scholarly journals Costi sanitari di un programma vaccinale: analisi di minimizzazione dei costi

2003 ◽  
Vol 4 (1) ◽  
pp. 25-32
Author(s):  
G. L. Colombo ◽  
A. Muzio ◽  
R. Giordani
Keyword(s):  
Cost Minimization ◽  
First Year ◽  
Liquid Formulation ◽  
Italian Market ◽  
Global Cost ◽  
Differential Costs ◽  
Mandatory Vaccination ◽  
First Year Of Life ◽  
The Cost ◽  
Cost Components

The global cost of a vaccination program is made up by many more cost components than the acquisition expense, although the former is the first cost usually taken into consideration when comparing two or more alternatives. The present article analyses the economical impact consequent to the use of two different hexavalent vaccine formulations (Hexavac, liquid ready for injection, and Infanrix Hexa, dry, to be re-hydrated) available on the Italian market for the mandatory vaccination of newborns during their first year of life. The cost minimization analysis was conducted considering only differential costs, i.e. those costs than can differ with the use of one of the two products, and not those common to the two competing products, such as acquisition cost (33 euro in average for both), the costs for the organization, the call of the infants to be vaccinated, etc.. The differences among the considered alternatives detected by this study regard the work for the preparation and administration of the vaccines, the quantity of special waste they produce and the incidence of serious febrile reactions leading to pharmacological treatment and physician consultation (body temperature > 40°C). The liquid formulation resulted more convenient in terms of cost for nurse work (0,63 euro saved per patient), waste disposal, and adverse reactions management. The robustness of these results was confirmed by sensitivity analysis and an estimate of the global saving for the Italian health system associated with the universal utilization of the liquid formulation is furnished.

The Cost of Prematurity: Hospital Charges at Birth and Frequency of Rehospitalizations and Acute Care Visits over the First Year of Life

2005 ◽  
Vol 105 (7) ◽  
pp. 56-64 ◽  
Author(s):  
Katherine D. Cuevas ◽  
Debra R. Silver ◽  
Dorothy Brooten ◽  
JoAnne M. Youngblut ◽  
Charles M. Bobo
Keyword(s):  
Acute Care ◽  
Hospital Charges ◽  
First Year ◽  
First Year Of Life ◽  
The Cost

First-year survival of great horned owls during a peak and decline of the snowshoe hare cycle

1996 ◽  
Vol 74 (6) ◽  
pp. 1092-1097 ◽  
Author(s):  
Christoph Rohner ◽  
D. Bruce Hunter
Keyword(s):  
Survival Rates ◽  
Bird Species ◽  
Population Cycle ◽  
First Year ◽  
Mortality Factors ◽  
Bubo Virginianus ◽  
Slow Development ◽  
Snowshoe Hares ◽  
First Year Of Life ◽  
The Cost

Most bird species have low survival rates in their first year of life, and the highest losses occur when juveniles become independent and disperse. Young great horned owls (Bubo virginianus), monitored by telemetry in the southwestern Yukon, Canada, survived well during the peak of the population cycle of snowshoe hares (Lepus americanus). Subsequently, juvenile survival collapsed parallel to the decline in hare densities. The proportion of starving owls did not increase, but there was a significant increase in mortalities involving parasitism and predation, probably as an interaction with food shortage. The mortality rates of juvenile great horned owls peaked before, not during, dispersal. We propose that extended parental care makes the postfledging stage safe during optimal conditions, but that the relatively slow development during this stage incurs the cost of increased susceptibility to disease and other mortality factors under environmental stress.

Improving production from September-born Merino lambs with a lupin grain supplement and phomopsis-resistant lupin stubbles

1993 ◽  
Vol 33 (6) ◽  
pp. 713 ◽  
Author(s):  
PW Morcombe ◽  
JG Allen
Keyword(s):  
Weight Loss ◽  
Liver Injury ◽  
Western Australia ◽  
First Year ◽  
Ewe Lamb ◽  
Grazing Sheep ◽  
Staple Strength ◽  
Good Productivity ◽  
First Year Of Life ◽  
The Cost

As a means of providing nutrition on dry pasture in the wheatbelt of Western Australia, supplements of lupin grain were fed to late-born Merino lambs and their dams before weaning onto lupin stubble. Each ewe-lamb pair consumed an average 19.5 kg lupin grain over the 46 days before weaning. This produced an extra 3.6 kg (P<0.01) liveweight gain by these lambs compared with their unsupplemented cohorts at weaning. The growth of the weaned lambs grazing phomopsis-resistant lupin stubbles was primarily influenced by the amount of residual lupin grain available to each sheep and liver injury caused by ingestion of phomopsins. In the first 69 days of stubble grazing, sheep stocked at 10ha gained 7.3 kg while those stocked at 20ka gained 2.1 kg (P<0.001). In the first 13 months of life, lambs supplemented with lupin grain before weaning grew more (P<0.05) clean wool by 0.17 kg than the unsupplemented lambs. However, the value of this extra wool would not have covered the cost of the lupin grain eaten. Wool staples produced by sheep grazed at 10/ha on lupin stubble were stronger (P<0.001) than those produced by sheep grazed at 20ha (24.4 v. 17.7 N/ktex). The position of greatest weakness in the staple coincided with weight loss prior to removal from the stubble. Singleton lambs born in September and weaned onto a phomopsis-resistant lupin stubble reached liveweights consistent with survival over the summer and good productivity in their first year of life. The effects of lupinosis and reductions in wool staple strength may have been avoided by monitoring liveweight change and taking the sheep off the stubbles when they were near peak liveweight.

Impact of Brook Trout (Salvelinus fontinalis) Predation on the Crayfish Orconectes virilis in Three Michigan Lakes

1979 ◽  
Vol 36 (10) ◽  
pp. 1191-1196 ◽  
Author(s):  
H. Gowing ◽  
W. T. Momot
Keyword(s):  
Brook Trout ◽  
Salvelinus Fontinalis ◽  
First Year ◽  
Orconectes Virilis ◽  
Trout Population ◽  
Production Growth ◽  
First Year Of Life ◽  
The Cost ◽  
Slow Growing ◽  
Northern Michigan

The crayfish Orconectes virilis is a major component of the benthos of three small lakes in northern Michigan. These lakes contained stocked brook trout (Salvelinus fontinalis) populations (age-0 and age-I) at densities of 188, 411, and 1398 fish/ha. Crayfish were preyed upon by brook trout, but only during their first year of life. Two-year production of age-0 crayfish was approximately 94 kg in each lake; brook trout consumed only about 1–2% in lakes with lower density offish. Even with greater trout density and accompanying higher rate of exploitation (40%), there was no impact on recruitment of young crayfish because compensatory mortality of crayfish occurred in lakes with less trout predation. However, stocking trout at higher densities decreased trout growth and condition. While 2-yr production was highest (59 kg/ha) in the lake stocked at the highest density and lowest (17 kg/ha) in one stocked at the lowest density, the former was achieved at the cost of a very slow growing trout population. Most of the crayfish production is not utilized as trout food but enters the non-predatory pool of detrital organic matter. Key words: Orconectes virilis, brook trout, predation, production growth, mortality

scholarly journals Tetracycline Resistance in Escherichia coli and Persistence in the Infantile Colonic Microbiota

2006 ◽  
Vol 50 (1) ◽  
pp. 156-161 ◽  
Author(s):  
Nahid Karami ◽  
Forough Nowrouzian ◽  
Ingegerd Adlerberth ◽  
Agnes E. Wold
Keyword(s):  
Escherichia Coli ◽  
Ecological Impact ◽  
Tetracycline Resistance ◽  
Resistant Variety ◽  
First Year ◽  
Tetracycline Resistance Genes ◽  
Resistant Strains ◽  
First Year Of Life ◽  
The Cost ◽  
Population Counts

ABSTRACT The ecological impact of antibiotic resistance in the absence of selective pressure has been poorly studied. We assessed the carriage of tetracycline resistance genes, persistence in the microbiota, fecal population counts and virulence factor genes in 309 commensal, intestinal Escherichia coli strains obtained from 128 Swedish infants followed during the first year of life with regular quantitative fecal cultures. No infant was given tetracycline, but 25% received other antibiotics. Tetracycline resistance was identified in 12% of strains, all of which carried either tet(A) (49%) or tet(B) (51%) genes. Resistance to other antibiotics occurred in 50% of tet(A)-positive strains, 42% of tet(B)-positive strains and 13% of tetracycline-sensitive strains. However, colonization with tetracycline-resistant strains was unrelated to treatment with antibiotics. Strains that were tet(B)- or tet(A)-positive carried the genes for P fimbriae and aerobactin, respectively, more often than susceptible strains. Tetracycline-resistant and -susceptible strains were equally likely to persist among the intestinal microbiota for ≥3 weeks and had similar population numbers. However, when a resistant strain and a susceptible strain colonized a child simultaneously, the resistant variety showed lower counts (P = 0.03). In cases of long-term colonization by initially tetracycline-resistant E. coli strains, loss of tet genes occurred in 3 of 13 cases with variable effects on population counts. The results indicate that there is limited pressure against the carriage of tet genes in the infantile gut microbiota even in the absence of antibiotics. Resistant strains may possess colonization factors that balance the cost of producing resistance elements.

scholarly journals Fluvoxamina: profilo farmacoeconomico

2001 ◽  
Vol 2 (3) ◽  
pp. 175-184
Author(s):  
Mario Eandi
Keyword(s):  
Cost Minimization ◽  
Economic Benefits ◽  
Pharmacoeconomic Evaluation ◽  
Term Therapy ◽  
Purchase Cost ◽  
Antidepressant Use ◽  
Differential Costs ◽  
Long Term Therapy ◽  
The Cost

In this study we mean to outline a brief pharmacoeconomic review of fluvoxamine, considering only its antidepressant use. Essential objective is to highlight all the variables of cost effectiveness, tolerance and safety that can lead some types of differential costs. This study analyses the epidemiology and the economic burden of depression and a pharmacoeconomic profile of fluvoxamine, with its characteristics of effectiveness, tolerance, safety and handiness. The pharmacoeconomic evaluation is conducted according to the cost minimization analysis (CMA), considering fluvoxamine, Selective Serotonine Reuptake Inhibitors (SSRI) and antidepressant tricycic as native treatments. Fluvoxamine differs from the others SSRI far the purchase cost and it’s more convenient than the antidepressant tricycic treatment, especially for long term therapy. Economic benefits can be distributed in a balanced way between the Italian national healthcare system (NACS), the society and the patients.

scholarly journals MODEL OPTIMISASI UNTUK MASALAH MINIMISASI BIAYA PERJALANAN WISATA TUR-TUNGGAL DI ZONA KEPULAUAN

2021 ◽  
Vol 4 ◽  
pp. 68-75
Author(s):  
M Thezar Afifudin ◽  
Dian P. Sahar
Keyword(s):  
Cost Minimization ◽  
Programming Approach ◽  
Transportation Mode ◽  
Travel Costs ◽  
Non Linear Programming ◽  
Time Minimization ◽  
The Cost ◽  
The Given ◽  
Cost Components ◽  
Selection Of

This study aims to develop an optimization model for solving the insular cost minimization single-tour travel problems. The model was developed using an integer non-linear programming approach by considering the selection of departure and arrival points of an island, selecting accommodation points, selecting transportation mode departure schedules, and selecting travel routes both within islands and between islands. The cost components considered include inter-island travel costs, land travel costs, costs at selective points, and costs waiting for departure. A numerical experiment was conducted on the case of planning a tourist route in Maluku, Indonesia. The departure day scenario is built to find out the exact route and schedule on each day of departure with a minimum total cost. In addition, comparisons were also made to the results obtained in the time minimization model that was introduced earlier. The results showed that the model can adapt through variations of solutions to changes in the given parameters and objectives.

Overview: The Effects of Chemical Pollutants on the Fetus and Child

PEDIATRICS ◽  
1974 ◽  
Vol 53 (5) ◽  
pp. 860-862
Author(s):  
Frederick C. Robbins
Keyword(s):  
Young Child ◽  
Later Life ◽  
Point Of View ◽  
First Year ◽  
Fetal Life ◽  
Environmental Chemical ◽  
Chronic Disability ◽  
Chemical Pollutants ◽  
First Year Of Life ◽  
The Cost

What I have to say in my summary will be very personal. It concerns information that has filtered through those remaining neurones, and perhaps reflects certain prejudices which result from a good many years of association with a rather comparable field, the prevention of infectious diseases and the development and introduction of vaccines. This work has many problems similar to those pertaining to chemical pollutants. Throughout this Conference we have emphasized repeatedly the peculiar susceptibility of the fetus and young child to environmental chemical pollutants. It has been pointed out that, in addition to the periods of special vulnerability (particularly evident in early fetal life), the infant and child are more subject to certain environmental risks at different stages of development (e.g., the high incidence of poisonings in toddlers). Our special concern for the fetus and the young child is not based on these considerations alone. Clearly, any adverse happening to an individual early in life, particularly if it affects intellectual achievement, provides a great burden on the social system; and, the longer the period this person must be supported by society, the greater the burden and the greater the cost-not just in money but in many other ways. Death from the socioeconomic point of view is relatively unimportant, compared to a chronic disability. Behavioral psychologists have taught us about imprinting, which is particularly evident in some animals but has not been demonstrated in children. Dr. Holland's comments about the effect of air pollution in the first year of life, and its sequelae in later life are of great importance, and certainly need to be subjected to further study.

scholarly journals Valutazione economica di Infliximab (Remicade®) vs Etanercept (Enbrel®) nel trattamento dell’artrite reumatoide

2003 ◽  
Vol 4 (2) ◽  
pp. 77-86
Author(s):  
G. L. Colombo ◽  
A. Muzio ◽  
A. Longhi
Keyword(s):  
Drug Administration ◽  
Cost Minimization ◽  
National Health System ◽  
Drug Acquisition ◽  
Joint Damage ◽  
New Drugs ◽  
Lower Drug ◽  
Acquisition Costs ◽  
Differential Costs ◽  
The Cost

Rheumatoid arthritis is one of the most severe chronic pathologies, affecting the whole organism, with invalidating outcomes that affect the quality of life of the patients. Its prevalence is estimated to be about 0,5% in Italy, with elevated costs for the national health system (NHS) and the society, in spite of the best treatment with traditional therapies that include anti-inflammatory and disease modifying antirheumatic drugs (DMARDs). The introduction of new drugs with biological activity, mainly acting through an antagonism of tumor necrosis factor (anti-TNF), is a great advance in the management of the disease, as their use has been shown to be effective in slowing the progression of the joint damage, and sometimes in reversing it,. The present article present a cost-minimization study conducted by comparing the two anti-TNFs available in Italy, etanercept and infliximab, assuming equal efficacy and approached from the perspectives of the Italian NHS and society. Only differential costs were considered, i.e. drug acquisition, drug administration and patient monitoring costs, and the analysis comprised two treatment years, in order two account for the cost differences between the first treatment year and the following. The analysis showed that infliximab represents the more convenient alternative from both the NHS and the society points of view, mainly due to lower drug acquisition costs, which offset the higher drug administration costs: the total two year treatment costs per patient with etanercept resulted of 20.173 euro and 22.164 euro from the societal and NHS perspectives, respectively, while the same costs resulted of 13.715 euro and 14.795 euro with infliximab. These results were tested with thorough sensitive analyses, conducted by varying the principal cost and time consumption estimates, that showed that etanercept results less convenient in all the hypothesis tested.

The Development of Swallowing Respiratory Coordination

2009 ◽  
Vol 18 (1) ◽  
pp. 19-24
Author(s):  
Maggie-Lee Huckabee
Keyword(s):  
Cortical Activation ◽  
First Year ◽  
Healthy Children ◽  
Nasal Airflow ◽  
Single Session ◽  
Primary Finding ◽  
Patterns Of Behavior ◽  
Cortical Modulation ◽  
First Year Of Life ◽  
Swallowing Apnea

Abstract Research exists that evaluates the mechanics of swallowing respiratory coordination in healthy children and adults as well and individuals with swallowing impairment. The research program summarized in this article represents a systematic examination of swallowing respiratory coordination across the lifespan as a means of behaviorally investigating mechanisms of cortical modulation. Using time-locked recordings of submental surface electromyography, nasal airflow, and thyroid acoustics, three conditions of swallowing were evaluated in 20 adults in a single session and 10 infants in 10 sessions across the first year of life. The three swallowing conditions were selected to represent a continuum of volitional through nonvolitional swallowing control on the basis of a decreasing level of cortical activation. Our primary finding is that, across the lifespan, brainstem control strongly dictates the duration of swallowing apnea and is heavily involved in organizing the integration of swallowing and respiration, even in very early infancy. However, there is evidence that cortical modulation increases across the first 12 months of life to approximate more adult-like patterns of behavior. This modulation influences primarily conditions of volitional swallowing; sleep and naïve swallows appear to not be easily adapted by cortical regulation. Thus, it is attention, not arousal that engages cortical mechanisms.

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