Cost-effectiveness of intensified interventions to control healthcare-associated MRSA infections -- A systematic literature review

Methicillin Resistant Staphylococcus aureus healthcare-associated infections (MRSA HAIs) are a major cause of morbidity in hospitalized patients. They pose great economic burden to hospitals caring for these patients. Intensified Interventions aim to control MRSA HAIs. Cost-effectiveness of Intensified Interventions is largely unclear. We performed a review of cost-effectiveness literature on Intensified Interventions , and provide a summary of study findings, the status of economic research in the area, and information that will help decision-makers at regional level and guide future research.^ We conducted literature search using electronic database PubMed, EBSCO, and The Cochrane Library. We limited our search to English articles published after 1999. We reviewed a total of 1,356 titles, and after applying our inclusion and exclusion criteria selected seven articles for our final review. We modified the Economic Evaluation Abstraction Form provided by CDC, and used this form to abstract data from studies.^ Of the seven selected articles two were cohort studies and the remaining five were modeling studies. They were done in various countries, in different study settings, and with different variations of the Intensified Intervention . Overall, six of the seven studies reported that Intensified Interventions were dominant or at least cost-effective in their study setting. This effect persisted on sensitivity testing.^ We identified many gaps in research in this field. The cost-effectiveness research in the field is mostly composed of modeling studies. The studies do not always clearly describe the intervention. The intervention and infection costs and the sources for these costs are not always explicit or are missing. In modeling studies, there is uncertainty associated with some key model inputs, but these inputs are not always identified. The models utilized in the modeling studies are not always tested for internal consistency or validity. Studies usually test the short term cost-effectiveness of Intensified Interventions but not the long results.^ Our study limitation was the inability to adjust for differences in study settings, intervention costs, disease costs, or effectiveness measures. Our study strength is the presentation of a focused literature review of Intensified Interventions in hospital settings. Through this study we provide information that will help decision makers at regional level, help guide future research, and might change clinical care and policies. ^

Packages of interventions for family planning, safe abortion care, maternal, newborn and child health

The evidence shows that high maternal, perinatal, neonatal and child mortality rates are associated with inadequate and poor quality health services. Evidence also suggests that explicit, evidence-based, cost effective packages of interventions can improve the processes and outcomes of health care when appropriately implemented. This document describes the key effective interventions organized in packages across the continuum of care through pre-pregnancy, pregnancy, childbirth, postpartum, newborn care and care of the child. The packages are defined for community and/or facility levels in developing countries and provide guidance on the essential components needed to assure adequacy and quality of care

Effects of Conservation Interventions on the Archaeological Roman Site of Merida (Spain). Advance of Research

Efectos derivados de tratamientos de conservación y restauración sobre material inorgánico en yacimientos arqueológicos. Caso de estudio: Mérida.

Effects of conservation interventions on the archaeological Roman site of Merida (Spain). Advance of research.

Research on the assessment of the effects of conservation/restoration treatments on stone material has been significant in recent years, with focus on the early observation of decay caused by the application of these treatments. However, in the case of archaeological sites, research is still scarce and few studies on the subject have been published. Restoration, as everything else, has changed according to trends, mainly guided by the release of new products and technologies, an experimental field where scientific assessment of suitability, efficacy and durability pre-evaluations of treatments are not always conducted. Some efforts have been made to solve this problem in the architectural field, where functional needs and technical requirements force to set clear standards. Unfortunately, archaeological sites, unlike historic buildings, have specific features that preclude the extrapolation of these results. A critical review of the methodologies, products and restoration materials is necessary, coupled with deeper research on degradation mechanisms caused by these treatments in the mid- and long-term. The aim of this paper is to introduce the research on the above issues using Merida as a case study.

Integrated assessment of policy interventions for promoting sustainable irrigation in semi-arid environments: A hydro-economic modeling approach

Sustaining irrigated agriculture to meet food production needs while maintaining aquatic ecosystems is at the heart of many policy debates in various parts of the world, especially in arid and semi-arid areas. Researchers and practitioners are increasingly calling for integrated approaches, and policy-makers are progressively supporting the inclusion of ecological and social aspects in water management programs. This paper contributes to this policy debate by providing an integrated economic-hydrologic modeling framework that captures the socio-economic and environmental effects of various policy initiatives and climate variability. This modeling integration includes a risk-based economic optimization model and a hydrologic water management simulation model that have been specified for the Middle Guadiana basin, a vulnerable drought-prone agro-ecological area with highly regulated river systems in southwest Spain. Namely, two key water policy interventions were investigated: the implementation of minimum environmental flows (supported by the European Water Framework Directive, EU WFD), and a reduction in the legal amount of water delivered for irrigation (planned measure included in the new Guadiana River Basin Management Plan, GRBMP, still under discussion). Results indicate that current patterns of excessive water use for irrigation in the basin may put environmental flow demands at risk, jeopardizing the WFD s goal of restoring the ?good ecological status? of water bodies by 2015. Conflicts between environmental and agricultural water uses will be stressed during prolonged dry episodes, and particularly in summer low-flow periods, when there is an important increase of crop irrigation water requirements. Securing minimum stream flows would entail a substantial reduction in irrigation water use for rice cultivation, which might affect the profitability and economic viability of small rice-growing farms located upstream in the river. The new GRBMP could contribute to balance competing water demands in the basin and to increase economic water productivity, but might not be sufficient to ensure the provision of environmental flows as required by the WFD. A thoroughly revision of the basin s water use concession system for irrigation seems to be needed in order to bring the GRBMP in line with the WFD objectives. Furthermore, the study illustrates that social, economic, institutional, and technological factors, in addition to bio-physical conditions, are important issues to be considered for designing and developing water management strategies. The research initiative presented in this paper demonstrates that hydro-economic models can explicitly integrate all these issues, constituting a valuable tool that could assist policy makers for implementing sustainable irrigation policies.

New York: the revitalization of public space. Recent interventions in the Manhattan grid

La reticula de Nueva York ha sido un formato de nuevos planteamientos de "hacer ciudad" desde hace dos siglos. Esta ultima decada ha suspuesto un periodo fructifero para el espacio publico neoyorkino bajo la administracion de Michael Bloomerg. Esta revitalizacion no habria podido ser posible sin la reactivacion de factores de espacio publico que ya existian: la reticula, la legislacion publica y el rol del ciudadano. El ciudadano juega un papel fundamental en la ciudad, ya que es usuario, critico y promotor de espacio publico. Sin embargo, en ocasiones no es evidente para quien o quienes estan pensados los nuevos espacios publicos en la ciudad. Desde esta perspectiva, podemos identificar diferentes usuarios en la ciudad y analizar formulas recientes de espacio publico para cada uno de ellos: el vecino, el ciudadano, y el visitante. En palabras de Jane Jacobs: " las ciudades tienen la capacidad de proveer algo para todo el mundo, solo porque, y solo cuando, han sido proyectadas por todo el mundo".

Identifying effective behavioural components of Intervention and Comparison group support provided in SMOKing cEssation interventions (IC-SMOKE) : a systematic review protocol

Funding The research described in this paper is funded by Cancer Research UK, registered under application number C50862/A18446. The systematic review protocol reported in this paper was previously peer-reviewed by Cancer Research UK as part of the funding process. The funders had no role in protocol design, decision to publish, or preparation of the manuscript.

Non-pharmacological interventions to reduce the risk of diabetes in people with impaired glucose regulation : a systematic review and economic evaluation

Peer reviewed

Interventions for improving employment outcomes for workers with HIV

Acknowledgements We would like to thank Cochrane Work Trials Search Co-ordinators Leena Isotalo and Kaisa Neuvonen for developing the search strategy and Managing Editor Jani Ruotsalainen and Co-ordinating Editor Jos Verbeek for editing the text and providing helpful comments. We would also like to thank Richard Othieno for his contributions to the protocol.

Effectiveness and Content Analysis of Interventions to Enhance Oral Antidiabetic Drug Adherence in Adults with Type 2 Diabetes : Systematic Review and Meta-Analysis

Peer reviewed

A systematic review of the cost-effectiveness of non-surgical obesity interventions in men

Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Psychological and Social Perspectives on Malingering and Symptom Exaggeration: Conceptualization and Interventions Using Acceptance and Commitment Therapy

Malingering and the production of false symptoms seen in such disorders as Factitious Disorder are an ongoing mystery to medical and mental health professionals. Historically, these presentations have been difficult to identify and treat. As might be expected, individuals with such symptomology rarely agree to participate in research, possibly because of a reluctance to admit to the feigning or exaggerating behaviors and a fear of reprisals. Many different etiologies have been proposed, including the assumption of roles in order to manage impressions, taking control of symptoms in order to gain attention or other rewards or avoid aversive events, and even the production of symptoms that is largely out of awareness such as is seen in conversion or somatoform presentations. By examining historical and present-day beliefs about etiology and treatment interventions, professionals can explore what new types of effective treatment might look like. The behaviorist philosophy that underlies Acceptance and Commitment Therapy proposes a perspective emphasizing effective working in context. This philosophy also suggests individuals sometimes engage in behavior in order to escape from or avoid aversive experiences. Utilizing case examples and fresh behavioral perspectives provides insight and ideas for conceptualization of these behaviors of interest. Using the above conceptualizations, an ACT based treatment of those who produce false symptoms is introduced.