Interdependent Factors of Demand-Side Rationale for Chemical, Biological, Radiological, and Nuclear Medical Countermeasures

2019 ◽  
pp. 1-17
Author(s):  
Mark Lawrence Johnson ◽  
Jean Belin ◽  
Frederic Dorandeu ◽  
Marianne Guille
Keyword(s):  
Government Procurement ◽  
Lessons Learned ◽  
Economic Consequences ◽  
Demand Side ◽  
Loss Of Life ◽  
Medical Expenses ◽  
Soft Factor ◽  
Health Vulnerability ◽  
The Impact ◽  
Medical Countermeasures

ABSTRACT The deliberate use of chemical, biological, radiological, and nuclear (CBRN) materials in war or terrorist attacks is perceived as a great threat globally. In the event of a release of CBRN agents, protection by means of medical countermeasures (MedCMs) could reduce health vulnerability. Nonetheless, for some diseases caused by these agents, innovative MedCMs do not exist and many of those that do might not be readily available. Inappropriate research and development funding and government procurement efforts can result in adverse economic consequences (eg, lost income, cost per loss of life, medical expenses) far exceeding the costs of strong and comprehensive preparedness initiatives. By illustrating factors of demand-side rationale for CBRN MedCMs, this article aims to strengthen integrity of policy-making associated with current demand requirements. Namely, an approach to inspire broader assessment is outlined by compiling and adapting existing economic models and concepts to characterize both soft and hard factors that influence demand-side rationale. First, the soft factor context is set by describing the impact of behavioral and political economics. Then, lessons learned from past public health funding models and associated collaborative access infrastructure are depicted to represent hard factors that can enhance the viability of MedCM preparedness evaluations.

scholarly journals Relevant lessons learned from the earthquakes El Asnam, 10/10/1980 and Zemmouri, 05/21/2003 on the paraseismic prevention in Algeria

2018 ◽  
Vol 149 ◽  
pp. 02040
Author(s):  
Yamina Ait-Meziane ◽  
Rania Souici ◽  
Farah Lazzali
Keyword(s):  
Risk Reduction ◽  
Seismic Risk ◽  
Lessons Learned ◽  
Risk Prevention ◽  
Loss Of Life ◽  
Seismic Code ◽  
Existing Structures ◽  
Fundamental Goal ◽  
Algerian Seismic Code ◽  
The Impact

In the field of seismic risk prevention in Algeria, the earthquake of El Asnam, 10/10/1980 is the triggering event and that of Zemmouri 21/05/2003 the accelerating element of the policy already in place. These two major events have been rich in information, as they are among the most studied internationally. The approaches and the development of methods for seismic risk reduction are based largely on feedback. The fundamental goal of seismic risk reduction is to avoid loss of life, which is mainly due to the partial or total collapse of structures. Exploiting lessons learned from past earthquakes is reflected in code requirements for new projects and approaches to vulnerability estimation for existing structures. In this paper, we give a description of the characteristics of the two events. The analysis of pathologies observed and the impact on the Algerian seismic code is discussed.

The Role of Threat and Economic Uncertainty in Support for Scottish Independence

2014 ◽  
Vol 23 (1) ◽  
pp. 103-124 ◽  
Author(s):  
Daniel Kopasker
Keyword(s):  
Economic Consequences ◽  
Perceived Threat ◽  
Constitutional Change ◽  
Lack Of Information ◽  
Economic Expectations ◽  
Scottish Independence ◽  
The Individual ◽  
The Impact ◽  
Levels Of Support

Existing research has consistently shown that perceptions of the potential economic consequences of Scottish independence are vital to levels of support for constitutional change. This paper attempts to investigate the mechanism by which expectations of the economic consequences of independence are formed. A hypothesised causal micro-level mechanism is tested that relates constitutional preferences to the existing skill investments of the individual. Evidence is presented that larger skill investments are associated with a greater likelihood of perceiving economic threats from independence. Additionally, greater perceived threat results in lower support for independence. The impact of uncertainty on both positive and negative economic expectations is also examined. While uncertainty has little effect on negative expectations, it significantly reduces the likelihood of those with positive expectations supporting independence. Overall, it appears that a general economy-wide threat is most significant, and it is conjectured that this stems a lack of information on macroeconomic governance credentials.

Characteristics of Physician Relocation Following Hurricane Katrina

2009 ◽  
Vol 95 (1) ◽  
pp. 6-12
Author(s):  
Kusuma Madamala ◽  
Claudia R. Campbell ◽  
Edbert B. Hsu ◽  
Yu-Hsiang Hsieh ◽  
James James
Keyword(s):  
Hurricane Katrina ◽  
Gulf Coast ◽  
General Medicine ◽  
The United States ◽  
Lessons Learned ◽  
Bivariate Analysis ◽  
Fisher Exact Test ◽  
Exact Test ◽  
Factors Associated ◽  
The Impact

ABSTRACT Introduction: On Aug. 29, 2005, Hurricane Katrina made landfall along the Gulf Coast of the United States, resulting in the evacuation of more than 1.5 million people, including nearly 6000 physicians. This article examines the relocation patterns of physicians following the storm, determines the impact that the disaster had on their lives and practices, and identifies lessons learned. Methods: An Internet-based survey was conducted among licensed physicians reporting addresses within Federal Emergency Management Agency-designated disaster zones in Louisiana and Mississippi. Descriptive data analysis was used to describe respondent characteristics. Multivariate logistic regression was performed to identify the factors associated with physician nonreturn to original practice. For those remaining relocated out of state, bivariate analysis with x2 or Fisher exact test was used to determine factors associated with plans to return to original practice. Results: A total of 312 eligible responses were collected. Among disaster zone respondents, 85.6 percent lived in Louisiana and 14.4 percent resided in Mississippi before the hurricane struck. By spring 2006, 75.6 percent (n = 236) of the respondents had returned to their original homes, whereas 24.4 percent (n = 76) remained displaced. Factors associated with nonreturn to original employment included family or general medicine practice (OR 0.42, 95 percent CI 0.17–1.04; P = .059) and severe or complete damage to the workplace (OR 0.24, 95 percent CI 0.13–0.42; P < .001). Conclusions: A sizeable proportion of physicians remain displaced after Hurricane Katrina, along with a lasting decrease in the number of physicians serving in the areas affected by the disaster. Programs designed to address identified physician needs in the aftermath of the storm may give confidence to displaced physicians to return.

Pound Wise and Penny Foolish? Weight Loss and The Dynamics of Health Care Spending

2011 ◽  
Vol 14 (2) ◽  
Author(s):  
Thomas G Koch
Keyword(s):  
Weight Loss ◽  
Cost Savings ◽  
Cost Effective ◽  
Economic Consequences ◽  
Health Care Spending ◽  
Order Of Magnitude ◽  
Dynamic Measures ◽  
The Cost ◽  
The Impact ◽  
The Relationship

Current estimates of obesity costs ignore the impact of future weight loss and gain, and may either over or underestimate economic consequences of weight loss. In light of this, I construct static and dynamic measures of medical costs associated with body mass index (BMI), to be balanced against the cost of one-time interventions. This study finds that ignoring the implications of weight loss and gain over time overstates the medical-cost savings of such interventions by an order of magnitude. When the relationship between spending and age is allowed to vary, weight-loss attempts appear to be cost-effective starting and ending with middle age. Some interventions recently proven to decrease weight may also be cost-effective.

Optimizing electronic capture of patient-reported outcome measures in oncology clinical trials: lessons learned from a qualitative study

2020 ◽  
Vol 9 (17) ◽  
pp. 1195-1204
Author(s):  
Florence D Mowlem ◽  
Brad Sanderson ◽  
Jill V Platko ◽  
Bill Byrom
Keyword(s):  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Lessons Learned ◽  
Structured Interviews ◽  
Patient Reported ◽  
Oncology Clinical Trials ◽  
Anticancer Treatment ◽  
Fit For Purpose ◽  
The Impact ◽  
Electronic Implementation

Aim: To understand the impact of anticancer treatment on oncology patients’ ability to use electronic solutions for completing patient-reported outcomes (ePRO). Materials & methods: Semi-structured interviews were conducted with seven individuals who had experienced a cancer diagnosis and treatment. Results: Participants reported that the following would impact the ability to interact with an ePRO solution: peripheral neuropathy of the hands (4/7), fatigue and/or concentration and memory issues (6/7), where they are in a treatment cycle (5/7). Approaches to improve usability included: larger, well-spaced buttons to deal with finger numbness, the ability to pause a survey and complete at a later point and presenting the recall period with every question to reduce reliance on memory. Conclusion: Symptoms associated with cancers and anticancer treatments can impact the use of technologies. The recommendations for optimizing the electronic implementation of patient-reported outcome instruments in this population provides the potential to improve data quality in oncology trials and places patient needs at the forefront to ensure ‘fit-for-purpose’ solutions.

Application of a Tax to E-Commerce Deliveries in Barcelona

2021 ◽  
pp. 036119812110124
Author(s):  
Genís Majoral ◽  
Francesc Gasparín ◽  
Sergi Saurí
Keyword(s):  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Supply Side ◽  
Environmental Tax ◽  
Positive Outcomes ◽  
Demand Side ◽  
Benefit Analysis ◽  
Revenue Collection ◽  
Last Mile ◽  
The Impact

The number of e-commerce transactions is increasing worldwide. Deliveries of goods purchased online generate externalities throughout the whole supply chain and, particularly, the increasing concern about the last-mile distribution of goods. The escalating presence of vans in cities contributes to poor air quality, climate change, noise, and congestion. So far, the majority of solutions to address this issue are based on the supply side, such as electric vans, optimizing the routing and pick-up-points, and so forth. Even in other transport sectors, pricing solutions are well known, yet they have not been extended to e-commerce delivery. This paper aims to propose an environmental tax falling on the demand side and equaling the externalities from this activity. The analysis has been particularized for the case of Barcelona. A cost–benefit analysis to assess the impact of such a tax has been carried out. When revenue collection is reinvested in the logistics sector, and for subsidizing electric distribution vehicles, the results indicate that the levying of the tax can generate positive outcomes.

scholarly journals The Impact of COVID-19 Related Lockdown on the Prevalence of Spousal Violence Against Women in Kurdistan Region of Iraq

2021 ◽  
pp. 088626052199792
Author(s):  
Kazhan I. Mahmood ◽  
Sherzad A. Shabu ◽  
Karwan M. M-Amen ◽  
Salar S. Hussain ◽  
Diana A. Kako ◽  
...  
Keyword(s):  
Violence Against Women ◽  
Emotional Abuse ◽  
Physical Violence ◽  
Lessons Learned ◽  
Spousal Violence ◽  
Kurdistan Region ◽  
Gender Based Violence ◽  
Effective Prevention ◽  
Gender Based ◽  
The Impact

There is increasing concern about the impact of the COVID-19 pandemic and the lockdown’s social and economic consequences on gender-based violence. This study aimed to assess the impact of the COVID-19 pandemic on gender-based violence by comparing the prevalence of spousal violence against women before and during the COVID-19 related lockdown periods. This study was conducted in the Kurdistan Region of Iraq using a self-administered online questionnaire survey after the COVID-19 lockdown period in June 2020. Data were collected from a sample of 346 married women about the occurrence, frequency, and forms of spousal violence before and during the lockdown period. Significant increases in violence were observed from the pre-lockdown period to the lockdown period for any violence (32.1% to 38.7%, p = .001), emotional abuse (29.5% to 35.0%, p = .005), and physical violence (12.7% to 17.6%, p = .002). Regarding emotional abuse, humiliation (24.6% to 28.3%, p = .041) and scaring or intimidation (14.2% to 21.4%, p < .001) significantly increased during the lockdown. For physical violence, twisting the arm or pulling hair (9.0% to 13.0%, p = .004) and hitting (5.2% to 9.2%, p = .003) significantly increased during the lockdown. Forcing to have sexual intercourse also significantly increased during lockdown (6.6% to 9.5%., p = .021). The concerned authorities and women’s rights organizations should collaborate to enhance the prevention of violence against women. An effective prevention strategy should emphasize recognizing and acknowledging the extent of the problem, raising awareness about the problem and the available resources to address it, and ensuring social and economic stability. Lessons learned about the increased prevalence of spousal violence against women during the COVID-19 pandemic and the need to adopt appropriate strategies to prevent and address it will be valuable for similar future crises.

Evaluating and Motivating Activation in Long Term Care: Lessons From a Pilot Study

2021 ◽  
Vol 10 (1) ◽  
pp. 42-46
Author(s):  
J. Jbilou ◽  
A. El Bouazaoui ◽  
B. Zhang ◽  
J.L. Henry ◽  
L McDonald ◽  
...  
Keyword(s):  
Long Term Care ◽  
Driving Simulator ◽  
Care Home ◽  
Lessons Learned ◽  
Term Care ◽  
Care Facilities ◽  
Technological Intervention ◽  
The Impact ◽  
Research Recommendations

Older adults living in long-term care facilities typically receive insufficient exercise and have long periods of the day when they are not doing anything other than sitting or lying down, watching television, or ruminating (Wilkinson et al., 2017). We developed an intervention called the Experiential Centivizer, which provides residents with opportunities to use a driving simulator, watch world travel videos, and engage in exercise. We assessed the impact of the intervention on residents of a long-term care home in Fredericton, NB, Canada. In this paper, we report on the results observed and highlight the lessons learned from implementing a technological intervention within a long-term care setting. Practical and research recommendations are also discussed to facilitate future intervention implementation in long-term care.

scholarly journals Enhancing Behavioral Health Competencies for Senior Center Staff: Lessons Learned From Workforce Training Efforts

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 1-1
Author(s):  
Bronwyn Keefe ◽  
Jennifer Tripken
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Behavioral Health ◽  
Lessons Learned ◽  
Organizational Level ◽  
Senior Center ◽  
Senior Centers ◽  
Knowledge And Skills ◽  
Center Staff ◽  
The Impact

Abstract Increases in the numbers of older adults with mental health and substance use concerns compel us to identify best practices in training to address these issues. Senior Centers are an ideal location for behavioral health education programs as they are the go-to place for many older adults. This session will describe a program funded by The Retirement Research Foundation and offered in collaboration with Center for Aging and Disability Education and Research at Boston University and NCOA to increase senior center staff knowledge and skills. Approximately 250 senior center staff in Illinois, Florida, and Wisconsin completed an online certificate in Behavioral Health and Aging. Results show that 100% of respondents felt that the training was useful for their job; 93% felt that they will be a more effective worker as a result of the training; and 97% felt that the information they learned in the training will make a difference with the people they serve. We held key informant interviews to assess the impact of training and participants stated that their knowledge, skills, and behaviors were influenced by the program. At the organizational level, leaders reported new programming related to behavioral health and revised practices and protocols. This presentation will cover: (1) the extent to which training participants mastered the competencies needed for effective practice; (2) knowledge and skills gained from the training program; (3) Senior Centers’ capacity to identify and refer older adults to mental health services; and (4) organizational changes related to behavioral health programming with older adults.

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