Integrated Value-based Assessments of Screening and Expensive Treatments; a focus on health-economic aspects

Global health costs have been rising for years with an annual growth rate of approximately 8%. This trend also applies to the Netherlands, where the increase in healthcare expenses continues to escalate. The costs of the basic health insurance package increased by 2.9% in 2022, reaching a total of €51.3 billion. This increase is partly due to the inclusion of new expensive medications in the Dutch health insurance. Projections indicate that future population aging and the influx of pricey medications could trigger exponential cost spikes and strain healthcare accessibility.The thesis presents measures to manage the cost increase and maintain accessibility to healthcare. Part 1 focuses on preventive measures for conditions reliant on costly medications such as Hepatitis C (HCV) and lung cancer. Early detection of HCV in migrants and pregnant women proves cost-effective, particularly through targeted screening of at-risk groups and potentially monitoring asymptomatic patients. Similarly, lung cancer screening demonstrates cost-effectiveness across various age groups of smokers and ex-smokers. Implementing screening programs for HCV and lung cancer in specific populations could reduce expenditure on expensive medications while concurrently enhancing health outcomes.Part 2 focuses on the current system of approval and reimbursement of expensive medicines, introducing value-based pricing as a potential solution. This approach integrates real-world data with clinical trial-data to gauge the value and costs of medications more accurately. It holds promise for transparent pricing and enhanced accessibility to expensive drugs, contingent on collaborative efforts among hospitals, health insurers, manufacturers, and the Ministry of Health, Welfare, and Sport

Preferred Learning Styles in Kindergarten Students by the Viewpoint of their Mothers' and Teachers'

One of the most important uses of learning styles is that it makes it easy for teachers and parents to incorporate them into their teaching. There are different learning styles. Three of the most popular in kindergartens grades (KG 1); ones are visual, auditory, and kinesthetic in which students take in information. Some students are visual learners, while others are auditory or kinesthetic learners. While students use all of their senses to take in information, they seem to have preferences in how they learn best. In order to help students learn, teachers and parents need to teach as many of these preferences as possible. This study is investigated of learning styles for Jordan Society, (465) mothers, and (74) females teachers completed (LSI) to determine if their children / students preferred learning styles auditory, visual or kinesthetic. The finding showed that the children's preferred auditory learning style by the viewpoint of his mothers. Therefore, the teachers stated that visual learning style is preferred in kindergartens grades (KG 1) students. The purpose of this study is to increase awareness and understanding of the effect of mother's education, gender, and environment on learning styles. A review of the literature will determine how learning styles affect the teaching process. Keywords: Learning styles, Auditory, Visual, Kinesthetic, Gender, mother's education

Dewetting Polymer Bilayers by Solvent Vapour Annealing: A Pathway to Manufacturing Biomimetic Water Harvesting Surface Coatings

Producing patterned surfaces by a simple and controlled process has important implications for an increasing number of technological and biomedical applications. The dewetting of thin polymer films is a robust and efficient route towards the fabrication of surfaces with topographical and chemical patterns from the nano to the macro scale. In this Thesis, a solvent vapour annealing technique is presented which provides control over the dynamics of the dewetting process, as well as the dewetted morphology. Polystyrene (PS) films, which are only slightly metastable on a silicon substrate with a native oxide layer (SiO/Si), were annealed in the saturated vapour of a toluene-ethanol mixture, resulting in the fast dewetting of the PS film from the substrate. The dewetting rate was shown to depend on the ratio of the two solvents: the poor solvent ethanol acted to increase the dewetting driving force, while the good solvent toluene, acted to plasticise the PS. The morphology of the rims surrounding the holes and the PS droplets were also affected by the concentration of ethanol in the solvent mixture. Utilising the principle of good-poor solvent mixture annealing to promote the dewetting of polymer films, a bilayer of poly(4-vinylpyridine) (P4VP) / PS films was dewetted to produce topographically and chemically patterned polymeric surfaces. Acetone and ethanol, poor solvents for P4VP, and water, a non-solvent for P4VP, were combined in binary mixtures and the individual effect of each solvent on dewetting rate, rim and droplet morphology was investigated. Using this solvent vapour annealing technique, nano to macro scale P4VP droplets on PS coated copper substrates were prepared and the water harvesting capability of these patterned surfaces was analysed in a custom-built condensation chamber. The effect of pattern size and density was compared with the condensation performance of an unpatterned hydrophobic coating under different humidity and temperature conditions

Integrated Value-based Assessments of Screening and Expensive Treatments; a focus on health-economic aspects

Global health costs have been rising for years with an annual growth rate of approximately 8%. This trend also applies to the Netherlands, where the increase in healthcare expenses continues to escalate. The costs of the basic health insurance package increased by 2.9% in 2022, reaching a total of €51.3 billion. This increase is partly due to the inclusion of new expensive medications in the Dutch health insurance. Projections indicate that future population aging and the influx of pricey medications could trigger exponential cost spikes and strain healthcare accessibility.The thesis presents measures to manage the cost increase and maintain accessibility to healthcare. Part 1 focuses on preventive measures for conditions reliant on costly medications such as Hepatitis C (HCV) and lung cancer. Early detection of HCV in migrants and pregnant women proves cost-effective, particularly through targeted screening of at-risk groups and potentially monitoring asymptomatic patients. Similarly, lung cancer screening demonstrates cost-effectiveness across various age groups of smokers and ex-smokers. Implementing screening programs for HCV and lung cancer in specific populations could reduce expenditure on expensive medications while concurrently enhancing health outcomes.Part 2 focuses on the current system of approval and reimbursement of expensive medicines, introducing value-based pricing as a potential solution. This approach integrates real-world data with clinical trial-data to gauge the value and costs of medications more accurately. It holds promise for transparent pricing and enhanced accessibility to expensive drugs, contingent on collaborative efforts among hospitals, health insurers, manufacturers, and the Ministry of Health, Welfare, and Sport

Integrated Value-based Assessments of Screening and Expensive Treatments; a focus on health-economic aspects

Global health costs have been rising for years with an annual growth rate of approximately 8%. This trend also applies to the Netherlands, where the increase in healthcare expenses continues to escalate. The costs of the basic health insurance package increased by 2.9% in 2022, reaching a total of €51.3 billion. This increase is partly due to the inclusion of new expensive medications in the Dutch health insurance. Projections indicate that future population aging and the influx of pricey medications could trigger exponential cost spikes and strain healthcare accessibility.The thesis presents measures to manage the cost increase and maintain accessibility to healthcare. Part 1 focuses on preventive measures for conditions reliant on costly medications such as Hepatitis C (HCV) and lung cancer. Early detection of HCV in migrants and pregnant women proves cost-effective, particularly through targeted screening of at-risk groups and potentially monitoring asymptomatic patients. Similarly, lung cancer screening demonstrates cost-effectiveness across various age groups of smokers and ex-smokers. Implementing screening programs for HCV and lung cancer in specific populations could reduce expenditure on expensive medications while concurrently enhancing health outcomes.Part 2 focuses on the current system of approval and reimbursement of expensive medicines, introducing value-based pricing as a potential solution. This approach integrates real-world data with clinical trial-data to gauge the value and costs of medications more accurately. It holds promise for transparent pricing and enhanced accessibility to expensive drugs, contingent on collaborative efforts among hospitals, health insurers, manufacturers, and the Ministry of Health, Welfare, and Sport

A Case Study for Developing Specification Limits for Hot-Mix Asphalt and the Impact on Pay Factors

Specification limits utilized in percent within limits (PWL) specifications are developed by highway agencies, and used to determine the percent of hot-mix asphalt “Lot” within specified limits, and used later to make payments to contractors. Development of specification limits must be based on the typical variability of test results used in PWL specifications. Using overly wide or tight specification limits to evaluate the new pavement could cause risk for highway agencies or contractors, respectively. This study explains how to develop new specification limits and evaluate the current ones by using different data sets from projects conducted by the Oregon Department of Transportation (ODOT). All the calculations and analysis performed in this study are based on data collected from 15 different projects and contractors. Typical standard deviations (within-process variability) and “target miss” variability (how the mean values of test results are variable around the target values) have been determined for aggregate gradation, asphalt content, and in-place density which are considered as pay-elements in ODOT standard specifications. New specification limits have been developed based on typical variability. Then current specification limits adopted by ODOT were evaluated and compared to the proposed new specification limits. Three projects have been utilized to investigate the impact of using the proposed new specification limits on final payment. Using the developed new limits will lead to a decrease in the final costs of the projects. Also, ODOT will see an improvement in contractors’ performance as these new limits will encourage the contractors to use high-quality materials with a low variability. It is recommended that DOTs consider regular evaluation of their specification limits by using new records and modify the specifications when needed

The Effectiveness of Cognitive Behavioral Training Program in Reducing the Risk of Diabetes among University Students

This study aimed to build cognitive training program of diabetes prevention of students who have risk elements of diabetes. The sample of the study which consisted of (26) university students was chosen regarding their results of the  accumulative average of sugar in addition to their obesity indicator ,  glucose  and  cholesterol  percent in blood . The sample of the study was divided into two experimental and control groups. The training program which consisted of (16) training sessions based on the cognitive behavioral theory. The results of the study showed that there were statistically significant differences between the two groups in risk elements of diabetes in favor of the experimental group, which its weight and sugar and glucose level in blood decreased.  The study concluded that the training program that based on the cognitive behavioral theory was effective in reducing the experimental risk elements of diabetes. In addition, the study recommended carrying out further studies, which care of the guided and training programs of diabetics in different categories of age. Keywords: training program, diabetes, risk elements

Certain Developments of Laguerre Equation and Laguerre Polynomials via Fractional Calculus

Recently, much interests have been paid in studying fractional calculus due to its effectiveness in modeling many of the natural phenomena. Motivated essentially by the success of the applications of the orthogonal polynomials, this paper is mainly devoted to developing Laguerre equation and Laguerre polynomials in the fractional calculus setting. We provide some type of generalizations of the classical Laguerre polynomials, via conformable fractional calculus. We start by solving the fractional Laguerre equation in the sense of conformable calculus about the fractional regular singular point. Next, we write the conformable fractional Laguerre polynomials (CFLPs), through various generating functions. Subsequently, Rodrigues’ type representation formula of fractional order is reported, besides certain types of recurrence relations are then developed. The conformable fractional integral and the fractional Laplace transform, and the orthogonal property of CFLPs, are established. As an application, we present a numerical technique to obtain solutions of interesting differential equations in the frame of conformable derivative. For this purpose, a new operational matrix of the fractional derivative of arbitrary order for CFLPs is derived. This operational matrix is applied together with the generalized Laguerre tau method for solving general linear multi-term fractional differential equations (FDEs). The method has the advantage of obtaining the solution in terms of the CFLPs’ parameters. Finally, some examples are given to illustrate the applicability and efficiency of the proposed method

Cognitive and Emotional Needs of the Gifted Students From Themselves Perspective: Survey

This study aimed at investigates the cognitive and emotional needs for the gifted students and there relationships with variables (sex, place of residence, and stage for talented students) in the Educational Directorate of Salt government schools in Jordan. The study has been applied on a 40 talented students. The rustles of the study shown that there is an emotional need of the students more than the cognitive needs in general. The results showed that there are emotional needs for students more than the cognitive needs. The mean of students performance on the paragraphs of emotional needs in general is higher than in the post-cognitive needs, The results also showed that there is a significant statistical difference in terms of students’ sex and educational stage