Watchout Watchmen! Congress Has Excluded Security Employees from Maritime Employment Coverage under the Longshore and Harborworkers\u27 Compensation Act Amendments of 1984

This Comment examines the recent Congressional decision that individuals employed exclusively to perform security work are no longer covered under the Longshore and Harbor Workers\u27 Compensation Act (LHWCA). The author argues that watchmen had been traditionally covered both before and after Congress added a status test for coverage in 1972. Examining the pre and post-1972 decisional history, the author argues that because Congress eliminated the jurisdictional dilemma which formerly served as the main justification for extending LHWCA coverage, the 1984 LHWCA amendments excluding coverage are consistent with those previous judicial decisions extending coverage to watchmen

End of an era of administering erythropoiesis stimulating agents among Veterans Administration cancer patients with chemotherapy-induced anemia.

Erythropoisis stimulating agent (ESA) use was addressed in Food and Drug Administration (FDA) Oncology Drug Advisory Committee (ODAC) meetings between 2004 and 2008. FDA safety-focused regulatory actions occurred in 2007 and 2008. In 2007, black box warnings advised of early death and venous thromboembolism (VTE) risks with ESAs in oncology. In 2010, a Risk Evaluation Strategies (REMS) was initiated, with cancer patient consent that mortality and VTE risks were noted with ESAs. We report warnings and REMS impacts on ESA utilization among Veterans Administration (VA) cancer patients with chemotherapy-induced anemia (CIA). Data were from Veterans Affairs database (2003-2012). Epoetin and darbepoetin use were primary outcomes. Segmented linear regression was used to estimate changes in ESA use levels and trends, clinical appropriateness, and adverse events (VTEs) among chemotherapy-treated cancer patients. To estimate changes in level of drug prescription rate after policy actions, model-specific indicator variables as covariates based on specific actions were included. ESA use fell by 95% and 90% from 2005, for epoetin and darbepoetin, from 22% and 11%, respectively, to 1% and 1%, respectively, among cancer patients with CIA, respectively (

Investigation of geomechanical responses of reservoirs induced by carbon dioxide storage

Assessment of the suitability of potential sub-surface storage sites for CO2 storage cuts across several issues, a dominant part being the sustainability in terms of the retention capacity of prospective reservoirs. Questions often raised but not properly investigated border on the stability of underground reservoirs during the injection process and the protracted effect after injection is fully completed. A review of studies on CO2 sequestration reveals several uncovered areas with one significant aspect being the geo-mechanical effect of CO2 injection and storage within the underground formation. A computational framework has been built as part of a series of ongoing investigations to ascertain the susceptibility of underground formations during and after CO2 is introduced. This is made possible by adopting a discrete element modelling methodology as a first step in the sequence of a designed procedure. By applying this technique, the formation materials are idealised as an assembly of discrete particles interacting in a manner which allows for specific descriptions of the morphology and fracturing events. Computational tests conducted on several types of models representative of reservoir formations reveal reservoir geo-mechanical responses highly dependent on factors, such as material property of rocks, pressure build-up and injection pressure. An example of this is observed in the mode of fracturing events which is significantly influenced by the rate of fluid injection. The outcome of this study forms a strong basis towards a better understanding of the behaviour of reservoir formations subjected to CO2 injection and storage. In addition, information from these studies could serve as a reference for enhanced oil recovery processes and enhanced coal bed methane productions

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially