Economic evaluations of non-communicable disease interventions

Background Demographic projections suggest a major increase in non-communicable disease (NCD) mortality over the next two decades in developing countries. In a climate of scarce resources, policy-makers need to know which interventions represent value for money. The prohibitive cost of performing multiple economic evaluations has generated interest in transferring the results of studies from one setting to another. This paper aims to bridge the gap in the current literature by critically evaluating the available published data on economic evaluations of NCD interventions in developing countries. Methods We identified and reviewed the methodological quality of 32 economic evaluations of NCD interventions in developing countries. Developing countries were defined according to the World Bank classification for low- and lower middle-income countries. We defined NCDs as the 12 categories listed in the 1993 World Bank report Investing in Health. English language literature was searched for the period January 1984 and January 2003 inclusive in Medline, Science Citation Index, HealthStar, NHS Economic Evaluation Database and Embase using medical subheading terms and free text searches. We then assessed the quality of studies according to a set of pre-defined technical criteria. Results We found that the quality of studies was poor and resource allocation decisions made by local and global policy-makers on the basis of this evidence could be misleading. Furthermore we have identified some clear gaps in the literature, particularly around injuries and strategies for tackling the consequences of the emerging tobacco epidemic. Conclusion In the face of poor evidence the role of so-called generalised cost-effectiveness analyses has an important role to play in aiding public health decision-making at the global level. Further research is needed to investigates the causes of variation among cost, effects and cost-effectiveness data within and between settings. Such analyses still need to take a broad view, present data in a transparent manner and take account of local constraints

Engaging Students Engaging Industry Engaging Enterprise

A reflective piece on how a small team of students and academics gained more awareness of their own sense of enterprise and creativity. The case study examines the phases and crisis points of the whole event process and identifies some of the key learning outcomes for all involved

Study of the use of Metal-Oxide-Silicon (MOS) devices for particulate detection and monitoring in the earth's atmosphere

A metal-oxide-silicon (MOS) capacitor-type particulate sensor was evaluated for use in atmospheric measurements. An accelerator system was designed and tested for the purpose of providing the necessary energy to trigger the MOS-type sensor. The accelerator system and the MOS sensor were characterized as a function of particle size and velocity. Diamond particles were used as particulate sources in laboratory tests. Preliminary tests were performed in which the detector was mounted on an aircraft and flown in the vicinity of coal-fired electric generating plants

Sunjammer

No abstract available

On the Cognition of States of Affairs

The theory of speech acts put forward by Adolf Reinach in his "The A Priori Foundations of the Civil Law" of 1913 rests on a systematic account of the ontological structures associated with various different sorts of language use. One of the most original features of Reinach's account lies in hIs demonstration of how the ontological structure of, say, an action of promising or of commanding, may be modified in different ways, yielding different sorts of non-standard instances of the corresponding speech act varieties. The present paper is an attempt to apply this idea of standard and modified instances of ontological structures to the realm of judgement and cognition, and thereby to develop a Reinachian theory of how intentionality is mediated through language in acts of thinking and speaking

Multipoint, high time resolution galactic cosmic ray observations associated with two interplanetary coronal mass ejections

[1] Galactic cosmic rays (GCRs) play an important role in our understanding of the interplanetary medium (IPM). The causes of their short timescale variations, however, remain largely unexplored. In this paper, we compare high time resolution, multipoint space-based GCR data to explore structures in the IPM that cause these variations. To ensure that features we see in these data actually relate to conditions in the IPM, we look for correlations between the GCR time series from two instruments onboard the Polar and INTEGRAL (International Gamma Ray Astrophysical Laboratory) satellites, respectively inside and outside Earth\u27s magnetosphere. We analyze the period of 18–24 August 2006 during which two interplanetary coronal mass ejections (ICMEs) passed Earth and produced a Forbush decrease (Fd) in the GCR flux. We find two periods, for a total of 10 h, of clear correlation between small-scale variations in the two GCR time series during these 7 days, thus demonstrating that such variations are observable using space-based instruments. The first period of correlation lasted 6 h and began 2 h before the shock of the first ICME passed the two spacecraft. The second period occurred during the initial decrease of the Fd, an event that did not conform to the typical one- or two-step classification of Fds. We propose that two planar magnetic structures preceding the first ICME played a role in both periods: one structure in driving the first correlation and the other in initiating the Fd

Economic considerations of Alzheimer's disease and related disorders

Economic analyses of geriatric syndromes are seldom performed. However, demographic and epidemiological imperatives have led to significant interest in the evaluation of AD-related costs. Over 300 papers devoted to economic considerations of Alzheimer's disease have been published in peer-reviewed journals, within the last five years. In these papers, the chosen perspective (costs to society or to specific payers) is important. Analytical methods are still evolving and remain complex. Unresolved methodological issues will need to be addressed to further our understanding of long-term economic consequences. At present, it is clear that diagnostic and drug costs are low compared to the major cost of institutionalization. Thus, directing efforts at early diagnosis and delaying nursing home placement are two key cost-containment interventions. In this respect, the need to support informal care should not be underestimate

Melanopsin-Containing ipRGCs Are Resistant to Excitotoxic Injury and Maintain Functional Non-Image Forming Behaviors After Insult in a Diurnal Rodent Model

Intrinsically photosensitive retinal ganglion cells (ipRGCs) are critical for the light signaling properties of non-image forming vision. Melanopsin-expressing ipRGCs project to retinorecipient brain regions involved in modulating circadian rhythms. Melanopsin has been shown to play an important role in how animals respond to light, including photoentrainment, masking (i.e., acute behavioral responses to light), and the pupillary light reflex (PLR). Importantly, ipRGCs are resistant to various forms of damage, including ocular hypertension, optic nerve crush, and excitotoxicity via N-methyl-D-aspartic acid (NMDA) administration. Although these cells are resistant to various forms of injury, the question still remains whether or not these cells remain functional following injury. Here we tested the hypothesis that ipRGCs would be resistant to excitotoxic damage in a diurnal rodent model, the Nile grass rat (Arvicanthis niloticus). In addition, we hypothesized that following insult, grass rats would maintain normal circadian entrainment and masking to light. In order to test these hypotheses, we injected NMDA intraocularly and examined its effect on the survivability of ipRGCs and RGCs, along with testing behavioral and functional consequences. Similar to findings in nocturnal rodents, ipRGCs were spared from significant damage but RGCs were not. Importantly, whereas image-forming vision was significantly impaired, non-image forming vision (i.e, photoentrainment, masking, and PLR) remained functional. The present study aims to characterize the resistance of ipRGCs to excitotoxicity in a diurnal rodent model