Economic Analysis of Children's Surgical Care in Low- and Middle-Income Countries: A Systematic Review and Analysis.

BackgroundUnderstanding the economic value of health interventions is essential for policy makers to make informed resource allocation decisions. The objective of this systematic review was to summarize available information on the economic impact of children's surgical care in low- and middle-income countries (LMICs).MethodsWe searched MEDLINE (Pubmed), Embase, and Web of Science for relevant articles published between Jan. 1996 and Jan. 2015. We summarized reported cost information for individual interventions by country, including all costs, disability weights, health outcome measurements (most commonly disability-adjusted life years [DALYs] averted) and cost-effectiveness ratios (CERs). We calculated median CER as well as societal economic benefits (using a human capital approach) by procedure group across all studies. The methodological quality of each article was assessed using the Drummond checklist and the overall quality of evidence was summarized using a scale adapted from the Agency for Healthcare Research and Quality.FindingsWe identified 86 articles that met inclusion criteria, spanning 36 groups of surgical interventions. The procedure group with the lowest median CER was inguinal hernia repair ($15/DALY). The procedure group with the highest median societal economic benefit was neurosurgical procedures ($58,977). We found a wide range of study quality, with only 35% of studies having a Drummond score ≥ 7.InterpretationOur findings show that many areas of children's surgical care are extremely cost-effective in LMICs, provide substantial societal benefits, and are an appropriate target for enhanced investment. Several areas, including inguinal hernia repair, trichiasis surgery, cleft lip and palate repair, circumcision, congenital heart surgery and orthopedic procedures, should be considered "Essential Pediatric Surgical Procedures" as they offer considerable economic value. However, there are major gaps in existing research quality and methodology which limit our current understanding of the economic value of surgical care

Revised Orbit and Transit Exclusion for HD 114762b

Transiting planets around bright stars have allowed the detailed follow-up and characterization of exoplanets, such as the study of exoplanetary atmospheres. The Transit Ephemeris Refinement and Monitoring Survey (TERMS) is refining the orbits of the known exoplanets to confirm or rule out both transit signatures and the presence of additional companions. Here we present results for the companion orbiting HD 114762 in an eccentric 84 day orbit. Radial velocity analysis performed on 19 years of Lick Observatory data constrain the uncertainty in the predicted time of mid-transit to ~5 hours, which is less than the predicted one-half day transit duration. We find no evidence of additional companions in this system. New photometric observations with one of our Automated Photoelectric Telescopes (APTs) at Fairborn Observatory taken during a revised transit time for companion b, along with 23 years of nightly automated observations, allow us to rule out on-time central transits to a limit of ~0.001 mag. Early or late central transits are ruled out to a limit of ~0.002 mag, and transits with half the duration of a central transit are ruled out to a limit of ~0.003 mag.Comment: 5 pages, 2 figures, accepted for publication in ApJ

Extracting and re-using research data from chemistry e-theses: the SPECTRa-T project

Scientific e-theses are data-rich resources, but much of the information they contain is not readily accessible. For chemistry, the SPECTRa-T project has addressed this problem by developing data-mining techniques to extract experimental data, creating RDF (Resource Description Framework) triples for exposure to sophisticated Semantic Web searches. We used OSCAR3, an Open Source chemistry text-mining tool, to parse and extract data from theses in PDF, and from theses in Office Open XML document format. Theses in PDF suffered data corruption and a loss of formatting that prevented the identification of chemical objects. Theses in .docx yielded semantically rich SciXML that enabled the additional extraction of associated data. Chemical objects were placed in a data repository, and RDF triples deposited in a triplestore. Data-mining from chemistry e-theses is both desirable and feasible; but the use of PDF, the de facto format standard for deposit in most repositories, prevents the optimal extraction of data for semantic querying. In order to facilitate this, we recommend that universities also require deposition of chemistry e-theses in an XML document format. Further work is required to clarify the complex IPR issues and ensure that they do not become an unwarranted barrier to data extraction and re-use

Sensory Integration: It\u27s Not Just for Children

Sensory integration theory and intervention techniques were originally developed by A. Jean Ayres, PhD, OTR, beginning in the late 1960s. Her pioneering work integrated scientific information from neuroscience, psychology, occupational therapy, and human development in an effort to help explain the relationship among experience, brain development, and function. Ayres\u27s theory of sensory integration provides a solid foundation for understanding the impact of sensation on occupational performance across the life span. Although much of the existing work related to sensory integration addresses occupational performance issues in children, some believe the theory and framework to be important across the life span. However, given the original emphasis on pediatrics, occupational therapy practitioners who work in other areas of practice likely do not have exposure to or training in sensory integration and, therefore, may not consider dysfunction in sensory integration as a contributing factor when evaluating clients at different ages or stages of life. This article makes a case that because humans are sensory beings and sensation is inherent in all occupations, the sensory integration framework is relevant to occupational therapy practice beyond pediatrics. Further, we propose that all occupational therapy practitioners should seek to understand the relevance of the sensory integration framework for the specific clientele with whom they work, regardless of age. We believe that the sensory integration framework can be a useful lens for interpreting behaviors and a guide for implementing strategies to enhance occupational performance in clients across the life span. To this end, some of the sensory-based experiences that persons may encounter across the life span are discussed, and the relevance of the sensory integration framework is proposed. We have chosen to present this information according to a developmental progression to express how dysfunction in sensory integration can be manifested across the life span

Non-detection of previously reported transits of HD 97658b with MOST photometry

The radial velocity-discovered exoplanet HD 97658b was recently announced to transit, with a derived planetary radius of 2.93 \pm 0.28 R_{Earth}. As a transiting super-Earth orbiting a bright star, this planet would make an attractive candidate for additional observations, including studies of its atmospheric properties. We present and analyze follow-up photometric observations of the HD 97658 system acquired with the MOST space telescope. Our results show no transit with the depth and ephemeris reported in the announcement paper. For the same ephemeris, we rule out transits for a planet with radius larger than 2.09 R_{Earth}, corresponding to the reported 3\sigma lower limit. We also report new radial velocity measurements which continue to support the existence of an exoplanet with a period of 9.5 days, and obtain improved orbital parameters.Comment: 16 pages, 4 figures; 1 Table; accepted for publication in ApJL, includes changes made in response to the referee repor

Teacher Residency as a Path to Teacher Diversity: Negotiating Tensions in Role and Identity

This phenomenological qualitative study examined the experiences of graduate-level teacher candidates enrolled in teacher residency programs and serving as teacher aides or assistants (TAs). Some participants were graduate-level teacher candidates already employed as TAs in a large urban district and enrolled in an Urban Pipeline Residency Program, a state-funded diversity initiative designed to increase the number of teachers from underrepresented groups by supporting TAs to pursue teacher certification. Additional participants were enrolled in the Traditional Residency Program and completed residencies in other local districts. Survey and interview data from TA/teacher candidates, mentors, and instructors showed that TA/teacher candidates in both groups experienced conflicting roles and identities, balanced demands of different classroom settings, lacked access to knowledge and materials, and balanced demands on their time. Informed by role theory, identity work, and culturally responsive pedagogy, this study suggests that programs for TA/teacher candidates may benefit from negotiating these tensions through: 1) support for TA/teacher candidates to develop their identities as teachers to address role conflict, 2) strong communication protocols to address role clarity, and 3) increased access to tools and knowledge to address role enactment

Improved Orbital Parameters and Transit Monitoring for HD 156846b

HD 156846b is a Jovian planet in a highly eccentric orbit (e = 0.85) with a period of 359.55 days. The pericenter passage at a distance of 0.16 AU is nearly aligned to our line of sight, offering an enhanced transit probability of 5.4% and a potentially rich probe of the dynamics of a cool planetary atmosphere impulsively heated during close approach to a bright star (V = 6.5). We present new radial velocity (RV) and photometric measurements of this star as part of the Transit Ephemeris Refinement and Monitoring Survey (TERMS). The RV measurements from Keck-HIRES reduce the predicted transit time uncertainty to 20 minutes, an order of magnitude improvement over the ephemeris from the discovery paper. We photometrically monitored a predicted transit window under relatively poor photometric conditions, from which our non-detection does not rule out a transiting geometry. We also present photometry that demonstrates stability at the millimag level over its rotational timescale.Comment: 7 pages, 4 figures, accepted for publication in Ap

The History, Development, and Purpose of the Sensory Integration Global Network

The Sensory Integration Global Network (SIGN) is a Web-based resource developed by a loosely structured group of international volunteers dedicated to protecting the integrity and promoting the work of Ayres Sensory Integration® (ASI). SIGN provides an international resource to educate the public and professionals about A. Jean Ayres and sensory integration theory and practice to help them to discriminate between ASI and other interventions, especially those that use similar descriptors of improving sensory integration and sensory processing. This article aims to increase awareness of the existence of SIGN within the readership of the American Occupational Therapy Association\u27s (AOTA\u27 s) Sensory Integration Special Interest Section. The persons working with SIGN hope that by informing the public about the trademark and exposing both the public and professionals to the underlying principles incorporated within the trademarked ASI approach, consumers will be able to make educated choices about the types of interventions they access. Additionally, the network hopes to assist practitioners by clarifying the terminology used when describing sensory integration practice

The HD 192263 system: planetary orbital period and stellar variability disentangled

As part of the Transit Ephemeris Refinement and Monitoring Survey (TERMS), we present new radial velocities and photometry of the HD 192263 system. Our analysis of the already available Keck-HIRES and CORALIE radial velocity measurements together with the five new Keck measurements we report in this paper results in improved orbital parameters for the system. We derive constraints on the size and phase location of the transit window for HD 192263b, a Jupiter-mass planet with a period of 24.3587 \pm 0.0022 days. We use 10 years of Automated Photoelectric Telescope (APT) photometry to analyze the stellar variability and search for planetary transits. We find continuing evidence of spot activity with periods near 23.4 days. The shape of the corresponding photometric variations changes over time, giving rise to not one but several Fourier peaks near this value. However, none of these frequencies coincides with the planet's orbital period and thus we find no evidence of star-planet interactions in the system. We attribute the ~23-day variability to stellar rotation. There are also indications of spot variations on longer (8 years) timescales. Finally, we use the photometric data to exclude transits for a planet with the predicted radius of 1.09 RJ, and as small as 0.79 RJ.Comment: 9 pages, 6 tables, 6 figures; accepted to Ap

Updated Parameters and a New Transmission Spectrum of HD 97658b

Recent years have seen increasing interest in the characterization of sub-Neptune-sized planets because of their prevalence in the Galaxy, contrasted with their absence in our solar system. HD 97658 is one of the brightest stars hosting a planet of this kind, and we present the transmission spectrum of this planet by combining four Hubble Space Telescope transits, 12 Spitzer/IRAC transits, and eight MOST transits of this system. Our transmission spectrum has a higher signal-to-noise ratio than those from previous works, and the result suggests that the slight increase in transit depth from wavelength 1.1–1.7 μm reported in previous works on the transmission spectrum of this planet is likely systematic. Nonetheless, our atmospheric modeling results are inconclusive, as no model provides an excellent match to our data. Nonetheless, we find that atmospheres with high C/O ratios (C/O ≳ 0.8) and metallicities of ≳100× solar metallicity are favored. We combine the mid-transit times from all of the new Spitzer and MOST observations and obtain an updated orbital period of P = 9.489295 ± 0.000005, with a best-fit transit time center at T₀ = 2456361.80690 ± 0.00038 (BJD). No transit timing variations are found in this system. We also present new measurements of the stellar rotation period (34 ± 2 days) and stellar activity cycle (9.6 yr) of the host star HD 97658. Finally, we calculate and rank the Transmission Spectroscopy Metric of all confirmed planets cooler than 1000 K and with sizes between 1 R⊕ and 4 R⊕. We find that at least a third of small planets cooler than 1000 K can be well characterized using James Webb Space Telescope, and of those, HD 97658b is ranked fifth, meaning that it remains a high-priority target for atmospheric characterization