Economic assessment of bovine tuberculosis and alternative policies

Break-even analyses of the costs and benefits of six alternative bovine tuberculosis (bTB) control strategies were undertaken. The results show that some strategies, such as zoning, would require relatively small reductions in bTB incidence as a result to be cost effective, whilst for others, such as proactive badger removal, the costs would require a substantial and relatively rapid reduction in bTB incidence to be worthwhile.

EU Policies on Bioenergy and their Potential Clash with the WTO

The paper outlines EU policy on bioenergy, including biofuels, in the context of its policy initiatives to promote renewable energy to combat greenhouse gas emissions and climate change. The EU's Member States are responsible for implementing EU policy: thus, the UK's Renewables Obligation on electricity suppliers and its Renewable Transport Fuel Obligation and road-fuel tax rebates are examined. It is unlikely that EU policy is in conflict with the WTO Agreement on Agriculture or that on Subsidies and Countervailing Measures, but its provisions on environmental sustainability criteria could be problematic.

Burn-in policies for products having dormant states

Many systems might have a long time dormant period, during which the systems are not operated. For example, most building services products are installed while a building is constructed, but they are not operated until the building is commissioned. Warranty terms for such products may cover the time starting from their installation times to the end of their warranty periods. Prior to the commissioning of the building, the building services products are protected by warranty although they are not operating. Developing optimal burn-in policies for such products is important when warranty cost is analysed. This paper considers two burn-in policies, which incur different burn-in costs, and have different burn-in effects on the products. A special case about the relationship between the failure rates of the products at the dormant state and at the operating state is presented. Numerical examples compare the mean total warranty costs of these two burn-in policies.

Burn in policies for products having dormant states

Constructing a building is a long process which can take several years. Most building services products are installed while a building is constructed, but they are not operated until the building is commissioned. The warranty term for the building service systems may cover the time starting from their installation to the end of the warranty period. Prior to the commissioning of the building, the building services systems are protected by warranty although they are not operated. The bum in time for such systems is important when warranty costs is analyzed. In this paper, warranty cost models for products with burn in periods are presented. Two burn in policies are developed to optimize the total mean warranty cost. A special case on the relationship between the failure rates of the product at the dormant state and at the I operating state is presented.

Optimal maintenance policies under different operational schedules

In the reliability literature, maintenance time is usually ignored during the optimization of maintenance policies. In some scenarios, costs due to system failures may vary with time, and the ignorance of maintenance time will lead to unrealistic results. This paper develops maintenance policies for such situations where the system under study operates iteratively at two successive states: up or down. The costs due to system failure at the up state consist of both business losses & maintenance costs, whereas those at the down state only include maintenance costs. We consider three models: Model A, B, and C: Model A makes only corrective maintenance (CM). Model B performs imperfect preventive maintenance (PM) sequentially, and CM. Model C executes PM periodically, and CM; this PM can restore the system as good as the state just after the latest CM. The CM in this paper is imperfect repair. Finally, the impact of these maintenance policies is illustrated through numerical examples.

Which drugs cause preventable admissions to hospital? A systematic review

Aim: Previous systematic reviews have found that drug-related morbidity accounts for 4.3% of preventable hospital admissions. None, however, has identified the drugs most commonly responsible for preventable hospital admissions. The aims of this study were to estimate the percentage of preventable drug-related hospital admissions, the most common drug causes of preventable hospital admissions and the most common underlying causes of preventable drug-related admissions. Methods: Bibliographic databases and reference lists from eligible articles and study authors were the sources for data. Seventeen prospective observational studies reporting the proportion of preventable drug-related hospital admissions, causative drugs and/or the underlying causes of hospital admissions were selected. Included studies used multiple reviewers and/or explicit criteria to assess causality and preventability of hospital admissions. Two investigators abstracted data from all included studies using a purpose-made data extraction form. Results: From 13 papers the median percentage of preventable drug-related admissions to hospital was 3.7% (range 1.4-15.4). From nine papers the majority (51%) of preventable drug-related admissions involved either antiplatelets (16%), diuretics (16%), nonsteroidal anti-inflammatory drugs (11%) or anticoagulants (8%). From five studies the median proportion of preventable drug-related admissions associated with prescribing problems was 30.6% (range 11.1-41.8), with adherence problems 33.3% (range 20.9-41.7) and with monitoring problems 22.2% (range 0-31.3). Conclusions: Four groups of drugs account for more than 50% of the drug groups associated with preventable drug-related hospital admissions. Concentrating interventions on these drug groups could reduce appreciably the number of preventable drug-related admissions to hospital from primary care.

Causes of preventable drug-related hospital admissions: a qualitative study

Objective: To explore the causes of preventable drug-related admissions (PDRAs) to hospital. Design: Qualitative case studies using semi-structured interviews and medical record review; data analysed using a framework derived from Reason's model of organisational accidents and cascade analysis. Participants: 62 participants, including 18 patients, 8 informal carers, 17 general practitioners, 12 community pharmacists, 3 practice nurses and 4 other members of healthcare staff, involved in events leading up to the patients' hospital admissions. Setting: Nottingham, UK. Results: PDRAs are associated with problems at multiple stages in the medication use process, including prescribing, dispensing, administration, monitoring and help seeking. The main causes of these problems are communication failures ( between patients and healthcare professionals and different groups of healthcare professionals) and knowledge gaps ( about drugs and patients' medical and medication histories). The causes of PDRAs are similar irrespective of whether the hospital admission is associated with a prescribing, monitoring or patient adherence problem. Conclusions: The causes of PDRAs are multifaceted and complex. Technical solutions to PDRAs will need to take account of this complexity and are unlikely to be sufficient on their own. Interventions targeting the human causes of PDRAs are also necessary - for example, improving methods of communication.