Uptake Success and Cost Savings from Switching to a Two-Drug Antiretroviral Regimen

Author(s):  
Hartmut B. Krentz ◽  
Shayna Campbell ◽  
Morgan Lahl ◽  
M. John Gill
Keyword(s):  
Author(s):  
Richard S. Chemock

One of the most common tasks in a typical analysis lab is the recording of images. Many analytical techniques (TEM, SEM, and metallography for example) produce images as their primary output. Until recently, the most common method of recording images was by using film. Current PS/2R systems offer very large capacity data storage devices and high resolution displays, making it practical to work with analytical images on PS/2s, thereby sidestepping the traditional film and darkroom steps. This change in operational mode offers many benefits: cost savings, throughput, archiving and searching capabilities as well as direct incorporation of the image data into reports.The conventional way to record images involves film, either sheet film (with its associated wet chemistry) for TEM or PolaroidR film for SEM and light microscopy. Although film is inconvenient, it does have the highest quality of all available image recording techniques. The fine grained film used for TEM has a resolution that would exceed a 4096x4096x16 bit digital image.


2014 ◽  
Vol 222 (1) ◽  
pp. 37-48 ◽  
Author(s):  
Stephanie Romney ◽  
Nathaniel Israel ◽  
Danijela Zlatevski

The present study examines the effect of agency-level implementation variation on the cost-effectiveness of an evidence-based parent training program (Positive Parenting Program: “Triple P”). Staff from six community-based agencies participated in a five-day training to prepare them to deliver a 12-week Triple P parent training group to caregivers. Prior to the training, administrators and staff from four of the agencies completed a site readiness process intended to prepare them for the implementation demands of successfully delivering the group, while the other two agencies did not complete the process. Following the delivery of each agency’s first Triple P group, the graduation rate and average cost per class graduate were calculated. The average cost-per-graduate was over seven times higher for the two agencies that had not completed the readiness process than for the four completing agencies ($7,811 vs. $1,052). The contrast in costs was due to high participant attrition in the Triple P groups delivered by the two agencies that did not complete the readiness process. The odds of Triple P participants graduating were 12.2 times greater for those in groups run by sites that had completed the readiness process. This differential attrition was not accounted for by between-group differences in participant characteristics at pretest. While the natural design of this study limits the ability to empirically test all alternative explanations, these findings indicate a striking cost savings for sites completing the readiness process and support the thoughtful application of readiness procedures in the early stages of an implementation initiative.


2002 ◽  
Vol 41 (01) ◽  
pp. 3-13 ◽  
Author(s):  
M. Schäfers

SummaryNuclear cardiological procedures have paved the way for non-invasive diagnostics of various partial functions of the heart. Many of these functions cannot be visualised for diagnosis by any other method (e. g. innervation). These techniques supplement morphological diagnosis with regard to treatment planning and monitoring. Furthermore, they possess considerable prognostic relevance, an increasingly important issue in clinical medicine today, not least in view of the cost-benefit ratio.Our current understanding shows that effective, targeted nuclear cardiology diagnosis – in particular for high-risk patients – can contribute toward cost savings while improving the quality of diagnostic and therapeutic measures.In the future, nuclear cardiology will have to withstand mounting competition from other imaging techniques (magnetic resonance imaging, electron beam tomography, multislice computed tomography). The continuing development of these methods increasingly enables measurement of functional aspects of the heart. Nuclear radiology methods will probably develop in the direction of molecular imaging.


1996 ◽  
Vol 75 (03) ◽  
pp. 412-416 ◽  
Author(s):  
Armando D’Angelo ◽  
Gabriella D’Alessandro ◽  
Loredana Tomassini ◽  
Jean Louis Pittet ◽  
G Dupuy ◽  
...  

SummaryThe sensitivity and specificity for deep vein thrombosis (DVT) of a new rapid, quantitative and precise (total imprecision < 10%) D-dimer assay suitable for individual measurements (VIDAS D-DIMER, bio-Merieux, France) were evaluated in a consecutive series of 103 in- and out-patients submitted to serial compression ultrasonography (C-US) for the clinical suspicion of DVT (n = 66) or of DVT recurrence (n = 37) and symptoms lasting from 1 to 15 days. DVT was found in 22 patients at baseline testing and no patient with an initially negative C-US developed vein incompressibility at follow up. The time elapsed from the onset of symptoms was negatively associated with D-dimer levels both in patients with and in those without DVT. In the entire series of patients, the sensitivity of a positive D-dimer test (≥1.0 Μg/ml) for the presence of DVT was 96% (21/22 patients, 95% confidence interval 75-100%) with a specificity of 75% (64-84%), a negative predictive value of 98% (90-100%), a positive predictive value of 51% (35-67%), and an overall accuracy of 80% (70-87%). A normal D-dimer value (0.22 Μg/ml) was observed in one patient with DVT and symptoms lasting from 15 days. The approach of withholding C-US testing in patients with symptoms lasting from less than 11 days and D-dimer levels below the cut-off value was compared to serial C-US testing alone in a cost-effectiveness analysis subdividing the 66 patients with a first episode according to their clinical pretest probability of DVT. Thrombosis was detected in 6.7% of the patients in the low probability group (n = 15), 16.7% of the patients in the moderate probability group (n = 24), 51.9% of the patients in the high probability group (n = 27) and 8.1% of patients with suspected DVT recurrence. Calculated cost-savings for each DVT diagnosed ranged from 5% in the high pretest probability group to 55% in the low pretest probability group and to 77% in patients with suspected DVT recurrence.The safety of avoiding C-US testing in symptomatic patients with a negative D-dimer test should be evaluated in clinical management studies.


TAPPI Journal ◽  
2018 ◽  
Vol 17 (09) ◽  
pp. 507-515 ◽  
Author(s):  
David Skuse ◽  
Mark Windebank ◽  
Tafadzwa Motsi ◽  
Guillaume Tellier

When pulp and minerals are co-processed in aqueous suspension, the mineral acts as a grinding aid, facilitating the cost-effective production of fibrils. Furthermore, this processing allows the utilization of robust industrial milling equipment. There are 40000 dry metric tons of mineral/microfbrillated (MFC) cellulose composite production capacity in operation across three continents. These mineral/MFC products have been cleared by the FDA for use as a dry and wet strength agent in coated and uncoated food contact paper and paperboard applications. We have previously reported that use of these mineral/MFC composite materials in fiber-based applications allows generally improved wet and dry mechanical properties with concomitant opportunities for cost savings, property improvements, or grade developments and that the materials can be prepared using a range of fibers and minerals. Here, we: (1) report the development of new products that offer improved performance, (2) compare the performance of these new materials with that of a range of other nanocellulosic material types, (3) illustrate the performance of these new materials in reinforcement (paper and board) and viscosification applications, and (4) discuss product form requirements for different applications.


2013 ◽  
Vol 10 (2) ◽  
pp. 201-227 ◽  
Author(s):  
Norman Matloff

The two main reasons cited by the U.S. tech industry for hiring foreign workers--remedying labour shortages and hiring "the best and the brightest"--are investigated, using data on wages, patents, and R&D work, as well as previous research and industry statements. The analysis shows that the claims of shortage and outstanding talent are not supported by the data, even after excluding the Indian IT service firms. Instead, it is shown that the primary goals of employers in hiring  foreign workers are to reduce labour costs and to obtain "indentured" employees. Current immigration policy is causing an ‘Internal Brain Drain’ in STEM.


2012 ◽  
Vol 7 (1) ◽  
pp. 28
Author(s):  
Giovanni Amoroso ◽  

The concept of downsized catheters (i.e., using catheters smaller than 6 French) for invasive coronary procedures, such as diagnostic cardiac catheterisation and percutaneous coronary intervention, has been developing over the years, particularly as a result of the rise of the transradial approach. Recent advances have allowed the use of smaller and sheathless catheters, which confer a number of advantages – such as fewer vascular complications, reduced use of contrast agent and reduced haemostasis – thus increasing patient safety and comfort and allowing more rapid patient mobilisation. Reductions in patient complications, number and length of hospital stay, and amount of contrast agent used can also lead to cost savings. While the use of smaller catheters has been hindered in the past because of poor angiographic image quality, new automated contrast injectors have helped overcome this limitation. There is a need to make interventional cardiologists worldwide more aware of the benefits of downsizing, in the light of the latest technical developments and the increased use of transradial approach.


2010 ◽  
Vol 5 (1) ◽  
pp. 20 ◽  
Author(s):  
Tim A Fischell ◽  

Coronary artery stenting has evolved substantially since the first use of coronary stenting as an adjunct to balloon angioplasty in the early 1990s. The performance (and particularly the deliverability) of coronary stents has improved such that coronary stenting is now the primary mode of revascularisation for percutaneous coronary interventions (PCIs) in more than 95% of cases. The new Svelte™ stent-on-a-wire (SOAW) delivery system represents one of the first substantive innovations in stent delivery systems (SDS) in more than a decade. This SDS uses a shapeable ‘fixed wire’ as an integral part of the SDS. This allows a significant reduction in SDS profile (~0.029 inches) compared with conventional monorail or over-the-wire SDS. This SOAW SDS is intended to facilitate direct stenting. It has the potential to provide substantial procedural cost savings by eliminating the need for a coronary guidewire and balloon pre-dilatation and/or post-dilatation, and by reducing contrast use and the time required to complete the procedure. The SOAW system is compatible with 5Fr guiding catheters, and may reduce the need for closure devices, facilitate stenting via the radial approach and (potentially) reduce bleeding risks. In conclusion, the Svelte SOAW SDS represents a new very-low-profile balloon-expandable SDS that should promote direct stenting in PCIs. The efficiency and small profile of this SDS may allow procedural cost savings, a reduction in procedure time and a reduced risk of bleeding complications. These theoretical advantages will need to be demonstrated in clinical trials.


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