Objective: Opioid abuse is a significant public health problem in the United States. We evaluate the clinical effectiveness and economic impact of abuse-deterrent formulations (ADF) of opioids relative to non-ADF opioids in preventing abuse. Methods: We developed a costeffectiveness model simulating 2 cohorts of 100 000 noncancer, chronic-pain patients newly prescribed either ADF or non-ADF extended-release (ER) opioids and followed them over 5 years, tracking new events of opioid abuse and opioid-related overdose deaths in addition to tracking 5-year cumulative costs of therapeutic use and abuse of ADF and non-ADF opioids. Patients in each cohort entered the model for therapeutic opioid use from where they could continue in that pathway, discontinue opioid use, or abuse opioids or die of opioid overdose-related or unrelated causes. In addition, oneway sensitivity and scenario analysis were conducted. Results: Over a 5-year time period, using ADF opioids prevented an additional 2300 new cases of opioid abuse at an additional cost of approximately $535 million to the healthcare sector. Threshold analyses showed that a 40% decrease in ADF opioid costs was required to attain cost neutrality between the 2 cohorts, whereas a 100% effectiveness in abuse reduction still did not result in cost neutrality. A 43% decrease in diversion with ADFs relative to non-ADFs was required to attain cost neutrality. Including a societal perspective produced results directionally similar to the base-case analysis findings. Conclusion: ADF opioids have the potential to prevent new cases of opioid abuse, but at substantially higher costs to the health system.

Aesthetically manipulating the visual variables of a navigation interface design has the potential for substantial improvements in the interpretation of, and subsequent navigational choices made resulting from that design. This paper reports on a study that explores how an 'optimal' path is understood across fifteen different types of route map designs for ten cities (approximately 150 route map designs in total). We are interested in how participants make sense of the route map, and subsequently choose an optimal pathway. The findings show that participants who experience certain aesthetically designed route maps are more inclined to meaningfully link information and create connections. By more deeply understanding people's perceptions of the aesthetics of a navigation problem spaceparticularly the ways in which people value and connect with aesthetic elements and how these impact the decisions made -a novel insight into individuals' understanding of data visualisation and how aesthetics affect is achieved.

Self-regulation is the control mechanism that enables a student to manage attention, emotion, behavior and cognition to engage in goal-directed actions, like learning. Too often, students atrisk for poor school outcomes do not enter school with strongly developed self-regulation skills and have difficulty developing them on their own. Self-regulation skills can be taught however, and are especially effective when introduced within the school setting. This manuscript describes a school based model for fostering self-regulation. We created the model within the Multi-Tiered Systems of Support (MTSS) framework, to facilitate successful implementation.

s263 and 15 of 16 comorbidities. In multivariate analyses age was not an independent risk factor for increased utilization, however patient comorbidities and diseaserelated complications did increase utilization. ConClusions: Hospital resource utilization is high in MFS patients, especially those < 18 years old. Disease-related complications and patient comorbidities drive resource use.

The move to care in the community is a key feature of NHS policy aimed at delivering better care while reducing costs. A multi-award-winning service in Oxford is leading the way in innovative community care, making a real difference to improving patient health and wellbeing. The Oxford Emergency Multidisciplinary Unit in Abingdon, Oxford was set up to meet the urgent assessment and treatment needs of patients with multiple, often complex problems, many of whom are frail and elderly. The unit provides comprehensive medical, nursing, therapist and social care assessment, supported by advances in ‘point-of-care’ diagnostic technology that provide test results within minutes of patients' arrival. This successful project has led to duplicate units not only in the Oxford region, but across the UK.