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We investigated ways of defining and measuring the value of services provided by governmental public health systems. Our data sources included literature syntheses and qualitative interviews of public health professionals. Our examination of the health economic literature revealed growing attempts to measure value of public health services explicitly, but few studies have addressed systems or infrastructure. Interview responses demonstrated no consensus on metrics and no connection to the academic literature. Key challenges for practitioners include developing rigorous, data-driven methods and skilled staff; being politically willing to base allocation decisions on economic evaluation; and developing metrics to capture "intangibles" (e.g., social justice and reassurance value). Academic researchers evaluating the economics of public health investments should increase focus on the working needs of public health professionals.

Dieser Sammelband bildet die Fortsetzung in einer Reihe von Tagungsbänden, die die Ergebnisse der Wissenschaftskonferenz "Studien zur Sachunmittelbaren Demokratie im interdisziplinären und internationalen Kontext" abbilden. Die Studien zur Sachunmittelbare Demokratie (StSD) greifen die Ergebnisse dieser seit 2008 zunächst jährlich und seit der 10. Ausgabe zweijährlich stattfindenden Wissenschaftskonferenz des DISUD auf. Die Kommunalen Erfahrungen der Sachunmittelbaren Demokratie in Form von Bürgerbegehren und Bürgerentscheiden bzw. Ratsbegehren und Ratsreferenden stehen im Zentrum der Aufmerksamkeit des 1. Kapitels des Tagungsbandes. Umfang, rechtliche Grenzen und Praxis kommunaler Volksrechte werden dokumentiert und eingeordnet.

Economic analysis of life‐saving investments in both the public and private sectors has the potential to dramatically improve longevity and the quality of life, but only if the analyses on which decisions are based are done well. In this article, we analyze a data set that provides information on the content and quality of journal articles that measure the cost‐effectiveness of life‐saving investments. Our study is the first to provide a detailed multivariate analysis of factors affecting objective measures of quality. We also explore whether a series of recommendations by an expert panel convened by the U.S. Public Health Service affect the way analyses of specific life‐saving investments are done. Our results suggest that four factors are positively correlated with an index we construct to measure analytical quality: (1) having at least one author affiliated with a university, (2) publication in a journal that has experience in publishing these analyses, (3) if the life‐saving investment is located in the United States, and (4) if the analysis considers a measure of social costs or benefits. Somewhat surprisingly, a study's funding source and whether it is affiliated with industry are not significantly correlated with the quality index. Finally, neither time nor the panel guidelines had an impact on the index.

International audience ; A few studies have investigated the analysis of neonicotinoid insecticides in honey bee royal jelly. An analytical method based on salting-out liquid-liquid extraction assisted with ultrasound followed by liquid chromatography-tandem mass spectrometry was developed for the determination of thiamethoxam and clothianidin in royal jelly. A cleaning step based on freezing before injection to the UHPLC-MS/MS (MRM mode) allowed maximizing the signal-to-noise ratio. The finalized method was validated in line with European legislation. The limits of quantification (LOQ), reached from a test sample of 100 mg royal jelly only, was 0.25 ng/g for both neonicotinoids. The recoveries were close to 100% with relative standard deviation below 13.7%, measured at three concentration levels. The validated method was finally applied to samples of royal jelly commercially available, and showed the presence of thiamethoxam at levels between the limit of determination (LOD = 0.15 ng/g) and LOQ in a few samples.

International audience ; A few studies have investigated the analysis of neonicotinoid insecticides in honey bee royal jelly. An analytical method based on salting-out liquid-liquid extraction assisted with ultrasound followed by liquid chromatography-tandem mass spectrometry was developed for the determination of thiamethoxam and clothianidin in royal jelly. A cleaning step based on freezing before injection to the UHPLC-MS/MS (MRM mode) allowed maximizing the signal-to-noise ratio. The finalized method was validated in line with European legislation. The limits of quantification (LOQ), reached from a test sample of 100 mg royal jelly only, was 0.25 ng/g for both neonicotinoids. The recoveries were close to 100% with relative standard deviation below 13.7%, measured at three concentration levels. The validated method was finally applied to samples of royal jelly commercially available, and showed the presence of thiamethoxam at levels between the limit of determination (LOD = 0.15 ng/g) and LOQ in a few samples.

International audience ; A few studies have investigated the analysis of neonicotinoid insecticides in honey bee royal jelly. An analytical method based on salting-out liquid-liquid extraction assisted with ultrasound followed by liquid chromatography-tandem mass spectrometry was developed for the determination of thiamethoxam and clothianidin in royal jelly. A cleaning step based on freezing before injection to the UHPLC-MS/MS (MRM mode) allowed maximizing the signal-to-noise ratio. The finalized method was validated in line with European legislation. The limits of quantification (LOQ), reached from a test sample of 100 mg royal jelly only, was 0.25 ng/g for both neonicotinoids. The recoveries were close to 100% with relative standard deviation below 13.7%, measured at three concentration levels. The validated method was finally applied to samples of royal jelly commercially available, and showed the presence of thiamethoxam at levels between the limit of determination (LOD = 0.15 ng/g) and LOQ in a few samples.

Using cost-effectiveness analysis in health and medicine : experiences since the original panel / Peter J. Neumann [and 6 others] -- Theoretical foundations of cost-effectiveness analysis in health and medicine / David O. Meltzer, Anirban Basu, and Mark J. Sculpher -- Recommendations on perspectives for the reference case -- Designing a cost-effectiveness analysis / Douglas K. Owens, Joanna E. Siegel, Mark J. Sculpher, Joshua A. Salomon -- Decision models in cost-effectiveness analysis / Karen M. Kuntz [and 5 others] -- Identifying and quantifying the consequences of interventions / Joshua A. Salomon, Thomas A. Trikalinos, Gillian D. Sanders, Jeanne S. Mandelblatt -- Valuing health outcomes / David Feeny, Murray Krahn, Lisa A. Prosser, and Joshua A. Salomon -- Estimating costs and valuations of non-health benefits in cost-effectiveness analysis / Anirban Basu -- Evidence synthesis for informing cost-effectiveness analysis / Thomas A. Trikalinos, Louise B. Russell, Gillian D. Sanders -- Discounting in cost-effectiveness analysis / Anirban Basu and Theodore G. Ganiats -- Reflecting uncertainty in cost-effectiveness analysis / Mark J. Sculpher, Anirban Basu, Karen M. Kuntz, David O. Meltzer -- Ethical and distributive considerations / Dan W. Brock, Norman Daniels, Peter J. Neumann, and Joanna E. Siegel -- Reporting cost-effectiveness analyses / Lisa A. Prosser, Peter J. Neumann, Gillian D. Sanders, Joanna E. Siegel

A new US law allows warrantless wiretapping whenever one end of the communication is believed to be outside national borders. This creates serious security risks: danger of exploitation of the system by unauthorized users, danger of criminal misuse by trusted insiders, and danger of misuse by government agents.

A COMPLETE UPDATE AND REVISION OF THE CLASSIC TEXT"At last, a manual of operations for comparing the cost-effectiveness of a preventive service with a treatment intervention." --American Journal of Preventive Medicine Twenty years after the first edition of COST-EFFECTIVENESS IN HEALTH AND MEDICINE established the practical benchmark for cost-effectiveness analysis, this completely revised edition of the classic text provides an essential resource to a new generation of practitioners, students, researchers, and policymakers

OBJECTIVE: Our objective was to examine perspective and costing approaches used in cost-effectiveness analyses (CEAs) and the distribution of reported incremental cost-effectiveness ratios (ICERs). METHODS: We analyzed the Tufts Medical Center's CEA and Global Health CEA registries, containing 6907 cost-per-quality-adjusted-life-year (QALY) and 698 cost-per-disability-adjusted-life-year (DALY) studies published through 2018. We examined how often published CEAs included non-health consequences and their impact on ICERs. We also reviewed 45 country-specific guidelines to examine recommended analytic perspectives. RESULTS: Study authors often mis-specified or did not clearly state the perspective used. After re-classification by registry reviewers, a healthcare sector or payer perspective was most prevalent (74%). CEAs rarely included unrelated medical costs and impacts on non-healthcare sectors. The most common non-health consequence included was productivity loss in the cost-per-QALY studies (12%) and patient transportation in the cost-per-DALY studies (21%). Of 19,946 cost-per-QALY ratios, the median ICER was $US26,000/QALY (interquartile range [IQR] 2900–110,000), and 18% were cost saving and QALY increasing. Of 5572 cost-per-DALY ratios, the median ICER was $US430/DALY (IQR 67–3400), and 8% were cost saving and DALY averting. Based on 16 cost-per-QALY studies (2017–2018) reporting 68 ICERs from both the healthcare sector and societal perspectives, the median ICER from a societal perspective ($US22,710/QALY [IQR 11,991–49,603]) was more favorable than from a healthcare sector perspective ($US30,402/QALY [IQR 10,486–77,179]). Most governmental guidelines (67%) recommended either a healthcare sector or a payer perspective. CONCLUSION: Researchers should justify and be transparent about their choice of perspective and costing approaches. The use of the impact inventory and reporting of disaggregate outcomes can reduce inconsistencies and confusion. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this ...

Welche Rolle spielen die Mög­lich­keiten des Inter­nets bei der Ra­di­ka­li­sierung von In­di­vi­duen und Gruppen? Dieser Re­port liefert eine Über­sicht über die be­ste­hende For­schung. Er geht der Frage nach, wie und warum ex­tre­mis­tische Or­ga­ni­sa­tionen und In­di­vi­duen das Inter­net ver­wenden. Darüber hinaus dis­ku­tiert er Mög­lich­keiten (und Grenzen), wie On­line-Ex­tre­mis­mus wirk­sam ent­ge­gen­ge­treten werden kann. Es zeigt sich unter anderem, dass die Nutz­ung von In­ter­net­an­ge­boten durch ex­tre­mis­tische Gruppen oft­mals eher laien­haft und her­kömm­lich ist. Dies sollte auch bei der Ent­wick­lung von Gegen­maß­nahmen be­achtet werden. Reine On­line-Gegen­maß­nahmen stoßen an Grenzen, da Off­line- und On­line-Ra­di­ka­li­sierung auf das engste ver­schränkt sind und nicht ge­trennt be­trachtet werden können. Um der Struk­tur und den Nutzungs­ge­wohn­heiten des Inter­nets ge­recht zu werden, be­darf es einer engen Inter­aktion zwischen öffent­lichen und privaten Ak­teuren in der Stra­te­gie­ent­wick­lung. Der öffent­liche Sek­tor sollte hier An­reize setzen und muss die Kon­se­quenzen von kritischen Maß­nahmen im Bereich der Zen­sur gründ­licher als bis­her ab­wägen.

Sex-related differences in susceptibility to pathogens are a common phenomenon in animals. In the eusocial Hymenoptera the two female castes, workers and queens, are diploid and males are haploid. The haploid susceptibility hypothesis predicts that haploid males are more susceptible to pathogen infections compared to females. Here we test this hypothesis using adult male (drone) and female (worker) honey bees (Apis mellifera), inoculated with the gut endoparasite Nosema ceranae and/or black queen cell virus (BQCV). These pathogens were chosen due to previously reported synergistic interactions between Nosema apis and BQCV. Our data do not support synergistic interactions between N. ceranae and BQCV and also suggest that BQCV has limited effect on both drone and worker health, regardless of the infection level. However, the data clearly show that, despite lower levels of N. ceranae spores in drones than in workers, Nosema-infected drones had both a higher mortality and a lower body mass than non-infected drones, across all treatment groups, while the mortality and body mass of worker bees were largely unaffected by N. ceranae infection, suggesting that drones are more susceptible to this pathogen than workers. In conclusion, the data reveal considerable sex-specific differences in pathogen susceptibility in honey bees and highlight the importance of ultimate measures for determining susceptibility, such as mortality and body quality, rather than mere infection levels. ; The European Union Seventh Framework Programme (FP7/2007-2013) under grant agreement no. (244956 CPFP), BEEDOC (BEes in Europe and the Decline Of Colonies), as well as the Vinetum, Swiss National Science and Ricola foundations. ; http://www.plosone.org ; am2014 ; ab2014