Cost-effectiveness analysis design for interventions to prevent children's oral disease

IntroductionIn 2015, the National Institute of Dental and Craniofacial Research (NIDCR) launched the Multidisciplinary Collaborative Research Consortium to Reduce Oral Health Disparities in Children, supporting four randomized trials testing strategies to improve preventive care. A Coordinating Center provides scientific expertise, data acquisition and quality assurance services, safety monitoring, and final analysis-ready datasets. This paper describes the trials' economic analysis strategies, placing these strategies within the broader context of contemporary economic analysis methods.MethodsThe Coordinating Center established a Cost Collaborative Working Group to share information from the four trials about the components of their economic analyses. Study teams indicated data sources for their economic analysis using a set of structured tables. The Group meets regularly to share progress, discuss challenges, and coordinate analytic approaches.ResultsAll four trials will calculate incremental cost-effectiveness ratios; two will also conduct cost-utility analyses using proxy diseases to estimate health state utilities. Each trial will consider at least two perspectives. Key process measures include dental services provided to child participants. The non-preference-weighted Early Childhood Oral Health Impact Scale (ECOHIS) will measure oral health-related quality of life. All trials are measuring training, implementation, personnel and supervision, service, supplies, and equipment costs.ConclusionsConsistent with best practices, all four trials have integrated economic analysis during their planning stages. This effort is critical since poor quality or absence of essential data can limit retrospective analysis. Integrating economic analysis into oral health preventive intervention research can provide guidance to clinicians and practices, payers, and policymakers

Technological literacy reconsidered: a model for enactment

The final publication is available at: http://link.springer.com/article/10.1007%2Fs10798-009-9108-6.This paper presents a model to describe technological literacy as enacted by individuals in the course of shaping their lives and the world around them. The model has two interrelated facets – the potential for and enactment of technological literacy – where enactment and potential mutually constitute each other. This potential is made up of knowledge of a particular situation, personal engagement with a situation, and social engagement in the world. Enactment requires a particular set of competencies in action, which together helps shape the situation: recognizing needs; articulating problems; contributing towards the technological process; and analysing consequences. The implications of this model for technological literacy in the context of the individual and society, and the role of technology education in developing technological literacy, are discussed

Exploring Aboriginal People\u27s connection to country to strengthen human-nature theoretical perspectives

Purpose Aboriginal people across Australia have diverse practices, beliefs and knowledges based on thousands of generations of managing and protecting their lands (Country). The intimate relationship Aboriginal people have with their Country is explored in this chapter because such knowledge is important for building insight into the relationship between social and ecological systems. Often in research Aboriginal views have been marginalised from discussions focused on their lands to the detriment of ecosystems and human health. This chapter aims to understand if such marginalisation is evident in Western human–nature relationship discourses.Approach This chapter provides a critical literature review which examines whether Aboriginal people’s diverse understanding of their ecosystems have been incorporated into human–nature theories using the biophilia hypothesis as a starting point. Other concepts explored include solastalgia, topophilia and place.Findings Critiques of these terminologies in the context of Aboriginal people’s connection to Country are limited but such incorporation is viewed in the chapter as a possible mechanism for better understanding human’s connection to nature. The review identified that Aboriginal people’s relationship to Country seems to be underrepresented in the human–nature theory literature.Value This chapter emphasises that the integration of Aboriginal perspectives into research, ecological management and policy can provide better insight into the interrelationships between social and ecological systems

Does having a twin-brother make for a bigger brain?

Objective: Brain volume of boys is larger than that of girls by ∼10%. Prenatal exposure to testosterone has been suggested in the masculinization of the brain. For example, in litter-bearing mammals intrauterine position increases prenatal testosterone exposure through adjacent male fetuses, resulting in masculinization of brain morphology. Design: The influence of intrauterine presence of a male co-twin on masculinization of human brain volume was studied in 9-year old twins. Methods: Magnetic resonance imaging brain scans, current testosterone, and estradiol levels were acquired from four groups of dizygotic (DZ) twins: boys from same-sex twin-pairs (SSM), boys from opposite-sex twin-pairs (OSM), girls from opposite-sex twin-pairs (OSF), and girls from same-sex twin-pairs (SSF; n=119 individuals). Data on total brain, cerebellum, gray and white matter volumes were examined. Results: Irrespective of their own sex, children with a male co-twin as compared to children with a female co-twin had larger total brain (+2.5%) and cerebellum (+5.5%) volumes. SSM, purportedly exposed to the highest prenatal testosterone levels, were found to have the largest volumes, followed by OSM, OSF and SSF children. Birth weight partly explained the effect on brain volumes. Current testosterone and estradiol levels did not account for the volumetric brain differences. However, the effects observed in children did not replicate in adult twins. Conclusions: Our study indicates that sharing the uterus with a DZ twin brother increases total brain volume in 9-year olds. The effect may be transient and limited to a critical period in childhood. © 2009 European Society of Endocrinology

Analisis Hidrolika Bangunan Krib Permeabel pada Saluran Tanah (Uji Model Laboratorium)

One of the structures to protect river bank erosion is groyne. Groyne can serve and control water flow, reducing flow velocity and scour of river bank. The purposes of this study is to analyze the changes in the river bed elevation (morphology) and the depth of scour in the upstream groyne caused by the permeable groyne installed at the river meanders. The experiment was conducted at Fluid Mechanics and Hydraulics Laboratory, Sriwijaya University. The study tested the hydraulics models, a trapezoidal channel, meanders angle of 90˚, five permeable groynes at meanders, and the water flowing in the channels was clear water. The observations were carried out with a flow rate was 63,32 Lt / min, three variations of permeable groynes angle were 45˚, 90˚ and 135˚ to the upstream within 1 hour, 2,5 hours and 4 hours for each angle variations . The results of this study showed that the flow velocity of meanders was decreasing to the end of the meanders, and the changes of channel only occurred at the riverbed. Maximum riverbed changes (Bt / Bo) for permeable groyne angle of 45˚, 90˚ and 135 ˚ were 1,376 cm, 1,346 cm dan 1,452 cm. The maximum depth of scour (ds/y) for permeable groyne angle of 45˚, 90˚ and 135˚ were 1,05 cm, 0,95 cm dan 1,17 cm. Thus, permeable groyne with angle of 90 proved to be the best with the smallest riverbed changes (Bt /Bo) was 1,346 cm and the coefficient of determination (R2) was 0,9384, and also the smallest scour depth (ds/y) was 0,95 cm and the coefficient of determination (R2) was 0,8317 compared to other groyne permeable angles

Evaluation of bottom-up and top-down strategies for aggregated forecasts: state space models and arima applications

Abstract. In this research, we consider monthly series from the M4 competition to study the relative performance of top-down and bottom-up strategies by means of implementing forecast automation of state space and ARIMA models. For the bottomup strategy, the forecast for each series is developed individually and then these are combined to produce a cumulative forecast of the aggregated series. For the top-down strategy, the series or components values are first combined and then a single forecast is determined for the aggregated series. Based on our implementation, state space models showed a higher forecast performance when a top-down strategy is applied. ARIMA models had a higher forecast performance for the bottom-up strategy. For state space models the top-down strategy reduced the overall error significantly. ARIMA models showed to be more accurate when forecasts are first determined individually. As part of the development we also proposed an approach to improve the forecasting procedure of aggregation strategies

The PHENIX Experiment at RHIC

The physics emphases of the PHENIX collaboration and the design and current status of the PHENIX detector are discussed. The plan of the collaboration for making the most effective use of the available luminosity in the first years of RHIC operation is also presented.Comment: 5 pages, 1 figure. Further details of the PHENIX physics program available at http://www.rhic.bnl.gov/phenix

Genomic research, publics and experts in Latin America: Nation, race and body

The articles in this issue highlight contributions that studies of Latin America can make to wider debates about the effects of genomic science on public ideas about race and nation. We argue that current ideas about the power of genomics to transfigure and transform existing ways of thinking about human diversity are often overstated. If a range of social contexts are examined, the effects are uneven. Our data show that genomic knowledge can unsettle and reinforce ideas of nation and race; it can be both banal and highly politicized. In this introduction, we outline concepts of genetic knowledge in society; theories of genetics, nation and race; approaches to public understandings of science; and the Latin American contexts of transnational ideas of nation and race

"Before we used to get sick all the time": perceptions of malaria and use of long-lasting insecticide-treated bed nets (LLINs) in a rural Kenyan community

<p>Abstract</p> <p>Background</p> <p>Malaria is a leading global cause of preventable morbidity and mortality, especially in sub-Saharan Africa, despite recent advances in treatment and prevention technologies. Scale-up and wide distribution of long-lasting insecticide-treated nets (LLINs) could rapidly decrease malarial disease in endemic areas, if used properly and continuously. Studies have shown that effective use of LLINs depends, in part, upon understanding causal factors associated with malaria. This study examined malaria beliefs, attitudes, and practices toward LLINs assessed during a large-scale integrated prevention campaign (IPC) in rural Kenya.</p> <p>Methods</p> <p>Qualitative interviews were conducted with 34 IPC participants who received LLINs as part of a comprehensive prevention package of goods and services. One month after distribution, interviewers asked these individuals about their attitudes and beliefs regarding malaria, and about their use of LLINs.</p> <p>Results</p> <p>Virtually all participants noted that mosquitoes were involved in causing malaria, though a substantial proportion of participants (47 percent) also mentioned an incorrect cause in addition to mosquitoes. For example, participants commonly noted that the weather (rain, cold) or consumption of bad food and water caused malaria. Regardless, most participants used the LLINs they were given and most mentioned positive benefits from their use, namely reductions in malarial illness and in the costs associated with its diagnosis and treatment.</p> <p>Conclusions</p> <p>Attitudes toward LLINs were positive in this rural community in Western Kenya, and respondents noted benefits with LLIN use. With improved understanding and clarification of the direct (mosquitoes) and indirect (e.g., standing water) causes of malaria, it is likely that LLIN use can be sustained, offering effective household-level protection against malaria.</p