Does responsibility affect the public valuation of health care interventions? A relative valuation approach to health care safety

This article is available open access through the publisher’s website at the link below. Copyright © 2012, International Society for Pharmacoeconomics and Outcomes Research (ISPOR).Objective - Health services often spend more on safety interventions than seems cost-effective. This study investigates whether the public value safety-related health care improvements more highly than the same improvements in contexts where the health care system is not responsible. Method - An online survey was conducted to elicit the relative importance placed on preventing harms caused by 1) health care (hospital-acquired infections, drug administration errors, injuries to health care staff), 2) individuals (personal lifestyle choices, sports-related injuries), and 3) nature (genetic disorders). Direct valuations were obtained from members of the public by using a person trade-off or “matching” method. Participants were asked to choose between two preventative interventions of equal cost and equal health benefit per person for the same number of people, but differing in causation. If participants indicated a preference, their strength of preference was measured by using person trade-off. Results - Responses were obtained from 1030 people, reflecting the sociodemographic mix of the UK population. Participants valued interventions preventing hospital-acquired infections (1.31) more highly than genetic disorders (1.0), although drug errors were valued similarly to genetic disorders (1.07), and interventions to prevent injury to health care staff were given less weight than genetic disorders (0.71). Less weight was also given to interventions related to lifestyle (0.65) and sports injuries (0.41). Conclusion - Our results suggest that people do not attach a simple fixed premium to “safety-related” interventions but that preferences depend more subtly on context. The use of the results of such public preference surveys to directly inform policy would therefore be premature.Brunel University

Grow more wool

THE amount of wool that each sheep grows is determined by many things, including the amount and quality of pasture available or how the sheep are fed, the stocking rate, the general health and thrift of the sheep and other management considerations such as cropping and the time of lambing

The effect of mulesing and tailstripping at lamb marking on subsequent lamb growth and incidence of fly strike

THE modified mules and tailstrip operation has been shown to be highly effective in reducing the incidence of crutch strike in sheep. In Western Australia the operation is usually performed on ewe weaners or hoggets immediately after either crutching or shearing

Stocking rates on light land : Wongan Hills Research Station

THE two most important things that determine the rate of return on invested capital in Merino sheep breeding and grazing are the stocking rate and lambing percentage

Weaner feeding practices need review

Many fanners feed large amounts of grain to their weaners over summer and autumn, in the belief that this is necessary for high lifetime production. The economics of this are open to doubt; in fact, the results of a recent experiment at Wongan Hills Research Station suggested that weaner feeding practices need review

Aids to better shearing

The demonstrations and instructional work in shearing that have been carried out in the farming areas have revealed the universal difficulty among learner-shearers in getting a cut. Experience has shown that this absence of good cutting in handpieces has been due in large measure to the general lack of knowledge regarding grinding and the correct adjustment or setting up of the combs and cutters on the handpiece. Poor cutting has also resulted from the common practice of using combs and cutters that do not match, together with faulty handpiece maintenance. These and other factors leading to such poor results will be dealt with and the necessary control measures fully described. The practical instruction in grinding, etc., which has been included in the shearing demonstrations is now supplemented by this article. To those who have attended the demonstrations the article will be very useful for reference, and to other

Shearing Schools - A successful innovation

To assist in overcoming the shortage of skilled shearers—which has become a major problem in the State\u27s sheep and wool industry—the Department of Agriculture conducted a series of 14-day instructional courses in shearing at Fremantle during 1954. A total of 57 trainees passed through the shearing schools and all of these received engagements as learner shearers during the 1954 season—in fact applications for the services of the learners exceeded the number available

Evidence against Wolbachia symbiosis in Loa loa

BACKGROUND: The majority of filarial nematode species are host to Wolbachia bacterial endosymbionts, although a few including Acanthocheilonema viteae, Onchocerca flexuosa and Setaria equina have been shown to be free of infection. Comparisons of species with and without symbionts can provide important information on the role of Wolbachia symbiosis in the biology of the nematode hosts and the contribution of the bacteria to the development of disease. Previous studies by electron microscopy and PCR have failed to detect intracellular bacterial infection in Loa loa. Here we use molecular and immunohistological techniques to confirm this finding. METHODS: We have used a combination of PCR amplification of bacterial genes (16S ribosomal DNA [rDNA], ftsZ and Wolbachia surface protein [WSP]) on samples of L. loa adults, third-stage larvae (L3) and microfilariae (mf) and immunohistology on L. loa adults and mf derived from human volunteers to determine the presence or absence of Wolbachia endosymbionts. Samples used in the PCR analysis included 5 adult female worms, 4 adult male worms, 5 mf samples and 2 samples of L3. The quality and purity of nematode DNA was tested by PCR amplification of nematode 5S rDNA and with diagnostic primers from the target species and used to confirm the absence of contamination from Onchocerca sp., Mansonella perstans, M. streptocerca and Wuchereria bancrofti. Immunohistology was carried out by light and electron microscopy on L. loa adults and mf and sections were probed with rabbit antibodies raised to recombinant Brugia malayi Wolbachia WSP. Samples from nematodes known to be infected with Wolbachia (O. volvulus, O. ochengi, Litomosoides sigmodontis and B. malayi) were used as positive controls and A. viteae as a negative control. RESULTS: Single PCR analysis using primer sets for the bacterial genes 16S rDNA, ftsZ, and WSP were negative for all DNA samples from L. loa. Positive PCR reactions were obtained from DNA samples derived from species known to be infected with Wolbachia, which confirmed the suitability of the primers and PCR conditions. The quality and purity of nematode DNA samples was verified by PCR amplification of 5S rDNA and with nematode diagnostic primers. Additional analysis by 'long PCR' failed to produce any further evidence for Wolbachia symbiosis. Immunohistology of L. loa adults and mf confirmed the results of the PCR with no evidence for Wolbachia symbiosis. CONCLUSION: DNA analysis and immunohistology provided no evidence for Wolbachia symbiosis in L. loa