Search

Universal rotavirus vaccination could be cost-effective, especially if the cost of the vaccine could be brought under $10 a dose. Researchers estimated the cost and benefits of a national program to vaccinate all infants against rotavirus at 2, 4, and 6 months. The program would prevent about 1 million cases of diarrhea, avoid 34,000 hospitalizations and 227,000 physician visits in the first 5 years. At $20 per dose, the program would cost $289 million but would save only $182 million in direct medical costs. However, savings to society from lost caregiver earnings would total $296 million. At $9 a dose, direct health care savings would pay for the program., Context.--Rotavirus is the most common cause of severe diarrhea in children, and a live, oral vaccine may soon be licensed for prevention. Objective.--To estimate the economic impact of a national rotavirus immunization program in the United States. Design.--Cost-effectiveness was analyzed from the perspectives of the health care system and society. A decision tree used estimates of disease burden, costs, vaccine coverage, efficacy, and price obtained from published and unpublished sources. Intervention.--The proposed vaccine would be administered to infants at ages 2, 4, and 6 months as part of the routine schedule of childhood immunizations. Main Outcome Measures.--Total costs, outcomes prevented, and incremental cost-effectiveness. Results.--A routine, universal rotavirus immunization program would prevent 1.08 million cases of diarrhea, avoiding 34 000 hospitalizations, 95 000 emergency department visits, and 227 000 physician visits in the first 5 years of life. At $20 per dose, the program would cost $289 million and realize a net loss of $107 million to the health care system--$103 per case prevented. The program would provide a net savings of $296 million to society. Threshold analysis identified a break-even price per dose of $9 for the health care system and $51 for the societal perspective. Greater disease burden and greater vaccine efficacy and lower vaccine price increased cost- effectiveness. Conclusions.--A US rotavirus immunization program would be cost- effective from the perspectives of society and the health care system, although the cost of the immunization program would not be fully offset by the reduction in health care cost of rotavirus diarrhea unless the price fell to $9 per dose. JAMA. 1998;279:1371-1376

In an effort to harmonize multi-jurisdictional surveillance and detection of aquatic invasive species, regional stakeholders have called for the development of a Great Lakes Aquatic Invasive Species Surveillance Framework to identify species that pose a risk to the basin, quantify the relative risk of various pathways of introduction, provide guidance on monitoring protocols for surveillance, and identify priority locations for surveillance based on this pathway assessment. Here, we screen 448 species to develop a surveillance list of 144 species that are relevant for Great Lakes surveillance: are not yet widespread throughout the basin, have a pathway through which they can arrive, are able to establish and are predicted to cause impacts. Using the Great Lakes Aquatic Nonindigenous Species Risk Assessment for consistent assessment across taxa, the surveillance species list consisted of 144 species: 64 plants, 4 algae, 40 fish, 5 mollusks, 28 crustaceans, 1 platyhelminthes and 2 bryozoans. While pathway risk varies by taxon, the highest risk pathways across all taxonomic groups are natural dispersal, hitchhiking/fouling, and intentional release. The taxonomic group predicted to have the most severe impacts on a per species basis is algae, followed by mollusks, and plants. However, the large number of plant and fish species on the surveillance species list means that overall predicted impact (from a taxonomic perspective) is greatest from these two groups. We recommend ways that the surveillance list could be applied to improve aquatic invasive species management efforts: engage in community-based surveillance, inform taxonomic and species surveillance priorities, provide guidance on monitoring protocols for surveillance, quantify the relative risk of various pathways of introduction and identify priority locations for surveillance based on this pathway assessment. [ABSTRACT FROM AUTHOR]

Much work has recently explored the remarkable legislative achievements that have benefited queer groups in South Africa. Less well understood has been an appreciation as to how the links between histories of racism and histories of sexuality deployed to legitimate such legal challenges may also have directly helped to entrench the ability of others to argue against queer rights. Drawing on the work of Stuart Hall, this article will explore how queer activist's association with an ideology of 'equality' (and the link between racism and sexuality-based discrimination) has not simply concluded discussion about the rights (or wrongs) of queer rights. Instead that association has helped align the issue of sexuality within a far broader debate as to what the 'New South Africa' should mean after a racist past. This may help us appreciate a so far little understood and yet key reason why homophobia remains such a pervasive problem in the country. [ABSTRACT FROM AUTHOR]

Significant opportunities exist to examine new ways of approaching geographies of sexualities in the Global South. This article argues a key way to consider this is via a systematic evaluation of diverse impacts in the Global South of very different internationally-driven processes designed to address local LGBT needs. Focusing on sub-Saharan Africa and drawing on and reviewing a range of disciplinary perspectives, this article offers a conceptualization and series of future research questions regarding the relational and diverse impacts of different internationally-driven processes. These concerns support existing geographies of sexualities interests including the interfaces between sexuality, intersectionality and space. [ABSTRACT FROM AUTHOR]

There are important opportunities to further consider how the framework presented by homonationalism can apply beyond relationships connected to the US or the Middle East where it is traditionally applied. From a southern perspective and focusing on post-apartheid South Africa, this article examines how homonationalism's framings may help us understand the subjectification of diverse sexualities in the country through their connection to national and regional politics. It begins by exploring the historical connections between biopolitics and necropolitics in South Africa's HIV/AIDS epidemic, to highlight how different contemporary sexual subjectivities are imbricated with different types of biopolitical population regulation. It then argues that such differences are reflected through and furthered by the way South Africa has projected ideas of its sexual exceptionalism within the wider region, a process that itself relies on South African-specific homonormativity. [ABSTRACT FROM AUTHOR]