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While involving patients in health technology assessment (HTA) has become increasingly common and important around the world, little is known about the optimal methods of evaluating patients’ involvement (PI) in HTA. This scoping review was undertaken to provide an overview of currently available methods for the evaluation of PI, specifically the impact of PI on HTA recommendations.
Methods
A literature search was conducted using nine databases as well as a grey literature search of the websites of 26 organizations related to the conduct, practice or research of HTA to identify articles, reports and abstracts related to the evaluation of PI impact in HTA.
Results
We identified 1,248 unique citations, six of which met our eligibility criteria. These six records (five articles, and one report) were all published after 2012. Four assessed the impact of patient experience submissions on final HTA recommendations; one evaluated the impact of direct involvement on HTA committees, and one assessed impact of multiple forms of involvement. Methods of evaluation included quantitative analyses of reimbursement decisions, qualitative interviews with those directly involved in an assessment, surveys of patient groups and committee members, and the review of HTA reports.
Conclusions
Quantitative evaluation of PI based on associations with funding decisions may not be feasible or fully capture the relevant impact of PI in the assessment of health technologies. Rather, a combination of both qualitative and quantitative strategies may allow for the most comprehensive assessment of the impact of PI on HTA recommendations when possible.
Accelerating innovation translation is a priority for improving healthcare and health. Although dissemination and implementation (D&I) research has made significant advances over the past decade, it has attended primarily to the implementation of long-standing, well-established practices and policies. We present a conceptual architecture for speeding translation of promising innovations as candidates for iterative testing in practice. Our framework to Design for Accelerated Translation (DART) aims to clarify whether, when, and how to act on evolving evidence to improve healthcare. We view translation of evidence to practice as a dynamic process and argue that much evidence can be acted upon even when uncertainty is moderately high, recognizing that this evidence is evolving and subject to frequent reevaluation. The DART framework proposes that additional factors – demand, risk, and cost, in addition to the evolving evidence base – should influence the pace of translation over time. Attention to these underemphasized factors may lead to more dynamic decision-making about whether or not to adopt an emerging innovation or de-implement a suboptimal intervention. Finally, the DART framework outlines key actions that will speed movement from evidence to practice, including forming meaningful stakeholder partnerships, designing innovations for D&I, and engaging in a learning health system.
To date, Ireland has been a leading light in the provision of youth mental health services. However, cognisant of the efforts of governmental and non-governmental agencies working in youth mental health, there is much to be done. Barriers into care as well as discontinuity of care across the spectrum of services remain key challenges. This editorial provides guidance for the next stage of development in youth mental care and support that will require significant national engagement and resource investment.
The Farmers’ Market Fresh Fund Incentive Program is a policy, systems and environmental intervention to improve access to fresh produce for participants on governmental assistance in the USA. The current study examined factors associated with ongoing participation in this matched monetary incentive programme.
Design
Relationship of baseline factors with number of Fresh Fund visits was assessed using Poisson regression. Mixed-effects modelling was used to explore changes in consumption of fruits and vegetables and diet quality.
Setting
San Diego, California.
Subjects
Recipients of Supplemental Nutrition Assistance Program (SNAP), Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and Supplemental Security Income (SSI) who attended participating farmers’ markets from 2010 to 2012 (n 7298).
Results
Among those with participation for ≤6 months, factors associated with increased visits included reporting more daily servings of fruits and vegetables (F&V) at baseline, being Vietnamese or Asian/Pacific Islander, and eligibility because of SNAP/CalFresh or SSI (v. WIC). Among those who came for 6–12 months, being Asian/Pacific Islander, eligibility because of SNAP/CalFresh and enrolling in the autumn, winter or spring were associated with a greater number of Fresh Fund visits. Among those who came for >12 months, being male and eligibility because of SSI were associated with a greater number of visits. Overall, the odds of increasing number of servings of F&V consumed increased by 2 % per month, and the odds of improved perception of diet quality increased by 10 % per month.
Conclusions
Sustaining and increasing Fresh Fund-type programme operations should be a top priority for future policy decisions concerning farmers’ market use in low-income neighbourhoods.
Complex oxides and semiconductors exhibit distinct yet complementary properties owing to their respective ionic and covalent natures. By electrically coupling complex oxides to traditional semiconductors within epitaxial heterostructures, enhanced or novel functionalities beyond those of the constituent materials can potentially be realized. Essential to electrically coupling complex oxides to semiconductors is control of the physical structure of the epitaxially grown oxide, as well as the electronic structure of the interface. Here we discuss how composition of the perovskite A- and B-site cations can be manipulated to control the physical and electronic structure of semiconductor—complex oxide heterostructures. Two prototypical heterostructures, Ba1−xSrxTiO3/Ge and SrZrxTi1−xO3/Ge, will be discussed. In the case of Ba1−xSrxTiO3/Ge, we discuss how strain can be engineered through A-site composition to enable the re-orientable ferroelectric polarization of the former to be coupled to carriers in the semiconductor. In the case of SrZrxTi1−xO3/Ge we discuss how B-site composition can be exploited to control the band offset at the interface. Analogous to heterojunctions between compound semiconducting materials, control of band offsets, i.e., band-gap engineering, provides a pathway to electrically couple complex oxides to semiconductors to realize a host of functionalities.
Nature leads the way. Man emerges on the scene, follows her footprints, marks and registers them in language, and makes a Science of Nature. Then he looks back and discovers that Language, while following the path of Nature, has left a trail of her own. He returns on this new trail, again marks and registers its footprints, and makes a Science of Language.
The Birth of Language (1937)
The great majority of linguists in Canada today belong to only the second academic generation of linguists in Canadian universities. Members of the first generation are, of course, still active—in some cases more active than the younger members of their departments. They are characterized, roughly, as founding members of the Canadian Linguistic Association, or as members of long standing. They are also characterized in a few cases as having been the teachers of junior members of the profession, although this is less often the case than it is in other disciplines, partly because there have been very few graduate programs in Linguistics until recently, and partly because there has been little demand for linguists trained in the specialty of the first generation anyway, which is almost unanimously dialect geography, and partly because there has been a decided tendency toward hiring non-Canadians in the social sciences to fill positions in Canadian universities. Now, with the increase in graduate programs in Linguistics, the more diverse specializations, and the national consciousness that Canadian universities can also be served by Canadians, the third generation of linguists will increasingly be selected from the students of the present academic generation, which is how academic generations have been gauged in other cultures for centuries.
This Paper discusses a particular phonological rule that occurs in several English dialects, including Canadian English. The rule will be referred to throughout as ‘Canadian Raising’ purely for mnemonic purposes; no geographical rigour is intended by the epithet ‘Canadian’—a point that is made abundantly clear in §4, where the distribution of the rule is taken up. The appropriateness of the term resides in the relative role the rule plays in Canadian English, where its effect is the most readily identifiable trait of the dialect. Thus, speakers of Canadian English are often identified by the speakers of adjoining dialects by their pronunciation of words like wife and south, which are usually mis-heard by speakers of General American as weef and sooth.
The main facts about Canadian Raising were first organized systematically three decades ago by Martin Joos, in a short article entitled “A phonological dilemma in Canadian English” (1942). Since then, they have been cursorily referred to in the literature several times (for example: Bloomfield 1948: 62; McDavid 1963: 470, etc.) and have been reorganized in a different theoretical framework (Halle 1962: 343) with no augmentation—and usually a simplification—of Joos’s observations.
Complex oxides and semiconductors exhibit distinct yet complementary propertiesowing to their respective ionic and covalent natures. By electrically couplingoxides to semiconductors within epitaxial heterostructures, enhanced or novelfunctionalities beyond those of the constituent materials can potentially berealized. Key to electrically coupling oxides to semiconductors is controllingthe physical and electronic structure of semiconductor – crystallineoxide heterostructures. Here we discuss how composition of the oxide can bemanipulated to control physical and electronic structure inBa1-xSrxTiO3/ Ge andSrZrxTi1-xO3/Ge heterostructures. In thecase of the former we discuss how strain can be engineered through compositionto enable the re-orientable ferroelectric polarization to be coupled to carriersin the semiconductor. In the case of the latter we discuss how composition canbe exploited to control the band offset at the semiconductor - oxide interface.The ability to control the band offset, i.e. band-gap engineering, provides apathway to electrically couple crystalline oxides to semiconductors to realize ahost of functionalities.
Linked administrative population data were used to estimate the burden of childhood respiratory syncytial virus (RSV) hospitalization in an Australian cohort aged <5 years. RSV-coded hospitalizations data were extracted for all children aged <5 years born in New South Wales (NSW), Australia between 2001 and 2010. Incidence was calculated as the total number of new episodes of RSV hospitalization divided by the child-years at risk. Mean cost per episode of RSV hospitalization was estimated using public hospital cost weights. The cohort comprised of 870 314 children. The population-based incidence/1000 child-years of RSV hospitalization for children aged <5 years was 4·9 with a rate of 25·6 in children aged <3 months. The incidence of RSV hospitalization (per 1000 child-years) was 11·0 for Indigenous children, 81·5 for children with bronchopulmonary dysplasia (BPD), 10·2 for preterm children with gestational age (GA) 32–36 weeks, 27·0 for children with GA 28–31 weeks, 39·0 for children with GA <28 weeks and 6·7 for term children with low birthweight. RSV hospitalization was associated with an average annual cost of more than AUD 9 million in NSW. RSV was associated with a substantial burden of childhood hospitalization specifically in children aged <3 months and in Indigenous children and children born preterm or with BPD.