Cost-Effectiveness Analysis of Administering Tranexamic Acid to Bleeding Trauma Patients Using Evidence from the CRASH-2 Trial

OBJECTIVE: To assess the cost effectiveness of giving tranexamic acid (TXA) to bleeding trauma patients in low, middle and high income settings. METHODS: The CRASH-2 trial showed that TXA administration reduces the risk of death in bleeding trauma patients with a small but statistically significant increase in non-intensive care stay. A Markov model was used to assess the cost effectiveness of TXA in Tanzania, India and the United Kingdom (UK). The health outcome was the number of life years gained (LYs). Two costs were considered: the cost of administering TXA and the cost of additional days in hospital. Cost data were obtained from hospitals, World Health Organization (WHO) database and UK reference costs. Cost-effectiveness was measured in international dollars ($) per LY. Both deterministic and probabilistic sensitivity analyses were performed to test the robustness of the results to model assumptions. FINDINGS: Administering TXA to bleeding trauma patients within three hours of injury saved an estimated 372, 315 and 755 LYs per 1,000 trauma patients in Tanzania, India and the UK respectively. The cost of giving TXA to 1,000 patients was$17,483 in Tanzania, $19,550 in India and$30,830 in the UK. The incremental cost of giving TXA versus not giving TXA was $18,025 in Tanzania,$20,670 in India and $48,002 in the UK. The estimated incremental cost per LY gained of administering TXA is$48, $66 and$64 in Tanzania, India and the UK respectively. CONCLUSION: Early administration of TXA to bleeding trauma patients is likely to be highly cost effective in low, middle and high income settings. TRIAL REGISTRATION: This paper uses data collected by the CRASH 2 trial: Controlled-Trials.com ISRCTN86750102, Clinicaltrials.govNCT00375258 and South African Clinical Trial Register DOH-27-0607-1919

Psychological capital of employee and innovativeness of Small and Medium-Sized Enterprises (SMEs)

Purpose: This study explores the association between employees (PsyCap) and the innovation ability of Small and Medium-Sized Enterprises (SMEs). Research methodology:  A descriptive correlational research design was employed, involving 150 respondents selected through simple random sampling. Two adapted questionnaires were used to measure PsyCap and innovation outcomes. Results: The results revealed A The strong positive relationship between employees' PsyCap and innovation outcomes (p<0.000, R=0.650), particularly creativity, risk-taking, and problem-solving. These findings underscore the importance of PsyCap as a significant predictor of innovative behavior within SMEs. Limitations: The study's limitations include its focus on SMEs, which may limit the generalizability of the results to larger organizations or different geographical regions. Despite this, the study contributes valuable insights into Human Resource Management (HRM) practices, emphasizing the need for targeted employee training and strategic organizational growth initiatives. Contributions: The findings highlight the critical role of Psychological Capital in fostering innovation and offer practical implications for enhancing competitiveness and sustainability in SMEs through the development of employees' psychological resources

Does Visualization Improve Our Ability To Find And Learn From Internet Based Information?

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