22 research outputs found
Recommended from our members
Direct oxide reduction demonstration, small-scale studies
This project was initiated to provide process design information to the Plutonium Recovery Project (PRP). Although direct oxide reduction (DOR) has been operated in a production mode both at the Rocky Flats Plant (now operated by EG&G, Inc.) and Los Alamos National Laboratory, many aspects of the process are ill-defined. Because the PRP plans include significant DOR capability, a well-defined process should minimize capital cost and maximize productivity. Reduced radiation exposure may also be realized. A detailed, statistically valid investigation of the direct oxide reduction process was carried out utilizing 100 grams or less of plutonium dioxide per experiment. Conditions were established for obtaining 95% + yields. Conclusions drawn from the results of the experimental work were utilized to make recommendations for future large-scale investigative and confirmative work as well large-scale production demonstration work. 4 refs., 5 figs., 14 tabs
Understanding attitudes toward adolescent vaccination and the decision-making dynamic among adolescents, parents and providers
Cost effectiveness analysis of Year 2 of an elementary school-located influenza vaccination program–Results from a randomized controlled trial
BACKGROUND: School-located vaccination against influenza (SLV-I) has the potential to improve current suboptimal influenza immunization coverage for U.S. school-aged children. However, little is known about SLV-I’s cost-effectiveness. The objective of this study is to establish the cost-effectiveness of SLV-I based on a two-year community-based randomized controlled trial (Year 1: 2009–2010 vaccination season, an unusual H1N1 pandemic influenza season, and Year 2: 2010–2011, a more typical influenza season). METHODS: We performed a cost-effectiveness analysis on a two-year randomized controlled trial of a Western New York SLV-I program. SLV-I clinics were offered in 21 intervention elementary schools (Year 1 n = 9,027; Year 2 n = 9,145 children) with standard-of-care (no SLV-I) in control schools (Year 1 n = 4,534 (10 schools); Year 2 n = 4,796 children (11 schools)). We estimated the cost-per-vaccinated child, by dividing the incremental cost of the intervention by the incremental effectiveness (i.e., the number of additionally vaccinated students in intervention schools compared to control schools). RESULTS: In Years 1 and 2, respectively, the effectiveness measure (proportion of children vaccinated) was 11.2 and 12.0 percentage points higher in intervention (40.7 % and 40.4 %) than control schools. In year 2, the cost-per-vaccinated child excluding vaccine purchase () consisted of three component costs: (A) the school costs (32.33); and (C) the vendor costs excluding vaccine purchase (59.73 (Year 1) and 39.54). However, taking indirect costs (e.g., averted parental costs to visit medical practices) into account, vaccination was less costly in SLV-I (24.07 in Year 2) than in medical practices. CONCLUSIONS: Our two-year trial’s findings reinforced the evidence to support SLV-I as a potentially favorable system to increase childhood influenza vaccination rates in a cost-efficient way. Increased efficiencies in SLV-I are needed for a sustainable and scalable SLV-I program
Effects of Once-Weekly Exenatide on Cardiovascular Outcomes in Type 2 Diabetes.
Abstract
BACKGROUND:
The cardiovascular effects of adding once-weekly treatment with exenatide to usual care in patients with type 2 diabetes are unknown.
METHODS:
We randomly assigned patients with type 2 diabetes, with or without previous cardiovascular disease, to receive subcutaneous injections of extended-release exenatide at a dose of 2 mg or matching placebo once weekly. The primary composite outcome was the first occurrence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. The coprimary hypotheses were that exenatide, administered once weekly, would be noninferior to placebo with respect to safety and superior to placebo with respect to efficacy.
RESULTS:
In all, 14,752 patients (of whom 10,782 [73.1%] had previous cardiovascular disease) were followed for a median of 3.2 years (interquartile range, 2.2 to 4.4). A primary composite outcome event occurred in 839 of 7356 patients (11.4%; 3.7 events per 100 person-years) in the exenatide group and in 905 of 7396 patients (12.2%; 4.0 events per 100 person-years) in the placebo group (hazard ratio, 0.91; 95% confidence interval [CI], 0.83 to 1.00), with the intention-to-treat analysis indicating that exenatide, administered once weekly, was noninferior to placebo with respect to safety (P<0.001 for noninferiority) but was not superior to placebo with respect to efficacy (P=0.06 for superiority). The rates of death from cardiovascular causes, fatal or nonfatal myocardial infarction, fatal or nonfatal stroke, hospitalization for heart failure, and hospitalization for acute coronary syndrome, and the incidence of acute pancreatitis, pancreatic cancer, medullary thyroid carcinoma, and serious adverse events did not differ significantly between the two groups.
CONCLUSIONS:
Among patients with type 2 diabetes with or without previous cardiovascular disease, the incidence of major adverse cardiovascular events did not differ significantly between patients who received exenatide and those who received placebo. (Funded by Amylin Pharmaceuticals; EXSCEL ClinicalTrials.gov number, NCT01144338 .)
Recommended from our members
Direct oxide reduction demonstration, small-scale studies
This project was initiated to provide process design information to the Plutonium Recovery Project (PRP). Although direct oxide reduction (DOR) has been operated in a production mode both at the Rocky Flats Plant (now operated by EG G, Inc.) and Los Alamos National Laboratory, many aspects of the process are ill-defined. Because the PRP plans include significant DOR capability, a well-defined process should minimize capital cost and maximize productivity. Reduced radiation exposure may also be realized. A detailed, statistically valid investigation of the direct oxide reduction process was carried out utilizing 100 grams or less of plutonium dioxide per experiment. Conditions were established for obtaining 95% + yields. Conclusions drawn from the results of the experimental work were utilized to make recommendations for future large-scale investigative and confirmative work as well large-scale production demonstration work. 4 refs., 5 figs., 14 tabs
A survey of maternity policies and pregnancy accommodations in American police departments
As police organizations in the United States accommodate pregnancy through the adoption and the implementation of disability and maternity policies, managers must negotiate the institutional pressures and organizational conflicts inherent to allocating resources. This study establishes a record of maternity policies in US agencies and indicates that maternity leave has morphed into family leave, with agencies reporting resources invested in paternity leave, and shared family leave. While prior research has suggested a lack of policy in American police departments, this research confirms that maternity and light duty policies have been established