Rethinking Rights Frohnen, Bruce P; Grasso, Kenneth L
2008, December 24, 2008, 20090101, Volume:
1
eBook
This book offers a radical reconsideration of the origins, nature, and role of rights in public life, interweaving perspectives of leading scholars in history, political science, philosophy, and law. ...An initial group of essays retraces the origins and historical development of rights in the West, assessing the influence of such thinkers as Locke, Burke, and the authors of the Declaration of Independence. A second group addresses the need to rethink our understanding of the nature of existence if we are to understand rights and their place in any decent life, examining the ontological basis of rights, the influence of custom on rights, the social nature of the human person, and the importance of institutional rights.
Healthcare worker (HCW) hand hygiene compliance is key to patient safety; however, compliance is suboptimal. Nevertheless hand hygiene compliance is not well studied in the long-term care setting.
To ...apply a behaviour change framework, the Theoretical Domains Framework (TDF), to identify modifiable facilitators and barriers for HCW hand hygiene compliance in long-term care settings.
HCW hand hygiene compliance facilitators and barriers were examined using a questionnaire for HCWs from long-term care homes in Ontario, Canada. The questionnaire was informed by the TDF, which is based on a synthesis of constructs from a number of relevant psychological theories of behaviour change.
Barriers identified from the questionnaire aligned with the TDF domain environmental context and resources (time pressure, workload, and environmental controls). Facilitators identified from questionnaire results aligned with the TDF domains social/professional role and identity (it is what is expected of HCWs), and beliefs about consequences (risk of transmission of micro-organisms to self or others).
There are several barriers to hand hygiene compliance that persist in long-term care. A behaviour change theory-informed framework such as the TDF can be helpful to identify those barriers. This study identified several key behavioural constructs aligned with the TDF that can be targeted when developing novel hand hygiene interventions.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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Background: The introduction of biosimilar colony-stimulating factors has led to the reduction in prices for these historically expensive therapies. To understand the impact of ...recent pricing trends on delivering efficient care, the cost-effectiveness of primary prophylaxis (PP) versus secondary prophylaxis (SP) using pegfilgrastim was assessed in patients with breast cancer, non–small-cell lung cancer (NSCLC), and non-Hodgkin lymphoma (NHL) receiving potentially curative chemotherapy at intermediate risk for febrile neutropenia per NCCN guidelines. Methods: A Markov decision analytic model was constructed from the US payer perspective over a lifetime horizon to evaluate pegfilgrastim PP versus SP in patients with breast cancer, NSCLC, and NHL receiving curative chemotherapy at intermediate risk of FN. Modeled chemotherapy regimens were adjuvant docetaxel (breast cancer), adjuvant carboplatin/paclitaxel (NSCLC), and R-CHOP (NHL) representing baseline FN risk of 16%, 18%, and 18%, respectively. Historical average sales prices (ASP) according to the Centers for Medicare and Medicaid Services of all pegfilgrastim products were obtained from January 2017 to April 2021. When more than one pegfilgrastim product was available, the average ASP was used as the cost input for the model. Cost-effectiveness for the base case scenario of each cancer type was evaluated over the range of years for cost per quality-adjusted life year (QALY) gained. Results: Pegfilgrastim as PP vs. SP provided an additional 0.069, 0.112, and 0.166 QALYs for breast cancer, NSCLC, and NHL, respectively. The peak ASP for pegfilgrastim was $4,554 per 6 mg during July 2018. Afterwards, a linear regression observed a declining ASP of approximately $134 dollars every 3 months to $3,024 per 6 mg during April 2021. At peak ASP, the incremental cost-effectiveness ratios (ICERs) for pegfilgrastim PP in patients with breast cancer, NSCLC, and NHL were $200,320, $113,942, and $103,495 per QALY, respectively. For April 2021, the ICERs were $124,845, $67,294, and $57,269 per QALY, respectively (Table). Conclusions: The trend of decreasing pegfilgrastim ASP improved the cost-effectiveness of PP vs. SP across intermediate risk breast cancer, NHL, and NSCLC indications between July 2018 to April 2021. For the most recent ASP, PP was cost-effective at a willingness-to-pay threshold of $100,000/QALY for NSCLC and NHL, and $150,000/QALY for breast cancer. This analysis provides support to expand the use of growth factor PP to intermediate risk patients. Table: see text
Most smokers abstain from smoking during hospitalization but relapse upon discharge. This study tests the effectiveness of two proven treatments (i.e., nicotine patches and telephone counseling) in ...helping these patients stay quit after discharge from the hospital, and assesses a model of hospital-quitline partnership.
This study had a 2×2 factorial design in which participants were stratified by recruitment site and smoking rate and randomly assigned to usual care, nicotine patches only, counseling only, or patches plus counseling. They were evaluated at 2 and 6 months post-randomization.
A total of 1,270 hospitalized adult smokers were recruited from August 2011 to November 2013 from five hospitals within three healthcare systems.
Participants in the patch condition were provided 8 weeks of nicotine patches at discharge (or were mailed them post-discharge). Quitline staff started proactively calling participants in the counseling condition 3 days post-discharge to provide standard quitline counseling.
The primary outcome measure was self-reported 30-day abstinence at 6 months using an intention-to-treat analysis. Data were analyzed from September 2015 to May 2016.
The 30-day abstinence rate at 6 months was 22.8% for the nicotine patch condition and 18.3% for the no-patch condition (p=0.051). Nearly all participants (99%) in the patch condition were provided nicotine patches, although 36% were sent post-discharge. The abstinence rates were 20.0% and 21.1% for counseling and no counseling conditions, respectively (p=0.651). Fewer than half of the participants in the counseling condition (47%) received counseling (mean follow-up sessions, 3.6).
Provision of nicotine patches proved feasible, although their effectiveness in helping discharged patients stay quit was not significant. Telephone counseling was not effective, in large part because of low rates of engagement. Future interventions will need to be more immediate to be effective.
This study is registered at www.clinicaltrials.gov NCT01289275.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
When a Standard Candle Flickers Wilson-Hodge, Colleen A; Cherry, Michael L; Case, Gary L ...
Astrophysical journal. Letters,
02/2011, Volume:
727, Issue:
2
Journal Article
Peer reviewed
Open access
The Crab Nebula is the only hard X-ray source in the sky that is both bright enough and steady enough to be easily used as a standard candle. As a result, it has been used as a normalization standard ...by most X-ray/gamma-ray telescopes. Although small-scale variations in the nebula are well known, since the start of science operations of the Fermi Gamma-ray Burst Monitor (GBM) in 2008 August, a ~7% (70 mCrab) decline has been observed in the overall Crab Nebula flux in the 15-50 keV band, measured with the Earth occultation technique. This decline is independently confirmed in the ~15-50 keV band with three other instruments: the Swift Burst Alert Telescope (Swift/BAT), the Rossi X-ray Timing Explorer Proportional Counter Array (RXTE/PCA), and the Imager on-Board the INTEGRAL Satellite (IBIS). A similar decline is also observed in the ~3-15 keV data from the RXTE/PCA and in the 50-100 keV band with GBM, Swift/BAT, and INTEGRAL/IBIS. The pulsed flux measured with RXTE/PCA since 1999 is consistent with the pulsar spin-down, indicating that the observed changes are nebular. Correlated variations in the Crab Nebula flux on a ~3 year timescale are also seen independently with the PCA, BAT, and IBIS from 2005 to 2008, with a flux minimum in 2007 April. As of 2010 August, the current flux has declined below the 2007 minimum.
Helping Hospitalized Smokers Cummins, Sharon E., PhD; Gamst, Anthony C., PhD; Brandstein, Kendra, PhD, MPH, MSW ...
American journal of preventive medicine,
October 2016, Volume:
51, Issue:
4
Journal Article
Peer reviewed
Open access
Introduction Most smokers abstain from smoking during hospitalization but relapse upon discharge. This study tests the effectiveness of two proven treatments (i.e., nicotine patches and telephone ...counseling) in helping these patients stay quit after discharge from the hospital, and assesses a model of hospital−quitline partnership. Study design This study had a 2×2 factorial design in which participants were stratified by recruitment site and smoking rate and randomly assigned to usual care, nicotine patches only, counseling only, or patches plus counseling. They were evaluated at 2 and 6 months post-randomization. Setting/participants A total of 1,270 hospitalized adult smokers were recruited from August 2011 to November 2013 from five hospitals within three healthcare systems. Intervention Participants in the patch condition were provided 8 weeks of nicotine patches at discharge (or were mailed them post-discharge). Quitline staff started proactively calling participants in the counseling condition 3 days post-discharge to provide standard quitline counseling. Main outcome measures The primary outcome measure was self-reported 30-day abstinence at 6 months using an intention-to-treat analysis. Data were analyzed from September 2015 to May 2016. Results The 30-day abstinence rate at 6 months was 22.8% for the nicotine patch condition and 18.3% for the no-patch condition ( p =0.051). Nearly all participants (99%) in the patch condition were provided nicotine patches, although 36% were sent post-discharge. The abstinence rates were 20.0% and 21.1% for counseling and no counseling conditions, respectively ( p =0.651). Fewer than half of the participants in the counseling condition (47%) received counseling (mean follow-up sessions, 3.6). Conclusions Provision of nicotine patches proved feasible, although their effectiveness in helping discharged patients stay quit was not significant. Telephone counseling was not effective, in large part because of low rates of engagement. Future interventions will need to be more immediate to be effective. Trial Registration This study is registered at www.clinicaltrials.gov NCT01289275.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The Gamma-ray Burst Monitor (GBM) on board Fermi has been providing continuous data to the astronomical community since 2008 August 12. In this paper, we present the results of the analysis of the ...first three years of these continuous data using the Earth occultation technique to monitor a catalog of 209 sources. From this catalog, we detect 99 sources, including 40 low-mass X-ray binary/neutron star systems, 31 high-mass X-ray binary/neutron star systems, 12 black hole binaries, 12 active galaxies, and 2 other sources, plus the Crab Nebula, and the Sun. Nine of these sources are detected in the 100-300 keV band, including seven black hole binaries, the active galaxy Cen A, and the Crab. The Crab and Cyg X-1 are also detected in the 300-500 keV band. GBM provides complementary data to other sky-monitors below 100 keV and is the only all-sky monitor above 100 keV. Up-to-date light curves for all of the catalog sources can be found online.
Concepts of Biology Samantha Fowler; Rebecca Roush; James Wise ...
04/2013
eBook
Open access
Concepts of Biology is designed for the typical introductory biology course for nonmajors, covering standard scope and sequence requirements. The text includes interesting applications and conveys ...the major themes of biology, with content that is meaningful and easy to understand. The book is designed to demonstrate biology concepts and to promote scientific literacy. Samantha Fowler, Clayton State University; Rebecca Roush, Sandhills Community College; James Wise, Hampton University
WHEN A STANDARD CANDLE FLICKERS WILSON-HODGE, Colleen A; CHERRY, Michael L; FINGER, Mark H ...
The Astrophysical journal,
2011, Volume:
727, Issue:
2
Journal Article
America is a nation making itself up as it goes along--a story of discovery and invention unfolding in speeches and images, letters and poetry, unprecedented feats of scholarship and imagination. In ...more than 200 original essays, this history brings together the nation's many voices.