Sample records for cost728 evaluation study

  1. Student Perceptions of a Trial of Electronic Text Matching Software: A Preliminary Investigation

    ERIC Educational Resources Information Center

    Green, David; Lindemann, Iris; Marshall, Kelly; Wilkinson, Grette

    2005-01-01

    It is accepted that using electronic detection methods has benefits within an overall strategy to promote academic integrity in an institution. Little attention has been paid to obtaining student perceptions to evaluate the cost/benefit of using such methods. This study reports on the evaluation of a trial of Turnitin software. 728 students…

  2. Evaluation of Wildlife Mitigation Sites at the Chief Joseph Dam Project (1993/1994 Season)

    DTIC Science & Technology

    1994-07-22

    vermiculatus black greasewood CHENOPODIACEAE R, BS. BB SHCA Shepherdia canadensis buffalo-berry ELAEAGNACEAE hrf. Sites SYAL Symphoricarpos albus...Occurances 26.0 Percent Coverage 41.50% Percent Coverage 46.80% - Sat End Total Species Start I End Total I rowo 98.0 72.8 25.2 1 syal 0.5 1.0 0.5 2 sya...96.1 91.9 4.2 2 shsp. 1.0 8.5 7.5 3 syal 72.8 72.2 0.6 3 syal 1.8 6.5 4.7 4 rowo 69.5 67.7 1.8 4 cost 7.5 10.1 2.6 5 syal 66.5 65.8 0.7 5 cost 13.4

  3. 32 CFR 728.12 - Extent of care.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... care. (ii) Occupational health services as defined in § 728.2(z). (iii) Necessary prosthetic devices... USPHS or NOAA, the resulting civilian health care costs will be paid by the referring facility. (3) The... referring MTF is not organized nor authorized to provide needed health care (see part 732 of this chapter...

  4. 32 CFR 728.12 - Extent of care.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... care. (ii) Occupational health services as defined in § 728.2(z). (iii) Necessary prosthetic devices... NOAA, the resulting civilian health care costs will be paid by the referring facility. (3) The member's... not organized nor authorized to provide needed health care (see part 732 of this chapter for naval...

  5. 32 CFR 728.12 - Extent of care.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... care. (ii) Occupational health services as defined in § 728.2(z). (iii) Necessary prosthetic devices... USPHS or NOAA, the resulting civilian health care costs will be paid by the referring facility. (3) The... referring MTF is not organized nor authorized to provide needed health care (see part 732 of this chapter...

  6. 32 CFR 728.12 - Extent of care.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... care. (ii) Occupational health services as defined in § 728.2(z). (iii) Necessary prosthetic devices... NOAA, the resulting civilian health care costs will be paid by the referring facility. (3) The member's... not organized nor authorized to provide needed health care (see part 732 of this chapter for naval...

  7. Direct medical cost and utility analysis of diabetics outpatient at Karanganyar public hospital

    NASA Astrophysics Data System (ADS)

    Eristina; Andayani, T. M.; Oetari, R. A.

    2017-11-01

    Diabetes Mellitus is a high cost disease, especially in long-term complication treatment. Long-term complication treatment cost was a problem for the patient, it can affect patients quality of life stated with utility value. The purpose of this study was to determine the medical cost, utility value and leverage factors of diabetics outpatient. This study was cross sectional design, data collected from retrospective medical record of the financial and pharmacy department to obtain direct medical cost, utility value taken from EQ-5D-5L questionnaire. Data analyzed by Mann-Whitney and Kruskal-Wallis test. Results of this study were IDR 433,728.00 for the direct medical cost and pharmacy as the biggest cost. EQ-5D-5L questionnaire showed the biggest proportion on each dimension were 61% no problem on mobility dimension, 89% no problems on self-care dimension, 54% slight problems on usual activities dimension, 41% moderate problems on pain/discomfort dimension and 48% moderate problems on anxiety/depresion dimension. Build upon Thailand value set, utility value was 0.833. Direct medical cost was IDR 433,728.00 with leverage factors were pattern therapy, blood glucose level and complication. Utility value was 0.833 with leverage factors were patients characteristic, therapy pattern, blood glucose level and complication.

  8. 30 CFR 7.28 - Test for flame resistance of rigid ventilation tubing.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Test for flame resistance of rigid ventilation tubing. 7.28 Section 7.28 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR TESTING, EVALUATION, AND APPROVAL OF MINING PRODUCTS TESTING BY APPLICANT OR THIRD PARTY Brattice Cloth...

  9. 30 CFR 7.28 - Test for flame resistance of rigid ventilation tubing.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Test for flame resistance of rigid ventilation tubing. 7.28 Section 7.28 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR TESTING, EVALUATION, AND APPROVAL OF MINING PRODUCTS TESTING BY APPLICANT OR THIRD PARTY Brattice Cloth...

  10. 30 CFR 7.28 - Test for flame resistance of rigid ventilation tubing.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Test for flame resistance of rigid ventilation tubing. 7.28 Section 7.28 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR TESTING, EVALUATION, AND APPROVAL OF MINING PRODUCTS TESTING BY APPLICANT OR THIRD PARTY Brattice Cloth...

  11. 30 CFR 7.28 - Test for flame resistance of rigid ventilation tubing.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Test for flame resistance of rigid ventilation tubing. 7.28 Section 7.28 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR TESTING, EVALUATION, AND APPROVAL OF MINING PRODUCTS TESTING BY APPLICANT OR THIRD PARTY Brattice Cloth...

  12. 30 CFR 7.28 - Test for flame resistance of rigid ventilation tubing.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Test for flame resistance of rigid ventilation tubing. 7.28 Section 7.28 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR TESTING, EVALUATION, AND APPROVAL OF MINING PRODUCTS TESTING BY APPLICANT OR THIRD PARTY Brattice Cloth...

  13. 75 FR 24730 - Agency Information Collection Activities: Proposed Collection; Comment Request, 1660-0046; FEMA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-05

    ... cost State, local or Tribal Government; Business or FEMA/EMI Independent Study 1,682,231 4 6,728,924 0... Tribal Government; Business or FEMA/EMI Independent Study 186,914 4 747,656 0.75 560,742 28.45 15,953,110... Independent Study Course Enrollment and Test Answer Sheet AGENCY: Federal Emergency Management Agency, DHS...

  14. Bioprocess optimization for production of thermoalkali-stable protease from Bacillus subtilis K-1 under solid-state fermentation.

    PubMed

    Singh, Satbir; Bajaj, Bijender Kumar

    2016-10-02

    Cost-effective production of proteases, which are robust enough to function under harsh process conditions, is always sought after due to their wide industrial application spectra. Solid-state production of enzymes using agro-industrial wastes as substrates is an environment-friendly approach, and it has several advantages such as high productivity, cost-effectiveness, being less labor-intensive, and less effluent production, among others. In the current study, different agro-wastes were employed for thermoalkali-stable protease production from Bacillus subtilis K-1 under solid-state fermentation. Agricultural residues such as cotton seed cake supported maximum protease production (728 U ml(-1)), which was followed by gram husk (714 U ml(-1)), mustard cake (680 U ml(-1)), and soybean meal (653 U ml(-1)). Plackett-Burman design of experiment showed that peptone, moisture content, temperature, phosphates, and inoculum size were the significant variables that influenced the protease production. Furthermore, statistical optimization of three variables, namely peptone, moisture content, and incubation temperature, by response surface methodology resulted in 40% enhanced protease production as compared to that under unoptimized conditions (from initial 728 to 1020 U ml(-1)). Thus, solid-state fermentation coupled with design of experiment tools represents a cost-effective strategy for production of industrial enzymes.

  15. 32 CFR 728.4 - Policies.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE... (Comptroller) and published in a yearly NAVMEDCOMNOTE 6320, (Cost elements of medical, dental, subsistence...-utilization of medical and dental facilities of the uniformed services, eligible persons, regardless of...

  16. 32 CFR 728.4 - Policies.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE... (Comptroller) and published in a yearly NAVMEDCOMNOTE 6320, (Cost elements of medical, dental, subsistence...-utilization of medical and dental facilities of the uniformed services, eligible persons, regardless of...

  17. Evaluation of thermal helium beam and line-ratio fast diagnostic on the National Spherical Torus Experiment-Upgrade

    DOE PAGES

    Munoz Burgos, Jorge M.; Agostini, Matteo; Scarin, Paolo; ...

    2015-05-06

    A 1-D kinetic collisional radiative model (CRM) with state-of-the-art atomic data is developed and employed to simulate line emission to evaluate the Thermal Helium Beam (THB) diagnostic on NSTX-U. This diagnostic is currently in operation on RFX-mod, and it is proposed to be installed on NSTX-U. The THB system uses the intensity ratios of neutral helium lines 667.8, 706.5, and 728.1 nm to derive electron temperature (eV ) and density (cm –3) profiles. The purpose of the present analysis is to evaluate the applications of this diagnostic for determining fast (~4 μs) electron temperature and density radial profiles on themore » scrape-off layer (SOL) and edge regions of NSTX-U that are needed in turbulence studies. The diagnostic is limited by the level of detection of the 728.1 nm line, which is the weakest of the three. In conclusion, this study will also aid in future design of a similar 2-D diagnostic systems on the divertor.« less

  18. 32 CFR 728.35 - Coordination of benefits-third party payers.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Retired Members and... care incurred by the United States on behalf of retirees and dependents. Naval hospital collection... to third-party payers for the cost of such care. Admission office personnel must obtain insurance...

  19. Project CHAMP, 1986-1987. OEA Evaluation Report.

    ERIC Educational Resources Information Center

    Cabrera, Eulalia; And Others

    In its fourth year, Project CHAMP (Chinese Achievement and Mastery Program) provided instruction in English as a second language (ESL), native language arts, mathematics, science, and social studies to 728 limited-English-speaking Chinese immigrant students in grades nine through twelve at three schools. Content-area classes were taught in English…

  20. 32 CFR 728.111 - General.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false General. 728.111 Section 728.111 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Initiating Collection Action on Pay Patients § 728...

  1. 32 CFR 728.111 - General.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false General. 728.111 Section 728.111 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Initiating Collection Action on Pay Patients § 728...

  2. 32 CFR 728.111 - General.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 5 2013-07-01 2013-07-01 false General. 728.111 Section 728.111 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Initiating Collection Action on Pay Patients § 728...

  3. 32 CFR 728.111 - General.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false General. 728.111 Section 728.111 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Initiating Collection Action on Pay Patients § 728...

  4. COST 728 Project Report: Urbanization of Meteorological and Air Quality Models - Chapter 5 - Model Urbanization Strategy: Summaries, Recommendations and Requirements

    EPA Science Inventory

    The urban canopy (UC), the layer of the atmosphere between the ground and the top of the highest buildings, is the region where people live and human activities take place. Because of this importance (e.g., human health, preservation of buildings) significant efforts have been d...

  5. 32 CFR 728.58 - Federal Aviation Agency (FAA) beneficiaries.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false Federal Aviation Agency (FAA) beneficiaries. 728.58 Section 728.58 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL... Federal Agencies § 728.58 Federal Aviation Agency (FAA) beneficiaries. (a) Beneficiaries. Air Traffic...

  6. 32 CFR 728.58 - Federal Aviation Agency (FAA) beneficiaries.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 5 2013-07-01 2013-07-01 false Federal Aviation Agency (FAA) beneficiaries. 728.58 Section 728.58 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL... Federal Agencies § 728.58 Federal Aviation Agency (FAA) beneficiaries. (a) Beneficiaries. Air Traffic...

  7. 32 CFR 728.58 - Federal Aviation Agency (FAA) beneficiaries.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Federal Aviation Agency (FAA) beneficiaries. 728.58 Section 728.58 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL... Federal Agencies § 728.58 Federal Aviation Agency (FAA) beneficiaries. (a) Beneficiaries. Air Traffic...

  8. 32 CFR 728.58 - Federal Aviation Agency (FAA) beneficiaries.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 5 2014-07-01 2014-07-01 false Federal Aviation Agency (FAA) beneficiaries. 728.58 Section 728.58 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL... Federal Agencies § 728.58 Federal Aviation Agency (FAA) beneficiaries. (a) Beneficiaries. Air Traffic...

  9. 32 CFR 728.58 - Federal Aviation Agency (FAA) beneficiaries.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false Federal Aviation Agency (FAA) beneficiaries. 728.58 Section 728.58 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL... Federal Agencies § 728.58 Federal Aviation Agency (FAA) beneficiaries. (a) Beneficiaries. Air Traffic...

  10. 32 CFR 728.92 - Policy.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false Policy. 728.92 Section 728.92 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Adjuncts to Medical Care § 728.92 Policy. (a) Provide...

  11. 7 CFR 58.728 - Cooking the batch.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Cooking the batch. 58.728 Section 58.728 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards... Procedures § 58.728 Cooking the batch. Each batch of cheese within the cooker, including the optional...

  12. Glycerol-based sterilization bioindicator system from Bacillus atrophaeus: development, performance evaluation, and cost analysis.

    PubMed

    Sella, Sandra R B R; Gouvea, Patricia Milla; Gomes, Vanessa F; Vandenberghe, Luciana P S; Minozzo, João Carlos; Soccol, Carlos Ricardo

    2013-02-01

    The development of new value-added applications for glycerol is of worldwide interest because of the environmental and economic problems that may be caused by an excess of glycerol generated from biodiesel production. A novel use of glycerol as a major substrate for production of a low-cost sterilization biological indicator system (BIS; spores on a carrier plus a recovery medium) was investigated. A sequential experimental design strategy was applied for product development and optimization. The proposed recovery medium enables germination and outgrowth of heat-damaged spores, promoting a D (160 °C) value of 6.6 ± 0.1 min. Bacillus atrophaeus spores production by solid-state fermentation reached a 2.3 ± 1.2 × 10(8) CFU/g dry matter. Sporulation kinetics results allowed this process to be restricted in 48 h. Germination kinetics demonstrated the visual identification of nonsterile BIS within 24 h. Performance evaluation of the proposed BIS against dry-heat and ethylene oxide sterilization showed compliance with the regulatory requirements. Cost breakdowns were from 41.8 (quality control) up to 72.8 % (feedstock). This is the first report on sterilization BIS production that uses glycerol as a sole carbon source, with significant cost reduction and the profitable use of a biodiesel byproduct.

  13. 32 CFR 728.71 - Ex-service maternity care.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Ex-service maternity care. 728.71 Section 728.71 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Other Persons § 728.71 Ex-service maternity...

  14. 32 CFR 728.71 - Ex-service maternity care.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 5 2013-07-01 2013-07-01 false Ex-service maternity care. 728.71 Section 728.71 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Other Persons § 728.71 Ex-service maternity...

  15. 32 CFR 728.71 - Ex-service maternity care.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false Ex-service maternity care. 728.71 Section 728.71 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Other Persons § 728.71 Ex-service maternity...

  16. 32 CFR 728.71 - Ex-service maternity care.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false Ex-service maternity care. 728.71 Section 728.71 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Other Persons § 728.71 Ex-service maternity...

  17. 32 CFR 728.76 - Naval Home residents.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 5 2014-07-01 2014-07-01 false Naval Home residents. 728.76 Section 728.76... FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Other Persons § 728.76 Naval Home residents. Provide necessary medical and dental care, both inpatient and outpatient, to residents of the Naval Home...

  18. 33 CFR 100.728 - Special Local Regulations; Hurricane Offshore Classic, St. Petersburg, FL.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...; Hurricane Offshore Classic, St. Petersburg, FL. 100.728 Section 100.728 Navigation and Navigable Waters... WATERS § 100.728 Special Local Regulations; Hurricane Offshore Classic, St. Petersburg, FL. (a) Regulated... commander designated by Coast Guard Sector St. Petersburg, Florida. (2) Spectator craft will be permitted...

  19. 32 CFR 728.113 - Categories of pay patients.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Categories of pay patients. 728.113 Section 728.113 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND... Pay Patients § 728.113 Categories of pay patients. The categories of patients for whom collection...

  20. 32 CFR 728.36 - Pay patients.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Pay patients. 728.36 Section 728.36 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR... Services § 728.36 Pay patients. Care is provided on a reimbursable basis to retired Coast Guard officers...

  1. 32 CFR 728.14 - Pay patients.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Pay patients. 728.14 Section 728.14 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR... § 728.14 Pay patients. Care is provided on a reimbursable basis to: Coast Guard active duty officers...

  2. 20 CFR 416.728 - Penalty period: Second failure to report.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Penalty period: Second failure to report. 416.728 Section 416.728 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Reports Required Penalty Deductions § 416.728 Penalty period: Second...

  3. 20 CFR 416.728 - Penalty period: Second failure to report.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Penalty period: Second failure to report. 416.728 Section 416.728 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Reports Required Penalty Deductions § 416.728 Penalty period: Second...

  4. 32 CFR 728.80 - U.S. Government employees.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 5 2014-07-01 2014-07-01 false U.S. Government employees. 728.80 Section 728.80... FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Other Persons § 728.80 U.S. Government... Government who sustain injuries while in the performance of duty, including diseases proximately caused by...

  5. HISTOLOGICAL AND HISTOPATHOLOGICAL EVALUATION OF THE TESTIS

    EPA Science Inventory

    This book, the first to describe how the testis is evaluated in research and toxicology testing settings, is a resource for individuals who wish to perform a systematic evaluation of the testis. he book contains 728 illustrations and drawings. The book begins with a description o...

  6. 32 CFR 728.4 - Policies.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 5 2014-07-01 2014-07-01 false Policies. 728.4 Section 728.4 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES General § 728.4 Policies. (a) Admissions to closed psychiatric wards. Admit patients to closed...

  7. 33 CFR 100.728 - Special Local Regulations; Hurricane Offshore Classic, St. Petersburg, FL.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...; Hurricane Offshore Classic, St. Petersburg, FL. 100.728 Section 100.728 Navigation and Navigable Waters... WATERS § 100.728 Special Local Regulations; Hurricane Offshore Classic, St. Petersburg, FL. (a) Regulated..., from 10 a.m. to 6 p.m. EDT. (3) All vessel traffic, not involved in the Hurricane Offshore Classic...

  8. 32 CFR 728.13 - Application for care.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Duty § 728.13 Application for care. Possession of an ID card (a green colored DD 2 (with letter suffix... 32 National Defense 5 2010-07-01 2010-07-01 false Application for care. 728.13 Section 728.13 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE...

  9. 33 CFR 100.728 - Special Local Regulations; Hurricane Offshore Classic, St. Petersburg, FL.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...; Hurricane Offshore Classic, St. Petersburg, FL. 100.728 Section 100.728 Navigation and Navigable Waters... WATERS § 100.728 Special Local Regulations; Hurricane Offshore Classic, St. Petersburg, FL. (a) Regulated..., from 10 a.m. to 6 p.m. EDT. (3) All vessel traffic, not involved in the Hurricane Offshore Classic...

  10. 33 CFR 100.728 - Special Local Regulations; Hurricane Offshore Classic, St. Petersburg, FL.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...; Hurricane Offshore Classic, St. Petersburg, FL. 100.728 Section 100.728 Navigation and Navigable Waters... WATERS § 100.728 Special Local Regulations; Hurricane Offshore Classic, St. Petersburg, FL. (a) Regulated..., from 10 a.m. to 6 p.m. EDT. (3) All vessel traffic, not involved in the Hurricane Offshore Classic...

  11. 33 CFR 100.728 - Special Local Regulations; Hurricane Offshore Classic, St. Petersburg, FL.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...; Hurricane Offshore Classic, St. Petersburg, FL. 100.728 Section 100.728 Navigation and Navigable Waters... WATERS § 100.728 Special Local Regulations; Hurricane Offshore Classic, St. Petersburg, FL. (a) Regulated..., from 10 a.m. to 6 p.m. EDT. (3) All vessel traffic, not involved in the Hurricane Offshore Classic...

  12. 32 CFR 728.60 - Job Corps and Volunteers in Service to America (VISTA) beneficiaries.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 5 2013-07-01 2013-07-01 false Job Corps and Volunteers in Service to America (VISTA) beneficiaries. 728.60 Section 728.60 National Defense Department of Defense (Continued... FACILITIES Beneficiaries of Other Federal Agencies § 728.60 Job Corps and Volunteers in Service to America...

  13. 32 CFR 728.60 - Job Corps and Volunteers in Service to America (VISTA) beneficiaries.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false Job Corps and Volunteers in Service to America (VISTA) beneficiaries. 728.60 Section 728.60 National Defense Department of Defense (Continued... FACILITIES Beneficiaries of Other Federal Agencies § 728.60 Job Corps and Volunteers in Service to America...

  14. 32 CFR 728.60 - Job Corps and Volunteers in Service to America (VISTA) beneficiaries.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false Job Corps and Volunteers in Service to America (VISTA) beneficiaries. 728.60 Section 728.60 National Defense Department of Defense (Continued... FACILITIES Beneficiaries of Other Federal Agencies § 728.60 Job Corps and Volunteers in Service to America...

  15. 32 CFR 728.60 - Job Corps and Volunteers in Service to America (VISTA) beneficiaries.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 5 2014-07-01 2014-07-01 false Job Corps and Volunteers in Service to America (VISTA) beneficiaries. 728.60 Section 728.60 National Defense Department of Defense (Continued... FACILITIES Beneficiaries of Other Federal Agencies § 728.60 Job Corps and Volunteers in Service to America...

  16. 48 CFR 728.305-70 - Overseas worker's compensation and war-hazard insurance-waivers and USAID insurance coverage.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Overseas worker's compensation and war-hazard insurance-waivers and USAID insurance coverage. 728.305-70 Section 728.305-70... REQUIREMENTS BONDS AND INSURANCE Insurance 728.305-70 Overseas worker's compensation and war-hazard insurance...

  17. Enhancing the Professionalism of Purchasing Agents (GS 1105s) within the Department of the Army.

    DTIC Science & Technology

    1987-09-01

    automated small purchase process offers distinct advantages, as well as cost savings in both time and money , for activities with a large volume of small...resident) Massasoit Northeast $1,888 $6,400 Boston, MA Broward Southeast 1,327 2,765 Ft. Lauder - dale, FL Rock Valley Midwest 1,728 7,552 Rockford, IL De

  18. 32 CFR 728.51 - General provisions-the “Economy Act.”

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false General provisions-the âEconomy Act.â 728.51 Section 728.51 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Beneficiaries of Other Federal Agencies § 728.51 General provisions—th...

  19. Cost effectiveness of intensive care in a low resource setting: A prospective cohort of medical critically ill patients

    PubMed Central

    Cubro, Hajrunisa; Somun-Kapetanovic, Rabija; Thiery, Guillaume; Talmor, Daniel; Gajic, Ognjen

    2016-01-01

    AIM: To calculate cost effectiveness of the treatment of critically ill patients in a medical intensive care unit (ICU) of a middle income country with limited access to ICU resources. METHODS: A prospective cohort study and economic evaluation of consecutive patients treated in a recently established medical ICU in Sarajevo, Bosnia and Herzegovina. A cost utility analysis of the intensive care of critically ill patients compared to the hospital ward treatment from the perspective of the health care system was subsequently performed. Incremental cost effectiveness was calculated using estimates of ICU vs non-ICU treatment effectiveness based on a formal systematic review of published studies. Decision analytic modeling was used to compare treatment alternatives. Sensitivity analyses of the key model parameters were performed. RESULTS: Out of 148 patients, seventy patients (47.2%) survived to one year after critical illness with a median quality of life index 0.64 [interquartile range(IQR) 0.49-0.76]. Median number of life years gained per patient was 30 (IQR 16-40) or 18 quality adjusted life years (QALYs) (IQR 7-28). The cost of treatment of critically ill patients varied between 1820 dollar and 20109 dollar per hospital survivor and between 100 dollar and 2514 dollar per QALY saved. Mean factors that influenced costs were: Age, diagnostic category, ICU and hospital length of stay and number and type of diagnostic and therapeutic interventions. The incremental cost effectiveness ratio for ICU treatment was estimated at 3254 dollar per QALY corresponding to 35% of per capita GDP or a Very Cost Effective category according to World Health Organization criteria. CONCLUSION: The ICU treatment of critically ill medical patients in a resource poor country is cost effective and compares favorably with other medical interventions. Public health authorities in low and middle income countries should encourage development of critical care services. PMID:27152258

  20. Estimation of the prevalence and direct medical costs of chronic myeloid leukemia in the I.R. of Iran in the era of tyrosine kinase inhibitors.

    PubMed

    Daroudi, Rajabali; Mirzania, Mehrzad; Nikravanfard, Nazila; Sadighi, Sanambar; Sedighi, Zahra; Zendehdel, Kazem

    2017-10-01

    After the introduction of tyrosine kinase inhibitors for chronic myeloid leukemia (CML), the survival of these patients has increased significantly. However, these new drugs are expensive and impose considerable expense to patients and governments. Epidemiologic and economic evaluation studies provide good information for resource allocation and decision making. We estimated the incidence, prevalence and direct medical cost of CML in Iran. We used the National Cancer Registry (NCR) data from 2006 to 2009 to estimate the incidence rate of CML (ICD-10 code C92.1). After adjustment for the underestimation of incidence rates, we used survival rates of CML and estimated the 5-year prevalence for these patients. In addition, we used clinical practice guideline, expert opinions and medical tariffs to estimate the direct medical costs through the prevalence approach. After an adjustment for the underestimation, the incidence rate of CML was 0.5 per 100 000 in the I.R. of Iran. The 5-year prevalence was about 2263 cases (2.98 per 100 000). The total direct medical cost of CML was $23 089 323 and the majority of the cost (97%) was related to drug costs. The total cost will increase considerably to $40 728 869 if all patients use the new drug nilotinib (800 mg/day) as a second-line treatment. The increased survival of CML patients and a possible increase in incidence of CML in Iran will most likely lead to a considerable rise in its prevalence and economic burden. © 2016 John Wiley & Sons Australia, Ltd.

  1. Work productivity and activity impairment in gastroesophageal reflux disease in Korean full-time employees: a multicentre study.

    PubMed

    Shin, Woon Geon; Kim, Heung Up; Kim, Sang Gyun; Kim, Gwang Ha; Shim, Ki-Nam; Kim, Jeong Wook; Kim, Jin Il; Kim, Jae Gyu; Kim, Jae J; Yim, Da-Hae; Park, Sue K; Park, Soo-Heon

    2012-04-01

    The costs of gastroesophageal reflux disease have not been assessed in Asia, even though the prevalence of gastroesophageal reflux disease is gradually increasing. We evaluated work presenteeism and absenteeism as indirect costs of gastroesophageal reflux disease in Korea. This was a cross-sectional and multicentre study using patient-reported outcome instruments. A total of 1009 full-time employees who visited the gastrointestinal department for any reason (281 patients with gastroesophageal reflux disease and 728 controls) were included. Main outcomes were presenteeism and absenteeism measured as work productivity loss and monetary cost per week. Absenteeism and presenteeism were significantly higher in the gastroesophageal reflux disease than the control group (1.49% vs. 0.46%, P=0.0010; 34.13% vs. 9.23%, P<0.0001). Loss of work productivity was significantly greater in the gastroesophageal reflux disease than the control group (33.09% vs. 9.02%; P<0.0001). This loss of work productivity difference between the two groups represented an additional productivity loss of 11.7h/week in the gastroesophageal reflux disease group compared with the control group. Assuming average hourly wages of $14.12, the weekly burden of gastroesophageal reflux disease reached $165.07 per person. Gastroesophageal reflux disease was associated with substantial work productivity loss, mainly due to presenteeism rather than absenteeism, in Korean full-time employees. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  2. Cost Analysis of Civilian-Sailor Substitution Plan for Ashore Aircraft Intermediate Maintenance Departments

    DTIC Science & Technology

    2006-12-01

    the reduction in personnel will not adversely affect the physical security of the facility. One aspect of job performance mentioned above with regard...4.29% ATAA $524,014 $421,844 $478,395 0 $0 100.00% $0 100.00% ATAN $5,078,679 $7,415,096 $10,728,638 25 $804,926 89.14% $1,101,328 85.15% ATAR

  3. 40 CFR 52.728 - Control strategy: Nitrogen dioxide. [Reserved

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 3 2010-07-01 2010-07-01 false Control strategy: Nitrogen dioxide. [Reserved] 52.728 Section 52.728 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR...: Nitrogen dioxide. [Reserved] ...

  4. 40 CFR 52.728 - Control strategy: Nitrogen dioxide. [Reserved

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 3 2014-07-01 2014-07-01 false Control strategy: Nitrogen dioxide. [Reserved] 52.728 Section 52.728 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR...: Nitrogen dioxide. [Reserved] ...

  5. 40 CFR 52.728 - Control strategy: Nitrogen dioxide. [Reserved

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 3 2012-07-01 2012-07-01 false Control strategy: Nitrogen dioxide. [Reserved] 52.728 Section 52.728 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR...: Nitrogen dioxide. [Reserved] ...

  6. 40 CFR 52.728 - Control strategy: Nitrogen dioxide. [Reserved

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 3 2013-07-01 2013-07-01 false Control strategy: Nitrogen dioxide. [Reserved] 52.728 Section 52.728 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR...: Nitrogen dioxide. [Reserved] ...

  7. 40 CFR 52.728 - Control strategy: Nitrogen dioxide. [Reserved

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 3 2011-07-01 2011-07-01 false Control strategy: Nitrogen dioxide. [Reserved] 52.728 Section 52.728 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR...: Nitrogen dioxide. [Reserved] ...

  8. 48 CFR 728.307-2 - Liability.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Section 728.307-2 Federal Acquisition Regulations System AGENCY FOR INTERNATIONAL DEVELOPMENT GENERAL CONTRACTING REQUIREMENTS BONDS AND INSURANCE Insurance 728.307-2 Liability. (a)-(b) [Reserved] (c) Automobile... an USAID contract are properly insured, USAID has established minimum required coverages as a...

  9. 48 CFR 728.307-2 - Liability.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Section 728.307-2 Federal Acquisition Regulations System AGENCY FOR INTERNATIONAL DEVELOPMENT GENERAL CONTRACTING REQUIREMENTS BONDS AND INSURANCE Insurance 728.307-2 Liability. (a)-(b) [Reserved] (c) Automobile... an USAID contract are properly insured, USAID has established minimum required coverages as a...

  10. An Interactive Life Cycle Cost Forecasting Tool

    DTIC Science & Technology

    1991-03-01

    0131 print* 0132 IF (yorn .EQ. 1) THEN 0133 print 721,NYEARS 0134 721 FORMAT(’ The life cycle of this system is’,14,1 years.’) 0135 print*,’Do you wish...464 481 521 535 556 613= 626= 627 631= 633 642= 643 658= 669 = 672= 673(2) 683= 689= 692= 693(2) 705= 706(4) 715 723= 727= 728 732= 737= 738 740= 747...REGION 0129 C OF THE TRAPEZOID. 0130 0131 50 IF (Cl .EQ. 0.0) GO TO 100 0132 0133 C DISTRIBUTE COST OVER TW’ RECTANGULAR REGION. 0134 0135 X = (Z2/Cl

  11. 32 CFR 728.41 - General provisions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false General provisions. 728.41 Section 728.41 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Members of Foreign Military Services and...

  12. 32 CFR 728.41 - General provisions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 5 2013-07-01 2013-07-01 false General provisions. 728.41 Section 728.41 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Members of Foreign Military Services and...

  13. 32 CFR 728.41 - General provisions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false General provisions. 728.41 Section 728.41 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Members of Foreign Military Services and...

  14. 32 CFR 728.41 - General provisions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false General provisions. 728.41 Section 728.41 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Members of Foreign Military Services and...

  15. 32 CFR 728.41 - General provisions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 5 2014-07-01 2014-07-01 false General provisions. 728.41 Section 728.41 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Members of Foreign Military Services and...

  16. 48 CFR 728.105-1 - Advance payment bonds.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ....105-1 Section 728.105-1 Federal Acquisition Regulations System AGENCY FOR INTERNATIONAL DEVELOPMENT GENERAL CONTRACTING REQUIREMENTS BONDS AND INSURANCE Bonds 728.105-1 Advance payment bonds. (a) Generally, advance payment bonds will not be required in connection with USAID contracts containing an advance...

  17. 48 CFR 728.105-1 - Advance payment bonds.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ....105-1 Section 728.105-1 Federal Acquisition Regulations System AGENCY FOR INTERNATIONAL DEVELOPMENT GENERAL CONTRACTING REQUIREMENTS BONDS AND INSURANCE Bonds 728.105-1 Advance payment bonds. (a) Generally, advance payment bonds will not be required in connection with USAID contracts containing an advance...

  18. Epidemiologic analysis: Prophylaxis and multidrug-resistance in surgery.

    PubMed

    Solís-Téllez, H; Mondragón-Pinzón, E E; Ramírez-Marino, M; Espinoza-López, F R; Domínguez-Sosa, F; Rubio-Suarez, J F; Romero-Morelos, R D

    Surgical site infection is defined as an infection related to the surgical procedure in the area of manipulation occurring within the first 30 postoperative days. The diagnostic criteria include: purulent drainage, isolation of microorganisms, and signs of infection. To describe the epidemiologic characteristics and differences among the types of prophylactic regimens associated with hospital-acquired infections at the general surgery service of a tertiary care hospital. The electronic case records of patients that underwent general surgery at a tertiary care hospital within the time frame of January 1, 2013 and December 31, 2014 were reviewed. A convenience sample of 728 patients was established and divided into the following groups: Group 1: n=728 for the epidemiologic study; Group 2: n=638 for the evaluation of antimicrobial prophylaxis; and Group 3: n=50 for the evaluation of multidrug-resistant bacterial strains in the intensive care unit. The statistical analysis was carried out with the SPSS 19 program, using the Mann-Whitney U test and the chi-square test. A total of 728 procedures were performed (65.9% were elective surgeries). Three hundred twelve of the patients were males and 416 were females. Only 3.98% of the patients complied with the recommended antimicrobial prophylaxis, and multidrug-resistant bacterial strains were found in the intensive care unit. A single prophylactic dose is effective, but adherence to this recommendation was not adequate. The prophylactic guidelines are not strictly adhered to in our environment. There was a significant association between the development of nosocomial infections from multidrug-resistant germs and admission to the intensive care unit. Copyright © 2016 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.

  19. 11 CFR 7.28 - Hearing date.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 11 Federal Elections 1 2010-01-01 2010-01-01 false Hearing date. 7.28 Section 7.28 Federal Elections FEDERAL ELECTION COMMISSION STANDARDS OF CONDUCT Post Employment Conflict of Interest: Procedures... employee's need for: (1) Adequate time to prepare a defense properly, and (2) An expeditious resolution of...

  20. 32 CFR 728.59 - Peace Corps beneficiaries.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Peace Corps beneficiaries. 728.59 Section 728.59 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Beneficiaries of Other Federal Agencies...

  1. 32 CFR 728.55 - Department of Justice beneficiaries.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 5 2014-07-01 2014-07-01 false Department of Justice beneficiaries. 728.55 Section 728.55 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Beneficiaries of Other...

  2. 32 CFR 728.55 - Department of Justice beneficiaries.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false Department of Justice beneficiaries. 728.55 Section 728.55 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Beneficiaries of Other...

  3. 32 CFR 728.52 - Veterans Administration beneficiaries (VAB).

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false Veterans Administration beneficiaries (VAB). 728.52 Section 728.52 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Beneficiaries of Other...

  4. 32 CFR 728.59 - Peace Corps beneficiaries.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false Peace Corps beneficiaries. 728.59 Section 728.59 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Beneficiaries of Other Federal Agencies...

  5. 32 CFR 728.52 - Veterans Administration beneficiaries (VAB).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false Veterans Administration beneficiaries (VAB). 728.52 Section 728.52 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Beneficiaries of Other...

  6. 32 CFR 728.52 - Veterans Administration beneficiaries (VAB).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Veterans Administration beneficiaries (VAB). 728.52 Section 728.52 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Beneficiaries of Other...

  7. 32 CFR 728.59 - Peace Corps beneficiaries.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 5 2013-07-01 2013-07-01 false Peace Corps beneficiaries. 728.59 Section 728.59 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Beneficiaries of Other Federal Agencies...

  8. 32 CFR 728.55 - Department of Justice beneficiaries.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 5 2013-07-01 2013-07-01 false Department of Justice beneficiaries. 728.55 Section 728.55 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Beneficiaries of Other...

  9. 32 CFR 728.55 - Department of Justice beneficiaries.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Department of Justice beneficiaries. 728.55 Section 728.55 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Beneficiaries of Other...

  10. 32 CFR 728.55 - Department of Justice beneficiaries.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false Department of Justice beneficiaries. 728.55 Section 728.55 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Beneficiaries of Other...

  11. 32 CFR 728.59 - Peace Corps beneficiaries.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false Peace Corps beneficiaries. 728.59 Section 728.59 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Beneficiaries of Other Federal Agencies...

  12. 32 CFR 728.59 - Peace Corps beneficiaries.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 5 2014-07-01 2014-07-01 false Peace Corps beneficiaries. 728.59 Section 728.59 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Beneficiaries of Other Federal Agencies...

  13. 32 CFR 728.14 - Pay patients.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false Pay patients. 728.14 Section 728.14 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Members of the Uniformed Services on Active Duty...

  14. 32 CFR 728.33 - Nonavailability statement (DD 1251).

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false Nonavailability statement (DD 1251). 728.33 Section 728.33 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Retired Members and...

  15. 32 CFR 728.76 - Naval Home residents.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false Naval Home residents. 728.76 Section 728.76 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE.... Provide necessary medical and dental care, both inpatient and outpatient, to residents of the Naval Home...

  16. 32 CFR 728.76 - Naval Home residents.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false Naval Home residents. 728.76 Section 728.76 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE.... Provide necessary medical and dental care, both inpatient and outpatient, to residents of the Naval Home...

  17. 32 CFR 728.13 - Application for care.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false Application for care. 728.13 Section 728.13 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Members of the Uniformed Services on Active...

  18. 32 CFR 728.76 - Naval Home residents.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 5 2013-07-01 2013-07-01 false Naval Home residents. 728.76 Section 728.76 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE.... Provide necessary medical and dental care, both inpatient and outpatient, to residents of the Naval Home...

  19. 32 CFR 728.32 - Application for care.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false Application for care. 728.32 Section 728.32 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE... medical and dental care may be rendered except in emergencies. When required inpatient or outpatient care...

  20. 32 CFR 728.76 - Naval Home residents.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Naval Home residents. 728.76 Section 728.76 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE.... Provide necessary medical and dental care, both inpatient and outpatient, to residents of the Naval Home...

  1. 20 CFR 416.728 - Penalty period: Second failure to report.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Penalty period: Second failure to report. 416.728 Section 416.728 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME... penalty period. The due date and the failure to report on time are the important factors in establishing a...

  2. 32 CFR 728.102 - Care from other than Federal sources.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Reservists-Continued Treatment, Return to Limited Duty, Separation, or Retirement for Physical Disability § 728.102 Care from... 32 National Defense 5 2010-07-01 2010-07-01 false Care from other than Federal sources. 728.102...

  3. 32 CFR 728.75 - Applicants for cadetship at service academies and applicants for the Uniformed Services...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... and applicants for the Uniformed Services University of Health Sciences (USUHS). 728.75 Section 728.75... cadetship at service academies and applicants for the Uniformed Services University of Health Sciences... Sciences (USUHS) will be furnished medical examinations at facilities designated by the DODMERB...

  4. 32 CFR 728.75 - Applicants for cadetship at service academies and applicants for the Uniformed Services...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... and applicants for the Uniformed Services University of Health Sciences (USUHS). 728.75 Section 728.75... cadetship at service academies and applicants for the Uniformed Services University of Health Sciences... Sciences (USUHS) will be furnished medical examinations at facilities designated by the DODMERB...

  5. 32 CFR 728.75 - Applicants for cadetship at service academies and applicants for the Uniformed Services...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... and applicants for the Uniformed Services University of Health Sciences (USUHS). 728.75 Section 728.75... cadetship at service academies and applicants for the Uniformed Services University of Health Sciences... Sciences (USUHS) will be furnished medical examinations at facilities designated by the DODMERB...

  6. 32 CFR 728.75 - Applicants for cadetship at service academies and applicants for the Uniformed Services...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... and applicants for the Uniformed Services University of Health Sciences (USUHS). 728.75 Section 728.75... cadetship at service academies and applicants for the Uniformed Services University of Health Sciences... Sciences (USUHS) will be furnished medical examinations at facilities designated by the DODMERB...

  7. 32 CFR 728.75 - Applicants for cadetship at service academies and applicants for the Uniformed Services...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... and applicants for the Uniformed Services University of Health Sciences (USUHS). 728.75 Section 728.75... cadetship at service academies and applicants for the Uniformed Services University of Health Sciences... Sciences (USUHS) will be furnished medical examinations at facilities designated by the DODMERB...

  8. Cost-benefit analysis of a Haemophilus influenzae type b meningitis prevention programme in The Philippines.

    PubMed

    Limcangco, M R; Armour, C L; Salole, E G; Taylor, S J

    2001-01-01

    Haemophilus influenzae type b (Hib) meningitis is associated with high mortality and serious sequelae in children under 5 years of age. Vaccines which can prevent this infection are available. To evaluate the costs and benefits of a 3-dose immunisation schedule in Manila, Philippines. Government and societal perspectives. A cost-benefit analysis based on a birth cohort of 100,000 children. The state of health of the cohort with and without a Hib immunisation programme was modelled over a 5-year period. A survey of medical records of patients with Hib in Manila provided data on the extent and cost of sequelae following infection. A 3-dose Hib vaccination programme given at ages 2, 3 and 4 months. The model predicted that vaccinating children against Hib meningitis would prevent 553 cases per year in a birth cohort of 100,000, at a cost of 56,200 Philippine pesos (PHP) [$US1,605; 1998 exchange rate] per case (base case assumptions of 90% vaccine efficacy rate, 95 per 100,000 Hib incidence rate, 85% vaccination coverage). Results from the cost-benefit analyses indicated that the saving to the government would be around PHP39 million ($US1.11 million), and the saving to society would be PHP255 million ($US7.28 million). There would be a positive economic benefit for the Philippine government and for the Filipino society if a Hib vaccination programme was introduced in Manila.

  9. 37 CFR 7.28 - Replacement of U.S. registration by registered extension of protection.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Replacement of U.S. registration by registered extension of protection. 7.28 Section 7.28 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE RULES OF PRACTICE IN FILINGS PURSUANT...

  10. 32 CFR 728.53 - Department of Labor, Office of Workers' Compensation Programs (OWCP) beneficiaries.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false Department of Labor, Office of Workers' Compensation Programs (OWCP) beneficiaries. 728.53 Section 728.53 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL...

  11. 48 CFR 728.313 - Contract clauses for insurance of transportation or transportation-related services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Contract clauses for insurance of transportation or transportation-related services. 728.313 Section 728.313 Federal Acquisition...) USAID is required by law to include language in all its direct contracts and subcontracts ensuring that...

  12. 32 CFR 728.72 - Applicants for enrollment in the Senior Reserve Officers' Training Program.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 5 2013-07-01 2013-07-01 false Applicants for enrollment in the Senior Reserve Officers' Training Program. 728.72 Section 728.72 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT...

  13. 32 CFR 728.82 - Individuals whose military records are being considered for correction.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 5 2013-07-01 2013-07-01 false Individuals whose military records are being considered for correction. 728.82 Section 728.82 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT...

  14. 32 CFR 728.82 - Individuals whose military records are being considered for correction.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false Individuals whose military records are being considered for correction. 728.82 Section 728.82 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT...

  15. 32 CFR 728.72 - Applicants for enrollment in the Senior Reserve Officers' Training Program.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Applicants for enrollment in the Senior Reserve Officers' Training Program. 728.72 Section 728.72 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT...

  16. 32 CFR 728.72 - Applicants for enrollment in the Senior Reserve Officers' Training Program.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false Applicants for enrollment in the Senior Reserve Officers' Training Program. 728.72 Section 728.72 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT...

  17. 32 CFR 728.82 - Individuals whose military records are being considered for correction.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false Individuals whose military records are being considered for correction. 728.82 Section 728.82 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT...

  18. 32 CFR 728.72 - Applicants for enrollment in the Senior Reserve Officers' Training Program.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false Applicants for enrollment in the Senior Reserve Officers' Training Program. 728.72 Section 728.72 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT...

  19. 32 CFR 728.82 - Individuals whose military records are being considered for correction.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Individuals whose military records are being considered for correction. 728.82 Section 728.82 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT...

  20. 48 CFR 728.313 - Contract clauses for insurance of transportation or transportation-related services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 5 2012-10-01 2012-10-01 false Contract clauses for insurance of transportation or transportation-related services. 728.313 Section 728.313 Federal Acquisition...) USAID is required by law to include language in all its direct contracts and subcontracts ensuring that...

  1. 48 CFR 728.313 - Contract clauses for insurance of transportation or transportation-related services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 false Contract clauses for insurance of transportation or transportation-related services. 728.313 Section 728.313 Federal Acquisition...) USAID is required by law to include language in all its direct contracts and subcontracts ensuring that...

  2. 48 CFR 728.313 - Contract clauses for insurance of transportation or transportation-related services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false Contract clauses for insurance of transportation or transportation-related services. 728.313 Section 728.313 Federal Acquisition...) USAID is required by law to include language in all its direct contracts and subcontracts ensuring that...

  3. 32 CFR 728.21 - Navy and Marine Corps reservists.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 5 2013-07-01 2013-07-01 false Navy and Marine Corps reservists. 728.21 Section..., Reserve Officers' Training Corps, Navy and Marine Corps Officer Candidate Programs, and National Guard Personnel § 728.21 Navy and Marine Corps reservists. (a) Scope. This section applies to reservists, as those...

  4. 32 CFR 728.21 - Navy and Marine Corps reservists.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false Navy and Marine Corps reservists. 728.21 Section..., Reserve Officers' Training Corps, Navy and Marine Corps Officer Candidate Programs, and National Guard Personnel § 728.21 Navy and Marine Corps reservists. (a) Scope. This section applies to reservists, as those...

  5. 32 CFR 728.21 - Navy and Marine Corps reservists.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Navy and Marine Corps reservists. 728.21 Section..., Reserve Officers' Training Corps, Navy and Marine Corps Officer Candidate Programs, and National Guard Personnel § 728.21 Navy and Marine Corps reservists. (a) Scope. This section applies to reservists, as those...

  6. 32 CFR 728.21 - Navy and Marine Corps reservists.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 5 2014-07-01 2014-07-01 false Navy and Marine Corps reservists. 728.21 Section..., Reserve Officers' Training Corps, Navy and Marine Corps Officer Candidate Programs, and National Guard Personnel § 728.21 Navy and Marine Corps reservists. (a) Scope. This section applies to reservists, as those...

  7. 32 CFR 728.21 - Navy and Marine Corps reservists.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false Navy and Marine Corps reservists. 728.21 Section..., Reserve Officers' Training Corps, Navy and Marine Corps Officer Candidate Programs, and National Guard Personnel § 728.21 Navy and Marine Corps reservists. (a) Scope. This section applies to reservists, as those...

  8. 9 CFR 72.8 - Interstate movement of cattle from free premises upon inspection and certification by APHIS...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Interstate movement of cattle from free premises upon inspection and certification by APHIS inspector. 72.8 Section 72.8 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE INTERSTATE...

  9. 32 CFR 728.25 - Army and Air Force National Guard personnel.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 5 2013-07-01 2013-07-01 false Army and Air Force National Guard personnel. 728... Guard Personnel § 728.25 Army and Air Force National Guard personnel. (a) Medical and dental care. Upon... Care) and AFR 168-6 (Persons Authorized Medical Care) to members of the Army and Air Force National...

  10. 32 CFR 728.25 - Army and Air Force National Guard personnel.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false Army and Air Force National Guard personnel. 728... Guard Personnel § 728.25 Army and Air Force National Guard personnel. (a) Medical and dental care. Upon... Care) and AFR 168-6 (Persons Authorized Medical Care) to members of the Army and Air Force National...

  11. 32 CFR 728.25 - Army and Air Force National Guard personnel.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Army and Air Force National Guard personnel. 728... Guard Personnel § 728.25 Army and Air Force National Guard personnel. (a) Medical and dental care. Upon... Care) and AFR 168-6 (Persons Authorized Medical Care) to members of the Army and Air Force National...

  12. 32 CFR 728.25 - Army and Air Force National Guard personnel.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false Army and Air Force National Guard personnel. 728... Guard Personnel § 728.25 Army and Air Force National Guard personnel. (a) Medical and dental care. Upon... Care) and AFR 168-6 (Persons Authorized Medical Care) to members of the Army and Air Force National...

  13. 32 CFR 728.51 - General provisions-the “Economy Act.”

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false General provisions-the âEconomy Act.â 728.51... Federal Agencies § 728.51 General provisions—the “Economy Act.” The Economy Act, 31 U.S.C. 1535, generally... convenient, or less expensive, than commercial procurement. Provisions of the Economy Act apply to requests...

  14. 32 CFR 728.51 - General provisions-the “Economy Act.”

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false General provisions-the âEconomy Act.â 728.51... Federal Agencies § 728.51 General provisions—the “Economy Act.” The Economy Act, 31 U.S.C. 1535, generally... convenient, or less expensive, than commercial procurement. Provisions of the Economy Act apply to requests...

  15. 32 CFR 728.51 - General provisions-the “Economy Act.”

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 5 2013-07-01 2013-07-01 false General provisions-the âEconomy Act.â 728.51... Federal Agencies § 728.51 General provisions—the “Economy Act.” The Economy Act, 31 U.S.C. 1535, generally... convenient, or less expensive, than commercial procurement. Provisions of the Economy Act apply to requests...

  16. 32 CFR 728.51 - General provisions-the “Economy Act.”

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 5 2014-07-01 2014-07-01 false General provisions-the âEconomy Act.â 728.51... Federal Agencies § 728.51 General provisions—the “Economy Act.” The Economy Act, 31 U.S.C. 1535, generally... convenient, or less expensive, than commercial procurement. Provisions of the Economy Act apply to requests...

  17. Investigation of the Feasibility of an Intervention to Manage Fall Risk in Wheeled Mobility Device Users with Multiple Sclerosis.

    PubMed

    Rice, Laura A; Isaacs, Zadok; Ousley, Cherita; Sosnoff, Jacob

    2018-01-01

    Falls are a common concern for wheeled mobility device users with multiple sclerosis (MS); however, no evidence-based fall prevention programs have been developed to meet the specific needs of the population. We examine the preliminary feasibility of a fall management intervention in wheeled mobility device users with MS. Study participants were exposed to an intervention program targeting risk factors for falls, including transfer skills and seated postural control. The feasibility of the program was evaluated by assessing participant perspectives, cost, recruitment rates, study adherence, participant retention, safety, and the ability to collect primary and secondary outcomes, including fall frequency, concerns about falling, transfer quality, and seated postural control. 16 wheeled mobility device users completed the program, which was found to be feasible and was positively evaluated by participants. No adverse events were experienced. After exposure to the intervention, fall frequency significantly decreased (P < .001) and transfer quality (P = .001) and seated postural control (P = .002) significantly improved. No significant differences were found regarding concerns about falling (P = .728). This study examined the feasibility of an intervention program to manage fall risk in wheeled mobility device users with MS. The program was found to be feasible, and preliminary results showed the intervention to be effective in decreasing fall frequency. Additional testing is needed to further examine the efficacy and long-term impact of the intervention.

  18. 32 CFR 728.34 - Care beyond the capabilities of a naval MTF.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Care beyond the capabilities of a naval MTF. 728... Dependents of the Uniformed Services § 728.34 Care beyond the capabilities of a naval MTF. When either during... determination is made that required care or services are beyond the capability of the naval MTF, the provisions...

  19. 32 CFR 728.34 - Care beyond the capabilities of a naval MTF.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false Care beyond the capabilities of a naval MTF. 728... Dependents of the Uniformed Services § 728.34 Care beyond the capabilities of a naval MTF. When either during... determination is made that required care or services are beyond the capability of the naval MTF, the provisions...

  20. Augmentation mastopexy after bariatric surgery: evaluation of patient satisfaction and surgical results.

    PubMed

    Junior, Wilson Cintra; Modolin, Miguel Luiz Antonio; Rocha, Rodrigo Itocazo; Gemperli, Rolf

    2016-01-01

    to evaluate patient satisfaction and surgical results obtained after mastopexy with breast implant inclusion. we conducted a prospective study of 20 consecutive female patients with a mean age of 39.9 years, submitted to augmentation mastopexy. We applied semi-directed psychological interviews pre and postoperatively. The answers to the evaluations were tabulated, categorized, and allowed patient satisfaction analysis. We evaluated surgical results through photographic analysis of three independent plastic surgeons, in the pre and postoperative periods, when scores were attributed to the following items: breasts shape, breasts volume, breasts symmetry, nipple-areolar complex position, and scar quality and extent. nineteen patients (95%) referred satisfaction with the surgical results attained (p<0,001). The mean sum of the scores attributed by the three surgeons to each patient varied between 4.7 and 10, with an overall mean of 7.28. The results were considered good or great for 65% of the sample and poor for 8.4%. there was a 95% satisfaction rate among patients with the results obtained through augmentation mastopexy. The photographic analysis of the results obtained a mean score of 7.28, considered as a good result, albeit the weak correlation among evaluators. avaliar a satisfação das pacientes e os resultados cirúrgicos obtidos após a mastopexia com inclusão de implantes mamários. estudo prospectivo com 20 pacientes consecutivas do sexo feminino, com média etária de 39,9 anos, que foram submetidas à mastopexia de aumento. Foram aplicadas entrevistas psicológicas semidirigidas nos períodos pré e pós-operatórios e cujas respostas foram tabuladas, divididas em categorias, e possibilitaram a avaliação da satisfação das pacientes. Foi realizada avaliação dos resultados cirúrgicos através da análise fotográfica por três cirurgiões plásticos independentes, nos períodos pré e pós-operatórios, que atribuíram notas aos seguintes itens: forma da mama, volume da mama, simetria entre as mamas, posicionamento do complexo aréolo-papilar e qualidade e extensão das cicatrizes. dezenove pacientes (95%) referiram satisfação com o resultado cirúrgico obtido (p<0,001). A média das somatórias das notas atribuídas pelos três cirurgiões, referentes a cada paciente, variou entre 4,7 e 10, sendo a média geral de 7,28. Os resultados foram considerados bons ou ótimos para 65% da amostra e pobres para 8,4%. houve satisfação de 95% das pacientes com os resultados obtidos pela mastopexia de aumento. A análise fotográfica dos resultados obteve nota média de 7,28, caracterizado como bom resultado, apesar da fraca concordância entre os avaliadores.

  1. Cost of diabetic foot in France, Spain, Italy, Germany and United Kingdom: A systematic review.

    PubMed

    Tchero, Huidi; Kangambega, Pauline; Lin, Lucien; Mukisi-Mukaza, Martin; Brunet-Houdard, Solenne; Briatte, Christine; Retali, Gerald Reparate; Rusch, Emmanuel

    2018-04-01

    Cost estimates for diabetic foot are available for developed countries based on cost data for different years. This study aimed to provide a comparison of the cost of diabetic foot in E5 (France, Spain, Italy, Germany, and the United Kingdom) and its characteristics across different conditions. PubMed, Central and Embase databases were searched in February 2017 for English language publications. Bibliographies of relevant papers were also searched manually. Reviews and research papers from E5 regions reporting on cost of diabetic foot were included. Reported cost was converted to equivalent 2016 $ for comparison purposes. All the costs presented are mean cost per patient per year in 2016 $. Nine studies were included in the analysis. The total cost of amputation ranged from $ 15,046 in 2001 to $ 38,621 in 2005. The direct cost of amputation ranged from $ 13,842 in 2001 to $ 83,728 during 2005-2009. Indirect cost of amputation was more uniform, ranging from between $ 1,043 to $ 1,442. The direct cost of gangrene ranged from $ 3,352 in 2003 to $ 8,818 in Germany. Although, for the same year, 2003, the cost for Spain was almost double that for Germany. The total cost of an uninfected ulcer was $ 6,174 in 2002, but increased to $ 14,441 in 2005; for an infected ulcer the cost increased from $ 2,637 to $ 2,957. The different countries showed variations in the components used to calculate the cost of diabetic foot. The E5 incurs a heavy cost from diabetic foot and its complications. There is an unmet need for the identification of cost-cutting strategies, as diabetic foot costs more than major cardiac diseases. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  2. Cost effectiveness analysis of immunotherapy in patients with grass pollen allergic rhinoconjunctivitis in Germany.

    PubMed

    Westerhout, K Y; Verheggen, B G; Schreder, C H; Augustin, M

    2012-01-01

    An economic evaluation was conducted to assess the outcomes and costs as well as cost-effectiveness of the following grass-pollen immunotherapies: OA (Oralair; Stallergenes S.A., Antony, France) vs GRZ (Grazax; ALK-Abelló, Hørsholm, Denmark), and ALD (Alk Depot SQ; ALK-Abelló) (immunotherapy agents alongside symptomatic medication) and symptomatic treatment alone for grass pollen allergic rhinoconjunctivitis. The costs and outcomes of 3-year treatment were assessed for a period of 9 years using a Markov model. Treatment efficacy was estimated using an indirect comparison of available clinical trials with placebo as a common comparator. Estimates for immunotherapy discontinuation, occurrence of asthma, health state utilities, drug costs, resource use, and healthcare costs were derived from published sources. The analysis was conducted from the insurant's perspective including public and private health insurance payments and co-payments by insurants. Outcomes were reported as quality-adjusted life years (QALYs) and symptom-free days. The uncertainty around incremental model results was tested by means of extensive deterministic univariate and probabilistic multivariate sensitivity analyses. In the base case analysis the model predicted a cost-utility ratio of OA vs symptomatic treatment of €14,728 per QALY; incremental costs were €1356 (95%CI: €1230; €1484) and incremental QALYs 0.092 (95%CI: 0.052; 0.140). OA was the dominant strategy compared to GRZ and ALD, with estimated incremental costs of -€1142 (95%CI: -€1255; -€1038) and -€54 (95%CI: -€188; €85) and incremental QALYs of 0.015 (95%CI: -0.025; 0.056) and 0.027 (95%CI: -0.022; 0.075), respectively. At a willingness-to-pay threshold of €20,000, the probability of OA being the most cost-effective treatment was predicted to be 79%. Univariate sensitivity analyses show that incremental outcomes were moderately sensitive to changes in efficacy estimates. The main study limitation was the requirement of an indirect comparison involving several steps to assess relative treatment effects. The analysis suggests OA to be cost-effective compared to GRZ and ALD, and a symptomatic treatment. Sensitivity analyses showed that uncertainty surrounding treatment efficacy estimates affected the model outcomes.

  3. Evaluation of an imputed pitch velocity model of the auditory kappa effect.

    PubMed

    Henry, Molly J; McAuley, J Devin

    2009-04-01

    Three experiments evaluated an imputed pitch velocity model of the auditory kappa effect. Listeners heard 3-tone sequences and judged the timing of the middle (target) tone relative to the timing of the 1st and 3rd (bounding) tones. Experiment 1 held pitch constant but varied the time (T) interval between bounding tones (T = 728, 1,000, or 1,600 ms) in order to establish baseline performance levels for the 3 values of T. Experiments 2 and 3 combined the values of T tested in Experiment 1 with a pitch manipulation in order to create fast (8 semitones/728 ms), medium (8 semitones/1,000 ms), and slow (8 semitones/1,600 ms) velocity conditions. Consistent with an auditory motion hypothesis, distortions in perceived timing were larger for fast than for slow velocity conditions for both ascending sequences (Experiment 2) and descending sequences (Experiment 3). Overall, results supported the proposed imputed pitch velocity model of the auditory kappa effect. (c) 2009 APA, all rights reserved.

  4. Health Care Costs for Patients With Chronic Spinal Cord Injury in the Veterans Health Administration

    PubMed Central

    French, Dustin D; Campbell, Robert R; Sabharwal, Sunil; Nelson, Audrey L; Palacios, Polly A; Gavin-Dreschnack, Deborah

    2007-01-01

    Background/Objective: Recurring annual costs of caring for patients with chronic spinal cord injury (SCI) is a large economic burden on health care systems, but information on costs of SCI care beyond the acute and initial postacute phase is sparse. The objective of this study was to establish a frame of reference and estimate of the annual direct medical costs associated with health care for a sample of patients with chronic SCI (ie, >2 years after injury). Methods: Patients were recruited from 3 Veterans Health Administration (VHA) SCI facilities; baseline patient information was cross-referenced to the Decision Support System (DSS) National Data Extracts (NDE) to obtain patient-specific health care costs in VHA. Descriptive statistical analysis of annual DSS-NDE cost of patients with SCI (N = 675) for fiscal year (FY) 2005 by level and completeness of injury was conducted. Results: Total (inpatient and outpatient) annual (FY 2005) direct medical costs for 675 patients with SCI exceeded $14.47 million or $21,450 per patient. Average annual total costs varied from $28,334 for cervical complete SCI to $16,792 for thoracic incomplete SCI. Two hundred thirty-three of the 675 patients with SCI who were hospitalized over the study period accounted for a total of 378 hospital discharges, costing in excess of $7.19 million. This approximated a cost of outpatient care received of $7.28 million for our entire sample. Conclusions: The comprehensive nature of health care delivery and related cost capture for people with chronic SCI in the VHA provided us the opportunity to accurately determine health care costs for this population. Future SCI postacute care cost analyses should consider case-mix adjusting patients at high risk for rehospitalization. PMID:18092564

  5. Evaluation of an Imputed Pitch Velocity Model of the Auditory Kappa Effect

    ERIC Educational Resources Information Center

    Henry, Molly J.; McAuley, J. Devin

    2009-01-01

    Three experiments evaluated an imputed pitch velocity model of the auditory kappa effect. Listeners heard 3-tone sequences and judged the timing of the middle (target) tone relative to the timing of the 1st and 3rd (bounding) tones. Experiment 1 held pitch constant but varied the time (T) interval between bounding tones (T = 728, 1,000, or 1,600…

  6. A prospective, randomized clinical trial to assess the cost-effectiveness of a modern foam dressing versus a traditional saline gauze dressing in the treatment of stage II pressure ulcers.

    PubMed

    Payne, Wyatt G; Posnett, John; Alvarez, Oscar; Brown-Etris, Marie; Jameson, Gayle; Wolcott, Randall; Dharma, Hussein; Hartwell, Samantha; Ochs, Diane

    2009-02-01

    Modern dressings such as hydrocolloids, gels, and foams are typically more expensive than traditional dressings such as gauze. However, if modern dressings require fewer changes, the overall cost of treatment may be lower despite the higher initial purchase price. If healing rates are comparable or better, modern dressings also may be cost-effective. A 4-week, prospective, randomized clinical trial to assess differences in treatment costs and cost-effectiveness between a modern foam dressing and saline-soaked gauze was conducted among 36 patients (22 men, 14 women, mean age 72.8 years) with a Stage II pressure ulcer (mean duration 35 weeks) at five centers in the United States. Participants were randomized to treatment with a self-adhesive polyurethane foam (n = 20) or saline-soaked gauze dressing (n = 16). No difference in time to wound closure was observed (P = 0.817). Patients in the foam group had less frequent dressing changes (P <0.001). Total cost over the study period was lower by $466 per patient (P = 0.055) and spending on dressings was lower by $92 per patient in the foam group (P = 0.025). Cost per ulcer healed was lower by $1,517 and cost per ulcer-free day was lower by $80 for patients in the foam group. On the evidence of this study, the foam dressing is a more cost-effective treatment than saline-soaked gauze for the treatment of Stage II pressure ulcers.

  7. Fresh Water Cyanobacteria Geitlerinema sp. CCC728 and Arthrospira sp. CCC729 as an Anticancer Drug Resource.

    PubMed

    Srivastava, Akanksha; Tiwari, Ratnakar; Srivastava, Vikas; Singh, Tej Bali; Asthana, Ravi Kumar

    2015-01-01

    An increasing number of cancer patients worldwide, especially in third world countries, have raised concern to explore natural drug resources, such as the less explored fresh water filamentous cyanobacteria. Six strains of cyanobacteria (Phormidium sp. CCC727, Geitlerinema sp. CCC728, Arthrospira sp. CCC729, Phormidium sp. CCC731, Phormidium sp. CCC730, and Leptolyngbya sp. CCC732) were isolated (paddy fields and ponds in the Banaras Hindu University, campus) and five strains screened for anticancer potential using human colon adenocarcinoma (HT29) and human kidney adenocarcinoma (A498) cancer cell lines. Geitlerinema sp. CCC728 and Arthrospira sp. CCC729 were the most potent as determined by examination of morphological features and by inhibition of growth by graded concentrations of crude extracts and thin-layer chromatography (TLC) eluates. Cell cycle analysis and multiplex assays using cancer biomarkers also confirmed Geitlerinema sp. CCC728 and Arthrospira sp. CCC729 as cancer drug resources. Apoptotic studies in the cells of A498 (cancer) and MCF-10A (normal human epithelial) exposed to crude extracts and TLC fractions revealed no significant impact on MCF-10A cells emphasizing its importance in the development of anticancer drug. Identification of biomolecules from these extracts are in progress.

  8. Fresh Water Cyanobacteria Geitlerinema sp. CCC728 and Arthrospira sp. CCC729 as an Anticancer Drug Resource

    PubMed Central

    Tiwari, Ratnakar; Srivastava, Vikas

    2015-01-01

    An increasing number of cancer patients worldwide, especially in third world countries, have raised concern to explore natural drug resources, such as the less explored fresh water filamentous cyanobacteria. Six strains of cyanobacteria (Phormidium sp. CCC727, Geitlerinema sp. CCC728, Arthrospira sp. CCC729, Phormidium sp. CCC731, Phormidium sp. CCC730, and Leptolyngbya sp. CCC732) were isolated (paddy fields and ponds in the Banaras Hindu University, campus) and five strains screened for anticancer potential using human colon adenocarcinoma (HT29) and human kidney adenocarcinoma (A498) cancer cell lines. Geitlerinema sp. CCC728 and Arthrospira sp. CCC729 were the most potent as determined by examination of morphological features and by inhibition of growth by graded concentrations of crude extracts and thin-layer chromatography (TLC) eluates. Cell cycle analysis and multiplex assays using cancer biomarkers also confirmed Geitlerinema sp. CCC728 and Arthrospira sp. CCC729 as cancer drug resources. Apoptotic studies in the cells of A498 (cancer) and MCF-10A (normal human epithelial) exposed to crude extracts and TLC fractions revealed no significant impact on MCF-10A cells emphasizing its importance in the development of anticancer drug. Identification of biomolecules from these extracts are in progress. PMID:26325186

  9. 32 CFR 728.32 - Application for care.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Uniformed Services § 728.32 Application for care. Possession of an ID card alone (DD 2 (Retired), PHS-1866-3 (Retired), or DD 1173 (Uniformed Services Identification and Privilege Card)) does not constitute...

  10. 49 CFR 572.131 - General description.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Assembly 880105-300 Lower Torso Assembly 880105-450 Complete Leg Assembly—left 880105-560-1 Complete Leg Assembly—right 880105-560-2 Complete Arm Assembly—left 880105-728-1 Complete Arm Assembly—right 880105-728...

  11. 49 CFR 572.131 - General description.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Assembly 880105-300 Lower Torso Assembly 880105-450 Complete Leg Assembly—left 880105-560-1 Complete Leg Assembly—right 880105-560-2 Complete Arm Assembly—left 880105-728-1 Complete Arm Assembly—right 880105-728...

  12. 32 CFR 728.3 - General restrictions and priorities.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES General § 728.3 General... domiciliary care. Routine dental care, other than dental prosthesis or orthodontia, may be rendered on a space...

  13. 32 CFR 728.3 - General restrictions and priorities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES General § 728.3 General... domiciliary care. Routine dental care, other than dental prosthesis or orthodontia, may be rendered on a space...

  14. 32 CFR 728.3 - General restrictions and priorities.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES General § 728.3 General... domiciliary care. Routine dental care, other than dental prosthesis or orthodontia, may be rendered on a space...

  15. 32 CFR 728.3 - General restrictions and priorities.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES General § 728.3 General... domiciliary care. Routine dental care, other than dental prosthesis or orthodontia, may be rendered on a space...

  16. The Economic Burden of Child Maltreatment in the United States And Implications for Prevention

    PubMed Central

    Fang, Xiangming; Brown, Derek S.; Florence, Curtis; Mercy, James A.

    2013-01-01

    Objectives To present new estimates of the average lifetime costs per child maltreatment victim and aggregate lifetime costs for all new child maltreatment cases incurred in 2008 using an incidence-based approach. Methods This study used the best available secondary data to develop cost per case estimates. For each cost category, the paper used attributable costs whenever possible. For those categories that attributable cost data were not available, costs were estimated as the product of incremental effect of child maltreatment on a specific outcome multiplied by the estimated cost associated with that outcome. The estimate of the aggregate lifetime cost of child maltreatment in 2008 was obtained by multiplying per-victim lifetime cost estimates by the estimated cases of new child maltreatment in 2008. Results The estimated average lifetime cost per victim of nonfatal child maltreatment is $210,012 in 2010 dollars, including $32,648 in childhood health care costs; $10,530 in adult medical costs; $144,360 in productivity losses; $7,728 in child welfare costs; $6,747 in criminal justice costs; and $7,999 in special education costs. The estimated average lifetime cost per death is $1,272,900, including $14,100 in medical costs and $1,258,800 in productivity losses. The total lifetime economic burden resulting from new cases of fatal and nonfatal child maltreatment in the United States in 2008 is approximately $124 billion. In sensitivity analysis, the total burden is estimated to be as large as $585 billion. Conclusions Compared with other health problems, the burden of child maltreatment is substantial, indicating the importance of prevention efforts to address the high prevalence of child maltreatment. PMID:22300910

  17. TOPS: Trial Of Prevention Strategies for low back pain in patients recently recovered from low back pain—study rationale and protocol

    PubMed Central

    Lin, Chung-Wei C; Hancock, Mark J; Latimer, Jane; Buchbinder, Rachelle; Grotle, Margreth; van Tulder, Maurits; New, Charles H; Wisby-Roth, Trish; Maher, Chris G

    2016-01-01

    Introduction Low back pain (LBP) is the health condition that carries the greatest disability burden worldwide; however, there is only modest support for interventions to prevent LBP. The aim of this trial is to establish the effectiveness and cost-effectiveness of group-based exercise and educational classes compared with a minimal intervention control in preventing recurrence of LBP in people who have recently recovered from an episode of LBP. Methods and analysis TOPS will be a pragmatic comparative effectiveness randomised clinical trial with a parallel economic evaluation combining three separate cohorts (TOPS Workers, TOPS Primary Care, TOPS Defence) with the same methodology. 1482 participants who have recently recovered from LBP will be randomised to either a comprehensive exercise and education programme or a minimal intervention control. Participants will be followed up for a minimum of 1 year. The primary outcome will be days till recurrence of LBP. Effectiveness will be assessed using survival analysis. Cost-effectiveness will be assessed from the societal perspective. Ethics and dissemination This trial has been approved by the University of Sydney Human Research Ethics Committee (HREC) (ref: 2015/728) and prospectively registered with the Australian and New Zealand Clinical Trials Registry (ref: 12615000939594). We will also obtain ethics approval from the Australian Defence Force HREC. The results of this study will be submitted for publication in a prominent journal and widely publicised in the general media. Trial registration number Australian and New Zealand Clinical Trial Registry (ANZCTR) 12615000939594. PMID:27217287

  18. Pretreatment of eucalyptus with recycled ionic liquids for low-cost biorefinery.

    PubMed

    Xu, Jikun; Liu, Bingchuan; Hou, Huijie; Hu, Jingping

    2017-06-01

    It is urgent to develop recycled ionic liquids (ILs) as green solvents for sustainable biomass pretreatment. The goal of this study is to explore the availability and performance of reusing 1-allyl-3-methylimidazolium chloride ([amim]Cl) and 1-butyl-3-methylimidazolium acetate ([bmim]OAc) for pretreatment, structural evolution, and enzymatic hydrolysis of eucalyptus. Cellulose enzymatic digestibility slightly decreased with the increased number of pretreatment recycles. The hydrolysis efficiencies of eucalyptus pretreated via 4th recycled ILs were 54.3% for [amim]Cl and 72.8% for [bmim]OAc, which were 5.0 and 6.7-folds higher than that of untreated eucalyptus. Deteriorations of ILs were observed by the relatively lower sugar conversion and lignin removal from eucalyptus after 4th reuse. No appreciable changes in fundamental framework and thermal stability of [amim]Cl were observed even after successive pretreatments, whereas the anionic structure of [bmim]OAc was destroyed or replaced. This study suggested that the biomass pretreatment with recycled ILs was a potential alternative for low-cost biorefinery. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. A comparison of HFrEF vs HFpEF's clinical workload and cost in the first year following hospitalization and enrollment in a disease management program.

    PubMed

    Murphy, T M; Waterhouse, D F; James, S; Casey, C; Fitzgerald, E; O'Connell, E; Watson, C; Gallagher, J; Ledwidge, M; McDonald, K

    2017-04-01

    Admission with heart failure (HF) is a milestone in the progression of the disease, often resulting in higher intensity medical care and ensuing readmissions. Whilst there is evidence supporting enrolling patients in a heart failure disease management program (HF-DMP), not all reported HF-DMPs have systematically enrolled patients with HF with preserved ejection fraction (HFpEF) and there is a scarcity of literature differentiating costs based on HF-phenotype. 1292 consenting, consecutive patients admitted with a primary diagnosis of HF were enrolled in a hospital based HF-DMP and categorized as HFpEF (EF≥45%) or HFrEF (EF<45%). Hospitalizations, primary care, medications, and DMP workload with associated costs were evaluated assessing DMP clinic-visits, telephonic contact, medication changes over 1year using a mixture of casemix and micro-costing techniques. The total average annual cost per patient was marginally higher in patients with HFrEF €13,011 (12,011, 14,078) than HFpEF, €12,206 (11,009, 13,518). However, emergency non-cardiovascular admission rates and average cost per patient were higher in the HFpEF vs HFrEF group (0.46 vs 0.31 per patient/12months) & €655 (318, 1073) vs €584 (396, 812). In the first 3months of the outpatient HF-DMP the HFrEF population cost more on average €791 (764, 819) vs €693 (660, 728). There are greater short-term (3-month) costs of HFrEF versus HFpEF as part of a HF-DMP following an admission. However, long-term (3-12month) costs of HFpEF are greater because of higher non-cardiovascular rehospitalisations. As HFpEF becomes the dominant form of HF, more work is required in HF-DMPs to address prevention of non-cardiovascular rehospitalisations and to integrate hospital based HF-DMPs into primary healthcare structures. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  20. IR, FT-ICR-MS studies on (1'S, 6'S)-1-cyclopropyl-7-(2,8-diazabicyclo[4.3.0] non-8-yl)-6-fluoro-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic acid hydrochloride salt.

    PubMed

    Lin, Zhiwei

    2014-01-01

    The infrared spectra of (1'S, 6'S)-1-cyclopropyl-7-(2,8-diazabicyclo[4.3.0] non-8-yl)-6-fluoro-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic acid hydrochloride salt (CLF-HCl) were studied and compared with free base. Their fragmentation pathways were investigated using tandem mass spectrometric (MS/MS) techniques on Fourier-transform ion cyclotron resonance spectrum, and many characteristic fragment ions were found. Copyright © 2013 Elsevier B.V. All rights reserved.

  1. The Vildagliptin Experience - 25 Years Since the Initiation of the Novartis Glucagon-like Peptide-1 Based Therapy Programme and 10 Years Since the First Vildagliptin Registration.

    PubMed

    Foley, James E; Ahrén, Bo

    2017-08-01

    The discovery of the incretin hormone glucagon like peptide-1 (GLP-1), and its usefulness in the treatment of type 2 diabetes mellitus (T2DM) followed by the finding that dipeptidyl peptidase-4 (DPP-4) inhibition prevents GLP-1 inactivation, led to the discovery of DPP-728. In 1999, studies with DPP-728 established the first proof-of-concept that DPP-4 inhibition improves glycaemic control in patients with T2DM. Further efforts to improve the binding kinetics of DPP-728 resulted in the discovery of vildagliptin (LAF237). In the last 20 years, a plethora of studies conducted by Novartis in collaboration with external investigators has demonstrated the mechanism of action of vildagliptin and its efficacy as monotherapy and as an add-on therapy for patients with T2DM. The studies establish that vildagliptin is a selective DPP-4 inhibitor that blocks GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) inactivation, thereby prolonging their action, resulting in improved glycaemic control. This review aims to discuss the discovery and development of vildagliptin, with an emphasis on mechanism of action and clinical efficacy.

  2. Policy evaluation in diabetes prevention and treatment using a population-based macro simulation model: the MICADO model.

    PubMed

    van der Heijden, A A W A; Feenstra, T L; Hoogenveen, R T; Niessen, L W; de Bruijne, M C; Dekker, J M; Baan, C A; Nijpels, G

    2015-12-01

    To test a simulation model, the MICADO model, for estimating the long-term effects of interventions in people with and without diabetes. The MICADO model includes micro- and macrovascular diseases in relation to their risk factors. The strengths of this model are its population scope and the possibility to assess parameter uncertainty using probabilistic sensitivity analyses. Outcomes include incidence and prevalence of complications, quality of life, costs and cost-effectiveness. We externally validated MICADO's estimates of micro- and macrovascular complications in a Dutch cohort with diabetes (n = 498,400) by comparing these estimates with national and international empirical data. For the annual number of people undergoing amputations, MICADO's estimate was 592 (95% interquantile range 291-842), which compared well with the registered number of people with diabetes-related amputations in the Netherlands (728). The incidence of end-stage renal disease estimated using the MICADO model was 247 people (95% interquartile range 120-363), which was also similar to the registered incidence in the Netherlands (277 people). MICADO performed well in the validation of macrovascular outcomes of population-based cohorts, while it had more difficulty in reflecting a highly selected trial population. Validation by comparison with independent empirical data showed that the MICADO model simulates the natural course of diabetes and its micro- and macrovascular complications well. As a population-based model, MICADO can be applied for projections as well as scenario analyses to evaluate the long-term (cost-)effectiveness of population-level interventions targeting diabetes and its complications in the Netherlands or similar countries. © 2015 The Authors. Diabetic Medicine © 2015 Diabetes UK.

  3. 75 FR 16896 - Proposed Agency Information Collection Activities; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-02

    ... Submission: On occasion; recordkeeping. Average time CFR section Respondent universe Total annual per...: Businesses. Frequency of Submission: On occasion. Respondent Universe: 728 railroads. Total Estimated... standard. Form Number(s): N/A. Affected Public: Businesses. Respondent Universe: 728 railroads. Frequency...

  4. 78 FR 18668 - Proposed Agency Information Collection Activities; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-27

    .... Frequency of Submission: On occasion. Respondent Universe: 728 railroads. Total Estimated Responses: 25,000... compliance with the performance standard. Respondent Universe: 728 railroads. Frequency of Submission: On... noise standards for new locomotives. Respondent Universe: 2 Locomotive Manufacturers. Frequency of...

  5. 32 CFR 728.92 - Policy.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Adjuncts to Medical Care § 728.92 Policy. (a) Provide adjuncts to medical care to eligible beneficiaries receiving inpatient or outpatient care when, in the...

  6. 1. NORTH AND WEST SIDES OF BUILDING 728 FROM CHEMICAL ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. NORTH AND WEST SIDES OF BUILDING 728 FROM CHEMICAL STORAGE TANK. VIEW TO SOUTHEAST. - Rocky Mountain Arsenal, Mustard Filling & Storage Building, 280 feet South of December Seventh Avenue; 2130 feet East of D Street, Commerce City, Adams County, CO

  7. Cost of best-practice primary care management of chronic disease in a remote Aboriginal community.

    PubMed

    Gador-Whyte, Andrew P; Wakerman, John; Campbell, David; Lenthall, Sue; Struber, Janet; Hope, Alex; Watson, Colin

    2014-06-16

    To estimate the cost of completing all chronic care tasks recommended by the Central Australian Rural Practitioners Association Standard Treatment Manual (CARPA STM) for patients with type 2 diabetes and chronic kidney disease (CKD). The study was conducted at a health service in a remote Central Australian Aboriginal community between July 2010 and May 2011. The chronic care tasks required were ascertained from the CARPA STM. The clinic database was reviewed for data on disease prevalence and adherence to CARPA STM guidelines. Recommended tasks were observed in a time-and-motion study of clinicians' work. Clinicians were interviewed about systematic management and its barriers. Expenditure records were analysed for salary and administrative costs. Diabetes and CKD prevalence; time spent on chronic disease care tasks; completion of tasks recommended by the CARPA STM; barriers to systematic care identified by clinicians; and estimated costs of optimal primary care management of all residents with diabetes or CKD. Projected annual costs of best-practice care for diabetes and CKD for this community of 542 people were $900 792, of which $645 313 would be met directly by the local primary care service. Estimated actual expenditure for these conditions in 2009-10 was $446 585, giving a projected funding gap of $198 728 per annum, or $1733 per patient. High staff turnover, acute care workload and low health literacy also hindered optimal chronic disease care. Barriers to optimal care included inadequate funding and workforce issues. Reduction of avoidable hospital admissions and overall costs necessitates adequate funding of primary care of chronic disease in remote communities.

  8. Design for Warehouse with Product Flow Type Allocation using Linear Programming: A Case Study in a Textile Industry

    NASA Astrophysics Data System (ADS)

    Khannan, M. S. A.; Nafisah, L.; Palupi, D. L.

    2018-03-01

    Sari Warna Co. Ltd, a company engaged in the textile industry, is experiencing problems in the allocation and placement of goods in the warehouse. During this time the company has not implemented the product flow type allocation and product placement to the respective products resulting in a high total material handling cost. Therefore, this study aimed to determine the allocation and placement of goods in the warehouse corresponding to product flow type with minimal total material handling cost. This research is a quantitative research based on the theory of storage and warehouse that uses a mathematical model of optimization problem solving using mathematical optimization model approach belongs to Heragu (2005), aided by software LINGO 11.0 in the calculation of the optimization model. Results obtained from this study is the proportion of the distribution for each functional area is the area of cross-docking at 0.0734, the reserve area at 0.1894, and the forward area at 0.7372. The allocation of product flow type 1 is 5 products, the product flow type 2 is 9 products, the product flow type 3 is 2 products, and the product flow type 4 is 6 products. The optimal total material handling cost by using this mathematical model equal to Rp43.079.510 while it is equal to Rp 49.869.728 by using the company’s existing method. It saves Rp6.790.218 for the total material handling cost. Thus, all of the products can be allocated in accordance with the product flow type with minimal total material handling cost.

  9. 32 CFR 728.101 - General.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR... Duty, Separation, or Retirement for Physical Disability § 728.101 General. (a) Notice of eligibility... for return to full duty within a reasonable period, a medical board will be convened and the case...

  10. 32 CFR 728.91 - General.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Adjuncts to Medical Care § 728.91 General. Adjuncts to medical care include but are not limited to prosthetic devices such as artificial limbs, artificial eyes...

  11. 48 CFR 728.307-70 - Medical Evacuation (MEDEVAC) Services (MAR 1993).

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... FOR INTERNATIONAL DEVELOPMENT GENERAL CONTRACTING REQUIREMENTS BONDS AND INSURANCE Insurance 728.307-70 Medical Evacuation (MEDEVAC) Services (MAR 1993). The Contracting Officer shall insert the clause at 752.228-70 in all contracts which require performance by contractor employees overseas. [59 FR...

  12. 48 CFR 728.307-70 - Medical Evacuation (MEDEVAC) Services (MAR 1993).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... FOR INTERNATIONAL DEVELOPMENT GENERAL CONTRACTING REQUIREMENTS BONDS AND INSURANCE Insurance 728.307-70 Medical Evacuation (MEDEVAC) Services (MAR 1993). The Contracting Officer shall insert the clause at 752.228-70 in all contracts which require performance by contractor employees overseas. [59 FR...

  13. Evaluation of the Flying Qualities Requirements of MIL-F-8785B (ASG) using the C-5A Airplane

    DTIC Science & Technology

    1975-03-20

    using only the elevator control (neutralizing the aileron and rudder controls is allowed). The same tech - nique used to recover from post-stall gyrations...AD-AO11 728 EVALUATION OF THE FLYING QUALITIES REQUIREMENTS OF MIL- F-8785B (ASG) USING THE C-5A AIRPLANE Charles L. Silvers, et al Lockheed-Geor-gia...75-3 00 EVALUATION OF THE FLYING QUALITIES •- ~REQUIRIMENTS OF MIL-F-878S5 (ASO) USING THE C-SA AIRPLANE LOCKHEED-GEORGIA COMPANY TECHNICAL REPORT

  14. 32 CFR 728.93 - Chart of adjuncts.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Adjuncts to Medical Care § 728.93 Chart of... the several categories of beneficiaries eligible for medical care at naval MTFs. Adjuncts Active duty...

  15. 32 CFR 728.93 - Chart of adjuncts.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Adjuncts to Medical Care § 728.93 Chart of... the several categories of beneficiaries eligible for medical care at naval MTFs. Adjuncts Active duty...

  16. 48 CFR 728.309 - Contract clause for worker's compensation insurance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... INTERNATIONAL DEVELOPMENT GENERAL CONTRACTING REQUIREMENTS BONDS AND INSURANCE Insurance 728.309 Contract clause... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Contract clause for worker... resulting in contracts which require worker's compensation insurance, USAID has contracted with an insurance...

  17. 48 CFR 728.309 - Contract clause for worker's compensation insurance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... INTERNATIONAL DEVELOPMENT GENERAL CONTRACTING REQUIREMENTS BONDS AND INSURANCE Insurance 728.309 Contract clause... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Contract clause for worker... resulting in contracts which require worker's compensation insurance, USAID has contracted with an insurance...

  18. Hysteroscopic polypectomy prior to infertility treatment: A cost analysis and systematic review.

    PubMed

    Mouhayar, Youssef; Yin, Ophelia; Mumford, Sunni L; Segars, James H

    2017-06-01

    The cost of fertility treatment is expensive and interventions that reduce cost can lead to greater efficiency and fewer embryos transferred. Endometrial polyps contribute to infertility and are frequently removed prior to infertility treatment. It is unclear whether polypectomy reduces fertility treatment cost and if so, the magnitude of cost reduction afforded by the procedure. The aim of this study was to determine whether performing office or operative hysteroscopic polypectomy prior to infertility treatment would be cost-effective. PubMed, Embase, and Cochrane libraries were used to identify publications reporting pregnancy rates after hysteroscopic polypectomy. Studies were required to have a polypectomy treatment group and control group of patients with polyps that were not resected. The charges of infertility treatments and polypectomy were obtained through infertility organizations and a private healthcare cost reporting website. These charges were applied to a decision tree model over the range of pregnancy rates observed in the representative studies to calculate an average cost per clinical or ongoing pregnancy. A sensitivity analysis was conducted to assess cost savings of polypectomy over a range of pregnancy rates and polypectomy costs. Pre-treatment office or operative hysteroscopic polypectomy ultimately saved €6658 ($7480) and €728 ($818), respectively, of the average cost per clinical pregnancy in women treated with four cycles of intrauterine insemination. Polypectomy prior to intrauterine insemination was cost-effective for clinical pregnancy rates greater than 30.2% for office polypectomy and 52.6% for operative polypectomy and for polypectomy price <€4414 ($4959). Office polypectomy or operative polypectomy saved €15,854 ($17,813) and €6644 ($7465), respectively, from the average cost per ongoing pregnancy for in vitro fertilization/intracytoplasmic sperm injection treated women and was cost-effective for ongoing pregnancy rates greater than 26.4% (office polypectomy) and 31.7% (operative polypectomy) and polypectomy price <€6376 ($7164). These findings suggested that office or operative hysteroscopic polypectomy was cost-effective when performed prior to both intrauterine insemination and in vitro fertilization over a range of plausible pregnancy rates and procedural costs. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. 32 CFR 728.24 - Navy and Marine Corps Officer Candidate Programs.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false Navy and Marine Corps Officer Candidate Programs... Reserve Components, Reserve Officers' Training Corps, Navy and Marine Corps Officer Candidate Programs, and National Guard Personnel § 728.24 Navy and Marine Corps Officer Candidate Programs. Members of the...

  20. 32 CFR 728.24 - Navy and Marine Corps Officer Candidate Programs.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 5 2013-07-01 2013-07-01 false Navy and Marine Corps Officer Candidate Programs... Reserve Components, Reserve Officers' Training Corps, Navy and Marine Corps Officer Candidate Programs, and National Guard Personnel § 728.24 Navy and Marine Corps Officer Candidate Programs. Members of the...

  1. 40 CFR 72.8 - Retired units exemption.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) PERMITS REGULATION Acid Rain Program General Provisions § 72.8 Retired units exemption. (a) This section... affected unit (except for an opt-in source) that is permanently retired shall be exempt from the Acid Rain... permitting authority otherwise responsible for administering a Phase II Acid Rain permit for the unit. If the...

  2. 40 CFR 72.8 - Retired units exemption.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) PERMITS REGULATION Acid Rain Program General Provisions § 72.8 Retired units exemption. (a) This section... affected unit (except for an opt-in source) that is permanently retired shall be exempt from the Acid Rain... permitting authority otherwise responsible for administering a Phase II Acid Rain permit for the unit. If the...

  3. 40 CFR 72.8 - Retired units exemption.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...) PERMITS REGULATION Acid Rain Program General Provisions § 72.8 Retired units exemption. (a) This section... affected unit (except for an opt-in source) that is permanently retired shall be exempt from the Acid Rain... permitting authority otherwise responsible for administering a Phase II Acid Rain permit for the unit. If the...

  4. 40 CFR 72.8 - Retired units exemption.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...) PERMITS REGULATION Acid Rain Program General Provisions § 72.8 Retired units exemption. (a) This section... affected unit (except for an opt-in source) that is permanently retired shall be exempt from the Acid Rain... permitting authority otherwise responsible for administering a Phase II Acid Rain permit for the unit. If the...

  5. 40 CFR 72.8 - Retired units exemption.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...) PERMITS REGULATION Acid Rain Program General Provisions § 72.8 Retired units exemption. (a) This section... affected unit (except for an opt-in source) that is permanently retired shall be exempt from the Acid Rain... permitting authority otherwise responsible for administering a Phase II Acid Rain permit for the unit. If the...

  6. 48 CFR 728.313 - Contract clauses for insurance of transportation or transportation-related services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Regulations System AGENCY FOR INTERNATIONAL DEVELOPMENT GENERAL CONTRACTING REQUIREMENTS BONDS AND INSURANCE Insurance 728.313 Contract clauses for insurance of transportation or transportation-related services. (a... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Contract clauses for...

  7. Cost-effectiveness of ticagrelor versus clopidogrel for the prevention of atherothrombotic events in adult patients with acute coronary syndrome in Germany.

    PubMed

    Theidel, Ulrike; Asseburg, Christian; Giannitsis, Evangelos; Katus, Hugo

    2013-06-01

    The aim of this health economic analysis was to compare the cost-effectiveness of ticagrelor versus clopidogrel within the German health care system. A two-part decision model was adapted to compare treatment with ticagrelor or clopidogrel in a low-dose acetylsalicylic acid (ASA) cohort (≤150 mg) for all ACS patients and subtypes NSTEMI/IA and STEMI. A decision-tree approach was chosen for the first year after initial hospitalization based on trial observations from a subgroup of the PLATO study. Subsequent years were estimated by a Markov model. Following a macro-costing approach, costs were based on official tariffs and published literature. Extensive sensitivity analyses were performed to test the robustness of the model. One-year treatment with ticagrelor is associated with an estimated 0.1796 life-years gained (LYG) and gained 0.1570 quality-adjusted life-years (QALY), respectively, over the lifetime horizon. Overall average cost with ticagrelor is estimated to be EUR 11,815 vs. EUR 11,387 with generic clopidogrel over a lifetime horizon. The incremental cost-effectiveness ratio (ICER) was EUR 2,385 per LYG (EUR 2,728 per QALY). Comparing ticagrelor with Plavix(®) or the lowest priced generic clopidogrel, ICER ranges from dominant to EUR 3,118 per LYG (EUR 3,567 per QALY). These findings are robust under various additional sensitivity analyses. Hence, 12 months of ACS treatment using ticagrelor/ASA instead of clopidogrel/ASA may offer a cost-effective therapeutic option, even when the generic price for clopidogrel is employed.

  8. The impact of morbid obesity on resource utilization after renal transplantation.

    PubMed

    Kim, Young; Chang, Alex L; Wima, Koffi; Ertel, Audrey E; Diwan, Tayyab S; Abbott, Daniel E; Shah, Shimul A

    2016-12-01

    A growing number of renal transplant recipients have a body mass index ≥40. While previous studies have shown that patient and graft survival are significantly decreased in renal transplant recipients with body mass indexes ≥40, less is known about perioperative outcomes and resource utilization in morbidly obese patients. We aimed to analyze the effects of morbid obesity on these parameters in renal transplant. Using a linkage between the Scientific Registry of Transplant Recipients and the databases of the University HealthSystem Consortium, we identified 29,728 adult renal transplant recipients and divided them into 2 cohorts based on body mass index (<40 vs ≥40 kg/m 2 ). The body mass index ≥40 group comprised 2.5% (n = 747) of renal transplant recipients studied. Body mass index ≥40 recipients incurred greater direct costs ($84,075 vs $79,580, P < .01), index admission costs ($91,169 vs $86,141, P < .01), readmission costs ($5,306 vs $4,596, P = .01), and combined costs ($99,590 vs $93,939, P < .001). Thirty-day readmission rates were also greater among body mass index ≥40 recipients (33.92% vs 26.9%, P < .01). Morbid obesity was not predictive of stay (odds ratio 1.01, P = .75). Morbidly obese renal transplant recipients incur greater costs and readmission rates compared with nonobese patients. Recognition of increased resource utilization should be accompanied by appropriate, risk-adjustment reimbursement. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. 32 CFR 728.43 - Members of other foreign military services and their dependents.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... or one of the military departments. For the purpose of § 728.43, members of foreign Security... home country for medical reasons, make immediate notification to the sponsoring unit of the patient or patient's sponsor with a copy to the Chief of Naval Operations (OP-61). Include all pertinent information...

  10. 32 CFR 728.11 - Eligible beneficiaries.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Duty § 728.11 Eligible beneficiaries. (a) A member of a uniformed service, as defined in subpart A, who is on active duty is entitled to and will be provided medical and dental care and adjuncts thereto. For the purpose of this part, the following are also considered on active duty: (1) Members of the...

  11. 32 CFR 728.11 - Eligible beneficiaries.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Duty § 728.11 Eligible beneficiaries. (a) A member of a uniformed service, as defined in subpart A, who is on active duty is entitled to and will be provided medical and dental care and adjuncts thereto. For the purpose of this part, the following are also considered on active duty: (1) Members of the...

  12. Costs of Urbanisation in Poland, Based on the Example of Wrocław

    NASA Astrophysics Data System (ADS)

    Hełdak, Maria; Płuciennik, Monika

    2017-10-01

    The paper deals with the issue of charging communes with the costs of realisation of the provisions contained in local spatial development plans. When such local spatial development plan enters into force, it leads to economic consequences. In Poland, these consequences are specified in the forecast of the financial impact, which contains a prognosis of own revenues as well as of costs incurred by the budget of the commune. The research consisted in the analysis of the costs of urbanisation of land located in Wrocław, in the southern part of the Krzyki district (Poland). This area is undeveloped to a major extent, consisting mainly of agricultural land, and its development requires the construction of technological and social infrastructure facilities. The expected costs of the realisation of local spatial development plans that are binding for the southern part of Wrocław demonstrate significant costs of the construction of sewage network and municipal roads. The planned development of residential districts is not supported by the existing infrastructure. Additionally, the development of new areas will require the city of Wrocław to take over the real properties on which public goals are planned to be realised. The estimated costs of land acquisition for the realisation of public goals amount to EUR 3 728 500.

  13. Obesity and workers' compensation: results from the Duke Health and Safety Surveillance System.

    PubMed

    Ostbye, Truls; Dement, John M; Krause, Katrina M

    2007-04-23

    Obese individuals have increased morbidity and use of health services. Less is known about the effect of obesity on workers' compensation. The objective of this study was to determine the relationship between body mass index (BMI) (calculated as weight in kilograms divided by height in meters squared) and number and types of workers' compensation claims, associated costs, and lost workdays. Retrospective cohort study. Participants included 11 728 health care and university employees (34 858 full-time equivalents [FTEs]) with at least 1 health risk appraisal between January 1, 1997, and December 31, 2004. The main outcome measures were stratified rates of workers' compensation claims, associated costs, and lost workdays, calculated by BMI, sex, age, race/ethnicity, smoking status, employment duration, and occupational group. The body part affected, nature of the illness or injury, and cause of the illness or injury were also investigated. Multivariate Poisson regression models examined the effects of BMI, controlling for demographic and work-related variables. There was a clear linear relationship between BMI and rate of claims. Employees in obesity class III (BMI >/=40) had 11.65 claims per 100 FTEs, while recommended-weight employees had 5.80; the effect on lost workdays (183.63 vs 14.19 lost workdays per 100 FTEs), medical claims costs ($51 091 vs $7503 per 100 FTEs), and indemnity claims costs ($59 178 vs $5396 per 100 FTEs) was even stronger. The claims most strongly affected by BMI were related to the following: lower extremity, wrist or hand, and back (body part affected); pain or inflammation, sprain or strain, and contusion or bruise (nature of the illness or injury); and falls or slips, lifting, and exertion (cause of the illness or injury). The combination of obesity and high-risk occupation was particularly detrimental. Maintaining healthy weight not only is important to workers but should also be a high priority for their employers given the strong effect of BMI on workers' injuries. Complementing general interventions to make all workplaces safer, work-based programs targeting healthy eating and physical activity should be developed and evaluated.

  14. Lymph node dissection for melanoma using tumescence local anaesthesia: an observational study.

    PubMed

    Kofler, Lukas; Breuninger, Helmut; Häfner, Hans-Martin; Schweinzer, Katrin; Schnabl, Saskia M; Eigentler, Thomas K; Leiter, Ulrike

    2018-04-01

    The possibility that tumescence local anaesthesia (TLA) may lead to dissemination of tumour cells in lymph nodes is presently unclear. To evaluate whether infiltration by TLA influences metastatic spread and survival probability, compared to general anaesthesia (GA), based on lymph node dissection in melanoma patients. In total, 281 patients (GA: 162; TLA: 119) with cutaneous melanoma and clinically or histologically-confirmed metastases in regional lymph nodes were included. All patients underwent complete lymph node dissection. Median follow-up was 70 months. The rate of lymph node recurrence at the dissection site was 25.3% in the GA group and 17.6% in the TLA group (p = 0.082). No significant difference was found concerning 10-year melanoma-specific survival (GA: 56.2%, TLA: 67.4%; p = 0.09), disease-free survival (GA: 72.8 %, TLA: 81.1%; p = 0.095), or lymph node-free survival (GA: 72.8%, TLA: 81.1%; p = 0.095). Distant metastases-free survival appeared to be slightly reduced in the TLA group (GA: 49.9%, TLA: 64.0%; p = 0.025). No differences were identified between the GA and TLA groups regarding prognostic outcome for overall survival or disease-free survival.

  15. AQA - Air Quality model for Austria - Evaluation and Developments

    NASA Astrophysics Data System (ADS)

    Hirtl, M.; Krüger, B. C.; Baumann-Stanzer, K.; Skomorowski, P.

    2009-04-01

    The regional weather forecast model ALADIN of the Central Institute for Meteorology and Geodynamics (ZAMG) is used in combination with the chemical transport model CAMx (www.camx.com) to conduct forecasts of gaseous and particulate air pollution over Europe. The forecasts which are done in cooperation with the University of Natural Resources and Applied Life Sciences in Vienna (BOKU) are supported by the regional governments since 2005 with the main interest on the prediction of tropospheric ozone. The daily ozone forecasts are evaluated for the summer 2008 with the observations of about 150 air quality stations in Austria. In 2008 the emission-model SMOKE was integrated into the modelling system to calculate the biogenic emissions. The anthropogenic emissions are based on the newest EMEP data set as well as on regional inventories for the core domain. The performance of SMOKE is shown for a summer period in 2007. In the frame of the COST-action 728 „Enhancing mesoscale meteorological modelling capabilities for air pollution and dispersion applications", multi-model ensembles are used to conduct an international model evaluation. The model calculations of meteorological- and concentration fields are compared to measurements on the ensemble platform at the Joint Research Centre (JRC) in Ispra. The results for 2 episodes in 2006 show the performance of the different models as well as of the model ensemble.

  16. 32 CFR 728.31 - Eligible beneficiaries and health benefits authorized.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Retired Members... authorized the same medical and dental benefits as active duty members subject to the availability of space... requirements of § 728.31(b)(7)(i) or (ii) may be provided medical and dental care as a dependent when the...

  17. 32 CFR 728.1 - Mission of Navy Medical Department facilities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES General § 728.1... is to provide medical and dental care for members of the Navy and Marine Corps and for members of the... facilities may provide medical and dental care to dependents of military personnel, to members not on active...

  18. 32 CFR 728.1 - Mission of Navy Medical Department facilities.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES General § 728.1... is to provide medical and dental care for members of the Navy and Marine Corps and for members of the... facilities may provide medical and dental care to dependents of military personnel, to members not on active...

  19. 32 CFR 728.1 - Mission of Navy Medical Department facilities.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES General § 728.1... is to provide medical and dental care for members of the Navy and Marine Corps and for members of the... facilities may provide medical and dental care to dependents of military personnel, to members not on active...

  20. 32 CFR 728.1 - Mission of Navy Medical Department facilities.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES General § 728.1... is to provide medical and dental care for members of the Navy and Marine Corps and for members of the... facilities may provide medical and dental care to dependents of military personnel, to members not on active...

  1. Risk Stratification of Stress Fractures and Prediction of Return-to-Duty

    DTIC Science & Technology

    2016-12-01

    African-American) and 20 male; [month 7-28] Done 4) Perform standard whole bone finite element analysis [month 7-28]. Done 5) Perform data cleaning and...NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Kristin Popp M Mary Betty Diamond 5d. PROJECT NUMBER Mary Bouxsein 5e. TASK NUMBER E-Mail: kpopp

  2. 9 CFR 72.8 - Interstate movement of cattle from free premises upon inspection and certification by APHIS...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Interstate movement of cattle from... TRANSPORTATION OF ANIMALS (INCLUDING POULTRY) AND ANIMAL PRODUCTS TEXAS (SPLENETIC) FEVER IN CATTLE § 72.8 Interstate movement of cattle from free premises upon inspection and certification by APHIS inspector. Cattle...

  3. 32 CFR 728.53 - Department of Labor, Office of Workers' Compensation Programs (OWCP) beneficiaries.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... of the Army (see paragraph (a)(7) of this section and § 728.80(c)(2) for civilian Military Sealift... result of employment with the Job Corps. (6) Former VISTA (Volunteers in Service to America) enrollees for injury or disease which is the proximate result of employment with VISTA. (7) Military Sealift...

  4. 32 CFR 728.53 - Department of Labor, Office of Workers' Compensation Programs (OWCP) beneficiaries.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... of the Army (see paragraph (a)(7) of this section and § 728.80(c)(2) for civilian Military Sealift... result of employment with the Job Corps. (6) Former VISTA (Volunteers in Service to America) enrollees for injury or disease which is the proximate result of employment with VISTA. (7) Military Sealift...

  5. 32 CFR 728.53 - Department of Labor, Office of Workers' Compensation Programs (OWCP) beneficiaries.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... of the Army (see paragraph (a)(7) of this section and § 728.80(c)(2) for civilian Military Sealift... result of employment with the Job Corps. (6) Former VISTA (Volunteers in Service to America) enrollees for injury or disease which is the proximate result of employment with VISTA. (7) Military Sealift...

  6. 32 CFR 728.53 - Department of Labor, Office of Workers' Compensation Programs (OWCP) beneficiaries.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... of the Army (see paragraph (a)(7) of this section and § 728.80(c)(2) for civilian Military Sealift... result of employment with the Job Corps. (6) Former VISTA (Volunteers in Service to America) enrollees for injury or disease which is the proximate result of employment with VISTA. (7) Military Sealift...

  7. 32 CFR 728.60 - Job Corps and Volunteers in Service to America (VISTA) beneficiaries.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Job Corps and Volunteers in Service to America... FACILITIES Beneficiaries of Other Federal Agencies § 728.60 Job Corps and Volunteers in Service to America... corpsmember's Job Corps center. (2) Job Corps applicants. Presentation of a letter from a screening agency (e...

  8. 75 FR 19394 - Notice of Public Information Collection(s) Being Submitted for Review and Approval to the Office...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-14

    ... and Responses: 2,728 respondents; 2,728 responses. Estimated Time per Response: 4 hours. Frequency of... clearance from them. There is no change in the reporting, recordkeeping and/or third party disclosure... rates to a nearby receiver, that permits greater patient mobility and increased comfort. The Commission...

  9. Metabolic Cost of Lateral Stabilization during Walking in People with Incomplete Spinal Cord Injury

    PubMed Central

    Matsubara, J.H.; Wu, M.; Gordon, K.E.

    2015-01-01

    People with incomplete spinal cord injury (iSCI) expend considerable energy to walk, which can lead to rapid fatigue and limit community ambulation. Selecting locomotor patterns that enhance lateral stability may contribute to this population’s elevated cost of transport. The goal of the current study was to quantify the metabolic energy demands of maintaining lateral stability during gait in people with iSCI. To quantify this metabolic cost, we observed ten individuals with iSCI walking with and without external lateral stabilization. We hypothesized that with external lateral stabilization, people with iSCI would adapt their gait by decreasing step width, which would correspond with a substantial decrease in cost of transport. Our findings support this hypothesis. Subjects significantly (p < 0.05) decreased step width by 22%, step width variability by 18%, and minimum lateral margin of stability by 25% when they walked with external lateral stabilization compared to unassisted walking. Metabolic cost of transport also decreased significantly (p < 0.05) by 10% with external lateral stabilization. These findings suggest that this population is capable of adapting their gait to meet changing demands placed on balance. The percent reduction in cost of transport when walking with external lateral stabilization was strongly correlated with functional impairment level as assessed by subjects’ scores on the Berg Balance Scale (R = 0.778) and Lower Extremity Motor Score (R = 0.728). These relationships suggest that as functional balance and strength decrease, the amount of metabolic energy used to maintain lateral stability during gait will increase. PMID:25670651

  10. Costs associated with influenza-related hospitalization in the elderly.

    PubMed

    Torner, Núria; Navas, Encarna; Soldevila, Núria; Toledo, Diana; Navarro, Gemma; Morillo, Aurea; Pérez, Maria José; Domínguez, Angela

    2017-02-01

    Seasonal influenza epidemics remain a considerable burden in adults, especially in those at higher risk of complications. The aim of this study was to determine the costs associated with influenza-related hospitalization in patients aged ≥65 y admitted to 20 hospitals from 7 Spanish regions during the 2013-14 and 2014-15 influenza seasons. Bivariate analysis was used to compare costs in vaccinated and unvaccinated cases. Costs were calculated according to the Spanish National Health System diagnosis-related group tables for influenza and other respiratory system conditions (GRD 89 and GRD 101). A total of 728 confirmed influenza cases were recorded: 52.9% were male, 46.7% were aged 75-84 years, and 49.3% received influenza vaccine ≥15 d prior to hospital admission. Influenza-related mean hospitalization costs (MHC) were € 1,184,808 in unvaccinated and € 1,152,333 in vaccinated cases (2.75% lower). Influenza vaccination showed significant protection against ICU admission (OR 0.35, 95%CI 0.21-0.59; p < 0001); mechanical ventilation (OR 0.56, 95%CI 0.39-0.80; p = 0.002); secondary bacterial pneumonia (OR 0.61, 95%CI 0.39-0.98; p = 0.04) and a higher degree of dependence (OR 0.74, 95%CI 0.55-0.99; p = 0.04). No association was observed for the Charlson comorbidity index or the mean hospital stay. Although influenza vaccination of the elderly may not achieve significant savings in mean hospitalization costs, it may lessen the degree of severity and avoid complications.

  11. 32 CFR 728.54 - U.S. Public Health Service (USPHS), other than members of the uniformed services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false U.S. Public Health Service (USPHS), other than... FACILITIES Beneficiaries of Other Federal Agencies § 728.54 U.S. Public Health Service (USPHS), other than... 43 (Contract Health Service Purchase Order for Hospital Services Rendered) or HRSA form 64 (Purchase...

  12. 32 CFR 728.54 - U.S. Public Health Service (USPHS), other than members of the uniformed services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 5 2013-07-01 2013-07-01 false U.S. Public Health Service (USPHS), other than... FACILITIES Beneficiaries of Other Federal Agencies § 728.54 U.S. Public Health Service (USPHS), other than... 43 (Contract Health Service Purchase Order for Hospital Services Rendered) or HRSA form 64 (Purchase...

  13. 32 CFR 728.54 - U.S. Public Health Service (USPHS), other than members of the uniformed services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 5 2014-07-01 2014-07-01 false U.S. Public Health Service (USPHS), other than... FACILITIES Beneficiaries of Other Federal Agencies § 728.54 U.S. Public Health Service (USPHS), other than... 43 (Contract Health Service Purchase Order for Hospital Services Rendered) or HRSA form 64 (Purchase...

  14. 32 CFR 728.44 - Members of security assistance training programs, foreign military sales, and their ITO...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... trainee in the United States or at an overseas training site, it is discovered that the trainee cannot...) Foreign military sales (FMS). Subject to reimbursement per § 728.46, FMS personnel of NATO nations who are... dependents, IMET personnel of NATO nations who are in the United States or at U.S. Armed Forces installations...

  15. 32 CFR 728.44 - Members of security assistance training programs, foreign military sales, and their ITO...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... trainee in the United States or at an overseas training site, it is discovered that the trainee cannot...) Foreign military sales (FMS). Subject to reimbursement per § 728.46, FMS personnel of NATO nations who are... dependents, IMET personnel of NATO nations who are in the United States or at U.S. Armed Forces installations...

  16. 32 CFR 728.44 - Members of security assistance training programs, foreign military sales, and their ITO...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... trainee in the United States or at an overseas training site, it is discovered that the trainee cannot...) Foreign military sales (FMS). Subject to reimbursement per § 728.46, FMS personnel of NATO nations who are... dependents, IMET personnel of NATO nations who are in the United States or at U.S. Armed Forces installations...

  17. 32 CFR 728.54 - U.S. Public Health Service (USPHS), other than members of the uniformed services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false U.S. Public Health Service (USPHS), other than... FACILITIES Beneficiaries of Other Federal Agencies § 728.54 U.S. Public Health Service (USPHS), other than... 43 (Contract Health Service Purchase Order for Hospital Services Rendered) or HRSA form 64 (Purchase...

  18. 32 CFR 728.54 - U.S. Public Health Service (USPHS), other than members of the uniformed services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false U.S. Public Health Service (USPHS), other than... FACILITIES Beneficiaries of Other Federal Agencies § 728.54 U.S. Public Health Service (USPHS), other than... 43 (Contract Health Service Purchase Order for Hospital Services Rendered) or HRSA form 64 (Purchase...

  19. Ammunition Cost Research Study. Volume I.

    DTIC Science & Technology

    1983-01-01

    0.048 4,000,000 1.72 1.74 M717 PD 0.25 571,490 8.22 6.13 M567 PD 1.30 300,000 10.43 17.22 M503A2 PD 0.34 814,701 10.64 7.28 M739 PD 1.43 915,837 10.65...M503A2 PD 0.34 252,336 10.73 7.58 M567 PD 1.30 1,071,100 11.23 16.29 M739 PD 1.43 915,837 11.30 17.47 M720 PD 2.10 90,000 11.41 23.46 m567 PD 1.30...14.86 12.91 M524A6 PD 1.27 3,982,150 15.11 13.04 M524A6 PD 1.27 3,181,102 15.44 13.81 M739 PD 1.43 3,168,072 15.47 14.86 M524A6 PD 1.27 3,045,000 17.37

  20. Observational study on immune response to yellow fever and measles vaccines in 9 to 15-month old children. Is it necessary to wait 4 weeks between two live attenuated vaccines?

    PubMed

    Michel, R; Berger, F; Ravelonarivo, J; Dussart, P; Dia, M; Nacher, M; Rogier, S; Moua, D; Sarr, F D; Diop, O M; Sall, A A; Baril, L

    2015-05-11

    The use of 2 live attenuated vaccines (LAV) is recommended to be simultaneous or after an interval of at least four weeks between injections. The primary objective of this study was to compare the humoral response to yellow fever (YF) and measles vaccines among children vaccinated against these two diseases, either simultaneously or separated by an interval of 7-28 days. A prospective, multicenter observational study was conducted among children aged 9-15 months. The primary endpoint was the occurrence of positive yellow fever antibodies after YF vaccine by estimating the titers of neutralizing antibodies from venous blood samples. Children vaccinated against YF 7-28 days after receiving the vaccine against measles (test group) were compared with children vaccinated the same day against these two diseases (referent group). Analysis was performed on 284 children. Of them, fifty-four belonged to the test group. Measles serology was positive in 91.7% of children. Neutralizing antibodies against YF were detected in 90.7% of the test group and 92.9 of the referent group (p=0.6). In addition, quantitative analysis of the immune response did not show a lower response to YF vaccination when it took place 1-28 days after measles vaccination. In 1965, Petralli showed a lower response to the smallpox vaccine when injected 4-20 days after measles vaccination. Since then, recommendations are to observe an interval of four weeks between LAV not injected on the same day. Other published studies failed to show a significant difference in the immune response to a LAV injected 1-28 days after another LAV. These results suggest that the usual recommendations for immunization with two LAV may not be correct. In low income countries, the current policy should be re-evaluated. This re-evaluation should also be applied to travelers to yellow fever endemic countries. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. [Radioiodine 131I therapy of hyperthyroidism on an outpatient basis - safe, effective and economic option].

    PubMed

    Jiskra, J; Kubinyi, J; Telička, Z

    2012-02-01

    Radioiodine 131I therapy of hyperthyroidism on an outpatient basis is widely accepted over the world. In Czech Republic, however, radioiodine therapy is still not enough used, and has been realized on an inpatient basis to date. Our work is the first analysis of the experiences with radioiodine therapy of hyperthyroidism on an outpatient basis in Czech Republic. Capsule with 550 MBq of 131I was administered orally in 39 hyperthyroid patients (32 women and 8 men, 21 with autoimmune Graves hyperthyroidism and 18 with toxic thyroid nodules, mean age 66.8 years). In 32 of them we evaluated effectiveness and complications of therapy after 12-42 months. We also compared financial costs of the radioiodine treatment on an outpatient basis with the treatment in hospitalization and with surgery. After the treatment, 9/32 (28 %) patients were euthyroid without thyrostatic/thyroxine treatment, 18/32 (60 %) patients were hypothyroid with thyroxine therapy, 2/32 (6 %) patients significantly decreased doses of thyrostatic drugs. In 2/32 (6 %) patients the treatment was ineffective. The effect of the treatment did not depend on the etiology and severity of hyperthyroidism, but decreased with thyroid volume. Patients with ineffective or only partially effective treatment had median of thyroid volume more than 40 ml. In 1 patient thyroid associated ophthalmopathy was moderately worsened. Other complications were not observed. If we compared financial costs in model with 1 patient, we found that the costs of radioiodine therapy on an outpatient basis (118.7 €) comprise only 16 % of the costs of radioiodine therapy in hospitalization (728 €) and only 25 % of the costs of surgery (475.6 €). Radioiodine 131I is effective and safe in the treatment of hyperthyroidism and the therapy on an outpatient basis is much cheaper choice. The therapy with 131I on an outpatient basis is not suitable in patients with thyroid volume more than 40 ml.

  2. 47 CFR 27.15 - Geographic partitioning and spectrum disaggregation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... licensees have agreed to a different signal level. (c) License term. The license term for a partitioned...) Except for WCS licensees holding authorizations for Block A in the 698-704 MHz and 728-734 MHz bands, Block B in the 704-710 MHz and 734-740 MHz bands, Block E in the 722-728 MHz band, Blocks C, C1, or C2...

  3. Prostate Health Index improves multivariable risk prediction of aggressive prostate cancer.

    PubMed

    Loeb, Stacy; Shin, Sanghyuk S; Broyles, Dennis L; Wei, John T; Sanda, Martin; Klee, George; Partin, Alan W; Sokoll, Lori; Chan, Daniel W; Bangma, Chris H; van Schaik, Ron H N; Slawin, Kevin M; Marks, Leonard S; Catalona, William J

    2017-07-01

    To examine the use of the Prostate Health Index (PHI) as a continuous variable in multivariable risk assessment for aggressive prostate cancer in a large multicentre US study. The study population included 728 men, with prostate-specific antigen (PSA) levels of 2-10 ng/mL and a negative digital rectal examination, enrolled in a prospective, multi-site early detection trial. The primary endpoint was aggressive prostate cancer, defined as biopsy Gleason score ≥7. First, we evaluated whether the addition of PHI improves the performance of currently available risk calculators (the Prostate Cancer Prevention Trial [PCPT] and European Randomised Study of Screening for Prostate Cancer [ERSPC] risk calculators). We also designed and internally validated a new PHI-based multivariable predictive model, and created a nomogram. Of 728 men undergoing biopsy, 118 (16.2%) had aggressive prostate cancer. The PHI predicted the risk of aggressive prostate cancer across the spectrum of values. Adding PHI significantly improved the predictive accuracy of the PCPT and ERSPC risk calculators for aggressive disease. A new model was created using age, previous biopsy, prostate volume, PSA and PHI, with an area under the curve of 0.746. The bootstrap-corrected model showed good calibration with observed risk for aggressive prostate cancer and had net benefit on decision-curve analysis. Using PHI as part of multivariable risk assessment leads to a significant improvement in the detection of aggressive prostate cancer, potentially reducing harms from unnecessary prostate biopsy and overdiagnosis. © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.

  4. Mechanisms and Factors Regulating the Uptake and Toxicity of Heavy Metals in Phytoplankton

    DTIC Science & Technology

    1997-09-30

    Laboratory, National Marine Fisheries Service, NOAA, Beaufort, NC 28516 Phone: 919/728-8754; Fax: 919/728-8784 E-mail: BSUNDA@HATTERAS.BEA.NMFS.GOV Award...composition of phytoplankton communities in coastal waters and to determine the role of algal metal uptake in controlling the particulate removal and...7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) National Oceanic and Atmospheric Administration (NOAA),National Marine Fisheries Service,325

  5. 47 CFR 27.20 - Digital television transition education reports.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... WCS license authorizations in Block A in the 698-704 MHz and 728-734 MHz bands, Block B in the 704-710 MHz and 734-740 MHz bands, Block E in the 722-728 MHz band, Block C, C1, or C2 in the 746-757 MHz and... requirements of this section—and on a quarterly basis thereafter as specified in paragraph (c) of this section...

  6. On the Power Dependence of Extraneous Microwave Fields in Atomic Frequency Standards

    DTIC Science & Technology

    2005-01-01

    uncertainty”, Metrologia 35 (1998) pp. 829-845. [6] K. Dorenwendt and A. Bauch, “Spurious Microwave Fields in Caesium Atomic Beam Standards...Cesium Beam Clocks Induced by Microwave Leakages”, IEEE Trans. UFFC 45 (1998)728-738. [8] M. Abgrall, “Evaluation des Performances de la Fontaine...Proc of the EFTF 2005 – in press. [12] A. DeMarchi, “The Optically Pumped Caesium Fountain: 10-15 Frequency Accuracy?”, Metrologia 18 (1982) pp

  7. [Maternity leave and experience of working mothers in Lebanon].

    PubMed

    Saadé, N; Barbour, B; Salameh, P

    2010-09-01

    We conducted a cross-sectional study of 802 Lebanese mothers to evaluate effect of rapid return to work on their health and that of their child. Breastfeeding practices were also assessed. The duration of maternity leave was insufficient for 72.8% of the women. Rapid return to work could cause physical and psychological problems depending on the type of work. The average length of breastfeeding was 4.7 months and while the average desired length was 10.9 months. Breastfeeding depended on the duration of the maternity leave, the possibility of breaks for breastfeeding and the presence of nurseries at work. Urgent interventions are necessary to prolong maternity leave and promote breastfeeding among working women.

  8. The economic impact of Marfan syndrome: a non-experimental, retrospective, population-based matched cohort study

    PubMed Central

    2014-01-01

    Background Marfan syndrome is a rare disease of the connective tissues, affecting multiple organ systems. Elevated morbidity and mortality in these patients raises the issue of costs for sickness funds and society. To date, there has been no study analysing the costs of Marfan syndrome from a sickness fund and societal perspective. Objective To estimate excess health resource utilisation, direct (non-)medical and indirect costs attributable to Marfan syndrome from a healthcare payer and a societal perspective in Germany in 2008. Methods A retrospective matched cohort study design is applied, using claims data. For isolating the causal effect of Marfan syndrome on excess costs, a genetic matching algorithm was used to reduce differences in observable characteristics between Marfan syndrome patients and the control group. 892 patients diagnosed with Marfan syndrome (ICD-10 Q87.4) were matched from a pool of 26,645 control individuals. After matching, we compared health resource utilisation and costs. Results From the sickness fund perspective, an average Marfan syndrome patient generates excess annual costs of €2496 compared with a control individual. From the societal perspective, excess annual costs amount to €15,728. For the sickness fund, the strongest cost drivers are inpatient treatment and care by non-physicians. From the sickness fund perspective, the third (25–41 years) and first (0–16 years) age quartiles reveal the greatest surplus in total costs. Marfan syndrome patients have 39% more physician contacts, a 153% longer average length of hospital stay, 119% more inpatient stays, 33% more prescriptions, 236% more medical imaging and 20% higher average prescription costs than control individuals. Depending on the prevalence, the economic impact from the sickness fund perspective ranges between €24.0 million and €61.4 million, whereas the societal economic impact extends from €151.3 million to €386.9 million. Conclusions Relative to its low frequency, Marfan syndrome requires high healthcare expenditure. Not only the high costs of Marfan syndrome but also its burden on patients’ lives call for more awareness from policy-makers, physicians and clinical researchers. Consequently, the diagnosis and treatment of Marfan syndrome should begin as soon as possible in order to prevent disease complications, early mortality and substantial healthcare expenditure. PMID:24954169

  9. The economic impact of Marfan syndrome: a non-experimental, retrospective, population-based matched cohort study.

    PubMed

    Achelrod, Dmitrij; Blankart, Carl Rudolf; Linder, Roland; von Kodolitsch, Yskert; Stargardt, Tom

    2014-06-23

    Marfan syndrome is a rare disease of the connective tissues, affecting multiple organ systems. Elevated morbidity and mortality in these patients raises the issue of costs for sickness funds and society. To date, there has been no study analysing the costs of Marfan syndrome from a sickness fund and societal perspective. To estimate excess health resource utilisation, direct (non-)medical and indirect costs attributable to Marfan syndrome from a healthcare payer and a societal perspective in Germany in 2008. A retrospective matched cohort study design is applied, using claims data. For isolating the causal effect of Marfan syndrome on excess costs, a genetic matching algorithm was used to reduce differences in observable characteristics between Marfan syndrome patients and the control group. 892 patients diagnosed with Marfan syndrome (ICD-10 Q87.4) were matched from a pool of 26,645 control individuals. After matching, we compared health resource utilisation and costs. From the sickness fund perspective, an average Marfan syndrome patient generates excess annual costs of €2496 compared with a control individual. From the societal perspective, excess annual costs amount to €15,728. For the sickness fund, the strongest cost drivers are inpatient treatment and care by non-physicians. From the sickness fund perspective, the third (25-41 years) and first (0-16 years) age quartiles reveal the greatest surplus in total costs. Marfan syndrome patients have 39% more physician contacts, a 153% longer average length of hospital stay, 119% more inpatient stays, 33% more prescriptions, 236% more medical imaging and 20% higher average prescription costs than control individuals. Depending on the prevalence, the economic impact from the sickness fund perspective ranges between €24.0 million and €61.4 million, whereas the societal economic impact extends from €151.3 million to €386.9 million. Relative to its low frequency, Marfan syndrome requires high healthcare expenditure. Not only the high costs of Marfan syndrome but also its burden on patients' lives call for more awareness from policy-makers, physicians and clinical researchers. Consequently, the diagnosis and treatment of Marfan syndrome should begin as soon as possible in order to prevent disease complications, early mortality and substantial healthcare expenditure.

  10. [Persistence to treatment by type of inhaler device in patients with asthma and chronic obstructive pulmonary disease].

    PubMed

    Sicras, A; Ferrer, V; Collar, J M; Navarro, R; Sáez, M

    To assess the initial treatment persistence with inhaled corticosteroids and long-acting beta-2 adrenergic bronchodilators (ICS/LABA) depending on the inhaler device used (pMDI or DPI), for the treatment of asthma and COPD. An multicenter observational study. Subjects in initial treatment with ICS/LABA during 2007-2011 were included, and a follow-up period of 3 years. 2 groups of study (asthma, COPD) and 2 subgroups were prepared according to the device type inhaler (pMDI or DPI). The main measurements were: sociodemographic, comorbidity, adherence (rate possession medication -RPM-), persistence, drugs, exacerbation rates, resources use, and their costs (direct and indirect costs). Multivariate methods were used for the variables correction, with significance level of P<.05. The study included 2,082 asthma patients (pMDI: N = 566, 27.2%; DPI = 1,516, 72.8%). Patients with MDI devices showed a higher degree of persistence (32.5 vs. 27.8%; P=.037), treatment adherence (RPM: 83.1 vs. 80.5%; P<.001), fewer exacerbations (17.7 vs. 24.9%; P=.001) and lower health care costs (2,583 vs. 2,938 EUR; P = 0.042). 1,418 patients with COPD also were analyzed (pMDI: N = 524, 41.9%; DPI: N = 824, 58.1%) were analyzed. Patients with MDI devices also showed a higher degree of persistence (31.5 vs. 24.8%; P=.005), treatment adherence (RPM: 83.3 vs. 80.1%; P= .001), less exacerbations (40.1 vs. 48.2%; P=.002) and lower health care costs (3,922 vs. 4,588 EUR; P=.021). pMDI devices (as ICS/LABA initial treatment) are associated with higher treatment persistence either in asthma or COPD, with lower exacerbation rates, and use of health resources and cost. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Secondary School Burnout Scale (SSBS)

    ERIC Educational Resources Information Center

    Aypay, Ayse

    2012-01-01

    The purpose of this study is to develop "Secondary School Burnout Scale." Study group included 728 students out of 14 schools in four cities in Turkey. Both Exploratory Factor Analysis and Confirmatory Factor Analysis were conducted on the data. A seven-factor solution emerged. The seven factors explained 61% of the total variance. The…

  12. Podoconiosis patients’ willingness to pay for treatment services in Northwest Ethiopia: potential for cost recovery

    PubMed Central

    2014-01-01

    Background Podoconiosis is non-filarial elephantiasis of the lower legs. It is more commonly found in tropical Africa, Central and South America, and northwest India. In Ethiopia, a few non-governmental organizations provide free treatment to podoconiosis patients, but sustainability of free treatment and scale-up of services to reach the huge unmet need is challenged by resource limitations. We aimed to determine podoconiosis patient’s willingness to pay (WTP) for a treatment package (composed of deep cleaning of limbs with diluted antiseptic solution, soap, and water, bandaging, application of emollient on the skin, and provision of shoes), and factors associated with WTP in northwestern Ethiopia. Methods A cross-sectional study was conducted among randomly selected untreated podoconiosis patients (n = 393) in Baso Liben woreda, northwestern Ethiopia. The contingent valuation method was used with a pre-tested interviewer-administered questionnaire. Results The majority of podoconiosis patients (72.8%) were willing to pay for treatment services. The median WTP amount was 64 Birr (US$ 3.28) per person per year. More than one-third of patients (36.7%) were willing to pay at least half of the full treatment cost and 76.2% were willing to pay at least half of the cost of shoes. A multivariate analysis showed that having a higher monthly income, being a woman, older age, being aware of the role of shoes to prevent podoconiosis, and possession of a functional radio were significantly associated with higher odds of WTP. Conclusions The considerable WTP estimates showed that podoconiosis treatment could improve sustainability and service utilization. A subsidized cost recovery scheme could reduce treatment costs and more feasibility integrate podoconiosis treatment service with other NTDs and the government’s primary health care system. PMID:24642085

  13. Podoconiosis patients' willingness to pay for treatment services in Northwest Ethiopia: potential for cost recovery.

    PubMed

    Tamiru, Abreham; Tsegay, Girmay; Wubie, Moges; Gedefaw, Molla; Tomczyk, Sara; Tekola-Ayele, Fasil

    2014-03-19

    Podoconiosis is non-filarial elephantiasis of the lower legs. It is more commonly found in tropical Africa, Central and South America, and northwest India. In Ethiopia, a few non-governmental organizations provide free treatment to podoconiosis patients, but sustainability of free treatment and scale-up of services to reach the huge unmet need is challenged by resource limitations. We aimed to determine podoconiosis patient's willingness to pay (WTP) for a treatment package (composed of deep cleaning of limbs with diluted antiseptic solution, soap, and water, bandaging, application of emollient on the skin, and provision of shoes), and factors associated with WTP in northwestern Ethiopia. A cross-sectional study was conducted among randomly selected untreated podoconiosis patients (n=393) in Baso Liben woreda, northwestern Ethiopia. The contingent valuation method was used with a pre-tested interviewer-administered questionnaire. The majority of podoconiosis patients (72.8%) were willing to pay for treatment services. The median WTP amount was 64 Birr (US$ 3.28) per person per year. More than one-third of patients (36.7%) were willing to pay at least half of the full treatment cost and 76.2% were willing to pay at least half of the cost of shoes. A multivariate analysis showed that having a higher monthly income, being a woman, older age, being aware of the role of shoes to prevent podoconiosis, and possession of a functional radio were significantly associated with higher odds of WTP. The considerable WTP estimates showed that podoconiosis treatment could improve sustainability and service utilization. A subsidized cost recovery scheme could reduce treatment costs and more feasibility integrate podoconiosis treatment service with other NTDs and the government's primary health care system.

  14. Department of the Navy Supporting Data for Fiscal Year 1984 Budget Estimates Descriptive Summaries Submitted to Congress January 1983. Research, Development, Test and Evaluation, Navy. Book 2. Tactical Programs

    DTIC Science & Technology

    1983-01-01

    SUMMARY: (ollars in Thouesands) The changes between the funding profile shown in the FY 1983 Descriptive Summary and that shown in this De ,,criptive...System (ONAV Report Symbol 3960-12 b. I April 1982 MOSC Test Report Joint Tactical Information Distribution System Phase II (Distributed Time De -ision...Vehicle Tricked (LVTP7) 453 - - - 5,728 Product Improvement C0021 Landing Vehicle Tracked-Al - - - 2,848*, TBD TED C0061 Battlefield Surveillance De -vices

  15. Dipeptidyl peptidase IV inhibition potentiates amino acid- and bile acid-induced bicarbonate secretion in rat duodenum

    PubMed Central

    Inoue, Takuya; Wang, Joon-Ho; Higashiyama, Masaaki; Rudenkyy, Sergiy; Higuchi, Kazuhide; Guth, Paul H.; Engel, Eli; Kaunitz, Jonathan D.

    2012-01-01

    Intestinal endocrine cells release gut hormones, including glucagon-like peptides (GLPs), in response to luminal nutrients. Luminal l-glutamate (l-Glu) and 5′-inosine monophosphate (IMP) synergistically increases duodenal HCO3− secretion via GLP-2 release. Since L cells express the bile acid receptor TGR5 and dipeptidyl peptidase (DPP) IV rapidly degrades GLPs, we hypothesized that luminal amino acids or bile acids stimulate duodenal HCO3− secretion via GLP-2 release, which is enhanced by DPPIV inhibition. We measured HCO3− secretion with pH and CO2 electrodes using a perfused rat duodenal loop under isoflurane anesthesia. l-Glu (10 mM) and IMP (0.1 mM) were luminally coperfused with or without luminal perfusion (0.1 mM) or intravenous (iv) injection (3 μmol/kg) of the DPPIV inhibitor NVP728. The loop was also perfused with a selective TGR5 agonist betulinic acid (BTA, 10 μM) or the non-bile acid type TGR5 agonist 3-(2-chlorophenyl)-N-(4-chlorophenyl)-N,5-dimethylisoxazole-4-carboxamide (CCDC; 10 μM). DPPIV activity visualized by use of the fluorogenic substrate was present on the duodenal brush border and submucosal layer, both abolished by the incubation with NVP728 (0.1 mM). An iv injection of NVP728 enhanced l-Glu/IMP-induced HCO3− secretion, whereas luminal perfusion of NVP728 had no effect. BTA or CCDC had little effect on HCO3− secretion, whereas NVP728 iv markedly enhanced BTA- or CCDC-induced HCO3− secretion, the effects inhibited by a GLP-2 receptor antagonist. Coperfusion of the TGR5 agonist enhanced l-Glu/IMP-induced HCO3− secretion with the enhanced GLP-2 release, suggesting that TGR5 activation amplifies nutrient sensing signals. DPPIV inhibition potentiated luminal l-Glu/IMP-induced and TGR5 agonist-induced HCO3− secretion via a GLP-2 pathway, suggesting that the modulation of the local concentration of the endogenous secretagogue GLP-2 by luminal compounds and DPPIV inhibition helps regulate protective duodenal HCO3− secretion. PMID:22821947

  16. Dipeptidyl peptidase IV inhibition potentiates amino acid- and bile acid-induced bicarbonate secretion in rat duodenum.

    PubMed

    Inoue, Takuya; Wang, Joon-Ho; Higashiyama, Masaaki; Rudenkyy, Sergiy; Higuchi, Kazuhide; Guth, Paul H; Engel, Eli; Kaunitz, Jonathan D; Akiba, Yasutada

    2012-10-01

    Intestinal endocrine cells release gut hormones, including glucagon-like peptides (GLPs), in response to luminal nutrients. Luminal L-glutamate (L-Glu) and 5'-inosine monophosphate (IMP) synergistically increases duodenal HCO3- secretion via GLP-2 release. Since L cells express the bile acid receptor TGR5 and dipeptidyl peptidase (DPP) IV rapidly degrades GLPs, we hypothesized that luminal amino acids or bile acids stimulate duodenal HCO3- secretion via GLP-2 release, which is enhanced by DPPIV inhibition. We measured HCO3- secretion with pH and CO2 electrodes using a perfused rat duodenal loop under isoflurane anesthesia. L-Glu (10 mM) and IMP (0.1 mM) were luminally coperfused with or without luminal perfusion (0.1 mM) or intravenous (iv) injection (3 μmol/kg) of the DPPIV inhibitor NVP728. The loop was also perfused with a selective TGR5 agonist betulinic acid (BTA, 10 μM) or the non-bile acid type TGR5 agonist 3-(2-chlorophenyl)-N-(4-chlorophenyl)-N,5-dimethylisoxazole-4-carboxamide (CCDC; 10 μM). DPPIV activity visualized by use of the fluorogenic substrate was present on the duodenal brush border and submucosal layer, both abolished by the incubation with NVP728 (0.1 mM). An iv injection of NVP728 enhanced L-Glu/IMP-induced HCO3- secretion, whereas luminal perfusion of NVP728 had no effect. BTA or CCDC had little effect on HCO3- secretion, whereas NVP728 iv markedly enhanced BTA- or CCDC-induced HCO3- secretion, the effects inhibited by a GLP-2 receptor antagonist. Coperfusion of the TGR5 agonist enhanced L-Glu/IMP-induced HCO3- secretion with the enhanced GLP-2 release, suggesting that TGR5 activation amplifies nutrient sensing signals. DPPIV inhibition potentiated luminal L-Glu/IMP-induced and TGR5 agonist-induced HCO3- secretion via a GLP-2 pathway, suggesting that the modulation of the local concentration of the endogenous secretagogue GLP-2 by luminal compounds and DPPIV inhibition helps regulate protective duodenal HCO3- secretion.

  17. Cost-Effectiveness and Cost-Utility Analysis of Ingenol Mebutate Versus Diclofenac 3% and Imiquimod 5% in the Treatment of Actinic Keratosis in Spain.

    PubMed

    Elías, I; Ortega-Joaquín, N; de la Cueva, P; Del Pozo, L J; Moreno-Ramírez, D; Boada, A; Aguilar, M; Mirada, A; Mosquera, E; Gibbons, C; Oyagüez, I

    2016-01-01

    To perform a cost-effectiveness and cost-utility analysis of ingenol mebutate in the treatment of actinic keratosis in Spain. We used an adapted Markov model to simulate outcomes in a cohort of patients (mean age, 73 years) with actinic keratosis over a 5-year period. The comparators were diclofenac 3% and imiquimod 5%. The analysis was performed from the perspective of the Spanish National Health System based on direct costs (2015 retail price plus value added tax less the mandatory discount). A panel of experts estimated resources, taking unit costs from national databases. An annual discount rate of 3% was applied. Deterministic and probabilistic sensitivity analyses were performed. The effectiveness of ingenol mebutate-with 0.192 and 0.129 more clearances gained in treatments for face and scalp lesions and trunk and extremity lesions, respectively-was superior to diclofenac's. The total costs of treatment with ingenol mebutate were lower at € 551.50 (face and scalp) and € 622.27 (trunk and extremities) than the respective costs with diclofenac (€ 849.11 and € 844.93). The incremental cost-effectiveness and cost-utility ratios showed that ingenol mebutate was a dominant strategy vs diclofenac. Ingenol mebutate also proved to be more effective than imiquimod, based on 0.535 and 0.503 additional clearances, and total costs of € 551.50 and € 527.89 for the two drugs, respectively. The resulting incremental cost-effectiveness ratio was € 728.64 per clearance gained with ingenol mebutate vs imiquimod. Ingenol mebutate was a dominant treatment option vs diclofenac and was efficient vs imiquimod (i.e., more effective at a higher cost, achieving an incremental cost-utility ratio of<€30000/quality-adjusted life-years). Copyright © 2016 AEDV. Published by Elsevier España, S.L.U. All rights reserved.

  18. Pacemaker diagnostics in atrial fibrillation: limited usefulness for therapy initiation in a pacemaker practice.

    PubMed

    Yedlapati, Neeraja; Fisher, John D

    2014-09-01

    We aimed to determine the practical value of pacemaker diagnostics for atrial fibrillation (AF) in an unselected general pacemaker practice, specifically workflow and initiation of anticoagulation or antiarrhythmic drug (AAD) therapy. We prospectively followed consecutive pacemaker interrogations over a period of 1 year to identify patients with AF (burden from 1% to 99%). We contacted referring physicians with AF details, and then determined whether the information resulted in therapeutic changes. Of the 1,100 pacemakers interrogated, 728 were dual chamber (DDDs) with AF diagnostic capability. AF was recorded in 73 (10%) but seven had limited information, leaving 66 patients; of these, 42 (63%) patients were already anticoagulated and in five (7%) patients, anticoagulation had been stopped because of complications. Initial diagnosis of AF was made by the pacemaker in 17 patients (26% of 66; 2% of 728); four (6% of 66) patients were newly initiated on anticoagulation. Of the 66 patients, 17 patients were already on AADs; 49 (74%) had satisfactory rate control or had other issues; only two (3% of 66; 0.3% of 728) received new AADs. Of 728 patients with DDD pacemakers, only 17 were newly discovered to have AF, and six (0.8%) had changes in medications based on the pacemaker data. Adding pacemaker-derived data to existing clinical information had little therapeutic impact, due to a combination of cumbersome workflow, and because AF was usually known to practitioners. Developments in automated monitoring systems may provide more accessible and therapeutically useful information. ©2014 Wiley Periodicals, Inc.

  19. Growing up in Violent Communities: Do Family Conflict and Gender Moderate Impacts on Adolescents' Psychosocial Development?

    ERIC Educational Resources Information Center

    McKelvey, Lorraine M.; Whiteside-Mansell, Leanne; Bradley, Robert H.; Casey, Patrick H.; Conners-Burrow, Nicola A.; Barrett, Kathleen W.

    2011-01-01

    This study examined the moderating effects of family conflict and gender on the relationship between community violence and psychosocial development at age 18. The study sample consisted of 728 children and families who were part of the Infant Health and Development Program study of low-birth-weight, pre-term infants. In this sample, adolescent…

  20. Intellectual Freedom, the Young Adult, and Schools; a Wisconsin Study. Revised Edition.

    ERIC Educational Resources Information Center

    Woodworth, Mary L.

    A survey investigated the existence and extent of censorship in the Wisconsin high schools. Questionnaires were sent to the principals, librarians, and some English, social studies and science teachers at 426 high schools. Tallies of the 728 questionnaires returned showed that censorship was a common event; 57.8% of respondents said there had been…

  1. Attrition in Psychotherapy: A Survival Analysis

    ERIC Educational Resources Information Center

    Roseborough, David John; McLeod, Jeffrey T.; Wright, Florence I.

    2016-01-01

    Purpose: Attrition is a common problem in psychotherapy and can be defined as clients ending treatment before achieving an optimal response. Method: This longitudinal, archival study utilized data for 3,728 clients, using the Outcome Questionnaire 45.2. A Cox regression proportional hazards (hazard ratios) model was used in order to better…

  2. Active Learning Promoting Student Teachers' Professional Competences in Finland and Turkey

    ERIC Educational Resources Information Center

    Niemi, Hannele; Nevgi, Anne; Aksit, Fisun

    2016-01-01

    This study investigates student teachers' active learning experiences in teacher education (TE) in Finnish and Turkish contexts and attempts to determine how active learning methods' impact student teachers' professional competences. Student teachers (N = 728) assessed their active learning experiences and the professional competences they…

  3. Perceived Parental Relationships and Health-Risk Behaviors in College-Attending Emerging Adults

    ERIC Educational Resources Information Center

    Schwartz, Seth J.; Zamboanga, Byron L.; Ravert, Russell D.; Kim, Su Yeong; Weisskirch, Robert S.; Williams, Michelle K.; Bersamin, Melina; Finley, Gordon E.

    2009-01-01

    The present study investigated the association of perceived parenting with health-risk behaviors in an ethnically diverse sample of 1,728 college-attending emerging adults. Participants completed retrospective measures of perceived maternal and paternal nurturance, connection, psychological control, and disrespect and reported their frequency of…

  4. Bioinformatics Analysis of the Complete Genome Sequence of the Mango Tree Pathogen Pseudomonas syringae pv. syringae UMAF0158 Reveals Traits Relevant to Virulence and Epiphytic Lifestyle

    PubMed Central

    Arrebola, Eva; Carrión, Víctor J.; Gutiérrez-Barranquero, José Antonio; Pérez-García, Alejandro; Ramos, Cayo; Cazorla, Francisco M.; de Vicente, Antonio

    2015-01-01

    The genome sequence of more than 100 Pseudomonas syringae strains has been sequenced to date; however only few of them have been fully assembled, including P. syringae pv. syringae B728a. Different strains of pv. syringae cause different diseases and have different host specificities; so, UMAF0158 is a P. syringae pv. syringae strain related to B728a but instead of being a bean pathogen it causes apical necrosis of mango trees, and the two strains belong to different phylotypes of pv.syringae and clades of P. syringae. In this study we report the complete sequence and annotation of P. syringae pv. syringae UMAF0158 chromosome and plasmid pPSS158. A comparative analysis with the available sequenced genomes of other 25 P. syringae strains, both closed (the reference genomes DC3000, 1448A and B728a) and draft genomes was performed. The 5.8 Mb UMAF0158 chromosome has 59.3% GC content and comprises 5017 predicted protein-coding genes. Bioinformatics analysis revealed the presence of genes potentially implicated in the virulence and epiphytic fitness of this strain. We identified several genetic features, which are absent in B728a, that may explain the ability of UMAF0158 to colonize and infect mango trees: the mangotoxin biosynthetic operon mbo, a gene cluster for cellulose production, two different type III and two type VI secretion systems, and a particular T3SS effector repertoire. A mutant strain defective in the rhizobial-like T3SS Rhc showed no differences compared to wild-type during its interaction with host and non-host plants and worms. Here we report the first complete sequence of the chromosome of a pv. syringae strain pathogenic to a woody plant host. Our data also shed light on the genetic factors that possibly determine the pathogenic and epiphytic lifestyle of UMAF0158. This work provides the basis for further analysis on specific mechanisms that enable this strain to infect woody plants and for the functional analysis of host specificity in the P. syringae complex. PMID:26313942

  5. Effectiveness, safety and costs of thromboembolic prevention in patients with non-valvular atrial fibrillation: phase I ESC-FA protocol study and baseline characteristics of a cohort from a primary care electronic database

    PubMed Central

    Vedia Urgell, Cristina; Roso-Llorach, Albert; Morros, Rosa; Capellà, Dolors; Castells, Xavier; Ferreira-González, Ignacio; Troncoso Mariño, Amelia; Diògene, Eduard; Elorza, Josep Mª; Casajuana, Marc; Bolíbar, Bonaventura; Violan, Concepció

    2016-01-01

    Purpose Atrial fibrillation is the most common arrhythmia. Its management aims to reduce symptoms and to prevent complications through rate and rhythm control, management of concomitant cardiac diseases and prevention of related complications, mainly stroke. The main objective of Effectiveness, Safety and Costs in Atrial Fibrillation (ESC-FA) study is to analyse the drugs used for the management of the disease in real-use conditions, particularly the antithrombotic agents for stroke prevention. The aim of this work is to present the study protocol of phase I of the ESC-FA study and the baseline characteristics of newly diagnosed patients with atrial fibrillation in Catalonia, Spain. Participants The data source is System for the Improvement of Research in Primary Care (SIDIAP) database. The population included are all patients with non-valvular atrial fibrillation diagnosis registered in the electronic health records during 2007–2012. Findings to date A total of 22 585 patients with non-valvular atrial fibrillation were included in the baseline description. Their mean age was 72.8 years and 51.6% were men. The most commonly prescribed antithrombotics were vitamin K antagonists (40.1% of patients) and platelet aggregation inhibitors (32.9%); 25.3% had not been prescribed antithrombotic treatment. Age, gender, comorbidities and co-medication at baseline were similar to those reported for previous studies. Future plans The next phase in the ESC-FA study will involve assessing the effectiveness and safety of antithrombotic treatments, analysing stroke events and bleeding episodes’ rates in our patients (rest of phase I), describing the current management of the disease and its costs in our setting, and assessing how the introduction of new oral anticoagulants changes the stroke prevention in non-valvular atrial fibrillation. PMID:26823179

  6. Investigation of the Effect of Sport on Submissive Behavior and Communication Skills of High School Students

    ERIC Educational Resources Information Center

    Abakay, Ugur

    2013-01-01

    This study was carried out to detect the differences in submissive behaviors and communication skills of high school students in terms of sports activities and relationship between communication skills and properties of submissive behavior of high school students who are actively involved in sports activities. In this respect at the study, 728…

  7. The Examination of Sport's Effects over High School Students' Resiliency Levels

    ERIC Educational Resources Information Center

    Sahin, Mustafa Yasar

    2013-01-01

    The aim of this study was to examine the resiliency of high school education students and to compare it by athletic or non-athletic factors. A sample of 728 (284 girls, 444 boys) high school students who were chosen randomly among pupils studying in Gaziantep provided responses. High School Version of California Resiliency Rating Scale which was…

  8. Adaptive functioning in children with epilepsy and learning problems.

    PubMed

    Buelow, Janice M; Perkins, Susan M; Johnson, Cynthia S; Byars, Anna W; Fastenau, Philip S; Dunn, David W; Austin, Joan K

    2012-10-01

    In the study we describe adaptive functioning in children with epilepsy whose primary caregivers identified them as having learning problems. This was a cross-sectional study of 50 children with epilepsy and learning problems. Caregivers supplied information regarding the child's adaptive functioning and behavior problems. Children rated their self-concept and completed a battery of neuropsychological tests. Mean estimated IQ (PPVT-III) in the participant children was 72.8 (SD = 18.3). On average, children scored 2 standard deviations below the norm on the Vineland Adaptive Behavior Scale-II and this was true even for children with epilepsy who had estimated IQ in the normal range. In conclusion, children with epilepsy and learning problems had relatively low adaptive functioning scores and substantial neuropsychological and mental health problems. In epilepsy, adaptive behavior screening can be very informative and guide further evaluation and intervention, even in those children whose IQ is in the normal range.

  9. Performance evaluation of 4 measuring methods of ground-glass opacities for predicting the 5-year relapse-free survival of patients with peripheral nonsmall cell lung cancer: a multicenter study.

    PubMed

    Kakinuma, Ryutaro; Kodama, Ken; Yamada, Kouzo; Yokoyama, Akira; Adachi, Shuji; Mori, Kiyoshi; Fukuyama, Yasuro; Fukuda, Yasuro; Kuriyama, Keiko; Oda, Junichi; Oda, Junji; Noguchi, Masayuki; Matsuno, Yoshihiro; Yokose, Tomoyuki; Ohmatsu, Hironobu; Nishiwaki, Yutaka

    2008-01-01

    To evaluate the performance of 4 methods of measuring the extent of ground-glass opacities as a means of predicting the 5-year relapse-free survival of patients with peripheral nonsmall cell lung cancer (NSLC). Ground-glass opacities on thin-section computed tomographic images of 120 peripheral NSLCs were measured at 7 medical institutions by the length, area, modified length, and vanishing ratio (VR) methods. The performance (Az) of each method in predicting the 5-year relapse-free survival was evaluated using receiver operating characteristic analysis. The mean Az value obtained by the length, area, modified length, and VR methods in the receiver operating characteristic analyses was 0.683, 0.702, 0.728, and 0.784, respectively. The differences between the mean Az value obtained by the VR method and by the other 3 methods were significant. Vanishing ratio method was the most accurate predictor of the 5-year relapse-free survival of patients with peripheral NSLC.

  10. Economic impact of expanded use of biologic therapy for the treatment of rheumatoid arthritis and Crohn's disease in Argentina, Brazil, Colombia, and Mexico.

    PubMed

    Tundia, Namita; Kotze, Paulo Gustavo; Rojas Serrano, Jorge; Mendes de Abreu, Mirhelen; Skup, Martha; Macaulay, Dendy; Signorovitch, James; Chaves, Leonardo; Chao, Jingdong; Bao, Yanjun

    2016-12-01

    To estimate economic impact resulting from increased biologics use for treatment of rheumatoid arthritis (RA) and Crohn's disease (CD) in Argentina, Brazil, Colombia, and Mexico. The influence of increasing biologics use for treatment of RA during 2012-2022 and for treatment of CD during 2013-2023 was modeled from a societal perspective. The economic model incorporated current and projected medical, indirect, and drug costs and epidemiologic and economic factors. Costs associated with expanded biologics use for RA were compared with non-expanded use in Argentina, Brazil, Colombia, and Mexico. A similar analysis was conducted for CD in Brazil, Colombia, and Mexico. Accounting for additional costs of biologics and medical and indirect cost offsets, the model predicts that expanded use of biologics for patients with RA from 2012 to 2022 will result in cumulative net cost savings of ARS$2.351 billion in Argentina, R$9.004 billion in Brazil, COP$728.577 billion in Colombia, and MXN$18.02 billion in Mexico; expanded use of biologics for patients with CD from 2013 to 2023 will result in cumulative net cost savings for patients with CD of R$0.082 billion in Brazil, COP$502.74 billion in Colombia, and MXN$1.80 billion in Mexico. Indirect cost offsets associated with expanded biologics use were a key driver in reducing annual per-patient net costs for RA and CD. Future economic projections are limited by the potential variance between projected and actual future values of biologic prices, wages, medical costs, and gross national product for each country. Increasing biologics use to treat RA and CD may limit cost growth over time by reducing medical and indirect costs. These findings may inform policy decisions regarding biologics use in Argentina, Brazil, Colombia, and Mexico.

  11. Utilization and Outcomes of Sentinel Lymph Node Biopsy for Vulvar Cancer.

    PubMed

    Cham, Stephanie; Chen, Ling; Burke, William M; Hou, June Y; Tergas, Ana I; Hu, Jim C; Ananth, Cande V; Neugut, Alfred I; Hershman, Dawn L; Wright, Jason D

    2016-10-01

    To examine the use and predictors of sentinel node biopsy in women with vulvar cancer. The Perspective database, an all-payer database that collects data from more than 500 hospitals, was used to perform a retrospective cohort study of women with vulvar cancer who underwent vulvectomy and lymph node assessment from 2006 to 2015. Multivariable models were used to determine factors associated with sentinel node biopsy. Length of stay and cost were compared between women who underwent sentinel node biopsy and lymphadenectomy. Among 2,273 women, sentinel node biopsy was utilized in 618 (27.2%) and 1,655 (72.8%) underwent inguinofemoral lymphadenectomy. Performance of sentinel node biopsy increased from 17.0% (95% confidence interval [CI] 12.0-22.0%) in 2006 to 39.1% (95% CI 27.1-51.0%) in 2015. In a multivariable model, women treated more recently were more likely to have undergone sentinel node biopsy, whereas women with more comorbidities and those treated at rural hospitals were less likely to have undergone the procedure. The median length of stay was shorter for those undergoing sentinel node biopsy (median 2 days, interquartile range 1-3) compared with women who underwent inguinofemoral lymphadenectomy (median 3 days, interquartile range 2-4). The cost of sentinel node biopsy was $7,599 (interquartile range $5,739-9,922) compared with $8,095 (interquartile range $5,917-11,281) for lymphadenectomy. The use of sentinel node biopsy for vulvar cancer has more than doubled since 2006. Sentinel lymph node biopsy is associated with a shorter hospital stay and decreased cost compared with inguinofemoral lymphadenectomy.

  12. Enamel cracks evaluation - A method to predict tooth surface damage during the debonding.

    PubMed

    Dumbryte, Irma; Jonavicius, Tomas; Linkeviciene, Laura; Linkevicius, Tomas; Peciuliene, Vytaute; Malinauskas, Mangirdas

    2015-01-01

    The objective of this in vitro study was to evaluate the effect of the enamel cracks on the tooth damage during the debonding. Measurements of the cracks characteristics (visibility, direction, length, and location) were performed utilizing a scanning electron microscopy (SEM) technique and mathematically derived formulas (x=h/30, l=n*x) before and following the removal of mechanically retained metal and ceramic brackets. The likelihood of having greater extent enamel defects was higher for the teeth with pronounced cracks (odds vatios, OR=3.728), increased when the crack was located in more than one zone of the tooth (OR=1.998), and the inclination did not exceed 30-45° (OR=0.505). Using ceramic brackets the risk of greater amount tooth structure defects raised 1.45 times (OR=1.450). Enamel crack showing all these characteristics at the beginning of the orthodontic treatment and the use of ceramic brackets might predispose to higher risk of greater extent tooth surface damage after the debonding by 20.4%.

  13. Laughter is the Best Medicine? A Cross-Sectional Study of Cardiovascular Disease Among Older Japanese Adults.

    PubMed

    Hayashi, Kei; Kawachi, Ichiro; Ohira, Tetsuya; Kondo, Katsunori; Shirai, Kokoro; Kondo, Naoki

    2016-10-05

    We sought to evaluate the associations between frequency of daily laughter with heart disease and stroke among community-dwelling older Japanese women and men. We analyzed cross-sectional data in 20 934 individuals (10 206 men and 10 728 women) aged 65 years or older, who participated in the Japan Gerontological Evaluation Study in 2013. In the mail-in survey, participants provided information on daily frequency of laughter, as well as body mass index, demographic and lifestyle factors, and diagnoses of cardiovascular disease, hyperlipidemia, hypertension, and depression. Even after adjustment for hyperlipidemia, hypertension, depression, body mass index, and other risk factors, the prevalence of heart diseases among those who never or almost never laughed was 1.21 (95% CI, -1.03-1.41) times higher than those who reported laughing every day. The adjusted prevalence ratio for stroke was 1.60 (95% CI, 1.24-2.06). Daily frequency of laughter is associated with lower prevalence of cardiovascular diseases. The association could not be explained by confounding factors, such as depressive symptoms.

  14. Laughter is the Best Medicine? A Cross-Sectional Study of Cardiovascular Disease Among Older Japanese Adults

    PubMed Central

    Hayashi, Kei; Kawachi, Ichiro; Ohira, Tetsuya; Kondo, Katsunori; Shirai, Kokoro; Kondo, Naoki

    2016-01-01

    Background We sought to evaluate the associations between frequency of daily laughter with heart disease and stroke among community-dwelling older Japanese women and men. Methods We analyzed cross-sectional data in 20 934 individuals (10 206 men and 10 728 women) aged 65 years or older, who participated in the Japan Gerontological Evaluation Study in 2013. In the mail-in survey, participants provided information on daily frequency of laughter, as well as body mass index, demographic and lifestyle factors, and diagnoses of cardiovascular disease, hyperlipidemia, hypertension, and depression. Results Even after adjustment for hyperlipidemia, hypertension, depression, body mass index, and other risk factors, the prevalence of heart diseases among those who never or almost never laughed was 1.21 (95% CI, −1.03–1.41) times higher than those who reported laughing every day. The adjusted prevalence ratio for stroke was 1.60 (95% CI, 1.24–2.06). Conclusions Daily frequency of laughter is associated with lower prevalence of cardiovascular diseases. The association could not be explained by confounding factors, such as depressive symptoms. PMID:26972732

  15. Maintaining persistence and adherence with subcutaneous growth-hormone therapy in children: comparing jet-delivery and needle-based devices.

    PubMed

    Spoudeas, Helen A; Bajaj, Priti; Sommerford, Nathan

    2014-01-01

    Persistence and adherence with subcutaneous growth hormone (GH; somatropin) therapy in children is widely acknowledged to be suboptimal. This study aimed to investigate how the use of a jet-delivery device, ZomaJet(®), impacts on medication-taking behaviors compared to needle-based devices. A retrospective cohort study of children aged ≤18 years was conducted using a UK-based, nationwide database of GH home-delivery schedules. Data were evaluated for the period between January 2010 and December 2012 for 6,061 children receiving either Zomacton(®) (somatropin) via the ZomaJet jet-delivery device or one of six brands of GH all administered via needle-based devices. Persistence was analyzed for patients with appropriate data, measured as the time interval between first and last home deliveries. An analysis of adherence was conducted only for patients using ZomaJet who had appropriate data, measured by proportion of days covered. Brand switches were identified for all patients. Persistence with GH therapy was significantly longer in patients using ZomaJet compared to needle-based devices (599 days versus 535 days, respectively, n=4,093; P<0.001); this association was observed in both sexes and across age subgroups (≤10 and 11-16 years). The majority (58%) of patients using ZomaJet were classed as adherent (n=728). Only 297 patients (5%) switched GH brand (n=6,061), and patients tended to use ZomaJet for longer than other devices before switching. It appears important that the choice of a jet-delivery device is offered to children prescribed daily GH therapy. These devices may represent a much-needed effective strategy for maintaining persistence with subcutaneous GH administration in children, potentially offering better clinical outcomes and greater cost-efficiency.

  16. The scope of costs in alcohol studies: Cost-of-illness studies differ from economic evaluations.

    PubMed

    van Gils, Paul F; Hamberg-van Reenen, Heleen H; van den Berg, Matthijs; Tariq, Luqman; de Wit, G Ardine

    2010-07-06

    Alcohol abuse results in problems on various levels in society. In terms of health, alcohol abuse is not only an important risk factor for chronic disease, but it is also related to injuries. Social harms which can be related to drinking include interpersonal problems, work problems, violent and other crimes. The scope of societal costs related to alcohol abuse in principle should be the same for both economic evaluations and cost-of-illness studies. In general, economic evaluations report a small part of all societal costs. To determine the cost- effectiveness of an intervention it is necessary that all costs and benefits are included. The purpose of this study is to describe and quantify the difference in societal costs incorporated in economic evaluations and cost-of-illness studies on alcohol abuse. To investigate the economic costs attributable to alcohol in cost-of-illness studies we used the results of a recent systematic review (June 2009). We performed a PubMed search to identify economic evaluations on alcohol interventions. Only economic evaluations in which two or more interventions were compared from a societal perspective were included. The proportion of health care costs and the proportion of societal costs were estimated in both type of studies. The proportion of healthcare costs in cost-of-illness studies was 17% and the proportion of societal costs 83%. In economic evaluations, the proportion of healthcare costs was 57%, and the proportion of societal costs was 43%. The costs included in economic evaluations performed from a societal perspective do not correspond with those included in cost-of-illness studies. Economic evaluations on alcohol abuse underreport true societal cost of alcohol abuse. When considering implementation of alcohol abuse interventions, policy makers should take into account that economic evaluations from the societal perspective might underestimate the total effects and costs of interventions.

  17. Elimination of Cost Sharing for Screening Mammography in Medicare Advantage Plans.

    PubMed

    Trivedi, Amal N; Leyva, Bryan; Lee, Yoojin; Panagiotou, Orestis A; Dahabreh, Issa J

    2018-01-18

    The Affordable Care Act (ACA) required most insurers and the Medicare program to eliminate cost sharing for screening mammography. We conducted a difference-in-differences study of biennial screening mammography among 15,085 women 65 to 74 years of age in 24 Medicare Advantage plans that eliminated cost sharing to provide full coverage for screening mammography, as compared with 52,035 women in 48 matched control plans that had and maintained full coverage. In plans that eliminated cost sharing, adjusted rates of biennial screening mammography increased from 59.9% (95% confidence interval [CI], 54.9 to 65.0) in the 2-year period before cost-sharing elimination to 65.4% (95% CI, 61.8 to 69.0) in the 2-year period thereafter. In control plans, the rates of biennial mammography were 73.1% (95% CI, 69.2 to 77.0) and 72.8% (95% CI, 69.7 to 76.0) during the same periods, yielding a difference in differences of 5.7 percentage points (95% CI, 3.0 to 8.4). The difference in differences was 9.8 percentage points (95% CI, 4.5 to 15.2) among women living in the areas with the highest quartile of educational attainment versus 4.3 percentage points (95% CI, 0.2 to 8.4) among women in the lowest quartile. As indicated by the difference-in-differences estimates, after the elimination of cost sharing, the rate of biennial mammography increased by 6.5 percentage points (95% CI, 3.7 to 9.4) for white women and 8.4 percentage points (95% CI, 2.5 to 14.4) for black women but was almost unchanged for Hispanic women (0.4 percentage points; 95% CI, -7.3 to 8.1). The elimination of cost sharing for screening mammography under the ACA was associated with an increase in rates of use of this service among older women for whom screening is recommended. The effect was attenuated among women living in areas with lower educational attainment and was negligible among Hispanic women. (Funded by the National Institute on Aging.).

  18. Genetic and Environmental Effects on Vocal Symptoms and Their Intercorrelations

    ERIC Educational Resources Information Center

    Nybacka, Ida; Simberg, Susanna; Santtila, Pekka; Sala, Eeva; Sandnabba, N. Kenneth

    2012-01-01

    Purpose: Recently, Simberg et al. (2009) found genetic effects on a composite variable consisting of 6 vocal symptom items measuring dysphonia. The purpose of the present study was to determine genetic and environmental effects on the individual vocal symptoms in a population-based sample of Finnish twins. Method: The sample comprised 1,728 twins…

  19. Economic costs of childhood lead exposure in low- and middle-income countries.

    PubMed

    Attina, Teresa M; Trasande, Leonardo

    2013-09-01

    Children's blood lead levels have declined worldwide, especially after the removal of lead in gasoline. However, significant exposure remains, particularly in low- and middle-income countries. To date, there have been no global estimates of the costs related to lead exposure in children in developing countries. Our main aim was to estimate the economic costs attributable to childhood lead exposure in low- and middle-income countries. We developed a regression model to estimate mean blood lead levels in our population of interest, represented by each 1-year cohort of children < 5 years of age. We used an environmentally attributable fraction model to estimate lead-attributable economic costs and limited our analysis to the neurodevelopmental impacts of lead, assessed as decrements in IQ points. Our main outcome was lost lifetime economic productivity due to early childhood exposure. We estimated a total cost of $977 billions of international dollars in low- and middle-income countries, with economic losses equal to $134.7 billion in Africa [4.03% of gross domestic product (GDP)], $142.3 billion in Latin America and the Caribbean (2.04% of GDP), and $699.9 billion in Asia (1.88% of GDP). Our sensitivity analysis indicates a total economic loss in the range of $728.6-1162.5 billion. We estimated that, in low- and middle-income countries, the burden associated with childhood lead exposure amounts to 1.20% of world GDP in 2011. For comparison, in the United States and Europe lead-attributable economic costs have been estimated at $50.9 and $55 billion, respectively, suggesting that the largest burden of lead exposure is now borne by low- and middle-income countries.

  20. Gauging the feasibility of cost-sharing and medical student interest groups to reduce interview costs.

    PubMed

    Lieber, Bryan A; Wilson, Taylor A; Bell, Randy S; Ashley, William W; Barrow, Daniel L; Wolfe, Stacey Quintero

    2014-11-01

    Indirect costs of the interview tour can be prohibitive. The authors sought to assess the desire of interviewees to mitigate these costs through ideas such as sharing hotel rooms and transportation, willingness to stay with local students, and the preferred modality to coordinate this collaboration. A survey link was posted on the Uncle Harvey website and the Facebook profile page of fourth-year medical students from 6 different medical schools shortly after the 2014 match day. There were a total of 156 respondents to the survey. The majority of the respondents were postinterview medical students (65.4%), but preinterview medical students (28.2%) and current residents (6.4%) also responded to the survey. Most respondents were pursuing a field other than neurosurgery (75.0%) and expressed a desire to share a hotel room and/or transportation (77.4%) as well as stay in the dorm room of a medical student at the program in which they are interviewing (70.0%). Students going into neurosurgery were significantly more likely to be interested in sharing hotel/transportation (89.2% neurosurgery vs 72.8% nonneurosurgery; p = 0.040) and in staying in the dorm room of a local student when on interviews (85.0% neurosurgery vs 57.1% nonneurosurgery; p = 0.040) than those going into other specialties. Among postinterview students, communication was preferred to be by private, email identification-only chat room. Given neurosurgery resident candidates' interest in collaborating to reduce interview costs, consideration should be given to creating a system that could allow students to coordinate cost sharing between interviewees. Moreover, interviewees should be connected to local students from neurosurgery interest groups as a resource.

  1. A cost-effective nanoporous ultrathin film electrode based on nanoporous gold/IrO2 composite for proton exchange membrane water electrolysis

    NASA Astrophysics Data System (ADS)

    Zeng, Yachao; Guo, Xiaoqian; Shao, Zhigang; Yu, Hongmei; Song, Wei; Wang, Zhiqiang; Zhang, Hongjie; Yi, Baolian

    2017-02-01

    A cost-effective nanoporous ultrathin film (NPUF) electrode based on nanoporous gold (NPG)/IrO2 composite has been constructed for proton exchange membrane (PEM) water electrolysis. The electrode was fabricated by integrating IrO2 nanoparticles into NPG through a facile dealloying and thermal decomposition method. The NPUF electrode is featured in its 3D interconnected nanoporosity and ultrathin thickness. The nanoporous ultrathin architecture is binder-free and beneficial for improving electrochemical active surface area, enhancing mass transport and facilitating releasing of oxygen produced during water electrolysis. Serving as anode, a single cell performance of 1.728 V (@ 2 A cm-2) has been achieved by NPUF electrode with a loading of IrO2 and Au at 86.43 and 100.0 μg cm-2 respectively, the electrolysis voltage is 58 mV lower than that of conventional electrode with an Ir loading an order of magnitude higher. The electrolysis voltage kept relatively constant up to 300 h (@250 mA cm-2) during the course of durability test, manifesting that NPUF electrode is promising for gas evolution.

  2. Hospital-onset Clostridium difficile infection among solid organ transplant recipients.

    PubMed

    Donnelly, J P; Wang, H E; Locke, J E; Mannon, R B; Safford, M M; Baddley, J W

    2015-11-01

    Clostridium difficile infection (CDI) is a considerable health issue in the United States and represents the most common healthcare-associated infection. Solid organ transplant recipients are at increased risk of CDI, which can affect both graft and patient survival. However, little is known about the impact of CDI on health services utilization posttransplantation. We examined hospital-onset CDI from 2012 to 2014 among transplant recipients in the University HealthSystem Consortium, which includes academic medical center-affiliated hospitals in the United States. Infection was five times more common among transplant recipients than among general medicine inpatients (209 vs 40 per 10 000 discharges), and factors associated with CDI among transplant recipients included transplant type, risk of mortality, comorbidities, and inpatient complications. Institutional risk-standardized CDI varied more than 3-fold across high-volume hospitals (infection ratio 0.54-1.82, median 1.04, interquartile range 0.78-1.28). CDI was associated with increased 30-day readmission, transplant organ complications, cytomegalovirus infection, inpatient costs, and lengths of stay. Total observed inpatient days and direct costs for those with CDI were substantially higher than risk-standardized expected values (40 094 vs 22 843 days, costs $198 728 368 vs $154 020 528). Further efforts to detect, prevent, and manage CDI among solid organ transplant recipients are warranted. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

  3. Biased attention retraining in dysphoria: a failure to replicate.

    PubMed

    Mastikhina, Liza; Dobson, Keith

    2017-04-01

    The present study replicated Wells and Beevers [(2010). Biased attention and dysphoria: Manipulating selective attention reduces subsequent depressive symptoms. Cognition & Emotion, 24, 719-728] and examined the longitudinal effects of attentional retraining on symptoms of depression. Dysphoric undergraduate psychology students were randomly assigned into either a neutral or control training condition. Training was administered using a dot-probe task that presented participants with pairs of pictures (of sad and neutral content) that were followed by a probe that participants had to respond to. Training took place over four sessions during a two-week period, followed by a final follow-up session two weeks later. Mood was measured at baseline, post-training, and at follow-up. All participants showed a significant reduction in depressive symptoms throughout the study, F(1.7, 73.55) = 21.19, p < .001; but the attentional retraining did not demonstrate any advantage over the control condition. Results were inconsistent with those of Wells and Beevers [(2010). Biased attention and dysphoria: Manipulating selective attention reduces subsequent depressive symptoms. Cognition & Emotion, 24, 719-728]. Implications of the findings on research on attentional retraining in the context of depression are discussed.

  4. 32 CFR 728.2 - Definitions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... adjuncts such as prosthetic devices, spectacles, hearing aids, orthopedic footwear, and other medically... retaining management, any additional material, professional diagnostic or consultative services, or other...

  5. Knowledge, Attitudes, and Practices of Pediatric Dentists Regarding Speech Evaluation of Patients: Implications for Dental Education.

    PubMed

    Van Eyndhoven, Lisa; Chussid, Steven; Yoon, Richard K

    2015-11-01

    The aim of this cross-sectional study was to determine pediatric dentists' attitudes about speech evaluation in the dental setting and assess their knowledge of speech development and pathology. In October 2013, members of the American Academy of Pediatric Dentistry were invited to participate in an electronic questionnaire. Categories of questions were demographics, attitudes and confidence in speech pathology, and theoretical and practical knowledge of speech development and speech pathology. Theoretical knowledge was assessed using questions about phonetics and speech milestones. Practical knowledge was determined with three 30-second interview-style video clips. A total of 539 responses were received for a response rate of 10.4%. The majority of respondents reported feeling that speech evaluation should be part of the pediatric dental visit (72.8%) and felt confident in their ability to detect speech issues (73.2%). However, they did poorly on the theoretical knowledge questions (41.9%) as well as the practical knowledge questions (8.5%). There was a statistically significant difference in theoretical score between gender and type of occupation (p<0.05). This difference was not observed when examining practical knowledge. This study suggests that although pediatric dentists are in an ideal position to aid in the detection of speech issues, they currently have insufficient training and knowledge to do so.

  6. The Estimation and Inclusion of Presenteeism Costs in Applied Economic Evaluation: A Systematic Review.

    PubMed

    Kigozi, Jesse; Jowett, Sue; Lewis, Martyn; Barton, Pelham; Coast, Joanna

    2017-03-01

    Given the significant costs of reduced productivity (presenteeism) in comparison to absenteeism, and overall societal costs, presenteeism has a potentially important role to play in economic evaluations. However, these costs are often excluded. The objective of this study is to review applied cost of illness studies and economic evaluations to identify valuation methods used for, and impact of including presenteeism costs in practice. A structured systematic review was carried out to explore (i) the extent to which presenteeism has been applied in cost of illness studies and economic evaluations and (ii) the overall impact of including presenteeism on overall costs and outcomes. Potential articles were identified by searching Medline, PsycINFO and NHS EED databases. A standard template was developed and used to extract information from economic evaluations and cost of illness studies incorporating presenteeism costs. A total of 28 studies were included in the systematic review which also demonstrated that presenteeism costs are rarely included in full economic evaluations. Estimation and monetisation methods differed between the instruments. The impact of disease on presenteeism whilst in paid work is high. The potential impact of presenteeism costs needs to be highlighted and greater consideration should be given to including these in economic evaluations and cost of illness studies. The importance of including presenteeism costs when conducting economic evaluation from a societal perspective should be emphasised in national economic guidelines and more methodological work is required to improve the practical application of presenteeism instruments to generate productivity cost estimates. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  7. Parametric study on the compressive strength geopolymer paving block

    NASA Astrophysics Data System (ADS)

    Aman; Awaluddin, A.; Ahmad, A.; Olivia, M.

    2018-04-01

    This paper reported about the investigated of sodium hidroxida concentration, effect of ratio liquid to solid (L/S), temperature and time on the compressive strength of geopolymer paving block using fly ash and fine aggregate as base material and combination of sodium hidroxida and sodium silicate as alkaline activator and the ratio of Na2SiO3/NaOH was 2 and fly ash to aggregate of 1: 3. The experiments were conducted with variation of the sodium hidroxida concentration of (10-16 M) liquid to solid (L/S) 0.1- 0.7 ratio, curing temperature 30-100 °C and curing time (7-28 day). The main evaluation techniques in this experimental were Compressive strength, X-ray diffraction (XRD),and Scaning Electron Microscope (SEM). The result showed that the compressive strength of Geopolymer Paving block has increased with an increasing of concentration, liquid to solid ratio, curing temperature and curing time.

  8. The study on the entrapment efficiency and in vitro release of puerarin submicron emulsion.

    PubMed

    Yue, Peng-Fei; Lu, Xiu-Yun; Zhang, Zeng-Zhu; Yuan, Hai-Long; Zhu, Wei-Feng; Zheng, Qin; Yang, Ming

    2009-01-01

    The entrapment efficiency (EE) and release in vitro are very important physicochemical characteristics of puerarin submicron emulsion (SME). In this paper, the performance of ultrafiltration (UF), ultracentrifugation (UC), and microdialysis (MD) for determining the EE of SME were evaluated, respectively. The release study in vitro of puerarin from SME was studied by using MD and pressure UF technology. The EE of SME was 86.5%, 72.8%, and 55.8% as determined by MD, UF, and UC, respectively. MD was not suitable for EE measurements of puerarin submicron oil droplet, which could only determine the total EE of submicron oil droplet and liposomes micelles, but it could be applied to determine the amount of free drug in SMEs. Although UC was the fastest and simplest to use, its results were the least reliable. UF was still the relatively accurate method for EE determination of puerarin SME. The release of puerarin SME could be evaluated by using MD and pressure UF, but MD seemed to be more suitable for the release study of puerarin emulsion. The drug release from puerarin SME at three drug concentrations was initially rapid, but reached a plateau value within 30 min. Drug release of puerarin from the SME occurred via burst release.

  9. 32 CFR 728.42 - NATO.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... evacuation system of the holding nation. (2) Classification of patients. Different channels for disposition... acute medical and surgical conditions, exclusive of nervous, mental, or contagious diseases or those...

  10. Assessment of transparency of cost estimates in economic evaluations of patient safety programmes.

    PubMed

    Fukuda, Haruhisa; Imanaka, Yuichi

    2009-06-01

    Transparency of costing is essential for decision-makers who require information on the efficiency of a health care programme, because effective decisions depend largely on applicability to their settings. The main objectives of this study were to assess published studies for transparency of cost estimates. We first developed criteria with two axes by reviewing publications dealing with economic evaluations and cost accounting studies: clarification of the scope of costing and accuracy of method evaluating costs. We then performed systematic searches of the literature for studies which estimated prevention costs and assessed the transparency and accuracy of costing based on our criteria. Forty studies met the inclusion criteria. Half of the studies reported data for both the quantity and unit price of programmes in regard to prevention costs. Although 30 studies estimated costs of adverse events, 19 of these described the scope of costing only, and just five studies used a micro-costing method. Among 30 studies that estimated 'gross cost savings' and 'net cost savings', there was a huge discrepancy in labels. Even if a cost study was conducted in accordance with existing techniques of economic evaluation which mostly paid attention to internal validity of cost estimates, without adequate explanation of the process of costing, reproducibility cannot be assured and the study may lose its value as scientific information. This study found that there is tremendous room for improvement.

  11. Economic Costs of Childhood Lead Exposure in Low- and Middle-Income Countries

    PubMed Central

    Trasande, Leonardo

    2013-01-01

    Background: Children’s blood lead levels have declined worldwide, especially after the removal of lead in gasoline. However, significant exposure remains, particularly in low- and middle-income countries. To date, there have been no global estimates of the costs related to lead exposure in children in developing countries. Objective: Our main aim was to estimate the economic costs attributable to childhood lead exposure in low- and middle-income countries. Methods: We developed a regression model to estimate mean blood lead levels in our population of interest, represented by each 1-year cohort of children < 5 years of age. We used an environmentally attributable fraction model to estimate lead-attributable economic costs and limited our analysis to the neurodevelopmental impacts of lead, assessed as decrements in IQ points. Our main outcome was lost lifetime economic productivity due to early childhood exposure. Results: We estimated a total cost of $977 billions of international dollars in low- and middle-income countries, with economic losses equal to $134.7 billion in Africa [4.03% of gross domestic product (GDP)], $142.3 billion in Latin America and the Caribbean (2.04% of GDP), and $699.9 billion in Asia (1.88% of GDP). Our sensitivity analysis indicates a total economic loss in the range of $728.6–1162.5 billion. Conclusions: We estimated that, in low- and middle-income countries, the burden associated with childhood lead exposure amounts to 1.20% of world GDP in 2011. For comparison, in the United States and Europe lead-attributable economic costs have been estimated at $50.9 and $55 billion, respectively, suggesting that the largest burden of lead exposure is now borne by low- and middle-income countries. Citation: Attina TM, Trasande L. 2013. Economic costs of childhood lead exposure in low- and middle-income countries. Environ Health Perspect 121:1097–1102; http://dx.doi.org/10.1289/ehp.1206424 PMID:23797342

  12. Establishing a cost-per-result of laboratory-based, reflex Cryptococcal antigenaemia screening (CrAg) in HIV+ patients with CD4 counts less than 100 cells/μl using a Lateral Flow Assay (LFA) at a typical busy CD4 laboratory in South Africa.

    PubMed

    Cassim, Naseem; Schnippel, Kathryn; Coetzee, Lindi Marie; Glencross, Deborah Kim

    2017-01-01

    Cryptococcal meningitis is a major cause of mortality and morbidity in countries with high HIV prevalence, primarily affecting patients whose CD4 are < = 100 cells/μl. Routine Cryptococcal Antigen (CrAg) screening is thus recommended in the South African HIV treatment guidelines for all patients with CD4 counts < = 100 cells/μl, followed by pre-emptive anti-fungal therapy where CrAg results are positive. A laboratory-based reflexed CrAg screening approach, using a Lateral Flow Assay (LFA) on remnant EDTA CD4 blood samples, was piloted at three CD4 laboratories. This study aimed to assess the cost-per-result of laboratory-based reflexed CrAg screening at one pilot CD4 referral laboratory. CD4 test volumes from 2014 were extracted to estimate percentage of CD4 < = 100 cells/μl. Daily average volumes were derived, assuming 12 months per/year and 21.73 working days per/month. Costing analyses were undertaken using Microsoft Excel and Stata with a provider prospective. The cost-per-result was estimated using a bottom-up method, inclusive of test kits and consumables (reagents), laboratory equipment and technical effort costs. The ZAR/$ exchange of 14.696/$1 was used, where applicable. One-way sensitivity analyses on the cost-per-result were conducted for possible error rates (3%- 8%, reductions or increases in reagent costs as well as test volumes (ranging from -60% to +60%). The pilot CD4 laboratory performed 267000 CD4 tests in 2014; ~ 9.3% (27500) reported CD4< = 100 cells/μl, equivalent to 106 CrAg tests performed daily. A batch of 30-tests could be performed in 1.6 hours, including preparation and analysis time. A cost-per-result of $4.28 was reported, with reagents contributing $3.11 (72.8%), while technical effort and laboratory equipment overheads contributed $1.17 (27.2%) and $0.03 (<1%) respectively. One-way sensitivity analyses including increasing or decreasing test volumes by 60% revealed a cost-per-result range of $3.84 to $6.03. A cost-per-result of $4.28 was established in a typical CD4 service laboratory to enable local budgetary cost projections and programmatic cost-effectiveness modelling. Varying reagent costs linked to currency exchange and varying test volumes in different levels of service can lead to varying cost-per-test and technical effort to manage workload, with an inverse relationship of higher costs expected at lower volumes of tests.

  13. 75 FR 20875 - Proposed Agency Information Collection Activities; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-21

    ... Public: Businesses. Respondent Universe: 728 railroads. Frequency of Submission: On occasion. Total.... Respondent Universe: 720 railroads. Frequency of Submission: On occasion; monthly. [[Page 20877

  14. Cost-effectiveness of telehealthcare to patients with chronic obstructive pulmonary disease: results from the Danish 'TeleCare North' cluster-randomised trial.

    PubMed

    Witt Udsen, Flemming; Lilholt, Pernille Heyckendorff; Hejlesen, Ole; Ehlers, Lars

    2017-05-17

    To investigate the cost-effectiveness of a telehealthcare solution in addition to usual care compared with usual care. A 12-month cost-utility analysis conducted alongside a cluster-randomised trial. Community-based setting in the geographical area of North Denmark Region in Denmark. 26 municipality districts define randomisation clusters with 13 districts in each arm. 1225 patients with chronic obstructive pulmonary disease were enrolled, of which 578 patients were randomised to telehealthcare and 647 to usual care. In addition to usual care, patients in the intervention group received a set of telehealthcare equipment and were monitored by a municipality-based healthcare team. Patients in the control group received usual care. Incremental costs per quality-adjusted life-years gained from baseline up to 12 months follow-up. From a healthcare and social sector perspective, the adjusted mean difference in total costs between telehealthcare and usual care was €728 (95% CI -754 to 2211) and the adjusted mean difference in quality-adjusted life-years gained was 0.0132 (95% CI -0.0083 to 0.0346). The incremental cost-effectiveness ratio was €55 327 per quality-adjusted life-year gained. Decision-makers should be willing to pay more than €55 000 to achieve a probability of cost-effectiveness >50%. This conclusion is robust to changes in the definition of hospital contacts and reduced intervention costs. Only in the most optimistic scenario combining the effects of all sensitivity analyses, does the incremental cost-effectiveness ratio fall below the UK thresholds values (€21 068 per quality-adjusted life-year). Telehealthcare is unlikely to be a cost-effective addition to usual care, if it is offered to all patients with chronic obstructive pulmonary disease and if the willingness-to-pay threshold values from the National Institute for Health and Care Excellence are applied. Clinicaltrials.gov, NCT01984840, 14 November 2013. © 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.

  15. Cost-effectiveness of telehealthcare to patients with chronic obstructive pulmonary disease: results from the Danish ‘TeleCare North’ cluster-randomised trial

    PubMed Central

    Witt Udsen, Flemming; Lilholt, Pernille Heyckendorff; Hejlesen, Ole; Ehlers, Lars

    2017-01-01

    Objectives To investigate the cost-effectiveness of a telehealthcare solution in addition to usual care compared with usual care. Design A 12-month cost-utility analysis conducted alongside a cluster-randomised trial. Setting Community-based setting in the geographical area of North Denmark Region in Denmark. Participants 26 municipality districts define randomisation clusters with 13 districts in each arm. 1225 patients with chronic obstructive pulmonary disease were enrolled, of which 578 patients were randomised to telehealthcare and 647 to usual care. Interventions In addition to usual care, patients in the intervention group received a set of telehealthcare equipment and were monitored by a municipality-based healthcare team. Patients in the control group received usual care. Main outcome measure Incremental costs per quality-adjusted life-years gained from baseline up to 12 months follow-up. Results From a healthcare and social sector perspective, the adjusted mean difference in total costs between telehealthcare and usual care was €728 (95% CI −754 to 2211) and the adjusted mean difference in quality-adjusted life-years gained was 0.0132 (95% CI −0.0083 to 0.0346). The incremental cost-effectiveness ratio was €55 327 per quality-adjusted life-year gained. Decision-makers should be willing to pay more than €55 000 to achieve a probability of cost-effectiveness >50%. This conclusion is robust to changes in the definition of hospital contacts and reduced intervention costs. Only in the most optimistic scenario combining the effects of all sensitivity analyses, does the incremental cost-effectiveness ratio fall below the UK thresholds values (€21 068 per quality-adjusted life-year). Conclusions Telehealthcare is unlikely to be a cost-effective addition to usual care, if it is offered to all patients with chronic obstructive pulmonary disease and if the willingness-to-pay threshold values from the National Institute for Health and Care Excellence are applied. Trial registration Clinicaltrials.gov, NCT01984840, 14 November 2013. PMID:28515193

  16. 32 CFR 728.23 - Reserve Officers' Training Corps (ROTC).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... training period (practice cruises or field training). (3) Medical, dental, pharmacy, veterinary or science... observation, including participation in service-sponsored sports, recreational, and training activities. (ii...

  17. 32 CFR 728.23 - Reserve Officers' Training Corps (ROTC).

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... training period (practice cruises or field training). (3) Medical, dental, pharmacy, veterinary or science... observation, including participation in service-sponsored sports, recreational, and training activities. (ii...

  18. 32 CFR 728.23 - Reserve Officers' Training Corps (ROTC).

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... training period (practice cruises or field training). (3) Medical, dental, pharmacy, veterinary or science... observation, including participation in service-sponsored sports, recreational, and training activities. (ii...

  19. 32 CFR 728.23 - Reserve Officers' Training Corps (ROTC).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... training period (practice cruises or field training). (3) Medical, dental, pharmacy, veterinary or science... observation, including participation in service-sponsored sports, recreational, and training activities. (ii...

  20. 32 CFR 728.23 - Reserve Officers' Training Corps (ROTC).

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... training period (practice cruises or field training). (3) Medical, dental, pharmacy, veterinary or science... observation, including participation in service-sponsored sports, recreational, and training activities. (ii...

  1. 6 CFR 7.28 - Automatic declassification.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Classification Appeals Panel (ISCAP) for approval. (d) Declassification guides that narrowly and precisely define... years after the date of its original classification with the exception of specific information exempt...

  2. Impacts of plastic film mulching on crop yields, soil water, nitrate, and organic carbon in Northwestern China: A meta-analysis.

    PubMed

    Ma, Dedi; Chen, Lei; Qu, Hongchao; Wang, Yilin; Misselbrook, Tom; Jiang, Rui

    2018-04-01

    In order to increase crop yield in semi-arid and arid areas, plastic film mulching (PFM) is widely used in Northwestern China. To date, many studies have addressed the effects of PFM on soil physical and biochemical properties in rain-fed agriculture in Northwestern China, but the findings of different studies are often contradictory. Therefore, a comprehensive review of the impacts of PFM on soil water content, soil nutrients and food production is needed. We compiled the results of 1278 observations to evaluate the overall effects of PFM on soil water content, the distribution of nitrate and soil organic carbon, and crop yield in rain-fed agriculture in Northwestern China. Our results showed that PFM increased soil moisture and nitrate concentration in topsoils (0-20 cm) by 12.9% and 28.2%, respectively, but slightly decreased (1.8%) soil organic carbon (SOC) content in the 0-10 cm soil layer. PFM significantly increased grain yields by 43.1%, with greatest effect in spring maize (79.4%). When related to cumulative precipitation during the crop growing season, yield increase from PFM was greatest (72.8%) at 200-300 mm, which was attributed to the large increase for spring maize and potato, implying that crop zoning would be beneficial for PFM in this region. When related to N application rate, crop yields benefited most from PFM (80.2%) at 200-300 kg/ha. A cost-benefit analysis indicated that PFM increased economic return by an average of 29.5%, with the best improvement for spring maize (71.1%) and no increase for spring wheat. In conclusion, PFM can significantly increase crop yield and economic return (especially for spring maize) in rain-fed agriculture areas of Northwestern China. Crop zoning is recommended for PFM to achieve the largest economic benefit. However, full account needs to be taken of the environmental impacts relating to N loss, SOC depletion and film pollution to evaluate the sustainability of PFM systems and further research is required to quantify and mitigate these impacts.

  3. The economics of health information technology in medication management: a systematic review of economic evaluations.

    PubMed

    O'Reilly, Daria; Tarride, Jean-Eric; Goeree, Ron; Lokker, Cynthia; McKibbon, K Ann

    2012-01-01

    To conduct a systematic review and synthesis of the evidence surrounding the cost-effectiveness of health information technology (HIT) in the medication process. Peer-reviewed electronic databases and gray literature were searched to identify studies on HIT used to assist in the medication management process. Articles including an economic component were reviewed for further screening. For this review, full cost-effectiveness analyses, cost-utility analyses and cost-benefit analyses, as well as cost analyses, were eligible for inclusion and synthesis. The 31 studies included were heterogeneous with respect to the HIT evaluated, setting, and economic methods used. Thus the data could not be synthesized, and a narrative review was conducted. Most studies evaluated computer decision support systems in hospital settings in the USA, and only five of the studied performed full economic evaluations. Most studies merely provided cost data; however, useful economic data involves far more input. A full economic evaluation includes a full enumeration of the costs, synthesized with the outcomes of the intervention. The quality of the economic literature in this area is poor. A few studies found that HIT may offer cost advantages despite their increased acquisition costs. However, given the uncertainty that surrounds the costs and outcomes data, and limited study designs, it is difficult to reach any definitive conclusion as to whether the additional costs and benefits represent value for money. Sophisticated concurrent prospective economic evaluations need to be conducted to address whether HIT interventions in the medication management process are cost-effective.

  4. Modulation of HepG2 cell net apolipoprotein B secretion by the citrus polymethoxyflavone, tangeretin.

    PubMed

    Kurowska, Elzbieta M; Manthey, John A; Casaschi, Adele; Theriault, Andre G

    2004-02-01

    The purpose of the present study was to examine the role of tangeretin, a polymethoxylated flavone from citrus fruits, on the regulation of apolipoprotein B (apoB) and lipid metabolism in the human hepatoma cell-line HepG2. The marked reduction in apoB secretion observed in cells incubated with 72.8 microM tangeretin was rapid, apoB-specific, and partly reversible. The reduction also was observed under lipid-rich conditions and found to be insensitive to proteasomal degradation of nascent apoB. We followed our study by examining lipid synthesis and mass. A 24-h exposure of cells to 72.8 microM tangeretin decreased intracellular synthesis of cholesteryl esters, free cholesterol, and TAG by 82, 45, and 64%, respectively; tangeretin also reduced the mass of cellular TAG by 37%. The tangeretin-induced suppression of TAG synthesis and mass were associated with decreased activities of DAG acyltransferase (up to -39.0 +/- 3.0% vs. control) and microsomal triglyceride transfer protein (up to -35.5 +/- 2.5% vs. control). Tangeretin was also found to activate the peroxisome proliferator-activated receptor, a transcription factor with a positive regulatory impact on FA oxidation and TAG availability (up to 36% increase vs. control). The data suggest that tangeretin modulates apoB-containing lipoprotein metabolism through multiple mechanisms.

  5. Excess costs of comorbidities in chronic obstructive pulmonary disease: a systematic review.

    PubMed

    Huber, Manuel B; Wacker, Margarethe E; Vogelmeier, Claus F; Leidl, Reiner

    2015-01-01

    Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. Comorbidities are often reported in patients with COPD and may influence the cost of care. Yet, the extent by which comorbidities affect costs remains to be determined. To review, quantify and evaluate excess costs of comorbidities in COPD. Using a systematic review approach, Pubmed and Embase were searched for studies analyzing excess costs of comorbidities in COPD. Resulting studies were evaluated according to study characteristics, comorbidity measurement and cost indicators. Mark-up factors were calculated for respective excess costs. Furthermore, a checklist of quality criteria was applied. Twelve studies were included. Nine evaluated comorbidity specific costs; three examined index-based results. Pneumonia, cardiovascular disease and diabetes were associated with the highest excess costs. The mark-up factors for respective excess costs ranged between 1.5 and 2.5 in the majority of cases. On average the factors constituted a doubling of respective costs in the comorbid case. The main cost driver, among all studies, was inpatient cost. Indirect costs were not accounted for by the majority of studies. Study heterogeneity was high. The reviewed studies clearly show that comorbidities are associated with significant excess costs in COPD. The inclusion of comorbid costs and effects in future health economic evaluations of preventive or therapeutic COPD interventions seems highly advisable.

  6. Excess Costs of Comorbidities in Chronic Obstructive Pulmonary Disease: A Systematic Review

    PubMed Central

    Huber, Manuel B.; Wacker, Margarethe E.; Vogelmeier, Claus F.; Leidl, Reiner

    2015-01-01

    Background Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. Comorbidities are often reported in patients with COPD and may influence the cost of care. Yet, the extent by which comorbidities affect costs remains to be determined. Objectives To review, quantify and evaluate excess costs of comorbidities in COPD. Methods Using a systematic review approach, Pubmed and Embase were searched for studies analyzing excess costs of comorbidities in COPD. Resulting studies were evaluated according to study characteristics, comorbidity measurement and cost indicators. Mark-up factors were calculated for respective excess costs. Furthermore, a checklist of quality criteria was applied. Results Twelve studies were included. Nine evaluated comorbidity specific costs; three examined index-based results. Pneumonia, cardiovascular disease and diabetes were associated with the highest excess costs. The mark-up factors for respective excess costs ranged between 1.5 and 2.5 in the majority of cases. On average the factors constituted a doubling of respective costs in the comorbid case. The main cost driver, among all studies, was inpatient cost. Indirect costs were not accounted for by the majority of studies. Study heterogeneity was high. Conclusions The reviewed studies clearly show that comorbidities are associated with significant excess costs in COPD. The inclusion of comorbid costs and effects in future health economic evaluations of preventive or therapeutic COPD interventions seems highly advisable. PMID:25875204

  7. 32 CFR 728.77 - Secretarial designees.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... license. (ii) A statement attesting to the fact that the sponsoring former spouse achieved 20 or more... members of the Uniformed Services University of Health Sciences (USUHS). They have been provided...

  8. 32 CFR 728.77 - Secretarial designees.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... license. (ii) A statement attesting to the fact that the sponsoring former spouse achieved 20 or more... members of the Uniformed Services University of Health Sciences (USUHS). They have been provided...

  9. 32 CFR 728.4 - Policies.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... texture, configuration, or relationship of contiguous structures of any feature of the human body which... Deficiency Syndrome (AIDS) or Human Immunodeficiency Virus (HIV), use one of the symptoms of the disease as...

  10. 32 CFR 728.4 - Policies.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... texture, configuration, or relationship of contiguous structures of any feature of the human body which... Deficiency Syndrome (AIDS) or Human Immunodeficiency Virus (HIV), use one of the symptoms of the disease as...

  11. 32 CFR 728.77 - Secretarial designees.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... depdendents must include: (i) Full name, social security number, grade or rate, branch or service, and date... members of the Uniformed Services University of Health Sciences (USUHS). They have been provided...

  12. 7 CFR 7.23 - County committee duties.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... § 7.28. There must be no employment discrimination due to race, color, national origin, gender... objectives and operations of the programs administered through the county committee; (6) Make available to...

  13. 7 CFR 7.23 - County committee duties.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... § 7.28. There must be no employment discrimination due to race, color, national origin, gender... objectives and operations of the programs administered through the county committee; (6) Make available to...

  14. 32 CFR 728.77 - Secretarial designees.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... nonbeneficiaries who are donor candidates for an organ or tissue transplant procedure in behalf of a military... Secretary of Defense for Research and Engineering. (x) The Secretaries, Under Secretaries, and the Assistant...

  15. 32 CFR 728.77 - Secretarial designees.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... nonbeneficiaries who are donor candidates for an organ or tissue transplant procedure in behalf of a military... Secretary of Defense for Research and Engineering. (x) The Secretaries, Under Secretaries, and the Assistant...

  16. The economics of health information technology in medication management: a systematic review of economic evaluations

    PubMed Central

    Tarride, Jean-Eric; Goeree, Ron; Lokker, Cynthia; McKibbon, K Ann

    2011-01-01

    Objective To conduct a systematic review and synthesis of the evidence surrounding the cost-effectiveness of health information technology (HIT) in the medication process. Materials and methods Peer-reviewed electronic databases and gray literature were searched to identify studies on HIT used to assist in the medication management process. Articles including an economic component were reviewed for further screening. For this review, full cost-effectiveness analyses, cost-utility analyses and cost-benefit analyses, as well as cost analyses, were eligible for inclusion and synthesis. Results The 31 studies included were heterogeneous with respect to the HIT evaluated, setting, and economic methods used. Thus the data could not be synthesized, and a narrative review was conducted. Most studies evaluated computer decision support systems in hospital settings in the USA, and only five of the studied performed full economic evaluations. Discussion Most studies merely provided cost data; however, useful economic data involves far more input. A full economic evaluation includes a full enumeration of the costs, synthesized with the outcomes of the intervention. Conclusion The quality of the economic literature in this area is poor. A few studies found that HIT may offer cost advantages despite their increased acquisition costs. However, given the uncertainty that surrounds the costs and outcomes data, and limited study designs, it is difficult to reach any definitive conclusion as to whether the additional costs and benefits represent value for money. Sophisticated concurrent prospective economic evaluations need to be conducted to address whether HIT interventions in the medication management process are cost-effective. PMID:21984590

  17. Meta-Analysis

    PubMed Central

    Kale-Pradhan, Pramodini B.; Mariani, Nicholas P.; Wilhelm, Sheila M.; Johnson, Leonard B.

    2015-01-01

    Background: Vancomycin is used to treat serious infections caused by methicillin-resistant Staphylococcus aureus (MRSA). It is unclear whether MRSA isolates with minimum inhibitory concentration (MIC) 1.5 to 2 µg/mL are successfully treated with vancomycin. Objective: Evaluate vancomycin failure rates in MRSA bacteremia with an MIC <1.5 versus ≥1.5 µg/mL, and MIC ≤1 versus ≥2 µg/mL. Methods: A literature search was conducted using MESH terms vancomycin, MRSA, bacteremia, MIC, treatment and vancomycin failure to identify human studies published in English. All studies of patients with MRSA bacteremia treated with vancomycin were included if they evaluated vancomycin failures, defined as mortality, and reported associated MICs determined by E-test. Study sample size, vancomycin failure rates, and corresponding MIC values were extracted and analyzed using RevMan 5.2.5. Results: Thirteen studies including 2955 patients met all criteria. Twelve studies including 2861 patients evaluated outcomes using an MIC cutoff of 1.5 µg/mL. A total of 413 of 1186 (34.8%) patients with an MIC <1.5 and 531 of 1675 (31.7%) patients with an MIC of ≥1.5 µg/mL experienced treatment failure (odds ratio = 0.72, 95% confidence interval = 0.49-1.04, P = .08). Six studies evaluated 728 patients using the cutoffs of ≤1 and ≥2 µg/mL. A total of 384 patients had isolates with MIC ≤1 µg/mL, 344 had an MIC ≥2 µg/mL. Therapeutic failure occurred in 87 and 102 patients, respectively (odds ratio = 0.61, 95% confidence interval = 0.34-1.10, P = .10). As heterogeneity between the studies was high, a random-effects model was used. Conclusion: Vancomycin MIC may not be an optimal sole indicator of vancomycin treatment failure in MRSA bacteremia.

  18. Economic evaluation of emergency obstetric care training: a systematic review.

    PubMed

    Banke-Thomas, Aduragbemi; Wilson-Jones, Megan; Madaj, Barbara; van den Broek, Nynke

    2017-12-04

    Training healthcare providers in Emergency Obstetric Care (EmOC) has been shown to be effective in improving their capacity to provide this critical care package for mothers and babies. However, little is known about the costs and cost-effectiveness of such training. Understanding costs and cost-effectiveness is essential in guaranteeing value-for-money in healthcare spending. This study systematically reviewed the available literature on cost and cost-effectiveness of EmOC trainings. Peer-reviewed and grey literature was searched for relevant papers published after 1990. Studies were included if they described an economic evaluation of EmOC training and the training cost data were available. Two reviewers independently searched, screened, and selected studies that met the inclusion criteria, with disagreements resolved by a third reviewer. Quality of studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards statement. For comparability, all costs in local currency were converted to International dollar (I$) equivalents using purchasing power parity conversion factors. The cost per training per participant was calculated. Narrative synthesis was used to summarise the available evidence on cost effectiveness. Fourteen studies (five full and nine partial economic evaluations) met the inclusion criteria. All five and two of the nine partial economic evaluations were of high quality. The majority of studies (13/14) were from low- and middle-income countries. Training equipment, per diems and resource person allowance were the most expensive components. Cost of training per person per day ranged from I$33 to I$90 when accommodation was required and from I$5 to I$21 when training was facility-based. Cost-effectiveness of training was assessed in 5 studies with differing measures of effectiveness (knowledge, skills, procedure cost and lives saved) making comparison difficult. Economic evaluations of EmOC training are limited. There is a need to scale-up and standardise processes that capture both cost and effectiveness of training and to agree on suitable economic evaluation models that allow for comparability across settings. PROSPERO_CRD42016041911 .

  19. Utilization of Physical Therapy Intervention Among Patients With Plantar Fasciitis in the United States.

    PubMed

    Fraser, John J; Glaviano, Neal R; Hertel, Jay

    2017-02-01

    Study Design Retrospective observational study. Background Plantar fasciitis is responsible for 1 million ambulatory patient care visits annually in the United States. Few studies have investigated practice patterns in the treatment of patients with plantar fasciitis. Objective To assess physical therapist utilization and employment of manual therapy and supervised rehabilitation in the treatment of patients with plantar fasciitis. Methods A retrospective review of the PearlDiver patient record database was used to evaluate physical therapist utilization and use of manual therapy and supervised rehabilitation in patients with plantar fasciitis between 2007 and 2011. An International Classification of Diseases code (728.71) was used to identify plantar fasciitis, and Current Procedural Terminology codes were used to identify evaluations (97001), manual therapy (97140), and rehabilitation services (97110, 97530, 97112). Results A total of 819 963 unique patients diagnosed with plantar fasciitis accounted for 5 739 737 visits from 2007 to 2011, comprising 2.7% of all patients in the database. Only 7.1% (95% confidence interval: 7.0%, 7.1%) of patients received a physical therapist evaluation. Of the 57 800 patients evaluated by a physical therapist (59.8% female), 50 382 (87.2% ± 0.4%) received manual therapy, with significant increases in utilization per annum. A large proportion (89.5% ± 0.4%) received rehabilitation following physical therapist evaluation. Conclusion Despite plantar fasciitis being a frequently occurring musculoskeletal condition, a small proportion of patients with plantar fasciitis were seen by physical therapists. Most patients who were evaluated by a physical therapist received manual therapy and a course of supervised rehabilitation as part of their plan of care. Level of Evidence Treatment, level 2a. J Orthop Sports Phys Ther 2017;47(2):49-55. doi:10.2519/jospt.2017.6999.

  20. Cost of epilepsy: a systematic review.

    PubMed

    Strzelczyk, Adam; Reese, Jens Peter; Dodel, Richard; Hamer, Hajo M

    2008-01-01

    The objective of this review was to overview published cost-of-illness (COI) studies of epilepsy and their methodological approaches. Epilepsy imposes a substantial burden on individuals and society as a whole. The mean prevalence of epilepsy is estimated at 0.52% in Europe, 0.68% in the US, and peaks up to 1.5% in developing countries. Estimation of the economic burden of epilepsy is of pivotal relevance to enable a rational distribution of healthcare resources. This is especially so with the introduction of the newer antiepileptic drugs (AEDs), the marketing of vagal-nerve stimulators and the resurgence of new surgical treatment options, which have the potential to considerably increase the costs of treating epilepsy.A systematic literature review was performed to identify studies that evaluated direct and indirect costs of epilepsy. Using a standardized assessment form, information on the study design, methodological framework and data sources were extracted from each publication and systematically reported. We identified 22 studies worldwide on costs of epilepsy. The majority of the studies reflected the costs of epilepsy in Europe (three studies each for the UK and Italy, one study each for Germany, the Netherlands, Switzerland, France and the EU) and the US (four studies), but studies were also available from India (two), Hong Kong, Oman, Burundi, Chile and Mexico. The studies utilized different frameworks to evaluate costs. All used a bottom-up approach; however, only 12 studies (55%) evaluated direct as well as indirect costs. The range for the mean annual direct costs lay between 40 International Dollar purchasing power parities (PPP-$) in rural Burundi and PPP-$4748 (adjusted to 2006 values) in a German epilepsy centre. Recent studies suggest AEDs are becoming the main contributor to direct costs. The mean indirect costs ranged between 12% and 85% of the total annual costs. Epilepsy is a cost-intensive disorder. A reliable comparison of the different COI studies in epilepsy is not easily feasible, as the evaluated studies show substantial methodological differences with respect to their patient selection criteria, diagnostic stratifications and evaluated costs. Therefore, there is an urgent need for studies that evaluate direct and indirect costs in a standardized fashion.

  1. Preliminary evaluation of glass resin materials for solar cell cover use. [on spacecraft

    NASA Technical Reports Server (NTRS)

    Marsik, S. J.; Swartz, C. K.; Baraona, C. R.

    1978-01-01

    Silicon solar cells and silicon wafers coated with a heat-curable resin consisting of alternating Si-O atoms were subjected to three tests to evaluate the potential utility of this coating in space environments. These included UV irradiation in vacuum at an intensity of 10 air mass zero UV energy-equivalent solar constants for 728 hours followed by a long thermal cycle; 15 thermal shock cycles between 100 C and minus 196 C; and high temperature and humidity (65 C at 90% relative humidity). The UV tests resulted in a 8 to 24% loss in short-circuit current and darkening of the covers. Modification of the resin to provide a better match between the coefficients of expansion of the resin and silicon improved resistance to thermal shock, but also increased the darkening effect under UV irradiation. Silicon wafers coated with the resin were not adversely affected by the temperature/humidity test.

  2. The impact of an emergency fee increase on the composition of patients visiting emergency departments.

    PubMed

    Jung, Hyemin; Do, Young Kyung; Kim, Yoon; Ro, Junsoo

    2014-11-01

    This study aimed to test our hypothesis that a raise in the emergency fee implemented on March 1, 2013 has increased the proportion of patients with emergent symptoms by discouraging non-urgent emergency department visits. We conducted an analysis of 728 736 patients registered in the National Emergency Department Information System who visited level 1 and level 2 emergency medical institutes in the two-month time period from February 1, 2013, one month before the raise in the emergency fee, to March 31, 2013, one month after the raise. A difference-in-difference method was used to estimate the net effects of a raise in the emergency fee on the probability that an emergency visit is for urgent conditions. The percentage of emergency department visits in urgent or equivalent patients increased by 2.4% points, from 74.2% before to 76.6% after the policy implementation. In a group of patients transferred using public transport or ambulance, who were assumed to be least conscious of cost, the change in the proportion of urgent patients was not statistically significant. On the other hand, the probability that a group of patients directly presenting to the emergency department by private transport, assumed to be most conscious of cost, showed a 2.4% point increase in urgent conditions (p<0.001). This trend appeared to be consistent across the level 1 and level 2 emergency medical institutes. A raise in the emergency fee implemented on March 1, 2013 increased the proportion of urgent patients in the total emergency visits by reducing emergency department visits by non-urgent patients.

  3. 77 FR 61789 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Workforce...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-11

    ... Programs Gold Standard Evaluation Follow-Up Surveys, Veterans Study, and Cost Data,'' to the Office of... Standard Evaluation Follow-Up Surveys, Veterans Study, and Cost Data ACTION: Notice. SUMMARY: The... Worker Programs Gold Standard Evaluation Follow-Up Surveys, Veterans Study, and Cost Data. OMB ICR...

  4. 32 CFR 728.57 - Department of State and associated agencies.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    .... Furnish reports per the letter of authorization. (5) Immunizations. Inoculations and vaccinations are... vaccination required and will state that the individual is entitled to services at the expense of the...

  5. 32 CFR 728.57 - Department of State and associated agencies.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    .... Furnish reports per the letter of authorization. (5) Immunizations. Inoculations and vaccinations are... vaccination required and will state that the individual is entitled to services at the expense of the...

  6. 32 CFR 728.57 - Department of State and associated agencies.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    .... Furnish reports per the letter of authorization. (5) Immunizations. Inoculations and vaccinations are... vaccination required and will state that the individual is entitled to services at the expense of the...

  7. 32 CFR 728.78 - American Red Cross representatives and their dependents.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Other Persons... those requiring domiciliary care. Routine dental care, other than dental prosthesis and orthodontia, is...

  8. 32 CFR 728.78 - American Red Cross representatives and their dependents.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Other Persons... those requiring domiciliary care. Routine dental care, other than dental prosthesis and orthodontia, is...

  9. 32 CFR 728.78 - American Red Cross representatives and their dependents.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Other Persons... those requiring domiciliary care. Routine dental care, other than dental prosthesis and orthodontia, is...

  10. 32 CFR 728.78 - American Red Cross representatives and their dependents.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Other Persons... those requiring domiciliary care. Routine dental care, other than dental prosthesis and orthodontia, is...

  11. 32 CFR 728.57 - Department of State and associated agencies.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    .... Furnish reports per the letter of authorization. (5) Immunizations. Inoculations and vaccinations are... vaccination required and will state that the individual is entitled to services at the expense of the...

  12. Economic evaluations and randomized trials in spinal disorders: principles and methods.

    PubMed

    Korthals-de Bos, Ingeborg; van Tulder, Maurits; van Dieten, Hiske; Bouter, Lex

    2004-02-15

    Descriptive methodologic recommendations. To help researchers designing, conducting, and reporting economic evaluations in the field of back and neck pain. Economic evaluations of both existing and new therapeutic interventions are becoming increasingly important. There is a need to improve the methods of economic evaluations in the field of spinal disorders. To improve the methods of economic evaluations in the field of spinal disorders, this article describes the various steps in an economic evaluation, using as example a study on the cost-effectiveness of manual therapy, physiotherapy, and usual care provided by the general practitioner for patients with neck pain. An economic evaluation is a study in which two or more interventions are systematically compared with regard to both costs and effects. There are four types of economic evaluations, based on analysis of: (1) cost-effectiveness, (2) cost-utility, (3) cost-minimization, and (4) cost-benefit. The cost-utility analysis is a special case of cost-effectiveness analysis. The first step in all these economic evaluations is to identify the perspective of the study. The choice of the perspective will have consequences for the identification of costs and effects. Secondly, the alternatives that will be compared should be identified. Thirdly, the relevant costs and effects should be identified. Economic evaluations are usually performed from a societal perspective and include consequently direct health care costs, direct nonhealth care costs, and indirect costs. Fourthly, effect data are collected by means of questionnaires or interviews, and relevant cost data with regard to effect measures and health care utilization, work absenteeism, travel expenses, use of over-the-counter medication, and help from family and friends, are collected by means of cost diaries, questionnaires, or (telephone) interviews. Fifthly, real costs are calculated, or the costs are estimated on the basis of real costs, guideline prices, or tariffs. Finally, in the statistical analysis the mean direct, indirect, and total costs of the alternatives are compared, using bootstrapping techniques. Incremental cost-effectiveness ratios are graphically presented on a cost-effectiveness plane and acceptability curves are calculated. Economic evaluations require specific methods. These recommendations may be helpful in improving the quality of economic evaluations of new and existing therapeutic interventions in the field of spinal disorders.

  13. VizieR Online Data Catalog: Spectral properties of 441 radio pulsars (Jankowski+, 2018)

    NASA Astrophysics Data System (ADS)

    Jankowski, F.; van Straten, W.; Keane, E. F.; Bailes, M.; Barr, E. D.; Johnston, S.; Kerr, M.

    2018-03-01

    We present spectral parameters for 441 radio pulsars. These were obtained from observations centred at 728, 1382 and 3100MHz using the 10-50cm and the 20cm multibeam receiver at the Parkes radio telescope. In particular, we list the pulsar names (J2000), the calibrated, band-integrated flux densities at 728, 1382 and 3100MHz, the spectral classifications, the frequency ranges the spectral classifications were performed over, the spectral indices for pulsars with simple power-law spectra and the robust modulation indices at all three centre frequencies for pulsars of which we have at least six measurement epochs. The flux density uncertainties include scintillation and a systematic contribution, in addition to the statistical uncertainty. Upper limits are reported at the 3σ level and all other uncertainties at the 1σ level. (1 data file).

  14. iCBLS: An interactive case-based learning system for medical education.

    PubMed

    Ali, Maqbool; Han, Soyeon Caren; Bilal, Hafiz Syed Muhammad; Lee, Sungyoung; Kang, Matthew Jee Yun; Kang, Byeong Ho; Razzaq, Muhammad Asif; Amin, Muhammad Bilal

    2018-01-01

    Medical students should be able to actively apply clinical reasoning skills to further their interpretative, diagnostic, and treatment skills in a non-obtrusive and scalable way. Case-Based Learning (CBL) approach has been receiving attention in medical education as it is a student-centered teaching methodology that exposes students to real-world scenarios that need to be solved using their reasoning skills and existing theoretical knowledge. In this paper, we propose an interactive CBL System, called iCBLS, which supports the development of collaborative clinical reasoning skills for medical students in an online environment. The iCBLS consists of three modules: (i) system administration (SA), (ii) clinical case creation (CCC) with an innovative semi-automatic approach, and (iii) case formulation (CF) through intervention of medical students' and teachers' knowledge. Two evaluations under the umbrella of the context/input/process/product (CIPP) model have been performed with a Glycemia study. The first focused on the system satisfaction, evaluated by 54 students. The latter aimed to evaluate the system effectiveness, simulated by 155 students. The results show a high success rate of 70% for students' interaction, 76.4% for group learning, 72.8% for solo learning, and 74.6% for improved clinical skills. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Maintaining persistence and adherence with subcutaneous growth-hormone therapy in children: comparing jet-delivery and needle-based devices

    PubMed Central

    Spoudeas, Helen A; Bajaj, Priti; Sommerford, Nathan

    2014-01-01

    Purpose Persistence and adherence with subcutaneous growth hormone (GH; somatropin) therapy in children is widely acknowledged to be suboptimal. This study aimed to investigate how the use of a jet-delivery device, ZomaJet®, impacts on medication-taking behaviors compared to needle-based devices. Materials and methods A retrospective cohort study of children aged ≤18 years was conducted using a UK-based, nationwide database of GH home-delivery schedules. Data were evaluated for the period between January 2010 and December 2012 for 6,061 children receiving either Zomacton® (somatropin) via the ZomaJet jet-delivery device or one of six brands of GH all administered via needle-based devices. Persistence was analyzed for patients with appropriate data, measured as the time interval between first and last home deliveries. An analysis of adherence was conducted only for patients using ZomaJet who had appropriate data, measured by proportion of days covered. Brand switches were identified for all patients. Results Persistence with GH therapy was significantly longer in patients using ZomaJet compared to needle-based devices (599 days versus 535 days, respectively, n=4,093; P<0.001); this association was observed in both sexes and across age subgroups (≤10 and 11–16 years). The majority (58%) of patients using ZomaJet were classed as adherent (n=728). Only 297 patients (5%) switched GH brand (n=6,061), and patients tended to use ZomaJet for longer than other devices before switching. Conclusion It appears important that the choice of a jet-delivery device is offered to children prescribed daily GH therapy. These devices may represent a much-needed effective strategy for maintaining persistence with subcutaneous GH administration in children, potentially offering better clinical outcomes and greater cost-efficiency. PMID:25258519

  16. Smoke in the Looking Glass: Effects of Discordance between Self- and Peer Rated Crowd Affiliation on Adolescent Anxiety, Depression and Self-Feelings

    ERIC Educational Resources Information Center

    Brown, B. Bradford; Von Bank, Heather; Steinberg, Laurence

    2008-01-01

    Peer crowds serve as an identity marker for adolescents, indicating their image and status among peers; but adolescents do not always endorse peer appraisals of crowd affiliation. We report on two studies--one with 924 adolescents in grades 7-12 and a second with a more diverse population of 2,728 students in grades 9-11, followed for 2…

  17. The Costs and Benefits of Substance Abuse Treatment: Findings from the National Treatment Improvement Evaluation Study (NTIES).

    ERIC Educational Resources Information Center

    Koenig, Lane; Denmead, Gabrielle; Nguyen, Robert; Harrison, Margaret; Harwood, Henrick

    This study seeks to quantify the costs and benefits of alcohol and drug abuse treatment and the resulting economic benefits to society. Using data from the National Treatment Improvement Evaluation Study (NTIES), and client questionnaires, estimates were made of the average costs per client in terms of crime-related costs, health care costs, and…

  18. Southern pulpwood production, 1961

    Treesearch

    Vernon L. Robinson; Agnes C. Nichols

    1962-01-01

    Southern pulpwood production reached 24,230,728 cords in 1961--60 percent of the Nations total. Significant increases were noted in the consumption of hardwood and residues. But pine roundwood remained virtually unchanged for the third consecutive year.

  19. Alabama rail directory 2001

    DOT National Transportation Integrated Search

    2002-01-01

    The State of Alabama is crisscrossed by some 4,728 miles rail lines hauling 93.5 million tons of cargo annually. This directory, Alabama's first comprehensive rail directory, provides a range of information regarding railroads operating in the state,...

  20. 32 CFR 728.24 - Navy and Marine Corps Officer Candidate Programs.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Members of... Reserve Officers Candidate Program and Platoon Leaders Class are entitled to the same medical and dental...

  1. Protective activity and immunogenicity of two recombinant anthrax vaccines for veterinary use.

    PubMed

    Fasanella, A; Tonello, F; Garofolo, G; Muraro, L; Carattoli, A; Adone, R; Montecucco, C

    2008-10-23

    In this study, the efficacy of two experimental vaccines against Bacillus anthracis toxinaemia was evaluated in the rabbit model. A recombinant Protective Antigen (rPA) mutant and a trivalent vaccine (TV) composed by the rPA, a inactive mutant of Lethal Factor (mLF-Y728A; E735A) and a inactive mutant of Edema Factor (mEF-K346R), both emulsified with mineral oils, were evaluated for their immunogenicity and protective activity in New Zealand white rabbits. Rabbits vaccinated subcutaneously with rPA and TV rapidly produced high level of anti-PA, anti-LF and anti-EF antibodies, which were still present 6 months later. In the efficacy test, these vaccines protected 100% of rabbits challenged with B. anthracis virulent strain 0843 one week after the vaccination. Moreover, all animals vaccinated twice with rPA and TV, resisted B. anthracis infection 6 months later. Our data indicate that rPA and TV could be good vaccine candidates for inducing protection against B. anthracis infection in target animal host. They could successfully be used in an emergency with simultaneous long-acting antibiotics to halt incubating infections or during an anthrax epidemic.

  2. Automated array assembly

    NASA Technical Reports Server (NTRS)

    Williams, B. F.

    1976-01-01

    Manufacturing techniques are evaluated using expenses based on experience and studying basic cost factors for each step to evaluate expenses from a first-principles point of view. A formal cost accounting procedure is developed which is used throughout the study for cost comparisons. The first test of this procedure is a comparison of its predicted costs for array module manufacturing with costs from a study which is based on experience factors. A manufacturing cost estimate for array modules of $10/W is based on present-day manufacturing techniques, expenses, and materials costs.

  3. Post-traumatic in situ fusion after calcaneal fractures: a retrospective study with 7-28 years follow-up.

    PubMed

    Ågren, Per-Henrik; Tullberg, Tycho; Mukka, Sebastian; Wretenberg, Per; Sayed-Noor, Arkan S

    2015-03-01

    In situ fusion as salvage operation after calcaneal fractures has been used. In this retrospective investigation, a group of in situ fused patients is analyzed with long-term follow-up. Twenty-nine patients with in situ single or multiple fusions performed between 1970 and 1990 were included. In 1998 these patients were examined with plain radiographs and computerized tomography (CT) scan of the affected foot. Also, a visual analogue score (VAS) for calcaneal fractures, short form health survey (SF-36), Olerud Molander score and American Orthopaedic Foot and Ankle society (AOFAS) hindfoot score were evaluated. The plain radiographs and CT scan showed severe remaining deformities in these patients. The outcome parameters were generally poor and correlated to the degree of remaining deformity. Simple in situ fusion, without consideration of the deformity at hand, after a calcaneal fracture is not an adequate treatment and generally associated with poor outcome. Copyright © 2014 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  4. The use of cost per life year gained as a measurement of cost-effectiveness in Spain: a systematic review of recent publications.

    PubMed

    Rodríguez Barrios, José Manuel; Pérez Alcántara, Ferran; Crespo Palomo, Carlos; González García, Paloma; Antón De Las Heras, Enrique; Brosa Riestra, Max

    2012-12-01

    The objective of this study was to evaluate the methodological characteristics of cost-effectiveness evaluations carried out in Spain, since 1990, which include LYG as an outcome to measure the incremental cost-effectiveness ratio. A systematic review of published studies was conducted describing their characteristics and methodological quality. We analyse the cost per LYG results in relation with a commonly accepted Spanish cost-effectiveness threshold and the possible relation with the cost per quality adjusted life year (QALY) gained when they both were calculated for the same economic evaluation. A total of 62 economic evaluations fulfilled the selection criteria, 24 of them including the cost per QALY gained result as well. The methodological quality of the studies was good (55%) or very good (26%). A total of 124 cost per LYG results were obtained with a mean ratio of 49,529 and a median of 11,490 (standard deviation of 183,080). Since 2003, a commonly accepted Spanish threshold has been referenced by 66% of studies. A significant correlation was found between the cost per LYG and cost per QALY gained results (0.89 Spearman-Rho, 0.91 Pearson). There is an increasing interest for economic health care evaluations in Spain, and the quality of the studies is also improving. Although a commonly accepted threshold exists, further information is needed for decision-making as well as to identify the relationship between the costs per LYG and per QALY gained.

  5. An Evaluation of the Cost Effectiveness of Alternative Compensatory Reading Programs, Volume IV: Cost Analysis of Summer Programs. Final Report.

    ERIC Educational Resources Information Center

    Al-Salam, Nabeel; Flynn, Donald L.

    This report describes the results of a study of the cost and cost effectiveness of 27 summer reading programs, carried through as part of a large-scale evaluation of compensatory reading programs. Three other reports describe cost and cost-effectiveness studies of programs during the regular school year. On an instructional-hour basis, the total…

  6. Mapping the Diagnosis Axis of an Interface Terminology to the NANDA International Taxonomy

    PubMed Central

    Juvé Udina, Maria-Eulàlia; Gonzalez Samartino, Maribel; Matud Calvo, Cristina

    2012-01-01

    Background. Nursing terminologies are designed to support nursing practice but, as with any other clinical tool, they should be evaluated. Cross-mapping is a formal method for examining the validity of the existing controlled vocabularies. Objectives. The study aims to assess the inclusiveness and expressiveness of the nursing diagnosis axis of a newly implemented interface terminology by cross-mapping with the NANDA-I taxonomy. Design/Methods. The study applied a descriptive design, using a cross-sectional, bidirectional mapping strategy. The sample included 728 concepts from both vocabularies. Concept cross-mapping was carried out to identify one-to-one, negative, and hierarchical connections. The analysis was conducted using descriptive statistics. Results. Agreement of the raters' mapping achieved 97%. More than 60% of the nursing diagnosis concepts in the NANDA-I taxonomy were mapped to concepts in the diagnosis axis of the new interface terminology; 71.1% were reversely mapped. Conclusions. Main results for outcome measures suggest that the diagnosis axis of this interface terminology meets the validity criterion of cross-mapping when mapped from and to the NANDA-I taxonomy. PMID:22830046

  7. Mapping the Diagnosis Axis of an Interface Terminology to the NANDA International Taxonomy.

    PubMed

    Juvé Udina, Maria-Eulàlia; Gonzalez Samartino, Maribel; Matud Calvo, Cristina

    2012-01-01

    Background. Nursing terminologies are designed to support nursing practice but, as with any other clinical tool, they should be evaluated. Cross-mapping is a formal method for examining the validity of the existing controlled vocabularies. Objectives. The study aims to assess the inclusiveness and expressiveness of the nursing diagnosis axis of a newly implemented interface terminology by cross-mapping with the NANDA-I taxonomy. Design/Methods. The study applied a descriptive design, using a cross-sectional, bidirectional mapping strategy. The sample included 728 concepts from both vocabularies. Concept cross-mapping was carried out to identify one-to-one, negative, and hierarchical connections. The analysis was conducted using descriptive statistics. Results. Agreement of the raters' mapping achieved 97%. More than 60% of the nursing diagnosis concepts in the NANDA-I taxonomy were mapped to concepts in the diagnosis axis of the new interface terminology; 71.1% were reversely mapped. Conclusions. Main results for outcome measures suggest that the diagnosis axis of this interface terminology meets the validity criterion of cross-mapping when mapped from and to the NANDA-I taxonomy.

  8. 7 CFR 58.728 - Cooking the batch.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946 AND THE EGG PRODUCTS INSPECTION ACT (CONTINUED) GRADING AND INSPECTION...

  9. 7 CFR 58.728 - Cooking the batch.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946 AND THE EGG PRODUCTS INSPECTION ACT (CONTINUED) GRADING AND INSPECTION...

  10. 7 CFR 58.728 - Cooking the batch.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946 AND THE EGG PRODUCTS INSPECTION ACT (CONTINUED) GRADING AND INSPECTION...

  11. 7 CFR 58.728 - Cooking the batch.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946 AND THE EGG PRODUCTS INSPECTION ACT (CONTINUED) GRADING AND INSPECTION...

  12. 36 CFR 7.28 - Olympic National Park.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., spoons, blades, flashers, or like attractions, or with more than one rudder, or more than two hooks... either that it is: (A) Reasonable and necessary for the conservation of a run as those terms are used by...

  13. 36 CFR 7.28 - Olympic National Park.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., spoons, blades, flashers, or like attractions, or with more than one rudder, or more than two hooks... either that it is: (A) Reasonable and necessary for the conservation of a run as those terms are used by...

  14. 36 CFR 7.28 - Olympic National Park.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ..., spoons, blades, flashers, or like attractions, or with more than one rudder, or more than two hooks... either that it is: (A) Reasonable and necessary for the conservation of a run as those terms are used by...

  15. 36 CFR 7.28 - Olympic National Park.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., spoons, blades, flashers, or like attractions, or with more than one rudder, or more than two hooks... either that it is: (A) Reasonable and necessary for the conservation of a run as those terms are used by...

  16. 36 CFR 7.28 - Olympic National Park.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., spoons, blades, flashers, or like attractions, or with more than one rudder, or more than two hooks... either that it is: (A) Reasonable and necessary for the conservation of a run as those terms are used by...

  17. 77 FR 28591 - Combined Notice of Filings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-15

    ... Due: 5 p.m. ET 5/21/12. Docket Numbers: RP12-728-000. Applicants: Leaf River Energy Center LLC. Description: Leaf River Energy Center LLC--Proposed Revisions to FERC Gas Tariff to be effective 6/7/2012...

  18. A systematic review assessing the economic impact of sildenafil citrate (Viagra) in the treatment of erectile dysfunction.

    PubMed

    Martin, Amber L; Huelin, Rachel; Wilson, David; Foster, Talia S; Mould, Joaquin F

    2013-05-01

    Sildenafil was the first oral phosphodiesterase type 5 (PDE5) inhibitor introduced as primary therapy for erectile dysfunction (ED). In the 7 years following its market launch, sildenafil was prescribed by more than 750,000 physicians to more than 23 million men worldwide. To date, few studies have evaluated the economic impact of sildenafil in treating ED. To evaluate the cost-effectiveness and impact of sildenafil on health care costs for patients with ED in multiple countries. Economic outcomes including cost, cost-effectiveness, cost of illness, cost consequence, resource use, productivity, work loss, and willingness to pay (WTP) were investigated. Using keywords related to economic outcomes and sildenafil, we systematically searched literature published between July 2001 and July 2011 using MEDLINE and EMBASE. Included articles pertained to costs, WTP, and economic evaluations. In the last 10 years, 12 studies assessed economic outcomes associated with sildenafil for ED. Most studies were conducted in the United States and the United Kingdom, with one study identified in Canada and one from Mexico. Six studies evaluated cost of illness, cost consequence, or cost of care, and four studies evaluated WTP or drug pricing by country in the United States and the United Kingdom. In the United States and the United Kingdom, costs to health care systems have increased with demand for treatment. Cost analyses suggested that sildenafil would lower direct costs compared with other PDE5 inhibitors. U.S. and U.K. studies found that patients exhibited WTP for sildenafil. The two cost-effectiveness models we identified examined ED sub-groups, those with spinal cord injury and those with diabetes or hypertension. These models indicated favorable cost-effectiveness profiles for sildenafil compared with other active-treatment options in both Mexico and Canada. The relative value of sildenafil vs. surgically implanted prosthetic devices and other PDE5 inhibitors, is underscored by patients' WTP, and cost-effectiveness in ED patients with comorbidities. © 2013 International Society for Sexual Medicine.

  19. Direct, indirect and intangible costs of acute hand and wrist injuries: A systematic review.

    PubMed

    Robinson, Luke Steven; Sarkies, Mitchell; Brown, Ted; O'Brien, Lisa

    2016-12-01

    Injuries sustained to the hand and wrist are common, accounting for 20% of all emergency presentations. The economic burden of these injuries, comprised of direct (medical expenses incurred), indirect (value of lost productivity) and intangible costs, can be extensive and rise sharply with the increase of severity. This paper systematically reviews cost-of-illness studies and health economic evaluations of acute hand and wrist injuries with a particular focus on direct, indirect and intangible costs. It aims to provide economic cost estimates of burden and discuss the cost components used in international literature. A search of cost-of-illness studies and health economic evaluations of acute hand and wrist injuries in various databases was conducted. Data extracted for each included study were: design, population, intervention, and estimates and measurement methodologies of direct, indirect and intangible costs. Reported costs were converted into US-dollars using historical exchange rates and then adjusted into 2015 US-dollars using an inflation calculator RESULTS: The search yielded 764 studies, of which 21 met the inclusion criteria. Twelve studies were cost-of-illness studies, and seven were health economic evaluations. The methodology used to derive direct, indirect and intangible costs differed markedly across all studies. Indirect costs represented a large portion of total cost in both cost-of-illness studies [64.5% (IQR 50.75-88.25)] and health economic evaluations [68% (IQR 49.25-73.5)]. The median total cost per case of all injury types was US$6951 (IQR $3357-$22,274) for cost-of-illness studies and US$8297 (IQR $3858-$33,939) for health economic evaluations. Few studies reported intangible cost data associated with acute hand and wrist injuries. Several studies have attempted to estimate the direct, indirect and intangible costs associated with acute hand and wrist injuries in various countries using heterogeneous methodologies. Estimates of the economic costs of different acute hand and wrist injuries varied greatly depending on the study methodology, however, by any standards, these injuries should be considered a substantial burden on the individual and society. Further research using standardised methodologies could provide guidance to relevant policy makers on how to best distribute limited resources by identifying the major disorders and exposures resulting in the largest burden. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Implementation and optimization of automated dispensing cabinet technology.

    PubMed

    McCarthy, Bryan C; Ferker, Michael

    2016-10-01

    A multifaceted automated dispensing cabinet (ADC) optimization initiative at a large hospital is described. The ADC optimization project, which was launched approximately six weeks after activation of ADCs in 30 patient care unit medication rooms of a newly established adult hospital, included (1) adjustment of par inventory levels (desired on-hand quantities of medications) and par reorder quantities to reduce the risk of ADC supply exhaustion and improve restocking efficiency, (2) expansion of ADC "common stock" (medications assigned to ADC inventories) to increase medication availability at the point of care, and (3) removal of some infrequently prescribed medications from ADCs to reduce the likelihood of product expiration. The purpose of the project was to address organizational concerns regarding widespread ADC medication stockouts, growing reliance on cart-fill medication delivery systems, and suboptimal medication order turnaround times. Leveraging of the ADC technology platform's reporting functionalities for enhanced inventory control yielded a number of benefits, including cost savings resulting from reduced pharmacy technician labor requirements (estimated at $2,728 annually), a substantial reduction in the overall weekly stockout percentage (from 3.2% before optimization to 0.5% eight months after optimization), an improvement in the average medication turnaround time, and estimated cost avoidance of $19,660 attributed to the reduced potential for product expiration. Efforts to optimize ADCs through par level optimization, expansion of common stock, and removal of infrequently used medications reduced pharmacy technician labor, decreased stockout percentages, generated opportunities for cost avoidance, and improved medication turnaround times. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  1. Retrospective database analysis of the impact of prior authorization for type 2 diabetes medications on health care costs in a Medicare Advantage Prescription Drug Plan population.

    PubMed

    Bergeson, Joette Gdovin; Worley, Karen; Louder, Anthony; Ward, Melea; Graham, John

    2013-06-01

    Health plans and pharmacy benefit managers have implemented utilization management strategies for newer type 2 diabetes mellitus (T2DM) medications to control pharmacy expenditures. Little is known about the impact of utilization management strategies on overall health care costs and subsequent use of T2DM medications among members who request, but do not receive, a T2DM medication requiring prior authorization (PA).  To examine the relationship between the receipt of a T2DM medication requiring PA, health care costs, and subsequent treatment for T2DM.  A retrospective cohort study using pharmacy, medical, and laboratory claims data was conducted among Medicare Advantage Prescription Drug plan members with a denied claim for a T2DM medication requiring PA (sitagliptin, a dipeptidyl peptidase-4 inhibitor [DPP-4i], and exenatide, an incretin mimetic) between January 1, 2008, and June 30, 2009. Subjects were required to have 12 months of continuous enrollment both before and after the index date. The entire study period was 24 months in duration, including a 12-month pre-index and 12-month post-index period. Three cohorts were identified: 1 that received a medication requiring PA (denied claim, subsequent fill) and 2 nonfilling control groups. Both control groups requested a medication requiring PA, as evidenced by the denied claim, but neither received the medication, either because the medication was not authorized or the member chose not to fill. Claims-based estimates were used to infer whether the individual likely met the criteria for PA, with 1 control group designated as having met the claims-based criteria (qualifying nonfilling cohort) and the other not having done so (nonqualifying nonfilling cohort.) The primary endpoint evaluated was the relationship between PA medication fill status and plan-paid costs (medical [including laboratory] and pharmacy) over the 12-month post-denial period, with generalized linear models adjusting for key covariates including demographics, concomitant medications, pre-index costs, pre-index adherence, and comorbidities. The secondary endpoint of T2DM medication use (post-denial) among the 2 nonfilling control groups was also evaluated.  There were 1,728 members identified who received medication for T2DM requiring PA (the received authorization cohort) and 2,373 who did not (606 qualifying nonfilling cohort; 1,767 nonqualifying nonfilling cohort.) Cohorts were similar with regard to age and gender, but the nonfilling cohort had more comorbidities. Total unadjusted plan-paid 12-month costs were lowest among the received authorization cohort ($11,739), slightly higher ($11,980) for the qualifying nonfilling cohort, and notably higher for the nonqualifying nonfilling cohort ($12,962), although no differences were statistically significant. After adjusting for key covariates, the difference between the nonqualifying nonfilling cohort ($11,980) and the received authorization cohort ($11,729) was statistically significant (P = 0.034). Large differences in plan-paid medical costs ($10,127 for the nonqualifying nonfilling cohort vs. $8,192 for the received authorization cohort) appeared to drive the overall cost totals and were significant in both the unadjusted (P = 0.005) and adjusted models (P  less than  0.001). Pharmacy costs were significantly lower for the nonqualifying nonfilling cohort in the adjusted model and for the qualifying nonfilling cohort in both models (all P  less than  0.001), but the lower pharmacy costs were not offset by the higher medical costs. In examining the use of medication for treatment of T2DM following the denied claim, 10.6% of the qualifying nonfilling cohort and 13.4% of the nonqualifying nonfilling cohort added another oral therapy, 10.2% and 5.8% added insulin, and 11.9% and 7.1% had treatment intensification, respectively. More than half (56.1%) of the qualifying nonfilling cohort, but only 32.1% of the nonqualifying nonfilling cohort, maintained current therapy.   This study found higher plan-paid health care costs (overall and medical alone) among members who requested a type 2 diabetes medication requiring PA, but never received it, compared with those who qualified for and received the requested medication. A notable number of individuals who were assumed to have met the criteria based on a claims-based equivalent, but who never received the medication, made no change to their current therapy. Failure of a member to take medication deemed necessary by his or her physician could translate to inadequate control of the diabetic condition and result in an excess of resource utilization and costs for treating the disease and associated comorbidities. In light of the present findings, health plans should consider not only the impact of utilization management strategies on reducing pharmacy costs, but the broader implication for overall health care costs and subsequent treatment patterns among members. 

  2. Economic evaluations in pain management: principles and methods.

    PubMed

    Asche, Carl V; Seal, Brian; Jackson, Kenneth C; Oderda, Gary M

    2006-01-01

    This paper describes how investigators may design, conduct, and report economic evaluations of pharmacotherapy for pain and symptom management. Because economic evaluation of therapeutic interventions is becoming increasingly important, there is a need for guidance on how economic evaluations can be optimally conducted. The steps required to conduct an economic evaluation are described to provide this guidance. Economic evaluations require two or more therapeutic interventions to be compared in relation to costs and effects. There are five types of economic evaluations, based on analysis of: (1) cost-effectiveness, (2) cost-utility, (3) cost-minimization, (4) cost-consequence, and (5) cost-benefit analyses. The six required steps are: identify the perspective of the study; identify the alternatives that will be compared; identify the relevant costs and effects; determine how to collect the cost and effect data; determine how to perform calculation for cost and effects data; and determine the manner in which to depict the results and draw comparisons.

  3. Economic evaluation of enhanced asthma management: a systematic review

    PubMed Central

    Yong, Yee V.; Shafie, Asrul A.

    2014-01-01

    Objectives: To evaluate and compare full economic evaluation studies on the cost-effectiveness of enhanced asthma management (either as an adjunct to usual care or alone) vs. usual care alone. Methods: Online databases were searched for published journal articles in English language from year 1990 to 2012, using the search terms ‘“asthma” AND (“intervene” OR “manage”) AND (“pharmacoeconomics” OR “economic evaluation” OR “cost effectiveness” OR “cost benefit” OR “cost utility”)’. Hand search was done for local publishing. Only studies with full economic evaluation on enhanced management were included (cost consequences (CC), cost effectiveness (CE), cost benefit (CB), or cost utility (CU) analysis). Data were extracted and assessed for the quality of its economic evaluation design and evidence sources. Results: A total of 49 studies were included. There were 3 types of intervention for enhanced asthma management: education, environmental control, and self-management. The most cost-effective enhanced management was a mixture of education and self-management by an integrated team of healthcare and allied healthcare professionals. In general, the studies had a fair quality of economic evaluation with a mean QHES score of 73.7 (SD=9.7), and had good quality of evidence sources. Conclusion: Despite the overall fair quality of economic evaluations but good quality of evidence sources for all data components, this review showed that the delivered enhanced asthma managements, whether as single or mixed modes, were overall effective and cost-reducing. Whilst the availability and accessibility are an equally important factor to consider, the sustainability of the cost-effective management has to be further investigated using a longer time horizon especially for chronic diseases such as asthma. PMID:25580173

  4. Evaluation of the economic burden of Herpes Zoster (HZ) infection

    PubMed Central

    Panatto, Donatella; Bragazzi, Nicola Luigi; Rizzitelli, Emanuela; Bonanni, Paolo; Boccalini, Sara; Icardi, Giancarlo; Gasparini, Roberto; Amicizia, Daniela

    2014-01-01

    The main objective of this systematic review was to evaluate the economic burden of Herpes Zoster (HZ) infection. The review was conducted in accordance with the standards of the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” guidelines. The following databases were accessed: ISI/Web of Knowledge (WoS), MEDLINE/PubMed, Scopus, ProQuest, the Cochrane Library and EconLit. Specific literature on health economics was also manually inspected. Thirty-three studies were included. The quality of the studies assessed in accordance with the Consolidated Health Economic Evaluation Reporting Standards checklist was good. All studies evaluated direct costs, apart from one which dealt only with indirect costs. Indirect costs were evaluated by 12 studies. The economic burden of HZ has increased over time. HZ management and drug prescriptions generate the highest direct costs. While increasing age, co-morbidities and drug treatment were found to predict higher direct costs, being employed was correlated with higher indirect costs, and thus with the onset age of the disease. Despite some differences among the selected studies, particularly with regard to indirect costs, all concur that HZ is a widespread disease which has a heavy social and economic burden. PMID:25483704

  5. Year 2001 Alabama rail plan update

    DOT National Transportation Integrated Search

    2002-01-01

    The State of Alabama is crisscrossed by some 4,728 miles rail lines hauling 93.5 million tons of cargo annually. There are five Class I railroads that operate in Alabama: Burlington Northern Santa Fe, Canadian National/Illinois Central, CSX Transport...

  6. 14. Photocopy of Illustration from Buffet, Edward P., 'Some Long ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    14. Photocopy of Illustration from Buffet, Edward P., 'Some Long Island Windmills,' American Machinist, 17 October 1918, p. 728 STONE CRANE AT THE SHELTER ISLAND WINDMILL - Shelter Island Windmill, Manwaring Road, Shelter Island, Suffolk County, NY

  7. 20 CFR 404.728 - Evidence a marriage has ended.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... person's divorced wife or divorced husband, you will be asked for evidence of your divorce. If you are... divorce or annulment; or (2) Evidence the person you married has died (see § 404.720). (c) Other evidence...

  8. 20 CFR 404.728 - Evidence a marriage has ended.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... person's divorced wife or divorced husband, you will be asked for evidence of your divorce. If you are... divorce or annulment; or (2) Evidence the person you married has died (see § 404.720). (c) Other evidence...

  9. 20 CFR 404.728 - Evidence a marriage has ended.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... person's divorced wife or divorced husband, you will be asked for evidence of your divorce. If you are... divorce or annulment; or (2) Evidence the person you married has died (see § 404.720). (c) Other evidence...

  10. 20 CFR 404.728 - Evidence a marriage has ended.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... person's divorced wife or divorced husband, you will be asked for evidence of your divorce. If you are... divorce or annulment; or (2) Evidence the person you married has died (see § 404.720). (c) Other evidence...

  11. 20 CFR 404.728 - Evidence a marriage has ended.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... person's divorced wife or divorced husband, you will be asked for evidence of your divorce. If you are... divorce or annulment; or (2) Evidence the person you married has died (see § 404.720). (c) Other evidence...

  12. Economic evaluations in shoulder pathologies: a systematic review of the literature.

    PubMed

    Kuye, Ifedayo O; Jain, Nitin B; Warner, Lauren; Herndon, James H; Warner, Jon J P

    2012-03-01

    Economic evaluations provide decision makers with a tool for reducing health care costs because they assess both the costs and consequences of health care interventions. This study reviewed the quality of published economic evaluations for shoulder pathologies. A MEDLINE search was conducted to identify articles published from 1980 to 2010 that contained "cost" or "economic" combined with terms for several shoulder disorders and treatments. We selected studies that fit the definition of 1 of the 4 routinely performed economic evaluations: cost-minimization, cost-effectiveness, cost-utility, and cost-benefit analyses. Study quality was determined by measuring adherence to 6 established health economic principles, as described in the literature. The search retrieved 942 studies. Of these, 32 were determined to be economic evaluations, and 53% of the economic evaluations were published from 2005 to 2010. Only 8 of the 32 studies (25%) adhered to all 6 health economic principles. Publication in a nonsurgical journal (P < .05) or in more recent years (P < .01) was significantly associated with higher quality. Future health care resource allocation will likely be based on the economic feasibility of treatments. Although the number and quality of economic evaluations of shoulder disorders have risen in recent years, the current state of the literature is poor. Given that availability of such data may factor in private and public reimbursement decisions, there is a clear demand for more rigorous economic evaluations. Copyright © 2012 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  13. Economic analysis of the health impacts of housing improvement studies: a systematic review.

    PubMed

    Fenwick, Elisabeth; Macdonald, Catriona; Thomson, Hilary

    2013-10-01

    Economic evaluation of public policies has been advocated but rarely performed. Studies from a systematic review of the health impacts of housing improvement included data on costs and some economic analysis. Examination of these data provides an opportunity to explore the difficulties and the potential for economic evaluation of housing. Data were extracted from all studies included in the systematic review of housing improvement which had reported costs and economic analysis (n=29/45). The reported data were assessed for their suitability to economic evaluation. Where an economic analysis was reported the analysis was described according to pre-set definitions of various types of economic analysis used in the field of health economics. 25 studies reported cost data on the intervention and/or benefits to the recipients. Of these, 11 studies reported data which was considered amenable to economic evaluation. A further four studies reported conducting an economic evaluation. Three of these studies presented a hybrid 'balance sheet' approach and indicated a net economic benefit associated with the intervention. One cost-effectiveness evaluation was identified but the data were unclearly reported; the cost-effectiveness plane suggested that the intervention was more costly and less effective than the status quo. Future studies planning an economic evaluation need to (i) make best use of available data and (ii) ensure that all relevant data are collected. To facilitate this, economic evaluations should be planned alongside the intervention with input from health economists from the outset of the study. When undertaken appropriately, economic evaluation provides the potential to make significant contributions to housing policy.

  14. A systematic review of the cost effectiveness of herpes zoster vaccination.

    PubMed

    Szucs, Thomas D; Pfeil, Alena M

    2013-02-01

    The varicella zoster virus (VZV) can cause two infections: chickenpox or herpes zoster (HZ). Whereas chickenpox infections are normally mild but common among children, HZ infections are common among elderly people and can give rise to post-herpetic neuralgia (PHN), a severe and painful complication. This review aimed to summarize the literature available on the cost effectiveness of HZ vaccination and to summarize key issues for decision makers to consider when deciding on the reimbursement of HZ vaccination. We conducted a literature search of the databases PubMed and EMBASE using EndNote X4 from Thomson Reuters. The following combinations of keywords were used: 'herpes zoster vaccine' AND 'cost(-)effectiveness' or AND 'economic evaluation', 'herpes zoster vaccination' AND 'cost(-)effectiveness' or AND 'economic evaluation', 'varicella zoster vaccine' AND 'cost(-)effectiveness' or AND 'economic evaluation', and 'varicella zoster vaccination' AND 'cost(-)effectiveness' or AND 'economic evaluation'. A total of 11 studies were identified and included. Cost-effectiveness analyses of varicella zoster vaccination were excluded. The quality of the included studies ranged from 'moderate' to 'moderate to good' according to the British Medical Journal guidelines of Drummond and Jefferson and the Quality of Health Economic Studies (QHES) score of Ofman et al. Most studies evaluated the cost effectiveness of universal HZ vaccination in adults aged 50 years or 60 years and older. Data sources and model assumptions regarding epidemiology, utility estimates and costs varied between studies. All studies calculated costs per QALY, which allows comparing costs of interventions in different diseases. The costs per QALY gained and the incremental cost-effectiveness ratio (ICER) differed between studies depending on the age at vaccination, duration of vaccine efficacy, cost of vaccine course and economic perspective. All but one of the studies concluded that most vaccination scenarios are cost effective and the vaccination of specific subgroups such as the older age group is most cost effective. Model input parameters such as age at vaccination, vaccine costs, HZ incidence, PHN length and duration of vaccine efficacy had a great impact on the estimated cost effectiveness of HZ vaccination. To compare the results of different cost-effectiveness studies of HZ vaccination, uniform methods should be used and the most important input parameters used for the different models should be critically assessed.

  15. Economic evaluations of fluticasone-propionate/salmeterol combination therapy for chronic obstructive pulmonary disease: a review of published studies.

    PubMed

    Roberts, M H; Borrego, M E; Kharat, A A; Marshik, P L; Mapel, D W

    2016-01-01

    This review identifies and evaluates the comprehensive reporting of peer-reviewed economic evaluations of the effectiveness of fluticasone-propionate/salmeterol combination (FSC) therapy for maintenance treatment of chronic obstructive pulmonary disease (COPD). Economic evaluations were included if published in English since 2003. Evaluation categories included in the review were cost-effectiveness, cost-utility, and cost-consequence analyses. FSC is cost-effective in comparison to short-acting bronchodilators (SABDs). Cost and outcome differences between FSC and other long-acting therapies were modest. Studies exhibited large variations in populations, designs and environment, limiting the ability to draw conclusions. Many new maintenance treatments for COPD have been approved since 2010. Most have yet to be compared to older treatments like FSC. Evaluations are needed that consider costs and outcomes from a societal perspective (e.g., patients' ability to keep working) and evaluations that include subgroup analyses to investigate differential impacts according to clusters of patient characteristics.

  16. A systematic review of economic evaluations of population-based sodium reduction interventions.

    PubMed

    Hope, Silvia F; Webster, Jacqui; Trieu, Kathy; Pillay, Arti; Ieremia, Merina; Bell, Colin; Snowdon, Wendy; Neal, Bruce; Moodie, Marj

    2017-01-01

    To summarise evidence describing the cost-effectiveness of population-based interventions targeting sodium reduction. A systematic search of published and grey literature databases and websites was conducted using specified key words. Characteristics of identified economic evaluations were recorded, and included studies were appraised for reporting quality using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Twenty studies met the study inclusion criteria and received a full paper review. Fourteen studies were identified as full economic evaluations in that they included both costs and benefits associated with an intervention measured against a comparator. Most studies were modelling exercises based on scenarios for achieving salt reduction and assumed effects on health outcomes. All 14 studies concluded that their specified intervention(s) targeting reductions in population sodium consumption were cost-effective, and in the majority of cases, were cost saving. Just over half the studies (8/14) were assessed as being of 'excellent' reporting quality, five studies fell into the 'very good' quality category and one into the 'good' category. All of the identified evaluations were based on modelling, whereby inputs for all the key parameters including the effect size were either drawn from published datasets, existing literature or based on expert advice. Despite a clear increase in evaluations of salt reduction programs in recent years, this review identified relatively few economic evaluations of population salt reduction interventions. None of the studies were based on actual implementation of intervention(s) and the associated collection of new empirical data. The studies universally showed that population-based salt reduction strategies are likely to be cost effective or cost saving. However, given the reliance on modelling, there is a need for the effectiveness of new interventions to be evaluated in the field using strong study designs and parallel economic evaluations.

  17. Are complementary therapies and integrative care cost-effective? A systematic review of economic evaluations

    PubMed Central

    Herman, Patricia M; Poindexter, Beth L; Witt, Claudia M; Eisenberg, David M

    2012-01-01

    Objective A comprehensive systematic review of economic evaluations of complementary and integrative medicine (CIM) to establish the value of these therapies to health reform efforts. Data sources PubMed, CINAHL, AMED, PsychInfo, Web of Science and EMBASE were searched from inception through 2010. In addition, bibliographies of found articles and reviews were searched, and key researchers were contacted. Eligibility criteria for selecting studies Studies of CIM were identified using criteria based on those of the Cochrane complementary and alternative medicine group. All studies of CIM reporting economic outcomes were included. Study appraisal methods All recent (and likely most cost-relevant) full economic evaluations published 2001–2010 were subjected to several measures of quality. Detailed results of higher-quality studies are reported. Results A total of 338 economic evaluations of CIM were identified, of which 204, covering a wide variety of CIM for different populations, were published 2001–2010. A total of 114 of these were full economic evaluations. And 90% of these articles covered studies of single CIM therapies and only one compared usual care to usual care plus access to multiple licensed CIM practitioners. Of the recent full evaluations, 31 (27%) met five study-quality criteria, and 22 of these also met the minimum criterion for study transferability (‘generalisability’). Of the 56 comparisons made in the higher-quality studies, 16 (29%) show a health improvement with cost savings for the CIM therapy versus usual care. Study quality of the cost-utility analyses (CUAs) of CIM was generally comparable to that seen in CUAs across all medicine according to several measures, and the quality of the cost-saving studies was slightly, but not significantly, lower than those showing cost increases (85% vs 88%, p=0.460). Conclusions This comprehensive review identified many CIM economic evaluations missed by previous reviews and emerging evidence of cost-effectiveness and possible cost savings in at least a few clinical populations. Recommendations are made for future studies. PMID:22945962

  18. 75 FR 23839 - Proposed Agency Information Collection Activities; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-04

    .... Respondent Universe: 2 Railroads. Frequency of Submission: On occasion. Affected Public: Foreign-Based... Respondent universe responses response burden hours 219.4--Recognition of Foreign 2 railroads........ 1.... Affected Public: Businesses. Respondent Universe: 728 railroads. Frequency of Submission: On occasion...

  19. High temperature autoclave vacuum seals

    NASA Technical Reports Server (NTRS)

    Hoffman, J. R.; Simpson, W. G.; Walker, H. M.

    1971-01-01

    Aluminum sheet forms effective sealing film at temperatures up to 728 K. Soft aluminum wire rings provide positive seal between foil and platen. For applications at temperatures above aluminum's service temperature, stainless steel is used as film material and copper wire as sealant.

  20. 75 FR 19368 - Foreign-Trade Zone 126-Reno, NV; Site Renumbering Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-14

    ... at 728 Spice Island Drive, Sparks; Site 2 (9 acres)--located at 450-475 Lillard Drive, Sparks; Site 3..., 700 South Rock Boulevard, Reno; Site 14 (0.4 acres)--located at 1095 Spice Island Drive, Sparks; Site...

  1. 32 CFR 728.73 - Applicants for enlistment or reenlistment in the Armed Forces, and applicants for enlistment in...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR... at Navy and Marine Corps facilities or MEPS may be furnished emergency medical and dental care...

  2. 32 CFR 728.74 - Applicants for appointment in the regular Navy or Marine Corps and reserve components, including...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Other... and Marine Corps facilities or MEPS may be furnished emergency medical and dental care, including...

  3. 32 CFR 728.12 - Extent of care.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR..., prosthetic dental appliances, hearing aids, spectacles, orthopedic footwear, and other orthopedic appliances... through negligence, repair or replacement is authorized at Government expense. (iv) Routine dental care...

  4. 32 CFR 728.74 - Applicants for appointment in the regular Navy or Marine Corps and reserve components, including...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Other... and Marine Corps facilities or MEPS may be furnished emergency medical and dental care, including...

  5. 32 CFR 728.74 - Applicants for appointment in the regular Navy or Marine Corps and reserve components, including...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Other... and Marine Corps facilities or MEPS may be furnished emergency medical and dental care, including...

  6. 32 CFR 728.73 - Applicants for enlistment or reenlistment in the Armed Forces, and applicants for enlistment in...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR... at Navy and Marine Corps facilities or MEPS may be furnished emergency medical and dental care...

  7. 32 CFR 728.73 - Applicants for enlistment or reenlistment in the Armed Forces, and applicants for enlistment in...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR... at Navy and Marine Corps facilities or MEPS may be furnished emergency medical and dental care...

  8. 32 CFR 728.73 - Applicants for enlistment or reenlistment in the Armed Forces, and applicants for enlistment in...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR... at Navy and Marine Corps facilities or MEPS may be furnished emergency medical and dental care...

  9. 32 CFR 728.74 - Applicants for appointment in the regular Navy or Marine Corps and reserve components, including...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Other... and Marine Corps facilities or MEPS may be furnished emergency medical and dental care, including...

  10. 32 CFR 728.44 - Members of security assistance training programs, foreign military sales, and their ITO...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., except bona fide emergency situations which might threaten the life or health of an individual. Generally... patient is an ITO authorized dependent), grade or rate, country of origin, diagnosis, type of elective...

  11. 6 CFR 7.28 - Automatic declassification.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... years after the date of its original classification with the exception of specific information exempt... information whenever the information exempted does not identify a confidential human source or human... Classification Appeals Panel (ISCAP) for approval. (d) Declassification guides that narrowly and precisely define...

  12. 6 CFR 7.28 - Automatic declassification.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... years after the date of its original classification with the exception of specific information exempt... information whenever the information exempted does not identify a confidential human source or human... Classification Appeals Panel (ISCAP) for approval. (d) Declassification guides that narrowly and precisely define...

  13. 6 CFR 7.28 - Automatic declassification.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... years after the date of its original classification with the exception of specific information exempt... information whenever the information exempted does not identify a confidential human source or human... Classification Appeals Panel (ISCAP) for approval. (d) Declassification guides that narrowly and precisely define...

  14. 6 CFR 7.28 - Automatic declassification.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... years after the date of its original classification with the exception of specific information exempt... information whenever the information exempted does not identify a confidential human source or human... Classification Appeals Panel (ISCAP) for approval. (d) Declassification guides that narrowly and precisely define...

  15. Costing evidence for health care decision-making in Austria: A systematic review.

    PubMed

    Mayer, Susanne; Kiss, Noemi; Łaszewska, Agata; Simon, Judit

    2017-01-01

    With rising healthcare costs comes an increasing demand for evidence-informed resource allocation using economic evaluations worldwide. Furthermore, standardization of costing and reporting methods both at international and national levels are imperative to make economic evaluations a valid tool for decision-making. The aim of this review is to assess the availability and consistency of costing evidence that could be used for decision-making in Austria. It describes systematically the current economic evaluation and costing studies landscape focusing on the applied costing methods and their reporting standards. Findings are discussed in terms of their likely impacts on evidence-based decision-making and potential suggestions for areas of development. A systematic literature review of English and German language peer-reviewed as well as grey literature (2004-2015) was conducted to identify Austrian economic analyses. The databases MEDLINE, EMBASE, SSCI, EconLit, NHS EED and Scopus were searched. Publication and study characteristics, costing methods, reporting standards and valuation sources were systematically synthesised and assessed. A total of 93 studies were included. 87% were journal articles, 13% were reports. 41% of all studies were full economic evaluations, mostly cost-effectiveness analyses. Based on relevant standards the most commonly observed limitations were that 60% of the studies did not clearly state an analytical perspective, 25% of the studies did not provide the year of costing, 27% did not comprehensively list all valuation sources, and 38% did not report all applied unit costs. There are substantial inconsistencies in the costing methods and reporting standards in economic analyses in Austria, which may contribute to a low acceptance and lack of interest in economic evaluation-informed decision making. To improve comparability and quality of future studies, national costing guidelines should be updated with more specific methodological guidance and a national reference cost library should be set up to allow harmonisation of valuation methods.

  16. Costing evidence for health care decision-making in Austria: A systematic review

    PubMed Central

    Mayer, Susanne; Kiss, Noemi; Łaszewska, Agata

    2017-01-01

    Background With rising healthcare costs comes an increasing demand for evidence-informed resource allocation using economic evaluations worldwide. Furthermore, standardization of costing and reporting methods both at international and national levels are imperative to make economic evaluations a valid tool for decision-making. The aim of this review is to assess the availability and consistency of costing evidence that could be used for decision-making in Austria. It describes systematically the current economic evaluation and costing studies landscape focusing on the applied costing methods and their reporting standards. Findings are discussed in terms of their likely impacts on evidence-based decision-making and potential suggestions for areas of development. Methods A systematic literature review of English and German language peer-reviewed as well as grey literature (2004–2015) was conducted to identify Austrian economic analyses. The databases MEDLINE, EMBASE, SSCI, EconLit, NHS EED and Scopus were searched. Publication and study characteristics, costing methods, reporting standards and valuation sources were systematically synthesised and assessed. Results A total of 93 studies were included. 87% were journal articles, 13% were reports. 41% of all studies were full economic evaluations, mostly cost-effectiveness analyses. Based on relevant standards the most commonly observed limitations were that 60% of the studies did not clearly state an analytical perspective, 25% of the studies did not provide the year of costing, 27% did not comprehensively list all valuation sources, and 38% did not report all applied unit costs. Conclusion There are substantial inconsistencies in the costing methods and reporting standards in economic analyses in Austria, which may contribute to a low acceptance and lack of interest in economic evaluation-informed decision making. To improve comparability and quality of future studies, national costing guidelines should be updated with more specific methodological guidance and a national reference cost library should be set up to allow harmonisation of valuation methods. PMID:28806728

  17. Toward rapid analysis, forecast and discovery of bioactive compounds from herbs by jointly using thin layer chromatography and ratiometric surface-enhanced Raman spectroscopy technique.

    PubMed

    Gu, Xiaoling; Jin, Yang; Dong, Fang; Cai, Yueqing; You, Zhengyi; You, Junhui; Zhang, Liying; Du, Shuhu

    2018-05-10

    Conventional isolation and identification of active compounds from herbs have been extensively reported by using various chromatographic and spectroscopic techniques. However, how to quickly discover new bioactive ingredients from natural sources still remains a challenging task due to the interference of their similar structures or matrices. Here, we present a grand approach for rapid analysis, forecast and discovery of bioactive compounds from herbs based on a hyphenated strategy of thin layer chromatography and ratiometric surface-enhanced Raman spectroscopy. The performance of the hyphenated strategy is first evaluated by analyzing four protoberberine alkaloids, berberine (BER), coptisine (COP), palmatine (PAT) and jatrorrhizine (JAT), from a typical herb Coptidis Rhizoma as an example. It has been demonstrated that this coupling method can identify the four compounds by characteristic peaks at 728, 708, 736 and 732 cm -1 , and especially discriminate BER and COP (with similar migration distances) by ratiometric Raman intensity (I 708 /I 728 ). The corresponding limits of detection are 0.1, 0.05, 0.1 and 0.5 μM, respectively, which are about 1-2 orders of magnitude lower than those of direct observation method under 254 nm UV lamp. Based on these findings, the proposed method further guides forecast and discovery of unknown compounds from traditional Chinese herb Typhonii Rhizoma. Results infer that two trace alkaloids (BER and COP) from the n-butanol extract of Typhonii Rhizoma are found for the first time. Moreover, in vitro experiments manifest that BER can effectively decrease the viability of human glioma U87 cells by inducing cell cycle arrest in a concentration-dependent manner. Copyright © 2018 Elsevier B.V. All rights reserved.

  18. Economic Studies in Motor Neurone Disease: A Systematic Methodological Review.

    PubMed

    Moore, Alan; Young, Carolyn A; Hughes, Dyfrig A

    2017-04-01

    Motor neurone disease (MND) is a devastating condition which greatly diminishes patients' quality of life and limits life expectancy. Health technology appraisals of future interventions in MND need robust data on costs and utilities. Existing economic evaluations have been noted to be limited and fraught with challenges. The aim of this study was to identify and critique methodological aspects of all published economic evaluations, cost studies, and utility studies in MND. We systematically reviewed all relevant published studies in English from 1946 until January 2016, searching the databases of Medline, EMBASE, Econlit, NHS Economic Evaluation Database (NHS EED) and the Health Economics Evaluation Database (HEED). Key data were extracted and synthesised narratively. A total of 1830 articles were identified, of which 15 economic evaluations, 23 cost and 3 utility studies were included. Most economic studies focused on riluzole (n = 9). Six studies modelled the progressive decline in motor function using a Markov design but did not include mutually exclusive health states. Cost estimates for a number of evaluations were based on expert opinion and were hampered by high variability and location-specific characteristics. Few cost studies reported disease-stage-specific costs (n = 3) or fully captured indirect costs. Utilities in three studies of MND patients used the EuroQol EQ-5D questionnaire or standard gamble, but included potentially unrepresentative cohorts and did not consider any health impacts on caregivers. Economic evaluations in MND suffer from significant methodological issues such as a lack of data, uncertainty with the disease course and use of inappropriate modelling framework. Limitations may be addressed through the collection of detailed and representative data from large cohorts of patients.

  19. Minimum effective dosages of anti-TNF in rheumatoid arthritis: a cross-sectional study.

    PubMed

    de la Torre, Inmaculada; Valor, Lara; Nieto, Juan Carlos; Montoro, María; Carreño, Luis

    2014-01-01

    To evaluate the modified dosages of anti-TNF in controlling disease activity in rheumatoid arthritis (RA) measured by DAS28-ESR. Cross-sectional study: RA patients treated with etanercept (ETN), adalimumab (ADA) or infliximab (IFX), at standard or modified doses. dosage, concomitant disease modifying drugs (DMARDs), DAS28-ESR. 195 RA patients included (79% women, mean age 58.1 years): ETN=81, ADA=56, IFX=58. Mean disease duration and time to first biological treatment was higher in IFX group (P=.01). Patients distribution by dosage: standard: ETN (72.8%), ADA (69.6%), IFX (27.6%); escalated: IFX (69%), ADA (5.4%), ETN (0%); reduced: ETN (27.1%), ADA (25%), IFX (3.4%). Concomitant DMARDs use was lower in ETN (58.2%) than ADA (66.07%) and IFX (79.31%). Higher proportion of responders (DAS28 ≤3.2) in ADA (65.3%) and ETN (61.7%) than IFX (48.3%). RA clinical control can be preserved with modified anti-TNF dosages. Controlled prospective studies should be performed to define when therapy can be tailored and for which patients. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  20. The evaluability bias in charitable giving: Saving administration costs or saving lives?

    PubMed Central

    Caviola, Lucius; Faulmüller, Nadira; Everett, Jim. A. C.; Savulescu, Julian; Kahane, Guy

    2014-01-01

    We describe the “evaluability bias”: the tendency to weight the importance of an attribute in proportion to its ease of evaluation. We propose that the evaluability bias influences decision making in the context of charitable giving: people tend to have a strong preference for charities with low overhead ratios (lower administrative expenses) but not for charities with high cost-effectiveness (greater number of saved lives per dollar), because the former attribute is easier to evaluate than the latter. In line with this hypothesis, we report the results of four studies showing that, when presented with a single charity, people are willing to donate more to a charity with low overhead ratio, regardless of cost-effectiveness. However, when people are presented with two charities simultaneously—thereby enabling comparative evaluation—they base their donation behavior on cost-effectiveness (Study 1). This suggests that people primarily value cost-effectiveness but manifest the evaluability bias in cases where they find it difficult to evaluate. However, people seem also to value a low overhead ratio for its own sake (Study 2). The evaluability bias effect applies to charities of different domains (Study 3). We also show that overhead ratio is easier to evaluate when its presentation format is a ratio, suggesting an inherent reference point that allows meaningful interpretation (Study 4). PMID:25279024

  1. The Cost-Effectiveness of Three Screening Alternatives for People with Diabetes with No or Early Diabetic Retinopathy

    PubMed Central

    Rein, David B; Wittenborn, John S; Zhang, Xinzhi; Allaire, Benjamin A; Song, Michael S; Klein, Ronald; Saaddine, Jinan B

    2011-01-01

    Objective To determine whether biennial eye evaluation or telemedicine screening are cost-effective alternatives to current recommendations for the estimated 10 million people aged 30–84 with diabetes but no or minimal diabetic retinopathy. Data Sources United Kingdom Prospective Diabetes Study, National Health and Nutrition Examination Survey, American Academy of Ophthalmology Preferred Practice Patterns, Medicare Payment Schedule. Study Design Cost-effectiveness Monte Carlo simulation. Data Collection/Extraction Methods Literature review, analysis of existing surveys. Principal Findings Biennial eye evaluation was the most cost-effective treatment option when the ability to detect other eye conditions was included in the model. Telemedicine was most cost-effective when other eye conditions were not considered or when telemedicine was assumed to detect refractive error. The current annual eye evaluation recommendation was costly compared with either treatment alternative. Self-referral was most cost-effective up to a willingness to pay (WTP) of U.S.$37,600, with either biennial or annual evaluation most cost-effective at higher WTP levels. Conclusions Annual eye evaluations are costly and add little benefit compared with either plausible alternative. More research on the ability of telemedicine to detect other eye conditions is needed to determine whether it is more cost-effective than biennial eye evaluation. PMID:21492158

  2. Economic analysis of the health impacts of housing improvement studies: a systematic review

    PubMed Central

    Fenwick, Elisabeth; Macdonald, Catriona; Thomson, Hilary

    2013-01-01

    Background Economic evaluation of public policies has been advocated but rarely performed. Studies from a systematic review of the health impacts of housing improvement included data on costs and some economic analysis. Examination of these data provides an opportunity to explore the difficulties and the potential for economic evaluation of housing. Methods Data were extracted from all studies included in the systematic review of housing improvement which had reported costs and economic analysis (n=29/45). The reported data were assessed for their suitability to economic evaluation. Where an economic analysis was reported the analysis was described according to pre-set definitions of various types of economic analysis used in the field of health economics. Results 25 studies reported cost data on the intervention and/or benefits to the recipients. Of these, 11 studies reported data which was considered amenable to economic evaluation. A further four studies reported conducting an economic evaluation. Three of these studies presented a hybrid ‘balance sheet’ approach and indicated a net economic benefit associated with the intervention. One cost-effectiveness evaluation was identified but the data were unclearly reported; the cost-effectiveness plane suggested that the intervention was more costly and less effective than the status quo. Conclusions Future studies planning an economic evaluation need to (i) make best use of available data and (ii) ensure that all relevant data are collected. To facilitate this, economic evaluations should be planned alongside the intervention with input from health economists from the outset of the study. When undertaken appropriately, economic evaluation provides the potential to make significant contributions to housing policy. PMID:23929616

  3. Changing environments and alternative perspectives in evaluating the cost-effectiveness of new antipsychotic drugs.

    PubMed

    Rosenheck, Robert; Doyle, Jefferson; Leslie, Douglas; Fontana, Alan

    2003-01-01

    This article examines the ways in which changes in the treatment environment and in measurement perspectives can affect the evaluation of cost-effectiveness of new medications. In three studies we reexamined data from a clinical trial of haloperidol and clozapine conducted from 1993 to 1996. The results of the studies are as follows: Study 1 found that clozapine treatment was associated with significantly reduced inpatient costs, and increased outpatient costs, suggesting that as systems use less inpatient care and more outpatient care, more effective medications may increase, rather than decrease, costs in sicker patients. Study 2 found that while provider assessments and standard measures favored clozapine over haloperidol, patient responses showed little evidence of a clinical advantage for clozapine and a less favorable side-effect profile. Study 3 found that while annual drug costs in the published trial were estimated to be dollars 4,545 for a full year of clozapine treatment, atypical antipsychotic costs in 2000 were estimated to range from dollars 1,254 to dollars 3,016 in the Department of Veterans Affairs system, and from dollars 2,221 to dollars 8,147 in the private sector. In conclusion, cost-effectiveness, as evaluated in studies like CATIE, will increasingly need to be tied to service system contingencies, environments, and evaluation perspectives.

  4. Economic Evaluation of Hospital and Community Pharmacy Services.

    PubMed

    Gammie, Todd; Vogler, Sabine; Babar, Zaheer-Ud-Din

    2017-01-01

    To review the international body of literature from 2010 to 2015 concerning methods of economic evaluations used in hospital- and community-based studies of pharmacy services in publicly funded health systems worldwide, their clinical outcomes, and economic effectiveness. The literature search was undertaken between May 2, 2015, and September 4, 2015. Keywords included "health economics" and "evaluation" "assessment" or "appraisal," "methods," "hospital" or "community" or "residential care," "pharmacy" or "pharmacy services" and "cost minimisation analysis" or "cost utility analysis" or "cost effectiveness analysis" or "cost benefit analysis." The databases searched included MEDLINE, PubMed, Google Scholar, Science Direct, Springer Links, and Scopus, and journals searched included PLoS One, PLoS Medicine, Nature, Health Policy, Pharmacoeconomics, The European Journal of Health Economics, Expert Review of Pharmacoeconomics and Outcomes Research, and Journal of Health Economics. Studies were selected on the basis of study inclusion criteria. These criteria included full-text original research articles undertaking an economic evaluation of hospital- or community-based pharmacy services in peer-reviewed scientific journals and in English, in countries with a publicly funded health system published between 2010 and 2015. 14 articles were included in this review. Cost-utility analysis (CUA) was the most utilized measure. Cost-minimization analysis (CMA) was not used by any studies. The limited use of cost-benefit analyses (CBAs) is likely a result of technical challenges in quantifying the cost of clinical benefits, risks, and outcomes. Hospital pharmacy services provided clinical benefits including improvements in patient health outcomes and reductions in adverse medication use, and all studies were considered cost-effective due to meeting a cost-utility (per quality-adjusted life year) threshold or were cost saving. Community pharmacy services were considered cost-effective in 8 of 10 studies. Economic evaluations of hospital and community pharmacy services are becoming increasingly commonplace to enable an understanding of which health care services provide value for money and to inform policy makers as to which services will be cost-effective in light of limited health care resources.

  5. Cost and Cost-Effectiveness of Donor Human Milk to Prevent Necrotizing Enterocolitis: Systematic Review.

    PubMed

    Buckle, Abigail; Taylor, Celia

    2017-11-01

    Necrotizing enterocolitis (NEC) is a costly gastrointestinal disorder that mainly affects preterm and low-birth-weight infants and can lead to considerable morbidity and mortality. Mother's own milk is protective against NEC but is not always available. In such cases, donor human milk has also been shown to be protective (although to a lesser extent) compared with formula milk, but it is more expensive. This systematic review aimed at evaluating the cost of donor milk, the cost of treating NEC, and the cost-effectiveness of exclusive donor milk versus formula milk feeding to reduce the short-term health and treatment costs of NEC. We systematically searched five relevant databases to find studies with verifiable costs or charges of donor milk and/or treatment of NEC and any economic evaluations comparing exclusive donor milk with exclusive formula milk feeding. All search results were double screened. Seven studies with verifiable donor milk costs and 17 with verifiable NEC treatment costs were included. The types of cost or charge included varied considerably across studies, so quantitative synthesis was not attempted. Estimates of the incremental length of stay associated with NEC were ∼18 days for medical NEC and 50 days for surgical NEC. Two studies claimed to report economic evaluations but did not do so in practice. It is likely that donor milk provides short-term cost savings by reducing the incidence of NEC. Future studies should provide more details on cost components included and a full economic evaluation, including long-term outcomes, should be undertaken.

  6. Recombineering Pseudomonas syringae

    USDA-ARS?s Scientific Manuscript database

    Here we report the identification of functions that promote genomic recombination of linear DNA introduced into Pseudomonas cells by electroporation. The genes encoding these functions were identified in Pseudomonas syringae pv. syringae B728a based on similarity to the lambda Red Exo/Beta and RecE...

  7. 32 CFR 728.2 - Definitions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR... services provided or ordered for CHAMPUS-eligible beneficiaries by USMTF providers. (i) Dental care... structures and thereby contribute to maintenance or restoration of the dental health of an individual. (j...

  8. 32 CFR 728.2 - Definitions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR... services provided or ordered for CHAMPUS-eligible beneficiaries by USMTF providers. (i) Dental care... structures and thereby contribute to maintenance or restoration of the dental health of an individual. (j...

  9. 32 CFR 728.2 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR... services provided or ordered for CHAMPUS-eligible beneficiaries by USMTF providers. (i) Dental care... structures and thereby contribute to maintenance or restoration of the dental health of an individual. (j...

  10. 32 CFR 728.2 - Definitions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR... services provided or ordered for CHAMPUS-eligible beneficiaries by USMTF providers. (i) Dental care... structures and thereby contribute to maintenance or restoration of the dental health of an individual. (j...

  11. 32 CFR 728.92 - Policy.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... humanitarian reasons, do not furnish orthopedic and prosthetic appliances on an elective basis to members of... these defects. (c) For active duty members, make the initial allowance of orthopedic footwear and orthopedic alterations to standard footwear the same quantity as provided in the initial clothing allowance...

  12. 32 CFR 728.92 - Policy.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... humanitarian reasons, do not furnish orthopedic and prosthetic appliances on an elective basis to members of... these defects. (c) For active duty members, make the initial allowance of orthopedic footwear and orthopedic alterations to standard footwear the same quantity as provided in the initial clothing allowance...

  13. 32 CFR 728.92 - Policy.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... humanitarian reasons, do not furnish orthopedic and prosthetic appliances on an elective basis to members of... these defects. (c) For active duty members, make the initial allowance of orthopedic footwear and orthopedic alterations to standard footwear the same quantity as provided in the initial clothing allowance...

  14. 76 FR 30904 - Allegheny Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-27

    ... Clarendon, Pennsylvania. The committee is authorized under the Secure Rural Schools and Community Self... Farm Colony Drive, Warren, Pennsylvania 16365. Please call ahead to Kathy Mohney at (814) 728-6298 to... Coordinator, Allegheny National Forest Supervisor's Office, 4 Farm Colony Drive, Warren, Pennsylvania 16365...

  15. 32 CFR 728.81 - Other civilians.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... cognizant hospital's commanding officer. Exception: Certain individuals, such as employees of the Federal... of the U.S. Olympic effort. (iv) Civilians competing in Navy or Marine Corps sponsored competitive... of America. (4) Other civilian personnel included below are not normally eligible for care in naval...

  16. Hospital-related cost of sepsis: A systematic review.

    PubMed

    Arefian, Habibollah; Heublein, Steffen; Scherag, André; Brunkhorst, Frank Martin; Younis, Mustafa Z; Moerer, Onnen; Fischer, Dagmar; Hartmann, Michael

    2017-02-01

    This article systematically reviews research on the costs of sepsis and, as a secondary aim, evaluates the quality of economic evaluations reported in peer-reviewed journals. We systematically searched the MEDLINE, National Health Service (Abstracts of Reviews of Effects, Economic Evaluation and Health Technology Assessment), Cost-effectiveness Analysis Registry and Web of Knowledge databases for studies published between January 2005 and June 2015. We selected original articles that provided cost and cost-effectiveness analyses, defined sepsis and described their cost calculation method. Only studies that considered index admissions and re-admissions in the first 30 days were published in peer-reviewed journals and used standard treatments were considered. All costs were adjusted to 2014 US dollars. Medians and interquartile ranges (IQRs) for various costs of sepsis were calculated. The quality of economic studies was assessed using the Drummond 10-item checklist. Overall, 37 studies met our eligibility criteria. The median of the mean hospital-wide cost of sepsis per patient was $32,421 (IQR $20,745-$40,835), and the median of the mean ICU cost of sepsis per patient was $27,461 (IQR $16,007-$31,251). Overall, the quality of economic studies was low. Estimates of the hospital-related costs of sepsis varied considerably across the included studies depending on the method used for cost calculation, the type of sepsis and the population that was examined. A standard model for conducting cost improve the quality of studies on the costs of sepsis. Copyright © 2016 The British Infection Association. All rights reserved.

  17. Strict adherence to malaria rapid test results might lead to a neglect of other dangerous diseases: a cost benefit analysis from Burkina Faso.

    PubMed

    Bisoffi, Zeno; Sirima, Sodiomon B; Meheus, Filip; Lodesani, Claudia; Gobbi, Federico; Angheben, Andrea; Tinto, Halidou; Neya, Bouma; Van den Ende, Klara; Romeo, Annalisa; Van den Ende, Jef

    2011-08-04

    Malaria rapid diagnostic tests (RDTs) have generally been found reliable and cost-effective. In Burkina Faso, the adherence of prescribers to the negative test result was found to be poor. Moreover, the test accuracy for malaria-attributable fever (MAF) is not the same as for malaria infection. This paper aims at determining the costs and benefits of two competing strategies for the management of MAF: presumptive treatment for all or use of RDTs. A cost benefit analysis was carried out using a decision tree, based on data previously obtained, including a randomized controlled trial (RCT) recruiting 852 febrile patients during the dry season and 1,317 in the rainy season. Cost and benefit were calculated using both the real adherence found by the RCT and assuming an ideal adherence of 90% with the negative result. The main parameters were submitted to sensitivity analysis. At real adherence, the test-based strategy was dominated. Assuming ideal adherence, at the value of 525 € for a death averted, the total cost of managing 1,000 febrile children was 1,747 vs. 1,862 € in the dry season and 1,372 vs. 2,138 in the rainy season for the presumptive vs. the test-based strategy. For adults it was 2,728 vs. 1,983 and 2,604 vs. 2,225, respectively. At the subsidized policy adopted locally, assuming ideal adherence, the RDT would be the winning strategy for adults in both seasons and for children in the dry season.At sensitivity analysis, the factors most influencing the choice of the better strategy were the value assigned to a death averted and the proportion of potentially severe NMFI treated with antibiotics in patients with false positive RDT results. The test-based strategy appears advantageous for adults if a satisfactory adherence could be achieved. For children the presumptive strategy remains the best choice for a wide range of scenarios. For RDTs to be preferred, a positive result should not influence the decision to treat a potentially severe NMFI with antibiotics. In the rainy season the presumptive strategy always remains the better choice for children.

  18. Diverse approaches to the health economic evaluation of bariatric surgery: a comprehensive systematic review.

    PubMed

    Campbell, J A; Venn, A; Neil, A; Hensher, M; Sharman, M; Palmer, A J

    2016-09-01

    Health economic evaluations inform healthcare resource allocation decisions for treatment options for obesity including bariatric/metabolic surgery. As an important advance on existing systematic reviews, we aimed to capture, summarize and synthesize a diverse range of economic evaluations on bariatric surgery. Studies were identified by electronic screening of all major biomedical/economic databases. Studies included if they reported any quantified health economic cost and/or consequence with a measure of effect for any type of bariatric surgery from 1995 to September 2015. Study screening, data extraction and synthesis followed international guidelines for systematic reviews. Six thousand one hundred eighty-seven studies were initially identified. After two levels of screening, 77 studies representing 17 countries (56% USA) were included. Despite study heterogeneity, common themes emerged, and important gaps were identified. Most studies adopted the healthcare system/third-party payer perspective; reported costs were generally healthcare resource use (inpatient/shorter-term outpatient). Out-of-pocket costs to individuals, family members (travel time, caregiving) and indirect costs due to lost productivity were largely ignored. Costs due to reoperations/complications were not included in one-third of studies. Body-contouring surgery included in only 14%. One study evaluated long-term waitlisted patients. Surgery was cost-effective/cost-saving for severely obese with type 2 diabetes mellitus. Study quality was inconsistent. There is a need for studies that assume a broader societal perspective (including out-of-pocket costs, costs to family and productivity losses) and longer-term costs (capture reoperations/complications, waiting, body contouring), and consequences (health-related quality-of-life). Full economic evaluation underpinned by reporting standards should inform prioritization of patients (e.g. type 2 diabetes mellitus with body mass index 30 to 34.9 kg/m(2) or long-term waitlisted) for surgery. © 2016 World Obesity. © 2016 World Obesity.

  19. Assessing the Quality of Economic Evaluations of FDA Novel Drug Approvals: A Systematic Review.

    PubMed

    Woersching, Alex L; Borrego, Matthew E; Raisch, Dennis W

    2016-12-01

    To systematically review and assess the quality of the novel drugs' economic evaluation literature in print during the drugs' early commercial availability following US regulatory approval. MEDLINE and the United Kingdom National Health Service Economic Evaluation Database were searched from 1946 through December 2011 for economic evaluations of the 50 novel drugs approved by the FDA in 2008 and 2009. The inclusion criteria were English-language, peer-reviewed, original economic evaluations (cost-utility, cost-effectiveness, cost-minimization, and cost-benefit analyses). We extracted and analyzed data from 36 articles considering 19 of the 50 drugs. Two reviewers assessed each publication's quality using the Quality of Health Economic Studies (QHES) instrument and summarized study quality on a 100-point scale. Study quality had a mean of 70.0 ± 16.2 QHES points. The only study characteristics associated with QHES score (with P < 0.05) were having used modeling or advanced statistics, 75.1 versus 61.9 without; using quality-adjusted life years as an outcome, 75.9 versus 64.7 without; and cost-utility versus cost-minimization analysis, 75.9 versus 58.7. Studies most often satisfied quality aspects about stating study design choices and least often satisfied aspects about justifying design choices. The reviewed literature considered a minority of the 2008-2009 novel drugs and had mixed study quality. Cost-effectiveness stakeholders might benefit from efforts to improve the quality and quantity of literature examining novel drugs. Editors and reviewers may support quality improvement by stringently imposing economic evaluation guidelines about justifying study design choices. © The Author(s) 2016.

  20. Importance of nondrug costs of intravenous antibiotic therapy.

    PubMed

    van Zanten, Arthur R H; Engelfriet, Peter M; van Dillen, Karin; van Veen, Miriam; Nuijten, Mark J C; Polderman, Kees H

    2003-12-01

    Costs are one of the factors determining physicians' choice of medication to treat patients in specific situations. However, usually only the drug acquisition costs are taken into account, whereas other factors such as the use of disposable materials, the drug preparation time and the staff workload are insufficiently taken into consideration. We therefore decided to assess true overall costs of intravenous (IV) antibiotic administration by performing an activity-based costing approach. A prospective survey on costs and workload by means of a time and motion analysis and activity-based costing was performed in a 605-bed secondary referral centre with 20 intensive care unit beds. The subjects were 50 consecutive patients admitted to our hospital with community-acquired pneumonia or intra-abdominal infections requiring treatment with IV antibiotics. A time and motion analysis of 103 routine acts of preparing and administering IV antibiotics was performed in the intensive care unit and in the Department of Internal Medicine. To measure the entire process an inventory and work flowchart were made using detailed questionnaires completed by members of the nursing staff, the medical staff and the pharmacy staff. In addition, questionnaires were distributed to management and secretarial staff to determine additional overhead costs. The average costs for different methods of IV antibiotic administration were then compared by timing all steps in the process. Four different methods of drug administration were used: administration by volumetric pump, administration by syringe pump, administration by 'unaided' infusion bag, and administration by direct IV injection. The average times required for each of these procedures, including preparation and administration of the drug, were 4:49 +/- 2:37, 4:56 +/- 2:03, 5:51 +/- 3:33 and 9:21 +/- 2:16 min (mean minutes:seconds +/- standard deviation), respectively. When the costs for expended staff time and materials (not including drug costs) were calculated this resulted in average costs of 5.65, 7.28, 5.36 and 3.83, respectively, for administration of each dose of antibiotics. These costs represent between 11% and 53% of the total daily costs of antibiotic therapy. Compared with the acquisition costs, these indirect costs ranged from 13% to 113%. Not included in this comparison is the time required for insertion of an IV catheter, which was found to be 10:15 +/- 6:31 min with an average calculated cost of 9.17. Total costs of IV antibiotic administration are formed not only by the costs of the drugs themselves, but also, to a substantial degree, by the time expended by medical and nursing staff, costs of disposable materials and overhead costs. Physicians making decisions regarding the use of specific medications in intensive care unit patients should take these factors into account. Use of IV antibiotics is associated with considerable workload and additional costs that can exceed the acquisition costs of the medications themselves.

  1. Immune responses after fractional doses of inactivated poliovirus vaccine using newly developed intradermal jet injectors: a randomized controlled trial in Cuba.

    PubMed

    Resik, Sonia; Tejeda, Alina; Mach, Ondrej; Fonseca, Magile; Diaz, Manuel; Alemany, Nilda; Garcia, Gloria; Hung, Lai Heng; Martinez, Yenisleydis; Sutter, Roland

    2015-01-03

    The World Health Organization recommends that, as part of the new polio endgame, a dose of inactivated poliovirus vaccine (IPV) be introduced by the end of 2015 in all countries using only oral poliovirus vaccine (OPV). Administration of fractional dose (1/5th of full dose) IPV (fIPV) intradermally may reduce costs, but its administration is cumbersome with BCG needle and syringe. We evaluated performance of two newly developed intradermal-only jet injectors and compared the immune response induced by fIPV with that induced by full-dose IPV. Children between 12 and 20 months of age, who had previously received two doses of OPV, were enrolled in Camaguey, Cuba. Subjects received a single dose of IPV (either full-dose IPV intramuscularly with needle and syringe or fIPV intradermally administered with one of two new injectors or with BCG needle or a conventional needle-free injector). Serum was tested for presence of poliovirus neutralizing antibodies on day 0 (pre-IPV) and on days 3, 7 and 21 (post-vaccination). Complete data were available from 74.2% (728/981) subjects. Baseline median antibody titers were 713, 284, and 113 for poliovirus types 1, 2, and 3, respectively. Seroprevalence at study end were similar across the intervention groups (≥ 94.8%). The immune response induced with one new injector was similar to BCG needle and to the conventional injector; and superior to the other new injector. fIPV induced significantly lower boosting response compared to full-dose IPV. No safety concerns were identified. One of the two new injectors demonstrated its ability to streamline intradermal fIPV administration, however, further investigations are needed to assess the potential contribution of fIPV in the polio endgame plan. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Health-related quality of life and utility scores of patients with breast neoplasms in China: A multicenter cross-sectional survey.

    PubMed

    Wang, Le; Shi, Ju-Fang; Zhu, Juan; Huang, Hui-Yao; Bai, Ya-Na; Liu, Guo-Xiang; Liao, Xian-Zhen; Mao, A-Yan; Ren, Jian-Song; Sun, Xiao-Jie; Guo, Lan-Wei; Fang, Yi; Zhou, Qi; Ma, Heng-Min; Xing, Xiao-Jing; Zhu, Lin; Song, Bing-Bing; Du, Ling-Bin; Mai, Ling; Liu, Yu-Qin; Ren, Ying; Lan, Li; Zhou, Jin-Yi; Qi, Xiao; Sun, Xiao-Hua; Lou, Pei-An; Wu, Shou-Ling; Li, Ni; Zhang, Kai; He, Jie; Dai, Min

    2018-06-01

    Health-related quality of life and utility scores of patients with breast cancer and precancerous lesions are sparse in China. This study aimed to derive utility scores of patients with breast cancer and precancer in China. An interviewer-administered cross-sectional survey was conducted in 12 provinces across China from 2013 to 2014. The three-level EuroQol-5-Dimension instrument was used to evaluate quality of life, and utility scores were generated using the Chinese value set. Univariate and multivariate analyses were performed to explore the determinants of utility scores. In total, 2626 breast cancer and 471 precancer patients were included. Mean age was 49.1 for breast cancer and 41.4 years for precancer (p < 0.001). Among the five dimensions, pain/discomfort was the most reported problem, 53.9% in breast cancer and 29.3% in precancer patients. Mean (95% CI) utility scores for breast cancer and precancer patients were estimated as 0.887 (0.875-0.899) and 0.781 (0.774-0.788), and the scores of breast cancer at stage-I, stage-II, stage-III and stage-IV were 0.789 (0.774-0.805), 0.793 (0.783-0.802), 0.774 (0.759-0.788) and 0.686 (0.654-0.717), respectively. Mean (95% CI) visual analogue scale scores for breast cancer and precancer were 75.6 (74.0-77.3) and 72.8 (72.3-73.3). Multiple regression showed advanced clinical stage, lower educational level, lower household income, surgery treatment, and undergoing treatment were independently associated with lower utility scores for breast cancer patients. The utility scores deteriorate with the severity of breast neoplasms. Detailed utility scores of breast cancer and precancer are fundamental for further cost-utility analysis in China. Copyright © 2018. Published by Elsevier Ltd.

  3. Is home-based palliative care cost-effective? An economic evaluation of the Palliative Care Extended Packages at Home (PEACH) pilot.

    PubMed

    McCaffrey, Nikki; Agar, Meera; Harlum, Janeane; Karnon, Jonathon; Currow, David; Eckermann, Simon

    2013-12-01

    The aim of this study was to evaluate the cost-effectiveness of a home-based palliative care model relative to usual care in expediting discharge or enabling patients to remain at home. Economic evaluation of a pilot randomised controlled trial with 28 days follow-up. Mean costs and effectiveness were calculated for the Palliative Care Extended Packages at Home (PEACH) and usual care arms including: days at home; place of death; PEACH intervention costs; specialist palliative care service use; acute hospital and palliative care unit inpatient stays; and outpatient visits. PEACH mean intervention costs per patient ($3489) were largely offset by lower mean inpatient care costs ($2450) and in this arm, participants were at home for one additional day on average. Consequently, PEACH is cost-effective relative to usual care when the threshold value for one extra day at home exceeds $1068, or $2547 if only within-study days of hospital admission are costed. All estimates are high uncertainty. The results of this small pilot study point to the potential of PEACH as a cost-effective end-of-life care model relative to usual care. Findings support the feasibility of conducting a definitive, fully powered study with longer follow-up and comprehensive economic evaluation.

  4. Factors influencing nurses' acceptance of hospital information systems in Iran: application of the Unified Theory of Acceptance and Use of Technology.

    PubMed

    Sharifian, Roxana; Askarian, Fatemeh; Nematolahi, Mohtaram; Farhadi, Payam

    User acceptance is a precondition for successful implementation of hospital information systems (HISs). Increasing investment in information technology by healthcare organisations internationally has made user acceptance an important issue in technology implementation and management. Despite the increased focus on hospital information systems, there continues to be user resistance. The present study aimed to investigate the factors affecting hospital information systems nurse-user acceptance of HISs, based on the Unified Theory of Acceptance and Use of Technology (UTAUT), in the Shiraz University of Medical Sciences teaching hospitals. A descriptive-analytical research design was employed to study nurses' adoption and use of HISs. Data collection was undertaken using a cross-sectional survey of nurses (n=303). The research model was examined using the LISREL path confirmatory modeling. The results demonstrated that the nurses' behavioural intention (BI) to use hospital information systems was predicted by Performance Expectancy (PE) (β= 2.34, p<0.01), Effort Expectancy (EE) (β= 2.21, p<0.01), Social Influence (SI) (β= 2.63, p<0.01) and Facilitating Conditions (FC) (β= 2.84, p<0.01). The effects of these antecedents of BI explained 72.8% of the variance in nurses' intention to use hospital information systems (R2 = 0.728). Application of the research model suggested that nurses' acceptance of HISs was influenced by performance expectancy, effort expectancy, social influence and facilitating conditions, with performance expectancy having the strongest effect on user intention.

  5. PubMed Central

    Turchetti, G.; Bellelli, S.; Palla, I.; Forli, F.

    2011-01-01

    SUMMARY The aim of the study consists in a systematic review concerning the economic evaluation of cochlear implant (CI) in children by searching the main international clinical and economic electronic databases. All primary studies published in English from January 2000 to May 2010 were included. The types of studies selected concerned partial economic evaluation, including direct and indirect costs of cochlear implantation; complete economic evaluation, including minimization of costs, cost-effectiveness analysis (CEA), cost-utility analysis (CUA) and cost-benefit analysis (CBA) performed through observational and experimental studies. A total of 68 articles were obtained from the database research. Of these, 54 did not meet the inclusion criteria and were eliminated. After reading the abstracts of the 14 articles selected, 11 were considered eligible. The articles were then read in full text. Furthermore, 5 articles identified by bibliography research were added manually. After reading 16 of the selected articles, 9 were included in the review. With regard to the studies included, countries examined, objectives, study design, methodology, prospect of analysis adopted, temporal horizon, the cost categories analyzed strongly differ from one study to another. Cost analysis, cost-effectiveness analysis and an analysis of educational costs associated with cochlear implants were performed. Regarding the cost analysis, only two articles reported both direct cost and indirect costs. The direct cost ranged between € 39,507 and € 68,235 (2011 values). The studies related to cost-effectiveness analysis were not easily comparable: one study reported a cost per QALY ranging between $ 5197 and $ 9209; another referred a cost of $ 2154 for QALY if benefits were not discounted, and $ 16,546 if discounted. Educational costs are significant, and increase with the level of hearing loss and type of school attended. This systematic review shows that the healthcare costs are high, but savings in terms of indirect and quality of life costs are also significant. Cochlear implantation in a paediatric age is cost-effective. The exiguity and heterogeneity of studies did not allow detailed comparative analysis of the studies included in the review. PMID:22287822

  6. Cost-effectiveness of health research study participant recruitment strategies: a systematic review.

    PubMed

    Huynh, Lynn; Johns, Benjamin; Liu, Su-Hsun; Vedula, S Swaroop; Li, Tianjing; Puhan, Milo A

    2014-10-01

    A large fraction of the cost of conducting clinical trials is allocated to recruitment of participants. A synthesis of findings from studies that evaluate the cost and effectiveness of different recruitment strategies will inform investigators in designing cost-efficient clinical trials. To systematically identify, assess, and synthesize evidence from published comparisons of the cost and yield of strategies for recruitment of participants to health research studies. We included randomized studies in which two or more strategies for recruitment of participants had been compared. We focused our economic evaluation on studies that randomized participants to different recruitment strategies. We identified 10 randomized studies that compared recruitment strategies, including monetary incentives (cash or prize), direct contact (letters or telephone call), and medical referral strategies. Only two of the 10 studies compared strategies for recruiting participants to clinical trials. We found that allocating additional resources to recruit participants using monetary incentives or direct contact yielded between 4% and 23% additional participants compared to using neither strategy. For medical referral, recruitment of prostate cancer patients by nurses was cost-saving compared to recruitment by consultant urologists. For all underlying study designs, monetary incentives cost more than direct contact with potential participants, with a median incremental cost per recruitment ratio of Int$72 (Int$-International dollar, a theoretical unit of currency) for monetary incentive strategy compared to Int$28 for direct contact strategy. Only monetary incentives and source of referral were evaluated for recruiting participants into clinical trials. We did not review studies that presented non-monetary cost or lost opportunity cost. We did not adjust for the number of study recruitment sites or the study duration in our economic evaluation analysis. Systematic and explicit reporting of cost and effectiveness of recruitment strategies from randomized comparisons is required to aid investigators to select cost-efficient strategies for recruiting participants to health research studies including clinical trials. © The Author(s) 2014.

  7. Review of economic evaluations of mask and respirator use for protection against respiratory infection transmission.

    PubMed

    Mukerji, Shohini; MacIntyre, C Raina; Newall, Anthony T

    2015-10-13

    There has been increasing debate surrounding mask and respirator interventions to control respiratory infection transmission in both healthcare and community settings. As decision makers are considering the recommendations they should evaluate how to provide the most efficient protection strategies with minimum costs. The aim of this review is to identify and evaluate the existing economic evaluation literature in this area and to offer advice on how future evaluations on this topic should be conducted. We searched the Scopus database for all literature on economic evaluation of mask or respirator use to control respiratory infection transmission. Reference lists from the identified studies were also manually searched. Seven studies met our inclusion criteria from the initial 806 studies identified by the search strategy and our manual search. Five studies considered interventions for seasonal and/or pandemic influenza, with one also considering SARS (Severe Acute Respiratory Syndrome). The other two studies focussed on tuberculosis transmission control interventions. The settings and methodologies of the studies varied greatly. No low-middle income settings were identified. Only one of the reviewed studies cited clinical evidence to inform their mask/respirator intervention effectiveness parameters. Mask and respirator interventions were generally reported by the study authors to be cost saving or cost-effective when compared to no intervention or other control measures, however the evaluations had important limitations. Given the large cost differential between masks and respirators, there is a need for more comprehensive economic evaluations to compare the relative costs and benefits of these interventions in situations and settings where alternative options are potentially applicable. There are at present insufficient well conducted cost-effectiveness studies to inform decision-makers on the value for money of alternative mask/respirator options.

  8. Evaluating the Reliability, Validity, and Usefulness of Education Cost Studies

    ERIC Educational Resources Information Center

    Baker, Bruce D.

    2006-01-01

    Recent studies that purport to estimate the costs of constitutionally adequate education have been described as either a "gold standard" that should guide legislative school finance policy design and judicial evaluation, or as pure "alchemy." Methods for estimating the cost of constitutionally adequate education can be roughly…

  9. English language YouTube videos as a source of lead poisoning-related information: a cross-sectional study.

    PubMed

    Basch, Corey H; Jackson, Ashley M; Yin, Jingjing; Hammond, Rodney N; Adhikari, Atin; Fung, Isaac Chun-Hai

    2017-07-01

    Exposure to lead is detrimental to children's development. YouTube is a form of social media through which people may learn about lead poisoning. The aim of this cross-sectional study was to analyze the variation in lead poisoning-related YouTube contents between different video sources. The 100 most viewed lead poisoning-related videos were manually coded, among which, 50 were consumer-generated, 19 were created by health care professionals, and 31 were news. The 100 videos had a total of more than 8.9 million views, with news videos accounting for 63% of those views. The odds of mentioning what lead poisoning is, how to remove lead, and specifically mentioning the danger in ages 1-5 because of rapid growth among videos created by health care professionals were 7.28 times (Odds ratio, OR = 7.28, 95% CI, 2.09, 25.37, p = 0.002); 6.83 times (OR = 6.83, 95% CI, 2.05, 22.75, p = 0.002) and 9.14 times (OR = 9.14, CI, 2.05, 40.70, p = 0.004) that of consumer-generated videos, respectively. In this study, professional videos had more accurate information regarding lead but their videos were less likely to be viewed compared to consumer-generated videos and news videos. If professional videos about lead poisoning can attract more viewers, more people would be better informed and could possibly influence policy agendas, thereby helping communities being affected by lead exposure.

  10. 78 FR 18672 - Proposed Agency Information Collection Activities; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-27

    ... monitoring regulatory compliance. Form Number(s): N/A. Affected Public: Businesses. Respondent Universe: 728 railroads. Frequency of Submission: On occasion. Average time CFR section Respondent universe Total annual... time CFR section Respondent universe Total annual per response Total annual responses (minutes) burden...

  11. 31 CFR 501.728 - Subpoenas.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... of hearing, and subpoenas requiring the production of documentary or other tangible evidence... subpoena shall be made in writing and served on each party pursuant to § 501.705. (b) Standards for..., file an opposition to the application. (2) Standards governing application to quash or modify. If the...

  12. 75 FR 21594 - Foreign-Trade Zone 126-Reno, NV, Application for Reorganization/Expansion Under Alternative Site...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-26

    ... 1 (13.9 acres)--728 Spice Island Drive, Sparks; Site 2 (9 acres)--450-475 Lillard Drive, Sparks... 700 South Rock Boulevard, Reno; Site 14 (0.4 acres)--1095 Spice Island Drive, Sparks; Site 15 (0.7...

  13. 32 CFR 728.46 - Charges and collection.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... provisions prohibiting the expenditure of appropriated funds “. . . to provide medical care in the United... have integral health care capability. Any health care services which members of such units receive from... National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE...

  14. 32 CFR 728.46 - Charges and collection.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... provisions prohibiting the expenditure of appropriated funds “. . . to provide medical care in the United... have integral health care capability. Any health care services which members of such units receive from... National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE...

  15. 32 CFR 728.46 - Charges and collection.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... provisions prohibiting the expenditure of appropriated funds “. . . to provide medical care in the United... have integral health care capability. Any health care services which members of such units receive from... National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE...

  16. 32 CFR 728.46 - Charges and collection.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... provisions prohibiting the expenditure of appropriated funds “. . . to provide medical care in the United... have integral health care capability. Any health care services which members of such units receive from... National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE...

  17. 32 CFR 728.46 - Charges and collection.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... provisions prohibiting the expenditure of appropriated funds “. . . to provide medical care in the United... have integral health care capability. Any health care services which members of such units receive from... National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE...

  18. 9 CFR 72.8 - Interstate movement of cattle from free premises upon inspection and certification by APHIS...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... located in areas where tick eradication is being conducted in co- operation with the State authorities, and which are on premises shown by the official records of tick eradication to be free from ticks, may...

  19. 9 CFR 72.8 - Interstate movement of cattle from free premises upon inspection and certification by APHIS...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... located in areas where tick eradication is being conducted in co- operation with the State authorities, and which are on premises shown by the official records of tick eradication to be free from ticks, may...

  20. 9 CFR 72.8 - Interstate movement of cattle from free premises upon inspection and certification by APHIS...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... located in areas where tick eradication is being conducted in co- operation with the State authorities, and which are on premises shown by the official records of tick eradication to be free from ticks, may...

  1. 32 CFR 728.81 - Other civilians.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR... domiciliary care. Routine dental care, other than dental prostheses and orthodontia, is authorized on a space...) of this section are authorized emergency medical and dental care in naval MTFs outside the 48...

  2. 32 CFR 728.80 - U.S. Government employees.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE..., exclusive of nervous, mental, or contagious diseases or those requiring domiciliary care. Routine dental care, other than dental prosthesis and orthodontia, is authorized on a space available basis provided...

  3. 32 CFR 728.81 - Other civilians.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR... domiciliary care. Routine dental care, other than dental prostheses and orthodontia, is authorized on a space...) of this section are authorized emergency medical and dental care in naval MTFs outside the 48...

  4. 32 CFR 728.79 - Employees of Federal contractors and subcontractors.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Other Persons... nervous, mental, or contagious diseases or those requiring domiciliary care. Routine dental care, other than dental prosthesis and orthodontia, is authorized on a space available basis provided facilities...

  5. 32 CFR 728.79 - Employees of Federal contractors and subcontractors.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Other Persons... nervous, mental, or contagious diseases or those requiring domiciliary care. Routine dental care, other than dental prosthesis and orthodontia, is authorized on a space available basis provided facilities...

  6. 32 CFR 728.80 - U.S. Government employees.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE..., exclusive of nervous, mental, or contagious diseases or those requiring domiciliary care. Routine dental care, other than dental prosthesis and orthodontia, is authorized on a space available basis provided...

  7. 32 CFR 728.80 - U.S. Government employees.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE..., exclusive of nervous, mental, or contagious diseases or those requiring domiciliary care. Routine dental care, other than dental prosthesis and orthodontia, is authorized on a space available basis provided...

  8. 32 CFR 728.81 - Other civilians.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR... domiciliary care. Routine dental care, other than dental prostheses and orthodontia, is authorized on a space...) of this section are authorized emergency medical and dental care in naval MTFs outside the 48...

  9. 32 CFR 728.80 - U.S. Government employees.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE..., exclusive of nervous, mental, or contagious diseases or those requiring domiciliary care. Routine dental care, other than dental prosthesis and orthodontia, is authorized on a space available basis provided...

  10. 32 CFR 728.79 - Employees of Federal contractors and subcontractors.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Other Persons... nervous, mental, or contagious diseases or those requiring domiciliary care. Routine dental care, other than dental prosthesis and orthodontia, is authorized on a space available basis provided facilities...

  11. 32 CFR 728.81 - Other civilians.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR... domiciliary care. Routine dental care, other than dental prostheses and orthodontia, is authorized on a space...) of this section are authorized emergency medical and dental care in naval MTFs outside the 48...

  12. 32 CFR 728.79 - Employees of Federal contractors and subcontractors.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Other Persons... nervous, mental, or contagious diseases or those requiring domiciliary care. Routine dental care, other than dental prosthesis and orthodontia, is authorized on a space available basis provided facilities...

  13. A Tri-Band Frequency Selective Surface (FSS) to Diplex Widely Separated Bands for Millimeter Wave Remote Sensing

    NASA Astrophysics Data System (ADS)

    Poojali, Jayaprakash; Ray, Shaumik; Pesala, Bala; Chitti, Krishnamurthy V.; Arunachalam, Kavitha

    2016-10-01

    A substrate-backed frequency selective surface (FSS) is presented for diplexing the widely separated frequency spectrum centered at 55, 89, and 183 GHz with varying bandwidth for spatial separation in the quasi-optical feed network of the millimeter wave sounder. A unit cell composed of a crossed dipole integrated with a circular ring and loaded inside a square ring is optimized for tri-band frequency response with transmission window at 89 GHz and rejection windows at 55 and 183 GHz. The reflection and transmission losses predicted for the optimized unit cell (728 μm × 728 μm) composed of dissimilar resonant shapes is less than 0.5 dB for transverse electric (TE) and transverse magnetic (TM) polarizations and wide angle of incidence (0°-45°). The FSS is fabricated on a 175-μm-thick quartz substrate using microfabrication techniques. The transmission characteristics measured with continuous wave (CW) terahertz transmit receive system are in good agreement with the numerical simulations.

  14. Evaluation and modeling of aerodynamic properties of mung bean seeds

    NASA Astrophysics Data System (ADS)

    Shahbazi, Feizollah

    2015-01-01

    Aerodynamic properties of solid materials have long been used to convey and separate seeds and grains during post harvest operations. The objective of this study was the evaluation of the aerodynamic properties of mung bean seeds as a function of moisture content and two grades referred to above and below a cut point of 4.8 mm in length. The results showed that as the moisture content increased from 7.8 to 25% (w.b.), the terminal velocity of seeds increased following a polynomial relationship, from 7.28 to 8.79 and 6.02 to 7.12 m s-1, for grades A and B, respectively. Seeds at grade A had terminal velocities with a mean value of 8.05 m s-1, while at grade B had a mean value of 6.46 m s-1. The Reynolds number of both grades increased linearly with the increase of seeds moisture content, while the drag coefficient decreased with the increase of moisture content. Mathematical relationships were developed to relate the change in seeds moisture content with the obtained values of aerodynamic properties. The analysis of variance showed that moisture content had a significant effect, at 1% probability level, on all the aerodynamics properties of mung beans.

  15. The complete nucleotide sequences of the five genetically distinct plastid genomes of Oenothera, subsection Oenothera: I. sequence evaluation and plastome evolution.

    PubMed

    Greiner, Stephan; Wang, Xi; Rauwolf, Uwe; Silber, Martina V; Mayer, Klaus; Meurer, Jörg; Haberer, Georg; Herrmann, Reinhold G

    2008-04-01

    The flowering plant genus Oenothera is uniquely suited for studying molecular mechanisms of speciation. It assembles an intriguing combination of genetic features, including permanent translocation heterozygosity, biparental transmission of plastids, and a general interfertility of well-defined species. This allows an exchange of plastids and nuclei between species often resulting in plastome-genome incompatibility. For evaluation of its molecular determinants we present the complete nucleotide sequences of the five basic, genetically distinguishable plastid chromosomes of subsection Oenothera (=Euoenothera) of the genus, which are associated in distinct combinations with six basic genomes. Sizes of the chromosomes range from 163 365 bp (plastome IV) to 165 728 bp (plastome I), display between 96.3% and 98.6% sequence similarity and encode a total of 113 unique genes. Plastome diversification is caused by an abundance of nucleotide substitutions, small insertions, deletions and repetitions. The five plastomes deviate from the general ancestral design of plastid chromosomes of vascular plants by a subsection-specific 56 kb inversion within the large single-copy segment. This inversion disrupted operon structures and predates the divergence of the subsection presumably 1 My ago. Phylogenetic relationships suggest plastomes I-III in one clade, while plastome IV appears to be closest to the common ancestor.

  16. The complete nucleotide sequences of the five genetically distinct plastid genomes of Oenothera, subsection Oenothera: I. Sequence evaluation and plastome evolution†

    PubMed Central

    Greiner, Stephan; Wang, Xi; Rauwolf, Uwe; Silber, Martina V.; Mayer, Klaus; Meurer, Jörg; Haberer, Georg; Herrmann, Reinhold G.

    2008-01-01

    The flowering plant genus Oenothera is uniquely suited for studying molecular mechanisms of speciation. It assembles an intriguing combination of genetic features, including permanent translocation heterozygosity, biparental transmission of plastids, and a general interfertility of well-defined species. This allows an exchange of plastids and nuclei between species often resulting in plastome–genome incompatibility. For evaluation of its molecular determinants we present the complete nucleotide sequences of the five basic, genetically distinguishable plastid chromosomes of subsection Oenothera (=Euoenothera) of the genus, which are associated in distinct combinations with six basic genomes. Sizes of the chromosomes range from 163 365 bp (plastome IV) to 165 728 bp (plastome I), display between 96.3% and 98.6% sequence similarity and encode a total of 113 unique genes. Plastome diversification is caused by an abundance of nucleotide substitutions, small insertions, deletions and repetitions. The five plastomes deviate from the general ancestral design of plastid chromosomes of vascular plants by a subsection-specific 56 kb inversion within the large single-copy segment. This inversion disrupted operon structures and predates the divergence of the subsection presumably 1 My ago. Phylogenetic relationships suggest plastomes I–III in one clade, while plastome IV appears to be closest to the common ancestor. PMID:18299283

  17. Evaluation of the Field Test of Project Information Packages: Volume III--Resource Cost Analysis.

    ERIC Educational Resources Information Center

    Al-Salam, Nabeel; And Others

    The third of three volumes evaluating the first year field test of the Project Information Packages (PIPs) provides a cost analysis study as a key element in the total evaluation. The resource approach to cost analysis is explained and the specific resource methodology used in the main cost analysis of the 19 PIP field-test projects detailed. The…

  18. A Systematic Review of the Economic Evidence for Home Support Interventions in Dementia.

    PubMed

    Clarkson, Paul; Davies, Linda; Jasper, Rowan; Loynes, Niklas; Challis, David

    2017-09-01

    Recent evidence signals the need for effective forms of home support to people with dementia and their carers. The cost-effectiveness evidence of different approaches to support is scant. To appraise economic evidence on the cost-effectiveness of home support interventions for dementia to inform future evaluation. A systematic literature review of full and partial economic evaluations was performed using the British National Health Service Economic Evaluation Database supplemented by additional references. Study characteristics and findings, including incremental cost-effectiveness ratios, when available, were summarized narratively. Study quality was appraised using the National Health Service Economic Evaluation Database critical appraisal criteria and independent ratings, agreed by two reviewers. Studies were located on a permutation matrix describing their mix of incremental costs/effects to aid decision making. Of the 151 articles retrieved, 14 studies met the inclusion criteria: 8 concerning support to people with dementia and 6 to carers. Five studies were incremental cost-utility analyses, seven were cost-effectiveness analyses, and two were cost consequences analyses. Five studies expressed incremental cost-effectiveness ratios as cost per quality-adjusted life-year (£6,696-£207,942 per quality-adjusted life-year). In four studies, interventions were dominant over usual care. Two interventions were more costly but more beneficial and were favorable against current acceptability thresholds. Occupational therapy, home-based exercise, and a carers' coping intervention emerged as cost-effective approaches for which there was better evidence. These interventions used environmental modifications, behavior management, physical activity, and emotional support as active components. More robust evidence is needed to judge the value of these and other interventions across the dementia care pathway. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  19. Systematic Review of Economic Evaluation of Laparotomy versus Laparoscopy for Patients Submitted to Roux-en-Y Gastric Bypass

    PubMed Central

    Sussenbach, Samanta Pereira; Silva, Everton Nunes; Pufal, Milene Amarante; Casagrande, Daniela Shan; Padoin, Alexandre Vontobel; Mottin, Cláudio Corá

    2014-01-01

    Background Because of the high prevalence of obesity, there is a growing demand for bariatric surgery worldwide. The objective of this systematic review was to analyze the difference in relation to cost-effectiveness of access route by laparoscopy versus laparotomy of Roux en-Y gastric bypass (RYGB). Methods A systematic review was conducted in the electronic databases MEDLINE, Embase, Scopus, Cochrane and Lilacs in order to identify economic evaluation studies that compare the cost-effectiveness of laparoscopic and laparotomic routes in RYGB. Results In a total of 494 articles, only 6 fulfilled the eligibility criteria. All studies were published between 2001 and 2008 in the United States (USA). Three studies fulfilled less than half of the items that evaluated the results quality; two satisfied 5 of the required items, and only 1 study fulfilled 7 of 10 items. The economic evaluation of studies alternated between cost-effectiveness and cost-consequence. Five studies considered the surgery by laparoscopy the dominant strategy, because it showed greater clinical benefit (less probability of post-surgical complications, less hospitalization time) and lower total cost. Conclusion This review indicates that laparoscopy is a safe and well-tolerated technique, despite the costs of surgery being higher when compared with laparotomy. However, the additional costs are compensated by the lower probability of complications after surgery and, consequently, avoiding their costs. PMID:24945704

  20. Cost effectiveness of pharmacological maintenance treatment for chronic obstructive pulmonary disease: a review of the evidence and methodological issues.

    PubMed

    Rutten-van Mölken, Maureen P M H; Goossens, Lucas M A

    2012-04-01

    Over 200 million people have chronic obstructive pulmonary disease (COPD) worldwide. The number of disease-year equivalents and deaths attributable to COPD are high. Guidelines for the pharmacological treatment of the disease recommend an individualized step-up approach in which treatment is intensified when results are unsatisfactory. Our objective was to present a systematic review of the cost effectiveness of pharmacological maintenance treatment for COPD and to discuss the methodological strengths and weaknesses of the studies. A systematic literature search for economic evaluations of drug therapy in COPD was performed in MEDLINE, EMBASE, the Economic Evaluation Database of the UK NHS (NHS-EED) and the European Network of Health Economic Evaluation Databases (EURONHEED). Full economic evaluations presenting both costs and health outcomes were included. A total of 40 studies were included in the review. Of these, 16 were linked to a clinical trial, 14 used Markov models, eight were based on observational data and two used a different approach. The few studies on combining short-acting bronchodilators were consistent in finding net cost savings compared with monotherapy. Studies comparing inhaled corticosteroids (ICS) with placebo or no maintenance treatment reported inconsistent results. Studies comparing fluticasone with salmeterol consistently found salmeterol to be more cost effective. The cost-effectiveness studies of tiotropium versus placebo, ipratropium or salmeterol pointed towards a reduction in total COPD-related healthcare costs for tiotropium in many but not all studies. All of these studies reported additional health benefits of tiotropium. The cost-effectiveness studies of the combination of inhaled long-acting β₂-agonists and ICS all report additional health benefits at an increase in total COPD-related costs in most studies. The cost-per-QALY estimates of this combination treatment vary widely and are very sensitive to the assumptions on mortality benefit and time horizon. The currently available economic evaluations indicate differences in cost effectiveness between COPD maintenance therapies, but for a more meaningful comparison of results it is important to improve the consistency with respect to study methodology and choice of comparator.

  1. Structural cost optimization of photovoltaic central power station modules and support structure

    NASA Technical Reports Server (NTRS)

    Sutton, P. D.; Stolte, W. J.; Marsh, R. O.

    1979-01-01

    The results of a comprehensive study of photovoltaic module structural support concepts for photovoltaic central power stations and their associated costs are presented. The objective of the study has been the identification of structural cost drivers. Parametric structural design and cost analyses of complete array systems consisting of modules, primary support structures, and foundations were performed. Area related module cost was found to be constant with design, size, and loading. A curved glass module concept was evaluated and found to have the potential to significantly reduce panel structural costs. Conclusions of the study are: array costs do not vary greatly among the designs evaluated; panel and array costs are strongly dependent on design loading; and the best support configuration is load dependent

  2. Evaluation and Characterization of Health Economics and Outcomes Research in SAARC Nations.

    PubMed

    Mehta, Manthan; Nerurkar, Rajan

    2018-05-01

    To identify, evaluate, and characterize the variety, quality, and intent of the health economics and outcomes research studies being conducted in SAARC (South Asian Association for Regional Cooperation) nations. Studies published in English language between 1990 and 2015 were retrieved from Medline databases using relevant search strategies. Studies were independently reviewed as per Cochrane methodology and information on the type of research and outcomes were extracted. Quality of reporting was assessed. Of the 2638 studies screened from eight SAARC nations, a total of 179 were included for review (India = 140; Bangladesh = 12; Sri Lanka = 8; Pakistan = 7; Afghanistan = 5; Nepal = 4; Bhutan = 2; Maldives = 1). The broad study categories were cost-effectiveness analyses (CEAs = 76 studies), cost analyses (35 studies), and burden of illness (BOI=26 studies). The outcomes evaluated were direct costs, indirect costs, and incremental cost-effectiveness ratio (ICER), quality-adjusted life-years (QALYs), and disability-adjusted life-years (DALYs). Cost of medicines, consultation and hospital charges, and monitoring costs were assessed as direct medical costs along with non-direct medical costs such as travel and food for patients and caregivers. The components of indirect costs were loss of income of patients and caregivers and loss of productivity. Quality of life (QoL) was assessed in 48 studies. The most commonly used instrument for assessing QoL was the WHO-Quality of Life BREF (WHOQOL-BREF) questionnaire (76%). The Quality of Health Economic Studies (QHES) score was used for quality assessment of full economic studies (44 studies). The mean QHES score was 43.76. This review identifies various patterns of health economic studies in eight SAARC nations. The quality of economic evaluation studies for health care in India, Bangladesh, Sri Lanka, Pakistan, Afghanistan, Nepal, Bhutan, and Maldives needs improvement. There is a need to generate the capacity of researchers to undertake quality economic evaluations as well as an orientation of the policy makers so that there is a demand for such studies as well as a scope for its use in policy making.

  3. A systematic review of economic evaluations of population-based sodium reduction interventions

    PubMed Central

    Hope, Silvia F.; Webster, Jacqui; Trieu, Kathy; Pillay, Arti; Ieremia, Merina; Bell, Colin; Snowdon, Wendy; Neal, Bruce; Moodie, Marj

    2017-01-01

    Objective To summarise evidence describing the cost-effectiveness of population-based interventions targeting sodium reduction. Methods A systematic search of published and grey literature databases and websites was conducted using specified key words. Characteristics of identified economic evaluations were recorded, and included studies were appraised for reporting quality using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Results Twenty studies met the study inclusion criteria and received a full paper review. Fourteen studies were identified as full economic evaluations in that they included both costs and benefits associated with an intervention measured against a comparator. Most studies were modelling exercises based on scenarios for achieving salt reduction and assumed effects on health outcomes. All 14 studies concluded that their specified intervention(s) targeting reductions in population sodium consumption were cost-effective, and in the majority of cases, were cost saving. Just over half the studies (8/14) were assessed as being of ‘excellent’ reporting quality, five studies fell into the ‘very good’ quality category and one into the ‘good’ category. All of the identified evaluations were based on modelling, whereby inputs for all the key parameters including the effect size were either drawn from published datasets, existing literature or based on expert advice. Conclusion Despite a clear increase in evaluations of salt reduction programs in recent years, this review identified relatively few economic evaluations of population salt reduction interventions. None of the studies were based on actual implementation of intervention(s) and the associated collection of new empirical data. The studies universally showed that population-based salt reduction strategies are likely to be cost effective or cost saving. However, given the reliance on modelling, there is a need for the effectiveness of new interventions to be evaluated in the field using strong study designs and parallel economic evaluations. PMID:28355231

  4. Development of low cost custom hybrid microcircuit technology

    NASA Technical Reports Server (NTRS)

    Perkins, K. L.; Licari, J. J.

    1981-01-01

    Selected potentially low cost, alternate packaging and interconnection techniques were developed and implemented in the manufacture of specific NASA/MSFC hardware, and the actual cost savings achieved by their use. The hardware chosen as the test bed for this evaluation ws the hybrids and modules manufactured by Rockwell International fo the MSFC Flight Accelerometer Safety Cut-Off System (FASCOS). Three potentially low cost packaging and interconnection alternates were selected for evaluation. This study was performed in three phases: hardware fabrication and testing, cost comparison, and reliability evaluation.

  5. Effect of Various Finishing Procedures on the Reflectivity (Shine) of Tooth Enamel - An In-vitro Study.

    PubMed

    Patil, Harshal Ashok; Chitko, Shrikant Shrinivas; Kerudi, Veerendra Virupaxappa; Maheshwari, Amit Ratanlal; Patil, Neeraj Suresh; Tekale, Pawankumar Dnyandeo; Gore, Ketan Ashorao; Zope, Amit Ashok

    2016-08-01

    Reflectivity of an object is a good parameter for surface finish. As the patient evaluates finishing as a function of gloss/reflectivity/shine an attempt is made here to evaluate changes in surface finish with custom made reflectometer. The aim of the present study was to study the effect of various procedures during orthodontic treatment on the shine of enamel, using a custom made reflectometer. Sixty one extracted premolars were collected and each tooth was mounted on acrylic block. Reflectivity of the teeth was measured as compared to standard before any procedure. One tooth was kept as standard throughout the study. Sixty teeth were acid etched. Reflectivity was measured on custom made reflectometer and readings recorded. Same procedure was repeated after debonding. Then 60 samples were divided into three groups: Group 1 - Tungsten Carbide, Group 2 - Astropol, Group 3- Sof-Lex disc depending upon the finishing method after debonding and reflectivity was measured. The mean percentage of reflectivity after acid etching was 31.4%, debonding 45.5%, Tungsten carbide bur finishing (Group 1) was 58.3%, Astropol (Group 2) 72.8%, and Sof-Lex disc (Group 3) 84.4% as that to the standard. There was statistically very highly significant (p<0.001) difference in reflectivity restored by the three finishing materials in the study. Thus, the light reflection was better in Group 3> Group 2> Group 1. The primary goal was to restore the enamel to its original state after orthodontic treatment. The methods tested in this study could not restore the original enamel reflectivity.

  6. Cost-effectiveness of Occupational Therapy in Older People: Systematic Review of Randomized Controlled Trials.

    PubMed

    Nagayama, Hirofumi; Tomori, Kounosuke; Ohno, Kanta; Takahashi, Kayoko; Yamauchi, Keita

    2016-06-01

    A systematic review of the cost-effectiveness of occupational therapy for older people was conducted. MEDLINE, CINAHL, Web of Science, PsycINFO, Cochrane Library, OT seeker and unpublished trials registers were searched. Reference lists of all potentially eligible studies were searched with no language restrictions. We included trial-based full economic evaluations that considered both costs and outcomes in occupational therapy for older people compared with standard care (i.e. other therapy) or no intervention. We reviewed each trial for methodological quality using the Cochrane risk of bias tool and assessed the quality of economic evaluations using a Drummond checklist. In the results of this review, we included five eligible studies (1-5) that were randomized controlled trials with high-quality economic evaluation. Two studies were full economic evaluations of interventions for fall prevention (1 and 2); two studies were full economic evaluations of preventive occupational therapy interventions (3 and 4; one was a comparison of an occupational therapy group with a social work group); one study was a full economic evaluation of occupational therapy for individuals with dementia (5). Two of the studies (one was preventive occupational therapy [3] and the other was occupational therapy for dementia [5]) found a significant effect and confirmed the cost-effectiveness of occupational therapy for older people compared with the control group. These studies found that occupational therapy for older people was clinically effective and cost-effective in comparison with standard care or other therapies. With reference to their clinical implication, these intervention studies (using a client-centred approach) suggested potentially cost-effective means to motivate clients to maintain their own health. However, this review has limitations because of the high heterogeneity of the reviewed studies on full economic evaluations of occupational therapy for older people. Future studies on the cost-effectiveness of occupational therapy in older people are strongly warranted. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  7. Life cycle cost analysis rehabilitation costs.

    DOT National Transportation Integrated Search

    2015-07-01

    This study evaluates data from CDOTs Cost Data books and Pavement Management Program. Cost : indices were used to normalize project data to year 2014. Data analyzed in the study was obtained from : the CDOTs Cost Data books and the Pavement Man...

  8. Quality of life of immigrant and non-immigrant infertile patients in a publicly funded in vitro fertilisation program: a cross-sectional study.

    PubMed

    Hasson, J; Tulandi, T; Shavit, T; Shaulov, T; Seccareccia, E; Takefman, J

    2017-11-01

    To investigate whether there are differences in fertility quality of life (FertiQoL) and socio-demographic characteristics between immigrants and non-immigrant patients attending a government-funded fertility program. Cross-sectional study. McGill University Reproductive Center in Montreal, Canada, at a time when governmental funding for in vitro fertilisation (IVF) was provided to all residents. All infertile patients, males and females, attending the center between March and July 2015. Patients were invited to complete anonymous questionnaires which included socio-demographic items and the validated FertiQoL questionnaire. Socio-demographic characteristics (age, gender, marital state, infertility type & duration, previous IVF attempts; education, employment, income, ethnicity, spoken languages) and FertiQoL scores. In all, 1020 patients completed the questionnaires; of these, 752 (77.7%) non-immigrant Canadian citizens and 215 (22.3%) resident immigrants were included in the analysis. Median duration in Canada for immigrants was 4 years. Immigrants were more likely to have university/graduate degrees (75% versus 64%), to be unemployed (37% versus 13.1%) and to have lower annual household incomes (72.8% versus 39.5%, all P < 0.05). They also reported poorer QoL and achieved significantly lower scores in the emotional, mind/body, social, treatment and total FertiQoL domains. Multivariate analysis showed male gender, lower education level and Caucasian/European ethnicity to be significantly associated with higher QoL. Despite governmental funding of IVF, immigrants experience reduced fertility QoL, implying cost is not the only barrier to IVF use. The reduced QoL may stem from cross-cultural differences in infertility perception. This population may be at greater risk for depression and anxiety and should be flagged accordingly. Immigrants' fertility QoL is lower despite publicly funded IVF implying cost is not the only barrier to IVF use. © 2017 Royal College of Obstetricians and Gynaecologists.

  9. [Is BNP assay useful for the diagnosis of acute dyspnea in emergencies departments?].

    PubMed

    Lakhdhar, Rim; Hamouda, Chokri; Ben Ammar, Lotfi; Majed, Kamel; Moncef, Fekih; Kaabachi, Naziha; Drissa, Habiba; Borsali Falfoul, Nebiha

    2013-01-01

    It would be interesting to the emergency doctor to have at his disposal a helpful diagnostic tool like brain natriuretic peptide (BNP). Such assay is simple, available and reliable. To report our experience on the role of BNP in the etiological diagnosis of acute dyspnea (AD) in emergency room (ER) and to assess the cost-effectiveness ratio of such diagnosis strategy. A prospective study conducted in the ER of Rabta university teaching hospital of Tunis, from March 1st to June 20th 2010, involving 30 consecutive patients presenting to the emergency for AD. All patients underwent echocardiography in their acute phase and benefited from the dosage of BNP during the first 4 hours. The echocardiography parameters were collected by a single operator who was unaware of the results of the BNP dosage. The mean age of patients was 72.8years with a sex ratio of 1.5. AD was of orthopnea type in 9 cases and stage III NYHA dyspnea in the other patients. Clinical and radiological signs of left heart failure were noted in 30% of cases. Ultrasound data have objectified systolic dysfunction in 4 cases, diastolic in 3 cases and systolic plus diastolic in 10 cases. The BNP levels were below 100 pg/ml in 10 cases with pulmonary origin of the AD. A BNP level between 100 and 400 pg/ml was noted in 3 cases. In our study, the clinical probability of AHF prior to performing the test was estimated at 53% and estimated at 100% after the BNP assay. The BNP assay has reduced the length of stay in the emergency department 4 to 5 days and saved nearly 50% of the cost of care per patient. The BNP assay, has allowed us to confirm the AHF all cases. Given the prognostic value and economic benefit of this test we recommend its use in ER of our country.

  10. Healthy Dental Pulp Oxygen Saturation Rates in Subjects with Homozygous Sickle Cell Anemia: A Cross-Sectional Study Nested in a Cohort.

    PubMed

    Souza, Soraia de Fátima Carvalho; Thomaz, Erika Bárbara Abreu Fonseca; Costa, Cyrene Piazera Silva

    2017-12-01

    To compare the percentage of arterial oxygen saturation (SpO 2 ) in healthy teeth with confirmed pulp vitality between individuals with sickle cell anemia (HbSS) and normal hemoglobin A (HbAA). This is a cross-sectional study nested within a cohort. Samples (n = 2543) comprised teeth with intact crowns and pulp vitality confirmed by thermal sensitivity tests and no history of caries, periodontal disease, or dental trauma. A total of 728 teeth of 113 individuals with HbSS and 1815 teeth of 246 individuals with HbAA were evaluated. Data analysis was performed using the χ 2 and Mann-Whitney tests and Spearman correlation analysis (α = 0.05). The study groups were comparable in terms of age, race, and sex (P > .05). Subjects with HbSS exhibited lower median SpO 2 levels in the body and upper teeth, excluding canines, than subjects with HbAA (P < .05). There were no significant differences in the evaluated parameters between the 2 groups (P > .05). Compared with individuals with HbAA, those with HbSS exhibited lower SpO 2 in maxillary teeth with confirmed pulp vitality, except in the canines. There was no correlation between SpO 2 levels of the body and dental pulp in individuals with HbSS or HbAA. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  11. Economic evaluation of drug abuse treatment and HIV prevention programs in pregnant women: a systematic review.

    PubMed

    Ruger, Jennifer Prah; Lazar, Christina M

    2012-01-01

    Drug abuse and transmission of HIV during pregnancy are public health problems that adversely affect pregnant women, their children and surrounding communities. Programs that address this vulnerable population have the ability to be cost-effective due to resulting cost savings for mother, child and society. Economic evaluations of programs that address these issues are an important tool to better understand the costs of services and create sustainable healthcare systems. This study critically examined economic evaluations of drug abuse treatment and HIV prevention programs in pregnant women. A systematic review was conducted using the criteria recommended by the Panel on Cost-Effectiveness in Health and Medicine and the British Medical Journal (BMJ) checklist for economic evaluations. The search identified 6 economic studies assessing drug abuse treatment for pregnant women, and 12 economic studies assessing programs that focus on prevention of mother-to-child transmission (PMTCT) of HIV. Results show that many programs for drug abuse treatment and PMTCT among pregnant women are cost-effective or even cost-saving. This study identified several shortcomings in methodology and lack of standardization of current economic evaluations. Efforts to address methodological challenges will help make future studies more comparable and have more influence on policy makers, clinicians and the public. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. 77 FR 58907 - Proposed Agency Information Collection Activities; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-24

    ... 6180.33/61/67/96/96A/109/110/111/112. Affected Public: Businesses. Respondent Universe: States and... Total annual CFR section universe responses response burden hours Application For Participation.... 15...): N/A. Affected Public: Businesses. Frequency of Submission: On occasion. Respondent Universe: 728...

  13. Earth observations taken from shuttle orbiter Columbia

    NASA Image and Video Library

    1995-10-22

    STS073-728-010 (22 October 1995) --- Photographed by the astronauts aboard the Space Shuttle Columbia orbiting at 146 nautical miles above Earth is this scene over West Virginia featuring the Appalachian Mountains. Center point coordinates are 37.5 degrees north latitude and 80.5 degrees west longitude.

  14. EPA’s SPECIATE 4.4 Database:Development and Uses

    EPA Science Inventory

    SPECIATE is the U.S. Environmental Protection Agency's (EPA)repository of volatile organic gas and particulate matter (PM) speciation profiles for air pollution sources. EPA released SPECIATE 4.4 in early 2014 and, in total, the SPECIATE 4.4 database includes 5,728 PM, VOC, total...

  15. EPA’s SPECIATE 4.4 Database: Development and Uses

    EPA Science Inventory

    SPECIATE is the U.S. Environmental Protection Agency's (EPA)repository of volatile organic gas and particulate matter (PM) speciation profiles for air pollution sources. EPA released SPECIATE 4.4 in early 2014 and, in total, the SPECIATE 4.4 database includes 5,728 PM, VOC, total...

  16. 32 CFR 728.112 - Responsibilities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... unless patient administration departments take the initial step to complete: (1) DD 7, Report of Treatment Furnished Pay Patients, Hospitalization Furnished (part A). Prepare a separate substantiating DD 7... any pay patient is admitted, submit DD 7's to the collection agent. (2) DD 7A, Report of Treatment...

  17. Recombineering using RecET from Pseudomonas syringae

    USDA-ARS?s Scientific Manuscript database

    Here we report the identification of functions that promote genomic recombination of linear DNA introduced into Pseudomonas cells by electroporation. The genes encoding these functions were identified in Pseudomonas syringae pv. syringae B728a based on similarity to the lambda Red Exo/Beta and RecE...

  18. 32 CFR 728.61 - Medicare beneficiaries.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... services are authorized for beneficiaries of the Social Security Health Insurance Program for the Aged and... attention could reasonably be expected to result in: (1) Placing the patient's health in serious jeopardy... and it is permissible from a medical standpoint, discharge or transfer the patient to a facility that...

  19. ASTRONAUTICS INFORMATION. OPEN LITERATURE SURVEY, VOL. IV, NO. 3, ENTRIES 40,454-40,728

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

    Carringer, E.M.; Hoppe, M.G.; Nichols, B.H. comps.

    1961-09-01

    An open literature survey dealing with astronautics covering the period of September 1961 is presented. A compilation was made of 274 references on space flight and applicable data and techniques. Author, subject, and periodical indexes are included. (M.C.G.)

  20. 48 CFR 752.228-70 - Medical Evacuation (MEDEVAC) Services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 false Medical Evacuation... Clauses 752.228-70 Medical Evacuation (MEDEVAC) Services. As prescribed in 728.307-70, for use in all contracts requiring performance overseas: Medical Evacuation (MEDEVAC) Services (JUL 2007) (a) Contractor...

  1. 48 CFR 752.228-70 - Medical Evacuation (MEDEVAC) Services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false Medical Evacuation... Clauses 752.228-70 Medical Evacuation (MEDEVAC) Services. As prescribed in 728.307-70, for use in all contracts requiring performance overseas: Medical Evacuation (MEDEVAC) Services (JUL 2007) (a) Contractor...

  2. 48 CFR 752.228-70 - Medical Evacuation (MEDEVAC) Services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Medical Evacuation... Clauses 752.228-70 Medical Evacuation (MEDEVAC) Services. As prescribed in 728.307-70, for use in all contracts requiring performance overseas: Medical Evacuation (MEDEVAC) Services (JUL 2007) (a) Contractor...

  3. 32 CFR 728.56 - Treasury Department beneficiaries.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Beneficiaries of Other... may be beneficiaries of the Treasury Department and may be rendered care as set forth below. (1.... Customs Service. (5) Prisoners (detainees) of the U.S. Customs Service. (b) Care authorized. (1) Secret...

  4. 32 CFR 728.61 - Medicare beneficiaries.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... attention could reasonably be expected to result in: (1) Placing the patient's health in serious jeopardy..., per subpart J, a DD 7 (Report of Treatment Furnished Pay Patients, Hospitalization Furnished, part A) or DD 7A (Report of Treatment Furnished Pay Patients, Outpatient Treatment, part B) when outpatient...

  5. 32 CFR 728.61 - Medicare beneficiaries.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... attention could reasonably be expected to result in: (1) Placing the patient's health in serious jeopardy..., per subpart J, a DD 7 (Report of Treatment Furnished Pay Patients, Hospitalization Furnished, part A) or DD 7A (Report of Treatment Furnished Pay Patients, Outpatient Treatment, part B) when outpatient...

  6. 32 CFR 728.61 - Medicare beneficiaries.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... attention could reasonably be expected to result in: (1) Placing the patient's health in serious jeopardy..., per subpart J, a DD 7 (Report of Treatment Furnished Pay Patients, Hospitalization Furnished, part A) or DD 7A (Report of Treatment Furnished Pay Patients, Outpatient Treatment, part B) when outpatient...

  7. 32 CFR 728.61 - Medicare beneficiaries.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... attention could reasonably be expected to result in: (1) Placing the patient's health in serious jeopardy..., per subpart J, a DD 7 (Report of Treatment Furnished Pay Patients, Hospitalization Furnished, part A) or DD 7A (Report of Treatment Furnished Pay Patients, Outpatient Treatment, part B) when outpatient...

  8. Storage stability of biodegradable polyethylene glycol microspheres

    NASA Astrophysics Data System (ADS)

    Jain, Era; Sheth, Saahil; Polito, Kristen; Sell, Scott A.; Zustiak, Silviya P.

    2017-10-01

    Degradable hydrogel microspheres are popular choices for multiple biomedical applications, including drug, protein, or cell carriers for minimally invasive delivery. Clinical transitioning of such new, sensitive pharmaceutical preparations requires investigation of storage methods that retain key properties for extended time. In this study, we sought to determine the influence of seven common storage conditions on the physical and mechanical properties of degradable polyethylene glycol (PEG) hydrogel microspheres: 25 °C, 4 °C, -80 °C, lyophilization/-20 °C, dimethyl sulfoxide/-80 °C, dimethyl sulfoxide/lyophilization/-20 °C, vacuum/-20 °C. We have outlined the storage conditions in detail and explained their effect on swelling ratio, stiffness and degradation rate post-storage. Additionally, we have implemented protein-loaded hydrogels to evaluate the effect of storage conditions on diffusivity as well as protein stability post-storage. We found that hydrogels could be stored short-term (1-4 d) under moist conditions (i.e. storage without drying) without a substantial loss of properties. For extended storage (7-28 d), they could be stored either at  -80 °C (moist condition) or vacuum drying (dry condition).

  9. The cost diary: a method to measure direct and indirect costs in cost-effectiveness research.

    PubMed

    Goossens, M E; Rutten-van Mölken, M P; Vlaeyen, J W; van der Linden, S M

    2000-07-01

    From a societal perspective long-term clinical trials or follow-up studies should preferably not only include an evaluation of the health effect for the patient, but also an economic evaluation. In order to yield comprehensive medical and nonmedical resource use data, we at least partly depend on respondents' recall for collecting these costing data. A patient cost diary was developed in order to estimate total resource use, expenses, and lost production due to illness and treatment. We applied the cost diary in two randomized clinical trials evaluating the cost-effectiveness of behavioral rehabilitation in 205 fibromyalgia and chronic low back pain patients. The use of the diary was evaluated, studying the feasibility, the influence of the period of data collection on the results, and some aspects of validity. Eighty-five percent of the patients completed at least one diary and in total 68% of the diaries were returned. Although the results for the three alternative periods of data collection (keeping the diary 1 week every month, 2 weeks every 2 months, or a full year) were not significantly different, they were only moderately correlated. Finally, self-reported specialist care contacts were generally in agreement with data from an insurance company. However, for physiotherapy contacts there were differences between the self-reported and insurance data. This study shows how the cost diary might be used successfully in cost-effectiveness studies.

  10. Prevalence of asthma in children and adolescents in a city in the Brazilian Amazon region.

    PubMed

    Rosa, Antonia Maria; Ignotti, Eliane; Hacon, Sandra de Souza; Castro, Hermano Albuquerque de

    2009-01-01

    To analyze the prevalence of asthma and asthma symptoms in students of two distinct age brackets residing in the city of Tangará da Serra, Brazil. Cross-sectional, population-based study of the prevalence of asthma in children from 6 to 7 years of age and adolescents from 13 to 14, using the standardized International Study of Asthma and Allergies in Childhood, phase 1 questionnaire, validated for use in Brazil. Students who responded affirmatively to question 2 (presence of wheezing in the preceding 12 months) were classified as suffering from asthma. The study comprised 3,362 students, of whom 1,634 (48.6%) were children and 1,728 (51.4%) were adolescents. Of the 1,634 children, 816 (49.9%) were male, and 818 (50.1%) were female. Of the 1,728 adolescents, 773 (45.0%) were male, and 955 (55.0%) were female. The prevalence of asthma among the children was 25.2%, whereas that among the adolescents was 15.9% (chi2 = 8.34; p = 0.00). The children presented higher prevalences of the following symptoms of asthma than did the adolescents: wheezing ever (54.3%), nocturnal dry cough (43.9%), wheezing in the preceding 12 months (25.2%), and from 1 to 3 attacks of wheezing in the preceding 12 months (19.1%). There were no differences between the two groups regarding physician-diagnosed asthma (approximately 4.5%). There were no statistical differences regarding the prevalence of asthma by gender in the two groups. Tangará da Serra has a high prevalence of asthma in children and adolescents, and this result is compatible with other studies carried out in Brazil and Latin America using the same methodology.

  11. Effects of artificial sweeteners on breath alcohol concentrations in male and female social drinkers.

    PubMed

    Stamates, Amy L; Maloney, Sarah F; Marczinski, Cecile A

    2015-12-01

    Alcohol is often mixed with various nonalcoholic beverages. While consumption of food with alcohol will decrease peak breath alcohol concentrations (BrAC), recent evidence has suggested that mixing alcohol with diet beverages can result in higher BrAC when compared with mixing the same amount of alcohol with sweetened beverages. The purpose of this study was to examine this phenomenon using two different moderate alcohol doses. Twenty participants (10 males) attended five sessions where they received 1 of 5 doses (0.91 ml/kg vodka+3.64 ml/kg of diet soda, 0.91 ml/kg vodka+3.64 of regular soda, 1.82 ml/kg vodka+7.28 ml/kg diet soda, 1.82 ml/kg vodka+7.28 ml/kg regular soda, and a placebo beverage). BrAC was recorded repeatedly up to 180 min after dose administration. Participants had significantly higher BrAC when the mixer was diet as compared to regular for both alcohol dose conditions. No gender differences were observed. Mixing alcohol with diet beverages can result in higher BrAC when compared to the same amount of alcohol administered with a similar sweetened beverage. Individuals who consume diet mixers with alcohol may reduce caloric intake but increase the harms associated with higher BrACs. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. Comparison of Molecular Species Distribution of DHA-Containing Triacylglycerols in Milk and Different Infant Formulas by Liquid Chromatography-Mass Spectrometry.

    PubMed

    Liu, Zhiqian; Cocks, Benjamin G; Rochfort, Simone

    2016-03-16

    Long-chain polyunsaturated fatty acids (LC-PUFA) are an important nutritional lipid and have potential in being able to promote human health. Docosahexaenoic acid (DHA, C22:6ω3) is often added in infant formulas to meet the nutritional requirement of formula-fed infants. A comprehensive survey on DHA-containing triacylglycerol (DHA-TAG) molecular species has been conducted for seven infant formulas (IFs) sourced from Australia, Europe, and the USA as well as bovine milk and human milk. Using LC-triple quadrupole MS and LC-LTQ-orbitrap MS we were able to identify and quantify 56 DHA-TAG species in these samples; the fatty acid structure of these species was assigned using their MS(2) spectra. The species composition of DHA-TAG was found to be different between bovine milk, human milk, and IFs and also between different brands of IFs. Bovine milk and human milk contain DHA-TAG of smaller molecular size (728-952 Da), whereas five out of the seven IF samples contain species of broader mass range (from 728 to 1035 Da). Our study indicates that two types of DHA were used in the seven IF products surveyed and that there is very large difference in molecular species distribution in different IF products that may influence the fine nutritional profile and biological functions of IF products.

  13. Cervical degenerative disease: systematic review of economic analyses.

    PubMed

    Alvin, Matthew D; Qureshi, Sheeraz; Klineberg, Eric; Riew, K Daniel; Fischer, Dena J; Norvell, Daniel C; Mroz, Thomas E

    2014-10-15

    Systematic review. To perform an evidence-based synthesis of the literature assessing the cost-effectiveness of surgery for patients with symptomatic cervical degenerative disc disease (DDD). Cervical DDD is a common cause of clinical syndromes such as neck pain, cervical radiculopathy, and myelopathy. The appropriate surgical intervention(s) for a given problem is controversial, especially with regard to quality-of-life outcomes, complications, and costs. Although there have been many studies comparing outcomes and complications, relatively few have compared costs and, more importantly, cost-effectiveness of the interventions. We conducted a systematic search in PubMed/MEDLINE, EMBASE, the Cochrane Collaboration Library, the Cost-Effectiveness Analysis registry database, and the National Health Service Economic Evaluation Database for full economic evaluations published through January 16, 2014. Identification of full economic evaluations that were explicitly designed to evaluate and synthesize the costs and consequences of surgical procedures or surgical intervention with nonsurgical management in patients with cervical DDD were considered for inclusion, based on 4 key questions. Five studies were included, each specific to 1 or more of our focus questions. Two studies suggested that cervical disc replacement may be more cost-effective compared with anterior cervical discectomy and fusion. Two studies comparing anterior with posterior surgical procedures for cervical spondylotic myelopathy suggested that anterior surgery was more cost-effective than posterior surgery. One study suggested that posterior cervical foraminotomy had a greater net economic benefit than anterior cervical discectomy and fusion in a military population with unilateral cervical radiculopathy. No studies assessed the cost-effectiveness of surgical intervention compared with nonoperative treatment of cervical myelopathy or radiculopathy, although it is acknowledged that existing studies demonstrate the cost-effectiveness of surgical intervention for these 2 clinical entities. A paucity of high-quality economic literature exists regarding cost-effectiveness of surgical intervention for cervical DDD. Future research is necessary to validate the findings of the few studies that do exist to guide decisions for surgery by the physician and patient with respect to cost-effectiveness. 2.

  14. Economic evaluations of clinical pharmacy services: 2006-2010.

    PubMed

    Touchette, Daniel R; Doloresco, Fred; Suda, Katie J; Perez, Alexandra; Turner, Stuart; Jalundhwala, Yash; Tangonan, Maria C; Hoffman, James M

    2014-08-01

    Studies have consistently evidenced the positive clinical, economic, and humanistic benefits of pharmacist-directed patient care in a variety of settings. Given the vast differences in clinical outcomes associated with evaluated clinical pharmacy services (CPS), more detail as to the nature of the CPS is needed to better understand observed differences in economic outcomes. With the growing trend of outpatient pharmacy services, these economic evaluations serve as viable decision-making tools in choosing the most effective and cost-effective pharmacy programs. We previously conducted three systematic reviews to evaluate the economic impact of CPS from 1988 to 2005. In this systematic review, our objectives were to describe and evaluate the quality of economic evaluations of CPS published between 2006 and 2010, with the goal of informing administrators and practitioners as to their cost-effectiveness. We searched the scientific literature by using the Medline, International Pharmaceutical Abstracts, Embase, and Cumulative Index to Nursing and Allied Health Literature databases to identify studies describing CPS published from 2006 to 2010. Studies meeting our inclusion criteria (original research articles that evaluated CPS and described economic and clinical outcomes) were reviewed by two investigators. Methodology used, economic evaluation type, CPS setting and type, and clinical and economic outcome results were extracted. Results were informally compared with previous systematic reviews. Of 3587 potential studies identified, 25 met inclusion criteria. Common CPS settings were hospital (36%), community (32%), and clinic or hospital-based ambulatory practices (28%). CPS types were disease state management (48%), general pharmacotherapeutic monitoring (24%), target drug programs (8%), and patient education (4%). Two studies (8%) listed CPS as medication therapy management. Costs were evaluated in 24 studies (96%) and sufficiently described in 13 (52%). Clinical or humanistic outcomes were evaluated in 20 studies (80%) and were sufficiently described in 18 (72%). Control groups were included in 16 (70%) of 23 studies not involving modeling. Study assumptions and limitations were stated and justified in eight studies (32%). Conclusions and recommendations were considered justified and based on results in 24 studies (96%). Eighteen studies (72%) involved full economic evaluation. The mean ± SD study quality score for full economic evaluations (18 studies) was 60.4 ± 22.3 of a possible 100 points. Benefit-cost ratios from three studies ranged from 1.05:1 to 25.95:1, and incremental cost-effectiveness ratios of five studies were calculated and reported. Fewer studies documented the economic impact of CPS from 2006-2010 than from 2001-2005, although a higher proportion involved controlled designs and were full economic evaluations. Evaluations of ambulatory practices were increasingly common. CPS were generally considered cost-effective or provided a good benefit-cost ratio. © 2014 Pharmacotherapy Publications, Inc.

  15. Evaluation of construction strategies for PCC pavement rehabilitation projects.

    DOT National Transportation Integrated Search

    2010-09-30

    This study investigated project management level solutions to optimizing resources, minimizing costs : (including user costs) and time for PCC pavement rehabilitation projects. This study extensively : evaluated the applicability of the Construction ...

  16. Economic evaluation of bevacizumab in the treatment of non-small cell lung cancer (NSCLC).

    PubMed

    Chien, Chun-Ru; Shih, Ya-Chen Tina

    2012-01-01

    Delivering affordable cancer care is becoming increasingly important. Bevacizumab (BEV) is a costly molecular targeted agent effective for a variety of cancer including lung cancer. The objective of this review is to assess published economic evaluation of BEV in the treatment of non-small cell lung cancer (NSCLC). A literature search in PubMed, Cochrane, and the Health Technology Assessment reports for English-language publications before February 2012 was performed. Studies were independently screened by two reviewers, and eight publications were included in the review. The results of these eight articles were tabulated and all cost estimates were reported in 2011 US dollars. Among the eight articles, three were cost studies and five were cost-effectiveness/utility analysis. For first-line treatment, BEV-containing regimen was reported to be the most costly regimen in one study but cost saving when compared with pemetrexed/cisplatin in another study. When compared with other regimens, BEV-containing regimen was reported to be cost effective in two cost-effectiveness studies (incremental cost-effectiveness ratio [ICER] in the range of US$30,318-US$54,317 per life year) but not cost effective in the other three studies (ICER over US$300,000 per life year). In this review of economic evaluation of BEV in the treatment of NSCLC, it was found that the literature was not conclusive on the economic benefit of BEV. The role of BEV in other treatment settings for NSCLC was unknown. Further studies, such as clinical trials with adequate power to compare the efficacy between low dose and high dose BEV, potential impact of predictive biomarkers for BEV, and comprehensive economic evaluation will strengthen the current state of knowledge on the economic value of BEV in NSCLC.

  17. Standardisation of costs: the Dutch Manual for Costing in economic evaluations.

    PubMed

    Oostenbrink, Jan B; Koopmanschap, Marc A; Rutten, Frans F H

    2002-01-01

    The lack of a uniform costing methodology is often considered a weakness of economic evaluations that hinders the interpretation and comparison of studies. Standardisation is therefore an important topic within the methodology of economic evaluations and in national guidelines that formulate the formal requirements for studies to be considered when deciding on the reimbursement of new medical therapies. Recently, the Dutch Manual for Costing: Methods and Standard Costs for Economic Evaluations in Health Care (further referred to as "the manual") has been published, in addition to the Dutch guidelines for pharmacoeconomic research. The objectives of this article are to describe the main content of the manual and to discuss some key issues of the manual in relation to the standardisation of costs. The manual introduces a six-step procedure for costing. These steps concern: the scope of the study;the choice of cost categories;the identification of units;the measurement of resource use;the monetary valuation of units; andthe calculation of unit costs. Each step consists of a number of choices and these together define the approach taken. In addition to a description of the costing process, five key issues regarding the standardisation of costs are distinguished. These are the use of basic principles, methods for measurement and valuation, standard costs (average prices of healthcare services), standard values (values that can be used within unit cost calculations), and the reporting of outcomes. The use of the basic principles, standard values and minimal requirements for reporting outcomes, as defined in the manual, are obligatory in studies that support submissions to acquire reimbursement for new pharmaceuticals. Whether to use standard costs, and the choice of a particular method to measure or value costs, is left mainly to the investigator, depending on the specific study setting. In conclusion, several instruments are available to increase standardisation in costing methodology among studies. These instruments have to be used in such a way that a balance is found between standardisation and the specific setting in which a study is performed. The way in which the Dutch manual tries to reach this balance can serve as an illustration for other countries.

  18. A Scoping Review of Economic Evaluations Alongside Randomised Controlled Trials of Home Monitoring in Chronic Disease Management.

    PubMed

    Kidholm, Kristian; Kristensen, Mie Borch Dahl

    2018-04-01

    Many countries have considered telemedicine and home monitoring of patients as a solution to the demographic challenges that health-care systems face. However, reviews of economic evaluations of telemedicine have identified methodological problems in many studies as they do not comply with guidelines. The aim of this study was to examine economic evaluations alongside randomised controlled trials of home monitoring in chronic disease management and hereby to explore the resources included in the programme costs, the types of health-care utilisation that change as a result of home monitoring and discuss the value of economic evaluation alongside randomised controlled trials of home monitoring on the basis of the studies identified. A scoping review of economic evaluations of home monitoring of patients with chronic disease based on randomised controlled trials and including information on the programme costs and the costs of equipment was carried out based on a Medline (PubMed) search. Nine studies met the inclusion criteria. All studies include both costs of equipment and use of staff, but there is large variation in the types of equipment and types of tasks for the staff included in the costs. Equipment costs constituted 16-73% of the total programme costs. In six of the nine studies, home monitoring resulted in a reduction in primary care or emergency contacts. However, in total, home monitoring resulted in increased average costs per patient in six studies and reduced costs in three of the nine studies. The review is limited by the small number of studies found and the restriction to randomised controlled trials, which can be problematic in this area due to lack of blinding of patients and healthcare professionals and the difficulty of implementing organisational changes in hospital departments for the limited period of a trial. Furthermore, our results may be based on assessments of older telemedicine interventions.

  19. Economic evaluations of influenza vaccination in healthy working-age adults. Employer and society perspective.

    PubMed

    Wood, S C; Nguyen, V H; Schmidt, C

    2000-08-01

    To determine what benefits to the employer and to society are associated with influenza (flu) vaccination in healthy adults. We performed a literature review concerning cost-benefit and cost-effectiveness evaluations of influenza vaccination in healthy, working-age adults. Up to the end of 1999, we found 6 published economic evaluations on the use of influenza vaccine in healthy, working-age adults: 3 prospective studies, 1 retrospective evaluation and 2 model-based simulations. Evaluations were performed from the perspective of an employer or society. Costs were reported in the local currency used in the published evaluation, with conversions into US dollars (when not provided in the article), for comparative purposes only, according to the exchange rates of June 8 1998. Estimations of the cost-benefit of vaccination, compared with a no vaccination strategy, varied widely from a net loss of $US106.59 per infection averted in one study to savings of varying sizes in the 5 others (savings ranged from $US2.58 per dollar invested to $US46.85 per vaccinee). Studies differed in the definition of illness and the measurement of costs associated with vaccination or illness. Decision makers have not yet extended existing vaccine recommendations to cover healthy, working-age adults, partly because of the disparity among economic studies in their methods of estimating costs and measuring effects. However, the published studies seem to suggest that influenza vaccination in the healthy, working adult would be a cost-effective health intervention, at least from the perspective of an employer.

  20. Economic Evaluations of Pathology Tests, 2010-2015: A Scoping Review.

    PubMed

    Watts, Rory D; Li, Ian W; Geelhoed, Elizabeth A; Sanfilippo, Frank M; St John, Andrew

    2017-09-01

    Concerns about pathology testing such as the value provided by new tests and the potential for inappropriate utilization have led to a greater need to assess costs and benefits. Economic evaluations are a formal method of analyzing costs and benefits, yet for pathology tests, questions remain about the scope and quality of the economic evidence. To describe the extent and quality of published evidence provided by economic evaluations of pathology tests from 2010 to 2015. Economic evaluations relating to pathology tests from 2010 to 2015 were reviewed. Eight databases were searched for published studies, and details recorded for the country, clinical focus, type of testing, and consideration of sensitivity, specificity, and false test results. The reporting quality of studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards checklist and cost-effectiveness ratios were analyzed for publication bias. We found 356 economic evaluations of pathology tests, most of which regarded developed countries. The most common economic evaluations were cost-utility analyses and the most common clinical focus was infectious diseases. More than half of the studies considered sensitivity and specificity, but few studies considered the impact of false test results. The average Consolidated Health Economic Evaluation Reporting Standards checklist score was 17 out of 24. Cost-utility ratios were commonly less than $10,000/quality-adjusted life-year or more than $200,000/quality-adjusted life-year. The number of economic evaluations of pathology tests has increased in recent years, but the rate of increase has plateaued. Furthermore, the quality of studies in the past 5 years was highly variable, and there is some question of publication bias in reporting cost-effectiveness ratios. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  1. Disparities in outcomes for Hispanic patients undergoing endovascular and open abdominal aortic aneurysm repair.

    PubMed

    Williams, Timothy K; Schneider, Eric B; Black, James H; Lum, Ying Wei; Freischlag, Julie A; Perler, Bruce A; Abularrage, Christopher J

    2013-01-01

    Previous studies have demonstrated racial and ethnic disparities associated with the outcomes of abdominal aortic aneurysm (AAA) repair, although little is known about the influence of race and ethnicity on the costs associated with these disparities. The current study was undertaken to examine the influence of race and ethnicity on the outcomes of endovascular (EVAR) and open repair (open AAA) of unruptured AAA and its effect on costs in contemporary practice. The Nationwide Inpatient Sample (2005 to 2008) was queried using ICD-9-CM codes for unruptured AAA (441.4). The primary outcomes were mortality and total hospital charges. Multivariate analyses were performed adjusting for age, gender, race, comorbidities (Charlson index), year, insurance type, and hospital characteristics. A total of 62,728 patients underwent EVAR and 24,253 patients underwent open AAA. White patients (72%) were more likely to undergo EVAR than Hispanic (69%) or black patients (69%; P = 0.02). On univariate analysis, in-hospital mortality after EVAR was increased in Hispanic patients compared with white patients (1% vs 2%; P = 0.02). There were no differences in mortality after EVAR between white and black patients, and there were no racial or ethnic differences in mortality after open AAA. Hispanic ethnicity remained an independent risk factor for increased mortality after AAA repair on multivariate analysis (RR 1.64; 95% CI [1.05 to 2.57]; P = 0.03). Hispanic ethnicity was associated with increased hospital charges compared with white ethnicity after both EVAR ($108,886 vs $77,748; P < 0.001) and open AAA ($134,356 vs $85,536; P < 0.001) and for black patients after open AAA ($101,168 vs $85,536; P = 0.04). Hispanic ethnicity is an independent risk factor for mortality after AAA repair independent of insurance type or hospital characteristics. There were dramatic disparities in hospital costs for Hispanic patients undergoing either EVAR or open AAA and for black patients after open AAA compared with white patients. This observation seems unrelated to length of stay, postoperative complications, and admission status. Further studies are needed to determine whether these disparities extend beyond the primary hospitalization. Copyright © 2013 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.

  2. Two new triterpenoids from the seeds of blackberry (Rubus fructicosus).

    PubMed

    Ono, Masateru; Yasuda, Shin; Nishi, Kaori; Yamamoto, Kazutaka; Fuchizaki, Satoshi; Higuchi, Satomi; Komatsu, Haruki; Okawa, Masafumi; Kinjo, Junei; Yoshimitsu, Hitoshi; Nohara, Toshihiro

    2016-01-01

    Two new ursane-type triterpenoids (1, 2) attached to isopropylidenedioxy group were isolated from the seeds of blackberry (Rubus fructicosus L., Rosaceae) along with two known ursane-type triterpenoids, 2,3-O-isopropylidenyl-2α,3α,19α-trihydroxyurs-12-en-28-oic acid (3) and 1β-hydroxyeuscaphic acid (4). The chemical structures of 1 and 2 were determined to be 2,3-O-isopropylidene-1β,2β,3β,19α-tetrahydroxyurs-12-en-28-oic acid and 1,2-O-isopropylidene-1β,2α,3α,19α-tetrahydroxyurs-12-en-28-oic acid, respectively, based on spectroscopic data. Additionally, their cytotoxic activity towards HL-60 human leukaemia cells was evaluated. Among them, 3 demonstrated a clear cytotoxic activity with 72.8 μM of IC50 value.

  3. FBI fingerprint identification automation study. AIDS 3 evaluation report. Volume 4: Economic feasibility

    NASA Technical Reports Server (NTRS)

    Mulhall, B. D. L.

    1980-01-01

    The results of the economic analysis of the AIDS 3 system design are presented. AIDS 3 evaluated a set of economic feasibility measures including life cycle cost, implementation cost, annual operating expenditures and annual capital expenditures. The economic feasibility of AIDS 3 was determined by comparing the evaluated measures with the same measures, where applicable, evaluated for the current system. A set of future work load scenarios was constructed using JPL's environmental evaluation study of the fingerprint identification system. AIDS 3 and the current system were evaluated for each of the economic feasibility measures for each of the work load scenarios. They were compared for a set of performance measures, including response time and accuracy, and for a set of cost/benefit ratios, including cost per transaction and cost per technical search. Benefit measures related to the economic feasibility of the system are also presented, including the required number of employees and the required employee skill mix.

  4. Cost-effectiveness of surgical interventions for the management of osteoarthritis: a systematic review of the literature.

    PubMed

    Kamaruzaman, Hanin; Kinghorn, Philip; Oppong, Raymond

    2017-05-10

    The primary purpose of this study is to assess the existing evidence on the cost-effectiveness of surgical interventions for the management of knee and hip osteoarthritis by systematically reviewing published economic evaluation studies. A systematic review was conducted for the period 2004 to 2016. Electronic databases were searched to identify both trial and model based economic evaluation studies that evaluated surgical interventions for knee and hip osteoarthritis. A total of 23 studies met the inclusion criteria and an assessment of these studies showed that total knee arthroplasty (TKA), and total hip arthroplasty (THA) showed evidence of cost-effectiveness and improvement in quality of life of the patients when compared to non-operative and non-surgical procedures. On the other hand, even though delaying TKA and THA may lead to some cost savings in the short-run, the results from the study showed that this was not a cost-effective option. TKA and THA are cost-effective and should be recommended for the management of patients with end stage/severe knee and hip OA. However, there needs to be additional studies to assess the cost-effectiveness of other surgical interventions in order for definite conclusions to be reached.

  5. Effects of Massage on Blood Pressure in Patients With Hypertension and Prehypertension: A Meta-analysis of Randomized Controlled Trials.

    PubMed

    Liao, I-Chen; Chen, Shiah-Lian; Wang, Mei-Yeh; Tsai, Pei-Shan

    2016-01-01

    Massage may help reduce blood pressure; previous studies on the effect of massage on blood pressure have presented conflicting findings. In addition, no systematic review is available. The aim of this study was to evaluate the evidence concerning the effect of massage on blood pressure in patients with hypertension or prehypertension. A search was performed on electronic database records up to October 31, 2013, based on the following medical subject headings or keywords: hypertension, massage, chiropractic, manipulation, and blood pressure. The methodological quality of randomized controlled trials was assessed based on the Cochrane collaboration tool. A meta-analysis was performed to evaluate the effect of massage on hypertension. The study selection, data extraction, and validation were performed independently by 2 reviewers. Nine randomized controlled trials met our inclusion criteria. The results of this study show that massage contributes to significantly enhanced reduction in both systolic blood pressure (SBP) (mean difference, -7.39 mm Hg) and diastolic blood pressure (DBP) (mean difference, -5.04 mm Hg) as compared with control treatments in patients with hypertension and prehypertension. The effect size (Hedges g) for SBP and DBP was -0.728 (95% confidence interval, -1.182 to -0.274; P = .002) and -0.334 (95% confidence interval, -0.560 to -0.107; P = .004), respectively. This systematic review found a medium effect of massage on SBP and a small effect on DBP in patients with hypertension or prehypertension. High-quality randomized controlled trials are urgently required to confirm these results, although the findings of this study can be used to guide future research.

  6. MEDICAL DEVICE PRICES IN ECONOMIC EVALUATIONS.

    PubMed

    Akpinar, Ilke; Jacobs, Philip; Husereau, Don

    2015-01-01

    Economic evaluations, although not formally used in purchasing decisions for medical devices in Canada, are still being conducted and published. The aim of this study was to examine the way that prices have been included in Canadian economic evaluations of medical devices. We conducted a review of the economic concepts and implications of methods used for economic evaluations of the eleven most implanted medical devices from the Canadian perspective. We found Canadian economic studies for five of the eleven medical devices and identified nineteen Canadian studies. Overall, the device costs were important components of total procedure cost, with an average ratio of 44.1 %. Observational estimates of the device costs were obtained from buyers or sellers in 13 of the 19 studies. Although most of the devices last more than 1 year, standard costing methods for capital equipment was never used. In addition, only eight studies included a sensitivity analysis for the device cost. None of the sensitivity analyses were based on actual price distributions. Economic evaluations are potentially important for policy making, but although they are being conducted, there is no standardized approach for incorporating medical device prices in economic analyses. Our review provides suggestions for improvements in how the prices are incorporated for economic evaluations of medical devices.

  7. Economic Evaluations of Pharmacogenetic and Pharmacogenomic Screening Tests: A Systematic Review. Second Update of the Literature

    PubMed Central

    Wilffert, Bob; Boersma, Cornelis; Annemans, Lieven; Vegter, Stefan; van Boven, Job F. M.; Postma, Maarten J.

    2016-01-01

    Objective Due to extended application of pharmacogenetic and pharmacogenomic screening (PGx) tests it is important to assess whether they provide good value for money. This review provides an update of the literature. Methods A literature search was performed in PubMed and papers published between August 2010 and September 2014, investigating the cost-effectiveness of PGx screening tests, were included. Papers from 2000 until July 2010 were included via two previous systematic reviews. Studies’ overall quality was assessed with the Quality of Health Economic Studies (QHES) instrument. Results We found 38 studies, which combined with the previous 42 studies resulted in a total of 80 included studies. An average QHES score of 76 was found. Since 2010, more studies were funded by pharmaceutical companies. Most recent studies performed cost-utility analysis, univariate and probabilistic sensitivity analyses, and discussed limitations of their economic evaluations. Most studies indicated favorable cost-effectiveness. Majority of evaluations did not provide information regarding the intrinsic value of the PGx test. There were considerable differences in the costs for PGx testing. Reporting of the direction and magnitude of bias on the cost-effectiveness estimates as well as motivation for the chosen economic model and perspective were frequently missing. Conclusions Application of PGx tests was mostly found to be a cost-effective or cost-saving strategy. We found that only the minority of recent pharmacoeconomic evaluations assessed the intrinsic value of the PGx tests. There was an increase in the number of studies and in the reporting of quality associated characteristics. To improve future evaluations, scenario analysis including a broad range of PGx tests costs and equal costs of comparator drugs to assess the intrinsic value of the PGx tests, are recommended. In addition, robust clinical evidence regarding PGx tests’ efficacy remains of utmost importance. PMID:26752539

  8. Statistics of AUV's Missions for Operational Ocean Observation at the South Brazilian Bight.

    NASA Astrophysics Data System (ADS)

    dos Santos, F. A.; São Tiago, P. M.; Oliveira, A. L. S. C.; Barmak, R. B.; Miranda, T. C.; Guerra, L. A. A.

    2016-02-01

    The high costs and logistics limitations of ship-based data collection represent an obstacle for a persistent in-situ data collection. Satellite-operated Autonomous Underwater Vehicles (AUV's) or gliders (as these AUV's are generally known by the scientific community) are presented as an inexpensive and reliable alternative to perform long-term and real-time ocean monitoring of important parameters such as temperature, salinity, water-quality and acoustics. This work is focused on the performance statistics and the reliability for continuous operation of a fleet of seven gliders navigating in Santos Basin - Brazil, since March 2013. The gliders performance were evaluated by the number of standby days versus the number of operating days, the number of interrupted missions due to (1) equipment failure, (2) weather, (3) accident versus the number of successful missions and the amount and quality of data collected. From the start of the operations in March 2013 to the preparation of this work (July 2015), a total of 16 glider missions were accomplished, operating during 728 of the 729 days passed since then. From this total, 11 missions were successful, 3 missions were interrupted due to equipment failure and 2 gliders were lost. Most of the identified issues were observed in the communication with the glider (when recovery was necessary) or the optode sensors (when remote settings solved the problem). The average duration of a successful mission was 103 days while interrupted ones ended on average in 7 days. The longest mission lasted for 139 days, performing 859 continuous profiles and covering a distance of 2734 Km. The 2 projects performed together 6856 dives, providing an average of 9,5 profiles per day or one profile every 2,5 hours each day during 2 consecutive years.

  9. The Social Distribution of Health: Estimating Quality-Adjusted Life Expectancy in England.

    PubMed

    Love-Koh, James; Asaria, Miqdad; Cookson, Richard; Griffin, Susan

    2015-07-01

    To model the social distribution of quality-adjusted life expectancy (QALE) in England by combining survey data on health-related quality of life with administrative data on mortality. Health Survey for England data sets for 2010, 2011, and 2012 were pooled (n = 35,062) and used to model health-related quality of life as a function of sex, age, and socioeconomic status (SES). Office for National Statistics mortality rates were used to construct life tables for age-sex-SES groups. These quality-of-life and length-of-life estimates were then combined to predict QALE as a function of these characteristics. Missing data were imputed, and Monte-Carlo simulation was used to estimate standard errors. Sensitivity analysis was conducted to explore alternative regression models and measures of SES. Socioeconomic inequality in QALE at birth was estimated at 11.87 quality-adjusted life-years (QALYs), with a sex difference of 1 QALY. When the socioeconomic-sex subgroups are ranked by QALE, a differential of 10.97 QALYs is found between the most and least healthy quintile groups. This differential can be broken down into a life expectancy difference of 7.28 years and a quality-of-life adjustment of 3.69 years. The methods proposed in this article refine simple binary quality-adjustment measures such as the widely used disability-free life expectancy, providing a more accurate picture of overall health inequality in society than has hitherto been available. The predictions also lend themselves well to the task of evaluating the health inequality impact of interventions in the context of cost-effectiveness analysis. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  10. US EPA's SPECIATE 4.4 Database: Development and Uses

    EPA Science Inventory

    SPECIATE is the U.S. Environmental Protection Agency’s (EPA) repository of volatile organic gas and particulate matter (PM) speciation profiles of air pollution sources. EPA released SPECIATE 4.4 in early 2014 and, in total, the SPECIATE 4.4 database includes 5,728 PM, volatile o...

  11. 333 E. Ontario, Nov. 2011, Lindsay Light Radiological Survey

    EPA Pesticide Factsheets

    No count rates were observed at any time that exceeded the USEPA’s threshold limit of 18,728 cpm for the 2”x2” 44-10 Sodium Iodide (NaI)probe. Based on the findings of the surface scan, no areas of elevated thorium concentrationswere identified.

  12. 32 CFR 728.71 - Ex-service maternity care.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... of pregnancy, or separated from the service under honorable conditions and found to have been... certified by medical authorities that the pregnancy existed prior to entry into service (EPTE), maternity benefits are not authorized. (1) Former women members of the Army, Air Force, Navy, and Marine Corps. (2...

  13. 75 FR 2163 - Constellation Energy; Notice of Docketing of Special Nuclear Material License SNM-2505 Amendment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-14

    ... NUCLEAR REGULATORY COMMISSION [Docket No. 72-8; NRC-2010-0011] Constellation Energy; Notice of... Independent Spent Fuel Storage Installation AGENCY: Nuclear Regulatory Commission. ACTION: Notice of license..., Division of Spent Fuel Storage and Transportation, Office of Nuclear Material Safety and Safeguards, U.S...

  14. 9 CFR 72.9 - Interstate movements of cattle; inspection and certification by APHIS inspector required.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... dipped as required by § 72.6 or by § 72.7 and are free of ticks, or have been inspected as required by § 72.8 and are free of ticks); all such certificates shall be handled, delivered, kept, and preserved...

  15. 9 CFR 72.9 - Interstate movements of cattle; inspection and certification by APHIS inspector required.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... dipped as required by § 72.6 or by § 72.7 and are free of ticks, or have been inspected as required by § 72.8 and are free of ticks); all such certificates shall be handled, delivered, kept, and preserved...

  16. 9 CFR 72.9 - Interstate movements of cattle; inspection and certification by APHIS inspector required.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... dipped as required by § 72.6 or by § 72.7 and are free of ticks, or have been inspected as required by § 72.8 and are free of ticks); all such certificates shall be handled, delivered, kept, and preserved...

  17. 32 CFR 728.83 - Persons in military custody and nonmilitary Federal prisoners.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES... executed but whose sentences have not expired are authorized all necessary medical and dental care. (ii... may be rendered all necessary medical and dental care. (c) Charges and collection. Care provided...

  18. 32 CFR 728.83 - Persons in military custody and nonmilitary Federal prisoners.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES... executed but whose sentences have not expired are authorized all necessary medical and dental care. (ii... may be rendered all necessary medical and dental care. (c) Charges and collection. Care provided...

  19. 32 CFR 728.83 - Persons in military custody and nonmilitary Federal prisoners.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES... executed but whose sentences have not expired are authorized all necessary medical and dental care. (ii... may be rendered all necessary medical and dental care. (c) Charges and collection. Care provided...

  20. 32 CFR 728.83 - Persons in military custody and nonmilitary Federal prisoners.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES... executed but whose sentences have not expired are authorized all necessary medical and dental care. (ii... may be rendered all necessary medical and dental care. (c) Charges and collection. Care provided...

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