Sample records for expected benefits include
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Lazorwitz, Aaron; Sheeder, Jeanelle; Teal, Stephanie; Guiahi, Maryam
2015-05-01
Continuation rates of short-acting contraception among young women are low; we attempted to determine if continuation is higher when women expect noncontraceptive benefits at initiation or perceive benefits 6 months later. A total of 243 young women ages 13-24 years initiating short-acting methods in an adolescent-only family planning clinic completed post-visit surveys that included directed and open-ended questions about anticipated noncontraceptive benefits. The study participants were contacted 6 months later. We compared contraceptive continuation between those who expected noncontraceptive benefits and those who did not and between those who reported experiencing benefits and those who did not. We examined the concordance between expectations and reported experiences. Six months after initiation, 69.3% of women were using the same method. Baseline expectation of noncontraceptive benefits was not associated with 6-month continuation. The experience of any benefit listed by the patient (odds ratio=2.69, 95% confidence interval 1.1, 6.0) was associated with greater continuation. Concordance between expectation and perception of noncontraceptive benefits was low (Kappa=0.2). Women who experienced noncontraceptive benefits at 6 months of use were more likely to continue short-acting contraception. Women who expected benefits when initiating were not more likely to report experiencing them, and many women who did not expect benefits reported them and were more likely to continue. These findings imply that building expectations of noncontraceptive benefits, e.g., through counseling, may not improve continuation and that new contraceptive development should include consideration of tangible noncontraceptive benefits. Although adolescents and young women who perceive noncontraceptive benefits after 6 months of use are more likely to continue, the expectation of such benefits does not correlate with continuation. Copyright © 2015 Elsevier Inc. All rights reserved.
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Løvvik, Camilla; Shaw, William; Øverland, Simon; Reme, Silje Endresen
2014-01-01
Objective Common mental disorders (CMDs) are among the leading causes of sick leave, and more knowledge on factors related to work participation and return-to-work (RTW) in CMDs is needed. The aim of this study was to investigate RTW-expectations and illness perceptions as predictors of benefit recipiency in CMDs. Design Study participants were enrolled in a randomised controlled trial and reported CMDs as a main obstacle for work participation. Three prespecified subgroups were included: people at risk of going on sick leave, people on sick leave (>3 weeks) or people on long-term benefits. Baseline questionnaire data and registry data at baseline and 6 months were used to investigate predictors of benefit recipiency at 6-month follow-up. Benefit recipiency included sickness benefits, disability pension, work assessment allowance and unemployment benefits. Results In this study, uncertain and negative RTW-expectations were strong predictors of benefit recipiency at 6 months follow-up. Illness perceptions predicted benefit recipiency in the unadjusted model, but not in the fully adjusted model. In the subgroup on sick leave, uncertain and negative RTW-expectations predicted benefit recipiency, while in the subgroup of people at risk of going on sick leave, negative RTW-expectations predicted benefit recipiency. In the subgroup on long-term benefits, only female gender predicted benefit recipiency. Conclusions For people with CMDs, uncertain and negative RTW-expectations predict later benefit recipiency, and expectations seem particularly important for those at risk of or on sick leave. For those at risk of sick leave, benefit recipiency at follow-up denoted a transition onto sick leave or long-term benefit, while those on sick leave had remained so or were receiving long-term benefits. Addressing RTW-expectations in occupational healthcare services or vocational rehabilitation might be beneficial in early stages or even prior to a sick leave episode. Trial registration http://www.clinicaltrials.gov, NCT01146730. PMID:24589824
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Benefits of an improved wheat crop information system
NASA Technical Reports Server (NTRS)
Kinne, I. L.
1976-01-01
The ECON work and the results of the independent reviews are summarized. Attempts are made to put this information into layman's terms and to present the benefits that can realistically be expected from a LANDSAT-type remote sensing system. Further the mechanisms by which these benefits can be expected to accrue are presented. The benefits are given including the nature of expected information improvements, how and why they can lead to benefits to society, and the estimated magnitude of the expected benefits. A brief description is presented of the ECON models, how they work, their results, and a summary of the pertinent aspects of each review. The ECON analyses show that substantial benefits will accrue from implementation of an improved wheat crop information system based on remote sensing.
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Which Benefits Are Mentioned Most Often in Drug Development Publications?
Strüver, Vanessa
2017-01-01
The aim was to identify theoretically expected as well as actually reported benefits from drug development and the importance of individual patient benefits compared to the collective benefits to society in general. Ethical guidelines require that clinical research involving humans offer the potential for benefit. A number of characteristics can be applied to define research benefit. Often benefit is categorized as being either direct or indirect. Indirect benefits can involve collective benefits for society rather than any benefits to the trial patient or subject. The purpose of this review was to examine which potential individual and societal benefits were mentioned as being expected in publications from government experts and which were mentioned in publications describing completed drug development trial results. Literature on research benefit was first identified by searching the PubMed database using several combinations of the key words benefit and clinical research . The search was limited to articles published in English. A Google search with the same combinations of key words but without any language limitation was then performed. Additionally, the reference lists of promising articles were screened for further thematically related articles. Finally, a narrative review was performed of relevant English- and German-language articles published between 1996 and 2016 to identify which of several potential benefits were either theoretically expected or which were mentioned in publications on clinical drug development trial results. The principal benefits from drug development discussed included 2 main types of benefit, namely individual benefits for the patients and collective benefits for society. Twenty-one of an overall total of 26 articles discussing theoretically expected benefits focused on individual patient benefits, whereas 17 out of 26 articles mentioned collective benefits to society. In these publications, the most commonly mentioned theoretically expected individual patient benefit was the chance to receive up-to-date care (38.1%). A general increase in knowledge about health care, treatments, or drugs (70.6%) was the most commonly mentioned theoretically expected benefit for society. In contrast, all 13 publications reporting actual benefits of clinical drug development trials focused on personal benefits and only 1 of these publications also mentioned a societal benefit. The most commonly mentioned individual benefit was an increased quality of life (53.9%), whereas the only mentioned collective benefit to society was a general gain of knowledge (100.0%). Both theoretically expected and actually reported benefits in the majority of the included publications emphasized the importance of individual patient benefits from drug development rather than the collective benefits to society in general. The authors of these publications emphasized the right of each individual patient or subject to look for and expect some personal benefit from participating in a clinical trial rather than considering societal benefit as a top priority. From an ethical point of view, the benefits each individual patient receives from his or her participation in a clinical trial might also be seen as a societal benefit, especially when the drug or device tested, if approved for marketing, would eventually be made available for other similar patients from the country in which the clinical trial was conducted.
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Sjoquist, Katrin M.; Friedlander, Michael L.; O'Connell, Rachel L.; Voysey, Merryn; King, Madeleine T.; Stockler, Martin R.; Oza, Amit M.; Gillies, Kim; Martyn, Julie K.
2013-01-01
Purpose. Chemotherapy for platinum-resistant/refractory ovarian cancer is motivated by the hope of benefit. We sought to determine the relationships between: (a) trait hope, expectation of symptom benefit from chemotherapy, and anxiety and depression; (b) hope and perceived efficacy of chemotherapy; and (c) unfulfilled hope (where expectations for benefit are not fulfilled) and depression. Methods. Adult patients enrolled within stage 1 of the Gynecologic Cancer Intergroup Symptom Benefit Study were included. Patient. Reported outcomes were collected from 126 women with predominantly platinum-resistant ovarian cancer at baseline, prior to the first four treatment cycles (12–16 weeks), and four weeks after completing chemotherapy or at disease progression, whichever came first. Associations were assessed with Spearman rank correlation coefficient (r) and odds ratio. Results. Trait hope and expectation of symptom benefit from chemotherapy were weakly correlated with each other (r = 0.25). Trait hope, but not expectation of symptom benefit, was negatively correlated with anxiety (r = −0.43) and depression (r = −0.50). The smaller the discrepancy between perceived and expected symptom benefit, the less likely the patient was to have scores indicative of depression (odds ratio: 0.68; 95% confidence interval: 0.49–0.96; p = .026). Conclusion. Trait hope and expectation of symptom benefit from chemotherapy appear to be distinct and independent of the aspects of quality of life and scores for depression. Hope did not appear to affect perceived efficacy of chemotherapy in alleviating symptoms, but women whose expectation of symptom benefit from chemotherapy was not fulfilled were more likely to have scores indicative of depression. It may be preferable to encourage hope toward achievable goals rather than toward benefits from chemotherapy. PMID:24107972
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Sjoquist, Katrin M; Friedlander, Michael L; O'Connell, Rachel L; Voysey, Merryn; King, Madeleine T; Stockler, Martin R; Oza, Amit M; Gillies, Kim; Martyn, Julie K; Butow, Phyllis N
2013-01-01
Chemotherapy for platinum-resistant/refractory ovarian cancer is motivated by the hope of benefit. We sought to determine the relationships between: (a) trait hope, expectation of symptom benefit from chemotherapy, and anxiety and depression; (b) hope and perceived efficacy of chemotherapy; and (c) unfulfilled hope (where expectations for benefit are not fulfilled) and depression. Methods. Adult patients enrolled within stage 1 of the Gynecologic Cancer Intergroup Symptom Benefit Study were included. Patient. Reported outcomes were collected from 126 women with predominantly platinum-resistant ovarian cancer at baseline, prior to the first four treatment cycles (12-16 weeks), and four weeks after completing chemotherapy or at disease progression, whichever came first. Associations were assessed with Spearman rank correlation coefficient (r) and odds ratio. Results. Trait hope and expectation of symptom benefit from chemotherapy were weakly correlated with each other (r = 0.25). Trait hope, but not expectation of symptom benefit, was negatively correlated with anxiety (r = -0.43) and depression (r = -0.50). The smaller the discrepancy between perceived and expected symptom benefit, the less likely the patient was to have scores indicative of depression (odds ratio: 0.68; 95% confidence interval: 0.49-0.96; p = .026). Conclusion. Trait hope and expectation of symptom benefit from chemotherapy appear to be distinct and independent of the aspects of quality of life and scores for depression. Hope did not appear to affect perceived efficacy of chemotherapy in alleviating symptoms, but women whose expectation of symptom benefit from chemotherapy was not fulfilled were more likely to have scores indicative of depression. It may be preferable to encourage hope toward achievable goals rather than toward benefits from chemotherapy.
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-07-01
... states to report to EPA. Expected benefits include lower processing costs for facilities and states... efficiencies should provide significant benefits, including reduced costs of processing paper forms, improved... biosolids) could be adapted into electronic reporting, costs and benefits to the states, permittees, EPA and...
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Stevens, Gretchen; Wilson, Andrew; Hammitt, James K
2005-08-01
In the Mexico City metropolitan area, poor air quality is a public health concern. Diesel vehicles contribute significantly to the emissions that are most harmful to health. Harmful diesel emissions can be reduced by retrofitting vehicles with one of several technologies, including diesel particulate filters. We quantified the social costs and benefits, including health benefits, of retrofitting diesel vehicles in Mexico City with catalyzed diesel particulate filters, actively regenerating diesel particulate filters, or diesel oxidation catalysts, either immediately or in 2010, when capital costs are expected to be lower. Retrofit with either type of diesel particulate filter or an oxidation catalyst is expected to provide net benefits to society beginning immediately and in 2010. At current prices, retrofit with an oxidation catalyst provides greatest net benefits. However, as capital costs decrease, retrofit with diesel particulate filters is expected to provide greater net benefits. In both scenarios, retrofit of older, dirtier vehicles that circulate only within the city provides greatest benefits, and retrofit with oxidation catalysts provides greater health benefits per dollar spent than retrofit with particulate filters. Uncertainty about the magnitude of net benefits of a retrofit program is significant. Results are most sensitive to values used to calculate benefits, such as the concentration-response coefficient, intake fraction (a measure of exposure), and the monetary value of health benefits.
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Disasters as a necessary part of benefit-cost analyses.
Mark, R K; Stuart-Alexander, D E
1977-09-16
Benefit-cost analyses for water projects generally have not included the expected costs (residual risk) of low-probability disasters such as dam failures, impoundment-induced earthquakes, and landslides. Analysis of the history of these types of events demonstrates that dam failures are not uncommon and that the probability of a reservoir-triggered earth-quake increases with increasing reservoir depth. Because the expected costs from such events can be significant and risk is project-specific, estimates should be made for each project. The cost of expected damage from a "high-risk" project in an urban area could be comparable to project benefits.
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Advancing Biofuels: Balancing for Sustainability
USDA-ARS?s Scientific Manuscript database
As with most technologies, use of biofuels has both benefits and risks, which vary by feedstock. Expected benefits include increased energy independence, reduced consumption of fossil fuels, reduced emission of greenhouse gases and invigorated rural economies. Anticipated risks include potential com...
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Distinguishing community benefits: tax exemption versus organizational legitimacy.
Byrd, James D; Landry, Amy
2012-01-01
US policymakers continue to call into question the tax-exempt status of hospitals. As nonprofit tax-exempt entities, hospitals are required by the Internal Revenue Service (IRS) to report the type and cost of community benefits they provide. Institutional theory indicates that organizations derive organizational legitimacy from conforming to the expectations of their environment. Expectations from the state and federal regulators (the IRS, state and local taxing authorities in particular) and the community require hospitals to provide community benefits to achieve legitimacy. This article examines community benefit through an institutional theory framework, which includes regulative (laws and regulation), normative (certification and accreditation), and cultural-cognitive (relationship with the community including the provision of community benefits) pillars. Considering a review of the results of a 2006 IRS study of tax-exempt hospitals, the authors propose a model of hospital community benefit behaviors that distinguishes community benefits between cost-quantifiable activities appropriate for justifying tax exemption and unquantifiable activities that only contribute to hospitals' legitimacy.
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Thanassoulis, George; Williams, Ken; Altobelli, Kathleen Kimler; Pencina, Michael J; Cannon, Christopher P; Sniderman, Allan D
2016-04-19
Current guidelines recommend statins in the primary prevention of cardiovascular disease on the basis of predicted cardiovascular risk without directly considering the expected benefits of statin therapy based on the available randomized, controlled trial evidence. We included 2134 participants representing 71.8 million American residents potentially eligible for statins in primary prevention from the National Health and Nutrition Examination Survey for the years 2005 to 2010. We compared statin eligibilities using 2 separate approaches: a 10-year risk-based approach (≥7.5% 10-year risk) and an individualized benefit approach (ie, based on predicted absolute risk reduction over 10 years [ARR10] ≥2.3% from randomized, controlled trial data). A risk-based approach led to the eligibility of 15.0 million (95% confidence interval, 12.7-17.3 million) Americans, whereas a benefit-based approach identified 24.6 million (95% confidence interval, 21.0-28.1 million). The corresponding numbers needed to treat over 10 years were 21 (range, 9-44) and 25 (range, 9-44). The benefit-based approach identified 9.5 million lower-risk (<7.5% 10-year risk) Americans not currently eligible for statin treatment who had the same or greater expected benefit from statins (≥2.3% ARR10) compared with higher-risk individuals. This lower-risk/acceptable-benefit group includes younger individuals (mean age, 55.2 versus 62.5 years; P<0.001 for benefit based versus risk based) with higher low-density lipoprotein cholesterol (140 versus133 mg/dL; P=0.01). Statin treatment in this group would be expected to prevent an additional 266 508 cardiovascular events over 10 years. An individualized statin benefit approach can identify lower-risk individuals who have equal or greater expected benefit from statins in primary prevention compared with higher-risk individuals. This approach may help develop guideline recommendations that better identify individuals who meaningfully benefit from statin therapy. © 2016 American Heart Association, Inc.
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Duintjer Tebbens, Radboud J; Thompson, Kimberly M
2017-07-05
Recognizing that infectious agents readily cross international borders, the International Health Regulations Emergency Committee issues Temporary Recommendations (TRs) that include vaccination of travelers from countries affected by public health emergencies, including serotype 1 wild polioviruses (WPV1s). This analysis estimates the costs and benefits of TRs implemented by countries with reported WPV1 during 2014-2016 while accounting for numerous uncertainties. We estimate the TR costs based on programmatic data and prior economic analyses and TR benefits by simulating potential WPV1 outbreaks in the absence of the TRs using the rate and extent of WPV1 importation outbreaks per reported WPV1 case during 2004-2013 and the number of reported WPV1 cases that occurred in countries with active TRs. The benefits of TRs outweigh the costs in 77% of model iterations, resulting in expected incremental net economic benefits of $210 million. Inclusion of indirect costs increases the costs by 13%, the expected savings from prevented outbreaks by 4%, and the expected incremental net benefits by 3%. Despite the considerable costs of implementing TRs, this study provides health and economic justification for these investments in the context of managing a disease in advanced stages of its global eradication. Copyright © 2017 The Auhors. Published by Elsevier Ltd.. All rights reserved.
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NASA Astrophysics Data System (ADS)
Qi, Wei
2017-11-01
Cost-benefit analysis is commonly used for engineering planning and design problems in practice. However, previous cost-benefit based design flood estimation is based on stationary assumption. This study develops a non-stationary cost-benefit based design flood estimation approach. This approach integrates a non-stationary probability distribution function into cost-benefit analysis, and influence of non-stationarity on expected total cost (including flood damage and construction costs) and design flood estimation can be quantified. To facilitate design flood selections, a 'Risk-Cost' analysis approach is developed, which reveals the nexus of extreme flood risk, expected total cost and design life periods. Two basins, with 54-year and 104-year flood data respectively, are utilized to illustrate the application. It is found that the developed approach can effectively reveal changes of expected total cost and extreme floods in different design life periods. In addition, trade-offs are found between extreme flood risk and expected total cost, which reflect increases in cost to mitigate risk. Comparing with stationary approaches which generate only one expected total cost curve and therefore only one design flood estimation, the proposed new approach generate design flood estimation intervals and the 'Risk-Cost' approach selects a design flood value from the intervals based on the trade-offs between extreme flood risk and expected total cost. This study provides a new approach towards a better understanding of the influence of non-stationarity on expected total cost and design floods, and could be beneficial to cost-benefit based non-stationary design flood estimation across the world.
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Noise-enhanced clustering and competitive learning algorithms.
Osoba, Osonde; Kosko, Bart
2013-01-01
Noise can provably speed up convergence in many centroid-based clustering algorithms. This includes the popular k-means clustering algorithm. The clustering noise benefit follows from the general noise benefit for the expectation-maximization algorithm because many clustering algorithms are special cases of the expectation-maximization algorithm. Simulations show that noise also speeds up convergence in stochastic unsupervised competitive learning, supervised competitive learning, and differential competitive learning. Copyright © 2012 Elsevier Ltd. All rights reserved.
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Patients' expectations of medicines--a review and qualitative synthesis.
Dohnhammar, Ulrica; Reeve, Joanne; Walley, Tom
2016-04-01
An increasing part of prescribing of medicines is done for the purpose of managing risk for disease and is motivated by clinical and economic benefit on a long-term, population level. This makes benefit from medicines less tangible for individuals. Sociology of pharmaceuticals includes personal and social perspectives in the study of how medicines are used. We use two characterizations of patients' expectations of medicines to start forming a description of how individuals conceptualize benefits from risk management medicines. We reviewed the literature on patients' expectations with a focus on the influences on expectations regarding medicines prescribed for long-term conditions. Searches in Medline and Scopus identified 20 studies for inclusion, describing qualitative aspects of beliefs, views, thoughts and expectations regarding medicines. A qualitative synthesis using a constant comparative thematic analysis identified four themes describing influences on expectations: a need to achieve a specific outcome; the development of experiences and evaluation over time; negative values such as dependency and social stigma; and personalized meaning of the necessity and usefulness of medicines. The findings in this synthesis resonate with previous research into expectations of medicines for prevention and treatment of different conditions. However, a gap in the knowledge regarding patients' conceptualization of future benefits with medicines is identified. The study highlights suggestions for further empirical work to develop a deeper understanding of the role of patients' expectations in prescribing for long-term risk management. © 2015 John Wiley & Sons Ltd.
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Mutual benefits in academic-service partnership: An integrative review.
Sadeghnezhad, Maliheh; Heshmati Nabavi, Fatemeh; Najafi, Fereshteh; Kareshki, Hossein; Esmaily, Habibollah
2018-05-30
Academic and service institutions involve with many challenges. Partnership programs are a golden opportunity to achieve mutual benefits to overcome these challenges. Identifying mutual benefits is the cornerstone of forming a successful partnership and guarantee to its continuity. There are definitions and instances of mutual benefits in the literature related to partnership programs, but there is no coherent evidence and clear picture of these benefits. This study is conducted to identify mutual benefits in academic-service partnership by analyzing the definitions and instances of it in the literature. An integrative review of key papers regarding mutual benefits in academic-service partnership was undertaken. This review was guided by the framework described by Whittemore and Knafl. Search of the following databases was conducted: MEDLINE, ERIC, Google Scholar, Emerald Insight and Science Direct. The search terms were mutual benefits, mutual gains, mutual interest, mutual expectations, mutual goals, mutual demand, partnership, collaboration, academic-service partnership and academic service collaboration. Cooper's five-stage integrative review method was used. Quality evaluation of articles was conducted. Data were abstracted from included articles. The analysis was conducted based on the qualitative content analysis of the literature suggested by Zhang and Wildemuth. 28 articles were included in this review. Mutual benefits are described in four categories include: synergy in training and empowerment of human resources, education improvement, access to shared resources, facilitate production and application of beneficial knowledge into practice. Mutual benefits in the academic-service partnership include a range of goals, interests, expectations, and needs of partner organizations that is achievable and measurable through joint planning and collaboration. We suggest academic and service policymakers to consider these benefits in the planning and evaluating partnership programs. Copyright © 2018 Elsevier Ltd. All rights reserved.
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A Case Study on the Failure of Management Controls around Expected Benefit Development
ERIC Educational Resources Information Center
Parsons, Earl H.
2013-01-01
Organization leaders manage change through projects to realize specific expected benefits. Under Expectation-Confirmation theory, expected benefits can be used to judge the ongoing viability and final success of the project. Organization leaders often develop management controls to ensure that the expected benefits are defined to allow their use…
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Duclos, Vincent; Yé, Maurice; Moubassira, Kagoné; Sanou, Hamidou; Sawadogo, N Hélène; Bibeau, Gilles; Sié, Ali
2017-07-12
The implementation of mobile health (mHealth) projects in low- and middle-income countries raises high and well-documented expectations among development agencies, policymakers and researchers. By contrast, the expectations of direct and indirect mHealth users are not often examined. In preparation for a proposed intervention in the Nouna Health District, in rural Burkina Faso, this study investigates the expected benefits, challenges and limitations associated with mHealth, approaching these expectations as a form of situated knowledge, inseparable from local conditions, practices and experiences. The study was conducted within the Nouna Health District. We used a qualitative approach, and conducted individual semi-structured interviews and group interviews (n = 10). Participants included healthcare workers (n = 19), godmothers (n = 24), pregnant women (n = 19), women with children aged 12-24 months (n = 33), and women of childbearing age (n = 92). Thematic and content qualitative analyses were conducted. Participants expect mHealth to help retrieve patients lost to follow-up, improve maternal care monitoring, and build stronger relationships between pregnant women and primary health centres. Expected benefits are not reducible to a technological realisation (sending messages), but rather point towards a wider network of support. mHealth implementation is expected to present considerable challenges, including technological barriers, organisational challenges, gender issues, confidentiality concerns and unplanned aftereffects. mHealth is also expected to come with intrinsic limitations, to be found as obstacles to maternal care access with which pregnant women are confronted and on which mHealth is not expected to have any significant impact. mHealth expectations appear as situated knowledges, inseparable from local health-related experiences, practices and constraints. This problematises universalistic approaches to mHealth knowledge, while nevertheless hinting at concrete, expected benefits. Findings from this study will help guide the design and implementation of mHealth initiatives, thus optimising their chances for success.
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The impact of self-efficacy, expectations, and readiness on hearing aid outcomes.
Ferguson, Melanie A; Woolley, Annie; Munro, Kevin J
2016-07-01
To examine the impact of self-efficacy and expectations for hearing aids, and readiness to improve hearing, on hearing aid outcome measures in first-time adult hearing aid users Design: A prospective, single centre design. Predictor variables measured at the hearing assessment included measures of self-efficacy, expectations and readiness to improve hearing. Outcome measures obtained at six-week follow-up were the Glasgow Hearing Aid Benefit Profile and Satisfaction with Amplification in Daily Life. A sample of 30 first-time adult hearing aid users were recruited through a public-sector funded audiology clinic. When measured prior to hearing aid fitting, self-efficacy for hearing aids predicted satisfaction with hearing aids but was not related to other hearing aid outcomes. Expectations of hearing aids, in particular positive expectations, and readiness to improve hearing predicted outcomes for hearing aid satisfaction and benefit, although not hearing aid use. Hearing sensitivity was not correlated with hearing aid outcomes. These results suggest that assessment of expectations of hearing aids, and readiness to improve hearing, may be useful to help identify individuals attending audiology clinics who would most likely benefit from hearing aid provision.
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-07-01
... emissions, (applicants are encouraged to provide quantitative information regarding expected reductions in...). Applicants are encouraged to provide quantitative information that validates the existence of substantial... infrastructure investments on systematic analysis of expected benefits and costs, including both quantitative and...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-06-01
... provide quantitative information regarding expected reductions in emissions of CO 2 or fuel consumption as... provide quantitative information that validates the existence of substantial transportation-related costs... infrastructure investments on systematic analysis of expected benefits and costs, including both quantitative and...
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"Trickle-Down" Reform: Hispanics, Higher Education, and the Excellence Movement.
ERIC Educational Resources Information Center
Halcon, John J.; de la Luz Reyes, Maria
1991-01-01
Recent excellence-in-education reform measures have created greater restrictions on the access of Hispanics to higher education. Suggests that reformers expect reform benefits to "trickle down" to minorities after first benefiting mainstream students. The idea of excellence must include that of educational equity. (CJS)
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Effort-based cost-benefit valuation and the human brain
Croxson, Paula L; Walton, Mark E; O'Reilly, Jill X; Behrens, Timothy EJ; Rushworth, Matthew FS
2010-01-01
In both the wild and the laboratory, animals' preferences for one course of action over another reflect not just reward expectations but also the cost in terms of effort that must be invested in pursuing the course of action. The ventral striatum and dorsal anterior cingulate cortex (ACCd) are implicated in the making of cost-benefit decisions in the rat but there is little information about how effort costs are processed and influence calculations of expected net value in other mammals including the human. We carried out a functional magnetic resonance imaging (fMRI) study to determine whether and where activity in the human brain was available to guide effort-based cost-benefit valuation. Subjects were scanned while they performed a series of effortful actions to obtain secondary reinforcers. At the beginning of each trial, subjects were presented with one of eight different visual cues which they had learned indicated how much effort the course of action would entail and how much reward could be expected at its completion. Cue-locked activity in the ventral striatum and midbrain reflected the net value of the course of action, signaling the expected amount of reward discounted by the amount of effort to be invested. Activity in ACCd also reflected the interaction of both expected reward and effort costs. Posterior orbitofrontal and insular activity, however, only reflected the expected reward magnitude. The ventral striatum and anterior cingulate cortex may be the substrate of effort-based cost-benefit valuation in primates as well as in rats. PMID:19357278
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Family Benefits--What Are Students' Attitudes and Expectations by Gender?
ERIC Educational Resources Information Center
Waner, Karen K.; Winter, Janet K.; Mansfield, Joan C.
2007-01-01
Benefits and leave policies are important aspects of employment when employees attempt to balance career and family. These policies include salary, promotion, vacation, tuition reimbursement, sick leave, medical insurance, life insurance, maternity or paternity leave, elder-care leave, discriminatory leave, and company support and counseling. The…
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Giannakeas, Vasily; Narod, Steven A
2018-01-01
Preventive breast surgery is offered to unaffected BRCA mutation carriers to prevent breast cancer incidence and mortality. The clinical benefit of preventive mastectomy can be measured in several ways, including extension of life expectancy (mean years of life gained) and by estimating the probability of surviving until age 80. We sought to estimate the expected benefit of a preventive mastectomy at various ages, using these indices of mortality, by simulating hypothetical cohorts of women. The age-specific annual risks of developing breast cancer were used to estimate the actuarial risk of developing breast cancer by age 80 for women with a BRCA1 or BRCA2 mutation. The probability of developing breast cancer before age 80 was then modified to include competing causes of death, including from ovarian cancer. The mortality rate from breast cancer after a diagnosis of breast cancer was set at 2% annually for the first 10 years and then 1% annually for years ten to twenty. The incidence rate and mortality rate from ovarian cancer were based on published literature. We assumed that preventive mastectomy was associated with complete protection against subsequent breast cancer. A series of simulations was conducted to evaluate the reduction in the probability of death (from all causes) until age 80, according to the age at mastectomy. The actuarial risk of developing breast cancer until age 80 was estimated to be 70.8%. The actual risk (incorporating competing risks) was 64.0%. The probability of being alive at age 80 by having a mastectomy at age 25 increased by 8.7% (from 42.7 to 51.3%). The estimated benefit declined with age at mastectomy; for surgery done at age 50 the improvement in survival to age 80 was much more modest (2.8% at age 80, from 42.7 to 45.5%). Among BRCA mutation carriers, the mortality benefit of preventive mastectomy at age 25 is substantial, but the expected benefit declines rapidly with increasing age at surgery.
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Identifying public expectations of genetic biobanks.
Critchley, Christine; Nicol, Dianne; McWhirter, Rebekah
2017-08-01
Understanding public priorities for biobanks is vital for maximising utility and efficiency of genetic research and maintaining respect for donors. This research directly assessed the relative importance the public place on different expectations of biobanks. Quantitative and qualitative results from a national sample of 800 Australians revealed that the majority attributed more importance to protecting privacy and ethical conduct than maximising new healthcare benefits, which was in turn viewed as more important than obtaining specific consent, benefit sharing, collaborating and sharing data. A latent class analysis identified two distinct classes displaying different patterns of expectations. One placed higher priority on behaviours that respect the donor ( n = 623), the other on accelerating science ( n = 278). Additional expectations derived from qualitative data included the need for biobanks to be transparent and to prioritise their research focus, educate the public and address commercialisation.
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Balancing the benefits and costs of antibiotic drugs: the TREAT model.
Leibovici, L; Paul, M; Andreassen, S
2010-12-01
TREAT is a computerized decision support system aimed at improving empirical antibiotic treatment of inpatients with suspected bacterial infections. It contains a model that balances, for each antibiotic choice (including 'no antibiotics'), expected benefit and expected costs. The main benefit afforded by appropriate, empirical, early antibiotic treatment in moderate to severe infections is a better chance of survival. Each antibiotic drug was consigned three cost components: cost of the drug and administration; cost of side effects; and costs of future resistance. 'No treatment' incurs no costs. The model worked well for decision support. Its analysis showed, yet again, that for moderate to severe infections, a model that does not include costs of resistance to future patients will always return maximum antibiotic treatment. Two major moral decisions are hidden in the model: how to take into account the limited life-expectancy and limited quality of life of old or very sick patients; and how to assign a value for a life-year of a future, unnamed patient vs. the present, individual patient. © 2010 The Authors. Clinical Microbiology and Infection © 2010 European Society of Clinical Microbiology and Infectious Diseases.
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Stakeholder e-Participation in Local Planning: The Camargue Park Case
NASA Astrophysics Data System (ADS)
Desquinabo, Nicolas; Ferrand, Nils; Marlier, Julie
The goal of this study is to evaluate several features and outcomes of the e-consultation organized by the Camargue Natural Park on its management plan. To estimate the benefits of the selected Internet devices, we have compared our assessment of this e-consultation with other face-to-face participative events organized on the same management plan. Following "computer-mediated communication" and deliberative theories, we expected that the tested e-tools would increase the deliberative features of the stakeholder participation. Several economic and organisational benefits were also expected. Our first results confirm the organisational benefits of this e-consultation (information gain, cost of the process, etc.). Several "deliberative" benefits have also been observed (more opinion and thematic diversity without an increase of "flames"). Nevertheless, speech is apparently more concentrated than in face-to-face events, even if many "non-posters" visited the consultation site but did not post because they had "all their comments already included".
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Faustmann and the forestry tradition of outcome-based performance measures
Peter J. Ince
1999-01-01
The concept of land expectation value developed by Martin Faustmann may serve as a paradigm for outcome-based performance measures in public forest management if the concept of forest equity value is broadened to include social and environmental benefits and costs, and sustainability. However, anticipation and accurate evaluation of all benefits and costs appears to...
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TNE-Trans-National Education or Tensions between National and External? a Case Study of Malaysia
ERIC Educational Resources Information Center
Hill, Christopher; Cheong, Kee-Cheok; Leong, Yin-Ching; Fernandez-Chung, Rozilini
2014-01-01
Transnational education, primarily at the tertiary level, has been growing rapidly, bringing with it high hopes and expectations of benefits to institutions in the countries of origin and destination. However, these potential benefits come with a set of challenges that must be overcome. These challenges include the need to reconcile the…
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Mothes, Hendrik; Leukel, Christian; Jo, Han-Gue; Seelig, Harald; Schmidt, Stefan; Fuchs, Reinhard
2017-04-01
The study investigated whether typical psychological, physiological, and neurophysiological changes from a single exercise are affected by one's beliefs and expectations. Seventy-six participants were randomly assigned to four groups and saw different multimedia presentations suggesting that the subsequent exercise (moderate 30 min cycling) would result in more or less health benefits (induced expectations). Additionally, we assessed habitual expectations reflecting previous experience and beliefs regarding exercise benefits. Participants with more positive habitual expectations consistently demonstrated both greater psychological benefits (more enjoyment, mood increase, and anxiety reduction) and greater increase of alpha-2 power, assessed with electroencephalography. Manipulating participants' expectations also resulted in largely greater increases of alpha-2 power, but not in more psychological exercise benefits. On the physiological level, participants decreased their blood pressure after exercising, but this was independent of their expectations. These results indicate that habitual expectations in particular affect exercise-induced psychological and neurophysiological changes in a self-fulfilling manner.
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Assertiveness expectancies: how hard people push depends on the consequences they predict.
Ames, Daniel R
2008-12-01
The present article seeks to explain varying levels of assertiveness in interpersonal conflict and negotiations with assertiveness expectancies, idiosyncratic predictions people make about the social and instrumental consequences of assertive behavior. This account complements motivation-based models of assertiveness and competitiveness, suggesting that individuals may possess the same social values (e.g., concern for relationships) but show dramatically different assertiveness due to different assumptions about behavioral consequences. Results clarify the form of assertiveness expectancies, namely that most people assume increasing assertiveness can yield positive social and instrumental benefits up to a point, beyond which benefits decline. However, people vary in how assertive this perceived optimal point is. These individual differences in expectancies are linked in 4 studies to assertiveness, including self-reported assertiveness, rated behavioral preferences in assorted interpersonal conflict scenarios, partner ratings of participants' behavior in a face-to-face dyadic negotiation, and work colleague ratings of participants' assertiveness in the workplace. In each case, the link between expectancies and behavior remained after controlling for values. The results suggest a place for expectancies alongside values in psychological models of interpersonal assertiveness.
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Wattson, Daniel A; Hunink, M G Myriam; DiPiro, Pamela J; Das, Prajnan; Hodgson, David C; Mauch, Peter M; Ng, Andrea K
2014-10-01
Hodgkin lymphoma (HL) survivors face an increased risk of treatment-related lung cancer. Screening with low-dose computed tomography (LDCT) may allow detection of early stage, resectable cancers. We developed a Markov decision-analytic and cost-effectiveness model to estimate the merits of annual LDCT screening among HL survivors. Population databases and HL-specific literature informed key model parameters, including lung cancer rates and stage distribution, cause-specific survival estimates, and utilities. Relative risks accounted for radiation therapy (RT) technique, smoking status (>10 pack-years or current smokers vs not), age at HL diagnosis, time from HL treatment, and excess radiation from LDCTs. LDCT assumptions, including expected stage-shift, false-positive rates, and likely additional workup were derived from the National Lung Screening Trial and preliminary results from an internal phase 2 protocol that performed annual LDCTs in 53 HL survivors. We assumed a 3% discount rate and a willingness-to-pay (WTP) threshold of $50,000 per quality-adjusted life year (QALY). Annual LDCT screening was cost effective for all smokers. A male smoker treated with mantle RT at age 25 achieved maximum QALYs by initiating screening 12 years post-HL, with a life expectancy benefit of 2.1 months and an incremental cost of $34,841/QALY. Among nonsmokers, annual screening produced a QALY benefit in some cases, but the incremental cost was not below the WTP threshold for any patient subsets. As age at HL diagnosis increased, earlier initiation of screening improved outcomes. Sensitivity analyses revealed that the model was most sensitive to the lung cancer incidence and mortality rates and expected stage-shift from screening. HL survivors are an important high-risk population that may benefit from screening, especially those treated in the past with large radiation fields including mantle or involved-field RT. Screening may be cost effective for all smokers but possibly not for nonsmokers despite a small life expectancy benefit. Copyright © 2014 Elsevier Inc. All rights reserved.
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Knowing what to respond in the future does not cancel the influence of past events.
Tubau, Elisabet; López-Moliner, Joan
2009-05-29
Everyday tasks seldom involve isolate actions but sequences of them. We can see whether previous actions influence the current one by exploring the response time to controlled sequences of stimuli. Specifically, depending on the response-stimulus temporal interval (RSI), different mechanisms have been proposed to explain sequential effects in two-choice serial response tasks. Whereas an automatic facilitation mechanism is thought to produce a benefit for response repetitions at short RSIs, subjective expectancies are considered to replace the automatic facilitation at longer RSIs, producing a cost-benefit pattern: repetitions are faster after other repetitions but they are slower after alternations. However, there is not direct evidence showing the impact of subjective expectancies on sequential effects. By using a fixed sequence, the results of the reported experiment showed that the repetition effect was enhanced in participants who acquired complete knowledge of the order. Nevertheless, a similar cost-benefit pattern was observed in all participants and in all learning blocks. Therefore, results of the experiment suggest that sequential effects, including the cost-benefit pattern, are the consequence of automatic mechanisms which operate independently of (and simultaneously with) explicit knowledge of the sequence or other subjective expectancies.
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Sulmasy, Daniel P.; Astrow, Alan B.; He, M. Kai; Seils, Damon M.; Meropol, Neal J.; Micco, Ellyn; Weinfurt, Kevin P.
2013-01-01
Purpose Patients’ estimates of their chances of therapeutic benefit from participation in early-phase trials greatly exceed historical data. Ethicists worry that this “therapeutic misestimation” undermines the validity of informed consent. Patients and Methods We interviewed 45 patients enrolled in phase I or II oncology trials about their expectations of therapeutic benefit and their reasons for those expectations. We employed a phenomenological, qualitative approach with one primary coder to identify emergent themes, verified by 2 independent coders. Results Median expectations of therapeutic benefit varied from 50% to 80%, depending on how the question was asked. Justifications universally invoked hope and optimism, and 27/45 participants used one of these words. Three major themes emerged: (1) optimism as performative, that is, the notion that positive thoughts and expressions improve chances of benefit; (2) fighting cancer as a battle; and (3) faith in God, science, or both. Many participants described a culture in which optimism was encouraged and expected, such that trial enrollment became a way of reflecting this expectation. Many reported they had been told few patients would benefit and appeared to understand the uncertainties of clinical research, yet expressed high expected personal therapeutic benefit. More distressed participants were less likely to invoke performative justifications for their expectations (50% vs 84%; P = .04). Conclusion Expressions of high expected therapeutic benefit had little to do with reporting knowledge and more to do with expressing optimism. These results have implications for understanding how to obtain valid consent from participants in early-phase clinical trials. PMID:20564120
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ERIC Educational Resources Information Center
Pickering, Catherine; Byrne, Jason
2014-01-01
Universities increasingly expect students to publish during a PhD candidature because it benefits the candidate, supervisor, institution, and wider community. Here, we describe a method successfully used by early-career researchers including PhD candidates to undertake and publish literature reviews--a challenge for researchers new to a field. Our…
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Weinfurt, Kevin P.; Seils, Damon M.; Tzeng, Janice P.; Compton, Kate L.; Sulmasy, Daniel P.; Astrow, Alan B.; Solarino, Nicholas A.; Schulman, Kevin A.; Meropol, Neal J.
2009-01-01
Background Participants in early-phase clinical trials have reported high expectations of benefit from their participation. There is concern that participants misunderstand the trials to which they have consented. Such concern is based on assumptions about what patients mean when they respond to questions about likelihood of benefit. Methods Participants were 27 women and 18 men in early-phase oncology trials at 2 academic medical centers in the United States. To determine whether expectations of benefit differ depending on how patients are queried, we randomly assigned participants to 1 of 3 interviews corresponding to 3 questions about likelihood of benefit: frequency-type, belief-type, and vague. In semistructured interviews, we queried participants about how they understood and answered the question. Participants then answered and discussed one of the other questions. Results Expectations of benefit in response to the belief-type question were significantly greater than expectations in response to the frequency-type and vague questions (P = .02). The most common justifications involved positive attitude (n = 27 [60%]) and references to physical health (n = 23 [51%]). References to positive attitude were most common among participants with higher (> 70%) expectations (n = 11 [85%]) and least common among those with lower (< 50%) expectations (n = 3 [27%]). Conclusions The wording of questions about likelihood of benefit shapes the expectations that patients express. Also, patients who express high expectations may not do so to communicate understanding, but rather to register optimism. Ongoing research will clarify the meaning of high expectations and examine methods for assessing understanding in this context. PMID:18378940
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Direct support workforce supporting individuals with IDD: current wages, benefits, and stability.
Bogenschutz, Matthew D; Hewitt, Amy; Nord, Derek; Hepperlen, Renee
2014-10-01
Abstract Direct support professionals (DSPs) and frontline supervisors (FLSs) play an integral role in the lives of people with intellectual and developmental disabilities (IDD) and are often the individuals directly responsible for assisting people with IDD to live and fully participate in their communities. These two groups of workers have typically been employed at lower wages with limited access to fringe benefits, contributing to high rates of turnover compared to a similarly skilled worker in the United States. This article summarizes findings and is the first investigation in several years to systematically examine the wages, fringe benefits, and stability of the DSP and FLS workforces supporting individuals with IDD. Findings suggest that a typical DSP may expect to earn about $11.25 per hour, while FLSs may expect wages of about $15.45 hourly. Of concern, however, is that fringe benefit provision was quite limited in this sample. Implications, including relation to past reports of DSP workforce development, are discussed.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Barr, Jonathan L.; Taira, Randal Y.; Orr, Heather M.
The purpose of this document is to describe the operating concepts, capabilities, and benefits of RAMS including descriptions of how the system implementations can improve emergency response, damage assessment, task prioritization, and situation awareness. This CONOPS provides general information on operational processes and procedures required to utilize RAMS, and expected performance benefits of the system. The primary audiences for this document are the end users of RAMS (including flight operators and incident commanders) and the RAMS management team. Other audiences include interested offices within the Department of Homeland Security (DHS), and officials from other state and local jurisdictions who wantmore » to implement similar systems.« less
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Comparing diagnostic tests on benefit-risk.
Pennello, Gene; Pantoja-Galicia, Norberto; Evans, Scott
2016-01-01
Comparing diagnostic tests on accuracy alone can be inconclusive. For example, a test may have better sensitivity than another test yet worse specificity. Comparing tests on benefit risk may be more conclusive because clinical consequences of diagnostic error are considered. For benefit-risk evaluation, we propose diagnostic yield, the expected distribution of subjects with true positive, false positive, true negative, and false negative test results in a hypothetical population. We construct a table of diagnostic yield that includes the number of false positive subjects experiencing adverse consequences from unnecessary work-up. We then develop a decision theory for evaluating tests. The theory provides additional interpretation to quantities in the diagnostic yield table. It also indicates that the expected utility of a test relative to a perfect test is a weighted accuracy measure, the average of sensitivity and specificity weighted for prevalence and relative importance of false positive and false negative testing errors, also interpretable as the cost-benefit ratio of treating non-diseased and diseased subjects. We propose plots of diagnostic yield, weighted accuracy, and relative net benefit of tests as functions of prevalence or cost-benefit ratio. Concepts are illustrated with hypothetical screening tests for colorectal cancer with test positive subjects being referred to colonoscopy.
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Oregon Department of Transportation : access management best practices manual.
DOT National Transportation Integrated Search
2012-12-01
This manual is provided as a resource to help Oregon transportation professionals quantify the expected benefits of various access management applications. As a result, this manual includes recommendations for how to evaluate potential access managem...
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Family members' perceptions of augmentative and alternative communication device use.
Bailey, Rita L; Parette, Howard P; Stoner, Julia B; Angell, Maureen E; Carroll, Kathleen
2006-01-01
Although advancements in technology have expanded the use of augmentative and alternative communication (AAC) devices for children with disabilities, the use of AAC devices in school and home settings is often inconsistent. The purpose of this study was to examine family members' perceptions regarding the use of AAC devices. Factors that were perceived to affect student's use of AAC devices, family expectations, and benefits of AAC device use were explored. Semistructured interviews were conducted with 6 family members (primary caregivers) of 7 youth who primarily use AAC devices to communicate in the school environment. The interviews were analyzed using cross-case analysis. A variety of common perspectives emerged from the data, including four thematic categories: expectations, facilitators, barriers, and benefits of AAC device use. Information gained in this investigation may be used to improve professional-family and teaming relationships and serve to benefit AAC users in school and home settings.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Wattson, Daniel A., E-mail: dwattson@partners.org; Hunink, M.G. Myriam; DiPiro, Pamela J.
2014-10-01
Purpose: Hodgkin lymphoma (HL) survivors face an increased risk of treatment-related lung cancer. Screening with low-dose computed tomography (LDCT) may allow detection of early stage, resectable cancers. We developed a Markov decision-analytic and cost-effectiveness model to estimate the merits of annual LDCT screening among HL survivors. Methods and Materials: Population databases and HL-specific literature informed key model parameters, including lung cancer rates and stage distribution, cause-specific survival estimates, and utilities. Relative risks accounted for radiation therapy (RT) technique, smoking status (>10 pack-years or current smokers vs not), age at HL diagnosis, time from HL treatment, and excess radiation from LDCTs.more » LDCT assumptions, including expected stage-shift, false-positive rates, and likely additional workup were derived from the National Lung Screening Trial and preliminary results from an internal phase 2 protocol that performed annual LDCTs in 53 HL survivors. We assumed a 3% discount rate and a willingness-to-pay (WTP) threshold of $50,000 per quality-adjusted life year (QALY). Results: Annual LDCT screening was cost effective for all smokers. A male smoker treated with mantle RT at age 25 achieved maximum QALYs by initiating screening 12 years post-HL, with a life expectancy benefit of 2.1 months and an incremental cost of $34,841/QALY. Among nonsmokers, annual screening produced a QALY benefit in some cases, but the incremental cost was not below the WTP threshold for any patient subsets. As age at HL diagnosis increased, earlier initiation of screening improved outcomes. Sensitivity analyses revealed that the model was most sensitive to the lung cancer incidence and mortality rates and expected stage-shift from screening. Conclusions: HL survivors are an important high-risk population that may benefit from screening, especially those treated in the past with large radiation fields including mantle or involved-field RT. Screening may be cost effective for all smokers but possibly not for nonsmokers despite a small life expectancy benefit.« less
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Boroff, Kari; Kauffman, Mandy; Peck, Dannele; Maichak, Eric; Scurlock, Brandon; Schumaker, Brant
2016-11-01
Recent cases of bovine brucellosis (Brucella abortus) in cattle (Bos taurus) and domestic bison (Bison bison) of the southern Greater Yellowstone Area (SGYA) have been traced back to free-ranging elk (Cervus elaphus). Several management activities have been implemented to reduce brucellosis seroprevalence in elk, including test-and-slaughter, low-density feeding at elk winter feedgrounds, and elk vaccination. It is unclear which of these activities are most cost-effective at reducing the risk of elk transmitting brucellosis to cattle. In a companion paper, a stochastic risk model was used to translate a reduction in elk seroprevalence to a reduction in the risk of transmission to cattle. Here, we use those results to estimate the expected economic benefits and costs of reducing seroprevalence in elk using three different management activities: vaccination of elk with Brucella strain 19 (S19), low-density feeding of elk, and elk test-and-slaughter. Results indicate that the three elk management activities yield negative expected net benefits, ranging from -$2983 per year for low-density feeding to -$595,471 per year for test-and-slaughter. Society's risk preferences will determine whether strategies that generate small negative net benefit, such as low-density feeding, are worth implementing. However, activities with large negative net benefits, such as test-and-slaughter and S19 vaccination, are unlikely to be economically worthwhile. Given uncertainty about various model parameters, we identify some circumstances in which individual management activities might generate positive expected net benefit. Copyright © 2016 Elsevier B.V. All rights reserved.
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What are cancer centers advertising to the public?: a content analysis.
Vater, Laura B; Donohue, Julie M; Arnold, Robert; White, Douglas B; Chu, Edward; Schenker, Yael
2014-06-17
Although critics have expressed concerns about cancer center advertising, analyses of the content of these advertisements are lacking. To characterize the informational and emotional content of direct-to-consumer cancer center advertisements. Content analysis. Top U.S. consumer magazines (n = 269) and television networks (n = 44) in 2012. Types of clinical services promoted; information provided about clinical services, including risks, benefits, costs, and insurance availability; use of emotional advertising appeals; and use of patient testimonials were assessed. Two investigators independently coded advertisements using ATLAS.ti, and κ values ranged from 0.77 to 1.00. A total of 102 cancer centers placed 409 unique clinical advertisements in top media markets in 2012. Advertisements promoted treatments (88%) more often than screening (18%) or supportive services (13%). Benefits of advertised therapies were described more often than risks (27% vs. 2%) but were rarely quantified (2%). Few advertisements mentioned coverage or costs (5%), and none mentioned specific insurance plans. Emotional appeals were frequent (85%), evoking hope for survival (61%), describing cancer treatment as a fight or battle (41%), and inducing fear (30%). Nearly one half of advertisements included patient testimonials, which were usually focused on survival, rarely included disclaimers (15%), and never described the results that a typical patient may expect. Internet advertisements were not included. Clinical advertisements by cancer centers frequently promote cancer therapy with emotional appeals that evoke hope and fear while rarely providing information about risks, benefits, costs, or insurance availability. Further work is needed to understand how these advertisements influence patient understanding and expectations of benefit from cancer treatments. National Institutes of Health.
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Optical Measurements for Intelligent Aerospace Propulsion
NASA Technical Reports Server (NTRS)
Mercer, Carolyn R.
2003-01-01
There is growing interest in applying intelligent technologies to aerospace propulsion systems to reap expected benefits in cost, performance, and environmental compliance. Cost benefits span the engine life cycle from development, operations, and maintenance. Performance gains are anticipated in reduced fuel consumption, increased thrust-toweight ratios, and operability. Environmental benefits include generating fewer pollutants and less noise. Critical enabling technologies to realize these potential benefits include sensors, actuators, logic, electronics, materials, and structures. For propulsion applications, the challenge is to increase the robustness of these technologies so that they can withstand harsh temperatures, vibrations, and grime while providing extremely reliable performance. This paper addresses the role that optical metrology is playing in providing solutions to these challenges. Optics for ground-based testing (development cycle), flight sensing (operations), and inspection (maintenance) are described. Opportunities for future work are presented.
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Using Gaming To Help Nursing Students Understand Ethics.
ERIC Educational Resources Information Center
Metcalf, Barbara L.; Yankou, Dawn
2003-01-01
An ethics game involves nursing students in defending actions in ethics-based scenarios. Benefits include increased confidence, ability to see multiple perspectives, values clarification, and exposure to decision-making models, professional responsibilities, ethical principles, social expectations, and legal requirements. Difficulties include…
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Coxeter, Peter D; Mar, Chris Del; Hoffmann, Tammy C
2017-03-01
Primary care visits for children with acute respiratory infections frequently result in antibiotic prescriptions, although antibiotics have limited benefits for common acute respiratory infections and can cause harms, including antibiotic resistance. Parental demands are often blamed for antibiotic prescription. We aimed to explore parents' beliefs about antibiotic necessity, quantify their expectations of antibiotic benefit, and report experiences of other management options and exposure to and preferences for shared decision making. We conducted computer-assisted telephone interviews in an Australia-wide community sample of primary caregivers, hereafter referred to as parents, of children aged 1 to 12 years, using random digit dialing of household landline telephones. Of the 14,505 telephone numbers called, 10,340 were eligible numbers; 589 potentially eligible parents were reached, of whom 401 were interviewed. Most believed antibiotics provide benefits for common acute respiratory infections, especially for acute otitis media (92%), although not using them, particularly for acute cough and sore throat, was sometimes acceptable. Parents grossly overestimated the mean benefit of antibiotics on illness symptom duration by 5 to 10 times, and believed they reduce the likelihood of complications. The majority, 78%, recognized antibiotics may cause harm. Recalling the most recent relevant doctor visit, 44% of parents reported at least some discussion about why antibiotics might be used; shared decision making about antibiotic use was inconsistent, while 75% wanted more involvement in future decisions. Some parents have misperceptions about antibiotic use for acute respiratory infections, highlighting the need for improved communication during visits, including shared decision making to address overoptimistic expectations of antibiotics. Such communication should be one of several strategies that is used to reduce antibiotic use. © 2017 Annals of Family Medicine, Inc.
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Coxeter, Peter D.; Mar, Chris Del; Hoffmann, Tammy C.
2017-01-01
PURPOSE Primary care visits for children with acute respiratory infections frequently result in antibiotic prescriptions, although antibiotics have limited benefits for common acute respiratory infections and can cause harms, including antibiotic resistance. Parental demands are often blamed for antibiotic prescription. We aimed to explore parents’ beliefs about antibiotic necessity, quantify their expectations of antibiotic benefit, and report experiences of other management options and exposure to and preferences for shared decision making. METHODS We conducted computer-assisted telephone interviews in an Australia-wide community sample of primary caregivers, hereafter referred to as parents, of children aged 1 to 12 years, using random digit dialing of household landline telephones. RESULTS Of the 14,505 telephone numbers called, 10,340 were eligible numbers; 589 potentially eligible parents were reached, of whom 401 were interviewed. Most believed antibiotics provide benefits for common acute respiratory infections, especially for acute otitis media (92%), although not using them, particularly for acute cough and sore throat, was sometimes acceptable. Parents grossly overestimated the mean benefit of antibiotics on illness symptom duration by 5 to 10 times, and believed they reduce the likelihood of complications. The majority, 78%, recognized antibiotics may cause harm. Recalling the most recent relevant doctor visit, 44% of parents reported at least some discussion about why antibiotics might be used; shared decision making about antibiotic use was inconsistent, while 75% wanted more involvement in future decisions. CONCLUSIONS Some parents have misperceptions about antibiotic use for acute respiratory infections, highlighting the need for improved communication during visits, including shared decision making to address overoptimistic expectations of antibiotics. Such communication should be one of several strategies that is used to reduce antibiotic use. PMID:28289114
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Beyond Strength: Participant Perspectives on the Benefits of an Older Adult Exercise Program.
Kohn, Marlana; Belza, Basia; Petrescu-Prahova, Miruna; Miyawaki, Christina E
2016-06-01
This study examines the expected and experienced benefits among participants in Enhance®Fitness (EF), an evidence-based group physical activity program for older adults. We also describe the implications for program dissemination (reach, implementation, and maintenance) within the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework. Twenty semistructured interviews were conducted with EF participants enrolled from 2005 to 2012. Interviews were digitally recorded, professionally transcribed, and analyzed using a deductive approach. Participants were motivated to join EF for expected physical benefits and the social environment of a group-based class. Actualized benefits of participation included physical, social, functional, and improved self-image/sense of well-being. Participants valued the practical application of class exercises to daily activities that support independent living, such as lifting objects and completing household chores. Organizations looking to implement EF or improve existing EF classes can improve program reach, implementation, and maintenance by incorporating participants' expressed motivations and valued benefits in program marketing and by improving organizational support to meet participant needs. EF class instructors can tailor their classes to engage participants based on their motivations. Understanding participants' motivations and valued benefits can improve EF dissemination by meeting participant needs with tailored class offerings and organizational needs informed by participant insights that aid program sustainability. © 2015 Society for Public Health Education.
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Rodrigue, James R; Guenther, Robert; Kaplan, Bruce; Mandelbrot, Didier A; Pavlakis, Martha; Howard, Richard J
2008-05-15
We report on the initial development and validation of the Living Donation Expectancies Questionnaire (LDEQ), designed to measure the expectations of living kidney donor candidates. Potential living donors (n=443) at two transplant centers were administered the LDEQ and other questionnaires, and their medical records were reviewed. Factor analysis provides support for six LDEQ scales: Interpersonal Benefit, Personal Growth, Spiritual Growth, Quid Pro Quo, Health Consequences, and Miscellaneous Consequences. All but one scale showed good internal consistency. Expected benefits of donation were associated with higher optimism and lower mental health; expected consequences of donation were associated with lower optimism and lower physical and mental health. More potential donors with relative or absolute contraindications had high Interpersonal Benefit (P<0.0001), Personal Growth (P<0.01), Quid Pro Quo (P<0.0001), and Health Consequences (P<0.0001) expectations. The LDEQ has promise in evaluating donor candidates' expectations.
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Longevity expectations in the pension fund, insurance, and employee benefits industries.
Zhavoronkov, Alex
2015-01-01
Considerable progress has been made in many areas of biomedical science since the 1960s, suggesting likely increases in life expectancy and decreases in morbidity and mortality in the adult population. These changes may pose substantial risks to the pensions and benefits industries. While there is no significant statistical evidence demonstrating rapid decreases in mortality rates, there are conflicting opinions among demographers and biogerontologists on the biological limits of the human lifespan and trends in life expectancy. We administered a survey of the International Employee Benefits Association (IEBA), a large, international industry group. Industry professionals employed by consulting (35%), insurance (24%), pension (14%), and other (27%) companies responded to 32 questions. Respondents showed reasonably conservative views on the future of longevity and retirement, including that for women. The respondents formed their personal longevity expectations based on their family history and, to a lesser degree, on the actuarial life tables. Most of the sample expressed no desire to life past age 100 years, even if the enabling technologies required to maintain a healthy youthful state were available, and only a few respondents in the sample expressed a desire to live for the maximum period (at least) offered by the survey question. The majority of the respondents would not undergo any invasive procedures, and only 56% of the respondents would opt for noninvasive therapies to extend their healthy lifespans to 150 years of age if these were available.
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The Distributional Impact of Social Security Policy Options.
Couch, Kenneth A; Reznik, Gayle L; Tamborini, Christopher R; Iams, Howard M
2017-01-01
Using microsimulation, we estimate the effects of three policy proposals that would alter Social Security's eligibility rules or benefit structure to reflect changes in women's labor force activity, marital patterns, and differential mortality among the aged. First, we estimate a set of options related to the duration of marriage required to receive divorced spouse and survivor benefits. Second, we estimate the effects of an earnings sharing proposal with survivor benefits, in which benefits are based entirely on earned benefits with spouses sharing their earnings during years of marriage. Third, we estimate the effects of adjusting benefits to reflect the increasing differential life expectancy by lifetime earnings. The results advance our understanding of the distributional effects of these alternative policy options on projected benefits and retirement income, including poverty and supplemental poverty status, of divorced and widowed women aged 60 or older in 2030.
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The Role of Jahoda's Latent and Financial Benefits for Work Involvement: A Longitudinal Study
ERIC Educational Resources Information Center
Stiglbauer, Barbara; Batinic, Bernad
2012-01-01
This study examined the role of the latent and financial benefits of work as defined by Marie Jahoda (1982) in explaining a person's work involvement. Drawing upon theoretical frameworks on work commitment and work motivation, the latent benefits were expected to have a positive, whereas the financial benefits were expected to have a negative…
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7 CFR 1466.20 - Application for contracts and selecting applications.
Code of Federal Regulations, 2014 CFR
2014-01-01
... concerning soil, water and air quality; wildlife habitat; and ground and surface water conservation; (vi... include water conservation or irrigation efficiency practices, the State Conservationist will give... conservation practices; (ii) The magnitude of the expected environmental benefits resulting from the...
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7 CFR 1466.20 - Application for contracts and selecting applications.
Code of Federal Regulations, 2012 CFR
2012-01-01
... concerning soil, water and air quality; wildlife habitat; and ground and surface water conservation; (vi... include water conservation or irrigation efficiency practices, the State Conservationist will give... conservation practices; (ii) The magnitude of the expected environmental benefits resulting from the...
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7 CFR 1466.20 - Application for contracts and selecting applications.
Code of Federal Regulations, 2013 CFR
2013-01-01
... concerning soil, water and air quality; wildlife habitat; and ground and surface water conservation; (vi... include water conservation or irrigation efficiency practices, the State Conservationist will give... conservation practices; (ii) The magnitude of the expected environmental benefits resulting from the...
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Realizing the financial benefits of capitation arbitrage.
Sussman, A J; Fairchild, D G; Colling, M C; Brennan, T A
1999-11-01
By anticipating the arbitrage potential of cash flow under budgeted capitation, healthcare organizations can make the best use of cash flow as a revenue-generating resource. Factors that determine the magnitude of the benefits for providers and insurers include settlement interval, withhold amount, which party controls the withhold, and incurred-but-not-reported expenses. In choosing how to structure these factors in their contract negotiations, providers and insurers should carefully assess whether capitation surpluses or deficits can be expected from the provider. In both instances, the recipient and magnitude of capitation arbitrage benefits are dictated largely by the performance of the provider.
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Commercialization of an Advanced Gearless Midsize Wind Turbine
DOE Office of Scientific and Technical Information (OSTI.GOV)
McKay, Chris; Ellis, Kyle
The objective of this project was the development and eventual commercialization of a Gearless Wind Turbine of rated power 450 kW. While the product was to be based on existing technology, a significant amount of new engineering effort was expected to be required to ensure maximum efficiency and realistic placement within the market. Expected benefits included positive impact on green job creation in over 15 states as well as strengthen the U.S. domestic capacity for turbine engineering.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Melaina, Marc; Warner, Ethan; Sun, Yongling
The Alternative and Renewable Fuel and Vehicle Technologies Program (ARFVTP) supports a wide range of alternative, low-carbon fuel and vehicle projects in California. This report focuses on two types of ARFVTP benefits. Expected benefits reflect successful deployment of vehicles and fuels supported through program projects. Market transformation benefits represent benefits resulting from project influences on future market conditions to accelerated technology adoption rates. Data collected directly from ARFVTP projects funded from 2009 to first quarter 2014 are used as inputs to the benefits analysis, where possible. Expected benefit estimation methods rely primarily upon project-level data and result in year single-pointmore » estimates within the 2011 to 2025 analysis period. Results suggest that the 178 projects evaluated for expected benefits, representing an investment of $351.3 million in ARFVTP funds, could result in a reduction in petroleum fuel use by 236 million gallons per year and greenhouse gases (GHGs) by 1.7 million metric tonnes carbon dioxide equivalent (MMTCO2e) per year by 2025. Market transformation benefits are described as accruing in addition to expected benefits. They are inherently more uncertain and theoretical than expected benefits, and are therefore reported as high and low ranges, with results suggesting reductions of 1.1 MMTCO2e to 2.5 MMTCO2e per year in GHG reductions and 102 million to 330 million gallons per year in petroleum fuel reductions by 2025. Taking both benefit types into account, results suggest that ARFVTP projects have the potential to make substantial progress toward meeting California's long-term GHG and petroleum fuel use reduction goals. As additional project data become available and market success with alternative and renewable fuels and vehicles grows, the analytic framework relied upon to develop these estimates will become more rigorous and will have a greater capacity to inform future ARFVTP activities.« less
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High-school seniors' college enrollment goals: Costs and benefits of ambitious expectations.
Villarreal, Brandilynn J; Heckhausen, Jutta; Lessard, Jared; Greenberger, Ellen; Chen, Chuansheng
2015-12-01
High school students with high long-term educational expectations attain higher levels of education than those with lower expectations. Less studied is the role of students' short-term college enrollment expectations for the year after high school graduation. The purpose of the current study was to examine the costs and benefits of ambitious short-term expectations and the impact of falling short of these expectations on mental health, motivation, and educational outcomes. Over 1000 youth with expectations to attend college were surveyed during their senior year of high school, one year later, and four years later. Participants who did not achieve their short-term expectations had lower educational attainment four years later but were not less satisfied with their educational progress. The negative consequences of falling short of one's expectations were restricted to individuals with less ambitious short-term expectations. Thus, the benefits of ambitious short-term expectations for youth may outweigh the costs. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.
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2017-04-01
environmental mitigation and the costs associated with it. In April 2015, the Navy released a draft environmental impact statement to the public that...economic analysis for decision making indicates that, as part of assessing the costs and benefits of alternatives, an economic analysis should include...Page 48 GAO-17-415 Marine Corps Asia-Pacific Realignment comprehensive estimates of the expected costs and benefits that are incident to achieving
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NASA Technical Reports Server (NTRS)
1975-01-01
A general description of the space shuttle program is presented, with emphasis on its application to the use of space for commercial, scientific, and defense needs. The following aspects of the program are discussed: description of the flight system (orbiter, external tank, solid rocket boosters) and mission profile, direct benefits related to life on earth (both present and expected), description of the space shuttle vehicle and its associated supporting systems, economic impacts (including indirect benefits such as lower inflation rates), listing of participating organizations.
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What Are Cancer Centers Advertising to the Public? A Content Analysis
Vater, Laura B.; Donohue, Julie M.; Arnold, Robert; White, Douglas B; Chu, Edward; Schenker, Yael
2015-01-01
Background Although critics have expressed concerns about cancer center advertising, the content of these advertisements has not been analyzed. Objective To characterize the informational and emotional content of cancer center advertisements. Design Systematic analysis of all cancer center advertisements in top U.S. consumer magazines (N=269) and television networks (N=44) in 2012. Measurements Using a standardized codebook, we assessed (1) types of clinical services promoted; (2) information provided about clinical services, including risks, benefits, and costs; (3) use of emotional advertising appeals; and (4) use of patient testimonials. Two investigators independently coded advertisements using ATLAS.ti. Kappa values ranged from 0.77 to 1.0. Results A total of 102 cancer centers placed 409 unique clinical advertisements in top media markets in 2012. Advertisements promoted treatments (88%) more often than screening (18%) or supportive services (13%; p<0.001). Benefits of advertised therapies were described more often than risks (27% vs. 2%; p<0.001) but rarely quantified (2%). Few advertisements mentioned insurance coverage or costs (5%). Emotional appeals were frequent (85%), most often evoking hope for survival (61%), describing cancer treatment as a fight or battle (41%), and evoking fear (30%). Nearly half of advertisements included patient testimonials, usually focused on survival or cure. Testimonials rarely included disclaimers (15%) and never described the results a typical patient might expect. Limitations Internet advertisements were not included. Conclusions Clinical advertisements by cancer centers frequently promote cancer therapy using emotional appeals that evoke hope and fear while rarely providing information about risks, benefits, or costs. Further work is needed to understand how these advertisements influence patient understanding and expectations of benefit from cancer treatments. PMID:24863081
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Shelton, A M; Zhao, J-Z; Roush, R T
2002-01-01
Transgenic plants expressing insecticidal proteins from the bacterium, Bacillus thuringiensis (Bt), are revolutionizing agriculture. Bt, which had limited use as a foliar insecticide, has become a major insecticide because genes that produce Bt toxins have been engineered into major crops grown on 11.4 million ha worldwide in 2000. Based on the data collected to date, generally these crops have shown positive economic benefits to growers and reduced the use of other insecticides. The potential ecological and human health consequences of Bt plants, including effects on nontarget organisms, food safety, and the development of resistant insect populations, are being compared for Bt plants and alternative insect management strategies. Scientists do not have full knowledge of the risks and benefits of any insect management strategies. Bt plants were deployed with the expectation that the risks would be lower than current or alternative technologies and that the benefits would be greater. Based on the data to date, these expectations seem valid.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Melaina, Marc; Warner, Ethan; Sun, Yongling
The Alternative and Renewable Fuel and Vehicle Technologies Program (ARFVTP) supports a wide range of alternative, low-carbon fuel and vehicle projects in California. This report focuses on two types of ARFVTP benefits. Expected benefits reflect successful deployment of vehicles and fuels supported through program projects. Market transformation benefits represent benefits resulting from project influences on future market conditions to accelerated technology adoption rates. Data collected directly from ARFVTP projects funded from 2009 to first quarter 2014 are used as inputs to the benefits analysis, where possible. Expected benefit estimation methods rely primarily upon project-level data and result in year single-pointmore » estimates within the 2011 to 2025 analysis period. Results suggest that the 178 projects evaluated for expected benefits, representing an investment of $351.3 million in ARFVTP funds, could result in a reduction in petroleum fuel use by 236 million gallons per year and greenhouse gases (GHGs) by 1.7 million metric tonnes carbon dioxide equivalent (MMTCO2e) per year by 2025. Market transformation benefits are described as accruing in addition to expected benefits. They are inherently more uncertain and theoretical than expected benefits, and are therefore reported as high and low ranges, with results suggesting reductions of 1.1 MMTCO2e to 2.5 MMTCO2e per year in GHG reductions and 102 million to 330 million gallons per year in petroleum fuel reductions by 2025. Taking both benefit types into account, results suggest that ARFVTP projects have the potential to make substantial progress toward meeting California's long-term GHG and petroleum fuel use reduction goals. As additional project data become available and market success with alternative and renewable fuels and vehicles grows, the analytic framework relied upon to develop these estimates will become more rigorous and will have a greater capacity to inform future ARFVTP activities.« less
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What are true community benefits?
Trocchio, J
1996-01-01
Not-for-profit healthcare organizations have increasingly recognized the need to document their community benefit services, but not all healthcare services should be included in a community benefits report. Some services are reasonably expected of any high-quality healthcare organization, regardless of its tax status. Others are provided as part of a commitment to the community, but they cannot or should not be quantified. A third group of services, however, can be counted and reported in an inventory of benefits. To qualify as a true community benefit, an activity must respond to a particular health problem in the community, especially one involving special populations. In addition, it must be financed through philanthropic contributions, volunteer efforts, or an endowment; generate a low or negative margin; or be a service that would be discontinued if the decision were made on a purely financial basis. Once an organization has determined that an activity is a community benefit and not a basic service or promotional program, organizational leaders must decide whether to include the service in a quantitative inventory or in a more general narrative without assignment of specific financial benefit. The community benefit services might be further broken down according to the intended recipient, whether it is the poor or the broader community.
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Worth of Geophysical Data in Natural-Disaster-Insurance Rate Setting.
NASA Astrophysics Data System (ADS)
Attanasi, E. D.; Karlinger, M. R.
1982-04-01
Insurance firms that offer natural-disaster insurance base their rates on available information. The benefits from collecting additional data and incorporating this information to improve parameter estimates of probability distributions that are used to characterize natural-disaster events can be determined by computing changes in premiums as a function of additional data. Specifically, the worth of data can be measured by changes in consumer's surplus (the widely applied measure of benefits to consumers used in benefit-cost analysis) brought about when the premiums are adjusted. In this paper, a formal model of the process for setting insurance rates is hypothesized in which the insurance firm sets rates so as to trade off penalties of overestimation and underestimation of expected damages estimated from currently available hydrologic data. A Bayesian preposterior analysis is performed which permits the determination of the expected benefits of collecting additional geophysical data by examining the changes in expected premium rates as a function of the longer record before the data are actually collected. An estimate of the expected benefits associated with collecting more data for the representative consumer is computed using an assumed demand function for insurance. In addition, a sensitivity analysis of expected benefits to changes in insurance demand and firm rate-setting procedures is carried out. From these results, conclusions are drawn regarding aggregate benefits to all flood insurance purchasers.
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The Impact of Emerging Technologies on Future Air Capabilities
1999-12-01
ferroelectric FPAs (60). More advanced FPA technologies include quantum well IR photodetectors ( QWIPS ) and strained layer superlattices. Significant...microspacecraft. Expected benefits include enhanced handling qualities, vibration suppression, alleviation of noise and vibration and monitoring of vehicle...of fatigue loads, cabin vibration and both internal and external noise , as well as contributing to enhanced handling. This would result in better
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ERIC Educational Resources Information Center
Lutz, Deborah; Fisher, Karen R.; Robinson, Sally
2016-01-01
Inclusive research is an increasing expectation to value and include people's voice in research and evaluations intended to benefit them. The active participation of people with communication support needs can be difficult due to the practical constraints of evaluations. One technique is to engage with workers who are familiar with the person, but…
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Valuing Trial Designs from a Pharmaceutical Perspective Using Value-Based Pricing.
Breeze, Penny; Brennan, Alan
2015-11-01
Our aim was to adapt the traditional framework for expected net benefit of sampling (ENBS) to be more compatible with drug development trials from the pharmaceutical perspective. We modify the traditional framework for conducting ENBS and assume that the price of the drug is conditional on the trial outcomes. We use a value-based pricing (VBP) criterion to determine price conditional on trial data using Bayesian updating of cost-effectiveness (CE) model parameters. We assume that there is a threshold price below which the company would not market the new intervention. We present a case study in which a phase III trial sample size and trial duration are varied. For each trial design, we sampled 10,000 trial outcomes and estimated VBP using a CE model. The expected commercial net benefit is calculated as the expected profits minus the trial costs. A clinical trial with shorter follow-up, and larger sample size, generated the greatest expected commercial net benefit. Increasing the duration of follow-up had a modest impact on profit forecasts. Expected net benefit of sampling can be adapted to value clinical trials in the pharmaceutical industry to optimise the expected commercial net benefit. However, the analyses can be very time consuming for complex CE models. © 2014 The Authors. Health Economics published by John Wiley & Sons Ltd.
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A History of the Little Rock District U.S. Army Corps of Engineers 1881-1979
1979-01-01
establishments with overnight accommodations for 8,339 people. In 1940 there were only seven restaurants, cafes , and public dining rooms in the vicinity...that only one out of five docks located in Barry County is included in the franchise release re- quests." 54 • District’s Purple Martin program...benefit of their own citizens. The Engineers also expected communities to benefit from franchises to local concessionaires. The plan did not work out
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Why we should build a Moon Village
NASA Astrophysics Data System (ADS)
Crawford, Ian A.
2017-12-01
A human-robotic "Moon Village" would offer significant scientific opportunities by providing an infrastructure on the lunar surface. An analogy would be the way in which human outposts in Antarctica facilitate research activities across multiple scientific disciplines on that continent. Scientific fields expected to benefit from a Moon Village will include: planetary science, astronomy, astrobiology, life sciences, and fundamental physics. In addition, a Moon Village will help develop the use of lunar resources, which will yield additional longer-term scientific benefits.
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NASA Technical Reports Server (NTRS)
Meyer, J. D.
1977-01-01
Space technology transfer is discussed as applied to the field of materials science. Advances made in processing include improved computer techniques, and structural analysis. Technology transfer is shown to have an important impact potential in the overall productivity of the United States.
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45 CFR 156.145 - Determination of minimum value.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 156.145 Public Welfare Department of Health and Human Services REQUIREMENTS RELATING TO HEALTH CARE ACCESS HEALTH INSURANCE ISSUER STANDARDS UNDER THE AFFORDABLE CARE ACT, INCLUDING STANDARDS RELATED TO... the expected spending for health care costs in a benefit year so that: (i) Any current year HSA...
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45 CFR 156.145 - Determination of minimum value.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 156.145 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS HEALTH INSURANCE ISSUER STANDARDS UNDER THE AFFORDABLE CARE ACT, INCLUDING STANDARDS RELATED TO... the expected spending for health care costs in a benefit year so that: (i) Any current year HSA...
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Thompson, Mark G; Gaglani, Manjusha J; Naleway, Allison; Ball, Sarah; Henkle, Emily M; Sokolow, Leslie Z; Brennan, Beth; Zhou, Hong; Foster, Lydia; Black, Carla; Kennedy, Erin D; Bozeman, Sam; Grohskopf, Lisa A; Shay, David K
2012-05-21
The relative importance of different attitudes in predicting vaccination among healthcare personnel (HCP) is unclear. We hypothesized that HCP who feel at risk without vaccination or say they would regret not getting vaccinated would be more likely to get vaccinated than HCP who do not expect these emotional benefits. A prospective cohort of 1544 HCP with direct patient care was enrolled from September 18 to December 18, 2010 at Scott & White Healthcare in Texas and Kaiser Permanente Northwest in Oregon and Washington. An Internet-based questionnaire assessed pre-season intention to be vaccinated and included 12 questions on attitudes about vaccination: single-item measures of perceived susceptibility and vaccine effectiveness, 5 items that were summed to form a concerns about vaccine scale, and 5 items summed to form an emotional benefits of vaccination scale. Influenza vaccination status for the 2010-2011 season and for 5 prior seasons was confirmed by medical record extraction. There were significant differences between vaccinated and unvaccinated HCP on all attitude items; 72% of vaccinated HCP agreed that they "worry less about getting the flu" if vaccinated, compared to only 26% of the unvaccinated (odds ratio=7.4, 95% confidence interval=5.8-9.5). In a multivariate model, the emotional benefits scale was the strongest predictor of 2010-2011 seasonal influenza vaccination, after adjusting for other attitude measures, prior vaccination history, and pre-season intention to be vaccinated. The predictive value of the emotional benefits scale was strongest for HCP with low pre-season intention to be vaccinated, where HCP vaccine receipt was 15% versus 83% for those with low versus high scores on the emotional benefits scale. The expected emotional benefits of vaccination strongly affect seasonal influenza vaccination among HCP, even after taking into account other attitudes, pre-season intentions, and prior vaccination history. These attitudes are promising targets for future vaccination campaigns. Published by Elsevier Ltd.
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Longevity expectations in the pension fund, insurance, and employee benefits industries
Zhavoronkov, Alex
2015-01-01
Considerable progress has been made in many areas of biomedical science since the 1960s, suggesting likely increases in life expectancy and decreases in morbidity and mortality in the adult population. These changes may pose substantial risks to the pensions and benefits industries. While there is no significant statistical evidence demonstrating rapid decreases in mortality rates, there are conflicting opinions among demographers and biogerontologists on the biological limits of the human lifespan and trends in life expectancy. We administered a survey of the International Employee Benefits Association (IEBA), a large, international industry group. Industry professionals employed by consulting (35%), insurance (24%), pension (14%), and other (27%) companies responded to 32 questions. Respondents showed reasonably conservative views on the future of longevity and retirement, including that for women. The respondents formed their personal longevity expectations based on their family history and, to a lesser degree, on the actuarial life tables. Most of the sample expressed no desire to life past age 100 years, even if the enabling technologies required to maintain a healthy youthful state were available, and only a few respondents in the sample expressed a desire to live for the maximum period (at least) offered by the survey question. The majority of the respondents would not undergo any invasive procedures, and only 56% of the respondents would opt for noninvasive therapies to extend their healthy lifespans to 150 years of age if these were available. PMID:25653568
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To share or not to share? Expected pros and cons of data sharing in radiological research.
Sardanelli, Francesco; Alì, Marco; Hunink, Myriam G; Houssami, Nehmat; Sconfienza, Luca M; Di Leo, Giovanni
2018-06-01
The aims of this paper are to illustrate the trend towards data sharing, i.e. the regulated availability of the original patient-level data obtained during a study, and to discuss the expected advantages (pros) and disadvantages (cons) of data sharing in radiological research. Expected pros include the potential for verification of original results with alternative or supplementary analyses (including estimation of reproducibility), advancement of knowledge by providing new results by testing new hypotheses (not explored by the original authors) on pre-existing databases, larger scale analyses based on individual-patient data, enhanced multidisciplinary cooperation, reduced publication of false studies, improved clinical practice, and reduced cost and time for clinical research. Expected cons are outlined as the risk that the original authors could not exploit the entire potential of the data they obtained, possible failures in patients' privacy protection, technical barriers such as the lack of standard formats, and possible data misinterpretation. Finally, open issues regarding data ownership, the role of individual patients, advocacy groups and funding institutions in decision making about sharing of data and images are discussed. • Regulated availability of patient-level data of published clinical studies (data-sharing) is expected. • Expected benefits include verification/advancement of knowledge, reduced cost/time of research, clinical improvement. • Potential drawbacks include faults in patients' identity protection and data misinterpretation.
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NASA Technical Reports Server (NTRS)
Andrews, J.
1977-01-01
An optimal decision model of crop production, trade, and storage was developed for use in estimating the economic consequences of improved forecasts and estimates of worldwide crop production. The model extends earlier distribution benefits models to include production effects as well. Application to improved information systems meeting the goals set in the large area crop inventory experiment (LACIE) indicates annual benefits to the United States of $200 to $250 million for wheat, $50 to $100 million for corn, and $6 to $11 million for soybeans, using conservative assumptions on expected LANDSAT system performance.
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Wirken, Lieke; van Middendorp, Henriët; Hooghof, Christina W; Sanders, Jan-Stephan F; Dam, Ruth E; van der Pant, Karlijn A M I; Berendsen, Elsbeth C M; Wellink, Hiske; Dackus, Henricus J A; Hoitsma, Andries J; Hilbrands, Luuk B; Evers, Andrea W M
2017-03-01
Cognitions surrounding living organ donation, including the motivation to donate, expectations of donation and worries about donation, are relevant themes during living donor evaluation. However, there is no reliable psychometric instrument assessing all these different cognitions. This study developed and validated a questionnaire to assess pre-donation motivations, expectations and worries regarding donation, entitled the Donation Cognition Instrument (DCI). Psychometric properties of the DCI were examined using exploratory factor analysis for scale structure and associations with validated questionnaires for construct validity assessment. From seven Dutch transplantation centres, 719 potential living kidney donors were included. The DCI distinguishes cognitions about donor benefits, recipient benefits, idealistic incentives, gratitude and worries about donation (Cronbach's alpha 0.76-0.81). Scores on pre-donation cognitions differed with regard to gender, age, marital status, religion and donation type. With regard to construct validity, the DCI was moderately correlated with expectations regarding donor's personal well-being and slightly to moderately to health-related quality of life. The DCI is found to be a reliable instrument assessing cognitions surrounding living organ donation, which might add to pre-donation quality of life measures in facilitating psychosocial donor evaluation by healthcare professionals. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.
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Expected results and outputs include: extensive dataset of in-field and laboratory emissions data for traditional and improved cookstoves; parameterization to predict cookstove emissions from drive cycle data; indoor and personal exposure data for traditional and improved cook...
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Supply Chain Collaboration Alternatives: Understanding the Expected Costs and Benefits.
ERIC Educational Resources Information Center
McLaren, Tim; Head, Milena; Yuan, Yufei
2002-01-01
Discusses collaboration as a recent trend in supply chain management (SCM) that focuses on joint planning, coordination, and process integration between suppliers, customers, and other partners in a supply chain. Analyzes alternative information systems approaches for supporting collaborative SCM, including phone, fax, or email systems; Web-based…
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Enhancing Professional Learning for Rural Educators by Rethinking Connectedness
ERIC Educational Resources Information Center
Broadley, Tania
2012-01-01
Impending changes in Australian education brings forth the expected transformation of teachers working in schools. Three key points for transforming Australian schools has been identified by Gillard (2008a) including the improvement of quality teaching, ensuring every child benefits and mandating transparency and accountability. A number of…
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29 CFR 4231.8 - Notice of merger or transfer.
Code of Federal Regulations, 2014 CFR
2014-07-01
..., including an enrolled actuary's certification to that effect). (3) The proposed effective date of the... statements, certified by an enrolled actuary: (i) A statement that the plan satisfies the applicable plan... on which the actuary has determined that benefits under the plan are not reasonably expected to be...
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The State of Racial Diversity in the Educator Workforce
ERIC Educational Resources Information Center
Office of Planning, Evaluation and Policy Development, US Department of Education, 2016
2016-01-01
Diversity is inherently valuable. Research shows that diversity in schools, including racial diversity among teachers, can provide significant benefits to students. While students of color are expected to make up 56 percent of the student population by 2024, the elementary and secondary educator workforce is still overwhelmingly white. The most…
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Leveraging the beneficial compounds of organic and pasture milk
USDA-ARS?s Scientific Manuscript database
Much discussion has arisen over the possible benefits of organic food, including milk. Organic milk comes from cows that are on pasture during the growing season, and would be expected to contain some compounds that are not found in animals receiving conventional feed, or at higher concentrations. ...
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Creating Meaning from Intersections of Career and Cultural Identity
ERIC Educational Resources Information Center
Gross, Linda S.
2004-01-01
For Latino students, career development and planning includes the negotiation of family influences, peer expectations, and challenges as they develop career efficacy in work experiences as undergraduates. The model presented here outlines how students can benefit from a holistic perspective on the intersections of career and cultural identity.…
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The Impact of Mission Duration on a Mars Orbital Mission
NASA Technical Reports Server (NTRS)
Arney, Dale; Earle, Kevin; Cirillo, Bill; Jones, Christopher; Klovstad, Jordan; Grande, Melanie; Stromgren, Chel
2017-01-01
Performance alone is insufficient to assess the total impact of changing mission parameters on a space mission concept, architecture, or campaign; the benefit, cost, and risk must also be understood. This paper examines the impact to benefit, cost, and risk of changing the total mission duration of a human Mars orbital mission. The changes in the sizing of the crew habitat, including consumables and spares, was assessed as a function of duration, including trades of different life support strategies; this was used to assess the impact on transportation system requirements. The impact to benefit is minimal, while the impact on cost is dominated by the increases in transportation costs to achieve shorter total durations. The risk is expected to be reduced by decreasing total mission duration; however, large uncertainty exists around the magnitude of that reduction.
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Hamilton, Kyra; Vayro, Caitlin; Schwarzer, Ralf
2015-01-01
To examine a mechanism by which social cognitive factors may predict fruit and vegetable consumption in long-haul truck drivers. Dietary self-efficacy, positive outcome expectancies, and intentions were assessed in 148 Australian truck drivers, and 1 week later they reported their fruit and vegetable consumption. A theory-guided sequential mediation model was specified that postulated self-efficacy and intention as mediators between outcome expectancies and behavior. The hypothesized model was confirmed. A direct effect of outcome expectancies was no longer present when mediators were included, and all indirect effects were significant, including the 2-mediator chain (β = .15; P < .05; 95% confidence interval, 0.05-0.32). Truck drivers who expected benefits from dietary change, felt confident about being capable to do so, and formed an intention were likely to report larger amounts of fruit and vegetable intake. The results suggest that the role of outcome expectancies and self-efficacy are important to consider for understanding and predicting healthy eating intentions in truck drivers. Copyright © 2015 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
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Dispositional Optimism and Therapeutic Expectations in Early Phase Oncology Trials
Jansen, Lynn A.; Mahadevan, Daruka; Appelbaum, Paul S.; Klein, William MP; Weinstein, Neil D.; Mori, Motomi; Daffé, Racky; Sulmasy, Daniel P.
2016-01-01
Purpose Prior research has identified unrealistic optimism as a bias that might impair informed consent among patient-subjects in early phase oncology trials. Optimism, however, is not a unitary construct – it can also be defined as a general disposition, or what is called dispositional optimism. We assessed whether dispositional optimism would be related to high expectations for personal therapeutic benefit reported by patient-subjects in these trials but not to the therapeutic misconception. We also assessed how dispositional optimism related to unrealistic optimism. Methods Patient-subjects completed questionnaires designed to measure expectations for therapeutic benefit, dispositional optimism, unrealistic optimism, and the therapeutic misconception. Results Dispositional optimism was significantly associated with higher expectations for personal therapeutic benefit (Spearman r=0.333, p<0.0001), but was not associated with the therapeutic misconception. (Spearman r=−0.075, p=0.329). Dispositional optimism was weakly associated with unrealistic optimism (Spearman r=0.215, p=0.005). In multivariate analysis, both dispositional optimism (p=0.02) and unrealistic optimism (p<0.0001) were independently associated with high expectations for personal therapeutic benefit. Unrealistic optimism (p=.0001), but not dispositional optimism, was independently associated with the therapeutic misconception. Conclusion High expectations for therapeutic benefit among patient-subjects in early phase oncology trials should not be assumed to result from misunderstanding of specific information about the trials. Our data reveal that these expectations are associated with either a dispositionally positive outlook on life or biased expectations about specific aspects of trial participation. Not all manifestations of optimism are the same, and different types of optimism likely have different consequences for informed consent in early phase oncology research. PMID:26882017
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Dispositional optimism and therapeutic expectations in early-phase oncology trials.
Jansen, Lynn A; Mahadevan, Daruka; Appelbaum, Paul S; Klein, William M P; Weinstein, Neil D; Mori, Motomi; Daffé, Racky; Sulmasy, Daniel P
2016-04-15
Prior research has identified unrealistic optimism as a bias that might impair informed consent among patient-subjects in early-phase oncology trials. However, optimism is not a unitary construct; it also can be defined as a general disposition, or what is called dispositional optimism. The authors assessed whether dispositional optimism would be related to high expectations for personal therapeutic benefit reported by patient-subjects in these trials but not to the therapeutic misconception. The authors also assessed how dispositional optimism related to unrealistic optimism. Patient-subjects completed questionnaires designed to measure expectations for therapeutic benefit, dispositional optimism, unrealistic optimism, and the therapeutic misconception. Dispositional optimism was found to be significantly associated with higher expectations for personal therapeutic benefit (Spearman rank correlation coefficient [r], 0.333; P<.0001), but was not associated with the therapeutic misconception (Spearman r, -0.075; P = .329). Dispositional optimism was found to be weakly associated with unrealistic optimism (Spearman r, 0.215; P = .005). On multivariate analysis, both dispositional optimism (P = .02) and unrealistic optimism (P<.0001) were found to be independently associated with high expectations for personal therapeutic benefit. Unrealistic optimism (P = .0001), but not dispositional optimism, was found to be independently associated with the therapeutic misconception. High expectations for therapeutic benefit among patient-subjects in early-phase oncology trials should not be assumed to result from misunderstanding of specific information regarding the trials. The data from the current study indicate that these expectations are associated with either a dispositionally positive outlook on life or biased expectations concerning specific aspects of trial participation. Not all manifestations of optimism are the same, and different types of optimism likely have different consequences for informed consent in early-phase oncology research. © 2016 American Cancer Society.
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Chou, Andrew Chia Chen; Ng, Sean Yung Chuan; Su, David Hsien Ching; Singh, Inderjeet Rikhraj; Koo, Kevin
2016-12-01
Radiofrequency microtenotomy (RM) is effective for treating plantar fasciitis. No studies have compared it to the plantar fasciotomy (PF). We hypothesized that RM is equally effective and provides no additional benefit when performed with PF. Between 2007 and 2014, all patients who underwent either or both procedures concurrently at our institution were analyzed. Data collected included demographics, SF-36 Health Survey, AOFAS Ankle-Hindfoot Scale, and two questions regarding satisfaction and expectations, all of which were assessed pre-operatively and post-operatively at 6-months and 1-year. ANOVA with Bonferroni correction was used to compare scores at each interval. Logistic regression was used to identify pre-operative factors that predicted for satisfaction and expectations. There were no differences in patient outcomes. No pre-operative factors predicted for satisfaction and expectations. RM is as effective as PF in the treatment of plantar fasciitis. Patients who underwent both procedures experienced no benefit and a higher rate of complications. Copyright © 2015 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.
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Hénault-Ethier, Louise; Martin, Jean-Philippe; Housset, Johann
2017-08-01
A dynamic systems model of organic waste management for the province of Quebec, Canada, was built. Six distinct modules taking into account social, economical and environmental issues and perspectives were included. Five scenarios were designed and tested to identify the potential consequences of different governmental and demographic combinations of decisions over time. Among these scenarios, one examines Quebec's organic waste management policy (2011-2015), while the other scenarios represent business as usual or emphasize ecology, economy or social benefits in the decision-making process. Model outputs suggest that the current governmental policy should yield favorable environmental benefits, energy production and waste valorization. The projections stemming from the current policy action plan approach the benefits gained by another scenario emphasizing the environmental aspects in the decision-making process. As expected, without the current policy and action plan in place, or business as usual, little improvements are expected in waste management compared to current trends, and strictly emphasizing economic imperatives does not favor sustainable organic waste management. Copyright © 2017. Published by Elsevier Ltd.
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Survey of Retired Military Pharmacist's Transition to a Civilian Pharmacy Career Path.
Bennett, David; Wellman, Greg; Mahmood, Maysaa; Freye, Ryan; Remund, Daniel; Samples, Phil L
2015-12-01
To explore variables relevant to transition to civilian pharmacy career path for retiring military pharmacists. A cross-sectional survey was designed to collect information from retired military pharmacists including demographics, military service information, postretirement employment and perceptions of transition, satisfaction, level of responsibility, work environment, rewards (level of financial compensation, opportunities for professional development and career advancement, health benefits), and level of supervisory support. The questionnaire also included additional items asking about their perception of their military experience, transition to civilian work and the impact the military career had on their personal and family life. Respondents included 140 retired pharmacists from the U.S. Army, Navy, Air Force, or Coast Guard. Factors found to be significant predictors of transition to civilian career included: bureaucracy in current job, time elapsed since retirement, extent to which an individual misses military structure and chain of command, access to military facilities and Veterans Administration benefits, and reporting little or no stress in committed long-term personal relationship while in the military. Findings suggest that the majority of retired military pharmacists perceived the transition to civilian professional sector was about what they expected or easier than expected. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.
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Development of sexual expectancies among adolescents: contributions by parents, peers and the media.
Ragsdale, Kathleen; Bersamin, Melina M; Schwartz, Seth J; Zamboanga, Byron L; Kerrick, Madeleine R; Grube, Joel W
2014-01-01
To expand the scant research on sexual expectancies development among non-sexually active adolescents, we examined the relationship between adolescents' exposure to four socializing agents--mother/female guardian, father/male guardian, peers, and television programs with high sexual content--and their endorsement of four sexual expectancies: social benefit, pleasure, social risk, and health risk. Data are from Waves 2 and 3 of a three-wave annual longitudinal study conducted among California adolescents, the majority of whom were not sexually active (N = 914, 84%). Structural equation models were conducted to examine cross-sectional and longitudinal associations between the socializing agents and the sexual expectancies. Cross-sectional results indicate associations between peer sexual communication and social benefit, pleasure, and social risk expectancies. A positive association was found between exposure to music videos and social benefit expectancies, and a negative association was found between exposure to music videos and health risk expectancies. Longitudinal results suggest that communication with peers positively predicted pleasure expectancies and negatively predicted social risk expectancies. No other socializing agents were associated with any sexual expectancies. An invariance test found that significant correlations were similar across the different age groups. Results suggest that efforts to support positive sexual decision making among non-sexually active adolescents should target peer sexual communication.
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Development of Sexual Expectancies among Adolescents: Contributions by Parents, Peers and the Media
Ragsdale, Kathleen; Bersamin, Melina; Schwartz, Seth J.; Zamboanga, Byron L.; Kerrick, R.; Grube, Joel W.
2013-01-01
In order to expand the scant research on sexual expectancies development among non-sexually active adolescents, we examined the relationship between adolescents’ exposure to four socializing agents—mother/female guardian, father/male guardian, peers, and television programs with high sexual content—and their endorsement of four sexual expectancies: Social Benefit, Pleasure, Social Risk, and Health Risk. Data are from Waves 2–3 of a three-wave annual longitudinal study conducted among California adolescents, the majority of whom were non-sexually active (N=914, 84%). Structural equation models were conducted to examine cross-sectional and longitudinal associations between the socializing agents and the sexual expectancies. Cross-sectional results indicate associations between peer sexual communication and Social Benefit, Pleasure and Social Risk expectancies. A positive association was found between exposure to music videos and Social Benefit expectancies and a negative association was found between exposure to music videos and Health Risk expectancies. Longitudinal results suggest that communication with peers positively predicted Pleasure expectancies and negatively predicted Social Risk expectancies. No other socializing agents were associated with any sexual expectancies. An invariance test found that significant correlations were similar across the different age groups. Results suggest that efforts to support positive sexual decision-making among non-sexually active adolescents should target peer sexual communication. PMID:23631710
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Expect the unexpected: place-based protections can lead to unforeseen benefits
Rebecca L. Flitcroft; Daniel L. Bottom; Karen L. Haberman; Ken F. Bierly; Kim K. Jones; Charles A. Simenstad; Ayesha Gray; Kami S. Ellingson; Erin Baumgartner; Trevan J. Cornwell; Lance A. Campbell
2016-01-01
1. Protection of places important for aesthetic, ecological, and cultural values has been a goal of conservationists for over 150 years. Cornerstones of place-based conservation include legal designations, international agreements, and purchase by public or non-profit organizations.2. In the Salmon River catchment, Oregon, protections were initially...
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Kevin M. Potter; Christopher W. Woodall; Christopher M. Oswalt; Basil V. III Iannone; Songlin Fei
2015-01-01
Biodiversity is expected to convey numerous functional benefits to forested ecosystems, including increased productivity and resilience. When assessing biodiversity, however, statistics that account for evolutionary relationships among species may be more ecologically meaningful than traditional measures such as species richness. In three broad-scale studies, we...
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Making the Three Ps Easier: Praise, Proximity, and Precorrection
ERIC Educational Resources Information Center
Lampi, Andrea R.; Fenty, Nicole S.; Beaunae, Cathrine
2005-01-01
The educational trend toward including students with disabilities in classrooms has been on the rise over the last 30 years. Supporters of inclusion state many expected benefits of inclusion such as: (a) a reduction in the negative feelings toward labeling; (b) an increase in friendships between disabled and nondisabled students; and (c) the…
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-09-13
... of Treatment in Hospital) Activity Under OMB Review AGENCY: Veterans Benefits Administration... nature of the information collection and its expected cost and burden; it includes the actual data... Treatment in Hospital, VA FL 29-551. OMB Control Number: 2900-0119. Type of Review: Extension of a currently...
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ERIC Educational Resources Information Center
Cullen, R. B.
Although education and training should be a source of relative advantage for Australia, the competitive benefits expected from the nation's "clever country" strategy have been slow to emerge. When 22 countries including Australia, Germany, Singapore, the United Kingdom, United States, and New Zealand were compared from the standpoint of…
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Nursing as a Career Choice by Hispanic/Latino College Students
ERIC Educational Resources Information Center
Stroup, Linda M.
2013-01-01
A culturally competent healthcare workforce is essential to meet the needs of an increasingly diverse society. Greater diversity in the healthcare workforce is expected have many benefits, including improved access to care for the medically underserved and the promotion of research in areas of societal need (Cohen, Gabriel, & Terrell, 2002).…
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Duintjer Tebbens, R J; Thompson, K M
2017-01-01
If the world can successfully control all outbreaks of circulating vaccine-derived poliovirus that may occur soon after global oral poliovirus vaccine (OPV) cessation, then immunodeficiency-associated vaccine-derived polioviruses (iVDPVs) from rare and mostly asymptomatic long-term excretors (defined as ⩾6 months of excretion) will become the main source of potential poliovirus outbreaks for as long as iVDPV excretion continues. Using existing models of global iVDPV prevalence and global long-term poliovirus risk management, we explore the implications of uncertainties related to iVDPV risks, including the ability to identify asymptomatic iVDPV excretors to treat with polio antiviral drugs (PAVDs) and the transmissibility of iVDPVs. The expected benefits of expanded screening to identify and treat long-term iVDPV excretors with PAVDs range from US$0.7 to 1.5 billion with the identification of 25-90% of asymptomatic long-term iVDPV excretors, respectively. However, these estimates depend strongly on assumptions about the transmissibility of iVDPVs and model inputs affecting the global iVDPV prevalence. For example, the expected benefits may decrease to as low as US$260 million with the identification of 90% of asymptomatic iVDPV excretors if iVDPVs behave and transmit like partially reverted viruses instead of fully reverted viruses. Comprehensive screening for iVDPVs will reduce uncertainties and maximize the expected benefits of PAVD use.
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Comparing and Contrasting Detectors: JWST NIR vs HST WFC3
NASA Technical Reports Server (NTRS)
Rauscher, Bernard J.
2015-01-01
In many ways, WFC3s IR channel is a good indicator for what to expect with JWST. There are some differences, most of which should be beneficial in JWST- JWSTs lower operating temperature will freeze out charge traps that would affect WFC3. Benefits should include lower dark current, lower persistence, and better reciprocity- JWSTs more recent HgCdTe process has lower defect density. The benefits are as described above- JWST uses better indium barriers. The benefits should include fewer RC type pixels. One area where more study might be beneficial is stability. The detector electronics play a significant role in determining how stable a detector system is(v.s. bias drifts and photometry). JWSTs SIDECARs are completely WFC3s Ball electronics- Studies comparing the bias and photometric stability of WFC3 and JWST might be useful to informing data acquisition and calibration strategies for JWST.
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Jackson, Debra
2009-01-01
There is an increasing expectation that academic and clinical nurses will contribute to disciplinary and professional discourses through scholarly writing. However, the difficulties and challenges associated with writing for publication mean that many papers will never be written. This current paper describes an innovative approach developed to support skill development and outcomes in writing for publication. Intensive residential writing retreats informed by the principles of servant leadership and incorporating strategies such as mentoring and peer learning were conducted in 2005 and 2007. Positive outcomes and benefits included publications submitted to peer-reviewed journals, as well as positive effects on collegial relationships, and team building. Novice writers benefited from intensive and sustained support and coaching by experienced writers. Organisational benefits included increased participation by staff and research higher degree students in publication activities, enhanced collegial relationships and opportunities for senior established writers to work with inexperienced writers.
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Franco, Oscar H; Bonneux, Luc; de Laet, Chris; Peeters, Anna; Steyerberg, Ewout W; Mackenbach, Johan P
2004-12-18
Although the Polypill concept (proposed in 2003) is promising in terms of benefits for cardiovascular risk management, the potential costs and adverse effects are its main pitfalls. The objective of this study was to identify a tastier and safer alternative to the Polypill: the Polymeal. Data on the ingredients of the Polymeal were taken from the literature. The evidence based recipe included wine, fish, dark chocolate, fruits, vegetables, garlic, and almonds. Data from the Framingham heart study and the Framingham offspring study were used to build life tables to model the benefits of the Polymeal in the general population from age 50, assuming multiplicative correlations. Combining the ingredients of the Polymeal would reduce cardiovascular disease events by 76%. For men, taking the Polymeal daily represented an increase in total life expectancy of 6.6 years, an increase in life expectancy free from cardiovascular disease of 9.0 years, and a decrease in life expectancy with cardiovascular disease of 2.4 years. The corresponding differences for women were 4.8, 8.1, and 3.3 years. The Polymeal promises to be an effective, non-pharmacological, safe, cheap, and tasty alternative to reduce cardiovascular morbidity and increase life expectancy in the general population.
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Code of Federal Regulations, 2010 CFR
2010-04-01
... notice. (See § 404.1595.) We will contact your spouse and children if they are receiving benefits on your...-month period of trial work more than 2 months ago and you are still working; (iii) At the time you filed for benefits your condition was expected to improve and you were expected to be able to return to work...
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Global value of GM rice: a review of expected agronomic and consumer benefits.
Demont, Matty; Stein, Alexander J
2013-06-25
Unlike the other major crops, no genetically modified (GM) varieties of rice have been commercialized at a large scale. Within the next 2-3 years new transgenic rice varieties could be ready for regulatory approval and subsequent commercialization, though. Given the importance of rice as staple crop for many of the world's poorest people, this will have implications for the alleviation of poverty, hunger and malnutrition. Thus, policy-makers need to be aware of the potential benefits of GM rice. We provide an overview of the literature and discuss the evidence on expected agronomic and consumer benefits of genetically engineered rice. We find that while GM rice with improved agronomic traits could deliver benefits similar to already commercialized biotechnology crops, expected benefits of consumer traits could be higher by an order of magnitude. By aggregating the expected annual benefits, we estimate the global value of GM rice to be US$64 billion per year. This is only an indicative value, as more GM varieties will become available in future. Nevertheless, such a figure can help guide policy-makers when deciding on the approval or funding of biotechnology crops and it may also raise awareness among consumers about what is at stake for their societies. Copyright © 2013 Elsevier B.V. All rights reserved.
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The Long-Term Benefits of Increased Aspirin Use by At-Risk Americans Aged 50 and Older.
Agus, David B; Gaudette, Étienne; Goldman, Dana P; Messali, Andrew
2016-01-01
The usefulness of aspirin to defend against cardiovascular disease in both primary and secondary settings is well recognized by the medical profession. Multiple studies also have found that daily aspirin significantly reduces cancer incidence and mortality. Despite these proven health benefits, aspirin use remains low among populations targeted by cardiovascular prevention guidelines. This article seeks to determine the long-term economic and population-health impact of broader use of aspirin by older Americans at higher risk for cardiovascular disease. We employ the Future Elderly Model, a dynamic microsimulation that follows Americans aged 50 and older, to project their lifetime health and spending under the status quo and in various scenarios of expanded aspirin use. The model is based primarily on data from the Health and Retirement Study, a large, representative, national survey that has been ongoing for more than two decades. Outcomes are chosen to provide a broad perspective of the individual and societal impacts of the interventions and include: heart disease, stroke, cancer, life expectancy, quality-adjusted life expectancy, disability-free life expectancy, and medical costs. Eligibility for increased aspirin use in simulations is based on the 2011-2012 questionnaire on preventive aspirin use of the National Health and Nutrition Examination Survey. These data reveal a large unmet need for daily aspirin, with over 40% of men and 10% of women aged 50 to 79 presenting high cardiovascular risk but not taking aspirin. We estimate that increased use by high-risk older Americans would improve national life expectancy at age 50 by 0.28 years (95% CI 0.08-0.50) and would add 900,000 people (95% CI 300,000-1,400,000) to the American population by 2036. After valuing the quality-adjusted life-years appropriately, Americans could expect $692 billion (95% CI 345-975) in net health benefits over that period. Expanded use of aspirin by older Americans with elevated risk of cardiovascular disease could generate substantial population health benefits over the next twenty years and do so very cost-effectively.
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The Long-Term Benefits of Increased Aspirin Use by At-Risk Americans Aged 50 and Older
Agus, David B.; Gaudette, Étienne; Goldman, Dana P.; Messali, Andrew
2016-01-01
Background The usefulness of aspirin to defend against cardiovascular disease in both primary and secondary settings is well recognized by the medical profession. Multiple studies also have found that daily aspirin significantly reduces cancer incidence and mortality. Despite these proven health benefits, aspirin use remains low among populations targeted by cardiovascular prevention guidelines. This article seeks to determine the long-term economic and population-health impact of broader use of aspirin by older Americans at higher risk for cardiovascular disease. Methods and Findings We employ the Future Elderly Model, a dynamic microsimulation that follows Americans aged 50 and older, to project their lifetime health and spending under the status quo and in various scenarios of expanded aspirin use. The model is based primarily on data from the Health and Retirement Study, a large, representative, national survey that has been ongoing for more than two decades. Outcomes are chosen to provide a broad perspective of the individual and societal impacts of the interventions and include: heart disease, stroke, cancer, life expectancy, quality-adjusted life expectancy, disability-free life expectancy, and medical costs. Eligibility for increased aspirin use in simulations is based on the 2011–2012 questionnaire on preventive aspirin use of the National Health and Nutrition Examination Survey. These data reveal a large unmet need for daily aspirin, with over 40% of men and 10% of women aged 50 to 79 presenting high cardiovascular risk but not taking aspirin. We estimate that increased use by high-risk older Americans would improve national life expectancy at age 50 by 0.28 years (95% CI 0.08–0.50) and would add 900,000 people (95% CI 300,000–1,400,000) to the American population by 2036. After valuing the quality-adjusted life-years appropriately, Americans could expect $692 billion (95% CI 345–975) in net health benefits over that period. Conclusions Expanded use of aspirin by older Americans with elevated risk of cardiovascular disease could generate substantial population health benefits over the next twenty years and do so very cost-effectively. PMID:27902693
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Eggel, Matthias; Grimm, Herwig
2018-02-28
Directive 2010/63/EU (henceforth "Directive") on the protection of animals used for scientific purposes mandates that every project proposal in EU member states involving procedures on living non-human vertebrates and cephalopods has to be approved in an review process, including a harm-benefit-analysis (HBA), to assess "whether the harm to the animals in terms of suffering, pain and distress is justified by the expected outcome taking into account ethical consideration and may ultimately benefit human beings, animals or the environment". Despite the justifying relevance of "outcome" and "benefit", it remains unclear how to understand these concepts. However, national authorities and applicants require a clear understanding of this to carry out a HBA. To analyze the underlying premises of the HBA and its consequences for the evaluation process, we introduce a heuristic to analyze the relation between "outcome", "benefit" and "prospective benefit assessment". We then apply the heuristic to all seven legitimate purposes for animal research stated in the Directive, namely basic research, translational or applied research, product safety, education and training, protection of the environment, preservation of species and forensic inquiries. As we show, regardless of which purpose is aimed for, applicants are hard-pressed to demonstrate tangible benefits in a prospective assessment. In the HBA, this becomes a problem since-as we argue-the only reasonable, expected and tangible outcome of research can ever be knowledge. The potential long-term benefits on the basis of gained knowledge are unforeseeable and impossible to predict. Research is bound to fall short of these proclaimed societal benefits and its credibility will suffer as long as research has to validate itself through short-term societal benefit. We propose to revise the ethical evaluation based on the HBA and we think it necessary to develop an alternative model for project evaluation that focuses on the value of knowledge as a scientific outcome as a necessary but not sufficient condition for societal benefit.
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48 CFR 1604.7001 - Coordination of benefits clause.
Code of Federal Regulations, 2011 CFR
2011-10-01
... FEDERAL EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION GENERAL ADMINISTRATIVE MATTERS Coordination of Benefits 1604.7001 Coordination of benefits clause. OPM expects all FEHBP plans to coordinate benefits... 48 Federal Acquisition Regulations System 6 2011-10-01 2011-10-01 false Coordination of benefits...
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48 CFR 1604.7001 - Coordination of benefits clause.
Code of Federal Regulations, 2012 CFR
2012-10-01
... FEDERAL EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION GENERAL ADMINISTRATIVE MATTERS Coordination of Benefits 1604.7001 Coordination of benefits clause. OPM expects all FEHBP plans to coordinate benefits... 48 Federal Acquisition Regulations System 6 2012-10-01 2012-10-01 false Coordination of benefits...
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Translational health economics: The key to accountable adoption of in vitro diagnostic technologies.
Price, Christopher P; Wolstenholme, Jane; McGinley, Patrick; St John, Andrew
2018-02-01
Adoption of new technologies, including diagnostic tests, is often considered not to deliver the expected return on investment. The reasons for this poor link between expectation and outcome include lack of evidence, variation in use of the technology, and an inability of the health system to manage the balance between investment and disinvestment associated with the change in care pathway. The challenges lie in the complex nature of healthcare provision where the investment is likely to be made in the jurisdiction of one stakeholder while the benefits (as well as dis-benefits) accrue to the other stakeholders. A prime example is found in the field of laboratory medicine and the use of diagnostic tests. The current economic tools employed in healthcare are primarily used to make policy and strategic decisions, particularly across health systems, and in purchaser and provider domains. These tools primarily involve cost effectiveness and budget impact analyses, both of which have been applied in health technology assessment of diagnostic technologies. However, they lack the granularity to translate findings down to the financial management and operational decision making at the provider department level. We propose an approach to translational health economics based on information derived from service line management and time-driven activity-based costing, identifying the resource utilisation for each of the units involved in the delivery of a care pathway, before and after adoption of new technology. This will inform investment and disinvestment decisions, along with identifying where the benefits, and dis-benefits, can be achieved for all stakeholders.
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42 CFR 403.253 - Calculation of benefits.
Code of Federal Regulations, 2011 CFR
2011-10-01
... calculated on a net level reserve basis, using appropriate values to account for lapse, mortality, morbidity, and interest, that on the valuation date represents— (A) The present value of expected incurred benefits over the loss ratio calculation period; less— (B) The present value of expected net premiums over...
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42 CFR 403.253 - Calculation of benefits.
Code of Federal Regulations, 2014 CFR
2014-10-01
... calculated on a net level reserve basis, using appropriate values to account for lapse, mortality, morbidity, and interest, that on the valuation date represents— (A) The present value of expected incurred benefits over the loss ratio calculation period; less— (B) The present value of expected net premiums over...
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42 CFR 403.253 - Calculation of benefits.
Code of Federal Regulations, 2013 CFR
2013-10-01
... calculated on a net level reserve basis, using appropriate values to account for lapse, mortality, morbidity, and interest, that on the valuation date represents— (A) The present value of expected incurred benefits over the loss ratio calculation period; less— (B) The present value of expected net premiums over...
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42 CFR 403.253 - Calculation of benefits.
Code of Federal Regulations, 2012 CFR
2012-10-01
... calculated on a net level reserve basis, using appropriate values to account for lapse, mortality, morbidity, and interest, that on the valuation date represents— (A) The present value of expected incurred benefits over the loss ratio calculation period; less— (B) The present value of expected net premiums over...
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Reading and Studying on the Screen: An Overview of Literature towards Good Learning Design Practice
ERIC Educational Resources Information Center
Nichols, Mark
2016-01-01
As distance education moves increasingly towards online provision, and because of the benefits provided by online approaches, students will be expected to engage with more resources available on screen. Contemporary forms of reading from the screen include reading from tablet devices, LCD monitors, and smartphones. However, print remains the…
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Work Experience Program Teacher Resource Manual. Junior and Senior High School. Interim Edition.
ERIC Educational Resources Information Center
Gullekson, Dale
This manual has been prepared to help educators in Alberta, Canada, organize and operate a work experience program that provides meaningful learning experiences for junior and senior high school students in partnership with the community. The manual: (1) outlines the expectations of the work experience program, including benefits to students,…
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The Fallacy of Structures and the Fortitude of Vegetation
Wayne Elmore; Robert L. Beschta
1989-01-01
Given time and proper management conditions, degraded rangeland streams can often produce by natural means the same results that we expect from streambank stabilization and fisheries enhancement structures. Advantages of using vegetation and natural recovery processes include: 1) costs are likely to be lower and 2) a wide range of benefits can accrue to a recovered...
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S. Hummel; Frank Lake; A. Watts
2015-01-01
Sustaining the health, diversity, and productivity of national forests and grasslands is the mission of the U.S. Department of Agriculture (USDA) Forest Service. Yet managing these lands is challenging because people hold different expectations for them. Public uses can include: ⢠Recreation (scenery, trails, bicycle and snowmobile routes)...
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ERIC Educational Resources Information Center
Phillippo, Katherine L.
2009-01-01
Recent research literature suggests that students benefit from positive relationships with their teachers. Small high schools attempt to formalize expectations for such relationships through a variety of organizational structures, including the advisor role. As advisors, teachers work with a group of students in order to guide and support them.…
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Vocational Education and the Work Ethic in a Changing Workplace. ERIC Digest No. 78.
ERIC Educational Resources Information Center
Naylor, Michele
Studies have shown that employers have traditionally agreed on the behaviors and attitudes they expect from employees and on the security and benefits that they are willing to provide in return. Various factors, including rapid technological advancement and increased foreign competition, have changed this. Today's workers generally have less job…
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-01-08
... proposals regarding the licensing, use, and assignment of the spectrum, including the costs and benefits of... downlink band. Accordingly, we tentatively conclude that licensing the Upper H Block under flexible use... to our expectation, the record results in a determination that licensing the Upper H Block, the Lower...
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Do placebo expectations influence perceived exertion during physical exercise?
Mothes, Hendrik; Leukel, Christian; Seelig, Harald; Fuchs, Reinhard
2017-01-01
This study investigates the role of placebo expectations in individuals' perception of exertion during acute physical exercise. Building upon findings from placebo and marketing research, we examined how perceived exertion is affected by expectations regarding a) the effects of exercise and b) the effects of the exercise product worn during the exercise. We also investigated whether these effects are moderated by physical self-concept. Seventy-eight participants conducted a moderate 30 min cycling exercise on an ergometer, with perceived exertion (RPE) measured every 5 minutes. Beforehand, each participant was randomly assigned to 1 of 4 conditions and watched a corresponding film clip presenting "scientific evidence" that the exercise would or would not result in health benefits and that the exercise product they were wearing (compression garment) would additionally enhance exercise benefits or would only be worn for control purposes. Participants' physical self-concept was assessed via questionnaire. Results partially demonstrated that participants with more positive expectations experienced reduced perceived exertion during the exercise. Furthermore, our results indicate a moderator effect of physical self-concept: Individuals with a high physical self-concept benefited (in terms of reduced perceived exertion levels) in particular from an induction of generally positive expectations. In contrast, individuals with a low physical self-concept benefited when positive expectations were related to the exercise product they were wearing. In sum, these results suggest that placebo expectations may be a further, previously neglected class of psychological factors that influence the perception of exertion.
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Do placebo expectations influence perceived exertion during physical exercise?
Leukel, Christian; Seelig, Harald; Fuchs, Reinhard
2017-01-01
This study investigates the role of placebo expectations in individuals’ perception of exertion during acute physical exercise. Building upon findings from placebo and marketing research, we examined how perceived exertion is affected by expectations regarding a) the effects of exercise and b) the effects of the exercise product worn during the exercise. We also investigated whether these effects are moderated by physical self-concept. Seventy-eight participants conducted a moderate 30 min cycling exercise on an ergometer, with perceived exertion (RPE) measured every 5 minutes. Beforehand, each participant was randomly assigned to 1 of 4 conditions and watched a corresponding film clip presenting “scientific evidence” that the exercise would or would not result in health benefits and that the exercise product they were wearing (compression garment) would additionally enhance exercise benefits or would only be worn for control purposes. Participants’ physical self-concept was assessed via questionnaire. Results partially demonstrated that participants with more positive expectations experienced reduced perceived exertion during the exercise. Furthermore, our results indicate a moderator effect of physical self-concept: Individuals with a high physical self-concept benefited (in terms of reduced perceived exertion levels) in particular from an induction of generally positive expectations. In contrast, individuals with a low physical self-concept benefited when positive expectations were related to the exercise product they were wearing. In sum, these results suggest that placebo expectations may be a further, previously neglected class of psychological factors that influence the perception of exertion. PMID:28662168
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Cesena, Fernando H Y; Laurinavicius, Antonio G; Valente, Viviane A; Conceição, Raquel D; Nasir, Khurram; Santos, Raul D; Bittencourt, Marcio S
2018-06-01
Guidelines have recommended statin initiation based on the absolute cardiovascular risk. We tested the hypothesis that a strategy based on the predicted cardiovascular benefit, compared with the risk-based approach, modifies statin eligibility and the estimated benefit in a population in primary cardiovascular prevention. The study included 16,008 subjects (48 ± 6 years, 73% men) with low-density lipoprotein cholesterol levels of 70 to <190 mg/dl, not on lipid-lowering drugs, who underwent a routine health screening in a single center. For the risk-based strategy, criterion for statin eligibility was defined as a 10-year atherosclerotic cardiovascular disease (ASCVD) risk of ≥7.5%. In the benefit-based strategy, subjects were considered for statin according to the predicted absolute cardiovascular risk reduction, so that the number of statin candidates would be the same as in the risk-based strategy. The benefit-based strategy would replace 11% of statin candidates allocated in the risk-based approach with younger, lower risk subjects with higher low-density lipoprotein cholesterol. Using the benefit-based strategy, 13% of subjects with 5.0% to < 7.5% ASCVD risk would shift from a statin-ineligible to a statin-eligible status, whereas 24% of those with 7.5% to <10.0% ASCVD risk would become statin ineligible. These effects would transfer the benefit from higher to lower risk subjects. In the entire population, no clinically meaningful change in the benefit would be expected. In conclusion, switching from a risk-based strategy to a benefit-based approach, while keeping the same rate of statin use in the population, is expected to promote substantial changes in statin eligibility in subjects at intermediate cardiovascular risk, modifying the subpopulation to be benefited by the treatment. Copyright © 2018 Elsevier Inc. All rights reserved.
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ITS benefits : review of evaluation methods and reported benefits
DOT National Transportation Integrated Search
1998-10-01
The purpose of this report is to summarize the reported benefits of deployed intelligent transportation systems (ITS) and the evaluation methods used to quantify these ITS benefits. A better understanding of the actual or expected benefits of ITS wil...
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Huff, Mark J; Yates, Tyler J; Balota, David A
2018-05-03
Recently, we have shown that two types of initial testing (recall of a list or guessing of critical items repeated over 12 study/test cycles) improved final recognition of related and unrelated word lists relative to restudy. These benefits were eliminated, however, when test instructions were manipulated within subjects and presented after study of each list, procedures designed to minimise expectancy of a specific type of upcoming test [Huff, Balota, & Hutchison, 2016. The costs and benefits of testing and guessing on recognition memory. Journal of Experimental Psychology: Learning, Memory, and Cognition, 42, 1559-1572. doi: 10.1037/xlm0000269 ], suggesting that testing and guessing effects may be influenced by encoding strategies specific for the type of upcoming task. We follow-up these experiments by examining test-expectancy processes in guessing and testing. Testing and guessing benefits over restudy were not found when test instructions were presented either after (Experiment 1) or before (Experiment 2) a single study/task cycle was completed, nor were benefits found when instructions were presented before study/task cycles and the task was repeated three times (Experiment 3). Testing and guessing benefits emerged only when instructions were presented before a study/task cycle and the task was repeated six times (Experiments 4A and 4B). These experiments demonstrate that initial testing and guessing can produce memory benefits in recognition, but only following substantial task repetitions which likely promote task-expectancy processes.
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Foster, Ida; Racicot, Simon; McGrath, Jennifer J.
2017-01-01
Purpose Attention deficit hyperactivity disorder (ADHD) is an established risk factor for smoking; however, no studies have considered whether precursors to smoking behavior differ among adolescents with ADHD. Smoking expectancies are beliefs about the potential consequences of smoking, and they develop before smoking initiation. ADHD characteristics may contribute to the formation of expectancies and eventual smoking behavior. We evaluated whether clinical levels of ADHD subtypes differentially predicted smoking expectancies. Methods Adolescents (n = 221; age mean = 12.67 years) completed the Smoking Expectancy Scale for Adolescents, answered standardized questions about their smoking behavior, and provided expired breath samples to verify never-smoking status. Parents completed the Conners’ Parent Rating Scale for ADHD symptoms of inattention and hyperactivity/impulsivity. Results Adolescents with clinical levels of inattention were significantly less likely to endorse negative consequences, including Expected Costs (odds ratio [OR] = .16), Appearance–Presentation Costs (OR = .29), Social Costs (OR = .19), Health Costs (OR = .21), and Addiction Costs (OR = .39). Inattentive female adolescents were significantly more likely to endorse Weight Control as a consequence. Adolescents with clinical levels of hyperactivity/impulsivity were more likely to endorse positive consequences, including Expected Benefits (OR = 5.31), Affect Control (OR = 2.60), and Boredom Reduction (OR = 3.14); they were less likely to endorse Social Costs (OR = .27). Conclusions ADHD subtype differentially predicted smoking expectancies. Adolescents with ADHD may be more vulnerable to developing pro-smoking expectancies due to subtype-related deficits in neurocognitive processing. These findings have potential implications for developing targeted smoking prevention programs. PMID:22999841
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Dadalto, Elâine Cristina Vargas; Rosa, Edinete Maria
2017-01-01
To evaluate the knowledge and expectations of mothers of preterm newborn infants admitted in a neonatal intensive care unit about breastfeeding and pacifier use, and to analyze their experience in dealing with the sucking urge in the first months of life. Mothers were interviewed during hospitalization of the newborn in the neonatal intensive care unit and when the infant was six months old. All mothers with availability to participate in the study were included. Exclusion criteria comprised infants with syndromes and neurological disorders and mothers with cognitive impairment, depression, and drug users. Data were analyzed with the SPSS software, with descriptive statistics and chi-square test. Sixty-two mothers were interviewed in the beginning and 52 at a six-month follow-up. Mothers' expectations concerning breastfeeding were positive when they listed the benefits to the mother (90.3%) and infant (100%). However, they had difficulties maintaining exclusive breastfeeding and used the baby bottle (75.0%), which most mothers (69.4%) had already acquired before the infant was born. The fact of having a pacifier in the infant's layette (43.6%) did not influence its use (p=0.820). This also occurred among mothers who said they would not offer the pacifier due to disadvantages to the mother (80.7%) and infant (96.8%). The previous expectation that the pacifier could bring benefits for mother and infant did not affect its use (p=0.375 and p=0.158). Mothers demonstrated prior knowledge about breastfeeding benefits and disadvantages of the pacifiers. However, they changed their view when dealing with the infant and introduced bottles and pacifiers.
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Dadalto, Elâine Cristina Vargas; Rosa, Edinete Maria
2017-01-01
ABSTRACT Objective: To evaluate the knowledge and expectations of mothers of preterm newborn infants admitted in a neonatal intensive care unit about breastfeeding and pacifier use, and to analyze their experience in dealing with the sucking urge in the first months of life. Methods: Mothers were interviewed during hospitalization of the newborn in the neonatal intensive care unit and when the infant was six months old. All mothers with availability to participate in the study were included. Exclusion criteria comprised infants with syndromes and neurological disorders and mothers with cognitive impairment, depression, and drug users. Data were analyzed with the SPSS software, with descriptive statistics and chi-square test. Results: Sixty-two mothers were interviewed in the beginning and 52 at a six-month follow-up. Mothers’ expectations concerning breastfeeding were positive when they listed the benefits to the mother (90.3%) and infant (100%). However, they had difficulties maintaining exclusive breastfeeding and used the baby bottle (75.0%), which most mothers (69.4%) had already acquired before the infant was born. The fact of having a pacifier in the infant’s layette (43.6%) did not influence its use (p=0.820). This also occurred among mothers who said they would not offer the pacifier due to disadvantages to the mother (80.7%) and infant (96.8%). The previous expectation that the pacifier could bring benefits for mother and infant did not affect its use (p=0.375 and p=0.158). Conclusions: Mothers demonstrated prior knowledge about breastfeeding benefits and disadvantages of the pacifiers. However, they changed their view when dealing with the infant and introduced bottles and pacifiers. PMID:28977129
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State-Level Community Benefit Regulation and Nonprofit Hospitals' Provision of Community Benefits.
Singh, Simone R; Young, Gary J; Loomer, Lacey; Madison, Kristin
2018-04-01
Do nonprofit hospitals provide enough community benefits to justify their tax exemptions? States have sought to enhance nonprofit hospitals' accountability and oversight through regulation, including requirements to report community benefits, conduct community health needs assessments, provide minimum levels of community benefits, and adhere to minimum income eligibility standards for charity care. However, little research has assessed these regulations' impact on community benefits. Using 2009-11 Internal Revenue Service data on community benefit spending for more than eighteen hundred hospitals and the Hilltop Institute's data on community benefit regulation, we investigated the relationship between these four types of regulation and the level and types of hospital-provided community benefits. Our multivariate regression analyses showed that only community health needs assessments were consistently associated with greater community benefit spending. The results for reporting and minimum spending requirements were mixed, while minimum income eligibility standards for charity care were unrelated to community benefit spending. State adoption of multiple types of regulation was consistently associated with higher levels of hospital-provided community benefits, possibly because regulatory intensity conveys a strong signal to the hospital community that more spending is expected. This study can inform efforts to design regulations that will encourage hospitals to provide community benefits consistent with policy makers' goals. Copyright © 2018 by Duke University Press.
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29 CFR 2590.732 - Special rules relating to group health plans.
Code of Federal Regulations, 2010 CFR
2010-07-01
... dental benefits, limited-scope vision benefits, or long-term care benefits are excepted if they are... structure within the mouth). (B) Vision benefits. Limited scope vision benefits are benefits substantially...) Based on cognitive impairment or a loss of functional capacity that is expected to be chronic. (v...
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Kowitt, Sarah; Sheeran, Paschal; Jarman, Kristen; Ranney, Leah M; Schmidt, Allison M; Huang, Li-Ling; Goldstein, Adam O
2017-10-01
Little is known on how to communicate messages on tobacco constituents to tobacco users. This study manipulated three elements of a message in the context of a theory-based communication campaign about tobacco constituents: (1) latency of response efficacy (how soon expected health benefits would accrue), (2) self-efficacy (confidence about quitting), and (3) interrogative cue ("Ready to be tobacco-free?"). Smokers (N = 1669, 55.4% women) were recruited via an online platform, and were randomized to a 3 (Latency of response efficacy) × 2 (Self-efficacy) × 2 (Interrogative cue) factorial design. The dependent variables were believability, credibility, perceived effectiveness of the communication message, and action expectancies (likelihood of seeking additional information and help with quitting). Latency of response efficacy influenced believability, perceived effectiveness, credibility, and action expectancies. In each case, scores were higher when specific health benefits were said to accrue within 1 month, as compared to general health benefits occurring in a few hours. The interrogative cue had a marginal positive effect on perceived effectiveness. The self-efficacy manipulation had no reliable effects, and there were no significant interactions among conditions. Smokers appear less persuaded by a communication message on constituents where general health benefits accrue immediately (within a few hours) than specific benefits over a longer timeframe (1 month). Additionally, smokers appeared to be more persuaded by messages with an interrogative cue. Such findings may help design more effective communication campaigns on tobacco constituents to smokers. This paper describes, for the first time, how components of tobacco constituent messages are perceived. We now know that smokers appear to be less persuaded by communication messages where general health benefits accrue immediately (within a few hours) than specific benefits over a longer timeframe (1 month). Additionally, including an interrogative cue ("Ready to be tobacco free?") may make messages more effective, whereas the self-efficacy manipulation designed to increase confidence about quitting had no effect. While messages were universally impactful across smoker subpopulations, everyday smokers and smokers with less trust in the government may be less receptive to communication campaigns. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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Teichert, Nils; Borja, Angel; Chust, Guillem; Uriarte, Ainhize; Lepage, Mario
2016-01-15
Estuaries are subjected to multiple anthropogenic stressors, which have additive, antagonistic or synergistic effects. Current challenges include the use of large databases of biological monitoring surveys (e.g. the European Water Framework Directive) to help environmental managers prioritizing restoration measures. This study investigated the impact of nine stressor categories on the fish ecological status derived from 90 estuaries of the North East Atlantic countries. We used a random forest model to: 1) detect the dominant stressors and their non-linear effects; 2) evaluate the ecological benefits expected from reducing pressure from stressors; and 3) investigate the interactions among stressors. Results showed that largest restoration benefits were expected when mitigating water pollution and oxygen depletion. Non-additive effects represented half of pairwise interactions among stressors, and antagonisms were the most common. Dredged sediments, flow changes and oxygen depletion were predominantly implicated in non-additive interactions, whereas the remainder stressors often showed additive impacts. The prevalence of interactive impacts reflects a complex scenario for estuaries management; hence, we proposed a step-by-step restoration scheme focusing on the mitigation of stressors providing the maximum of restoration benefits under a multi-stress context. Copyright © 2015 Elsevier B.V. All rights reserved.
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Supporting Emerging Disciplines with e-Communities: Needs and Benefits
Butler, Brian S; Schleyer, Titus K; Weiss, Patricia M; Wang, Xiaoqing; Thyvalikakath, Thankam P; Hatala, Courtney L; Naderi, Reza A
2008-01-01
Background Science has developed from a solitary pursuit into a team-based collaborative activity and, more recently, into a multidisciplinary research enterprise. The increasingly collaborative character of science, mandated by complex research questions and problems that require many competencies, requires that researchers lower the barriers to the creation of collaborative networks of experts, such as communities of practice (CoPs). Objectives The aim was to assess the information needs of prospective members of a CoP in an emerging field, dental informatics, and to evaluate their expectations of an e-community in order to design a suitable electronic infrastructure. Methods A Web-based survey instrument was designed and administered to 2768 members of the target audience. Benefit expectations were analyzed for their relationship to (1) the respondents’ willingness to participate in the CoP and (2) their involvement in funded research. Two raters coded the respondents’ answers regarding expected benefits using a 14-category coding scheme (Kappa = 0.834). Results The 256 respondents (11.1% response rate) preferred electronic resources over traditional print material to satisfy their information needs. The most frequently expected benefits from participation in the CoP were general information (85% of respondents), peer networking (31.1%), and identification of potential collaborators and/or research opportunities (23.2%). Conclusions The competitive social-information environment in which CoPs are embedded presents both threats to sustainability and opportunities for greater integration and impact. CoP planners seeking to support the development of emerging biomedical science disciplines should blend information resources, social search and filtering, and visibility mechanisms to provide a portfolio of social and information benefits. Assessing benefit expectations and alternatives provides useful information for CoP planners seeking to prioritize community infrastructure development and encourage participation. PMID:18653443
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Framing sound: Using expectations to reduce environmental noise annoyance.
Crichton, Fiona; Dodd, George; Schmid, Gian; Petrie, Keith J
2015-10-01
Annoyance reactions to environmental noise, such as wind turbine sound, have public health implications given associations between annoyance and symptoms related to psychological distress. In the case of wind farms, factors contributing to noise annoyance have been theorised to include wind turbine sound characteristics, the noise sensitivity of residents, and contextual aspects, such as receiving information creating negative expectations about sound exposure. The experimental aim was to assess whether receiving positive or negative expectations about wind farm sound would differentially influence annoyance reactions during exposure to wind farm sound, and also influence associations between perceived noise sensitivity and noise annoyance. Sixty volunteers were randomly assigned to receive either negative or positive expectations about wind farm sound. Participants in the negative expectation group viewed a presentation which incorporated internet material indicating that exposure to wind turbine sound, particularly infrasound, might present a health risk. Positive expectation participants viewed a DVD which framed wind farm sound positively and included internet information about the health benefits of infrasound exposure. Participants were then simultaneously exposed to sub-audible infrasound and audible wind farm sound during two 7 min exposure sessions, during which they assessed their experience of annoyance. Positive expectation participants were significantly less annoyed than negative expectation participants, while noise sensitivity only predicted annoyance in the negative group. Findings suggest accessing negative information about sound is likely to trigger annoyance, particularly in noise sensitive people and, importantly, portraying sound positively may reduce annoyance reactions, even in noise sensitive individuals. Copyright © 2015 Elsevier Inc. All rights reserved.
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Nurses' experiences, expectations, and preferences for mind-body practices to reduce stress.
Kemper, Kathi; Bulla, Sally; Krueger, Deborah; Ott, Mary Jane; McCool, Jane A; Gardiner, Paula
2011-04-11
Most research on the impact of mind-body training does not ask about participants' baseline experience, expectations, or preferences for training. To better plan participant-centered mind-body intervention trials for nurses to reduce occupational stress, such descriptive information would be valuable. We conducted an anonymous email survey between April and June, 2010 of North American nurses interested in mind-body training to reduce stress. The e-survey included: demographic characteristics, health conditions and stress levels; experiences with mind-body practices; expected health benefits; training preferences; and willingness to participate in future randomized controlled trials. Of the 342 respondents, 96% were women and 92% were Caucasian. Most (73%) reported one or more health conditions, notably anxiety (49%); back pain (41%); GI problems such as irritable bowel syndrome (34%); or depression (33%). Their median occupational stress level was 4 (0 = none; 5 = extreme stress). Nearly all (99%) reported already using one or more mind-body practices to reduce stress: intercessory prayer (86%), breath-focused meditation (49%), healing or therapeutic touch (39%), yoga/tai chi/qi gong (34%), or mindfulness-based meditation (18%). The greatest expected benefits were for greater spiritual well-being (56%); serenity, calm, or inner peace (54%); better mood (51%); more compassion (50%); or better sleep (42%). Most (65%) wanted additional training; convenience (74% essential or very important), was more important than the program's reputation (49%) or scientific evidence about effectiveness (32%) in program selection. Most (65%) were willing to participate in a randomized trial of mind-body training; among these, most were willing to collect salivary cortisol (60%), or serum biomarkers (53%) to assess the impact of training. Most nurses interested in mind-body training already engage in such practices. They have greater expectations about spiritual and emotional than physical benefits, but are willing to participate in studies and to collect biomarker data. Recruitment may depend more on convenience than a program's scientific basis or reputation. Knowledge of participants' baseline experiences, expectations, and preferences helps inform future training and research on mind-body approaches to reduce stress.
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Nurses' experiences, expectations, and preferences for mind-body practices to reduce stress
2011-01-01
Background Most research on the impact of mind-body training does not ask about participants' baseline experience, expectations, or preferences for training. To better plan participant-centered mind-body intervention trials for nurses to reduce occupational stress, such descriptive information would be valuable. Methods We conducted an anonymous email survey between April and June, 2010 of North American nurses interested in mind-body training to reduce stress. The e-survey included: demographic characteristics, health conditions and stress levels; experiences with mind-body practices; expected health benefits; training preferences; and willingness to participate in future randomized controlled trials. Results Of the 342 respondents, 96% were women and 92% were Caucasian. Most (73%) reported one or more health conditions, notably anxiety (49%); back pain (41%); GI problems such as irritable bowel syndrome (34%); or depression (33%). Their median occupational stress level was 4 (0 = none; 5 = extreme stress). Nearly all (99%) reported already using one or more mind-body practices to reduce stress: intercessory prayer (86%), breath-focused meditation (49%), healing or therapeutic touch (39%), yoga/tai chi/qi gong (34%), or mindfulness-based meditation (18%). The greatest expected benefits were for greater spiritual well-being (56%); serenity, calm, or inner peace (54%); better mood (51%); more compassion (50%); or better sleep (42%). Most (65%) wanted additional training; convenience (74% essential or very important), was more important than the program's reputation (49%) or scientific evidence about effectiveness (32%) in program selection. Most (65%) were willing to participate in a randomized trial of mind-body training; among these, most were willing to collect salivary cortisol (60%), or serum biomarkers (53%) to assess the impact of training. Conclusions Most nurses interested in mind-body training already engage in such practices. They have greater expectations about spiritual and emotional than physical benefits, but are willing to participate in studies and to collect biomarker data. Recruitment may depend more on convenience than a program's scientific basis or reputation. Knowledge of participants' baseline experiences, expectations, and preferences helps inform future training and research on mind-body approaches to reduce stress. PMID:21481259
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Benefits of a Unified LaSRS++ Simulation for NAS-Wide and High-Fidelity Modeling
NASA Technical Reports Server (NTRS)
Glaab, Patricia; Madden, Michael
2014-01-01
The LaSRS++ high-fidelity vehicle simulation was extended in 2012 to support a NAS-wide simulation mode. Since the initial proof-of-concept, the LaSRS++ NAS-wide simulation is maturing into a research-ready tool. A primary benefit of this new capability is the consolidation of the two modeling paradigms under a single framework to save cost, facilitate iterative concept testing between the two tools, and to promote communication and model sharing between user communities at Langley. Specific benefits of each type of modeling are discussed along with the expected benefits of the unified framework. Current capability details of the LaSRS++ NAS-wide simulations are provided, including the visualization tool, live data interface, trajectory generators, terminal routing for arrivals and departures, maneuvering, re-routing, navigation, winds, and turbulence. The plan for future development is also described.
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Cost-benefit analysis of electronic medical record system at a tertiary care hospital.
Choi, Jong Soo; Lee, Woo Baik; Rhee, Poong-Lyul
2013-09-01
Although Electronic Medical Record (EMR) systems provide various benefits, there are both advantages and disadvantages regarding its cost-effectiveness. This study analyzed the economic effects of EMR systems using a cost-benefit analysis based on the differential costs of managerial accounting. Samsung Medical Center (SMC) is a general hospital in Korea that developed an EMR system for outpatients from 2006 to 2008. This study measured the total costs and benefits during an 8-year period after EMR adoption. The costs include the system costs of building the EMR and the costs incurred in smoothing its adoption. The benefits included cost reductions after its adoption and additional revenues from both remodeling of paper-chart storage areas and medical transcriptionists' contribution. The measured amounts were discounted by SMC's expected interest rate to calculate the net present value (NPV), benefit-cost ratio (BCR), and discounted payback period (DPP). During the analysis period, the cumulative NPV and the BCR were US$3,617 thousand and 1.23, respectively. The DPP was about 6.18 years. Although the adoption of an EMR resulted in overall growth in administrative costs, it is cost-effective since the cumulative NPV was positive. The positive NPV was attributed to both cost reductions and additional revenues. EMR adoption is not so attractive to management in that the DPP is longer than 5 years at 6.18 and the BCR is near 1 at 1.23. However, an EMR is a worthwhile investment, seeing that this study did not include any qualitative benefits and that the paper-chart system was cost-centric.
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Electromagnetic thrusters for spacecraft prime propulsion
NASA Technical Reports Server (NTRS)
Rudolph, L. K.; King, D. Q.
1984-01-01
The benefits of electromagnetic propulsion systems for the next generation of US spacecraft are discussed. Attention is given to magnetoplasmadynamic (MPD) and arc jet thrusters, which form a subset of a larger group of electromagnetic propulsion systems including pulsed plasma thrusters, Hall accelerators, and electromagnetic launchers. Mission/system study results acquired over the last twenty years suggest that for future prime propulsion applications high-power self-field MPD thrusters and low-power arc jets have the greatest potential of all electromagnetic thruster systems. Some of the benefits they are expected to provide include major reductions in required launch mass compared to chemical propulsion systems (particularly in geostationary orbit transfer) and lower life-cycle costs (almost 50 percent less). Detailed schematic drawings are provided which describe some possible configurations for the various systems.
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Closing the gap between knowledge and clinical application: challenges for genomic translation.
Burke, Wylie; Korngiebel, Diane M
2015-01-01
Despite early predictions and rapid progress in research, the introduction of personal genomics into clinical practice has been slow. Several factors contribute to this translational gap between knowledge and clinical application. The evidence available to support genetic test use is often limited, and implementation of new testing programs can be challenging. In addition, the heterogeneity of genomic risk information points to the need for strategies to select and deliver the information most appropriate for particular clinical needs. Accomplishing these tasks also requires recognition that some expectations for personal genomics are unrealistic, notably expectations concerning the clinical utility of genomic risk assessment for common complex diseases. Efforts are needed to improve the body of evidence addressing clinical outcomes for genomics, apply implementation science to personal genomics, and develop realistic goals for genomic risk assessment. In addition, translational research should emphasize the broader benefits of genomic knowledge, including applications of genomic research that provide clinical benefit outside the context of personal genomic risk.
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Big Data Management in US Hospitals: Benefits and Barriers.
Schaeffer, Chad; Booton, Lawrence; Halleck, Jamey; Studeny, Jana; Coustasse, Alberto
Big data has been considered as an effective tool for reducing health care costs by eliminating adverse events and reducing readmissions to hospitals. The purposes of this study were to examine the emergence of big data in the US health care industry, to evaluate a hospital's ability to effectively use complex information, and to predict the potential benefits that hospitals might realize if they are successful in using big data. The findings of the research suggest that there were a number of benefits expected by hospitals when using big data analytics, including cost savings and business intelligence. By using big data, many hospitals have recognized that there have been challenges, including lack of experience and cost of developing the analytics. Many hospitals will need to invest in the acquiring of adequate personnel with experience in big data analytics and data integration. The findings of this study suggest that the adoption, implementation, and utilization of big data technology will have a profound positive effect among health care providers.
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Ding, Yao; Yeh, Sylvia H; Mink, Chris Anna M; Zangwill, Kenneth M; Allred, Norma J; Hay, Joel W
2013-05-24
To assess the economic benefits associated with hospital-based postpartum Tdap (combined tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) vaccination. A decision tree model was constructed to calculate the potential cost-benefit of this strategy from both a health care system and a societal perspective. Probabilities and costs were derived from published literature, data reported to Centers for Disease Control and Prevention, and recommendations from expert panels. The maternal vaccination protection period for infants was defined as 7 months, and 10 years of waning immunity following Tdap for birth mothers was estimated in the model. All cost estimates were inflated to year 2012 US dollars and discounted at a 3% annual discount rate. In the base case from a societal perspective, the expected costs per vaccinated and unvaccinated mother were estimated at $129.27 and $187.97, respectively, suggesting an expected net benefit of $58.70 per vaccinated mother. The overall societal benefits in the cohort of 3.6 million U.S. birth mothers ranged from $52.8-126.8 million, depending on the vaccination coverage level. If including direct medical costs only, the strategy would not generate net savings from a health care system perspective. Annual incidence of pertussis in birth mothers and Tdap efficacy exhibited substantial impact on the model as shown in one-way and two-way sensitivity analyses. Although postpartum Tdap vaccination is not cost-beneficial from a health care system perspective in the base case, this strategy is likely to generate net benefits from a societal perspective. Copyright © 2013 Elsevier Ltd. All rights reserved.
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Physician Prescribing Practices of Vitamin D in a Psychiatric Hospital.
Mulcahy, Kimberly B; Trigoboff, Eileen; Opler, Lewis; Demler, Tammie Lee
2016-01-01
Vitamin D supplementation has become an increasingly popular prescribing practice, despite our limited knowledge of both the definition and degree of deficiency as well as the expected benefits or risks of exogenous administration. Many of the hypothesized benefits of vitamin D supplementation include a variety of improvements in mental health; however, these claims are not consistently or robustly supported by current research. In this paper, we provide a brief overview of what is currently known about vitamin D deficiency and about outcomes of supplementation as well as a summary of the data relative to prescribing practices for inpatients in an urban psychiatric hospital.
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Pet dogs as promoters of wellbeing.
While, Alison
2017-07-02
The rise in life expectancy requires strategies to enable healthy ageing and the promotion of a high quality of life in old age. Poor mental health including depression and social isolation can blight older people's lives. Despite the positive benefits of physical activity for both mental and physical health, only a minority of those over 65 years are attaining the recommended levels of physical activity. The evidence relating to the benefits of pet dogs as promoters of wellbeing is set out in this article, although meeting their care needs may place an additional strain on an older person and/or their carer who has limited resources and physical capabilities.
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ERIC Educational Resources Information Center
Goldner, Limor
2016-01-01
Background: Community-based mentoring interventions can benefit high-risk youth. However, meta-analyses suggest that these benefits may be conditioned by protégés' personality. Objectives: Associations between protégés' personality traits and mentoring expectations, the quality of the mentoring relationship, the perceived mentoring contribution,…
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Tsunematsu, Miwako; Kakehashi, Masayuki
2015-01-01
Background Although the United States Preventive Services Task Force (USPSTF) downgraded their recommendation for breast cancer screening for women aged 40–49 years in 2009, Japanese women in their 40s have been encouraged to attend breast cancer screenings since 2004. The aim of this study is to examine whether these different mass-screening strategies are justifiable by the different situations of these countries and to provide evidence for suitable judgment. Methods Performance of screening strategies (annual/biennial intervals; initiating/terminating ages) was evaluated using a mathematical model based on the natural history of breast cancer and the transition between its stages. Benefits (reduced number of deaths and extended average life expectancy) and harm (false-positives) associated with these strategies were calculated. Results Additional average life expectancy by including women in their 40s as participants were 13 days (26%) and 25 days (22%) in Japan and the United States, respectively, under the biennial screening condition; however, the respective increases in numbers of false-positive cases were 65% and 53% in Japan and the United States. Moreover, the number of screenings needed to detect one diagnosis or to avert one death was smaller when participants were limited to women of age 50 or over than when women in their 40s were included. The validity of including women in their 40s in Japan could not be determined without specifying the weight of harms compared to benefits. Conclusions Whether screening of women in their 40s in Japan is justifiable must be carefully determined based the quantitative balance of benefits and harms. PMID:25483105
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Questions and answers on employee benefit issues.
1994-06-01
This Issue Brief addresses 19 topics in the areas of pensions, health insurance, and other benefits. In addition to the topics listed below, the report includes data on the prevalence of benefits, tax incentives associated with benefits, lump-sum distributions, number of private pension plans, pension coverage rates, 401(k) plans, employer spending on group health insurance, self-insured health plans, employer initiatives to reduce health care costs, and employers' response to the retiree health benefits accounting rule, and flexible benefits plans. In 1992, U.S. employers (public and private) spent $629 billion for noncash benefits, representing nearly 18 percent of total compensation, excluding paid time off. In 1992, 71 percent of the 50.1 million individuals aged 55 and over received retirement benefits, including distributions from private and public pensions, annuities, individual retirement accounts, Keoghs, 401(k)s, and Social Security. Among the 76 percent of all private pension plan participants who participated in a single plan, 30 percent named a defined benefit plan as their pension plan type, 58 percent named a defined contribution plan as their pension plan type, and 12 percent did not know their plan type. Private and public pension funds held more than $4.6 trillion in assets at the end of 1993. The 1993 year-end assets are more than triple the asset level of 1983 (nominal terms). According to the Congressional Budget Office, U.S. expenditures on health care were expected to have reached $898 billion in 1993, up from $751.8 billion in 1991, an increase of 19.4 percent in nominal terms.
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Kim, Min Ju; Kim, Kyung Won
2015-10-01
Calcium is important but deficient in diets of young adult women. This study aimed to examine if cognitive factors and eating behaviors differ according to calcium intake based on the Social Cognitive Theory. Subjects were female college students in Seoul, Korea. Three hundred students completed the questionnaire regarding calcium intake, nutrition knowledge, outcome expectations, self-efficacy and eating behaviors. Data on 240 students were analyzed using t-test or χ(2)-test. Subjects were categorized into two groups, high calcium intake (HC, ≥ 650 mg/day) and low calcium intake (LC, < 650 mg/day), according to recommended intakes of calcium for women aged 19-29 years. The LC group constituted 77.9% of total subjects. Nutrition knowledge was not different according to calcium intake. Three out of 12 outcome expectations items were significantly different between the HC and LC groups. Subjects in the HC group agreed more strongly with the practical benefits of consuming calcium-rich foods, including 'taste' (P < 0.01) and 'going well with other snacks' (P < 0.05), compared to those in the LC group. Negative expectations of 'indigestion' were stronger in the LC group than HC group (P < 0.001). Among self-efficacy items, perceived ability of 'eating dairy foods for snacks' (P < 0.001), 'eating dairy foods every day' (P < 0.01), and 'eating calcium-rich side dishes at meals' (P < 0.05) differed significantly between the HC and LC groups. Eating behaviors including more frequent consumption of dairy foods, fruits or fruit juice (P < 0.001), anchovy, seaweeds, green vegetables, protein-rich foods (P < 0.05), and less frequent consumption of sweets or soft drinks (P < 0.01) were significantly related to calcium intake. This study found that outcome expectations, self-efficacy in consuming calcium-rich foods, and eating behaviors are important in explaining calcium intake. Nutrition education needs to address practical benefits, reduce negative expectations of calcium-rich foods, increase self-efficacy, and modify eating behaviors contributing to calcium intake.
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The fragility of omics risk and benefit perceptions.
Börner, Franziska U; Schütz, Holger; Wiedemann, Peter
2011-03-25
How do individuals judge the risks and benefits of toxicogenomics, an emerging field of research which is completely unfamiliar to them? The hypothesis is that individuals' perceptions of the risks and benefits of toxicogenomics are fragile and can by influenced by different issues and context framings as a technology. The researchers expected that the effects on risk and benefit judgements would differ between lay individuals and experts in toxicogenomics. A 2×2×2 experiment that encompassed three factors was conducted. The first factor, issue framing incorporated the field of application for the technology (therapy vs. diagnosis setting). The second factor, context framing included organisations and institutions that would profit from the technology (companies vs. regulatory agencies) and the third factor encompasses the quality of individuals' level of knowledge, for example lay vs. expert knowledge. Research results suggest the differential power of framing effects. It seems that the clues provided by context frames - but not by issue frames - are able to influence the ways in which lay people and experts process information. The findings are interpreted in the line of the fuzzy trace theory that predicts reliance on fuzzy gist representations formed by stereotypes on a wide range of judgement problem including risk and benefit perceptions. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
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Temporal view of the costs and benefits of self-deception
Chance, Zoë; Norton, Michael I.; Gino, Francesca; Ariely, Dan
2011-01-01
Researchers have documented many cases in which individuals rationalize their regrettable actions. Four experiments examine situations in which people go beyond merely explaining away their misconduct to actively deceiving themselves. We find that those who exploit opportunities to cheat on tests are likely to engage in self-deception, inferring that their elevated performance is a sign of intelligence. This short-term psychological benefit of self-deception, however, can come with longer-term costs: when predicting future performance, participants expect to perform equally well—a lack of awareness that persists even when these inflated expectations prove costly. We show that although people expect to cheat, they do not foresee self-deception, and that factors that reinforce the benefits of cheating enhance self-deception. More broadly, the findings of these experiments offer evidence that debates about the relative costs and benefits of self-deception are informed by adopting a temporal view that assesses the cumulative impact of self-deception over time. PMID:21383150
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Anticipated Benefits of Care (ABC): psychometrics and predictive value in psychiatric disorders.
Warden, D; Trivedi, M H; Carmody, T J; Gollan, J K; Kashner, T M; Lind, L; Crismon, M L; Rush, A J
2010-06-01
Attitudes and expectations about treatment have been associated with symptomatic outcomes, adherence and utilization in patients with psychiatric disorders. No measure of patients' anticipated benefits of treatment on domains of everyday functioning has previously been available. The Anticipated Benefits of Care (ABC) is a new, 10-item questionnaire used to measure patient expectations about the impact of treatment on domains of everyday functioning. The ABC was collected at baseline in adult out-patients with major depressive disorder (MDD) (n=528), bipolar disorder (n=395) and schizophrenia (n=447) in the Texas Medication Algorithm Project (TMAP). Psychometric properties of the ABC were assessed, and the association of ABC scores with treatment response at 3 months was evaluated. Evaluation of the ABC's internal consistency yielded Cronbach's alpha of 0.90-0.92 for patients across disorders. Factor analysis showed that the ABC was unidimensional for all patients and for patients with each disorder. For patients with MDD, lower anticipated benefits of treatment was associated with less symptom improvement and lower odds of treatment response [odds ratio (OR) 0.72, 95% confidence interval (CI) 0.57-0.87, p=0.0011]. There was no association between ABC and symptom improvement or treatment response for patients with bipolar disorder or schizophrenia, possibly because these patients had modest benefits with treatment. The ABC is the first self-report that measures patient expectations about the benefits of treatment on everyday functioning, filling an important gap in available assessments of attitudes and expectations about treatment. The ABC is simple, easy to use, and has acceptable psychometric properties for use in research or clinical settings.
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Ando, Amy W; Mallory, Mindy L
2012-04-24
Climate change is likely to alter the spatial distributions of species and habitat types but the nature of such change is uncertain. Thus, climate change makes it difficult to implement standard conservation planning paradigms. Previous work has suggested some approaches to cope with such uncertainty but has not harnessed all of the benefits of risk diversification. We adapt Modern Portfolio Theory (MPT) to optimal spatial targeting of conservation activity, using wetland habitat conservation in the Prairie Pothole Region (PPR) as an example. This approach finds the allocations of conservation activity among subregions of the planning area that maximize the expected conservation returns for a given level of uncertainty or minimize uncertainty for a given expected level of returns. We find that using MPT instead of simple diversification in the PPR can achieve a value of the conservation objective per dollar spent that is 15% higher for the same level of risk. MPT-based portfolios can also have 21% less uncertainty over benefits or 6% greater expected benefits than the current portfolio of PPR conservation. Total benefits from conservation investment are higher if returns are defined in terms of benefit-cost ratios rather than benefits alone. MPT-guided diversification can work to reduce the climate-change-induced uncertainty of future ecosystem-service benefits from many land policy and investment initiatives, especially when outcomes are negatively correlated between subregions of a planning area.
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Risk-based zoning for urbanizing floodplains.
Porse, Erik
2014-01-01
Urban floodplain development brings economic benefits and enhanced flood risks. Rapidly growing cities must often balance the economic benefits and increased risks of floodplain settlement. Planning can provide multiple flood mitigation and environmental benefits by combining traditional structural measures such as levees, increasingly popular landscape and design features (green infrastructure), and non-structural measures such as zoning. Flexibility in both structural and non-structural options, including zoning procedures, can reduce flood risks. This paper presents a linear programming formulation to assess cost-effective urban floodplain development decisions that consider benefits and costs of development along with expected flood damages. It uses a probabilistic approach to identify combinations of land-use allocations (residential and commercial development, flood channels, distributed runoff management) and zoning regulations (development zones in channel) to maximize benefits. The model is applied to a floodplain planning analysis for an urbanizing region in the Baja Sur peninsula of Mexico. The analysis demonstrates how (1) economic benefits drive floodplain development, (2) flexible zoning can improve economic returns, and (3) cities can use landscapes, enhanced by technology and design, to manage floods. The framework can incorporate additional green infrastructure benefits, and bridges typical disciplinary gaps for planning and engineering.
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Renewable Energy Feasibility Study Final Report
DOE Office of Scientific and Technical Information (OSTI.GOV)
Rooney, Tim
2013-10-30
The Gila River Indian Community (GRIC or the Community) contracted the ANTARES Group, Inc. (“ANTARES”) to assess the feasibility of solar photovoltaic (PV) installations. A solar energy project could provide a number of benefits to the Community in terms of potential future energy savings, increased employment, environmental benefits from renewable energy generation and usage, and increased energy self-sufficiency. The study addresses a number of facets of a solar project’s overall feasibility, including: Technical appropriateness; Solar resource characteristics and expected system performance; Levelized cost of electricity (LCOE) economic assessment. The Gila River Indian Community (GRIC or the Community) contracted the ANTARESmore » Group, Inc. (“ANTARES”) to prepare a biomass resource assessment study and evaluate the feasibility of a bioenergy project on Community land. A biomass project could provide a number of benefits to the Community in terms of increased employment, environmental benefits from renewable energy generation and usage, and increased energy self-sufficiency. The study addresses a number of facets of a biomass project’s overall feasibility, including: Resource analysis and costs; Identification of potential bioenergy projects; Technical and economic (levelized cost of energy) modeling for selected project configuration.« less
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Human versus automation in responding to failures: an expected-value analysis
NASA Technical Reports Server (NTRS)
Sheridan, T. B.; Parasuraman, R.
2000-01-01
A simple analytical criterion is provided for deciding whether a human or automation is best for a failure detection task. The method is based on expected-value decision theory in much the same way as is signal detection. It requires specification of the probabilities of misses (false negatives) and false alarms (false positives) for both human and automation being considered, as well as factors independent of the choice--namely, costs and benefits of incorrect and correct decisions as well as the prior probability of failure. The method can also serve as a basis for comparing different modes of automation. Some limiting cases of application are discussed, as are some decision criteria other than expected value. Actual or potential applications include the design and evaluation of any system in which either humans or automation are being considered.
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The economic benefit of treating subclinical Streptococcus agalactiae mastitis in lactating cows.
Yamagata, M; Goodger, W J; Weaver, L; Franti, C
1987-12-15
The economic benefits of treating lactating cows for Streptococcus agalactiae mastitis were studied at a large (689 milking cows) central California dairy. Postcure milk production of case cows (infected, treated, and cured) was compared with production of paired control cows (uninfected) and was matched for yield, days in milk, days in gestation, and parity. A simulation was used to plot expected lactation curves for mastitic cows (infected, not treated) with characteristics similar to those of each control cow, and these curves were compared with actual case-cow lactation curves. The difference in actual and expected production was used to calculate net economic benefits of treatment. Comparison of expected with actual production indicated a net benefit from treatment of $396/cow for cows treated in early lactation and $237 for cows treated in midlactation, but a net loss of $55 for cows treated in late lactation. Lactation number did not have a significant impact on economic benefits of treatment. In contrast to other studies indicating no economic benefit from treating mastitis during lactation, this study's positive results may have been attributable to the high cure rate (98%) and the subclinical form of mastitis being treated. Streptococcus agalactiae mastitis treatment during early and midlactation would appear to be an economically justifiable option for dairy managers.
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Marketing Education Through Benefit Segmentation. AIR Forum 1981 Paper.
ERIC Educational Resources Information Center
Goodnow, Wilma Elizabeth
The applicability of the "benefit segmentation" marketing technique to education was tested at the College of DuPage in 1979. Benefit segmentation identified target markets homogeneous in benefits expected from a program offering and may be useful in combatting declining enrollments. The 487 randomly selected students completed the 223…
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Expectations for methodology and translation of animal research: a survey of health care workers.
Joffe, Ari R; Bara, Meredith; Anton, Natalie; Nobis, Nathan
2015-05-07
Health care workers (HCW) often perform, promote, and advocate use of public funds for animal research (AR); therefore, an awareness of the empirical costs and benefits of animal research is an important issue for HCW. We aim to determine what health-care-workers consider should be acceptable standards of AR methodology and translation rate to humans. After development and validation, an e-mail survey was sent to all pediatricians and pediatric intensive care unit nurses and respiratory-therapists (RTs) affiliated with a Canadian University. We presented questions about demographics, methodology of AR, and expectations from AR. Responses of pediatricians and nurses/RTs were compared using Chi-square, with P < .05 considered significant. Response rate was 44/114(39%) (pediatricians), and 69/120 (58%) (nurses/RTs). Asked about methodological quality, most respondents expect that: AR is done to high quality; costs and difficulty are not acceptable justifications for low quality; findings should be reproducible between laboratories and strains of the same species; and guidelines for AR funded with public money should be consistent with these expectations. Asked about benefits of AR, most thought that there are sometimes/often large benefits to humans from AR, and disagreed that "AR rarely produces benefit to humans." Asked about expectations of translation to humans (of toxicity, carcinogenicity, teratogenicity, and treatment findings), most: expect translation >40% of the time; thought that misleading AR results should occur <21% of the time; and that if translation was to occur <20% of the time, they would be less supportive of AR. There were few differences between pediatricians and nurses/RTs. HCW have high expectations for the methodological quality of, and the translation rate to humans of findings from AR. These expectations are higher than the empirical data show having been achieved. Unless these areas of AR significantly improve, HCW support of AR may be tenuous.
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What constitutes responsiveness of physicians: A qualitative study in rural Bangladesh
George, Asha; Ahmed, Syed Masud; Rashid, Sabina Faiz; Sarker, Malabika
2017-01-01
Responsiveness entails the social actions by health providers to meet the legitimate expectations of patients. It plays a critical role in ensuring continuity and effectiveness of care within people centered health systems. Given the lack of contextualized research on responsiveness, we qualitatively explored the perceptions of outpatient users and providers regarding what constitute responsiveness in rural Bangladesh. An exploratory study was undertaken in Chuadanga, a southwestern Bangladeshi District, involving in-depth interviews of physicians (n = 17) and users (n = 7), focus group discussions with users (n = 4), and observations of patient provider interactions (three weeks). Analysis was guided by a conceptual framework of responsiveness, which includes friendliness, respecting, informing and guiding, gaining trust and optimizing benefits. In terms of friendliness, patients expected physicians to greet them before starting consultations; even though physicians considered this unusual. Patients also expected physicians to hold social talks during consultations, which was uncommon. With regards to respect patients expected physicians to refrain from disrespecting them in various ways; but also by showing respect explicitly. Patients also had expectations related to informing and guiding: they desired explanation on at least the diagnosis, seriousness of illness, treatment and preventive steps. In gaining trust, patients expected that physicians would refrain from illegal or unethical activities related to patients, e.g., demanding money against free services, bringing patients in own private clinics by brokers (dalals), colluding with diagnostic centers, accepting gifts from pharmaceutical representatives. In terms of optimizing benefits: patients expected that physicians should be financially sensitive and consider individual need of patients. There were multiple dimensions of responsiveness- for some, stakeholders had a consensus; context was an important factor to understand them. This being an exploratory study, further research is recommended to validate the nuances of the findings. It can be a guideline for responsiveness practices, and a tipping point for future research. PMID:29253891
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Gerhardt, Andreas; Weidner, Gerdi; Grassmann, Mariel; Spaderna, Heike
2014-04-01
Physical activity (PA) is recommended for stable patients with advanced heart failure (HF). We evaluated expected health benefits of PA and social support as facilitators of PA, and physical symptom distress and psychological distress (depression, anxiety) as barriers to PA. Additionally, we investigated if facilitators of PA are of particular importance for patients who report barriers. We analyzed data assessed at time of waitlisting in 231 ambulatory patients (53.4 ± 10.3 years, 18 % women) who were enrolled in the multisite Waiting for a New Heart Study in 1 Austrian and 16 German hospitals. Self-reported everyday PA scores (number of activities, duration of activities) was regressed on demographic characteristics and indicators of disease severity (ejection fraction, peak oxygen consumption), facilitators (expected health benefits of PA, perceived emotional support, perceived support for PA), and barriers to PA (physical symptom distress, psychological distress). Interaction terms of facilitators with barriers were also examined. PA was positively associated with higher peak oxygen consumption, validating self-reported PA. Regarding facilitators, expected health benefits of PA were independently associated with higher PA (p values < 0.001). There were no main effects for social support on PA. Regarding barriers, depression tended to be associated with fewer activities (p = 0.068). However, in the presence of barriers (depression, physical symptoms), feeling supported for being physically active was positively associated with PA (p values < 0.05). Interventions to improve PA may benefit from strengthening positive expectations of health outcomes associated with everyday PA and fostering PA-specific social support for those distressed by HF symptoms or depression.
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Tuffaha, Haitham W; Reynolds, Heather; Gordon, Louisa G; Rickard, Claire M; Scuffham, Paul A
2014-12-01
Value of information analysis has been proposed as an alternative to the standard hypothesis testing approach, which is based on type I and type II errors, in determining sample sizes for randomized clinical trials. However, in addition to sample size calculation, value of information analysis can optimize other aspects of research design such as possible comparator arms and alternative follow-up times, by considering trial designs that maximize the expected net benefit of research, which is the difference between the expected cost of the trial and the expected value of additional information. To apply value of information methods to the results of a pilot study on catheter securement devices to determine the optimal design of a future larger clinical trial. An economic evaluation was performed using data from a multi-arm randomized controlled pilot study comparing the efficacy of four types of catheter securement devices: standard polyurethane, tissue adhesive, bordered polyurethane and sutureless securement device. Probabilistic Monte Carlo simulation was used to characterize uncertainty surrounding the study results and to calculate the expected value of additional information. To guide the optimal future trial design, the expected costs and benefits of the alternative trial designs were estimated and compared. Analysis of the value of further information indicated that a randomized controlled trial on catheter securement devices is potentially worthwhile. Among the possible designs for the future trial, a four-arm study with 220 patients/arm would provide the highest expected net benefit corresponding to 130% return-on-investment. The initially considered design of 388 patients/arm, based on hypothesis testing calculations, would provide lower net benefit with return-on-investment of 79%. Cost-effectiveness and value of information analyses were based on the data from a single pilot trial which might affect the accuracy of our uncertainty estimation. Another limitation was that different follow-up durations for the larger trial were not evaluated. The value of information approach allows efficient trial design by maximizing the expected net benefit of additional research. This approach should be considered early in the design of randomized clinical trials. © The Author(s) 2014.
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An analysis of online messages about probiotics
2013-01-01
Internet websites are a resource for patients seeking information about probiotics. We examined a sample of 71 websites presenting probiotic information. We found that descriptions of benefits far outnumbered descriptions of risks and commercial websites presented significantly fewer risks than noncommercial websites. The bias towards the presentation of therapeutic benefits in online content suggests that patients are likely interested in using probiotics and may have unrealistic expectations for therapeutic benefit. Gastroenterologists may find it useful to initiate conversations about probiotics within the context of a comprehensive health management plan and should seek to establish realistic therapeutic expectations with their patients. PMID:23311418
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Ralph Alig; Greg Latta; Darius Adams; Bruce McCarl
2009-01-01
The forest sector can contribute to atmospheric greenhouse gas reduction, while also providing other environmental, economic, and social benefits. Policy tools for climate change mitigation include carbon-related payment programs as well as laws and programs to impede the loss of agricultural and forest lands to development. Policy makers will base their expectations...
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ERIC Educational Resources Information Center
Bulawa, Philip
2012-01-01
Different forms of the performance management system have been implemented in many countries for some years. As in other countries, in 1999 the government of Botswana took a decision to implement a performance management system (PMS) across the entire public service including schools. The government explained the purpose for which this reform was…
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Valente, Inês Maria; Rodrigues, José António
2014-01-01
Abstract Cardamonin, as shown by the increasing number of publications, has received growing attention from the scientific community due to the expectations toward its benefits to human health. In this study, research on cardamonin is reviewed, including its natural sources, health promoting aspects, and analytical methods for its determination. Therefore, this article hopes to aid current and future researchers on the search for reliable answers concerning cardamonin's value in medicine. PMID:24433078
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Goodwin, C. Rory; Khattab, Mohamed H.; Sankey, Eric W.; Elder, Benjamin D.; Kosztowski, Thomas A.; Sarabia-Estrada, Rachel; Bydon, Ali; Witham, Timothy F.; Wolinsky, Jean-Paul; Gokaslan, Ziya L.; Sciubba, Daniel M.
2015-01-01
Study Design Retrospective study. Objective Our objective was to identify preoperative prognostic factors associated with survival in patients with spinal metastasis from lung carcinoma. Methods A retrospective analysis of 26 patients diagnosed with lung carcinoma metastatic to the spinal column was performed to determine factors associated with survival. We used 3 months survival as the clinical cutoff for whether surgical intervention should be performed. We analyzed patients who survived less than 3 months compared with those who survived more than 3 months. Demographic, preoperative, operative, and postoperative factors including functional scores were collected for analysis. Results The median survival for all patients in our study was 3.5 months. We found a statistically significant difference between the group that survived less than 3 months and the group that survived greater than 3 months in terms of extrathoracic metastasis, visceral metastasis, and average postoperative modified Rankin score. Conclusion Determining which patients with lung cancer spinal metastases will benefit from surgical intervention is often dictated by the patient's predicted life expectancy. Factors associated with poorer prognosis include age, functional status, visceral metastases, and extrathoracic metastases. Although the prognosis for patients with lung cancer spinal metastases is poor, some patients may experience long-term benefit from surgical intervention. PMID:26430597
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Welfare and Generational Equity in Sustainable Unfunded Pension Systems
Auerbach, Alan J.; Lee, Ronald
2011-01-01
Using stochastic simulations we analyze how public pension structures spread the risks arising from demographic and economic shocks across generations. We consider several actual and hypothetical sustainable PAYGO pension structures, including: (1) versions of the US Social Security system with annual adjustments of taxes or benefits to maintain fiscal balance; (2) Sweden’s Notional Defined Contribution system and several variants developed to improve fiscal stability; and (3) the German system, which also includes annual adjustments to maintain fiscal balance. For each system, we present descriptive measures of uncertainty in representative outcomes for a typical generation and across generations. We then estimate expected utility for generations based on simplifying assumptions and incorporate these expected utility calculations in an overall social welfare measure. Using a horizontal equity index, we also compare the different systems’ performance in terms of how neighboring generations are treated. While the actual Swedish system smoothes stochastic fluctuations more than any other and produces the highest degree of horizontal equity, it does so by accumulating a buffer stock of assets that alleviates the need for frequent adjustments. In terms of social welfare, this accumulation of assets leads to a lower average rate of return that more than offsets the benefits of risk reduction, leaving systems with more frequent adjustments that spread risks broadly among generations as those most preferred. PMID:21818166
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Consumer Opinions of Health Information Exchange, e-Prescribing, and Personal Health Records.
Cochran, Gary L; Lander, Lina; Morien, Marsha; Lomelin, Daniel E; Brittin, Jeri; Reker, Celeste; Klepser, Donald G
2015-01-01
Consumer satisfaction is a crucial component of health information technology (HIT) utilization, as high satisfaction is expected to increase HIT utilization among providers and to allow consumers to become full participants in their own healthcare management. The primary objective of this pilot study was to identify consumer perspectives on health information technologies including health information exchange (HIE), e-prescribing (e-Rx), and personal health records (PHRs). Eight focus groups were conducted in seven towns and cities across Nebraska in 2013. Each group consisted of 10-12 participants. Discussions were organized topically in the following categories: HIE, e-Rx, and PHR. The qualitative analysis consisted of immersion and crystallization to develop a coding scheme that included both preconceived and emergent themes. Common themes across focus groups were identified and compiled for each discussion category. The study had 67 participants, of which 18 (27 percent) were male. Focus group findings revealed both perceived barriers and benefits to the adoption of HIT. Common HIT concerns expressed across focus groups included privacy and security of medical information, decreases in quality of care, inconsistent provider participation, and the potential cost of implementation. Positive expectations regarding HIT included better accuracy and completeness of information, and improved communication and coordination between healthcare providers. Improvements in patient care were expected as a result of easy physician access to consolidated information across providers as well as the speed of sharing and availability of information in an emergency. In addition, participants were optimistic about patient empowerment and convenient access to and control of personal health data. Consumer concerns focused on privacy and security of the health information, as well as the cost of implementing the technologies and the possibility of an unintended negative impact on the quality of care. While negative perceptions present barriers for potential patient acceptance, benefits such as speed and convenience, patient oversight of health data, and safety improvements may counterbalance these concerns.
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Consumer Opinions of Health Information Exchange, e-Prescribing, and Personal Health Records
Cochran, Gary L.; Lander, Lina; Morien, Marsha; Lomelin, Daniel E.; Brittin, Jeri; Reker, Celeste; Klepser, Donald G.
2015-01-01
Background Consumer satisfaction is a crucial component of health information technology (HIT) utilization, as high satisfaction is expected to increase HIT utilization among providers and to allow consumers to become full participants in their own healthcare management. Objective The primary objective of this pilot study was to identify consumer perspectives on health information technologies including health information exchange (HIE), e-prescribing (e-Rx), and personal health records (PHRs). Methods Eight focus groups were conducted in seven towns and cities across Nebraska in 2013. Each group consisted of 10–12 participants. Discussions were organized topically in the following categories: HIE, e-Rx, and PHR. The qualitative analysis consisted of immersion and crystallization to develop a coding scheme that included both preconceived and emergent themes. Common themes across focus groups were identified and compiled for each discussion category. Results The study had 67 participants, of which 18 (27 percent) were male. Focus group findings revealed both perceived barriers and benefits to the adoption of HIT. Common HIT concerns expressed across focus groups included privacy and security of medical information, decreases in quality of care, inconsistent provider participation, and the potential cost of implementation. Positive expectations regarding HIT included better accuracy and completeness of information, and improved communication and coordination between healthcare providers. Improvements in patient care were expected as a result of easy physician access to consolidated information across providers as well as the speed of sharing and availability of information in an emergency. In addition, participants were optimistic about patient empowerment and convenient access to and control of personal health data. Conclusion Consumer concerns focused on privacy and security of the health information, as well as the cost of implementing the technologies and the possibility of an unintended negative impact on the quality of care. While negative perceptions present barriers for potential patient acceptance, benefits such as speed and convenience, patient oversight of health data, and safety improvements may counterbalance these concerns. PMID:26604874
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Wise, Robert A; Bartlett, Susan J; Brown, Ellen D; Castro, Mario; Cohen, Rubin; Holbrook, Janet T; Irvin, Charles G; Rand, Cynthia S; Sockrider, Marianna M; Sugar, Elizabeth A
2009-09-01
Information that enhances expectations about drug effectiveness improves the response to placebos for pain. Although asthma symptoms often improve with placebo, it is not known whether the response to placebo or active treatment can be augmented by increasing expectation of benefit. The study objective was to determine whether response to placebo or a leukotriene antagonist (montelukast) can be augmented by messages that increase expectation of benefit. A randomized 20-center controlled trial enrolled 601 asthmatic patients with poor symptom control who were assigned to one of 5 study groups. Participants were randomly assigned to one of 4 treatment groups in a factorial design (ie, placebo with enhanced messages, placebo with neutral messages, montelukast with enhanced messages, or montelukast with neutral messages) or to usual care. Assignment to study drug was double masked, assignment to message content was single masked, and usual care was not masked. The enhanced message aimed to increase expectation of benefit from the drug. The primary outcome was mean change in daily peak flow over 4 weeks. Secondary outcomes included lung function and asthma symptom control. Peak flow and other lung function measures were not improved in participants assigned to the enhanced message groups versus the neutral messages groups for either montelukast or placebo; no differences were noted between the neutral placebo and usual care groups. Placebo-treated participants had improved asthma control with the enhanced message but not montelukast-treated participants; the neutral placebo group did have improved asthma control compared with the usual care group after adjusting for baseline difference. Headaches were more common in participants provided messages that mentioned headache as a montelukast side effect. Optimistic drug presentation augments the placebo effect for patient-reported outcomes (asthma control) but not lung function. However, the effect of montelukast was not enhanced by optimistic messages regarding treatment effectiveness.
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Should patients with Björk-Shiley valves undergo prophylactic replacement?
Birkmeyer, J D; Marrin, C A; O'Connor, G T
1992-08-29
About 85,000 patients have undergone replacement of diseased heart valves with prosthetic Björk-Shiley convexo-concave (CC) valves. These valves are prone to fracture of the outlet strut, which leads to acute valve failure that is usually fatal. Should patients with these valves undergo prophylactic replacement to avoid fracture? The incidence of strut fracture varies between 0% and 1.5% per year, depending on valve opening angle (60 degrees or 70 degrees), diameter (less than 29 mm or greater than or equal to 29 mm), and location (aortic or mitral). Other factors include the patient's life expectancy and the expected morbidity and mortality associated with reoperation. We have used decision analysis to identify the patients most likely to benefit from prophylactic reoperation. The incidence of outlet strut fracture was estimated from the data of three large studies on CC valves, and stratified by opening angle, diameter, and location. A Markov decision analysis model was used to estimate life expectancy for patients undergoing prophylactic valve replacement and for those not undergoing reoperation. Prophylactic valve replacement does not benefit patients with CC valves that have low strut fracture risks (60 degrees aortic valves and less than 29 mm, 60 degrees mitral valves). For most patients with CC valves that have high strut fracture risks (greater than or equal to 29 mm, 70 degrees CC), prophylactic valve replacement increases life expectancy. However, elderly patients with such valves benefit from prophylactic reoperation only if the risk of operative mortality is low. Patient age and operative risk are most important in recommendations for patients with CC valves that have intermediate strut fracture risks (less than 29 mm, 70 degrees valves and greater than or equal to 29 mm, 60 degrees mitral valves). For all patients and their doctors facing the difficult decision on whether to replace CC valves, individual estimates of operative mortality risk that take account of both patient-specific and institution-specific factors are essential.
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Ponicki, William R; Gruenewald, Paul J; LaScala, Elizabeth A
2007-05-01
There is a considerable body of prior research indicating that a number of public policies that limit alcohol availability affect youth traffic fatalities. These limitations can be economic (e.g., beverage taxation), physical (e.g., numbers or operating hours of alcohol outlets), or demographic (e.g., minimum legal drinking age). The estimated impacts of these policies differ widely across studies. A full-price theoretical approach suggests that people weigh the benefits of drinking against the sum of all the associated costs, including the price of the beverages themselves plus the difficulty of obtaining them and any additional risks of injury or punishment related to their use. This study tested one prediction of this model, namely that the impact from changing one availability-related cost depends on the level of other components of full cost. The current analyses concentrate on 2 forms of limitations on availability that have been shown to affect youth traffic fatalities: minimum legal drinking age (MLDA) laws and beer taxes. The interdependence between the impacts of MLDA and taxes is investigated using a panel of 48 US states over the period 1975 to 2001. All age-group-specific models control for numerous other variables previously shown to affect vehicle fatalities, as well as fixed effects to account for unexplained crosssectional and time-series variation. The analyses showed that raising either MLDA or beer taxes in isolation led to fewer youth traffic fatalities. As expected, a given change in MLDA causes a larger proportional change in fatalities when beer taxes are low than when they are high. These findings suggest that a community's expected benefit from a proposed limitation on alcohol availability depends on its current regulatory environment. Specifically, communities with relatively strong existing policies might expect smaller impacts than suggested by prior research, while places with weak current regulations might expect larger benefits from the same policy initiative.
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Overview of the Telescience Testbed Program
NASA Technical Reports Server (NTRS)
Rasmussen, Daryl N.; Mian, Arshad; Leiner, Barry M.
1991-01-01
The NASA's Telescience Testbed Program (TTP) conducted by the Ames Research Center is described with particular attention to the objectives, the approach used to achieve these objectives, and the expected benefits of the program. The goal of the TTP is to gain operational experience for the Space Station Freedom and the Earth Observing System programs, using ground testbeds, and to define the information and communication systems requirements for the development and operation of these programs. The results of TTP are expected to include the requirements for the remote coaching, command and control, monitoring and maintenance, payload design, and operations management. In addition, requirements for technologies such as workstations, software, video, automation, data management, and networking will be defined.
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Decision-Making Regarding Mammography Screening for Older Women.
Schonberg, Mara A
2016-12-01
The population is aging, and breast cancer incidence increases with age, peaking between the ages of 75 and 79. However, it is not known whether mammography screening helps women aged 75 and older live longer because they have not been included in randomized controlled trials evaluating mammography screening. Guidelines recommend that older women with less than a 10-year life expectancy not be screened because it takes approximately 10 years before a screen-detected breast cancer may affect an older woman's survival. Guidelines recommend that clinicians discuss the benefits and risks of screening with women aged 75 and older with a life expectancy of 10 years or longer to help them elicit their values and preferences. It is estimated that two of 1,000 women who continue to be screened every other year from age 70 to 79 may avoid breast cancer death, but 12% to 27% of these women will experience a false-positive test, and 10% to 20% of women who experience a false-positive test will undergo a breast biopsy. In addition, approximately 30% of screen-detected cancers would not otherwise have shown up in an older woman's lifetime, yet nearly all older women undergo treatment for these breast cancers, and the risks of treatment increase with age. To inform decision-making, tools are available to estimate life expectancy and to educate older women about the benefits and harms of mammography screening. Guides are also available to help clinicians discuss stopping screening with older women with less than a 10-year life expectancy. Ideally, screening decisions would consider an older woman's life expectancy, breast cancer risk, and her values and preferences. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.
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High-precision radiometric tracking for planetary approach and encounter in the inner solar system
NASA Technical Reports Server (NTRS)
Christensen, C. S.; Thurman, S. W.; Davidson, J. M.; Finger, M. H.; Folkner, W. M.
1989-01-01
The benefits of improved radiometric tracking data have been studied for planetary approach within the inner Solar System using the Mars Rover Sample Return trajectory as a model. It was found that the benefit of improved data to approach and encounter navigation was highly dependent on the a priori uncertainties assumed for several non-estimated parameters, including those for frame-tie, Earth orientation, troposphere delay, and station locations. With these errors at their current levels, navigational performance was found to be insensitive to enhancements in data accuracy. However, when expected improvements in these errors are modeled, performance with current-accuracy data significantly improves, with substantial further improvements possible with enhancements in data accuracy.
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Analyzing qualitative data with computer software.
Weitzman, E A
1999-01-01
OBJECTIVE: To provide health services researchers with an overview of the qualitative data analysis process and the role of software within it; to provide a principled approach to choosing among software packages to support qualitative data analysis; to alert researchers to the potential benefits and limitations of such software; and to provide an overview of the developments to be expected in the field in the near future. DATA SOURCES, STUDY DESIGN, METHODS: This article does not include reports of empirical research. CONCLUSIONS: Software for qualitative data analysis can benefit the researcher in terms of speed, consistency, rigor, and access to analytic methods not available by hand. Software, however, is not a replacement for methodological training. PMID:10591282
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NASA Astrophysics Data System (ADS)
Bessler, Wolfgang; Holler, Julian
Based on the belief that hedge funds are able to generate positive risk-adjusted returns (alpha) and diversification benefits in a portfolio context, many investors have included hedge funds in their asset allocation in order to optimize the risk-return trade-off of their investments. We provide evidence that more optimistic prior beliefs about expected risk-adjusted returns (alpha) lead to higher allocations into hedge funds. It appears, however, that history may not be the best guide for future fund performance and that the diversification benefits have declined over time. One reason for the lower risk-adjusted returns is a capacity effect in that previously exceptional hedge fund returns caused higher inflows to these funds and consequently a competition for alpha among investors. In our empirical analysis we provide additional evidence of other explanations for decreasing hedge fund benefits such as an increase in correlations with other asset classes and changes in the style composition of hedge funds.
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NASA Technical Reports Server (NTRS)
Hazelrigg, G. A., Jr.; Heiss, K. P.
1974-01-01
An overview of the ERTS program is given to determine the magnitude of the benefits that can be reasonably expected to flow from an Earth Resources Survey (ERS) Program, and to assess the benefits foregone in the event of a one or two-year gap in ERS services. An independent evaluation of the benefits attributable to ERS-derived information in key application areas is presented. These include two case studies in agriculture-distribution, production and import/export, and one study in water management. The cost-effectiveness of satellites in an ERS system is studied by means of a land cover case study. The annual benefits achieveable from an ERS system are measured by the in-depth case studies to be in the range of $430 to $746 million. Benefits foregone in the event of a one-year gap in ERS service are estimated to be $147 to $220 million and $274 to $420 million for a two-year gap in ERS service.
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Psychological determinants of exercise behavior of nursing students.
Chan, Joanne Chung-Yan
2014-01-01
Though expected to be role models in health promotion, research has shown that nursing students often have suboptimal exercise behavior. This study explored the psychological factors associated with the exercise behavior of nursing students. A total of 195 first-year undergraduate nursing students completed a cross-sectional quantitative survey questionnaire, which included measures of their exercise behavior, the Physical Exercise Self-efficacy Scale, and the Exercise Barriers/Benefits Scale. The results showed that male students spent more time exercising and had higher exercise self-efficacy compared with female students, but there were no gender differences in the perceived barriers to or benefits of exercise. Fatigue brought on by exercising was the greatest perceived barrier to exercise, whereas increasing physical fitness and mental health were the greatest perceived benefits of exercise. Multiple linear regression showed that gender, exercise self-efficacy, perceived barriers to exercise, and perceived benefits of exercise were independent predictors of exercise behavior. Nurse educators can endeavor to promote exercise behavior among nursing students by highlighting the specific benefits of exercise, empowering students to overcome their perceived barriers to exercise, and enhancing students' exercise self-efficacy.
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Kim, Sang Hyuck; Shin, Dong Wook; Nam, You-Seon; Kim, So Young; Yang, Hyung-Kook; Cho, Be Long; Park, Keeho; Jo, Heui-Sug; Yim, Chang-Yeol; Kam, Sin; Park, Jong-Hyock
2016-10-01
This study sought to identify discrepancies between the expectations of patients with cancer and oncologists regarding the efficacy of complementary and alternative medicines (CAMs), and to determine how patients evaluate CAM efficacy after its use. Data from the Cancer Patient Experience Study, a nationwide survey, were used. Seven subdivided efficacy domains were included in the survey. An oncologist-patient matching analysis was done to assess the concordance of CAM efficacies between oncologists and patients with cancer. In addition, the patients' expectations of CAM efficacies were compared before and after use. Out of 719 participants, 201 patients with cancer (28.0%) reported using CAMs. The patients with cancer generally tended to be more positive about CAM efficacies than the oncologists. The largest discrepancy in efficacy perception was found in the efficacy domain of survival benefit, which included complete disease remission and prolonged survival. Many patients reported that they did not experience the positive efficacy they had anticipated before use. However, a substantial proportion of patients indicated that CAMs were as effective as they had expected, even though there is little evidence supporting the CAM efficacies. There was a marked discrepancy and a lack of concordance in expectations of CAM efficacy between patients with cancer and oncologists. Better communication between the patients and oncologists regarding CAM efficacy would be needed to make the patients to have shared expectations, and to reduce unnecessary CAM use. Copyright © 2016. Published by Elsevier Ltd.
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Lakdawalla, Darius N; Chou, Jacquelyn W; Linthicum, Mark T; MacEwan, Joanna P; Zhang, Jie; Goldman, Dana P
2015-05-01
Surrogate end points may be used as proxy for more robust clinical end points. One prominent example is the use of progression-free survival (PFS) as a surrogate for overall survival (OS) in trials for oncologic treatments. Decisions based on surrogate end points may expedite regulatory approval but may not accurately reflect drug efficacy. Payers and clinicians must balance the potential benefits of earlier treatment access based on surrogate end points against the risks of clinical uncertainty. To present a framework for evaluating the expected net benefit or cost of providing early access to new treatments on the basis of evidence of PFS benefits before OS results are available, using non-small-cell lung cancer (NSCLC) as an example. A probabilistic decision model was used to estimate expected incremental social value of the decision to grant access to a new treatment on the basis of PFS evidence. The model analyzed a hypothetical population of patients with NSCLC who could be treated during the period between PFS and OS evidence publication. Estimates for delay in publication of OS evidence following publication of PFS evidence, expected OS benefit given PFS benefit, incremental cost of new treatment, and other parameters were drawn from the literature on treatment of NSCLC. Incremental social value of early access for each additional patient per month (in 2014 US dollars). For "medium-value" model parameters, early reimbursement of drugs with any PFS benefit yields an incremental social cost of more than $170,000 per newly treated patient per month. In contrast, granting early access on the basis of PFS benefit between 1 and 3.5 months produces more than $73,000 in incremental social value. Across the full range of model parameter values, granting access for drugs with PFS benefit between 3 and 3.5 months is robustly beneficial, generating incremental social value ranging from $38,000 to more than $1 million per newly treated patient per month, whereas access for all drugs with any PFS benefit is usually not beneficial. The value of providing access to new treatments on the basis of surrogate end points, and PFS in particular, likely varies considerably. Payers and clinicians should carefully consider how to use PFS data in balancing potential benefits against costs in each particular disease.
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Oberste, Max; Hartig, Philipp; Bloch, Wilhelm; Elsner, Benjamin; Predel, Hans-Georg; Ernst, Bernhard; Zimmer, Philipp
2017-01-01
Introduction: Many studies report improvements in cognitive performance following acute endurance exercise compared to control group treatment. These cognitive benefits are interpreted as a result of a physiological response to exercise. However, it was also hypothesized that expectation-driven placebo effects account for these positive effects. The purpose of this study was to investigate the differences between expectations for cognitive benefits toward acute endurance exercise and multiple control group treatments. Methods: Healthy individuals ( N = 247, 24.26 ± 3.88 years) were randomized to eight different groups watching videos of a moderate, a vigorous exercise treatment or one control group treatment (waiting, reading, video-watching, stretching, myofascial release workout, and very light exercise). Then, they were introduced to three commonly used cognitive test procedures in acute exercise-cognition research (Stroop-test, Trail-Making-test, Free-recall-task). Participants rated the effect they would expect on their performance in those tasks, if they had received the treatment shortly before the task, on an 11-point Likert scale. Results: No significantly different expectations for cognitive benefits toward acute moderate exercise and control group treatments could be revealed. Participants expected significantly worse performance following vigorous exercise compared to following waiting and stretching for all cognitive tests. Significantly worse performance after vigorous exercise compared to after very light exercise was expected for Stroop and Free-recall. For Free-recall, participants expected worse performance after vigorous exercise compared to myofascial release training as well. Conclusion: Our results indicate that expectation-driven placebo effects are unlikely to cause the reported greater cognitive improvements following acute moderate and vigorous endurance exercise compared to following common control group treatments.
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Oberste, Max; Hartig, Philipp; Bloch, Wilhelm; Elsner, Benjamin; Predel, Hans-Georg; Ernst, Bernhard; Zimmer, Philipp
2017-01-01
Introduction: Many studies report improvements in cognitive performance following acute endurance exercise compared to control group treatment. These cognitive benefits are interpreted as a result of a physiological response to exercise. However, it was also hypothesized that expectation-driven placebo effects account for these positive effects. The purpose of this study was to investigate the differences between expectations for cognitive benefits toward acute endurance exercise and multiple control group treatments. Methods: Healthy individuals (N = 247, 24.26 ± 3.88 years) were randomized to eight different groups watching videos of a moderate, a vigorous exercise treatment or one control group treatment (waiting, reading, video-watching, stretching, myofascial release workout, and very light exercise). Then, they were introduced to three commonly used cognitive test procedures in acute exercise-cognition research (Stroop-test, Trail-Making-test, Free-recall-task). Participants rated the effect they would expect on their performance in those tasks, if they had received the treatment shortly before the task, on an 11-point Likert scale. Results: No significantly different expectations for cognitive benefits toward acute moderate exercise and control group treatments could be revealed. Participants expected significantly worse performance following vigorous exercise compared to following waiting and stretching for all cognitive tests. Significantly worse performance after vigorous exercise compared to after very light exercise was expected for Stroop and Free-recall. For Free-recall, participants expected worse performance after vigorous exercise compared to myofascial release training as well. Conclusion: Our results indicate that expectation-driven placebo effects are unlikely to cause the reported greater cognitive improvements following acute moderate and vigorous endurance exercise compared to following common control group treatments. PMID:29276483
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Harris, Connie; Shannon, Ronald
2008-01-01
A Canadian specialty nursing association identified the necessity to examine the role and impact of enterostomal (ET) nursing in Canada. We completed a retrospective analysis of the cost-effectiveness and benefits of ET nurse-driven resources for the treatment of acute and chronic wounds in the community. This was a multicenter retrospective pragmatic chart audit of 3 models of nursing care utilizing 4 community nursing agencies and 1 specialty company owned and operated by ET nurses. An analysis was completed using quantitative methods to evaluate healing outcomes, nursing costs, and cost-effectiveness. Kaplan-Meier estimates were calculated to determine the average time to 100% healing of acute and chronic wounds and total nursing visit costs for treatment in a community setting. Average direct nursing costs related to management of each wound were determined by number of nursing visits and related reimbursement for each visit. A Monte Carlo simulation method was used to help account for costs and benefits in determination of cost-effectiveness between caring groups and the uncertainty from variation between patients and wounds. Three hundred sixty chronic wounds and 54 acute surgical wound charts were audited. Involvement of a registered nurse (RN) with ET or advanced wound ostomy skills (AWOS) in community-level chronic and acute wound care was associated with lower overall costs mainly due to reduced time to 100% closure of the wound and reduced number of nursing visits. The differences in health benefits and total costs of nursing care between the ET/AWOS and a hybrid group that includes interventions developed by an ET nurse and followed by general visiting nurses that could include both RNs and registered practical nurses is an expected reduction in healing times of 45 days and an expected cost difference of $5927.00 per chronic wound treated. When outcomes were broken into ET/AWOS involvement categories for treatment of chronic wounds, there was a significantly faster time to 100% closure at a lower mean cost as the ET/AWOS involvement increased in the case. For acute wound treatment, the differences in health benefits and total costs between the ET/AWOS and a hybrid nursing care model were an expected reduction in healing times of 95 days and an expected cost difference of $9578.00 per acute wound treated. Again, there was a significant difference in healing times and reduced mean cost as the ET/AWOS became more involved in the treatment. The financial benefit to the Ontario Ministry of Health and Long-Term Care is estimated to increase as the involvement of nurses with ET/AWOS specialty training increases. The greater the involvement both directly and indirectly of an ET/AWOS nurse in the management of wounds, the greater the savings and the shorter the healing times.
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Martial arts as sport and therapy.
Burke, D T; Al-Adawi, S; Lee, Y T; Audette, J
2007-03-01
The term Martial Arts is often used as general phrase to describe many of the combat arts, which have developed in eastern cultures over the past millennium. This paper reviews the Martial Arts from the original context of a trio of life skills. This trio includes the healing arts such as acupuncture, the self-exploration arts such as yoga, and the vital life skills such as meditation. As Martial Arts suggests the waging of combat, the origins of the most common combat arts are reviewed, with an overview of the difference between the hard and the soft styles. The arts developed not only in the eastern, but also in all parts of the world, with references of these types of combats arts in the writings of the ancient Egyptians and Greeks. In modern times, the combat arts are performed for both exercise and sport. A review of the injuries that occur, and the health benefits that might be expected are discussed. A review of the medical literature that demonstrates some of these health benefits is included, with Tai Chi Chuan as the most studied of these. The health benefits discussed include strengthen and self-efficacy of the elderly, reduced falls, increased exercise capacity, and benefits to the immune system and autonomic nervous system. The paper emphasized the breadth of the Martial Arts and the import of these to the sports and health community.
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Increasing Enrollment through Benefit Segmentation.
ERIC Educational Resources Information Center
Goodnow, Betty
1982-01-01
The applicability of benefit segmentation, a market research technique which groups people according to benefits expected from a program offering, was tested at the College of DuPage. Preferences and demographic characteristics were analyzed and program improvements adopted, increasing enrollment by 20 percent. (Author/SK)
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Bollaerts, Kaatje; De Smedt, Tom; Donegan, Katherine; Titievsky, Lina; Bauchau, Vincent
2018-03-26
New vaccines are launched based on their benefit-risk (B/R) profile anticipated from clinical development. Proactive post-marketing surveillance is necessary to assess whether the vaccination uptake and the B/R profile are as expected and, ultimately, whether further public health or regulatory actions are needed. There are several, typically not integrated, facets of post-marketing vaccine surveillance: the surveillance of vaccination coverage, vaccine safety, effectiveness and impact. With this work, we aim to assess the feasibility and added value of using an interactive dashboard as a potential methodology for near real-time monitoring of vaccine coverage and pre-specified health benefits and risks of vaccines. We developed a web application with an interactive dashboard for B/R monitoring. The dashboard is demonstrated using simulated electronic healthcare record data mimicking the introduction of rotavirus vaccination in the UK. The interactive dashboard allows end users to select certain parameters, including expected vaccine effectiveness, age groups, and time periods and allows calculation of the incremental net health benefit (INHB) as well as the incremental benefit-risk ratio (IBRR) for different sets of preference weights. We assessed the potential added value of the dashboard by user testing amongst a range of stakeholders experienced in the post-marketing monitoring of vaccines. The dashboard was successfully implemented and demonstrated. The feedback from the potential end users was generally positive, although reluctance to using composite B/R measures was expressed. The use of interactive dashboards for B/R monitoring is promising and received support from various stakeholders. In future research, the use of such an interactive dashboard will be further tested with real-life data as opposed to simulated data.
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Agapova, Maria; Devine, Emily Beth; Bresnahan, Brian W; Higashi, Mitchell K; Garrison, Louis P
2014-09-01
Health agencies making regulatory marketing-authorization decisions use qualitative and quantitative approaches to assess expected benefits and expected risks associated with medical interventions. There is, however, no universal standard approach that regulatory agencies consistently use to conduct benefit-risk assessment (BRA) for pharmaceuticals or medical devices, including for imaging technologies. Economics, health services research, and health outcomes research use quantitative approaches to elicit preferences of stakeholders, identify priorities, and model health conditions and health intervention effects. Challenges to BRA in medical devices are outlined, highlighting additional barriers in radiology. Three quantitative methods--multi-criteria decision analysis, health outcomes modeling and stated-choice survey--are assessed using criteria that are important in balancing benefits and risks of medical devices and imaging technologies. To be useful in regulatory BRA, quantitative methods need to: aggregate multiple benefits and risks, incorporate qualitative considerations, account for uncertainty, and make clear whose preferences/priorities are being used. Each quantitative method performs differently across these criteria and little is known about how BRA estimates and conclusions vary by approach. While no specific quantitative method is likely to be the strongest in all of the important areas, quantitative methods may have a place in BRA of medical devices and radiology. Quantitative BRA approaches have been more widely applied in medicines, with fewer BRAs in devices. Despite substantial differences in characteristics of pharmaceuticals and devices, BRA methods may be as applicable to medical devices and imaging technologies as they are to pharmaceuticals. Further research to guide the development and selection of quantitative BRA methods for medical devices and imaging technologies is needed. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.
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Liang, Jie; Zhong, Minzhou; Zeng, Guangming; Chen, Gaojie; Hua, Shanshan; Li, Xiaodong; Yuan, Yujie; Wu, Haipeng; Gao, Xiang
2017-02-01
Land-use change has direct impact on ecosystem services and alters ecosystem services values (ESVs). Ecosystem services analysis is beneficial for land management and decisions. However, the application of ESVs for decision-making in land use decisions is scarce. In this paper, a method, integrating ESVs to balance future ecosystem-service benefit and risk, is developed to optimize investment in land for ecological conservation in land use planning. Using ecological conservation in land use planning in Changsha as an example, ESVs is regarded as the expected ecosystem-service benefit. And uncertainty of land use change is regarded as risk. This method can optimize allocation of investment in land to improve ecological benefit. The result shows that investment should be partial to Liuyang City to get higher benefit. The investment should also be shifted from Liuyang City to other regions to reduce risk. In practice, lower limit and upper limit for weight distribution, which affects optimal outcome and selection of investment allocation, should be set in investment. This method can reveal the optimal spatial allocation of investment to maximize the expected ecosystem-service benefit at a given level of risk or minimize risk at a given level of expected ecosystem-service benefit. Our results of optimal analyses highlight tradeoffs between future ecosystem-service benefit and uncertainty of land use change in land use decisions. Copyright © 2016 Elsevier B.V. All rights reserved.
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Coverage of genetic technologies under national health reform.
Mehlman, M. J.; Botkin, J. R.; Scarrow, A.; Woodhall, A.; Kass, J.; Siebenschuh, E.
1994-01-01
This article examines the extent to which the technologies expected to emerge from genetic research are likely to be covered under Government-mandated health insurance programs such as those being proposed by advocates of national health reform. Genetic technologies are divided into three broad categories; genetic information services, including screening, testing, and counseling; experimental technologies; and gene therapy. This article concludes that coverage of these technologies under national health reform is uncertain. The basic benefits packages provided for in the major health reform plans are likely to provide partial coverage of experimental technologies; relatively broad coverage of information services; and varying coverage of gene therapies, on the basis of an evaluation of their costs, benefits, and the degree to which they raise objections on political and religious grounds. Genetic services that are not included in the basic benefits package will be available only to those who can purchase supplemental insurance or to those who can purchase the services with personal funds. The resulting multitiered system of access to genetic services raises serious questions of fairness. PMID:7977343
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Pharmacy practice department chairs' perspectives on part-time faculty members.
Fjortoft, Nancy; Winkler, Susan R; Mai, Thy
2012-05-10
To identify the benefits and consequences of having part-time faculty members in departments of pharmacy practice from the department chair's perspective. A stratified purposive sample of 12 pharmacy practice department chairs was selected. Eleven telephone interviews were conducted. Two investigators independently read interview notes and categorized and enumerated responses to determine major themes using content analysis. The investigators jointly reviewed the data and came to consensus on major themes. Benefits of allowing full-time faculty members to reduce their position to part-time included faculty retention and improved individual faculty work/life balance. Consequences of allowing part-time faculty positions included the challenges of managing individual and departmental workloads, the risk of marginalizing part-time faculty members, and the challenges of promotion and tenure issues. All requests to switch to part-time status were faculty-driven and most were approved. There are a variety of benefits and consequences of having part-time faculty in pharmacy practice departments from the chair's perspective. Clear faculty and departmental expectations of part-time faculty members need to be established to ensure optimal success of this working arrangement.
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Kuklinski, Margaret R; Fagan, Abigail A; Hawkins, J David; Briney, John S; Catalano, Richard F
2015-06-01
To determine whether the Communities That Care (CTC) prevention system is a cost-beneficial intervention. Data were from a longitudinal panel of 4,407 youth participating in a randomized controlled trial including 24 towns in 7 states, matched in pairs within state and randomly assigned to condition. Significant differences favoring intervention youth in sustained abstinence from delinquency, alcohol use, and tobacco use through Grade 12 were monetized and compared to economic investment in CTC. CTC was estimated to produce $4,477 in benefits per youth (discounted 2011 dollars). It cost $556 per youth to implement CTC for 5 years. The net present benefit was $3,920. The benefit-cost ratio was $8.22 per dollar invested. The internal rate of return was 21%. Risk that investment would exceed benefits was minimal. Investment was expected to be recouped within 9 years. Sensitivity analyses in which effects were halved yielded positive cost-beneficial results. CTC is a cost-beneficial, community-based approach to preventing initiation of delinquency, alcohol use, and tobacco use. CTC is estimated to generate economic benefits that exceed implementation costs when disseminated with fidelity in communities.
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Exploration of the validity of weak magnets as a suitable placebo in trials of magnetic therapy.
Greaves, C J; Harlow, T N
2008-06-01
To investigate whether 50 mT magnetic bracelets would be suitable as a placebo control condition for studying the pain relieving effects of higher strength magnetic bracelets in arthritis. Randomised controlled comparison between groups given either a weak 50 mT or a higher strength 180 mT magnetic bracelets to test. Four arthritis support groups in Devon, UK. One hundred sixteen people with osteoarthritis and rheumatoid arthritis. Beliefs about group allocation and expectation of benefit. There was no significant difference between groups in beliefs about allocation to the 'active magnet' group. Participants were however more likely to have an expectation of benefit (pain relief) with the higher strength magnetic bracelets. Asking about perceived group allocation is not sufficient to rule out placebo effects in trials of magnetic bracelets which use weak magnets as a control condition. There are differences in expectation of benefit between different magnet strengths.
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Willan, Andrew R; Eckermann, Simon
2012-10-01
Previous applications of value of information methods for determining optimal sample size in randomized clinical trials have assumed no between-study variation in mean incremental net benefit. By adopting a hierarchical model, we provide a solution for determining optimal sample size with this assumption relaxed. The solution is illustrated with two examples from the literature. Expected net gain increases with increasing between-study variation, reflecting the increased uncertainty in incremental net benefit and reduced extent to which data are borrowed from previous evidence. Hence, a trial can become optimal where current evidence is sufficient assuming no between-study variation. However, despite the expected net gain increasing, the optimal sample size in the illustrated examples is relatively insensitive to the amount of between-study variation. Further percentage losses in expected net gain were small even when choosing sample sizes that reflected widely different between-study variation. Copyright © 2011 John Wiley & Sons, Ltd.
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Advertising, expectations and informed consent: the contents and functions of acupuncture leaflets.
Bishop, Felicity L; Salmon, Cathy
2013-12-01
To evaluate the content of patient information leaflets about acupuncture. 401 patient information leaflets were obtained from practising UK acupuncturists and subjected to content and thematic analysis. 59% of included leaflets were from NHS physiotherapists. Almost all the leaflets defined acupuncture and the majority explained how it might work, described the treatment process and placed it in a historical context. Most described possible benefits and risks of acupuncture and discussed contraindications and safety. Just under a third of leaflets (120, 30%) suggested conditions that might be helped by acupuncture, most commonly musculoskeletal pain, arthritis and injuries. By emphasising differences between individuals in acupuncture treatments and responsiveness, the leaflets fostered hope for positive effects without making any guarantees. Information leaflets are broadly consistent with the evidence for acupuncture, but some claims are inconsistent with official advice from advertising regulators. An ethically sound, scientifically grounded and psychologically effective leaflet should accurately convey both benefits and risks of treatment, optimise patients' expectations and allay concerns about needling. This study suggests that acupuncture leaflets might achieve these multiple functions but care should be taken to ensure adequate coverage of risks.
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Keuffel, Eric; Jaskiewicz, Wanda; Paphassarang, Chanthakhath; Tulenko, Kate
2013-11-01
Many developing countries are examining whether to institute incentive packages that increase the share of health workers who opt to locate in rural settings; however, uncertainty exists with respect to the expected net cost (or benefit) from these packages. We utilize the findings from the discrete choice experiment surveys applied to students training to be health professionals and costing analyses in Lao People's Democratic Republic to model the anticipated effect of incentive packages on new worker location decisions and direct costs. Incorporating evidence on health worker density and health outcomes, we then estimate the expected 5-year net cost (or benefit) of each incentive packages for 3 health worker cadres--physicians, nurses/midwives, and medical assistants. Under base case assumptions, the optimal incentive package for each cadre produced a 5-year net benefit (maximum net benefit for physicians: US$ 44,000; nurses/midwives: US$ 5.6 million; medical assistants: US$ 485,000). After accounting for health effects, the expected net cost of select incentive packages would be substantially less than the original estimate of direct costs. In the case of Lao People's Democratic Republic, incentive packages that do not invest in capital-intensive components generally should produce larger net benefits. Combining discrete choice experiment surveys, costing surveys and cost-benefit analysis methods may be replicated by other developing countries to calculate whether health worker incentive packages are viable policy options.
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A benefit-cost framework of motivation for a specific activity.
Studer, B; Knecht, S
2016-01-01
How can an individual be motivated to perform a target exercise or activity? This question arises in training, therapeutic, and education settings alike, yet despite-or even because of-the large range of extant motivation theories, finding a clear answer to this question can be challenging. Here we propose an application-friendly framework of motivation for a specific activity or exercise that incorporates core concepts from several well-regarded psychological and economic theories of motivation. The key assumption of this framework is that motivation for performing a given activity is determined by the expected benefits and the expected costs of (performance of) the activity. Benefits comprise positive feelings, gains, and rewards experienced during performance of the activity (intrinsic benefits) or achieved through the activity (extrinsic benefits). Costs entail effort requirements, time demands, and other expenditure (intrinsic costs) as well as unwanted associated outcomes and missing out on alternative activities (extrinsic costs). The expected benefits and costs of a given exercise are subjective and state dependent. We discuss convergence of the proposed framework with a selection of extant motivation theories and briefly outline neurobiological correlates of its main components and assumptions. One particular strength of our framework is that it allows to specify five pathways to increasing motivation for a target exercise, which we illustrate and discuss with reference to previous empirical data. © 2016 Elsevier B.V. All rights reserved.
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Ando, Amy W.; Mallory, Mindy L.
2012-01-01
Climate change is likely to alter the spatial distributions of species and habitat types but the nature of such change is uncertain. Thus, climate change makes it difficult to implement standard conservation planning paradigms. Previous work has suggested some approaches to cope with such uncertainty but has not harnessed all of the benefits of risk diversification. We adapt Modern Portfolio Theory (MPT) to optimal spatial targeting of conservation activity, using wetland habitat conservation in the Prairie Pothole Region (PPR) as an example. This approach finds the allocations of conservation activity among subregions of the planning area that maximize the expected conservation returns for a given level of uncertainty or minimize uncertainty for a given expected level of returns. We find that using MPT instead of simple diversification in the PPR can achieve a value of the conservation objective per dollar spent that is 15% higher for the same level of risk. MPT-based portfolios can also have 21% less uncertainty over benefits or 6% greater expected benefits than the current portfolio of PPR conservation. Total benefits from conservation investment are higher if returns are defined in terms of benefit–cost ratios rather than benefits alone. MPT-guided diversification can work to reduce the climate-change–induced uncertainty of future ecosystem-service benefits from many land policy and investment initiatives, especially when outcomes are negatively correlated between subregions of a planning area. PMID:22451914
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Ahl, Richard E; Dunham, Yarrow
2017-08-21
Young children show social preferences for resource-rich individuals, although few studies have explored the causes underlying such preferences. We evaluate the viability of one candidate cause: Children believe that resource wealth relates to behavior, such that they expect the resource rich to be more likely to materially benefit others (including themselves) than the resource poor. In Studies 1 and 2 (ages 4-10), American children from predominantly middle-income families (n = 94) and Indian children from lower income families (n = 30) predicted that the resource rich would be likelier to share with others than the resource poor. In Study 3, American children (n = 66) made similar predictions in an incentivized decision-making task. The possibility that children's expectations regarding giving contribute to prowealth preferences is discussed. © 2017 The Authors. Child Development © 2017 Society for Research in Child Development, Inc.
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PEM-PCA: a parallel expectation-maximization PCA face recognition architecture.
Rujirakul, Kanokmon; So-In, Chakchai; Arnonkijpanich, Banchar
2014-01-01
Principal component analysis or PCA has been traditionally used as one of the feature extraction techniques in face recognition systems yielding high accuracy when requiring a small number of features. However, the covariance matrix and eigenvalue decomposition stages cause high computational complexity, especially for a large database. Thus, this research presents an alternative approach utilizing an Expectation-Maximization algorithm to reduce the determinant matrix manipulation resulting in the reduction of the stages' complexity. To improve the computational time, a novel parallel architecture was employed to utilize the benefits of parallelization of matrix computation during feature extraction and classification stages including parallel preprocessing, and their combinations, so-called a Parallel Expectation-Maximization PCA architecture. Comparing to a traditional PCA and its derivatives, the results indicate lower complexity with an insignificant difference in recognition precision leading to high speed face recognition systems, that is, the speed-up over nine and three times over PCA and Parallel PCA.
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NASA Astrophysics Data System (ADS)
Damayanti, Irma; Nur Bambang, Azis; Retnaningsih Soeprobowati, Tri
2018-05-01
Petungkriyono is the last tropical forest in Java and provides biodiversity including rare flora and fauna that must be maintained, managed and utilized in order to give meaning for humanity and sustainability. Services of Forest Ecosystem in Petungkriyono are included such as goods supply, soil-water conservation, climate regulation, purification environment and flora fauna habitats. The approach of this study is the literature review from various studies before perceiving the influenced of economic valuation in determining the measurement conservation strategies of Petungkriyono Natural Forest Ecosystem in Pekalongan Regency. The aims of this study are to analyzing an extended benefit cost of natural forest ecosystems and internalizing them in decision making. The method of quantification and valuation of forest ecosystem is Cost and Benefit Analysis (CBA) which is a standard economic appraisal tools government in development economics. CBA offers the possibility capturing impact of the project. By using productivity subtitution value and extended benefit cost analysis any comodity such as Backwoods,Pine Woods, Puspa woods and Pine Gum. Water value, preventive buildings of landslide and carbon sequestration have total economic value of IDR.163.065.858.080, and the value of Extended Benefit Cost Ratio in Petungkriyono is 281.35 %. However, from the result is expected the local government of Pekalongan to have high motivation in preserve the existence of Petungkriyono forest.
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The Spotlight of Attention Illuminates Failed Feature-based Expectancies
Bengson, Jesse J.; Lopez-Calderon, Javier; Mangun, George R.
2012-01-01
A well-replicated finding is that visual stimuli presented at an attended location are afforded a processing benefit in the form of speeded reaction times and increased accuracy (Posner, 1979; Mangun 1995). This effect has been described using a spotlight metaphor, in which all stimuli within the focus of spatial attention receive facilitated processing, irrespective of other stimulus parameters. However, the spotlight metaphor has been brought into question by a series of combined expectancy studies which demonstrated that the behavioral benefits of spatial attention are contingent upon secondary feature-based expectancies (Kingstone, 1992). The present work used an event-related potential (ERP) approach to reveal that the early neural signature of the spotlight of spatial attention is not sensitive to the validity of secondary feature-based expectancies. PMID:22775503
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2013-11-01
system does not support certain critical requirements, including enabling the Army to generate auditable financial statements by fiscal year 2017 ...current system will not enable the Army to generate auditable financial statements by 2017 , the statutory deadline for this goal. Increment 2, which...fourth quarter of fiscal year 2017 , all three of these enterprise resource planning systems are expected to be fully deployed, to share a common set
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Using Modeling and Simulation to Examine the Benefits of a Network Tasking Order
2010-01-01
Without careful planning, the topolo- gies that form can suffer from poor Quality of Service (QoS). The networks could have bottlenecks, or worse, be... quality of service Report Documentation Page Form ApprovedOMB No. 0704-0188 Public reporting burden for the collection of information is estimated to...mission type include: • expected communications partners; • type of data transmitted; • bandwidth required (average, burst); • quality of service
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46 CFR 349.5 - Reemployment rights and benefits.
Code of Federal Regulations, 2010 CFR
2010-10-01
... and there was not at the time of leaving such employment any reasonable expectation that such... plan, insurance coverage and awards, bonuses, severance pay, supplemental unemployment and benefits...
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Medical equipment libraries: implementation, experience and user satisfaction.
Keay, S; McCarthy, J P; Carey-Smith, B E
2015-01-01
The hospital-wide pooling and sharing of certain types of medical equipment can lead to both significant improvements in patient safety and financial advantages when compared with a department or ward-level equipment ownership system. In September 2003, a Medical Equipment Loan Service (MELS) was established, focusing initially on infusion pumps. The aims and expected benefits included; improving availability of equipment for both patients and clinical users, managing and reducing clinical risk, reducing equipment diversity, improving equipment management and reducing the overall cost of equipment provision. A user survey was carried out in 2005 and repeated in 2011. The results showed wide and continued satisfaction with the service. The process and difficulties of establishing the service and its development to include additional types of equipment are described. The benefits of managing medical equipment which is in widespread general use, through a MELS as part of a Clinical Engineering Department, are presented.
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How molecular profiling could revolutionize drug discovery.
Stoughton, Roland B; Friend, Stephen H
2005-04-01
Information from genomic, proteomic and metabolomic measurements has already benefited target discovery and validation, assessment of efficacy and toxicity of compounds, identification of disease subgroups and the prediction of responses of individual patients. Greater benefits can be expected from the application of these technologies on a significantly larger scale; by simultaneously collecting diverse measurements from the same subjects or cell cultures; by exploiting the steadily improving quantitative accuracy of the technologies; and by interpreting the emerging data in the context of underlying biological models of increasing sophistication. The benefits of applying molecular profiling to drug discovery and development will include much lower failure rates at all stages of the drug development pipeline, faster progression from discovery through to clinical trials and more successful therapies for patient subgroups. Upheavals in existing organizational structures in the current 'conveyor belt' models of drug discovery might be required to take full advantage of these methods.
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The potential benefits of a new poliovirus vaccine for long-term poliovirus risk management.
Duintjer Tebbens, Radboud J; Thompson, Kimberly M
2016-12-01
To estimate the incremental net benefits (INBs) of a hypothetical ideal vaccine with all of the advantages and no disadvantages of existing oral and inactivated poliovirus vaccines compared with current vaccines available for future outbreak response. INB estimates based on expected costs and polio cases from an existing global model of long-term poliovirus risk management. Excluding the development costs, an ideal poliovirus vaccine could offer expected INBs of US$1.6 billion. The ideal vaccine yields small benefits in most realizations of long-term risks, but great benefits in low-probability-high-consequence realizations. New poliovirus vaccines may offer valuable insurance against long-term poliovirus risks and new vaccine development efforts should continue as the world gathers more evidence about polio endgame risks.
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Safety and Benefit of Discontinuing Statin Therapy in the Setting of Advanced, Life-Limiting Illness
Kutner, Jean S.; Blatchford, Patrick J.; Taylor, Don H.; Ritchie, Christine S.; Bull, Janet H.; Fairclough, Diane L.; Hanson, Laura C.; LeBlanc, Thomas W.; Samsa, Greg P.; Wolf, Steven; Aziz, Noreen M.; Currow, David C.; Ferrell, Betty; Wagner-Johnston, Nina; Zafar, S. Yousuf; Cleary, James F.; Dev, Sandesh; Goode, Patricia S.; Kamal, Arif H.; Kassner, Cordt; Kvale, Elizabeth A.; McCallum, Janelle G.; Ogunseitan, Adeboye B.; Pantilat, Steven Z.; Portenoy, Russell K.; Prince-Paul, Maryjo; Sloan, Jeff A.; Swetz, Keith M.; Von Gunten, Charles F.; Abernethy, Amy P.
2015-01-01
IMPORTANCE For patients with limited prognosis, some medication risks may outweigh the benefits, particularly when benefits take years to accrue; statins are one example. Data are lacking regarding the risks and benefits of discontinuing statin therapy for patients with limited life expectancy. OBJECTIVE To evaluate the safety, clinical, and cost impact of discontinuing statin medications for patients in the palliative care setting. DESIGN, SETTING, AND PARTICIPANTS This was a multicenter, parallel-group, unblinded, pragmatic clinical trial. Eligibility included adults with an estimated life expectancy of between 1 month and 1 year, statin therapy for 3 months or more for primary or secondary prevention of cardiovascular disease, recent deterioration in functional status, and no recent active cardiovascular disease. Participants were randomized to either discontinue or continue statin therapy and were monitored monthly for up to 1 year. The study was conducted from June 3, 2011, to May 2, 2013. All analyses were performed using an intent-to-treat approach. INTERVENTIONS Statin therapy was withdrawn from eligible patients who were randomized to the discontinuation group. Patients in the continuation group continued to receive statins. MAIN OUTCOMES AND MEASURES Outcomes included death within 60 days (primary outcome), survival, cardiovascular events, performance status, quality of life (QOL), symptoms, number of nonstatin medications, and cost savings. RESULTS A total of 381 patients were enrolled; 189 of these were randomized to discontinue statins, and 192 were randomized to continue therapy. Mean (SD) age was 74.1 (11.6) years, 22.0% of the participants were cognitively impaired, and 48.8% had cancer. The proportion of participants in the discontinuation vs continuation groups who died within 60 days was not significantly different (23.8% vs 20.3%; 90% CI, −3.5% to 10.5%; P = .36) and did not meet the noninferiority end point. Total QOL was better for the group discontinuing statin therapy (mean McGill QOL score, 7.11 vs 6.85; P = .04). Few participants experienced cardiovascular events (13 in the discontinuation group vs 11 in the continuation group). Mean cost savings were $3.37 per day and $716 per patient. CONCLUSIONS AND RELEVANCE This pragmatic trial suggests that stopping statin medication therapy is safe and may be associated with benefits including improved QOL, use of fewer nonstatin medications, and a corresponding reduction in medication costs. Thoughtful patient-provider discussions regarding the uncertain benefit and potential decrement in QOL associated with statin continuation in this setting are warranted. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01415934 PMID:25798575
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Dehmer, Steven P; Maciosek, Michael V; Flottemesch, Thomas J; LaFrance, Amy B; Whitlock, Evelyn P
2016-06-21
Evidence indicates that aspirin is effective for the primary prevention of cardiovascular disease (CVD) and colorectal cancer (CRC) but also increases the risk for gastrointestinal (GI) and cerebral hemorrhages. To assess the net balance of benefits and harms from routine aspirin use across clinically relevant age, sex, and CVD risk groups. Decision analysis using a microsimulation model. 3 systematic evidence reviews. Men and women aged 40 to 79 years with a 10-year CVD risk of 20% or less, and no history of CVD and without elevated risk for GI or cerebral hemorrhages that would contraindicate aspirin use. Lifetime, 20 years, and 10 years. Clinical. Low-dose aspirin (≤100 mg/d). Primary outcomes are length and quality of life measured in net life-years and quality-adjusted life-years. Benefits include reduced nonfatal myocardial infarction, nonfatal ischemic stroke, fatal CVD, CRC incidence, and CRC mortality. Harms include increased fatal and nonfatal GI bleeding and hemorrhagic stroke. Lifetime net quality-adjusted life-years are positive for most adults initiating aspirin at ages 40 to 69 years, and life expectancy gains are expected for most men and women initiating aspirin at ages 40 to 59 years and 60 to 69 years with higher CVD risk. Harms may exceed benefits for persons starting aspirin in their 70s and for many during the first 10 to 20 years of use. Results are most sensitive to the relative risk for hemorrhagic stroke and CVD mortality but are affected by all relative risk estimates, baseline GI bleeding incidence and case-fatality rates, and disutilities associated with aspirin use. Aspirin effects by age are uncertain. Stroke benefits are conservatively estimated. Gastrointestinal bleeding incidence and case-fatality rates account only for age and sex. Lifetime aspirin use for primary prevention initiated at younger ages (40 to 69 years) and in persons with higher CVD risk shows the greatest potential for positive net benefit. Agency for Healthcare Research and Quality.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Ormond, Kelly E
2005-01-20
Genetic databases are generally created with the long-term goal of establishing genotype-phenotype correlations, and are explicitly NOT intended for participant benefit through the personal receipt of genetic information. In fact, most well-known genetic databases are set up to preclude the recontact of participants, both to protect confidentiality and because any genetic discoveries will likely have unclear implications in the near future. Issues of recontact and sample use raise significant issues around the informed consent process for such genetic databases. The NUgene study is a longitudinal genetic database at Northwestern University created to assess the genetic components of common diseases. Inmore » summer 2001, prior to the start of NUgene recruitment, a planning committee met for over one year to discuss the project's format, including ethical aspects. The project's advisory committee felt strongly that recontact of study participants was not warranted. However, because of the broad and longitudinal nature of the project, the IRB requested a modified consent process for recontacting subjects. This consent allowed participants to opt for recontact under either of the following circumstances: (1) if more information was required for a future study or to participate in future research and (2) if ''clinically significant results'' were discovered through research examination. During the first year of the study, 808 participants were enrolled in NUgene. 92% opted for recontact regarding more information or future research and 96% opted for recontact for ''medically significant'' findings. The current DOE funded study of NUgene participants examined informed consent, including recontact options. In November 2002, the NUgene project began recruiting for a large, longitudinal genetic database; concurrent with NUgene enrollment, we solicited 200 participants for interviews to address attitudes about participation in NUgene in both a quantitative and qualitative manner. Demographic data on these subjects was representative of the participants in the overall NUgene project. 200 subjects underwent the quantitative measure QuIC to measure the knowledge and understanding of participants using a previously validated measure. The summary knowledge score was 69.3 (on a scale of 0-100, being the highest possible score) and the summary self-assessment score was 89.6. The best understood domains included: the nature of the study (100), benefit to future patients (99.8), and the voluntary nature of participation (93.2). Domains with the lowest knowledge scores included: potential risks and discomforts (17.5), experimental nature of the research (24.0), procedures in the event of study-related injury (35.7), and confidentiality issues (42.9).In addition to this quantitative data, 109 semi-structured interviews were transcribed and analyzed. Themes focused on reasons for participation, beliefs regarding the risks and benefits of the study, expectations regarding results and ways in which participants would prefer to be recontacted if future studies or results become available. Most enrolled in NUgene in order to help mankind or the ''general population'' in some manner (>75%), to help find disease genes, treatments or cures, and/or to contribute to the overall medical knowledge. Many participants ({approx}30%) clearly expressed a hope for personal benefit and often named specific disorders or family members. Confidentiality protections of the study were described as good by most (>50%), and almost half specifically described one or more of the privacy protections. While many were able to articulate the general privacy concerns, and several cited concerns with employer (12%) or insurance discrimination (25%), most considered the risks to privacy low (25%) or none ({approx}60%). Only 10% of participants explicitly stated they had no expectation for personal benefit, and when asked whether they expected to be contacted with study results, respondents were split between having no expectation (39%), being hopeful for results (37%) and expecting to be contacted with results (12%). Over 75% of study participants felt that if a genetic test became available for their family they would wish to undertake it, and few caveats were mentioned. Overall, our study demonstrated that participants had a good understanding of the purposes of the study and that the benefit was for future patients; however, participants had difficulty understanding the potential risks and discomforts and confidentiality issues. The data show that participants in population-based studies may be less likely to harbor the ''therapeutic misconception'', often reported in clinical studies, but further study is needed to assess whether patients perceive personal benefits not revealed by this measure. These findings are informative to those providing informed consent and to the IRBs reviewing such studies.« less
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Applying an Employee-Motivation Model to Prevent Student Plagiarism.
ERIC Educational Resources Information Center
Malouff, John M.; Sims, Randi L.
1996-01-01
A model based on Vroom's expectancy theory of employee motivation posits that instructors can prevent plagiarism by ensuring that students understand the rules of ethical writing, expect assignments to be manageable and have personal benefits, and expect plagiarism to be difficult and have important personal costs. (SK)
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Recruitment and ethical considerations in HIV cure trials requiring treatment interruption.
Arnold, Michael P; Evans, David; Vergel, Nelson
2015-01-01
Relative to antiretroviral treatment (ART), early HIV cure-related trials (HCRTs) carry limited therapeutic benefits and unknown risks. In HCRTs requiring treatment interruption (TI) the health risks and burdens may create a barrier to study enrolment and increase the possibility for unintentional ethical violations in recruitment. An online survey was administered to over 2,000 HIV-positive ART users in the US. Using multivariable ordinal regression we assessed effects of research participation attitudes, health and demographic traits on willingness to participate in treatment interruption studies (WtP-TI). WtP-TI was greatest among those who were highly motivated to participate in research studies for the benefit of science, society and, to a lesser extent, personal benefit. Personal benefit was less of an influence on WtP-TI among persons with higher viral loads or a history of multiple ART regimens. WtP-TI was greater among respondents who were more likely to consider personal health in making decisions about trial participation. WtP-TI had no association with perceptions of the importance of compensation to research participation. After accounting for attitudes, health status and demographic traits were generally not significantly related to WtP-TI. Notable exceptions included viral suppression status and race/ethnicity. Recruitment strategies in TI studies can benefit from a focus on the long-term scientific and social benefits of study participation. Strategies targeted to particular demographic groups may have little impact on accrual, and in some cases will need to be accompanied by strategies to improve the quality of researcher-community relationships. Findings also suggest that informing communities about the health impacts of trial participation may positively impact participation decisions. However, more research is needed to interpret the impact of health messaging on recruitment and therapeutic expectations. Future work should explore the implications of altruism-based expectations on the strategic and ethical appropriateness of TI study recruitment efforts.
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Radiation treatment in older patients: a framework for clinical decision making.
Smith, Grace L; Smith, Benjamin D
2014-08-20
In older patients, radiation treatment plays a vital role in curative and palliative cancer therapy. Radiation treatment recommendations should be informed by a comprehensive, personalized risk-benefit assessment that evaluates treatment efficacy and toxicity. We review several clinical factors that distinctly affect efficacy and toxicity of radiation treatment in older patients. First, locoregional tumor behavior may be more indolent in older patients for some disease sites but more aggressive for other sites. Assessment of expected locoregional relapse risk informs the magnitude and timeframe of expected radiation treatment benefits. Second, assessment of the competing cancer versus noncancer mortality and morbidity risks contextualizes cancer treatment priorities holistically within patients' entire spectrum and time course of health needs. Third, assessment of functional reserve helps predict patients' acute treatment tolerance, differentiating those patients who are unlikely to benefit from treatment or who are at high risk for treatment complications. Potential radiation treatment options include immediate curative treatment, delayed curative treatment, and no treatment, with additional consideration given to altered radiation target, dose, or sequencing with chemotherapy and/or surgery. Finally, when cure is not feasible, palliative radiation therapy remains valuable for managing symptoms and achieving meaningful quality-of-life improvements. Our proposed decision-making framework integrates these factors to help radiation oncologists formulate strategic treatment recommendations within a multidisciplinary context. Future research is still needed to identify how advanced technologies can be judiciously applied in curative and palliative settings to enhance risk-benefit profiles of radiation treatment in older patients and more accurately quantify treatment efficacy in this group. © 2014 by American Society of Clinical Oncology.
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Tabor, Holly K.; Stock, Jacquie; Brazg., Tracy; McMillin, Margaret J.; Dent., Karin M.; Yu, Joon-Ho; Shendure, Jay; Bamshad, Michael J.
2012-01-01
Scientific evidence on the extent to which ethical concerns about privacy, confidentiality, and return of results for whole genome sequencing (WGS) are effectively conveyed by informed consent (IC) is lacking. The aim of this study was to learn, via qualitative interviews, about participant expectations and perceptions of risks, benefits, and harms of WGS. Participants in two families with Miller syndrome consented for WGS were interviewed about their experiences of the IC process and their perceptions of risks, benefits, and harms of WGS. Interviews were transcribed and analyzed for common themes. IC documents are included in the supplementary materials. Participants expressed minimal concerns about privacy and confidentiality with regard to both their participation and sharing of their WGS data in restricted access databases. Participants expressed strong preferences about how results should be returned, requesting both flexibility of the results return process and options for the types of results to be returned. Participant concerns about risks to privacy and confidentiality from broad sharing of WGS data are likely to be strongly influenced by social and medical context. In these families with a rare Mendelian syndrome, the perceived benefits of participation strongly trumped concerns about risks. Individual preferences, for results return, even within a family, varied widely. This underscores the need to develop a framework for results return that allows explicitly for participant preferences and enables modifications to preferences over time. Web-based tools that facilitate participant management of their individual research results could accommodate such a framework. PMID:22532433
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Uyei, Jennifer; Braithwaite, R Scott
2016-01-01
Despite the benefits of the placebo-controlled trial design, it is limited by its inability to quantify total benefits and harms. Such trials, for example, are not designed to detect an intervention's placebo or nocebo effects, which if detected could alter the benefit-to-harm balance and change a decision to adopt or reject an intervention. In this article, we explore scenarios in which alternative experimental trial designs, which differ in the type of control used, influence expected value across a range of pretest assumptions and study sample sizes. We developed a decision model to compare 3 trial designs and their implications for decision making: 2-arm placebo-controlled trial ("placebo-control"), 2-arm intervention v. do nothing trial ("null-control"), and an innovative 3-arm trial design: intervention v. do nothing v. placebo trial ("novel design"). Four scenarios were explored regarding particular attributes of a hypothetical intervention: 1) all benefits and no harm, 2) no biological effect, 3) only biological effects, and 4) surreptitious harm (no biological benefit or nocebo effect). Scenario 1: When sample sizes were very small, the null-control was preferred, but as sample sizes increased, expected value of all 3 designs converged. Scenario 2: The null-control was preferred regardless of sample size when the ratio of placebo to nocebo effect was >1; otherwise, the placebo-control was preferred. Scenario 3: When sample size was very small, the placebo-control was preferred when benefits outweighed harms, but the novel design was preferred when harms outweighed benefits. Scenario 4: The placebo-control was preferred when harms outweighed placebo benefits; otherwise, preference went to the null-control. Scenarios are hypothetical, study designs have not been tested in a real-world setting, blinding is not possible in all designs, and some may argue the novel design poses ethical concerns. We identified scenarios in which alternative experimental study designs would confer greater expected value than the placebo-controlled trial design. The likelihood and prevalence of such situations warrant further study. © The Author(s) 2015.
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Grosse, Scott D; Thompson, John D; Ding, Yao; Glass, Michael
2016-06-01
Newborn screening not only saves lives but can also yield net societal economic benefit, in addition to benefits such as improved quality of life to affected individuals and families. Calculations of net economic benefit from newborn screening include the monetary equivalent of avoided deaths and reductions in costs of care for complications associated with late-diagnosed individuals minus the additional costs of screening, diagnosis, and treatment associated with prompt diagnosis. Since 2001 the Washington State Department of Health has successfully implemented an approach to conducting evidence-based economic evaluations of disorders proposed for addition to the state-mandated newborn screening panel. Economic evaluations can inform policy decisions on the expansion of newborn screening panels. This article documents the use of cost-benefit models in Washington State as part of the rule-making process that resulted in the implementation of screening for medium-chain acyl-CoA dehydrogenase (MCAD) deficiency and 4 other metabolic disorders in 2004, cystic fibrosis (CF) in 2006, 15 other metabolic disorders in 2008, and severe combined immune deficiency (SCID) in 2014. We reviewed Washington State Department of Health internal reports and spreadsheet models of expected net societal benefit of adding disorders to the state newborn screening panel. We summarize the assumptions and findings for 2 models (MCAD and CF) and discuss them in relation to findings in the peer-reviewed literature. The MCAD model projected a benefit-cost ratio of 3.4 to 1 based on assumptions of a 20.0 percentage point reduction in infant mortality and a 13.9 percentage point reduction in serious developmental disability. The CF model projected a benefit-cost ratio of 4.0-5.4 to 1 for a discount rate of 3%-4% and a plausible range of 1-2 percentage point reductions in deaths up to age 10 years. The Washington State cost-benefit models of newborn screening were broadly consistent with peer-reviewed literature, and their findings of net benefit appear to be robust to uncertainty in parameters. Public health newborn screening programs can develop their own capacity to project expected costs and benefits of expansion of newborn screening panels, although it would be most efficient if this capacity were shared among programs. © 2016 Milbank Memorial Fund.
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Opinion Expression as a Rational Behavior.
ERIC Educational Resources Information Center
Kim, Sei-Hill
This study looks at individuals' opinion expressions as a rational behavior based on a conscious calculus of expected benefits and costs (economic analysis). The influences of "issue benefit,""opinion congruence," and "issue knowledge," as sources of benefits and costs on opinion expression were hypothesized and tested. The study also examined the…
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Sicherman, N; Bombard, A T; Rappoport, P
1995-01-01
The expected utility theory suggests eliminating an age-specific criterion for recommending prenatal diagnosis to patients. We isolate the factors which patients and physicians need to consider intelligently in prenatal diagnosis, and show that the sole use of a threshold age as a screening device is inadequate. Such a threshold fails to consider adequately patients' attitudes regarding many of the possible outcomes of prenatal diagnosis; in particular, the birth of a chromosomally abnormal child and procedural-related miscarriages. It also precludes testing younger women and encourages testing in patients who do not necessarily require or desire it. All pregnant women should be informed about their prenatal diagnosis options, screening techniques, and diagnostic procedures, including their respective limitations, risks, and benefits.
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Older adults' exercise behavior: roles of selected constructs of social-cognitive theory.
Umstattd, M Renée; Hallam, Jeffrey
2007-04-01
Exercise is consistently related to physical and psychological health benefits in older adults. Bandura's social-cognitive theory (SCT) is one theoretical perspective on understanding and predicting exercise behavior. Thus, the authors examined whether three SCT variables-self-efficacy, self-regulation, and outcome-expectancy value-predicted older adults' (N = 98) exercise behavior. Bivariate analyses revealed that regular exercise was associated with being male, White, and married; having higher income, education, and self-efficacy; using self-regulation skills; and having favorable outcome-expectancy values (p < .05). In a simultaneous multivariate model, however, self-regulation (p = .0097) was the only variable independently associated with regular exercise. Thus, exercise interventions targeting older adults should include components aimed at increasing the use of self-regulation strategies.
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Cole, Caitlin; Petree, Linda E; Phillips, John P; Shoemaker, Jody M; Holdsworth, Mark; Helitzer, Deborah L
2015-10-01
To identify the specific needs, preferences and expectations of the stakeholders impacted by returning neuroimaging incidental findings to research participants. Six key stakeholder groups were identified to participate in focus group discussions at our active neuroimaging research facility: Participants, Parents of child participants, Investigators, Institutional Review Board (IRB) Members, Physicians and Community Members. A total of 151 subjects attended these discussions. Transcripts were analysed using principles of Grounded Theory and group consensus coding. A series of similar and divergent themes were identified across our subject groups. Similarities included beliefs that it is ethical for researchers to disclose incidental findings as it grants certain health and emotional benefits to participants. All stakeholders also recognised the potential psychological and financial risks to disclosure. Divergent perspectives elucidated consistent differences between our 'Participant' subjects (Participants, Parents, Community Members) and our 'Professional' subjects (IRB Members, Investigators and Physicians). Key differences included (1) what results should be reported, (2) participants' autonomous right to research information and (3) the perception of the risk-benefit ratio in managing results. Understanding the perceived impact on all stakeholders involved in the process of disclosing incidental findings is necessary to determine appropriate research management policy. Our data further demonstrate the challenge of this task as different stakeholders evaluate the balance between risk and benefit related to their unique positions in this process. These findings offer some of the first qualitative insight into the expectations of the diverse stakeholders affected by incidental finding disclosure. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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Test Expectation Enhances Memory Consolidation across Both Sleep and Wake
Wamsley, Erin J.; Hamilton, Kelly; Graveline, Yvette; Manceor, Stephanie; Parr, Elaine
2016-01-01
Memory consolidation benefits from post-training sleep. However, recent studies suggest that sleep does not uniformly benefit all memory, but instead prioritizes information that is important to the individual. Here, we examined the effect of test expectation on memory consolidation across sleep and wakefulness. Following reports that information with strong “future relevance” is preferentially consolidated during sleep, we hypothesized that test expectation would enhance memory consolidation across a period of sleep, but not across wakefulness. To the contrary, we found that expectation of a future test enhanced memory for both spatial and motor learning, but that this effect was equivalent across both wake and sleep retention intervals. These observations differ from those of least two prior studies, and fail to support the hypothesis that the “future relevance” of learned material moderates its consolidation selectively during sleep. PMID:27760193
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Space travel: bringing medical discoveries down to Earth.
Thirsk, R B
1985-11-01
Space travel has necessitated intensive study of certain physical conditions, notably cardiovascular deconditioning, motion sickness, musculoskeletal atrophy and psychological isolation. Benefits of this research are beginning to be available to terrestrial medicine, for example in research on osteoporosis and motion sickness. Other space technology of benefit to medicine includes diagnostic and therapeutic devices, transmission of medical data and satellite communications. A permanently inhabited space station is planned for the 1990s and further research into isolation, occupational hazards in remote locations, transportation of accident victims and stabilization awaiting transportation can be expected, all with probable spinoffs for terrestrial medicine. Space is also a good environment for production of very pure, specific pharmaceuticals, such as alpha1-antitrypsin, interferon and pancreatic beta cells.
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Space Travel: Bringing Medical Discoveries Down to Earth
Thirsk, Robert B.
1985-01-01
Space travel has necessitated intensive study of certain physical conditions, notably cardiovascular deconditioning, motion sickness, musculoskeletal atrophy and psychological isolation. Benefits of this research are beginning to be available to terrestrial medicine, for example in research on osteoporosis and motion sickness. Other space technology of benefit to medicine includes diagnostic and therapeutic devices, transmission of medical data and satellite communications. A permanently inhabited space station is planned for the 1990s and further research into isolation, occupational hazards in remote locations, transportation of accident victims and stabilization awaiting transportation can be expected, all with probable spinoffs for terrestrial medicine. Space is also a good environment for production of very pure, specific pharmaceuticals, such as alpha1-antitrypsin, interferon and pancreatic beta cells. ImagesFig. 1 PMID:21274132
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Social Security and the Retirement and Savings Behavior of Low Income Households1
van der Klaauw, Wilbert; Wolpin, Kenneth I.
2011-01-01
In this paper, we develop and estimate a model of retirement and savings incorporating limited borrowing, stochastic wage offers, health status and survival, social security benefits, Medicare and employer provided health insurance coverage, and intentional bequests. The model is estimated on sample of relatively poor households from the first three waves of the Health and Retirement Study (HRS), for whom we would expect social security income to be of particular importance. The estimated model is used to simulate the responses to changes in social security rules, including changes in benefit levels, in the payroll tax, in the social security earnings tax and in early and normal retirement ages. Welfare and budget consequences are estimated. PMID:21566719
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2015-01-01
The Energy Information Administration (EIA) is investigating the potential benefits of incorporating interval electricity data into its residential energy end use models. This includes interval smart meter and submeter data from utility assets and systems. It is expected that these data will play a significant role in informing residential energy efficiency policies in the future. Therefore, a long-term strategy for improving the RECS end-use models will not be complete without an investigation of the current state of affairs of submeter data, including their potential for use in the context of residential building energy modeling.
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Developing physician pay arrangements: the cash and care equation.
Levitch, J H
1998-11-01
Developing physician compensation packages that help a healthcare organization meet its business objectives while satisfying physician pay expectations requires new ways of linking pay to physician performance. Such compensation arrangements specifically should include pay tied to defined performance standards, compensation linked to group performance, performance incentives based on realistic, achievable goals, work performance measured by common criteria, and similar pay ensured for similar work. Final pay arrangements also should include items that are sometimes overlooked, such as fully delineated job responsibilities, performance measures aligned correctly with performance areas, and the value of benefits considered in the cash compensation levels.
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The Military Survivor Benefit Plan: How Much Does It Benefit the Retiree?
1979-12-01
advantages . Chapter V offers conclusions and recommendations. 4 I II. What is the Survivor Benefit Plan This chapter briefly traces military survivor...basis, founded upon the relation of parties to each other, either pecuniary or of blood or affinity, to expect some benefit or advantage from the...AFIT/GOR/SM/79D-9 THE MILITARY SURVIVOR BENEFIT PLAN: HOW MUCH DOES IT BENEFIT THE RETIREE THESIS AFIT/GOR/SM /79D-9 Thomas L. Wade Captain USAF ,zkC
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-01-31
...In compliance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501-3521), this notice announces that the Veterans Benefits Administration (VBA), Department of Veterans Affairs, will submit the collection of information abstracted below to the Office of Management and Budget (OMB) for review and comment. The PRA submission describes the nature of the information collection and its expected cost and burden; it includes the actual data collection instrument.
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Nanotechnology: Societal Implications - I. Maximising Benefits for Humanity
NASA Astrophysics Data System (ADS)
Roco, Mihail C.; Bainbridge, William S.
Advances in nanoscience and nanotechnology promise to have major impacts on human health, wealth, and peace in the coming decades. Among the expected breakthroughs are `designer' materials created from directed assembly of atoms and molecules, and the emergence of entirely new phenomena in chemistry and physics. This book includes a collection of essays by leading scientists, engineers, and social scientists reviewing the possible uses of these impending developments in various applications, and the corresponding issues that they raise.
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-08-09
...In compliance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501-3521), this notice announces that the Veterans Benefits Administration, Department of Veterans Affairs, will submit the collection of information abstracted below to the Office of Management and Budget (OMB) for review and comment. The PRA submission describes the nature of the information collection and its expected cost and burden; it includes the actual data collection instrument.
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-19
...In compliance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501-3521), this notice announces that the Veterans Benefits Administration, Department of Veterans Affairs, will submit the collection of information abstracted below to the Office of Management and Budget (OMB) for review and comment. The PRA submission describes the nature of the information collection and its expected cost and burden; it includes the actual data collection instrument.
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Acute coronary syndrome in the elderly.
Shanmugasundaram, Madhan; Alpert, Joseph S
2009-11-01
The spectrum of acute coronary syndrome (ACS) including unstable angina, non-ST-elevation myocardial infarction and ST-elevation myocardial infarction accounts for increasing numbers of deaths among persons age > or = 65 years in the US. This is important given demographic changes involving falling birth rates and increasing life expectancy. Elderly patients are likely to benefit the most from treatment of ACS, even though community practice still demonstrates less use of cardiac medications as an early-invasive approach among this population.
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ERIC Educational Resources Information Center
Thomas, Marshall W.
2010-01-01
Given the increased educational benefits of the Post 9/11 G. I. Bill for veterans, and as the current conflicts in Iraq and Afghanistan wind down and the troops come home, the number of military veterans entering colleges and universities is expected to increase. As non-traditional students with significant life experience, often including combat,…
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NASA Technical Reports Server (NTRS)
Bobick, J. C.; Braun, R. L.; Denny, R. E.
1979-01-01
The analysis of the benefits and costs of aeronautical research and technology (ABC-ART) models are documented. These models were developed by NASA for use in analyzing the economic feasibility of applying advanced aeronautical technology to future civil aircraft. The methodology is composed of three major modules: fleet accounting module, airframe manufacturing module, and air carrier module. The fleet accounting module is used to estimate the number of new aircraft required as a function of time to meet demand. This estimation is based primarily upon the expected retirement age of existing aircraft and the expected change in revenue passenger miles demanded. Fuel consumption estimates are also generated by this module. The airframe manufacturer module is used to analyze the feasibility of the manufacturing the new aircraft demanded. The module includes logic for production scheduling and estimating manufacturing costs. For a series of aircraft selling prices, a cash flow analysis is performed and a rate of return on investment is calculated. The air carrier module provides a tool for analyzing the financial feasibility of an airline purchasing and operating the new aircraft. This module includes a methodology for computing the air carrier direct and indirect operating costs, performing a cash flow analysis, and estimating the internal rate of return on investment for a set of aircraft purchase prices.
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Esophageal surgery in minimally invasive era
Bencini, Lapo; Moraldi, Luca; Bartolini, Ilenia; Coratti, Andrea
2016-01-01
The widespread popularity of new surgical technologies such as laparoscopy, thoracoscopy and robotics has led many surgeons to treat esophageal diseases with these methods. The expected benefits of minimally invasive surgery (MIS) mainly include reductions of postoperative complications, length of hospital stay, and pain and better cosmetic results. All of these benefits could potentially be of great interest when dealing with the esophagus due to the potentially severe complications that can occur after conventional surgery. Moreover, robotic platforms are expected to reduce many of the difficulties encountered during advanced laparoscopic and thoracoscopic procedures such as anastomotic reconstructions, accurate lymphadenectomies, and vascular sutures. Almost all esophageal diseases are approachable in a minimally invasive way, including diverticula, gastro-esophageal reflux disease, achalasia, perforations and cancer. Nevertheless, while the limits of MIS for benign esophageal diseases are mainly technical issues and costs, oncologic outcomes remain the cornerstone of any procedure to cure malignancies, for which the long-term results are critical. Furthermore, many of the minimally invasive esophageal operations should be compared to pharmacologic interventions and advanced pure endoscopic procedures; such a comparison requires a difficult literature analysis and leads to some confounding results of clinical trials. This review aims to examine the evidence for the use of MIS in both malignancies and more common benign disease of the esophagus, with a particular emphasis on future developments and ongoing areas of research. PMID:26843913
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Automatics adjusment on private pension fund for Asian Mathematics Conferences
NASA Astrophysics Data System (ADS)
Purwadi, J.
2017-10-01
This paper discussed about how the automatic adjustment mechanism in the pension fund with defined benefits in case conditions beyond assumptions - assumptions that have been determined. Automatic adjustment referred to in this experiment is intended to anticipate changes in economic and demographic conditions. The method discuss in this paper are indexing life expectancy. In this paper discussed about how the methods on private pension fund and how’s the impact of the change of life expectancy on benefit.
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Ohly, Heather; Gentry, Sarah; Wigglesworth, Rachel; Bethel, Alison; Lovell, Rebecca; Garside, Ruth
2016-03-25
School gardening programmes are increasingly popular, with suggested benefits including healthier eating and increased physical activity. Our objectives were to understand the health and well-being impacts of school gardens and the factors that help or hinder their success. We conducted a systematic review of quantitative and qualitative evidence (PROSPERO CRD42014007181). We searched multiple databases and used a range of supplementary approaches. Studies about school gardens were included if they reported on physical or mental health or well-being. Quantitative studies had to include a comparison group. Studies were quality appraised using appropriate tools. Findings were narratively synthesised and the qualitative evidence used to produce a conceptual framework to illustrate how benefits might be accrued. Evidence from 40 articles (21 quantitative studies; 16 qualitative studies; 3 mixed methods studies) was included. Generally the quantitative research was poor. Evidence for changes in fruit and vegetable intake was limited and based on self-report. The qualitative research was better quality and ascribed a range of health and well-being impacts to school gardens, with some idealistic expectations for their impact in the long term. Groups of pupils who do not excel in classroom activities were thought to particularly benefit. Lack of funding and over reliance on volunteers were thought to threaten success, while involvement with local communities and integration of gardening activities into the school curriculum were thought to support success. More robust quantitative research is needed to convincingly support the qualitative evidence suggesting wide ranging benefits from school gardens.
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The role of interventional radiology in management of benign and malignant gynecologic diseases.
Yu, Hyeon; Stavas, Joseph M
2013-10-01
This article focuses on the role of interventional radiology in the therapeutic and diagnostic management of benign and malignant gynecologic conditions. The subspecialty of interventional radiology utilizes minimally invasive advanced image-guided percutaneous techniques in gynecology that include central venous catheter placement, fluid aspiration, drainage catheter placement, tissue biopsy, inferior vena cava filter placement, and pelvic arterial embolization. Central venous catheters, such as ports, peripherally inserted central catheters, and tunneled catheters, are placed for intermediate to long-term intravenous chemotherapy or total parental nutrition or antibiotics. Patients with refractory malignant ascites or pleural effusion from seeding of advanced gynecologic cancers may benefit by percutaneous aspiration of fluid collections or placement of drainage catheters. Postoperative fluid collections including abscess, seroma, or lymphocele are managed by percutaneous drainage catheter insertion. Pelvic, peritoneal, or retroperitoneal masses can be sampled by image-guided percutaneous biopsy or aspiration of fluid to determine a pathologic diagnosis. Certain patients are at risk for deep venous thrombosis with pulmonary embolism and may benefit from an inferior vena cava filter. Patients with uncontrolled postoperative or postpartum bleeding can be effectively managed with emergent transarterial pelvic embolization. Each of the aforementioned interventions with indications, expected benefits, and complications is described including a published literature.
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Federal Register 2010, 2011, 2012, 2013, 2014
2011-12-01
... a low, medium, or high probability of retiring early. The determination is based on the year a... the expected retirement age after the probability of early retirement has been determined using Table I. These tables establish, by probability category, the expected retirement age based on both the...
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-12-01
..., medium, or high probability of retiring early. The determination is based on the year a participant would... the expected retirement age after the probability of early retirement has been determined using Table I. These tables establish, by probability category, the expected retirement age based on both the...
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"Survivor: Satis House"--Creating Classroom Community while Teaching Dickens in a Reality-TV World
ERIC Educational Resources Information Center
Bucolo, Joe
2011-01-01
Engaging 9th grade students in contemporary reality-show parodies based on "Great Expectations," the author helps students explore the intricacies of Charles Dickens's novel. In "Stay Tuned for Our Next Episode: Teaching 'Great Expectations' in Installments," the author highlighted the benefits of teaching "Great Expectations" in installments, as…
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Intensifying drought eliminates the expected benefits of elevated [CO2] for soybean
USDA-ARS?s Scientific Manuscript database
Stimulation of C3 crop yield by rising [CO2] is widely expected to counteract crop losses to greater drought this century. But these expectations come from sparse field trials that have been biased towards mesic growth conditions. This eight-year study used precipitation manipulations and year-to-ye...
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Subjective expectations in the context of HIV/AIDS in Malawi
Delavande, Adeline; Kohler, Hans-Peter
2009-01-01
In this paper we present a newly developed interactive elicitation methodology for collecting probabilistic expectations in a developing country context with low levels of literacy and numeracy, and we evaluate the feasibility and success of this method for a wide range of outcomes in rural Malawi. We find that respondents’ answers about their subjective expectations take into account basic properties of probabilities, and vary meaningfully with observable characteristics and past experience. From a substantive point of view, the elicited expectations indicate that individuals are generally aware of differential risks. For example, individuals with lower incomes and less land rightly feel at greater risk of financial distress than people with higher socioeconomic status (SES), and people who are divorced or widowed rightly feel at greater risk of being infected with HIV than currently married individuals. Meanwhile many expectations—including the probability of being currently infected with HIV—are well-calibrated compared to actual probabilities, but mortality expectations are substantially overestimated compared to life table estimates. This overestimation may lead individuals to underestimate the benefits of adopting HIV risk-reduction strategies. The skewed distribution of expectations about condom use also suggests that a small group of innovators are the forerunners in the adoption of condoms within marriage for HIV prevention. PMID:19946378
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Construction Project Management for RED HORSE Troop Training Projects
1989-02-02
estimating, scheduling, and cost control required for project management decision making in RED HORSE construction projects. The expected benefits of...After receiving tentative approval for a project, either the benefiting base engineering section or the appropriate RED HORSE squadron executes the...approved by the benefiting base commander and forwarded to RED HORSE for review. Once the design has started, the benefiting base reports to Headquarters
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The benefits of social influence in optimized cultural markets.
Abeliuk, Andrés; Berbeglia, Gerardo; Cebrian, Manuel; Van Hentenryck, Pascal
2015-01-01
Social influence has been shown to create significant unpredictability in cultural markets, providing one potential explanation why experts routinely fail at predicting commercial success of cultural products. As a result, social influence is often presented in a negative light. Here, we show the benefits of social influence for cultural markets. We present a policy that uses product quality, appeal, position bias and social influence to maximize expected profits in the market. Our computational experiments show that our profit-maximizing policy leverages social influence to produce significant performance benefits for the market, while our theoretical analysis proves that our policy outperforms in expectation any policy not displaying social signals. Our results contrast with earlier work which focused on showing the unpredictability and inequalities created by social influence. Not only do we show for the first time that, under our policy, dynamically showing consumers positive social signals increases the expected profit of the seller in cultural markets. We also show that, in reasonable settings, our profit-maximizing policy does not introduce significant unpredictability and identifies "blockbusters". Overall, these results shed new light on the nature of social influence and how it can be leveraged for the benefits of the market.
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Mangla, Sundeep; O'Connell, Keara; Kumari, Divya; Shahrzad, Maryam
2016-01-20
Ischemic strokes result in significant healthcare expenditures (direct costs) and loss of quality-adjusted life years (QALYs) (indirect costs). Interventional therapy has demonstrated improved functional outcomes in patients with large vessel occlusions (LVOs), which are likely to reduce the economic burden of strokes. To develop a novel real-world dollar model to assess the direct and indirect cost-benefit of mechanical embolectomy compared with medical treatment with intravenous tissue plasminogen activator (IV tPA) based on shifts in modified Rankin scores (mRS). A cost model was developed including multiple parameters to account for both direct and indirect stroke costs. These were adjusted based upon functional outcome (mRS). The model compared IV tPA with mechanical embolectomy to assess the costs and benefits of both therapies. Direct stroke-related costs included hospitalization, inpatient and outpatient rehabilitation, home care, skilled nursing facilities, and long-term care facility costs. Indirect costs included years of life expectancy lost and lost QALYs. Values for the model cost parameters were derived from numerous resources and functional outcomes were derived from the MR CLEAN study as a reflective sample of LVOs. Direct and indirect costs and benefits for the two treatments were assessed using Microsoft Excel 2013. This cost-benefit model found a cost-benefit of mechanical embolectomy over IV tPA of $163 624.27 per patient and the cost benefit for 50 000 patients on an annual basis is $8 181 213 653.77. If applied widely within the USA, mechanical embolectomy will significantly reduce the direct and indirect financial burden of stroke ($8 billion/50 000 patients). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
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The Net Benefits of Early Childhood Investments: Findings, Implications and a Texas Agenda.
ERIC Educational Resources Information Center
King, Christopher T.; Faliski, Katherine; Betsinger, Alicia M.; O'Shea, Daniel P.
This report primarily addresses the question, "What are the net benefits associated with targeted early childhood investments in Texas?" The expected benefits and costs of targeted early childhood investments are estimated and projected for an illustrative cohort of Texas infants: children 0-1 year old living in families with annual…
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Mudyarabikwa, Oliver; Tobi, Patrick; Regmi, Krishna
2017-07-01
Aim To examine assumptions about public-private partnership (PPP) activities and their role in improving public procurement of primary healthcare surgeries. PPPs were developed to improve the quality of care and patient satisfaction. However, evidence of their effectiveness in delivering health benefits is limited. A qualitative study design was employed. A total of 25 interviews with public sector staff (n=23) and private sector managers (n=2) were conducted to understand their interpretations of assumptions in the activities of private investors and service contractors participating in Local Improvement Finance Trust (LIFT) partnerships. Realist evaluation principles were applied in the data analysis to interpret the findings. Six thematic areas of assumed health benefits were identified: (i) quality improvement; (ii) improved risk management; (iii) reduced procurement costs; (iv) increased efficiency; (v) community involvement; and (vi) sustainable investment. Primary Care Trusts that chose to procure their surgeries through LIFT were expected to support its implementation by providing an environment conducive for the private participants to achieve these benefits. Private participant activities were found to be based on a range of explicit and tacit assumptions perceived helpful in achieving government objectives for LIFT. The success of PPPs depended upon private participants' (i) capacity to assess how PPP assumptions added value to their activities, (ii) effectiveness in interpreting assumptions in their expected activities, and (iii) preparedness to align their business principles to government objectives for PPPs. They risked missing some of the expected benefits because of some factors constraining realization of the assumptions. The ways in which private participants preferred to carry out their activities also influenced the extent to which expected benefits were achieved. Giving more discretion to public than private participants over critical decisions may help in ensuring that assumptions in PPP activities result in outcomes that match the anticipated health benefits.
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Peay, Holly L; Tibben, Aad; Fisher, Tyler; Brenna, Ethan; Biesecker, Barbara B
2014-02-01
The social context of rare disease research is changing, with increased community engagement around drug development and clinical trials. This engagement may benefit patients and families but may also lead to heightened trial expectations and therapeutic misconception. Clinical investigators are also susceptible to harboring high expectations. Little is known about parental motivations and expectations for clinical trials for rare pediatric disorders. We describe the experience of parents and clinical investigators involved in a phase II clinical trial for Duchenne and Becker muscular dystrophy: their expectations, hopes, motivations, and reactions to the termination of the trial. This qualitative study was based on interviews with clinical investigators and parents of sons with Duchenne and Becker muscular dystrophy (DBMD) who participated in the phase IIa or IIb ataluren clinical trial in the United States. Interviews were transcribed and coded for thematic analysis. Participants were 12 parents of affected boys receiving active drug and 9 clinical investigators. High trial expectations of direct benefit were reported by parents and many clinicians. Investigators described monitoring and managing parents' expectations; several worried about their own involvement in increasing parents' expectations. Most parents were able to differentiate their expectations from their optimistic hopes for a cure. Parents' expectations arose from other parents, advocacy organizations, and the sponsor. All parents reported some degree of clinical benefit to their children. Secondary benefits were hopefulness and powerful feelings associated with active efforts to affect the disease course. Parents and clinical investigators reported strong, close relationships that were mutually important. Parents and clinicians felt valued by the sponsor for the majority of the trial. When the trial abruptly stopped, they described loss of engagement, distress, and feeling unprepared for the possibility of trial termination. This was a retrospective study of one clinical trial. We were unable to recruit participants whose children received placebo. The interviews occurred during a time of significant uncertainty and distress for many of the participants. This pilot study reflects complex outcomes of strong community engagement. The findings highlight a need for renewed education about, and support for, clinical trial termination and loss of drug access. The primary positive outcome was demonstration of strong relationships among committed parents and study teams. These relationships were highly valued by both parties and may suggest an ideal intervention opportunity for efforts to improve psychological well-being. A negative outcome attributed, in part, to community engagement was inappropriately high trial expectations. More optimistically, high expectations were attributed, in part, to the importance of hope and powerful feelings associated with active efforts to affect the disease course.
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Peay, Holly L; Tibben, Aad; Fisher, Tyler; Brenna, Ethan; Biesecker, Barbara B
2014-01-01
Background The social context of rare disease research is changing, with increased community engagement around drug development and clinical trials. This engagement may benefit patients and families, but may also lead to heightened trial expectations and therapeutic misconception. Clinical investigators are also susceptible to harboring high expectations. Little is known about parental motivations and expectations for clinical trials for rare pediatric disorders. Purpose We describe the experience of parents and clinical investigators involved in a phase II clinical trial for Duchenne and Becker muscular dystrophy: their expectations, hopes, motivations, and reactions to the termination of the trial. Methods This qualitative study was based on interviews with clinical investigators and parents of sons with DBMD who participated in the phase IIa or IIb ataluren clinical trial in the United States. Interviews were transcribed and coded for thematic analysis. Results Participants were twelve parents of affected boys receiving active drug and nine clinical investigators. High trial expectations of direct benefit were reported by parents and many clinicians. Investigators described monitoring and managing parents’ expectations; several worried about their own involvement in increasing parents’ expectations. Most parents were able to differentiate their expectations from their optimistic hopes for a cure. Parents’ expectations arose from other parents, advocacy organizations, and the sponsor. All parents reported some degree of clinical benefit to their children. Secondary benefits were hopefulness and powerful feelings associated with active efforts to affect the disease course. Parents and clinical investigators reported strong, close relationships that were mutually important. Parents and clinicians felt valued by the sponsor for the majority of the trial. When the trial abruptly stopped, they described loss of engagement, distress, and feeling unprepared for the possibility of trial termination. Limitations This was a retrospective study of one clinical trial. We were unable to recruit participants whose children received placebo. The interviews occurred during a time of significant uncertainty and distress for many of the participants. Conclusions This pilot study reflects complex outcomes of strong community engagement. The findings highlight a need for renewed education about, and support for, clinical trial termination and loss of drug access. The primary positive outcome was demonstration of strong relationships among committed parents and study teams. These relationships were highly valued by both parties, and may suggest an ideal intervention opportunity for efforts to improve psychological wellbeing. A negative outcome attributed, in part, to community engagement was inappropriately high trial expectations. More optimistically, high expectations were attributed, in part, to the importance of hope and powerful feelings associated with active efforts to affect the disease course. PMID:24311736
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Kuklinski, Margaret R.; Fagan, Abigail A.; Hawkins, J. David; Briney, John S.; Catalano, Richard F.
2015-01-01
Objective To determine whether the Communities That Care (CTC) prevention system is a cost-beneficial intervention. Methods Data were from a longitudinal panel of 4,407 youth participating in a randomized controlled trial including 24 towns in 7 states, matched in pairs within state and randomly assigned to condition. Significant differences favoring intervention youth in sustained abstinence from delinquency, alcohol use, and tobacco use through Grade 12 were monetized and compared to economic investment in CTC. Results CTC was estimated to produce $4,477 in benefits per youth (discounted 2011 dollars). It cost $556 per youth to implement CTC for 5 years. The net present benefit was $3,920. The benefit-cost ratio was $8.22 per dollar invested. The internal rate of return was 21%. Risk that investment would exceed benefits was minimal. Investment was expected to be recouped within 9 years. Sensitivity analyses in which effects were halved yielded positive cost-beneficial results. Conclusions CTC is a cost-beneficial, community-based approach to preventing initiation of delinquency, alcohol use, and tobacco use. CTC is estimated to generate economic benefits that exceed implementation costs when disseminated with fidelity in communities. PMID:26213527
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García-Hernández, M-Noelia; Fraga-Hernández, Ma Elena; Mahtani-Chugani, Vinita
2014-12-01
To determine from the health care professionals perspective the impact on clinical practice of incorporating an assessment tool for primary care paediatric emergency. Qualitative study based on the collection of written documents. Twenty-four wide and detailed documents were collected. Thematic analysis was used. Participants were 9 nurses and 7 paediatricians, all with experience in the Paediatric Emergency Department. The results are grouped into three areas: perception of previous situation; benefits perceived; difficulties of the change process related to the triage instrument. The benefits perceived include the achievement of the objectives related to triage as well as collateral benefits for the organization and distribution of structural resources, adequacy of human resources, self-assessment and professional recognition, improvement of team communication and users service perception. The difficulties identified are related to the feasibility of using this instrument when patient flow is high and to the need of specialized training. All participants perceived more benefits than disadvantages, and both nurses and paediatricians experienced the process as a positive experience. The introduction of the assessment tool had a broader impact than expected.
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Essential health benefits and the Affordable Care Act: law and process.
Bagley, Nicholas; Levy, Helen
2014-04-01
Starting in 2014, the Affordable Care Act (ACA) will require private insurance plans sold in the individual and small-group markets to cover a roster of "essential health benefits." Precisely which benefits should count as essential, however, was left to the discretion of the Department of Health and Human Services (HHS). The matter was both important and controversial. Nonetheless, HHS announced its policy by posting on the Internet a thirteen-page bulletin stating that it would allow each state to define essential benefits for itself. On both substance and procedure, the move was surprising. The state-by-state approach departed from the uniform, federal standard that the ACA appears to anticipate and that informed observers expected HHS to adopt. And announcing the policy through an Internet bulletin appeared to allow HHS to sidestep traditional administrative procedures, including notice and comment, immediate review in the courts, and White House oversight. This article explores two questions. First, is the state-by-state approach a lawful exercise of HHS's authority? Second, did HHS in fact evade the procedural obligations that are meant to shape the exercise of its discretion?
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Using return on investment to maximize conservation effectiveness in Argentine grasslands.
Murdoch, William; Ranganathan, Jai; Polasky, Stephen; Regetz, James
2010-12-07
The rapid global loss of natural habitats and biodiversity, and limited resources, place a premium on maximizing the expected benefits of conservation actions. The scarcity of information on the fine-grained distribution of species of conservation concern, on risks of loss, and on costs of conservation actions, especially in developing countries, makes efficient conservation difficult. The distribution of ecosystem types (unique ecological communities) is typically better known than species and arguably better represents the entirety of biodiversity than do well-known taxa, so we use conserving the diversity of ecosystem types as our conservation goal. We define conservation benefit to include risk of conversion, spatial effects that reward clumping of habitat, and diminishing returns to investment in any one ecosystem type. Using Argentine grasslands as an example, we compare three strategies: protecting the cheapest land ("minimize cost"), maximizing conservation benefit regardless of cost ("maximize benefit"), and maximizing conservation benefit per dollar ("return on investment"). We first show that the widely endorsed goal of saving some percentage (typically 10%) of a country or habitat type, although it may inspire conservation, is a poor operational goal. It either leads to the accumulation of areas with low conservation benefit or requires infeasibly large sums of money, and it distracts from the real problem: maximizing conservation benefit given limited resources. Second, given realistic budgets, return on investment is superior to the other conservation strategies. Surprisingly, however, over a wide range of budgets, minimizing cost provides more conservation benefit than does the maximize-benefit strategy.
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Taksler, Glen B; Perzynski, Adam T; Kattan, Michael W
2017-04-01
Recommendations for colorectal cancer screening encourage patients to choose among various screening methods based on individual preferences for benefits, risks, screening frequency, and discomfort. We devised a model to illustrate how individuals with varying tolerance for screening complications risk might decide on their preferred screening strategy. We developed a discrete-time Markov mathematical model that allowed hypothetical individuals to maximize expected lifetime utility by selecting screening method, start age, stop age, and frequency. Individuals could choose from stool-based testing every 1 to 3 years, flexible sigmoidoscopy every 1 to 20 years with annual stool-based testing, colonoscopy every 1 to 20 years, or no screening. We compared the life expectancy gained from the chosen strategy with the life expectancy available from a benchmark strategy of decennial colonoscopy. For an individual at average risk of colorectal cancer who was risk neutral with respect to screening complications (and therefore was willing to undergo screening if it would actuarially increase life expectancy), the model predicted that he or she would choose colonoscopy every 10 years, from age 53 to 73 years, consistent with national guidelines. For a similar individual who was moderately averse to screening complications risk (and therefore required a greater increase in life expectancy to accept potential risks of colonoscopy), the model predicted that he or she would prefer flexible sigmoidoscopy every 12 years with annual stool-based testing, with 93% of the life expectancy benefit of decennial colonoscopy. For an individual with higher risk aversion, the model predicted that he or she would prefer 2 lifetime flexible sigmoidoscopies, 20 years apart, with 70% of the life expectancy benefit of decennial colonoscopy. Mathematical models may formalize how individuals with different risk attitudes choose between various guideline-recommended colorectal cancer screening strategies.
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The social value of clinical research.
Habets, Michelle G J L; van Delden, Johannes J M; Bredenoord, Annelien L
2014-09-05
International documents on ethical conduct in clinical research have in common the principle that potential harms to research participants must be proportional to anticipated benefits. The anticipated benefits that can justify human research consist of direct benefits to the research participant, and societal benefits, also called social value. In first-in-human research, no direct benefits are expected and the benefit component of the risks-benefit assessment thus merely exists in social value. The concept social value is ambiguous by nature and is used in numerous ways in the research ethics literature. Because social value justifies involving human participants, especially in early human trials, this is problematic. Our analysis and interpretation of the concept social value has led to three proposals. First, as no direct benefits are expected for the research participants in first-in-human trials, we believe it is better to discuss a risk- value assessment instead of a risk - benefit assessment. This will also make explicit the necessity to have a clear and common use for the concept social value. Second, to avoid confusion we propose to limit the concept social value to the intervention tested. It is the expected improvement the intervention can bring to the wellbeing of (future) patients or society that is referred to when we speak about social value. For the sole purpose of gaining knowledge, we should not expose humans to potential harm; the ultimate justification of involving humans in research lies in the anticipated social value of the intervention. Third, at the moment only the validity of the clinical research proposal is a prerequisite for research to take place. We recommend making the anticipated social value a prerequisite as well. In this paper we analyze the use of the concept social value in research ethics. Despite its unavoidable ambiguity, we aim to find a best use of the concept, subject to its role in justifying involving humans in first-in-human research.
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Public expectations about access fees and road closures on public lands
Cline, K.; Lamb, B.L.; Ponds, P.D.
2006-01-01
It is sometimes suggested that land managers could better communicate with the general public by relying on people who are active in community affairs to frame the message. By comparing responses from the 'attentive' and general public on the Colorado Plateau in the USA, this study investigated the expected effects of using recreation access fees or road closures to manage recreation on public lands. Although neither the attentive nor general public strongly anticipated benefits from the two management options, the attentive public was more likely than the general public to report positive expectations. Those more likely to expect fewer benefits from the management options do so because of factors that are outside the influence of managers (e.g., socio-demographics and value orientation). The results point out challenges for building public support through mobilizing the attentive public to develop a positive management atmosphere with fees and road closures. ?? 2006 University of Newcastle upon Tyne.
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Insomnia during pregnancy: Diagnosis and Rational Interventions.
Hashmi, Ali M; Bhatia, Shashi K; Bhatia, Subhash K; Khawaja, Imran S
2016-01-01
Sleep disturbances are common in pregnancy. Insomnia is a frequent sleep disturbance experienced by pregnant women which can be primary or due to co-morbid conditions. The differential diagnosis of insomnia in pregnancy includes anxiety disorders, mood disorders, breathing related sleep disorders and restless legs syndrome. Early interventions to treat the sleep disturbance are recommended to avoid adverse pregnancy outcomes. Management strategies include improving sleep hygiene, behavioral therapies, and pharmacotherapy. The risks of pharmacotherapy must be weighed against their benefits due to the possible risk of teratogenicity associated with some medications. We searched PubMed and Google Scholar employing a combination of key words: pregnancy, sleep disturbances, Obstructive Sleep Apnea, Sleep disorders and insomnia. We included original studies, review articles, meta-analysis and systematic reviews in our search prioritizing articles from the last 10-15 years. Articles older than 15 years were only included if their findings had not been superseded by more recent data. Further selection of articles was done from bibliographies and references of selected articles. Sleep disturbances in pregnancy are common and cause considerable morbidity. Management includes a combination of non-pharmacological and pharmacological treatments carefully weighing the risks and benefits of each for the expectant mother and fetus.
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Insomnia during pregnancy: Diagnosis and Rational Interventions
Hashmi, Ali M.; Bhatia, Shashi K.; Bhatia, Subhash K.; Khawaja, Imran S.
2016-01-01
Sleep disturbances are common in pregnancy. Insomnia is a frequent sleep disturbance experienced by pregnant women which can be primary or due to co-morbid conditions. The differential diagnosis of insomnia in pregnancy includes anxiety disorders, mood disorders, breathing related sleep disorders and restless legs syndrome. Early interventions to treat the sleep disturbance are recommended to avoid adverse pregnancy outcomes. Management strategies include improving sleep hygiene, behavioral therapies, and pharmacotherapy. The risks of pharmacotherapy must be weighed against their benefits due to the possible risk of teratogenicity associated with some medications. Methods: We searched PubMed and Google Scholar employing a combination of key words: pregnancy, sleep disturbances, Obstructive Sleep Apnea, Sleep disorders and insomnia. We included original studies, review articles, meta-analysis and systematic reviews in our search prioritizing articles from the last 10-15 years. Articles older than 15 years were only included if their findings had not been superseded by more recent data. Further selection of articles was done from bibliographies and references of selected articles. Conclusion: Sleep disturbances in pregnancy are common and cause considerable morbidity. Management includes a combination of non-pharmacological and pharmacological treatments carefully weighing the risks and benefits of each for the expectant mother and fetus. PMID:27648062
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Brazos Santiago Inlet, Texas, Shoaling Study
2018-02-01
However, benefits to dredging costs are not considered and must be weighed against other issues such as environmental concerns. DISCLAIMER: The contents...reduction benefits from this alternative would be small compared to the jetty construction costs , which are expected to be significant, but this study did... benefits of an in-channel sediment trap and alterations to the structure of the jetty. However, benefits to dredging costs are not considered and must be
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Taylor, Maureen T; Wayne Taylor, D; Burrows, Kristen; Cunnington, John; Lombardi, Andrea; Liou, Michelle
2013-11-01
To explore the experiences and perceptions of Ontario physician assistant (PA) employers about the barriers to and benefits of hiring PAs. A qualitative design using semistructured interviews. Rural and urban eastern and southwestern Ontario. Seven family physicians and 7 other specialists. The 14 physicians participated in semistructured interviews, which were audiorecorded and transcribed verbatim. An iterative approach using immersion and crystallization was employed for analysis. Physician-specific benefits to hiring PAs included increased flexibility, the opportunity to expand practice, the ability to focus more time on complex patients, overall reduction in work hours and stress, and an opportunity for professional fellowship. Physicians who hired PAs without government financial support said PAs were affordable as long as they were able to retain them. Barriers to hiring PAs included uncertainty about funding, the initial need for intensive supervision and training, and a lack of clarity around delegation of acts. Physicians are motivated to hire PAs to help deal with long wait times and long hours, but few are expecting to increase their income by taking on PAs. Governments, medical colleges, educators, and regulators must address the perceived barriers to PA hiring in order to expand and optimize this profession.
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Pharmacy Practice Department Chairs’ Perspectives on Part-Time Faculty Members
Winkler, Susan R.; Mai, Thy
2012-01-01
Objective. To identify the benefits and consequences of having part-time faculty members in departments of pharmacy practice from the department chair’s perspective. Methods. A stratified purposive sample of 12 pharmacy practice department chairs was selected. Eleven telephone interviews were conducted. Two investigators independently read interview notes and categorized and enumerated responses to determine major themes using content analysis. The investigators jointly reviewed the data and came to consensus on major themes. Results. Benefits of allowing full-time faculty members to reduce their position to part-time included faculty retention and improved individual faculty work/life balance. Consequences of allowing part-time faculty positions included the challenges of managing individual and departmental workloads, the risk of marginalizing part-time faculty members, and the challenges of promotion and tenure issues. All requests to switch to part-time status were faculty-driven and most were approved. Conclusions. There are a variety of benefits and consequences of having part-time faculty in pharmacy practice departments from the chair’s perspective. Clear faculty and departmental expectations of part-time faculty members need to be established to ensure optimal success of this working arrangement. PMID:22611268
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Weight-Loss Expectancies, Relative Weight, and Symptoms of Bulimia in Young Women.
ERIC Educational Resources Information Center
Thombs, Dennis L.; And Others
1996-01-01
A canonical correlation analysis of various weight concerns in a sample of college women revealed that strong expectations of weight loss benefits and a high relative body weight were positively correlated with the four major symptoms of bulimia. Expectations of increased self-worth and social confidence were linked to eating problems. (RJM)
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Federal Register 2010, 2011, 2012, 2013, 2014
2012-11-30
... participant has a low, medium, or high probability of retiring early. The determination is based on the year a... the expected retirement age after the probability of early retirement has been determined using Table I. These tables establish, by probability category, the expected retirement age based on both the...
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Federal Register 2010, 2011, 2012, 2013, 2014
2013-12-02
... has a low, medium, or high probability of retiring early. The determination is based on the year a... the expected retirement age after the probability of early retirement has been determined using Table I. These tables establish, by probability category, the expected retirement age based on both the...
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1999-09-01
often includes middle aged PCGs who must constantly balance responsibilities to the breast cancer patient, other family members, and personal life and...responsibilities when one family member is admitted to the hospital. The balance of increased family responsibilities and career expectations is...University, Office of the President 1996-97 Member of Worklife Community for JHU, Co-chairperson for JHU benefits 1995-97 Member of Committee for Global
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Evaluating perceived benefits of ecoregional assessments.
Bottrill, Madeleine C; Mills, Morena; Pressey, Robert L; Game, Edward T; Groves, Craig
2012-10-01
The outcomes of systematic conservation planning (process of assessing, implementing, and managing conservation areas) are rarely reported or measured formally. A lack of consistent or rigorous evaluation in conservation planning has fueled debate about the extent to which conservation assessment (identification, design, and prioritization of potential conservation areas) ultimately influences actions on the ground. We interviewed staff members of a nongovernmental organization, who were involved in 5 ecoregional assessments across North and South America and the Asia-Pacific region. We conducted 17 semistructured interviews with open and closed questions about the perceived purpose, outputs, and outcomes of the ecoregional assessments in which respondents were involved. Using qualitative data collected from those interviews, we investigated the types and frequency of benefits perceived to have emerged from the ecoregional assessments and explored factors that might facilitate or constrain the flow of benefits. Some benefits reflected the intended purpose of ecoregional assessments. Other benefits included improvements in social interactions, attitudes, and institutional knowledge. Our results suggest the latter types of benefits enable ultimate benefits of assessments, such as guiding investments by institutional partners. Our results also showed a clear divergence between the respondents' expectations and perceived outcomes of implementation of conservation actions arising from ecoregional assessments. Our findings suggest the need for both a broader perspective on the contribution of assessments to planning goals and further evaluation of conservation assessments. ©2012 Society for Conservation Biology.
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Giesbrecht, Melissa; Crooks, Valorie A; Williams, Allison
2010-11-01
Recognising their valuable role as key informants, this study examines the perspectives of front-line palliative care providers (FLPCP) regarding a social benefit programme in Canada designed to support family caregivers at end-of-life, namely the Compassionate Care Benefit (CCB). The CCB's purpose is to provide income assistance and job security to family caregivers who take temporary leave from employment to care for a dying family member. Contributing to an evaluative study that aims to provide policy-relevant recommendations about the CCB, this analysis draws on semi-structured interviews undertaken in 2007/2008 with FLPCPs (n = 50) from across Canada. Although participants were not explicitly asked during interviews about their expectations of the CCB, thematic content analysis revealed 'expectations' as a key finding. Through participants' discussions of their knowledge of and familiarity with the CCB, specific expectations were identified and grouped into four categories: (1) temporal; (2) financial; (3) informational; and (4) administrative. Findings demonstrate that participants expect the CCB to provide: (1) an adequate length of leave time from work, which is reflective of the uncertain nature of caregiving at end-of-life; (2) adequate financial support; (3) information on the programme to be disseminated to FLPCPs so that they may share it with others; and (4) a simple, clear, and quick application process. FLPCPs hold unique expertise, and ultimately the power to shape uptake of the CCB. As such, their expectations of the CCB contribute valuable knowledge from which relevant policy recommendations can be made to better meet the needs of family caregivers and FLPCPs alike. © 2010 Blackwell Publishing Ltd.
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Engelhardt, Ellen G; Pieterse, Arwen H; van der Hout, Anja; de Haes, Hanneke J C J M; Kroep, Judith R; Quarles van Ufford-Mannesse, Patricia; Portielje, Johanneke E A; Smets, Ellen M A; Stiggelbout, Anne M
2016-10-01
Shared decision making (SDM) is widely advocated, especially for preference-sensitive decisions like those on adjuvant treatment for early-stage cancer. Here, decision making involves a subjective trade-off between benefits and side-effects, and therefore, patients' informed preferences should be taken into account. If clinicians consciously or unconsciously steer patients towards the option they think is in their patients' best interest (i.e. implicit persuasion), they may be unwittingly subverting their own efforts to implement SDM. We assessed the frequency of use of implicit persuasion during consultations and whether the use of implicit persuasion was associated with expected treatment benefit and/or decision making. Observational study design in which consecutive consultations about adjuvant systemic therapy with stage I-II breast cancer patients treated at oncology outpatient clinics of general teaching hospitals and university medical centres were audiotaped, transcribed and coded by two researchers independently. In total, 105 patients (median age = 59; range: 35-87 years) were included. A median of five (range: 2-10) implicitly persuasive behaviours were employed per consultation. The number of behaviours used did not differ by disease stage (P = 0.07), but did differ by treatment option presented (P = 0.002) and nodal status (P = 0.01). About 50% of patients with stage I or node-negative disease were steered towards undergoing chemotherapy, whereas 96% of patients were steered towards undergoing endocrine therapy, irrespective of expected treatment benefit. Decisions were less often postponed if more implicit persuasion was used (P = 0.03). Oncologists frequently use implicit persuasion, steering patients towards the treatment option that they think is in their patients' best interest. Expected treatment benefit does not always seem to be the driving force behind implicit persuasion. Awareness of one's use of these steering behaviours during decision making is a first step to help overcome the performance gap between advocating and implementing SDM. Copyright © 2016 Elsevier Ltd. All rights reserved.
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USDA-ARS?s Scientific Manuscript database
Elevated atmospheric CO2 concentrations ([CO2]) are expected to benefit the production of C3 crops through the CO2 fertilization effect (CFE) by stimulating photosynthesis and by reducing stomatal conductance and transpiration. The latter effect is also widely believed to lead to greater benefits in...
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Kessel, Line; Andresen, Jens; Erngaard, Ditte; Flesner, Per; Tendal, Britta; Hjortdal, Jesper
2016-02-01
The need for cataract surgery is expected to rise dramatically in the future due to the increasing proportion of elderly citizens and increasing demands for optimum visual function. The aim of this study was to provide an evidence-based recommendation for the indication of cataract surgery based on which group of patients are most likely to benefit from surgery. A systematic literature search was performed in the MEDLINE, CINAHL, EMBASE and COCHRANE LIBRARY databases. Studies evaluating the outcome after cataract surgery according to preoperative visual acuity and visual complaints were included in a meta-analysis. We identified eight observational studies comparing outcome after cataract surgery in patients with poor (<20/40) and fair (>20/40) preoperative visual acuity. We could not find any studies that compared outcome after cataract surgery in patients with few or many preoperative visual complaints. A meta-analysis showed that the outcome of cataract surgery, evaluated as objective and subjective visual improvement, was independent on preoperative visual acuity. There is a lack of scientific evidence to guide the clinician in deciding which patients are most likely to benefit from surgery. To overcome this shortage of evidence, many systems have been developed internationally to prioritize patients on waiting lists for cataract surgery, but the Swedish NIKE (Nationell Indikationsmodell för Katarakt Ekstraktion) is the only system where an association to the preoperative scoring of a patient has been related to outcome of cataract surgery. We advise that clinicians are inspired by the NIKE system when they decide which patients to operate to ensure that surgery is only offered to patients who are expected to benefit from cataract surgery. © 2015 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.
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Do employee health management programs work?
Serxner, Seth; Gold, Daniel; Meraz, Angela; Gray, Ann
2009-01-01
Current peer review literature clearly documents the economic return and Return-on-Investment (ROI) for employee health management (EHM) programs. These EHM programs are defined as: health promotion, self-care, disease management, and case management programs. The evaluation literature for the sub-set of health promotion and disease management programs is examined in this article for specific evidence of the level of economic return in medical benefit cost reduction or avoidance. The article identifies the methodological challenges associated with determination of economic return for EHM programs and summarizes the findings from 23 articles that included 120 peer review study results. The article identifies the average ROI and percent health plan cost impact to be expected for both types of EHM programs, the expected time period for its occurrence, and caveats related to its measurement.
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Spectromicroscopy and coherent diffraction imaging: focus on energy materials applications.
Hitchcock, Adam P; Toney, Michael F
2014-09-01
Current and future capabilities of X-ray spectromicroscopy are discussed based on coherence-limited imaging methods which will benefit from the dramatic increase in brightness expected from a diffraction-limited storage ring (DLSR). The methods discussed include advanced coherent diffraction techniques and nanoprobe-based real-space imaging using Fresnel zone plates or other diffractive optics whose performance is affected by the degree of coherence. The capabilities of current systems, improvements which can be expected, and some of the important scientific themes which will be impacted are described, with focus on energy materials applications. Potential performance improvements of these techniques based on anticipated DLSR performance are estimated. Several examples of energy sciences research problems which are out of reach of current instrumentation, but which might be solved with the enhanced DLSR performance, are discussed.
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Can Regulatory Bodies Expect Efficient Help from Formal Methods?
NASA Technical Reports Server (NTRS)
Lopez Ruiz, Eduardo R.; Lemoine, Michel
2010-01-01
In the context of EDEMOI - a French national project that proposed the use of semiformal and formal methods to infer the consistency and robustness of aeronautical regulations through the analysis of faithfully representative models- a methodology had been suggested (and applied) to different (safety and security-related) aeronautical regulations. This paper summarizes the preliminary results of this experience by stating which were the methodology s expected benefits, from a scientific point of view, and which are its useful benefits, from a regulatory body s point of view.
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Government mandates and employer-sponsored health insurance: who is still not covered?
Vanness, David J; Wolfe, Barbara L
2002-06-01
We characterize employer-sponsored health insurance offering strategies in light of benefit non-discrimination and minimum wage regulation when workers have heterogeneous earnings and partially unobservable demand for (and cost of) insurance. We then empirically examine how earnings and expected medical expenses are associated with low wage workers' ability to obtain insurance before and after enactment of federal benefit non-discrimination rules. We find no evidence that the non-discrimination rules helped low wage workers (especially those with high own or children's expected medical expenses) to obtain insurance.
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NANOTECHNOLOGY: A NOVEL APPROACH TO PREVENT BIOCIDE LEACHING
This project will demonstrate the environmental benefits of introducing biocide into wood using hydrophobic nanoparticles as a delivery vehicle and controlled release device for organic and inorganic biocides. The primary benefits expected from use of nanoparticles as controll...
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... be frank and upfront with your PT about cost, payment plans, and the benefits you can expect from therapy. Weakness Muscle weakness ... medical equipment) may be available through private or public insurance, community ... benefits if you have done military service. Reimbursement programs ...
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Lifelong antiretroviral therapy or HIV cure: The benefits for the individual patient.
Buell, Kevin G; Chung, Christopher; Chaudhry, Zain; Puri, Aiysha; Nawab, Khizr; Ravindran, Rahul Prashanth
2016-01-01
There are an estimated 35 million people living with human immunodeficiency virus (HIV) globally, 19 million of whom are unaware of their HIV status and, in the absence of antiretroviral therapy (ART), will have a shortened life expectancy. Although ART remains the "gold standard" for treatment of HIV infection, the requirement for lifelong treatment poses multiple challenges for the patient. These include stigma, an untenable pill burden, side effects, and the threat of viral resistance in the case of non-compliance. This review evaluates the challenges of accessing, delivering, and sustaining ART for people living with HIV and will discuss the case for pursuing a goal of HIV cure, the potential benefits of such a cure for the individual patient, and the current potential candidates for such a cure.
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The potential impact of rural mayday systems on vehicular crash fatalities.
Evanco, W M
1999-09-01
Rural mayday systems can reduce the time between the occurrence of an accident and the notification of emergency medical services--called the accident notification time. Reductions in this time, in turn, may affect the numbers of fatalities. A statistical analysis is used to estimate the quantitative relationship between fatalities and the accident notification time. The elasticity of rural fatalities with respect to the accident notification time was found to be 0.14. If a rural mayday system were fully implemented (i.e. a 100% market penetration) and the service availability were 100%, then we would expect monetary benefits of about $1.83 billion per year and comprehensive benefits (which includes the monetary value attached to the lost quality of life) of $6.37 billion per year.
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Comparison of high-speed rail and maglev system costs
DOE Office of Scientific and Technical Information (OSTI.GOV)
Rote, D.M.
1998-07-01
This paper compares the two modes of transportation, and notes important similarities and differences in the technologies and in how they can be implemented to their best advantage. Problems with making fair comparisons of the costs and benefits are discussed and cost breakdowns based on data reported in the literature are presented and discussed in detail. Cost data from proposed and actual construction projects around the world are summarized and discussed. Results from the National Maglev Initiative and the recently-published Commercial Feasibility Study are included in the discussion. Finally, estimates will be given of the expected cost differences between HSRmore » and maglev systems implemented under simple and complex terrain conditions. The extent to which the added benefits of maglev technology offset the added costs is examined.« less
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Cunningham, Tony J.; Chambers, Alexis M.; Payne, Jessica D.
2014-01-01
Successful prospective memory is necessarily driven by an expectation that encoded information will be relevant in the future, leading to its preferential placement in memory storage. Like expectation, emotional salience is another type of cue that benefits human memory formation. Although separate lines of research suggest that both emotional information and information explicitly expected to be important in the future benefit memory consolidation, it is unknown how expectation affects the processing of emotional information and whether sleep, which is known to maximize memory consolidation, plays a critical role. The purpose of this study was to investigate how expectation would impact the consolidation of emotionally salient content, and whether this impact would differ across delays of sleep and wake. Participants encoded scenes containing an emotionally charged negative or neutral foreground object placed on a plausible neutral background. After encoding, half of the participants were informed they would later be tested on the scenes (expected condition), while the other half received no information about the test (unexpected condition). At recognition, following a 12-h delay of sleep or wakefulness, the scene components (objects and backgrounds) were presented separately and one at a time, and participants were asked to determine if each component was old or new. Results revealed a greater disparity for memory of negative objects over their paired neutral backgrounds for both the sleep and wake groups when the memory test was expected compared to when it was unexpected, while neutral memory remained unchanged. Analyzing each group separately, the wake group showed a threefold increase in the magnitude of this object/background trade-off for emotional scenes when the memory test was expected compared to when it was unexpected, while those who slept performed similarly across conditions. These results suggest that emotional salience and expectation cues interact to benefit emotional memory consolidation during a delay of wakefulness. The sleeping brain, however, may automatically tag emotionally salient information as important, such that explicit instruction of an upcoming memory test does not further improve memory performance. PMID:25136328
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Munsick, Tristram R.; Peck, Dannele E.; Ritten, John P.; Jones, Randall; Jones, Michelle; Miller, Myrna M.
2017-01-01
Recurring outbreaks of bluetongue virus in domestic sheep of the US Intermountain West have prompted questions about the economic benefits and costs of vaccinating individual flocks against bluetongue (BT) disease. We estimate the cost of a BT outbreak on a representative rangeland sheep operation in the Big Horn Basin of the state of Wyoming using enterprise budgets and stochastic simulation. The latter accounts for variability in disease severity and lamb price, as well as uncertainty about when an outbreak will occur. We then estimate the cost of purchasing and administering a BT vaccine. Finally, we calculate expected annual net benefit of vaccinating under various outbreak intervals. Expected annual net benefit is calculated for both a killed virus (KV) vaccine and modified-live virus vaccine, using an observed price of $0.32 per dose for modified-live and an estimated price of $1.20 per dose for KV. The modified-live vaccine’s expected annual net benefit has a 100% chance of being positive for an outbreak interval of 5, 10, or 20 years, and a 77% chance of being positive for a 50-year interval. The KV vaccine’s expected annual net benefit has a 97% chance of being positive for a 5-year outbreak interval, and a 42% chance of being positive for a 10-year interval. A KV vaccine is, therefore, unlikely to be economically attractive to producers in areas exposed less frequently to BT disease. A modified-live vaccine, however, requires rigorous authorization before legal use can occur in Wyoming. To date, no company has requested to manufacture a modified-live vaccine for commercial use in Wyoming. The KV vaccine poses less risk to sheep reproduction and less risk of unintentional spread, both of which facilitate approval for commercial production. Yet, our results show an economically consequential tradeoff between a KV vaccine’s relative safety and higher cost. Unless the purchase price is reduced below our assumed $1.20 per dose, producer adoption of a KV vaccine for BT is likely to be low in the study area. This tradeoff between cost and safety should be considered when policymakers regulate commercial use of the two vaccine types. PMID:29075635
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State of the art in benefit-risk analysis: economics and marketing-finance.
Kalogeras, N; Odekerken-Schröder, G; Pennings, J M E; Gunnlaugsdóttir, H; Holm, F; Leino, O; Luteijn, J M; Magnússon, S H; Pohjola, M V; Tijhuis, M J; Tuomisto, J T; Ueland, Ø; White, B C; Verhagen, H
2012-01-01
All market participants (e.g., investors, producers, consumers) accept a certain level of risk as necessary to achieve certain benefits. There are many types of risk including price, production, financial, institutional, and individual human risks. All these risks should be effectively managed in order to derive the utmost of benefits and avoid disruption and/or catastrophic economic consequences for the food industry. The identification, analysis, determination, and understanding of the benefit-risk trade-offs of market participants in the food markets may help policy makers, financial analysts and marketers to make well-informed and effective corporate investment strategies in order to deal with highly uncertain and risky situations. In this paper, we discuss the role that benefits and risks play in the formation of the decision-making process of market-participants, who are engaged in the upstream and downstream stages of the food supply chain. In addition, we review the most common approaches (expected utility model and psychometrics) for measuring benefit-risk trade-offs in the economics and marketing-finance literature, and different factors that may affect the economic behaviour in the light of benefit-risk analyses. Building on the findings of our review, we introduce a conceptual framework to study the benefit-risk behaviour of market participants. Specifically, we suggest the decoupling of benefits and risks into the separate components of utilitarian benefits, hedonic benefits, and risk attitude and risk perception, respectively. Predicting and explaining how market participants in the food industry form their overall attitude in light of benefit-risk trade-offs may be critical for policy-makers and managers who need to understand the drivers of the economic behaviour of market participants with respect to production, marketing and consumption of food products. Copyright © 2011 Elsevier Ltd. All rights reserved.
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NASA Astrophysics Data System (ADS)
Panopoulos, Dimitrios; Sachpazidis, Ilias; Rizou, Despoina; Menary, Wayne; Cardenas, Jose; Psarras, John
Peru, officially classified as a middle-income country, has benefited from sustained economic growth in recent years. However, the benefits have not been seen by the vast majority of the population, particularly Peru's rural population. Virtually all of the nation's rural health-care centres are cut off from the rest of the country, so access to care for most people is not only difficult but also costly. MEDNET attempts to redress this issue by developing a medical health network with the help of the collaboration medical application based on TeleConsult & @HOME medical database for vital signs. The expected benefits include improved support for medics in the field, reduction of patient referrals, reduction in number of emergency interventions and improved times for medical diagnosis. An important caveat is the emphasis on exploiting the proposed infrastructure for education and social enterprise initiatives. The project has the full support of regional political and health authorities and, importantly, full local community support.
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Gan, Hui K; You, Benoit; Pond, Gregory R; Chen, Eric X
2012-04-18
In designing phase III randomized clinical trials (RCTs), the expected magnitude of the benefit of the experimental therapy (δ) determines the number of patients required and the number of person-years of follow-up. We conducted a systematic review to evaluate how reliably δ approximates the observed benefit (B) in RCTs that evaluated cancer treatment. RCTs evaluating systemic therapy in adult cancer patients published in 10 journals from January 1, 2005, through December 31, 2009, were identified. Data were extracted from each publication independently by two investigators. The related-samples Sign test was used to determine whether the median difference between δ and B was statistically significant in different study subsets and was two-sided. A total of 253 RCTs met the eligibility criteria and were included in the analysis. Regardless of whether benefit was defined as proportional change (median difference between δ and B = -13.0%, 95% confidence interval [CI] = -21.0% to -8.0%), absolute change (median difference between δ and B = -8.0%, 95% CI = -9.9% to -5.1%), or median increase in a time-to-event endpoint (median difference between δ and B = -1.4 months, 95% CI = -2.1 to -0.8 months), δ was consistently and statistically significantly larger than B (P < .001, for each, respectively). This relationship between δ and B was independent of year of publication, industry funding, management by cooperative trial groups, type of control arm, type of experimental arm, disease site, adjuvant treatment, or treatment for advanced disease, and likely contributed to the high proportion of negative RCTs (158 [62.5%] of 253 studies). Investigators consistently make overly optimistic assumptions regarding treatment benefits when designing RCTs. Attempts to reduce the number of negative RCTs should focus on more realistic estimations of δ. Increased use of interim analyses, certain adaptive trial designs, and better biological characterization of patients are potential ways of mitigating this problem.
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Cleemput, Irina; Christiaens, Wendy; Kohn, Laurence; Léonard, Christian; Daue, François; Denis, Alain
2015-06-01
In systems with public health insurance, coverage decisions should reflect social values. Deliberation among stakeholders could achieve this goal, but rarely involves patients and citizens directly. This study aimed at evaluating the acceptability, and the perceived benefits and risks, of public and patient involvement (PPI) in coverage decision making to Belgian stakeholders. A two-round Delphi survey was conducted among all stakeholder groups. The survey was constructed on the basis of interviews with 10 key stakeholders and a review of the literature on participation models. Consensus was defined as 65% or more of the respondents agreeing with a statement and less than 15% disagreeing. Eighty stakeholders participated in both rounds. They were defined as the Delphi panel. Belgian stakeholders are open toward PPI in coverage decision processes. Benefits are expected to exceed risks. The preferred model for involvement is to consult citizens or patients, within the existing decision-making structures and at specific milestones in the process. Consulting citizens and patients is a higher level of involvement than merely informing them and a lower level than letting them participate actively. Consultation involves asking nonbinding advice on (parts of) the decision problem. According to the Delphi panel, the benefits of PPI could be increasing awareness among members of the general public and patients about the challenges and costs of health care, and enriched decision processes with expertise by experience from patients. Potential risks include subjectivity, insufficient resources to participate and weigh on the process, difficulties in finding effective ways to express a collective opinion, the risk of manipulation, and lobbying or power games of other stakeholders. PPI in coverage decision-making processes is acceptable to Belgian stakeholders, be it in different ways for different types of decisions. Benefits are expected to outweigh risks. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
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Cresswell, Kathrin; Coleman, Jamie; Slee, Ann; Williams, Robin; Sheikh, Aziz
2013-01-01
Background ePrescribing systems have significant potential to improve the safety and efficiency of healthcare, but they need to be carefully selected and implemented to maximise benefits. Implementations in English hospitals are in the early stages and there is a lack of standards guiding the procurement, functional specifications, and expected benefits. We sought to provide an updated overview of the current picture in relation to implementation of ePrescribing systems, explore existing strategies, and identify early lessons learned. Methods A descriptive questionnaire-based study, which included closed and free text questions and involved both quantitative and qualitative analysis of the data generated. Results We obtained responses from 85 of 108 NHS staff (78.7% response rate). At least 6% (n = 10) of the 168 English NHS Trusts have already implemented ePrescribing systems, 2% (n = 4) have no plans of implementing, and 34% (n = 55) are planning to implement with intended rapid implementation timelines driven by high expectations surrounding improved safety and efficiency of care. The majority are unclear as to which system to choose, but integration with existing systems and sophisticated decision support functionality are important decisive factors. Participants highlighted the need for increased guidance in relation to implementation strategy, system choice and standards, as well as the need for top-level management support to adequately resource the project. Although some early benefits were reported by hospitals that had already implemented, the hoped for benefits relating to improved efficiency and cost-savings remain elusive due to a lack of system maturity. Conclusions Whilst few have begun implementation, there is considerable interest in ePrescribing systems with ambitious timelines amongst those hospitals that are planning implementations. In order to ensure maximum chances of realising benefits, there is a need for increased guidance in relation to implementation strategy, system choice and standards, as well as increased financial resources to fund local activities. PMID:23335961
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Survival Benefit of Lung Transplantation in the Modern Era of Lung Allocation.
Vock, David M; Durheim, Michael T; Tsuang, Wayne M; Finlen Copeland, C Ashley; Tsiatis, Anastasios A; Davidian, Marie; Neely, Megan L; Lederer, David J; Palmer, Scott M
2017-02-01
Lung transplantation is an accepted and increasingly employed treatment for advanced lung diseases, but the anticipated survival benefit of lung transplantation is poorly understood. To determine whether and for which patients lung transplantation confers a survival benefit in the modern era of U.S. lung allocation. Data on 13,040 adults listed for lung transplantation between May 2005 and September 2011 were obtained from the United Network for Organ Sharing. A structural nested accelerated failure time model was used to model the survival benefit of lung transplantation over time. The effects of patient, donor, and transplant center characteristics on the relative survival benefit of transplantation were examined. Overall, 73.8% of transplant recipients were predicted to achieve a 2-year survival benefit with lung transplantation. The survival benefit of transplantation varied by native disease group (P = 0.062), with 2-year expected benefit in 39.2 and 98.9% of transplants occurring in those with obstructive lung disease and cystic fibrosis, respectively, and by lung allocation score at the time of transplantation (P < 0.001), with net 2-year benefit in only 6.8% of transplants occurring for lung allocation score less than 32.5 and in 99.9% of transplants for lung allocation score exceeding 40. A majority of adults undergoing transplantation experience a survival benefit, with the greatest potential benefit in those with higher lung allocation scores or restrictive native lung disease or cystic fibrosis. These results provide novel information to assess the expected benefit of lung transplantation at an individual level and to enhance lung allocation policy.
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Direct Operational Field Test Evaluation, Simulation And Modeling
DOT National Transportation Integrated Search
1998-08-01
THE PURPOSE OF THE SIMULATION EVALUATION IS TO ASSESS THE EXPECTED FUTURE IMPACTS OF THE DIRECT TECHNOLOGIES UNDER SCENARIOS OF FULL DEPLOYMENT. THIS PROVIDED SOME INDICATION OF THE LEVEL OF BENEFITS THAT CAN BE EXPECTED FROM DIRECT IN THE FUTURE. BE...
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Hiligsmann, Mickael; Reginster, Jean-Yves
2018-04-01
There is a paucity of research that projects the public health and economic impact of healthcare interventions in the future. In this study, we aimed to estimate the public health and economic impact of vitamin D fortified dairy products for the years 2020, 2030, 2040, 2050 and 2060. We used a previously validated Markov microsimulation model that was designed to assess the public health and economic impact of dairy products for fracture prevention in the French general population aged over 60 years in the year 2015. The expected benefit (in terms of fractures prevented) of the recommended intake of dairy products compared to the absence of appropriate intake is expected to increase by 63% in 2040 and by 85% in 2060. The cost per quality-adjusted life years gained of the appropriate intake of dairy products is expected to decrease from €58,244 in 2015 to €42,616 in 2060. The potential public health and economic benefits of vitamin D fortified dairy products is expected to substantially increase in the future, especially in the population aged over 80 years. Decision makers should be aware of the current and future potential benefits of dairy products to protect bone fractures.
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Decision-making competence predicts domain-specific risk attitudes
Weller, Joshua A.; Ceschi, Andrea; Randolph, Caleb
2015-01-01
Decision-making competence (DMC) reflects individual differences in rational responding across several classic behavioral decision-making tasks. Although it has been associated with real-world risk behavior, less is known about the degree to which DMC contributes to specific components of risk attitudes. Utilizing a psychological risk-return framework, we examined the associations between risk attitudes and DMC. Italian community residents (n = 804) completed an online DMC measure, using a subset of the original Adult-DMC battery. Participants also completed a self-reported risk attitude measure for three components of risk attitudes (risk-taking, risk perceptions, and expected benefits) across six risk domains. Overall, greater performance on the DMC component scales were inversely, albeit modestly, associated with risk-taking tendencies. Structural equation modeling results revealed that DMC was associated with lower perceived expected benefits for all domains. In contrast, its association with perceived risks was more domain-specific. These analyses also revealed stronger indirect effects for the DMC → expected benefits → risk-taking path than the DMC → perceived risk → risk-taking path, especially for behaviors that may be considered more maladaptive in nature. These results suggest that DMC performance differentially impacts specific components of risk attitudes, and may be more strongly related to the evaluation of expected value of a specific behavior. PMID:26029128
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Cannabis finds its way into treatment of Crohn's disease.
Schicho, Rudolf; Storr, Martin
2014-01-01
In ancient medicine, cannabis has been widely used to cure disturbances and inflammation of the bowel. A recent clinical study now shows that the medicinal plant Cannabis sativa has lived up to expectations and proved to be highly efficient in cases of inflammatory bowel diseases. In a prospective placebo-controlled study, it has been shown what has been largely anticipated from anecdotal reports, i.e. that cannabis produces significant clinical benefits in patients with Crohn's disease. The mechanisms involved are not yet clear but most likely include peripheral actions on cannabinoid receptors 1 and 2, and may also include central actions. © 2013 S. Karger AG, Basel.
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Parent Preferences for Medical Error Disclosure: A Qualitative Study.
Coffey, Maitreya; Espin, Sherry; Hahmann, Tara; Clairman, Hayyah; Lo, Lisha; Friedman, Jeremy N; Matlow, Anne
2017-01-01
According to disclosure guidelines, patients experiencing adverse events due to medical errors should be offered full disclosure, whereas disclosure of near misses is not traditionally expected. This may conflict with parental expectations; surveys reveal most parents expect full disclosure whether errors resulted in harm or not. Protocols regarding whether to include children in these discussions have not been established. This study explores parent preferences around disclosure and views on including children. Fifteen parents of hospitalized children participated in semistructured interviews. Three hypothetical scenarios of different severity were used to initiate discussion. Interviews were audiotaped, transcribed, and coded for emergent themes. Parents uniformly wanted disclosure if harm occurred, although fewer wanted their child informed. For nonharmful errors, most parents wanted disclosure for themselves but few for their children.With respect to including children in disclosure, parents preferred to assess their children's cognitive and emotional readiness to cope with disclosure, wishing to act as a "buffer" between the health care team and their children. Generally, as event severity decreased, they felt that risks of informing children outweighed benefits. Parents strongly emphasized needing reassurance of a good final outcome and anticipated difficulty managing their emotions. Parents have mixed expectations regarding disclosure. Although survey studies indicate a stronger desire for disclosure of nonharmful events than for adult patients, this qualitative study revealed a greater degree of hesitation and complexity. Parents have a great need for reassurance and consistently wish to act as a buffer between the health care team and their children. Copyright © 2017 by the American Academy of Pediatrics.
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Prospects of Supercritical Fluids in Realizing Graphene-Based Functional Materials.
Padmajan Sasikala, Suchithra; Poulin, Philippe; Aymonier, Cyril
2016-04-13
Supercritical-fluids science and technology predate all the approaches that are currently established for graphene production by several decades in advanced materials design. However, it has only recently been proposed as a plausible approach for graphene processing. Since then, supercritical fluids have emerged into contention as an alternative to existing technologies because of their scalability and versatility in processing graphene materials, which include composites, aerogels, and foams. Here, an overview is presented of such materials prepared through supercritical fluids from an advanced materials science standpoint, with a discussion on their fundamental properties and technological applications. The benefits of supercritical-fluid processing over conventional liquid-phase processing are presented. The benefits include not only better performances for advanced applications but also environmental issues associated with the synthesis process. Nevertheless, the limitations of supercritical-fluid processing are also stressed, along with challenges that are still faced toward the achievement of the great expectations from graphene materials. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
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Padon, Alisa A.; Rimal, Rajiv N.; Jernigan, David; Siegel, Michael; DeJong, William
2016-01-01
Social norms affect human behavior, and underage drinking is no exception. Using the theory of normative social behavior (TNSB), this paper tested the proposition that the association between perceptions about the prevalence of drinking (descriptive norms) and underage drinking is strengthened when perceived pressures to conform (injunctive norms) and beliefs about the benefits of drinking (outcome expectations) are high. This proposition was tested on a nationally representative sample of underage drinkers, ages 13–20, (N = 1,031) in relation to their alcohol consumption, expanding on research with college-age youth. On average, males and females reported drinking 23 and 18 drinks per month, respectively. The main effect of descriptive norms (β = .10, p < .01) on alcohol consumption was modified by interactions with injunctive norms (β = .11, p < .01), benefit to self (β = .12, p < .001), and benefit to others (β = .10, p < .01). Underage drinkers are most vulnerable to excessive drinking if they believe that most others drink, that they themselves are expected to drink, and that drinking confers several benefits. Norms-based interventions to reduce youth alcohol use need to focus on changing not only descriptive norms, but also injunctive norms and outcome expectations. PMID:27668832
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Padon, Alisa A; Rimal, Rajiv N; Jernigan, David; Siegel, Michael; DeJong, William
2016-10-01
Social norms affect human behavior, and underage drinking is no exception. Using the theory of normative social behavior, this study tested the proposition that the association between perceptions about the prevalence of drinking (descriptive norms) and underage drinking is strengthened when perceived pressures to conform (injunctive norms) and beliefs about the benefits of drinking (outcome expectations) are high. This proposition was tested on a nationally representative sample of underage drinkers ages 13-20 (N = 1,031) in relation to their alcohol consumption, expanding on research with college-age youth. On average, males and females reported drinking 23 and 18 drinks per month, respectively. The main effect of descriptive norms (β = .10, p < .01) on alcohol consumption was modified by interactions with injunctive norms (β = .11, p < .01), benefit to self (β = .12, p < .001), and benefit to others (β = .10, p < .01). Underage drinkers are most vulnerable to excessive drinking if they believe that most others drink, that they themselves are expected to drink, and that drinking confers several benefits. Norms-based interventions to reduce youth alcohol use need to focus on changing not only descriptive norms but also injunctive norms and outcome expectations.
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THOMPSON, JOHN D.; DING, YAO; GLASS, MICHAEL
2016-01-01
Policy Points: Newborn screening not only saves lives but can also yield net societal economic benefit, in addition to benefits such as improved quality of life to affected individuals and families.Calculations of net economic benefit from newborn screening include the monetary equivalent of avoided deaths and reductions in costs of care for complications associated with late‐diagnosed individuals minus the additional costs of screening, diagnosis, and treatment associated with prompt diagnosis.Since 2001 the Washington State Department of Health has successfully implemented an approach to conducting evidence‐based economic evaluations of disorders proposed for addition to the state‐mandated newborn screening panel. Context Economic evaluations can inform policy decisions on the expansion of newborn screening panels. This article documents the use of cost‐benefit models in Washington State as part of the rule‐making process that resulted in the implementation of screening for medium‐chain acyl‐CoA dehydrogenase (MCAD) deficiency and 4 other metabolic disorders in 2004, cystic fibrosis (CF) in 2006, 15 other metabolic disorders in 2008, and severe combined immune deficiency (SCID) in 2014. Methods We reviewed Washington State Department of Health internal reports and spreadsheet models of expected net societal benefit of adding disorders to the state newborn screening panel. We summarize the assumptions and findings for 2 models (MCAD and CF) and discuss them in relation to findings in the peer‐reviewed literature. Findings The MCAD model projected a benefit‐cost ratio of 3.4 to 1 based on assumptions of a 20.0 percentage point reduction in infant mortality and a 13.9 percentage point reduction in serious developmental disability. The CF model projected a benefit‐cost ratio of 4.0‐5.4 to 1 for a discount rate of 3%‐4% and a plausible range of 1‐2 percentage point reductions in deaths up to age 10 years. Conclusions The Washington State cost‐benefit models of newborn screening were broadly consistent with peer‐reviewed literature, and their findings of net benefit appear to be robust to uncertainty in parameters. Public health newborn screening programs can develop their own capacity to project expected costs and benefits of expansion of newborn screening panels, although it would be most efficient if this capacity were shared among programs. PMID:27265561
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Code of Federal Regulations, 2011 CFR
2011-10-01
... expectations that the performer will receive present or future economic benefits beyond the instant contract as... economic benefits to the performer, DOE will consider the technical feasibility, projected economic viability, societal and political acceptability of commercial application, as well as possible effects of...
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Code of Federal Regulations, 2013 CFR
2013-10-01
... expectations that the performer will receive present or future economic benefits beyond the instant contract as... economic benefits to the performer, DOE will consider the technical feasibility, projected economic viability, societal and political acceptability of commercial application, as well as possible effects of...
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Code of Federal Regulations, 2012 CFR
2012-10-01
... expectations that the performer will receive present or future economic benefits beyond the instant contract as... economic benefits to the performer, DOE will consider the technical feasibility, projected economic viability, societal and political acceptability of commercial application, as well as possible effects of...
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Code of Federal Regulations, 2014 CFR
2014-10-01
... expectations that the performer will receive present or future economic benefits beyond the instant contract as... economic benefits to the performer, DOE will consider the technical feasibility, projected economic viability, societal and political acceptability of commercial application, as well as possible effects of...
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Code of Federal Regulations, 2010 CFR
2010-10-01
... expectations that the performer will receive present or future economic benefits beyond the instant contract as... economic benefits to the performer, DOE will consider the technical feasibility, projected economic viability, societal and political acceptability of commercial application, as well as possible effects of...
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Sjobbema, Christiaan; van der Mei, Sijrike; Cornelius, Bert; van der Klink, Jac; Brouwer, Sandra
2018-08-01
In the Dutch social security system, insurance physicians (IPs) assess participatory behaviour as part of the overall disability claim assessment. This study aims to explore the views and opinions of IPs regarding participatory behaviour as well as factors related to inadequate participatory behaviour, and to incorporate these factors in the International Classification of Functioning, Disability and Health (ICF) biopsychosocial framework. This qualitative study collected data by means of open-ended questions in 10 meetings of local peer review groups (PRGs) which included a total of 78 IPs of the Dutch Social Security Institute. In addition, a concluding discussion meeting with 8 IPs was organized. After qualitative data analyses, four major themes emerged: (1) participation as an outcome, (2) efforts of disability benefit claimants in the process of participatory behaviour, (3) beliefs of disability benefit claimants concerning participation, and (4) recovery behaviour. Identified factors of inadequate participatory behaviour covered all ICF domains, including activities, environmental, and personal factors, next to factors related to health condition and body functions or structures. Outcomes of the discussion meeting indicated the impossibility of formulating general applicable criteria for quantifying and qualifying participatory behaviour. Views of IPs on disability benefit claimants' (in)adequate participatory behaviour reflect a broad biopsychosocial perspective. IPs adopt a nuanced tailor-made approach during assessment of individual disability benefit claimants' participatory behaviour and related expected activities aimed at recovery of health and RTW. Implications for Rehabilitation Within a biopsychosocial perspective, it is not possible to formulate general criteria for the assessment of participatory behaviour for each unique case. Individual disability benefit claimant characteristics and circumstances are taken into account. To optimize the return-to-work (RTW) process, insurance physicians (IPs) assess participatory behaviour according to the International Classification of Functioning, Disability and Health, including medical, personal, and environmental factors. Some aspects within the concept of participatory behaviour extend beyond the boundaries of the domain where IPs operate because opinions in society on personal and societal responsibility influence participatory behaviour.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
NONE
The Albuquerque Operations Office through the Pinellas Plant Area Office is involved in a joint venture to establish a Partnership School and a Day Care Facility at the Plant. The venture is unique in that it is based on a partnership with the local county school system. The county school system will provide the teachers, supplies and classroom furnishings for the operation of the school for pre-kindergarten, kindergarten, first and second grade during regular school hours. The Government will provide the facility and its normal operating and maintenance costs. A Day Care Facility will also be available for children frommore » infancy through the second grade for outside school hours. The day care will be operated as a non-profit corporation. Fees paid by parents with children in the day care center will cove the cost of staff, food, supplies and liability insurance. Again, the government will provide the facility and its normal operating and maintenance costs. Between 75 and 90 children are expected in the first year of operation. The Partnership School will consist of one class each for pre-kindergarten, kindergarten and first grade. Second grade will be added in 1990. The total estimated number of children for both the Child Care and Partnership School should not exceed 200 children. Expected benefits include reduced absenteeism, tardiness and turnover and thus increased productivity. The program will be an asset in recruiting and retaining the best workforce. Other benefits include improved education for the children.« less
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DOT National Transportation Integrated Search
1998-07-01
The purpose of this study was to identify, through a literature review, the potential safety benefits of implementing various Intelligent Transportation System (ITS) technologies through Virginia's Smart Travel Program. This study was requested by th...
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Ecological restoration can reestablish ecosystem services (ES) that provide important social benefits, but managers with limited funds and resources are forced to prioritize potential restoration sites. Prioritizing restoration sites based on ecological functioning and expected ...
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van Meijgaard, Jeroen; Fielding, Jonathan E
2012-01-01
Despite years of declining smoking prevalence, tobacco use is still the leading preventable contributor to illness and death in the United States, and the effect of past tobacco-use control efforts has not fully translated into improvements in health outcomes. The objective of this study was to use a life course model with multiple competing causes of death to elucidate the ongoing benefits of tobacco-use control efforts on US death rates. We used a continuous-time life course simulation model for the US population. We modeled smoking initiation and cessation and 20 leading causes of death as competing risks over the life span, with the risk of death for each cause dependent on past and current smoking status. Risk parameters were estimated using data from the National Health Interview Survey that were linked to follow-up mortality data. Up to 14% (9% for men, 14% for women) of the total gain in life expectancy since 1960 was due to tobacco-use control efforts. Past efforts are expected to further increase life expectancy by 0.9 years for women and 1.3 years for men. Additional reduction in smoking prevalence may eventually yield an average 3.4-year increase in life expectancy in the United States. Coronary heart disease is expected to increase as a share of total deaths. A dynamic individual-level model with multiple causes of death supports assessment of the delayed benefits of improved tobacco-use control efforts. We show that past smoking reduction efforts will translate into further increases in life expectancy in the coming years. Smoking will remain a major contributor to preventable illness and death, worthy of continued interventions.
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Becker, Jan; Beutel, Manfred E; Gerzymisch, Katharina; Schulz, Dirk; Siepmann, Martin; Knickenberg, Rudolf J; Schmädeke, Stefan; Ferdinand, Peter; Zwerenz, Rüdiger
2016-06-13
Patients' treatment expectations are a key factor in psychotherapy. Several studies have linked higher expectations to better treatment success. Therefore, we want to evaluate the impact of a targeted video-based intervention on patients' expectations and the treatment success of inpatient rehabilitation. All patients who will be referred to inpatient psychosomatic rehabilitation in three clinics will receive a study flyer with information about how to log in to the study platform together with the usual clinic information leaflet. Patients will receive the study information and informed consent upon login and will be randomized into the intervention or the control group. The intervention group (n = 394) will get access to our virtual online clinic, containing several videos about inpatient rehabilitation, until their admission to inpatient rehabilitation. The control group (n = 394) will receive no special treatment preparation. Questionnaires will be given at study inclusion (T0), two weeks before admission to (T1), and at the end of (T2) inpatient rehabilitation. The primary outcome is the outcome expectancy measured with the Credibility Expectancy Questionnaire at T1. Secondary outcomes include treatment motivation, mental health, work ability, depression, anxiety, and satisfaction with and usage of the Internet platform. We expect the intervention group to benefit from the additional preparation concerning their outcome expectancy. If successful, this approach could be used in the future to enhance the efficacy of inpatient rehabilitation. ClinicalTrials.gov: NCT02532881 . Registered on 25 August 2015.
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Bodnar, Benjamin E; Claassen, Cassidy W; Solomon, Julie; Mayanja-Kizza, Harriet; Rastegar, Asghar
2015-01-01
The MUYU Collaboration is a partnership between Mulago Hospital-Makerere University College of Health Sciences (M-MakCHS), in Kampala, Uganda, and the Yale University School of Medicine. The program allows Ugandan junior faculty to receive up to 1 year of subspecialty training within the Yale hospital system. The authors performed a qualitative study to assess the effects of this program on participants, as well as on M-MakCHS as an institution. Data was collected via semi-structured interviews with exchange participants. Eight participants (67% of those eligible as of 4/2012) completed interviews. Study authors performed data analysis using standard qualitative data analysis techniques. Analysis revealed themes addressing the benefits, difficulties, and opportunities for improvement of the program. Interviewees described the main benefit of the program as its effect on their fund of knowledge. Participants also described positive effects on their clinical practice and on medical education at M-MakCHS. Most respondents cited financial issues as the primary difficulty of participation. Post-participation difficulties included resource limitations and confronting longstanding institutional and cultural habits. Suggestions for programmatic improvement included expansion of the program, ensuring appropriate management of pre-departure expectations, and refinement of program mentoring structures. Participants also voiced interest in expanding post-exchange programming to ensure both the use of and the maintenance of new capacity. The MUYU Collaboration has benefitted both program participants and M-MakCHS, though these benefits remain difficult to quantify. This study supports the assertion that resource-poor to resource-rich exchanges have the potential to provide significant benefits to the resource-poor partner.
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Water and Benefit Sharing in Transboundary River Basins
NASA Astrophysics Data System (ADS)
Arjoon, D.; Tilmant, A.; Herrmann, M.
2015-12-01
Growing water scarcity underlies the importance of cooperation for the effective management of river basins, particularly in the context of international rivers in which unidirectional externalities can lead to asymmetric relationships between riparian countries. Studies have shown that significant economic benefits can be expected through basin-wide cooperation, however, the equitable partitioning of these benefits over the basin is less well studied and tends to overlook the importance of stakeholder input in the definition of equitability. In this study, an institutional arrangement to maximize welfare and then share the scarcity cost in a river basin is proposed. A river basin authority plays the role of a bulk water market operator, efficiently allocating bulk water to the users and collecting bulk water charges which are then equitably redistributed among water users. This highly regulated market restrains the behaviour of water users to control externalities and to ensure basin-wide coordination, enhanced efficiency, and the equitable redistribution of the scarcity cost. The institutional arrangement is implemented using the Eastern Nile River basin as a case study. The importance of this arrangement is that it can be adopted for application in negotiations to cooperate in trans-boundary river basins. The benefit sharing solution proposed is more likely to be perceived as equitable because water users help define the sharing rule. As a result, the definition of the sharing rule is not in question, as it would be if existing rules, such as bankruptcy rules or cooperative game theory solutions, are applied, with their inherent definitions of fairness. Results of the case study show that the sharing rule is predictable. Water users can expect to receive between 93.5% and 95% of their uncontested benefits (benefits that they expect to receive if water was not rationed), depending on the hydrologic scenario.
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Risk analysis of tractor overturns on catfish farms.
Stephens, Walter B; Ibendahl, Gregory A; Myers, Melvin L; Cole, Henry P
2010-10-01
Fatal and nonfatal injuries occur on catfish farms as a result of tractor overturns, but these injuries can be greatly mitigated when a tractor is equipped with a rollover protective structure (ROPS) and seatbelt. This study analyzed the proportion of tractors on catfish farms in Mississippi not equipped with ROPS and the cost of retrofitting those tractors with a ROPS and seatbelt as compared to the expected benefits gained from adding the protection. To determine if farmers have the financial incentive to retrofit older tractors, a net present value framework was used because the expected benefits occur over a number of years. The ROPS retrofit is a one-time cost that occurs immediately, and thus the present value does not need to be calculated, i.e., time period 0. According to this study adding ROPS will provide a net benefit of $22,877 in the event of an overturn. When dealing with small farms (<125 acres) where an average tractor is used for approximately twice as many hours compared to an average tractor on large farms, the extra hours worked by a single tractor resulted in total benefits of retrofitting ROPS of $9.45 per year, whereas for large farms the net benefit is $4.70 (=125 acres). Given that the least expensive retrofit is $147, it would take 15.5 years of tractor use on the small farms for the expected benefits to outweigh the cost. Given the large range of costs that could occur due to an overturn, there could be a significant premium for not having ROPS protection. In other words, there likely is a smaller range of costs from an overturn with ROPS than without ROPS because ROPS reduces the more serious incidents.
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Framing expectations in early HIV cure research.
Dubé, Karine; Henderson, Gail E; Margolis, David M
2014-10-01
Language used to describe clinical research represents a powerful opportunity to educate volunteers. In the case of HIV cure research there is an emerging need to manage expectations by using the term 'experiment'. Cure experiments are proof-of-concept studies designed to evaluate novel paradigms to reduce persistent HIV-1 reservoirs, without any expectation of medical benefit. Copyright © 2014 Elsevier Ltd. All rights reserved.
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Active and passive surveillance of enoxaparin generics: a case study relevant to biosimilars.
Grampp, Gustavo; Bonafede, Machaon; Felix, Thomas; Li, Edward; Malecki, Michael; Sprafka, J Michael
2015-03-01
This retrospective analysis assessed the capability of active and passive safety surveillance systems to track product-specific safety events in the USA for branded and generic enoxaparin, a complex injectable subject to immune-related and other adverse events (AEs). Analysis of heparin-induced thrombocytopenia (HIT) incidence was performed on benefit claims for commercial and Medicare supplemental-insured individuals newly treated with enoxaparin under pharmacy benefit (1 January 2009 - 30 June 2012). Additionally, spontaneous reports from the FDA AE Reporting System were reviewed to identify incidence and attribution of enoxaparin-related reports to specific manufacturers. Specific, dispensed products were identifiable from National Drug Codes only in pharmacy-benefit databases, permitting sensitive comparison of HIT incidence in nearly a third of patients treated with brand or generic enoxaparin. After originator medicine's loss of exclusivity, only 5% of spontaneous reports were processed by generic manufacturers; reports attributable to specific generics were approximately ninefold lower than expected based on market share. Claims data were useful for active surveillance of enoxaparin generics dispensed under pharmacy benefits but not for products administered under medical benefits. These findings suggest that the current spontaneous reporting system will not distinguish product-specific safety signals for products distributed by multiple manufacturers, including biosimilars.
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Therapeutic Effects of Brief Hospitalization
LIEBERMAN, PAUL B.; VON REHN, SUSAN; DICKIE, ELLEN; ELLIOTT, BINETTE; EGERTER, ELISE
1992-01-01
Correlational data in this study suggest that a strong therapeutic alliance is associated with improvement during brief hospitalization. Two measures of alliance were used: patient-staff agreement on treatment goals and patient expectations of benefit from treatment. Greater patient-staff agreement at admission was associated with symptomatic improvement, independent of medication use; less use of immature defense mechanisms at discharge; and reduced risk of precipitous discharge. For a given level of symptoms, greater agreement was associated with lower doses of antipsychotics but higher doses of minor tranquilizers and antidepressants. Perception of the ward was associated with patients’ expectation of benefit. PMID:22700056
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Expectations and final evaluation of complete dentures by patients, dentist and dental technician.
Marachlioglou, C R M Z; Dos Santos, J F F; Cunha, V P P; Marchini, Leonardo
2010-07-01
There is a poor association between the dentist's evaluation of denture quality and patients' satisfaction with their dentures. Possible differences between dental professionals and patients' expectations might help explain differences in outcome evaluations. This study compared scores given by a dentist, a dental technician and patients for their expectations before and their final evaluation after complete dentures treatment. Twenty completely edentulous patients, a prosthodontist and a dental technician provided scores for the expected aesthetic and functional results of their dentures based on a visual analogue scale at baseline. Post-treatment completion ratings were given after adjustments, by dentist and patients. The dental technician provided post-treatment completion ratings after completing the dentures. The patients had higher expectations than the dental technician and the dentist perceived for both aesthetic and function (P < 0.001). The patients also presented higher post-treatment completion ratings than the dental professionals perceived for final aesthetics (P = 0.016, Kendall's W = 0.207) and function (P = 0.002, Kendall's W = 0.303). Only the dentist presented a statistically significant difference between expectations (lower) and final (higher) outcomes for aesthetics (P = 0.017) and function (P = 0.003). There was no correlation between expectations and post-treatment completion ratings according to the patients' age. There was also no correlation between the patients' gender and expectation scores. Patients presented higher expectations regarding their dentures than dental professionals. The dentist believed that dentures would bring fewer benefits than patients did, but his perception of denture benefits post-treatment was significantly higher than his expectations.
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DOT National Transportation Integrated Search
1998-01-01
The purpose of this study was to identify, through a literature review, the potential safety benefits of implementing various ITS technologies through Virginia's Smart Travel Program. This study was requested by the ITS Section of the Virginia Depart...
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Code of Federal Regulations, 2010 CFR
2010-04-01
... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Subpoenas. 405.332 Section 405.332 Employees' Benefits SOCIAL SECURITY ADMINISTRATION ADMINISTRATIVE REVIEW PROCESS FOR ADJUDICATING INITIAL DISABILITY... them; (3) State the important facts that the witness or document is expected to show; and (4) Indicate...
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Survival Benefit of Lung Transplantation in the Modern Era of Lung Allocation
Tsuang, Wayne M.; Copeland, C. Ashley Finlen; Tsiatis, Anastasios A.; Davidian, Marie; Neely, Megan L.; Lederer, David J.; Palmer, Scott M.
2017-01-01
Rationale: Lung transplantation is an accepted and increasingly employed treatment for advanced lung diseases, but the anticipated survival benefit of lung transplantation is poorly understood. Objectives: To determine whether and for which patients lung transplantation confers a survival benefit in the modern era of U.S. lung allocation. Methods: Data on 13,040 adults listed for lung transplantation between May 2005 and September 2011 were obtained from the United Network for Organ Sharing. A structural nested accelerated failure time model was used to model the survival benefit of lung transplantation over time. The effects of patient, donor, and transplant center characteristics on the relative survival benefit of transplantation were examined. Measurements and Main Results: Overall, 73.8% of transplant recipients were predicted to achieve a 2-year survival benefit with lung transplantation. The survival benefit of transplantation varied by native disease group (P = 0.062), with 2-year expected benefit in 39.2 and 98.9% of transplants occurring in those with obstructive lung disease and cystic fibrosis, respectively, and by lung allocation score at the time of transplantation (P < 0.001), with net 2-year benefit in only 6.8% of transplants occurring for lung allocation score less than 32.5 and in 99.9% of transplants for lung allocation score exceeding 40. Conclusions: A majority of adults undergoing transplantation experience a survival benefit, with the greatest potential benefit in those with higher lung allocation scores or restrictive native lung disease or cystic fibrosis. These results provide novel information to assess the expected benefit of lung transplantation at an individual level and to enhance lung allocation policy. PMID:27779905
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Eggel, Matthias; Grimm, Herwig
2018-01-01
Simple Summary According to Directive 2010/63/EU, project proposals involving experiments on animals have to be approved in a harm-benefit-analysis (HBA) that weighs the potential benefits of the experiment against the harm inflicted on animals. Only if the benefit outweighs the harm, will the project be approved. However, it is unclear what counts as a valid benefit. In this paper, we analyze the underlying premises of the HBA and its consequences for the project evaluation process. We come to the conclusion that knowledge, as such, is considered a low benefit and that only knowledge applied to benefit society, e.g., new cancer treatment or potent vaccine, etc., is considered to be a high benefit. However, we demonstrate that benefit of this kind cannot be assessed prospectively for research proposals due to the inherent uncertainties of research and the difficulty of determining extra-scientific factors that are crucial for the generation of societal benefit. As a consequence, we advocate a reevaluation of current project evaluation and propose to develop an alternative model for project evaluation. Abstract Directive 2010/63/EU (henceforth “Directive”) on the protection of animals used for scientific purposes mandates that every project proposal in EU member states involving procedures on living non-human vertebrates and cephalopods has to be approved in an review process, including a harm-benefit-analysis (HBA), to assess “whether the harm to the animals in terms of suffering, pain and distress is justified by the expected outcome taking into account ethical consideration and may ultimately benefit human beings, animals or the environment”. Despite the justifying relevance of “outcome” and “benefit”, it remains unclear how to understand these concepts. However, national authorities and applicants require a clear understanding of this to carry out a HBA. To analyze the underlying premises of the HBA and its consequences for the evaluation process, we introduce a heuristic to analyze the relation between “outcome”, “benefit” and “prospective benefit assessment”. We then apply the heuristic to all seven legitimate purposes for animal research stated in the Directive, namely basic research, translational or applied research, product safety, education and training, protection of the environment, preservation of species and forensic inquiries. As we show, regardless of which purpose is aimed for, applicants are hard-pressed to demonstrate tangible benefits in a prospective assessment. In the HBA, this becomes a problem since—as we argue—the only reasonable, expected and tangible outcome of research can ever be knowledge. The potential long-term benefits on the basis of gained knowledge are unforeseeable and impossible to predict. Research is bound to fall short of these proclaimed societal benefits and its credibility will suffer as long as research has to validate itself through short-term societal benefit. We propose to revise the ethical evaluation based on the HBA and we think it necessary to develop an alternative model for project evaluation that focuses on the value of knowledge as a scientific outcome as a necessary but not sufficient condition for societal benefit. PMID:29495562
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Could Relatedness Help Explain Why Individuals Lead in Bottlenose Dolphin Groups?
Lewis, Jennifer S.; Wartzok, Douglas; Heithaus, Michael; Krützen, Michael
2013-01-01
In many species, particular individuals consistently lead group travel. While benefits to followers often are relatively obvious, including access to resources, benefits to leaders are often less obvious. This is especially true for species that feed on patchy mobile resources where all group members may locate prey simultaneously and food intake likely decreases with increasing group size. Leaders in highly complex habitats, however, could provide access to foraging resources for less informed relatives, thereby gaining indirect benefits by helping kin. Recently, leadership has been documented in a population of bottlenose dolphins (Tursiops truncatus) where direct benefits to leaders appear unlikely. To test whether leaders could benefit indirectly we examined relatedness between leader-follower pairs and compared these levels to pairs who associated but did not have leader-follower relationship (neither ever led the other). We found the average relatedness value for leader-follower pairs was greater than expected based on chance. The same was not found when examining non leader-follower pairs. Additionally, relatedness for leader-follower pairs was positively correlated with association index values, but no correlation was found for this measure in non leader-follower pairs. Interestingly, haplotypes were not frequently shared between leader-follower pairs (25%). Together, these results suggest that bottlenose dolphin leaders have the opportunity to gain indirect benefits by leading relatives. These findings provide a potential mechanism for the maintenance of leadership in a highly dynamic fission-fusion population with few obvious direct benefits to leaders. PMID:23516445
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The "for-benefit" academic medical center: a solution for survival.
Sabeti, Heerad; Kahn, Marc J; Sachs, Benjamin P
2015-05-01
Academic medical centers (AMCs) are the backbone of the U.S. health care system. They provide a disproportionate share of charity care and serve as a training ground for future physicians. Yet, AMCs face profound economic challenges, from changes in funding to changes in the health care market. To survive, many AMCs will need to form integrated health systems, a process expected to cost tens, if not hundreds, of millions of dollars. Nearly all AMCs are structured as not-for- profit entities, which places restrictions on their ability to forge partnerships, pursue joint ventures, and access private capital, often essential elements for forming such integrated systems. An alternative model known as the "for-benefit" corporation can allow AMCs to retain their important social mission and the other advantages of their not-for-profit status while allowing them flexibility and access to both investment and philanthropic capital. To pursue the for-benefit pathway, AMCs have two options-either they could work within the constraints of existing laws to restructure themselves as for-benefit entities, or they could create, under federal law, a new for-benefit AMC model, allowing for the orderly conversion of not-for-profit AMCs. Essential components of a for-benefit AMC include a social purpose, access to multiple forms of capital, the use of earnings to support its purpose, transparency, aligned compensation, and tax exemptions. Restructuring an AMC as a for-benefit entity enables it to both advance shareholder value and further the public good.
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Pharmacotherapy for Parkinson's disease.
Chen, Jack J; Swope, David M
2007-12-01
The available pharmacotherapies for Parkinson's disease address symptomatology because no agent has been demonstrated to provide definite neuroprotection against the disease. Choice of pharmacotherapy must include consideration of short-term benefits as well as long-term consequences. Patients with mild Parkinson's disease often function adequately without symptomatic treatment. However, recent data suggest that initiation of treatment with a well-tolerated agent (e.g., the monoamine oxidase [MAO]-B inhibitor rasagiline) in the absence of functional impairment is associated with improved long-term outcomes. Consideration should also be given to many patient-specific factors, including patient expectations, level of disability, employment status, functional as well as chronologic age, expected efficacy and tolerability of drugs, and response to previous Parkinson's disease therapies. Increasingly, initial monotherapy begins with a nondopaminergic agent or, if the patient is considered functionally young, a dopamine agonist. Since Parkinson's disease is a progressive disorder, adjustments to pharmacotherapy must be expected over time. When greater symptomatic relief is desired, or in the more frail elderly patient, levodopa therapy should be considered. If motor fluctuations develop, addition of a catechol-O-methyltransferase inhibitor or MAO-B inhibitor should be considered. For management of levodopa-induced dyskinesias, addition of amantadine is an option. Surgery may be considered when patients need additional symptomatic control or are experiencing severe motor complications despite pharmacologically optimized therapy.
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The good, the bad and the ugly of marine reserves for fishery yields
De Leo, Giulio A.; Micheli, Fiorenza
2015-01-01
Marine reserves (MRs) are used worldwide as a means of conserving biodiversity and protecting depleted populations. Despite major investments in MRs, their environmental and social benefits have proven difficult to demonstrate and are still debated. Clear expectations of the possible outcomes of MR establishment are needed to guide and strengthen empirical assessments. Previous models show that reserve establishment in overcapitalized, quota-based fisheries can reduce both catch and population abundance, thereby negating fisheries and even conservation benefits. By using a stage-structured, spatially explicit stochastic model, we show that catches under quota-based fisheries that include a network of MRs can exceed maximum sustainable yield (MSY) under conventional quota management if reserves provide protection to old, large spawners that disproportionally contribute to recruitment outside the reserves. Modelling results predict that the net fishery benefit of MRs is lost when gains in fecundity of old, large individuals are small, is highest in the case of sedentary adults with high larval dispersal, and decreases with adult mobility. We also show that environmental variability may mask fishery benefits of reserve implementation and that MRs may buffer against collapse when sustainable catch quotas are exceeded owing to stock overestimation or systematic overfishing. PMID:26460129
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Cost considerations for long-term ecological monitoring
Caughlan, L.; Oakley, K.L.
2001-01-01
For an ecological monitoring program to be successful over the long-term, the perceived benefits of the information must justify the cost. Financial limitations will always restrict the scope of a monitoring program, hence the program's focus must be carefully prioritized. Clearly identifying the costs and benefits of a program will assist in this prioritization process, but this is easier said than done. Frequently, the true costs of monitoring are not recognized and are, therefore, underestimated. Benefits are rarely evaluated, because they are difficult to quantify. The intent of this review is to assist the designers and managers of long-term ecological monitoring programs by providing a general framework for building and operating a cost-effective program. Previous considerations of monitoring costs have focused on sampling design optimization. We present cost considerations of monitoring in a broader context. We explore monitoring costs, including both budgetary costs--what dollars are spent on--and economic costs, which include opportunity costs. Often, the largest portion of a monitoring program budget is spent on data collection, and other, critical aspects of the program, such as scientific oversight, training, data management, quality assurance, and reporting, are neglected. Recognizing and budgeting for all program costs is therefore a key factor in a program's longevity. The close relationship between statistical issues and cost is discussed, highlighting the importance of sampling design, replication and power, and comparing the costs of alternative designs through pilot studies and simulation modeling. A monitoring program development process that includes explicit checkpoints for considering costs is presented. The first checkpoint occur during the setting of objectives and during sampling design optimization. The last checkpoint occurs once the basic shape of the program is known, and the costs and benefits, or alternatively the cost-effectiveness, of each program element can be evaluated. Moving into the implementation phase without careful evaluation of costs and benefits is risky because if costs are later found to exceed benefits, the program will fail. The costs of development, which can be quite high, will have been largely wasted. Realistic expectations of costs and benefits will help ensure that monitoring programs survive the early, turbulent stages of development and the challenges posed by fluctuating budgets during implementation.
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Retiree out-of-pocket healthcare spending: a study of consumer expectations and policy implications.
Hoffman, Allison K; Jackson, Howell E
2013-01-01
Even though most American retirees benefit from Medicare coverage, a mounting body of research predicts that many will face large and increasing out-of-pocket expenditures for healthcare costs in retirement and that many already struggle to finance these costs. It is unclear, however, whether the general population understands the likely magnitude of these out-of-pocket expenditures well enough to plan for them effectively. This study is the first comprehensive examination of Americans' expectations regarding their out-of-pocket spending on healthcare in retirement. We surveyed over 1700 near retirees and retirees to assess their expectations regarding their own spending and then compared their responses to experts' estimates. Our main findings are twofold. First, overall expectations of out-of-pocket spending are mixed. While a significant proportion of respondents estimated out-of-pocket costs in retirement at or above expert estimates of what the typical retiree will spend, a disproportionate number estimated their future spending substantially below what experts view as likely. Estimates by members of some demographic subgroups, including women and younger respondents, deviated relatively further from the experts' estimates. Second, respondents consistently misjudged spending uncertainty. In particular, respondents significantly underestimated how much individual health experience and changes in government policy can affect individual out-of-pocket spending. We discuss possible policy responses, including efforts to improve financial planning and ways to reduce unanticipated financial risk through reform of health insurance regulation.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Mujumdar, A.S.
1987-01-01
Topics covered in this volume include recent thoughts in modeling of drying phenomena, use of computers in rational design of drying particulates, recent advances in drying of wood, and heat/mass transfer phenomena in drying of solids. As the readers will no doubt notice, special effort is made to ensure the truly international nature of the contents of this serial publication. As existing knowledge on drying and dryers becomes more widely and readily accessible, it is expected that more and more dryers will be designed rationally rather than built solely with the benefit of empiricism.
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Expected Improvements in Work Truck Efficiency Through Connectivity and Automation
DOE Office of Scientific and Technical Information (OSTI.GOV)
Walkowicz, Kevin A
This presentation focuses on the potential impact of connected and automated technologies on commercial vehicle operations. It includes topics such as the U.S. Department of Energy's Energy Efficient Mobility Systems (EEMS) program and the Systems and Modeling for Accelerated Research in Transportation (SMART) Mobility Initiative. It also describes National Renewable Energy Laboratory (NREL) research findings pertaining to the potential energy impacts of connectivity and automation and stresses the need for integration and optimization to take advantage of the benefits offered by these transformative technologies while mitigating the potential negative consequences.
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Parental expectations and outcomes of pediatric cochlear implantation.
Piazza, Elizabeth; Kandathil, Cherian; Carron, Jeffrey D
2009-10-01
Cochlear implants have been used with increasing frequency over the past twenty years, including very young patients. To determine if parents are satisfied with their children's performance after cochlear implantation. Survey mailed to parents of children receiving cochlear implants. 31 questionnaires were returned out of 69 mailed (45 %). The vast majority of responding parents felt that their children benefited substantially from cochlear implant surgery. Cochlear implantation is effective in helping children develop auditory-oral communication skills. Access to auditory/oral communication programs in this state remains an obstacle in postoperative habilitation.
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Concept of Operations for Commercial and Business Aircraft Synthetic Vision Systems. 1.0
NASA Technical Reports Server (NTRS)
Williams Daniel M.; Waller, Marvin C.; Koelling, John H.; Burdette, Daniel W.; Capron, William R.; Barry, John S.; Gifford, Richard B.; Doyle, Thomas M.
2001-01-01
A concept of operations (CONOPS) for the Commercial and Business (CaB) aircraft synthetic vision systems (SVS) is described. The CaB SVS is expected to provide increased safety and operational benefits in normal and low visibility conditions. Providing operational benefits will promote SVS implementation in the Net, improve aviation safety, and assist in meeting the national aviation safety goal. SVS will enhance safety and enable consistent gate-to-gate aircraft operations in normal and low visibility conditions. The goal for developing SVS is to support operational minima as low as Category 3b in a variety of environments. For departure and ground operations, the SVS goal is to enable operations with a runway visual range of 300 feet. The system is an integrated display concept that provides a virtual visual environment. The SVS virtual visual environment is composed of three components: an enhanced intuitive view of the flight environment, hazard and obstacle defection and display, and precision navigation guidance. The virtual visual environment will support enhanced operations procedures during all phases of flight - ground operations, departure, en route, and arrival. The applications selected for emphasis in this document include low visibility departures and arrivals including parallel runway operations, and low visibility airport surface operations. These particular applications were selected because of significant potential benefits afforded by SVS.
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Out of the corner of my eye: Foveal semantic load modulates parafoveal processing in reading
Payne, Brennan R.; Stites, Mallory C.; Federmeier, Kara D.
2016-01-01
In two experiments, we examined the impact of foveal semantic expectancy and congruity on parafoveal word processing during reading. Experiment 1 utilized an eye-tracking gaze contingent display change paradigm, and Experiment 2 measured event-related brain potentials (ERP) in a modified flanker RSVP paradigm. Eye-tracking and ERP data converged to reveal graded effects of foveal load on parafoveal processing. In Experiment 1, when word n was highly expected, and thus foveal load was low, there was a large parafoveal preview benefit to word n + 1. When word n was unexpected but still plausible, preview benefits to n + 1 were reduced in magnitude, and when word n was semantically incongruent, the preview benefit to n + 1 was unreliable in early-pass measures. In Experiment 2, ERPs indicated that when word n was expected, and thus foveal load on was low, readers successfully discriminated between valid and orthographically invalid previews during parafoveal perception. However, when word n was unexpected, parafoveal processing of n + 1 was reduced, and it was eliminated when word n was semantically incongruent. Taken together, these findings suggest that sentential context modulates the allocation of attention in the parafovea, such that covert allocation of attention to parafoveal processing is disrupted when foveal words are inconsistent with expectations based on various contextual constraints. PMID:27428778
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Out of the corner of my eye: Foveal semantic load modulates parafoveal processing in reading.
Payne, Brennan R; Stites, Mallory C; Federmeier, Kara D
2016-11-01
In 2 experiments, we examined the impact of foveal semantic expectancy and congruity on parafoveal word processing during reading. Experiment 1 utilized an eye-tracking gaze-contingent display change paradigm, and Experiment 2 measured event-related brain potentials (ERPs) in a modified flanker rapid serial visual presentation (RSVP) paradigm. Eye-tracking and ERP data converged to reveal graded effects of foveal load on parafoveal processing. In Experiment 1, when word n was highly expected, and thus foveal load was low, there was a large parafoveal preview benefit to word n + 1. When word n was unexpected but still plausible, preview benefits to n + 1 were reduced in magnitude, and when word n was semantically incongruent, the preview benefit to n + 1 was unreliable in early pass measures. In Experiment 2, ERPs indicated that when word n was expected, and thus foveal load was low, readers successfully discriminated between valid and orthographically invalid previews during parafoveal perception. However, when word n was unexpected, parafoveal processing of n + 1 was reduced, and it was eliminated when word n was semantically incongruent. Taken together, these findings suggest that sentential context modulates the allocation of attention in the parafovea, such that covert allocation of attention to parafoveal processing is disrupted when foveal words are inconsistent with expectations based on various contextual constraints. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
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18 CFR 50.6 - Applications: general content.
Code of Federal Regulations, 2010 CFR
2010-04-01
... interstate commerce and protects or benefits consumers; (3) Is consistent with sound national energy policy... Energy under section 216 of the Federal Power Act. (e) Evidence that: (1) A State in which the... the facilities or consider the interstate benefits expected to be achieved by the proposed...
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Genomic selection in forage breeding: designing an estimation population
USDA-ARS?s Scientific Manuscript database
The benefits of genomic selection to livestock, crops and forest tree breeding can be extended to forage grasses and legumes. The main benefits expected are increased selection accuracy and reduced costs per unit of genotype evaluated and breeding cycle length. Aiming at designing a training populat...
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Exploring the resilience of Bt cotton's "pro-poor success story".
Glover, Dominic
2010-01-01
Expectations play a powerful role in driving technological change. Expectations are often encapsulated in narratives of technological promise that emphasize potential benefits and downplay potential negative impacts. Genetically modified (GM, transgenic) crops have been framed by expectations that they would be an intrinsically "pro-poor" innovation that would contribute powerfully to international agricultural development. However, expectations typically have to be scaled back in the light of experience. Published reviews of the socio-economic impacts of GM crops among poor, small-scale farmers in the developing world indicate that these effects have been very mixed and contingent on the agronomic, socio-economic and institutional settings where the technology has been applied. These conclusions should modulate expectations about the pro-poor potential of GM crop technology and focus attention on the conditions under which it might deliver substantial and sustainable benefits for poor farmers. However, the idea of GM crop technology as an intrinsically pro-poor developmental success story has been sustained in academic, public and policy arenas. This narrative depends upon an analysis that disembeds the technology from the technical, social and institutional contexts in which it is applied. Agricultural development policy should be based on a more rigorous and dispassionate analysis, rather than optimistic expectations alone.
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Using return on investment to maximize conservation effectiveness in Argentine grasslands
Murdoch, William; Ranganathan, Jai; Polasky, Stephen; Regetz, James
2010-01-01
The rapid global loss of natural habitats and biodiversity, and limited resources, place a premium on maximizing the expected benefits of conservation actions. The scarcity of information on the fine-grained distribution of species of conservation concern, on risks of loss, and on costs of conservation actions, especially in developing countries, makes efficient conservation difficult. The distribution of ecosystem types (unique ecological communities) is typically better known than species and arguably better represents the entirety of biodiversity than do well-known taxa, so we use conserving the diversity of ecosystem types as our conservation goal. We define conservation benefit to include risk of conversion, spatial effects that reward clumping of habitat, and diminishing returns to investment in any one ecosystem type. Using Argentine grasslands as an example, we compare three strategies: protecting the cheapest land (“minimize cost”), maximizing conservation benefit regardless of cost (“maximize benefit”), and maximizing conservation benefit per dollar (“return on investment”). We first show that the widely endorsed goal of saving some percentage (typically 10%) of a country or habitat type, although it may inspire conservation, is a poor operational goal. It either leads to the accumulation of areas with low conservation benefit or requires infeasibly large sums of money, and it distracts from the real problem: maximizing conservation benefit given limited resources. Second, given realistic budgets, return on investment is superior to the other conservation strategies. Surprisingly, however, over a wide range of budgets, minimizing cost provides more conservation benefit than does the maximize-benefit strategy. PMID:21098281
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Alberti, Philip M; Sutton, Karey M; Baker, Matthew
2018-05-22
U.S. teaching hospitals that qualify as 501(c)(3) organizations (a not-for-profit designation) are required to demonstrate community benefit annually. Increases in health insurance access driven by Affordable Care Act (ACA) implementation, along with new regulations, research opportunities, and educational expectations, may be changing hospitals' allocations of community benefit dollars. This study aimed to describe changes in teaching hospitals' community benefit spending between 2012 (pre-ACA implementation) and 2015 (post-ACA implementation), and to explore differences in spending changes between hospitals in Medicaid expansion and non-expansion states. In 2017, for each teaching hospital member of the Association of American Medical Colleges' (AAMC's) Council of Teaching Hospitals and Health Systems required to submit Form 990s to the Internal Revenue Service, the authors sought community benefit spending data for 2012 and 2015 as reported on Schedule H. The analysis included 169 pairs of Form 990s representing 184 AAMC member teaching hospitals (93% of 198 eligible hospitals). Compared with 2012, hospitals in 2015 spent $3.1 billion (20.14%) more on community benefit despite spending $804 million (16.17%) less on charity care. Hospitals in Medicaid expansion states increased spending on subsidized health services and Medicaid shortfalls at rates higher than hospitals in non-expansion states. The latter increased spending at higher rates on community health improvement and cash/in-kind contributions. After ACA implementation, teaching hospitals increased their overall community benefit spending while their charity care spending declined. Changes in community benefit spending differed according to states' Medicaid expansion status, demonstrating hospitals' responsiveness to state and local realities.
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Reassessing the human health benefits from cleaner air.
Cox, Louis Anthony
2012-05-01
Recent proposals to further reduce permitted levels of air pollution emissions are supported by high projected values of resulting public health benefits. For example, the Environmental Protection Agency recently estimated that the 1990 Clean Air Act Amendment (CAAA) will produce human health benefits in 2020, from reduced mortality rates, valued at nearly $2 trillion per year, compared to compliance costs of $65 billion ($0.065 trillion). However, while compliance costs can be measured, health benefits are unproved: they depend on a series of uncertain assumptions. Among these are that additional life expectancy gained by a beneficiary (with median age of about 80 years) should be valued at about $80,000 per month; that there is a 100% probability that a positive, linear, no-threshold, causal relation exists between PM(2.5) concentration and mortality risk; and that progress in medicine and disease prevention will not greatly diminish this relationship. We present an alternative uncertainty analysis that assigns a positive probability of error to each assumption. This discrete uncertainty analysis suggests (with probability >90% under plausible alternative assumptions) that the costs of CAAA exceed its benefits. Thus, instead of suggesting to policymakers that CAAA benefits are almost certainly far larger than its costs, we believe that accuracy requires acknowledging that the costs purchase a relatively uncertain, possibly much smaller, benefit. The difference between these contrasting conclusions is driven by different approaches to uncertainty analysis, that is, excluding or including discrete uncertainties about the main assumptions required for nonzero health benefits to exist at all. © 2011 Society for Risk Analysis.
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Austin, Erica Weintraub; Chen, Yi-Chun Yvonnes; Pinkleton, Bruce E; Quintero Johnson, Jessie
2006-03-01
Channel One is a public-affairs program that includes 10 minutes of news and 2 minutes of paid product advertising or public service announcements. Advocates assert that it increases public-affairs knowledge, but critics charge that it garners a captive audience for teen-targeted advertising. This experiment analyzed the differential effects of Channel One depending on whether early-adolescent viewers received a media-literacy lesson in conjunction with viewing the program. Outcomes included perceptions of Channel One news programming, recall of program content and advertising, materialism, and political efficacy. Researchers used a posttest-only field experiment (N = 240) of seventh- and eighth-grade students using random assignment to conditions. Conditions included a control group, a group that received a fact-based lesson, and a group that received the same lesson content using a more emotive teaching style. It was expected that the emotion-added lesson condition would be more effective than the logic-only lesson condition because of its motivational component. On average, students remembered more ads from Channel One than news stories. Participants in the control group remembered fewer news stories than did the groups that received the lessons. Students reported having purchased during the preceding 3 months an average of 2.5 items advertised on the program. Both fact-based and affect-added training increased student skepticism toward advertisers. As expected, student liking of the program enhanced their learning from it and was associated with higher levels of political efficacy. Students held misconceptions about the role of their school in the production of Channel One. The use of Channel One by schools can have benefits, but these come with risk that some may consider unacceptable. On the positive side, student liking of the program was associated with their political efficacy. Although those who responded positively to program content and presentation style learned more from it, they also tended to want things that they saw in the advertisements. The data therefore show that the program can provide some benefits to young adolescents, but the results also provide justification for concerns about the commercialization of the classroom.
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Miller, Fiona A; Painter-Main, Michael; Axler, Renata; Lehoux, Pascale; Giacomini, Mita; Slater, Barbara
2015-12-01
Responsiveness to citizens as users of technological innovation helps motivate translational research and commercial engagement among academics. Yet, retaining citizen trust and support for research encourages caution in pursuit of commercial science. We explore citizen expectations of the specifically academic nature of commercial science [i.e. academic entrepreneurship (AE)] and the influence of conflict of interest concerns, hopes about practical benefits and general beliefs. We conducted a cross-sectional national opinion survey of 1002 Canadians online in 2010. Approval of AE was moderate (mean 3.2/5, SD 0.84), but varied by entrepreneurial activity. Concern about conflict of interests (COI) was moderate (mean 2.9/5, SD 0.86) and varied by type of concern. An ordinary least-squares regression showed that expectations of practical benefits informed support for AE, specifically that academic-industry collaboration can better address real-world problems; conflict of interest concerns were insignificant. These findings suggest that citizens support AE for its potential to produce practical benefits, but enthusiasm varies and is reduced for activities that may prioritize private over public interests. Further, support exists despite concern about COI, perhaps due to trust in the academic research context. For user engagement in research priority setting, these findings suggest the need to attend to the commercial nature of translational science. For research policy, they suggest the need for governance arrangements for responsible innovation, which can sustain public trust in academic research, and realize the practical benefits that inform public support for AE. © 2014 John Wiley & Sons Ltd.
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Thabit, Hood; Hovorka, Roman
2016-01-01
Continuous subcutaneous insulin infusion (CSII) therapy is currently accepted as a treatment strategy for type 1 diabetes. Transition from multiple daily injection therapy (MDI; including basal-bolus regimens) to CSII is based on expectations of better metabolic control and fewer hypoglycaemic events. Evidence to date has not been always conclusive. Evidence for CSII and MDI in terms of glycaemic control, hypoglycaemia and psychosocial outcomes is reviewed in the adult and paediatric population with type 1 diabetes. Findings from studies on threshold-based insulin pump suspension and predictive low glucose management (PLGM) are outlined. Limitations of current CSII application and future technological developments are discussed. Glycaemic control and quality of life (QOL) may be improved by CSII compared to MDI depending on baseline HbA1c and hypoglycaemia rates. Future studies are expected to provide evidence on clinical and cost effectiveness in those who will benefit the most. Training, structured education and support are important to benefit from CSII. Novel technological approaches linking continuous glucose monitoring (CGM) and CSII may help mitigate against frequent hypoglycaemia in those at risk. Development of glucose-responsive automated closed-loop insulin delivery systems may reduce the burden of disease management and improve outcomes in type 1 diabetes.
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Older people’s perspectives on an elderly-friendly hospital environment: an exploratory study
Karki, Sushmita; Bhatta, Dharma Nand; Aryal, Umesh Raj
2015-01-01
Background Many older people are vulnerable with multiple health problems and need of extensive care and support for quality of life. The main objective of this study was to explore the older people’s perspectives on an “elderly-friendly” hospital. Methods Hospital was stratified by four domains including government, semi-government, community, and private. We interviewed 33 hospitalized older patients and four hospital managers between June and December 2014 in Kathmandu, Nepal, using purposive sampling technique. We executed a qualitative content analysis step with extensive review of the interviews. Final name of the theme was given after the agreement between the research team and experts to improve trustworthiness. Elderly-friendly services, expectation from government and hospital, and health policy related to senior citizen were developed as main themes. Results Most of the participants were satisfied with the behavior of health personnel. However, none of the health personnel were trained with geriatric health care. Elderly-friendly hospital guidelines and policy were not developed by any hospitals. Older people health card, advocacy for older people’s health and benefit, and hospital environment were the common expectations of older patients. Government policy and budget constraint were the main obstacles to promote elderly-friendly health care services. Conclusion Elderly-related health policies, physical environments of hospital, elderly-friendly health manpower, advocacy, and other facilities and benefits should be improved and developed. There are urgent needs to develop elderly-friendly hospital policies and guidelines that focus on older people’s health benefits and friendly services. PMID:26028980
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26 CFR 1.175-7 - Allocation of expenditures in certain circumstances.
Code of Federal Regulations, 2014 CFR
2014-04-01
... the time the taxpayer paid or incurred expenditures for the purpose of soil or water conservation, or... that A's expenditures for the purpose of soil and water conservation can reasonably be expected to... soil and water conservation can reasonably be expected to directly and substantially benefit only the...
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26 CFR 1.175-7 - Allocation of expenditures in certain circumstances.
Code of Federal Regulations, 2012 CFR
2012-04-01
... the time the taxpayer paid or incurred expenditures for the purpose of soil or water conservation, or... that A's expenditures for the purpose of soil and water conservation can reasonably be expected to... soil and water conservation can reasonably be expected to directly and substantially benefit only the...
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26 CFR 1.175-7 - Allocation of expenditures in certain circumstances.
Code of Federal Regulations, 2011 CFR
2011-04-01
... the time the taxpayer paid or incurred expenditures for the purpose of soil or water conservation, or... that A's expenditures for the purpose of soil and water conservation can reasonably be expected to... soil and water conservation can reasonably be expected to directly and substantially benefit only the...
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26 CFR 1.175-7 - Allocation of expenditures in certain circumstances.
Code of Federal Regulations, 2010 CFR
2010-04-01
... the taxpayer paid or incurred expenditures for the purpose of soil or water conservation, or for the... that A's expenditures for the purpose of soil and water conservation can reasonably be expected to... soil and water conservation can reasonably be expected to directly and substantially benefit only the...
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26 CFR 1.175-7 - Allocation of expenditures in certain circumstances.
Code of Federal Regulations, 2013 CFR
2013-04-01
... the time the taxpayer paid or incurred expenditures for the purpose of soil or water conservation, or... that A's expenditures for the purpose of soil and water conservation can reasonably be expected to... soil and water conservation can reasonably be expected to directly and substantially benefit only the...
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ERIC Educational Resources Information Center
Green, Kenneth C.; Gilbert, Steven W.
1995-01-01
College and university investments in information technology should focus on content, curriculum, and communication, not productivity. In addition, expectations about how technology can benefit higher education should be realistic; there is much to be learned about the appropriate use of technological innovation. (MSE)
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Career Expectations and Perceptions of Part-Time MBA Students
ERIC Educational Resources Information Center
Fish, Lynn A.; Fish, Lauren A.
2010-01-01
In the U.S., part-time MBA students regard work/life balance as the critical factor that drives career expectations and perceptions. Job aspects and benefits/compensation closely follow in importance, while employee relations are valued less. Within work/life balance, students value job location, travel time, and telecommuting. Promotional…
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Men, Women, and Life Annuities
ERIC Educational Resources Information Center
King, Francis P.
1976-01-01
A senior research officer of Teacher Insurance and Annuity Association (TIAA) and College Retirement Equities Fund (CREF) discusses the issue of different life annuity benefits to men and women concluding that age and sex are two objective and statistically reliable factors used in determining life expectancy and thus the expected duration of…
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32 CFR 776.56 - Professional independence of a covered USG attorney.
Code of Federal Regulations, 2010 CFR
2010-07-01
... attorney. Nevertheless, the practice of law requires the exercise of judgment solely for the benefit of the... detailed or assigned to represent an individual member or employee of the DON is expected to exercise... DON is expected to exercise unfettered loyalty and professional independence during the representation...
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The use of existing value of statistical life (VSL) estimates in benefit-cost analysis relates to relatively short changes in life expectancy. The authors' strategy for addressing this question is to briefly survey the existing economics literature.
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Economic Observations on the Decision to Attend Law School
ERIC Educational Resources Information Center
Ahart, Alan M.
1975-01-01
On the premise that the expected benefits of a legal education can be measured in dollar terms, the author develops a formula for determining whether or not to matriculate based on expected earnings, educational costs, and probability of employment (graduation, class rank, passing bar exam, and supply/demand conditions). (JT)
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Januchowski-Hartley, Stephanie Renee; Moon, Katie; Stoeckl, Natalie; Gray, Sally
2012-11-15
Private land conservation is an essential component of conservation that requires organizing both protection and restoration actions accordingly. Yet private land conservation programs are often formulated to generate public benefits, with inadequate consideration of costs or benefits to private landholders. Landholders' willingness to participate in conservation programs depends on a complex set of social factors, and the benefits they expect from participation. However, these two attributes are commonly evaluated independent of one another. We addressed this limitation through interviews aimed at determining landholders': 1) willingness to participate in restoration programs; 2) barriers to participation; 3) prioritization of proposed riverine restoration actions; 4) expected public or private benefits for undertaking proposed riverine restoration actions; and 5) most preferred incentive for undertaking proposed restoration actions on their land. Our results revealed four main findings. First, landholders stated that biases towards ecological rather than production outcomes, impractical programs, and government mistrust (structural factors) were the major barriers that prevented them from participating in riverine restoration on their land. Second, private benefits influenced landholders' willingness to engage riverine restoration. Third, 'a sense of stewardship and improved landscape aesthetics' (an internal factor) was the most commonly reported private benefit. Fourth, the most preferred incentives for high priority restoration actions were cash for on-ground works, extension and community recognition. We highlight the importance of designing private land conservation programs that align with landholders' priorities and deliver public benefits. Copyright © 2012 Elsevier Ltd. All rights reserved.
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Michaud, Pierre-Carl
2010-01-01
We look at the effect of the 2000 repeal of the earnings test above the normal retirement age on retirement expectations of workers in the Health and Retirement Study, aged 51 to 61 in 1992. For men, we find that those whose marginal wage rate increased when the earnings test was repealed, had the largest increase in the probability to work full-time past normal retirement age. We do not find significant evidence of effects of the repeal of the earnings test on the probability to work past age 62 or the expected claiming age. On the other hand, for those reaching the normal retirement age, deviations between the age at which Social Security benefits are actually claimed and the previously reported expected age are more negative in 2000 than in 1998. Since our calculations show that the tax introduced by the earnings test was small when accounting for actuarial benefit adjustments and differential mortality, our results suggest that although male workers form expectations in a way consistent with forward-looking behavior, they misperceive the complicated rules of the earnings test. Results for females suggest similar patterns but estimates are imprecise. PMID:21037938
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Perceived Benefits of an Undergraduate Degree
ERIC Educational Resources Information Center
Norton, Cole; Martini, Tanya
2017-01-01
Canadian university students tend to endorse employment-related reasons for attending university ahead of other reasons such as personal satisfaction or intellectual growth. In the present study, first- and fourth-year students from a mid-sized Canadian university reported on the benefits they expected to receive from their degree and rated their…
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Technical Advances and Fifth Grade Reading Comprehension: Do Students Benefit?
ERIC Educational Resources Information Center
Fountaine, Drew
This paper takes a look at some recent studies on utilization of technical tools, primarily personal computers and software, for improving fifth-grade students' reading comprehension. Specifically, the paper asks what benefits an educator can expect students to derive from closed-captioning and computer-assisted reading comprehension products. It…
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20 CFR 416.909 - How long the impairment must last.
Code of Federal Regulations, 2010 CFR
2010-04-01
... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false How long the impairment must last. 416.909 Section 416.909 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE... long the impairment must last. Unless your impairment is expected to result in death, it must have...
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20 CFR 404.1505 - Basic definition of disability.
Code of Federal Regulations, 2013 CFR
2013-04-01
... activity by reason of any medically determinable physical or mental impairment which can be expected to... disability, or disability insurance benefits as a disabled worker, or child's insurance benefits based on... for individuals who are statutorily blind. We discuss these in §§ 404.1581 through 404.1587. There are...
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20 CFR 404.1505 - Basic definition of disability.
Code of Federal Regulations, 2014 CFR
2014-04-01
... activity by reason of any medically determinable physical or mental impairment which can be expected to... disability, or disability insurance benefits as a disabled worker, or child's insurance benefits based on... for individuals who are statutorily blind. We discuss these in §§ 404.1581 through 404.1587. There are...
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Investigating the Value of Personalization in a Mobile Learning System
ERIC Educational Resources Information Center
Kalloo, Vani; Mohan, Permanand
2015-01-01
This paper investigates the potential benefits of personalization in a mobile learning environment for high school students learning mathematics. Personalization was expected to benefit the students in two main ways. These are improving their performance in mathematics and making navigation of the application easier. Personalization was…
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Beyond Strength: Participant Perspectives on the Benefits of an Older Adult Exercise Program
ERIC Educational Resources Information Center
Kohn, Marlana; Belza, Basia; Petrescu-Prahova, Miruna; Miyawaki, Christina E.
2016-01-01
This study examines the expected and experienced benefits among participants in Enhance®Fitness (EF), an evidence-based group physical activity program for older adults. We also describe the implications for program dissemination (reach, implementation, and maintenance) within the RE-AIM (reach, effectiveness, adoption, implementation, and…
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Cost Benefit Analysis and Other Fun and Games.
ERIC Educational Resources Information Center
White, Herbert S.
1985-01-01
Discussion of application of cost benefit analysis (CBA) accounting techniques to libraries highlights user willingness to be charged for services provided, reasons why CBA will not work in library settings, libraries and budgets, cost distribution on basis of presumed or expected use, implementation of information-seeking behavior control, and…
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41 CFR 102-75.900 - What is a negotiated sale for economic development purposes?
Code of Federal Regulations, 2010 CFR
2010-07-01
... sale for economic development purposes? 102-75.900 Section 102-75.900 Public Contracts and Property... negotiated sale for economic development purposes? A negotiated sale for economic development purposes means... community's economic benefit. This type of negotiated sale is acceptable where the expected public benefits...
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The parent-coach/child-athlete relationship in youth sport: cordial, contentious, or conundrum?
Weiss, Maureen R; Fretwell, Susan D
2005-09-01
The roles of coach and parent are often synonymous in youth sport, but little data-based research has been conducted on the parent-coach/child-athlete relationship. Six boys in U-12 competitive soccer were interviewed regarding positive and negative aspects about playing for their father-coach. Similar questions were posed to father-coaches and two teammates. Inductive content analysis indicated that, among the benefits, sons identified perks, praise, technical instruction, understanding of ability level, insider information, involvement in decision making, special attention, quality time, and motivation. Costs of being coached by one's father included negative emotional responses, pressure/expectations, conflict, lack of understanding/empathy, criticism for mistakes, and unfair behavior. For father-coaches, positive themes included taking pride in son's achievements, reason for coaching, positive social interactions, opportunity to teach skills and values, enjoying coaching son, and quality time. Negatives included inability to separate parent-child from coach-player role, placing greater expectations and pressure on son, and showing differential attention toward son. While teammates perceived some favoritism by the parent-coach, they cited mostly positive instructional experiences. Results are discussed within motivational theories that highlight the influence of significant adults on children's psychosocial development in the physical domain.
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PEGylated nanomedicines: recent progress and remaining concerns.
Vllasaliu, Driton; Fowler, Robyn; Stolnik, Snow
2014-01-01
Recent biopharma deals related to nanocarrier drug delivery technologies highlight the emergence of nanomedicine. This is perhaps an expected culmination of many years of research demonstrating the potential of nanomedicine as the next generation of therapeutics with improved performance. PEGylated nanocarriers play a key role within this field. The drug delivery advantages of nanomedicines in general are discussed, focusing on nanocarriers and PEGylated nanomedicines, including products under current development/clinical evaluation. Well-established drug delivery benefits of PEGylation (e.g., prolonged circulation) are only briefly covered. Instead, attention is deliberately made to less commonly reported advantages of PEGylation, including mucosal delivery of nanomedicines. Finally, some of the issues related to the safety of PEGylated nanomedicines in clinical application are discussed. The advent of nanomedicine providing therapeutic options of refined performance continues. Although PEGylation as a tool to improve the pharmacokinetics of nanomedicines is well established and is used clinically, other benefits of 'PEGnology', including enhancement of physicochemical properties and/or biocompatibility of actives and/or drug carriers, as well as mucosal delivery, have attracted less attention. While concerns regarding the clinical use of PEGylated nanomedicines remain, evidence suggests that at least some safety issues may be controlled by adequate designs of nanosystems.
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Berei, Catherine P; Pratt, Erica; Parker, Melissa; Shephard, Kevin; Liang, Tanjian; Nampai, Udon; Neamphoka, Guntima
2017-12-01
Scholarship is essential for the growth and development of the physical education field. Over time, scholarship expectations have changed, forcing faculty members to alter time spent for research, teaching, and service. Social-cognitive career theory (SCCT) presents a model for understanding performance and persistence in an occupational environment. The interconnected aspects of SCCT have different emphasis related to self-efficacy, outcome expectations, or personal goals pursuit. This study explored physical education teacher education (PETE) faculty members' continuing engagement in scholarly activity through SCCT. Data collection included interviews with 9 senior PETE faculty members who met the criteria for "productive scholars over time." Curriculum vitae were collected to verify productivity. Data analysis revealed guidepost themes that included collaborating, finding balance, defining a research process, and maintaining a strong work ethic. Roadblocks encountered included other obligations and lack of support for research. Participants demonstrated strong self-efficacy; held high, positive expectations for success; and set very specific, clear, and deliberate goals. Participant behavior was moderated by their personal attributes (capacity to build relationships, set goals, and maintain interest and passion) and was tempered by the environments in which they worked. Fostering similar behaviors has the potential to guide future and current PETE faculty members in creating supportive and encouraging atmospheres for sustained productivity. The lack of literature relating to this topic warrants the need for more research exploring the influential factors and benefits gained from sustained scholarly productivity over time for PETE faculty members.
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Zieger, B; Praskova, M; Busse, E; Barth, M
2013-05-01
Blood drawings are very painful and stressful for children. In a prospective control group study we investigated if using a picture book could reduce the children's pain expectation. In addition, the children's pain experience and the observed pain behaviour was monitored. Block-randomization were used and 120 children at the age of 6-12 years who were visiting the general pediatric and coagulation outpatient clinics were included in this study. Pain expectation and experience were assessed with the Face-Pain-Scale-Revised and the pain behavior with the Faces-Legs-Activity-Cry-Consolability Scale. Multivariate covariance analysis was used for data analysis. The results showed that with statistical controlling the influence of the primary pain expectation (baseline) the pain expectation before blood withdrawal was reduced significantly (p=0.001) and effectively (ES=0.56) using the picture book. Children who received no local anaesthesia reported that they felt less pain during blood drawing after reading the picture book. The few children with local anaesthesia reported no benefit from the picture book. The observed use of local anaesthesia was very heterogeneous. The results recommend the usage of this picture book in everyday practice, if the use of local anaesthesia could not be used in an appropriate way. © Georg Thieme Verlag KG Stuttgart · New York.
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Mori, Amani Thomas; Kampata, Linda; Musonda, Patrick; Johansson, Kjell Arne; Robberstad, Bjarne; Sandøy, Ingvild
2017-12-19
Early marriages, pregnancies and births are the major cause of school drop-out among adolescent girls in sub-Saharan Africa. Birth complications are also one of the leading causes of death among adolescent girls. This paper outlines a protocol for a cost-benefit analysis (CBA) and an extended cost-effectiveness analysis (ECEA) of a comprehensive adolescent pregnancy prevention program in Zambia. It aims to estimate the expected costs, monetary and non-monetary benefits associated with health-related and non-health outcomes, as well as their distribution across populations with different standards of living. The study will be conducted alongside a cluster-randomized controlled trial, which is testing the hypothesis that economic support with or without community dialogue is an effective strategy for reducing adolescent childbearing rates. The CBA will estimate net benefits by comparing total costs with monetary benefits of health-related and non-health outcomes for each intervention package. The ECEA will estimate the costs of the intervention packages per unit health and non-health gain stratified by the standards of living. Cost data include program implementation costs, healthcare costs (i.e. costs associated with adolescent pregnancy and birth complications such as low birth weight, pre-term birth, eclampsia, medical abortion procedures and post-abortion complications) and costs of education and participation in community and youth club meetings. Monetary benefits are returns to education and averted healthcare costs. For the ECEA, health gains include reduced rate of adolescent childbirths and non-health gains include averted out-of-pocket expenditure and financial risk protection. The economic evaluations will be conducted from program and societal perspectives. While the planned intervention is both comprehensive and expensive, it has the potential to produce substantial short-term and long-term health and non-health benefits. These benefits should be considered seriously when evaluating whether such a program can justify the required investments in a setting with scarce resources. The economic evaluations outlined in this paper will generate valuable information that can be used to guide large-scale implementation of programs to address the problem of the high prevalence of adolescent childbirth and school drop-outs in similar settings. ClinicalTrials.gov, NCT02709967. Registered on 2 March 2016. ISRCTN, ISRCTN12727868. Registered on 4 March 2016.
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Yeh, M; Wickens, C D; Seagull, F J
1999-12-01
Two experiments were performed to examine how frame of reference (world-referenced vs. screen-referenced) and target expectancy can modulate the effects of target cuing in directing attention for see-through helmet-mounted displays (HMDs). In the first experiment, the degree of world referencing was varied by the spatial accuracy of the cue; in the second, the degree of world referencing was varied more radically between a world-referenced HMD and a hand-held display. Participants were asked to detect, identify, and give azimuth information for targets hidden in terrain presented in the far domain (i.e., the world) while performing a monitoring task in the near domain (i.e., the display). The results of both experiments revealed a cost-benefit trade-off for cuing such that the presence of cuing aided the target detection task for expected targets but drew attention away from the presence of unexpected targets in the environment. Analyses support the observation that this effect can be mediated by the display: The world-referenced display reduced the cost of cognitive tunneling relative to the screen-referenced display in Experiment 1; this cost was further reduced in Experiment 2 when participants were using a hand-held display. Potential applications of this research include important design guidelines and specifications for automated target recognition systems as well as any terrain-and-targeting display system in which superimposed symbology is included, specifically in assessing the costs and benefits of attentional cuing and the means by which this information is displayed.
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Karl, J Bradley; Medders, Lorilee A; Maroney, Patrick F
2016-06-01
We examine whether the risk characterization estimated by catastrophic loss projection models is sensitive to the revelation of new information regarding risk type. We use commercial loss projection models from two widely employed modeling firms to estimate the expected hurricane losses of Florida Atlantic University's building stock, both including and excluding secondary information regarding hurricane mitigation features that influence damage vulnerability. We then compare the results of the models without and with this revealed information and find that the revelation of additional, secondary information influences modeled losses for the windstorm-exposed university building stock, primarily evidenced by meaningful percent differences in the loss exceedance output indicated after secondary modifiers are incorporated in the analysis. Secondary risk characteristics for the data set studied appear to have substantially greater impact on probable maximum loss estimates than on average annual loss estimates. While it may be intuitively expected for catastrophe models to indicate that secondary risk characteristics hold value for reducing modeled losses, the finding that the primary value of secondary risk characteristics is in reduction of losses in the "tail" (low probability, high severity) events is less intuitive, and therefore especially interesting. Further, we address the benefit-cost tradeoffs that commercial entities must consider when deciding whether to undergo the data collection necessary to include secondary information in modeling. Although we assert the long-term benefit-cost tradeoff is positive for virtually every entity, we acknowledge short-term disincentives to such an effort. © 2015 Society for Risk Analysis.
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Benefit-risk Evaluation for Diagnostics: A Framework (BED-FRAME).
Evans, Scott R; Pennello, Gene; Pantoja-Galicia, Norberto; Jiang, Hongyu; Hujer, Andrea M; Hujer, Kristine M; Manca, Claudia; Hill, Carol; Jacobs, Michael R; Chen, Liang; Patel, Robin; Kreiswirth, Barry N; Bonomo, Robert A
2016-09-15
The medical community needs systematic and pragmatic approaches for evaluating the benefit-risk trade-offs of diagnostics that assist in medical decision making. Benefit-Risk Evaluation of Diagnostics: A Framework (BED-FRAME) is a strategy for pragmatic evaluation of diagnostics designed to supplement traditional approaches. BED-FRAME evaluates diagnostic yield and addresses 2 key issues: (1) that diagnostic yield depends on prevalence, and (2) that different diagnostic errors carry different clinical consequences. As such, evaluating and comparing diagnostics depends on prevalence and the relative importance of potential errors. BED-FRAME provides a tool for communicating the expected clinical impact of diagnostic application and the expected trade-offs of diagnostic alternatives. BED-FRAME is a useful fundamental supplement to the standard analysis of diagnostic studies that will aid in clinical decision making. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.
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Carr, Sandra E.; Celenza, Antonio; Lake, Fiona
2009-01-01
The essential procedural skills that newly graduated doctors require are rarely defined, do not take into account pre-vocational employer expectations, and differ between Universities. This paper describes how one Faculty used local evaluation data to drive curriculum change and implement a clinically integrated, multi-professional skills program. A curriculum restructure included a review of all undergraduate procedural skills training by academic staff and clinical departments, resulting in a curriculum skills map. Undergraduate training was then linked with postgraduate expectations using the Delphi process to identify the skills requiring structured standardised training. The skills program was designed and implemented without a dedicated simulation center. This paper shows the benefits of an alternate model in which clinical integration of training and multi-professional collaboration encouraged broad ownership of a program and, in turn, impacted the clinical experience obtained. PMID:20165528
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Personal Narratives of Genetic Testing: Expectations, Emotions, and Impact on Self and Family.
Anderson, Emily E; Wasson, Katherine
2015-01-01
The stories in this volume shed light on the potential of narrative inquiry to fill gaps in knowledge, particularly given the mixed results of quantitative research on patient views of and experiences with genetic and genomic testing. Published studies investigate predictors of testing (particularly risk perceptions and worry); psychological and behavioral responses to testing; and potential impact on the health care system (e.g., when patients bring DTC genetic test results to their primary care provider). Interestingly, these themes did not dominate the narratives published in this issue. Rather, these narratives included consistent themes of expectations and looking for answers; complex emotions; areas of contradiction and conflict; and family impact. More narrative research on patient experiences with genetic testing may fill gaps in knowledge regarding how patients define the benefits of testing, changes in psychological and emotional reactions to test results over time, and the impact of testing on families.
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Lo, Grace Hsiao-Wei; Balasubramanyam, Ajay S.; Barbo, Andrea; Street, Richard L.; Suarez-Almazor, Maria E.
2016-01-01
Objective A prior knee osteoarthritis (OA) trial found that provider conveyed expectations for treatment success were associated with pain improvement. We hypothesized this relationship was mediated by patient self-efficacy since expectations of improvement may enhance one’s ability to control health behaviors, and therefore health. Our aim was to examine whether self-efficacy was a mediator of the relationship observed in this trial. Methods A secondary analysis of a three arm (traditional acupuncture, sham acupuncture, and wait list) trial for knee OA was conducted. Those in the acupuncture groups were equally randomized to acupuncturists trained to communicate a high or neutral expectation of treatment success (e.g. used language conveying high or unclear likelihood that acupuncture would reduce knee pain). A modified Arthritis Self-Efficacy Questionnaire and the Western Ontario McMasters (WOMAC) pain subscale were administered. Linear regression analyses were used to examine whether patient self-efficacy mediated the relationship between provider communication style and knee pain at 3 months. Results High expectation provider communication was associated with patient self-efficacy, β coefficient of 0.14 (95%CI: 0.01, 0.28). Self-efficacy was associated with WOMAC pain, β coefficient of −9.29 (95%CI: −11.11, −7.47), while controlling for the provider communication style. The indirect effect a*b of −1.36 for high versus neutral expectation, (bootstrap 95% CI: −2.80, −0.15, does not include 0), supports that patient self-efficacy mediates the relationship between provider-communicated expectations of treatment effects and knee pain. Conclusion Our findings suggest that clinician-conveyed expectations can enhance the benefit of treatments targeting knee OA symptoms, mediated by improved patient self-efficacy. PMID:26554869
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Hsiao-Wei Lo, Grace; Balasubramanyam, Ajay S; Barbo, Andrea; Street, Richard L; Suarez-Almazor, Maria E
2016-07-01
A prior knee osteoarthritis (OA) trial found that provider-conveyed expectations for treatment success were associated with pain improvement. We hypothesized this relationship was mediated by patient self-efficacy, since expectations of improvement may enhance one's ability to control health behaviors, and therefore health. Our aim was to examine whether self-efficacy was a mediator of the relationship observed in this trial. A secondary analysis of a 3-arm (traditional acupuncture, sham acupuncture, and wait list) trial for knee OA was conducted. Those in the acupuncture groups were equally randomized to acupuncturists trained to communicate a high or neutral expectation of treatment success (e.g., using language conveying high or unclear likelihood that acupuncture would reduce knee pain). A modified Arthritis Self-Efficacy Questionnaire and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale were administered. Linear regression analyses were used to examine whether patient self-efficacy mediated the relationship between provider communication style and knee pain at 3 months. High-expectation provider communication was associated with patient self-efficacy, β coefficient of 0.14 (95% confidence interval [95% CI] 0.01, 0.28). Self-efficacy was associated with WOMAC pain, β coefficient of -9.29 (95% CI -11.11, -7.47), while controlling for the provider communication style. The indirect effect a × b of -1.36 for high versus neutral expectation (bootstrap 95% CI -2.80, -0.15; does not include 0), supports the conclusion that patient self-efficacy mediates the relationship between provider-communicated expectations of treatment effects and knee pain. Our findings suggest that clinician-conveyed expectations can enhance the benefit of treatments targeting knee OA symptoms, mediated by improved patient self-efficacy. © 2016, American College of Rheumatology.
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Are Indirect Benefits Relevant to Health Care Allocation Decisions?
Du Toit, Jessica; Millum, Joseph
2016-01-01
Abstract When allocating scarce healthcare resources, the expected benefits of alternative allocations matter. But, there are different kinds of benefits. Some are direct benefits to the recipient of the resource such as the health improvements of receiving treatment. Others are indirect benefits to third parties such as the economic gains from having a healthier workforce. This article considers whether only the direct benefits of alternative healthcare resource allocations are relevant to allocation decisions, or whether indirect benefits are relevant too. First, we distinguish different conceptions of direct and indirect benefits and argue that only a recipient conception could be morally relevant. We analyze four arguments for thinking that indirect benefits should not count and argue that none is successful in showing that the indirectness of a benefit is a good reason not to count it. We conclude that direct and indirect benefits should be evaluated in the same way. PMID:27465773
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NASA Astrophysics Data System (ADS)
Kuldeep, Kuldeep; Banu, Vijaya
2016-07-01
The introduction of the novel technology mostly leads to a number of advantages to the society. The space technology has shown such benefits in many fields including the areas of health and education, communication sectors, land and water resources management, weather forecasting and disaster management. It has vast potential for addressing a variety of societal problems of the developing countries especially in India in a effective manner. Large population which is spread over vast and remote areas of the nation, reaching out to them is a difficult task. This manuscript aims to explain the benefits originated from the application of space technology. The satellite imagery and its derived products can better be utilized for local level planning and sustainable development of a region. A case-study using Bhuvan Panchayat Portal developed by National Remote Sensing Centre, ISRO under the project "Space Based Information Support for De-Centralised Planning" towards Digital Empowerment of Society for Panchayat level Planning and Governance has been carried out, which list out the benefits that have accrued from the use of space technology for planning and development at grass root level in India. It covers, in particular, the benefits expected to be derived from the Indian Remote Sensing Satellite (IRS) Images and derived products. Certain conclusions about the benefits from space based inputs have been drawn that may be generally applicable to all developing countries. This paper also investigates the various possibilities and potentials of Remote Sensing technologies for societal applications.
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De Gruyter, Elaine; Ford, Greg; Stavreski, Bill
2016-02-01
Cardiac rehabilitation can reduce mortality, improve cardiac risk factor profile and reduce readmissions; yet uptake remains low at 30%. This research aims to investigate the social and economic impact of increasing the uptake of cardiac rehabilitation in Victoria, Australia using cost benefit analysis (CBA). Cost benefit analysis has been undertaken over a 10-year period to analyse three scenarios: (1) Base Case: 30% uptake; (2) Scenario 1: 50% uptake; and (3) Scenario 2: 65% uptake. Impacts considered include cardiac rehabilitation program costs, direct inpatient costs, other healthcare costs, burden of disease, productivity losses, informal care costs and net deadweight loss. There is a net financial saving of $46.7-$86.7 million under the scenarios. Compared to the Base Case, an additional net benefit of $138.9-$227.2 million is expected. This results in a Benefit Cost Ratio of 5.6 and 6.8 for Scenarios 1 and 2 respectively. Disability Adjusted Life Years were 21,117-37,565 years lower than the Base Case. Greater uptake of cardiac rehabilitation can reduce the burden of disease, directly translating to benefits for society and the economy. This research supports the need for greater promotion, routine referral to be made standard practice and implementation of reforms to boost uptake. Copyright © 2015 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
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Attitudes and Expectations Regarding Maternal Employment among Male and Female College Students.
ERIC Educational Resources Information Center
Gambone, Kirsten; Rowles, Dorothy; Szuchyt, Jamie; Deitrick, Susan; Gelband, Amy; Lu, Barbara Chris; Zohe, Dorothy; Stickney, Deborah; Fields, Susan; Chambliss, Catherine
This study examined the attitudes of male and female college students regarding maternal employment and their own career and family expectations. Perceptions of the benefits and costs associated with maternal employment were assessed through the Beliefs about the Consequences of Maternal Employment for Children (BACMEC) questionnaire (E.…
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Work Placement in UK Undergraduate Programmes. Student Expectations and Experiences.
ERIC Educational Resources Information Center
Leslie, David; Richardson, Anne
1999-01-01
A survey of 189 pre- and 106 post-sandwich work-experience students in tourism suggested that potential benefits were not being maximized. Students needed better preparation for the work experience, especially in terms of their expectations. The work experience needed better design, and the role of industry tutors needed clarification. (SK)
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ERIC Educational Resources Information Center
Silverman, Wayne
2009-01-01
People commonly expect to stay active well into their 80s, and while it may be hard to believe, people over 100 make up the fastest growing segment of the population. Thankfully, these impressive increases in longevity have also benefited people with developmental disabilities (DD), most of whom can now expect to live just as long as their…
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ERIC Educational Resources Information Center
Reynolds, John R.; Baird, Chardie L.
2010-01-01
Despite decades of research on the benefits of educational expectations, researchers have failed to show that unrealized plans are consequential for mental health, as self-discrepancy and other social psychological theories would predict. This article uses two national longitudinal studies of youth to test whether unrealized educational…
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Economic Effects of Introducing Alternative Salmonella Control Strategies in Sweden
Sundström, Kristian; Wahlström, Helene; Ivarsson, Sofie; Sternberg Lewerin, Susanna
2014-01-01
The objective of the study was to analyse the economic effects of introducing alternative Salmonella control strategies in Sweden. Current control strategies in Denmark and the Netherlands were used as benchmarks. The true number of human Salmonella cases was estimated by reconstructing the reporting pyramids for the various scenarios. Costs were calculated for expected changes in human morbidity (Salmonella and two of its sequelae), for differences in the control programmes and for changes in cattle morbidity. The net effects (benefits minus costs) were negative in all scenarios (€ −5 to −105 million), implying that it would not be cost-effective to introduce alternative control strategies in Sweden. This result was mainly due to an expected increase in the incidence of Salmonella in humans (6035–57108 reported and unreported new cases/year), with expected additional costs of € 5–55 million. Other increased costs were due to expected higher incidences of sequelae (€ 3–49 million) and a higher cattle morbidity (€ 4–8 million). Benefits in terms of lower control costs amounted to € 4–7 million. PMID:24831797
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Patient and public involvement: how much do we spend and what are the benefits?
Pizzo, Elena; Doyle, Cathal; Matthews, Rachel; Barlow, James
2015-12-01
Patient and public involvement (PPI) is seen as a way of helping to shape health policy and ensure a patient-focused health-care system. While evidence indicates that PPI can improve health-care decision making, it also consumes monetary and non-monetary resources. Given the financial climate, it is important to start thinking about the costs and benefits of PPI and how to evaluate it in economic terms. We conducted a literature review to assess the potential benefits and costs of involvement and the challenges in carrying out an economic evaluation of PPI. The benefits of PPI include effects on the design of new projects or services, on NHS governance, on research design and implementation and on citizenship and equity. Economic evaluation of PPI activities is limited. The lack of an appropriate analytical framework, data recording and understanding of the potential costs and benefits of PPI, especially from participants' perspectives, represent serious constraints on the full evaluation of PPI. By recognizing the value of PPI, health-care providers and commissioners can embed it more effectively within their organizations. Better knowledge of costs may prompt organizations to effectively plan, execute, evaluate and target resources. This should increase the likelihood of more meaningful activity, avoid tokenism and enhance organizational efficiency and reputation. © 2014 The Authors Health Expectations Published by John Wiley & Sons Ltd.
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Student diversity at Erasmus Medical Centre Rotterdam: does it make any difference?
Selleger, Veronica J; Bonke, Benno; Leeman, Yvonne A M
2006-08-01
In an ethnically diverse society cultural competence is indispensable for medical doctors. At present 10% of the Dutch population are first- or second-generation non-Western immigrants. With 8% Western and 18% non-Western immigrants, originating from 30 different countries, the 2001 Rotterdam first-year students highly out-rated the national average of immigrant medical students. Diverse student populations may enhance students' cultural competence but can also generate conflicts or even racism. This was the first Dutch study on expectations and experiences of medical students related to their ethnic and religious background. In December 2001 all first-year students were approached with an anonymous questionnaire, including statements on the expected influence of their culture and religion on their medical education (rated on a 1-5 Likert scale). In spring 2003 17 students from the same cohort, 8 immigrants and 9 ethnic Dutch, were interviewed extensively on their study experiences in a diverse student population. In 2001 the response rate was 90% (277/308), female-male ratio 63% (175/102). Non-Western immigrants expected for their medical education more benefits from their culture but also more obstacles than ethnic Dutch (p < or = 0.005). Protestants and Muslims expected more obstacles than the non-religious and Catholics (p < or = 0.05). In the interviews three main issues emerged: peer training in physical examination in mixed-gender groups, lack of attention to student diversity during education, and demand for education in cross-cultural medicine. Three incidents of perceived discrimination were reported. The ethnic Dutch students interviewed did not socialize much with immigrants, nor did students of both groups learn much from one another. Most students favoured mixed study groups. The diversity of the population does not seem to have caused serious problems, nor has it offered educational benefits. The challenge for educators is to provide systematic education in cultural competence and cross-cultural medicine, in which students and educators indeed practise communication across cultural borders.
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Chang, Jun-Yih; Chen, Liang-Kung; Chang, Chia-Ching
2009-07-01
This study assessed current perspectives and expectations for telemedicine by nursing home caregivers and families of nursing home patients in Taipei, Taiwan. A total of 116 interviews were conducted with family members (n=37) and caregivers (n=79) using an original, four-part questionnaire devised to assess the expectations and concerns related to prospective telemedicine opportunities, including consumer attitude, knowledge of and interest in medicine, concerns and worries about telemedicine, and anticipated benefits of telemedicine. Statistical significance between the two groups was observed in sex, age, and educational level (all p<0.001). Most respondents had heard about telemedicine before participation and showed some interest in telemedicine implementation. More than 70.0% of subjects in both groups had perceptions of telemonitoring of patients, notifications of health abnormalities, teleconferencing between physicians and family members, obtaining test/exam results and face-to-face consultation through telenetworks. Both groups hoped for information and education through telemedicine. More caregivers were concerned about increased costs (p=0.020), poor hardware quality (p<0.001), poor security, confidentiality, and reliability (p=0.036), inconvenience to patients (p=0.006), associated moral and ethical issues (p=0.006), and uncertainty about responsibility (p=0.022). The two groups did not differ in expectations concerning benefits of telemedicine. More than 60% of family members or caregivers expected improved efficiency and quality of hospital and nursing home health care, greater rapport between nursing homes and either staff or patients, reduced overall medical costs of caregiving, and reduced staff/caregiver working hours. The acceptable cost was anything up to $15.30 USD per month. Nursing home caregivers and families of nursing home patients are highly interested in telemedicine; however, they are only willing to pay a slightly higher cost of nursing care for this service. The challenge for the future in this industry is to balance peoples' demands and telemedicine's associated costs. Results of this study suggest that caregivers and families of nursing home residents favour telemedicine implementation to provide enhanced care coordination in nursing homes when economic circumstances are favourable.
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The Deep Space Atomic Clock Mission
NASA Technical Reports Server (NTRS)
Ely, Todd A.; Koch, Timothy; Kuang, Da; Lee, Karen; Murphy, David; Prestage, John; Tjoelker, Robert; Seubert, Jill
2012-01-01
The Deep Space Atomic Clock (DSAC) mission will demonstrate the space flight performance of a small, low-mass, high-stability mercury-ion atomic clock with long term stability and accuracy on par with that of the Deep Space Network. The timing stability introduced by DSAC allows for a 1-Way radiometric tracking paradigm for deep space navigation, with benefits including increased tracking via utilization of the DSN's Multiple Spacecraft Per Aperture (MSPA) capability and full ground station-spacecraft view periods, more accurate radio occultation signals, decreased single-frequency measurement noise, and the possibility for fully autonomous on-board navigation. Specific examples of navigation and radio science benefits to deep space missions are highlighted through simulations of Mars orbiter and Europa flyby missions. Additionally, this paper provides an overview of the mercury-ion trap technology behind DSAC, details of and options for the upcoming 2015/2016 space demonstration, and expected on-orbit clock performance.
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The psychology of neurofeedback: Clinical intervention even if applied placebo.
Thibault, Robert T; Raz, Amir
2017-10-01
Advocates of neurofeedback make bold claims concerning brain regulation, treatment of disorders, and mental health. Decades of research and thousands of peer-reviewed publications support neurofeedback using electroencephalography (EEG-nf); yet, few experiments isolate the act of receiving feedback from a specific brain signal as a necessary precursor to obtain the purported benefits. Moreover, while psychosocial parameters including participant motivation and expectation, rather than neurobiological substrates, seem to fuel clinical improvement across a wide range of disorders, for-profit clinics continue to sprout across North America and Europe. Here, we highlight the tenuous evidence supporting EEG-nf and sketch out the weaknesses of this approach. We challenge classic arguments often articulated by proponents of EEG-nf and underscore how psychologists and mental health professionals stand to benefit from studying the ubiquitous placebo influences that likely drive these treatment outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
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Global Economic Effects of USA Biofuel Policy and the Potential Contribution from Advanced Biofuels
DOE Office of Scientific and Technical Information (OSTI.GOV)
Gbadebo Oladosu; Keith Kline; Paul Leiby
2012-01-01
This study evaluates the global economic effects of the USA renewable fuel standards (RFS2), and the potential contribution from advanced biofuels. Our simulation results imply that these mandates lead to an increase of 0.21 percent in the global gross domestic product (GDP) in 2022, including an increase of 0.8 percent in the USA and 0.02 percent in the rest of the world (ROW); relative to our baseline, no-RFS scenario. The incremental contributions to GDP from advanced biofuels in 2022 are estimated at 0.41 percent and 0.04 percent in the USA and ROW, respectively. Although production costs of advanced biofuels aremore » higher than for conventional biofuels in our model, their economic benefits result from reductions in oil use, and their smaller impacts on food markets compared with conventional biofuels. Thus, the USA advanced biofuels targets are expected to have positive economic benefits.« less
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Adoption and use of e-invoicing in Greece
DOE Office of Scientific and Technical Information (OSTI.GOV)
Marinagi, C., E-mail: marinagi@teihal.gr, E-mail: ptrivel@yahoo.com, E-mail: preklitis@yahoo.com; Trivellas, P., E-mail: marinagi@teihal.gr, E-mail: ptrivel@yahoo.com, E-mail: preklitis@yahoo.com; Reklitis, Panagiotis, E-mail: marinagi@teihal.gr, E-mail: ptrivel@yahoo.com, E-mail: preklitis@yahoo.com
2015-02-09
This paper investigates the adoption and use of electronic invoices (e-invoices) in Greek organizations. The study attempts to evaluate current practices applied in implementing e-invoicing. A field research has been conducted, which is based on a structured questionnaire. The target sample consisted of 42 Greek enterprises. The main issues of the investigation include the existing invoice processing practices, the barriers that prevent the extended adoption and use of e-invoicing, the observed benefits from e-invoicing implementation, and the strategic drivers for transition to e-invoicing. Currently, the use of e-invoicing in Greece is low. However, the research results testify that the adoptionmore » of e-invoicing in Greece is promising. Even though, a number of enterprises state that benefits of e-invoicing are not clear yet, the majority of enterprises agree that there are crucial financial priorities that e-invoicing is expected to support.« less
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Prescott, J S; Andrews, P A; Baker, R W; Bogdanffy, M S; Fields, F O; Keller, D A; Lapadula, D M; Mahoney, N M; Paul, D E; Platz, S J; Reese, D M; Stoch, S A; DeGeorge, J J
2017-08-01
Severely-debilitating or life-threatening (SDLT) diseases include conditions in which life expectancy is short or quality of life is greatly diminished despite available therapies. As such, the medical context for SDLT diseases is comparable to advanced cancer and the benefit vs. risk assessment and development of SDLT disease therapeutics should be similar to that of advanced cancer therapeutics. A streamlined development approach would allow patients with SDLT conditions earlier access to therapeutics and increase the speed of progression through development. In addition, this will likely increase the SDLT disease therapeutic pipeline, directly benefiting patients and reducing the economic and societal burden of SDLT conditions. Using advanced-stage heart failure (HF) as an example that illustrates the concepts applicable to other SDLT indications, this article proposes a streamlined development paradigm for SDLT disease therapeutics and recommends development of aligned global regulatory guidance. © 2017 American Society for Clinical Pharmacology and Therapeutics.
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Adoption and use of e-invoicing in Greece
NASA Astrophysics Data System (ADS)
Marinagi, C.; Trivellas, P.; Reklitis, Panagiotis; Skourlas, C.
2015-02-01
This paper investigates the adoption and use of electronic invoices (e-invoices) in Greek organizations. The study attempts to evaluate current practices applied in implementing e-invoicing. A field research has been conducted, which is based on a structured questionnaire. The target sample consisted of 42 Greek enterprises. The main issues of the investigation include the existing invoice processing practices, the barriers that prevent the extended adoption and use of e-invoicing, the observed benefits from e-invoicing implementation, and the strategic drivers for transition to e-invoicing. Currently, the use of e-invoicing in Greece is low. However, the research results testify that the adoption of e-invoicing in Greece is promising. Even though, a number of enterprises state that benefits of e-invoicing are not clear yet, the majority of enterprises agree that there are crucial financial priorities that e-invoicing is expected to support.
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Marsh, T L; Pendell, D; Knippenberg, R
2017-04-01
For animal disease events the outcomes and consequences often remain unclear or uncertain, including the expected changes in benefits (e.g. profit to firms, prices to consumers) and in costs (e.g. response, clean-up). Moreover, the measurement of changes in benefits and costs across alternative interventions used to control animal disease events may be inexact. For instance, the economic consequences of alternative vaccination strategies to mitigate a disease can vary in magnitude due to trade embargoes and other factors. The authors discuss the economic measurement of animal disease outbreaks and interventions and how measurement is used in private and public decision-making. Two illustrative case studies in the United States of America are provided: a hypothetical outbreak of foot and mouth disease in cattle, and the 2014-2015 outbreak of highly pathogenic avian influenza in poultry.
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The future of yogurt: scientific and regulatory needs1234
German, J Bruce
2014-01-01
Lactation biology, microbial selection, and human diversity are central themes that could guide investment in scientific research, industrial innovation, and regulatory policy oversight to propel yogurt into the central role for health-promoting food products. The ability of yogurt to provide the nourishing properties of milk together with the live microorganisms from fermentation provides a unique combination of food assets. Academic research must now define the various targets on which these biological assets act to improve health and develop the metrics that can quantitatively document their benefits. The food industry must reconcile that yogurt and its microorganisms cannot be expected to provide measurable benefits for all consumers, at all doses, and at all times. A supportive regulatory oversight must demand safety and yet encourage innovations that support a value proposition for yogurt in health. Health valuation in the marketplace will be driven by parallel innovations, including accurate assessment technologies, validated microbial ingredients, and health-aware consumers. PMID:24695899
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The future of yogurt: scientific and regulatory needs.
German, J Bruce
2014-05-01
Lactation biology, microbial selection, and human diversity are central themes that could guide investment in scientific research, industrial innovation, and regulatory policy oversight to propel yogurt into the central role for health-promoting food products. The ability of yogurt to provide the nourishing properties of milk together with the live microorganisms from fermentation provides a unique combination of food assets. Academic research must now define the various targets on which these biological assets act to improve health and develop the metrics that can quantitatively document their benefits. The food industry must reconcile that yogurt and its microorganisms cannot be expected to provide measurable benefits for all consumers, at all doses, and at all times. A supportive regulatory oversight must demand safety and yet encourage innovations that support a value proposition for yogurt in health. Health valuation in the marketplace will be driven by parallel innovations, including accurate assessment technologies, validated microbial ingredients, and health-aware consumers.
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Pulmonary Metastasectomy: A Common Practice Based on Weak Evidence
Treasure, Tom
2007-01-01
The resection of secondary metastases from the lungs is a wide-spread surgical practice. Patients are referred from coloproctology teams to thoracic surgeons specifically for this surgery. What is the expected benefit? I have explored the rationale and searched the literature in order to present these patients with a well-informed opinion for their consideration. I find only weak evidence based on uncontrolled retrospective series which have been interpreted as showing a survival benefit. This has been extrapolated to policy and practice that do not stand up to scrutiny. The practice has never been subjected to randomised trial and I will argue that the present evidence is insufficient to justify the uncontrolled use of an intervention with inescapable short-term morbidity, permanent loss of function, and major cost implications. I propose ways in which the evidence may be improved, including a trial in the areas of most uncertainty. PMID:17999813
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Survey of Internship Education in Western Countries and the Problems to be Considered in Japan
NASA Astrophysics Data System (ADS)
Noguchi, Toru; Yoshikawa, Kozo; Kaneko, Katsuhiko
To survey the states of internship education in western countries, the authors visited seven universities, three companies and an institute in North America and Europe. The survey showed that internship of one semester (2-3 months) or more is quite common in these countries. In the graduate courses, joining some research/development projects out of the school, including overseas, is strongly recommended. Accepting internship students gives benefits also to the host companies/institutions by carrying short term projects as well as attracting talented students as expected employees. To promote such internship system in Japan, it is necessary to make education programs concordant with such long term internships. Marked improvement in practical abilities of students will also be reflected to research activities and will result in the benefit of the universities. Promotion of internship here is also necessary from the global aspect, to attract good overseas students.
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Chen, Pei-Ching; Lee, Yue-Chune; Tsai, Shih-Tzu; Lai, Chih-Kuan
2012-05-01
This study applied a cost-benefit analysis from a societal viewpoint to evaluate the Outpatient Smoking Cessation Services (OSCS) program. The costs measured in this study include the cost to the health sector, non-health sectors, the patients and their family, as well as the loss of productivity as a result of smoking. The benefits measured the medical costs savings and the earnings due to the increased life expectancy of a person that has stopped smoking for 15 years. Data were obtained from the primary data of a telephone survey, the literatures and reports from the Outpatient Smoking Cessation Management Center and government. Sensitivity analyses were conducted to verify the robustness of the results. There were 169,761 cases that participated in the outpatient smoking cessation program in the years 2007 and 2008, of those cases, 8,282 successfully stopped smoking. The total cost of the OSCS program was 18 million USD. The total benefits of the program were 215 million USD with a 3% discount rate; the net benefit to society was 196 million USD. After conducting sensitivity analyses on the different abstinence, relapse, and discount rates, from a societal perspective, the benefits still far exceeded the costs, while from a health care perspective, there was only a net benefit when the respondent's abstinence rate was used. From a societal perspective, the OSCS program in Taiwan is cost-beneficial. This study provides partial support for the policy makers to increase the budget and expand the OSCS program.
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Effect of expectation on pain assessment of lower- and higher-intensity stimuli.
Ružić, Valentina; Ivanec, Dragutin; Modić Stanke, Koraljka
2017-01-01
Pain modulation via expectation is a well-documented phenomenon. So far it has been shown that expectations about effectiveness of a certain treatment enhance the effectiveness of different analgesics and of drug-free pain treatments. Also, studies demonstrate that people assess same-intensity stimuli differently, depending on the experimentally induced expectations regarding the characteristics of the stimuli. Prolonged effect of expectation on pain perception and possible symmetry in conditions of lower- and higher-intensity stimuli is yet to be studied. Aim of this study is to determine the effect of expectation on the perception of pain experimentally induced by the series of higher- and lower-intensity stimuli. 192 healthy participants were assigned to four experimental groups differing by expectations regarding the intensity of painful stimuli series. Expectations of two groups were congruent with actual stimuli; one group expected and received lower-intensity stimuli and the other expected and received higher-intensity stimuli. Expectations of the remaining two groups were not congruent with actual stimuli; one group expected higher-intensity stimuli, but actually received lower-intensity stimuli while the other group expected lower-intensity stimuli, but in fact received higher-intensity ones. Each group received a series of 24 varied-intensity electrical stimuli rated by the participants on a 30° intensity scale. Expectation manipulation had statistically significant effect on pain intensity assessment. When expecting lower-intensity stimuli, the participants underestimated pain intensity and when expecting higher-intensity stimuli, they overestimated pain intensity. The effect size of expectations upon pain intensity assessment was equal for both lower- and higher-intensity stimuli. The obtained results imply that expectation manipulation can achieve the desired effect of decreasing or increasing both slight and more severe pain for a longer period of time. Manipulation via expectation before the stimuli series was proven to be effective for pain modulation in the entire series of stimuli which lasted around 10min. The results suggest a potential benefit of manipulating expectations to alleviate emerging pain, since the obtained effects are moderate to large. It seems that expectation effect is strong enough to "overcome" even the direct effect of stimulus intensity (at least in the low to moderate intensity range), which suggests potential benefits of verbal instructions even in rather painful stimuli. Copyright © 2016 Scandinavian Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.
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Cultivating Effective Corpus Use by Language Learners
ERIC Educational Resources Information Center
Kennedy, Claire; Miceli, Tiziana
2017-01-01
While there is widespread agreement on the expected benefits of hands-on access to corpora for language learners, reports abound of the difficulties involved in realising those benefits in practice. A particular focus of discussion is the challenge of transferring the skills of the corpus linguist to learners, so that they can explore this type of…
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20 CFR 220.28 - How long the impairment must last.
Code of Federal Regulations, 2010 CFR
2010-04-01
... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false How long the impairment must last. 220.28 Section 220.28 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT ACT... long the impairment must last. Unless the claimant's impairment is expected to result in death, it must...
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USDA-ARS?s Scientific Manuscript database
Recurring outbreaks of bluetongue virus in large rangeland sheep flocks in the Intermountain West of the United States have prompted questions about the economic benefits and costs of vaccinating individual flocks against bluetongue disease. We use enterprise budgets and stochastic simulation to est...
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Weber, Christian; Neeser, Kurt
2006-08-01
Diabetes is an increasing health problem, but efforts to handle this pandemic by disease management programs (DMP) have shown conflicting results. Our hypothesis is that, in addition to a program's content and setting, the choice of the right patients is crucial to a program's efficacy and effectiveness. We used individualized predictive disease modeling (IPDM) on a cohort of 918 patients with type 2 diabetes to identify those patients with the greatest potential to benefit from inclusion in a DMP. A portion of the patients (4.7%) did not have even a theoretical potential for an increase in life expectancy and would therefore be unlikely to benefit from a DMP. Approximately 16.1% had an increase in life expectancy of less than half a year. Stratification of the entire cohort by surrogate parameters like preventable 10-year costs or gain in life expectancy was much more effective than stratification by classical clinical parameters such as high HbA1c level. Preventable costs increased up to 50.6% (or 1,010 per patient (1 = US dollars 1.28), p < 0.01) and life expectancy increased up to 54.8% (or 2.3 years, p < 0.01). IPDM is a valuable strategy to identify those patients with the greatest potential to avoid diabetes-related complications and thus can improve the overall effectiveness and efficacy of DMPs for diabetes mellitus.
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Saelen, Cécile; Markovits, Henry
2008-05-01
This study examined the idea that expectations of behavior in hypothetical situations involving potential moral transgressions are related to emotion attributions relating to both moral and cost-benefit considerations. We asked younger (14 years 5 months) and older (16 years 1 month) female and male adolescents (a) to make predictions about the probability that an adolescent placed in a hypothetical situation where a payoff could be obtained by acting in a nonmoral way would choose to do so and (b) to evaluate adolescents' attributions of moral (guilt) and cost-benefit-related emotions (satisfaction and fear) to the nonmoral action. Two different situations were examined; one looked at the possibility of stealing money from a lost wallet, and the other examined a situation where a contract with another peer could be broken for personal reasons. Results showed that expectations that the nonmoral action would be taken were positively related to the degree of satisfaction and negatively related to the degree of guilt and fear. However, the pattern of relations between emotion attributions and behavioral expectations differed between the two situations. Female and male adolescents had different levels of emotion attributions and behavioral expectations, but the relation between the two was similar for both. Finally, developmental comparisons indicated that older adolescents put more weight on guilt and were more internally consistent in the way that emotions were integrated into behavioral expectations.
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Gwak, Jae Ha; Lee, Bo Kyeong; Lee, Won Kyung; Sohn, So Young
2017-03-15
This study proposes a new framework for the selection of optimal locations for green roofs to achieve a sustainable urban ecosystem. The proposed framework selects building sites that can maximize the benefits of green roofs, based not only on the socio-economic and environmental benefits to urban residents, but also on the provision of urban foraging sites for honeybees. The framework comprises three steps. First, building candidates for green roofs are selected considering the building type. Second, the selected building candidates are ranked in terms of their expected socio-economic and environmental effects. The benefits of green roofs are improved energy efficiency and air quality, reduction of urban flood risk and infrastructure improvement costs, reuse of storm water, and creation of space for education and leisure. Furthermore, the estimated cost of installing green roofs is also considered. We employ spatial data to determine the expected effects of green roofs on each building unit, because the benefits and costs may vary depending on the location of the building. This is due to the heterogeneous spatial conditions. In the third step, the final building sites are proposed by solving the maximal covering location problem (MCLP) to determine the optimal locations for green roofs as urban honeybee foraging sites. As an illustrative example, we apply the proposed framework in Seoul, Korea. This new framework is expected to contribute to sustainable urban ecosystems. Copyright © 2016 Elsevier Ltd. All rights reserved.
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Potential explanations for control group benefit.
Nichols, Linda O; Martindale-Adams, Jennifer L; Burns, Robert; Graney, Marshall J; Zuber, Jeffrey K; Kennedy, Sarah E
2012-10-01
Estimating effectiveness of clinical interventions depends on detecting differences between the responses of intervention and control groups. The outcome, intervention, and moderating factors all may influence the between group change. The absence of a clinically or statistically meaningful difference may also result from control group improvement due to nonspecific factors such as participants' perception of attention, positive regard, expectations, desire to please, and therapeutic alliance with the care provider. We examined perceived benefit and sources of benefit for control caregivers who participated in the CONNECT randomized controlled trial of a dementia caregiving intervention. After the final scheduled data collection in CONNECT, control group participants were asked whether they believed they benefited from study participation. Those who reported benefit were asked to describe the benefit received. Data were analyzed qualitatively. Of 60 available control caregivers, 82% reported a perceived benefit from study participation in five areas: getting information about dementia and caregiving; having someone to talk to and feeling supported; receiving understanding and validation of feelings; knowledge that others were in similar situations; and perceived appreciation of own abilities. Control caregivers who reported benefit were less burdened and depressed and spent less time on duty at baseline than those who did not report benefit. From caregivers' responses, we have identified the assessment battery, both content and time spent in data collection, as a possible mechanism of action for benefit. Study limitations include the better baseline characteristics of the control caregivers who reported benefit, the sample size of benefit control caregivers, the possibility of perceptions of benefit being a function of social desirability, and the lack of a similar question about benefit being asked of intervention caregivers. These findings suggest that the outcome assessment questionnaires used in this and similar trials may be an intervention of sorts for caregiver participants in the control group. Caregivers who are less distressed may benefit more from the attention provided during assessment. These findings underscore the importance of asking caregivers how they are doing. For researchers, there is a need to develop innovative ways to assess outcomes to avoid unintended benefit of assessments.
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Akiyama, Miki; Abraham, Chon
2017-08-01
Tele-homecare is gaining prominence as a viable care alternative, as evidenced by the increase in financial support from international governments to fund initiatives in their respective countries. The primary reason for the funding is to support efforts to reduce lags and increase capacity in access to care as well as to promote preventive measures that can avert costly emergent issues from arising. These efforts are especially important to super-aged and aging societies such as in Japan, many European countries, and the United States (US). However, to date and to our knowledge, a direct comparison of non-government vs. government-supported funding models for tele-homecare is particularly lacking in Japan. The aim of this study is to compare these operational models (i.e., non-government vs. government-supported funding) from a cost-benefit perspective. This simulation study applies to a Japanese hypothetical cohort with implications for other super-aged and aging societies abroad. We performed a cost-benefit analysis (CBA) on two operational models for enabling tele-homecare for elderly community-dwelling cohorts based on a decision tree model, which we created with parameters from published literature. The two models examined are (a) Model 1-non-government-supported funding that includes monthly fixed charges paid by users for a portion of the operating costs, and (b) Model 2-government-supported funding that includes startup and installation costs only (i.e., no operating costs) and no monthly user charges. We performed base case cost-benefit analysis and probabilistic cost-benefit analysis with a Monte Carlo simulation. We calculated net benefit and benefit-to-cost ratios (BCRs) from the societal perspective with a five-year time horizon applying a 3% discount rate for both cost and benefit values. The cost of tele-homecare included (a) the startup system expense, averaged over a five-year depreciation period, and (b) operation expenses (i.e., labor and non-labor) per user per year. The benefit of tele-homecare was measured by annual willingness to pay (WTP) for tele-homecare by a user and medical expenditures avoided. Both costs and benefits were inflated using the relevant Japanese consumer price index (CPI) and converted into 2015 US dollars with purchasing power parity (PPP) adjusted. Base case net benefits of Model 1 and Model 2 were $417.00 and $97.30, respectively. Base case BCR of Model 1 tele-homecare was 1.63, while Model 2 was 1.03. The probabilistic analysis estimated mean (95%CI) for BCRs of Model 1 and Model 2 was 1.84 (1.89, 1.88) and 1.46 (1.43, 1.49), respectively. Sensitivity analysis showed robustness of Model 1 in 7 parameters but Model 2 was sensitive in all key parameters such as initial system cost, device cost, number of users, and medical expenditure saved. Break-even analysis showed that the system cost of Model 2 had to be under $187,500. Our results for each model collectively showed that tele-homecare in Japan is cost-saving to some extent. However, the government-funded model (i.e., Model 2), which typically requires use of all startup funding to be spent within the first year on system costs, was inferior to the monthly fee model (i.e., Model 1) that did not use the government funding for installation or continued operations, but rather incorporated a monthly fee from users to support the receipt of services via tele-homecare. While the benefits of Model 1 outweighed the benefits of Model 2, the government-subsidized method employed in Model 2 could be more beneficial in general if some explicit prequalifying estimated metrics are instituted prior to funding. Thus, governments need to require applicants requesting funding to note, at a minimum, (a) estimated costs, (b) the expected number of tele-homecare users, and expected benefits such as (c) WTP by the user, or (d) medical expenditure saved by tele-homecare as a means of financing some of the operational costs. Copyright © 2017 Elsevier B.V. All rights reserved.
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Comparison of psychosocial status in treatment-seeking women with class III vs. class I-II obesity.
Wadden, Thomas A; Butryn, Meghan L; Sarwer, David B; Fabricatore, Anthony N; Crerand, Canice E; Lipschutz, Patti E; Faulconbridge, Lucy; Raper, Steven; Williams, Noel N
2006-01-01
This study compared the psychosocial status and weight loss expectations of women with extreme (class III) obesity who sought bariatric surgery with those of women with class I-II obesity who enrolled in a research study on behavioral weight control. Before treatment, all participants completed the Beck Depression Inventory-II and the Weight and Lifestyle Inventory. This latter questionnaire assesses several domains including symptoms of depression and low self-esteem, history of psychiatric complications, current stressors, and weight loss expectations. Women with class III obesity, as compared with class I-II, reported significantly more symptoms of depression. Fully 25% of women in the former group appeared to have a significant mood disorder that would benefit from treatment. As compared with women with class I-II obesity, significantly more women with class III obesity also reported a history of psychiatric complications, which included physical and sexual abuse and greater stress related to their physical health and financial/legal matters. Both groups of women had unrealistic weight loss expectations. Those who sought surgery expected to lose 47.6 +/- 9.3% of initial weight, compared with 24.8 +/- 8.7% for those who enrolled in behavioral weight control. These findings suggest that women with extreme obesity who seek bariatric surgery should be screened for psychosocial complications. Those determined to have significant psychiatric distress should be referred for behavioral or pharmacological treatment to alleviate their suffering. Long-term studies are needed to provide definitive guidance concerning the relationship between preoperative psychopathology and the outcome of bariatric surgery.
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Patient-centered and visual quality outcomes of premium cataract surgery: a systematic review.
Wang, Sophia Y; Stem, Maxwell S; Oren, Gale; Shtein, Roni; Lichter, Paul R
2017-06-26
Over 8 million cataract surgeries are performed in the United States and the European Union annually, with many patients choosing to pay out of pocket for premium options including premium intraocular lens implants (IOLs) or laser-assisted cataract surgery (LACS). This report provides a systematic review evaluating patient-centered and visual quality outcomes comparing standard monofocal IOLs to premium cataract surgery options. PubMed and EMBASE were searched for publications published between January 1, 1980, and September 18, 2016, on multifocal, accommodative, and toric IOLs, monovision, and LACS, which reported on 1) dysphotopsias, 2) contrast sensitivity, 3) spectacle independence, 4) vision-related quality of life or patient satisfaction, and 5) IOL exchange. Multifocal lenses achieved higher rates of spectacle independence compared to monofocal lenses but also had higher reported frequency of dysphotopsia and worse contrast sensitivity, especially with low light or glare. Accommodative lenses were not associated with reduced contrast sensitivity or more dysphotopsia but had only modest improvements in spectacle independence compared to monofocal lenses. Studies of monovision did not target a sufficiently myopic outcome in the near-vision eye to achieve the full potential for spectacle independence. Patients reported high levels of overall satisfaction regardless of implanted IOL. No studies correlated patient-reported outcomes with patient expectations. Studies are needed to thoroughly compare patient-reported outcomes with concomitant patient expectations. In light of the substantial patient costs for premium options, patients and their surgeons will benefit from a better understanding of which surgical options best meet patients' expectations and how those expectations can be impacted by premium versus monofocal-including monovision-options.
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NASA Astrophysics Data System (ADS)
Chaianong, A.; Bangviwat, A.; Menke, C.
2017-07-01
Driven by decreasing PV and energy storage prices, increasing electricity costs and policy supports from Thai government (self-consumption era), rooftop PV and energy storage systems are going to be deployed in the country rapidly that may disrupt existing business models structure of Thai distribution utilities due to revenue erosion and lost earnings opportunities. The retail rates that directly affect ratepayers (non-solar customers) are expected to increase. This paper focuses on a framework for evaluating impacts of PV with and without energy storage systems on Thai distribution utilities and ratepayers by using cost-benefit analysis (CBA). Prior to calculation of cost/benefit components, changes in energy sales need to be addressed. Government policies for the support of PV generation will also help in accelerating the rooftop PV installation. Benefit components include avoided costs due to transmission losses and deferring distribution capacity with appropriate PV penetration level, while cost components consist of losses in revenue, program costs, integration costs and unrecovered fixed costs. It is necessary for Thailand to compare total costs and total benefits of rooftop PV and energy storage systems in order to adopt policy supports and mitigation approaches, such as business model innovation and regulatory reform, effectively.
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The public goods game with a new form of shared reward
NASA Astrophysics Data System (ADS)
Zhang, Chunyan; Chen, Zengqiang
2016-10-01
Altruistic contribution to a common good evenly enjoyed by all group members is hard to explain because of the greater benefits obtained by a defector than a cooperator. A variety of mechanisms have been proposed to resolve the collective dilemma over the years, including rewards for altruism. An underrated and easily ignored phenomenon is that the altruistic behaviors of cooperators not only directly enhance the benefits of their game opponents, but also indirectly produce good influences to other allied members in their surroundings (e.g. relatives or friends). Here we propose a shared reward, in the form of extensive benefits, to extend the traditional definition of the public goods game. Mathematical analysis using the Moran process helps us to obtain the fixation probability for one ‘mutant’ cooperator to invade and dominate the whole defecting population. Results suggest that a tunable parameter exists, above a certain critical value of which natural selection favors cooperation over defection. In addition, analytical results with replicator dynamics show that this critical value influencing the evolution of altruism is closely correlated with the population size, the gaming group size and the synergy factor of the public goods game. These results, based on an extended notion of shared reward and extensive benefits, are expected to provide novel explanations for the emergence of altruistic behaviors.
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García-Ubaque, César A; García-Ubaque, Juan C; Vaca-Bohórquez, Martha L
2015-12-01
Objective To estimate the economic benefits related to environment and health in the context of the implementation of the Stockholm Convention for the control of Persistent Organic Pollutants in the country. The estimation was conducted based on two scenarios: non-compliance with the agreement and compliance with the Convention. Gross profit was derived from the difference in present value between the health and environmental costs that are assumed in each scenario. Results Gross profit by decreasing health costs arising from the implementation of the Convention was estimated at USD $ 511 and USD $ 501 million. By introducing variables such as management costs and agreement on potential benefits for access to international markets, the benefits to the country were estimated at between USD $1 631 and USD $ 3 118 million. Discussion Despite the economic benefits generated by lower expenditure on health for the Convention implementation, the costs associated with reducing pollutant emissions generated a negative balance, compensated only by the expectation of higher revenues for international market access. We consider this initial economic assessment an important contribution, but it should be reviewed to include valuation methodologies involving other social profitability variables and different scenarios for emerging technologies, new scientific knowledge about these pollutants, changes in legislation and / or changes in trade agreement conditions, among others.
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The good, the bad and the ugly of marine reserves for fishery yields.
De Leo, Giulio A; Micheli, Fiorenza
2015-11-05
Marine reserves (MRs) are used worldwide as a means of conserving biodiversity and protecting depleted populations. Despite major investments in MRs, their environmental and social benefits have proven difficult to demonstrate and are still debated. Clear expectations of the possible outcomes of MR establishment are needed to guide and strengthen empirical assessments. Previous models show that reserve establishment in overcapitalized, quota-based fisheries can reduce both catch and population abundance, thereby negating fisheries and even conservation benefits. By using a stage-structured, spatially explicit stochastic model, we show that catches under quota-based fisheries that include a network of MRs can exceed maximum sustainable yield (MSY) under conventional quota management if reserves provide protection to old, large spawners that disproportionally contribute to recruitment outside the reserves. Modelling results predict that the net fishery benefit of MRs is lost when gains in fecundity of old, large individuals are small, is highest in the case of sedentary adults with high larval dispersal, and decreases with adult mobility. We also show that environmental variability may mask fishery benefits of reserve implementation and that MRs may buffer against collapse when sustainable catch quotas are exceeded owing to stock overestimation or systematic overfishing. © 2015 The Author(s).
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Land-use planning for nearshore ecosystem services—the Puget Sound Ecosystem Portfolio Model
Byrd, Kristin
2011-01-01
The 2,500 miles of shoreline and nearshore areas of Puget Sound, Washington, provide multiple benefits to people—"ecosystem services"—including important fishing, shellfishing, and recreation industries. To help resource managers plan for expected growth in coming decades, the U.S. Geological Survey Western Geographic Science Center has developed the Puget Sound Ecosystem Portfolio Model (PSEPM). Scenarios of urban growth and shoreline modifications serve as model inputs to develop alternative futures of important nearshore features such as water quality and beach habitats. Model results will support regional long-term planning decisions for the Puget Sound region.
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Bourquin, Vincent; Ponte, Belén; Hirschel, Bernard; Pugin, Jérôme; Martin, Pierre-Yves; Saudan, Patrick
2011-01-01
Background. Leptospirosis is a spirochetal zoonosis with complex clinical features including renal and liver failure. Case report. We report the case of a Swiss fisherman presenting with leptospirosis. After initial improvement, refractory septic shock and severe liver and kidney failure developed. The expected mortality was estimated at 90% with clinical scores. The patient underwent plasma exchanges and high-volume hemofiltration (HVHF) with complete recovery of hepatic and kidney functions. Discussion. Plasma exchanges and HVHF may confer survival benefit on patients with severe leptospirosis, refractory septic shock, and multiple-organ failure.
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Factors associated with antiretroviral adherence among HIV-infected women with children.
Murphy, Debra A; Greenwell, Lisa; Hoffman, Dannie
2002-01-01
HIV symptomatic or AIDS diagnosed women who had a young well child were recruited for a study investigating their adherence to antiretrovirals (N = 46). Very poor rates of adherence were found, ranging from 43% (pill count assessment) to 56% (self-report of 3-day adherence to dose). Several factors were associated with nonadherence, including alcohol use, perceived stress, having a partner and age of youngest child, poor self-efficacy to stay with treatment, and poor outcome expectancies regarding the benefits of following the treatment regimen. Interventions to assist these women in improving adherence are urgently needed.
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Paudel, Krishna P; McIntosh, Christopher S
2005-01-01
This report describes the development of the broiler litter problem in the southeastern United States, including the economic opportunity and environmental challenges brought to the region by the industry. Through an analysis applied to the State of Georgia, land application of litter as a disposal alternative is examined along with its associated benefits. The analysis indicates that litter could be transported economically up to 256 km for cropland application. Excessive broiler litter production in a few concentrated regions is expected to stimulate the development of alternative approaches to broiler litter management, such as electricity generation.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Hinman, N.D.; Yancey, M.A.
1997-12-31
One of the main functions of government is to invest taxpayers dollars in projects, programs, and properties that will result in social benefit. Public programs focused on the development of technology are examples of such opportunities. Selecting these programs requires the same investment analysis approaches that private companies and individuals use. Good use of investment analysis approaches to these programs will minimize our tax costs and maximize public benefit from tax dollars invested. This article describes the use of the net present value (NPV) analysis approach to select public R&D programs and valuate expected private sector participation in the programs.more » 5 refs.« less
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Wilson, James H; Mullen, Maureen A; Bollman, Andrew D; Thesing, Kirstin B; Salhotra, Manish; Divita, Frank; Neumann, James E; Price, Jason C; DeMocker, James
2008-05-01
Section 812 of the Clean Air Act Amendments (CAAA) of 1990 requires the U.S. Environmental Protection Agency (EPA) to perform periodic, comprehensive analyses of the total costs and total benefits of programs implemented pursuant to the CAAA. The first prospective analysis was completed in 1999. The second prospective analysis was initiated during 2005. The first step in the second prospective analysis was the development of base and projection year emission estimates that will be used to generate benefit estimates of CAAA programs. This paper describes the analysis, methods, and results of the recently completed emission projections. There are several unique features of this analysis. One is the use of consistent economic assumptions from the Department of Energy's Annual Energy Outlook 2005 (AEO 2005) projections as the basis for estimating 2010 and 2020 emissions for all sectors. Another is the analysis of the different emissions paths for both with and without CAAA scenarios. Other features of this analysis include being the first EPA analysis that uses the 2002 National Emission Inventory files as the basis for making 48-state emission projections, incorporating control factor files from the Regional Planning Organizations (RPOs) that had completed emission projections at the time the analysis was performed, and modeling the emission benefits of the expected adoption of measures to meet the 8-hr ozone National Ambient Air Quality Standards (NAAQS), the Clean Air Visibility Rule, and the PM2.5 NAAQS. This analysis shows that the 1990 CAAA have produced significant reductions in criteria pollutant emissions since 1990 and that these emission reductions are expected to continue through 2020. CAAA provisions have reduced volatile organic compound (VOC) emissions by approximately 7 million t/yr by 2000, and are estimated to produce associated VOC emission reductions of 16.7 million t by 2020. Total oxides of nitrogen (NO(x)) emission reductions attributable to the CAAA are 5, 12, and 17 million t in 2000, 2010, and 2020, respectively. Sulfur dioxide (SO2) emission benefits during the study period are dominated by electricity-generating unit (EGU) SO2 emission reductions. These EGU emission benefits go from 7.5 million t reduced in 2000 to 15 million t reduced in 2020.
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The management service company's expectation of the customer.
Kuykendall, R D
1992-02-01
The one constant factor in health care today is change. Choose your management support company carefully, expect high quality results, and communicate both positive and negative feedback immediately. This formula will give you excellent results as well as a long-term productive partnership in which cost, risk, and the end objectives can be balanced for maximum benefit.
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Relating Social Welfare to Life Satisfaction in the Postmodern Era of Hong Kong
ERIC Educational Resources Information Center
Cheung, Chau-kiu; Leung, Kwan-kwok
2007-01-01
Social welfare is supposedly beneficial not only to the needy receiving it but to citizens in general who expect social welfare to help the needy. Whereas direct benefits to the needy represent the gratification of material needs, the fulfillment of citizens' expectation registers an idealistic path to life satisfaction. These materialistic and…
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ERIC Educational Resources Information Center
Saelen, Cecile; Markovits, Henry
2008-01-01
This study examined the idea that expectations of behavior in hypothetical situations involving potential moral transgressions are related to emotion attributions relating to both moral and cost-benefit considerations. We asked younger (14 years 5 months) and older (16 years 1 month) female and male adolescents (a) to make predictions about the…
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USDA-ARS?s Scientific Manuscript database
TV and other screen use are common among elementary-school-aged children with both potential benefits and harms. It is not clear why some parents restrict their children's screen use and others do not. Parents' outcome expectations for allowing their child to watch TV and other screen media, i.e., t...
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Sport Management Internships: Agency Perspectives, Expectations, and Concerns
ERIC Educational Resources Information Center
Williams, Jo
2004-01-01
Should we hire a sport management intern in our organization or department? What role will the intern play? How will we benefit? What can we expect from sport management interns in terms of preparation and commitment? How easy is it to find, select, and work with an appropriately prepared intern? Professionals ask all of these questions when they…
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J. H. Scott; D. J. Helmbrecht; M. P. Thompson
2014-01-01
Characterizing wildfire risk to a fire-adapted ecosystem presents particular challenges due to its broad spatial extent, inherent complexity, and the difficulty in defining wildfire-induced losses and benefits. Our approach couples stochastic wildfire simulation with a vegetation condition assessment framework to estimate the conditional and expected response of...
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29 CFR Appendix D to Part 4044 - Tables Used To Determine Expected Retirement Age
Code of Federal Regulations, 2010 CFR
2010-07-01
... 29 Labor 9 2010-07-01 2010-07-01 false Tables Used To Determine Expected Retirement Age D Appendix D to Part 4044 Labor Regulations Relating to Labor (Continued) PENSION BENEFIT GUARANTY CORPORATION PLAN TERMINATIONS ALLOCATION OF ASSETS IN SINGLE-EMPLOYER PLANS Pt. 4044, App. D Appendix D to Part...
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Breeze, P R; Thomas, C; Squires, H; Brennan, A; Greaves, C; Diggle, P; Brunner, E; Tabak, A; Preston, L; Chilcott, J
2017-08-01
To analyse the cost-effectiveness of different interventions for Type 2 diabetes prevention within a common framework. A micro-simulation model was developed to evaluate the cost-effectiveness of a range of diabetes prevention interventions including: (1) soft drinks taxation; (2) retail policy in socially deprived areas; (3) workplace intervention; (4) community-based intervention; and (5) screening and intensive lifestyle intervention in individuals with high diabetes risk. Within the model, individuals follow metabolic trajectories (for BMI, cholesterol, systolic blood pressure and glycaemia); individuals may develop diabetes, and some may exhibit complications of diabetes and related disorders, including cardiovascular disease, and eventually die. Lifetime healthcare costs, employment costs and quality-adjusted life-years are collected for each person. All interventions generate more life-years and lifetime quality-adjusted life-years and reduce healthcare spending compared with doing nothing. Screening and intensive lifestyle intervention generates greatest lifetime net benefit (£37) but is costly to implement. In comparison, soft drinks taxation or retail policy generate lower net benefit (£11 and £11) but are cost-saving in a shorter time period, preferentially benefit individuals from deprived backgrounds and reduce employer costs. The model enables a wide range of diabetes prevention interventions to be evaluated according to cost-effectiveness, employment and equity impacts over the short and long term, allowing decision-makers to prioritize policies that maximize the expected benefits, as well as fulfilling other policy targets, such as addressing social inequalities. © 2017 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.
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Tai chi for upper limb rehabilitation in stroke patients: the patient's perspective.
Desrochers, Pascal; Kairy, Dahlia; Pan, Shujuan; Corriveau, Hélène; Tousignant, Michel
2017-06-01
This study aimed at exploring the perceived benefits and drawbacks of practicing tai chi, an alternative therapy that can be implemented in the community, as part of upper-limb rehabilitation following stroke. Semistructured interviews were carried out with participants with chronic stroke (>6 months). The participants took part in 16 tai chi sessions over 8 weeks. Interviews were conducted in person using an interview guide based on the theory of planned behavior (TPB), and a thematic analysis was conducted. Eight interviews were carried out with participants at various stages of motor recovery. Participants perceived a number of physical, functional, and psychological benefits. They found tai chi to be a global exercise, including both physical and mental aspects, and suggested that it can be included as part of rehabilitation for stroke patients. Many participants expressed a desire to continue practicing tai chi after completion of the study because it exceeded their expectations, among other reasons. This study can serve to guide future tai chi interventions and research on tai chi for rehabilitation in terms of the characteristics of the intervention and the various areas to assess in order to measure the overall benefits. IMPLICATIONS FOR REHABILITATION Tai chi was perceived as a good way of integrating various skills learned during rehabilitation. Despite having different functional abilities, all the participants noted various physical, functional, and psychological benefits from participating in the tai chi sessions. Tai chi seems to be a form of exercise that stroke patients would perform more long-term since all the participants in this study expressed the desire to continue practicing tai chi.
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Basen-Engquist, Karen; Carmack, Cindy L; Perkins, Heidi; Hughes, Daniel; Serice, Susan; Scruggs, Stacie; Pinto, Bernardine; Waters, Andrew
2011-01-01
Physical activity has been shown to benefit cancer survivors' physical functioning, emotional well-being, and symptoms. Physical activity may be of particular benefit to survivors of endometrial cancer because they are more likely to be obese and sedentary than the general population, as these are risk factors for the disease, and thus experience a number of related co-morbid health problems. However, there is little research systematically studying mechanisms of physical activity adherence in cancer survivor populations. This paper describes the design of the Steps to Health study, which applies a Social Cognitive Theory-based model of endometrial cancer survivors' adoption and maintenance of exercise in the context of an intervention to increase walking or other moderate intensity cardiovascular activity. In Steps to Health we will test the influence of self-efficacy and outcome expectations on adherence to exercise recommendations, as well as studying the determinants of self-efficacy. Endometrial cancer survivors who are at least 6 months post-treatment are provided with an intervention involving print materials and telephone counseling, and complete assessments of fitness, activity, self-efficacy and outcome expectations, and determinants of self-efficacy every two months for a six month period. In addition to testing an innovative model, the Steps to Health study employs multiple assessment methods, including ecological momentary assessment, implicit tests of cognitive variables, and ambulatory monitoring of physical activity. The study results can be used to develop more effective interventions for increasing physical activity in sedentary cancer survivors by taking into account the full complement of sources of self-efficacy information and outcome expectations.
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Energy manager design for microgrids
DOE Office of Scientific and Technical Information (OSTI.GOV)
Firestone, Ryan; Marnay, Chris
2005-01-01
On-site energy production, known as distributed energy resources (DER), offers consumers many benefits, such as bill savings and predictability, improved system efficiency, improved reliability, control over power quality, and in many cases, greener electricity. Additionally, DER systems can benefit electric utilities by reducing congestion on the grid, reducing the need for new generation and transmission capacity, and offering ancillary services such as voltage support and emergency demand response. Local aggregations of distributed energy resources (DER) that may include active control of on-site end-use energy devices can be called microgrids. Microgrids require control to ensure safe operation and to make dispatchmore » decisions that achieve system objectives such as cost minimization, reliability, efficiency and emissions requirements, while abiding by system constraints and regulatory rules. This control is performed by an energy manager (EM). Preferably, an EM will achieve operation reasonably close to the attainable optimum, it will do this by means robust to deviations from expected conditions, and it will not itself incur insupportable capital or operation and maintenance costs. Also, microgrids can include supervision over end-uses, such as curtailing or rescheduling certain loads. By viewing a unified microgrid as a system of supply and demand, rather than simply a system of on-site generation devices, the benefits of integrated supply and demand control can be exploited, such as economic savings and improved system energy efficiency.« less
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All-Male Discussion Forums for Expectant Fathers: Evaluation of a Model
Friedewald, Mark; Fletcher, Richard; Fairbairn, Hedy
2005-01-01
This paper describes an all-male discussion forum for expectant fathers led by a male facilitator. The 617 participants completed an evaluation form and were unanimous in their agreement about the benefits of the forum, in particular the opportunity to discuss issues of importance to them with others in a similar situation. The results should encourage those developing antenatal education programs to be more inclusive of expectant fathers and to acknowledge their feelings, unique role, and contribution. PMID:17273428
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Effects of threat management interactions on conservation priorities.
Auerbach, Nancy A; Wilson, Kerrie A; Tulloch, Ayesha I T; Rhodes, Jonathan R; Hanson, Jeffrey O; Possingham, Hugh P
2015-12-01
Decisions need to be made about which biodiversity management actions are undertaken to mitigate threats and about where these actions are implemented. However, management actions can interact; that is, the cost, benefit, and feasibility of one action can change when another action is undertaken. There is little guidance on how to explicitly and efficiently prioritize management for multiple threats, including deciding where to act. Integrated management could focus on one management action to abate a dominant threat or on a strategy comprising multiple actions to abate multiple threats. Furthermore management could be undertaken at sites that are in close proximity to reduce costs. We used cost-effectiveness analysis to prioritize investments in fire management, controlling invasive predators, and reducing grazing pressure in a bio-diverse region of southeastern Queensland, Australia. We compared outcomes of 5 management approaches based on different assumptions about interactions and quantified how investment needed, benefits expected, and the locations prioritized for implementation differed when interactions were taken into account. Managing for interactions altered decisions about where to invest and in which actions to invest and had the potential to deliver increased investment efficiency. Differences in high priority locations and actions were greatest between the approaches when we made different assumptions about how management actions deliver benefits through threat abatement: either all threats must be managed to conserve species or only one management action may be required. Threatened species management that does not consider interactions between actions may result in misplaced investments or misguided expectations of the effort required to mitigate threats to species. © 2015 The Authors. Conservation Biology published by Wiley Periodicals, Inc., on behalf of Society for Conservation Biology.
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Frew, Emma J; Bhatti, Mobeen; Win, Khine; Sitch, Alice; Lyon, Anna; Pallan, Miranda; Adab, Peymane
2014-02-01
To determine the cost-effectiveness of a physical activity programme (Be Active) aimed at city-dwelling adults living in Birmingham, UK. Very little is known about the cost-effectiveness of public health programmes to improve city-wide physical activity rates. This paper presents a cost-effectiveness analysis that compares a physical activity intervention (Be Active) with no intervention (usual care) using an economic model to quantify the reduction in disease risk over a lifetime. Metabolic equivalent minutes achieved per week, quality-adjusted life years (QALYs) gained and healthcare costs were all included as the main outcome measures in the model. A cost-benefit analysis was also conducted using 'willingness-to-pay' as a measure of value. Under base-case assumptions-that is, assuming that the benefits of increased physical activity are sustained over 5 years, participation in the Be Active programme increased quality-adjusted life expectancy by 0.06 years, at an expected discounted cost of £3552, and thus the cost-effectiveness of Be Active is £400 per QALY. When the start-up costs of the programme are removed from the economic model, the cost-effectiveness is further improved to £16 per QALY. The societal value placed on the Be Active programme was greater than the operation cost therefore the Be Active physical activity intervention results in a net benefit to society. Participation in Be Active appeared to be cost-effective and cost-beneficial. These results support the use of Be Active as part of a public health programme to improve physical activity levels within the Birmingham-wide population.
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Dalton, Alexandra F; Golin, Carol E; Esserman, Denise; Pignone, Michael P; Pathman, Donald E; Lewis, Carmen L
2015-05-01
The goal of this study was to examine associations between physicians' clinical assessments, their certainty in these assessments, and the likelihood of a patient-centered recommendation about colorectal cancer (CRC) screening in the elderly. Two hundred seventy-six primary care physicians in the United States read 3 vignettes about an 80-year-old female patient and answered questions about her life expectancy, their confidence in their life expectancy estimate, the balance of benefits/downsides of CRC screening, their certainty in their benefit/downside assessment, and the best course of action regarding CRC screening. We used logistic regression to determine the relationship between these variables and patient-centered recommendations about CRC screening. In bivariate analyses, physicians had higher odds of making a patient-centered recommendation about CRC screening when their clinical assessments did not lead to a clear screening recommendation or when they experienced uncertainty in their clinical assessments. However, in a multivariate regression model, only benefit/downside assessment and best course of action remained statistically significant predictors of a patient-centered recommendation. Our findings demonstrate that when the results of clinical assessments do not lead to obvious screening decisions or when physicians feel uncertain about their clinical assessments, they are more likely to make patient-centered recommendations. Existing uncertainty frameworks do not adequately describe the uncertainty associated with patient-centered recommendations found in this study. Adapting or modifying these frameworks to better reflect the constructs associated with uncertainty and the interactions between uncertainty and the complexity inherent in clinical decisions will facilitate a more complete understanding of how and when physicians choose to include patients in clinical decisions. © The Author(s) 2015.
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ERIC Educational Resources Information Center
Diep, Nguyet A.; Cocquyt, Celine; Zhu, Chang; Vanwing, Tom
2017-01-01
The present study employs social cognitive theory (SCT) and social capital as the guiding frameworks to explain online interaction quality among learners in a blended learning program (N = 179). Capturing performance expectancy by perceived learning benefits and online interaction quality with nuanced cognitive measures, the study aims to validate…
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ERIC Educational Resources Information Center
Huntington-Klein, Nick
2015-01-01
The decision to pursue formal education has significant labor market implications. To approach the decision rationally, a student must consider the costs and benefits of each available option. However, mounting empirical evidence suggests that reported expectations of costs and benefits are uncertain and vary across students. Hastings et al.…
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ERIC Educational Resources Information Center
Escolar Chua, Rowena L.; de Guzman, Allan B.
2014-01-01
As the elderly population increases, encouraging older adults to participate in lifelong learning has become a priority for many countries. Properly structured lifelong learning programs have consistently yielded numerous benefits to older adults; therefore, careful attention and effort should be exerted to ensure its effectiveness by involving…
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Factors Influencing Military Affiliation Intentions of First Term Army Enlisted.
1984-12-01
were: Demographic: Biographical data Ten u r e Cognitive/Affective Orientation: Factors designed to assess respondents’ feelings about aspects of...Compensation and Benefits ............. Basic pay, BAQ, BAS, Special pays bonuses, valuation of benefits, VEAP participation Military Retirement System ...Preferred retirement pay sched- ule, expected YOS/Paygrade under alternative systems Civilian Labor Force Experience ............ Hours
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Benefits of advanced software techniques for mission planning systems
NASA Technical Reports Server (NTRS)
Gasquet, A.; Parrod, Y.; Desaintvincent, A.
1994-01-01
The increasing complexity of modern spacecraft, and the stringent requirement for maximizing their mission return, call for a new generation of Mission Planning Systems (MPS). In this paper, we discuss the requirements for the Space Mission Planning and the benefits which can be expected from Artificial Intelligence techniques through examples of applications developed by Matra Marconi Space.
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ERIC Educational Resources Information Center
Adachi, Chie; Tai, Joanna Hong-Meng; Dawson, Phillip
2018-01-01
Despite compelling evidence of its potential effectiveness, uptake of self and peer assessment in higher education has been slower than expected. As with other assessment practices, self and peer assessment is ultimately enabled, or inhibited, by the actions of individual academics. This paper explores what academics see as the benefits and…
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Benefits of advanced software techniques for mission planning systems
NASA Astrophysics Data System (ADS)
Gasquet, A.; Parrod, Y.; Desaintvincent, A.
1994-10-01
The increasing complexity of modern spacecraft, and the stringent requirement for maximizing their mission return, call for a new generation of Mission Planning Systems (MPS). In this paper, we discuss the requirements for the Space Mission Planning and the benefits which can be expected from Artificial Intelligence techniques through examples of applications developed by Matra Marconi Space.
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Snyder, E Amanda; Caprio, Anthony J; Wessell, Kathryn; Lin, Feng Chang; Hanson, Laura C
2013-02-01
In advanced dementia, feeding problems are nearly universal, and families face difficult decisions about feeding options. Initial interviews for a randomized trial were used to describe surrogates' perceptions of feeding options, and to determine whether a decision aid on feeding options in advanced dementia would improve knowledge, reduce expectation of benefit from tube feeding, and reduce conflict over treatment choices for persons with advanced dementia. Semistructured interview with prestudy and poststudy design for surrogates in the intervention group. Twenty-four skilled nursing facilities across North Carolina participating in a cluster randomized trial. Two hundred and fifty-five surrogate decision makers for nursing home residents with advanced dementia and feeding problems, in control (n = 129) and intervention (n = 126) groups. For intervention surrogates only, an audiovisual-print decision aid provided information on dementia, feeding problems in dementia, advantages and disadvantages of feeding tubes or assisted oral feeding options, and the role of surrogates in making these decisions. The interview included open-ended items asking surrogates to report advantages and disadvantages of tube feeding and assisted oral feeding. Knowledge of feeding options was measured with 19 true/false items and items measuring expectation of benefit from tube feeding. Surrogates reported which of these two feeding options they preferred for the person with dementia, and how confident they were in this choice; their level of conflict about the choice was measured using the decisional conflict scale. Before the decision aid, surrogates described advantages and disadvantages of assisted oral feeding and tube feeding in practical, ethical, and medical terms. After review of the decision aid, intervention surrogates had improved knowledge scores (15.5 vs 16.8; P < .001), decreased expectation of benefits from tube feeding (2.73 vs 2.32; P = .001), and reduced decisional conflict (2.24 vs 1.91; P < .001). Surrogates preferred assisted oral feeding initially and reported more certainty about this choice after the decision aid. A structured decision aid can be used to improve decision making about feeding options in dementia care. Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.
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Samoocha, David; Bruinvels, David J; Anema, Johannes R; Steenbeek, Romy; van der Beek, Allard J
2009-05-10
Individuals claiming a disability benefit after long-term sickness absence, have to undergo medical disability assessments. These assessments, often carried out by specialized physicians, can be complicated by wrong expectations or defensive attitudes of disability benefit claimants. It is hypothesized that empowerment of these claimants will enhance the physician-patient relationship by shifting claimants from a passive role to a more active and constructive role during disability assessments. Furthermore, empowerment of claimants may lead to a more realistic expectation and acceptance of the assessment outcome among claimants and may lead to a more accurate assessment by the physician. In a two-armed randomized controlled trial (RCT), 230 claimants will be randomized to either the intervention or control group. For the intervention group, an interactive website was designed http://www.wiagesprek.nl using an Intervention Mapping procedure. This website was tested during a pilot study among 51 claimants. The final version of the website consists of five interactive modules, in which claimants will be prepared and empowered step-by-step, prior to their upcoming disability assessment. Other website components are a forum, a personal health record, a personal diary, and information on disability assessment procedures, return to work, and coping with disease and work disability. Subjects from the control group will be directed to a website with commonly available information only. Approximately two weeks prior to their disability assessment, disability claimants will be recruited through the Dutch Workers Insurance Authority (UWV). Outcomes will be assessed at five occasions: directly after recruitment (baseline), prior to disability assessment, directly after disability assessment as well as 6 and 16 weeks after the assessment. The study's primary outcome is empowerment, measured with the Vrijbaan questionnaire. Secondary outcomes include claimants' satisfaction, perceived justice, coping strategy, and knowledge. A process evaluation will also be conducted. This study evaluates the effectiveness of an interactive website aimed at empowerment of disability claimants. It is hypothesized that by increasing empowerment, the physician-patient relationship may be enhanced and claimants' satisfaction and perceived justice can be improved. Results are expected in 2010. NTR-1414.
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MacLaren, Robert; Campbell, Jon
2014-04-01
To examine the cost-effectiveness of using histamine receptor-2 antagonist or proton pump inhibitor for stress ulcer prophylaxis. Decision analysis model examining costs and effectiveness of using histamine receptor-2 antagonist or proton pump inhibitor for stress ulcer prophylaxis. Costs were expressed in 2012 U.S. dollars from the perspective of the institution and included drug regimens and the following outcomes: clinically significant stress-related mucosal bleed, ventilator-associated pneumonia, and Clostridium difficile infection. Effectiveness was the mortality risk associated with these outcomes and represented by survival. Costs, occurrence rates, and mortality probabilities were extracted from published data. A simulation model. A mixed adult ICU population. Histamine receptor-2 antagonist or proton pump inhibitor for 9 days of stress ulcer prophylaxis therapy. Output variables were expected costs, expected survival rates, incremental cost, and incremental survival rate. Univariate sensitivity analyses were conducted to determine the drivers of incremental cost and incremental survival. Probabilistic sensitivity analysis was conducted using second-order Monte Carlo simulation. For the base case analysis, the expected cost of providing stress ulcer prophylaxis was $6,707 with histamine receptor-2 antagonist and $7,802 with proton pump inhibitor, resulting in a cost saving of $1,095 with histamine receptor-2 antagonist. The associated mortality probabilities were 3.819% and 3.825%, respectively, resulting in an absolute survival benefit of 0.006% with histamine receptor-2 antagonist. The primary drivers of incremental cost and survival were the assumptions surrounding ventilator-associated pneumonia and bleed. The probabilities that histamine receptor-2 antagonist was less costly and provided favorable survival were 89.4% and 55.7%, respectively. A secondary analysis assuming equal rates of C. difficile infection showed a cost saving of $908 with histamine receptor-2 antagonists, but the survival benefit of 0.0167% favored proton pump inhibitors. Histamine receptor-2 antagonist therapy appears to reduce costs with survival benefit comparable to proton pump inhibitor therapy for stress ulcer prophylaxis. Ventilator-associated pneumonia and bleed are the variables most affecting these outcomes. The uncertainty in the findings justifies a prospective trial.
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Snyder, E. Amanda; Caprio, Anthony J.; Wessell, Kathryn; Lin, Feng Chang; Hanson, Laura C.
2012-01-01
Objective In advanced dementia, feeding problems are nearly universal, and families face difficult decisions about feeding options. Initial interviews for a randomized trial were used to describe surrogates’ perceptions feeding options, and to determine if a decision aid on feeding options in advanced dementia would improve knowledge, reduce expectation of benefit from tube feeding, and reduce conflict over treatment choices for persons with advanced dementia. Design Semi-structured interview with pre-post study design for surrogates in the intervention group. Setting Twenty-four skilled nursing facilities across North Carolina participating in a cluster randomized trial. Participants Two hundred fifty-five surrogate decision-makers for nursing home residents with advanced dementia and feeding problems, in control (n=129) and intervention (n=126) groups. Intervention For intervention surrogates only, an audiovisual-print decision aid provided information on dementia, feeding problems in dementia, advantages and disadvantages of feeding tubes or assisted oral feeding options and the role of surrogates in making these decisions. Measurements The interview included open-ended items asking surrogates to report advantages and disadvantages of tube feeding and assisted oral feeding. Knowledge of feeding options was measured with 19 true-false items, and items measuring expectation of benefit from tube feeding. Surrogates reported which of these two feeding options they preferred for the person with dementia, and how confident they were in this choice; their level of conflict about the choice was measured using the Decisional Conflict Scale. Results Prior to the decision aid, surrogates described advantages and disadvantages of assisted oral feeding and tube feeding in practical, ethical and medical terms. After review of the decision aid, intervention surrogates had improved knowledge scores (15.5 vs. 16.8; p<0.001), decreased expectation of benefits from tube feeding (2.73 vs. 2.32; p = 0.001) and reduced decisional conflict (2.24 vs. 1.91, p<0.001). Surrogates preferred assisted oral feeding initially, and reported more certainty about this choice after the decision aid. Conclusion A structured decision aid can be used to improve decision-making about feeding options in dementia care. PMID:23273855
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2009-01-01
Background Individuals claiming a disability benefit after long-term sickness absence, have to undergo medical disability assessments. These assessments, often carried out by specialized physicians, can be complicated by wrong expectations or defensive attitudes of disability benefit claimants. It is hypothesized that empowerment of these claimants will enhance the physician-patient relationship by shifting claimants from a passive role to a more active and constructive role during disability assessments. Furthermore, empowerment of claimants may lead to a more realistic expectation and acceptance of the assessment outcome among claimants and may lead to a more accurate assessment by the physician. Methods/Design In a two-armed randomized controlled trial (RCT), 230 claimants will be randomized to either the intervention or control group. For the intervention group, an interactive website was designed http://www.wiagesprek.nl using an Intervention Mapping procedure. This website was tested during a pilot study among 51 claimants. The final version of the website consists of five interactive modules, in which claimants will be prepared and empowered step-by-step, prior to their upcoming disability assessment. Other website components are a forum, a personal health record, a personal diary, and information on disability assessment procedures, return to work, and coping with disease and work disability. Subjects from the control group will be directed to a website with commonly available information only. Approximately two weeks prior to their disability assessment, disability claimants will be recruited through the Dutch Workers Insurance Authority (UWV). Outcomes will be assessed at five occasions: directly after recruitment (baseline), prior to disability assessment, directly after disability assessment as well as 6 and 16 weeks after the assessment. The study's primary outcome is empowerment, measured with the Vrijbaan questionnaire. Secondary outcomes include claimants' satisfaction, perceived justice, coping strategy, and knowledge. A process evaluation will also be conducted. Discussion This study evaluates the effectiveness of an interactive website aimed at empowerment of disability claimants. It is hypothesized that by increasing empowerment, the physician-patient relationship may be enhanced and claimants' satisfaction and perceived justice can be improved. Results are expected in 2010. Trial registration NTR-1414 PMID:19426557
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How to anticipate the assessment of the public health benefit of new medicines?
Massol, Jacques; Puech, Alain; Boissel, Jean-Pierre
2007-01-01
The Public Health Benefit (PHB) of new medicines is a recent and French-specific criterion (October 1999 decree) which is often only partially documented in the transparency files due to a lack of timely information. At the time of the first reimbursement application for a new medicine to the "Transparency Committee", the file is exclusively based on data from randomised clinical trials. These data are generated from a global clinical development plan which was designed a long time before the new medicine's submission for reimbursement. And this plan does not systematically provide the data needed to assess the PHB. Thus, one easily understands the difficulty to anticipate and document this recent French criterion. In France, the PHB is both one of the necessary criteria for the reimbursement submission and an indicator for the national health policy management. Its assessment also helps to identify the needs and objectives of the post-registration studies (nowadays in the scope of responsibilities of the "Drug Economics Committee"). The assessment of the PHB criterion is carried through after the marketing authorization process and is an addition to it. To understand how to anticipate the assessment of the new medicines' PHB, one needs to consider how it differs from the preliminary step of the marketing authorization process. Whereas the evaluation for marketing authorization seeks to determine if the new medicine could be useful in a specific indication, the PHB assessment aims at quantifying the therapeutic benefit in a population, taking into account the reference treatments in this population. A new medicine receives a marketing authorization based on the data of the registration file which provides information on the clinical benefit of the new medicine in the populations of the trials and in the context of the trials. On the other side, the PHB looks at the effects of the new medicine at the scale of the general population, in real practice. The PHB components of a new medicine at first submission are the expected response of this new medicine to a public health need, the expected benefit on the health status of the population and ultimately the expected impact on the health care system. The benefit of a new medicine on the health status of a population is based on public health criteria which can be morbi-mortality or quality of life criteria. However, few registration files contain these public health criteria from the beginning and the predictive value of the surrogate criteria used in the trials is not always precisely assessed. It is, thus, difficult to quantify the expected benefit on these public health criteria. Moreover, the data that enable to quantify the new medicine's effects according to the various characteristics of the target population, are rarely available. Similarly, the French population epidemiological data related to the indication of the new medicine are often not available at the time of the assessment. Therefore it is difficult to evaluate the expected number of events that could be avoided if the new medicine reached the market. The authors suggest to adapt the clinical development plan for a better documentation of the PHB. They specifically recommend to integrate to the judgment criteria (endpoints) of the trials, criteria that are relevant in terms of public health, and to check for a good heterogeneity of the trial populations. They also suggest to start early enough collecting reliable national epidemiological data and the necessary elements for the assessment of the transposability of the trial results to the French population (ability to target the patients to be treated, adaptation of the healthcare system...). About the epidemiological data, the authors consider that the needs are covered in various ways depending on the diseases. To meet the needs of evaluation of the new medicines' target populations in specific indications, they recommend to use ad hoc studies as much as needed. In addition, epidemiological studies designed for market purpose with an acceptable methodology should not be systematically rejected but deserve to be presented. To be able to assess the importance of the expected theoretical benefit of a new medicine in a population, the authors underline the necessity to have access to study results with criteria related to this objective. They suggest to first define and list the criteria by disease. Regarding the representativity of the populations, it comes out that it would be advisable, but unrealistic to include in trials a population 100% representative of the population to be treated. Therefore the effect of the new medicine must be modelised (the "effect model") to be evaluated in the general population. Yet to obtain a reliable effect model, the study population must be sufficiently heterogeneous, which legitimates the demand to ensure a good population heterogeneity at the time of decision-making about trials methodology. When the criteria assessed during the development plan does not correspond to the PHB criteria, the only way to evaluate the number of events related to the PHB criterion is, again, to use modelisation. However, modelisation is only possible when the scientific literature has established a reliable correlation between the two types of criteria. In this case, the new model should be applied to a French target population to assess the expected benefit. As a conclusion, the possibilities to estimate the expected benefit of a new medicine on the health status of a specific population are currently limited. These limitations are regrettable because such an estimate is feasible without disrupting the development plans. The authors' general recommendations to update the development plans seem especially appropriate as the additions should not only be beneficial to France but to all the health authorities who would wish to assess the expected benefit of a new medicine on their territories. Anticipating the lack of clinical and epidemiological data and the lack of data that enable to evaluate the transposability of the trials results to real clinical practice is a sine qua none condition to improve the PHB assessment. The anticipation of these needs should be planned early enough by the pharmaceutical companies which could in this purpose meet the health authorities and the heads of the French public health policy in a consultation.Finally, because of the PHB's universal dimension, it is suggested that the necessary actions and publications be initiated so that the PHB can be acknowledged at the European level.
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Cost considerations for long-term ecological monitoring
Caughlan, L.; Oakley, K.L.
2001-01-01
For an ecological monitoring program to be successful over the long-term, the perceived benefits of the information must justify the cost. Financial limitations will always restrict the scope of a monitoring program, hence the program’s focus must be carefully prioritized. Clearly identifying the costs and benefits of a program will assist in this prioritization process, but this is easier said than done. Frequently, the true costs of monitoring are not recognized and are, therefore, underestimated. Benefits are rarely evaluated, because they are difficult to quantify. The intent of this review is to assist the designers and managers of long-term ecological monitoring programs by providing a general framework for building and operating a cost-effective program. Previous considerations of monitoring costs have focused on sampling design optimization. We present cost considerations of monitoring in a broader context. We explore monitoring costs, including both budgetary costs, what dollars are spent on, and economic costs, which include opportunity costs. Often, the largest portion of a monitoring program budget is spent on data collection, and other, critical aspects of the program, such as scientific oversight, training, data management, quality assurance, and reporting, are neglected. Recognizing and budgeting for all program costs is therefore a key factor in a program’s longevity. The close relationship between statistical issues and cost is discussed, highlighting the importance of sampling design, replication and power, and comparing the costs of alternative designs through pilot studies and simulation modeling. A monitoring program development process that includes explicit checkpoints for considering costs is presented. The first checkpoint occurs during the setting of objectives and during sampling design optimization. The last checkpoint occurs once the basic shape of the program is known, and the costs and benefits, or alternatively the cost-effectiveness, of each program element can be evaluated. Moving into the implementation phase without careful evaluation of costs and benefits is risky because if costs are later found to exceed benefits, the program will fail. The costs of development, which can be quite high, will have been largely wasted. Realistic expectations of costs and benefits will help ensure that monitoring programs survive the early, turbulent stages of development and the challenges posed by fluctuating budgets during implementation.
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Palmer, Amanda M; Brandon, Thomas H
2018-05-01
Although electronic cigarettes (e-cigarettes) are frequently initiated for smoking cessation, results from the first two clinical trials testing this suggest that the perceived benefits of vaping may be influenced by non-nicotine factors, including cognitive outcome expectancies. The current study investigated the separate and combined effects of nicotine delivery and outcome expectancies on cravings for cigarettes and e-cigarettes using a balanced-placebo experiment. Drug dosage (contains nicotine or not) was crossed with instructional set (told nicotine or non-nicotine) during ad lib e-cigarette use sessions by 128 current e-cigarette users (52 identifying as current cigarette smokers or "dual users"). It was hypothesized that reduction in craving for both cigarettes and e-cigarettes following e-cigarette administration would be driven primarily by the instructional set manipulation, reflecting the influence of outcome expectancies. As hypothesized, among dual users, a main effect of instructional set emerged on reductions in craving to smoke cigarettes, with participants who were told that their e-cigarette contained nicotine reporting greater craving reduction (p = .046). With respect to reduced cravings for e-cigarettes, we found an interaction between drug dose and instructional set (p = .02) such that nicotine e-cigarettes reduced cravings more than non-nicotine e-cigarettes only among participants told to expect nicotine. Findings suggest that cognitive expectancies contribute to the acute effects of e-cigarettes on craving, which may provide guidance for their potential as smoking cessation aids. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Awareness of BIM adoption in Brunei
NASA Astrophysics Data System (ADS)
Rahman, Md Motiar
2017-09-01
Building Information Modelling (BIM) is getting increased attention day-by-day due to its many benefits, including clash detection, collaboration between contract parties, visualization future structure, optimized schedule and project control, waste control, design documentation, and harmonized facilities management. As such, many countries have already adopted BIM, and many other countries are exploring the potential of adopting it. However, it is still relatively new and unknown to some other countries like Brunei. This study was therefore undertaken to generate and/or gauge the awareness of Brunei construction industry participants, targeting adoption of BIM, through a structured questionnaire survey. Responses from 90 industry participants reveal that Brunei Construction industry is not well aware of BIM, lack the required technical knowledge and application in construction, and cost involvement. They are unsure about the potential benefits and barriers to implementing BIM. However, respondents are hopeful that BIM can bring the required changes in construction, willing to adopt BIM, expects cliental support with initial investment for its adoption, and believe that BIM is the future of construction project information management. On the whole, private sector was seen to be more aware on BIM than public sector. The study outcomes are expected to provide the policy makers a first-hand information on the industry awareness on BIM, which in turn help them for further exploration / examination and to design any action plan and guidelines for BIM adoption.
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Using ecosystem services to represent the environment in hydro-economic models
NASA Astrophysics Data System (ADS)
Momblanch, Andrea; Connor, Jeffery D.; Crossman, Neville D.; Paredes-Arquiola, Javier; Andreu, Joaquín
2016-07-01
Demand for water is expected to grow in line with global human population growth, but opportunities to augment supply are limited in many places due to resource limits and expected impacts of climate change. Hydro-economic models are often used to evaluate water resources management options, commonly with a goal of understanding how to maximise water use value and reduce conflicts among competing uses. The environment is now an important factor in decision making, which has resulted in its inclusion in hydro-economic models. We reviewed 95 studies applying hydro-economic models, and documented how the environment is represented in them and the methods they use to value environmental costs and benefits. We also sought out key gaps and inconsistencies in the treatment of the environment in hydro-economic models. We found that representation of environmental values of water is patchy in most applications, and there should be systematic consideration of the scope of environmental values to include and how they should be valued. We argue that the ecosystem services framework offers a systematic approach to identify the full range of environmental costs and benefits. The main challenges to more holistic representation of the environment in hydro-economic models are the current limits to understanding of ecological functions which relate physical, ecological and economic values and critical environmental thresholds; and the treatment of uncertainty.
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The role of multisensory interplay in enabling temporal expectations.
Ball, Felix; Michels, Lara E; Thiele, Carsten; Noesselt, Toemme
2018-01-01
Temporal regularities can guide our attention to focus on a particular moment in time and to be especially vigilant just then. Previous research provided evidence for the influence of temporal expectation on perceptual processing in unisensory auditory, visual, and tactile contexts. However, in real life we are often exposed to a complex and continuous stream of multisensory events. Here we tested - in a series of experiments - whether temporal expectations can enhance perception in multisensory contexts and whether this enhancement differs from enhancements in unisensory contexts. Our discrimination paradigm contained near-threshold targets (subject-specific 75% discrimination accuracy) embedded in a sequence of distractors. The likelihood of target occurrence (early or late) was manipulated block-wise. Furthermore, we tested whether spatial and modality-specific target uncertainty (i.e. predictable vs. unpredictable target position or modality) would affect temporal expectation (TE) measured with perceptual sensitivity (d ' ) and response times (RT). In all our experiments, hidden temporal regularities improved performance for expected multisensory targets. Moreover, multisensory performance was unaffected by spatial and modality-specific uncertainty, whereas unisensory TE effects on d ' but not RT were modulated by spatial and modality-specific uncertainty. Additionally, the size of the temporal expectation effect, i.e. the increase in perceptual sensitivity and decrease of RT, scaled linearly with the likelihood of expected targets. Finally, temporal expectation effects were unaffected by varying target position within the stream. Together, our results strongly suggest that participants quickly adapt to novel temporal contexts, that they benefit from multisensory (relative to unisensory) stimulation and that multisensory benefits are maximal if the stimulus-driven uncertainty is highest. We propose that enhanced informational content (i.e. multisensory stimulation) enables the robust extraction of temporal regularities which in turn boost (uni-)sensory representations. Copyright © 2017 Elsevier B.V. All rights reserved.
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Benson, Alex J; Eys, Mark A; Irving, P Gregory
2016-04-01
Many athletes experience a discrepancy between the roles they expect to fulfill and the roles they eventually occupy. Drawing from met expectations theory, we applied response surface methodology to examine how role expectations, in relation to role experiences, influence perceptions of group cohesion among Canadian Interuniversity Sport athletes (N = 153). On the basis of data from two time points, as athletes approached and exceeded their role contribution expectations, they reported higher perceptions of task cohesion. Furthermore, as athletes approached and exceeded their social involvement expectations, they reported higher perceptions of social cohesion. These response surface patterns-pertaining to task and social cohesion-were driven by the positive influence of role experiences. On the basis of the interplay between athletes' role experiences and their perception of the group environment, efforts to improve team dynamics may benefit from focusing on improving the quality of role experiences, in conjunction with developing realistic role expectations.
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Decision theory and the evaluation of risks and benefits of clinical trials.
Bernabe, Rosemarie D C; van Thiel, Ghislaine J M W; Raaijmakers, Jan A M; van Delden, Johannes J M
2012-12-01
Research ethics committees (RECs) are tasked to assess the risks and the benefits of a clinical trial. In previous studies, it was shown that RECs find this task difficult, if not impossible, to do. The current approaches to benefit-risk assessment (i.e. Component Analysis and the Net Risk Test) confound the various risk-benefit tasks, and as such, make balancing impossible. In this article, we show that decision theory, specifically through the expected utility theory and multiattribute utility theory, enable for an explicit and ethically weighted risk-benefit evaluation. This makes a balanced ethical justification possible, and thus a more rationally defensible decision making. Copyright © 2012 Elsevier Ltd. All rights reserved.
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Increases in adult life expectancy in rural South Africa: valuing the scale-up of HIV treatment
Bor, Jacob; Herbst, Abraham J; Newell, Marie-Louise; Bärnighausen, Till
2013-01-01
The scale-up of antiretroviral therapy (ART) is expected to raise adult life expectancy in populations with high HIV prevalence. Using data from a population cohort of over 101,000 individuals in rural KwaZulu-Natal, South Africa, we measured changes in adult life expectancy for 2000–2011. In 2003, the year before ART became available in the public sector health system, adult life expectancy was 49.2 years; by 2011, adult life expectancy had increased to 60.5 years – an 11.3-year gain. Based on standard monetary valuation of life, the survival benefits of ART far outweigh the costs of providing treatment in this community. These gains in adult life expectancy signify the social value of ART and have implications for investment decisions of individuals, governments, and donors. PMID:23430655
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Are Indirect Benefits Relevant to Health Care Allocation Decisions?
Du Toit, Jessica; Millum, Joseph
2016-10-01
When allocating scarce healthcare resources, the expected benefits of alternative allocations matter. But, there are different kinds of benefits. Some are direct benefits to the recipient of the resource such as the health improvements of receiving treatment. Others are indirect benefits to third parties such as the economic gains from having a healthier workforce. This article considers whether only the direct benefits of alternative healthcare resource allocations are relevant to allocation decisions, or whether indirect benefits are relevant too. First, we distinguish different conceptions of direct and indirect benefits and argue that only a recipient conception could be morally relevant. We analyze four arguments for thinking that indirect benefits should not count and argue that none is successful in showing that the indirectness of a benefit is a good reason not to count it. We conclude that direct and indirect benefits should be evaluated in the same way. Published by Oxford University Press on behalf of the Journal of Medicine and Philosophy, Inc. 2016.
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Expectations of iPad use in an internal medicine residency program: is it worth the "hype"?
Luo, Nancy; Chapman, Christopher G; Patel, Bhakti K; Woodruff, James N; Arora, Vineet M
2013-05-08
While early reports highlight the benefits of tablet computing in hospitals, introducing any new technology can result in inflated expectations. The aim of the study is to compare anticipated expectations of Apple iPad use and perceptions after deployment among residents. 115 internal medicine residents received Apple iPads in October 2010. Residents completed matched surveys on anticipated usage and perceptions after distribution 1 month prior and 4 months after deployment. In total, 99% (114/115) of residents responded. Prior to deployment, most residents believed that the iPad would improve patient care and efficiency on the wards; however, fewer residents "strongly agreed" after deployment (34% vs 15% for patient care, P<.001; 41% vs 24% for efficiency, P=.005). Residents with higher expectations were more likely to report using the iPad for placing orders post call and during admission (71% vs 44% post call, P=.01, and 16% vs 0% admission, P=.04). Previous Apple iOS product owners were also more likely to use the iPad in key areas. Overall, 84% of residents thought the iPad was a good investment for the residency program, and over half of residents (58%) reported that patients commented on the iPad in a positive way. While the use of tablets such as the iPad by residents is generally well received, high initial expectations highlight the danger of implementing new technologies. Education on the realistic expectations of iPad benefits may be warranted.
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Cost-Benefit Analysis of a Support Program for Nursing Staff.
Moran, Dane; Wu, Albert W; Connors, Cheryl; Chappidi, Meera R; Sreedhara, Sushama K; Selter, Jessica H; Padula, William V
2017-04-27
A peer-support program called Resilience In Stressful Events (RISE) was designed to help hospital staff cope with stressful patient-related events. The aim of this study was to evaluate the impact of the RISE program by conducting an economic evaluation of its cost benefit. A Markov model with a 1-year time horizon was developed to compare the cost benefit with and without the RISE program from a provider (hospital) perspective. Nursing staff who used the RISE program between 2015 and 2016 at a 1000-bed, private hospital in the United States were included in the analysis. The cost of running the RISE program, nurse turnover, and nurse time off were modeled. Data on costs were obtained from literature review and hospital data. Probabilities of quitting or taking time off with or without the RISE program were estimated using survey data. Net monetary benefit (NMB) and budget impact of having the RISE program were computed to determine cost benefit to the hospital. Expected model results of the RISE program found a net monetary benefit savings of US $22,576.05 per nurse who initiated a RISE call. These savings were determined to be 99.9% consistent on the basis of a probabilistic sensitivity analysis. The budget impact analysis revealed that a hospital could save US $1.81 million each year because of the RISE program. The RISE program resulted in substantial cost savings to the hospital. Hospitals should be encouraged by these findings to implement institution-wide support programs for medical staff, based on a high demand for this type of service and the potential for cost savings.
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Lowry, Kathryn P; Gazelle, G Scott; Gilmore, Michael E; Johanson, Colden; Munshi, Vidit; Choi, Sung Eun; Tramontano, Angela C; Kong, Chung Yin; McMahon, Pamela M
2015-05-15
Lung cancer screening with annual chest computed tomography (CT) is recommended for current and former smokers with a ≥30-pack-year smoking history. Patients with chronic obstructive pulmonary disease (COPD) are at increased risk of developing lung cancer and may benefit from screening at lower pack-year thresholds. We used a previously validated simulation model to compare the health benefits of lung cancer screening in current and former smokers ages 55-80 with ≥30 pack-years with hypothetical programs using lower pack-year thresholds for individuals with COPD (≥20, ≥10, and ≥1 pack-years). Calibration targets for COPD prevalence and associated lung cancer risk were derived using the Framingham Offspring Study limited data set. We performed sensitivity analyses to evaluate the stability of results across different rates of adherence to screening, increased competing mortality risk from COPD, and increased surgical ineligibility in individuals with COPD. The primary outcome was projected life expectancy. Programs using lower pack-year thresholds for individuals with COPD yielded the highest life expectancy gains for a given number of screens. Highest life expectancy was achieved when lowering the pack-year threshold to ≥1 pack-year for individuals with COPD, which dominated all other screening strategies. These results were stable across different adherence rates to screening and increases in competing mortality risk for COPD and surgical ineligibility. Current and former smokers with COPD may disproportionately benefit from lung cancer screening. A lower pack-year threshold for screening eligibility may benefit this high-risk patient population. © 2015 American Cancer Society.
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"Watching time tick by…": Decision making for Duchenne muscular dystrophy trials.
Peay, Holly L; Scharff, Hadar; Tibben, Aad; Wilfond, Benjamin; Bowie, Janice; Johnson, Joanna; Nagaraju, Kanneboyina; Escolar, Diana; Piacentino, Jonathan; Biesecker, Barbara B
2016-01-01
This interview study explored clinicians' perspectives and parents' decision making about children's participation in Duchenne muscular dystrophy (DMD) clinical trials. Data from semi-structured interviews conducted with clinicians and parents in U.S. or Canada were assessed using thematic analysis. Eleven clinicians involved in ten trials and fifteen parents involved in six trials were interviewed. Parents described benefit-risk assessments using information from advocacy, peers, professionals, and sponsors. Strong influence was attributed to the progressive nature of DMD. Most expected direct benefit. Few considered the possibility of trial failure. Most made decisions to participate before the informed consent (IC) process, but none-the-less perceived informed choice with little to lose for potential gain. Clinicians described more influence on parental decisions than attributed by parents. Clinicians felt responsible to facilitate IC while maintaining hope. Both clinicians and parents reported criticisms about the IC process and regulatory barriers. The majority of parents described undertaking benefit-risk assessments that led to informed choices that offered psychological and potential disease benefits. Parents' high expectations influenced their decisions while also reflecting optimism. Clinicians felt challenged in balancing parents' expectations and likely outcomes. Prognosis-related pressures coupled with decision making prior to IC suggest an obligation to ensure educational materials are understandable and accurate, and to consider an expanded notion of IC timeframes. Anticipatory guidance about potential trial failure might facilitate parents' deliberations while aiding clinicians in moderating overly-optimistic motivations. Regulators and industry should appreciate special challenges in progressive disorders, where doing nothing was equated with doing harm. Copyright © 2015 Elsevier Inc. All rights reserved.
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Vaccination, herd behavior, and herd immunity.
Cohen, Matan J; Brezis, Mayer; Block, Colin; Diederich, Adele; Chinitz, David
2013-11-01
During the 2009 outbreak of novel influenza AH1N1, insufficient data were available to adequately inform decision makers about benefits and risks of vaccination and disease. We hypothesized that individuals would opt to mimic their peers, having no better decision anchor. We used Game Theory, decision analysis, and transmission models to simulate the impact of subjective risks and preference estimates on vaccination behavior. We asked 95 students to provide estimates of risk and health state valuations with regard to AH1N1 infection, complications, and expectations of vaccine benefits and risks. These estimates were included in a sequential chain of models: a dynamic epidemic model, a decision tree, and a population-level model. Additionally, participants' intentions to vaccinate or not at varying vaccination rates were documented. The model showed that at low vaccination rates, vaccination dominated. When vaccination rates increased above 78%, nonvaccination was the dominant strategy. We found that vaccination intentions did not correspond to the shift in strategy dominance and segregated to 3 types of intentions: regardless of what others do 29/95 (31%) intended to vaccinate while 27/95 (28%) did not; among 39 of 95 (41%) intention was positively associated with putative vaccination rates. Some people conform to the majority's choice, either shifting epidemic dynamics toward herd immunity or, conversely, limiting societal goals. Policy leaders should use models carefully, noting their limitations and theoretical assumptions. Behavior drivers were not explicitly explored in this study, and the discrepant results beg further investigation. Models including real subjective perceptions with empiric or subjective probabilities can provide insight into deviations from expected rational behavior and suggest interventions in order to provide better population outcomes.
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Habermehl, Christina; Benner, Axel; Kopp-Schneider, Annette
2018-03-01
In recent years, numerous approaches for biomarker-based clinical trials have been developed. One of these developments are multiple-biomarker trials, which aim to investigate multiple biomarkers simultaneously in independent subtrials. For low-prevalence biomarkers, small sample sizes within the subtrials have to be expected, as well as many biomarker-negative patients at the screening stage. The small sample sizes may make it unfeasible to analyze the subtrials individually. This imposes the need to develop new approaches for the analysis of such trials. With an expected large group of biomarker-negative patients, it seems reasonable to explore options to benefit from including them in such trials. We consider advantages and disadvantages of the inclusion of biomarker-negative patients in a multiple-biomarker trial with a survival endpoint. We discuss design options that include biomarker-negative patients in the study and address the issue of small sample size bias in such trials. We carry out a simulation study for a design where biomarker-negative patients are kept in the study and are treated with standard of care. We compare three different analysis approaches based on the Cox model to examine if the inclusion of biomarker-negative patients can provide a benefit with respect to bias and variance of the treatment effect estimates. We apply the Firth correction to reduce the small sample size bias. The results of the simulation study suggest that for small sample situations, the Firth correction should be applied to adjust for the small sample size bias. Additional to the Firth penalty, the inclusion of biomarker-negative patients in the analysis can lead to further but small improvements in bias and standard deviation of the estimates. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
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Implementing CER: what will it take?
Biskupiak, Joseph E; Dunn, Jeffrey D; Holtorf, Anke-Peggy
2012-06-01
Comparative effectiveness research (CER) is undeniably changing how drugs are developed, launched, priced, and reimbursed in the United States. But most organizations are still evaluating what CER can do for them and how and when they can utilize the data. A roundtable of stakeholders, including formulary decision makers, evaluated CER's possible effects on managed care organizations (MCOs) and what it may take to fully integrate CER into decision making. To examine the role of CER in current formulary decision making, compare CER to modeling, discuss ways CER may be used in the future, and describe CER funding sources. While decision makers from different types of organizations, such as pharmacy benefit management (PBM) companies and MCOs, may have varying definitions and expectations of CER, most thought leaders from a roundtable of stakeholders, including formulary decision makers, see value in CER's ability to enhance their formulary decision making. Formulary decision makers may be able to use CER to better inform their coverage decisions in areas such as benefit design, contracting, conditional reimbursement, pay for performance, and other alternative pricing arrangements. Real-world CER will require improvement in the health information technology infrastructure to better capture value-related information. The federal government is viewed as a key driver and funding source behind CER, especially for infrastructure and methods development, while industry will adapt the clinical development and create increasing CER evidence. CER then needs to be applied to determining value (or cost efficacy). It is expected that CER will continue to grow as a valuable component of formulary decision making. Future integration of CER into formulary decision making will require federal government and academic leadership, improvements in the health information technology infrastructure, ongoing funding, and improved and more consistent methodologies.
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The "Downside" of Women Empowerment in India: An Experimental Inquiry into the Role of Expectations
ERIC Educational Resources Information Center
van Kempen, Luuk
2009-01-01
The paper reports on a field experiment conducted among poor women organized in self-help groups in the north-east of India. The experiment tests in a simple game whether overly optimistic expectations with respect to the benefits of exercising agency reduces one's appreciation of remaining with agency in the future. If so, unrealistic…
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Ding, Yao; Thompson, John D; Kobrynski, Lisa; Ojodu, Jelili; Zarbalian, Guisou; Grosse, Scott D
2016-05-01
To evaluate the expected cost-effectiveness and net benefit of the recent implementation of newborn screening (NBS) for severe combined immunodeficiency (SCID) in Washington State. We constructed a decision analysis model to estimate the costs and benefits of NBS in an annual birth cohort of 86 600 infants based on projections of avoided infant deaths. Point estimates and ranges for input variables, including the birth prevalence of SCID, proportion detected asymptomatically without screening through family history, screening test characteristics, survival rates, and costs of screening, diagnosis, and treatment were derived from published estimates, expert opinion, and the Washington NBS program. We estimated treatment costs stratified by age of identification and SCID type (with or without adenosine deaminase deficiency). Economic benefit was estimated using values of $4.2 and $9.0 million per death averted. We performed sensitivity analyses to evaluate the influence of key variables on the incremental cost-effectiveness ratio (ICER) of net direct cost per life-year saved. Our model predicts an additional 1.19 newborn infants with SCID detected preclinically through screening, in addition to those who would have been detected early through family history, and 0.40 deaths averted annually. Our base-case model suggests an ICER of $35 311 per life-year saved, and a benefit-cost ratio of either 5.31 or 2.71. Sensitivity analyses found ICER values <$100 000 and positive net benefit for plausible assumptions on all variables. Our model suggests that NBS for SCID in Washington is likely to be cost-effective and to show positive net economic benefit. Published by Elsevier Inc.
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Must research benefit human subjects if it is to be permissible?
Wikler, Daniel
2017-01-01
Must medical experiments with human subjects offer them a ‘favourable risk-benefit ratio’, that is, more expectation of benefit than harm or burden, if they are to be judged as ethically justified? Ethical justification is easier for experiments that do offer net benefit to subjects, but ethical justification is possible also for some experiments that do not. Basic science experiments with healthy volunteers and ‘Phase I’ drug trials that seek to determine tolerable dosage levels are routinely approved by ethical review committees; moreover, guidance they receive from government funding agencies specifically asks them to weigh risks to subjects against benefits to subjects and also benefits to those who may benefit from the knowledge gained in the experiment. If a puzzle remains, it is why there remains any assumption that research ethics requires a ‘favourable risk-benefit ratio’ for the individual research subject. PMID:27573151
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Rudbeck, Marianne; Johansen, Jens Peter; Omland, Øyvind
2018-03-01
To describe characteristics of claimants reporting an occupational injury associated with disability benefits for income independently granted by the municipality the subsequent year. Multivariate logistic regression was used on self-reported data and register data. Primary outcome was long-term disability benefits. We found that perceived low work ability, high emotional stress, perceived low health, and expected recognition increased the risk of disability benefits. Work ability was the most influential factor. Work ability of responders on benefits was 2.40 [2.23 to 2.58] (scale 1 to 10-low to high). Responders with recognized claims differed only little in characteristics regarding benefits. Responders with ongoing claims had highest risk (18.48%) of benefits despite few health differences. Low perceived work ability was characteristic; health and social issues explained only little of the differences in long-term benefits according to decision of workers' compensation system.
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Punishment diminishes the benefits of network reciprocity in social dilemma experiments
Li, Xuelong; Wang, Zhen; Li, Huijia; Shi, Lei; Podobnik, Boris; Havlin, Shlomo; Boccaletti, Stefano
2018-01-01
Network reciprocity has been widely advertised in theoretical studies as one of the basic cooperation-promoting mechanisms, but experimental evidence favoring this type of reciprocity was published only recently. When organized in an unchanging network of social contacts, human subjects cooperate provided the following strict condition is satisfied: The benefit of cooperation must outweigh the total cost of cooperating with all neighbors. In an attempt to relax this condition, we perform social dilemma experiments wherein network reciprocity is aided with another theoretically hypothesized cooperation-promoting mechanism—costly punishment. The results reveal how networks promote and stabilize cooperation. This stabilizing effect is stronger in a smaller-size neighborhood, as expected from theory and experiments. Contrary to expectations, punishment diminishes the benefits of network reciprocity by lowering assortment, payoff per round, and award for cooperative behavior. This diminishing effect is stronger in a larger-size neighborhood. An immediate implication is that the psychological effects of enduring punishment override the rational response anticipated in quantitative models of cooperation in networks. PMID:29259113
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-08-06
... this spring; and the potential for higher prices in the wine and juice markets, which compete for...-term benefits of this action are expected to outweigh the costs. The committee believes that with no... NS raisin producers benefit more from those raisins which are free tonnage, a lower free tonnage...
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The Economic Benefits of Reducing High School Dropout Rates in the Louisville, Kentucky, Metro Area
ERIC Educational Resources Information Center
Alliance for Excellent Education, 2009
2009-01-01
In an effort to better understand the various economic benefits that a particular urban area could expect were it to reduce its number of high school dropouts, the Alliance for Excellent Education, has developed a sophisticated economic model in partnership with Economic Modeling Specialists Inc. The model allows various economic projections to be…
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The Economic Benefits of Reducing High School Dropout Rates in the Detroit, Michigan, Metro Area
ERIC Educational Resources Information Center
Alliance for Excellent Education, 2009
2009-01-01
In an effort to better understand the various economic benefits that a particular urban area could expect were it to reduce its number of high school dropouts, the Alliance for Excellent Education, with the generous support of State Farm[R], has developed a sophisticated economic model in partnership with Economic Modeling Specialists Inc. The…
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The Economic Benefits of Reducing High School Dropout Rates in the Oakland, California, Metro Area
ERIC Educational Resources Information Center
Alliance for Excellent Education, 2009
2009-01-01
In an effort to better understand the various economic benefits that a particular urban area could expect were it to reduce its number of high school dropouts, the Alliance for Excellent Education, has developed a sophisticated economic model in partnership with Economic Modeling Specialists Inc. The model allows various economic projections to be…
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The Economic Benefits of Reducing High School Dropout Rates in the Atlanta, Georgia, Metro Area
ERIC Educational Resources Information Center
Alliance for Excellent Education, 2009
2009-01-01
In an effort to better understand the various economic benefits that a particular urban area could expect were it to reduce its number of high school dropouts, the Alliance for Excellent Education, with the generous support of State Farm[R], has developed a sophisticated economic model in partnership with Economic Modeling Specialists Inc. The…
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The Economic Benefits of Reducing High School Dropout Rates in the Chicago, Illinois, Metro Area
ERIC Educational Resources Information Center
Alliance for Excellent Education, 2009
2009-01-01
In an effort to better understand the various economic benefits that a particular urban area could expect were it to reduce its number of high school dropouts, the Alliance for Excellent Education, has developed, with the generous support of State Farm[R], a sophisticated economic model in partnership with Economic Modeling Specialists Inc. The…
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The Economic Benefits of Reducing High School Dropout Rates in the Indianapolis, Indiana, Metro Area
ERIC Educational Resources Information Center
Alliance for Excellent Education, 2009
2009-01-01
In an effort to better understand the various economic benefits that a particular urban area could expect were it to reduce its number of high school dropouts, the Alliance for Excellent Education, has developed a sophisticated economic model in partnership with Economic Modeling Specialists Inc. The model allows various economic projections to be…
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The Economic Benefits of Reducing High School Dropout Rates in the Nashville, Tennessee, Metro Area
ERIC Educational Resources Information Center
Alliance for Excellent Education, 2009
2009-01-01
In an effort to better understand the various economic benefits that a particular urban area could expect were it to reduce its number of high school dropouts, the Alliance for Excellent Education, has developed a sophisticated economic model in partnership with Economic Modeling Specialists Inc. The model allows various economic projections to be…
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The Economic Benefits of Reducing High School Dropout Rates in the Washington, DC Metro Area
ERIC Educational Resources Information Center
Alliance for Excellent Education, 2009
2009-01-01
In an effort to better understand the various economic benefits that a particular urban area could expect were it to reduce its number of high school dropouts, the Alliance for Excellent Education, has developed a sophisticated economic model in partnership with Economic Modeling Specialists Inc. The model allows various economic projections to be…
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The Economic Benefits of Reducing High School Dropout Rates in the New York City Metro Area
ERIC Educational Resources Information Center
Alliance for Excellent Education, 2009
2009-01-01
In an effort to better understand the various economic benefits that a particular urban area could expect were it to reduce its number of high school dropouts, the Alliance for Excellent Education, with the generous support of State Farm[R], has developed a sophisticated economic model in partnership with Economic Modeling Specialists Inc. The…
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ERIC Educational Resources Information Center
Alliance for Excellent Education, 2009
2009-01-01
In an effort to better understand the various economic benefits that a particular urban area could expect were it to reduce its number of high school dropouts, the Alliance for Excellent Education, with the generous support of State Farm[R], has developed a sophisticated economic model in partnership with Economic Modeling Specialists Inc. The…
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The Economic Benefits of Reducing High School Dropout Rates in the Jackson, Mississippi, Metro Area
ERIC Educational Resources Information Center
Alliance for Excellent Education, 2009
2009-01-01
In an effort to better understand the various economic benefits that a particular urban area could expect were it to reduce its number of high school dropouts, the Alliance for Excellent Education, with the generous support of State Farm[R], has developed a sophisticated economic model in partnership with Economic Modeling Specialists Inc. The…
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The Economic Benefits of Reducing High School Dropout Rates in the Houston, Texas, Metro Area
ERIC Educational Resources Information Center
Alliance for Excellent Education, 2009
2009-01-01
In an effort to better understand the various economic benefits that a particular urban area could expect were it to reduce its number of high school dropouts, the Alliance for Excellent Education, with the generous support of State Farm[R], has developed a sophisticated economic model in partnership with Economic Modeling Specialists Inc. The…
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Can mutualistic morality predict how individuals deal with benefits they did not deserve?
Bonnefon, Jean-François; Girotto, Vittorio; Heimann, Marco; Legrenzi, Paolo
2013-02-01
An individual obtains an unfair benefit and faces the dilemma of either hiding it (to avoid being excluded from future interactions) or disclosing it (to avoid being discovered as a deceiver). In line with the target article, we expect that this dilemma will be solved by a fixed individual strategy rather than a case-by-case rational calculation.
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Mediterranean diet and life expectancy; beyond olive oil, fruits and vegetables
Martinez-Gonzalez, Miguel A.; Martín-Calvo, Nerea
2018-01-01
Purpose to review the recent relevant evidence of the effects of the Mediterranean diet and lifestyle on health (2015 and first months of 2016). Recent findings Large observational prospective epidemiological studies with adequate control of confounding and two large randomized trials support the benefits of the Mediterranean dietary pattern to increase life expectancy, reduce the risk of major chronic disease, and improve quality of life and well-being. Recently, 19 new reports from large prospective studies showed –with nearly perfect consistency– strong benefits of the Mediterranean diet to reduce the risk of myocardial infarction, stroke, total mortality, heart failure and disability. Interestingly, two large and well-conducted cohorts reported significant cardiovascular benefits after using repeated measurements of diet during a long follow-up period. Besides, PREDIMED, the largest randomized trial with Mediterranean diet, recently reported benefits of this dietary pattern to prevent cognitive decline and breast cancer. Summary In the era of evidence-based medicine, the Mediterranean diet represents the gold standard in preventive medicine, probably due to the harmonic combination of many elements with antioxidant and antiinflammatory properties, which overwhelm any single nutrient or food item. The whole seems more important than the sum of its parts. PMID:27552476
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Mediterranean diet and life expectancy; beyond olive oil, fruits, and vegetables.
Martinez-Gonzalez, Miguel A; Martin-Calvo, Nerea
2016-11-01
The recent relevant evidence of the effects of the Mediterranean diet (MedDiet) and lifestyle on health (2015 and first months of 2016). Large observational prospective epidemiological studies with adequate control of confounding and two large randomized trials support the benefits of the Mediterranean dietary pattern to increase life expectancy, reduce the risk of major chronic disease, and improve quality of life and well-being. Recently, 19 new studies from large prospective studies showed - with nearly perfect consistency - strong benefits of the MedDiet to reduce the risk of myocardial infarction, stroke, total mortality, heart failure, and disability. Interestingly, two large and well conducted cohorts reported significant cardiovascular benefits after using repeated measurements of diet during a long follow-up period. In addition, Prevención con Dieta Mediterránea, the largest randomized trial with MedDiet, recently reported benefits of this dietary pattern to prevent cognitive decline and breast cancer. In the era of evidence-based medicine, the MedDiet represents the gold standard in preventive medicine, probably because of the harmonic combination of many elements with antioxidant and anti-inflammatory properties, which overwhelm any single nutrient or food item. The whole seems more important than the sum of its parts.
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[Primary prevention of coronary thrombosis by antithrombotic agents].
Milon, H; Lantelme, P; Khettab, F; Mestre-Fernandes, C; Lasserre-Remy, S
2001-11-01
At the start of the eighties, in the wake of the good results obtained with aspirin in secondary prevention, two studies were launched aimed at testing the effect of aspirin on the primary prevention of myocardial infarction. The results published in 1988 and 1989 were divergent: the study conducted by British doctors showed no benefit with aspirin, that conducted by American doctors showed a very distinct benefit concerning myocardial infarction but no advantage for cerebral vascular accidents. Besides, in both studies an additional risk of haemorrhagic cerebral vascular accident was described. Methodological reasons were the origin of these facts, but it resulted in a certain confusion as to the practical conduct to adopt. Ten years later it is much more clear after the publication of three supplementary trials. The benefits of aspirin in terms of prevention of myocardial infarction are certain and considerable, at the price of a haemorrhagic risk equally certain but moderate. On the other hand, questions remain concerning the preventive effect of aspirin on cerebral vascular accidents and also on the expected benefits in the female sex. In practice, the prescription of aspirin with the objective of primary prevention must take into account the absolute benefit which can be expected. This is a function of the individual absolute risk before treatment which therefore signifies an evaluation based on the risk factors. Only subjects exposed to a substantial risk before treatment are likely to benefit from aspirin. For the others, the risks linked with aspirin could counterbalance its preventive advantages.
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Runway Scheduling Using Generalized Dynamic Programming
NASA Technical Reports Server (NTRS)
Montoya, Justin; Wood, Zachary; Rathinam, Sivakumar
2011-01-01
A generalized dynamic programming method for finding a set of pareto optimal solutions for a runway scheduling problem is introduced. The algorithm generates a set of runway fight sequences that are optimal for both runway throughput and delay. Realistic time-based operational constraints are considered, including miles-in-trail separation, runway crossings, and wake vortex separation. The authors also model divergent runway takeoff operations to allow for reduced wake vortex separation. A modeled Dallas/Fort Worth International airport and three baseline heuristics are used to illustrate preliminary benefits of using the generalized dynamic programming method. Simulated traffic levels ranged from 10 aircraft to 30 aircraft with each test case spanning 15 minutes. The optimal solution shows a 40-70 percent decrease in the expected delay per aircraft over the baseline schedulers. Computational results suggest that the algorithm is promising for real-time application with an average computation time of 4.5 seconds. For even faster computation times, two heuristics are developed. As compared to the optimal, the heuristics are within 5% of the expected delay per aircraft and 1% of the expected number of runway operations per hour ad can be 100x faster.
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Weintraub Austin, Erica; Chen, Yin Ju
2003-01-01
Although alcohol consumption is a problem on the college campus, beliefs and behaviors predictive of alcohol use are in development in children as young as third grade. Because they develop partially in response to interpretations of media messages, for which parents can have an influence, this study examined how college students' (N=300) recollections of parental reinforcement of media messages associated with alcohol-related beliefs and behaviors. Structural equation modeling showed that recalled positive mediation negatively predicted skepticism, and positively predicted desirability and expectancies. Desirability of media messages predicted more positive norms perceptions, and a lack of skepticism predicted more positive expectancies. With age of first experimentation controlled, expectancies predicted heavier current drinking behavior. Norms did not predict behavior, and positive mediation did not predict norms. The study concludes that to the extent parental communication leads adolescents to interpret media messages less skeptically, they encourage adolescents to find alcohol portrayals appealing. This in turn appears to lead toward more risky behaviors. The results suggest that college-based anti-alcohol campaigns can benefit by acknowledging the appeal of competing messages and by including parents as a campaign target.
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Hottes, Travis Salway; Farrell, Janine; Bondyra, Mark; Haag, Devon; Shoveller, Jean
2012-01-01
Background The feasibility and acceptability of Internet-based sexually transmitted infection (STI) testing have been demonstrated; however, few programs have included testing for human immunodeficiency virus (HIV). In British Columbia, Canada, a new initiative will offer online access to chlamydia, gonorrhea, syphilis, and HIV testing, integrated with existing clinic-based services. We presented the model to gay men and other men who have sex with men (MSM) and existing clinic clients through a series of focus groups. Objective To identify perceived benefits, concerns, and expectations of a new model for Internet-based STI and HIV testing among potential end users. Methods Participants were recruited through email invitations, online classifieds, and flyers in STI clinics. A structured interview guide was used. Focus groups were audio recorded, and an observer took detailed field notes. Analysts then listened to audio recordings to validate field notes. Data were coded and analyzed using a scissor-and-sort technique. Results In total, 39 people participated in six focus groups. Most were MSM, and all were active Internet users and experienced with STI/HIV testing. Perceived benefits of Internet-based STI testing included anonymity, convenience, and client-centered control. Salient concerns were reluctance to provide personal information online, distrust of security of data provided online, and the need for comprehensive pretest information and support for those receiving positive results, particularly for HIV. Suggestions emerged for mitigation of these concerns: provide up-front and detailed information about the model, ask only the minimal information required for testing, give positive results only by phone or in person, and ensure that those testing positive are referred for counseling and support. End users expected Internet testing to offer continuous online service delivery, from booking appointments, to transmitting information to the laboratory, to getting prescriptions. Most participants said they would use the service or recommend it to others. Those who indicated they would be unlikely to use it generally either lived near an STI clinic or routinely saw a family doctor with whom they were comfortable testing. Participants expected that the service would provide the greatest benefit to individuals who do not already have access to sensitive sexual health services, are reluctant to test due to stigma, or want to take immediate action (eg, because of a recent potential STI/HIV exposure). Conclusions Internet-based STI/HIV testing has the potential to reduce barriers to testing, as a complement to existing clinic-based services. Trust in the new online service, however, is a prerequisite to client uptake and may be engendered by transparency of information about the model, and by accounting for concerns related to confidentiality, data usage, and provision of positive (especially HIV) results. Ongoing evaluation of this new model will be essential to its success and to the confidence of its users. PMID:22394997
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Hottes, Travis Salway; Farrell, Janine; Bondyra, Mark; Haag, Devon; Shoveller, Jean; Gilbert, Mark
2012-03-06
The feasibility and acceptability of Internet-based sexually transmitted infection (STI) testing have been demonstrated; however, few programs have included testing for human immunodeficiency virus (HIV). In British Columbia, Canada, a new initiative will offer online access to chlamydia, gonorrhea, syphilis, and HIV testing, integrated with existing clinic-based services. We presented the model to gay men and other men who have sex with men (MSM) and existing clinic clients through a series of focus groups. To identify perceived benefits, concerns, and expectations of a new model for Internet-based STI and HIV testing among potential end users. Participants were recruited through email invitations, online classifieds, and flyers in STI clinics. A structured interview guide was used. Focus groups were audio recorded, and an observer took detailed field notes. Analysts then listened to audio recordings to validate field notes. Data were coded and analyzed using a scissor-and-sort technique. In total, 39 people participated in six focus groups. Most were MSM, and all were active Internet users and experienced with STI/HIV testing. Perceived benefits of Internet-based STI testing included anonymity, convenience, and client-centered control. Salient concerns were reluctance to provide personal information online, distrust of security of data provided online, and the need for comprehensive pretest information and support for those receiving positive results, particularly for HIV. Suggestions emerged for mitigation of these concerns: provide up-front and detailed information about the model, ask only the minimal information required for testing, give positive results only by phone or in person, and ensure that those testing positive are referred for counseling and support. End users expected Internet testing to offer continuous online service delivery, from booking appointments, to transmitting information to the laboratory, to getting prescriptions. Most participants said they would use the service or recommend it to others. Those who indicated they would be unlikely to use it generally either lived near an STI clinic or routinely saw a family doctor with whom they were comfortable testing. Participants expected that the service would provide the greatest benefit to individuals who do not already have access to sensitive sexual health services, are reluctant to test due to stigma, or want to take immediate action (eg, because of a recent potential STI/HIV exposure). Internet-based STI/HIV testing has the potential to reduce barriers to testing, as a complement to existing clinic-based services. Trust in the new online service, however, is a prerequisite to client uptake and may be engendered by transparency of information about the model, and by accounting for concerns related to confidentiality, data usage, and provision of positive (especially HIV) results. Ongoing evaluation of this new model will be essential to its success and to the confidence of its users.
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Jayanti, R K
1997-01-01
Problem recognition styles--desired state types (DSTs) and actual state types (ASTs)--have an effect on preventive health care decision making. Segmenting the market along these lines can help marketers position products and services to educate and attract people who will not see a doctor unless there is something wrong with them. Both groups expect the same benefits from preventive health care actions, but ASTs fail to act on those expectations. Therefore, marketing strategy touting the benefits of preventive health care might be futile. Educational promotional campaigns aimed at both DSTs and ASTs also are wasteful because DSTs already possess much health knowledge, lead wellness-oriented lifestyles, and practice preventive health behaviors.
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Promises and challenges in solid-state lighting
NASA Astrophysics Data System (ADS)
Schubert, Fred
2010-03-01
Lighting technologies based on semiconductor light-emitting diodes (LEDs) offer unprecedented promises that include three major benefits: (i) Gigantic energy savings enabled by efficient conversion of electrical energy to optical energy; (ii) Substantial positive contributions to sustainability through reduced emissions of global-warming gases, acid-rain gases, and toxic substances such as mercury; and (iii) The creation of new paradigms in lighting driven by the unique controllability of solid-state lighting sources. Due to the powerful nature of these benefits, the transition from conventional lighting sources to solid-state lighting is virtually assured. This presentation will illustrate the new world of lighting and illustrate the pervasive changes to be expected in lighting, displays, communications, and biotechnology. The presentation will also address the formidable challenges that must be addressed to continue the further advancement of solid-state lighting technology. These challenges offer opportunities for research and innovation. Specific challenges include light management, carrier transport, and optical design. We will present some innovative approaches in order to solve known technical challenges faced by solid-state lighting. These approaches include the demonstration and use of new optical thin-film materials with a continuously tunable refractive index. These approaches also include the use of polarization-matched structures that reduce the polarization fields in GaInN LEDs and the hotly debated efficiency droop, that is, the decreasing LED efficiency at high currents.
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Study participants incentives, compensation and reimbursement in resource-constrained settings.
Mduluza, Takafira; Midzi, Nicholas; Duruza, Donold; Ndebele, Paul
2013-01-01
Controversies still exists within the research fraternity on the form and level of incentives, compensation and reimbursement to study participants in resource-constrained settings. While most research activities contribute significantly to advancement of mankind, little has been considered in rewarding directly the research participants from resource-constrained areas. A study was conducted in Zimbabwe to investigate views and expectations of various stakeholders on study participation incentives, compensation and reimbursement issues. Data was collected using various methods including a survey of about 1,008 parents/guardians of school children participating in various immunological cohort studies and parasitology surveys. Community advisory boards (CABs) at 9 of the sites were also consulted. Further, information was gathered during discussions held at a basic research ethics training workshop. The workshop had 45 participants that including 40 seasoned Zimbabwean researchers and 5 international research collaborators. About 90% (907) of the study participants and guardians expected compensation of reasonable value, in view of the researchers' value and comparison to other sites regardless of economic status of the community. During discussion with researchers at a basic ethics training workshop, about 80% (32) believed that decisions on level of compensation should be determined by the local research ethics committees. While, the few international research collaborators were of the opinion that compensation should be in accordance with local guidelines, and incentives should be in line with funding. Both the CAB members and study participants expressed that there should be a clear distinction between study incentive and compensation accorded to individual and community expectations on benefits from studies. However, CABs expressed that their suggestions on incentives and compensation are often moderated by the regulatory authorities who cite fear of unknown concerns. Overall, both personal and community benefits need to be considered collectively in future studies to be conducted in resource-constrained communities. There is projected fear that recruitment in future may be a challenge, now that almost every community, has somehow been reached and participated in some form of studies. A major concern on reimbursement, compensation or incentives should be internationally pegged regardless of different economic status of the individuals or communities where the study is to be conducted.