In The Little Red School House

https://digitalcommons.library.umaine.edu/mmb-vp/2015/thumbnail.jp

Telemonitoring after discharge from hospital with heart failure: cost-effectiveness modelling of alternative service designs.

Objectives To estimate the cost-effectiveness of remote monitoring strategies versus usual care for adults recently discharged after a heart failure (HF) exacerbation. Design Decision analysis modelling of cost-effectiveness using secondary data sources. Setting Acute hospitals in the UK. Patients Patients recently discharged (within 28 days) after a HF exacerbation. Interventions Structured telephone support (STS) via human to machine (STS HM) interface, (2) STS via human to human (STS HH) contact and (3) home telemonitoring (TM), compared with (4) usual care. Main outcome measures The incremental cost per quality-adjusted life year (QALY) gained by each strategy compared to the next most effective alternative and the probability of each strategy being cost-effective at varying willingness to pay per QALY gained. Results TM was the most cost-effective strategy in the scenario using these base case costs. Compared with usual care, TM had an estimated incremental cost effectiveness ratio (ICER) of £11 873/QALY, whereas STS HH had an ICER of £228 035/QALY against TM. STS HM was dominated by usual care. Threshold analysis suggested that the monthly cost of TM has to be higher than £390 to have an ICER greater than £20 000/QALY against STS HH. Scenario analyses performed using higher costs of usual care, higher costs of STS HH and lower costs of TM do not substantially change the conclusions. Conclusions Cost-effectiveness analyses suggest that TM was an optimal strategy in most scenarios, but there is considerable uncertainty in relation to clear descriptions of the interventions and robust estimation of costs

Boys to Men: A Conference Report

Nearly 350 middle and high school aged boys, fathers and male mentors attended. It was the first such conference to be held in Maine. “Boys to Men” was intended to launch a community dialogue about how schools, families and other institutions can better understand, celebrate and support boys in their journey to manhood. There was a special emphasis on the pressures exerted by popular culture in shaping the behavior of adolescent boys

Referral Physicians’ Knowledge of Radiation Dose: A Cross-sectional Study

AIM: The purpose of the study was to evaluate the knowledge of referring physicians of general practitioners, residents, and medical specialists in Jordan and the Middle East on radiation dose and its impact on vulnerable patients. MATERIALS AND METHODS: The Institutional Review Board approved this study before data collection. A cross-sectional study employed questionnaire that was distributed to respondents (n = 293) of general practitioners, residents, specialists, and therapists. The questionnaire consisted of 29 questions. Nine questions concerned with demographics and the remaining 20 questions were divided into five sections: Radiation dose, ionizing radiation, pediatric radiation, pregnant women radiation, and radiation risks. The mean score was computed out of 20. Chi-squared test of independence was utilized to analyze each question. To compare the responses between the demographic variables groups, Kruskal–Wallis and Mann–Whitney tests were used. RESULTS: Out of the 293 respondents, 128 (43.7%) were aware of radiation. The average score of the questionnaire was 9.5 out of 20 (47.5%). Within each section, the level of knowledge varied. Physicians had the highest level of knowledge in radiation risk (85.7%) followed by ionizing radiation (62.1%). The questionnaire revealed lower levels of knowledge in the areas of pediatric radiation, pregnant women radiation, and radiation dose. The percentages of respondents, (with fair to good level of knowledge), were 47.1%, 34.5%, and 24.6%, respectively. CONCLUSION: The results of this study were consistent with previous studies that demonstrated a poor level of general knowledge in referring physicians regarding radiation dose, ionizing radiation, pediatric radiation, pregnant women radiation, and radiation risks

That\u27s a Lot of Bunk / words by Al Wilson, James A. Brennan, and Mack Henshaw

Cover: photo of James Barton, a Caucasian male in blackface; cartoon drawings satirizing ideas such as taxi drivers never cheat or landlords never raise the rent; Publisher: Edward B. Marks Music Co. (New York)https://egrove.olemiss.edu/sharris_d/1050/thumbnail.jp

Regional variation in characteristics of patients with decompensated cirrhosis admitted to hospitals in the UK

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