Effectiveness and Cost-Benefit of an Elementary School-Based Telehealth Program

Utilization of telehealth in school-based health centers (SBHCs) is increasing rapidly during the COVID-19 pandemic. This study used a quasi-experimental design to evaluate the effect on school absences and cost-benefit of telehealth-exclusive SBHCs at 6 elementary schools from 2015–2017. The effect of telehealth on absences was estimated compared to students without telehealth using negative binomial regression controlling for absences and health suite visits in 2014 and sociodemographic characteristics. The sample included 7,164 observations from 4,203 students. Telehealth was associated with a 7.7% (p = 0.025; 95% CI: 1.0%, 14%) reduction in absences (0.60 days/year). The program cost $189,000/yr and an estimated total benefit of $384,995 (95% CI: $60,416; $687,479) and an annual net benefit of $195,873 (95% CI: −$128,706; $498,357). While this cost-benefit analysis is limited by a lack of data on total healthcare utilization, the use of telehealth-exclusive SBHCs can improve student health and attendance while delivering cost savings to society.

Case Study: Single-Aqueous-Phase Retarded Acid Performance Offshore Sarawak

The purpose of acid stimulation of carbonate formations is to increase production. The essential component for these stimulation fluids is the carbonate-dissolving agent, which creates conductivity channels connecting the reservoir with the wellbore. Controlling the reactivity of hydrochloric acid (HCl), the most-used dissolving agent due to its high dissolving capacity, wide availability, and low unit cost, is the most viable approach to successfully stimulate a high-temperature carbonate reservoir. It is essential to retard the HCl-carbonate rock reaction to achieve the optimum balance between total fluid used and enhanced well production. It is well documented that the conventional emulsified acid exhibits high friction pressure, is cumbersome to prepare, and performs with sensitivity to a multitude of parameters. These drawbacks have prevented the industrywide adoption of this method. The recently developed single-aqueous-phase retarded acid (SAPRA) designed for primarily 15–25% HCl solutions represents a significant step forward. The first successful field implementation of SAPRA took place offshore the Malaysian state of Sarawak in early 2021. At Sarawak, the HCl reactivity was regulated and retarded by a single potent low- dosage additive, which is compatible with selected acid corrosion inhibitors, nonemulsifiers, H2S scavengers, other commonly used additives, and if necessary, friction reducers. Improving Acid Stimulation Efficiency The technical approach behind SAPRA is based on chemical technology that enables the reduction of the reaction rate and allows the control of the diffusion/mass transfer mechanism. This is key in designing the acid treatment to optimize chemical program cost and well production and has been extensively studied (Al Moajil et al. 2020; Czupski et al. 2020; Daeffler et al. 2018; and Abdrazakov et al. 2018). The technology was developed utilizing a surface barrier concept where transiently adsorbed retarder molecules adhere to a carbonate surface and thus, delay the hydrogen ion carbonate reaction over a range of acid concentrations and operating temperatures. Due to the complexity of the chemical interactions among all the additives in the acid fluid system, the selected additives must be screened to ensure mutual compatibility before conducting performance testing such as corrosion rate, calcite solubility capacity characterization, and coreflow measurements. Incompatible chemistry could lead to severe corrosion issues such as the examples shown in Table 1.

Cost-effectiveness analysis of a large-scale crèche intervention to prevent child drowning in rural Bangladesh

Background Drowning is the leading cause of death among children 12–59 months old in rural Bangladesh. This study evaluated the cost-effectiveness of a large-scale crèche (daycare) intervention in preventing child drowning. Methods The cost of the crèches intervention was evaluated using an ingredients-based approach and monthly expenditure data collected prospectively throughout the study period from two agencies implementing the intervention in different study areas. The estimate of the effectiveness of the crèches intervention was based on a previous study. The study evaluated the cost-effectiveness from both a program and societal perspective. Results From the program perspective the annual operating cost of a crèche was $416.35 (95% CI: $221 to $576), the annual cost per child was $16 (95% CI: $8 to $23), and the incremental-cost-effectiveness ratio (ICER) per life saved with the crèches was $17,008 (95% CI: $8817 to $24,619). From the societal perspective (including parents time valued) the ICER per life saved was − $166,833 (95% CI: − $197,421 to − $141,341)—meaning crèches generated net economic benefits per child enrolled. Based on the ICER per disability-adjusted-life years averted from the societal perspective (excluding parents time), $1978, the crèche intervention was cost-effective even when the societal economic benefits were ignored. Conclusions Based on the evidence, the crèche intervention has great potential for generating net societal economic gains by reducing child drowning at a program cost that is reasonable.

Quantifying Metrology’s Real Value

Where practicable, the total end-to-end test-and-calibration program cost would serve as the ultimate measurement quality metric (MQM). Total cost includes both the capitalization and ongoing costs that support product quality (sometimes called cost of quality) and the consequence costs (sometimes called cost of poor quality) that result from imperfect measurement and products. End-to-end means capturing costs from the entire traceability chain: from measurement standards to end products. Minimizing this MQM, total end-toend cost (TETEC), equates to optimizing measurement quality assurance (MQA). Lacking easily available measurement and performance data automatically fed to modeling software, organizations have found cost metrics unimaginable or impracticable, so their measurement programs instead target more easily computed MQMs, such as false-accept risk or simpler proxies thereof, setting minimum, but sub-optimal, quality levels. However, modern computing systems and software, such as laboratory management systems with testpoint- level traceability, rapidly approach the point at which the TETEC MQM will become practicable. Preparing for this eventuality, the NCSLI 173 Metrology Practices Committee has developed models that relate costs to measurement program information such as product specifications, test and measurement uncertainties, calibration intervals and reliability targets. Applications include optimizing overall program MQA, but also estimating the value of metrology and return on equipment investments, selecting instruments, designing test and calibration processes, designing products. This paper applies the cost models to case studies and examples to illustrate some applications.

Sandia’s Uncertainty Calculator: A Case Study in the Graded Approach to Software Quality Assurance

Where practicable, the total end-to-end test-and-calibration program cost would serve as the ultimate measurement quality metric (MQM). Total cost includes both the capitalization and ongoing costs that support product quality (sometimes called cost of quality) and the consequence costs (sometimes called cost of poor quality) that result from imperfect measurement and products. End-to-end means capturing costs from the entire traceability chain: from measurement standards to end products. Minimizing this MQM, total end-toend cost (TETEC), equates to optimizing measurement quality assurance (MQA). Lacking easily available measurement and performance data automatically fed to modeling software, organizations have found cost metrics unimaginable or impracticable, so their measurement programs instead target more easily computed MQMs, such as false-accept risk or simpler proxies thereof, setting minimum, but sub-optimal, quality levels. However, modern computing systems and software, such as laboratory management systems with testpoint- level traceability, rapidly approach the point at which the TETEC MQM will become practicable. Preparing for this eventuality, the NCSLI 173 Metrology Practices Committee has developed models that relate costs to measurement program information such as product specifications, test and measurement uncertainties, calibration intervals and reliability targets. Applications include optimizing overall program MQA, but also estimating the value of metrology and return on equipment investments, selecting instruments, designing test and calibration processes, designing products. This paper applies the cost models to case studies and examples to illustrate some applications.

Budesonide-Glycopyrronium-Formoterol Fumarate Dihydrate (Breztri Aerosphere)

CADTH recommends that Breztri Aerosphere be reimbursed by public drug plans for the treatment of chronic obstructive pulmonary disease (COPD), including chronic bronchitis and/or emphysema if certain conditions are met. Breztri Aerosphere should only be covered to treat patients who are not controlled on optimal dual inhaled therapy for COPD. Breztri Aerosphere should be reimbursed similar to Trelegy Ellipta. The price of Breztri Aerosphere should not exceed the drug program cost with the least-costly fixed-dose inhaled corticosteroid/long-acting muscarinic antagonist/long-acting beta2-agonist (ICS/LAMA/LABA) triple therapy combination for the same indication.

An Imperfect Debugging Software Reliability Growth Model: Optimal Release Problems through Warranty Period based on Software Maintenance Cost Model

Software come to be an important element in recent times, from small residence hold gadgets to large machinery wishes fine software. software development is a technical oriented system where range of quantitative and qualitative duties have been completed parallel a good way to meets the needs of the consumer. Many people play a vital role within the improvement of software program product, consequently there is chance of committing errors by way of these humans and these errors becomes faults in later stages. Computing software program cost for the duration of software development can facilitate us predicting the time of release of the software. In this paper we have investigated release time of software program by way of considering the imperfect debugging software program reliability growth model and cost model.

Factors influencing international and U.S. dentists’ interest in advanced periodontal education: a pilot study

Background The enrollment of international periodontal students in U.S. dental schools has been increasing in recent years. Interest in applying to a periodontics specialty program may differ between U.S and international dental school graduates. The purpose of this study is to assess, from the perspective of periodontal residents, (1) factors that interest dental students to apply to periodontics programs and (2) differences in background and interest between U.S and international graduates. Methods A 20-question survey was sent out electronically to periodontics residents. The survey questions were designed to obtain information on the participants’ backgrounds, factors that influenced them to specialize in periodontics, and their preferred features of graduate periodontics programs. The data were analyzed using descriptive statistics for socio-demographic variables, a Wilcoxon two sample test to compare mean Likert scale scores, and Fisher’s exact test for associations between comparison groups. Results Of the two hundred residents invited to participate, 28% responded. The majority of the respondents stated that interest in implantology, previous exposure to periodontal procedures, interest in improving periodontal surgery skills, a good relationship with periodontics faculty, the residency curriculum, advanced program and faculty reputation as influencing factors in selecting periodontics as specialization. The majority of international graduates have up to $50,000 dollars in student debt; by comparison, half of the domestic graduates have a debt of over $250,000 dollars (p ≤ 0.05). Working experience as a dentist was significantly greater among international residents (73%) in comparison to U.S graduates (32%). In contrast with international graduates, U.S graduates more frequent reported that good relationships with the periodontics predoctoral faculty contributed to their interest in periodontics (p ≤ 0.05). Program cost and location had a greater impact on the decision of U.S. graduates than international graduates (p ≤ 0.05). Conclusions Overall, factors associated with personal finance and predoctoral education have a greater impact on the decision of American graduates than international graduates to pursue an advanced education in periodontics, which may influence the increased enrollment of international students.