Economic analysis of the implementation of autologous transfusion technologies throughout England

Objectives: This study aims to provide the first estimates of the costs and effects of the large scale introduction of autologous transfusion technologies into the United Kingdom National Health Service. Methods: A model was constructed to allow disparate data sources to be combined to produce estimates of the scale, costs, and effects of introducing four interventions. The interventions considered were preparing patients for surgery (PPS) clinics, preoperative autologous donation (PAD), intraoperative cell salvage (ICS), and postoperative cell salvage (PoCS). Results: The key determinants of cost per operation are the anticipated level of reductions in blood use, the mean level of blood use, mean length of stay, and the cost of the technology. The results show the potential for considerable reductions in blood use. The greatest reductions are anticipated to be through the use of PPS and ICS. Vascular surgery, transplant surgery, and cardiothoracic surgery appear to be the specialties that will benefit most from the technologies. Conclusions: Several simplifications were used in the production of these estimates; consequently, caution should be used in their interpretation and use. Despite the drawbacks in the methods used in the study, the model shows the scale of the issue, the importance of gathering better data, and the form that data must take. Such preliminary modeling exercises are essential for rational policy development and to direct future research and discussion among stakeholders

Cost effectiveness of community leg ulcer clinics: randomised controlled trial

Objectives: To establish the relative cost effectiveness of community leg ulcer clinics that use four layer compression bandaging versus usual care provided by district nurses. Design: Randomised controlled trial with 1 year of follow up. Setting: Eight community based research clinics in four trusts in Trent. Subjects: 233 patients with venous leg ulcers allocated at random to intervention (120) or control (113) group. Interventions: Weekly treatment with four layer bandaging in a leg ulcer clinic (clinic group) or usual care at home by the district nursing service (control group). Main outcome measures: Time to complete ulcer healing, patient health status, and recurrence of ulcers. Satisfaction with care, use of services, and personal costs were also monitored. Results: The ulcers of patients in the clinic group tended to heal sooner than those in the control group over the whole 12 month follow up (log rank P=0.03). At 12 weeks, 34% of patients in the clinic group were healed compared with 24% in the control. The crude initial healing rate of ulcers in intervention compared with control patients was 1.45 (95% confidence interval 1.04 to 2.03). No significant differences were found between the groups in health status. Mean total NHS costs were £878.06 per year for the clinic group and £859.34 for the control (P=0.89). Conclusions: Community based leg ulcer clinics with trained nurses using four layer bandaging is more effective than traditional home based treatment. This benefit is achieved at a small additional cost and could be delivered at reduced cost if certain service configurations were used

Land use and marketing in north east Thailand : A case study of the Lam Pao area.

This study examines the process of agricultural development with particular reference to the interaction between land use and the market system. Agricultural change is seen in terms of increasing orientation towards commercialisation. The existing subsistence land use pattern has been gradually modified as a result of the farmers' response to stimulation of cash expectations by contact with the wider market economy. This response follows the two main lines of the expansion of production of a marketable surplus in the traditional crops, and the adoption of new land use elements which differ markedly from the established pattern. These trends are not necessarily mutually exclusive and may indeed occur together. The instability of the environmental conditions, the unpredictable nature of commodity prices, the weakness of the market system and the farmers' desire to continue to provide their basic subsistence needs, all act as constraints on the progress of agriculture towards highly commercialised and specialised production. A combination of continued stimulation of farmers' cash expectations, the unreliable flow of income from farming and the government policy of heavy investment in rural infrastructure, which generates a large amount of unskilled labouring employment in the short term, may cause farmers to turn increasingly away from agricultural pursuits. Whether or not these farmers revert to agriculture as the mainstay of cash income once the employment in construction work ceases could have very significant implications for the future land use pattern of an area planned for modernised intensive agriculture

Ion-beam-assisted fabrication and manipulation of metallic nanowires

Metallic nanowires (NWs) are the key performers for future micro/nanodevices. The controlled manoeuvring and integration of such nanoscale entities are essential requirements. Presented is a discussion of a fabrication approach that combines chemical etching and ion beam milling to fabricate metallic NWs. The shape modification of the metallic NWs using ion beam irradiation (bending towards the ion beam side) is investigated. The bending effect of the NWs is observed to be instantaneous and permanent. The ion beam-assisted shape manoeuvre of the metallic structures is studied in the light of ion-induced vacancy formation and reconfiguration of the damaged layers. The manipulation method can be used for fabricating structures of desired shapes and aligning structures at a large scale. The controlled bending method of the metallic NWs also provides an understanding of the strain formation process in nanoscale metals

Next-to-Leading order Higgs + 2 jet production via gluon fusion

We present phenomenological results for the production of a Higgs boson in association with two jets at the LHC. The calculation is performed in the limit of large top mass and is accurate to next-to-leading order in the strong coupling, i.e. ${\cal O}(\alpha_s^6)$Comment: 13 pages, 6 figures; v2: references added, modified acknowledgments, final version as published in JHE

Recursion relations, Helicity Amplitudes and Dimensional Regularization

Using the method of on-shell recursion relations we compute tree level amplitudes including D-dimensional scalars and fermions. These tree level amplitudes are needed for calculations of one-loop amplitudes in QCD involving external quarks and gluons.Comment: 28 pages, 6 figures, clarifications adde

Renormalization group and isochronous oscillations

We show how the condition of isochronicity can be studied for two dimensional systems in the renormalization group (RG) context. We find a necessary condition for the isochronicity of the Cherkas and another class of cubic systems. Our conditions are satisfied by all the cases studied recently by Bardet et al \cite{bard} and Ghose Choudhury and Guh