When benefits are difficult to measure

Benefit cost analysis is seldom applied to programs which aim directly at improving human well-being; the problems in quantifying such benefits, particularly in dollar form, are simply too great. This paper explains /ldthreshold benefit analysis," the derivation of the minimum dollar value which the benefits must attain in order for the value of the benefits to equal the cost of the intervention. As an example, the method is applied to a mobility training program. The threshold benefit of such training is approximately two dollars per commute. The empirical results include a sensitivity analysis which allows considerable flexibility on the part of potential users. The methodology is applicable to analyzing any intervention where costs are incurred early, initial "successes" can be counted in natural numbers, and duration of success can be modelled simply.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/26882/1/0000448.pd

Child support and public policy: Securing support from absent father : By Judith Cassetty Lexington, Mass.: Lexington books 171 + xviii pp., $16.00.

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/24535/1/0000814.pd

Attitudes toward the employment of mothers of preschoolers: Implications for child care

With increasing numbers of mothers entering the work force, including mothers of preschool age children, the policies that guide child care have yet to provide adequate services for large numbers of families. In this article, we investigate several possibilities for this delay in services by focusing on current attitudes toward maternal employment and certain factors that may influence these attitudes. We look at whether mothers and fathers differ on this issue and what, if any, demographic, situational, and values characteristics, may be influencing these attitudes. The implications for policy changes affecting child care services are discussed within this context.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44271/1/10566_2004_Article_BF00868989.pd

How Can We Improve Oncofertility Care for Patients? A Systematic Scoping Review of Current International Practice and Models of Care

© The Author(s) 2018. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. BACKGROUND: Fertility preservation (FP) is an important quality of life issue for cancer survivors of reproductive age. Despite the existence of broad international guidelines, the delivery of oncofertility care, particularly amongst paediatric, adolescent and young adult patients, remains a challenge for healthcare professionals (HCPs). The quality of oncofertility care is variable and the uptake and utilization of FP remains low. Available guidelines fall short in providing adequate detail on how oncofertility models of care (MOC) allow for the real-world application of guidelines by HCPs. OBJECTIVE AND RATIONALE: The aim of this study was to systematically review the literature on the components of oncofertility care as defined by patient and clinician representatives, and identify the barriers, facilitators and challenges, so as to improve the implementation of oncofertility services. SEARCH METHODS: A systematic scoping review was conducted on oncofertility MOC literature published in English between 2007 and 2016, relating to 10 domains of care identified through consumer research: communication, oncofertility decision aids, age-appropriate care, referral pathways, documentation, training, supportive care during treatment, reproductive care after cancer treatment, psychosocial support and ethical practice of oncofertility care. A wide range of electronic databases (CINAHL, Embase, PsycINFO, PubMed, AEIPT, Education Research Complete, ProQuest and VOCED) were searched in order to synthesize the evidence around delivery of oncofertility care. Related citations and reference lists were searched. The review was undertaken following registration (International prospective register of systematic reviews (PROSPERO) registration number CRD42017055837) and guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). OUTCOMES: A total of 846 potentially relevant studies were identified after the removal of duplicates. All titles and abstracts were screened by a single reviewer and the final 147 papers were screened by two reviewers. Ten papers on established MOC were identified amongst the included papers. Data were extracted from each paper and quality scores were then summarized in the oncofertility MOC summary matrix. The results identified a number of themes for improving MOC in each domain, which included: the importance of patients receiving communication that is of a higher quality and in different formats on their fertility risk and FP options; improving provision of oncofertility care in a timely manner; improving access to age-appropriate care; defining the role and scope of practice of all HCPs; and improving communication between different HCPs. Different forms of decision aids were found useful for assisting patients to understand FP options and weigh up choices. WIDER IMPLICATIONS: This analysis identifies core components for delivery of oncofertility MOC. The provision of oncofertility services requires planning to ensure services have safe and reliable referral pathways and that they are age-appropriate and include medical and psychological oncofertility care into the survivorship period. In order for this to happen, collaboration needs to occur between clinicians, allied HCPs and executives within paediatric and adult hospitals, as well as fertility clinics across both public and private services. Training of both cancer and non-cancer HCPs is needed to improve the knowledge of HCPs, the quality of care provided and the confidence of HCPs with these consultations