Cost – Benefit Analysis of Austin Public Health’s Peer to Peer Adolescent Sexual Health Education Program

Background Despite the rapid decline in teen pregnancy rates in recent years, teen pregnancies and STIs remain a significant concern, especially for minority youth. As a result, numerous sexual health programs have been introduced, with some success. In Austin, Texas, an implementation of “Making Proud Choices” entitled Peer-to-Peer (P2P) was introduced in 2015 and serves between 750 and 800 students of largely Hispanic origin annually. Methods In this study, we assessed whether P2P was cost-beneficial. We used a Bernoulli model to estimate averted cases of pregnancies, key STIs and their sequelae: HIV, chlamydia, gonorrhea, genital herpes, human papillomavirus and pelvic inflammatory disease based on changes in sexual activity and contraceptive use. We estimated costs by multiplying these averted outcomes by their costs. Interpretation of the results was hampered by low power, a pre-post methodology with serial cross-section design. We therefore also substituted results from two widely-cited meta-analyses. Results Results from P2P when using data from the program evaluation were adverse, with increases in all of our negative outcomes. Therefore, P2P was not cost-beneficial. Using results from our meta-analyses yielded positive outcomes, but the results still were not cost-beneficial. Sensitivity analyses were performed based on a Monte Carlo simulation. They reveal that when the most advantageous values of certain parameters were included, P2P would be cost-beneficial in some instances. Discussion or Conclusion Our results were largely driven by the fact that condom use did not increase in the P2P program, nor did sexual activity decline. However, our Monte Carlo simulation revealed that in some instances, P2P was cost beneficial. However, this study, along with others revealing mixed outcomes, shows that the intervention needs modification to be successful

Role of MRI in Evaluation of Cranial Nerve Pathologies

Introduction: The human body has 12 pairs of cranial nerves that control motor and sensory functions of the head and neck. The anatomy of cranial nerves is complex and its knowledge is crucial to detect pathological alterations in case of nervous disorders. MRI brain using cranial nerve protocol is routinely used in evaluating patients presenting with cranial nerve related symptoms and pathology. It is also a non-invasive study. Material & Method: Retrospective observational study was done in the 60 patients over a course of 1 year from April 2022 to 31 st march 2023 at department of radiodiagnosis, SVP hospital, NHLMMC, Ahmedabad with Siemens MagnetomSkyra using CISS protocol and contrast images. Result: Out of 60 patients having cranial nerve related symptoms, 52 showed abnormal finding/ pathology in MRI scan. The most commonly observed abnormality was vascular pathology causing nerve compression followed by compression by mass lesion. Conclusion: Because of its high resolution and no radiation exposure, MR imaging is the gold standard investigation in visualising cranial nerves & identifying pathologies in patients having cranial nerve related symptoms. Its ability in identifying subtle lesions & its extent is excellent

Cost-effectiveness of program to improve nutrition in pregnant women from low-income groups

It is common knowledge that improper nutrition and obesity during pregnancy can lead to many serious health shortcomings for infants as well as mothers. Malnutrition in mothers during prenatal period is related to many chronic as well as acute diseases. Any program that focuses on proper maternal nutrition and physical activity and intervenes at an early fetal development stage may deliver better health results for infants and mothers. Investing in maternal and child health will ultimately lead to improved outcomes in terms of longevity as well as quality of life. However, the question is not simply are there benefits, but whether those benefits are worth the costs. Accordingly, the intent of this study was to determine whether a program focused on physical activity and better dietary habits for pregnant women is able to improve the quality of life for mothers (particularly by decreasing incidences of postpartum depression) and help deliver better birth outcomes. The main purpose and important aspect of the study was to carry out an economic evaluation using cost-effectiveness analysis. This was done by estimating the costs associated with carrying out the intervention and the enhancement seen in the quality of life due to the same. Healthy Eating Active Living (HEAL) was a primary prevention program with the overarching goal of increasing healthy eating, breastfeeding and physical activity behaviors to promote healthy weight gain during pregnancy for the mother, improve birth outcomes and prevent childhood obesity later in life. The program was carried out with 244 pregnant female participants living in and around Houston, Texas. All of these women who participated in the study belonged to low-income groups and were eligible for Medicaid. The costs of conducting the program were calculated in terms of staff costs, material costs and participants cost. Participants’ health was measured in terms of Quality Adjusted Life Years (QALYs) with the aid of EuroQol-5D set of questionnaire, before and after the intervention. This was done to assess the quality of life before and after intervention with respect to postpartum depression. Cost-effectiveness was calculated in terms of costs per unit increase in QALY. The cost of conducting the program per participant was found to be $283. This further led to incremental costs of conducting the program to be$9,399 per unit increase in QALY. This is fairly cost-effective considering the threshold of $50,000 per unit of QALY. Therefore, it was concluded that HEAL program was cost-effective

Gender differences in BaYaka forager sleep-wake patterns in forest and village contexts

Sleep studies in small-scale subsistence societies have broadened our understanding of cross-cultural sleep patterns, revealing the flexibility of human sleep. We examined sleep biology among BaYaka foragers from the Republic of Congo who move between environmentally similar but socio-ecologically distinct locations to access seasonal resources. We analyzed the sleep–wake patterns of 51 individuals as they resided in a village location (n = 39) and a forest camp (n = 23) (362 nights total). Overall, BaYaka exhibited high sleep fragmentation (50.5) and short total sleep time (5.94 h), suggestive of segmented sleep patterns. Sleep duration did not differ between locations, although poorer sleep quality was exhibited in the village. Linear mixed effect models demonstrated that women’s sleep differed significantly from men’s in the forest, with longer total sleep time (β ± SE =  − 0.22 ± 0.09, confidence interval (CI) = [− 0.4, − 0.03]), and higher sleep quality (efficiency; β ± SE =  − 0.24 ± 0.09, CI = [− 0.42, − 0.05]). These findings may be due to gender-specific social and economic activities. Circadian rhythms were consistent between locations, with women exhibiting stronger circadian stability. We highlight the importance of considering intra-cultural variation in sleep–wake patterns when taking sleep research into the field