Hiatal surfaces from the Miocene Globigerina Limestone Formation of Malta: Biostratigraphy, sedimentology, trace fossils and early diagenesis

The Miocene Globigerina Limestone of the Maltese islands contains widespread omission surfaces with very different characteristics and origins. The terminal Lower Globigerina Limestone hardground (TLGLHg) formed during a period of falling sea level. Coccolith assemblages suggest shallowness. Sedimentary structures and trace fossil assemblages, indicate increasing frequency of storm events and erosional episodes, towards the surface. Calcite cementation which took place around Thalassinoides burrows and formed irregular nodules was followed by dissolution of aragonite. It is suggested that lithification was linked to microbial reactions involving organic matter. In contrast two later surfaces, the terminal Middle Globigerina Limestone omissionground (TMGLOg), which marks the Lower to Middle Miocene boundary, and the Fomm-ir-Rih local hardground (FiRLHg) both contain early diagenetic dolomite. Lithification took place in two phases. The dolomite is interpreted to have formed beneath the sea floor: it was subsequently exhumed and partially corroded as the precipitation of calcitic and phosphatic cements took place around burrows open to the circulation of sea water. (C) 2008 Elsevier B.V. All rights reserved.

An illustration of the modelling of cost and efficacy data from a clinical trial

Health care providers, purchasers and policy makers need to make informed decisions regarding the provision of cost-effective care. When a new health care intervention is to be compared with the current standard, an economic evaluation alongside an evaluation of health benefits provides useful information for the decision making process. We consider the information on cost-effectiveness which arises from an individual clinical trial comparing the two interventions. Recent methods for conducting a cost-effectiveness analysis for a clinical trial have focused on the net benefit parameter. The net benefit parameter, a function of costs and health benefits, is positive if the new intervention is cost-effective compared with the standard. In this paper we describe frequentist and Bayesian approaches to cost-effectiveness analysis which have been suggested in the literature and apply them to data from a clinical trial comparing laparoscopic surgery with open mesh surgery for the repair of inguinal hernias. We extend the Bayesian model to allow the total cost to be divided into a number of different components. The advantages and disadvantages of the different approaches are discussed. In January 2001, NICE issued guidance on the type of surgery to be used for inguinal hernia repair. We discuss our example in the light of this information. Copyright © 2003 John Wiley & Sons, Ltd.