Background Influenza vaccination has been clinically shown to reduce adverse cardiovascular outcomes in acute coronary syndrome （ACS） patients, but the economic perspectives can provide important data to make inform...Background Influenza vaccination has been clinically shown to reduce adverse cardiovascular outcomes in acute coronary syndrome （ACS） patients, but the economic perspectives can provide important data to make informed decisions. This study aimed to perform the economic evaluation of lifelong annual influenza vaccination for cardiovascular events and well-established pneumonia prevention. Methods Lifetime costs, life-expectancy, and quality-adjusted live years （QALYs） were estimated beyond one-year cycle length of a six-health states Markov model condition on whether a hospitalization for ACS, stroke, heart failure, pneumonia, no hospitalizations occurred, or death. The comparison of three age-groups of 40-49, 50-65, and 〉 65 years scenario was performed. Incremental cost-effectiveness ratio （ICER） and net monetary benefit （NMB） were presented as a societal perspective in 2016. The model robustness was determined by one-way and prob- abilistic sensitivity analyses. Results The influenza vaccination was cost-effective in all age-groups, by dominant ICERs （lower cost with higher effectiveness） which was completely lower than acceptable willingness-to-pay threshold of Thailand [160,000 THB （4,466.8 USD） per QALYs], with a great incremental value of NMB. Especially, the 50-year-old-and- above scenario was shown as the most benefit at 129,092 THB （3,603.9 USD） for each patient. Conclusions The annually additional influenza vaccination to standard treatment in ACS was cost-effective in all age-groups, which should be considered in clinical practice and health-policy making process.展开更多
Coal burst represented a major hazard for some U.S. mining operations. This paper provides an historical review of the coal burst hazards,identifies the fundamental geological factors associated with these events,and ...Coal burst represented a major hazard for some U.S. mining operations. This paper provides an historical review of the coal burst hazards,identifies the fundamental geological factors associated with these events,and discusses mechanisms that can be used to avoid their occurrences. Coal burst are not common in most underground mines. Their occurrence almost always has such dramatic consequences to a mining operation that changes in practice are required. Fundamental factors influencing coal burst events include strong strata,abnormal strata caving,elevated stresses,critical size pillars and the lack of sufficiently sized barrier pillars during extraction. These factors interact to produce excessive stress,seismic shock and loss of confinement mechanisms. Over the 90 years of dealing with these hazards,many novel prevention controls have been developed including novel mine designs and extraction sequences,most of which are site specific in their application. Without an accurate assessment of the fundamental factors that influence coal burst and knowledge of their mechanisms of occurrence,control techniques may be misapplied and risk inadequately mitigated.展开更多
This paper will review three broad types of political implications of emergency management, since historically emergency management was considered only a function of law enforcement and fire departments, with the supp...This paper will review three broad types of political implications of emergency management, since historically emergency management was considered only a function of law enforcement and fire departments, with the support in the event of a major catastrophe from public health and civil defense organizations. The issue is not whether governments will be required to respond to emergencies but rather when and how frequently. The time to think about emergencies is before they happen. Despite some significant weakness in the overall approach, political implications offer many benefits and provide various options for CDCs （community development corporations） to get involved in disaster recovery and emergency management. Based upon a generally positive evaluation, the paper concludes that emergency management must become a central activity, whether at the federal, state, or local or as an intergovernmental activity. Hopefully for the future the government does not have to wait for a disaster to strike for one to put a policy into place, since they have had several to occur over decades. The government should be ready to take on any disaster if it occurs with the following policies and procedures that are in place.展开更多
文摘Background Influenza vaccination has been clinically shown to reduce adverse cardiovascular outcomes in acute coronary syndrome （ACS） patients, but the economic perspectives can provide important data to make informed decisions. This study aimed to perform the economic evaluation of lifelong annual influenza vaccination for cardiovascular events and well-established pneumonia prevention. Methods Lifetime costs, life-expectancy, and quality-adjusted live years （QALYs） were estimated beyond one-year cycle length of a six-health states Markov model condition on whether a hospitalization for ACS, stroke, heart failure, pneumonia, no hospitalizations occurred, or death. The comparison of three age-groups of 40-49, 50-65, and 〉 65 years scenario was performed. Incremental cost-effectiveness ratio （ICER） and net monetary benefit （NMB） were presented as a societal perspective in 2016. The model robustness was determined by one-way and prob- abilistic sensitivity analyses. Results The influenza vaccination was cost-effective in all age-groups, by dominant ICERs （lower cost with higher effectiveness） which was completely lower than acceptable willingness-to-pay threshold of Thailand [160,000 THB （4,466.8 USD） per QALYs], with a great incremental value of NMB. Especially, the 50-year-old-and- above scenario was shown as the most benefit at 129,092 THB （3,603.9 USD） for each patient. Conclusions The annually additional influenza vaccination to standard treatment in ACS was cost-effective in all age-groups, which should be considered in clinical practice and health-policy making process.
文摘Coal burst represented a major hazard for some U.S. mining operations. This paper provides an historical review of the coal burst hazards,identifies the fundamental geological factors associated with these events,and discusses mechanisms that can be used to avoid their occurrences. Coal burst are not common in most underground mines. Their occurrence almost always has such dramatic consequences to a mining operation that changes in practice are required. Fundamental factors influencing coal burst events include strong strata,abnormal strata caving,elevated stresses,critical size pillars and the lack of sufficiently sized barrier pillars during extraction. These factors interact to produce excessive stress,seismic shock and loss of confinement mechanisms. Over the 90 years of dealing with these hazards,many novel prevention controls have been developed including novel mine designs and extraction sequences,most of which are site specific in their application. Without an accurate assessment of the fundamental factors that influence coal burst and knowledge of their mechanisms of occurrence,control techniques may be misapplied and risk inadequately mitigated.
文摘This paper will review three broad types of political implications of emergency management, since historically emergency management was considered only a function of law enforcement and fire departments, with the support in the event of a major catastrophe from public health and civil defense organizations. The issue is not whether governments will be required to respond to emergencies but rather when and how frequently. The time to think about emergencies is before they happen. Despite some significant weakness in the overall approach, political implications offer many benefits and provide various options for CDCs （community development corporations） to get involved in disaster recovery and emergency management. Based upon a generally positive evaluation, the paper concludes that emergency management must become a central activity, whether at the federal, state, or local or as an intergovernmental activity. Hopefully for the future the government does not have to wait for a disaster to strike for one to put a policy into place, since they have had several to occur over decades. The government should be ready to take on any disaster if it occurs with the following policies and procedures that are in place.
