Texas House Bill 790 resulted in the expansion of the newborn screening panel from 7 to 27 disorders. The long-term economic implications of this expansion have not been studied. The objective of this study was to estimate the incremental cost-effectiveness of the expanded newborn screening program compared to the previous standard screening in Texas. A Markov model (for a hypothetical cohort of Texas births in 2007) was constructed to compare life-time costs and QALYs between the expanded newborn screening and pre-expansion newborn screening. Estimates of costs, probabilities of sequelae, and utilities for disorder categories were obtained from Texas statistics, the literature, and expert opinion. A baseline discount rate of 3% was used for both costs and QALYs, with a range of 0% to 5%. Analyses were conducted from a payer's perspective, so only direct medical cost estimates were included. The life-time incremental cost-effectiveness ratio (ICER) for expanded versus pre-expansion screening was about $12,000/QALY. Probabilistic sensitivity analysis using key variables showed that results ranged from about $9,500 to $13,000 /QALY. This range is well below the commonly cited willingness to pay threshold of $50,000/QALY. Therefore, expanded newborn screening results in additional expense to the payer but also improves patient outcomes by preventing avoidable morbidity and mortality. The screened population benefits from greater QALYs as compared to the unscreened population. Overall, expanded newborn screening in Texas was estimated to be a cost-effective option as compared to unexpanded newborn screening. / text

This study was conducted to analyze the effect of implementation of Texas House Bill 72 on budgets of selected Texas public school districts and to ascertain educational benefits to students derived from implementation of the bill as perceived by superintendents. Questionnaires were sent to superintendents of the Region 10 Education Service Center to determine perceived educational benefits to students. A demographic data sheet provided information for classifying respondents by educational experience, superintendent experience, and district enrollment classifications. Sixty-two districts responded. Official public school budget data for each district were analyzed for fiscal years 1983 through 1986 as were data from the questionnaire. Overall statistical information was gleaned through CONDESCRIPTIVE. Mean total expenditures, mean total tax rate, and state fiscal aid data were compiled, tabulated, and reported for each enrollment classification and entire sample. In addition, a t-test between the difference of two independent means at a probability level of .05 was applied. The two independent means were the averages of data for the two years prior to and after implementation of the law for expenditures, tax rates, and state fiscal contributions. Data comparing local and state expenditures were compiled, tabulated, and reported for each group to compare local and state fiscal effort prior to and after implementation. One-way analysis of variance was used to compare demographic variables with perceived educational benefits. Item and factor analyses were applied to establish reliability.

El objeto de estudio del trabajo titulado Variaciones sobre la Bye House de John Hejduk es la casa Wall House 2; proyectada entre 1972 y 1974 para la ciudad de Ridgefield, en Connecticut (U.S.A), y construida sobre el año 2000 en la ciudad de Groningen, en Holanda. Se dedican dos capítulos para analizar la Wall House a partir del material publicado en Mask of Medusa y Five Architects. Los capítulos se titulan "Presentación de la Wall House 2 (Bye House) de John Hejduk" y "Una visita a la Wall House 2 de papel". En estos dos apartados, se pone en orden la información sobre la Wall House disponible en los documentos. En estos dos primeros capítulos la casa, de papel, es visitada a través de los libros donde aparece el proyecto. En el capítulo tercero, "Una visita a la Wall House 2 construida en Groningen", se describe la visita a la casa construida en Holanda. Se comparan las explicaciones sobre la experiencia en el interior de la casa con algunas explicaciones que Hejduk da sobre la experiencia arquitectónica. Se considera que la casa surge de un proyecto y de un proceso que la origina. En el capítulo 4, titulado "La Wall House 2 como instrumento musical", se compara el proyecto de la Wall House con algunos dibujos sobre instrumentos musicales que Hejduk plantea a los estudiantes de la Escuela de Arquitectura de New York. En este capítulo se introduce la concepción de la casa como un instrumento musical. Es, en parte, un prólogo al planteamiento de la tesis doctoral, es un preludio a la exposición, donde la Wall House empieza a presentarse desde la particularidad de la casa al compararla con la música. El capítulo siguiente analiza las relaciones que vinculan el proceso de la transformación de un cuadrado, sobre el cual se fundamenta la casa, con otros proyectos anteriores, como son las Texas Houses, las Diamond Houses y otras Wall Houses. El último capítulo, "La Casa para el Habitante que se Negó a Participar en la Wall House 2", es una continuación del anterior / Barberá Pastor, C. (2009). Variaciones sobre la Bye House de John Hejduk [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/37607