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Andrea Messori, Sabrina Trippoli
Cost-effectiveness evaluations concerning devices for total knee arthroplasty (TKA) have little impact on real-life management of these devices. This study explored how pharmacoeconomic models can inform the procurement of TKA devices to improve their value for money. Our study included three phases: i) literature search for data of outcome, cost, and device type in TKA; ii) development of a Markov model predicting costs, QALYs, and net monetary benefit (NMB); iii) simulation of tenders aimed at value-based device procurement...
December 14, 2017: Orthopedic Reviews
Simon D Kloß, Wolfgang Schnick
The structural diversity of tetrahedra networks of phosphates can greatly be enhanced by introduction of mixed N/O anion positions. LiPr2 P4 N7 O3 exemplifies the benefits of N/O mixed anion positions as it is the first rare-earth (oxo)nitridophosphate with a single-layered structure and a degree of condensation (atomic ratio of tetrahedra centers (P) to tetrahedra corners (N/O atoms)) of 2/5. The compound was prepared through high-pressure metathesis starting from PrF3 , LiPN2 , Li2 O, and PON using a hydraulic 1000t press and the multianvil technique...
March 21, 2018: Inorganic Chemistry
David C Grossman, Susan J Curry, Douglas K Owens, Michael J Barry, Aaron B Caughey, Karina W Davidson, Chyke A Doubeni, John W Epling, Alex R Kemper, Alex H Krist, Martha Kubik, Seth Landefeld, Carol M Mangione, Michael Silverstein, Melissa A Simon, Chien-Wen Tseng
Importance: Skin cancer is the most common type of cancer in the United States. Although invasive melanoma accounts for only 2% of all skin cancer cases, it is responsible for 80% of skin cancer deaths. Basal and squamous cell carcinoma, the 2 predominant types of nonmelanoma skin cancer, represent the vast majority of skin cancer cases. Objective: To update the 2012 US Preventive Services Task Force (USPSTF) recommendation on behavioral counseling for the primary prevention of skin cancer and the 2009 recommendation on screening for skin cancer with skin self-examination...
March 20, 2018: JAMA: the Journal of the American Medical Association
Philip E Castle, Cosette M Wheeler, Nicole G Campos, Stephen Sy, Emily A Burger, Jane J Kim
There is limited information on the cost-inefficiencies of non-adherence to recommended cervical cancer screening or the potential value for improving non-adherence. We estimated the incremental value of adhering to recommended screening every three years with cytology, using a disease simulation model that integrated real-world screening practice data from New Mexico. The amount that can be spent to improve adherence was estimated by calculating the incremental net monetary benefit (INMB) under scenarios of Current Practice (assuming a population of mixed adherence) and Uniformly Non-Adherent populations with imperfect or perfect adherence to follow-up of screen-positive women...
March 14, 2018: Preventive Medicine
Carla T Murray, Matthew Schmit
Introduction: We estimate the effect on health care spending of an option to change TRICARE. Under the option, which is based on a proposal made by the Military Compensation and Retirement Modernization Commission (MCRMC), most beneficiaries could choose from a range of commercial health networks instead of the current TRICARE plans. Military treatment facilities would become network providers under the commercial plans. Materials and Methods: We used data from the Department of Defense (DoD) to estimate the cost of providing the current health care benefit to working-age retirees and their dependents and survivors, and active duty family members...
March 14, 2018: Military Medicine
George A Fisher, Edward M Wolin, Nilani Liyanage, Susan Pitman Lowenthal, Beloo Mirakhur, Rodney F Pommier, Montaser Shaheen, Aaron I Vinik
OBJECTIVE: This ELECT prospective analysis examined lanreotide depot/autogel for carcinoid syndrome (CS) symptom control in patients with neuroendocrine tumors (NETs) who were responsive to prior octreotide (prior octreotide group) compared with patients who were naïve to prior somatostatin analogue treatment (de novo group). METHODS: Adults with histopathologically confirmed NET and stable CS (diarrhea and/or flushing) were randomized to subcutaneous (SC) lanreotide 120 mg or placebo every 4 weeks for 16 weeks...
March 2018: Endocrine Practice
Kresimir Radic, Marko Curkovic, Dario Bagaric, Maja Vilibic, Andrea Tomic, Maja Zivkovic
Patients with schizophrenia, nowadays chronic, frequently disabling mental disorder, get initial treatment after detection of a psychotic episode, seemingly late, potentially preventable stage of illness. As our knowledge about the nature of schizophrenia and other diseases of the spectrum is growing, so are the early interventions becoming more possible, and it is important to conceptualize the clinical, legal and moral issues emerging with new preventive treatments. Every intervention, especially in pre-clinical population, demands a careful risk-benefit assessment and having basic bioethical principles - primacy of patient's welfare, beneficience/non-maleficience, autonomy and justice - in mind...
March 2018: Psychiatria Danubina
Kednapa Thavorn, Howsikan Kugathasan, Darrell H S Tan, Nasheed Moqueet, Stefan D Baral, Becky Skidmore, Derek MacFadden, Anna Simkin, Sharmistha Mishra
BACKGROUND: Pre-exposure prophylaxis (PrEP) with antiretrovirals is an efficacious and effective intervention to decrease the risk of HIV (human immunodeficiency virus) acquisition. Yet drug and delivery costs prohibit access in many jurisdictions. In the absence of guidelines for the synthesis of economic evaluations, we developed a protocol for a systematic review of economic evaluation studies for PrEP by drawing on best practices in systematic reviews and the conduct and reporting of economic evaluations...
March 15, 2018: Systematic Reviews
Jenifer E Clapp, Sarah A Niederman, Elizabeth Leonard, Christine J Curtis
INTRODUCTION: Approximately 60% of the American diet comes from processed foods, which makes improving their nutritional quality important for Americans' health. The objective of this study was to measure changes in serving sizes, calories, and sodium in top-selling processed foods that were on the market in 2009 and 2015. METHODS: We analyzed products in the top 80% of sales in the 54 processed food categories with consistent serving sizes and sales metrics that were on the market in both 2009 and 2015...
March 15, 2018: Preventing Chronic Disease
(no author information available yet)
Background: Type 1 diabetes is a condition in which the pancreas produces little or no insulin. People with type 1 diabetes must manage their blood glucose levels by monitoring the amount of glucose in their blood and administering appropriate amounts of insulin via injection or an insulin pump. Continuous glucose monitoring may be beneficial compared to self-monitoring of blood glucose using a blood glucose meter. It provides insight into a person's blood glucose levels on a continuous basis, and can identify whether blood glucose levels are trending up or down...
2018: Ontario Health Technology Assessment Series
Hidenori Takeshima, Kanako Saitoh, Shuhei Nitta, Taichiro Shiodera, Tomoyuki Takeguchi, Shuhei Bannae, Shigehide Kuhara
PURPOSE: Dynamic MR techniques, such as cardiac cine imaging, benefit from shorter acquisition times. The goal of the present study was to develop a method that achieves short acquisition times, while maintaining a cost-effective reconstruction, for dynamic MRI. k - t sensitivity encoding (SENSE) was identified as the base method to be enhanced meeting these two requirements. METHODS: The proposed method achieves a reduction in acquisition time by estimating the spatiotemporal (x - f) sensitivity without requiring the acquisition of the alias-free signals, typical of the k - t SENSE technique...
March 13, 2018: Magnetic Resonance in Medical Sciences: MRMS
Rachael M Hunter, Naomi J Fulop, Ruth J Boaden, Christopher McKevitt, Catherine Perry, Angus I G Ramsay, Anthony G Rudd, Simon J Turner, Pippa J Tyrrell, Charles D A Wolfe, Stephen Morris
BACKGROUND: The economic implications of major system change are an important component of the decision to implement health service reconfigurations. Little is known about how best to report the results of economic evaluations of major system change to inform decision-makers. Reconfiguration of acute stroke care in two metropolitan areas in England, namely London and Greater Manchester (GM), was used to analyse the economic implications of two different implementation strategies for major system change...
March 14, 2018: Health Research Policy and Systems
David L Chan, Lesley Moody, Eva Segelov, David Metz, Jonathan Strosberg, Nick Pavlakis, Simron Singh
<br>Objectives: There is no consensus regarding optimal follow-up in resected GEP-NETS. We aimed to perform a practice survey to ascertain follow-up patterns by health care practitioners and highlight areas of variation that may benefit from further quantitative research. METHODS: A web-based survey targeted at NET health care providers in Australia, New Zealand, Canada and the United States was developed by a steering committee of medical oncologists and a research methodologist...
March 14, 2018: Neuroendocrinology
Samir S Soneji, Hai-Yen Sung, Brian A Primack, John P Pierce, James D Sargent
BACKGROUND: Electronic cigarettes (e-cigarettes) may help cigarette smokers quit smoking, yet they may also facilitate cigarette smoking for never-smokers. We quantify the balance of health benefits and harms associated with e-cigarette use at the population level. METHODS AND FINDINGS: Monte Carlo stochastic simulation model. Model parameters were drawn from census counts, national health and tobacco use surveys, and published literature. We calculate the expected years of life gained or lost from the impact of e-cigarette use on smoking cessation among current smokers and transition to long-term cigarette smoking among never smokers for the 2014 US population cohort...
2018: PloS One
Dinh Bao Truong, Flavie Luce Goutard, Stéphane Bertagnoli, Alexis Delabouglise, Vladimir Grosbois, Marisa Peyre
This study aimed to analyze the financial impact of foot-and-mouth disease (FMD) outbreaks in cattle at the farm-level and the benefit-cost ratio (BCR) of biannual vaccination strategy to prevent and eradicate FMD for cattle in South Vietnam. Production data were collected from 49 small-scale dairy farms, 15 large-scale dairy farms, and 249 beef farms of Long An and Tay Ninh province using a questionaire. Financial data of FMD impacts were collected using participatory tools in 37 villages of Long An province...
2018: Frontiers in Veterinary Science
Jannik B Bertelsen, Nasrin Tayyari Dehbarez, Jens Refsgaard, Helle Kanstrup, Søren P Johnsen, Ina Qvist, Bo Christensen, Rikke Søgaard, Kent L Christensen
Background: Changes in the organisation of chronic healthcare, an increased awareness of costs and challenges of low adherence in cardiac rehabilitation (CR) call for the exploration of more flexible CR programmes as alternatives to hospital-based CR (H-CR). A model of shared care cardiac rehabilitation (SC-CR) that included general practitioners and the municipality was developed. The aim of this study was to analyse the cost utility of SC-CR versus H-CR. Methods: The cost-utility analysis was based on a randomised controlled trial of 212 patients who were allocated to SC-CR or H-CR and followed up for 12 months...
2018: Open Heart
Tobias Hagen
Purpose During 2009‒2013 a pilot project was carried out in Zurich which aimed to increase the income of disability insurance (DI) benefit recipients in order to reduce their entitlement to DI benefits. The project consisted of placement coaching carried out by a private company that specialized in this field. It was exceptional with respect to three aspects: firstly, it did not include any formal training and/or medical aid; secondly, the coaches did not have the possibility of providing additional financial incentives or sanctioning lack of effort; and thirdly due to performance bonuses, the company not only had incentives to bring the participants into (higher paid) work, but also to keep them there for 52 weeks...
March 9, 2018: Journal of Occupational Rehabilitation
Anne-Claire Pierrefeu-Lagrange, Karine Mari, Caroline Hoss, Breda Cullen, Lorraine Nisbet
INTRODUCTION: Dressings are a mainstay for wound management; however, dressing adherence to the wound or periwound area can cause pain and trauma at removal. Dressing-related trauma includes skin reactions, adherence to the wound, and skin stripping. The development of atraumatic wound contact layer dressings has been a major advancement in reducing trauma. OBJECTIVE: This study compares the benefits of a cellulose acetate mesh (CAM) coated with soft silicone versus a flexible polyamide net (FPN) coated with soft silicone...
January 26, 2018: Wounds: a Compendium of Clinical Research and Practice
Xing Fan, Jie Chang, Yuan Ren, Xu Wu, Yuanyuan Du, Ronghua Xu, Dong Liu, Scott X Chang, Laura A Meyerson, Changhui Peng, Ying Ge
Dairy production is becoming more industrialized globally, especially in developing countries. The large amount of animal wastes from industrial feedlots cannot be fully used on nearby farmlands, leading to severe environmental problems. Using China as a case study, we found that most dairy feedlots employ a semi-coupled mode that only recycles solid manure to farmlands, and only a few dairy feedlots employ a fully-coupled mode that recycles both solid and liquid animal manure. To produce one ton of milk, the fully-coupled mode could reduce greenhouse gas (including carbon dioxide, methane, and nitrous oxide in this paper) emissions by 24%, ammonia emissions by 14%, and N discharge into water by 29%, compared with the semi-coupled systems...
March 8, 2018: Environmental Science & Technology
Maximiliano A Hawkes, Alejandro A Rabinstein
Background: We summarize the existing evidence on the potential benefit of oral anticoagulation (OAC) in intracerebral hemorrhage (ICH) survivors with nonvalvular atrial fibrillation (NVAF). Methods: Systematic review of the literature to address the following issues: (1) prevalence of NVAF in ICH survivors, (2) current prescription of OAC, (3) factors associated with resumption of OAC, (4) risk of ischemic stroke (IS) and recurrent ICH, and (5) ideal timing for restarting OAC in ICH survivors with NVAF...
February 2018: Neurology. Clinical Practice
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