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The 13-valent pneumococcal conjugated vaccine (PCV13) is already recommended for some adult groups and is being considered for wider use in many countries. In order to identify the strengths and limitations of the existing economic evaluation studies of PCV13 in adults and the elderly a literature review was conducted. The majority of the studies identified (9 out of 10) found that PCV13 was costeffective in adults and/or the elderly. However, these results were based on assumptions that could not always be informed by robust evidence. Key uncertainties included the efficacy of PCV13 against non-invasive pneumonia and the herd immunity effect of childhood vaccination programs. Emerging trial evidence on PCV13 in adults from the Netherlands offers the ability to parameterize future economic evaluations with empirical efficacy data. However, it is important that these estimates are used thoughtfully when they are transferred to other settings.

A large historical data set from the Adirondack region of New York was compiled to study the relationship between water chemistry variables associated with acid precipitation and the presence/absence of selected fish species. The data set was used to examine simple statistical models for fish presence/absence, as a function of the water chemistry variables, for brook trout (Salvelinus fontinalis), lake trout (Salvelinus namaycush), white sucker (Catostomus commersoni), and yellow perch (Perca flavescens). Of these models, only those for brook trout and lake trout were found to be acceptable based on statistical goodness-of-fit criteria; thus, parameters for models of these two species alone were estimated using maximum likelihood logistic regression. Candidate models for brook trout and lake trout were then examined, with particular consideration for the problems associated with model misspecification, errors-in-variables, and multicollinearity. For each of the two species, a model was recommended that may be used to predict the effect of changes in lake acidification on species presence/absence in lakes in the Adirondack region.

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