Consolidation of soft clays with special reference to sand drains

Imperial Users onl

The Forecast Accuracy Of Second Board IPOs (1989 – 1994)

The reliability of the earnings forecasts has been a topic of criticism recently since some of the listed companies are found to have documented a large discretipency between the actual and forecast profits. This study intend to substantiate the previously documented evidence on the Initial Public Offerings forecast errors of the Main Board. The IPO for firms listed on the Second Board for the period 1989 to 1994. The companies under study covered a wide range of sectors such as Industrial, Consumer, Construction, Trading/Service and Finance. The forecast accuracy is measured by forecast errors, absolute forecast errors and squared forecast error. The level of forecast accuracy appears to be better for the Second Board listed companies compared to that of Main Board IPOs. The accuracy levels are closed to the developed markets such as United Kingdom, United States and Australia. A multiple regression model was needed to explain the variation in the absolute forecast errors (the dependent variable) with firms characteristics as independent variables. The only variable that showed significant relationship with absolute forecast errors was forecast interval that is the time between the prospectus issued date and the year end of the forecast pertain. Other variables, such as Auditor Choice, Age Size Financial Leverage, Industry sectors were not significant. In general, the findings are consistent with that reported for the Main Board IPOs (Shamser et. al. 1994) and inconsistent with those reported in developed markets

Cost-consequence analysis of remifentanil-based analgo-sedation vs. conventional analgesia and sedation for patients on mechanical ventilation in the Netherlands

Introduction: Hospitals are increasingly forced to consider the economics of technology use. We estimated the incremental cost-consequences of remifentanil-based analgo-sedation (RS) vs. conventional analgesia and sedation (CS) in patients requiring mechanical ventilation (MV) in the intensive care unit (ICU), using a modelling approach. Methods: A Markov model was developed to describe patient flow in the ICU. The hourly probabilities to move from one state to another were derived from UltiSAFE, a Dutch clinical study involving ICU patients with an expected MV-time of 2-3 days requiring analgesia and sedation. Study medication was either: CS (morphine or fentanyl combined with propofol, midazolam or lorazepam) or: RS (remifentanil, combined with propofol when required). Study drug costs were derived from the trial, whereas all other ICU costs were estimated separately in a Dutch micro-costing study. All costs were measured from the hospital perspective (price level of 2006). Patients were followed in the model for 28 days. We also studied the sub-population where weaning had started within 72 hours. Results: The average total 28-day costs were 15,626 euros with RS versus 17,100 euros with CS, meaning a difference in costs of 1474 euros (95% CI -2163, 5110). The average length-of-stay (LOS) in the ICU was 7.6 days in the RS group versus 8.5 days in the CS group (difference 1.0, 95% CI -0.7, 2.6), while the average MV time was 5.0 days for RS versus 6.0 days for CS. Similar differences were found in the subgroup analysis. Conclusions: Compared to CS, RS significantly decreases the overall costs in the ICU

Microcosting in economic evaluations: Issues of accuracy, feasibility, consistency and generalisability

Omdat de diversiteit aan medische behandelingen in de afgelopen decennia enorm is gegroeid, staan de zorgbudgetten in Westerse landen voortdurend onder druk. De beslissing om bronnen voor een doeleinde aan te wenden in plaats van aan een ander doeleinde moet dus gestruktureerd worden afwogen. Deze afweging wordt doorgaans gemaakt met behulp van economische evaluaties die zowel de kosten als effecten van alternatieve medische behandelingen schatten. Hoewel de effecten van medische behandelingen minstens zo belangrijk zijn, stonden in mijn proefschrift de kosten centraal. De doelstelling was de kosten van specifieke medische behandelingen te schatten en algemene methodologische conclusies te trekken wat betreft de toepassing van drie kostenmethoden. De methoden werden toegepast in een verscheidenheid aan medische specialismen, waaronder oncologie, hematologie, intensive care medicine, tandheelkunde, huisartsgeneeskunde, cardiologie en neurochirurgie. Er bestaat nog geen consensus over de methode van voorkeur voor de kostenschatting van behandelingen. De ‘bottom up microcosting’ methode wordt over het algemeen verondersteld de meest nauwkeurige kostenschatting te geven, omdat kosten worden berekend per individuele patiënt en per individuele kostencomponent. De methode wordt echter niet op grote schaal toegepast omdat zij vanwege haar tijdsintensieve karakter nauwelijks haalbaar is. Omgekeerd wordt de ‘gross costi

A noticeable difference? Productivity costs related to paid and unpaid work in economic evaluations on expensive drugs

Productivity costs can strongly impact cost-effectiveness outcomes. This study investigated the impact in the context of expensive hospital drugs. This study aimed to: (1) investigate the effect of productivity costs on cost-effectiveness outcomes, (2) determine whether economic evaluations of expensive drugs commonly include productivity costs related to paid and unpaid work, and (3) explore potential reasons for excluding productivity costs from the economic evaluation. We conducted a systematic literature review to identify economic evaluation

A microcosting study of the surgical correction of upper extremity deformity in children with spastic cerebral palsy

_Objective:_ Determine healthcare costs of upper-extremity surgical correction in children with spastic cerebral palsy (CP). _Method:_ This cohort study included 39 children with spastic CP who had surgery for their upper extremity at a Dutch hospital. A retrospective cost analysis was performed including both hospital and rehabilitation costs. Hospital costs were determined using microcosting methodology. Rehabilitation costs were estimated using reference prices. _Results:_ Hospital costs averaged €6813 per child. Labor (50%), overheads (29%), and medical aids (15%) were important cost drivers. Rehabilitation costs were estimated at €3599 per child. _Conclusions:_ Surgery of the upper extremity is an important contributor to the healthcare costs of children with CP. Our study shows that labor is the most important cost driver for hospital costs, owing to the multidisciplinary approach and patient-specific treatment plan. A remarkable finding was the substantial amount of rehabilitation costs

Quantifying the Persistence of Vaccine-Related T Cell Epitopes in Circulating Swine Influenza A Strains from 2013-2017

When swine flu vaccines and circulating influenza A virus (IAV) strains are poorly matched, vaccine-induced antibodies may not protect from infection. Highly conserved T cell epitopes may, however, have a disease-mitigating effect. The degree of T cell epitope conservation among circulating strains and vaccine strains can vary, which may also explain differences in vaccine efficacy. Here, we evaluate a previously developed conserved T cell epitope-based vaccine and determine the persistence of T cell epitope conservation over time. We used a pair-wise homology score to define the conservation between the vaccine’s swine leukocyte antigen (SLA) class I and II-restricted epitopes and T cell epitopes found in 1272 swine IAV strains sequenced between 2013 and 2017. Twenty-four of the 48 total T cell epitopes included in the epitope-based vaccine were highly conserved and found in >1000 circulating swine IAV strains over the 5-year period. In contrast, commercial swine IAV vaccines developed in 2013 exhibited a declining conservation with the circulating IAV strains over the same 5-year period. Conserved T cell epitope vaccines may be a useful adjunct for commercial swine flu vaccines and to improve protection against influenza when antibodies are not cross-reactive