Congenital Toxoplasmosis in Austria: Prenatal Screening for Prevention is Cost-Saving

Background: Primary infection of Toxoplasma gondii during pregnancy can be transmitted to the unborn child and may have serious consequences, including retinochoroiditis, hydrocephaly, cerebral calcifications, encephalitis, splenomegaly, hearing loss, blindness, and death. Austria, a country with moderate seroprevalence, instituted mandatory prenatal screening for toxoplasma infection to minimize the effects of congenital transmission. This work compares the societal costs of congenital toxoplasmosis under the Austrian national prenatal screening program with the societal costs that would have occurred in a No-Screening scenario. Methodology/Principal Findings: We retrospectively investigated data from the Austrian Toxoplasmosis Register for birth cohorts from 1992 to 2008, including pediatric long-term follow-up until May 2013. We constructed a decision-analytic model to compare lifetime societal costs of prenatal screening with lifetime societal costs estimated in a No-Screening scenario. We included costs of treatment, lifetime care, accommodation of injuries, loss of life, and lost earnings that would have occurred in a No-Screening scenario and compared them with the actual costs of screening, treatment, lifetime care, accommodation, loss of life, and lost earnings. We replicated that analysis excluding loss of life and lost earnings to estimate the budgetary impact alone. Our model calculated total lifetime costs of €103 per birth under prenatal screening as carried out in Austria, saving €323 per birth compared with No-Screening. Without screening and treatment, lifetime societal costs for all affected children would have been €35 million per year; the implementation costs of the Austrian program are less than €2 million per year. Calculating only the budgetary impact, the national program was still cost-saving by more than €15 million per year and saved €258 million in 17 years. Conclusions/Significance: Cost savings under a national program of prenatal screening for toxoplasma infection and treatment are outstanding. Our results are of relevance for health care providers by supplying economic data based on a unique national dataset including long-term follow-up of affected infants

Getting the story from child witnesses : exploring the application of a story grammar framework

Investigative interviews with children about alleged abuse were analysed to determine the degree to which the child\u27s responses adhered to a story grammar framework, and whether the presence of story grammar elements was associated with interviewers\u27 adherence to best-practice (i.e. open-ended) questioning. The sample included 51 interviews with child witnesses from across Australia. The interviews were administered by a police officer with children (37 girls and 14 boys) aged 3-16 years (M age = 103.82 months, SD = 34.21 months). The interviewers\u27 questions were categorised as open-ended or specific and the children\u27s responses were classified as a story grammar element, context/background information, or \u27don\u27t know\u27 responses. The majority of interviewer questions were specific in nature and the majority of children\u27s responses were context/background details. Open-ended questions were more successful in eliciting story grammar from children. Of the story grammar elements, the interviewers\u27 specific questions usually targeted setting and attempt details. These findings suggest that improvement in the narrative coherence of children\u27s reports of abusive events can potentially be achieved by increasing interviewers\u27 use of open-ended questions.<br /

Dissociation rates of J/psi's with comoving mesons - thermal vs. nonequilibrium scenario

We study J/psi dissociation processes in hadronic environments. The validity of a thermal meson gas ansatz is tested by confronting it with an alternative, nonequilibrium scenario. Heavy ion collisions are simulated in the framework of the microscopic transport model UrQMD, taking into account the production of charmonium states through hard parton-parton interactions and subsequent rescattering with hadrons. The thermal gas and microscopic transport scenarios are shown to be very dissimilar. Estimates of J/psi survival probabilities based on thermal models of comover interactions in heavy ion collisions are therefore not reliable.Comment: 12 pages, 6 figure