scholarly journals Evaluating Alternative Designs of a Multilevel HIV Intervention in Maharashtra, India: The Impact of Stakeholder Constraints

2018 ◽  
Vol 3 (2) ◽  
pp. 238146831880394
Author(s):  
Anik R. Patel ◽  
Kelly V. Ruggles ◽  
Kimberly Nucifora ◽  
Qinlian Zhou ◽  
Stephen Schensul ◽  
...  
Keyword(s):  
Risk Aversion ◽  
Group Counseling ◽  
Annual Cost ◽  
Text Message ◽  
Individual Counseling ◽  
Hiv Intervention ◽  
Sex Risk ◽  
Adherence Support ◽  
Alcohol Counseling ◽  
The Impact

Background. Multilevel interventions combine individual component interventions, and their design can be informed by decision analysis. Our objective was to identify the optimal combination of interventions for alcohol-using HIV+ individuals on antiretroviral drug therapy in Maharashtra, India, explicitly considering stakeholder constraints. Methods. Using an HIV simulation, we evaluated the expected net monetary benefit (ENMB), the probability of lying on the efficiency frontier (PEF), and annual program costs of 5,836 unique combinations of 15 single-focused HIV risk-reduction interventions. We evaluated scenarios of 1) no constraints (i.e., maximize expected value), 2) short-term budget constraints (limits on annual programmatic costs of US$200,000 and $400,000), and 3) a constraint stemming from risk aversion (requiring that the strategy has >50% PEF). Results. With no constraints, the combination including long individual alcohol counseling, text-message adherence support, long group counseling for sex-risk, and long individual counseling for sex-risk (annual cost = $428,886; PEF ∼27%) maximized ENMB and would be the optimal design. With a cost constraint of $400,000, the combination including long individual alcohol counseling, text-message adherence support, brief group counseling for sex-risk, and long individual counseling for sex-risk (annual cost = $374,745; PEF ∼4%) maximized ENMB. With a cost constraint of $200,000, the combination including long individual alcohol counseling, text-message adherence support, and brief group counseling for sex-risk (annual cost = $187,335; PEF ∼54%) maximized ENMB. With the risk aversion constraint, the same configuration ( long individual alcohol counseling, text-message support, and brief group counseling for sex-risk) maximized health benefit. Conclusion. Evaluating the costs, risks, and projected benefits of alternatives supports informed decision making prior to initiating study; however, stakeholder constraints should be explicitly included and discussed when using decision analyses to guide study design.

scholarly journals The Impact of a Career Group Counseling Mix Model on Satisfaction of Low-achieving College Students──Specialty-Oriented Career Exploration Group Counseling

2020 ◽  
Vol 12 (2) ◽  
pp. 1
Author(s):  
Huiling Peng ◽  
Yahui Shih ◽  
LungFu Chang
Keyword(s):  
College Students ◽  
Career Counseling ◽  
Peer Tutoring ◽  
Group Counseling ◽  
Unique Feature ◽  
Counseling Center ◽  
Career Exploration ◽  
Counseling Program ◽  
Individual Counseling ◽  
The Impact

The unique feature of the group counseling program in this study is the integration of group counseling, individual counseling and peer tutoring. This study aims to determine the satisfaction level of low-achieving college students, who participated in the "Specialty-oriented Career Exploration" group counseling mix model. This study is an action research that lasts one semester. The research samples are 12 low-achieving freshmen students in the Finance Department of a business university (these students, as recommended by the class mentor, achieved average performance in the last fifth tier in their first semester), who participated in all three phases of career group counseling mix model. The unique feature of the group counseling program instituted in this study is the integration of group counseling, individual counseling and peer tutoring: (1) Phase 1: Group counseling before the mid-term exams, which included the design of structured career group counseling activities that were held eight times in eight weeks; (2) Phase 2: Individual counseling performed after mid-term exams; (3) Peer tutoring added to the process. According to the statistical analysis results of the satisfaction questionnaire, the results of the questionnaire show that they are very satisfied with the appropriateness of the overall planning (M=4.8; S=0.16); and that Specialty-oriented Career Counseling mix model is very helpfulimportant for individuals thinking about future careers (M=4.6; S=0.24).  The preventive measures adopted by the career counseling program received positive responses from students who participated in this career counseling group mix model, that they then became familiar with the counseling center. Group members who had serious emotional and interpersonal problems were willing to seek out counselors in the collage counseling center and continue with individual counseling. This study recommended that individual counseling or peer tutoring can be arranged after specialty-oriented career exploration group counseling, in order to meet the career counseling needs for various low-achieving college students. Lastly, this study offers specific suggestions, based on the research results, for "specialty-oriented career group counseling" in higher education to enhance the diversified contents of college career counseling.

scholarly journals Improved adherence with Medicines Use Review service in Slovenia: a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Urška Nabergoj Makovec ◽  
Igor Locatelli ◽  
Mitja Kos
Keyword(s):  
Medication Adherence ◽  
Controlled Trial ◽  
Test Group ◽  
Multiple Linear Regression Model ◽  
Relative Difference ◽  
Control Group ◽  
Adherence Support ◽  
Medicines Use ◽  
The Impact ◽  
Medicines Use Review

Abstract Background Based on several existing patient-oriented activities, Medicines Use Review (MUR) service was standardized and officially adopted in Slovenia in 2015. Service aims to provide adherence support and ensure safe and effective medicines use. Therefore, the aim of the study was to evaluate the benefits of MUR in Slovenia, primarily the impact on medication adherence. Methods A randomised controlled trial was performed in community pharmacies to compare MUR with standard care. Patients were randomised into either the test (patients received MUR by a certified MUR provider at visit 1), or control group. The study primary outcome was self-reported adherence to multiple medications, assessed by electronic ©Morisky Widget MMAS-8 Software at the first visit (V1) and after 12 weeks (V2). A sub-analysis of intentional and unintentional non-adherence was performed. MUR impact was defined as the relative difference in ©MMAS-8 score after 12 weeks between the test and control group. A multiple linear regression model was used to predict MUR impact based on baseline adherence (low versus medium and high). Several secondary outcomes (e.g. evaluation of drug-related problems (DRPs)) were also assessed. Results Data from 153 (V1) and 140 (V2) patients were analysed. Baseline adherence was low, moderate and high in 17.6, 48.4 and 34.0% patients, respectively. In the low adherence subpopulation, test group patients showed a 1.20 point (95% CI = 0.16–2.25) increase in total ©MMAS-8 score (p = 0.025) compared to control group patients. A 0.84 point (95% CI = 0.05–1.63) increase was due to intentional non-adherence (p = 0.038), and a 0.36 point (95% CI = − 0.23-0.95) was due to unintentional non-adherence (p = 0.226). Additionally, statistically significant decrease in the proportion of patients with manifested DRPs (p < 0.001) and concerns regarding chronic medicines use (p = 0.029) were revealed. Conclusion MUR service in Slovenia improves low medication adherence and is effective in addressing DRPs and concerns regarding chronic medicines use. Trial registration ClinicalTrials.gov - NCT04417400; 4th June 2020; retrospectively registered.

Cost of Dementia and Its Correlation With Dependence

2016 ◽  
Vol 28 (8) ◽  
pp. 1448-1464 ◽  
Author(s):  
Örjan Åkerborg ◽  
Andrea Lang ◽  
Anders Wimo ◽  
Anders Sköldunger ◽  
Laura Fratiglioni ◽  
...  
Keyword(s):  
Cognitive Ability ◽  
Resource Utilization ◽  
Annual Cost ◽  
Neuropsychiatric Symptoms ◽  
Dementia Care ◽  
Cost Of Care ◽  
Path Model ◽  
National Study ◽  
Strong Impact ◽  
The Impact

Objective: To estimate the cost of dementia care and its relation to dependence. Method: Disease severity and health care resource utilization was retrieved from the Swedish National Study on Aging and Care. Informal care was assessed with the Resource Utilization in Dementia instrument. A path model investigates the relationship between annual cost of care and dependence, cognitive ability, functioning, neuropsychiatric symptoms, and comorbidities. Results: Average annual cost among patients diagnosed with dementia was €43,259, primarily incurred by accommodation. Resource use, that is, institutional care, community care, and accommodation, and corresponding costs increased significantly by increasing dependency. Path analysis showed that cognitive ability, functioning, and neuropsychiatric symptoms were significantly correlated with dependence, which in turn had a strong impact on annual cost. Discussion: This study confirms that cost of dementia care increases with dependence and that the impact of other disease indicators is mainly mediated by dependence.

Group Counseling for English Language Learners to Promote Academic Navigational Capital

2020 ◽  
Vol 24 (1) ◽  
pp. 2156759X2097956
Author(s):  
Adonay A. Montes ◽  
Erika Ramos
Keyword(s):  
English Language Learners ◽  
Language Learners ◽  
Group Counseling ◽  
English Language Learner ◽  
English Language ◽  
Language Learner ◽  
Ell Students ◽  
Academic Settings ◽  
The Impact ◽  
Minimal Research

The purpose of this study was to explore the impact of an 8-week academic navigational capital group with English language learner (ELL) students. Minimal research exists examining ELL students’ acquisition of navigational capital skills (skills needed to navigate and succeed in academic settings) in school. We used a pre- and postintervention survey to measure the impact of the group. Results showed growth in the academic navigational capital skills of all participants. Such increases represent a starting blueprint to consider when working with ELL students.

scholarly journals Spillover Effect of Global Financial Cycle To Asset Markets in Asean-5 Countries: A Structural VAR Approach

2018 ◽  
Vol 2 (02) ◽  
pp. 1
Author(s):  
Sri Andaiyani ◽  
Telisa Aulia Falianty
Keyword(s):  
Risk Aversion ◽  
Capital Flows ◽  
Asset Prices ◽  
Emerging Market ◽  
Structural Var ◽  
Asset Markets ◽  
Equity Prices ◽  
Financial Cycle ◽  
Property Prices ◽  
The Impact

<p><em>An upsurge and volatility of capital flows to Emerging Asian Economies indicated that there is the potential effect of global financial cycle to emerging market. It provides an overview of investor risk aversion in short term investment after financial crisis 2008. Global financial cycle could have a significant impact to asset prices, including equity prices and property prices. Rey (2015) has triggered an interesting discussion about global financial cycle. She found that there was a global financial cycle in capital flows, asset prices and credit growth. This cycle was co</em><em>‐</em><em>moves with the VIX, a measure of uncertainty and risk aversion of the markets. Therefore, this study attempts to analyze empirically global financial cycle shocks, measured by the VIX, on equity prices and property prices in ASEAN-5, namely Indonesia, Malaysia, Singapore, Thailand and Philippines. We estimate quarterly frequency data from Q1 1990 to Q2 2016 with Structural Vector Autoregressive (SVAR) approach. The result of this study showed that global financial cycle has a negative significant impact on the ASEAN-5 asset markets, in spite of the response of shock differs by country and size. This result is consistent with ASEAN-5 as small open economies that remain vulnerable to the global factor. This study contributes to the literature in several ways. First, we identify not only cyclical expansions or contraction in asset markets but also the impact of global financial cycle to asset markets in ASEAN-5 countries. Second, we investigate whether there are heterogeneous responses of ASEAN-5 countries to global financial cycle shocks. Third, we also identify the pattern of cycle in ASEAN-5 countries</em>.</p><p><strong><em>J</em></strong><strong><em>EL Classification: </em></strong>F30, F37, F42</p><strong><em>Keywords: </em></strong><em>ASEAN, Asset Markets, Global Financial Cycle, SVAR</em>

scholarly journals Large-scale application of the flood damage model RAilway Infrastructure Loss (RAIL)

2016 ◽  
Vol 16 (11) ◽  
pp. 2357-2371 ◽  
Author(s):  
Patric Kellermann ◽  
Christine Schönberger ◽  
Annegret H. Thieken
Keyword(s):  
Risk Management ◽  
Risk Aversion ◽  
Flood Risk ◽  
Structural Damage ◽  
Large Scale ◽  
Damage Model ◽  
Flood Damage ◽  
Railway Infrastructure ◽  
Increased Risk ◽  
The Impact

Abstract. Experience has shown that river floods can significantly hamper the reliability of railway networks and cause extensive structural damage and disruption. As a result, the national railway operator in Austria had to cope with financial losses of more than EUR 100 million due to flooding in recent years. Comprehensive information on potential flood risk hot spots as well as on expected flood damage in Austria is therefore needed for strategic flood risk management. In view of this, the flood damage model RAIL (RAilway Infrastructure Loss) was applied to estimate (1) the expected structural flood damage and (2) the resulting repair costs of railway infrastructure due to a 30-, 100- and 300-year flood in the Austrian Mur River catchment. The results were then used to calculate the expected annual damage of the railway subnetwork and subsequently analysed in terms of their sensitivity to key model assumptions. Additionally, the impact of risk aversion on the estimates was investigated, and the overall results were briefly discussed against the background of climate change and possibly resulting changes in flood risk. The findings indicate that the RAIL model is capable of supporting decision-making in risk management by providing comprehensive risk information on the catchment level. It is furthermore demonstrated that an increased risk aversion of the railway operator has a marked influence on flood damage estimates for the study area and, hence, should be considered with regard to the development of risk management strategies.

scholarly journals Deep–sequence phylogenetics to quantify patterns of HIV transmission in the context of a universal testing and treatment trial — BCPP/ Ya Tsie trial

2021 ◽  
Author(s):  
Lerato E Magosi ◽  
Yinfeng Zhang ◽  
Tanya Golubchick ◽  
Victor De Gruttola ◽  
Eric J Tchetgen Tchetgen ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
Population Level ◽  
Treatment As Prevention ◽  
Population Mobility ◽  
Mobility Patterns ◽  
Test And Treat ◽  
Hiv Intervention ◽  
Universal Test ◽  
Universal Test And Treat ◽  
The Impact

Mathematical models predict that community–wide access to HIV testing–and–treatment can rapidly and substantially reduce new HIV infections. Yet several large universal test–and–treat HIV prevention trials in high–prevalence epidemics demonstrated variable reduction in population–level incidence. To elucidate patterns of HIV spread in universal test–and–treat trials we quantified the contribution of geographic–location, gender, age and randomized–HIV–intervention to HIV transmissions in the 30–community Ya Tsie trial in Botswana (estimated trial population: 175,664). Deep–sequence phylogenetic analysis revealed that most inferred HIV transmissions within the trial occurred within the same or between neighboring communities, and between similarly–aged partners. Transmissions into intervention communities from control communities were more common than the reverse post–baseline (30% [12.2 – 56.7] versus 3% [0.1 – 27.3]) than at baseline (7% [1.5 – 25.3] versus 5% [0.9 – 22.9]) compatible with a benefit from treatment–as–prevention. Our findings suggest that population mobility patterns are fundamental to HIV transmission dynamics and to the impact of HIV control strategies.

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