measuring the cost of a pediatric vaccine administration in the uk

Abstract The administration of a vaccine dose involves a series of activities prior to and on the day of vaccine delivery. Total vaccination cost should include the cost of each activity, which is often not done or poorly reported. To calculate those costs a field study was performed in 6 United Kingdom (UK) sites (General Practitioner (GP) practices) during a 4-month period (April–June 2015). First, a workflow map of all the relevant vaccine-related activities per site was obtained through interviews. Second, time estimates for activities happening prior to the vaccination day were obtained through interviews and associated costs were calculated. A prospective, non-interventional study using Time & Motion (T&M) methodology was used to measure time for activities happening on the day of vaccination. Consumables, wastage, and guardian time were also collected. Third, the time for each task and for all tasks combined during the T&M study was analyzed using a random intercept model to account for site effect. Hundred and twenty-three T&M observations with approximately 20 per site were collected and were equally stratified by vaccination visit during the first year of a baby's life. Total cost per visit was £11.9 (site range: £8.6–£17.0) when supply cost and time for activities prior to the vaccination day were included. Time per dose administrated was 7.1 min (site range: 5.7–9.2) and the associated cost was £4.3 (site range: £3.1–£6.2). The study demonstrates an accurate reflection of the time and cost involved in a vaccine dose administration in a pediatric setting in the UK. The amount measured is consistent with the current National Health Services fee schedule

Clinical audit of malaria diagnosis in urban primary curative care clinics, Zimbabwe

A CAJM journal article.Clinical audit was performed on the accuracy of malaria diagnosis by nursing staff within Harare City Health Department using diagnosis by doctors as the reference standard. This was found to be about 10 pc based on symptoms. The criteria for diagnosis of malaria as in ZEDAP manuals and in-house training were not being utilised. Pyrexia was not present in 40 pc of the patients. Serious illnesses were occasionally dismissed as malaria and not treated appropriately or reviewed. The most common misdiagnosis was of acute respiratory tract infections which also have clear guidelines for diagnosis. More appropriate training methods need to be developed to improve the diagnostic capacity of nursing staff who are front line providers of primary health care. This study shows the importance of performing an audit for process evaluation, compared to set standards and to be used for improving the quality of services

Financial phantasmagoria: corporate image-work in times of crisis

Our purpose in this article is to relate the real movements in the economy during 2008 to the ?image-work? of financial institutions. Over the period January?December 2008 we collected 241 separate advertisements from 61 financial institutions published in the Financial Times. Reading across the ensemble of advertisements for themes and evocative images provides an impression of the financial imaginaries created by these organizations as the global financial crisis unfolded. In using the term ?phantasmagoria? we move beyond its colloquial sense of a set of strange images designed to dazzle towards the more technical connotation used by Ranci�re (2004) who suggested that words and images can offer a trace of an overall determining set-up if they are torn from their obviousness so they become phantasmagoric figures. The key phantasmagoric figure we identify here is that of the financial institution as timeless, immortal and unchanging; a coherent and autonomous entity amongst other actors. This notion of uniqueness belies the commonality of thinking which precipitated the global financial crisis as well as the limited capacity for control of financial institutions in relation to market events. It also functions as a powerful naturalizing force, making it hard to question certain aspects of the recent period of ?capitalism in crisis?

Privacy threat model in lifelogging

The lifelogging activity enables a user, the lifelogger, to passively capture multimodal records from a first-person perspective and ultimately create a visual diary encompassing every possible aspect of her life with unprecedented details. In recent years it has gained popularity among different groups of users. However, the possibility of ubiquitous presence of lifelogging devices especially in private spheres has raised serious concerns with respect to personal privacy. Different practitioners and active researchers in the field of lifelogging have analysed the issue of privacy in lifelogging and proposed different mitigation strategies. However, none of the existing works has considered a well-defined privacy threat model in the domain of lifelogging. Without a proper threat model, any analysis and discussion of privacy threats in lifelogging remains incomplete. In this paper we aim to fill in this gap by introducing a first-ever privacy threat model identifying several threats with respect to lifelogging. We believe that the introduced threat model will be an essential tool and will act as the basis for any further research within this domain

Flipping the classroom:an effective approach to deal with diversity at higher education

Even though the flipped classroom is an increasingly popular method in education, a literature search shows a gap in research on this method in higher education. This article describes an experiment with two central questions: (1) How do students and lecturers assess the effectiveness of the FC method? And (2) What are crucial design elements? To be able to answer these questions we designed an experiment within a large-size, interdisciplinary, course. For three years we carefully monitored and evaluated the course. A mixed-method approach was used to collect data. Our findings show a positive contribution of the FC approach to the learning experience of students. We also found that a strong link between theory and practice is essential in the course design; combined with active learning we were able to involve students and stimulate them to reach a deeper level of understanding. Moreover, we believe that the FC approach offers opportunities to have a large interdisciplinary group, with different learning needs, work together on higher attainment levels