Plos One
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Availability of directly-acting antivirals (DAAs) has changed the treatment landscape of hepatitis C virus (HCV) infection. The high price of DAAs has restricted their use in several countries. However, in some countries such as India, generic DAAs are available at much cheaper price. This study examined whether generic DAAs could be cost-saving and how long it would take for the treatment to become cost-saving/effective. ⋯ Treatment with generic DAAs available in India will improve patient outcomes, provide a good value for money within 2 years, and be ultimately cost-saving. Therefore, in this and similar settings, HCV treatment should be a priority from a public health as well an economic perspective.
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From 2012 to 2016, Gavi, the Vaccine Alliance, provided support for countries to conduct small-scale demonstration projects for the introduction of the human papillomavirus vaccine, with the aim of determining which human papillomavirus vaccine delivery strategies might be effective and sustainable upon national scale-up. This study reports on the operational costs and cost determinants of different vaccination delivery strategies within these projects across twelve countries using a standardized micro-costing tool. The World Health Organization Cervical Cancer Prevention and Control Costing Tool was used to collect costing data, which were then aggregated and analyzed to assess the costs and cost determinants of vaccination. ⋯ Vaccination costs may be decreased further by annual vaccination, high initial investment in social mobilization, or introducing/strengthening school health programs. Our analysis shows that drivers of cost are dependent on country and district characteristics. We therefore recommend that countries carry out detailed planning at the national and district levels to define a sustainable strategy for national HPV vaccine roll-out, in order to achieve the optimal balance between coverage and cost.
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Patient-reported outcome (PRO) measures and validated instruments have become integral in assessing the quality of healthcare delivery, including pharmaceutical care services. The Pharmacy Services Questionnaire (PSQ) measures patient satisfaction with pharmaceutical care. In this study, we developed a modified Korean version of the PSQ (PSQ-K) and evaluated its validity and reliability. ⋯ The PSQ-K indicated good discriminant and divergent validity. Known-group comparisons revealed that the PSQ-K was able to distinguish between respondents differing in socio-demographic characteristics, such as gender, level of education, and household income. In conclusion, the PSQ-K is a highly reliable and valid PRO instrument for assessing the level of satisfaction with community pharmacy services.
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Physiological and functional parameters, such as body composition, or physical fitness are known to differ between men and women and to change with age. The goal of this study was to investigate how sex and age-related physiological conditions are reflected in the metabolome of healthy humans and whether sex and age can be predicted based on the plasma and urine metabolite profiles. In the cross-sectional KarMeN (Karlsruhe Metabolomics and Nutrition) study 301 healthy men and women aged 18-80 years were recruited. ⋯ Several metabolites important for this prediction could be identified including choline in plasma and sedoheptulose in urine. For women, classification according to their menopausal status was possible from metabolome data with > 80% accuracy. The metabolite profile of human urine and plasma allows the prediction of sex and age with high accuracy, which means that sex and age are associated with a discriminatory metabolite signature in healthy humans and therefore should always be considered in metabolomics studies.
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In Australia, there is limited evidence on the impact of antenatal depression on perinatal outcomes. This study investigates the association between maternal depressive symptoms during pregnancy and key perinatal outcomes, including birth weight, gestational age at birth, breastfeeding indicators and postnatal depressive symptoms. ⋯ Maternal depressive symptoms in the antenatal period are strongly associated with postnatal depressive symptoms and adverse perinatal outcomes in Australian infants. Early identification of antenatal and postnatal depressive symptoms, and referral for appropriate management could benefit not only the mother's mental health, but also the infant's health and development.