevant and disease-specific outcomes, such as depression, loneliness, quality of life, self-esteem, social support and well-being. Results A total of 14 trials (2411 participants) were included; 7 were judged at low risk of bias. Most trials showed improvement in symptoms associated with befriending but these associations did not reach statistical significance in all trials. Befriending was significantly associated with better patient-reported outcomes across primary measures (standardised mean difference 0.18 (95% CI, −0.002 to 0.36, I2=26%, seven trials)). However, there was no significant benefit on single outcomes, including depression, quality of life, loneliness ratings, self-esteem measures, social support structures and well-being. Conclusions There was moderate quality evidence to support the use of befriending for the treatment of individuals with different physical and mental health conditions. This evidence refers to an overall improvement benefit in patient-reported primary outcomes, although with a rather small effect size. The current evidence base does not allow for firm conclusions on more specific outcomes. Future trials should hypothesise a model for the precise effects of befriending and use specified inclusion and outcome criteria. PMID:28446525

The benefits and challenges of using computer-assisted symptom assessments in oncology clinics: results of a qualitative assessment.

PubMed

Mark, Tami L; Johnson, Gina; Fortner, Barry; Ryan, Katheryn

2008-10-01

Developed for clinical use in oncology settings, the Patient Assessment, Care & Education (PACE) System is a computer technology tool designed to address the under-identification and treatment of chemotherapy-related symptoms. This system includes general core questions together with the Patient Care Monitor (PCM), a validated questionnaire that assesses patient-reported problems, six symptom burden indices, and one global quality of life index. The system automatically scores the PCM and generates a written report. The objective of this study was to assess the manner in which clinicians use this system and identify the benefits and challenges that oncology clinics may face when adopting this system. The study was part of a larger evaluation of the system that included standardized surveys and chart review. Sixteen providers (physicians, nurses, and physician assistants) at 13 community oncology clinics participated in a 30-minute interview. Responses were coded according to common phrases or concepts. Clinicians indicated that they use the system mainly for symptom assessment or review of systems. The most common benefits identified included the improved ability to identify under-reported symptoms, enhanced communication with patients; increased efficiency; and its ability to highlight patients' most bothersome symptoms. Challenges included patient burden from the frequent need to answer the questionnaires, issues with the wording and formatting of the screening questionnaire, and technical difficulties. In sum, these interviews suggest that electronic symptom assessments offer potential advantages in terms improving the integration of routine assessment of patients' symptoms and health-related quality of life into the daily flow of an oncology clinic. The approach should receive additional research and development attention.

Enabled or Disabled: Is the Environment Right for Using Biodiversity to Improve Nutrition?

PubMed Central

Hunter, Danny; Özkan, Isa; Moura de Oliveira Beltrame, Daniela; Samarasinghe, Wellakke Lokuge Gamini; Wasike, Victor Wafula; Charrondière, U. Ruth; Borelli, Teresa; Sokolow, Jessica

2016-01-01

How can we ensure that 9 billion people will have access to a nutritious and healthy diet that is produced in a sustainable manner by 2050? Despite major advances, our global food system still fails to feed a significant part of humanity adequately. Diversifying food systems and diets to include nutrient-rich species can help reduce malnutrition, while contributing other multiple benefits including healthy ecosystems. While research continues to demonstrate the value of incorporating biodiversity into food systems and diets, perverse subsidies, and barriers often prevent this. Countries like Brazil have shown that, by strategic actions and interventions, it is indeed possible to create better contexts to mainstream biodiversity for improved nutrition into government programs and public policies. Despite some progress, there are few global and national policy mechanisms or processes that effectively join biodiversity with agriculture and nutrition efforts. This perspective paper discusses the benefits of biodiversity for nutrition and explores what an enabling environment for biodiversity to improve nutrition might look like, including examples of steps and actions from a multi-country project that other countries might replicate. Finally, we suggest what it might take to create enabling environments to mainstream biodiversity into global initiatives and national programs and policies on food and nutrition security. With demand for new thinking about how we improve agriculture for nutrition and growing international recognition of the role biodiversity, the 2030 Agenda for Sustainable Development presents an opportunity to move beyond business-as-usual to more holistic approaches to food and nutrition security. PMID:27376067