Comparative cost-effectiveness of Option B+ for prevention of mother-to-child transmission of HIV in Malawi.

OBJECTIVE To estimate the cost-effectiveness of prevention of mother-to-child transmission (MTCT) of HIV with lifelong antiretroviral therapy (ART) for pregnant and breastfeeding women ('Option B+') compared with ART during pregnancy or breastfeeding only unless clinically indicated ('Option B'). DESIGN Mathematical modelling study of first and second pregnancy, informed by data from the Malawi Option B+ programme. METHODS Individual-based simulation model. We simulated cohorts of 10 000 women and their infants during two subsequent pregnancies, including the breastfeeding period, with either Option B+ or B. We parameterized the model with data from the literature and by analysing programmatic data. We compared total costs of antenatal and postnatal care, and lifetime costs and disability-adjusted life-years of the infected infants between Option B+ and Option B. RESULTS During the first pregnancy, 15% of the infants born to HIV-infected mothers acquired the infection. With Option B+, 39% of the women were on ART at the beginning of the second pregnancy, compared with 18% with Option B. For second pregnancies, the rates MTCT were 11.3% with Option B+ and 12.3% with Option B. The incremental cost-effectiveness ratio comparing the two options ranged between about US$ 500 and US$ 1300 per DALY averted. CONCLUSION Option B+ prevents more vertical transmissions of HIV than Option B, mainly because more women are already on ART at the beginning of the next pregnancy. Option B+ is a cost-effective strategy for PMTCT if the total future costs and lost lifetime of the infected infants are taken into account.

Community College Student Participation in Undergraduate Research: An Explanatory Case Study for Faculty and Research Mentors

This study adapted the current model of science undergraduate research experiences (URE's) and applied this novel modification to include community college students. Numerous researchers have examined the efficacy of URE's in improving undergraduate retention and graduation rates, as well as matriculation rates for graduate programs. However, none have detailed the experience for community college students, and few have employed qualitative methodologies to gather relevant descriptive data from URE participants. This study included perspectives elicited from both non-traditional student participants and the established laboratory community. The purpose of this study was to determine the effectiveness of the traditional model for a non-traditional student population. The research effort described here utilized a qualitative design and an explanatory case study methodology. Six non-traditional students from the Maine Community College System participated in this study. Student participants were placed in six academic research laboratories located throughout the state. Student participants were interviewed three times during their ten-week internship and asked to record their personal reflections in electronic format. Participants from the established research community were also interviewed. These included both faculty mentors and other student laboratory personnel. Ongoing comparative analysis of the textual data revealed that laboratory organizational structure and social climate significantly influence acculturation outcomes for non-traditional URE participants. Student participants experienced a range of acculturation outcomes from full integration to marginalization. URE acculturation outcomes influenced development of non-traditional students? professional and academic self-concepts. Positive changes in students? self-concepts resulted in greater commitment to individual professional goals and academic aspirations. The findings from this study suggest that traditional science URE models can be successfully adapted to meet the unique needs of a non-traditional student population – community college students. These interpretations may encourage post-secondary educators, administrators, and policy makers to consider expanded access and support for non-traditional students seeking science URE opportunities.

Policy analysis of iron micronutrient programs at USAID: The FANTA program in East Africa and the micronutrient initiative in Bihar region of India, using comparative cost effective and cost benefit analysis

It is the aim of this paper to examine iron supplementation programs which receive funding from United States Agency for International Development (USAID) but approach combating iron deficiency anemia in two vastly different ways. A brief literature review and background information on iron deficiencies and the differences between supplementation programs and micronutrient fortification were reviewed. Two non-governmental organizations (NGO's) were examined for this paper: the Food and Nutrition Technical Assistance II (FANTA) and the MicroNutrient Initiative. The FANTA program included an educational component to their supplementation program while the MicroNutrient Initiative solely used supplementation of micronutrients to their population. Methods used were cost-benefit analysis and cost-effectiveness analysis to determine the overall effectiveness of each program in reducing iron deficiency anemia in each population, if the added costs of the incentives in the FANTA program changed the cost-effectiveness of the program compared to the MicroNutrient Initiative program and to determine which program imparted the greatest benefit to each population by reducing the disease burden in Disability Adjusted Life Years (DALY). Results showed that the unit cost of the FANTA program per person was higher than the MicroNutrient Initiative program due to the educational component. The FANTA program reduced iron deficiency anemia less overall but cost less for each percentage point of anemia decreased in their respective populations. The MicroNutrient Initiative program had a better benefit cost ratio for the populations it served. The MicroNutrient Initiative's large scale program imparted many advantages by reducing unit cost per person and decreasing iron deficiency anemia. The FANTA program was more effective at decreasing iron deficiency anemia with less money: $5,660 per 1% decrease in iron deficiency anemia versus $18,450 per 1% decrease in iron deficiency anemia for the MicroNutrient Initiative program. ^ In conclusion, economic analysis cannot measure all of the benefits associated with programs that contain an educational component or large scale supplementation. More information needs to be gathered by NGOs and reported to USAID, such as detailed prevalence rates of iron deficiency anemia among the populations served. Further research is needed to determine the effects an educational supplementation program has on compliance rates of participants and motivation to participate in supplementation programs whose aim is to decrease iron deficiency anemia in a targeted population.^

A comparative analysis of hospital -based physician monitoring systems

The purpose of the multiple case-study was to determine how hospital subsystems (such as physician monitoring and credentialing; quality assurance; risk management; and peer review) were supporting the monitoring of physicians? Three large metropolitan hospitals in Texas were studied and designated as hospitals #1, #2, and #3. Realizing that hospital subsystems are a unique entity and part of a larger system, conclusions were made on the premises of a quality control system, in relation to the tools of government (particularly the Health Care Quality Improvement Act (HCQIA)), and in relation to itself as a tool of a hospital.^ Three major analytical assessments were performed. First, the subsystems were analyzed as to their "completeness"; secondly, the subsystems were analyzed for "performance"; and thirdly, the subsystems were analyzed in reference to the interaction of completeness and performance.^ The physician credentialing and monitoring and the peer review subsystems as quality control systems were most complete, efficient, and effective in hospitals #1 and #3. The HCQIA did not seem to be an influencing factor in the completeness of the subsystem in hospital #1. The quality assurance and risk management subsystem in hospital #2 was not representative of completeness and performance and the HCQIA was not an influencing factor in the completeness of the Q.A. or R.M. systems in any hospital. The efficiency (computerization) of the physician credentialing, quality assurance and peer review subsystems in hospitals #1 and #3 seemed to contribute to their effectiveness (system-wide effect).^ The results indicated that the more complete, effective, and efficient subsystems were characterized by (1) all defined activities being met, (2) the HCQIA being an influencing factor, (3) a decentralized administrative structure, (4) computerization an important element, and (5) staff was sophisticated in subsystem operations. However, other variables were identified which deserve further research as to their effect on completeness and performance of subsystems. They include (1) medical staff affiliations, (2) system funding levels, (3) the system's administrative structure, and (4) the physician staff "cultural" characteristics. Perhaps by understanding other influencing factors, health care administrators may plan subsystems that will be compatible with legislative requirements and administrative objectives. ^

Conventions in comparative constitutional law. Research Paper in Law 4/2003

Introduction. “Convention” is an ambiguous term, not only for lawyers, containing a wide variety of different meanings. Even when restricted to denote an assembly it may be used for all sorts of gatherings. In the context of constitutional law a convention is a very specific instrument, and the question is to what extent it is actually known in European constitutional law and whether the “Convention on the Future of Europe” as called forth by the Declaration of Laeken conforms to what is understood in constitutional law by “convention”.1 Or did the Laeken Council pick up a term without any foundation in European constitutional law, rarely practiced and even less understood, the only precedents of which are supposed to be the American Federal Convention in Philadelphia in 1787 and the convention that drafted the European Charter on Fundamental Rights, as can be read time and again? 2 As it is the privilege of the constitutional historian to make aware the evolution of legal institutions and to analyze their conferred meaning so that they will be available in political discourse, I shall examine the meaning of “convention” in constitutional history and comparative constitutional law in a first part, while a second part will place the Convention on the Future of the European Union according to its composition and commission into the context of constitutional conventions as understood in law.

EU democratization policies in the Neighbourhood countries and Russia’s reaction as a destabilizing factor. A comparative case study of Georgia and Moldova. Bruges Political Research Papers 45/2015.

The EU democratization policies have not achieved the expected results in Eastern Partnership (EaP) countries. On the contrary, they have led to the outbreak of the most important crisis in Europe after the end of the cold war. A new vision of cooperation in the field of democracy is necessary in the East, as long as even Georgia and Moldova, countries considered to be the most advanced among the EaP states, have not registered essential progress in the democratization of their societies. Assuming that democratization, as part of EU’s neighbourhood policies, can be considered a threat to Russia and hence a ‘destabilizing factor’ for the EU partners, this thesis tried to understand what changes can be made to EU policies and to what extent cooperation between EU and Russia is possible in the process developing democratization policies in Georgia and Moldova. While arguing for the revitalization of the instruments used for the implementation of the democratization policies, this thesis finds that cooperation between the EU and Russia in the field of democracy is excluded as long as the two geo-political actors have different values and different views on the notion of democracy. The most likely cooperation that might occur between EU and Russia is the establishment of a Common Economic Space ‘from Lisbon to Vladivostok’. Even though such a scenario would have the potential to reduce confrontation between the two actors in the common neighbourhood, this cooperation would, however, have a negative impact on the on-going democratic reforms in Georgia and Moldova.

An investigation of the effectiveness of existing bridge design methodology in providing adequate structural resistance to seismic disturbances : Phase III, Nonlinear soil-structure interaction of skew highway bridges : final report : prepared for Federal Highway Administration, Offices of Research and Development /

Bibliography: p. 46-48.

Effectiveness of a pilot information service for educational research materials.

Mode of access: Internet.

Effectiveness of fire control agents on chemical fires : phase I, test methodology and baseline hexane tests : final report ; prepared for U.S. Department of Transportation, United States Coast Guard, Office of Research and Development.

"Report no. CG-D-50-80."

A dictionary of chemistry, exhibiting the present state of the theory and practice of that science, its application to natural philosophy, the processes of manufactures, metallurgy, and numerous other arts dependant on the properties and habitudes of bodies, in the mineral, vegetable, and animal kingdoms. With a considerable number of tables, expressing the elective attractions, specific gravities, comparative heats, component parts, combinations, and other affections of the objects of chemical research. Illustrated with engravings.

Paged continuously.