scholarly journals Modelling to inform the COVID-19 response in Bangladesh

2021 ◽  
Author(s):  
Elaine A Ferguson ◽  
Eric Brum ◽  
Anir Chowdhury ◽  
Shayan Chowdhury ◽  
Mikolaj Kundegorski ◽  
...  
Keyword(s):  
Scale Up ◽  
Cost Effective ◽  
Filtration Efficiency ◽  
Potential Outcomes ◽  
Case Detection ◽  
Effective Response ◽  
Seir Model ◽  
Death Data ◽  
Pharmaceutical Interventions

AbstractBackgroundNon-pharmaceutical interventions (NPIs) used to limit SARS-CoV-2 transmission vary in their feasibility, appropriateness and effectiveness in different contexts. In Bangladesh a national lockdown implemented after the first detected case in early March 2020 rapidly exacerbated poverty and was considered untenable long-term, whilst surging cases in 2021 warrant renewed NPIs. We examine potential outcomes and costs of NPIs considered appropriate and feasible to deploy in Dhaka over the course of the pandemic including challenges of compliance and scale up.MethodsWe developed an SEIR model for application to Dhaka District, parameterised from literature values and calibrated to death data from Bangladesh. We discussed scenarios and parameterizations with policymakers using an interactive app, to guide modelling of lockdown and post-lockdown measures considered feasible to deliver; symptoms-based household quarantining and compulsory mask-wearing. We examined how testing capacity affects case detection and compared deaths, hospitalisations relative to capacity, working days lost from illness and NPI compliance, and cost-effectiveness.ResultsLockdowns alone were predicted to delay the first epidemic peak but were unable to prevent overwhelming of the health service and were extremely costly. Predicted impacts of post-lockdown interventions depended on their reach within communities and levels of compliance: symptoms-based household quarantining alone was unable to prevent hospitalisations exceeding capacity whilst mask-wearing could prevent overwhelming health services and be cost-effective given masks of high filtration efficiency. The modelled combination of these measures was most effective at preventing excess hospitalizations for both medium and high filtration efficiency masks. Even at maximum testing capacity, confirmed cases far underestimate total cases, with saturation limiting reliability for assessing trends. Recalibration to surging cases in 2021 suggests limited immunity from previous infections and the need to re-sensitize communities to increase mask wearing.ConclusionsMasks and symptoms-based household quarantining act synergistically to prevent transmission, and are cost-effective in mitigating impacts. Our interactive app was valuable in supporting decision-making in Bangladesh, where mask-wearing was mandated early, and community teams have been deployed to support household quarantining across Dhaka. This combination of measures likely contributed to averting the worst impacts of a public health disaster as predicted under an unmitigated epidemic, but delivering an effective response at scale has been challenging. Moreover, lack of protection to the B.1.351 variant means messaging to improve mask-wearing is urgently needed in response to surging cases.

scholarly journals Assessing the Sustainability and Acceptance Rate of Cost-Effective Household Water Treatment Systems in Rural Communities of Makwane Village, South Africa

Crystals ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 872
Author(s):  
Resoketswe Charlotte Moropeng ◽  
Maggy Ndombo Benteke Momba
Keyword(s):  
Water Treatment ◽  
Scale Up ◽  
Cost Effective ◽  
Acceptance Rate ◽  
Target Area ◽  
Household Water Treatment ◽  
Biosand Filter ◽  
Point Of Use ◽  
Household Water

The current study investigated the acceptance rate and long-term effectiveness of cost-effective household water treatment systems deployed in Makwane Village. A structured questionnaire was used prior to implementation to collect information such as level of education, level of employment, and knowledge about point-of-use water treatment systems in the target area. The long-term effectiveness was determined by factors such as the Escherichia coli removal efficiency, turbidity reduction, silver leached, and flow rate of the household water treatment devices. The results of the survey prior to deployment revealed that only 4.3% of the community had a tertiary qualification. Moreover, 54.3% of the community were unemployed. The results further revealed that 65.9% of the community were knowledgeable about other point-of-use water treatment methods. The acceptance rate, which was found to be initially higher (100%), reduced after three months of implantation (biosand filter with zeolite-silver clay granular—82.9%; silver-impregnated porous pot filters—97.1%). Moreover, the long-term effectiveness was determined, taking into consideration the adoption rate, and it was found that silver-impregnated porous pot filters have a long life compared to biosand filter with zeolite-silver clay granular. Although household water treatment systems can effectively reduce the burden of waterborne diseases in impoverished communities, the success of adoption is dependent on the targeted group. This study highlights the significance of involving community members when making the decision to scale up household water treatment devices in rural areas for successful adoption.

scholarly journals Dynamical SPQEIR model assesses the effectiveness of non-pharmaceutical interventions against COVID-19 epidemic outbreaks

2020 ◽  
Author(s):  
Daniele Proverbio ◽  
Françoise Kemp ◽  
Stefano Magni ◽  
Andreas Husch ◽  
Atte Aalto ◽  
...  
Keyword(s):  
Decision Makers ◽  
Contact Tracing ◽  
Online Tool ◽  
Seir Model ◽  
Social Distancing ◽  
Quantitative Understanding ◽  
Cross Country ◽  
Pharmaceutical Interventions

AbstractAgainst the current COVID-19 pandemic, governments worldwide have devised a variety of non-pharmaceutical interventions to suppress it, but the efficacy of distinct measures is not yet well quantified. In this paper, we propose a novel tool to achieve this quantification. In fact, this paper develops a new extended epidemic SEIR model, informed by a socio-political classification of different interventions, to assess the value of several suppression approaches. First, we inquire the conceptual effect of suppression parameters on the infection curve. Then, we illustrate the potential of our model on data from a number of countries, to perform cross-country comparisons. This gives information on the best synergies of interventions to control epidemic outbreaks while minimising impact on socio-economic needs. For instance, our results suggest that, while rapid and strong lock-down is an effective pandemic suppression measure, a combination of social distancing and contact tracing can achieve similar suppression synergistically. This quantitative understanding will support the establishment of mid- and long-term interventions, to prepare containment strategies against further outbreaks. This paper also provides an online tool that allows researchers and decision makers to interactively simulate diverse scenarios with our model.

Physical and Psychological Benefits of Written Emotional Expression

2015 ◽  
Vol 20 (4) ◽  
pp. 242-251 ◽  
Author(s):  
Éva Kállay
Keyword(s):  
Mental Health ◽  
Expressive Writing ◽  
Mental Health Problems ◽  
Cost Effective ◽  
Health Problems ◽  
Future Research ◽  
Psychological Benefits ◽  
Cost Effective Treatment ◽  
Meta Analyses

Abstract. The last several decades have witnessed a substantial increase in the number of individuals suffering from both diagnosable and subsyndromal mental health problems. Consequently, the development of cost-effective treatment methods, accessible to large populations suffering from different forms of mental health problems, became imperative. A very promising intervention is the method of expressive writing (EW), which may be used in both clinically diagnosable cases and subthreshold symptomatology. This method, in which people express their feelings and thoughts related to stressful situations in writing, has been found to improve participants’ long-term psychological, physiological, behavioral, and social functioning. Based on a thorough analysis and synthesis of the published literature (also including most recent meta-analyses), the present paper presents the expressive writing method, its short- and long-term, intra-and interpersonal effects, different situations and conditions in which it has been proven to be effective, the most important mechanisms implied in the process of recovery, advantages, disadvantages, and possible pitfalls of the method, as well as variants of the original technique and future research directions.

Antithrombotic Therapy for DVT/PE

1997 ◽  
Vol 17 (03) ◽  
pp. 161-162
Author(s):  
Thomas Hyers
Keyword(s):  
Molecular Weight ◽  
Low Molecular Weight Heparin ◽  
Oral Anticoagulants ◽  
Cost Effective ◽  
Therapeutic Agents ◽  
Great Promise ◽  
Term Therapy ◽  
Low Molecular Weight ◽  
Long Term Therapy

SummaryProblems with unfractionated heparin as an antithrombotic have led to the development of new therapeutic agents. Of these, low molecular weight heparin shows great promise and has led to out-patient therapy of DVT/PE in selected patients. Oral anticoagulants remain the choice for long-term therapy. More cost-effective ways to give oral anticoagulants are needed.

Strategic planning in grassland farming: Principles andapplications

1997 ◽  
pp. 191-197
Author(s):  
W.J. Parker ◽  
N.M. Shadbolt ◽  
D.I. Gray
Keyword(s):  
Strategic Planning ◽  
Performance Indicators ◽  
Cost Effective ◽  
Key Performance Indicators ◽  
Strategic Plans ◽  
Effective Manner ◽  
Farm Business ◽  
Pastoral Farming ◽  
Financial Environment

Three levels of planning can be distinguished in grassland farming: strategic, tactical and operational. The purpose of strategic planning is to achieve a sustainable long-term fit of the farm business with its physical, social and financial environment. In pastoral farming, this essentially means developing plans that maximise and best match pasture growth with animal demand, while generating sufficient income to maintain or enhance farm resources and improvements, and attain personal and financial goals. Strategic plans relate to the whole farm business and are focused on the means to achieve future needs. They should be routinely (at least annually) reviewed and monitored for effectiveness through key performance indicators (e.g., Economic Farm Surplus) that enable progress toward goals to be measured in a timely and cost-effective manner. Failure to link strategy with control is likely to result in unfulfilled plans. Keywords: management, performance

Deep Controlled Source Electro-Magnetic Sensing: A Cost Effective, Long-Term Tool for Sequestration Monitoring

2017 ◽  
Author(s):  
Douglas LaBrecque ◽  
◽  
Russell D. Brigham ◽  
Conny Schmidt-Hattenburger ◽  
Evan Um ◽  
...  
Keyword(s):  
Cost Effective ◽  
Magnetic Sensing ◽  
Controlled Source ◽  
Electro Magnetic

From Start-Up to Scale-Up

2018 ◽  
Author(s):  
Gilles Duruflé ◽  
Thomas Hellmann ◽  
Karen Wilson
Keyword(s):  
United States ◽  
Conceptual Framework ◽  
Public Policies ◽  
Scale Up ◽  
The United States ◽  
Smart Money ◽  
Start Up ◽  
The Us ◽  
The Creation

This chapter examines the challenge for entrepreneurial companies of going beyond the start-up phase and growing into large successful companies. We examine the long-term financing of these so-called scale-up companies, focusing on the United States, Europe, and Canada. The chapter first provides a conceptual framework for understanding the challenges of financing scale-ups. It emphasizes the need for investors with deep pockets, for smart money, for investor networks, and for patient money. It then shows some data about the various aspects of financing scale-ups in the United States, Europe, and Canada, showing how Europe and Canada are lagging behind the US relatively more at the scale-up than the start-up stage. Finally, the chapter raises the question of long-term public policies for supporting the creation of a better scale-up environment.

scholarly journals Adopt, adapt, or abandon technology-supported person-centred care initiatives: healthcare providers’ beliefs matter

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kari Dyb ◽  
Gro Rosvold Berntsen ◽  
Lisbeth Kvam
Keyword(s):  
Information Technologies ◽  
Scale Up ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Analytical Framework ◽  
Development Project ◽  
Technology Support ◽  
Care Needs ◽  
Term Care

Abstract Background Technology support and person-centred care are the new mantra for healthcare programmes in Western societies. While few argue with the overarching philosophy of person-centred care or the potential of information technologies, there is less agreement on how to make them a reality in everyday clinical practice. In this paper, we investigate how individual healthcare providers at four innovation arenas in Scandinavia experienced the implementation of technology-supported person-centred care for people with long-term care needs by using the new analytical framework nonadoption, abandonment, and challenges to the scale-up, spread, and sustainability (NASSS) of health and care technologies. We also discuss the usability and sensitivity of the NASSS framework for those seeking to plan, implement, and evaluate technology-supported healthcare programmes. This study is part of an interdisciplinary research and development project called Patients and Professionals in Partnership (2016–2020). It originates at one of ten work packages in this project. Method The main data consist of ethnographic field observations at the four innovation arenas and 29 interviews with involved healthcare providers. To ensure continuous updates and status on work in the four innovation arenas, we have also participated in a total of six annual network meetings arranged by the project. Results While the NASSS framework is very useful for identifying and communicating challenges with the adoption and spread of technology-supported person-centred care initiatives, we found it less sensitive towards capturing the dedication, enthusiasm, and passion for care transformation that we found among the healthcare providers in our study. When it comes to technology-supported person-centred care, the point of no return has passed for the involved healthcare providers. To them, it is already a definite part of the future of healthcare services. How to overcome barriers and obstacles is pragmatically approached. Conclusion Increased knowledge about healthcare providers and their visions as potential assets for care transformation might be critical for those seeking to plan, implement, and evaluate technology-supported healthcare programmes.

scholarly journals Anti-meningococcal B vaccination in Italian adolescents: a cost-effective health opportunity

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Panatto ◽  
P Landa ◽  
D Amicizia ◽  
P L Lai ◽  
E Lecini ◽  
...  
Keyword(s):  
Large Scale ◽  
Public Health Problem ◽  
Vaccination Strategy ◽  
Cost Effective ◽  
Dose Schedule ◽  
Developed Countries ◽  
Invasive Disease ◽  
International Setting ◽  
The Impact

Abstract Background Invasive disease due to Neisseria meningitidis (Nm) is a serious public health problem even in developed countries, owing to its high lethality rate (8-15%) and the invalidating sequelae suffered by many (up to 60%) survivors. As the microorganism is transmitted via the airborne route, the only available weapon in the fight against Nm invasive disease is vaccination. Our aim was to carry out an HTA to evaluate the costs and benefits of anti-meningococcal B (MenB) vaccination with Trumenba® in adolescents in Italy, while also considering the impact of this new vaccination strategy on organizational and ethics aspects. Methods A lifetime Markov model was developed. MenB vaccination with the two-dose schedule of Trumenba® in adolescents was compared with 'non-vaccination'. Two perspectives were considered: the National Health Service (NHS) and society. Three disease phases were defined: acute, post-acute and long-term. Epidemiological, economic and health utilities data were taken from Italian and international literature. The analysis was conducted by means of Microsoft Excel 2010®. Results Our study indicated that vaccinating adolescents (11th year of life) with Trumenba® was cost-effective with an ICER = € 7,912/QALY from the NHS perspective and € 7,758/QALY from the perspective of society. Vaccinating adolescents reduces the number of cases of disease due to meningococcus B in one of the periods of highest incidence of the disease, resulting in significant economic and health savings. Conclusions This is the first study to evaluate the overall impact of free MenB vaccination in adolescents both in Italy and in the international setting. Although cases of invasive disease due to meningococcus B are few, if the overall impact of the disease is adequately considered, it becomes clear that including anti-meningococcal B vaccination into the immunization program for adolescents is strongly recommended from the health and economic standpoints. Key messages Free, large-scale MenB vaccination is key to strengthening the global fight against invasive meningococcal disease. Anti-meningococcal B vaccination in adolescents is a cost-effective health opportunity.

scholarly journals Trends and Clinico-Epidemiological Features of Human Rabies Cases in Bangladesh, 2006–2018

2020 ◽  
Vol 41 (S1) ◽  
pp. s416-s416
Author(s):  
Sumon Ghosh ◽  
Md. Sohel Rana ◽  
Sukanta Chowdhury
Keyword(s):  
Effective Means ◽  
Scale Up ◽  
Traditional Healers ◽  
Human Rabies ◽  
Epidemiological Analysis ◽  
Increasing Trend ◽  
The Mean ◽  
Death Cases ◽  
Death Data

Background: Vaccinating dogs against rabies is an effective means of reducing human rabies. Methods: We analyzed 1,327 clinically diagnosed human rabies deaths and mass dog vaccination (MDV) data during 2006–2018 to quantify the impacts of MDV on human rabies incidence in Bangladesh and a subset of rabies death data (n = 422) for clinico-epidemiological analysis. Results: We found a positive and increasing trend of dog population vaccination (P = .01 and τ = 0.71) and a negative and declining trend (P < .001 and τ = −0.88) of human rabies cases (correlation coefficient, −0.82). Among 422 human rabies death cases, most victims (78%) sought treatment from traditional healers, and 12% received postexposure prophylaxis (PEP). The mean incubation period of rabies cases with exposure sites on the head and neck (35 days) was shorter than the upper limb (mean, 64 days; P = .02) and lower limb (mean, 89 days; P < .01). MDV is effective for reducing human rabies cases in Bangladesh. Conclusions: Creating awareness among the animal bite victims to stop relying on traditional healers rather seeking PEP, addressing the role of traditional healers through an awareness education program in respect to the treatment of dog bites, ensuring availability of PEP, and continuing to scale up MDV can help prevent human rabies deaths.Funding: NoneDisclosures: None

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