A Panel Approach to Evaluating TravelSmart Initiatives in the Short Term – South Australia Pilot Survey

An unusual TravelSmart intervention is being undertaken in South Australia, in which the intervention will take place over a period of about two years, using a variety of techniques to gain increasing acceptance from the population over that time. ITLS has the task of evaluating the travel impacts of this initiative. Two new approaches are being undertaken to evaluate the travel impacts – an odometer panel and a GPS panel. The odometer panel will consist of about 1,000 households that will be asked to provide the odometer readings from all cars used by the household every 4 months for a period of 2-1/2 years. The GPS panel will consist of about 200 households that will be asked to use wearable GPS devices for one week once a year for a period lasting just over 2 years (therefore, participants will use the GPS devices three times). Panel attrition is expected from both panels and participants lost through attrition will be replaced at each wave of each panel. This paper describes a pilot survey for both the odometer and GPS surveys, conducted in the period from March to June, 2005. The paper describes the method used to recruit households, the data collected at recruitment, the procedures used to obtain odometer readings and to have participants use the GPS devices, and summarises the resulting data from the pilot survey. The response rates to recruitment and completion of the panel tasks are noted for both panels

Frenotomy and Breastfeeding Outcomes in Infants with Ankyloglossia

This systematic review explores whether frenotomy (lingual frenulum division) improves breastfeeding outcomes for newborn infants with ankyloglossia. Ankyloglossia, also called tongue-tie, is a congenital anomaly whereby the baby has an unusually short or thick lingual frenulum. This condition can restrict breastfeeding by limiting tongue movement (NICE, 2005)

Bat Ensembles Differ in Response to Use Zones in a Tropical Biosphere Reserve

Biosphere reserves, designated under The United Nations Education, Scientific and Cultural Organization's (UNESCO) Man and Biosphere Programme, aim to sustainably integrate protected areas into the biological and economic landscape around them by buffering strictly protected habitats with zones of limited use. However, the effectiveness of biosphere reserves and the contribution of the different zones of use to protection is poorly known. We assessed the diversity and activity of bats in the Crocker Range Biosphere Reserve (CRBR) in Sabah, Malaysia, using harp traps, mist nets and acoustic surveys in each zone-core, buffer, transition and in agricultural plots outside of the reserve. We captured 30 species, bringing the known bat fauna of CRBR to 50 species, half of Borneo's bat species. Species composition and acoustic activity varied among zones and by foraging ensemble, with the core and buffer showing particular importance for conserving forest-dependent insectivorous bats. Frugivorous bats were found in all zones but were the most abundant and most species-rich ensemble within agricultural sites. Although sampling was limited, bat diversity and activity was low in the transition zone compared to other zones, indicating potential for management practices that increase food availability and enhance biodiversity value. We conclude that, collectively, the zones of the CRBR effectively protect diversity, but the value of the transition zone can be improved

The Indirect Cost Burden of Cancer Care in Canada : A Systematic Literature Review

BACKGROUND AND OBJECTIVES: Cancer poses a substantial health and economic burden on patients and caregivers in Canada. Previous reviews have estimated the indirect cost burden as work-related productivity losses associated with cancer. However, these estimates require updating and complementing with more comprehensive data that include relevant dimensions beyond labor market costs, such as patient time, lost leisure time and home productivity losses. METHODS: A systematic review of the literature was conducted to identify studies published from 2006 to 2020 that measured and reported the indirect costs borne by cancer patients and their caregivers in Canada, from the patient, caregiver, employer, and societal perspectives. Study characteristics and cost estimation methods were extracted from relevant studies. Costs estimates were reported and converted to 2020 CAD for the following categories: lost earnings, caregiving time costs, home production losses, patient time (leisure), morbidity-, disability-, premature mortality-related costs, friction costs, and overall productivity losses. A quality assessment of individual studies was conducted for included studies using the Newcastle-Ottawa Assessment Tool. RESULTS: In total, 3980 studies were identified, of which 18 Canadian studies met the inclusion criteria for review. One-third of the studies used or developed prediction models, 38% enrolled patient cohorts, and 27% used administrative databases. Over one-third of the studies were conducted at a national level (38%). All studies employed the human capital approach to estimate costs, and 16% also used the friction cost approach. Lost earnings were higher among self-employed patients (43% vs 24% among employees) and females ($8200 vs$3200 for males). Caregiver costs ranged from $15,786 to$20,414 per patient per year. Household productivity losses were estimated to be up to $238,904 per household per year. Patient time (leisure) costs were estimated to be between$13,000 and $18,704 per patient per year. Premature annual mortality costs were estimated to be$2.98 billion overall in Quebec. Friction costs incurred by employers were estimated between $6400 and$23,987 per patient per year. Societal productivity losses associated with cancer were estimated between $75 million to$317 million, annually. CONCLUSIONS: This review suggests that the indirect cost burden of cancer is considerable from the patient, caregiver, employer, and societal perspectives. This up-to-date review of the literature provides a comprehensive understanding of the indirect cost burden by including non-labor market activity costs and by examining all relevant perspectives. These results provide a strong case for the government and employers to ensure there are supports in place to help patients and caregivers buffer the impact of cancer so they can continue to engage in productive activities and enjoy leisure time

Profiling of the molecular weight and structural isomer abundance of macroalgae-derived phlorotannins

peer-reviewedPhlorotannins are a group of complex polymers of phloroglucinol (1,3,5-trihydroxybenzene) unique to macroalgae. These phenolic compounds are integral structural components of the cell wall in brown algae, but also play many secondary ecological roles such as protection from UV radiation and defense against grazing. This study employed Ultra Performance Liquid Chromatography (UPLC) with tandem mass spectrometry to investigate isomeric complexity and observed differences in phlorotannins derived from macroalgae harvested off the Irish coast (Fucus serratus, Fucus vesiculosus, Himanthalia elongata and Cystoseira nodicaulis). Antioxidant activity and total phenolic content assays were used as an index for producing phlorotannin fractions, enriched using molecular weight cut-off dialysis with subsequent flash chromatography to profile phlorotannin isomers in these macroalgae. These fractions were profiled using UPLC-MS with multiple reaction monitoring (MRM) and the level of isomerization for specific molecular weight phlorotannins between 3 and 16 monomers were determined. The majority of the low molecular weight (LMW) phlorotannins were found to have a molecular weight range equivalent to 4-12 monomers of phloroglucinol. The level of isomerization within the individual macroalgal species differed, resulting in substantially different numbers of phlorotannin isomers for particular molecular weights. F. vesiculosus had the highest number of isomers of 61 at one specific molecular mass, corresponding to 12 phloroglucinol units (PGUs). These results highlight the complex nature of these extracts and emphasize the challenges involved in structural elucidation of these compounds.PUBLISHEDpeer-reviewe

The Out-of-Pocket Cost Burden of Cancer Care—A Systematic Literature Review

Background: Out-of-pocket costs pose a substantial economic burden to cancer patients and their families. The purpose of this study was to evaluate the literature on out-of-pocket costs of cancer care. Methods: A systematic literature review was conducted to identify studies that estimated the out-of-pocket cost burden faced by cancer patients and their caregivers. The average monthly out-of-pocket costs per patient were reported/estimated and converted to 2018 USD. Costs were reported as medical and non-medical costs and were reported across countries or country income levels by cancer site, where possible, and category. The out-of-pocket burden was estimated as the average proportion of income spent as non-reimbursable costs. Results: Among all cancers, adult patients and caregivers in the U.S. spent between USD 180 and USD 2600 per month, compared to USD 15–400 in Canada, USD 4–609 in Western Europe, and USD 58–438 in Australia. Patients with breast or colorectal cancer spent around USD 200 per month, while pediatric cancer patients spent USD 800. Patients spent USD 288 per month on cancer medications in the U.S. and USD 40 in other high-income countries (HICs). The average costs for medical consultations and in-hospital care were estimated between USD 40–71 in HICs. Cancer patients and caregivers spent 42% and 16% of their annual income on out-of-pocket expenses in low- and middle-income countries and HICs, respectively. Conclusions: We found evidence that cancer is associated with high out-of-pocket costs. Healthcare systems have an opportunity to improve the coverage of medical and non-medical costs for cancer patients to help alleviate this burden and ensure equitable access to care

Baker Center Journal of Applied Public Policy, Vol. III No. I

Welcome to the third issue of the Baker Center Journal for Applied PublicPolicy. I am pleased that this issue, as its predecessors, evidences the vibrancy of the Baker Center’s governance and public policy programs and makes a contribution to our collective understanding about a variety of policy issues currently being discussed in America. Relating to our system of governance, Jess Hale Jr. examines a proposal for a uniform state approach to reining in renegade presidential electors and Professor Glenn Reynolds reviews Jack Goldsmith’s book The Terror Presidency: Law and Judgment Inside the Bush Administration. Relating to media and foreign affairs and the role of the media in political life, Dr. Mike Fitzgerald and two of his students provide us with “A Comparative Study of Images Created by Press Coverage of the United States and the Republic of Belarus.” Relating to health policy, Dr. David Mirvis, recently appointed as a Senior Fellow for Health Policy at the Center, explores the public policy implications of viewing health as an engine of economic growth. Relating to energy and environmental policy, Drs. Bruce Tonn and Amy Gibson and Baker Scholars Stephanie Smith and Rachel Tuck explore U.S. Attitudes and Perspectives on National Energy Policy. I am also very pleased that this issue includes a report of an excellent conference – “Formulation of a Bipartisan Energy and Climate Policy: Toward and Open and Transparent Process “- that was co-sponsored by the Baker Center and the Woodrow Wilson International Center for Scholars. This issue also includes the result ofanother successful collaboration between the Baker and Wilson Centers that focused on “Five Public Policy Ideas for Building Obama’s New Economy.” I look forward to further productive collaborations between the Baker and Wilson Centers. Relating to global security policy, this issue includes a Student Symposium onNational Security. Although the Baker Center Journal has provided an outlet for publication of student scholarship since its inception, I am particularly pleased that the student co-editors - Baker Scholars Elizabeth Wilson Vaughan and Bradford A. Vaughan - took the initiative to expand upon the efforts of their predecessors and to provide us with an expanded set of excellent students essays each of which addresses an important national security policy issue. It is an important part of the Baker Center’s mission to engage UTK students in the political and public policy process, and I applaud our student authors fortheir contributions to this symposium. I hope you find this issue of the Baker Center Journal for Applied Public Policy to be both interesting and thought-provoking and that it will encourage you to participate in America’s unique and wonderful political and policy processes

The psychosocial cost burden of cancer : A systematic literature review

BACKGROUND AND OBJECTIVE: Psychosocial costs, or quality of life costs, account for psychological distress, pain, suffering and other negative experiences associated with cancer. They contribute to the overall economic burden of cancer that patients experience. But this category of costs remains poorly understood. This hinders opportunities to make the best cancer control policy decisions. This study explored the psychosocial cost burden associated with cancer, how studies measure psychosocial costs and the impact of this burden. METHODS: A systematic literature review of academic and grey literature published from 2008 to 2018 was conducted by searching electronic databases, guided by the Institute of Medicine's conceptualization of psychosocial burden. Results were analyzed using a narrative synthesis and a weighted proportion of populations affected was calculated. Study quality was assessed using the Ottawa-Newcastle instrument. RESULTS: A total of 25 studies were included. There was variation in how psychosocial costs were conceptualized and an inconsistent approach to measurement. Most studies measured social dimensions and focused on the financial consequences of paying for care. Fewer studies assessed costs associated with the other domains of this burden, including psychological, physical, and spiritual dimensions. Fourty-four percent of cancer populations studied were impacted by psychosocial costs and this varied by disease site (38%-71%). Two studies monetized the psychosocial cost burden, estimating a lifetime cost per case ranging from CAD$427753 to CAD$528769. Studies were of varying quality; 60% of cross-sectional studies had a high risk of bias. CONCLUSIONS: Consistency in approach to measurement would help to elevate this issue for researchers and decision makers. At two-thirds of the total economic burden of cancer, economic evaluations should account for psychosocial costs to better inform decision-making. More support is needed to address the psychosocial cost burden faced by patients and their families

Breaking the waves: improved detection of copy number variation from microarray-based comparative genomic hybridization.

BACKGROUND: Large-scale high throughput studies using microarray technology have established that copy number variation (CNV) throughout the genome is more frequent than previously thought. Such variation is known to play an important role in the presence and development of phenotypes such as HIV-1 infection and Alzheimer's disease. However, methods for analyzing the complex data produced and identifying regions of CNV are still being refined. RESULTS: We describe the presence of a genome-wide technical artifact, spatial autocorrelation or 'wave', which occurs in a large dataset used to determine the location of CNV across the genome. By removing this artifact we are able to obtain both a more biologically meaningful clustering of the data and an increase in the number of CNVs identified by current calling methods without a major increase in the number of false positives detected. Moreover, removing this artifact is critical for the development of a novel model-based CNV calling algorithm - CNVmix - that uses cross-sample information to identify regions of the genome where CNVs occur. For regions of CNV that are identified by both CNVmix and current methods, we demonstrate that CNVmix is better able to categorize samples into groups that represent copy number gains or losses. CONCLUSION: Removing artifactual 'waves' (which appear to be a general feature of array comparative genomic hybridization (aCGH) datasets) and using cross-sample information when identifying CNVs enables more biological information to be extracted from aCGH experiments designed to investigate copy number variation in normal individuals.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are