OBJECTIVE: The availability of a single vaccine active against hepatitis A and B may facilitate prevention of both infections, but complicates the question of whether to conduct pre-vaccination screening. The authors examined the cost-effectiveness of pre-vaccination screening for several populations: first-year college students, military recruits, travelers to hepatitis A-endemic areas, patients at sexually transmitted disease clinics, and prison inmates. METHODS: Three prevention protocols were examined: (1) screen and defer vaccination until serology results are known; (2) screen and begin vaccination immediately to avoid a missed vaccination opportunity; and (3) vaccinate without screening. Data describing pre-vaccination immunity, vaccine effectiveness, and prevention costs borne by the health system (i.e., serology, vaccine acquisition, and administration) were derived from published literature and U.S. government websites. Using spreadsheet models, the authors calculated the ratio of prevention costs to the number of vaccine protections conferred. RESULTS: The vaccinate without screening protocol was most cost-effective in nine of 10 analyses conducted under baseline assumptions, and in 69 of 80 sensitivity analyses. In each population considered, vaccinate without screening was less costly than and at least equally as effective as screen and begin vaccination. The screen and defer vaccination protocol would reduce costs in seven populations, but effectiveness would also be lower. CONCLUSIONS: Unless directed at vaccination candidates with the highest probability of immunity, pre-vaccination screening for hepatitis A and B immunity is not cost-effective. Balancing cost reduction with reduced effectiveness, screen and defer may be preferred for older travelers and prison inmates.
The purpose of this study was to explore relationships between senior management team culture and organizational performance in English hospital organizations (NHS trusts [National Health Service]). We used an established culture-rating instrument, the Competing Values Framework, to assess senior management team culture. Organizational performance was assessed using a wide variety of routinely collected measures. Data were gathered from all English NHS acute hospital trusts, a total of 197 organizations. Multivariate econometric analyses were used to explore the associations between measures of culture and measures of performance using regressions, ANOVA, multinomial logit, and ordered probit. Organizational culture varied across hospital organizations, and at least some of this variation was associated in consistent and predictable ways with a variety of organizational characteristics and measures of performance. The findings provide particular support for a contingent relationship between culture and performance.
Background: The COVID-19 pandemic has disrupted routine hospital services globally. This study estimated the total number of adult elective operations that would be cancelled worldwide during the 12 weeks of peak disruption due to COVID-19. Methods: A global expert response study was conducted to elicit projections for the proportion of elective surgery that would be cancelled or postponed during the 12 weeks of peak disruption. A Bayesian β-regression model was used to estimate 12-week cancellation rates for 190 countries. Elective surgical case-mix data, stratified by specialty and indication (surgery for cancer versus benign disease), were determined. This case mix was applied to country-level surgical volumes. The 12-week cancellation rates were then applied to these figures to calculate the total number of cancelled operations. Results: The best estimate was that 28 404 603 operations would be cancelled or postponed during the peak 12 weeks of disruption due to COVID-19 (2 367 050 operations per week). Most would be operations for benign disease (90·2 per cent, 25 638 922 of 28 404 603). The overall 12-week cancellation rate would be 72·3 per cent. Globally, 81·7 per cent of operations for benign conditions (25 638 922 of 31 378 062), 37·7 per cent of cancer operations (2 324 070 of 6 162 311) and 25·4 per cent of elective caesarean sections (441 611 of 1 735 483) would be cancelled or postponed. If countries increased their normal surgical volume by 20 per cent after the pandemic, it would take a median of 45 weeks to clear the backlog of operations resulting from COVID-19 disruption. Conclusion: A very large number of operations will be cancelled or postponed owing to disruption caused by COVID-19. Governments should mitigate against this major burden on patients by developing recovery plans and implementing strategies to restore surgical activity safely.
ANPCyT, Argentina ; YerPhI, Armenia ; ARC, Australia ; BMWFW, Austria ; FWF, Austria ; ANAS, Azerbaijan ; SSTC, Belarus ; Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) ; Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) ; NSERC, Canada ; NRC, Canada ; CFI, Canada ; CERN ; CONICYT, Chile ; CAS, China ; MOST, China ; NSFC, China ; COLCIENCIAS, Colombia ; MSMT CR, Czech Republic ; MPO CR, Czech Republic ; VSC CR, Czech Republic ; DNRF, Denmark ; DNSRC, Denmark ; IN2P3-CNRS, CEA-DRF/IRFU, France ; SRNSFG, Georgia ; BMBF, Germany ; HGF, Germany ; MPG, Germany ; GSRT, Greece ; RGC, Hong Kong SAR, China ; ISF, Israel ; Benoziyo Center, Israel ; INFN, Italy ; MEXT, Japan ; JSPS, Japan ; CNRST, Morocco ; NWO, Netherlands ; RCN, Norway ; MNiSW, Poland ; NCN, Poland ; FCT, Portugal ; MNE/IFA, Romania ; MES of Russia, Russian Federation ; NRC KI, Russian Federation ; JINR ; MESTD, Serbia ; MSSR, Slovakia ; ARRS, Slovenia ; MIZS, Slovenia ; DST/NRF, South Africa ; MINECO, Spain ; SRC, Sweden ; Wallenberg Foundation, Sweden ; SERI, Switzerland ; SNSF, Switzerland ; Canton of Bern, Switzerland ; MOST, Taiwan ; TAEK, Turkey ; STFC, United Kingdom ; DOE, United States of America ; NSF, United States of America ; BCKDF, Canada ; CANARIE, Canada ; CRC, Canada ; Compute Canada, Canada ; COST, European Union ; ERC, European Union ; ERDF, European Union ; Horizon 2020, European Union ; Marie Sk lodowska-Curie Actions, European Union ; Investissements d' Avenir Labex and Idex, ANR, France ; DFG, Germany ; AvH Foundation, Germany ; Greek NSRF, Greece ; BSF-NSF, Israel ; GIF, Israel ; CERCA Programme Generalitat de Catalunya, Spain ; Royal Society, United Kingdom ; Leverhulme Trust, United Kingdom ; BMBWF (Austria) ; FWF (Austria) ; FNRS (Belgium) ; FWO (Belgium) ; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) ; Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ) ; FAPERGS (Brazil) ; MES (Bulgaria) ; CAS (China) ; MoST (China) ; NSFC (China) ; COLCIENCIAS (Colombia) ; MSES (Croatia) ; CSF (Croatia) ; RPF (Cyprus) ; SENESCYT (Ecuador) ; MoER (Estonia) ; ERC IUT (Estonia) ; ERDF (Estonia) ; Academy of Finland (Finland) ; MEC (Finland) ; HIP (Finland) ; CEA (France) ; CNRS/IN2P3 (France) ; BMBF (Germany) ; DFG (Germany) ; HGF (Germany) ; GSRT (Greece) ; NKFIA (Hungary) ; DAE (India) ; DST (India) ; IPM (Iran) ; SFI (Ireland) ; INFN (Italy) ; MSIP (Republic of Korea) ; NRF (Republic of Korea) ; MES (Latvia) ; LAS (Lithuania) ; MOE (Malaysia) ; UM (Malaysia) ; BUAP (Mexico) ; CINVESTAV (Mexico) ; CONACYT (Mexico) ; LNS (Mexico) ; SEP (Mexico) ; UASLP-FAI (Mexico) ; MOS (Montenegro) ; MBIE (New Zealand) ; PAEC (Pakistan) ; MSHE (Poland) ; NSC (Poland) ; FCT (Portugal) ; JINR (Dubna) ; MON (Russia) ; RosAtom (Russia) ; RAS (Russia) ; RFBR (Russia) ; NRC KI (Russia) ; MESTD (Serbia) ; SEIDI (Spain) ; CPAN (Spain) ; PCTI (Spain) ; FEDER (Spain) ; MOSTR (Sri Lanka) ; MST (Taipei) ; ThEPCenter (Thailand) ; IPST (Thailand) ; STAR (Thailand) ; NSTDA (Thailand) ; TAEK (Turkey) ; NASU (Ukraine) ; SFFR (Ukraine) ; STFC (United Kingdom ; DOE (U.S.A.) ; NSF (U.S.A.) ; Marie-Curie programme ; Horizon 2020 Grant (European Union) ; Leventis Foundation ; A.P. Sloan Foundation ; Alexander von Humboldt Foundation ; Belgian Federal Science Policy Office ; Fonds pour la Formation a la Recherche dans l'Industrie et dans l'Agriculture (FRIA-Belgium) ; Agentschap voor Innovatie door Wetenschap en Technologie (IWT-Belgium) ; F.R.S.-FNRS (Belgium) ; Beijing Municipal Science & Technology Commission ; Ministry of Education, Youth and Sports (MEYS) of the Czech Republic ; Hungarian Academy of Sciences (Hungary) ; New National Excellence Program UNKP (Hungary) ; Council of Science and Industrial Research, India ; HOMING PLUS programme of the Foundation for Polish Science ; European Union, Regional Development Fund ; Mobility Plus programme of the Ministry of Science and Higher Education ; National Science Center (Poland) ; National Priorities Research Program by Qatar National Research Fund ; Programa Estatal de Fomento de la Investigacion Cientfica y Tecnica de Excelencia Maria de Maeztu ; Programa Severo Ochoa del Principado de Asturias ; EU-ESF ; Greek NSRF ; Rachadapisek Sompot Fund for Postdoctoral Fellowship, Chulalongkorn University (Thailand) ; Chulalongkorn Academic into Its 2nd Century Project Advancement Project (Thailand) ; Welch Foundation ; Weston Havens Foundation (U.S.A.) ; Canton of Geneva, Switzerland ; Herakleitos programme ; Thales programme ; Aristeia programme ; European Research Council (European Union) ; Horizon 2020 Grant (European Union): 675440 ; FWO (Belgium): 30820817 ; Beijing Municipal Science & Technology Commission: Z181100004218003 ; NKFIA (Hungary): 123842 ; NKFIA (Hungary): 123959 ; NKFIA (Hungary): 124845 ; NKFIA (Hungary): 124850 ; NKFIA (Hungary): 125105 ; National Science Center (Poland): Harmonia 2014/14/M/ST2/00428 ; National Science Center (Poland): Opus 2014/13/B/ST2/02543 ; National Science Center (Poland): 2014/15/B/ST2/03998 ; National Science Center (Poland): 2015/19/B/ST2/02861 ; National Science Center (Poland): Sonata-bis 2012/07/E/ST2/01406 ; Programa Estatal de Fomento de la Investigacion Cientfica y Tecnica de Excelencia Maria de Maeztu: MDM-2015-0509 ; Welch Foundation: C-1845 ; This paper presents the combinations of single-top-quark production cross-section measurements by the ATLAS and CMS Collaborations, using data from LHC proton-proton collisions at = 7 and 8 TeV corresponding to integrated luminosities of 1.17 to 5.1 fb(-1) at = 7 TeV and 12.2 to 20.3 fb(-1) at = 8 TeV. These combinations are performed per centre-of-mass energy and for each production mode: t-channel, tW, and s-channel. The combined t-channel cross-sections are 67.5 +/- 5.7 pb and 87.7 +/- 5.8 pb at = 7 and 8 TeV respectively. The combined tW cross-sections are 16.3 +/- 4.1 pb and 23.1 +/- 3.6 pb at = 7 and 8 TeV respectively. For the s-channel cross-section, the combination yields 4.9 +/- 1.4 pb at = 8 TeV. The square of the magnitude of the CKM matrix element V-tb multiplied by a form factor f(LV) is determined for each production mode and centre-of-mass energy, using the ratio of the measured cross-section to its theoretical prediction. It is assumed that the top-quark-related CKM matrix elements obey the relation |V-td|, |V-ts| « |V-tb|. All the |f(LV)V(tb)|(2) determinations, extracted from individual ratios at = 7 and 8 TeV, are combined, resulting in |f(LV)V(tb)| = 1.02 +/- 0.04 (meas.) +/- 0.02 (theo.). All combined measurements are consistent with their corresponding Standard Model predictions.