The Impact of Cryoballoon Versus Radiofrequency Ablation for Paroxysmal Atrial Fibrillation on Healthcare Utilization and Costs: An Economic Analysis From the FIRE AND ICE Trial

BACKGROUND: This study sought to assess payer costs following cryoballoon or radiofrequency current (RFC) catheter ablation of paroxysmal atrial fibrillation in the randomized FIRE AND ICE trial. METHODS AND RESULTS: A trial period analysis of healthcare costs evaluated the impact of ablation modality (cryoballoon versus RFC) on differences in resource use and associated payer costs. Analyses were based on repeat interventions, rehospitalizations, and cardioversions during the trial, with unit costs based on 3 national healthcare systems (Germany [euro], the United Kingdom [ pound], and the United States [$]). Total payer costs were calculated by applying standard unit costs to hospital stays, using International Classification of Diseases, 10th Revision diagnoses and procedure codes that were mapped to country-specific diagnosis-related groups. Patients (N=750) randomized 1:1 to cryoballoon (n=374) or RFC (n=376) ablation were followed for a mean of 1.5 years. Resource use was lower in the cryoballoon than the RFC group (205 hospitalizations and/or interventions in 122 patients versus 268 events in 154 patients). The cost differences per patient in mean total payer costs during follow-up were euro640, pound364, and$925 in favor of cryoballoon ablation (P=0.012, 0.013, and 0.016, respectively). This resulted in trial period total cost savings of euro245 000, pound140 000, and $355 000. CONCLUSIONS: When compared with RFC ablation, cryoballoon ablation was associated with a reduction in resource use and payer costs. In all 3 national healthcare systems analyzed, this reduction resulted in substantial trial period cost savings, primarily attributable to fewer repeat ablations and a reduction in cardiovascular rehospitalizations with cryoballoon ablation. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Identifier: NCT01490814

Kenyon Collegian - March 28, 2002

https://digital.kenyon.edu/collegian/1410/thumbnail.jp

A Study of the Effects of Gender and Judging Experience in Lincoln-Douglas Debate

Many people still recall the years when contestants in debate and individual events were divided into a men\u27s and women\u27s division. It is just in the last decade that some high school forensic tournaments in South Dakota have abolished this practice of segregation and have combined the two divisions into a single all-encompassing division. The original rationale for such a practice of separation is not immediately evident. Apparently, the tournament directors believed that one sex had an inherent advantage over the other in equal competition. One event that had not yet been initiated during this period of segregation was the type of debate known as Lincoln-Douglas or single-person debate. The purpose of this study was to determine the impact of the participant\u27s gender, as well as the judge\u27s gender, on the success of the participants at several debate tournaments in Eastern South Dakota. This research identified several variables related to the impact of gender on judge\u27s decisions and contestant ratings in Lincoln-Douglas debate. There have been only three studies concerning the effect of gender in academic debate published in communication journals, and in all three studies the common notion of male superiority in debate has been discussed. The results of the three studies have concluded that empirical study does not bear out this commonly held notion. Having participated as a judge at Lincoln-Douglas debate tournaments, this researcher has witnessed the existence of the belief of male superiority in Lincoln Douglas debate. Therefore, this research attempted to establish whether the previous research dealing with two person debate is applicable with single-person or Lincoln Douglas debate teams and whether the commonly held belief of male superiority would be verified by statistical analysis

Marine tourism and sharks : a case study of Protea Banks.

Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2005.Marine tourism is an expanding segment of both international and domestic tourism in KwaZulu-Natal and can be of valuable contribution to the national and local economy, but there are also concern s about its sustainability. Two of the most popular marine activities in KwaZulu-Natal are diving and recreational fishing. However, these two different user groups can also create conflicts as they have very different user practices in relation to the same marine area and its resources. While certain marine regions along the coast have been declared marine protected areas with site specific management plans, other popular marine areas remain almost unmanaged. Shelly Beach on the South Coast of KwaZulu-Natal is the most popular boat launching site on the Natal coastline with both divers and recreational fishermen visiting a fossilised sand dune reef called Protea Banks which is situated 7 to 8 km off-shore from Shelly Beach. The reef is famous for its abundance of fish as the attraction for fishermen and big sharks attracting divers. A controversial topic in association with Protea Banks is its shark population. The divers are concerned that the number of sharks is decreasing, while the fishermen are concerned about there being too many sharks eating their hooked fish before they can boat their catch. This study looks at marine tourism and sharks using Protea Banks as a case study for marine tourism and management. The focus is on stakeholders' and different marine user groups' opinions on management, marine resource protection and user conflict. The issue of sharks and sustainability in association with both diving and recreational fishing is also investigated. The study shows that the stakeholders have developed a system of self-regulation based on the experience gained from their utilisation of Protea Banks. The stakeholders prefer to maintain this system rath er than the authorities declaring the area a marine protected area or in other ways further involve the authorities. The various stakeholders express different but specific environmental concerns including carrying capaci ty, seasonality and unsustainable pressure during the peak tourist season, shark and fish management, and lack of enforcement of regulations. The study concludes with recommendations toward s a site specific management plan for Protea Banks

Maintaining traditions, managing transitions : towards a re-contextualisation and re-imagination of music as missional practice within The Salvation Army. Three autoethnographic case studies in London

My research asks how and why music is used as missional practice within The Salvation Army, part of the Christian Church. What music is considered to be effective within a changing missiology, and how does the practice of Army worship differ according to location, leadership, and resources? As an officer (Minister of Religion), worship leader, composer and instrumentalist who has contributed to, and participated in music and mission, I recognise the importance and value of music to the Army and myself. The use of music is an important and interesting feature of missional practice in the Christian Church. Within the Salvation Army tradition, Salvationists have witnessed how Army ecclesiology has been shaped by the introduction of new musics to existing repertoire. In particular, the Army has embraced new songs, new styles and genres, new sounds and instrumentation, new formulae and methodology in order to promote its mission objectives within the changing and challenging marketplace of consumerism, multiculturalism, cultural practice and diversity. This mixed-method, autoethnographic empirical research is contextualised, using the Army's mission statement, 'Save souls, grow saints, and serve suffering humanity'. I make use of qualitative and quantitative data, together with my own reflective practice, in order to examine the interplay between music as missional practice of three diverse case studies, based in London: Regent Hall Band, Stepney Corps, and the annual Commissioning and Ordination event, held at Central Hall, Westminster. I use three concepts, Sodal and Modal and Nodal to contextualise congregational type, and apply and refine four 'evaluative frames' - Expression, Materials, Construction and Values - as well as my own notion of Parochial Protectionism, in order to assess and evaluate current practice within different Army congregations. My research demonstrates that Army music is used within the context of its location, congregational type, resources and tradition and, in so doing, provides musicians, congregants and bystanders with opportunities for worship, service, moments of reflection, and response. It recognises and acknowledges the diversity of music and mission within the Army, and celebrates the unique contribution both make to the embodied witness of the gospel message, developing community, and a sense of belonging. Although my case studies were all based in London, they are representative of similar expressions of Army worship and music throughout the Army world. The results of this thesis will contribute to the widening field of Practical Theology and Ethnomusicology. As the Army enters its 157th year, my conclusions highlight the way in which traditional and transitional music as missional practice are being adopted within 'traditional conservative' and 'radical liberal' Salvationist traditions