Using spatial statistics to improve the primary forestry supply chain.
In: Sustainable forestry: from monitoring and modelling to knowledge management and policy science, S. 285-297
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In: Sustainable forestry: from monitoring and modelling to knowledge management and policy science, S. 285-297
BACKGROUND: Despite clinical advantages over conventional compounds, second-generation antipsychotics are prescribed less frequently in some European countries than in the United States because of their higher acquisition price and the current cost-containment strategies of many European health systems. This has been criticized on the grounds that the higher acquisition costs of the new antipsychotics might be more than outweighed by savings in other fields, e. g., through a reduction in rehospitalizations or indirect costs. METHOD: In order to create an empirical basis for this discussion, a review of the results of pharmacoeconomic studies (mostly cost-effectiveness studies) comparing second-generation with conventional antipsychotics was undertaken. RESULTS: Of the 35 studies identified, most report at least cost-neutrality of the new antipsychotics (in many cases clozapine) that is due to reductions in hospitalization costs. These results cannot be generalized, however, because of methodological shortcomings such as small patient samples and study designs with low validity, and especially because of a lack of studies performed outside the U.S. It is shown that results from studies in the U.S. cannot be generalized to other health systems in Europe or in developing countries. Furthermore, only a few findings on newer second-generation antipsychotics other than clozapine are reported, and no study investigated indirect costs, which play a major role because of the early onset and chronicity of schizophrenia. CONCLUSION: Until now, there has been no sufficient evidence for the superior cost-effectiveness of atypical antipsychotics in European countries. Considering the importance of this topic for health politics, more cost-effectiveness studies in European countries are urgently needed.But even if economic superiority of the second-generation antipsychotics cannot be demonstrated in such studies, their use is nevertheless indicated with respect to patient's well-being.
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OBJECTIVE: A comprehensive review of the present state and new approaches of patient participation in German psychiatry was conducted. METHODS: Literature search. RESULTS: Most psychiatric patients wish to be informed about their disease and treatment options and express a desire for participation in medical decisions. Patient representatives want to participate in political decisions concerning health care. There have been political and legal improvements in recent years, including the implementation of a federal government commissioner for patient issues and the publication of patients' rights. With regard to potential effects of programs promoting patient participation, there are almost no results available for German psychiatry. Pilot studies have demonstrated the feasibility of user involvement and shared decision making in mental health and have also shown favourable outcomes. CONCLUSIONS: Until now there has been no general implementation of user involvement in all areas of German psychiatry. However, the desire of patients to participate in all levels of health care system will tend to increase within the next years. Thus, it seems important for physicians to develop new skills in order to meet the participation and information needs of their patients.
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In: Journal of contemporary African studies, Band 16, Heft 1, S. 65-94
ISSN: 0258-9001
World Affairs Online
In: Economic notes, Band 28, Heft 3, S. 255-284
ISSN: 1468-0300
ESA ; CNES (France) ; CNRS/INSU-IN2P3-INP (France) ; ASI (Italy) ; CNR (Italy) ; INAF (Italy) ; NASA (USA) ; DoE (USA) ; STFC (UK) ; UKSA (UK) ; CSIC (Spain) ; MINECO (Spain) ; JA (Spain) ; RES (Spain) ; Tekes (Finland) ; AoF (Finland) ; CSC (Finland) ; DLR (Germany) ; MPG (Germany) ; CSA (Canada) ; DTU Space (Denmark) ; SER/SSO (Switzerland) ; RCN (Norway) ; SFI (Ireland) ; FCT/MCTES (Portugal) ; ERC (EU) ; PRACE (EU) ; UK BIS NEI grants ; Office of Science of the U.S. Department of Energy ; Canada Foundation for Innovation under Compute Canada ; Government of Ontario ; University of Toronto ; Science and Technology Facilities Council ; Office of Science of the U.S. Department of Energy: DE-AC02-05CH11231 ; Science and Technology Facilities Council: ST/L000768/1 ; Science and Technology Facilities Council: ST/L000652/1 ; Science and Technology Facilities Council: ST/J005673/1 ; Science and Technology Facilities Council: ST/M00418X/1 ; Science and Technology Facilities Council: ST/L000393/1 ; Science and Technology Facilities Council: ST/M007065/1 ; Science and Technology Facilities Council: ST/K00333X/1 ; The Planck full mission cosmic microwave background (CMB) temperature and E-mode polarization maps are analysed to obtain constraints on primordial non-Gaussianity (NG). Using three classes of optimal bispectrum estimators - separable template-fitting (KSW), binned, and modal we obtain consistent values for the primordial local, equilateral, and orthogonal bispectrum amplitudes, quoting as our final result from temperature alone f(NL)(local) = 2.5 +/- 5.7, f(NL)(equil) = 16 +/- 70, and f(NL)(ortho) = 34 +/- 33 (68% CL, statistical). Combining temperature and polarization data we obtain f(NL)(local) = 0.8 +/- 5.0, f(NL)(equil) = 4 +/- 43, and f(NL)(ortho) = 26 +/- 21 (68% CL, statistical). The results are based on comprehensive cross-validation of these estimators on Gaussian and non-Gaussian simulations, are stable across component separation techniques, pass an extensive suite of tests, and are consistent with estimators based on measuring the Minkowski functionals of the CMB. The effect of time-domain de-glitching systematics on the bispectrum is negligible. In spite of these test outcomes we conservatively label the results including polarization data as preliminary, owing to a known mismatch of the noise model in simulations and the data. Beyond estimates of individual shape amplitudes, we present model-independent, three-dimensional reconstructions of the Planck CMB bispectrum and derive constraints on early universe scenarios that generate primordial NG, including general single-field models of inflation, axion inflation, initial state modifications, models producing parity-violating tensor bispectra, and directionally dependent vector models. We present a wide survey of scale-dependent feature and resonance models, accounting for the look elsewhere effect in estimating the statistical significance of features. We also look for isocurvature NG, and find no signal, but we obtain constraints that improve significantly with the inclusion of polarization. The primordial trispectrum amplitude in the local model is constrained to be g(NL)(local) = (9.0 +/- 7.7) x 10(4) (68% CL statistical), and we perform an analysis of trispectrum shapes beyond the local case. The global picture that emerges is one of consistency with the premises of the Lambda CDM cosmology, namely that the structure we observe today was sourced by adiabatic, passive, Gaussian, and primordial seed perturbations.
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