Search

Background: Recent evidence suggests that 1 dose of the human papillomavirus (HPV) vaccine may have similar effectiveness in reducing HPV infection risk compared to 2 or 3 doses. Objective: To evaluate the public health impact and cost-effectiveness of implementing a 1-dose or a 2-dose program of the 9-valent HPV vaccine in a low- and middle-income country (LMIC). Methods: We adapted a dynamic transmission model to the Indonesia setting, and conducted a probabilistic sensitivity analysis using distributions reflecting the uncertainty in levels and durability of protection of a 1-dose that were estimated under a Bayesian framework incorporating 3-year vaccine efficacy data from the KEN SHE trial (base-case) and 10 year effectiveness data from the India IARC study (alternative analysis). Scenarios included different coverage levels targeted at girls-only, or girls and boys. Costs and benefits were computed over 100 years from a national single-payer perspective. Results: Depending on the coverage and target population, the median number of cancer cases avoided in 2-dose programs ranged between 600,000–2,100,000, compared to 200,000–600,000 in 1-dose programs. The 1-dose programs are unlikely to be cost-effective compared to 2-dose programs even at low willingness-to-pay (WTP) thresholds. The girls-only 2-dose program tends to be cost-effective at lower WTP thresholds, particularly in scenarios with high coverage, dose price and discount rate, while the girls and boys 2-dose program is cost-effective at higher WTP thresholds. In the alternative analysis, 1-dose programs have higher probability of being cost-effective compared to the base-case, particularly for low WTP thresholds (less than 0.5 GDP) and for high coverage, dose price and discount rate. Conclusion: Adoption of 1-dose programs with 9-valent vaccine in an LMIC resulted in more vaccine-preventable HPV-related cancer cases than 2-dose programs. The 2-dose programs were more likely to be cost-effective than 1-dose programs for a wide range of WTP thresholds and scenarios. [ABSTRACT FROM AUTHOR]

The purpose of this article is to begin an exploration into the value of certification preparation programs in high skills lifelong learning, specifically in the field of business and management. This segment of lifelong learning is often referred to as executive and professional education (EPE). As professions and skills are made obsolete in the knowledge economy the need for continued high level lifelong learning becomes increasing important to the sustainability and viability of local, regional, state and national economies. This research paper focuses on programs that prepare participants for nationally and internationally recognized certifications. Additionally the research addresses issues relating to the motivation of participants to enroll in EPE programs.

The purpose of this paper is to begin an exploration into high-skills lifelong learning in the field of business and management, referred to as executive and professional education (EPE). Several additional undertakings were necessary, including: discovering methods of valuing knowledge to a region, state or country, and establishing why participants in EPE programs enroll in them. To support this inquiry two research questions were developed, as follows: 1. What are the components of relevant EPE? 2. What motivates participants to take part in EPE? An exploratory case study was written exploring the intricacies of developing a successful EPE department. This exploratory case study served as a basis for developing a survey, administered to participants in EPE to determine reasons for their participation. This final survey was conducted in the classroom. The researchers believe that the findings and conclusions will be of value to practitioners involved in EPE, as well as to academics studying this area of business education. This research exercise has assisted the researchers in being more effective in managing and developing EPE within their own university. As professions and skills are made obsolete in the knowledge economy the need for continued high level lifelong learning becomes increasing important to the sustainability and viability of local, regional, state and national economies.

Background Universal childhood vaccination against varicella began in the United States as a 1-dose schedule in 1996, changing to a 2-dose schedule in 2006. The exogenous boosting hypothesis, which postulates that reexposure to circulating wild-type varicella delays the onset of herpes zoster, predicts a transient increase in the incidence of herpes zoster, peaking in adults 15–35 years after the start of varicella vaccination. Methods This was a retrospective study of administrative claims data from the MarketScan Commercial and Medicare databases between 1991–2016. Outcome measures were the incidences of herpes zoster per 100 000 person-years, by calendar year and age category, and the annual rates of change in herpes zoster by age category, in an interrupted time series regression analysis, for the periods of 1991–1995 (prevaccine), 1996–2006 (1-dose vaccination period), and 2007–2016 (2-dose vaccination period). Results The annual incidences of herpes zoster increased throughout the period of 1991–2012 in all adult age categories, with a plateau in 2013–2016 that was most evident in the ≥65 age group. In 1991–1995, the herpes zoster incidences increased at annual rates of 4–6% in age categories 18–34, 35–44, 45–54, and 55–64 years. In the same age categories during 1996–2006 and 2007–2016, the herpes zoster incidences increased at annual rates of 1–5%. Conclusions Although the annual incidence of herpes zoster in adults has continued to increase, the rates of change decreased during both the 1- and 2-dose vaccination periods. The hypothesized increase in herpes zoster predicted from modelling of the exogenous boosting hypothesis was not observed. [ABSTRACT FROM AUTHOR]