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1
Roić, Sanja. "Alberto Savinio i Balkan." Italica Belgradensia 2023, Speciale (2023): 53–65. http://dx.doi.org/10.18485/italbg.2023.ns_vuco.4.
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Gordon, Mel. "Alberto Savinio and the Teatro Metafisico." Performing Arts Journal 9, no. 1 (1985): 83. http://dx.doi.org/10.2307/3247819.
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Epstein, Mark. "Book Review: Alberto Savinio: Lo psichismo delle forme." Forum Italicum: A Journal of Italian Studies 34, no. 2 (September 2000): 594–96. http://dx.doi.org/10.1177/001458580003400231.
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Ricci, Roberta. "Grecità (e romanticismo) nella "mitologia moderna" di Alberto Savinio." Quaderni d'italianistica 17, no. 1 (April 1, 1996): 33–59. http://dx.doi.org/10.33137/q.i..v17i1.10319.
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Zudini, Claudia. "La presenza degli animali nell’opera narrativa di Alberto Savinio." Italies, no. 12 (December 1, 2008): 299–318. http://dx.doi.org/10.4000/italies.1322.
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Heyd, Milly. "ALBERTO SAVINIO: THE PHOTOGRAPH AND THE MIRROR IMAGE, PART II." Source: Notes in the History of Art 8, no. 2 (January 1989): 32–36. http://dx.doi.org/10.1086/sou.8.2.23202534.
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Lizza, Marinella. "Il mito di Alcesti in Alberto Savinio e Corrado Alvaro." Italian Culture 22, no. 1 (January 2004): 47–69. http://dx.doi.org/10.1179/itc.2004.22.1.47.
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Giammei, Alessandro. "Stratigraphy of Andromeda: Giorgio de Chirico, Alberto Savinio, Origins, and Originality." Modernism/modernity 25, no. 1 (2018): 21–43. http://dx.doi.org/10.1353/mod.2018.0001.
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Gutiérrez, María Elena. "LA POETICA DEL LAPSUS: INCONSCIO E LINGUAGGIO NELL'OPERA DI ALBERTO SAVINIO." Forum Italicum: A Journal of Italian Studies 31, no. 2 (September 1997): 439–57. http://dx.doi.org/10.1177/001458589703100207.
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Tramuta, Marie-José. "Alberto Savinio, scénariste de la vie de saint François : la tentation épique." Double jeu, no. 13 (December 31, 2016): 37–45. http://dx.doi.org/10.4000/doublejeu.333.
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Vannini, Angelo. "Dedicatorias." Eikasía Revista de Filosofía, no. 92 (January 9, 2023): 169–78. http://dx.doi.org/10.57027/eikasia.92.429.
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Entre la creación poética y la reflexión especulativa, Dedizioni traza un itinerario de lugares, memorias y textos buscando las motivaciones que animan la experiencia de escribir, la relación que los poetas tienen con el lenguaje y el contenido más esquivo de ese gesto primordial que es el nombrar. El autor convoca a algunos de sus amigos insustituibles, entre ellos la escritora francesa Hélène Cixous, la poeta quebequense Nicole Brossard, los poetas italianos Giovanni Raboni y Francesco Scarabicchi, los escritores italianos Dolores Prato y Alberto Savinio.
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Baldasso, Franco. "Alberto Savinio and the Myth of Babel: Homecoming, Genealogies, and Translation in Hermaphrodito." Italianist 40, no. 1 (January 2, 2020): 44–65. http://dx.doi.org/10.1080/02614340.2020.1773140.
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DAVIES, MIKE. "Saving Albert: The Albert Memorial Visitors' Centre, 1995–8." Art Book 14, no. 4 (November 2007): 17–18. http://dx.doi.org/10.1111/j.1467-8357.2007.00862.x.
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Knecht, Brigit M. "Government Imposition of Sustainable Business Practices in the Arts: A Saving Grace?" Stream: Interdisciplinary Journal of Communication 3, no. 1 (June 10, 2009): 20–32. http://dx.doi.org/10.21810/strm.v3i1.25.
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The paper examines how the Alberta Foundation for the Arts has prioritized economic measures of sustainability and best business practices by including economic language and demands into arts funding applications. Analyzing ten years of granting documents from the Alberta Foundation for the Arts the research explores how the gradual inclusion of business language increases the demand on arts organizations to operate as sustainable organizations. The paper also considers how the very imposition of economic priorities onto non-profit arts organizations may, ironically, be the saving grace for such organizations in the face of global economic crisis. Forced to operate under the rigid fiscal demands of granting programs, arts organizations in Alberta are accustomed to efficient operation with limited resources. Therefore they may actually be poised to weather the economic storm better than other arts organizations in Canada.
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Veitch, David. "One province, one healthcare system: A decade of healthcare transformation in Alberta." Healthcare Management Forum 31, no. 5 (August 22, 2018): 167–71. http://dx.doi.org/10.1177/0840470418794272.
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Nearly a decade has passed since Alberta folded nine regional health authorities and three government agencies into one province-wide health system: Alberta Health Services (AHS). Deemed a reckless experiment by some at the time, there is now mounting evidence province-wide integration of services across the healthcare continuum is an enabler of improved quality, safety, and financial sustainability. The article highlights specific examples of how AHS is strengthening partnerships, standardizing best practices, and driving innovation, making Alberta a national and international leader in areas such as stroke care and potentially inappropriate use of antipsychotics in long-term care. It also shows how province-wide integration is being leveraged to build workplace culture, enhance patient safety, and find operational efficiencies that result in cost savings and cost avoidance.
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Bisch, Steven P., Leah Gramlich, and Gregg Nelson. "Aplicación del programa ERAS® como una política de salud pública en el sistema de salud de Alberta, Canadá." Revista Argentina de Cirugía 113, no. 2 (June 1, 2021): 169–75. http://dx.doi.org/10.25132/raac.v113.n2.eras03spb.ei.
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Enhanced Recovery After Surgery (ERAS®) was implemented across Alberta Health Services, a single payer publicly funded provincial health system starting in 2013. Implementation across multiple provincial sites in colorectal surgery reduced postoperative complications by 12% and median length of stay by one day. Subsequent implementation in gynecologic oncology reduced postoperative complications by 17% and length of stay by 2 days in high complexity surgery. Implementation has had an estimated net savings in the province of $7.22 million Canadian dollars (CAD) over 5 years with a return on investment of $1.05 to $7.31 for every dollar invested in the project. Patient involvement enabled success of the program, with support, education, and mitigation of patient stress identified as key components for success. Provider knowledge and motivation were essential to ensure ongoing compliance with ERAS guidelines. Provider education, and demonstration of improvement in patient outcomes using audit is one method to ensure continued motivation from care providers. Systemlevel leadership is essential to provide consistent messaging and support for initiatives, while providerlevel leadership in the form of physician champions and nurse coordinators ensures compliance and appropriate integration of ERAS into daily practice. Implementation of ERAS across a unified health care system has improved patient outcomes while saving resources. Further research into expansion of the program to community hospitals and all surgical domains is underway.
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Brown, Bijon A., Henry An, and Scott R. Jeffrey. "Benefit-cost analysis of near-infrared spectroscopy technology adoption by Alberta hog producers." Canadian Journal of Animal Science 100, no. 3 (September 1, 2020): 557–69. http://dx.doi.org/10.1139/cjas-2019-0144.
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Feed cost is a significant component of livestock production costs, accounting for over half of total operating costs for hog producers. This provides an incentive to minimize feed costs while meeting dietary requirements. However, producers may not know the nutritional content of their feed grains with certainty. Near-infrared reflectance spectroscopy (NIRS) imaging technology can quickly and accurately estimate the nutritional content of different types of feed grain. Although the technology has been available for almost five decades, producer adoption has been slow due to issues with cost and usability. The objectives of this study are to estimate feed cost savings resulting from the adoption of NIRS on a representative Alberta hog farm and to conduct a benefit-cost analysis to investigate the potential viability of NIRS adoption. A joint mathematical programming-simulation approach is used to estimate the cost savings generated by adoption of NIRS technology. Results suggest mean annual savings of up to $4 per hog and benefit-cost results suggest that adopting NIRS technology may be viable, particularly for larger Alberta hog operations. However, initial investment requirements, uncertainty in the magnitude of benefits, and access to the technology from feed mills will likely continue to limit adoption.
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Kalluri, Meena, Lakshmi Puttagunta, Arto Ohinmaa, Nguyen Xuan Thanh, and Eric Wong. "COST ANALYSIS OF INTRA PROCEDURAL RAPID ON SITE EVALUATION OF CYTOPATHOLOGY WITH ENDOBRONCHIAL ULTRASOUND." International Journal of Technology Assessment in Health Care 31, no. 5 (2015): 273–80. http://dx.doi.org/10.1017/s0266462315000513.
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Background: Rapid on site evaluation (ROSE) allows immediate processing and interpretation of the aspirate in the procedural suite. It improves diagnostic yield and lowers patient care costs. There are limited data on its cost-effectiveness with endobronchial ultrasound (EBUS).Methods: We developed an economic model with two arms, no ROSE (our current practice) and simulated ROSE. To simulate ROSE, a cytopathologist retrospectively identified the first diagnostic slide in each case. Using a decision analytic modeling technique under a hospital diagnostic unit perspective, the benefits of simulated ROSE were estimated as cost-savings. The model input was estimated from actual data, consulting experts, and the literature. The benefits were estimated as cost savings per patient and for the province of Alberta per year. Due to differences in the procedure, sarcoidosis and cancer patients were analyzed separately. The costs are shown in 2012 Canadian dollars, CAD.Results: In our model without ROSE, the procedure cost/patient was CAD 646.00(USD 523.32) for cancer and CAD 1,170.00 (USD 947.73) for sarcoidosis. With simulated ROSE cost savings of CAD 63.00(37.00 to 89.00) [USD 51.04(29.97 to 72.10)], CAD 544.00(490.00 to 598.00) [USD 440.65(397.05 to 484.44)] for cancer and sarcoidosis, respectively. Extrapolating this to provincial data, our model estimates that EBUS with ROSE would lead to savings of CAD 50,000.00(30,000 to 71,000) [USD 40,501.24 (24,300.75 to 57,531.34)] for cancer and CAD 109,000.00 (87,000 to 130,000) [USD 88,337.07 (70,546.45 to 105,313.04) for sarcoidosis.Conclusion: The use of ROSE with EBUS is cost saving. The projected savings were CAD 50,000.00 (USD 40,501.24) and CAD 109,000.00(USD 88,337.07) in cancer and sarcoidosis, respectively, for the province of Alberta, Canada.
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Kotlikoff, Laurence J. "Intergenerational Transfers and Savings." Journal of Economic Perspectives 2, no. 2 (May 1, 1988): 41–58. http://dx.doi.org/10.1257/jep.2.2.41.
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What is the main explanation for savings? Is it primarily accumulation for retirement as claimed by Albert Ando, Richard Brumberg, and Franco Modigliani in their celebrated Life Cycle Model of Savings? Is it primarily intentional accumulation for intergenerational transfers? Or is it primarily precautionary savings, much of which may be bequeathed because of imperfections in annuity markets? The answer to the savings puzzle has many policy implications and is key to understanding the distribution of wealth. A major piece of the puzzle is the quantitative importance of intergenerational transfers to the accumulation of wealth. As I will argue there is strong evidence that intergenerational transfers play a very important and perhaps dominant role in U.S. wealth accumulation. This does not mean, however, that intentional saving for gifts and bequests is the main motive for savings. Significant intergenerational transfers could also arise in the Life Cycle Model in the absence of well-functioning private annuity markets or close substitutes for such markets. In such a setting, bequests would be involuntary and potentially quite sizeable. Let us first look at the evidence on the importance of intergenerational transfers and then turn to the deeper question of why such transfers arise.
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Torello, Giulia. "Alberto Savinio's Alcesti di Samuele in the Aftermath of the Second World War." Comparative Drama 44, no. 4 (2010): 533–35. http://dx.doi.org/10.1353/cdr.2010.0014.
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Moore, W., and T. Polzin. "ER-2 High Altitude Reconnaissance: A Case Study." Forestry Chronicle 66, no. 5 (October 1, 1990): 480–86. http://dx.doi.org/10.5558/tfc66480-5.
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There is an increasing requirement for a cost-effective means of updating digital base map and natural resources information systems. The Northern Forestry Centre of Forestry Canada is cooperating with Alberta Forestry, Lands and Wildlife and United States agencies to evaluate ER-2 high altitude (i.e., about 20 km) reconnaissance in Alberta. A demonstration flight was arranged on 20 July 1988 to cover flight lines from Waterton Lakes National Park to Lesser Slave Lake, and return (i.e., about 1500 km). The ER-2 platform provides both the high altitude perspective of earth satellite systems and the flexibilities of aircraft. The demonstration flight carried a panoramic camera, two mapping cameras and a digital scanner that were operated simultaneously. This provided rapid, high resolution and stereoscopic coverage of large areas. The savings from improved efficiencies for base map revisions alone, using one mapping camera were greater than the costs of routine ER-2 operations over Alberta. The three other selectable sensors would also permit natural resources information system updates for only the costs of processing, interpretation and data entry. These high altitude capabilities are required for forestry in Canada.
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Thanh, Nguyen Xuan, Arto Ohinmaa, Cheryl Barnabe, Joanne Homik, Susan G. Barr, Liam Martin, and Walter P. Maksymowych. "Self-Reported Productivity Losses of People with Rheumatoid Arthritis in Alberta, Canada." Open Pharmacoeconomics & Health Economics Journal 5, no. 1 (August 23, 2013): 11–14. http://dx.doi.org/10.2174/1876824501305010011.
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Objectives: To estimate the annual cost of productivity losses per person with RA by 0.5 increment in HAQscore, and the annual cost of productivity losses for Alberta province. Methods: Using data from the Alberta Biologics Registry - a prospective observational cohort of consecutive patients receiving DMARD or anti-TNF therapies created in 2004, we compared the mean and median costs of productivity losses per patient per year between HAQ-score categories using multiple linear and quantile regressions, respectively. We used a prevalence-based approach to estimate the cost (in 2010 CA$) of productivity losses of RA for Alberta. Results: In total there were 1222 patients with RA interviewed at the baseline. Of this, 358 were the “current employees” and 204 were the “previous employees” totalling 563 patients for analyses. For all HAQ-score categories, the mean (median) of the cost per patient per year was estimated at $18,242 ($3,840). The cost was increasing along with the HAQscore increase. The lowest cost ($6,295) was found in category HAQ<=0.5 and the highest ($31,095) in category HAQ>2.0. The significant differences were found between the worse categories (HAQ>1.5) and the better categories (HAQ<=1.5). The mean costs of productivity losses of RA for the province of Alberta were estimated at $270 million. Conservatively, if median was used for mean, the costs for province would be $57 million. Conclusion: The results suggest that an improvement in the controlling of RA could have a significant economic impact in Alberta and that preventing HAQ-score from the worse categories may be associated with substantial savings in terms of productivity losses.
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Larson, Dorothy, Ralph Odegard, and N. E. Brown. "A Specialized Home Care Team Does Make a Difference." Healthcare Management Forum 5, no. 3 (October 1992): 38–41. http://dx.doi.org/10.1016/s0840-4704(10)61214-8.
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Results of a study done in a large teaching and research facility in Alberta reveal that a specialized home care team can substantially lower the cost of caring for people who are ventilator dependent. With the assistance of a pulmonary physician, the Respiratory Home Care program has shown excellent results. Patients report that they “feel as safe at home as in the hospital”, and the savings to the health care system are estimated to be about $2,000,000 per year.
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Krentz, Hartmut, Shayna Campbell, and John Gill. "Desimplification of Single Tablet Antiretroviral (ART) Regimens—A Practical Cost-Savings Strategy?" Journal of the International Association of Providers of AIDS Care (JIAPAC) 18 (January 1, 2019): 232595821882230. http://dx.doi.org/10.1177/2325958218822304.
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Introduction: The use of lifelong antiretroviral therapy (ART) results in increased costs of care; the ability to finance and control sustained costs of ART needs to be discussed. Approach: The Southern Alberta Clinic initiated a practical cost savings approach that switched select patients from a branded ART to a less expensive generic variation. Our approach surveyed physicians and patients on their acceptance of switching and then launched a program asking patients if they would switch to generic variations for cost control purposes. Results: Our early findings found >50% of patients approached agreed to switch. We found no evidence of increased risk of viral breakthrough, resistance, side effects, or displeasure with generic drugs. Measured cost savings in the first year were >$1.1 million with annual projected savings of between $4.3 million and $2.6 million (in 2017 Cdn$). Conclusion: Our approach can provide an option for controlling costs of HIV care without compromising quality.
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Beasley, Gerald, and Trish Rosseel. "Leaning into sustainability at University of Alberta Libraries." Library Management 37, no. 3 (March 14, 2016): 136–48. http://dx.doi.org/10.1108/lm-04-2016-0023.
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Purpose – The purpose of this paper is to present a case study that considers the links between cost avoidance, lean design, and sustainability in relation to two different library projects at University of Alberta Libraries (UAL) – the design of the Research and Collections Resource Facility and the development of new fee-based library services at UAL’s John W. Scott Health Sciences Library. Design/methodology/approach – This case study describes the analysis of each project’s workflows in relation to lean design in order to enhance processes and service delivery. Findings – Findings to date in both of these ongoing projects suggest that consideration of the lean philosophy has already led to process and service improvements. With regard to the new building design project, revised task design is already resulting in significant savings in staff time, and work space. And the staffing model for fee-based specialized services has already been redesigned, an alignment with lean principles. Research limitations/implications – While this paper does discuss and define lean design, it does not provide a comprehensive summary of research in this area. Originality/value – This paper highlights the value of lean design as a framework for designing, developing, and reviewing academic library buildings, services, processes, and workflows to ensure they are sustainable.
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Nicol, Lorraine A., Henning Bjornlund, and K. K. Klein. "Improved Technologies and Management Practices in Irrigation—Implications for Water Savings in Southern Alberta." Canadian Water Resources Journal 33, no. 3 (January 2008): 283–94. http://dx.doi.org/10.4296/cwrj3303283.
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Barnabe, Cheryl, Nguyen Xuan Thanh, Arto Ohinmaa, Joanne Homik, Susan G. Barr, Liam Martin, and Walter P. Maksymowych. "Effect of Remission Definition on Healthcare Cost Savings Estimates for Patients with Rheumatoid Arthritis Treated with Biologic Therapies." Journal of Rheumatology 41, no. 8 (July 15, 2014): 1600–1606. http://dx.doi.org/10.3899/jrheum.131449.
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Objective.Sustained remission in rheumatoid arthritis (RA) results in healthcare utilization cost savings. We evaluated the variation in estimates of savings when different definitions of remission [2011 American College of Rheumatology/European League Against Rheumatism Boolean Definition, Simplified Disease Activity Index (SDAI) ≤ 3.3, Clinical Disease Activity Index (CDAI) ≤ 2.8, and Disease Activity Score-28 (DAS28) ≤ 2.6] are applied.Methods.The annual mean healthcare service utilization costs were estimated from provincial physician billing claims, outpatient visits, and hospitalizations, with linkage to clinical data from the Alberta Biologics Pharmacosurveillance Program (ABioPharm). Cost savings in patients who had a 1-year continuous period of remission were compared to those who did not, using 4 definitions of remission.Results.In 1086 patients, sustained remission rates were 16.1% for DAS28, 8.8% for Boolean, 5.5% for CDAI, and 4.2% for SDAI. The estimated mean annual healthcare cost savings per patient achieving remission (relative to not) were SDAI $1928 (95% CI 592, 3264), DAS28 $1676 (95% CI 987, 2365), and Boolean $1259 (95% CI 417, 2100). The annual savings by CDAI remission per patient were not significant at $423 (95% CI −1757, 2602). For patients in DAS28, Boolean, and SDAI remission, savings were seen both in costs directly related to RA and its comorbidities, and in costs for non-RA-related conditions.Conclusion.The magnitude of the healthcare cost savings varies according to the remission definition used in classifying patient disease status. The highest point estimate for cost savings was observed in patients attaining SDAI remission and the least with the CDAI; confidence intervals for these estimates do overlap. Future pharmacoeconomic analyses should employ all response definitions in assessing the influence of treatment.
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Frascani, Paolo. "Nitti, Beneduce e il problema della regolazione del capitalismo italiano." SOCIETÀ E STORIA, no. 123 (June 2009): 97–111. http://dx.doi.org/10.3280/ss2009-123005.
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- This essay deals with the relationship between Francesco Saverio Nitti and Alberto Beneduce. The author focuses on the peculiarities of the Italian State's attitudes towards industrial capitalism in the first decades of the twentieth century. The collaboration of Beneduce, a technocrat in the age of Giolitti and later the builder of the public sector of the Italian economy in the interwar years, with the famous southern economist found a congenial ground in the construction of institutional props and control systems capable of protecting savings from the risky initiatives of Italian bankers. Their joint efforts produced the new system of bank regulations adopted in 1936 and announced the more modern and effective modes of governance of financial institutions typical of postwar mature capitalism.Keywords: Nitti, Beneduce, capitalism, governance, financial institutionsParole chiave: Nitti, Beneduce, capitalismo, regolazione, istituzioni finanziarie
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Monteiro, Magali de Fátima, Aline Sirlene de Souza, Luiz Antônio de Oliveira, and Jorge Sobral da Silva Maia. "O programa de desenvolvimento educacional do Paraná." Revista HISTEDBR On-line 23 (November 29, 2023): e023029. http://dx.doi.org/10.20396/rho.v23i00.8663588.
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No século XXI, em 2003, o Estado do Paraná iniciou uma política de formação continuada que distinguia de outras experiências oferecidas aos docentes do Quadro Próprio do Magistério. Era o Programa de Desenvolvimento Educacional (PDE), pensado e constituído no governo de Roberto Requião de Mello e Silva, cuja característica fundamental era o diálogo entre Universidade e Rede Pública de Educação Básica, com finalidade de melhoria da educação e valorização profissional. Nos governos de Carlos Alberto Richa as vagas ofertadas foram diminuídas e o PDE-PR sofreu impactos estruturais e orçamentários. Quase extinto em 2015, retomado em 2018 para seleção de nova turma PDE – 2019, limitando-se a um grupo restrito de docentes com títulos de mestrado ou doutorado. A discussão apresentada apoia-se em pesquisa documental e bibliográfica, fundamentada em Gatti, Barretto e André (2011), Martins (2010) e Saviani (2011, 2013). Evidenciam-se as principais características do PDE-PR, nas gestões de Requião e Beto Richa, bem como sua importância para melhoria das práxis docentes, a valorização dos profissionais da educação em um contexto marcado por contradições dos sistemas político, econômico, social e cultural. O texto está organizado em três momentos: no primeiro tematiza-se o conceito de política pública, as características do PDE-PR para formação docente; no segundo, apresenta-se a idealização e implementação do programa no governo de Roberto Requião até o governo de Carlos Alberto Richa e encerra a trajetória desse estudo com o governo de Cida Borghetti; por fim apontam-se as contribuições do Programa para a formação continuada e suas limitações.
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Lilley, M., S. Christian, P. Blumenschein, S. Chan, and M. Somerville. "A centralized approach to out-of-province genetic testing leads to cost savings: the Alberta experience." Clinical Genetics 84, no. 4 (January 4, 2013): 373–77. http://dx.doi.org/10.1111/cge.12077.
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Aftab, Mohammad Adnan, James Byrne, Paul Hazendonk, Dan Johnson, Locke Spencer, and Tim Weis. "Implementing Tri-Brid Energy Systems for Renewable Integration in Southern Alberta, Canada." Clean Technologies 6, no. 3 (August 13, 2024): 1038–56. http://dx.doi.org/10.3390/cleantechnol6030052.
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The steep decline in the price of wind turbines and solar photovoltaics provides a possibility to decarbonize electricity deeply and affordably. This study uses the HOMER Pro energy modeling tool to model an optimized grid-connected renewable energy system for a community in southern Alberta, Canada. The study’s goal is to identify the best renewable energy technology combinations that can provide electricity at the lowest levelized cost of energy (LCOE) and has lower greenhouse gas emissions as compared to the electricity produced by traditional fossil fuel. Gleichen is a small town in southern Alberta that is close to numerous commercial wind and solar projects given the region’s high quality renewable resources. “Tri-brid” systems consisting of wind turbines, solar photovoltaics, and battery energy storage systems (BESS) are considered and compared based on electricity prices, net present cost, and greenhouse gas emissions savings. This tri-brid system is connected to the grid to sell excess generated electricity or buy electricity when there is less or no availability of solar and wind energy. The tri-brid energy system has an estimated LCOE of 0.0705 CAD/kWh, which is competitive with the price of electricity generated by natural gas and coal, which is 0.127 CAD/kWh.
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Majorowicz, Jacek, and Michal Moore. "The feasibility and potential of geothermal heat in the deep Alberta foreland basin-Canada for CO2 savings." Renewable Energy 66 (June 2014): 541–49. http://dx.doi.org/10.1016/j.renene.2013.12.044.
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Alhayaf, Nassir, Eoin Lalor, Vincent Bain, John McKaigney, and Gurpal Singh Sandha. "The Clinical Impact and Cost Implications of Endoscopic Ultrasound on the Use of Endoscopic Retrograde Cholangiopancreatography in a Canadian University Hospital." Canadian Journal of Gastroenterology 22, no. 2 (2008): 138–42. http://dx.doi.org/10.1155/2008/498213.
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BACKGROUND: Endoscopic ultrasound (EUS) is a safe alternative to endoscopic retrograde cholangiopancreatography (ERCP) for diagnostic biliary imaging in choledocholithiasis. Evidence linking a decline in diagnostic ERCP with the introduction of EUS in clinical practice is limited.OBJECTIVE: To assess the clinical impact and cost implications of a new EUS program on diagnostic ERCP at a tertiary referral centre.PATIENTS AND METHODS: A retrospective review was performed of data collected during the first year of EUS at the University of Alberta Hospital (Edmonton, Alberta). Patients were referred for ERCP because of suspicion of choledocholithiasis based on clinical, biochemical and/or radiological parameters. If they were assessed to have an intermediate probability of choledocholithiasis, EUS was performed first. ERCP was performed if EUS suggested choledocholithiasis, whereas patients were clinically followed for six months if their EUS was normal. Cost data were assessed from a third-party payer perspective, and cost savings were expressed in terms of ERCP procedures avoided.RESULTS: Over 12 months, 90 patients (63 female, mean age 58 years) underwent EUS for suspected biliary tract abnormalities. EUS suggested choledocholithiasis in 20 patients (22%), and this was confirmed by ERCP in 17 of the 20 patients. EUS was normal in 69 patients, and none underwent a subsequent ERCP during a six-month follow-up period. One patient had pancreatic cancer and did not undergo ERCP. The sensitivity and specificity of EUS for choledocholithiasis were 100% and 96%, respectively. A total of 440 ERCP procedures were performed over the same 12-month period, suggesting that EUS resulted in a 14% reduction in ERCP procedures (70 of 510). There were no complications of EUS. The cost of 90 EUS procedures was $42,840, compared with $108,854 for 70 ERCP procedures. The cost savings for the first year were $66,014.CONCLUSION: EUS appears to be accurate, safe and cost effective in diagnostic biliary imaging for suspected choledocholithiasis. The impact of EUS is the avoidance of ERCP in selected cases, thereby preventing the risk of complications. Diagnostic ERCP should not be performed in centres and regions with physicians trained in EUS.
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Lathia, Nina, Karen Sullivan, Kathy Tam, Margaret Brna, Paula MacNeil, Deb Saltmarche, and Karen Agro. "Cost-minimization analysis of community pharmacy-based point-of-care testing for strep throat in 5 Canadian provinces." Canadian Pharmacists Journal / Revue des Pharmaciens du Canada 151, no. 5 (August 17, 2018): 322–31. http://dx.doi.org/10.1177/1715163518790993.
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Background: Strep throat point-of-care (POC) testing in community pharmacies will enable pharmacist-based care for this condition. Our objective was to conduct an economic evaluation of treating severe sore throat when this service was offered in pharmacies in 5 Canadian provinces. Methods: We conducted 5 separate cost-minimization analyses for the provinces of Alberta, British Columbia, Nova Scotia, Ontario and Saskatchewan, from the public payer perspective, to estimate mean cost per patient of treating severe sore throat in 2 scenarios: 1) physician-based usual care in a family physician’s office, a walk-in clinic or an emergency room (ER) and 2) a new scenario where patients received care described above or in a pharmacy offering strep throat POC testing. One-way sensitivity analyses were conducted to account for model uncertainty. Results: Mean cost per patient for each pathway in the base-case analyses for the 5 provinces ranged from 1) $37.55 to $61.57 for family physician, 2) $37.55 to $61.57 for walk-in clinic, 3) $38.88 to $57.56 for ER and 4) $19.12 to $21.83 for pharmacy, representing savings ranging from $12.47 to $24.36 per patient for the new scenario. Approximate total cost savings range from $1.3 million to $2.6 million per year across the 5 provinces. All sensitivity analyses yielded cost savings for the new scenario. Discussion: Across 5 provinces, strep throat POC testing in pharmacies was cost saving compared to physician-based care. Sensitivity analyses demonstrated the robustness of these results. Conclusions: Funding strep throat POC testing in community pharmacies in these 5 provinces would lead to public health system cost savings and potentially improve patients’ access to care for severe sore throat.
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Hall, R. J., A. R. Kruger, W. C. Moore, J. Scheffer, and S. J. Titus. "A Statistical Evaluation of LANDSAT TM and MSS Data for Mapping Forest Cutovers." Forestry Chronicle 65, no. 6 (December 1, 1989): 441–49. http://dx.doi.org/10.5558/tfc65441-6.
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The cutover area and boundary placement mapping accuracies from currently used air photo techniques and LANDSAT TM and MSS imagery were determined for Alberta forestry conditions. Overall area accuracies for the air photo techniques. LANDSAT TM, and MSS images were 86.7%, 89.5%, and 86.9%, respectively. The influence of increasing accuracy with increasing cutover size, however, must be kept in perspective. Although interpreted cutover areas were generally smaller compared with their actual areas, the deviation was systematic and could therefore be corrected by regression techniques. Overall boundary placement errors for air photo techniques. LANDSAT TM, and MSS images were 30.1, 24.9, and 38.3 m, respectively. Most of the LANDSAT TM errors were in the 20-m range and were within 5 m of the target 15-20 m desired by the Alberta Forest Service. Improvements to this may be achieved by using larger scale satellite images. The base map scale of 1:20 000 was a limiting factor to this study, however, as it was too small with both plotting errors and pen line widths contributing to existing map errors. LANDSAT TM images offered a 12:1 cost savings in data acquisition and are more efficient in comparison with conventional air photos. Use of either medium scale air photos or LANDSAT TM images can be recommended depending on the level of timber commitment accuracy requirements and is presented in the paper as an operational cutover update mapping strategy. Keywords: Forest inventory, update, LANDSAT, change detection, mapping, accuracy analysis, remote sensing.
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Kaplan, Gilaad G., Christopher Ma, Cynthia H. Seow, Karen I. Kroeker, and Remo Panaccione. "The Argument Against a Biosimilar Switch Policy for Infliximab in Patients with Inflammatory Bowel Disease Living in Alberta." Journal of the Canadian Association of Gastroenterology 3, no. 5 (January 24, 2020): 234–42. http://dx.doi.org/10.1093/jcag/gwz044.
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Abstract A nonmedical switch policy is currently being considered in Alberta, which would force patients on originator biologics to biosimilar alternatives with the hypothetical aim of reducing costs to the health care system. The evidence to support the safety of nonmedical switching in patients with inflammatory bowel disease (IBD) is of low to very low quality; in fact, existing data suggest a potential risk of harm. In a pooled analysis of randomized controlled trials, one patient would lose response to infliximab for every 11 patients undergoing nonmedical switching. Switching to a biosimilar has important logistical and ethical implications including potential forced treatment changes without appropriate patient consent and unfairly penalizing patients living in rural areas and those without private drug insurance. Even in the best-case scenario, assuming perfectly executed switching without logistical delays, we predict switching 2,000 patients with Remicade will lead to over 60 avoidable surgeries in Alberta. Furthermore, nonmedical switching has not been adequately studied in vulnerable populations such as children, pregnant women, and elderly patients. While the crux of the argument for nonmedical switching is cost savings, biosimilar switching may not be cost effective: Particularly when originator therapies are being offered at the same price as biosimilars. Canadian patients with IBD have been surveyed, and their response is clear: They are not in support of nonmedical switching. Policies that directly influence patient health need to consider patient perspectives. Solutions to improve cost efficiency in health care exist but open, transparent collaboration between all involved stakeholders is required.
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Ali, Babkir. "Integration of Impacts on Water, Air, Land, and Cost towards Sustainable Petroleum Oil Production in Alberta, Canada." Resources 9, no. 6 (May 28, 2020): 62. http://dx.doi.org/10.3390/resources9060062.
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This paper intends to develop quantitative indicators for comparative sustainability assessment of petroleum oil pathways in the province of Alberta, Canada. Eighteen pathways of oil production were developed in this study, and the sustainability indicators were assigned for each pathway to cover greenhouse gas (GHG) emissions, water demand, and land use in addition to the cost of supply. The developed sustainability indicators were aligned per functional unit and covered the full life cycle of petroleum oil production. The developed GHG emissions, cost of supply, and land use indicators are found in the range 17.50–226.20 kg of CO2 eq./bbl, 12.28–53.53 USD/bbl, and 0.06–0.178 m2/bbl, respectively. Four scenarios were comparatively conducted and assessed against the business-as-usual scenario within the period horizon 2009–2030. The cost-effective scenario was optimized with the objective function to minimize the cost of supply based on the constraints derived from the business-as-usual scenario. Sustainable scenarios were conducted with the lowest possible impacts on natural resources, GHG emissions, and the cost of supply accompanied by specific assumptions for petroleum oil production from different pathways in Alberta. The average annual savings on water demand and land area were found to be 67 and 30%, respectively, due to the shifting of upgrader feedstock from surface mining to the in-situ steam-assisted gravity drainage (SAGD) pathway. The corresponding increases due to this shifting in upgrader feedstock were found to be 40 and 3% in GHG emissions and cost of supply, respectively.
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Lei, Yang, Jennifer Halasz, Kerri L. Novak, and Stephen E. Congly. "Intermittent Proton Pump Inhibitor Therapy in Low-Risk Non-Variceal Upper Gastrointestinal Bleeding May Be Significantly Cost-Saving." Medicines 10, no. 7 (July 20, 2023): 44. http://dx.doi.org/10.3390/medicines10070044.
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Background: High-dose proton pump inhibitor (PPI) therapy, given either intermittently or continuously for non-variceal upper gastrointestinal bleeding (NV-UGIB), is efficacious. Using intermittent PPI for low-risk patients may be cost-saving. Our objective was to estimate the annual cost savings if all low-risk NV-UGIB patients received intermittent PPI therapy. Methods: Patients who presented to hospital in Calgary, Alberta, who received a PPI for NV-UGIB from July 2015 to March 2017 were identified using ICD-10 codes. Patients were stratified into no endoscopy, high-risk, and low-risk lesion groups and further subdivided into no PPI, oral PPI, intermittent intravenous (IV), and continuous IV subgroups. Average length of stay (LOS) in each subgroup and costs were calculated. Results: We identified 4141 patients with NV-UGIBs, (median age 61, 57.4% male). One-thousand two-hundred and thirty-one low-risk patients received continuous IV PPI, with an average LOS of 6.8 days (95% CI 6.2–7.3) versus 4.9 days (95% CI 3.9–5.9) for intermittent IV patients. If continuous IV PPI patients instead received intermittent IV PPI, 3852 patient days and CAD 11,714,390 (2017 CAD)/year could be saved. Conclusions: Using real-world administrative data, we demonstrate that a sizable portion of low-risk patients with NV-UGIB who were given continuous IV PPI if switched to intermittent IV therapy could generate significant potential cost savings.
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Krentz, Hartmut B., and M. John Gill. "The Direct Medical Costs of Late Presentation (<350/mm3) of HIV Infection over a 15-Year Period." AIDS Research and Treatment 2012 (2012): 1–8. http://dx.doi.org/10.1155/2012/757135.
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We describe the immediate- and longer-term direct medical costs of care for individuals diagnosed with HIV at CD4 counts <350/mm3(“late presenters”). We collected and stratified by initial CD4 count all inpatient, outpatient, and drug costs for all newly diagnosed patients accessing HIV care within Southern Alberta from 1/1/1995 to 1/1/2010. 59% of new patients were late presenters. We found significantly higher costs for late presenters, especially inpatient costs, during the first year after accessing care. Direct medical costs remained almost twice as high for late presenters in subsequent years compared to patients presenting with CD4 counts >350/mm3despite significantly their improved CD4 counts. The sustained high cost for late presenters has implications for recent recommendations for wider routine HIV testing and the earlier initiation of cART. Earlier diagnosis and treatment, while increasing the immediate expenditures within a population, may produce both direct and indirect cost savings in the longer term.
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Sharma, Vishal, Vinaykumar Kulkarni, Tanya Joon, Dean T. Eurich, Scot H. Simpson, Don Voaklander, Bruce Wright, and Salim Samanani. "Predicting falls-related admissions in older adults in Alberta, Canada: a machine-learning falls prevention tool developed using population administrative health data." BMJ Open 13, no. 8 (August 2023): e071321. http://dx.doi.org/10.1136/bmjopen-2022-071321.
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ObjectiveTo construct a machine-learning (ML) model for health systems with organised falls prevention programmes to identify older adults at risk for fall-related admissions.DesignThis prognostic study used population-level administrative health data to develop an ML prediction model.SettingThis study took place in Alberta, Canada during 2018–2019.ParticipantsAlbertans aged 65 and older with at least one prior admission. Those with palliative conditions or emigrated out of Alberta were excluded.ExposureUnit of analysis was the individual person.Main outcomes/measuresWe identified fall-related admissions. A CatBoost model was developed on 2018 data to predict risk of fall-related emergency department visits or hospitalisations. Temporal validation was done using 2019 data to evaluate model performance. We reported discrimination, calibration and other relevant metrics measured at the end of 2019 on both ranked predictions and predicted probability thresholds. A cost-savings simulation was performed using 2019 data.ResultsFinal number of study participants was 224 445. The validation set had 203 584 participants with 19 389 fall-related events (9.5% pretest probability) and an ML model c-statistic of 0.70. The highest ranked predictions had post-test probabilities ranging from 40% to 50%. Net benefit analysis presented mixed results with some net benefit using the ML model in the 6%–30% range. The top 50 percentile of predicted risks represented nearly $C60 million in health system costs related to falls. Intervening on the top 25 or 50 percentiles of predicted risk could realise substantial (up to $C16 million) savings.ConclusionML prediction models based on population-level administrative data can assist health systems with fall prevention programmes identify older adults at risk of fall-related admissions and reduce costs. ML predictions based on ranked predictions or probability thresholds could guide subsequent interventions to mitigate fall risks. Increased access to diverse forms of data could improve ML performance and further reduce costs.
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Nelson, G., L. N. Kiyang, A. Chuck, N. X. Thanh, and L. M. Gramlich. "Cost impact analysis of Enhanced Recovery After Surgery program implementation in Alberta colon cancer patients." Current Oncology 23, no. 3 (June 13, 2016): 221. http://dx.doi.org/10.3747/co.23.2980.
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Background The Enhanced Recovery After Surgery (ERAS) colorectal guideline has been implemented widely across Alberta. Our study examined the clinical and cost impacts of eras on colon cancer patients across the province.Methods We first used both summary statistics and multivariate regression methods to compare, before and after guideline implementation, clinical outcomes (length of stay, complications, readmissions) in consecutive elective colorectal patients 18 or more years of age and in colon cancer and non-cancer patients treated at the Peter Lougheed Centre and the Grey Nuns Hospital between February 2013 and December 2014. We then used the differences in clinical outcomes for colon cancer patients, together with the average cost per hospital day, to estimate cost impacts.Results The analysis considered 790 patients (398 cancer and 392 non-cancer patients). Mean guideline compliance increased to 60% in cancer patients and 57% in non-cancer patients after ERAS implementation from 37% overall before ERAS implementation. From pre- to post-ERAS, mean length of stay declined to 8.4 ± 5 days from 9.5 ± 7 days in cancer patients, and to 6.4 ± 4 days from 8.8 ± 5.5 days in non-cancer patients (p = 0.0012 and p = 0.0041 respectively). Complications declined significantly in the renal, hepatic, pancreatic, and gastrointestinal groups (difference in proportions: 13% in cancer patients; p < 0.05). No significant change in the risk of readmission was observed. The net cost savings attributable to ERAS implementation ranged from $1,096 to $2,771 per cancer patient and from $3,388 to $7,103 per non-cancer patient.Conclusions Implementation of eras not only resulted in clinical outcome improvements, but also had a significant beneficial impact on scarce health system resources. The effect for cancer patients was different from that for noncancer patients, representing an opportunity for further refinement and study.
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Brooks, Stephen. "The State as Financier: A Comparison of the Caisse de dépôt et placement du Québec and Alberta Heritage Savings Trust Fund." Canadian Public Policy / Analyse de Politiques 13, no. 3 (September 1987): 318. http://dx.doi.org/10.2307/3550908.
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Mansuy, Nicolas, Diana Staley, and Leila Taheriazad. "Woody Biomass Mobilization for Bioenergy in a Constrained Landscape: A Case Study from Cold Lake First Nations in Alberta, Canada." Energies 13, no. 23 (November 28, 2020): 6289. http://dx.doi.org/10.3390/en13236289.
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Wood-based bioenergy systems developed and managed by Indigenous communities can improve their ability to thrive and grow economically and socially and improve their resource-based decision-making processes. In this study, we collaborated with Cold Lake First Nations (CLFN), a community located in Northern Alberta, Canada, to investigate the opportunities and challenges of biomass mobilization from different feedstocks. Based on remote sensing and ground data, harvest residue and fire residue feedstocks were identified within the boundaries of the community and inside a radius of 200 km at 18 and 39 oven-dry metric tonnes (odt)/ha, respectively. CLFN also received woody biomass from local oil and gas producers that operate in their traditional territory, which is estimated at 19,000 odt/year. Despite being abundant, the woody biomass is difficult to access due to the extensive human footprint that surrounds the area and constrains the landscape. In terms of greenhouse gas (GHG) mitigation, the potential also appears limited because the community has access to natural gas at a competitive and stable price, unlike off-grid communities. In terms of cost savings, the low oil and gas prices make the biomass resources (pellets) less competitive to utilize than the natural gas that is available in the community.
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Wiepjes, M., H. Q. Huynh, J. Wu, M. Chen, L. Shirton, M. Zarrabi, and J. Turner. "A113 COST SAVINGS OF SEROLOGIC VERSUS BIOPSY PROVEN DIAGNOSIS OF PEDIATRIC CELIAC DISEASE." Journal of the Canadian Association of Gastroenterology 3, Supplement_1 (February 2020): 131–32. http://dx.doi.org/10.1093/jcag/gwz047.112.
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Abstract Background Celiac disease (CD) affects approximately one percent of the population in Canada and the United States. At present, endoscopic diagnosis (ED) of CD remains the gold standard in North America, despite mounting evidence and validated European guidelines for serologic diagnosis (SD). Within publicly funded healthcare systems there is pressure to ensure optimal resource utilization and cost efficiency, including for endoscopic services. At Stollery Children’s Hospital, Edmonton, Canada, we have adopted serologic diagnosis as routine practice since 2016. Aims The aim of this study is to estimate cost savings, i.e. hard dollar savings and capacity improvements, to the health care system as well as impacts on families in regard to reduced work days lost and missing child school days for SD versus ED. Initial cost saving data is presented. Methods Micro-costing methods were used to determine health care resource use in patients undergoing ED or SD from 2017–2018. SD testing included anti-tissue glutaminase antibody (aTTG) ≥200IU/mL (on two occasions), human leukocyte antigen (HLA) DQA5/DQ2, blood sampling, transport and laboratory costs. ED diagnosis included gastroenterologist, anesthetist, OR equipment, staff, overhead and histopathology. Cost of each unit of resource was obtained from the schedule of medical benefits (Alberta) and reported average ambulatory cost for day hospital endoscopy for Stollery Children’s Hospital determined in 2016; reported in CAN$. Results Between March 2017-December 2018, 473 patients were referred for diagnosis of CD; 233 had ED and 127 SD. Estimated cost for ED was $1240 per patient; for SD was $85 per patient (6.8% of ED cost). Based on 127 patients not requiring endoscopy and a cost saving of $1155 per patient there was a total cost savings of $146,685 over 22 months. Conclusions A SD approach presents a significant cost savings to the public health care system. It also frees up valuable endoscopic resources, and limits exposure of children to the immediate and long-term risks associated with anesthesia and biopsy. SD also decreases time to diagnosis and the cost of the process to families (lost days of school/work, travel costs etc.). Our costing data can be used in combination with mounting evidence on the test performance of SD versus ED to determine cost-effectiveness of serological diagnosis for pediatric CD. Given the potential for cost saving and more efficient operating room utilization, SD for pediatric CD warrants further investigation in North America. Funding Agencies None
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Lissorgues, Yvan. "Albert Savine. “Le naturalisme en Espagne. El naturalismo en España”. Edición bilingüe, traducción, introducción, notas y apéndices de Esteban Gutiérrez Díaz – Bernardo. Vigo: Editorial Academia del Hispanismo, 2009." BOLETÍN DE LA BIBLIOTECA DE MENÉNDEZ PELAYO 85, Único (September 14, 2022): 617–20. http://dx.doi.org/10.55422/bbmp.776.
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Esteban Gutiérrez es el traductor y editor de Le naturalisme en Espagne, escrito por Albert Savine. Gutiérrez se encarga de traducir, introducir y comentar la obra, que hace un repaso por el género literario del naturalismo, cómo surgió y se desarrolló en España y sus relaciones con Francia, su país de origen. A través del texto origina de Savine se pueden aprender muchos datos del siglo XIX, de cómo escribían los autores de esa época, etc., pero el verdadero análisis profundo se obtiene gracias a las anotaciones de Esteban Gutiérrez, quien, además, incluye una biografía de Savine y un contexto histórico y literario. En general, es una obra muy bien comentada, a pesar de que falten algunos índices que sean de ayuda, y que demuestra la gran labor de investigación de su editor.
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Solick, Donald I., and Robert M. R. Barclay. "Thermoregulation and roosting behaviour of reproductive and nonreproductive female western long-eared bats (Myotis evotis) in the Rocky Mountains of Alberta." Canadian Journal of Zoology 84, no. 4 (April 2006): 589–99. http://dx.doi.org/10.1139/z06-028.
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Entering torpor can yield significant energy savings for temperate-zone bats but can be costly for reproductive females by slowing fetal development and reducing milk production. We studied western long-eared bats (Myotis evotis (H. Allen, 1864)) in the Rocky Mountains of Alberta to test the hypothesis that different costs of torpor result in different patterns of thermoregulation and roosting behaviour for reproductive and nonreproductive females. We radio-tracked bats to monitor body temperatures and locate roosts. We took roost measurements and inserted temperature data loggers to measure roost microclimate. Bats entered torpor frequently, but nonreproductive females spent longer periods in torpor, had lower minimum body temperatures, and entered deep torpor more often than reproductive females did, supporting the hypothesis that entering torpor is more costly for reproductive individuals. Roosts were located mainly in rock fields on steep, open, south-facing slopes. Reproductive females roosted in crevices between rocks located above or on the surface of the ground. Roosts warmed rapidly and reached warm daytime temperatures. Females roosted alone during pregnancy but formed small colonies within roosts during lactation when ambient conditions were cooler. Clustering may reduce thermoregulatory costs for both adults and young. Nonreproductive females roosted mainly alone in crevices in the ground. These roosts had cooler, more stable microclimates, allowing females to enter deeper bouts of torpor and remain torpid longer.
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Chong, Christy, James Wick, Scott Klarenbach, Braden Manns, Brenda Hemmelgarn, and Paul Ronksley. "Cost of Potentially Preventable Hospitalizations Among Adults With Chronic Kidney Disease: A Population-Based Cohort Study." Canadian Journal of Kidney Health and Disease 8 (January 2021): 205435812110185. http://dx.doi.org/10.1177/20543581211018528.
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Background: Prior studies report high hospitalization rates among patients with chronic kidney disease (CKD) and approximately 10% to 20.9% of hospitalizations are potentially preventable. Objective: To determine the rate, proportion, and cost of potentially preventable hospitalizations and whether this varied by CKD category. Design: Retrospective cohort study using population-based data. Setting: Alberta, Canada. Patients: All adults with an outpatient serum creatinine measurement between January 1 and December 31, 2017 in the Alberta Kidney Disease Network data repository. Measurements: CKD risk categories were based on measures of proteinuria (where available), eGFR, and use of dialysis. Patients were linked to administrative data to capture frequency and cost of hospital encounters and followed until death or end of study (December 31, 2018). The outcomes of interest were the rate and cost of potentially preventable hospitalizations, as identified using the Canadian Institute for Health Information (CIHI)-defined ambulatory care sensitive condition (ACSC) algorithm and a CKD-related ACSC algorithm. Methods: Unadjusted and adjusted rates per 1000-patient years, proportions, and cost attributable to preventable hospitalizations were identified for the cohort as a whole and for patients within each CKD risk category. Results: Of the 1,110,895 adults with eGFR and proteinuria measurements, 181,422 had CKD. During a median follow-up of 1 year, there were 62,023 hospitalizations among patients with CKD resulting in a total cost of $946 million CAD; 6907 (11.1%) of these hospitalizations were for CIHI-defined ACSCs while 4323 (7.0%) were for CKD-related ACSCs. Adjusted rates of hospitalization for ACSCs increased with CKD risk category and were highest among patients treated with dialysis. Among CKD patients, the total cost of potentially preventable hospitalizations was $79 million and $58 million CAD for CIHI-defined and CKD-related ACSCs (8.4% and 6.2% of total hospitalization cost, respectively). Limitations: Based on the ACSC construct, we were unable to determine if these hospitalizations were truly preventable. Conclusions: Potentially preventable hospitalizations have a substantial cost and burden on the health care system among people with CKD. Effective strategies that reduce preventable admissions among CKD patients may lead to significant cost savings. Trial registration: Not applicable—observational study design
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De Araújo Silva, Marcos Érico. "Filosofia como exercício do pensamento em Kierkegaard: apontamentos sobre o fazer e ensinar filosofia." Ítaca, no. 30 (December 1, 2016): 245–70. http://dx.doi.org/10.59488/itaca.v0i30.10103.
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Este artigo procura pensar a caracterização da filosofia como exercício do pensamento em Kierkegaard. Existem dois modos de pensar: o erudito, e o filosófico. A “clareza” da erudição fundamenta-se numa obscuridade. Apenas o pensar filosófico, aquele que pensa um único pensamento, é que adquire transparência. A partir dessa ideia da filosofia decorre alguns apontamentos sobre o fazer e o ensinar filosofia. Referências bibliográficas BERGSON, Henri. Introdução à metafísica. In: O pensamento e o movente. Tradução de Bento Prado Neto. São Paulo: Martins Fontes, 2006. DESCARTES, René. Regras para a direção do espírito. Tradução de João Gama. Lisboa: Edições 70, 1985. ______ . Meditações sobre filosofia primeira. Tradução de Fausto Castilho. Edição em latim e em português. São Paulo: Editora UNICAMP, 2004. HEIDEGGER, Martin. Carta sobre o humanismo. In: Marcas do caminho. Tradução de Enio Paulo Giachini, e Ernildo Stein. Petrópolis: Vozes, 2008a. HEIDEGGER, Martin. Introdução à filosofia. Tradução de Marco Antônio Casanova. São Paulo: Martins Fontes, 2008b. ______ . Ejercitación en el pensamento filosófico: Ejercicios en el semestre de invierno de 1941-1942. Traducción de Alberto Ciria. Barcelona: Herder, 2011. KIERKEGAARD, Søren. As obras do amor: algumas considerações cristãs em forma de discursos. Tradutor Álvaro Luiz Montenegro Valls. 1ª ed. Petrópolis: Vozes; Bragança Paulista: Editora Universitária São Francisco, 2005. ______ . Pós-escrito conclusivo não científico às migalhas filosóficas: coletânea mímico-patético-dialética, contribuição existencial, por Johannes Climacus. Vol. I. Tradução de Álvaro Luiz Montenegro Valls e Marília Murta de Almeida. Petrópolis: Vozes; Bragança Paulista: Editora Universitária São Francisco, 2013. ______ . Pós-escrito conclusivo não científico às migalhas filosóficas: coletânea mímico-patético-dialética, contribuição existencial, por Johannes Climacus. Vol. II. Tradução de Álvaro Luiz Montenegro Valls e Marília Murta de Almeida. Petrópolis: Vozes; Bragança Paulista: Editora Universitária São Francisco, 2016. ______ . Johannes Climacus ou É preciso duvidar de tudo. Tradução de Sílvia Saviano Sampaio e Álvaro Luiz Montenegro Valls. Prefácios e notas de Jacques Lafarge. 1ª ed. São Paulo: Martins Fontes, 2003. WITTGENSTEIN, Ludiwig. Tractatus logico-philosophicus. Tradução de José Arthur Giannotti. São Paulo: Editora da Universidade de São Paulo, 1968.Referências bibliográficas BERGSON, Henri. Introdução à metafísica. In: O pensamento e o movente. Tradução de Bento Prado Neto. São Paulo: Martins Fontes, 2006. DESCARTES, René. Regras para a direção do espírito. Tradução de João Gama. Lisboa: Edições 70, 1985. ______ . Meditações sobre filosofia primeira. Tradução de Fausto Castilho. Edição em latim e em português. São Paulo: Editora UNICAMP, 2004. HEIDEGGER, Martin. Carta sobre o humanismo. In: Marcas do caminho. Tradução de Enio Paulo Giachini, e Ernildo Stein. Petrópolis: Vozes, 2008a. HEIDEGGER, Martin. Introdução à filosofia. Tradução de Marco Antônio Casanova. São Paulo: Martins Fontes, 2008b. ______ . Ejercitación en el pensamento filosófico: Ejercicios en el semestre de invierno de 1941-1942. Traducción de Alberto Ciria. Barcelona: Herder, 2011. KIERKEGAARD, Søren. As obras do amor: algumas considerações cristãs em forma de discursos. Tradutor Álvaro Luiz Montenegro Valls. 1ª ed. Petrópolis: Vozes; Bragança Paulista: Editora Universitária São Francisco, 2005. ______ . Pós-escrito conclusivo não científico às migalhas filosóficas: coletânea mímico-patético-dialética, contribuição existencial, por Johannes Climacus. Vol. I. Tradução de Álvaro Luiz Montenegro Valls e Marília Murta de Almeida. Petrópolis: Vozes; Bragança Paulista: Editora Universitária São Francisco, 2013. ______ . Pós-escrito conclusivo não científico às migalhas filosóficas: coletânea mímico-patético-dialética, contribuição existencial, por Johannes Climacus. Vol. II. Tradução de Álvaro Luiz Montenegro Valls e Marília Murta de Almeida. Petrópolis: Vozes; Bragança Paulista: Editora Universitária São Francisco, 2016. ______ . Johannes Climacus ou É preciso duvidar de tudo. Tradução de Sílvia Saviano Sampaio e Álvaro Luiz Montenegro Valls. Prefácios e notas de Jacques Lafarge. 1ª ed. São Paulo: Martins Fontes, 2003. WITTGENSTEIN, Ludiwig. Tractatus logico-philosophicus. Tradução de José Arthur Giannotti. São Paulo: Editora da Universidade de São Paulo, 1968.
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Kawchuk, Gregory N., Jacob Aaskov, Matthew Mohler, Justin Lowes, Maureen Kruhlak, Stephanie Couperthwaite, Esther H. Yang, Cristina Villa-Roel, and Brian H. Rowe. "A prospective study of patients with low back pain attending a Canadian emergency department: Why they came and what happened?" PLOS ONE 17, no. 5 (May 10, 2022): e0268123. http://dx.doi.org/10.1371/journal.pone.0268123.
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Low back pain is a common presentation to emergency departments, but the reasons why people choose to attend the emergency department have not been explored. We aimed to fill this gap with this study to understand why persons with low back pain choose to attend the emergency department. Between July 4, 2017 and October 1, 2018, consecutive patients with a complaint of low back pain presenting to the University of Alberta Hospital emergency department were screened. Those enrolled completed a 13-item questionnaire to assess reasons and expectations related to their presentation. Demographics, acuity and disposition were obtained electronically. Factors associated with admission were examined in a logistic regression model. After screening 812 patients, 209 participants met the study criteria. The most common Canadian Triage and Acuity Scale score was 3 (73.2%). Overall, 37 (17.7%) received at least one consultation, 89.0% of participants were discharged home, 9.6% were admitted and 1.4% were transferred. Participants had a median pain intensity of 8/10 and a median daily functioning of 3/10. When asked, 64.6% attended for pain control while 44.5% stated ease of access. Most participants expected to obtain pain medication (67%) and advice (56%). Few attended because of cost savings (3.8%). After adjustment, only advanced age and ambulance arrival were significantly associated with admission. In conclusion, most low back pain patients came to the emergency department for pain control yet few were admitted and the majority did not receive a consultation. Timely alternatives for management of low back pain in the emergency department appear needed, yet are lacking.
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Hailey, David, Philip Jacobs, Irvin Mayers, and Shaila Mensinkai. "The Current Status of Autotitrating Continuous Positive Airway Pressure Systems in the Management of Obstructive Sleep Apnea." Canadian Respiratory Journal 12, no. 5 (2005): 271–76. http://dx.doi.org/10.1155/2005/870786.
Full textAbstract:
BACKGROUND: Autotitrating continuous positive airway pressure (APAP) devices have the potential to address some of the disadvantages of titration and treatment with conventional continuous positive airway pressure (CPAP). Information on the performance of APAP in clinical use is still comparatively limited.OBJECTIVE: To assess the status of APAP devices in the management of obstructive sleep apnea (OSA) by reviewing evidence of their efficacy, effectiveness and costs.METHODS: A systematic search of electronic databases and a review of selected comparative studies on the use of APAP in the diagnosis, titration and treatment of OSA was undertaken. Cost analysis using data applicable to the management of OSA in Edmonton, Alberta was performed.RESULTS: Thirty-three studies met the selection criteria: three on the use of APAP in diagnosing OSA; six on APAP for titration; 14 that considered short-term treatment outcomes; and 10 that addressed longer-term treatment of OSA. In most studies, patients suffering from cardiac, pulmonary and other medical conditions were excluded. Available data suggested some potential for the use of APAP in the diagnosis of OSA, but further validation is needed. In titration, estimated treatment pressures tended to be lower with APAP than with the manual titration of CPAP. Although lower treatment pressures were achieved with APAP, there was no significant difference in clinical outcome measures between APAP and CPAP. Estimates of costs suggested that APAP may provide savings in some scenarios.CONCLUSIONS: APAP shows promise in the management of OSA; however, given the exclusion of some categories of patients from trials of this technology, caution is still required in its use.