scholarly journals Assessing Health Consequences of Vitamin D Fortification Utilizing a Societal Experiment Design: Methodological Lessons Learned from the D-Tect Project

2021 ◽  
Vol 18 (15) ◽  
pp. 8136
Author(s):  
Mina Nicole Händel ◽  
Ramune Jacobsen ◽  
Fanney Thorsteinsdottir ◽  
Amélie Cléo Keller ◽  
Maria Stougaard ◽  
...  
Keyword(s):  
Vitamin D ◽  
Cost Effectiveness ◽  
Outcome Data ◽  
Lessons Learned ◽  
Effect Evaluation ◽  
Health Consequences ◽  
Before And After ◽  
Statistical Approaches ◽  
The Cost ◽  
Analytical Approaches

By utilizing historical changes in Danish legislation related to mandatory vitamin D fortification of margarine, which was implemented in the mid 1930s and abruptly abandoned in June 1985, the studies in the D-tect project investigated the effects of vitamin D on health outcomes in individuals, who during gestation were exposed or unexposed to extra vitamin D from fortified margarine. This paper reviews and narratively summarizes the analytic approaches alongside the results of the societal fortification experiment studies from the D-tect project and addresses the challenges in designing societal experiment studies and evaluating their results. The latter are discussed as lessons learned that may be useful for designers of similar studies, expected to be extensively utilized while researching the health consequences of the COVID-19 pandemic by comparing individuals born before and after the epidemic. In the D-tect project, 16 articles based on the societal fortification experiment were published analyzing 10 different outcomes and using different statistical approaches. Lessons learned included the detail of the analysis of the historical information on the exposure, availability and validity of the outcome data, variety of analytical approaches, and specifics concerning vitamin D effect evaluation, such as consideration of the influence of sunshine or season. In conclusion, the D-tect project clearly demonstrated the cost-effectiveness and research potential of natural- or societal-experiment-based studies.

scholarly journals Evaluation of the Cost-Effectiveness of the Installation of Heat-Cost Allocators in Multifamily Buildings in Croatia

Energies ◽  
2019 ◽  
Vol 12 (3) ◽  
pp. 507 ◽  
Author(s):  
Sunčana Slijepčević ◽  
Davor Mikulić ◽  
Kristijan Horvat
Keyword(s):  
Energy Consumption ◽  
Cost Effectiveness ◽  
Net Present Value ◽  
Energy Savings ◽  
Heat Energy ◽  
Energy Prices ◽  
Present Value ◽  
Improve Energy Efficiency ◽  
Before And After ◽  
The Cost

In order to improve energy efficiency, the Croatian government introduced an individual metering obligation for all district heat network users. The purpose of the research was to evaluate this policy measure regarding its effects on tenants’ behavior and energy savings, but also from the perspective of cost-effectiveness. The sample includes approximately 20% of all Croatian users of district heat energy. Energy savings related to the installation of heat cost allocators are calculated by comparing the specific heat energy consumption, corrected for the number of heating degree days, in periods before and after the installation of the heat cost allocators. The cost-effectiveness assessment is based on the concept of the net present value. The transition to individual metering in Croatia resulted in significant energy savings averaged from 20 to 35%. However, low heat energy prices in cities with a dominant share of heat energy consumption did not ensure a positive net present value of investment for all buildings.

scholarly journals Eggs Represent a Cost-Effective Approach in Delivering Protein, Choline, Vitamin A and Vitamin D in the American Diet of Children and Adults

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1471-1471
Author(s):  
Yanni Papanikolaou ◽  
Victor Fulgoni
Keyword(s):  
Vitamin D ◽  
Cost Effectiveness ◽  
Vitamin A ◽  
Protein Delivery ◽  
Cost Effective ◽  
Food Groups ◽  
Funding Sources ◽  
Key Barrier ◽  
Nutrient Profiles ◽  
The Cost

Abstract Objectives Cost has been identified as a key barrier in preventing many Americans from consuming recommended nutrients from healthy eating patterns. The purpose of the current study was to examine the cost-effectiveness of eggs for delivering selected nutrients (i.e., protein, vitamin A, choline, vitamin D) in children and adults. Methods The present analysis used dietary intake data from the National Health and Nutrition Examination Survey 2013–2016 (2–18 years-old, N = 956; 19+ years-old, N = 2424). Cost and nutrient profiles for What We Eat in America food categories were compared to whole eggs. Food cost and the cost of nutrients were obtained from the Center for Nutrition Promotion and Policy food cost database. Results Of 15 main food groups examined, whole eggs ranked third for cost-effectiveness per 100 g (excluding beverages), such that eggs cost $0.35 per 100 g, with dairy and grains representing the first and second most cost-effective foods at $0.23 and $0.27 per 100 g, respectively. In children and adults, eggs represented a cost-effective food for protein delivery, such that eggs provided nearly 2.7 and 3.7% of all protein in the diet, respectively, at a cost of about $0.03 per g of protein. Eggs contributed 3.8% and 6.0% of all vitamin A in the diet of children and adults, at a cost of approximately $0.002 and $0.003 per RAE mcg of vitamin A, respectively. In children and adolescents 2–18 years-old, nearly 12% of all choline in the diet is delivered at a cost of approximately $0.002 per mg of choline. Similarly, in adults 19+ years-old, eggs provide nearly 14.8% of all dietary choline in the diet at a cost of approximately $0.002 per mg of choline. Eggs provide nearly 5% and 9.5% of all vitamin D in the diet of children and adults, at a cost of approximately $0.21 and $0.22 per mcg of vitamin D, respectively. Overall, eggs ranked as the most cost-effective food for delivering protein, choline, and vitamin A, and third for vitamin D in children. In adults, eggs ranked as the most cost-effective food for delivering protein and choline, second for vitamin A, and third for vitamin D. Conclusions In summary, eggs represent a cost-effective food choice for delivery of protein and several shortfall nutrients (choline, vitamin A, and vitamin D) in the American diet. Funding Sources The study was supported by the Egg Nutrition Center.

scholarly journals Economic analysis of service and delivery interventions in health care

2018 ◽  
Vol 6 (5) ◽  
pp. 1-16 ◽  
Author(s):  
Matt Sutton ◽  
Steph Garfield-Birkbeck ◽  
Graham Martin ◽  
Rachel Meacock ◽  
Stephen Morris ◽  
...  
Keyword(s):  
Health Care ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Economic Analysis ◽  
Clinical Interventions ◽  
Before And After ◽  
Implementation Costs ◽  
The Cost ◽  
Care System ◽  
Professional Preferences

There are well-developed guidelines for economic evaluation of clearly defined clinical interventions, but no such guidelines for economic analysis of service interventions. Distinctive challenges for analysis of service interventions include diffuse effects, wider system impacts, and variability in implementation, costs and effects. Cost-effectiveness evidence is as important for service interventions as for clinical interventions. There is also an important role for wider forms of economic analysis to increase our general understanding of context, processes and behaviours in the care system. Methods exist to estimate the cost-effectiveness of service interventions before and after introduction, to measure patient and professional preferences, to reflect the value of resources used by service interventions, and to capture wider system effects, but these are not widely applied. Future priorities for economic analysis should be to produce cost-effectiveness evidence and to increase our understanding of how service interventions affect, and are affected by, the care system.

scholarly journals COST-EFFECTIVENESS OF NEEDLE AND CATHETER OVER NEEDLE WITH ACTIVE PROTECTION DEVICES IN THE HOSPITAL SETTING

2015 ◽  
Vol 24 (3) ◽  
pp. 867-874 ◽  
Author(s):  
Rodrigo Nonato Coelho Mendes ◽  
Larissa Gutierrez de Carvalho Silva ◽  
Maria do Carmo Lourenço Haddad ◽  
Fernanda Novaes Moreno ◽  
Roseli Broggi Gil
Keyword(s):  
Cost Effectiveness ◽  
Hospital Setting ◽  
University Hospital ◽  
Educational Strategies ◽  
Healthcare Organizations ◽  
Cross Sectional ◽  
Safety Devices ◽  
Active Protection ◽  
Before And After ◽  
The Cost

ABSTRACTThe aim of this study was to evaluate the cost-effectiveness of needle and catheter over needle with active protection safety devices in the hospital context. A cross-sectional and retrospective study was undertaken at a public university hospital in Southern Brazil. The population was composed of consumption and material cost worksheets and 53 records of workers and students who suffered perforating accidents that occurred before and after the implementation of the safety devices, in the periods named A: June/2010 till June/2011 and B: June/2012 till June/2013. Data were analyzed using descriptive statistics. There was a 30% increase in accidents between period A and period B. The cost went from 44.769,93 to 139.558,08 American dollars. Educational strategies are recommended to enhance the cost-effectiveness of safety devices in healthcare organizations.

The Association between Needle Size and Waste Product and Its Effect on Cost-Effectiveness of Botulinum Toxin Injections?

2020 ◽  
Vol 36 (04) ◽  
pp. 484-486 ◽  
Author(s):  
Shani Golan ◽  
John Pena ◽  
Jeffrey Moore ◽  
Sangeetha Tandalam ◽  
Gary Lelli
Keyword(s):  
Botulinum Toxin ◽  
Cost Effectiveness ◽  
Dead Space ◽  
Waste Product ◽  
Needle Size ◽  
Syringe Needle ◽  
Significant Difference ◽  
Before And After ◽  
Cost Implications ◽  
The Cost

AbstractClostridium botulinum toxin (BT) must be administered intramuscularly with a syringe, but dead space in the syringe–needle complex may cause product waste and result in cost implications for the patient and provider. Syringe dead space is the volume of residual fluid that remains within the syringe after the plunger is fully depressed during medication injection. We calculated the average volume of remaining product in a syringe–needle complex and cost loss implication of this volume of BT. This is a single-center, analytical study using saline and four different sized needles for analytics of waste product and cost-effectiveness. Syringes of 1 mL with attached 18, 21, 30, and 32-gauge (G) needles, respectively, were compared. The syringe–needle complex was weighed before drawing 0.05 mL of saline. The fluid was then discarded with the appropriate syringe and then weighed again. This procedure was repeated for the four needle types and the average difference in weight of the syringe–needle complex before and after saline waste was measured. The volume was converted to units of BT used in clinical practice and the cost of waste product evaluated. The mean difference in needle–syringe complex weight before and after intervention was 0.068, 0.056, 0.04, and 0.026 g for the 18, 21, 30, and 32G needles, respectively. We found a statistically significant difference comparing the 18G with the 30 and 32G (0.02 and 0.0007, respectively) and comparing the 21G with the 30 and 32G (0.0042 and 0.00002, respectively). When we extrapolated the data to BT units (4U/0.1 mL), we found that theoretically 2.72, 2.24, 1.6, and 1.04 units of BT are left in the syringe–needle complex for the 18, 21, 30, and 32G syringes, respectively. At a cost of $6.01/U of onabotulinum toxin A, we then calculated a provider loss of a gross average (mean) revenue of $96 and 62.4 per 10 syringes used with 30 and 32G needles. Needle size used for drawing up and administering BT has an effect on the amount of waste product and subsequently on cost-effectiveness.

Contingent Intermediate Sentences: New Jersey's Intensive Supervision Program

1990 ◽  
Vol 36 (1) ◽  
pp. 75-86 ◽  
Author(s):  
Frank S. Pearson
Keyword(s):  
Cost Effectiveness ◽  
Lessons Learned ◽  
Recidivism Rates ◽  
Intensive Supervision ◽  
The Cost

New Jersey's Intensive Supervision Program (ISP) provides substantially higher levels of punishment, supervision, and counseling than are provided under ordinary probation or parole. These three correctional elements are contingently administered. Based on the nature of the offense and the offender's conformity to the rules of ISP, the counseling and the punitive and supervisory constraints are gradually lessened over the 18-month program. The most recent data on participants' terminations and recidivism rates are presented. The cost-effectiveness of the program and some practical lessons learned are also discussed.

The cost-effectiveness analysis of a nationwide vitamin D supplementation program among Iranian adolescents for adulthood cardiovascular diseases prevention

Public Health ◽  
2021 ◽  
Vol 198 ◽  
pp. 340-347
Author(s):  
Narges Zandieh ◽  
Mohsen Rezaei Hemami ◽  
Ali Darvishi ◽  
Seyed Mohammad Hasheminejad ◽  
Zahra Abdollahi ◽  
...  
Keyword(s):  
Vitamin D ◽  
Cost Effectiveness ◽  
Cardiovascular Diseases ◽  
Vitamin D Supplementation ◽  
Cost Effectiveness Analysis ◽  
Effectiveness Analysis ◽  
The Cost
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