Cost of asthma in children: A nationwide, population-based, cost-of-illness study

BACKGROUND: Childhood asthma is very prevalent and costs can be high, especially in severe disease. This study aimed to estimate the cost of asthma in Portuguese children and the variations by level of asthma control. METHODS: A nationwide, population- and prevalence-based cost-of-illness study with a societal perspective was conducted. We measured direct and indirect costs using a bottom-up approach and a human capital method, respectively, for 208 children (<18 years), from two national repositories. Generalized linear modelling for analysis of asthma costs' determinants and sensitivity analysis to assess uncertainty were performed. RESULTS: The mean annualized asthma cost per child was €929.35 (95% CI, 809.65-1061.11): €698.65 (95% CI, 600.88-798.27) for direct costs and €230.70 (95% CI, 197.36-263.81) for indirect costs. Extrapolations for the Portuguese children amounted to €161 410 007.61 (95% CI, 140 620 769.55-184 293 968.55) for total costs. Direct costs represent 75.2% with the costliest domain (51.1% of total costs) being the healthcare service use: 20.7% for scheduled medical visits and 30.4% for acute asthma care-non-scheduled medical visits (7.9%, €12 766 203.20), emergency department visits (11.7%, €18 932 464.80) and hospitalizations (10.8%, €17 406 946.00). Children with partly controlled and uncontrolled asthma had higher mean costs per year (adjusted coefficients: 1.46 [95% CI, 1.12-1.90] and 2.25 [95% CI, 1.56-3.24], respectively). CONCLUSIONS: Costs of childhood asthma are high (0.9% of the healthcare expenditures in Portugal). Direct costs represented three-fourth of total costs, mainly related to the use of healthcare services for acute asthma care. Policies and interventions to improve asthma control and reduce acute use of healthcare services have the potential to reduce asthma costs.info:eu-repo/semantics/publishedVersio

Passive Multiplexer Test Structure For Fast and Accurate Contact and Via Fail-Rate Evaluation

Abstract-Complexity of integrated circuits has led to millions of contacts and vias on every chip. To allow accurate yield evaluation, it is required to determine fail rates of 10 faults per billion, which requires test structures with huge chains of 1 million or more contacts and vias. At the same time, contacts and vias are getting smaller, and thus their resistance is increasing for every new technology node. Consequently, the resistance of such chains becomes impossible to measure. To overcome this limit without increasing the number of measurement pads, we are proposing a passive multiplexer array of via chains, which breaks up a huge contact-via chain in many individually measurable subchains. Accuracy of fail rates will be increased since the fail rate can be determined based on many subchains, instead of being determined based on only one huge chain. Furthermore, this test structure better supports failure analysis since it is faster to locate a faulty contact or via. No additional devices or process steps are required which allows implementation as short flows for fast process problem debugging

Diversity in collaborative research communities: a multicultural, multidisciplinary thesis writing group in public health

Writing groups for doctoral students are generally agreed to provide valuable learning spaces for Ph.D. candidates. Here an academic developer and the eight members of a writing group formed in a Discipline of Public Health provide an account of their experiences of collaborating in a multicultural, multidisciplinary thesis writing group. We consider the benefits of belonging to such a group for Ph.D. students who are operating in a research climate in which disciplinary boundaries are blurring and where an increasing number of doctoral projects are interdisciplinary in nature; in which both academic staff and students come from enormously diverse cultural and language backgrounds; and in which teamwork, networking and collaboration are prized but not always proactively facilitated. We argue that doctoral writing groups comprising students from diverse cultural and disciplinary backgrounds can be of significant value for postgraduates who wish to collaborate on their own academic development to improve their research writing and communication skills; at the same time, such collaborative work effectively builds an inclusive, dynamic research community.Cally Guerin, Vicki Xafis, Diana V. Doda, Marianne H. Gillam, Allison J. Larg, Helene Luckner, Nasreen Jahan, Aris Widayati and Chuangzhou X

The Cost of Unhealthy Weight: What Should Policymakers Know? A South Australian Case Study.

After decades of healthcare expenditure growth exceeding general inflation, the advent of the COVID-19 pandemic highlighted the importance of maintaining sustainable health systems capable of withstanding demand shocks. Fundamental to this is getting the right evidence into the hands of policy- and decision-makers - the goal of knowledge translation (KT) in public health policymaking. Importantly, the KT research has emphasised the centrality of understanding the nature and context of policymaking in producing evidence that supports policy decisions aimed at maximising population health from available resources. Explanations of rising healthcare expenditure growth have often referred to an increasing prevalence of chronic disease and related impacts on healthcare utilisation from progressively older and overweight populations. As a key modifiable risk factor for a range of chronic conditions, an increasing prevalence of unhealthy weight imposes potentially avoidable costs on already stretched healthcare systems. This thesis applies a KT framework to explore the role of cost analysis in public health policymaking through an example in which South Australian (SA) public health policymakers sought evidence on the acute public hospital costs of unhealthy weight in the context of perceived unsustainable growth in public hospital expenditure. Using a case study approach, I examine how this evidence was used as a knowledge translation tool to support cost-effective healthy weight policy within a highly contested policy context. My findings contribute to the knowledge translation research on the usefulness of evidence on the cost of public health problems, which had not yet been examined from a practical policymaker’s perspective. In two subsequent studies, I examine the extent to which unhealthy weight has driven acute public hospital expenditure growth in this SA example through trend and decomposition analysis, the latter emerging as a powerful method to dissect such growth into its constituent parts. I find that, contrary to the importance local policymakers placed on the earlier single-year estimates, unhealthy weight accounted for a minor 4.0% of the real growth in inpatient expenditure over a 5-year period. Furthermore, over a 12-year interval in which the SA adult prevalence of unhealthy weight grew by 8.1 percentage points, hospital utilisation rate changes contributed only 14.0% of the AU$667 real increase in per capita expenditure on SA’s acute public hospitals, while 86.0% was attributable to an increase in the average cost of delivering hospital care. These findings challenge the narrative within Australia and contribute to the relatively small body of published evidence outside of the US on healthcare expenditure drivers. I suggest several avenues for containing hospital expenditure growth, maximising population health outcomes, and building sustainable healthcare systems within Australian and international settings. Lastly, to support the standardised conduct of cost-of-illness studies and the correct interpretation of their findings, I developed a guide and checklist that can be applied to any health problem and setting. The frequent citation of my resulting published paper within the scholarly literature, as both an authoritative source and in appraising study quality, attests to its contribution to knowledge translation by averting the misuse of cost evidence in public health policymaking.Thesis (Ph.D.) -- University of Adelaide, School of Public Health, 202

5° Campeonato Estadoal de Athletismo (Porto Alegre, 1929) - Programma Official

O documento integra o acervo doado por Henrique LichtPrograma do 5° Campeonato Estadoal de Athletismo, organizada pela Liga Athletica Rio Grandense. O documento apresenta a direção da prova e a programação detalhada das inumeras provas de atletismo com a nominata dos atletas participantes e seus respectivos Clubes. O local da prova foi a Praça de Desportos da S.Turner Bund (Sogipa).DoaçãoEducação Física e Esport

5° Campeonato Estadoal de Athletismo (Porto Alegre, 1929) - Programma Official

O documento integra o acervo doado por Henrique LichtPrograma do 5° Campeonato Estadoal de Athletismo, organizada pela Liga Athletica Rio Grandense. O documento apresenta a direção da prova e a programação detalhada das inumeras provas de atletismo com a nominata dos atletas participantes e seus respectivos Clubes. O local da prova foi a Praça de Desportos da S.Turner Bund (Sogipa).DoaçãoEducação Física e Esport