Cost of oral cholera vaccine delivery in a mass immunization program for children in urban Bangladesh.

Cholera poses a substantial health burden in the developing world due to both epidemic and endemic diseases. The World Health Organization recommends oral cholera vaccines for mass vaccination campaigns in addition to traditional prevention practices and treatments in resource-poor settings. In many developing countries like Bangladesh, the major challenge behind implementing mass vaccination campaigns concerns the affordability of the oral cholera vaccine (OCV). Vaccination of children with OCV is not only an impactful approach for controlling cholera at the population level and reducing childhood morbidity but is also considered more cost-effective than vaccinating all ages. The aim of the study was to estimate the cost of an OCV campaign for children from a societal perspective using empirical study. A total of 66,311 children aged 1 to 14 years old were fully vaccinated with two doses of the OCV Shanchol while 9,035 individuals received one dose of this vaccine. The estimated societal cost per individual for full vaccination was US$ 6.11, which includes the cost of vaccine delivery estimated at US$ 1.95. The cost per single dose was estimated at US$ 2.86. The total provider cost for full vaccination was estimated at US$ 6.01 and the recipient cost at US$ 0.10. Our estimation of OCV delivery costs for children was relatively higher than what was found in a similar mass OCV campaign for all age groups, indicating that there may be additional cost factors to consider in targeted vaccine campaigns. This analysis provides useful benchmarks for the possible costs related to delivery of OCV to children and future OCV cost-effectiveness models should factor in these possible cost disparities. Attempts to reduce the cost per dose are likely to have a greater impact on the cost of similar vaccination campaigns in many resource-poor settings.

Attending Surgeons Demonstrate Greater Correlations of Skill Assessment and Anticipation of Adverse Events Than Residents During Laparoscopic Cholecystectomy.

BACKGROUND: Surgical training includes the development of technical and nontechnical skills. While technical skills are more easily quantified, nontechnical skills such as situation awareness (SA) are more difficult to measure and quantify. This study investigated the relationships between different SA elements and expertise. METHODS: Twenty attending and resident surgeons rated their anticipation of an impending adverse event while watching 20 videos of laparoscopic cholecystectomies with and without adverse events. After watching each video, they assessed surgeon skills and self-assessed their anticipation ratings. All participants answered a general confidence questionnaire before and after the study. RESULTS: Videos with adverse events led to significantly higher anticipation of adverse events (P < 0.001), lower surgeon skill rating (P < 0.001), and higher self-assessment in their anticipation ratings (P < 0.001) across both participant groups. General confidence was significantly lower for residents than that for attending surgeons (P < 0.001). Compared with the residents, attendings exhibited stronger and more stable correlations between measurements of SA. When viewing videos with adverse events, attendings showed significantly higher correlation between anticipation of an impending adverse event and skill assessment of the surgeon (P = 0.005). CONCLUSIONS: This study investigated how different elements of SA and their relationships were influenced by experience. The results indicated that attendings had stronger and more stable correlations between SA elements than residents, demonstrating how measurement correlations could be meaningful and sensitive indicators of expertise and autonomy readiness.

Development of a database for government-funded health/functional food research.

The Korean Health/Functional Food Act of 2002 has led to the promotion of research on health/functional foods (HFFs). In order to track government-funded studies on HFFs, a free accessible database (National Research & Development on Functional Food, NaReaD(ff)) has been established by the Korea Food and Drug Administration. About 200 project reports funded by government agencies from 1993 through 2007 were retrieved, using existing government-wide online databases created by the Korea Institute Science and Technology, Evaluation and Planning and the Korea Institute of Science and Technology Information. In 2008, the database was released with information regarding individual projects and technological achievements for individual ingredients with a vision for HFF development. Overall, government-funded HFF research has primarily involved botanicals including herbs and food plants. The immune system, oxidant stress alleviation, and the cardiovascular system are the three leading health systems being investigated. With regard to the types of studies performed, the majority were in vitro studies and animal studies with limited numbers of human intervention studies. Government funds have been fragmented for many different ingredients, and this represents a major gap in HFF development. This database is most valuable for evaluating trends in government-funded HFF research. It is also useful to identify research overlaps and gaps and to help research scientists within academia and industry identify potential sources of government funding.

Assessment of estimated daily intakes of benzoates for average and high consumers in Korea.

A study was performed to evaluate the estimated daily intakes (EDI) of benzoates for the average and high (90th percentile) consumers by age and sex categories in Korea. The estimation of daily intakes of benzoates was based on individual dietary intake data from the National Health and Nutrition Survey in 1998 and on the determination of benzoates in eight food categories. The EDI of benzoates for average consumers of different age groups ranged from 0.009 to 0.025 mg kg(-1) bw day(-1). For high consumers, the range of EDI of benzoates was 0.195-1.878 mg kg(-1) bw day(-1). The intakes represented 0.18-0.50% of the acceptable daily intake (ADI) of benzoates for average consumers and 3.9-37.6% of the ADI for high consumers. Foods that contributed most to the daily intakes of benzoates were mixed beverages and soy sauce in Korea.