The cost effectiveness of integrated care for people living with HIV including antiretroviral treatment in a primary health care centre in Bujumbura, Burundi

The incremental cost effectiveness of an integrated care package (i.e., medical care including antiretroviral therapy (ART) and other services such as psychological and social support) for people living with HIV/AIDS was calculated in a not-for-profit primary health care centre in Bujumbura run by Society of Women against AIDS-Burundi (SWAA-Burundi), an African non-governmental organisation (NGO). Results are expressed as cost-effectiveness ratio 2007, constant US$per disability-adjusted life year (DALY) averted. Unit costs are estimated from the NGO's accounting data and activity reports, healthcare utilisation is estimated from the medical records of a cohort of 149 patients. Effectiveness is modelled on the survival of this cohort, using standard calculation methods. The incremental cost of integrated care for people living with HIV/AIDS in the Bujumbura health centre of SWAA-Burundi is 258 US$ per DALY averted. The package of care provided by SWAA-Burundi is therefore a very cost-effective intervention in comparison with other interventions against HIV/AIDS that include ART. It is however, less cost effective than other types of interventions against HIV/AIDS, such as preventive activities

Experimental and numerical modelling of aerated flows over stepped spillways

Stepped spillways are a popular design choice for reservoir overflows due to the high rates of energy dissipation and air entrainment compared to smooth spillways. Air entrainment is important in spillway flows as it affects the pressures acting on the spillway surface, which in adverse conditions can damage the spillway. Air entrainment also causes flow bulking which increases the depth of flow. This study presents free surface and pressure data for aerated flows over an experimental stepped spillway, with pressures measured at different positions across the width of the channel. Within the step cavities, recirculating vortices are observed in both the stream-wise and cross-stream directions, with the direction of circulation alternating at each subsequent step. These 3D effects cause the pressures acting on the step edges to vary across the width of the channel. The Volume of Fluid (VOF) and Eulerian multiphase numerical models are used to predict flows over the spillway. The Eulerian multiphase model shows high levels of air entrainment and is able to predict the position of the free surface to reasonable accuracy. The VOF model, conversely, does not show any air entrainment and therefore under predicts the position of the free surface. The accuracy to which each numerical model predicts pressures on the step faces varies depending on the measurement location. Both of the numerical models accurately simulate the direction of circulation of the 3D vortices within the step cavities. Simulations with varying channel widths, conducted using the VOF model, show that the pattern of 3D vortices repeats as the channel width is increased

Melting Point and Lattice Parameter Shifts in Supported Metal Nanoclusters

The dependencies of the melting point and the lattice parameter of supported metal nanoclusters as functions of clusters height are theoretically investigated in the framework of the uniform approach. The vacancy mechanism describing the melting point and the lattice parameter shifts in nanoclusters with decrease of their size is proposed. It is shown that under the high vacuum conditions (p<10^-7 torr) the essential role in clusters melting point and lattice parameter shifts is played by the van der Waals forces of cluster-substrate interation. The proposed model satisfactorily accounts for the experimental data.Comment: 6 pages, 3 figures, 1 tabl