Vaccine-preventable haemophilus influenza type B disease burden and cost-effectiveness of infant vaccination in Indonesia.

BACKGROUND: Most of Asia, including Indonesia, does not use Haemophilus influenzae type b (Hib) conjugate vaccines. We estimated total vaccine-preventable disease burden and the cost-effectiveness of Hib conjugate vaccine in Indonesia. METHODS: Hib pneumonia and meningitis incidences for children with access to health care were derived from a randomized vaccine probe study on Lombok Island, Indonesia during 1998-2002. Incidences were adjusted for limited access to care. Health system and patient out-of-pocket treatment cost data were collected concurrent with the probe study. For Hib vaccine in monovalent and combined (with DTP-HepB) presentations, we used 2007 UNICEF vaccine prices of US$3.30 and$3.75 per dose. RESULTS: For the 2007 Indonesian birth cohort, Hib vaccine would prevent meningitis in 1 of every 179 children, pneumonia in 1 of every 18 children, and 4.9% of mortality among those younger than 5 years. The total incremental societal costs of introducing Hib vaccine in monovalent and pentavalent presentations were, respectively, US$11.74 and$8.93 per child vaccinated. Annual discounted treatment costs averted amounted to 20% of pentavalent vaccine costs. For the pentavalent vaccine, the incremental costs per discounted death and disability adjusted life-year averted amounted to US$3102 and$74, respectively, versus $4438 and$102 for monovalent vaccine. CONCLUSIONS: Routine infant Hib vaccination would prevent a large burden of pediatric illness and death in Indonesia. Even without external funding support, Hib vaccine will be a highly cost-effective intervention in either a monovalent or pentavalent presentation based on commonly used benchmarks

The local electronic structure of alpha-Li3N

New theoretical and experimental investigation of the occupied and unoccupied local electronic density of states (DOS) are reported for alpha-Li3N. Band structure and density functional theory calculations confirm the absence of covalent bonding character. However, real-space full-multiple-scattering (RSFMS) calculations of the occupied local DOS finds less extreme nominal valences than have previously been proposed. Nonresonant inelastic x-ray scattering (NRIXS), RSFMS calculations, and calculations based on the Bethe-Salpeter equation are used to characterize the unoccupied electronic final states local to both the Li and N sites. There is good agreement between experiment and theory. Throughout the Li 1s near-edge region, both experiment and theory find strong similarities in the s- and p-type components of the unoccupied local final density of states projected onto an orbital angular momentum basis (l-DOS). An unexpected, significant correspondence exists between the near-edge spectra for the Li 1s and N 1s initial states. We argue that both spectra are sampling essentially the same final density of states due to the combination of long core-hole lifetimes, long photoelectron lifetimes, and the fact that orbital angular momentum is the same for all relevant initial states. Such considerations may be generically applicable for low atomic number compounds.Comment: 34 pages, 7 figures, 1 tabl

Creative coping: A cognitive-behavioral group for borderline personality disorder

Patients with borderline personality disorder (BPD) pose major therapeutic challenges to mental health professionals. Effective and practical treatment of the patient with BPD is needed in short-term inpatient settings, and psychiatric nurses are in a unique position to implement innovative treatment strategles for the borderline patient. The Creative Coping Group is a practice model designed by psychiatric nurses for patients with BPD, using a cognitive-behavioral framework. It is a group therapy intervention based on linehan's Dialectical Behavior Therapy (DBT) that addresses the ineffective coping of patients with BPD that results in chronic suicidal behavior. Linehan's framework focuses on deficits in emotional control, interpersonal effectiveness, and distress tolerance. The objective of the group sesslons is to foster insight and awareness into symptoms, feelings, and behaviors through psychoeducation, group exercises, discussion, and homework assignments.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/31403/1/0000320.pd

Blowtooth: a provocative pervasive game for smuggling virtual drugs through real airport security

In this paper we describe a pervasive game, Blowtooth, in which players use their mobile phones to hide virtual drugs on nearby airline passengers in real airport check-in queues. After passing through airport security, the player must find and recover their drugs from the innocent bystanders, without them ever realizing they were involved in the game. The game explores the nature of pervasive game playing in environments that are not, generally, regarded as playful or “fun”. This paper describes the game’s design and implementation as well as an evaluation conducted with participants in real airports. It explores the players’ reactions to the game through questionnaire responses and in-game activity. The technologies used in Blowtooth are, intentionally, simple in order for the enjoyment of the game to be reliant more on the physical environment rather than the enabling technologies. We conclude that situating pervasive games in unexpected and challenging environments, such as international airports, may provide interesting and unique gaming experiences for players. In addition, we argue that pervasive games benefit most from using the specific features and nature of interesting real-world environments rather than focusing on the enabling technologies