Economic evaluations of non-communicable disease interventions

Background Demographic projections suggest a major increase in non-communicable disease (NCD) mortality over the next two decades in developing countries. In a climate of scarce resources, policy-makers need to know which interventions represent value for money. The prohibitive cost of performing multiple economic evaluations has generated interest in transferring the results of studies from one setting to another. This paper aims to bridge the gap in the current literature by critically evaluating the available published data on economic evaluations of NCD interventions in developing countries. Methods We identified and reviewed the methodological quality of 32 economic evaluations of NCD interventions in developing countries. Developing countries were defined according to the World Bank classification for low- and lower middle-income countries. We defined NCDs as the 12 categories listed in the 1993 World Bank report Investing in Health. English language literature was searched for the period January 1984 and January 2003 inclusive in Medline, Science Citation Index, HealthStar, NHS Economic Evaluation Database and Embase using medical subheading terms and free text searches. We then assessed the quality of studies according to a set of pre-defined technical criteria. Results We found that the quality of studies was poor and resource allocation decisions made by local and global policy-makers on the basis of this evidence could be misleading. Furthermore we have identified some clear gaps in the literature, particularly around injuries and strategies for tackling the consequences of the emerging tobacco epidemic. Conclusion In the face of poor evidence the role of so-called generalised cost-effectiveness analyses has an important role to play in aiding public health decision-making at the global level. Further research is needed to investigates the causes of variation among cost, effects and cost-effectiveness data within and between settings. Such analyses still need to take a broad view, present data in a transparent manner and take account of local constraints

Economic Interpretations of Intergenerational Correlations

Economic theory offers interpretations of intergenerational correlations that are different from the theories of other disciplines, and have important policy implications. Our paper presents a subset of those theories, and shows how they are consistent with observed mobility patterns as they vary across countries, demographic groups, and economic status measure. The data may suggest that the economic approach overemphasizes credit constraints, although more work is needed to further develop some of the alternative economic models. We also show how, in the models, 'progressive' policy may reduce mobility depending on how the policy is administered and how mobility is measured.

Asymptotic Spectrum of Kerr Black Holes in the Small Angular Momentum Limit

We study analytically the highly damped quasinormal modes of Kerr black holes in the small angular momentum limit. To check the previous analytic calculations in the literature, which use a combination of radial and tortoise coordinates, we reproduce all the results using the radial coordinate only. According to the earlier calculations, the real part of the highly damped quasinormal mode frequency of Kerr black holes approaches zero in the limit where the angular momentum goes to zero. This result is not consistent with the Schwarzschild limit where the real part of the highly damped quasinormal mode frequency is equal to c^3 ln(3)/(8 pi G M). In this paper, our calculations suggest that the highly damped quasinormal modes of Kerr black holes in the zero angular momentum limit make a continuous transition from the Kerr value to the Schwarzschild value. We explore the nature of this transition using a combination of analytical and numerical techniques. Finally, we calculate the highly damped quasinormal modes of the extremal case in which the topology of Stokes/anti-Stokes lines takes a different form.Comment: 13 pages, 6 figure

Marriage Market Values Systems and Global Gender Inequality

Marriage and gender inequality represent two nearly amaranthine worldwide conventions. This research looks to compare the relative local political economics of marriage with worldwide gender inequality. A comparison of United Nations gender inequality index ratings with this works duly established relative local marriage market gender equity values systems ratings indicate the presence of potentially significant correlation within these two data sets. This study concludes that these findings merit a more comprehensive look at prevailing global/ local cultural marriage traditions and their potential relationship with the prevalence of worldwide gender inequality

Engaging Students Engaging Industry Engaging Enterprise

A reflective piece on how a small team of students and academics gained more awareness of their own sense of enterprise and creativity. The case study examines the phases and crisis points of the whole event process and identifies some of the key learning outcomes for all involved

Mechanisms of tumour-induced cachexia

The effect of cancer cachexia on host metabolism has been studied in mice transplanted with either the MAC16 adenocarcinoma which induces profound loss of host body weight and depletion of lipid stores or, the MAC13 adenocarcinoma which is of the same histological type, but which grows without an effect on host body weight. Oxidation of D-[U-14C]glucose was elevated in both tumour-bearing states irrespective of cachexia, when compared with non tumour-bearing controls. Both the MAC16 and MAC13 tumours in vivo utilised glucose at the expense of the brain, where its use was partially replaced by 3-hydroxybutyrate, a ketone body. Oxidation of both [U-14C]palmitic acid and [1-14C]triolein was significantly increased in MAC16 tumour-bearing animals and decreased in MAC13 tumour-bearing animals when compared with non tumour-bearing controls, suggesting that in cachectic tumour-bearing animals, mobilisation of body lipids is accompanied by an increased utilisation by the host. Weight loss in MAC16 tumour-bearing animals is associated with the production of a lipolytic factor. Injection of this partially purified lipolytic factor induced weight loss in recipient animals which could be maintained over time in tumour-bearing animals. This suggests that the tumour acts as a sink for the free fatty acids liberated as a result of the mobilisatation of adipose stores. Lipids are important as an energy source in cachectic animals because of their high calorific value and because glucose is being diverted away from host tissues to support tumour growth. Their importance is further demonstrated by the evidence of a MAC16 tumour-associated lipolytic factor. This lipolytic factor is the key to understanding the alterations in host metabolism that occur in tumour-induced cachexia, and may provide future alternatives for the reversal of cachexia and the treatment of cancer itself

Sunjammer

No abstract available

Study of the use of Metal-Oxide-Silicon (MOS) devices for particulate detection and monitoring in the earth's atmosphere

A metal-oxide-silicon (MOS) capacitor-type particulate sensor was evaluated for use in atmospheric measurements. An accelerator system was designed and tested for the purpose of providing the necessary energy to trigger the MOS-type sensor. The accelerator system and the MOS sensor were characterized as a function of particle size and velocity. Diamond particles were used as particulate sources in laboratory tests. Preliminary tests were performed in which the detector was mounted on an aircraft and flown in the vicinity of coal-fired electric generating plants

Isolated familial pheochromocytoma as a variant of von Hippel-Lindau disease.

Inherited pheochromocytomas are often part of familial syndromes, especially multiple endocrine neoplasia type 2 (MEN 2), retinal cerebellar hemangioblastomatosis [von Hippel-Lindau (vHL) disease] or neurofibromatosis type 1. It is not clear whether isolated familial pheochromocytoma exists as a separate clinical entity. In a family with pheochromocytomas in three generations and with at least seven affected members, we investigated by clinical and genetic analyses the presence or absence of associated conditions. The clinical investigations included ophthalmological and radiological studies for von Hippel-Lindau disease (magnetic resonance imaging of the brain, computed tomography of the abdomen, and direct ophthalmoscopy after mydriasis) and annual calcitonin stimulation tests for C cell disease in five members who agreed to regular follow-up. Besides the pheochromocytomas (so far, these have been multiple in five of seven individuals) no definite second associated condition was found. Genetic analysis did not identify any MEN 2-specific RET protooncogene point mutations (which are present in 97% of MEN 2a families). However, despite the complete absence of other clinical manifestations of the vHL disease (besides pheochromocytomas), a previously undescribed germline missense mutation in the vHL tumor suppressor gene was found (C775G transversion with a predicted substitution of a leucine by a valine at codon 259 in the putative vHL protein). We conclude that in this family the sole occurrence of pheochromocytoma is a variant of vHL disease