Cost effectiveness analysis of different approaches of screening for familial hypercholesterolaemia

Objectives To assess the cost effectiveness of strategies to screen for and treat familial hypercholesterolaemia. Design Cost effectiveness analysis. A care pathway for each patient was delineated and the associated probabilities, benefits, and costs were calculated. Participants Simulated population aged 16­54 years in England and Wales. Interventions Identification and treatment of patients with familial hypercholesterolaemia by universal screening, opportunistic screening in primary care, screening of people admitted to hospital with premature myocardial infarction, or tracing family members of affected patients. Main outcome measure Cost effectiveness calculated as cost per life year gained (extension of life expectancy resulting from intervention) including estimated costs of screening and treatment. Results Tracing of family members was the most cost effective strategy (£3097 (&5066, $4479) per life year gained) as 2.6 individuals need to be screened to identify one case at a cost of £133 per case detected. If the genetic mutation was known within the family then the cost per life year gained (£4914) was only slightly increased by genetic confirmation of the diagnosis. Universal population screening was least cost effective (£13 029 per life year gained) as 1365 individuals need to be screened at a cost of £9754 per case detected. For each strategy it was more cost effective to screen younger people and women. Targeted strategies were more expensive per person screened, but the cost per case detected was lower. Population screening of 16 year olds only was as cost effective as family tracing (£2777 with a clinical confirmation). Conclusions Screening family members of people with familial hypercholesterolaemia is the most cost effective option for detecting cases across the whole population

Developing an On-Line Interactive Health Psychology Module.

On-line teaching material in health psychology was developed which ensured a range of students could access appropriate material for their course and level of study. This material has been developed around the concept of smaller 'content chunks' which can be combined into whole units of learning (topics), and ultimately, a module. On the basis of the underlying philosophy that the medium is part of the message, we considered interactivity to be a key element in engaging the student with the material. Consequently, the key aim of this development was to stimulate and engage students, promoting better involvement with the academic material, and hence better learning. It was hoped that this was achieved through the development of material including linked programmes and supporting material, small Java Scripts and basic email, forms and HTML additions. This material is outlined as are some of the interactive activities introduced, and the preliminary student and tutor experience described

Report of the Committee on Science and the Arts on Ainsworth's automatic safety-switch for railroads

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Amperometric and spectrophotometric determination of carbaryl in natural waters and commercial formulations

The work presented describes the development and evaluation of two flow-injection analysis (FIA) systems for the automated determination of carbaryl in spiked natural waters and commercial formulations. Samples are injected directly into the system where they are subjected to alkaline hydrolysis thus forming 1-naphthol. This product is readily oxidised at a glassy carbon electrode. The electrochemical behaviour of 1-naphthol allows the development of an FIA system with an amperometric detector in which 1-naphthol determination, and thus measurement of carbaryl concentration, can be performed. Linear response over the range 1.0×10–7 to 1.0×10–5 mol L–1, with a sampling rate of 80 samples h–1, was recorded. The detection limit was 1.0×10–8 mol L–1. Another FIA manifold was constructed but this used a colorimetric detector. The methodology was based on the coupling of 1-naphthol with phenylhydrazine hydrochloride to produce a red complex which has maximum absorbance at 495 nm. The response was linear from 1.0×10–5 to 1.5×10–3 mol L–1 with a detection limit of 1.0×10–6 mol L–1. Sample-throughput was about 60 samples h–1. Validation of the results provided by the two FIA methodologies was performed by comparing them with results from a standard HPLC–UV technique. The relative deviation was <5%. Recovery trials were also carried out and the values obtained ranged from 97.0 to 102.0% for both methods. The repeatability (RSD, %) of 12 consecutive injections of one sample was 0.8% and 1.6% for the amperometric and colorimetric systems, respectively

Close Packing of Atoms, Geometric Frustration and the Formation of Heterogeneous States in Crystals

To describe structural peculiarities in inhomogeneous media caused by the tendency to the close packing of atoms a formalism based on the using of the Riemann geometry methods (which were successfully applied lately to the description of structures of quasicrystals and glasses) is developed. Basing on this formalism we find in particular the criterion of stability of precipitates of the Frank-Kasper phases in metallic systems. The nature of the ''rhenium effect'' in W-Re alloys is discussed.Comment: 14 pages, RevTex, 2 PostScript figure

Translating the Physics of Snowfall to Radar-Based Validation of GPM

No abstract availabl

Self-aligned fabrication process for silicon quantum computer devices

We describe a fabrication process for devices with few quantum bits (qubits), which are suitable for proof-of-principle demonstrations of silicon-based quantum computation. The devices follow the Kane proposal to use the nuclear spins of 31P donors in 28Si as qubits, controlled by metal surface gates and measured using single electron transistors (SETs). The accurate registration of 31P donors to control gates and read-out SETs is achieved through the use of a self-aligned process which incorporates electron beam patterning, ion implantation and triple-angle shadow-mask metal evaporation

Electronic structure of phosphorus and arsenic d-doped germanium

Density functional theory in the LDA+U approximation is used to calculate the electronic structure ofgermanium d doped with phosphorus and arsenic. We characterize the principal band minima of the twodimensional electron gas created by d doping and their dependence on the dopant concentration. Populated first at low concentrations is a set of band minima at the perpendicular projection of the bulk conduction band minima at L into the (kx ,ky ) plane. At higher concentrations, band minima at and become involved. Valley splittings and effective masses are computed using an explicit-atom approach, taking into account the effects of disorder in the arrangement of dopant atoms in the d plane

Polytetrahedral Clusters

By studying the structures of clusters bound by a model potential that favours polytetrahedral order, we find a previously unknown series of `magic numbers' (i.e. sizes of special stability) whose polytetrahedral structures are characterized by disclination networks that are analogous to hydrocarbons.Comment: 4 pages, 4 figure