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Estimating the Cost of Public Health Interventions: Methodologies and Options
No full textInformation on the costs of public health interventions is crucial for policy makers to assess whether scarce resources are being used efficiently. There is growing recognition of the importance of cost analyses of health interventions at a local level particularly in developing countries. There are several methods available for costing of public health interventions but each method has its own strengths and weaknesses. This paper gives an outline of the basic principles of estimating costs of public health interventionsand types of costs to be in different perspectives chosen that have a considerable influence on the cost estimates
Four scales measuring mental wellbeing in the Nordic countries: do they tell the same story?
No full textBackground Mental wellbeing is an important focus in surveys among adolescents. Several relevant instruments are available. In the Nordic part of the Health Behaviour in School-aged Children (HBSC) study 2022, four different scales for the measurement of wellbeing, were employed: Cantril’s Ladder, the WHO-5 Wellbeing Index, the seven-item Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS), and the HBSC Health Complaints Scale. This study aims to examine statistically to what extent these scales overlap or measure distinctly different aspects of mental wellbeing. Methods Data stem from the Nordic part of the HBSC 2022 study (n=28 189). In all statistical analyses, data are weighted to ensure equal representation of genders, age groups (ages 11, 13, and 15 years), and countries (Denmark, Finland, Iceland, Norway, Sweden). Adjustments were made for cluster effects (school classes). The statistical analyses included factor analysis, general linear modeling, variants of latent variable analysis, and structural equation modeling including bifactor modeling. Results Exploratory factor analysis produced three factors corresponding well to the three multi-item instruments, with the single item Cantril’s ladder loading on the factor defined by the WHO-5 Wellbeing Index. Confirmatory factor analysis produced good ft for a model with one factor consisting of the three positively worded scales and a separate factor for health complaints, but with a high negative correlation between the two factors. Analyses of each of the four scales against gender, age, and 16 other covariates, showed strikingly similar patterns of associations. In an analysis based on a hierarchical model, adjustments for the general mental wellbeing (second-order) factor reduced associations between the first-order factors (one for each scale) and covariates substantially. Latent variable and bifactor modeling confirmed that most of the covariance among all items from all scales combined was captured by one general dimension. Information curve analysis showed that for all scales, the most reliable scores were obtained for participants with below average latent scores. Conclusion The study indicates that the four scales essentially reflect one underlying dimension. In studies such as HBSC, efforts should be made to use instruments that cover distinctly different aspects of mental health and wellbeing
Neurobiological Concomitants of Autism as Informers of Clinical Practice: a Status Review
No full textObjectives Although a great deal of research is conducted into the neurobiological correlates of autism, there has been no recent overview of the findings from this research in terms of how they translate to clinical practice. To provide an overview of recent literature in the fields of head size, brain volume, brain region, connectivity between brain regions, and synaptic function, as they apply to autism, with a view to informing clinical practice. Methods Major empirical and review papers on these topics from the last 30 years were identifed via a search of PubMed, Google Scholar, and PsychInfo, using the descriptors ‘autism’, ‘head size’, ‘brain volume’, ‘brain region’, ‘connectivity between brain regions’, and ‘synaptic function’. To distil the key findings relevant to clinical practice, both authors conducted blind reviews, producing a set of ‘key’ papers for this purpose. Results Each feld produced a number of major fndings, which were then described and discussed, and translated into a table of ‘Findings’, ‘Diagnostic suggestions’ (for the clinician’s protocols), and ‘Clinical actions’ (suggestions for interactions with carers of autistic children and adults). Conclusions The stability of the research within each field varies, with some clear findings and others that are yet to be consistently verified. Despite this, some specific clinical implications for diagnosis and treatment (particularly clinician-carer interactions) are described
The relationship between profitability and stock price of companies listed on The Stock Exchange of Thailand.
No full textImmune challenge changes social behavior in the guppy (Poecilia reticulata)
No full textIncreased exposure to pathogens is often considered to be one of the most significant costs of group living. As a result, animals typically avoid close association with individuals who manifest symptoms of disease. The question remains, however, whether avoidance behaviors are mediated by effects relating specifically to the disease itself, or through recognition of more general sickness behaviors that emerge from the activity of the immune system in response to infection. Here we examined the effects of an immune challenge, induced through exposure to bacterial lipopolysaccharides (LPS), on individual and social behavior in female guppies (Poecilia reticulata). We found that in a binary choice presentation, healthy focal individuals showed a strong preference to associate with stimulus shoals of saline-injected fish rather than stimulus shoals of LPS-injected fish. In a subsequent examination of group-level dynamics, shoals of LPS-injected females were more dispersed than similar shoals comprised of control fish and showed less coherent collective behavior despite the lack of any obvious difference in general activity between LPS and control fish. We discuss these findings in relation to the need for social animals to mitigate the risk of disease that is associated with living in proximity to conspecifics
Geometric morphometric analysis of cranium shape differences in sheep from colonial Sydney, Australia
Get PDFGeometric morphometrics (GMMs) is a valuable tool that can be used to identify variability within species, thereby distinguishing between breeds and closely related animals (e.g. sheep and goats). Identifying fine morphological differences is key to better understanding early herd management practices. Interestingly, GMMs has yet to be used in a colonial Australian context, particularly in the foundational period of colonial Sydney from 1790 to 1850. Given the overall importance of sheep to the development of colonial Australia, this analytical gap provides an opportunity to identify potential morphological variability, and so better understand colonial herd management strategies. Here we use GMMs to analyse an archaeological assemblage of sheep crania (n = 27) from the colonial Clarence Street site, in Sydney, Australia. These crania are compared to modern sheep specimens to test GMMs’ effectiveness at distinguishing between, as well as potentially allocating individuals to, specific breeds. We found certain morphological variations between the study assemblages, and so discuss our results in the context of a variety of explanatory frameworks such as differences in husbandrypractices in colonial Sydney
A rare functional haplotype of the P2RX4 and P2RX7 genes leads to loss of innate phagocytosis and confers increased risk of age-related macular degeneration
No full textAge-related macular degeneration (AMD) is a leading cause of blindness in Western countries and is diagnosed by the clinical appearance of yellow subretinal deposits called drusen. Genetic changes in immune components are clearly implicated in the pathology of this disease. We have previously shown that the purinergic receptor P2X7 can act as a scavenger receptor, mediating phagocytosis of apoptotic cells and insoluble debris. We performed a genetic association study of functional polymorphisms in the P2RX7 and P2RX4 genes in a cohort of 744 patients with AMD and 557 age-matched Caucasian control subjects. The P2X4 Tyr315Cys variant was 2-fold more frequent in patients with AMD compared to control subjects, with the minor allele predicting susceptibility to disease. Pairwise linkage disequilibrium was observed between Tyr315Cys in the P2RX4 gene and Gly150Arg in the P2RX7 gene, and these two minor alleles formed a rare haplotype that was overrepresented in patients with AMD (n=17) compared with control subjects (n=3) (odds ratio 4.05, P=0.026). Expression of P2X7 (wild type or variant 150Arg) in HEK293 cells conferred robust phagocytosis toward latex beads, whereas coexpression of the P2X7 150Arg with P2X4 315Cys variants almost completely inhibited phagocytic capacity. Fresh human monocytes harboring this heterozygous 150Arg-315Cys haplotype showed 40% reduction in bead phagocytosis. In the primate eye, immunohistochemistry indicated that P2X7 and P2X4 receptors were coexpressed on microglia and macrophages, but neither receptor was seen on retinal pigment epithelial cells. These results demonstrate that a haplotype including two rare variants in P2RX7 and P2RX4 confers a functional interaction between these two variant receptors that impairs the normal scavenger function of macrophages and microglia. Failure of this P2X7-mediated phagocytic pathway may impair removal of subretinal deposits and predispose individuals toward AMD.—Gu, B. J., Baird, P. N., Vessey, K. A., Skarratt, K. K., Fletcher, E. L., Fuller, S. J., Richardson, A. J., Guymer, R. H., Wiley, J. S. A rare functional haplotype of the P2RX4 and P2RX7 genes leads to loss of innate phagocytosis and confers increased risk of age related macular degeneration
Homelessness: A Health and Social Crisis
No full textHomelessness is an issue across the world with countries of all economies having numbers of homeless people. Globally, in 2020 it was estimated that more than 1.6 billion people were homeless (McWilliams et al. 2022). Australian census data indicate an increase in homelessness in Australia, especially among women, with recent estimates reporting 44.1% of homeless people in Australia were women (Australian Bureau of Statistics 2018). According to the Australian Bureau of Statistics (2018), Indigenous Australians comprise 20% of people who are homeless in Australia. International literature suggests that homeless populations are ageing, with more and more older people unable to find and afford suitable housing (Hargrave et al. 2022)
Low-dose interleukin 2 therapy halts the progression of poststreptococcal autoimmune complications in a rat model of rheumatic heart disease
No full textAcute rheumatic fever (ARF) is an autoimmune disease triggered by antibodies and T cells targeting the group A Streptococcus (GAS, Strep A) bacterium, often leading to rheumatic heart disease (RHD) and Sydenham’s chorea. Long-term monthly penicillin injections are recognized as a cornerstone of public health programs to prevent Strep A reinfection and progression of ARF. However, compliance is poor, and better tools are required to slow disease progression. Preclinical evidence suggests that this can be achieved. Using a rat model that replicates post-streptococcal autoimmune complications, we explored the potential of low-dose interleukin-2 (LD-IL-2) as an immunotherapeutic intervention for ARF/RHD. In this model, injections of recombinant M protein from Strep A type 5 (rM5) to Lewis rats induce cardiac tissue inflammation, conduction abnormalities, and cross-reactive antibodies against cardiac and brain proteins central to disease pathogenesis. In animals injected with rM5 and treated with LD-IL-2, no cardiac functional or histological changes was observed. LD-IL-2 therapy effectively reduced the production of cross-reactive antibodies raised against host proteins and significantly increased regulatory T cells in the mediastinal lymph nodes. These novel findings suggest that LD-IL-2 will be an effective immunotherapeutic agent for treating ARF and has the potential to replace the standard monthly penicillin injections
Muscarinic receptor protein expression in the ocular tissues of the chick during normal and myopic eye development
No full textMuscarinic receptor signalling has been implicated in both the embryonic and postnatal development of ocular structures as well as in myopic eye growth. A radioligand binding assay was used to determine whether changes in muscarinic receptor density and/or affinity occurred in the chick retina, choroid and sclera during early post-hatching development or with the induction of myopia. Specific receptor binding sites were saturable with increasing concentrations of the muscarinic receptor ligand [3H]N-methyl-scopolamine in the retina and choroid but not in the sclera. In normal eyes, binding density in the retina was not altered from age P5 to P10 (447±14 vs. 411±13 fmol/mg of protein, P=0.07). However, in the choroid, the number of receptor binding sites significantly increased between P5 and P10 (637±39 vs. 1125±121 fmol/mg of protein, PKD) was not altered with age in either the retina or choroid. Myopia was induced in chicks by deprivation of form vision, using translucent diffusers, from age P3. Despite the induction of significant degrees of ocular elongation and myopia at P5 (−8.7±0.3 D, P