The cost of treating stroke in urban and rural Tanzania: a 6-month pilot study

Background: Economic evaluations have significant roles in informing funding decisions. They provide the means to choose which programme of care to fund among the many competing for resources. Unlike in higher-income countries, published studies on economic evaluations of stroke in Sub-Saharan Africa are rare.Objective: To pilot a method for estimating the cost of treating stroke in rural and urban Tanzania that will assist with future economic evaluations of stroke.Methods: The pilot study was conducted as part of the Tanzania Stroke Incidence Study. Incident cases were reported by resident community informants. Cost data were summarised from project documents and data on out-ofpocket payments were collected by interviewing patients/carers. Productivity losses relating to post-stroke occupations were also estimated in monetary terms using standard monthly salary estimates by job category and gender.Results: Sixteen incident cases (11 rural and 5 urban) were identified and followed-up for six monthsin 2005/2006. The overall mean cost per case was TZS 256,338 (USD 220) and included diagnostic tests (blood, ECG, echocardiogram, chest X-ray, CT scans), hospitalisation cost (registration, inpatient stay and drugs), transport cost to designated hospitals, physiotherapy and out-of-pocket payments to other points of care. Costs were more than four-fold higher in the urban district than in the rural district. Mean productivity loss per patient was TZS 247,930 (USD 213) and was more than double in the urban district than in the rural district.Conclusion: This is the first published research investigating the cost of treating stroke in Tanzania. A bigger sample, long-term follow up and modeling are required for better estimates of stroke economic burden.Keywords: Cost analysis, Stroke, Tanzania, Sub-Saharan Africa, Populations Rural/Urba

Development of the Orion Crew Module Static Aerodynamic Database

This work describes the process of developing the nominal static aerodynamic coefficients and associated uncertainties for the Orion Crew Module for Mach 8 and below. The database was developed from wind tunnel test data and computational simulations of the smooth Crew Module geometry, with no asymmetries or protuberances. The database covers the full range of Reynolds numbers seen in both entry and ascent abort scenarios. The basic uncertainties were developed as functions of Mach number and total angle of attack from variations in the primary data as well as computations at lower Reynolds numbers, on the baseline geometry, and using different flow solvers. The resulting aerodynamic database represents the Crew Exploration Vehicle Aerosciences Project's best estimate of the nominal aerodynamics for the current Crew Module vehicle

Boys to Men: A Conference Report

Nearly 350 middle and high school aged boys, fathers and male mentors attended. It was the first such conference to be held in Maine. “Boys to Men” was intended to launch a community dialogue about how schools, families and other institutions can better understand, celebrate and support boys in their journey to manhood. There was a special emphasis on the pressures exerted by popular culture in shaping the behavior of adolescent boys

Pemberton hydroelectric power station: a teacher resource

This publication provides a resource for teachers of students in years seven to ten. Teachers are able to address a range of outcomes pertinent to the Western Australian curriculum within the context of the Pemberton Hydroelectric Power Station. The resource contains plans for four units of work, one in each of the following Learning Areas: Science, Mathematics, English, and Society and Environment

A Novel PANK2 Mutation in a Patient with Atypical Pantothenate-Kinase-Associated Neurodegeneration Presenting with Adult-Onset Parkinsonism

BACKGROUND: Pantothenate-kinase-associated neurodegeneration (PKAN) is an autosomal recessive neurodegenerative disorder that is characterized by progressive extrapyramidal signs, visual loss, and cognitive impairment. PKAN is caused by mutations in the pantothenate kinase gene (PANK2), which is located on chromosome 20p13 and encodes pantothenate kinase, the key regulatory enzyme in coenzyme-A biosynthesis. CASE REPORT: In this report we describe a case of atypical PKAN with a novel PANK2 mutation, presenting with a 10-year history of postural tremor involving both hands. Upon neurological examination, the patient's face was masked and he spoke in a monotonous voice. The patient presented with mild bradykinesia and rigidity that involved all of the extremities. Horizontal saccadic eye movements were slow and fragmented. Brain MRI revealed a typical "eye-of-the-tiger" sign. A mutation analysis revealed three PANK2 mutations: two in exon 3 (Asp 378Gly and Leu385CysfsX13) and one in exon 4 (Arg440Pro). CONCLUSIONS: Parkinsonism is not an unusual presenting symptom in patients with atypical PKAN, and so it is important for physicians to consider PKAN in the differential diagnosis of patients presenting with young-onset parkinsonism.ope

Frequency and surface dependence of the mechanical loss in fused silica

We have compiled measurements of the mechanical loss in fused silica from samples spanning a wide range of geometries and resonant frequency in order to model the known variation of the loss with frequency and surface-to-volume ratio. This improved understanding of the mechanical loss has contributed significantly to the design of advanced interferometric gravitational wave detectors, which require ultra-low loss materials for their test mass mirrors.Comment: 5 pages, 3 figure but 5 figure file

Silicon Micromachining in RF and Photonic Applications

Texas Instruments (TI) has developed membrane and micromirror devices since the late 1970s. An eggcrate space membrane was used as the spatial light modulator in the early years. Discrete micromirrors supported by cantilever beams created a new era for micromirror devices. Torsional micromirror and flexure-beam micromirror devices were promising for mass production because of their stable supports. TI's digital torsional micromirror device is an amplitude modulator (known as the digital micromirror device (DMD) and is in production development, discussed elsewhere. We also use a torsional device for a 4 x 4 fiber-optic crossbar switch in a 2 cm x 2 cm package. The flexure-beam micromirror device is an analog phase modulator and is considered more efficient than amplitude modulators for use in optical processing systems. TI also developed millimeter-sized membranes for integrated optical switches for telecommunication and network applications. Using a member in radio frequency (RF) switch applications is a rapidly growing area because of the micromechanical device performance in microsecond-switching characteristics. Our preliminary membrane RF switch test structure results indicate promising speed and RF switching performance. TI collaborated with MIT for modeling of metal-based micromachining