scholarly journals The cost effective role of Eschmarch tourniquet and psychosocial awareness of disease as a key factor in decompressive therapy of filarial lymphedema

2019 ◽  
Vol 6 (8) ◽  
pp. 2895
Author(s):  
Arun Y. Mane ◽  
Narendra G. Naik
Keyword(s):  
Job Insecurity ◽  
Cost Effective ◽  
Secondary Lymphedema ◽  
The People ◽  
Key Factor ◽  
Effective Role ◽  
The Cost ◽  
Pitting Edema

Background: The filiariasis is the most common cause of secondary lymphedema of the lower limb. Due to poor awareness of this disease in the people of the lower socioeconomic strata, the patient understands the importance of conservative modality of therapy very late. The cutaneous changes and its complications develop in patient due to unawareness about the nature of noncurable progressive disease. The self-negligence to their own limb also contributes to increase in the morbidity of the disease. The article discusses about cost effective role of Eschmarch tourniquet as a decompressive therapy. The disease causes socioeconomic impairments, stigmatization due to elephantiasis and job insecurity due to cosmetic and functional disability.Methods: This was a retrospective study done in 28 cases of filarial lymphedema. All patients received limb elevation and decompressive therapy by Eschmarch tourniquet.Results: Out of 28 cases, 14 cases in study group of filarial lymphedema with pitting edema (71.42%) and non-pitting edema feet with minimal cutaneous changes (28.57%) showed significant reduction in size of limb girth and satisfactory fluctuating limb girth during the follow up period in OPD respectively, by adequate limb elevation, elastic stockinet and decompressive therapy by Eschmarch tourniquet as compared to the remaining 14 patients of control who received only limb elevation. The better follow up results are noticed by proper guidance to the patient about the disease and its conservative modality of treatment.Conclusions: It is a challenge for the treating consultant to create early awareness about the nature of the filarial disease and early guidance about the conservative treatment which helps to restrict the rapid growth of limb size in filiariatic lymphedema. The eschmarch tourniquet is one of the cost effective decompressive therapy. 

Is Acupuncture for Pain Relief in General Practice Cost-Effective?

1999 ◽  
Vol 17 (2) ◽  
pp. 97-100 ◽  
Author(s):  
Steven Lindall
Keyword(s):  
General Practice ◽  
Pain Relief ◽  
Acupuncture Treatment ◽  
Cost Effective ◽  
Total Saving ◽  
Hospital Outpatient ◽  
The Cost ◽  
Lost To Follow Up ◽  
Practice Cost

Sixty-five selected patients with pain, mainly of musculo-skeletal origin, were offered treatment by a qualified medical acupuncturist in his general practice surgery as an alternative to hospital outpatient referral. The patients assessed their own outcomes on a digital scale: there were 46 successful treatments and 14 failures, with 5 being lost to follow up. The cost of acupuncture treatment was compared to that of the referral that would have been made if acupuncture had not been offered. The acupuncture was found to have cost £10,943 against a minimum likely cost for hospital referrals of £26,783. A minimum total saving for all 60 patients of £13,916 was determined, giving an average saving per patient of £232. Additional hidden savings through avoiding further hospital procedures and expenditure on medication were not taken into account. It is concluded that acupuncture in selected patients and when used by an appropriately qualified practitioner appears to be a cost-effective therapy for use in general practice, reducing the need for more expensive hospital referrals.

scholarly journals INCREASE IN THE ROLE OF PHARMACIST AS A PROFESSIONAL UNDER THE CONDITIONS OF THE BOLOGNA SYSTEM IN UKRAINE

2014 ◽  
Vol 2 ◽  
pp. 319-322
Author(s):  
Vitaliy Moskalenko ◽  
Iryna Nizhenkovskaya ◽  
Elena Welchinska
Keyword(s):  
Cost Effective ◽  
Healthcare Spending ◽  
Healthcare Management ◽  
Public Health Care ◽  
Public Healthcare ◽  
State Agencies ◽  
High Quality Education ◽  
Technological Advances ◽  
The Cost

Countries worldwide are facing similar healthcare problems.  Medicine develops new methods for treatment, and pharmaceutical companies invent more efficient products.  These technological advances are, however, expensive, and put a double-strain on public healthcare spending: the cost of sophisticated treatment keeps growing, and improved healthcare allows patients to live longer, thus requiring more treatment.  Budgetary constraints, however, require government to restrict expenditure.  These challenges have to be answered in the context of existing public healthcare systems, which, are well established and complex.  Healthcare reforms will necessarily reflect these characteristics, as well as the relative political weight of the partners.  Such reforms will most likely affect all partners involved in the provision and healthcare management, including social security institutions (state agencies, sickness funds, etc.), doctors, and other health professionals—pharmacists.  Currently one of most important strategic tasks of modernization of the system of higher education in Ukraine is the high quality education provided to pharmacists in order to satisfy the worldwide needs.Whatever specific reform will be adopted, the main goals are to make the system more efficient and, thus, more cost effective; and, because the first aspect will not sufficiently decrease the expenditure, it is necessary to limit the scope of public health care while maintaining a balance of benefits.  

scholarly journals Nine Recommendations for the Safety on Road both of the People and the Traffic Police

2018 ◽  
Vol 1 (01) ◽  
pp. 79-85
Author(s):  
Madhur Dev Bhattarai
Keyword(s):  
Cost Effective ◽  
Road Accident ◽  
Public Hospitals ◽  
Occupational Hazards ◽  
Traffic Police ◽  
The Road ◽  
The People ◽  
On The Road ◽  
The Cost ◽  
Injured Patients

Safety of people and traffic police on road and the provision of prompt and appropriate treatment of injured persons in road accident are urgent concerns. The nine recommendations accordingly made are 1) Considering anyone who informs about or brings to the hospitals the accident victims as innocent until proved otherwise, 2) Annual payment by all vehicle owners (as per the cost of vehicles) to generate treatment fund for any road accident injured patients in the free general (not paying or private or extended health service) outdoor or emergency clinics or ward of the public hospitals irrespective of anyone’ fault in the accident (insurance or other agencies may be assigned to handle the amount deposited and reimbursement of the payments to the hospitals), 3) Implementation of helmet wearing by motorcycle riders and pillion riders in motorcycles, 4) Stricter fine for hazardous traffic offenses, 5) Drivers of the larger vehicles should not automatically be held responsible for any accidents involving other smaller vehicles (to prevent smaller vehicles and motorcycles to drive recklessly), 6) Drivers should not be just held responsible to bear health expenses of injured patients (which is much more than the compensation required in the event of death of injured persons); this is to encourage drivers to take injured persons immediately to hospitals and prevent inclination to allow their deaths indirectly or directly; the drivers should be proportionately fined or punished as per the traffic regulations if they are found to be negligent, 7) Safe and visible platform for the traffic police to stay on the road, 8) Provision of cost-effective respirators for traffic police and traffic supervisors, and 9) Compensation for occupational hazards to the traffic police and field traffic supervisors by distributing to them adequate proportion (e.g. one-third to one-half) of the fund collected by stricter fine paid for the hazardous traffic offences. Provision of various allowances, including for hazards, and benefits is a common practice in the country. Compensation for the occupational hazards of the traffic police provides incentives to and motivates them to remain vigilant about hazardous traffic offenses day and night everywhere and, thus, is essential for the safety of the people.   

Effective Pharmacist led interventional strategies to improve outcomes in hypertensive patients: a narrative review

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Samra Bashir ◽  
Akash Syed
Keyword(s):  
Pharmaceutical Care ◽  
Cost Effective ◽  
Pharmacist Intervention ◽  
Care Plan ◽  
Hypertensive Patients ◽  
Disease Outcomes ◽  
Cost Effective Alternative ◽  
The Impact

The role of pharmacist intervention as a cost-effective alternative to physician in disease management is increasingly been recognized. Studies have demonstrated that pharmaceutical care can improve drug therapy as well as patient satisfaction in chronic health conditions including cardiovascular diseases. This study is aimed to review and outline a comprehensive pharmaceutical care plan from the randomized controlled trials previously conducted to assess the impact of pharmacist-managed care on disease outcomes in hypertensive patients. Compared with usual care, the pharmaceutical intervention involved patient evaluation, patient education and counselling, medication review and management, patient monitoring and follow-up, and feedback to the primary physician as major strategies.

Do Americans View Financial Threats as Important Political Issues?

2015 ◽  
Author(s):  
Adam Seth Levine
Keyword(s):  
Time Series Data ◽  
Job Insecurity ◽  
Time Frame ◽  
Study Data ◽  
Series Data ◽  
Daily Lives ◽  
Political Issues ◽  
The People ◽  
National Election Study ◽  
The Cost

This chapter describes in greater detail the objective situation facing Americans in four major areas of financial threats: job insecurity, healthcare costs, retirement, and the cost of college. It analyzes the politics of such threats among the mass public. It examines the extent to which the people who consider such issues important are facing them in their own daily lives, as opposed to a situation in which their concerns are reflective of what others are facing. The data for this chapter are drawn from several sources, including time series data from Gallup beginning in the early 1950s as well as American National Election Study data from the past three decades that (broadly) match the time frame in which the objective situation in these four areas has become more insecure.

Abstract 21: Telemedicine And The Barbershop Model Of Hypertension Care For Black Men

Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
Ciantel A Blyler ◽  
Mohamad Rashid ◽  
Norma B Moy ◽  
Kayslee A Kemp ◽  
Florian Rader
Keyword(s):  
Blood Pressure ◽  
Los Angeles ◽  
Black Men ◽  
Medication Management ◽  
Cost Effective ◽  
Serious Adverse Events ◽  
Blood Pressure Study ◽  
Collaborative Practice Agreement ◽  
The Cost

Background: The Los Angeles Barbershop Blood Pressure Study (LABBPS) demonstrated both efficacy and sustainability of a new model of hypertension (HTN) care for non-Hispanic black men that links health promotion by barbers to medication management by specialty-trained pharmacists. Barriers to scaling the model include logistical inefficiencies that contribute to the cost of the intervention. Most notable was the amount of time pharmacists spent traveling between barbershops. To address this, we tested whether telemedicine (remote follow-up) could be substituted for in-person visits after blood pressure (BP) control was achieved. Methods: We enrolled 10 black male patrons with systolic BP ≥ 140 mm Hg in this proof-of-concept study in which barbers promoted follow-up with pharmacists who initially met each patron in the barbershop where they prescribed BP medication under a collaborative practice agreement with the patrons’ physician. Medications were titrated during bimonthly in-person visits to achieve a BP goal of ≤130/80 mmHg. Once BP goal was reached, monthly visits were done by videoconference while barbers assisted with BP checks. Final BP and safety outcomes were assessed at 12 months. Results: After exclusion of one participant who declined adherence, 9 patients completed the intervention. Baseline BP of 155 + 14 / 83 + 11 mmHg decreased by 29 + 13 / 8.9 + 15 mmHg (p<.0001), with eight participants (89%) achieving systolic control and seven (78%) diastolic control at 12 months. These new data are statistically indistinguishable from our previous LABBPS data (p=0.8 for both change in systolic BP and diastolic BP). Overall HTN control (≤ 130/80) was 67% (6 of 9), numerically greater than the 63% observed in LABBPS (p=N.S.). As intended, the mean number of in-person pharmacist visits per patron fell from 11 in LABBPS to 6.6 visits over 12 months. No treatment-related serious adverse events occurred. Cohort retention was 90%. Conclusions: Telemedicine represents a viable substitute for in-person visits, both improving pharmacist efficiency and reducing cost while preserving intervention potency. These findings are crucial for future broad-scale implementation efforts and development of cost-effective barbershop HTN management programs for black men.

Fundamentals of Electrostatic Spraying

2015 ◽  
pp. 461-490 ◽  
Author(s):  
Manoj Kumar Patel ◽  
Chirravoori Ghanshyam
Keyword(s):  
Cost Effective ◽  
Future Research ◽  
Electrostatic Spraying ◽  
Research Perspectives ◽  
The People ◽  
Agricultural Applications ◽  
Engineering Practices ◽  
Agriculture And Food ◽  
Uniform Deposition

The desired attributes of electrostatic spraying are uniform deposition onto both directly exposed or obscured crop surfaces which minimize the off-target losses of active ingredients to soil, water, atmosphere and provide more effective and economical pest control. This chapter presents an overview of electrostatic spraying technologies in the field of agriculture emphasizing the key role of advanced electrostatic instrumentation and chronicles the scientific innovations in the parlance of providing cost effective and reliable commercial systems along with an insight on the needs of future research perspectives and directives. It is aimed primarily at a familiarization with spraying concepts and engineering practices. This text is to bridge the knowledge and experience gap among researchers and technology developers and the people involved in electrostatic processes applied to agriculture and food processing. It will also introduce the engineering aspects of design and development of an electrostatic spraying nozzle for agricultural applications.

scholarly journals Routine blood cultures in the management of community acquired pneumonia; is it necessary?

2013 ◽  
Vol 1 (2) ◽  
pp. 54-57
Author(s):  
TM Ibrahim
Keyword(s):  
Case Fatality ◽  
Length Of Hospital Stay ◽  
Cost Effective ◽  
Antibiotic Use ◽  
Community Acquired Pneumonia ◽  
Blood Cultures ◽  
True Positive ◽  
It Use ◽  
The Cost

INTRODUCTION: The role of blood cultures (BCs) in the management of community acquired pneumonia (CAP) has generated a lot of controversy among clinicians in recent times. The main objectives of this audit were to determine if BC results impact the choice of antibiotics, and hospital outcomes in CAP. MATERIALS AND METHODS: This was a retrospective study of adults with CAP treated in the ED of Goulbourn Valley Base Hospital, Shepparton in Australia from November 2010 to November 2011. RESULTS: Two hundred and twenty five patients were treated for CAP during the period in review with a mean age of 67.09±19.82 yrs and male:female of 1.5:1. 277 sets of BCs were performed and only 2.2% of the cases had true positive BCs .87% of the total cost of performing these BCs was spent on those with negative cultres.15.1% of the cases had their antibiotics changed during their hospitalization but the results of the BCs had no impact on the antibiotic change. Even though not statistically significant true positive BCs was associated with prolong length of hospital stay (7.6 ± 9.39 days vs 4.89 ± 3.24 days, p=0.44), and duration of IV antibiotic use (4.8±3.27 days vs 3.58±1.97 days, p=0.39). But the case fatality rate was much lower in those with positive BCs, (0 vs 5.7%,p< 0.05). Tachycardia (>120.4±12.46 bpm), neutrophilia (15.0± 8.16 /ul), and high CRP (326.4±146.32 ug/l) were predictors of true positive BCs. CONCLUSIONS: Routine BCs in the management of CAP is not cost-effective with large portion of the cost spent on cultures that returned negative result .Therefore it use show be limited to those likely to return positive cultures. DOI: http://dx.doi.org/10.3126/ijim.v1i2.7408 Int J Infect Microbiol 2012;1(1):54-57

scholarly journals Occupational Stress and Its Economic Cost in Hong Kong: The Role of Positive Emotions

2020 ◽  
Vol 17 (22) ◽  
pp. 8601
Author(s):  
Oi Ling Siu ◽  
Cary L. Cooper ◽  
Lara C. Roll ◽  
Carol Lo
Keyword(s):  
Hong Kong ◽  
Occupational Stress ◽  
Positive Emotions ◽  
Job Insecurity ◽  
Economic Cost ◽  
Economic Costs ◽  
Job Stressors ◽  
Organizational Constraints ◽  
The Cost

There has been less research on the costs of occupational stress attributed to certain job stressors in Chinese contexts. This study identified and validated common job stressors and estimated the economic cost in Hong Kong. The role of positive emotions in alleviating the economic costs of job stressors was also examined. Both qualitative and quantitative approaches were adopted. The findings obtained from five focus group discussions and a survey validated five common job stressors: Job insecurity; quantitative workload; organizational constraints; interpersonal conflicts; and work/home interface. A total of 2511 employees were surveyed, with 2032 valid questionnaires returned (925 males, 1104 females, and 3 unidentified, whose ages ranged from 18 to 70 years). The economic costs were estimated by combining the costs of absenteeism, presenteeism, and medical expenses. Absenteeism mainly caused by job stressors of the work/home interface, job insecurity, and quantitative workload accounted for an annual economic cost of HK$550 million to HK$860 million. The annual economic cost due to presenteeism mainly caused by job stressors of job insecurity, interpersonal conflict, quantitative workload, and organizational constraints ranged from HK$1.373 billion to HK$2.146 billion. The cost of medical treatments associated with occupational stress was HK$2.889 billion to HK$4.083 billion. Therefore, the total annual economic cost of occupational stress was approximately HK$4.81 billion to HK$7.09 billion. Positive emotions, representing a less explored individual factor in the cost of occupational stress studies, was found to be negatively correlated with presenteeism and buffered the negative impact of job stressors on absenteeism. The theoretical contributions and practical implications of findings are discussed.

Cost-effectiveness of zoledronic (ZOL) acid plus endocrine therapy (ET) in premenopausal women with early breast cancer (EBC) from a Canadian perspective

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 557-557
Author(s):  
K. E. Ougari ◽  
C. Taneja ◽  
O. Sofrygin ◽  
S. Kaura ◽  
T. Delea
Keyword(s):  
Breast Cancer ◽  
Cost Effectiveness ◽  
Premenopausal Women ◽  
Cost Effective ◽  
System Perspective ◽  
Healthcare System Perspective ◽  
The Cost ◽  
Canadian Healthcare System ◽  
Canadian Healthcare

557 Background: The Austrian Breast and Colorectal Cancer Study Group Trial 12 (ABCSG-12) examined the efficacy of 3 years (yrs) of treatment with goserelin in combination with ET (anastrozole or tamoxifen) with or without ZOL 4 mg q6 mos in 1,803 premenopausal women with EBC (median age 45 yrs). After a median follow-up of 47.8 mos (max 84 mos), risk of disease-free survival (DFS) events was reduced by 36% (HR = 0.64; p = 0.01) in patients (pts) who received ZOL (ZOL+ET) compared with those who did not (ET). Methods: A Markov model was used to estimate the cost per quality adjusted life years (QALYs) gained of 3 years treatment duration of ZOL+ET versus ET-only in premenopausal women with EBC based on results of the ABCSG-12. A Canadian healthcare system perspective and a lifetime timeframe were used. Outcomes and cost of breast cancer recurrence were based on recent published studies. Results were generated under 2 scenarios regarding duration of benefit (reduction in risk of recurrence) with ZOL: (1) Benefits persist to maximum follow-up in ABCSG-12 (trial benefit); (2) Benefits persist until death (lifetime benefit). Results: The cost of 3 years of ZOL (medication and administration) is 4 191 $CDN. Under the lifetime benefit scenario, 73% of these costs are offset by savings in the cost of recurrences. Under the trial benefit scenario, 12% are offset. QALYs gained are 1.63 yrs and 0.52 yrs under the lifetime and trial benefit scenarios respectively; cost-effectiveness is 1 122 $CDN and 3 675 $CDN per QALY gained respectively, which is well below the 50 000 $CDN per QALY threshold frequently used to assess whether therapies are cost-effective. Conclusions: The combination of ZOL + ET is a cost-effective use of healthcare resources from a Canadian healthcare system perspective. [Table: see text]

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