scholarly journals Managing chronic, nonhealing wounds stalled in the inflammatory phase: a case series using a novel matrix therapy, CACIPLIQ20

2019 ◽  
Vol 24 (Sup9) ◽  
pp. S33-S37
Author(s):  
Sally Irving
Keyword(s):  
Heparan Sulphate ◽  
Healthcare Providers ◽  
Case Series ◽  
Cost Effective ◽  
Evidence Base ◽  
Conventional Care ◽  
Inflammatory Phase ◽  
Healing Wounds ◽  
The Uk ◽  
First Time

One of the biggest challenges faced by healthcare providers is the treatment of chronic, non-healing wounds. This paper reports for the first time in the UK the results of five case studies in which a novel regenerating matrix-based therapy, CACIPLIQ20, was used. CACIPLIQ20 is a heparan sulphate mimetic designed to replace the destroyed heparan sulphate in the extracellular matrix of wound cells. All five patients in this case series had chronic, non-healing ulcers that had not improved with conventional care. Treatment included two applications of CACIPLIQ20 per week, for a maximum of 12 weeks. Three of the five wounds healed completely, and the remaining two showed significant improvements in size and quality. The treatment was well tolerated by the patients and also led to a significant reduction in pain. Moreover, CACIPLIQ20 treatment was found to be highly cost-effective when compared to conventional care, with the potential to save healthcare systems significant resources. Further studies are needed to build a strong evidence base on the use of this product, but these preliminary findings are certainly promising.

scholarly journals Self-fill oxygen technology: benefits for patients, healthcare providers and the environment

Breathe ◽  
2016 ◽  
Vol 12 (2) ◽  
pp. 113-119 ◽  
Author(s):  
Phyllis Murphie ◽  
Nick Hex ◽  
Jo Setters ◽  
Stuart Little
Keyword(s):  
Positive Impact ◽  
Healthcare Providers ◽  
Cost Savings ◽  
Cost Effective ◽  
Evidence Base ◽  
Environmental Benefits ◽  
List Type ◽  
Potential Cost ◽  
Unlimited Supply ◽  
Technology Benefits

“Non-delivery” home oxygen technologies that allow self-filling of ambulatory oxygen cylinders are emerging. They can offer a relatively unlimited supply of ambulatory oxygen in suitably assessed people who require long-term oxygen therapy (LTOT), providing they can use these systems safely and effectively. This allows users to be self-sufficient and facilitates longer periods of time away from home. The evolution and evidence base of this technology is reported with the experience of a national service review in Scotland (UK). Given that domiciliary oxygen services represent a significant cost to healthcare providers globally, these systems offer potential cost savings, are appealing to remote and rural regions due to the avoidance of cylinder delivery and have additional lower environmental impact due to reduced fossil fuel consumption and subsequently reduced carbon emissions. Evidence is emerging that self-fill/non-delivery oxygen systems can meet the ambulatory oxygen needs of many patients using LTOT and can have a positive impact on quality of life, increase time spent away from home and offer significant financial savings to healthcare providers.Educational aimsProvide update for oxygen prescribers on options for home oxygen provision.Provide update on the evidence base for available self-fill oxygen technologies.Provide and update for healthcare commissioners on the potential cost-effective and environmental benefits of increased utilisation of self-fill oxygen systems.

scholarly journals Reconceptualising fair access to highly academically selective universities

2021 ◽  
Author(s):  
Vikki Boliver ◽  
Pallavi Banerjee ◽  
Stephen Gorard ◽  
Mandy Powell
Keyword(s):  
Higher Education ◽  
Social Background ◽  
Procedural Fairness ◽  
Evidence Base ◽  
Highly Qualified ◽  
Distributive Fairness ◽  
Selective Universities ◽  
The Uk ◽  
First Time ◽  
Fair Access

AbstractThe higher education regulator for England has set challenging new widening access targets requiring universities to rethink how merit is judged in admissions. Universities are being encouraged to move away from the traditional meritocratic equality of opportunity model of fair access, which holds that university places should go to the most highly qualified candidates irrespective of social background, in accordance with the principles of procedural fairness. Instead, they are being asked to move towards what we term the meritocratic equity of opportunity model, which holds that prospective students’ qualifications should be judged in light of the socioeconomic circumstances in which these were obtained to enhance distributive fairness, a practice known in the UK as contextualised admissions. In this paper, we critically discuss the theoretical underpinnings of these two competing perspectives on fair access and review the existing empirical evidence base, drawing together for the first time insights from our ESRC and Nuffield Foundation funded studies of fair access to highly academically selective universities in England. We argue that reconceptualising fair access in terms of distributive fairness rather than procedural fairness offers a more socially just set of principles on which to allocate valuable but scarce places at the most academically selective universities in England, unless or until such time as the vertical stratification of higher education institutions is reduced or eliminated entirely.

Brief alcohol interventions – everybody's business

2008 ◽  
Vol 14 (6) ◽  
pp. 469-476 ◽  
Author(s):  
Billy Boland ◽  
Colin Drummond ◽  
Eileen Kaner
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Heavy Drinking ◽  
Significant Risk ◽  
Cost Effective ◽  
Evidence Base ◽  
Excessive Alcohol Consumption ◽  
Alcohol Interventions ◽  
Cost Effective Method ◽  
The Uk

Heavy drinking poses a significant risk to public health in the UK. Opportunistic screening and brief interventions offer a cost-effective method of reducing the harm related to excessive alcohol consumption at both an individual and a public health level. Given the high prevalence of alcohol misuse among patients attending mental health services and its impact on behaviour and health, professionals need to be skilled in identifying and treating these problems in all areas of mental health. There is also a need for effective joint working between mental health and specialist addiction services. This article describes the principles and evidence base for brief alcohol interventions, and methods of implementation in health settings.

scholarly journals Supporting Formulary Decisions: The Discovery of New Facts or Constructed Evidence?

2016 ◽  
Vol 7 (2) ◽  
Author(s):  
Paul C Langley
Keyword(s):  
Cost Effectiveness ◽  
Lifetime Cost ◽  
Cost Effective ◽  
Evidence Base ◽  
Normal Science ◽  
Critical Question ◽  
Reference Case ◽  
Life Years ◽  
The One ◽  
The Uk

A critical question, given the growing importance of more targeted therapies to support personalized and precision medicine, is the credibility of the evidence base to support formulary decisions and pricing. On the one hand, for those who subscribe to the reference case model of the National Institute of Health and Care Excellence (NICE) in the UK, the decision rests upon the creation of modeled or simulated imaginary worlds and the application of threshold willingness-to-pay cost-per-QALY thresholds. On the other hand, for those who subscribe to the standards of normal science, the decision rests upon the ability to evaluate competing claims, both clinical and cost-effective, in a timeframe that is meaningful to a formulary committee. If we subscribe to the scientific method where the focus is on the discovery of new facts, untestable claims for clinical benefit and cost-effectiveness, such as created claims for lifetime cost per-quality-adjusted discounted life years (QALYs), are properly relegated to the category of pseudoscience. We have no idea, and will never know, whether the claims are right or even if they are wrong. If formulary decisions are to respect the standards of normal science then there has to be a commitment to claims evaluation. A willingness to accept new products provisionally, subject to an agreed protocol to support the evaluation of clinical and cost-effectiveness claims. This dichotomy between the standards of normal science and pseudoscience is explored in the context of published claims for cost-effectiveness and recommendations for product pricing in the US.   Type: Commentary

scholarly journals The advance of research governance in psychiatry: one step forward, two steps back

2013 ◽  
Vol 22 (4) ◽  
pp. 313-320 ◽  
Author(s):  
V. C. Leeson ◽  
P. Tyrer
Keyword(s):  
Mental Health ◽  
Health Research ◽  
Cost Effective ◽  
Evidence Base ◽  
Research Governance ◽  
Additional Time ◽  
Start Date ◽  
Effective Interventions ◽  
Health Studies ◽  
The Uk

Purpose.To investigate the reasons behind difficulties in recruiting patients to randomized controlled trials (RCTs) in psychiatry and to examine a database of RCTs for differences between studies in mental health and other specialities.Methods.A discussion of recent changes in research governance in the UK and Europe followed by an examination of the database of all trials supported by the Health Technology Assessment programme of the National Institute of Health Research in the UK between 1993 and 2007 to determine if three different measures, (i) time between grant approval and study start date, (ii) percentage of additional time given to extend recruitment and (iii) percentage of planned recruitment achieved, changed over the time period studied and differed between mental health, cancer and other medical disciplines.Findings.Despite attempts in the UK to accelerate the process of clinical trials in recent years, there was a significant increase in the extension time for trials to be completed (p = 0.038) and the percentage of planned recruitment to mental health studies (71%) was significantly less than for cancer (90.3%) and other studies (86.1%) (p = 0.032).Summary.These results suggest that, despite the priority afforded to the advancement of RCTs in healthcare, such studies are encountering increasing difficulty in recruiting to time and target. We suggest that this difficulty can be attributed, at least in part, to the excessively byzantine regulation and governance processes for health research in the UK, and unnecessary bureaucracy in the current National Health Service system. Mental health studies appear particularly vulnerable to delay and better systems to facilitate recruitment are required urgently for the evidence base to be improved and facilitate new cost-effective interventions.

Is Yoga an Effective Treatment for Low Back Pain: A Research Review

2009 ◽  
Vol 19 (1) ◽  
pp. 103-112 ◽  
Author(s):  
Zena Kelly
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Effective Treatment ◽  
Healthcare Providers ◽  
Case Series ◽  
Holistic Approach ◽  
Evidence Base ◽  
Research Review ◽  
Low Back ◽  
And Function

Low back pain is a significant health problem. Current conventional medical interventions seem largely ineffective and do not address the contributing issues of low back pain in a comprehensive or holistic manner. The holistic approach of Yoga makes it an ideal intervention for low back pain, as it addresses the multifactorial physical, psychological, and social factors associated with low back pain. The objectives of this research review were to (1) identify all relevant published studies that identify Yoga as an intervention for low back pain; (2) draw conclusions about whether Yoga is an effective treatment for low back pain and comparable to other interventions; and (3) summarize interventions used in studies to better inform practitioners, healthcare providers, and researchers about how Yoga may be used to treat low back pain. Seven studies were identified: five moderate- to high-quality randomized controlled trials (RCTs) and two case series. Participants of six out of the seven studies had chronic low back pain with a duration of greater than three months. The main outcome measures were disability questionnaires and pain. Styles of Yoga included Anusara, Iyengar, Viniyoga, a combined intervention of Yoga and Pilates, and Hatha Yoga, not further specified.The findings of this review suggest that Yoga has a positive effect on low back pain and function, with effects comparable to education combined with aerobic and strengthening exercise and more effective than education alone or no treatment. Yoga may provide an inexpensive and easily accessible way for those with low back pain to manage their symptoms. However, the small number of studies prevents definite conclusions from being drawn. This demonstrates a need to increase the evidence base through larger, well-designed RCTs in this area.

Update on Dialysis Economics in the UK

2011 ◽  
Vol 31 (2_suppl) ◽  
pp. 58-62 ◽  
Author(s):  
Adnan Sharif ◽  
Keshwar Baboolal
Keyword(s):  
Renal Failure ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Healthcare Providers ◽  
Significant Proportion ◽  
Cost Effective ◽  
Treatment Modalities ◽  
Cost Effective Treatment ◽  
The Uk

The burgeoning population of patients requiring renal replacement therapy contributes a disproportionate strain on National Health Service resources. Although renal transplantation is the preferred treatment modality for patients with established renal failure, achieving both clinical and financial advantages, limitations to organ donation and clinical comorbidities will leave a significant proportion of patients with established renal failure requiring expensive dialysis therapy in the form of either hemodialysis or peritoneal dialysis. An understanding of dialysis economics is essential for both healthcare providers and clinical leaders to establish clinically efficient and cost-effective treatment modalities that maximize service provision. In light of changes to the provision of healthcare funds in the form of “Payment by Results,” it is imperative for UK renal units to adopt clinically effective and financially accountable dialysis programs. This article explores the role of dialysis economics and implications for UK renal replacement therapy programs.

scholarly journals Poverty and child health in the UK: using evidence for action

2016 ◽  
Vol 101 (8) ◽  
pp. 759-766 ◽  
Author(s):  
Sophie Wickham ◽  
Elspeth Anwar ◽  
Ben Barr ◽  
Catherine Law ◽  
David Taylor-Robinson
Keyword(s):  
Child Health ◽  
Child Poverty ◽  
Evidence Base ◽  
Poor Health ◽  
Life Chances ◽  
Wide Range ◽  
Outcomes For Children ◽  
The Uk ◽  
The Impact ◽  
First Time

There are currently high levels of child poverty in the UK, and for the first time in almost two decades child poverty has started to rise in absolute terms. Child poverty is associated with a wide range of health-damaging impacts, negative educational outcomes and adverse long-term social and psychological outcomes. The poor health associated with child poverty limits children's potential and development, leading to poor health and life chances in adulthood. This article outlines some key definitions with regard to child poverty, reviews the links between child poverty and a range of health, developmental, behavioural and social outcomes for children, describes gaps in the evidence base and provides an overview of current policies relevant to child poverty in the UK. Finally, the article outlines how child health professionals can take action by (1) supporting policies to reduce child poverty, (2) providing services that reduce the health consequences of child poverty and (3) measuring and understanding the problem and assessing the impact of action.

Exploring the Benefits of Early Contractor Involvement (ECI) and the Mechanism for Automated 5D BIM Quantification Process in Offsite Modular Construction

2016 ◽  
Author(s):  
Tochukwu Moses ◽  
David Heesom ◽  
David Oloke ◽  
Martin Crouch
Keyword(s):  
Effective Means ◽  
Cost Effective ◽  
Modular Construction ◽  
Automated Quantification ◽  
Building Information ◽  
Project Risks ◽  
Value Add ◽  
The Uk ◽  
The Impact ◽  
Level 2

The UK Construction Industry through its Government Construction Strategy has recently been mandated to implement Level 2 Building Information Modelling (BIM) on public sector projects. This move, along with other initiatives is key to driving a requirement for 25% cost reduction (establishing the most cost-effective means) on. Other key deliverables within the strategy include reduction in overall project time, early contractor involvement, improved sustainability and enhanced product quality. Collaboration and integrated project delivery is central to the level 2 implementation strategy yet the key protocols or standards relative to cost within BIM processes is not well defined. As offsite construction becomes more prolific within the UK construction sector, this construction approach coupled with BIM, particularly 5D automated quantification process, and early contractor involvement provides significant opportunities for the sector to meet government targets. Early contractor involvement is supported by both the industry and the successive Governments as a credible means to avoid and manage project risks, encourage innovation and value add, making cost and project time predictable, and improving outcomes. The contractor is seen as an expert in construction and could be counter intuitive to exclude such valuable expertise from the pre-construction phase especially with the BIM intent of äóÖbuild it twiceäó», once virtually and once physically. In particular when offsite construction is used, the contractoräó»s construction expertise should be leveraged for the virtual build in BIM-designed projects to ensure a fully streamlined process. Building in a layer of automated costing through 5D BIM will bring about a more robust method of quantification and can help to deliver the 25% reduction in overall cost of a project. Using a literature review and a case study, this paper will look into the benefits of Early Contractor Involvement (ECI) and the impact of 5D BIM on the offsite construction process.

Green Synthesis and Spectroscopic Studies of Ag-rGO Nanocomposites for Highly Selective Mercury (II) Sensing

2018 ◽  
Vol 9 (1) ◽  
pp. 101-108 ◽  
Author(s):  
Shubhangi J. Mane-Gavade ◽  
Sandip R. Sabale ◽  
Xiao-Ying Yu ◽  
Gurunath H. Nikam ◽  
Bhaskar V. Tamhankar
Keyword(s):  
Green Synthesis ◽  
Color Change ◽  
Limit Of Detection ◽  
Aqueous Media ◽  
Suitable Condition ◽  
Cost Effective ◽  
Spectroscopic Studies ◽  
Calibration Plot ◽  
First Time

Introduction: Herein we report the green synthesis and characterization of silverreduced graphene oxide nanocomposites (Ag-rGO) using Acacia nilotica gum for the first time. Experimental: We demonstrate the Hg2+ ions sensing ability of the Ag-rGO nanocomposites form aqueous medium. The developed colorimetric sensor method is simple, fast and selective for the detection of Hg2+ ions in aqueous media in presence of other associated ions. A significant color change was noticed with naked eye upon Hg2+ addition. The color change was not observed for cations including Sr2+, Ni2+, Cd2+, Pb2+, Mg2+, Ca2+, Fe2+, Ba2+ and Mn2+indicating that only Hg2+ shows a strong interaction with Ag-rGO nanocomposites. Under the most suitable condition, the calibration plot (A0-A) against concentration of Hg2+ was linear in the range of 0.1-1.0 ppm with a correlation coefficient (R2) value 0.9998. Results & Conclusion The concentration of Hg2+ was quantitatively determined with the Limit of Detection (LOD) of 0.85 ppm. Also, this method shows excellent selectivity towards Hg2+ over nine other cations tested. Moreover, the method offers a new cost effective, rapid and simple approach for the detection of Hg2+ in water samples.

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