scholarly journals Cost Comparison of Rodent Soiled Bedding Sentinel and Exhaust Air Dust Health-Monitoring Programs

2020 ◽  
Vol 59 (5) ◽  
pp. 508-511
Author(s):  
Kerith R Luchins ◽  
Chago J Bowers ◽  
Darya Mailhiot ◽  
Betty R Theriault ◽  
George P Langan
Keyword(s):  
Health Monitoring ◽  
Cost Savings ◽  
Cost Comparison ◽  
Care Staff ◽  
Complete Replacement ◽  
Monitoring Programs ◽  
Increased Sensitivity ◽  
Veterinary Technicians ◽  
Animal Care ◽  
Multiple Pathogens

Rodent vivaria have traditionally used soiled bedding sentinel (SBS) health-monitoring programs to detect and exclude adventitious pathogens that could affect research results. Given the limitations of SBS, a likely reduction in animal usage, and a decrease in animal care staff labor, exhaust air dust (EAD) health monitoring has been evaluated by several groups for its efficacy in detecting pathogens when used as a complete replacement for traditional SBS health-monitoring programs. Compared with SBS, EAD has also been shown to provide increased sensitivity for the detection of multiple pathogens. After implementing EAD at our institution, we conducted an analysis to compare the annual costs of the 2 health-monitoring programs. The EAD program was found to be 26% less expensive than SBS. In addition to these cost savings, EAD decreased the amount of time spent by the staff on heath-monitoring activities. For veterinary technicians, this decrease in time was calculated as a savings of 150 h annually, almost 3 h each week. Finally, the EAD program replaced the use of live sentinel animals, decreasing the associated yearly usage from 1,676 animals to zero.

Clinical and Cost Comparison Evaluation of Inpatient Versus Outpatient Administration of EPOCH-Containing Regimens in Non-Hodgkin Lymphoma

2016 ◽  
Vol 30 (4) ◽  
pp. 400-405 ◽  
Author(s):  
Sarah S. Evans ◽  
Arpita S. Gandhi ◽  
Amber B. Clemmons ◽  
David L. DeRemer
Keyword(s):  
Chart Review ◽  
Hospital Admissions ◽  
Antiviral Agents ◽  
Cost Savings ◽  
Outpatient Setting ◽  
Primary Objective ◽  
Cost Comparison ◽  
Non Hodgkin Lymphoma ◽  
Institutional Review ◽  
Stimulating Factor

Background: Etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin (EPOCH)-containing regimens are frequently utilized in non-Hodgkin’s lymphoma, however, the incidence of febrile neutropenia (FN) in patients receiving inpatient versus outpatient EPOCH has not been described. Additionally, no comparisons have been made regarding financial implications of EPOCH administration in either setting. This study’s primary objective was to compare hospital admissions for FN in patients receiving inpatient or outpatient EPOCH. Methods: A single-center, institutional review board-approved review was conducted for adults receiving EPOCH beginning January 2010. Clinical and financial data were collected through chart review and the institution’s financial department. Descriptive statistics were utilized for analysis. Results: A total of 25 patients received 86 cycles of an EPOCH-containing regimen (61 [70.9%] inpatient). Five (8.2%) inpatient cycles resulted in an admission for FN compared to 4 (16%) outpatient cycles. Prophylactic antifungal and antiviral agents were prescribed more often after inpatient cycles (>80%) compared to outpatient cycles (<50%). Overall, 27 (31.4%) of 86 cycles did not receive granulocyte colony-stimulating factor support. Outpatient EPOCH administration was associated with a cost savings of approximately US$141 116 for both chemotherapy costs and hospital day avoidance. Conclusion: EPOCH-containing regimens can be safely administered in the outpatient setting, which may result in cost savings for healthcare institutions.

scholarly journals Characterizing abnormal behavior in a large population of zoo-housed chimpanzees: prevalence and potential influencing factors

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e2225 ◽  
Author(s):  
Sarah L. Jacobson ◽  
Stephen R. Ross ◽  
Mollie A. Bloomsmith
Keyword(s):  
Large Population ◽  
The United States ◽  
Care Staff ◽  
Abnormal Behavior ◽  
Logistic Regression Models ◽  
Opposing Effects ◽  
Abnormal Behaviors ◽  
Animal Care ◽  
Recent Claim ◽  
Poor Welfare

Abnormal behaviors in captive animals are generally defined as behaviors that are atypical for the species and are often considered to be indicators of poor welfare. Although some abnormal behaviors have been empirically linked to conditions related to elevated stress and compromised welfare in primates, others have little or no evidence on which to base such a relationship. The objective of this study was to investigate a recent claim that abnormal behavior is endemic in the captive population by surveying a broad sample of chimpanzees (Pan troglodytes), while also considering factors associated with the origins of these behaviors. We surveyed animal care staff from 26 accredited zoos to assess the prevalence of abnormal behavior in a large sample of chimpanzees in the United States for which we had information on origin and rearing history. Our results demonstrated that 64% of this sample was reported to engage in some form of abnormal behavior in the past two years and 48% of chimpanzees engaged in abnormal behavior other than coprophagy. Logistic regression models were used to analyze the historical variables that best predicted the occurrence of all abnormal behavior, any abnormal behavior that was not coprophagy, and coprophagy. Rearing had opposing effects on the occurrence of coprophagy and the other abnormal behaviors such that mother-reared individuals were more likely to perform coprophagy, whereas non-mother-reared individuals were more likely to perform other abnormal behaviors. These results support the assertion that coprophagy may be classified separately when assessing abnormal behavior and the welfare of captive chimpanzees. This robust evaluation of the prevalence of abnormal behavior in our sample from the U.S. zoo population also demonstrates the importance of considering the contribution of historical variables to present behavior, in order to better understand the causes of these behaviors and any potential relationship to psychological wellbeing.

scholarly journals 2694. Incidence of Pneumocytis jiroveci (PJP) Infection with 3-Month Prophylaxis of Aerosolized Pentamidine (AP) in Autologous Hematopoietic Stem Cell Transplantation (HSCT)

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S947-S947
Author(s):  
Sarah Perreault ◽  
Dayna McManus ◽  
Rebecca Pulk ◽  
Jeffrey E Topal ◽  
Francine Foss ◽  
...  
Keyword(s):  
Cost Savings ◽  
Cost Comparison ◽  
High Dose ◽  
Potential Cost ◽  
Hematopoietic Stem ◽  
Increased Risk ◽  
One Year ◽  
Relapsed Disease ◽  
The Cost ◽  
Autologous Hsct

Abstract Background HSCT patients are at an increased risk of developing PJP after transplant due to treatment induced immunosuppression. Given the risk of cytopenias with co-trimoxazole, AP is utilized as an alternative for PJP prophylaxis. A prior study revealed a 0% (0/19 patients) incidence when AP prophylaxis was given for one year post autologous HSCT. Current guidelines recommend a duration of 3 – 6 months for PJP prophylaxis in autologous HSCT. The primary endpoint of this study was to assess the incidence of PJP infection within one year post autologous HSCT in patients who received 3 months of AP. Secondary endpoint was a cost comparison of 3 months compared with 6 months of AP. Methods A single-center, retrospective study of adult autologous HSCT patients at Yale New Haven Hospital between February 2013 and December 2017 was performed. Patients were excluded if: <18 years of age, received < or >3 months of AP, changed to alternative PJP prophylactic agent or received no PJP prophylaxis, received tandem HSCT, deceased prior to one year post-transplant from a non PJP-related infection, HIV positive, or lost to follow-up. Pentamidine was given as a 300 mg inhalation monthly for 3 months starting Day +15 after autologous HSCT. Results A total of 288 patients were analyzed, no PJP infections occurred within one year post HSCT. Additionally, 187 (65%) patients received treatment post HSCT with 135/215 (63%) receiving maintenance immunomodulatory drugs for myeloma and 40/288 (14%) patients developing relapsed disease. 43% of the chemotherapy regimens for relapsed disease included high dose corticosteroids. The cost difference of using 3 months vs. 6 months of AP is $790, reflecting the cost of drug and its administration. Applying our incidence of 0%, potential cost savings of 3 months vs. 6 months of AP would be $330,000 over 5 years or $66,000 per year. Conclusion Three months of AP for PJP prophylaxis in autologous HSCT patients is safe and effective as well as cost-effective compared with a 6 month regimen. Disclosures All authors: No reported disclosures.

Oral Antibiotic Management of Acute Osteomyelitis of the Hand: Outcomes and Cost Comparison to Standard Intravenous Regimen

Hand ◽  
2019 ◽  
pp. 155894471987314
Author(s):  
Mark Henry ◽  
Forrest H. Lundy
Keyword(s):  
Bone Loss ◽  
Direct Cost ◽  
Cost Model ◽  
Cost Savings ◽  
Cost Of Care ◽  
Cost Comparison ◽  
Study Cohort ◽  
Oral Antibiotic ◽  
Direct Inoculation ◽  
The Cost

Background: Acute, direct inoculation osteomyelitis of the hand has traditionally been managed by intravenous antibiotics. With proven high levels of bone and joint penetration, specific oral antimicrobials may deliver clinical efficacy but at substantially lower cost. Methods: Sixty-nine adult patients with surgically proven acute, direct inoculation osteomyelitis of the hand were evaluated for clinical response on a 6-week postdebridement regimen of susceptibility-matched oral antibiotics. Inclusion required gross purulence and bone loss demonstrated at the initial debridement and radiographic evidence of bone loss. Excluded were 2 patients with extreme medical comorbidities. There were 53 men and 16 women with a mean age of 46 years. Mean follow-up was 16 weeks (±10). The cost model for the outpatient oral antibiotic treatment was intentionally maximized using Walgreen’s undiscounted cash price. The cost model for the traditional intravenous treatment regimen was intentionally minimized using the fully discounted Medicare fee schedule. Results: All patients achieved resolution of osteomyelitis by clinical and radiographic criteria. In addition, 7 patients underwent successful subsequent osteosynthesis procedures at the previously affected site without reactivation. The mean postdebridement direct cost of care per patient in the study cohort was $482.85, the cost of the antibiotic alone. The postdebridement direct cost of care per patient on a regimen of vancomycin 1.5 g every 12 hours via peripherally inserted central catheter line was $21 646.90. Conclusions: Acute, direct inoculation osteomyelitis of the hand can be successfully managed on oral antibiotic agents with substantial direct and indirect cost savings.

scholarly journals Cost Comparison of Suture Anchor Modified Broström Repair and Augmentation of the Modified Broström with FiberTape Device

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0047
Author(s):  
Emily Vannatta ◽  
Chris M. Stauch ◽  
Jesse King ◽  
Morgan S. Kim ◽  
Laura R. Luick ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Return To Work ◽  
Ankle Instability ◽  
Group Versus ◽  
Cost Savings ◽  
Chronic Ankle Instability ◽  
Cost Comparison ◽  
Suture Anchors ◽  
Ligament Repair ◽  
The Cost

Category: Ankle; Sports Introduction/Purpose: Augmentation of the Broström procedure with FiberTape device has been described for the treatment of chronic ankle instability. However, it has yet to be determined if the cost of the implant is negated by the benefits to the patient. The purpose of this study was to perform a comprehensive cost analysis by comparing the cost of surgical procedure, physical therapy visits, time off work, and any costs related to revision surgery between the Broström reconstruction with suture anchors alone versus augmentation with a FiberTape device. Methods: 166 patients undergoing lateral ankle ligament repair were analyzed retrospectively. Patients underwent either a modified Broström ligament repair with two suture anchors or Broström ligament repair with FiberTape augmentation. All patients followed the same post-operative protocol for early weight bearing and initiation of physical therapy once the wound was healed. Timing of return to work and the total number of visits of physical therapy before discharge were recorded. Implant costs, facility charges and professional fees were obtained from billing records. Lost income for missed days of work was based on the Pennsylvania Bureau of Labor Statistics. Complications requiring return to the operating room were recorded. Patients were followed out to one year. Results: Aggregate cost in the modified Broström group was $2,219 more expensive than when augmenting with FiberTape ($20,970 vs. $18,751) despite an increased implant cost of $900. This difference was the result of a greater number of therapy visits and days out of work in the modified Broström group versus the augmentation group (14.9 vs 12.4) as well as a significantly higher amount of days out of work in the modified Broström group versus augmentation (63.3 vs. 53.8 days respectively). No statistically significant difference was found for operation time between groups, and failure rates were similar; 2.0% (1/49) for FiberTape and 3.4% (4/117) for modified Broström. Conclusion: The aim of this study was to explore the cost comparison of the modified Broström procedure for chronic ankle instability versus the FiberTape augmentation. Despite an upfront increase in implant costs, the average cost per procedure was lower for the augmentation group. The majority of cost savings occurred in decreases in the number of physical therapy visits and faster return to work times. The results of this study suggest that the use of FiberTape to augment modified Broström repair may have a financial benefit and cost savings to patients and the healthcare system.

Are Smelly Animals Happy Animals? Competing Definitions of Laboratory Animal Cruelty and Public Policy

1994 ◽  
Vol 2 (2) ◽  
pp. 125-144
Author(s):  
Julian McAllister Groves
Keyword(s):  
Animal Rights ◽  
Laboratory Animal ◽  
Animal Cruelty ◽  
Care Staff ◽  
Public Image ◽  
Laboratory Animals ◽  
Research Personnel ◽  
The Public ◽  
Cruelty To Animals ◽  
Animal Care

AbstractRegulations surrounding laboratory animal care have tried to address aspects of an image of laboratory animal cruelty publicized by animal rights activists. This image of cruelty, however, is not consistent with the experiences of those charged with the day-to-day care of laboratory animals. This article examines the incongruities between the public image of cruelty to animals in laboratories as promoted by animal rights activists, and the experiences of laboratory animal care staff who apply and enforce laboratory animal care regulations. In doing so, the article illuminates why regulations surrounding laboratory animal care are difficult to comply with on the part of the policy enforcers, and are continuously contested by both animal rights activists and animal research personnel.

scholarly journals Cost Comparison of Outpatient Versus Inpatient Unicompartmental Knee Arthroplasty

2017 ◽  
Vol 5 (3) ◽  
pp. 232596711769435 ◽  
Author(s):  
Dustin L. Richter ◽  
David R. Diduch
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Outpatient Surgery ◽  
Cost Savings ◽  
Cost Comparison ◽  
Secondary Outcome ◽  
Average Charge ◽  
Significant Cost ◽  
Unicompartmental Knee ◽  
Percentage Difference

Background: Outpatient unicompartmental knee arthroplasty (UKA) has been shown to be safe and feasible when compared with inpatient surgery; however, no studies have evaluated the cost-effectiveness and cost-benefit of performing outpatient versus inpatient UKA. Hypothesis: Significant cost savings can be achieved by transitioning UKAs from an inpatient to an outpatient procedure in an outpatient surgical facility, with no appreciable difference in complication or readmission rates. Study Design: Economic and decision analysis; Level of evidence, 3. Methods: A retrospective chart review of 25 consecutive medial UKAs was performed. A total of 10 inpatient UKAs with a mean length of stay of 1.6 days (range, 1-4 days) and 12 outpatient UKAs were included in the final analysis. A simple difference in costs incurred, reimbursements, and percentage difference between inpatient and outpatient surgery in an outpatient surgical facility was calculated. Charges were subdivided into surgical facility fees, inpatient room charges, operating room supply fees, and other fees. Secondary outcome measures included reason for greater than 1 day stay for the inpatient UKAs, complications, readmissions, and the type of regional anesthesia utilized. Results: The outpatient UKA charges were a mean $20,500 less per patient than the inpatient average charge of $46,845. The primary cost savings were attributed to the outpatient surgical facility fee, which averaged $3800 per patient, while the inpatient facility charge was 350% more expensive at $13,200 per patient (approximately $9500 savings). On the inpatient side, the average reimbursement was 55% of charges, or $25,550. For outpatient procedures, the average reimbursement was 47%, or $12,370. There was no difference between the inpatient and outpatient groups in terms of complications or readmissions. Conclusion: This work demonstrated that significant cost savings of roughly 50% can be achieved with an outpatient UKA protocol done at an outpatient surgical facility. Not only is it feasible and economically attractive to perform outpatient UKA, but it can reduce inpatient bed occupancy and resource allocation for a busy hospital.

A Fuels Cost Comparison of Gasoline and Electric Powered Vehicles

2008 ◽  
Author(s):  
George Ford ◽  
Paul Yanik
Keyword(s):  
United States ◽  
Energy Efficiency ◽  
Fossil Fuels ◽  
Cost Savings ◽  
The United States ◽  
Cost Comparison ◽  
Environmentally Safe ◽  
Personal Transportation ◽  
Fuel Costs

Per British thermal unit (BTU), in the United States, gasoline currently costs about 7.6 times as much as coal. Due to the prevalence of coal fired electricity generating stations in the country, electrically powered vehicles may provide a fuel cost savings over similar gasoline powered vehicles. Fuel costs for electric vehicles have been reported to cost about $0.045 per mile to operate. Higher efficiency, gasoline operated automobiles such as the Toyota Corolla have reported fuel costs of about $0.093 per mile. This paper provides a first glance examination of electrically powered and gasoline powered vehicles in the United States. While gasoline costs continue to rise, a cheap, environmentally safe transportation alternative is needed to maintain the flexible lifestyle currently enjoyed by Americans. The cycle energy efficiency of coal produced electricity for personal transportation is much lower than the energy efficiency of gasoline, but the large cost differences between these two forms of fossil fuels may provide a temporary fix to a looming transportation crisis in the United States. The long-term environmental effects of an electrically powered, private transportation fleet could prove catastrophic due to increased use of coal and accompanying combustion product air pollution, but clean, renewable, electricity producing technologies may support more prolific long-term use of electrically powered transportation modes.

scholarly journals The effects of dietary changes on chimpanzee behavior

2016 ◽  
Author(s):  
Amy Fultz ◽  
Raven Jackson-Jewett ◽  
Kathleen Taylor ◽  
Connie Philipp ◽  
Akie Yanagi ◽  
...  
Keyword(s):  
National Research Council ◽  
Behavioral Changes ◽  
Care Staff ◽  
Abnormal Behavior ◽  
Health Issues ◽  
Dietary Changes ◽  
Advisory Groups ◽  
Limited Food ◽  
Age Range ◽  
Animal Care

Captive chimpanzees (Pan troglodytes) often suffer from obesity-related health issues including arthritis, diabetes, and heart disease. It is becoming increasingly common to house captive chimpanzees in large social groups, which may increase aggression due to the competition over limited food resources. In order to improve the health of sanctuary chimpanzees at Chimp Haven, Inc, USA. we recently made some modifications to the chimpanzee’s diet. Diet formulations were created by our veterinarian using recommendations from Association of Zoos and Aquariums Nutrition Advisory Groups and National Research Council guidelines on daily nonhuman primate caloric needs. The current study examined behavioral changes in the chimpanzees when diet modifications included a reduction in the overall amount of produce given. As dietary changes were being implemented, animal care staff voiced concerns over the possibility of increased competition, abnormal behavior and aggression with the reduction in the amount of produce provided. We observed six groups of chimpanzees (N = 85; M = 34 F = 51, age: range 3-55, mean = 27.8) when produce was provided in the morning and afternoon for seven weeks before and three weeks after the dietary changes were made. We completed two 30 minute scans with six minute intervals per week on each group for a total of 820 scans. Groups ranged in size from 11-23 members (mean = 14.33). Although we found no significant changes in aggressive behavior after the dietary changes (t = .007, p = .99), there was a non-significant tendency towards an increase in abnormal behavior (t = 2.30, p = .06).

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