The Societal Benefits and Costs of School Dropout Recovery

Directory of Open Access Journals (Sweden)

James S. Catterall

2011-01-01

Full Text Available This article reports an analysis of the societal benefits and costs of recovering school dropouts. Successful recovery is defined by subsequent graduation from high school. The analysis is based on established estimates of the societal costs of dropping out including reduced government tax collections and higher social costs of welfare, healthcare, and crime. These potential costs are cast as benefits when a dropout is recovered. A large dropout recovery program provides the setting for the analysis. Rigorous attention is given to accurate estimation of the number of students who would not have graduated without the program in the year assessed and to the induced public costs of their continued education. Estimated benefits are weighed against the total annual public costs of the program, which operates in 65 school centers and commands an annual budget of about $70 million. The estimated benefit-cost ratio for this program is 3 to 1, a figure comparable to benefit-cost ratio estimates reported in studies of dropout prevention. The sensitivity of this conclusion to specific assumptions within the analysis is discussed.

The economic effect of electricity net-metering with solar PV: Consequences for network cost recovery, cross subsidies and policy objectives

International Nuclear Information System (INIS)

Eid, Cherrelle; Reneses Guillén, Javier; Frías Marín, Pablo; Hakvoort, Rudi

2014-01-01

Net-metering is commonly known as a practice by which owners of distributed generation (DG) units may offset their electricity consumption from the grid with local generation. The increasing number of prosumers (consumers that both produce and consume electricity) with solar photovoltaic (PV) generation combined with net-metering results in reduced incomes for many network utilities worldwide. Consequently, this pushes utilities to increase charges per kW h in order to recover costs. For non-PV owners, this could result into inequality issues due to the fact that also non-PV owners have to pay higher chargers for their electricity consumed to make up for netted costs of PV-owners. In order to provide insight in those inequality issues caused by net-metering, this study presents the effects on cross-subsidies, cost recovery and policy objectives evolving from different applied netmetering and tariff designs for a residential consumer. Eventually this paper provides recommendations regarding tariffs and metering that will result in more explicit incentives for PV, instead of the current implicit incentives which are present to PV owners due to net-metering. - Highlights: • Network users are frequently charged by energy charging and fixed charging. • Net-metering with energy charging causes potential problems for DSO cost recovery. • Increasing rolling credit timeframes amplify net-metering impacts on cost recovery. • Observed capacity charging can incentivize local storage and self-consumption. • PV owners should receive direct incentives in order to avoid cross subsidization

40 CFR 35.928-3 - Implementation of the industrial cost recovery system.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Implementation of the industrial cost...-Clean Water Act § 35.928-3 Implementation of the industrial cost recovery system. (a) When a grantee's industrial cost recovery system is approved, implementation of the approved system shall become a condition...

Cost analysis, cost recovery, marketing and fee-based services a guide for the health sciences librarian

CERN Document Server

Wood, M Sandra

2013-01-01

This outstanding volume won the 1986 Ida and George Eliot Prize--awarded by the Medical Library Association for the work judged most effective in furthering medical librarianship. Library professionals review the controversy behind fee-for-service programs and provide a rationale for incorporating them into contemporary library philosophies of service. Some fee-based services are necessary for survival in a society that treats information as a marketable commodity; this comprehensive book gives practical advice on cost analysis, cost recovery and marketing of reference services, and presents i

Selection and application of effective LNAPL recovery techniques

International Nuclear Information System (INIS)

Fulton, D.E.

1996-01-01

The accumulation of light non-aqueous phase liquids (LNAPL) such as gasoline, diesel, fuel oil and lubricating oil resulting from historical or catastrophic releases, is present at numerous industrial and hazardous waste sites. Initiating LNAPL removal is the first step in remediating impacted groundwater with the LNAPL recovery process having a profound effect on the ability to cost effectively achieve site closure. In many cases, LNAPL recovery precedes full-scale groundwater design activities or even final site characterization due to regulatory compliance issues. Therefore, the timely and effective implementation of a LNAPL recovery system can result in reduced project costs by mitigating further plume migration, achieving maximum volume of recoverable hydrocarbons, eliminating the source area associated with dissolved phase contamination, and allowing comprehensive groundwater remediation to be employed sooner. Effective LNAPL recovery systems begin with evaluating a number of site-specific parameters to quantify the physical characteristics of the type of LNAPL to be recovered, the hydrogeological environment, LNAPL, plume geometry, and the specified client or regulatory cleanup goals. These parameters are discussed along with their significance in developing a conceptual understanding of the site

Costs, CO{sub 2}- and primary energy balances of forest-fuel recovery systems at different forest productivity

Energy Technology Data Exchange (ETDEWEB)

Eriksson, Lisa; Gustavsson, Leif [Ecotechnology, Department of Engineering and Sustainable Development, Mid Sweden University, SE-831 25 Oestersund (Sweden)

2010-05-15

Here we examine the cost, primary energy use, and net carbon emissions associated with removal and use of forest residues for energy, considering different recovery systems, terrain, forwarding distance and forest productivity. We show the potential recovery of forest fuel for Sweden, its costs and net carbon emissions from primary energy use and avoided fossil carbon emissions. The potential annual net recovery of forest fuel is about 66 TWh, which would cost one billion EUR{sub 2005} to recover and would reduce fossil emissions by 6.9 Mt carbon if coal were replaced. Of the forest fuel, 56% is situated in normal terrain with productivity of >30 t dry-matter ha{sup -1} and of this, 65% has a forwarding distance of <400 m. In normal terrain with >30 t dry-matter ha{sup -1} the cost increase for the recovery of forest fuel, excluding stumps, is around 4-6% and 8-11% for medium and longer forwarding distances, respectively. The stump and small roundwood systems are less cost-effective at lower forest fuel intensity per area. For systems where loose material is forwarded, less dry-matter per hectare increases costs by 6-7%, while a difficult terrain increases costs by 3-4%. Still, these systems are quite cost-effective. The cost of spreading ash is around 40 EUR{sub 2005} ha{sup -1}, while primary energy use for spreading ash in areas where logging residues, stumps, and small roundwood are recovered is about 0.025% of the recovered bioenergy. (author)

Medical Care Cost Recovery National Database (MCCR NDB)

Data.gov (United States)

Department of Veterans Affairs — The Medical Care Cost Recovery National Database (MCCR NDB) provides a repository of summary Medical Care Collections Fund (MCCF) billing and collection information...

AECB Cost Recovery Fees Regulations, amendment

International Nuclear Information System (INIS)

1991-01-01

The amendment to the Regulations was published on 24 October 1991 (SOR/91-590,Canada Gazette Part II, Vol.125, No 23). It modifies the list of institutions exempted from paying cost recovery fees (licence fees) to the Atomic Energy Control Board. The exemptions now include educational and health care institutions as well as Departments. (NEA)

Cost recovery of NGO primary health care facilities: a case study in Bangladesh

Directory of Open Access Journals (Sweden)

Alam Khurshid

2010-06-01

Full Text Available Abstract Background Little is known about the cost recovery of primary health care facilities in Bangladesh. This study estimated the cost recovery of a primary health care facility run by Building Resources Across Community (BRAC, a large NGO in Bangladesh, for the period of July 2004 - June 2005. This health facility is one of the seven upgraded BRAC facilities providing emergency obstetric care and is typical of the government and private primary health care facilities in Bangladesh. Given the current maternal and child mortality in Bangladesh and the challenges to addressing health-related Millennium Development Goal (MDG targets the financial sustainability of such facilities is crucial. Methods The study was designed as a case study covering a single facility. The methodology was based on the 'ingredient approach' using the allocation techniques by inpatient and outpatient services. Cost recovery of the facility was estimated from the provider's perspective. The value of capital items was annualized using 5% discount rate and its market price of 2004 (replacement value. Sensitivity analysis was done using 3% discount rate. Results The cost recovery ratio of the BRAC primary care facility was 59%, and if excluding all capital costs, it increased to 72%. Of the total costs, 32% was for personnel while drugs absorbed 18%. Capital items were17% of total costs while operational cost absorbed 12%. Three-quarters of the total cost was variable costs. Inpatient services contributed 74% of total revenue in exchange of 10% of total utilization. An average cost per patient was US$ 10 while it was US$ 67 for inpatient and US$ 4 for outpatient. Conclusion The cost recovery of this NGO primary care facility is important for increasing its financial sustainability and decreasing donor dependency, and achieving universal health coverage in a developing country setting. However, for improving the cost recovery of the health facility, it needs to increase

75 FR 49508 - Recovery Policy, RP9525.7, Labor Costs-Emergency Work

Science.gov (United States)

2010-08-13

...] Recovery Policy, RP9525.7, Labor Costs--Emergency Work AGENCY: Federal Emergency Management Agency, DHS... (FEMA) is accepting comments on RP9525.7, Labor Costs--Emergency Work. This is an existing policy that is scheduled for review to ensure that Recovery Directorate policies are up to date, incorporate...

Manipulative therapy in addition to usual medical care accelerates recovery of shoulder complaints at higher costs: economic outcomes of a randomized trial

Directory of Open Access Journals (Sweden)

Bergman Gert JD

2010-09-01

Full Text Available Abstract Background Shoulder complaints are common in primary care and have unfavourable long term prognosis. Our objective was to evaluate the clinical effectiveness of manipulative therapy of the cervicothoracic spine and the adjacent ribs in addition to usual medical care (UMC by the general practitioner in the treatment of shoulder complaints. Methods This economic evaluation was conducted alongside a randomized trial in primary care. Included were 150 patients with shoulder complaints and a dysfunction of the cervicothoracic spine and adjacent ribs. Patients were treated with UMC (NSAID's, corticosteroid injection or referral to physical therapy and were allocated at random (yes/no to manipulative therapy (manipulation and mobilization. Patient perceived recovery, severity of main complaint, shoulder pain, disability and general health were outcome measures. Data about direct and indirect costs were collected by means of a cost diary. Results Manipulative therapy as add-on to UMC accelerated recovery on all outcome measures included. At 26 weeks after randomization, both groups reported similar recovery rates (41% vs. 38%, but the difference between groups in improvement of severity of the main complaint, shoulder pain and disability sustained. Compared to the UMC group the total costs were higher in the manipulative group (€1167 vs. €555. This is explained mainly by the costs of the manipulative therapy itself and the higher costs due sick leave from work. The cost effectiveness ratio showed that additional manipulative treatment is more costly but also more effective than UMC alone. The cost-effectiveness acceptability curve shows that a 50%-probability of recovery with AMT within 6 months after initiation of treatment is achieved at €2876. Conclusion Manipulative therapy in addition to UMC accelerates recovery and is more effective than UMC alone on the long term, but is associated with higher costs. International Standard

A conceptional design, cost and sensitivity analysis on adsorption process for uranium recovery from seawater

International Nuclear Information System (INIS)

Ogata, Noboru

1986-01-01

The system model for a conceptional design and cost estimation was studied on a multi-layered fluidizing bed with a pump which used hydrous titanium oxide (HTO) and amidoxime resin (AOR) as adsorbents. The cost effect of some parameters, namely characteristics of adsorbent, operating conditions, price of materials and some others, were estimated, and finally there was shown a direction of improvement and a possibility of cost reduction. The conceptional design and operating condition were obtained from the balance point on expansion ratio, recovery and characteristics of adsorbent. A suitable plan was obtained from the minimum cost condition in some level of the expansion ratio and some parameters. HTO was heavy in density and cheap in price. The main results of the study indicated that the thickness of the bed was 1 m, the linear velocity of seawater was 52 m/hr, the number of bed layers was 4, the construction cost of a 100 t/y plant was 10 billion yen, and the uranium cost was 160 $/1b. AOR had a large adsorption capacity. As the main results, the thickness of bed was 0.08 m, the linear velosity of seawater was 11.6 m, the number of the bed layers was 27, the construction cost of a 100 t/y plant was 15 billion yen, and the uranium cost was 280 $/1b. The size of the 100 t/y plant was about 800 m length x 80 m depth x 30 m height at 80 % of recovery. An increase of adsorption capacity in HTO, and an increase of density and particle size in AOR had the greatest merit for cost reduction. Other effective parameters were the adsorption velocity, the recovery, temperature, the price of adsorbent, the manufacturing cost of instrument, and the rate of interest. The cost of uranium by this process had a possibility of cost reduction to 67 $/1b at HTO and 79 $/1b at AOR. (author)

Cost analysis and ecological benefits of environmental recovery methodologies in bauxite mining

Directory of Open Access Journals (Sweden)

João Carlos Costa Guimarães

2013-03-01

Full Text Available This work analyzed and compared three methods of environmental recovery in bauxite mining commonly used in Poços de Caldas Plateau, MG, by means of recovery costs and ecological benefits. Earnings and costs data of environmental recovery activities were obtained for the areas that belonged to the Companhia Geral de Minas – CGM, on properties sited in the city of Poços de Caldas, MG. The amount of costs of these activities was used to compare the recovery methods by updating them monetarily to a reference date, in other words, the present moment. It is concluded that the difference between the present value of costs for simple restoration and rehabilitation activities are less than 1% and that between the complete restoration and rehabilitation is about 15.12%, suggesting that the choice of the methods to be used must be based on the ecological earnings proportional to each of them. The methodology of environmental restoration of the mining areas emphasizes the ecological variables in the process of establishment of the community, to the detriment of complex ecological aspects, which show difficulties in measuring the actual moment of the development of the ecosystem considered.

Waste Processing Cost Recovery at Los Alamos National Laboratory-Analysis and Recommendations

International Nuclear Information System (INIS)

Booth, St. R.

2009-01-01

Los Alamos National Laboratory is implementing full cost recovery for waste processing in fiscal year 2009 (FY2009), after a transition year in FY2008. Waste processing cost recovery has been implemented in various forms across the nuclear weapons complex and in corporate America. The fundamental reasoning of sending accurate price signals to waste generators is economically sound, and leads to waste minimization and reduced waste expense over time. However, Los Alamos faces significant implementation challenges because of its status as a government-owned, contractor-operated national scientific institution with a diverse suite of experimental and environmental cleanup activities, and the fact that this represents a fundamental change in how waste processing is viewed by the institution. This paper describes the issues involved during the transition to cost recovery and the ultimate selection of the business model. Of the six alternative cost recovery models evaluated, the business model chosen to be implemented in FY2009 is Recharge Plus Generators Pay Distributed Direct. Under this model, all generators who produce waste must pay a distributed direct share associated with their specific waste type to use a waste processing capability. This cost share is calculated using the distributed direct method on the fixed cost only, i.e., the fixed cost share is based on each program's forecast proportion of the total Los Alamos volume forecast of each waste type. (Fixed activities are those required to establish the waste processing capability, i.e., to make the process ready, permitted, certified, and prepared to handle the first unit of waste. Therefore, the fixed cost ends at the point just before waste begins to be processed. The activities to actually process the waste are considered variable.) The volume of waste actually sent for processing is charged a unit cost based solely on the variable cost of disposing of that waste. The total cost recovered each year is the

The long-term power purchase: Recovery of capacity costs

International Nuclear Information System (INIS)

Cross, P.S.

1990-01-01

As electric utilities increase their reliance on the long-term power purchase as an alternative to utility-owned generation, the appropriate rate treatment of the costs established in the purchase agreement assumes growing importance. In the November 9, 1989, issue, the authors examined the recent trend among state regulators to treat the long-term purchase in a manner similar to the addition by a utility of a new plant, including a full-scale prudence review. This installment will review recent rulings on the related issue of rate recovery of long-term capacity costs through the fuel cost adjustment clause

18 CFR 284.265 - Cost recovery by interstate pipeline.

Science.gov (United States)

2010-04-01

... 1978 AND RELATED AUTHORITIES Emergency Natural Gas Sale, Transportation, and Exchange Transactions... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Cost recovery by interstate pipeline. 284.265 Section 284.265 Conservation of Power and Water Resources FEDERAL ENERGY...

Claus sulphur recovery potential approaches 99% while minimizing cost

Energy Technology Data Exchange (ETDEWEB)

Berlie, E M

1974-01-21

In a summary of a paper presented to the fourth joint engineering conference of the American Institute of Chemical Engineers and the Canadian Society for Chemical Engineering, the Claus process is discussed in a modern setting. Some problems faced in the operation of sulfur recovery plants include (1) strict pollution control regulations; (2) design and operation of existing plants; (3) knowledge of process fundamentals; (4) performance testing; (5) specification of feed gas; (6) catalyst life; (7) instrumentation and process control; and (8) quality of feed gas. Some of the factors which must be considered in order to achieve the ultimate capability of the Claus process are listed. There is strong evidence to support the contention that plant operators are reluctant to accept new fundamental knowledge of the Claus sulfur recovery process and are not taking advantage of its inherent potential to achieve the emission standards required, to minimize cost of tail gas cleanup systems and to minimize operating costs.

Cost recovery of NGO primary health care facilities: a case study in Bangladesh

OpenAIRE

Alam, Khurshid; Ahmed, Shakil

2010-01-01

Abstract Background Little is known about the cost recovery of primary health care facilities in Bangladesh. This study estimated the cost recovery of a primary health care facility run by Building Resources Across Community (BRAC), a large NGO in Bangladesh, for the period of July 2004 - June 2005. This health facility is one of the seven upgraded BRAC facilities providing emergency obstetric care and is typical of the government and private primary health care facilities in Bangladesh. Give...

Cost analysis of enhanced recovery after surgery in microvascular breast reconstruction.

Science.gov (United States)

Oh, Christine; Moriarty, James; Borah, Bijan J; Mara, Kristin C; Harmsen, William S; Saint-Cyr, Michel; Lemaine, Valerie

2018-06-01

Enhanced recovery after surgery (ERAS) pathways have been shown in multiple surgical specialties to decrease hospital length of stay (LOS) after surgery. ERAS in breast reconstruction has been found to decrease hospital LOS and inpatient opioid use. ERAS protocols can facilitate a patient's recovery and can potentially increase the quality of care while decreasing costs. A standardized ERAS pathway was developed through multidisciplinary collaboration. It addressed all phases of surgical care for patients undergoing free-flap breast reconstruction utilizing an abdominal donor site. In this retrospective cohort study, clinical variables associated with hospitalization costs for patients who underwent free-flap breast reconstruction with the ERAS pathway were compared with those of historical controls, termed traditional recovery after surgery (TRAS). All patients included in the study underwent surgery between September 2010 and September 2014. Predicted costs of the study groups were compared using generalized linear modeling. A total of 200 patients were analyzed: 82 in the ERAS cohort and 118 in the TRAS cohort. Clinical variables that were identified to potentially affect costs were found to have a statistically significant difference between groups and included unilateral versus bilateral procedures (p = 0.04) and the need for postoperative blood transfusion (p = 0.03). The cost regression analysis on the two cohorts was adjusted for these significant variables. Adjusted mean costs of patients with ERAS were found to be $4,576 lesser than those of the TRAS control group ($38,688 versus $43,264). Implementation of the ERAS pathway was associated with significantly decreased costs when compared to historical controls. There has been a healthcare focus toward prudent resource allocation, which dictates the need for plastic surgeons to recognize economic evaluation of clinical practice. The ERAS pathway can increase healthcare accountability by improving

Energy Recovery Hydropower: Prospects for Off-Setting Electricity Costs for Agricultural, Municipal, and Industrial Water Providers and Users; July 2017 - September 2017

Energy Technology Data Exchange (ETDEWEB)

Levine, Aaron L. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Curtis, Taylor L. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Johnson, Kurt [Telluride Energy; Telluride, CO (United States)

2018-01-11

Energy recovery hydropower is one of the most cost-effective types of new hydropower development because it is constructed utilizing existing infrastructure, and it is typically able to complete Federal Energy Regulatory Commission (FERC) review in 60 days. Recent changes in federal and state policy have supported energy recovery hydropower. In addition, some states have developed programs and policies to support energy recovery hydropower, including resource assessments, regulatory streamlining initiatives, and grant and loan programs to reduce project development costs. This report examines current federal and state policy drivers for energy recovery hydropower, reviews market trends, and looks ahead at future federal resource assessments and hydropower reform legislation.

The effect of pre-existing health conditions on the cost of recovery from road traffic injury: insights from data linkage of medicare and compensable injury claims in Victoria, Australia.

Science.gov (United States)

Hassani-Mahmooei, Behrooz; Berecki-Gisolf, Janneke; Hahn, Youjin; McClure, Roderick J

2016-04-29

Comorbidity is known to affect length of hospital stay and mortality after trauma but less is known about its impact on recovery beyond the immediate post-accident care period. The aim of this study was to investigate the role of pre-existing health conditions in the cost of recovery from road traffic injury using health service use records for 1 year before and after the injury. Individuals who claimed Transport Accident Commission (TAC) compensation for a non-catastrophic injury that occurred between 2010 and 2012 in Victoria, Australia and who provided consent for Pharmaceutical Benefits Scheme (PBS) and Medicare Benefits Schedule (MBS) linkage were included (n = 738) in the analysis. PBS and MBS records dating from 12 months prior to injury were provided by the Department of Human Services (Canberra, Australia). Pre-injury use of health service items and pharmaceuticals were considered to indicate pre-existing health condition. Bayesian Model Averaging techniques were used to identify the items that were most strongly correlated with recovery cost. Multivariate regression models were used to determine the impact of these items on the cost of injury recovery in terms of compensated ambulance, hospital, medical, and overall claim cost. Out of the 738 study participants, 688 used at least one medical item (total of 15,625 items) and 427 used at least one pharmaceutical item (total of 9846). The total health service cost of recovery was $10,115,714. The results show that while pre-existing conditions did not have any significant impact on the total cost of recovery, categorical costs were affected: e.g. on average, for every anaesthetic in the year before the accident, hospital cost of recovery increased by 24 % [95 % CI: 13, 36 %] and for each pathological test related to established diabetes, hospital cost increased by $10,407 [5466.78, 15346.28]. For medical costs, each anaesthetic led to $258 higher cost [174.16, 341.16] and every prescription of drugs

43 CFR 426.23 - Recovery of operation and maintenance (O&M) costs.

Science.gov (United States)

2010-10-01

... operation and maintenance (O&M) costs. (a) General. All new, amended, and renewed contracts shall provide... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Recovery of operation and maintenance (O&M) costs. 426.23 Section 426.23 Public Lands: Interior Regulations Relating to Public Lands BUREAU OF...

Cost-Benefit Analysis of the Implementation of an Enhanced Recovery Program in Liver Surgery.

Science.gov (United States)

Joliat, Gaëtan-Romain; Labgaa, Ismaïl; Hübner, Martin; Blanc, Catherine; Griesser, Anne-Claude; Schäfer, Markus; Demartines, Nicolas

2016-10-01

Enhanced recovery after surgery (ERAS) programs have been shown to ease the postoperative recovery and improve clinical outcomes for various surgery types. ERAS cost-effectiveness was demonstrated for colorectal surgery but not for liver surgery. The present study aim was to analyze the implementation costs and benefits of a specific ERAS program in liver surgery. A dedicated ERAS protocol for liver surgery was implemented in our department in July 2013. The subsequent year all consecutive patients undergoing liver surgery were treated according to this protocol (ERAS group). They were compared in terms of real in-hospital costs with a patient series before ERAS implementation (pre-ERAS group). Mean costs per patient were compared with a bootstrap T test. A cost-minimization analysis was performed. Seventy-four ERAS patients were compared with 100 pre-ERAS patients. There were no significant pre- and intraoperative differences between the two groups, except for the laparoscopy number (n = 18 ERAS, n = 9 pre-ERAS, p = 0.010). Overall postoperative complications were observed in 36 (49 %) and 64 patients (64 %) in the ERAS and pre-ERAS groups, respectively (p = 0.046). The median length of stay was significantly shorter for the ERAS group (8 vs. 10 days, p = 0.006). The total mean costs per patient were €38,726 and €42,356 for ERAS and pre-ERAS (p = 0.467). The cost-minimization analysis showed a total mean cost reduction of €3080 per patient after ERAS implementation. ERAS implementation for liver surgery induced a non-significant decrease in cost compared to standard care. Significant decreased complication rate and hospital stay were observed in the ERAS group.

An Insight Into Budgeting, The Funding And Cost Recovery of ...

African Journals Online (AJOL)

The study further revealed that Institutions' financial support for students was woefully inadequate. Students' fee payment was also identified as the main modality for cost recovery of tertiary education. It was recommended that communities and industries should be made to make meaningful contributions towards tertiary ...

76 FR 54223 - Notice of Proposed Administrative Cost Recovery Settlement Pursuant to the Comprehensive...

Science.gov (United States)

2011-08-31

... Costs Incurred at Marine Corps Logistics Base Barstow, CA AGENCY: Department of the Navy, DoD. ACTION... of response costs incurred by the DON at the Site. The proposed Administrative Settlement resolves... DEPARTMENT OF DEFENSE Department of the Navy Notice of Proposed Administrative Cost Recovery...

A Stochastic Market Design With Revenue Adequacy and Cost Recovery by Scenario: Benefits and Costs

DEFF Research Database (Denmark)

Kazempour, Jalal; Pinson, Pierre; Hobbs, Benjamin F.

2018-01-01

Two desirable properties of electricity market mechanisms include: i) revenue adequacy for the market, and ii) cost recovery for all generators. Previously proposed stochastic market-clearing mechanisms satisfy both properties in expectation only, or satisfy one property by scenario and another...... scheme that ensures both properties by scenario. However, this approach is cost-inefficient in general and may sacrifice other desirable market attributes. Undesirable consequences include: one group of participants will have to pay more to ensure that all other participants have their costs covered......, and thus their prices will not be equilibrium supporting; and day-ahead and real-time prices are not arbitraged in expectation, although this can be fixed by allowing virtual bidders to arbitrage but at the potential cost of increased market inefficiency. Considering these pros and cons, we propose our...

Cost Effective Surfactant Formulations for Improved Oil Recovery in Carbonate Reservoirs

Energy Technology Data Exchange (ETDEWEB)

William A. Goddard; Yongchun Tang; Patrick Shuler; Mario Blanco; Yongfu Wu

2007-09-30

This report summarizes work during the 30 month time period of this project. This was planned originally for 3-years duration, but due to its financial limitations, DOE halted funding after 2 years. The California Institute of Technology continued working on this project for an additional 6 months based on a no-cost extension granted by DOE. The objective of this project is to improve the performance of aqueous phase formulations that are designed to increase oil recovery from fractured, oil-wet carbonate reservoir rock. This process works by increasing the rate and extent of aqueous phase imbibition into the matrix blocks in the reservoir and thereby displacing crude oil normally not recovered in a conventional waterflood operation. The project had three major components: (1) developing methods for the rapid screening of surfactant formulations towards identifying candidates suitable for more detailed evaluation, (2) more fundamental studies to relate the chemical structure of acid components of an oil and surfactants in aqueous solution as relates to their tendency to wet a carbonate surface by oil or water, and (3) a more applied study where aqueous solutions of different commercial surfactants are examined for their ability to recover a West Texas crude oil from a limestone core via an imbibition process. The first item, regarding rapid screening methods for suitable surfactants has been summarized as a Topical Report. One promising surfactant screening protocol is based on the ability of a surfactant solution to remove aged crude oil that coats a clear calcite crystal (Iceland Spar). Good surfactant candidate solutions remove the most oil the quickest from the surface of these chips, plus change the apparent contact angle of the remaining oil droplets on the surface that thereby indicate increased water-wetting. The other fast surfactant screening method is based on the flotation behavior of powdered calcite in water. In this test protocol, first the calcite

SOR/93-163 AECB Cost Recovery Fees Regulations, 1993

International Nuclear Information System (INIS)

1993-01-01

The Atomic Energy Control Board (Cost Recovery Fees Regulations 1990 and subsequent amendments have been revoked and replaced by those new Regulations of 30 march 1993 which entered into force on 1 April 1993. The regulations were first made in 1990 in order to carry out the Government's policy of introducing the principle of ''user pay'' for the cost incurred by the AECB in its regulatory activities. The objective of the policy was to shift the cost of Government regulatory efforts for the taxpayer at large to those who most benefited from or whose activities were the reason for such effort. This new version of the Regulations reflects licensees' comments, e.g. extension of the period for review of proposed fees, and sets out increases in the fees. (NEA)

Influencing Factor of Postoperation Fast-track Recovery and in Hospital Cost after Lobctomy for Lung Cancer

Directory of Open Access Journals (Sweden)

Jianhua SU

2014-07-01

Full Text Available Background and objective It is unknown that the postoperation fast-track recovery and in hospital cost of the lobectomy in lung cancer, we explored the influencing factor of postoperative fast-track recovery and in hospital cost after undergoing lobectomy for lung cancer. Methods We retrospectively reviewed the medical records of all patients (n=176 who underwent lobectomy for lung cancer between January 2010 and November 2011 by a thoracic surgeon. Results The hospital costs of video-assisted thoracic surgery (VATS lobectomy (47,308.21 ¥ is significantly higher than open lobectomy (45,664.31 ¥(P=0.007. The hospital costs of body mass index (BMI ≥ 24 kg/m2 (51,186.99 ¥ is significantly higher than BMI < 24 kg/m2 (41,701.64 ¥(P=0.032. The hospital stay of VATS lobectomy (5.70 d is significantly less than open lobectomy (7.10 d(P<0.001. Conclusion These findings indicate that preoperative pulmonary rehabilitation and VATS lobectomy is contributed to fast-track recovery for patients who undergo lobectomy, but increase the hospital costs.

Reducing Wildlife Damage with Cost-Effective Management Programmes.

Directory of Open Access Journals (Sweden)

Cheryl R Krull

Full Text Available Limiting the impact of wildlife damage in a cost effective manner requires an understanding of how control inputs change the occurrence of damage through their effect on animal density. Despite this, there are few studies linking wildlife management (control, with changes in animal abundance and prevailing levels of wildlife damage. We use the impact and management of wild pigs as a case study to demonstrate this linkage. Ground disturbance by wild pigs has become a conservation issue of global concern because of its potential effects on successional changes in vegetation structure and composition, habitat for other species, and functional soil properties. In this study, we used a 3-year pig control programme (ground hunting undertaken in a temperate rainforest area of northern New Zealand to evaluate effects on pig abundance, and patterns and rates of ground disturbance and ground disturbance recovery and the cost effectiveness of differing control strategies. Control reduced pig densities by over a third of the estimated carrying capacity, but more than halved average prevailing ground disturbance. Rates of new ground disturbance accelerated with increasing pig density, while rates of ground disturbance recovery were not related to prevailing pig density. Stochastic simulation models based on the measured relationships between control, pig density and rate of ground disturbance and recovery indicated that control could reduce ground disturbance substantially. However, the rate at which prevailing ground disturbance was reduced diminished rapidly as more intense, and hence expensive, pig control regimes were simulated. The model produced in this study provides a framework that links conservation of indigenous ecological communities to control inputs through the reduction of wildlife damage and suggests that managers should consider carefully the marginal cost of higher investment in wildlife damage control, relative to its marginal conservation

77 FR 58989 - Proposed CERCLA Administrative Cost Recovery Settlement for the Buckbee-Mears Co. Superfund Site...

Science.gov (United States)

2012-09-25

... paid $150,000 attributable to the costs of marketing and selling the Properties; (b) The Bank will pay... ENVIRONMENTAL PROTECTION AGENCY [FRL-9720-7] Proposed CERCLA Administrative Cost Recovery... costs concerning the Buckbee-Mears Co. Superfund Site located in Cortland, Cortland County, New York...

Energy and cost savings potential of oscillating heat pipes for waste heat recovery ventilation

Directory of Open Access Journals (Sweden)

Govinda Mahajan

2017-11-01

Full Text Available The feasibility of using finned oscillating heat pipes (OHPs for heat exchange between counter-flowing air streams in HVAC air systems (i.e., outdoor and exhaust air flows, along with the associated cost savings in typical North American climates, is investigated. For a prescribed temperature difference and volumetric flow rate of air, rudimentary design parameters for a viable OHP Heat Recovery Ventilator (OHP-HRV were determined using the ε-NTU (effectiveness-Number of Transfer Unit method. The two-phase heat transfer within the OHP-HRV is modeled via effective evaporation/condensation heat transfer coefficients, while the latent heat transfer required to initiate OHP operation via boiling and evaporation is also considered. Results suggest that an OHP-HRV can possess a reasonable pressure drop (5 kW. The proposed OHP-HRV can possess an effectiveness near 0.5 and can pre-cool/heat HVAC air by >5°C. Potential energy and cost savings associated with using an OHP-HRV were estimated for commercial building envelopes in various regions of the United States. It is found that the proposed OHP-HRV can save more than $2500 annually in cities that have continental climatic conditions, such as Chicago and Denver, and for the selected locations the average yearly cost savings per building is found to be on-the-order of $700. Overall, the OHP-HRV shows potential in effectively reducing energy consumption and the operational cost of air handling units in buildings.

A Cost-Effectiveness Analysis for Incineration or Recycling of Dutch Household Plastics

NARCIS (Netherlands)

R.H.J.M. Gradus (Raymond); R. van Koppen (Rick); E. Dijkgraaf (Elbert); P. Nillesen (Paul)

2016-01-01

textabstractThe cost-effectiveness of plastic recycling is compared to energy recovery from plastic incineration in a waste-to-energy plant using data for the Netherlands. Both options have specific benefits and costs. The benefits of recycling are the avoidance of both CO2 that otherwise would be

Cost-effectiveness of focal psychodynamic therapy and enhanced cognitive-behavioural therapy in out-patients with anorexia nervosa.

Science.gov (United States)

Egger, N; Wild, B; Zipfel, S; Junne, F; Konnopka, A; Schmidt, U; de Zwaan, M; Herpertz, S; Zeeck, A; Löwe, B; von Wietersheim, J; Tagay, S; Burgmer, M; Dinkel, A; Herzog, W; König, H-H

2016-12-01

Anorexia nervosa (AN) is a serious illness leading to substantial morbidity and mortality. The treatment of AN very often is protracted; repeated hospitalizations and lost productivity generate substantial economic costs in the health care system. Therefore, this study aimed to determine the differential cost-effectiveness of out-patient focal psychodynamic psychotherapy (FPT), enhanced cognitive-behavioural therapy (CBT-E), and optimized treatment as usual (TAU-O) in the treatment of adult women with AN. The analysis was conducted alongside the randomized controlled Anorexia Nervosa Treatment of OutPatients (ANTOP) study. Cost-effectiveness was determined using direct costs per recovery at 22 months post-randomization (n = 156). Unadjusted incremental cost-effectiveness ratios (ICERs) were calculated. To derive cost-effectiveness acceptability curves (CEACs) adjusted net-benefit regressions were applied assuming different values for the maximum willingness to pay (WTP) per additional recovery. Cost-utility and assumptions underlying the base case were investigated in exploratory analyses. Costs of in-patient treatment and the percentage of patients who required in-patient treatment were considerably lower in both intervention groups. The unadjusted ICERs indicated FPT and CBT-E to be dominant compared with TAU-O. Moreover, FPT was dominant compared with CBT-E. CEACs showed that the probability for cost-effectiveness of FTP compared with TAU-O and CBT-E was ⩾95% if the WTP per recovery was ⩾€9825 and ⩾€24 550, respectively. Comparing CBT-E with TAU-O, the probability of being cost-effective remained <90% for all WTPs. The exploratory analyses showed similar but less pronounced trends. Depending on the WTP, FPT proved cost-effective in the treatment of adult AN.

The impact of consumer awareness of water sector issues on willingness to pay and cost recovery in Zambia

Science.gov (United States)

Ntengwe, F. W.

The recovery of costs in water utilities is a key element in sustainability of both the provider and of the water resource itself. This paper examines the role played by consumer awareness in their willingness to pay for water supply in two cities in Zambia. Research conducted in Kitwe and Lusaka reveals that level of awareness, willingness to pay and cost recovery all vary directly. Whereas awareness may increase consumers’ willingness to pay, therefore assisting service provider’s cost recovery, the research presented here also reveals that factors such as ability to pay, affordability of bills, quality of water and of the service provided, as well as good business-consumer relations are important factors affecting a utility’s ability to recover its costs. If water utilities are to attain sustainability over the long-term, they will have to embark on and maintain consumer awareness programmes, raise the quality of service (e.g., through improved operation and maintenance), and develop and apply the right water tariff.

Transaction Costs in Collective Waste Recovery Systems in the EU

OpenAIRE

Nozharov, Shteryo

2018-01-01

The study aims to identify the institutional flaws of the current EU waste management model by analysing the economic model of extended producer responsibility and collective waste management systems and to create a model for measuring the transaction costs borne by waste recovery organizations. The model was approbated by analysing the Bulgarian collective waste management systems that have been complying with the EU legislation for the last 10 years. The analysis focuses on waste oils becau...

Cost Recovery in Urban Water Services : Select Experiences in Indian Cities

OpenAIRE

Gupta, Anjali Sen

2011-01-01

The report draws on a Water and Sanitation Program (WSP) study from 2008 which made a comparative analysis of 23 Urban Local Bodies (ULBs)-looking at seven cities in detail and another 16 based on secondary data-to understand the factors affecting cost recovery in India and provide an indication of current performance. It also draws out examples and lessons to inform reform approaches and ...

Decommissioning cost recovery in the United States: lessons learned from Connecticut Yankee NPP

International Nuclear Information System (INIS)

Joosten, J.

1999-01-01

The international audience at ICONE-7 is already familiar with the roles of the owner and the NRC in ensuring the technical and safety performance goals of nuclear plant decommissioning. This paper addresses the role of the economic regulator since the pursuit of technical and safety goals must necessarily carry with them -a price tag- and owners must be concerned with the recovery of those costs. Answers to questions about how to pay and who should pay for decommissioning can very often influence nuclear power plant owner's decision-making. In the United States, most nuclear power plants are privately owned. Nevertheless, their owners are not totally free to determine the plant's economics or profitability. Instead, plant owners must sell their electricity to consumers in a regulated market wherein the price of electricity and terms of sale are controlled by the government. Under this regulatory regime, utilities are generally allowed to recover their investment costs -including decommissioning costs- provided that such costs are prudently, incurred. However, when an owner retires the plant prematurely, the prudence of his actions -up to and including the shutdown- are likely to be challenged. In 1997, for example, the owners of the Connecticut Yankee reactor faced a stiff challenge to the recovery of decommissioning costs when they shut down the plant ten years before license expiration. The Connecticut Yankee case thus provides valuable insights into the role of economic regulation on a nuclear plant's decommissioning strategy. (author)

Promoting mental health recovery after hurricanes Katrina and Rita: what can be done at what cost.

Science.gov (United States)

Schoenbaum, Michael; Butler, Brittany; Kataoka, Sheryl; Norquist, Grayson; Springgate, Benjamin; Sullivan, Greer; Duan, Naihua; Kessler, Ronald C; Wells, Kenneth

2009-08-01

Concerns about mental health recovery persist after the 2005 Gulf storms. We propose a recovery model and estimate costs and outcomes. To estimate the costs and outcomes of enhanced mental health response to large-scale disasters using the 2005 Gulf storms as a case study. Decision analysis using state-transition Markov models for 6-month periods from 7 to 30 months after disasters. Simulated movements between health states were based on probabilities drawn from the clinical literature and expert input. A total of 117 counties/parishes across Louisiana, Mississippi, Alabama, and Texas that the Federal Emergency Management Agency designated as eligible for individual relief following hurricanes Katrina and Rita. Hypothetical cohort, based on the size and characteristics of the population affected by the Gulf storms. Intervention Enhanced mental health care consisting of evidence-based screening, assessment, treatment, and care coordination. Morbidity in 6-month episodes of mild/moderate or severe mental health problems through 30 months after the disasters; units of service (eg, office visits, prescriptions, hospital nights); intervention costs; and use of human resources. Full implementation would cost $1133 per capita, or more than $12.5 billion for the affected population, and yield 94.8% to 96.1% recovered by 30 months, but exceed available provider capacity. Partial implementation would lower costs and recovery proportionately. Evidence-based mental health response is feasible, but requires targeted resources, increased provider capacity, and advanced planning.

The impact of cost recovery on electric utilities' Clean Air Act compliance strategies

International Nuclear Information System (INIS)

Bensinger, D.L.

1993-01-01

By 1995, over 200 electric power plant units in twenty one states must comply with Phase I of the acid rain requirements in Title IV of the 1990 Clean Air Act Amendments (CAAA). By the year 2000, an additional 2200 units must comply with the Title IV. Compliance costs are expected to necessitate significant electricity rate increases. In order to recover their compliance costs, utilities must file rate increase requests with state public utility commissions (PUC's), and undergo a rate proceeding involving public heatings. Because of the magnitude of cost and the complexity of compliance options, including interaction with Titles I and III of the CAAA, extensive PUC reviews of compliance strategies are likely. These reviews could become as adversarial as the nuclear prudence reviews of the 1980's. A lack of understanding of air pollution and the CAA by much of the general public and the flexibility of compliance options creates an environment conducive to adverse public reaction to the cost of complying with the Clean Air Act. Public attitudes toward pollution control technologies will be greatly affected by these hearings, and the early plant hearings will shape the utility rate making process under the Clean Air Act. Inadequate cost recovery due to constrained compliance strategies or adverse hearings could significantly inhibit industry willingness to invest in certain control technologies or advanced combustion technologies. There are already signs that Clean Air Act compliance will be the prudence issue of the 1990's for utilities, even where state statutes mandate particular compliance approaches. Specific actions should be undertaken now by the utility industry to improve the probability of sound cost recovery decisions, preserve compliance options, including multimedia strategies, and avoid the social- and cost-acceptance problems of nuclear power

[Cost recovery for the treatment of retinal and vitreal diseases by pars plana vitrectomy under the German DRG system].

Science.gov (United States)

Framme, C; Franz, D; Mrosek, S; Helbig, H

2007-10-01

environment is not covered for complex procedures requiring more cost-effective material and personnel time. To consider an adequate cost recovery for these procedures a DRG split for both DRGs (C03Z and C17Z) in basic ppVs and complex ppVs is required. We recommend this proposal for the InEK.

Lowering operation costs by energy recovery

Energy Technology Data Exchange (ETDEWEB)

Wegener, W; Hausmann, H; Hausmann, K H

1976-01-01

Heat recovery and the heat sources available as well as possible applications of the heat recovered are discussed. Groundwater, shower water and waste air are considered as energy sources. Energy recovery by means of finned-tube systems and the heat pump, and economic aspects of the techniques are described.

Supplying synthetic crude oil from Canadian oil sands: A comparative study of the costs and CO2 emissions of mining and in-situ recovery

International Nuclear Information System (INIS)

Méjean, Aurélie; Hope, Chris

2013-01-01

High crude oil prices and the eventual decline of conventional oil production raise the issue of alternative fuels such as non-conventional oil. The paper describes a simple probabilistic model of the costs of synthetic crude oil produced from Canadian oil sands. Synthetic crude oil is obtained by upgrading bitumen that is first produced through mining or in-situ recovery techniques. This forward-looking analysis quantifies the effects of learning and production constraints on the costs of supplying synthetic crude oil. The sensitivity analysis shows that before 2035, the most influential parameters are the learning parameter in the case of in-situ bitumen and the depletion parameter in the case of mined bitumen. After 2035, depletion dominates in both cases. The results show that the social cost of CO 2 has a large impact on the total costs of synthetic crude oil, in particular in the case of synthetic crude oil from in-situ bitumen, due to the carbon intensity of the recovery techniques: taking into account the social cost of CO 2 adds more than half to the cost of producing synthetic crude oil from mined bitumen in 2050 (mean value), while the cost of producing synthetic crude oil from in-situ bitumen more than doubles. - Highlights: • We model the cost of Canadian synthetic crude oil (SCO) using Monte-Carlo techniques. • We reveal the uncertainty associated with each input parameter. • We quantify the effect of learning, depletion and CO 2 using sensitivity analyses. • Accounting for the social cost of CO 2 doubles the cost of SCO from in-situ bitumen. • CO 2 pricing could have a large effect on the economics of the oil sands

Development of a Field Demonstration for Cost-Effective Low-Grade Heat Recovery and Use Technology Designed to Improve Efficiency and Reduce Water Usage Rates for a Coal-Fired Power Plant

Energy Technology Data Exchange (ETDEWEB)

Noble, Russell [Southern Company Services, Incorporated, Birmingham, AL (United States); Dombrowski, K. [AECOM Technical Services, Austin, TX (United States); Bernau, M. [AECOM Technical Services, Austin, TX (United States); Morett, D. [AECOM Technical Services, Austin, TX (United States); Maxson, A. [EPRI, Palo Alto, CA (United States); Hume, S. [EPRI, Palo Alto, CA (United States)

2016-06-30

Coal-based power generation systems provide reliable, low-cost power to the domestic energy sector. These systems consume large amounts of fuel and water to produce electricity and are the target of pending regulations that may require reductions in water use and improvements in thermal efficiency. While efficiency of coal-based generation has improved over time, coal power plants often do not utilize the low-grade heat contained in the flue gas and require large volumes of water for the steam cycle make-up, environmental controls, and for process cooling and heating. Low-grade heat recovery is particularly challenging for coal-fired applications, due in large part to the condensation of acid as the flue gas cools and the resulting potential corrosion of the heat recovery materials. Such systems have also not been of significant interest as recent investments on coal power plants have primarily been for environmental controls due to more stringent regulations. Also, in many regions, fuel cost is still a pass-through to the consumer, reducing the motivation for efficiency improvements. Therefore, a commercial system combining low-grade heat-recovery technologies and associated end uses to cost effectively improve efficiency and/or reduce water consumption has not yet been widely applied. However, pressures from potential new regulations and from water shortages may drive new interest, particularly in the U.S. In an effort to address this issue, the U.S. Department of Energy (DOE) has sought to identify and promote technologies to achieve this goal.

77 FR 4997 - Proposed Information Collection; Comment Request; Alaska Individual Fishing Quota Cost Recovery...

Science.gov (United States)

2012-02-01

... Jessup, Departmental Paperwork Clearance Officer, Department of Commerce, Room 6616, 14th and... about the value of landings of IFQ species and to calculate and submit fees. The Cost Recovery Program.... Estimated Number of Respondents: 2,500. Estimated Time per Response: 2 hours to complete IFQ Permit Holder...

Treated Seawater as a Magnesium Source for Phosphorous Recovery from Wastewater—A Feasibility and Cost Analysis

Directory of Open Access Journals (Sweden)

Cejna Anna Quist-Jensen

2016-12-01

Full Text Available Conventional resources of phosphorous are at high risk of depletion in the near future due to current practices of its exploitation, thus new and improved exploration methodologies need to be developed to ensure phosphorous security. Today, some treatment plants recover phosphorous from municipal wastewater as struvite (MgNH4PO4·6H2O. Magnesium is often added to the wastewater as MgCl2·6H2O to facilitate the phosphorous recovery. However, the use of magnesium increases the costs of the process and is not aligned with sustainable development, therefore, alternative magnesium sources have to be found. The current study analyzes the feasibility of integrated membrane processes for magnesium recovery from seawater for utilization in the phosphorous recovery process. The integrated membrane systems consist of nanofiltration (NF, membrane distillation (MD, and membrane crystallization (MCr. The lowest associated cost is found for standalone NF treatment. However, the additional treatment with MD and MCr produces fresh water and salts like NaCl or potentially other valuable minerals at the expense of low-grade heat.

Guidance Document - Full-cost Recovery for Molybdenum-99 Irradiation Services: Methodology and Implementation

International Nuclear Information System (INIS)

Westmacott, Chad; Cameron, Ron

2012-02-01

At the request of its member countries, the OECD Nuclear Energy Agency (NEA) became involved in global efforts to ensure a reliable supply of molybdenum-99 ( 99 Mo) and its decay product, technetium-99m (' 99m Tc), the most widely used medical radioisotope. The NEA established the High-level Group on the Security of Supply of Medical Radioisotopes (HLG-MR) in 2009. Under its first mandate (June 2009-2011), the HLG-MR examined the major issues that affect the short-, medium- and long-term reliability of 99 Mo/' 99m Tc supply and then developed a policy approach to move the supply chain to a sustainable basis and ensure security of supply. The objectives of the HLG-MR during its second mandate (July 2011-2013) are to work towards increasing the long-term security of supply of 99 Mo and ' 99m Tc, especially through the implementation of the HLG-MR policy approach and its associated recommendations. This will entail actions to maintain transparency on global developments, continue communication with the supply chain and end users, evaluate progress toward implementation and provide additional information and analysis where necessary. A key action under the second mandate is to provide guidance on the implementation of the HLG-MR policy approach. This document provides guidance to reactor and alternative production technology (e.g., cyclotrons, accelerators) operators on how to undertake full-cost identification and implement full-cost recovery. The document also discusses issues related to levelling the playing field between old and new reactors. In order to move toward a long-term secure supply of 99 Mo and ' 99m Tc, the HLG-MR policy approach will need to be implemented by all countries that have an impact on the global market - as producers or consumers. A key recommendation of the policy approach is the implementation of full-cost identification and recovery by operators of 99 Mo-producing research reactors or alternative technologies. This document provides the

Cost-benefit analysis of copper recovery in remediation projects: A case study from Sweden.

Science.gov (United States)

Volchko, Yevheniya; Norrman, Jenny; Rosén, Lars; Karlfeldt Fedje, Karin

2017-12-15

Contamination resulting from past industrial activity is a problem throughout the world and many sites are severely contaminated by metals. Advances in research in recent years have resulted in the development of technologies for recovering metal from metal-rich materials within the framework of remediation projects. Using cost-benefit analysis (CBA), and explicitly taking uncertainties into account, this paper evaluates the potential social profitability of copper recovery as part of four remediation alternatives at a Swedish site. One alternative involves delivery of copper-rich ash to a metal production company for refining. The other three alternatives involve metal leaching from materials and sale of the resulting metal sludge for its further processing at a metal production company using metallurgical methods. All the alternatives are evaluated relative to the conventional excavation and disposal method. Metal recovery from the ash, metal sludge sale, and disposal of the contaminated soil and the ash residue at the local landfill site, was found to be the best remediation alternative. However, given the present conditions, its economic potential is low relative to the conventional excavation and disposal method but higher than direct disposal of the copper-rich ash for refining. Volatile copper prices, the high cost of processing equipment, the highly uncertain cost of the metal leaching and washing process, coupled with the substantial project risks, contribute most to the uncertainties in the CBA results for the alternatives involving metal leaching prior to refining. However, investment in processing equipment within the framework of a long-term investment project, production of safe, reusable soil residue, and higher copper prices on the metal market, can make metal recovery technology socially profitable. Copyright © 2017 Elsevier B.V. All rights reserved.

Unbundling payments for radioisotopes from radiopharmaceuticals and from diagnostic procedures: A tool to support the implementation of full-cost recovery. NEA discussion document

International Nuclear Information System (INIS)

2012-01-01

The objective of the NEA's HLG-MR policy approach is to ensure a long-term secure supply. The HLG-MR has determined that to attain that objective, a necessary (but not sufficient) requirement is that irradiation services in the 99 Mo/ 99m Tc supply chain must be provided on a full-cost recovery (FCR) basis (OECD-NEA, 2011). The HLG-MR policy approach also recommended that supply chain participants should implement payment reforms that promote full-cost recovery within their reimbursement systems. Reforms might include separate radioisotope pricing or auditing, separate radioisotope payment, differential radioisotope payment for FCR, or other approaches to promote a complete transition to full-cost recovery

Nitrous Oxide and Nitrous Oxide-Free Low-Flow Anesthesia Using Bispectral Index Monitoring: Effects on Hemodynamics, Recovery Times, Volatile Anesthetic Consumption and Costs

Directory of Open Access Journals (Sweden)

Bengü Gülhan Köksal

2010-12-01

Full Text Available Aim: In this study, we aimed to compare the effects of desfluraneN2O and desflurane-fentanyl combinations on hemodynamics, recovery times, volatile anesthetic consumption and costs in low-flow desflurane anesthesia by bispectral index (BIS monitoring of depth of anesthesia. Methods: After approval of ethics committee and obtaining patient consents, 60 patients were divided into two equal groups randomly. Non-invasive blood pressure measurement, ECG, SpO2 and BIS were monitored. All patients received 10 L .min-1 100% oxygen with mask for 5 minute before intubation. 2 mg.kg-1 propofol, 2 μg.kg-1 fentanyl and 0.6 mg.kg-1 rocuronium bromide were administered at induction in both groups. Desfluran 6% was chosen for anesthesia maintenance. Group 1 received 50% O2-N2O mixture in 6 L.min-1 and Group 2 received 50% O2-air mixture in 6 L.min-1 as carrier gas. Low-flow anesthesia (1 L.min-1 was started after a 10-min period of initial high flow (6 L.min-1. In Group 2, infusion of fentanyl was begun in 1 μg.kg.hour-1 rate. Desflurane level was adjusted at a main BIS value of 40-60. Blood pressure, heart rate, FiO2, etO2, FiN22, EtN2O, FiCO2, EtCO2, Fidesfluran and Etdesflurane were recorded. Results: There were no significant differences between the two groups in terms of heart rate, arterial blood pressure, settings of desfluran and recovery time. BIS values (p<0.001 and anesthetic agent costs (p<0.001 were higher in Group 2. Conclusion: Using fentanyl infusion instead of nitrous oxide in low flow-anesthesia with desflurane did not alter the hemodynamic parameters. Fentanyl infusion with medical air-oxygen as carrier gas is an alternative technique, but increases BIS values and anesthetic agent costs. (The Medical Bulletin of Haseki 2010; 48: 132-8

Comparative Effects of Biomass Pre-Treatments for Direct and Indirect Transesterification to Enhance Microalgal Lipid Recovery

International Nuclear Information System (INIS)

Ghasemi Naghdi, Forough; Thomas-Hall, Skye R.; Durairatnam, Reuben; Pratt, Steven; Schenk, Peer M.

2014-01-01

Microalgal lipid recovery for biodiesel production is currently considered suboptimal, but pre-treatment of algal biomass, the use of solvent mixtures and the positioning of transesterification can lead to increased yields. Here, the effect of various reportedly successful pre-treatments and solvent mixtures were directly compared to each other and combined with direct and indirect transesterification methods using the oleaginous microalga Tetraselmis sp. M8. Microwave and thermal pre-treatments were applied and the total lipid and fatty acid methyl ester (FAME) recoveries were investigated. The application of pre-treatments increased FAME recovery through indirect transesterification when a Soxhlet system was used but they had no significant effect for direct transesterification. Gravimetric analyses of total lipids revealed that lipid recovery was highest when utilizing the chloroform-based Bligh and Dyer extraction method; however, FAME yield was the highest when applying a Soxhlet system utilizing a solvent mixture of hexane–ethanol (3:1). Total lipid recovery did not necessarily correlate with the recovery of FAMEs. The highest FAME recovery was achieved from thermal or microwave pre-treated biomass followed by indirect transesterification through Soxhlet extraction. FAME recovery could be more than doubled (increase of up to 171%) under these conditions. We conclude that a simple thermal pre-treatment (80°C for 10 min) in combination with solvent mixture extraction through indirect transesterification may present a cost-effective and scalable option for large-scale lipid extraction from microalgae.

Comparative effects of biomass pre-treatments for direct and indirect transesterification to enhance microalgal lipid recovery

Directory of Open Access Journals (Sweden)

Forough eGhasemi Naghdi

2014-12-01

Full Text Available Microalgal lipid recovery for biodiesel production is currently considered suboptimal, but pre-treatment of algal biomass, the use of solvent mixtures and the positioning of transesterification can lead to increased yields. Here, the effect of various reportedly successful pre-treatments and solvent mixtures were directly compared to each other and combined with direct and indirect transesterification methods using the oleaginous microalga Tetraselmis sp. M8. Microwave and thermal pre-treatments were applied and the total lipid and fatty acid methyl ester (FAME recoveries were investigated. The application of pre-treatments increased FAME recovery through indirect transesterification when a Soxhlet system was used but they had no significant effect for direct transesterification. Gravimetric analyses of total lipids revealed that lipid recovery was highest when utilizing the chloroform-based Bligh and Dyer extraction method; however FAME yield was the highest when applying a Soxhlet system utilizing a solvent mixture of hexane-ethanol (3:1. Total lipid recovery did not necessarily correlate with the recovery of FAMEs. The highest FAME recovery was achieved from thermal or microwave pre-treated biomass followed by indirect transesterification through Soxhlet extraction. FAME recovery could be more than doubled (increase of up to 171% under these conditions. We conclude that a simple thermal pre-treatment (80°C for 10 min in combination with solvent mixture extraction through indirect transesterification may present a cost-effective and scalable option for large-scale lipid extraction from microalgae.

Comparative Effects of Biomass Pre-Treatments for Direct and Indirect Transesterification to Enhance Microalgal Lipid Recovery

Energy Technology Data Exchange (ETDEWEB)

Ghasemi Naghdi, Forough; Thomas-Hall, Skye R.; Durairatnam, Reuben [Algae Biotechnology Laboratory, School of Agriculture and Food Sciences, The University of Queensland, Brisbane, QLD (Australia); Pratt, Steven [School of Chemical Engineering, The University of Queensland, Brisbane, QLD (Australia); Schenk, Peer M., E-mail: p.schenk@uq.edu.au [Algae Biotechnology Laboratory, School of Agriculture and Food Sciences, The University of Queensland, Brisbane, QLD (Australia)

2014-12-04

Microalgal lipid recovery for biodiesel production is currently considered suboptimal, but pre-treatment of algal biomass, the use of solvent mixtures and the positioning of transesterification can lead to increased yields. Here, the effect of various reportedly successful pre-treatments and solvent mixtures were directly compared to each other and combined with direct and indirect transesterification methods using the oleaginous microalga Tetraselmis sp. M8. Microwave and thermal pre-treatments were applied and the total lipid and fatty acid methyl ester (FAME) recoveries were investigated. The application of pre-treatments increased FAME recovery through indirect transesterification when a Soxhlet system was used but they had no significant effect for direct transesterification. Gravimetric analyses of total lipids revealed that lipid recovery was highest when utilizing the chloroform-based Bligh and Dyer extraction method; however, FAME yield was the highest when applying a Soxhlet system utilizing a solvent mixture of hexane–ethanol (3:1). Total lipid recovery did not necessarily correlate with the recovery of FAMEs. The highest FAME recovery was achieved from thermal or microwave pre-treated biomass followed by indirect transesterification through Soxhlet extraction. FAME recovery could be more than doubled (increase of up to 171%) under these conditions. We conclude that a simple thermal pre-treatment (80°C for 10 min) in combination with solvent mixture extraction through indirect transesterification may present a cost-effective and scalable option for large-scale lipid extraction from microalgae.

Clinical effectiveness and cost-effectiveness of laparoscopic surgery for colorectal cancer: systematic reviews and economic evaluation.

Science.gov (United States)

Murray, A; Lourenco, T; de Verteuil, R; Hernandez, R; Fraser, C; McKinley, A; Krukowski, Z; Vale, L; Grant, A

2006-11-01

incorporated into a Markov model used to estimate cost-effectiveness for a time horizon of up to 25 years. In terms of incremental cost per life-year, laparoscopic surgery was found to be more costly and no more effective than open surgery. With respect to incremental cost per QALY, few data were available to differentiate between laparoscopic and open surgery. The results of the base-case analysis indicate that there is an approximately 40% chance that laparoscopic surgery is the more cost-effective intervention at a threshold willingness to pay for a QALY of pound 30,000. A second analysis assuming equal mortality and disease-free survival found that there was an approximately 50% likelihood at a similar threshold value. Broadly similar results were found in the sensitivity analyses. A threshold analysis was performed to investigate the magnitude of QALY gain associated with quicker recovery following laparoscopic surgery required to provide an incremental cost per QALY of pound 30,000. The implied number of additional QALYs required would be 0.009-0.010 compared with open surgery. Laparoscopic resection is associated with a quicker recovery (shorter time to return to usual activities and length of hospitalisation) and no evidence of a difference in mortality or disease-free survival up to 3 years following surgery. However, operation times are longer and a significant number of procedures initiated laparoscopically may need to be converted to open surgery. The rate of conversion may be dependent on experience in terms of both patient selection and performing the technique. Laparoscopic resection appears more costly to the health service than open resection, with an estimated extra total cost of between pound 250 and pound 300 per patient. In terms of relative cost-effectiveness, laparoscopic resection is associated with a modest additional cost, short-term benefits associated with more rapid recovery and similar long-term outcomes in terms of survival and cure rates up to 3

Controlling Healthcare Costs: Just Cost Effectiveness or "Just" Cost Effectiveness?

Science.gov (United States)

Fleck, Leonard M

2018-04-01

Meeting healthcare needs is a matter of social justice. Healthcare needs are virtually limitless; however, resources, such as money, for meeting those needs, are limited. How then should we (just and caring citizens and policymakers in such a society) decide which needs must be met as a matter of justice with those limited resources? One reasonable response would be that we should use cost effectiveness as our primary criterion for making those choices. This article argues instead that cost-effectiveness considerations must be constrained by considerations of healthcare justice. The goal of this article will be to provide a preliminary account of how we might distinguish just from unjust or insufficiently just applications of cost-effectiveness analysis to some healthcare rationing problems; specifically, problems related to extraordinarily expensive targeted cancer therapies. Unconstrained compassionate appeals for resources for the medically least well-off cancer patients will be neither just nor cost effective.

Costs and cost-effectiveness of periviable care.

Science.gov (United States)

Caughey, Aaron B; Burchfield, David J

2014-02-01

With increasing concerns regarding rapidly expanding healthcare costs, cost-effectiveness analysis allows assessment of whether marginal gains from new technology are worth the increased costs. Particular methodologic issues related to cost and cost-effectiveness analysis in the area of neonatal and periviable care include how costs are estimated, such as the use of charges and whether long-term costs are included; the challenges of measuring utilities; and whether to use a maternal, neonatal, or dual perspective in such analyses. A number of studies over the past three decades have examined the costs and the cost-effectiveness of neonatal and periviable care. Broadly, while neonatal care is costly, it is also cost effective as it produces both life-years and quality-adjusted life-years (QALYs). However, as the gestational age of the neonate decreases, the costs increase and the cost-effectiveness threshold is harder to achieve. In the periviable range of gestational age (22-24 weeks of gestation), whether the care is cost effective is questionable and is dependent on the perspective. Understanding the methodology and salient issues of cost-effectiveness analysis is critical for researchers, editors, and clinicians to accurately interpret results of the growing body of cost-effectiveness studies related to the care of periviable pregnancies and neonates. Copyright © 2014 Elsevier Inc. All rights reserved.

The Role of Dairy in Effectiveness and Cost of Treatment of Children With Moderate Acute Malnutrition: A Narrative Review.

Science.gov (United States)

Suri, Devika J; Moorthy, Denish; Rosenberg, Irwin H

2016-06-01

Dairy is recommended in specially formulated supplementary foods to treat children with moderate acute malnutrition (MAM) but with limited evidence and added cost. Review studies of ready-to-use foods (RUFs) versus fortified blended foods (FBFs) to determine whether inclusion of dairy modifies the comparative effectiveness and cost. We reviewed literature comparing FBF and RUF in treatment of MAM among children younger than 5 years in developing countries. Outcomes of recovery from MAM, weight, and length gain were compared among treatment categories: FBF with dairy (FBF+), FBF without dairy (FBF-), RUF with dairy (RUF+), and RUF without dairy (RUF-). Supplement cost was compared per 500 kcal. Eight studies were included. Rations were heterogeneous in energy and type of dairy. Overall, RUF+, RUF-, and FBF+ performed similarly, with higher recovery and weight gain compared with FBF-. RUF+ had higher recovery (in 5 of 6 comparisons), weight gain (4 of 4), and length gain (1 of 4) versus FBF-. The RUF+ had higher recovery (1 of 2) versus FBF+, with no other differences. The RUF- versus FBF+ had no differences (0 of 2). The RUF- had higher recovery (1 of 2), weight gain (2 of 2) versus FBF-. Four studies reported supplement costs, which averaged US$0.15 (FBF-), US$0.18 (FBF+), US$0.18 (RUF-), and US$0.37 (RUF+) per 500 kcal. There is a consistent benefit of FBF that include dairy in treatment of children with MAM. Benefits of dairy in RUF require further investigation. Evidence from rigorous quantitative analysis of existing data, cost-effectiveness, and prospective trials will be essential in determining policy on treatment for children with MAM. © The Author(s) 2016.

Recovery Risk and Labor Costs in Public-Private Partnerships : Contractual Choice in the US Water industry

OpenAIRE

Albalate, Daniel, 1980-; Bel i Queralt, Germà, 1963-; Geddes, R. Richard

2012-01-01

We use an ordered logistic model to empirically examine the factors that explain varying degrees of private involvement in the U.S. water sector through public-private partnerships. Our estimates suggest that a variety of factors help explain greater private participation in this sector. We find that the risk to private participants regarding cost recovery is an important driver of private participation. The relative cost of labor is also a key factor in determining the degree of private invo...

Integrating the Carbon and Water Footprints’ Costs in the Water Framework Directive 2000/60/EC Full Water Cost Recovery Concept: Basic Principles Towards Their Reliable Calculation and Socially Just Allocation

Directory of Open Access Journals (Sweden)

Anastasia Papadopoulou

2012-01-01

Full Text Available This paper presents the basic principles for the integration of the water and carbon footprints cost into the resource and environmental costs respectively, taking the suggestions set by the Water Framework Directive (WFD 2000/60/EC one step forward. WFD states that full water cost recovery (FWCR should be based on the estimation of the three sub-costs related: direct; environmental; and resource cost. It also strongly suggests the EU Member States develop and apply effective water pricing policies to achieve FWCR. These policies must be socially just to avoid any social injustice phenomena. This is a very delicate task to handle, especially within the fragile economic conditions that the EU is facing today. Water losses play a crucial role for the FWC estimation. Water losses should not be neglected since they are one of the major “water uses” in any water supply network. A methodology is suggested to reduce water losses and the related Non Revenue Water (NRW index. An Expert Decision Support System is proposed to assess the FWC incorporating the Water and Carbon Footprint costs.

Un-bundling payments for radioisotopes from radiopharmaceuticals and from diagnostic procedures: A tool to support the implementation of full-cost recovery - NEA discussion document

International Nuclear Information System (INIS)

2012-09-01

The objective of the NEA's HLG-MR policy approach is to ensure a long-term secure supply. The HLG-MR has determined that to attain that objective, a necessary (but not sufficient) requirement is that irradiation services in the 99 Mo/' 99m Tc supply chain must be provided on a full-cost recovery (FCR) basis (OECD-NEA, 2011). The HLG-MR policy approach also recommended that supply chain participants should implement payment reforms that promote full-cost recovery within their reimbursement systems. Reforms might include separate radioisotope pricing or auditing, separate radioisotope payment, differential radioisotope payment for FCR, or other approaches to promote a complete transition to full-cost recovery. This paper is written to provide a basis for further discussion on the use of separate reimbursement to encourage the move to full-cost recovery. Separate reimbursement is one tool that could be used by public and private health insurance to support the move to ensuring sufficient reimbursement rates (or payments) for 99 Mo/' 99m Tc while the industry moves to full-cost recovery for irradiation services, paying for outage reserve capacity and transitioning to using LEU targets. Other tools are available (such as differential payments, separate radioisotope payments, auditing) that could lead to similar outcomes that support the changes necessary in the 99 Mo/' 99m Tc supply chain to ensure a long-term reliable supply of these important medical isotopes

Effects of Microwave Radiation on Oil Recovery

Science.gov (United States)

Esmaeili, Abdollah

2011-12-01

A variety of oil recovery methods have been developed and applied to mature and depleted reservoirs in order to improve the efficiency. Microwave radiation oil recovery method is a relatively new method and has been of great interest in the recent years. Crude oil is typically co-mingled with suspended solids and water. To increase oil recovery, it is necessary to remove these components. The separation of oil from water and solids using gravitational settling methods is typically incomplete. Oil-in-water and oil-water-solid emulsions can be demulsified and separated into their individual layers by microwave radiation. The data also show that microwave separation is faster than gravity separation and can be faster than conventional heating at many conditions. After separation of emulsion into water and oil layers, water can be discharged and oil is collected. High-frequency microwave recycling process can recover oil and gases from oil shale, residual oil, drill cuttings, tar sands oil, contaminated dredge/sediments, tires and plastics with significantly greater yields and lower costs than are available utilizing existing known technologies. This process is environmentally friendly, fuel-generating recycler to reduce waste, cut emissions, and save energy. This paper presents a critical review of Microwave radiation method for oil recovery.

Recovery of Utility Fixed Costs: Utility, Consumer, Environmental and Economist Perspectives

Energy Technology Data Exchange (ETDEWEB)

Wood, Lisa [Inst. for Electric Innovation and The Edison Foundation, Washington DC (United States); Hemphill, Ross [RCHemphill Solutions, Columbus, OH (United States); Howat, John [National Consumer Law Center, Boston, MA (United States); Cavanagh, Ralph [Natural Resources Defense Council, New York, NY (United States); Borenstein, Severin [Univ. of California, Berkeley, CA (United States); Deason, Jeff [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Schwartz, Lisa [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Schwartz, Lisa [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2016-06-14

Utilities recover costs for providing electric service to retail customers through a combination of rate components that together comprise customers’ monthly electric bills. Rates and rate designs are set by state regulators and vary by jurisdiction, utility and customer class. In addition to the fundamental tenet of setting fair and reasonable rates, rate design balances economic efficiency, equity and fairness, customer satisfaction, utility revenue stability, and customer price and bill stability.1 At the most basic level, retail electricity bills in the United States typically include a fixed monthly customer charge — a set dollar amount regardless of energy usage — and a volumetric energy charge for each kilowatt-hour consumed.2 The energy charge may be flat across all hours, vary by usage level (for example, higher rates at higher levels of usage), or vary based on time of consumption.3 While some utility costs, such as fuel costs, clearly vary according to electricity usage, other costs are “fixed” over the short run — generally, those that do not vary over the course of a year. Depending on your point of view, and whether the state’s electricity industry has been restructured or remains vertically integrated, the set of costs that are “fixed” may be quite limited. Or the set may extend to all capacity costs for generation, transmission and distribution. In the long run, all costs are variable. In the context of flat or declining loads in some regions, utilities are proposing a variety of changes to retail rate designs, particularly for residential customers, to recover fixed costs. In this report, authors representing utility (Chapter 1), consumer (Chapter 2), environmentalist (Chapter 3) and economist (Chapter 4) perspectives discuss fixed costs for electric utilities and set out their principles for recovering those costs. The table on the next page summarizes each author’s relative preferences for various options for fixed cost

Can a Costly Intervention Be Cost-effective?

Science.gov (United States)

Foster, E. Michael; Jones, Damon

2009-01-01

Objectives To examine the cost-effectiveness of the Fast Track intervention, a multi-year, multi-component intervention designed to reduce violence among at-risk children. A previous report documented the favorable effect of intervention on the highest-risk group of ninth-graders diagnosed with conduct disorder, as well as self-reported delinquency. The current report addressed the cost-effectiveness of the intervention for these measures of program impact. Design Costs of the intervention were estimated using program budgets. Incremental cost-effectiveness ratios were computed to determine the cost per unit of improvement in the 3 outcomes measured in the 10th year of the study. Results Examination of the total sample showed that the intervention was not cost-effective at likely levels of policymakers' willingness to pay for the key outcomes. Subsequent analysis of those most at risk, however, showed that the intervention likely was cost-effective given specified willingness-to-pay criteria. Conclusions Results indicate that the intervention is cost-effective for the children at highest risk. From a policy standpoint, this finding is encouraging because such children are likely to generate higher costs for society over their lifetimes. However, substantial barriers to cost-effectiveness remain, such as the ability to effectively identify and recruit such higher-risk children in future implementations. PMID:17088509

LOWER COST METHODS FOR IMPROVED OIL RECOVERY (IOR) VIA SURFACTANT FLOODING

Energy Technology Data Exchange (ETDEWEB)

William A. Goddard III; Yongchun Tang; Patrick Shuler; Mario Blanco; Seung Soon Jang; Shiang-Tai Lin; Prabal Maiti; Yongfu Wu; Stefan Iglauer; Xiaohang Zhang

2004-09-01

This report provides a summary of the work performed in this 3-year project sponsored by DOE. The overall objective of this project is to identify new, potentially more cost-effective surfactant formulations for improved oil recovery (IOR). The general approach is to use an integrated experimental and computational chemistry effort to improve our understanding of the link between surfactant structure and performance, and from this knowledge, develop improved IOR surfactant formulations. Accomplishments for the project include: (1) completion of a literature review to assemble current and new surfactant IOR ideas, (2) Development of new atomistic-level MD (molecular dynamic) modeling methodologies to calculate IFT (interfacial tension) rigorously from first principles, (3) exploration of less computationally intensive mesoscale methods to estimate IFT, Quantitative Structure Property Relationship (QSPR), and cohesive energy density (CED) calculations, (4) experiments to screen many surfactant structures for desirable low IFT and solid adsorption behavior, and (5) further experimental characterization of the more promising new candidate formulations (based on alkyl polyglycosides (APG) and alkyl propoxy sulfate surfactants). Important findings from this project include: (1) the IFT between two pure substances may be calculated quantitatively from fundamental principles using Molecular Dynamics, the same approach can provide qualitative results for ternary systems containing a surfactant, (2) low concentrations of alkyl polyglycoside surfactants have potential for IOR (Improved Oil Recovery) applications from a technical standpoint (if formulated properly with a cosurfactant, they can create a low IFT at low concentration) and also are viable economically as they are available commercially, and (3) the alkylpropoxy sulfate surfactants have promising IFT performance also, plus these surfactants can have high optimal salinity and so may be attractive for use in higher

Learning how to recover from job stress: effects of a recovery training program on recovery, recovery-related self-efficacy, and well-being.

Science.gov (United States)

Hahn, Verena C; Binnewies, Carmen; Sonnentag, Sabine; Mojza, Eva J

2011-04-01

This quasi-experimental study evaluated the effects of a recovery training program on recovery experiences (psychological detachment from work, relaxation, mastery experiences, and control during off-job time), recovery-related self-efficacy, and well-being outcomes. The training comprised two sessions held one week apart. Recovery experiences, recovery-related self-efficacy, and well-being outcomes were measured before the training (T1) and one week (T2) and three weeks (T3) after the training. A training group consisting of 48 individuals and a waitlist control group of 47 individuals were compared (N = 95). Analyses of covariance revealed an increase in recovery experiences at T2 and T3 (for mastery only at T2). Recovery-related self-efficacy and sleep quality increased at T2 and T3, perceived stress and state negative affect decreased at T3. No training effects were found for emotional exhaustion.

Impediments to the success of management actions for species recovery.

Directory of Open Access Journals (Sweden)

Chooi Fei Ng

Full Text Available Finding cost-effective management strategies to recover species declining due to multiple threats is challenging, especially when there are limited resources. Recent studies offer insights into how costs and threats can influence the best choice of management actions. However, when implementing management actions in the real-world, a range of impediments to management success often exist that can be driven by social, technological and land-use factors. These impediments may limit the extent to which we can achieve recovery objectives and influence the optimal choice of management actions. Nonetheless, the implications of these impediments are not well understood, especially for recovery planning involving multiple actions. We used decision theory to assess the impact of these types of impediments for allocating resources among recovery actions to mitigate multiple threats. We applied this to a declining koala (Phascolarctos cinereus population threatened by habitat loss, vehicle collisions, dog attacks and disease. We found that the unwillingness of dog owners to restrain their dogs at night (a social impediment, the effectiveness of wildlife crossings to reduce vehicle collisions (a technological impediment and the unavailability of areas for restoration (a land-use impediment significantly reduced the effectiveness of our actions. In the presence of these impediments, achieving successful recovery may be unlikely. Further, these impediments influenced the optimal choice of recovery actions, but the extent to which this was true depended on the target koala population growth rate. Given that species recovery is an important strategy for preserving biodiversity, it is critical that we consider how impediments to the success of recovery actions modify our choice of actions. In some cases, it may also be worth considering whether investing in reducing or removing impediments may be a cost-effective course of action.

The economics of recovery after pancreatic surgery: detailed cost minimization analysis of an enhanced recovery program.

Science.gov (United States)

Kagedan, Daniel J; Devitt, Katharine S; Tremblay St-Germain, Amélie; Ramjaun, Aliya; Cleary, Sean P; Wei, Alice C

2017-11-01

Clinical pathways (CPW) are considered safe and effective at decreasing postoperative length of stay (LoS), but the effect on economic costs is uncertain. This study sought to elucidate the effect of a CPW on direct hospitalization costs for patients undergoing pancreaticoduodenectomy (PD). A CPW for PD patients at a single Canadian institution was implemented. Outcomes included LoS, 30-day readmissions, and direct costs of hospital care. A retrospective cost minimization analysis compared patients undergoing PD prior to and following CPW implementation, using a bootstrapped t test and deviation-based cost modeling. 121 patients undergoing PD after CPW implementation were compared to 74 controls. Index LoS was decreased following CPW implementation (9 vs. 11 days, p = 0.005), as was total LoS (10 vs. 11 days, p = 0.003). The mean total cost of postoperative hospitalization per patient decreased in the CPW group ($15,678.45 CAD vs. $25,732.85 CAD, p = 0.024), as was the mean 30-day cost including readmissions ($16,627.15 CAD vs. $29,872.72 CAD, p = 0.016). Areas of significant cost savings included laboratory tests and imaging investigations. CPWs may generate cost savings by reducing unnecessary investigations, and improve quality of care through process standardization and decreasing practice variation. Copyright © 2017 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

Phosphorus recovery from municipal wastewater: An integrated comparative technological, environmental and economic assessment of P recovery technologies.

Science.gov (United States)

Egle, L; Rechberger, H; Krampe, J; Zessner, M

2016-11-15

Phosphorus (P) is an essential and limited resource. Municipal wastewater is a promising source of P via reuse and could be used to replace P derived from phosphate rocks. The agricultural use of sewage sludge is restricted by legislation or is not practiced in several European countries due to environmental risks posed by organic micropollutants and pathogens. Several technologies have been developed in recent years to recover wastewater P. However, these technologies target different P-containing flows in wastewater treatment plants (effluent, digester supernatant, sewage sludge, and sewage sludge ash), use diverse engineering approaches and differ greatly with respect to P recycling rate, potential of removing or destroying pollutants, product quality, environmental impact and cost. This work compares 19 relevant P recovery technologies by considering their relationships with existing wastewater and sludge treatment systems. A combination of different methods, such as material flow analysis, damage units, reference soil method, annuity method, integrated cost calculation and a literature study on solubility, fertilizing effects and handling of recovered materials, is used to evaluate the different technologies with respect to technical, ecological and economic aspects. With regard to the manifold origins of data an uncertainty concept considering validity of data sources is applied. This analysis revealed that recovery from flows with dissolved P produces clean and plant-available materials. These techniques may even be beneficial from economic and technical perspectives under specific circumstances. However, the recovery rates (a maximum of 25%) relative to the wastewater treatment plant influent are relatively low. The approaches that recover P from sewage sludge apply complex technologies and generally achieve effective removal of heavy metals at moderate recovery rates (~40-50% relative to the WWTP input) and comparatively high costs. Sewage sludge ash is

The cost-effectiveness of psychotherapy for the major psychiatric diagnoses.

Science.gov (United States)

Lazar, Susan G

2014-09-01

Psychotherapy is an effective and often highly cost-effective medical intervention for many serious psychiatric conditions. Psychotherapy can also lead to savings in other medical and societal costs. It is at times the firstline and most important treatment and at other times augments the efficacy of psychotropic medication. Many patients are in need of more prolonged and intensive psychotherapy, including those with personality disorders and those with chronic complex psychiatric conditions often with severe anxiety and depression. Many patients with serious and complex psychiatric illness have experienced severe early life trauma in an atmosphere in which family members or caretakers themselves have serious psychiatric disorders. Children and adolescents with learning disabilities and those with severe psychiatric disorders can also require more than brief treatment. Other diagnostic groups for whom psychotherapy is effective and cost-effective include patients with schizophrenia, anxiety disorders (including posttraumatic stress disorder), depression, and substance abuse. In addition, psychotherapy for the medically ill with concomitant psychiatric illness often lowers medical costs, improves recovery from medical illness, and at times even prolongs life compared to similar patients not given psychotherapy. While "cost-effective" treatments can yield savings in healthcare costs, disability claims, and other societal costs, "cost-effective" by no means translates to "cheap" but instead describes treatments that are clinically effective and provided at a cost that is considered reasonable given the benefit they provide, even if the treatments increase direct expenses. In the current insurance climate in which Mental Health Parity is the law, insurers nonetheless often use their own non-research and non-clinically based medical necessity guidelines to subvert it and limit access to appropriate psychotherapeutic treatments. Many patients, especially those who need

Design and implementation of a cost-effective microscope for fabrication and imaging

International Nuclear Information System (INIS)

Trout, G; Basu, S

2009-01-01

The use of lasers and optical systems for advanced research and demonstrative purposes has traditionally been cost-prohibitive for many researchers. In this note, we present the design and optimization of a low-cost microscopy setup capable of imaging, fabrication or photopolymerization via multiphoton excitation of a photoactivator and the study of processes such as diffusion using fluorescence recovery after photobleaching (FRAP). The setup features a continuous wave (CW) Ar-ion laser, a pulsed Nd 3+ :YAG laser, an inverted microscope with a CCD camera and appropriate optics. The setup is cost-effective and puts a once-expensive setup within reach of more researchers interested in micron- and sub-micron-scale processes. (technical design note)

Is high recovery more effective than expected recovery in addressing service failure? - a moral judgment perspective

OpenAIRE

Chen, Tong; Ma, Ke; Bian, Xuemei; Zheng, Chundong; Devlin, James

2018-01-01

In the context of two distinctive consumer categories and two different product settings, this research examines the effects of recovery on recovery performance as a function of consumer moral judgment of service failure. The findings of two studies reveal that consumers' response to recovery anchors on the magnitude of recovery but these responses are adjusted according to consumers' moral judgment of service failure. Specifically, consumers react more positively toward expected recovery tha...

76 FR 10028 - Settlement Agreement for Recovery of Past Response Costs 10,000 Havana Street Site, Commerce City...

Science.gov (United States)

2011-02-23

... ENVIRONMENTAL PROTECTION AGENCY [FRL-9269-7] Settlement Agreement for Recovery of Past Response Costs 10,000 Havana Street Site, Commerce City, Adams County, CO AGENCY: Environmental Protection Agency. ACTION: Notice and request for public comment. SUMMARY: In accordance with the requirements of Section...

Precious Metals Recovery from Electroplating Wastewater: A Review

Science.gov (United States)

Azmi, A. A.; Jai, J.; Zamanhuri, N. A.; Yahya, A.

2018-05-01

Metal bearing electroplating wastewater posts great health and environmental concerns, but could also provide opportunities for precious and valuable metal recovery, which can make the treatment process more cost-effective and sustainable. Current conventional electroplating wastewater treatment and metal recovery methods include chemical precipitation, coagulation and flocculation, ion exchange, membrane filtration, adsorption, electrochemical treatment and photocatalysis. However, these physico-chemical methods have several disadvantages such as high initial capital cost, high operational cost due to expensive chemical reagents and electricity supply, generation of metal complexes sludge which requires further treatment, ineffective in diluted and/or concentrated wastewater, low precious metal selectivity, and slow recovery process. On the other hand, metal bio-reduction assisted by bioactive phytochemical compounds extracted from plants and plant parts is a new found technology explored by several researchers in recent years aiming to recover precious and valuable metals from secondary sources mainly industrial wastewater by utilizing low-cost and eco-friendly biomaterials as reagents. Extract of plants contains polyphenolic compounds which have great antioxidant properties and reducing capacities, able to reduce metal ions into zerovalent metal atoms and stabilize the metal particles formed. This green bio-recovery method has a value added in their end products since the metals are recovered in nano-sized particles which are more valuable and have high commercial demand in other fields ranging from electrochemistry to medicine.

Costs, health effects and cost-effectiveness of alcohol and tobacco control strategies in Estonia.

NARCIS (Netherlands)

Lai, T.; Habicht, J.; Reinap, M.; Chisholm, D.; Baltussen, R.M.P.M.

2007-01-01

OBJECTIVE: To assess the population-level costs, effects and cost-effectiveness of different alcohol and tobacco control strategies in Estonia. DESIGN: A WHO cost-effectiveness modelling framework was used to estimate the total costs and effects of interventions. Costs were assessed in Estonian

Simple Recovery of Intracellular Gold Nanoparticles from Peanut Seedling Roots.

Science.gov (United States)

Raju, D; Mehta, Urmil J; Ahmad, Absar

2015-02-01

Fabrication of inorganic nanomaterials via a biological route witnesses the formation either extracellularly, intracellulary or both. Whereas extracellular formation of these nanomaterials is cherished owing to their easy and economical extraction and purification processes; the intracellular formation of nanomaterials, due to the lack of a proper recovery protocol has always been dreaded, as the extraction processes used so far were tedious, costly, time consuming and often resulting in very low recovery. The aim of the present study was to overcome the problems related with the extraction and recovery of intracellularly synthesized inorganic nanoparticles, and to devise a method to increasing the output, the shape, size, composition and dispersal of nanoparticles is not altered. Water proved to be much better system as it provided well dispersed, stable gold nanoparticles and higher recovery. This is the first report, where intracellular nanoparticles have been recovered using a very cost-effective and eco-friendly approach.

Effects of particle shape and size on nanofluid properties for potential Enhanced Oil Recovery (EOR

Directory of Open Access Journals (Sweden)

Tengku Mohd Tengku Amran

2016-01-01

Full Text Available Application of Enhanced Oil Recovery (EOR in oil and gas industry is very important to increase oil recovery and prolong the lifetime of a reservoir but it has been very costly and losing properties of EOR agent due to harsh condition. Nanoparticles have been used in EOR application since they are not degradable in reservoir condition and used in smaller amount compared to polymer usage. Commonly, EOR techniques are focusing on increasing the sweep efficiency by controlling the mobility ratio between reservoir fluid and injected fluid. Thus, this research aimed to analyze the nanofluid viscosity at different particle size and shape, volumetric concentration and types of dispersing fluid, as well as to determine the oil recovery performance at different nanofluid concentration. The nanofluid viscosity was investigated at nanoparticle sizes of 15nm and 60nm and shapes of 15nm spherical-solid and porous. Five nanofluid samples with concentration ranging from 0.1wt.% to 7wt.% were used to investigate the effect of volumetric concentration. Distilled water, ethanol, ethylene glycol (EG and brine were used for the effect of dispersing fluids. Oil recovery was investigated at five different concentrations of nanofluid samples through flooding test. It was found that viscosity of nanofluid increased with decreasing particle size and increasing volumetric concentration. Solid shape particle and increasing dispersing fluid viscosity resulted in higher nanofluid viscosity. The higher the nanofluid concentration, the higher the oil recovery obtained. It can be concluded that nanofluid properties have been significantly affected by the environment and the particle used for potential EOR application.

Cost-effective management alternatives for Snake River Chinook salmon: a biological-economic synthesis.

Science.gov (United States)

Halsing, David L; Moore, Michael R

2008-04-01

The mandate to increase endangered salmon populations in the Columbia River Basin of North America has created a complex, controversial resource-management issue. We constructed an integrated assessment model as a tool for analyzing biological-economic trade-offs in recovery of Snake River spring- and summer-run chinook salmon (Oncorhynchus tshawytscha). We merged 3 frameworks: a salmon-passage model to predict migration and survival of smolts; an age-structured matrix model to predict long-term population growth rates of salmon stocks; and a cost-effectiveness analysis to determine a set of least-cost management alternatives for achieving particular population growth rates. We assessed 6 individual salmon-management measures and 76 management alternatives composed of one or more measures. To reflect uncertainty, results were derived for different assumptions of effectiveness of smolt transport around dams. Removal of an estuarine predator, the Caspian Tern (Sterna caspia), was cost-effective and generally increased long-term population growth rates regardless of transport effectiveness. Elimination of adult salmon harvest had a similar effect over a range of its cost estimates. The specific management alternatives in the cost-effective set depended on assumptions about transport effectiveness. On the basis of recent estimates of smolt transport effectiveness, alternatives that discontinued transportation or breached dams were prevalent in the cost-effective set, whereas alternatives that maximized transportation dominated if transport effectiveness was relatively high. More generally, the analysis eliminated 80-90% of management alternatives from the cost-effective set. Application of our results to salmon management is limited by data availability and model assumptions, but these limitations can help guide research that addresses critical uncertainties and information. Our results thus demonstrate that linking biology and economics through integrated models can

Exploring the effects of ZVI addition on resource recovery in the anaerobic digestion process

DEFF Research Database (Denmark)

Puyol, D.; Flores-Alsina, Xavier; Segura, Y.

2018-01-01

not compensate the costs of ZVI purchase, and (b) ZVI dramatically decreases the P recovery potential in the digestate of the AD systems. This is the first study to experimentally and mathematically describe the effect of ZVI on biogas production/composition and on the fate of phosphorus compounds, and its......The influence of Zero Valent Iron (ZVI) addition on the potential resource recovery during the anaerobic digestion (AD) of domestic waste sludge is assessed. Potentially recoverable resources analyzed were nutrients such as struvite to recover P, and energy as biogas to recover C. Short term...... (biochemical methane potential tests, BMP) and long term (AD1, AD2) experiments are conducted using two types of set-up (batch, continuous). Process data (influent, effluent and biogas) is continuously collected and the dry digested sludge is analyzed by XPS. A mathematical model is developed based...

A prospective cohort study to investigate cost-minimisation, of Traditional open, open fAst track recovery and laParoscopic fASt track multimodal management, for surgical patients with colon carcinomas (TAPAS study

Directory of Open Access Journals (Sweden)

van Duivendijk Peter

2010-06-01

Full Text Available Abstract Background The present developments in colon surgery are characterized by two innovations: the introduction of the laparoscopic operation technique and fast recovery programs such as the Enhanced Recovery After Surgery (ERAS recovery program. The Tapas-study was conceived to determine which of the three treatment programs: open conventional surgery, open 'ERAS' surgery or laparoscopic 'ERAS' surgery for patients with colon carcinomas is most cost minimizing? Method/design The Tapas-study is a three-arm multicenter prospective cohort study. All patients with colon carcinoma, eligible for surgical treatment within the study period in four general teaching hospitals and one university hospital will be included. This design produces three cohorts: Conventional open surgery is the control exposure (cohort 1. Open surgery with ERAS recovery (cohort 2 and laparoscopic surgery with ERAS recovery (cohort 3 are the alternative exposures. Three separate time periods are used in order to prevent attrition bias. Primary outcome parameters are the two main cost factors: direct medical costs (real cost price calculation and the indirect non medical costs (friction method. Secondary outcome parameters are mortality, complications, surgical-oncological resection margins, hospital stay, readmission rates, time back to work/recovery, health status and quality of life. Based on an estimated difference in direct medical costs (highest cost factor of 38% between open and laparoscopic surgery (alfa = 0.01, beta = 0.05, a group size of 3×40 = 120 patients is calculated. Discussion The Tapas-study is three-arm multicenter cohort study that will provide a cost evaluation of three treatment programs for patients with colon carcinoma, which may serve as a guideline for choice of treatment and investment strategies in hospitals. Trial registration ISRCTN44649165.

The cost-effectiveness of an outpatient anesthesia consultation clinic before surgery: a matched Hong Kong cohort study

Directory of Open Access Journals (Sweden)

Lee Anna

2012-06-01

Full Text Available Abstract Background Outpatient anesthesia clinics are well established in North America, Europe and Australia, but few economic evaluations have been published. The Perioperative Systems in Hong Kong are best described as a hybrid model of the new and old systems of surgical care. In this matched cohort study, we compared the costs and effects of an outpatient anesthesia clinic (OPAC with the conventional system of admitting patients to the ward a day before surgery for their pre-anesthesia consultation. A second objective of the study was to determine the patient’s median Willingness To Pay (WTP value for an OPAC. Methods A total of 352 patients were matched (1:1 on their elective surgical procedure to either the clinic group or to the conventional group. The primary outcome was quality of recovery score and overall perioperative treatment cost (US$. To detect a difference in the joint cost-effect relationship between groups, a cost-effectiveness acceptability curve (CEAC was drawn. A modified Poisson regression model was used to examine the factors associated with patients willing to pay more than the median WTP value for an OPAC. Results The quality of recovery scores on the first day after surgery between the clinic and conventional groups were similar (mean difference, -0.1; 95% confidence interval (CI, -0.6 to 0.3; P = 0.57. Although the preoperative costs were less in the clinic group (mean difference, -$463, 95% CI, -$648 to -$278 per patient; P P = 0.51. The CEAC showed that we could not be 95% confident that the clinic was cost-effective. Compared to the conventional group, clinic patients were three times more likely to prefer OPAC care (relative risk (RR 2.75, 95% CI, 2.13 to 3.55; P P Conclusions There is uncertainty about the cost-effectiveness of an OPAC in the Hong Kong setting. Most clinic patients were willing to pay a small amount for an anesthesia clinic consultation.

Nuclear plant cancellations: causes, costs, and consequences

International Nuclear Information System (INIS)

1983-04-01

This study was commissioned in order to help quantify the effects of nuclear plant cancellations on the Nation's electricity prices. This report presents a historical overview of nuclear plant cancellations through 1982, the costs associated with those cancellations, and the reasons that the projects were terminated. A survey is presented of the precedents for regulatory treatment of the costs, the specific methods of cost recovery that were adopted, and the impacts of these decisions upon ratepayers, utility stockholders, and taxpayers. Finally, the report identifies a series of other nuclear plants that remain at risk of canellation in the future, principally as a result of similar demand, finance, or regulatory problems cited as causes of cancellation in the past. The costs associated with these potential cancellations are estimated, along with their regional distributions, and likely methods of cost recovery are suggested

The impact of cost recovery and sharing system on water policy implementation and human right to water: a case of Ileje, Tanzania.

Science.gov (United States)

Kibassa, Deusdedit

2011-01-01

In Tanzania, the National Water Policy (NAWAPO) of 2002 clearly stipulates that access to water supply and sanitation is a right for every Tanzanian and that cost recovery is the foundation of sustainable service delivery. To meet these demands, water authorities have introduced cost recovery and a water sharing system. The overall objective of this study was to assess the impact of cost recovery and the sharing system on water policy implementation and human rights to water in four villages in the Ileje district. The specific objectives were: (1) to assess the impact of cost recovery and the sharing system on the availability of water to the poor, (2) to assess user willingness to pay for the services provided, (3) to assess community understanding on the issue of water as a human right, (4) to analyse the implications of the results in relation to policies on human rights to water and the effectiveness of the implementation of the national water policy at the grassroots, and (5) to establish the guidelines for water pricing in rural areas. Questionnaires at water demand, water supply, ability and willingness to pay and revenue collection were the basis for data collection. While 36.7% of the population in the district had water supply coverage, more than 73,077 people of the total population of 115,996 still lacked access to clean and safe water and sanitation services in the Ileje district. The country's rural water supply coverage is 49%. Seventy-nine percent of the interviewees in all four villages said that water availability in litres per household per day had decreased mainly due to high water pricing which did not consider the income of villagers. On the other hand, more than 85% of the villagers were not satisfied with the amount they were paying because the services were still poor. On the issue of human rights to water, more than 92% of the villagers know about their right to water and want it exercised by the government. In all four villages, more than

Costs and Cost-Effectiveness of Plasmodium vivax Control.

Science.gov (United States)

White, Michael T; Yeung, Shunmay; Patouillard, Edith; Cibulskis, Richard

2016-12-28

The continued success of efforts to reduce the global malaria burden will require sustained funding for interventions specifically targeting Plasmodium vivax The optimal use of limited financial resources necessitates cost and cost-effectiveness analyses of strategies for diagnosing and treating P. vivax and vector control tools. Herein, we review the existing published evidence on the costs and cost-effectiveness of interventions for controlling P. vivax, identifying nine studies focused on diagnosis and treatment and seven studies focused on vector control. Although many of the results from the much more extensive P. falciparum literature can be applied to P. vivax, it is not always possible to extrapolate results from P. falciparum-specific cost-effectiveness analyses. Notably, there is a need for additional studies to evaluate the potential cost-effectiveness of radical cure with primaquine for the prevention of P. vivax relapses with glucose-6-phosphate dehydrogenase testing. © The American Society of Tropical Medicine and Hygiene.

Effect of hydrotherapy on recovery from fatigue.

Science.gov (United States)

Vaile, J; Halson, S; Gill, N; Dawson, B

2008-07-01

The present study investigated the effects of three hydrotherapy interventions on next day performance recovery following strenuous training. Twelve cyclists completed four experimental trials differing only in 14-min recovery intervention: cold water immersion (CWI), hot water immersion (HWI), contrast water therapy (CWT), or passive recovery (PAS). Each trial comprised five consecutive exercise days of 105-min duration, including 66 maximal effort sprints. Additionally, subjects performed a total of 9-min sustained effort (time trial - TT). After completing each exercise session, athletes performed one of four recovery interventions (randomly assigned to each trial). Performance (average power), core temperature, heart rate (HR), and rating of perceived exertion (RPE) were recorded throughout each session. Sprint (0.1 - 2.2 %) and TT (0.0 - 1.7 %) performance were enhanced across the five-day trial following CWI and CWT, when compared to HWI and PAS. Additionally, differences in rectal temperature were observed between interventions immediately and 15-min post-recovery; however, no significant differences were observed in HR or RPE regardless of day of trial/intervention. Overall, CWI and CWT appear to improve recovery from high-intensity cycling when compared to HWI and PAS, with athletes better able to maintain performance across a five-day period.

Bioenergy, material, and nutrients recovery from household waste: Advanced material, substance, energy, and cost flow analysis of a waste refinery process

International Nuclear Information System (INIS)

Tonini, Davide; Dorini, Gianluca; Astrup, Thomas Fruergaard

2014-01-01

Highlights: • We modeled material, substance, energy, and cost flows of a waste refinery process. • Ca. 56% of 1 Mg dry waste input can be recovered as bioliquid yielding 6.2 GJ biogas. • Nutrients and carbon recovery in the bioliquid was estimated to 81–89%. • The biogenic carbon in the input waste was 63% of total carbon based on 14 C analyses. • The quality of the digestate may be critical with respect to use on land. - Abstract: Energy, materials, and resource recovery from mixed household waste may contribute to reductions in fossil fuel and resource consumption. For this purpose, legislation has been enforced to promote energy recovery and recycling. Potential solutions for separating biogenic and recyclable materials are offered by waste refineries where a bioliquid is produced from enzymatic treatment of mixed waste. In this study, potential flows of materials, energy, and substances within a waste refinery were investigated by combining sampling, analyses, and modeling. Existing material, substance, and energy flow analysis was further advanced by development of a mathematical optimization model for determination of the theoretical recovery potential. The results highlighted that the waste refinery may recover ca. 56% of the dry matter input as bioliquid, yielding 6.2 GJ biogas-energy. The potential for nitrogen, phosphorous, potassium, and biogenic carbon recovery was estimated to be between 81% and 89% of the input. Biogenic and fossil carbon in the mixed household waste input was determined to 63% and 37% of total carbon based on 14 C analyses. Additional recovery of metals and plastic was possible based on further process optimization. A challenge for the process may be digestate quality, as digestate may represent an emission pathway when applied on land. Considering the potential variability of local revenues for energy outputs, the costs for the waste refinery solution appeared comparable with alternatives such as direct incineration

Cost, cost-efficiency and cost-effectiveness of integrated family planning and HIV services.

Science.gov (United States)

Shade, Starley B; Kevany, Sebastian; Onono, Maricianah; Ochieng, George; Steinfeld, Rachel L; Grossman, Daniel; Newmann, Sara J; Blat, Cinthia; Bukusi, Elizabeth A; Cohen, Craig R

2013-10-01

To evaluate costs, cost-efficiency and cost-effectiveness of integration of family planning into HIV services. Integration of family planning services into HIV care and treatment clinics. A cluster-randomized trial. Twelve health facilities in Nyanza, Kenya were randomized to integrate family planning into HIV care and treatment; six health facilities were randomized to (nonintegrated) standard-of-care with separately delivered family planning and HIV services. We assessed costs, cost-efficiency (cost per additional use of more effective family planning), and cost-effectiveness (cost per pregnancy averted) associated with the first year of integration of family planning into HIV care. More effective family planning methods included oral and injectable contraceptives, subdermal implants, intrauterine device, and female and male sterilization. We collected cost data through interviews with study staff and review of financial records to determine costs of service integration. Integration of services was associated with an average marginal cost of $841 per site and $48 per female patient. Average overall and marginal costs of integration were associated with personnel costs [initial ($1003 vs. $872) and refresher ($498 vs. $330) training, mentoring ($1175 vs. $902) and supervision ($1694 vs. $1636)], with fewer resources required for other fixed ($18 vs. $0) and recurring expenses ($471 vs. $287). Integration was associated with a marginal cost of $65 for each additional use of more effective family planning and $1368 for each pregnancy averted. Integration of family planning and HIV services is feasible, inexpensive to implement, and cost-efficient in the Kenyan setting, and thus supports current Kenyan integration policy.

Effect of illite clay and divalent cations on bitumen recovery

Energy Technology Data Exchange (ETDEWEB)

Ding, X. [SNC-Lavalin Inc., Calgary, AB (Canada); Repka, C. [Baker Petrolite Corp., Fort McMurray, AB (Canada); Xu, Z.; Masliyah, J. [Alberta Univ., Edmonton, AB (Canada). Dept. of Chemical and Materials Engineering

2006-12-15

Nearly 35 per cent of Canada's petroleum needs can be met from the Athabasca oil sands, particularly as conventional sources of petroleum decline. The interactions between bitumen and clay minerals play a key role in the recovery process of bitumen because they affect bitumen aeration. The 2 clays minerals found in various oil sands extraction process streams are kaolinite and illite. In this study, doping flotation tests using deionized water and electrokinetic studies were performed to examine the effect of illite clays on bitumen recovery. The effect of magnesium ions was also examined and compared with calcium ions. This paper also discussed the effects of temperature and tailings water chemistry. The negative effect of illite clay on bitumen recovery was found to be associated with its acidity. Denver flotation cell measurements indicated that the addition of calcium or magnesium ions to the flotation deionized water had only a slight effect on bitumen recovery, but the co-addition of illite clay and divalent cations resulted in a dramatic reduction in bitumen recovery. The effect was more significant at lower process temperature and low pH values. Zeta potential distributions of illite suspensions and bitumen emulsions were measured individually and as a mixture to determine the effect of divalent cations on the interaction between bitumen and illite clay. The presence of 1 mM calcium or magnesium ions in deionized water had a pronounced effect on the interactions between bitumen and illite clay. Slime coating of illite onto bitumen was not observed in zeta potential distribution measurements performed in alkaline tailings water. When tests were conducted using plant recycle water, the combination of illite clay and divalent cations did not have an adverse effect on bitumen recovery. 25 refs., 3 tabs., 15 figs.

The role of complaint management in the service recovery process.

Science.gov (United States)

Bendall-Lyon, D; Powers, T L

2001-05-01

Patient satisfaction and retention can be influenced by the development of an effective service recovery program that can identify complaints and remedy failure points in the service system. Patient complaints provide organizations with an opportunity to resolve unsatisfactory situations and to track complaint data for quality improvement purposes. Service recovery is an important and effective customer retention tool. One way an organization can ensure repeat business is by developing a strong customer service program that includes service recovery as an essential component. The concept of service recovery involves the service provider taking responsive action to "recover" lost or dissatisfied customers and convert them into satisfied customers. Service recovery has proven to be cost-effective in other service industries. The complaint management process involves six steps that organizations can use to influence effective service recovery: (1) encourage complaints as a quality improvement tool; (2) establish a team of representatives to handle complaints; (3) resolve customer problems quickly and effectively; (4) develop a complaint database; (5) commit to identifying failure points in the service system; and (6) track trends and use information to improve service processes. Customer retention is enhanced when an organization can reclaim disgruntled patients through the development of effective service recovery programs. Health care organizations can become more customer oriented by taking advantage of the information provided by patient complaints, increasing patient satisfaction and retention in the process.

Medicaid program; premiums and cost sharing. Final rule; delay of effective date and reopening of comment period.

Science.gov (United States)

2009-03-27

This action temporarily delays the effective date of the November 25, 2008 final rule entitled, Medicaid Program; Premiums and Cost Sharing" (73 FR 71828) until December 31, 2009. In addition, this action reopens the comment period on the policies set out in the November 25, 2008 final rule, and specifically solicits comments on the effect of certain provisions of the American Recovery and Reinvestment Act of 2009.

Cost-effectiveness of point-of-care C-reactive protein testing to inform antibiotic prescribing decisions

Science.gov (United States)

Oppong, Raymond; Jit, Mark; Smith, Richard D; Butler, Christopher C; Melbye, Hasse; Mölstad, Sigvard; Coast, Joanna

2013-01-01

Background Point-of-care C-reactive protein (POCCRP) is a biomarker of inflammation that offers clinicians a rapid POC test to guide antibiotic prescribing decisions for acute cough and lower respiratory tract infections (LRTI). However, evidence that POCCRP is cost-effective is limited, particularly outside experimental settings. Aim To assess the cost-effectiveness of POCCRP as a diagnostic tool for acute cough and LRTI from the perspective of the health service. Design and setting Observational study of the presentation, management, and outcomes of patients with acute cough and LRTI in primary care settings in Norway and Sweden. Method Using hierarchical regression, data were analysed in terms of the effect on antibiotic use, cost, and patient outcomes (symptom severity after 7 and 14 days, time to recovery, and EQ-5D), while controlling for patient characteristics (self-reported symptom severity, comorbidities, and health-related quality of life) at first attendance. Results POCCRP testing is associated with non-significant positive reductions in antibiotic prescribing (P = 0.078) and increased cost (P = 0.092). Despite the uncertainty, POCCRP testing is also associated with a cost per quality-adjusted life year (QALY) gain of €9391. At a willingness-to-pay threshold of €30 000 per QALY gained, there is a 70% probability of CRP being cost-effective. Conclusion POCCRP testing is likely to provide a cost-effective diagnostic intervention both in terms of reducing antibiotic prescribing and in terms of QALYs gained. PMID:23834883

Customer complaints and recovery effectiveness : A customer base approach

NARCIS (Netherlands)

Knox, G.; van Oest, R.D.

2014-01-01

Although customer complaints are a well-studied aspect of business, no study has measured the impact of actual complaints and recoveries on subsequent customer purchasing. The authors develop a customer base model to investigate the effectiveness of recovery in preventing customer churn. They

THE EFFECT OF MASSAGE ON SOME RECOVERY PARAMETERS

Directory of Open Access Journals (Sweden)

Bilgehan Baydil

2017-12-01

Full Text Available The aim of this study was investigate the effect of total classic body massage on some recovery and circulation parameters. Fourteen non-athlete physically active male university students voluntarily participated in the study. Participants randomly divided into two group Massage Group (MG and Control Group (KG. All participants were informed about the purpose of the study, food consumption and not join the exercise before the test. 30 second Wingate Test protocol was used as exhaustive exercise. Heart Rate (KAH, systolic (SKB and diastolic (DKB blood pressures and blood lactate measured immediately after and 15 min recovery after exhaustive exercise. During 15 min recovery, total classic body massage was applied to MG group. Passive recovery was applied to KG group. The Shapiro Wilk Test of normality was used to determine if the data were normally distributed. Pair Sample T-Test was used for data’s were normally distributed, Wilcoxon Signed Ranks Test was used for data’s were not normally distributed. All analyses were set at p.05. Both groups blood lactate levels were significantly decreased (MG; t = 4.47, p = .004; KG; t = -2.36, p = .018. Blood lactate levels were determined as -51.60% and -24.63% on MG group and KG group respectively. Consequently, the total classic body massage thought to be effective on lactate removal level in short period of recovery.

The Effect of Different Recovery Duration on Repeated Anaerobic Performance in Elite Cyclists

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Harbili Sultan

2015-12-01

Full Text Available This study investigated the effect of recovery duration on repeated anaerobic performance in elite cyclists. The study followed a cross-over design protocol. Twelve elite male cyclists were randomly assigned to three groups (with recovery duration of 1, 2 and 3 min, respectively. All the subjects performed 4 repeated Wingate tests (4 × 30 s WT at 48 h intervals for three different recovery periods. No significant interaction was observed between the effects of recovery duration and repetition (p>0.05, whereas there was a significant main effect of repetition on peak power, mean power, and a fatigue index (p0.05. In contrast, mean power decreased significantly in repeated WTs with 1, 2 and 3 min recovery duration (p0.05. In a 4 × 30 s WT, peak power decreased in cycles with 1 and 2 min recovery duration, but remained unchanged with 3 min recovery duration, whereas mean power decreased in all recovery duration procedures. The WT with 1 min recovery duration caused greater fatigue. Although recovery duration affected both peak power and mean power, the effect on peak power was greater.

Multi-bits error detection and fast recovery in RISC cores

International Nuclear Information System (INIS)

Wang Jing; Yang Xing; Zhang Weigong; Shen Jiao; Qiu Keni; Zhao Yuanfu

2015-01-01

The particles-induced soft errors are a major threat to the reliability of microprocessors. Even worse, multi-bits upsets (MBUs) are ever-increased due to the rapidly shrinking feature size of the IC on a chip. Several architecture-level mechanisms have been proposed to protect microprocessors from soft errors, such as dual and triple modular redundancies (DMR and TMR). However, most of them are inefficient to combat the growing multi-bits errors or cannot well balance the critical paths delay, area and power penalty. This paper proposes a novel architecture, self-recovery dual-pipeline (SRDP), to effectively provide soft error detection and recovery with low cost for general RISC structures. We focus on the following three aspects. First, an advanced DMR pipeline is devised to detect soft error, especially MBU. Second, SEU/MBU errors can be located by enhancing self-checking logic into pipelines stage registers. Third, a recovery scheme is proposed with a recovery cost of 1 or 5 clock cycles. Our evaluation of a prototype implementation exhibits that the SRDP can successfully detect particle-induced soft errors up to 100% and recovery is nearly 95%, the other 5% will inter a specific trap. (paper)

Multi-bits error detection and fast recovery in RISC cores

Science.gov (United States)

Jing, Wang; Xing, Yang; Yuanfu, Zhao; Weigong, Zhang; Jiao, Shen; Keni, Qiu

2015-11-01

The particles-induced soft errors are a major threat to the reliability of microprocessors. Even worse, multi-bits upsets (MBUs) are ever-increased due to the rapidly shrinking feature size of the IC on a chip. Several architecture-level mechanisms have been proposed to protect microprocessors from soft errors, such as dual and triple modular redundancies (DMR and TMR). However, most of them are inefficient to combat the growing multi-bits errors or cannot well balance the critical paths delay, area and power penalty. This paper proposes a novel architecture, self-recovery dual-pipeline (SRDP), to effectively provide soft error detection and recovery with low cost for general RISC structures. We focus on the following three aspects. First, an advanced DMR pipeline is devised to detect soft error, especially MBU. Second, SEU/MBU errors can be located by enhancing self-checking logic into pipelines stage registers. Third, a recovery scheme is proposed with a recovery cost of 1 or 5 clock cycles. Our evaluation of a prototype implementation exhibits that the SRDP can successfully detect particle-induced soft errors up to 100% and recovery is nearly 95%, the other 5% will inter a specific trap.

Life cycle cost of a hybrid forward osmosis - low pressure reverse osmosis system for seawater desalination and wastewater recovery.

Science.gov (United States)

Valladares Linares, R; Li, Z; Yangali-Quintanilla, V; Ghaffour, N; Amy, G; Leiknes, T; Vrouwenvelder, J S

2016-01-01

In recent years, forward osmosis (FO) hybrid membrane systems have been investigated as an alternative to conventional high-pressure membrane processes (i.e. reverse osmosis (RO)) for seawater desalination and wastewater treatment and recovery. Nevertheless, their economic advantage in comparison to conventional processes for seawater desalination and municipal wastewater treatment has not been clearly addressed. This work presents a detailed economic analysis on capital and operational expenses (CAPEX and OPEX) for: i) a hybrid forward osmosis - low-pressure reverse osmosis (FO-LPRO) process, ii) a conventional seawater reverse osmosis (SWRO) desalination process, and iii) a membrane bioreactor - reverse osmosis - advanced oxidation process (MBR-RO-AOP) for wastewater treatment and reuse. The most important variables affecting economic feasibility are obtained through a sensitivity analysis of a hybrid FO-LPRO system. The main parameters taken into account for the life cycle costs are the water quality characteristics (similar feed water and similar water produced), production capacity of 100,000 m(3) d(-1) of potable water, energy consumption, materials, maintenance, operation, RO and FO module costs, and chemicals. Compared to SWRO, the FO-LPRO systems have a 21% higher CAPEX and a 56% lower OPEX due to savings in energy consumption and fouling control. In terms of the total water cost per cubic meter of water produced, the hybrid FO-LPRO desalination system has a 16% cost reduction compared to the benchmark for desalination, mainly SWRO. Compared to the MBR-RO-AOP, the FO-LPRO systems have a 7% lower CAPEX and 9% higher OPEX, resulting in no significant cost reduction per m(3) produced by FO-LPRO. Hybrid FO-LPRO membrane systems are shown to have an economic advantage compared to current available technology for desalination, and comparable costs with a wastewater treatment and recovery system. Based on development on FO membrane modules, packing density, and

Cost analysis and cost justification of automated data processing in the clinical laboratory.

Science.gov (United States)

Westlake, G E

1983-03-01

Prospective cost analysis of alternative data processing systems can be facilitated by proper selection of the costs to be analyzed and realistic appraisal of the effect on staffing. When comparing projects with dissimilar cash flows, techniques such as analysis of net present value can be helpful in identifying financial benefits. Confidence and accuracy in prospective analyses will increase as more retrospective studies are published. Several accounts now in the literature describe long-term experience with turnkey laboratory information systems. Acknowledging the difficulty in longitudinal studies, they all report favorable effects on labor costs and recovery of lost charges. Enthusiasm is also expressed for the many intangible benefits of the systems. Several trends suggest that cost justification and cost effectiveness will be more easily demonstrated in the future. These are the rapidly decreasing cost of hardware (with corresponding reduction in service costs) and the entry into the market of additional systems designed for medium to small hospitals. The effect of broadening the sales base may be lower software prices. Finally, operational and executive data management and reporting are destined to become the premier extensions of the LIS for cost justification. Aptly applied, these facilities can promote understanding of costs, control of costs, and greater efficiency in providing laboratory services.

A Bridge to Recovery

Directory of Open Access Journals (Sweden)

Rebecca M. Loya

2015-02-01

Full Text Available Sexual violence can trigger adverse economic events for survivors, including increased expenses and decreased earnings. Using interview data, this exploratory study examines how access to assets (liquid assets, familial financial assistance, and homeownership affects survivors’ economic well-being during recovery. In keeping with asset theory, liquid assets and familial assistance can help offset post-assault expenses and facilitate access to services. Homeownership, meanwhile, appears to have mixed effects on survivors’ economic well-being. These findings suggest that the economic costs of sexual violence can burden survivors with fewer financial resources more heavily than those who own significant assets. As such, these findings shift the focus toward a dimension of inequality in recovery from sexual violence that is often overlooked in research and that may have implications for public policy and victim services.

Effect of dose on creep and recovery of polyethylene

Energy Technology Data Exchange (ETDEWEB)

Novakovic, Lj; Gal, O; Charlesby, A; Stannett, V T

1987-01-01

The effect of high energy radiation on polyethylene is to crosslink it, and connect it into an elastic network above the melting point. In this paper the creep and recovery properties of a stabilized polyethylene subjected to doses from 100 to 870 kGy are measured at 150/sup 0/C. Two cycles are measured - Creep I + Recovery I, and Creep II + Recovery II -mainly over periods of 20 min. The creep or recovery behaviour falls into three steps - immediate, fast and slow, and data are given for these steps together with the time parameter. The first cycle includes a non-recoverable creep which is almost absent in the second cycle.

Effect of dose on creep and recovery of polyethylene

International Nuclear Information System (INIS)

Novakovic, Lj.; Gal, O.; Charlesby, A.; Stannett, V.T.

1987-01-01

The effect of high energy radiation on polyethylene is to crosslink it, and connect it into an elastic network above the melting point. In this paper the creep and recovery properties of a stabilized polyethylene subjected to doses from 100 to 870 kGy are measured at 150 0 C. Two cycles are measured - Creep I + Recovery I, and Creep II + Recovery II -mainly over periods of 20 min. The creep or recovery behaviour falls into three steps - immediate, fast and slow, and data are given for these steps together with the time parameter. The first cycle includes a non-recoverable creep which is almost absent in the second cycle. (author)

A Departmental Cost-Effectiveness Model.

Science.gov (United States)

Holleman, Thomas, Jr.

In establishing a departmental cost-effectiveness model, the traditional cost-effectiveness model was discussed and equipped with a distant and deflation equation for both benefits and costs. Next, the economics of costing was examined and program costing procedures developed. Then, the model construct was described as it was structured around the…

Increasing freshwater recovery upon aquifer storage : A field and modelling study of dedicated aquifer storage and recovery configurations in brackish-saline aquifers

NARCIS (Netherlands)

Zuurbier, Koen

2016-01-01

The subsurface may provide opportunities for robust, effective, sustainable, and cost-efficient freshwater management solutions. For instance, via aquifer storage and recovery (ASR; Pyne, 2005): “the storage of water in a suitable aquifer through a well during times when water is available, and the

Biosimilar medicines and cost-effectiveness

Directory of Open Access Journals (Sweden)

Steven Simoens

2011-02-01

Full Text Available Steven SimoensResearch Centre for Pharmaceutical Care and Pharmaco-economics, Faculty of Pharmaceutical Sciences, Katholieke Universiteit Leuven, Leuven, BelgiumAbstract: Given that biosimilars are agents that are similar but not identical to the reference biopharmaceutical, this study aims to introduce and describe specific issues related to the economic evaluation of biosimilars by focusing on the relative costs, relative effectiveness, and cost-effectiveness of biosimilars. Economic evaluation assesses the cost-effectiveness of a medicine by comparing the costs and outcomes of a medicine with those of a relevant comparator. The assessment of cost-effectiveness of a biosimilar is complicated by the fact that evidence needed to obtain marketing authorization from a registration authority does not always correspond to the data requirements of a reimbursement authority. In particular, this relates to the availability of adequately powered equivalence or noninferiority studies, the need for comparative data about the effectiveness in a real-world setting rather than the efficacy in a structured setting, and the use of health outcome measures instead of surrogate endpoints. As a biosimilar is likely to be less expensive than the comparator (eg, the reference biopharmaceutical, the assessment of the cost-effectiveness of a biosimilar depends on the relative effectiveness. If appropriately designed and powered clinical studies demonstrate equivalent effectiveness between a biosimilar and the comparator, then a cost-minimization analysis identifies the least expensive medicine. If there are differences in the effectiveness of a biosimilar and the comparator, other techniques of economic evaluation need to be employed, such as cost-effectiveness analysis or cost-utility analysis. Given that there may be uncertainty surrounding the long-term safety (ie, risk of immunogenicity and rare adverse events and effectiveness of a biosimilar, the cost-effectiveness

Longitudinal Recovery and Reduced Costs After 120 Sessions of Locomotor Training for Motor Incomplete Spinal Cord Injury.

Science.gov (United States)

Morrison, Sarah A; Lorenz, Douglas; Eskay, Carol P; Forrest, Gail F; Basso, D Michele

2018-03-01

To determine the impact of long-term, body weight-supported locomotor training after chronic, incomplete spinal cord injury (SCI), and to estimate the health care costs related to lost recovery potential and preventable secondary complications that may have occurred because of visit limits imposed by insurers. Prospective observational cohort with longitudinal follow-up. Eight outpatient rehabilitation centers that participate in the Christopher & Dana Reeve Foundation NeuroRecovery Network (NRN). Individuals with motor incomplete chronic SCI (American Spinal Injury Association Impairment Scale C or D; N=69; 0.1-45y after SCI) who completed at least 120 NRN physical therapy sessions. Manually assisted locomotor training (LT) in a body weight-supported treadmill environment, overground standing and stepping activities, and community integration tasks. International Standards for Neurological Classification of Spinal Cord Injury motor and sensory scores, orthostatic hypotension, bowel/bladder/sexual function, Spinal Cord Injury Functional Ambulation Inventory (SCI-FAI), Berg Balance Scale, Modified Functional Reach, 10-m walk test, and 6-minute walk test. Longitudinal outcome measure collection occurred every 20 treatments and at 6- to 12-month follow-up after discharge from therapy. Significant improvement occurred for upper and lower motor strength, functional activities, psychological arousal, sensation of bowel movement, and SCI-FAI community ambulation. Extended training enabled minimal detectable changes at 60, 80, 100, and 120 sessions. After detectable change occurred, it was sustained through 120 sessions and continued 6 to 12 months after treatment. Delivering at least 120 sessions of LT improves recovery from incomplete chronic SCI. Because walking reduces rehospitalization, LT delivered beyond the average 20-session insurance limit can reduce rehospitalizations and long-term health costs. Copyright © 2018 American Congress of Rehabilitation Medicine

Simulation Opportunity Index, A Simple and Effective Method to Boost the Hydrocarbon Recovery

KAUST Repository

Saputra, Wardana

2016-09-08

During periods of low oil prices, profitability of field developments drops drastically. To help with this difficulty, a cost-effective method has been proposed to boost the hydrocarbon recovery by optimizing well locations through the Simulated Opportunity Index (SOI). SOI is an intelligent method to identify zones with high potential for production which is empirically calculated from basic rock and fluid properties, and from reservoir pressure as its energy capacity. In order to obtain the best results, the original SOI formula (Molina et al., 2009) was extended to both oil and gas fields. Based on this modified SOI formula, a software program has been developed to locate the best well locations considering multilayer, existing wells, and fault existences. This paper describes how the SOI software helps as a simple, fast, and accurate way to obtain the higher hydrocarbon production than that of trial-error method and previous studies in two different fields located in offshore Indonesia. On one hand, the proposed method could save money by minimizing the required number of wells. On the other hand, it could maximize profit by maximizing recovery.

Optimization of Surfactant Mixtures and Their Interfacial Behavior for Advanced Oil Recovery

Energy Technology Data Exchange (ETDEWEB)

Somasundaran, Prof. P.

2001-02-27

The goal of this report is to develop improved extraction processes to mobilize and produce the oil left untapped using conventional techniques. Current chemical schemes for recovering the residual oil have been in general less than satisfactory. High cost of the processes as well as significant loss of chemicals by adsorption on reservoir materials and precipitation has limited the utility of chemical-flooding operations. There is a need to develop cost-effective, improved reagent schemes to increase recovery from domestic oil reservoirs. The goal of the report was to develop and evaluate novel mixtures of surfactants for improved oil recovery.

Recovery in soccer : part ii-recovery strategies.

Science.gov (United States)

Nédélec, Mathieu; McCall, Alan; Carling, Chris; Legall, Franck; Berthoin, Serge; Dupont, Gregory

2013-01-01

In the formerly published part I of this two-part review, we examined fatigue after soccer matchplay and recovery kinetics of physical performance, and cognitive, subjective and biological markers. To reduce the magnitude of fatigue and to accelerate the time to fully recover after completion, several recovery strategies are now used in professional soccer teams. During congested fixture schedules, recovery strategies are highly required to alleviate post-match fatigue, and then to regain performance faster and reduce the risk of injury. Fatigue following competition is multifactorial and mainly related to dehydration, glycogen depletion, muscle damage and mental fatigue. Recovery strategies should consequently be targeted against the major causes of fatigue. Strategies reviewed in part II of this article were nutritional intake, cold water immersion, sleeping, active recovery, stretching, compression garments, massage and electrical stimulation. Some strategies such as hydration, diet and sleep are effective in their ability to counteract the fatigue mechanisms. Providing milk drinks to players at the end of competition and a meal containing high-glycaemic index carbohydrate and protein within the hour following the match are effective in replenishing substrate stores and optimizing muscle-damage repair. Sleep is an essential part of recovery management. Sleep disturbance after a match is common and can negatively impact on the recovery process. Cold water immersion is effective during acute periods of match congestion in order to regain performance levels faster and repress the acute inflammatory process. Scientific evidence for other strategies reviewed in their ability to accelerate the return to the initial level of performance is still lacking. These include active recovery, stretching, compression garments, massage and electrical stimulation. While this does not mean that these strategies do not aid the recovery process, the protocols implemented up until

Comparison of Configurations for High-Recovery Inland Desalination Systems

Directory of Open Access Journals (Sweden)

Philip A. Davies

2012-09-01

Full Text Available Desalination of brackish groundwater (BW is an effective approach to augment water supply, especially for inland regions that are far from seawater resources. Brackish water reverse osmosis (BWRO desalination is still subject to intensive energy consumption compared to the theoretical minimum energy demand. Here, we review some of the BWRO plants with various system arrangements. We look at how to minimize energy demands, as these contribute considerably to the cost of desalinated water. Different configurations of BWRO system have been compared from the view point of normalized specific energy consumption (SEC. Analysis is made at theoretical limits. The SEC reduction of BWRO can be achieved by (i increasing number of stages, (ii using an energy recovery device (ERD, or (iii operating the BWRO in batch mode or closed circuit mode. Application of more stages not only reduces SEC but also improves water recovery. However, this improvement is less pronounced when the number of stages exceeds four. Alternatively and more favourably, the BWRO system can be operated in Closed Circuit Desalination (CCD mode and gives a comparative SEC to that of the 3-stage system with a recovery ratio of 80%. A further reduction of about 30% in SEC can be achieved through batch-RO operation. Moreover, the costly ERDs and booster pumps are avoided with both CCD and batch-RO, thus furthering the effectiveness of lowering the costs of these innovative approaches.

Battleground Energy Recovery Project

Energy Technology Data Exchange (ETDEWEB)

Bullock, Daniel [USDOE Gulf Coast Clean Energy Application Center, Woodlands, TX (United States)

2011-12-31

In October 2009, the project partners began a 36-month effort to develop an innovative, commercial-scale demonstration project incorporating state-of-the-art waste heat recovery technology at Clean Harbors, Inc., a large hazardous waste incinerator site located in Deer Park, Texas. With financial support provided by the U.S. Department of Energy, the Battleground Energy Recovery Project was launched to advance waste heat recovery solutions into the hazardous waste incineration market, an area that has seen little adoption of heat recovery in the United States. The goal of the project was to accelerate the use of energy-efficient, waste heat recovery technology as an alternative means to produce steam for industrial processes. The project had three main engineering and business objectives: Prove Feasibility of Waste Heat Recovery Technology at a Hazardous Waste Incinerator Complex; Provide Low-cost Steam to a Major Polypropylene Plant Using Waste Heat; and Create a Showcase Waste Heat Recovery Demonstration Project.

[Cost-effectiveness of addiction care].

Science.gov (United States)

Suijkerbuijk, A W M; van Gils, P F; Greeven, P G J; de Wit, G A

2015-01-01

A large number of interventions are available for the treatment of addiction. Professionals need to know about the effectiveness and cost-effectiveness of interventions so they can prioritise appropriate interventions for the treatment of addiction. To provide an overview of the scientific literature on the cost-effectiveness of addiction treatment for alcohol- and drug-abusers. We searched the databases Medline and Centre for Reviews and Dissemination. To be relevant for our study, articles had to focus on interventions in the health-care setting, have a Western context and have a health-related outcome measure such as quality adjusted life years (QALY). Twenty-nine studies met our inclusion criteria: 15 for alcohol and 14 for drugs. The studies on alcohol addiction related mainly to brief interventions. They proved to be cost-saving or had a favourable incremental cost-effectiveness ratio (ICER), remaining below the threshold of € 20,000 per QALY. The studies on drug addiction all involved pharmacotherapeutic interventions. In the case of 10 out of 14 interventions, the ICER was less than € 20,000 per QALY. Almost all of the interventions studied were cost-saving or cost-effective. Many studies consider only health-care costs. Additional research, for instance using a social cost-benefit analysis, could provide more details about the costs of addiction and about the impact that an intervention could have in these/the costs.

The difference between energy consumption and energy cost: Modelling energy tariff structures for water resource recovery facilities.

Science.gov (United States)

Aymerich, I; Rieger, L; Sobhani, R; Rosso, D; Corominas, Ll

2015-09-15

The objective of this paper is to demonstrate the importance of incorporating more realistic energy cost models (based on current energy tariff structures) into existing water resource recovery facilities (WRRFs) process models when evaluating technologies and cost-saving control strategies. In this paper, we first introduce a systematic framework to model energy usage at WRRFs and a generalized structure to describe energy tariffs including the most common billing terms. Secondly, this paper introduces a detailed energy cost model based on a Spanish energy tariff structure coupled with a WRRF process model to evaluate several control strategies and provide insights into the selection of the contracted power structure. The results for a 1-year evaluation on a 115,000 population-equivalent WRRF showed monthly cost differences ranging from 7 to 30% when comparing the detailed energy cost model to an average energy price. The evaluation of different aeration control strategies also showed that using average energy prices and neglecting energy tariff structures may lead to biased conclusions when selecting operating strategies or comparing technologies or equipment. The proposed framework demonstrated that for cost minimization, control strategies should be paired with a specific optimal contracted power. Hence, the design of operational and control strategies must take into account the local energy tariff. Copyright © 2015 Elsevier Ltd. All rights reserved.

Life cycle cost of a hybrid forward osmosis – low pressure reverse osmosis system for seawater desalination and wastewater recovery

KAUST Repository

Valladares Linares, Rodrigo

2015-10-19

In recent years, forward osmosis (FO) hybrid membrane systems have been investigated as an alternative to conventional high-pressure membrane processes (i.e. reverse osmosis (RO)) for seawater desalination and wastewater treatment and recovery. Nevertheless, their economic advantage in comparison to conventional processes for seawater desalination and municipal wastewater treatment has not been clearly addressed. This work presents a detailed economic analysis on capital and operational expenses (CAPEX and OPEX) for: i) a hybrid forward osmosis – low-pressure reverse osmosis (FO-LPRO) process, ii) a conventional seawater reverse osmosis (SWRO) desalination process, and iii) a membrane bioreactor – reverse osmosis – advanced oxidation process (MBR-RO-AOP) for wastewater treatment and reuse. The most important variables affecting economic feasibility are obtained through a sensitivity analysis of a hybrid FO-LPRO system. The main parameters taken into account for the life cycle costs are the water quality characteristics (similar feed water and similar water produced), production capacity of 100,000 m3 d−1 of potable water, energy consumption, materials, maintenance, operation, RO and FO module costs, and chemicals. Compared to SWRO, the FO-LPRO systems have a 21% higher CAPEX and a 56% lower OPEX due to savings in energy consumption and fouling control. In terms of the total water cost per cubic meter of water produced, the hybrid FO-LPRO desalination system has a 16% cost reduction compared to the benchmark for desalination, mainly SWRO. Compared to the MBR-RO-AOP, the FO-LPRO systems have a 7% lower CAPEX and 9% higher OPEX, resulting in no significant cost reduction per m3 produced by FO-LPRO. Hybrid FO-LPRO membrane systems are shown to have an economic advantage compared to current available technology for desalination, and comparable costs with a wastewater treatment and recovery system. Based on development on FO membrane modules, packing density, and

The Interpersonal Sunk-Cost Effect.

Science.gov (United States)

Olivola, Christopher Y

2018-05-01

The sunk-cost fallacy-pursuing an inferior alternative merely because we have previously invested significant, but nonrecoverable, resources in it-represents a striking violation of rational decision making. Whereas theoretical accounts and empirical examinations of the sunk-cost effect have generally been based on the assumption that it is a purely intrapersonal phenomenon (i.e., solely driven by one's own past investments), the present research demonstrates that it is also an interpersonal effect (i.e., people will alter their choices in response to other people's past investments). Across eight experiments ( N = 6,076) covering diverse scenarios, I documented sunk-cost effects when the costs are borne by someone other than the decision maker. Moreover, the interpersonal sunk-cost effect is not moderated by social closeness or whether other people observe their sunk costs being "honored." These findings uncover a previously undocumented bias, reveal that the sunk-cost effect is a much broader phenomenon than previously thought, and pose interesting challenges for existing accounts of this fascinating human tendency.

Health economic studies: an introduction to cost-benefit, cost-effectiveness, and cost-utility analyses.

Science.gov (United States)

Angevine, Peter D; Berven, Sigurd

2014-10-15

Narrative overview. To provide clinicians with a basic understanding of economic studies, including cost-benefit, cost-effectiveness, and cost-utility analyses. As decisions regarding public health policy, insurance reimbursement, and patient care incorporate factors other than traditional outcomes such as satisfaction or symptom resolution, health economic studies are increasingly prominent in the literature. This trend will likely continue, and it is therefore important for clinicians to have a fundamental understanding of the common types of economic studies and be able to read them critically. In this brief article, the basic concepts of economic studies and the differences between cost-benefit, cost-effectiveness, and cost-utility studies are discussed. An overview of the field of health economic analysis is presented. Cost-benefit, cost-effectiveness, and cost-utility studies all integrate cost and outcome data into a decision analysis model. These different types of studies are distinguished mainly by the way in which outcomes are valued. Obtaining accurate cost data is often difficult and can limit the generalizability of a study. With a basic understanding of health economic analysis, clinicians can be informed consumers of these important studies.

Cost and effectiveness of lung lobectomy by video-assisted thoracic surgery for lung cancer.

Science.gov (United States)

Mafé, Juan J; Planelles, Beatriz; Asensio, Santos; Cerezal, Jorge; Inda, María-Del-Mar; Lacueva, Javier; Esteban, Maria-Dolores; Hernández, Luis; Martín, Concepción; Baschwitz, Benno; Peiró, Ana M

2017-08-01

Video-assisted thoracic surgery (VATS) emerged as a minimally invasive surgery for diseases in the field of thoracic surgery. We herein reviewed our experience on thoracoscopic lobectomy for early lung cancer and evaluated Health System use. A cost-effectiveness study was performed comparing VATS vs. open thoracic surgery (OPEN) for lung cancer patients. Demographic data, tumor localization, dynamic pulmonary function tests [forced vital capacity (FVC), forced expiratory volume in one second (FEV1), diffusion capacity (DLCO) and maximal oxygen uptake (VO2max)], surgical approach, postoperative details, and complications were recorded and analyzed. One hundred seventeen patients underwent lung resection by VATS (n=42, 36%; age: 63±9 years old, 57% males) or OPEN (n=75, 64%; age: 61±11 years old, 73% males). Pulmonary function tests decreased just after surgery with a parallel increasing tendency during first 12 months. VATS group tended to recover FEV1 and FVC quicker with significantly less clinical and post-surgical complications (31% vs. 53%, P=0.015). Costs including surgery and associated hospital stay, complications and costs in the 12 months after surgery were significantly lower for VATS (P<0.05). The VATS approach surgery allowed earlier recovery at a lower cost than OPEN with a better cost-effectiveness profile.

42 CFR 457.1015 - Cost-effectiveness.

Science.gov (United States)

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Cost-effectiveness. 457.1015 Section 457.1015... Waivers: General Provisions § 457.1015 Cost-effectiveness. (a) Definition. For purposes of this subpart... may demonstrate cost-effectiveness by comparing the cost of coverage for the family to the cost of...

Isolation and recovery of microbial polyhydroxyalkanoates

Directory of Open Access Journals (Sweden)

2011-07-01

Full Text Available The deleterious environmental impacts caused by plastic wastes have attracted worldwide concern. The biobased and biodegradable polyhydroxyalkanoate (PHA appears to be one of the potential candidates to replace some conventional plastics. However, high production cost of PHAs has limited their market penetration. The major cost absorbing factors are the upstream fermentation processes and the downstream PHA recovery technologies. The latter significantly affects the overall process economics. Various recovery technologies have been proposed and studied in small scales in the laboratory as well as in industrial scales. These include solvent extraction, chemical digestion, enzymatic treatment and mechanical disruption, supercritical fluid disruption, flotation techniques, use of gamma irradiation and aqueous two-phase system. This paper reviews all the recovery methods known to date and compares their efficiency and the quality of the resulting PHA. Some of the large-scale production of PHA and the strategies employed to reduce the production cost are also discussed.

Chloride metallurgy for uranium recovery: concept and costs

International Nuclear Information System (INIS)

Campbell, M.C.; Ritcey, G.M.; Joe, E.G.

1982-01-01

Uranium, thorium and radium are all effectively solubilized in chloride media. This provides a means to separate and isolate these species for ultimate sale or disposal. The laboratory work on the applications of hydrochloric acid leaching, chlorine assisted leaching and high temperature chlorination is reviewed. An indication of costs and benefits is provided to enable the evaluation of this technology as an option for reducing the environmental impact of tailings

Cost effectiveness analysis in radiopharmacy

International Nuclear Information System (INIS)

Carpentier, N.; Verbeke, S.; Ducloux, T.

1999-01-01

Objective: to evaluate the cost effectiveness of radiopharmaceuticals and their quality control. Materials and methods: this retrospective study was made in the Nuclear Medicine Department of the University Hospital of Limoges. Radiopharmaceutical costs were obtained with adding the price of the radiotracer, the materials, the equipments, the labour, the running expenses and the radioisotope. The costs of quality control were obtained with adding the price of labour, materials, equipments, running expenses and the cost of the quality control of 99m Tc eluate. Results: during 1998, 2106 radiopharmaceuticals were prepared in the Nuclear Medicine Department. The mean cost effectiveness of radiopharmaceutical was 1430 francs (846 to 4260). The mean cost effectiveness of quality control was 163 francs (84 to 343). The rise of the radiopharmaceutical cost induced by quality control was 11%. Conclusion: the technical methodology of quality control must be mastered to optimize the cost of this operation. (author)

CT colonography and cost-effectiveness

Energy Technology Data Exchange (ETDEWEB)

Mavranezouli, Ifigeneia [University College London, National Collaborating Centre for Mental Health, Centre for Outcomes Research and Effectiveness, Sub-department of Clinical Health Psychology, London (United Kingdom); East, James E. [St Marks Hospital, Imperial College London, Wolfson Unit for Endoscopy, London (United Kingdom); Taylor, Stuart A. [University College Hospital, Specialist X-Ray, London (United Kingdom); University College Hospital, Department of Imaging, London (United Kingdom)

2008-11-15

CT colonography (CTC) is increasingly advocated as an effective initial screening tool for colorectal cancer. Nowadays, policy-makers are increasingly interested in cost-effectiveness issues. A number of studies assessing the cost-effectiveness of CTC have been published to date. The majority of findings indicate that CTC is probably not cost-effective when colonoscopy is available, but this conclusion is sensitive to a number of key parameters. This review discusses the findings of these studies, and considers those factors which most influence final conclusions, notably intervention costs, compliance rates, effectiveness of colonoscopy, and the assumed prevalence and natural history of diminutive advanced polyps. (orig.)

CT colonography and cost-effectiveness

International Nuclear Information System (INIS)

Mavranezouli, Ifigeneia; East, James E.; Taylor, Stuart A.

2008-01-01

CT colonography (CTC) is increasingly advocated as an effective initial screening tool for colorectal cancer. Nowadays, policy-makers are increasingly interested in cost-effectiveness issues. A number of studies assessing the cost-effectiveness of CTC have been published to date. The majority of findings indicate that CTC is probably not cost-effective when colonoscopy is available, but this conclusion is sensitive to a number of key parameters. This review discusses the findings of these studies, and considers those factors which most influence final conclusions, notably intervention costs, compliance rates, effectiveness of colonoscopy, and the assumed prevalence and natural history of diminutive advanced polyps. (orig.)

Surplus Facilities and Resource Conservation and Recovery Act Closure program plan, fiscal year 1992

International Nuclear Information System (INIS)

Hughes, M.C.; Wahlen, R.K.; Winship, R.A.

1991-10-01

The Surplus Facilities and Resource Conservation and Recovery Act Closure program is responsible to US Department of Energy Field Office, Richland for the safe, cost-effective surveillance, maintenance, and decommissioning of surplus facilities at the Hanford Site. The Surplus Facilities and Resource Conservation and Recovery Act Closure program is also responsible to US Department of Energy Field Office, Richland for the program management of specific Resource Conservation and Recovery Act closures at the Hanford Site. This program plan addresses only the surplus facilities. The criteria used to evaluate each factor relative to decommissioning are based on the guidelines presented by the US Department of Energy Field Office, Richland, Environmental Restoration Division. The guidelines are consistent with the Westinghouse Hanford Company commitment to decommission Hanford Site retired facilities in the safest and most cost-effective way achievable. This document outlines the plan for managing these facilities until disposal

Can treatment and disposal costs be reduced through metal recovery?

Science.gov (United States)

Smith, Kathleen S.; Figueroa, Linda; Plumlee, Geoffrey S.

2015-01-01

This paper describes a framework to conduct a “metal-recovery feasibility assessment” for mining influenced water (MIW) and associated treatment sludge. There are multiple considerations in such a determination, including the geologic/geochemical feasibility, market feasibility, technical feasibility, economic feasibility, and administrative feasibility. Each of these considerations needs to be evaluated to determine the practicality of metal recovery from a particular MIW.

Costs and cost-effectiveness of pediatric inguinal hernia repair in Uganda.

Science.gov (United States)

Eeson, Gareth; Birabwa-Male, Doreen; Pennington, Mark; Blair, Geoffrey K

2015-02-01

Surgically treatable diseases contribute approximately 11% of disability-adjusted life years (DALYs) worldwide yet they remain a neglected public health priority in low- and middle-income countries (LMICs). Pediatric inguinal hernia is the most common congenital abnormality in newborns and a major cause of morbidity and mortality yet elective repair remains largely unavailable in LMICs. This study is aimed to determine the costs and cost-effectiveness of pediatric inguinal hernia repair (PIHR) in a low-resource setting. Medical costs of consecutive elective PIHRs were recorded prospectively at two centers in Uganda. Decision modeling was used to compare two different treatment scenarios (adoption of PIHR and non-adoption) from a provider perspective. A Markov model was constructed to estimate health outcomes under each scenario. The robustness of the cost-effectiveness results in the base case analysis was tested in one-way and probabilistic sensitivity analysis. The primary outcome of interest was cost per DALY averted by the intervention. Sixty-nine PIHRs were performed in 65 children (mean age 3.6 years). Mean cost per procedure was $86.68 US (95% CI 83.1-90.2 USD) and averted an average of 5.7 DALYs each. Incremental cost-effectiveness ratio was $12.41 per DALY averted. The probability of cost-effectiveness was 95% at a cost-effectiveness threshold of $35 per averted DALY. Results were robust to sensitivity analysis under all considered scenarios. Elective PIHR is highly cost-effective for the treatment and prevention of complications of hernia disease even in low-resource settings. PIHR should be prioritized in LMICs alongside other cost-effective interventions.

Mechanical ventilation with heat recovery in arctic climate

DEFF Research Database (Denmark)

Kragh, Jesper; Svendsen, Svend

2005-01-01

Mechanical ventilations systems with highly effective heat recovery units in arctic climate have problems with condensing water from the extracted humid indoor air. If the condensing water freezes to ice in the heat recovery unit, the airflow rate will quickly diminish due to the increasing...... pressure drop. Preheating the inlet air (outdoor air) to a temperature just above 0ºC is typically used to solve the problem. To minimize the energy cost, a more efficient solution to the problem is therefore desirable. In this project a new design of a heat recovery unit has been developed to the low......-energy house in Sisimiut, which is capable of continuously defrosting itself. The disadvantage of the unit is that it is quite big compared with other units. In this paper the new heat recovery unit is described and laboratory measurements are presented showing that the unit is capable of continuously...

Microbial enhanced oil recovery: Entering the log phase

Energy Technology Data Exchange (ETDEWEB)

Bryant, R.S.

1995-12-31

Microbial enhanced oil recovery (MEOR) technology has advanced internationally since 1980 from a laboratory-based evaluation of microbial processes to field applications. In order to adequately support the decline in oil production in certain areas, research on cost-effective technologies such as microbial enhanced oil recovery processes must focus on both near-term and long-term applications. Many marginal wells are desperately in need of an inexpensive improved oil recovery technology today that can assist producers in order to prevent their abandonment. Microbial enhanced waterflooding technology has also been shown to be an economically feasible technology in the United States. Complementary environmental research and development will also be required to address any potential environmental impacts of microbial processes. In 1995 at this conference, the goal is to further document and promote microbial processes for improved oil recovery and related technology for solving environmental problems.

Effectiveness and cost-effectiveness of antidepressants in primary care: a multiple treatment comparison meta-analysis and cost-effectiveness model.

Directory of Open Access Journals (Sweden)

Joakim Ramsberg

Full Text Available OBJECTIVE: To determine effectiveness and cost-effectiveness over a one-year time horizon of pharmacological first line treatment in primary care for patients with moderate to severe depression. DESIGN: A multiple treatment comparison meta-analysis was employed to determine the relative efficacy in terms of remission of 10 antidepressants (citalopram, duloxetine escitalopram, fluoxetine, fluvoxamine mirtazapine, paroxetine, reboxetine, sertraline and venlafaxine. The estimated remission rates were then applied in a decision-analytic model in order to estimate costs and quality of life with different treatments at one year. DATA SOURCES: Meta-analyses of remission rates from randomised controlled trials, and cost and quality-of-life data from published sources. RESULTS: The most favourable pharmacological treatment in terms of remission was escitalopram with an 8- to 12-week probability of remission of 0.47. Despite a high acquisition cost, this clinical effectiveness translated into escitalopram being both more effective and having a lower total cost than all other comparators from a societal perspective. From a healthcare perspective, the cost per QALY of escitalopram was €3732 compared with venlafaxine. CONCLUSION: Of the investigated antidepressants, escitalopram has the highest probability of remission and is the most effective and cost-effective pharmacological treatment in a primary care setting, when evaluated over a one year time-horizon. Small differences in remission rates may be important when assessing costs and cost-effectiveness of antidepressants.

Costs and cost-effectiveness of malaria control interventions - a systematic review

Directory of Open Access Journals (Sweden)

White Michael T

2011-11-01

Full Text Available Abstract Background The control and elimination of malaria requires expanded coverage of and access to effective malaria control interventions such as insecticide-treated nets (ITNs, indoor residual spraying (IRS, intermittent preventive treatment (IPT, diagnostic testing and appropriate treatment. Decisions on how to scale up the coverage of these interventions need to be based on evidence of programme effectiveness, equity and cost-effectiveness. Methods A systematic review of the published literature on the costs and cost-effectiveness of malaria interventions was undertaken. All costs and cost-effectiveness ratios were inflated to 2009 USD to allow comparison of the costs and benefits of several different interventions through various delivery channels, across different geographical regions and from varying costing perspectives. Results Fifty-five studies of the costs and forty three studies of the cost-effectiveness of malaria interventions were identified, 78% of which were undertaken in sub-Saharan Africa, 18% in Asia and 4% in South America. The median financial cost of protecting one person for one year was $2.20 (range $0.88-$9.54 for ITNs, $6.70 (range $2.22-$12.85 for IRS, $0.60 (range $0.48-$1.08 for IPT in infants, $4.03 (range $1.25-$11.80 for IPT in children, and $2.06 (range $0.47-$3.36 for IPT in pregnant women. The median financial cost of diagnosing a case of malaria was $4.32 (range $0.34-$9.34. The median financial cost of treating an episode of uncomplicated malaria was $5.84 (range $2.36-$23.65 and the median financial cost of treating an episode of severe malaria was $30.26 (range $15.64-$137.87. Economies of scale were observed in the implementation of ITNs, IRS and IPT, with lower unit costs reported in studies with larger numbers of beneficiaries. From a provider perspective, the median incremental cost effectiveness ratio per disability adjusted life year averted was $27 (range $8.15-$110 for ITNs, $143 (range $135

Cost benefit analysis cost effectiveness analysis

International Nuclear Information System (INIS)

Lombard, J.

1986-09-01

The comparison of various protection options in order to determine which is the best compromise between cost of protection and residual risk is the purpose of the ALARA procedure. The use of decision-aiding techniques is valuable as an aid to selection procedures. The purpose of this study is to introduce two rather simple and well known decision aiding techniques: the cost-effectiveness analysis and the cost-benefit analysis. These two techniques are relevant for the great part of ALARA decisions which need the use of a quantitative technique. The study is based on an hypothetical case of 10 protection options. Four methods are applied to the data

Changes in transcription during recovery from heat injury in Salmonella typhimurium and effects of BCAA on recovery.

Science.gov (United States)

Hsu-Ming, Wen; Naito, Kimitaka; Kinoshita, Yoshimasa; Kobayashi, Hiroshi; Honjoh, Ken-ichi; Tashiro, Kousuke; Miyamoto, Takahisa

2012-06-01

Mechanisms of recovery from heat injury in Salmonella typhimurium were elucidated. Recovery of the heat-injured S. typhimurium cells in TSB resulted in full recovery after 3 h of incubation at 37°C. The DNA microarray analysis of 30- and 60-min recovering cells resulted in an increase in transcription of 89 and 141 genes, respectively. Among them, 15 genes, with known function, seemed to be somewhat involved in recovery. They encoded proteins involved in branched-chain amino acid (BCAA) transport (livJ, livH), cell envelope integrity (ddg), heat-shock response (cpxP, rrmJ), phage shock protein (pspA), ribosome modulation factor (rmf), virulence (sseB) transcriptional regulation (rpoE, rpoH, rseA, rseB, rseC) and ArcB signal transduction (sixA) and cytoplasmic membrane protein (fxsA). Among them, the effects of BCAA supplementation on recovery from heat injury were studied to confirm the importance of the BCAA transport liv genes during recovery. It was found that supplementation of TSB with 0.1% BCAA resulted in an enhanced recovery of injured cells in comparison to those recovered in TSB without BCAA. Supplementation of BCAA at 0.1% resulted in a cell count increase 4.4-fold greater than that of the control after 1 h incubation. It seems that BCAA promoted the recovery by promoting protein synthesis either directly through their use in translation or indirectly through stimulation of protein synthesis by activation of the Lrp protein.

Effect of different musical tempo on post-exercise recovery in young adults.

Science.gov (United States)

Savitha, D; Mallikarjuna, Reddy N; Rao, Chythra

2010-01-01

The role of music in increasing the exercise performance is well recognised. There is very little information about effect of music on time taken for post exercise recovery. We examined the effect of music and different musical tempo on post exercise recovery time, following treadmill work. 30 volunteers (15 male, 15 female) subjected to isotonic exercise (submaximal treadmill work) on three consecutive days. They were allowed to rest in silence on the first day, rest by hearing slow music on second day and rest with fast music on third day. Parameters such as Pulse rate, blood pressure, rating of perceived exertion (RPE) were measured at predetermined intervals. Repeated measures ANOVA test showed that with slow music, recovery time of systolic blood pressure (SBP) (7.9 +/- 2.5), diastolic blood pressure (DBP) (5.5 +/- 3.4) pulse rate recovery (PR) (8.0 +/- 2.3) and recovery from exertion (RPE) (7.7 +/- 2.5) were significantly faster when compared to both no music and fast music. The individual music preference made no significant difference in the relaxation time. The study concluded that music hastens post exercise recovery and slow music has greater relaxation effect than fast or no music, recovery time being independent of the gender and individual music preference.

City-scale analysis of water-related energy identifies more cost-effective solutions.

Science.gov (United States)

Lam, Ka Leung; Kenway, Steven J; Lant, Paul A

2017-02-01

Energy and greenhouse gas management in urban water systems typically focus on optimising within the direct system boundary of water utilities that covers the centralised water supply and wastewater treatment systems, despite a greater energy influence by the water end use. This work develops a cost curve of water-related energy management options from a city perspective for a hypothetical Australian city. It is compared with that from the water utility perspective. The curves are based on 18 water-related energy management options that have been implemented or evaluated in Australia. In the studied scenario, the cost-effective energy saving potential from a city perspective (292 GWh/year) is far more significant than that from a utility perspective (65 GWh/year). In some cases, for similar capital cost, if regional water planners invested in end use options instead of utility options, a greater energy saving potential at a greater cost-effectiveness could be achieved in urban water systems. For example, upgrading a wastewater treatment plant for biogas recovery at a capital cost of $27.2 million would save 31 GWh/year with a marginal cost saving of $63/MWh, while solar hot water system rebates at a cost of $28.6 million would save 67 GWh/year with a marginal cost saving of $111/MWh. Options related to hot water use such as water-efficient shower heads, water-efficient clothes washers and solar hot water system rebates are among the most cost-effective city-scale opportunities. This study demonstrates the use of cost curves to compare both utility and end use options in a consistent framework. It also illustrates that focusing solely on managing the energy use within the utility would miss substantial non-utility water-related energy saving opportunities. There is a need to broaden the conventional scope of cost curve analysis to include water-related energy and greenhouse gas at the water end use, and to value their management from a city perspective. This

Investigation of the strontium (Sr(II)) adsorption of an alginate microsphere as a low-cost adsorbent for removal and recovery from seawater.

Science.gov (United States)

Hong, Hye-Jin; Ryu, Jungho; Park, In-Su; Ryu, Taegong; Chung, Kang-Sup; Kim, Byuong-Gyu

2016-01-01

In this paper, we investigated alginate microspheres as a low-cost adsorbent for strontium (Sr(II)) removal and recovery from seawater. Alginate microspheres have demonstrated a superior adsorption capacity for Sr(II) ions (≈110 mg/g). A Freundlich isotherm model fits well with the Sr(II) adsorption of an alginate microsphere. The mechanism of Sr(II) adsorption is inferred as an ion exchange reaction with Ca(II) ions. The effects of the solution pH and co-existing ions in seawater are also investigated. Except for a pH of 1-2, Sr(II) adsorption capacity is not affected by pH. However, increasing the seawater concentration of metal cations seriously decreases Sr(II) uptake. In particular, highly concentrated (15,000 mg/L) Na(I) ions significantly interfere with Sr(II) adsorption. Sr(II) desorption was performed using 0.1 M HCl and CaCl2. Both regenerants show an excellent desorption efficiency, but the FTIR spectrum reveals that the chemical structure of the microsphere is destroyed after repeated use of HCl. Conversely, CaCl2 successfully desorbed Sr(II) without damage, and the Sr(II) adsorption capacity does not decrease after three repeated uses. The alginate microsphere was also applied to the adsorption of Sr(II) in a real seawater medium. Because of inhibition by co-existing ions, the Sr(II) adsorption capacity was decreased and the adsorption rate was retarded compared with D.I. water. Although the Sr(II) adsorption capacity was decreased, the alginate microsphere still exhibited 17.8 mg/g of Sr(II) uptake in the seawater medium. Considering its excellent Sr(II) uptake in seawater and its reusability, an alginate microsphere is an appropriate cost-effective adsorbent for the removal and recovery of Sr(II) from seawater. Copyright © 2015 Elsevier Ltd. All rights reserved.

Case study: Free product recovery and site remediation using horizontal trenching, soil vapor treatment and groundwater extraction

International Nuclear Information System (INIS)

Sanderson, E.P.; Johnston, H.S. Jr.; Farrell, M.; Twedell, D.B.

1993-01-01

Sites with soil and groundwater impacted by petroleum hydrocarbons have been remediated using a variety of traditional techniques. However, when the site impacted lies within a very confined downtown area of an expanding metropolitan city, a more complex array of technologies must be considered. The Law Enforcement Center site is the City of Charlotte's worst known underground storage tank (UST) release to date. A cost effective free product recovery, soil vapor and groundwater extraction system is being piloted here using new horizontal trenching technology and state of the art equipment. On-site low permeability soil required that an alternative to standard recovery wells be developed for groundwater recovery and vapor extraction. Operation and maintenance (O and M) of the large number of recovery wells required would have been extremely costly over the expected lifetime of the project. Although horizontal trenching was the best solution to the O and M costs, many problems were encountered during their installation

Downstream extraction process development for recovery of organic acids from a fermentation broth.

Science.gov (United States)

Bekatorou, Argyro; Dima, Agapi; Tsafrakidou, Panagiotia; Boura, Konstantina; Lappa, Katerina; Kandylis, Panagiotis; Pissaridi, Katerina; Kanellaki, Maria; Koutinas, Athanasios A

2016-11-01

The present study focused on organic acids (OAs) recovery from an acidogenic fermentation broth, which is the main problem regarding the use of OAs for production of ester-based new generation biofuels or other applications. Specifically, 10 solvents were evaluated for OAs recovery from aqueous media and fermentation broths. The effects of pH, solvent/OAs solution ratios and application of successive extractions were studied. The 1:1 solvent/OAs ratio showed the best recovery rates in most cases. Butyric and isobutyric acids showed the highest recovery rates (80-90%), while lactic, succinic, and acetic acids were poorly recovered (up to 45%). The OAs recovery was significantly improved by successive 10-min extractions. Alcohols presented the best extraction performance. The process using repeated extractions with 3-methyl-1-butanol led to the highest OAs recovery. However, 1-butanol can be considered as the most cost-effective option taking into account its price and availability. Copyright © 2016 Elsevier Ltd. All rights reserved.

Argonne's Expedited Site Characterization: An integrated approach to cost- and time-effective remedial investigation

International Nuclear Information System (INIS)

Burton, J.C.; Walker, J.L.; Aggarwal, P.K.; Meyer, W.T.

1995-01-01

Argonne National Laboratory has developed a methodology for remedial site investigation that has proven to be both technically superior to and more cost- and time-effective than traditional methods. This methodology is referred to as the Argonne Expedited Site Characterization (ESC). Quality is the driving force within the process. The Argonne ESC process is abbreviated only in time and cost and never in terms of quality. More usable data are produced with the Argonne ESC process than with traditional site characterization methods that are based on statistical-grid sampling and multiple monitoring wells. This paper given an overview of the Argonne ESC process and compares it with traditional methods for site characterization. Two examples of implementation of the Argonne ESC process are discussed to illustrate the effectiveness of the process in CERCLA (Comprehensive Environmental Response, Compensation, and Liability Act) and RCRA (Resource Conservation and Recovery Act) programs

Integrated cost-effectiveness analysis of greenhouse gas emission abatement. The case of Finland

Energy Technology Data Exchange (ETDEWEB)

Lehtilae, A.; Tuhkanen, S. [VTT Energy, Espoo (Finland). Energy Systems

1999-11-01

In Finland greenhouse gas emissions are expected to increase during the next decades due to economic growth, particularly in the energy intensive industrial sectors. The role of these industries is very central in the national economy. The emission control according to the Kyoto Protocol will therefore be quite difficult and costly. The study analyses the cost-effectiveness of different technical options for reducing the emissions of carbon dioxide, methane, and nitrous oxide in Finland. The analysis is performed with the help of a comprehensive energy system model for Finland, which has been extended to cover all major sources of methane and nitrous oxide emissions in the energy sector, industry, waste management and agriculture. The focus being on technical options, no consideration is given to possible policy measures, emission trading or joint implementation in the study. Under the boundary conditions given for the development of the Finnish energy economy, cost-effective technical measures in the energy system include increases in the use of wood biomass, natural gas and wind energy, increases in the contribution of CHP to the power supply, and intensified energy conservation in all end-use sectors. Additional cost-effective measures are landfill gas recovery, utilisation of the combustible fraction of waste and catalytic conversion of N{sub 2}O in nitric acid production. With baseline assumptions, the direct annual costs of emission abatement are calculated to be about 2000 MFIM (330 M{epsilon}) in 2010. The marginal costs are estimated to be about 230 FIM (40 {epsilon}) per tonne of CO{sub 2}-equivalent in 2010. The cost curie derived from the analysis could be used in further analyses concerning emissions trading. (orig.) 109 refs. SIHTI Research Programme

Fluid diversion in oil recovery

International Nuclear Information System (INIS)

Nimir, Hassan B.

1999-01-01

In any oil recovery process, large scale heterogeneities, such as fractures, channels, or high-permeability streaks, can cause early break through of injected fluid which will reduce oil recovery efficiency. In waterflooding, enhanced oil recovery, and acidizing operations, this problem is particularly acute because of the cost of the injected fluid. On the other hand coping with excess water production is always a challenging task for field operators. The cost of handling and disposing produced water can significantly shorten the economic production life of an oil well. The hydrostatic pressure created by high fluid levels in a well (water coning) is also detrimental to oil production. In this paper, the concept of fluid diversion is explained. Different methods that are suggested to divert the fluid into the oil-bearing-zones are briefly discussed, to show their advantages and disadvantages. Methods of reducing water production in production well are also discussed. (Author)

Nutrition for recovery in aquatic sports.

Science.gov (United States)

Burke, Louise M; Mujika, Iñigo

2014-08-01

Postexercise recovery is an important topic among aquatic athletes and involves interest in the quality, quantity, and timing of intake of food and fluids after workouts or competitive events to optimize processes such as refueling, rehydration, repair, and adaptation. Recovery processes that help to minimize the risk of illness and injury are also important but are less well documented. Recovery between workouts or competitive events may have two separate goals: (a) restoration of body losses and changes caused by the first session to restore performance for the next and (b) maximization of the adaptive responses to the stress provided by the session to gradually make the body become better at the features of exercise that are important for performance. In some cases, effective recovery occurs only when nutrients are supplied, and an early supply of nutrients may also be valuable in situations in which the period immediately after exercise provides an enhanced stimulus for recovery. This review summarizes contemporary knowledge of nutritional strategies to promote glycogen resynthesis, restoration of fluid balance, and protein synthesis after different types of exercise stimuli. It notes that some scenarios benefit from a proactive approach to recovery eating, whereas others may not need such attention. In fact, in some situations it may actually be beneficial to withhold nutritional support immediately after exercise. Each athlete should use a cost-benefit analysis of the approaches to recovery after different types of workouts or competitive events and then periodize different recovery strategies into their training or competition programs.

Biofuels from stumps and small roundwood - Costs and CO{sub 2} benefits

Energy Technology Data Exchange (ETDEWEB)

Eriksson, Lisa Naeslund; Gustavsson, Leif [Ecotechnology, Department of Engineering, Physics and Mathematics, Mid Sweden University, SE-831 25 Oestersund (Sweden)

2008-10-15

In this study, we analysed and compared costs, primary energy use and CO{sub 2} benefits of recovering stumps and small roundwood from thinnings, together with logging residues. Small roundwood, chipped at a terminal or end-user, has a cost comparable to the chip system and a primary energy use comparable to the bundle system used for recovery of logging residues. The small roundwood system with roadside chipping is more expensive. As productivity in the cutting process improves, the small roundwood alternatives become more cost-effective. The stump system has costs in the same range as or lower than the chip and bundle systems. Forestry operations for stump and small roundwood recovery require considerable primary energy, but net recovery per hectare is much greater than for the chip and bundle systems, which means that more fossil fuel can be displaced per hectare of clearcut than with a chip or a bundle system. Stumps and small roundwood from thinnings can become as cost-effective as logging residues in the near future. Furthermore, when stumps and small roundwood from thinnings are also used to replace fossil fuels, the potential CO{sub 2} reduction will be about four times as great as when only logging residues are used with a traditional chip system. (author)

Implementation of enhanced recovery programme for laparoscopic distal pancreatectomy: feasibility, safety and cost analysis.

Science.gov (United States)

Richardson, John; Di Fabio, Francesco; Clarke, Hannah; Bajalan, Mohammed; Davids, Joe; Abu Hilal, Mohammed

2015-01-01

The adoption of laparoscopy for distal pancreatectomy has proven to substantially improve short-term outcomes. Stress response after major surgery can be further minimized within an enhanced recovery programme (ERP). However, data on the potential benefit of an ERP for laparoscopic distal pancreatectomy are still lacking. The aim was to assess the feasibility, safety and cost of ERP for patients undergoing laparoscopic distal pancreatectomy. This is a case-control study from a Tertiary University Hospital. Sixty-six consecutive patients who underwent laparoscopic distal pancreatectomy were analyzed. Twenty-two patients were enrolled for the ERP and compared with previous consecutive 44 patients managed traditionally (1:2 ratio). Operative details, post-operative outcome and cost analysis were compared in the two groups. Patients enrolled in the ERP had similar intraoperative blood loss (median 165 ml vs. 200 ml; p = 0.176), operation time (225 min vs. 210 min; p = 0.633), time to remove naso-gastric tube (1 vs. 1 day; p = 0.081) but significantly shorter time to mobilization (median 1 vs. 2 days; p = 0.0001), start solid diet (2 vs. 3 days; p = 0004), and pass stools (3 vs. 5 days; p = 0.002) compared to the control group. Median length of stay was significantly shorter in the ERP group (3 vs. 6 days; p pancreatectomy with significant earlier return to normal gut function, reduced length of stay and cost saving. Copyright © 2015 IAP and EPC. Published by Elsevier B.V. All rights reserved.

Cost and cost-effectiveness of conventional and liquid-based ...

African Journals Online (AJOL)

Methods. The unit of effectiveness was defined as the number of cervical intraepithelial neoplasm (CIN) II or higher lesions detected. Costs were assessed retrospectively for the financial year (2010/11) from a laboratory service provider perspective. A cost-effectiveness analysis was performed by combining secondary data ...

The effects of multiple anaesthetic episodes on equine recovery quality.

Science.gov (United States)

Platt, J P; Simon, B T; Coleman, M; Martinez, E A; Lepiz, M A; Watts, A E

2018-01-01

Although rare, 70% of equine fatalities during recovery from general anaesthesia (GA) are due to catastrophic fractures from poor recovery quality. To determine the effect of repeated GA recovery on GA recovery quality. Experimental blinded trial. Eight adult horses underwent six GA events on sevoflurane for distal limb MRI examination over a 14-week period. Prior to GA recovery, xylazine was administered. Randomly ordered video-recorded GA recoveries were scored by three blinded board certified veterinary anaesthesiologists, unaware of patient identity or GA event number, for nine parameters using a 100 mm visual analogue scale (VAS) where 0 = worst and 100 = best. The number of attempts to stand, duration of lateral and sternal recumbency, total recovery duration and physiologic parameters during each GA event were recorded. Repeated measures ANOVA were used to detect differences. Agreement between observer VAS scores was determined via inter-rater reliability using an intraclass correlation. With GA recovery experience, VAS scores for balance and coordination, knuckling, and overall quality of recovery were improved and the duration of lateral recumbency was increased. There were no differences in total recovery duration, number of attempts to stand, physiologic parameters other than heart rate during GA, or VAS scores for activity in lateral recumbency, move to sternal, move to stand, or strength. Each GA event was relatively short and there was no surgical stimulation. The same results may not occur if there was surgical stimulation and pain during each GA event. Recovery from GA improves with multiple anaesthetic episodes in horses. Clinicians can advise clients that horses are likely to have better GA recovery on repeated GA recovery due to improved balance and coordination and reduced knuckling. Additionally, there is no change in anaesthetic morbidity with six repeated GA events over a 14-week period. © 2017 EVJ Ltd.

Costs and effects in lumbar spinal fusion

DEFF Research Database (Denmark)

Soegaard, Rikke; Christensen, Finn Bjarke; Christiansen, Terkel

2007-01-01

of the Dallas Pain Questionnaire and the Low Back Pain Rating Scale at baseline and 2 years postoperatively. Regression models were used to reveal determinants for costs and effects. Costs and effects were analyzed as a net-benefit measure to reveal determinants for cost-effectiveness, and finally, adjusted...... areas. Multi-level fusion and surgical technique significantly affected the net-benefit as well. Surprisingly, no correlation was found between treatment costs and treatment effects. Incremental analysis suggested that the probability of posterior instrumentation being cost-effective was limited......Although cost-effectiveness is becoming the foremost evaluative criterion within health service management of spine surgery, scientific knowledge about cost-patterns and cost-effectiveness is limited. The aims of this study were (1) to establish an activity-based method for costing at the patient...

Energy recovery from wastes

International Nuclear Information System (INIS)

De Stefanis, P.

1999-01-01

In this paper are reported analysis of some energy recovery form wastes plants. In this work are considered materials and energy flows, environmental impacts and related treatment costs and financial resources [it

The costs and cost-effectiveness of an integrated sepsis treatment protocol.

Science.gov (United States)

Talmor, Daniel; Greenberg, Dan; Howell, Michael D; Lisbon, Alan; Novack, Victor; Shapiro, Nathan

2008-04-01

Sepsis is associated with high mortality and treatment costs. International guidelines recommend the implementation of integrated sepsis protocols; however, the true cost and cost-effectiveness of these are unknown. To assess the cost-effectiveness of an integrated sepsis protocol, as compared with conventional care. Prospective cohort study of consecutive patients presenting with septic shock and enrolled in the institution's integrated sepsis protocol. Clinical and economic outcomes were compared with a historical control cohort. Beth Israel Deaconess Medical Center. Overall, 79 patients presenting to the emergency department with septic shock in the treatment cohort and 51 patients in the control group. An integrated sepsis treatment protocol incorporating empirical antibiotics, early goal-directed therapy, intensive insulin therapy, lung-protective ventilation, and consideration for drotrecogin alfa and steroid therapy. In-hospital treatment costs were collected using the hospital's detailed accounting system. The cost-effectiveness analysis was performed from the perspective of the healthcare system using a lifetime horizon. The primary end point for the cost-effectiveness analysis was the incremental cost per quality-adjusted life year gained. Mortality in the treatment group was 20.3% vs. 29.4% in the control group (p = .23). Implementing an integrated sepsis protocol resulted in a mean increase in cost of approximately $8,800 per patient, largely driven by increased intensive care unit length of stay. Life expectancy and quality-adjusted life years were higher in the treatment group; 0.78 and 0.54, respectively. The protocol was associated with an incremental cost of $11,274 per life-year saved and a cost of $16,309 per quality-adjusted life year gained. In patients with septic shock, an integrated sepsis protocol, although not cost-saving, appears to be cost-effective and compares very favorably to other commonly delivered acute care interventions.

Effects of optimism on recovery and mental health after a tornado outbreak.

Science.gov (United States)

Carbone, Eric G; Echols, Erin Thomas

2017-05-01

Dispositional optimism, a stable expectation that good things will happen, has been shown to improve health outcomes in a wide range of contexts, but very little research has explored the impact of optimism on post-disaster health and well-being. Data for this study come from the Centers for Disease Control and Prevention's Public health systems and mental health community recovery (PHSMHCR) Survey. Participants included 3216 individuals living in counties affected by the April 2011 tornado outbreak in Mississippi and Alabama. This study assesses the effect of dispositional optimism on post-disaster recovery and mental health. Dispositional optimism was found to have a positive effect on personal recovery and mental health after the disaster. Furthermore, it moderated the relationship between level of home damage and personal recovery as well as the relationship between home damage and post-traumatic stress disorder (PTSD), with stronger effects for those with increased levels of home damage. The utility of screening for optimism is discussed, along with the potential for interventions to increase optimism as a means of mitigating adverse mental health effects and improving the recovery of individuals affected by disasters and other traumatic events.

No effect of fibrin sealant on drain output or functional recovery following simultaneous bilateral total knee arthroplasty

DEFF Research Database (Denmark)

Skovgaard, Christian; Holm, Bente; Troelsen, Anders

2013-01-01

Background and purpose Blood loss after total knee arthroplasty (TKA) may lead to anemia, blood transfusions, and increased total costs. Also, bleeding into the periarticular tissue may cause swelling and a reduction in quadriceps strength, thus impairing early functional recovery. In this random...... in TKA showed no benefit in reducing drain output or in facilitating early functional recovery when used with a tourniquet, tranexamic acid, and a femoral bone plug....

Two-step optimization of pressure and recovery of reverse osmosis desalination process.

Science.gov (United States)

Liang, Shuang; Liu, Cui; Song, Lianfa

2009-05-01

Driving pressure and recovery are two primary design variables of a reverse osmosis process that largely determine the total cost of seawater and brackish water desalination. A two-step optimization procedure was developed in this paper to determine the values of driving pressure and recovery that minimize the total cost of RO desalination. It was demonstrated that the optimal net driving pressure is solely determined by the electricity price and the membrane price index, which is a lumped parameter to collectively reflect membrane price, resistance, and service time. On the other hand, the optimal recovery is determined by the electricity price, initial osmotic pressure, and costs for pretreatment of raw water and handling of retentate. Concise equations were derived for the optimal net driving pressure and recovery. The dependences of the optimal net driving pressure and recovery on the electricity price, membrane price, and costs for raw water pretreatment and retentate handling were discussed.

Transmission pricing and stranded costs in the electric power industry

International Nuclear Information System (INIS)

Baumol, W.J.; Sidak, J.G.

1995-09-01

Stranded costs are those costs that electric utilities are currently permitted to recover through their rates but whose recovery may be impeded or prevented by the advent of competition in the industry. Estimates of these costs run from the tens to the hundreds of billions of dollars. Should regulators permit utilities to recover stranded costs while they take steps to promote competition in the electric power industry. William Baumol and J. Gregory Sidak argue that answer to that question should be yes.The authors show that a transmission price, the price for sending electricity over the transmission grid, can be determined in a manner that is compatible with economic efficiency and clearly neutral in its effects upon all competitors in electricity generation. A correctly constructed regime of transmission pricing may in fact achieve the efficiency and equity goals that justify the recovery of stranded costs

Cost-effectiveness thresholds: pros and cons.

Science.gov (United States)

Bertram, Melanie Y; Lauer, Jeremy A; De Joncheere, Kees; Edejer, Tessa; Hutubessy, Raymond; Kieny, Marie-Paule; Hill, Suzanne R

2016-12-01

Cost-effectiveness analysis is used to compare the costs and outcomes of alternative policy options. Each resulting cost-effectiveness ratio represents the magnitude of additional health gained per additional unit of resources spent. Cost-effectiveness thresholds allow cost-effectiveness ratios that represent good or very good value for money to be identified. In 2001, the World Health Organization's Commission on Macroeconomics in Health suggested cost-effectiveness thresholds based on multiples of a country's per-capita gross domestic product (GDP). In some contexts, in choosing which health interventions to fund and which not to fund, these thresholds have been used as decision rules. However, experience with the use of such GDP-based thresholds in decision-making processes at country level shows them to lack country specificity and this - in addition to uncertainty in the modelled cost-effectiveness ratios - can lead to the wrong decision on how to spend health-care resources. Cost-effectiveness information should be used alongside other considerations - e.g. budget impact and feasibility considerations - in a transparent decision-making process, rather than in isolation based on a single threshold value. Although cost-effectiveness ratios are undoubtedly informative in assessing value for money, countries should be encouraged to develop a context-specific process for decision-making that is supported by legislation, has stakeholder buy-in, for example the involvement of civil society organizations and patient groups, and is transparent, consistent and fair.

Spatially Dispersed Employee Recovery

DEFF Research Database (Denmark)

Hvass, Kristian Anders; Torfadóttir, Embla

2014-01-01

Employee recovery addresses either employee well-being or management's practices in aiding employees in recovering themselves following a service failure. This paper surveys the cabin crew at a small, European, low-cost carrier and investigates employees' perceptions of management practices to aid...... personnel achieve service recovery. Employee recovery within service research often focuses on front-line employees that work in a fixed location, however a contribution to the field is made by investigating the recovery of spatially dispersed personnel, such as operational personnel in the transport sector......, who have a work place away from a fixed or central location and have minimal management contact. Results suggest that the support employees receive from management, such as recognition, information sharing, training, and strategic awareness are all important for spatially dispersed front...

Reading Recovery: Exploring the Effects on First-Graders' Reading Motivation and Achievement

Science.gov (United States)

Bates, Celeste C.; D'Agostino, Jerome V.; Gambrell, Linda; Xu, Meling

2016-01-01

This study examined the effects of Reading Recovery on children's motivational levels, and how motivation may contribute to the effect of the intervention on literacy achievement. Prior studies concluded that Reading Recovery was positively associated with increased student motivation levels, but most of those studies were limited…

The evolving regulation of uranium recovery operations in the United States: Inovative approaches are necessary for cost effective regulatory oversight

International Nuclear Information System (INIS)

Thompson, A.J.; Lehrenbaum, W.U.; Lashway, D.C.

2000-01-01

The US domestic uranium industry is at a crossroads. Historic low prices for uranium, combined with stringent and often irrational regulatory requirements, pose a very real threat to the industry's continued viability. The Nuclear Regulatory Commission has taken a number of innovative steps to reform and rationalize its regulatory program. However, if the domestic uranium recovery industry is to remain viable, additional steps toward innovation and reform are needed, and effective implementation of reforms adopted by the Commission is essential. (author)

Statin cost effectiveness in primary prevention: A systematic review of the recent cost-effectiveness literature in the United States

Directory of Open Access Journals (Sweden)

Mitchell Aaron P

2012-07-01

Full Text Available Abstract Background The literature on the cost-effectiveness of statin drugs in primary prevention of coronary heart disease is complex. The objective of this study is to compare the disparate results of recent cost-effectiveness analyses of statins. Findings We conducted a systematic review of the literature on statin cost-effectiveness. The four studies that met inclusion criteria reported varying conclusions about the cost-effectiveness of statin treatment, without a clear consensus as to whether statins are cost-effective for primary prevention. However, after accounting for each study’s assumptions about statin costs, we found substantial agreement among the studies. Studies that assumed statins to be more expensive found them to be less cost-effective, and vice-versa. Furthermore, treatment of low-risk groups became cost-effective as statins became less expensive. Conclusions Drug price is the primary determinant of statin cost-effectiveness within a given risk group. As more statin drugs become generic, patients at low risk for coronary disease may be treated cost-effectively. Though many factors must be weighed in any medical decision, from a cost-effectiveness perspective, statins may now be considered an appropriate therapy for many patients at low risk for heart disease.

Enhanced Recovery Implementation in Major Gynecologic Surgeries: Effect of Care Standardization.

Science.gov (United States)

Modesitt, Susan C; Sarosiek, Bethany M; Trowbridge, Elisa R; Redick, Dana L; Shah, Puja M; Thiele, Robert H; Tiouririne, Mohamed; Hedrick, Traci L

2016-09-01

To examine implementing an enhanced recovery after surgery (ERAS) protocol for women undergoing major gynecologic surgery at an academic institution and compare surgical outcomes before and after implementation. Two ERAS protocols were developed: a full pathway using regional anesthesia for open procedures and a light pathway without regional anesthesia for vaginal and minimally invasive procedures. Enhanced recovery after surgery pathways included extensive preoperative counseling, carbohydrate loading and oral fluids before surgery, multimodal analgesia with avoidance of intravenous opioids, intraoperative goal-directed fluid resuscitation, and immediate postoperative feeding and ambulation. A before-and-after study design was used to compare clinical outcomes, costs, and patient satisfaction. Complications and risk-adjusted length of stay were drawn from the American College of Surgeons' National Surgical Quality Improvement Program database. On the ERAS full protocol, 136 patients were compared with 211 historical controls and the median length of stay was reduced (2.0 compared with 3.0 days; P=.007) despite an increase in National Surgical Quality Improvement Program-predicted length of stay (2.5 compared with 2.0 days; P=.009). Reductions were seen in median intraoperative morphine equivalents (0.3 compared with 12.7 mg; Pcontrols and demonstrated decreased intraoperative and postoperative morphine equivalents (0.0 compared with 13.0 mg; Pcontrol, nurses keeping patients informed, and staff teamwork; 30-day total hospital costs were significantly decreased in both ERAS groups. Implementation of ERAS protocols in gynecologic surgery was associated with a substantial decrease in intravenous fluids and morphine administration coupled with reduction in length of stay for open procedures combined with improved patient satisfaction and decreased hospital costs.

Evaluation of resource recovery from waste incineration residues--the case of zinc.

Science.gov (United States)

Fellner, J; Lederer, J; Purgar, A; Winterstetter, A; Rechberger, H; Winter, F; Laner, D

2015-03-01

Solid residues generated at European Waste to Energy plants contain altogether about 69,000 t/a of Zn, of which more than 50% accumulates in air pollution control residues, mainly boiler and filter ashes. Intensive research activities aiming at Zn recovery from such residues recently resulted in a technical scale Zn recovery plant at a Swiss waste incinerator. By acidic leaching and subsequent electrolysis this technology (FLUREC) allows generating metallic Zn of purity>99.9%. In the present paper the economic viability of the FLUREC technology with respect to Zn recovery from different solid residues of waste incineration has been investigated and subsequently been categorised according to the mineral resource classification scheme of McKelvey. The results of the analysis demonstrate that recovery costs for Zn are highly dependent on the costs for current fly ash disposal (e.g. cost for subsurface landfilling). Assuming current disposal practice costs of 220€/ton fly ash, resulting recovery costs for Zn are generally higher than its current market price of 1.6€/kg Zn. With respect to the resource classification this outcome indicates that none of the identified Zn resources present in incineration residues can be economically extracted and thus cannot be classified as a reserve. Only for about 4800 t/a of Zn an extraction would be marginally economic, meaning that recovery costs are only slightly (less than 20%) higher than the current market price for Zn. For the remaining Zn resources production costs are between 1.5 and 4 times (7900 t/a Zn) and 10-80 times (55,300 t/a Zn) higher than the current market value. The economic potential for Zn recovery from waste incineration residues is highest for filter ashes generated at grate incinerators equipped with wet air pollution control. Copyright © 2014 Elsevier Ltd. All rights reserved.

Clinical and cost effectiveness-related aspects of retransfusion in total hip and knee arthroplasty.

Science.gov (United States)

Dobosz, Bartłomiej; Dutka, Julian; Dutka, Lukasz; Maleta, Paweł

2012-01-01

An increasing demand for blood products forces the rationalisation of management and conservation of blood. The aim of the study is to evaluate the possibility of retransfusion of blood conservation and the cost-effectiveness of this procedure when employed in Total Hip Replacement and Total Knee Arthroplasty. This prospective cohort study involved two groups of patients. Group I comprised 50 patients who underwent blood retransfusion and in several cases had supplementary allogeneic transfusion. Group II, a control group, consisted of 50 patients who did not receive retransfusion. The retransfusion in Group I enabled the recovery of a mean amount of 364.5 ml (± 52.7) of blood in THR patients and 403.8 ml (± 110.7) in TKA patients. Demand for allogeneic blood transfusions in Group I versus Group II was 46% lower in THR patients and 42% lower in TKA patients. The blood recovered for retransfusion is biologically valuable with regard to cellular elements and plasma chemistries. In the costs evaluation, the total savings in Group I were 5,000 PLN. Retransfusion of recuperated blood from postoperative drainage tubing is a simple and safe method that provides clinical and cost-effectiveness advantages.

10 CFR 436.18 - Measuring cost-effectiveness.

Science.gov (United States)

2010-01-01

... 10 Energy 3 2010-01-01 2010-01-01 false Measuring cost-effectiveness. 436.18 Section 436.18 Energy... Procedures for Life Cycle Cost Analyses § 436.18 Measuring cost-effectiveness. (a) In accordance with this section, each Federal agency shall measure cost-effectiveness by combining cost data established under...

Cost-effectiveness of extraperitoneal laparoscopic inguinal hernia repair: a randomized comparison with conventional herniorrhaphy. Coala trial group.

Science.gov (United States)

Liem, M S; Halsema, J A; van der Graaf, Y; Schrijvers, A J; van Vroonhoven, T J

1997-12-01

To determine the cost-effectiveness of laparoscopic inguinal hernia repair. Laparoscopic inguinal hernia repair seems superior to open techniques with respect to short-term results. An issue yet to be studied in depth remains the cost-effectiveness of the procedure. As part of a multicenter randomized study in which >1000 patients were included, a cost-effectiveness analysis from a societal point of view was performed. After informed consent, all resource costs, both in and outside the hospital, for patients between August 1994 and July 1995 were recorded prospectively. Actual costs were calculated in a standardized fashion according to international guidelines. The main measures used for the evaluation of inguinal hernia repair were the number of averted recurrences and quality of life measured with the Short Form 36 questionnaire. Resource costs were recorded for 273 patients, 139 in the open and 134 in the laparoscopic group. Both groups were comparable at baseline. Average total hospital costs were Dfl 1384.91 (standard deviation: Dfl 440.15) for the open repair group and Dfl 2417.24 (standard deviation: Dfl 577.10) for laparoscopic repair, including a disposable kit of Dfl 676. Societal costs, including costs for days of sick leave, were lower for the laparoscopic repair and offset the hospital costs by Dfl 780.83 (75.6%), leaving the laparoscopic repair Dfl 251.50 more expensive (Dfl 4665 versus Dfl 4916.50). At present, the recurrence rate is 2.6% lower after laparoscopic repair. Thus, 38 laparoscopic repairs, costing an additional Dfl 9,557, prevent the occurrence of one recurrent hernia. Quality of life was better after laparoscopic repair. A better quality of life in the recovery period and the possibility of replacing parts of the disposable kit with reusable instruments may result in the laparoscopic repair becoming dominantly better--that is, less expensive and more effective from a societal perspective.

Joint recovery programme versus usual care - An economic evaluation of a clinical pathway for joint replacement surgery

NARCIS (Netherlands)

Brunenberg, DE; van Steyn, MJ; Sluimer, JC; Bekebrede, LL; Bulstra, SK; Joore, MA

2005-01-01

Objective: The objective of the present study was to determine the incremental cost-effectiveness of a clinical pathway for patients undergoing joint replacement, the Joint Recovery Programme (JRP), as compared with usual care. The existing care process was revised to contain costs and shorten

Incineration with energy recovery

Energy Technology Data Exchange (ETDEWEB)

Mahoney, T.G.

1986-02-01

Motherwell Bridge Tacol Ltd. operate a 'Licence Agreement' with Deutsche Babcock Anlagen of Krefeld, West Germany, for the construction of Municipal Refuse Incineration plant and Industrial Waste plant with or without the incorporation of waste heat recovery equipment. The construction in the UK of a number of large incineration plants incorporating the roller grate incinerator unit is discussed. The historical background, combustion process, capacity, grate details, refuse analysis and use as fuel, heat recovery and costs are outlined.

Cost-Effective Fuel Treatment Planning

Science.gov (United States)

Kreitler, J.; Thompson, M.; Vaillant, N.

2014-12-01

The cost of fighting large wildland fires in the western United States has grown dramatically over the past decade. This trend will likely continue with growth of the WUI into fire prone ecosystems, dangerous fuel conditions from decades of fire suppression, and a potentially increasing effect from prolonged drought and climate change. Fuel treatments are often considered the primary pre-fire mechanism to reduce the exposure of values at risk to wildland fire, and a growing suite of fire models and tools are employed to prioritize where treatments could mitigate wildland fire damages. Assessments using the likelihood and consequence of fire are critical because funds are insufficient to reduce risk on all lands needing treatment, therefore prioritization is required to maximize the effectiveness of fuel treatment budgets. Cost-effectiveness, doing the most good per dollar, would seem to be an important fuel treatment metric, yet studies or plans that prioritize fuel treatments using costs or cost-effectiveness measures are absent from the literature. Therefore, to explore the effect of using costs in fuel treatment planning we test four prioritization algorithms designed to reduce risk in a case study examining fuel treatments on the Sisters Ranger District of central Oregon. For benefits we model sediment retention and standing biomass, and measure the effectiveness of each algorithm by comparing the differences among treatment and no treat alternative scenarios. Our objective is to maximize the averted loss of net benefits subject to a representative fuel treatment budget. We model costs across the study landscape using the My Fuel Treatment Planner software, tree list data, local mill prices, and GIS-measured site characteristics. We use fire simulations to generate burn probabilities, and estimate fire intensity as conditional flame length at each pixel. Two prioritization algorithms target treatments based on cost-effectiveness and show improvements over those

An evaluation of service use outcomes in a Recovery College.

Science.gov (United States)

Bourne, Philippa; Meddings, Sara; Whittington, Adrian

2017-12-23

Recovery Colleges offer educational courses about recovery and mental health which are co-produced by mental health professionals and experts by lived experience. Previous evaluations have found positive effects of Recovery Colleges on a range of outcomes including wellbeing, recovery and quality of life. To evaluate service use outcomes for Sussex Recovery College students who use mental health services. The study used a controlled-before-and-after design. It used archival data to analyse service use before and after participants registered with the Recovery College (n = 463). Participants acted as their own control. Students used mental health services less after attending the Recovery College than before. Students who attended the Recovery College showed significant reductions in occupied hospital bed days, admissions, admissions under section and community contacts in the 18 months post compared with the 18 months before registering. Reductions in service use were greater for those who completed a course than those who registered but did not complete a course. These findings suggest that attending Recovery College courses is associated with reduced service use. The reductions equate to non-cashable cost-savings of £1200 per registered student and £1760 for students who completed a course. Further research is needed to investigate causality.

An Analysis of Failure Handling in Chameleon, A Framework for Supporting Cost-Effective Fault Tolerant Services

Science.gov (United States)

Haakensen, Erik Edward

1998-01-01

The desire for low-cost reliable computing is increasing. Most current fault tolerant computing solutions are not very flexible, i.e., they cannot adapt to reliability requirements of newly emerging applications in business, commerce, and manufacturing. It is important that users have a flexible, reliable platform to support both critical and noncritical applications. Chameleon, under development at the Center for Reliable and High-Performance Computing at the University of Illinois, is a software framework. for supporting cost-effective adaptable networked fault tolerant service. This thesis details a simulation of fault injection, detection, and recovery in Chameleon. The simulation was written in C++ using the DEPEND simulation library. The results obtained from the simulation included the amount of overhead incurred by the fault detection and recovery mechanisms supported by Chameleon. In addition, information about fault scenarios from which Chameleon cannot recover was gained. The results of the simulation showed that both critical and noncritical applications can be executed in the Chameleon environment with a fairly small amount of overhead. No single point of failure from which Chameleon could not recover was found. Chameleon was also found to be capable of recovering from several multiple failure scenarios.

Indirect effects of recovery strategies

DEFF Research Database (Denmark)

Andersen, Ken Haste; Rice, Jake

-based models of fish communities indicate that theserelationships have lawful dynamics that continue to be expressed, even when individualspecies become rarer - as predators or as prey. An ecosystem based management recoverystrategies of a given species or group of species should therefore not be seen...... in isolation,but the expected consequences for the rest of the ecosystem must be analyzed. We use ageneral size- and trait-based model to calculate the ecosystem effects of fishing andrecovery. We present a general analysis of a recovery strategies targeting either large fishes(consumer fishery), small fishes...

Dose-Response Effects of Exercise Duration and Recovery on Cognitive Functioning.

Science.gov (United States)

Crush, Elizabeth A; Loprinzi, Paul D

2017-12-01

We examined the effects of different acute exercise durations and recovery periods on cognitive function in a counterbalanced, cross-over randomized controlled experiment. We placed 352 participants, aged 18 to 35 years into one of 16 experimental groups. Each participant visited the laboratory twice, separated by a 1-week washout period. Either Visit 1 or 2 consisted of an acute bout of moderate-intensity treadmill exercise (10, 20, 30, 45, or 60 minutes) followed by a period of rest (5, 15, or 30 minutes) before taking a set of five cognitive tests; the other visit consisted only of completing the cognitive tests (no exercise). Cognitive tests sampled multiple cognitive parameters, including reasoning, concentration, memory, attention, and planning. We found that a short recovery period (i.e., 5 minutes) may have a less favorable effect on planning ability but may be beneficial for memory. In addition, for various exercise durations and recovery periods, a Group × Time × Resting (nonexercise) A cognitive interaction effect was observed such that for both memory and inhibitory cognitive ability, acute exercise (vs. no exercise) had an enhancement effect for those with lower resting cognitive functioning. The length of the acute exercise recovery period and resting cognitive ability most influenced the association between exercise and cognitive function.

The effect of DNA recovery on the subsequent quality of latent fingermarks.

Science.gov (United States)

Fieldhouse, Sarah; Oravcova, Eliska; Walton-Williams, Laura

2016-10-01

The recovery of DNA and fingermark evidence from the same site can be problematic on account of potential contamination from fingermark visualisation techniques, and/or the destructive capability of the DNA recovery method. Forensic investigators are therefore often required to choose which evidence type to recover, or to recover both evidence types from different sites. Research typically documents the effects of fingermark visualisation techniques on the subsequent recovery of DNA, whereas this research has investigated the effects of DNA recovery on the quality of subsequently recovered latent fingermarks. Eccrine rich, sebaceous rich, and 'normal' latent fingermarks were deposited onto five substrates: glass; aluminium; textured plastic; varnished wood; photocopier paper and aged from 4h to 4 weeks. Approximately half of the control fingermarks were developed without DNA recovery on all substrates. The remaining samples were subjected to one of five DNA recovery methods prior to fingermark development. Pre and post DNA recovered fingermarks were graded for quality, and AFIS correlations scores were obtained and analysed for statistically significant differences using Wilcoxon Signed Rank tests and Friedman tests. All of the DNA recovery methods reduced the quality of latent fingermarks on glass surfaces. Flocked swabs and gel lifts were the least destructive DNA recovery methods on the remaining surfaces, except for aluminium sheet metal. The quality of latent fingermarks deposited onto glossed wood and textured plastic and paper were less affected by dry swabbing. Wet swabbing and tape lifting were very damaging methods of DNA recovery. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Electrodialysis reversal: Process and cost approximations for treating coal-bed methane waters

Energy Technology Data Exchange (ETDEWEB)

Sajtar, E.T.; Bagley, D.M. [University of Wyoming, Laramie, WY (United States)

2009-02-15

Brackish waters with total dissolved solids (TDS) concentrations less than 10,000 mg/L are extracted from coal-beds in the Wyoming Powder River basin to facilitate the production of coal-bed methane. These waters frequently require treatment before disposal or use. Electrodialysis reversal (EDR) has not yet been used to treat these waters but this technology should be suitable. The question is whether EDR would be cost-effective. The purpose of this work, then, was to develop models for predicting the cost of EDR for brackish waters. These models, developed from data available in the literature, were found to predict actual EDR costs as a function of TDS removal, influent flow rate, chemical rejection efficiency, water recovery, electricity use, and labor cost within 10% of reported values. The total amortized cost for removing 1,000 mg/L of TDS from 10,000 m{sup 3}/day of influent assuming no concentrate disposal costs was predicted to range from $0.23/m{sup 3} to $0.85/m{sup 3} and was highly dependent on capital cost and facility life. Concentrate disposal costs significantly affected total treatment cost, providing a total treatment cost range from $0.38/m{sup 3} to $6.38/m{sup 3}, depending on concentrate disposal cost and water recovery. Pilot demonstrations of EDR in the Powder River basin should be conducted to determine the achievable water recovery when treating these waters.

Advanced regenerative heat recovery system

Science.gov (United States)

Prasad, A.; Jasti, J. K.

1982-02-01

A regenerative heat recovery system was designed and fabricated to deliver 1500 scfm preheated air to a maximum temperature of 1600 F. Since this system is operating at 2000 F, the internal parts were designed to be fabricated with ceramic materials. This system is also designed to be adaptable to an internal metallic structure to operate in the range of 1100 to 1500 F. A test facility was designed and fabricated to test this system. The test facility is equipped to impose a pressure differential of up to 27 inches of water column in between preheated air and flue gas lines for checking possible leakage through the seals. The preliminary tests conducted on the advanced regenerative heat recovery system indicate the thermal effectiveness in the range of 60% to 70%. Bench scale studies were conducted on various ceramic and gasket materials to identify the proper material to be used in high temperature applications. A market survey was conducted to identify the application areas for this heat recovery system. A cost/benefit analysis showed a payback period of less than one and a half years.

How rebates, copayments, and administration costs affect the cost-effectiveness of osteoporosis therapies.

Science.gov (United States)

Ferko, Nicole C; Borisova, Natalie; Airia, Parisa; Grima, Daniel T; Thompson, Melissa F

2012-11-01

Because of rising drug expenditures, cost considerations have become essential, necessitating the requirement for cost-effectiveness analyses for managed care organizations (MCOs). The study objective is to examine the impact of various drug-cost components, in addition to wholesale acquisition cost (WAC), on the cost-effectiveness of osteoporosis therapies. A Markov model of osteoporosis was used to exemplify different drug cost scenarios. We examined the effect of varying rebates for oral bisphosphonates--risedronate and ibandronate--as well as considering the impact of varying copayments and administration costs for intravenous zoledronate. The population modeled was 1,000 American women, > or = 50 years with osteoporosis. Patients were followed for 1 year to reflect an annual budget review of formularies by MCOs. The cost of therapy was based on an adjusted WAC, and is referred to as net drug cost. The total annual cost incurred by an MCO for each drug regimen was calculated using the net drug cost and fracture cost. We estimated cost on a quality adjusted life year (QALY) basis. When considering different rebates, results for risedronate versus ibandronate vary from cost-savings (i.e., costs less and more effective) to approximately $70,000 per QALY. With no risedronate rebate, an ibandronate rebate of approximately 65% is required before cost per QALY surpasses $50,000. With rebates greater than 25% for risedronate, irrespective of ibandronate rebates, results become cost-saving. Results also showed the magnitude of cost savings to the MCO varied by as much as 65% when considering no administration cost and the highest coinsurance rate for zoledronate. Our study showed that cost-effectiveness varies considerably when factors in addition to the WAC are considered. This paper provides recommendations for pharmaceutical manufacturers and MCOs when developing and interpreting such analyses.

Costs and cost-effectiveness of delivering intermittent preventive treatment through schools in western Kenya

Directory of Open Access Journals (Sweden)

Jukes Matthew CH

2008-09-01

Full Text Available Abstract Background Awareness of the potential impact of malaria among school-age children has stimulated investigation into malaria interventions that can be delivered through schools. However, little evidence is available on the costs and cost-effectiveness of intervention options. This paper evaluates the costs and cost-effectiveness of intermittent preventive treatment (IPT as delivered by teachers in schools in western Kenya. Methods Information on actual drug and non-drug associated costs were collected from expenditure and salary records, government budgets and interviews with key district and national officials. Effectiveness data were derived from a cluster-randomised-controlled trial of IPT where a single dose of sulphadoxine-pyrimethamine and three daily doses of amodiaquine were provided three times in year (once termly. Both financial and economic costs were estimated from a provider perspective, and effectiveness was estimated in terms of anaemia cases averted. A sensitivity analysis was conducted to assess the impact of key assumptions on estimated cost-effectiveness. Results The delivery of IPT by teachers was estimated to cost US$ 1.88 per child treated per year, with drug and teacher training costs constituting the largest cost components. Set-up costs accounted for 13.2% of overall costs (equivalent to US$ 0.25 per child whilst recurrent costs accounted for 86.8% (US$ 1.63 per child per year. The estimated cost per anaemia case averted was US$ 29.84 and the cost per case of Plasmodium falciparum parasitaemia averted was US$ 5.36, respectively. The cost per case of anaemia averted ranged between US$ 24.60 and 40.32 when the prices of antimalarial drugs and delivery costs were varied. Cost-effectiveness was most influenced by effectiveness of IPT and the background prevalence of anaemia. In settings where 30% and 50% of schoolchildren were anaemic, cost-effectiveness ratios were US$ 12.53 and 7.52, respectively. Conclusion This

Possibility of heat recovery from gray water in residential building

Directory of Open Access Journals (Sweden)

Mazur Aleksandra

2017-12-01

Full Text Available Recovery of waste heat from gray water can be an interesting alternative to other energy saving systems in a building, including alternative energy sources. Mainly, due to a number of advantages including independence from weather conditions, small investment outlay, lack of user support, or a slight interference with the installation system. The purpose of this article is to present the financial effectiveness of installations which provide hot, usable water to a detached house, using a Drain Water Heat Recovery (DWHR system depending on the number of system users and the various combinations of bathing time in the shower, which has an influence on the daily warm water demand in each of the considered options. The economic analysis of the adopted installation variants is based on the Life Cycle Cost (LCC method, which is characterized by the fact that it also includes the operating costs in addition to the capital expenditure during the entire analysis period. For each case, the necessary devices were selected and the cost of their installation was estimated.

Possibility of heat recovery from gray water in residential building

Science.gov (United States)

Mazur, Aleksandra; Słyś, Daniel

2017-12-01

Recovery of waste heat from gray water can be an interesting alternative to other energy saving systems in a building, including alternative energy sources. Mainly, due to a number of advantages including independence from weather conditions, small investment outlay, lack of user support, or a slight interference with the installation system. The purpose of this article is to present the financial effectiveness of installations which provide hot, usable water to a detached house, using a Drain Water Heat Recovery (DWHR) system depending on the number of system users and the various combinations of bathing time in the shower, which has an influence on the daily warm water demand in each of the considered options. The economic analysis of the adopted installation variants is based on the Life Cycle Cost (LCC) method, which is characterized by the fact that it also includes the operating costs in addition to the capital expenditure during the entire analysis period. For each case, the necessary devices were selected and the cost of their installation was estimated.

Spontaneous recovery of effects of contrast adaptation without awareness

Directory of Open Access Journals (Sweden)

Gaoxing eMei

2015-09-01

Full Text Available Prolonged exposure to a high contrast stimulus reduces the neural sensitivity to subsequent similar patterns. Recent work has disclosed that contrast adaptation is controlled by multiple mechanisms operating over differing timescales. Adaptation to high contrast for a relatively longer period can be rapidly eliminated by adaptation to a lower contrast (or meanfield in the present study. Such rapid deadaptation presumably causes a short-term mechanism to signal for a sensitivity increase, cancelling ongoing signals from long-term mechanisms. Once deadaptation ends, the short-term mechanism rapidly returns to baseline, and the slowly decaying effects in the long-term mechanisms reemerge, allowing the perceptual aftereffects to recover during continued testing. Although this spontaneous recovery effect is considered strong evidence supporting the multiple mechanisms theory, it remains controversial whether the effect is mainly driven by visual memory established during the initial longer-term adaptation period. To resolve this debate, we used a modified Continuous Flash Suppression (CFS and visual crowding paradigms to render the adapting stimuli invisible, but still observed the spontaneous recovery phenomenon. These results exclude the possibility that spontaneous recovery found in the previous work was merely the consequence of explicit visual memory. Our findings also demonstrate that contrast adaptation, even at the unconscious processing levels, is controlled by multiple mechanisms.

Cost-effectiveness Analysis for Technology Acquisition.

Science.gov (United States)

Chakravarty, A; Naware, S S

2008-01-01

In a developing country with limited resources, it is important to utilize the total cost visibility approach over the entire life-cycle of the technology and then analyse alternative options for acquiring technology. The present study analysed cost-effectiveness of an "In-house" magnetic resonance imaging (MRI) scan facility of a large service hospital against outsourcing possibilities. Cost per unit scan was calculated by operating costing method and break-even volume was calculated. Then life-cycle cost analysis was performed to enable total cost visibility of the MRI scan in both "In-house" and "outsourcing of facility" configuration. Finally, cost-effectiveness analysis was performed to identify the more acceptable decision option. Total cost for performing unit MRI scan was found to be Rs 3,875 for scans without contrast and Rs 4,129 with contrast. On life-cycle cost analysis, net present value (NPV) of the "In-house" configuration was found to be Rs-(4,09,06,265) while that of "outsourcing of facility" configuration was Rs-(5,70,23,315). Subsequently, cost-effectiveness analysis across eight Figures of Merit showed the "In-house" facility to be the more acceptable option for the system. Every decision for acquiring high-end technology must be subjected to life-cycle cost analysis.

Impact of generic alendronate cost on the cost-effectiveness of osteoporosis screening and treatment.

Directory of Open Access Journals (Sweden)

Smita Nayak

Full Text Available Since alendronate became available in generic form in the Unites States in 2008, its price has been decreasing. The objective of this study was to investigate the impact of alendronate cost on the cost-effectiveness of osteoporosis screening and treatment in postmenopausal women.Microsimulation cost-effectiveness model of osteoporosis screening and treatment for U.S. women age 65 and older. We assumed screening initiation at age 65 with central dual-energy x-ray absorptiometry (DXA, and alendronate treatment for individuals with osteoporosis; with a comparator of "no screening" and treatment only after fracture occurrence. We evaluated annual alendronate costs of $20 through $800; outcome measures included fractures; nursing home admission; medication adverse events; death; costs; quality-adjusted life-years (QALYs; and incremental cost-effectiveness ratios (ICERs in 2010 U.S. dollars per QALY gained. A lifetime time horizon was used, and direct costs were included. Base-case and sensitivity analyses were performed.Base-case analysis results showed that at annual alendronate costs of $200 or less, osteoporosis screening followed by treatment was cost-saving, resulting in lower total costs than no screening as well as more QALYs (10.6 additional quality-adjusted life-days. When assuming alendronate costs of $400 through $800, screening and treatment resulted in greater lifetime costs than no screening but was highly cost-effective, with ICERs ranging from $714 per QALY gained through $13,902 per QALY gained. Probabilistic sensitivity analyses revealed that the cost-effectiveness of osteoporosis screening followed by alendronate treatment was robust to joint input parameter estimate variation at a willingness-to-pay threshold of $50,000/QALY at all alendronate costs evaluated.Osteoporosis screening followed by alendronate treatment is effective and highly cost-effective for postmenopausal women across a range of alendronate costs, and may be cost

Digital innovations and emerging technologies for enhanced recovery programmes

DEFF Research Database (Denmark)

Michard, F; Gan, T J; Kehlet, H

2017-01-01

Enhanced recovery programmes (ERPs) are increasingly used to improve post-surgical recovery. However, compliance to various components of ERPs-a key determinant of success-remains sub-optimal. Emerging technologies have the potential to help patients and caregivers to improve compliance with ERPs...... of the above-mentioned ERP elements is omitted during the surgical journey.By optimizing compliance to the multiple components of ERPs, digital innovations, non-invasive techniques and wearable sensors have the potential to magnify the clinical and economic benefits of ERPs. Among the growing number...... of technical innovations, studies are needed to clarify which tools and solutions have real clinical value and are cost-effective....

Milk: An Effective Recovery Drink for Female Athletes.

Science.gov (United States)

Rankin, Paula; Landy, Adrian; Stevenson, Emma; Cockburn, Emma

2018-02-17

Milk has become a popular post-exercise recovery drink. Yet the evidence for its use in this regard comes from a limited number of investigations utilising very specific exercise protocols, and mostly with male participants. Therefore, the aim of this study was to investigate the effects of post-exercise milk consumption on recovery from a sprinting and jumping protocol in female team-sport athletes. Eighteen females participated in an independent-groups design. Upon completion of the protocol participants consumed 500 mL of milk (MILK) or 500 mL of an energy-matched carbohydrate (CHO) drink. Muscle function (peak torque, rate of force development (RFD), countermovement jump (CMJ), reactive strength index (RSI), sprint performance), muscle soreness and tiredness, symptoms of stress, serum creatine kinase (CK) and high-sensitivity C-reactive protein (hsCRP) were determined pre- and 24 h, 48 h and 72 h post-exercise. MILK had a very likely beneficial effect in attenuating losses in peak torque (180 ○ /s) from baseline to 72 h (0.0 ± 10.0% vs. -8.7 ± 3.7%, MILK v CHO), and countermovement jump (-1.1 ± 5.2% vs. -10.4 ± 6.7%) and symptoms of stress (-13.5 ± 7.4% vs. -18.7 ± 11.0%) from baseline to 24 h. MILK had a likely beneficial effect and a possibly beneficial effect on other peak torque measures and 5 m sprint performance at other timepoints but had an unclear effect on 10 and 20 m sprint performance, RSI, muscle soreness and tiredness, CK and hsCRP. In conclusion, consumption of 500 mL milk attenuated losses in muscle function following repeated sprinting and jumping and thus may be a valuable recovery intervention for female team-sport athletes following this type of exercise.

Milk: An Effective Recovery Drink for Female Athletes

Directory of Open Access Journals (Sweden)

Paula Rankin

2018-02-01

Full Text Available Milk has become a popular post-exercise recovery drink. Yet the evidence for its use in this regard comes from a limited number of investigations utilising very specific exercise protocols, and mostly with male participants. Therefore, the aim of this study was to investigate the effects of post-exercise milk consumption on recovery from a sprinting and jumping protocol in female team-sport athletes. Eighteen females participated in an independent-groups design. Upon completion of the protocol participants consumed 500 mL of milk (MILK or 500 mL of an energy-matched carbohydrate (CHO drink. Muscle function (peak torque, rate of force development (RFD, countermovement jump (CMJ, reactive strength index (RSI, sprint performance, muscle soreness and tiredness, symptoms of stress, serum creatine kinase (CK and high-sensitivity C-reactive protein (hsCRP were determined pre- and 24 h, 48 h and 72 h post-exercise. MILK had a very likely beneficial effect in attenuating losses in peak torque (180○/s from baseline to 72 h (0.0 ± 10.0% vs. −8.7 ± 3.7%, MILK v CHO, and countermovement jump (−1.1 ± 5.2% vs. −10.4 ± 6.7% and symptoms of stress (−13.5 ± 7.4% vs. −18.7 ± 11.0% from baseline to 24 h. MILK had a likely beneficial effect and a possibly beneficial effect on other peak torque measures and 5 m sprint performance at other timepoints but had an unclear effect on 10 and 20 m sprint performance, RSI, muscle soreness and tiredness, CK and hsCRP. In conclusion, consumption of 500 mL milk attenuated losses in muscle function following repeated sprinting and jumping and thus may be a valuable recovery intervention for female team-sport athletes following this type of exercise.

Cost competitive “soft sensor” for determining product recovery in industrial methanol

DEFF Research Database (Denmark)

S.B.A. Udugama, Isuru; Mansouri, Seyed Soheil; Huusom, Jakob Kjøbsted

2017-01-01

The measurement of ratio of product recovery in industrial methanol distillation is of high economic importance and represent a key performance index (KPI) of the distillation unit. In current operations, the product recovery of many industrial distillation units are not actively monitored, instead...

Strontium-90 and promethium-147 recovery

International Nuclear Information System (INIS)

Hoisington, J.E.; McDonell, W.R.

1982-01-01

Strontium-90 and promethium-147 are fission product radionuclides with potential for use as heat source materials in high reliability, non-interruptible power supplies. Interest has recently been expressed in their utilization for Department of Defense (DOD) applications. This memorandum summarizes the current inventories, the annual production rates, and the possible recovery of Sr-90 and Pm-147 from nuclear materials production operations at Hanford and Savannah River. Recovery of these isotopes from LWR spend fuel utilizing the Barnwell Nuclear Fuels Plant (BNFP) is also considered. Unit recovery costs at each site are provided

Psychophysiological effects of music on acute recovery from high-intensity interval training.

Science.gov (United States)

Jones, Leighton; Tiller, Nicholas B; Karageorghis, Costas I

2017-03-01

Numerous studies have examined the multifarious effects of music applied during exercise but few have assessed the efficacy of music as an aid to recovery. Music might facilitate physiological recovery via the entrainment of respiratory rhythms with music tempo. High-intensity exercise training is not typically associated with positive affective responses, and thus ways of assuaging negative affect warrant further exploration. This study assessed the psychophysiological effects of music on acute recovery and prevalence of entrainment in between bouts of high-intensity exercise. Thirteen male runners (M age =20.2±1.9years; BMI=21.7±1.7; V̇O 2 max=61.6±6.1mL·kg·min -1 ) completed three exercise sessions comprising 5×5-min bouts of high-intensity intervals interspersed with 3-min periods of passive recovery. During recovery, participants were administered positively-valenced music of a slow-tempo (55-65bpm), fast-tempo (125-135bpm), or a no-music control. A range of measures including affective responses, RPE, cardiorespiratory indices (gas exchange and pulmonary ventilation), and music tempo-respiratory entrainment were recorded during exercise and recovery. Fast-tempo, positively-valenced music resulted in higher Feeling Scale scores throughout recovery periods (pmusic-moderated differences in cardiorespiratory responses. In conclusion, fast-tempo, positively-valenced music applied during recovery periods engenders a more pleasant experience. However, there is limited evidence that music expedites cardiorespiratory recovery in between bouts of high-intensity exercise. These findings have implications for athletic training strategies and individuals seeking to make high-intensity exercise sessions more pleasant. Copyright © 2016 Elsevier Inc. All rights reserved.

Integrated economic and experimental framework for screening of primary recovery technologies for high cell density CHO cultures.

Science.gov (United States)

Popova, Daria; Stonier, Adam; Pain, David; Titchener-Hooker, Nigel J; Farid, Suzanne S

2016-07-01

Increases in mammalian cell culture titres and densities have placed significant demands on primary recovery operation performance. This article presents a methodology which aims to screen rapidly and evaluate primary recovery technologies for their scope for technically feasible and cost-effective operation in the context of high cell density mammalian cell cultures. It was applied to assess the performance of current (centrifugation and depth filtration options) and alternative (tangential flow filtration (TFF)) primary recovery strategies. Cell culture test materials (CCTM) were generated to simulate the most demanding cell culture conditions selected as a screening challenge for the technologies. The performance of these technology options was assessed using lab scale and ultra scale-down (USD) mimics requiring 25-110mL volumes for centrifugation and depth filtration and TFF screening experiments respectively. A centrifugation and depth filtration combination as well as both of the alternative technologies met the performance selection criteria. A detailed process economics evaluation was carried out at three scales of manufacturing (2,000L, 10,000L, 20,000L), where alternative primary recovery options were shown to potentially provide a more cost-effective primary recovery process in the future. This assessment process and the study results can aid technology selection to identify the most effective option for a specific scenario. © 2016 The Authors. Biotechnology Journal published by WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Innovative bioelectrochemical-anaerobic-digestion integrated system for ammonia recovery and bioenergy production from ammonia-rich residues

DEFF Research Database (Denmark)

Zhang, Yifeng; Angelidaki, Irini

2015-01-01

(SMRC) and a continuous stirred tank reactor (CSTR), to prevent ammonia toxicity during anaerobic digestion by in-situ ammonia recovery and electricity production (Figure 1). In batch experiment, the ammonia concentration in the CSTR decreased from 6 to 0.7 g-N/L with an average recovery rate of 0.18 g-N/L(CSTR...... performance was enhanced. In addition, the coexistence of other cations in CSTR or cathode had no negative effect on the ammonia transportation. In continuous reactor operation, 112% extra biogas production was achieved due to ammonia recovery. High-throughput molecular sequencing analysis showed an impact...... of ammonia recovery on the microbial community composition in the integrated system. Results clearly indicate the great potential of the SMRC-CSTR-coupled system for efficient and cost-effective ammonia recovery, energy production and treatment of ammonia-rich residues....

Benefits and costs of alcoholic relationships and recovery through Al-Anon.

Science.gov (United States)

Young, Lance Brendan; Timko, Christine

2015-01-01

Codependence is an ambiguous and disputed term often used to characterize both those who maintain relationships with alcoholics and those who seek help through resources such as Al-Anon Family Groups. The purpose of this article is to better understand non-pathological reasons for maintaining alcoholic relationships and for help-seeking by detailing the costs and benefits of those choices. The costs and benefits both of remaining in an alcoholic relationship and of seeking help in Al-Anon were identified through a review of available research on alcoholic family systems, Al-Anon, and other mutual-support groups. Alcoholic relationships may benefit concerned others by preserving self-identity, social identity, values, security, stability, and hope. Costs of alcoholic relationships include physical symptoms, injury, mental problems, financial difficulty, legal troubles, and relational distress. Al-Anon is perceived beneficial for six primary reasons: Al-Anon philosophy, format, social support, accessibility, effectiveness, and potential to change the drinker's behavior. Possible costs of Al-Anon include marginalization of the concerned other, blame, codependent pathology, sexist stereotyping, substitute dependency, and perpetuating victimization. Conclusions/Importance: The identified costs and benefits of alcoholic relationships and help-seeking in Al-Anon can help to model decision-making processes using existing behavioral health frameworks without defaulting to the stigmatized and ambiguous codependence terminology.

Attentional demands and postural recovery: the effects of aging.

Science.gov (United States)

Brown, L A; Shumway-Cook, A; Woollacott, M H

1999-04-01

Cognitive demands associated with balance and locomotion may contribute to the incidence of falling among older adults. This study addressed issues related to the effects of aging on the attentional demands of recovering from an external disturbance to balance. This research also investigated whether performing a secondary cognitive task differentially affects postural recovery in young versus older adults. Fifteen young and 10 healthy older adults were exposed to a series of balance disturbances. Attentional demands were assessed using a dual task paradigm where postural recovery served as the primary task, and counting backwards served as a concurrent secondary cognitive task. The effect of the counting task was assessed by comparing kinematic variables related to feet-in-place and stepping recovery strategies. Recovering upright stance was found to be attentionally demanding in both age groups. The type of recovery strategy did not influence attentional demands in young adults; however, a hierarchy of increasing attentional demands between the ankle strategy and compensatory stepping was apparent among older adults. In addition, stepping appears to be more attentionally demanding for older adults than for younger adults. Counting backwards did not affect the type of strategy used; however, it did affect the kinematics of stepping. For both age groups, steps occurred when the center of mass was located in a more central location within the base of support when the secondary task was added. The ability to recover a stable posture following an external perturbation is more attentionally demanding for older adults than for younger adults. This would suggest that for some older adults, an increased risk for loss of balance and falls may result if sufficient attentional resources are not allocated to the task of postural recovery.

[Effect of postoperative precision nutrition therapy on postoperative recovery for advanced gastric cancer after neoadjuvant chemotherapy].

Science.gov (United States)

Zhao, Q; Li, Y; Yu, B; Yang, P G; Fan, L Q; Tan, B B; Tian, Y; Yang, A B

2018-02-23

Objective: To investigate the effect of postoperative precision nutrition therapy on postoperative recovery (PR) of patients with advanced gastric cancer (AGC) after neoadjuvant chemotherapy (NC). Methods: 71 subjects were randomly divided into 2 groups. The 34 patients of research group were treated with postoperative precision nutrition treatment according to the indirect energy measurement method. The 31 patients of control group were treated with traditional postoperative nutrition treatment. All participants were measured for body mass index (BMI), NRS2002, PG-SGA and relevant laboratory test within the 1st day before surgery and 7th day after surgery. Moreover, the difference between two groups in short-term effects were evaluated. Results: The daily energy supply of control group was 30.1%-43.74% higher than that of the experimental group ( P nutritional risk became lower in the research group ( P recovery of patients in the research group was comparable to that of the control group ( P >0.05). Moreover, the complication rate and hospitalization costs of in research group were significantly lower than that of in control group ( P nutritional risks before surgery, the nutritional index and inflammatory index in the research group were better than those in the control group. Conclusion: Postoperative precision nutrition therapy may improve the postoperative nutritional status and short-term effects of patients with AGC after NC.

Application of molten salt oxidation for the minimization and recovery of plutonium-238 contaminated wastes

International Nuclear Information System (INIS)

Wishau, R.; Ramsey, K.B.; Montoya, A.

1998-01-01

This paper presents the technical and economic feasibility of molten salt oxidation technology as a volume reduction and recovery process for 238 Pu contaminated waste. Combustible low-level waste material contaminated with 238 Pu residue is destroyed by oxidation in a 900 C molten salt reaction vessel. The combustible waste is destroyed creating carbon dioxide and steam and a small amount of ash and insoluble 2328 Pu in the spent salt. The valuable 238 Pu is recycled using aqueous recovery techniques. Experimental test results for this technology indicate a plutonium recovery efficiency of 99%. Molten salt oxidation stabilizes the waste converting it to a non-combustible waste. Thus installation and use of molten salt oxidation technology will substantially reduce the volume of 238 Pu contaminated waste. Cost-effectiveness evaluations of molten salt oxidation indicate a significant cost savings when compared to the present plans to package, or re-package, certify and transport these wastes to the Waste Isolation Pilot Plant for permanent disposal. Clear and distinct cost advantages exist for MSO when the monetary value of the recovered 238 Pu is considered

Enhanced Recovery in Thoracic Surgery: A Review

Directory of Open Access Journals (Sweden)

Vesna D. Dinic

2018-02-01

Full Text Available The main goal of enhanced recovery program after thoracic surgery is to minimize stress response, reduce postoperative pulmonary complications, and improve patient outcome, which will in addition decrease hospital stay and reduce hospital costs. As minimally invasive technique, video-assisted thoracoscopic surgery represents an important element of enhanced recovery program in thoracic surgery. Anesthetic management during preoperative, intraoperative and postoperative period is essential for the enhanced recovery. In the era of enhanced recovery protocols, non-intubated thoracoscopic procedures present a step forward. This article focuses on the key elements of the enhanced recovery program in thoracic surgery. Having reviewed recent literature, the authors highlight potential procedures and techniques that might be incorporated into the program.

Bayesian models for cost-effectiveness analysis in the presence of structural zero costs.

Science.gov (United States)

Baio, Gianluca

2014-05-20

Bayesian modelling for cost-effectiveness data has received much attention in both the health economics and the statistical literature, in recent years. Cost-effectiveness data are characterised by a relatively complex structure of relationships linking a suitable measure of clinical benefit (e.g. quality-adjusted life years) and the associated costs. Simplifying assumptions, such as (bivariate) normality of the underlying distributions, are usually not granted, particularly for the cost variable, which is characterised by markedly skewed distributions. In addition, individual-level data sets are often characterised by the presence of structural zeros in the cost variable. Hurdle models can be used to account for the presence of excess zeros in a distribution and have been applied in the context of cost data. We extend their application to cost-effectiveness data, defining a full Bayesian specification, which consists of a model for the individual probability of null costs, a marginal model for the costs and a conditional model for the measure of effectiveness (given the observed costs). We presented the model using a working example to describe its main features. © 2013 The Authors. Statistics in Medicine published by John Wiley & Sons, Ltd.

Cost-effectiveness Analysis with Influence Diagrams.

Science.gov (United States)

Arias, M; Díez, F J

2015-01-01

Cost-effectiveness analysis (CEA) is used increasingly in medicine to determine whether the health benefit of an intervention is worth the economic cost. Decision trees, the standard decision modeling technique for non-temporal domains, can only perform CEA for very small problems. To develop a method for CEA in problems involving several dozen variables. We explain how to build influence diagrams (IDs) that explicitly represent cost and effectiveness. We propose an algorithm for evaluating cost-effectiveness IDs directly, i.e., without expanding an equivalent decision tree. The evaluation of an ID returns a set of intervals for the willingness to pay - separated by cost-effectiveness thresholds - and, for each interval, the cost, the effectiveness, and the optimal intervention. The algorithm that evaluates the ID directly is in general much more efficient than the brute-force method, which is in turn more efficient than the expansion of an equivalent decision tree. Using OpenMarkov, an open-source software tool that implements this algorithm, we have been able to perform CEAs on several IDs whose equivalent decision trees contain millions of branches. IDs can perform CEA on large problems that cannot be analyzed with decision trees.

Podoconiosis patients’ willingness to pay for treatment services in Northwest Ethiopia: potential for cost recovery

Science.gov (United States)

2014-01-01

Background Podoconiosis is non-filarial elephantiasis of the lower legs. It is more commonly found in tropical Africa, Central and South America, and northwest India. In Ethiopia, a few non-governmental organizations provide free treatment to podoconiosis patients, but sustainability of free treatment and scale-up of services to reach the huge unmet need is challenged by resource limitations. We aimed to determine podoconiosis patient’s willingness to pay (WTP) for a treatment package (composed of deep cleaning of limbs with diluted antiseptic solution, soap, and water, bandaging, application of emollient on the skin, and provision of shoes), and factors associated with WTP in northwestern Ethiopia. Methods A cross-sectional study was conducted among randomly selected untreated podoconiosis patients (n = 393) in Baso Liben woreda, northwestern Ethiopia. The contingent valuation method was used with a pre-tested interviewer-administered questionnaire. Results The majority of podoconiosis patients (72.8%) were willing to pay for treatment services. The median WTP amount was 64 Birr (US$ 3.28) per person per year. More than one-third of patients (36.7%) were willing to pay at least half of the full treatment cost and 76.2% were willing to pay at least half of the cost of shoes. A multivariate analysis showed that having a higher monthly income, being a woman, older age, being aware of the role of shoes to prevent podoconiosis, and possession of a functional radio were significantly associated with higher odds of WTP. Conclusions The considerable WTP estimates showed that podoconiosis treatment could improve sustainability and service utilization. A subsidized cost recovery scheme could reduce treatment costs and more feasibility integrate podoconiosis treatment service with other NTDs and the government’s primary health care system. PMID:24642085

Cost-effective analysis of PET application in NSCLC

International Nuclear Information System (INIS)

Gu Aichun; Liu Jianjun; Sun Xiaoguang; Shi Yiping; Huang Gang

2006-01-01

Objective: To evaluate the cost-effectiveness of PET and CT application for diagnosis of non-small cell lung cancer (NSCLC) in China. Methods: Using decision analysis method the diagnostic efficiency of PET and CT for diagnosis of NSCLC in china was analysed. And also the value of cost for accurate diagnosis (CAD), cost for accurate staging (CAS) and cost for effective therapy (CAT) was calculated. Results: (1) For the accurate diagnosis, CT was much more cost-effective than PET. (2) For the accurate staging, CT was still more cost-effective than PET. (3) For the all over diagnostic and therapeutic cost, PET was more cost-effective than CT. (4) The priority of PET to CT was for the diagnosis of stage I NSCLC. Conclusion: For the management of NSCLC patient in China, CT is more cost-effective for screening, whereas PET for clinical staging and monitoring therapeutic effect. (authors)

Double-Shell Tanks System Maintenance and Recovery Needs Report

International Nuclear Information System (INIS)

SMITH, D.F.

2002-01-01

This report represents an initial effort to identify maintenance equipment needed to support critical components used for delivery of waste feed to the Waste Isolation and Treatment Plant (WTP). Rough estimates of cost benefits for selected maintenance capabilities are provided. A follow-on to this report should include a detailed cost analysis showing cost benefits and tradeoffs in selection and development of specific maintenance capabilities. Critical component failures during delivery of waste feed from the DSTs to the WTP have the potential to idle WTP facilities if the duration of the recovery operations are long enough to allow the WTP to exhaust a planned 60-day lag storage capacity for waste feed. If a critical component within the transfer route fails, current planning does not provide for an alternative HLW feed source. Critical components with relatively high failure frequencies and recovery times are identified, along with a summary of documentation regarding historical maintenance and recovery operations and planning. Components, such as mixer pumps and transfer pumps, are estimated to have relatively long recovery times due, in part, to the current practice of sending spare pumps, when needed, off-site to a remote location, for vendor refurbishment and testing prior to installation in a tank. No capability is provided on-site for pump ''run-in''. As neither the spare pumps in storage, installed pumps, or other critical components are subjected to periodic preventive maintenance, and these critical components are planned to be operated intermittently over a long period of time, component failures are to be expected. Recommendations are made for further analysis to identify specific equipment cost benefits, development costs, and tradeoffs in selection of alternatives. This new equipment will provide capabilities for component storage and maintenance in line with vendor recommendations, reduce the duration of recovery operations, and support personnel

Conceptual design on uranium recovery plant from seawater

International Nuclear Information System (INIS)

Kato, Toshiaki; Okugawa, Katsumi; Sugihara, Yutaka; Matsumura, Tsuyoshi

1999-01-01

Uranium containing in seawater is extremely low concentration, which is about 3 mg (3 ppb) per 1 ton of seawater. Recently, a report on development of a more effective collector of uranium in seawater (a radiation graft polymerization product of amidoxime onto polyethylene fiber) was issued by Japan Atomic Energy Research Institute. In this paper, an outline design of a uranium recovery plant from seawater was conducted on a base of the collector. As a result of cost estimation, the collection cost of seawater uranium using this method was much higher than that of uranium mine on land and described in the Red Book for mineral uranium cost. In order to make the seawater uranium cost comparable to the on-land uranium cost, it is necessary to establish comprehensive efforts in future technical development, such as development in absorption property of uranium with the collector, resolution method using less HCl, and so forth. (G.K.)

Commercial Demonstration of Wood Recovery, Recycling, and Value Adding Technologies

Energy Technology Data Exchange (ETDEWEB)

Auburn Machinery, Inc.

2004-07-15

This commercial demonstration project demonstrated the technical feasibility of converting low-value, underutilized and waste stream solid wood fiber material into higher valued products. With a growing need to increase product/production yield and reduce waste in most sawmills, few recovery operations and practically no data existed to support the viability of recovery operations. Prior to our efforts, most all in the forest products industry believed that recovery was difficult, extremely labor intensive, not cost effective, and that recovered products had low value and were difficult to sell. This project provided an opportunity for many within the industry to see through demonstration that converting waste stream material into higher valued products does in fact offer a solution. Our work, supported by the U.S. Department of Energy, throughout the project aimed to demonstrate a reasonable approach to reducing the millions of recoverable solid wood fiber tons that are annually treated as and converted into low value chips, mulch and fuel. Consequently sawmills continue to suffer from reduced availability of forest resources, higher raw material costs, growing waste disposal problems, increased global competition, and more pressure to operate in an Environmentally Friendly manner. It is our belief (based upon the experience of this project) that the successful mainstreaming of the recovery concept would assist in alleviating this burden as well as provide for a realistically achievable economic benefit to those who would seriously pursue the concept and tap into the rapidly growing ''GREEN'' building marketplace. Ultimately, with participation and aggressive pursuit of the recovery concept, the public would benefit in that: (1) Landfill/disposal waste volume could be reduced adding greater life to existing municipal landfill sites thereby minimizing the need to prematurely license and open added facilities. Also, there would be a cost

The cost of preventing undernutrition: cost, cost-efficiency and cost-effectiveness of three cash-based interventions on nutrition outcomes in Dadu, Pakistan.

Science.gov (United States)

Trenouth, Lani; Colbourn, Timothy; Fenn, Bridget; Pietzsch, Silke; Myatt, Mark; Puett, Chloe

2018-07-01

Cash-based interventions (CBIs) increasingly are being used to deliver humanitarian assistance and there is growing interest in the cost-effectiveness of cash transfers for preventing undernutrition in emergency contexts. The objectives of this study were to assess the costs, cost-efficiency and cost-effectiveness in achieving nutrition outcomes of three CBIs in southern Pakistan: a 'double cash' (DC) transfer, a 'standard cash' (SC) transfer and a 'fresh food voucher' (FFV) transfer. Cash and FFVs were provided to poor households with children aged 6-48 months for 6 months in 2015. The SC and FFV interventions provided $14 monthly and the DC provided $28 monthly. Cost data were collected via institutional accounting records, interviews, programme observation, document review and household survey. Cost-effectiveness was assessed as cost per case of wasting, stunting and disability-adjusted life year (DALY) averted. Beneficiary costs were higher for the cash groups than the voucher group. Net total cost transfer ratios (TCTRs) were estimated as 1.82 for DC, 2.82 for SC and 2.73 for FFV. Yet, despite the higher operational costs, the FFV TCTR was lower than the SC TCTR when incorporating the participation cost to households, demonstrating the relevance of including beneficiary costs in cost-efficiency estimations. The DC intervention achieved a reduction in wasting, at $4865 per case averted; neither the SC nor the FFV interventions reduced wasting. The cost per case of stunting averted was $1290 for DC, $882 for SC and $883 for FFV. The cost per DALY averted was $641 for DC, $434 for SC and $563 for FFV without discounting or age weighting. These interventions are highly cost-effective by international thresholds. While it is debatable whether these resource requirements represent a feasible or sustainable investment given low health expenditures in Pakistan, these findings may provide justification for continuing Pakistan's investment in national social safety

The economics of aquifer storage recovery technology

Energy Technology Data Exchange (ETDEWEB)

David, R.; Pyne, G.

2014-10-01

Aquifer storage recovery (ASR) technology is increasingly being utilized around the world for storing water underground through one or more wells during wet months and other times when water is available for storage. The water is then recovered from the same wells when needed to meet a growing variety of water supply objectives. The economics of ASR constitute the principal reason for its increasing utilization. ASR unit capital costs are typically less than half those of other water supply and water storage alternatives. Unit operating costs are usually only slightly greater than for conventional production well-fields. Marginal costs for ASR storage and recovery provide a powerful tool for making more efficient use of existing infrastructure, providing water supply sustainability and reliability at relatively low cost. The opportunity exists for a careful analysis of the net present value of ASR well-fields, addressing not only the associated capital and operating costs but also the value of the benefits achieved for each of the water supply objectives at each site. (Author)

The economics of aquifer storage recovery technology

International Nuclear Information System (INIS)

David, R.; Pyne, G.

2014-01-01

Aquifer storage recovery (ASR) technology is increasingly being utilized around the world for storing water underground through one or more wells during wet months and other times when water is available for storage. The water is then recovered from the same wells when needed to meet a growing variety of water supply objectives. The economics of ASR constitute the principal reason for its increasing utilization. ASR unit capital costs are typically less than half those of other water supply and water storage alternatives. Unit operating costs are usually only slightly greater than for conventional production well-fields. Marginal costs for ASR storage and recovery provide a powerful tool for making more efficient use of existing infrastructure, providing water supply sustainability and reliability at relatively low cost. The opportunity exists for a careful analysis of the net present value of ASR well-fields, addressing not only the associated capital and operating costs but also the value of the benefits achieved for each of the water supply objectives at each site. (Author)

Psychophysiological effects of music on acute recovery from high-intensity interval training

OpenAIRE

Jones, L; Tiller, NB; Karageorghis, CI

2016-01-01

Numerous studies have examined the multifarious effects of music applied during exercise but few have assessed the efficacy of music as an aid to recovery. Music might facilitate physiological recovery via the entrainment of respiratory rhythms with music tempo. High-intensity exercise training is not typically associated with positive affective responses, and thus ways of assuaging negative affect warrant further exploration. This study assessed the psychophysiological effects of music on ac...

Cost-effectiveness and the socialization of health care.

Science.gov (United States)

Musgrove, P

1995-01-01

The more health care is socialized, the more cost-effectiveness is an appropriate criterion for expenditure. Utility-maximizing individuals, facing divisibility of health care purchases and declining marginal health gains, and complete information about probable health improvements, should buy health care according to its cost-effectiveness. Absent these features, individual health spending will not be cost-effective; and in any case, differences in personal utilities and risk aversion will not lead to the same ranking of health care interventions for everyone. Private insurance frees consumers from concern for cost, which undermines cost-effectiveness, but lets them emphasize effectiveness, which favors value for money. This is most important for costly and cost-effective interventions, especially for poor people. Cost-effectiveness is more appropriate and easier to achieve under second-party insurance. More complete socialization of health care, via public finance, can yield greater efficiency by making insurance compulsory. Cost-effectiveness is also more attractive when taxpayers subsidize others' care: needs (effectiveness) take precedence over wants (utility). The gain in effectiveness may be greater, and the welfare loss from Pareto non-optimality smaller, in poor countries than in rich ones.

The Vessel Schedule Recovery Problem

DEFF Research Database (Denmark)

Brouer, Berit Dangaard; Plum, Christian Edinger Munk; Vaaben, Bo

Maritime transportation is the backbone of world trade and is accountable for around 3% of the worlds CO2 emissions. We present the Vessel Schedule Recovery Problem (VSRP) to evaluate a given disruption scenario and to select a recovery action balancing the trade off between increased bunker cons...... consumption and the impact on the remaining network and the customer service level. The model is applied to 4 real cases from Maersk Line. Solutions are comparable or superior to those chosen by operations managers. Cost savings of up to 58% may be achieved.......Maritime transportation is the backbone of world trade and is accountable for around 3% of the worlds CO2 emissions. We present the Vessel Schedule Recovery Problem (VSRP) to evaluate a given disruption scenario and to select a recovery action balancing the trade off between increased bunker...

The Effects of Electrostimulation and Core Exercises on Recovery After High-Intensity Exercise

Directory of Open Access Journals (Sweden)

Ahmet Mor

2017-12-01

Full Text Available Introduction and objectives: The purpose of this study was to determine the effects of electrostimulation and core exercises on recovery after high-intensity exercise. Methods: The participants of this study consists of 12 male bodybuilders who regularly train and between the ages 18-30. Tabata high intensity interval training (HIIT was applied with different recovery methods to the athletes on three different days and the recovery levels of athletes were analysed. Heart rate and blood lactate levels were measured at baseline (PRE at immediately after the HIIT (POST, at the 1 minutes after HIIT (1min, at the 5 minutes after HIIT (5min, and at the 10 minutes after HIIT (10min. On the rest days, serum lactate dehydrogenase (LDH and serum creatine kinase (CK  measurements were done to determine the muscle damage. Results: The in-group comparisons for lactate levels showed no significant difference (p>0,01. The level of lactate on the 10min was found to be significantly lower than the 5min in the core exercise group (p0,01. These results show that the lactate level reaches to the maximum level after HIIT, and the level of lactate decreases between the 5th and the 10th minutes. Discussion and conclusion: These indicate that the active recovery methods are more effective than the passive. It was found that the active recovery methods accelerate the lactate removal from the metabolism and provide effective recovery in short time during the recovery period after exercise.

Recovery of energy in a gaseous diffusion plant

International Nuclear Information System (INIS)

Ergalant, Jacques; Guais, J.-C.; Perrault, Michel; Vignet, Paul

1975-01-01

Any energy recovery, even partial, goes in the direction of savings in energy and should be sought for. The Tricastin plant, now in the course of being built, will be able to deliver several hundreds of MW for the purpose of urban and agricultural heating. The new Coredif project will more completely integrate the valorization of calories in its definition (choice of temperatures, design of the heat exchangers, recovery cycles). In fact the recent evolution in energy costs renders the otpimization of a plant equipped with a heat recovery system (1 to 2% on the cost of the uranium produced) now economically worth-while. In the same way, the choice of the site of the future plant may be conditioned by the possible uses of calories in its vicinity [fr

A prospective cohort study evaluating the cost-effectiveness of carbetocin for prevention of postpartum haemorrhage in caesarean sections.

Science.gov (United States)

Luni, Yasmin; Borakati, Aditya; Matah, Arti; Skeats, Katie; Eedarapalli, Padma

2017-07-01

Postpartum haemorrhage (PPH) is the leading cause of maternal mortality worldwide. Prophylaxis with oxytocic medication is recommended by the WHO to prevent its occurrence. Carbetocin is a newer oxytocic, with potential to lower PPH rates, reduce the total use of oxytocic drugs and lead to financial savings. Meta-analyses have confirmed a reduction in the use of additional oxytocic medication with the use of carbetocin compared to oxytocin. However, there are few studies evaluating the costs of carbetocin prophylaxis. We carried out a prospective cohort study evaluating the financial impact of carbetocin, following its introduction at our centre for caesarean section. We collected data for 400 patients in total, making this, to our knowledge, the largest study conducted on this topic. We found a significant reduction in PPH rates and the use of additional oxytocics with projected overall financial savings of £68.93 per patient with the use of carbetocin. Impact statement It is well established that carbetocin reduces the use of secondary oxytocics compared to oxytocin alone in the active management of the third stage of labour. Evidence for reduction of post-partum haemorrhage and its cost effectiveness are more equivocal. Our study demonstrates that carbetocin also reduces post-partum haemorrhage, use of blood and blood products and midwifery recovery time in the setting of caesarean section. We have also demonstrated that despite the increased index cost of carbetocin it delivers an overall substantial cost benefit. The implications of these findings are of reduced morbidity, faster recovery and cost savings in these times of austerity in the UK. It allows more efficient labour distribution of midwives, particularly in the setting of staff shortages across the NHS. A randomised control trial in this area needs to be conducted to determine the cost benefit of carbetocin and with this and post-partum haemorrhage rates as the primary outcome measures.

Cost-effectiveness evaluation of an RCT in rehabilitation after lumbar spinal fusion: a low-cost, behavioural approach is cost-effective over individual exercise therapy

DEFF Research Database (Denmark)

Søgaard, Rikke; Laurberg, Ida; Christensen, Finn B

2008-01-01

Recently, Christensen et al. reported the clinical effects of a low-cost rehabilitation program equally efficient to a relatively intensive program of individual, physiotherapist-guided exercise therapy. Yet, the low-cost approach is not fully supported as an optimal strategy until a full......-scale economic evaluation, including extra-hospital effects such as service utilization in the primary health care sector and return-to-work, is conducted. The objective of this study was to conduct such evaluation i.e. investigate the cost-effectiveness of (1) a low-cost rehabilitation regimen...... with a behavioural element and (2) a regimen of individual exercise therapy, both in comparison with usual practice, from a health economic, societal perspective. Study design was a cost-effectiveness evaluation of an RCT with a 2-year follow-up. Ninety patients having had posterolateral or circumferential fusion...

FIRM SIZE EFFECTS ON TRANSACTION COSTS

NARCIS (Netherlands)

NOOTEBOOM, B

1993-01-01

Associated with effects of scale, scope, experience and learning there are effects of firm size on transaction costs; in the stages of contact, contract and control. These effects are due to ''threshold costs'' in setting up contacts, contracts and governance schemes, and to differences with respect

Cost-effectiveness of rotavirus vaccination in Albania.

Science.gov (United States)

Ahmeti, Albana; Preza, Iria; Simaku, Artan; Nelaj, Erida; Clark, Andrew David; Felix Garcia, Ana Gabriela; Lara, Carlos; Hoestlandt, Céline; Blau, Julia; Bino, Silvia

2015-05-07

Rotavirus vaccines have been introduced in several European countries but can represent a considerable cost, particularly for countries that do not qualify for any external financial support. This study aimed to evaluate the cost-effectiveness of introducing rotavirus vaccination into Albania's national immunization program and to inform national decision-making by improving national capacity to conduct economic evaluations of new vaccines. The TRIVAC model was used to assess vaccine impact and cost-effectiveness. The model estimated health and economic outcomes attributed to 10 successive vaccinated birth cohorts (2013-2022) from a government and societal perspective. Epidemiological and economic data used in the model were based on national cost studies, and surveillance data, as well as estimates from the scientific literature. Cost-effectiveness was estimated for both the monovalent (RV1) and pentavalent vaccines (RV5). A multivariate scenario analysis (SA) was performed to evaluate the uncertainty around the incremental cost-effectiveness ratios (ICERs). With 3% discounting of costs and health benefits over the period 2013-2022, rotavirus vaccination in Albania could avert 51,172 outpatient visits, 14,200 hospitalizations, 27 deaths, 950 disability-adjusted life-years (DALYs), and gain 801 life-years. When both vaccines were compared to no vaccination, the discounted cost per DALY averted was US$ 2008 for RV1 and US$ 5047 for RV5 from a government perspective. From the societal perspective the values were US$ 517 and US$ 3556, respectively. From both the perspectives, the introduction of rotavirus vaccine to the Albanian immunization schedule is either cost-effective or highly cost-effective for a range of plausible scenarios. In most scenarios, including the base-case scenario, the discounted cost per DALY averted was less than three times the gross domestic product (GDP) per capita. However, rotavirus vaccination was not cost-effective when rotavirus cases

Cost-of-illness studies and cost-effectiveness analyses in anxiety disorders: a systematic review.

Science.gov (United States)

Konnopka, Alexander; Leichsenring, Falk; Leibing, Eric; König, Hans-Helmut

2009-04-01

To review cost-of-illness studies (COI) and cost-effectiveness analyses (CEA) conducted for anxiety disorders. Based on a database search in Pubmed, PsychINFO and NHS EED, studies were classified according to various criteria. Cost data were inflated and converted to 2005 US-$ purchasing power parities (PPP). We finally identified 20 COI and 11 CEA of which most concentrated on panic disorder (PD) and generalized anxiety disorder (GAD). Differing inclusion of cost categories limited comparability of COI. PD and GAD tended to show higher direct costs per case, but lower direct cost per inhabitant than social and specific phobias. Different measures of effectiveness severely limited comparability of CEA. Overall CEA analysed 26 therapeutic or interventional strategies mostly compared to standard treatment, 8 of them resulting in lower better effectiveness and costs than the comparator. Anxiety disorders cause considerable costs. More research on phobias, more standardised inclusion of cost categories in COI and a wider use of comparable effectiveness measures (like QALYs) in CEA is needed.

Enhanced Recovery Pathways for Improving Outcomes After Minimally Invasive Gynecologic Oncology Surgery.

Science.gov (United States)

Chapman, Jocelyn S; Roddy, Erika; Ueda, Stefanie; Brooks, Rebecca; Chen, Lee-Lynn; Chen, Lee-May

2016-07-01

To estimate whether an enhanced recovery after surgery pathway facilitates early recovery and discharge in gynecologic oncology patients undergoing minimally invasive surgery. This was a retrospective case-control study. Consecutive gynecologic oncology patients undergoing laparoscopic or robotic surgery between July 1 and November 5, 2014, were treated on an enhanced recovery pathway. Enhanced recovery pathway components included patient education, multimodal analgesia, opioid minimization, nausea prophylaxis as well as early catheter removal, ambulation, and feeding. Cases were matched in a one-to-two ratio with historical control patients on the basis of surgery type and age. Primary endpoints were length of hospital stay, rates of discharge by noon, 30-day hospital readmission rates, and hospital costs. There were 165 patients included in the final cohort, 55 of whom were enhanced recovery pathway patients. Enhanced recovery patients were more likely to be discharged on postoperative day 1 compared with patients in the control group (91% compared with 60%, Pcontrol patients (P=.03). Postoperative pain scores decreased (2.6 compared with 3.12, P=.03) despite a 30% reduction in opioid use. Average total hospital costs were decreased by 12% in the enhanced recovery group ($13,771 compared with $15,649, P=.01). Readmission rates, mortality, and reoperation rates did not differ between the two groups. An enhanced recovery pathway in patients undergoing gynecologic oncology minimally invasive surgery is associated with significant improvements in recovery time, decreased pain despite reduced opioid use, and overall lower hospital costs.

Cost-effectiveness of monitoring free flaps.

Science.gov (United States)

Subramaniam, Shiva; Sharp, David; Jardim, Christopher; Batstone, Martin D

2016-06-01

Methods of free flap monitoring have become more sophisticated and expensive. This study aims to determine the cost of free flap monitoring and examine its cost effectiveness. We examined a group of patients who had had free flaps to the head and neck over a two-year period, and combined these results with costs obtained from business managers and staff. There were 132 free flaps with a success rate of 99%. The cost of monitoring was Aus $193/flap. Clinical monitoring during this time period cost Aus$25 476 and did not lead to the salvage of any free flaps. Cost equivalence is reached between monitoring and not monitoring only at a failure rate of 15.8%. This is to our knowledge the first study to calculate the cost of clinical monitoring of free flaps, and to examine its cost-effectiveness. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. All rights reserved.

Cost-effectiveness of root caries preventive treatments.

Science.gov (United States)

Schwendicke, Falk; Göstemeyer, Gerd

2017-01-01

With a growing number of individuals retaining their teeth lifelong, often with periodontitis-induced root surface exposure, there is the need for cost-effective management strategies for root caries lesions. The present study aimed to assess the cost-effectiveness of root caries preventive treatments. Patients were simulated over 10 years using a Markov model. Four treatments were compared: No treatment, daily 225-800ppm fluoride rinses, chlorhexidine (CHX) varnish (2×/year), silver diamine fluoride (SDF) varnish (2×/year). Data from a systematic review were submitted to network meta-analysis for inferring relative efficacies of treatments. The health outcome was years of teeth being free of root caries. A mixed public-private payer perspective within 2016 German healthcare was taken, with costs being estimated from fee item catalogues or based on market prices. Populations with different numbers of teeth and tooth-level risks were modelled. Monte-Carlo microsimulations, univariate- and probabilistic sensitivity analyses were performed. In populations with 16 teeth at risk and low tooth-level risk for root caries, providing no preventive treatment was least costly, but also least effective (130 Euro, 144 years). SDF ranked next, being more costly (180 Euro), but also more effective (151 years). Payers willing to invest 8.30 Euro per root caries-free tooth-year found SDF most cost-effective. CHX varnish and fluoride rinse were not cost-effective. In populations with more teeth and high tooth-level risk, SDF was the most effective and least costly option. Root caries preventive treatments (like SDF) are effective and might even be cost-saving in high risk populations. Application of SDF can be recommended as a cost-saving treatment for prevention of root caries in patients with high risk of root caries. Copyright © 2016 Elsevier Ltd. All rights reserved.

Storage duration effect on deformation recovery of repacked alginates

Directory of Open Access Journals (Sweden)

Siti Sunarintyas

2009-09-01

Full Text Available Background: Manufacturers supply alginate impression materials as a powder that is packaged in bulk and in individual container. Some Indonesian dental suppliers often repackage the bulk alginate into individual plastic packages which are not tied tightly and stored in the display room without air conditioner. It is known that critical factors to the shelf life of alginate includer avoidance of moisture contamination which may lead to premature setting of the alginate and avoidance of high temperature which may cause depolymerization of the alginate. Purpose: The aim of this study was to determine storage duration effect of repacked alginates on deformation recovery. Methods: Two brands of alginates (Tulip®TU, and Aroma Fine DF III®AF were repacked into 120 plastic containers. The samples were stored in room condition (temperature 29° C ± 1° C, relative humidity 60% ± 10% for 1, 2, 3, 4 and 5 weeks. The alginates setting time and recovery from deformation were measured according to the ANSI/ADA specification number 18 (ISO 1563. result: The results revealed that there was decreased setting time during 5 weeks but there was slight decreased in deformation recovery after 3 weeks storage. The ANOVA showed there was no significant difference of alginates deformation recovery among the storage times (p > 0.05. Conclusion: Storage duration of repacked alginates in plastic containers during 5 weeks in room condition do not influence the alginate deformation recovery.

10 CFR 455.63 - Cost-effectiveness testing.

Science.gov (United States)

2010-01-01

... 10 Energy 3 2010-01-01 2010-01-01 false Cost-effectiveness testing. 455.63 Section 455.63 Energy..., Hospitals, Units of Local Government, and Public Care Institutions § 455.63 Cost-effectiveness testing. (a... paragraph (a) of this section, if the State plan requires the cost effectiveness of an energy conservation...

Cost and Systems Analysis of Innovative Fuel Resources Concepts

Energy Technology Data Exchange (ETDEWEB)

Schneider, Erich [Univ. of Texas, Austin, TX (United States). Nuclear and Radiation Engineering Program; Byers, M. [Univ. of Texas, Austin, TX (United States). Nuclear and Radiation Engineering Program

2017-05-04

Economically recovered uranium from seawater can have a transformative effect on the way policy makers view the long-term viability of uranium based fuel cycles. Seawater uranium, even when estimated to cost more than terrestrially mined uranium, is integral in establishing an economic backstop, thus reducing uncertainty in future nuclear power costs. While a passive recovery scheme relying on a field of polymer adsorbents prepared via radiation induced grafting has long been considered the leading technology for full scale deployment, non-trivial cost and logistical barriers persist. Consequently, university partners of the nation-wide consortium for seawater uranium recovery have developed variants of this technology, each aiming to address a substantial weakness. The focus of this NEUP project is the economic impacts of the proposed variant technologies. The team at University of Alabama has pursued an adsorbent synthesis method that replaces the synthetic fiber backbone with a natural waste product. Chitin fibers suitable for ligand grafting have been prepared from shrimp shell waste. These environmental benefits could be realized at a comparable cost to the reference fiber so long as the uptake can be increased or the chemical consumption cost decreased.

Incentive pricing and cost recovery at the basin scale.

Science.gov (United States)

Ward, Frank A; Pulido-Velazquez, Manuel

2009-01-01

Incentive pricing programs have potential to promote economically efficient water use patterns and provide a revenue source to compensate for environmental damages. However, incentive pricing may impose disproportionate costs and aggravate poverty where high prices are levied for basic human needs. This paper presents an analysis of a two-tiered water pricing system that sets a low price for subsistence needs, while charging a price equal to marginal cost, including environmental cost, for discretionary uses. This pricing arrangement can promote efficient and sustainable water use patterns, goals set by the European Water Framework Directive, while meeting subsistence needs of poor households. Using data from the Rio Grande Basin of North America, a dynamic nonlinear program, maximizes the basin's total net economic and environmental benefits subject to several hydrological and institutional constraints. Supply costs, environmental costs, and resource costs are integrated in a model of a river basin's hydrology, economics, and institutions. Three programs are compared: (1) Law of the River, in which water allocations and prices are determined by rules governing water transfers; (2) marginal cost pricing, in which households pay the full marginal cost of supplying treated water; (3) two-tiered pricing, in which households' subsistence water needs are priced cheaply, while discretionary uses are priced at efficient levels. Compared to the Law of the River and marginal cost pricing, two-tiered pricing performs well for efficiency and adequately for sustainability and equity. Findings provide a general framework for formulating water pricing programs that promote economically and environmentally efficient water use programs while also addressing other policy goals.

Cost-effectiveness of tubal patency tests.

Science.gov (United States)

Verhoeve, H R; Moolenaar, L M; Hompes, P; van der Veen, F; Mol, B W J

2013-04-01

Guidelines are not in agreement on the most effective diagnostic scenario for tubal patency testing; therefore, we evaluated the cost-effectiveness of invasive tubal testing in subfertile couples compared with no testing and treatment. Cost-effectiveness analysis. Decision analytic framework. Computer-simulated cohort of subfertile women. We evaluated six scenarios: (1) no tests and no treatment; (2) immediate treatment without tubal testing; (3) delayed treatment without tubal testing; (4) hysterosalpingogram (HSG), followed by immediate or delayed treatment, according to diagnosis (tailored treatment); (5) HSG and a diagnostic laparoscopy (DL) in case HSG does not prove tubal patency, followed by tailored treatment; and (6) DL followed by tailored treatment. Expected cumulative live births after 3 years. Secondary outcomes were cost per couple and the incremental cost-effectiveness ratio. For a 30-year-old woman with otherwise unexplained subfertility for 12 months, 3-year cumulative live birth rates were 51.8, 78.1, 78.4, 78.4, 78.6 and 78.4%, and costs per couple were €0, €6968, €5063, €5410, €5405 and €6163 for scenarios 1, 2, 3, 4, 5 and 6, respectively. The incremental cost-effectiveness ratios compared with scenario 1 (reference strategy), were €26,541, €19,046, €20,372, €20,150 and €23,184 for scenarios 2, 3, 4, 5 and 6, respectively. Sensitivity analysis showed the model to be robust over a wide range of values for the variables. The most cost-effective scenario is to perform no diagnostic tubal tests and to delay in vitro fertilisation (IVF) treatment for at least 12 months for women younger than 38 years old, and to perform no tubal tests and start immediate IVF treatment from the age of 39 years. If an invasive diagnostic test is planned, HSG followed by tailored treatment, or a DL if HSG shows no tubal patency, is more cost-effective than DL. © 2013 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2013

A Systematic Review of Cost-Effectiveness Studies Reporting Cost-per-DALY Averted.

Directory of Open Access Journals (Sweden)

Peter J Neumann

Full Text Available Calculating the cost per disability-adjusted life years (DALYs averted associated with interventions is an increasing popular means of assessing the cost-effectiveness of strategies to improve population health. However, there has been no systematic attempt to characterize the literature and its evolution.We conducted a systematic review of cost-effectiveness studies reporting cost-per-DALY averted from 2000 through 2015. We developed the Global Health Cost-Effectiveness Analysis (GHCEA Registry, a repository of English-language cost-per-DALY averted studies indexed in PubMed. To identify candidate studies, we searched PubMed for articles with titles or abstracts containing the phrases "disability-adjusted" or "DALY". Two reviewers with training in health economics independently reviewed each article selected in our abstract review, gathering information using a standardized data collection form. We summarized descriptive characteristics on study methodology: e.g., intervention type, country of study, study funder, study perspective, along with methodological and reporting practices over two time periods: 2000-2009 and 2010-2015. We analyzed the types of costs included in analyses, the study quality on a scale from 1 (low to 7 (high, and examined the correlation between diseases researched and the burden of disease in different world regions.We identified 479 cost-per-DALY averted studies published from 2000 through 2015. Studies from Sub-Saharan Africa comprised the largest portion of published studies. The disease areas most commonly studied were communicable, maternal, neonatal, and nutritional disorders (67%, followed by non-communicable diseases (28%. A high proportion of studies evaluated primary prevention strategies (59%. Pharmaceutical interventions were commonly assessed (32% followed by immunizations (28%. Adherence to good practices for conducting and reporting cost-effectiveness analysis varied considerably. Studies mainly included

Comparative costs and cost-effectiveness of behavioural interventions as part of HIV prevention strategies.

Science.gov (United States)

Hsu, Justine; Zinsou, Cyprien; Parkhurst, Justin; N'Dour, Marguerite; Foyet, Léger; Mueller, Dirk H

2013-01-01

Behavioural interventions have been widely integrated in HIV/AIDS social marketing prevention strategies and are considered valuable in settings with high levels of risk behaviours and low levels of HIV/AIDS awareness. Despite their widespread application, there is a lack of economic evaluations comparing different behaviour change communication methods. This paper analyses the costs to increase awareness and the cost-effectiveness to influence behaviour change for five interventions in Benin. Cost and cost-effectiveness analyses used economic costs and primary effectiveness data drawn from surveys. Costs were collected for provider inputs required to implement the interventions in 2009 and analysed by 'person reached'. Cost-effectiveness was analysed by 'person reporting systematic condom use'. Sensitivity analyses were performed on all uncertain variables and major assumptions. Cost-per-person reached varies by method, with public outreach events the least costly (US$2.29) and billboards the most costly (US$25.07). Influence on reported behaviour was limited: only three of the five interventions were found to have a significant statistical correlation with reported condom use (i.e. magazines, radio broadcasts, public outreach events). Cost-effectiveness ratios per person reporting systematic condom use resulted in the following ranking: magazines, radio and public outreach events. Sensitivity analyses indicate rankings are insensitive to variation of key parameters although ratios must be interpreted with caution. This analysis suggests that while individual interventions are an attractive use of resources to raise awareness, this may not translate into a cost-effective impact on behaviour change. The study found that the extensive reach of public outreach events did not seem to influence behaviour change as cost-effectively when compared with magazines or radio broadcasts. Behavioural interventions are context-specific and their effectiveness influenced by a

Delayed gastrointestinal recovery after abdominal operation – role of alvimopan

Directory of Open Access Journals (Sweden)

Berger NG

2015-08-01

Full Text Available Nicholas G Berger, Timothy J Ridolfi, Kirk A LudwigDivision of Colorectal Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin USAAbstract: Postoperative Ileus (POI, which occurs after surgical manipulation of the bowel during abdominal operations, is associated with prolonged hospital stay, increasing medical costs, and delayed advancement of enteral diet, which contributes to a significant economic burden on the healthcare system. The use of accelerated care pathways has shown to positively impact gut function, but inevitable postoperative opioid use contributes to POI. Alvimopan is a peripherally acting µ-opioid receptor antagonist designed to mitigate antimotility effects of opioids. In our review, we examined ten trials on alvimopan's use after abdominal operations. Several of the earlier studies on patients undergoing bowel resection showed correlations between the study group and GI recovery as defined by passage of flatus, first bowel movement, and time to readiness for discharge. Data in patients undergoing total abdominal hysterectomy showed similarly decreased GI recovery time. Additionally, data within the past few years shows alvimopan is associated with more rapid GI recovery time in patients undergoing radical cystectomy. Based on our review, use of alvimopan remains a safe and potentially cost-effective means of reducing POI in patients following open GI surgery, radical cystectomy, and total abdominal hysterectomy, and should be employed following these abdominal operations.Keywords: postoperative ileus, alvimopan, ileus, bowel resection, return of bowel function

Cost and cost-effectiveness of PPM-DOTS for tuberculosis control: evidence from India.

OpenAIRE

Floyd, Katherine; Arora, V. K.; Murthy, K. J. R.; Lonnroth, Knut; Singla, Neeta; Akbar, Y.; Zignol, Matteo; Uplekar, Mukund

2006-01-01

OBJECTIVE: To assess the cost and cost-effectiveness of the Public-Private Mix DOTS (PPM-DOTS) strategy for tuberculosis (TB) control in India. METHODS: We collected data on the costs and effects of pilot PPM-DOTS projects in Delhi and Hyderabad using documentary data and interviews. The cost of PPM-DOTS was compared with public sector DOTS (i.e. DOTS delivered through public sector facilities only) and non-DOTS treatment in the private sector. Costs for 2002 in US$ were assessed for the publ...

Clinical benefits, costs, and cost-effectiveness of neonatal intensive care in Mexico.

Directory of Open Access Journals (Sweden)

Jochen Profit

2010-12-01

Full Text Available Neonatal intensive care improves survival, but is associated with high costs and disability amongst survivors. Recent health reform in Mexico launched a new subsidized insurance program, necessitating informed choices on the different interventions that might be covered by the program, including neonatal intensive care. The purpose of this study was to estimate the clinical outcomes, costs, and cost-effectiveness of neonatal intensive care in Mexico.A cost-effectiveness analysis was conducted using a decision analytic model of health and economic outcomes following preterm birth. Model parameters governing health outcomes were estimated from Mexican vital registration and hospital discharge databases, supplemented with meta-analyses and systematic reviews from the published literature. Costs were estimated on the basis of data provided by the Ministry of Health in Mexico and World Health Organization price lists, supplemented with published studies from other countries as needed. The model estimated changes in clinical outcomes, life expectancy, disability-free life expectancy, lifetime costs, disability-adjusted life years (DALYs, and incremental cost-effectiveness ratios (ICERs for neonatal intensive care compared to no intensive care. Uncertainty around the results was characterized using one-way sensitivity analyses and a multivariate probabilistic sensitivity analysis. In the base-case analysis, neonatal intensive care for infants born at 24-26, 27-29, and 30-33 weeks gestational age prolonged life expectancy by 28, 43, and 34 years and averted 9, 15, and 12 DALYs, at incremental costs per infant of US$11,400, US$9,500, and US$3,000, respectively, compared to an alternative of no intensive care. The ICERs of neonatal intensive care at 24-26, 27-29, and 30-33 weeks were US$1,200, US$650, and US$240, per DALY averted, respectively. The findings were robust to variation in parameter values over wide ranges in sensitivity analyses

Gedanken Experiments in Educational Cost Effectiveness

Science.gov (United States)

Brudner, Harvey J.

1978-01-01

Discusses the effectiveness of cost determining techniques in education. The areas discussed are: education and management; cost-effectiveness models; figures of merit determination; and the implications as they relate to the areas of audio-visual and computer educational technology. (Author/GA)

IDC reengineering Phase 2 & 3 US industry standard cost estimate summary

Energy Technology Data Exchange (ETDEWEB)

Harris, James M. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Huelskamp, Robert M. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2015-01-01

Sandia National Laboratories has prepared a ROM cost estimate for budgetary planning for the IDC Reengineering Phase 2 & 3 effort, using a commercial software cost estimation tool calibrated to US industry performance parameters. This is not a cost estimate for Sandia to perform the project. This report provides the ROM cost estimate and describes the methodology, assumptions, and cost model details used to create the ROM cost estimate. ROM Cost Estimate Disclaimer Contained herein is a Rough Order of Magnitude (ROM) cost estimate that has been provided to enable initial planning for this proposed project. This ROM cost estimate is submitted to facilitate informal discussions in relation to this project and is NOT intended to commit Sandia National Laboratories (Sandia) or its resources. Furthermore, as a Federally Funded Research and Development Center (FFRDC), Sandia must be compliant with the Anti-Deficiency Act and operate on a full-cost recovery basis. Therefore, while Sandia, in conjunction with the Sponsor, will use best judgment to execute work and to address the highest risks and most important issues in order to effectively manage within cost constraints, this ROM estimate and any subsequent approved cost estimates are on a 'full-cost recovery' basis. Thus, work can neither commence nor continue unless adequate funding has been accepted and certified by DOE.

Effect of Cytoflavin on Early Postanesthetic Recovery of Cancer Patients

Directory of Open Access Journals (Sweden)

K. F. Fatullayeva

2008-01-01

Full Text Available Objective: to evaluate the effect of the metabolic antihypoxant cytoflavin on the course of early postanesthetic recovery in patients operated on for various cancers. Subjects and methods: Fifty-seven patients aged 30 to 65 years, operated on for gynecological cancer, were examined. The patients were divided into 2 groups: 1 28 patients who took cytoflavin and 2 29 who did not. At the end of an operation, the agent was intravenously injected in a dose of 10 ml in a mixture with an equal volume of 0.9% sodium chloride solution. Thiopental sodium was used for initial anesthesia; arduan was employed to maintain muscle relaxation. Neuroleptic analgesia with fentanyl and droperidol or ataralgesia (fentanyl + relanium was applied in both groups. The levels of hemoglobin, glucose, sodium, potassium, calcium, malonic dialdehyde (MDA (Andreyev’s test, antioxidative activity (AOA (Semenov’s test were measured to evaluate the functional state of patients. The rating system for determining the recovery of consciousness, respiration, and motor activity, proposed by Aldret and Kroulik [8], and Bidway’s psychological testing, blood oxygen saturation and cardiac performance monitoring (TRITON, Russia and some others were used to evaluate the efficacy of the drug in the early postanesthetic period. The results were statistically processed using Microsoft Excel and a package of Biostatistics 6.0. Results. The use of cytoflavin at the end of surgery has been established to have a beneficial effect on the early recovery period. This is manifested as shorter recovery of consciousness and respiration mainly in the ataralgesia group; fair oxygen saturation, lower MDA concentrations and higher AOA are revealed. Conclusion. Cytoflavin significantly reduces the recovery of consciousness and adequate respiration and the incidence of the fever, muscle tremor syndrome and fails to favor the occurrence of hypoglycemia. Inclusion of cytoflavin into a complex of

Effectiveness of the food recovery at the retailing stage under shelf life uncertainty: An application to Italian food chains

International Nuclear Information System (INIS)

Muriana, Cinzia

2015-01-01

Highlights: • The food recovery is seen as suitable way to manage food near to its expiry date. • The variability of the products shelf life must be taken into account. • The paper addresses the mathematic modeling of the profit related to food recovery. • The optimal time to withdraw the products is determinant for food recovery. - Abstract: Food losses represent a significant issue affecting food supply chains. The possibility of recovering such products can be seen as an effective way to reduce such a phenomenon, improve supply chain performances and ameliorate the conditions of undernourished people. The topic has been already investigated by a previous paper enforcing the hypothesis of deterministic and constant Shelf Life (SL) of products. However, such a model cannot be properly extended to products affected by uncertainties of the SL as it does not take into account the deterioration costs and loss of profits due to the overcoming of the SL within the cycle time. Thus the present paper presents an extension of the previous one under stochastic conditions of the food quality. Differently from the previous publication, this work represents a general model applicable to all supply chains, especially to those managing fresh products characterized by uncertain SL such as fruits and vegetables. The deterioration costs and loss of profits are included in the model and the optimal time at which to withdraw the products from the shelves as well as the quantities to be shipped at each alternative destination have been determined. A comparison of the proposed model with that reported in the previous publication has been carried out in order to underline the impact of the SL variability on the optimality conditions. The results show that the food recovery strategy in the presence of uncertainty of the food quality is rewarding, even if the optimal profit is lower than that of the deterministic case

Effectiveness of the food recovery at the retailing stage under shelf life uncertainty: An application to Italian food chains

Energy Technology Data Exchange (ETDEWEB)

Muriana, Cinzia, E-mail: cinzia.muriana@unipa.it

2015-07-15

Highlights: • The food recovery is seen as suitable way to manage food near to its expiry date. • The variability of the products shelf life must be taken into account. • The paper addresses the mathematic modeling of the profit related to food recovery. • The optimal time to withdraw the products is determinant for food recovery. - Abstract: Food losses represent a significant issue affecting food supply chains. The possibility of recovering such products can be seen as an effective way to reduce such a phenomenon, improve supply chain performances and ameliorate the conditions of undernourished people. The topic has been already investigated by a previous paper enforcing the hypothesis of deterministic and constant Shelf Life (SL) of products. However, such a model cannot be properly extended to products affected by uncertainties of the SL as it does not take into account the deterioration costs and loss of profits due to the overcoming of the SL within the cycle time. Thus the present paper presents an extension of the previous one under stochastic conditions of the food quality. Differently from the previous publication, this work represents a general model applicable to all supply chains, especially to those managing fresh products characterized by uncertain SL such as fruits and vegetables. The deterioration costs and loss of profits are included in the model and the optimal time at which to withdraw the products from the shelves as well as the quantities to be shipped at each alternative destination have been determined. A comparison of the proposed model with that reported in the previous publication has been carried out in order to underline the impact of the SL variability on the optimality conditions. The results show that the food recovery strategy in the presence of uncertainty of the food quality is rewarding, even if the optimal profit is lower than that of the deterministic case.

[Incremental cost effectiveness of multifocal cataract surgery].

Science.gov (United States)

Pagel, N; Dick, H B; Krummenauer, F

2007-02-01

Supplementation of cataract patients with multifocal intraocular lenses involves an additional financial investment when compared to the corresponding monofocal supplementation, which usually is not funded by German health care insurers. In the context of recent resource allocation discussions, however, the cost effectiveness of multifocal cataract surgery could become an important rationale. Therefore an evidence-based estimation of its cost effectiveness was carried out. Three independent meta-analyses were implemented to estimate the gain in uncorrected near visual acuity and best corrected visual acuity (vision lines) as well as the predictability (fraction of patients without need for reading aids) of multifocal supplementation. Study reports published between 1995 and 2004 (English or German language) were screened for appropriate key words. Meta effects in visual gain and predictability were estimated by means and standard deviations of the reported effect measures. Cost data were estimated by German DRG rates and individual lens costs; the cost effectiveness of multifocal cataract surgery was then computed in terms of its marginal cost effectiveness ratio (MCER) for each clinical benefit endpoint; the incremental costs of multifocal versus monofocal cataract surgery were further estimated by means of their respective incremental cost effectiveness ratio (ICER). An independent meta-analysis estimated the complication profiles to be expected after monofocal and multifocal cataract surgery in order to evaluate expectable complication-associated additional costs of both procedures; the marginal and incremental cost effectiveness estimates were adjusted accordingly. A sensitivity analysis comprised cost variations of +/- 10 % and utility variations alongside the meta effect estimate's 95 % confidence intervals. Total direct costs from the health care insurer's perspective were estimated 3363 euro, associated with a visual meta benefit in best corrected visual

Cost-effective treatment for the couple with infertility.

Science.gov (United States)

Van Voorhis, B J; Syrop, C H

2000-12-01

Although the evaluation of cost-effective approaches to infertility treatment remains in its infancy, several important principles have emerged from the initial studies in this field. Currently, in treating couples with infertility without tubal disease or severe male-factor infertility, the most cost-effective approach is to start with IUI or superovulation-IUI treatments before resorting to IVF procedures. The woman's age and number of sperm present for insemination are significant factors influencing cost-effectiveness. The influence of certain diagnoses on the cost-effectiveness of infertility treatments requires further study. Even when accounting for the costs associated with multiple gestations and premature deliveries, the cost of IVF decreases within the range of other cost-effective medical procedures and decreases to less than the willingness to pay for these procedures. Indeed, for patients with severe tubal disease, IVF has been found to be more cost-effective than surgical repair. The cost-effectiveness of IVF will likely improve as success rates show continued improvements over the course of time. In addition, usefulness of embryo selection and practices to reduce the likelihood of high-order multiple pregnancies, without reductions in pregnancy rates, will significantly impact cost-effectiveness. The exclusion of infertility treatments from insurance plans is unfortunate and accentuates the importance of physicians understanding the economics of infertility treatment with costs that are often passed directly to the patient. The erroneous economic policies and judgments that have led to inequities in access to infertility health care should not be tolerated.

49 CFR 639.21 - Determination of cost-effectiveness.

Science.gov (United States)

2010-10-01

... 49 Transportation 7 2010-10-01 2010-10-01 false Determination of cost-effectiveness. 639.21... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CAPITAL LEASES Cost-Effectiveness § 639.21 Determination of cost...-effectiveness comparison as described in this subpart, it may ask FTA to approve an alternate form of cost...

The evolving regulation of uranium recovery operations in the United States of America: Innovative approaches are necessary for cost effective regulatory oversight

International Nuclear Information System (INIS)

Thompson, A.J.; Lehrenbaum, W.U.; Lashway, D.C.

2002-01-01

The US domestic uranium industry is at a crossroads. Historic low prices for uranium, combined with stringent and often irrational regulatory requirements, pose a very real threat to the industry's continued viability. The Nuclear Regulatory Commission has taken a number of innovative steps to reform and rationalize its regulatory programme. However, if the domestic uranium recovery industry is to remain viable, additional steps toward innovation and reform are needed, and effective implementation of reforms adopted by the Commission is essential. (author)

Changes in Federal Water Project Repayment Policies Can Reduce Federal Costs.

Science.gov (United States)

1981-08-07

a reimburs - able purpose, the users should share in cost recovery. RECOMMENDATIONS To provide for equitable cost reimbursement on underutilized...Department of the Interior’s Bureau of Reclamation that do not ensure fair and timely recovery of water projects’ reimbursable costs. We made this...such costs for reimbursable project purposes and considering them in future water price determinations, agencies often reas- signed them to

Cost-effectiveness analysis of sandhill crane habitat management

Science.gov (United States)

Kessler, Andrew C.; Merchant, James W.; Shultz, Steven D.; Allen, Craig R.

2013-01-01

Invasive species often threaten native wildlife populations and strain the budgets of agencies charged with wildlife management. We demonstrate the potential of cost-effectiveness analysis to improve the efficiency and value of efforts to enhance sandhill crane (Grus canadensis) roosting habitat. We focus on the central Platte River in Nebraska (USA), a region of international ecological importance for migrating avian species including sandhill cranes. Cost-effectiveness analysis is a valuation process designed to compare alternative actions based on the cost of achieving a pre-determined objective. We estimated costs for removal of invasive vegetation using geographic information system simulations and calculated benefits as the increase in area of sandhill crane roosting habitat. We generated cost effectiveness values for removing invasive vegetation on 7 land parcels and for the entire central Platte River to compare the cost-effectiveness of management at specific sites and for the central Platte River landscape. Median cost effectiveness values for the 7 land parcels evaluated suggest that costs for creating 1 additional hectare of sandhill crane roosting habitat totaled US $1,595. By contrast, we found that creating an additional hectare of sandhill crane roosting habitat could cost as much as US $12,010 for some areas in the central Platte River, indicating substantial cost savings can be achieved by using a cost effectiveness analysis to target specific land parcels for management. Cost-effectiveness analysis, used in conjunction with geographic information systems, can provide decision-makers with a new tool for identifying the most economically efficient allocation of resources to achieve habitat management goals.

Training effectiveness vs. cost effectiveness: The next millennium challenge

International Nuclear Information System (INIS)

Coe, Richard P.

2003-01-01

With the advent of the new millennium and energy deregulation, organizations will be challenged to be cost competitive and profitable. Deregulation in the US energy industry will force utilities and, more specifically, commercial nuclear power production to unprecedented cost control measures. It will also renew the fires of debate about costs vs. safety. With personnel costs being the single largest expenditure for most organizations management will be faced with constant dilemmas of competition for scarce resources. Salaries, benefits and training costs will be under greater scrutiny. Training resources and programs will face increased pressure to be job related, based on conservative requirements and more cost effective than in the past. For nearly two decades the US National Academy for Nuclear Training (NANT) has developed and used industry-wide accreditation and evaluation standards based on the Systematic Approach to Training (SAT). This process assures that existing and emerging technical training is constantly reviewed and evaluated against standardized criteria to assure job relatedness and enhanced job performance. The process also requires management to approve, actively participate in and support the training of NPP personnel. Instructors must be highly skilled and well trained in the SAT process and various instructional strategies. The SAT process is grounded in five interlocking keystone steps; Analysis - Design - Development - Implementation - Evaluation (ADDIE). Evaluation of training is often said to be the most crucial and most difficult step. Here is where an organization determines if the training is effective and meeting the legitimate needs of all of the stakeholders. This QA/QC aspect of training must be an ongoing process involving management, instructors and the students. It is only through the discipline of an SAT based evaluation process that an organization can truly determine if the training is efficient, effective, cost effective and

[Cost-Effectiveness and Cost-Utility Analyses of Antireflux Medicine].

Science.gov (United States)

Gockel, Ines; Lange, Undine Gabriele; Schürmann, Olaf; Jansen-Winkeln, Boris; Sibbel, Rainer; Lyros, Orestis; von Dercks, Nikolaus

2018-04-12

Laparoscopic antireflux surgery and medical therapy with proton pump inhibitors are gold standards of gastroesophageal reflux treatment. On account of limited resources and increasing healthcare needs and costs, in this analysis, not only optimal medical results, but also superiority in health economics of these 2 methods are evaluated. We performed an electronic literature survey in MEDLINE, PubMed, Cochrane Library, ISRCTN (International Standard Randomization Controlled Trial Number) as well as in the NHS Economic Evaluation Database, including studies published until 1/2017. Only studies considering the effect size of QALY (Quality-Adjusted Life Years) (with respect to different quality of life-scores) as primary outcome comparing laparoscopic fundoplication and medical therapy were included. Criteria of comparison were ICER (Incremental Cost-Effectiveness Ratio) and ICUR (Incremental Cost-Utility Ratio). Superiority of the respective treatment option for each publication was worked out. In total, 18 comparative studies were identified in the current literature with respect to above-mentioned search terms, qualifying for the defined inclusion criteria. Six studies were finally selected for analyses. Out of 6 publications, 3 showed superiority of laparoscopic fundoplication over long-term medical management based on current cost-effectiveness data. Limitations were related to different time intervals, levels of evidence of studies and underlying resources/costs of analyses, healthcare systems and applied quality of life instruments. Future prospective, randomized trials should examine this comparison in greater detail. Additionally, there is a large potential for further research in the health economics assessment of early diagnosis and prevention measures of reflux disease and Barrett's esophagus/carcinoma. © Georg Thieme Verlag KG Stuttgart · New York.

Costs of diarrheal disease and the cost-effectiveness of a rotavirus vaccination program in kyrgyzstan.

Science.gov (United States)

Flem, Elmira T; Latipov, Renat; Nurmatov, Zuridin S; Xue, Yiting; Kasymbekova, Kaliya T; Rheingans, Richard D

2009-11-01

We examined the cost-effectiveness of a rotavirus immunization program in Kyrgyzstan, a country eligible for vaccine funding from the GAVI Alliance. We estimated the burden of rotavirus disease and its economic consequences by using national and international data. A cost-effectiveness analysis was conducted from government and societal perspectives, along with a range of 1-way sensitivity analyses. Rotavirus-related hospitalizations and outpatient visits cost US$580,864 annually, of which $421,658 (73%) is direct medical costs and $159,206 (27%) is nonmedical and indirect costs. With 95% coverage, vaccination could prevent 75% of rotavirus-related hospitalizations and deaths and 56% of outpatient visits and could avert $386,193 (66%) in total costs annually. The medical break-even price at which averted direct medical costs equal vaccination costs is $0.65/dose; the societal break-even price is $1.14/dose for a 2-dose regimen. At the current GAVI Alliance-subsidized vaccine price of $0.60/course, rotavirus vaccination is cost-saving for the government. Vaccination is cost-effective at a vaccine price $9.41/dose, according to the cost-effectiveness standard set by the 2002 World Health Report. Addition of rotavirus vaccines to childhood immunization in Kyrgyzstan could substantially reduce disease burden and associated costs. Vaccination would be cost-effective from the national perspective at a vaccine price $9.41 per dose.

The Potential Cost-Effectiveness of Amblyopia Screening Programs

Science.gov (United States)

Rein, David B.; Wittenborn, John S.; Zhang, Xinzhi; Song, Michael; Saaddine, Jinan B.

2013-01-01

Background To estimate the incremental cost-effectiveness of amblyopia screening at preschool and kindergarten, we compared the costs and benefits of 3 amblyopia screening scenarios to no screening and to each other: (1) acuity/stereopsis (A/S) screening at kindergarten, (2) A/S screening at preschool and kindergarten, and (3) photoscreening at preschool and A/S screening at kindergarten. Methods We programmed a probabilistic microsimulation model of amblyopia natural history and response to treatment with screening costs and outcomes estimated from 2 state programs. We calculated the probability that no screening and each of the 3 interventions were most cost-effective per incremental quality-adjusted life year (QALY) gained and case avoided. Results Assuming a minimal 0.01 utility loss from monocular vision loss, no screening was most cost-effective with a willingness to pay (WTP) of less than $16,000 per QALY gained. A/S screening at kindergarten alone was most cost-effective between a WTP of $17,000 and $21,000. A/S screening at preschool and kindergarten was most cost-effective between a WTP of $22,000 and $75,000, and photoscreening at preschool and A/S screening at kindergarten was most cost-effective at a WTP greater than $75,000. Cost-effectiveness substantially improved when assuming a greater utility loss. All scenarios were cost-effective when assuming a WTP of $10,500 per case of amblyopia cured. Conclusions All 3 screening interventions evaluated are likely to be considered cost-effective relative to many other potential public health programs. The choice of screening option depends on budgetary resources and the value placed on monocular vision loss prevention by funding agencies. PMID:21877675

Tuition fees and sunk-cost effects

NARCIS (Netherlands)

Ketel, N.; Linde, J.; Oosterbeek, H.; van der Klaauw, B.

2016-01-01

This article reports on a field experiment testing for sunk-cost effects in an education setting. Students signing up for extra-curricular tutorial sessions randomly received a discount on the tuition fee. The sunk-cost effect predicts that students who pay more will attend more tutorial sessions,

Cost and cost-effectiveness of tuberculosis treatment shortening: a model-based analysis.

Science.gov (United States)

Gomez, G B; Dowdy, D W; Bastos, M L; Zwerling, A; Sweeney, S; Foster, N; Trajman, A; Islam, M A; Kapiga, S; Sinanovic, E; Knight, G M; White, R G; Wells, W A; Cobelens, F G; Vassall, A

2016-12-01

Despite improvements in treatment success rates for tuberculosis (TB), current six-month regimen duration remains a challenge for many National TB Programmes, health systems, and patients. There is increasing investment in the development of shortened regimens with a number of candidates in phase 3 trials. We developed an individual-based decision analytic model to assess the cost-effectiveness of a hypothetical four-month regimen for first-line treatment of TB, assuming non-inferiority to current regimens of six-month duration. The model was populated using extensive, empirically-collected data to estimate the economic impact on both health systems and patients of regimen shortening for first-line TB treatment in South Africa, Brazil, Bangladesh, and Tanzania. We explicitly considered 'real world' constraints such as sub-optimal guideline adherence. From a societal perspective, a shortened regimen, priced at USD1 per day, could be a cost-saving option in South Africa, Brazil, and Tanzania, but would not be cost-effective in Bangladesh when compared to one gross domestic product (GDP) per capita. Incorporating 'real world' constraints reduces cost-effectiveness. Patient-incurred costs could be reduced in all settings. From a health service perspective, increased drug costs need to be balanced against decreased delivery costs. The new regimen would remain a cost-effective option, when compared to each countries' GDP per capita, even if new drugs cost up to USD7.5 and USD53.8 per day in South Africa and Brazil; this threshold was above USD1 in Tanzania and under USD1 in Bangladesh. Reducing the duration of first-line TB treatment has the potential for substantial economic gains from a patient perspective. The potential economic gains for health services may also be important, but will be context-specific and dependent on the appropriate pricing of any new regimen.

The Effects of Total Sleep Deprivation and Recovery Sleep on Cognitive Performance and Brain Function

National Research Council Canada - National Science Library

Gillin, J

2003-01-01

..... Even less is known about the cerebral effects of recovery sleep. The objective of this study is to investigate the effects of 2 full nights of sleep loss and 2 full nights of recovery sleep on cognitive performance and brain function...

Some Observations on Cost-Effectiveness Analysis in Education.

Science.gov (United States)

Geske, Terry G.

1979-01-01

The general nature of cost-effectiveness analysis is discussed, analytical frameworks for conducting cost-effectiveness studies are described, and some of the problems inherent in measuring educational costs and in assessing program effectiveness are addressed. (Author/IRT)

Recovery of uranium (VI) from low level aqueous radioactive waste

International Nuclear Information System (INIS)

Kulshrestha, Mukul

1996-01-01

Investigation was undertaken to evaluate the uranium (VI) removal and recovery potential of a naturally occurring, nonviable macrofungus, Ganoderma Lucidum from the simulated low level aqueous nuclear waste. These low level waste waters discharged from nuclear mine tailings and nuclear power reactors have a typical U(VI) concentration of 10-100 mg/L. It is possible to recover this uranium economically with the advent of biosorption as a viable technology. Extensive laboratory studies have revealed Ganoderma Lucidum to be a potential biosorbent with a specific uptake of 2.75 mg/g at an equilibrium U(VI) concentration of 10 mg/L at pH 4.5. To recover the sorbed U(VI), the studies indicated 0.2N Na 2 CO 3 to be an effective elutant. The kinetics of U(VI) desorption from loaded Ganoderma Lucidum with 0.2N Na 2 CO 3 as elutant, was found to be rapid with more than 75% recovery occurring in the first five minutes, the specific metal release rate being 0.102 mg/g/min. The equilibrium data fitted to a linearised Freundlich plot and exhibited a near 100% recovery of sorbed U(VI), clearly revealing a cost-effective method of recovery of precious uranium from low level wastewater. (author). 7 refs., 3 figs., 1 tab

Cost-effective conservation planning: lessons from economics.

Science.gov (United States)

Duke, Joshua M; Dundas, Steven J; Messer, Kent D

2013-08-15

Economists advocate that the billions of public dollars spent on conservation be allocated to achieve the largest possible social benefit. This is "cost-effective conservation"-a process that incorporates both monetized benefits and costs. Though controversial, cost-effective conservation is poorly understood and rarely implemented by planners. Drawing from the largest publicly financed conservation programs in the United States, this paper seeks to improve the communication from economists to planners and to overcome resistance to cost-effective conservation. Fifteen practical lessons are distilled, including the negative implications of limiting selection with political constraints, using nonmonetized benefit measures or benefit indices, ignoring development risk, using incomplete cost measures, employing cost measures sequentially, and using benefit indices to capture costs. The paper highlights interrelationships between benefits and complications such as capitalization and intertemporal planning. The paper concludes by identifying the challenges at the research frontier, including incentive problems associated with adverse selection, additionality, and slippage. Copyright © 2013 Elsevier Ltd. All rights reserved.

A review on cost-effectiveness and cost-utility of psychosocial care in cancer patients

Directory of Open Access Journals (Sweden)

Femke Jansen

2016-01-01

Full Text Available Several psychosocial care interventions have been found effective in improving psychosocial outcomes in cancer patients. At present, there is increasingly being asked for information on the value for money of this type of intervention. This review therefore evaluates current evidence from studies investigating cost-effectiveness or cost-utility of psychosocial care in cancer patients. A systematic search was conducted in PubMed and Web of Science yielding 539 unique records, of which 11 studies were included in the study. Studies were mainly performed in breast cancer populations or mixed cancer populations. Studied interventions included collaborative care (four studies, group interventions (four studies, individual psychological support (two studies, and individual psycho-education (one study. Seven studies assessed the cost-utility of psychosocial care (based on quality-adjusted-life-years while three studies investigated its cost-effectiveness (based on profile of mood states [mood], Revised Impact of Events Scale [distress], 12-Item Health Survey [mental health], or Fear of Progression Questionnaire [fear of cancer progression]. One study did both. Costs included were intervention costs (three studies, intervention and direct medical costs (five studies, or intervention, direct medical, and direct nonmedical costs (three studies. In general, results indicated that psychosocial care is likely to be cost-effective at different, potentially acceptable, willingness-to-pay thresholds. Further research should be performed to provide more clear information as to which psychosocial care interventions are most cost-effective and for whom. In addition, more research should be performed encompassing potential important cost drivers from a societal perspective, such as productivity losses or informal care costs, in the analyses.

Re-evaluation of the effectiveness of the central A/M Area recovery well network

International Nuclear Information System (INIS)

Haselow, J.S.

1991-06-01

A groundwater recovery well network has been operating in the central portion of the A/M Area of the Savannah River Site (SRS) since 1985 to retrieve chlorinated volatile organic solvents. In 1986, a groundwater modeling study was performed to evaluate the effectiveness of the recovery well network that included planned recovery wells (RWM 1 through 11) and process water wells (S. S. Papadopulous, 1986). Since the original modeling study, use of some of the process wells has discontinued and some pumping rates at other wells have changed. Also, the understanding of the hydrologic system in the A/M Area has improved because additional monitoring wells have been installed in the area. As a result, an updated groundwater flow model (Beaudoin et al., 1991) for the area was used to evaluate the effectiveness of the existing recovery network. The results of this study indicate that the estimated effectiveness of the recovery well has not changed dramatically since the original groundwater modeling study. However, slight differences do exist between the original study and this study because the recent model more accurately reflects the A/M Area subsurface hydrologic system

Cardiopulmonary resuscitation: what cost to cheat death?

Science.gov (United States)

Lee, K H; Angus, D C; Abramson, N S

1996-12-01

To review the various outcomes from cardiopulmonary resuscitation (CPR), the factors that influence these outcomes, the costs associated with CPR, and the application of cost-analyses to CPR. Data used to prepare this article were drawn from published articles and work in progress. Articles were selected for their relevance to the subjects of CPR and cost-analysis by MEDLINE keyword search. The authors extracted all applicable data from the English literature. Cost-analysis studies of CPR programs are limited by the high variation in resources consumed and attribution of cost to these resources. Furthermore, cost projections have not been adjusted to reflect patient-dependent variation in outcome. Variation in the patient's underlying condition, presenting cardiac rhythm, time to provision of definitive CPR, and effective perfusion all influence final outcome and, consequently, influence the cost-effectiveness of CPR programs. Based on cost data from previous studies, preliminary estimates of the cost-effectiveness of CPR programs for all 6-month survivors of a large international multicenter collaborative trial are $406,605.00 per life saved (range $344,314.00 to $966,759.00), and $225,892.00 per quality-adjusted-life-year (range $191,286.00 to $537,088.00). Reported outcome from CPR has varied from reasonable rates of good recovery, including return to full employment to 100% mortality. Appropriate CPR is encouraged, but continued widespread application appears extremely expensive.

The Effects of Electrostimulation and Core Exercises on Recovery After High-Intensity Exercise

OpenAIRE

Ahmet Mor; Gökhan İpekoğlu; Cansel Arslanoglu; Kursat Acar; Erkal Arslanoglu

2017-01-01

Introduction and objectives: The purpose of this study was to determine the effects of electrostimulation and core exercises on recovery after high-intensity exercise. Methods: The participants of this study consists of 12 male bodybuilders who regularly train and between the ages 18-30. Tabata high intensity interval training (HIIT) was applied with different recovery methods to the athletes on three different days and the recovery levels of athletes were analysed. Heart rate and blood lacta...

The Effects of Total Sleep Deprivation and Recovery Sleep on Cognitive Performance and Brain Function

National Research Council Canada - National Science Library

Drummond, Sean P

2004-01-01

.... Even less is known about the cerebral effects of recovery sleep. The overarching objective of this study is to investigate the effects of 2 full nights of sleep loss and 2 full nights of recovery sleep on cognitive performance and brain function...

Resource recovery. A report for the Royal Commission of Environmental Pollution

Energy Technology Data Exchange (ETDEWEB)

1986-01-01

A report for the Royal Commission on Environmental Pollution describes the key factors influencing the level of resource recovery in the UK and compares the level in other European countries and the US. Aspects covered include waste paper, oils and batteries, cost allocation, waste disposal cost and charges, separation of waste streams and energy from waste. Finally the report identifies a number of specific areas where action might be taken to increase resource recovery. (UK).

Systematic Review of the Cost and Cost-Effectiveness of Rapid Endovascular Therapy for Acute Ischemic Stroke.

Science.gov (United States)

Sevick, Laura K; Ghali, Sarah; Hill, Michael D; Danthurebandara, Vishva; Lorenzetti, Diane L; Noseworthy, Tom; Spackman, Eldon; Clement, Fiona

2017-09-01

Rapid endovascular therapy (EVT) is an emerging treatment option for acute ischemic stroke. Several economic evaluations have been published examining the cost-effectiveness of EVT, and many international bodies are currently making adoption decisions. The objective of this study was to establish the cost-effectiveness of EVT for ischemic stroke patients and to synthesize all the publicly available economic literature. A systematic review of the published literature was conducted to identify economic evaluations and cost analyses of EVT for acute ischemic stroke patients. Systematic review best practices were followed, and study quality was assessed. Four-hundred sixty-three articles were identified from electronic databases. After deduplication, abstract review, and full-text review, 17 studies were included. Seven of the studies were cost analyses, and 10 were cost-effectiveness studies. Generally, the cost analyses reported on the cost of the approach/procedure or the hospitalization costs associated with EVT. All of the cost-effectiveness studies reported a cost per quality-adjusted life year as the primary outcomes. Studies varied in regards to the costs considered, the perspective adopted, and the time horizon used. All the studies reported a cost per quality-adjusted life year of cost and cost-effectiveness of EVT. The cost analyses suggested that although EVT was associated with higher costs, it also resulted in improved patient outcomes. From the cost-effectiveness studies, EVT seems to be good value for money when a threshold of $50 000 per quality-adjusted life year gained is adopted. © 2017 American Heart Association, Inc.

Trait Positive Affect Buffers the Effects of Acute Stress on Skin Barrier Recovery

Science.gov (United States)

Robles, Theodore F.; Brooks, Kathryn P.; Pressman, Sarah D.

2010-01-01

Objective This study examines the role of self-reported trait positive affect (PA) on skin barrier recovery after skin disruption, and whether the role of trait PA in wound healing is consistent with the direct effects model or the stress-buffering model of PA and health. Design Sixty healthy participants (mean age 22.7 ± 3.9 years) completed a self-report measure of trait positive and negative affect, underwent a “tape-stripping” procedure that disrupts normal skin barrier function, and were randomly assigned to a Stress (Trier Social Stress Test) or No Stress (reading task) condition. Main Outcome Measures Skin barrier recovery was assessed by measuring transepidermal water loss up to 2 hr after skin disruption. Results Multilevel modeling indicated that greater trait PA was related to faster skin barrier recovery (p < .05). The effects of PA on skin barrier recovery were independent of levels of trait NA. Conclusion These findings suggest that trait PA may influence skin barrier recovery following a brief stressor. In addition, these results provide additional evidence that trait PA can positively impact objective health outcomes. PMID:19450044

Cost effectiveness of radon mitigation in Canada

International Nuclear Information System (INIS)

Letourneau, E.G.; Krewski, D.; Zielinski, J.M.; McGregor, R.G.

1992-01-01

This paper examines the cost effectiveness of comprehensive strategies for reducing exposure to radon gas in indoor air in Canadian homes. The analysis is conducted within the context of a general framework for risk management programme evaluation which includes well-known evaluation techniques such as cost effectiveness and cost-benefit analyses as special cases. Based on this analysis, it is clear that any comprehensive programme to reduce exposure to environmental radon will be extremely expensive, and may not be justifiable in terms of health impact, particularly when considered in relation to other public health programmes. Testing of homes at the point of sale and installing sub-slab suction equipment to reduce exposure to indoor radon where necessary appears to be a relatively cost-effective radon mitigation strategy. In general, radon mitigation was found to be most cost effective in cities with relatively high levels of radon. (author)

Recovery and use of fission product noble metals

International Nuclear Information System (INIS)

Jensen, G.A.; Rohmann, C.A.; Perrigo, L.D.

1980-06-01

Noble metals in fission products are of strategic value. Market prices for noble metals are rising more rapidly than recovery costs. A promising concept has been developed for recovery of noble metals from fission product waste. Although the assessment was made only for the three noble metal fission products (Rh, Pd, Ru), there are other fission products and actinides which have potential value

Is expanding Medicare coverage cost-effective?

Directory of Open Access Journals (Sweden)

Muennig Peter

2005-03-01

Full Text Available Abstract Background Proposals to expand Medicare coverage tend to be expensive, but the value of services purchased is not known. This study evaluates the efficiency of the average private supplemental insurance plan for Medicare recipients. Methods Data from the National Health Interview Survey, the National Death Index, and the Medical Expenditure Panel Survey were analyzed to estimate the costs, changes in life expectancy, and health-related quality of life gains associated with providing private supplemental insurance coverage for Medicare beneficiaries. Model inputs included socio-demographic, health, and health behavior characteristics. Parameter estimates from regression models were used to predict quality-adjusted life years (QALYs and costs associated with private supplemental insurance relative to Medicare only. Markov decision analysis modeling was then employed to calculate incremental cost-effectiveness ratios. Results Medicare supplemental insurance is associated with increased health care utilization, but the additional costs associated with this utilization are offset by gains in quality-adjusted life expectancy. The incremental cost-effectiveness of private supplemental insurance is approximately $24,000 per QALY gained relative to Medicare alone. Conclusion Supplemental insurance for Medicare beneficiaries is a good value, with an incremental cost-effectiveness ratio comparable to medical interventions commonly deemed worthwhile.

Community financing of local ivermectin distribution in Nigeria: potential payment and cost-recovery outlook.

Science.gov (United States)

Onwujekwe, O E; Shu, E N; Okonkwo, P O

2000-04-01

The preferred payment mechanism in a community financing scheme for local ivermectin distribution was elicited from randomly selected household heads from three communities in Nigeria using interviewer-administered structured questionnaires. The majority of the respondents in the three communities were prepared to pay for local ivermectin distribution. Additionally, the average amounts the respondents were prepared to pay per person treated ($0.28, $0.30 and $0.38 in Nike, Achi and Toro, respectively) were all more than the $0.20 ceiling recommended by the partners of the African Programme on Onchocerciasis Control (APOC). Thus, the cost-recovery outlook is bright in these communities. However, the preferred payment modality varied. Fee-for-service was the predominant payment modality in the Achi and Nike communities, while the Toro community preferred pre-payment. This study demonstrates that many communities have different payment preferences for endemic disease control efforts. This knowledge will help in developing acceptable and sustainable schemes. The imposition of unacceptable payment mechanisms will lead to an unwillingness to pay.

Effectiveness evaluation of whole-body electromyostimulation as a post-exercise recovery method.

Science.gov (United States)

DE LA Camara, Miguel A; Pardos, Ana I; Veiga, Óscar L

2018-01-04

Whole-body electromyostimulation (WB-EMS) devices are now being used in health and sports training, although there are few studies investigating their benefits. The objective of this research was to evaluate the effectiveness of WB-EMS as a post-exercise recovery method, and compare it with other methods like active and passive recovery. The study included nine trained men (age = 21 ± 1years, height = 1.77 ± 0.4 m, mass = 62 ± 7 kg). Three trials were performed in three different sessions, 1 week apart. Each trial, the participants completed the same exercise protocol and a different recovery method each time. A repeated measures design was used to check the basal reestablishing on several physiological variables [lactate, heart rate, percentage of tissue hemoglobin saturation, temperature, and neuromuscular fatigue] and to evaluate the quality of recovery. The non-parametric Wilcoxon and Friedman ANOVA tests were used to examine the differences between recovery methods. The results showed no differences between methods in the physiological and psychological variables analyzed. Although, the blood lactate concentration showed borderline statistical significance between methods (P = 0.050). Likewise, WB-EMS failed to recover baseline blood lactate concentration (P = 0.021) and percentage of tissue hemoglobin saturation (P = 0.023), in contrast to the other two methods. These findings suggest that WB-EMS is not a good recovery method because the power of reestablishing of several physiological and psychological parameters is not superior to other recovery methods like active and passive recovery.

Tax incentives and enhanced oil recovery techniques

International Nuclear Information System (INIS)

Stathis, J.S.

1991-05-01

Tax expenditures-reductions in income tax liability resulting from a special tax provision-are often used to achieve economic and social objectives. The arguments for petroleum production tax incentives usually encompass some combination of enhancing energy security, rewarding risk, or generating additional investment in new technologies. Generally, however, some portion of any tax expenditure is spend on activities that would have occurred anyway. This paper is a review of tax incentives for petroleum production found two to be of questionable merit. Others, including tax preferences for enhanced oil recovery methods, which offered the potential for better returns on the tax dollar. Increased use of enhanced oil recovery techniques could lead to additional environmental costs, however, and these need to be factored into any cost-benefit calculation

Global cost-effectiveness of GDM screening and management

DEFF Research Database (Denmark)

Weile, Louise K K; Kahn, James G; Marseille, Elliot

2015-01-01

a systematic search and abstraction of cost-effectiveness and cost-utility studies from 2002 to 2014. We standardized all findings to 2014 US dollars. We found that cost-effectiveness ratios varied widely. Most variation was found to be due to differences in geographic setting, diagnostic criteria...... and intervention approaches, and outcomes (e.g., inclusion or exclusion of long-term type 2 diabetes risk and associated costs). We concluded that incorporation of long-term benefits of GDM screening and treatment has huge impact on cost-effectiveness estimates. Based on the large methodological heterogeneity...

Optimization of Surfactant Mixtures and Their Interfacial Behavior for Advanced Oil Recovery, Annual Report, September 30, 1999-September 30, 2000

Energy Technology Data Exchange (ETDEWEB)

Somasundaran, Prof. P.

2001-04-04

The goal of this report is to develop improved extraction processes to mobilize and produce the oil left untapped using conventional techniques. Current chemical schemes for recovering the residual oil have been in general less than satisfactory. High cost of the processes as well as significant loss of chemicals by adsorption on reservoir materials and precipitation has limited the utility of chemical-flooding operations. There is a need to develop cost-effective, improved reagent schemes to increase recovery from domestic oil reservoirs. The goal of the report was to develop and evaluate novel mixtures of surfactants for improved oil recovery.

10 CFR 436.13 - Presuming cost-effectiveness results.

Science.gov (United States)

2010-01-01

... 10 Energy 3 2010-01-01 2010-01-01 false Presuming cost-effectiveness results. 436.13 Section 436... Methodology and Procedures for Life Cycle Cost Analyses § 436.13 Presuming cost-effectiveness results. (a) If the investment and other costs for an energy or water conservation measure considered for retrofit to...

Inherently safe in situ uranium recovery

International Nuclear Information System (INIS)

Krumhansl, James Lee; Beauheim, Richard Louis; Brady, Patrick Vane; Arnold, Bill Walter; Kanney, Joseph F.; McKenna, Sean Andrew

2009-01-01

Expansion of uranium mining in the United States is a concern to some environmental groups and sovereign Native American Nations. An approach which may alleviate some problems is to develop inherently safe in situ uranium recovery ('ISR') technologies. Current ISR technology relies on chemical extraction of trace levels of uranium from aquifers that, once mined, can still contain dissolved uranium and other trace metals that are a health concern. Existing ISR operations are few in number; however, high uranium prices are driving the industry to consider expanding operations nation-wide. Environmental concerns and enforcement of the new 30 ppb uranium drinking water standard may make opening new mining operations more difficult and costly. Here we propose a technological fix: the development of inherently safe in situ recovery (ISISR) methods. The four central features of an ISISR approach are: (1) New 'green' leachants that break down predictably in the subsurface, leaving uranium, and associated trace metals, in an immobile form; (2) Post-leachant uranium/metals-immobilizing washes that provide a backup decontamination process; (3) An optimized well-field design that increases uranium recovery efficiency and minimizes excursions of contaminated water; and (4) A combined hydrologic/geochemical protocol for designing low-cost post-extraction long-term monitoring. ISISR would bring larger amounts of uranium to the surface, leave fewer toxic metals in the aquifer, and cost less to monitor safely - thus providing a 'win-win-win' solution to all stakeholders.

Effects of Quebracho Tannin on Recovery of Colloidal Gold from ...

African Journals Online (AJOL)

This paper considered effects of Quebracho Tannin (QT) on recovery of gold from the oxidized flotation concentrate wash liquor. The effect of Quebracho Tannin on Total Suspended Solids (TSS) was also established. This research established that the gold lost to tailings was not soluble in the effluent but was mainly in the ...

The effect of local cryotherapy on subjective and objective recovery characteristics following an exhaustive jump protocol.

Science.gov (United States)

Hohenauer, Erich; Clarys, Peter; Baeyens, Jean-Pierre; Clijsen, Ron

2016-01-01

The purpose of this controlled trial was to investigate the effects of a single local cryotherapy session on the recovery characteristics over a period of 72 hours. Twenty-two young and healthy female (n=17; mean age: 21.9±1.1 years) and male (n=5;mean age: 25.4±2.8 years) adults participated in this study. Following an exhaustive jump protocol (3×30 countermovement jumps), half of the participants received either a single local cryotherapy application (+8°C) or a single local thermoneutral application (+32°C) of 20-minute duration using two thigh cuffs. Subjective measures of recovery (delayed-onset muscle soreness and ratings of perceived exertion) and objective measures of recovery (vertical jump performance and peak power output) were assessed immediately following the postexercise applications (0 hours) and at 24 hours, 48 hours, and 72 hours after the jump protocol. Local cryotherapy failed to significantly affect any subjective recovery variable during the 72-hour recovery period (P>0.05). After 72 hours, the ratings of perceived exertion were significantly lower in the thermoneutral group compared to that in the cryotherapy group (P=0.002). No significant differences were observed between the cryotherapy and the thermoneutral groups with respect to any of the objective recovery variables. In this experimental study, a 20-minute cryotherapy cuff application failed to demonstrate a positive effect on any objective measures of recovery. The effects of local thermoneutral application on subjective recovery characteristics were superior when compared to the effects of local cryotherapy application at 72 hours postapplication.

Thermodynamic and thermoeconomic analyses of seawater reverse osmosis desalination plant with energy recovery

International Nuclear Information System (INIS)

El-Emam, Rami Salah; Dincer, Ibrahim

2014-01-01

This paper investigates the performance of a RO (reverse osmosis) desalination plant at different seawater salinity values. An energy recovery Pelton turbine is integrated with the desalination plant. Thermodynamic analysis, based on the first and second laws of thermodynamics, as well as a thermo-based economic analysis is performed for the proposed system. The effects of the system components irreversibilities on the economics and cost of product water are parametrically studied through the thermoeconomic analysis. The exergy analysis shows that large irreversibilities occur in the high pressure pump and in the RO module. Both thermodynamic and thermoeconomic performances of the overall system are investigated under different operating parameters. For the base case; the system achieves an exergy efficiency of 5.82%. The product cost is estimated to be 2.451 $/m 3 and 54.2 $/MJ when source water with salinity of 35,000 ppm is fed to the system. - Highlights: • Thermodynamic and exergoeconomic analyses are performed for SWRO with energy recovery. • Parametric studies are done to study effects of operating conditions on performance. • Different seawater sources with different salinity values are tested. • At base case, plant exergy efficiency is 5.82% and product cost is 2.451 $/m 3

A novel bio-electrochemical system with sand/activated carbon separator, Al anode and bio-anode integrated micro-electrolysis/electro-flocculation cost effectively treated high load wastewater with energy recovery.

Science.gov (United States)

Gao, Changfei; Liu, Lifen; Yang, Fenglin

2018-02-01

A novel bio-electrochemical system (BES) was developed by integrating micro-electrolysis/electro-flocculation from attaching a sacrificing Al anode to the bio-anode, it effectively treated high load wastewater with energy recovery (maximum power density of 365.1 mW/m 3 and a maximum cell voltage of 0.97 V), and achieving high removals of COD (>99.4%), NH 4 + -N (>98.7%) and TP (>98.6%). The anode chamber contains microbes, activated carbon (AC)/graphite granules and Al anode. It was separated from the cathode chamber containing bifunctional catalytic and filtration membrane cathode (loaded with Fe/Mn/C/F/O catalyst) by a multi-medium chamber (MMC) filled with manganese sand and activated carbon granules, which replaced expensive PEM and reduced cost. An air contact oxidation bed for aeration was still adopted before liquid entering the cathode chamber. micro-electrolysis/electro-flocculation helps in achieving high removal efficiencies and contributes to membrane fouling migration. The increase of activated carbon in the separator MMC increased power generation and reduced system electric resistance. Copyright © 2017 Elsevier Ltd. All rights reserved.

A Mixed Bi-level Model to Correspond Service Recovery Chain

OpenAIRE

Abdolalipour, Amirhossein; Nazemi, Jamshid; Eshlaghi, Abbas Toloie; Lotfi, Farhad Hosseinzadeh

2017-01-01

In the competitive environment, minimizing time space between service failure perception and service recovery with lowest cost is one of fast responsiveness company’s requirements. In this article, modeling service failure response time is considered. It was not only service recovery chain profit optimization carefully planned but also satisfaction of consumers who disturbed by a service failure was considered profoundly. Inconsistency between optimization of service recovery chain’s total be...

Studying the effects of combining internal and external heat recovery on techno-economic performances of gas–steam power plants

International Nuclear Information System (INIS)

Carapellucci, Roberto; Giordano, Lorena

2016-01-01

Highlights: • Effects of gas-cycle regeneration on steam–gas power plants are investigated. • Power plant performances are evaluated varying gas turbine operative parameters. • The power plant operational flexibility is assessed through an off-design analysis. • Gas-cycle regeneration improves energy and economic performance parameters. • Power increase due to regenerator by-pass depends on steam section design. - Abstract: Thermodynamic regeneration is regarded as a conventional technique to enhance the efficiency of gas turbines, by means of an internal recovery of waste heat from exhaust gases. In combined cycle power plants (CCGTs), only external heat recovery is usually applied, in order to achieve the highest steam cycle power. Combining internal and external recovery, while decreasing the power plant rated capacity, has the potential to boost the efficiency of CCGTs. This paper aims to examine the effects of thermodynamic regeneration on steam–gas power plants from the energy and economic point of view. First, a dual pressure combined cycle based on a regenerative gas turbine is designed using GateCycle software and effects on energy and economic performances are evaluated varying gas turbine operating parameters. Then, an off-design simulation of different CCGT configurations is carried out, in order to evaluate the power increase achieved by-passing the regenerator and its effects on efficiency and cost of electricity. The study has shown that the improvement of energy and economic performances of regenerative CCGTs is more and more pronounced with the increase of turbine inlet temperature (TIT). Additionally, regeneration enhances the power plant operational flexibility, allowing to obtain a 30% power increase with respect to the design value, if the regenerator is fully by-passed and the bottoming steam cycle is designed to manage the increased flue gas temperature.

Cost-effectiveness analysis and innovation.

Science.gov (United States)

Jena, Anupam B; Philipson, Tomas J

2008-09-01

While cost-effectiveness (CE) analysis has provided a guide to allocating often scarce resources spent on medical technologies, less emphasis has been placed on the effect of such criteria on the behavior of innovators who make health care technologies available in the first place. A better understanding of the link between innovation and cost-effectiveness analysis is particularly important given the large role of technological change in the growth in health care spending and the growing interest of explicit use of CE thresholds in leading technology adoption in several Westernized countries. We analyze CE analysis in a standard market context, and stress that a technology's cost-effectiveness is closely related to the consumer surplus it generates. Improved CE therefore often clashes with interventions to stimulate producer surplus, such as patents. We derive the inconsistency between technology adoption based on CE analysis and economic efficiency. Indeed, static efficiency, dynamic efficiency, and improved patient health may all be induced by the cost-effectiveness of the technology being at its worst level. As producer appropriation of the social surplus of an innovation is central to the dynamic efficiency that should guide CE adoption criteria, we exemplify how appropriation can be inferred from existing CE estimates. For an illustrative sample of technologies considered, we find that the median technology has an appropriation of about 15%. To the extent that such incentives are deemed either too low or too high compared to dynamically efficient levels, CE thresholds may be appropriately raised or lowered to improve dynamic efficiency.

Dutchess County Resource Recovery Task Force report: Dutchess County Pyrolysis Program

Energy Technology Data Exchange (ETDEWEB)

None

1980-07-01

Dutchess County initiated development of a long-range master plan for Solid Waste Management in 1971. The plan included development of a resource recovery facility to service the municipalities in the County population center. Based on early recommendations, a pyrolysis facility employing Purox technology was to be implemented. A feasibility study, paid for by County funds was completed in 1975. The study provided siting recommendations, estimation of available waste, and preliminary facility design. Because of various considerations, the project was not developed. Under the Department of Energy grant, the County reassessed the feasibility of a resource recovery facility, with emphasis on confirming previous conclusions supporting the Purox technology, waste availability, energy recovery and sale and siting of the plant. The conclusions reached in the new study were: a resource recovery facility is feasible for the County; sufficient waste for such a facility is available and subject to control; While Purox technology was feasible it is not the most appropriate available technoloy for the County; that mass burning with steam recovery is the most appropriate technology; and that resource recovery while presently more expensive than landfilling, represents the only cost effective, energy efficient, and environmentally sound way to handle the solid waste problem in the County.

Recovery of light nonaqueous-phase liquids without groundwater pumping

International Nuclear Information System (INIS)

Markley, D.E.; Prince-Larsen, N.

1995-01-01

This paper outlines recovery of light nonaqueous-phase liquids (LNAPL) encountered in the subsurface at a remote natural gas facility. Remediation of LNAPL in the subsurface usually begins with dual pumping of LNAPL and groundwater. However, regulations required that only LNAPL be recovered. Methods were sought for recovering LNAPL from groundwater without pumping groundwater to the surface. Alternative methods of LNAPL recovery, using a variety of skimming pumps, included: LNAPL recovery from large-diameter wells; LNAPL recovery from trenches; LNAPL recovery from small-diameter wells; and vacuum-enhanced recovery of LNAPL while skimming with a belt skimmer. Based on the goals of the site owner and the costs associated with each alternative examined, the recommended method for recovering LNAPL without groundwater pumping was recovery of LNAPL while skimming with a belt skimmer. This paper discusses both the advantages and limitations of this technique

A cost effective CO2 strategy

DEFF Research Database (Denmark)

, a scenario-part and a cost-benefit part. Air and sea modes are not analyzed. The model adopts a bottom-up approach to allow a detailed assessment of transport policy measures. Four generic areas of intervention were identified and the likely effect on CO2 emissions, socioeconomic efficiency and other...... are evaluated according to CO2 reduction potential and according to the ‘shadow price’ on a reduction of one ton CO2. The shadow price reflects the costs (and benefits) of the different measures. Comparing the measures it is possible to identify cost effective measures, but these measures are not necessarily...... by the Ministry of Transport, with the Technical University of Denmark as one of the main contributors. The CO2-strategy was to be based on the principle of cost-effectiveness. A model was set up to assist in the assessment. The model consists of a projection of CO2-emissions from road and rail modes from 2020...

An innovative bioelectrochemical-anaerobic digestion-coupled system for in-situ ammonia recovery and biogas enhancement: process performance and microbial ecology

DEFF Research Database (Denmark)

Zhang, Yifeng; Angelidaki, Irini

(SMRC) and a continuous stirred tank reactor (CSTR), to prevent ammonia toxicity during anaerobic digestion by in-situ ammonia recovery and electricity production. In batch experiment, the ammonia concentration in the CSTR decreased from 6 to 0.7 g-N/L with an average recovery rate of 0.18 g-N/L(CSTR...... performance was enhanced. In addition, the coexistence of other cations in CSTR or cathode had no negative effect on the ammonia transportation. In continuous reactor operation, 112% extra biogas production was achieved due to ammonia recovery. High-throughput molecular sequencing analysis showed an impact...... of ammonia recovery on the microbial community composition in the integrated system. Results clearly indicate the great potential of the SMRC-CSTR-coupled system for efficient and cost-effective ammonia recovery, energy production and treatment of ammonia-rich residues....

Platforms for energy and nutrient recovery from domestic wastewater: A review.

Science.gov (United States)

Batstone, D J; Hülsen, T; Mehta, C M; Keller, J

2015-12-01

Alternative domestic wastewater treatment processes that recover energy and nutrients while achieving acceptable nutrient limits (650mgCODL(-1). PRR offers the possibility for recovery of nitrogen and other nutrients (including potassium) through assimilative recovery. However, the energetic overhead of this is substantial, requiring 5kWhkgN(-1) as electricity, which compares to ammonia fixation costs. The lower energy costs, and near to market status of LEM treatment make it likely as a recovery platform in the shorter term, while ability to recover other elements such as nitrogen and potassium, as well as enhance favourability on concentrated wastewaters may enhance the desirability of partitioning in the longer term. Copyright © 2014 Elsevier Ltd. All rights reserved.

Effects of cost metric on cost-effectiveness of protected-area network design in urban landscapes.

Science.gov (United States)

Burkhalter, J C; Lockwood, J L; Maslo, B; Fenn, K H; Leu, K

2016-04-01

A common goal in conservation planning is to acquire areas that are critical to realizing biodiversity goals in the most cost-effective manner. The way monetary acquisition costs are represented in such planning is an understudied but vital component to realizing cost efficiencies. We sought to design a protected-area network within a forested urban region that would protect 17 birds of conservation concern. We compared the total costs and spatial structure of the optimal protected-area networks produced using three acquisition-cost surrogates (area, agricultural land value, and tax-assessed land value). Using the tax-assessed land values there was a 73% and 78% cost savings relative to networks derived using area or agricultural land value, respectively. This cost reduction was due to the considerable heterogeneity in acquisition costs revealed in tax-assessed land values, especially for small land parcels, and the corresponding ability of the optimization algorithm to identify lower-cost parcels for inclusion that had equal value to our target species. Tax-assessed land values also reflected the strong spatial differences in acquisition costs (US$0.33/m(2)-$55/m(2)) and thus allowed the algorithm to avoid inclusion of high-cost parcels when possible. Our results add to a nascent but growing literature that suggests conservation planners must consider the cost surrogate they use when designing protected-area networks. We suggest that choosing cost surrogates that capture spatial- and size-dependent heterogeneity in acquisition costs may be relevant to establishing protected areas in urbanizing ecosystems. © 2015 Society for Conservation Biology.

Cost-effectiveness of osteo-odonto keratoprosthesis in Singapore.

Science.gov (United States)

Dong, Di; Tan, Anna; Mehta, Jodhbir S; Tan, Donald; Finkelstein, Eric Andrew

2014-01-01

To determine the long-term cost-effectiveness of osteo-odonto keratoprosthesis (OOKP) relative to no treatment among patients with end-stage corneal and ocular surface diseases in Singapore. Cost-effectiveness analysis based on data from a retrospective cohort study. From a health system perspective, we calculated the incremental cost-effectiveness ratio of OOKP treatment relative to no treatment over a 30-year horizon, based on data from a cohort of 23 patients who underwent OOKP surgery between 2004 and 2009 at Singapore National Eye Centre. Preoperative and postoperative vision-related quality-of-life values were estimated from patients' visual outcomes and were used to calculate the gain in quality-adjusted life years (QALYs) resulting from OOKP treatment. Unsubsidized costs for surgery, consultations, examinations, medications, follow-up visits, and treatments for complications were retrieved from patients' bills to estimate the total costs associated with OOKP treatment. Sensitivity analyses were conducted to test the robustness of the model. Over a 30-year period, OOKP treatment, compared with no treatment, improved QALYs by 3.991 among patients with end-stage corneal and ocular surface diseases at an additional cost of S$67 840 (US$55 150), resulting in an incremental cost-effectiveness ratio of S$17 000/QALY (US$13 820/QALY). Based on commonly cited cost-effectiveness benchmarks, the OOKP is a cost-effective treatment for patients with end-stage corneal and ocular surface diseases. Copyright © 2014 Elsevier Inc. All rights reserved.

CLINSULF sub-dew-point process for sulphur recovery

Energy Technology Data Exchange (ETDEWEB)

Heisel, M.; Marold, F.

1988-01-01

In a 2-reactor system, the CLINSULF process allows very high sulphur recovery rates. When operated at 100/sup 0/C at the outlet, i.e. below the sulphur solidification point, a sulphur recovery rate of more than 99.2% was achieved in a 2-reactor series. Assuming a 70% sulphur recovery in an upstream Claus furnace plus sulphur condenser, an overall sulphur recovery of more than 99.8% results for the 2-reactor system. This is approximately 2% higher than in conventional Claus plus SDP units, which mostly consist of 4 reactors or more. This means the the CLINSULF SSP process promises to be an improvement both in respect of efficiency and low investment cost.

Cost, affordability and cost-effectiveness of strategies to control tuberculosis in countries with high HIV prevalence

Directory of Open Access Journals (Sweden)

Williams Brian G

2005-12-01

Full Text Available Abstract Background The HIV epidemic has caused a dramatic increase in tuberculosis (TB in East and southern Africa. Several strategies have the potential to reduce the burden of TB in high HIV prevalence settings, and cost and cost-effectiveness analyses can help to prioritize them when budget constraints exist. However, published cost and cost-effectiveness studies are limited. Methods Our objective was to compare the cost, affordability and cost-effectiveness of seven strategies for reducing the burden of TB in countries with high HIV prevalence. A compartmental difference equation model of TB and HIV and recent cost data were used to assess the costs (year 2003 US$ prices and effects (TB cases averted, deaths averted, DALYs gained of these strategies in Kenya during the period 2004–2023. Results The three lowest cost and most cost-effective strategies were improving TB cure rates, improving TB case detection rates, and improving both together. The incremental cost of combined improvements to case detection and cure was below US$15 million per year (7.5% of year 2000 government health expenditure; the mean cost per DALY gained of these three strategies ranged from US$18 to US$34. Antiretroviral therapy (ART had the highest incremental costs, which by 2007 could be as large as total government health expenditures in year 2000. ART could also gain more DALYs than the other strategies, at a cost per DALY gained of around US$260 to US$530. Both the costs and effects of treatment for latent tuberculosis infection (TLTI for HIV+ individuals were low; the cost per DALY gained ranged from about US$85 to US$370. Averting one HIV infection for less than US$250 would be as cost-effective as improving TB case detection and cure rates to WHO target levels. Conclusion To reduce the burden of TB in high HIV prevalence settings, the immediate goal should be to increase TB case detection rates and, to the extent possible, improve TB cure rates, preferably

Understanding Cost-Effectiveness of Energy Efficiency Programs

Science.gov (United States)

Discusses the five standard tests used to assess the cost-effectiveness of energy efficiency, how states are using these tests, and how the tests can be used to determine the cost-effectiveness of energy efficiency measures.

Cost-effectiveness of antiplatelet drugs after percutaneous coronary intervention.

Science.gov (United States)

Wisløff, Torbjørn; Atar, Dan

2016-01-01

Clopidogrel has, for long time, been accepted as the standard treatment for patients who have undergone a percutaneous coronary intervention (PCI). The introduction of prasugrel-and more recently, ticagrelor-has introduced a decision-making problem for clinicians and governments worldwide: to use the cheaper clopidogrel or the more effective, and also more expensive prasugrel or ticagrelor. We aim to give helpful contributions to this debate by analysing the cost-effectiveness of clopidogrel, prasugrel, and ticagrelor compared with each other. We modified a previously developed Markov model of cardiac disease progression. In the model, we followed up cohorts of patients who have recently had a PCI until 100 years or death. Possible events are revascularization, bleeding, acute myocardial infarction, and death. Our analysis shows that ticagrelor is cost-effective in 77% of simulations at an incremental cost-effectiveness ratio of €7700 compared with clopidogrel. Ticagrelor was also cost-effective against prasugrel at a cost-effectiveness ratio of €7800. Given a Norwegian cost-effectiveness threshold of €70 000, both comparisons appear to be clearly cost-effective in favour of ticagrelor. Ticagrelor is cost-effective compared with both clopidogrel and prasugrel for patients who have undergone a PCI.

Recovery from schizophrenia and the recovery model.

Science.gov (United States)

Warner, Richard

2009-07-01

The recovery model refers to subjective experiences of optimism, empowerment and interpersonal support, and to a focus on collaborative treatment approaches, finding productive roles for user/consumers, peer support and reducing stigma. The model is influencing service development around the world. This review will assess whether optimism about outcome from serious mental illness and other tenets of the recovery model are borne out by recent research. Remission of symptoms has been precisely defined, but the definition of 'recovery' is a more diffuse concept that includes such factors as being productive and functioning independently. Recent research and a large, earlier body of data suggest that optimism about outcome from schizophrenia is justified. A substantial proportion of people with the illness will recover completely and many more will regain good social functioning. Outcome is better for people in the developing world. Mortality for people with schizophrenia is increasing but is lower in the developing world. Working appears to help people recover from schizophrenia, and recent advances in vocational rehabilitation have been shown to be effective in countries with differing economies and labor markets. A growing body of research supports the concept that empowerment is an important component of the recovery process. Key tenets of the recovery model - optimism about recovery from schizophrenia, the importance of access to employment and the value of empowerment of user/consumers in the recovery process - are supported by the scientific research. Attempts to reduce the internalized stigma of mental illness should enhance the recovery process.

Composite tube cracking in kraft recovery boilers: A state-of-the-art review

Energy Technology Data Exchange (ETDEWEB)

Singbeil, D.L.; Prescott, R. [Pulp and Paper Research Inst. of Canada, Vancouver, British Columbia (Canada); Keiser, J.R.; Swindeman, R.W. [Oak Ridge National Lab., TN (United States)

1997-07-01

Beginning in the mid-1960s, increasing energy costs in Finland and Sweden made energy recovery more critical to the cost-effective operation of a kraft pulp mill. Boiler designers responded to this need by raising the steam operating pressure, but almost immediately the wall tubes in these new boilers began to corrode rapidly. Test panels installed in the walls of the most severely corroding boiler identified austenitic stainless steel as sufficiently resistant to the new corrosive conditions, and discussions with Sandvik AB, a Swedish tube manufacturer, led to the suggestion that coextruded tubes be used for water wall service in kraft recovery boilers. Replacement of carbon steel by coextruded tubes has solved most of the corrosion problems experienced by carbon steel wall tubes, however, these tubes have not been problem-free. Beginning in early 1995, a multidisciplinary research program funded by the US Department of Energy was established to investigate the cause of cracking in coextruded tubes and to develop improved materials for use in water walls and floors of kraft recovery boilers. One portion of that program, a state-of-the-art review of public- and private-domain documents related to coextruded tube cracking in kraft recovery boilers is reported here. Sources of information that were consulted for this review include the following: tube manufacturers, boiler manufacturers, public-domain literature, companies operating kraft recovery boilers, consultants and failure analysis laboratories, and failure analyses conducted specifically for this project. Much of the information contained in this report involves cracking problems experienced in recovery boiler floors and those aspects of spout and air-port-opening cracking not readily attributable to thermal fatigue. 61 refs.

Algorithms for image recovery calculation in extended single-shot phase-shifting digital holography

Science.gov (United States)

Hasegawa, Shin-ya; Hirata, Ryo

2018-04-01

The single-shot phase-shifting method of image recovery using an inclined reference wave has the advantages of reducing the effects of vibration, being capable of operating in real time, and affording low-cost sensing. In this method, relatively low reference angles compared with that in the conventional method using phase shift between three or four pixels has been required. We propose an extended single-shot phase-shifting technique which uses the multiple-step phase-shifting algorithm and the corresponding multiple pixels which are the same as that of the period of an interference fringe. We have verified the theory underlying this recovery method by means of Fourier spectral analysis and its effectiveness by evaluating the visibility of the image using a high-resolution pattern. Finally, we have demonstrated high-contrast image recovery experimentally using a resolution chart. This method can be used in a variety of applications such as color holographic interferometry.

A cost comparison study of open pit mining vs. in situ assisted gravity drainage

International Nuclear Information System (INIS)

McIntosh, J.; Luhning, R.W.

1991-01-01

The twin-well steam assisted gravity drainage (SAGD) process has resulted in breakthrough technology to access previously uneconomical deep-seated oil sands reserves in Alberta, and to provide a very cost-effective and environmentally acceptable method for extracting bitumen from reserves having a minimum of 30 m overburden. In the evaluation of new or improved bitumen recovery technologies for its new North Mine, Syncrude Canada has recognized that SAGD was a potential alternate to the current open pit mining and hot water extraction process. A study was conducted to compare and evaluate bitumen recovery by the two schemes at the North Mine site, scheduled to begin operations in 1996, for the reserves under Syncrude's tailings pond, and at a new grassroots area. Study description and analysis of results are presented for the grassroots case. The assumptions and mining/recovery processes used for the mining or SAGD method are detailed and the advantages and drawbacks of each scheme are noted. Results show that the SAGD unit supply costs are projected to be proportionately lower than the corresponding open pit mining/hot water extraction (OP/X) cost, using a 20-y project life. A sensitivity analysis indicates that the SAGD process is more sensitive to natural gas costs, while the OP/X scheme is more sensitive to power costs. The SAGD process is much less labor-intensive than OP/X and has obvious advantages in terms of tailings disposal and post-mining reclamation. In addition, the underground nature of SAGD operation eliminates adverse effects of the weather on working conditions. 11 figs

Cost-effectiveness analysis of brief and expanded evidence-based risk reduction interventions for HIV-infected people who inject drugs in the United States.

Directory of Open Access Journals (Sweden)

Dahye L Song

Full Text Available Two behavioral HIV prevention interventions for people who inject drugs (PWID infected with HIV include the Holistic Health Recovery Program for HIV+ (HHRP+, a comprehensive evidence-based CDC-supported program, and an abbreviated Holistic Health for HIV (3H+ Program, an adapted HHRP+ version in treatment settings. We compared the projected health benefits and cost-effectiveness of both programs, in addition to opioid substitution therapy (OST, to the status quo in the U.S.A dynamic HIV transmission model calibrated to epidemic data of current US populations was created. Projected outcomes include future HIV incidence, HIV prevalence, and quality-adjusted life years (QALYs gained under alternative strategies. Total medical costs were estimated to compare the cost-effectiveness of each strategy.Over 10 years, expanding HHRP+ access to 80% of PWID could avert up to 29,000 HIV infections, or 6% of the projected total, at a cost of $7,777/QALY gained. Alternatively, 3H+ could avert 19,000 infections, but is slightly more cost-effective ($7,707/QALY, and remains so under widely varying effectiveness and cost assumptions. Nearly two-thirds of infections averted with either program are among non-PWIDs, due to reduced sexual transmission from PWID to their partners. Expanding these programs with broader OST coverage could avert up to 74,000 HIV infections over 10 years and reduce HIV prevalence from 16.5% to 14.1%, but is substantially more expensive than HHRP+ or 3H+ alone.Both behavioral interventions were effective and cost-effective at reducing HIV incidence among both PWID and the general adult population; however, 3H+, the economical HHRP+ version, was slightly more cost-effective than HHRP+.

Cost-effectiveness and pricing of antibacterial drugs.

Science.gov (United States)

Verhoef, Talitha I; Morris, Stephen

2015-01-01

Growing resistance to antibacterial agents has increased the need for the development of new drugs to treat bacterial infections. Given increasing pressure on limited health budgets, it is important to study the cost-effectiveness of these drugs, as well as their safety and efficacy, to find out whether or not they provide value for money and should be reimbursed. In this article, we systematically reviewed 38 cost-effectiveness analyses of new antibacterial agents. Most studies showed the new antibacterial drugs were cost-effective compared to older generation drugs. Drug pricing is a complicated process, involving different stakeholders, and has a large influence on cost-effectiveness. Value-based pricing is a method to determine the price of a drug at which it can be cost-effective. It is currently unclear what the influence of value-based pricing will be on the prices of new antibacterial agents, but an important factor will be the definition of 'value', which as well as the impact of the drug on patient health might also include other factors such as wider social impact and the health impact of disease. © 2015 The Authors. Chemical Biology & Drug Design Published by John Wiley & Sons Ltd.

Life-Cycle Cost and Environmental Assessment of Decentralized Nitrogen Recovery Using Ion Exchange from Source-Separated Urine through Spatial Modeling.

Science.gov (United States)

Kavvada, Olga; Tarpeh, William A; Horvath, Arpad; Nelson, Kara L

2017-11-07

Nitrogen standards for discharge of wastewater effluent into aquatic bodies are becoming more stringent, requiring some treatment plants to reduce effluent nitrogen concentrations. This study aimed to assess, from a life-cycle perspective, an innovative decentralized approach to nitrogen recovery: ion exchange of source-separated urine. We modeled an approach in which nitrogen from urine at individual buildings is sorbed onto resins, then transported by truck to regeneration and fertilizer production facilities. To provide insight into impacts from transportation, we enhanced the traditional economic and environmental assessment approach by combining spatial analysis, system-scale evaluation, and detailed last-mile logistics modeling using the city of San Francisco as an illustrative case study. The major contributor to energy intensity and greenhouse gas (GHG) emissions was the production of sulfuric acid to regenerate resins, rather than transportation. Energy and GHG emissions were not significantly sensitive to the number of regeneration facilities. Cost, however, increased with decentralization as rental costs per unit area are higher for smaller areas. The metrics assessed (unit energy, GHG emissions, and cost) were not significantly influenced by facility location in this high-density urban area. We determined that this decentralized approach has lower cost, unit energy, and GHG emissions than centralized nitrogen management via nitrification-denitrification if fertilizer production offsets are taken into account.

A systematic review of the cost and cost effectiveness of treatment for multidrug-resistant tuberculosis.

Science.gov (United States)

Fitzpatrick, Christopher; Floyd, Katherine

2012-01-01

Around 0.4 million cases of multidrug-resistant tuberculosis (MDR-TB) occur each year. Only a small fraction of these cases are treated according to international guidelines. Evidence relevant to decisions about whether to scale-up treatment for MDR-TB includes cost and cost-effectiveness data. Up to 2010, no systematic review of this evidence has been available. Our objective was to conduct a systematic review of the cost and cost effectiveness of treatment for MDR-TB and synthesize the available data. We searched for papers published or prepared for publication in peer-review journals and grey literature using search terms in five languages: English, French, Portuguese, Russian and Spanish. From an initial set of 420 studies, four were included, from Peru, the Philippines, Estonia and Tomsk Oblast in the Russian Federation. Results on costs, effectiveness and cost effectiveness were extracted. Assessment of the quality of each economic evaluation was guided by two existing checklists around which there is broad consensus. Costs were adjusted to a common year of value (2005) to remove distortions caused by inflation, and calculated in two common currencies: $US and international dollars (I$), to standardize for purchasing power parity. Data from the four identified studies were then synthesized using probabilistic sensitivity analysis, to appraise the likely cost and cost effectiveness of MDR-TB treatment in other settings, relative to WHO benchmarks for assessing whether or not an intervention is cost effective. Best estimates are provided as means, with 5th and 95th percentiles of the distributions. The cost per patient for MDR-TB treatment in Estonia, Peru, the Philippines and Tomsk was $US10 880, $US2423, $US3613 and $US14 657, respectively. Best estimates of the cost per disability-adjusted life-year (DALY) averted were $US598 (I$960), $US163 (I$291), $US143 (I$255) and $US745 (I$1059), respectively. The main influences on costs were (i) the model of care

Cost-effectiveness of pharmacological and psychosocial interventions for schizophrenia

Science.gov (United States)

2011-01-01

Background Information on cost-effectiveness of interventions to treat schizophrenia can assist health policy decision making, particularly given the lack of health resources in developing countries like Thailand. This study aims to determine the optimal treatment package, including drug and non-drug interventions, for schizophrenia in Thailand. Methods A Markov model was used to evaluate the cost-effectiveness of typical antipsychotics, generic risperidone, olanzapine, clozapine and family interventions. Health outcomes were measured in disability adjusted life years. We evaluated intervention benefit by estimating a change in disease severity, taking into account potential side effects. Intervention costs included outpatient treatment costs, hospitalization costs as well as time and travel costs of patients and families. Uncertainty was evaluated using Monte Carlo simulation. A sensitivity analysis of the expected range cost of generic risperidone was undertaken. Results Generic risperidone is more cost-effective than typicals if it can be produced for less than 10 baht per 2 mg tablet. Risperidone was the cheapest treatment with higher drug costs offset by lower hospital costs in comparison to typicals. The most cost-effective combination of treatments was a combination of risperidone (dominant intervention). Adding family intervention has an incremental cost-effectiveness ratio of 1,900 baht/DALY with a 100% probability of a result less than a threshold for very cost-effective interventions of one times GDP or 110,000 baht per DALY. Treating the most severe one third of patients with clozapine instead of risperidone had an incremental cost-effectiveness ratio of 320,000 baht/DALY with just over 50% probability of a result below three times GDP per capita. Conclusions There are good economic arguments to recommend generic risperidone as first line treatment in combination with family intervention. As the uncertainty interval indicates the addition of clozapine

Cost-effectiveness of pharmacological and psychosocial interventions for schizophrenia

Directory of Open Access Journals (Sweden)

Vos Theo

2011-05-01

Full Text Available Abstract Background Information on cost-effectiveness of interventions to treat schizophrenia can assist health policy decision making, particularly given the lack of health resources in developing countries like Thailand. This study aims to determine the optimal treatment package, including drug and non-drug interventions, for schizophrenia in Thailand. Methods A Markov model was used to evaluate the cost-effectiveness of typical antipsychotics, generic risperidone, olanzapine, clozapine and family interventions. Health outcomes were measured in disability adjusted life years. We evaluated intervention benefit by estimating a change in disease severity, taking into account potential side effects. Intervention costs included outpatient treatment costs, hospitalization costs as well as time and travel costs of patients and families. Uncertainty was evaluated using Monte Carlo simulation. A sensitivity analysis of the expected range cost of generic risperidone was undertaken. Results Generic risperidone is more cost-effective than typicals if it can be produced for less than 10 baht per 2 mg tablet. Risperidone was the cheapest treatment with higher drug costs offset by lower hospital costs in comparison to typicals. The most cost-effective combination of treatments was a combination of risperidone (dominant intervention. Adding family intervention has an incremental cost-effectiveness ratio of 1,900 baht/DALY with a 100% probability of a result less than a threshold for very cost-effective interventions of one times GDP or 110,000 baht per DALY. Treating the most severe one third of patients with clozapine instead of risperidone had an incremental cost-effectiveness ratio of 320,000 baht/DALY with just over 50% probability of a result below three times GDP per capita. Conclusions There are good economic arguments to recommend generic risperidone as first line treatment in combination with family intervention. As the uncertainty interval indicates

Cost-effectiveness of pharmacological and psychosocial interventions for schizophrenia.

Science.gov (United States)

Phanthunane, Pudtan; Vos, Theo; Whiteford, Harvey; Bertram, Melanie

2011-05-13

Information on cost-effectiveness of interventions to treat schizophrenia can assist health policy decision making, particularly given the lack of health resources in developing countries like Thailand. This study aims to determine the optimal treatment package, including drug and non-drug interventions, for schizophrenia in Thailand. A Markov model was used to evaluate the cost-effectiveness of typical antipsychotics, generic risperidone, olanzapine, clozapine and family interventions. Health outcomes were measured in disability adjusted life years. We evaluated intervention benefit by estimating a change in disease severity, taking into account potential side effects. Intervention costs included outpatient treatment costs, hospitalization costs as well as time and travel costs of patients and families. Uncertainty was evaluated using Monte Carlo simulation. A sensitivity analysis of the expected range cost of generic risperidone was undertaken. Generic risperidone is more cost-effective than typicals if it can be produced for less than 10 baht per 2 mg tablet. Risperidone was the cheapest treatment with higher drug costs offset by lower hospital costs in comparison to typicals. The most cost-effective combination of treatments was a combination of risperidone (dominant intervention). Adding family intervention has an incremental cost-effectiveness ratio of 1,900 baht/DALY with a 100% probability of a result less than a threshold for very cost-effective interventions of one times GDP or 110,000 baht per DALY. Treating the most severe one third of patients with clozapine instead of risperidone had an incremental cost-effectiveness ratio of 320,000 baht/DALY with just over 50% probability of a result below three times GDP per capita. There are good economic arguments to recommend generic risperidone as first line treatment in combination with family intervention. As the uncertainty interval indicates the addition of clozapine may be dominated and there are serious

Blueberry effects on dark vision and recovery after photobleaching: placebo-controlled crossover studies.

Science.gov (United States)

Kalt, Wilhelmina; McDonald, Jane E; Fillmore, Sherry A E; Tremblay, Francois

2014-11-19

Clinical evidence for anthocyanin benefits in night vision is controversial. This paper presents two human trials investigating blueberry anthocyanin effects on dark adaptation, functional night vision, and vision recovery after retinal photobleaching. One trial, S2 (n = 72), employed a 3 week intervention and a 3 week washout, two anthocyanin doses (271 and 7.11 mg cyanidin 3-glucoside equivalents (C3g eq)), and placebo. The other trial, L1 (n = 59), employed a 12 week intervention and an 8 week washout and tested one dose (346 mg C3g eq) and placebo. In both S2 and L1 neither dark adaptation nor night vision was improved by anthocyanin intake. However, in both trials anthocyanin consumption hastened the recovery of visual acuity after photobleaching. In S2 both anthocyanin doses were effective (P = 0.014), and in L1 recovery was improved at 8 weeks (P = 0.027) and 12 weeks (P = 0.030). Although photobleaching recovery was hastened by anthocyanins, it is not known whether this improvement would have an impact on everyday vision.

The effect of active recovery on power performance during the bench press exercise.

Science.gov (United States)

Lopes, Felipe A S; Panissa, Valéria L G; Julio, Ursula F; Menegon, Elton M; Franchini, Emerson

2014-03-27

The objective of this study was to verify the effect of active and passive recovery on blood lactate concentration and power performance. Twelve male subjects were submitted to a maximal strength test in the the bench press, a maximal aerobic test in the bench step, and to four sets of bench press exercise performed as fast and as long as possible, using 80% of maximal strength when active or passive recovery was performed. The maximum number of repetitions, mean and peak power in eccentric and concentric phases were computed and blood lactate concentration was measured. Comparisons for the variables were made using a two-way variance analysis (recovery type and set numer) with repeated measures in the second factor. When significant differences were detected (p 2, 3, and 4; 2 > 3 and 4; 3 > 4). Mean and peak power in both eccentric and concentric phases also differed across sets (1 > 2, 3, and 4; 2 > 4). There was also a main effect for the recovery type, with lower values (p bench press exercise.

24 CFR 266.656 - Recovery of costs after final claim settlement.

Science.gov (United States)

2010-04-01

... AUTHORITIES HOUSING FINANCE AGENCY RISK-SHARING PROGRAM FOR INSURED AFFORDABLE MULTIFAMILY PROJECT LOANS... project or otherwise, the total amount of such recovery shall be shared by HUD and the HFA in accordance...

Cost effective waste management through composting in Africa

International Nuclear Information System (INIS)

Couth, R.; Trois, C.

2012-01-01

Highlights: ► The financial/social/institutional sustainability of waste management in Africa is analysed. ► This note is a compendium of a study on the potential for GHG control via improved zero waste in Africa. ► This study provides the framework for Local Authorities for realizing sustained GHG reductions. - Abstract: Greenhouse gas (GHG) emissions per person from urban waste management activities are greater in sub-Saharan African countries than in other developing countries, and are increasing as the population becomes more urbanised. Waste from urban areas across Africa is essentially dumped on the ground and there is little control over the resulting gas emissions. The clean development mechanism (CDM), from the 1997 Kyoto Protocol has been the vehicle to initiate projects to control GHG emissions in Africa. However, very few of these projects have been implemented and properly registered. A much more efficient and cost effective way to control GHG emissions from waste is to stabilise the waste via composting and to use the composted material as a soil improver/organic fertiliser or as a component of growing media. Compost can be produced by open windrow or in-vessel composting plants. This paper shows that passively aerated open windrows constitute an appropriate low-cost option for African countries. However, to provide an usable compost material it is recommended that waste is processed through a materials recovery facility (MRF) before being composted. The paper demonstrates that material and biological treatment (MBT) are viable in Africa where they are funded, e.g. CDM. However, they are unlikely to be instigated unless there is a replacement to the Kyoto Protocol, which ceases for Registration in December 2012.

Controlling Campylobacter in the chicken meat chain - Cost-effectiveness and cost-utility analysis

NARCIS (Netherlands)

Mangen MJJ; Havelaar AH; Nauta MJ; Koeijer AA de; Wit GA de; LEI; Animal Sciences Group; PZO; MGB

2005-01-01

The aim of this study was the estimation of cost-effectiveness and cost-utility of various interventions to control Campylobacter contamination of broiler meat. The relative risk, the intervention costs, the disease burden (expressed in Disability Adjusted Live Years (DALYs)) and the

Recovery Based Nanowire Field-Effect Transistor Detection of Pathogenic Avian Influenza DNA

Science.gov (United States)

Lin, Chih-Heng; Chu, Chia-Jung; Teng, Kang-Ning; Su, Yi-Jr; Chen, Chii-Dong; Tsai, Li-Chu; Yang, Yuh-Shyong

2012-02-01

Fast and accurate diagnosis is critical in infectious disease surveillance and management. We proposed a DNA recovery system that can easily be adapted to DNA chip or DNA biosensor for fast identification and confirmation of target DNA. This method was based on the re-hybridization of DNA target with a recovery DNA to free the DNA probe. Functionalized silicon nanowire field-effect transistor (SiNW FET) was demonstrated to monitor such specific DNA-DNA interaction using high pathogenic strain virus hemagglutinin 1 (H1) DNA of avian influenza (AI) as target. Specific electric changes were observed in real-time for AI virus DNA sensing and device recovery when nanowire surface of SiNW FET was modified with complementary captured DNA probe. The recovery based SiNW FET biosensor can be further developed for fast identification and further confirmation of a variety of influenza virus strains and other infectious diseases.

Disaster recovery: mitigating loss through documentation.

Science.gov (United States)

Boisvert, Sue

2011-01-01

Flood, fire, tornado, hurricane. Whatever the cause, natural or man-made, the result on an organization can be devastating. Planning and preparation for disaster must include significant attention to disaster recovery. The ability to produce documentation of what existed, what was damaged, recovery costs and income losses will be essential to the claims adjustment process. This article discusses strategies for creating a historical record, leveraging contemporaneous incident command documentation and working with contractors to identify and record disaster-related expenses. © 2011 American Society for Healthcare Risk Management of the American Hospital Association.

A cost-effectiveness and cost-utility analysis of radiosurgery vs. resection for single-brain metastases

International Nuclear Information System (INIS)

Mehta, Minesh; Noyes, William; Craig, Bruce; Lamond, John; Auchter, Richard; French, Molly; Johnson, Mark; Levin, Allan; Badie, Behnam; Robbins, Ian; Kinsella, Timothy

1997-01-01

Purpose: The median survival of well-selected patients with single-brain metastases treated with whole-brain irradiation and resection or radiosurgery is comparable, although a randomized trial of these two modalities has not been performed. In this era of cost containment, it is imperative that health-care professionals make fiscally prudent decisions. The present environment necessitates a critical appraisal of apparently equi-efficacious therapeutic modalities, and it is within this context that we present a comparison of the actual costs of resection and radiosurgery for brain metastases. Methods and Materials: Survival and quality of life outcome data for radiation alone or with surgery were obtained from two randomized trials, and radiosurgical results were obtained from a multiinstitutional analysis that specifically evaluated patients meeting surgical criteria. Only linear accelerator radiosurgery data were considered. Cost analysis was performed from a societal view point, and the following parameters were evaluated: actual cost, cost ratios, cost effectiveness, incremental cost effectiveness, cost utility, incremental cost utility, and national cost burden. The computerized billing records for all patients undergoing resection or radiosurgery for single-brain metastases from January 1989 to July 1994 were reviewed. A total of 46 resections and 135 radiosurgery procedures were performed. During the same time period, 454 patients underwent whole-brain radiation alone. An analysis of the entire bill was performed for each procedure, and each itemized cost was assigned a proportionate figure. The relative cost ratios of resection and radiosurgery were compared using the Wilcoxon rank sum test. Cost effectiveness of each modality, defined as the cost per year of median survival, was evaluated. Incremental cost effectiveness, defined as the additional cost per year of incremental gain in median survival, compared to the next least expensive modality, was also

Review on dog rabies vaccination coverage in Africa: a question of dog accessibility or cost recovery?

Science.gov (United States)

Jibat, Tariku; Hogeveen, Henk; Mourits, Monique C M

2015-02-01

Rabies still poses a significant human health problem throughout most of Africa, where the majority of the human cases results from dog bites. Mass dog vaccination is considered to be the most effective method to prevent rabies in humans. Our objective was to systematically review research articles on dog rabies parenteral vaccination coverage in Africa in relation to dog accessibility and vaccination cost recovery arrangement (i.e.free of charge or owner charged). A systematic literature search was made in the databases of CAB abstracts (EBSCOhost and OvidSP), Scopus, Web of Science, PubMed, Medline (EBSCOhost and OvidSP) and AJOL (African Journal Online) for peer reviewed articles on 1) rabies control, 2) dog rabies vaccination coverage and 3) dog demography in Africa. Identified articles were subsequently screened and selected using predefined selection criteria like year of publication (viz. ≥ 1990), type of study (cross sectional), objective(s) of the study (i.e. vaccination coverage rates, dog demographics and financial arrangements of vaccination costs), language of publication (English) and geographical focus (Africa). The selection process resulted in sixteen peer reviewed articles which were used to review dog demography and dog ownership status, and dog rabies vaccination coverage throughout Africa. The main review findings indicate that 1) the majority (up to 98.1%) of dogs in African countries are owned (and as such accessible), 2) puppies younger than 3 months of age constitute a considerable proportion (up to 30%) of the dog population and 3) male dogs are dominating in numbers (up to 3.6 times the female dog population). Dog rabies parenteral vaccination coverage was compared between "free of charge" and "owner charged" vaccination schemes by the technique of Meta-analysis. Results indicate that the rabies vaccination coverage following a free of charge vaccination scheme (68%) is closer to the World Health Organization recommended coverage rate

Counteracting ammonia inhibition during anaerobic digestion by recovery using submersible microbial desalination cell.

Science.gov (United States)

Zhang, Yifeng; Angelidaki, Irini

2015-07-01

Ammonia inhibition is one of the most frequent and serious problems in biogas plants. In this study, a novel hybrid system consisting of a submersible microbial desalination cell (SMDC) and a continuous stirred tank reactor (CSTR) was developed for counteracting ammonia inhibition during anaerobic digestion (AD) with simultaneous in situ ammonia recovery and electricity production. The SMDC was powered by acetate in a buffer solution, while synthetic ammonia-rich wastewater was used as the feeding of the CSTR. Under continuous operation, ammonia recovery rate of 86 g-N/m(2) /day and current density of 4.33 A/m(2) were achieved at steady-state condition. As a result, 112% extra biogas was produced due to ammonia recovery by the SMDC. High-throughput sequencing showed that ammonia recovery had an impact on the microbial community structures in the SMDC and CSTR. Considering the additional economic benefits of biogas enhancement and possible wastewater treatment, the SMDC may represent a cost-effective and environmentally friendly method for waste resources recovery and biomethanation of ammonia-rich residues. © 2015 Wiley Periodicals, Inc.

Total Value of Phosphorus Recovery.

Science.gov (United States)

Mayer, Brooke K; Baker, Lawrence A; Boyer, Treavor H; Drechsel, Pay; Gifford, Mac; Hanjra, Munir A; Parameswaran, Prathap; Stoltzfus, Jared; Westerhoff, Paul; Rittmann, Bruce E

2016-07-05

Phosphorus (P) is a critical, geographically concentrated, nonrenewable resource necessary to support global food production. In excess (e.g., due to runoff or wastewater discharges), P is also a primary cause of eutrophication. To reconcile the simultaneous shortage and overabundance of P, lost P flows must be recovered and reused, alongside improvements in P-use efficiency. While this motivation is increasingly being recognized, little P recovery is practiced today, as recovered P generally cannot compete with the relatively low cost of mined P. Therefore, P is often captured to prevent its release into the environment without beneficial recovery and reuse. However, additional incentives for P recovery emerge when accounting for the total value of P recovery. This article provides a comprehensive overview of the range of benefits of recovering P from waste streams, i.e., the total value of recovering P. This approach accounts for P products, as well as other assets that are associated with P and can be recovered in parallel, such as energy, nitrogen, metals and minerals, and water. Additionally, P recovery provides valuable services to society and the environment by protecting and improving environmental quality, enhancing efficiency of waste treatment facilities, and improving food security and social equity. The needs to make P recovery a reality are also discussed, including business models, bottlenecks, and policy and education strategies.

Techno-economic analysis and optimization of the heat recovery of utility boiler flue gas

International Nuclear Information System (INIS)

Xu, Gang; Huang, Shengwei; Yang, Yongping; Wu, Ying; Zhang, Kai; Xu, Cheng

2013-01-01

Highlights: • Four typical flue gas heat recovery schemes are quantitatively analyzed. • The analysis considers thermodynamic, heat transfer and hydrodynamics factors. • Techno-economic analysis and optimization design are carried out. • High-stage steam substitute scheme obtains better energy-saving effect. • Large heat transfer area and high flue gas resistances weaken overall performance. - Abstract: Coal-fired power plants in China consume nearly half of available coals, and the resulting CO 2 emissions cover over 40% of total national emissions. Therefore, reducing the energy expenditure of coal-fired power plants is of great significance to China’s energy security and greenhouse gas reduction programs. For coal-fired power plants, the temperature of a boiler’s exhaust gas reaches 120–150 °C or even higher. The thermal energy of boiler’s exhaust accounts for approximately 3–8% of the total energy of fuel input. Given these factors, we conducted a techno-economic analysis and optimization design of the heat recovery system using boiler exhaust gas. This research is conformed to the principles of thermodynamic, heat transfer, and hydrodynamics. Based on the data from an existing 1000 MW typical power generation unit in China, four typical flue gas heat recovery schemes are quantitatively analyzed from the thermodynamics perspective. The impacts of flue gas heat recovery on net work output and standard coal consumption rate of various schemes are performed. Furthermore, the transfer area of heat recovery exchanger and the draft fan work increment due to the flue gas pressure drop are analyzed. Finally, a techno-economic analysis of the heat recovery schemes is conducted, and some recommendations on optimization design parameters are proposed, with full consideration of various factors such as the decrease on fuel cost due to energy conservation as well as the investment cost of heat recovery retrofitting. The results revealed that, high

Effect of contrast water therapy duration on recovery of running performance.

Science.gov (United States)

Versey, Nathan G; Halson, Shona L; Dawson, Brian T

2012-06-01

To investigate whether contrast water therapy (CWT) assists acute recovery from high-intensity running and whether a dose-response relationship exists. Ten trained male runners completed 4 trials, each commencing with a 3000-m time trial, followed by 8 × 400-m intervals with 1 min of recovery. Ten minutes postexercise, participants performed 1 of 4 recovery protocols: CWT, by alternating 1 min hot (38°C) and 1 min cold (15°C) for 6 (CWT6), 12 (CWT12), or 18 min (CWT18), or a seated rest control trial. The 3000-m time trial was repeated 2 h later. 3000-m performance slowed from 632 ± 4 to 647 ± 4 s in control, 631 ± 4 to 642 ± 4 s in CWT6, 633 ± 4 to 648 ± 4 s in CWT12, and 631 ± 4 to 647 ± 4 s in CWT18. Following CWT6, performance (smallest worthwhile change of 0.3%) was substantially faster than control (87% probability, 0.8 ± 0.8% mean ± 90% confidence limit), however, there was no effect for CWT12 (34%, 0.0 ± 1.0%) or CWT18 (34%, -0.1 ± 0.8%). There were no substantial differences between conditions in exercise heart rates, or postexercise calf and thigh girths. Algometer thigh pain threshold during CWT12 was higher at all time points compared with control. Subjective measures of thermal sensation and muscle soreness were lower in all CWT conditions at some post-water-immersion time points compared with control; however, there were no consistent differences in whole body fatigue following CWT. Contrast water therapy for 6 min assisted acute recovery from high-intensity running; however, CWT duration did not have a dose-response effect on recovery of running performance.

Cost-effectiveness of Chlamydia antibody tests in subfertile women.

Science.gov (United States)

Fiddelers, A A A; Land, J A; Voss, G; Kessels, A G H; Severens, J L

2005-02-01

For the evaluation of tubal function, Chlamydia antibody testing (CAT) has been introduced as a screening test. We compared six CAT screening strategies (five CAT tests and one combination of tests), with respect to their cost-effectiveness, by using IVF pregnancy rate as outcome measure. A decision analytic model was developed based on a source population of 1715 subfertile women. The model incorporates hysterosalpingography (HSG), laparoscopy and IVF. To calculate IVF pregnancy rates, costs, effects, cost-effectiveness and incremental costs per effect of the six different CAT screening strategies were determined. pELISA Medac turned out to be the most cost-effective CAT screening strategy (15 075 per IVF pregnancy), followed by MIF Anilabsystems (15 108). A combination of tests (pELISA Medac and MIF Anilabsystems; 15 127) did not improve the cost-effectiveness of the single strategies. Sensitivity analyses showed that the results are robust for changes in the baseline values of the model parameters. Only small differences were found between the screening strategies regarding the cost-effectiveness, although pELISA Medac was the most cost-effective strategy. Before introducing a particular CAT test into clinical practice, one should consider the effects and consequences of the entire screening strategy, instead of only the diagnostic accuracy of the test used.

Recovery from cannabis use disorders: Abstinence versus moderation and treatment-assisted recovery versus natural recovery.

Science.gov (United States)

Stea, Jonathan N; Yakovenko, Igor; Hodgins, David C

2015-09-01

The present study of recovery from cannabis use disorders was undertaken with 2 primary objectives that address gaps in the literature. The first objective was to provide an exploratory portrait of the recovery process from cannabis use disorders, comparing individuals who recovered naturally with those who were involved in treatment. The second objective was to explore systematically the similarities and differences between abstinence and moderation recoveries. Adults who have recovered from a cannabis use disorder were recruited in the community (N = 119). The abstinence and treatment-assisted participants exhibited higher levels of lifetime cannabis problem severity than the moderation and natural recovery participants, respectively. As well, cognitive factors were identified as the most useful strategies for recovery (e.g., thinking about benefits and negative consequences of cannabis), followed by behavioral factors (e.g., avoidance of triggers for use and high-risk situations). Findings lend further support to the effectiveness of cognitive, motivational, and behavioral strategies as helpful actions and maintenance factors involved in the recovery process. The findings also generally support the idea that cannabis use disorders lie on a continuum of problem severity, with moderation and natural recoveries more likely to occur at the lower end of the continuum and abstinence and treatment-assisted recoveries more likely to occur at the upper end. (c) 2015 APA, all rights reserved).

Investigation and optimization of the depth of flue gas heat recovery in surface heat exchangers

Science.gov (United States)

Bespalov, V. V.; Bespalov, V. I.; Melnikov, D. V.

2017-09-01

Economic issues associated with designing deep flue gas heat recovery units for natural gas-fired boilers are examined. The governing parameter affecting the performance and cost of surface-type condensing heat recovery heat exchangers is the heat transfer surface area. When firing natural gas, the heat recovery depth depends on the flue gas temperature at the condenser outlet and determines the amount of condensed water vapor. The effect of the outlet flue gas temperature in a heat recovery heat exchanger on the additionally recovered heat power is studied. A correlation has been derived enabling one to determine the best heat recovery depth (or the final cooling temperature) maximizing the anticipated reduced annual profit of a power enterprise from implementation of energy-saving measures. Results of optimization are presented for a surface-type condensing gas-air plate heat recovery heat exchanger for the climatic conditions and the economic situation in Tomsk. The predictions demonstrate that it is economically feasible to design similar heat recovery heat exchangers for a flue gas outlet temperature of 10°C. In this case, the payback period for the investment in the heat recovery heat exchanger will be 1.5 years. The effect of various factors on the optimal outlet flue gas temperature was analyzed. Most climatic, economical, or technological factors have a minor effect on the best outlet temperature, which remains between 5 and 20°C when varying the affecting factors. The derived correlation enables us to preliminary estimate the outlet (final) flue gas temperature that should be used in designing the heat transfer surface of a heat recovery heat exchanger for a gas-fired boiler as applied to the specific climatic conditions.

Laboratory simulations of the mixed solvent extraction recovery of dominate polymers in electronic waste.

Science.gov (United States)

Zhao, Yi-Bo; Lv, Xu-Dong; Yang, Wan-Dong; Ni, Hong-Gang

2017-11-01

The recovery of four dominant plastics from electronic waste (e-waste) using mixed solvent extraction was studied. The target plastics included polycarbonate (PC), polystyrene (PS), acrylonitrile butadiene styrene (ABS), and styrene acrylonitrile (SAN). The extraction procedure for multi-polymers at room temperature yielded PC, PS, ABS, and SAN in acceptable recovery rates (64%, 86%, 127%, and 143%, respectively, where recovery rate is defined as the mass ratio of the recovered plastic to the added standard polymer). Fourier transform infrared spectroscopy (FTIR) was used to verify the recovered plastics' purity using a similarity analysis. The similarities ranged from 0.98 to 0.99. Another similar process, which was denoted as an alternative method for plastic recovery, was examined as well. Nonetheless, the FTIR results showed degradation may occur over time. Additionally, the recovery cost estimation model of our method was established. The recovery cost estimation indicated that a certain range of proportion of plastics in e-waste, especially with a higher proportion of PC and PS, can achieve a lower cost than virgin polymer product. It also reduced 99.6%, 30.7% and 75.8% of energy consumptions and CO 2 emissions during the recovery of PC, PS and ABS, and reduced the amount of plastic waste disposal via landfill or incineration and associated environmental impacts. Copyright © 2017 Elsevier Ltd. All rights reserved.

A new helium gas recovery and purification system

International Nuclear Information System (INIS)

Yamamotot, T.; Suzuki, H.; Ishii, J.; Hamana, I.; Hayashi, S.; Mizutani, S.; Sanjo, S.

1974-01-01

A helium gas recovery and purification system, based on the principle of gas permeation through a membrane, is described. The system can be used for the purification of helium gas containing air as a contaminant. The apparatus, operating at ambient temperature does not need constant attention, the recovery ratio of helium gas is satisfactory and running costs are low. Gases other than helium can be processed with the apparatus. (U.K.)

Cost effectiveness and efficiency in assistive technology service delivery.

Science.gov (United States)

Warren, C G

1993-01-01

In order to develop and maintain a viable service delivery program, the realities of cost effectiveness and cost efficiency in providing assistive technology must be addressed. Cost effectiveness relates to value of the outcome compared to the expenditures. Cost efficiency analyzes how a provider uses available resources to supply goods and services. This paper describes how basic business principles of benefit/cost analysis can be used to determine cost effectiveness. In addition, basic accounting principles are used to illustrate methods of evaluating a program's cost efficiency. Service providers are encouraged to measure their own program's effectiveness and efficiency (and potential viability) in light of current trends. This paper is meant to serve as a catalyst for continued dialogue on this topic.

Modeling economic costs of disasters and recovery involving positive effects of reconstruction: analysis using a dynamic CGE model

Science.gov (United States)

Xie, W.; Li, N.; Wu, J.-D.; Hao, X.-L.

2013-11-01

Disaster damages have negative effects on economy, whereas reconstruction investments have positive effects. The aim of this study is to model economic causes of disasters and recovery involving positive effects of reconstruction activities. Computable general equilibrium (CGE) model is a promising approach because it can incorporate these two kinds of shocks into a unified framework and further avoid double-counting problem. In order to factor both shocks in CGE model, direct loss is set as the amount of capital stock reduced on supply side of economy; A portion of investments restore the capital stock in existing period; An investment-driven dynamic model is formulated due to available reconstruction data, and the rest of a given country's saving is set as an endogenous variable. The 2008 Wenchuan Earthquake is selected as a case study to illustrate the model, and three scenarios are constructed: S0 (no disaster occurs), S1 (disaster occurs with reconstruction investment) and S2 (disaster occurs without reconstruction investment). S0 is taken as business as usual, and the differences between S1 and S0 and that between S2 and S0 can be interpreted as economic losses including reconstruction and excluding reconstruction respectively. The study showed that output from S1 is found to be closer to real data than that from S2. S2 overestimates economic loss by roughly two times that under S1. The gap in economic aggregate between S1 and S0 is reduced to 3% in 2011, a level that should take another four years to achieve under S2.

Recovery of succinic acid produced by fermentation of a metabolically engineered Mannheimia succiniciproducens strain.

Science.gov (United States)

Song, Hyohak; Huh, Yun Suk; Lee, Sang Yup; Hong, Won Hi; Hong, Yeon Ki

2007-12-01

There have recently been much advances in the production of succinic acid, an important four-carbon dicarboxylic acid for many industrial applications, by fermentation of several natural and engineered bacterial strains. Mannheimia succiniciproducens MBEL55E isolated from bovine rumen is able to produce succinic acid with high efficiency, but also produces acetic, formic and lactic acids just like other anaerobic succinic acid producers. We recently reported the development of an engineered M. succiniciproducens LPK7 strain which produces succinic acid as a major fermentation product while producing much reduced by-products. Having an improved succinic acid producer developed, it is equally important to develop a cost-effective downstream process for the recovery of succinic acid. In this paper, we report the development of a simpler and more efficient method for the recovery of succinic acid. For the recovery of succinic acid from the fermentation broth of LPK7 strain, a simple process composed of a single reactive extraction, vacuum distillation, and crystallization yielded highly purified succinic acid (greater than 99.5% purity, wt%) with a high yield of 67.05wt%. When the same recovery process or even multiple reactive extraction steps were applied to the fermentation broth of MBEL55E, lower purity and yield of succinic acid were obtained. These results suggest that succinic acid can be purified in a cost-effective manner by using the fermentation broth of engineered LPK7 strain, showing the importance of integrating the strain development, fermentation and downstream process for optimizing the whole processes for succinic acid production.

RJD A Cost Effective Frackless Solution For Production Enhancement In Marginal Fields

Directory of Open Access Journals (Sweden)

Ahmed Kamel

2017-02-01

Full Text Available With the worldwide trend of low oil prices high maturity of oil fields excessive cost of horizontal and fracking technologies and necessity for green drilling applications radial jet drilling RJD technology can be a cost effective and environmentally-friendly alternative. RJD is an unconventional drilling technique that utilizes coiled tubing conveyed tools and the energy of high velocity jet fluids to drill laterals inside the reservoir. In recent years rapid advances in high pressure water jet technology has tremendously increased its application in oil and gas industry not only in drilling operations to improve drilling rate and reduce drilling cost but also in production to maximize hydrocarbon recovery. In addition RJD can be used to bypass near wellbore damage direct reservoir treatmentsinjections improve water disposal and re-injection rates and assist in steam or CO2 treatments. This paper highlights the theoretical basis technological advancement procedures applications and challenges of high pressure water jets. Several worldwide case studies are discussed to evaluate the success results pros and cons of RJD. The results show that nearly an average of four to five fold production increase can be obtained. The present paper clearly shows that radial jet drilling is a viable and attractive alternative in marginal and small reservoirs that still have significant oil in place to capture the benefits of horizontal drillingfracking and to improve productivity from both new wells andor workover wells that cannot be produced with the existing expensive conventional completions.

Effect of a package of health and nutrition services on sustained recovery in children after moderate acute malnutrition and factors related to sustaining recovery: a cluster-randomized trial.

Science.gov (United States)

Stobaugh, Heather C; Bollinger, Lucy B; Adams, Sara E; Crocker, Audrey H; Grise, Jennifer B; Kennedy, Julie A; Thakwalakwa, Chrissie; Maleta, Kenneth M; Dietzen, Dennis J; Manary, Mark J; Trehan, Indi

2017-08-01

Background: Children who recover from moderate acute malnutrition (MAM) have high rates of relapse in the year after nutritional recovery. Interventions to decrease these adverse outcomes are needed to maximize the overall effectiveness of supplemental feeding programs (SFPs). Objective: We evaluated the effectiveness of a package of health and nutrition interventions on improving the proportion of children who sustained recovery for 1 y after MAM treatment. We further explored factors related to sustained recovery. Design: We conducted a cluster-randomized clinical effectiveness trial involving rural Malawian children aged 6-62 mo who were enrolled on discharge from an SFP for MAM. We enrolled 718 children at 10 control sites and 769 children at 11 intervention sites. In addition to routine health and nutrition counseling, the intervention group received a package of health and nutrition interventions that consisted of a lipid nutrient supplement, deworming medication, zinc supplementation, a bed net, and malaria chemoprophylaxis. A survival analysis was used to determine the effectiveness of the intervention as well as to identify factors associated with sustained recovery. Results: Of 1383 children who returned for the full 12-mo follow-up period, 407 children (56%) and 347 children (53%) sustained recovery in the intervention and control groups, respectively. There was no significant difference in relapse-free survival curves between the treatment and control groups ( P = 0.380; log-rank test). The risk factors for relapse or death after initial recovery were a smaller midupper arm circumference on SFP admission ( P = 0.01) and discharge ( P nutrition services in addition to traditional SFP treatment has no significant effect on improving sustained recovery in children after treatment of MAM. This trial was registered at clinicaltrials.gov as NCT02351687. © 2017 American Society for Nutrition.

Cost effectiveness analysis of indoor radon control measures

International Nuclear Information System (INIS)

Fujimoto, Kenzo

1989-01-01

The problem of radon 222 in buildings as a contributor to radiation exposure is described. Five different control methods and the dose reductions that would result from each are analysed. The annualized cost for each control measure was evaluated and the cost effectiveness of each control measure was calculated on the basis of dollars per person-sievert dose reduction. The use of unipolar ion generators for particle removal appears to be the most cost effective and the use of ceiling fans to increase air circulation the least cost effective. 3 figs., 1 tab

Therapeutic effect of Chinese herbal medicines for post stroke recovery: A traditional and network meta-analysis.

Science.gov (United States)

Han, Shi-You; Hong, Zhi-You; Xie, Yu-Hua; Zhao, Yong; Xu, Xiao

2017-12-01

Stroke is a condition with high morbidity and mortality, and 75% of stroke survivors lose their ability to work. Stroke is a burden to the family and society. The purpose of this study was to evaluate the effectiveness of Chinese herbal patent medicines in the treatment of patients after the acute phase of a stroke. We searched the following databases through August 2016: PubMed, Embase, Cochrane library, China Knowledge Resource Integrated Database (CNKI), China Science Periodical Database (CSPD), and China Biology Medicine disc (CBMdisc) for studies that evaluated Chinese herbal patent medicines for post stroke recovery. A random-effect model was used to pool therapeutic effects of Chinese herbal patent medicines on stroke recovery. Network meta-analysis was used to rank the treatment for each Chinese herbal patent medicine. In our meta-analysis, we evaluated 28 trials that included 2780 patients. Chinese herbal patent medicines were effective in promoting recovery after stroke (OR, 3.03; 95% CI: 2.53-3.64; P herbal patent medicines significantly improved neurological function defect scores when compared with the controls (standard mean difference [SMD], -0.89; 95% CI, -1.44 to -0.35; P = .001). Chinese herbal patent medicines significantly improved the Barthel index (SMD, 0.73; 95% CI, 0.53-0.94; P herbal medicines most likely to improve stroke recovery when combined with acupuncture. Our research suggests that the Chinese herbal patent medicines were effective for stroke recovery. The most effective treatments for stroke recovery were MLC601, Shuxuetong, and BuchangNaoxintong. However, to clarify the specific effective ingredients of Chinese herbal medicines, a well-designed study is warranted.

A cost-effectiveness analysis of shipboard telemedicine.

Science.gov (United States)

Stoloff, P H; Garcia, F E; Thomason, J E; Shia, D S

1998-01-01

The U.S. Navy is considering the installation of telemedicine equipment on more than 300 ships. Besides improving the quality of care, benefits would arise from avoiding medical evacuations (MEDEVACs) and returning patients to work more quickly. Because telemedicine has not yet been fully implemented by the Navy, we relied on projections of anticipated savings and costs, rather than actual expenditures, to determine cost-effectiveness. To determine the demand for telemedicine and the cost-effectiveness of various technologies (telephone and fax, e-mail and Internet, video teleconferencing (VTC), teleradiology, and diagnostic instruments), as well as their bandwidth requirements. A panel of Navy medical experts with telemedicine experience reviewed a representative sample of patient visits collected over a 1-year period and estimated the man-day savings and quality-of-care enhancements that might have occurred had telemedicine technologies been available. The savings from potentially avoiding MEDEVACs was estimated from a survey of ships' medical staff. These sample estimates were then projected to the medical workload of the entire fleet. Off-the-shelf telemedicine equipment prices were combined with installation, maintenance, training, and communication costs to obtain the lifecycle costs of the technology. If telemedicine were available to the fleet, ship medical staffs would initiate nearly 19, 000 consults in a year-7% of all patient visits. Telemedicine would enhance quality of care in two-thirds of these consults. Seventeen percent of the MEDEVACs would be preventable with telemedicine (representing 155,000 travel miles), with a savings of $4400 per MEDEVAC. If the ship's communication capabilities were available, e-mail and Internet and telephone and fax would be cost-effective on all ships (including small ships and submarines). Video teleconferencing would be cost-effective on large ships (aircraft carriers and amphibious) only. Teleradiology would be cost-effective

Uses and abuses of recovery: implementing recovery-oriented practices in mental health systems

Science.gov (United States)

Slade, Mike; Amering, Michaela; Farkas, Marianne; Hamilton, Bridget; O'Hagan, Mary; Panther, Graham; Perkins, Rachel; Shepherd, Geoff; Tse, Samson; Whitley, Rob

2014-01-01

An understanding of recovery as a personal and subjective experience has emerged within mental health systems. This meaning of recovery now underpins mental health policy in many countries. Developing a focus on this type of recovery will involve transformation within mental health systems. Human systems do not easily transform. In this paper, we identify seven mis-uses (“abuses”) of the concept of recovery: recovery is the latest model; recovery does not apply to “my” patients; services can make people recover through effective treatment; compulsory detention and treatment aid recovery; a recovery orientation means closing services; recovery is about making people independent and normal; and contributing to society happens only after the person is recovered. We then identify ten empirically-validated interventions which support recovery, by targeting key recovery processes of connectedness, hope, identity, meaning and empowerment (the CHIME framework). The ten interventions are peer support workers, advance directives, wellness recovery action planning, illness management and recovery, REFOCUS, strengths model, recovery colleges or recovery education programs, individual placement and support, supported housing, and mental health trialogues. Finally, three scientific challenges are identified: broadening cultural understandings of recovery, implementing organizational transformation, and promoting citizenship. PMID:24497237

Recovery of noble metals from fission products

International Nuclear Information System (INIS)

Jenson, G.A.; Platt, A.M.; Mellinger, G.B.; Bjorklund, W.J.

1982-11-01

Scoping studies were started in 1979 to develop a cost-effective, waste-management-compatible process to extract noble metals from fission products. The process, involving the reaction with glassmelting chemicals, a metal oxide (PbO), and a reducing agent (charcoal), was demonstrated for recovering noble metals from simulated high-level waste oxides. The process has now been demonstrated on a laboratory scale (100 g) using irradiated fuels. Recoveries in the recovered lead averaged 80% for Pd, 60% for Rh, and 14% Ru. The resulting glass product was homogeneous in appearance, and the chemical durability was comparable to other waste oxides

HYBRID SULFUR RECOVERY PROCESS FOR NATURAL GAS UPGRADING

International Nuclear Information System (INIS)

Girish Srinivas; Steven C. Gebhard; David W. DeBerry

2002-01-01

This first quarter report of 2002 describes progress on a project funded by the U.S. Department of Energy (DOE) to test a hybrid sulfur recovery process for natural gas upgrading. The process concept represents a low cost option for direct treatment of natural gas streams to remove H(sub 2)S in quantities equivalent to 0.2-25 metric tons (LT) of sulfur per day. This process is projected to have lower capital and operating costs than the competing technologies, amine/aqueous iron liquid redox and amine/Claus/tail gas treating, and have a smaller plant footprint, making it well suited to both on-shore and offshore applications. CrystaSulf(sup SM) (service mark of CrystaTech, Inc.) is a new nonaqueous sulfur recovery process that removes hydrogen sulfide (H(sub 2)S) from gas streams and converts it into elemental sulfur. CrystaSulf features high sulfur recovery similar to aqueous-iron liquid redox sulfur recovery processes, but differs from the aqueous processes in that CrystaSulf controls the location where elemental sulfur particles are formed. In the hybrid process, approximately 1/3 of the total H(sub 2)S in the natural gas is first oxidized to SO(sub 2) at low temperatures over a heterogeneous catalyst. Low temperature oxidation is done so that the H(sub 2)S can be oxidized in the presence of methane and other hydrocarbons without oxidation of the hydrocarbons. The project involves the development of a catalyst using laboratory/bench-scale catalyst testing, and then demonstration of the catalyst at CrystaTech's pilot plant in west Texas. In a previous reporting period tests were done to determine the effect of hydrocarbons such as n-hexane on catalyst performance with and without H(sub 2)S present. The experiments showed that hexane oxidation is suppressed when H(sub 2)S is present. Hexane represents the most reactive of the C1 to C6 series of alkanes. Since hexane exhibits low reactivity under H(sub 2)S oxidation conditions, and more importantly, does not change

Cost-effectiveness of emergency contraception options over 1 year.

Science.gov (United States)

Bellows, Brandon K; Tak, Casey R; Sanders, Jessica N; Turok, David K; Schwarz, Eleanor B

2018-05-01

The copper intrauterine device is the most effective form of emergency contraception and can also provide long-term contraception. The levonorgestrel intrauterine device has also been studied in combination with oral levonorgestrel for women seeking emergency contraception. However, intrauterine devices have higher up-front costs than oral methods, such as ulipristal acetate and levonorgestrel. Health care payers and decision makers (eg, health care insurers, government programs) with financial constraints must determine if the increased effectiveness of intrauterine device emergency contraception methods are worth the additional costs. We sought to compare the cost-effectiveness of 4 emergency contraception strategies-ulipristal acetate, oral levonorgestrel, copper intrauterine device, and oral levonorgestrel plus same-day levonorgestrel intrauterine device-over 1 year from a US payer perspective. Costs (2017 US dollars) and pregnancies were estimated over 1 year using a Markov model of 1000 women seeking emergency contraception. Every 28-day cycle, the model estimated the predicted number of pregnancy outcomes (ie, live birth, ectopic pregnancy, spontaneous abortion, or induced abortion) resulting from emergency contraception failure and subsequent contraception use. Model inputs were derived from published literature and national sources. An emergency contraception strategy was considered cost-effective if the incremental cost-effectiveness ratio (ie, the cost to prevent 1 additional pregnancy) was less than the weighted average cost of pregnancy outcomes in the United States ($5167). The incremental cost-effectiveness ratios and probability of being the most cost-effective emergency contraception strategy were calculated from 1000 probabilistic model iterations. One-way sensitivity analyses were used to examine uncertainty in the cost of emergency contraception, subsequent contraception, and pregnancy outcomes as well as the model probabilities. In 1000 women

Dual-earner couples' weekend recovery support, state of recovery, and work engagement: Work-linked relationship as a moderator.

Science.gov (United States)

Park, YoungAh; Haun, Verena C

2017-10-01

Despite growing recovery research, little is known about couple-dyadic processes of recovery from work. Given that dual-earner couples experience most of their recovery opportunities during nonwork times when they are together, partners in a couple relationship may substantially affect recovery and work engagement. In this study, we propose a couple-dyadic model in which weekend partner recovery support (reported by the recipient partner) is positively related to the recipient partner's state of recovery after the weekend which, in turn, increases the recipient's work engagement the following week (actor-actor mediation effect). We also test the effect of one's state of recovery on the partner's subsequent work engagement (partner effect). Additionally, work-linked relationship status is tested as a moderator of the partner effect. Actor-partner interdependence mediation modeling is used to analyze the data from 167 dual-earner couples who answered surveys on 4 measurement occasions. The results support the indirect effect of partner recovery support on work engagement through the postweekend state of recovery. Multigroup analysis results reveal that the partner effect of state of recovery on work engagement is significant for work-linked couples only and is absent for non-work-linked couples. Theoretical and practical implications, limitations, and future research directions are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Implementation of self-rostering (the PRIO-project) Effects on working hours, recovery and health

DEFF Research Database (Denmark)

Garde, Anne Helene; Albertsen, Karen; Nabe Nielsen, Kirsten

2012-01-01

Objectives The aim of this study was to (i) investigate the consequences of self-rostering for working hours, recovery, and health, and (ii) elucidate the mechanisms through which recovery and health are affected. Methods Twenty eight workplaces were allocated to either an intervention or reference...... workplace reports of working hours (N=718) were obtained at baseline and 12 months later. The interaction term between intervention and time was tested in mixed models and multinomial logistic regression models. Results The odds ratio (OR) of having short [OR 4.8, 95 % confidence interval (95% CI) 1.......17, 95% CI -0.29– -0.04) and B (β= -0.17, 95% CI -0.27– -0.07). There were no effects on recovery and health in intervention C, and overall, there were no detrimental effects on recovery or health. The benefits of the intervention were not related to changes in working hours and did not differ by gender...

Consumer-Operated Service Programs: monetary and donated costs and cost-effectiveness.

Science.gov (United States)

Yates, Brian T; Mannix, Danyelle; Freed, Michael C; Campbell, Jean; Johnsen, Matthew; Jones, Kristine; Blyler, Crystal R

2011-01-01

Examine cost differences between Consumer Operated Service Programs (COSPs) as possibly determined by a) size of program, b) use of volunteers and other donated resources, c) cost-of-living differences between program locales, d) COSP model applied, and e) delivery system used to implement the COSP model. As part of a larger evaluation of COSP, data on operating costs, enrollments, and mobilization of donated resources were collected for eight programs representing three COSP models (drop-in centers, mutual support, and education/advocacy training). Because the 8 programs were operated in geographically diverse areas of the US, costs were examined with and without adjustment for differences in local cost of living. Because some COSPs use volunteers and other donated resources, costs were measured with and without these resources being monetized. Scale of operation also was considered as a mediating variable for differences in program costs. Cost per visit, cost per consumer per quarter, and total program cost were calculated separately for funds spent and for resources donated for each COSP. Differences between COSPs in cost per consumer and cost per visit seem better explained by economies of scale and delivery system used than by cost-of-living differences between program locations or COSP model. Given others' findings that different COSP models produce little variation in service effectiveness, minimize service costs by maximizing scale of operation while using a delivery system that allows staff and facilities resources to be increased or decreased quickly to match number of consumers seeking services.

Cost Effective Technologies and Renewable Substrates for Biosurfactants’ Production

Directory of Open Access Journals (Sweden)

Ibrahim M Banat

2014-12-01

Full Text Available Diverse types of microbial surface-active amphiphilic molecules are produced by a range of microbial communities. The extraordinary properties of biosurfactant / bioemulsifier (BS/BE as surface active products allows them to have key roles in various field of applications such as bioremediation, biodegradation, enhanced oil recovery, pharmaceutics, food processing among many others. This leads to a vast number of potential applications of these BS/BE in different industrial sectors. Despite the huge number of reports and patents describing BS and BE applications and advantages, commercialization of these compounds remain difficult, costly and to a large extent irregular. This is mainly due to the usage of chemically synthesized media for growing producing microorganism and in turn the production of preferred quality products. It is important to note that although a number of developments have taken place in the field of biosurfactant industries, large scale production remains economically challenging for many types of these products. This is mainly due to the huge monetary difference between the investment and achievable productivity from the commercial point of view. This review discusses low cost, renewable raw substrates and fermentation technology in BS/BE production processes and their role in reducing the production cost.

Ethical objections against including life-extension costs in cost-effectiveness analysis: a consistent approach.

Science.gov (United States)

Gandjour, Afschin; Müller, Dirk

2014-10-01

One of the major ethical concerns regarding cost-effectiveness analysis in health care has been the inclusion of life-extension costs ("it is cheaper to let people die"). For this reason, many analysts have opted to rule out life-extension costs from the analysis. However, surprisingly little has been written in the health economics literature regarding this ethical concern and the resulting practice. The purpose of this work was to present a framework and potential solution for ethical objections against life-extension costs. This work found three levels of ethical concern: (i) with respect to all life-extension costs (disease-related and -unrelated); (ii) with respect to disease-unrelated costs only; and (iii) regarding disease-unrelated costs plus disease-related costs not influenced by the intervention. Excluding all life-extension costs for ethical reasons would require-for reasons of consistency-a simultaneous exclusion of savings from reducing morbidity. At the other extreme, excluding only disease-unrelated life-extension costs for ethical reasons would require-again for reasons of consistency-the exclusion of health gains due to treatment of unrelated diseases. Therefore, addressing ethical concerns regarding the inclusion of life-extension costs necessitates fundamental changes in the calculation of cost effectiveness.

Key Recovery Using Noised Secret Sharing with Discounts over Large Clouds

OpenAIRE

JAJODIA , Sushil; Litwin , Witold; Schwarz , Thomas

2013-01-01

Encryption key loss problem is the Achilles's heel of cryptography. Key escrow helps, but favors disclosures. Schemes for recoverable encryption keys through noised secret sharing alleviate the dilemma. Key owner escrows a specifically encrypted backup. The recovery needs a large cloud. Cloud cost, money trail should rarefy illegal attempts. We now propose noised secret sharing schemes supporting discounts. The recovery request with discount code lowers the recovery complexity, easily by orde...

High-Level Disinfection of Otorhinolaryngology Clinical Instruments: An Evaluation of the Efficacy and Cost-effectiveness of Instrument Storage.

Science.gov (United States)

Yalamanchi, Pratyusha; Yu, Jason; Chandler, Laura; Mirza, Natasha

2018-01-01

Objectives Despite increasing interest in individual instrument storage, risk of bacterial cross-contamination of otorhinolaryngology clinic instruments has not been assessed. This study is the first to determine the clinical efficacy and cost-effectiveness of standard high-level disinfection and clinic instrument storage. Methods To assess for cross-contamination, surveillance cultures of otorhinolaryngology clinic instruments subject to standard high-level disinfection and storage were obtained at the start and end of the outpatient clinical workday. Rate of microorganism recovery was compared with cultures of instruments stored in individual peel packs and control cultures of contaminated instruments. Based on historical clinic data, the direct allocation method of cost accounting was used to determine aggregate raw material cost and additional labor hours required to process and restock peel-packed instruments. Results Among 150 cultures of standard high-level disinfected and co-located clinic instruments, 3 positive bacterial cultures occurred; 100% of control cultures were positive for bacterial species ( P cost of individual semicritical instrument storage at $97,852.50 per year. Discussion With in vitro inoculation of >200 otorhinolaryngology clinic instruments, this study demonstrates that standard high-level disinfection and storage are equally efficacious to more time-consuming and expensive individual instrument storage protocols, such as peel packing, with regard to bacterial contamination. Implications for Practice Standard high-level disinfection and storage are equally effective to labor-intensive and costly individual instrument storage protocols.

Steel impurity element effects on postirradiation properties recovery by annealing

International Nuclear Information System (INIS)

Hawthorne, J.R.

1987-01-01

The influence of copper content and phosphorus content on notch ductility recovery by 399 0 C postirradiation heat treatment was explored for A 533-B and A 302-B pressure vessel steels. Charpy-V (C/sub V/) specimens for the investigation were obtained from ten plates produced from four (4-way split) laboratory melts. The plates were 15.2 mm thick but were heat treated to reproduce the microstructure of 150-mm and thicker A 302-B plates at the quarter-thickness location. The C/sub V/ specimens were irradiated in two assemblies at 288 0 C (550 0 F) to a fluence of --2.5 x 10/sup 19/ n/cm/sup 2/ in a light-water-cooled and moderated test reactor. Notch ductility properties in the asirradiated and 399 0 C, 168 h postirradiation-annealed conditions were determined. In addition, separate sets of specimens were thermally conditioned at 288 0 C and at 288 0 C followed by 399 0 C to benchmark the effects of temperature in the absence of irradiation. The results indicate that copper has a significant influence on the magnitude of residual embrittlement after annealing. In contrast, phosphorus contents in the range of 0.002 to 0.025% were found not to have an effect on residual embrittlement either in high or low copper steels. Essentially full recovery in 41-J transition temperature was observed for high phosphorus, low copper content steels. Effects of nickel alloying on recovery behavior were also investigated through data comparisons for A 302-B versus A 533-B plates

Addressing the recovery of feeding rates in post-exposure feeding bioassays: Cyathura carinata as a case study

Energy Technology Data Exchange (ETDEWEB)

Pais-Costa, Antonia Juliana [IMAR—Institute of Marine Research, MARE—Marine and Environmental Sciences Centre, Faculty of Sciences and Technology, University of Coimbra, 3004-517 Coimbra (Portugal); Acevedo, Pelayo [SaBio IREC, Instituto de Investigación en Recursos Cinegéticos (UCLM-CSIC-JCCM), Ciudad Real 13005 (Spain); Marques, João Carlos [IMAR—Institute of Marine Research, MARE—Marine and Environmental Sciences Centre, Faculty of Sciences and Technology, University of Coimbra, 3004-517 Coimbra (Portugal); Martinez-Haro, Mónica, E-mail: monica.martinezharo@gmail.com [IMAR—Institute of Marine Research, MARE—Marine and Environmental Sciences Centre, Faculty of Sciences and Technology, University of Coimbra, 3004-517 Coimbra (Portugal)

2015-02-15

Post-exposure bioassays are used in environmental assessment as a cost-effective tool, but the effects of organism's recovery after exposure to pollutant has not yet been addressed in detail. The recoveries of post-exposure feeding rates after being exposed to two sublethal concentrations of cadmium during two different exposure periods (48 h and 96 h) were evaluated under laboratory conditions using the estuarine isopod Cyathura carinata. Results showed that feeding depression was a stable endpoint up to 24 h after cadmium exposure, which is useful for ecotoxicological bioassays. - Highlights: • We studied recovery of post-exposure feeding rates 48–96 h after cadmium exposure. • The assay is based on the isopod Cyathura carinata. • Post-exposure feeding inhibition is a stable sublethal endpoint.

Determination of cost-effective operating condition for CO{sub 2} capturing using 1-butyl-3-methylimidazolium tetrafluoroborate ionic liquid

Energy Technology Data Exchange (ETDEWEB)

Ali, Emad; Alnashef, Inas; Ajbar, Abdelhamid; Mulyono, Sarwono; Hadj-Kali, Mohamed Kamel [King Saud University, Riyadh (Saudi Arabia); Hizaddin, Hanee Farzana [University of Malaya, Kuala Lumpur (Malaysia)

2013-11-15

1-Butyl-3-methylimidazolium tetrafluoroborate ([BMIM][BF4]) ionic liquid (IL) is considered for CO{sub 2} capturing in a typical absorption/stripper process. The use of ionic liquids is considered to be cost-effective because it requires less energy for solvent recovery compared to other conventional processes. A mathematical model was developed for the process based on Peng-Robinson (PR) equation of state (EoS). The model was validated with experimental data for CO{sub 2} solubility in [BMIM][BF4]. The model is utilized to study the sorbent effect and energy demand for selected operating pressure at specific CO{sub 2} capturing rates. The energy demand is expressed by the vapor-liquid equilibrium temperature necessary to remove the captured CO{sub 2} from the spent solvent in the regeneration step. It is found that low recovery temperature can be achieved at specific pressure combination for the absorber/stripper units. In fact, the temperature requirement is less than that required by the typical monoethanolamine (MEA) solvent. The effect of the CO{sub 2} loading in the sorbent stream on the process performance is also examined.

Cost of childhood diarrhoea in rural South Africa: exploring cost-effectiveness of universal zinc supplementation.

Science.gov (United States)

Chhagan, Meera K; Van den Broeck, Jan; Luabeya, Kany-Kany Angelique; Mpontshane, Nontobeko; Bennish, Michael L

2014-09-01

To describe the cost of diarrhoeal illness in children aged 6-24 months in a rural South African community and to determine the threshold prevalence of stunting at which universal Zn plus vitamin A supplementation (VAZ) would be more cost-effective than vitamin A alone (VA) in preventing diarrhoea. We conducted a cost analysis using primary and secondary data sources. Using simulations we examined incremental costs of VAZ relative to VA while varying stunting prevalence. Data on efficacy and societal costs were largely from a South African trial. Secondary data were from local and international published sources. The trial included children aged 6-24 months. The secondary data sources were a South African health economics survey and the WHO-CHOICE (CHOosing Interventions that are Cost Effective) database. In the trial, stunted children supplemented with VAZ had 2·04 episodes (95 % CI 1·37, 3·05) of diarrhoea per child-year compared with 3·92 episodes (95 % CI 3·02, 5·09) in the VA arm. Average cost of illness was $Int 7·80 per episode (10th, 90th centile: $Int 0·28, $Int 15·63), assuming a minimum standard of care (oral rehydration and 14 d of therapeutic Zn). In simulation scenarios universal VAZ had low incremental costs or became cost-saving relative to VA when the prevalence of stunting was close to 20 %. Incremental cost-effectiveness ratios were sensitive to the cost of intervention and coverage levels. This simulation suggests that universal VAZ would be cost-effective at current levels of stunting in parts of South Africa. This requires further validation under actual programmatic conditions.

Potential of Russian Regions to Implement CO2-Enhanced Oil Recovery

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Alexey Cherepovitsyn

2018-06-01

Full Text Available The paper assesses the techno-economic potential of Russia to implement carbon capture and storage technologies that imply the capture of anthropogenic CO2 and its injection into geologic reservoirs for long-term storage. The focus is on CO2 enhanced oil recovery projects that seem to be the most economically promising option of carbon capture and storage. The novelty of the work lies in the formulation of a potential assessment method of CO2 enhanced oil recovery, which allows for establishing a connection between energy production and oil extraction from the viewpoint of CO2 supply and demand. Using linear optimization, the most promising combinations of CO2 sources and sinks are identified and an economic evaluation of these projects is carried out. Based on this information, regions of Russia are ranked according to their prospects in regards to CO2 capture and enhanced oil recovery storage. The results indicate that Russia has a significant potential to utilize its power plants as CO2 sources for enhanced oil recovery projects. It has been estimated that 71 coal-fired power plants, and 185 of the gas-fired power plants of Russia annually produce 297.1 and 309.6 Mt of CO2 that can cover 553.4 Mt of the demand of 322 Russian oil fields. At the same time, the total CO2 storage capacity of the Russian fields is estimated at 7382.6 Mt, however, due to geological and technical factors, only 22.6% can be used for CO2-EOR projects. Of the 183 potential projects identified in the regional analysis phase, 99 were found to be cost-effective, with an average unit cost of € 19.07 per ton of CO2 and a payback period of 8.71 years. The most promising of the estimated regions is characterized by a well-developed energy industry, relatively low transportation costs, numerous large and medium-sized oil fields at the final stages of development, and favorable geological conditions that minimize the cost of injection. Geographically, they are located in the

Cost-effectiveness of rotavirus vaccination in Turkey

Directory of Open Access Journals (Sweden)

Tulin Koksal

2017-10-01

Conclusion: At a cost per vaccine course of US$31.5 for monovalent and US$38 for pentavalent vaccine, routine RV vaccination could be potentially cost effective and also cost saving in Turkey. National RV vaccinations will play a significant role in preventing RV infections.

Cost-effectiveness of private umbilical cord blood banking.

Science.gov (United States)

Kaimal, Anjali J; Smith, Catherine C; Laros, Russell K; Caughey, Aaron B; Cheng, Yvonne W

2009-10-01

To investigate the cost-effectiveness of private umbilical cord blood banking. A decision-analytic model was designed comparing private umbilical cord blood banking with no umbilical cord blood banking. Baseline assumptions included a cost of $3,620 for umbilical cord blood banking and storage for 20 years, a 0.04% chance of requiring an autologous stem cell transplant, a 0.07% chance of a sibling requiring an allogenic stem cell transplant, and a 50% reduction in risk of graft-versus-host disease if a sibling uses banked umbilical cord blood. Private cord blood banking is not cost-effective because it cost an additional $1,374,246 per life-year gained. In sensitivity analysis, if the cost of umbilical cord blood banking is less than $262 or the likelihood of a child needing a stem cell transplant is greater than 1 in 110, private umbilical cord blood banking becomes cost-effective. Currently, private umbilical cord blood banking is cost-effective only for children with a very high likelihood of needing a stem cell transplant. Patients considering private blood banking should be informed of the remote likelihood that a unit will be used for a child or another family member. III.

Cost-Effectiveness of Old and New Technologies for Aneuploidy Screening.

Science.gov (United States)

Sinkey, Rachel G; Odibo, Anthony O

2016-06-01

Cost-effectiveness analyses allow assessment of whether marginal gains from new technology are worth increased costs. Several studies have examined cost-effectiveness of Down syndrome (DS) screening and found it to be cost-effective. Noninvasive prenatal screening also appears to be cost-effective among high-risk women with respect to DS screening, but not for the general population. Chromosomal microarray (CMA) is a genetic sequencing method superior to but more expensive than karyotype. In light of CMAs greater ability to detect genetic abnormalities, it is cost-effective when used for prenatal diagnosis of an anomalous fetus. This article covers methodology and salient issues of cost-effectiveness. Copyright © 2016 Elsevier Inc. All rights reserved.

Cost effectiveness of Tuberculosis Treatment from the Patients ...

African Journals Online (AJOL)

... Directly Observed Treatment Short course is more cost effective from the patients' point of view. DOTS needs to be re-focused out of the hospitals and clinics and made community based in view of the increasing TB caseload occasioned by HI V/AIDS. Key Words: Cost effectiveness, Tuberculosis treatment, personal cost, ...

Effects of commercially available pneumatic compression on muscle glycogen recovery after exercise.

Science.gov (United States)

Keck, Nathan A; Cuddy, John S; Hailes, Walter S; Dumke, Charles L; Ruby, Brent C

2015-02-01

The purpose of this study was to investigate the effects of pneumatic compression pants on postexercise glycogen resynthesis. Active male subjects (n = 10) completed 2 trials consisting of a 90-minute glycogen depleting ride, followed by 4 hours of recovery with either a pneumatic compression device (PCD) or passive recovery (PR) in a random counterbalanced order. A carbohydrate beverage (1.8 g·kg bodyweight) was provided at 0 and 2 hours after exercise. Muscle biopsies (vastus lateralis) were obtained immediately and 4 hours after exercise for glycogen analyses. Blood samples were collected throughout recovery to measure glucose and insulin. Eight fingerstick blood samples for lactate were collected in the last 20 minutes of the exercise period and during the initial portion of the recovery period. Heart rate was monitored throughout the trial. During the PCD trial, subjects recovered using a commercially available recovery device (NormaTec PCD) operational at 0-60 and 120-180 minutes into recovery period. The same PCD was worn during the PR trial but was not turned on to create pulsatile pressures. There was no difference in muscle glycogen resynthesis during the recovery period (6.9 ± 0.8 and 6.9 ± 0.5 mmol·kg wet wt·h for the PR and PCD trials, respectively). Blood glucose, insulin, and lactate concentrations changed with respect to time but were not different between trials (p > 0.05). The use of PCD did not alter the rate of muscle glycogen resynthesis, blood lactate, or blood glucose and insulin concentrations associated with a postexercise oral glucose load.

Cost-effectiveness in fall prevention for older women.

Science.gov (United States)

Hektoen, Liv F; Aas, Eline; Lurås, Hilde

2009-08-01

The aim of this study was to estimate the cost-effectiveness of implementing an exercise-based fall prevention programme for home-dwelling women in the > or = 80-year age group in Norway. The impact of the home-based individual exercise programme on the number of falls is based on a New Zealand study. On the basis of the cost estimates and the estimated reduction in the number of falls obtained with the chosen programme, we calculated the incremental costs and the incremental effect of the exercise programme as compared with no prevention. The calculation of the average healthcare cost of falling was based on assumptions regarding the distribution of fall injuries reported in the literature, four constructed representative case histories, assumptions regarding healthcare provision associated with the treatment of the specified cases, and estimated unit costs from Norwegian cost data. We calculated the average healthcare costs per fall for the first year. We found that the reduction in healthcare costs per individual for treating fall-related injuries was 1.85 times higher than the cost of implementing a fall prevention programme. The reduction in healthcare costs more than offset the cost of the prevention programme for women aged > or = 80 years living at home, which indicates that health authorities should increase their focus on prevention. The main intention of this article is to stipulate costs connected to falls among the elderly in a transparent way and visualize the whole cost picture. Cost-effectiveness analysis is a health policy tool that makes politicians and other makers of health policy conscious of this complexity.

The Cost-Effectiveness of NBPTS Teacher Certification

Science.gov (United States)

Yeh, Stuart S.

2010-01-01

A cost-effectiveness analysis of the National Board for Professional Teaching Standards (NBPTS) program suggests that Board certification is less cost-effective than a range of alternative approaches for raising student achievement, including comprehensive school reform, class size reduction, a 10% increase in per pupil expenditure, the use of…

Data Error Detection and Recovery in Embedded Systems: a Literature Review

Directory of Open Access Journals (Sweden)

Venu Babu Thati

2017-06-01

Full Text Available This paper presents a literature review on data flow error detection and recovery techniques in embedded systems. In recent years, embedded systems are being used more and more in an enormous number of applications from small mobile device to big medical devices. At the same time, it is becoming important for embedded developers to make embedded systems fault-tolerant. To make embedded systems fault-tolerant, error detection and recovery mechanisms are effective techniques to take into consideration. Fault tolerance can be achieved by using both hardware and software techniques. This literature review focuses on software-based techniques since hardware-based techniques need extra hardware and are an extra investment in cost per product. Whereas, software-based techniques needed no or limited hardware. A review on various existing data flow error detection and error recovery techniques is given along with their strengths and weaknesses. Such an information is useful to identify the better techniques among the others.

Economics of mycotoxins: evaluating costs to society and cost-effectiveness of interventions.

Science.gov (United States)

2012-01-01

The economic impacts of mycotoxins to human society can be thought of in two ways: (i) the direct market costs associated with lost trade or reduced revenues due to contaminated food or feed, and (ii) the human health losses from adverse effects associated with mycotoxin consumption. Losses related to markets occur within systems in which mycotoxins are being monitored in the food and feed supply. Food that has mycotoxin levels above a particular maximum allowable level is either rejected outright for sale or sold at a lower price for a different use. Such transactions can take place at local levels or at the level of trade among countries. Sometimes this can result in heavy economic losses for food producers, but the benefit of such monitoring systems is a lower risk of mycotoxins in the food supply. Losses related to health occur when mycotoxins are present in food at levels that can cause illness. In developed countries, such losses are often measured in terms of cost of illness; around the world, such losses are more frequently measured in terms of disability-adjusted life years (DALYs). It is also useful to assess the economics of interventions to reduce mycotoxins and their attendant health effects; the relative effectiveness of public health interventions can be assessed by estimating quality-adjusted life years (QALYs) associated with each intervention. Cost-effectiveness assessment can be conducted to compare the cost of implementing the intervention with the resulting benefits, in terms of either improved markets or improved human health. Aside from cost-effectiveness, however, it is also important to assess the technical feasibility of interventions, particularly in low-income countries, where funds and infrastructures are limited.

Cost-Effectiveness of School-Based Prevention of Cannabis Use.

Science.gov (United States)

Deogan, Charlotte; Zarabi, Natalie; Stenström, Nils; Högberg, Pi; Skärstrand, Eva; Manrique-Garcia, Edison; Neovius, Kristian; Månsdotter, Anna

2015-10-01

Cannabis is the most frequently used illicit drug globally. Despite increasing evidence that cannabis use is associated with adverse health effects, the knowledge on preventative strategies is still limited. This study stemmed from a systematic review of effective prevention in which school-based programmes were identified as promising. The primary objective was to evaluate the cost effectiveness of Project ALERT (Adolescent, Learning, Experiences, Resistance, and Training), compared with ordinary ATOD (Alcohol, Tobacco, and Other Drug) education, among Swedish students in the eighth grade of compulsory school. The cost-effectiveness analysis was performed from the societal perspective with quality-adjusted life-years (QALYs) as an outcome (willingness-to-pay threshold €50,000) and follow-up periods from 1 year to a lifetime, considering a discounting rate of 3%, and with costs inflated to 2013 levels. A Markov model was constructed on the basis of the 'states' of single use, regular use, daily use and use of other illicit drugs, which were associated with 'complications' of psychosis, schizophrenia, traffic accidents, depression and amotivational syndrome. Health and cost consequences were linked to both states and complications. The programme was cost saving on the basis of evidence from the USA (ratio 1:1.1), and was cost effective (incremental cost-effectiveness ratio €22,384 per QALY) after reasonable adjustment for the Swedish context and with 20 years of follow-up. When the target group was restricted to boys who were neither studying nor working/doing work experience, the programme was cost effective after 9 years and cost saving (ratio 1:3.2) after 20 years. School-based prevention such as Project ALERT has the potential to be cost effective and to be cost saving if implemented in deprived areas. In the light of the shifting landscape regarding legalization of cannabis, it seems rational to continue the health economic analysis of prevention initiated

The effect of follicular fluid hormones on oocyte recovery after ovarian stimulation: FSH level predicts oocyte recovery

Directory of Open Access Journals (Sweden)

Rinaudo Paolo F

2009-04-01

Full Text Available Abstract Background Ovarian stimulation for assisted reproductive technology (ART overcomes the physiologic process to develop a single dominant follicle. However, following stimulation, egg recovery rates are not 100%. The objective of this study is to determine if the follicular fluid hormonal environment is associated with oocyte recovery. Methods This is a prospective study involving patients undergoing ART by standard ovarian stimulation protocols at an urban academic medical center. A total of 143 follicular fluid aspirates were collected from 80 patients. Concentrations of FSH, hCG, estradiol, progesterone, testosterone and prolactin were determined. A multivariable regression analysis was used to investigate the relationship between the follicular fluid hormones and oocyte recovery. Results Intrafollicular FSH was significantly associated with oocyte recovery after adjustment for hCG (Adjusted odds ratio (AOR = 1.21, 95%CI 1.03–1.42. The hCG concentration alone, in the range tested, did not impact the odds of oocyte recovery (AOR = 0.99, 95%CI 0.93–1.07. Estradiol was significantly associated with oocyte recovery (AOR = 0.98, 95% CI 0.96–0.99. After adjustment for progesterone, the strength of association between FSH and oocyte recovery increased (AOR = 1.84, 95%CI 1.45–2.34. Conclusion The relationship between FSH and oocyte recovery is significant and appears to work through mechanisms independent of the sex hormones. FSH may be important for the physiologic event of separation of the cumulus-oocyte complex from the follicle wall, thereby influencing oocyte recovery. Current methods for inducing the final stages of oocyte maturation, with hCG administration alone, may not be optimal. Modifications of treatment protocols utilizing additional FSH may enhance oocyte recovery.

Impacts of optimum cost effective energy efficiency standards

International Nuclear Information System (INIS)

Brancic, A.B.; Peters, J.S.; Arch, M.

1991-01-01

Building Codes are increasingly required to be responsive to social and economic policy concerns. In 1990 the State of Connecticut passes An Act Concerning Global Warming, Public Act 90-219, which mandates the revision of the state building code to require that buildings and building elements be designed to provide optimum cost-effective energy efficiency over the useful life of the building. Further, such revision must meet the American Society of Heating, Refrigerating and Air Conditioning Engineers (ASHRAE) Standard 90.1 - 1989. As the largest electric energy supplier in Connecticut, Northeast Utilities (NU) sponsored a pilot study of the cost effectiveness of alternative building code standards for commercial construction. This paper reports on this study which analyzed design and construction means, building elements, incremental construction costs, and energy savings to determine the optimum cost-effective building code standard. Findings are that ASHRAE 90.1 results in 21% energy savings and alternative standards above it result in significant additional savings. Benefit/cost analysis showed that both are cost effective

30 CFR 220.013 - Unallowable costs.

Science.gov (United States)

2010-07-01

...)); (c) Depreciation, depletion, amortization, or any other charge for capital recovery for materiel... employee move that is for the primary benefit of the lessee's non-NPSL operations; (h) The lessee's own cost of administering employee benefit plans; (i) The cost of acquiring or constructing shore base...

New method for evaluating effective recovery time and single photoelectron response in silicon photomultipliers

Energy Technology Data Exchange (ETDEWEB)

Grodzicka, Martyna, E-mail: m.grodzicka@ncbj.gov.pl; Szczęśniak, Tomasz; Moszyński, Marek; Szawłowski, Marek; Grodzicki, Krystian

2015-05-21

The linearity of a silicon photomultiplier (SiPM) response depends on the number of APD cells and its effective recovery time and it is related to the intensity and duration of the detected light pulses. The aim of this study was to determine the effective recovery time on the basis of the measured SiPM response to light pulses of different durations. A closer analysis of the SiPM response to the light pulses shorter than the effective recovery time of APD cells led to a method for the evaluation of the single photoelectron response of the devices where the single photoelectron peak cannot be clearly measured. This is necessary in the evaluation of the number of fired APD cells (or the number of photoelectrons) in measurements with light pulses of various durations. Measurements were done with SiPMs manufactured by two companies: Hamamatsu and SensL.

Monitoring of HIV viral load, CD4 cell count, and clinical assessment versus clinical monitoring alone for antiretroviral therapy in low-resource settings (Stratall ANRS 12110/ESTHER) : a cost-effectiveness analysis

OpenAIRE

Boyer, S.; March, L.; Kouanfack, C.; Laborde-Balen, G.; Marino, P.; Aghokeng Fobang, Avelin; Mpoudi-Ngole, E.; Koulla-Shiro, S.; Delaporte, Eric; Carrieri, M. P.; Spire, B.; Laurent, Christian; Moatti, Jean-Paul

2013-01-01

Background In low-income countries, the use of laboratory monitoring of patients taking antiretroviral therapy (ART) remains controversial in view of persistent resource constraints. The Stratall trial did not show that clinical monitoring alone was non-inferior to laboratory and clinical monitoring in terms of immunological recovery. We aimed to evaluate the costs and cost-effectiveness of the ART monitoring approaches assessed in the Stratall trial. Methods The randomised, controlled, non-i...

Cost-Effectiveness of a Nonpharmacological Intervention in Pediatric Burn Care.

Science.gov (United States)

Brown, Nadia J; David, Michael; Cuttle, Leila; Kimble, Roy M; Rodger, Sylvia; Higashi, Hideki

2015-07-01

To report the cost-effectiveness of a tailored handheld computerized procedural preparation and distraction intervention (Ditto) used during pediatric burn wound care in comparison to standard practice. An economic evaluation was performed alongside a randomized controlled trial of 75 children aged 4 to 13 years who presented with a burn to the Royal Children's Hospital, Brisbane, Australia. Participants were randomized to either the Ditto intervention (n = 35) or standard practice (n = 40) to measure the effect of the intervention on days taken for burns to re-epithelialize. Direct medical, direct nonmedical, and indirect cost data during burn re-epithelialization were extracted from the randomized controlled trial data and combined with scar management cost data obtained retrospectively from medical charts. Nonparametric bootstrapping was used to estimate statistical uncertainty in cost and effect differences and cost-effectiveness ratios. On average, the Ditto intervention reduced the time to re-epithelialize by 3 days at AU$194 less cost for each patient compared with standard practice. The incremental cost-effectiveness plane showed that 78% of the simulated results were within the more effective and less costly quadrant and 22% were in the more effective and more costly quadrant, suggesting a 78% probability that the Ditto intervention dominates standard practice (i.e., cost-saving). At a willingness-to-pay threshold of AU$120, there is a 95% probability that the Ditto intervention is cost-effective (or cost-saving) against standard care. This economic evaluation showed the Ditto intervention to be highly cost-effective against standard practice at a minimal cost for the significant benefits gained, supporting the implementation of the Ditto intervention during burn wound care. Copyright © 2015. Published by Elsevier Inc.

Significance of the Capacity Recovery Effect in Pouch Lithium-Sulfur Battery Cells

DEFF Research Database (Denmark)

Knap, Vaclav; Zhang, Teng; Stroe, Daniel Loan

2016-01-01

Lithium-Sulfur (Li-S) batteries are an emerging energy storage technology, which is technically-attractive due to its high theoretical limits; practically, it is expected that Li-S batteries will result into lighter energy storage devices with higher capacities than traditional Lithium-ion...... batteries. One of the actual disadvantages for this technology is the highly pronounced rate capacity effect, which reduces the available capacity to be discharged when high currents are used. This drawback might be addressed by the use of the capacity recovery effect, which by introducing relaxation...... periods between consecutive pulse discharges of the battery, increases the available discharge capacity of the cell. The capacity recovery effect of the Li-S cell is studied in this paper using the pulse discharge technique, considering its dependence on the applied current, discharge step length...

Cost effectiveness of detritiating water with resin columns

International Nuclear Information System (INIS)

Drake, R.H.; Williams, D.S.

1997-10-01

There are technologies in use for cleaning up concentrated tritiated process water. These are not cost effective for tritiated water with low concentrations of tritium. There are currently no cost-effective technologies for cleaning up low-tritium-concentration tritiated water, such as most tritiated groundwater, spent fuel storage basin water, or underground storage tank water. Resin removal of tritium from tritiated water at low concentrations (near the order of magnitude of drinking water standard maximums) is being tested on TA-SO (Los Alamos National Laboratory's Liquid Radioactive Waste Treatment Facility) waste streams. There are good theoretical and test indications that this may be a technologically effective means of removing tritium from tritiated water. Because of likely engineering design similarity, it is reasonable to anticipate that a resin column system's costs will be similar to some common commercial water treatment systems. Thus, the potential cost effectiveness of a resin treatment system offers hope for treating tritiated water at affordable costs. The TA-50 resin treatment cost projection of $18 per 1,000 gallons is within the same order of magnitude as cost data for typical commercial groundwater cleanup projects. The prospective Los Alamos National Laboratory (LANL) resin treatment system at $18 per 1,000 gallons appears to have a likely cost advantage of at least an order of magnitude over the competing, developmental, water detritiation technologies

An improved set of standards for finding cost for cost-effectiveness analysis.

Science.gov (United States)

Barnett, Paul G

2009-07-01

Guidelines have helped standardize methods of cost-effectiveness analysis, allowing different interventions to be compared and enhancing the generalizability of study findings. There is agreement that all relevant services be valued from the societal perspective using a long-term time horizon and that more exact methods be used to cost services most affected by the study intervention. Guidelines are not specific enough with respect to costing methods, however. The literature was reviewed to identify the problems associated with the 4 principal methods of cost determination. Microcosting requires direct measurement and is ordinarily reserved to cost novel interventions. Analysts should include nonwage labor cost, person-level and institutional overhead, and the cost of development, set-up activities, supplies, space, and screening. Activity-based cost systems have promise of finding accurate costs of all services provided, but are not widely adopted. Quality must be evaluated and the generalizability of cost estimates to other settings must be considered. Administrative cost estimates, chiefly cost-adjusted charges, are widely used, but the analyst must consider items excluded from the available system. Gross costing methods determine quantity of services used and employ a unit cost. If the intervention will affect the characteristics of a service, the method should not assume that the service is homogeneous. Questions are posed for future reviews of the quality of costing methods. The analyst must avoid inappropriate assumptions, especially those that bias the analysis by exclusion of costs that are affected by the intervention under study.

Applicability of Zeolite Based Systems for Ammonia Removal and Recovery From Wastewater.

Science.gov (United States)

Das, Pallabi; Prasad, Bably; Singh, Krishna Kant Kumar

2017-09-01

  Ammonia discharged in industrial effluents bears deleterious effects and necessitates remediation. Integrated systems devoted to recovery of ammonia in a useful form and remediation of the same addresses the challenges of waste management and its utilization. A comparative performance evaluation study was undertaken to access the suitability of different zeolite based systems (commercial zeolites and zeolites synthesized from fly ash) for removal of ammonia followed by its subsequent release. Four main parameters which were studied to evaluate the applicability of such systems for large scale usage are cost-effectiveness, ammonia removal efficiency, performance on regeneration, and ammonia release percentage. The results indicated that synthetic zeolites outperformed zeolites synthesized from fly ash, although the later proved to be more efficient in terms of total cost incurred. Process technology development in this direction will be a trade-of between cost and ammonia removal and release efficiencies.

Can delivery systems use cost-effectiveness analysis to reduce healthcare costs and improve value?

Science.gov (United States)

Savitz, Lucy A; Savitz, Samuel T

2016-01-01

Understanding costs and ensuring that we demonstrate value in healthcare is a foundational presumption as we transform the way we deliver and pay for healthcare in the U.S. With a focus on population health and payment reforms underway, there is increased pressure to examine cost-effectiveness in healthcare delivery. Cost-effectiveness analysis (CEA) is a type of economic analysis comparing the costs and effects (i.e. health outcomes) of two or more treatment options. The result is expressed as a ratio where the denominator is the gain in health from a measure (e.g. years of life or quality-adjusted years of life) and the numerator is the incremental cost associated with that health gain. For higher cost interventions, the lower the ratio of costs to effects, the higher the value. While CEA is not new, the approach continues to be refined with enhanced statistical techniques and standardized methods. This article describes the CEA approach and also contrasts it to optional approaches, in order for readers to fully appreciate caveats and concerns. CEA as an economic evaluation tool can be easily misused owing to inappropriate assumptions, over reliance, and misapplication. Twelve issues to be considered in using CEA results to drive healthcare delivery decision-making are summarized. Appropriately recognizing both the strengths and the limitations of CEA is necessary for informed resource allocation in achieving the maximum value for healthcare services provided.

Cost-effectiveness Analysis of Antipsychotic Combination Therapy in Schizophrenia Inpatients

Directory of Open Access Journals (Sweden)

Rizky Abdulah

2017-03-01

Full Text Available Schizophrenia is one of mental disorders with high cost and lifetime morbidity risk. Hence, it is necessary to analyze the cost-effectiveness of various combinations of antipsychotics. The aim of this study was to analyze the most cost-effective group of antipsychotic combinations in schizophrenia inpatients in West Java Psychiatric Hospital during 2012–2013. Data were collected retrospectively from medical record of patients who used antipsychotics clozapine-haloperidol or clozapine-risperidone therapy. Direct medical costs were obtained from antipsychotics costs, costs of medical treatment, medical expenses, hospitalization costs, and administrative costs. The results showed that the average cost-effectiveness ratio of antipsychotic clozapine-haloperidol was Rp126.898/day and Rp132.781/day for the combination of clozapine-haloperidol and clozapine-risperidone, respectively. Considering length of stay as the therapy effectiveness, it can be concluded that the combination of clozapine-haloperidol is more cost-effective than clozapine-risperidone.

The cost effectiveness of intracyctoplasmic sperm injection (ICSI).

Science.gov (United States)

Hollingsworth, Bruce; Harris, Anthony; Mortimer, Duncan

2007-12-01

To estimate the incremental cost effectiveness of ICSI, and total costs for the population of Australia. Treatment effects for three patient groups were drawn from a published systematic review and meta-analysis of trials comparing fertilisation outcomes for ICSI. Incremental costs derived from resource-based costing of ICSI and existing practice comparators for each patient group. Incremental cost per live birth for patients unsuited to IVF is estimated between A$8,500 and 13,400. For the subnormal semen indication, cost per live birth could be as low as A$3,600, but in the worst case scenario, there would just be additional incremental costs of A$600 per procedure. Multiplying out the additional costs of ICSI over the relevant target populations in Australia gives potential total financial implications of over A$31 million per annum. While there are additional benefits from ICSI procedure, particularly for those with subnormal sperm, the additional cost for the health care system is substantial.

Lifecycle effects of a recession on health behaviors: Boom, bust, and recovery in Iceland.

Science.gov (United States)

Ásgeirsdóttir, Tinna Laufey; Corman, Hope; Noonan, Kelly; Reichman, Nancy E

2016-03-01

This study uses individual-level longitudinal data from Iceland, a country that experienced a severe economic crisis in 2008 and substantial recovery by 2012, to investigate the extent to which the effects of a recession on health behaviors are lingering or short-lived and to explore trajectories in health behaviors from pre-crisis boom, to crisis, to recovery. Health-compromising behaviors (smoking, heavy drinking, sugared soft drinks, sweets, fast food, and tanning) declined during the crisis, and all but sweets continued to decline during the recovery. Health-promoting behaviors (consumption of fruit, fish oil, and vitamins/minerals and getting recommended sleep) followed more idiosyncratic paths. Overall, most behaviors reverted back to their pre-crisis levels or trends during the recovery, and these short-term deviations in trajectories were probably too short-lived in this recession to have major impacts on health or mortality. A notable exception is for binge drinking, which declined by 10% during the 2 crisis years, continued to fall (at a slower rate of 8%) during the 3 recovery years, and did not revert back to the upward pre-crisis trend during our observation period. These lingering effects, which directionally run counter to the pre-crisis upward trend in consumption and do not reflect price increases during the recovery period, suggest that alcohol is a potential pathway by which recessions improve health and/or reduce mortality. Copyright © 2015 Elsevier B.V. All rights reserved.

Implementation of self-rostering (the PRIO-project): effects on working hours, recovery, and health.

Science.gov (United States)

Garde, Anne Helene; Albertsen, Karen; Nabe-Nielsen, Kirsten; Carneiro, Isabella Gomes; Skotte, Jørgen; Hansen, Sofie Mandrup; Lund, Henrik; Hvid, Helge; Hansen, Åse Marie

2012-07-01

The aim of this study was to (i) investigate the consequences of self-rostering for working hours, recovery, and health, and (ii) elucidate the mechanisms through which recovery and health are affected. Twenty eight workplaces were allocated to either an intervention or reference group. Intervention A encompassed the possibility to specify preferences for starting time and length of shift down to 15 minutes intervals. Interventions B and C included the opportunity to choose between a number of predefined duties. Questionnaires (N=840) on recovery and health and objective workplace reports of working hours (N=718) were obtained at baseline and 12 months later. The interaction term between intervention and time was tested in mixed models and multinomial logistic regression models. The odds ratio (OR) of having short [OR 4.8, 95 % confidence interval (95% CI) 1.9-12.3] and long (OR 4.8, 95% CI 2.9-8.0) shifts increased in intervention A. Somatic symptoms (β= -0.10, 95% CI -0.19- -0.02) and mental distress (β= -0.13, 95% CI -0.23- -0.03) decreased, and sleep (β= 1.7, 95% CI 0.04-0.30) improved in intervention B, and need for recovery was reduced in interventions A (β= -0.17, 95% CI -0.29- -0.04) and B (β= -0.17, 95% CI -0.27- -0.07). There were no effects on recovery and health in intervention C, and overall, there were no detrimental effects on recovery or health. The benefits of the intervention were not related to changes in working hours and did not differ by gender, age, family type, degree of employment, or working hour arrangements. After implementation of self-rostering, employees changed shift length and timing but did not compromise most recommendations for acceptable shift work schedules. Positive consequences of self-rostering for recovery and health were observed, particularly in intervention B where worktime control increased but less extensively than intervention A. The effect could not be statistically explained by changes in actual working hours.

Simulation of the cost-effectiveness of malaria vaccines

Directory of Open Access Journals (Sweden)

Tediosi Fabrizio

2009-06-01

Full Text Available Abstract Background A wide range of possible malaria vaccines is being considered and there is a need to identify which vaccines should be prioritized for clinical development. An important element of the information needed for this prioritization is a prediction of the cost-effectiveness of potential vaccines in the transmission settings in which they are likely to be deployed. This analysis needs to consider a range of delivery modalities to ensure that clinical development plans can be aligned with the most appropriate deployment strategies. Methods The simulations are based on a previously published individual-based stochastic model for the natural history and epidemiology of Plasmodium falciparum malaria. Three different vaccine types: pre-erythrocytic vaccines (PEV, blood stage vaccines (BSV, mosquito-stage transmission-blocking vaccines (MSTBV, and combinations of these, are considered each delivered via a range of delivery modalities (Expanded Programme of Immunization – EPI-, EPI with booster, and mass vaccination combined with EPI. The cost-effectiveness ratios presented are calculated for four health outcomes, for assumed vaccine prices of US$ 2 or US$ 10 per dose, projected over a 10-year period. Results The simulations suggest that PEV will be more cost-effective in low transmission settings, while BSV at higher transmission settings. Combinations of BSV and PEV are more efficient than PEV, especially in moderate to high transmission settings, while compared to BSV they are more cost-effective in moderate to low transmission settings. Combinations of MSTBV and PEV or PEV and BSV improve the effectiveness and the cost-effectiveness compared to PEV and BSV alone only when applied with EPI and mass vaccinations. Adding booster doses to the EPI is unlikely to be a cost-effective alternative to delivering vaccines via the EPI for any vaccine, while mass vaccination improves effectiveness, especially in low transmission settings, and is

Cost-Effectiveness of the Freeze-All Policy.

Science.gov (United States)

Roque, Matheus; Valle, Marcello; Guimarães, Fernando; Sampaio, Marcos; Geber, Selmo

2015-08-01

To evaluate the cost-effectiveness of freeze-all cycles when compared to fresh embryo transfer. This was an observational study with a cost-effectiveness analysis. The analysis consisted of 530 intracytoplasmic sperm injection (ICSI) cycles in a private center in Brazil between January 2012 and December 2013. A total of 530 intracytoplasmic sperm injection (ICSI) cycles - 351 fresh embryo transfers and 179 freeze-all cycles - with a gonadotropin-releasing hormone (GnRH) antagonist protocol and day 3 embryo transfers. The pregnancy rate was 31.1% in the fresh group and 39.7% in the freeze-all group. We performed two scenario analyses for costs. In scenario 1, we included those costs associated with the ICSI cycle (monitoring during controlled ovarian stimulation [COS], oocyte retrieval, embryo transfer, IVF laboratory, and medical costs), embryo cryopreservation of supernumerary embryos, hormone measurements during COS and endometrial priming, medication use (during COS, endometrial priming, and luteal phase support), ultrasound scan for frozen- thawed embryo transfer (FET), obstetric ultrasounds, and miscarriage. The total cost (in USD) per pregnancy was statistically lower in the freeze-all cycles (19,156.73 ± 1,732.99) when compared to the fresh cycles (23,059.72 ± 2,347.02). Even in Scenario 2, when charging all of the patients in the freeze-all group for cryopreservation (regardless of supernumerary embryos) and for FET, the fresh cycles had a statistically significant increase in treatment costs per ongoing pregnancy. The results presented in this study suggest that the freeze-all policy is a cost-effective strategy when compared to fresh embryo transfer.

Low-cost carriers fare competition effect

NARCIS (Netherlands)

Carmona Benitez, R.B.; Lodewijks, G.

2010-01-01

This paper examines the effects that low-cost carriers (LCC’s) produce when entering new routes operated only by full-service carriers (FSC’s) and routes operated by low-cost carriers in competition with full-service carriers. A mathematical model has been developed to determine what routes should

Cost effective waste management through composting in Africa

Energy Technology Data Exchange (ETDEWEB)

Couth, R. [CRECHE, Centre for Environmental, Coastal and Hydrological Engineering, Civil Engineering Programme, School of Engineering, University of KwaZulu-Natal, Durban 4041 (South Africa); Trois, C., E-mail: troisc@ukzn.ac.za [CRECHE, Centre for Environmental, Coastal and Hydrological Engineering, Civil Engineering Programme, School of Engineering, University of KwaZulu-Natal, Durban 4041 (South Africa)

2012-12-15

Highlights: Black-Right-Pointing-Pointer The financial/social/institutional sustainability of waste management in Africa is analysed. Black-Right-Pointing-Pointer This note is a compendium of a study on the potential for GHG control via improved zero waste in Africa. Black-Right-Pointing-Pointer This study provides the framework for Local Authorities for realizing sustained GHG reductions. - Abstract: Greenhouse gas (GHG) emissions per person from urban waste management activities are greater in sub-Saharan African countries than in other developing countries, and are increasing as the population becomes more urbanised. Waste from urban areas across Africa is essentially dumped on the ground and there is little control over the resulting gas emissions. The clean development mechanism (CDM), from the 1997 Kyoto Protocol has been the vehicle to initiate projects to control GHG emissions in Africa. However, very few of these projects have been implemented and properly registered. A much more efficient and cost effective way to control GHG emissions from waste is to stabilise the waste via composting and to use the composted material as a soil improver/organic fertiliser or as a component of growing media. Compost can be produced by open windrow or in-vessel composting plants. This paper shows that passively aerated open windrows constitute an appropriate low-cost option for African countries. However, to provide an usable compost material it is recommended that waste is processed through a materials recovery facility (MRF) before being composted. The paper demonstrates that material and biological treatment (MBT) are viable in Africa where they are funded, e.g. CDM. However, they are unlikely to be instigated unless there is a replacement to the Kyoto Protocol, which ceases for Registration in December 2012.

Cost-effectiveness analysis of treatments for premenstrual dysphoric disorder.

Science.gov (United States)

Rendas-Baum, Regina; Yang, Min; Gricar, Joseph; Wallenstein, Gene V

2010-01-01

Premenstrual syndrome (PMS) is reported to affect between 13% and 31% of women. Between 3% and 8% of women are reported to meet criteria for the more severe form of PMS, premenstrual dysphoric disorder (PMDD). Although PMDD has received increased attention in recent years, the cost effectiveness of treatments for PMDD remains unknown. To evaluate the cost effectiveness of the four medications with a US FDA-approved indication for PMDD: fluoxetine, sertraline, paroxetine and drospirenone plus ethinyl estradiol (DRSP/EE). A decision-analytic model was used to evaluate both direct costs (medication and physician visits) and clinical outcomes (treatment success, failure and discontinuation). Medication costs were based on average wholesale prices of branded products; physician visit costs were obtained from a claims database study of PMDD patients and the Agency for Healthcare Research and Quality. Clinical outcome probabilities were derived from published clinical trials in PMDD. The incremental cost-effectiveness ratio (ICER) was calculated using the difference in costs and percentage of successfully treated patients at 6 months. Deterministic and probabilistic sensitivity analyses were used to assess the impact of uncertainty in parameter estimates. Threshold values where a change in the cost-effective strategy occurred were identified using a net benefit framework. Starting therapy with DRSP/EE dominated both sertraline and paroxetine, but not fluoxetine. The estimated ICER of initiating treatment with fluoxetine relative to DRSP/EE was $US4385 per treatment success (year 2007 values). Cost-effectiveness acceptability curves revealed that for ceiling ratios>or=$US3450 per treatment success, fluoxetine had the highest probability (>or=0.37) of being the most cost-effective treatment, relative to the other options. The cost-effectiveness acceptability frontier further indicated that DRSP/EE remained the option with the highest expected net monetary benefit for

Novel integrated gasification combined cycles with a carbon dioxide recovery option

Energy Technology Data Exchange (ETDEWEB)

Lawton, J.

1997-08-01

Two novel combined cycle configurations offering potential to reduce the cost of electricity from coal-fired IGCCs were investigated - one based on the use of flue gas recycling with heat recovery to the recycled stream, the other, aimed at removing carbon dioxide, using flue gas recycle and heat recovery but with oxygen as the oxidant in the gas turbine. The investigation included the use of fuels other than coal. It was found that gasification efficiency was increased by use of a coal/Orimulsion slurry. Flue gas recycling at 1 bar for the industrial gas turbine offered a gain of about 0.4 percentage points. In a standard IGCC the industrial gas turbine showed an advantage of 1.5 percentage points over the aero-derived machine. The least cost electricity with CO{sub 2} removal was achieved using an oxygen-fed industrial gas turbine with flue gas recycling and recovery. Several recommendations are made for further studies to reduce costs of electricity production. 11 refs., 3 figs., 5 tabs., 1 app.

Cost and cost effectiveness of long-lasting insecticide-treated bed nets - a model-based analysis

Directory of Open Access Journals (Sweden)

Pulkki-Brännström Anni-Maria

2012-04-01

Full Text Available Abstract Background The World Health Organization recommends that national malaria programmes universally distribute long-lasting insecticide-treated bed nets (LLINs. LLINs provide effective insecticide protection for at least three years while conventional nets must be retreated every 6-12 months. LLINs may also promise longer physical durability (lifespan, but at a higher unit price. No prospective data currently available is sufficient to calculate the comparative cost effectiveness of different net types. We thus constructed a model to explore the cost effectiveness of LLINs, asking how a longer lifespan affects the relative cost effectiveness of nets, and if, when and why LLINs might be preferred to conventional insecticide-treated nets. An innovation of our model is that we also considered the replenishment need i.e. loss of nets over time. Methods We modelled the choice of net over a 10-year period to facilitate the comparison of nets with different lifespan (and/or price and replenishment need over time. Our base case represents a large-scale programme which achieves high coverage and usage throughout the population by distributing either LLINs or conventional nets through existing health services, and retreats a large proportion of conventional nets regularly at low cost. We identified the determinants of bed net programme cost effectiveness and parameter values for usage rate, delivery and retreatment cost from the literature. One-way sensitivity analysis was conducted to explicitly compare the differential effect of changing parameters such as price, lifespan, usage and replenishment need. Results If conventional and long-lasting bed nets have the same physical lifespan (3 years, LLINs are more cost effective unless they are priced at more than USD 1.5 above the price of conventional nets. Because a longer lifespan brings delivery cost savings, each one year increase in lifespan can be accompanied by a USD 1 or more increase in price

Costs and cost-effectiveness of 9-valent human papillomavirus (HPV) vaccination in two East African countries.

Science.gov (United States)

Kiatpongsan, Sorapop; Kim, Jane J

2014-01-01

Current prophylactic vaccines against human papillomavirus (HPV) target two of the most oncogenic types, HPV-16 and -18, which contribute to roughly 70% of cervical cancers worldwide. Second-generation HPV vaccines include a 9-valent vaccine, which targets five additional oncogenic HPV types (i.e., 31, 33, 45, 52, and 58) that contribute to another 15-30% of cervical cancer cases. The objective of this study was to determine a range of vaccine costs for which the 9-valent vaccine would be cost-effective in comparison to the current vaccines in two less developed countries (i.e., Kenya and Uganda). The analysis was performed using a natural history disease simulation model of HPV and cervical cancer. The mathematical model simulates individual women from an early age and tracks health events and resource use as they transition through clinically-relevant health states over their lifetime. Epidemiological data on HPV prevalence and cancer incidence were used to adapt the model to Kenya and Uganda. Health benefit, or effectiveness, from HPV vaccination was measured in terms of life expectancy, and costs were measured in international dollars (I$). The incremental cost of the 9-valent vaccine included the added cost of the vaccine counterbalanced by costs averted from additional cancer cases prevented. All future costs and health benefits were discounted at an annual rate of 3% in the base case analysis. We conducted sensitivity analyses to investigate how infection with multiple HPV types, unidentifiable HPV types in cancer cases, and cross-protection against non-vaccine types could affect the potential cost range of the 9-valent vaccine. In the base case analysis in Kenya, we found that vaccination with the 9-valent vaccine was very cost-effective (i.e., had an incremental cost-effectiveness ratio below per-capita GDP), compared to the current vaccines provided the added cost of the 9-valent vaccine did not exceed I$9.7 per vaccinated girl. To be considered very cost-effective

Encouraging smokers to quit: the cost effectiveness of reimbursing the costs of smoking cessation treatment.

Science.gov (United States)

Kaper, Janneke; Wagena, Edwin J; van Schayck, Constant P; Severens, Johan L

2006-01-01

Smoking cessation should be encouraged in order to increase life expectancy and reduce smoking-related healthcare costs. Results of a randomised trial suggested that reimbursing the costs of smoking cessation treatment (SCT) may lead to an increased use of SCT and an increased number of quitters versus no reimbursement. To assess whether reimbursement for SCT is a cost-effective intervention (from the Dutch societal perspective), we calculated the incremental costs per quitter and extrapolated this outcome to incremental costs per QALY saved versus no reimbursement. In the reimbursement trial, 1266 Dutch smokers were randomly assigned to the intervention or control group using a randomised double consent design. Reimbursement for SCT was offered to the intervention group for a period of 6 months. No reimbursement was offered to the control group. Prolonged abstinence from smoking was determined 6 months after the end of the reimbursement period. The QALYs gained from quitting were calculated until 80 years of age using data from the US. Costs (year 2002 values) were determined from the societal perspective during the reimbursement period (May-November 2002). Benefits were discounted at 4% per annum. The uncertainty of the incremental cost-effectiveness ratios was estimated using non-parametric bootstrapping. Eighteen participants in the control group (2.8%) and 35 participants in the intervention group (5.5%) successfully quit smoking. The costs per participant were 291 euro and 322 euro, respectively. If society is willing to pay 1000 euro or 10,000 euro for an additional 12-month quitter, the probability that reimbursement for SCT would be cost effective was 50% or 95%, respectively. If society is willing to pay 18,000 euro for a QALY, the probability that reimbursement for SCT would be cost effective was 95%. However, the external validity of the extrapolation from quitters to QALYs is uncertain and several assumptions had to be made. Reimbursement for SCT may