Weight Status and Satisfaction With Healthcare Received in the U.S. And Georgia

Background: Two-thirds of the U.S. population is overweight or obese, and, in Georgia, adult obesity rates are among the highest. Obesity is a risk factor for diabetes, heart disease, stroke, and some types of cancer, and adherence to treatment of such disease conditions is affected by patients’ perception of healthcare received. The present study examined the association between weight status and satisfaction with healthcare received in the U.S. and in Georgia. Methods: The association between weight status and satisfaction with healthcare received in the U.S. and Georgia was examined using multiple logistic regression analyses, controlling for demographic and other healthcare-related variables. The data used were from the 2013 Behavioral Risk Factor Surveillance System (BRFSS) dataset. Results: There were 265,468 complete cases for the U.S., 66% (181,911) were overweight or obese. The odds of being very satisfied with healthcare received was lower for the underweight, overweight, and obese groups by 11.8% (p \u3c0.001), 2.4% (p = 0.022), and 10.1% (p \u3c0.001), respectively, compared to the normal group. Of the 5,947 complete cases for Georgia, 62% (3698) were overweight or obese. The odds of being very satisfied with healthcare received was lower for the overweight and obese groups by 15.1% (p = 0.023) and 18.3% (p = 0.006), respectively, compared to the normal group. Conclusions: The probability of being very satisfied with healthcare received is lower for obese and overweight patients. Improvements in healthcare services provided to these individuals are needed to ensure satisfaction and adherence to treatment of chronic diseases, including weight loss treatment and management

POST COVID PNEUMONIA: MODERN THERAPEUTIC APPROACH BY PULMONARY DRUG DELIVERY DEVICE

Streptococcus pneumonia (also known as pneumococcal) is a commensal that colonizes the upper respiratory tract and a pathogen that causes intrusive illnesses like otitis media, pneumonia, sepsis, and meningitis. In India, the Invasive Bacterial Infection Surveillance (IBIS) organization and South Asian Pneumococcal Alliance (SAPNA) have been associated with assortment of significant information in regards to serotype dissemination and antimicrobial obstruction of pneumococcal diseases for over 12 years. COVID 19 Patients are much more prone towards this infection, if untreated at appropriate time. So development of New Device are immense Important which contributes rapid and Proper Drug Delivery to lungs. Research must be carried out in the field of Novel Drug Delivery System for target delivery of Drugs like Antibiotic, Bronchodiator and Corticosteroid to Respiratory Tract. The present Review article focus Different grade of Pneumococcal Infection and Infection associated with Post COVID Condition. The article also highlights new devices which helpful for Pulmonary drug delivery which is vital during COVID Associated Pneumococcal Infection

Costs Analysis of Fibrin Sealant for Prevention of Anastomotic Leakage in Lower Colorectal Surgery

Introduction: Postoperative anastomotic leaks remain a common and serious complication of colorectal surgeries and are a major cause of mortality and morbidity of these procedures. Anastomotic leaks (AL) have been extensively studied; however, there has been no significant reduction in their prevalence over time. In addition, there is a significant economic burden from AL attributed to the need for repeat surgery, radiologic intervention and lengthened hospital stay. We conducted a comparative cost analysis of patients undergoing colorectal surgery with anastomosis, with the application of fibrin sealant (FS) to the sutured anastomosis versus not treating the sutured anastomosis with FS. Methods: The deterministic decision-tree model was populated with clinical data including operating room time, hospitalization days, occurrence of AL, need for revision surgery, blood products and radiologic interventions to treat the AL in lower colorectal surgery. A systematic literature review was conducted to identify appropriate studies with these variables. Results: The average cost per case treated lower colorectal surgery with fibrin sealant glue 10 mL Tisseel® and those not treated with a fibrin sealant after suturing the anastomoses was €3233 and €4130, respectively, for resource expenses paid by the healthcare system. This would suggest potential savings of €897 per surgery, achieved through the application of FS to the sutured anastomosis for preventing AL following colorectal surgery. Conclusion: Application of FS to the sutured anastomosis in lower colorectal surgery resulted in a decrease in post-operative AL, and cost savings based on a reduction in hospitalization days, a reduction needing: revision surgery, radiologic intervention and blood products to treat AL

Estimating the fiscal impact of rare diseases using a public economic framework:a case study applied to hereditary transthyretin-mediated (hATTR) amyloidosis

Background A wide range of rare diseases can have fiscal impacts on government finances that extend beyond expected healthcare costs. Conditions preventing people from achieving national lifetime work averages will influence lifetime taxes paid and increase the likelihood of dependence on public income support. Consequently, interventions that influence projected lifetime work activity, morbidity and mortality can have positive and negative fiscal consequences for government. The aim of this study was to apply a public economic framework to a rare disease that takes into consideration a broad range of costs that are relevant to government in relation to transfers received and taxes paid. As a case study we constructed a simulation model to calculate the fiscal life course of an individual with hereditary transthyretin-mediated (hATTR) amyloidosis in The Netherlands. In this lethal disease different progressive disease scenarios occur, including polyneuropathy and/or cardiomyopathy. Results Due to progressive disability, health care resource use, and early death, hATTR amyloidosis with polyneuropathy receives more transfers from government compared to the general population. In a scenario where a patient is diagnoses with hATTR at age 45, an individual pays €180,812 less in lifetime taxes and receives incrementally €111,695 in transfers from the government, compared to a person without hATTR. Patients suffering from cardiomyopathy die after median 4 years. The health costs of this scenario are therefore lower than that of the other polyneuropathy-based scenarios. Conclusions The fiscal analysis illustrates how health conditions influence not only health costs, but also the cross-sectorial public economic burden attributed to lost tax revenues and public disability allowances. Due to the progressive nature of hATTR amyloidosis used in this study, public costs including disability increase as the disease progresses with reduced lifetime taxes paid. The results indicate that halting disease progression early in the disease course would generate fiscal benefits beyond health benefits for patients. This analysis highlights the fiscal consequences of diseases and the need for broader perspectives applied to evaluate health conditions. Conventional cost-effectiveness framework used by many health technology assessment agencies have well-documented limitations in the field of rare diseases and fiscal modeling should be a complementary approach to consider

Environmental sustainability during machining of hardened steel using nanofluid: A case study

The positive effects of nanofluid-assisted minimum quantity lubrication include improved performance during machining and environmental sustainability. In the present study two cutting parameters levels such as feed rate of 0.05 (mm/rev)- depth of cut of 0.1(mm)-cutting speed of 80(m/min) and feed rate of 0.15(mm/rev)-depth of cut of 0.3(mm)-cutting speed of 200(m/min) has been used in the hard turning of D2 steel. It was determined that the 0.3% ZrO2 wt% observed to be improved machinability as compared to dry and Minimum Quantity Lubrication (MQL) environment. Finally, the sustainability assessment through the Pugh Matrix Assessment (PMA) presented the potential of nanofluid-MQL for improvement of machinability of hardened D2 steel for cleaner production

A contemporary advancement of intelligent machining and sustainability aspects in hard machining area: A Critical Review

The intelligent manufacturing devotes considerable effort to towards machining process. This phenomenon is engendered by the growing demand for advanced machining process for manufacturing of precise parts by adopting optimization techniques. This article illustrates the most significant developments in the sustainability aspects as well as optimization and modelling techniques adopted to solve the problems and complexity in hard machining process. Machining realisation necessitates recent and future breakthroughs in technological innovations for Industry 4.0. A significant amount of focus is also paid to the different sustainability aspects, modelling strategies and performance analysis during hard machining process. Many avenues for future study on the needs of intelligent manufacturing are discussed in this article. The future directions for intelligent machine systems and sustainability factors are also discussed for the green, sustainable, and high dimensional accuracy manufacturing in hard machining area

WASPAS Based Multi Response Optimization in Hard Turning of AISI 52100 Steel under ZnO Nanofluid Assisted Dual Nozzle Pulse-MQL Environment

Hard turning is an emerging machining technology that evolved as a substitute for grinding in the production of precision parts from hardened steel. It offers advantages such as reduced cycle times, lower costs, and environmental benefits over grinding. Hard turning is stated to be difficult because of the high hardness of the workpiece material, which causes higher tool wear, cutting temperature, surface roughness, and cutting force. In this work, a dual-nozzle minimum quantity lubrication (MQL) system’s performance assessment of ZnO nano-cutting fluid in the hard turning of AISI 52100 bearing steel is examined. The objective is to evaluate the ZnO nano-cutting fluid’s impacts on flank wear, surface roughness, cutting temperature, cutting power consumption, and cutting noise. The tool flank wear was traced to be very low (0.027 mm to 0.095 mm) as per the hard turning concern. Additionally, the data acquired are statistically analyzed using main effects plots, interaction plots, and analysis of variance (ANOVA). Moreover, a novel Weighted Aggregated Sum Product Assessment (WASPAS) optimization tool was implemented to select the optimal combination of input parameters. The following optimal input variables were found: depth of cut = 0.3 mm, feed = 0.05 mm/rev, cutting speed = 210 m/min, and flow rate = 50 mL/hr

Estimating the government public economic benefits attributed to investing in assisted reproductive technology: a South African case study: Fiscal analysis of IVF in South Africa

Limited resources and high treatment costs are arguments often used in many public health systems in low- and middle-income countries to justify providing limited treatments for people with infertility. In this analysis, we apply a government public economic perspective to evaluate public subsidy for in-vitro fertilization (IVF) in South Africa. A fiscal model was developed that considered lifetime direct and indirect taxes paid and government transfers received by a child conceived by IVF. The model was constructed from public data sources and was adjusted for mortality, age-specific educational costs, participation in the informal economy, proportions of persons receiving social grants, and health costs. Based on current proportions of individuals receiving social grants and average payments, including education and health costs, we estimate each citizen will receive ZAR513,165 (USD35,587) in transfers over their lifetime. Based on inflated age-specific earnings, we estimate lifetime direct and indirect taxes paid per citizen of ZAR452,869 (USD31,405) and ZAR494,521 (USD34,294), respectively, which also includes adjustments for the proportions of persons participating in the informal economy. The lifetime net tax after deducting transfers was estimated to be ZAR434,225 (USD31,112) per person. Based on the average IVF investment cost needed to achieve one live birth, the fiscal return on investment (ROI) for the South African Government is 5.64. Varying the discount rate from 4% to 7%, the ROI ranged from 9.54 to 1.53, respectively. Positive economic benefits can emanate from public financing of IVF. The fiscal analytic framework described here can be a useful approach for health services to evaluate future public economic benefits