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Megan D Barnes, Louise Glew, Carina Wyborn, Ian D Craigie
No abstract text is available yet for this article.
March 19, 2018: Nature Ecology & Evolution
Lu Dai, Ka-Di Zhu, Wenzhong Shen, Xiaojiang Huang, Li Zhang, Alain Goriely
Chiral structures play an important role in natural sciences due to their great variety and potential applications. A perversion connecting two helices with opposite chirality creates a dual-chirality helical structure. In this paper, we develop a novel model to explore quantitatively the mechanical behavior of normal, binormal and transversely isotropic helical structures with dual chirality and apply these ideas to known nanostructures. It is found that both direction and amplitude of rotation can be finely controlled by designing the cross-sectional shape...
March 15, 2018: Nanoscale
Dennis Waithaka, Benjamin Tsofa, Edwine Barasa
Background : Decentralization of health systems has made sub-national/regional healthcare systems the backbone of healthcare delivery. These regions are tasked with the difficult responsibility of determining healthcare priorities and resource allocation amidst scarce resources. We aimed to review empirical literature that evaluated priority setting practice at the meso level of health systems. Methods : We systematically searched PubMed, ScienceDirect and Google scholar databases and supplemented these with manual searching for relevant studies, based on the reference list of selected papers...
2018: Wellcome Open Research
Divya Narain, Martine Maron
Biodiversity offsetting aims to compensate for development-induced biodiversity loss through commensurate conservation gains and is gaining traction among governments and businesses. However, cost shifting (i.e., diversion of offset funds to other conservation programs) and other perverse incentives can undermine the effectiveness of biodiversity offsetting. Additionality - the requirement that biodiversity offsets result in conservation outcomes that would not have been achieved otherwise - is fundamental to biodiversity offsetting...
February 23, 2018: Conservation Biology: the Journal of the Society for Conservation Biology
Graham P Martin, Emma-Louise Aveling, Anne Campbell, Carolyn Tarrant, Peter J Pronovost, Imogen Mitchell, Christian Dankers, David Bates, Mary Dixon-Woods
BACKGROUND: Healthcare organisations often fail to harvest and make use of the 'soft intelligence' about safety and quality concerns held by their own personnel. We aimed to examine the role of formal channels in encouraging or inhibiting employee voice about concerns. METHODS: Qualitative study involving personnel from three academic hospitals in two countries. Interviews were conducted with 165 participants from a wide range of occupational and professional backgrounds, including senior leaders and those from the sharp end of care...
February 19, 2018: BMJ Quality & Safety
Jing Sun, Cecile Jia Hu, Mark Stuntz, Hans Hogerzeil, Yuanli Liu
BACKGROUND: Despite recent reforms, distorting funding mechanisms and over-prescribing still maintain severe financial barriers to medicines access in China. Complicated and interrelated problems in the pharmaceutical sector require a common framework to be resolved as fragmented solutions do not work. We present a preliminary assessment of the impact of the national healthcare reforms on access to medicines, and propose policy recommendations for promoting universal access to medicines in China...
February 20, 2018: BMC Health Services Research
Aymeric Amelot, Louis-Marie Terrier, Bertrand Mathon, Ann-Rose Cook, Jean-Jacques Mazeron, Charles-Ambroise Valery, Philippe Cornu, Marc Leveque, Alexandre Carpentier
Brain metastases natural history from one primary tumor type might be accelerated or favored by using certain systemic chemotherapy. A great deal was described in mice and suggested in human with antiangiogenic drugs, but little is known about the metastatic progression generated by the perverse effect of anticancer drugs. A total of 413 patients who underwent treatment for brain metastasis (2013-2016) were included. The identification of all previous anticancer drugs received by patients from primary tumor diagnosis to brain metastases diagnosis was collated...
February 9, 2018: Medical Oncology
David Robert Grimes, Chris T Bauch, John P A Ioannidis
Scientific publication is immensely important to the scientific endeavour. There is, however, concern that rewarding scientists chiefly on publication creates a perverse incentive, allowing careless and fraudulent conduct to thrive, compounded by the predisposition of top-tier journals towards novel, positive findings rather than investigations confirming null hypothesis. This potentially compounds a reproducibility crisis in several fields, and risks undermining science and public trust in scientific findings...
January 2018: Royal Society Open Science
Jan Wolff, Thomas Heister, Claus Normann, Klaus Kaier
BACKGROUND: Psychiatric comorbidities are relevant for the diagnostic and therapeutic regimes in somatic hospital care. The main aim of this study was to analyse the association between psychiatric comorbidities and hospital costs per inpatient episode. A further aim was to discuss and address the methodological challenges in the estimation of these outcomes based on retrospective data. METHODS: The study included 338,162 inpatient episodes consecutively discharged between 2011 and 2014 at a German university hospital...
January 30, 2018: BMC Health Services Research
Moreno Di Marco, James E M Watson, David J Currie, Hugh P Possingham, Oscar Venter
Protecting biomass carbon stocks to mitigate climate change has direct implications for biodiversity conservation. Yet, evidence that a positive association exists between carbon density and species richness is contrasting. Here, we test how this association varies (1) across spatial extents and (2) as a function of how strongly carbon and species richness depend on environmental variables. We found the correlation weakens when moving from larger extents, e.g. realms, to narrower extents, e.g. ecoregions. For ecoregions, a positive correlation emerges when both species richness and carbon density vary as functions of the same environmental variables (climate, soil, elevation)...
January 4, 2018: Ecology Letters
Graham F Moore, Rhiannon E Evans
Recent years have seen a growing emphasis on the value of building and testing middle range theory throughout the development and evaluation of complex population health interventions. We agree that a coherent theoretical basis for intervention development, and use of evaluation to test key causal assumptions and build theory, are crucial. However, in this editorial, we argue that such recommendations have often been operationalised in somewhat simplistic terms with potentially perverse consequences, and that an uncritical assumption that an intervention explicitly based on theory is inherently superior carries significant risks...
December 2017: SSM—Population Health
Steven F Koch
Tobacco taxes are known to reduce tobacco consumption and to be regressive, such that tobacco control policy may have the perverse effect of further harming the poor. However, if tobacco consumption falls faster amongst the poor than the rich, tobacco control policy can actually be progressive. We take advantage of persistent and committed tobacco control activities in South Africa to examine the household tobacco expenditure burden. For the analysis, we make use of two South African Income and Expenditure Surveys (2005/06 and 2010/11) that span a series of such tax increases and have been matched across the years, yielding 7806 matched pairs of tobacco consuming households and 4909 matched pairs of cigarette consuming households...
November 4, 2017: Social Science & Medicine
Gert Jan van der Wilt, Wietske Kievit, Wija Oortwijn
A central idea underlying the INTEGRATE-HTA project is that many of the interventions that are being used in health care are quite complex. By this, we mean that the relation between the delivery of the intervention on the one hand, and the onset of (desired and undesired) changes may be less straightforward than hoped for. There may be all sorts of reasons for this, varying from a lack of resources, lack of skills, perverse incentives, organizational problems, etc. Not identifying such factors and their potential impact may seriously compromise the policy relevance of a health technology assessment (HTA) (1)...
November 8, 2017: International Journal of Technology Assessment in Health Care
Batya R Monder
No abstract text is available yet for this article.
December 2017: International Journal of Psycho-analysis
K E Young, I Soussi, M Toumi
Objective: The study compared the relative cost differences of similar orphan drugs among high and low GDP countries in Europe: Bulgaria, France, Germany, Greece, Hungary, Italy, Norway, Poland, Romania, Spain, Sweden, UK. Methods: Annual treatment costs per patient were calculated. Relative costs were computed by dividing the costs by each economic parameter: nominal GDP per capita, GDP in PPP per capita, % GDP contributed by the government, government budget per inhabitant, % GDP spent on healthcare, % GDP spent on pharmaceuticals, and average annual salary...
2017: Journal of Market Access & Health Policy
Jan Greene
The move to a value-based payment system was supposed to end perverse incentives that pay doctors more for delivering often unnecessary services. But things are changing slowly and the market is still 95% fee for service. There's talk of reworking the Medicare fee schedule so docs are paid more for the things that work, and less for those that don't.
September 2017: Managed Care
Marie Hutchinson, Debra Jackson, Stacey Wilson
In recent decades, debate on the quality and safety of healthcare has been dominated by a measure and manage administrative rationality. More recently, this rationality has been overlaid by ideas from human factors, ergonomics and systems engineering. Little critical attention has been given in the nursing literature to how risk of harm is understood and actioned, or how patients can be subjectified and marginalised through these discourses. The problem of assuring safety for particular patient groups, and the dominance of technical forms of rationality, has seen the word 'unavoidable' used in connection with intractable forms of patient harm...
October 4, 2017: Nursing Inquiry
Stephen Gilligan
NHS England is to introduce a new Commissioning for Quality and Innovation to reduce delayed discharges from adult critical care to ward-level care. A delayed discharge is greater than 4 h, this occurred in 64.2% of patients in the critical care minimum data set database from Intensive Care National Audit & Research Centre from the last five years; 46.3% were delayed between 4 and 24 h and 17.9% were delayed more than 24 h. For those who had a delay in their discharge of greater than 24 h, the data suggests that "sicker" patients ultimately do better, since there was a reduction in expected mortality of 5892 patients to an actual mortality of 5201 patients over the five years...
May 2017: Journal of the Intensive Care Society
Sophie Witter, Andrew Kardan, Molly Scott, Lucie Moore, Louise Shaxson
BACKGROUND: The Demand-Driven Evaluations for Decisions (3DE) programme was piloted in Zambia and Uganda in 2012-2015. It aimed to answer evaluative questions raised by policymakers in Ministries of Health, rapidly and with limited resources. The aim of our evaluation was to assess whether the 3DE model was successful in supporting and increasing evidence-based policymaking, building capacity and changing behaviour of Ministry staff. METHODS: Using mixed methods, we compared the ex-ante theory of change with what had happened in practice, why and with what results (intended and unintended), including a qualitative assessment of 3DE's contribution...
October 2, 2017: Health Research Policy and Systems
Ajay Aggarwal, Daniel Lewis, Arunan Sujenthiran, Susan C Charman, Richard Sullivan, Heather Payne, Malcolm Mason, Jan van der Meulen
PURPOSE: To investigate whether patients requiring radiation treatment are prepared to travel to alternative more distant centers in response to hospital choice policies, and the factors that influence this mobility. METHODS AND MATERIALS: We present the results of a national cohort study using administrative hospital data for all 44,363 men who were diagnosed with prostate cancer and underwent radical radiation therapy in the English National Health Service between 2010 and 2014...
December 1, 2017: International Journal of Radiation Oncology, Biology, Physics
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