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Health Technology Assessment in Support of National Health Insurance in South Africa
- Maryke Wilkinson, Andrew Lofts Gray, Roger Wiseman, Tamara Kredo, Karen Cohen, Jacqui Miot, Mark Blecher, Paul Ruff, Yasmina Johnson, Mladen Poluta, Shelley McGee, Trudy D Leong, Mark Brand, Fatima Suleman, Esnath Maramba, Marc Blockman, Janine Jugathpal, Susan Cleary, Noluthando Nematswerani, Sarvashni Moodliar, Andy Parrish, Khadija K Jamaloodien, Tienie Stander, Kim MacQuilkan, Nicholas Crisp, Thomas Wilkinson
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- Journal:
- International Journal of Technology Assessment in Health Care / Volume 38 / Issue 1 / 2022
- Published online by Cambridge University Press:
- 06 May 2022, e44
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South Africa has embarked on major health policy reform to deliver universal health coverage through the establishment of National Health Insurance (NHI). The aim is to improve access, remove financial barriers to care, and enhance care quality. Health technology assessment (HTA) is explicitly identified in the proposed NHI legislation and will have a prominent role in informing decisions about adoption and access to health interventions and technologies. The specific arrangements and approach to HTA in support of this legislation are yet to be determined. Although there is currently no formal national HTA institution in South Africa, there are several processes in both the public and private healthcare sectors that use elements of HTA to varying extents to inform access and resource allocation decisions. Institutions performing HTAs or related activities in South Africa include the National and Provincial Departments of Health, National Treasury, National Health Laboratory Service, Council for Medical Schemes, medical scheme administrators, managed care organizations, academic or research institutions, clinical societies and associations, pharmaceutical and devices companies, private consultancies, and private sector hospital groups. Existing fragmented HTA processes should coordinate and conform to a standardized, fit-for-purpose process and structure that can usefully inform priority setting under NHI and for other decision makers. This transformation will require comprehensive and inclusive planning with dedicated funding and regulation, and provision of strong oversight mechanisms and leadership.
The rise of Portuguese Antarctic research: implications for Portugal's status under the Antarctic Treaty
- José C. Xavier, Andrew D. Gray, Kevin A. Hughes
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- Journal:
- Polar Record / Volume 54 / Issue 1 / January 2018
- Published online by Cambridge University Press:
- 22 February 2018, pp. 11-17
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Portugal has developed an active Antarctic programme over the past decade. Here, we examine Portuguese Antarctic activity using a variety of bibliometric measures, showing that Portuguese scientific output has grown substantially faster than the field as a whole, with quality remaining broadly constant. Antarctic science made up a growing percentage of overall Portuguese research, up to 0.14% of all papers in 2016—a level comparable to many other nations with well-established research programmes. Alongside this, Portugal has increasingly engaged in policy discussions and produced policy papers for Antarctic Treaty Consultative Meetings, some of which were based on Portuguese environmental science. The Antarctic Treaty reserves decision-making powers to ‘Consultative Parties’—those who have been recognised as demonstrating substantial research activity in the continent. Our data indicates that Portugal is currently the fourth most productive non-Consultative Party, and has similar or greater output than several Parties who have already attained consultative status—its publication record is similar to that of the Czech Republic, which became a Consultative Party in 2014. The rapid growth of Portugal's Antarctic research may make it well placed to consider attaining consultative status to the Antarctic Treaty in the near future.
Vegetable Crop Response to EPTC Applied Preemergence Under Low-Density Polyethylene and High Barrier Plastic Mulch
- Rebekah D. Wallace, A. Stanley Culpepper, Andrew W. MacRae, Lynn M. Sosnoskie, Timothy L. Grey
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- Journal:
- Weed Technology / Volume 26 / Issue 1 / March 2012
- Published online by Cambridge University Press:
- 20 January 2017, pp. 54-60
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The continued phase-out of methyl bromide (MBr) challenges vegetable growers' abilities to control weeds in plasticulture production. Herbicides, such as EPTC (S-ethyl dipropylthiocarbamate), may be needed as part of a MBr alternative system. An experiment was conducted during the springs of 2008 and 2009 in Ty Ty, GA, to determine tomato, pepper, eggplant, and watermelon tolerance to EPTC applied under mulch. Treatments consisted of a factorial arrangement of four rates of EPTC (0, 2, 3, or 4 kg ai ha−1) and two plastic mulch types (low density polyethylene [LDPE] mulch or a high barrier mulch [HBM]). Each crop was planted 28 d after applying herbicides and laying mulch. EPTC, regardless of rate, applied under LDPE mulch did not impact plant growth, fruit number produced, or fruit weights for any crop. Conversely, pepper, tomato, and eggplant heights were reduced 65 to 72%, 30 to 75%, and 9 to 32%, respectively, by EPTC at 2 to 4 kg ai ha−1 when applied under HBM. Similar trends were observed for crop yield; fruit number and weight were reduced by 71 to 84% for pepper, 36 to 76% for tomato, and 7 to 15% for eggplant when EPTC was applied at 2 to 4 kg ai ha−1 as compared to the no EPTC HBM control. Watermelon stem lengths, fruit number, and fruit weights were not impacted by EPTC applied under HBM mulch. It appears as though HBMs reduce the loss of EPTC through volatilization, thereby increasing the dose present at time of planting. EPTC could be included as part of a MBr alternative system for tomato, pepper, eggplant, and watermelon when applied under LDPE mulch, and may also be applied at labeled rates with the HBM utilized in this experiment for watermelon.
Presence of Irritability During Depressive Episodes in Bipolar Disorder
- Thilo Deckersbach, Roy H. Perlis, W. Gordon Frankle, Stephen M. Gray, Louisa Grandin, Darin D. Dougherty, Andrew A. Nierenberg, Gary S. Sachs
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- Journal:
- CNS Spectrums / Volume 9 / Issue 3 / March 2004
- Published online by Cambridge University Press:
- 07 November 2014, pp. 227-231
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Background:This study examined the prevalence of irritability in patients with bipolar I disorder during an episode of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) major depression who do not meet criteria for a mixed episode.
Method:A chart review of 111 patients with bipolar I disorder treated at the Massachusetts General Hospital Bipolar Clinic between 1998 and 2000 identified 34 patients who met criteria for a DSM-IV major depressive episode in the absence of (1) mood elevation and/or (2) irritability associated with any additional above threshold DSM-IV symptoms of mania. Data gathered from the charts utilized prospective ratings made routinely at each clinic visit using the Clinical Monitoring Form (CMF), a structured assessment instrument which includes modified versions of the mood modules of the Structured Clinical Interview for DSM-IV. Data from these 34 patients were reviewed to determine the presence of irritability.
Results:The frequency of abnormal irritability in these 34 patients followed a bimodal distribution: 26% of the patients showed abnormal irritability ≥75% of the time, compared with 68% of the patients with abnormal irritabihty ≤30% of the time. Of the high-irritability patients, psychomotor agitation was rated as definitely present to a significant degree in 44%. Talkativeness and distractibility were rated present but subthreshold in one patient each. All other symptoms of DSM-IV mania were absent.
Conclusion:Approximately 25% of patients with bipolar I disorder who meet criteria for a DSM-IV major depressive episode also experienced substantial irritability in the absence of associated symptoms of mania. Our results suggest that abnormal irritability is not limited to mania or mixed states.
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- By Tod C. Aeby, Melanie D. Altizer, Ronan A. Bakker, Meghann E. Batten, Anita K. Blanchard, Brian Bond, Megan A. Brady, Saweda A. Bright, Ellen L. Brock, Amy Brown, Ashley Carroll, Jori S. Carter, Frances Casey, Weldon Chafe, David Chelmow, Jessica M. Ciaburri, Stephen A. Cohen, Adrianne M. Colton, PonJola Coney, Jennifer A. Cross, Julie Zemaitis DeCesare, Layson L. Denney, Megan L. Evans, Nicole S. Fanning, Tanaz R. Ferzandi, Katie P. Friday, Nancy D. Gaba, Rajiv B. Gala, Andrew Galffy, Adrienne L. Gentry, Edward J. Gill, Philippe Girerd, Meredith Gray, Amy Hempel, Audra Jolyn Hill, Chris J. Hong, Kathryn A. Houston, Patricia S. Huguelet, Warner K. Huh, Jordan Hylton, Christine R. Isaacs, Alison F. Jacoby, Isaiah M. Johnson, Nicole W. Karjane, Emily E. Landers, Susan M. Lanni, Eduardo Lara-Torre, Lee A. Learman, Nikola Alexander Letham, Rachel K. Love, Richard Scott Lucidi, Elisabeth McGaw, Kimberly Woods McMorrow, Christopher A. Manipula, Kirk J. Matthews, Michelle Meglin, Megan Metcalf, Sarah H. Milton, Gaby Moawad, Christopher Morosky, Lindsay H. Morrell, Elizabeth L. Munter, Erin L. Murata, Amanda B. Murchison, Nguyet A. Nguyen, Nan G. O’Connell, Tony Ogburn, K. Nathan Parthasarathy, Thomas C. Peng, Ashley Peterson, Sarah Peterson, John G. Pierce, Amber Price, Heidi J. Purcell, Ronald M. Ramus, Nicole Calloway Rankins, Fidelma B. Rigby, Amanda H. Ritter, Barbara L. Robinson, Danielle Roncari, Lisa Rubinsak, Jennifer Salcedo, Mary T. Sale, Peter F. Schnatz, John W. Seeds, Kathryn Shaia, Karen Shelton, Megan M. Shine, Haller J. Smith, Roger P. Smith, Nancy A. Sokkary, Reni A. Soon, Aparna Sridhar, Lilja Stefansson, Laurie S. Swaim, Chemen M. Tate, Hong-Thao Thieu, Meredith S. Thomas, L. Chesney Thompson, Tiffany Tonismae, Angela M. Tran, Breanna Walker, Alan G. Waxman, C. Nathan Webb, Valerie L. Williams, Sarah B. Wilson, Elizabeth M. Yoselevsky, Amy E. Young
- Edited by David Chelmow, Virginia Commonwealth University, Christine R. Isaacs, Virginia Commonwealth University, Ashley Carroll, Virginia Commonwealth University
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- Book:
- Acute Care and Emergency Gynecology
- Published online:
- 05 November 2014
- Print publication:
- 30 October 2014, pp ix-xiv
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Calcium supplements and cancer risk: a meta-analysis of randomised controlled trials
- Sarah M. Bristow, Mark J. Bolland, Graeme S. MacLennan, Alison Avenell, Andrew Grey, Greg D. Gamble, Ian R. Reid
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- Journal:
- British Journal of Nutrition / Volume 110 / Issue 8 / 28 October 2013
- Published online by Cambridge University Press:
- 19 April 2013, pp. 1384-1393
- Print publication:
- 28 October 2013
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Some evidence suggests that Ca and vitamin D supplements affect cancer risk; however, it is uncertain whether the effects are due to Ca, vitamin D or the combination. We investigated the effect of Ca supplements without co-administered vitamin D on cancer risk. Medline, Embase and the Cochrane Central Register of Controlled Trials, reference lists of meta-analyses and two clinical trial registries were searched for randomised, placebo-controlled trials of Ca supplements ( ≥ 500 mg/d), with ≥ 100 participants and duration >1 year. The lead authors of eligible trials supplied data on cancer outcomes. Trial-level data were analysed using random-effects meta-analyses and patient-level data using Cox proportional hazards models. A total of sixteen trials were eligible, six had no data available, ten provided trial-level data (n 10 496, mean duration 3·9 years), and of these, four provided patient-level data (n 7221, median duration 3·5 years). In the meta-analysis of trial-level data, allocation to Ca did not alter the risk of total cancer (relative risk 0·95, 95 % CI 0·76, 1·18, P= 0·63), colorectal cancer (relative risk 1·38, 95 % CI 0·89, 2·15, P= 0·15), breast cancer (relative risk 1·01, 95 % CI 0·64, 1·59, P= 0·97) or cancer-related mortality (relative risk 0·96, 95 % CI 0·74, 1·24, P= 0·75), but reduced the risk of prostate cancer (relative risk 0·54, 95 % CI 0·30, 0·96, P= 0·03), although there were few events. The meta-analysis of patient-level data showed similar results, with no effect of Ca on the risk of total cancer (hazard ratio 1·07, 95 % CI 0·89, 1·28, P= 0·50). Ca supplements without co-administered vitamin D did not alter total cancer risk over 4 years, although the meta-analysis lacked power to detect very small effects, or those with a longer latency.
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- By Yasir Abu-Omar, Matthew E. Atkins, Joseph E. Arrowsmith, Alan Ashworth, Rubia Baldassarri, Craig R. Bailey, David J. Barron, Christiana C. Burt, David Cardone, Coralie Carle, Jose Coddens, Alan M. Cohen, Simon Colah, Sarah Conolly, David J. Daly, Helen M. Daly, Stefan G. De Hert, Ravi J. De Silva, Mark Dougherty, John J. Dunning, Maros Elsik, Betsy Evans, Florian Falter, Nigel Farnum, Jens Fassl, Juliet E. Foweraker, Simon P. Fynn, Andrew I. Gardner, Margaret I. Gillham, Martin J. Goddard, Maximilien J. Gourdin, Jon Graham, Stephen J. Gray, Cameron Graydon, Fabio Guarracino, Roger M. O. Hall, Michael Haney, Charles W. Hogue, Ben W. Howes, Bevan Hughes, Siân I. Jaggar, David P. Jenkins, Jörn Karhausen, Todd Kiefer, Khalid Khan, Andrew A. Klein, John D. Kneeshaw, Andrew C. Knowles, Catherine V. Koffel, R. Clive Landis, Trevor W. R. Lee, Clive J. Lewis, Jonathan H. Mackay, Amod Manocha, Jonathan B. Mark, Sarah Marstin, William T. McBride, Kenneth H. McKinlay, Alan F. Merry, Berend Mets, Britta Millhoff, Kevin P. Morris, Samer A. M. Nashef, Andrew Neitzel, Stephane Noble, Rabi Panigrahi, Barbora Parizkova, J. M. Tom Pierce, Mihai V. Podgoreanu, Hans-Joachim Priebe, Paul Quinton, C. Ramaswamy Rajamohan, Doris M. Rassl, Tom Rawlings, Fiona E. Reynolds, Andrew J. Richardson, David Riddington, Andrew Roscoe, Paul H. M. Sadleir, Ving Yuen See Tho, Herve Schlotterbeck, Maura Screaton, Shitalkumar Shah, Harjot Singh, Jon H. Smith, M. L. Srikanth, Yeewei W. Teo, Kamen P. Valchanov, Jean-Pierre van Besouw, Isabeau A. Walker, Stephen T. Webb, Francis C. Wells, John Whitbread, Charles Willmott, Patrick Wouters
- Edited by Jonathan H. Mackay, Joseph E. Arrowsmith
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- Book:
- Core Topics in Cardiac Anesthesia
- Published online:
- 05 April 2012
- Print publication:
- 15 March 2012, pp x-xiii
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- By Jane E. Adcock, Yahya Aghakhani, A. Anand, Eva Andermann, Frederick Andermann, Alexis Arzimanoglou, Sandrine Aubert, Nadia Bahi-Buisson, Carman Barba, Agatino Battaglia, Geneviève Bernard, Nadir E. Bharucha, Laurence A. Bindoff, William Bingaman, Francesca Bisulli, Thomas P. Bleck, Stewart G. Boyd, Andreas Brunklaus, Harry Bulstrode, Jorge G. Burneo, Laura Canafoglia, Laura Cantonetti, Roberto H. Caraballo, Fernando Cendes, Kevin E. Chapman, Patrick Chauvel, Richard F. M. Chin, H. T. Chong, Fahmida A. Chowdhury, Catherine J. Chu-Shore, Rolando Cimaz, Andrew J. Cole, Bernard Dan, Geoffrey Dean, Alessio De Ciantis, Fernando De Paolis, Rolando F. Del Maestro, Irissa M. Devine, Carlo Di Bonaventura, Concezio Di Rocco, Henry B. Dinsdale, Maria Alice Donati, François Dubeau, Michael Duchowny, Olivier Dulac, Monika Eisermann, Brent Elliott, Bernt A. Engelsen, Kevin Farrell, Natalio Fejerman, Rosalie E. Ferner, Silvana Franceschetti, Robert Friedlander, Antonio Gambardella, Hector H. Garcia, Serena Gasperini, Lorenzo Genitori, Gioia Gioi, Flavio Giordano, Leif Gjerstad, Daniel G. Glaze, Howard P. Goodkin, Sidney M. Gospe, Andrea Grassi, William P. Gray, Renzo Guerrini, Marie-Christine Guiot, William Harkness, Andrew G. Herzog, Linda Huh, Margaret J. Jackson, Thomas S. Jacques, Anna C. Jansen, Sigmund Jenssen, Michael R. Johnson, Dorothy Jones-Davis, Reetta Kälviäinen, Peter W. Kaplan, John F. Kerrigan, Autumn Marie Klein, Matthias Koepp, Edwin H. Kolodny, Kandan Kulandaivel, Ruben I. Kuzniecky, Ahmed Lary, Yolanda Lau, Anna-Elina Lehesjoki, Maria K. Lehtinen, Holger Lerche, Michael P. T. Lunn, Snezana Maljevic, Mark R. Manford, Carla Marini, Bindu Menon, Giulia Milioli, Eli M. Mizrahi, Manish Modi, Márcia Elisabete Morita, Manuel Murie-Fernandez, Vivek Nambiar, Lina Nashef, Vincent Navarro, Aidan Neligan, Ruth E. Nemire, Charles R. J. C. Newton, John O'Donavan, Hirokazu Oguni, Teiichi Onuma, Andre Palmini, Eleni Panagiotakaki, Pasquale Parisi, Elena Parrini, Liborio Parrino, Ignacio Pascual-Castroviejo, M. Scott Perry, Perrine Plouin, Charles E. Polkey, Suresh S. Pujar, Karthik Rajasekaran, R. Eugene Ramsey, Rahul Rathakrishnan, Roberta H. Raven, Guy M. Rémillard, David Rosenblatt, M. Elizabeth Ross, Abdulrahman Sabbagh, P. Satishchandra, Swati Sathe, Ingrid E. Scheffer, Philip A. Schwartzkroin, Rod C. Scott, Frédéric Sedel, Michelle J. Shapiro, Elliott H. Sherr, Michael Shevell, Simon D. Shorvon, Adrian M. Siegel, Gagandeep Singh, S. Sinha, Barbara Spacca, Waney Squier, Carl E. Stafstrom, Bernhard J. Steinhoff, Andrea Taddio, Gianpiero Tamburrini, C. T. Tan, Raymond Y. L. Tan, Erik Taubøll, Robert W. Teasell, Mario Giovanni Terzano, Federica Teutonico, Suzanne A. Tharin, Elizabeth A. Thiele, Pierre Thomas, Paolo Tinuper, Dorothée Kasteleijn-Nolst Trenité, Sumeet Vadera, Pierangelo Veggiotti, Jean-Pierre Vignal, J. M. Walshe, Elizabeth J. Waterhouse, David Watkins, Ruth E. Williams, Yue-Hua Zhang, Benjamin Zifkin, Sameer M. Zuberi
- Edited by Simon D. Shorvon, Frederick Andermann, Renzo Guerrini
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- The Causes of Epilepsy
- Published online:
- 05 March 2012
- Print publication:
- 14 April 2011, pp ix-xvi
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- By Robert C. Albright, Joe Arrowsmith, Constantine Athanasuleas, Ashish A Bartakke, Gerald D. Buckberg, Victoria Chilton, Simon Colah, Kevin Collins, David Cook, Kirsty Dempster, Helen Dunningham, Liza Enriquez, Betsy Evans, Steve Gray, Roger Hall, George Hallward, Charles W. Hogue, Brian Keogh, James Keogh, Andrew Klein, G. Burkhard Mackensen, Sukumaran Nair, Barbora Parizkova, Giles J Peek, Susanna Price, Linda Shore-Lesserson, Andrew Snell, Steven Tsui, John Wallwork
- Sunit Ghosh, Papworth Hospital, Cambridge, Florian Falter, Papworth Hospital, Cambridge, David J. Cook
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- Book:
- Cardiopulmonary Bypass
- Published online:
- 15 December 2009
- Print publication:
- 17 September 2009, pp vii-viii
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- By Graham Allan, Donna M. Allen, Irwin Altman, Arthur Aron, Donald H. Baucom, Steven R. H. Beach, Ellen Berscheid, Rosemary Blieszner, Jeffrey Boase, Tyfany M. J. Boettcher, Barbara B. Brown, Abraham P. Buunk, Lorne Campbell, Daniel J. Canary, Rodney Cate, John P. Caughlin, Mahnaz Charania, Jennie Y. Chen, F. Scott Christopher, Jennifer A. Clarke, Marilyn Coleman, W. Andrew Collins, Michael K. Coolsen, Nathan R. Cottle, Carolyn E. Cutrona, Marianne Dainton, Valerian J. Derlega, Lisa M. Diamond, Pieternel Dijkstra, Steve Duck, Pearl A. Dykstra, Norman B. Epstein, Beverley Fehr, Frank D. Fincham, Helen E. Fisher, Julie Fitness, Garth J. O. Fletcher, Myron D. Friesen, Lawrence Ganong, Kelli A. Gardner, Jenny de Jong Gierveld, Robin Goodwin, Christine R. Gray, Kathryn Greene, David W. Harris, Willard W. Hartup, John H. Harvey, Kathi L. Heffner, Ted L. Huston, William J. Ickes, Emily A. Impett, Michael P. Johnson, Deborah J. Jones, Deborah A. Kashy, Janice K. Kiecolt‐Glaser, Jeffrey L. Kirchner, Brighid M. Kleinman, Galena H. Kline, Mark L. Knapp, Ascan Koerner, Jean‐Philippe Laurenceau, Kim Leon, Timothy J. Loving, Stephanie D. Madsen, Howard J. Markman, Alicia Mathews, Mario Mikulincer, Patricia Noller, Nickola C. Overall, Letitia Anne Peplau, Daniel Perlman, Sally Planalp, Urmila Pillay, Nicole D. Pleasant, Caryl E. Rusbult, Barbara R. Sarason, Irwin G. Sarason, Phillip R. Shaver, Alan L. Sillars, Jeffry A. Simpson, Susan Sprecher, Susan Stanton, Greg Strong, Catherine A. Surra, Anita L. Vangelisti, C. Arthur VanLear, Theo van Tilburg, Barry Wellman, Amy Wenzel, Carol M. Werner, Adam R. West, Sarah W. Whitton, Heike A. Winterheld
- Edited by Anita L. Vangelisti, University of Texas, Austin, Daniel Perlman, University of British Columbia, Vancouver
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- Book:
- The Cambridge Handbook of Personal Relationships
- Published online:
- 05 June 2012
- Print publication:
- 05 June 2006, pp xvii-xxii
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