Does responsibility affect the public valuation of health care interventions? A relative valuation approach to health care safety

This article is available open access through the publisher’s website at the link below. Copyright © 2012, International Society for Pharmacoeconomics and Outcomes Research (ISPOR).Objective - Health services often spend more on safety interventions than seems cost-effective. This study investigates whether the public value safety-related health care improvements more highly than the same improvements in contexts where the health care system is not responsible. Method - An online survey was conducted to elicit the relative importance placed on preventing harms caused by 1) health care (hospital-acquired infections, drug administration errors, injuries to health care staff), 2) individuals (personal lifestyle choices, sports-related injuries), and 3) nature (genetic disorders). Direct valuations were obtained from members of the public by using a person trade-off or “matching” method. Participants were asked to choose between two preventative interventions of equal cost and equal health benefit per person for the same number of people, but differing in causation. If participants indicated a preference, their strength of preference was measured by using person trade-off. Results - Responses were obtained from 1030 people, reflecting the sociodemographic mix of the UK population. Participants valued interventions preventing hospital-acquired infections (1.31) more highly than genetic disorders (1.0), although drug errors were valued similarly to genetic disorders (1.07), and interventions to prevent injury to health care staff were given less weight than genetic disorders (0.71). Less weight was also given to interventions related to lifestyle (0.65) and sports injuries (0.41). Conclusion - Our results suggest that people do not attach a simple fixed premium to “safety-related” interventions but that preferences depend more subtly on context. The use of the results of such public preference surveys to directly inform policy would therefore be premature.Brunel University

Remote functionalisation via sodium alkylamidozincate intermediates : access to unusual fluorenone and pyridyl ketone reactivity patterns

Treating fluorenone or 2-benzoylpyridine with the sodium zincate [(TMEDA)center dot Na(mu-Bu-t)(mu-TMP)Zn(Bu-t)] in hexane solution, gives efficient Bu-t addition across the respective organic substrate in a highly unusual 1,6-fashion, producing isolable organometallic intermediates which can be quenched and aerobically oxidised to give 3-tert-butyl-9H-fluoren-9-one and 2-benzoyl-5-tert-butylpyridine respectively

A parallel multistate framework for atomistic non-equilibrium reaction dynamics of solutes in strongly interacting organic solvents

We describe a parallel linear-scaling computational framework developed to implement arbitrarily large multi-state empirical valence bond (MS-EVB) calculations within CHARMM. Forces are obtained using the Hellman-Feynmann relationship, giving continuous gradients, and excellent energy conservation. Utilizing multi-dimensional Gaussian coupling elements fit to CCSD(T)-F12 electronic structure theory, we built a 64-state MS-EVB model designed to study the F + CD3CN -> DF + CD2CN reaction in CD3CN solvent. This approach allows us to build a reactive potential energy surface (PES) whose balanced accuracy and efficiency considerably surpass what we could achieve otherwise. We use our PES to run MD simulations, and examine a range of transient observables which follow in the wake of reaction, including transient spectra of the DF vibrational band, time dependent profiles of vibrationally excited DF in CD3CN solvent, and relaxation rates for energy flow from DF into the solvent, all of which agree well with experimental observations. Immediately following deuterium abstraction, the nascent DF is in a non-equilibrium regime in two different respects: (1) it is highly excited, with ~23 kcal mol-1 localized in the stretch; and (2) not yet Hydrogen bonded to the CD3CN solvent, its microsolvation environment is intermediate between the non-interacting gas-phase limit and the solution-phase equilibrium limit. Vibrational relaxation of the nascent DF results in a spectral blue shift, while relaxation of its microsolvation environment results in a red shift. These two competing effects result in a post-reaction relaxation profile distinct from that observed when DF vibration excitation occurs within an equilibrium microsolvation environment. The parallel software framework presented in this paper should be more broadly applicable to a range of complex reactive systems.Comment: 58 pages and 29 Figure

Time Spent Working in Custody Influences Work Sample Test Battery Performance of Deputy Sheriffs Compared to Recruits

This study determined the influence of years spent working in custody on fitness measured by a state-specific testing battery (Work Sample Test Battery; WSTB) in deputy sheriffs. Retrospective analysis was conducted on one patrol school class (51 males, 13 females) divided into three groups depending on time spent working in custody: DS24 (<24 months; n = 20); DS2547 (25–47 months; n = 23); and DS48+ (≥48 months; n = 21). These groups were compared to a recruit class (REC; 219 males, 34 females) in the WSTB, which comprised five tasks completed for time: 99-yard (90.53-m) obstacle course (99OC); 165-pound (75-kg) dummy drag; six-foot (1.83-m) chain link fence (CLF) and solid wall (SW) climb; and 500-yard (457.2-m) run (500R). A univariate analysis of covariance (ANCOVA) (controlling for sex and age) with Bonferroni post hoc determined significant between-group differences. DS48+ were slower in the 99OC compared to the REC (p = 0.007) and performed the CLF and SW slower than all groups (p ≤ 0.012). DS24, DS2547, and DS48+ were all slower than REC in the 500R (p ≤ 0.002). Physical training should be implemented to maintain fitness and job-specific task performance in deputy sheriffs working custody, especially considering the sedentary nature of this work

Performance of concrete with recycled plastic as a partial replacement for sand

Environmental concerns have led to severe restrictions on dredging for sand in much of India, including in the state of Goa, leading to direct impacts on the economics of concrete construction. At the same time, waste plastic is rarely recycled across India, with a large proportion of plastic simply exposed of into landfill presenting further environmental concerns.This paper describes a study seeking a solution to both problems by utilising processed waste plastic as a partial replacement for fine sand in concrete mixes.This initial work was supported through project funding from the British Council under the UKIERI (United Kingdom India Educational Research Initiative) programme. The compressive strength and performance of concrete mixes with plastic have been tested, and suggestions for suitable replacement percentages are proposed. Parameters including the size and aspect ratio of the plastic particles replacing the san aggregate and effects of chemical treatment are addressed. Results show that replacing sand with recycled plastic is viable and by using a suitable mix design the impact on the compressive strength of the concrete mix can be kept at acceptably low levels