Deploying a spreadsheet tool for early economic value assessment of medical device innovations with healthcare decision makers

Early stage evaluation of medical device innovations is important for healthcare decision-makers as much as for manufacturers, meaning that a wider application of a basic cost-effectiveness analysis is becoming necessary outside the usual expert base of health technology assessment specialists. Resulting from an academic-industry-healthcare professional collaboration, a spreadsheet tool is described that was designed to be accessible both to professionals in healthcare delivery organisations and to innovators in the healthcare technology industry who are non-experts in the field of health economics. The tool enables a basic cost-effectiveness analysis to be carried out, using a simplified decision-tree model to compare costs and patient benefit for a new device-related procedure with that of standard care employing an incumbent device or other alternative. Such a tool is useful to healthcare professionals because it enables them to rapidly elucidate the cost-effectiveness of heterogeneous innovations by means of the standard quality adjusted life year (QALY) measure of clinical outcome, which is intended to be broadly comparable across treatments. For the innovator or manufacturer it helps them focus on what is required for future stages of development, in order to fill gaps in the input data and so further strengthen their case from a health economics perspective. Results are presented of first experiences from deploying the tool on three medical device exemplars, in face-to-face meetings of the NHS National Innovation Centre (NIC) along with the innovator or clinical champion. The results show that mapping of device-related innovations to the tool is achievable in a short meeting between the NIC and the innovator using expected costs, outcomes data from the literature and estimates of ranges for unknown input data. Whilst the result of a simplified analysis is not expected to be definitive, the process of reasoning is found to be illuminating for the parties involved, enabling innovators to articulate the benefits of their innovations and for all parties to highlight gaps in data and evidence that will be required to take the innovation forward. The partnership model of the authors’ organisation supports the kind of cooperative design approach that is necessary to produce the kind of tool described.---------------------------7dd39101208fa Content-Disposition: form-data; name="c14_creators_1_name_family" Crave

A descriptive analysis comparing the academic success of student athletes and non-student athletes

This study was undertaken to measure and compare the academic success of student athletes and non-student athletes. The suggested hypothesis was that student athletes would perform better academically because of factors relating to accomplished goal setting and discipline. This study implies that student athletes are more prepared for academic success because of their goal oriented behaviors. 206 students participated in the experiment. There were 141 athletes and 65 non athletes. Those who were described as an athlete were a participating member of a varsity sport. The students were all members of a local Catholic high school. With the permission of the school, the researcher was presented with a listing of each student which revealed their G.P.A. score and the participatory status as an athlete or non-athlete. A descriptive analysis was performed in order to indicate the percentage ranking of both groups of subjects within specified G.P.A. ranges. The results of the analysis indicated that non-athletes outperformed athletes academically within the highest G.P.A. ranges. It was concluded that considering these results, the hypothesis predicting student athletes\u27 academic success would be superior to that of non-student athletes would be rejected

Control Theory: The Double Pendulum Inverted on a Cart

In this thesis the Double Pendulum Inverted on a Cart (DPIC) system is modeled using the Euler-Lagrange equation for the chosen Lagrangian, giving a second-order nonlinear system. This system can be approximated by a linear first-order system in which linear control theory can be used. The important definitions and theorems of linear control theory are stated and proved to allow them to be utilized on a linear version of the DPIC system. Controllability and eigenvalue placement for the linear system are shown using MATLAB. Linear Optimal control theory is likewise explained in this section and its uses are applied to the DPIC system to derive a Linear Quadratic Regulator (LQR). Two different LQR controllers are then applied to the full nonlinear DPIC system, which is concurrently modeled in MATLAB. Also, an in-depth look is taken at the Riccati equation and its solutions. Finally, results from various MATLAB simulations are shown

Membrane-bound β-catenin degradation is enhanced by ETS2-mediated Siah1 induction in Helicobacter pylori-infected gastric cancer cells.

β-catenin has two different cellular functions: intercellular adhesion and transcriptional activity. The E3 ubiquitin ligase Siah1 causes ubiquitin-mediated degradation of the cytosolic β-catenin and therefore, impairs nuclear translocation and oncogenic function of β-catenin. However, the effect of Siah1 on the cell membrane bound β-catenin has not been studied. In this study, we identified that the carcinogenic bacterium H. pylori increased ETS2 transcription factor-mediated Siah1 protein expression in gastric cancer cells (GCCs) MKN45, AGS and Kato III. Siah1 protein level was also noticeably higher in gastric adenocarcinoma biopsy samples as compared to non-cancerous gastric epithelia. Siah1 knockdown significantly decreased invasiveness and migration of H. pylori-infected GCCs. Although, Siah1 could not increase degradation of the cytosolic β-catenin and its nuclear translocation, it enhanced degradation of the membrane-bound β-catenin in the infected GCCs. This loss of membrane-bound pool of β-catenin was not associated with the proteasomal degradation of E-cadherin. Thus, this work delineated the role of Siah1 in increasing invasiveness of H. pylori-infected GCCs

Babcock Testing - Principles and Uses

The manufacturing of dairy products on a commercial scale began about the middle of the nineteenth century and was greatly stimulated by the development of the centrifugal cream separator in the late eighties. The invention of the Babcock test in the early nineties overcame some of the difficulties that had developed in paying for milk upon its butterfat content, since it was early recognized that milk varied widely in that respect

Narrative identity reconstruction as adaptive growth during mental health recovery: A narrative coaching boardgame approach

Objective: The purpose of this paper is to construct a conceptual framework for investigating the reconstruction of narrative identity in mental health recovery from a complexity perspective. This conceptual framework provides the foundation for developing a health boardgame to facilitate narrative identity reconstruction. Methods: A selective integrative review of the theoretical and empirical literature relevant to narrative identity reconstruction in recovery was conducted. Sources included books, dissertations, internet resources, and professional journals. Findings: The reviewed material provides a conceptual framework that offers an enriched understanding of narrative identity reconstruction in recovery as a process of adaptive growth. It identifies the Hero\u27s Journey, the life story model of identity (LSMI), and intentional change theory (ITC) as particularly relevant in informing strategies for narrative identity reconstruction. The conceptual framework can be operationalized in a narrative coaching treatment approach using a boardgame. Conclusion and Implications for Practice: In practice, mental health professionals could use the narrative coaching boardgame to facilitate people\u27s adaptive change with a focus on building skills to reconstruct their preferred narrative identity and foster hope. Future research should explore what aspects of narrative identity and non-linear dynamic processes of change are most important in people\u27s recovery narratives and in particular these processes can be assessed in response to the use of the boardgame