Current Knowledge and Attitudes Concerning Cost-Effectiveness in Glaucoma Pharmacotherapy: A Glaucoma Specialists Focus Group Study.

Background:Rising healthcare costs motivate continued cost-reduction efforts. To help lower costs associated with open-angle glaucoma (OAG), a prevalent, progressive disease with substantial direct and indirect costs, clinicians need to understand the cost-effectiveness of intraocular pressure (IOP)-lowering pharmacotherapies. There is little published information on clinicians' knowledge and attitudes about cost-effectiveness in glaucoma treatment. Purpose:This pilot focus group study aimed to explore clinician attitudes and perspectives around the costs and cost drivers of glaucoma therapy; the implementation of cost-effectiveness decisions; the clinical utility of cost-effectiveness studies; and the cost-effectiveness of available treatments. Methods:Six US glaucoma specialists participated in two separate teleconferencing sessions (three participants each), managed by an independent, skilled moderator (also a glaucoma specialist) using a discussion guide. Participants reviewed recent publications (n=25) on health economics outcomes research in glaucoma prior to the sessions. Results:Participants demonstrated a clear understanding of the economic burden of glaucoma therapy and identified medications, diagnostics, office visits, and treatment changes as key cost drivers. They considered cost-effectiveness an appropriate component of treatment decision-making but identified the need for additional data to inform these decisions. Participants indicated that there were only a few recent studies on health economics outcomes in glaucoma which evaluate parameters important to patient care, such as quality of life and medication adherence, and that longitudinal data were scant. In addition to efficacy, participants felt patient adherence and side-effect profile should be included in economic evaluations of glaucoma pharmacotherapy. Recently approved medications were evaluated in this context. Conclusion:Clinicians deem treatment decisions based on cost-effectiveness data as clinically appropriate. Newer IOP-lowering therapies with potentially greater efficacy and favorable side-effect and adherence profiles may help optimize cost-effectiveness. Future studies should include: clinicians' perspectives; lack of commercial bias; analysis of long-term outcomes/costs; more comprehensive parameters; real-world (including quality-of-life) data; and a robust Markov model

Technical Paper No. 2: Student Evaluation of Faculty Teaching Performance: Analysis of Four Years' Data

Student evaluation of faculty teaching performance has provided an important source of evidence in making faculty personnel decisions at Sangamon State University. Students have been asked to rate the competency and the teaching ability of their instructors; specifically, near the end of each term, students have rated faculty using the following two items: 1) Do you think this teacher is competent in the content or matter offered in this course? 2) Overall, do you consider this person a good teacher? The two items were administered from 1971 to 1975, and a record of the resultant data has been maintained. The research reported in this paper was motivated by a desire to look at the stability and reliability of the evaluations obtained from the two item evaluations over the four year period.The present paper reports on the amount of agreement between the ratings given on the teaching item and the ratings on the competency item. The effect of rewording the teaching item on the ratings is also reported.published or submitted for publicationis peer reviewe

Training Community-Based Professionals to Implement an Empirically Supported Parenting Program

Professionals representing 14 community-based organizations were trained at three different sites serving urban and rural families to implement an empirically supported parenting program for families of young children with challenging behaviors. Of the 44 practitioners trained, 23 successfully completed the program, which involved passing a knowledge test and facilitating the entire 10session program with a family. A total of 28, primarily low-income families completed the program. The family outcomes obtained by the facilitators, based on multiple pre-program and post-program measures, were comparable with those reported previously in the literature for facilitators trained in university settings. The challenges inherent in efforts to increase the community’s capacity to implement empirically supported programs are addressed

\u3ci\u3eTomicus Piniperda\u3c/i\u3e (Coleoptera: Scolytidae): Is Shoot Feeding Required for Reproductive Maturation?

The pine shoot beetle, Tomicus piniperda (Coleoptera: Scolytidae), is a univoltine pest of pine in its native range of Europe and Asia. Tomicus piniperda is now widely established in the Great Lakes region and poses a potentially significant threat to other pine-producing areas in North America. An unusual aspect of the life history of T. piniperda is the extended period of maturation-feeding that takes place in the shoots of living pine trees and subsequent overwintering before adults reproduce the following year. We investigated the extent to which shoot-feeding is required by newly-emerged T. piniperda before introduction into Scotch pine (Pinus sylvestris) logs and before any overwintering, in order for successful reproduction to occur. Tomi­cus piniperda F1 adults successfully reproduced in pine logs in the laboratory after either no shoot-feeding or after 2 to 10 weeks of shoot-feeding. Thus, it is theoretically possible for T. piniperda to be multivoltine, yet it remains univoltine

Toddlers with Developmental Delays and Challenging Behaviors

Behavior problems and parental expectations and practices were studied in a sample of 58 toddlers with developmental disabilities who were consecutively referred to a mental health clinic. The majority of children (70.7%) exceeded the clinical cut-off score for significant behavior problems including tantrums, aggression, defiance, and hyperactivity, and 77.6% met the DSM-IV criteria for a psychiatric diagnosis with oppositional defiant disorder being the most common. Consistent with previous research, child behavior problems were related to parental use of verbal and corporal punishment and were detrimental to the quality of the parent-child relationship. A new finding was that parental expectations also were positively related to the emergence of early child behavior problems