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"Irving, Adam"
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Irving Penn : centennial
\"Celebrating the centennial of Irving Penn's birth, this volume spans the entirety of his groundbreaking career. The introduction situates his work in the context of the various artistic, social, and political environments and events that affected the content of his photographs. The essays acquaint readers with Penn's primary subjects and campaigns, including early documentary scenes and imagery; portraits; fashion; female nudes; people of Peru, Dahomey (Benin), New Guinea, and Morocco; still lifes; and more\"-- Provided by publisher.
Book
Developing and validating a discrete-event simulation model of multiple myeloma disease outcomes and treatment pathways using a national clinical registry
Multiple myeloma is a haematological malignancy typically characterised by neoplastic plasma cell infiltration of the bone marrow. Treatment for multiple myeloma consists of multi-line chemotherapy with or without autologous stem cell transplantation and has been rapidly evolving in recent years. However, clinical trials are unable to provide patients and clinicians with long-term prognostic information nor policymakers with the full body of evidence needed to perform economic evaluation of new therapies or make reimbursement decisions. To address these limitations of the available evidence, this study aimed to develop and validate the EpiMAP Myeloma model, a discrete-event simulation model of multiple myeloma disease outcomes and treatment pathways. Risk equations were estimated using the Australian and New Zealand Myeloma & Related Diseases Registry after multiple imputation of missing data. Risk equation coefficients were combined with multiple myeloma patients at diagnosis from the Registry to perform the simulation. The model was validated with 100 bootstraps of an out-of-sample prediction analysis using a 70/30 split of the 4,121 registry patients diagnosed between 2009 and 2023, resulting in 2,884 and 1,237 patients in the training and validation cohorts, respectively. For 90% of the 120 months in the 10-year post-diagnosis period, there was no significant difference in overall survival between the validation and simulated cohorts. These results highlight that the EpiMAP Myeloma model is robust at predicting multiple myeloma disease outcomes and treatment pathways in Australia & New Zealand. In the future, clinicians will be able to use the EpiMAP Myeloma model to provide personalised estimates of life expectancy to patients based on their specific characteristics, disease stage, and response to treatment. Policymakers will also be able to use the model to perform economic evaluation, to forecast the number of patients receiving treatment at different stages, and to determine the downstream impact of listing new, effective therapies.
Journal Article
The Cost Effectiveness of Nalmefene for Reduction of Alcohol Consumption in Alcohol-Dependent Patients with High or Very High Drinking-Risk Levels from a UK Societal Perspective
Aim
To evaluate costs and health outcomes of nalmefene plus psychosocial support, compared with psychosocial intervention alone, for reducing alcohol consumption in alcohol-dependent patients, specifically focusing on societal costs related to productivity losses and crime.
Methods
A Markov model was constructed to model costs and health outcomes of the treatments over 5 years. Analyses were conducted for nalmefene’s licensed population: adults with both alcohol dependence and high or very high drinking-risk levels (DRLs) who do not require immediate detoxification and who have high or very high DRLs after initial assessment. The main outcome measure was cost per quality-adjusted life-year (QALY) gained as assessed from a UK societal perspective. Alcohol-attributable productivity loss, crime and health events occurring at different levels of alcohol consumption were taken from published risk-relation studies. Health-related and societal costs were drawn from public data and the literature. Data on the treatment effect, as well as baseline characteristics of the modelled population and utilities, came from three pivotal phase 3 trials of nalmefene.
Results
Nalmefene plus psychosocial support was dominant compared with psychosocial intervention alone, resulting in QALYs gained and reduced societal costs. Sensitivity analyses showed that this conclusion was robust. Nalmefene plus psychosocial support led to per-patient reduced costs of £3324 and £2483, due to reduced productivity losses and crime events, respectively.
Conclusion
Nalmefene is cost effective from a UK societal perspective, resulting in greater QALY gains and lower costs compared with psychosocial support alone. Nalmefene demonstrates considerable public benefits by reducing alcohol-attributable productivity losses and crime events in adults with both alcohol dependence and high or very high DRLs who do not require immediate detoxification and who have high or very high DRLs after initial assessment.
Journal Article
Off the Rails
The remarkable true story of Darius McCollum, a man with Asperger's syndrome, whose overwhelming love of transit has landed him in jail 32 times for impersonating New York City bus drivers and subway conductors and driving their routes. As a boy in Queens, NY, Darius found sanctuary from school bullies in the subway. There he befriended transit workers who taught him to drive trains. By age 8, he memorized the entire subway system. At 15, he drove a packed train 6 stops by himself, making all the stops and announcements. Over the next three decades, Darius commandeered hundreds of trains and buses, staying en route and on schedule, without ever getting paid. He attended transit worker union meetings, lobbying for better pay and working conditions for a union he didn't belong to. Although Darius has never damaged any property or hurt anyone in his decades of service, he has spent 23 years in maximum security prison. Darius' recidivism embodies the criminal justice system's failure to channel the passions of a harmless, mentally-challenged man into a productive career and purposeful life.
Streaming Video
A propensity matched cost analysis of medical emergency team calls led by nurse practitioners versus intensive care registrars
Nurse practitioner-led MET calls have been shown to improve clinical outcomes versus ICU registrar-led MET calls. However, the cost implications of a nurse practitioner-led MET call system is not known. We conducted cost analysis from the healthcare service perspective to compare the costs of nurse practitioner- and ICU registrar-led MET calls.
A retrospective study of MET calls between 1 June 2016 and 9 March 2018 including patients with first MET call during their hospital admission. The cost analysis compared MET calls attended by nurse practitioners against those attended by ICU registrars.
Inpatient costs for nurse practitioner- and ICU registrar-led MET calls.
1,343 MET calls were included in the full dataset with a mean cost per ICU registrar-led MET calls and nurse practitioner led MET calls of AU$19,836 (95 % CI: AU$15,778 – AU$23,895) versus AU$16,404 (95 % CI: AU$14,988 – AU$17,820) respectively and a difference of AU$3,432 (95 % CI: −AU$38 – AU$6,903, p = 0.053). In the propensity-score matched analysis, the mean cost per ICU registrar-led MET calls and nurse practitioner led MET calls was AU$19,009 (95 % CI: AU$15,439 – AU$22,578) and AU$13,937 (95 % CI: AU$12,038 – AU$15,835) respectively, with a difference of AU$5,072 (95 % CI: AU$1,061 – AU$9,082, p = 0.013). A 24-hour nurse practitioners-led MET call service would break even at 101 MET calls leading to ICU admissions per year.
Nurse practitioners-led MET calls saved significant costs compared to ICU registrar-led MET calls. Assuming that the difference in costs is due to shorter ICU length of stay, a health service that receives more than 101 MET calls leading to ICU admissions per year can save costs with a 24-hour nurse practitioner-led MET call service.
This study helps in identifying the healthcare services where nurse practitioners −led MET systems could be implemented to be cost saving from health service perspective.
Journal Article
PD23 Economic Evaluation Of Prophylactic Immunoglobulin Versus Prophylactic Antibiotics In Hematological Malignancies: Results From The RATIONAL Feasibility Trial
IntroductionPatients with hematological malignancies are at high risk of infections due to both the disease and the associated treatments. The use of immunoglobulin (Ig) to prevent infections is increasing in this population, but its cost effectiveness is unknown. This trial-based economic evaluation aimed to compare the cost effectiveness of prophylactic Ig with prophylactic antibiotics in patients with hematological malignancies.MethodsThe economic evaluation used individual patient data from the RATIONAL feasibility trial, which randomly assigned 63 adults with chronic lymphocytic leukemia, multiple myeloma, or lymphoma to prophylactic Ig or prophylactic antibiotics. The following two analyses were conducted to estimate the cost effectiveness of the two treatments over the 12-month trial period from the perspective of the Australian health system:(i) a cost-utility analysis (CUA) to assess the incremental cost per quality-adjusted life-year (QALY) gained using data collected with the EuroQol 5D-5L questionnaire; and(ii) a cost-effectiveness analysis (CEA) to assess the incremental cost per serious infection prevented (grade ≥3) and per infection prevented (any grade).ResultsThe total cost per patient was significantly higher in the Ig arm than in the antibiotic arm (difference AUD29,140 [USD19,000]). There were non-significant differences in health outcomes between the treatment arms: patients treated with Ig had fewer QALYs (difference −0.072) and serious infections (difference −0.26) than those given antibiotics, but more overall infections (difference 0.76). The incremental cost-effectiveness from the CUA indicated that Ig was more costly than antibiotics and associated with fewer QALYs. In the CEA, Ig costed an additional AUD111,262 (USD73,000) per serious infection prevented, but it was more costly than antibiotics and associated with more infections when all infections were included.ConclusionsThese results indicate that, on average, Ig prophylactic treatment may not be cost effective compared with prophylactic antibiotics for the group of patients with hematological malignancies recruited to the RATIONAL feasibility trial. Further research is needed to confirm these findings in a larger population and over the longer term.
Journal Article
River novel & complementary discourses
The complementary discourse explores the function and value of narrative and why mankind seems to have always seen events, connected or unconnected, as stories. It investigates how we process and perceive fiction and compares narratives found in non-fiction, police witness statements, films and diaries to consider why the human brain seems hard-wired to transform events into narrative. The accompanying novel, A River, is set in Manchester over a three hundred year period. The events in the chapters are presented in reverse order; from the 1990's to the 1720's, beginning with the chronological end of the tale and working towards the starting point. The chapter's regression highlights how a familiar location is constantly in flux and sometimes shares little with the same place of the past. Time and location are both treated as characters, playing important roles in the personality of the city. The buildings and streets, events, food and language have all been researched for accuracy, either first hand or using diaries, films, maps and photographs. The novel occupies a grey area between fiction and history. The narrative actively avoids the traditional novel formulas of historical fiction and magic realism and is intended to be an accessible experimental novel, questioning the idea of what a story is.
Dissertation
NY MINUTE
\"New York City's homeless population has continued to rise dramatically,\" said Patrick Markee of the Coalition for the Homeless. Homeless Services Commissioner Robert Hess said the number of people living on the street has fallen 47% and that the city has improved how it treats homeless families.Adam Lisberg The NYPD Organized Crime Control Bureau stopped Joe Coffey, 26, and John Malone, 26, both of West Islip, on Staten Island's West Shore Expressway. Coffey and Malone were charged with possession and dealing of fireworks.News Staff Credit: BY Adam Lisberg Irving DeJohn The Associated Press News Staff [Joy Resmovits] and [Simone Weichselbaum]
Newspaper Article
Scientific consensus on the COVID-19 pandemic: we need to act now
The infection fatality rate of COVID-19 is several-fold higher than that of seasonal influenza,2 and infection can lead to persisting illness, including in young, previously healthy people (ie, long COVID).3 It is unclear how long protective immunity lasts,4 and, like other seasonal coronaviruses, SARS-CoV-2 is capable of re-infecting people who have already had the disease, but the frequency of re-infection is unknown.5 Transmission of the virus can be mitigated through physical distancing, use of face coverings, hand and respiratory hygiene, and by avoiding crowds and poorly ventilated spaces. PK reports personal fees from Kymab, outside the submitted work; PK also has a patent ‘Monoclonal antibodies to treat and prevent infection by SARS-CoV-2 (Kymab)’ pending and is a scientific advisor to the Serology Working Group (Public Heath England), Testing Advisory Group (Department of Health and Social Care) and the Vaccines Task force (Department for Business, Energy and Industrial Strategy). CS reports grants from BMS, Ono-Pharmaceuticals, and Archer Dx (collaboration in minimal residual disease sequencing technologies), outside the submitted work; personal fees from Bristol Myers Squibb, Roche-Ventana, Ono Pharmaceutical, GlaxoSmithKline, Novartis, Celgene, Illumina, MSD, Sarah Canon Research Institute, Genentech, Bicycle Therapeutics, and Medicixi, outside the submitted work; personal fees and stock options from GRAIL and Achilles Therapeutics, outside the submitted work; and stock options from Epic Biosciences and Apogen Biotechnologies, outside the submitted work.
Journal Article