Site of service trend and chemotherapy costs of commercial insured patients in 2020 compared to 2014.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18858-e18858
Author(s):  
Rogelio Alberto Brito ◽  
Kevin Hastings ◽  
Elisea Avalos-Reyes
Keyword(s):  
Outpatient Setting ◽  
Published Data ◽  
Significant Shift ◽  
Office Setting ◽  
Hospital Outpatient ◽  
The Past ◽  
Cost Differential ◽  
Insured Patients ◽  
The Impact ◽  
Care Costs

e18858 Background: Over the past decade, chemotherapy site of service has shifted from the physician’s office setting to the hospital outpatient setting. This trend has led to a concern that cancer care costs increase when patients are administered chemotherapy in the hospital outpatient setting (H) compared to a physician’s outpatient office setting (O). In 2014, we published data on the impact of site of service and chemotherapy costs. The purpose of this study is to evaluate the site of service trend and cost differential in a Commercial Insured (CI) population over time. Methods: We examined (CI) claims paid for chemotherapy by a large national payor from February 2019 through January 2020 for breast, colon, and lung cancer (BCL) patients. We then compared these changes to our July 2013 through June 2014 chemotherapy paid claims for BCL patients. Results: From February 2019 through January 2020, paid chemotherapy claims for approximately 23,000 unique patients with BCL had an increase of 23% from 2014. For all patients receiving chemotherapy with BCL, 56% received chemotherapy in the H setting and 44% received chemotherapy in the O setting. This was a significant shift from 2014 where 24% received chemotherapy in H and 76% in O settings. In 2020, the chemotherapy allowable reimbursement share was 67% for H and 33% in the O, a change from 2014 where the chemotherapy allowable reimbursement share was 34% in H and 66% in O. The overall cost per patient increased 57% from 2014 to 2020. When examining costs per patient by site of service, there was a statistically significant increase in H costs from $35,460 to $45,273 (p < 0.0001) per patient and a statistically significant increase in O costs from $21,577 to $28,270 (p < 0.0001) per patient treated in 2014 compared to 2020. Conclusions: In this study, the majority of BCL patients received chemotherapy in the H; this trend has led to substantially higher costs of care for patients treated with chemotherapy in the H compared to the O. Future studies are needed to determine the impact of clinical characteristics, genetic factors and treatment choice on these differences.

The Organic carbon content of gravel bed herring spawning grounds and the impact of herring spawn deposition

1993 ◽  
Vol 73 (4) ◽  
pp. 863-870 ◽  
Author(s):  
Ian R. Napier
Keyword(s):  
Organic Carbon ◽  
Carbon Content ◽  
Dry Weight ◽  
Published Data ◽  
Organic Carbon Content ◽  
Spawning Grounds ◽  
The Past ◽  
Benthic Food ◽  
The Impact

The dry weight and organic carbon content of eggs and components of Clyde spring herring eggs were measured at intervals during their development. Comparison with previously published data suggests that an increase has occurred in the weight of these eggs over the past thirty years. It is clear that only a small proportion of the material deposited in the form of herring spawn actually remains attached to the substratum when the larvae hatch and so is available for potential integration into the benthic food web. This was confirmed by the determination at intervals over two years of the organic carbon content of the gravel sediments on spawning grounds of the Clyde spring herring. Although the deposition of herring spawn resulted in an immediate marked increase in the carbon content of the spawning ground sediments, carbon levels quickly returned to pre-spawning levels and there was no evidence of any permanent or long lasting increase. This held true when the spawn died and decayed in situ and even when it was mixed into the sediment by wave action. The rapid decrease in carbon levels is attributed to the strong water movements which frequently occur over the spawning grounds.

scholarly journals THE ROLE OF WOMEN EMPOWERMENT TOWARDS HOUSEHOLD POVERTY REDUCTION: EVIDENCE FROM PUNJAB, PAKISTAN

2021 ◽  
Vol 9 (3) ◽  
pp. 384-397
Author(s):  
Ambreen Sarwar ◽  
Mumtaz Anwar Chaudhry
Keyword(s):  
Factor Analysis ◽  
Structural Equation ◽  
Poverty Reduction ◽  
Primary Data ◽  
Equation Modeling ◽  
Published Data ◽  
Women Empowerment ◽  
The Past ◽  
Household Poverty ◽  
The Impact

Purpose of the study: This study intends to examine the impact of various dimensions of women empowerment on multiple constituents of household poverty in the three cities (Lahore, Multan and, Rawalpindi) of province Punjab, Pakistan. Methodology: The primary data was gathered from a sample of 2400 married and employed females belonging to the three cities of Punjab, Pakistan. For analysis, the study develops its own all-embracing Women Empowerment and Household Poverty variables using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) and examines the relationship between the empowerment of women and household poverty using structural equation modeling (SEM). Main Findings: The results show that women empowerment positively and significantly contributes towards household poverty reduction. Applications of this study: Since poverty is one of the greatest challenges that Pakistan is facing today, the need to change poor standards of living and inspiring women to contribute effectively to society through their active participation in the development process is the dire need of time. The results of the study suggest that in addition to targeting poverty directly, policies should be devised that eradicate poverty through the empowerment of women. Novelty/Originality of this study: The majority of the past studies have limited generalizability because they use already available surveys/published data, having limited dimensions/indicators of women empowerment and household poverty. Moreover, the past studies that have examined the phenomenon of women empowerment ignore its psychological dimensions. Therefore, because of minimal comprehensive investigation, the examination of the effect of the empowerment of women on household poverty remains a topic of interest for the researchers.

scholarly journals COVID-19 scenarios for comparing the effectiveness of age-specific vaccination regimes, exemplified for the city of Aschaffenburg (Germany)

2021 ◽  
Author(s):  
Tobias Krebs ◽  
Holger von Jouanne-Diedrich ◽  
Michael J Moeckel
Keyword(s):  
Local Population ◽  
Age Groups ◽  
The Elderly ◽  
Strong Increase ◽  
Published Data ◽  
Model Parameters ◽  
Agent Based ◽  
The Past ◽  
The Impact ◽  
The City

Purpose of this report: The purpose of this rapid communication is to illustrate the effectiveness of different vaccination regimes for controlling the number of severe and critical COVID-19 cases in the city of Aschaffenburg, Germany. Our results show that, despite numerous vaccinations in the past, further vaccinations are necessary to immunize the population and to keep the number of severe and critical cases low in the coming months. Considering that not all people can or want to receive vaccination, we compare different age-specific vaccination approaches. Applied Methods: We use the agent-based epidemiological simulator Covasim for discussing the impact of different vaccination strategies. We calibrate it to reproduce the historical course of the COVID-19 pandemic in the city of Aschaffenburg, Germany; for this, we model and integrate numerous public health interventions imposed on the local population. As for some of the political actions rigorous quantification is currently not available, we fit those unknown (free) model parameters to published data on the measured epidemiological dynamics. Then we calculate the state of immunization of the population, gained through infections and vaccinations, at any time in the past, including models for time-dependent immunity decay that have been made available in Covasim. Finally, we define and compare scenar-ios of different vaccination regimes, especially with regard to vaccinating adolescents and providing booster vaccinations to the elderly. Key message: Without further vaccinations, we expect a strong increase in severe and critical cases. In order to restrict their growth our simulations suggest that in all considered cases vaccinations of unvaccinated people is more effective than booster vaccinations for already fully vaccinated people. This applies even to vaccinations of young people who are not themselves at high risk of developing severe or critical illness. We attribute this observation to the fact that immunization of adolescents indirectly protects vulnerable age groups by preventing the spread of the virus more ef-fectively than further immunizing other age groups. This indicates that with the pandemic ongoing, strategies focussed on minimizing individual health risks by vaccinations may no longer coincide with those needed to minimize the num-ber of severe and critical cases.

scholarly journals Tsunamis in the Greek Region: An Overview of Geological and Geomorphological Evidence

Geosciences ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 4
Author(s):  
Anna Karkani ◽  
Niki Evelpidou ◽  
Maria Tzouxanioti ◽  
Alexandros Petropoulos ◽  
Marilia Gogou ◽  
...  
Keyword(s):  
Active Regions ◽  
Mitigation Measures ◽  
Published Data ◽  
Public Authorities ◽  
The Past ◽  
Significant Research ◽  
Tectonically Active ◽  
The Impact ◽  
Greek Region ◽  
Made In

The Greek region is known as one of the most seismically and tectonically active areas and it has been struck by some devastating tsunamis, with the most prominent one being the 365 AD event. During the past decade significant research efforts have been made in search of geological and geomorphological evidence of palaeotsunamis along the Greek coasts, primarily through the examination of sediment corings (72% of studies) and secondarily through boulders (i.e., 18%). The published data show that some deposits have been correlated with well-known events such as 365 AD, 1303 AD, the Minoan Santorini Eruption and the 1956 Amorgos earthquake and tsunami, while coastal studies from western Greece have also reported up to five tsunami events, dating as far back as the 6th millennium BC. Although the Ionian Islands, Peloponnese and Crete has been significantly studied, in the Aegean region research efforts are still scarce. Recent events such as the 1956 earthquake and tsunami and the 2020 Samos earthquake and tsunami highlight the need for further studies in this region, to better assess the impact of past events and for improving our knowledge of tsunami history. As Greece is amongst the most seismically active regions globally and has suffered from devastating tsunamis in the past, the identification of tsunami prone areas is essential not only for the scientific community but also for public authorities to design appropriate mitigation measures and prevent tsunami losses in the future.

The Breastfeeding-Friendly Pediatric Office Practice

2018 ◽  
pp. 10-18
Author(s):  
Joan Younger Meek ◽  
Amy J. Hatcher
Keyword(s):  
Outpatient Setting ◽  
Pediatric Care ◽  
First Year ◽  
Clinical Report ◽  
Care Providers ◽  
Breastfeeding Support ◽  
Office Setting ◽  
Office Practice ◽  
The Past ◽  
First Year Of Life

The landscape of breastfeeding has changed over the past several decades as more women initiate breastfeeding in the postpartum period and more hospitals are designated as Baby-Friendly Hospitals by following the evidence-based Ten Steps to Successful Breastfeeding. The number of births in such facilities has increased more than sixfold over the past decade. With more women breastfeeding and stays in the maternity facilities lasting only a few days, the vast majority of continued breastfeeding support occurs in the community. Pediatric care providers evaluate breastfeeding infants and their mothers in the office setting frequently during the first year of life. The office setting should be conducive to providing ongoing breastfeeding support. Likewise, the office practice should avoid creating barriers for breastfeeding mothers and families or unduly promoting infant formula. This clinical report aims to review practices shown to support breastfeeding that can be implemented in the outpatient setting, with the ultimate goal of increasing the duration of exclusive breastfeeding and the continuation of any breastfeeding.

Fluorescent potentiometric dyes for membrane-potential imaging

1994 ◽  
Vol 52 ◽  
pp. 166-167
Author(s):  
Leslie M. Loew
Keyword(s):  
Membrane Potential ◽  
Single Cells ◽  
Quantitative Imaging ◽  
Optical Recording ◽  
Biological Processes ◽  
Major Focus ◽  
The Past ◽  
Excitable Systems ◽  
Major Application ◽  
The Impact

A major application of potentiometric dyes has been the multisite optical recording of electrical activity in excitable systems. After being championed by L.B. Cohen and his colleagues for the past 20 years, the impact of this technology is rapidly being felt and is spreading to an increasing number of neuroscience laboratories. A second class of experiments involves using dyes to image membrane potential distributions in single cells by digital imaging microscopy - a major focus of this lab. These studies usually do not require the temporal resolution of multisite optical recording, being primarily focussed on slow cell biological processes, and therefore can achieve much higher spatial resolution. We have developed 2 methods for quantitative imaging of membrane potential. One method uses dual wavelength imaging of membrane-staining dyes and the other uses quantitative 3D imaging of a fluorescent lipophilic cation; the dyes used in each case were synthesized for this purpose in this laboratory.

Perceived Burden of Informal Caregivers of a Chronically Ill Older Family Member

GeroPsych ◽  
2011 ◽  
Vol 24 (3) ◽  
pp. 143-154 ◽  
Author(s):  
Elmar Gräßel ◽  
Raffaela Adabbo
Keyword(s):  
Family Member ◽  
Informal Caregiver ◽  
Chronically Ill ◽  
Stress Model ◽  
The Past ◽  
Perceived Burden ◽  
Hypothetical Construct ◽  
Care Situation ◽  
The Impact ◽  
Further Development

The burden of caregivers has been intensively researched for the past 30 years and has resulted in a multitude of individual findings. This review illustrates the significance of the hypothetical construct of perceived burden for the further development and design of the homecare situation. Following explanations regarding the term informal caregiver, we derive the construct burden from its conceptual association with the transactional stress model of Lazarus and Folkman. Once the extent and characteristics of burden have been set forth, we then present the impact of perceived burden as the care situation. The question of predictors of burden will lead into the last section from which implications can be derived for homecare and relief of caregivers.

Soziale Disziplinierung im flexiblen Kapitalismus

2004 ◽  
Vol 34 (136) ◽  
pp. 339-356
Author(s):  
Tobias Wölfle ◽  
Oliver Schöller
Keyword(s):  
Social Welfare ◽  
Second Step ◽  
Social Rights ◽  
Federal Law ◽  
Capitalist Development ◽  
The Core ◽  
The Past ◽  
The Impact ◽  
Municipal Level

Under the term “Hilfe zur Arbeit” (aid for work) the federal law of social welfare subsumes all kinds of labour disciplining instruments. First, the paper shows the historical connection of welfare and labour disciplining mechanisms in the context of different periods within capitalist development. In a second step, against the background of historical experiences, we will analyse the trends of “Hilfe zur Arbeit” during the past two decades. It will be shown that by the rise of unemployment, the impact of labour disciplining aspects of “Hilfe zur Arbeit” has increased both on the federal and on the municipal level. For this reason the leverage of the liberal paradigm would take place even in the core of social rights.

Regulatory and sustainability initiatives lead to improved polyaminopolyamide epichlorohydrin (PAE) wet-strength resins and paper products

TAPPI Journal ◽  
2018 ◽  
Vol 17 (09) ◽  
pp. 519-532 ◽  
Author(s):  
Mark Crisp ◽  
Richard Riehle
Keyword(s):  
Health And Safety ◽  
Cost Effective ◽  
Worker Safety ◽  
Regulatory Requirements ◽  
Wet Strength ◽  
The Past ◽  
Consumer Safety ◽  
Federal Institute ◽  
Sustainability Initiatives ◽  
The Impact

Polyaminopolyamide-epichlorohydrin (PAE) resins are the predominant commercial products used to manufacture wet-strengthened paper products for grades requiring wet-strength permanence. Since their development in the late 1950s, the first generation (G1) resins have proven to be one of the most cost-effective technologies available to provide wet strength to paper. Throughout the past three decades, regulatory directives and sustainability initiatives from various organizations have driven the development of cleaner and safer PAE resins and paper products. Early efforts in this area focused on improving worker safety and reducing the impact of PAE resins on the environment. These efforts led to the development of resins containing significantly reduced levels of 1,3-dichloro-2-propanol (1,3-DCP) and 3-monochloropropane-1,2-diol (3-MCPD), potentially carcinogenic byproducts formed during the manufacturing process of PAE resins. As the levels of these byproducts decreased, the environmental, health, and safety (EH&S) profile of PAE resins and paper products improved. Recent initiatives from major retailers are focusing on product ingredient transparency and quality, thus encouraging the development of safer product formulations while maintaining performance. PAE resin research over the past 20 years has been directed toward regulatory requirements to improve consumer safety and minimize exposure to potentially carcinogenic materials found in various paper products. One of the best known regulatory requirements is the recommendations of the German Federal Institute for Risk Assessment (BfR), which defines the levels of 1,3-DCP and 3-MCPD that can be extracted by water from various food contact grades of paper. These criteria led to the development of third generation (G3) products that contain very low levels of 1,3-DCP (typically <10 parts per million in the as-received/delivered resin). This paper outlines the PAE resin chemical contributors to adsorbable organic halogens and 3-MCPD in paper and provides recommendations for the use of each PAE resin product generation (G1, G1.5, G2, G2.5, and G3).

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