Social evaluations

Economic evaluation is an assessment of the probable benefit or reward of a proposed course of action, relative to other choices. Although the benefit usually takes the form of a financial return, in environmental management, transportation (qv), health care, and other social areas, the benefit may be a social gain instead. Some method is then developed to translate the social gain into a monetary equivalent. The discussion herein is limited to the financial return expected from some type of production or service activity. 

At the time of writing photodegradants are in an early stage of development and have not yet been fully evaluated. It is a moot point whether or not manufacturers will put such materials into polymer compounds and thus increase the price about 5% without legal necessity. However, if such legislation, considered socially desirable by many, took place one might expect polyethylene... 

Evaluation of public health, economic, social, political consequences of regulatory options... 

Evaluation level change operators criteria for performance—enforce meaningful procedures—address work conditions and social content. Also it is necessary to change management s perception of the need for supervision and the importance of solvent charging. Obviously it is a failure of supervision to be imaware or to tolerate that valves were not reset after use. 

Social Factors. The personalities of co-w orkers and supervisors arc also factors to be considered when evaluating Uie workplace. The liigher Uie employee morale, Uie lower Uie potcnUal for accidents. Another factor is Uie relationship of one job to another, and wheUier Uie job requires Uie coordinating of information, materials, and human effort. 

Marketing forecasts for batteries have been compiled from the Annual Reports published by several battery companies. Information based on the trade journals and investor s brochures, which surveyed and evaluated the present and future global distribution of battery types, was collected. Points of interest were the availability of batteries and their performance/cost ratios, but also geographical usage in connection with social considerations, such as per-... 

Educating the Patient and Family The nurse evaluates the patient s ability to understand the therapeutic drug regimen, ability to care for himself or herself in the home environment, and ability to comply with the prescribed drug therapy. If any type of assistance is needed, the nurse provides a referral to the discharge planning coordinator or social worker. 

Cantopher T, Olivieri S, Cleave N, et al Chronic benzodiazepine dependence a comparative smdy of abrupt withdrawal under propranolol cover versus gradual withdrawal. Br J Psychiatry 156 406-411, 1990 Caplan RD, Andrews FM, Conway TL, et al Social effects of diazepam use a longitudinal field study. Soc Sci Med 21 887—898, 1985 Charney DA, Paraherakis AM, Gill KJ The treatment of sedative-hypnotic dependence evaluating clinical predictors of outcome. J Clin Psychiatry 61 190—195, 2000... 

Cost-benefit analysis (CBA) is unique among economic evaluations in that it addresses the extent to which a particular course of action, such as a drug treatment or a hospital admission, is economically or socially worth while in the broadest sense. A CBA measures... 

The objective of economic evaluations of health and social care interventions is to inform decision-makers about the relative costs and benefits to society of two or more methods of providing care. In the context of dementia these may be comparisons of different drug therapies (pharmacoeconomic... 

Economic studies should consider the costs of all the resources and services used in the process of care. In addition, the outcomes that are a consequence of the health or social care interventions evaluated need to be included. For dementia, these include the costs of hospital inpatient and out-patient care, primary and community-based health-care services, social welfare services, and care provided by voluntary agencies or by femily and friends. Ideally, a broad perspective reflecting the costs and outcomes to society should be adopted. As a minimum, the perspective of the analysis should include the costs and outcomes to key health and social care providers or funders and to patients and their families. 

The interventions compared need to be relevant to the health and social care choices faced by decision-makers. Unless do nothing is a valid management strategy, comparison of a new intervention with placebo is not appropriate for an economic evaluation. Since there are a number of dmg therapies and non-pharmacological approaches to the management of people with dementia, the relative cost-effectiveness of these needs to be... 

To be useful to those concerned with choices in the allocation of health and social care resources, the data for economic evaluations need to be timely, relevant, credible and accurate (Davies, 1998). As a minimum, the costs associated with the interventions should be estimated from activity data, which quantify resources used, and price or unit cost data. Often evidence from well-controlled prospective trials with high internal validity is required to establish whether differences in economic end points are directly attributable to the interventions. However, the economic evaluations of acetylcholinesterase inhibitors estimated costs from retrospective analysis of available datasets Qonsson et al, 1999b), analysis of published literature (e.g. Stewart et al, 1998) and expert opinion (e.g. O Brien et al, 1999 Neumann et al, 1999). This means that it is not clear whether differences in costs were due to the anticholinesterase inhibitors or to other factors such as availability of services in different areas, the living situation of the patient, or disease severity. 

In the near future new drugs for the treatment of Alzheimer s disease are expected to be licensed, and it would be extremely valuable to be able to compare them in a clear and well-defined framework. In addition, if economic evaluation is to inform health and social care providers and policy-makers about the potential impact of new interventions in practice, estimation of the value for money of these new interventions requires consideration of (a) the perceived and objective risks and benefits of care (b) attitudes of people with... 

Linda Davies is Reader and Director of Health Economics Research at the University of Manchester. Her research focuses on the economic evaluation of health and social care interventions in general and mental... 

How the different neurotransmitters may be involved in the initiation and maintenance of some brain disorders, such as Parkinson s disease, epilepsy, schizophrenia, depression, anxiety and dementia, as well as in the sensation of pain, is then evaluated and an attempt made to see how the drugs which are used in these conditions produce their effect by modifying appropriate neurotransmitter function (section C). The final section (D) deals with how neurotransmitters are involved in sleep and consciousness and in the social problems of drug use and abuse. 

Most of these models evaluate the effects of drugs on the behaviour of animals when they are exposed to a novel environment. Novelty normally reduces animals exploratory activity but established anti-anxiety drugs consistently increase exploration of, and approaches to, the novel stimulus and reduce the neophobic ( avoidance ) reaction. There are several examples of tests based on this principle (Table 19.2) but two that are widely used are the plus-maze and the social interaction tests. 

Information from wel1-control 1 ed animal studies that focus on the effects of prenatal exposure to single and polydrug use will be of great value. Further evaluation of the fine motor movements that appear to be clearly neurological ly deviant in the PCP-exposed infants is essential. The emerging socialization skills during the second year of life also need more detailed evaluations. 

Assess patients for improvement of anxiety symptoms and for return to baseline occupational, social, and interpersonal functioning. With effective treatment, the patient should have no or minimal symptoms of anxiety or depression. While drug therapy is being initiated, evaluate patients more frequently to ensure tolerability and response. Increase the dose in patients exhibiting a partial response after 2 to 4 weeks on an antidepressant or 2 weeks on a benzodiazepine. Individualize the duration of treatment because some patients require up to one year of treatment.27... 

It is important to carefully document core ADHD symptoms at baseline to provide a reference point from which to evaluate effectiveness of treatment. Improvement in individualized patient outcomes are desired, such as (1) family and social relationships, (2) disruptive behavior, (3) completing required tasks, (4) self-motivation, (5) appearance, and (6) self-esteem. It is very important to elicit evaluations of the patient s behavior from family, school, and social environments in order to assess the preceding. Using standardized rating scales (e.g., Conners Rating Scales-Revised, Brown Attention-Deficit Disorder Scale, and IOWA Conners Scale) in both children and adults with ADHD helps to minimize variability in evaluation.29 After initiation of therapy, evaluations should be done every 2 to 4 weeks to determine efficacy of treatment, height, weight, pulse, and blood pressure. Physical examination or liver function tests may be used to monitor for adverse effects. 

Achee, J., Tesser, A., and Pilkington, C., Social perception A test of the role of arousal in self-evaluation maintenance processes. Special Issue Affect in social judgments and cognition. European Journal of Social Psychology 24(1), 147-159, 1994. 

Another study with citalopram evaluated its efficacy in the treatment of social anxiety disorder along with co-morbid major depression (Schneier etal., 2003). The outpatients (n= 21) were predominantly Hispanic (76%) and from New York. Response rates for the intent-to-treat sample were 66.7% for social anxiety disorder and 76.2% for major depression. Only one subject was known to have withdrawn secondary to severe side effects. The mean dose of the medication was 37.6 mg/day and there was no placebo control. The depressive symptoms tended to improve... 

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