scholarly journals HTA and HIV: The Case of Dual NRTI Backbones in the Italian Setting

2020 ◽  
Vol 17 (23) ◽  
pp. 9010
Author(s):  
Elisabetta Garagiola ◽  
Emanuela Foglia ◽  
Lucrezia Ferrario ◽  
Giovanni Cenderello ◽  
Antonio Di Biagio ◽  
...  
Keyword(s):  
Healthcare Providers ◽  
Healthcare Services ◽  
Point Of View ◽  
P Value ◽  
Baseline Scenario ◽  
Economic Point ◽  
Italian Market ◽  
Virologic Control ◽  
Tenofovir Alafenamide

The aim of this study is to analyze the potential advantages of emtricitabine/tenofovir alafenamide (FTC/TAF) introduction, creating evidence-based information to orient strategies to reduce costs, thus preserving effectiveness and appropriateness. An Health Technology Assessment (HTA) was implemented in the years 2017–2018 comparing the dual backbones available in the Italian market: FTC/TAF, FTC/TDF (tenofovir disoproxil fumarate/emtricitabine) and ABC/3TC (abacavir/lamivudine). From an efficacy point of view, FTC/TAF ensured a higher percentage of virologic control and a better safety impact than FTC/TDF (improving the renal and bone safety profile, as well as the lipid picture). From an economic point of view, the results revealed a 4% cost saving for the Italian National Healthcare Service NHS with FTC/TAF introduction compared with the baseline scenario. Qualitative perceptions’ results showed that FTC/TAF would decrease the burden of adverse events management, increasing the accessibility of patients to healthcare providers (FTC/TAF: 0.95, FTC/TDF: 0.10, ABC/3TC: 0.28; p-value: 0.016) and social costs (FTC/TDF: −0.23, FTC/TAF: 1.04, ABC/3TC: 0.23; p-value < 0.001), improving patient quality of life (FTC/TDF: 0.31, FTC/TAF: 1.85, ABC/3TC: 0.38; p-value < 0.001). Healthcare services may consider the evidence provided by the present study as an opportunity to include HIV patients in a more adequate antiretroviral treatment arm, guaranteeing a personalized clinical pathway, thus becoming more efficient and effective over time.

scholarly journals USING THE METHOD OF SEQUENTIAL RESTRICTIONS FOR SOLVING A DUAL-OBJECTIVE PROBLEM OF PRODUCTION PLANNING

2020 ◽  
Vol 11 (87) ◽  
Author(s):  
Nataliia Dovha ◽  
◽  
Hryhorii Tsehelyk ◽  
Keyword(s):  
Optimization Problem ◽  
Production Efficiency ◽  
Point Of View ◽  
Main Task ◽  
Production Plan ◽  
Optimal Production ◽  
Economic Point ◽  
Use Of Resources ◽  
Maximum Profit

The processes of optimization of the production plan according to certain criteria by modeling were investigated. Achieving effective results directly depends on the optimal production plan. The most important thing in determining the optimal production plan is the choice of modeling criteria. For the most part, the quality of decisions is characterized not by one but by many incomparable criteria. Therefore, it is necessary to make decisions based not on one but on many criteria. This so-called multi-objective optimization problem. For solving such problems is widely used mathematical methods. Mathematical approach can be used to solve problems in any particular activity as mathematics abstracted from specific features characteristic of a particular solution. Therefore, from the point of view of mathematics, the optimal result can be obtained with various established criteria, but from the economic point of view it is important to choose the ones that are of decisive importance. That is, their weight is important for the consumer when making a purchase decision, and for the manufacturer – in terms of production capabilities of certain types and results (production efficiency). The basis of the operation of any enterprise is a production program (production and sales plan). The main task of the production plan is to meet the needs of consumers in high-quality products, which are produced with the best use of resources, on the one hand, and the enterprise to get the maximum profit, on the other. With this in mind, a two-criteria optimization model that allows to make a production plan was proposed. The plan ensures that products are produced with the best use of available resources and at the same time ensures maximum quality of manufactured products and maximum profit from sales of these products. The solution of the problem with two objective functions and linear constraints is achieved by step-by-step solution of the proposed mathematical model of optimization of the production plan using the method of sequential restrictions. The simplex method was also used. An example shows an algorithm for solving the optimization problem.

scholarly journals Effect of different staking methods and stem pruning on yield and quality of summer tomato

2016 ◽  
Vol 41 (3) ◽  
pp. 419-432
Author(s):  
MS Alam ◽  
N Islam ◽  
S Ahmad ◽  
MI Hossen ◽  
MR Islam
Keyword(s):  
Fruit Quality ◽  
Fruit Set ◽  
Block Design ◽  
Total Yield ◽  
Point Of View ◽  
Fruit Firmness ◽  
Economic Point ◽  
Yield And Quality ◽  
Agriculture Research Institute

The study was carried out during summer of 2012 with BARI hybrid tomato 4, planted in the Olericulture farm of Bangladesh Agriculture Research Institute, Joydebpur, Gazipur, Bangladesh to find out the response of plants to some staking and pruning treatments on yield, fruit quality and cost of production. A two factor experiment consisting of three staking methods and four level of pruning, laid out in complete block design with three repetitions. Plants were staked on inverted „V? shaped staking, high platform and string. The plants were pruned to two stem, three stem, four stem and no pruning as control. Results showed that significantly the highest total number of fruits per plant (37.1), marketable fruits per plant (33.7), yield per plant (1.68 kg) and total yield (44.6 t/ha) were produced by the plants having the treatment string staking with four stem. The highest fruit set (43.50%) was found in the plants staking with string having three stems. Plants grown on string staking allowing two stem gave the maximum length (4.71 cm), diameter (4.83 cm) and weight (53.4g) of single fruit as well as maximum fruit firmness (3.43 kg-f cm-2). From the economic point of view, it was apparent that summer tomato produced by string staking with four stem pruning exhibited better performance compared to other treatment combinations in relation to net return and BCR (2.10).Bangladesh J. Agril. Res. 41(3): 419-432, September 2016

scholarly journals On BRT Spread around the World: Analysis of Some Particular Cities

2020 ◽  
Vol 5 (10) ◽  
pp. 88
Author(s):  
Salvatore Trubia ◽  
Alessandro Severino ◽  
Salvatore Curto ◽  
Fabio Arena ◽  
Giovanni Pau
Keyword(s):  
Public Transport ◽  
Autonomous Vehicles ◽  
Social Impact ◽  
High Efficiency ◽  
Civil Engineering ◽  
Road Transport ◽  
Point Of View ◽  
Transport Systems ◽  
Economic Point

The goal of civil engineering has always been the research and implementation of methods, technologies, and infrastructures to improve the community’s quality of life. One of the branches of civil engineering that has the strongest effect on progress is transport. The quality of transport has a profound economic and social impact on our communities regarding trade (freight transport) and city livability (public transport systems). However, innovation is not the only way to improve the features above-mentioned, especially public transport, considering that it is usually beneficial to enhance and repurpose vehicles with appropriate adjustments to offer more efficient services. Other perspectives that influence public transport systems are the costs and times of design and construction, maintenance, operating costs, and environmental impact, especially concerning CO2 emissions. Considering these issues, among the various types of existing public transport systems, those of the so-called Bus Rapid Transit (BRT) offer worthwhile results. The BRT system is a type of public road transport operated by bus on reserved lanes, and it is significantly profitable, especially from an economic point of view, in areas where there are existing bus routes. Nonetheless, for the construction of works minimization, it is closely linked to other features that improve its usefulness, depending on the vehicles’ quality such as capacity, but above all, the propulsion or driving autonomy that would guarantee high efficiency. This paper introduces an analysis of some BRT systems operating worldwide, presenting the background, general technical features, and the correlation with autonomous vehicles.

Perspectives and actions to improve water quality in European Union Member States

elni Review ◽  
2015 ◽  
pp. 10-16
Author(s):  
Guiseppe Sgorbati ◽  
Nicoletta Dotti
Keyword(s):  
European Union ◽  
Point Of View ◽  
Member States ◽  
Economic Point ◽  
Healthy Environment ◽  
Playing Field ◽  
Quality Of Waters ◽  
Water Issues ◽  
European Union Member States

Although the European rules on water, which are mainly based on the Water Framework Directive (WFD 2000/60/EC), have been in force for many years, the quality of waters in Europe still have huge room for improvement before they can fulfil the objectives set by the WFD and by its “daughters Directive”. Two questions are key here: Are the European rules adequate for this challenging goal? If yes, are the rules applied homogeneously and correctly in European Union Countries or do many issues remain which prevent their full implementation? This article provides a broad overview of water issues in Europe, focusing on the level of fulfillment of requisites from EU legislation and the level of its implementation in Member States. This point of view has been adopted because an uneven implementation of EU laws prevents several European citizens from fulfillment of their right to a healthy environment and a good water resource quality and, furthermore, endangers the level playing field across Europe, from a social and economic point of view.

Women Living with Fibromyalgia: “Do No Harm”

2008 ◽  
Vol 12 (4) ◽  
pp. 21-25 ◽  
Author(s):  
Nancey E.M. France, ◽  
Kathleen Farrell, ◽  
Barbara Kearney, ◽  
Sharon Myatt,
Keyword(s):  
Quality Of Life ◽  
Focus Groups ◽  
Support Groups ◽  
Policy Making ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Clinical Nurse ◽  
Clinical Nurse Specialists ◽  
Do No Harm

The phenomenon of interest of this study was the woman’s perspective on what it was like to live with fibromyalgia (FMS). Aphenomenological study was conducted utilizing participant interviews, focus groups, and observations of FMS support groups. The participants portrayed the unending struggle of living with FMS with progressive disability further complicated by lack of trust and not feeling safe with the healthcare provider and system. Clinical Nurse Specialists (CNS) are crucial in educating healthcare providers on FMS, individualizing care to slow disability and promote quality of life, and influencing policy-making bodies to improve healthcare services.

Monitoring Quality in a Federal State with Shared Powers in Healthcare: The Case of Belgium

2011 ◽  
Vol 18 (4) ◽  
pp. 413-422 ◽  
Author(s):  
Diego Fornaciari ◽  
Arthur Vleugels ◽  
Stefaan Callens ◽  
Kristof Eeckloo
Keyword(s):  
Healthcare System ◽  
Healthcare Providers ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Federal State ◽  
Flemish Community ◽  
The Government ◽  
Regulatory Powers ◽  
Monitoring Quality

AbstractThe Belgian healthcare system consists of a complex of more or less autonomous groups of healthcare providers. It is the responsibility of the government to ensure that the fundamental right to qualitative healthcare is secured through the services they provide. In Belgium, the regulatory powers in healthcare are divided between the federal state and the three communities. Both levels, within their area of competence, monitor the quality of healthcare services. Unique to the Belgian healthcare system is that the government that providers are accountable to is not always the same as the government that is competent to set the criteria. The goal of this article is to provide an overview of the main mechanisms that are used by the federal government and the government of the Flemish community to monitor healthcare quality in hospitals. The Flemish community is Belgian’s largest community (6.2 million inhabitants). The overview is followed by a critical analysis of the dual system of quality monitoring.

scholarly journals COVID-19 Lockdown Period: Perception of Doctors regarding Telemedicine Use for General Practice

2021 ◽  
Author(s):  
Sumitha Arumugam ◽  
Dhanasekaran Ramadoss ◽  
Parthiban Brindhadevi ◽  
Subbalakshmi Easwaran ◽  
Shanthi Santhosh Kumari
Keyword(s):  
General Practice ◽  
Clinical Care ◽  
Tertiary Care ◽  
Healthcare Services ◽  
Easy Access ◽  
P Value ◽  
Care Hospital ◽  
Cross Sectional ◽  
Future Practice

Introduction: During this COVID-19 lockdown period, telemedicine is widely being used by doctors for continuing clinical care of patients so that physical distancing can be maintained and the risk of contracting the virus can be avoided. Aim: To assess perception of doctors regarding quality of healthcare by telemedicine as compared to traditional face to face consultation and, to assess the opinion of doctors on whether telemedicine could be an option for future practice after lockdown period. Materials and Methods: A questionnaire based cross-sectional study was conducted in which perception of doctors regarding their telemedicine usage for general practice during this lockdown period has been evaluated. The study was done during April to June 2020 among doctors working in a medical college attached to a tertiary care hospital in Chennai and using telemedicine for their practice during COVID-19 lockdown period. After collection of responses, data obtained were entered in excel sheet and analysed using SPSS version 23.0. Chi-square test was used to assess the association between different variables associated with perception regarding telemedicine usage for general practice. A p-value <0.05 was considered as statistically significant. Results: Easy access to healthcare services can be done with telemedicine practice according to 73.7% of doctors. Nearly 60.6% of doctors like to continue telemedicine for their practice even after COVID lockdown period. Conclusion: Telemedicine has helped doctors for continuing patient care during COVID-19 pandemic, but the quality of care delivered by telemedicine consultation was not good as compared to the quality of traditional healthcare. Telemedicine could be an option for future practice of doctors if awareness regarding proper usage of telemedicine is created among patients and if guidelines regarding legal concerns in telemedicine are properly framed.

scholarly journals Perceived Consequences of Healthcare Service Decentralization on Access, Affordability and Quality of Care in Khartoum Locality, Sudan

2020 ◽  
Author(s):  
Bandar Noory ◽  
Sara Hassanein ◽  
Jeffrey Edwards ◽  
Benedikte Victoria Lindskog
Keyword(s):  
Quality Of Care ◽  
Healthcare Providers ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
System Capacity ◽  
Cross Sectional ◽  
Study Results ◽  
Catchment Areas ◽  
The Impact

Abstract Background: Decentralization of healthcare services have been widely utilized, especially in developing countries, to improve the performance of healthcare systems by increasing the access and efficiency of service delivery. Experiences have been variable secondary to disparities in financial and human resources, system capacity and community engagement. Sudan is no exception and understanding the perceived effect of decentralization on access, affordability, and quality of care among stakeholders is crucial.Methods: This was a mixed method, cross-sectional, explorative study that involved 418 household members among catchment areas and 40 healthcare providers of Ibrahim Malik Hospital (IBMH) and Khartoum Teaching Hospital (KTH). Data were collected through a structured survey and in-depth interviews from July-December 2015.Results: Access, affordability and quality of healthcare services were all perceived as worse, compared to before decentralization was implemented. Reported affordability was found to be 53% and 55% before decentralization compared to 24% to 16% after decentralization, within KTH and IBMH catchment areas respectively, (p= 0.01). The quality of healthcare services were reported to have declined from 47% and 38% before decentralization to 38% and 28% after, in KTH and IBMH respectively (p=0.02). Accessibility was found to be more limited, with services being accessible before decentralization approximately 59% and 52% of the time, compared to 41% and 30% after, in KTH and IBMH catchment areas respectively, (p=0.01).Accessibility to healthcare was reported to have decreased secondary to facility closures, reverse transference of services, and low capacity of devolved facilities. Lastly, privatized services were reported as strengthened in response to this decentralization of healthcare. Conclusions: The deterioration of access, affordability and quality of health services was experienced as the predominant perception among stakeholders after decentralization implementation. Our study results suggest there is an urgent need for a review of the current healthcare policies, structure and management within Sudan in order to provide evidence and insights regarding the impact of decentralization.

scholarly journals Quality of pre-sprouted sugarcane seedlings grown on substrates with decomposed babassu palm stem

2021 ◽  
Vol 51 ◽  
Author(s):  
Romário Martins Costa ◽  
Marcos Renan Lima Leite ◽  
Sâmia dos Santos Matos ◽  
Rayssa Carolinne Mouzinho de Sousa ◽  
Raissa Rachel Salustriano da Silva-Matos ◽  
...  
Keyword(s):  
Growth And Development ◽  
Dry Mass ◽  
Quality Parameters ◽  
Point Of View ◽  
Production Costs ◽  
Economic Point ◽  
Babassu Palm ◽  
Number Of Leaves ◽  
The Cost

ABSTRACT The use of pre-sprouted seedlings in the implantation of sugarcane crops not only reduces the establishment period and production costs, but also has other advantages, such as a lesser requirement of propagules (stems) and greater phytosanitary control of the seedlings, when compared to conventional planting. Commercial substrates are also expensive and their use increases the cost of seedlings. This study aimed to evaluate the quality of sugarcane pre-sprouted seedlings grown on substrates with different proportions of decomposed babassu palm stem (DBPS), as well as to recommend the substrate formulation that provides the most favorable environment for the growth and development of sugarcane pre-sprouted seedlings. For preparation of the substrate (S), DBPS and soil were used in the following proportions: S1: 0 % of DBPS + 100 % of soil; S2: 20 % of DBPS + 80 % of soil; S3: 40 % of DBPS + 60 % of soil; S4: 60 % of DBPS + 40 % of soil; S5: 80 % of DBPS + 20 % of soil; S6: 100 % of DBPS + 0 % of soil. The use of S2 and S3 considerably improved the seedling quality parameters, such as sprout diameter and length, number of leaves and total, shoot and root dry mass. However, from an economic point of view, S2 is recommended for use.

e-Healthcare service quality: consumer satisfaction and its association with demographic characteristics

2020 ◽  
Vol 33 (6) ◽  
pp. 413-428 ◽  
Author(s):  
Prachi Verma ◽  
Satinder Kumar ◽  
Sanjeev K. Sharma
Keyword(s):  
Consumer Satisfaction ◽  
Strong Association ◽  
Healthcare Providers ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Demographic Characteristics ◽  
Content Type ◽  
Interaction Quality ◽  
Quality Dimensions

PurposeUse of technology for quality healthcare services has developed into a new field known as “e-Healthcare services.” Healthcare providers often judge their quality of services with consumer satisfaction. With e-Healthcare services, consumer satisfaction is influenced by the quality of healthcare services provided and the demographic characteristics. The purpose of the present case study is to recognize the important predictors of quality, which are significant for consumer satisfaction with e-Healthcare services by using Zineldin's 5Qs model. It also aims to find the strength of association among the predictors of consumer satisfaction and the demographic characteristics of the respondents.Design/methodology/approachA questionnaire-based study was conducted at a public (PGIMER, Chandigarh) and a private hospital (Fortis Hospital, Mohali) of Punjab, India, from February 2018 to March 2019. The structured, closed-ended questionnaire, to be marked on a 1–5 point Likert scale, was adapted from Zineldin's 5Qs model and was distributed to the respondents sitting in the waiting halls of the selected hospitals. The respondents comprised of both the patients and their attendants who were aware of e-Healthcare services and were using them.FindingsThe analysis identified quality of interaction, quality of hospital atmosphere and quality of object to be the key predictors of consumer satisfaction with e-Healthcare services. The results reveal a strong association between different demographic characteristics and overall consumer satisfaction with e-Healthcare services.Practical implicationsThe results suggest that improvements in the quality of interaction, quality of hospital atmosphere and quality of object may result in higher consumer satisfaction with e-Healthcare services. Working on the identified dimensions of quality will help the e-Healthcare providers in identifying functional problems of e-Healthcare services and developing improvement strategies, which will also result in better health and quality outcomes. The results of this study will help the e-Healthcare providers in better segmentation of e-Healthcare consumers based on their demographic characteristics and in developing better marketing strategies.Originality/valueThis paper focuses on the quality of e-Healthcare services only and attempts to identify the quality dimensions, which leads to the satisfaction of e-Healthcare consumers. The identified quality dimensions will help in designing better e-Healthcare services and framing policies. It also highlights the association of demographic characteristics with important quality dimensions.

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