Sustainable development in agriculture: is it really sustainable?

International Nuclear Information System (INIS)

Singh, S.R.K.; Srinivas, K.; Kumar, L.R.; Gupta, H.S.

2005-01-01

Indian agriculture has achieved remarkable success in the food grain production due to inception of 'rainbow revolution', which made the country self-sufficient in food production. Sustainable agriculture (SA) is an ongoing process, in which people take actions leading to development of agriculture that meets their current needs without compromising the ability of future generations to meet their needs. It advocates avoiding all those actions, which reduce the ability of future generations to meet out the present generations. It is based on the optimal interaction between clean environment, healthy economy, and vital society by avoiding trade-off of problems to other regions on to the future. Moreover, sustainable agriculture is the function of people's progress and nature's capacity. In fact, SA commits us to considering the long-term effect and to recognize our place within the ecosystem. It encourages a continuous reflection on the implications of human activity on the ecosystem. Empirical evidences shows that in the race of self-sufficiency in food grain production, we compromised a lot on social and environmental fronts. The aftermath of green revolution is not so sustainable as it showed reverse side too, in the form of environmental degradation and ecological imbalances. Such threats have led to the need for promoting sustainable development in agriculture. Due to several unsustainable activities which resulted in resource degradation in the form of top soil loss, ground water depletion and forest degradation. The average soil loss is estimated to be over 16 tonnes/ha/year. The ground water depletion resulted in several blocks as 'grey blocks' and 'dark blocks'. This happened mainly due to increase in number of tube-wells and free supply of electricity making the cost of pumping water very low. Rate of human induced land degradation is very high. Out of total geographical area of 329.0 million ha, 187 million ha (57.0 %) are reported to have degraded, of

Sustainability in Multi-Religious Societies: An Islamic Perspective

Science.gov (United States)

Grine, Fadila; Bensaid, Benaouda; Nor, Mohd Roslan Mohd; Ladjal, Tarek

2013-01-01

The question of sustainability in multi-religious societies underscores interrelating theological, moral and cultural issues affecting the very process of social co-existence, cohesion and development. This article discusses Islam's understanding of the question of sustainability in multi-religious contexts while highlighting the contribution of…

Social cost benefit analysis of sustainable industrial areas

International Nuclear Information System (INIS)

Blom, M.J.; Schroten, A.

2010-05-01

In restructuring a industrial park many different interests are involved, such as space, business climate, environmental quality or landscape. The social cost-benefit analysis (SCBA) is a tool for mapping all current and future pros and cons (expressed in Euros) of a restructuring project for society as a whole as objective as possible. The SCBA manual for sustainable industrial parks describes how an SCBA can be performed and how the results could accommodate decisions made. SCBA pilots have been carried out for restructuring projects in four Dutch municipalities: Katwijk, Rijnwoude, Hardinxveld-Giessendam and Westland. [nl

Environmental Sustainability of Gm Crops for Food Safety on Risk Society

Directory of Open Access Journals (Sweden)

Gil Ramos de Carvalho Neto

2016-10-01

Full Text Available GM crops are presented as an alternative to the erradication of hunger. The risk society, however, considering the brazilian environmental law - specially the brazilian legislation on biosafety - the food safety and nutritional law and the economic and social data on the subject, it appears that the environmental sustainability of these crops is not yet complete. Producers should adopt additional safeguards if they wish a sustainable agriculture with effective food security.

Tunisia-Japan Symposium: R&D of Energy and Material Sciences for Sustainable Society

Science.gov (United States)

Akimoto, Katsuhiro; Suzuki, Yoshikazu; Monirul Islam, Muhammad

2015-04-01

This volume of the Journal of Physics: Conference Series contains papers presented at the Tunisia-Japan Symposium: R&D of Energy and Material Sciences for Sustainable Society (TJS 2014) held at Gammarth, Republic of Tunisia on November 28-30, 2014. The TJS 2014 is based on the network of the Tunisia-Japan Symposium on Science, Society and Technology (TJASSST) which has been regularly organized since 2000. The symposium was focused on the technological developments of energy and materials for the realization of sustainable society. To generate technological breakthrough and innovation, it seems to be effective to discuss with various fields of researchers such as solid-state physicists, chemists, surface scientists, process engineers and so on. In this symposium, there were as many as 109 attendees from a wide variety of research fields. The technical session consisted of 106 contributed presentations including 3 plenary talks and 7 key-note talks. We hope the Conference Series and publications like this volume will contribute to the progress in research and development in the field of energy and material sciences for sustainable society and in its turn contribute to the creation of cultural life and peaceful society.

Coal technology in a sustainable society

International Nuclear Information System (INIS)

Anon

2000-01-01

Coal is a major world energy resource. For many countries it is the primary fuel in electricity generation. As world energy demand increases so also will the demand for coal. Steel and aluminium-essential elements in the fabric of modern society -also rely heavily on coal. This article points out that the Australian coal industry is responding to the challenges facing coal by investigating a sustainable development strategy and examining the full life cycle outcomes of coal as fuel and reductant. The challenge is to deliver much more efficient ways of extracting energy from coal. The most effective strategies are seen to be: ash displacement credits, synergies with renewables and integration with other industries

Operationalising the Sustainable Knowledge Society Concept through a Multi-dimensional Scorecard

Science.gov (United States)

Dragomirescu, Horatiu; Sharma, Ravi S.

Since the early 21st Century, building a Knowledge Society represents an aspiration not only for the developed countries, but for the developing ones too. There is an increasing concern worldwide for rendering this process manageable towards a sustainable, equitable and ethically sound societal system. As proper management, including at the societal level, requires both wisdom and measurement, the operationalisation of the Knowledge Society concept encompasses a qualitative side, related to vision-building, and a quantitative one, pertaining to designing and using dedicated metrics. The endeavour of enabling policy-makers mapping, steering and monitoring the sustainable development of the Knowledge Society at national level, in a world increasingly based on creativity, learning and open communication, led researchers to devising a wide range of composite indexes. However, as such indexes are generated through weighting and aggregation, their usefulness is limited to retrospectively assessing and comparing levels and states already attained; therefore, to better serve policy-making purposes, composite indexes should be complemented by other instruments. Complexification, inspired by the systemic paradigm, allows obtaining "rich pictures" of the Knowledge Society; to this end, a multi-dimensional scorecard of the Knowledge Society development is hereby suggested, that seeks a more contextual orientation towards sustainability. It is assumed that, in the case of the Knowledge Society, the sustainability condition goes well beyond the "greening" desideratum and should be of a higher order, relying upon the conversion of natural and productive life-cycles into virtuous circles of self-sustainability.

GREEN CONCEPTS AND MATERIAL FLOW COST ACCOUNTING APPLICATION FOR COMPANY SUSTAINABILITY

Directory of Open Access Journals (Sweden)

Rochman Marota

2017-02-01

Full Text Available Health equipment and furniture become a complementary factor for good health services to the communities. Management of health equipment and furniture is started by manufacturers within the industry scope and sustainable business processes. This study aimed to apply green concepts and MFCA at PT XYZ, and to analyze their effects on the dimensions of the company sustainability. To measure the effects of green concepts and MFCA on the dimensions of corporate sustainability, a multiple regression analysis was used. The analysis showed that they gave significant effects from the results of the F test, t test and probability test. From these results, a number of suggestions for improvement of production process performance as managerial implications for maintaining the stability of the company sustainability index were formulated.Keywords: efficiency and effectiveness of production cost, green concepts, the company sustainability, material flow cost accounting

Creating Sustainable Societies: Developing Emerging Professionals through Transforming Current Mindsets

Science.gov (United States)

Griswold, Wendy

2017-01-01

Future professionals will bear the brunt of creating sustainable societies. Equipping them for the task is the challenge of current educators. Educational experiences facilitating the development of sustainable habits of mind are needed. This research reports on the experiences of developing scientists and engineers engaged in a sustainable energy…

Rapid and sustained cost management

International Nuclear Information System (INIS)

Hanson, D.

2009-01-01

Accenture helps clients develop comprehensive, process-driven strategies for rapid and sustained cost management that leverage deep insights and analytics. This approach enables companies to gain operating cost advantages by rationalizing, simplifying and automating current operating capabilities. It drives structural cost advantages by optimizing business mix, capital structure, organizational structure and geographic presence. This paper discussed how successful companies achieve high performance during times of economic turmoil. It also discussed the value of the winner's strategy in terms of rapid and sustained cost management (RSCM). It discussed how Accenture operates and its leveraged capabilities, improved efficiency, margins and cash flow while maintaining customer service levels. Building structural advantage and the Accenture difference were also discussed. It was concluded that RSCM is one vital way that Accenture can help companies achieve success. 4 figs

Waste management in a sustainable society

International Nuclear Information System (INIS)

Ascari, Sergio; Milan, Univ. ''Bocconi''

1997-01-01

This paper summarises the environmental economics debate about sustainable management of solid wastes. Sustainable levels of solid waste generation, recycling and disposal cannot be set by general criteria, but priorities are better defined locally. Preferable solutions are mostly determined by market forces once economic instruments are introduced in order to compel agents to incorporate environmental costs and benefits into their decisions. Greater care should be devoted to dangerous wastes, where schemes may be devised to subsidize not only recovery and recycling but environmentally safe disposal as well; these may be financed by raw materials levies

Applying Andragogical Concepts in Creating a Sustainable Lifelong Learning Society

Science.gov (United States)

Charungkaittikul, Suwithida; Henschke, John A.

2017-01-01

Today, the world is changing, re-establishing the role of education to have a developed society. This article aims to explore the practical application of Andragogy as a key element for creating a sustainable lifelong learning society, to propose strategies for developing a lifelong learning society using andragogical concepts, to enhance…

Energy, society and environment. Technology for a sustainable future

International Nuclear Information System (INIS)

Elliott, D.

1997-04-01

Energy, Society and Environment examines energy and energy use, and the interactions between technology, society and the environment. The book is clearly structured to examine; Key environmental issues, and the harmful impacts of energy use; New technological solutions to environmental problems; Implementation of possible solutions, and Implications for society in developing a sustainable approach to energy use. Social processes and strategic solutions to problems are located within a clear, technological context with topical case studies. (UK)

The 24-hour society between myth and reality.

Science.gov (United States)

Costa, G

2001-12-01

The 24-hour society appears to be an ineluctable process towards a social organisation where time constraints are no more "restricting" the human life. But, what kind of 24-hour society do we need? At what costs? Are they acceptable/sustainable? Shift work, night work, irregular and flexible working hours, together with new technologies, are the milestone of this epochal passage, of which shift workers are builders and victims at the same time. The borders between working and social times are no more fixed and rigidly determined: not only the link between work place and working hours is broken, but also the value of working time changes according to the different economic/productive/social effects it can make. What are the advantages and disadvantages for the individual, the companies, and the society? What is the cost/benefit ratio in terms of physical health; psychological well-being, family and social life? The research on irregular working hours and health shows us what can be the negative consequences of non-human-centered working times organisations. Coping properly with this process means avoiding a passive acceptance of it with consequent maladjustments at both individual and social level, but adopting effective preventive and compensative strategies aimed at building a more sustainable society, at acceptable costs and with the highest possible benefits.

Social sustainability in an ageing chinese society : Towards an integrative conceptual framework

NARCIS (Netherlands)

Liu, Yafei; Dijst, Martin; Geertman, Stan; Cui, Can

2017-01-01

Social sustainability is a relatively underexposed dimension of the sustainability debate. Diversified and discipline-specific study perspectives and the lack of contextualization make it difficult to gain a comprehensive understanding of social sustainability in non-Western societies. In examining

The role of cost-effectiveness analysis in developing nutrition policy.

Science.gov (United States)

Cobiac, Linda J; Veerman, Lennert; Vos, Theo

2013-01-01

Concern about the overconsumption of unhealthy foods is growing worldwide. With high global rates of noncommunicable diseases related to poor nutrition and projections of more rapid increases of rates in low- and middle-income countries, it is vital to identify effective but low-cost interventions. Cost-effectiveness studies show that individually targeted dietary interventions can be effective and cost-effective, but a growing number of modeling studies suggest that population-wide approaches may bring larger and more sustained benefits for population health at a lower cost to society. Mandatory regulation of salt in processed foods, in particular, is highly recommended. Future research should focus on lacunae in the current evidence base: effectiveness of interventions addressing the marketing, availability, and price of healthy and unhealthy foods; modeling health impacts of complex dietary changes and multi-intervention strategies; and modeling health implications in diverse subpopulations to identify interventions that will most efficiently and effectively reduce health inequalities.

Compatibility of Corporate Sustainability with a Cost Leadership Strategy

OpenAIRE

Bouvrain, Stanislas; Sarka, Darius

2015-01-01

BACKGROUND Exploring literature about corporate sustainability and cost leadership strategy and to study the collusion of the two concepts through the case of Ikea. AIM Researching whether firms can align corporate sustainability approach to doing business on the imperatives of a cost leadership strategy. The contribution aims to provide guidance on choosing appropriate sustainability activities within the context of cost leadership strategy. Furthermore, it should be noted that this paper se...

Maintaining the competitiveness of the American fisheries society journals: an assessment based on influence and cost-effectiveness

Science.gov (United States)

Hewitt, David A.; Link, Jason S.; Steinich, Dave R.; Wahl, David H.; Mather, Martha E.

2009-01-01

Recent changes in the landscape of scientific publishing prompted the Publications Overview Committee of the American Fisheries Society (AFS) to review the Society's portfolio of scientific journals. We evaluated journals based on metrics in two categories: (1) citation-based measures of the influence of a journal on the scientific literature, and (2) measures of the cost-effectiveness of a journal (citation rate adjusted for subscription cost). Over the long-term, we found that ecology journals had far stronger citation-based influence than fisheries and aquatic sciences journals, and that journals publishing primarily basic research had stronger influence than journals publishing applied research (including four AFS journals and Fisheries magazine). In evaluating the current status of fisheries and aquatic sciences journals, we found that metrics of influence and cost-effectiveness provided considerably different portrayals of journals relative to their peers. In terms of citation-based influence, we found that the AFS journal Transactions of the American Fisheries Society (TAFS) and Fisheries magazine were competitive with highly regarded peer fisheries journals, but that North American Journal of Aquaculture (NAJA) and Journal of Aquatic Animal Health (JAAH) were less influential than their peers. The citation-based influence of North American Journal of Fisheries Management (NAJFM) was intermediate between TAFS/Fisheries and NAJA/JAAH. For journals like NAJFM and NAJA, we expect that much of the scientific influence on policy and management is not captured by citations in the primary literature, and alternative methods of evaluation may be needed. All of the AFS journals ranked highly with regard to cost-effectiveness because their subscription costs are low, and these rankings are in accordance with membership needs and the strategic mission of AFS to provide broad and timely dissemination of scientific information. We conclude by suggesting

Cost consideration in the clinical guidance documents of physician specialty societies in the United States.

Science.gov (United States)

Schwartz, Jennifer A T; Pearson, Steven D

2013-06-24

Despite increasing concerns regarding the cost of health care, the consideration of costs in the development of clinical guidance documents by physician specialty societies has received little analysis. To evaluate the approach to consideration of cost in publicly available clinical guidance documents and methodological statements produced between 2008 and 2012 by the 30 largest US physician specialty societies. Qualitative document review. Whether costs are considered in clinical guidance development, mechanism of cost consideration, and the way that cost issues were used in support of specific clinical practice recommendations. Methodological statements for clinical guidance documents indicated that 17 of 30 physician societies (57%) explicitly integrated costs, 4 (13%) implicitly considered costs, 3 (10%) intentionally excluded costs, and 6 (20%) made no mention. Of the 17 societies that explicitly integrated costs, 9 (53%) consistently used a formal system in which the strength of recommendation was influenced in part by costs, whereas 8 (47%) were inconsistent in their approach or failed to mention the exact mechanism for considering costs. Among the 138 specific recommendations in these guidance documents that included cost as part of the rationale, the most common form of recommendation (50 [36%]) encouraged the use of a specific medical service because of equal effectiveness and lower cost. Slightly more than half of the largest US physician societies explicitly consider costs in developing their clinical guidance documents; among these, approximately half use an explicit mechanism for integrating costs into the strength of recommendations. Many societies remain vague in their approach. Physician specialty societies should demonstrate greater transparency and rigor in their approach to cost consideration in documents meant to influence care decisions.

The High Rise Low Cost Housing : Sustainable Neighbourhood Elements (Green Elements) in Malaysia

Science.gov (United States)

Wahi, Noraziah; Mohamad, Ismail; Mohamad Zin, Rosli; Munikanan, Vikneswaran; Junaini, Syahrizan

2018-03-01

The sustainable development is a vital measure to alleviate the greenhouse gas effect, global warming and any other environment issues. The sustainable neighbourhood concept is not new in Malaysia, However, the concept still needs attention and awareness from the stakeholders. This paper discusses on the sustainable neighbourhood elements specifically green elements application on the high rise low cost housing in Malaysia. Malaysia should have focused sustainable neighbourhood planning and design especially on the high rise low cost housing therefore the future generation can be benefited from this type development.

Literacy Education and Sustainable Development in Developing Societies

Science.gov (United States)

Oghenekohwo, Jonathan E.; Frank-Oputu, Ekima A.

2017-01-01

The development of a literate society is a pre-requisite for the emergence of a knowledge economy. The thesis advanced in this paper is that, without massive investment and promotion of literacy education, development that is targeted at the 17-point sustainable development goals (SDGs) will be bereft of citizen's empowerment, engagement,…

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.

Challenges of science-society interactions in the frame of sustainable development: A case-study of contemporary Bulgaria

Directory of Open Access Journals (Sweden)

Paneva Aneliya

2016-01-01

Full Text Available Effectively tackling problems of sustainable development such as climate change, poverty, and biodiversity loss requires a different perspective on the role of science in society. Building on the understanding that knowledge production processes shall go hand in hand with governance processes, sustainability science and ecological economics promote transdisciplinarity and participatory procedures as a key requirement for scientific work on nature-society interactions. Involving non-academic actors such as local lay persons, civil society representatives, businesses, and decision makers in the research process promises the discovery of practical solutions to related problems and empowerment of communities. While this novel research approach has been increasingly applied in Western societies, its adoption by scientific actors in the context of Central and Eastern Europe, however, remains relatively low. Employing Bulgaria as a case study, this investigation examined the inter-actions between academia and practice through a series of expert interviews and a review of policy documents, thus offering insights into the specific conditions of implementing science for sustainable development. It emerges that knowledge transfer and experience exchange in the field are needed. Promoting social learning in this domain requires clarification of the roles of actors and institutions for sustainable development. Finally, recommendations for science related policies and scientific work are given.

Integrated, long term, sustainable, cost effective biosolids management at a large Canadian wastewater treatment facility.

Science.gov (United States)

Leblanc, R J; Allain, C J; Laughton, P J; Henry, J G

2004-01-01

The Greater Moncton Sewerage Commission's 115,000 m3/d advanced, chemically assisted primary wastewater treatment facility located in New Brunswick, Canada, has developed an integrated, long term, sustainable, cost effective programme for the management and beneficial utilization of biosolids from lime stabilized raw sludge. The paper overviews biosolids production, lime stabilization, conveyance, and odour control followed by an indepth discussion of the wastewater sludge as a resource programme, namely: composting, mine site reclamation, landfill cover, land application for agricultural use, tree farming, sod farm base as a soil enrichment, topsoil manufacturing. The paper also addresses the issues of metals, pathogens, organic compounds, the quality control program along with the regulatory requirements. Biosolids capital and operating costs are presented. Research results on removal of metals from primary sludge using a unique biological process known as BIOSOL as developed by the University of Toronto, Canada to remove metals and destroy pathogens are presented. The paper also discusses an ongoing cooperative research project with the Université de Moncton where various mixtures of plant biosolids are composted with low quality soil. Integration, approach to sustainability and "cumulative effects" as part of the overall biosolids management strategy are also discussed.

Beyond the Conflict and Weak Civil Society; Stories from Ukraine: Cases of Grassroots Initiatives for Sustainable Development

Directory of Open Access Journals (Sweden)

Oksana Udovyk

2017-09-01

Full Text Available This study explores the diversity of grassroots initiatives (GIs for sustainable development that are emerging in post-EuroMaidan Ukraine. It first focuses on an overview of different theories on civil society and trends in Ukrainian civil society development. Eight cases of GIs are selected to represent different pillars of sustainability work done by the initiatives (economic, social, environmental, and political-institutional. These cases question the arguments behind the weak and pseudo-plenipotentiary vision of civil society in Ukraine, and demonstrate mechanisms of sustainable development suggested by analyzed GIs. In general, this study challenges the myth of a weak civil society in Ukraine, opens up a broader discussion on the meaning and role of civil society, and provides new ideas for building a sustainable society.

AN APROACH OF LOCAL FINANCIAL AUTONOMY AND IMPLICATION OVER SUSTAINABLE DEVELOPMENT IN THE KNOWLEDGE SOCIETY

OpenAIRE

Elena CIGU

2014-01-01

Local governments play an important role in sustainable development processes based on their administrative and financial autonomy. Policies and programs undertaken to assure sustainable development by local governments produce benefits for persistence of the knowledge society. This paper will try to highlight the implication of local financial autonomy over sustainable development of local communities in a knowledge society, based especially on local financial autonomy theory approach.

AN APROACH OF LOCAL FINANCIAL AUTONOMY AND IMPLICATION OVER SUSTAINABLE DEVELOPMENT IN THE KNOWLEDGE SOCIETY

Directory of Open Access Journals (Sweden)

Elena CIGU

2014-12-01

Full Text Available Local governments play an important role in sustainable development processes based on their administrative and financial autonomy. Policies and programs undertaken to assure sustainable development by local governments produce benefits for persistence of the knowledge society. This paper will try to highlight the implication of local financial autonomy over sustainable development of local communities in a knowledge society, based especially on local financial autonomy theory approach.

Costing systems design for sustainability

Directory of Open Access Journals (Sweden)

Mihaela TURTUREA

2013-10-01

Full Text Available The aim of this article is to present an overall image of the way Accounting responds to nowadays user’s needs in relation to the quantification of the impact companies have towards the environment. Regarding this, there have been analyzed concepts like sustainable development, environmental accounting, environmental costs and there have been presented the main progress towards environmental cost identification and measurement from the perspective of Activity Based Costing system. To provide an overall image of this concepts, there have been used as research methodology methods the documentation from literature review, analysis, synthesis and comparison.

Modular laboratories--cost-effective and sustainable infrastructure for resource-limited settings.

Science.gov (United States)

Bridges, Daniel J; Colborn, James; Chan, Adeline S T; Winters, Anna M; Dengala, Dereje; Fornadel, Christen M; Kosloff, Barry

2014-12-01

High-quality laboratory space to support basic science, clinical research projects, or health services is often severely lacking in the developing world. Moreover, the construction of suitable facilities using traditional methods is time-consuming, expensive, and challenging to implement. Three real world examples showing how shipping containers can be converted into modern laboratories are highlighted. These include use as an insectary, a molecular laboratory, and a BSL-3 containment laboratory. These modular conversions have a number of advantages over brick and mortar construction and provide a cost-effective and timely solution to offer high-quality, user-friendly laboratory space applicable within the developing world. © The American Society of Tropical Medicine and Hygiene.

Integrated, long term, sustainable, cost effective biosolids management at a large Canadian wastewater treatment facility

Energy Technology Data Exchange (ETDEWEB)

LeBlance, R.J.; Allain, C.J.; Laughton, P.J.; Henry, J.G.

2003-07-01

The Greater Moncton Sewerage Commission's 115 000 m{sup 3}/d advanced, chemically assisted primary wastewater treatment facility located in New Brunswick, Canada, has developed an integrated, long term, sustainable, cost effective programme for the management and beneficial utilization of biosolids from lime stabilized raw sludge. The paper overviews biosolids production, lime stabilization, conveyance, and odour control followed by an indepth discussion of the wastewater sludge as a resource programme, namely: composting, mine site reclamation, landfill cover, land application for agricultural use, tree farming, sod farm base as a soil enrichment, topsoil manufacturing. The paper also addresses the issues of metals, pathogens, organic compounds, the quality control program along with the regulatory requirements. Biosolids capital and operating costs are presented. Research results on removal of metals from primary sludge using a unique biological process known as BIOSOL as developed by the University of Toronto, Canada to remove metals and destroy pathogens are presented. The paper also discusses an ongoing cooperative research project with the Universite de Moncton where various mixtures of plant biosolids are composted with low quality soil. Integration, approach to sustainability and ''cumulative effects'' as part of the overall biosolids management strategy is also discussed. (author)

Visualizing the application of GIS in transformation towards a sustainable development and a low carbon society

International Nuclear Information System (INIS)

Ahmad, M H; Ariffin, A; Malik, T A

2014-01-01

A strategy for sustainable development is a significant milestone on the road to a more socially, economically and environmentally responsible society. It creates a framework within which the stakeholders can make a strong contribution to a better future. Because of the merits and growing interest in sustainable development, the race is on for researchers and stakeholders in the construction sector to initiate actions to reduce the negative impacts of development and sharpen their competitive edge. The cities should be created with a vision which supports harmonious communities and living conditions through sustainable urban development. The resources must be used efficiently while reducing the development impact on human health and environment during the buildings' life cycle. Environmental auditing and pressure-state response based models to monitor sustainable development in Malaysia should be developed. A data availability and sharing system should be developed and implemented to facilitate for the use in the establishment of sustainable development and low carbon society. Ideas which affect millions of people and guide the policies of nations must be accessible to all. Only thus can they permeate the institutions from the local to the global level. Creating sustainable development and low carbon societies depends on the knowledge and involvement of all stakeholders in the industry. So what is our level of understanding of GIS and its application? The development of geospatial data in Malaysia is important because the successful implementation of sustainable development and low carbon projects depend largely on the availability of geospatial information. It would facilitate the stakeholders and resolve some of the problems regarding the availability, quality, organisation, accessibility and sharing of spatial information. The introduction of GIS may change the way for better sustainable urban development and low carbon society performance. The use of GIS

Visualizing the application of GIS in transformation towards a sustainable development and a low carbon society

Science.gov (United States)

Ahmad, M. H.; Ariffin, A.; Malik, T. A.

2014-02-01

A strategy for sustainable development is a significant milestone on the road to a more socially, economically and environmentally responsible society. It creates a framework within which the stakeholders can make a strong contribution to a better future. Because of the merits and growing interest in sustainable development, the race is on for researchers and stakeholders in the construction sector to initiate actions to reduce the negative impacts of development and sharpen their competitive edge. The cities should be created with a vision which supports harmonious communities and living conditions through sustainable urban development. The resources must be used efficiently while reducing the development impact on human health and environment during the buildings' life cycle. Environmental auditing and pressure-state response based models to monitor sustainable development in Malaysia should be developed. A data availability and sharing system should be developed and implemented to facilitate for the use in the establishment of sustainable development and low carbon society. Ideas which affect millions of people and guide the policies of nations must be accessible to all. Only thus can they permeate the institutions from the local to the global level. Creating sustainable development and low carbon societies depends on the knowledge and involvement of all stakeholders in the industry. So what is our level of understanding of GIS and its application? The development of geospatial data in Malaysia is important because the successful implementation of sustainable development and low carbon projects depend largely on the availability of geospatial information. It would facilitate the stakeholders and resolve some of the problems regarding the availability, quality, organisation, accessibility and sharing of spatial information. The introduction of GIS may change the way for better sustainable urban development and low carbon society performance. The use of GIS is to

Nuclear energy economics in a sustainable development perspective

International Nuclear Information System (INIS)

Bertel, E.; Morrison, R.

2001-01-01

In order to contribute effectively to sustainable development goals, a technology option must meet the test of economic efficiency to justify its use of scarce capital. However, in a sustainable development perspective, this test should be considered in a broad context, taking into account the need to preserve capital assets of all kinds: natural, man-made, human and social. Assessments of competitiveness in this context should be based upon comparisons of full costs to society of a product or a service. At present, many of the costs associated with the supply of goods and services are not reflected in their market prices. Economists are looking for ways of valuing these costs and incorporating them into price, i.e. internalizing the externalities. Within a sustainable development framework, getting the prices right so that market mechanisms can operate efficiently implies taking into account social and environmental costs for present and future generations. On that basis, the comparative assessment of alternative technologies will become an effective policy-making tool. (authors)

The total lifetime health cost savings of smoking cessation to society

DEFF Research Database (Denmark)

Rasmussen, Gitte Susanne; Prescott, Eva; Sørensen, Thorkild I A

2005-01-01

Smoking cessation has major immediate and long-term health benefits. However, ex-smokers' total lifetime health costs and continuing smokers' costs remain uncompared, and hence the economic savings of smoking cessation to society have not been determined.......Smoking cessation has major immediate and long-term health benefits. However, ex-smokers' total lifetime health costs and continuing smokers' costs remain uncompared, and hence the economic savings of smoking cessation to society have not been determined....

Solar Irradiance Measurements Using Smart Devices: A Cost-Effective Technique for Estimation of Solar Irradiance for Sustainable Energy Systems

Directory of Open Access Journals (Sweden)

Hussein Al-Taani

2018-02-01

Full Text Available Solar irradiance measurement is a key component in estimating solar irradiation, which is necessary and essential to design sustainable energy systems such as photovoltaic (PV systems. The measurement is typically done with sophisticated devices designed for this purpose. In this paper we propose a smartphone-aided setup to estimate the solar irradiance in a certain location. The setup is accessible, easy to use and cost-effective. The method we propose does not have the accuracy of an irradiance meter of high precision but has the advantage of being readily accessible on any smartphone. It could serve as a quick tool to estimate irradiance measurements in the preliminary stages of PV systems design. Furthermore, it could act as a cost-effective educational tool in sustainable energy courses where understanding solar radiation variations is an important aspect.

Earth Stewardship: An initiative by the Ecological Society of America to foster engagement to sustain Planet Earth

Science.gov (United States)

Chapin, F. Stuart; Pickett, S.T.A.; Power, Mary E.; Collins, Scott L.; Baron, Jill S.; Inouye, David W.; Turner, Monica G.

2017-01-01

The Ecological Society of America (ESA) has responded to the growing commitment among ecologists to make their science relevant to society through a series of concerted efforts, including the Sustainable Biosphere Initiative (1991), scientific assessment of ecosystem management (1996), ESA’s vision for the future (2003), Rapid Response Teams that respond to environmental crises (2005), and the Earth Stewardship Initiative (2009). During the past 25 years, ESA launched five new journals, largely reflecting the expansion of scholarship linking ecology with broader societal issues. The goal of the Earth Stewardship Initiative is to raise awareness and to explore ways for ecologists and other scientists to contribute more effectively to the sustainability of our planet. This has occurred through four approaches: (1) articulation of the stewardship concept in ESA publications and Website, (2) selection of meeting themes and symposia, (3) engagement of ESA sections in implementing the initiative, and (4) outreach beyond ecology through collaborations and demonstration projects. Collaborations include societies and groups of Earth and social scientists, practitioners and policy makers, religious and business leaders, federal agencies, and artists and writers. The Earth Stewardship Initiative is a work in progress, so next steps likely include continued nurturing of these emerging collaborations, advancing the development of sustainability and stewardship theory, improving communication of stewardship science, and identifying opportunities for scientists and civil society to take actions that move the Earth toward a more sustainable trajectory.

Towards Sustainable Lifestyles. A Variety of Lifestyles for a Post-carbon Society

International Nuclear Information System (INIS)

Huber, Andreas; Le Marre, Pierre; Girard, Sebastien

2013-01-01

In 2009 a programme 'Re-thinking Society in a Post-carbon Society'- steered jointly by the Foresight Department of the French Ecology Ministry and the French Environment and Energy Management Agency (ADEME), was launched in France. It is still ongoing and aims to produce a final report in 2013. The idea of a transition towards a 'post- carbon' society includes four main objectives: reducing greenhouse gas emissions by 2050 to one quarter of what they were in 1990; near-autonomy with regard to carbon energies (petrol, gas, coal); an adequate capacity to adapt to climate change and, lastly, greater attention to situations of 'energy precariousness'. As part of the dossier Futuribles is devoting to this programme this month, Andreas Huber, Sebastien Girard and Pierre Le Marre lay out in this article the results of the studies they have carried out on 'sustainable urban milieus'. After a presentation of the notion of 'milieu' (based here on a segmentation using the Socio-milieus R method) and of the typology employed (nine main social milieus, three emergent milieus and 16 contrasting profiles), the authors show the extent to which individuals' carbon foot - prints vary, depending upon lifestyles, and what a determining effect these lifestyles have in the fields of housing and transport. They then specify the various factors influencing behaviour in the direction of sustain - able consumption (or not) and the different types of strategies of intervention that are likely to modify those behaviours. Lastly, they detail two targeted strategies, one aimed at the 'precarious seniors' milieu and the other at the 'eco-elite' milieu. Despite certain imperfections that remain to be sorted out in the study of sustainable urban milieus, these studies open up new perspectives for the development of sociologically targeted policies for a post-carbon transition. (authors)

Cost-effectiveness of a pressure ulcer quality collaborative

Directory of Open Access Journals (Sweden)

Bal Roland

2010-06-01

Full Text Available Abstract Background A quality improvement collaborative (QIC in the Dutch long-term care sector (nursing homes, assisted living facilities, home care used evidence-based prevention methods to reduce the incidence and prevalence of pressure ulcers (PUs. The collaborative consisted of a core team of experts and 25 organizational project teams. Our aim was to determine its cost-effectiveness from a healthcare perspective. Methods We used a non-controlled pre-post design to establish the change in incidence and prevalence of PUs in 88 patients over the course of a year. Staff indexed data and prevention methods (activities, materials. Quality of life (Qol weights were assigned to the PU states. We assessed the costs of activities and materials in the project. A Markov model was built based on effectiveness and cost data, complemented with a probabilistic sensitivity analysis. To illustrate the results of longer term, three scenarios were created in which change in incidence and prevalence measures were (1 not sustained, (2 partially sustained, and (3 completely sustained. Results Incidence of PUs decreased from 15% to 4.5% for the 88 patients. Prevalence decreased from 38.6% to 22.7%. Average Quality of Life (Qol of patients increased by 0.02 Quality Adjusted Life Years (QALYs in two years; healthcare costs increased by €2000 per patient; the Incremental Cost-effectiveness Ratio (ICER was between 78,500 and 131,000 depending on whether the changes in incidence and prevalence of PU were sustained. Conclusions During the QIC PU incidence and prevalence significantly declined. When compared to standard PU care, the QIC was probably more costly and more effective in the short run, but its long-term cost-effectiveness is questionable. The QIC can only be cost-effective if the changes in incidence and prevalence of PU are sustained.

Cost-effectiveness of a pressure ulcer quality collaborative.

Science.gov (United States)

Makai, Peter; Koopmanschap, Marc; Bal, Roland; Nieboer, Anna P

2010-06-01

A quality improvement collaborative (QIC) in the Dutch long-term care sector (nursing homes, assisted living facilities, home care) used evidence-based prevention methods to reduce the incidence and prevalence of pressure ulcers (PUs). The collaborative consisted of a core team of experts and 25 organizational project teams. Our aim was to determine its cost-effectiveness from a healthcare perspective. We used a non-controlled pre-post design to establish the change in incidence and prevalence of PUs in 88 patients over the course of a year. Staff indexed data and prevention methods (activities, materials). Quality of life (Qol) weights were assigned to the PU states. We assessed the costs of activities and materials in the project. A Markov model was built based on effectiveness and cost data, complemented with a probabilistic sensitivity analysis. To illustrate the results of longer term, three scenarios were created in which change in incidence and prevalence measures were (1) not sustained, (2) partially sustained, and (3) completely sustained. Incidence of PUs decreased from 15% to 4.5% for the 88 patients. Prevalence decreased from 38.6% to 22.7%. Average Quality of Life (Qol) of patients increased by 0.02 Quality Adjusted Life Years (QALY)s in two years; healthcare costs increased by euro2000 per patient; the Incremental Cost-effectiveness Ratio (ICER) was between 78,500 and 131,000 depending on whether the changes in incidence and prevalence of PU were sustained. During the QIC PU incidence and prevalence significantly declined. When compared to standard PU care, the QIC was probably more costly and more effective in the short run, but its long-term cost-effectiveness is questionable. The QIC can only be cost-effective if the changes in incidence and prevalence of PU are sustained.

Role of Mass Media in the Disaster Preparedness and Sustainable Development of Society

International Nuclear Information System (INIS)

Seid-Aliyeva, Dinara E.

2006-01-01

Better understanding of the causes and effects of large earthquakes can assists in mitigation of damage and loss of lives as a result of destructive natural events. Well-informed and educated population living in geological hazard-prone regions can reduce catastrophic consequences of natural disasters and guaranty the sustainable development of healthy society. A development of information service for disaster management is of importance in reduction of the disaster's consequences

Effectiveness and Cost-benefit Evaluation of a Comprehensive Workers' Health Surveillance Program for Sustainable Employability of Meat Processing Workers

NARCIS (Netherlands)

Holland, van Berry J.; Reneman, Michiel F; Soer, Remko; Brouwer, Sandra; de Boer, Michiel R

Objective To evaluate the effectiveness of a comprehensive workers' health surveillance (WHS) program on aspects of sustainable employability and cost-benefit. Methods A cluster randomized stepped wedge trial was performed in a Dutch meat processing company from february 2012 until march 2015. In

Effectiveness and Cost-benefit Evaluation of a Comprehensive Workers' Health Surveillance Program for Sustainable Employability of Meat Processing Workers

NARCIS (Netherlands)

van Holland, Berry J; Reneman, Michiel F; Soer, Remko; Brouwer, Sandra; de Boer, Michiel R

2017-01-01

Objective To evaluate the effectiveness of a comprehensive workers' health surveillance (WHS) program on aspects of sustainable employability and cost-benefit. Methods A cluster randomized stepped wedge trial was performed in a Dutch meat processing company from february 2012 until march 2015. In

Cost Based Value Stream Mapping as a Sustainable Construction Tool for Underground Pipeline Construction Projects

Directory of Open Access Journals (Sweden)

Murat Gunduz

2017-11-01

Full Text Available This paper deals with application of Value Stream Mapping (VSM as a sustainable construction tool on a real construction project of installation of underground pipelines. VSM was adapted to reduce the high percentage of non-value-added activities and time wastes during each construction stage and the paper searched for an effective way to consider the cost for studied construction of underground pipeline. This paper is unique in its way that it adopts cost implementation of VSM to improve the productivity in underground pipeline projects. The data was observed and collected from site during construction, indicating the cycle time, value added and non-value added of each construction stage. The current state was built based on these details. This was an eye-opening exercise and a process management tool as a trigger for improvement. After the current state assessment, a future state is attempted by Value Stream Mapping tool balancing the resources using a Line of Balance (LOB technique. Moreover, a sustainable cost estimation model was developed during current state and future state to calculate the cost of underground pipeline construction. The result shows a cost reduction of 20.8% between current and future states. This reflects the importance of the cost based Value Stream Mapping in construction as a sustainable measurement tool. This new tool could be utilized in construction industry to add the sustainability and effective cost management.

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

Electricity Technology Roadmap. Technology for the Sustainable Society. 2025

International Nuclear Information System (INIS)

2002-01-01

The Dutch Electricity Technology Roadmap Initiative is being developed by KEMA as a joint effort of Dutch and European experts of universities, industry and (non)governmental organisations. It aims to assess how to structure the ongoing collaborative research and technological advancement, the exploration of the opportunities and the threats for the electricity-based innovations over the next twenty-five years. In addition it analyses how to manage the transition towards a knowledge based economy and a more sustainable society. To date, about 100 organisations have participated with KEMA and its sponsors in shaping a comprehensive vision of the opportunities to structure the knowledge based economy in the Digital Society with as basis the increase of electricity's value to society. This vision is being translated into a set of technology development destinations and a total of six distinct initiatives for targeted projects. KEMA is leading this ongoing road-mapping effort, with the support of TENNET and EPRI (USA). The Dutch power generation utilities and the Ministry of Economics (EZ) financially support the work. It is an investment in the future of the Dutch knowledge based economy and a guidance to structure and strengthen the value of public and private RandD investments. The Electricity Technology Roadmap Initiative explores a period of fast regulatory, political, technological and institutional change in the electricity enterprise and in the society. The strategic choices made in this period of change can have profound consequences on whether future opportunities are opened or closed, and whether threats increase or are eliminated The reluctance to proceed with important changes is understandable, given the extreme uncertainty under which decisions must be made. No regrets solutions may be appropriate in some circumstances. These situations highlight the need for foresight and the importance of strategic roadmapping. The first year of the Roadmap

Cost-effectiveness of a Nutrition Education Curriculum Intervention in Elementary Schools.

Science.gov (United States)

Graziose, Matthew M; Koch, Pamela A; Wang, Y Claire; Lee Gray, Heewon; Contento, Isobel R

2017-09-01

To estimate the long-term cost-effectiveness of an obesity prevention nutrition education curriculum (Food, Health, & Choices) as delivered to all New York City fifth-grade public school students over 1 year. This study is a standard cost-effectiveness analysis from a societal perspective, with a 3% discount rate and a no-intervention comparator, as recommended by the US Panel on Cost-effectiveness in Health and Medicine. Costs of implementation, administration, and future obesity-related medical costs were included. Effectiveness was based on a cluster-randomized, controlled trial in 20 public schools during the 2012-2013 school year and linked to published estimates of childhood-to-adulthood body mass index trajectories using a decision analytic model. The Food, Health, & Choices intervention was estimated to cost $8,537,900 and result in 289 fewer males and 350 fewer females becoming obese (0.8% of New York City fifth-grade public school students), saving 1,599 quality-adjusted life-years (QALYs) and $8,098,600 in direct medical costs. Food, Health, & Choices is predicted to be cost-effective at $275/QALY (95% confidence interval, -$2,576/QALY to $2,084/QALY) with estimates up to $6,029/QALY in sensitivity analyses. This cost-effectiveness model suggests that a nutrition education curriculum in public schools is effective and cost-effective in reducing childhood obesity, consistent with the authors' hypothesis and previous literature. Future research should assess the feasibility and sustainability of scale-up. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

The economic costs of radiation-induced health effects: Estimation and simulation

International Nuclear Information System (INIS)

Nieves, L.A.; Tawil, J.J.

1988-08-01

This effort improves the quantitative information available for use in evaluating actions that alter health risks due to population exposure to ionizing radiation. To project the potential future costs of changes in health effects risks, Pacific Northwest Laboratory (PNL) constructed a probabilistic computer model, Health Effects Costs Model (HECOM), which utilizes the health effect incidence estimates from accident consequences models to calculate the discounted sum of the economic costs associated with population exposure to ionizing radiation. Application of HECOM to value-impact and environmental impact analyses should greatly increase the quality of the information available for regulatory decision making. Three major types of health effects present risks for any population sustaining a significant radiation exposure: acute radiation injuries (and fatalities), latent cancers, and impairments due to genetic effects. The literature pertaining to both incidence and treatment of these health effects was reviewed by PNL and provided the basis for developing economic cost estimates. The economic costs of health effects estimated by HECOM represent both the value of resources consumed in diagnosing, treating, and caring for the patient and the value of goods not produced because of illness or premature death due to the health effect. Additional costs to society, such as pain and suffering, are not included in the PNL economic cost measures since they do not divert resources from other uses, are difficult to quantify, and do not have a value observable in the marketplace. 83 refs., 3 figs., 19 tabs

The economic costs of radiation-induced health effects: Estimation and simulation

Energy Technology Data Exchange (ETDEWEB)

Nieves, L.A.; Tawil, J.J.

1988-08-01

This effort improves the quantitative information available for use in evaluating actions that alter health risks due to population exposure to ionizing radiation. To project the potential future costs of changes in health effects risks, Pacific Northwest Laboratory (PNL) constructed a probabilistic computer model, Health Effects Costs Model (HECOM), which utilizes the health effect incidence estimates from accident consequences models to calculate the discounted sum of the economic costs associated with population exposure to ionizing radiation. Application of HECOM to value-impact and environmental impact analyses should greatly increase the quality of the information available for regulatory decision making. Three major types of health effects present risks for any population sustaining a significant radiation exposure: acute radiation injuries (and fatalities), latent cancers, and impairments due to genetic effects. The literature pertaining to both incidence and treatment of these health effects was reviewed by PNL and provided the basis for developing economic cost estimates. The economic costs of health effects estimated by HECOM represent both the value of resources consumed in diagnosing, treating, and caring for the patient and the value of goods not produced because of illness or premature death due to the health effect. Additional costs to society, such as pain and suffering, are not included in the PNL economic cost measures since they do not divert resources from other uses, are difficult to quantify, and do not have a value observable in the marketplace. 83 refs., 3 figs., 19 tabs.

Sustainable Design and Postindustrial Society: Our Ethical and Aesthetic Crossroads

Directory of Open Access Journals (Sweden)

Leonard Bachman

2016-12-01

Full Text Available Mid-20th century transitions from industrial product society to postindustrial information society have marked profound but now familiar conversions to service economy, knowledge workers, and cybernetic reasoning. Second order, but equally important consequences of this change involve the transformation from predominantly human-machine heroics to human-human collaboration. Collectively, these events have revolutionized the bases of production and value across the developed world. Less appreciated however, are the more subtle shifts of postindustrialism and their ultimate epochal transformations of contemporary life. The short list of these more elusive transitions includes local scale isolation to macro and global scale interaction, mechanistic routine to systemic reasoning, static to dynamic assumptions, short-termism to scenario planning, profit to value motives, hero to team attribution, intuitive to cybernetic decisions, and a move away from rote procedural expertise in favor of reasoned principle, wisdom, and theory. Our historical perspective thus argues for the relevance of postindustrial society in the emergence of a sustainable future, with particular reference to the built environment and to the complex, collaborative, evidence based and cybernetic processes it involves. The difficulty here is that without a vivid and operational understanding of the aesthetic connections and ethical mandates inherent in these more sublime postindustrial events; it is entirely possible that all the best scientific, technical, and political efforts toward sustainability are hampered by old habits of piecemeal procedures, mechanistic approaches, individual expertise, quick profit, and simplistic short-termism. Postindustrial ethics and aesthetics, on the other hand, offer a new and different apparatus by embracing complexity and dynamic interaction. Within that new aesthetic lies a set of principles and sensitivities towards postindustrial and

The cost-effectiveness, health benefits, and financial costs of new antiviral treatments for hepatitis C virus.

Science.gov (United States)

Rein, David B; Wittenborn, John S; Smith, Bryce D; Liffmann, Danielle K; Ward, John W

2015-07-15

New hepatitis C virus (HCV) treatments deliver higher cure rates with fewer contraindications, increasing demand for treatment and healthcare costs. The cost-effectiveness of new treatments is unknown. We conducted a microsimulation of guideline testing followed by alternative treatment regimens for HCV among the US population aged 20 and older to estimate cases identified, treated, sustained viral response, deaths, medical costs, quality-adjusted life-years (QALYs), and the incremental cost-effectiveness ratio (ICER) of different treatment options expressed as discounted lifetime costs and benefits from the healthcare perspective. Compared to treatment with pegylated interferon and ribavirin (PR), and a protease inhibitor for HCV genotype (G) 1 and PR alone for G2/3, treatment with PR and Sofosbuvir (PRS) for G1/4 and treatment with Sofosbuvir and ribavirin (SR) for G2/3 increased QALYs by 555 226, reduced deaths by 80 682, and increased costs by $26.2 billion at an ICER of $47 304 per QALY gained. As compared to PRS/SR, treating with an all oral regimen of Sofosbuvir and Simeprevir (SS) for G1/4 and SR for G2/3, increased QALYs by 1 110 451 and reduced deaths by an additional 164 540 at an incremental cost of $80.1 billion and an ICER of $72 169. In sensitivity analysis, where treatment with SS effectiveness was set to the list price of Viekira Pak and then Harvoni, treatment cost $24 921 and $25 405 per QALY gained as compared to PRS/SR. New treatments are cost-effectiveness per person treated, but pent-up demand for treatment may create challenges for financing. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Occupational ethis sustainable a global society

Directory of Open Access Journals (Sweden)

Nilton Cesar Flores

2015-09-01

Full Text Available The thematic working environment reproduces the complexities of the risks in a globalized world. In imbricar the interrelationship of this globalization movement of the economy and productive restructuring that triggers a series of social consequences. While globalization and the emergence of new technologies benefited the man, however, they gave up the cost of a degree of disregard and neglect the integrity of those involved in the process. Thus arises the need for new approaches to law. To this end, the study overcomes the theory of shallow ecology and of the understanding of the theory of deep ecology without it looses its essence, proposing an analysis focused on the human element within the web of life, indicating a new guiding principle: sustainable occupational ethics.

Evaluating the cost-effectiveness of ecosystem-based adaptation: Kamiesberg wetlands case study

Directory of Open Access Journals (Sweden)

David Black

2016-12-01

Full Text Available Ecosystem-based adaptation (EbA is increasingly being promoted as a cost-effective means of adaptation to climate change. However, in spite of considerable international press, there is still little evidence to substantiate this claim. This study proposes a method through which the cost-effectiveness of EbA strategies can be evaluated against alternative adaptation options, and contributes to South African literature on the subject. The potential cost-effectiveness of wetland restoration is assessed as a means of securing the carrying capacity of land for pastoralist communities of the Kamiesberg communal area in South Africa under projected future climate conditions. The conventional alternatives would be to respond to increasingly dry conditions by drilling boreholes and using supplemental feed for livestock. It was assumed that the EbA interventions would occur upfront, whereas the alternatives are more likely to be implemented in reaction to droughts over a longer time period. The study found the implementation of conventional alternatives to be more cost-effective than EbA as a means to sustaining livestock stocking rates, with EbA being twice as costly. However, this is framed from the perspective of those directly affected (the landowners, and does not include the benefits to broader society.

The Impact of Civil Society Organizations on Sustainable ...

African Journals Online (AJOL)

Civil society groups are agents of development in any nation. Civil society organizations appear to play important role in social, political and economic development activities. The transformation of any society or system, particularly the developing societies like Nigeria depend on the effectiveness and efficiency of its civil ...

Toward commercialization of FBR cycle (1). Promotion of R and D on technologies maintaining sustainable society

International Nuclear Information System (INIS)

Nagaoki, Yoshihiro; Nagura, Fuminori; Sakaguchi, Tomoyoshi; Kawasaki, Hirotsugu; Kikuchi, Shin

2008-01-01

The FBR cycle is a key technology maintaining a sustainable society through efficient utilization of limited uranium resources and conformance to global environmental protection. The domestic and overseas R and D of the FBR cycle entered on a new phase aiming at its commercialization and JAEA started the Fast Reactor Cycle Technology Development (FaCT) project. The FaCT project targeted at international standardization of the FBR fuel cycle and promoting the advanced R and D on the innovative technologies to increase cost-efficiency and reliability for the commercialization under international competition and cooperation. The combination of a sodium cooled FBR and advanced fuel cycle system with advanced aqueous reprocessing and simplified pelletizing fuel fabrication was selected a major concept. (T. Tanaka)

Beyond cost-effectiveness, analysis. Value-based pricing and result-oriented financing as a pathway to sustainability for the national health system in Spain

Directory of Open Access Journals (Sweden)

Alvaro Hidalgo-Vega

2017-01-01

Full Text Available Beyond cost-effectiveness, analysis. Value-based pricing and result-oriented financing as a pathway to sustainability for the national health system in SpainThe editorial addresses the current use of economic evaluation in the assessment and potential funding and reimbursement of health technologies. Cost-effectiveness ratio and the acceptability thresholds are analyzed, pointing out the limitations that the current approach has for capturing the value of new technologies. A potential shift from National Health Systems to value-based prices is discussed, with a focus on health economics outcomes where multi-criteria analyses can be a complementary tool to traditional cost-effectiveness approaches.

Physiotherapy after arthroscopic partial meniscectomy surgery: an assessment of costs to the National Health Service, patients, and society.

Science.gov (United States)

Goodwin, Peter Charles; Ratcliffe, Julie; Morrissey, Matthew Charles

2005-01-01

The purpose of this study was to determine and inform clinicians, managers, and budget allocators of the costs incurred to the British National Health Service (NHS), patient, and society when attending clinic-based physiotherapy compared with not attending clinic-based physiotherapy after arthroscopic partial meniscectomy surgery. The valuation principle used in this study was the economic concept of opportunity cost. Costs were referred to as direct medical (NHS), direct nonmedical (patient), and indirect (societal) costs. Due to the difficulties of their measurement and valuation, intangible costs, in the form of pain and anxiety related to the effect of receiving or not receiving treatment, have not been considered in this analysis. Providing clinic-based physiotherapy after knee arthroscopic partial meniscectomy surgery is more costly to the NHS and patient, but no more costly to society than when not providing it and does not result in reduced contact with the NHS. Clinic-based physiotherapy after knee arthroscopic partial meniscectomy surgery is costly and evidence is needed that its effectiveness is high enough to support its use.

Innovation, Cooperation, and the Perceived Benefits and Costs of Sustainable Agriculture Practices

Directory of Open Access Journals (Sweden)

Mark Lubell

2011-12-01

Full Text Available A central goal of most sustainable agriculture programs is to encourage growers to adopt practices that jointly provide economic, environmental, and social benefits. Using surveys of outreach professionals and wine grape growers, we quantify the perceived costs and benefits of sustainable viticulture practices recommended by sustainability outreach and certification programs. We argue that the mix of environmental benefits, economic benefits, and economic costs determine whether or not a particular practice involves decisions about innovation or cooperation. Decision making is also affected by the overall level of knowledge regarding different practices, and we show that knowledge gaps are an increasing function of cost and a decreasing function of benefits. How different practices are related to innovation and cooperation has important implications for the design of sustainability outreach programs. Cooperation, innovation, and knowledge gaps are issues that are likely to be relevant for the resilience and sustainability of many different types of social-ecological systems.

The dual sustainability of wind energy

Energy Technology Data Exchange (ETDEWEB)

Welch, Jonathan B.; Venkateswaran, Anand [413 Hayden Hall, College of Business, Northeastern University, 360 Huntington Avenue, Boston, MA 02115 (United States)

2009-06-15

Academics, practitioners, and policy makers continue to debate the benefits and costs of alternative sources of energy. Environmental and economic concerns have yet to be fully reconciled. One view is that decisions that incorporate both society's concern with the environment and investors' desire for shareholder value maximization are more likely to be truly sustainable. We coin the term dual sustainability to mean the achievement of environmental and financial sustainability simultaneously. Many experts believe that wind energy can help to meet society's needs without harming future generations. It is clean and renewable. Because the fuel is free it provides the ultimate in energy independence. Wind energy has emerged as a leading prospect, in part, because it is considered by many to be environmentally sustainable. However, a key question that remains is whether wind energy is financially sustainable without the extensive government support that has helped to create and nurture this growth industry. Using reliable, proprietary data from field research, our analysis employs a capital budgeting framework to evaluate the financial economics of investments in wind energy. We find that because of the convergence of improved technology, greater efficiency, and with the increasing cost of traditional, competing sources such as oil and natural gas, wind energy is close to becoming self-sustaining financially without the extensive federal government support that exists today. Wind energy can provide the best of both worlds. It is sustainable from an environmental perspective and it is becoming sustainable financially. In short, those companies investing in wind energy will be able to do well by doing good. Perhaps the achievement of dual sustainability is true sustainability. Our research findings and dual sustainability have several interesting and important implications for public policy towards wind energy. All imply that public policy can now be

Sustained employability of workers in a production environment: design of a stepped wedge trial to evaluate effectiveness and cost-benefit of the POSE program.

Science.gov (United States)

van Holland, Berry J; de Boer, Michiel R; Brouwer, Sandra; Soer, Remko; Reneman, Michiel F

2012-11-20

Sustained employability and health are generating awareness of employers in an aging and more complex work force. To meet these needs, employers may offer their employees health surveillance programs, to increase opportunities to work on health and sustained employability. However, evidence for these health surveillance programs is lacking. The FLESH study (Functional Labour Evaluation for Sustained Health and employment) was developed to evaluate a comprehensive workers' health promotion program on its effectiveness, cost-benefit, and process of the intervention. The study is designed as a cluster randomised stepped wedge trial with randomisation at company plant level and is carried out in a large meat processing company. Every contracted employee is offered the opportunity to participate in the POSE program (Promotion Of Sustained Employability). The main goals of the POSE program are 1) providing employee's insight into their current employability and health status, 2) offering opportunities to improve employability and decrease health risks and 3) improving employability and health sustainably in order to keep them healthy at work. The program consists of a broad assessment followed by a counselling session and, if needed, a tailored intervention. Measurements will be performed at baseline and will be followed up at 20, 40, 60, 80, 106 and 132 weeks. The primary outcome measures are work ability, productivity and absenteeism. Secondary outcomes include health status, vitality, and psychosocial workload. A cost-benefit study will be conducted from the employers' perspective. A process evaluation will be conducted and the satisfaction of employer and employees with the program will be assessed. This study provides information on the effectiveness of the POSE program on sustained employment. When the program proves to be effective, employees benefit by improved work ability, and health. Employers benefit from healthier employees, reduced sick leave (costs) and

Effects of Corporate Sustainability on Established Brand : the case of IKEA

OpenAIRE

Gbanabila, Yenimi

2014-01-01

The emergence of Sustainable Development as an alternative approach to changing unsustainable behaviour in today’s business practices to save the planet towards a sustainable society is shifting branding paradigm from the “what of the commodity to the how of shared values”. For marketers responding to this changing paradigm to maintain competitive in today’s market sustainable branding is gaining attention in today’s business practices. But does sustainable practice have effects on branding i...

Export growth, energy costs, and sustainable supply chains

Science.gov (United States)

2010-11-01

The report examines sustainable supply chains in North America and the role played by rail intermodal : operations in lowering ten-mile fuel and emission costs. It examines whether current systems favor imports : over exports a current complaint ...

The Cost-Effectiveness of Investments to Meet the Guiding Principles for High-Performance Sustainable Buildings on the PNNL Campus

Energy Technology Data Exchange (ETDEWEB)

Cort, Katherine A.; Judd, Kathleen S.

2014-08-29

As part its campus sustainability efforts, Pacific Northwest National Laboratory (PNNL) has invested in eight new and existing buildings to ensure they meet the U.S. Department of Energy’s requirements for high performance sustainable buildings (HPSB) at DOE sites. These investments are expected to benefit PNNL by reducing the total life-cycle cost of facilities, improving energy efficiency and water conservation, and making buildings safer and healthier for the occupants. This study examines the cost-effectiveness of the implementing measures that meet the criteria for HPSBs in 3 different types of buildings on the PNNL campus: offices, scientific laboratories, and data centers. In each of the three case studies examined the investments made to achieve HPSB status demonstrated a high return on the HPSB investments that have taken place in these varied environments. Simple paybacks for total investments in the three case study buildings ranged from just 2 to 5 years; savings-to-investment ratios all exceeded the desirable threshold of 1; and the net present values associated with these investments were all positive.

Investment strategy for sustainable society by development of regional economies and prevention of industrial pollutions in Japanese manufacturing sectors

International Nuclear Information System (INIS)

Sueyoshi, Toshiyuki; Goto, Mika

2014-01-01

A balance between industrial pollution prevention and economic growth becomes a world-wide issue to develop a sustainable society in many industrial nations. To discuss the issue, this study proposes a new use of DEA environmental assessment to determine how to effectively allocate capital for developing regional industries. The amount of capital is used to invest for technology innovation for both local economic growth and environmental protection. In this study, the proposed approach separates outputs into desirable and undesirable categories. Inputs are also separated into two categories, one of which indicates an amount of investment on capital assets. The other category is used for production activities. The proposed approach unifies them by two disposability concepts. This study has evaluated the performance of manufacturing industries in 47 prefectures (local government units in Japan) by Unified Efficiency under Natural disposability (UEN), Unified Efficiency under Managerial disposability (UEM) and Unified Efficiency under Natural and Managerial disposability (UENM). The UENM is further separated into its two cases: with and without a possible occurrence on desirable congestion, or technology innovation, on undesirable outputs. This study has empirically confirmed that Japanese manufacturing industries need to make their efforts to reduce greenhouse gas emissions and air pollution substances by investing in technology innovation. Furthermore, most of economic activities are currently located at metropolitan regions (e.g., Tokyo) in Japan. To develop a sustainable society, Japan needs to allocate capital into regions with a high level of investment effectiveness by shifting the manufacturing industries from the metropolitan regions to much promising local areas identified in this study. Such a shift, along with technology innovation, makes it possible to reduce air pollutions in the entire Japan by balancing economic growth and pollution prevention. This

A SUSTAINABLE COMPANY AND ITS CONTRIBUTIONS TO SOCIETY: CASE STUDY OF EDP-ENERGIAS DO BRAZIL SA

Directory of Open Access Journals (Sweden)

Leonardo Fabris Lugoboni

2014-06-01

Full Text Available Sustainability is a reality that can be understood as the use of resources to meet the need of the present without compromising the ability of future generations to meet their own needs. This article seeks to highlight the importance of sustainability in the business environment and show how companies are pressured by the market, the society - more aware of its role - and regulators that not only alert and educate, but are also more rigorous in their inspections so that their activities are permeated with social and environmental responsability. It is an exploratory and descriptive study as it addresses generally the importance of sustainability for business by providing benefits related to corporate image, tax incentives and credit facilitation as well as contribution to society through cultural projects and environmental policies.

How can plant genetic engineering contribute to cost-effective fish vaccine development for promoting sustainable aquaculture?

Science.gov (United States)

Clarke, Jihong Liu; Waheed, Mohammad Tahir; Lössl, Andreas G; Martinussen, Inger; Daniell, Henry

2013-09-01

Aquaculture, the fastest growing food-producing sector, now accounts for nearly 50 % of the world's food fish (FAO in The state of world fisheries and aquaculture. FAO, Rome, 2010). The global aquaculture production of food fish reached 62.7 million tonnes in 2011 and is continuously increasing with an estimated production of food fish of 66.5 million tonnes in 2012 (a 9.4 % increase in 1 year, FAO, www.fao.org/fishery/topic/16140 ). Aquaculture is not only important for sustainable protein-based food fish production but also for the aquaculture industry and economy worldwide. Disease prevention is the key issue to maintain a sustainable development of aquaculture. Widespread use of antibiotics in aquaculture has led to the development of antibiotic-resistant bacteria and the accumulation of antibiotics in the environment, resulting in water and soil pollution. Thus, vaccination is the most effective and environmentally-friendly approach to combat diseases in aquaculture to manage fish health. Furthermore, when compared to >760 vaccines against human diseases, there are only about 30 fish vaccines commercially available, suggesting the urgent need for development and cost-effective production of fish vaccines for managing fish health, especially in the fast growing fish farming in Asia where profit is minimal and therefore given high priority. Plant genetic engineering has made significant contributions to production of biotech crops for food, feed, valuable recombinant proteins etc. in the past three decades. The use of plants for vaccine production offers several advantages such as low cost, safety and easy scaling up. To date a large number of plant-derived vaccines, antibodies and therapeutic proteins have been produced for human health, of which a few have been made commercially available. However, the development of animal vaccines in plants, especially fish vaccines by genetic engineering, has not yet been addressed. Therefore, there is a need to exploit

The effect of natural resources on a sustainable development policy: The approach of non-sustainable externalities

International Nuclear Information System (INIS)

Schilling, Markus; Chiang Lichun

2011-01-01

The debate about the importance of non-renewable resources for economic development between optimists and pessimists shows that the extensive depletion of non-renewable resources, particularly oil, along with a higher level of consumption could have a significant impact on the economic development of future generations. Based on this debate, this paper proposes criteria under which the depletion of non-renewable resources would create excess costs for future generations. Therefore, this paper aims to answer the question 'What will be the impact of the depletion of non-renewable resources on sustainable economic development?' Accordingly, a sustainable development policy appears feasible by minimizing non-sustainable externalities which derive from future externalities that weigh the benefits from a previous employment of natural resources. The research based on qualitative analysis clarifies the reasons for and the extents of taking sustainability into account as well as points to difficulties of implementing policies to time the transition towards a sustainable economic development. Finally, the research shows the implications of this approach for environmental degradation, the depletion of non-renewable resources and energy production. - Research Highlights: →Economic development will more or less smoothly switch to the use of renewable substitutes. →The transition towards a sustainable use of resources may inherit costs for future generations. →Non-sustainable externalities show the future costs of excessive resource depletion. →The approach aims to take the long-term global effects of resource substitution into account.

The Impact of Civil Society Organizations on Sustainable ...

African Journals Online (AJOL)

Toshiba

society organizations appear to play important role in social, political and economic ... depend on the effectiveness and efficiency of its civil societies. This ..... media provided a strong leadership and organized protests against unpopular ...

Sustaining the wild equals sustaining the world.

Science.gov (United States)

Nelson, G

1994-01-01

Sustainable development and carrying capacity are concepts that denote meeting society's needs without compromising the survival of future generations. The United States and other industrialized countries are pursuing a self-destructive course when fueling their economies by consuming their capital and degrading and depleting their resource base. Maximum exploitation of all resources has been the guiding ethic without paying respect to the environmental consequences. A sustainable society is still possible if strong political leadership and an ecologically literate society with an environmental ethic evolves. In the 1990s the world's population is calculated to increase to 6.3 billion people, the population of the United States already exceeds its carrying capacity and neither of these population increases are sustainable in the long run. In 1916 the US had 98 million people, and in 1994 it had about 260 million and it is still growing. The consequences are already obvious: the National Park System had just 358,000 visitors in 1916, 33 million in 1950, 172 million in 1970, and over 270 million in 1993. Often economists are an impediment to a sustainable economy because they fail to factor in the accumulated environmental deficit or annual cost of environmental deterioration when measuring annual economic output. Fortunately, in the US a conservation ethic is beginning to develop that will eventually become a strong social, political, and economic force. For instance, Wisconsin has mandated environmental education in every school from kindergarten through 12th grade. Such a program will provide the moral and political support to move the country to a sustainable economy. Even losing nations have recovered from World War II, but there is no recovery from destroyed ecosystems.

The cost of sustaining a patient-centered medical home: experience from 2 states.

Science.gov (United States)

Magill, Michael K; Ehrenberger, David; Scammon, Debra L; Day, Julie; Allen, Tatiana; Reall, Andreu J; Sides, Rhonda W; Kim, Jaewhan

2015-09-01

As medical practices transform to patient-centered medical homes (PCMHs), it is important to identify the ongoing costs of maintaining these "advanced primary care" functions. A key required input is personnel effort. This study's objective was to assess direct personnel costs to practices associated with the staffing necessary to deliver PCMH functions as outlined in the National Committee for Quality Assurance Standards. We developed a PCMH cost dimensions tool to assess costs associated with activities uniquely required to maintain PCMH functions. We interviewed practice managers, nurse supervisors, and medical directors in 20 varied primary care practices in 2 states, guided by the tool. Outcome measures included categories of staff used to perform various PCMH functions, time and personnel costs, and whether practices were delivering PCMH functions. Costs per full-time equivalent primary care clinician associated with PCMH functions varied across practices with an average of $7,691 per month in Utah practices and $9,658 in Colorado practices. PCMH incremental costs per encounter were $32.71 in Utah and $36.68 in Colorado. The average estimated cost per member per month for an assumed panel of 2,000 patients was $3.85 in Utah and $4.83 in Colorado. Identifying costs of maintaining PCMH functions will contribute to effective payment reform and to sustainability of transformation. Maintenance and ongoing support of PCMH functions require additional time and new skills, which may be provided by existing staff, additional staff, or both. Adequate compensation for ongoing and substantial incremental costs is critical for practices to sustain PCMH functions. © 2015 Annals of Family Medicine, Inc.

Financial sustainability in municipal solid waste management--costs and revenues in Bahir Dar, Ethiopia.

Science.gov (United States)

Lohri, Christian Riuji; Camenzind, Ephraim Joseph; Zurbrügg, Christian

2014-02-01

chain by sales of organic waste recycling products; (iii) diversifying revenue streams and financing mechanisms (polluter-pays-, cross-subsidy- and business-principles); and (iv) cost reduction and improved cost-effectiveness. We argue that in a PPP setup such as in Bahir Dar, a strong alliance between the municipality and private enterprise is important so that appropriate solutions for improved financial sustainability of a SWM system can be sought and implemented. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Cost-effectiveness of using small vertebrates as indicators of disturbance.

Science.gov (United States)

Peck, Mika Robert; Maddock, Simon T; Morales, Jorge Noe; Oñate, Hugolino; Mafla-Endara, Paola; Peñafiel, Vanessa Aguirre; Torres-Carvajal, Omar; Pozo-Rivera, Wilmer E; Cueva-Arroyo, Xavier A; Tolhurst, Bryony A

2014-10-01

In species-rich tropical forests, effective biodiversity management demands measures of progress, yet budgetary limitations typically constrain capacity of decision makers to assess response of biological communities to habitat change. One approach is to identify ecological-disturbance indicator species (EDIS) whose monitoring is also monetarily cost-effective. These species can be identified by determining individual species' responses to disturbance across a gradient; however, such responses may be confounded by factors other than disturbance. For example, in mountain environments the effects of anthropogenic habitat alteration are commonly confounded by elevation. EDIS have been identified with the indicator value (IndVal) metric, but there are weaknesses in the application of this approach in complex montane systems. We surveyed birds, small mammals, bats, and leaf-litter lizards in differentially disturbed cloud forest of the Ecuadorian Andes. We then incorporated elevation in generalized linear (mixed) models (GL(M)M) to screen for EDIS in the data set. Finally, we used rarefaction of species accumulation data to compare relative monetary costs of identifying and monitoring EDIS at equal sampling effort, based on species richness. Our GL(M)M generated greater numbers of EDIS but fewer characteristic species relative to IndVal. In absolute terms birds were the most cost-effective of the 4 taxa surveyed. We found one low-cost bird EDIS. In terms of the number of indicators generated as a proportion of species richness, EDIS of small mammals were the most cost-effective. Our approach has the potential to be a useful tool for facilitating more sustainable management of Andean forest systems. © 2014 Society for Conservation Biology.

Sustained employability of workers in a production environment: design of a stepped wedge trial to evaluate effectiveness and cost-benefit of the POSE program

Directory of Open Access Journals (Sweden)

van Holland Berry J

2012-11-01

Full Text Available Abstract Background Sustained employability and health are generating awareness of employers in an aging and more complex work force. To meet these needs, employers may offer their employees health surveillance programs, to increase opportunities to work on health and sustained employability. However, evidence for these health surveillance programs is lacking. The FLESH study (Functional Labour Evaluation for Sustained Health and employment was developed to evaluate a comprehensive workers’ health promotion program on its effectiveness, cost-benefit, and process of the intervention. Methods The study is designed as a cluster randomised stepped wedge trial with randomisation at company plant level and is carried out in a large meat processing company. Every contracted employee is offered the opportunity to participate in the POSE program (Promotion Of Sustained Employability. The main goals of the POSE program are 1 providing employee’s insight into their current employability and health status, 2 offering opportunities to improve employability and decrease health risks and 3 improving employability and health sustainably in order to keep them healthy at work. The program consists of a broad assessment followed by a counselling session and, if needed, a tailored intervention. Measurements will be performed at baseline and will be followed up at 20, 40, 60, 80, 106 and 132 weeks. The primary outcome measures are work ability, productivity and absenteeism. Secondary outcomes include health status, vitality, and psychosocial workload. A cost-benefit study will be conducted from the employers’ perspective. A process evaluation will be conducted and the satisfaction of employer and employees with the program will be assessed. Discussion This study provides information on the effectiveness of the POSE program on sustained employment. When the program proves to be effective, employees benefit by improved work ability, and health. Employers benefit

Approaches for assessing sustainable remediation

DEFF Research Database (Denmark)

Søndergaard, Gitte Lemming; Binning, Philip John; Bjerg, Poul Løgstrup

Sustainable remediation seeks to reduce direct contaminant point source impacts on the environment, while minimizing the indirect cost of remediation to the environment, society and economy. This paper presents an overview of available approaches for assessing the sustainability of alternative...... remediation strategies for a contaminated site. Most approaches use multi-criteria assessment methods (MCA) to structure a decision support process. Different combinations of environmental, social and economic criteria are employed, and are assessed either in qualitative or quantitative forms with various...... tools such as life cycle assessment and cost benefit analysis. Stakeholder involvement, which is a key component of sustainable remediation, is conducted in various ways. Some approaches involve stakeholders directly in the evaluation or weighting of criteria, whereas other approaches only indirectly...

The Impact of Brands on People, Markets and Society : Build Bridge Bond Method for Sustainable Brand Leadership

NARCIS (Netherlands)

Schoppen, Hendrik Sietze

2017-01-01

The Impact of Brands on People, Markets and Society Build Bridge Bond Method for Sustainable Brand Leadership Authorized translation of the chapter ‘Impact of brands on people, markets and society’ (prepublication Build Bridge Bond, method for sustainable leadership and building future-proof trust)

Nanotechnology for sustainable development: retrospective and outlook

Science.gov (United States)

Diallo, Mamadou S.; Fromer, Neil A.; Jhon, Myung S.

2013-11-01

The world is facing great challenges in meeting rising demands for basic commodities (e.g., food, water and energy), finished goods (e.g., cell phones, cars and airplanes) and services (e.g., shelter, healthcare and employment) while reducing and minimizing the impact of human activities on Earth's global environment and climate. Nanotechnology has emerged as a versatile platform that could provide efficient, cost-effective and environmentally acceptable solutions to the global sustainability challenges facing society. This special issue of the Journal of Nanoparticle Research is devoted to the utilization of nanotechnology to improve or achieve sustainable development. We highlight recent advances and discuss opportunities of utilizing nanotechnology to address global challenges in (1) water purification, (2) clean energy technologies, (3) greenhouse gases management, (4) materials supply and utilization, and (5) green manufacturing and chemistry. In addition to the technical challenges listed above, we also discuss societal perspectives and provide an outlook of the role of nanotechnology in the convergence of knowledge, technology and society for achieving sustainable development.

Nanotechnology for sustainable development: retrospective and outlook

International Nuclear Information System (INIS)

Diallo, Mamadou S.; Fromer, Neil A.; Jhon, Myung S.

2013-01-01

The world is facing great challenges in meeting rising demands for basic commodities (e.g., food, water and energy), finished goods (e.g., cell phones, cars and airplanes) and services (e.g., shelter, healthcare and employment) while reducing and minimizing the impact of human activities on Earth’s global environment and climate. Nanotechnology has emerged as a versatile platform that could provide efficient, cost-effective and environmentally acceptable solutions to the global sustainability challenges facing society. This special issue of the Journal of Nanoparticle Research is devoted to the utilization of nanotechnology to improve or achieve sustainable development. We highlight recent advances and discuss opportunities of utilizing nanotechnology to address global challenges in (1) water purification, (2) clean energy technologies, (3) greenhouse gases management, (4) materials supply and utilization, and (5) green manufacturing and chemistry. In addition to the technical challenges listed above, we also discuss societal perspectives and provide an outlook of the role of nanotechnology in the convergence of knowledge, technology and society for achieving sustainable development

Nanotechnology for sustainable development: retrospective and outlook

Energy Technology Data Exchange (ETDEWEB)

Diallo, Mamadou S., E-mail: mdiallo@kaist.ac.kr [Korea Advanced Institute of Science and Technology (KAIST), Graduate School of Energy, Environment, Water and Sustainability (EEWS) (Korea, Republic of); Fromer, Neil A. [California Institute of Technology, Resnick Sustainability Institute (United States); Jhon, Myung S. [Carnegie Mellon University, Department of Chemical Engineering (United States)

2013-11-15

The world is facing great challenges in meeting rising demands for basic commodities (e.g., food, water and energy), finished goods (e.g., cell phones, cars and airplanes) and services (e.g., shelter, healthcare and employment) while reducing and minimizing the impact of human activities on Earth’s global environment and climate. Nanotechnology has emerged as a versatile platform that could provide efficient, cost-effective and environmentally acceptable solutions to the global sustainability challenges facing society. This special issue of the Journal of Nanoparticle Research is devoted to the utilization of nanotechnology to improve or achieve sustainable development. We highlight recent advances and discuss opportunities of utilizing nanotechnology to address global challenges in (1) water purification, (2) clean energy technologies, (3) greenhouse gases management, (4) materials supply and utilization, and (5) green manufacturing and chemistry. In addition to the technical challenges listed above, we also discuss societal perspectives and provide an outlook of the role of nanotechnology in the convergence of knowledge, technology and society for achieving sustainable development.

Sustainability, Transformational Leadership, and Social Entrepreneurship

Directory of Open Access Journals (Sweden)

Etayankara Muralidharan

2018-02-01

Full Text Available This article examines the extent to which culturally endorsed transformational leadership theories (CLTs and the sustainability of society, both considered societal level institutional indicators, impact the emergence of social entrepreneurship. Using 107,738 individual-level responses from 27 countries for the year 2009 obtained from the Global Entrepreneurship Monitor (GEM survey, and supplementing with country-level data obtained from Global Leadership and Organizational Behavior Effectiveness (GLOBE and Sustainability Society Foundation (SSF, our findings from multilevel analysis show that transformational CLTs and sustainability conditions of society positively influence the likelihood of individuals becoming social entrepreneurs. Further, the effectiveness of transformational CLTs matters more for social entrepreneurship when the sustainability of society is low, which suggests the interaction between cultural leadership styles and societal sustainability. This article contributes to comparative entrepreneurship research by introducing strong cultural antecedents of social entrepreneurship in transformational CLTs and societal sustainability. We discuss various implications and limitations of our study, and we suggest directions for future research.

Sustainability Ethics Emergency and Media Responsibility in the Consumption Society

Directory of Open Access Journals (Sweden)

Rogério Bianchi de Araujo

2008-08-01

Full Text Available In this article, it is discussed the sustainable development and the importance of the environmental cause, in order to create models of development that consider the sustainability and environmental preservation for the future generations. The participation of all society is essential in this debate. The establishment of new habits that do not compromise the subsistence and the conscience of the real self-destruction possibility must be studied and analysed; they consist in challenging intentions, which detach the relevance and the moral duty of the media to restore a new ethics and a new way to understand the reality, as well as to divulge the impact of this different perception in the human life. Therefore occurs the requirement of a responsible compromise relating to the development, by way of understanding the biosphere as the social life basis, considering that, in these ecosystems, the human being is only one of the many species that live in an interdependence relationship.

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

Determinants of Sustainability and Organisational Effectiveness in Non-Profit Organisations

Directory of Open Access Journals (Sweden)

Chux Gervase Iwu

2015-07-01

Full Text Available This case study investigates the criteria for organizational effectiveness in non-profit organizations (NPOs with the aim to determine how the elements of sustainability fit within the criteria. To achieve this, the study utilized the research questions: “what criteria do NPOs use to evaluate their effectiveness?” and “how is sustainability embedded in NPO effectiveness?” The research design was interpretivist, adopting focus group interviews to obtain data. Specifically, two focus group interviews were held with the top management of an NPO which revealed that both financial and non-financial criteria were equally essential for NPO effectiveness. This finding is consistent with the literature, although it contradicts the initial assumption of the study that NPO effectiveness was based more on non-financial criteria than financial criteria. The study also found that the effectiveness of an NPO should be viewed in two ways: firstly, “the full achievement of its mandate” and, secondly, “the ability to run business projects to cover cost.” It also emerged that both the ability to cover costs and the achievement of a mandate should be done in a sustainable manner (a sustainable manner is seen as one that is harmonious with the natural and the socio-political environment. The results of this paper present a practical case for the management of NPOs by reiterating that the full achievement of the NPO mandate and the successful running of social projects to generate funds for sustainability are key elements of effectiveness. Given the essential role that NPOs play in developing countries, this study has provided the foundation for more widespread enquiry into the sustainability and effectiveness of NPOs.

Quantifying the external cost of oil consumption within the context of sustainable development

International Nuclear Information System (INIS)

Abdel Sabour, S.A.

2005-01-01

The concept of sustainability implies that the flow of services derived from the use of natural capital must be constant over time and should be obtained at a constant price. For a depletable resource such as oil, the future generations are highly impacted due to the consumption behavior of the current generation. Since the ultimate oil stock within the Earth declines with cumulative consumption, excessive consumption of oil now reduces the availability of oil for future needs. Moreover, since oil reserves are normally extracted in the order of ascending cost and descending quality, excessive consumption of relatively high-quality, cheap oil reserves by the current generation raises the cost at which future generations can meet their needs of oil and hence imposes an external cost on the future generations. This study aims to quantify the external cost of consuming a barrel of oil within the context of sustainable development. An option-pricing model is developed to quantify this external cost assuming that the external cost of consuming a barrel of oil now equals the value of the option to get a barrel of oil in the future at the same current cost. Then, the total cost of consuming a barrel of oil now, that should be used in lifecycle costing to design more sustainable products, is the summation of the oil price and the external cost

Metrics for value creation in a sustainable knowledge society

Energy Technology Data Exchange (ETDEWEB)

Huovila, P., Email: pekka.huovila@vtt.fi

2012-06-15

This paper highlights the need to create potential value metrics for sustainable neighbourhoods, capable of working simultaneously at a variety of spatial scales for different stakeholders (multi-scalar reciprocity), moving from top-down imposed metrics towards bottom-up formulated ones. Metrics for Value Creation should be constituted using different approaches. One dimension is the built environment, where the present rating schemes focus on the environmental impact of the use of buildings, namely energy use. Another dimension is the corporate aspect, where triple bottom line reporting also emphasises environmental and social issues, but the discursive civic square environment risks domination by economic sustainability of the production and growth-oriented business environment. The third dimension is the city itself with its social networks, concerning indicators for employment and crime, for example. The fourth dimension aims to measure the quality of life of individual citizens, which is not easy to define. At present, all four approaches are used separately without interoperability between the systems. Current environmental rating schemes, such as BREEAM, CASBEE, Green Star, HQE, LEED, PromisE, etc. are able to structure the processes of setting objectives, monitoring the process and assessing the state of buildings by some simple indicators. Mostly they focus on resource use and environmental impacts, but also cover some performance parameters, such as indoor environmental quality or aspects of accessibility. However, they are not contributing to the objectives of value creation in a knowledge society. This paper discusses major limitations of current sustainability indicator sets and rating tools. Finally, it describes a new approach to value metrics for sustainable neighbourhoods, using the LivingLab approach. This is a user-centric multidisciplinary research approach and a user community-driven innovation based on real-life experiments. The benefits of

The Cost of Sustaining a Patient-Centered Medical Home: Experience From 2 States

Science.gov (United States)

Magill, Michael K.; Ehrenberger, David; Scammon, Debra L.; Day, Julie; Allen, Tatiana; Reall, Andreu J.; Sides, Rhonda W.; Kim, Jaewhan

2015-01-01

PURPOSE As medical practices transform to patient-centered medical homes (PCMHs), it is important to identify the ongoing costs of maintaining these “advanced primary care” functions. A key required input is personnel effort. This study’s objective was to assess direct personnel costs to practices associated with the staffing necessary to deliver PCMH functions as outlined in the National Committee for Quality Assurance Standards. METHODS We developed a PCMH cost dimensions tool to assess costs associated with activities uniquely required to maintain PCMH functions. We interviewed practice managers, nurse supervisors, and medical directors in 20 varied primary care practices in 2 states, guided by the tool. Outcome measures included categories of staff used to perform various PCMH functions, time and personnel costs, and whether practices were delivering PCMH functions. RESULTS Costs per full-time equivalent primary care clinician associated with PCMH functions varied across practices with an average of $7,691 per month in Utah practices and $9,658 in Colorado practices. PCMH incremental costs per encounter were $32.71 in Utah and $36.68 in Colorado. The average estimated cost per member per month for an assumed panel of 2,000 patients was $3.85 in Utah and $4.83 in Colorado. CONCLUSIONS Identifying costs of maintaining PCMH functions will contribute to effective payment reform and to sustainability of transformation. Maintenance and ongoing support of PCMH functions require additional time and new skills, which may be provided by existing staff, additional staff, or both. Adequate compensation for ongoing and substantial incremental costs is critical for practices to sustain PCMH functions. PMID:26371263

Systems, Society, Sustainability and the Geosciences: A Workshop to Create New Curricular Materials to Integrate Geosciences into the Teaching of Sustainability

Science.gov (United States)

Gosselin, D. C.; Manduca, C. A.; Oches, E. A.; MacGregor, J.; Kirk, K. B.

2012-12-01

Sustainability is emerging as a central theme for teaching about the environment, whether it be from the perspective of science, economics, or society. The Systems, Society, Sustainability and the Geosciences workshop provided 48 undergraduate faculty from 46 institutions a forum to discuss the challenges and possibilities for integrating geoscience concepts with a range of other disciplines to teach about the fundamentals of sustainability. Participants from community college to doctorate-granting universities had expertise that included geosciences, agriculture, biological sciences, business, chemistry, economics, ethnic studies, engineering, environmental studies, environmental education, geography, history, industrial technology, landscape design, philosophy, physics, and political science. The workshop modeled a range of teaching strategies that encouraged participants to network and collaborate, share successful strategies and materials for teaching sustainability, and identify opportunities for the development of new curricular materials that will have a major impact on the integration of geosciences into the teaching of sustainability. The workshop design provided participants an opportunity to reflect upon their teaching, learning, and curriculum. Throughout the workshop, participants recorded their individual and collective ideas in a common online workspace to which all had access. A preliminary synthesis of this information indicates that the concept of sustainability is a strong organizing principle for modern, liberal education requiring systems thinking, synthesis and contributions from all disciplines. Sustainability is inherently interdisciplinary and provides a framework for educational collaboration between and among geoscientists, natural/physical scientists, social scientists, humanists, engineers, etc.. This interdisciplinary framework is intellectually exciting and productive for educating students at all levels of higher education

Cost-effectiveness of sustainable measures for water protection; Kosten-Wirksamkeitsanalyse von nachhaltigen Massnahmen im Gewaesserschutz

Energy Technology Data Exchange (ETDEWEB)

Boehm, E.; Hillenbrand, T.; Liebert, J.; Schleich, J.; Walz, R.

2001-08-01

The study continues the project 'Environmental Action Plan for Sustainable Water Resources Management' (UBA-Texte 25/99). The methodological basis in high-priority fields of water protection is improved and the available knowledge with regard to costs and effectiveness of the measures is evaluated systematically. Especially for the fields urban waste water, agriculture and morphological water structures the cost-effectiveness of different measures could be assessed. The results may be an important item for priority setting among different measures on a national basis. On the other hand these methods and data may be helpful for action plans in river basin management as well. (orig.) [German] Das Vorhaben hatte zum Ziel, anknuepfend an das Projekt 'Massnahmenplan Nachhaltige Wasserwirtschaft' (UBA-Texte 25/99), fuer besonders wichtige Zielbereiche des Gewaesserschutzes die methodische Basis fuer die Abschaetzung kurz- bis mittelfristiger Wirkungen zu verbessern und fuer diese Bereiche die aktuellen Kenntnisse zu den Kosten und Wirkungen systematisch auszuwerten. Insbesondere fuer die Schwerpunkte Siedlungsentwaesserung, Landwirtschaft und Verbesserung der Gewaesserstruktur konnten damit Aussagen zur Kosten-Wirksamkeit unterschiedlicher Massnahmen zum Gewaesserschutz getroffen werden, die ein wesentliches Element der Priorisierung denkbarer Massnahmen sein koennen. Gegenstand der Untersuchung waren Massnahmen auf nationaler Ebene, jedoch koennen die erarbeiteten Methoden und Daten auch als Orientierung fuer das Erstellen von Massnahmenplaenen fuer einzelne Flusseinzugsgebiete dienen. (orig.)

Activity-Based Costing Using Multicriteria Drivers: An Accounting Proposal to Boost Companies Toward Sustainability

Directory of Open Access Journals (Sweden)

Heitor F. Marinho Neto

2018-05-01

Full Text Available Recognizing that natural environment is reaching its maximum limits in providing resources and diluting the waste generated by human production systems, efforts toward more sustainable production systems are mandatory to secure the development of future generations. For this purpose, changing the productivity model adopted by companies that are almost exclusively rooted on circulating money to generate profit, named business as usual, is an important issue. In this sense, an alternative would be establishing the relationship of stocks and flows of energy, material, and information with environmental, economic and social outcomes, thus resulting in new accounting approaches. This work aims to propose an activity-based costing (ABC based on multicriteria drivers including economic, emissions, and emergy (with an “m” values. The proposed ABC costing allocates each one of the multicriteria drivers into a specific part of the sustainability conceptual model, in an attempt to embrace a holistic perspective and allow for a sustainable-based decision, rather than considering purely economic drivers. The goal programming (GP method is considered so as to support a decision based on multicriteria aspects. Results show that the proposed accounting approach known as ABCsustain allows for decisions toward a company's sustainability by acting on both the amount and kind of a company's product that should be managed, as well as on the effective increase of a specific company's activity or process. The proposed ABCsustain could make the insertion of environmental issues into companies strategic planning more effective. It is expected that environmental issues go beyond a simple diagnoses and begin to be considered as action in factum in the companies' decisions toward achieving a more sustainable world system.

Designing Energy Supply Chains with the P-graph Framework under Cost Constraints and Sustainability Considerations

Science.gov (United States)

A computer-aided methodology for designing sustainable supply chains is presented using the P-graph framework to develop supply chain structures which are analyzed using cost, the cost of producing electricity, and two sustainability metrics: ecological footprint and emergy. They...

Cost-effectiveness analysis of computer-based assessment

Directory of Open Access Journals (Sweden)

Pauline Loewenberger

2003-12-01

Full Text Available The need for more cost-effective and pedagogically acceptable combinations of teaching and learning methods to sustain increasing student numbers means that the use of innovative methods, using technology, is accelerating. There is an expectation that economies of scale might provide greater cost-effectiveness whilst also enhancing student learning. The difficulties and complexities of these expectations are considered in this paper, which explores the challenges faced by those wishing to evaluate the costeffectiveness of computer-based assessment (CBA. The paper outlines the outcomes of a survey which attempted to gather information about the costs and benefits of CBA.

Challenges to achievement of metal sustainability in our high-tech society.

Science.gov (United States)

Izatt, Reed M; Izatt, Steven R; Bruening, Ronald L; Izatt, Neil E; Moyer, Bruce A

2014-04-21

Achievement of sustainability in metal life cycles from mining of virgin ore to consumer and industrial devices to end-of-life products requires greatly increased recycling rates and improved processing of metals using conventional and green chemistry technologies. Electronic and other high-tech products containing precious, toxic, and specialty metals usually have short lifetimes and low recycling rates. Products containing these metals generally are incinerated, discarded as waste in landfills, or dismantled in informal recycling using crude and environmentally irresponsible procedures. Low recycling rates of metals coupled with increasing demand for high-tech products containing them necessitate increased mining with attendant environmental, health, energy, water, and carbon-footprint consequences. In this tutorial review, challenges to achieving metal sustainability, including projected use of urban mining, in present high-tech society are presented; health, environmental, and economic incentives for various government, industry, and public stakeholders to improve metal sustainability are discussed; a case for technical improvements, including use of molecular recognition, in selective metal separation technology, especially for metal recovery from dilute feed stocks is given; and global consequences of continuing on the present path are examined.

Construction cost prediction model for conventional and sustainable college buildings in North America

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Othman Subhi Alshamrani

2017-03-01

Full Text Available The literature lacks in initial cost prediction models for college buildings, especially comparing costs of sustainable and conventional buildings. A multi-regression model was developed for conceptual initial cost estimation of conventional and sustainable college buildings in North America. RS Means was used to estimate the national average of construction costs for 2014, which was subsequently utilized to develop the model. The model could predict the initial cost per square feet with two structure types made of steel and concrete. The other predictor variables were building area, number of floors and floor height. The model was developed in three major stages, such as preliminary diagnostics on data quality, model development and validation. The developed model was successfully tested and validated with real-time data.

Use of cost-effective construction technologies in India to mitigate climate change

Energy Technology Data Exchange (ETDEWEB)

Sengupta, N. [Forum of Scientists, Engineers and Technologists, Kolkata (India)

2008-01-10

Concentration of greenhouse gases plays a major role in raising the earth's temperature. Carbon dioxide, produced from burning of fossil fuels, is the principle greenhouse gas and efforts are being made at international level to reduce its emission through adoption of energy-efficient technologies. The UN Conference on Environment and Development, 1992 made a significant development in this field by initiating the discussion on sustainable development under the Agenda 21. Cost-effective construction technologies can bring down the embodied energy level associated with production of building materials by lowering use of energy-consuming materials. This embodied energy is a crucial factor for sustainable construction practices and effective reduction of the same would contribute in mitigating global warming. The cost-effective construction technologies would emerge as the most acceptable case of sustainable technologies in India both in terms of cost and environment.

Impact of automatic calibration techniques on HMD life cycle costs and sustainable performance

Science.gov (United States)

Speck, Richard P.; Herz, Norman E., Jr.

2000-06-01

Automatic test and calibration has become a valuable feature in many consumer products--ranging from antilock braking systems to auto-tune TVs. This paper discusses HMDs (Helmet Mounted Displays) and how similar techniques can reduce life cycle costs and increase sustainable performance if they are integrated into a program early enough. Optical ATE (Automatic Test Equipment) is already zeroing distortion in the HMDs and thereby making binocular displays a practical reality. A suitcase sized, field portable optical ATE unit could re-zero these errors in the Ready Room to cancel the effects of aging, minor damage and component replacement. Planning on this would yield large savings through relaxed component specifications and reduced logistic costs. Yet, the sustained performance would far exceed that attained with fixed calibration strategies. Major tactical benefits can come from reducing display errors, particularly in information fusion modules and virtual `beyond visual range' operations. Some versions of the ATE described are in production and examples of high resolution optical test data will be discussed.

Sustainable cost reduction by lean management in metallurgical processes

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A. V. Todorut

2016-10-01

Full Text Available This paper focuses on the need for sustainable cost reduction in the metallurgical industry by applying Lean Management (LM tools and concepts in metallurgical production processes leading to increased competitiveness of corporations in a global market. The paper highlights that Lean Management is a novel way of thinking, adapting to change, reducing waste and continuous improvement, leading to sustainable development of companies in the metallurgical industry. The authors outline the main Lean Management instruments based on recent scientific research and include a comparative analysis of other tools, such as Sort, Straighten, Shine, Standardize, Sustain (5S, Visual Management (VM, Kaizen, Total Productive Maintenance (TPM, Single-Minute Exchange of Dies (SMED, leading to a critical appraisal of their application in the metallurgical industry.

Design for a sustainable society utilizing information and communication technologies (ICT) - proposal: a new EcoDesign method and its application

Energy Technology Data Exchange (ETDEWEB)

Fujimoto, J. [Research Center for Advanced Science and Technology, the Univ. of Tokyo (Japan); Matsumoto, M. [Fundamental and Environment Labs., NEC Corp. (Japan)

2004-07-01

We discuss a new EcoDesign method, with a goal of improving the economy, and its application to a sustainable networked society. The new EcoDesign method differs from conventional EcoDesign in three respects: it utilizes a top-down approach, project-style research, and fact-finding and benchmarking. We systematize EcoDesign for a networked society from the viewpoint of technology and divide it into four components. Feasibility studies of the individual components reveal that if we promote ICT diffusion with EcoDesign in mind, we can suppress CO2 emissions and move towards a more sustainable society. (orig.)

Transdisciplinary Challenges for Sustainable Management of Mediterranean Landscapes in the Global Information Society

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Zev Naveh

2009-11-01

Full Text Available The present chaotic transformation from the industrial to the global information society is accelerating the ecological, social and economic unsustainability. The rapidly growing unsustainable, fossil energy powered urbanindustrial technosphere and their detrimental impacts on nature and human well-being are threatening the solar energy powered natural and seminatural biosphere landscapes and their vital ecosystem services. A sustainability revolution is therefore urgently needed, requiring a shift from the „fossil age“ to the „solar age“ of a new world economy, coupled with more sustainable lifestyles and consumption patterns. The sustainable future of viable multifunctional biosphere landscapes of the Mediterranean Region and elsewhere and their biological and cultural richness can only be ensured by a post-industrial symbiosis between nature and human society. For this purpose a mindset shift of scientists and professionals from narrow disciplinarity to transdisciplinarity is necessary, dealing with holistic land use planning and management, in close cooperation with land users and stakeholders. To conserve and restore the rapidly vanishing and degrading Mediterranean uplands and highest biological ecological and cultural landscape ecodiversity, their dynamic homeorhetic flow equilibrium, has to be maintained by continuing or simulating all anthropogenic processes of grazing, browsing by wild and domesticated ungulates. Catastrophic wildfires can be prevented only by active fire and fuel management, converting highly inflammable pine forests and dense shrub thickets into floristically enriched, multi- layered open woodlands and recreation forests.

The Carpathians. Integrating nature and society towards sustainability

Energy Technology Data Exchange (ETDEWEB)

Kozak, Jacek; Ostapowicz, Katarzyna [Jagiellonian Univ., Krakow (Poland). Inst. of Geography and Spatial Management; Bytnerowicz, Andrzej [Pacific Southwest Research Station, Riverside, CA (United States). USDA Forest Service; Wyzga, Bartlomiej (eds.) [Polish Academy of Sciences, Krakow (Poland). Inst. of Nature Conservation

2013-06-01

Provides an interdisciplinary approach. Explores ways to generate value for the Carpathian mountain region. Gives a new insight into the Carpathian mountain region. The Carpathians are a distinct mountain chain in the core of Central and Eastern Europe holding valuable biological resources and a rich cultural heritage. The last twenty years have witnessed an increasing awareness of the Carpathians' value for European society and strengthened research cooperation in the region, especially after the enlargement of the European Union in 2004 and 2007. This book presents a wide range of problems related to sustainable development in the Carpathian region that were discussed during the 1{sup st} Forum Carpaticum held in 2010 in Krakow, Poland. The four sections of the book deal with various issues related to the abiotic environment, forests and biodiversity, human activities, and research methods allowing a better understanding of the past, present and future of the Carpathians.

Realism and Impartiality: Making Sustainability Effective in Decision-Making.

Science.gov (United States)

Bastons, Miquel; Armengou, Jaume

2017-08-01

There is both individual and collective widespread concern in society about the impact of human activity and the effects of our decisions on the physical and social environment. This concern is included within the idea of sustainability. The meaning of the concept is still ambiguous and its practical effectiveness disputed. Like many other authors, this article uses as a starting point the definition proposed by the World Commission on Environment and Development (Our common future, Oxford University Press, Oxford, 1987), considering it to be a proposal for changing the assessment of the effects of decisions, from at least two perspectives: (1) what effects we should consider and (2) how we should assess them. Based on this double perspective, sustainability is explored as a method for decision-making which both expands the assessment of the consequences, and also provides an objective criterion for such assessment. It will be argued that the idea of sustainability, seen from this perspective, brings to decision-making two qualities which had been partially lost: realism and impartiality. In turn, the criteria for realism and impartiality in decision-making can be used to identify the limitations of some partial approaches to sustainability, which suffer from insufficient realism (emotional altruism), insufficient impartiality (tactical altruism) or both phenomena at once (egoism). The article concludes by demonstrating how realism and impartiality provide the basis for a new form of sustainable decision-making (ethical sustainability), which is dependent on the development of two moral virtues, prudence and benevolence, and which brings practical effectiveness and ethical sense to the concept of sustainability.

The world at a crossroads: Financial scenarios for sustainability

International Nuclear Information System (INIS)

Carnicer, Jofre; Peñuelas, Josep

2012-01-01

The global financial system is a major component of our global society. The available analyses of sustainability, however, have poorly assessed the role of the financial system in scenarios of future global change. Here we contrast current global flows in the financial system with the future economic costs of a worldwide transition to renewable energies under the baseline and 450 ppm scenarios for emissions of greenhouse gases proposed by the IPCC. We show that annual global financial flows are three orders of magnitude greater than the annual economic costs of policies for global sustainability. A small global tax on financial transactions of 0.05% could thus provide the required funds for the deployment of renewable energies. To assess the roles of the financial sector in future policies for sustainability, we identified 14 key international actors and enumerated 16 key policies for sustainability that should be implemented to achieve effective global ecological and financial sustainability. We conclude that the proposed structural reforms to the financial system are essential steps urgently required for financing a global transition to a sustainable economy. Consequently, we suggest that the international scientific community should urgently pursue an academic consensus on policy recommendations for the financial sector.

A strategic decision-making model considering the social costs of carbon dioxide emissions for sustainable supply chain management.

Science.gov (United States)

Tseng, Shih-Chang; Hung, Shiu-Wan

2014-01-15

Incorporating sustainability into supply chain management has become a critical issue driven by pressures from governments, customers, and various stakeholder groups over the past decade. This study proposes a strategic decision-making model considering both the operational costs and social costs caused by the carbon dioxide emissions from operating such a supply chain network for sustainable supply chain management. This model was used to evaluate carbon dioxide emissions and operational costs under different scenarios in an apparel manufacturing supply chain network. The results showed that the higher the social cost rate of carbon dioxide emissions, the lower the amount of the emission of carbon dioxide. The results also suggested that a legislation that forces the enterprises to bear the social costs of carbon dioxide emissions resulting from their economic activities is an effective approach to reducing carbon dioxide emissions. Copyright © 2013 Elsevier Ltd. All rights reserved.

Sustained health-economic effects after reorganisation of a Swiss hospital emergency centre: a cost comparison study.

Science.gov (United States)

Eichler, Klaus; Hess, Sascha; Chmiel, Corinne; Bögli, Karin; Sidler, Patrick; Senn, Oliver; Rosemann, Thomas; Brügger, Urs

2014-10-01

Emergency departments (EDs) are increasingly overcrowded by walk-in patients. However, little is known about health-economic consequences resulting from long waiting times and inefficient use of specialised resources. We have evaluated a quality improvement project of a Swiss urban hospital: In 2009, a triage system and a hospital-associated primary care unit with General Practitioners (H-GP-unit) were implemented beside the conventional hospital ED. This resulted in improved medical service provision with reduced process times and more efficient diagnostic testing. We now report on health-economic effects. From the hospital perspective, we performed a cost comparison study analysing treatment costs in the old emergency model (ED, only) versus treatment costs in the new emergency model (triage plus ED plus H-GP-unit) from 2007 to 2011. Hospital cost accounting data were applied. All consecutive outpatient emergency contacts were included for 1 month in each follow-up year. The annual number of outpatient emergency contacts increased from n=10 440 (2007; baseline) to n=16 326 (2011; after intervention), reflecting a general trend. In 2007, mean treatment costs per outpatient were €358 (95% CI 342 to 375). Until 2011, costs increased in the ED (€423 (396 to 454)), but considerably decreased in the H-GP-unit (€235 (221 to 250)). Compared with 2007, the annual local budget spent for treatment of 16 326 patients in 2011 showed cost reductions of €417 600 (27 200 to 493 600) after adjustment for increasing patient numbers. From the health-economic point of view, our new service model shows 'dominance' over the old model: While quality of service provision improved (reduced waiting times; more efficient resource use in the H-GP-unit), treatment costs sustainably decreased against the secular trend of increase. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The perspective of sustainability in networked knowledge society: governance, education, ethics

Directory of Open Access Journals (Sweden)

Pilar AZNAR MINGUET

2013-12-01

Full Text Available This article aims to stimulate thinking about entering the perspective of sustainability in new information societies and knowledge supported by ICTs, and characterized by globalization is far from inclusive. It involves the construction of a global system that promotes the pursuit of environmental quality, social justice and an equitable economy and viable long term. UNESCO has identified three basic ways to get it: governance, education and ethics.Governance can promote equitable social connectivity, changes in patterns of production and consumption and application search and real solutions to the socio-environmental. Education can foster continuing education of those critical, responsible and committed attitudes of respect and harmony with the natural and social environment, international organizations like the OECD, UN and governments through the development of their educational systems, have shaped the competency-based training model, including skills for sustainability are key consider. And all from ethical approaches to guide human capacity to think, act and promote the defense of life on our planet.

Sustainable development tables for science teachers training within the information society

Energy Technology Data Exchange (ETDEWEB)

Horta, L.M.P. [Portuguese Ministry of Education' s Secondary School at Sabugal, Sabugal (Portugal)

2006-07-01

Certain essential criteria are needed to achieve sustainable development. These include information about the benefits of investment and public awareness about environmental education, training, appropriate energy technologies, energy storage strategies, the availability of renewable energy sources and cleaner technologies. This paper reported on the value of the Internet in providing new opportunities to both students and teachers to improve their knowledge in renewable energy technologies and environment awareness. The Internet provides a starting point for pedagogical projects. The Internet's capability of providing ideas for secondary and post secondary teachers in chemistry, physics, biology, and engineering was discussed with reference to the Science Technology and Society (Environmental) approach in the Portuguese National Education Curriculum. The approach provides opportunities for improving the image of science to students and offers the use of laboratory experiments to motivate students. It was concluded that public awareness and education on issues concerning sustainable development, such as renewable energies, energy efficiency, can be promoted by the Internet. 106 refs., 2 tabs.

Energy and sustainable development in Finland

International Nuclear Information System (INIS)

2003-01-01

The U.N. World Summit on Environment and Development in Rio de Janeiro in June 1992 was the origin of the international framework for sustainable development. As a basis for joint, sustainable action by governments, organizations, industries, and the public, the participating countries signed the Rio Declaration on Environment and Development, and drafted the associated action program, Agenda 21. Sustainable development comprises these three determinant factors: - Economy. - Ecology. - Social aspects. This is where entrepreneurial responsibility for society comes in. If industries want to generate overall positive effects, they must be efficient, competitive, and profitable on a long-term basis. Power supply systems meeting the criteria of sustainable development must be reliable, economically viable, socially acceptable, and environmentally compatible. The power supply in Finland is meeting these sustainability requirements in many ways. Finland's electricity supply is decentralized, using a variety of energy sources. Electricity can be generated and made available at low cost. The Finnish power industry is an important employer and a major factor in the economy. Moreover, electricity is generated in advanced types of power plants. In this way, the structure of the Finnish power supply system incorporates important factors of sustainable development. (orig.)

Sustainable Civil-Society Engagement: Potentials of a Transnational Civil Society in French-German, Polish-German, and Czech-German Border Regions

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Klaus Boehnke

2015-04-01

Full Text Available Based on representative survey data, the present study examines potentials for the sustainable development of a transnational civil society in French-German, Polish-German, and Czech-German border regions. The theoretical framework is a social capital approach in the tradition of Putnam. Transnational engagement is seen as a key element for the development of a border-crossing civil society. For the analysis, existing forms of social capital were classified according to their bridging and bonding functions and the potentials of local and transnational activities are described. Furthermore, using multilevel analysis, the predictive power of different variables like individual dispositions and specific contexts of the regions on cross-border activities are examined. Descriptively, the expected lower level of local civil-society engagement, in general, and also with regard to the transnational activities was found for post-socialist border regions. It is shown that, first and foremost, existing experience in civil-society engagement in the local context is a high-impact predictor for both transnational activities and an interest in such activities. Other variables like feelings of a historical burden or the economic situation of the region are less important.

Increasing the Sustainability of Museums through International Strategy

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Izabela Luiza POP

2014-12-01

Full Text Available Museums use resources in order to provide public goods and services. The most important sources of income for many museums are budgetary subsidies. Unfortunately, these grants are limited and shrinking. In this context, during the last years the need for sustainable development of museums was stressed. In order to continue to operate, museums were forced to find ways of increasing their own income and keeping their costs under control. Thus museums have begun to use management and marketing strategies similar to those used by private companies. This paper examines the positive effects of international strategy implementation on museums’ sustainability. The first part of the paper explains why it is necessary to reform the traditional management of museums, which its main development directions are, what the sustainable development of museums is and why they should become sustainable. In the second part our research conducted on three museums (Guggenheim, Louvre, Hermitage shows that international expansion helps museums to increase their sustainability. The international strategy enables museums to increase their revenue, through licensing agreements, reduce their storage costs, highlight their heritage, improve their market image and be closer to consumers. Thus, through a strategy applied until recently only in the private sector, museums can improve their sustainability, but also better fulfill their purpose of serving the society.

Financial sustainability in municipal solid waste management – Costs and revenues in Bahir Dar, Ethiopia

Energy Technology Data Exchange (ETDEWEB)

Lohri, Christian Riuji, E-mail: christian.lohri@eawag.ch; Camenzind, Ephraim Joseph, E-mail: ephraimcamenzind@hotmail.com; Zurbrügg, Christian, E-mail: christian.zurbruegg@eawag.ch

2014-02-15

financial deficit could else endanger the public-private partnership (PPP) and lead to failure of this setup in the medium to long term, thus also endangering the now existing improved and currently reliable service. We present four options on how financial sustainability of the SWM system in Bahir Dar might be enhanced: (i) improved fee collection efficiency by linking the fees of solid waste collection to water supply; (ii) increasing the value chain by sales of organic waste recycling products; (iii) diversifying revenue streams and financing mechanisms (polluter-pays-, cross-subsidy- and business-principles); and (iv) cost reduction and improved cost-effectiveness. We argue that in a PPP setup such as in Bahir Dar, a strong alliance between the municipality and private enterprise is important so that appropriate solutions for improved financial sustainability of a SWM system can be sought and implemented.

Financial sustainability in municipal solid waste management – Costs and revenues in Bahir Dar, Ethiopia

International Nuclear Information System (INIS)

Lohri, Christian Riuji; Camenzind, Ephraim Joseph; Zurbrügg, Christian

2014-01-01

financial deficit could else endanger the public-private partnership (PPP) and lead to failure of this setup in the medium to long term, thus also endangering the now existing improved and currently reliable service. We present four options on how financial sustainability of the SWM system in Bahir Dar might be enhanced: (i) improved fee collection efficiency by linking the fees of solid waste collection to water supply; (ii) increasing the value chain by sales of organic waste recycling products; (iii) diversifying revenue streams and financing mechanisms (polluter-pays-, cross-subsidy- and business-principles); and (iv) cost reduction and improved cost-effectiveness. We argue that in a PPP setup such as in Bahir Dar, a strong alliance between the municipality and private enterprise is important so that appropriate solutions for improved financial sustainability of a SWM system can be sought and implemented

Sustained volunteerism: justification, motivation and management

NARCIS (Netherlands)

Renes, R.J.

2005-01-01

In a society such as ours, where the tendency exists to always weigh costs against benefits (“what’s in it for me?”), unselfish volunteerism seems difficult to understand. An unselfish act such as sustained volunteerism lacks clear-cut, visible extrinsic rewards or benefits. The present thesis tries

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.

Globalization of the economy and women's work in a sustainable society.

Science.gov (United States)

Mies, M

1998-01-01

This article critiques theories of development and growth models, which are not compatible with conservation of resources, women's empowerment, and a sustainable society. Affluent societies are using up most of the world's resources in unsustainable ways. Industrial giants have co-opted the term "sustainability." This gender discussion addresses the issue of patriarchal and capitalist systems and presents a new theoretical framework. The author disagrees with the global division of labor, where women are manipulated as producer-housewives and consumer-housewives, and with the global level of violence against women, in general. Gender equality is not viable in the present patriarchal order. In all economic theories, women's work is a free resource and invisible as unpaid housework and nurturing work. The globalization of the economy leads to greater capital and power concentration in the hands of a few. Women are ill served by structural adjustment policies. New global restructuring has improved the welfare of Third World elites. Globalization of capital and new technology makes ethics obsolete. A new economic model must be based on the preservation of life at the center, with livelihood based on wage labor and unpaid work, control of communal assets, and solidarity of communities. Unpaid necessary social labor must be shared by men and women equally. The checklist for change includes, for example, that money would be a means of circulation, not of accumulation. Nature would be reintegrated into economics. There must be new meanings for work, productive labor, economics, the good life, satisfaction of needs, and political structures.

Assessing District-Heating Sustainability. Case Studies of CO{sub 2} Mitigation Strategies and Environmental Cost Accounting

Energy Technology Data Exchange (ETDEWEB)

Fahlen, Elsa

2012-11-01

District heating (DH) may play an important role in achieving the EU goal of a secure, competitive and sustainable energy supply. Integrated energy solutions based on technologies, such as biomass gasification for transport fuel, electricity and heat production and heat-driven absorption cooling, create new optimisation possibilities through the linkage between heat, power, cooling and transport fuel markets which may reduce the global warming contribution of the energy sector. With increasing focus on climate change impacts of greenhouse gas emissions, the environmental effects of other air pollutants should not be neglected. To achieve both a competitive and a sustainable energy supply, it is necessary to integrate environmental considerations into economic policies. Through accounting for external costs of air pollution in energy system modelling and analysis, sustainability aspects may be integrated into DH assessments. The aim of this thesis is to develop, apply and evaluate methodologies for assessing conventional and new technology solutions in a DH system; the assessments are made from a DH perspective with respect to two factors - cost-effectiveness and environmental impacts - which are either assessed separately or integrated through external cost accounting. Various CO{sub 2} mitigation strategies are evaluated with regard to the robustness of the DH system in meeting future developments of energy market prices and policies. The studies are performed using a systems approach by using the simulating DH supply model MARTES as applied to the DH system Sweden. This thesis concludes that the integration of biomass gasification technology and absorption cooling technology in DH systems has the potential for cost-effective CO{sub 2} emission reduction, in line with other EU goals to increase the share of renewable sources in energy use and to increase energy efficiency. Accounting for external costs of not only climate change but also other environmental

Sustainable and participatory society for the realization of urban settlement (Case study: Green kampong, Malang City)

Science.gov (United States)

Purnamasari, W. D.; Kirana, V.; Wardhani, D. K.

2017-06-01

Green Kampong is one of the participatory development to conserve our environment. RW 03 Sukun, Malang City has chosen by researcher become case study because it has be successful to obtain a predicate as “Green Kampong” by following environmental management contests through the participatory society. There was some purpose of this study. The first aim was to find out the level of participation at every kind of the social activities such as waste separation for households, bio-pores project, stone massage therapy on the road, and other greening acts. The second aim was to evaluate the level for sustainable society which consists of: the leadership, the social capital, the internal controls activity, the use of technology, and also the finance of physical development in green kampong. The researcher has used the scoring and schema methods in this study. The result showed that the activity that has reached the maintenance phase are sorting waste and greening, whilst the activity that only reached the stage of control are bio-pores development and stone therapy. The social activities with highest participation was taken by greening act and the lowest was taken by bio-pores project. The sustainability of the community rw 03 Sukun known that of the five components aspects the sustainability of, three of whom were have achieved good progress toward the sustainability of the aspects leadership, social capital, and technology facilities and infrastructure while two aspects of whom were still achieved a good start toward sustainability of the aspects monitoring and evaluation and financing.

Building a Sustainable Society: The Necessity to Change the Term 'Consumer'

Directory of Open Access Journals (Sweden)

Sabrina Chakori

2017-10-01

Full Text Available The profit-seeking system leads to many negative environmental impacts. Within this economic system, consumption reflects an important relationship between humans and nature. However, despite the growing international attention to environmental sustainability, our society does not necessarily acknowledge consumerism as the cause of global environmental degradation. Deconstructing the consumption culture and redefining what determines well-being, this paper will attempt to provide a comprehensive overview of the existing definition of people in the economic system. Many authors have defined our role in the economy; however, in terms of customer, citizen-consumer, and socially conscious consumer, most of the literature in this domain remains rooted in consumerism. Consumerism cannot be fixed with further consumerism; therefore this paper discusses the importance of reclaiming our identity and the need to define new terms for people in a new economic system. Any new terms should integrate interests and responsibilities that go beyond simple utility maximization. Moving beyond the term “consumer” will change our worldview. This cultural transformation may help facilitate long-term environmental sustainability.

Cost-effectiveness of external cephalic version for term breech presentation.

Science.gov (United States)

Tan, Jonathan M; Macario, Alex; Carvalho, Brendan; Druzin, Maurice L; El-Sayed, Yasser Y

2010-01-21

External cephalic version (ECV) is recommended by the American College of Obstetricians and Gynecologists to convert a breech fetus to vertex position and reduce the need for cesarean delivery. The goal of this study was to determine the incremental cost-effectiveness ratio, from society's perspective, of ECV compared to scheduled cesarean for term breech presentation. A computer-based decision model (TreeAge Pro 2008, Tree Age Software, Inc.) was developed for a hypothetical base case parturient presenting with a term singleton breech fetus with no contraindications for vaginal delivery. The model incorporated actual hospital costs (e.g., $8,023 for cesarean and $5,581 for vaginal delivery), utilities to quantify health-related quality of life, and probabilities based on analysis of published literature of successful ECV trial, spontaneous reversion, mode of delivery, and need for unanticipated emergency cesarean delivery. The primary endpoint was the incremental cost-effectiveness ratio in dollars per quality-adjusted year of life gained. A threshold of $50,000 per quality-adjusted life-years (QALY) was used to determine cost-effectiveness. The incremental cost-effectiveness of ECV, assuming a baseline 58% success rate, equaled $7,900/QALY. If the estimated probability of successful ECV is less than 32%, then ECV costs more to society and has poorer QALYs for the patient. However, as the probability of successful ECV was between 32% and 63%, ECV cost more than cesarean delivery but with greater associated QALY such that the cost-effectiveness ratio was less than $50,000/QALY. If the probability of successful ECV was greater than 63%, the computer modeling indicated that a trial of ECV is less costly and with better QALYs than a scheduled cesarean. The cost-effectiveness of a trial of ECV is most sensitive to its probability of success, and not to the probabilities of a cesarean after ECV, spontaneous reversion to breech, successful second ECV trial, or adverse

Cost-effectiveness of external cephalic version for term breech presentation

Directory of Open Access Journals (Sweden)

Carvalho Brendan

2010-01-01

Full Text Available Abstract Background External cephalic version (ECV is recommended by the American College of Obstetricians and Gynecologists to convert a breech fetus to vertex position and reduce the need for cesarean delivery. The goal of this study was to determine the incremental cost-effectiveness ratio, from society's perspective, of ECV compared to scheduled cesarean for term breech presentation. Methods A computer-based decision model (TreeAge Pro 2008, Tree Age Software, Inc. was developed for a hypothetical base case parturient presenting with a term singleton breech fetus with no contraindications for vaginal delivery. The model incorporated actual hospital costs (e.g., $8,023 for cesarean and $5,581 for vaginal delivery, utilities to quantify health-related quality of life, and probabilities based on analysis of published literature of successful ECV trial, spontaneous reversion, mode of delivery, and need for unanticipated emergency cesarean delivery. The primary endpoint was the incremental cost-effectiveness ratio in dollars per quality-adjusted year of life gained. A threshold of $50,000 per quality-adjusted life-years (QALY was used to determine cost-effectiveness. Results The incremental cost-effectiveness of ECV, assuming a baseline 58% success rate, equaled $7,900/QALY. If the estimated probability of successful ECV is less than 32%, then ECV costs more to society and has poorer QALYs for the patient. However, as the probability of successful ECV was between 32% and 63%, ECV cost more than cesarean delivery but with greater associated QALY such that the cost-effectiveness ratio was less than $50,000/QALY. If the probability of successful ECV was greater than 63%, the computer modeling indicated that a trial of ECV is less costly and with better QALYs than a scheduled cesarean. The cost-effectiveness of a trial of ECV is most sensitive to its probability of success, and not to the probabilities of a cesarean after ECV, spontaneous reversion

Can Precision Agriculture Increase the Profitability and Sustainability of the Production of Potatoes and Olives?

Directory of Open Access Journals (Sweden)

Frits K. van Evert

2017-10-01

Full Text Available For farmers, the application of Precision Agriculture (PA technology is expected to lead to an increase in profitability. For society, PA is expected to lead to increased sustainability. The objective of this paper is to determine for a number of common PA practices how much they increase profitability and sustainability. For potato production in The Netherlands, we considered variable rate application (VRA of soil herbicide, fungicide for late blight control, sidedress N, and haulm killing herbicide. For olive production in Greece, we considered spatially variable application of P and K fertilizer and lime. For each of the above scenarios, we quantified the value of outputs, the cost of inputs, and the environmental costs. This allowed us to calculate profit as well as social profit, where the latter is defined as revenues minus conventional costs minus the external costs of production. Social profit can be considered an overall measure of sustainability. Our calculations show that PA in potatoes increases profit by 21% (420 € ha−1 and social profit by 26%. In olives, VRA application of P, K, and lime leads to a strong reduction in nutrient use and although this leads to an increase in sustainability, it has only a small effect on profit and on social profit. In conclusion, PA increases sustainability in olives and both profitability and sustainability in potatoes.

American Society of Clinical Oncology guidance statement: the cost of cancer care.

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Meropol, Neal J; Schrag, Deborah; Smith, Thomas J; Mulvey, Therese M; Langdon, Robert M; Blum, Diane; Ubel, Peter A; Schnipper, Lowell E

2009-08-10

Advances in early detection, prevention, and treatment have resulted in consistently falling cancer death rates in the United States. In parallel with these advances have come significant increases in the cost of cancer care. It is well established that the cost of health care (including cancer care) in the United States is growing more rapidly than the overall economy. In part, this is a result of the prices and rapid uptake of new agents and other technologies, including advances in imaging and therapeutic radiology. Conventional understanding suggests that high prices may reflect the costs and risks associated with the development, production, and marketing of new drugs and technologies, many of which are valued highly by physicians, patients, and payers. The increasing cost of cancer care impacts many stakeholders who play a role in a complex health care system. Our patients are the most vulnerable because they often experience uneven insurance coverage, leading to financial strain or even ruin. Other key groups include pharmaceutical manufacturers that pass along research, development, and marketing costs to the consumer; providers of cancer care who dispense increasingly expensive drugs and technologies; and the insurance industry, which ultimately passes costs to consumers. Increasingly, the economic burden of health care in general, and high-quality cancer care in particular, will be less and less affordable for an increasing number of Americans unless steps are taken to curb current trends. The American Society of Clinical Oncology (ASCO) is committed to improving cancer prevention, diagnosis, and treatment and eliminating disparities in cancer care through support of evidence-based and cost-effective practices. To address this goal, ASCO established a Cost of Care Task Force, which has developed this Guidance Statement on the Cost of Cancer Care. This Guidance Statement provides a concise overview of the economic issues facing stakeholders in the cancer

Scalable, sustainable cost-effective surgical care: a model for safety and quality in the developing world, part III: impact and sustainability.

Science.gov (United States)

Campbell, Alex; Restrepo, Carolina; Mackay, Don; Sherman, Randy; Varma, Ajit; Ayala, Ruben; Sarma, Hiteswar; Deshpande, Gaurav; Magee, William

2014-09-01

The Guwahati Comprehensive Cleft Care Center (GCCCC) utilizes a high-volume, subspecialized institution to provide safe, quality, and comprehensive and cost-effective surgical care to a highly vulnerable patient population. The GCCCC utilized a diagonal model of surgical care delivery, with vertical inputs of mission-based care transitioning to investments in infrastructure and human capital to create a sustainable, local care delivery system. Over the first 2.5 years of service (May 2011-November 2013), the GCCCC made significant advances in numerous areas. Progress was meticulously documented to evaluate performance and provide transparency to stakeholders including donors, government officials, medical oversight bodies, employees, and patients. During this time period, the GCCCC provided free operations to 7,034 patients, with improved safety, outcomes, and multidisciplinary services while dramatically decreasing costs and increasing investments in the local community. The center has become a regional referral cleft center, and governments of surrounding states have contracted the GCCCC to provide care for their citizens with cleft lip and cleft palate. Additional regional and global impact is anticipated through continued investments into education and training, comprehensive services, and research and outcomes. The success of this public private partnership demonstrates the value of this model of surgical care in the developing world, and offers a blueprint for reproduction. The GCCCC experience has been consistent with previous studies demonstrating a positive volume-outcomes relationship, and provides evidence for the value of the specialty hospital model for surgical delivery in the developing world.

Central venous catheter infections in home parenteral nutrition patients: Outcomes from Sustain: American Society for Parenteral and Enteral Nutrition's National Patient Registry for Nutrition Care.

Science.gov (United States)

Ross, Vicki M; Guenter, Peggi; Corrigan, Mandy L; Kovacevich, Debra; Winkler, Marion F; Resnick, Helaine E; Norris, Tina L; Robinson, Lawrence; Steiger, Ezra

2016-12-01

Home parenteral nutrition (HPN) is a high-cost, complex nutrition support therapy that requires the use of central venous catheters. Central line-associated bloodstream infections (CLABSIs) are among the most serious risks of this therapy. Sustain: American Society for Parenteral and Enteral Nutrition's National Patient Registry for Nutrition Care (Sustain registry) provides the most current and comprehensive data for studying CLABSI among a national cohort of HPN patients in the United States. This is the first Sustain registry report detailing longitudinal data on CLABSI among HPN patients. To describe CLABSI rates for HPN patients followed in the Sustain registry from 2011-2014. Descriptive, χ 2 , and t tests were used to analyze data from the Sustain registry. Of the 1,046 HPN patients from 29 sites across the United States, 112 (10.7%) experienced 194 CLABSI events during 223,493 days of HPN exposure, for an overall CLABSI rate of 0.87 episodes/1,000 parenteral nutrition-days. Although the majority of patients were female (59%), adult (87%), white (75%), and with private insurance or Medicare (69%), CLABSI episodes per 1,000 parenteral nutrition-days were higher for men (0.69 vs 0.38), children (1.17 vs 0.35), blacks (0.91 vs 0.41), and Medicaid recipients (1.0 vs 0.38 or 0.39). Patients with implanted ports or double-lumen catheters also had more CLABSIs than those with peripherally inserted or central catheters or single-lumen catheters. Staphylococci were the most commonly reported pathogens. These data support findings of smaller studies about CLABSI risk for children and by catheter type and identify new potential risk factors, including gender, race, and insurance type. Additional studies are needed to determine effective interventions that will reduce HPN-associated CLABSI. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

The cost of crime to society: new crime-specific estimates for policy and program evaluation.

Science.gov (United States)

McCollister, Kathryn E; French, Michael T; Fang, Hai

2010-04-01

Estimating the cost to society of individual crimes is essential to the economic evaluation of many social programs, such as substance abuse treatment and community policing. A review of the crime-costing literature reveals multiple sources, including published articles and government reports, which collectively represent the alternative approaches for estimating the economic losses associated with criminal activity. Many of these sources are based upon data that are more than 10 years old, indicating a need for updated figures. This study presents a comprehensive methodology for calculating the cost to society of various criminal acts. Tangible and intangible losses are estimated using the most current data available. The selected approach, which incorporates both the cost-of-illness and the jury compensation methods, yields cost estimates for more than a dozen major crime categories, including several categories not found in previous studies. Updated crime cost estimates can help government agencies and other organizations execute more prudent policy evaluations, particularly benefit-cost analyses of substance abuse treatment or other interventions that reduce crime. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

The effectiveness and cost-effectiveness of community-based support for adolescents receiving antiretroviral treatment: an operational research study in South Africa.

Science.gov (United States)

Fatti, Geoffrey; Jackson, Debra; Goga, Ameena E; Shaikh, Najma; Eley, Brian; Nachega, Jean B; Grimwood, Ashraf

2018-02-01

Adolescents and youth receiving antiretroviral treatment (ART) in sub-Saharan Africa have high attrition and inadequate ART outcomes, and evaluations of interventions improving ART outcomes amongst adolescents are very limited. Sustainable Development Goal (SDG) target 3c is to substantially increase the health workforce in developing countries. We measured the effectiveness and cost-effectiveness of community-based support (CBS) provided by lay health workers for adolescents and youth receiving ART in South Africa. A retrospective cohort study including adolescents and youth who initiated ART at 47 facilities. Previously unemployed CBS-workers provided home-based ART-related education, psychosocial support, symptom screening for opportunistic infections and support to access government grants. Outcomes were compared between participants who received CBS plus standard clinic-based care versus participants who received standard care only. Cumulative incidences of all-cause mortality and loss to follow-up (LTFU), adherence measured using medication possession ratios (MPRs), CD4 count slope, and virological suppression were analysed using multivariable Cox, competing-risks regression, generalized estimating equations and mixed-effects models over five years of ART. An expenditure approach was used to determine the incremental cost of CBS to usual care from a provider perspective. Incremental cost-effectiveness ratios were calculated as annual cost per patient-loss (through death or LTFU) averted. Amongst 6706 participants included, 2100 (31.3%) received CBS. Participants who received CBS had reduced mortality, adjusted hazard ratio (aHR) = 0.52 (95% CI: 0.37 to 0.73; p effectiveness of CBS in reducing attrition ranged from 42.2% after one year to 35.9% after five years. Virological suppression was similar after three years, but after five years 18.8% CBS participants versus 37.2% non-CBS participants failed to achieve viral suppression, adjusted odds ratio = 0

Effectiveness and Cost-benefit Evaluation of a Comprehensive Workers' Health Surveillance Program for Sustainable Employability of Meat Processing Workers.

Science.gov (United States)

van Holland, Berry J; Reneman, Michiel F; Soer, Remko; Brouwer, Sandra; de Boer, Michiel R

2018-03-01

Objective To evaluate the effectiveness of a comprehensive workers' health surveillance (WHS) program on aspects of sustainable employability and cost-benefit. Methods A cluster randomized stepped wedge trial was performed in a Dutch meat processing company from february 2012 until march 2015. In total 305 workers participated in the trial. Outcomes were retrieved during a WHS program, by multiple questionnaires, and from company registries. Primary outcomes were sickness absence, work ability, and productivity. Secondary outcomes were health, vitality, and psychosocial workload. Data were analyzed with linear and logistic multilevel models. Cost-benefit analyses from the employer's perspective were performed as well. Results Primary outcomes sickness absence (OR = 1.40), work ability (B = -0.63) and productivity (OR = 0.71) were better in the control condition. Secondary outcomes did not or minimally differ between conditions. Of the 12 secondary outcomes, the only outcome that scored better in the experimental condition was meaning of work (B = 0.18). Controlling for confounders did not or minimally change the results. However, our stepped wedge design did not enable adjustment for confounding in the last two periods of the trial. The WHS program resulted in higher costs for the employer on the short and middle term. Conclusions Primary outcomes did not improve after program implementation and secondary outcomes remained equal after implementation. The program was not cost-beneficial after 1-3 year follow-up. Main limitation that may have contributed to absence of positive effects may be program failure, because interventions were not deployed as intended.

Methodology for Evaluating Cost-effectiveness of Commercial Energy Code Changes

Energy Technology Data Exchange (ETDEWEB)

Hart, Philip R. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Liu, Bing [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

2015-01-31

This document lays out the U.S. Department of Energy’s (DOE’s) method for evaluating the cost-effectiveness of energy code proposals and editions. The evaluation is applied to provisions or editions of the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) Standard 90.1 and the International Energy Conservation Code (IECC). The method follows standard life-cycle cost (LCC) economic analysis procedures. Cost-effectiveness evaluation requires three steps: 1) evaluating the energy and energy cost savings of code changes, 2) evaluating the incremental and replacement costs related to the changes, and 3) determining the cost-effectiveness of energy code changes based on those costs and savings over time.

A new energy paradigm for Turkey: A political risk-inclusive cost analysis for sustainable energy

International Nuclear Information System (INIS)

Oksay, Serhan; Iseri, Emre

2011-01-01

Implementing sustainable development policies in order to achieve economic and social development while maintaining adequate environmental protection to minimize the damage inflicted by the constantly increasing world population must be a major priority in the 21st century. While the emerging global debate on potential cost-effective responses has produced potential solutions such as cap and trade systems and/or carbon taxes as part of evolving sustainable energy/environmental policies, this kind of intellectual inquiry does not seem to be an issue among Turkish policy-making elites. This is mainly due to their miscalculation that pursuing sustainable energy policies is much more expensive in comparison to the utilization of fossil fuels such as natural gas. Nevertheless, the pegged prices of an energy sector dominated by natural gas are illusive, as both the political risks and environmental damage have not been incorporated into the current cost calculations. This paper evaluates energy policies through a lens of risk management and takes an alternative approach to calculating energy costs by factoring in political risks. This formulation reveals that the cost of traditional fossil-based energy is in fact more expensive than renewable energy. In addition to being environmentally friendly, the paradigm shift towards renewable energy policies would provide Turkey with a significant opportunity to stimulate its economy by being one of the first countries to develop green technologies and as a result this burgeoning sector would prompt job creation as well; mainly due to the externalities. - Research highlights: → This paper evaluates Turkish energy policies through risk management scope and takes an alternative approach on calculating electricity costs by factoring in political risks. → The cost of traditional fossil-based energy turns out to be more expensive than renewable energy. → The paradigm shift towards renewable energy policies could provide Turkey

A new energy paradigm for Turkey: A political risk-inclusive cost analysis for sustainable energy

Energy Technology Data Exchange (ETDEWEB)

Oksay, Serhan, E-mail: serhano@khas.edu.t [Kadir Has University, Department of Business Administration (Turkey); Iseri, Emre, E-mail: eiseri@khas.edu.t [Kadir Has University, Department of International Relations, Cibali Campus, Kadir Has Caddesi 34083, Istanbul (Turkey)

2011-05-15

Implementing sustainable development policies in order to achieve economic and social development while maintaining adequate environmental protection to minimize the damage inflicted by the constantly increasing world population must be a major priority in the 21st century. While the emerging global debate on potential cost-effective responses has produced potential solutions such as cap and trade systems and/or carbon taxes as part of evolving sustainable energy/environmental policies, this kind of intellectual inquiry does not seem to be an issue among Turkish policy-making elites. This is mainly due to their miscalculation that pursuing sustainable energy policies is much more expensive in comparison to the utilization of fossil fuels such as natural gas. Nevertheless, the pegged prices of an energy sector dominated by natural gas are illusive, as both the political risks and environmental damage have not been incorporated into the current cost calculations. This paper evaluates energy policies through a lens of risk management and takes an alternative approach to calculating energy costs by factoring in political risks. This formulation reveals that the cost of traditional fossil-based energy is in fact more expensive than renewable energy. In addition to being environmentally friendly, the paradigm shift towards renewable energy policies would provide Turkey with a significant opportunity to stimulate its economy by being one of the first countries to develop green technologies and as a result this burgeoning sector would prompt job creation as well; mainly due to the externalities. - Research highlights: {yields} This paper evaluates Turkish energy policies through risk management scope and takes an alternative approach on calculating electricity costs by factoring in political risks. {yields} The cost of traditional fossil-based energy turns out to be more expensive than renewable energy. {yields} The paradigm shift towards renewable energy policies could

IMPROVING BIOMASS LOGISTICS COST WITHIN AGRONOMIC SUSTAINABILITY CONSTRAINTS AND BIOMASS QUALITY TARGETS

Energy Technology Data Exchange (ETDEWEB)

J. Richard Hess; Kevin L. Kenney; Christopher T. Wright; David J. Muth; William Smith

2012-10-01

Equipment manufacturers have made rapid improvements in biomass harvesting and handling equipment. These improvements have increased transportation and handling efficiencies due to higher biomass densities and reduced losses. Improvements in grinder efficiencies and capacity have reduced biomass grinding costs. Biomass collection efficiencies (the ratio of biomass collected to the amount available in the field) as high as 75% for crop residues and greater than 90% for perennial energy crops have also been demonstrated. However, as collection rates increase, the fraction of entrained soil in the biomass increases, and high biomass residue removal rates can violate agronomic sustainability limits. Advancements in quantifying multi-factor sustainability limits to increase removal rate as guided by sustainable residue removal plans, and mitigating soil contamination through targeted removal rates based on soil type and residue type/fraction is allowing the use of new high efficiency harvesting equipment and methods. As another consideration, single pass harvesting and other technologies that improve harvesting costs cause biomass storage moisture management challenges, which challenges are further perturbed by annual variability in biomass moisture content. Monitoring, sampling, simulation, and analysis provide basis for moisture, time, and quality relationships in storage, which has allowed the development of moisture tolerant storage systems and best management processes that combine moisture content and time to accommodate baled storage of wet material based upon “shelf-life.” The key to improving biomass supply logistics costs has been developing the associated agronomic sustainability and biomass quality technologies and processes that allow the implementation of equipment engineering solutions.

GREEN COSTS IN CONTEXT OF SUSTAINABLE DEVELOPMENT TRENDS

Directory of Open Access Journals (Sweden)

ZEFINESCU CARMEN-VERONICA

2015-06-01

Full Text Available The paper aims an analysis of the role of the information provided by the accounting of environmental resources in the context of sustainable development. The impact of economic organizations on the natural environment and society tends to become increasingly important to managers, generating a number of risks which a company must face, the necessary information in substantiation of managerial decisions which must be included in the financial reporting. In the present circumstances consumers show a higher interest in products and services which take into account the environmental protection. Thus, economic organizations are determined to report information about such characteristics of their products and services. It is estimated that green accounting must take into account the consequences of company activities on the natural environment accounting, as well as management actions taken by the company to avoid such incidents. Green accounting involves the aggregation of information in order to assess the costs and risks of natural disasters. Thus, criteria which allow to establish costs belonging to the natural environment must be found. Anti-pollution investments involve the restructuring of the entire production process, in order to avoid antipoluate emissions during the production process. Accounting takes into account resource consumption which has a price. Consumption of natural resources is considered to be free and is not included in the production cost. The policy pursued by some enterprises to reduce consumption of natural resources considered free is noticed. The existence of a conceptual framework for accounting for the environmental accounting becomes necessary in the current economic context. Thus, the accountants will have support for developing an environmental accounting. The UN has developed a conceptual framework and methods of assessing and accounting consequences of the activities of companies upon the natural environment. The

Sustainable Sizing.

Science.gov (United States)

Robinette, Kathleen M; Veitch, Daisy

2016-08-01

To provide a review of sustainable sizing practices that reduce waste, increase sales, and simultaneously produce safer, better fitting, accommodating products. Sustainable sizing involves a set of methods good for both the environment (sustainable environment) and business (sustainable business). Sustainable sizing methods reduce (1) materials used, (2) the number of sizes or adjustments, and (3) the amount of product unsold or marked down for sale. This reduces waste and cost. The methods can also increase sales by fitting more people in the target market and produce happier, loyal customers with better fitting products. This is a mini-review of methods that result in more sustainable sizing practices. It also reviews and contrasts current statistical and modeling practices that lead to poor fit and sizing. Fit-mapping and the use of cases are two excellent methods suited for creating sustainable sizing, when real people (vs. virtual people) are used. These methods are described and reviewed. Evidence presented supports the view that virtual fitting with simulated people and products is not yet effective. Fit-mapping and cases with real people and actual products result in good design and products that are fit for person, fit for purpose, with good accommodation and comfortable, optimized sizing. While virtual models have been shown to be ineffective for predicting or representing fit, there is an opportunity to improve them by adding fit-mapping data to the models. This will require saving fit data, product data, anthropometry, and demographics in a standardized manner. For this success to extend to the wider design community, the development of a standardized method of data collection for fit-mapping with a globally shared fit-map database is needed. It will enable the world community to build knowledge of fit and accommodation and generate effective virtual fitting for the future. A standardized method of data collection that tests products' fit methodically

Cost-effectiveness analysis of the introduction of rotavirus vaccine in Iran.

Science.gov (United States)

Javanbakht, Mehdi; Moradi-Lakeh, Maziar; Yaghoubi, Mohsen; Esteghamati, Abdoulreza; Mansour Ghanaie, Roxana; Mahmoudi, Sussan; Shamshiri, Ahmad-Reza; Zahraei, Seyed Mohsen; Baxter, Louise; Shakerian, Sareh; Chaudhri, Irtaza; Fleming, Jessica A; Munier, Aline; Baradaran, Hamid R

2015-05-07

Although the mortality from diarrheal diseases has been decreasing dramatically in Iran, it still represents an important proportion of disease burden in children Rotavirus vaccines are among the most effective strategies against diarrheal diseases in specific epidemiological conditions. This study aimed to evaluate the cost-effectiveness of the introduction of rotavirus vaccine (3 doses of pentavalent RotaTeq (RV5)) in Iran, from the viewpoints of Iran's health system and society. The TRIVAC decision support model was used to calculate total incremental costs, life years (LYs) gained, and disability-adjusted life years (DALYs) averted due to the vaccination program. Necessary input data were collected from the most valid accessible sources as well as a systematic review and meta-analysis on epidemiological studies. We used WHO guidelines to estimate vaccination cost. An annual discount rate of 3% was considered for both health gain and costs. A deterministic sensitivity analysis was performed for testing the robustness of the models results. Our results indicated that total DALYs potentially lost due to rotavirus diarrhea within 10 years would be 138,161, of which 76,591 could be prevented by rotavirus vaccine. The total vaccination cost for 10 cohorts was estimated to be US$ 499.91 million. Also, US$ 470.61 million would be saved because of preventing outpatient visits and inpatient admissions (cost-saving from the society perspective). We estimated a cost per DALY averted of US$ 2868 for RV5 vaccination, which corresponds to a highly cost-effective strategy from the government perspective. In the sensitivity analysis, all scenarios tested were still cost-saving or highly cost-effective from the society perspective, except in the least favorable scenario and low vaccine efficacy and disease incidence scenario. Based on the findings, introduction of rotavirus vaccine is a highly cost-effective strategy from the government perspective. Introducing the vaccine to

A Postulate for Accelerated Implementation of Sustainable Development Goals and Principles

Science.gov (United States)

Kassenberg, Andrzej

2017-12-01

The last 30-year period has been increasingly important for sustainable development, as is evidenced by the UN's announcement of 17 Sustainable Development Goals to be achieved by 2030. However, many megatrends continue to progress in the direction opposite to that meeting the needs of sustainable development. For the Earth and human civilisation to be protected, it is necessary for a new approach to be developed - a new order that might be termed the civilization/economics of enough, or of moderation. However, convincing societies, including that of Poland, in regard to the benefits of addressing the challenges sustainable development poses is not an easy task; even though a redirecting of the economy and of society along new paths will bring measurable benefits capable of compensating for the costs of transformation.

Toward a Sustainable Society in the Mena (Middle East and North Africa) Region: Roadmap and Priorities

Science.gov (United States)

El-Bassiouny, Noha

2012-01-01

The Business and Society Research Cluster (BSRC) at the German University in Cairo, the El-Khazindar Business Research and Case Center at the American University in Cairo and Misr El-Kheir (MEK) Foundation, Egypt, hosted the region's first sustainability and corporate social responsibility (CSR) case studies conference, entitled "Toward a…

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

PREFACE: International Symposium on Materials Science and Innovation for Sustainable Society - Eco-Materials and Eco-Innovation for Global Sustainability - The 21st Iketani Conference 2011

Science.gov (United States)

Takahashi, Yasuo

2012-08-01

Conference logo The 21st century has been called the century of environmental revolution. Green innovations and environmentally friendly production systems based on physics, chemistry, materials science, and electronic engineering will be indispensable for ensuring renewable energy and establishing a sustainable society. In particular, production design, materials processing, and fabrication technologies such as welding and joining will be very important components of such green innovations. For these reasons, the International Symposium on Materials Science and Innovation for Sustainable Society - eco-materials and eco-innovation for global sustainability - (ECO-MATES 2011) was organized by the Joining and Welding Research Institute (JWRI) and the Center of Environmental Innovation Design for Sustainability (CEIDS), Osaka University. ECO-MATES 2011 was held at Hotel Hankyu Expo Park, Osaka, Japan from 28-30 November 2011. 435 participants from 20 countries around the world attended the symposium. 149 oral presentations including 60 invited talks and 160 posters were presented at the symposium to discuss the latest research and developments in green innovations in relation to environmental issues. The topics of the symposium covered all environmentally related fields including renewable energy, energy-materials, environment and resources, waste and biomass, power electronics, semiconductor, rare-earth metals, functional materials, organic electronics materials, electronics packaging, smart processing, joining and welding, eco-efficient processes, and green applied physics and chemistry. Therefore, 55 full papers concerning green innovations and environmentally benign production were selected and approved by the editorial board and the program committee of ECO-MATES 2011. All papers were accepted through peer review processes. I believe that all the papers have many informative contents. On behalf of the steering committee of the symposium, I would like to express

Sustainable development at tax-deductible costs or how to assure sustainable development by one’s way of living

Directory of Open Access Journals (Sweden)

Willem Adrianus de Bruijn

2006-08-01

Full Text Available The purpose of this paper is to demonstrate that an imperative demand for an existence in harmony with Nature is created when the costs incurred for such an existence can be deducted from taxable income. All reasonable consumers who pay income taxes will then be driven to buy tax-deductible products. Producers will have to satisfy this demand. They will also have to justify their products’ characteristics, which assure sustainable development and to identify the costs which are associated with these qualities. The consumer needs to know which percentage of the purchase price he paid corresponds with the environmental cost free quality of the merchandise, in order for him to deduct the consequent amount from his taxable income. The theory underlying the deductibility of costs of living from taxable income is based on the following three assumptions: The goal of development is constantly determined by the purchases of consumers. Currently, the only goal with which consumers spend their income seems to be the one of consuming more. The recurring ecological crises reveal that it is impossible to continue to consume more of limited resources without eventually exhausting them. One of the functions of the consumer in the economy is to maintain a way of living which assures sustainable development. The principle of efficiency of economy, according to which the efficient place to manage any cost is at the source of the revenues which costs sustain. This paper also presents a practical and feasible application of our ideas. The creation of a way of living qualifies as research if it is achieved within the context of a scientific project with the cooperation of, in particular, academic institutions. Such a project could be operated within the context of the UNECE 1998 Aarhus Convention on Access to Information, Public Participation in Decision-making and Access to Justice in Environmental Matters, signed by Romania on 25 June 1998 and already ratified

External costs in the global energy optimization models. A tool in favour of sustain ability

International Nuclear Information System (INIS)

Cabal Cuesta, H.

2007-01-01

The aim of this work is the analysis of the effects of the GHG external costs internalization in the energy systems. This may provide a useful tool to support decision makers to help reaching the energy systems sustain ability. External costs internalization has been carried out using two methods. First, CO 2 externalities of different power generation technologies have been internalized to evaluate their effects on the economic competitiveness of these present and future technologies. The other method consisted of analysing and optimizing the global energy system, from an economic and environmental point of view, using the global energy optimization model generator, TIMES, with a time horizon of 50 years. Finally, some scenarios regarding environmental and economic strategic measures have been analysed. (Author)

Sustentabilidade empresarial e o impacto no custo de capital próprio das empresas de capital aberto Sustainable development and consequences for equity costs in public companies

Directory of Open Access Journals (Sweden)

Lílian Simone Aguiar da Silva

2006-12-01

Full Text Available Este trabalho apresenta o impacto no custo de capital próprio para as empresas brasileiras de capital aberto face à adoção dos princípios de sustentabilidade. O conceito de desenvolvimento sustentável tem se aprimorado num processo contínuo de reavaliação da relação existente entre: crescimento econômico, a sociedade civil e o meio ambiente. O triple-bottom-line das dimensões econômica, ambiental e social da sustentabilidade tem emergido como um modelo de interpretação pelas empresas, embora cada uma dessas dimensões represente um grande desafio. O segmento corporativo vem atendendo às demandas cada vez maiores da sociedade frente a essas questões, ficando a dúvida quanto à legitimidade dessas ações e o questionamento relativo ao papel das empresas na economia e na sociedade. Para avaliar o impacto no custo de capital próprio, foi implementado um modelo de decomposição do beta em medidas contábeis de risco, incluindo uma variável referente à sustentabilidade. O resultado confirma a expectativa de que ao aderir aos padrões de sustentabilidade a empresa reduz o risco corporativo medido pelo risco sistemático, determinando a redução do custo de capital e aumento do valor econômico.This article provides an analysis of equity costs in Brazilian public companies regarding the adoption of sustainability principles. The concept of sustainable development has evolved considering the relation among economic growth, the society and the environment. The triple-bottom-line of economic, environmental, and social dimensions has emerged as an interpretation model by companies, although each of these dimensions may present a challenge. The corporate sector has faced an increasing demand from society regarding these sustainability concepts, though the actions and the role to be played by companies within this context are still being questioned. Equity costs were analyzed by a multivariate regression of beta on accounting measures

Landscapes of Lost Energy: Counterfactual Geographical Imaginary for A More Sustainable Society

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van der Horst Dan

2014-07-01

Full Text Available The quest for sustainable energy, one of the greatest challenges of the 21st century, calls for more input from academics than 'simply' producing good science. Geographical imaginations are as old as storytelling and mapmaking, but this essay is neither about 'long ago and far away', nor about utopian energy futures. This is a call to geographers to engage with 'alternative present' energy scenarios, using the full range of analytical and discursive tools at our disposal. Drawing on a diverse tradition of imagined spaces and the awareness of absences (material, relational or otherwise, geographers should be able to contribute to the quest for a more sustainable society by assessing, envisaging, and communicating a counterfactual 'here and now', based on good practices existing right now, but not (yet right here. We need to understand how much more sustainable our bit of the planet would be if we could just, environmentally speaking, 'keep up' with the best of our neighbours. This counterfactual present should be seen as neither radical nor utopian, because it only assumes the historic adoption of best practices which we now know to be feasible and successful. And if thi alternative current scenario looks radically different from the 'real' state we are in, then this goes to show how radically unsustainable our business-as-usual approach has been.

Improving Maternal Care through a State-Wide Health Insurance Program: A Cost and Cost-Effectiveness Study in Rural Nigeria.

Science.gov (United States)

Gomez, Gabriela B; Foster, Nicola; Brals, Daniella; Nelissen, Heleen E; Bolarinwa, Oladimeji A; Hendriks, Marleen E; Boers, Alexander C; van Eck, Diederik; Rosendaal, Nicole; Adenusi, Peju; Agbede, Kayode; Akande, Tanimola M; Boele van Hensbroek, Michael; Wit, Ferdinand W; Hankins, Catherine A; Schultsz, Constance

2015-01-01

While the Nigerian government has made progress towards the Millennium Development Goals, further investments are needed to achieve the targets of post-2015 Sustainable Development Goals, including Universal Health Coverage. Economic evaluations of innovative interventions can help inform investment decisions in resource-constrained settings. We aim to assess the cost and cost-effectiveness of maternal care provided within the new Kwara State Health Insurance program (KSHI) in rural Nigeria. We used a decision analytic model to simulate a cohort of pregnant women. The primary outcome is the incremental cost effectiveness ratio (ICER) of the KSHI scenario compared to the current standard of care. Intervention cost from a healthcare provider perspective included service delivery costs and above-service level costs; these were evaluated in a participating hospital and using financial records from the managing organisations, respectively. Standard of care costs from a provider perspective were derived from the literature using an ingredient approach. We generated 95% credibility intervals around the primary outcome through probabilistic sensitivity analysis (PSA) based on a Monte Carlo simulation. We conducted one-way sensitivity analyses across key model parameters and assessed the sensitivity of our results to the performance of the base case separately through a scenario analysis. Finally, we assessed the sustainability and feasibility of this program's scale up within the State's healthcare financing structure through a budget impact analysis. The KSHI scenario results in a health benefit to patients at a higher cost compared to the base case. The mean ICER (US$46.4/disability-adjusted life year averted) is considered very cost-effective compared to a willingness-to-pay threshold of one gross domestic product per capita (Nigeria, US$ 2012, 2,730). Our conclusion was robust to uncertainty in parameters estimates (PSA: median US$49.1, 95% credible interval 21

Improving Maternal Care through a State-Wide Health Insurance Program: A Cost and Cost-Effectiveness Study in Rural Nigeria.

Directory of Open Access Journals (Sweden)

Gabriela B Gomez

Full Text Available While the Nigerian government has made progress towards the Millennium Development Goals, further investments are needed to achieve the targets of post-2015 Sustainable Development Goals, including Universal Health Coverage. Economic evaluations of innovative interventions can help inform investment decisions in resource-constrained settings. We aim to assess the cost and cost-effectiveness of maternal care provided within the new Kwara State Health Insurance program (KSHI in rural Nigeria.We used a decision analytic model to simulate a cohort of pregnant women. The primary outcome is the incremental cost effectiveness ratio (ICER of the KSHI scenario compared to the current standard of care. Intervention cost from a healthcare provider perspective included service delivery costs and above-service level costs; these were evaluated in a participating hospital and using financial records from the managing organisations, respectively. Standard of care costs from a provider perspective were derived from the literature using an ingredient approach. We generated 95% credibility intervals around the primary outcome through probabilistic sensitivity analysis (PSA based on a Monte Carlo simulation. We conducted one-way sensitivity analyses across key model parameters and assessed the sensitivity of our results to the performance of the base case separately through a scenario analysis. Finally, we assessed the sustainability and feasibility of this program's scale up within the State's healthcare financing structure through a budget impact analysis. The KSHI scenario results in a health benefit to patients at a higher cost compared to the base case. The mean ICER (US$46.4/disability-adjusted life year averted is considered very cost-effective compared to a willingness-to-pay threshold of one gross domestic product per capita (Nigeria, US$ 2012, 2,730. Our conclusion was robust to uncertainty in parameters estimates (PSA: median US$49.1, 95% credible

What are the Most Effective Drivers of Sustainable Development in the Decision Making Process

DEFF Research Database (Denmark)

Hansen, Hanne Tine Ring; Knudstrup, Mary-Ann

2017-01-01

The identification of the most effective drivers of sustainable development is a focal point for most – if not all – policymakers and companies interested in sustainable development. Whilst the answer to this is of course very contextual this paper presents a practitioner’s review of the political...... and sustaining the market demand for sustainable buildings it is actually the economic and social drivers for sustainable building, such as life cycle costs, futureproofing of investments, better quality and Corporate Social Responsibility (CSR), that have the greatest impact on construction clients’ decision...

Key features for more successful place-based sustainability research on social-ecological systems: A Programme on Ecosystem Change and Society (PECS) perspective

NARCIS (Netherlands)

Balvanera, P.; Daw, T.M.; Gardner, T.A.; Martín-López, B.; Norström, A.V.; Ifejika Speranza, C.; Spierenburg, M.J.; Bennett, E.M.; Farfán, M.; Hamann, M.; Kittinger, J.N.; Luthe, T.; Maass, M.; Peterson, G.D.; Pérez-Verdin, G.

2017-01-01

The emerging discipline of sustainability science is focused explicitly on the dynamic interactions between nature and society and is committed to research that spans multiple scales and can support transitions toward greater sustainability. Because a growing body of place-based social-ecological

Impact of geohazards on sustainable development of society

International Nuclear Information System (INIS)

Blistan, P.

2015-01-01

In this paper the authors analyze environmental risk factors in Slovakia in terms of sustainable development within environmental conditions and perspectives. Geological and geomorphological conditions affecting sustainable development are analyzed. Monitoring system of the environment and the need for sustainable development is presented.

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

LOCAL WISDOM OF SABANG ISLAND SOCIETY (ACEH, INDONESIA IN BUILDING ECOLOGICAL INTELLIGENCE TO SUPPORT SUSTAINABLE TOURISM

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Dian ASWITA

2018-05-01

Full Text Available One of the existing natural and environmental uses in Aceh (Indonesia is tourism. One of the aspects that determine the development and sustainability of tourism is the institutional and community aspects. Sustainable tourism is a picture of the ecosystem sustainability and socio-economic development of the community. This study aims to reveal and find local wisdom practices and explore local knowledge owned by Sabang Island community in the management and conservation of the environment so as to support the realization of sustainable tourism. This study uses rationalistic paradigm and uses qualitative research method. The data that has been collected is analyzed descriptively. Local wisdom and local knowledge are reflected in how society has a unique way of looking at and understanding nature and interacting with it. In the Aceh community, there are customary institutions that regulate the rules or interactions of the community with the environment, including “panglima laot”, “keujreun blang”, “peutua seuneubok”, “pawang glee or peutua uteun”, “haria peukan” and “syahbanda”. Local wisdom and local knowledge have great potential in maintaining, preserving and sustainability of the environment used by communities to meet their living needs. Ecological, social and religious intelligence formed through local wisdom and local knowledge can be an aspect in maintaining environmental sustainability in order to build sustainable tourism on Sabang Island.

5th Physics and Society Forum - EPS

CERN Multimedia

2012-01-01

The Fifth Physics and Society Forum, organized by the European Physical Society, will take place at CERN from 28 to 29 March 2012. 
The purpose of the meeting is to explore the challenges experienced by physicists who leave their field of study to pursue alternative careers in the market place outside of teaching and university-based research. 
     It is widely recognized that a knowledgeable society is a prerequisite for growth. Value is only created if knowledge can be transformed into know-how and "know-how-to-do". Today it is widely recognized that a society is unable to grow and sustain an advanced science system unless equally advanced production is present. Today production is off-shored to emerging economies in Asia and elsewhere where labour costs are more favourable. European physicists therefore have the choice of being smarter, working harder and working cheaper or moving into other fields. 

 Registration is open until 1st March 2012. Please ...

India's Proposed Universal Health Coverage Policy: Evidence for Age Structure Transition Effect and Fiscal Sustainability.

Science.gov (United States)

Narayana, Muttur Ranganathan

2016-12-01

health expenditures. These new results strengthen the proposed UHC policy by accounting for age structure transition effect and justifying its sustainability within the framework of India's current fiscal policies. The age structure transition effect is important to incorporate the age-specific cost and benefit of the proposed UHC policy, especially as India moves toward an ageing society. Fiscal sustainability is essential to ensure that the proposed UHC is implementable on a long-term basis and within the framework of current fiscal policies.

Enabling Effective Problem-oriented Research for Sustainable Development

Directory of Open Access Journals (Sweden)

Christoph Kueffer

2012-12-01

Full Text Available Environmental problems caused by human activities are increasing; biodiversity is disappearing at an unprecedented rate, soils are being irreversibly damaged, freshwater is increasingly in short supply, and the climate is changing. To reverse or even to reduce these trends will require a radical transformation in the relationship between humans and the natural environment. Just how this can be achieved within, at most, a few decades is unknown, but it is clear that academia must play a crucial role. Many believe, however, that academic institutions need to become more effective in helping societies move toward sustainability. We first synthesize current thinking about this crisis of research effectiveness. We argue that those involved in producing knowledge to solve societal problems face three particular challenges: the complexity of real-world sustainability problems, maintaining impartiality when expert knowledge is used in decision making, and ensuring the salience of the scientific knowledge for decision makers. We discuss three strategies to meet these challenges: conducting research in interdisciplinary teams, forming research partnerships with actors and experts from outside academia, and framing research questions with the aim of solving specific problems (problem orientation. However, we argue that implementing these strategies within academia will require both cultural and institutional change. We then use concepts from transition management to suggest how academic institutions can make the necessary changes. At the level of system optimization, we call for: quality criteria, career incentives, and funding schemes that reward not only disciplinary excellence but also achievements in inter-/transdisciplinary work; professional services and training through specialized centers that facilitate problem-oriented research and reciprocal knowledge exchange with society; and the integration of sustainability and inter

LCA and external costs in comparative assessment of electricity chains. Decision support for sustainable electricity provision?

International Nuclear Information System (INIS)

Voss, A.

2002-01-01

The provision of energy and electricity plays an important role in a country's economic and environmental performance and the sustainability of its development. Sustainable development of the energy and electricity sector depends on finding ways of meeting energy service demands of the present generation that are economically viable, environmentally sound, and socially acceptable and do not jeopardize the ability of future generations to meet their own energy needs. Life Cycle Assessment (LCA) and external cost valuation are considered to offer opportunities to assist energy policy in a comprehensive comparative evaluation of electricity supply options with regard to the different dimensions of sustainable energy provision as well as in the implementation of appropriate internalization strategies. The paper addresses life cycle assessment and external cost analysis carried out for selected electricity systems of interest under German conditions. Results from a comprehensive comparative assessment of various electricity supply options with regard to their environmental impacts, health risks, raw materials requirements as well as their resulting external cost will be summarised. The use of LCA based indicators for assessing the relative sustainability of electricity systems and the use of total (internal plus external) cost assessment as measure of economic and environmental efficiency of energy systems will be discussed. Open problems related to life cycle analysis of energy chains and the assessment of environmental damage costs are critically reviewed, to illustrate how in spite of existing uncertainties the state of the art results may provide helpful energy policy decision support. The paper starts with some remarks on what the concept of sustainability in terms of energy systems means. (author)

WATER SUPPLY PIPE REPLACEMENT CONSIDERING SUSTAINABLE TRANSITION TO POPULATION DECREASED SOCIETY

Science.gov (United States)

Hosoi, Yoshihiko; Iwasaki, Yoji; Aklog, Dagnachew; Masuda, Takanori

Social infrastructures are aging and population is decreasing in Japan. The aged social infrastructures should be renewed. At the same time, they are required to be moved into new framework suitable for population decreased societies. Furthermore, they have to continue to supply sufficient services even during transition term that renewal projects are carried out. Authors propose sustainable soft landing management of infrastructures and it is tried to apply to water supply pipe replacement in this study. Methodology to replace aged pipes not only aiming for the new water supply network which suits for population decreased condition but also ensuring supply service and feasibility while the project is carried out was developed. It is applied for a model water supply network and discussions were carried out.

Society, materiality, resilience and sustainability: inquiries from the fields of industrial waste management, urban climate science and eco-urbanism

Science.gov (United States)

MacKillop, Fionn

2018-06-01

This paper aims to investigate the links between materiality and society at a conceptual level, using examples from the author's decade of research in several fields relevant to the issue. With current talk of the need for `sustainability' and `resilience' reaching fever pitch in industry, politics and other arenas, there is a regrettable tendency to muddle the meaning of these words. Drawing on original research carried out in the UK, China, Germany, and Australia, and using the conceptual approaches of actor-network theory (ANT) and urban political ecology (UPE), the author invites us to re-engage with the materiality of society and how we, as businesses, consumers and thinkers, can advance sustainability and resilience through this re-engagement. We will ask what sustainability and resilience mean, for whom and in what context. We will also look at how we can shift thinking and reinvigorate these words, by contributing to the dialogue between the social sciences and business and industry. Specific examples will be taken from the UK and Chinese steel industries; climate-sensitive urban design in Manchester and Stuttgart; and housing construction and affordability in Scotland and Australia, thus covering a wide range of issues related to urban sustainability and resilience in relation to materiality.

Cost-effectiveness of modern radiotherapy techniques in locally advanced pancreatic cancer.

Science.gov (United States)

Murphy, James D; Chang, Daniel T; Abelson, Jon; Daly, Megan E; Yeung, Heidi N; Nelson, Lorene M; Koong, Albert C

2012-02-15

Radiotherapy may improve the outcome of patients with pancreatic cancer but at an increased cost. In this study, the authors evaluated the cost-effectiveness of modern radiotherapy techniques in the treatment of locally advanced pancreatic cancer. A Markov decision-analytic model was constructed to compare the cost-effectiveness of 4 treatment regimens: gemcitabine alone, gemcitabine plus conventional radiotherapy, gemcitabine plus intensity-modulated radiotherapy (IMRT); and gemcitabine with stereotactic body radiotherapy (SBRT). Patients transitioned between the following 5 health states: stable disease, local progression, distant failure, local and distant failure, and death. Health utility tolls were assessed for radiotherapy and chemotherapy treatments and for radiation toxicity. SBRT increased life expectancy by 0.20 quality-adjusted life years (QALY) at an increased cost of $13,700 compared with gemcitabine alone (incremental cost-effectiveness ratio [ICER] = $69,500 per QALY). SBRT was more effective and less costly than conventional radiotherapy and IMRT. An analysis that excluded SBRT demonstrated that conventional radiotherapy had an ICER of $126,800 per QALY compared with gemcitabine alone, and IMRT had an ICER of $1,584,100 per QALY compared with conventional radiotherapy. A probabilistic sensitivity analysis demonstrated that the probability of cost-effectiveness at a willingness to pay of $50,000 per QALY was 78% for gemcitabine alone, 21% for SBRT, 1.4% for conventional radiotherapy, and 0.01% for IMRT. At a willingness to pay of $200,000 per QALY, the probability of cost-effectiveness was 73% for SBRT, 20% for conventional radiotherapy, 7% for gemcitabine alone, and 0.7% for IMRT. The current results indicated that IMRT in locally advanced pancreatic cancer exceeds what society considers cost-effective. In contrast, combining gemcitabine with SBRT increased clinical effectiveness beyond that of gemcitabine alone at a cost potentially acceptable by

Lignocellulosic biorefinery as a model for sustainable development of biofuels and value added products.

Science.gov (United States)

De Bhowmick, Goldy; Sarmah, Ajit K; Sen, Ramkrishna

2018-01-01

A constant shift of society's dependence from petroleum-based energy resources towards renewable biomass-based has been the key to tackle the greenhouse gas emissions. Effective use of biomass feedstock, particularly lignocellulosic, has gained worldwide attention lately. Lignocellulosic biomass as a potent bioresource, however, cannot be a sustainable alternative if the production cost is too high and/ or the availability is limited. Recycling the lignocellulosic biomass from various sources into value added products such as bio-oil, biochar or other biobased chemicals in a bio-refinery model is a sensible idea. Combination of integrated conversion techniques along with process integration is suggested as a sustainable approach. Introducing 'series concept' accompanying intermittent dark/photo fermentation with co-cultivation of microalgae is conceptualised. While the cost of downstream processing for a single type of feedstock would be high, combining different feedstocks and integrating them in a bio-refinery model would lessen the production cost and reduce CO 2 emission. Copyright © 2017 Elsevier Ltd. All rights reserved.

Proactive sustainability strategy and corporate sustainability performance: The mediating effect of sustainability control systems.

Science.gov (United States)

Wijethilake, Chaminda

2017-07-01

This study examines to what extent corporations use sustainability control systems (SCS) to translate proactive sustainability strategy into corporate sustainability performance. The study investigates the mediating effect of SCS on the relationship between proactive sustainability strategy and corporate sustainability performance. Survey data were collected from top managers in 175 multinational and local corporations operating in Sri Lanka and analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). SCS were observed to only partially mediate the relationship between proactive sustainability strategy and corporate sustainability performance. The mediating effect of SCS is further examined under three sustainability strategies; environmental and social strategies reveal a partial mediation, while the economic strategy exhibits no mediation. The study also finds that (i) a proactive sustainability strategy is positively associated with SCS and corporate sustainability performance and (ii) SCS are positively associated with corporate sustainability performance. Copyright © 2017 Elsevier Ltd. All rights reserved.

Towards Sustainable Health Care Organizations

Directory of Open Access Journals (Sweden)

Mauro ROMANELLI

2017-09-01

Full Text Available Health care organizations have to develop a sustainable path for creating public value by seeking legitimacy for building and maintaining public trust with patients as social and economic institutions creating value and sustaining both health and wealth for people and communities within society. Health care organizations having at disposal decreasing resources and meeting increasing demands of citizens are following an unsustainable path. Designing sustainable health care systems and organizations is emerging as a strategic goal for developing the wealth of people and communities over time. Building sustainable organizations relies on valuing human resources, designing efficient and effective processes, using technology for better managing the relationships within and outside organizations. Sustainable health care organizations tend to rediscover the importance of human resource management and policies for effectively improving communication with patients and building trust-based relationships. While processes of accreditation contribute to legitimizing effectiveness and quality of health care services and efficient processes, introducing and using new information and communication technologies (ICTs and informatics helps communication leading to restore trust-based relationships between health care institutions and patients for value creation within society.

Cost-Effectiveness Analysis of Fondaparinux vs Enoxaparin in Non-ST Elevation Acute Coronary Syndrome in Thailand.

Science.gov (United States)

Permsuwan, Unchalee; Chaiyakunapruk, Nathorn; Nathisuwan, Surakit; Sukonthasarn, Apichard

2015-09-01

Non-ST elevation acute coronary syndrome (NSTE-ACS) imposes a significant health and economic burden on a society. Anticoagulants are recommended as standard therapy by various clinical practice guidelines. Fondaparinux was introduced and evaluated in a number of large randomised, controlled trials. This study therefore aimed to determine the cost-effectiveness of fondaparinux versus enoxaparin in the treatment of NSTE-ACS in Thailand. A two-part construct model comprising a one-year decision tree and a Markov model was developed to capture short and long-term costs and outcomes from the perspective of provider and society. Effectiveness data were derived from OASIS-5 trial while bleeding rates were derived from the Thai Acute Coronary Syndrome Registry (TACSR). Costs data were based on a Thai database and presented in the year of 2013. Both costs and outcomes were discounted by 3% annually. A series of sensitivity analyses were performed. The results showed that compared with enoxaparin, fondaparinux was a cost-saving strategy (lower cost with slightly higher effectiveness). Cost of revascularisation with major bleeding had a greater impact on the amount of cost saved both from societal and provider perspectives. With a threshold of 160,000 THB ((4,857.3 USD) per QALY in Thailand, fondaparinux was about 99% more cost-effective compared with enoxaparin. Fondaparinux should be considered as a cost-effective alternative when compared to enoxaparin for NSTE-ACS based on Thailand's context, especially in the era of limited healthcare resources. Copyright © 2015 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

Local perceptions as a guide for the sustainable management of natural resources: empirical evidence from a small-scale society in Bolivian Amazonia

Directory of Open Access Journals (Sweden)

Álvaro Fernández-Llamazares

2016-03-01

Full Text Available Research on natural resource management suggests that local perceptions form the basis upon which many small-scale societies monitor availability and change in the stock of common-pool natural resources. In contrast, this literature debates whether local perceptions can be effective in guiding the sustainable management of natural resources. With empirical evidence on this matter still highly limited, we explored the role of local perceptions as drivers of harvesting and management behavior in a small-scale society in Bolivian Amazonia. We conducted structured interviews to capture local perceptions of availability and change in the stock of thatch palm (Geonoma deversa among the Tsimane', an indigenous society of foragers-horticulturalists (n = 296 adults in 13 villages. We analyzed whether perceptions of availability match estimates of abundance obtained from ecological data and whether differences in perception help to explain harvesting behavior and local management of thatch palm. Perceptions of availability of G. deversa are highly contingent upon the social, economic, and cultural conditions within which the Tsimane' have experienced changes in the availability of the resource, thus giving a better reflection of the historical, rather than of the ecological, dimensions of the changes undergone. Although local perceptions might fall short in precision when scrutinized from an ecological standpoint, their importance in informing sustainable management should not be underestimated. Our findings show that most of the harvesting and management actions that the Tsimane' undertake are, at least partially, shaped by their local perceptions. This paper contributes to the broader literature on natural resource management by providing empirical evidence of the critical role of local perceptions in promoting collective responses for the sustainable management of natural resources.

Strategic research on the sustainable development cost of manufacturing industry under the background of carbon allowance and trade policy

Science.gov (United States)

Ma, Zhongmin; Cheng, Mengting; Wang, Mei

2017-08-01

The important subjects of energy consumption and carbon emission are manufacturing enterprises, with the deepening of international cooperation, and the implementation of carbon limit and trade policy, costs of manufacturing industry will rise sharply. How can the manufacturing industry survive in this reform, and it has to be a problem that the managers of the manufacturing industry need to solve. This paper analyses sustainable development cost connotation and value basis on the basis of sustainable development concept, discusses the influence of carbon allowance and trade policy for cost strategy of manufacturing industry, thinks that manufacturing industry should highlight social responsibility and realize maximization of social value, implement cost strategy the sustainable development, and pointed out the implementation way.

Early stage design decisions: the way to achieve sustainable buildings at lower costs.

Science.gov (United States)

Bragança, Luís; Vieira, Susana M; Andrade, Joana B

2014-01-01

The construction industry attempts to produce buildings with as lower environmental impact as possible. However, construction activities still greatly affect environment; therefore, it is necessary to consider a sustainable project approach based on its performance. Sustainability is an important issue to consider in design, not only due to environmental concerns but also due to economic and social matters, promoting architectural quality and economic advantages. This paper aims to identify the phases through which a design project should be developed, emphasising the importance and ability of earlier stages to influence sustainability, performance, and life cycle cost. Then, a selection of sustainability key indicators, able to be used at the design conceptual phase and able to start predicting environmental sustainability performance of buildings is presented. The output of this paper aimed to enable designers to compare and evaluate the consequences of different design solutions, based on preliminary data, and facilitate the collaboration between stakeholders and clients and eventually yield a sustainable and high performance building throughout its life cycle.

@AACAnatomy twitter account goes live: A sustainable social media model for professional societies.

Science.gov (United States)

Benjamin, Hannah K; Royer, Danielle F

2018-05-01

Social media, with its capabilities of fast, global information sharing, provides a useful medium for professional development, connecting and collaborating with peers, and outreach. The goals of this study were to describe a new, sustainable model for Twitter use by professional societies, and analyze its impact on @AACAnatomy, the Twitter account of the American Association of Clinical Anatomists. Under supervision of an Association committee member, an anatomy graduate student developed a protocol for publishing daily tweets for @AACAnatomy. Five tweet categories were used: Research, Announcements, Replies, Engagement, and Community. Analytics from the 6-month pilot phase were used to assess the impact of the new model. @AACAnatomy had a steady average growth of 33 new followers per month, with less than 10% likely representing Association members. Research tweets, based on Clinical Anatomy articles with an abstract link, were the most shared, averaging 5,451 impressions, 31 link clicks, and nine #ClinAnat hashtag clicks per month. However, tweets from non-Research categories accounted for the highest impression and engagement metrics in four out of six months. For all tweet categories, monthly averages show consistent interaction of followers with the account. Daily tweet publication resulted in a 103% follower increase. An active Twitter account successfully facilitated regular engagement with @AACAnatomy followers and the promotion of clinical anatomy topics within a broad community. This Twitter model has the potential for implementation by other societies as a sustainable medium for outreach, networking, collaboration, and member engagement. Clin. Anat. 31:566-575, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Cost benefit analysis, sustainability and long-lived radioactive waste management

International Nuclear Information System (INIS)

Berkhout, F.

1994-01-01

The objective of this paper is to examine how far the sustainability concept and the technique of cost-benefit analysis (CBA) can be applied to the problem of radioactive waste management. The paper begins with a slightly altered definition of the problem to the one carried in the Nea's background document (Nea 1994). A preliminary attempt is then be made to ascribe burdens to the various phases of long-lived radioactive waste management. The appropriateness of CBA and the sustainability concept for making decisions about long-term waste management policy is then discussed. The author ends with some conclusions about the appropriateness of systematic assessment approaches in the political process of constructing social consent for technological decisions. (O.L.). 12 refs., 1 tab

Sustainability cost accounting, Part 1: A Monetary procedure to evaluate the sustainability of technologies in the South African process industry

CSIR Research Space (South Africa)

Brent, AC

2006-11-01

Full Text Available impacts at macro-level, for which a company is (typically) not held financially liable – into management practices. This paper introduces the Sustainability Cost Accounting (SCA) procedure, whereby externalities (burdens and benefits) are translated...

KRAS early testing: consensus initiative and cost-effectiveness evaluation for metastatic colorectal patients in an Italian setting.

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Carlo Barone

Full Text Available KRAS testing is relevant for the choice of the most appropriate first-line therapy of metastatic colorectal cancer (CRC. Strategies for preventing unequal access to the test should be implemented, but their relevance in the practice is related to economic sustainability. The study adopted the Delphi technique to reach a consensus on several topics. Issues related to execution of KRAS testing were identified by an expert's board and proposed to 108 Italian oncologists and pathologists through two subsequent questionnaires. The emerging proposal was evaluated by decision analyses models employed by technology assessment agencies in order to assess cost-effectiveness. Alternative therapeutic strategies included most commonly used chemotherapy regimens alone or in combination with cetuximab or bevacizumab. The survey indicated that time interval for obtaining KRAS test should not exceed 15 days, 10 days being an optimal interval. To assure the access to proper treatment, a useful strategy should be to anticipate the test after radical resection in patients at high risk of relapse. Early KRAS testing in high risk CRC patients generates incremental cost-effectiveness ratios between 6,000 and 13,000 Euro per quality adjusted life year (QALY gained. In extensive sensitivity analyses ICER's were always below 15,000 Euro per QALY gained, far within the threshold of 60,000 Euro/QALY gained accepted by regulatory institutions in Italy. In metastatic CRC a time interval higher than 15 days for result of KRAS testing limits access to therapeutic choices. Anticipating KRAS testing before the onset of metastatic disease in patients at high risk does not affect the sustainability and cost-effectiveness profile of cetuximab in first-line mCRC. Early KRAS testing may prevent this inequality in high-risk patients, whether they develop metastases, and is a cost-effective strategy. Based on these results, present joined recommendations of Italian societies of

Sustainable Ergonomic Program - Basic Condition for Implementation of Corporate Social Responsibility

Science.gov (United States)

Marková, Petra; Beňo, Rastislav; Hatiar, Karol

2012-12-01

Gradually increasing pressure on companies to start to behave socially responsible is a response to social, environmental and economic requirements. The society faces a period of changes that have occurred since the beginning of the crisis and revealing weaknesses in the economy. We become witnesses of rapid changes and challenges posed by globalization, lack of resources, demographic structure and innovation. Objective necessity becomes a corporate social responsibility (CSR) already at the companies’ level, which is supported by the approach of the EU institutions and the Slovak Republic. One of the possible appliance through which we can contribute to the sustainability of CSR are sustainable ergonomic programs. When we want to talk about sustainable ergonomic program is important to focus on three key areas. The first area is the Impact of technic and technology to employees at work, the second area is the Importance and impact of socially responsible HR in ergonomics and last area is the Creation of the work environment in relation to environmental sustainability. Ergonomic programs sustainability requires to apply appropriate methods for evaluation of their cost benefit and health effect.

Sustainable Cost Models for mHealth at Scale: Modeling Program Data from m4RH Tanzania.

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Emily R Mangone

Full Text Available There is increasing evidence that mobile phone health interventions ("mHealth" can improve health behaviors and outcomes and are critically important in low-resource, low-access settings. However, the majority of mHealth programs in developing countries fail to reach scale. One reason may be the challenge of developing financially sustainable programs. The goal of this paper is to explore strategies for mHealth program sustainability and develop cost-recovery models for program implementers using 2014 operational program data from Mobile for Reproductive Health (m4RH, a national text-message (SMS based health communication service in Tanzania.We delineated 2014 m4RH program costs and considered three strategies for cost-recovery for the m4RH program: user pay-for-service, SMS cost reduction, and strategic partnerships. These inputs were used to develop four different cost-recovery scenarios. The four scenarios leveraged strategic partnerships to reduce per-SMS program costs and create per-SMS program revenue and varied the structure for user financial contribution. Finally, we conducted break-even and uncertainty analyses to evaluate the costs and revenues of these models at the 2014 user volume (125,320 and at any possible break-even volume.In three of four scenarios, costs exceeded revenue by $94,596, $34,443, and $84,571 at the 2014 user volume. However, these costs represented large reductions (54%, 83%, and 58%, respectively from the 2014 program cost of $203,475. Scenario four, in which the lowest per-SMS rate ($0.01 per SMS was negotiated and users paid for all m4RH SMS sent or received, achieved a $5,660 profit at the 2014 user volume. A Monte Carlo uncertainty analysis demonstrated that break-even points were driven by user volume rather than variations in program costs.These results reveal that breaking even was only probable when all SMS costs were transferred to users and the lowest per-SMS cost was negotiated with telecom partners

Sustainable Cost Models for mHealth at Scale: Modeling Program Data from m4RH Tanzania.

Science.gov (United States)

Mangone, Emily R; Agarwal, Smisha; L'Engle, Kelly; Lasway, Christine; Zan, Trinity; van Beijma, Hajo; Orkis, Jennifer; Karam, Robert

2016-01-01

There is increasing evidence that mobile phone health interventions ("mHealth") can improve health behaviors and outcomes and are critically important in low-resource, low-access settings. However, the majority of mHealth programs in developing countries fail to reach scale. One reason may be the challenge of developing financially sustainable programs. The goal of this paper is to explore strategies for mHealth program sustainability and develop cost-recovery models for program implementers using 2014 operational program data from Mobile for Reproductive Health (m4RH), a national text-message (SMS) based health communication service in Tanzania. We delineated 2014 m4RH program costs and considered three strategies for cost-recovery for the m4RH program: user pay-for-service, SMS cost reduction, and strategic partnerships. These inputs were used to develop four different cost-recovery scenarios. The four scenarios leveraged strategic partnerships to reduce per-SMS program costs and create per-SMS program revenue and varied the structure for user financial contribution. Finally, we conducted break-even and uncertainty analyses to evaluate the costs and revenues of these models at the 2014 user volume (125,320) and at any possible break-even volume. In three of four scenarios, costs exceeded revenue by $94,596, $34,443, and $84,571 at the 2014 user volume. However, these costs represented large reductions (54%, 83%, and 58%, respectively) from the 2014 program cost of $203,475. Scenario four, in which the lowest per-SMS rate ($0.01 per SMS) was negotiated and users paid for all m4RH SMS sent or received, achieved a $5,660 profit at the 2014 user volume. A Monte Carlo uncertainty analysis demonstrated that break-even points were driven by user volume rather than variations in program costs. These results reveal that breaking even was only probable when all SMS costs were transferred to users and the lowest per-SMS cost was negotiated with telecom partners. While this

Participation, Value Rationality and Mutual Learning in Transdisciplinary Knowledge Production for Sustainable Development

Science.gov (United States)

Polk, Merritt; Knutsson, Per

2008-01-01

Given the complexity of current social structures and environmental problems, attaining a truly sustainable society seems rather improbable today. Not only has society not been planned for the complexity of the preconditions and effects that sustainability entails, sustainability is also unlikely given current individual consumption patterns,…

Evaluating the effectiveness of palm oil certification in delivering multiple sustainability objectives

Science.gov (United States)

Morgans, Courtney L.; Meijaard, Erik; Santika, Truly; Law, Elizabeth; Budiharta, Sugeng; Ancrenaz, Marc; Wilson, Kerrie A.

2018-06-01

Industrial oil palm plantations in South East Asia have caused significant biodiversity losses and perverse social outcomes. To address concerns over plantation practices and in an attempt to improve sustainability through market mechanisms, civil society organisations and industry representatives developed the Roundtable on Sustainable Palm Oil (RSPO) in 2004. The effectiveness of RSPO in improving the sustainability of the palm oil industry is frequently debated and to date, few quantitative analyses have been undertaken to assess how successful RSPO has been in delivering the social, economic and environmental sustainability outcomes it aims to address. With the palm oil industry continuing to expand in South East Asia and significant estates being planted in Africa and South America, this paper evaluates the effectiveness of RSPO plantations compared to non-certified plantations by assessing the relative performance of several key sustainability metrics compared to business as usual practices. Using Indonesian Borneo (Kalimantan) as a case study, a novel dataset of RSPO concessions was developed and causal analysis methodologies employed to evaluate the environmental, social and economic sustainability of the industry. No significant difference was found between certified and non-certified plantations for any of the sustainability metrics investigated, however positive economic trends including greater fresh fruit bunch yields were revealed. To achieve intended outcomes, RSPO principles and criteria are in need of substantial improvement and rigorous enforcement.

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.

Sustainable Mobility: Using a Global Energy Model to Inform Vehicle Technology Choices in a Decarbonized Economy

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Timothy Wallington

2013-04-01

Full Text Available The reduction of CO2 emissions associated with vehicle use is an important element of a global transition to sustainable mobility and is a major long-term challenge for society. Vehicle and fuel technologies are part of a global energy system, and assessing the impact of the availability of clean energy technologies and advanced vehicle technologies on sustainable mobility is a complex task. The global energy transition (GET model accounts for interactions between the different energy sectors, and we illustrate its use to inform vehicle technology choices in a decarbonizing economy. The aim of this study is to assess how uncertainties in future vehicle technology cost, as well as how developments in other energy sectors, affect cost-effective fuel and vehicle technology choices. Given the uncertainties in future costs and efficiencies for light-duty vehicle and fuel technologies, there is no clear fuel/vehicle technology winner that can be discerned at the present time. We conclude that a portfolio approach with research and development of multiple fuel and vehicle technology pathways is the best way forward to achieve the desired result of affordable and sustainable personal mobility. The practical ramifications of this analysis are illustrated in the portfolio approach to providing sustainable mobility adopted by the Ford Motor Company.

Early Stage Design Decisions: The Way to Achieve Sustainable Buildings at Lower Costs

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Luís Bragança

2014-01-01

Full Text Available The construction industry attempts to produce buildings with as lower environmental impact as possible. However, construction activities still greatly affect environment; therefore, it is necessary to consider a sustainable project approach based on its performance. Sustainability is an important issue to consider in design, not only due to environmental concerns but also due to economic and social matters, promoting architectural quality and economic advantages. This paper aims to identify the phases through which a design project should be developed, emphasising the importance and ability of earlier stages to influence sustainability, performance, and life cycle cost. Then, a selection of sustainability key indicators, able to be used at the design conceptual phase and able to start predicting environmental sustainability performance of buildings is presented. The output of this paper aimed to enable designers to compare and evaluate the consequences of different design solutions, based on preliminary data, and facilitate the collaboration between stakeholders and clients and eventually yield a sustainable and high performance building throughout its life cycle.

Early Stage Design Decisions: The Way to Achieve Sustainable Buildings at Lower Costs

Science.gov (United States)

Bragança, Luís; Vieira, Susana M.; Andrade, Joana B.

2014-01-01

The construction industry attempts to produce buildings with as lower environmental impact as possible. However, construction activities still greatly affect environment; therefore, it is necessary to consider a sustainable project approach based on its performance. Sustainability is an important issue to consider in design, not only due to environmental concerns but also due to economic and social matters, promoting architectural quality and economic advantages. This paper aims to identify the phases through which a design project should be developed, emphasising the importance and ability of earlier stages to influence sustainability, performance, and life cycle cost. Then, a selection of sustainability key indicators, able to be used at the design conceptual phase and able to start predicting environmental sustainability performance of buildings is presented. The output of this paper aimed to enable designers to compare and evaluate the consequences of different design solutions, based on preliminary data, and facilitate the collaboration between stakeholders and clients and eventually yield a sustainable and high performance building throughout its life cycle. PMID:24578630

Cost-Effectiveness Analysis of Regorafenib for Metastatic Colorectal Cancer.

Science.gov (United States)

Goldstein, Daniel A; Ahmad, Bilal B; Chen, Qiushi; Ayer, Turgay; Howard, David H; Lipscomb, Joseph; El-Rayes, Bassel F; Flowers, Christopher R

2015-11-10

Regorafenib is a standard-care option for treatment-refractory metastatic colorectal cancer that increases median overall survival by 6 weeks compared with placebo. Given this small incremental clinical benefit, we evaluated the cost-effectiveness of regorafenib in the third-line setting for patients with metastatic colorectal cancer from the US payer perspective. We developed a Markov model to compare the cost and effectiveness of regorafenib with those of placebo in the third-line treatment of metastatic colorectal cancer. Health outcomes were measured in life-years and quality-adjusted life-years (QALYs). Drug costs were based on Medicare reimbursement rates in 2014. Model robustness was addressed in univariable and probabilistic sensitivity analyses. Regorafenib provided an additional 0.04 QALYs (0.13 life-years) at a cost of $40,000, resulting in an incremental cost-effectiveness ratio of $900,000 per QALY. The incremental cost-effectiveness ratio for regorafenib was > $550,000 per QALY in all of our univariable and probabilistic sensitivity analyses. Regorafenib provides minimal incremental benefit at high incremental cost per QALY in the third-line management of metastatic colorectal cancer. The cost-effectiveness of regorafenib could be improved by the use of value-based pricing. © 2015 by American Society of Clinical Oncology.

Life-cycle design for sustainable architecture

Directory of Open Access Journals (Sweden)

Francesca Thiébat

2013-05-01

Full Text Available Sustainability in architecture should involve environmental and social aspects and also economic aspects. However, in a design process budget issues usually outweigh ecological aspects. How can we then drive clients and builders to put more socially responsible buildings on the market that do not exceed the fixed budget but are environmentally friendly? This paper propose an economic and environmental assessment tool to aid private or public building designers and owners to find the global sustainability value of a green building within a life cycle perspective. Sustainable life cycle tools for buildings design and construction help to achieve successfully integrated architecture. The research here presented proposes a new point of view of the “time-cost-quality triangle” of Project Management, by introducing three further aspects: environment, society and aesthetics.

Cost-free and sustainable incentive increases healthy eating decisions during elementary school lunch.

Science.gov (United States)

Pittman, D W; Parker, J S; Getz, B R; Jackson, C M; Le, T-A P; Riggs, S B; Shay, J M

2012-01-01

We aimed to develop a cost-free and sustainable program to influence healthier eating decisions during elementary school lunch. Baseline food and beverage choices were assessed for 9 days during lunch service at two racially and economically diverse elementary schools in Spartanburg County, SC, USA. After being informed that the labeled items on the daily lunch menu represented the healthiest choice, students were allowed to ring a call bell in the cafeteria for public recognition when they chose all of the identified healthiest food and beverage items during lunch service. Using menus matched to the baseline phase, food and beverage choices were measured during a 9-day intervention phase. After 30 days, food and beverage choices were reassessed during a 3-day follow-up phase. Healthiest food & beverage choices increased 49% with >60% of students choosing non-flavored milk over flavored milk during the intervention phase. There was no difference in the success of the program between the two schools. The program continued and healthy eating decisions were significantly sustained at a 30-day follow-up assessment. Public recognition through bell ringing appears to be an effective practice to sustain increases in healthy eating decisions during elementary school lunch and warrants expansion to larger scale, longitudinal trials.

Cost-effectiveness of interventions to prevent cardiovascular disease in Australia's indigenous population.

Science.gov (United States)

Ong, Katherine S; Carter, Rob; Vos, Theo; Kelaher, Margaret; Anderson, Ian

2014-05-01

Cardiovascular disease is the leading cause of disease burden in Australia's Indigenous population, and the greatest contributor to the Indigenous 'health gap'. Economic evidence can help identify interventions that efficiently address this discrepancy. Five interventions (one community-based and four pharmacological) to prevent cardiovascular disease in Australia's Indigenous population were subject to economic evaluation. Pharmacological interventions were evaluated as delivered either via Aboriginal Community Controlled Health Services or mainstream general practitioner services. Cost-utility analysis methods were used, with health benefit measured in disability-adjusted life-years saved. All pharmacological interventions produced more Indigenous health benefit when delivered via Indigenous health services, but cost-effectiveness ratios were higher due to greater health service costs. Cost-effectiveness ratios were also higher in remote than in non-remote regions. The polypill was the most cost-effective intervention evaluated, while the community-based intervention produced the most health gain. Local and decision-making contextual factors are important in the conduct and interpretation of economic evaluations. For Australia's Indigenous population, different models of health service provision impact on reach and cost-effectiveness results. Both the extent of health gain and cost-effectiveness are important considerations for policy-makers in light of government objectives to address health inequities and bridge the health gap. Copyright © 2013 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). All rights reserved.

Sustainability of the Peritoneal Dialysis-First Policy in Hong Kong.

Science.gov (United States)

Choy, Agnes Shin-Man; Li, Philip Kam-Tao

2015-01-01

In Hong Kong, the average annual cost of haemodialysis (HD) per patient is more than double of that of peritoneal dialysis (PD). As the number of patients with end-stage renal disease (ESRD) has surged, it has posed a great financial burden to the government and society. A PD-first policy has been implemented in Hong Kong for three decades based on its cost-effectiveness, and has achieved successful outcomes throughout the years. A successful PD-first policy requires medical expertise in PD, the support of dedicated staff and a well-designed patient training programme. Addressing patients' PD problems is the key to sustainability of the PD-first policy. In this article, we highlight three important groups of patients: those with frequent peritonitis, ultrafiltration failure or inadequate dialysis. Potential strategies to improve the outcomes of these groups will be discussed. Moreover, enhancing HD as back-up support and promoting organ transplantation are needed in order to maintain sustainability of the PD-first policy. © 2015 S. Karger AG, Basel.

A Sustainable Outsourcing Strategy Regarding Cost, Capacity Flexibility, and Risk in a Textile Supply Chain

Directory of Open Access Journals (Sweden)

Shaheen Sardar

2016-03-01

Full Text Available The textile industry achieves economic benefits through outsourcing to low cost markets. Today, reshoring is an emerging trend due to rising cost and unemployment concerns. This problem is primarily due to an industry-wide focus on economic benefits only. Cost saving is a basic reason for international outsourcing while domestic outsourcing provides capacity flexibility. Moreover, outsourcing risk has a major impact on strategic location of the production destinations. Therefore, the merging of capacity flexibility and outsourcing risk comprises a sustainable outsourcing strategy. This paper suggests a sustainable outsourcing strategy in which a textile manufacturer outsources to international markets for cost savings and outsources to the domestic market for capacity flexibility. The manufacturer reserves some capacity with domestic suppliers, and pays a unit penalty cost if this capacity flexibility is not utilized. The manufacturer seeks minimum risk in international markets. Operational cost, penalty cost, and outsourcing risk are considered to be objective functions. Decisions include the assignment of contracts to suitable facilities, the quantity of each contract, and allocation of reserved capacity flexibility among domestic suppliers. Multi-objective problem of this research was solved using three variants of goal programming. Several insights are proposed for outsourcing decision making in the current global environment.

The cost and cost-effectiveness of childhood cancer treatment in El Salvador, Central America: A report from the Childhood Cancer 2030 Network.

Science.gov (United States)

Fuentes-Alabi, Soad; Bhakta, Nickhill; Vasquez, Roberto Franklin; Gupta, Sumit; Horton, Susan E

2018-01-15

Although previous studies have examined the cost of treating individual childhood cancers in low-income and middle-income countries, to the authors' knowledge none has examined the overall cost and cost-effectiveness of operating a childhood cancer treatment center. Herein, the authors examined the cost and sources of financing of a pediatric cancer unit in Hospital Nacional de Ninos Benjamin Bloom in El Salvador, and make estimates of cost-effectiveness. Administrative data regarding costs and volumes of inputs were obtained for 2016 for the pediatric cancer unit. Similar cost and volume data were obtained for shared medical services provided centrally (eg, blood bank). Costs of central nonmedical support services (eg, utilities) were obtained from hospital data and attributed by inpatient share. Administrative data also were used for sources of financing. Cost-effectiveness was estimated based on the number of new patients diagnosed annually and survival rates. The pediatric cancer unit cost $5.2 million to operate in 2016 (treating 90 outpatients per day and experiencing 1385 inpatient stays per year). Approximately three-quarters of the cost (74.7%) was attributed to 4 items: personnel (21.6%), pathological diagnosis (11.5%), pharmacy (chemotherapy, supportive care medications, and nutrition; 31.8%), and blood products (9.8%). Funding sources included government (52.5%), charitable foundations (44.2%), and a social security contribution scheme (3.4%). Based on 181 new patients per year and a 5-year survival rate of 48.5%, the cost per disability-adjusted life-year averted was $1624, which is under the threshold considered to be very cost effective. Treating childhood cancer in a specialized unit in low-income and middle-income countries can be done cost-effectively. Strong support from charitable foundations aids with affordability. Cancer 2018;124:391-7. © 2017 American Cancer Society. © 2017 American Cancer Society.

The nitrogen cost of food production: Norwegian society

Energy Technology Data Exchange (ETDEWEB)

Azzaroli Bleken, M. [Agricultural Univ. of Norway, Aas (Norway). Dept. of Horticulture and Crop Sciences; Bakken, L.R. [Agricultural Univ. of Norway, Aas (Norway). Dept. of Soil and Water Sciences

1997-05-01

The N-enrichment of the biosphere due to human activities has potential global consequences in enhancing cumulatively, the emission of N{sub 2}O to the atmosphere. This aspect of nitrogen pollution demands a global analysis of the `human nitrogen cycle`. We have used Norway as an example to analyze the nitrogen flows within a society and the dissipation of N to the environment. The present paper concentrates on the food producing sector, which was found to represent the largest N-flow and had the most complex interferences within the nitrogen cycle. The edible products that reach the consumers` mouths account for around 10% of the total N inputs at the primary (plant) production level. The largest N-dissipation occurs in plant production, but the performance of the society as a whole is largely determined by the human diet. The N-cost, defined as the ratio between fertilizer N-input (including animal manure) and the N products, is around 3 for wheat, 14 for dairy products and 21 for meat. The analysis of different mitigation options also reveal the importance of recycling at the highest possible trophic level. Major reductions in the total consumption of N can be obtained by moderate changes towards a more vegetarian diet and better utilization of existing food. In contrast, recycling of waste at the lowest trophic level (compost) is very inefficient. 43 refs, 2 figs, 5 tabs

Supply chain management with cost-containment & financial-sustainability in a tertiary care hospital.

Science.gov (United States)

Chandra, Hem; Rinkoo, Arvind Vashishta; Verma, Jitendra Kumar; Verma, Shuchita; Kapoor, Rakesh; Sharma, R K

2013-01-01

Financial crunch in the present recession results in the non-availability of the right materials at the right time in large hospitals. However due to insufficient impetus towards systems development, situation remains dismal even when funds are galore. Cost incurred on materials account for approximately one-third of the total recurring expenditures in hospitals. Systems development for effective and efficient materials management is thus tantamount to cost-containment and sustainability. This scientific paper describes an innovative model, Hospital Revolving Fund (HRF), developed at a tertiary care research institute in Asia. The main idea behind inception of HRF was to ensure availability of all supplies in the hospital so that the quality of healthcare delivery was not affected. The model was conceptualized in the background of non-availability of consumables in the hospital leading to patient as well as staff dissatisfaction. Hospital supplies have been divided into two parts, approximately 3250 unit items and 1750 miscellaneous items. This division is based on cost, relative-utility and case-specific utilization. 0.1 Million USD, separated from non-planned budget, was initially used as seed money in 1998. HRF procures supplies from reputed firms on concessional rates (8-25%) and make them available to patients at much lesser rates vis-à-vis market rates, levying minimal maintenance charges. In 2009-10, total annual purchases of 14 Million USD were made. The balance sheet reflected 1.4 Million USD as fixed deposit investment. The minimal maintenance charges levied on the patients along with the interest income were sufficient to pay for all recurring expenses related to HRF. Even after these expenses, HRF boosted of 0.2 Million USD as cash-in-hand in financial year 2009-10. In-depth analysis of 'balance sheet' and 'Income and Expenditure' statement of the fund for last five financial years affirms that HRF is a self-sustainable and viable supply chain

Sustainability or profitability?

Energy Technology Data Exchange (ETDEWEB)

Khennas, Smail; Doig, Alsion [Intermediate Technology, Bourton on Dunsmore, Rugby (United Kingdom)

1999-10-01

For small rural communities off-grid, micro-hydro power is often the most cost-effective means of providing electricity. Whether the electricity should be provided without cost to the beneficiaries or whether it should be paid for are the points under discussion. Details of cost and technology of schemes in both Nepal and Sri Lanka show that micro hydro can be sustainable in small isolated communities. (UK)

Flexible embedded circuitry : a novel process for high density, cost effective electronics

NARCIS (Netherlands)

Brand, van den J.; Kusters, R.; Barink, M.; Dietzel, A.H.

2010-01-01

Flexible electronics are starting to emerge with all-printed but also hybrid cost effective, smart electronic products that will find a wide range of applications in large quantities in our society. Such products have to be built on low cost substrate materials like PEN or PET foils. Because of the

International Partnerships for Sustainable Societies | IDRC ...

International Development Research Centre (IDRC) Digital Library (Canada)

... we face opportunities and challenges with multiple social, economic, environmental, ... These collaborations are producing high-quality research to inform academic, public, and policy debates in ways that can help create just, inclusive, and sustainable social and economic development. ... Careers · Contact Us · Site map.

Agroecology and Sustainable Agriculture

Directory of Open Access Journals (Sweden)

Fabio Caporali

Full Text Available In the framework of the 16th National Meeting of the Italian Ecological Society (“Global Change, Ecological Diversity and Sustainability”, University of Tuscia, Viterbo, 19-22 September 2006, a symposium was devoted to “Agroecology and Sustainable Development”. A major goal of this symposium was to contribute to keeping the dialogue among the experts of the various disciplines alive. Sustainability of agriculture is a challenge for society world wide. Universities and society as a whole have a responsibility in re-examining current perception of nature, of the world and of human society in the light of natural resources depletion, increasing pollution and social inequalities. The urgency to address sustainability issues is increasingly being reflected in the manner in which institutions of higher education around the world are giving priority to the teaching, research and practice of sustainability. The University of Tuscia is involved in international initiatives concerning teaching and research in Agroecology and Sustainable Agriculture.

Cost-effectiveness of active transport for primary school children - Walking School Bus program

Directory of Open Access Journals (Sweden)

Swinburn Boyd

2009-09-01

Full Text Available Abstract Background To assess from a societal perspective the incremental cost-effectiveness of the Walking School Bus (WSB program for Australian primary school children as an obesity prevention measure. The intervention was modelled as part of the ACE-Obesity study, which evaluated, using consistent methods, thirteen interventions targeting unhealthy weight gain in Australian children and adolescents. Methods A logic pathway was used to model the effects on body mass index [BMI] and disability-adjusted life years [DALYs] of the Victorian WSB program if applied throughout Australia. Cost offsets and DALY benefits were modelled until the eligible cohort reached 100 years of age or death. The reference year was 2001. Second stage filter criteria ('equity', 'strength of evidence', 'acceptability', feasibility', sustainability' and 'side-effects' were assessed to incorporate additional factors that impact on resource allocation decisions. Results The modelled intervention reached 7,840 children aged 5 to 7 years and cost $AUD22.8M ($16.6M; $30.9M. This resulted in an incremental saving of 30 DALYs (7:104 and a net cost per DALY saved of $AUD0.76M ($0.23M; $3.32M. The evidence base was judged as 'weak' as there are no data available documenting the increase in the number of children walking due to the intervention. The high costs of the current approach may limit sustainability. Conclusion Under current modelling assumptions, the WSB program is not an effective or cost-effective measure to reduce childhood obesity. The attribution of some costs to non-obesity objectives (reduced traffic congestion and air pollution etc. is justified to emphasise the other possible benefits. The program's cost-effectiveness would be improved by more comprehensive implementation within current infrastructure arrangements. The importance of active transport to school suggests that improvements in WSB or its variants need to be developed and fully evaluated.

Cost-effectiveness of active transport for primary school children - Walking School Bus program.

Science.gov (United States)

Moodie, Marjory; Haby, Michelle; Galvin, Leah; Swinburn, Boyd; Carter, Robert

2009-09-14

To assess from a societal perspective the incremental cost-effectiveness of the Walking School Bus (WSB) program for Australian primary school children as an obesity prevention measure. The intervention was modelled as part of the ACE-Obesity study, which evaluated, using consistent methods, thirteen interventions targeting unhealthy weight gain in Australian children and adolescents. A logic pathway was used to model the effects on body mass index [BMI] and disability-adjusted life years [DALYs] of the Victorian WSB program if applied throughout Australia. Cost offsets and DALY benefits were modelled until the eligible cohort reached 100 years of age or death. The reference year was 2001. Second stage filter criteria ('equity', 'strength of evidence', 'acceptability', feasibility', sustainability' and 'side-effects') were assessed to incorporate additional factors that impact on resource allocation decisions. The modelled intervention reached 7,840 children aged 5 to 7 years and cost $AUD22.8M ($16.6M; $30.9M). This resulted in an incremental saving of 30 DALYs (7:104) and a net cost per DALY saved of $AUD0.76M ($0.23M; $3.32M). The evidence base was judged as 'weak' as there are no data available documenting the increase in the number of children walking due to the intervention. The high costs of the current approach may limit sustainability. Under current modelling assumptions, the WSB program is not an effective or cost-effective measure to reduce childhood obesity. The attribution of some costs to non-obesity objectives (reduced traffic congestion and air pollution etc.) is justified to emphasise the other possible benefits. The program's cost-effectiveness would be improved by more comprehensive implementation within current infrastructure arrangements. The importance of active transport to school suggests that improvements in WSB or its variants need to be developed and fully evaluated.

Nuclear power and sustainable development

International Nuclear Information System (INIS)

Sandklef, S.

2000-01-01

Nuclear Power is a new, innovative technology for energy production, seen in the longer historic perspective. Nuclear technology has a large potential for further development and use in new applications. To achieve this potential the industry needs to develop the arguments to convince policy makers and the general public that nuclear power is a real alternative as part of a sustainable energy system. This paper examines the basic concept of sustainable development and gives a quality review of the most important factors and requirements, which have to be met to quality nuclear power as sustainable. This paper intends to demonstrate that it is not only in minimising greenhouse gas emissions that nuclear power is a sustainable technology, also with respect to land use, fuel availability waste disposal, recycling and use of limited economic resources arguments can be developed in favour of nuclear power as a long term sustainable technology. It is demonstrated that nuclear power is in all aspects a sustainable technology, which could serve in the long term with minimal environmental effects and at minimum costs to the society. And the challenge can be met. But to achieve need political leadership is needed, to support and develop the institutional and legal framework that is the basis for a stable and long-term energy policy. Industry leaders are needed as well to stand up for nuclear power, to create a new industry culture of openness and communication with the public that is necessary to get the public acceptance that we have failed to do so far. The basic facts are all in favour of nuclear power and they should be used

Methodologies for local development in smart society

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Lorena BĂTĂGAN

2012-07-01

Full Text Available All of digital devices which are connected through the Internet, are producing a big quantity of data. All this information can be turned into knowledge because we now have the computational power and solutions for advanced analytics to make sense of it. With this knowledge, cities could reduce costs, cut waste, and improve efficiency, productivity and quality of life for their citizens. The efficient/smart cities are characterized by more importance given to environment, resources, globalization and sustainable development. This paper represents a study on the methodologies for urban development that become the central element to our society.

Sustainable Deforestation Evaluation Model and System Dynamics Analysis

Science.gov (United States)

Feng, Huirong; Lim, C. W.; Chen, Liqun; Zhou, Xinnian; Zhou, Chengjun; Lin, Yi

2014-01-01

The current study used the improved fuzzy analytic hierarchy process to construct a sustainable deforestation development evaluation system and evaluation model, which has refined a diversified system to evaluate the theory of sustainable deforestation development. Leveraging the visual image of the system dynamics causal and power flow diagram, we illustrated here that sustainable forestry development is a complex system that encompasses the interaction and dynamic development of ecology, economy, and society and has reflected the time dynamic effect of sustainable forestry development from the three combined effects. We compared experimental programs to prove the direct and indirect impacts of the ecological, economic, and social effects of the corresponding deforest techniques and fully reflected the importance of developing scientific and rational ecological harvesting and transportation technologies. Experimental and theoretical results illustrated that light cableway skidding is an ecoskidding method that is beneficial for the sustainable development of resources, the environment, the economy, and society and forecasted the broad potential applications of light cableway skidding in timber production technology. Furthermore, we discussed the sustainable development countermeasures of forest ecosystems from the aspects of causality, interaction, and harmony. PMID:25254225

Sustainable deforestation evaluation model and system dynamics analysis.

Science.gov (United States)

Feng, Huirong; Lim, C W; Chen, Liqun; Zhou, Xinnian; Zhou, Chengjun; Lin, Yi

2014-01-01

The current study used the improved fuzzy analytic hierarchy process to construct a sustainable deforestation development evaluation system and evaluation model, which has refined a diversified system to evaluate the theory of sustainable deforestation development. Leveraging the visual image of the system dynamics causal and power flow diagram, we illustrated here that sustainable forestry development is a complex system that encompasses the interaction and dynamic development of ecology, economy, and society and has reflected the time dynamic effect of sustainable forestry development from the three combined effects. We compared experimental programs to prove the direct and indirect impacts of the ecological, economic, and social effects of the corresponding deforest techniques and fully reflected the importance of developing scientific and rational ecological harvesting and transportation technologies. Experimental and theoretical results illustrated that light cableway skidding is an ecoskidding method that is beneficial for the sustainable development of resources, the environment, the economy, and society and forecasted the broad potential applications of light cableway skidding in timber production technology. Furthermore, we discussed the sustainable development countermeasures of forest ecosystems from the aspects of causality, interaction, and harmony.

Sustainable Deforestation Evaluation Model and System Dynamics Analysis

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Huirong Feng

2014-01-01

Full Text Available The current study used the improved fuzzy analytic hierarchy process to construct a sustainable deforestation development evaluation system and evaluation model, which has refined a diversified system to evaluate the theory of sustainable deforestation development. Leveraging the visual image of the system dynamics causal and power flow diagram, we illustrated here that sustainable forestry development is a complex system that encompasses the interaction and dynamic development of ecology, economy, and society and has reflected the time dynamic effect of sustainable forestry development from the three combined effects. We compared experimental programs to prove the direct and indirect impacts of the ecological, economic, and social effects of the corresponding deforest techniques and fully reflected the importance of developing scientific and rational ecological harvesting and transportation technologies. Experimental and theoretical results illustrated that light cableway skidding is an ecoskidding method that is beneficial for the sustainable development of resources, the environment, the economy, and society and forecasted the broad potential applications of light cableway skidding in timber production technology. Furthermore, we discussed the sustainable development countermeasures of forest ecosystems from the aspects of causality, interaction, and harmony.

The Reputation Crisis: Risk Management Based Logical Framework to the Corporate Sustainability

OpenAIRE

Yilmaz, Ayse Kucuk; Kucuk, Ferziye

2010-01-01

Risk is a constituent part of both the business and the society in which we survive. Reputation is valuable assest for corporates in sustainable way. Integrating risk management with strategy-setting, such as an enterprise risk management (ERM) approach, helps an organization manage its risks to protect and enhance enterprise value in three ways. First, it helps to establish sustainable competitive advantage. Second, it optimizes the cost of managing risk. Third, it helps management improve b...

A cost-effect analysis of an intervention against radon in homes

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Hein Stigum

2009-10-01

Full Text Available Background  Key words  : Radon exposure, lung cancer, cost-effect analysis, attributable risk, models-mathematical: Radon is a radioactive gas that may leak into buildings from the ground. Radon exposure is a risk factor for lung cancer. An intervention against radon exposure in homes may consist of locating homes with high radon exposure (above 200 Bq m-3 and improving these, and of protecting future houses. The purpose of this paper is to calculate the costs and the effects of this intervention. Methods: We performed a cost-effect analysis from the perspective of the society, followed by an uncertainty and sensitivity analysis. The distribution of radon levels in Norwegian homes is lognormal with mean=74.5 Bq/m3, and 7.6% above 200 Bq/m3. Results: The preventable attributable fraction of radon on lung cancer was 3.8% (95% uncertainty interval: 0.6%, 8.3%. In cumulative present values the intervention would cost $238 (145, 310 million and save 892 (133, 1981 lives, each life saved costs $0.27 (0.09, 0.9 million. The cost-effect ratio was sensitive to the radon risk, the radon exposure distribution, and the latency period of lung cancer. Together these three parameters explained 90% of the variation in the cost-effect ratio. Conclusions: Reducing the radon concentration in present and future homes to below 200 Bq/m3 will cost $0.27 (0.09, 0.9 million per life saved. The uncertainty in the estimated cost per life is large, mainly due to uncertainty in the risk of lung cancer from radon. Based on estimates from road construction, the Norwegian society has been willing to pay $1 million to save a life. We therefore conclude that the intervention against radon in homes is justifiable. The willingness to pay is also larger that the upper uncertainty limit of the cost per life. Our conclusion is therefore robust against the uncertainties in the parameters.

Cost-effectiveness analysis of anidulafungin for the treatment of candidaemia and other forms of invasive candidiasis.

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Auzinger, Georg; Playford, E Geoffrey; Graham, Christopher N; Knox, Hediyyih N; Weinstein, David; Kantecki, Michal; Schlamm, Haran; Charbonneau, Claudie

2015-10-26

Candidaemia and other forms of invasive candidiasis (C/IC) in the intensive care unit are challenging conditions that are associated with high rates of mortality. New guidelines from the European Society for Clinical Microbiology and Infectious Diseases strongly recommend echinocandins for the first-line treatment of C/IC. Here, a cost-effectiveness model was developed from the United Kingdom perspective to examine the costs and outcomes of antifungal treatment for C/IC based on the European Society for Clinical Microbiology and Infectious Diseases guidelines. Costs and treatment outcomes with the echinocandin anidulafungin were compared with those for caspofungin, micafungin and fluconazole. The model included non-neutropenic patients aged ≥16 years with confirmed C/IC who were receiving intravenous first-line treatment. Patients were categorised as either a clinical success or failure (patients with persistent/breakthrough infection); successfully treated patients switched to oral therapy, while patients categorised as clinical failures switched to a different antifungal class. Other inputs were all-cause mortality at 6 weeks, costs of treatment-related adverse events and other medical resource utilisation costs. Resource use was derived from the published literature and from discussion with clinical experts. Drug-acquisition/administration costs were taken from standard United Kingdom costing sources. The model indicated that first-line anidulafungin could be considered cost-effective versus fluconazole (incremental cost-effectiveness ratio £813 per life-year gained) for the treatment of C/IC. Anidulafungin was cost-saving versus caspofungin and micafungin due to lower total costs and a higher rate of survival combined with a higher probability of clinical success. European Society for Clinical Microbiology and Infectious Diseases guidelines recommend echinocandins for the first-line treatment of C/IC; our model indicated that anidulafungin marries clinical

Sustainable Technologies and Social Costs for Eliminating Contamination of an Aquifer

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Mario Schirmer

2010-07-01

Full Text Available This case study deals with long-term contamination of the Leuna aquifer, which is intended to be restored using sustainable technologies financed by the state. The contamination can only be solved using active rather than passive intervention, because the aquifer has an extraordinarily low natural attenuation capacity for the specific pollutants. Due to the longevity of the contamination source, the groundwater treatment technology that was chosen for the site must operate for a minimum of 20 years but probably much longer. Since the polluter-pay principle cannot be applied, the estimated dynamic primary remediation costs must be accepted as a political or social cost, which must be paid by current and future generations.

The contribution of the European Society for Soil Conservation (ESSC) to scientific knowledge, education and sustainability

Science.gov (United States)

Dazzi, Carmelo; Fullen, Michael A.; Costantini, Edoardo A. C.; Theocharopoulos, Sid; Rickson, Jane; Kasparinskis, Raimonds; Lo Papa, Giuseppe; Peres, Guenola; Sholten, Thomas; Kertész, Adam; Vasenev, Ivan; Dumitru, Mihail; Cornelis, Wim; Rubio, José L.

2017-04-01

Soil is an integral component of the global environmental system that supports the quality and diversity of terrestrial life on Earth. Therefore, it is vital to consider the processes and impacts of soil degradation on society, especially on the provision of environmental goods and services, including food security and climate change mitigation and adaptation. Scientific societies devoted to Soil Science play significant roles in promoting soil security by advancing scientific knowledge, education and environmental sustainability. The European Society for Soil Conservation (ESSC) was founded in Ghent (Belgium) on 4 November 1988 by a group of 23 researchers from several European countries. It is an interdisciplinary, non-political association with over 500 members in 56 countries. The ESSC produces and distributes a hardcopy Newsletter twice a year and maintains both a website and Facebook page: http://www.soilconservation.eu/ https://www.facebook.com/European-Society-for-Soil-Conservation-ESSC-100528363448094/ The ESSC aims to: • Support research on soil degradation, soil protection and soil and water conservation. • Provide a network for the exchange of knowledge about soil degradation processes and soil conservation research and practises. • Produce publications on major issues relating to soil degradation and soil and water conservation. • Advise regulators and policy-makers on soil issues, especially soil degradation, protection and conservation. The ESSC held its First International Congress in Silsoe (UK) in 1992. Further International Congresses were held in Munich (1996), Valencia (2000), Budapest (2004), Palermo (2007), Thessaloniki (2011) and Moscow (2015). The Eighth International Congress will be held in Lleida (Spain) in June 2017: http://www.consowalleida2017.com/ Interspersed between these international congresses, the ESSC organizes annual international conferences on specific topics. These include Imola, Italy (Biogeochemical Processes at

The impact of common mental and physical health conditions on days out of role: costs for the individual and society.

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Corina Benjet

2013-05-01

Full Text Available Objective. To estimate the individual and societal costs of common mental and physical health conditions in the Mexican population with regards to the number of days out of role. Materials and methods. 5 826 adults were evaluated in 2001-2002 with the Composite International Diagnostic Interview and the WHO Disability Assessment Schedule. General linear models were used to estimate individuallevel effects. Societal-level effects were estimated with the population attributable risk proportion which takes into account prevalence and comorbidity of disorders. Results. The conditions with the strongest individual-level effects were major depression, post-traumatic stress disorder and bipolar disorder. The strongest societal-level effects were associated with major depression, pain, insomnia and cardiovascular conditions. Conclusion. The findings suggest the importance of investing in mental health expenditure to a level commensurate with the costs to society of mental health disorders.

Costs of reducing water use of concentrating solar power to sustainable levels: Scenarios for North Africa

International Nuclear Information System (INIS)

Damerau, Kerstin; Williges, Keith; Patt, Anthony G.; Gauche, Paul

2011-01-01

Concentrating solar power (CSP) has the potential to become a leading sustainable energy technology for the European electricity system. In order to reach a substantial share in the energy mix, European investment in CSP appears most profitable in North Africa, where solar potential is significantly higher than in southern Europe. As well as sufficient solar irradiance, however, the majority of today's CSP plants also require a considerable amount of water, primarily for cooling purposes. In this paper we examine water usage associated with CSP in North Africa, and the cost penalties associated with technologies that could reduce those needs. We inspect four representative sites to compare the ecological and economical drawbacks from conventional and alternative cooling systems, depending on the local environment, and including an outlook with climate change to the mid-century. Scaling our results up to a regional level indicates that the use of wet cooling technologies would likely be unsustainable. Dry cooling systems, as well as sourcing of alternative water supplies, would allow for sustainable operation. Their cost penalty would be minor compared to the variance in CSP costs due to different average solar irradiance values. - Highlights: → Scaling up CSP with wet cooling from ground water will be unsustainable in North Africa. → Desalination and alternative cooling systems can assure a sustainable water supply. → On large-scale, the cost penalties of alternative cooling technologies appear minor.

Digital sustainability: basic conditions for sustainable digital artifacts and their ecosystems

OpenAIRE

Stürmer, Matthias; Abu-Tayeh, Gabriel; Myrach, Thomas

2017-01-01

The modern age has heralded a shift from the industrial society, in which natural resources are crucial input factors for the economy, towards a knowledge society. To date, sustainability literature has treated knowledge—and in particular digital artifacts—mainly as a means to the end of achieving sustainable development. In this conceptual paper, we argue that digital artifacts themselves ought also to be considered as resources, which also need to be sustainable. While over-consumption is a...

Determining a sustainable and economically optimal wastewater treatment and discharge strategy.

Science.gov (United States)

Hardisty, Paul E; Sivapalan, Mayuran; Humphries, Robert

2013-01-15

Options for treatment and discharge of wastewater in regional Western Australia (WA) are examined from the perspective of overall sustainability and social net benefit. Current practice in the state has typically involved a basic standard of treatment deemed to be protective of human health, followed by discharge to surface water bodies. Community and regulatory pressure to move to higher standards of treatment is based on the presumption that a higher standard of treatment is more protective of the environment and society, and thus is more sustainable. This analysis tests that hypothesis for Western Australian conditions. The merits of various wastewater treatment and discharge strategies are examined by quantifying financial costs (capital and operations), and by monetising the wider environmental and social costs and benefits of each option over an expanded planning horizon (30 years). Six technical treatment-disposal options were assessed at a test site, all of which met the fundamental criterion of protecting human health. From a financial perspective, the current business-as-usual option is preferred - it is the least cost solution. However, valuing externalities such as water, greenhouse gases, ecological impacts and community amenity, the status quo is revealed as sub-optimal. Advanced secondary treatment with stream disposal improves water quality and provides overall net benefit to society. All of the other options were net present value (NPV) negative. Sensitivity analysis shows that the favoured option outperforms all of the others under a wide range of financial and externality values and assumptions. Expanding the findings across the state reveals that moving from the identified socially optimal level of treatment to higher (tertiary) levels of treatment would result in a net loss to society equivalent to several hundred million dollars. In other words, everyone benefits from improving treatment to the optimum point. But society, the environment, and

I Evolution of Environmental Costs Discolsur: A Study in Cellulose and Paper Companies - Members of Corporate Sustainability Index - CSI

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Daniel Fonseca

2016-07-01

Full Text Available This research aimed to analyse, in relation to previous studies, the evolution of classification and disclosure of environmental costs on cellulose and paper companies listed on the CSI. The research, of a descriptive, documentary and qualitative nature, was based on content analysis of financial statements, accompanying notes, management reports and sustainability reports in the fiscal years 2010 to 2014. The results indicate that companies show environmental costs mainly in a qualitative way and of the positive type. The most part of this information is contained in the sustainability report. As to the classification, the highlighted environmental costs are of these types, (a prevention costs; (b internal failure costs; (c indirect costs; (d internal costs; (e costs for contingencies; (f potentially hidden costs; (g image and relationship costs, though not by these names. These results demonstrate a change, compared to previous studies on the quality and quantity of disclosure of environmental costs. It is suggested for future research the broadening of samples for other organizational activity sectors, with the aim of possible understanding of the Brazilian environment.

Nuclear fuel: sustainable source of energy or burden on society?

International Nuclear Information System (INIS)

Williams, T.; Klaiber, G.

2007-01-01

In the past, the question concerning the sustainability of a resource primarily addressed its finite nature. Accordingly, electricity production using renewable energies was clearly sustainable. Contrasting this are systems based on oil, gas, coal or uranium. However, from the perspective of 'neo-sustainability' being analyzed today, this assessment appears less clear-cut, especially in light of the definition of sustainability as provided by the Brundtland report. Nowadays, the depletion time of fuel resources is thus not the only significant aspect, but factors such as efficiency, ecofriendliness and social responsibility also figure in. The nuclear fuel supply is analyzed from a sustainability perspective. After a short description of the supply chain, each of the most important aspects of sustainability are related to the individual stages of the supply chain and evaluated. This method aims at answering the question concerning to what extent nuclear fuel is a sustainable source of energy. Although the recycling of fissile materials from reprocessing and the deployment of advanced reactors are key factors as regards the issue of sustainability, these topics are deliberately only touched on. The main focus lies on the sustainability of the nuclear fuel cycle as it is currently utilized in light water reactors, without discussing the subject of reprocessing. (orig.)

INFORMATION SOCIETY AND FINANCIAL SUSTAINABILITY OF THE ROMANIAN HEALTH SYSTEM

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TATIANA BOGDAN

2016-06-01

Full Text Available The financial sustainability of the health systems often reveals the ability of policy makers to finance healthcare in the face of growing cost pressures, with populations ageing, new technologies and increased patient expectations for healthcare coverage and quality. Thus, the healthcare systems need to reinvent themselves by using innovative financing mechanisms coupled with electronic information and communication systems, while offering greater transparency, flexibility and choice and increasing access to the services available. The paper analyses the healthcare financing models: the national health system, the social insurance or the private insurance model so that the Romanian health care reform should preserve the best elements of its existing system while selectively adapt techniques and processes that seemed to have been successful in other countries. Moreover, the application of information and communication technologies – eHealth offers new possibilities for improving almost every aspect of healthcare, from making medical systems more powerful and responsive to providing better health information to all.

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.

Cost Accounting as a Possible Solution for Financial Sustainability of Croatian Public Hospitals

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Ivana Dražić Lutilsky

2016-12-01

Full Text Available The purpose of this paper is to present the current usage of cost accounting methodology in Croatian public hospitals through conducted empirical research and to provide opinions of accountants and financial officers regarding possible implementation of cost accounting methodology in public hospitals. In the paper, the authors analyze the accounting system in Croatian public hospitals, identifying the flaws of the current accounting system with regard to the recording and allocation of costs. National healthcare systems of different European countries provide a theoretical background for the usage of accrual accounting basis and cost accounting methodologies, showing better governance and financial sustainability of public hospitals which have introduced cost accounting methodology. The conducted empirical research shows that accountants and financial officers believe that the healthcare system in Croatia is ready for a change in the current accounting system based on the modified accrual basis through the implementation of accrual accounting basis and full costing approach to cost allocation. Full costing approach is also known as activity-based accounting method for cost allocation. The authors also recommend some initial steps for implementation of the new cost accounting system in Croatian public hospitals.

Resilient Communities: From Sustainable to Secure

Science.gov (United States)

Bragdon, Clifford R.

2009-07-01

A sustainable biosphere is an absolute necessity to support the world's growing population, (now exceeding 6.2 billion persons), as civilization advances through the 21st century. Sustainability primarily refers to a bio-physical environment that is not a risk, which can provide the necessary support system for both plant and human habitat involving the earth's lithosphere, hydrosphere and atmosphere. However, that alone will not provide the necessary protection, since our human habitat must also be safe and secure. A more operable term should be resilient, rather than sustainable, since a climate positive community, with an on-site CO2 emission near zero, does not mean the population is protected from both natural and manmade disasters. Effective neoteric planning of our biosphere is necessary as it involves spatial, temporal, and sensory aspects of the community habitat. Two-dimensional planning that addresses just the surface (e.g., land), fails to be comprehensive, since both aerial and subsurface features are omitted. Effective neoteric planning of our biosphere is necessary as it involves spatial, temporal, and sensory aspects of the community habitat. Two-dimensional planning that addresses just the surface (e.g., land), is not comprehensive, since aerial and subsurface features are omitted. A three dimensional approach is needed, which involves the combination of the x, y and z axis, in order to be spatially accurate. Our personal transportation based mobility systems, along with its accompanying infrastructure, has resulted in a drive-thru society that is becoming supersized. Urban obesity in terms of modes of transport and today's living environment has resulted in McMansions and mega-vehicles have created an energy demand that if unchecked could create a carhenge by the year 3000. Infrastructure gridlock besides global warming is costing the world's economy, approximately 6% of the gross domestic product (GDP). Impaired global mobility which threatens

Flexibility of working hours in the 24-hour society.

Science.gov (United States)

Costa, G

2006-01-01

The 24-hour Society undergoes an ineluctable process towards a social organisation where time constraints are no more restricting human life. The borders between working and social times are no more fixed and rigidly determined, and the value of working time changes according to the different economic and social effects you may consider. Shift and night work, irregular and flexible working hours, together with new technologies, are the milestone of this epochal passage. What are the advantages and disadvantages for the individual, the companies, and the society? What is the cost/benefit ratio in terms of health and social well-being? Coping properly with this process means avoiding a passive acceptance of it with consequent maladjustments at both individual and social level, but adopting effective preventive and compensative strategies aimed at building up a more sustainable society. Flexible working times now appear to be one of the best ways to cope with the demands of the modern life, but there are different points of view about labour and temporal 'flexibility" between employers and employees. For the former it means a prompt adaptation to market demands and technological innovations; for the latter it is a way to improve working and social life, by decreasing work constraints and increasing control and autonomy. Although it can be easily speculated that individual-based 'flexibility" should improve health and well-being, and especially satisfaction, whereas company-based flexibility" might interfere negatively, the effective consequences on health and well-being have still to be analysed properly.

Cost effectiveness of regorafenib as second-line therapy for patients with advanced hepatocellular carcinoma.

Science.gov (United States)

Parikh, Neehar D; Singal, Amit G; Hutton, David W

2017-10-01

Regorafenib, a multikinase inhibitor, has demonstrated prolonged survival by 2.8 months as a second-line agent in patients with hepatocellular carcinoma (HCC) who progress on sorafenib therapy. The objective of the current study was to examine the cost effectiveness of regorafenib for the treatment of HCC. The authors constructed a Markov simulation model of patients with unresectable HCC and Child-Pugh A cirrhosis who received treatment with regorafenib versus best supportive care. Model inputs for regorafenib effectiveness and rates of adverse events in patients with HCC were based on published clinical trial data and literature review. Quality-adjusted life years (QALYs) were calculated along with the incremental cost-effectiveness ratio (ICER) of regorafenib therapy. One-way sensitivity analyses also were conducted simultaneously on all model parameters and on various Monte-Carlo simulation parameters, and the regorafenib cost threshold at which cost effectiveness would be achieved was determined. Regorafenib provided an increase of 0.18 QALYs at a cost of $47,112. The ICER for regorafenib, compared with best supportive care, was $224,362. In 1-way sensitivity analyses, there were no scenarios in which regorafenib was cost effective. In cost threshold analysis, regorafenib would have to be priced at or below $67 per pill to be cost effective at an ICER of $100,000. Regorafenib is not cost effective as a second-line agent in the treatment of HCC, with a marginal increase in QALYs at a high cost. Lowering the cost of regorafenib or improving the selection of patients who can achieve maximal survival benefit would improve its value as a second-line treatment option for patients with HCC. Cancer 2017;123:3725-3731. © 2017 American Cancer Society. © 2017 American Cancer Society.

Three necessary conditions for establishing effective Sustainable Development Goals in the Anthropocene

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Albert V. Norström

2014-09-01

Full Text Available The purpose of the United Nations-guided process to establish Sustainable Development Goals is to galvanize governments and civil society to rise to the interlinked environmental, societal, and economic challenges we face in the Anthropocene. We argue that the process of setting Sustainable Development Goals should take three key aspects into consideration. First, it should embrace an integrated social-ecological system perspective and acknowledge the key dynamics that such systems entail, including the role of ecosystems in sustaining human wellbeing, multiple cross-scale interactions, and uncertain thresholds. Second, the process needs to address trade-offs between the ambition of goals and the feasibility in reaching them, recognizing biophysical, social, and political constraints. Third, the goal-setting exercise and the management of goal implementation need to be guided by existing knowledge about the principles, dynamics, and constraints of social change processes at all scales, from the individual to the global. Combining these three aspects will increase the chances of establishing and achieving effective Sustainable Development Goals.

External Costs as Driving Forces of Land Use Changes

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Dirk Loehr

2010-04-01

Full Text Available Land conversion is often not carried out in a sustainable way. The loss of arable land and biodiversity, concern about food security and rising costs of infrastructure due to urban sprawl are just some of the problems under discussion. This paper compares Germany, China and Cambodia. The article points out that, despite huge differences in institutions and governance, unsustainable land use changes mostly have some patterns in common: The beneficiaries of land conversion are often well-organized actors, whereas the costs of land conversion are often shifted to poorly organized groups and to society as a whole. A sustainable land use policy has to look for a better coupling of benefits and costs of land use changes. In order to achieve this goal, the article suggests completing the planning law with a suitable economic framework.

Cost-effective conservation of an endangered frog under uncertainty.

Science.gov (United States)

Rose, Lucy E; Heard, Geoffrey W; Chee, Yung En; Wintle, Brendan A

2016-04-01

How should managers choose among conservation options when resources are scarce and there is uncertainty regarding the effectiveness of actions? Well-developed tools exist for prioritizing areas for one-time and binary actions (e.g., protect vs. not protect), but methods for prioritizing incremental or ongoing actions (such as habitat creation and maintenance) remain uncommon. We devised an approach that combines metapopulation viability and cost-effectiveness analyses to select among alternative conservation actions while accounting for uncertainty. In our study, cost-effectiveness is the ratio between the benefit of an action and its economic cost, where benefit is the change in metapopulation viability. We applied the approach to the case of the endangered growling grass frog (Litoria raniformis), which is threatened by urban development. We extended a Bayesian model to predict metapopulation viability under 9 urbanization and management scenarios and incorporated the full probability distribution of possible outcomes for each scenario into the cost-effectiveness analysis. This allowed us to discern between cost-effective alternatives that were robust to uncertainty and those with a relatively high risk of failure. We found a relatively high risk of extinction following urbanization if the only action was reservation of core habitat; habitat creation actions performed better than enhancement actions; and cost-effectiveness ranking changed depending on the consideration of uncertainty. Our results suggest that creation and maintenance of wetlands dedicated to L. raniformis is the only cost-effective action likely to result in a sufficiently low risk of extinction. To our knowledge we are the first study to use Bayesian metapopulation viability analysis to explicitly incorporate parametric and demographic uncertainty into a cost-effective evaluation of conservation actions. The approach offers guidance to decision makers aiming to achieve cost-effective

Assessing Cost-Effectiveness in Obesity (ACE-Obesity: an overview of the ACE approach, economic methods and cost results

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Swinburn Boyd

2009-11-01

Full Text Available Abstract Background The aim of the ACE-Obesity study was to determine the economic credentials of interventions which aim to prevent unhealthy weight gain in children and adolescents. We have reported elsewhere on the modelled effectiveness of 13 obesity prevention interventions in children. In this paper, we report on the cost results and associated methods together with the innovative approach to priority setting that underpins the ACE-Obesity study. Methods The Assessing Cost Effectiveness (ACE approach combines technical rigour with 'due process' to facilitate evidence-based policy analysis. Technical rigour was achieved through use of standardised evaluation methods, a research team that assembles best available evidence and extensive uncertainty analysis. Cost estimates were based on pathway analysis, with resource usage estimated for the interventions and their 'current practice' comparator, as well as associated cost offsets. Due process was achieved through involvement of stakeholders, consensus decisions informed by briefing papers and 2nd stage filter analysis that captures broader factors that influence policy judgements in addition to cost-effectiveness results. The 2nd stage filters agreed by stakeholders were 'equity', 'strength of the evidence', 'feasibility of implementation', 'acceptability to stakeholders', 'sustainability' and 'potential for side-effects'. Results The intervention costs varied considerably, both in absolute terms (from cost saving [6 interventions] to in excess of AUD50m per annum and when expressed as a 'cost per child' estimate (from Conclusion The use of consistent methods enables valid comparison of potential intervention costs and cost-offsets for each of the interventions. ACE-Obesity informs policy-makers about cost-effectiveness, health impact, affordability and 2nd stage filters for important options for preventing unhealthy weight gain in children. In related articles cost-effectiveness results and

The impact of sustainability criteria on the costs and potentials of bioenergy production. An exploration of the impact of the implementation of sustainability criteria on the costs and potential of bioenergy production, applied for case studies in Brazil and Ukraine

International Nuclear Information System (INIS)

Smeets, E.; Faaij, A.; Lewandowski, I.

2005-02-01

The goal of this study is to make a first attempt to analyse the impact on the potential (quantity) and the costs (per unit) of bioenergy that the compliance with various sustainability criteria brings along. The nature of this work is exploratory. Because of the broad set of issues covered very little work has been published on which we could build. Ukraine and Brazil are used as case studies, because both regions are identified as promising bioenergy producers. This study is part of the FAIR Biotrade project, which is aimed to identify and quantify the impact of sustainability criteria on the potential of bioenergy. Previous work includes an identification of sustainability criteria relevant for bioenergy, an assessment of the environmental and economic costs of long distance biotrade and an assessment of bioenergy production potentials in 2050 in various world regions. In section 2 the approach is presented which is used to select and quantify the impact of sustainability criteria on bioenergy production. In section 3 the selection of the various sustainability criteria is described in detail, followed by a detailed description of how the various socials, ecological and economical sustainability criteria are operationalised. In section 4 (intermediate) results are presented for each sustainability criterium. In section 5 final results are presented, followed by a discussion and by conclusions (section 6)

Cost Effectiveness of Screening Colonoscopy Depends on Adequate Bowel Preparation Rates - A Modeling Study.

Directory of Open Access Journals (Sweden)

James Kingsley

Full Text Available Inadequate bowel preparation during screening colonoscopy necessitates repeating colonoscopy. Studies suggest inadequate bowel preparation rates of 20-60%. This increases the cost of colonoscopy for our society.The aim of this study is to determine the impact of inadequate bowel preparation rate on the cost effectiveness of colonoscopy compared to other screening strategies for colorectal cancer (CRC.A microsimulation model of CRC screening strategies for the general population at average risk for CRC. The strategies include fecal immunochemistry test (FIT every year, colonoscopy every ten years, sigmoidoscopy every five years, or stool DNA test every 3 years. The screening could be performed at private practice offices, outpatient hospitals, and ambulatory surgical centers.At the current assumed inadequate bowel preparation rate of 25%, the cost of colonoscopy as a screening strategy is above society's willingness to pay (<$50,000/QALY. Threshold analysis demonstrated that an inadequate bowel preparation rate of 13% or less is necessary before colonoscopy is considered more cost effective than FIT. At inadequate bowel preparation rates of 25%, colonoscopy is still more cost effective compared to sigmoidoscopy and stool DNA test. Sensitivity analysis of all inputs adjusted by ±10% showed incremental cost effectiveness ratio values were influenced most by the specificity, adherence, and sensitivity of FIT and colonoscopy.Screening colonoscopy is not a cost effective strategy when compared with fecal immunochemical test, as long as the inadequate bowel preparation rate is greater than 13%.

Generating Sustainable Value from Open Data in a Sharing Society

DEFF Research Database (Denmark)

Jetzek, Thorhildur; Avital, Michel; Bjørn-Andersen, Niels

2014-01-01

Our societies are in the midst of a paradigm shift that transforms hierarchical markets into an open and networked economy based on digital technology and information. In that context, open data is widely presumed to have a positive effect on social, environmental and economic value; however...

Resolving the "Cost-Effective but Unaffordable" Paradox: Estimating the Health Opportunity Costs of Nonmarginal Budget Impacts.

Science.gov (United States)

Lomas, James; Claxton, Karl; Martin, Stephen; Soares, Marta

2018-03-01

Considering whether or not a proposed investment (an intervention, technology, or program of care) is affordable is really asking whether the benefits it offers are greater than its opportunity cost. To say that an investment is cost-effective but not affordable must mean that the (implicit or explicit) "threshold" used to judge cost-effectiveness does not reflect the scale and value of the opportunity costs. Existing empirical estimates of health opportunity costs are based on cross-sectional variation in expenditure and mortality outcomes by program budget categories (PBCs) and do not reflect the likely effect of nonmarginal budget impacts on health opportunity costs. The UK Department of Health regularly updates the needs-based target allocation of resources to local areas of the National Health Service (NHS), creating two subgroups of local areas (those under target allocation and those over). These data provide the opportunity to explore how the effects of changes in health care expenditure differ with available resources. We use 2008-2009 data to evaluate two econometric approaches to estimation and explore a range of criteria for accepting subgroup specific effects for differences in expenditure and outcome elasticities across the 23 PBCs. Our results indicate that health opportunity costs arising from an investment imposing net increases in expenditure are underestimated unless account is taken of likely nonmarginal effects. They also indicate the benefits (reduced health opportunity costs or increased value-based price of a technology) of being able to "smooth" these nonmarginal budget impacts by health care systems borrowing against future budgets or from manufacturers offering "mortgage" type arrangements. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Selecting cost-effective areas for restoration of ecosystem services.

Science.gov (United States)

Adame, M F; Hermoso, V; Perhans, K; Lovelock, C E; Herrera-Silveira, J A

2015-04-01

Selection of areas for restoration should be based on cost-effectiveness analysis to attain the maximum benefit with a limited budget and overcome the traditional ad hoc allocation of funds for restoration projects. Restoration projects need to be planned on the basis of ecological knowledge and economic and social constraints. We devised a novel approach for selecting cost-effective areas for restoration on the basis of biodiversity and potential provision of 3 ecosystem services: carbon storage, water depuration, and coastal protection. We used Marxan, a spatial prioritization tool, to balance the provision of ecosystem services against the cost of restoration. We tested this approach in a mangrove ecosystem in the Caribbean. Our approach efficiently selected restoration areas that at low cost were compatible with biodiversity targets and that maximized the provision of one or more ecosystem services. Choosing areas for restoration of mangroves on the basis carbon storage potential, largely guaranteed the restoration of biodiversity and other ecosystem services. © 2014 Society for Conservation Biology.

Civil Society

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Effectiveness, cost-effectiveness and cost-benefit of a single annual professional intervention for the prevention of childhood dental caries in a remote rural Indigenous community.

Science.gov (United States)

Lalloo, Ratilal; Kroon, Jeroen; Tut, Ohnmar; Kularatna, Sanjeewa; Jamieson, Lisa M; Wallace, Valda; Boase, Robyn; Fernando, Surani; Cadet-James, Yvonne; Scuffham, Paul A; Johnson, Newell W

2015-08-29

The aim of the study is to reduce the high prevalence of tooth decay in children in a remote, rural Indigenous community in Australia, by application of a single annual dental preventive intervention. The study seeks to (1) assess the effectiveness of an annual oral health preventive intervention in slowing the incidence of dental caries in children in this community, (2) identify the mediating role of known risk factors for dental caries and (3) assess the cost-effectiveness and cost-benefit of the intervention. The intervention is novel in that most dental preventive interventions require regular re-application, which is not possible in resource constrained communities. While tooth decay is preventable, self-care and healthy habits are lacking in these communities, placing more emphasis on health services to deliver an effective dental preventive intervention. Importantly, the study will assess cost-benefit and cost-effectiveness for broader implementation across similar communities in Australia and internationally. There is an urgent need to reduce the burden of dental decay in these communities, by implementing effective, cost-effective, feasible and sustainable dental prevention programs. Expected outcomes of this study include improved oral and general health of children within the community; an understanding of the costs associated with the intervention provided, and its comparison with the costs of allowing new lesions to develop, with associated treatment costs. Findings should be generalisable to similar communities around the world. The research is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR), registration number ACTRN12615000693527; date of registration: 3rd July 2015.

Striving for Economic and Political Sustainability

OpenAIRE

Rothman, Andy

2010-01-01

Hu Jintao, China’s president and Communist Party chief, is asking his government to abandon its 25-year-old policy of striving for the fastest possible economic growth, regardless of the costs to society and the environment. Instead, he wants China to balance sustainable growth with a programme to redress the many negative consequences of two decades of 9%-plus GDP growth. Although we do not expect Hu to fix China’s health care system or to deliver a clean and green environment in just five y...

Proceedings of the International Conferences on Internet Technologies & Society (ITS), Education Technologies (ICEduTECH), and Sustainability, Technology and Education (STE) (Melbourne, Australia, December 6-8, 2016)

Science.gov (United States)

Kommers, Piet, Ed.; Issa, Tomayess, Ed.; Issa, Theodora, Ed.; McKay, Elspeth, Ed.; Isias, Pedro, Ed.

2016-01-01

These proceedings contain the papers and posters of the International Conferences on Internet Technologies & Society (ITS 2016), Educational Technologies (ICEduTech 2016) and Sustainability, Technology and Education (STE 2016), which have been organised by the International Association for Development of the Information Society and…

The 1.5 kilowatt society: Towards a sustainable, equitable, and habitable world

International Nuclear Information System (INIS)

Duerr, H.P.

1998-01-01

Numerous tremblings around the globe painfully signal that the end of the Cold War has not carried mankind to the envisaged less troubled political and economical waters. The defects of the present industrial civilization present mankind today with a formidable challenge to fulfil successfully and simultaneously to reconcile three incompatible requirements: ecological sustainability; social sustainability; individual sustainability; energy resources, their abundance, accessibility and if scarce possible substitutions, or in case of renewable resources possibilities of their regeneration; environmentally and socially tolerable deposition of the non-recycled remnants of non-renewable fuels (safe removal of radioactive wastes in case of nuclear energy, and the release of carbondioxide in case of fossil fuels without climatic changes); appropriate limitation of local and global primary energy conversion because of the negative side effects of human energy applications, and in view of limited robustness of the earth's ecosystem

Trade off between costs and environmental effects of weed control on pavements

NARCIS (Netherlands)

Kempenaar, C.; Lotz, L.A.P.; Horst, van der C.L.M.; Beltman, W.H.J.; Leemans, K.J.M.; Bannink, A.D.

2007-01-01

An actor-participative project on sustainable weed control on pavements was started in 2000 in the Netherlands. The aim of the project was to develop a new concept of weed management that provides cost-effective and environmentally sound weed control. Early in 2002, practical guidelines were drawn

Relative Sustainability of Natural Gas Assisted High-Octane Gasoline Blendstock Production from Biomass

Energy Technology Data Exchange (ETDEWEB)

Tan, Eric C [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Zhang, Yi Min [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Cai, Hao [Argonne National Laboratory

2017-11-01

Biomass-derived hydrocarbon fuel technologies are being developed and pursued for better economy, environment, and society benefits underpinning the sustainability of transportation energy. Increasing availability and affordability of natural gas (NG) in the US can play an important role in assisting renewable fuel technology development, primarily in terms of economic feasibility. When a biorefinery is co-processing NG with biomass, the current low cost of NG coupled with the higher NG carbon conversion efficiency potentially allow for cost competitiveness of the fuel while achieving a minimum GHG emission reduction of 50 percent or higher compared to petroleum fuel. This study evaluates the relative sustainability of the production of high-octane gasoline blendstock via indirect liquefaction (IDL) of biomass (and with NG co-feed) through methanol/dimethyl ether intermediates. The sustainability metrics considered in this study include minimum fuel selling price (MFSP), carbon conversion efficiency, life cycle GHG emissions, life cycle water consumption, fossil energy return on investment (EROI), GHG emission avoidance cost, and job creation. Co-processing NG can evidently improve the MFSP. Evaluation of the relative sustainability can shed light on the biomass-NG synergistic impacts and sustainability trade-offs associated with the IDL as high-octane gasoline blendstock production.

The Sustainability Cycle and Loop: models for a more unified understanding of sustainability.

Science.gov (United States)

Hay, Laura; Duffy, Alex; Whitfield, R I

2014-01-15

In spite of the considerable research on sustainability, reports suggest that we are barely any closer to a more sustainable society. As such, there is an urgent need to improve the effectiveness of human efforts towards sustainability. A clearer and more unified understanding of sustainability among different people and sectors could help to facilitate this. This paper presents the results of an inductive literature investigation, aiming to develop models to explain the nature of sustainability in the Earth system, and how humans can effectively strive for it. The major contributions are two general and complementary models, that may be applied in any context to provide a common basis for understanding sustainability: the Sustainability Cycle (S-Cycle), and the Sustainability Loop (S-Loop). Literature spanning multiple sectors is examined from the perspective of three concepts, emerging as significant in relation to our aim. Systems are shown to provide the context for human action towards sustainability, and the nature of the Earth system and its sub-systems is explored. Activities are outlined as a fundamental target that humans need to sustain, since they produce the entities both needed and desired by society. The basic behaviour of activities operating in the Earth system is outlined. Finally, knowledge is positioned as the driver of human action towards sustainability, and the key components of knowledge involved are examined. The S-Cycle and S-Loop models are developed via a process of induction from the reviewed literature. The S-Cycle describes the operation of activities in a system from the perspective of sustainability. The sustainability of activities in a system depends upon the availability of resources, and the availability of resources depends upon the rate that activities consume and produce them. Humans may intervene in these dynamics via an iterative process of interpretation and action, described in the S-Loop model. The models are briefly

Sustainable collaboration : The impact of governance and institutions on sustainable performance

NARCIS (Netherlands)

Niesten, Eva; Jolink, Albert; Lopes de Sousa Jabbour, Ana Beatriz; Chappin, Maryse; Lozano, Rodrigo

2017-01-01

Collaboration between firms is important to stimulate the transition to a more sustainable society. This special volume shows that collaboration is indeed one of the preferred forms of governance to manage relations between firms in a sustainability context. Collaboration enhances sustainable

High-Level System Change: Protecting Business and Society

Directory of Open Access Journals (Sweden)

Frank Dixon

2017-10-01

Full Text Available Over the past 15 years, sustainability has become mainstream in the corporate and financial sectors. But environmental and social conditions are declining rapidly in many regions. Nearly all corporate and financial sector sustainability strategies are focused on company-level activities, such as unilaterally mitigating negative environmental and social impacts. But flawed economic and political systems make it impossible for businesses to mitigate about 80 percent of negative impacts. These impacts often return to harm companies, for example, in the form of market rejection, lawsuits and reputation damage. System change is the most important sustainability issue. Protecting business and society requires substantially shifting the focus of corporate sustainability strategies from company change to system change. A growing number of collaborative system change efforts are being implemented. Most focus on specific issues, sectors or system flaws. They frequently are ineffective because they do not use a whole system approach. All major aspects of human society are connected. Root causes, key leverage points and most effective solutions often lie outside of issue-specific areas. Climate change, economic reform and other complex issues can only be effectively addressed through a whole system approach. This paper summarizes important economic and political system flaws and describes a collaborative, whole system approach for engaging the corporate and financial sectors in system change.

Sustaining an Effective ABC-ABM System

Directory of Open Access Journals (Sweden)

Gary COKINS

2011-02-01

Full Text Available The purpose of this paper is to describe the Activity- Based Costing (ABC and Activity-Based Management (ABM system and techniques to sustain them as a permanent and repeatable production reporting system, not just for one-off analysis. A comparison is made between ABC/ABM modeling software that extracts source data and business systems that include ABC/ABM modeling features. There are presented the stages of updating, running and rerunning the ABC/ABM system. The resulting information calculated and provided by the ABC/ABM system are analyzed and interpreted in terms of a multidimensional data analysis. The article ends with the authors' conclusions about the benefits of continued operation of sustaining the ABC/ABM system.

Costing the Australian National Hand Hygiene Initiative.

Science.gov (United States)

Page, K; Barnett, A G; Campbell, M; Brain, D; Martin, E; Fulop, N; Graves, N

2014-11-01

The Australian National Hand Hygiene Initiative (NHHI) is a major patient safety programme co-ordinated by Hand Hygiene Australia (HHA) and funded by the Australian Commission for Safety and Quality in Health Care. The annual costs of running this programme need to be understood to know the cost-effectiveness of a decision to sustain it as part of health services. To estimate the annual health services cost of running the NHHI; the set-up costs are excluded. A health services perspective was adopted for the costing and collected data from the 50 largest public hospitals in Australia that implemented the initiative, covering all states and territories. The costs of HHA, the costs to the state-level infection-prevention groups, the costs incurred by each acute hospital, and the costs for additional alcohol-based hand rub are all included. The programme cost AU$5.56 million each year (US$5.76, £3.63 million). Most of the cost is incurred at the hospital level (65%) and arose from the extra time taken for auditing hand hygiene compliance and doing education and training. On average, each infection control practitioner spent 5h per week on the NHHI, and the running cost per annum to their hospital was approximately AU$120,000 in 2012 (US$124,000, £78,000). Good estimates of the total costs of this programme are fundamental to understanding the cost-effectiveness of implementing the NHHI. This paper reports transparent costing methods, and the results include their uncertainty. Copyright © 2014 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Costs of telaprevir-based triple therapy for hepatitis C: $189,000 per sustained virological response.

Science.gov (United States)

Bichoupan, Kian; Martel-Laferriere, Valerie; Sachs, David; Ng, Michel; Schonfeld, Emily A; Pappas, Alexis; Crismale, James; Stivala, Alicia; Khaitova, Viktoriya; Gardenier, Donald; Linderman, Michael; Perumalswami, Ponni V; Schiano, Thomas D; Odin, Joseph A; Liu, Lawrence; Moskowitz, Alan J; Dieterich, Douglas T; Branch, Andrea D

2014-10-01

In registration trials, triple therapy with telaprevir (TVR), pegylated interferon (Peg-IFN), and ribavirin (RBV) achieved sustained virological response (SVR) rates between 64% and 75%, but the clinical effectiveness and economic burdens of this treatment in real-world practice remain to be determined. Records of 147 patients who initiated TVR-based triple therapy at the Mount Sinai Medical Center (May-December 2011) were reviewed. Direct medical costs for pretreatment, on-treatment, and posttreatment care were calculated using data from Medicare reimbursement databases, RED Book, and the Healthcare Cost and Utilization Project database. Costs are presented in 2012 U.S. dollars. SVR (undetectable hepatitis C virus [HCV] RNA 24 weeks after the end of treatment) was determined on an intention-to-treat basis. Cost per SVR was calculated by dividing the median cost by the SVR rate. Median age of the 147 patients was 56 years (interquartile range [IQR] = 51-61), 68% were male, 19% were black, 11% had human immunodeficiency virus/HCV coinfection, 36% had advanced fibrosis/cirrhosis (FIB-4 scores ≥3.25), and 44% achieved an SVR. The total cost of care was $11.56 million. Median cost of care was $83,721 per patient (IQR = $66,652-$98,102). The median cost per SVR was $189,338 (IQR = $150,735-$221,860). Total costs were TVR (61%), IFN (24%), RBV (4%), adverse event management (8%), professional fees (2%), and laboratory tests (1%). TVR and Peg-IFN accounted for 85% of costs. Pharmaceutical prices and the low (44%) SVR rate, in this real-world study, were major contributors to the high cost per SVR. © 2014 by the American Association for the Study of Liver Diseases.

Cost-effectiveness analysis of mammography and clinical breast examination strategies

Science.gov (United States)

Ahern, Charlotte Hsieh; Shen, Yu

2009-01-01

Purpose Breast cancer screening by mammography and clinical breast exam are commonly used for early tumor detection. Previous cost-effectiveness studies considered mammography alone or did not account for all relevant costs. In this study, we assessed the cost-effectiveness of screening schedules recommended by three major cancer organizations and compared them with alternative strategies. We considered costs of screening examinations, subsequent work-up, biopsy, and treatment interventions after diagnosis. Methods We used a microsimulation model to generate women’s life histories, and assessed screening and treatment impacts on survival. Using statistical models, we accounted for age-specific incidence, preclinical disease duration, and age-specific sensitivity and specificity for each screening modality. The outcomes of interest were quality-adjusted life years (QALYs) saved and total costs with a 3% annual discount rate. Incremental cost-effectiveness ratios were used to compare strategies. Sensitivity analyses were performed by varying some of the assumptions. Results Compared to guidelines from the National Cancer Institute and the U.S. Preventive Services Task Force, alternative strategies were more efficient. Mammography and clinical breast exam in alternating years from ages 40 to 79 was a cost-effective alternative compared to the guidelines, costing $35,500 per QALY saved compared with no screening. The American Cancer Society guideline was the most effective and the most expensive, costing over $680,000 for an added QALY compared to the above alternative. Conclusion Screening strategies with lower costs and benefits comparable to those currently recommended should be considered for implementation in practice and for future guidelines. PMID:19258473

Teaching sustainability to a broad audience through an entertainment game – The effect of Catan : Oil Springs

NARCIS (Netherlands)

Chappin, E.J.L.; Bijvoet, Xanna; Oei, A.

2017-01-01

In order to attain a truly sustainable society it is necessary for people to make ‘the sustainable choice’ in daily life, business and governance. Instrumental in increasing the awareness and understanding about sustainability issues and improving people's behaviour regarding sustainability

The Dialectic of the Nature-Society-System

Directory of Open Access Journals (Sweden)

Christian Fuchs

2008-07-01

ecological crisis. The productive forces are in modern society socially and ecologically destructive forces. In late capitalism there is a tendency of commodification and privatization of nature and human knowledge. Especially in the later writings of Marx and Engels one can find formulations that suggest a productivist logic that sees nature as an enemy opposed to man, as a resource and object that must be mastered, exploited, and controlled. But throughout the works of Marx and Engels one can find many passages where they argue that there is an antagonism between capitalism and nature that results in ecological degradation and that a free society is also based on alternative, sustainable relationships between man and nature. The idea of an alternative society-nature-relationship and of nature conservation can already be found in the works of Marx and Engels, they are precursors of ecological thinking. In Orthodox Marxism dialectical thinking has been interpreted as deterministic and mechanic laws and misused for arguing that the Soviet system is a free society. An alternative is a dialectic that stresses human practice and that structures condition alternative possibilities for action. Dialectic thinkers like Herbert Marcuse and Ernst Bloch have argued that nature is a producing subject, a non-teleological subject (Marcuse. Describing nature as a subject implies that if man destroys nature the latter as a producing subject will probably produce uncontrollable negative effects on society and that hence nature should be appropriated in sustainable ways. Matter is a natural subject that acts upon itself, whereas man is a human self-conscious subject that acts upon nature and society.

What is the Minimum EROI that a Sustainable Society Must Have?

Directory of Open Access Journals (Sweden)

David J.R. Murphy

2009-01-01

Full Text Available Economic production and, more generally, most global societies, are overwhelmingly dependant upon depleting supplies of fossil fuels. There is considerable concern amongst resource scientists, if not most economists, as to whether market signals or cost benefit analysis based on today’s prices are sufficient to guide our decisions about our energy future. These suspicions and concerns were escalated during the oil price increase from 2005 – 2008 and the subsequent but probably related market collapse of 2008. We believe that Energy Return On Investment (EROI analysis provides a useful approach for examining disadvantages and advantages of different fuels and also offers the possibility to look into the future in ways that markets seem unable to do. The goal of this paper is to review the application of EROI theory to both natural and economic realms, and to assess preliminarily the minimum EROI that a society must attain from its energy exploitation to support continued economic activity and social function. In doing so we calculate herein a basic first attempt at the minimum EROI for current society and some of the consequences when that minimum is approached. The theory of the minimum EROI discussed here, which describes the somewhat obvious but nonetheless important idea that for any being or system to survive or grow it must gain substantially more energy than it uses in obtaining that energy, may be especially important. Thus any particular being or system must abide by a “Law of Minimum EROI”, which we calculate for both oil and corn-based ethanol as about 3:1 at the mine-mouth/farm-gate. Since most biofuels have EROI’s of less than 3:1 they must be subsidized by fossil fuels to be useful.

Engineering Sustainability: A Technical Approach to Sustainability

OpenAIRE

Rosen, Marc A.

2012-01-01

Sustainability is a critically important goal for human activity and development. Sustainability in the area of engineering is of great importance to any plans for overall sustainability given 1) the pervasiveness of engineering activities in societies, 2) their importance in economic development and living standards, and 3) the significant impacts that engineering processes and systems have had, and continue to have, on the environment. Many factors that need to be considered and appropriate...

Sustainable development in city districts: BaLaLuZ project - Society; Schlussbericht 'Gesellschaft' - Phase 1

Energy Technology Data Exchange (ETDEWEB)

Arend, M

2004-07-01

This final report for the Swiss Federal Office of Energy (SFOE) is one of a series of reports concerning municipal development in various cities in Switzerland. The four city districts involved include Basel (Gundeldinger Feld), Lausanne (Bellevaux), Lucerne (Basel-/Bernstrasse) and Zurich (Werdwies). This paper takes a look at society aspects in the four districts and examines the factors that influence the sustainable development of the districts. Topics discussed include basic residential needs, safety, health, and supply along with culture and education. Also examined are the possible topics equality and fairness and participation along with geographical reference and neighbourhood relations. A project for this area of investigation is suggested.

Are labour-intensive efforts to prevent pressure ulcers cost-effective?

Science.gov (United States)

Mathiesen, Anne Sofie Mølbak; Nørgaard, Kamilla; Andersen, Marie Frederikke Bruun; Møller, Klaus Meyer; Ehlers, Lars Holger

2013-10-01

Pressure ulcers are a major problem in Danish healthcare with a prevalence of 13-43% among hospitalized patients. The associated costs to the Danish Health Care Sector are estimated to be €174.5 million annually. In 2010, The Danish Society for Patient Safety introduced the Pressure Ulcer Bundle (PUB) in order to reduce hospital-acquired pressure ulcers by a minimum of 50% in five hospitals. The PUB consists of evidence-based preventive initiatives implemented by ward staff using the Model for Improvement. To investigate the cost-effectiveness of labour-intensive efforts to reduce pressure ulcers in the Danish Health Care Sector, comparing the PUB with standard care. A decision analytic model was constructed to assess the costs and consequences of hospital-acquired pressure ulcers during an average hospital admission in Denmark. The model inputs were based on a systematic review of clinical efficacy data combined with local cost and effectiveness data from the Thy-Mors Hospital, Denmark. A probabilistic sensitivity analysis (PSA) was conducted to assess the uncertainty. Prevention of hospital-acquired pressure ulcers by implementing labour-intensive effects according to the PUB was cost-saving and resulted in an improved effect compared to standard care. The incremental cost of the PUB was -€38.62. The incremental effects were a reduction of 9.3% prevented pressure ulcers and 0.47% prevented deaths. The PSAs confirmed the incremental cost-effectiveness ratio (ICER)'s dominance for both prevented pressure ulcers and saved lives with the PUB. This study shows that labour-intensive efforts to reduce pressure ulcers on hospital wards can be cost-effective and lead to savings in total costs of hospital and social care. The data included in the study regarding costs and effects of the PUB in Denmark were based on preliminary findings from a pilot study at Thy-Mors Hospital and literature.

Cost-effectiveness analysis of introducing universal human papillomavirus vaccination of girls aged 11 years into the National Immunization Program in Brazil.

Science.gov (United States)

Novaes, Hillegonda Maria Dutilh; de Soárez, Patrícia Coelho; Silva, Gulnar Azevedo; Ayres, Andreia; Itria, Alexander; Rama, Cristina Helena; Sartori, Ana Marli Christovam; Clark, Andrew D; Resch, Stephen

2015-05-07

To evaluate the impact and cost-effectiveness of introducing universal human papillomavirus (HPV) vaccination into the National Immunization Program (NIP) in Brazil. The Excel-based CERVIVAC decision support model was used to compare two strategies: (1) status quo (with current screening program) and (2) vaccination of a cohort of 11-year-old girls. National parameters for the epidemiology and costs of cervical cancer were estimated in depth. The estimates were based on data from the health information systems of the public health system, the PNAD 2008 national household survey, and relevant scientific literature on Brazil. Costs are expressed in 2008 United States dollars (US$), and a 5% discount rate is applied to both future costs and future health benefits. Introducing the HPV vaccine would reduce the burden of disease. The model estimated there would be 229 deaths avoided and 6677 disability-adjusted life years (DALYs) averted in the vaccinated cohort. The incremental cost-effectiveness ratios (ICERs) per DALY averted from the perspectives of the government (US$ 7663), health system (US$ 7412), and society (US$ 7298) would be considered cost-effective, according to the parameters adopted by the World Health Organization. In the sensitivity analysis, the ICERs were most sensitive to variations in discount rate, disease burden, vaccine efficacy, and proportion of cervical cancer caused by types 16 and 18. However, universal HPV vaccination remained a cost-effective strategy in most variations of the key estimates. Vaccine introduction could contribute additional benefits in controlling cervical cancer, but it requires large investments by the NIP. Among the essential conditions for attaining the expected favorable results are immunization program sustainability, equity in a population perspective, improvement of the screening program, and development of a surveillance system. Copyright © 2014 Elsevier Ltd. All rights reserved.

FOREIGN TRADE TEACHING ACTIVITY: DECIDING BETWEEN COST AND SUSTAINABILITY

Directory of Open Access Journals (Sweden)

Cristiano Henrique Antonelli da Veiga

2015-03-01

Full Text Available The world debate focused on preserving the environment, such a s that held during the United Nations Conference on Sustainable Development, Rio +20, in conjunction with Brazil’s growing foreign trade requires a study of all these topics in management courses. The central premise of this paper is to investigate the systematization of trade concepts through the use of business games. Two asymmetric scenarios for exporting and importing teams were developed using action research and qualitative data analysis. The longitudinal study was conducted on four separate, sequential classes from the Foreign Trade discipline of two universities from southern Brazilian. The students were able to discuss a variety of foreign trade topics and interact autonomously among themselves using business games that stimulate business negotiations through role playing dynamics, demonstrating that this teaching strategy can be used as a foreign trade teaching support tool. The final proposal was to change the game scenarios to focus on the decision between lowest costs and sustainable manufacturing processes without losing the aspects developed previously. The results showed that students’ decisions are more linked to their prior personal environmental concepts than to competition strategies developed for the company.

Cost-effectiveness and cost utility of community screening for glaucoma in urban India.

Science.gov (United States)

John, Denny; Parikh, Rajul

2017-07-01

), the introduction of a community screening programme for glaucoma for the 40-69 years age group is likely to be relatively cost-effective if implemented in the urban areas of India. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Cost-effectiveness of a smokeless tobacco control mass media campaign in India.

Science.gov (United States)

Murukutla, Nandita; Yan, Hongjin; Wang, Shuo; Negi, Nalin Singh; Kotov, Alexey; Mullin, Sandra; Goodchild, Mark

2017-08-10

Tobacco control mass media campaigns are cost-effective in reducing tobacco consumption in high-income countries, but similar evidence from low-income countries is limited. An evaluation of a 2009 smokeless tobacco control mass media campaign in India provided an opportunity to test its cost-effectiveness. Campaign evaluation data from a nationally representative household survey of 2898 smokeless tobacco users were compared with campaign costs in a standard cost-effectiveness methodology. Costs and effects of the Surgeon campaign were compared with the status quo to calculate the cost per campaign-attributable benefit, including quit attempts, permanent quits and tobacco-related deaths averted. Sensitivity analyses at varied CIs and tobacco-related mortality risk were conducted. The Surgeon campaign was found to be highly cost-effective. It successfully generated 17 259 148 additional quit attempts, 431 479 permanent quits and 120 814 deaths averted. The cost per benefit was US$0.06 per quit attempt, US$2.6 per permanent quit and US$9.2 per death averted. The campaign continued to be cost-effective in sensitivity analyses. This study suggests that tobacco control mass media campaigns can be cost-effective and economically justified in low-income and middle-income countries. It holds significant policy implications, calling for sustained investment in evidence-based mass media campaigns as part of a comprehensive tobacco control strategy. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Effectiveness and cost effectiveness of television, radio and print advertisements in promoting the New York smokers' quitline.

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Farrelly, Matthew C; Hussin, Altijani; Bauer, Ursula E

2007-12-01

This study assessed the relative effectiveness and cost effectiveness of television, radio and print advertisements to generate calls to the New York smokers' quitline. Regression analysis was used to link total county level monthly quitline calls to television, radio and print advertising expenditures. Based on regression results, standardised measures of the relative effectiveness and cost effectiveness of expenditures were computed. There was a positive and statistically significant relation between call volume and expenditures for television (padvertisements and a marginally significant effect for expenditures on newspaper advertisements (peffect was for television advertising. However, because of differences in advertising costs, for every $1000 increase in television, radio and newspaper expenditures, call volume increased by 0.1%, 5.7% and 2.8%, respectively. Television, radio and print media all effectively increased calls to the New York smokers' quitline. Although increases in expenditures for television were the most effective, their relatively high costs suggest they are not currently the most cost effective means to promote a quitline. This implies that a more efficient mix of media would place greater emphasis on radio than television. However, because the current study does not adequately assess the extent to which radio expenditures would sustain their effectiveness with substantial expenditure increases, it is not feasible to determine a more optimal mix of expenditures.

Intermediate steps towards the 2000 W society in Switzerland: An energy-economic scenario analysis

International Nuclear Information System (INIS)

Schulz, Thorsten F.; Kypreos, Socrates; Barreto, Leonardo; Wokaun, Alexander

2008-01-01

In the future, sustainable development under the umbrella of the 2000 W society could be of major interest. Could the target of the 2000 W society, i.e. a primary energy per capita (PEC) consumption of 2000 W, be realized until 2050? Various combinations of PEC and CO 2 targets are tested, and the additional costs to be paid by the society are estimated. The assessment is carried out with the Swiss MARKAL model, a bottom-up energy-system model projecting future technology investments for Switzerland. The analysis reveals that the 2000 W society should be seen as a long-term goal. For all contemplated scenarios, a PEC consumption of 3500 W per capita (w/cap) is feasible in the year 2050. However, strong PEC consumption targets can reduce CO 2 emissions to an equivalent of 5% per decade at maximum. For stronger CO 2 emission reduction goals, corresponding targets must be formulated explicitly. At an oil price of 75 US$ 2000 /bbl in 2050, the additional (cumulative, discounted) costs to reach a 10% CO 2 reduction per decade combined with a 3500 W per capita target amount to about 40 billion US$ 2000 . On the contrary, to reach pure CO 2 reduction targets is drastically cheaper, challenging the vision of the 2000 W society

Cost-effectiveness of emergency department-initiated treatment for opioid dependence.

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Busch, Susan H; Fiellin, David A; Chawarski, Marek C; Owens, Patricia H; Pantalon, Michael V; Hawk, Kathryn; Bernstein, Steven L; O'Connor, Patrick G; D'Onofrio, Gail

2017-11-01

In a recent randomized trial, patients with opioid dependence receiving brief intervention, emergency department (ED)-initiated buprenorphine and ongoing follow-up in primary care with buprenorphine (buprenorphine) were twice as likely to be engaged in addiction treatment compared with referral to community-based treatment (referral) or brief intervention and referral (brief intervention). Our aim was to evaluate the relative cost-effectiveness of these three methods of intervening on opioid dependence in the ED. Measured health-care use was converted to dollar values. We considered a health-care system perspective and constructed cost-effectiveness acceptability curves that indicate the probability each treatment is cost-effective under different thresholds of willingness-to-pay for outcomes studied. An urban ED in the United States. Opioid-dependent patients aged 18 years or older. Self-reported 30-day assessment data were used to construct cost-effectiveness acceptability curves for patient engagement in formal addiction treatment at 30 days and the number of days illicit opioid-free in the past week. Considering only health-care system costs, cost-effectiveness acceptability curves indicate that at all positive willingness-to-pay values, ED-initiated buprenorphine treatment was more cost-effective than brief intervention or referral. For example, at a willingness-to-pay threshold of $1000 for 30-day treatment engagement, we are 79% certain ED-initiated buprenorphine is most cost-effective compared with other studied treatments. Similar results were found for days illicit opioid-free in the past week. Results were robust to secondary analyses that included patients with missing cost data, included crime and patient time costs in the numerator, and to changes in unit price estimates. In the United States, emergency department-initiated buprenorphine intervention for patients with opioid dependence provides high value compared with referral to community

Steering sustainability. On the potential of a radical energy tax subsidy scheme to move the Dutch society towards sustainable development in the energy domain

International Nuclear Information System (INIS)

Kamminga, K.J.

2001-01-01

After an introduction to the issue of sustainable development, relevant aspects of the discussion about sustainable development are discussed. In particular, various perspectives on sustainable development based on different views of nature. However, since sustainable development is such a broad and general concept, narrowing its reach is necessary to enlarge its applicability. From various observations, it is concluded that there are good reasons to focus the sustainable development discussion on the energy domain. First, the existence of sources of potential energy is the basis for all physical activity. Second, fossil fuel reserves -which are by far the most dominant types of energy in the western, industrialized world at present- are limited. Third, the extraction, transportation, use and/or combustion of fossil fuels give rise to serious pressure on the world's natural environment. On a global scale, this particularly concerns the emission of CO2. Starting from a system approach, the relationship between society (the production and consumption system) and nature (the natural system) is dealt with, distinguishing between two relevant views. The first one regards the production and consumption system as separated from, though interacting with, the natural system. Thus, two systems in fact exist next to each other. By contrast, the second view explicitly defines boundaries for the production and consumption system on biophysical grounds. According to this vision, the production and consumption system should be considered a subsystem of the natural system. Chapter 2 offers a first elaboration upon the relation between the two systems. From a historical perspective sustainable development is addressed against the background of the main development in economics over the last three centuries; that is, the development from the physiocrats and the classical economists to the theory of neoclassical economics. The issue of natural resources is chosen as a proxy of

Cost-effectiveness of seven IVF strategies: results of a Markov decision-analytic model.

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Fiddelers, Audrey A A; Dirksen, Carmen D; Dumoulin, John C M; van Montfoort, Aafke P A; Land, Jolande A; Janssen, J Marij; Evers, Johannes L H; Severens, Johan L

2009-07-01

A selective switch to elective single embryo transfer (eSET) in IVF has been suggested to prevent complications of fertility treatment for both mother and infants. We compared seven IVF strategies concerning their cost-effectiveness using a Markov model. The model was based on a three IVF-attempts time horizon and a societal perspective using real world strategies and data, comparing seven IVF strategies, concerning costs, live births and incremental cost-effectiveness ratios (ICERs). In order to increase pregnancy probability, one cycle of eSET + one cycle of standard treatment policy [STP, i.e. eSET in patients IVF treatment, combining several transfer policies was not cost-effective. A choice has to be made between three cycles of eSET, STP or DET. It depends, however, on society's willingness to pay which strategy is to be preferred from a cost-effectiveness point of view.

Using community partners to deliver low-cost and effective emergency management and business continuity services.

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Thomas, Joan; Roggiero, Jean Paul; Silva, Brian

2010-11-01

Small to medium-sized organisations enhance their business mission as well as their communities by continuing to offer services in extreme circumstances. Developing emergency preparedness and business continuity plans that are cost-effective, comprehensive and operational for small to medium-sized organisations with limited resources requires a consistent, supportive, hands-on approach over time with professionals to create appropriate and sustainable strategies. Using a unique, multi-layered and applied approach to emergency preparedness training, organisations have successfully created plans that are effective and sustainable.

Cost-effectiveness of preventive interventions to reduce alcohol consumption in Denmark.

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Astrid Ledgaard Holm

Full Text Available INTRODUCTION: Excessive alcohol consumption increases the risk of many diseases and injuries, and the Global Burden of Disease 2010 study estimated that 6% of the burden of disease in Denmark is due to alcohol consumption. Alcohol consumption thus places a considerable economic burden on society. METHODS: We analysed the cost-effectiveness of six interventions aimed at preventing alcohol abuse in the adult Danish population: 30% increased taxation, increased minimum legal drinking age, advertisement bans, limited hours of retail sales, and brief and longer individual interventions. Potential health effects were evaluated as changes in incidence, prevalence and mortality of alcohol-related diseases and injuries. Net costs were calculated as the sum of intervention costs and cost offsets related to treatment of alcohol-related outcomes, based on health care costs from Danish national registers. Cost-effectiveness was evaluated by calculating incremental cost-effectiveness ratios (ICERs for each intervention. We also created an intervention pathway to determine the optimal sequence of interventions and their combined effects. RESULTS: Three of the analysed interventions (advertising bans, limited hours of retail sales and taxation were cost-saving, and the remaining three interventions were all cost-effective. Net costs varied from € -17 million per year for advertisement ban to € 8 million for longer individual intervention. Effectiveness varied from 115 disability-adjusted life years (DALY per year for minimum legal drinking age to 2,900 DALY for advertisement ban. The total annual effect if all interventions were implemented would be 7,300 DALY, with a net cost of € -30 million. CONCLUSION: Our results show that interventions targeting the whole population were more effective than individual-focused interventions. A ban on alcohol advertising, limited hours of retail sale and increased taxation had the highest probability of being cost

Cost-effectiveness of preventive interventions to reduce alcohol consumption in Denmark.

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Holm, Astrid Ledgaard; Veerman, Lennert; Cobiac, Linda; Ekholm, Ola; Diderichsen, Finn

2014-01-01

Excessive alcohol consumption increases the risk of many diseases and injuries, and the Global Burden of Disease 2010 study estimated that 6% of the burden of disease in Denmark is due to alcohol consumption. Alcohol consumption thus places a considerable economic burden on society. We analysed the cost-effectiveness of six interventions aimed at preventing alcohol abuse in the adult Danish population: 30% increased taxation, increased minimum legal drinking age, advertisement bans, limited hours of retail sales, and brief and longer individual interventions. Potential health effects were evaluated as changes in incidence, prevalence and mortality of alcohol-related diseases and injuries. Net costs were calculated as the sum of intervention costs and cost offsets related to treatment of alcohol-related outcomes, based on health care costs from Danish national registers. Cost-effectiveness was evaluated by calculating incremental cost-effectiveness ratios (ICERs) for each intervention. We also created an intervention pathway to determine the optimal sequence of interventions and their combined effects. Three of the analysed interventions (advertising bans, limited hours of retail sales and taxation) were cost-saving, and the remaining three interventions were all cost-effective. Net costs varied from € -17 million per year for advertisement ban to € 8 million for longer individual intervention. Effectiveness varied from 115 disability-adjusted life years (DALY) per year for minimum legal drinking age to 2,900 DALY for advertisement ban. The total annual effect if all interventions were implemented would be 7,300 DALY, with a net cost of € -30 million. Our results show that interventions targeting the whole population were more effective than individual-focused interventions. A ban on alcohol advertising, limited hours of retail sale and increased taxation had the highest probability of being cost-saving and should thus be first priority for implementation.

Business Management in Sustainable Buildings: Ankara-Turkey Case

Science.gov (United States)

Kutay Karaca, Neşet; Burcu Gültekin, Arzuhan

2017-10-01

The concept of the sustainability is described as efficiently and effectively consuming of exhaustible and recyclable sources of the world. A sustainable building implements sustainability criteria in its life cycle, and business management is the process by which an organization uses its resources in the most efficient way to reach its goal. From the beginning, sustainable building proves their differences from the conventional buildings. Sustainable buildings are resource-efficient and environmentally responsible structures in terms of energy consumption, construction principles, siting, renovation and maintenance throughout its life cycle while conventional buildings are more traditional in these matters. The differences are observable especially in costs and expenditures. It is possible and feasible to compare and contrast the design, construction and management costs of both types of structures. Thence, contributions of sustainable buildings are priced favourably in terms of ecological and sociological aspects. In this context, a prospective projection can be made considering the extra costs of sustainable structures, as well as the consumption profits due to the use of less energy than conventional construction. Considering this, it is possible to project consumption savings in long term. By calculating a forward-looking net cash flow projection, it can be forecasted how much time it will take to cover the extra cost. When making decisions, investors always contemplate maximum profitability. Within the scope of this study, costs of sustainable and conventional buildings will be compared and contrasted through precedence of a sustainable building certificated and non-certificated building. It will be analysed in which time period the initial cost difference between them will be compensated totally and partially. Furthermore, an efficiency analyses will be done in the scope of the necessities and expenses of these businesses.

Controlling cost escalation of healthcare: making universal health coverage sustainable in China

Science.gov (United States)

2012-01-01

An increasingly number of low- and middle-income countries have developed and implemented a national policy towards universal coverage of healthcare for their citizens over the past decade. Among them is China which has expanded its population coverage by health insurance from around 29.7% in 2003 to over 90% at the end of 2010. While both central and local governments in China have significantly increased financial inputs into the two newly established health insurance schemes: new cooperative medical scheme (NCMS) for the rural population, and urban resident basic health insurance (URBMI), the cost of healthcare in China has also been rising rapidly at the annual rate of 17.0%% over the period of the past two decades years. The total health expenditure increased from 74.7 billion Chinese yuan in 1990 to 1998 billion Chinese yuan in 2010, while average health expenditure per capital reached the level of 1490.1 Chinese yuan per person in 2010, rising from 65.4 Chinese yuan per person in 1990. The repaid increased population coverage by government supported health insurance schemes has stimulated a rising use of healthcare, and thus given rise to more pressure on cost control in China. There are many effective measures of supply-side and demand-side cost control in healthcare available. Over the past three decades China had introduced many measures to control demand for health care, via a series of co-payment mechanisms. The paper introduces and discusses new initiatives and measures employed to control cost escalation of healthcare in China, including alternative provider payment methods, reforming drug procurement systems, and strengthening the application of standard clinical paths in treating patients at hospitals, and analyses the impacts of these initiatives and measures. The paper finally proposes ways forward to make universal health coverage in China more sustainable. PMID:22992484

Cost effectiveness of the Dutch incentive for the environmental quality of power generation (MEP)

International Nuclear Information System (INIS)

Melgerd, R.

2005-01-01

This article relates to research on the cost effectiveness of the MEP scheme ('Milieukwaliteit Elektriciteitsproductie' or Environmental Quality of Electricity Generation), carried out as a graduation project at the Vrije Universiteit, Amsterdam, Netherlands. MEP subsidies are intended to promote investment in sustainable energy sources in the Netherlands by offering investors more certainty and a simpler structure than previous energy subsidies. The MEP also helps prevent Dutch taxpayers' money 'leaking' abroad to purchase sustainable electricity produced cheaper elsewhere. This makes the MEP measurably more effective than its predecessors. The scheme is moreover a step towards the effective deployment of state funds for the reduction of CO2 emission [nl

The cost effectiveness of pandemic influenza interventions: a pandemic severity based analysis.

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George J Milne

Full Text Available BACKGROUND: The impact of a newly emerged influenza pandemic will depend on its transmissibility and severity. Understanding how these pandemic features impact on the effectiveness and cost effectiveness of alternative intervention strategies is important for pandemic planning. METHODS: A cost effectiveness analysis of a comprehensive range of social distancing and antiviral drug strategies intended to mitigate a future pandemic was conducted using a simulation model of a community of ∼30,000 in Australia. Six pandemic severity categories were defined based on case fatality ratio (CFR, using data from the 2009/2010 pandemic to relate hospitalisation rates to CFR. RESULTS: Intervention strategies combining school closure with antiviral treatment and prophylaxis are the most cost effective strategies in terms of cost per life year saved (LYS for all severity categories. The cost component in the cost per LYS ratio varies depending on pandemic severity: for a severe pandemic (CFR of 2.5% the cost is ∼$9 k per LYS; for a low severity pandemic (CFR of 0.1% this strategy costs ∼$58 k per LYS; for a pandemic with very low severity similar to the 2009 pandemic (CFR of 0.03% the cost is ∼$155 per LYS. With high severity pandemics (CFR >0.75% the most effective attack rate reduction strategies are also the most cost effective. During low severity pandemics costs are dominated by productivity losses due to illness and social distancing interventions, while for high severity pandemics costs are dominated by hospitalisation costs and productivity losses due to death. CONCLUSIONS: The most cost effective strategies for mitigating an influenza pandemic involve combining sustained social distancing with the use of antiviral agents. For low severity pandemics the most cost effective strategies involve antiviral treatment, prophylaxis and short durations of school closure; while these are cost effective they are less effective than other strategies in

The Cost Effectiveness of Pandemic Influenza Interventions: A Pandemic Severity Based Analysis

Science.gov (United States)

Milne, George J.; Halder, Nilimesh; Kelso, Joel K.

2013-01-01

Background The impact of a newly emerged influenza pandemic will depend on its transmissibility and severity. Understanding how these pandemic features impact on the effectiveness and cost effectiveness of alternative intervention strategies is important for pandemic planning. Methods A cost effectiveness analysis of a comprehensive range of social distancing and antiviral drug strategies intended to mitigate a future pandemic was conducted using a simulation model of a community of ∼30,000 in Australia. Six pandemic severity categories were defined based on case fatality ratio (CFR), using data from the 2009/2010 pandemic to relate hospitalisation rates to CFR. Results Intervention strategies combining school closure with antiviral treatment and prophylaxis are the most cost effective strategies in terms of cost per life year saved (LYS) for all severity categories. The cost component in the cost per LYS ratio varies depending on pandemic severity: for a severe pandemic (CFR of 2.5%) the cost is ∼$9 k per LYS; for a low severity pandemic (CFR of 0.1%) this strategy costs ∼$58 k per LYS; for a pandemic with very low severity similar to the 2009 pandemic (CFR of 0.03%) the cost is ∼$155 per LYS. With high severity pandemics (CFR >0.75%) the most effective attack rate reduction strategies are also the most cost effective. During low severity pandemics costs are dominated by productivity losses due to illness and social distancing interventions, while for high severity pandemics costs are dominated by hospitalisation costs and productivity losses due to death. Conclusions The most cost effective strategies for mitigating an influenza pandemic involve combining sustained social distancing with the use of antiviral agents. For low severity pandemics the most cost effective strategies involve antiviral treatment, prophylaxis and short durations of school closure; while these are cost effective they are less effective than other strategies in reducing the

Evaluating sustainability of truck weight regulations: A system dynamics view

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Pei Liu

2015-11-01

Full Text Available Purpose: Targeting the problem of overload trucking in Highway Transportation of iron ore from Caofeidian to Tangshan (HTCT, this paper aims to assess long-term effects of alternative Truck Weight Regulation (TWR policies on sustainability of HTCT. Design/methodology/approach: A system dynamics model was established for policy evaluation. The model, composed of six interrelating modules, is able to simulate policies effects on trucking issues such as freight flow, truck traffic flow, pavement performance, highway transport capacity and trucking time, and further on the Cumulative Economic Cost (CEC including transport cost and time cost of freight owners and the Cumulative Social Cost (CSC including pavement maintenance cost, green house gas emission cost, air pollutants emission cost and traffic accidents cost, so the effects of TWR policies on sustainability of HTCT could be evaluated. Findings: According to different values of overload ratio which a TWR policy allows, alternative TWR policies are classified into three types, which are The Rigid Policy (TRP, The Moderate Policy (TMP and The Tolerant Policy (TTP. Results show that the best policy for sustainability of HTCT depends on the importance of CSC which is expected by the local government. To be specific, (1 if CSC is considered much less important than CEC, the local government should continue implementing the current TTP with the maximum overload ratio; (2 if CSC is considered much more important than CEC, then TRP is recommended; and (3 if CSC is considered slightly more important than CES, TMP with overload ratio of 80% is the best. Practical implications: Conclusions of this paper may help the local government design appropriate TWR policies to achieve sustainability of HTCT. Originality/value: To the best of our knowledge, this is the first effort to evaluate TWR policies on sustainability of regional freight transportation based on system dynamics modeling.

A protocol for sustained reduction of Total Parenteral Nutrition and cost savings by improvement of nutritional care in hospitals.

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van Schaik, Rian; Van den Abeele, Kurt; Melsens, Glenn; Schepens, Peter; Lanssens, Truus; Vlaemynck, Bernadette; Devisch, Maria; Niewold, Theo A

2016-10-01

Malnutrition and the use of Total Parenteral Nutrition (TPN) contribute considerably to hospital costs. Recently, we reported on the introduction of malnutrition screening and monitoring of TPN use in our hospital, which resulted in a large (40%) reduction in TPN and improved quality of nutritional care in two years (2011/12). Here, we aimed to assure continuation of improved care by developing a detailed malnutrition screening and TPN use protocol involving instruction tools for hospital staff, while monitoring the results in the following two years (2013/14). A TPN decision tree for follow up of TPN in patients and a TP-EN instruction card for caregivers was introduced, showing TPN/EN introduction schedules based on the energy needs of patients according to EB guidelines, also addressing the risk of refeeding syndrome. TPN patients were monitored by dietitians and TPN usage and costs were presented to the (medical) staff. Screening and treatment of malnourished patients by dietitians is simultaneously ongoing. In 2014 48% of patients, hospitalized for at least 48 h, were screened on malnutrition, 17% of them were diagnosed at risk, 7.9% malnourished and treated by dietitians. TPN usage dropped by 53% and cost savings of 51% were obtained due to 50% decrease of TPN users in 2014 versus 2010. TPN over EN ratio dropped from 2.4 in 2010 to 1.2 in 2014. Sustained improvement of nutritional care and reduction of TPN usage and costs is possible by introduction of procedures embedded in the existing structures. Copyright © 2016 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

Evolution of cooperation in a hierarchical society with corruption control.

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Huang, Feng; Chen, Xiaojie; Wang, Long

2018-07-14

Punishment is widely recognized as a potential promoter in sustaining or even enhancing public cooperation, but it meanwhile induces the problem of second-order free-riders. Particularly, recent evidence shows that costly punishment can be maintained if punishers may engage in corruption. However, how to reduce or eliminate incidents of corruption has been the enduring conundrum in human society. As power asymmetries are associated with hierarchies, we investigate how costly punishment affects the evolution of cooperation in the cases without and with corruption control. In the absence of corruption control, altruistic punishers are incapable of punishing corrupt punishers. Corrupt punishment maintains civilian cooperation but undermines the evolution of altruistic punishment. Otherwise, altruistic punishers can enforce symmetrical or asymmetrical punishment on both corrupt punishers and civilian defectors. In this case, both civilian cooperation and altruistic punishment can be promoted. And as an instrument of corruption control, the policy of asymmetrical punishment is more effective in fostering public cooperation and improving social welfare than symmetrical punishment. Moreover, no matter whether corruption control is considered or not, spiteful corruption that non-cooperative punishers penalize defectors is a more effective form for enhancing cooperation compared with bribery. Our work may thus offer an insight into the effects of corruption on public cooperation and the policy of anti-corruption. Copyright © 2018 Elsevier Ltd. All rights reserved.

Modular Laboratories—Cost-Effective and Sustainable Infrastructure for Resource-Limited Settings

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Bridges, Daniel J.; Colborn, James; Chan, Adeline S. T.; Winters, Anna M.; Dengala, Dereje; Fornadel, Christen M.; Kosloff, Barry

2014-01-01

High-quality laboratory space to support basic science, clinical research projects, or health services is often severely lacking in the developing world. Moreover, the construction of suitable facilities using traditional methods is time-consuming, expensive, and challenging to implement. Three real world examples showing how shipping containers can be converted into modern laboratories are highlighted. These include use as an insectary, a molecular laboratory, and a BSL-3 containment laboratory. These modular conversions have a number of advantages over brick and mortar construction and provide a cost-effective and timely solution to offer high-quality, user-friendly laboratory space applicable within the developing world. PMID:25223943

Investment Success in Public Health: An Analysis of the Cost-Effectiveness and Cost-Benefit of the Global Programme to Eliminate Lymphatic Filariasis.

Science.gov (United States)

Turner, Hugo C; Bettis, Alison A; Chu, Brian K; McFarland, Deborah A; Hooper, Pamela J; Mante, Sunny D; Fitzpatrick, Christopher; Bradley, Mark H

2017-03-15

It has been estimated that $154 million per year will be required during 2015-2020 to continue the Global Programme to Eliminate Lymphatic Filariasis (GPELF). In light of this, it is important to understand the program's current value. Here, we evaluate the cost-effectiveness and cost-benefit of the preventive chemotherapy that was provided under the GPELF between 2000 and 2014. In addition, we also investigate the potential cost-effectiveness of hydrocele surgery. Our economic evaluation of preventive chemotherapy was based on previously published health and economic impact estimates (between 2000 and 2014). The delivery costs of treatment were estimated using a model developed by the World Health Organization. We also developed a model to investigate the number of disability-adjusted life years (DALYs) averted by a hydrocelectomy and identified the cost threshold under which it would be considered cost-effective. The projected cost-effectiveness and cost-benefit of preventive chemotherapy were very promising, and this was robust over a wide range of costs and assumptions. When the economic value of the donated drugs was not included, the GPELF would be classed as highly cost-effective. We projected that a typical hydrocelectomy would be classed as highly cost-effective if the surgery cost less than $66 and cost-effective if less than $398 (based on the World Bank's cost-effectiveness thresholds for low income countries). Both the preventive chemotherapy and hydrocele surgeries provided under the GPELF are incredibly cost-effective and offer a very good investment in public health. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America.

Power Electronics and Renewable Energy Systems – a perfect match for a sustainable society

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Frede Blaabjerg

2015-08-01

Full Text Available The energy consumption is steadily increasing very rapid due to more people on the earth, betterliving conditions as well as we are trying to live in areas where the energy demand is high. Theeconomy growth in the last century has not been possible without low prize of energy which has beenachieved by fossil fuels. Looking into the future – the fossil fuel resources have a time limit – whichcan appear faster than expected – both because of the limited resources but also because the marketcan suddenly increase the prize. Therefore there is a demand to come up with sustainable energysolutions for energy production like wind turbines, hydro power as well as photovoltaics. At the sametime it is evident that by the use of new technology it is possible to make energy saving. In bothsituations power electronics are making this possible – we are using power electronics to interfacerenewable sources to maximize the energy yield from wind turbines and photovoltaics as well assmoothly integrate it to the grid. Also in many applications we use power electronics to interface a loadwith the grid and control the behavior of the electrical equipment according to the demand. In manycases power electronics is able to ensure a large amount of energy saving like in pumps, compressorsas well as in ventilation systems. Also the transportation gain a lot of using electricity instead of fossilfuel – clearly made possible due to the power electronics. Denmark is one of the societies which have been the frontier of implementing the renewabletechnology and has today covered more than 50 % of the electrical energy consumption by means ofrenewable and has as ambition to be fully independent on fossil fuels in 2050. Already in 2035 100 %of the electricity will be covered by renewables. At the same time the energy consumption has notreally increased for 20 years despite the GDP has grown by more than 60 % - much is enabled byenergy efficient technologies based on

Sustainability of biomass electricity systems. An estimate of costs, macro-economic and environmental impacts

International Nuclear Information System (INIS)

Van den Broek, R

2001-01-01

Since the 1990s there has been a renewal of interest in the possibility of sustainable generating energy from biomass, an interest driven in part by the climate issue. Other motives are the search for alternatives for parts of Western agriculture and progress in the technological feasibility of efficiently producing high-quality energy from biomass. World-wide this renewed interest has led to a clear increase in research, demonstration and commercial implementation of biomass energy systems. A recent thesis concludes that biomass can contribute to all aspects of sustainability. In the context of sustainable development (often viewed as a concept having economic, social and ecological dimensions), the central question asked by this Ph.D. research is: How do biomass electricity systems compare to fossil-fuel systems and to the land-use that they may replace, in terms of costs, macro-economic and environmental impacts. This article presents a number of conclusions

For sustainable participation by civil society in Europe in the oversight of nuclear activities

International Nuclear Information System (INIS)

Delalonde, J.C.

2010-01-01

The Aarhus Convention on access to information, public participation in decision-making and access to justice in environmental matters, was signed in 1998 by the European Community and European countries including the 27 Member States of the European Union (EU). That same year, the Committee of the Regions adopted a resolution on nuclear safety and local and regional democracy. These two texts indicate strong political and legal recognition of access to information and participation in the nuclear field. Ten years later, it would seem to be important to observe how these principles are actually implemented. As of 2009, the ANCCLI and the European Commission opened an 18-month European dialogue on the practical application of the Aarhus Convention in the nuclear field. The principle of this approach, called ACN for Aarhus Convention and Nuclear, is to promote feedback about practical application of the Aarhus Convention in the nuclear field in the various European countries, and to share this feedback in order to identify both difficulties and good practices and to initiate progress jointly with the various stakeholders concerned (authorities, civil society, operators, experts, local authorities, etc.). It is also an opportunity to look at the conditions for sustainable participation by civil society in monitoring nuclear issues. (author)

The value of the phenomenon of communication for the sustainable development of modern society

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O. I. Plaksina

2016-06-01

On this basis the substantial potential of communication is determined. A di-verse range of communication’s actions is presented. Communication carries out satisfaction the people’s need in emotional resonance and empathy; penetration into the inner world of Another, co-presence, being «here» and «now» together with Another; integration, unity, feeling part of a whole people and becoming related; finding a certain sense; producing and approving of values, humanization; realiza-tion of the basic human need - to be included in society and culture, i.e., generic quality of sociality which is inherent to man; improvisation, in conjunction with the presence of algorithms in the communication; preventing, overcoming an inferiority of people’s objectivisation, de-objectivisation; counteracting to the massification, standardization, «oversimplification» of consciousness and personality. Thereby this paper shows that communication efficiently overcomes and blocks the most of the challenges/risks, which might lead to instability of the socie-ty’s development in the informational stage of history - the four groups from six groups, which were identified in this article. As a result, the positive influence of communication on the sustainability of modern society in a global scale has been substantiated and proven.

PATHWAYS TO SUSTAINABLE BANKING MANAGEMENT

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Dragan (Santamarian Oana Raluca

2012-12-01

Full Text Available This paper describes one of the major challenges of the future: the sustainable development of the society. Sustainability is now increasingly recognized as central to the growth of emerging market economies. For the banking sector, this represents both a demand for greater social and environmental responsibility as well as a new landscape of business opportunity. Several years ago, the main part of the banks did not consider the social and environmental problems relevant for their operations. Recently, the banks began to realize the major impact of the sustainable development over the way of ulterior development of the society and, implicitly over the way of creating of the banking value in the future. In this context, the development of a banking management system, based on sustainable principles represents one of the provocations of these days.Starting from literature in the sustainable banking management field in this paper are presented several relevant issues related to risk management in the context of sustainable banking financing: the need to implement the sustainable management principles in financial and banking industry; the role of banks in sustainable development of society; social and environmental risk management policies, events that have shaped the role of the banking sector in sustainable development; international standards regarding sustainable banking management such us: Equator Principles for sustainable investment projects’ financing or GRI principles for sustainable reporting. Furthermore, we developed a practical case study related to the implementation of sustainable banking management at Bank of America.

Sustainability in Supply Chain Management: Aggregate Planning from Sustainability Perspective.

Science.gov (United States)

Türkay, Metin; Saraçoğlu, Öztürk; Arslan, Mehmet Can

2016-01-01

Supply chain management that considers the flow of raw materials, products and information has become a focal issue in modern manufacturing and service systems. Supply chain management requires effective use of assets and information that has far reaching implications beyond satisfaction of customer demand, flow of goods, services or capital. Aggregate planning, a fundamental decision model in supply chain management, refers to the determination of production, inventory, capacity and labor usage levels in the medium term. Traditionally standard mathematical programming formulation is used to devise the aggregate plan so as to minimize the total cost of operations. However, this formulation is purely an economic model that does not include sustainability considerations. In this study, we revise the standard aggregate planning formulation to account for additional environmental and social criteria to incorporate triple bottom line consideration of sustainability. We show how these additional criteria can be appended to traditional cost accounting in order to address sustainability in aggregate planning. We analyze the revised models and interpret the results on a case study from real life that would be insightful for decision makers.

Sustainability in Supply Chain Management: Aggregate Planning from Sustainability Perspective

Science.gov (United States)

Türkay, Metin; Saraçoğlu, Öztürk; Arslan, Mehmet Can

2016-01-01

Supply chain management that considers the flow of raw materials, products and information has become a focal issue in modern manufacturing and service systems. Supply chain management requires effective use of assets and information that has far reaching implications beyond satisfaction of customer demand, flow of goods, services or capital. Aggregate planning, a fundamental decision model in supply chain management, refers to the determination of production, inventory, capacity and labor usage levels in the medium term. Traditionally standard mathematical programming formulation is used to devise the aggregate plan so as to minimize the total cost of operations. However, this formulation is purely an economic model that does not include sustainability considerations. In this study, we revise the standard aggregate planning formulation to account for additional environmental and social criteria to incorporate triple bottom line consideration of sustainability. We show how these additional criteria can be appended to traditional cost accounting in order to address sustainability in aggregate planning. We analyze the revised models and interpret the results on a case study from real life that would be insightful for decision makers. PMID:26807848

Cost and sustainability of a successful package of interventions to improve vaccination coverage for children in urban slums of Bangladesh.

Science.gov (United States)

Hayford, K; Uddin, M J; Koehlmoos, T P; Bishai, D M

2014-04-25

To estimate the incremental economic costs and explore satisfaction with a highly effective intervention for improving immunization coverage among slum populations in Dhaka, Bangladesh. A package of interventions based on extended clinic hours, vaccinator training, active surveillance, and community participation was piloted in two slum areas of Dhaka, and resulted in an increase in valid fully immunized children (FIC) from 43% pre-intervention to 99% post-intervention. Cost data and stakeholder perspectives were collected January-February 2010 via document review and 10 key stakeholders interviews to estimate the financial and opportunity costs of the intervention, including uncompensated time, training and supervision costs. The total economic cost of the 1-year intervention was $18,300, comprised of external management and supervision (73%), training (11%), coordination costs (1%), uncompensated staff time and clinic costs (2%), and communications, supplies and other costs (13%). An estimated 874 additional children were correctly and fully immunized due to the intervention, at an average cost of $20.95 per valid FIC. Key stakeholders ranked extended clinic hours and vaccinator training as the most important components of the intervention. External supervision was viewed as the most important factor for the intervention's success but also the costliest. All stakeholders would like to reinstate the intervention because it was effective, but additional funding would be needed to make the intervention sustainable. Targeting slum populations with an intensive immunization intervention was highly effective but would nearly triple the amount spent on immunization per FIC in slum areas. Those committed to increasing vaccination coverage for hard-to-reach children need to be prepared for substantially higher costs to achieve results. Copyright © 2014. Published by Elsevier Ltd.

Active and intelligent packaging systems for a modern society.

Science.gov (United States)

Realini, Carolina E; Marcos, Begonya

2014-11-01

Active and intelligent packaging systems are continuously evolving in response to growing challenges from a modern society. This article reviews: (1) the different categories of active and intelligent packaging concepts and currently available commercial applications, (2) latest packaging research trends and innovations, and (3) the growth perspectives of the active and intelligent packaging market. Active packaging aiming at extending shelf life or improving safety while maintaining quality is progressing towards the incorporation of natural active agents into more sustainable packaging materials. Intelligent packaging systems which monitor the condition of the packed food or its environment are progressing towards more cost-effective, convenient and integrated systems to provide innovative packaging solutions. Market growth is expected for active packaging with leading shares for moisture absorbers, oxygen scavengers, microwave susceptors and antimicrobial packaging. The market for intelligent packaging is also promising with strong gains for time-temperature indicator labels and advancements in the integration of intelligent concepts into packaging materials. Copyright © 2014 Elsevier Ltd. All rights reserved.

Education for sustainable development. Just do it : guide to designing education for sustainable development

NARCIS (Netherlands)

Frijters, S.

Sustainable development has become a crucial part of our modern society and our education. Sustainability is a complex concept. After all, what is considered sustainable to us now may not necessarily be so in the future. We need to continually review our judgments with regards to sustainability.

Cost-effectiveness of alternative changes to a national blood collection service.

Science.gov (United States)

Willis, S; De Corte, K; Cairns, J A; Zia Sadique, M; Hawkins, N; Pennington, M; Cho, G; Roberts, D J; Miflin, G; Grieve, R

2018-05-16

To evaluate the cost-effectiveness of changing opening times, introducing a donor health report and reducing the minimum inter-donation interval for donors attending static centres. Evidence is required about the effect of changes to the blood collection service on costs and the frequency of donation. This study estimated the effect of changes to the blood collection service in England on the annual number of whole-blood donations by current donors. We used donors' responses to a stated preference survey, donor registry data on donation frequency and deferral rates from the INTERVAL trial. Costs measured were those anticipated to differ between strategies. We reported the cost per additional unit of blood collected for each strategy versus current practice. Strategies with a cost per additional unit of whole blood less than £30 (an estimate of the current cost of collection) were judged likely to be cost-effective. In static donor centres, extending opening times to evenings and weekends provided an additional unit of whole blood at a cost of £23 and £29, respectively. Introducing a health report cost £130 per additional unit of blood collected. Although the strategy of reducing the minimum inter-donation interval had the lowest cost per additional unit of blood collected (£10), this increased the rate of deferrals due to low haemoglobin (Hb). The introduction of a donor health report is unlikely to provide a sufficient increase in donation frequency to justify the additional costs. A more cost-effective change is to extend opening hours for blood collection at static centres. © 2018 The Authors. Transfusion Medicine published by John Wiley & Sons Ltd on behalf of British Blood Transfusion Society.

Cost of practice in a tertiary/quaternary referral center: is it sustainable?

Science.gov (United States)

Cologne, K G; Hwang, G S; Senagore, A J

2014-11-01

Third-party payers are moving toward a bundled care payment system. This means that there will need to be a warranty cost of care-where the cost of complexity and complication rates is built into the bundled payment. The theoretical benefit of this system is that providers with lower complication rates will be able to provide care with lower warranty costs and lower overall costs. This may also result in referring riskier patients to tertiary or quaternary referral centers. Unless the payment model truly covers the higher cost of managing such referred cases, the economic risk may be unsustainable for these centers. We took the last seven patients that were referred by other surgeons as "too high risk" for colectomy at other centers. A contribution margin was calculated using standard Medicare reimbursement rates at our institution and cost of care based on our administrative database. We then recalculated a contribution margin assuming a 3 % reduction in payment for a higher than average readmission rate, like that which will take effect in 2014. Finally, we took into account the cost of any readmissions. Seven patients with diagnosis related group (DRG) 330 were reviewed with an average age of 66.8 ± 16 years, American Society of Anesthesiologists score 2.3 ± 1.0, body mass index 31.6 ± 9.8 kg/m(2) (range 22-51 kg/m(2)). There was a 57 % readmission rate, 29 % reoperation rate, 10.8 ± 7.7 day average initial length of stay with 14 ± 8.6 day average readmission length of stay. Forty-two percent were discharged to a location other than home. Seventy-one percent of these patients had Medicare insurance. The case mix index was 2.45. Average reimbursement for DRG 330 was $17,084 (based on Medicare data) for our facility in 2012, with the national average being $12,520. The total contribution margin among all cases collectively was -$19,122 ± 13,285 (average per patient -$2,731, range -$21,905-$12,029). Assuming a 3 % reimbursement reduction made the overall

The impact of minimum pay implementation on small businesses operating cost and sustainability: A case of service business

Directory of Open Access Journals (Sweden)

Hanim Rusly Fariza

2017-01-01

Full Text Available The implementation of minimum wage requirement in Malaysia beginning mid 2016 seems to impact both employees and employers in different ways. While this implementation could increase household income and claimed to boost employees’ productivity, employers or business operators, on the other hand are experiencing stringent effect on their business operating cost. The effect is more significant for small business operators, including the childcare centers. Childcare industry operates in the service sector, which represents the main contributor of Malaysian SMEs. Unfortunately for the industry, there is an increasing numbers of childcare centers have to cease their operation due to inability to comply with the minimum pay requirement. In the absence of thorough understanding of the phenomena, the small businesses, particularly among institution-based childcare, is at the risk of losing their businesses. This exploratory study intends to assess how the implementation of minimum pay requirement affects the existing operating cost structure, and consequently business sustainability of Malaysian childcare industry.

Sustainable mining management

International Nuclear Information System (INIS)

Tejera Oliver, J. L.

2009-01-01

Mining activities are carried out by the older man and have provided resources, since ancient times, for their development and progress. With the discovery of fire will show the first metals that have marked the civilizations of copper, bronze and iron, and is the prehistory of the Stone Age tools that man has made from the exploitation of quarries first. The industrial revolution of the nineteenth century is linked to coal and steel, and could not conceiver of todays society without oil and gas, without silicon and coltan. But the mines are often aggressive and, despite their need and what they contribute to the development are answered by the societies where are made. during recent years there has been growing international efforts to try to make the minimum requirements of sustainable exploitation (European Directives, GMI, GRI, etc.) In AENOR, and within the Technical Committee of Standardization 22 Mining and Explosives, chaired by AITEMIN, was established the subcommittee 3, chaired by IGME, where, with the participation of all stake holders, have developed some standards on sustainable mining management sustainable mining that will be a tool available to mining companies to demonstrate their sustainable use to Society. (Author)

Single versus double embryo transfer: cost-effectiveness analysis alongside a randomized clinical trial.

Science.gov (United States)

Fiddelers, Audrey A A; van Montfoort, Aafke P A; Dirksen, Carmen D; Dumoulin, John C M; Land, Jolande A; Dunselman, Gerard A J; Janssen, J Marij; Severens, Johan L; Evers, Johannes L H

2006-08-01

Twin pregnancies after IVF are still frequent and are considered high-risk pregnancies leading to high costs. Transferring one embryo can reduce the twin pregnancy rate. We compared cost-effectiveness of one fresh cycle elective single embryo transfer (eSET) versus one fresh cycle double embryo transfer (DET) in an unselected patient population. Patients starting their first IVF cycle were randomized between eSET and DET. Societal costs per couple were determined empirically, from hormonal stimulation up to 42 weeks after embryo transfer. An incremental cost-effectiveness ratio (ICER) was calculated, representing additional costs per successful pregnancy. Successful pregnancy rates were 20.8% for eSET and 39.6% for DET. Societal costs per couple were significantly lower after eSET (7334 euro) compared with DET (10,924 euro). The ICER of DET compared with eSET was 19,096 euro, meaning that each additional successful pregnancy in the DET group will cost 19,096 euro extra. One cycle eSET was less expensive, but also less effective compared to one cycle DET. It depends on the society's willingness to pay for one extra successful pregnancy, whether one cycle DET is preferred from a cost-effectiveness point of view.

Moving Towards Sustainable Food Consumption : Identifying Barriers to Sustainable Student Diets

OpenAIRE

Ede, James; Graine, Sophia; Rhodes, Chris

2011-01-01

Adopting more sustainable consumption habits has been identified as a necessary step in the progression towards a sustainable society. In the area of sustainable consumption, personal food behaviour represents a strong leverage point. University students have been identified as a strategic audience; habits established during this transformative period can track forward into later life. This study seeks to identify the barriers inhibiting students from eating more sustainably. Perceived benefi...

Sustainable rural development and communicative learning

DEFF Research Database (Denmark)

Noe, Egon; Langvad, Anne-Mette

2006-01-01

Functional differentiation within society at large poses a major challenge to practising sustainable rural development. Multiplication of perspectives on sustainability calls for a theoretical position that is based on the integrity of each of the perspectives in play and for an approach that is ......Functional differentiation within society at large poses a major challenge to practising sustainable rural development. Multiplication of perspectives on sustainability calls for a theoretical position that is based on the integrity of each of the perspectives in play and for an approach...

Choice of Hemodialysis Access in Older Adults: A Cost-Effectiveness Analysis.

Science.gov (United States)

Hall, Rasheeda K; Myers, Evan R; Rosas, Sylvia E; O'Hare, Ann M; Colón-Emeric, Cathleen S

2017-06-07

month of dialysis diminishes with increasing age and lower life expectancy and is not the most cost-effective option for those with the most limited life expectancy. Copyright © 2017 by the American Society of Nephrology.

Climate-based policies may increase life-cycle social costs of vehicle fleet operation

International Nuclear Information System (INIS)

Emery, Isaac; Mbonimpa, Eric; Thal, Alfred E.

2017-01-01

Sustainability guidelines and regulations in the United States often focus exclusively on carbon or petroleum reductions. Though some of these policies have resulted in substantial progress toward their goals, the effects of these efforts on other social and environmental externalities are often ignored. In this study, we examine the life-cycle air pollutant emissions for alternative fuel and vehicle purchase scenarios at a military installation near a typical urban area in the United States (U.S.). We find that scenarios which minimize petroleum use or greenhouse gas emissions do not concomitantly minimize criteria air pollutant emissions. We also employ social cost methodologies to quantify economic externalities due to climate change and health-related air pollutant impacts. Accounting for the social costs of climate change and air pollution from vehicle use reveals that criteria air pollutants may have a greater total impact than greenhouse gas emissions in locations similar to the urban area examined in this study. Use of first-generation biofuels, particularly corn grain ethanol, may reduce net petroleum use at the cost of increased total health impacts. More comprehensive policies may be needed to ensure that sustainability policies result in a net benefit to society. - Highlights: • U.S. energy and transportation policies focus on petroleum use and greenhouse gases. • Use of corn ethanol at a military base in Ohio, U.S. increases total social costs vs. gasoline. • Renewable electricity provides cost-effective climate and health protection. • DOD strategy to improve energy security may damage Americans' health. • More inclusive policies needed to protect health and climate.

The effects of fabric type, fabric width and model type on the cost of unit raw material in terms of apparel

Science.gov (United States)

Bilgiç, H.; Duru Baykal, P.

2017-10-01

The cost of the fabric which is the raw material of apparel constitutes approximately the half of the total product cost. So, it is highly important that the fabric should be used with the greatest productivity. Cost analysis are of great importance in terms of competitiveness of readymade clothing and apparel sector both in national and international markets. The proximity of costs to international average and the average cost of the countries that are competitors of Turkey in clothing market is essential for Turkey to sustain its effect in textile sector. In the contrary case, the sector won’t be able to maintain its competitive capacity sustainably [1].The main cost elements of textile and apparel sector consist of raw material, labor, energy and financing [2].

Cost-Effectiveness of Endoscopic Versus Microscopic Transsphenoidal Surgery for Pituitary Adenoma.

Science.gov (United States)

Ament, Jared D; Yang, Zhuo; Khatchadourian, Vic; Strong, Edward B; Shahlaie, Kiarash

2018-02-01

Endoscopic transsphenoidal surgery (ETPS) has become increasingly popular for resection of pituitary tumors, whereas microscopic transsphenoidal surgery (MTPS) also remains a commonly used approach. The economic sustainability of new techniques and technologies is rarely evaluated in the neurosurgical skull base literature. The aim of this study was to determine the cost-effectiveness of ETPS compared with MTPS. A Markov model was constructed to conduct a cost-utility analysis of ETPS versus MTPS from a single-payer health care perspective. Data were obtained from previously published outcomes studies. Costs were based on Medicare reimbursement rates, considering covariates such as complications, length of stay, and operative time. The base case adopted a 2-year follow-up period. Univariate and multivariate sensitivity analyses were conducted. On average, ETPS costs $143 less and generates 0.014 quality-adjusted life years (QALYs) compared with MTPS over 2 years. The incremental cost-effectiveness ratio (ICER) is -$10,214 per QALY, suggesting economic dominance. The QALY benefit increased to 0.105 when modeled to 10 years, suggesting that ETPS becomes even more favorable over time. ETPS appears to be cost-effective when compared with MTPS because the ICER falls below the commonly accepted $50,000 per QALY benchmark. Model limitations and assumptions affect the generalizability of the conclusion; however, ongoing efforts to improve rhinologic morbidity related to ETPS would appear to further augment the marginal cost savings and QALYs gained. Further research on the cost-effectiveness of ETPS using prospective data is warranted. Copyright © 2017 Elsevier Inc. All rights reserved.

The sustainability of our society

International Nuclear Information System (INIS)

Sommer, T.

1997-01-01

German society is in a crisis characterized by five criteria: the German unification process, globalization, social achievements, a crisis of meaning and of leadership. Five problems must be solved if the crisis is to be overcome: A new attitude to work and to technology must be found. After reunification, there is need for thorough renewal. The democratic system must give answers to the essential questions of social life and life in a community. A new leading elite with imagination, initiative, and responsibility for the 21st century must be found. What is needed, in a way, is the ethical equivalent of war and defeat. The present crisis should be the cause, and the reason, for seizing and opportunity it includes. (orig.) [de

Cost Effectiveness Analysis of Optimal Malaria Control Strategies in Kenya

Directory of Open Access Journals (Sweden)

Gabriel Otieno

2016-03-01

which produces health improvements in the most cost effective way for different epidemiological zones. This offers the good value for money for the public health programs and can guide in the allocation of malaria control resources for the post-2015 malaria eradication strategies and the achievement of the Sustainable Development Goals.

The Two Faces of Sustainability : Fuzzy Evaluation of Sustainable Development

NARCIS (Netherlands)

Cornelissen, T.

2003-01-01

An evaluative framework of sustainable development operates at both the production system level and the society level: objective information gathered at the production system level is given subjective meaning at the society level. The evaluative framework constitutes a complete cycle to monitor

Energy and sustainable development. Perspectives from the Paris-based International Energy Agency

International Nuclear Information System (INIS)

Priddle, R.

1999-01-01

The G-8 leaders issued a statement expressing their commitment 'to encourage the development of energy markets' and declared that 'the greatest environmental threat of our future prosperity remains climate change and we confirm our determination to address it'. One of the options for tackling the greenhouse gas problem is to encourage substitution of carbon free fuels for conventional fossil fuels. This includes renewable energy sources and nuclear power, which has significant advantages to a society troubled by the prospect of climate change triggered by carbon emissions. Fuel supply to civil nuclear power plants is potentially, indefinitely sustainable. Uranium resources are globally widespread and could last 60 years, longer than the known reserves of oil and gas. Technological options are known for increasing the energy extracted from natural uranium. A recent IEA publication 'Nuclear Power Sustainability: Climate Change, Competition' discusses what would be necessary to make both renewable and nuclear energy sources cost-effective

The cost of treatment failure: resource use and costs incurred by hepatitis C virus genotype 1-infected patients who do or do not achieve sustained virological response to therapy.

Science.gov (United States)

Backx, M; Lewszuk, A; White, J R; Cole, J; Sreedharan, A; van Sanden, S; Diels, J; Lawson, A; Neal, K R; Wiselka, M J; Ito, T; Irving, W L

2014-03-01

Chronic hepatitis C virus (HCV) infection places a considerable economic burden on health services. Cost-effectiveness analyses of antiviral treatment for patients with chronic HCV infection are dependent on assumptions about cost reductions following sustained virological response (SVR) to therapy. This study quantified the medium-term difference in health resource usage and costs depending on treatment outcome. Retrospective chart review of patients with HCV genotype 1 infection who had received at least 2 months pegylated interferon and ribavirin therapy, with known treatment outcome was conducted. Disease status was categorized as chronic hepatitis, cirrhosis or decompensated liver disease. Health resource use was documented for each patient in each disease state. Unit costs were from the NHS 'Payment by Results' database and the British National Formulary. One hundred and ninety three patients (108 SVR, 85 non-SVR) with mean follow-up of 3.5 (SVR) and 4.9 (non-SVR) years were enrolled. No SVR patient progressed to a more severe liver disease state. Annual transition rates for non-SVR patients were 7.4% (chronic hepatitis to cirrhosis) and 4.9% (cirrhosis to decompensated liver disease). By extrapolation of modelled data over a 5-year post-treatment period, failure of patients with chronic hepatitis to achieve SVR was associated with a 13-fold increase (roughly £2300) in costs, whilst for patients who were retreated, the increase was 56-fold, equating to more than £10 000. Achievement of an SVR has significant effects on health service usage and costs. This work provides real-life data for future cost-effectiveness analyses related to the treatment for chronic HCV infection. © 2013 John Wiley & Sons Ltd.

Preference Construction Processes for Renewable Energies: Assessing the Influence of Sustainability Information and Decision Support Methods

Directory of Open Access Journals (Sweden)

Kiyotada Hayashi

2016-11-01

Full Text Available Sustainability information and decision support can be two important driving forces for making sustainable transitions in society. However, not enough knowledge is available on the effectiveness of these two factors. Here, we conducted an experimental study to support the hypotheses that acquisition of sustainability information and use of decision support methods consistently construct preferences for renewable power generation technologies that use solar power, wind power, small-scale hydroelectric power, geothermal power, wood biomass, or biogas as energy sources. The sustainability information was prepared using a renewable energy-focused input-output model of Japan and contained life cycle greenhouse gas emissions, electricity generation costs, and job creation. We measured rank-ordered preferences in the following four steps in experimental workshops conducted for municipal officials: provision of (1 energy-source names; (2 sustainability information; (3 additional explanation of public value; and (4 knowledge and techniques about multi-attribute value functions. The degree of changes in preference orders was evaluated using Spearman’s rank correlation coefficient. The consistency of rank-ordered preferences among participants was determined by using the maximum eigenvalue for the coefficient matrix. The results show: (1 the individual preferences evolved drastically in response to the sustainability information and the decision support method; and (2 the rank-ordered preferences were more consistent during the preference construction processes. These results indicate that provision of sustainability information, coupled with decision support methods, is effective for decision making regarding renewable energies.

Reclaiming Society Publishing

Directory of Open Access Journals (Sweden)

Philip E. Steinberg

2015-07-01

Full Text Available Learned societies have become aligned with commercial publishers, who have increasingly taken over the latter’s function as independent providers of scholarly information. Using the example of geographical societies, the advantages and disadvantages of this trend are examined. It is argued that in an era of digital publication, learned societies can offer leadership with a new model of open access that can guarantee high quality scholarly material whose publication costs are supported by society membership dues.

An Integrated Modeling Approach to Evaluate and Optimize Data Center Sustainability, Dependability and Cost

Directory of Open Access Journals (Sweden)

Gustavo Callou

2014-01-01

Full Text Available Data centers have evolved dramatically in recent years, due to the advent of social networking services, e-commerce and cloud computing. The conflicting requirements are the high availability levels demanded against the low sustainability impact and cost values. The approaches that evaluate and optimize these requirements are essential to support designers of data center architectures. Our work aims to propose an integrated approach to estimate and optimize these issues with the support of the developed environment, Mercury. Mercury is a tool for dependability, performance and energy flow evaluation. The tool supports reliability block diagrams (RBD, stochastic Petri nets (SPNs, continuous-time Markov chains (CTMC and energy flow (EFM models. The EFM verifies the energy flow on data center architectures, taking into account the energy efficiency and power capacity that each device can provide (assuming power systems or extract (considering cooling components. The EFM also estimates the sustainability impact and cost issues of data center architectures. Additionally, a methodology is also considered to support the modeling, evaluation and optimization processes. Two case studies are presented to illustrate the adopted methodology on data center power systems.

Sustainable Design: A Case of Environmental and Cost Life Cycle Assessment of a Kitchen Designed for Seniors and Disabled People

Directory of Open Access Journals (Sweden)

Anna Lewandowska

2017-07-01

Full Text Available Sustainable production and consumption patterns require a change in approach at the early conceptual stages, i.e., when planning and designing products and services. This article presents an example of sustainable kitchen design aimed at the needs of seniors and people with physical disabilities, which takes into account social, economic, and environmental aspects. The interdisciplinary project team used a variety of traditional design methods such as the identification of requirements using QFD (Quality Function Deployment and FMEA (Failure Mode Effects Analysis, the development and verification of the technical concepts of the designed objects and their use, the development of construction and technological documentation, assembly drawings of the product architecture and its parts, function cost analysis, virtual and real prototyping, and tools based on the concept of a life cycle such as environmental life cycle assessment (LCA and life cycle costing (LCC. The analysis of the design solutions from the point of view of several criteria and several life cycle stages shows the complexity of the decision-making process and the difficulties in selecting a clearly favourable solution. Environmentally preferred materials may be difficult for users to accept due to their costs. On the other hand, materials that have a high environmental impact at the production stage may show great potential for final disposal.

Sustaining an Effective ABC-ABM System

OpenAIRE

Gary COKINS; Sorinel CĂPUŞNEANU

2011-01-01

The purpose of this paper is to describe the Activity- Based Costing (ABC) and Activity-Based Management (ABM) system and techniques to sustain them as a permanent and repeatable production reporting system, not just for one-off analysis. A comparison is made between ABC/ABM modeling software that extracts source data and business systems that include ABC/ABM modeling features. There are presented the stages of updating, running and rerunning the ABC/ABM system. The resul...

Transition management. Key to a sustainable society; Transitiemanagement. Sleutel voor een duurzame samenleving

Energy Technology Data Exchange (ETDEWEB)

Rotmans, J. [International Centre for Integrative Studies ICIS, Universiteit Maastricht, Maastricht (Netherlands)

2003-07-01

Via transitions outdated societal systems need to be replaced by new societal and sustainable systems. In this book attention is paid to how the renewal process can be steered. The first part deals with the transition philosophy, while the second part is dedicated to a series of practical examples in the field of water, agriculture, energy, construction, mobility and biodiversity which must bring us to a new, sustainable society. [Dutch] Het creeren van een duurzame samenleving is van levensbelang voor de huidige en toekomstige generaties. Toch krijgt duurzaamheid van de politiek nog steeds niet de aandacht die zij verdient. Dit boek biedt daarom een vernieuwende en uitdagende kijk op deze grote maatschappelijke opgave. Onze tegenwoordige samenleving is verre van duurzaam; ondanks het veelgeroemde 'poldermodel' zijn we er tot nu toe niet in geslaagd de hardnekkige problemen in sectoren als de landbouw, de gezondheidszorg en de energievoorziening het hoofd te bieden. Meer en meer wordt duidelijk dat een duurzame samenleving een echte cultuuromslag vergt. Via transities - maatschappelijke overgangen die tijd, durf en energie vergen - zullen verouderde maatschappelijke systemen (deels) moeten worden afgebroken om vervolgens opnieuw te worden opgebouwd. Dit boek gaat in op de wijze waarop dit noodzakelijke vernieuwingsproces kan worden gestuurd. Het eerste deel behandelt het transitiedenken, inclusief de achterliggende filosofie. In het tweede deel staat het transitiehandelen centraal, aan de hand van een serie praktijkvoorbeelden op de terreinen water, landbouw, energie, de bouwsector, mobiliteit en biodiversiteit. Een inspirerend boek voor iedereen die een bijdrage wil leveren aan de totstandkoming van een nieuwe, duurzame samenleving.

Cost-effectiveness analysis of treatment strategies for initial Clostridium difficile infection.

Science.gov (United States)

Varier, R U; Biltaji, E; Smith, K J; Roberts, M S; Jensen, M K; LaFleur, J; Nelson, R E

2014-12-01

Clostridium difficile infection (CDI) is costly. Current guidelines recommend metronidazole as first-line therapy and vancomycin as an alternative. Recurrence is common. Faecal microbiota transplantation (FMT) is an effective therapy for recurrent CDI (RCDI). This study explores the cost-effectiveness of FMT, vancomycin and metronidazole for initial CDI. We constructed a decision-analytic computer simulation using inputs from published literature to compare FMT with a 10-14-day course of oral metronidazole or vancomycin for initial CDI. Parameters included cure rates (baseline value (range)) for metronidazole (80% (65-85%)), vancomycin (90% (88-92%)) and FMT(91% (83-100%)). Direct costs of metronidazole, vancomycin and FMT, adjusted to 2011 dollars, were $57 ($43-72), $1347 ($1195-1499) and $1086 ($815-1358), respectively. Our effectiveness measure was quality-adjusted life years (QALYs). One-way and probabilistic sensitivity analyses were conducted from the third-party payer perspective. Analysis using baseline values showed that FMT($1669, 0.242 QALYs) dominated (i.e. was less costly and more effective) vancomycin ($1890, 0.241 QALYs). FMT was more costly and more effective than metronidazole ($1167, 0.238 QALYs), yielding an incremental cost-effectiveness ratio (ICER) of $124 964/QALY. One-way sensitivity analyses showed that metronidazole dominated both strategies if its probability of cure were >90%; FMT dominated if it cost costly. FMT and vancomycin are more effective. However, FMT is less likely to be economically favourable, and vancomycin is unlikely to be favourable as first-line therapy when compared with FMT. © 2014 The Authors Clinical Microbiology and Infection © 2014 European Society of Clinical Microbiology and Infectious Diseases.

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

Cost-effectiveness of SHINE: A Telephone Translation of the Diabetes Prevention Program

Directory of Open Access Journals (Sweden)

Christopher S. Hollenbeak

2016-01-01

Full Text Available Background The Support, Health Information, Nutrition, and Exercise (SHINE trial recently showed that a telephone adaptation of the Diabetes Prevention Program (DPP lifestyle intervention was effective in reducing weight among patients with metabolic syndrome. The aim of this study is to determine whether a conference call (CC adaptation was cost effective relative to an individual call (IC adaptation of the DPP lifestyle intervention in the primary care setting. Methods We performed a stochastic cost-effectiveness analysis alongside a clinical trial comparing two telephone adaptations of the DPP lifestyle intervention. The primary outcomes were incremental cost-effectiveness ratios estimated for weight loss, body mass index (BMI, waist circumference, and quality-adjusted life years (QALYs. Costs were estimated from the perspective of society and included direct medical costs, indirect costs, and intervention costs. Results After one year, participants receiving the CC intervention accumulated fewer costs ($2,831 vs. $2,933 than the IC group, lost more weight (6.2 kg vs. 5.1 kg, had greater reduction in BMI (2.1 vs. 1.9, and had greater reduction in waist circumference (6.5 cm vs. 5.9 cm. However, participants in the CC group had fewer QALYs than those in the IC group (0.635 vs. 0.646. The incremental cost-effectiveness ratio for CC vs. IC was $9,250/QALY, with a 48% probability of being cost-effective at a willingness-to-pay of $100,000/QALY. Conclusions CC delivery of the DPP was cost effective relative to IC delivery in the first year in terms of cost per clinical measure (weight lost, BMI, and waist circumference but not in terms of cost per QALY, most likely because of the short time horizon.

Sustainable Sanitation—A Cost-Effective Tool to Improve Plant Yields and the Environment

Directory of Open Access Journals (Sweden)

Päivi Karinen

2010-01-01

Full Text Available Human urine and faeces are products formed every day in every human society. The volume and fertilisation value of urine is higher than that of faeces. This paper reviews data that urine has been used successfully as a fertiliser for cereals and some vegetables. According to the literature, urine fertilised plants may have produced higher, similar or slightly lower yields than mineral fertilized plants but they invariably resulted in higher yields than non-fertilised plants. There have been no microbiological risks associated with any products. The taste and chemical quality of the products are similar to plants treated with mineral fertilisers. Separating toilets, where urine and faeces are separated already in the toilet, could be beneficial not only in poor but also in the industrialized countries. A separating toilet could be installed also in old buildings and it could allow individuals to live in coastal areas, mountainous or other sensitive environments. In poor areas, urine fertilisation could increase food production also in home plots and reduce hunger. It could also combat water contamination and help to reduce diseases caused by enteric micro-organisms. If urine were to be viewed as a resource rather than a waste product, more families could be encouraged to install low-cost toilets which would especially improve the wellbeing of women.

Nuclear power in the frame of sustainable development

International Nuclear Information System (INIS)

Constantin, M.

2003-01-01

Nuclear energy is treated taking into account the three dimensions of sustainable development: economic, environmental and social. Some nuclear energy relevant indicators are identified and used in the analysis. The economic efficiency is a relevant indicator insofar as market prices reflect the full costs for society of a given product or activity. For nuclear energy the economic criteria applicable to market competition and subsidies are used. The core indicators for the environmental dimension of sustainable development include criteria related to natural resource management, climate change, air and water quality, biodiversity and landscaping. The nuclear electricity generation chain does not release gases or particles that acidify rains, contribute to urban smog or deplete of the ozone layer. The human and social dimension comprises human capital in the form of knowledge, education and employment opportunities, human welfare, equity and participation, social capital in the form of effective institutions and voluntary associations, the rule of law, and social cohesion. From this point of view the nuclear energy is characterized by a net contribution to human and social capital and a challenge in terms of public acceptability and widely varying perceptions of the risks and benefits. (authors)

Overall Bike Effectiveness as a Sustainability Metric for Bike Sharing Systems

Directory of Open Access Journals (Sweden)

Bernardo Nugroho Yahya

2017-11-01

Full Text Available Bike sharing systems (BSS have been widely accepted as an urban transport scheme in many cities around the world. The concept is recently expanded and followed by many cities to offer citizen a “green” and flexible transportation scheme in urban areas. Many works focus on the issues of bike availability while the bike performance, i.e., life cycle issues and its sustainability, for better management has been abandoned. As a consequence, mismanagement of BSS would lead to cost inefficiency and, the worst case, end with operation termination. This study proposes a design science approach by developing an Overall Bike Effectiveness (OBE framework. By incorporating the concept of overall equipment analysis (OEE, the proposed framework is used to measure the bike utilization. Accordingly, the OBE is extended into Theoretical OBE to measure the sustainability of the early-stage of BSS. The framework has been verified and evaluated using a real dataset of BSS. The proposed method provides valuable results for benchmarking, life cycle analysis, system expansion and strategy planning toward sustainability. The paper concludes with a discussion to show the impact of the proposed approach into the real practices of BSS including an outlook toward sustainability of BSS.

Cost-effectiveness analysis of fidaxomicin versus vancomycin in Clostridium difficile infection.

Science.gov (United States)

Nathwani, Dilip; Cornely, Oliver A; Van Engen, Anke K; Odufowora-Sita, Olatunji; Retsa, Peny; Odeyemi, Isaac A O

2014-11-01

Fidaxomicin was non-inferior to vancomycin with respect to clinical cure rates in the treatment of Clostridium difficile infections (CDIs) in two Phase III trials, but was associated with significantly fewer recurrences than vancomycin. This economic analysis investigated the cost-effectiveness of fidaxomicin compared with vancomycin in patients with severe CDI and in patients with their first CDI recurrence. A 1 year time horizon Markov model with seven health states was developed from the perspective of Scottish public healthcare providers. Model inputs for effectiveness, resource use, direct costs and utilities were obtained from published sources and a Scottish expert panel. The main model outcome was the incremental cost-effectiveness ratio (ICER), expressed as cost per quality-adjusted life year (QALY), for fidaxomicin versus vancomycin; ICERs were interpreted using willingness-to-pay thresholds of £20,000/QALY and £30,000/QALY. One-way and probabilistic sensitivity analyses were performed. Total costs were similar with fidaxomicin and vancomycin in patients with severe CDI (£14,515 and £14,344, respectively) and in patients with a first recurrence (£16,535 and £16,926, respectively). Improvements in clinical outcomes with fidaxomicin resulted in small QALY gains versus vancomycin (severe CDI, +0.010; patients with first recurrence, +0.019). Fidaxomicin was cost-effective in severe CDI (ICER £16,529/QALY) and dominant (i.e. more effective and less costly) in patients with a first recurrence. The probability that fidaxomicin was cost-effective at a willingness-to-pay threshold of £30,000/QALY was 60% for severe CDI and 68% in a first recurrence. Fidaxomicin is cost-effective in patients with severe CDI and in patients with a first CDI recurrence versus vancomycin. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy.

Cost-effectiveness of cervical-cancer screening in five developing countries.

Science.gov (United States)

Goldie, Sue J; Gaffikin, Lynne; Goldhaber-Fiebert, Jeremy D; Gordillo-Tobar, Amparo; Levin, Carol; Mahé, Cédric; Wright, Thomas C

2005-11-17

Cervical-cancer screening strategies that involve the use of conventional cytology and require multiple visits have been impractical in developing countries. We used computer-based models to assess the cost-effectiveness of a variety of cervical-cancer screening strategies in India, Kenya, Peru, South Africa, and Thailand. Primary data were combined with data from the literature to estimate age-specific incidence and mortality rates for cancer and the effectiveness of screening for and treatment of precancerous lesions. We assessed the direct medical, time, and program-related costs of strategies that differed according to screening test, targeted age and frequency, and number of clinic visits required. Single-visit strategies involved the assumption that screening and treatment could be provided in the same day. Outcomes included the lifetime risk of cancer, years of life saved, lifetime costs, and cost-effectiveness ratios (cost per year of life saved). The most cost-effective strategies were those that required the fewest visits, resulting in improved follow-up testing and treatment. Screening women once in their lifetime, at the age of 35 years, with a one-visit or two-visit screening strategy involving visual inspection of the cervix with acetic acid or DNA testing for human papillomavirus (HPV) in cervical cell samples, reduced the lifetime risk of cancer by approximately 25 to 36 percent, and cost less than 500 dollars per year of life saved. Relative cancer risk declined by an additional 40 percent with two screenings (at 35 and 40 years of age), resulting in a cost per year of life saved that was less than each country's per capita gross domestic product--a very cost-effective result, according to the Commission on Macroeconomics and Health. Cervical-cancer screening strategies incorporating visual inspection of the cervix with acetic acid or DNA testing for HPV in one or two clinical visits are cost-effective alternatives to conventional three

Global comparative healthcare effectiveness research: Evaluating sustainable programmes in low & middle resource settings

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Rajesh Balkrishnan

2013-01-01

Full Text Available The need to focus healthcare expenditures on innovative and sustainable health systems that efficiently use existing effective therapies are the major drivers stimulating Comparative Effectiveness Research (CER across the globe. Lack of adequate access and high cost of essential medicines and technologies in many countries increases morbidity and mortality and cost of care that forces people and families into poverty due to disability and out-of-pocket expenses. This review illustrates the potential of value-added global health care comparative effectiveness research in shaping health systems and health care delivery paradigms in the "global south". Enabling the development of effective CER systems globally paves the way for tangible local and regional definitions of equity in health care because CER fosters the sharing of critical assets, resources, skills, and capabilities and the development of collaborative of multi-sectorial frameworks to improve health outcomes and metrics globally.

Cost of New Technologies in Prostate Cancer Treatment: Systematic Review of Costs and Cost Effectiveness of Robotic-assisted Laparoscopic Prostatectomy, Intensity-modulated Radiotherapy, and Proton Beam Therapy.

Science.gov (United States)

Schroeck, Florian Rudolf; Jacobs, Bruce L; Bhayani, Sam B; Nguyen, Paul L; Penson, David; Hu, Jim

2017-11-01

Some of the high costs of robot-assisted radical prostatectomy (RARP), intensity-modulated radiotherapy (IMRT), and proton beam therapy may be offset by better outcomes or less resource use during the treatment episode. To systematically review the literature to identify the key economic trade-offs implicit in a particular treatment choice for prostate cancer. We systematically reviewed the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement and protocol. We searched Medline, Embase, and Web of Science for articles published between January 2001 and July 2016, which compared the treatment costs of RARP, IMRT, or proton beam therapy to the standard treatment. We identified 37, nine, and three studies, respectively. RARP is costlier than radical retropubic prostatectomy for hospitals and payers. However, RARP has the potential for a moderate cost advantage for payers and society over a longer time horizon when optimal cancer and quality-of-life outcomes are achieved. IMRT is more expensive from a payer's perspective compared with three-dimensional conformal radiotherapy, but also more cost effective when defined by an incremental cost effectiveness ratio new versus traditional technologies is costlier. However, given the low quality of evidence and the inconsistencies across studies, the precise difference in costs remains unclear. Attempts to estimate whether this increased cost is worth the expense are hampered by the uncertainty surrounding improvements in outcomes, such as cancer control and side effects of treatment. If the new technologies can consistently achieve better outcomes, then they may be cost effective. We review the cost and cost effectiveness of robot-assisted radical prostatectomy, intensity-modulated radiotherapy, and proton beam therapy in prostate cancer treatment. These technologies are costlier than their traditional counterparts. It remains unclear whether their use is associated

Knowledge Sharing for the Provision of sustainable Cooperation ...

African Journals Online (AJOL)

pc

2018-03-05

Mar 5, 2018 ... affect development of a sustainable society and will determine tendencies in ... artificial intelligence and should be defined as 'intellectual systems' ..... Grundspeņķis,"Multi-Agent Robotic System Architecture for Effective Task.

Social responsibility (SR) of nuclear research and its practice for pursuing integrity and sustainability of nuclear research with society

International Nuclear Information System (INIS)

Tetsuo, Sawada; Naoki, Yamano; Yoshiko, Aoyama; Akiko, Shioda; Junichi, Mizuo; Yasuhiko, Fujii

2007-01-01

Corporate Social Responsibility (CSR), which includes compliance, engineering and business ethics, safety and security, and corporate governance, is being widely applied not only in the field of business administrations but also in academia and research communities. The basic 3 ideals of CSR are sustainability, stakeholder dialogue (stakeholder include consumers, suppliers, employees, investors and local communities) and triple basic constraints (be environment-friendly, competitive and beneficial for the society as a whole). A typical aspect of this trend is that most electric power company publishes documents such as Corporate Social Responsibility (CSR) reports which are the improved version of social-environmental reports. CSR reflects the very expectations from the society that how far the corporations and organizations including universities can resolve the issues in which the society is necessarily involved. The nuclear power generations and related facilities are sorts of societal systems and not merely technological systems. This paper describes the concept of CSR, its basic prerequisites and the framework of the civic forum that is a part of the practices of Nuclear CSR

Towards the sustainable energy system. The future of the transition policy for energy and environment

International Nuclear Information System (INIS)

Bruggink, J.J.C.

2006-11-01

Inaugural speech at the occasion of the acceptance of the office for Energy Transition and Sustainable Development at the Faculty of Earth and Life Sciences of the Vrije Universiteit in Amsterdam, Netherlands, November 21, 2006. The transition policy in the Netherlands towards a sustainable energy supply system succeeded in creating a basis in the Dutch society, although at the cost of making clear choices with regard to concrete projects, new policy tools and financial means. In order to accelerate those choices the Dutch government needs to take decisive measures [nl

Examining the effectiveness of municipal solid waste management systems: An integrated cost-benefit analysis perspective with a financial cost modeling in Taiwan

International Nuclear Information System (INIS)

Weng, Yu-Chi; Fujiwara, Takeshi

2011-01-01

In order to develop a sound material-cycle society, cost-effective municipal solid waste (MSW) management systems are required for the municipalities in the context of the integrated accounting system for MSW management. Firstly, this paper attempts to establish an integrated cost-benefit analysis (CBA) framework for evaluating the effectiveness of MSW management systems. In this paper, detailed cost/benefit items due to waste problems are particularly clarified. The stakeholders of MSW management systems, including the decision-makers of the municipalities and the citizens, are expected to reconsider the waste problems in depth and thus take wise actions with the aid of the proposed CBA framework. Secondly, focusing on the financial cost, this study develops a generalized methodology to evaluate the financial cost-effectiveness of MSW management systems, simultaneously considering the treatment technological levels and policy effects. The impacts of the influencing factors on the annual total and average financial MSW operation and maintenance (O and M) costs are analyzed in the Taiwanese case study with a demonstrative short-term future projection of the financial costs under scenario analysis. The established methodology would contribute to the evaluation of the current policy measures and to the modification of the policy design for the municipalities.

Examining the effectiveness of municipal solid waste management systems: an integrated cost-benefit analysis perspective with a financial cost modeling in Taiwan.

Science.gov (United States)

Weng, Yu-Chi; Fujiwara, Takeshi

2011-06-01

In order to develop a sound material-cycle society, cost-effective municipal solid waste (MSW) management systems are required for the municipalities in the context of the integrated accounting system for MSW management. Firstly, this paper attempts to establish an integrated cost-benefit analysis (CBA) framework for evaluating the effectiveness of MSW management systems. In this paper, detailed cost/benefit items due to waste problems are particularly clarified. The stakeholders of MSW management systems, including the decision-makers of the municipalities and the citizens, are expected to reconsider the waste problems in depth and thus take wise actions with the aid of the proposed CBA framework. Secondly, focusing on the financial cost, this study develops a generalized methodology to evaluate the financial cost-effectiveness of MSW management systems, simultaneously considering the treatment technological levels and policy effects. The impacts of the influencing factors on the annual total and average financial MSW operation and maintenance (O&M) costs are analyzed in the Taiwanese case study with a demonstrative short-term future projection of the financial costs under scenario analysis. The established methodology would contribute to the evaluation of the current policy measures and to the modification of the policy design for the municipalities. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

Is aggressive treatment of traumatic brain injury cost-effective?

Science.gov (United States)

Whitmore, Robert G; Thawani, Jayesh P; Grady, M Sean; Levine, Joshua M; Sanborn, Matthew R; Stein, Sherman C

2012-05-01

The object of this study was to determine whether aggressive treatment of severe traumatic brain injury (TBI), including invasive intracranial monitoring and decompressive craniectomy, is cost-effective. A decision-analytical model was created to compare costs, outcomes, and cost-effectiveness of 3 strategies for treating a patient with severe TBI. The aggressive-care approach is compared with "routine care," in which Brain Trauma Foundation guidelines are not followed. A "comfort care" category, in which a single day in the ICU is followed by routine floor care, is included for comparison only. Probabilities of each treatment resulting in various Glasgow Outcome Scale (GOS) scores were obtained from the literature. The GOS scores were converted to quality-adjusted life years (QALYs), based on expected longevity and calculated quality of life associated with each GOS category. Estimated direct (acute and long-term medical care) and indirect (loss of productivity) costs were calculated from the perspective of society. Sensitivity analyses employed a 2D Monte Carlo simulation of 1000 trials, each with 1000 patients. The model was also used to estimate these values for patients 40, 60, and 80 years of age. For the average 20-year-old, aggressive care yields 11.7 (± 1.6 [SD]) QALYs, compared with routine care (10.0 ± 1.5 QALYs). This difference is highly significant (p care remains significantly better at all ages. When all costs are considered, aggressive care is also significantly less costly than routine care ($1,264,000 ± $118,000 vs $1,361,000 ± $107,000) for the average 20-year-old. Aggressive care remains significantly less costly until age 80, at which age it costs more than routine care. However, even in the 80-year-old, aggressive care is likely the more cost-effective approach. Comfort care is associated with poorer outcomes at all ages and with higher costs for all groups except 80-year-olds. When all the costs of severe TBI are considered, aggressive

Sustainable Business Models - A Need For New And Sustainable Business Models

OpenAIRE

Heir, Nina

2016-01-01

Business plays a key role for the sustainable development of the society. However, business models of today do not have a sustainable perspective, indicating that they do not balance the three dimensions of sustainability; the social, environmental and economical dimension. A change at the business model level is therefore required for sustainable business models to become the new business models of tomorrow. The purpose of this study is to increase the knowledge of how companies can con...

Sustainability in Supply Chain Management: Aggregate Planning from Sustainability Perspective.

Directory of Open Access Journals (Sweden)

Metin Türkay

Full Text Available Supply chain management that considers the flow of raw materials, products and information has become a focal issue in modern manufacturing and service systems. Supply chain management requires effective use of assets and information that has far reaching implications beyond satisfaction of customer demand, flow of goods, services or capital. Aggregate planning, a fundamental decision model in supply chain management, refers to the determination of production, inventory, capacity and labor usage levels in the medium term. Traditionally standard mathematical programming formulation is used to devise the aggregate plan so as to minimize the total cost of operations. However, this formulation is purely an economic model that does not include sustainability considerations. In this study, we revise the standard aggregate planning formulation to account for additional environmental and social criteria to incorporate triple bottom line consideration of sustainability. We show how these additional criteria can be appended to traditional cost accounting in order to address sustainability in aggregate planning. We analyze the revised models and interpret the results on a case study from real life that would be insightful for decision makers.

INTERNAL COMMUNICATION, THE PROGRESS OF TECHNOLOGY AND SUSTAINABLE DEVELOPMENT

Directory of Open Access Journals (Sweden)

CRISTINA ANDREI

2014-05-01

Full Text Available Sustainable development involves the broad public participation including the national, regional and local authorities, business and industry, civil society, all major groups – women, children and youth, all workers, trade unions and families. Not only organizations but also employees have a role to play in applying sustainable development in their jobs because their decisions taken every day have an environmental impact. Communication within organization is used as a means to coordinate information exchange and to establish effective coordination of activities between the members of organization. Internet, e-mail, mobile phones, satellite and wireless have had an effect on the way in which information is exchanged and on how people communicate not only in their day-to-day life but also within in the organizations they belong to. New communication technologies have increased the possibilities for a better access to information for employees and made possible to have their voices heard from their colleagues to superior levels, offering the possibility of a two-way communication and creating the potential for greater understanding and dialogue between them. Besides increasing profits, saving time and costs, the use of e-communication within organizations, offer the convenience of combating environmental damage through cutting back on paper and ink usage

The development of ecological environment in China based on the system dynamics method from the society, economy and environment perspective.

Science.gov (United States)

Guang, Yang; Ge, Song; Han, Liu

2016-01-01

The harmonious development in society, economy and environment are crucial to regional sustained boom. However, the society, economy and environment are not respectively independent, but both mutually promotes one which, or restrict mutually complex to have the long-enduring overall process. The present study is an attempt to investigate the relationship and interaction of society, economy and environment in China based on the data from 2004 to 2013. The principal component analysis (PCA) model was employed to identify the main factors effecting the society, economy and environment subsystems, and SD (system dynamics) method used to carry out dynamic assessment for future state of sustainability from society, economy and environment perspective with future indicator values. Sustainable development in China was divided in the study into three phase from 2004 to 2013 based competitive values of these three subsystems. According to the results of PCA model, China is in third phase, and the economy growth is faster than the environment development, while the social development still maintained a steady and rapid growth, implying that the next step for sustainable development in China should focus on society development, especially the environment development.

Server Operation and Virtualization to Save Energy and Cost in Future Sustainable Computing

Directory of Open Access Journals (Sweden)

Jun-Ho Huh

2018-06-01

Full Text Available Since the introduction of the LTE (Long Term Evolution service, we have lived in a time of expanding amounts of data. The amount of data produced has increased every year with the increase of smart phone distribution in particular. Telecommunication service providers have to struggle to secure sufficient network capacity in order to maintain quick access to necessary data by consumers. Nonetheless, maintaining the maximum capacity and bandwidth at all times requires considerable cost and excessive equipment. Therefore, to solve such a problem, telecommunication service providers need to maintain an appropriate level of network capacity and to provide sustainable service to customers through a quick network development in case of shortage. So far, telecommunication service providers have bought and used the network equipment directly produced by network equipment manufacturers such as Ericsson, Nokia, Cisco, and Samsung. Since the equipment is specialized for networking, which satisfied consumers with their excellent performances, they are very costly because they are developed with advanced technologies. Moreover, it takes much time due to the purchase process wherein the telecommunication service providers place an order and the manufacturer produces and delivers. Accordingly, there are cases that require signaling and two-way data traffic as well as capacity because of the diversity of IoT devices. For these purposes, the need for NFV (Network Function Virtualization is raised. Equipment virtualization is performed so that it is operated on an x86-based compatible server instead of working on the network equipment manufacturer’s dedicated hardware. By operating in some compatible servers, it can reduce the wastage of hardware and cope with the change thanks to quick hardware development. This study proposed an efficient system of reducing cost in network server operation using such NFV technology and found that the cost was reduced by 24

Cost-effectiveness of human papillomavirus vaccination for adolescent girls in Punjab state: Implications for India's universal immunization program.

Science.gov (United States)

Prinja, Shankar; Bahuguna, Pankaj; Faujdar, Dharmjeet Singh; Jyani, Gaurav; Srinivasan, Radhika; Ghoshal, Sushmita; Suri, Vanita; Singh, Mini P; Kumar, Rajesh

2017-09-01

Introduction of human papillomavirus (HPV) vaccination for adolescent girls is being considered in the Punjab state of India. However, evidence regarding cost-effectiveness is sought by policy makers when making this decision. The current study was undertaken to evaluate the incremental cost per quality-adjusted life-years (QALYs) gained with introduction of the HPV vaccine compared with a no-vaccination scenario. A static progression model, using a combination of decision tree and Markov models, was populated using epidemiological, cost, coverage, and effectiveness data to determine the cost-effectiveness of HPV vaccination. Using a societal perspective, lifetime costs and consequences (in terms of QALYs) among a cohort of 11-year-old adolescent girls in Punjab state were modeled in 2 alternate scenarios with and without vaccination. All costs and consequences were discounted at a rate of 3%. Although immunizing 1 year's cohort of 11-year-old girls in Punjab state costs Indian National Rupees (INR) 135 million (US dollars [USD] 2.08 million and International dollars [Int$] 6.25 million) on an absolute basis, its net cost after accounting for treatment savings is INR 38 million (USD 0.58 million and Int$ 1.76 million). Incremental cost per QALY gained for HPV vaccination was found to be INR 73 (USD 1.12 and Int$ 3.38). Given all the data uncertainties, there is a 90% probability for the vaccination strategy to be cost-effective in Punjab state at a willingness-to-pay threshold of INR 10,000, which is less than one-tenth of the per capita gross domestic product. HPV vaccination appears to be a very cost-effective strategy for Punjab state, and is likely to be cost-effective for other Indian states. Cancer 2017;123:3253-60. © 2017 American Cancer Society. © 2017 American Cancer Society.

Cost Effectiveness of Monoclonal Antibody Therapy for Rare Diseases: A Systematic Review.

Science.gov (United States)

Park, Taehwan; Griggs, Scott K; Suh, Dong-Churl

2015-08-01

Monoclonal antibody (mAb)-based orphan drugs have led to advances in the treatment of diseases by selectively targeting molecule functions. However, their high treatment costs impose a substantial cost burden on patients and society. The study aimed to systematically review cost-effectiveness evidence of mAb orphan drugs. Ovid MEDLINE(®), EMBASE(®), and PsycINFO(®) were searched in June 2014 and articles were selected if they conducted economic evaluations of the mAb orphan drugs that had received marketing approval in the USA. The quality of the selected studies was assessed using the Quality of Health Economic Studies (QHES) instrument. We reviewed 16 articles that included 24 economic evaluations of nine mAb orphan drugs. Six of these nine drugs were included in cost-utility analysis studies, whereas three drugs were included in cost-effectiveness analysis studies. Previous cost-utility analysis studies revealed that four mAb orphan drugs (cetuximab, ipilimumab, rituximab, and trastuzumab) were found to be cost effective; one drug (bevacizumab) was not cost effective; and one drug (infliximab) was not consistent across the studies. Prior cost-effectiveness analysis studies which included three mAb orphan drugs (adalimumab, alemtuzumab, and basiliximab) showed that the incremental cost per effectiveness gained for these drugs ranged from $US4669 to $Can52,536 Canadian dollars. The quality of the included studies was good or fair with the exception of one study. Some mAb orphan drugs were reported as cost effective under the current decision-making processes. Use of these expensive drugs, however, can raise an equity issue which concerns fairness in access to treatment. The issue of equal access to drugs needs to be considered alongside other societal values in making the final health policy decisions.

Resources available in society

International Nuclear Information System (INIS)

Berg, S.E.

1997-01-01

A decontamination operation will only be successful if cost-efficient methods are used. The cost-effectiveness depends, among many other factors, including the qualifications and training of the personnel and the capability of the equipment. The personnel must be able to handle the equipment in a professional way and should also know how to protect themselves. To fulfil these requirements they need courses in radiation protection. The equipment must be suitable for the selected countermeasure. Societies planning and preparedness for reclamation should meet realistic demands for early actions and outline a cost-effective strategy that implies reasonable use of personnel and equipment resources. Planning for early cleanup actions is different from that of long term planning with respect to the available time and quantity and quality of available information on which to base decisions. Available resources vary, of course, between the Nordic countries, but in all countries there are organisations with both knowledgeable staff and suitable equipment accessible for decontamination operations. (EG)

Framework for Sustainability Performance Assessment for Manufacturing Processes- A Review

Science.gov (United States)

Singh, K.; Sultan, I.

2017-07-01

Manufacturing industries are facing tough competition due to increasing raw material cost and depleting natural resources. There is great pressure on the industry to produce environmental friendly products using environmental friendly processes. To address these issues modern manufacturing industries are focusing on sustainable manufacturing. To develop more sustainable societies, industries need to better understand how to respond to environmental, economic and social challenges. This paper proposed some framework and tools that accelerate the transition towards a sustainable system. The developed framework will be beneficial for sustainability assessment comparing different plans alongside material properties, ultimately helping the manufacturing industries to reduce the carbon emissions and material waste, besides improving energy efficiency. It is expected that this would be highly beneficial for determination of environmental impact of a process at early design stages. Therefore, it would greatly help the manufacturing industries for selection of process plan based on sustainable indices. Overall objective of this paper would have good impact on reducing air emissions and protecting environment. We expect this work to contribute to the development of a standard reference methodology to help further sustainability in the manufacturing sector.

ICT for society through society: Application of code-sprints as entrepreneurial enabler

CSIR Research Space (South Africa)

Coetzee, L

2010-08-31

Full Text Available Information and Communications Technology for Development (ICT4D) is faced with the challenge of creating sustainable and innovative success stories which speak to the creation of an inclusive digital society. Initial attempts at ICT4D had limited...

Key features for more successful place-based sustainability research on social-ecological systems: a Programme on Ecosystem Change and Society (PECS perspective

Directory of Open Access Journals (Sweden)

Patricia Balvanera

2017-03-01

Full Text Available The emerging discipline of sustainability science is focused explicitly on the dynamic interactions between nature and society and is committed to research that spans multiple scales and can support transitions toward greater sustainability. Because a growing body of place-based social-ecological sustainability research (PBSESR has emerged in recent decades, there is a growing need to understand better how to maximize the effectiveness of this work. The Programme on Ecosystem Change and Society (PECS provides a unique opportunity for synthesizing insights gained from this research community on key features that may contribute to the relative success of PBSESR. We surveyed the leaders of PECS-affiliated projects using a combination of open, closed, and semistructured questions to identify which features of a research project are perceived to contribute to successful research design and implementation. We assessed six types of research features: problem orientation, research team, and contextual, conceptual, methodological, and evaluative features. We examined the desirable and undesirable aspects of each feature, the enabling factors and obstacles associated with project implementation, and asked respondents to assess the performance of their own projects in relation to these features. Responses were obtained from 25 projects working in 42 social-ecological study cases within 25 countries. Factors that contribute to the overall success of PBSESR included: explicitly addressing integrated social-ecological systems; a focus on solution- and transformation-oriented research; adaptation of studies to their local context; trusted, long-term, and frequent engagement with stakeholders and partners; and an early definition of the purpose and scope of research. Factors that hindered the success of PBSESR included: the complexities inherent to social-ecological systems, the imposition of particular epistemologies and methods on the wider research group

Conceptualizing the Effectiveness of Sustainability Assessment in Development Cooperation

Directory of Open Access Journals (Sweden)

Jean Hugé

2015-05-01

Full Text Available Sustainability assessment has emerged as a key decision-support process in development cooperation in response to the growing acknowledgement of the impacts of global change. This paper aims at conceptualizing the effectiveness of sustainability assessment as applied in development cooperation, by focusing on the sustainability assessment practice by actors of the official Belgian Development Cooperation. The conceptualization of the effectiveness of sustainability assessment is synthesized in a set of issues and concerns, based on semi-structured interviews. The paper highlights the specificity of sustainability assessment in the development cooperation sector (e.g., through the cultural and discursive compatibility dimensions of assessment in a North-South context. Effectiveness is inherently linked to the expected functions of sustainability assessment in the decision-making process, which include fostering organizational change, shaping contextually adapted framings of sustainability and operationalizing the sustainability transition. These findings highlight the relevance of a discourse-sensitive approach to sustainability assessment if one is to strengthen its credibility and legitimacy.

Sustainable development in city districts: BaLaLuZ project - Society; Schlussbericht 'Gesellschaft' - Phase 1

Energy Technology Data Exchange (ETDEWEB)

Arend, M.

2004-07-01

This final report for the Swiss Federal Office of Energy (SFOE) is one of a series of reports concerning municipal development in various cities in Switzerland. The four city districts involved include Basel (Gundeldinger Feld), Lausanne (Bellevaux), Lucerne (Basel-/Bernstrasse) and Zurich (Werdwies). This paper takes a look at society aspects in the four districts and examines the factors that influence the sustainable development of the districts. Topics discussed include basic residential needs, safety, health, and supply along with culture and education. Also examined are the possible topics equality and fairness and participation along with geographical reference and neighbourhood relations. A project for this area of investigation is suggested.

[Sustainable development of the three economic patterns in China: The application of genuine progress indicator in the sustainability assessment of six typical cities.

Science.gov (United States)

Li, Jing; Huang, Lu; Yan, Li Jiao

2016-06-01

Three economic patterns, i.e., Zhujiang Model, Wenzhou Model and Sunan Model, were all generated in the developed areas of China. Sustainability assessment of those areas plays an important role in guiding future development of the economy of China. Genuine progress indicator (GPI) was adopted in this study to evaluate the sustainability of 6 typical cities (Guangzhou, Shenzhen, Wenzhou, Suzhou, Wuxi, and Changzhou) of the three economic patterns from 1995 to 2012. During the study period, the values of GDP for the six cities had experienced exponential growth, while the values of GPI started to increase since 2005 after a relatively constant period between 1995 and 2005. The gap between GPI and GDP had been widening from a historical perspective. Zhujiang Model made great progress in economic growth, however, the economic, social, and environmental costs were evident. It should tackle income inequality, traffic jam, and environmental pollution to reach sustainability. The development of Wenzhou Model slowed down in the late pe-riod, with inadequate potential to develop. Its income inequality was tough, social and economic development was slow, and the economic development pattern needed to be urgently changed. Sunan Model had a higher value of GPI and the potential to reach sustainability, with remarkable growth of economy, median level of the GPI costs, and steady improvement of social development, although its natural resources were depleted. Three economic patterns should focus on the three dimensions of sustainability (economy, environment, and society), and Zhujiang Model and Wenzhou Model needed to be more active to search for transition of their development.

Healthcare Building Sustainability Assessment tool - Sustainable Effective Design criteria in the Portuguese context

International Nuclear Information System (INIS)

Castro, Maria de Fátima; Mateus, Ricardo; Bragança, Luís

2017-01-01

Tools and methods to improve current practices and quality in the healthcare building sector are necessary to support decision-making at different building life cycle phases. Furthermore, Healthcare Building Sustainability Assessment (HBSA) Methods are based on criteria organised into different levels, such as categories and indicators. These criteria highlight aspects of significant importance when designing and operating a sustainable healthcare building. To bring more objectivity to the sustainability assessments, the standardisation bodies (CEN and ISO) proposed core indicators that should be used in the evaluation of the environmental, societal and economic performances of buildings. Nevertheless, relying on state of the art analysis, it is possible to conclude that there are aspects of major importance for the operation of healthcare buildings that are not considered in the HBSA methods. Thus, the aim of this paper is to discuss the context of sustainability assessment methods in the field of healthcare buildings and to present a proposal for the incorporation of Sustainable-Effective Design (SED) criteria in a new HBSA method. The used research method is innovative since in the development of the list of sustainability criteria it considers the opinion of main healthcare buildings' stakeholders, the existing healthcare assessment methods and the ISO and CEN standardisation works in the field of the methods to assess the sustainability of construction works. As a result, the proposed method is composed of fifty-two sustainability indicators that cover the different dimensions of the sustainability concept to support decision making during the design of a new or retrofitted healthcare building in urban areas. - Highlights: •A new system to assess the sustainability of healthcare buildings is presented. •We propose a method to develop the list of sustainability indicators for hospitals. •We propose a new concept – Sustainable-Effective Design (SED

Sustainable development - opening address 29th Annual Canadian Nuclear Society Conference

International Nuclear Information System (INIS)

Lamarre, P.

2008-01-01

This paper discusses sustainable development which in a broad sense incorporates three dimensions: economic growth, environmental protection, and social welfare. The challenge for sustainable development is to address these three dimensions in a balanced way

Cost-effectiveness of interventions to promote physical activity: a modelling study.

Directory of Open Access Journals (Sweden)

Linda J Cobiac

2009-07-01

. CONCLUSIONS: Intervention to promote physical activity is recommended as a public health measure. Despite substantial variability in the quantity and quality of evidence on intervention effectiveness, and uncertainty about the long-term sustainability of behavioural changes, it is highly likely that as a package, all six interventions could lead to substantial improvement in population health at a cost saving to the health sector. Please see later in the article for Editors' Summary.

Cost-Effectiveness and Clinical Practice Guidelines: Have We Reached a Tipping Point?-An Overview.

Science.gov (United States)

Garrison, Louis P

2016-01-01

Given recent developments in the United States, where professional clinical societies have attempted to define "value" and consider it in their deliberations about appropriate care, this thematic article describes those recent specialty society efforts in the United States in cardiology and oncology and the multispecialty efforts in the United Kingdom for over 10 years. Despite our high levels of health spending, and our field's long and consistent approach to the basic tools of cost-effectiveness analysis (CEA), US private and public payers are not routinely or explicitly using CEAs in their reimbursement decisions. This is a puzzle that raises the following question: Why does the United States have so many skilled pharmacoeconomic practitioners and produce so many CEAs given this apparent lack of interest and trust? There are multiple reasons, but the lack of incentives to use the information certainly matters. This article identifies and discusses a number of key issues and challenges for incorporating CEA into US clinical guidelines development: potential bias in manufacturer-sponsored CEAs, the role of societal perspective, payer-subscriber and physician-patient agency relationships, the need for disease area CEA studies and modeling, patient heterogeneity, investigators' conflicts of interest, assessing the quality of economic studies, and aggregation of information using multicriteria decision analysis. These developments suggest that the application of CEA in health care decision making in the United States is evolving and may be approaching a tipping point. With increasing pressures on drug prices, perhaps reflecting challenges to industry sustainability, payers, providers, and patients are looking for value for money. CEA should be an important part of this process. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Human-Nature for Climate Action: Nature-Based Solutions for Urban Sustainability

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Helen Santiago Fink

2016-03-01

Full Text Available The global climate change agenda proceeds at an incremental pace while the Earth is approaching critical tipping points in its development trajectory. Climate action at this pinnacle juncture needs to be greatly accelerated and rooted in the fundamentals of the problem—human beings’ disconnection from nature. This paper underscores the valuable role nature and nature-based solutions can play in addressing climate change at the city scale and its implications for broader sustainability. Urban ecosystems (nature in cities are seen as an integral part of a proposed local climate action rubric wherein policy measures and integrated planning guide lowcarbon/impact development to create more resilient and sustainable urban environments. The use of green infrastructure is highlighted as a cost-effective means to contribute to mitigation and adaptation needs as well as to promote human wellbeing. The paper takes an exploratory view of the influence of ecosystem services, particularly cultural services, and its economics in relation to the individual and society to understand how biophilia can be nurtured to promote environmental stewardship and climate action.

Sustainable business models: systematic approach toward successful ambulatory care pharmacy practice.

Science.gov (United States)

Sachdev, Gloria

2014-08-15

This article discusses considerations for making ambulatory care pharmacist services at least cost neutral and, ideally, generate a margin that allows for service expansion. The four pillars of business sustainability are leadership, staffing, information technology, and compensation. A key facet of leadership in ambulatory care pharmacy practice is creating and expressing a clear vision for pharmacists' services. Staffing considerations include establishing training needs, maximizing efficiencies, and minimizing costs. Information technology is essential for efficiency in patient care delivery and outcomes assessment. The three domains of compensation are cost savings, pay for performance, and revenue generation. The following eight steps for designing and implementing an ambulatory care pharmacist service are discussed: (1) prepare a needs assessment, (2) analyze existing strengths, weaknesses, opportunities, and threats, (3) analyze service gaps and feasibility, (4) consider financial opportunities, (5) consider stakeholders' interests, (6) develop a business plan, (7) implement the service, and (8) measure outcomes. Potential future changes in national healthcare policy (such as pharmacist provider status and expanded pay for performance) could enhance the opportunities for sustainable ambulatory care pharmacy practice. The key challenges facing ambulatory care pharmacists are developing sustainable business models, determining which services yield a positive return on investment, and demanding payment for value-added services. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Allergic rhinitis and the common cold--high cost to society.

Science.gov (United States)

Hellgren, J; Cervin, A; Nordling, S; Bergman, A; Cardell, L O

2010-06-01

The common cold and allergic rhinitis constitute a global health problem that affects social life, sleep, school and work performance and is likely to impose a substantial economic burden on society because of absence from work and reduced working capacity. This study assesses the loss of productivity as a result of both allergic rhinitis and the common cold in the Swedish working population. Four thousand questionnaires were sent to a randomized adult population, aged 18-65 years, in Sweden, stratified by gender and area of residence (metropolitan area vs rest of the country). The human capital approach was used to assign monetary value to lost productivity in terms of absenteeism (absence from work), presenteeism (reduced working capacity while at work) and caregiver absenteeism (absence from work to take care of a sick child). Thousand two hundred and thirteen individuals responded, response rate 32%. The mean productivity loss was estimated at 5.1 days or euro 653 per worker and year, yielding a total productivity loss in Sweden of euro 2.7 billion a year. Of the total costs, absenteeism (44%) was the dominant factor, followed by presenteeism (37%) and caregiver absenteeism (19%). Poisson regression analyses revealed that women, people in the 18-29 year age group, and respondents with 'doctor-diagnosed asthma' reported more lost days than the rest of the group. In Sweden, the cost of rhinitis is euro 2.7 billion a year in terms of lost productivity. A reduction in lost productivity of 1 day per individual and year would potentially save euro 528 million.

Society and education

DEFF Research Database (Denmark)

Moutsios, Stavros

in Europe. Elaborating on the Castoriadian ontology, the book delves into the magma of social imaginary significations that characterise and associate pivotal epochs of the continent’s history, Classical Greece and Modernity, and exemplifies their incarnation in educational systems and in the formation...... countries. Nevertheless, as Moutsios suggests, the European tradition, notwithstanding its ideological usage by much of social sciences, contains an indissoluble critical and self-reflective dimension, which needs to be sustained and advanced in education and its cross-cultural comparison, perhaps, more......'Society and Education: An Outline of Comparison' explores the relation of society to education in Europe, as well as its comparative perspective towards overseas societies and their institutions. It is an enquiry into the social-historical institution of education and cross-cultural studies...

Sustainability needs communication - German ICT-industry's strategy to promote sustainability

Energy Technology Data Exchange (ETDEWEB)

Tobias, M. [German Association for Information Technology, Telecommunications and New Media - BITKOM, Berlin (Germany); Pongratz, S. [Motorola Advanced Technology Center, Taunusstein (Germany)

2004-07-01

Information and communication technologies (ICT) lay the basis for the information society and have therefore a daily influence on almost everybody. This involves certain requirements regarding the purpose of a sustainable development as for example energy use, careful use of resources, and global compliance with social standards. However, ICT applications and their integration into business processes as well as daily private life also offer enormous potential for shaping sustainable development. Based on this realization, active companies and their associations are to play an important role in promoting new approaches for Sustainability. To this reason the German ICT-Association BITKOM together with some of the most active players in this field founded a new workgroup for International Environmental Policy and Sustainability. Main targets are the communication of an orientation towards sustainability within the own branch as well as the usage of ICT-products and services to enable sustainable development on a society basis. This covers political activities, publication of guidelines and brochures as well as the discussion of new approaches with scientists and NGOs. By critically questioning the approach within the own branch the process of a transparent communication shall be initiated, by which everybody will be able to contribute his specific part to the whole ''sustainability-puzzle''. (orig.)

A framework of initiatives for successful application of life cycle costing (LCC in industrialised building system (IBS in Malaysian construction industry

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Shamsuddin Siti Mazzuana

2017-01-01

Full Text Available Industrialised Building System (IBS contributes a great shift in sustainable construction and benefits the society. Previous studies have proven in general that one of the hindrances in promoting sustainable in IBS, is a high cost for any pre-cast material specifically thus effected the overall cost. The introduction of Life Cycle Costing (LCC leads into providing a better and comprehensive cost estimation, including projecting actual cost to operate the building, hence providing a better baseline for decision making. The lacking application of LCC in IBS is still in trivial impact, therefore, this paper presents a framework which produced by expressing the successful initiatives of LCC and IBS in Malaysia construction industry. The framework developed based on findings from the extensive literature reviews, 164 responded questionnaires, and 19 expert opinions, which has three sections: Strategy Development, System Development and the last part is Decision Level. Aspects of objectivity, practicality, reliability, completeness that were likely to be implemented in the Malaysian construction industry were used. There are significant opinions on the usefulness and completeness of the proposed framework in providing a comprehensive cost estimates which helps much in deciding to carry out IBS or remain with a traditional construction method.

Innovative Integrated Management System (IIMS for Sustainable Food Industry

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Suttiprasit Prasert

2014-11-01

Full Text Available It is evident that the long-term survival and growth of global food industry depend on the availability and efficient use of raw materials, energy and water and other facilities under the concept of sustainable practice, i.e. in environment, society and economics. Quality and safety managements are essential to ensure that the industry can continue to support the communities in which it operates. Awarding a number of certifications to show the high standing of international quality and hygiene characteristics are currently necessary, e.g. ISO 9001: 2000, GMP/GHP, HACCP, ISO 22000, BRC and etc. To minimize the cost and maximize the efficiency, the Innovative Integration Management System (IIMS has been implemented effectively under the frameworks of sustainability in a numbers of national and international food production companies in Thailand during the past years. This will allow the organization to integrate all common processes such as management review, document control, record control, training, monitoring & measuring, data analysing, internal audits, and corrective and preventive actions whereas the critical or specific processes required by each standard are still retained harmoniously with the others.

On the Travel Emissions of Sustainability Science Research

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Timothy Waring

2014-05-01

Full Text Available This paper presents data on carbon emissions generated by travel undertaken for a major sustainability science research effort. Previous research has estimated CO2 emissions generated by individual scientists, by entire academic institutions, or by international climate conferences. Here, we sought to investigate the size, distribution and factors affecting the carbon emissions of travel for sustainability research in particular. Reported airline and automobile travel of participants in Maine’s Sustainability Solutions Initiative were used to calculate the carbon dioxide emissions attributable to research-related travel over a three-year period. Carbon emissions varied substantially by researcher and by purpose of travel. Travel for the purpose of dissemination created the largest carbon footprint. This result suggests that alternative networking and dissemination models are needed to replace the high carbon costs of annual society meetings. This research adds to literature that questions whether the cultural demands of contemporary academic careers are compatible with climate stabilization. We argue that precise record keeping and routine analysis of travel data are necessary to track and reduce the climate impacts of sustainability research. We summarize the barriers to behavioral change at individual and organizational levels and conclude with suggestions for reducing climate impacts of travel undertaken for sustainability research.

'Sustainability does not quite get the attention it deserves': synergies and tensions in the sustainability frames of Australian food policy actors.

Science.gov (United States)

Trevena, Helen; Kaldor, Jenny Claire; Downs, Shauna M

2015-09-01

The development of food policy is strongly influenced by the understanding and position actors adopt in their 'framing' of sustainability. The Australian Government developed a National Food Plan (2010-2013). In public consultations on the National Food Plan Green Paper, the government sought stakeholders' views on sustainability. The present study examined the way in which the food industry and civil society organizations framed sustainability in their submissions to the Green Paper. Submissions by food industry actors and civil society organizations were analysed using a framing matrix that examined positioning, drivers, underlying principles and policy solutions related to sustainability. Submissions were open coded and subsequently organized based on themes within the framing matrix. Australia. One hundred and twenty-four written submissions (1420 pages). While submissions from industry and civil society organizations often framed sustainability similarly, there were also major differences. Civil society organizations were more likely to make the link between the food supply and population health, while industry was more likely to focus on economic sustainability. Both viewed consumer demand as a driver of sustainability, welcomed the idea of a whole-of-government approach and stressed the need for investment in research and development to improve productivity and sustainable farming practices. The meaning of sustainability shifted throughout the policy process. There are opportunities for creating shared value in food policy, where the health, environment and economic dimensions of sustainability can be compatible. However, despite pockets of optimism there is a need for a shared vision of sustainability if Australia is to have a food policy integrating these dimensions.

Cost effectiveness of FDG-PET: rapid evaluation in recurrent colorectal cancer

International Nuclear Information System (INIS)

Kelley, B.B.; Miles, K.A.; Keith, C.J.; Wong, D.C.; Griffiths, M.R.

2002-01-01

Full text: Intensive patient follow-up in assessments of the cost-effectiveness of a new imaging modality is associated with time-delays, ethical difficulties and increased costs. This study aims to evaluate the cost-effectiveness of FDG-PET in recurrent colorectal cancer using Australian data whilst avoiding intensive patient follow-up. The study population comprised patients with recurrent colorectal under consideration for resection of apparently isolated hepatic metastasis in whom demonstration of extra-hepatic tumour would preclude surgery. The results of FDG-PET in a consecutive series of 75 such patients referred to the Wesley PET centre were used to determine the range of possible values for disease prevalence and specificity, assuming the value for PET sensitivity as reported in the federal government's PET review. These values, along with the diagnostic accuracy of CT and Australian costs for procedures (PET = $ 1200), were entered into decision trees modelling a diagnostic strategy comprising CT only and an alternative strategy where patients without extra-hepatic tumour on CT also undergo FDG-PET. The cost per patient, accuracy and Incremental Cost-Accuracy Ratio (ICAR) were determined for each strategy. The PET strategy is cheaper for all possible values of disease prevalence and PET specificity ($306-328/patient) and is more cost-effective for values of disease prevalence above 0.18 or PET specificity above 0.86. At a typical disease prevalence of 0.3 (PET specificity 0.92), the ICAR for the PET strategy is $9700 versus $11,200 for CT. PET remains cost saving even if the best reported values for sensitivity of CT and worse values for PET are used, FDG-PET for recurrent colorectal cancer in Australia would be cost-saving and most probably cost-effective. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

SUSTAINABILITY, GLOBALIZATION, CULTURE AND WORK

Directory of Open Access Journals (Sweden)

João Almeida Santos

2013-11-01

Full Text Available This paper discusses the development process and the influence of globalization on culture and behavior of society seen on reflexes in the consumer market and how they participate or interfere in sustainability. Whereas globalization as a process of interaction between people in general originated in trade and political relations, reflections on the culture and behavior of society are inevitable from the point of view of consumption of products that are offered for new consumers in these markets that are in the process of globalization. Considering this necessity, it is important to consider the sustainable use of resources and by-products. This article is a reflection on sustainability, globalization, culture and work, and can be summarized in: a identifying the consequences of globalization on employment from the use of technology, b the consequences of globalization on culture are positive or negative for both involved, c benefits globalization and society have with new, better and cheaper products to meet the population needs and d how sustainability is in this consuming-producing context.

Cryptococcal Meningitis Treatment Strategies Affected by the Explosive Cost of Flucytosine in the United States: A Cost-effectiveness Analysis.

Science.gov (United States)

Merry, Matthew; Boulware, David R

2016-06-15

In the United States, cryptococcal meningitis causes approximately 3400 hospitalizations and approximately 330 deaths annually. The US guidelines recommend treatment with amphotericin B plus flucytosine for at least 2 weeks, followed by fluconazole for a minimum of 8 weeks. Due to generic drug manufacturer monopolization, flucytosine currently costs approximately $2000 per day in the United States, with a 2-week flucytosine treatment course costing approximately $28 000. The daily flucytosine treatment cost in the United Kingdom is approximately $22. Cost-effectiveness analysis was performed to determine the value of flucytosine relative to alternative regimens. We estimated the incremental cost-effectiveness ratio (ICER) of 3 cryptococcal induction regimens: (1) amphotericin B deoxycholate for 4 weeks; (2) amphotericin and flucytosine (100 mg/kg/day) for 2 weeks; and (3) amphotericin and fluconazole (800 mg/day) for 2 weeks. Costs of care were calculated using 2015 US prices and the medication costs. Survival estimates were derived from a randomized trial and scaled relative to published US survival data. Cost estimates were $83 227 for amphotericin monotherapy, $75 121 for amphotericin plus flucytosine, and $44 605 for amphotericin plus fluconazole. The ICER of amphotericin plus flucytosine was $23 842 per quality-adjusted life-year. Flucytosine is currently cost-effective in the United States despite a dramatic increase in price in recent years. Combination therapy with amphotericin and flucytosine is the most attractive treatment strategy for cryptococcal meningitis, though the rising price may be creating access issues that will exacerbate if the trend of profiteering continues. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Cost analysis and exploratory cost-effectiveness of youth-friendly sexual and reproductive health services in the Republic of Moldova

Science.gov (United States)

2014-01-01

Background Youth-friendly sexual and reproductive health services (YFHS) have high priority in many countries. Yet, little is known about the cost and cost-effectiveness of good quality YFHS in resource limited settings. This paper analyses retrospectively costs and potential cost-effectiveness of four well performing youth-friendly health centres (YFHC) in Moldova. This study assesses: (1) what were the costs of YFHSs at centre level, (2) how much would scaling-up to a national good quality YFHS programme cost, and (3) was the programme potentially cost-effective? Methods Four well performing YFHCs were selected for the study. YFHS costs were analysed per centre, funding source, service and person reached. The costing results were extrapolated to estimate cost of a good quality national YFHS programme in Moldova. A threshold analysis was carried out to estimate the required impact level for the YFHSs to break-even (become cost saving). Results Average annual cost of a well performing YFHC was USD 26,000 in 2011. 58% was financed by the National Health Insurance Company and the rest by external donors (42%). Personnel salaries were the largest expense category (47%). The annual implementation costs of a good quality YFHSs in all 38 YFHCs of Moldova were estimated to be USD 1.0 million. The results of the threshold analysis indicate that the annual break-even impact points in a YFHC for: 1) STI services would be >364 averted STIs, 2) early pregnancy and contraceptive services >178 averted unwanted pregnancies, and 3) HIV services only >0.65 averted new HIV infections. Conclusions The costing results highlight the following: 1) significant additional resources would be required for implementation of a good quality national YFHS programme, 2) the four well performing YFHCs rely heavily on external funding (42%), 3) which raises questions about financial sustainability of the programme. At the same time results of the threshold analysis are encouraging. The result

Cost analysis and exploratory cost-effectiveness of youth-friendly sexual and reproductive health services in the Republic of Moldova.

Science.gov (United States)

Kempers, Jari; Ketting, Evert; Lesco, Galina

2014-07-21

Youth-friendly sexual and reproductive health services (YFHS) have high priority in many countries. Yet, little is known about the cost and cost-effectiveness of good quality YFHS in resource limited settings. This paper analyses retrospectively costs and potential cost-effectiveness of four well performing youth-friendly health centres (YFHC) in Moldova. This study assesses: (1) what were the costs of YFHSs at centre level, (2) how much would scaling-up to a national good quality YFHS programme cost, and (3) was the programme potentially cost-effective? Four well performing YFHCs were selected for the study. YFHS costs were analysed per centre, funding source, service and person reached. The costing results were extrapolated to estimate cost of a good quality national YFHS programme in Moldova. A threshold analysis was carried out to estimate the required impact level for the YFHSs to break-even (become cost saving). Average annual cost of a well performing YFHC was USD 26,000 in 2011. 58% was financed by the National Health Insurance Company and the rest by external donors (42%). Personnel salaries were the largest expense category (47%). The annual implementation costs of a good quality YFHSs in all 38 YFHCs of Moldova were estimated to be USD 1.0 million. The results of the threshold analysis indicate that the annual break-even impact points in a YFHC for: 1) STI services would be >364 averted STIs, 2) early pregnancy and contraceptive services >178 averted unwanted pregnancies, and 3) HIV services only >0.65 averted new HIV infections. The costing results highlight the following: 1) significant additional resources would be required for implementation of a good quality national YFHS programme, 2) the four well performing YFHCs rely heavily on external funding (42%), 3) which raises questions about financial sustainability of the programme. At the same time results of the threshold analysis are encouraging. The result suggest that, together the three SRH

Experts’ Perceptions of the Effects of Forest Biomass Harvesting on Sustainability in the Alpine Region

Directory of Open Access Journals (Sweden)

Gianluca Grilli

2015-06-01

Full Text Available Background and Purpose: In the EU political agenda, the use of forest biomass for energy has grown rapidly and significantly, in order to mitigate carbon dioxide emissions and reduce the energy dependence on fossil fuels of European member countries. The target of the EU climate and energy package is to raise the share of renewable energy consumption produced from renewable resources to 20% in 2020 (Directive 2009/28/EC. With regards to biomass energy, the supply of forest wood biomass is expected to rise by 45% (reference period: 2006-2020, in response to increasing demand for renewable sources. The increase of forest biomass supply could have both positive and negative effects on several forest ecosystem services (ESs and local development. These effects should be assessed in a proper manner and taken into account when formulating management strategies. The aim of the paper is to assess the environmental, economic and social sustainability of forest biomass harvesting for energy, using the Figure of Merit (FoM approach. Materials and Methods: Sustainability was assessed through a set of four indicators: two focused on experts’ opinions regarding the effects of forest biomass harvesting and the other two focused on the cost-benefit analysis (potential energy obtained and costs for wood chips. The research was developed through four case studies located in the Alpine Region. A semi-structured questionnaire was administered face-to-face to 32 selected experts. The perceived effects of forest biomass harvesting for energy on ESs and local development were evaluated by experts using a 5-point Likert scale (from “quite negative effect” to “quite positive effect”. Results: All experts agree that forest biomass harvesting has a positive effect on forest products provision and local economic development (employment of local workforce, local entrepreneurship and market diversification, while the effects on other ESs are controversial (e

Cost-Effectiveness Analysis of an Automated Medication System Implemented in a Danish Hospital Setting.

Science.gov (United States)

Risør, Bettina Wulff; Lisby, Marianne; Sørensen, Jan

To evaluate the cost-effectiveness of an automated medication system (AMS) implemented in a Danish hospital setting. An economic evaluation was performed alongside a controlled before-and-after effectiveness study with one control ward and one intervention ward. The primary outcome measure was the number of errors in the medication administration process observed prospectively before and after implementation. To determine the difference in proportion of errors after implementation of the AMS, logistic regression was applied with the presence of error(s) as the dependent variable. Time, group, and interaction between time and group were the independent variables. The cost analysis used the hospital perspective with a short-term incremental costing approach. The total 6-month costs with and without the AMS were calculated as well as the incremental costs. The number of avoided administration errors was related to the incremental costs to obtain the cost-effectiveness ratio expressed as the cost per avoided administration error. The AMS resulted in a statistically significant reduction in the proportion of errors in the intervention ward compared with the control ward. The cost analysis showed that the AMS increased the ward's 6-month cost by €16,843. The cost-effectiveness ratio was estimated at €2.01 per avoided administration error, €2.91 per avoided procedural error, and €19.38 per avoided clinical error. The AMS was effective in reducing errors in the medication administration process at a higher overall cost. The cost-effectiveness analysis showed that the AMS was associated with affordable cost-effectiveness rates. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

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.

Cost-effectiveness of indwelling pleural catheter compared with talc in malignant pleural effusion.

Science.gov (United States)

Olfert, Jordan A P; Penz, Erika D; Manns, Braden J; Mishra, Eleanor K; Davies, Helen E; Miller, Robert F; Luengo-Fernandez, Ramon; Gao, Song; Rahman, Najib M

2017-05-01

Malignant pleural effusion is associated with morbidity and mortality. A randomized controlled trial previously compared clinical outcomes and resource use with indwelling pleural catheter (IPC) and talc pleurodesis in this population. Using unpublished quality of life data, we estimate the cost-effectiveness of IPC compared with talc pleurodesis. Healthcare utilization and costs were captured during the trial. Utility weights produced by the EuroQol Group five-dimensional three-level questionnaire and survival were used to determine quality-adjusted life-years (QALYs) gained. The incremental cost-effectiveness ratio (ICER) was calculated over the 1-year trial period. Sensitivity analysis used patient survival data and modelled additional nursing time required per week for catheter drainage. Utility scores, cost and QALYs gained did not differ significantly between groups. The ICER for IPC compared with talc was favorable at $US10 870 per QALY gained. IPC was less costly with a probability exceeding 95% of being cost-effective when survival was pleural effusion in patients without history of prior pleurodesis, with consideration for patient survival, support and preferences. © 2016 The Authors. Respirology published by John Wiley & Sons Australia, Ltd on behalf of Asian Pacific Society of Respirology.

The grain of spatially referenced economic cost and biodiversity benefit data and the effectiveness of a cost targeting strategy.

Science.gov (United States)

Sutton, N J; Armsworth, P R

2014-12-01

Facing tight resource constraints, conservation organizations must allocate funds available for habitat protection as effectively as possible. Often, they combine spatially referenced economic and biodiversity data to prioritize land for protection. We tested how sensitive these prioritizations could be to differences in the spatial grain of these data by demonstrating how the conclusion of a classic debate in conservation planning between cost and benefit targeting was altered based on the available information. As a case study, we determined parcel-level acquisition costs and biodiversity benefits of land transactions recently undertaken by a nonprofit conservation organization that seeks to protect forests in the eastern United States. Then, we used hypothetical conservation plans to simulate the types of ex ante priorities that an organization could use to prioritize areas for protection. We found the apparent effectiveness of cost and benefit targeting depended on the spatial grain of the data used when prioritizing parcels based on local species richness. However, when accounting for complementarity, benefit targeting consistently was more efficient than a cost targeting strategy regardless of the spatial grain of the data involved. More pertinently for other studies, we found that combining data collected over different spatial grains inflated the apparent effectiveness of a cost targeting strategy and led to overestimation of the efficiency gain offered by adopting a more integrative return-on-investment approach. © 2014 Society for Conservation Biology.

Cost-effectiveness analysis alongside a pilot study of prophylactic negative pressure wound therapy.

Science.gov (United States)

Heard, Christopher; Chaboyer, Wendy; Anderson, Vinah; Gillespie, Brigid M; Whitty, Jennifer A

2017-02-01

Negative pressure wound therapy (NPWT) is increasingly used prophylactically following surgery despite limited evidence of clinical or cost-effectiveness. To evaluate whether NPWT is cost-effective compared to standard care, for the prevention of surgical site infection (SSI) in obese women undergoing elective caesarean section, and inform development of a larger trial. An economic evaluation was conducted alongside a pilot randomised controlled trial at one Australian hospital, in which women were randomised to NPWT (n = 44) or standard care (n = 43). A public health care provider perspective and time horizon to four weeks post-discharge was adopted. Cost-effectiveness assessment was based on incremental cost per SSI prevented and per quality-adjusted life year (QALY) gained. Patients receiving NPWT each received health care costing AU$5887 (±1038) and reported 0.069 (±0.010) QALYs compared to AU$5754 (±1484) and 0.066 (±0.010) QALYs for patients receiving standard care. NPWT may be slightly more costly and more effective than standard care, with estimated incremental cost-effectiveness ratios (ICERs) of AU$1347 (95%CI dominant- $41,873) per SSI prevented and AU$42,340 (95%CI dominant- $884,019) per QALY gained. However, there was considerable uncertainty around these estimates. NPWT may be cost-effective in the prophylactic treatment of surgical wounds following elective caesarean section in obese women. Larger trials could clarify the cost-effectiveness of NPWT as a prophylactic treatment for SSI. Sensitive capture of QALYs and cost offsets will be important given the high level of uncertainty around the point estimate cost-effectiveness ratio which was close to conventional thresholds. ACTRN12612000171819. Copyright © 2016 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

Systematic review of model-based analyses reporting the cost-effectiveness and cost-utility of cardiovascular disease management programs.

Science.gov (United States)

Maru, Shoko; Byrnes, Joshua; Whitty, Jennifer A; Carrington, Melinda J; Stewart, Simon; Scuffham, Paul A

2015-02-01

The reported cost effectiveness of cardiovascular disease management programs (CVD-MPs) is highly variable, potentially leading to different funding decisions. This systematic review evaluates published modeled analyses to compare study methods and quality. Articles were included if an incremental cost-effectiveness ratio (ICER) or cost-utility ratio (ICUR) was reported, it is a multi-component intervention designed to manage or prevent a cardiovascular disease condition, and it addressed all domains specified in the American Heart Association Taxonomy for Disease Management. Nine articles (reporting 10 clinical outcomes) were included. Eight cost-utility and two cost-effectiveness analyses targeted hypertension (n=4), coronary heart disease (n=2), coronary heart disease plus stoke (n=1), heart failure (n=2) and hyperlipidemia (n=1). Study perspectives included the healthcare system (n=5), societal and fund holders (n=1), a third party payer (n=3), or was not explicitly stated (n=1). All analyses were modeled based on interventions of one to two years' duration. Time horizon ranged from two years (n=1), 10 years (n=1) and lifetime (n=8). Model structures included Markov model (n=8), 'decision analytic models' (n=1), or was not explicitly stated (n=1). Considerable variation was observed in clinical and economic assumptions and reporting practices. Of all ICERs/ICURs reported, including those of subgroups (n=16), four were above a US$50,000 acceptability threshold, six were below and six were dominant. The majority of CVD-MPs was reported to have favorable economic outcomes, but 25% were at unacceptably high cost for the outcomes. Use of standardized reporting tools should increase transparency and inform what drives the cost-effectiveness of CVD-MPs. © The European Society of Cardiology 2014.

Is local participation always optimal for sustainable action? The costs of consensus-building in Local Agenda 21.

Science.gov (United States)

Brandt, Urs Steiner; Svendsen, Gert Tinggaard

2013-11-15

Is local participation always optimal for sustainable action? Here, Local Agenda 21 is a relevant case as it broadly calls for consensus-building among stakeholders. Consensus-building is, however, costly. We show that the costs of making local decisions are likely to rapidly exceed the benefits. Why? Because as the number of participants grows, the more likely it is that the group will include individuals who have an extreme position and are unwilling to make compromises. Thus, the net gain of self-organization should be compared with those of its alternatives, for example voting, market-solutions, or not making any choices at all. Even though the informational value of meetings may be helpful to policy makers, the model shows that it also decreases as the number of participants increase. Overall, the result is a thought provoking scenario for Local Agenda 21 as it highlights the risk of less sustainable action in the future. Copyright © 2013 Elsevier Ltd. All rights reserved.

Chemistry of cost effective water treatment programme in HWP (Manuguru)

International Nuclear Information System (INIS)

Mohapatra, C.; Laxmana Prasad, K.

2008-01-01

In order to develop a water treatment programme following points must be kept in mind: Effectiveness to achieve desired water quality objectives; Compliance with regulatory requirements; Cost minimization; Safety; Easy operation and protection to equipments. Heavy Water Plant (Manuguru) laboratory has developed treatment programs to treat raw water and cooling water which satisfy the above requirements and has been in use for last several years successfully without any problem. These treatment programs have been given to other plants in Heavy Water Board for implementation. This paper describes the chemistry of the treatment program and cost minimization achieved. Further these treatments have helped the plant in achieving ΦZero Discharge and indirectly reduced the production cost. The chemistry parameters are monitored regularly to ascertain the effectiveness of these treatments. The areas where significant benefits derived are raw water treatment using polyelectrolyte instead of inorganic coagulant (alum), change over of regenerant of cation exchangers from hydrochloric acid to sulfuric acid and development of in-house cooling water treatment formulation. The advantages and cost effectiveness of these treatments are discussed in detail. Further these treatments helped the plant in achieving Zero discharge and indirectly reduced production cost of heavy water. The dosage of 3 ppm of polyelectrolyte can replace 90 ppm alum at turbidity level of 300 NTU of raw water which has resulted in cost saving of Rs. 15 - 20 Lakhs in a year besides other advantages. The changeover of regenerant from HCl to H 2 SO 4 will result in cost saving of at least Rs. 1.4 Crore a year along with other advantages. The change over of proprietary formulation to in-house formulation in cooling water treatment has resulted a saving about Rs. 11 Lakhs a year. To achieve the above objectives in a sustainable way the performance results are being monitored (author)

Catalysing low cost green technologies for sustainable water service delivery in Kenya: Feasibility Study Report

DEFF Research Database (Denmark)

Ndirangu, Wangai; Schaer, Caroline

2017-01-01

Since 1974, the government of Kenya has recognised water supplies as critical for poverty reduction and development. Kenya’s economic and social development Vision 2030 emphasises the need for adequate and sustainable provision of water supply and sanitation services, with a target to achieve...... universal access by 2030. However, thus far most water development targets have not been achieved. Improvement has been much slower in rural and low income urban areas, and the current funding level is inadequate to achieve universal access by 2030. Over the years, official effort have been complemented...... to planning, standards and operations and maintenance, including source and cost of energy in rural and peri-urban water supplies is a key challenge to functionality and sustainability....

Health care financing and the sustainability of health systems.

Science.gov (United States)

Liaropoulos, Lycourgos; Goranitis, Ilias

2015-09-15

The economic crisis brought an unprecedented attention to the issue of health system sustainability in the developed world. The discussion, however, has been mainly limited to "traditional" issues of cost-effectiveness, quality of care, and, lately, patient involvement. Not enough attention has yet been paid to the issue of who pays and, more importantly, to the sustainability of financing. This fundamental concept in the economics of health policy needs to be reconsidered carefully. In a globalized economy, as the share of labor decreases relative to that of capital, wage income is increasingly insufficient to cover the rising cost of care. At the same time, as the cost of Social Health Insurance through employment contributions rises with medical costs, it imperils the competitiveness of the economy. These reasons explain why spreading health care cost to all factors of production through comprehensive National Health Insurance financed by progressive taxation of income from all sources, instead of employer-employee contributions, protects health system objectives, especially during economic recessions, and ensures health system sustainability.

Good research practices for measuring drug costs in cost-effectiveness analyses: a societal perspective: the ISPOR Drug Cost Task Force report--Part II.

Science.gov (United States)

Garrison, Louis P; Mansley, Edward C; Abbott, Thomas A; Bresnahan, Brian W; Hay, Joel W; Smeeding, James

2010-01-01

Major guidelines regarding the application of cost-effectiveness analysis (CEA) have recommended the common and widespread use of the "societal perspective" for purposes of consistency and comparability. The objective of this Task Force subgroup report (one of six reports from the International Society for Pharmacoeconomics and Outcomes Research [ISPOR] Task Force on Good Research Practices-Use of Drug Costs for Cost Effectiveness Analysis [Drug Cost Task Force (DCTF)]) was to review the definition of this perspective, assess its specific application in measuring drug costs, identify any limitations in theory or practice, and make recommendations regarding potential improvements. Key articles, books, and reports in the methodological literature were reviewed, summarized, and integrated into a draft review and report. This draft report was posted for review and comment by ISPOR membership. Numerous comments and suggestions were received, and the report was revised in response to them. The societal perspective can be defined by three conditions: 1) the inclusion of time costs, 2) the use of opportunity costs, and 3) the use of community preferences. In practice, very few, if any, published CEAs have met all of these conditions, though many claim to have taken a societal perspective. Branded drug costs have typically used actual acquisition cost rather than the much lower social opportunity costs that would reflect only short-run manufacturing and distribution costs. This practice is understandable, pragmatic, and useful to current decision-makers. Nevertheless, this use of CEA focuses on static rather than dynamic efficacy and overlooks the related incentives for innovation. Our key recommendation is that current CEA practice acknowledge and embrace this limitation by adopting a new standard for the reference case as one of a "limited societal" or "health systems" perspective, using acquisition drug prices while including indirect costs and community preferences. The

A sustainable scenario for Venezuelan power generation sector in 2050 and its costs

International Nuclear Information System (INIS)

Bautista, Santiago

2012-01-01

The present research study used the quantitative approach to analyze the present and future situation of the Venezuelan power generation sector; to achieve that, the total energy generation costs and GHG emissions of four scenarios in 2050 were estimated and compared, considering two demand groups, high and low demand. For each demand scenario, two supply matrix were considered, a generation matrix based on the existing national power generation plans and trends (these scenarios were referred as BAU) and a configuration based on the renewable energy resources available in Venezuela and without the use of either nuclear or CCS technologies, and these scenarios are referred as Sustainable Scenarios (SUS). In the first section, the present situation is presented, followed by an explanation of the applied methodology and the implemented tools. In the third and fourth sections the available recourses and the applied basic assumptions for the four of scenarios are presented and discussed, respectively, followed by the results. In this study it is shown that Venezuela has all the resources it needs to achieve sustainable development in the power generation sector. It is also proved that an energy efficiency improvement is the easiest path to reduce GHG emissions. - Highlights: ► Venezuela has enough energy resources to supply the energy require for its development. ► A sustainable scenario is posible in Venezuelan power generation sector in 2050. ► The sustainable scenario is technically possible without nuclear power or carbon capture storage technologies. ► The impact over the depleatable resources is higher under the BAU assumptions.

Tax modifications: sustainable energy and society

International Nuclear Information System (INIS)

Thorp, J.P.

2000-01-01

The application of taxes is said to be a valuable means of solving environmental problems; provision of the right incentives will invariably achieve the goal. The policy requirements for addressing the environmental problems are (i) to understand and accept a vision of a sustainable future; (ii) to understand the nature of the challenge; (iii) decide a course of action for the desired future and (iv) the will to implement the actions. The subject is discussed under the sub-headings of (a) The Government Approach; (b) The Climate Change Levy; (c) The Future (short, medium and long term); (d) Recommendations and (e) Renewable Technologies. The potential for carbon savings through a market led transition to a low carbon economy is 'extensive'. The Government must have regulation, taxation or legislation to shape the market to lead to a socially desirable outcome

Reducing transport costs and improving sustainability simultaneously through horizontal logistics collaboration: a case study

OpenAIRE

Van Lier, Tom; Macharis, Cathy; Caris, An; Vrenken, Huub

2010-01-01

In this paper the potential of a more systematic bundling of the outbound freight flows out of three neighboring distribution centers (DCs) of the same company, each specialized in a specific product category and each using a separate planning system, is investigated. Most of the outbound flows are currently still transported by truck, so one way to simultaneously achieve lower transport costs and more sustainable logistics is through supply chain collaboration in outbound logistics. This pap...

Sustainability of common pool resources.

Science.gov (United States)

Timilsina, Raja Rajendra; Kotani, Koji; Kamijo, Yoshio

2017-01-01

Sustainability has become a key issue in managing natural resources together with growing concerns for capitalism, environmental and resource problems. We hypothesize that the ongoing modernization of competitive societies, which we refer to as "capitalism," affects human nature for utilizing common pool resources, thus compromising sustainability. To test this hypothesis, we design and implement a set of dynamic common pool resource games and experiments in the following two types of Nepalese areas: (i) rural (non-capitalistic) and (ii) urban (capitalistic) areas. We find that a proportion of prosocial individuals in urban areas is lower than that in rural areas, and urban residents deplete resources more quickly than rural residents. The composition of proself and prosocial individuals in a group and the degree of capitalism are crucial in that an increase in prosocial members in a group and the rural dummy positively affect resource sustainability by 65% and 63%, respectively. Overall, this paper shows that when societies move toward more capitalistic environments, the sustainability of common pool resources tends to decrease with the changes in individual preferences, social norms, customs and views to others through human interactions. This result implies that individuals may be losing their coordination abilities for social dilemmas of resource sustainability in capitalistic societies.

Cost-effectiveness of embryo transfer strategies: a decision analytic model using long-term costs and consequences of singletons and multiples born as a consequence of IVF.

Science.gov (United States)

van Heesch, M M J; van Asselt, A D I; Evers, J L H; van der Hoeven, M A H B M; Dumoulin, J C M; van Beijsterveldt, C E M; Bonsel, G J; Dykgraaf, R H M; van Goudoever, J B; Koopman-Esseboom, C; Nelen, W L D M; Steiner, K; Tamminga, P; Tonch, N; Torrance, H L; Dirksen, C D

2016-11-01

What is the cost-effectiveness of elective single embryo transfer (eSET) versus double embryo transfer (DET) strategies from a societal perspective, when applying a time horizon of 1, 5 and 18 years? From a short-term perspective (1 year) it is cost-effective to replace DET with single embryo transfer; however when intermediate- (5 years) and long-term (18 years) costs and consequences are incorporated, DET becomes the most cost-effective strategy, given a ceiling ratio of €20 000 per quality-adjusted life years (QALY) gained. According to previous cost-effectiveness research into embryo transfer strategies, DET is considered cost-effective if society is willing to pay around €20 000 for an extra live birth. However, interpretation of those studies is complicated, as those studies fail to incorporate long-term costs and outcomes and used live birth as a measure of effectiveness instead of QALYs. With this outcome, both multiple and singletons were valued as one live birth, whereas costs of all children of a multiple were incorporated. A Markov model (cycle length: 1 year; time horizon: 1, 5 and 18 years) was developed comparing a maximum of: (i) three cycles of eSET in all patients; (ii) four cycles of eSET in all patients; (iii) five cycles of eSET in all patients; (iv) three cycles of standard treatment policy (STP), i.e. eSET in women costs were estimated for all comparators. Input parameters were derived from a retrospective cohort study, in which hospital resource data were collected (n=580) and a parental questionnaire was sent out (431 respondents). Probabilistic sensitivity analysis (5000 iterations) was performed. With a time horizon of 18 years, DETx3 is most effective (0.54 live births, 10.2 LYs and 9.8 QALYs) and expensive (€37 871) per couple starting IVF. Three cycles of eSET are least effective (0.43 live births, 7.1 LYs and 6.8 QALYs) and expensive (€25 563). We assumed that society is willing to pay €20 000 per QALY gained. With a time

Cost-effectiveness of nutritional intervention on healing of pressure ulcers.

Science.gov (United States)

Hisashige, Akinori; Ohura, Takehiko

2012-12-01

Pressure ulcers not only affect quality of life among the elderly, but also bring a large economic burden. There is limited evidence available for the effectiveness of nutritional interventions for treatment of pressure ulcers. In Japan, recently, a 60-patient randomized controlled trial of nutritional intervention on pressure ulcers demonstrated improvement in healing of pressure ulcers, compared with conventional management. To evaluate value for money of nutritional intervention on healing of pressure ulcers, cost-effective analysis was carried out using these trial results. The analysis was carried out from a societal perspective. As effectiveness measures, pressure ulcer days (PUDs) and quality-adjusted life years (QALYs) were estimated. Prevalence of pressure ulcers was estimated by the Kaplan-Meier method. Utility score for pressure ulcers is derived from a cross-sectional survey among health professionals related to pressure ulcers. Costs (e.g., nutritional interventions and management of pressure ulcers) were estimated from trial data during observation and follow-up. Stochastic and qualitative sensitivity analyses were performed to examine the robustness of results. For observation (12 weeks) and follow-up (12-week observation plus 4-week follow-up), nutritional intervention reduced PUDs by 9.6 and 16.2 per person, and gained 0.226 × 10(-2) QALYs and 0.382 × 10(-2) QALYs per person, respectively. In addition, costs were reduced by $542 and $881 per person, respectively. This means nutritional intervention is dominant (cost savings and greater effectiveness). The sensitivity analyses showed the robustness of these results. Economic evaluation of nutritional intervention on healing pressure ulcers from a small randomized controlled trial showed that this intervention is cost saving with health improvement. Further studies are required to determine whether this is a cost-effective intervention for widespread use. Copyright © 2012 Elsevier Ltd and

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 of eptifibatide in acute coronary syndromes; an economic analysis of Western European patients enrolled in the PURSUIT trial. The Platelet IIa/IIb in unstable Angina: Receptor Suppression Using Integrilin Therapy.

Science.gov (United States)

Brown, R E; Henderson, R A; Koster, D; Hutton, J; Simoons, M L

2002-01-01

To assess the direct medical costs and cost effectiveness of routine eptifibatide use amongst patients with unstable angina and myocardial infarction without persistent ST-segment elevation in the Western European subgroup of the PURSUIT trial. Health care resources were collected for the Western European PURSUIT trial patients (n=3697). Unit costs for major resources were developed within six countries using a consistent bottom-up methodology. Resource consumption from the Western European population was used to calculate the average direct medical costs per patient in the eptifibatide and placebo arms of the trial. Eptifibatide was estimated to cost 524 Euros per treatment. Long-term survival estimated from the 6-month trial survival data and combined with the cost data was used to calculate cost-effectiveness ratios. Additionally, cost per death and non-fatal myocardial infarction at 30 days was calculated. Sensitivity analyses were conducted on the discount rate and resource consumption. Cost-effectiveness ratios ranged from 9603 Euros to 18 115 Euros per year of life saved with 3% discount. Using resource consumption based on countries with low coronary arteriography rates, the cost per year of life saved was between 3329 Euros and 10 079 Euros. Using resource consumption based on high coronary arteriography rate countries, the cost per year of life saved was between 17 089 Euros and 24 099 Euros. Assuming no difference in treatment costs except for the addition of eptifibatide, the incremental cost per year of life saved was 23 818 Euros. Routine eptifibatide use was associated with a reduction in the combined end-point of death and myocardial infarction at 30 days, which was sustained at 6 months. Long-term projections indicate a modest increase in survival in eptifibatide patients. These data translate into cost-effectiveness ratios that compare favourably with other new technologies that are currently in use. Copyright 2001 The European Society of

Surgical management of bilateral vocal fold paralysis: A cost-effectiveness comparison of two treatments.

Science.gov (United States)

Naunheim, Matthew R; Song, Phillip C; Franco, Ramon A; Alkire, Blake C; Shrime, Mark G

2017-03-01

Endoscopic management of bilateral vocal fold paralysis (BVFP) includes cordotomy and arytenoidectomy, and has become a well-accepted alternative to tracheostomy. However, the costs and quality-of-life benefits of endoscopic management have not been examined with formal economic analysis. This study undertakes a cost-effectiveness analysis of tracheostomy versus endoscopic management of BVFP. Cost-effectiveness analysis. A literature review identified a range of costs and outcomes associated with surgical options for BVFP. Additional costs were derived from Medicare reimbursement data; all were adjusted to 2014 dollars. Cost-effectiveness analysis evaluated both therapeutic strategies in short-term and long-term scenarios. Probabilistic sensitivity analysis was used to assess confidence levels regarding the economic evaluation. The incremental cost effectiveness ratio for endoscopic management versus tracheostomy is $31,600.06 per quality-adjusted life year (QALY), indicating that endoscopic management is the cost-effective short-term strategy at a willingness-to-pay (WTP) threshold of $50,000/QALY. The probability that endoscopic management is more cost-effective than tracheostomy at this WTP is 65.1%. Threshold analysis demonstrated that the model is sensitive to both utilities and cost in the short-term scenario. When costs of long-term care are included, tracheostomy is dominated by endoscopic management, indicating the cost-effectiveness of endoscopic management at any WTP. Endoscopic management of BVFP appears to be more cost-effective than tracheostomy. Though endoscopic cordotomy and arytenoidectomy require expertise and specialized equipment, this model demonstrates utility gains and long-term cost advantages to an endoscopic strategy. These findings are limited by the relative paucity of robust utility data and emphasize the need for further economic analysis in otolaryngology. NA Laryngoscope, 127:691-697, 2017. © 2016 The American Laryngological

A New Perspective On Architectural Sustainability

DEFF Research Database (Denmark)

Hermund, Anders; Klint, Lars; Schipull Kauschen, Jan

2013-01-01

The research presented in this paper intends to establish a new perspective on architectural sustainability as an effect of good architectural quality. The intention is to show the importance of an actual architectural mindset in the design phase, and whether the conscious architectural material...... selection based on a balanced cost and aesthetics decision making will prove more sustainable and ensure better maintenance, as a result of architectural appeal, than cheaper standard houses....

The cost-effectiveness of multi-purpose HIV and pregnancy prevention technologies in South Africa.

Science.gov (United States)

Quaife, Matthew; Terris-Prestholt, Fern; Eakle, Robyn; Cabrera Escobar, Maria A; Kilbourne-Brook, Maggie; Mvundura, Mercy; Meyer-Rath, Gesine; Delany-Moretlwe, Sinead; Vickerman, Peter

2018-03-01

averted (range: $214-$810/DALY averted among non-dominant scenarios), however, none were cost-effective among women aged 25-49 (minimum $1706/DALY averted). The cost-effectiveness of products improved with additional protection from pregnancy. Estimates were sensitive to variation in incidence assumptions, but robust to other parameters. To the best of our knowledge, this is the first study to estimate the cost-effectiveness of a range of potential MPTs; suggesting that MPTs will be cost-effective among higher incidence FSWs or young women, but not among lower incidence older women. More work is needed to make attractive MPTs available to potential users who could use them effectively. © 2018 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society.

Improving the cost-effectiveness of a healthcare system for depressive disorders by implementing telemedicine: a health economic modeling study.

Science.gov (United States)

Lokkerbol, Joran; Adema, Dirk; Cuijpers, Pim; Reynolds, Charles F; Schulz, Richard; Weehuizen, Rifka; Smit, Filip

2014-03-01

Depressive disorders are significant causes of disease burden and are associated with substantial economic costs. It is therefore important to design a healthcare system that can effectively manage depression at sustainable costs. This article computes the benefit-to-cost ratio of the current Dutch healthcare system for depression, and investigates whether offering more online preventive interventions improves the cost-effectiveness overall. A health economic (Markov) model was used to synthesize clinical and economic evidence and to compute population-level costs and effects of interventions. The model compared a base case scenario without preventive telemedicine and alternative scenarios with preventive telemedicine. The central outcome was the benefit-to-cost ratio, also known as return-on-investment (ROI). In terms of ROI, a healthcare system with preventive telemedicine for depressive disorders offers better value for money than a healthcare system without Internet-based prevention. Overall, the ROI increases from €1.45 ($1.72) in the base case scenario to €1.76 ($2.09) in the alternative scenario in which preventive telemedicine is offered. In a scenario in which the costs of offering preventive telemedicine are balanced by reducing the expenditures for curative interventions, ROI increases to €1.77 ($2.10), while keeping the healthcare budget constant. For a healthcare system for depressive disorders to remain economically sustainable, its cost-benefit ratio needs to be improved. Offering preventive telemedicine at a large scale is likely to introduce such an improvement. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Holistic Development: Muslim Women's Civil Society Groups in ...