Economic Evaluation of Newborn Screening for Severe Combined Immunodeficiency

Evidence on the cost-effectiveness of newborn screening (NBS) for severe combined immunodeficiency (SCID) in the Australian policy context is lacking. In this study, a pilot population-based screening program in Australia was used to model the cost-effectiveness of NBS for SCID from the government perspective. Markov cohort simulations were nested within a decision analytic model to compare the costs and quality-adjusted life-years (QALYs) over a time horizon of 5 and 60 years for two strategies: (1) NBS for SCID and treat with early hematopoietic stem cell transplantation (HSCT); (2) no NBS for SCID and treat with late HSCT. Incremental costs were compared to incremental QALYs to calculate the incremental cost-effectiveness ratios (ICER). Sensitivity analyses were performed to assess the model uncertainty and identify key parameters impacting on the ICER. In the long-term over 60 years, universal NBS for SCID would gain 10 QALYs at a cost of US $0.3 million, resulting in an ICER of US$33,600/QALY. Probabilistic sensitivity analysis showed that more than half of the simulated ICERs were considered cost-effective against the common willingness-to-pay threshold of A$50,000/QALY (US$35,000/QALY). In the Australian context, screening for SCID should be introduced into the current NBS program from both clinical and economic perspectives

Portaria n. 90 de 12 de maio de 2009

Designa o Ministro Teori Albino Zavascki e outras autoridades para compor o Comitê Interinstitucional de Gestão do II Pacto Republicano de Estado por um Sistema de Justiça mais Acessível, Ágil e Efetivo

An integrated microfluidic chip with 40 MHz lead-free transducer for fluid analysis

Author name used in this publication: S. T. F. LeeAuthor name used in this publication: K. H. LamAuthor name used in this publication: L. LeiAuthor name used in this publication: X. M. ZhangAuthor name used in this publication: H. L. W. Chan2010-2011 > Academic research: refereed > Publication in refereed journalVersion of RecordPublishe

Portaria conjunta n. 3 de 27 de novembro de 2015

Ficam indisponíveis para empenho e movimentação financeira os valores constantes do Anexo a esta Portaria, consignados aos Órgãos do Poder Judiciário da União na Lei n° 13.115, de 20 de abril de 2015

Portaria Conjunta n. 2 de 29 de junho de 2015

Ficam indisponíveis para empenho e movimentação financeira os valores constantes do Anexo a esta Portaria, consignados aos Órgãos do Poder Judiciário da União na Lei n° 13.115, de 20 de abril de 2015

Portaria Conjunta n. 5 de 21 de setembro de 2006

Acompanha anexoAltera, no âmbito do Superior Tribunal de Justiça e da Justiça Federal, os valores indisponíveis para empenho e movimentação financeira estabelecidos na Portaria Conjunta n. 4 de 27.07.2006

Portaria Conjunta n. 5 de 28 de dezembro de 2009

Revoga a Portaria Conjunta n. 4 de 26.11.2008.Ficam disponíveis integralmente para empenho e movimentação financeira os valores constantes do Anexo à Portaria Conjunta n. 4 de 26.11.2009, publicada no Diário Oficial da União de 30.11.2009, consignados aos Órgãos do Poder Judiciário da União na Lei n. 11.897 de 30.12.2008

Evaluation of a self-management programme for congestive heart failure patients: design of a randomised controlled trial

BACKGROUND: Congestive heart failure (CHF) has a substantial impact on care utilisation and quality of life. It is crucial for patients to cope with CHF adequately, if they are to live an acceptable life. Self-management may play an important role in this regard. Previous studies have shown the effectiveness of the 'Chronic Disease Self-Management Program' (CDSMP), a group-based cognitive behavioural programme for patients with various chronic conditions. However, the programme's effectiveness has not yet been studied specifically among CHF patients. This paper presents the design of a randomised controlled trial to evaluate the effects of the CDSMP on psychosocial attributes, health behaviour, quality of life, and health care utilisation of CHF patients. METHODS/DESIGN: The programme is being evaluated in a two-group randomised controlled trial. Patients were eligible if they had been diagnosed with CHF and experienced slight to marked limitation of physical activity. They were selected from the Heart Failure and/or Cardiology Outpatient Clinics of six hospitals. Eligible patients underwent a baseline assessment and were subsequently allocated to the intervention or control group. Patients allocated to the intervention group were invited to attend the self-management programme consisting of six weekly sessions, led by a CHF nurse specialist and a CHF patient. Those allocated to the control group received care as usual. Follow-up measurements are being carried out immediately after the intervention period, and six and twelve months after the start of the intervention. An effect evaluation and a process evaluation are being conducted. The primary outcomes of the effect evaluation are self-efficacy expectancies, perceived control, and cognitive symptom management. The secondary outcome measures are smoking and drinking behaviour, Body Mass Index (BMI), physical activity level, self-care behaviour, health-related quality of life, perceived autonomy, symptoms of anxiety and depression, and health care utilisation. The programme's feasibility is assessed by measuring compliance with the protocol, patients' attendance and adherence, and the opinions about the programme. DISCUSSION: A total number of 318 patients were included in the trial. At present, follow-up data are being collected. The results of the trial become clear after completion of the data collection in January 2007. TRIAL REGISTRATION: Trialregister () ISRCTN88363287

Nurse- and peer-led self-management programme for patients with an implantable cardioverter defibrillator; a feasibility study

<p>Abstract</p> <p>Background</p> <p>The prevalence of cardiovascular disease is increasing. Improved treatment options increase survival after an acute myocardial infarction or sudden cardiac arrest, although patients often have difficulty adjusting and regaining control in daily life. In particular, patients who received an implantable cardioverter defibrillator (ICD) experience physical and psychological problems. Interventions to enhance perceived control and acceptance of the device are therefore necessary. This paper describes a small-scale study to explore the feasibility and the possible benefits of a structured nurse- and peer-led self-management programme ('Chronic Disease Self-Management Program' – CDSMP) among ICD patients.</p> <p>Methods</p> <p>Ten male ICD patients (mean age = 65.5 years) participated in a group programme, consisting of six sessions, led by a team consisting of a nurse specialist and a patient with cardiovascular disease. Programme feasibility was evaluated among patients and leaders by measuring performance of the intervention according to protocol, attendance and adherence of the participating ICD patients, and patients' and leaders' opinions about the programme. In addition, before and directly after attending the intervention, programme benefits (e.g. perceived control, symptoms of anxiety and depression, and quality of life) were assessed.</p> <p>Results</p> <p>The programme was conducted largely according to protocol. Eight patients attended at least four sessions, and adherence ranged from good to very good. On average, the patients reported to have benefited very much from the programme, which they gave an overall report mark of 8.4. The leaders considered the programme feasible as well. Furthermore, improvements were identified for general self-efficacy expectancies, symptoms of anxiety, physical functioning, social functioning, role limitations due to physical problems, and pain.</p> <p>Conclusion</p> <p>This study suggests that a self-management programme led by a team consisting of a nurse specialist and a patient with cardiovascular disease seems feasible according to both patients and leaders. The programme may improve general self-efficacy expectancies, symptoms of anxiety, and quality of life (physical functioning, social functioning, role limitations due to physical problems, and pain) as well. Further investigation of the programme's effectiveness among a larger sample of ICD patients or other patient groups with cardiovascular disease, is recommended.</p