The Long-Term Effectiveness of Methadone Maintenance Treatment in Prevention of Hepatitis C Virus Among Illicit Drug Users : A Modeling Study

Article Accepted Date: Oct 7, 2013 Acknowledgments: We would like to thank all MMT centers' staff in Shiraz for their cooperation in this study. Funding Support: This study was funded and supported by the Tehran University of Medical Sciences.Peer reviewedPublisher PD

Projection of Diabetes Population Size and Associated Economic Burden through 2030 in Iran : Evidence from Micro-Simulation Markov Model and Bayesian Meta-Analysis

Acknowledgments The authors would like to thank kindly all advisors and colleagues, for their valuable technical support. We would like to thank you Ms Laura Marie Dysart for editing the paper.Peer reviewedPublisher PD

Health Related Quality of Life in Patients with Type 2 Diabetes Mellitus in Iran : A National Survey

Acknowledgements The authors would like to thank kindly all participants in the study.Peer reviewedPublisher PD

Cost-Effectiveness Analysis of Intravascular Targeted Temperature Management after Cardiac Arrest in England

Background: Targeted temperature management (TTM) has been shown to improve neurological outcomes and survival in patients resuscitated from cardiac arrest; however, the cost effectiveness of multiple TTM methods is not well studied. Objective: This study aimed to evaluate the cost effectiveness of intravascular temperature management (IVTM) using Thermogard XP compared with surface cooling methods after cardiac arrest in the England from the perspectives of the UK national health service and Personal Social Services. Methods: We developed a multi-state Markov model that evaluated IVTM (Thermogard XP) compared with surface cooling using two different devices (Blanketrol III and Arctic Sun 5000) over a short-term and lifetime time horizon. Model input parameters were obtained from the literature and local databases. We assumed a hypothetical cohort of 1000 patients who required TTM after cardiac arrest per year in the England. The outcomes were costs (in £, year 2019 values) and quality-adjusted life-years (QALYs), discounted at 3.5% annually. Deterministic and probabilistic sensitivity analyses were undertaken to examine the effect of alternative assumptions and uncertainty in model parameters on the results. Results: The cost-effectiveness analysis determined that Thermogard XP resulted in direct cost savings of £2339 and £2925 (per patient) compared with Blanketrol III and Arctic Sun 5000, respectively, and a gain of 0.98 QALYs over the patient lifetime. The probabilistic sensitivity analysis demonstrated that the probability of Thermogard XP being cost saving would be 69.2% and 65.3% versus the Arctic Sun 5000 and Blanketrol III, respectively. Conclusion: Implementation of IVTM using Thermogard XP can lead to cost savings and improved patient quality of life versus surface cooling methods

Parent-child reading to improve language development and school readiness: A systematic review and meta-analysis (Final report)

Item also deposited in University of Newcastle repository (21 July 2018) at: https://eprints.ncl.ac.uk/246226Executive Summary: What we know already - For a number of years now population studies have shown us that parental book reading is an important feature of what is sometimes called the child’s Home Learning Environment (HLE). Evidence suggests that the more parents read to their children and the more books there are in the child’s home, the better a child will perform in terms of their later academic and social performance. This then raises the question of whether it is possible to provide interventions that promote early reading and whether those effects last. There have been a number of reviews of the intervention literature, but these have included a mixture of different types of studies and ages of children and have a variety of different foci. In this report we carry out a narrowly constrained systematic review focusing specifically on book reading interventions carried out specifically by parents and carers with preschool children (up to the age of five years) and looking primarily at the impact of parent child reading interventions on expressive language (use of language to convey meaning to others) and receptive language (understanding the words and language of others) and pre-reading skills.This is the final published version of a report and research snapshot (summary) published in its final definitive form by Newcastle University and Queen Margaret University, 2018.Report for the Nuffield Foundation.Research project funded by the Nuffield Foundation.pubpu

Estimation and prediction of avoidable health care costs of cardiovascular diseases and type 2 diabetes through adequate dairy food consumption: a systematic review and micro simulation modeling study

Background: Recent evidence from prospective cohort studies show a relationship between consumption of dairy foods and cardiovascular diseases (CVDs) and type 2 diabetes mellitus (T2DM). This association highlights the importance of dairy foods consumption in prevention of these diseases and also reduction of associated healthcare costs. The aim of this study was to estimate avoidable healthcare costs of CVD and T2D through adequate dairy foods consumption in Iran. Methods: This was a multistage modelling study. We conducted a systematic literature review in PubMed and EMBASE to identify any association between incidence of CVD and T2DM and dairy foods intake, and also associated relative risks. We obtained age- and sex-specific dairy foods consumption level and healthcare expenditures from national surveys and studies. Patient level simulation Markov models were constructed to predict the disease incidence, patient population size and associated healthcare costs for current and optimal dairy foods consumption at different time horizons (1, 5, 10 and 20 years). All parameters including costs and transition probabilities were defined as statistical distributions in the models, and all analyses were conducted by accounting for first and second order uncertainty. Results: The systematic review results indicated that dairy foods consumption was inversely associated with incidence of T2DM, coronary heart disease (CHD) and stroke. We estimated that the introduction of a diet containing 3 servings of dairy foods per day may produce a $0.43 saving in annual per capita healthcare costs in Iran in the first year due to saving in cost of CVD and T2DM treatment. The estimated savings in per capita healthcare costs were$8.42, $39.97 and$190.25 in 5, 10 and 20-years’ time, respectively. Corresponding total aggregated avoidable costs for the entire Iranian population within the study time horizons were $33.83,$661.31, $3,138.21 and$14,934.63 million, respectively. Conclusion: Our analysis demonstrated that increasing dairy foods consumption to recommended levels would be associated with reductions in healthcare costs. Further randomized trial studies are required to investigate the effect of dairy foods intake on cost of CVD and T2DM in the population

Cost-of-Illness Analysis of Type 2 Diabetes Mellitus in Iran

Diabetes is a worldwide high prevalence chronic progressive disease that poses a significant challenge to healthcare systems. The aim of this study is to provide a detailed economic burden of diagnosed type 2 diabetes mellitus (T2DM) and its complications in Iran in 2009 year.This is a prevalence-based cost-of-illness study focusing on quantifying direct health care costs by bottom-up approach. Data on inpatient hospital services, outpatient clinic visits, physician services, drugs, laboratory test, education and non-medical cost were collected from two national registries. The human capital approach was used to calculate indirect costs separately in male and female and also among different age groups.The total national cost of diagnosed T2DM in 2009 is estimated at 3.78 billion USA dollars (USD) including 2.04±0.28 billion direct (medical and non-medical) costs and indirect costs of 1.73 million. Average direct and indirect cost per capita was 842.6±102 and 864.8 USD respectively. Complications (48.9%) and drugs (23.8%) were main components of direct cost. The largest components of medical expenditures attributed to diabetes's complications are cardiovascular disease (42.3% of total Complications cost), nephropathy (23%) and ophthalmic complications (14%). Indirect costs include temporarily disability (335.7 million), permanent disability (452.4 million) and reduced productivity due to premature mortality (950.3 million).T2DM is a costly disease in the Iran healthcare system and consume more than 8.69% of total health expenditure. In addition to these quantified costs, T2DM imposes high intangible costs on society in terms of reduced quality of life. Identification of effective new strategies for the control of diabetes and its complications is a public health priority

Laparoscopic colposuspension for urinary incontinence in women

We are grateful to the editors and peer referees who have provided valuable comments on draBs of this update and to Sheila Wallace for her help with the searches. We are also grateful to Dr Karen Boyd for providing information about her trial. We would like to acknowledge the work of all contributors to previous versions of the review, particularly Don Wilson who was responsible for the review from its inception. An earlier version of this review was part of a project to add brief economic commentaries to Cochrane Incontinence's reviews on surgery for urinary incontinence in women (Dean 2017). This project was supported by the National Institute for Health Research (NIHR), via the Cochrane Review Incentive Scheme 2016.Peer reviewedPublisher PD

Evaluation of the sedative and physiological effects of xylazine, detomidine, medetomidine and dexmedetomidine in goats

Abstract Background Many α2‐agonists are commonly used for sedation and analgesia in ruminants. Introduction The present study aims to compare the sedative and physiological effects of intravenous (IV) administration of xylazine, detomidine, medetomidine and dexmedetomidine in goats. Methods Ten healthy goats aged 6 ± 1 months and weighing 15 ± 2 kg were used in experimental, crossover Latin square, randomised and blinded study. Animals were assigned to five IV treatments: control (normal saline); xylazine (100 μg kg−1); detomidine (50 μg kg−1); medetomidine (20 μg kg−1) and dexmedetomidine (5 μg kg−1). The degree of sedation was investigated using a numerical ranking scale of 0–10. Sedation scores were compared at each time using nonparametric (Kruskal–Wallis and Mann–Whitney U) tests. Results Heart rate (HR), respiratory rate (RR), rectal temperature (RT), ruminal motility and capillary refill time (CRT) were performed before (baseline) and after drug administration. Animals in α2‐adrenergic agonist treatments were sedated at 5–60 min. There were no significant differences among α2‐adrenergic agonist treatments at 5–60 min in sedation scores. HR significantly decreased from baseline 5–90 min after α2‐adrenergic agonists’ administration. Ruminal motility was decreased in α2‐adrenergic agonist treatments at 5, 90 and 120 min and absent at 10–60 min. A significant decrease from baseline in RR was detected between 30 and 90 min after α2‐adrenergic agonists’ administration. RT was unchanged in any treatment for 120 min. CRT was less than 2 s at all time points following each treatment. Conclusions The duration of sedation was up to 60 min after IV administration of xylazine (100 μg kg−1), detomidine (50 μg kg−1), medetomidine (20 μg kg−1) and dexmedetomidine (5 μg kg−1) in goats in this study. No significant differences were detected between xylazine, detomidine, medetomidine and dexmedetomidine in goats