Tiger beetles (Carabidae) mainly provide services- Dung beetles (Scara.docx
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Tiger beetles (Carabidae) mainly provide services. Dung beetles (Scarabaeidae) mainly provide services by Weevils (Curculionidae) are known for [a. Leaf-cutter ants engage in several services, most notably the services of Hornets (Vespa species) are primarily known for their services but can also while Stingless bees are well-known for their services. .
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Objectives : Music intervention has been shown to reduce anxiety and sedative exposure among mechanically ventilated patients. Whether music intervention reduces ICU costs is not known. The aim of this study was to examine ICU costs for patients receiving a patient-directed music intervention compared with patients who received usual ICU care.
Design : A cost-effectiveness analysis from the hospital perspective was conducted to determine if patient-directed music intervention was cost-effective in improving patient-reported anxiety. Cost savings were also evaluated. One-way and probabilistic sensitivity analyses determined the influence of input variation on the cost-effectiveness.
Setting : Midwestern ICUs.
Patients : Adult ICU patients from a parent clinical trial receiving mechanical ventilatory support.
Interventions : Patients receiving the experimental patient-directed music intervention received a MP3 player, noise-canceling headphones, and music tailored to individual preferences by a music therapist.
Measurements and Main Results : The base case cost-effectiveness analysis estimated patient-directed music intervention reduced anxiety by 19 points on the Visual Analogue Scale-Anxiety with a reduction in cost of $2,322/patient compared with usual ICU care, resulting in patient-directed music dominance (Table 1). The probabilistic cost-effectiveness analysis found that average patient-directed music intervention costs were $2,155 less than usual ICU care and projected that cost saving is achieved in 70% of 1,000 iterations. Based on break-even analyses, cost saving is achieved if the per-patient cost of patient-directed music intervention remains below $2,651, a value eight times the base case of $329.
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Cost-Effectiveness Components
PDM
UC
Incremental Value
Costs
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329
Not applicable
ICU cost, $
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129,803
Physician cost, $
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3,898
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-22
Total cost, $
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133,701
- 2,322
Effectiveness
Anxiety score (100-mm Visual Analogue Scale for Anxiety)
33
52
- 19
Study Outcomes
Incremental cost-effective ratio, b incremental cost per unit change in anxiety score
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a Sedative medications are included in ICU costs, and therefore, no adjustment in sedative medication costs were made for UC.
b Incremental cost-effective ratio assumes a $0 willingness-to-pay to reduce the Visual Analogue Scale for Anxiety score by one unit.
Reference:
Chlan LL, Heiderscheit A, Skaar DJ, Neidecker M.
Chapter wise All Notes of First year Basic Civil Engineering.pptx
Chapter wise All Notes of First year Basic Civil Engineering
Syllabus
Chapter-1
Introduction to objective, scope and outcome the subject
Chapter 2
Introduction: Scope and Specialization of Civil Engineering, Role of civil Engineer in Society, Impact of infrastructural development on economy of country.
Chapter 3
Surveying: Object Principles & Types of Surveying; Site Plans, Plans & Maps; Scales & Unit of different Measurements.
Linear Measurements: Instruments used. Linear Measurement by Tape, Ranging out Survey Lines and overcoming Obstructions; Measurements on sloping ground; Tape corrections, conventional symbols. Angular Measurements: Instruments used; Introduction to Compass Surveying, Bearings and Longitude & Latitude of a Line, Introduction to total station.
Levelling: Instrument used Object of levelling, Methods of levelling in brief, and Contour maps.
Chapter 4
Buildings: Selection of site for Buildings, Layout of Building Plan, Types of buildings, Plinth area, carpet area, floor space index, Introduction to building byelaws, concept of sun light & ventilation. Components of Buildings & their functions, Basic concept of R.C.C., Introduction to types of foundation
Chapter 5
Transportation: Introduction to Transportation Engineering; Traffic and Road Safety: Types and Characteristics of Various Modes of Transportation; Various Road Traffic Signs, Causes of Accidents and Road Safety Measures.
Chapter 6
Environmental Engineering: Environmental Pollution, Environmental Acts and Regulations, Functional Concepts of Ecology, Basics of Species, Biodiversity, Ecosystem, Hydrological Cycle; Chemical Cycles: Carbon, Nitrogen & Phosphorus; Energy Flow in Ecosystems.
Water Pollution: Water Quality standards, Introduction to Treatment & Disposal of Waste Water. Reuse and Saving of Water, Rain Water Harvesting. Solid Waste Management: Classification of Solid Waste, Collection, Transportation and Disposal of Solid. Recycling of Solid Waste: Energy Recovery, Sanitary Landfill, On-Site Sanitation. Air & Noise Pollution: Primary and Secondary air pollutants, Harmful effects of Air Pollution, Control of Air Pollution. . Noise Pollution Harmful Effects of noise pollution, control of noise pollution, Global warming & Climate Change, Ozone depletion, Greenhouse effect
Text Books:
1. Palancharmy, Basic Civil Engineering, McGraw Hill publishers.
2. Satheesh Gopi, Basic Civil Engineering, Pearson Publishers.
3. Ketki Rangwala Dalal, Essentials of Civil Engineering, Charotar Publishing House.
4. BCP, Surveying volume 1
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Objectives : Music intervention has been shown to reduce anxiety and sedative exposure among mechanically ventilated patients. Whether music intervention reduces ICU costs is not known. The aim of this study was to examine ICU costs for patients receiving a patient-directed music intervention compared with patients who received usual ICU care.
Design : A cost-effectiveness analysis from the hospital perspective was conducted to determine if patient-directed music intervention was cost-effective in improving patient-reported anxiety. Cost savings were also evaluated. One-way and probabilistic sensitivity analyses determined the influence of input variation on the cost-effectiveness.
Setting : Midwestern ICUs.
Patients : Adult ICU patients from a parent clinical trial receiving mechanical ventilatory support.
Interventions : Patients receiving the experimental patient-directed music intervention received a MP3 player, noise-canceling headphones, and music tailored to individual preferences by a music therapist.
Measurements and Main Results : The base case cost-effectiveness analysis estimated patient-directed music intervention reduced anxiety by 19 points on the Visual Analogue Scale-Anxiety with a reduction in cost of $2,322/patient compared with usual ICU care, resulting in patient-directed music dominance (Table 1). The probabilistic cost-effectiveness analysis found that average patient-directed music intervention costs were $2,155 less than usual ICU care and projected that cost saving is achieved in 70% of 1,000 iterations. Based on break-even analyses, cost saving is achieved if the per-patient cost of patient-directed music intervention remains below $2,651, a value eight times the base case of $329.
Conclusions : Patient-directed music intervention is cost-effective for reducing anxiety in mechanically ventilated ICU patients.
TABLE 1. Incremental Cost-Effectiveness Ratio of Patient-Directed Music Versus Usual ICU Care
Cost-Effectiveness Components
PDM
UC
Incremental Value
Costs
Patient-directed music intervention, $
329
Not applicable
ICU cost, $
127,343
129,803
Physician cost, $
3,728
3,898
Sedative medication savings during PDM intervention period, a $
-22
Total cost, $
131,379
133,701
- 2,322
Effectiveness
Anxiety score (100-mm Visual Analogue Scale for Anxiety)
33
52
- 19
Study Outcomes
Incremental cost-effective ratio, b incremental cost per unit change in anxiety score
PDM dominates UC in 70% of probabilistic sensitivity analysis iterations
PDM = patient-directed music, UC = usual ICU care.
a Sedative medications are included in ICU costs, and therefore, no adjustment in sedative medication costs were made for UC.
b Incremental cost-effective ratio assumes a $0 willingness-to-pay to reduce the Visual Analogue Scale for Anxiety score by one unit.
Reference:
Chlan LL, Heiderscheit A, Skaar DJ, Neidecker M.
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Syllabus
Chapter-1
Introduction to objective, scope and outcome the subject
Chapter 2
Introduction: Scope and Specialization of Civil Engineering, Role of civil Engineer in Society, Impact of infrastructural development on economy of country.
Chapter 3
Surveying: Object Principles & Types of Surveying; Site Plans, Plans & Maps; Scales & Unit of different Measurements.
Linear Measurements: Instruments used. Linear Measurement by Tape, Ranging out Survey Lines and overcoming Obstructions; Measurements on sloping ground; Tape corrections, conventional symbols. Angular Measurements: Instruments used; Introduction to Compass Surveying, Bearings and Longitude & Latitude of a Line, Introduction to total station.
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