Abstract. Information visualization has been a research topic for many years, leading to a mature field where guidelines and practices are well established. Knowledge visualization, in contrast, is a relatively new area of research that has received more attention recently due to the interest from the business community in Knowledge Management. In this paper we present the CmapTools software as an example of how concept maps, a knowledge visualization tool, can be combined with recent technology to provide integration between knowledge and information visualizations. We show how concept map-based knowledge models can be used to organize repositories of information in a way that makes them easily browsable, and how concept maps can improve searching algorithms for the Web. We also report on how information can be used to complement knowledge models and, based on the searching algorithms, improve the process of constructing concept maps.
A program where wild bottlenose dolphins (Tursiops truncatus) are fed by tourists in shallow water adjacent to a wharf has been established at Tangalooma, Queensland, Australia. Up to nine dolphins attend the nightly feedings, and between 60 and 80 resort guests are permitted to hand feed these dolphins each night. Since this program began in 1992, the dolphins have increased in confidence and have started, at times, to make forceful contact with guests who enter the water to feed them. This paper categorizes such behavior as “pushy” and reports on a study which quantifies the “pushiness” of the dolphins which feed at Tangalooma. The study examines ecological variables which may determine how pushy the dolphins are at different feeding sessions. The number of dolphins attending a particular feeding significantly increases the pushiness. In addition, the presence of adult males at a feeding is likely to increase pushing. Tidal state also influences how pushy the dolphins are. At low tide, when the dolphins’mobility is restricted by the water depth, they are less likely to be pushy. Given the problems experienced in a number of other situations where wild animals are fed by humans, it is important to monitor carefully the escalation of pushy behavior in this dolphin feeding program, as it may be a precursor to more aggressive actions on the part of the dolphins.
C o p y r i g h t © 2 0 1 3 I n f o r m a U K L i m i t e d N o t f o r S a l e o r C o m m e r c i a l D i s t r i b u t i o n U n a u t h o r i z e d u s e p r o h i b i t e d . A u t h o r i s e d u s e r s c a n d o w n l o a d , Abstract Objective:Evaluate the cost-effectiveness of primary vs secondary prophylaxis (PP vs SP) with pegfilgrastim to reduce the risk of febrile neutropenia (FN) in Non-Hodgkin's Lymphoma (NHL) patients receiving myelosuppressive chemotherapy from a US payer perspective. Methods:A Markov model was used to compare PP vs SP with pegfilgrastim in a cohort of patients receiving six cycles of cyclophosphamide, vincristine, doxorubicin, and prednisone (CHOP) or CHOP plus rituximab (CHOP-R) chemotherapy. Model inputs, including efficacy of pegfilgrastim in reducing risk of FN and costs, were estimated from publicly available sources and peer-reviewed publications. Incremental cost-effectiveness was evaluated in terms of net cost per life-year saved (LYS), per quality-adjusted life-year (QALY) gained, and per FN event avoided over a lifetime horizon. Deterministic and probabilistic analyses were performed to assess sensitivity and robustness of results. Results:Lifetime costs for PP were $5000 greater than for SP; however, PP was associated with fewer FN events and more LYs and QALYs gained vs SP. Incremental cost-effectiveness ratios (ICERs) for PP vs SP for CHOP were $13,400 per FN event avoided, $29,500 per QALY gained, and $25,800 per LYS. CHOP-R results were similar ($15,000 per FN event avoided, $33,000 per QALY gained, and $28,900 per LYS). Results were most sensitive to baseline FN risk, cost per FN episode, and odds ratio for reduced relative dose intensity due to prior FN event. PP was cost-effective vs SP in 85% of simulations at a $50,000 per QALY threshold. Limitations:In the absence of NHL-specific data, estimates for pegfilgrastim efficacy and relative risk reduction of FN were based on available data for neoadjuvant TAC in patients with breast cancer. Baseline risks of FN for CHOP and CHOP-R were assumed to be equivalent. Conclusions:PP with pegfilgrastim is cost-effective compared to SP with pegfilgrastim in NHL patients receiving CHOP or CHOP-R. Cost effectiveness of prophylaxis with pegfilgrastim Hill et al. 33 Journal of Medical Economics Downloaded from informahealthcare.com by Yale Dermatologic Surgery on 07/05/15 For personal use only. M Markov 2: (Annual cycles) Survive Completed chemo (RDI<90%) Death from cancer Death from other causes Survive Completed chemo (RDI ≥90%) Death from cancer Death from other causes M Figure 1. Model Structure: (a) Decision Tree; (b) Markov1; and (c) Markov2. Cost effectiveness of prophylaxis with pegfilgrastim Hill et al. 37 Journal of Medical Economics Downloaded from informahealthcare.com by Yale Dermatologic Surgery on 07/05/15For personal use only.*All treatments and FN-related events occur during the on-chemotherapy phase in the first year of the model; accordingly, the number of FN events and total (i.e., treatment and FN-related...
ObjectivesHealth benefits and costs of combined reduced-antigen-content tetanus, diphtheria, and pertussis (Tdap) immunization among adults ≥65 years have not been evaluated. In February 2012, the Advisory Committee on Immunization Practices (ACIP) recommended expanding Tdap vaccination (one single dose) to include adults ≥65 years not previously vaccinated with Tdap. Our study estimated the health and economic outcomes of one-time replacement of the decennial tetanus and diphtheria (Td) booster with Tdap in the 10% of individuals aged 65 years assumed eligible each year compared with a baseline scenario of continued Td vaccination.MethodsWe constructed a model evaluating the cost-effectiveness of vaccinating a cohort of adults aged 65 with Tdap, by calculating pertussis cases averted due to direct vaccine effects only. Results are presented from societal and payer perspectives for a range of pertussis incidences (25–200 cases per 100,000), due to the uncertainty in estimating true annual incidence. Cases averted were accrued throughout the patient 's lifetime, and a probability tree used to estimate the clinical outcomes and costs (US$ 2010) for each case. Quality-adjusted life-years (QALYs) lost to acute disease were calculated by multiplying cases of mild/moderate/severe pertussis by the associated health-state disutility; QALY losses due to death and long-term sequelae were also considered. Incremental costs and QALYs were summed over the cohort to derive incremental cost-effectiveness ratios. Scenario analyses evaluated the effect of alternative plausible parameter estimates on results.ResultsAt incidence levels of 25, 100, 200 cases/100,000, vaccinating adults aged 65 years costs an additional $336,000, $63,000 and $17,000/QALY gained, respectively. Vaccination has a cost-effectiveness ratio less than $50,000/QALY if pertussis incidence is >116 cases/100,000 from societal and payer perspectives. Results were robust to scenario analyses.ConclusionsTdap immunization of adults aged 65 years according to current ACIP recommendations is a cost-effective health-care intervention at plausible incidence assumptions.
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