1,355,830 research outputs found
The Economic Value of Rotavirus Vaccination When Optimally Implemented in a High-Income Country
No full textRotavirus vaccination was introduced in high-income countries starting in 2006, with no recommendation for optimal implementation. Economic evaluations were presented before launch projecting potential impacts. Few economic reassessments have been reported following reimbursement. This study compares the short- to long-term economic value of rotavirus vaccination between pre-launch predictions and real-world evidence collected over 15 years, proposing recommendations for optimal vaccine launch. A cost-impact analysis compared rotavirus hospitalisation data after the introduction of vaccination between pre-launch modelled projections and observed data collected in the RotaBIS study in Belgium. A best model fit of the observed data was used to simulate launch scenarios to identify the optimal strategy. Data from other countries in Europe were used to confirm the potential optimal launch assessment. The Belgian analysis in the short term (first 8 years) indicated a more favourable impact for the observed data than predicted pre-launch model results. The long-term assessment (15 years) showed bigger economic disparities in favour of the model-predicted scenario. A simulated optimal vaccine launch, initiating the vaccination at least 6 months prior the next seasonal disease peak with an immediate very high vaccine coverage, indicated important additional potential gains, which would make vaccination very cost impactful. Finland and the UK are on such a route leading to long-term vaccination success, whereas Spain and Belgium have difficulties in achieving optimum vaccine benefits. An optimal launch of rotavirus vaccination may generate substantial economic gains over time. For high-income countries that are considering implementing rotavirus vaccination, achieving an optimal launch is a critical factor for long-term economic success
Mary T. Clark, Augustine, Philosopher of Freedom. A Study in Comparative Philosophy
No full textStandaert P. Mary T. Clark, Augustine, Philosopher of Freedom. A Study in Comparative Philosophy. In: Revue Philosophique de Louvain. Troisième série, tome 59, n°63, 1961. pp. 543-544
Comment on Postma et al. Predicted Public Health and Economic Impact of Respiratory Syncytial Virus Vaccination with Variable Duration of Protection for Adults ≥60 Years in Belgium. <i>Vaccines</i> 2023, <i>11</i>, 990
No full textPresently, there are at least five important vaccine producers that have already launched or intend to launch a new vaccine designed to prevent infections caused by the Respiratory Syncytial Virus (RSV), which is highly prevalent in the youngest as well as the oldest age groups [...
Defining the Recipe for an Optimal Rotavirus Vaccine Introduction in a High-Income Country in Europe
No full textObservational data over 15 years of rotavirus vaccine introduction in Belgium have indicated that rotavirus hospitalisations in children aged <5 years plateaued at a higher level than expected, and was followed by biennial disease peaks. The research objective was to identify factors influencing these real-world vaccine impact data. We constructed mathematical models simulating rotavirus-related hospitalisations by age group and year for those children. Two periods were defined using different model constructs. First, the vaccine uptake period encompassed the years required to cover the whole at-risk population. Second, the post-uptake period covered the years in which a new infection/disease equilibrium was reached. The models were fitted to the observational data using optimisation programmes with regression and differential equations. Modifying parameter values identified factors affecting the pattern of hospitalisations. Results indicated that starting vaccination well before the peak disease season in the first year and rapidly achieving high coverage was critical in maximising early herd effect and minimising secondary sources of infection. This, in turn, would maximise the reduction in hospitalisations and minimise the size and frequency of subsequent disease peaks. The analysis and results identified key elements to consider for countries initiating an optimal rotavirus vaccine launch programme
Direct and Indirect Government Venture Capital Investments in Europe
No full textThis paper provides evidence of the broad government presence in the European venture capital industry. Two forms of intervention are considered: first, direct stand-alone government venture capital funds and, second, indirect private funds to which governments commit funds as limited partners. The overall government presence seems to be much more important than previously documented, as we find that the government intervenes, on average, in 42.2% of venture capital investments in Europe. We also show that European countries are heterogeneous in their use of these two channels, and we consider possible early explanations for this choice of policy mix. Lastly, we provide some evidence on the consequences of these policies in terms of SME's perceived access to financing
Striatal cholinergic dysfunction as a unifying theme in the pathophysiology of dystonia
No full textDystonia is a movement disorder of both genetic and non-genetic causes, which typically results in twisted posturing due to abnormal muscle contraction. Evidence from dystonia patients and animal models of dystonia indicate a crucial role for the striatal cholinergic system in the pathophysiology of dystonia. In this review, we focus on striatal circuitry and the centrality of the acetylcholine system in the function of the basal ganglia in the control of voluntary movement and ultimately clinical manifestation of movement disorders. We consider the impact of cholinergic interneurons (ChIs) on dopamine-acetylcholine interactions and examine new evidence for impairment of ChIs in dysfunction of the motor systems producing dystonic movements, particularly in animal models. We have observed paradoxical excitation of ChIs in the presence of dopamine D2 receptor agonists and impairment of striatal synaptic plasticity in a mouse model of DYT1 dystonia, which are improved by administration of recently developed M1 receptor antagonists. These findings have been confirmed across multiple animal models of DYT1 dystonia and may represent a common endophenotype by which to investigate dystonia induced by other types of genetic and non-genetic causes and to investigate the potential effectiveness of pharmacotherapeutics and other strategies to improve dystonia
Did we follow the right approach in economic evaluations by discounting health gain?
No full textOBJECTIVES: Discounting health is routinely applied in health economic evaluations causing debates 4 about its appropriate level and whether it should be equivalent or lower than discounting cost. Different 5 fundamental arguments were put forward to keep the discount rate for health the same as for cost. 6 Differential discounting may cause inconsistencies in the interpretation of the results or may cause 7 paradoxes in initiating prevention. The question we have however is different, is health gain a suitable 8 measure to be discounted like money is? 9 METHODS: Looking at economic assessments of consumable goods, discounting is only applied to the 10 monetary value. Money is a flexible instrument for trading purposes, but subject to value changes over time. 11 With money, product value can be expressed with value-based pricing processes the consumer is willing to 12 pay. Money is then discounted in that process because its amount allows to do other things within different 13 time periods. However, the outcomes of the processes that can be instantaneous or continuous such as 14 energy (joules), distance travelled (km), cooling periods (temperature), are not part of the discounting if the 15 outcome is produced over a long duration period. 16 RESULTS: In health economics of new interventions brought into the market, values are presented with an 17 obliged discount for the heath outcome that could however be considered equivalent to energy, travelled 18 distance, cooling periods, and the like. We are presenting a list of comparative conditions between the 19 economic assessment of consumable goods versus the situation in healthcare in which paradoxical 20 conditions are highlighted especially related to the situation of vaccine prevention. 21 CONCLUSIONS: This analysis should give us the right arguments that health gain is not a suitable 22 outcome measure for being discounted. 23 2
Did we follow the right approach in economic evaluations by discounting health gain?
No full textOBJECTIVES: Discounting health is routinely applied in health economic evaluations causing debates 4 about its appropriate level and whether it should be equivalent or lower than discounting cost. Different 5 fundamental arguments were put forward to keep the discount rate for health the same as for cost. 6 Differential discounting may cause inconsistencies in the interpretation of the results or may cause 7 paradoxes in initiating prevention. The question we have however is different, is health gain a suitable 8 measure to be discounted like money is? 9 METHODS: Looking at economic assessments of consumable goods, discounting is only applied to the 10 monetary value. Money is a flexible instrument for trading purposes, but subject to value changes over time. 11 With money, product value can be expressed with value-based pricing processes the consumer is willing to 12 pay. Money is then discounted in that process because its amount allows to do other things within different 13 time periods. However, the outcomes of the processes that can be instantaneous or continuous such as 14 energy (joules), distance travelled (km), cooling periods (temperature), are not part of the discounting if the 15 outcome is produced over a long duration period. 16 RESULTS: In health economics of new interventions brought into the market, values are presented with an 17 obliged discount for the heath outcome that could however be considered equivalent to energy, travelled 18 distance, cooling periods, and the like. We are presenting a list of comparative conditions between the 19 economic assessment of consumable goods versus the situation in healthcare in which paradoxical 20 conditions are highlighted especially related to the situation of vaccine prevention. 21 CONCLUSIONS: This analysis should give us the right arguments that health gain is not a suitable 22 outcome measure for being discounted. 23 2
Going Beyond Counting First Authors in Author Co-citation Analysis
No full textThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Altered responses to dopaminergic D2 receptor activation and N-type calcium currents in striatal cholinergic interneurons in a mouse model of DYT1 dystonia
No full textEarly-onset torsion dystonia (DYT1) is an autosomal dominant disease caused by a deletion in the gene encoding the protein torsinA. Recently, a transgenic mouse model of DYT1 has been described, expressing either the human wild-type torsinA (hWT) or mutant torsinA (hMT). We recorded the activity of striatal cholinergic interneurons of hWT, hMT, and control mice. In slice preparations, no significant differences were observed in resting membrane potential (RMP), firing activity, action potential duration or Ih current. Quinpirole, a D2-like dopamine receptor agonist, did not produce detectable effects on RMP of cholinergic interneurons in control mice and hWT mice, but in the hMT mice caused membrane depolarization and an increase in the firing rate. D2 receptor activation inhibits N-type high-voltage-activated calcium currents. We found that, in isolated interneurons from hMT mice, the quinpirole-mediated inhibition of N-type currents was significantly larger than in hWT and controls. Moreover, the N-type component was significantly over-represented in hMT mice. The altered sensitivity of N-type channels in hMT mice could account for the paradoxical excitatory effect of D2 stimulation. Our data support the existence of an imbalance between striatal dopaminergic and cholinergic signaling in DYT1 dystonia. © 2006 Elsevier Inc. All rights reserved
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