WorldWideScience

Sample records for full cost initiative

  1. The Full Costs of Electricity Provision

    International Nuclear Information System (INIS)

    Horst Keppler, Jan; Rothwell, Geoffrey; Cometto, Marco; Deffrennes, Marc; Iracane, Daniel; Ha, Jaejoo; Paillere, Henri; ); Aspelund, Karl; Aydil, Ismail; ); Berthelemy, Michel; Devezeaux De Lavergne, Jean-Guy; Burtin, Alain; Crozat, Matthew P.; D'Haeseleer, William; Friedrich, Reiner; Gonzalez Jimenez, Antonio; Hirschberg, Stefan; Kiso, Jan-Ole; ); Lee, Manki; Le Masne, Dominique; ); Lundmark, Roger J.; Neumann, Doris; ); Politis, Savvas; ); Prin, Coralie; Skonieczny, Olgierd; Voss, Alfred

    2018-01-01

    Electricity provision touches upon every facet of life in OECD and non-OECD countries alike, and choosing how this electricity is generated - whether from fossil fuels, nuclear energy or renewables - affects not only economic outcomes but individual and social well-being in the broader sense. Research on the overall costs of electricity is an ongoing effort, as only certain costs of electricity provision are perceived directly by producers and consumers. Other costs, such as the health impacts of air pollution, damage from climate change or the effects on the electricity system of small-scale variable production are not reflected in market prices and thus diminish well-being in unaccounted for ways. Accounting for these social costs in order to establish the full costs of electricity provision is difficult, yet such costs are too important to be disregarded in the context of the energy transitions currently under way in OECD and NEA countries. This report draws on evidence from a large number of studies concerning the social costs of electricity and identifies proven instruments for internalising them so as to improve overall welfare. The results outlined in the report should lead to new and more comprehensive research on the full costs of electricity, which in turn would allow policy makers and the public to make better informed decisions along the path towards fully sustainable electricity systems

  2. A Reconsideration of Full-Cost Pricing

    OpenAIRE

    Nubbemeyer, Elmar

    2010-01-01

    The wide use of full-cost pricing techniques remains an explanandum in both economics and management accounting theory. This work surveys and develops possible theoretical explanations of this industrial pricing behaviour and analyses some of its implications. By recognition of the widespread use of imperfect cost-plus pricing heuristics, observable pricing behaviour, as well as empirical market-level phenomena, can be explained. Furthermore, methodological aspects of marginalist price the...

  3. Mixed signals emerging on full cost accounting

    International Nuclear Information System (INIS)

    Rutherford, D.

    1993-01-01

    In Ontario, various nongovernmental and governmental agencies have put forward mixed views on the use of full cost accounting (FCA) for electric utilities (Ontario Hydro, in particular). Full cost accounting is defined as a process by which social and environmental impacts of projects and technologies can be quantified and assessed for their comparative consequences on the local community and society at large. A November 1992 statement from the Ontario Ministry of Environment and Energy has said that all social and environmental costs, impacts, risks, and benefits should be considered in planning. A report of the energy task force of the Ontario Round Table on Environment and Economy (ORTEE) included a strong endorsement of FCA. A task force with the mandate to help Ontario Hydro develop a sustainable energy policy includes a group which will examine FCA and how to implement it. Critics of Ontario Hydro note that the utility's recent announcement of offering substantial discounts to some of its largest industrial customers goes directly against FCA. In addition, Hydro's continued reliance on an avoided cost model (without consideration of social and environmental impacts of power generation) makes it difficult for the utility to think beyond traditional approaches. In contrast, British Columbia is announcing a Social Costing policy to evaluate power projects according to their environmental as well as financial impact. Under the right conditions, adopting FCA can offer distinct trade advantages to Ontario. Under international trade agreements that pay heed to environmental costs, jurisdictions which have high environmental standards stand to gain

  4. Smart Environmental Policy with Full-Cost Pricing

    Directory of Open Access Journals (Sweden)

    Nancy Olewiler

    2012-03-01

    Full Text Available Canada’s natural capital — its resources, ecosystems and wildlife — are indispensable to the productivity of industry. Despite this, both the public and private sectors have failed to adequately factor in the consequences of production and consumption on the natural environment. There is a growing need for full-cost pricing, a system that adjusts market prices to reflect not only the direct costs of good and services, but also their impact on this country’s natural capital. As this paper argues, the onus is on the federal government to create the conditions for full-cost pricing to succeed. Ottawa needs to eliminate energy subsidies (to producers and consumers, implement full-cost pricing on air contaminants and greenhouse gases and encourage projects at the provincial and municipal levels that adopt that methodology. The benefits include productivity gains; potentially billions in savings for consumers, businesses and governments; a strong environment supporting sustainable industries; and simplified tax systems. In surveying past and existing federal initiatives and missed opportunities in previous budgets, this paper assesses costs and consequences, arguing that a healthy environment is synonymous with a healthy economy, and providing hard data to back up that conviction. With Budget 2012 just around the corner, the time is ripe for the Harper government to introduce full-cost pricing, and guarantee Canada a brighter future.

  5. Assessing the full costs of electricity

    International Nuclear Information System (INIS)

    Keppler, Jan Horst

    2016-01-01

    For decades, economists, energy specialists and policy-makers have been satisfied with assessing the comparative costs of electricity generation on the basis of discounted average costs over the lifetime and the total output of a generating plant. As a standardised form of cost-benefit accounting (CBA), these levelised costs of electricity (LCOE) indicate the required expenditures in terms of capital, fuel, and operations and management (O and M), adjusted for their incidence in time or the different technology options per unit of output (i.e. a MWh of electricity). This straightforward, transparent and comparatively simple metric worked well in a context of regulated markets where generators were centrally dispatched according to system requirements, tariffs were set by regulators and load factors could be predicted with confidence. In order to satisfy a given demand for electricity, the technology with the lowest LCOE was usually chosen, thus minimising the costs of the electricity system. Nuclear energy thus competed with hydro, where available, and coal and gas on the basis of their respective capital, labour and fuel costs at the level of the individual plant. (author)

  6. 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.

  7. Purchasing motors under consideration of full-cost pricing

    International Nuclear Information System (INIS)

    Mauchle, P.; Ritz, Ch.

    2007-01-01

    This final report for the Swiss Federal Office of Energy (SFOE) takes a look at how full-cost pricing should be considered when purchasing electric motors. The authors consider it essential that the overall life-cycle costs are carefully considered. This also guarantees economical operation and enables users to avoid unexpected costs throughout the service life of the motor. The aim of this project was to provide industrial companies with suitable tools for calculating the overall life-cycle costs of motors at the time of their acquisition. These tools take the form of a sample 'Call for Tender' for motors along with software for calculating life-cycle costs. The factors involved, such as investment, installation costs, energy and environmental costs as well as operational, maintenance and disposal costs are examined.

  8. Full cost accounting for decision making at Ontario Hydro

    International Nuclear Information System (INIS)

    Plagiannakos, T.

    1996-01-01

    Ontario Hydro's approach to full cost accounting (FCA) was outlined in response to questions raised earlier, in another forum, regarding Ontario Hydro's views on FCA. FCA was defined as an evaluation framework (as opposed to an accounting system) which tries to account for the internal (private) as well as the external (environment and human health) costs and benefits and integrate them into business decisions. When the external impacts cannot be monetized, qualitative evaluations are used based on the damage costing approach, which Ontario Hydro prefers to the cost of control method recommended by its critics. In general, however, Ontario Hydro is not opposed to FCA in so far as it puts the Utility in a better position to make more informed decisions, improve environmental cost management, avoid future costs, enhance revenue, improve environmental quality, contribute to environmental policy, and contribute to sustainable development. 1 fig

  9. Safeguards First Principle Initiative (SFPI) Cost Model

    International Nuclear Information System (INIS)

    Price, Mary Alice

    2010-01-01

    The Nevada Test Site (NTS) began operating Material Control and Accountability (MC and A) under the Safeguards First Principle Initiative (SFPI), a risk-based and cost-effective program, in December 2006. The NTS SFPI Comprehensive Assessment of Safeguards Systems (COMPASS) Model is made up of specific elements (MC and A plan, graded safeguards, accounting systems, measurements, containment, surveillance, physical inventories, shipper/receiver differences, assessments/performance tests) and various sub-elements, which are each assigned effectiveness and contribution factors that when weighted and rated reflect the health of the MC and A program. The MC and A Cost Model, using an Excel workbook, calculates budget and/or actual costs using these same elements/sub-elements resulting in total costs and effectiveness costs per element/sub-element. These calculations allow management to identify how costs are distributed for each element/sub-element. The Cost Model, as part of the SFPI program review process, enables management to determine if spending is appropriate for each element/sub-element.

  10. The full costs of thermal power production in Eastern Canada

    International Nuclear Information System (INIS)

    Venema, H.D.; Barg, S.

    2003-07-01

    This study examines the public health and global warming costs associated with generating electricity with fossil fuels such as coal, oil or natural gas. A Full Cost Accounting approach was used to determine the costs for Eastern Canada. The electricity sector is chosen because it is a large emitter of air pollutants and greenhouse gases. The sector it will undergo potentially significant structural changes as Canada complies with the Kyoto Protocol. Alternative investments in nonpolluting sources of electricity should include analysis of full costs. Two types of factors are evaluated in this study: the public health costs caused by emissions of sulphur and nitrogen oxides and volatile organic carbon (VOC) in Eastern Canada, and the marginal climate change damages caused by the emissions of greenhouse gasses (GHGs) in Eastern Canada. The major contribution of this study is the application of the impact-pathway approach to power sector emissions. Recent Canadian studies have reported either the pollutant emission rates for different power generation technologies and fuels, or the health costs of ambient air pollution not specifically attributable to the power sector. This study isolates the component of air pollution attributable to the power sector and analyses its geographic distribution. It was concluded that coal-fired generation should be closely monitored because the externalities burden is the same magnitude as the marginal production cost. 77 refs., 20 tabs., 21 figs

  11. Fitting of full Cobb-Douglas and full VRTS cost frontiers by solving goal programming problem

    Science.gov (United States)

    Venkateswarlu, B.; Mahaboob, B.; Subbarami Reddy, C.; Madhusudhana Rao, B.

    2017-11-01

    The present research article first defines two popular production functions viz, Cobb-Douglas and VRTS production frontiers and their dual cost functions and then derives their cost limited maximal outputs. This paper tells us that the cost limited maximal output is cost efficient. Here the one side goal programming problem is proposed by which the full Cobb-Douglas cost frontier, full VRTS frontier can be fitted. This paper includes the framing of goal programming by which stochastic cost frontier and stochastic VRTS frontiers are fitted. Hasan et al. [1] used a parameter approach Stochastic Frontier Approach (SFA) to examine the technical efficiency of the Malaysian domestic banks listed in the Kuala Lumpur stock Exchange (KLSE) market over the period 2005-2010. AshkanHassani [2] exposed Cobb-Douglas Production Functions application in construction schedule crashing and project risk analysis related to the duration of construction projects. Nan Jiang [3] applied Stochastic Frontier analysis to a panel of New Zealand dairy forms in 1998/99-2006/2007.

  12. Specialty and full-service hospitals: a comparative cost analysis.

    Science.gov (United States)

    Carey, Kathleen; Burgess, James F; Young, Gary J

    2008-10-01

    To compare the costs of physician-owned cardiac, orthopedic, and surgical single specialty hospitals with those of full-service hospital competitors. The primary data sources are the Medicare Cost Reports for 1998-2004 and hospital inpatient discharge data for three of the states where single specialty hospitals are most prevalent, Texas, California, and Arizona. The latter were obtained from the Texas Department of State Health Services, the California Office of Statewide Health Planning and Development, and the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project. Additional data comes from the American Hospital Association Annual Survey Database. We identified all physician-owned cardiac, orthopedic, and surgical specialty hospitals in these three states as well as all full-service acute care hospitals serving the same market areas, defined using Dartmouth Hospital Referral Regions. We estimated a hospital cost function using stochastic frontier regression analysis, and generated hospital specific inefficiency measures. Application of t-tests of significance compared the inefficiency measures of specialty hospitals with those of full-service hospitals to make general comparisons between these classes of hospitals. Results do not provide evidence that specialty hospitals are more efficient than the full-service hospitals with whom they compete. In particular, orthopedic and surgical specialty hospitals appear to have significantly higher levels of cost inefficiency. Cardiac hospitals, however, do not appear to be different from competitors in this respect. Policymakers should not embrace the assumption that physician-owned specialty hospitals produce patient care more efficiently than their full-service hospital competitors.

  13. Cost trend analysis of initial cancer treatment in Taiwan.

    Directory of Open Access Journals (Sweden)

    Tsai-Yun Li

    Full Text Available BACKGROUND: Despite the high cost of initial cancer care, that is, care in the first year after diagnosis, limited information is available for specific categories of cancer-related costs, especially costs for specific services. This study purposed to identify causes of change in cancer treatment costs over time and to perform trend analyses of the percentage of cancer patients who had received a specific treatment type and the mean cost of care for patients who had received that treatment. METHODOLOGY/PRINCIPAL FINDINGS: The analysis of trends in initial treatment costs focused on cancer-related surgery, chemotherapy, radiation therapy, and treatments other than active treatments. For each cancer-specific trend, slopes were calculated for regression models with 95% confidence intervals. Analyses of patients diagnosed in 2007 showed that the National Health Insurance (NHI system paid, on average, $10,780 for initial care of a gastric cancer patient and $10,681 for initial care of a lung cancer patient, which were inflation-adjusted increases of $6,234 and $5,522, respectively, over the 1996 care costs. During the same interval, the mean NHI payment for initial care for the five specific cancers increased significantly (p<0.05. Hospitalization costs comprised the largest portion of payments for all cancers. During 1996-2007, the use of chemotherapy and radiation therapy significantly increased in all cancer types (p<0.05. In 2007, NHI payments for initial care for these five cancers exceeded $12 billion, and gastric and lung cancers accounted for the largest share. CONCLUSIONS/SIGNIFICANCE: In addition to the growing number of NHI beneficiaries with cancer, treatment costs and the percentage of patients who undergo treatment are growing. Therefore, the NHI must accurately predict the economic burden of new chemotherapy agents and radiation therapies and may need to develop programs for stratifying patients according to their potential benefit

  14. 42 CFR 417.930 - Initial costs of operation.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Initial costs of operation. 417.930 Section 417.930... PREPAYMENT PLANS Administration of Outstanding Loans and Loan Guarantees § 417.930 Initial costs of operation. Under section 1305 of the PHS, loans and loan guarantees were awarded for initial costs of operation of...

  15. The cost of making wine: A Tuscan case study based on a full cost approach

    Directory of Open Access Journals (Sweden)

    Enrico Marone

    2017-12-01

    Full Text Available This article׳s aim is to identify and quantify the connection between a winery business typology and its production cost per bottle to create benchmarks for managerial and organisational choices. Accounting data from wineries in representative areas of the Tuscan wine sector were collected with direct, face-to-face interviews. The data were processed using a cost accounting model elaborated by UniCeSV (Centre for the Strategic Development of the Wine Sector, University of Florence to classify costs according to production phases and production factors. The study was completed using a hierarchical cluster analysis (HCA approach to investigate the relation between cost structures and business typologies. The implementation of the cost accounting model and the HCA showed a strong relationship between how wineries are organised and how costs are structured. Moreover, the weight of geographical localisation (i.e., belonging to a specific denomination of origin has proved to be a key determinant in the shape of the cost structures of wineries. Keywords: Wine production, Full cost analysis, Clustering

  16. Initial Tests on First Full-size Endcap Crystals

    CERN Document Server

    Davies, Gavin; Lecoq, Paul; Marcos, Roger; Schneegans, Marc; Sempere-Roldan, P

    1999-01-01

    At the end of last year the first full size ECAL endcap crystals were delivered to CERN.Thirty in number, they were produced to the final geometrical specifications; 220mm long with a rear square face of 30mm and a front square face of 28.6mm. All were de livered polished. The visual inspection, dimension, transmission, light yield and light yield uniformity tests carried out since are discussed, with particular emphasis on the light yield uniformity. The results are very encouraging.

  17. Formation of initial cost of stocks of own production

    Directory of Open Access Journals (Sweden)

    Elena Krukovskiy

    2016-06-01

    Full Text Available The concept and component stocks according to national accounting standards are revealed. The procedure for forming the initial value of the stock, depending on the way they arrive at the company according to the guidelines as well as methods for evaluating stocks of own production is grounded. The methodological principles of formation of information on stocks and the disclosure of its financial statements are considered. In the article investigated the procedure of forming the original value of stocks depending on how they flow to the enterprise. Number of methods of assessment of inventory, which can be used to reflect their value in the accounting and financial reporting, and methods of evaluation of own production is characterized. Identified costs are included in the initial cost of inventories, including inventories of own production. The estimation of the definition of agricultural produce at fair value and features of its application in the enterprise is proposed by authors.

  18. Initial evaluation of a full breast digital system

    International Nuclear Information System (INIS)

    Vano, E.; Fernandez, J.M.; Chevalier, M.; Moran, P.; Cepeda, T.; Fabra, A.; Alvarez Pedrosa, C.S.

    2001-01-01

    Full-field digital mammography systems have been developed for overcoming the limitations of the screen-film mammography. This work is focused on the system from GE Medical Systems (Senographe 2000) which has been recently installed in our institution. The imager consists of a thin Ics:Tl scintillator which is in narrow contact with an array of amorphous silicon detectors mounted in a single panel. The flat-panel detector is integrated in a x-ray system with a high-frequency generator Senographe DM and dual track anode of Mo and Rh with Mo and Rh filtration. The aim of this work is to analyse the defaults exposure factors set at the installation of the x-ray unit. The image quality has been evaluated by using one of the two phantoms recommended in the ACR Accreditation Program. Phantom images were obtained at each of the three available imaging modes: contrast (CNT), standard (STD) and DOSE. While maintaining the defaults of kilovoltage and anode/filter combination, phantom images were obtained at lower dose vales. The contrast noise ratio (CNR) was calculated for each of the low contrast objects (masses) of the phantom images and the detail visibility was also evaluated. The results obtained for both parameters reveal that similar image quality can be obtained with significant reductions of the average glandular dose. (author)

  19. Impact of Costing and Cost Analysis Methods on the Result of the Period: Methods Based on Full Cost Theory

    Directory of Open Access Journals (Sweden)

    Toma Maria

    2017-01-01

    In light of the above, in the present paper we have proposed that objectives, to approach the methods of calculating full costs (economic or traditional, and comparing them to determine the effect they have on the outcome of the period.

  20. NATO Initiatives to Improve Life Cycle Costing

    NARCIS (Netherlands)

    Smit, M.C.

    2009-01-01

    There is a long and documented history of both cost growth and estimating optimism within military programmes. This is particularly the case for multi-national programmes. The NATO ALP-10 –Guidance on Integrated Logistics Support for multi-national equipment projects (ILS) dated June 1990 (Reference

  1. Penetapan Harga Jual dengan Cost Plus Pricing Menggunakan Pendekatan Full Costing pada Ud Gladys Bakery

    OpenAIRE

    Moray, Jessica Claudia; Saerang, David Paul Elia; Runtu, Treesje

    2014-01-01

    Setiap badan USAha didirikan pada prinsipnya bertujuan untuk mendapatkan laba, yang diperoleh dari kegiatan USAha dan dapat bersaing dalam pasar. Harga jual yang terlalu tinggi akan menjadikan produk kurang bersaing di pasar, sementara harga jual yang terlalu rendah tidak akan memberikan keuntungan bagi pengusaha. Tujuan penelitian ini adalah untuk mengetahui cara penetapan harga jual pada UD. Gladys Bakery dengan harga jual menurut metode cost plus pricing menggunakan pendekatan full costin...

  2. Economics of tobacco control research initiative: Operating costs for ...

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

    Economics of tobacco control research initiative: Operating costs for capacity building ... (but misinformed) beliefs about the economic benefits of the tobacco industry ... Nutrition, health policy, and ethics in the age of public-private partnerships.

  3. Direct medical costs and medication compliance among fibromyalgia patients: duloxetine initiators vs. pregabalin initiators.

    Science.gov (United States)

    Sun, Peter; Peng, Xiaomei; Sun, Steve; Novick, Diego; Faries, Douglas E; Andrews, Jeffrey S; Wohlreich, Madelaine M; Wu, Andrew

    2014-01-01

    To assess and compare direct medical costs and medication compliance between patients with fibromyalgia who initiated duloxetine and patients with fibromyalgia who initiated pregabalin in 2008. A retrospective cohort study design was used based on a large US national commercial claims database (2006 to 2009). Patients with fibromyalgia aged 18 to 64 who initiated duloxetine or pregabalin in 2008 and who had continuous health insurance 1 year preceding and 1 year following the initiation were selected into duloxetine cohort or pregabalin cohort based on their initiated agent. Medication compliance was measured by total supply days, medication possession ratio (MPR), and proportion of patients with MPR ≥ 0.8. Direct medical costs were measured by annual costs per patient and compared between the cohorts in the year following the initiation. Propensity score stratification and bootstrapping methods were used to adjust for distribution bias, as well as cross-cohort differences in demographic, clinical and economic characteristics, and medication history prior to the initiation. Both the duloxetine (n = 3,033) and pregabalin (n = 4,838) cohorts had a mean initiation age around 49 years, 89% were women. During the postindex year, compared to the pregabalin cohort, the duloxetine cohort had higher totally annual supply days (273.5 vs. 176.6, P costs ($2,994.9 vs. $4,949.6, P costs ($8,259.6 vs. $10,312.2, P costs ($5,214.6 vs. $5,290.8, P > 0.05), and lower total medical costs ($16,469.1 vs. $20,552.6, P compliance and consumed less inpatient, outpatient, and total medical costs than those who initiated pregabalin. © 2013 The Authors Pain Practice © 2013 World Institute of Pain.

  4. Healthcare utilization and costs for patients initiating Dabigatran or Warfarin.

    Science.gov (United States)

    Reynolds, Shannon L; Ghate, Sameer R; Sheer, Richard; Gandhi, Pranav K; Moretz, Chad; Wang, Cheng; Sander, Stephen; Costantino, Mary E; Annavarapu, Srinivas; Andrews, George

    2017-06-21

    Novel oral anticoagulants (NOAC) such as dabigatran, when compared to warfarin, have been shown to potentially reduce the risk of stroke in patients with non-valvular atrial fibrillation (NVAF) together with lower healthcare resource utilization (HCRU) and similar total costs. This study expands on previous work by comparing HCRU and costs for patients newly diagnosed with NVAF and newly initiated on dabigatran or warfarin, and is the first study specifically in a Medicare population. A retrospective matched-cohort study was conducted using data from administrative health care claims during the study period 01/01/2010-12/31/2012. Cox regression analyses were used to compare all-cause risk of first hospitalizations and emergency room (ER) visits. Medical, pharmacy, and total costs per-patient-per-month (PPPM) were compared between dabigatran and warfarin users. A total of 1110 patients initiated on dabigatran were propensity score-matched with corresponding patients initiated on warfarin. The mean number of hospitalizations (0.92 vs. 1.13, P = 0.012), ER visits (1.32 vs. 1.56, P warfarin users. Patients initiated on dabigatran had significantly lower risk of first all-cause ER visits [hazard ratio (HR): 0.84, 95% confidence interval (CI): 0.73-0.98] compared to those initiated on warfarin. Adjusted mean pharmacy costs PPPM were significantly greater for dabigatran users ($510 vs. $250, P warfarin users. Dabigatran users had significantly lower HCRU compared to warfarin users. In addition, dabigatran users had lower risk of all-cause ER visits. Despite higher pharmacy costs, the two cohorts did not differ significantly in medical or total all-cause costs.

  5. Full-field initialized decadal predictions with the MPI earth system model: an initial shock in the North Atlantic

    Science.gov (United States)

    Kröger, Jürgen; Pohlmann, Holger; Sienz, Frank; Marotzke, Jochem; Baehr, Johanna; Köhl, Armin; Modali, Kameswarrao; Polkova, Iuliia; Stammer, Detlef; Vamborg, Freja S. E.; Müller, Wolfgang A.

    2017-12-01

    Our decadal climate prediction system, which is based on the Max-Planck-Institute Earth System Model, is initialized from a coupled assimilation run that utilizes nudging to selected state parameters from reanalyses. We apply full-field nudging in the atmosphere and either full-field or anomaly nudging in the ocean. Full fields from two different ocean reanalyses are considered. This comparison of initialization strategies focuses on the North Atlantic Subpolar Gyre (SPG) region, where the transition from anomaly to full-field nudging reveals large differences in prediction skill for sea surface temperature and ocean heat content (OHC). We show that nudging of temperature and salinity in the ocean modifies OHC and also induces changes in mass and heat transports associated with the ocean flow. In the SPG region, the assimilated OHC signal resembles well OHC from observations, regardless of using full fields or anomalies. The resulting ocean transport, on the other hand, reveals considerable differences between full-field and anomaly nudging. In all assimilation runs, ocean heat transport together with net heat exchange at the surface does not correspond to OHC tendencies, the SPG heat budget is not closed. Discrepancies in the budget in the cases of full-field nudging exceed those in the case of anomaly nudging by a factor of 2-3. The nudging-induced changes in ocean transport continue to be present in the free running hindcasts for up to 5 years, a clear expression of memory in our coupled system. In hindcast mode, on annual to inter-annual scales, ocean heat transport is the dominant driver of SPG OHC. Thus, we ascribe a significant reduction in OHC prediction skill when using full-field instead of anomaly initialization to an initialization shock resulting from the poor initialization of the ocean flow.

  6. Production costs and operative margins in electric energy generation from biogas. Full-scale case studies in Italy.

    Science.gov (United States)

    Riva, C; Schievano, A; D'Imporzano, G; Adani, F

    2014-08-01

    The purpose of this study was to observe the economic sustainability of three different biogas full scale plants, fed with different organic matrices: energy crops (EC), manure, agro-industrial (Plants B and C) and organic fraction of municipal solid waste (OFMSW) (Plant A). The plants were observed for one year and total annual biomass feeding, biomass composition and biomass cost (€ Mg(-1)), initial investment cost and plant electric power production were registered. The unit costs of biogas and electric energy (€ Sm(-3)biogas, € kWh(-1)EE) were differently distributed, depending on the type of feed and plant. Plant A showed high management/maintenance cost for OFMSW treatment (0.155 € Sm(-3)biogas, 45% of total cost), Plant B suffered high cost for EC supply (0.130 € Sm(-3)biogas, 49% of total cost) and Plant C showed higher impact on the total costs because of the depreciation charge (0.146 € Sm(-3)biogas, 41% of total costs). The breakeven point for the tariff of electric energy, calculated for the different cases, resulted in the range 120-170 € MWh(-1)EE, depending on fed materials and plant scale. EC had great impact on biomass supply costs and should be reduced, in favor of organic waste and residues; plant scale still heavily influences the production costs. The EU States should drive incentives in dependence of these factors, to further develop this still promising sector. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. [The World Initiative for the Eradication of Poliomyelitis: a long road full of pitfalls].

    Science.gov (United States)

    Kuss, Jean-Jacques

    2011-01-01

    The World Initiative for the Eradication of Poliomyelitis (IMEP), launched in 1988, is based on two strategies: mass vaccination with oral polio vaccine (OPV) and surveillance of acute flaccid paralysis (AFP). The disease incidence was reduced by 99%, but eradication, originally scheduled for 2000, has still not been reached in 2010, and four countries continue to be endemic (India, Pakistan, Afghanistan and Nigeria). The obstacles to eradication are the difficulty in reaching all children to be vaccinated, especially in areas of insecurity; the imperfections of OPV--irregular efficacy and genetic instability; and the limitations of surveillance in detecting only the paralytic form of the disease, which often remains asymptomatic. The repeated postponements of the ending of the initiative, which greatly increased the cost of IMEP, spark debate about the actual feasibility of eradication and justification to continue funding in a difficult global economic context, so the initiative remains without significant impact on indicators of the Millennium Goals for Development.

  8. Full cost accounting in the analysis of separated waste collection efficiency: A methodological proposal.

    Science.gov (United States)

    D'Onza, Giuseppe; Greco, Giulio; Allegrini, Marco

    2016-02-01

    Recycling implies additional costs for separated municipal solid waste (MSW) collection. The aim of the present study is to propose and implement a management tool - the full cost accounting (FCA) method - to calculate the full collection costs of different types of waste. Our analysis aims for a better understanding of the difficulties of putting FCA into practice in the MSW sector. We propose a FCA methodology that uses standard cost and actual quantities to calculate the collection costs of separate and undifferentiated waste. Our methodology allows cost efficiency analysis and benchmarking, overcoming problems related to firm-specific accounting choices, earnings management policies and purchase policies. Our methodology allows benchmarking and variance analysis that can be used to identify the causes of off-standards performance and guide managers to deploy resources more efficiently. Our methodology can be implemented by companies lacking a sophisticated management accounting system. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. 43 CFR 426.6 - Leasing and full-cost pricing.

    Science.gov (United States)

    2010-10-01

    ...) deficits funded. O&M deficits funded are the annual O&M costs including project-use pumping power allocated... payments due the United States. (6) In determining full-cost charges, the following factors will be... of the contract, whichever is later, to the anticipated date of project repayment; and (D) In cases...

  10. Investing in breastfeeding - the world breastfeeding costing initiative.

    Science.gov (United States)

    Holla-Bhar, Radha; Iellamo, Alessandro; Gupta, Arun; Smith, Julie P; Dadhich, Jai Prakash

    2015-01-01

    Despite scientific evidence substantiating the importance of breastfeeding in child survival and development and its economic benefits, assessments show gaps in many countries' implementation of the 2003 WHO and UNICEF Global Strategy for Infant and Young Child Feeding (Global Strategy). Optimal breastfeeding is a particular example: initiation of breastfeeding within the first hour of birth, exclusive breastfeeding for the first six months; and continued breastfeeding for two years or more, together with safe, adequate, appropriate, responsive complementary feeding starting in the sixth month. While the understanding of "optimal" may vary among countries, there is a need for governments to facilitate an enabling environment for women to achieve optimal breastfeeding. Lack of financial resources for key programs is a major impediment, making economic perspectives important for implementation. Globally, while achieving optimal breastfeeding could prevent more than 800,000 under five deaths annually, in 2013, US$58 billion was spent on commercial baby food including milk formula. Support for improved breastfeeding is inadequately prioritized by policy and practice internationally. The World Breastfeeding Costing Initiative (WBCi) launched in 2013, attempts to determine the financial investment that is necessary to implement the Global Strategy, and to introduce a tool to estimate the costs for individual countries. The article presents detailed cost estimates for implementing the Global Strategy, and outlines the WBCi Financial Planning Tool. Estimates use demographic data from UNICEF's State of the World's Children 2013. The WBCi takes a programmatic approach to scaling up interventions, including policy and planning, health and nutrition care systems, community services and mother support, media promotion, maternity protection, WHO International Code of Marketing of Breastmilk Substitutes implementation, monitoring and research, for optimal breastfeeding practices

  11. Full environmental life cycle cost analysis of concentrating solar power technology: contribution of externalities to overall energy costs

    NARCIS (Netherlands)

    Corona, B.; Cerrajero, E.; San Miguel, G.

    2016-01-01

    The aim of this work is to investigate the use of Full Environmental Life Cycle Costing (FeLCC) methodology to evaluate the economic performance of a 50 MW parabolic trough Concentrated Solar Power (CSP) plant operating in hybrid mode with different natural gas inputs (between 0% and 30%). The

  12. Biologically Costly Altruism Depends on Emotional Closeness among Step but Not Half or Full Sibling

    Directory of Open Access Journals (Sweden)

    Paola Bressan

    2009-01-01

    Full Text Available We studied altruistic behaviors of varying biological cost (high, medium, and low among siblings of varying genetic relatedness (full, half, and step. In agreement with inclusive fitness theory, the relative importance of either reliable (such as co-residence or heuristic (such as emotional closeness kinship cues depended crucially on the costs of help. When help did not endanger the altruist's life, thus making reciprocation possible, emotional closeness was the strongest predictor of altruism; perceived physical and psychological similarity to the sibling amplified altruistic behavior via their association with emotional closeness. When help endangered the altruist's life, thus making reciprocation unlikely, the strongest predictor of altruism was the ancestrally valid kinship cue of co-residence duration. Emotional closeness predicted costly altruism only for step siblings; its effects were nonsignificant when siblings were genetically related. Our findings support the idea that emotional closeness promotes costly altruistic behavior by serving as a surrogate kinship cue when more reliable cues are missing.

  13. Purchasing motors in the light of full-cost calculation; Beschaffung von Motoren unter der Vollkostenbetrachtung

    Energy Technology Data Exchange (ETDEWEB)

    Mauchle, P.; Schnyder, G.

    2006-07-01

    This final report published by the Swiss Federal Office of Energy (SFOE) presents the results of a study made on how full-cost calculation can help define the optimal purchasing strategy for electrical drives. According to the authors, taking total life-cycle costs into consideration also guarantees economical operation and helps avoid unexpected service costs. The report describes the goals of the project and co-operation with industry and users. Factors influencing life-cycle costs are looked at in detail, including investments, installation and operator-training, operation and monitoring as well as maintenance and repair. Also, energy costs are looked at, as are environmental aspects and the disposal of drives taken out of service. The calculation of the economic feasibility of two types of motor is looked at. Sample Calls for Tender are presented and software for the evaluation of offers is briefly discussed.

  14. Cost-effectiveness of early initiation of first-line combination antiretroviral therapy in Uganda

    Directory of Open Access Journals (Sweden)

    Sempa Joseph

    2012-09-01

    Full Text Available Abstract Background Ugandan national guidelines recommend initiation of combination antiretroviral therapy (cART at CD4+ T cell (CD4 count below 350 cell/μl, but the implementation of this is limited due to availability of medication. However, cART initiation at higher CD4 count increases survival, albeit at higher lifetime treatment cost. This analysis evaluates the cost-effectiveness of initiating cART at a CD4 count between 250–350 cell/μl (early versus Methods Life expectancy of cART-treated patients, conditional on baseline CD4 count, was modeled based on published literature. First-line cART costs $192 annually, with an additional $113 for patient monitoring. Delaying initiation of cART until the CD4 count falls below 250 cells/μl would incur the cost of the bi-annual CD4 count tests and routine maintenance care at $85 annually. We compared lifetime treatment costs and disability adjusted life-expectancy between early vs. delayed cART for ten baseline CD4 count ranges from 250-350 cell/μl. All costs and benefits were discounted at 3% annually. Results Treatment delay varied from 6–18 months. Early cART initiation increased life expectancy from 1.5-3.5 years and averted 1.33–3.10 disability adjusted life years (DALY’s per patient. Lifetime treatment costs were $4,300–$5,248 for early initiation and $3,940–$4,435 for delayed initiation. The cost/DALY averted of the early versus delayed start ranged from $260–$270. Conclusions In HIV-positive patients presenting with CD4 count between 250-350 cells/μl, immediate initiation of cART is a highly cost-effective strategy using the recommended one-time per capita GDP threshold of $490 reported for Uganda. This would constitute an efficient use of scarce health care funds.

  15. The full financial costs of irrigation services: A discussion on existing ...

    African Journals Online (AJOL)

    Considering water as an economic good entails, among other requisites, properly assessing the cost incurred by supplying and managing the resource, and the required infrastructure thereof. Regarding irrigation, the International Commission for Irrigation and Drainage (ICID) set up a method for assessing the full financial ...

  16. Tax shift : eliminating subsidies and moving to full cost electricity pricing

    International Nuclear Information System (INIS)

    Gibbons, J.

    2008-01-01

    In order to ensure that Ontario's service needs are met at the lowest possible total cost, energy conservation and small-scale distributed generation options must be able to compete with large scale-centralized generation and transmission options on a level playing field. This report discussed how electricity is priced in Ontario. The report described the policies that subsidize coal and nuclear generation and promote excessive consumption of grid-supplied electricity. The report also presented an analysis of the impact of these subsidies and policies on Ontario's electricity consumption, electricity productivity, standard of living and air pollutant emissions. It described a practical strategy whereby these subsidies can be eliminated by recycling or shifting the monies currently spent on subsidies in a way that creates an incentive to reduce electricity consumption. It also described how full cost pricing could lead to a net financial benefit for residential customers as well as an adaptation strategy for businesses that would ensure that they remain competitive. Finally the report identified ten major subsidies that artificially reduce the cost of electricity in Ontario. These included below-market water royalty rates; corporate income tax revenue subsidy for nuclear debt; sales tax exemption; average cost pricing; and bulk metering. It was concluded that phasing out the subsidies for grid-supplied electricity and moving to full cost pricing will provide multiple benefits for Ontario. 36 refs., 5 tabs., 5 figs

  17. An Analysis of Missile Systems Cost Growth and Implementation of Acquisition Reform Initiatives Using a Hybrid Adjusted Cost Growth Model

    National Research Council Canada - National Science Library

    Abate, Christopher

    2004-01-01

    ...) data with a hybrid adjusted cost growth (ACG) model. In addition, an analysis of acquisition reform initiatives during the treatment period was conducted to determine if reform efforts impacted missile system cost growth. A pre-reform...

  18. Use of Iodine-based contrast media in digital full-field mammography - initial experience

    International Nuclear Information System (INIS)

    Diekmann, F.; Diekmann, S.; Taupitz, M.; Bick, U.; Winzer, K.-J.; Huettner, C.; Muller, S.; Jeunehomme, F.; Hamm, B.

    2003-01-01

    Aim: To investigate the use of iodine-based contrast media in digital full-field mammography. Methods: After performing initial phantom studies, seven patients underwent digital mammography (Senographe 2000D, GE Medical Systems, Milwaukee, USA) using a specially filtered beam before as well as 60, 120, and 180 seconds after injection of 80 ml of iodine contrast medium (Ultravist 370, Schering AG, Germany). The precontrast mammograms were then subtracted from the postcontrast mammograms and the resulting images compared with a contrast-enhanced dynamic MRI study, performed on all women. Results: Contrast medium accumulation within the tumors was visualized with a good quality in all cases. The conditions under which successful contrast-enhanced digital mammography can be performed were determined in phantom studies. Conclusions: Contrast-enhanced digital mammography has a potential for improving the visualization of breast tumors in mammography using special beam filtering, adjusted X-ray parameters, proper timing, and suitable subtraction software. (orig.) [de

  19. Building a good initial model for full-waveform inversion using frequency shift filter

    Science.gov (United States)

    Wang, Guanchao; Wang, Shangxu; Yuan, Sanyi; Lian, Shijie

    2018-05-01

    Accurate initial model or available low-frequency data is an important factor in the success of full waveform inversion (FWI). The low-frequency helps determine the kinematical relevant components, low-wavenumber of the velocity model, which are in turn needed to avoid FWI trap in local minima or cycle-skipping. However, in the field, acquiring data that common point of low- and high-frequency signal, then utilize the high-frequency data to obtain the low-wavenumber velocity model. It is well known that the instantaneous amplitude envelope of a wavelet is invariant under frequency shift. This means that resolution is constant for a given frequency bandwidth, and independent of the actual values of the frequencies. Based on this property, we develop a frequency shift filter (FSF) to build the relationship between low- and high-frequency information with a constant frequency bandwidth. After that, we can use the high-frequency information to get a plausible recovery of the low-wavenumber velocity model. Numerical results using synthetic data from the Marmousi and layer model demonstrate that our proposed envelope misfit function based on the frequency shift filter can build an initial model with more accurate long-wavelength components, when low-frequency signals are absent in recorded data.

  20. Utilization and costs of lumbar and full spine radiography by Ontario chiropractors from 1994 to 2001.

    Science.gov (United States)

    Ammendolia, Carlo; Côté, Pierre; Hogg-Johnson, Sheilah; Bombardier, Claire

    2009-07-01

    In Ontario, chiropractors see one-third of patients who seek care for low back pain. Previous studies suggest that chiropractors have high utilization rates of lumbar and full spine radiography. There has been a proliferation of evidence-based guidelines recommending that plain film radiography be used only to assess high-risk patients with low back pain. Evidence for the use of full spine radiography, except for the evaluation of scoliosis is lacking. It is uncertain what impact the growing evidence against their use has had on radiography utilization by Ontario chiropractors. To describe the annual costs and use of lumbar and full spine plain film radiography among Ontario chiropractors between 1994 and 2001. Time-trend analysis of radiography utilization by Ontario chiropractors. Chiropractic claims data submitted to the Ontario Health Insurance Plan or the Workplace Safety & Insurance Board from 1994/1995 to 2000/2001. Change in the annual cost and proportion of claimants receiving lumbar and full spine radiography. Time-trend analysis of chiropractic claims submitted to the Ontario Health Insurance Plan (OHIP) or Workplace Safety & Insurance Board (WSIB) from 1994/1995 to 2000/2001 fiscal years. During the 7-year period, the proportion of OHIP claimants receiving lumbar spine radiography decreased from 4.54% to 3.25% and for full spine radiography from 3.87% to 3.04%. For WSIB claimants, lumbar spine radiography deceased from 6.49% to 3.30% of claimants and full spine radiography from 1.51% to 0.94%. OHIP payments for lumbar spine radiography decreased 12.7% to $562,944, whereas full spine radiography payments decreased 5.3% to $1,071,408. WSIB lumbar and full spine radiography payments decreased 44.2% and 34.3% to $31,202 and $11,713 respectively. Claims data from the two largest third-party payers of chiropractic services in Ontario, suggest that lumbar and full spine radiography, and their associated costs decreased steadily between 1994 and 2001.

  1. Study of the full-service and low-cost carriers network configuration

    Directory of Open Access Journals (Sweden)

    Oriol Lordan

    2014-10-01

    Full Text Available Purpose: The network strategies used by airline carriers have been a recurring subject in air transport research. The aim of this paper is to investigate the relationship between the different operational characteristics of the airline and its route network configuration. Design/methodology/approach: The two main airline carrier typologies - Full-Service and Low-Cost carriers – are analysed using empirical models developed on complex network research relating them to the business model of the airlines. Findings and Originality/value: Just in Europe, one can differentiate between Full-Service and Low-Cost Carriers by complex network analyses. In this process, it has been also found that new concept Low-Cost Carriers, such as Vueling, have network properties closer to Full-Service Carriers. Research limitations/implications: This paper has a limited sample, as includes 26 airline case studies from Europe, United States and Asia. Practical implications: The analysis carried out in this research can help to the assessment of the evolution of the strategies of airline carriers, and has also operational implications, since the configuration of an airline route network can determine its resilience to attacks and errors. Social implications: A better understanding of the properties of airline route networks can benefit airlines, passengers and another stakeholders of the air transport industry. Originality/value: Current research on air transport networks has only considered the global or regional level, but few studies have addressed the study of airline transport networks, and its relationship with their business model.

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

    International Nuclear Information System (INIS)

    Westmacott, Chad; Cameron, Ron

    2012-02-01

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

  3. Prevalence and cost of full-time research fellowships during general surgery residency: a national survey.

    Science.gov (United States)

    Robertson, Charles M; Klingensmith, Mary E; Coopersmith, Craig M

    2009-01-01

    To quantify the prevalence, outcomes, and cost of surgical resident research. General surgery is unique among graduate medical education programs because a large percentage of residents interrupt their clinical training to spend 1 to 3 years performing full-time research. No comprehensive data exists on the scope of this practice. Survey sent to all 239 program directors of general surgery residencies participating in the National Resident Matching Program. Response rate was 200 of 239 (84%). A total of 381 of 1052 trainees (36%) interrupt residency to pursue full-time research. The mean research fellowship length is 1.7 years, with 72% of trainees performing basic science research. A significant association was found between fellowship length and postresidency activity, with a 14.7% increase in clinical fellowship training and a 15.2% decrease in private practice positions for each year of full-time research (P < 0.0001). Program directors at 31% of programs reported increased clinical duties for research fellows as a result of Accreditation Council for Graduate Medical Education work hour regulations for clinical residents, whereas a further 10% of programs are currently considering such changes. It costs $41.5 million to pay the 634 trainees who perform research fellowships each year, the majority of which is paid for by departmental funds (40%) and institutional training grants (24%). Interrupting residency to perform a research fellowship is a common and costly practice among general surgery residents. Although performing a research fellowship is associated with clinical fellowship training after residency, it is unclear to what extent this practice leads to the development of surgical investigators after postgraduate training.

  4. Water resource taxation with full-cost water pricing: lessons from Europe

    DEFF Research Database (Denmark)

    Andersen, Mikael Skou; Pizzol, Massimo

    Green fiscal reform involves removal of environmentally harmful subsidies, introduction of taxes on pollution and resource depletion as well as full-cost pricing for environmental services. One sector which traditionally has been shielded against Green Fiscal Reform is the water sector, where...... social and distributional concerns have had priority over charging policies. This may seem a paradox, as the water sector is of major financial significance and traditionally accounts for 1-2 per cent of GDP in developed nations. Moreover, in the European Union the Water Framework Directive prescribes...

  5. Full structure assignments of pyrrolizidine alkaloid DNA adducts and mechanism of tumor initiation.

    Science.gov (United States)

    Zhao, Yuewei; Xia, Qingsu; Gamboa da Costa, Gonçalo; Yu, Hongtao; Cai, Lining; Fu, Peter P

    2012-09-17

    Pyrrolizidine alkaloid-containing plants are widespread in the world and are probably the most common poisonous plants affecting livestock, wildlife, and humans. Pyrrolizidine alkaloids are among the first chemical carcinogens identified in plants. Previously, we determined that metabolism of pyrrolizidine alkaloids in vivo and in vitro generated a common set of DNA adducts that are responsible for tumor induction. Using LC-ESI/MS/MS analysis, we previously determined that four DNA adducts (DHP-dG-3, DHP-dG-4, DHP-dA-3, and DHP-dA-4) were formed in rats dosed with riddelliine, a tumorigenic pyrrolizidine alkaloid. Because of the lack of an adequate amount of authentic standards, the structures of DHP-dA-3 and DHP-dA-4 were not elucidated, and the structural assignment for DHP-dG-4 warranted further validation. In this study, we developed an improved synthetic methodology for these DNA adducts, enabling their full structural elucidation by mass spectrometry and NMR spectroscopy. We determined that DHP-dA-3 and DHP-dA-4 are a pair of epimers of 7-hydroxy-9-(deoxyadenosin-N(6)-yl) dehydrosupinidine, while DHP-dG-4 is 7-hydroxy-9-(deoxyguanosin-N(2)-yl)dehydrosupinidine, an epimer of DHP-dG-3. With the structures of these DNA adducts unequivocally elucidated, we conclude that cellular DNA preferentially binds dehydropyrrolizidine alkaloid, for example, dehydroriddelliine, at the C9 position of the necine base, rather than at the C7 position. We also determined that DHP-dA-3 and DHP-dA-4, as well as DHP-dG-3 and DHP-dG-4, are interconvertible. This study represents the first report with detailed structural assignments of the DNA adducts that are responsible for pyrrolizidine alkaloid tumor induction on the molecular level. A mechanism of tumor initiation by pyrrolizidine alkaloids is consequently fully determined.

  6. Cost of Care for the Initial Management of Ovarian Cancer.

    Science.gov (United States)

    Bercow, Alexandra S; Chen, Ling; Chatterjee, Sudeshna; Tergas, Ana I; Hou, June Y; Burke, William M; Ananth, Cande V; Neugut, Alfred I; Hershman, Dawn L; Wright, Jason D

    2017-12-01

    To examine the cost of care during the first year after a diagnosis of ovarian cancer, estimate the sources of cost, and explore the out-of-pocket costs. We performed a retrospective cohort study of women with ovarian cancer diagnosed from 2009 to 2012 who underwent both surgery and adjuvant chemotherapy using the Truven Health MarketScan database. This database is comprised of patients covered by commercial insurance sponsored by more than 100 employers in the United States. Medical expenditures, including physician reimbursement, for a 12-month period beginning on the date of surgery were estimated. All payments were examined, including out-of-pocket costs for patients. Payments were divided into expenditures for inpatient care, outpatient care (including chemotherapy), and outpatient drug costs. The 12-month treatment period was divided into three phases: surgery to 30 days (operative period), 1-6 months (adjuvant therapy), and 6-12 months after surgery. The primary outcome was the overall cost of care within the first year of diagnosis of ovarian cancer; secondary outcomes included assessment of factors associated with cost. A total of 26,548 women with ovarian cancer who underwent surgery were identified. After exclusion of patients with incomplete insurance enrollment or coverage, those who did not undergo chemotherapy, and those with capitated plans, our cohort consisted of 5,031 women. The median total medical expenditures per patient during the first year after the index procedure were $93,632 (interquartile range $62,319-140,140). Inpatient services accounted for $30,708 (interquartile range $20,102-51,107; 37.8%) in expenditures, outpatient services $52,700 (interquartile range $31,210-83,206; 58.3%), and outpatient drug costs $1,814 (interquartile range $603-4,402; 3.8%). The median out-of-pocket expense was $2,988 (interquartile range $1,649-5,088). This included $1,509 (interquartile range $705-2,878) for outpatient services, $589 (interquartile range

  7. Variability in the Initial Costs of Care and One-Year Outcomes of Observation Services

    Directory of Open Access Journals (Sweden)

    Abbass, Ibrahim

    2015-05-01

    Full Text Available Introduction: The use of observation units (OUs following emergency departments (ED visits as a model of care has increased exponentially in the last decade. About one-third of U.S. hospitals now have OUs within their facilities. While their use is associated with lower costs and comparable level of care compared to inpatient units, there is a wide variation in OUs characteristics and operational procedures. The objective of this research was to explore the variability in the initial costs of care of placing patients with non-specific chest pain in observation units (OUs and the one-year outcomes. Methods: The author retrospectively investigated medical insurance claims of 22,962 privately insured patients (2009-2011 admitted to 41 OUs. Outcomes included the one-year chest pain/cardiovascular related costs and primary and secondary outcomes. Primary outcomes included myocardial infarction, congestive heart failure, stroke or cardiac arrest, while secondary outcomes included revascularization procedures, ED revisits for angina pectoris or chest pain and hospitalization due to cardiovascular diseases. The author aggregated the adjusted costs and prevalence rates of outcomes for patients over OUs, and computed the weighted coefficients of variation (WCV to compare variations across OUs. Results: There was minimal variability in the initial costs of care (WCV=2.2%, while the author noticed greater variability in the outcomes. Greater variability were associated with the adjusted cardiovascular-related costs of medical services (WCV=17.6% followed by the adjusted prevalence odds ratio of patients experiencing primary outcomes (WCV=16.3% and secondary outcomes (WCV=10%. Conclusion: Higher variability in the outcomes suggests the need for more standardization of the observation services for chest pain patients. [West J Emerg Med. 2015;16(3:395–400.

  8. Functionality of the approach of hierarchical analysis in the full cost accounting in the IRP of a metropolitan airport

    International Nuclear Information System (INIS)

    Cicone, Decio; Morales Udaeta, Miguel Edgar; Aquiles Baesso Grimoni, Jose; Ribeiro Galvao, Luiz Claudio

    2008-01-01

    This work shows the application of the analytic hierarchy process (AHP) in the full cost accounting (FCA) within the integrated resource planning (IRP) process. For this purpose, a pioneer case was developed and different energy solutions of supply and demand for a metropolitan airport (Congonhas) were considered [Moreira, E.M., 2005. Modelamento energetico para o desenvolvimento limpo de aeroporto metropolitano baseado na filosofia do PIR-O caso da metropole de Sao Paulo. Dissertacao de mestrado, GEPEA/USP]. These solutions were compared and analyzed utilizing the software solution 'Decision Lens' that implements the AHP. The final part of this work has a classification of resources that can be considered to be the initial target as energy resources, thus facilitating the restraints of the IRP of the airport and setting parameters aiming at sustainable development

  9. Novel cost effective full scale mussel shell bioreactors for metal removal and acid neutralization.

    Science.gov (United States)

    DiLoreto, Z A; Weber, P A; Olds, W; Pope, J; Trumm, D; Chaganti, S R; Heath, D D; Weisener, C G

    2016-12-01

    Acid mine drainage (AMD) impacted waters are a worldwide concern for the mining industry and countries dealing with this issue; both active and passive technologies are employed for the treatment of such waters. Mussel shell bioreactors (MSB) represent a passive technology that utilizes waste from the shellfish industry as a novel substrate. The aim of this study is to provide insight into the biogeochemical dynamics of a novel full scale MSB for AMD treatment. A combination of water quality data, targeted geochemical extractions, and metagenomic analyses were used to evaluate MSB performance. The MSB raised the effluent pH from 3.4 to 8.3 while removing up to ∼99% of the dissolved Al, and Fe and >90% Ni, Tl, and Zn. A geochemical gradient was observed progressing from oxidized to reduced conditions with depth. The redox conditions helped define the microbial consortium that consists of a specialized niche of organisms that influence elemental cycling (i.e. complex Fe and S cycling). MSB technology represents an economic and effective means of full scale, passive AMD treatment that is an attractive alternative for developing economies due to its low cost and ease of implementation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Cost-Cutting in Higher Education: Lessons Learned from Collaboration, Technology, and Outsourcing Initiatives. Draft.

    Science.gov (United States)

    Kaganoff, Tessa

    This document presents a review of cost-containment initiatives relevant to higher education institutions. Originally commissioned to examine cost containment initiatives carried out by institutions affiliated with the Foundation for Independent Higher Education (FIHE), the paper was expanded to include a sector-wide review of three types of…

  11. Purchasing motors under consideration of full-cost pricing; Beschaffung von Motoren unter der Vollkostenbetrachtung (inklusive Permanentmagneterregte-Synchronmotoren) - Schlussbericht

    Energy Technology Data Exchange (ETDEWEB)

    Mauchle, P. [Schnyder Ingenieure AG, Huenenberg (Switzerland); Ritz, Ch. [Schnyder Ingenieure AG, Steg (Switzerland)

    2007-07-01

    This final report for the Swiss Federal Office of Energy (SFOE) takes a look at how full-cost pricing should be considered when purchasing electric motors. The authors consider it essential that the overall life-cycle costs are carefully considered. This also guarantees economical operation and enables users to avoid unexpected costs throughout the service life of the motor. The aim of this project was to provide industrial companies with suitable tools for calculating the overall life-cycle costs of motors at the time of their acquisition. These tools take the form of a sample 'Call for Tender' for motors along with software for calculating life-cycle costs. The factors involved, such as investment, installation costs, energy and environmental costs as well as operational, maintenance and disposal costs are examined.

  12. Costs and cost-effectiveness of full implementation of a biennial faecal occult blood test screening program for bowel cancer in Australia.

    Science.gov (United States)

    Pignone, Michael P; Flitcroft, Kathy L; Howard, Kirsten; Trevena, Lyndal J; Salkeld, Glenn P; St John, D James B

    2011-02-21

    To examine the costs and cost-effectiveness of full implementation of biennial bowel cancer screening for Australian residents aged 50-74 years. Identification of existing economic models from 1993 to 2010 through searches of PubMed and economic analysis databases, and by seeking expert advice; and additional modelling to determine the costs and cost-effectiveness of full implementation of biennial faecal occult blood test screening for the five million adults in Australia aged 50-74 years. Estimated number of deaths from bowel cancer prevented, costs, and cost-effectiveness (cost per life-year gained [LYG]) of biennial bowel cancer screening. We identified six relevant economic analyses, all of which found colorectal cancer (CRC) screening to be very cost-effective, with costs per LYG under $55,000 per year in 2010 Australian dollars. Based on our additional modelling, we conservatively estimate that full implementation of biennial screening for people aged 50-74 years would have gross costs of $150 million, reduce CRC mortality by 15%-25%, prevent 300-500 deaths from bowel cancer, and save 3600-6000 life-years annually, for an undiscounted cost per LYG of $25,000-$41,667, compared with no screening, and not taking cost savings as a result of treatment into consideration. The additional expenditure required, after accounting for reductions in CRC incidence, savings in CRC treatment costs, and existing ad-hoc colonoscopy use, is likely to be less than $50 million annually. Full implementation of biennial faecal occult blood test screening in Australia can reduce bowel cancer mortality, and is an efficient use of health resources that would require modest additional government investment.

  13. Performance of initial full-length RHIC [Relativistic Heavy Ion Collider] dipoles

    International Nuclear Information System (INIS)

    Dahl, P.; Cottingham, J.; Garber, M.

    1987-01-01

    The first four full-length (9.7 m) R and D dipoles for the proposed Relativistic Heavy Ion Collider (RHIC) have been successfully tested. The magnets reached a quench plateau of approximately 4.5 T with very reasonable training - a field level comfortably above the design field of 3.45 T required for operation with beams of 100 GeV/amu gold nuclei. Measured field multipoles are considered to be quite acceptable for this series of R and D magnets

  14. Full seismic waveform inversion of the African crust and Mantle - Initial Results

    Science.gov (United States)

    Afanasiev, Michael; Ermert, Laura; Staring, Myrna; Trampert, Jeannot; Fichtner, Andreas

    2016-04-01

    We report on the progress of a continental-scale full-waveform inversion (FWI) of Africa. From a geodynamic perspective, Africa presents an especially interesting case. This interest stems from the presence of several anomalous features such as a triple junction in the Afar region, a broad region of high topography to the south, and several smaller surface expressions such as the Cameroon Volcanic Line and Congo Basin. The mechanisms behind these anomalies are not fully clear, and debate on their origin spans causative mechanisms from isostatic forcing, to the influence of localized asthenospheric upwelling, to the presence of deep mantle plumes. As well, the connection of these features to the African LLSVP is uncertain. Tomographic images of Africa present unique challenges due to uneven station coverage: while tectonically active areas such as the Afar rift are well sampled, much of the continent exhibits a severe dearth of seismic stations. As well, while mostly surrounded by tectonically active spreading plate boundaries (a fact which contributes to the difficulties in explaining the South's high topography), sizeable seismic events (M > 5) in the continent's interior are relatively rare. To deal with these issues, we present a combined earthquake and ambient noise full-waveform inversion of Africa. The noise component serves to boost near-surface sensitivity, and aids in mitigating issues related to the sparse source / station coverage. The earthquake component, which includes local and teleseismic sources, aims to better resolve deeper structure. This component also has the added benefit of being especially useful in the search for mantle plumes: synthetic tests have shown that the subtle scattering of elastic waves off mantle plumes makes the plumes an ideal target for FWI [1]. We hope that this new model presents a fresh high-resolution image of sub-African geodynamic structure, and helps advance the debate regarding the causative mechanisms of its surface

  15. Measuring the value of process improvement initiatives in a preoperative assessment center using time-driven activity-based costing.

    Science.gov (United States)

    French, Katy E; Albright, Heidi W; Frenzel, John C; Incalcaterra, James R; Rubio, Augustin C; Jones, Jessica F; Feeley, Thomas W

    2013-12-01

    The value and impact of process improvement initiatives are difficult to quantify. We describe the use of time-driven activity-based costing (TDABC) in a clinical setting to quantify the value of process improvements in terms of cost, time and personnel resources. Difficulty in identifying and measuring the cost savings of process improvement initiatives in a Preoperative Assessment Center (PAC). Use TDABC to measure the value of process improvement initiatives that reduce the costs of performing a preoperative assessment while maintaining the quality of the assessment. Apply the principles of TDABC in a PAC to measure the value, from baseline, of two phases of performance improvement initiatives and determine the impact of each implementation in terms of cost, time and efficiency. Through two rounds of performance improvements, we quantified an overall reduction in time spent by patient and personnel of 33% that resulted in a 46% reduction in the costs of providing care in the center. The performance improvements resulted in a 17% decrease in the total number of full time equivalents (FTE's) needed to staff the center and a 19% increase in the numbers of patients assessed in the center. Quality of care, as assessed by the rate of cancellations on the day of surgery, was not adversely impacted by the process improvements. © 2013 Published by Elsevier Inc.

  16. Literature review of the passenger airline business models : Full service carrier, low-cost carrier and charter airlines

    NARCIS (Netherlands)

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

    2008-01-01

    The deregulation and liberalization of the air transportation industry have developed three main passenger business models: full service carriers, low-cost carriers, and charter airlines. Deregulation removed regulated fares and routes increasing competition and yields. Airlines business models main

  17. Understanding Consumer Preference Between Low Cost Airlines and Full Service Carriers : A Study on Consumer Choice and Decisions

    OpenAIRE

    Lee, Alex Hoong Onn

    2008-01-01

    The emergence of low cost or no frills airlines in last decade or so have posed considerable threat to the businesses of traditional full service airlines. The competition between the different type of airlines have changed the landscape of the airline industry tremendously and have provided air travelers with options which are unprecedented. The aim of this study is to understand consumer preference between low cost and full service airlines and to determine what are the motivations or facto...

  18. Cost minimization in a full-scale conventional wastewater treatment plant: associated costs of biological energy consumption versus sludge production.

    Science.gov (United States)

    Sid, S; Volant, A; Lesage, G; Heran, M

    2017-11-01

    Energy consumption and sludge production minimization represent rising challenges for wastewater treatment plants (WWTPs). The goal of this study is to investigate how energy is consumed throughout the whole plant and how operating conditions affect this energy demand. A WWTP based on the activated sludge process was selected as a case study. Simulations were performed using a pre-compiled model implemented in GPS-X simulation software. Model validation was carried out by comparing experimental and modeling data of the dynamic behavior of the mixed liquor suspended solids (MLSS) concentration and nitrogen compounds concentration, energy consumption for aeration, mixing and sludge treatment and annual sludge production over a three year exercise. In this plant, the energy required for bioreactor aeration was calculated at approximately 44% of the total energy demand. A cost optimization strategy was applied by varying the MLSS concentrations (from 1 to 8 gTSS/L) while recording energy consumption, sludge production and effluent quality. An increase of MLSS led to an increase of the oxygen requirement for biomass aeration, but it also reduced total sludge production. Results permit identification of a key MLSS concentration allowing identification of the best compromise between levels of treatment required, biological energy demand and sludge production while minimizing the overall costs.

  19. Integrating tuberculosis and HIV services for people living with HIV: Costs of the Zambian ProTEST Initiative

    Directory of Open Access Journals (Sweden)

    Kayawe Ignatius

    2008-01-01

    Full Text Available Abstract Background In the face of the dual TB/HIV epidemic, the ProTEST Initiative was one of the first to demonstrate the feasibility of providing collaborative TB/HIV care for people living with HIV (PLWH in poor settings. The ProTEST Initiative facilitated collaboration between service providers. Voluntary counselling and testing (VCT acted as the entry point for services including TB screening and preventive therapy, clinical treatment for HIV-related disease, and home-based care (HBC, and a hospice. This paper estimates the costs of the ProTEST Initiative in two sites in urban Zambia, prior to the introduction of anti-retroviral therapy. Methods Annual financial and economic providers costs and output measures were collected in 2000–2001. Estimates are made of total costs for each component and average costs per: person reached by ProTEST; VCT pre-test counselled, tested and completed; isoniazid preventive therapy started and completed; clinic visit; HBC patient; and hospice admission and bednight. Results Annual core ProTEST costs were (in 2007 US dollars $84,213 in Chawama and $31,053 in Matero. The cost of coordination was 4%–5% of total site costs ($1–$6 per person reached. The largest cost component in Chawama was voluntary counselling and testing (56% and the clinic in Matero (50%, where VCT clients had higher HIV-prevalences and more advanced HIV. Average costs were lower for all components in the larger site. The cost per HBC patient was $149, and per hospice bednight was $24. Conclusion This study shows that coordinating an integrated and comprehensive package of services for PLWH is relatively inexpensive. The lessons learnt in this study are still applicable today in the era of ART, as these services must still be provided as part of the continuum of care for people living with HIV.

  20. Application of light-initiated explosive for simulating x-ray blowoff impulse effects on a full scale reentry vehicle

    International Nuclear Information System (INIS)

    Benham, R.A.; Mathews, F.H.; Higgins, P.B.

    1976-01-01

    Laboratory nuclear effects testing allows the study of reentry vehicle response to simulated exoatmospheric x-ray encounters. Light-initiated explosive produces the nearly simultaneous impulse loading of a structure by using a spray painted coating of explosive which is detonated by an intense flash of light. A lateral impulse test on a full scale reentry vehicle is described which demonstrates that the light-initiated explosive technique can be extended to the lateral loading of very large systems involving load discontinuities. This experiment required the development of a diagnostic method for verifying the applied impulse, and development of a large light source for simultaneously initiating the explosive over the surface of the vehicle. Acceptable comparison between measured strain response and code predictions is obtained. The structural capability and internal response of a vehicle subjected to an x-ray environment was determined from a light-initiated explosive test

  1. 77 FR 33007 - Submission for Review: Initial Certification of Full-Time School Attendance, RI 25-41

    Science.gov (United States)

    2012-06-04

    ..., electronic, mechanical, or other technological collection techniques or other forms of information technology... OFFICE OF PERSONNEL MANAGEMENT Submission for Review: Initial Certification of Full-Time School... and other federal agencies the opportunity to comment on a revised information collection request (ICR...

  2. 77 FR 71200 - Submission for Review: Initial Certification of Full-Time School Attendance, RI 25-41

    Science.gov (United States)

    2012-11-29

    ..., mechanical, or other technological collection techniques or other forms of information technology, e.g... OFFICE OF PERSONNEL MANAGEMENT Submission for Review: Initial Certification of Full-Time School... and other federal agencies the opportunity to comment on a revised information collection request (ICR...

  3. Procedures for Determining Historical Full Costs. Technical Report 65. Second Edition.

    Science.gov (United States)

    National Association of College and University Business Officers, Washington, DC.

    The procedures form the costing component of the National Center for Higher Education Management Systems'"Information Exchange Procedures" (IEP). The IEP are a set of standard definitions and procedures for collecting information about disciplines and student degree programs, outcomes of instructional programs, and general institutional…

  4. Towards a low-cost, full-service air quality data archival system

    NARCIS (Netherlands)

    Samourkasidis, Argyris; Athanasiadis, Ioannis N.

    2014-01-01

    We present our explorations towards a low-cost solution for creating an autonomous environmental data archival system. AiRCHIVE is a software platform for providing open access to sensor data with different ways, that account for machine interoperability. It is built with Raspberry Pi, a

  5. Manufacturing Cost Analysis for YSZ-Based FlexCells at Pilot and Full Scale Production Scales

    Energy Technology Data Exchange (ETDEWEB)

    Scott Swartz; Lora Thrun; Robin Kimbrell; Kellie Chenault

    2011-05-01

    Significant reductions in cell costs must be achieved in order to realize the full commercial potential of megawatt-scale SOFC power systems. The FlexCell designed by NexTech Materials is a scalable SOFC technology that offers particular advantages over competitive technologies. In this updated topical report, NexTech analyzes its FlexCell design and fabrication process to establish manufacturing costs at both pilot scale (10 MW/year) and full-scale (250 MW/year) production levels and benchmarks this against estimated anode supported cell costs at the 250 MW scale. This analysis will show that even with conservative assumptions for yield, materials usage, and cell power density, a cost of $35 per kilowatt can be achieved at high volume. Through advancements in cell size and membrane thickness, NexTech has identified paths for achieving cell manufacturing costs as low as $27 per kilowatt for its FlexCell technology. Also in this report, NexTech analyzes the impact of raw material costs on cell cost, showing the significant increases that result if target raw material costs cannot be achieved at this volume.

  6. Cost effectiveness of arthrocentesis as initial treatment for temporomandibular joint arthralgia: A randomized controlled trial

    NARCIS (Netherlands)

    Vos, L.M.; Stant, A.D.; Quik, E.H.; Huddleston Slater, J.J.R.; Stegenga, B.

    2013-01-01

    Objective: To determine the cost effectiveness of arthrocentesis as initial treatment compared to care as usual (CAU) for temporomandibular joint (TMJ) arthralgia. Materials and methods: 80 patients were randomly allocated to arthrocentesis as initial treatment (n = 40) or CAU (n = 40).

  7. Full-length mRNA sequencing uncovers a widespread coupling between transcription initiation and mRNA processing.

    Science.gov (United States)

    Anvar, Seyed Yahya; Allard, Guy; Tseng, Elizabeth; Sheynkman, Gloria M; de Klerk, Eleonora; Vermaat, Martijn; Yin, Raymund H; Johansson, Hans E; Ariyurek, Yavuz; den Dunnen, Johan T; Turner, Stephen W; 't Hoen, Peter A C

    2018-03-29

    The multifaceted control of gene expression requires tight coordination of regulatory mechanisms at transcriptional and post-transcriptional level. Here, we studied the interdependence of transcription initiation, splicing and polyadenylation events on single mRNA molecules by full-length mRNA sequencing. In MCF-7 breast cancer cells, we find 2700 genes with interdependent alternative transcription initiation, splicing and polyadenylation events, both in proximal and distant parts of mRNA molecules, including examples of coupling between transcription start sites and polyadenylation sites. The analysis of three human primary tissues (brain, heart and liver) reveals similar patterns of interdependency between transcription initiation and mRNA processing events. We predict thousands of novel open reading frames from full-length mRNA sequences and obtained evidence for their translation by shotgun proteomics. The mapping database rescues 358 previously unassigned peptides and improves the assignment of others. By recognizing sample-specific amino-acid changes and novel splicing patterns, full-length mRNA sequencing improves proteogenomics analysis of MCF-7 cells. Our findings demonstrate that our understanding of transcriptome complexity is far from complete and provides a basis to reveal largely unresolved mechanisms that coordinate transcription initiation and mRNA processing.

  8. Pretreatment costs of care and time to initial treatment for patients with cancer of unknown primary.

    Science.gov (United States)

    Walker, Mark S; Weinstein, Laura; Luo, Roger; Marino, Ingrid

    2018-06-01

    Time to treatment and pretreatment costs may be affected by unknown primary tumor site. This retrospective study used electronic medical record data from patients in ten US community oncology practices. Eligible patients were ≥18 years, diagnosed with cancer of unknown primary (CUP) or known metastatic solid tumor, and presented between 1 January 2012 and 30 June 2014. Patients with CUP (n = 294) had a longer interval than non-CUP patients (n = 92) from presentation to treatment initiation (1.18 vs 0.49 months, p < 0.0001), and had higher pretreatment costs (US$27,882 vs US$20,449, p = 0.0075). When analyzed as monthly cost, the difference between groups in log-cost per month was nonsignificant. Higher pretreatment costs in CUP patients appeared attributable to significantly longer time to initiation of therapy.

  9. Cost-effectiveness of magnetic resonance imaging versus ultrasound for the detection of symptomatic full-thickness supraspinatus tendon tears.

    Science.gov (United States)

    Gyftopoulos, Soterios; Guja, Kip E; Subhas, Naveen; Virk, Mandeep S; Gold, Heather T

    2017-12-01

    The purpose of this study was to determine the value of magnetic resonance imaging (MRI) and ultrasound-based imaging strategies in the evaluation of a hypothetical population with a symptomatic full-thickness supraspinatus tendon (FTST) tear using formal cost-effectiveness analysis. A decision analytic model from the health care system perspective for 60-year-old patients with symptoms secondary to a suspected FTST tear was used to evaluate the incremental cost-effectiveness of 3 imaging strategies during a 2-year time horizon: MRI, ultrasound, and ultrasound followed by MRI. Comprehensive literature search and expert opinion provided data on cost, probability, and quality of life estimates. The primary effectiveness outcome was quality-adjusted life-years (QALYs) through 2 years, with a willingness-to-pay threshold set to $100,000/QALY gained (2016 U.S. dollars). Costs and health benefits were discounted at 3%. Ultrasound was the least costly strategy ($1385). MRI was the most effective (1.332 QALYs). Ultrasound was the most cost-effective strategy but was not dominant. The incremental cost-effectiveness ratio for MRI was $22,756/QALY gained, below the willingness-to-pay threshold. Two-way sensitivity analysis demonstrated that MRI was favored over the other imaging strategies over a wide range of reasonable costs. In probabilistic sensitivity analysis, MRI was the preferred imaging strategy in 78% of the simulations. MRI and ultrasound represent cost-effective imaging options for evaluation of the patient thought to have a symptomatic FTST tear. The results indicate that MRI is the preferred strategy based on cost-effectiveness criteria, although the decision between MRI and ultrasound for an imaging center is likely to be dependent on additional factors, such as available resources and workflow. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  10. Full-field and anomaly initialization using a low-order climate model: a comparison and proposals for advanced formulations

    Science.gov (United States)

    Carrassi, A.; Weber, R. J. T.; Guemas, V.; Doblas-Reyes, F. J.; Asif, M.; Volpi, D.

    2014-04-01

    Initialization techniques for seasonal-to-decadal climate predictions fall into two main categories; namely full-field initialization (FFI) and anomaly initialization (AI). In the FFI case the initial model state is replaced by the best possible available estimate of the real state. By doing so the initial error is efficiently reduced but, due to the unavoidable presence of model deficiencies, once the model is let free to run a prediction, its trajectory drifts away from the observations no matter how small the initial error is. This problem is partly overcome with AI where the aim is to forecast future anomalies by assimilating observed anomalies on an estimate of the model climate. The large variety of experimental setups, models and observational networks adopted worldwide make it difficult to draw firm conclusions on the respective advantages and drawbacks of FFI and AI, or to identify distinctive lines for improvement. The lack of a unified mathematical framework adds an additional difficulty toward the design of adequate initialization strategies that fit the desired forecast horizon, observational network and model at hand. Here we compare FFI and AI using a low-order climate model of nine ordinary differential equations and use the notation and concepts of data assimilation theory to highlight their error scaling properties. This analysis suggests better performances using FFI when a good observational network is available and reveals the direct relation of its skill with the observational accuracy. The skill of AI appears, however, mostly related to the model quality and clear increases of skill can only be expected in coincidence with model upgrades. We have compared FFI and AI in experiments in which either the full system or the atmosphere and ocean were independently initialized. In the former case FFI shows better and longer-lasting improvements, with skillful predictions until month 30. In the initialization of single compartments, the best

  11. A Cost-Effective Design and Analysis of Full Bridge LLC Resonant Converter

    OpenAIRE

    Kaibalya Prasad Panda; Sreyasee Rout

    2016-01-01

    LLC (Inductor-inductor-capacitor) resonant converter has lots of advantages over other type of resonant converters which include high efficiency, more reliable and have high power density. This paper presents the design and analysis of a full bridge LLC resonant converter. In addition to the operational principle, the ZVS and ZCS conditions are also explained with the DC characteristics. Simulation of the LLC resonant converter is performed in MATLAB/ Simulink and the practical prototype setu...

  12. Making the Organization Fly Organizational Identification and Citizenship in Full-Service and Low-Cost Airlines

    NARCIS (Netherlands)

    Peters, K.; Tevichapong, Passagorn; Haslam, S. Alexander; Postmes, Tom

    2010-01-01

    Recently, the service industry has seen a low-cost sector emerge alongside the traditional full-service sector. We explored whether these business models have different implications for employee cooperation, one factor that plays an important role in organizational functioning. Drawing on the social

  13. Pricing Unmetered Irrigation Water under Asymmetric Information and Full Cost Recovery

    Directory of Open Access Journals (Sweden)

    Alban Lika

    2016-12-01

    Full Text Available The objective of this study is to define an efficient pricing scheme for irrigation water in conditions of unmetered water use. The study is based on a principal-agent model and identifies a menu of contracts, defined as a set of payments and share of irrigated area, able to provide incentives for an efficient use of the resource by maximizing social welfare. The model is applied in the case study of the Çukas region (Albania where irrigation water is not metered. The results demonstrate that using a menu of contracts makes it possible to define a second best solution that may improve the overall social welfare derived from irrigation water use compared with the existing pricing structure, though, in the specific case study, the improvement is small. Furthermore, the results also suggest that irrigation water pricing policy needs to take into account different farm types, and that appropriate contract-type pricing schemes have a potential role in providing incentives to farmers to make irrigation choices to the social optimum.

  14. Cost Analysis of Total Joint Arthroplasty Readmissions in a Bundled Payment Care Improvement Initiative.

    Science.gov (United States)

    Clair, Andrew J; Evangelista, Perry J; Lajam, Claudette M; Slover, James D; Bosco, Joseph A; Iorio, Richard

    2016-09-01

    The Bundled Payment for Care Improvement (BPCI) Initiative is a Centers for Medicare and Medicaid Services program designed to promote coordinated and efficient care. This study seeks to report costs of readmissions within a 90-day episode of care for BPCI Initiative patients receiving total knee arthroplasty (TKA) or total hip arthroplasty (THA). From January 2013 through December 2013, 1 urban, tertiary, academic orthopedic hospital admitted 664 patients undergoing either primary TKA or THA through the BPCI Initiative. All patients readmitted to our hospital or an outside hospital within 90-days from the index episode were identified. The diagnosis and cost for each readmission were analyzed. Eighty readmissions in 69 of 664 patients (10%) were identified within 90-days. There were 53 readmissions (45 patients) after THA and 27 readmissions (24 patients) after TKA. Surgical complications accounted for 54% of THA readmissions and 44% of TKA readmissions. These complications had an average cost of $36,038 (range, $6375-$60,137) for THA and $38,953 (range, $4790-$104,794) for TKA. Eliminating the TKA outlier of greater than $100,000 yields an average cost of $27,979. Medical complications of THA and TKA had an average cost of $22,775 (range, $5678-$82,940) for THA and $24,183 (range, $3306-$186,069) for TKA. Eliminating the TKA outlier of greater than $100,000 yields an average cost of $11,682. Hospital readmissions after THA and TKA are common and costly. Identifying the causes for readmission and assessing the cost will guide quality improvement efforts. Copyright © 2016 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    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

  16. Summary report on close-coupled subsurface barrier technology: Initial field trials to full-scale demonstration

    International Nuclear Information System (INIS)

    Heiser, J.H.

    1997-09-01

    The primary objective of this project was to develop and demonstrate the installation and measure the performance of a close-coupled barrier for the containment of subsurface waste or contaminant migration. A close-coupled barrier is produced by first installing a conventional, low-cost, cement-grout containment barrier followed by a thin lining of a polymer grout. The resultant barrier is a cement-polymer composite that has economic benefits derived from the cement and performance benefits from the durable and resistant polymer layer. The technology has matured from a regulatory investigation of the issues concerning the use of polymers to laboratory compatibility and performance measurements of various polymer systems to a pilot-scale, single column injection at Sandia to full-scale demonstration. The feasibility of the close-coupled barrier concept was proven in a full-scale cold demonstration at Hanford, Washington and then moved to the final stage with a full-scale demonstration at an actual remediation site at Brookhaven National Laboratory (BNL). At the Hanford demonstration the composite barrier was emplaced around and beneath a 20,000 liter tank. The secondary cement layer was constructed using conventional jet grouting techniques. Drilling was completed at a 45 degree angle to the ground, forming a cone-shaped barrier. The primary barrier was placed by panel jet-grouting with a dual-wall drill stem using a two part polymer grout. The polymer chosen was a high molecular weight acrylic. At the BNL demonstration a V-trough barrier was installed using a conventional cement grout for the secondary layer and an acrylic-gel polymer for the primary layer. Construction techniques were identical to the Hanford installation. This report summarizes the technology development from pilot- to full-scale demonstrations and presents some of the performance and quality achievements attained

  17. 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.

  18. Eosinophilic esophagitis: dilate or medicate? A cost analysis model of the choice of initial therapy.

    Science.gov (United States)

    Kavitt, R T; Penson, D F; Vaezi, M F

    2014-07-01

    Eosinophilic esophagitis (EoE) is an increasingly recognized clinical entity. The optimal initial treatment strategy in adults with EoE remains controversial. The aim of this study was to employ a decision analysis model to determine the less costly option between the two most commonly employed treatment strategies in EoE. We constructed a model for an index case of a patient with biopsy-proven EoE who continues to be symptomatic despite proton-pump inhibitor therapy. The following treatment strategies were included: (i) swallowed fluticasone inhaler (followed by esophagogastroduodenoscopy [EGD] with dilation if ineffective); and (ii) EGD with dilation (followed by swallowed fluticasone inhaler if ineffective). The time horizon was 1 year. The model focused on cost analysis of initial treatment strategies. The perspective of the healthcare payer was used. Sensitivity analyses were performed to assess the robustness of the model. For every patient whose symptoms improved or resolved with the strategy of fluticasone first followed by EGD, if necessary, it cost an average of $1078. Similarly, it cost an average of $1171 per patient if EGD with dilation was employed first. Sensitivity analyses indicated that initial treatment with fluticasone was the less costly strategy to improve dysphagia symptoms as long as the effectiveness of fluticasone remains at or above 0.62. Swallowed fluticasone inhaler (followed by EGD with dilation if necessary) is the more economical initial strategy when compared with EGD with dilation first. © 2012 Copyright the Authors. Journal compilation © 2012, Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.

  19. Assessing the full costs of water, liquid waste, energy and solid waste infrastructure in the Fraser Valley Regional District (FVRD)

    International Nuclear Information System (INIS)

    Pollard, D.

    2001-01-01

    This document presents a newly drafted growth strategy developed by the Fraser Valley Regional District (FVRD) in British Columbia. It guides the sustainable growth, change and development of the region for the next 25 years and deals with air pollution, water quality, traffic congestion, affordable housing, employment, energy use, parks and green space. In particular, this case study develops a method to apply full cost accounting (FCA) to a growth strategy. FCA is the most appropriate way to approach a sustainable strategy because it considers economic, social and environmental issues. The study also includes the development of a software tool consisting of an ACCESS database and an ARCVIEW GIS file for compiling and analyzing detailed infrastructure profiles which can be used to assess the full costs of different growth scenarios. The following four issue categories of environmental and economic indicators of FVRD performance were addressed: solid waste, water and wastewater, energy, and infrastructure costs. Each issue category was then used to establish a set of 5 performance indicators that can be measured and assessed over time. These included solid waste, water consumption, wastewater, energy consumption and air emissions. The database and methodology developed for this project is suitable for other regions. The software can be viewed by contacting the Sheltair Group Resource Consultants Inc. in Vancouver

  20. Initiating antiretroviral therapy for HIV at a patient's first clinic visit: a cost-effectiveness analysis of the rapid initiation of treatment randomized controlled trial.

    Science.gov (United States)

    Long, Lawrence C; Maskew, Mhairi; Brennan, Alana T; Mongwenyana, Constance; Nyoni, Cynthia; Malete, Given; Sanne, Ian; Fox, Matthew P; Rosen, Sydney

    2017-07-17

    Determine the cost and cost-effectiveness of single-visit (same-day) antiretroviral treatment (ART) initiation compared to standard of care initiation. Cost-effectiveness analysis of individually randomized (1 : 1) pragmatic trial of single-visit initiation, which increased viral suppression at 10 months by 26% [relative risk (95% confidence interval) 1.26 (1.05-1.50)]. Primary health clinic in Johannesburg, South Africa. HIV positive, adult, nonpregnant patients not yet on ART or known to be eligible who presented at the clinic 8 May 2013 to 29 August 2014. Same-day ART initiation using point-of-care laboratory instruments and accelerated clinic procedures to allow treatment-eligible patients to receive antiretroviral medications at the same visit as testing HIV positive or having an eligible CD4 cell count. Comparison was to standard of care ART initiation, which typically required three to five additional clinic visits. Average cost per patient enrolled and per patient achieving the primary outcome of initiated 90 days or less and suppressed 10 months or less, and production cost per patient achieving primary outcome (all costs per primary outcome patients). The average cost per patient enrolled, per patient achieving the primary outcome, and production cost were $319, $487, and $738 in the standard arm and $451, $505, and $707 in the rapid arm. Same-day treatment initiation was more effective than standard initiation, more expensive per patient enrolled, and less expensive to produce a patient achieving the primary outcome. Omitting point-of-care laboratory tests at initiation and focusing on high-volume clinics have the potential to reduce costs substantially and should be evaluated in routine settings.

  1. The Business Change Initiative: A Novel Approach to Improved Cost and Schedule Management

    Science.gov (United States)

    Shinn, Stephen A.; Bryson, Jonathan; Klein, Gerald; Lunz-Ruark, Val; Majerowicz, Walt; McKeever, J.; Nair, Param

    2016-01-01

    Goddard Space Flight Center's Flight Projects Directorate employed a Business Change Initiative (BCI) to infuse a series of activities coordinated to drive improved cost and schedule performance across Goddard's missions. This sustaining change framework provides a platform to manage and implement cost and schedule control techniques throughout the project portfolio. The BCI concluded in December 2014, deploying over 100 cost and schedule management changes including best practices, tools, methods, training, and knowledge sharing. The new business approach has driven the portfolio to improved programmatic performance. The last eight launched GSFC missions have optimized cost, schedule, and technical performance on a sustained basis to deliver on time and within budget, returning funds in many cases. While not every future mission will boast such strong performance, improved cost and schedule tools, management practices, and ongoing comprehensive evaluations of program planning and control methods to refine and implement best practices will continue to provide a framework for sustained performance. This paper will describe the tools, techniques, and processes developed during the BCI and the utilization of collaborative content management tools to disseminate project planning and control techniques to ensure continuous collaboration and optimization of cost and schedule management in the future.

  2. On the sensitivity of teleseismic full-waveform inversion to earth parametrization, initial model and acquisition design

    Science.gov (United States)

    Beller, S.; Monteiller, V.; Combe, L.; Operto, S.; Nolet, G.

    2018-02-01

    Full-waveform inversion (FWI) is not yet a mature imaging technology for lithospheric imaging from teleseismic data. Therefore, its promise and pitfalls need to be assessed more accurately according to the specifications of teleseismic experiments. Three important issues are related to (1) the choice of the lithospheric parametrization for optimization and visualization, (2) the initial model and (3) the acquisition design, in particular in terms of receiver spread and sampling. These three issues are investigated with a realistic synthetic example inspired by the CIFALPS experiment in the Western Alps. Isotropic elastic FWI is implemented with an adjoint-state formalism and aims to update three parameter classes by minimization of a classical least-squares difference-based misfit function. Three different subsurface parametrizations, combining density (ρ) with P and S wave speeds (Vp and Vs) , P and S impedances (Ip and Is), or elastic moduli (λ and μ) are first discussed based on their radiation patterns before their assessment by FWI. We conclude that the (ρ, λ, μ) parametrization provides the FWI models that best correlate with the true ones after recombining a posteriori the (ρ, λ, μ) optimization parameters into Ip and Is. Owing to the low frequency content of teleseismic data, 1-D reference global models as PREM provide sufficiently accurate initial models for FWI after smoothing that is necessary to remove the imprint of the layering. Two kinds of station deployments are assessed: coarse areal geometry versus dense linear one. We unambiguously conclude that a coarse areal geometry should be favoured as it dramatically increases the penetration in depth of the imaging as well as the horizontal resolution. This results because the areal geometry significantly increases local wavenumber coverage, through a broader sampling of the scattering and dip angles, compared to a linear deployment.

  3. Costs and role of ultrasound follow-up of polytrauma patients after initial computed tomography

    International Nuclear Information System (INIS)

    Maurer, M.H.; Winkler, A.; Powerski, M.J.; Elgeti, F.; Huppertz, A.; Roettgen, R.; Marnitz, T.; Wichlas, F.

    2012-01-01

    Purpose: To assess the costs and diagnostic gain of abdominal ultrasound follow-up of polytrauma patients initially examined by whole-body computed tomography (CT). Materials and Methods: A total of 176 patients with suspected multiple trauma (126 men, 50 women; age 43.5 ± 17.4 years) were retrospectively analyzed with regard to supplementary and new findings obtained by ultrasound follow-up compared with the results of exploratory FAST (focused assessment with sonography for trauma) at admission and the findings of whole-body CT. A process model was used to document the staff, materials, and total costs of the ultrasound follow-up examinations. Results: FAST yielded 26 abdominal findings (organ injury and/or free intra-abdominal fluid) in 19 patients, while the abdominal scan of whole-body CT revealed 32 findings in 25 patients. FAST had 81 % sensitivity and 100 % specificity. Follow-up ultrasound examinations revealed new findings in 2 of the 25 patients with abdominal injuries detected with initial CT. In the 151 patients without abdominal injuries in the initial CT scan, ultrasound follow-up did not yield any supplementary or new findings. The total costs of an ultrasound follow-up examination were EUR 28.93. The total costs of all follow-up ultrasound examinations performed in the study population were EUR 5658.23. Conclusion: Follow-up abdominal ultrasound yields only a low overall diagnostic gain in polytrauma patients in whom initial CT fails to detect any abdominal injuries but incurs high personnel expenses for radiological departments. (orig.)

  4. Prevalence and Cost of Full-Time Research Fellowships During General Surgery Residency – A National Survey

    Science.gov (United States)

    Robertson, Charles M.; Klingensmith, Mary E.; Coopersmith, Craig M.

    2009-01-01

    Structured Abstract Objective To quantify the prevalence, outcomes, and cost of surgical resident research. Summary Background Data General surgery is unique among graduate medical education programs because a large percentage of residents interrupt their clinical training to spend 1-3 years performing full-time research. No comprehensive data exists on the scope of this practice. Methods Survey sent to all 239 program directors of general surgery residencies participating in the National Resident Matching Program. Results Response rate was 200/239 (84%). A total of 381 out of 1052 trainees (36%) interrupt residency to pursue full-time research. The mean research fellowship length is 1.7 years, with 72% of trainees performing basic science research. A significant association was found between fellowship length and post-residency activity, with a 14.7% increase in clinical fellowship training and a 15.2% decrease in private practice positions for each year of full-time research (p<0.0001). Program directors at 31% of programs reported increased clinical duties for research fellows as a result of ACGME work hour regulations for clinical residents, while a further 10% of programs are currently considering such changes. It costs $41.5 million to pay the 634 trainees who perform research fellowships each year, the majority of which is paid for by departmental funds (40%) and institutional training grants (24%). Conclusions Interrupting residency to perform a research fellowship is a common and costly practice among general surgery residents. While performing a research fellowship is associated with clinical fellowship training after residency, it is unclear to what extent this practice leads to the development of surgical investigators after post-graduate training. PMID:19106692

  5. A simulation model to estimate the cost and effectiveness of alternative dialysis initiation strategies.

    Science.gov (United States)

    Lee, Chris P; Chertow, Glenn M; Zenios, Stefanos A

    2006-01-01

    Patients with end-stage renal disease (ESRD) require dialysis to maintain survival. The optimal timing of dialysis initiation in terms of cost-effectiveness has not been established. We developed a simulation model of individuals progressing towards ESRD and requiring dialysis. It can be used to analyze dialysis strategies and scenarios. It was embedded in an optimization frame worked to derive improved strategies. Actual (historical) and simulated survival curves and hospitalization rates were virtually indistinguishable. The model overestimated transplantation costs (10%) but it was related to confounding by Medicare coverage. To assess the model's robustness, we examined several dialysis strategies while input parameters were perturbed. Under all 38 scenarios, relative rankings remained unchanged. An improved policy for a hypothetical patient was derived using an optimization algorithm. The model produces reliable results and is robust. It enables the cost-effectiveness analysis of dialysis strategies.

  6. Biofuels cost developments in the EU27+ until 2030. Full-chain cost assessment and implications of policy options. REFUEL WP4 final report

    International Nuclear Information System (INIS)

    Londo, H.M.; Lensink, S.M.; Deurwaarder, E.P.; Wakker, A.; De Wit, M.; Junginger, M.; Koenighofer, K; Jungmeier, G.

    2008-02-01

    With the rapid developments in the biofuels domain comes the need for biofuel policies that spur their introduction in a responsible way. The REFUEL project, supported by the EU Intelligent Energy Europe programme, develops a road map for biofuels in the EU27+ up to 2030. This WP4 report shows the results of a full-chain analysis of the costs of different biofuels. Effects of different levels of biofuel target setting were analysed, and also the impact of different additional policy measures, such as the introduction of a CO2 pricing mechanism and specific subsidies

  7. Procedures for initiation, cost-sharing and management of OECD projects in nuclear safety

    International Nuclear Information System (INIS)

    2002-01-01

    The OECD (CSNI) projects aim to produce results relevant for the safe operation of nuclear power plants through international collaborative projects. In general, the projects consist of advanced experimental programmes that are conducted at specialized facilities. At present, the following OECD (CSNI) projects are in operation: - The Halden Project, covering fuel/materials and I and C/Human Factors issues; - The Cabri Project, addressing reactivity transients on high burnup fuels; - The MASCA Project, which deals with in-vessel corium phenomena; - The OLHF Project, dealing with lower head failure mechanisms; - The SETH Project addressing thermal-hydraulics issues, started in 2001; - The MCCI Project on ex-vessel coolability and melt-concrete interaction. There are significant differences among these projects in terms of their motivation, size and scope. The Halden Project and the Cabri Water Loop Project are large undertakings where the host organisations assume full and direct responsibility for the project establishment and administration - as well as for the negotiation with relevant parties on the terms of participation. In the other cases, instead, the NEA secretariat has a more direct responsibility, conferred by the CSNI, in establishing the project technical and financial basis, as well as for its implementation and administration. The objective of this procedure is to provide a common basis for the establishment and management of the OECD projects in the area of nuclear safety. It is a follow-up of a recommendation expressed by the CSNI Bureau during its meeting in October 2001, where the procedures for the establishment and management of the OECD (CSNI) projects in nuclear safety were addressed. While this procedure attempts at defining general guidelines for project initiation, financing and management, one should bear in mind that each project has its own motivation, background and framework. Thus, some degree of flexibility in project structure

  8. Peak capacity analysis of coal power in China based on full-life cycle cost model optimization

    Science.gov (United States)

    Yan, Xiaoqing; Zhang, Jinfang; Huang, Xinting

    2018-02-01

    13th five-year and the next period are critical for the energy and power reform of China. In order to ease the excessive power supply, policies have been introduced by National Energy Board especially toward coal power capacity control. Therefore the rational construction scale and scientific development timing for coal power are of great importance and paid more and more attentions. In this study, the comprehensive influence of coal power reduction policies is analyzed from diverse point of views. Full-life cycle cost model of coal power is established to fully reflect the external and internal cost. Then this model is introduced in an improved power planning optimization theory. The power planning and diverse scenarios production simulation shows that, in order to meet the power, electricity and peak balance of power system, China’s coal power peak capacity is within 1.15 ∼ 1.2 billion kilowatts before or after 2025. The research result is expected to be helpful to the power industry in 14th and 15th five-year periods, promoting the efficiency and safety of power system.

  9. Paying the full cost of power : an indicative comparative analysis of residential electricity rates across Canadian provinces

    International Nuclear Information System (INIS)

    Goulding, A.J.; Sabatier, G.

    2005-01-01

    This study was commissioned to review electricity rates charged to residential consumers across Canada and to determine how the basics of ratemaking change from province to province. Rates in each province vary significantly due to differences in the industry structure and their resource base. It was noted that direct comparisons are difficult because some rates reflect the financing, fuel and opportunity costs of power. For that reason, a simple adjustment factor was developed for fair comparison between jurisdictions. This assessment compared the all-in cost to final consumers which includes power generation, transmission, distribution and all other charges, as calculated by Statistics Canada. It was revealed that Alberta is Canada's only province where prices to final consumers reflect the market value of the underlying commodity. Ratepayers have the advantage of not being responsible for bad investment choices in the power sector and there are no hidden subsidies due to provincial ownership of power resources. Another consumer advantage is that they receive appropriate price signals in terms of energy consumption and conservation. This report suggests that low electricity rates in other provinces can be expected to rise much more rapidly than those in Alberta in the coming decade as consumers may be charged the full value of the electricity they use. 18 refs., 9 figs

  10. Benefit-Cost Analysis of Undergraduate Education Programs: An Example Analysis of the Freshman Research Initiative.

    Science.gov (United States)

    Walcott, Rebecca L; Corso, Phaedra S; Rodenbusch, Stacia E; Dolan, Erin L

    2018-01-01

    Institutions and administrators regularly have to make difficult choices about how best to invest resources to serve students. Yet economic evaluation, or the systematic analysis of the relationship between costs and outcomes of a program or policy, is relatively uncommon in higher education. This type of evaluation can be an important tool for decision makers considering questions of resource allocation. Our purpose with this essay is to describe methods for conducting one type of economic evaluation, a benefit-cost analysis (BCA), using an example of an existing undergraduate education program, the Freshman Research Initiative (FRI) at the University of Texas Austin. Our aim is twofold: to demonstrate how to apply BCA methodologies to evaluate an education program and to conduct an economic evaluation of FRI in particular. We explain the steps of BCA, including assessment of costs and benefits, estimation of the benefit-cost ratio, and analysis of uncertainty. We conclude that the university's investment in FRI generates a positive return for students in the form of increased future earning potential. © 2018 R. L. Walcott et al. CBE—Life Sciences Education © 2018 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  11. Cost Analysis of a High Support Housing Initiative for Persons with Severe Mental Illness and Long-Term Psychiatric Hospitalization.

    Science.gov (United States)

    Rudoler, David; de Oliveira, Claire; Jacob, Binu; Hopkins, Melonie; Kurdyak, Paul

    2018-01-01

    The objective of this article was to conduct a cost analysis comparing the costs of a supportive housing intervention to inpatient care for clients with severe mental illness who were designated alternative-level care while inpatient at the Centre for Addiction and Mental Health in Toronto. The intervention, called the High Support Housing Initiative, was implemented in 2013 through a collaboration between 15 agencies in the Toronto area. The perspective of this cost analysis was that of the Ontario Ministry of Health and Long-Term Care. We compared the cost of inpatient mental health care to high-support housing. Cost data were derived from a variety of sources, including health administrative data, expenditures reported by housing providers, and document analysis. The High Support Housing Initiative was cost saving relative to inpatient care. The average cost savings per diem were between $140 and $160. This amounts to an annual cost savings of approximately $51,000 to $58,000. When tested through sensitivity analysis, the intervention remained cost saving in most scenarios; however, the result was highly sensitive to health system costs for clients of the High Support Housing Initiative program. This study suggests the High Support Housing Initiative is potentially cost saving relative to inpatient hospitalization at the Centre for Addiction and Mental Health.

  12. Full-scale testing, production and cost analysis data for the advanced composite stabilizer for Boeing 737 aircraft. Volume 1: Technical summary

    Science.gov (United States)

    Aniversario, R. B.; Harvey, S. T.; Mccarty, J. E.; Parsons, J. T.; Peterson, D. C.; Pritchett, L. D.; Wilson, D. R.; Wogulis, E. R.

    1983-01-01

    The full scale ground test, ground vibration test, and flight tests conducted to demonstrate a composite structure stabilizer for the Boeing 737 aircraft and obtain FAA certification are described. Detail tools, assembly tools, and overall production are discussed. Cost analyses aspects covered include production costs, composite material usage factors, and cost comparisons.

  13. An empirical investigation into the changing visual identity of full service and low cost carriers, 2000 vs. 2012

    Directory of Open Access Journals (Sweden)

    Adam Taylor

    2013-09-01

    Full Text Available This paper reports on the findings of a semiotic content analysis of the visual branding of over 630 airline tail fins as they appeared in 2000 and 2012. Unlike existing studies of airlines’ visual identities that rely on a snap shot in time and examine all airlines, this paper focuses on changes that have occurred in the visual branding of full-service carriers (FSCs and low cost carriers (LCCs between 2000 and 2012. The results confirm that there have been significant changes in the visual content of FSC and LCC tail fins and the way in which these airlines portray non-price competitive characteristics. The research shows that while an increasing number of LCCs now use aircraft tail fins to display their corporate name, FSCs are increasingly employing icons of nationhood. This suggests that while LCCs are trying to appeal to a wide passenger demographic who value low fares over service, FSCs are responding to the competitive threat by explicitly drawing on the cultural rhetoric of symbols of sovereign national identity to differentiate themselves in an increasingly competitive market.

  14. Cost of initial management of musculoskeletal injuries due to road traffic crashes: A register-based study from North-West India

    Directory of Open Access Journals (Sweden)

    Bhanu Awasthi

    2017-01-01

    Full Text Available Background: There is a paucity of information on the actual costs incurred by the family as a result of musculoskeletal injuries due to road traffic crash from our part of India. This study was conducted with the objective to ascertain the costs of initial management of musculoskeletal injuries due to road traffic crashes. Materials and Methods: This prospective study was conducted as a register-based descriptive study in a tertiary care teaching hospital in a rural area (with a predominantly mountainous terrain of North-West India. All patients with nonfatal musculoskeletal injuries due to road traffic crashes, presenting between 2014 and 2015 and agreeing to participate in the study were included in the study. Results: Of 313 cases, 116 were managed conservatively, whereas in 189 cases, operative intervention was required. In 8 cases, both the modalities of management were required. The average cost of management was Rs. 20,386 in operative group. The average cost in the conservative group was Rs. 3726. Average cost calculated for patients in whom both modality of treatment was required was Rs. 24,000. It was observed that the indirect cost of management was proportionately higher in conservative group. Conclusions: The initial cost of management for patients managed conservatively is less than those managed by operative intervention. Importantly, however, the indirect cost of management is a major contributor to the total cost of management.

  15. Models of Disease Vector Control: When Can Aggressive Initial Intervention Lower Long-Term Cost?

    Science.gov (United States)

    Oduro, Bismark; Grijalva, Mario J; Just, Winfried

    2018-04-01

    Insecticide spraying of housing units is an important control measure for vector-borne infections such as Chagas disease. As vectors may invade both from other infested houses and sylvatic areas and as the effectiveness of insecticide wears off over time, the dynamics of (re)infestations can be approximated by [Formula: see text]-type models with a reservoir, where housing units are treated as hosts, and insecticide spraying corresponds to removal of hosts. Here, we investigate three ODE-based models of this type. We describe a dual-rate effect where an initially very high spraying rate can push the system into a region of the state space with low endemic levels of infestation that can be maintained in the long run at relatively moderate cost, while in the absence of an aggressive initial intervention the same average cost would only allow a much less significant reduction in long-term infestation levels. We determine some sufficient and some necessary conditions under which this effect occurs and show that it is robust in models that incorporate some heterogeneity in the relevant properties of housing units.

  16. Comparison Between Individually and Group-Based Insulin Pump Initiation by Time-Driven Activity-Based Costing.

    Science.gov (United States)

    Ridderstråle, Martin

    2017-07-01

    Depending on available resources, competencies, and pedagogic preference, initiation of insulin pump therapy can be performed on either an individual or a group basis. Here we compared the two models with respect to resources used. Time-driven activity-based costing (TDABC) was used to compare initiating insulin pump treatment in groups (GT) to individual treatment (IT). Activities and cost drivers were identified, timed, or estimated at location. Medical quality and patient satisfaction were assumed to be noninferior and were not measured. GT was about 30% less time-consuming and 17% less cost driving per patient and activity compared to IT. As a batch driver (16 patients in one group) GT produced an upward jigsaw-shaped accumulative cost curve compared to the incremental increase incurred by IT. Taking the alternate cost for those not attending into account, and realizing the cost of opportunity gained, suggested that GT was cost neutral already when 5 of 16 patients attended, and that a second group could be initiated at no additional cost as the attendance rate reached 15:1. We found TDABC to be effective in comparing treatment alternatives, improving cost control and decision making. Everything else being equal, if the setup is available, our data suggest that initiating insulin pump treatment in groups is far more cost effective than on an individual basis and that TDABC may be used to find the balance point.

  17. Two-Year Costs and Quality in the Comprehensive Primary Care Initiative.

    Science.gov (United States)

    Dale, Stacy B; Ghosh, Arkadipta; Peikes, Deborah N; Day, Timothy J; Yoon, Frank B; Taylor, Erin Fries; Swankoski, Kaylyn; O'Malley, Ann S; Conway, Patrick H; Rajkumar, Rahul; Press, Matthew J; Sessums, Laura; Brown, Randall

    2016-06-16

    The 4-year, multipayer Comprehensive Primary Care Initiative was started in October 2012 to determine whether several forms of support would produce changes in care delivery that would improve the quality and reduce the costs of care at 497 primary care practices in seven regions across the United States. Support included the provision of care-management fees, the opportunity to earn shared savings, and the provision of data feedback and learning support. We tracked changes in the delivery of care by practices participating in the initiative and used difference-in-differences regressions to compare changes over the first 2 years of the initiative in Medicare expenditures, health care utilization, claims-based measures of quality, and patient experience for Medicare fee-for-service beneficiaries attributed to initiative practices and a group of matched comparison practices. During the first 2 years, initiative practices received a median of $115,000 per clinician in care-management fees. The practices reported improvements in approaches to the delivery of primary care in areas such as management of the care of high-risk patients and enhanced access to care. Changes in average monthly Medicare expenditures per beneficiary did not differ significantly between initiative and comparison practices when care-management fees were not taken into account (-$11; 95% confidence interval [CI], -$23 to $1; P=0.07; negative values indicate less growth in spending at initiative practices) or when these fees were taken into account ($7; 95% CI, -$5 to $19; P=0.27). The only significant differences in other measures were a 3% reduction in primary care visits for initiative practices relative to comparison practices (Pinitiative practices relative to comparison practices (P=0.006 and Pinitiative have reported progress in transforming the delivery of primary care. However, at this point these practices have not yet shown savings in expenditures for Medicare Parts A and B after

  18. Initial investigation into lower-cost CT for resource limited regions of the world

    Science.gov (United States)

    Dobbins, James T., III; Wells, Jered R.; Segars, W. Paul; Li, Christina M.; Kigongo, Christopher J. N.

    2010-04-01

    This paper describes an initial investigation into means for producing lower-cost CT scanners for resource limited regions of the world. In regions such as sub-Saharan Africa, intermediate level medical facilities serving millions have no CT machines, and lack the imaging resources necessary to determine whether certain patients would benefit from being transferred to a hospital in a larger city for further diagnostic workup or treatment. Low-cost CT scanners would potentially be of immense help to the healthcare system in such regions. Such scanners would not produce state-of-theart image quality, but rather would be intended primarily for triaging purposes to determine the patients who would benefit from transfer to larger hospitals. The lower-cost scanner investigated here consists of a fixed digital radiography system and a rotating patient stage. This paper describes initial experiments to determine if such a configuration is feasible. Experiments were conducted using (1) x-ray image acquisition, a physical anthropomorphic chest phantom, and a flat-panel detector system, and (2) a computer-simulated XCAT chest phantom. Both the physical phantom and simulated phantom produced excellent image quality reconstructions when the phantom was perfectly aligned during acquisition, but artifacts were noted when the phantom was displaced to simulate patient motion. An algorithm was developed to correct for motion of the phantom and demonstrated success in correcting for 5-mm motion during 360-degree acquisition of images. These experiments demonstrated feasibility for this approach, but additional work is required to determine the exact limitations produced by patient motion.

  19. Costs and cost-effectiveness analysis of 2015 GESIDA/Spanish AIDS National Plan recommended guidelines for initial antiretroviral therapy in HIV-infected adults.

    Science.gov (United States)

    Berenguer, Juan; Rivero, Antonio; Blasco, Antonio Javier; Arribas, José Ramón; Boix, Vicente; Clotet, Bonaventura; Domingo, Pere; González-García, Juan; Knobel, Hernando; Lázaro, Pablo; López, Juan Carlos; Llibre, Josep M; Lozano, Fernando; Miró, José M; Podzamczer, Daniel; Tuset, Montserrat; Gatell, Josep M

    2016-01-01

    GESIDA and the AIDS National Plan panel of experts suggest a preferred (PR), alternative (AR) and other regimens (OR) for antiretroviral treatment (ART) as initial therapy in HIV-infected patients for 2015. The objective of this study is to evaluate the costs and the effectiveness of initiating treatment with these regimens. Economic assessment of costs and effectiveness (cost/effectiveness) based on decision tree analyses. Effectiveness was defined as the probability of reporting a viral load de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  20. Cost and consequences of noncompliance with osteoporosis treatment among women initiating therapy.

    Science.gov (United States)

    Modi, Ankita; Siris, Ethel S; Tang, Jackson; Sen, Shuvayu

    2015-04-01

    The objective was to evaluate compliance with osteoporosis (OP) treatments and determine the fracture and healthcare burden associated with noncompliance. This retrospective analysis of a US claims database identified women initiating an OP medication from 1 January 2002 to 30 June 2009. Patients were ≥55 years and had ≥1 pharmacy claim for a bisphosphonate or non-bisphosphonate (raloxifene, calcitonin, teriparatide); the index date was the first pharmacy claim. There were three study periods: baseline (12 months pre-index); compliance period (0-12 months post-index); and follow-up period (12-24 months post-index). Medication possession ratio (MPR) was calculated during the compliance period to differentiate two cohorts: compliant (MPR ≥ 80%) and noncompliant (MPR costs), all adjusted for patient demographic and clinical characteristics. Overall, 685,505 women initiating OP therapy were identified and 57,913 (8.4%) met the inclusion criteria: only 23,430 (40.5%) were compliant and 34,483 (59.5%) were noncompliant. Mean age was 64 years. Noncompliance was associated with a 20% higher risk of any fracture (odds ratio: 1.20, 95% CI = 1.07-1.35), a higher incidence rate ratio (IRR) for inpatient utilization (IRR: 1.26, 95% CI = 1.19-1.34) and a lower rate of outpatient utilization (IRR: 0.97, 95% CI = 0.95-0.98). Noncompliant patients had 13% higher medical costs (cost ratio: 1.13, 95% CI = 1.06-1.21) than compliant patients. Inclusion in this study required 36 months of continuous healthcare coverage. Thus, the results are primarily applicable to a stable, managed care population and may not be generalizable to other populations. Noncompliance with OP therapy was associated with a higher risk of fracture, higher all-cause medical costs and a higher frequency of inpatient service utilization. Additional research is needed to identify barriers to compliance with OP therapy.

  1. Perhitungan Biaya Produksi Ayam Bakar Dengan Metode Full Costing (Studi Kasus Ayam Bakar Kaki Lima Jalan Dr. Mansyur Iii Padang Bulan Medan)

    OpenAIRE

    Marthsari, Rica

    2016-01-01

    To avoid errors in the calculation of cost of production and cost efficient to produce required an appropriate method. The exact method used in calculating the cost of production is the full costing method. As for the problem of this research is an error in the calculation of production costs generated often causes the price is set too low or too high. This resulted in an incompatibility of the expected profit with the actual profit we earn. The purpose of this study is to analyze the prod...

  2. Development of friction and wear full-scale testing for TKR prostheses with reliable low cost apparatus

    Science.gov (United States)

    Suwandi, Agri; Soemardi, Tresna P.; Kiswanto, Gandjar; Kusumaningsih, Widjajalaksmi; I. Gusti Agung I. G., W.

    2018-02-01

    Prostheses products must undergo simulation and physical testing, before clinical testing. Finite element method is a preliminary simulation for in vivo test. The method visualizes the magnitude of the compressive force and the critical location of the Total Knee Replacement (TKR) prostheses design. In vitro testing is classified as physical testing for prostheses product. The test is conducted to evaluate the potential failure of the product and the characteristics of the prostheses TKR material. Friction and wear testing are part of the in vivo test. Motion of knee joints, which results in the phenomena of extension and deflection in the femoral and tibia insert, is represented by friction and wear testing. Friction and wear tests aim to obtain an approximate lifetime in normal and extreme load patterns as characterized by the shape of the friction surface area. The lifetime estimation requires friction and wear full-scale testing equipments for TKR prostheses products. These are necessary in obtaining initial data on potential product failures and characterizing of the material based on the ASTM F2724-08 standards. Based on the testing result and statistical analysis data, the average wear rate value per year is 2.19 × 10-3 mg/MC, with a 10 % safety limit of volume and 14,400 cycles times, for 15 hours moving nonstop then the prediction of wear life of the component tibia insert is ± 10 years.

  3. [Analysis of costs and cost-effectiveness of preferred GESIDA/National AIDS Plan regimens for initial antiretroviral therapy in human immunodeficiency virus infected adult patients in 2013].

    Science.gov (United States)

    Blasco, Antonio Javier; Llibre, Josep M; Arribas, José Ramón; Boix, Vicente; Clotet, Bonaventura; Domingo, Pere; González-García, Juan; Knobel, Hernando; López, Juan Carlos; Lozano, Fernando; Miró, José M; Podzamczer, Daniel; Santamaría, Juan Miguel; Tuset, Montserrat; Zamora, Laura; Lázaro, Pablo; Gatell, Josep M

    2013-11-01

    The GESIDA and National AIDS Plan panel of experts have proposed "preferred regimens" of antiretroviral treatment (ART) as initial therapy in HIV infected patients for 2013. The objective of this study is to evaluate the costs and effectiveness of initiating treatment with these "preferred regimens". An economic assessment of costs and effectiveness (cost/effectiveness) was performed using decision tree analysis models. Effectiveness was defined as the probability of having viral load <50copies/mL at week48, in an intention-to-treat analysis. Cost of initiating treatment with an ART regime was defined as the costs of ART and its consequences (adverse effects, changes of ART regime and drug resistance analyses) during the first 48weeks. The perspective of the analysis is that of the National Health System was applied, only taking into account differential direct costs: ART (official prices), management of adverse effects, resistance studies, and determination of HLA B*5701. The setting is Spain and the costs are those of 2013. A sensitivity deterministic analysis was performed, constructing three scenarios for each regimen: baseline, most favourable, and most unfavourable cases. In the baseline case scenario, the cost of initiating treatment ranges from 6,747euros for TDF/FTC+NVP to 12,059euros for TDF/FTC+RAL. The effectiveness ranges between 0.66 for ABC/3TC+LPV/r and ABC/3TC+ATV/r, and 0.87 for TDF/FTC+RAL and ABC/3TC+RAL. Effectiveness, in terms of cost/effectiveness, varies between 8,396euros and 13,930euros per responder at 48weeks, for TDF/FTC/RPV and TDF/FTC+RAL, respectively. Taking ART at official prices, the most effective regimen was TDF/FTC/RPV, followed by the rest of non-nucleoside containing regimens. The sensitivity analysis confirms the robustness of these findings. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  4. Time-driven activity-based costing: a driver for provider engagement in costing activities and redesign initiatives.

    Science.gov (United States)

    McLaughlin, Nancy; Burke, Michael A; Setlur, Nisheeta P; Niedzwiecki, Douglas R; Kaplan, Alan L; Saigal, Christopher; Mahajan, Aman; Martin, Neil A; Kaplan, Robert S

    2014-11-01

    To date, health care providers have devoted significant efforts to improve performance regarding patient safety and quality of care. To address the lagging involvement of health care providers in the cost component of the value equation, UCLA Health piloted the implementation of time-driven activity-based costing (TDABC). Here, the authors describe the implementation experiment, share lessons learned across the care continuum, and report how TDABC has actively engaged health care providers in costing activities and care redesign. After the selection of pilots in neurosurgery and urology and the creation of the TDABC team, multidisciplinary process mapping sessions, capacity-cost calculations, and model integration were coordinated and offered to engage care providers at each phase. Reviewing the maps for the entire episode of care, varying types of personnel involved in the delivery of care were noted: 63 for the neurosurgery pilot and 61 for the urology pilot. The average cost capacities for care coordinators, nurses, residents, and faculty were $0.70 (range $0.63-$0.75), $1.55 (range $1.28-$2.04), $0.58 (range $0.56-$0.62), and $3.54 (range $2.29-$4.52), across both pilots. After calculating the costs for material, equipment, and space, the TDABC model enabled the linking of a specific step of the care cycle (who performed the step and its duration) and its associated costs. Both pilots identified important opportunities to redesign care delivery in a costconscious fashion. The experimentation and implementation phases of the TDABC model have succeeded in engaging health care providers in process assessment and costing activities. The TDABC model proved to be a catalyzing agent for cost-conscious care redesign.

  5. Full-scale testing, production and cost analysis data for the advanced composite stabilizer for Boeing 737 aircraft, volume 2

    Science.gov (United States)

    Aniversario, R. B.; Harvey, S. T.; Mccarty, J. E.; Parson, J. T.; Peterson, D. C.; Pritchett, L. D.; Wilson, D. R.; Wogulis, E. R.

    1982-01-01

    The development, testing, production activities, and associated costs that were required to produce five-and-one-half advanced-composite stabilizer shipsets for Boeing 737 aircraft are defined and discussed.

  6. Capital and Operating Costs of Full-Scale Fecal Sludge Management and Wastewater Treatment Systems in Dakar, Senegal

    Science.gov (United States)

    2012-01-01

    A financial comparison of a parallel sewer based (SB) system with activated sludge, and a fecal sludge management (FSM) system with onsite septic tanks, collection and transport (C&T) trucks, and drying beds was conducted. The annualized capital for the SB ($42.66 capita–1 year–1) was ten times higher than the FSM ($4.05 capita–1 year–1), the annual operating cost for the SB ($11.98 capita–1 year–1) was 1.5 times higher than the FSM ($7.58 capita–1 year–1), and the combined capital and operating for the SB ($54.64 capita–1 year–1) was five times higher than FSM ($11.63 capita–1 year–1). In Dakar, costs for SB are almost entirely borne by the sanitation utility, with only 6% of the annualized cost borne by users of the system. In addition to costing less overall, FSM operates with a different business model, with costs spread among households, private companies, and the utility. Hence, SB was 40 times more expensive to implement for the utility than FSM. However, the majority of FSM costs are borne at the household level and are inequitable. The results of the study illustrate that in low-income countries, vast improvements in sanitation can be affordable when employing FSM, whereas SB systems are prohibitively expensive. PMID:22413875

  7. Capital and operating costs of full-scale fecal sludge management and wastewater treatment systems in Dakar, Senegal.

    Science.gov (United States)

    Dodane, Pierre-Henri; Mbéguéré, Mbaye; Sow, Ousmane; Strande, Linda

    2012-04-03

    A financial comparison of a parallel sewer based (SB) system with activated sludge, and a fecal sludge management (FSM) system with onsite septic tanks, collection and transport (C&T) trucks, and drying beds was conducted. The annualized capital for the SB ($42.66 capita(-1) year(-1)) was ten times higher than the FSM ($4.05 capita(-1) year(-1)), the annual operating cost for the SB ($11.98 capita(-1) year(-1)) was 1.5 times higher than the FSM ($7.58 capita(-1) year(-1)), and the combined capital and operating for the SB ($54.64 capita(-1) year(-1)) was five times higher than FSM ($11.63 capita(-1) year(-1)). In Dakar, costs for SB are almost entirely borne by the sanitation utility, with only 6% of the annualized cost borne by users of the system. In addition to costing less overall, FSM operates with a different business model, with costs spread among households, private companies, and the utility. Hence, SB was 40 times more expensive to implement for the utility than FSM. However, the majority of FSM costs are borne at the household level and are inequitable. The results of the study illustrate that in low-income countries, vast improvements in sanitation can be affordable when employing FSM, whereas SB systems are prohibitively expensive.

  8. An analysis of cost effective incentives for initial commercial deployment of advanced clean coal technologies

    Energy Technology Data Exchange (ETDEWEB)

    Spencer, D.F. [SIMTECHE, Half Moon Bay, CA (United States)

    1997-12-31

    This analysis evaluates the incentives necessary to introduce commercial scale Advanced Clean Coal Technologies, specifically Integrated Coal Gasification Combined Cycle (ICGCC) and Pressurized Fluidized Bed Combustion (PFBC) powerplants. The incentives required to support the initial introduction of these systems are based on competitive busbar electricity costs with natural gas fired combined cycle powerplants, in baseload service. A federal government price guarantee program for up to 10 Advanced Clean Coal Technology powerplants, 5 each ICGCC and PFBC systems is recommended in order to establish the commercial viability of these systems by 2010. By utilizing a decreasing incentives approach as the technologies mature (plants 1--5 of each type), and considering the additional federal government benefits of these plants versus natural gas fired combined cycle powerplants, federal government net financial exposure is minimized. Annual net incentive outlays of approximately 150 million annually over a 20 year period could be necessary. Based on increased demand for Advanced Clean Coal Technologies beyond 2010, the federal government would be revenue neutral within 10 years of the incentives program completion.

  9. Paying the full price of steel – Perspectives on the cost of reducing carbon dioxide emissions from the steel industry

    International Nuclear Information System (INIS)

    Rootzén, Johan; Johnsson, Filip

    2016-01-01

    This study examines the impacts felt downstream of carbon pricing and investments made in CO_2 abatement within the steel industry. Using the supply of steel to a passenger car as a case study, the effects of a steel price increase on cost structures and price at each step of the supply chain were assessed. Since the prices of emission allowances under the European Union Emissions Trading System fall well below those required to unlock investments in low-CO_2 production processes in the integrated steelmaking industry this paper seeks to pave the way for a discussion on complementary policy options. The results of the analysis suggest that passing on the compliance costs of the steel industry would have only marginal impacts on costs and prices for the end-use sectors (e.g., on the production cost or selling price of the passenger car). Under the assumptions made herein, at a carbon price of 100 €/tCO_2, the retail price of a mid-sized European passenger car would have to be increased by approximately 100–125 €/car (<0.5%) to cover the projected increases in steel production costs. - Highlights: • Examines impacts downstream of investments in CO_2 abatement in the steel industry. • Show how investing in low-CO_2 processes have marginal impacts in end-user stage. • Increase in the retail price of a mid-sized passenger car would be well below 1%. • Open up for complementary policies, financing mechanisms or new business models.

  10. A Cost-effective and Emission-aware Power Management System for Ships with Integrated Full Electric Propulsion

    DEFF Research Database (Denmark)

    Kanellos, Fotis D.; Anvari-Moghaddam, Amjad; Guerrero, Josep M.

    2017-01-01

    The extensive exploitation of electric power in ships enables the development of more efficient and environmentally friendlier ships, as it allows for a more flexible ship power system operation and configuration. In this paper, an optimal power management method for ship electric power systems....... The proposed fuzzy-based particle swarm optimization (FPSO) algorithm aims at minimizing the operation cost, limiting the greenhouse gas (GHG) emissions and satisfying the technical and operational constraints of the ship....

  11. Low-cost autonomous orbit control about Mars: Initial simulation results

    Science.gov (United States)

    Dawson, S. D.; Early, L. W.; Potterveld, C. W.; Königsmann, H. J.

    1999-11-01

    Interest in studying the possibility of extraterrestrial life has led to the re-emergence of the Red Planet as a major target of planetary exploration. Currently proposed missions in the post-2000 period are routinely calling for rendezvous with ascent craft, long-term orbiting of, and sample-return from Mars. Such missions would benefit greatly from autonomous orbit control as a means to reduce operations costs and enable contact with Mars ground stations out of view of the Earth. This paper present results from initial simulations of autonomously controlled orbits around Mars, and points out possible uses of the technology and areas of routine Mars operations where such cost-conscious and robust autonomy could prove most effective. These simulations have validated the approach and control philosophies used in the development of this autonomous orbit controller. Future work will refine the controller, accounting for systematic and random errors in the navigation of the spacecraft from the sensor suite, and will produce prototype flight code for inclusion on future missions. A modified version of Microcosm's commercially available High Precision Orbit Propagator (HPOP) was used in the preparation of these results due to its high accuracy and speed of operation. Control laws were developed to allow an autonomously controlled spacecraft to continuously control to a pre-defined orbit about Mars with near-optimal propellant usage. The control laws were implemented as an adjunct to HPOP. The GSFC-produced 50 × 50 field model of the Martian gravitational potential was used in all simulations. The Martian atmospheric drag was modeled using an exponentially decaying atmosphere based on data from the Mars-GRAM NASA Ames model. It is hoped that the simple atmosphere model that was implemented can be significantly improved in the future so as to approach the fidelity of the Mars-GRAM model in its predictions of atmospheric density at orbital altitudes. Such additional work

  12. Cost-Effectiveness of a National Initiative to Improve Hand Hygiene Compliance Using the Outcome of Healthcare Associated Staphylococcus aureus Bacteraemia.

    Directory of Open Access Journals (Sweden)

    Nicholas Graves

    Full Text Available The objective is to estimate the incremental cost-effectiveness of the Australian National Hand Hygiene Inititiave implemented between 2009 and 2012 using healthcare associated Staphylococcus aureus bacteraemia as the outcome. Baseline comparators are the eight existing state and territory hand hygiene programmes. The setting is the Australian public healthcare system and 1,294,656 admissions from the 50 largest Australian hospitals are included.The design is a cost-effectiveness modelling study using a before and after quasi-experimental design. The primary outcome is cost per life year saved from reduced cases of healthcare associated Staphylococcus aureus bacteraemia, with cost estimated by the annual on-going maintenance costs less the costs saved from fewer infections. Data were harvested from existing sources or were collected prospectively and the time horizon for the model was 12 months, 2011-2012.No useable pre-implementation Staphylococcus aureus bacteraemia data were made available from the 11 study hospitals in Victoria or the single hospital in Northern Territory leaving 38 hospitals among six states and territories available for cost-effectiveness analyses. Total annual costs increased by $2,851,475 for a return of 96 years of life giving an incremental cost-effectiveness ratio (ICER of $29,700 per life year gained. Probabilistic sensitivity analysis revealed a 100% chance the initiative was cost effective in the Australian Capital Territory and Queensland, with ICERs of $1,030 and $8,988 respectively. There was an 81% chance it was cost effective in New South Wales with an ICER of $33,353, a 26% chance for South Australia with an ICER of $64,729 and a 1% chance for Tasmania and Western Australia. The 12 hospitals in Victoria and the Northern Territory incur annual on-going maintenance costs of $1.51M; no information was available to describe cost savings or health benefits.The Australian National Hand Hygiene Initiative was cost

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

    International Nuclear Information System (INIS)

    2012-09-01

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

  14. Costs and cost-efficacy analysis of the 2016 GESIDA/Spanish AIDS National Plan recommended guidelines for initial antiretroviral therapy in HIV-infected adults.

    Science.gov (United States)

    Rivero, Antonio; Pérez-Molina, José Antonio; Blasco, Antonio Javier; Arribas, José Ramón; Crespo, Manuel; Domingo, Pere; Estrada, Vicente; Iribarren, José Antonio; Knobel, Hernando; Lázaro, Pablo; López-Aldeguer, José; Lozano, Fernando; Moreno, Santiago; Palacios, Rosario; Pineda, Juan Antonio; Pulido, Federico; Rubio, Rafael; de la Torre, Javier; Tuset, Montserrat; Gatell, Josep M

    2017-02-01

    GESIDA and the AIDS National Plan panel of experts suggest preferred (PR), alternative (AR), and other regimens (OR) for antiretroviral treatment (ART) as initial therapy in HIV-infected patients for the year 2016. The objective of this study is to evaluate the costs and the efficacy of initiating treatment with these regimens. Economic assessment of costs and efficiency (cost/efficacy) based on decision tree analyses. Efficacy was defined as the probability of reporting a viral load <50copies/mL at week 48 in an intention-to-treat analysis. Cost of initiating treatment with an ART regimen was defined as the costs of ART and its consequences (adverse effects, changes of ART regimen, and drug resistance studies) during the first 48 weeks. The payer perspective (National Health System) was applied, only taking into account differential direct costs: ART (official prices), management of adverse effects, studies of resistance, and HLA B*5701 testing. The setting is Spain and the costs correspond to those of 2016. A sensitivity deterministic analysis was conducted, building three scenarios for each regimen: base case, most favourable, and least favourable. In the base case scenario, the cost of initiating treatment ranges from 4663 Euros for 3TC+LPV/r (OR) to 10,894 Euros for TDF/FTC+RAL (PR). The efficacy varies from 0.66 for ABC/3TC+ATV/r (AR) and ABC/3TC+LPV/r (OR), to 0.89 for TDF/FTC+DTG (PR) and TDF/FTC/EVG/COBI (AR). The efficiency, in terms of cost/efficacy, ranges from 5280 to 12,836 Euros per responder at 48 weeks, for 3TC+LPV/r (OR), and RAL+DRV/r (OR), respectively. Despite the overall most efficient regimen being 3TC+LPV/r (OR), among the PR and AR, the most efficient regimen was ABC/3TC/DTG (PR). Among the AR regimes, the most efficient was TDF/FTC/RPV. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  15. Costs and cost-efficacy analysis of the 2017 GESIDA/Spanish National AIDS Plan recommended guidelines for initial antiretroviral therapy in HIV-infected adults.

    Science.gov (United States)

    Rivero, Antonio; Pérez-Molina, José Antonio; Blasco, Antonio Javier; Arribas, José Ramón; Asensi, Víctor; Crespo, Manuel; Domingo, Pere; Iribarren, José Antonio; Lázaro, Pablo; López-Aldeguer, José; Lozano, Fernando; Martínez, Esteban; Moreno, Santiago; Palacios, Rosario; Pineda, Juan Antonio; Pulido, Federico; Rubio, Rafael; Santos, Jesús; de la Torre, Javier; Tuset, Montserrat; Gatell, Josep M

    2018-05-01

    GESIDA and the Spanish National AIDS Plan panel of experts have recommended preferred (PR), alternative (AR) and other regimens (OR) for antiretroviral therapy (ART) as initial therapy in HIV-infected patients for 2017. The objective of this study was to evaluate the costs and the efficiency of initiating treatment with PR and AR. Economic assessment of costs and efficiency (cost-efficacy) based on decision tree analyses. Efficacy was defined as the probability of reporting a viral load <50copies/mL at week 48, in an intention-to-treat analysis. Cost of initiating treatment with an ART regimen was defined as the costs of ART and its consequences (adverse effects, changes of ART regimen and drug resistance studies) during the first 48 weeks. The payer perspective (National Health System) was applied considering only differential direct costs: ART (official prices), management of adverse effects, resistance studies and HLA B*5701 screening. The setting was Spain and the costs correspond to those of 2017. A deterministic sensitivity analysis was conducted, building three scenarios for each regimen: base case, most favourable and least favourable. In the base case scenario, the cost of initiating treatment ranged from 6882 euro for TFV/FTC/RPV (AR) to 10,904 euros for TFV/FTC+RAL (PR). The efficacy varied from 0.82 for TFV/FTC+DRV/p (AR) to 0.92 for TAF/FTC/EVG/COBI (PR). The efficiency, in terms of cost-efficacy, ranged from 7923 to 12,765 euros per responder at 48 weeks, for ABC/3TC/DTG (PR) and TFV/FTC+RAL (PR), respectively. Considering ART official prices, the most efficient regimen was ABC/3TC/DTG (PR), followed by TFV/FTC/RPV (AR) and TAF/FTC/EVG/COBI (PR). Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  16. Costs and cost-efficacy analysis of the 2014 GESIDA/Spanish National AIDS Plan recommended guidelines for initial antiretroviral therapy in HIV-infected adults.

    Science.gov (United States)

    Blasco, Antonio Javier; Llibre, Josep M; Berenguer, Juan; González-García, Juan; Knobel, Hernando; Lozano, Fernando; Podzamczer, Daniel; Pulido, Federico; Rivero, Antonio; Tuset, Montserrat; Lázaro, Pablo; Gatell, Josep M

    2015-03-01

    GESIDA and the National AIDS Plan panel of experts suggest preferred (PR) and alternative (AR) regimens of antiretroviral treatment (ART) as initial therapy in HIV-infected patients for 2014. The objective of this study is to evaluate the costs and the efficiency of initiating treatment with these regimens. An economic assessment was made of costs and efficiency (cost/efficacy) based on decision tree analyses. Efficacy was defined as the probability of reporting a viral load <50 copies/mL at week 48, in an intention-to-treat analysis. Cost of initiating treatment with an ART regimen was defined as the costs of ART and its consequences (adverse effects, changes of ART regimen, and drug resistance studies) during the first 48 weeks. The payer perspective (National Health System) was applied by considering only differential direct costs: ART (official prices), management of adverse effects, studies of resistance, and HLA B*5701 testing. The setting is Spain and costs correspond to those of 2014. A sensitivity deterministic analysis was conducted, building three scenarios for each regimen: base case, most favourable and least favourable. In the base case scenario, the cost of initiating treatment ranges from 5133 Euros for ABC/3TC+EFV to 11,949 Euros for TDF/FTC+RAL. The efficacy varies between 0.66 for ABC/3TC+LPV/r and ABC/3TC+ATV/r, and 0.89 for TDF/FTC/EVG/COBI. Efficiency, in terms of cost/efficacy, ranges from 7546 to 13,802 Euros per responder at 48 weeks, for ABC/3TC+EFV and TDF/FTC+RAL respectively. Considering ART official prices, the most efficient regimen was ABC/3TC+EFV (AR), followed by the non-nucleoside containing PR (TDF/FTC/RPV and TDF/FTC/EFV). The sensitivity analysis confirms the robustness of these findings. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  17. Determining the True Cost to Deliver Total Hip and Knee Arthroplasty Over the Full Cycle of Care: Preparing for Bundling and Reference-Based Pricing.

    Science.gov (United States)

    DiGioia, Anthony M; Greenhouse, Pamela K; Giarrusso, Michelle L; Kress, Justina M

    2016-01-01

    The Affordable Care Act accelerates health care providers' need to prepare for new care delivery platforms and payment models such as bundling and reference-based pricing (RBP). Thriving in this environment will be difficult without knowing the true cost of care delivery at the level of the clinical condition over the full cycle of care. We describe a project in which we identified true costs for both total hip and total knee arthroplasty. With the same tool, we identified cost drivers in each segment of care delivery and collected patient experience information. Combining cost and experience information with outcomes data we already collect allows us to drive costs down while protecting outcomes and experiences, and compete successfully in bundling and RBP programs. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Resource utilization and costs during the initial years of lung cancer screening with computed tomography in Canada.

    Science.gov (United States)

    Cressman, Sonya; Lam, Stephen; Tammemagi, Martin C; Evans, William K; Leighl, Natasha B; Regier, Dean A; Bolbocean, Corneliu; Shepherd, Frances A; Tsao, Ming-Sound; Manos, Daria; Liu, Geoffrey; Atkar-Khattra, Sukhinder; Cromwell, Ian; Johnston, Michael R; Mayo, John R; McWilliams, Annette; Couture, Christian; English, John C; Goffin, John; Hwang, David M; Puksa, Serge; Roberts, Heidi; Tremblay, Alain; MacEachern, Paul; Burrowes, Paul; Bhatia, Rick; Finley, Richard J; Goss, Glenwood D; Nicholas, Garth; Seely, Jean M; Sekhon, Harmanjatinder S; Yee, John; Amjadi, Kayvan; Cutz, Jean-Claude; Ionescu, Diana N; Yasufuku, Kazuhiro; Martel, Simon; Soghrati, Kamyar; Sin, Don D; Tan, Wan C; Urbanski, Stefan; Xu, Zhaolin; Peacock, Stuart J

    2014-10-01

    It is estimated that millions of North Americans would qualify for lung cancer screening and that billions of dollars of national health expenditures would be required to support population-based computed tomography lung cancer screening programs. The decision to implement such programs should be informed by data on resource utilization and costs. Resource utilization data were collected prospectively from 2059 participants in the Pan-Canadian Early Detection of Lung Cancer Study using low-dose computed tomography (LDCT). Participants who had 2% or greater lung cancer risk over 3 years using a risk prediction tool were recruited from seven major cities across Canada. A cost analysis was conducted from the Canadian public payer's perspective for resources that were used for the screening and treatment of lung cancer in the initial years of the study. The average per-person cost for screening individuals with LDCT was $453 (95% confidence interval [CI], $400-$505) for the initial 18-months of screening following a baseline scan. The screening costs were highly dependent on the detected lung nodule size, presence of cancer, screening intervention, and the screening center. The mean per-person cost of treating lung cancer with curative surgery was $33,344 (95% CI, $31,553-$34,935) over 2 years. This was lower than the cost of treating advanced-stage lung cancer with chemotherapy, radiotherapy, or supportive care alone, ($47,792; 95% CI, $43,254-$52,200; p = 0.061). In the Pan-Canadian study, the average cost to screen individuals with a high risk for developing lung cancer using LDCT and the average initial cost of curative intent treatment were lower than the average per-person cost of treating advanced stage lung cancer which infrequently results in a cure.

  19. An Analysis of Costs and Cenefits Associated with Initial Contracting Technical Education and Training for Unrestricted Marine Officers

    Science.gov (United States)

    2017-03-01

    Distance learning education can be very valuable for working adults, especially for busy service members. The NPS DLP offers a defense-focused...COSTS AND BENEFITS ASSOCIATED WITH INITIAL CONTRACTING TECHNICAL EDUCATION AND TRAINING FOR UNRESTRICTED MARINE OFFICERS by Lee A. White...WITH INITIAL CONTRACTING TECHNICAL EDUCATION AND TRAINING FOR UNRESTRICTED MARINE OFFICERS 5. FUNDING NUMBERS 6. AUTHOR(S) Lee A. White 7. PERFORMING

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

    International Nuclear Information System (INIS)

    2012-01-01

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

  1. Collecting costs of community prevention programs: communities putting prevention to work initiative.

    Science.gov (United States)

    Khavjou, Olga A; Honeycutt, Amanda A; Hoerger, Thomas J; Trogdon, Justin G; Cash, Amanda J

    2014-08-01

    Community-based programs require substantial investments of resources; however, evaluations of these programs usually lack analyses of program costs. Costs of community-based programs reported in previous literature are limited and have been estimated retrospectively. To describe a prospective cost data collection approach developed for the Communities Putting Prevention to Work (CPPW) program capturing costs for community-based tobacco use and obesity prevention strategies. A web-based cost data collection instrument was developed using an activity-based costing approach. Respondents reported quarterly expenditures on labor; consultants; materials, travel, and services; overhead; partner efforts; and in-kind contributions. Costs were allocated across CPPW objectives and strategies organized around five categories: media, access, point of decision/promotion, price, and social support and services. The instrument was developed in 2010, quarterly data collections took place in 2011-2013, and preliminary analysis was conducted in 2013. Preliminary descriptive statistics are presented for the cost data collected from 51 respondents. More than 50% of program costs were for partner organizations, and over 20% of costs were for labor hours. Tobacco communities devoted the majority of their efforts to media strategies. Obesity communities spent more than half of their resources on access strategies. Collecting accurate cost information on health promotion and disease prevention programs presents many challenges. The approach presented in this paper is one of the first efforts successfully collecting these types of data and can be replicated for collecting costs from other programs. Copyright © 2014 American Journal of Preventive Medicine. All rights reserved.

  2. Cost-effectiveness of preventing dental caries and full mouth dental reconstructions among Alaska Native children in the Yukon–Kuskokwim delta region of Alaska

    Science.gov (United States)

    Atkins, Charisma Y.; Thomas, Timothy K.; Lenaker, Dane; Day, Gretchen M.; Hennessy, Thomas W.; Meltzer, Martin I.

    2016-01-01

    Objective We conducted a cost-effectiveness analysis of five specific dental interventions to help guide resource allocation. Methods We developed a spreadsheet-based tool, from the healthcare payer perspective, to evaluate the cost effectiveness of specific dental interventions that are currently used among Alaska Native children (6-60 months). Interventions included: water fluoridation, dental sealants, fluoride varnish, tooth brushing with fluoride toothpaste, and conducting initial dental exams on children caries treatments completed by a dental provider in the dental chair, while 161 children received FMDRs completed by a dental surgeon in an operating room. The average cost of treating dental caries in the dental chair was $1,467 (~258,000 per year); while the cost of treating FMDRs was $9,349 (~1.5 million per year). All interventions were shown to prevent caries and FMDRs; however tooth brushing prevented the greatest number of caries at minimum and maximum effectiveness with 1,433 and 1,910, respectively. Tooth brushing also prevented the greatest number of FMDRs (159 and 211) at minimum and maximum effectiveness. Conclusions All of the dental interventions evaluated were shown to produce cost savings. However, the level of that cost saving is dependent on the intervention chosen. PMID:26990678

  3. A nested case-control study of influenza vaccination was a cost-effective alternative to a full cohort analysis

    NARCIS (Netherlands)

    Hak, E; Wei, F; Grobbee, D E; Nichol, K L

    OBJECTIVE: In the absence of trial results that are applicable to the target population, nested case-control studies might be an alternative to full-cohort analysis. We compared relative and absolute estimates of associations in an influenza vaccine study using both designs. STUDY DESIGN AND

  4. Crude costs: a framework for a full-cost accounting analysis of oil and gas exploration off Cape Breton, Nova Scotia

    International Nuclear Information System (INIS)

    Landon, L.; Pannozzo, L.

    2001-12-01

    Defined as the total quantity of all goods and services produced and the total money earned and spent, the Gross Domestic Product (GDP) is a measure used to determine how well an economy is doing. For its part, the Genuine Progress Index (GPI) measures 26 variables and was first developed in 1995. In Nova Scotia, a set of 20 social, economic and environmental indicators are examined to obtain a better picture of the well-being of the region and determine if the development is sustainable over time. The authors explained their approach based on the use of GPI analysis to assist decision makers in identifying the real costs and benefits of different options applied to the oil and gas exploration situation off Cape Breton, Nova Scotia. The document is divided into five parts as follows: (1) Part 1: introduction, (2) Part 2: natural capital and the impacts of oil and gas development, (3) Part 3: social capital and the economic value of fishing and tourism, (4) Part 4: the real cost of oil and gas, and (5) Part 5: recommendations. Some of the recommendations call for the further study of cumulative and sub-lethal effects from petroleum development, the establishment of Marine Protected Areas preceded by a moratorium on oil and gas exploration in the Southern Gulf of St. Lawrence and Sydney Bight areas until the establishment of the Areas is made, and that future environmental assessments concerning oil and gas development to address the impacts on species and ecosystems as a whole. 209 refs., 11 tabs., 4 figs

  5. Cost-effectiveness of internal limiting membrane peeling versus no peeling for patients with an idiopathic full-thickness macular hole: results from a randomised controlled trial.

    Science.gov (United States)

    Ternent, Laura; Vale, Luke; Boachie, Charles; Burr, Jennifer M; Lois, Noemi

    2012-03-01

    To determine whether internal limiting membrane (ILM) peeling is cost-effective compared with no peeling for patients with an idiopathic stage 2 or 3 full-thickness macular hole. A cost-effectiveness analysis was performed alongside a randomised controlled trial. 141 participants were randomly allocated to receive macular-hole surgery, with either ILM peeling or no peeling. Health-service resource use, costs and quality of life were calculated for each participant. The incremental cost per quality-adjusted life year (QALY) gained was calculated at 6 months. At 6 months, the total costs were on average higher (£424, 95% CI -182 to 1045) in the No Peel arm, primarily owing to the higher reoperation rate in the No Peel arm. The mean additional QALYs from ILM peel at 6 months were 0.002 (95% CI 0.01 to 0.013), adjusting for baseline EQ-5D and other minimisation factors. A mean incremental cost per QALY was not computed, as Peeling was on average less costly and slightly more effective. A stochastic analysis suggested that there was more than a 90% probability that Peeling would be cost-effective at a willingness-to-pay threshold of £20,000 per QALY. Although there is no evidence of a statistically significant difference in either costs or QALYs between macular hole surgery with or without ILM peeling, the balance of probabilities is that ILM Peeling is likely to be a cost-effective option for the treatment of macular holes. Further long-term follow-up data are needed to confirm these findings.

  6. Grid-connected polymer solar panels: initial considerations of cost, lifetime, and practicality.

    Science.gov (United States)

    Medford, Andrew J; Lilliedal, Mathilde R; Jørgensen, Mikkel; Aarø, Dennis; Pakalski, Heinz; Fyenbo, Jan; Krebs, Frederik C

    2010-09-13

    Large solar panels were constructed from polymer solar cell modules prepared using full roll-to-roll (R2R) manufacture based on the previously published ProcessOne. The individual flexible polymer solar modules comprising multiple serially connected single cell stripes were joined electrically and laminated between a 4 mm tempered glass window and black Tetlar foil using two sheets of 0.5 mm thick ethylene vinyl acetate (EVA). The panels produced up to 8 W with solar irradiance of ~960 Wm⁻², and had outer dimensions of 1 m x 1.7 m with active areas up to 9180 cm². Panels were mounted on a tracking station and their output was grid connected between testing. Several generations of polymer solar cells and panel constructions were tested in this context to optimize the production of polymer solar panels. Cells lacking a R2R barrier layer were found to degrade due to diffusion of oxygen after less than a month, while R2R encapsulated cells showed around 50% degradation after 6 months but suffered from poor performance due to de-lamination during panel production. A third generation of panels with various barrier layers was produced to optimize the choice of barrier foil and it was found that the inclusion of a thin protective foil between the cell and the barrier foil is critical. The findings provide a preliminary foundation for the production and optimization of large-area polymer solar panels and also enabled a cost analysis of solar panels based on polymer solar cells.

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

    Directory of Open Access Journals (Sweden)

    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.

  8. Revision Arthroscopic Repair Versus Latarjet Procedure in Patients With Recurrent Instability After Initial Repair Attempt: A Cost-Effectiveness Model.

    Science.gov (United States)

    Makhni, Eric C; Lamba, Nayan; Swart, Eric; Steinhaus, Michael E; Ahmad, Christopher S; Romeo, Anthony A; Verma, Nikhil N

    2016-09-01

    To compare the cost-effectiveness of arthroscopic revision instability repair and Latarjet procedure in treating patients with recurrent instability after initial arthroscopic instability repair. An expected-value decision analysis of revision arthroscopic instability repair compared with Latarjet procedure for recurrent instability followed by failed repair attempt was modeled. Inputs regarding procedure cost, clinical outcomes, and health utilities were derived from the literature. Compared with revision arthroscopic repair, Latarjet was less expensive ($13,672 v $15,287) with improved clinical outcomes (43.78 v 36.76 quality-adjusted life-years). Both arthroscopic repair and Latarjet were cost-effective compared with nonoperative treatment (incremental cost-effectiveness ratios of 3,082 and 1,141, respectively). Results from sensitivity analyses indicate that under scenarios of high rates of stability postoperatively, along with improved clinical outcome scores, revision arthroscopic repair becomes increasingly cost-effective. Latarjet procedure for failed instability repair is a cost-effective treatment option, with lower costs and improved clinical outcomes compared with revision arthroscopic instability repair. However, surgeons must still incorporate clinical judgment into treatment algorithm formation. Level IV, expected value decision analysis. Copyright © 2016. Published by Elsevier Inc.

  9. Full cost accounting as a tool for the financial assessment of Pay-As-You-Throw schemes: a case study for the Panorama municipality, Greece.

    Science.gov (United States)

    Karagiannidis, Avraam; Xirogiannopoulou, Anna; Tchobanoglous, George

    2008-12-01

    In the present paper, implementation scenarios of a Pay-As-You-Throw program were developed and analyzed for the first time in Greece. Firstly, the necessary steps for implementing a Pay-As-You-Throw program were determined. A database was developed for the needs of the full cost accounting method, where all financial and waste-production data were inserted, in order to calculate the unit price of charging for four different implementation scenarios of the "polluter-pays" principle. For each scenario, the input in waste management cost was estimated, as well as the total waste charges for households. Finally, a comparative analysis of the results was performed.

  10. Cost-Effectiveness Model for Chemoimmunotherapy Options in Patients with Previously Untreated Chronic Lymphocytic Leukemia Unsuitable for Full-Dose Fludarabine-Based Therapy.

    Science.gov (United States)

    Becker, Ursula; Briggs, Andrew H; Moreno, Santiago G; Ray, Joshua A; Ngo, Phuong; Samanta, Kunal

    2016-06-01

    To evaluate the cost-effectiveness of treatment with anti-CD20 monoclonal antibody obinutuzumab plus chlorambucil (GClb) in untreated patients with chronic lymphocytic leukemia unsuitable for full-dose fludarabine-based therapy. A Markov model was used to assess the cost-effectiveness of GClb versus other chemoimmunotherapy options. The model comprised three mutually exclusive health states: "progression-free survival (with/without therapy)", "progression (refractory/relapsed lines)", and "death". Each state was assigned a health utility value representing patients' quality of life and a specific cost value. Comparisons between GClb and rituximab plus chlorambucil or only chlorambucil were performed using patient-level clinical trial data; other comparisons were performed via a network meta-analysis using information gathered in a systematic literature review. To support the model, a utility elicitation study was conducted from the perspective of the UK National Health Service. There was good agreement between the model-predicted progression-free and overall survival and that from the CLL11 trial. On incorporating data from the indirect treatment comparisons, it was found that GClb was cost-effective with a range of incremental cost-effectiveness ratios below a threshold of £30,000 per quality-adjusted life-year gained, and remained so during deterministic and probabilistic sensitivity analyses under various scenarios. GClb was estimated to increase both quality-adjusted life expectancy and treatment costs compared with several commonly used therapies, with incremental cost-effectiveness ratios below commonly referenced UK thresholds. This article offers a real example of how to combine direct and indirect evidence in a cost-effectiveness analysis of oncology drugs. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  11. Cost benefit analysis of outsourcing initiatives/strategy at water utilities corporation (Botswana) / G Mogomotsi

    OpenAIRE

    Mogomotsi, G

    2016-01-01

    After the Water Utilities Corporation adopted outsourcing as a policy initiative and operational directive various non-core functions were outsourced. This raises obvious questions as to why the Corporation suddenly decided to do this. Does the Corporation indeed benefit in terms of value addition from outsourced functions? Some of the pertinent questions include: To what extent did policy guidelines and operational measures govern the said outsourcing initiatives? What are the...

  12. Investing in cow-welfare – a cost-effective initiative?

    DEFF Research Database (Denmark)

    Kudahl, Anne Braad; Kirchner, Marlene; Denwood, Matt

    2017-01-01

    The aim of the project was to identify the most cost-effective investments in improving welfare for Danish dairy herds by identifying the most serious welfare problems and their causes, suggesting solutions and calculating the economic consequences of investing in the solutions.......The aim of the project was to identify the most cost-effective investments in improving welfare for Danish dairy herds by identifying the most serious welfare problems and their causes, suggesting solutions and calculating the economic consequences of investing in the solutions....

  13. Open vs Laparoscopic Simple Prostatectomy: A Comparison of Initial Outcomes and Cost.

    Science.gov (United States)

    Demir, Aslan; Günseren, Kadir Ömür; Kordan, Yakup; Yavaşçaoğlu, İsmet; Vuruşkan, Berna Aytaç; Vuruşkan, Hakan

    2016-08-01

    We compared the cost-effectiveness of laparoscopic simple prostatectomy (LSP) vs open prostatectomy (OP). A total of 73 men treated for benign prostatic hyperplasia were enrolled for OP and LSP in groups 1 and 2, respectively. The findings were recorded perioperative, including operation time (OT), blood lost, transfusion rate, conversion to the open surgery, and the complications according to the Clavien Classification. The postoperative findings, including catheterization and drainage time, the amount of analgesic used, hospitalization time, postoperative complications, international prostate symptom score (IPSS) and International Index of Erectile Function (IIEF) scores, the extracted prostate weight, the uroflowmeter, as well as postvoiding residual (PVR) and quality of life (QoL) score at the postoperative third month, were analyzed. The cost of both techniques was also compared statistically. No statistical differences were found in the preoperative parameters, including age, IPSS and QoL score, maximum flow rate (Qmax), PVR, IIEF score, and prostate volumes, as measured by transabdominal ultrasonography. No statistical differences were established in terms of the OT and the weight of the extracted prostate. No differences were established with regard to complications according to Clavien's classification in groups. However, the bleeding rate was significantly lower in group 2. The drainage, catheterization, and hospitalization times and the amount of analgesics were significantly lower in the second group. The postoperative third month findings were not different statistically. Only the Qmax values were significantly greater in group 2. While there was only a $52 difference between groups with regard to operation cost, this difference was significantly different. The use of LSP for the prostates over 80 g is more effective than the OP in terms of OT, bleeding amount, transfusion rates, catheterization time, drain removal time, hospitalization time

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

    Directory of Open Access Journals (Sweden)

    Anastasia Papadopoulou

    2012-01-01

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

  15. Clinical and cost-effectiveness of internal limiting membrane peeling for patients with idiopathic full thickness macular hole. Protocol for a Randomised Controlled Trial: FILMS (Full-thickness macular hole and Internal Limiting Membrane peeling Study

    Directory of Open Access Journals (Sweden)

    Cook Jonathan

    2008-11-01

    Full Text Available Abstract Background A full-thickness macular hole (FTMH is a common retinal condition associated with impaired vision. Randomised controlled trials (RCTs have demonstrated that surgery, by means of pars plana vitrectomy and post-operative intraocular tamponade with gas, is effective for stage 2, 3 and 4 FTMH. Internal limiting membrane (ILM peeling has been introduced as an additional surgical manoeuvre to increase the success of the surgery; i.e. increase rates of hole closure and visual improvement. However, little robust evidence exists supporting the superiority of ILM peeling compared with no-peeling techniques. The purpose of FILMS (Full-thickness macular hole and Internal Limiting Membrane peeling Study is to determine whether ILM peeling improves the visual function, the anatomical closure of FTMH, and the quality of life of patients affected by this disorder, and the cost-effectiveness of the surgery. Methods/Design Patients with stage 2–3 idiopathic FTMH of less or equal than 18 months duration (based on symptoms reported by the participant and with a visual acuity ≤ 20/40 in the study eye will be enrolled in this FILMS from eight sites across the UK and Ireland. Participants will be randomised to receive combined cataract surgery (phacoemulsification and intraocular lens implantation and pars plana vitrectomy with postoperative intraocular tamponade with gas, with or without ILM peeling. The primary outcome is distance visual acuity at 6 months. Secondary outcomes include distance visual acuity at 3 and 24 months, near visual acuity at 3, 6, and 24 months, contrast sensitivity at 6 months, reading speed at 6 months, anatomical closure of the macular hole at each time point (1, 3, 6, and 24 months, health related quality of life (HRQOL at six months, costs to the health service and the participant, incremental costs per quality adjusted life year (QALY and adverse events. Discussion FILMS will provide high quality evidence on the

  16. Chronic care model and cost reduction in initial health: a new approach for satisfaction and improvement of chronicity

    Directory of Open Access Journals (Sweden)

    Stefano Marcelli

    2017-10-01

    Full Text Available Nowadays, the number of elderly is growing, with consequent increase of chronic diseases. An effective approach to reduce the costs incurred is required. The Chronic Care Model has proven to be a good starting point for a better management of economic and human resources.

  17. The cost-effectiveness and budget impact of stepwise addition of bolus insulin in the treatment of type 2 diabetes: evaluation of the FullSTEP trial.

    Science.gov (United States)

    Saunders, Rhodri; Lian, Jean; Karolicki, Boris; Valentine, William

    2014-12-01

    Abstract Background and aims: Intensification of basal insulin-only therapy in type 2 diabetes is often achieved through addition of bolus insulin 3-times daily. The FullSTEP trial demonstrated that stepwise addition (SWA) of bolus insulin aspart was non-inferior to full basal-bolus (FBB) therapy and reduced the rate of hypoglycemia. Here the cost-effectiveness and budget impact of SWA is evaluated. Cost-effectiveness and budget impact models were developed to assess the cost and quality-of-life (QoL) implications of intensification using SWA compared with FBB in the US setting. At assessment, SWA patients added one bolus dose to their current regimen if the HbA1c target was not met. SWA patients reaching three bolus doses used FBB event rates. Outcomes were evaluated at trial end and projected annually up to 5 years. Models captured hypoglycemic events, the proportion meeting HbA1c target, and self-measured blood glucose. Event rates and QoL utilities were taken from trial data and published literature. Costs were evaluated from a healthcare-payer perspective, reported in 2013 USD, and discounted (like clinical outcomes) at 3.5% annually. This analysis applies to patients with HbA1c 7.0-9.0% and body mass index Budget impact analysis estimated that, by moving from FBB to SWA, a health plan with 77,000 patients with type 2 diabetes, of whom 7.8% annually intensified to basal-bolus therapy, would save USD 1304 per intensifying patient over the trial period. SWA of bolus insulin should be considered a beneficial and cost-saving alternative to FBB therapy for the intensification of treatment in type 2 diabetes.

  18. Economic Order Quantity (EOQ) Optimal Control Considering Selling Price and Salesman Initiative Cost

    Science.gov (United States)

    Hertini, Elis; Anggriani, Nursanti; Mianna, Winda; Supriatna, Asep K.

    2018-03-01

    Retailers usually offer several types of similar products. A larger number of available stock products in display space will lead consumer to buy more, as well as giving a negative impression on other types of less available products. However, the amount of display space is limited so capacity of carrying the products is limited. Competition among products to increase demand rate is influenced by stock levels available in display space, price and salesmen’s initiative in promoting the products. The Economic Order Quantity (EOQ) to replenish the stock of the product is dependent on the on-hand inventory. Salesman’s initiative also affects maximum profit obtained by the seller. In this paper, Potryagin’s Maximal Principle is used to determine the state of the inventory levels response to control prices of products. Sensitivity analysis of capacity allocation display space is also presented numerically.

  19. New U.S. financial initiatives: covering the cost of managing radioactive waste

    International Nuclear Information System (INIS)

    Rosselli, R.M.

    1983-01-01

    This paper focuses on new financial initiatives in the US embodied in the Nuclear Waste Policy Act of 1982, namely the setting up of the Nuclear Waste Fund and the Interim Storage Fund. It describes the major goal of the Act and hence, the use to which the funds will be put: the construction of a nuclear waste repository, to be operational by 1st January 1998. (NEA) [fr

  20. Use of Bone Scan During Initial Prostate Cancer Workup, Downstream Procedures, and Associated Medicare Costs

    Energy Technology Data Exchange (ETDEWEB)

    Falchook, Aaron D. [Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Salloum, Ramzi G. [Department of Health Services Policy and Management, University of South Carolina, Columbia, South Carolina (United States); Hendrix, Laura H. [Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Chen, Ronald C., E-mail: ronald_chen@med.unc.edu [Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States)

    2014-06-01

    Purpose: For patients with a high likelihood of having metastatic disease (high-risk prostate cancer), bone scan is the standard, guideline-recommended test to look for bony metastasis. We quantified the use of bone scans and downstream procedures, along with associated costs, in patients with high-risk prostate cancer, and their use in low- and intermediate-risk patients for whom these tests are not recommended. Methods and Materials: Patients in the Surveillance, Epidemiology, and End Results (SEER)-Medicare database diagnosed with prostate cancer from 2004 to 2007 were included. Prostate specific antigen (PSA), Gleason score, and clinical T stage were used to define D'Amico risk categories. We report use of bone scans from the date of diagnosis to the earlier of treatment or 6 months. In patients who underwent bone scans, we report use of bone-specific x-ray, computed tomography (CT), and magnetic resonance imaging (MRI) scans, and bone biopsy within 3 months after bone scan. Costs were estimated using 2012 Medicare reimbursement rates. Results: In all, 31% and 48% of patients with apparent low- and intermediate-risk prostate cancer underwent a bone scan; of these patients, 21% underwent subsequent x-rays, 7% CT, and 3% MRI scans. Bone biopsies were uncommon. Overall, <1% of low- and intermediate-risk patients were found to have metastatic disease. The annual estimated Medicare cost for bone scans and downstream procedures was $11,300,000 for low- and intermediate-risk patients. For patients with apparent high-risk disease, only 62% received a bone scan, of whom 14% were found to have metastasis. Conclusions: There is overuse of bone scans in patients with low- and intermediate-risk prostate cancers, which is unlikely to yield clinically actionable information and results in a potential Medicare waste. However, there is underuse of bone scans in high-risk patients for whom metastasis is likely.

  1. Proven Innovations and New Initiatives in Ground System Development: Reducing Costs in the Ground System

    Science.gov (United States)

    Gunn, Jody M.

    2006-01-01

    The state-of-the-practice for engineering and development of Ground Systems has evolved significantly over the past half decade. Missions that challenge ground system developers with significantly reduced budgets in spite of requirements for greater and previously unimagined functionality are now the norm. Making the right trades early in the mission lifecycle is one of the key factors to minimizing ground system costs. The Mission Operations Strategic Leadership Team at the Jet Propulsion Laboratory has spent the last year collecting and working through successes and failures in ground systems for application to future missions.

  2. 2015 South Carolina PV soft cost and workforce development Part I. Initial survey results

    Energy Technology Data Exchange (ETDEWEB)

    Fox, Elise B. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Edwards, Thomas B. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

    2016-05-01

    The South Carolina solar industry has surged over the past two years, largely due to the implementation of Act 236, and continues to grow at a rapid pace. At the beginning of 2014, there was little more than 3MW total spread across the state, but by the end of 2021, that state solar industry will have grown to over 300MW across all sectors. Prior to this study, there has been little publically available information on the solar industry in SC and throughout the Southeastern US. This makes SC a key case study of an emerging market, enabling the development of regional best practices in order to decrease associated costs and increase deployment.

  3. Adjusting patients streaming initiated by a wait time threshold in emergency department for minimizing opportunity cost.

    Science.gov (United States)

    Kim, Byungjoon B J; Delbridge, Theodore R; Kendrick, Dawn B

    2017-07-10

    Purpose Two different systems for streaming patients were considered to improve efficiency measures such as waiting times (WTs) and length of stay (LOS) for a current emergency department (ED). A typical fast track area (FTA) and a fast track with a wait time threshold (FTW) were designed and compared effectiveness measures from the perspective of total opportunity cost of all patients' WTs in the ED. The paper aims to discuss these issues. Design/methodology/approach This retrospective case study used computerized ED patient arrival to discharge time logs (between July 1, 2009 and June 30, 2010) to build computer simulation models for the FTA and fast track with wait time threshold systems. Various wait time thresholds were applied to stream different acuity-level patients. National average wait time for each acuity level was considered as a threshold to stream patients. Findings The fast track with a wait time threshold (FTW) showed a statistically significant shorter total wait time than the current system or a typical FTA system. The patient streaming management would improve the service quality of the ED as well as patients' opportunity costs by reducing the total LOS in the ED. Research limitations/implications The results of this study were based on computer simulation models with some assumptions such as no transfer times between processes, an arrival distribution of patients, and no deviation of flow pattern. Practical implications When the streaming of patient flow can be managed based on the wait time before being seen by a physician, it is possible for patients to see a physician within a tolerable wait time, which would result in less crowded in the ED. Originality/value A new streaming scheme of patients' flow may improve the performance of fast track system.

  4. Comparative cost-effectiveness of a fluticasone-propionate/salmeterol combination versus anticholinergics as initial maintenance therapy for chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    An

    2010-12-01

    Full Text Available Anand A Dalal1, Melissa H Roberts2, Hans V Petersen2, Christopher M Blanchette3, Douglas W Mapel41US Health Outcomes, GlaxoSmithKline, Research Triangle Park, NC; 2Division of Clinical and Outcomes Research, Lovelace Respiratory Research Institute, Albuquerque, NM; 3Kannapolis, North Carolina; 4Lovelace Clinic Foundation, Albuquerque, NM, USAPurpose: Relative costs and utilization-related outcomes of a fluticasone propionate 250 µg + salmeterol 50 µg combination (FSC, tiotropium bromide, and ipratropium as initial maintenance therapy in COPD have not been compared in a commercially-insured population.Methods: This retrospective, observational cohort study used health care claims data from January 2004 to June 2009 from a large administrative database for patients aged ≥40 years with COPD. Time-to-first COPD-related health care event beginning 30 days following therapy initiation with FSC (n = 16,684, ipratropium alone or in fixed dose combination with albuterol (n = 14,449, or tiotropium (n = 12,659 was estimated using Cox proportional hazard models that controlled for differences in patient demographic characteristics, health care utilization, and comorbidities at baseline. Mean adjusted costs and numbers of COPD-related health care encounters and prescription medication fills were compared among patients with 12 months of follow-up (FSC, n = 12,595; ipratropium, n = 10,617; tiotropium, n = 9126.Results: With FSC as the reference, risk for a COPD-related hospitalization and/or emergency department visit was significantly higher for ipratropium (hazard ratio [HR] 1.64, 95% confidence interval [CI] 1.50–1.79 and tiotropium (HR 1.29, CI 1.17–1.41. Mean adjusted 12-month COPD-related total health care costs were lower for FSC ($2068, standard deviation [SD] $1190 than for ipratropium ($2841, SD $1858 and tiotropium ($2408, SD $1511, both P < 0.05. Mean number of COPD-related hospitalizations, emergency department visits, and outpatient

  5. Evaluation of caregiver-friendly workplace policy (CFWPs interventions on the health of full-time caregiver employees (CEs: implementation and cost-benefit analysis

    Directory of Open Access Journals (Sweden)

    Allison M. Williams

    2017-09-01

    Full Text Available Abstract Background Current Canadian evidence illustrating the health benefits and cost-effectiveness of caregiver-friendly workplace policies is needed if Canadian employers are to adopt and integrate caregiver-friendly workplace policies into their employment practices. The goal of this three-year, three study research project is to provide such evidence for the auto manufacturing and educational services sectors. The research questions being addressed are: What are the impacts for employers (economic and workers (health of caregiver-friendly workplace policy intervention(s for full-time caregiver-employees? What are the impacts for employers, workers and society of the caregiver-friendly workplace policy intervention(s in each participating workplace? What contextual factors impact the successful implementation of caregiver-friendly workplace policy intervention(s? Methods Using a pre-post-test comparative case study design, Study A will determine the effectiveness of newly implemented caregiver-friendly workplace policy intervention(s across two workplaces to determine impacts on caregiver-employee health. A quasi-experimental pre-post design will allow the caregiver-friendly workplace policy intervention(s to be tested with respect to potential impacts on health, and specifically on caregiver employee mental, psychosocial, and physical health. Framed within a comparative case study design, Study B will utilize cost-benefit and cost-effectiveness analysis approaches to evaluate the economic impacts of the caregiver-friendly workplace policy intervention(s for each of the two participating workplaces. Framed within a comparative case study design, Study C will undertake an implementation analysis of the caregiver-friendly workplace policy intervention(s in each participating workplace in order to determine: the degree of support for the intervention(s (reflected in the workplace culture; how sex and gender are implicated; co

  6. Design of a low cost miniaturized SFCW GPR with initial results

    Science.gov (United States)

    Duggal, Swati; Sinha, Piyush; Gupta, Manish; Patel, Anand; Vedam, V. V.; Mevada, Pratik; Chavda, Rajesh; Shah, Amita; Putrevu, Deepak

    2016-05-01

    This paper discusses about the design &developmental of Ground Penetrating Radar (GPR), various scientific and commercial applications of GPR along with the testing and results of GPR at Antarctica for Ice thickness measurement. GPR instruments are categorised as per their frequency of operation, which is inversely proportional to the depth of penetration. GPRs are also categorized as per method of operation which is time-domain or frequency-domain. Indian market is presently procuring GPRs from only foreign suppliers. Space Applications Centre (SAC) had taken up GPR as R&D Technological development with a view to benchmark the technology which may be transferred to local industry for mass production of instrument at a relatively cheaper cost (~20 times cheaper). Hence, this instrument presents a viable indigenous alternative. Also, the design and configuration was targeted for terrestrial as well as future interplanetary (Lander/Rover) missions of ISRO to map subsurface features. The developed GPR has a very large bandwidth (100%, i.e. bandwidth of 500MHz with centre-frequency of 500MHz) and high dynamic range along with the advantage of being highly portable (<10kg). The system was configured as a Stepped-Frequency-Continuous-Wave (SFCW) GPR which is a frequency domain GPR with the aim to increase the detection capabilities with respect to current systems. In order to achieve this goal, innovative electronic equipment have been designed and developed. Three prototypes were developed and two of them have been delivered for Indian Scientific Expedition to Antarctica (ISEA) in 2013 and 2014-15, respectively and promising results have been obtained. The results from the same closely compare with that from commercial GPR too.

  7. A Comparative Study on Evaluating the Service Quality Attributes based on Kano Model: A Case of Low-cost Carrier and Full-service Carrier

    Directory of Open Access Journals (Sweden)

    Byun Hyojeong

    2014-01-01

    Full Text Available The emergence and development of low-cost carriers(LCC with competitive price is heating up the competition in the aviation market more, especially between low-cost carriers(LCC and full-service carriers(FSC. Therefore, it became more important than ever to implement service differentiation strategies of each airline for securing customers and competitiveness. In this sense, the purpose of this study is to compare and assess the different expectations of the customers for airline service attributes pursued by FSCs and LCCs. Three main dimensions of airline service quality attributes (physical, human, and system service, were selected and this study clarified the service quality attributes of each airline carrier using Kano Model. Data were collected from Korean passengers who experienced both LCCs and FSCs for international or domestic flights. As results, this study demonstrated several differences in airline service quality attributes between FSCs and LCCs, which imply that each airline needs to adopt differential strategies to be more competitive. In particular, most physical-related attributes for FSCs were a ‘must-be’ dimension while the majority of attributes for LCCs was clarified ‘one-dimensional’ attribute. The current study also presented implications to be helpful in developing the quality of service and establishing marketing strategies for improvement in customer satisfaction.

  8. Grid-connected polymer solar panels: initial considerations of cost, lifetime, and practicality

    DEFF Research Database (Denmark)

    Medford, Andrew James; Lilliedal, Mathilde Raad; Jørgensen, Mikkel

    2010-01-01

    Large solar panels were constructed from polymer solar cell modules prepared using full roll-to-roll (R2R) manufacture based on the previously published ProcessOne. The individual flexible polymer solar modules comprising multiple serially connected single cell stripes were joined electrically...... and laminated between a 4 mm tempered glass window and black Tetlar foil using two sheets of 0.5 mm thick ethylene vinyl acetate (EVA). The panels produced up to 8 W with solar irradiance of ~960 Wm−2, and had outer dimensions of 1 m x 1.7 m with active areas up to 9180 cm2. Panels were mounted on a tracking...... station and their output was grid connected between testing. Several generations of polymer solar cells and panel constructions were tested in this context to optimize the production of polymer solar panels. Cells lacking a R2R barrier layer were found to degrade due to diffusion of oxygen after less than...

  9. Cost-utility analysis of the fixed-dose combination of dolutegravir/abacavir/lamivudine as initial treatment of HIV+ patients in Spain

    Directory of Open Access Journals (Sweden)

    Santiago Moreno Guillen

    2017-09-01

    Full Text Available Objective: Fixed-dose combinations of antiretroviral drugs have meant an important step forward in simplifying treatment and improving compliance and has led to an increased effectiveness of therapy, a viral load decrease and improving the quality of life of patients. The single-table formulation of dolutegravir with abacavir and lamivudine (DTG/ABC/3TC is a highly efficacious and well-tolerated once-daily regimen for HIV-infected patients. The objective of the study was to assess the incremental cost-utility ratio of the fixed-dose combination of (DTG/ABC/3TC versus the combinations emtricitabine/tenofovir/efavirenz (FTC/TDF/EFV, and darunavir/r (DRV/r or raltegravir (RAL with emtricitabine/tenofovir (FTC/TDF or abacavir/lamivudine (ABC/3TC as initial antiretroviral therapy in patients infected with HIV-1 from the perspective of the Spanish National Health System. Method: The ARAMIS model, which uses a microsimulation approach to simulate the individual changes in each patient from the start of treatment to death through a Markov chain of descriptive health states of the disease, was adapted to Spain. The alternatives used for comparison were the fixed-dose combination of emtricitabine/tenofovir/efavirenz (FTC/TDF/EFV, and the fixed- dose combinations of emtricitabine/tenofovir (FTC/TDF or abacavir/lamivudine (ABC/3TC with darunavir/r (DRV/r or raltegravir (RAL. The probability of achieving virological suppression by the treatments included in the model was obtained from clinical trials SINGLE, SPRING-2 and FLAMINGO and the costs were expressed in € (2015. The model use the perspective of the Spanish National Health System, with a lifetime horizon and a discount rate of 3% was applied to cost and effectiveness. Results: Treatment initiation with DTG/ABC/3TC was dominant when it was compared with treatment initiation with all the comparators: vs. FTC/TDF/EFV (-67 210.71€/QALY, vs. DRV/r + FTC/TDF or ABC/3TC (-1 787 341.44€/QALY, and vs

  10. Evaluation of caregiver-friendly workplace policy (CFWPs) interventions on the health of full-time caregiver employees (CEs): implementation and cost-benefit analysis.

    Science.gov (United States)

    Williams, Allison M; Tompa, Emile; Lero, Donna S; Fast, Janet; Yazdani, Amin; Zeytinoglu, Isik U

    2017-09-20

    Current Canadian evidence illustrating the health benefits and cost-effectiveness of caregiver-friendly workplace policies is needed if Canadian employers are to adopt and integrate caregiver-friendly workplace policies into their employment practices. The goal of this three-year, three study research project is to provide such evidence for the auto manufacturing and educational services sectors. The research questions being addressed are: What are the impacts for employers (economic) and workers (health) of caregiver-friendly workplace policy intervention(s) for full-time caregiver-employees? What are the impacts for employers, workers and society of the caregiver-friendly workplace policy intervention(s) in each participating workplace? What contextual factors impact the successful implementation of caregiver-friendly workplace policy intervention(s)? Using a pre-post-test comparative case study design, Study A will determine the effectiveness of newly implemented caregiver-friendly workplace policy intervention(s) across two workplaces to determine impacts on caregiver-employee health. A quasi-experimental pre-post design will allow the caregiver-friendly workplace policy intervention(s) to be tested with respect to potential impacts on health, and specifically on caregiver employee mental, psychosocial, and physical health. Framed within a comparative case study design, Study B will utilize cost-benefit and cost-effectiveness analysis approaches to evaluate the economic impacts of the caregiver-friendly workplace policy intervention(s) for each of the two participating workplaces. Framed within a comparative case study design, Study C will undertake an implementation analysis of the caregiver-friendly workplace policy intervention(s) in each participating workplace in order to determine: the degree of support for the intervention(s) (reflected in the workplace culture); how sex and gender are implicated; co-workers' responses to the chosen intervention(s), and

  11. Women's Initiative for Nonsmoking-VII: evaluation of health service utilization and costs among women smokers with cardiovascular disease.

    Science.gov (United States)

    Froelicher, Erika Sivarajan; Sohn, Min; Max, Wendy; Bacchetti, Peter

    2004-01-01

    The Women's Initiative for Nonsmoking (WINS), a randomized clinical trial of a smoking cessation intervention for women with cardiovascular disease, permitted an assessment of the types and costs of health services women used during the 30 months after their hospitalization with cardiovascular disease. A prospective design nested within WINS was used for this study. A structured telephone interview guide included questions about medical services and 15 categories of prevention services, including cardiac rehabilitation at 6, 12, 24, and 30 months. Costs were estimated from state and national databases. The 277 women studied had a mean age of 60.7 +/- 10 years. They had smoked approximately 40 +/- 11.4 years. More than 50% of the women had one or more risk factors for cardiovascular disease. During the first 6 months after the index hospitalization, 94% had a physician visit, 39% had an emergency-room visit, and 36% had a hospital admission. Prevention services used were home healthcare by nurse or home health aide (26%), a cardiac rehabilitation program, including Multifit and Heart Smart (19%), and physical therapy (14%). Usage decreased over the 30 months. For the women who used any service, the mean total monthly cost per woman was 913 dollars +/- 1204 dollars. This is the first report on health service use by women smokers with cardiovascular disease. Data collection using a telephone interview guide proved feasible for evaluating health service use. The greatest costs resulted from hospital admissions and physician and emergency-room visits. Considering the high prevalence of risk factors in this cohort, secondary prevention services were severely underutilized. By increasing referrals to such services, physicians and nurses might influence women to reduce their risk for subsequent cardiovascular disease.

  12. A model for evaluating the institutional costs and benefits of ICT initiatives in teaching and learning in higher education

    Directory of Open Access Journals (Sweden)

    David Nicol

    2003-12-01

    Full Text Available Significant investments are being made in the application of new information and communications technologies (ICT to teaching and learning in higher education. However, until recently, there has been little progress in devising an integrated costbenefit model that decision-makers can use to appraise ICT investment options from the wider institutional perspective. This paper describes and illustrates a model that has been developed to enable evaluations of the costs and benefits of the use of ICT. The strengths and limitations of the model are highlighted and discussed

  13. Initial public offerings in Brazil (2004-2006: Valuation with the use of multiples and discounting of cash flows using the appropriate cost of equity

    Directory of Open Access Journals (Sweden)

    Luiz Felipe Jacques da Motta

    2008-10-01

    Full Text Available The pricing process of new shares in IPOs has been under study in several countries. This paper initially looks at the valuation process using multiples and seeks to classify the new shares under two categories: underpriced or overpriced at the time of the IPOs. Analysis of the cost of equity, comparing betas at the time of the offerings (usually calculated as the betas of comparable companies and the betas of the companies after 12 months of trading, is also carried out. Companies in the sample are those that went public between 2004 and 2006. Results indicated that companies were not undervalued, even after some high short-term returns. However there is no statistical evidence that they were overvalued. Finally, results indicated that betas after twelve months of trading are significantly higher than the comparable companies’ betas used at the time of the IPOs.

  14. Cost-effective sequencing of full-length cDNA clones powered by a de novo-reference hybrid assembly.

    Science.gov (United States)

    Kuroshu, Reginaldo M; Watanabe, Junichi; Sugano, Sumio; Morishita, Shinichi; Suzuki, Yutaka; Kasahara, Masahiro

    2010-05-07

    Sequencing full-length cDNA clones is important to determine gene structures including alternative splice forms, and provides valuable resources for experimental analyses to reveal the biological functions of coded proteins. However, previous approaches for sequencing cDNA clones were expensive or time-consuming, and therefore, a fast and efficient sequencing approach was demanded. We developed a program, MuSICA 2, that assembles millions of short (36-nucleotide) reads collected from a single flow cell lane of Illumina Genome Analyzer to shotgun-sequence approximately 800 human full-length cDNA clones. MuSICA 2 performs a hybrid assembly in which an external de novo assembler is run first and the result is then improved by reference alignment of shotgun reads. We compared the MuSICA 2 assembly with 200 pooled full-length cDNA clones finished independently by the conventional primer-walking using Sanger sequencers. The exon-intron structure of the coding sequence was correct for more than 95% of the clones with coding sequence annotation when we excluded cDNA clones insufficiently represented in the shotgun library due to PCR failure (42 out of 200 clones excluded), and the nucleotide-level accuracy of coding sequences of those correct clones was over 99.99%. We also applied MuSICA 2 to full-length cDNA clones from Toxoplasma gondii, to confirm that its ability was competent even for non-human species. The entire sequencing and shotgun assembly takes less than 1 week and the consumables cost only approximately US$3 per clone, demonstrating a significant advantage over previous approaches.

  15. Initial laparoscopic basic skills training shortens the learning curve of laparoscopic suturing and is cost-effective.

    Science.gov (United States)

    Stefanidis, Dimitrios; Hope, William W; Korndorffer, James R; Markley, Sarah; Scott, Daniel J

    2010-04-01

    Laparoscopic suturing is an advanced skill that is difficult to acquire. Simulator-based skills curricula have been developed that have been shown to transfer to the operating room. Currently available skills curricula need to be optimized. We hypothesized that mastering basic laparoscopic skills first would shorten the learning curve of a more complex laparoscopic task and reduce resource requirements for the Fundamentals of Laparoscopic Surgery suturing curriculum. Medical students (n = 20) with no previous simulator experience were enrolled in an IRB-approved protocol, pretested on the Fundamentals of Laparoscopic Surgery suturing model, and randomized into 2 groups. Group I (n = 10) trained (unsupervised) until proficiency levels were achieved on 5 basic tasks; Group II (n = 10) received no basic training. Both groups then trained (supervised) on the Fundamentals of Laparoscopic Surgery suturing model until previously reported proficiency levels were achieved. Two weeks later, they were retested to evaluate their retention scores, training parameters, instruction requirements, and cost between groups using t-test. Baseline characteristics and performance were similar for both groups, and 9 of 10 subjects in each group achieved the proficiency levels. The initial performance on the simulator was better for Group I after basic skills training, and their suturing learning curve was shorter compared with Group II. In addition, Group I required less active instruction. Overall time required to finish the curriculum was similar for both groups; but the Group I training strategy cost less, with a savings of $148 per trainee. Teaching novices basic laparoscopic skills before a more complex laparoscopic task produces substantial cost savings. Additional studies are needed to assess the impact of such integrated curricula on ultimate educational benefit. Copyright (c) 2010 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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

  17. Half dose sugammadex combined with neostigmine is non-inferior to full dose sugammadex for reversal of rocuronium-induced deep neuromuscular blockade: a cost-saving strategy.

    Science.gov (United States)

    Aouad, Marie T; Alfahel, Waseem S; Kaddoum, Roland N; Siddik-Sayyid, Sahar M

    2017-04-11

    Sugammadex reverses the effect of rocuronium more rapidly and effectively than neostigmine, at all levels of neuromuscular blockade (NMB). However, its cost is prohibitive. The combination of half dose sugammadex with neostigmine would be non-inferior to full dose sugammadex for the reversal of deep NMB. This approach would reduce the cost of sugammadex while preserving its efficacy. Patients were randomly allocated to receive sugammadex 4 mg/kg (Group S) or sugammadex 2 mg/kg with neostigmine 50 μg/kg and glycopyrrolate 10 μg/kg (Group NS) for reversal of rocuronium deep NMB. The primary outcome was the percentage of patients who recovered to 90% Train of Four (TOF) ratio within 5 min. The non-inferiority margin was set at 10%. Twenty eight patients were enrolled in each group. The number of patients who reached 90% TOF ratio within 5 min was 27 out of 28 (96%) in group S versus 25 out of 28 (89%) in group NS by intention-to-treat (difference: 7%, 95% CI of the difference: -9% to 24%). The number of patients who reached 90% TOF ratio within 5 min was 26 out of 26 (100%) in group S versus 23 out of 25 (92%) in group NS by per-protocol (difference: 8%, 95% CI of the difference: -6% to 25%). Sugammadex 2 mg/kg with neostigmine 50 μg/kg was at worst 9% and 6% less effective than sugammadex 4 mg/kg by intention-to-treat and by per-protocol analysis respectively. Hence, the combination is non-inferior to the recommended dose of sugammadex. Clinicaltrials.gov NCT 02375217 , registered on February 11, 2015.

  18. Study protocol for the Integra Initiative to assess the benefits and costs of integrating sexual and reproductive health and HIV services in Kenya and Swaziland

    Directory of Open Access Journals (Sweden)

    Warren Charlotte E

    2012-11-01

    Full Text Available Abstract Background In sub-Saharan Africa (SSA there are strong arguments for the provision of integrated sexual and reproductive health (SRH and HIV services. Most HIV transmissions are sexually transmitted or associated with pregnancy, childbirth, and breastfeeding. Many of the behaviours that prevent HIV transmission also prevent sexually transmitted infections and unintended pregnancies. There is potential for integration to increase the coverage of HIV services, as individuals who use SRH services can benefit from HIV services and vice-versa, as well as increase cost-savings. However, there is a dearth of empirical evidence on effective models for integrating HIV/SRH services. The need for robust evidence led a consortium of three organizations – International Planned Parenthood Federation, Population Council and the London School of Hygiene & Tropical Medicine – to design/implement the Integra Initiative. Integra seeks to generate rigorous evidence on the feasibility, effectiveness, cost and impact of different models for delivering integrated HIV/SRH services in high and medium HIV prevalence settings in SSA. Methods/design A quasi-experimental study will be conducted in government clinics in Kenya and Swaziland – assigned into intervention/comparison groups. Two models of service delivery are investigated: integrating HIV care/treatment into 1 family planning and 2 postnatal care. A full economic-costing will be used to assess the costs of different components of service provision, and the determinants of variations in unit costs across facilities/service models. Health facility assessments will be conducted at four time-periods to track changes in quality of care and utilization over time. A two-year cohort study of family planning/postnatal clients will assess the effect of integration on individual outcomes, including use of SRH services, HIV status (known/unknown and pregnancy (planned/unintended. Household surveys within some

  19. Comparing cost and process performance of activated sludge (AS) and biological aerated filters (BAF) over ten years of full sale operation.

    Science.gov (United States)

    Hansen, R; Thogersen, T; Rogalla, F

    2007-01-01

    In the early 1990s, the Wastewater Treatment Plant (WWTP) of Frederikshavn, Denmark, was extended to meet new requirements for nutrient removal (8 mg/L TN, 1.5 mg TP/L) as well as to increase its average daily flow to 16,500 m(3)/d (4.5 MGD). As the most economical upgrade of the existing activated sludge (AS) plant, a parallel biological aerated filter (BAF) was selected, and started up in 1995. Running two full scale processes in parallel for over ten years on the same wastewater and treatment objectives enabled a direct comparison in relation to operating performance, costs and experience. Common pretreatment consists of screening, an aerated grit and grease removal and three primary settlers with chemical addition. The effluent is then pumped to the two parallel biological treatment stages, AS with recirculation and an upflow BAF with floating media. The wastewater is a mixture of industrial and domestic wastewater, with a dominant discharge of fish processing effluent which can amount to 50% of the flow. The maximum hydraulic load on the pretreatment section as a whole is 1,530 m(3)/h. Approximately 60% of the sewer system is combined with a total of 32 overflow structures. To avoid the direct discharge of combined sewer overflows into the receiving waters, the total hydraulic wet weather capacity of the plant is increased to 4,330 m(3)/h, or 6 times average flow. During rain, some of the raw sewage can be directed through a stormwater bypass to the BAF, which can be modified in its operation to accommodate various treatment needs: either using simultaneous nitrification/denitrification in all filters with recirculation introducing bottom aeration with full nitrification in some filters for storm treatment and/or post-denitrification in one filter. After treatment, the wastewater is discharged to the Baltic Sea through a 500 m outfall. The BAF backwash sludge, approximately 1,900 m(3) per 24 h in dry weather, is redirected to the AS plant. Primary settler

  20. Full text

    African Journals Online (AJOL)

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    impact of using a robotic dispensing machine in community pharmacies was gathered using a structured questionnaire and analysed in ... dispensing time was also shorter and staff satisfaction increased. ... reference customers who were using a ROWA robotic .... Costs situation Purchase price Stock value Personnel costs.

  1. Change in healthcare utilization and costs following initiation of benzodiazepine therapy for long-term treatment of generalized anxiety disorder: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Berger Ariel

    2012-10-01

    Full Text Available Abstract Background Selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and benzodiazepine anxiolytics are used in the US to treat generalized anxiety disorder (GAD. While benzodiazepines typically provide rapid symptomatic relief, long-term use is not recommended due to risks of dependency, sedation, falls, and accidents. Methods Using a US health insurance database, we identified all persons with GAD (ICD-9-CM diagnosis code 300.02 who began a long-term course of treatment (≥90 days with a benzodiazepine anxiolytic between 1/1/2003 and 12/31/2007, We compared healthcare utilization and costs over the six-month periods preceding and following the date of treatment initiation (“pretreatment” and “post-treatment”, respectively, and focused attention on accident-related encounters (e.g., for treatment of fractures and care received for other reasons possibly related benzodiazepine use (e.g., sedation, dizziness. Results A total of 866 patients met all study entry criteria; 25% of patients began treatment on an add-on basis (i.e., adjunctive to escitalopram, paroxetine, sertraline, or venlafaxine, while 75% of patients did not receive concomitant therapy. Mean total healthcare costs increased by $2334 between the pretreatment and post-treatment periods (from $4637 [SD=$9840] to $6971 [$17,002]; p Conclusions Healthcare costs increase in patients with GAD beginning long-term (≥90 days treatment with a benzodiazepine anxiolytic; a substantial proportion of this increase is attributable to care associated with accidents and other known sequelae of long-term benzodiazepine use.

  2. The Annual Economic Burden of Syphilis: An Estimation of Direct, Productivity, and Intangible Costs for Syphilis in Guangdong Initiative for Comprehensive Control of Syphilis Sites.

    Science.gov (United States)

    Zou, Yaming; Liao, Yu; Liu, Fengying; Chen, Lei; Shen, Hongcheng; Huang, Shujie; Zheng, Heping; Yang, Bin; Hao, Yuantao

    2017-11-01

    Syphilis has continuously posed a great challenge to China. However, very little data existed regarding the cost of syphilis. Taking Guangdong Initiative for Comprehensive Control of Syphilis area as the research site, we aimed to comprehensively measure the annual economic burden of syphilis from a societal perspective. Newly diagnosed and follow-up outpatient cases were investigated by questionnaire. Reported tertiary syphilis cases and medical institutions cost were both collected. The direct economic burden was measured by the bottom-up approach, the productivity cost by the human capital method, and the intangible burden by the contingency valuation method. Three hundred five valid early syphilis cases and 13 valid tertiary syphilis cases were collected in the investigation to estimate the personal average cost. The total economic burden of syphilis was US $729,096.85 in Guangdong Initiative for Comprehensive Control of Syphilis sites in the year of 2014, with medical institutions cost accounting for 73.23% of the total. Household average direct cost of early syphilis was US $23.74. Average hospitalization cost of tertiary syphilis was US $2,749.93. Of the cost to medical institutions, screening and testing comprised the largest proportion (26%), followed by intervention and case management (22%) and operational cost (21%). Household average productivity cost of early syphilis was US $61.19. Household intangible cost of syphilis was US $15,810.54. Syphilis caused a substantial economic burden on patients, their families, and society in Guangdong. Household productivity and intangible costs both shared positive relationships with local economic levels. Strengthening the prevention and effective treatment of early syphilis could greatly help to lower the economic burden of syphilis.

  3. Multilevel Correlates of Non-Adherence in Kidney Transplant Patients Benefitting from Full Cost Coverage for Immunosuppressives: A Cross-Sectional Study.

    Science.gov (United States)

    Marsicano, Elisa Oliveira; Fernandes, Neimar Silva; Colugnati, Fernando Antônio Basile; Fernandes, Natalia Maria Silva; De Geest, Sabina; Sanders-Pinheiro, Helady

    2015-01-01

    Adherence is the result of the interaction of the macro, meso, micro, and patient level factors. The macro level includes full coverage of immunosuppressive medications as is the case in Brazil. We studied the correlates of immunosuppressive non-adherence in post kidney transplant patients in the Brazilian health care system. Using a cross-sectional design, adherence to immunosuppressives was assessed in a sample of 100 kidney transplant patients using a composite non-adherence score consisting of three methods (self-report [i.e., The Basel Adherence Scale for Assessment of Immunossupressives-BAASIS], collateral report, and immunosuppressive blood levels). Multilevel correlations of non-adherence were assessed (macro, meso, micro and patient level). Univariate and multivariate logistic regression was applied to assess the correlates of non-adherence. Our sample consisted primarily of male (65%), Caucasians (72%) with a mean age of 45.0 ± 13.5 years old, who received grafts from a living donor (89%), with a mean time after transplantation of 72.3 ± 44.4 months. Prevalence of non-adherence was 51%. Family income higher than five reference wages (21.6 vs. 4%; OR 6.46 [1.35-30.89], p = 0.009; patient level), and having access to private health insurance (35.3% vs. 18.4%; OR 2.42 [0.96-6.10], p = 0.04; meso level) were associated with non-adherence in univariate analysis. Only the higher family income variable was retained in the multiple logistic regression model (OR 5.0; IC: 1.01-25.14; p = 0.04). Higher family income was the only factor that was associated with immunosuppressive non-adherence. In Brazil, lower income recipients benefit from better access to care and coverage of health care costs after transplantation. This is supposed to result in a better immunosuppressive adherence compared to high-income patients who have experienced these benefits continuously.

  4. Full text

    African Journals Online (AJOL)

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    2009-01-11

    Jan 11, 2009 ... battery, retail for approximately £30GBP although bulk buying ..... care to store them carefully. Electrode costs .... nerve stimulation does not relieve in labour pain: updated ... (Online : Update Software), 2003(3): p. CD003222.

  5. Multilevel Correlates of Non-Adherence in Kidney Transplant Patients Benefitting from Full Cost Coverage for Immunosuppressives: A Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Elisa Oliveira Marsicano

    Full Text Available Adherence is the result of the interaction of the macro, meso, micro, and patient level factors. The macro level includes full coverage of immunosuppressive medications as is the case in Brazil. We studied the correlates of immunosuppressive non-adherence in post kidney transplant patients in the Brazilian health care system.Using a cross-sectional design, adherence to immunosuppressives was assessed in a sample of 100 kidney transplant patients using a composite non-adherence score consisting of three methods (self-report [i.e., The Basel Adherence Scale for Assessment of Immunossupressives-BAASIS], collateral report, and immunosuppressive blood levels. Multilevel correlations of non-adherence were assessed (macro, meso, micro and patient level. Univariate and multivariate logistic regression was applied to assess the correlates of non-adherence.Our sample consisted primarily of male (65%, Caucasians (72% with a mean age of 45.0 ± 13.5 years old, who received grafts from a living donor (89%, with a mean time after transplantation of 72.3 ± 44.4 months. Prevalence of non-adherence was 51%. Family income higher than five reference wages (21.6 vs. 4%; OR 6.46 [1.35-30.89], p = 0.009; patient level, and having access to private health insurance (35.3% vs. 18.4%; OR 2.42 [0.96-6.10], p = 0.04; meso level were associated with non-adherence in univariate analysis. Only the higher family income variable was retained in the multiple logistic regression model (OR 5.0; IC: 1.01-25.14; p = 0.04.Higher family income was the only factor that was associated with immunosuppressive non-adherence. In Brazil, lower income recipients benefit from better access to care and coverage of health care costs after transplantation. This is supposed to result in a better immunosuppressive adherence compared to high-income patients who have experienced these benefits continuously.

  6. Cost Effectiveness Analysis of the "Sea to SWOS" Training Initiative on the Surface Warfare Officer Qualification Process

    National Research Council Canada - National Science Library

    Gavino, Christopher

    2002-01-01

    ... (combat effectiveness) while the quantitative analysis shows additional costs to the Navy Personnel Command and savings in training costs for the Naval Education and Training Command and OPNAV N76, the Surface Warfare Resource Sponsor...

  7. Decreased health care utilization and health care costs in the inpatient and emergency department setting following initiation of ketogenic diet in pediatric patients: The experience in Ontario, Canada.

    Science.gov (United States)

    Whiting, Sharon; Donner, Elizabeth; RamachandranNair, Rajesh; Grabowski, Jennifer; Jetté, Nathalie; Duque, Daniel Rodriguez

    2017-03-01

    To assess the change in inpatient and emergency department utilization and health care costs in children on the ketogenic diet for treatment of epilepsy. Data on children with epilepsy initiated on the ketogenic diet (KD) Jan 1, 2000 and Dec 31, 2010 at Ontario pediatric hospitals were linked to province wide inpatient, emergency department (ED) data at the Institute for Clinical Evaluative Sciences. ED and inpatient visits and costs for this cohort were compared for a maximum of 2 years (730days) prior to diet initiation and for a maximum of 2 years (730days) following diet initiation. KD patient were compared to matched group of children with epilepsy who did not receive the ketogenic diet (no KD). Children on the KD experienced a mean decrease in ED visits of 2.5 visits per person per year [95% CI (1.5-3.4)], and a mean decrease of 0.8 inpatient visits per person per year [95% CI (0.3-1.3)], following diet initiation. They had a mean decrease in ED costs of $630 [95% CI (249-1012)] per person per year and a median decrease in inpatient costs of $1059 [IQR: 7890; pdiet experienced a mean reduction of 2.1 ED visits per child per year [95% CI (1.0-3.2)] and a mean decrease of 0.6 [95% CI (0.1-1.1)] inpatient visits per child per year. Patients on the KD experienced a reduction of $442 [95% CI (34.4-850)] per child per year more in ED costs than the matched group. The ketogenic diet group had greater median decrease in inpatient costs per child per year than the matched group [pketogenic diet, experienced decreased ED and inpatient visits as well as costs following diet initiation in Ontario, Canada. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Evaluation of costs accrued through inadvertent continuation of hospital-initiated proton pump inhibitor therapy for stress ulcer prophylaxis beyond hospital discharge: a retrospective chart review

    Directory of Open Access Journals (Sweden)

    Shin S

    2015-04-01

    Full Text Available Sooyoung Shin Ajou University College of Pharmacy, Yeongtong-gu, Suwon-si, Gyeonggi-do, South Korea Background: Stress ulcers and related upper gastrointestinal bleeding are well-known complications in intensive care unit (ICU patients. Proton pump inhibitor (PPI-based stress ulcer prophylaxis (SUP has been widely prescribed in noncritically ill patients who are at low risk for clinically significant bleeding, which is then injudiciously continued after hospital discharge. This study aimed to evaluate the incidence of inappropriate prescribing of PPI-based preventative therapy in ICU versus non-ICU patients that subsequently continued postdischarge, and to estimate the costs incurred by the unwarranted outpatient continuation of PPI therapy.Methods: A retrospective review of patient data at a major teaching hospital in Korea was performed. During the 4-year study period, adult patients who were newly initiated on PPI-based SUP during hospital admission and subsequently discharged on a PPI without a medical indication for such therapy were captured for data analysis. The incidence rates of inappropriate prescribing of PPIs were compared between ICU and non-ICU patients, and the costs associated with such therapy were also examined.Results: A total of 4,410 patients, more than half of the inpatient-initiated PPI users, were deemed to have been inadvertently prescribed a PPI at discharge in the absence of a medical need for acid suppression. The incidence of inappropriate outpatient continuation of the prophylaxis was higher among ICU patients compared with non-ICU patients (57.7% versus 52.2%, respectively; P=0.001. The total expenditure accrued through the continuation of nonindicated PPI therapy was approximately US$40,175.Conclusion: This study confirmed that excess usage of PPIs for SUP has spread to low-risk, non-ICU patients. The overuse of unwarranted PPI therapy can incur large health care expenditure, as well as clinical complications

  9. Brain tumours at 7T MRI compared to 3T - contrast effect after half and full standard contrast agent dose: initial results

    International Nuclear Information System (INIS)

    Noebauer-Huhmann, Iris-Melanie; Weber, M.; Szomolanyi, P.; Juras, V.; Kronnerwetter, C.; Widhalm, G.; Nemec, S.; Prayer, D.; Ladd, M.E.; Trattnig, S.

    2015-01-01

    To compare the contrast agent effect of a full dose and half the dose of gadobenate dimeglumine in brain tumours at 7 Tesla (7T) MR versus 3 Tesla (3T). Ten patients with primary brain tumours or metastases were examined. Signal intensities were assessed in the lesion and normal brain. Tumour-to-brain contrast and lesion enhancement were calculated. Additionally, two independent readers subjectively graded the image quality and artefacts. The enhanced mean tumour-to-brain contrast and lesion enhancement were significantly higher at 7T than at 3T for both half the dose (91.8 ± 45.8 vs. 43.9 ± 25.3 [p = 0.010], 128.1 ± 53.7 vs. 75.5 ± 32.4 [p = 0.004]) and the full dose (129.2 ± 50.9 vs. 66.6 ± 33.1 [p = 0.002], 165.4 ± 54.2 vs. 102.6 ± 45.4 [p = 0.004]). Differences between dosages at each field strength were also significant. Lesion enhancement was higher with half the dose at 7T than with the full dose at 3T (p =.037), while the tumour-to-brain contrast was not significantly different. Subjectively, contrast enhancement, visibility, and lesion delineation were better at 7T and with the full dose. All parameters were rated as good, at the least. Half the routine contrast agent dose at 7T provided higher lesion enhancement than the full dose at 3T which indicates the possibility of dose reduction at 7T. (orig.)

  10. Brain tumours at 7T MRI compared to 3T - contrast effect after half and full standard contrast agent dose: initial results

    Energy Technology Data Exchange (ETDEWEB)

    Noebauer-Huhmann, Iris-Melanie; Weber, M. [Medical University of Vienna, High Field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Vienna (Austria); Medical University of Vienna, Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-guided Therapy, Vienna (Austria); Szomolanyi, P.; Juras, V. [Medical University of Vienna, High Field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Vienna (Austria); Slovak Academy of Sciences, Department of Imaging Methods, Institute of Measurement Science, Bratislava (Slovakia); Kronnerwetter, C. [Medical University of Vienna, High Field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Vienna (Austria); Widhalm, G. [Medical University of Vienna, Department of Neurosurgery, Vienna (Austria); Nemec, S.; Prayer, D. [Medical University of Vienna, Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-guided Therapy, Vienna (Austria); Ladd, M.E. [University Duisburg-Essen, Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen (Germany); German Cancer Research Center (DKFZ), Division of Medical Physics in Radiology, Heidelberg (Germany); Trattnig, S. [Medical University of Vienna, High Field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Vienna (Austria); Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Austrian Cluster for Tissue Regeneration, Vienna (Austria)

    2015-01-15

    To compare the contrast agent effect of a full dose and half the dose of gadobenate dimeglumine in brain tumours at 7 Tesla (7T) MR versus 3 Tesla (3T). Ten patients with primary brain tumours or metastases were examined. Signal intensities were assessed in the lesion and normal brain. Tumour-to-brain contrast and lesion enhancement were calculated. Additionally, two independent readers subjectively graded the image quality and artefacts. The enhanced mean tumour-to-brain contrast and lesion enhancement were significantly higher at 7T than at 3T for both half the dose (91.8 ± 45.8 vs. 43.9 ± 25.3 [p = 0.010], 128.1 ± 53.7 vs. 75.5 ± 32.4 [p = 0.004]) and the full dose (129.2 ± 50.9 vs. 66.6 ± 33.1 [p = 0.002], 165.4 ± 54.2 vs. 102.6 ± 45.4 [p = 0.004]). Differences between dosages at each field strength were also significant. Lesion enhancement was higher with half the dose at 7T than with the full dose at 3T (p =.037), while the tumour-to-brain contrast was not significantly different. Subjectively, contrast enhancement, visibility, and lesion delineation were better at 7T and with the full dose. All parameters were rated as good, at the least. Half the routine contrast agent dose at 7T provided higher lesion enhancement than the full dose at 3T which indicates the possibility of dose reduction at 7T. (orig.)

  11. Cost-effectiveness of initiating antiretroviral therapy at different points in TB treatment in HIV-TB co-infected ambulatory patients in South Africa

    Science.gov (United States)

    Naidoo, Kogieleum; Grobler, Anneke C; Deghaye, Nicola; Reddy, Tarylee; Gengiah, Santhanalakshmi; Gray, Andrew; Karim, Salim Abdool

    2015-01-01

    Objective Initiation of antiretroviral therapy (ART) during tuberculosis (TB) treatment improves survival in TB-HIV co-infected patients. In patients with CD4+ counts benefit of early ART initiation. The purpose of this study was to assess the costs and cost effectiveness of starting ART at various time points during TB treatment in patients with CD4+ counts ≥50cells/mm3. Methods In the SAPiT trial, 642 HIV-TB co-infected patients were randomized to three arms, either receiving ART within 4 weeks of starting TB treatment (early treatment arm; Arm-1), after the intensive phase of TB treatment (late treatment arm; Arm-2), or after completing TB treatment (sequential arm; Arm-3). Direct healthcare costs were measured from a provider perspective using a micro-costing approach. The incremental cost per death averted was calculated using the trial outcomes. Results For patients with CD4+ count≥50cells/mm3, median monthly variable costs per patient were $116, $113 and $102 in Arms-1, -2 and -3, respectively. There were 12 deaths in 177 patients in Arm-1, 8 deaths in 180 patients in the Arm-2 and 19 deaths in 172 patients in Arm-3. While the costs were lower in Arm-3, it had a substantially higher mortality rate. The incremental cost per death averted associated with moving from Arm-3 to Arm-2 was $4199. There was no difference in mortality between Arm-1 and Arm-2, but Arm-1 was slightly more expensive. Conclusions Initiation of ART after the completion of the intensive phase of TB treatment is cost effective for patients with CD4+ counts≥50cells/mm3. PMID:26167618

  12. Cost-Effectiveness Analysis (CEA) of Intravenous Urography (IVU) and Unenhanced Multidetector Computed Tomography (MDCT) for Initial Investigation of Suspected Acute Ureterolithiasis

    International Nuclear Information System (INIS)

    Eikefjord, E.; Askildsen, J.E.; Roervik, J.

    2008-01-01

    Background: It is important to compare the cost and effectiveness of multidetector computed tomography (MDCT) and intravenous urography (IVU) to determine the most cost-effective alternative for the initial investigation of acute ureterolithiasis. Purpose: To analyze the task-specific variable costs combined with the diagnostic effect of MDCT and IVU for patients with acute flank pain, and to determine which is most cost effective. Material and Methods: 119 patients with acute flank pain suggestive of stone disease (ureterolithiasis) were examined by both MDCT and IVU. Variable costs related to medical equipment, consumption material, equipment control, and personnel were calculated. The diagnostic effect was assessed. Results: The variable costs of MDCT versus IVU were EUR 32 and EUR 117, respectively. This significant difference was mainly due to savings in examination time, higher annual examination frequency, lower material costs, and no use of contrast media. As for diagnostic effect, MDCT proved considerably more accurate in the diagnosis of stone disease than IVU and markedly more accurate concerning differential diagnoses. Conclusion: MDCT had lower differential costs and a higher capacity to determine correctly stone disease and differential diagnoses, as compared to IVU, in patients with acute flank pain. Consequently, MDCT is a dominant alternative to IVU when evaluated exclusively from a cost-effective perspective

  13. A Full Cost Analysis of the Replacement of Naval Base, Guantanamo Bay's Marine Ground Defense Force by the Fleet Antiterrorism Security Team

    National Research Council Canada - National Science Library

    Ordona, Placido

    2000-01-01

    ... of these diminishing resources. One such initiative is the restructuring of the Marine security presence at Naval Station, Guantanamo Bay, Cuba, through the replacement of the 350 man Marine Ground Defense Force with a smaller...

  14. Federal uranium-enrichment program and the criteria and full-cost-recovery requirements of Section 161 of the Atomic Energy Act

    International Nuclear Information System (INIS)

    Montange, C.H.

    1987-01-01

    DOE operates the US uranium enrichment business, which makes it responsible for the reliable supply of nuclear fuel to most US nuclear utilities as well as to many in other countries. Questions have arisen about DOE's compliance with key legal provisions and DOE's future as a reliable and competitive supplier of enrichment services. An overview of the implications of the loss of the US monopoly and the declining market also shows how demand forecasts erred. The author traces the historical development of DOE's monopoly and the shift toward policies encouraging private ownership. The three pricing options available to DOE are to price above cost (i.e., for profit), below (i.e., subsidize), or at cost. Current law requires pricing at cost. The other options will require political and economic policy changes

  15. A full cost analysis of the replacement of Naval Base, Guantanamo Bay's Marine ground defense force by the fleet antiterrorism security team

    OpenAIRE

    Ordona, Placido C.

    2000-01-01

    Constrained defense budgets and manpower resources have motivated the United States Marine Corps and the United States Navy to seek initiatives that maximize the efficient use and allocation of these diminishing resources. One such initiative is the restructuring of the Marine security presence at Naval Station, Guantanamo Bay, Cuba, through the replacement of the 350 man Marine Ground Defense Force with a smaller, rotating unit consisting of two platoons from the Fleet Antiterrorism Security...

  16. Cost-Effectiveness of a National Initiative to Improve Hand Hygiene Compliance Using the Outcome of Healthcare Associated Staphylococcus aureus Bacteraemia

    Science.gov (United States)

    Graves, Nicholas; Page, Katie; Martin, Elizabeth; Brain, David; Hall, Lisa; Campbell, Megan; Fulop, Naomi; Jimmeison, Nerina; White, Katherine; Paterson, David; Barnett, Adrian G.

    2016-01-01

    Background The objective is to estimate the incremental cost-effectiveness of the Australian National Hand Hygiene Inititiave implemented between 2009 and 2012 using healthcare associated Staphylococcus aureus bacteraemia as the outcome. Baseline comparators are the eight existing state and territory hand hygiene programmes. The setting is the Australian public healthcare system and 1,294,656 admissions from the 50 largest Australian hospitals are included. Methods The design is a cost-effectiveness modelling study using a before and after quasi-experimental design. The primary outcome is cost per life year saved from reduced cases of healthcare associated Staphylococcus aureus bacteraemia, with cost estimated by the annual on-going maintenance costs less the costs saved from fewer infections. Data were harvested from existing sources or were collected prospectively and the time horizon for the model was 12 months, 2011–2012. Findings No useable pre-implementation Staphylococcus aureus bacteraemia data were made available from the 11 study hospitals in Victoria or the single hospital in Northern Territory leaving 38 hospitals among six states and territories available for cost-effectiveness analyses. Total annual costs increased by $2,851,475 for a return of 96 years of life giving an incremental cost-effectiveness ratio (ICER) of $29,700 per life year gained. Probabilistic sensitivity analysis revealed a 100% chance the initiative was cost effective in the Australian Capital Territory and Queensland, with ICERs of $1,030 and $8,988 respectively. There was an 81% chance it was cost effective in New South Wales with an ICER of $33,353, a 26% chance for South Australia with an ICER of $64,729 and a 1% chance for Tasmania and Western Australia. The 12 hospitals in Victoria and the Northern Territory incur annual on-going maintenance costs of $1.51M; no information was available to describe cost savings or health benefits. Conclusions The Australian National Hand

  17. Predictors for total hospital and cardiology cost claims among patients with atrial fibrillation initiating dabigatran or acenocoumarol in the Netherlands

    NARCIS (Netherlands)

    Jacobs, M S; van Leent, M W J; Tieleman, R G; Jansman, F G A; Cao, Q; Postma, M J; van Hulst, M

    2017-01-01

    Aims: The prevalence of atrial fibrillation (AF) has increased over the past years due to aging of the population, and healthcare costs associated with AF reflect a significant financial burden. The aim of this study was to explore predictors for the real-world AF-related in-hospital costs in

  18. Applying emerging digital video interface standards to airborne avionics sensor and digital map integrations: benefits outweigh the initial costs

    Science.gov (United States)

    Kuehl, C. Stephen

    1996-06-01

    Video signal system performance can be compromised in a military aircraft cockpit management system (CMS) with the tailoring of vintage Electronics Industries Association (EIA) RS170 and RS343A video interface standards. Video analog interfaces degrade when induced system noise is present. Further signal degradation has been traditionally associated with signal data conversions between avionics sensor outputs and the cockpit display system. If the CMS engineering process is not carefully applied during the avionics video and computing architecture development, extensive and costly redesign will occur when visual sensor technology upgrades are incorporated. Close monitoring and technical involvement in video standards groups provides the knowledge-base necessary for avionic systems engineering organizations to architect adaptable and extendible cockpit management systems. With the Federal Communications Commission (FCC) in the process of adopting the Digital HDTV Grand Alliance System standard proposed by the Advanced Television Systems Committee (ATSC), the entertainment and telecommunications industries are adopting and supporting the emergence of new serial/parallel digital video interfaces and data compression standards that will drastically alter present NTSC-M video processing architectures. The re-engineering of the U.S. Broadcasting system must initially preserve the electronic equipment wiring networks within broadcast facilities to make the transition to HDTV affordable. International committee activities in technical forums like ITU-R (former CCIR), ANSI/SMPTE, IEEE, and ISO/IEC are establishing global consensus on video signal parameterizations that support a smooth transition from existing analog based broadcasting facilities to fully digital computerized systems. An opportunity exists for implementing these new video interface standards over existing video coax/triax cabling in military aircraft cockpit management systems. Reductions in signal

  19. Cost effectiveness analysis of HLA-B*58:01 genotyping prior to initiation of allopurinol for gout.

    Science.gov (United States)

    Plumpton, Catrin O; Alfirevic, Ana; Pirmohamed, Munir; Hughes, Dyfrig A

    2017-10-01

    To determine whether prospective testing for HLA-B*58:01, as a strategy to prevent serious adverse reactions to allopurinol in patients with gout, is cost-effective from the perspective of the National Health Service in the UK. A systematic review and meta-analysis for the association of HLA-B*58:01 with cutaneous and hypersensitivity adverse drug reactions informed a decision analytic and Markov model to estimate lifetime costs and outcomes associated with testing vs standard care (with febuxostat prescribed for patients who test positive). Scenario analyses assessed alternative treatment assumptions and patient populations. The number of patients needed to test to prevent one case of adverse drug reaction was 11 286 (95% central range (CR): 2573, 53 594). Cost and quality-adjusted life-year (QALY) gains were small, £103 (95% CR: £98, £106) and 0.0023 (95% CR: -0.0006, 0.0055), respectively, resulting in an incremental cost-effectiveness ratio (ICER) of £44 954 per QALY gained. The probability of testing being cost-effective at a threshold of £30 000 per QALY was 0.25. Reduced costs of testing or febuxostat resulted in an ICER below £30 000 per QALY gained. The ICER for patients with chronic renal insufficiency was £38 478 per QALY gained. Routine testing for HLA-B*58:01 in order to reduce the incidence of adverse drug reactions in patients being prescribed allopurinol for gout is unlikely to be cost-effective in the UK; however testing is expected to become cost-effective with reductions in the cost of genotyping, and with the future availability of cheaper, generic febuxostat. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  20. Evaluation of caregiver-friendly workplace policy (CFWPs) interventions on the health of full-time caregiver employees (CEs): implementation and cost-benefit analysis

    OpenAIRE

    Williams, Allison M.; Tompa, Emile; Lero, Donna S.; Fast, Janet; Yazdani, Amin; Zeytinoglu, Isik U.

    2017-01-01

    Background Current Canadian evidence illustrating the health benefits and cost-effectiveness of caregiver-friendly workplace policies is needed if Canadian employers are to adopt and integrate caregiver-friendly workplace policies into their employment practices. The goal of this three-year, three study research project is to provide such evidence for the auto manufacturing and educational services sectors. The research questions being addressed are: What are the impacts for employers (econom...

  1. Comparison of hospitalizations, emergency department visits, and costs in a historical cohort of Texas Medicaid patients with chronic obstructive pulmonary disease, by initial medication regimen.

    Science.gov (United States)

    Rascati, Karen L; Akazawa, Manabu; Johnsrud, Michael; Stanford, Richard H; Blanchette, Christopher M

    2007-06-01

    Limited information is available on the relative outcomes and treatment costs of various pharmacotherapies for chronic obstructive pulmonary disease (COPD) in a Medicaid population. This study compared the effects of initial medication regimens for COPD on COPD-related and all-cause events (hospitalizations and/or emergency department [ED] visits) and COPD-related and all-cause costs. The study population was a historical cohort of Texas Medicaid beneficiaries aged 40 to 64 years with COPD-related medical costs (International Classification of Diseases, Ninth Revision, Clinical Modification codes 491.xx, 492.xx, 496.xx), 24 months of continuous Medicaid enrollment (12 months before and after the index prescription), and at least 1 prescription claim (index) for a combination product containing fluticasone propionate + salmeterol, an inhaled corticosteroid, salmeterol, or ipratropium between April 1, 2001, and March 31, 2003. The analyses of events employed Cox proportional hazards regression, controlling for baseline factors and preindex events. The analyses of costs used a 2-part model with logistic regression and generalized linear model to adjust for baseline characteristics and preindex utilization and costs. The study population included 6793 patients (1211 combination therapy, 968 inhaled corticosteroid, 401 salmeterol, and 4213 ipratropium). Only combination therapy was associated with a significantly lower risk for any COPD-related event (hazard ratio [HR] = 0.733; 95% CI, 0.650-0.826) and any all-cause event (HR = 0.906; 95% CI, 0.844-0.972) compared with ipratropium. COPD-related prescription costs were higher in all cohorts compared with the ipratropium cohort, but COPD-related medical costs were lower, offsetting the increase in prescription costs. For all-cause costs, prescription costs were higher in the combination-therapy cohort (+$415; P costs in the combination-therapy cohort (-$1735; P costs. In this historical population of Texas Medicaid

  2. Cost-effectiveness of retreatment with varenicline after failure with or relapse after initial treatment for smoking cessation

    Directory of Open Access Journals (Sweden)

    Lieven Annemans

    2015-01-01

    Conclusion: This analysis suggests that in the long term, varenicline retreatment is a dominant intervention, meaning both greater health gains and greater costs saved, over other possible interventions and therefore should be considered as a standard option.

  3. Atmospheric Nitrogen Deposition Loadings to the Chesapeake Bay: An Initial Analysis of the Cost Effectiveness of Control Options (1996)

    Science.gov (United States)

    This report examines the cost effectiveness of control options which reduce nitrate deposition to the Chesapeake watershed and to the tidal Bay. The report analyzes current estimates of the reductions expected in the ozone transport region.

  4. 76 FR 9329 - Efficiency Initiative Effort To Reduce Non-Value-Added Costs Imposed on Industry by Department of...

    Science.gov (United States)

    2011-02-17

    ... Department of Defense as part of the first stage of Undersecretary Carter's Better Buying Power Initiative... capacity for current and projected future levels of demand. DoD will use these submissions as part of its internal deliberations on the Better Buying Power Initiative. We expect to seek further industry comment at...

  5. Costs and role of ultrasound follow-up of polytrauma patients after initial computed tomography; Kosten und Stellenwert von Ultraschallverlaufskontrollen bei polytraumatisierten Patienten nach initialer Computertomografie

    Energy Technology Data Exchange (ETDEWEB)

    Maurer, M.H.; Winkler, A.; Powerski, M.J.; Elgeti, F.; Huppertz, A.; Roettgen, R.; Marnitz, T. [Charite - Universitaetsmedizin Berlin (Germany). Klinik fuer Diagnostische und Interventionelle Radiologie; Wichlas, F. [Charite - Universitaetsmedizin Berlin (Germany). Centrum fuer Muskuloskeletale Chirurgie

    2012-01-15

    Purpose: To assess the costs and diagnostic gain of abdominal ultrasound follow-up of polytrauma patients initially examined by whole-body computed tomography (CT). Materials and Methods: A total of 176 patients with suspected multiple trauma (126 men, 50 women; age 43.5 {+-} 17.4 years) were retrospectively analyzed with regard to supplementary and new findings obtained by ultrasound follow-up compared with the results of exploratory FAST (focused assessment with sonography for trauma) at admission and the findings of whole-body CT. A process model was used to document the staff, materials, and total costs of the ultrasound follow-up examinations. Results: FAST yielded 26 abdominal findings (organ injury and/or free intra-abdominal fluid) in 19 patients, while the abdominal scan of whole-body CT revealed 32 findings in 25 patients. FAST had 81 % sensitivity and 100 % specificity. Follow-up ultrasound examinations revealed new findings in 2 of the 25 patients with abdominal injuries detected with initial CT. In the 151 patients without abdominal injuries in the initial CT scan, ultrasound follow-up did not yield any supplementary or new findings. The total costs of an ultrasound follow-up examination were EUR 28.93. The total costs of all follow-up ultrasound examinations performed in the study population were EUR 5658.23. Conclusion: Follow-up abdominal ultrasound yields only a low overall diagnostic gain in polytrauma patients in whom initial CT fails to detect any abdominal injuries but incurs high personnel expenses for radiological departments. (orig.)

  6. Costs and resource utilization for diagnosis and treatment during the initial year in a European inflammatory bowel disease inception cohort

    DEFF Research Database (Denmark)

    Burisch, Johan; Vardi, Hillel; Pedersen, Natalia

    2015-01-01

    :: The EpiCom cohort is a prospective population-based inception cohort of unselected inflammatory bowel disease patients from 31 Western and Eastern European centers. Patients were followed every third month from diagnosis, and clinical data regarding treatment and investigations were collected. Costs were...

  7. The Albufera Initiative for Biodiversity: a cost effective model for integrating science and volunteer participation in coastal protected area management

    NARCIS (Netherlands)

    Riddiford, N.J.; Veraart, J.A.; Férriz, I.; Owens, N.W.; Royo, L.; Honey, M.R.

    2014-01-01

    This paper puts forward a multi-disciplinary field project, set up in 1989 at the Parc Natural de s’Albufera in Mallorca, Balearic Islands, Spain, as an example of a cost effective model for integrating science and volunteer participation in a coastal protected area. Outcomes include the provision

  8. Impact of initiation of asenapine on patterns of utilization and cost of healthcare resources associated with the treatment of bipolar I disorder.

    Science.gov (United States)

    Chitnis, Abhishek; Wang, Rosa; Sun, Shawn X; Dixit, Shailja; Tawah, Alie; Boulanger, Luke

    2015-01-01

    To assess the impact of initiation of asenapine on "real-world" levels of utilization and cost of healthcare services for the treatment of bipolar I disorder (BPD) in the US. Using two large US healthcare claims databases that collectively included commercially insured patients aged a BPD diagnosis, plus psychiatric medications and the costs thereof (2012 dollars) were deemed 'BPD-related'. Differences in BPD-related utilization and cost of healthcare services were compared between the pre- and post-index periods. A total of 1403 patients met all selection criteria; the mean age was 42.8 years and 70.6% were women. Relative to pre-index, significant decreases were noted in post-index use of BPD-related healthcare services, most notably admissions (from 24.0% to 12.3% during the post-index period) and emergency department visits (from 4.6% to 2.6%) (both p levels of utilization of BPD-related healthcare services and costs decreased during the 6-month period immediately following initiation of asenapine therapy.

  9. Multilevel Correlates of Non-Adherence in Kidney Transplant Patients Benefitting from Full Cost Coverage for Immunosuppressives: A Cross-Sectional Study

    OpenAIRE

    Marsicano, Elisa Oliveira; Fernandes, Neimar Silva; Colugnati, Fernando Ant?nio Basile; Fernandes, Natalia Maria Silva; De Geest, Sabina; Sanders-Pinheiro, Helady

    2015-01-01

    Background Adherence is the result of the interaction of the macro, meso, micro, and patient level factors. The macro level includes full coverage of immunosuppressive medications as is the case in Brazil. We studied the correlates of immunosuppressive non-adherence in post kidney transplant patients in the Brazilian health care system. Methods Using a cross-sectional design, adherence to immunosuppressives was assessed in a sample of 100 kidney transplant patients using a composite non-adher...

  10. The Reduction of Faculty Reassigned Time as a Community College Cost Containment Initiative: A Case Study of the Maricopa County Community College District.

    Science.gov (United States)

    Petrowsky, Michael C.

    This paper argues that community colleges can contain costs by reducing faculty reassigned time, defined as a conscious or deliberate management action, either discretionary or mandated, that releases full-time faculty from teaching duties in order to perform other tasks. According to the paper, standard financial accounting systems have a…

  11. A cost and economic evaluation of the Leeds personality disorder managed clinical network-A service and commissioning development initiative.

    Science.gov (United States)

    Kane, Eddie; Reeder, Neil; Keane, Kimberley; Prince, Sharon

    2016-08-01

    In the UK, patients with personality disorders presenting complex needs frequently experience an unhelpful pattern of acute treatment followed by community care-with associated high cost implications for services. With UK mental health resources under severe pressure, this leaves commissioners with difficult decisions to make. Yet studies on cost-effectiveness in respect of personality disorder treatment are scarce, particularly for treatments taking place outside of major teaching hospitals in the USA. This paper studies the benefits of an intensive, holistic approach and finds that the Network achieved substantial reductions in health care usage and expenditure in the short to medium term. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  12. Study on the Full-cost Accounting System in Hospital Financial Management%医院财务管理中全成本合算系统的研究

    Institute of Scientific and Technical Information of China (English)

    姜婷

    2013-01-01

    This paper mainly describes the value for using full-cost accounting system in hospital financial management, the following principle of full-cost accounting in the implementation process and the main problems and contradictions of full-cost accounting in the implementation of hospital. The paper makes everyone has a deep understanding for using full-cost accounting system in hospital financial management by investigating these problems.%本文主要是通过对医院财务管理中采用全成本合算系统的价值意义、全成本核算在实施过程中所遵循的原理以及医院在实施全成本核算中所面临的主要的问题和存在的主要矛盾来展开描述,通过对这些问题的探讨使得大家对医院财务管理中采用全成本核算系统有一个更加深入的认识。

  13. Skilled Nursing Facility Partnerships May Decrease 90-Day Costs in a Total Joint Arthroplasty Episode Under the Bundled Payments for Care Improvement Initiative.

    Science.gov (United States)

    Behery, Omar A; Kouk, Shalen; Chen, Kevin K; Mullaly, Kathleen A; Bosco, Joseph A; Slover, James D; Iorio, Richard; Schwarzkopf, Ran

    2018-03-01

    The Bundled Payments for Care Improvement initiative was developed to reduce costs associated with total joint arthroplasty through a single payment for all patient care from index admission through a 90-day post-discharge period, including care at skilled nursing facilities (SNFs). The aim of this study is to investigate whether forming partnerships between hospitals and SNFs could lower the post-discharge costs. We hypothesize that institutionally aligned SNFs have lower post-discharge costs than non-aligned SNFs. A cohort of 615 elective, primary total hip and knee arthroplasty subjects discharged to an SNF under the Bundled Payments for Care Improvement from 2014 to 2016 were included in our analysis. Patients were grouped into one of the 3 categories of SNF alignment: group 1: non-partners; group 2: agreement-based partners; group 3: institution-owned partners. Demographics, comorbidities, length of stay (LOS) at SNF, and associated costs during the 90-day post-operative period were compared between the 3 groups. Mean index hospital LOS was statistically shortest in group 3 (mean 2.7 days vs 3.5 for groups 1 and 2, P = .001). SNF LOS was also shortest in group 3 (mean 11 days vs 19 and 21 days in groups 2 and 1 respectively, P Total SNF costs and total 90-day costs were both significantly lower in group 3 compared with groups 1 and 2 (P total 90-day costs, without increased risk of readmissions, compared with other SNFs. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Treatment Patterns and Associated Health Care Costs Before and After Treatment Initiation Among Pulmonary Arterial Hypertension Patients in the United States.

    Science.gov (United States)

    Burger, Charles D; Ozbay, A Burak; Lazarus, Howard M; Riehle, Ellen; Montejano, Leslie B; Lenhart, Gregory; White, R James

    2018-02-13

    Despite multiple treatment options, the prognosis of pulmonary arterial hypertension (PAH) remains poor. PAH patients experience a high economic burden due to comorbidities, hospitalizations, and medication costs. Although combination therapy has been shown to reduce hospitalizations, the relationship between treatment, health care utilization, and costs remains unclear. To provide a characterization of health care utilization and costs in real-world settings by comparing periods before and after initiating PAH-specific treatment. This retrospective study identified PAH patients in the Truven Health MarketScan Commercial and Medicare Supplemental Databases between 2010 and 2014 who initiated treatment with endothelin receptor antagonists (ERAs), phosphodiesterase-5 inhibitors (PDE-5Is), or soluble guanylate cyclase (sGC) stimulators. The index date was the date of the first PAH pharmacy claim. We included patients with ≥ 2 medical claims with diagnoses for PAH (ICD-9-CM: 416.0, 416.8) or PAH-related conditions and continuous enrollment in medical and pharmacy benefits for the 6 months before and after the index date. Treatment patterns were assessed at the drug class level (ERAs, PDE-5Is, sGC stimulators, and prostacyclins) from outpatient pharmacy claims during the 6-month post-index period. All-cause and PAH-related utilization and costs were measured. McNemar's and paired t-tests were used to compare patients' health care resource utilization and costs in the 6-month pre- and posttreatment periods. A total of 3,908 patients met the selection criteria. The study sample was 63% female with a mean age of 63 ± 15 years. Only 5% of patients began initial combination therapy for PAH, defined as claims for ≥ 2 medication classes within the first 30 days of treatment. Treatment interruption (≥ 30-day gap in days supply) of any PAH-specific medication was observed in 38% of patients. Compared with the 6-month pre-index period, the proportion of patients in the 6

  15. Improving cost-effectiveness for the furnace in a full-scale refinery plant with reuse of waste tail gas fuel

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Chien-Li [Department of Leisure and Recreation Management, Diwan University, Tainan (China); Hou, Shuhn-Shyurng [Department of Mechanical Engineering, Kun Shan University (China); Lee, Wen-Jhy [Department of Environmental Engineering, National Cheng Kung University (China); Jou, Chih-Ju G. [Department of Safety, Health and Environmental Engineering, National Kaohsiung First University of Science and Technology, 2, Juoyue Rd., Nantz District, Kaohsiung 811 (China)

    2010-02-15

    The waste tail gas fuel emitted from refinery plant in Taiwan e.g. catalytic reforming unit, catalytic cracking unit and residue desulfurization unit, was recovered and reused as a replacement fuel. In this study, it was slowly added to the fuel stream of a heater furnace to replace natural gas for powering a full-scale distillation process. The waste tail gas fuel contained on average 60 mol% of hydrogen. On-site experimental results show that both the flame length and orange-yellowish brightness decrease with increasing proportion of waste gas fuel in the original natural gas fuel. Moreover, the adiabatic flame temperature increases as the content of waste gas fuel is increased in the fuel mixture since waste gas fuel has a higher adiabatic flame temperature than that of natural gas. The complete replacement of natural gas by waste gas fuel for a heater furnace operating at 70% loading (i.e. 3.6 x 10{sup 7} kcal/h of combustion capacity) will save 5.8 x 10{sup 6} m{sup 3} of natural gas consumption, and 3.5 x 10{sup 4} tons (or 53.4%) of CO{sub 2} emission annually. Recovering and reusing the waste tail gas fuel as natural gas replacement will achieve tremendous savings of natural gas usage and effectively lower the emission of carbon dioxide. (author)

  16. INITIAL PUBLIC OFFERING IN BRAZIL (2004-2006): A VALUATION APPROACH USING MULTIPLES AND COST OF EQUITY

    OpenAIRE

    FELIPE PRETTI CASOTTI

    2007-01-01

    A precificação das ações emitidas em ofertas públicas iniciais tem sido alvo de estudos em diversos países. Abordando o conceito de avaliação por múltiplos, este trabalho busca verificar se as ações das empresas estavam sub-avaliadas ou super-avaliadas no momento das suas Ofertas Públicas Iniciais (Initial Public Offerings). Posteriormente, são determinados os custos de capital próprio adotados na emissão, verificando-se a diferença entre betas utili...

  17. The Neuroeconomics of Tobacco Demand: An Initial Investigation of the Neural Correlates of Cigarette Cost-Benefit Decision Making in Male Smokers.

    Science.gov (United States)

    Gray, Joshua C; Amlung, Michael T; Owens, Max; Acker, John; Brown, Courtney L; Brody, Gene H; Sweet, Lawrence H; MacKillop, James

    2017-02-03

    How the brain processes cigarette cost-benefit decision making remains largely unknown. Using functional magnetic resonance imaging (fMRI), this study investigated the neural correlates of decisions for cigarettes (0-10 cigarettes) at varying levels of price during a Cigarette Purchase Task (CPT) in male regular smokers (N = 35). Differential neural activity was examined between choices classified as inelastic, elastic, and suppressed demand, operationalized as consumption unaffected by cost, partially suppressed by cost, and entirely suppressed by cost, respectively. Decisions reflecting elastic demand, putatively the most effortful decisions, elicited greater activation in regions associated with inhibition and planning (e.g., middle frontal gyrus and inferior frontal gyrus), craving and interoceptive processing (anterior insula), and conflict monitoring (e.g., anterior cingulate cortex). Exploratory examination in a harmonized dataset of both cigarette and alcohol demand (N = 59) suggested common neural activation patterns across commodities, particularly in the anterior insula, caudate, anterior cingulate, medial frontal gyrus, and dorsolateral prefrontal cortex. Collectively, these findings provide initial validation of a CPT fMRI paradigm; reveal the interplay of brain regions associated with executive functioning, incentive salience, and interoceptive processing in cigarette decision making; and add to the literature implicating the insula as a key brain region in addiction.

  18. Cost/efficacy analysis of preferred Spanish AIDS study group regimens and the dual therapy with lopinavir/ritonavir plus lamivudine for initial ART in HIV infected adults.

    Science.gov (United States)

    Gatell Artigas, Josep María; Arribas López, José Ramón; Lázaro Y de Mercado, Pablo; Blasco Bravo, Antonio Javier

    2016-01-01

    The National AIDS Plan and the Spanish AIDS study group (GESIDA) proposes "preferred regimens" (PR) of antiretroviral treatment (ART) as initial therapy in HIV-infected patients. In 2013, the recommended regimens were all triple therapy regimens. The Gardel Study assessed the efficacy of a dual therapy (DT) combination of lopinavir/ritonavir (LPV/r) plus lamivudine (3TC). Our objective is to evaluate the GESIDA PR and the DT regimen LPV/r+3TC cost/efficacy ratios. Decision tree models were built. probability of having viral load cost: costs of ART, adverse effects, and drug resistance tests during the first 48 weeks. Cost/efficacy ratios varied between 5,817 and 13,930 euros per responder at 48 weeks, for the DT of LPV/r+3TC and tenofovir DF/emtricitabine+raltegravir, respectively. Taking into account the official Spanish prices of ART, the most efficient regimen was DT of LPV/r+3TC, followed by the triple therapy with non-nucleoside containing regimens. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  19. Motivation for a near term gun launch to space demonstration and a variable induction power supply concept to minimize initial demonstration costs

    International Nuclear Information System (INIS)

    Palmer, M.R.

    1993-01-01

    The history of the Gun Launch to Space (GLTS) concept is briefly reviewed along with recent progress and motivations for a near term launch demonstration. A current multiplying reconfigurable inductor design is developed which could couple to an existing battery system to power a GLTS railgun demonstration at the 300 megajoule muzzle energy level. The design is developed using proven approaches and performance levels and appears capable of reducing the power supply cost for an initial GLTS demonstration below that of a simple battery charged inductor system. Possible uses are (1) launching of space weapons; (2) launching of communication satellites; (3) and launching of satellites for space disposal of radioactive wastes

  20. Deployment of Low-Cost, Carbon Dioxide Sensors throughout the Washington Metropolitan Area - The Capital Climate Initiative

    Science.gov (United States)

    Caine, Kristen M.; Bailey, D. Michelle; Houston Miller, J.

    2016-04-01

    According to the IPCC from 1995 to 2005, atmospheric carbon dioxide (CO2) concentrations increased by 19 ppm, the highest average growth rate recorded for any decade since measurements began in the 1950s. Due to its ability to influence global climate change, it is imperative to continually monitor carbon dioxide emission levels, particularly in urban areas where some estimate in excess of 75% of total greenhouse gas emissions occur. Although high-precision sensors are commercially available, these are not cost effective for mapping a large spatial area. A goal of this research is to build out a network of sensors that are accurate and precise enough to provide a valuable data tool for accessing carbon emissions from a large, urban area. This publically available greenhouse gas dataset can be used in numerous environmental assessments and as validation for remote sensing products. It will also be a valuable teaching tool for classes at our university and will promote further engagement of K-12 students and their teachers through education and outreach activities. Each of our sensors (referred to as "PiOxides") utilizes a non-dispersive infrared (NDIR) sensor for the detection of carbon dioxide along with a combination pressure/temperature/humidity sensor. The collection of pressure and temperature increases the accuracy and precision of the CO2 measurement. The sensors communicate using a serial interfaces with a Raspberry Pi microcontroller. Each PiOxide is connected to a website that leverages recent developments in open source GIS tools. In this way, data from individual sensors can be followed individually or aggregated to provide real-time, spatially-resolved data of CO2 trends across a broad area. Our goal for the network is to expand across the entire DC/Maryland/Virginia Region through partnerships with private and public schools. We are also designing GHG Bluetooth beacons that may be accessed by mobile phone users in their vicinity. In two additional

  1. The neuroeconomics of alcohol demand: an initial investigation of the neural correlates of alcohol cost-benefit decision making in heavy drinking men.

    Science.gov (United States)

    MacKillop, James; Amlung, Michael T; Acker, John; Gray, Joshua C; Brown, Courtney L; Murphy, James G; Ray, Lara A; Sweet, Lawrence H

    2014-07-01

    Neuroeconomics integrates concepts and methods from psychology, economics, and cognitive neuroscience to understand how the brain makes decisions. In economics, demand refers to the relationship between a commodity's consumption and its cost, and, in behavioral studies, high alcohol demand has been consistently associated with greater alcohol misuse. Relatively little is known about how the brain processes demand decision making, and the current study is an initial investigation of the neural correlates of alcohol demand among heavy drinkers. Using an event-related functional magnetic resonance imaging (fMRI) paradigm, participants (N=24) selected how much they would drink under varying levels of price. These choices determined access to alcohol during a subsequent bar laboratory self-administration period. During decisions to drink in general, greater activity was present in multiple distinct subunits of the prefrontal and parietal cortices. In contrast, during decisions to drink that were demonstrably affected by the cost of alcohol, significantly greater activation was evident in frontostriatal regions, suggesting an active interplay between cognitive deliberation and subjective reward value. These choices were also characterized by significant deactivation in default mode network regions, suggesting suppression resulting from greater cognitive load. Across choice types, the anterior insula was notably recruited in diverse roles, further implicating the importance of interoceptive processing in decision-making behavior. These findings reveal the neural signatures subserving alcohol cost-benefit decision making, providing a foundation for future clinical applications of this paradigm and extending this approach to understanding the neural correlates of demand for other addictive commodities.

  2. Barriers to initiation of antiretroviral treatment in rural and urban areas of Zambia: a cross-sectional study of cost, stigma, and perceptions about ART.

    Science.gov (United States)

    Fox, Matthew P; Mazimba, Arthur; Seidenberg, Phil; Crooks, Denise; Sikateyo, Bornwell; Rosen, Sydney

    2010-03-06

    While the number of HIV-positive patients on antiretroviral therapy (ART) in resource-limited settings has increased dramatically, some patients eligible for treatment do not initiate ART even when it is available to them. Understanding why patients opt out of care, or are unable to opt in, is important to achieving the goal of universal access. We conducted a cross-sectional survey among 400 patients on ART (those who were able to access care) and 400 patients accessing home-based care (HBC), but who had not initiated ART (either they were not able to, or chose not to, access care) in two rural and two urban sites in Zambia to identify barriers to and facilitators of ART uptake. HBC patients were 50% more likely to report that it would be very difficult to get to the ART clinic than those on ART (RR: 1.48; 95% CI: 1.21-1.82). Stigma was common in all areas, with 54% of HBC patients, but only 15% of ART patients, being afraid to go to the clinic (RR: 3.61; 95% CI: 3.12-4.18). Cost barriers differed by location: urban HBC patients were three times more likely to report needing to pay to travel to the clinic than those on ART (RR: 2.84; 95% CI: 2.02-3.98) and 10 times more likely to believe they would need to pay a fee at the clinic (RR: 9.50; 95% CI: 2.24-40.3). In rural areas, HBC subjects were more likely to report needing to pay non-transport costs to attend the clinic than those on ART (RR: 4.52; 95% CI: 1.91-10.7). HBC patients were twice as likely as ART patients to report not having enough food to take ART being a concern (27% vs. 13%, RR: 2.03; 95% CI: 1.71-2.41), regardless of location and gender. Patients in home-based care for HIV/AIDS who never initiated ART perceived greater financial and logistical barriers to seeking HIV care and had more negative perceptions about the benefits of the treatment. Future efforts to expand access to antiretroviral care should consider ways to reduce these barriers in order to encourage more of those medically eligible

  3. Cost analysis of initial highly active antiretroviral therapy regimens for managing human immunodeficiency virus-infected patients according to clinical practice in a hospital setting

    Directory of Open Access Journals (Sweden)

    Colombo GL

    2013-12-01

    Full Text Available Giorgio L Colombo,1,2 Antonella Castagna,3 Sergio Di Matteo,2 Laura Galli,3 Giacomo Bruno,2 Andrea Poli,3 Stefania Salpietro,3 Alessia Carbone,3 Adriano Lazzarin3,41Department of Drug Sciences, School of Pharmacy, University of Pavia, Italy; 2Studi Analisi Valutazioni Economiche (S.A.V.E., Milan, 3Infectious Diseases Department, San Raffaele Hospital, Milan, 4Vita-Salute San Raffaele University, Milan, ItalyObjective: In the study reported here, single-tablet regimen (STR versus (vs multi-tablet regimen (MTR strategies were evaluated through a cost analysis in a large cohort of patients starting their first highly active antiretroviral therapy (HAART. Adult human immunodeficiency virus (HIV 1-naïve patients, followed at the San Raffaele Hospital, Milan, Italy, starting their first-line regimen from June 2008 to April 2012 were included in the analysis.Methods: The most frequently used first-line HAART regimens (>10% were grouped into two classes: 1 STR of tenofovir disoproxil fumarate (TDF + emtricitabine (FTC + efavirenz (EFV and 2 MTR including TDF + FTC + EFV, TDF + FTC + atazanavir/ritonavir (ATV/r, TDF + FTC + darunavir/ritonavir (DRV/r, and TDF + FTC + lopinavir/ritoavir (LPV/r. Data were analyzed from the point of view of the Lombardy Regional Health Service. HAART, hospitalizations, visits, medical examinations, and other concomitant non-HAART drug costs were evaluated and price variations included. Descriptive statistics were calculated for baseline demographic, clinical, and laboratory characteristics; associations between categorical variables and type of antiretroviral strategy (STR vs MTR were examined using chi-square or Fisher's exact tests. At multivariate analysis, the generalized linear model was used to identify the predictive factors of the overall costs of the first-line HAART regimens.Results: A total of 474 naïve patients (90% male, mean age 42.2 years, mean baseline HIV-RNA 4.50 log10 copies/mL, and cluster of

  4. Cost-effectiveness of alternative strategies for the initial medical management of non-ST elevation acute coronary syndrome: systematic review and decision-analytical modelling.

    Science.gov (United States)

    Robinson, M; Palmer, S; Sculpher, M; Philips, Z; Ginnelly, L; Bowens, A; Golder, S; Alfakih, K; Bakhai, A; Packham, C; Cooper, N; Abrams, K; Eastwood, A; Pearman, A; Flather, M; Gray, D; Hall, A

    2005-07-01

    as part of the initial medical management of all non-ST elevation ACS was the optimal choice, with an incremental cost-effectiveness ratio (ICER) of 5738 pounds per quality-adjusted life-year (QALY) compared with no use of GPAs. Stochastic analysis showed that if the health service is willing to pay 10,000 pounds per additional QALY, the probability of this strategy being cost-effective was around 82%, increasing to 95% at a threshold of 50,000 pounds per QALY. A sensitivity analysis including an additional strategy of using GPAs as part of initial medical management only in patients at particular high risk (as defined by age, ST depression or diabetes) showed that this additional strategy was yet more cost-effective, with an ICER of 3996 pounds per QALY compared with no treatment with GPA. Value of information analysis suggested that there was considerable merit in additional research to reduce the level of uncertainty in the optimal decision. At a threshold of 10,000 pounds per QALY, the maximum potential value of such research in the base case was calculated as 12.7 million pounds per annum for the UK as a whole. Taking account of the greater uncertainty in the sensitivity analyses including clopidogrel, this figure was increased to approximately 50 million pounds. This study suggests the use of GPAs in all non-ST elevation ACS patients as part of their initial medical management. Sensitivity analysis showed that virtually all of the benefit could be realised by treating only high-risk patients. Further clarification of the optimum role of GPAs in the UK NHS depends on the availability of further high-quality observational and trial data. Value of information analysis derived from the model suggests that a relatively large investment in such research may be worthwhile. Further research should focus on the identification of the characteristics of patients who benefit most from GPAs as part of medical management, the comparison of GPAs with clopidogrel as an adjunct

  5. Unilateral initiatives

    International Nuclear Information System (INIS)

    Anon.

    1988-01-01

    This paper reports on arms control which is generally thought of in terms of formal negotiations with an opponent, with the resulting agreements embodied in a treaty. This is not surprising, since arms control discussions between opponents are both important and politically visible. There are, however, strong reasons for countries to consider and frequently take unilateral initiatives. To do so is entirely consistent with the established major precepts of arms control which state that arms control is designed to reduce the risk of war, the costs of preparing for war, and the death and destruction if war should come. Unilateral initiatives on what weapons are purchased, which ones are eliminated and how forces are deployed can all relate to these objectives. There are two main categories of motives for unilateral initiatives in arms control. In one category, internal national objectives are the dominant, often sole, driving force; the initiative is undertaken for our own good

  6. Cost-effectiveness of initiating extrafine- or standard size-particle inhaled corticosteroid for asthma in two health-care systems: a retrospective matched cohort study

    NARCIS (Netherlands)

    Martin, Richard J.; Price, David; Roche, Nicolas; Israel, Elliot; van Aalderen, Willem M. C.; Grigg, Jonathan; Postma, Dirkje S.; Guilbert, Theresa W.; Hillyer, Elizabeth V.; Burden, Anne; von Ziegenweidt, Julie; Colice, Gene

    2014-01-01

    Real-life studies are needed to determine the cost-effectiveness of asthma therapies in clinical practice. To compare the cost-effectiveness of extrafine-particle inhaled corticosteroid (ICS) with standard size-particle ICS in the United Kingdom (UK) and United States (US). These retrospective

  7. Cost-effectiveness of initiating extrafine- or standard size-particle inhaled corticosteroid for asthma in two health-care systems : a retrospective matched cohort study

    NARCIS (Netherlands)

    Martin, Richard J.; Price, David; Roche, Nicolas; Israel, Elliot; van Aalderen, Willem M. C.; Grigg, Jonathan; Postma, Dirkje S.; Guilbert, Theresa W.; Hillyer, Elizabeth V.; Burden, Anne; von Ziegenweidt, Julie; Colice, Gene

    2014-01-01

    BACKGROUND: Real-life studies are needed to determine the cost-effectiveness of asthma therapies in clinical practice. AIM: To compare the cost-effectiveness of extrafine-particle inhaled corticosteroid (ICS) with standard size-particle ICS in the United Kingdom (UK) and United States (US). METHODS:

  8. Cost-effectiveness analysis of HLA-B*58: 01 genetic testing before initiation of allopurinol therapy to prevent allopurinol-induced Stevens-Johnson syndrome/toxic epidermal necrolysis in a Malaysian population.

    Science.gov (United States)

    Chong, Huey Yi; Lim, Yi Heng; Prawjaeng, Juthamas; Tassaneeyakul, Wichittra; Mohamed, Zahurin; Chaiyakunapruk, Nathorn

    2018-02-01

    Studies found a strong association between allopurinol-induced Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) and the HLA-B*58:01 allele. HLA-B*58:01 screening-guided therapy may mitigate the risk of allopurinol-induced SJS/TEN. This study aimed to evaluate the cost-effectiveness of HLA-B*58:01 screening before allopurinol therapy initiation compared with the current practice of no screening for Malaysian patients with chronic gout in whom a hypouricemic agent is indicated. This cost-effectiveness analysis adopted a societal perspective with a lifetime horizon. A decision tree model coupled with Markov models were developed to estimate the costs and outcomes, represented by quality-adjusted life years (QALYs) gained, of three treatment strategies: (a) current practice (allopurinol initiation without HLA-B*58:01 screening); (b) HLA-B*58:01 screening before allopurinol initiation; and (c) alternative treatment (probenecid) without HLA-B*58:01 screening. The model was populated with data from literature review, meta-analysis, and published government documents. Cost values were adjusted for the year 2016, with costs and health outcomes discounted at 3% per annum. A series of sensitivity analysis including probabilistic sensitivity analysis were carried out to determine the robustness of the findings. Both HLA-B*58:01 screening and probenecid prescribing were dominated by current practice. Compared with current practice, HLA-B*58:01 screening resulted in 0.252 QALYs loss per patient at an additional cost of USD 322, whereas probenecid prescribing resulted in 1.928 QALYs loss per patient at an additional cost of USD 2203. One SJS/TEN case would be avoided for every 556 patients screened. At the cost-effectiveness threshold of USD 8695 per QALY, the probability of current practice being the best choice is 99.9%, in contrast with 0.1 and 0% in HLA-B*58:01 screening and probenecid prescribing, respectively. This is because of the low incidence of

  9. International Programme for Resource Use in Critical Care (IPOC)--a methodology and initial results of cost and provision in four European countries.

    Science.gov (United States)

    Negrini, D; Sheppard, L; Mills, G H; Jacobs, P; Rapoport, J; Bourne, R S; Guidet, B; Csomos, A; Prien, T; Anderson, G; Edbrooke, D L

    2006-01-01

    A standardized top-down costing method is not currently available internationally. An internally validated method developed in the UK was modified for use in critical care in different countries. Costs could then be compared using the World Health Organization's Purchasing Power Parities (WHO PPPs). This was an observational, retrospective, cross-sectional, multicentre study set in four European countries: France, UK, Germany and Hungary. A total of 329 adult intensive care units (ICUs) participated in the study. The costs are reported in international dollars ($) derived from the WHO PPP programme. The results show significant differences in resource use and costs of ICUs over the four countries. On the basis of the sum of the means for the major components, the average cost per patient day in UK hospitals was $1512, in French hospitals $934, in German hospitals $726 and in Hungarian hospitals $280. The reasons for such differences are poorly understood but warrant further investigation. This information will allow us to better adjust our measures of international ICU costs.

  10. RESULTS FROM THE U.S. DOE 2006 SAVE ENERGY NOW ASSESSMENT INITIATIVE: DOE's Partnership with U.S. Industry to Reduce Energy Consumption, Energy Costs, and Carbon Dioxide Emissions

    Energy Technology Data Exchange (ETDEWEB)

    Wright, Anthony L [ORNL; Martin, Michaela A [ORNL; Gemmer, Bob [U.S. Department of Energy, Office of Energy Efficiency and Renewable Energy; Scheihing, Paul [U.S. Department of Energy, Industrial Technologies Program; Quinn, James [U.S. Department of Energy

    2007-09-01

    In the wake of Hurricane Katrina and other severe storms in 2005, natural gas supplies were restricted, prices rose, and industry sought ways to reduce its natural gas use and costs. In October 2005, U.S. Department of Energy (DOE) Energy Secretary Bodman launched his Easy Ways to Save Energy campaign with a promise to provide energy assessments to 200 of the largest U.S. manufacturing plants. A major thrust of the campaign was to ensure that the nation's natural gas supplies would be adequate for all Americans, especially during home heating seasons. In a presentation to the National Press Club on October 3, 2005, Secretary Bodman said: 'America's businesses, factories, and manufacturing facilities use massive amounts of energy. To help them during this period of tightening supply and rising costs, our Department is sending teams of qualified efficiency experts to 200 of the nation's most energy-intensive factories. Our Energy Saving Teams will work with on-site managers on ways to conserve energy and use it more efficiently.' DOE's Industrial Technologies Program (ITP) responded to the Secretary's campaign with its Save Energy Now initiative, featuring a new and highly cost-effective form of energy assessments. The approach for these assessments drew heavily on the existing resources of ITP's Technology Delivery component. Over the years, ITP-Technology Delivery had worked with industry partners to assemble a suite of respected software decision tools, proven assessment protocols, training curricula, certified experts, and strong partnerships for deployment. Because of the program's earlier activities and the resources that had been developed, ITP was prepared to respond swiftly and effectively to the sudden need to promote improved industrial energy efficiency. Because of anticipated supply issues in the natural gas sector, the Save Energy Now initiative strategically focused on natural gas savings and targeted the

  11. Arthroscopic meniscectomy for degenerative meniscal tears reduces knee pain but is not cost-effective in a routine health care setting: a multi-center longitudinal observational study using data from the osteoarthritis initiative.

    Science.gov (United States)

    Rongen, J J; Govers, T M; Buma, P; Rovers, M M; Hannink, G

    2018-02-01

    It is disputed whether arthroscopic meniscectomy is an (cost-) effective treatment for degenerative meniscus tears in day-to-day clinical practice. The objective of this study was to assess the cost-effectiveness of arthroscopic meniscectomy in subjects with knee osteoarthritis, in routine clinical practice, while taking into account the increased risk for future knee replacement surgery. We compared cost-effectiveness of arthroscopic meniscectomy compared to no surgery. We used a state transition (Markov) simulation model to evaluate the cost-effectiveness of arthroscopic meniscectomy compared to no surgery in subjects with knee osteoarthritis (age range 45-79 years). Data used in the preparation of the current study were obtained from the Osteoarthritis Initiative (AOI) database. We applied a 9 years' time horizon (which is equal to the current OAI study follow up period), and evaluated cost-effectiveness from a societal perspective. The main outcome measure was the incremental cost-effectiveness ratio (Euros per quality adjusted life-year (QALY) gained). Arthroscopic meniscectomy was associated with 8.09 (SD ± 0.07) QALYs at a cost of € 21,345 (SD ± 841), whereas the no surgery was associated with 8.05 (SD ± 0.07) QALYs at a cost of € 16,284 (SD ± 855). For arthroscopic meniscectomy, the incremental cost per QALY gained was € 150,754. In day-to-day clinical practice, arthroscopic meniscectomy in subjects with knee osteoarthritis is associated with € 150,754 per QALY gained, which exceeds the generally accepted willingness to pay (WTP) (range € 20,000-€ 80,000). Copyright © 2017 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  12. Randomized study comparing full dose monotherapy (S-1 followed by irinotecan) and reduced dose combination therapy (S-1/oxaliplatin followed by S-1/irinotecan) as initial therapy for older patients with metastatic colorectal cancer

    DEFF Research Database (Denmark)

    Winther, Stine Braendegaard; Österlund, Pia; Berglund, Åke

    2017-01-01

    to select which older patients should receive therapy. Methods: The NORDIC 9 trial is a Nordic multicenter randomized phase II study comparing full dose monotherapy (S-1 30 mg/m2 twice daily days 1-14 every 3 weeks, followed by second line irinotecan 250-350 mg/m2 iv day 1 every 3 weeks or 180-250 mg/m2 iv...... day 1 every 2 weeks) with reduced dose combination therapy (S-1 20 mg/m2 days 1-14 + oxaliplatin 100 mg/m2 iv day 1 every 3 weeks, followed by second line S-1 20 mg/m2 days 1-14 + irinotecan 180 mg/m2 day 1 every 3 week) for older patients (≥70 years) with mCRC who are not candidates for full...... chance for tailored treatment strategies in these patients. Trial registration: EU Clinical Trial Register, EudraCT no. 2014-000394-39. Registered 05 May 2014....

  13. Does integration of HIV and SRH services achieve economies of scale and scope in practice? A cost function analysis of the Integra Initiative.

    Science.gov (United States)

    Obure, Carol Dayo; Guinness, Lorna; Sweeney, Sedona; Initiative, Integra; Vassall, Anna

    2016-03-01

    Policy-makers have long argued about the potential efficiency gains and cost savings from integrating HIV and sexual reproductive health (SRH) services, particularly in resource-constrained settings with generalised HIV epidemics. However, until now, little empirical evidence exists on whether the hypothesised efficiency gains associated with such integration can be achieved in practice. We estimated a quadratic cost function using data obtained from 40 health facilities, over a 2-year-period, in Kenya and Swaziland. The quadratic specification enables us to determine the existence of economies of scale and scope. The empirical results reveal that at the current output levels, only HIV counselling and testing services are characterised by service-specific economies of scale. However, no overall economies of scale exist as all outputs are increased. The results also indicate cost complementarities between cervical cancer screening and HIV care; post-natal care and HIV care and family planning and sexually transmitted infection treatment combinations only. The results from this analysis reveal that contrary to expectation, efficiency gains from the integration of HIV and SRH services, if any, are likely to be modest. Efficiency gains are likely to be most achievable in settings that are currently delivering HIV and SRH services at a low scale with high levels of fixed costs. The presence of cost complementarities for only three service combinations implies that careful consideration of setting-specific clinical practices and the extent to which they can be combined should be made when deciding which services to integrate. NCT01694862. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  14. Predicting Retear after Repair of Full-Thickness Rotator Cuff Tear: Two-Point Dixon MR Imaging Quantification of Fatty Muscle Degeneration-Initial Experience with 1-year Follow-up.

    Science.gov (United States)

    Nozaki, Taiki; Tasaki, Atsushi; Horiuchi, Saya; Ochi, Junko; Starkey, Jay; Hara, Takeshi; Saida, Yukihisa; Yoshioka, Hiroshi

    2016-08-01

    Purpose To determine the degree of preoperative fatty degeneration within muscles, postoperative longitudinal changes in fatty degeneration, and differences in fatty degeneration between patients with full-thickness supraspinatus tears who do and those who do not experience a retear after surgery. Materials and Methods This prospective study had institutional review board approval and was conducted in accordance with the Committee for Human Research. Informed consent was obtained. Fifty patients with full-thickness supraspinatus tears (18 men, 32 women; mean age, 67.0 years ± 8.0; age range, 41-91 years) were recruited. The degrees of preoperative and postoperative fatty degeneration were quantified by using a two-point Dixon magnetic resonance (MR) imaging sequence; two radiologists measured the mean signal intensity on in-phase [S(In)] and fat [S(Fat)] images. Estimates of fatty degeneration were calculated with "fat fraction" values by using the formula S(Fat)/S(In) within the supraspinatus, infraspinatus, and subscapularis muscles at baseline preoperative and at postoperative 1-year follow-up MR imaging. Preoperative fat fractions in the failed-repair group and the intact-repair group were compared by using the Mann-Whitney U test. Results The preoperative fat fractions in the supraspinatus muscle were significantly higher in the failed-repair group than in the intact-repair group (37.0% vs 19.5%, P muscle tended to progress at 1 year postoperatively in only the failed-repair group. Conclusion MR imaging quantification of preoperative fat fractions by using a two-point Dixon sequence within the rotator cuff muscles may be a viable method for predicting postoperative retear. (©) RSNA, 2016.

  15. Assessment of a robust model protocol with accelerated throughput for a human recombinant full length estrogen receptor-alpha binding assay: protocol optimization and intralaboratory assay performance as initial steps towards validation.

    Science.gov (United States)

    Freyberger, Alexius; Wilson, Vickie; Weimer, Marc; Tan, Shirlee; Tran, Hoai-Son; Ahr, Hans-Jürgen

    2010-08-01

    Despite about two decades of research in the field of endocrine active compounds, still no validated human recombinant (hr) estrogen receptor-alpha (ERalpha) binding assay is available, although hr-ERalpha is available from several sources. In a joint effort, US EPA and Bayer Schering Pharma with funding from the EU-sponsored 6th framework project, ReProTect, developed a model protocol for such a binding assay. Important features of this assay are the use of a full length hr-ERalpha and performance in a 96-well plate format. A full length hr-ERalpha was chosen, as it was considered to provide the most accurate and human-relevant results, whereas truncated receptors could perform differently. Besides three reference compounds [17beta-estradiol, norethynodrel, dibutylphthalate] nine test compounds with different affinities for the ERalpha [diethylstilbestrol (DES), ethynylestradiol, meso-hexestrol, equol, genistein, o,p'-DDT, nonylphenol, n-butylparaben, and corticosterone] were used to explore the performance of the assay. Three independent experiments per compound were performed on different days, and dilutions of test compounds from deep-frozen stocks, solutions of radiolabeled ligand and receptor preparation were freshly prepared for each experiment. The ERalpha binding properties of reference and test compounds were well detected. As expected dibutylphthalate and corticosterone were non-binders in this assay. In terms of the relative ranking of binding affinities, there was good agreement with published data obtained from experiments using a human recombinant ERalpha ligand binding domain. Irrespective of the chemical nature of the compound, individual IC(50)-values for a given compound varied by not more than a factor of 2.5. Our data demonstrate that the assay was robust and reliably ranked compounds with strong, weak, and no affinity for the ERalpha with high accuracy. It avoids the manipulation and use of animals, i.e., the preparation of uterine cytosol as

  16. What should be given a priority - costly medications for relatively few people or inexpensive ones for many? The Health Parliament public consultation initiative in Israel.

    Science.gov (United States)

    Guttman, Nurit; Shalev, Carmel; Kaplan, Giora; Abulafia, Ahuva; Bin-Nun, Gabi; Goffer, Ronen; Ben-Moshe, Roei; Tal, Orna; Shani, Mordechai; Lev, Boaz

    2008-06-01

    In the past two decades, government and civic organizations have been implementing a wide range of deliberative public consultations on health care-related policy. Drawing on these experiences, a public consultation initiative in Israel called the Health Parliament was established. To implement a public consultation initiative that will engage members of the public in the discussion of four healthcare policy questions associated with equity in health services and on priorities for determining which medications and treatments should be included in the basket of national health services. One hundred thirty-two participants from the general population recruited through a random sample were provided with background materials and met over several months in six regional sites. Dilemma activities were used and consultants were available for questions and clarifications. Participants presented their recommendations in a national assembly to the Minister of Health. Across the regional groups the recommendations were mostly compatible, in particular regarding considering the healthcare system's monetary state, even at the expense of equity, but for each policy question minority views were also expressed. A strong emphasis in the recommendations was pragmatism. Participants felt the experience was worthwhile; though the actual impact of their recommendations on policy making was indirect, they were willing to participate in future consultations. However, despite enthusiasm the initiative was not continued. Issues raised are whether consultation initiatives must have a direct impact on healthcare policy decisions or can be mainly a venue to involve citizens in the deliberation of healthcare policy issues.

  17. 2-[{sup 18}F]-fluoro-2-deoxy-D-glucose positron-emission tomography is cost-effective in the initial staging of non-small cell lung cancer patients in Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Cerci, Juliano Julio, E-mail: cercijuliano@hotmail.com [PET-CT Center, Quanta - Diagnostico e Terapia, Curitiba, PR (Brazil); Instituto do Coracao (InCor) - Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), Sao Paulo, SP (Brazil); Takagaki, Teresa Yae [Universidade de Sao Paulo (USP), Sao Paulo, SP (Brazil); Trindade, Evelinda; Morgado, Roberta; Morabito, Fausto; Musolino, Rafael Silva; Meneghetti, Jose Claudio; Soares Junior, Jose [Instituto do Coracao (InCor) - Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), Sao Paulo, SP (Brazil)

    2012-07-15

    Objective: To evaluate the accuracy and cost-effectiveness of metabolic staging (MS) with FDG-PET as compared with the conventional staging (CS) strategy in the preoperative staging of non-small cell lung cancer (NSCLC). Materials And Methods: A total of 95 patients with initial diagnosis of NSCLC were staged before undergoing treatment. The MS and CS results were compared with regard to treatment definition and incidence of futile thoracotomies with both strategies. Results: Metabolic staging with FDG-PET upstaged 48.4% and down staged 5.3% of the patients, and would lead to change in the treatment of 41% of cases. Thoracotomy was considered as futile in 47% of the patients with CS, and in 19% of the patients with MS. The cost of futile thoracotomies in eight patients with MS was R$ 79,720, while in 31 patients with CS it would be R$ 308,915. Just such saving in costs would be more than enough to cover the costs of all FDG-PETs (R$ 126,350) or FDG-PET/CTs (R$ 193,515) for the 95 patients. Conclusion: The metabolic staging with FDG-PET is more accurate than CS in patients with NSCLC. Both FDG-PET and FDG-PET/CT are cost-effective methods and their utilization is economically justifiable in the Brazilian public health system. (author)

  18. What should be given a priority – costly medications for relatively few people or inexpensive ones for many? The Health Parliament public consultation initiative in Israel

    Science.gov (United States)

    Guttman, Nurit; Shalev, Carmel; Kaplan, Giora; Abulafia, Ahuva; Bin‐Nun, Gabi; Goffer, Ronen; Ben‐Moshe, Roei; Tal, Orna; Shani, Mordechai; Lev, Boaz

    2008-01-01

    Abstract Background  In the past two decades, government and civic organizations have been implementing a wide range of deliberative public consultations on health care‐related policy. Drawing on these experiences, a public consultation initiative in Israel called the Health Parliament was established. Goals  To implement a public consultation initiative that will engage members of the public in the discussion of four healthcare policy questions associated with equity in health services and on priorities for determining which medications and treatments should be included in the basket of national health services. Method  One hundred thirty‐two participants from the general population recruited through a random sample were provided with background materials and met over several months in six regional sites. Dilemma activities were used and consultants were available for questions and clarifications. Participants presented their recommendations in a national assembly to the Minister of Health. Outcomes  Across the regional groups the recommendations were mostly compatible, in particular regarding considering the healthcare system’s monetary state, even at the expense of equity, but for each policy question minority views were also expressed. A strong emphasis in the recommendations was pragmatism. Conclusion  Participants felt the experience was worthwhile; though the actual impact of their recommendations on policy making was indirect, they were willing to participate in future consultations. However, despite enthusiasm the initiative was not continued. Issues raised are whether consultation initiatives must have a direct impact on healthcare policy decisions or can be mainly a venue to involve citizens in the deliberation of healthcare policy issues. PMID:18429997

  19. Full system decontamination feasibility studies

    International Nuclear Information System (INIS)

    Denault, R.P.; LeSurf, J.E.; Walschot, F.W.

    1988-01-01

    Many chemical decontaminations have been performed on subsystems in light water reactors (BWRs and PWRs) but none on the full system (including the fuel) of large, (>500 MWe) investor owned reactors. Full system decontaminations on pressure-tubed reactors have been shown to facilitate maintenance, inspection, repair and replacement of reactor components. Further advantages are increased reactor availability and plant life extension. A conceptual study has been performed for EPRI (for PWRs) and Commonwealth Edison Co (for BWRs) into the applicability and cost benefit of full system decontaminations (FSD). The joint study showed that FSDs in both PWRs and BWRs, with or without the fuel included in the decontamination, are feasible and cost beneficial provided a large amount of work is to be done following the decontamination. The large amounts of radioactive waste generated can be managed using current technologies. Considerable improvements in waste handling, and consequent cost savings, can be obtained if new techniques which are now reaching commercial application are used. (author)

  20. An assessment of electric vehicles: technology, infrastructure requirements, greenhouse-gas emissions, petroleum use, material use, lifetime cost, consumer acceptance and policy initiatives.

    Science.gov (United States)

    Delucchi, M A; Yang, C; Burke, A F; Ogden, J M; Kurani, K; Kessler, J; Sperling, D

    2014-01-13

    Concerns about climate change, urban air pollution and dependence on unstable and expensive supplies of foreign oil have led policy-makers and researchers to investigate alternatives to conventional petroleum-fuelled internal-combustion-engine vehicles in transportation. Because vehicles that get some or all of their power from an electric drivetrain can have low or even zero emissions of greenhouse gases (GHGs) and urban air pollutants, and can consume little or no petroleum, there is considerable interest in developing and evaluating advanced electric vehicles (EVs), including pure battery-electric vehicles, plug-in hybrid electric vehicles and hydrogen fuel-cell electric vehicles. To help researchers and policy-makers assess the potential of EVs to mitigate climate change and reduce petroleum use, this paper discusses the technology of EVs, the infrastructure needed for their development, impacts on emissions of GHGs, petroleum use, materials use, lifetime costs, consumer acceptance and policy considerations.

  1. Global Methane Initiative

    Science.gov (United States)

    The Global Methane Initiative promotes cost-effective, near-term methane recovery through partnerships between developed and developing countries, with participation from the private sector, development banks, and nongovernmental organizations.

  2. VirtoScan - a mobile, low-cost photogrammetry setup for fast post-mortem 3D full-body documentations in x-ray computed tomography and autopsy suites.

    Science.gov (United States)

    Kottner, Sören; Ebert, Lars C; Ampanozi, Garyfalia; Braun, Marcel; Thali, Michael J; Gascho, Dominic

    2017-03-01

    Injuries such as bite marks or boot prints can leave distinct patterns on the body's surface and can be used for 3D reconstructions. Although various systems for 3D surface imaging have been introduced in the forensic field, most techniques are both cost-intensive and time-consuming. In this article, we present the VirtoScan, a mobile, multi-camera rig based on close-range photogrammetry. The system can be integrated into automated PMCT scanning procedures or used manually together with lifting carts, autopsy tables and examination couch. The VirtoScan is based on a moveable frame that carries 7 digital single-lens reflex cameras. A remote control is attached to each camera and allows the simultaneous triggering of the shutter release of all cameras. Data acquisition in combination with the PMCT scanning procedures took 3:34 min for the 3D surface documentation of one side of the body compared to 20:20 min of acquisition time when using our in-house standard. A surface model comparison between the high resolution output from our in-house standard and a high resolution model from the multi-camera rig showed a mean surface deviation of 0.36 mm for the whole body scan and 0.13 mm for a second comparison of a detailed section of the scan. The use of the multi-camera rig reduces the acquisition time for whole-body surface documentations in medico-legal examinations and provides a low-cost 3D surface scanning alternative for forensic investigations.

  3. Initial Concept of Operations for Full Management by Trajectory

    Science.gov (United States)

    Fernandes, Alicia D.; Atkins, Steve; Leiden, Ken; Kaler, Curt; Evans, Mark; Bell, Alan; Kilbourne, Todd; Jackson, Michael

    2017-01-01

    This document describes Management by Trajectory (MBT), a concept for future air traffic management (ATM) in which flights are assigned four-dimensional trajectories (4DTs) through a negotiation process between the Federal Aviation Administration (FAA) and flight operators that respects the flight operator's goals while complying with National Airspace System (NAS) constraints.

  4. Full closure strategic analysis.

    Science.gov (United States)

    2014-07-01

    The full closure strategic analysis was conducted to create a decision process whereby full roadway : closures for construction and maintenance activities can be evaluated and approved or denied by CDOT : Traffic personnel. The study reviewed current...

  5. Pre-school manager training: a cost-effective tool to promote nutrition- and health-related practice improvements in the Irish full-day-care pre-school setting.

    LENUS (Irish Health Repository)

    Johnston Molloy, Charlotte

    2013-10-18

    To evaluate the impact on nutrition- and health-related practice of two methods of delivery of a nutrition and health intervention in Irish full-day-care pre-schools: training of pre-school managers only or training of managers and their staff.

  6. The U.S. Department of Energy's Advanced Fuel Cycle Initiative is evaluating potential costs and benefits of partitioning and transmutation

    International Nuclear Information System (INIS)

    Van Luik, Abraham E.

    2003-01-01

    Abe van Luik (DOE, USA) stated that the U.S. Department of Energy is interested in P and T to the extent that transmutation is technically feasible and will reduce the toxicity of the waste to a point that makes it technically and economically justified. Therefore, research on P and T strategies incorporates the evaluation of its potential costs and benefits. A progress report to Congress (in preparation) will likely state that system studies in the USA and in Europe indicate a preference for reactor based transmutation rather than accelerator-driven systems. DOE proposes isolation of Cs and Sr, the recycling of Pu and Np in LWRs, and later the recycling of minor actinides in fast reactors. The report identifies the high-level waste volume reduction, the easier management of short-term heat load, the reduction of long-term heat load and radiotoxicity, and therefore long-term dose reduction as potential benefits. The goal of ongoing work is to quantify these benefits in order to allow an assessment of which alternatives can be economically useful in increasing the repository capacity, reducing the potential hazard from the repository and reducing uncertainties associated with the performance of the repository. This may, depending on the national nuclear power scenario, delay or avoid the need for a second repository for high-level waste in the USA. Furthermore DOE has received and is evaluating a proposal for simulation-based engineering to integrate all aspects of nuclear energy including reactor technology and waste disposal

  7. Full page insight

    DEFF Research Database (Denmark)

    Cortsen, Rikke Platz

    2014-01-01

    Alan Moore and his collaborating artists often manipulate time and space by drawing upon the formal elements of comics and making alternative constellations. This article looks at an element that is used frequently in comics of all kinds – the full page – and discusses how it helps shape spatio......, something that it shares with the full page in comics. Through an analysis of several full pages from Moore titles like Swamp Thing, From Hell, Watchmen and Promethea, it is made clear why the full page provides an apt vehicle for an apocalypse in comics....

  8. Risk of stroke/systemic embolism, major bleeding and associated costs in non-valvular atrial fibrillation patients who initiated apixaban, dabigatran or rivaroxaban compared with warfarin in the United States Medicare population.

    Science.gov (United States)

    Amin, Alpesh; Keshishian, Allison; Trocio, Jeffrey; Dina, Oluwaseyi; Le, Hannah; Rosenblatt, Lisa; Liu, Xianchen; Mardekian, Jack; Zhang, Qisu; Baser, Onur; Vo, Lien

    2017-09-01

    To compare the risk and cost of stroke/systemic embolism (SE) and major bleeding between each direct oral anticoagulant (DOAC) and warfarin among non-valvular atrial fibrillation (NVAF) patients. Patients (≥65 years) initiating warfarin or DOACs (apixaban, rivaroxaban, and dabigatran) were selected from the Medicare database from 1 January 2013 to 31 December 2014. Patients initiating each DOAC were matched 1:1 to warfarin patients using propensity score matching to balance demographics and clinical characteristics. Cox proportional hazards models were used to estimate the risks of stroke/SE and major bleeding of each DOAC vs. warfarin. Two-part models were used to compare the stroke/SE- and major-bleeding-related medical costs between matched cohorts. Of the 186,132 eligible patients, 20,803 apixaban-warfarin pairs, 52,476 rivaroxaban-warfarin pairs, and 16,731 dabigatran-warfarin pairs were matched. Apixaban (hazard ratio [HR] = 0.40; 95% confidence interval [CI] 0.31, 0.53) and rivaroxaban (HR = 0.72; 95% CI 0.63, 0.83) were significantly associated with lower risk of stroke/SE compared to warfarin. Apixaban (HR = 0.51; 95% CI 0.44, 0.58) and dabigatran (HR = 0.79; 95% CI 0.69, 0.91) were significantly associated with lower risk of major bleeding; rivaroxaban (HR = 1.17; 95% CI 1.10, 1.26) was significantly associated with higher risk of major bleeding compared to warfarin. Compared to warfarin, apixaban ($63 vs. $131) and rivaroxaban ($93 vs. $139) had significantly lower stroke/SE-related medical costs; apixaban ($292 vs. $529) and dabigatran ($369 vs. $450) had significantly lower major bleeding-related medical costs. Among the DOACs in the study, only apixaban is associated with a significantly lower risk of stroke/SE and major bleeding and lower related medical costs compared to warfarin.

  9. Managing costs at Ginna Station

    International Nuclear Information System (INIS)

    Mecredy, R.C.

    1990-01-01

    A nuclear power plant with a capital cost of $88 million and an annual operations and maintenance (O and M) cost of $3.2 million that is operated by a plant staff of 59 people? The Ginna nuclear power plant was indeed such a plant in 1970, its first full year of operation. Today that same plant has a total invested capital cost of $400 million with an annual capital cost, including upgrade projects which are being amortized, of $37 million. The annual O and M expenditure is nearly $60 million, and the total staffing, both plant and corporate support, is nearly 600 people. The result of this increased cost has been a dramatic narrowing of the cost margin between Ginna and coal units in the rochester Gas and Electric system. While increased expenditures have resulted in improved reliability and operability, and have increased the margins of safety, it is becoming necessary to implement cost monitoring and control measures so that each dollar spent provides maximum value. The factors which have contributed to the increased capital and O and M expenditures are well known. They include a broad range of safety, reliability, and operating projects and activities. Current upward pressures on cost include initiatives such as procurement control, procedure upgrades, configuration management, enhanced maintenance activities, and equipment replacements and upgrades

  10. Incorporating psychological influences in probabilistic cost analysis

    Energy Technology Data Exchange (ETDEWEB)

    Kujawski, Edouard; Alvaro, Mariana; Edwards, William

    2004-01-08

    Today's typical probabilistic cost analysis assumes an ''ideal'' project that is devoid of the human and organizational considerations that heavily influence the success and cost of real-world projects. In the real world ''Money Allocated Is Money Spent'' (MAIMS principle); cost underruns are rarely available to protect against cost overruns while task overruns are passed on to the total project cost. Realistic cost estimates therefore require a modified probabilistic cost analysis that simultaneously models the cost management strategy including budget allocation. Psychological influences such as overconfidence in assessing uncertainties and dependencies among cost elements and risks are other important considerations that are generally not addressed. It should then be no surprise that actual project costs often exceed the initial estimates and are delivered late and/or with a reduced scope. This paper presents a practical probabilistic cost analysis model that incorporates recent findings in human behavior and judgment under uncertainty, dependencies among cost elements, the MAIMS principle, and project management practices. Uncertain cost elements are elicited from experts using the direct fractile assessment method and fitted with three-parameter Weibull distributions. The full correlation matrix is specified in terms of two parameters that characterize correlations among cost elements in the same and in different subsystems. The analysis is readily implemented using standard Monte Carlo simulation tools such as {at}Risk and Crystal Ball{reg_sign}. The analysis of a representative design and engineering project substantiates that today's typical probabilistic cost analysis is likely to severely underestimate project cost for probability of success values of importance to contractors and procuring activities. The proposed approach provides a framework for developing a viable cost management strategy for

  11. Costo-efectividad de prácticas en salud pública: revisión bibliográfica de las intervenciones de la Iniciativa Mesoamericana de Salud Cost-effectiveness of public health practices: A literature review of public health interventions from the Mesoamerican Health Initiative

    Directory of Open Access Journals (Sweden)

    Atanacio Valencia-Mendoza

    2011-01-01

    Full Text Available OBJETIVO: Presentar y analizar información de costo-efectividad de intervenciones propuestas por la Iniciativa Mesoamericana de Salud (IMS en las áreas de nutrición infantil, inmunizaciones, paludismo, dengue y salud materno-infantil y reproductiva. MATERIAL Y MÉTODOS: Se llevó a cabo una revisión sistemática de la literatura de evaluaciones económicas publicadas entre el año 2000 y agosto 2009 sobre intervenciones en las áreas de la salud mencionadas, en los idiomas inglés y español. RESULTADOS: Las intervenciones en nutrición y de salud materno-infantil mostraron ser altamente costo-efectivas (con rangos menores a US$200 por año de vida ajustado por discapacidad [AVAD] evitado para nutrición y US$100 para materno-infantil. En dengue sólo se encontró información sobre la aplicación de larvicidas, cuya razón de costo efectividad estimada fue de US$40.79 a US$345.06 por AVAD evitado. Respecto al paludismo, las intervenciones estudiadas resultaron costo-efectivas (OBJECTIVE: Present and analyze cost-effectiveness information of public health interventions proposed by the Mesoamerican Health Initiative in child nutrition, vaccination, malaria, dengue, and maternal, neonatal, and reproductive health. MATERIAL AND METHODS: A systematic literature review was conducted on cost-effectiveness studies published between January 2000 and August 2009 on interventions related to the health areas previously mentioned. Studies were included if they measured effectiveness in terms of Disability-Adjusted Life Year (DALY or death averted. RESULTS: Child nutrition and maternal and neonatal health interventions were found to be highly cost-effective (most of them below US$200 per DALY averted for nutritional interventions and US$100 for maternal and neonatal health. For dengue, information on cost-effectiveness was found just for application of larvicides, which resulted in a cost per DALY averted ranking from US$40.79 to US$345.06. Malarial

  12. Full Service Leasing

    OpenAIRE

    Richter, Ján

    2009-01-01

    Aim of this master thesis is to describe the service of Full Service Leasing, as a modern form of financing and management of assets, primarily automobile fleet. Description of full service leasing is designed as a comprehensive and complete guide to support reader's position when deciding to finance and manage a fleet by this service. Whether the reader is an entrepreneur, CFO, fleet manager, new employee of leasing company, or anyone who is interested in this service, this master thesis wil...

  13. Implementation of life cycle costing for a commercial building: case of a residential apartment at Yogyakarta

    Directory of Open Access Journals (Sweden)

    Kaming Peter F

    2017-01-01

    Full Text Available Analysis of a design process is very important in controlling the initial costs and future costs in possession of an investment project such as commercial building. Therefore, it should be wise to perform a life cycle cost analysis to determine the cost of any category contained in future cost of the building. The analysis also provide information to see how much the total cost incurred by a development project from initial to the future cost by implementing BS ISO 15686 part 5: 2008, regarding life cycle costing. The purpose of this study is to identify the cost proportion and make long-term plans of a commercial building in term of its life cycle costing from a case of a residential apartment in Yogyakarta, Indonesia. Results of the study show that there are three groups that make up the life cycle cost: the cost of development of the building, the operating costs, and the cost of maintenance and replacement. For a long-term plan the life cycle cost for 25 years the percentage obtained as follows, initial development cost of 42%, operational costs 39%, maintenance and replacement costs 19%. The results would also make comparison with other existing commercial buildings.

  14. Compressive full waveform lidar

    Science.gov (United States)

    Yang, Weiyi; Ke, Jun

    2017-05-01

    To avoid high bandwidth detector, fast speed A/D converter, and large size memory disk, a compressive full waveform LIDAR system, which uses a temporally modulated laser instead of a pulsed laser, is studied in this paper. Full waveform data from NEON (National Ecological Observatory Network) are used. Random binary patterns are used to modulate the source. To achieve 0.15 m ranging resolution, a 100 MSPS A/D converter is assumed to make measurements. SPIRAL algorithm with canonical basis is employed when Poisson noise is considered in the low illuminated condition.

  15. Full faith in myself

    Indian Academy of Sciences (India)

    Lawrence

    Full faith in myself. Meenakshi Banerjee. 12. Ihad my schooling at the Irish Convent, Loreto, in Asansol,. West Bengal. Perhaps the earliest memories I have are of myself as a very determined child with a deep appreciation of and inquisitiveness regarding nature although not understanding most of it at that tender age.

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

    Directory of Open Access Journals (Sweden)

    Smita Nayak

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

  17. Plate Full of Color

    Centers for Disease Control (CDC) Podcasts

    The Eagle Books are a series of four books that are brought to life by wise animal characters - Mr. Eagle, Miss Rabbit, and Coyote - who engage Rain That Dances and his young friends in the joy of physical activity, eating healthy foods, and learning from their elders about health and diabetes prevention. Plate Full of Color teaches the value of eating a variety of colorful and healthy foods.

  18. Production costs and fruit yield profitability in the initial harvest of custard apple trees Custo de produção e lucratividade da produção de frutos de inheiras nas primeiras safras

    Directory of Open Access Journals (Sweden)

    Frederico Silva Thé Pontes

    2008-12-01

    Full Text Available The aim of this study was to estimate the production cost and economic indicators associated with the production and sales of fruits from 20 custard apple progenies during the initial five harvests, in order to identify the harvest season from which custard apple exploitation becomes profitable, as well as the most promising progenies from an economic point of view. The fruit yield data upon which the present work was based were obtained during the period from 2001 to 2005, in an experiment that evaluated 20 custard apple half-sibling progenies, under sprinkler irrigation. The progenies were evaluated in a random block design with five replicates and plots consisting of four plants each. The exploitation of custard apple progenies only showed to be a profitable agribusiness after the fourth year. Before that, only A3 and A4 progenies in the second year, and P3 and P11 in the third year provided profitable incomes. Considering the methodological assumptions imposed concerning the time period analysis and the prices as of July 2007, the most important profitability indicators (operating profit, return index and equilibrium price evidenced that the A4 progeny is the most recommended, although other progenies are also highlighted, such as FJ1 and FJ2. As already discussed, the progenies showing the highest average yields of five harvests are not always the most economically recommendable ones.O presente trabalho tem como objetivo estimar o custo de produção e indicadores econômicos, relativos à produção e comercialização de frutos de 20 progênies de pinheiras, nas cinco primeiras safras, visando a identificar a safra a partir da qual a exploração da pinheira é lucrativa e as progênies mais promissoras, do ponto de vista econômico. Os dados de rendimentos de frutos em que se baseou o presente trabalho, foram obtidos no período de 2001 a 2005, em um experimento de avaliação de 20 progênies de meias-irmãs de pinheira, com irriga

  19. Synthesis of the ICT4RED initiative

    CSIR Research Space (South Africa)

    Herselman, M

    2014-12-01

    Full Text Available on Sustainability and how value is derived through improved decision-making. The issue of sustainability, and how it plays an important role in the ICT4RED initiative, is discussed. Total Cost of Ownership-, Cost utility- and Tablet selection-models, which were...&E), models, guidelines and tools. Arranged access to digital content on the content servers at each school which teachers and learners can download via Wi-Fi to their tablets. Access to McMillan and Pearson e-books. Developed processes...

  20. Tankering Fuel: A Cost Saving Initiative

    Science.gov (United States)

    2011-05-01

    2.41075 RIO DE JANEIRO IAP SBGL OS 3.1867 Riyadh Mil Apt Saudi A OERY OS 2.5587 Riyadh Mil Apt Saudi A OERY OS 2.5396 ROANOKE RGNLWOODRUM FLD KROA...US NGB NORTHCOM Davis Monthan AFB KDMA AF Arizona US ACC NORTHCOM Davision Army Airfield ARMY Virginia US IMCOM NORTHCOM Des Moines ANG KDSM AF...Carolina US NULL NORTHCOM MCAS New River NAVY North Carolina US NULL NORTHCOM MCAS Yuma KYUM NAVY Arizona US NULL NORTHCOM MCB 29 Palms NAVY

  1. Full dose CHOP chemotherapy

    International Nuclear Information System (INIS)

    Tominaga, Shinichi; Kondo, Makoto; Ando, Yutaka; Yamashita, Shoji; Uematsu, Minoru; Shigematsu, Naoyuki; Nishiguchi, Iku; Hashimoto, Shozo

    1985-01-01

    Since 1982, we have performed 125 courses of CHOP chemotherapy for 27 patients of malignancy, adhering to the original regimen as strictly as possible. CHOP chemotherapy consisted of Cyclophosphamide 750 mg/m 2 , iv, on day 1; Adriamycin 50 mg/m 2 , iv, on day 1; Vincristine 1.4 mg/m 2 , iv, on day 1 (maximum single dose 2.0 mg) and Prednisolone 50 mg/m 2 , po, day 1 through 5. The cycle was repeated every 21 days. As side effects, myelosuppression, hair loss, fever, nausea, vomiting, liver dysfunction, stomatitis, neuropathy, herpes zoster, arrhythmia and hemorrhagic cystitis were seen. Due to myelosuppression, twenty patients experienced febrile episodes at each nadir of WBC counts on 40 courses. However, any febrile patient did not have life threatening infection. Other side effects were also reversible. The radiotherapy of most patients was carried out as initially scheduled, except for 3 patients in whom irradiation was interrupted due to severe stomatitis or herpes zoster. We consider that CHOP chemotherapy is excellent in feasibility even when combined with radiotherapy. (author)

  2. Plate Full of Color

    Centers for Disease Control (CDC) Podcasts

    2008-08-04

    The Eagle Books are a series of four books that are brought to life by wise animal characters - Mr. Eagle, Miss Rabbit, and Coyote - who engage Rain That Dances and his young friends in the joy of physical activity, eating healthy foods, and learning from their elders about health and diabetes prevention. Plate Full of Color teaches the value of eating a variety of colorful and healthy foods.  Created: 8/4/2008 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 8/5/2008.

  3. Analysis of Cost of Rework on Time and Cost Performance of Building Construction Projects in Abuja, Nigeria

    Directory of Open Access Journals (Sweden)

    Emmanuel Chidiebere Eze

    2018-01-01

    Full Text Available Rework is a menace that leads to undesired and unnecessary loss of efforts, it degrades project cost and schedule performance of construction projects, both at design and construction phases. This study therefore, analyzed the impact of cost of rework on time and cost performance of building construction projects in Nigerian, using selected commercial building project within the country’s capital. A pro forma was adopted for gathering data on rework cost, project cost and time of selected building projects, while structured questionnaire was used to collect information on the likely measures for reducing rework incidences from construction professionals that were involved in the delivery of the identified projects. Regression analysis, relative importance index and Kruskal-Walis test were employed for data analysis. The study revealed a significant relationship between the cost of rework and initial and final project cost of delivering commercial buildings, as an average of 3.53% impact on the initial project cost, 46.60% contribution to cost overrun, and p-value of 0.000 was observed on all assessed projects. For the project delivery time, a significant relationship between the cost of rework and initial and final project duration, as an average of 7.35% impact on the initial delivery time, extra 19 days and p-value of 0.000 was observed on all assessed projects. Team building and education, management commitment, employee involvement, were some of the best possible measures to minimized rework problems.

  4. The cost of antiretroviral therapy in Haiti

    Directory of Open Access Journals (Sweden)

    Fitzgerald Daniel W

    2008-02-01

    Full Text Available Abstract Background We determined direct medical costs, overhead costs, societal costs, and personnel requirements for the provision of antiretroviral therapy (ART to patients with AIDS in Haiti. Methods We examined data from 218 treatment-naïve adults who were consecutively initiated on ART at the GHESKIO Center in Port-au-Prince, Haiti between December 23, 2003 and May 20, 2004 and calculated costs and personnel requirements for the first year of ART. Results The mean total cost of treatment per patient was $US 982 including $US 846 in direct costs, $US 114 for overhead, and $US 22 for societal costs. The direct cost per patient included generic ART medications $US 355, lab tests $US 130, nutrition $US 117, hospitalizations $US 62, pre-ART evaluation $US 58, labor $US 51, non-ART medications $US 39, outside referrals $US 31, and telephone cards for patient retention $US 3. Higher treatment costs were associated with hospitalization, change in ART regimen, TB treatment, and survival for one year. We estimate that 1.5 doctors and 2.5 nurses are required to treat 1000 patients in the first year after initiating ART. Conclusion Initial ART treatment in Haiti costs approximately $US 1,000 per patient per year. With generic first-line antiretroviral drugs, only 36% of the cost is for medications. Patients who change regimens are significantly more expensive to treat, highlighting the need for less-expensive second-line drugs. There may be sufficient health care personnel to treat all HIV-infected patients in urban areas of Haiti, but not in rural areas. New models of HIV care are needed for rural areas using assistant medical officers and community health workers.

  5. HBA1C CONTROL AND COST-EFFECTIVENESS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS INITIATED ON CANAGLIFLOZIN OR A GLUCAGON-LIKE PEPTIDE 1 RECEPTOR AGONIST IN A REAL-WORLD SETTING.

    Science.gov (United States)

    Wysham, Carol H; Pilon, Dominic; Ingham, Mike; Lafeuille, Marie-Hélène; Emond, Bruno; Kamstra, Rhiannon; Pfeifer, Michael; Lefebvre, Patrick

    2018-03-01

    To compare glycated hemoglobin (HbA1c) control and medication costs between patients with type 2 diabetes mellitus (T2DM) treated with canagliflozin 300 mg (CANA) or a glucagon-like peptide 1 receptor agonist (GLP-1 RA) in a real-world setting. Adults with T2DM newly initiated on CANA or a GLP-1 RA (index date) were identified from IQVIA ™ Real-World Data Electronic Medical Records U.S. database (March 29, 2012-April 30, 2016). Inverse probability of treatment weighting accounted for differences in baseline characteristics. HbA1c levels at 3-month intervals were compared using generalized estimating equations. Medication costs used wholesale acquisition costs. For both cohorts (CANA: n = 11,435; GLP-1 RA: n = 11,582), HbA1c levels decreased at 3 months postindex and remained lower through 30 months. Absolute changes in mean HbA1c from index to 3 months postindex for CANA and GLP-1 RA were -1.16% and -1.21% (patients with baseline HbA1c ≥7% [53 mmol/mol]); -1.54% and -1.51% (patients with baseline HbA1c ≥8% [64 mmol/mol]); and -2.13% and -1.99% (patients with baseline HbA1c ≥9% [75 mmol/mol]), respectively. Postindex, CANA patients with baseline HbA1c ≥7% had similar HbA1c levels at each interval versus GLP-1 RA patients, except 9 months (mean HbA1c, 7.75% [61 mmol/mol] vs. 7.86% [62 mmol/mol]; P = .0305). CANA patients with baseline HbA1c ≥8% and ≥9% had consistently lower HbA1c numerically versus GLP-1 RA patients and statistically lower HbA1c at 9 (baseline HbA1c ≥8% or ≥9%), 27, and 30 months (baseline HbA1c ≥9%). Continuous 12-month medication cost $3,326 less for CANA versus GLP-1 RA. This retrospective study demonstrated a similar evolution of HbA1c levels among CANA and GLP-1 RA patients in a real-world setting. Lower medication costs suggest CANA is economically dominant over GLP-1 RA (similar effectiveness, lower cost). AHA = antihyperglycemic agent BMI = body mass index CANA = canagliflozin 300 mg DCSI = diabetes complications severity

  6. Emptiness and Fullness

    DEFF Research Database (Denmark)

    Bregnbæk, Susanne; Bunkenborg, Mikkel

    As critical voices question the quality, authenticity, and value of people, goods, and words in post-Mao China, accusations of emptiness render things open to new investments of meaning, substance, and value. Exploring the production of lack and desire through fine-grained ethnography, this volume...... examines how diagnoses of emptiness operate in a range of very different domains in contemporary China: In the ostensibly meritocratic exam system and the rhetoric of officials, in underground churches, housing bubbles, and nationalist fantasies, in bodies possessed by spirits and evaluations of jade......, there is a pervasive concern with states of lack and emptiness and the contributions suggest that this play of emptiness and fullness is crucial to ongoing constructions of quality, value, and subjectivity in China....

  7. Initial Experience With Tofacitinib in Clinical Practice: Treatment Patterns and Costs of Tofacitinib Administered as Monotherapy or in Combination With Conventional Synthetic DMARDs in 2 US Health Care Claims Databases.

    Science.gov (United States)

    Harnett, James; Curtis, Jeffrey R; Gerber, Robert; Gruben, David; Koenig, Andrew

    2016-06-01

    Tofacitinib is an oral Janus kinase inhibitor indicated for the treatment of rheumatoid arthritis (RA). Tofacitinib can be administered as a monotherapy or in combination with conventional synthetic disease-modifying antirheumatic drugs (DMARDs). This study describes RA patients' characteristics, treatment patterns, and costs for those initiating tofacitinib treatment as monotherapy or combination therapy, using US claims data from clinical practice. A retrospective cohort analysis of patients aged ≥18 years with RA (International Classification of Diseases, Ninth Revision code 714.xx) and with ≥1 tofacitinib claim in the Truven Marketscan (TM) or the Optum Clinformatics (OC) database. Index was defined as the first tofacitinib fill date (November 2012-June 2014). Patients were continuously enrolled for ≥12 months before and after index. Adherence was assessed using the proportion of days covered (PDC) and medication possession ratio (MPR). Persistence was evaluated using a 1.5× days' supply gap or switch. All-cause and RA-related costs in the 12-month pre- and post-index periods were evaluated. Unadjusted and adjusted analyses were conducted on data on treatment patterns and costs stratified by monotherapy status. A total of 337 (TM) and 118 (OC) tofacitinib patients met the selection criteria; 52.2% (TM) and 50.8% (OC) received monotherapy and 83.7% (TM) and 76.3% (OC) had pre-index biologic DMARD experience. Twelve-month mean PDC values were 0.56 (TM) and 0.53 (OC), and 12-month mean MPR was 0.84 (TM) and 0.80 (OC), with persistence of 140.0 (TM) and 124.6 (OC) days. Between 12-month pre- and post-index periods, mean (SD) 12-month RA-related medical costs decreased by $5784 ($31,832) in TM and $6103 ($25,897) in OC (both, P tofacitinib knowledge base and will enable informed clinical and policy decision making based on valuable datasets independent of randomized controlled trials. Copyright © 2016 Elsevier HS Journals, Inc. All rights reserved.

  8. Full metal jacket!

    CERN Document Server

    Laëtitia Pedroso

    2011-01-01

    Ten years ago, standard issue clothing only gave CERN firemen partial protection but today our fire-fighters are equipped with state-of-the-art, full personal protective equipment.   CERN's Fire Brigade team. For many years, the members of CERN's Fire Brigade went on call-outs clad in their work trousers and fire-rescue coats, which only afforded them partial protection. Today, textile manufacturing techniques have moved on a long way and CERN's firemen are now kitted out with state-of-the-art personal protective equipment. The coat and trousers are three-layered, comprising fire-resistant aramide, a protective membrane and a thermal lining. The CERN Fire Brigade' new state-of-the-art personal protection equipment. "This equipment is fully compliant with the standards in force and is therefore resistant to cuts, abrasion, electrical arcs with thermal effects and, of course, fire," explains Patrick Berlinghi, the CERN Fire Brigade's Logistics Officer. You might think that su...

  9. Policies for full employment

    DEFF Research Database (Denmark)

    de Koning, Jaap; Layard, Richard; Nickel, Stephen

    European unemployment is too high, and employment is too low. Over 7½ per cent of Europe's workforce is unemployed, and only two thirds of people aged 15-64 are in work. At the Lisbon summit two years ago the heads of government set the target that by 2010 the employment rate should rise from 64...... per cent to at least 70 per cent. And for older workers between 55 and 64 the employment rate should rise from 38 per cent to at least one half. These are ambitious targets. They will require two big changes: more people must seek work, and among those seeking work a higher proportion must get a job....... So we need higher participation, and (for full employment) we need a much lower unemployment rate. Can it be done? A mere glance at the experience of different European countries shows that it can. As Table 1 shows, four E.U. countries already exceed the overall target for 2010 (Britain, Denmark...

  10. Low-Cost IoT: A Holistic Approach

    Directory of Open Access Journals (Sweden)

    Augusto Ciuffoletti

    2018-05-01

    Full Text Available The key factors for a successful smart-city project are its initial cost and its scalability. The initial cost depends on several inter-related aspects that cannot be designed and optimized separately. After the pilot deployment, scaling-up takes place only if the cost remains affordable: an initial financial support may induce dependencies from technologies that become unsustainable in the long period. In addition, the initial adoption of an emerging technology that fails to affirm may jeopardize investment return. This paper investigates a smart-village use case, the success of which strongly depends on the initial cost and scalability, exploring a low-cost way for Internet of Things (IoT. We propose a simple conceptual framework for cost evaluation, and we verify its effectiveness with an exhaustive use case: a prototype sensor designed and tested with its surrounding eco-system. Using experimental results, we can estimate both performance and cost for a pilot system made of fifty sensors deployed in an urban area. We show that such cost grows linearly with system size, taking advantage of widely adopted technologies. The code and the design of the prototype are available, so that all steps are reproducible.

  11. COSTS CALCULATION OF TARGET COSTING METHOD

    Directory of Open Access Journals (Sweden)

    Sebastian UNGUREANU

    2014-06-01

    Full Text Available Cost information system plays an important role in every organization in the decision making process. An important task of management is ensuring control of the operations, processes, sectors, and not ultimately on costs. Although in achieving the objectives of an organization compete more control systems (production control, quality control, etc., the cost information system is important because monitors results of the other. Detailed analysis of costs, production cost calculation, quantification of losses, estimate the work efficiency provides a solid basis for financial control. Knowledge of the costs is a decisive factor in taking decisions and planning future activities. Managers are concerned about the costs that will appear in the future, their level underpinning the supply and production decisions as well as price policy. An important factor is the efficiency of cost information system in such a way that the information provided by it may be useful for decisions and planning of the work.

  12. Potential cost savings with terrestrial rabies control

    Directory of Open Access Journals (Sweden)

    Cherry Bryan

    2007-04-01

    Full Text Available Abstract Background The cost-benefit of raccoon rabies control strategies such as oral rabies vaccination (ORV are under evaluation. As an initial quantification of the potential cost savings for a control program, the collection of selected rabies cost data was pilot tested for five counties in New York State (NYS in a three-year period. Methods Rabies costs reported to NYS from the study counties were computerized and linked to a human rabies exposure database. Consolidated costs by county and year were averaged and compared. Results Reported rabies-associated costs for all rabies variants totalled $2.1 million, for human rabies postexposure prophylaxes (PEP (90.9%, animal specimen preparation/shipment to laboratory (4.7%, and pet vaccination clinics (4.4%. The proportion that may be attributed to raccoon rabies control was 37% ($784,529. Average costs associated with the raccoon variant varied across counties from $440 to $1,885 per PEP, $14 to $44 per specimen, and $0.33 to $15 per pet vaccinated. Conclusion Rabies costs vary widely by county in New York State, and were associated with human population size and methods used by counties to estimate costs. Rabies cost variability must be considered in developing estimates of possible ORV-related cost savings. Costs of PEPs and specimen preparation/shipments, as well as the costs of pet vaccination provided by this study may be valuable for development of more realistic scenarios in economic modelling of ORV costs versus benefits.

  13. Manufacturing Initiative

    Data.gov (United States)

    National Aeronautics and Space Administration — The Advanced Manufacturing Technologies (AMT) Project supports multiple activities within the Administration's National Manufacturing Initiative. A key component of...

  14. Potential and Challenges of Low-Cost and High-Tech Crowd-sensing Approaches in Hydrometeorology for Better Water Resources Management - Insights and Learnings from the Global iMoMo Initiative

    Science.gov (United States)

    Siegfried, Tobias

    2016-04-01

    In developing and transition countries and despite significant global investments in hydrometeorology, data on water remain scarce/fragmented. One key reason is that traditional sensing in hydrology, hydro- and agro-meteorology does not scale because of high investment costs and difficult maintenance of traditional technology, esp. in remote and/or poor regions. Even where there are data, these are often difficult to access and interpret for local stakeholders due outdated data transmission and the lack of access to modern tools for data management/analysis/synthesis and exchange. In recent years, there have been substantial technology developments in environmental sensing and mobile communication technology that enable the application and deployment of affordable and scalable high-tech solutions for better water monitoring at different scales (local to transboundary levels). The WMO is acknowledging and promoting the potential for application of these technologies. One key aspect is to anchor these technologies in local communities that perform crowd-sensing tasks on a regular basis. The merits as well as challenges (including introduction of human factor, less accuracy as compared to traditional sensing, intermittency of data, …) of such approaches will be discussed in the context of the WMO-led Global iMoMo Initiative and its numerous activities on the ground in Eastern and Southern Africa as well as in Central Asia.

  15. Estimation of marginal costs at existing waste treatment facilities

    DEFF Research Database (Denmark)

    Martinez Sanchez, Veronica; Hulgaard, Tore; Hindsgaul, Claus

    2016-01-01

    , marginal costs were not (provided a response was initiated at the WtE to keep constant the utilized thermal capacity). Failing to systematically address and include costs in existing waste facilities in decision-making may unintendedly lead to higher overall costs at societal level. To avoid misleading...... a constant thermal load, (ii) Refused-Derived-Fuel (RDF) was included to maintain a constant thermal load, or (iii) no reaction occurred resulting in a reduced waste throughput without full utilization of the facility capacity. Results demonstrated that marginal costs of diversion from WtE were up to eleven...

  16. Cost and performance of innovative remediation technologies

    International Nuclear Information System (INIS)

    Cummings, J.B.; Kingscott, J.W.; Fiedler, L.D.

    1995-01-01

    The selection and use of more cost-effective remedies requires better access to data on the performance and cost of technologies used in the field. To make data more widely available, the US Environmental Protection Agency is working jointly with member agencies of the Federal Remediation Technologies Round table to publish case studies of full-scale remediation and demonstration projects. EPA, DoD, and DOE have published case studies of cleanup projects primarily consisting of bioremediation, soil vapor extraction, and thermal desorption. Within the limits of this initial data set, the paper evaluates technology performance and cost. In the analysis of cost factors, the paper shows the use of a standardized Work Breakdown Structure (WBS). Use of the WBS will be important in future reporting of completed projects to facilitate cost comparison. The paper notes the limits to normalization and thus cross-site comparison which can be achieved using the WBS. The paper identifies conclusions from initial efforts to compile cost and performance data, highlights the importance of such efforts to the overall remediation effort, and discusses future cost and performance documentation efforts

  17. Information Technology Budgets and Costs: Do You Know What Your Information Technology Costs Each Year?

    Science.gov (United States)

    Dugan, Robert E.

    2002-01-01

    Discusses yearly information technology costs for academic libraries. Topics include transformation and modernization activities that affect prices and budgeting; a cost model for information technologies; life cycle costs, including initial costs and recurring costs; cost benchmarks; and examples of pressures concerning cost accountability. (LRW)

  18. COST MEASUREMENT AND COST MANAGEMENT IN TARGET COSTING

    Directory of Open Access Journals (Sweden)

    Moisello Anna Maria

    2012-07-01

    Full Text Available Firms are coping with a competitive scenario characterized by quick changes produced by internationalization, concentration, restructuring, technological innovation processes and financial market crisis. On the one hand market enlargement have increased the number and the segmentation of customers and have raised the number of competitors, on the other hand technological innovation has reduced product life cycle. So firms have to adjust their management models to this scenario, pursuing customer satisfaction and respecting cost constraints. In a context where price is a variable fixed by the market, firms have to switch from the cost measurement logic to the cost management one, adopting target costing methodology. The target costing process is a price driven, customer oriented profit planning and cost management system. It works, in a cross functional way, from the design stage throughout all the product life cycle and it involves the entire value chain. The process implementation needs a costing methodology consistent with the cost management logic. The aim of the paper is to focus on Activity Based Costing (ABC application to target costing process. So: -it analyzes target costing logic and phases, basing on a literary review, in order to highlight the costing needs related to this process; -it shows, through a numerical example, how to structure a flexible ABC model – characterized by the separation between variable, fixed in the short and fixed costs - that effectively supports target costing process in the cost measurement phase (drifting cost determination and in the target cost alignment; -it points out the effectiveness of the Activity Based Costing as a model of cost measurement applicable to the supplier choice and as a support for supply cost management which have an important role in target costing process. The activity based information allows a firm to optimize the supplier choice by following the method of minimizing the

  19. Optimal Cost-Analysis and Design of Circular Footings

    Directory of Open Access Journals (Sweden)

    Prabir K. Basudhar

    2012-10-01

    Full Text Available The study pertains to the optimal cost-analysis and design of a circular footing subjected to generalized loadings using sequential unconstrained minimization technique (SUMT in conjunction with Powell’s conjugate direction method for multidimensional search and quadratic interpolation method for one dimensional minimization. The cost of the footing is minimized satisfying all the structural and geotechnical engineering design considerations. As extended penalty function method has been used to convert the constrained problem into an unconstrained one, the developed technique is capable of handling both feasible and infeasible initial design vector. The net saving in cost starting from the best possible manual design ranges from 10 to 20 %. For all practical purposes, the optimum cost is independent of the initial design point. It was observed that for better convergence, the transition parameter  should be chosen at least 100 times the initial penalty parameter kr .

  20. Ports Initiative

    Science.gov (United States)

    EPA's Ports Initiative works in collaboration with the port industry, communities, and government to improve environmental performance and increase economic prosperity. This effort helps people near ports breath cleaner air and live better lives.

  1. The cost of hemodialysis in a large hemodialysis center

    Directory of Open Access Journals (Sweden)

    Khalid Al Saran

    2012-01-01

    Full Text Available To assess the cost of hemodialysis (HD delivered at our center according to the treatment protocols based on the current Kidney Disease Outcome Quality Initiative (K/DOQI guidelines, we analyzed our cost data during the period from 1st of January 2007 to 30th of June 2010. The methods were used to determine both direct costs (related to dialysis treatment such as dialysis disposables, dialysis related drugs, medical personnel, out-patient medications, laboratory and other ancillary services and overhead costs (building, maintenance and engineering costs, housekeeping, and administrative personnel. During the study period, an average of 2,500 HD sessions per month were performed for 200 patients. The mean total cost per HD session was calculated as 297 US dollars (USD [1,114 Saudi Riyals (SR], and the mean total cost of dialysis per patient per year was 46,332 USD (173,784 SR. Direct costs contributed to 81.15% of the total cost from which the personnel cost represented 41.11% and dialysis disposables represented 13.64%, while medications (outpatient and intravenous dialysis related medications including albumin, erythropoiesis stimulating agents, iron and vitamin D3 accounted for 12.47% of the total cost. Our total cost level is well below the average cost in the industrialized countries.

  2. Cost Analysis in Shoulder Arthroplasty Surgery

    Directory of Open Access Journals (Sweden)

    Matthew J. Teusink

    2012-01-01

    Full Text Available Cost in shoulder surgery has taken on a new focus with passage of the Patient Protection and Affordable Care Act. As part of this law, there is a provision for Accountable Care Organizations (ACOs and the bundled payment initiative. In this model, one entity would receive a single payment for an episode of care and distribute funds to all other parties involved. Given its reproducible nature, shoulder arthroplasty is ideally situated to become a model for an episode of care. Currently, there is little research into cost in shoulder arthroplasty surgery. The current analyses do not provide surgeons with a method for determining the cost and outcomes of their interventions, which is necessary to the success of bundled payment. Surgeons are ideally positioned to become leaders in ACOs, but in order for them to do so a methodology must be developed where accurate costs and outcomes can be determined for the episode of care.

  3. Assessing the Multiple Benefits of Clean Energy Full Report

    Science.gov (United States)

    Guidance for state energy, environmental, and economic policy makers to identify and quantify the many benefits of clean energy to support the development and implementation of cost-effective clean energy initiatives.

  4. Full MOX core for PWRs

    International Nuclear Information System (INIS)

    Puill, A.; Aniel-Buchheit, S.

    1997-01-01

    Plutonium management is a major problem of the back end of the fuel cycle. Fabrication costs must be reduced and plant operation simplified. The design of a full MOX PWR core would enable the number of reactors devoted to plutonium recycling to be reduced and fuel zoning to be eliminated. This paper is a contribution to the feasibility studies for achieving such a core without fundamental modification of the current design. In view of the differences observed between uranium and plutonium characteristics it seems necessary to reconsider the safety of a MOX-fuelled PWR. Reduction of the control worth and modification of the moderator density coefficient are the main consequences of using MOX fuel in a PWR. The core reactivity change during a draining or a cooling is thus of prime interest. The study of core global draining leads to the following conclusion: only plutonium fuels of very poor quality (i.e. with low fissile content) cannot be used in a 900 MWe PWR because of a positive global voiding reactivity effect. During a cooling accident, like an spurious opening of a secondary-side valve, the hypothetical return to criticality of a 100% MOX core controlled by means of 57 control rod clusters (made of hafnium-clad B 4 C rods with a 90% 10 B content) depends on the isotopic plutonium composition. But safety criteria can be complied with for all isotopic compositions provided the 10 B content of the soluble boron is increased to a value of 40%. Core global draining and cooling accidents do not present any major obstacle to the feasibility of a 100% MOX PWR, only minor hardware modifications will be required. (author)

  5. Lives Saved Tool (LiST costing: a module to examine costs and prioritize interventions

    Directory of Open Access Journals (Sweden)

    Lori A. Bollinger

    2017-11-01

    Full Text Available Abstract Background Achieving the Sustainable Development Goals will require careful allocation of resources in order to achieve the highest impact. The Lives Saved Tool (LiST has been used widely to calculate the impact of maternal, neonatal and child health (MNCH interventions for program planning and multi-country estimation in several Lancet Series commissions. As use of the LiST model increases, many have expressed a desire to cost interventions within the model, in order to support budgeting and prioritization of interventions by countries. A limited LiST costing module was introduced several years ago, but with gaps in cost types. Updates to inputs have now been added to make the module fully functional for a range of uses. Methods This paper builds on previous work that developed an initial version of the LiST costing module to provide costs for MNCH interventions using an ingredients-based costing approach. Here, we update in 2016 the previous econometric estimates from 2013 with newly-available data and also include above-facility level costs such as program management. The updated econometric estimates inform percentages of intervention-level costs for some direct costs and indirect costs. These estimates add to existing values for direct cost requirements for items such as drugs and supplies and required provider time which were already available in LiST Costing. Results Results generated by the LiST costing module include costs for each intervention, as well as disaggregated costs by intervention including drug and supply costs, labor costs, other recurrent costs, capital costs, and above-service delivery costs. These results can be combined with mortality estimates to support prioritization of interventions by countries. Conclusions The LiST costing module provides an option for countries to identify resource requirements for scaling up a maternal, neonatal, and child health program, and to examine the financial impact of different

  6. Full MOX core design in ABWR

    International Nuclear Information System (INIS)

    Ihara, Toshiteru; Mochida, Takaaki; Izutsu, Sadayuki; Fujimaki, Shingo

    2003-01-01

    Electric Power Development Co., Ltd. (EPDC) has been investigating an ABWR plant for construction at Oma-machi in Aomori Prefecture. The reactor, termed FULL MOX-ABWR will have its reactor core eventually loaded entirely with mixed-oxide (MOX) fuel. Extended use of MOX fuel in the plant is expected to play important roles in the country's nuclear fuel recycling policy. MOX fuel bundles will initially be loaded only to less than one-third of the reactor, but will be increased to cover its entire core eventually. The number of MOX fuel bundles in the core thus varies anywhere from 0 to 264 for the initial cycle and, 0 to 872 for equilibrium cycles. The safety design of the FULL MOX-ABWR briefly stated next considers any probable MOX loading combinations out of such MOX bundle usage scheme, starting from full UO 2 to full MOX cores. (author)

  7. overall cost in recurrent soft-tissue sarcoma

    Directory of Open Access Journals (Sweden)

    Arash O. Naghavi

    2017-01-01

    Full Text Available Purpose : Adjuvant brachytherapy (AB with immediate (IR and staged reconstruction (SR are distinct treatment modalities available for patients with recurrent soft tissue sarcoma (STS. Although SR may offer local control and toxicity benefit, it requires additional upfront procedures, and there is no evidence that it improves overall survival. With the importance of value-based care, our goal is to identify which technique is more cost effective. Material and methods : A retrospective review of 22 patients with recurrent extremity STS treated with resection followed by AB alone. Hospital charges were used to compare the cost between SR and IR at the time of initial treatment, at 6-month intervals following surgery, and cumulative cost comparisons at 18 months. Results : Median follow-up was 31 months. Staged reconstruction (n = 12 was associated with an 18-month local control benefit (85% vs. 42%, p = 0.034, compared to IR (n = 10. Staged reconstruction had a longer hospital stay during initial treatment (10 vs. 3 days, p = 0.002, but at 18 months, the total hospital stay was no longer different (11 vs. 11 days. Initially, there was no difference in the cost of SR and IR. With longer follow-up, cost eventually favored SR, which was attributed primarily to the costs associated with local failure (LF. On multivariate analysis, cost of initial treatment was associated with length of hospital stay (~$4.5K per hospital day, p < 0.001, and at 18 months, the cumulative cost was ~175K lower with SR (p = 0.005 and $58K higher with LF (p = 0.02. Conclusions : In recurrent STS, SR has a longer initial hospital stay when compared to IR. At 18 months, SR had lower rates of LF, translating to lower total costs for the patient. SR is the more cost-effective brachytherapy approach in the treatment of STS, and should be considered as healthcare transitions into value-based medicine.

  8. Review of the cost of venous thromboembolism

    Directory of Open Access Journals (Sweden)

    Fernandez MM

    2015-08-01

    Full Text Available Maria M Fernandez,1 Susan Hogue,1 Ronald Preblick,2 Winghan Jacqueline Kwong2 1RTI-Health Solutions, Market Access and Outcomes Strategy, Research Triangle Park, NC, 2Daiichi Sankyo, Inc., Health Economics & Outcomes Research, Parsippany, NJ, USA Background: Venous thromboembolism (VTE is the second most common medical complication and a cause of excess length of hospital stay. Its incidence and economic burden are expected to increase as the population ages. We reviewed the recent literature to provide updated cost estimates on VTE management. Methods: Literature search strategies were performed in PubMed, Embase, Cochrane Collaboration, Health Economic Evaluations Database, EconLit, and International Pharmaceutical Abstracts from 2003–2014. Additional studies were identified through searching bibliographies of related publications. Results: Eighteen studies were identified and are summarized in this review; of these, 13 reported data from the USA, four from Europe, and one from Canada. Three main cost estimations were identified: cost per VTE hospitalization or per VTE readmission; cost for VTE management, usually reported annually or during a specific period; and annual all-cause costs in patients with VTE, which included the treatment of complications and comorbidities. Cost estimates per VTE hospitalization were generally similar across the US studies, with a trend toward an increase over time. Cost per pulmonary embolism hospitalization increased from $5,198–$6,928 in 2000 to $8,764 in 2010. Readmission for recurrent VTE was generally more costly than the initial index event admission. Annual health plan payments for services related to VTE also increased from $10,804–$16,644 during the 1998–2004 period to an estimated average of $15,123 for a VTE event from 2008 to 2011. Lower costs for VTE hospitalizations and annualized all-cause costs were estimated in European countries and Canada. Conclusion: Costs for VTE treatment are

  9. What is the value of routinely testing full blood count, electrolytes and urea, and pulmonary function tests before elective surgery in patients with no apparent clinical indication and in subgroups of patients with common comorbidities: a systematic review of the clinical and cost-effective literature.

    Science.gov (United States)

    Czoski-Murray, C; Lloyd Jones, M; McCabe, C; Claxton, K; Oluboyede, Y; Roberts, J; Nicholl, J P; Rees, A; Reilly, C S; Young, D; Fleming, T

    2012-12-01

    The evidence base which supported the National Institute for Health and Clinical Excellence (NICE) published Clinical Guideline 3 was limited and 50% was graded as amber. However, the use of tests as part of pre-operative work-up remains a low-cost but high-volume activity within the NHS, with substantial resource implications. The objective of this study was to identify, evaluate and synthesise the published evidence on the clinical effectiveness and cost-effectiveness of the routine use of three tests, full blood counts (FBCs), urea and electrolytes tests (U&Es) and pulmonary function tests, in the pre-operative work-up of otherwise healthy patients undergoing minor or intermediate surgery in the NHS. The aims of this study were to estimate the clinical effectiveness and cost-effectiveness of routine pre-operative testing of FBC, electrolytes and renal function and pulmonary function in adult patients classified as American Society of Anaesthesiologists (ASA) grades 1 and 2 undergoing elective minor (grade 1) or intermediate (grade 2) surgical procedures; to compare NICE recommendations with current practice; to evaluate the cost-effectiveness of mandating or withdrawing each of these tests in this patient group; and to identify the expected value of information and whether or not it has value to the NHS in commissioning further primary research into the use of these tests in this group of patients. The following electronic bibliographic databases were searched: (1) BIOSIS; (2) Cumulative Index to Nursing and Allied Health Literature; (3) Cochrane Database of Systematic Reviews; (4) Cochrane Central Register of Controlled Trials; (5) EMBASE; (6) MEDLINE; (7) MEDLINE In-Process & Other Non-Indexed Citations; (8) NHS Database of Abstracts of Reviews of Effects; (9) NBS Health Technology Assessment Database; and (10) Science Citation Index. To identify grey and unpublished literature, the Cochrane Register of Controlled Trials, National Research Register Archive

  10. Initial Study

    DEFF Research Database (Denmark)

    Torp, Kristian

    2009-01-01

    increased. In the initial study presented here, the time it takes to pass an intersection is studied in details. Two major signal-controlled four-way intersections in the center of the city Aalborg are studied in details to estimate the congestion levels in these intersections, based on the time it takes...

  11. Restoration ecology: two-sex dynamics and cost minimization.

    Directory of Open Access Journals (Sweden)

    Ferenc Molnár

    Full Text Available We model a spatially detailed, two-sex population dynamics, to study the cost of ecological restoration. We assume that cost is proportional to the number of individuals introduced into a large habitat. We treat dispersal as homogeneous diffusion in a one-dimensional reaction-diffusion system. The local population dynamics depends on sex ratio at birth, and allows mortality rates to differ between sexes. Furthermore, local density dependence induces a strong Allee effect, implying that the initial population must be sufficiently large to avert rapid extinction. We address three different initial spatial distributions for the introduced individuals; for each we minimize the associated cost, constrained by the requirement that the species must be restored throughout the habitat. First, we consider spatially inhomogeneous, unstable stationary solutions of the model's equations as plausible candidates for small restoration cost. Second, we use numerical simulations to find the smallest rectangular cluster, enclosing a spatially homogeneous population density, that minimizes the cost of assured restoration. Finally, by employing simulated annealing, we minimize restoration cost among all possible initial spatial distributions of females and males. For biased sex ratios, or for a significant between-sex difference in mortality, we find that sex-specific spatial distributions minimize the cost. But as long as the sex ratio maximizes the local equilibrium density for given mortality rates, a common homogeneous distribution for both sexes that spans a critical distance yields a similarly low cost.

  12. Cost Accounting for Decision Makers.

    Science.gov (United States)

    Kaneklides, Ann L.

    1985-01-01

    Underscores the importance of informed decision making through accurate anticipation of cost incurrence in light of changing economic and environmental conditions. Explains the concepts of cost accounting, full allocation of costs, the selection of an allocation base, the allocation of indirect costs, depreciation, and implications for community…

  13. The Ethos of Cost Management

    Directory of Open Access Journals (Sweden)

    Sorinel Capusneanu

    2008-05-01

    Full Text Available This article describes the ethos of cost management, distinguishing the definition, functions and principles governing cost management. I have emphasized the efforts made by the specialists in the field towards finding a much more complete definition of cost management. The description of cost management principles reveals the current interest of the specialists in this extremely important domain of company management.

  14. [Cost-effectiveness analysis of sofosbuvir, peginterferon and ribavirin in patients with chronic hepatitis C: Early treatment in the initial stage of fibrosis vs. delayed treatment in advanced fibrosis].

    Science.gov (United States)

    Buti, María; Domínguez-Hernández, Raquel; Oyagüez, Itziar; Casado, Miguel Ángel

    2016-01-01

    Cost-effectiveness analysis of sofosbuvir combined with peginterferon alpha-2a and ribavirin (SOF/Peg-IFN/RBV) in early versus advanced fibrosis in previously untreated patients with chronic hepatitis C genotype 1 (CHC-GT1), from the perspective of the Spanish National Health System (NHS). A Markov model was developed to compare lifetime costs and outcomes (life years gained [LYGs] and quality-adjusted life years [QALYs]) of 2 treatment strategies: SOF/Peg-IFN/RBV administered during early fibrosis (mild-moderate fibrosis; F2-F3) or advanced fibrosis (cirrhosis; F4). Efficacy (sustained virologic response), annual transition probabilities, disease management costs and utilities were obtained from the literature. Costs and outcomes were discounted annually at 3%. Direct costs were considered, expressed in Euros (€, 2014). Probabilistic sensitivity analysis (PSA) was also performed. SOF/Peg-IFN/RBV therapy at F2-F3 was more effective (19.12 LYGs and 14.14 QALYs) compared to F4. In a cohort of 1,000 patients, SOF/Peg-IFN/RBV prevented 66 cases of decompensated cirrhosis, 60 hepatocellular carcinomas and 4 liver transplantations compared with therapy in advanced fibrosis. The total lifetime cost of early therapy (€43,263) was less than the cost of treatment in the advanced stage (€49,018). Early therapy was a dominant strategy, more effective and less costly in all simulations. In the PSA analysis, administration of SOF/PEG-IFN/RBV at F2-F3 was dominant in all simulations. Starting SOF/Peg-IFN/RBV therapy at F2-F3, compared with therapy at F4, reduced the incidence of liver disease complications and was associated with cost savings for the Spanish NHS in CHC-GT1 patients. Copyright © 2016 Elsevier España, S.L.U. y AEEH y AEG. All rights reserved.

  15. Full-scope training simulators

    International Nuclear Information System (INIS)

    Ugedo, E.

    1986-01-01

    The following topics to be covered in this report are: Reasons justifying the use of full-scope simulators for operator qualification. Full-scope simulator description: the control room, the physical models, the computer complex, the instructor's console. Main features of full-scope simulators. Merits of simulator training. The role of full-scope simulators in the training programs. The process of ordering and acquiring a full-scope simulator. Maintaining and updating simulator capabilities. (orig./GL)

  16. Costs of employee turnover

    Directory of Open Access Journals (Sweden)

    Jiří Duda

    2013-01-01

    Full Text Available The aim of this paper is to establish a general methodology for calculating the costs incurred by employee turnover. This paper deals with identification of costs incurred by the departure of an employee, and does not deal with the cost of recruitment of a new employee. Economic calculations are adjusted to the tax policy in the Czech Republic. The costs of employee turnover (according to Bliss, 2012 include the costs of substitution of the unoccupied position, costs of conducting the exit interview and termination of the contract. The cost of an executive’s time to understand the causes of leaving and costs of the leaving employee’s training were also determined. Important factors in the costs of employee turnover also include the loss of knowledge and possibly also a loss of customers. Costs of lost employee and department productiveness represent an important part of the costs of employee turnover, as well. For all of these costs there have been proposed general calculations formulas.

  17. Tracking environmental costs

    International Nuclear Information System (INIS)

    Blahutova, Z.

    2011-01-01

    Tracking Environmental Costs and Investments in SAP will provide us with a managerial tool that will help us understand better the magnitude of the financial resources we are dedicating to environmental protection activities and investments. Environmental Cost Accounting is a new project in Slovenske Elektrarne that will be particularly valuable for the Company's environmental management initiatives, such as waste monitoring, cleaner production, eco-design and environmental management systems; its launch is expected in September. (author)

  18. Quality of Security Service Costing Demonstration for the MSHN Project

    National Research Council Canada - National Science Library

    Spyropoulou, Evdoxia

    2000-01-01

    .... Each service has two costs: an initialization cost and a run-time cost. The demonstration illustrates the costs incurred as network modes and security levels are changed. High level and detailed specifications are provided.

  19. New economic initiatives are designed to protect the environment

    International Nuclear Information System (INIS)

    Fleet, B.; Fleet, N.S.

    1992-01-01

    The use of economic initiatives or economic instruments as an alternative to or as support for existing environmental legislation is reviewed. The most controversial area of economic incentives is the concept of creating a market in pollution rights. While emissions trading can enable economic growth in areas of high pollution, this approach is only marginally different than the traditional regulatory approach. Environmental economics is complex, with mixtures of private and public costs. Social costs include subsidies, waste treatment, landfill disposal costs, etc. More intangible social costs include public health costs and damage to the natural environment. Conventional economic approaches ignore most such social costs. Several European countries have started to develop a green gross national product (GNP) which sets out an alternative approach to the traditional measure of economic activity by subtracting a figure for harm to the environment from economic activity. This ambitious approach attempts to measure the costs of all toxic discharges along with the disappearance of plant and animal life and other environmental changes. A powerful new tool for the environmental manager is full cost accounting, which uses a long (10-20 y) window for projects, anticipates the impact of stricter discharge standards, and attempts to quantify a range of less tangible social costs elements, such as liability, improved environmental image, etc. Various strategies can be ranked on the basis of their future risk cost. The application of full cost accounting models, small business, computer models and expert systems, developing country debt-for-nature swaps, and environmental risk assessment are discussed. 12 refs

  20. Dynamic modeling and simulation of power transformer maintenance costs

    Directory of Open Access Journals (Sweden)

    Ristić Olga

    2016-01-01

    Full Text Available The paper presents the dynamic model of maintenance costs of the power transformer functional components. Reliability is modeled combining the exponential and Weibull's distribution. The simulation was performed with the aim of corrective maintenance and installation of the continuous monitoring system of the most critical components. Simulation Dynamic System (SDS method and VENSIM PLE software was used to simulate the cost. In this way, significant savings in maintenance costs will be achieved with a small initial investment. [Projekat Ministarstva nauke Republike Srbije, br. III 41025 i br. OI 171007

  1. Full Employment in Industrialized Countries.

    Science.gov (United States)

    Britton, Andrew

    1997-01-01

    Argues that full employment must be acceptable on both social and economic grounds. Examines profound changes in industrialized economies since the 1970s and the diversity of employment contracts. Suggests that difficult policy decisions surround full employment. (SK)

  2. Costing the lifecycle of networked learning: documenting the costs from conception to evaluation

    Directory of Open Access Journals (Sweden)

    Paul Bacsich

    2000-12-01

    Full Text Available Analysing the costs of new learning technologies within the educational sector is currently a neglected area, yet the issue of how to spend money effectively in this context is a question that must be answered. This question is made especially pertinent with the current expansion of information technology into higher and further education. To know the costeffectiveness of these initiatives, it is first necessary to gain some comprehension of the costs involved. This must be done in a way that is comprehensible to everyone in academia. A recently completed research study undertaken by the authors addressed these problems.

  3. Cost Behavior

    DEFF Research Database (Denmark)

    Hoffmann, Kira

    The objective of this dissertation is to investigate determinants and consequences of asymmetric cost behavior. Asymmetric cost behavior arises if the change in costs is different for increases in activity compared to equivalent decreases in activity. In this case, costs are termed “sticky......” if the change is less when activity falls than when activity rises, whereas costs are termed “anti-sticky” if the change is more when activity falls than when activity rises. Understanding such cost behavior is especially relevant for decision-makers and financial analysts that rely on accurate cost information...... to facilitate resource planning and earnings forecasting. As such, this dissertation relates to the topic of firm profitability and the interpretation of cost variability. The dissertation consists of three parts that are written in the form of separate academic papers. The following section briefly summarizes...

  4. Sustainable Agricultural Marketing Initiatives

    Directory of Open Access Journals (Sweden)

    Hakan Adanacıoğlu

    2015-07-01

    Full Text Available Sustainable marketing is a holistic approach that puts equal emphasis on environmental, social equity, and economic concerns in the development of marketing strategies. The purpose of the study is to examine and discuss the sustainable agricultural marketing initiatives practiced throughout the World and Turkey, and to put forth suggestions to further improve the performance of agricultural marketing initiatives in Turkey. Some of the sustainable agricultural marketing initiatives practiced around the world are carried out through civil organizations. Furthermore; some of these initiatives have also launched by farmers, consumers, food processors and retailers. The long-term strategies to increase these initiatives should be determined due to the fact that examples of successful sustainable agricultural marketing initiatives are inadequate and cannot be spread in Turkey. In this context, first of all, the supports provided by the government to improve agricultural marketing systems, such as EU funds for rural development should be compatible with the goals of sustainable marketing. For this purpose, it should be examined whether all proposed projects related to agricultural marketing meet the social, economic, and environmental principles of sustainable marketing. It is important that supporting organizations, especially civil society organisations, should take an active role for faster dissemination and adoption of sustainable agricultural marketing practices in Turkey. These organizations may provide technical assistance in preparing successful project proposals and training to farm groups. In addition, the other organizations, such as local administrations, producers' associations, cooperatives, can contribute to the success of sustainable agricultural marketing initiatives. The use of direct marketing strategies and vertical integration attempts in sustainable agricultural marketing initiatives that will likely be implemented in Turkey is

  5. Designer's unified cost model

    Science.gov (United States)

    Freeman, William T.; Ilcewicz, L. B.; Swanson, G. D.; Gutowski, T.

    1992-01-01

    A conceptual and preliminary designers' cost prediction model has been initiated. The model will provide a technically sound method for evaluating the relative cost of different composite structural designs, fabrication processes, and assembly methods that can be compared to equivalent metallic parts or assemblies. The feasibility of developing cost prediction software in a modular form for interfacing with state of the art preliminary design tools and computer aided design programs is being evaluated. The goal of this task is to establish theoretical cost functions that relate geometric design features to summed material cost and labor content in terms of process mechanics and physics. The output of the designers' present analytical tools will be input for the designers' cost prediction model to provide the designer with a data base and deterministic cost methodology that allows one to trade and synthesize designs with both cost and weight as objective functions for optimization. The approach, goals, plans, and progress is presented for development of COSTADE (Cost Optimization Software for Transport Aircraft Design Evaluation).

  6. Designers' unified cost model

    Science.gov (United States)

    Freeman, W.; Ilcewicz, L.; Swanson, G.; Gutowski, T.

    1992-01-01

    The Structures Technology Program Office (STPO) at NASA LaRC has initiated development of a conceptual and preliminary designers' cost prediction model. The model will provide a technically sound method for evaluating the relative cost of different composite structural designs, fabrication processes, and assembly methods that can be compared to equivalent metallic parts or assemblies. The feasibility of developing cost prediction software in a modular form for interfacing with state-of-the-art preliminary design tools and computer aided design programs is being evaluated. The goal of this task is to establish theoretical cost functions that relate geometric design features to summed material cost and labor content in terms of process mechanics and physics. The output of the designers' present analytical tools will be input for the designers' cost prediction model to provide the designer with a database and deterministic cost methodology that allows one to trade and synthesize designs with both cost and weight as objective functions for optimization. This paper presents the team members, approach, goals, plans, and progress to date for development of COSTADE (Cost Optimization Software for Transport Aircraft Design Evaluation).

  7. Logistics costs of the enterprise

    Directory of Open Access Journals (Sweden)

    Andrea Rosová

    2007-06-01

    Full Text Available The article describe a problem of specification and systematization of enterprise’s logistics costs. With in a growing division of labour, also logistics costs increase their part in enterprises total costs.Almost all decisions about products and production in general, influence logistics processes even logistics costs and performances.In present is not clear enough, which of the cost-particles are relevant fot logistics costs, because some of logistics cost-particles accounts within overhead are charged together with costs of other sorts.Substantive step in the process of the monitoring and evidence of logistics costs is definition of this, that costs of enterprise´s processes will be inclusive in logistics costs and determining points of contact with the others departments (acquisition, production, sale etc.. After the specification of meditation processes, there is a need to choose applicable parameters for the expression of logistics performances. Besides logistics costs is needed to know logistics performances equivalent herewith at a cost of, therefore from the control side have for enterprise bigger value indices expressive correlation costs and performances(e.g. share of logistics unit costs performance.At the proposal and evidence of logistics costs and performances is needed consistently entertain an individual conditions of enterprise. Because the area of processes included strongly affects the size of account logistics costs and its share part in total costs of enterprise. Logistics costs are flow line between economy and logistics of the enterprise.

  8. The Yekaterinburg headache initiative

    DEFF Research Database (Denmark)

    Lebedeva, Elena R; Olesen, Jes; Osipova, Vera V

    2013-01-01

    for a demonstrational interventional project in Russia, undertaken within the Global Campaign against Headache. The initiative proposes three actions: 1) raise awareness of need for improvement; 2) design and implement a three-tier model (from primary care to a single highly specialized centre with academic affiliation......) for efficient and equitable delivery of headache-related health care; 3) develop a range of educational initiatives aimed at primary-care physicians, non-specialist neurologists, pharmacists and the general public to support the second action. RESULTS AND CONCLUSION: We set these proposals in a context...... of a health-care needs assessment, and as a model for all Russia. We present and discuss early progress of the initiative, justify the investment of resources required for implementation and call for the political support that full implementation requires. The more that the Yekaterinburg headache initiative...

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

    Directory of Open Access Journals (Sweden)

    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.

  10. How Full is Full Employment? : How Tools and Not Theory Explained Full Employment

    NARCIS (Netherlands)

    Rodenburg, P.

    2016-01-01

    The post-war debate on full employment policy was blurred and unclear since the concept of full employment itself was theoretically unclear and un-operational. Unable to theoretically determine the unemployment level of full employment, economists tried to find more empirically based ways to

  11. The full circle of powerpoint

    DEFF Research Database (Denmark)

    Kjærgaard, Thomas

    This thesis investigates the use of Digital Technologies in University College teaching, with a particular focus on the use of Digital Technologies in lessons at Teacher Education at University College North, Denmark. The initial investigations in the thesis serve as the foundation for a series o...

  12. Openness initiative

    International Nuclear Information System (INIS)

    Duncan, S.S.

    1995-01-01

    Although antinuclear campaigns seem to be effective, public communication and education efforts on low-level radioactive waste have mixed results. Attempts at public information programs on low-level radioactive waste still focus on influencing public opinion. A question then is: open-quotes Is it preferable to have a program focus on public education that will empower individuals to make informed decisions rather than trying to influence them in their decisions?close quotes To address this question, a case study with both quantitative and qualitative data will be used. The Ohio Low-Level Radioactive Waste Education Program has a goal to provide people with information they want/need to make their own decisions. The program initiated its efforts by conducting a statewide survey to determine information needed by people and where they turned for that information. This presentation reports data from the survey and then explores the program development process in which programs were designed and presented using the information. Pre and post data from the programs reveal attitude and knowledge shifts

  13. Openness initiative

    Energy Technology Data Exchange (ETDEWEB)

    Duncan, S.S. [Los Alamos National Lab., NM (United States)

    1995-12-31

    Although antinuclear campaigns seem to be effective, public communication and education efforts on low-level radioactive waste have mixed results. Attempts at public information programs on low-level radioactive waste still focus on influencing public opinion. A question then is: {open_quotes}Is it preferable to have a program focus on public education that will empower individuals to make informed decisions rather than trying to influence them in their decisions?{close_quotes} To address this question, a case study with both quantitative and qualitative data will be used. The Ohio Low-Level Radioactive Waste Education Program has a goal to provide people with information they want/need to make their own decisions. The program initiated its efforts by conducting a statewide survey to determine information needed by people and where they turned for that information. This presentation reports data from the survey and then explores the program development process in which programs were designed and presented using the information. Pre and post data from the programs reveal attitude and knowledge shifts.

  14. Initiative hard coal; Initiative Steinkohle

    Energy Technology Data Exchange (ETDEWEB)

    Leonhardt, J.

    2007-08-02

    In order to decrease the import dependence of hard coal in the European Union, the author has submitted suggestions to the director of conventional sources of energy (directorate general for energy and transport) of the European community, which found a positive resonance. These suggestions are summarized in an elaboration 'Initiative Hard Coal'. After clarifying the starting situation and defining the target the presupposition for a better use of hard coal deposits as raw material in the European Union are pointed out. On that basis concrete suggestions for measures are made. Apart from the conditions of the deposits it concerns thereby also new mining techniques and mining-economical developments, connected with tasks for the mining-machine industry. (orig.)

  15. Hanford tanks initiative plan

    International Nuclear Information System (INIS)

    McKinney, K.E.

    1997-01-01

    Abstract: The Hanford Tanks Initiative (HTI) is a five-year project resulting from the technical and financial partnership of the U.S. Department of Energy's Office of Waste Management (EM-30) and Office of Science and Technology Development (EM-50). The HTI project accelerates activities to gain key technical, cost performance, and regulatory information on two high-level waste tanks. The HTI will provide a basis for design and regulatory decisions affecting the remainder of the Tank Waste Remediation System's tank waste retrieval Program

  16. Initiating statistical maintenance optimization

    International Nuclear Information System (INIS)

    Doyle, E. Kevin; Tuomi, Vesa; Rowley, Ian

    2007-01-01

    Since the 1980 s maintenance optimization has been centered around various formulations of Reliability Centered Maintenance (RCM). Several such optimization techniques have been implemented at the Bruce Nuclear Station. Further cost refinement of the Station preventive maintenance strategy includes evaluation of statistical optimization techniques. A review of successful pilot efforts in this direction is provided as well as initial work with graphical analysis. The present situation reguarding data sourcing, the principle impediment to use of stochastic methods in previous years, is discussed. The use of Crowe/AMSAA (Army Materials Systems Analysis Activity) plots is demonstrated from the point of view of justifying expenditures in optimization efforts. (author)

  17. (Reportıng of Operation Results In Basis Of Actual Variable Cost)

    OpenAIRE

    Çıkrıkçı, Mustafa; Dabbağoğlu, Kadir

    2007-01-01

    Calculation of production cost is primarily, essential to calculate cost of sales. Production cost is in the field of cost accounting and there are different approaches on calculation of production cost in cost accounting theory. These approaches designate the cost system. A cost system is a combination of cost principle, cost method and cost procedure. Principals consist of full cost and partial cost. Methods consist of actual cost and estimated cost. Procedures consist of order cost and sta...

  18. THE COST OF PRODUCTION UNDER DIRECT COSTING AND ABSORPTION COSTING – A COMPARATIVE APPROACH

    Directory of Open Access Journals (Sweden)

    Bunea-Bontaş Cristina Aurora

    2013-04-01

    Full Text Available Managerial accounting has an important role in strategic management of a company, being designed especially for managers, in order to optimise their decision regarding operating activities. One of the objectives of managerial accounting is the cost calculation, for measuring inventory costs, and the costs and profitability of products and services. Cost calculation systems can vary in terms of which costs are assigned to cost objects, two significant calculation systems being adopted by the costing theory: full cost accounting, which includes all costs of production as product costs, and partial cost accounting, which includes only those costs that vary with output. This article provides a comparative approach regarding the differences between the calculation of the cost of production under direct costing and absorption costing. It also examines the implication of using each of these calculation systems on the financial position and financial performance of the companies reported on the statement of financial position and the income statement. Finally, the advantages of using direct costing for internal reporting are discussed, considering that this method is not acceptable for external reporting to stockholders and other external users.

  19. Teacher Costs

    OpenAIRE

    DINIS MOTA DA COSTA PATRICIA; DE SOUSA LOBO BORGES DE ARAUJO LUISA

    2015-01-01

    The purpose of this technical brief is to assess current methodologies for the collection and calculation of teacher costs in European Union (EU) Member States in view of improving data series and indicators related to teacher salaries and teacher costs. To this end, CRELL compares the Eurydice collection on teacher salaries with the similar Organisation for Economic Co-operation and Development (OECD) data collection and calculates teacher costs based on the methodology established by Statis...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-01-01

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

  1. Full scale solvent extraction remedial results

    International Nuclear Information System (INIS)

    Cash, A.B.

    1992-01-01

    Sevenson Extraction Technology, Inc. has completed the development of the Soil Restoration Unit (initially developed by Terra-Kleen Corporation), a mobile, totally enclosed solvent extraction treatment facility for the removal of organic contaminated media is greater by a closed loop, counter current process that recycles all solvents. The solvents used are selected for the individual site dependant upon the contaminants, such as PCB's, oil, etc. and the soil conditions. A mixture of up to fourteen non-toxic solvents can be used for complicated sites. The full scale unit has been used to treat one superfund site, the Traband Site in Tulsa, Oklahoma, and is currently treating another superfund site, the Pinette's Salvage Yard Site in Washburn, Maine. The full scale Soil Restoration Unit has also been used at a non-superfund site, as part of a TSCA Research and Development permit. The results from these sites will be discussed in brief herein, and in more detail in the full paper

  2. Project Cost Estimation for Planning

    Science.gov (United States)

    2010-02-26

    For Nevada Department of Transportation (NDOT), there are far too many projects that ultimately cost much more than initially planned. Because project nominations are linked to estimates of future funding and the analysis of system needs, the inaccur...

  3. Developed Turbulence: From Full Simulations to Full Mode Reductions

    NARCIS (Netherlands)

    Grossmann, Siegfried; Lohse, Detlef; Reeh, Achim

    1996-01-01

    Developed Navier-Stokes turbulence is simulated with varying wave-vector mode reductions. The flatness and the skewness of the velocity derivative depend on the degree of mode reduction. They show a crossover towards the value of the full numerical simulation when the viscous subrange starts to be

  4. Cost of treatment for breast cancer in central Vietnam

    Directory of Open Access Journals (Sweden)

    Nguyen Hoang Lan

    2013-02-01

    Full Text Available Background: In recent years, cases of breast cancer have been on the rise in Vietnam. To date, there has been no study on the financial burden of the disease. This study estimates the direct medical cost of a 5-year treatment course for women with primary breast cancer in central Vietnam. Methods: Retrospective patient-level data from medical records at the Hue Central Hospital between 2001 and 2006 were analyzed. Cost analysis was conducted from the health care payers’ perspective. Various direct medical cost categories were computed for a 5-year treatment course for patients with breast cancer. Costs, in US dollars, discounted at a 3% rate, were converted to 2010 after adjusting for inflation. For each cost category, the mean, standard deviation, median, and cost range were estimated. Median regression was used to investigate the relationship between costs and the stage, age at diagnosis, and the health insurance coverage of the patients. Results: The total direct medical cost for a 5-year treatment course for breast cancer in central Vietnam was estimated at $975 per patient (range: $11.7–$3,955. The initial treatment cost, particularly the cost of chemotherapy, was found to account for the greatest proportion of total costs (64.9%. Among the patient characteristics studied, stage at diagnosis was significantly associated with total treatment costs. Patients at later stages of breast cancer did not differ significantly in their total costs from those at earlier stages however, but their survival time was much shorter. The absence of health insurance was the main factor limiting service uptake. Conclusion: From the health care payers’ perspective, the Government subsidization of public hospital charges lowered the direct medical costs of a 5-year treatment course for primary breast cancer in central Vietnam. However, the long treatment course was significantly influenced by out-of-pocket payments for patients without health insurance.

  5. Spectral implementation of full waveform inversion based on reflections

    KAUST Repository

    Wu, Zedong; Alkhalifah, Tariq Ali

    2014-01-01

    Using the reflection imaging process as a source to model reflections for full waveform inversion (FWI), referred to as reflection FWI (RFWI), allows us to update the background component of the model, and avoid using the relatively costly migration

  6. Initial results from a charge exchange q-diagnostic on TEXT-U

    International Nuclear Information System (INIS)

    Valanju, P.M.; Duraiappah, L.; Bengtson, R.D.; Karzhavin, Y.; Nikitin, A.

    1994-01-01

    The authors present initial results from a new q-diagnostic for TEXT-Upgrade. This method is based on using a toroidal array of detectors to determine the plane in which beam-injected neutrals are emitted after two charge-exchange collisions. The potential advantages are low cost, full plasma accessibility, and good time resolution. Their initial series of experiments on TEXT-U established the feasibility of this technique

  7. Rehabilitation costs

    Energy Technology Data Exchange (ETDEWEB)

    Kubo, Arthur S [BDM Corp., VA (United States); [Bikini Atoll Rehabilitation Committee, Berkeley, CA (United States)

    1986-07-01

    The costs of radioactivity contamination control and other matters relating to the resettlement of Bikin atoll were reviewed for Bikini Atoll Rehabilitation Committee by a panel of engineers which met in Berkeley, California on January 22-24, 1986. This Appendix presents the cost estimates.

  8. Rehabilitation costs

    International Nuclear Information System (INIS)

    Kubo, Arthur S.

    1986-01-01

    The costs of radioactivity contamination control and other matters relating to the resettlement of Bikin atoll were reviewed for Bikini Atoll Rehabilitation Committee by a panel of engineers which met in Berkeley, California on January 22-24, 1986. This Appendix presents the cost estimates

  9. Cost considerations

    NARCIS (Netherlands)

    Michiel Ras; Debbie Verbeek-Oudijk; Evelien Eggink

    2013-01-01

    Original title: Lasten onder de loep The Dutch government spends almost 7 billion euros  each year on care for people with intellectual disabilities, and these costs are rising steadily. This report analyses what underlies the increase in costs that occurred between 2007 and 2011. Was

  10. Troubleshooting Costs

    Science.gov (United States)

    Kornacki, Jeffrey L.

    Seventy-six million cases of foodborne disease occur each year in the United States alone. Medical and lost productivity costs of the most common pathogens are estimated to be 5.6-9.4 billion. Product recalls, whether from foodborne illness or spoilage, result in added costs to manufacturers in a variety of ways. These may include expenses associated with lawsuits from real or allegedly stricken individuals and lawsuits from shorted customers. Other costs include those associated with efforts involved in finding the source of the contamination and eliminating it and include time when lines are shut down and therefore non-productive, additional non-routine testing, consultant fees, time and personnel required to overhaul the entire food safety system, lost market share to competitors, and the cost associated with redesign of the factory and redesign or acquisition of more hygienic equipment. The cost associated with an effective quality assurance plan is well worth the effort to prevent the situations described.

  11. Cost comparisons

    CERN Multimedia

    CERN Bulletin

    2010-01-01

    How much does the LHC cost? And how much does this represent in other currencies? Below we present a table showing some comparisons with the cost of other projects. Looking at the figures, you will see that the cost of the LHC can be likened to that of three skyscrapers, or two seasons of Formula 1 racing! One year's budget of a single large F1 team is comparable to the entire materials cost of the ATLAS or CMS experiments.   Please note that all the figures are rounded for ease of reading.    CHF € $   LHC 4.6 billions 3 billions  4 billions   Space Shuttle Endeavour (NASA) 1.9 billion 1.3 billion 1.7 billion   Hubble Space Telescope (cost at launch – NASA/...

  12. Full truckload vehicle routing problem with profits

    Directory of Open Access Journals (Sweden)

    Jian Li

    2014-04-01

    Full Text Available A new variant of the full truckload vehicle routing problem is studied. In this problem there are more than one delivery points corresponding to the same pickup point, and one order is allowed to be served several times by the same vehicle or different vehicles. For the orders which cannot be assigned because of resource constraint, the logistics company outsources them to other logistics companies at a certain cost. To maximize its profits, logistics company decides which to be transported by private fleet and which to be outsourced. The mathematical model is constructed for the problem. Since the problem is NP-hard and it is difficult to solve the large-scale problems with an exact algorithm, a hybrid genetic algorithm is proposed. Computational results show the effectiveness of the hybrid genetic algorithm.

  13. Next generation initiation techniques

    Science.gov (United States)

    Warner, Tom; Derber, John; Zupanski, Milija; Cohn, Steve; Verlinde, Hans

    1993-01-01

    Four-dimensional data assimilation strategies can generally be classified as either current or next generation, depending upon whether they are used operationally or not. Current-generation data-assimilation techniques are those that are presently used routinely in operational-forecasting or research applications. They can be classified into the following categories: intermittent assimilation, Newtonian relaxation, and physical initialization. It should be noted that these techniques are the subject of continued research, and their improvement will parallel the development of next generation techniques described by the other speakers. Next generation assimilation techniques are those that are under development but are not yet used operationally. Most of these procedures are derived from control theory or variational methods and primarily represent continuous assimilation approaches, in which the data and model dynamics are 'fitted' to each other in an optimal way. Another 'next generation' category is the initialization of convective-scale models. Intermittent assimilation systems use an objective analysis to combine all observations within a time window that is centered on the analysis time. Continuous first-generation assimilation systems are usually based on the Newtonian-relaxation or 'nudging' techniques. Physical initialization procedures generally involve the use of standard or nonstandard data to force some physical process in the model during an assimilation period. Under the topic of next-generation assimilation techniques, variational approaches are currently being actively developed. Variational approaches seek to minimize a cost or penalty function which measures a model's fit to observations, background fields and other imposed constraints. Alternatively, the Kalman filter technique, which is also under investigation as a data assimilation procedure for numerical weather prediction, can yield acceptable initial conditions for mesoscale models. The

  14. Transmission line capital costs

    International Nuclear Information System (INIS)

    Hughes, K.R.; Brown, D.R.

    1995-05-01

    The displacement or deferral of conventional AC transmission line installation is a key benefit associated with several technologies being developed with the support of the U.S. Department of Energy's Office of Energy Management (OEM). Previous benefits assessments conducted within OEM have been based on significantly different assumptions for the average cost per mile of AC transmission line. In response to this uncertainty, an investigation of transmission line capital cost data was initiated. The objective of this study was to develop a database for preparing preliminary estimates of transmission line costs. An extensive search of potential data sources identified databases maintained by the Bonneville Power Administration (BPA) and the Western Area Power Administration (WAPA) as superior sources of transmission line cost data. The BPA and WAPA data were adjusted to a common basis and combined together. The composite database covers voltage levels from 13.8 to 765 W, with cost estimates for a given voltage level varying depending on conductor size, tower material type, tower frame type, and number of circuits. Reported transmission line costs vary significantly, even for a given voltage level. This can usually be explained by variation in the design factors noted above and variation in environmental and land (right-of-way) costs, which are extremely site-specific. Cost estimates prepared from the composite database were compared to cost data collected by the Federal Energy Regulatory Commission (FERC) for investor-owned utilities from across the United States. The comparison was hampered because the only design specifications included with the FERC data were voltage level and line length. Working within this limitation, the FERC data were not found to differ significantly from the composite database. Therefore, the composite database was judged to be a reasonable proxy for estimating national average costs

  15. Full-F gyrofluid model

    DEFF Research Database (Denmark)

    Madsen, Jens

    2013-01-01

    variables. The fluid moment hierarchy is closed by approximating the gyrokinetic distribution function as a finite order Hermite-Laguerre polynomial and by determining closure approximations for terms involving the gyrokinetic gyro-averaging operator. The model exactly conserves the gyrokinetic full......A global electromagnetic gyrofluid model based on the full-F gyrokinetic model is derived. The gyrofluid moment variables are not split into fluctuating and equilibrium parts. Profiles are evolved freely, and gyro-averaging operators are not parametrized, but are functions of the gyrofluid moment...

  16. COST QUALITY MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Vitanova Gordana

    2009-05-01

    Full Text Available Within the contemporary economic conditions, enterprises might achieve a competitive advantage if only they sell goods and services with high quality and lower prices. Customers, usually, prefer quality goods with acceptable prices, while such goods create reputation with the particular brand. The perfect control system is necessary to achieve a high quality product, which the cost quality management is considered to be an indispensable part in. The cost quality is nevertheless created to ensure that customers’ requirements are being appropriately attained. The most important objective of quality costs controlling is to assist the management in enhancing the product’s value permanently. The superior cost quality control system helps the management to achieve other strategic objectives, such as: producing goods with acceptable costs and deliver the products to their customers in time.

  17. The Fiction of Full BEKK

    NARCIS (Netherlands)

    C-L. Chang (Chia-Lin); M.J. McAleer (Michael)

    2017-01-01

    textabstractThe purpose of the paper is to show that univariate GARCH is not a special case of multivariate GARCH, specifically the Full BEKK model, except under parametric restrictions on the off-diagonal elements of the random coefficient autoregressive coefficient matrix, provides the regularity

  18. Empty calories and phantom fullness

    NARCIS (Netherlands)

    Camps, Guido; Mars, Monica; Graaf, de Kees; Smeets, Paul A.M.

    2016-01-01

    Background: Stomach fullness is a determinant of satiety. Although both the viscosity and energy content have been shown to delay gastric emptying, their relative importance is not well understood. Objective: We compared the relative effects of and interactions between the viscosity and energy

  19. Toward full MOX core design

    International Nuclear Information System (INIS)

    Rouviere, G.; Guillet, J.L.; Bruna, G.B.; Pelet, J.

    1999-01-01

    This paper presents a selection of the main preliminary results of a study program sponsored by COGEMA and currently carried out by FRAMATOME. The objective of this study is to investigate the feasibility of full MOX core loading in a French 1300 MWe PWR, a recent and widespread standard nuclear power plant. The investigation includes core nuclear design, thermal hydraulic and systems aspects. (authors)

  20. Rectilinear Full Steiner Tree Generation

    DEFF Research Database (Denmark)

    Zachariasen, Martin

    1999-01-01

    The fastest exact algorithm (in practice) for the rectilinear Steiner tree problem in the plane uses a two-phase scheme: First, a small but sufficient set of full Steiner trees (FSTs) is generated and then a Steiner minimum tree is constructed from this set by using simple backtrack search, dynamic...

  1. Full autonomy; Autarkie im Komplettpaket

    Energy Technology Data Exchange (ETDEWEB)

    Augsten, Eva

    2011-05-31

    Normally, those who talk of full solar autonomy refer to the annual balance of a house. Now, architect Timo Leukefeld and Helma Eigenheimbau AG presented a really autonomous solar house which is available on a turnkey basis for 363,000 Euros.

  2. [Endoscopic full-thickness resection].

    Science.gov (United States)

    Meier, B; Schmidt, A; Caca, K

    2016-08-01

    Conventional endoscopic resection techniques such as endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) are powerful tools for the treatment of gastrointestinal (GI) neoplasms. However, those techniques are limited to the superficial layers of the GI wall (mucosa and submucosa). Lesions without lifting sign (usually arising from deeper layers) or lesions in difficult anatomic positions (appendix, diverticulum) are difficult - if not impossible - to resect using conventional techniques, due to the increased risk of complications. For larger lesions (>2 cm), ESD appears to be superior to the conventional techniques because of the en bloc resection, but the procedure is technically challenging, time consuming, and associated with complications even in experienced hands. Since the development of the over-the-scope clips (OTSC), complications like bleeding or perforation can be endoscopically better managed. In recent years, different endoscopic full-thickness resection techniques came to the focus of interventional endoscopy. Since September 2014, the full-thickness resection device (FTRD) has the CE marking in Europe for full-thickness resection in the lower GI tract. Technically the device is based on the OTSC system and combines OTSC application and snare polypectomy in one step. This study shows all full-thickness resection techniques currently available, but clearly focuses on the experience with the FTRD in the lower GI tract.

  3. Costing and competition.

    Science.gov (United States)

    Bates, K; Brignall, S

    1994-01-01

    Working for patients established a new system of contracts between providers and purchasers of healthcare, with prices based on full costs, avoiding cross-subsidization. The new regime necessitates greatly improved costing systems, to improve the efficiency of service provision by creating price competition between providers. Ken Bates and Stan Brignall argue that non-price competition also occurs, with providers 'differentiating' on quality of service/product, flexibility or innovation.

  4. The cost of children

    DEFF Research Database (Denmark)

    Nordström, Leif Jonas

    , the opportunity cost of two children is estimated to 28-29 per cent of full income, which in monetary units is close to estimated income difference between women employed in the public and private sector. The opportunity cost of fatherhood is generally positive, but only significantly positive for men born......In this paper we estimate the opportunity cost of children. The underlying theoretical model is represented by a household production model. In the empirical analysis, we consider three different cohorts for men and women born between 1955 and 1970. For the women in the two oldest cohorts...

  5. INITIATION AND CONDUCT OF ADMINISTRATIVE PROCEDURE

    Directory of Open Access Journals (Sweden)

    Milan Stipic

    2013-12-01

    Full Text Available General administrative procedure act contains legal norms that are valid for all identical cases. In addition to the general, there are special administrative procedures, customized to the specific administrative areas. Procedure initiation is regulated. Administrative procedure can be initiated at the request of the proponent and ex officio. When the official determines that the conditions for the conduct of administrative procedure are met, before making a decision, all the facts and circumstances relevant to the resolution of administrative matter have to be identified. When there are no legal requirements for the initiation of procedures, the official shall make a decision to reject the application of the party. The procedure is initiated ex officio when stipulated by law or when protection of public interest requires it. When initiating procedure ex officio, the public authority shall take into consideration the petition or other information that indicate the need to protect the public interest. In such cases the applicant is not a party, and the official is obliged to notify the applicant, if initiation of procedures is not accepted ex officio. Based on the notification, the applicant has a right to complain, including the situation when there is no response within the prescribed period of 30 days. Public authority may, therefore it is not obliged to, initiate administrative procedure by public announcement only in a situation where the parties are unknown, while it is obliged to initiate procedure by public announcement when this method of initiating the procedure is prescribed by law. Initiation of procedure with public announcement occurs in rare cases. Due to the application of efficiency and cost-effectiveness principle, two or more administrative procedures can be merged into one procedure by a conclusion. The condition for this is that the rights or obligations of the parties are based on the same legal basis and on the same or

  6. The PS Booster's ejection kicker: full house.

    CERN Multimedia

    CERN PhotoLab

    1971-01-01

    The modules of the Booster's four-storied full-aperture kicker pretty much fill their vacuum tank (front cover removed). In the original 800 MeV version, the delay-type modules were pulsed at 30 kV from a Pulse-Forming-Network (PFN), yielding a field risetime as short as 60 ns. The fieldstrength was 0.1 T at a current of 1200 A. The modules are made from steel plates and ferrite slabs. The ferrite's high initial outgassing rate presented a serious vacuum problem for a long time.

  7. Workflows for Full Waveform Inversions

    Science.gov (United States)

    Boehm, Christian; Krischer, Lion; Afanasiev, Michael; van Driel, Martin; May, Dave A.; Rietmann, Max; Fichtner, Andreas

    2017-04-01

    Despite many theoretical advances and the increasing availability of high-performance computing clusters, full seismic waveform inversions still face considerable challenges regarding data and workflow management. While the community has access to solvers which can harness modern heterogeneous computing architectures, the computational bottleneck has fallen to these often manpower-bounded issues that need to be overcome to facilitate further progress. Modern inversions involve huge amounts of data and require a tight integration between numerical PDE solvers, data acquisition and processing systems, nonlinear optimization libraries, and job orchestration frameworks. To this end we created a set of libraries and applications revolving around Salvus (http://salvus.io), a novel software package designed to solve large-scale full waveform inverse problems. This presentation focuses on solving passive source seismic full waveform inversions from local to global scales with Salvus. We discuss (i) design choices for the aforementioned components required for full waveform modeling and inversion, (ii) their implementation in the Salvus framework, and (iii) how it is all tied together by a usable workflow system. We combine state-of-the-art algorithms ranging from high-order finite-element solutions of the wave equation to quasi-Newton optimization algorithms using trust-region methods that can handle inexact derivatives. All is steered by an automated interactive graph-based workflow framework capable of orchestrating all necessary pieces. This naturally facilitates the creation of new Earth models and hopefully sparks new scientific insights. Additionally, and even more importantly, it enhances reproducibility and reliability of the final results.

  8. LHCb : Full Experiment System Test

    CERN Multimedia

    Cattaneo, M

    2009-01-01

    LHCb had been planning to commission its High Level Trigger software and Data Quality monitoring procedures using real collisions data from the LHC pilot run. Following the LHC incident on 19th September 2008, it was decided to commission the system using simulated data. This “Full Experiment System Test” consists of: - Injection of simulated minimum bias events into the full HLT farm, after selection by a simulated Level 0 trigger. - Processing in the HLT farm to achieve the output rate expected for nominal LHC luminosity running, sustained over the typical duration of an LHC fill. - Real time Data Quality validation of the HLT output, validation of calibration and alignment parameters for use in the reconstruction. - Transmission of the event data, calibration data and book-keeping information to Tier1 sites and full reconstruction of the event data. - Data Quality validation of the reconstruction output. We will report on the preparations and results of FEST09, and on the status of commissioning for no...

  9. The Distributed Wind Cost Taxonomy

    Energy Technology Data Exchange (ETDEWEB)

    Forsyth, Trudy; Jimenez, Tony; Preus, Robert; Tegen, Suzanne; Baring-Gould, Ian

    2017-03-28

    To date, there has been no standard method or tool to analyze the installed and operational costs for distributed wind turbine systems. This report describes the development of a classification system, or taxonomy, for distributed wind turbine project costs. The taxonomy establishes a framework to help collect, sort, and compare distributed wind cost data that mirrors how the industry categorizes information. The taxonomy organizes costs so they can be aggregated from installers, developers, vendors, and other sources without losing cost details. Developing a peer-reviewed taxonomy is valuable to industry stakeholders because a common understanding the details of distributed wind turbine costs and balance of station costs is a first step to identifying potential high-value cost reduction opportunities. Addressing cost reduction potential can help increase distributed wind's competitiveness and propel the U.S. distributed wind industry forward. The taxonomy can also be used to perform cost comparisons between technologies and track trends for distributed wind industry costs in the future. As an initial application and piloting of the taxonomy, preliminary cost data were collected for projects of different sizes and from different regions across the contiguous United States. Following the methods described in this report, these data are placed into the established cost categories.

  10. Full traveltime inversion in source domain

    KAUST Repository

    Liu, Lu

    2017-06-01

    This paper presents a new method of source-domain full traveltime inversion (FTI). The objective of this study is automatically building near-surface velocity using the early arrivals of seismic data. This method can generate the inverted velocity that can kinetically best match the reconstructed plane-wave source of early arrivals with true source in source domain. It does not require picking first arrivals for tomography, which is one of the most challenging aspects of ray-based tomographic inversion. Besides, this method does not need estimate the source wavelet, which is a necessity for receiver-domain wave-equation velocity inversion. Furthermore, we applied our method on one synthetic dataset; the results show our method could generate a reasonable background velocity even when shingling first arrivals exist and could provide a good initial velocity for the conventional full waveform inversion (FWI).

  11. A full quantum network scheme

    International Nuclear Information System (INIS)

    Ma Hai-Qiang; Wei Ke-Jin; Yang Jian-Hui; Li Rui-Xue; Zhu Wu

    2014-01-01

    We present a full quantum network scheme using a modified BB84 protocol. Unlike other quantum network schemes, it allows quantum keys to be distributed between two arbitrary users with the help of an intermediary detecting user. Moreover, it has good expansibility and prevents all potential attacks using loopholes in a detector, so it is more practical to apply. Because the fiber birefringence effects are automatically compensated, the scheme is distinctly stable in principle and in experiment. The simple components for every user make our scheme easier for many applications. The experimental results demonstrate the stability and feasibility of this scheme. (general)

  12. Cusiana Cupiagua. Towards full production

    International Nuclear Information System (INIS)

    Carta Petrolera

    1998-01-01

    When production facilities at Cupiagua are ready around mid-year, the Cusiana Cupiagua complex will start full production, this is the largest oil project in Colombia to date. The Cupiagua CPF covers over 60 hectares on the tableland of the same name in the jurisdiction of Aguazul, a town in Casanare province in northeast Colombia, and currently considered the country's oil cradle. Work is being carried out in a sort of niche that appears to be protected by a natural wall made up of the folds of the Casanare foothills

  13. Potential costs of breast augmentation mammaplasty.

    Science.gov (United States)

    Schmitt, William P; Eichhorn, Mitchell G; Ford, Ronald D

    2016-01-01

    Augmentation mammaplasty is one of the most common surgical procedures performed by plastic surgeons. The aim of this study was to estimate the cost of the initial procedure and its subsequent complications, as well as project the cost of Food and Drug Administration (FDA)-recommended surveillance imaging. The potential costs to the individual patient and society were calculated. Local plastic surgeons provided billing data for the initial primary silicone augmentation and reoperative procedures. Complication rates used for the cost analysis were obtained from the Allergen Core study on silicone implants. Imaging surveillance costs were considered in the estimations. The average baseline initial cost of silicone augmentation mammaplasty was calculated at $6335. The average total cost of primary breast augmentation over the first decade for an individual patient, including complications requiring reoperation and other ancillary costs, was calculated at $8226. Each decade thereafter cost an additional $1891. Costs may exceed $15,000 over an averaged lifetime, and the recommended implant surveillance could cost an additional $33,750. The potential cost of a breast augmentation, which includes the costs of complications and imaging, is significantly higher than the initial cost of the procedure. Level III, economic and decision analysis study. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  14. Distribution costs -- the cost of local delivery

    International Nuclear Information System (INIS)

    Winger, N.; Zarnett, P.; Carr, J.

    2000-01-01

    Most of the power transmission system in the province of Ontario is owned and operated as a regulated monopoly by Ontario Hydro Services Company (OHSC). Local distribution systems deliver to end-users from bulk supply points within a service territory. OHSC distributes to approximately one million, mostly rural customers, while the approximately 250 municipal utilities together serve about two million, mostly urban customers. Under the Energy Competition Act of 1998 local distribution companies will face some new challenges, including unbundled billing systems, a broader range of distribution costs, increased costs, made up of corporate taxes or payments in lieu of taxes and added costs for regulatory affairs. The consultants provide a detailed discussion of the components of distribution costs, the three components of the typical budget process (capital expenditures, (CAPEX), operating and maintenance (O and M) and administration and corporate (GA and C), a summary of some typical distribution costs in Ontario, and the estimated impacts of the Energy Competition Act (ECA) compliance on charges and rates. Various mitigation strategies are also reviewed. Among these are joint ventures by local distribution companies to reduce ECA compliance costs, re-examination of controllable costs, temporary reduction of the allowable return on equity (ROE) by 50 per cent, and/or reducing the competitive transition charge (CTC). It is estimated that either one of these two reductions could eliminate the full amount of the five to seven per cent uplift in delivered energy service costs. The conclusion of the consultants is that local distribution delivery charges will make up a greater proportion of end-user cost in the future than it has in the past. An increase to customers of about five per cent is expected when the competitive electricity market opens and unbundled billing begins. The cost increase could be mitigated by a combination of actions that would be needed for about

  15. Global Prospects for Full Employment

    Directory of Open Access Journals (Sweden)

    Ivo Šlaus

    2011-04-01

    Full Text Available The recent international financial crisis highlights the crucial role of employment in human welfare and social stability. Access to remunerative employment opportunities is essential for economic security in a market-based economic system. As the rise of democracy compelled nations to extend the voting right to all citizens, employment must be recognized as a fundamental human right. In total defiance of conventional wisdom, since 1950 job growth has outpaced the explosive growth of population, the rapid adoption of labor-saving technologies, the manifold expansion of world trade, and the dramatic shift from manual labor to white collar work. In an increasingly globalized labor market, current nation-centric theories and models of employment need to be replaced with a human-centered global perspective complemented by new indicators that recognize the central and essential contribution of employment to human economic welfare. Employment and economy are subsets of society and their growth is driven by the more fundamental process of social development. A vast array of unmet social needs combined with an enormous reservoir of underutilized social resources – technological, scientific, educational, organizational, cultural and psychological – can be harnessed to dramatically expand employment opportunities and achieve full employment on a global basis. This paper examines the theoretical basis, policy issues and strategies required to eradicate unemployment nationally and globally.

  16. Achieving and sustaining full employment.

    Science.gov (United States)

    Rosen, S M

    1995-01-01

    Human rights and public health considerations provide strong support for policies that maximize employment. Ample historical and conceptual evidence supports the feasibility of full employment policies. New factors affecting the labor force, the rate of technological change, and the globalization of economic activity require appropriate policies--international as well as national--but do not invalidate the ability of modern states to apply the measures needed. Among these the most important include: (I) systematic reduction in working time with no loss of income, (2) active labor market policies, (3) use of fiscal and monetary measures to sustain the needed level of aggregate demand, (4) restoration of equal bargaining power between labor and capital, (5) social investment in neglected and outmoded infrastructure, (6) accountability of corporations for decisions to shift or reduce capital investment, (7) major reductions in military spending, to be replaced by socially needed and economically productive expenditures, (8) direct public sector job creation, (9) reform of monetary policy to restore emphasis on minimizing unemployment and promoting full employment. None are without precedent in modern economies. The obstacles are ideological and political. To overcome them will require intellectual clarity and effective advocacy.

  17. Estimating the cost of healthcare delivery in three hospitals in ...

    African Journals Online (AJOL)

    Objective: The cost burden (called full cost) of providing health services at a referral, a district and a mission hospital in Ghana were determined. Methods: Standard cost-finding and cost analysis tools recommended by World Health Organization are used to analyse 2002 and 2003 hospital data. Full cost centre costs were ...

  18. Instrumented Pipeline Initiative

    Energy Technology Data Exchange (ETDEWEB)

    Thomas Piro; Michael Ream

    2010-07-31

    This report summarizes technical progress achieved during the cooperative agreement between Concurrent Technologies Corporation (CTC) and U.S. Department of Energy to address the need for a for low-cost monitoring and inspection sensor system as identified in the Department of Energy (DOE) National Gas Infrastructure Research & Development (R&D) Delivery Reliability Program Roadmap.. The Instrumented Pipeline Initiative (IPI) achieved the objective by researching technologies for the monitoring of pipeline delivery integrity, through a ubiquitous network of sensors and controllers to detect and diagnose incipient defects, leaks, and failures. This report is organized by tasks as detailed in the Statement of Project Objectives (SOPO). The sections all state the objective and approach before detailing results of work.

  19. Initiation devices, initiation systems including initiation devices and related methods

    Energy Technology Data Exchange (ETDEWEB)

    Daniels, Michael A.; Condit, Reston A.; Rasmussen, Nikki; Wallace, Ronald S.

    2018-04-10

    Initiation devices may include at least one substrate, an initiation element positioned on a first side of the at least one substrate, and a spark gap electrically coupled to the initiation element and positioned on a second side of the at least one substrate. Initiation devices may include a plurality of substrates where at least one substrate of the plurality of substrates is electrically connected to at least one adjacent substrate of the plurality of substrates with at least one via extending through the at least one substrate. Initiation systems may include such initiation devices. Methods of igniting energetic materials include passing a current through a spark gap formed on at least one substrate of the initiation device, passing the current through at least one via formed through the at least one substrate, and passing the current through an explosive bridge wire of the initiation device.

  20. Research on Initiation Sensitivity of Solid Explosive and Planer Initiation System

    Directory of Open Access Journals (Sweden)

    N Matsuo

    2016-09-01

    Full Text Available Firstly, recently, there are a lot of techniques being demanded for complex process, various explosive initiation method and highly accurate control of detonation are needed. In this research, the metal foil explosion using high current is focused attention on the method to obtain linear or planate initiation easily, and the main evaluation of metal foil explosion to initiate explosive was conducted. The explosion power was evaluated by observing optically the underwater shock wave generated from the metal foil explosion. Secondly, in high energy explosive processing, there are several applications, such as shock compaction, explosive welding, food processing and explosive forming. In these explosive applications, a high sensitive explosive has been mainly used. The high sensitive explosive is so dangerous, since it can lead to explosion suddenly. So, for developing explosives, the safety is the most important thing as well as low manufacturing cost and explosive characteristics. In this work, we have focused on the initiation sensitivity of a solid explosive and performed numerical analysis of sympathetic detonation. The numerical analysis is calculated by LS-DYNA 3D (commercial code. To understand the initiation reaction of an explosive, Lee-Tarver equation was used and impact detonation process was analyzed by ALE code. Configuration of simulation model is a quarter of circular cylinder. The donor type of explosive (SEP was used as initiation explosive. When the donor explosive is exploded, a shock wave is generated and it propagates into PMMA, air and metallic layers in order. During passing through the layers, the shock wave is attenuated and finally, it has influence on the acceptor explosive, Comp. B. Here, we evaluate the initiation of acceptor explosive and discuss about detonation pressure, reactive rate of acceptor explosive and attenuation of impact pressure.

  1. Full-automatic Special Drill Hydraulic System and PLC Control

    Directory of Open Access Journals (Sweden)

    Tian Xue Jun

    2016-01-01

    Full Text Available A hydraulic-driven and PLC full-automatic special drill is introduced, working principle of the hydraulic system and PLC control system are analyzed and designed, this equipment has the advantages of high efficiency, superior quality and low cost etc.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Passive Infrared Signature Augmentation of Full-Scale Plastic Targets

    National Research Council Canada - National Science Library

    Gebus, Lisa M; Sanders, Jeffrey S

    2002-01-01

    ... (IR), and radar signatures of threat systems. To address this need, a program was initiated by TMO to augment an existing full-scale, vacuum-formed plastic target with sufficient signature fidelity to adequately stress U.S...

  4. Environmental Parametric Cost Model in Oil and Gas EPC Contracts

    Directory of Open Access Journals (Sweden)

    Madjid Abbaspour

    2018-01-01

    Full Text Available This study aims at identifying the parameters that govern the environmental costs in oil and gas projects. An initial conceptual model was proposed. Next, the costs of environmental management work packages were estimated, separately and were applied in project control tools (WBS/CBS. Then, an environmental parametric cost model was designed to determine the environmental costs and relevant weighting factors. The suggested model can be considered as an innovative approach to designate the environmental indicators in oil and gas projects. The validity of variables was investigated based on Delphi method. The results indicated that the project environmental management’s weighting factor is 0.87% of total project’s weighting factor.

  5. Fitness cost

    DEFF Research Database (Denmark)

    Nielsen, Karen L.; Pedersen, Thomas M.; Udekwu, Klas I.

    2012-01-01

    phage types, predominantly only penicillin resistant. We investigated whether isolates of this epidemic were associated with a fitness cost, and we employed a mathematical model to ask whether these fitness costs could have led to the observed reduction in frequency. Bacteraemia isolates of S. aureus...... from Denmark have been stored since 1957. We chose 40 S. aureus isolates belonging to phage complex 83A, clonal complex 8 based on spa type, ranging in time of isolation from 1957 to 1980 and with varyous antibiograms, including both methicillin-resistant and -susceptible isolates. The relative fitness...... of each isolate was determined in a growth competition assay with a reference isolate. Significant fitness costs of 215 were determined for the MRSA isolates studied. There was a significant negative correlation between number of antibiotic resistances and relative fitness. Multiple regression analysis...

  6. Costs involved in using a cochlear implant in South Africa

    Directory of Open Access Journals (Sweden)

    Gillian Robyn Kerr

    2012-12-01

    Full Text Available Cochlear implantation is an expensive but effective lifelong intervention for individuals with a severe-to-profound hearing loss. The primary aim of this study was to survey the short- and long-term costs of cochlear implantation. Individuals (N=154 using cochlear implants obtained from the University of Stellenbosch-Tygerberg Hospital Cochlear Implant Unit in Cape Town, South Africa were surveyed using a questionnaire and patient record review. The questionnaire used a combination of closed and open-ended questions to gather both quantitative and qualitative information. Costs were categorised as short- and long-term costs. All costs were converted to constant rands (June 2010 using the Consumer Price Index to allow for comparison in real terms over time. In the first 10 years of implantation the average estimated costs incurred by adults totalled R379 626, and by children R455 225. The initial purchase of the implant system was the most substantial cost, followed by upgrading of the processor. Travel and accommodation costs peaked in the first 2 years. On average the participants spent R2 550 per year on batteries and spares. Rehabilitation for children cost an average of R7 200. Insurance costs averaged R4 040 per year, and processor repairs R3 000 each. In addition to the upfront expense of obtaining the cochlear implant system, individuals using a cochlear implant in South Africa should be prepared for the long-term costs of maintenance, accessing the unit, support services and additional costs associated with use. Knowledge of these costs is important to ensure that individuals are successful users of their cochlear implants in the long term.

  7. (Super Variable Costing-Throughput Costing)

    OpenAIRE

    Çakıcı, Cemal

    2006-01-01

    (Super Variable Costing-Throughput Costing) The aim of this study is to explain the super-variable costing method which is a new subject in cost and management accounting and to show it’s working practicly.Shortly, super-variable costing can be defined as a costing method which is use only direct material costs in calculate of product costs and treats all costs except these (direct labor and overhead) as periad costs or operating costs.By using super-variable costing method, product costs ar...

  8. INITIAL TRAINING OF RESEARCHERS

    Directory of Open Access Journals (Sweden)

    Karina Alejandra Cruz-Pallares

    2015-07-01

    Full Text Available The document presents results of a research that used as strategy a complementary training project with thirty-three students of a Bachelors Degree in Primary School 1997(DPS,1997 of an Education Faculty for the initial training of investigators, applied by four teachers members of the academic research group in Mexico; that develops through process of action research methodology. Highlighted in results is the strengthening of the competition of reading, understanding and writing scientific texts, which is analogous to the first feature of the graduate profile called intellectual skills. Among the conclusions it is emphasized that the initial training of teachers in a task that is quite interesting, challenging and complex, as is the educational complex phenomenon.

  9. Systematization of Cost Factors for Cost Management at Industrial Enterprises

    Directory of Open Access Journals (Sweden)

    N. Y.

    2017-12-01

    Full Text Available Identification and structuring of factors determining the cost level has significant importance in cost analysis and control. Cost factors need to be systematized for more effective cost management. The objective of the study is to identify and structure the factors with impact on the enterprise costs. The external and internal factors with impact on the enterprise costs in industry are highlighted. For cost management purposes, it is proposed to group the cost factors into the two categories: structural and functional. The essence of structural and functional factors is shown; a classification of functional factors is given. The effect of a structural factor such as products range (complexity is illustrated. As the factor of complexity, combined with cost analysis systems and innovative tools of analysis (ABC and XYZ methods, has been increasingly in focus of analysts, three problems are described which, once dealt with, will enable ABC method to fit into the cost management system. The importance of another structural factor of costs, technology selection, in cost management is shown. The analysis allows for the following conclusions: for purposes of current cost management, including one based on operational analysis, the output needs to be addressed as the central factor determining the cost level; in the strategic perspective, an enterprise needs to concentrate on calculating the costs for the structural alternatives that are supposed to determine its competitive position; for cost management purposes, the cost factors should be broken into two categories, structural and functional; a specific management system exists for each cost factor, which is greatly important for the positioning of an enterprise.

  10. IDC Reengineering Phase 2 & 3 Rough Order of Magnitude (ROM) Cost Estimate Summary (Leveraged NDC Case).

    Energy Technology Data Exchange (ETDEWEB)

    Harris, James M.; Prescott, Ryan; Dawson, Jericah M.; Huelskamp, Robert M.

    2014-11-01

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

  11. Review Document: Full Software Trigger

    CERN Document Server

    Albrecht, J; Raven, G

    2014-01-01

    This document presents a trigger system for the upgraded LHCb detector, scheduled to begin operation in 2020. This document serves as input for the internal review towards the "DAQ, online and trigger TDR". The proposed trigger system is implemented entirely in software. In this document we show that track reconstruction of a similar quality to that available in the offline algorithms can be performed on the full inelastic $pp$-collision rate, without prior event selections implemented in custom hardware and without relying upon a partial event reconstruction. A track nding eciency of 98.8 % relative to oine can be achieved for tracks with $p_T >$ 500 MeV/$c$. The CPU time required for this reconstruction is about 40 % of the available budget. Proof-of-principle selections are presented which demonstrate that excellent performance is achievable using an inclusive beauty trigger, in addition to exclusive beauty and charm triggers. Finally, it is shown that exclusive beauty and charm selections that do not intr...

  12. Quality Cost in the Construction Industry ' Preliminary Findings in Malaysia

    Directory of Open Access Journals (Sweden)

    Mukhtar Che Ali

    2010-06-01

    Full Text Available One of the key areas being emphasis in ISO 9001 Quality Management System (QMS is performance measurement towards continual improvement. Among the primary measuring tools is quality cost approach. Quality cost has been well practice in manufacturing sector but slowly gain its importance in construction industry. In fact Project Management Body of Knowledge (PMBOK has reckoned quality cost as one of the tool and technique in few of its management processes. In view of such circumstances that has prompted an effort to undertake a study to ascertain the level of knowledge and practice on quality cost in Malaysian construction landscape. The targeted group of respondents was the personnel in the project management team. Capitalizing Construction Industry Development Board (CIDB National Electronic Tendering Initiatives (NETI road shows which were held in year 2007 throughout the country, the author was able to garner 263 respondents representing the project management team. Subsequently the data gathered from the completed forms were analyzed using Statistical Package for Social Science (SPSS software. General findings indicated that the level of knowledge and practice on quality cost among the project management team were relatively low. One of the main contributing factors was poor knowledge in the area related to quality cost. Despite of such scenario most of the respondents showed their interest in acquiring knowledge in the field of quality cost. Hence quality cost approach is at the infancy stage in Malaysian construction industry.

  13. Cost Reporting at a Navy Branch Clinic

    Science.gov (United States)

    1993-03-01

    John Wiley & Sons, 1991. 15 Horngren , Charles, Cost Accounting -=A Managerial Emphasis, 5th Edition, Prentice Hall, Inc., Englewood Cliffs, N.J., 1982...traditionally reported under a partial cost reporting system. By applying basic principles of managerial accounting , a full cost reporting system is...traditionally reported under a partial cost reporting system. By applying basic principles of managerial accounting , a proposed full cost reporting

  14. Nuclear Energy Research Initiative Project No. 02 103 Innovative Low Cost Approaches to Automating QA/QC of Fuel Particle Production Using On Line Nondestructive Methods for Higher Reliability Final Project Report

    Energy Technology Data Exchange (ETDEWEB)

    Ahmed, Salahuddin; Batishko, Charles R.; Flake, Matthew; Good, Morris S.; Mathews, Royce; Morra, Marino; Panetta, Paul D.; Pardini, Allan F.; Sandness, Gerald A.; Tucker, Brian J.; Weier, Dennis R.; Hockey, Ronald L.; Gray, Joseph N.; Saurwein, John J.; Bond, Leonard J.; Lowden, Richard A.; Miller, James H.

    2006-02-28

    This Nuclear Energy Research Initiative (NERI) project was tasked with exploring, adapting, developing and demonstrating innovative nondestructive test methods to automate nuclear coated particle fuel inspection so as to provide the United States (US) with necessary improved and economical Quality Assurance and Control (QA/QC) that is needed for the fuels for several reactor concepts being proposed for both near term deployment [DOE NE & NERAC, 2001] and Generation IV nuclear systems. Replacing present day QA/QC methods, done manually and in many cases destructively, with higher speed automated nondestructive methods will make fuel production for advanced reactors economically feasible. For successful deployment of next generation reactors that employ particle fuels, or fuels in the form of pebbles based on particles, extremely large numbers of fuel particles will require inspection at throughput rates that do not significantly impact the proposed manufacturing processes. The focus of the project is nondestructive examination (NDE) technologies that can be automated for production speeds and make either: (I) On Process Measurements or (II) In Line Measurements. The inspection technologies selected will enable particle “quality” qualification as a particle or group of particles passes a sensor. A multiple attribute dependent signature will be measured and used for qualification or process control decisions. A primary task for achieving this objective is to establish standard signatures for both good/acceptable particles and the most problematic types of defects using several nondestructive methods.

  15. A life cycle cost economics model for projects with uniformly varying operating costs. [management planning

    Science.gov (United States)

    Remer, D. S.

    1977-01-01

    A mathematical model is developed for calculating the life cycle costs for a project where the operating costs increase or decrease in a linear manner with time. The life cycle cost is shown to be a function of the investment costs, initial operating costs, operating cost gradient, project life time, interest rate for capital and salvage value. The results show that the life cycle cost for a project can be grossly underestimated (or overestimated) if the operating costs increase (or decrease) uniformly over time rather than being constant as is often assumed in project economic evaluations. The following range of variables is examined: (1) project life from 2 to 30 years; (2) interest rate from 0 to 15 percent per year; and (3) operating cost gradient from 5 to 90 percent of the initial operating costs. A numerical example plus tables and graphs is given to help calculate project life cycle costs over a wide range of variables.

  16. Transaction Costs For Innovations Diffusion

    Directory of Open Access Journals (Sweden)

    Ilya A. Romanov

    2012-10-01

    Full Text Available The article deals with the analysis of transaction costs of the innovations distribution. The factors, affecting the innovations diffusion in accordance with the clusters, relations, dynamics of the distribution are disclosed. Transaction costs as a result of bounded rationality of economic entities are detected. The inevitability of transaction costs as an objective phenomenon is shown. Their dependence on the quality of economic information and information uncertainty is indicated. Correlative approach for the analysis of these costs is applied. The article justifies that the reduction of transaction costs increases the efficiency of innovations.

  17. CALCULATION OF LASER CUTTING COSTS

    Directory of Open Access Journals (Sweden)

    Bogdan Nedic

    2016-09-01

    Full Text Available The paper presents description methods of metal cutting and calculation of treatment costs based on model that is developed on Faculty of mechanical engineering in Kragujevac. Based on systematization and analysis of large number of calculation models of cutting with unconventional methods, mathematical model is derived, which is used for creating a software for calculation costs of metal cutting. Software solution enables resolving the problem of calculating the cost of laser cutting, comparison' of costs made by other unconventional methods and provides documentation that consists of reports on estimated costs.

  18. NASA Instrument Cost/Schedule Model

    Science.gov (United States)

    Habib-Agahi, Hamid; Mrozinski, Joe; Fox, George

    2011-01-01

    NASA's Office of Independent Program and Cost Evaluation (IPCE) has established a number of initiatives to improve its cost and schedule estimating capabilities. 12One of these initiatives has resulted in the JPL developed NASA Instrument Cost Model. NICM is a cost and schedule estimator that contains: A system level cost estimation tool; a subsystem level cost estimation tool; a database of cost and technical parameters of over 140 previously flown remote sensing and in-situ instruments; a schedule estimator; a set of rules to estimate cost and schedule by life cycle phases (B/C/D); and a novel tool for developing joint probability distributions for cost and schedule risk (Joint Confidence Level (JCL)). This paper describes the development and use of NICM, including the data normalization processes, data mining methods (cluster analysis, principal components analysis, regression analysis and bootstrap cross validation), the estimating equations themselves and a demonstration of the NICM tool suite.

  19. Fission Surface Power System Initial Concept Definition

    Science.gov (United States)

    2010-01-01

    Under the NASA Exploration Technology Development Program (ETDP) and in partnership with the Department of Energy (DOE), NASA has embarked on a project to develop Fission Surface Power (FSP) technology. The primary goals of the project are to 1) develop FSP concepts that meet expected surface power requirements at reasonable cost with added benefits over other options, 2) establish a hardwarebased technical foundation for FSP design concepts and reduce overall development risk, 3) reduce the cost uncertainties for FSP and establish greater credibility for flight system cost estimates, and 4) generate the key products to allow NASA decision-makers to consider FSP as a preferred option for flight development. The FSP project was initiated in 2006 as the Prometheus Program and the Jupiter Icy Moons Orbiter (JIMO) mission were phased-out. As a first step, NASA Headquarters commissioned the Affordable Fission Surface Power System Study to evaluate the potential for an affordable FSP development approach. With a cost-effective FSP strategy identified, the FSP team evaluated design options and selected a Preliminary Reference Concept to guide technology development. Since then, the FSP Preliminary Reference Concept has served as a point-of-departure for several NASA mission architecture studies examining the use of nuclear power and has provided the foundation for a series of "Pathfinder" hardware tests. The long-term technology goal is a Technology Demonstration Unit (TDU) integrated system test using full-scale components and a non-nuclear reactor simulator. The FSP team consists of Glenn Research Center (GRC), Marshall Space Flight Center (MSFC) and the DOE National Laboratories at Los Alamos (LANL), Idaho (INL), Oak Ridge (ORNL), and Sandia (SNL). The project is organized into two main elements: Concept Definition and Risk Reduction. Under Concept Definition, the team performs trade studies, develops analytical tools, and formulates system concepts. Under Risk

  20. Managing Hidden Costs of Offshoring

    DEFF Research Database (Denmark)

    Larsen, Marcus M.; Pedersen, Torben

    2014-01-01

    This chapter investigates the concept of the ‘hidden costs’ of offshoring, i.e. unexpected offshoring costs exceeding the initially expected costs. Due to the highly undefined nature of these costs, we position our analysis towards the strategic responses of firms’ realisation of hidden costs....... In this regard, we argue that a major response to the hidden costs of offshoring is the identification and utilisation of strategic mechanisms in the organisational design to eventually achieving system integration in a globally dispersed and disaggregated organisation. This is heavily moderated by a learning......-by-doing process, where hidden costs motivate firms and their employees to search for new and better knowledge on how to successfully manage the organisation. We illustrate this thesis based on the case of the LEGO Group....

  1. Application Of The Work Breakdown Structure In Determining Cost Buffers In Construction Schedules

    Directory of Open Access Journals (Sweden)

    Połoński M.

    2015-03-01

    Full Text Available The paper presents methods of determining the location of cost buffers and corresponding contingency costs in the CPM schedule based on its work breakdown structure. Application of correctly located cost buffers with appropriately established reserve costs is justified by the common overrunning of scheduled costs in construction projects. Interpolated cost buffers (CB as separate tasks have been combined with relevant summary tasks by the start–to–start (SS relationship, whereas the time of their execution has been dynamically connected with the time of accomplishment of particular summary tasks using the “paste connection” option. Besides cost buffers linked with the group of tasks assigned to summary tasks, a definition of the cost buffer for the entire project (PCB has been proposed, i.e. as one initial task of the entire project. Contingency costs corresponding to these buffers, depending on the data that the planner has at his disposal, can be determined using different methods, but always depend on the costs of all tasks protected by each buffer. The paper presents an exemplary schedule for a facility and the method of determining locations and cost for buffers CB and PCB, as well as their influence on the course of the curve illustrating the budgeted cost of work scheduled (BCWS. The proposed solution has been adjusted and presented with consideration of the possibilities created by the scheduling software MS Project, though its general assumptions may be implemented with application of other similar specialist tools.

  2. Impact of Costing and Cost Analysis Methods on the Result of the Period: Methods Based on Partial Cost Theory

    Directory of Open Access Journals (Sweden)

    Toma Maria

    2017-01-01

    Looking from this perspective, in the present paper we have proposed that objectives, to approach the full cost calculation methods based on partial costs (direct-costing on the product or direct-costing evolved, and comparing them to determine the effect they have on the outcome of the period.

  3. (20) Akinwole CORRECTED Cost (new art)

    African Journals Online (AJOL)

    Adeyinka Odunsi

    Recirculating fish production technology re-‐uses water more than once by passing it through ... Within fixed costs input, interest payment on initial investment ranks the highest. While feed cost accounts for the highest among variable costs for fingerlings and growout systems. ... efforts geared towards obtaining information.

  4. VISIBLE COSTS AND HIDDEN COSTS IN THE BAKING INDUSTRY

    Directory of Open Access Journals (Sweden)

    Criveanu Maria

    2013-04-01

    Full Text Available Hidden costs are present in the activity of any company, hardly identified in the traditional administrative accounting. The high levels of the hidden costs and their unknown presence have serious consequences on the decisions made by the managers. This paper aims at presenting some aspects related to the hidden costs that occur in the activity of the companies in the baking industry and the possibilities to reduce their level.

  5. Implementing Patient Safety Initiatives in Rural Hospitals

    Science.gov (United States)

    Klingner, Jill; Moscovice, Ira; Tupper, Judith; Coburn, Andrew; Wakefield, Mary

    2009-01-01

    Implementation of patient safety initiatives can be costly in time and energy. Because of small volumes and limited resources, rural hospitals often are not included in nationally driven patient safety initiatives. This article describes the Tennessee Rural Hospital Patient Safety Demonstration project, whose goal was to strengthen capacity for…

  6. Cost restructuring

    International Nuclear Information System (INIS)

    Schmidt, J.A.

    1991-01-01

    This paper reports on the cost restructuring of the petroleum industry. This current decade is likely to be one of the most challenging for the petroleum industry. Though petroleum remains among the world's biggest businesses, news of consolidations, restructuring, and layoffs permeates the oil patch from the Gulf of Mexico to the Arctic Isles. The recessionary economy has accelerated these changes, particularly in the upstream sector. Today, even the best-managed companies are transforming their cost structures, and companies that fail to do likewise probably won't survive as independent companies. Indeed, significant consolidation took place during the 1980s. More consolidations can be expected in this decade for companies that do not adapt to the economic realities of the mature business

  7. 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.

  8. Advanced Fuel Cycle Cost Basis

    Energy Technology Data Exchange (ETDEWEB)

    D. E. Shropshire; K. A. Williams; W. B. Boore; J. D. Smith; B. W. Dixon; M. Dunzik-Gougar; R. D. Adams; D. Gombert; E. Schneider

    2009-12-01

    This report, commissioned by the U.S. Department of Energy (DOE), provides a comprehensive set of cost data supporting a cost analysis for the relative economic comparison of options for use in the Advanced Fuel Cycle Initiative (AFCI) Program. The report describes the AFCI cost basis development process, reference information on AFCI cost modules, a procedure for estimating fuel cycle costs, economic evaluation guidelines, and a discussion on the integration of cost data into economic computer models. This report contains reference cost data for 25 cost modules—23 fuel cycle cost modules and 2 reactor modules. The cost modules were developed in the areas of natural uranium mining and milling, conversion, enrichment, depleted uranium disposition, fuel fabrication, interim spent fuel storage, reprocessing, waste conditioning, spent nuclear fuel (SNF) packaging, long-term monitored retrievable storage, near surface disposal of low-level waste (LLW), geologic repository and other disposal concepts, and transportation processes for nuclear fuel, LLW, SNF, transuranic, and high-level waste.

  9. Advanced Fuel Cycle Cost Basis

    Energy Technology Data Exchange (ETDEWEB)

    D. E. Shropshire; K. A. Williams; W. B. Boore; J. D. Smith; B. W. Dixon; M. Dunzik-Gougar; R. D. Adams; D. Gombert

    2007-04-01

    This report, commissioned by the U.S. Department of Energy (DOE), provides a comprehensive set of cost data supporting a cost analysis for the relative economic comparison of options for use in the Advanced Fuel Cycle Initiative (AFCI) Program. The report describes the AFCI cost basis development process, reference information on AFCI cost modules, a procedure for estimating fuel cycle costs, economic evaluation guidelines, and a discussion on the integration of cost data into economic computer models. This report contains reference cost data for 26 cost modules—24 fuel cycle cost modules and 2 reactor modules. The cost modules were developed in the areas of natural uranium mining and milling, conversion, enrichment, depleted uranium disposition, fuel fabrication, interim spent fuel storage, reprocessing, waste conditioning, spent nuclear fuel (SNF) packaging, long-term monitored retrievable storage, near surface disposal of low-level waste (LLW), geologic repository and other disposal concepts, and transportation processes for nuclear fuel, LLW, SNF, and high-level waste.

  10. Advanced Fuel Cycle Cost Basis

    Energy Technology Data Exchange (ETDEWEB)

    D. E. Shropshire; K. A. Williams; W. B. Boore; J. D. Smith; B. W. Dixon; M. Dunzik-Gougar; R. D. Adams; D. Gombert; E. Schneider

    2008-03-01

    This report, commissioned by the U.S. Department of Energy (DOE), provides a comprehensive set of cost data supporting a cost analysis for the relative economic comparison of options for use in the Advanced Fuel Cycle Initiative (AFCI) Program. The report describes the AFCI cost basis development process, reference information on AFCI cost modules, a procedure for estimating fuel cycle costs, economic evaluation guidelines, and a discussion on the integration of cost data into economic computer models. This report contains reference cost data for 25 cost modules—23 fuel cycle cost modules and 2 reactor modules. The cost modules were developed in the areas of natural uranium mining and milling, conversion, enrichment, depleted uranium disposition, fuel fabrication, interim spent fuel storage, reprocessing, waste conditioning, spent nuclear fuel (SNF) packaging, long-term monitored retrievable storage, near surface disposal of low-level waste (LLW), geologic repository and other disposal concepts, and transportation processes for nuclear fuel, LLW, SNF, transuranic, and high-level waste.

  11. Reference costs for power generation

    International Nuclear Information System (INIS)

    2003-12-01

    The first part of the 2003 study of reference costs for power generation has been completed. It was carried out by the General Directorate for Energy and Raw Materials (DGEMP) of the French Ministry of the Economy, Finance and Industry, with the collaboration of power-plant operators, construction firms and many other experts. A Review Committee of experts including economists (Forecasting Department, French Planning Office), qualified public figures, representatives of power-plant construction firms and operators, and non-governmental organization (NGO) experts, was consulted in the final phase. The study examines the costs of power generated by different methods (i.e. nuclear and fossil-fuel [gas-, coal-, and oil-fired] power plants) in the context of an industrial operation beginning in the year 2015. - The second part of the study relating to decentralized production methods (wind, photovoltaic, combined heat and power) is still in progress and will be presented at the beginning of next year. - 1. Study approach: The study is undertaken mainly from an investor's perspective and uses an 8% discount rate to evaluate the expenses and receipts from different years. In addition, the investment costs are considered explicitly in terms of interest during construction. - 2. Plant operating on a full-time basis (year-round): The following graph illustrates the main conclusions of the study for an effective operating period of 8000 hours. It can be seen that nuclear is more competitive than the other production methods for a year-round operation with an 8% discount rate applied to expenses. This competitiveness is even better if the costs related to greenhouse-gas (CO 2 ) emission are taken into account in estimating the MWh cost price. Integrating the costs resulting from CO 2 emissions by non-nuclear fuels (gas, coal), which will be compulsory as of 2004 with the transposition of European directives, increases the total cost per MWh of these power generation methods

  12. Activity- Based Costing: An Application In The Olive Sector

    OpenAIRE

    Bekçioğlu, Selim; Gürel, Eymen; Kızılyalçın, D. Ali

    2014-01-01

    The purpose of the study named as “The Activity Based Costing: An Application in the Olive Sector” is the implementation of activity based costing in olive sector and the statement of the differences as regards to the traditional costing. The accepted basic hypothesis in the thesis is that the activity-based costing provides more accurate cost information than the traditional costing process. In this study initially comprehensive information about activity based costing is given and after th...

  13. Which Triple Aim related measures are being used to evaluate population management initiatives? An international comparative analysis.

    Science.gov (United States)

    Hendrikx, Roy J P; Drewes, Hanneke W; Spreeuwenberg, Marieke; Ruwaard, Dirk; Struijs, Jeroen N; Baan, Caroline A

    2016-05-01

    Population management (PM) initiatives are introduced in order to create sustainable health care systems. These initiatives should focus on the continuum of health and well-being of a population by introducing interventions that integrate various services. To be successful they should pursue the Triple Aim, i.e. simultaneously improve population health and quality of care while reducing costs per capita. This study explores how PM initiatives measure the Triple Aim in practice. An exploratory search was combined with expert consultations to identify relevant PM initiatives. These were analyzed based on general characteristics, utilized measures and related selection criteria. In total 865 measures were used by 20 PM initiatives. All quality of care domains were included by at least 11 PM initiatives, while most domains of population health and costs were included by less than 7 PM initiatives. Although their goals showed substantial overlap, the measures applied showed few similarities between PM initiatives and were predominantly selected based on local priority areas and data availability. Most PM initiatives do not measure the full scope of the Triple Aim. Additionally, variety between measures limits comparability between PM initiatives. Consensus on the coverage of Triple Aim domains and a set of standardized measures could further both the inclusion of the various domains as well as the comparability between PM initiatives. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. Activity based costing (ABC Method

    Directory of Open Access Journals (Sweden)

    Prof. Ph.D. Saveta Tudorache

    2008-05-01

    Full Text Available In the present paper the need and advantages are presented of using the Activity BasedCosting method, need arising from the need of solving the information pertinence issue. This issue has occurreddue to the limitation of classic methods in this field, limitation also reflected by the disadvantages ofsuch classic methods in establishing complete costs.

  15. Strategic Aspects of Cost Management

    Directory of Open Access Journals (Sweden)

    Angelika I. Petrova

    2013-01-01

    Full Text Available This report is a summary of a research done on the area of Strategic Cost Management (SCM. This report includes a detailed discussion and application of Life Cycle Costing (LCC which a company can use to achieve its strategic objects in today's dynamic business environment. Hence, the main focus of this report is on LCC as mentioned

  16. Initial Assessment of Whiplash Patients

    Directory of Open Access Journals (Sweden)

    R Gunzburg

    2003-01-01

    Full Text Available The article looks at how for severe trauma, the outcome of treatment depends on the initial medical care. This has now also been accepted for whiplash associated disorders, underlining the importance of a proper initial assessment. Once major injury has been excluded and the diagnosis of whiplash associated disorder has been established, the initial treatment of whiplash in the emergency room can be started. The four key points to remember are described, including reassuring the patient about evolution, no soft collar, nonsteroidal anti-inflammatory drugs and early mobilisation.

  17. Canada's family violence initiative: partnerships

    Directory of Open Access Journals (Sweden)

    Elaine Scott

    1994-01-01

    Full Text Available Under Canada's four-year, $136 million Family Violence Initiative, the federal government is calling upon all Canadians to work in partnerships towards the elimination of family violence - child abuse, violence against women, and elder (senior abuse. Family violence is a complex problem and requires the efforts of all Canadians to resolve it. One of the key themes of the Initiative - a multidisciplinary approach to the problem of family violence - is reflected in the selection and development of projects. Activities funded by the seven federal departments and agencies involved in the Initiative emphasize partnerships with the professional, voluntary, corporate, non-government and government sectors.

  18. Financing Preference Behaviour for Private Finance Initiative (PFI Projects

    Directory of Open Access Journals (Sweden)

    Yati Md Lasa

    2016-01-01

    Full Text Available Project Financing Initiative (PFI projects require the private sector to invest an enormous amount of capital for the development of public projects. The private sector has to seek cost-effective financing sources for their survival in the long-term concession. Conventional financing uses widely; however, Islamic financing promises better financing through profit and loss sharing. This paper reviews financing preferences for PFI projects and the factors influencing the choice of funding. The results show that religious perspective, quality of services, financing facilities and reputation are the factors that are expected will influence the financing preference behaviour, either Islamic or conventional finance.

  19. Cost and cost-effectiveness of smear-positive tuberculosis treatment by Health Extension Workers in Southern Ethiopia: a community randomized trial.

    Directory of Open Access Journals (Sweden)

    Daniel G Datiko

    Full Text Available UNLABELLED: Treatments by HEWs in the health posts and general health workers at health facility were compared along a community-randomized trial. Costs were analysed from societal perspective in 2007 in US $ using standard methods. We prospectively enrolled smear positive patients, and calculated cost-effectiveness as the cost per patient successfully treated. The total cost for each successfully treated smear-positive patient was higher in health facility ($158.9 compared with community ($61.7. Community-based treatment reduced the total, patient and caregiver cost by 61.2%, 68.1% and 79.8%, respectively. Involving HEWs added a total cost of $8.80 (14.3% of total cost on health service per patient treated in the community. CONCLUSIONS/SIGNIFICANCE: Community-based treatment by HEWs costs only 39% of what treatment by general health workers costs for similar outcomes. Involving HEWs in TB treatment is a cost effective treatment alternative to the health service, to the patients and the family. There is an economic and public health reason to consider involving HEWs in TB treatment in Ethiopia. However, community-based treatment requires initial investment to start its implementation, training and supervision. TRIAL REGISTRATION: ClinicalTrials.gov NCT00803322.

  20. ASSESSING THE COSTS OF THE THERMAL REHABILITATIONS OF A STUDIO BLOCK ENVELOPE

    Directory of Open Access Journals (Sweden)

    DINU R.C.

    2017-06-01

    Full Text Available A view to reducing thermal energy consumption for a block of studios, this paper presents an assessment of the costs of energy efficient building materials used for the thermal rehabilitation of the analyzed building’s tire. Based on information obtained from the evaluation of heat energy consumption and of the actual heat balance of the studios block, resulted the necessity for thermal rehabilitation. These works aimed equally both exterior walls as well as exterior windows and doors and involves a certain level of initial costs wich will be recovered through lower cost of the consumed thermal energy after thermal rehabilitation of the building tire.

  1. Combining Time-Driven Activity-Based Costing with Clinical Outcome in Cost-Effectiveness Analysis to Measure Value in Treatment of Depression.

    Directory of Open Access Journals (Sweden)

    Samir El Alaoui

    Full Text Available A major challenge of mental health care is to provide safe and effective treatment with limited resources. The main purpose of this study was to examine a value-based approach in clinical psychiatry when evaluating a process improvement initiative. This was accomplished by using the relatively new time driven activity based costing (TDABC method within the more widely adopted cost-effectiveness analysis framework for economic evaluation of healthcare technologies. The objective was to evaluate the cost-effectiveness of allowing psychologists to perform post-treatment assessment previously performed by psychiatrists at an outpatient clinic treating depression using internet-based cognitive-behavioral therapy (ICBT.Data was collected from 568 adult patients treated with ICBT for depression during 2013-2014. The TDABC methodology was used to estimate total healthcare costs, including development of process maps for the complete cycle of care and estimation of resource use and minute costs of staff, hospital space and materials based on their relative proportions used. Clinical outcomes were measured using the Patient Health Questionnaire depression scale (PHQ-9 before and after treatment and at 6-month follow-up. Cost-effectiveness analyses (CEA was performed and the results presented as incremental net benefits (INB, cost-effectiveness acceptability curves (CEACs and confidence ellipses to demonstrate uncertainty around the value of the organizational intervention.Taking into account the complete healthcare process (from referral to follow-up assessment, treatment costs decreased from $709 (SD = $130 per patient in 2013 to $659 (SD = $134 in 2014 while treatment effectiveness was maintained; 27% had achieved full remission from depression after treatment (PHQ-9 < 5 during both 2013 and 2014 and an additional 35% and 33% had achieved partial remission in 2013 and 2014, respectively. At follow-up, 42% were in full remission after treatment during

  2. Database citation in full text biomedical articles.

    Science.gov (United States)

    Kafkas, Şenay; Kim, Jee-Hyub; McEntyre, Johanna R

    2013-01-01

    Molecular biology and literature databases represent essential infrastructure for life science research. Effective integration of these data resources requires that there are structured cross-references at the level of individual articles and biological records. Here, we describe the current patterns of how database entries are cited in research articles, based on analysis of the full text Open Access articles available from Europe PMC. Focusing on citation of entries in the European Nucleotide Archive (ENA), UniProt and Protein Data Bank, Europe (PDBe), we demonstrate that text mining doubles the number of structured annotations of database record citations supplied in journal articles by publishers. Many thousands of new literature-database relationships are found by text mining, since these relationships are also not present in the set of articles cited by database records. We recommend that structured annotation of database records in articles is extended to other databases, such as ArrayExpress and Pfam, entries from which are also cited widely in the literature. The very high precision and high-throughput of this text-mining pipeline makes this activity possible both accurately and at low cost, which will allow the development of new integrated data services.

  3. Full waveform inversion for mechanized tunneling reconnaissance

    Science.gov (United States)

    Lamert, Andre; Musayev, Khayal; Lambrecht, Lasse; Friederich, Wolfgang; Hackl, Klaus; Baitsch, Matthias

    2016-04-01

    In mechanized tunnel drilling processes, exploration of soil structure and properties ahead of the tunnel boring machine can greatly help to lower costs and improve safety conditions during drilling. We present numerical full waveform inversion approaches in time and frequency domain of synthetic acoustic data to detect different small scale structures representing potential obstacles in front of the tunnel boring machine. With the use of sensitivity kernels based on the adjoint wave field in time domain and in frequency domain it is possible to derive satisfactory models with a manageable amount of computational load. Convergence to a suitable model is assured by the use of iterative model improvements and gradually increasing frequencies. Results of both, time and frequency approach, will be compared for different obstacle and source/receiver setups. They show that the image quality strongly depends on the used receiver and source positions and increases significantly with the use of transmission waves due to the installed receivers and sources at the surface and/or in bore holes. Transmission waves lead to clearly identified structure and position of the obstacles and give satisfactory guesses for the wave speed. Setups using only reflected waves result in blurred objects and ambiguous position of distant objects and allow to distinguish heterogeneities with higher or lower wave speed, respectively.

  4. Full Life Wind Turbine Gearbox Lubricating Fluids

    Energy Technology Data Exchange (ETDEWEB)

    Lutz, Glenn A.; Jungk, Manfred; Bryant, Jonathan J.; Lauer, Rebecca S.; Chobot, Anthony; Mayer, Tyler; Palmer, Shane; Kauffman, Robert E.

    2012-02-28

    for real world but creates the ability to test the lubricating fluids performance under the most extreme conditions. The PAO Reference oil also passed its testing without any noticeable deterioration of the gear surface. However the PAO Reference oil was replaced midway through the progressive loading, as the lubricant was burned in an attempt to raise the sump temperature to the same levels as for the PFPE. Both materials experienced a decrease of viscosity during their respective run times. The viscosity index decreased for the PAO there while there was a slight increase for the PFPE. FZG laboratory gear tests and measurements of the drive motor's current during the full scale gear box trial were made to characterize the relative efficiency between the PFPE fluid and the PAO Reference oil. In the FZG laboratory efficiency test, the PFPE fluids show much higher churning losses due to their higher viscosity and density. The analysis seems to show that the efficiency correlates better to dynamic viscosity than any other of the measured metrics such as film thickness. In load stages where the load, speed and temperature are similar, the PFPE fluid has a greater film thickness and theoretical gear protection, but requires a larger current for the drive motor than the PAO. However in load stages where the film thickness is the same, the PFPE fluid's reduced dynamic viscosity gives it a slight efficiency advantage relative to the PAO reference oil. Ultimately, many factors such as temperature, rotational speed, and fluid viscosity combine in a complex fashion to influence the results. However, the PFPE's much lower change of viscosity with respect to temperature, allows variations in designing an optimum viscosity to balance efficiency versus gear protection. Economic analysis was done using Cost of Energy calculations. The results vary from 5.3% for a 'Likely Case' to 16.8% for a 'Best Case' scenario as potential cost improvement by

  5. The direct cost of "Thriasio" school screening program

    Directory of Open Access Journals (Sweden)

    Maziotou Christina

    2007-05-01

    Full Text Available Abstract Background There is great diversity in the policies for scoliosis screening worldwide. The initial enthusiasm was succeeded by skepticism and the worth of screening programs has been challenged. The criticisms of school screening programs cite mainly the negative psychological impact on children and their families and the increased financial cost of visits and follow-up radiographs. The purpose of this report is to evaluate the direct cost of performing the school screening in a district hospital. Methods A cost analysis was performed for the estimation of the direct cost of the "Thriasio" school-screening program between January 2000 and May 2006. The analysis involved all the 6470 pupils aged 6–18 years old who were screened at schools for spinal deformities during this period. The factors which were taken into consideration in order to calculate the direct cost of the screening program were a the number of the examiners b the working hours, c the examiners' salary, d the cost of transportation and finally e the cost of examination per child. Results During the examined period 20 examiners were involved in the program and worked for 1949 working hours. The hourly salary for the trainee doctors was 6.80 euro, for the Health Visitors 6.70 euro and for the Physiotherapists 5.50 euro in current prices. The cost of transportation was 32 euro per year. The direct cost for the examination of each child for the above studied period was calculated to be 2.04 euro. Conclusion The cost of our school-screening program is low. The present study provides a strong evidence for the continuation of the program when looking from a financial point of view.

  6. The societal costs of insomnia

    Directory of Open Access Journals (Sweden)

    Alan G Wade

    2010-12-01

    Full Text Available Alan G WadeCPS Research, Glasgow, ScotlandObjective: Insomnia can be broadly defined as difficulty initiating or maintaining sleep, or sleep that is not refreshing or of poor quality with negative effect on daytime function. Insomnia can be a primary condition or comorbid to an underlying disorder. Subjective measures of insomnia used in population studies, usually based on complaints of unsatisfactory sleep, put the prevalence at about 10%. Insomnia is more common in the elderly and in women, and is often associated with medical and psychiatric disorders. This review examines the measures used to assess quality of sleep (QOS and daytime functioning and the impact of insomnia on society using these measures.Methods: Literature searches were performed to identify all studies of insomnia (primary and comorbid in adults (aged 18–64 years and the elderly (aged ≥ 65 years with baseline and/or outcomes relating to QOS or daytime functioning. The impact of poor QOS on quality of life (QOL, psychomotor and cognitive skills, health care resource utilization, and other societal effects was examined.Results: Although definitions and measurement scales used to assess sleep quality vary widely, it is clear that the societal consequences of insomnia are substantial and include impaired QOL and increased health care utilization. The impact of poor QOS and impaired daytime functioning common in insomnia can lead to indirect effects such as lower work productivity, increased sick leave, and a higher rate of motor vehicle crashes.Conclusions: Insomnia is associated with substantial direct and indirect costs to society. It is almost impossible to separate the costs associated with primary and comorbid insomnia. More studies are required which control for the severity of any primary disorder to accurately evaluate the costs of comorbid insomnia. Development of standardized diagnostic and assessment scales will enable more accurate quantification of the true

  7. Benchmarking for Cost Improvement. Final report

    Energy Technology Data Exchange (ETDEWEB)

    1993-09-01

    The US Department of Energy`s (DOE) Office of Environmental Restoration and Waste Management (EM) conducted the Benchmarking for Cost Improvement initiative with three objectives: Pilot test benchmarking as an EM cost improvement tool; identify areas for cost improvement and recommend actions to address these areas; provide a framework for future cost improvement. The benchmarking initiative featured the use of four principal methods (program classification, nationwide cost improvement survey, paired cost comparison and component benchmarking). Interested parties contributed during both the design and execution phases. The benchmarking initiative was conducted on an accelerated basis. Of necessity, it considered only a limited set of data that may not be fully representative of the diverse and complex conditions found at the many DOE installations. The initiative generated preliminary data about cost differences and it found a high degree of convergence on several issues. Based on this convergence, the report recommends cost improvement strategies and actions. This report describes the steps taken as part of the benchmarking initiative and discusses the findings and recommended actions for achieving cost improvement. The results and summary recommendations, reported below, are organized by the study objectives.

  8. Soft Costs Fact Sheet

    Energy Technology Data Exchange (ETDEWEB)

    None

    2016-05-01

    This fact sheet is an overview of the systems integration subprogram at the U.S. Department of Energy SunShot Initiative. Soft costs can vary significantly as a result of a fragmented energy marketplace. In the U.S., there are 18,000 jurisdictions and 3,000 utilities with different rules and regulations for how to go solar. The same solar equipment may vary widely in its final installation price due to process and market variations across jurisdictions, creating barriers to rapid industry growth. SunShot supports the development of innovative solutions that enable communities to build their local economies and establish clean energy initiatives that meet their needs, while at the same time creating sustainable solar market conditions.

  9. RECTIFIED ETHANOL PRODUCTION COST ANALYSIS

    Directory of Open Access Journals (Sweden)

    Nikola J Budimir

    2011-01-01

    Full Text Available This paper deals with the impact of the most important factors of the total production costs in bioethanol production. The most influential factors are: total investment costs, price of raw materials (price of biomass, enzymes, yeast, and energy costs. Taking into account these factors, a procedure for estimation total production costs was establish. In order to gain insight into the relationship of production and selling price of bioethanol, price of bioethanol for some countries of the European Union and the United States are given.

  10. 24 CFR 941.304 - Full proposal content.

    Science.gov (United States)

    2010-04-01

    ... with all applicable Federal relocation requirements; (j) Life-cycle analysis. For new construction and... cooling systems, and which shall include a life-cycle cost analysis of the installation, maintenance and... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Full proposal content. 941.304...

  11. ON SECURE FULL DUPLEX COMMUNICATION IN MOBILE AD HOC NETWORK

    OpenAIRE

    S. C. Dutta; Sudha Singh; D. K. Singh

    2013-01-01

    This paper is to establish Ad Hoc network in mobile phones and start fully secured full duplex communication in any situation. This type of communication will be cost effective and it will be fastest way of communication in case of any server failure or server error.

  12. An Analysis Of Activity Based Costing Between Benefit And Cost For Its Implementation

    Directory of Open Access Journals (Sweden)

    Dadan Soekardan

    2015-08-01

    Full Text Available This research discusses how the importance of adopting activity-based costing for the company in order to carry out its business strategy. One objective is to implement activity based costing cost efficiency by cutting costs incurred for non-value added activity. But the phenomenon shows that there are still many companies organizations are not interested in adopting the activity based costing. This article also outlines the advantages and limitations in adopting activity based costing for the company.

  13. Process Approach to Cost of Quality

    Directory of Open Access Journals (Sweden)

    Katarzyna Szczepańska

    2009-12-01

    Full Text Available Contemporary understanding comprehending cost of quality is connected both with the sphere of the management, as well as the operational activity. Borders of considering the category of quality costs moved beyond the technical – technological area. Trial including costs let the quality for classifying them with reference to all action carried out in the modern enterprise. Standard models of quality costs and the activity – based costing appointed new prospects of economics of the quality in the business administration.

  14. Design to Cost and Life Cycle Cost.

    Science.gov (United States)

    1980-07-01

    MANAGEMENT TASK ORIENTATED COST STRUCTURE 5. COSTS OF CONSTRUCTION INIFRA 2. COSTS DURING DEVELOPMENT -6. COSTS OF TRAINING 3. COSTS DURING TESi ...de r~duction des coats, ii faut disponer de ?!vyenr. performants d’eetimation des coats en main-d’oeuvre et en applrvininrinesent. Cam moyenm doivent

  15. Initiation of trailing edge failure in full-scale wind turbine blade test

    DEFF Research Database (Denmark)

    Haselbach, Philipp Ulrich; Branner, Kim

    2016-01-01

    non-linear buckling effect of the trailing edge under combined loading, and how it affects the ultimate strength of a blade in a trailing-edge failure dominated load direction were investigated. The study details the interaction between trailing edge buckling on damage onset and sandwich panel failure...

  16. Low Cost Vision Based Personal Mobile Mapping System

    Directory of Open Access Journals (Sweden)

    M. M. Amami

    2014-03-01

    Full Text Available Mobile mapping systems (MMS can be used for several purposes, such as transportation, highway infrastructure mapping and GIS data collecting. However, the acceptance of these systems is not wide spread and their use is still limited due the high cost and dependency on the Global Navigation Satellite System (GNSS. A low cost vision based personal MMS has been produced with an aim to overcome these limitations. The system has been designed to depend mainly on cameras and use of low cost GNSS and inertial sensors to provide a bundle adjustment solution with initial values. The system has the potential to be used indoor and outdoor. The system has been tested indoors and outdoors with different GPS coverage, surrounded features, and narrow and curvy paths. Tests show that the system is able to work in such environments providing 3D coordinates of better than 10 cm accuracy.

  17. COST BENEFIT ANALYSIS OF A DG INTEGRATED SYSTEM: CASE STUDY

    Directory of Open Access Journals (Sweden)

    Ch. V. S. S. SAILAJA

    2017-09-01

    Full Text Available Distributed Generation is capable of meeting the load of the consumers partially or completely. Depending on the type of DG involved it can be operated in interconnected mode and islanded mode. The availability of numerous alternatives present for the DG technologies and large initial investments necessitates a detailed cost benefit analysis for the implementation of DG technologies. In this work an attempt has been made to study the costs involved in implementing the DG technologies. A practical system having two kinds of distributed generation i.e., Diesel Generator and solar photovoltaic system for its back up purpose is considered. A detailed cost analysis of the two DG technologies is carried out.

  18. Army Net Zero Installation Initiative and Cost Benefit Analysis Activity

    Science.gov (United States)

    2011-10-31

    freshwater resources and returns water back to the same watershed so not to deplete the groundwater and surface water resources of that... freshwater resources & returns water back to the same watershed so not to deplete the groundwater & surface water resources of that region in quantity...Goals: Reduce freshwater demand through water efficiency & conservation Access/develop alternate water sources to offset freshwater demand Develop

  19. Documenting success of energy management cost reduction initiatives

    International Nuclear Information System (INIS)

    Stewart, A.

    1993-01-01

    The scope of this paper is to offer methods to document energy saving projects. The examples used are based on actual industrial facilities. I will define concepts to be used in the analysis of the industrial work place energy consumption. With the concepts defined we can begin to apply the documentation strategy for some specific examples. Why should we be interested in auditing the results of energy projects? Nearly every industrial facility has embarked on the road to energy efficiency. As one of my plant engineer associates relates open-quotes If all our energy saving programs were working as stated the power company would be paying us.close quotes The underlying principles in this statement are true. Does it mean we as technicians, engineers and managers of energy projects have failed? No, we have however failed to finish the job and document there results. My experience has shown there is good support and enthusiasm for those energy projects we begin. It is also my experience that a well documented successful project provides many levels of satisfaction. Large energy management projects involve a major financial commitment. Documenting the results provides all those who supported the project from finance, management and the technical staff the positive reinforcement to support your future projects. We should begin by defining what an energy audit is and what is the expected result of an audit

  20. Student initiative: A conceptual analysis

    Directory of Open Access Journals (Sweden)

    Polovina Nada

    2014-01-01

    Full Text Available In the description and scientific consideration of the attitude of children and youth towards their education and development, the concept of student initiative has been gaining ground lately, and it is hence the subject of analysis in this paper. The analysis is important because of the discrepancy between the increased efforts of the key educational policy holders to promote the idea about the importance of the development of student initiative and rare acceptance of this idea among theoreticians, researchers and practitioners dealing with the education and development of children and youth. By concretising the features of initiative student behaviour, our aim was, on the one hand, to observe the structural determinants and scientific status of the very concept of an initiative student, and, on the other, to contribute to the understanding of the initiative behaviour in practice. In the first part of the paper we deal with different notions and concretisations of the features of initiative behaviour of children and youth, which includes the consideration of: basic student initiative, academic student initiative, individual student initiative, the capacity for initiative and personal development initiative. In the second part of the paper, we discuss the relations of the concept of student initiative with the similar general concepts (activity/passivity, proactivity, agency and the concepts immediately related to school environment (student involvement, student participation. The results of our analysis indicate that the concept of student initiative has: particular features that differentiate it from similar concepts; the potential to reach the status of a scientific concept, bearing in mind the initial empirical specifications and general empirical verifiability of the yet unverified determinants of the concept. In the concluding part of the paper, we discuss the implications of the conceptual analysis for further research, as well as for

  1. Lower extremity muscle functions during full squats.

    Science.gov (United States)

    Robertson, D G E; Wilson, Jean-Marie J; St Pierre, Taunya A

    2008-11-01

    The purpose of this research was to determine the functions of the gluteus maximus, biceps femoris, semitendinosus, rectus femoris, vastus lateralis, soleus, gastrocnemius, and tibialis anterior muscles about their associated joints during full (deep-knee) squats. Muscle function was determined from joint kinematics, inverse dynamics, electromyography, and muscle length changes. The subjects were six experienced, male weight lifters. Analyses revealed that the prime movers during ascent were the monoarticular gluteus maximus and vasti muscles (as exemplified by vastus lateralis) and to a lesser extent the soleus muscles. The biarticular muscles functioned mainly as stabilizers of the ankle, knee, and hip joints by working eccentrically to control descent or transferring energy among the segments during scent. During the ascent phase, the hip extensor moments of force produced the largest powers followed by the ankle plantar flexors and then the knee extensors. The hip and knee extensors provided the initial bursts of power during ascent with the ankle extensors and especially a second burst from the hip extensors adding power during the latter half of the ascent.

  2. Image-domain full waveform inversion

    KAUST Repository

    Zhang, Sanzong

    2013-08-20

    The main difficulty with the data-domain full waveform inversion (FWI) is that it tends to get stuck in the local minima associated with the waveform misfit function. This is because the waveform misfit function is highly nonlinear with respect to changes in velocity model. To reduce this nonlinearity, we define the image-domain objective function to minimize the difference of the suboffset-domain common image gathers (CIGs) obtained by migrating the observed data and the calculated data. The derivation shows that the gradient of this new objective function is the combination of the gradient of the conventional FWI and the image-domain differential semblance optimization (DSO). Compared to the conventional FWI, the imagedomain FWI is immune to cycle skipping problems by smearing the nonzero suboffset images along wavepath. It also can avoid the edge effects and the gradient artifacts that are inherent in DSO due to the falsely over-penalized focused images. This is achieved by subtracting the focused image associated with the calculated data from the unfocused image associated with the observed data in the image-domain misfit function. The numerical results of the Marmousi model show that image-domain FWI is less sensitive the initial model than the conventional FWI. © 2013 SEG.

  3. Full Waveform Inversion Using Nonlinearly Smoothed Wavefields

    KAUST Repository

    Li, Y.; Choi, Yun Seok; Alkhalifah, Tariq Ali; Li, Z.

    2017-01-01

    The lack of low frequency information in the acquired data makes full waveform inversion (FWI) conditionally converge to the accurate solution. An initial velocity model that results in data with events within a half cycle of their location in the observed data was required to converge. The multiplication of wavefields with slightly different frequencies generates artificial low frequency components. This can be effectively utilized by multiplying the wavefield with itself, which is nonlinear operation, followed by a smoothing operator to extract the artificially produced low frequency information. We construct the objective function using the nonlinearly smoothed wavefields with a global-correlation norm to properly handle the energy imbalance in the nonlinearly smoothed wavefield. Similar to the multi-scale strategy, we progressively reduce the smoothing width applied to the multiplied wavefield to welcome higher resolution. We calculate the gradient of the objective function using the adjoint-state technique, which is similar to the conventional FWI except for the adjoint source. Examples on the Marmousi 2 model demonstrate the feasibility of the proposed FWI method to mitigate the cycle-skipping problem in the case of a lack of low frequency information.

  4. Full Waveform Inversion Using Nonlinearly Smoothed Wavefields

    KAUST Repository

    Li, Y.

    2017-05-26

    The lack of low frequency information in the acquired data makes full waveform inversion (FWI) conditionally converge to the accurate solution. An initial velocity model that results in data with events within a half cycle of their location in the observed data was required to converge. The multiplication of wavefields with slightly different frequencies generates artificial low frequency components. This can be effectively utilized by multiplying the wavefield with itself, which is nonlinear operation, followed by a smoothing operator to extract the artificially produced low frequency information. We construct the objective function using the nonlinearly smoothed wavefields with a global-correlation norm to properly handle the energy imbalance in the nonlinearly smoothed wavefield. Similar to the multi-scale strategy, we progressively reduce the smoothing width applied to the multiplied wavefield to welcome higher resolution. We calculate the gradient of the objective function using the adjoint-state technique, which is similar to the conventional FWI except for the adjoint source. Examples on the Marmousi 2 model demonstrate the feasibility of the proposed FWI method to mitigate the cycle-skipping problem in the case of a lack of low frequency information.

  5. Image-domain full waveform inversion

    KAUST Repository

    Zhang, Sanzong; Schuster, Gerard T.

    2013-01-01

    The main difficulty with the data-domain full waveform inversion (FWI) is that it tends to get stuck in the local minima associated with the waveform misfit function. This is because the waveform misfit function is highly nonlinear with respect to changes in velocity model. To reduce this nonlinearity, we define the image-domain objective function to minimize the difference of the suboffset-domain common image gathers (CIGs) obtained by migrating the observed data and the calculated data. The derivation shows that the gradient of this new objective function is the combination of the gradient of the conventional FWI and the image-domain differential semblance optimization (DSO). Compared to the conventional FWI, the imagedomain FWI is immune to cycle skipping problems by smearing the nonzero suboffset images along wavepath. It also can avoid the edge effects and the gradient artifacts that are inherent in DSO due to the falsely over-penalized focused images. This is achieved by subtracting the focused image associated with the calculated data from the unfocused image associated with the observed data in the image-domain misfit function. The numerical results of the Marmousi model show that image-domain FWI is less sensitive the initial model than the conventional FWI. © 2013 SEG.

  6. Full-Automatic Parking registration and payment

    DEFF Research Database (Denmark)

    Agerholm, Niels; Lahrmann, Harry; Jørgensen, Brian

    2014-01-01

    As part of ITS Platform North Denmark, a full-automatic GNSS-based parking payment (PP) system was developed (PP app). On the basis of the parking position and parking time, the PP app can determine the price of parking and collect the amount from the car owner’s bank account. The driver...... is informed about any initiation of PP via SMS message. If the driver finds the payment erroneous, it can be cancelled via SMS message. Parking attendants can check if the car in question has an ongoing payment for parking. To handle the problems with GNSS-based positioning in densely built-up areas......, an advanced map matching algorithm was integrated in the PP app. 24 of the participating vehicles used the PP app, and 58 parking payments were carried out without errors. In a few cases, the wrong parking area was selected. This was due to lack of information in the map rather than errors in the map matching...

  7. Direct cost associated with acquired brain injury in Ontario

    Directory of Open Access Journals (Sweden)

    Chen Amy

    2012-08-01

    Full Text Available Abstract Background Acquired Brain Injury (ABI from traumatic and non traumatic causes is a leading cause of disability worldwide yet there is limited research summarizing the health system economic burden associated with ABI. The objective of this study was to determine the direct cost of publicly funded health care services from the initial hospitalization to three years post-injury for individuals with traumatic (TBI and non-traumatic brain injury (nTBI in Ontario Canada. Methods A population-based cohort of patients discharged from acute hospital with an ABI code in any diagnosis position in 2004 through 2007 in Ontario was identified from administrative data. Publicly funded health care utilization was obtained from several Ontario administrative healthcare databases. Patients were stratified according to traumatic and non-traumatic causes of brain injury and whether or not they were discharged to an inpatient rehabilitation center. Health system costs were calculated across a continuum of institutional and community settings for up to three years after initial discharge. The continuum of settings included acute care emergency departments inpatient rehabilitation (IR complex continuing care home care services and physician visits. All costs were calculated retrospectively assuming the government payer’s perspective. Results Direct medical costs in an ABI population are substantial with mean cost in the first year post-injury per TBI and nTBI patient being $32132 and $38018 respectively. Among both TBI and nTBI patients those discharged to IR had significantly higher treatment costs than those not discharged to IR across all institutional and community settings. This tendency remained during the entire three-year follow-up period. Annual medical costs of patients hospitalized with a brain injury in Ontario in the first follow-up year were approximately $120.7 million for TBI and $368.7 million for nTBI. Acute care cost accounted for 46

  8. Florida Hydrogen Initiative

    Energy Technology Data Exchange (ETDEWEB)

    Block, David L

    2013-06-30

    The Florida Hydrogen Initiative (FHI) was a research, development and demonstration hydrogen and fuel cell program. The FHI program objectives were to develop Florida?s hydrogen and fuel cell infrastructure and to assist DOE in its hydrogen and fuel cell activities The FHI program funded 12 RD&D projects as follows: Hydrogen Refueling Infrastructure and Rental Car Strategies -- L. Lines, Rollins College This project analyzes strategies for Florida's early stage adaptation of hydrogen-powered public transportation. In particular, the report investigates urban and statewide network of refueling stations and the feasibility of establishing a hydrogen rental-car fleet based in Orlando. Methanol Fuel Cell Vehicle Charging Station at Florida Atlantic University ? M. Fuchs, EnerFuel, Inc. The project objectives were to design, and demonstrate a 10 kWnet proton exchange membrane fuel cell stationary power plant operating on methanol, to achieve an electrical energy efficiency of 32% and to demonstrate transient response time of less than 3 milliseconds. Assessment of Public Understanding of the Hydrogen Economy Through Science Center Exhibits, J. Newman, Orlando Science Center The project objective was to design and build an interactive Science Center exhibit called: ?H2Now: the Great Hydrogen Xchange?. On-site Reformation of Diesel Fuel for Hydrogen Fueling Station Applications ? A. Raissi, Florida Solar Energy Center This project developed an on-demand forecourt hydrogen production technology by catalytically converting high-sulfur hydrocarbon fuels to an essentially sulfur-free gas. The removal of sulfur from reformate is critical since most catalysts used for the steam reformation have limited sulfur tolerance. Chemochromic Hydrogen Leak Detectors for Safety Monitoring ? N. Mohajeri and N. Muradov, Florida Solar Energy Center This project developed and demonstrated a cost-effective and highly selective chemochromic (visual) hydrogen leak detector for safety

  9. Forest management units through cost

    Directory of Open Access Journals (Sweden)

    Cristina Tenovici

    2010-12-01

    Full Text Available Costs minimizing and profit maximizing make the costs adjustment seems to be a vital necessity when the activity developed within the company does not assure the maintenance and stability of the necessary relation between consuming factors and costs. In such circumstances, approaching differing sides of the production cost and improving the methods of calculation has much significance in determining the most appropriate measures necessary for its adjustment and for profit increasing. The whole informational process of costs – formation, control and analysis of costs – involves a careful use the methodological concepts known under the name of classical methods and modern or complementary methods, as well as of other proceedings. Such methods and proceedings cannot be applied separately, only conjugated and integrated in a unitary methodological system, each of these methods and proceedings participating at achieving one or more objectives. Only by their unitary action they can fulfill all the system objective.

  10. Cost Model for Digital Preservation: Cost of Digital Migration

    Directory of Open Access Journals (Sweden)

    Ulla Bøgvad Kejser

    2011-03-01

    Full Text Available The Danish Ministry of Culture has funded a project to set up a model for costing preservation of digital materials held by national cultural heritage institutions. The overall objective of the project was to increase cost effectiveness of digital preservation activities and to provide a basis for comparing and estimating future cost requirements for digital preservation. In this study we describe an activity-based costing methodology for digital preservation based on the Open Archice Information System (OAIS Reference Model. Within this framework, which we denote the Cost Model for Digital Preservation (CMDP, the focus is on costing the functional entity Preservation Planning from the OAIS and digital migration activities. In order to estimate these costs we have identified cost-critical activities by analysing the functions in the OAIS model and the flows between them. The analysis has been supplemented with findings from the literature, and our own knowledge and experience. The identified cost-critical activities have subsequently been deconstructed into measurable components, cost dependencies have been examined, and the resulting equations expressed in a spreadsheet. Currently the model can calculate the cost of different migration scenarios for a series of preservation formats for text, images, sound, video, geodata, and spreadsheets. In order to verify the model it has been tested on cost data from two different migration projects at the Danish National Archives (DNA. The study found that the OAIS model provides a sound overall framework for the cost breakdown, but that some functions need additional detailing in order to cost activities accurately. Running the two sets of empirical data showed among other things that the model underestimates the cost of manpower-intensive migration projects, while it reinstates an often underestimated cost, which is the cost of developing migration software. The model has proven useful for estimating the

  11. Initialized Fractional Calculus

    Science.gov (United States)

    Lorenzo, Carl F.; Hartley, Tom T.

    2000-01-01

    This paper demonstrates the need for a nonconstant initialization for the fractional calculus and establishes a basic definition set for the initialized fractional differintegral. This definition set allows the formalization of an initialized fractional calculus. Two basis calculi are considered; the Riemann-Liouville and the Grunwald fractional calculi. Two forms of initialization, terminal and side are developed.

  12. Costs of fire suppression forces based on cost-aggregation approach

    Science.gov (United States)

    Gonz& aacute; lez-Cab& aacute; Armando n; Charles W. McKetta; Thomas J. Mills

    1984-01-01

    A cost-aggregation approach has been developed for determining the cost of Fire Management Inputs (FMls)-the direct fireline production units (personnel and equipment) used in initial attack and large-fire suppression activities. All components contributing to an FMI are identified, computed, and summed to estimate hourly costs. This approach can be applied to any FMI...

  13. Estimating Maintenance Cost for Web Applications

    Directory of Open Access Journals (Sweden)

    Ion IVAN

    2016-01-01

    Full Text Available The current paper tackles the issue of determining a method for estimating maintenance costs for web applications. The current state of research in the field of web application maintenance is summarized and leading theories and results are highlighted. The cost of web maintenance is determined by the number of man-hours invested in maintenance tasks. Web maintenance tasks are categorized into content maintenance and technical maintenance. Research is centered on analyzing technical maintenance tasks. The research hypothesis is formulated on the assumption that the number of man-hours invested in maintenance tasks can be assessed based on the web application’s user interaction level, complexity and content update effort. Data regarding the costs of maintenance tasks is collected from 24 maintenance projects implemented by a web development company that tackles a wide area of web applications. Homogeneity and diversity of collected data is submitted for debate by presenting a sample of the data and depicting the overall size and comprehensive nature of the entire dataset. A set of metrics dedicated to estimating maintenance costs in web applications is defined based on conclusions formulated by analyzing the collected data and the theories and practices dominating the current state of research. Metrics are validated with regards to the initial research hypothesis. Research hypothesis are validated and conclusions are formulated on the topic of estimating the maintenance cost of web applications. The limits of the research process which represented the basis for the current paper are enunciated. Future research topics are submitted for debate.

  14. The economic cost of implementing maternal and neonatal death review in a district of Bangladesh

    Directory of Open Access Journals (Sweden)

    Animesh Biswas

    2016-12-01

    Full Text Available Introduction: Maternal and neonatal death review (MNDR introduced in Bangladesh and initially piloted in a district during 2010. MNDR is able to capture each of the maternal, neonatal deaths and stillbirths from the community and government facilities (hospitals. This study aimed to estimate the cost required to implement MNDR in a district of Bangladesh during 2010-2012. Materials and methods: MNDR was implemented in Thakurgaon district in 2010 and later gradually extended until 2015. MNDR implementation framework, guidelines, tools and manual were developed at the national level with national level stakeholders including government health and family planning staff at different cadre for piloting at Thakurgaon. Programme implementation costs were calculated by year of costing and costing as per component of MNDR in 2013. The purchasing power parity conversion rate was 1 $INT = 24.46 BDT, as of 31st Dec 2012. Results: Overall programme implementation costs required to run MNDR were 109,02,754 BDT (445,738 $INT $INT in the first year (2010. In the following years cost reduced to 8,208,995 BDT (335,609 $INT, during 2011 and 6,622,166 BDT (270,735 $INT, during 2012. The average cost per activity required was 3070 BDT in 2010, 1887 BDT and 2207 BDT required in 2011 and 2012 respectively. Each death notification cost 4.09 $INT, verbal autopsy cost 8.18 $INT, and social autopsy cost 16.35 $INT. Facility death notification cost 2.04 $INT and facility death review meetings cost 20.44 $INT. One death saved by MNDR costs 53,654 BDT (2193 $INT.Conclusions: Programmatic implementation cost of conducting MPDR give an idea on how much cost will be required to run a death review system for a low income country settings using government health system.

  15. Potential savings of harmonising hospital and community formularies for chronic disease medications initiated in hospital.

    Directory of Open Access Journals (Sweden)

    Lauren Lapointe-Shaw

    Full Text Available Hospitals in Canada manage their formularies independently, yet many inpatients are discharged on medications which will be purchased through publicly-funded programs. We sought to determine how much public money could be saved on chronic medications if hospitals promoted the initiation of agents with the lowest outpatient formulary prices.We used administrative databases for the province of Ontario to identify patients initiated on a proton pump inhibitor (PPI, angiotensin-converting enzyme (ACE inhibitor or angiotensin receptor blocker (ARB following hospital admission from April 1(st 2008-March 31(st 2009. We assessed the cost to the Ontario Drug Benefit Program (ODB over the year following initiation and determined the cost savings if prescriptions were substituted with the least expensive agent in each class.The cost for filling all PPI, ACE inhibitor and ARB prescriptions was $ 2.48 million, $968 thousand and $325 thousand respectively. Substituting the least expensive agent could have saved $1.16 million (47% for PPIs, $162 thousand (17% for ACE inhibitors and $14 thousand (4% for ARBs over the year following discharge.In a setting where outpatient prescriptions are publicly funded, harmonising outpatient formularies with inpatient therapeutic substitution resulted in modest cost savings and may be one way to control rising pharmaceutical costs.

  16. Sustainability Life Cycle Cost Analysis of Roof Waterproofing Methods Considering LCCO2

    Directory of Open Access Journals (Sweden)

    Sangyong Kim

    2013-12-01

    Full Text Available In a construction project, selection of an appropriate method in the planning/design stage is very important for ensuring effective project implementation and success. Many companies have adopted the life cycle cost (LCC method, one of the methods for analyzing economic efficiency, for appropriate decision-making in the basic/detailed design stage by estimating overall costs and expenses generated over the entire project. This paper presents an LCC method for calculating the LCC of CO2 (LCCO2, based on materials committed during the lifecycle of a structure for each roof waterproofing method and adding this cost to the LCC for comparative analysis. Thus, this technique presents the LCC that includes the cost of CO2 emission. The results show that in terms of initial construction cost, asphalt waterproofing had the highest CO2 emission cost, followed by sheet waterproofing. LCCO2 did not greatly influence the initial construction cost and maintenance cost, as it is relatively smaller than the LCC. However, when the number of durable years was changed, the LCC showed some changes.

  17. Cost-Benefit Analysis for the Concentrated Solar Power in China

    Directory of Open Access Journals (Sweden)

    Shuxia Yang

    2018-01-01

    Full Text Available In 2016, the first batch of concentrated solar power (CSP demonstration projects of China was formally approved. Due to the important impact of the cost-benefit on the investment decisions and policy-making, this paper adopted the static payback period (SP, net present value (NPV, net present value rate (NPVR, and internal rate of return (IRR to analyze and discuss the cost-benefit of CSP demonstration plants. The results showed the following. (1 The SP of CSP systems is relatively longer, due to high initial investment; but the cost-benefit of CSP demonstration plants as a whole is better, because of good expected incomes. (2 Vast majority of CSP projects could gain excess returns, on the basis of meeting the profitability required by the benchmark yield of 10%. (3 The cost-benefit of solar tower CSP technology (IRR of 12.33% is better than that of parabolic trough CSP technology (IRR of 11.72% and linear Fresnel CSP technology (IRR of 11.43%. (4 The annual electricity production and initial costs have significant impacts on the cost-benefit of CSP systems; the effects of operation and maintenance costs and loan interest rate on the cost-benefit of CSP systems are relatively smaller but cannot be ignored.

  18. Costing in Radiotherapy. Chapter 18

    International Nuclear Information System (INIS)

    Zubizarreta, E.; Lievens, Y.; Levin, V.C.; Van Der Merwe, D.

    2017-01-01

    The available literature on the cost of radiotherapy yields a large variation in data related to the specifics of the methodology used (the viewpoint of the analysis, time frame, health care system, etc.) and to the cost components and radiotherapy activities included. To overcome this difficulty, the reimbursement paid by medical insurance is commonly used as a proxy for the actual radiotherapy costs. Costs, however, generally bear little or no resemblance to charges, as the latter also include allowances for non-capacity use and profit margins. Accurate resource cost data are therefore more valid and should ideally be used in the context of economic evaluations and public health provisions. In addition to the theoretical problems related to obtaining accurate costs, it is difficult to interpret cost data across country borders because of differences in economics. If this is already the case for high income countries, using these cost data for low and middle income countries (LMICs) is even more problematic. Thus, there clearly is a need for calculations performed from the viewpoint of LMICs to prevent misapprehensions based on conclusions derived from data from their high income counterparts. The IAEA endeavours to assist Member States in accumulating appropriate and sufficient cost data for the initiation or expansion of radiation oncology services. Although relatively simple and easy to understand, the IAEA has found that in many countries where it has been involved in the establishment of new radiotherapy departments, the basic principles of cost calculation for radiotherapy facilities were not followed by the local planners. Radiotherapy needs careful planning, organization and a strong quality assurance (QA) programme in order to deliver safe treatments, due to the complexity of the planning and treatment process and the possibility of systematic errors. Administrators should be aware that the cost of building a radiotherapy facility and buying machines

  19. The Role of Logistics in Practical Levelized Cost of Energy Reduction Implementation and Government Sponsored Cost Reduction Studies: Day and Night in Offshore Wind Operations and Maintenance Logistics

    Directory of Open Access Journals (Sweden)

    Thomas Poulsen

    2017-04-01

    Full Text Available This paper reveals that logistics make up at least 17% of annual operational expenditure costs for offshore wind farms. Annual operational expenditure is found to vary by a factor of 9.5, making its share of levelized cost of energy for offshore wind range from 13% to 57%. These are key findings of a 20-month research project targeting cost reduction initiatives for offshore wind systems. The findings reveal that cost-out measures are difficult to implement due to cultural differences. Implementation efforts are rendered by personnel located offshore in a harsh sea environment which is in stark contrast to the shore-based office personnel who develop studies directing cost reduction efforts. This paper details the company motivation to join industry-wide cost reduction initiatives. A business case for offshore wind operations and maintenance logistics yielding 1% savings in levelized cost of energy is included on how to expand working hours from daytime to also work at night.

  20. REDUCTION OF THE PRODUCTION COST. EXPERIENCE OF THE COSTS REDUCTION AT RUP “BMZ”

    Directory of Open Access Journals (Sweden)

    S. S. Sereda

    2004-01-01

    Full Text Available The method of the daily operative monitoring of the costs for reduction of net cost and reinforcement of control on the costs has been applied for the first time in 2003 in RB at RUP “BMZ”, that allowed for the enterprise to control the costs in regime of real time.

  1. Reducing Reforestation Costs in Lebanon: Adaptive Field Trials

    Directory of Open Access Journals (Sweden)

    Garabet (Garo Haroutunian

    2017-05-01

    Full Text Available Lebanon’s Ministry of Environment initiated a project in 2009 to determine low-cost reforestation techniques for stone pine (Pinus pinea and Lebanon cedar (Cedrus libani for large-scale land rehabilitation activities in the arid Middle East. Irrigation (several techniques vs. no water, planting (8- to 18-month-old seedlings, seeding, and soil preparation methods were evaluated in three sets of adaptive management field trials. The aim was to reduce reforestation costs while still achieving sufficient regeneration. A key result for management was that non-irrigated seed planting of stone pine and possibly of Lebanon cedar showed promise for cost-effective reforestation and could be competitive with seedlings, given correct seed source and planting conditions. Stone pine seeds collected from nearby mother trees and planted without irrigation on sandy soil showed 35% survival for <600 USD/ha; seedlings planted without irrigation cost about 2500 USD/ha and achieved 50–70% survival (costs based on 800 seedlings/ha. Water supplements increased establishment costs over 2 years without concomitant improvements to survival. Future studies should evaluate how soil texture and soil preparation interact with other factors to affect seed germination and survival for each species.

  2. Initial measurement of assets produced in Bulgarian companies – current state and ways for improvement

    Directory of Open Access Journals (Sweden)

    Mincho Minev

    2017-10-01

    Full Text Available The initial evaluation of the production is one of the most complex tasks that accounting specialists face in their practice. The quality of the accounting information provided to the various internal and external users depends to a great extent on the way in which this task is resolved. In this article, using the results of an undertaken research, the practice of leading Bulgarian companies will be analyzed with regard to the costing of their production. The main purpose is to make recommendations for optimizing the process of costing in Bulgarian companies and to increase the quality of the accounting information produced as a result of this process.

  3. Initial Evaluation of Patients with Presumed Syncope

    Directory of Open Access Journals (Sweden)

    Ilknur Can, MD

    2008-01-01

    Full Text Available Syncope is a common clinical problem, but nevertheless is but one element of the broader issue of ‘transient loss of consciousness’ (TLOC. The first step is to ascertain whether the patient actually suffered a syncopal episode, and thereafter the goal must be to determine the basis of symptoms with sufficient confidence to assess prognosis and initiate an effective treatment strategy. The initial evaluation of these patients, which usually takes place in an emergency department (ED. or acute care facility, is challenging since patients are usually asymptomatic when they come for medical attention, may have little or no recall of the event, and witnesses, if any, often cannot provide reliable information. Given these circumstances, it is understandable that frontline physicians often tend to take a seemingly ‘safe’ approach, and admit both high-risk and intermediate-risk syncope patients to hospital. This strategy has many implications, including life-style and economic concerns for the patient, and health care management issues for physicians, hospital administrators and the overall health care system. The European Society of Cardiology (ESC. guidelines and several clinical studies provide helpful advice regarding “risk stratification” to help guide physicians in selecting patients for either early hospital admission or later oupatient subspeciality evaluation. The utility of syncope management units in the ED, and a guideline-based approach to the syncope patient, has tended to both diminish the number of undiagnosed cases and reduce the hospital admission rate. In this review, we have attempted to both highlight a cost-effective diagnostic pathway beginning with the initial evaluation of the patient with suspected syncope, and to provide criteria which may help frontline physicians better base their decisions regarding need for in-hospital versus outpatient clinic evaluation of syncope patients.

  4. ANN Based Approach for Estimation of Construction Costs of Sports Fields

    Directory of Open Access Journals (Sweden)

    Michał Juszczyk

    2018-01-01

    Full Text Available Cost estimates are essential for the success of construction projects. Neural networks, as the tools of artificial intelligence, offer a significant potential in this field. Applying neural networks, however, requires respective studies due to the specifics of different kinds of facilities. This paper presents the proposal of an approach to the estimation of construction costs of sports fields which is based on neural networks. The general applicability of artificial neural networks in the formulated problem with cost estimation is investigated. An applicability of multilayer perceptron networks is confirmed by the results of the initial training of a set of various artificial neural networks. Moreover, one network was tailored for mapping a relationship between the total cost of construction works and the selected cost predictors which are characteristic of sports fields. Its prediction quality and accuracy were assessed positively. The research results legitimatize the proposed approach.

  5. An Insight Into the Two Costing Technique: Absorption Costing and Marginal Costing

    Directory of Open Access Journals (Sweden)

    Mariam Nawaz

    2013-02-01

    Full Text Available This paper will investigate the controversy that is innate between the two costing techniques; Absorption Costing and Marginal Costing and would throw light on which costing technique better serves its purpose in helping management for decision making process and if Marginal Costing technique is concluded as better technique then why it should not be used for external reporting purpose. This paper will only crystallize and highlight the issues descriptively and will not resolve the issues that are inherent between the two costing techniques. The unique thing about this paper is that it is in favor of treating fixed cost as product cost that is it is supporting the advocates of Absorption Costing Technique but it is against to consider profit as a function of production rather it believes that profit should only be considered as function of sales for stock valuation and to help management in decision making process that is, regarding this point it is supporting advocates of Marginal Costing.

  6. Full scope simulator commissioning and training experience at Cernavoda NPP

    International Nuclear Information System (INIS)

    Balan, M.

    2000-01-01

    The paper presents the experience gained during commissioning and the initial use of the CANDU training full-scope simulator for operation personnel at Cernavoda NPP. The full-scope simulator as an integral part of the training programs that take place in Cernavoda Nuclear Training Department (CNTD), is mainly used for the development of operational skills, knowledge and attitudes required to operate the plant in a safe and efficient manner. (author)

  7. The Haiti Breast Cancer Initiative: Initial Findings and Analysis of Barriers-to-Care Delaying Patient Presentation

    Directory of Open Access Journals (Sweden)

    Ketan Sharma

    2013-01-01

    Full Text Available Background. In Haiti, breast cancer patients present at such advanced stages that even modern therapies offer modest survival benefit. Identifying the personal, sociocultural, and economic barriers-to-care delaying patient presentation is crucial to controlling disease. Methods. Patients presenting to the Hôpital Bon Sauveur in Cange were prospectively accrued. Delay was defined as 12 weeks or longer from initial sign/symptom discovery to presentation, as durations greater than this cutoff correlate with reduced survival. A matched case-control analysis with multivariate logistic regression was used to identify factors predicting delay. Results. Of N=123 patients accrued, 90 (73% reported symptom-presentation duration and formed the basis of this study: 52 patients presented within 12 weeks of symptoms, while 38 patients waited longer than 12 weeks. On logistic regression, lower education status (OR = 5.6, P=0.03, failure to initially recognize mass as important (OR = 13.0, P<0.01, and fear of treatment cost (OR = 8.3, P=0.03 were shown to independently predict delayed patient presentation. Conclusion. To reduce stage at presentation, future interventions must educate patients on the recognition of initial breast cancer signs and symptoms and address cost concerns by providing care free of charge and/or advertising that existing care is already free.

  8. Powering the Space Exploration Initiative

    International Nuclear Information System (INIS)

    Bennett, G.L.

    1991-01-01

    The Space Exploration Initiative (SEI) establishes the long-term goal of returning to the Moon and then exploring Mars. One of the prerequisites of SEI is the Exploration Technology Program which includes program elements on space nuclear power and surface solar power. These program elements in turn build upon the ongoing NASA research and technology base program in space energy conversion. There is a wide range of missions in NASA's strategic planning and most would benefit from power sources with improved efficiency, lighter weight and reduced cost

  9. Teachers’ perceptions of their own initiative: Collective initiative vs. personal initiative

    Directory of Open Access Journals (Sweden)

    Džinović Vladimir

    2013-01-01

    Full Text Available Current trends in education demand from teachers to exhibit proactive behaviour and assume responsibility for the implementation of changes in school practice. In that sense, it is important to study how teachers perceive their own initiative and to gain insight into the activities where such initiative is demonstrated. This study has been conceived as a mixed-methods research. The qualitative study implied forming four focus groups with subject teachers and class teachers (N=38, while the quantitative study entailed surveying 1441 teachers in forty primary schools in Serbia using the questionnaire constructed based on qualitative data. Data from focus groups were processed by qualitative thematic analysis, while the questionnaire data were processed by principal component analysis and univariate analysis of variance. The findings of the study have shown that teachers mostly demonstrate initiative through co­operative activities that include planning of joint teaching as well as conducting joint projects within school and with the local community actors. Teachers are least ready to demonstrate personal initiative and the initiative aimed at accomplishing considerable changes in school work. The concluding part includes the recommendations for encouraging teachers’ personal initiative and building organizational culture that would support such initiative. [Projekat Ministarstva nauke Republike Srbije, br. br. 47008: Unapređivanje kvaliteta i dostupnosti obrazovanja u procesima modernizacije Srbije i br. 179034: Od podsticanja inicijative, saradnje i stvaralaštva u obrazovanju do novih uloga i identiteta u društvu

  10. Low cost solar air heater

    International Nuclear Information System (INIS)

    Gill, R.S.; Singh, Sukhmeet; Singh, Parm Pal

    2012-01-01

    Highlights: ► Single glazed low cost solar air heater is more efficient during summer while double glazed is better in winter. ► For the same initial investment, low cost solar air heaters collect more energy than packed bed solar air heater. ► During off season low cost solar air heater can be stored inside as it is light in weight. - Abstract: Two low cost solar air heaters viz. single glazed and double glazed were designed, fabricated and tested. Thermocole, ultraviolet stabilised plastic sheet, etc. were used for fabrication to reduce the fabrication cost. These were tested simultaneously at no load and with load both in summer and winter seasons along with packed bed solar air heater using iron chips for absorption of radiation. The initial costs of single glazed and double glazed are 22.8% and 26.8% of the initial cost of packed bed solar air heater of the same aperture area. It was found that on a given day at no load, the maximum stagnation temperatures of single glazed and double glazed solar air heater were 43.5 °C and 62.5 °C respectively. The efficiencies of single glazed, double glazed and packed bed solar air heaters corresponding to flow rate of 0.02 m 3 /s-m 2 were 30.29%, 45.05% and 71.68% respectively in winter season. The collector efficiency factor, heat removal factor based on air outlet temperature and air inlet temperature for three solar air heaters were also determined.

  11. The Enzyme Function Initiative.

    Science.gov (United States)

    Gerlt, John A; Allen, Karen N; Almo, Steven C; Armstrong, Richard N; Babbitt, Patricia C; Cronan, John E; Dunaway-Mariano, Debra; Imker, Heidi J; Jacobson, Matthew P; Minor, Wladek; Poulter, C Dale; Raushel, Frank M; Sali, Andrej; Shoichet, Brian K; Sweedler, Jonathan V

    2011-11-22

    The Enzyme Function Initiative (EFI) was recently established to address the challenge of assigning reliable functions to enzymes discovered in bacterial genome projects; in this Current Topic, we review the structure and operations of the EFI. The EFI includes the Superfamily/Genome, Protein, Structure, Computation, and Data/Dissemination Cores that provide the infrastructure for reliably predicting the in vitro functions of unknown enzymes. The initial targets for functional assignment are selected from five functionally diverse superfamilies (amidohydrolase, enolase, glutathione transferase, haloalkanoic acid dehalogenase, and isoprenoid synthase), with five superfamily specific Bridging Projects experimentally testing the predicted in vitro enzymatic activities. The EFI also includes the Microbiology Core that evaluates the in vivo context of in vitro enzymatic functions and confirms the functional predictions of the EFI. The deliverables of the EFI to the scientific community include (1) development of a large-scale, multidisciplinary sequence/structure-based strategy for functional assignment of unknown enzymes discovered in genome projects (target selection, protein production, structure determination, computation, experimental enzymology, microbiology, and structure-based annotation), (2) dissemination of the strategy to the community via publications, collaborations, workshops, and symposia, (3) computational and bioinformatic tools for using the strategy, (4) provision of experimental protocols and/or reagents for enzyme production and characterization, and (5) dissemination of data via the EFI's Website, http://enzymefunction.org. The realization of multidisciplinary strategies for functional assignment will begin to define the full metabolic diversity that exists in nature and will impact basic biochemical and evolutionary understanding, as well as a wide range of applications of central importance to industrial, medicinal, and pharmaceutical efforts.

  12. Full Dynamic Analysis of Mooring Solution Candidates - First Iteration

    DEFF Research Database (Denmark)

    Thomsen, Jonas Bjerg; Ferri, Francesco

    This report covers an initial full dynamic analysis of the mooring solutions for the four wave energy converters in the project “Mooring Solutions for Large Wave Energy Converters”. The analysis tends to provide the first understanding of the layouts and provide discussion on what parameters that...

  13. Alfalfa silage ratios and full fat extruded soybeans on milk

    African Journals Online (AJOL)

    USER

    2010-08-16

    Aug 16, 2010 ... Treatments were arranged in a 2 × 3 factorial with 0 or 5% full fat extruded soybeans meal (dry matter basis) and ... Milk fat and lactose were not affected by replacing corn .... The oven temperature was initially 180°C for 45.

  14. Cost estimation and management over the life cycle of metallurgical ...

    African Journals Online (AJOL)

    This study investigates whether all expected costs over the life cycle of metallurgical research projects are included in initial, normal and fi nal cost estimates, and whether these costs are managed throughout a project's life cycle since there is not enough emphasis on the accurate estimation of costs and their management ...

  15. Cost estimating for CERCLA remedial alternatives a unit cost methodology

    International Nuclear Information System (INIS)

    Brettin, R.W.; Carr, D.J.; Janke, R.J.

    1995-06-01

    The United States Environmental Protection Agency (EPA) Guidance for Conducting Remedial Investigations and Feasibility Studies Under CERCLA, Interim Final, dated October 1988 (EPA 1988) requires a detailed analysis be conducted of the most promising remedial alternatives against several evaluation criteria, including cost. To complete the detailed analysis, order-of-magnitude cost estimates (having an accuracy of +50 percent to -30 percent) must be developed for each remedial alternative. This paper presents a methodology for developing cost estimates of remedial alternatives comprised of various technology and process options with a wide range of estimated contaminated media quantities. In addition, the cost estimating methodology provides flexibility for incorporating revisions to remedial alternatives and achieves the desired range of accuracy. It is important to note that the cost estimating methodology presented here was developed as a concurrent path to the development of contaminated media quantity estimates. This methodology can be initiated before contaminated media quantities are estimated. As a result, this methodology is useful in developing cost estimates for use in screening and evaluating remedial technologies and process options. However, remedial alternative cost estimates cannot be prepared without the contaminated media quantity estimates. In the conduct of the feasibility study for Operable Unit 5 at the Fernald Environmental Management Project (FEMP), fourteen remedial alternatives were retained for detailed analysis. Each remedial alternative was composed of combinations of remedial technologies and processes which were earlier determined to be best suited for addressing the media-specific contaminants found at the FEMP site, and achieving desired remedial action objectives

  16. Dioxin Exposure Initiative

    Science.gov (United States)

    The Dioxin Exposure Initiative (DEI) is no longer active. This page contains a summary of the dioxin exposure initiative with illustrations, contact and background information.Originally supported by scientist Matthew Lorber, who retired in Mar 2017.

  17. Building Energy and Cost Performance: An Analysis of Thirty Melbourne Case Studies

    Directory of Open Access Journals (Sweden)

    Yu Lay Langston

    2012-11-01

    Full Text Available This study investigates the energy and cost performance of thirty recent buildings in Melbourne, Australia. Commonly, building design decisions are based on issues pertaining to construction cost, and consideration of energy performance is made only within the context of the initial project budget. Even where energy is elevated to more importance, operating energy is seen as the focus and embodied energy is nearly always ignored. For the first time, a large sample of buildings has been assembled and analyzed to improve the understanding of both energy and cost performance over their full life cycle, which formed the basis of a wider doctoral study into the inherent relationship between energy and cost. The aim of this paper is to report on typical values for embodied energy, operating energy, capital cost and operating cost per square metre for a range of building functional types investigated in this research. The conclusion is that energy and cost have quite different profiles across projects, and yet the mean GJ/m2 or cost/m2 have relatively low coefficients of variation and therefore may be useful as benchmarks of typical building performance.  

  18. Combining Time-Driven Activity-Based Costing with Clinical Outcome in Cost-Effectiveness Analysis to Measure Value in Treatment of Depression.

    Science.gov (United States)

    El Alaoui, Samir; Lindefors, Nils

    2016-01-01

    A major challenge of mental health care is to provide safe and effective treatment with limited resources. The main purpose of this study was to examine a value-based approach in clinical psychiatry when evaluating a process improvement initiative. This was accomplished by using the relatively new time driven activity based costing (TDABC) method within the more widely adopted cost-effectiveness analysis framework for economic evaluation of healthcare technologies. The objective was to evaluate the cost-effectiveness of allowing psychologists to perform post-treatment assessment previously performed by psychiatrists at an outpatient clinic treating depression using internet-based cognitive-behavioral therapy (ICBT). Data was collected from 568 adult patients treated with ICBT for depression during 2013-2014. The TDABC methodology was used to estimate total healthcare costs, including development of process maps for the complete cycle of care and estimation of resource use and minute costs of staff, hospital space and materials based on their relative proportions used. Clinical outcomes were measured using the Patient Health Questionnaire depression scale (PHQ-9) before and after treatment and at 6-month follow-up. Cost-effectiveness analyses (CEA) was performed and the results presented as incremental net benefits (INB), cost-effectiveness acceptability curves (CEACs) and confidence ellipses to demonstrate uncertainty around the value of the organizational intervention. Taking into account the complete healthcare process (from referral to follow-up assessment), treatment costs decreased from $709 (SD = $130) per patient in 2013 to $659 (SD = $134) in 2014 while treatment effectiveness was maintained; 27% had achieved full remission from depression after treatment (PHQ-9 cost-effectiveness plane at both post-treatment and at follow-up, indicating that the ICBT treatment was less costly and equally effective after staff reallocation. Treating patients to the target

  19. The CRINE initiative -- Education and training

    International Nuclear Information System (INIS)

    Littlewood, S.K.

    1995-01-01

    CRINE's aim is to have everyone in the industry working in new ways and doing so because it is second nature. CRINE is an acronym for Cost Reduction Initiative for the New Era, is an industry-wide program now under way in the UK continental shelf oil and gas fields whose main objective is to achieve thirty percent or more savings in capital costs and to half the operating costs over the next few years. Such a culture change is only feasible through an extensive program of education and training. This is under way, helped in many organizations by CRINE 'champions' driving the courses and training aids

  20. Tall Buildings Initiative

    Science.gov (United States)

    Initiative 2017 TBI Guidelines Version 2.03 Now Available Screen Shot 2017-10-10 at 3.05.10 PM PEER has just initiative to develop design criteria that will ensure safe and usable tall buildings following future earthquakes. Download the primary product of this initiative: Guidelines for Performance-Based Seismic Design

  1. Road crash costs.

    NARCIS (Netherlands)

    2010-01-01

    Road crashes result in all kinds of social costs, such as medical costs, production loss, human losses, property damage, settlement costs and costs due to congestion. Studies into road crash costs and their trends are carried out quite regularly. In 2009, the costs amounted to € 12.5 billion, or

  2. Agency costs and income taxation

    Directory of Open Access Journals (Sweden)

    Ulrich Schmidt

    2012-03-01

    Full Text Available This paper analyzes agency costs and the moral hazard problem in the presence of income taxation. As basic framework, income taxes are integrated in the hidden action model of agency theory. In the case of symmetric information no agency costs occur, i.e. optimal risk-sharing can be achieved, if and only if the tax is proportional. It is well-known that asymmetric information causes a welfare loss, termed agency costs, even if no taxes are imposed. Introducing a proportional income tax now increases (decreases these agency costs if the agent exhibits decreasing (increasing absolute risk aversion. Additionally, we show that non-proportional taxes cause higher (lower agency costs than a proportional tax if the agent’s marginal tax rate exceeds (is smaller than the marginal tax rate of the principal.

  3. The REFANI-N study protocol: a cluster-randomised controlled trial of the effectiveness and cost-effectiveness of early initiation and longer duration of emergency/seasonal unconditional cash transfers for the prevention of acute malnutrition among children, 6-59 months, in Tahoua, Niger.

    Science.gov (United States)

    Sibson, Victoria L; Grijalva-Eternod, Carlos S; Bourahla, Leila; Haghparast-Bidgoli, Hassan; Morrison, Joanna; Puett, Chloe; Trenouth, Lani; Seal, Andrew

    2015-12-23

    arms. Quantitative and qualitative process evaluation data will be prospectively collected and programme costs will be collected and cost-effectiveness ratios calculated. This randomised study design with a concurrent process evaluation will provide evidence on the effectiveness and cost-effectiveness of earlier initiation of seasonal unconditional cash transfer for the prevention of acute malnutrition, which will be generalisable to similar humanitarian situations. ISRCTN25360839, registered March 19, 2015.

  4. Nuclear generation cost management and economic benefits

    International Nuclear Information System (INIS)

    Horton, E.P.; Sepa, T.R.

    1989-01-01

    The CANDU-Pressurized Heavy Water (CANDU-PHW) type of nuclear generating station has been developed jointly by Atomic Energy of Canada Limited and Ontario Hydro. This report discusses the cost management principles used for Ontario Hydro's CANDU-PHW program, current cost management initiatives, and the economic benefits of nuclear power to the provinces of Ontario and New Brunswick, in Canada

  5. Low-cost high purity production

    Science.gov (United States)

    Kapur, V. K.

    1978-01-01

    Economical process produces high-purity silicon crystals suitable for use in solar cells. Reaction is strongly exothermic and can be initiated at relatively low temperature, making it potentially suitable for development into low-cost commercial process. Important advantages include exothermic character and comparatively low process temperatures. These could lead to significant savings in equipment and energy costs.

  6. THEORETICAL AND PRACTICAL CONSIDERATIONS REGARDING THE COST CALCULATION USING DIRECT COSTING

    Directory of Open Access Journals (Sweden)

    Cristina Aurora, Bunea-Bontaş

    2012-01-01

    Full Text Available The definition of the cost of production as applied to inventories refers to the acquisition and production cost, and its determination involves many considerations. This article emphasizes a comparative approach of the calculation of production cost under direct costing and absorption costing, and examines the impact of using these calculation systems on the financial performance of the companies presented in the income statement.

  7. Full Employment in a Green Society

    OpenAIRE

    Steve Dawe

    2012-01-01

    This article is an attempt to re-conceptualise Full Employment. The UK context is the main geographical focus. A normative route to the rehabilitation of Full Employment is offered - recast here as 'Green Full Employment' - utilising a variety of Green perspectives from sociology, politics and economics. This contribution to the debate about Full Employment is 'normative', because without ethical values we may lack a moral compass to motivate policies. Green Full Employment is presented here ...

  8. Determination production costs using PBC method

    Directory of Open Access Journals (Sweden)

    Todić Vladimir V.

    2014-01-01

    Full Text Available Basic characteristics of modern markets make requirements in quality increasing, decreasing prices and shortening delivery of products. In the middle of this requirements are production costs for whose determination are developed many traditional and alternative methods including PBC method (Process Based Costing. This method enables precisely locating and calculating indirect production costs, and with determined direct costs enables determination of total production costs. This paper shows usage of PBC method for determination production costs for three forms of processing cutting tools.

  9. ABC model and the management of costs

    Directory of Open Access Journals (Sweden)

    Pravdić Predrag

    2016-01-01

    Full Text Available When a company has multiple objectives at the same time, they all must be considered and balanced when making any business decisions. Linking the markets, capital and resources so as to thus ensure the highest yield is, In fact, the search for competitive advantage as a basic condition for survival in a market economy. In highly detailed systems based on the management of costs or ABC (activity based costing systems, the cost of activities often result in erroneous evaluation of aggregate costs of the action. Improvements in information technology and monitoring decrease of technology costs enabled the ABC system to become a feasible system calculating costs in many organizations.

  10. CALiPER Report 21.3. Cost Effectiveness of Linear (T8) LED Lamps

    Energy Technology Data Exchange (ETDEWEB)

    None

    2014-05-01

    Meeting performance expectations is important for driving adoption of linear LED lamps, but cost-effectiveness may be an overriding factor in many cases. Linear LED lamps cost more initially than fluorescent lamps, but energy and maintenance savings may mean that the life-cycle cost is lower. This report details a series of life-cycle cost simulations that compared a two-lamp troffer using LED lamps (38 W total power draw) or fluorescent lamps (51 W total power draw) over a 10-year study period. Variables included LED system cost ($40, $80, or $120), annual operating hours (2,000 hours or 4,000 hours), LED installation time (15 minutes or 30 minutes), and melded electricity rate ($0.06/kWh, $0.12/kWh, $0.18/kWh, or $0.24/kWh). A full factorial of simulations allows users to interpolate between these values to aid in making rough estimates of economic feasibility for their own projects. In general, while their initial cost premium remains high, linear LED lamps are more likely to be cost-effective when electric utility rates are higher than average and hours of operation are long, and if their installation time is shorter.

  11. CALiPER Report 21.3: Cost-Effectiveness of Linear (T8) LED Lamps

    Energy Technology Data Exchange (ETDEWEB)

    Miller, Naomi J.; Perrin, Tess E.; Royer, Michael P.

    2014-05-27

    Meeting performance expectations is important for driving adoption of linear LED lamps, but cost-effectiveness may be an overriding factor in many cases. Linear LED lamps cost more initially than fluorescent lamps, but energy and maintenance savings may mean that the life-cycle cost is lower. This report details a series of life-cycle cost simulations that compared a two-lamp troffer using LED lamps (38 W total power draw) or fluorescent lamps (51 W total power draw) over a 10-year study period. Variables included LED system cost ($40, $80, or $120), annual operating hours (2,000 hours or 4,000 hours), LED installation time (15 minutes or 30 minutes), and melded electricity rate ($0.06/kWh, $0.12/kWh, $0.18/kWh, or $0.24/kWh). A full factorial of simulations allows users to interpolate between these values to aid in making rough estimates of economic feasibility for their own projects. In general, while their initial cost premium remains high, linear LED lamps are more likely to be cost-effective when electric utility rates are higher than average and hours of operation are long, and if their installation time is shorter.

  12. PENETAPAN TARGET TERHADAP STICKINESS COST

    Directory of Open Access Journals (Sweden)

    Windyastuti Windyastuti

    2017-03-01

    Full Text Available This study aimed to analyze the influence of manager targeting to the stickiness cost. The research data was amanufacturing company’s financial statements during 1999-2011 published at BEI. The research data includedcost of sales, administration and general, net sales and Price Earnings Ratio (PER. This study used adynamic panel data regression analysis. The results showed that cost of sales, administration and general weresticky. Furthermore, manager targeting caused the stickiness degree of sales, administration and general costlower. Manager targeting changed the manager’s behavior. When the net sales declined, manager reduced theresource use drastically so the cost of sales, administration and general also decreased drastically.

  13. 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.

  14. CAD/CAM monolithic restorations and full-mouth adhesive rehabilitation to restore a patient with a past history of bulimia: the modified three-step technique.

    Science.gov (United States)

    Vailati, Francesca; Carciofo, Sylvain

    2016-01-01

    Due to an increasing awareness about dental erosion, many clinicians would like to propose treatments even at the initial stages of the disease. However, when the loss of tooth structure is visible only to the professional eye, and it has not affected the esthetics of the smile, affected patients do not usually accept a full-mouth rehabilitation. Reducing the cost of the therapy, simplifying the clinical steps, and proposing noninvasive adhesive techniques may promote patient acceptance. In this article, the treatment of an ex-bulimic patient is illustrated. A modified approach of the three-step technique was followed. The patient completed the therapy in five short visits, including the initial one. No tooth preparation was required, no anesthesia was delivered, and the overall (clinical and laboratory) costs were kept low. At the end of the treatment, the patient was very satisfied from a biologic and functional point of view.

  15. Economic analysis of the global polio eradication initiative.

    Science.gov (United States)

    Duintjer Tebbens, Radboud J; Pallansch, Mark A; Cochi, Stephen L; Wassilak, Steven G F; Linkins, Jennifer; Sutter, Roland W; Aylward, R Bruce; Thompson, Kimberly M

    2010-12-16

    The global polio eradication initiative (GPEI), which started in 1988, represents the single largest, internationally coordinated public health project to date. Completion remains within reach, with type 2 wild polioviruses apparently eradicated since 1999 and fewer than 2000 annual paralytic poliomyelitis cases of wild types 1 and 3 reported since then. This economic analysis of the GPEI reflects the status of the program as of February 2010, including full consideration of post-eradication policies. For the GPEI intervention, we consider the actual pre-eradication experience to date followed by two distinct potential future post-eradication vaccination policies. We estimate GPEI costs based on actual and projected expenditures and poliomyelitis incidence using reported numbers corrected for underreporting and model projections. For the comparator, which assumes only routine vaccination for polio historically and into the future (i.e., no GPEI), we estimate poliomyelitis incidence using a dynamic infection transmission model and costs based on numbers of vaccinated children. Cost-effectiveness ratios for the GPEI vs. only routine vaccination qualify as highly cost-effective based on standard criteria. We estimate incremental net benefits of the GPEI between 1988 and 2035 of approximately 40-50 billion dollars (2008 US dollars; 1988 net present values). Despite the high costs of achieving eradication in low-income countries, low-income countries account for approximately 85% of the total net benefits generated by the GPEI in the base case analysis. The total economic costs saved per prevented paralytic poliomyelitis case drive the incremental net benefits, which become positive even if we estimate the loss in productivity as a result of disability as below the recommended value of one year in average per-capita gross national income per disability-adjusted life year saved. Sensitivity analysis suggests that the finding of positive net benefits of the GPEI remains

  16. Reduced cost mission design using surrogate models

    Science.gov (United States)

    Feldhacker, Juliana D.; Jones, Brandon A.; Doostan, Alireza; Hampton, Jerrad

    2016-01-01

    This paper uses surrogate models to reduce the computational cost associated with spacecraft mission design in three-body dynamical systems. Sampling-based least squares regression is used to project the system response onto a set of orthogonal bases, providing a representation of the ΔV required for rendezvous as a reduced-order surrogate model. Models are presented for mid-field rendezvous of spacecraft in orbits in the Earth-Moon circular restricted three-body problem, including a halo orbit about the Earth-Moon L2 libration point (EML-2) and a distant retrograde orbit (DRO) about the Moon. In each case, the initial position of the spacecraft, the time of flight, and the separation between the chaser and the target vehicles are all considered as design inputs. The results show that sample sizes on the order of 102 are sufficient to produce accurate surrogates, with RMS errors reaching 0.2 m/s for the halo orbit and falling below 0.01 m/s for the DRO. A single function call to the resulting surrogate is up to two orders of magnitude faster than computing the same solution using full fidelity propagators. The expansion coefficients solved for in the surrogates are then used to conduct a global sensitivity analysis of the ΔV on each of the input parameters, which identifies the separation between the spacecraft as the primary contributor to the ΔV cost. Finally, the models are demonstrated to be useful for cheap evaluation of the cost function in constrained optimization problems seeking to minimize the ΔV required for rendezvous. These surrogate models show significant advantages for mission design in three-body systems, in terms of both computational cost and capabilities, over traditional Monte Carlo methods.

  17. The global cost of eliminating avoidable blindness

    Directory of Open Access Journals (Sweden)

    Kirsten L Armstrong

    2012-01-01

    Full Text Available Aims : To complete an initial estimate of the global cost of eliminating avoidable blindness, including the investment required to build ongoing primary and secondary health care systems, as well as to eliminate the ′backlog′ of avoidable blindness. This analysis also seeks to understand and articulate where key data limitations lie. Materials and Methods : Data were collected in line with a global estimation approach, including separate costing frameworks for the primary and secondary care sectors, and the treatment of backlog. Results : The global direct health cost to eliminate avoidable blindness over a 10-year period from 2011 to 2020 is estimated at $632 billion per year (2009 US$. As countries already spend $592 billion per annum on eye health, this represents additional investment of $397.8 billion over 10 years, which is $40 billion per year or $5.80 per person for each year between 2010 and 2020. This is concentrated in high-income nations, which require 68% of the investment but comprise 16% of the world′s inhabitants. For all other regions, the additional investment required is $127 billion. Conclusions : This costing estimate has identified that low- and middle-income countries require less than half the additional investment compared with high-income nations. Low- and middle-income countries comprise the greater investment proportion in secondary care whereas high-income countries require the majority of investment into the primary sector. However, there is a need to improve sector data. Investment in better data will have positive flow-on effects for the eye health sector.

  18. The Cost-Effectiveness of Treatment Modalities for Ureteral Stones

    Directory of Open Access Journals (Sweden)

    Justin Ji-Yuen Siu MD

    2016-10-01

    Full Text Available Additional intervention and medical treatment of complications may follow the primary treatment of a ureteral stone. We investigated the cost of the treatment of ureteral stone(s within 45 days after initial intervention by means of retrospective analysis of the National Health Insurance Research Database of Taiwan. All patients of ages ≥20 years diagnosed with ureteral stone(s( International Classification of Diseases, Ninth Revision, Clinical Modification/ICD-9-CM: 592.1 from January 2001 to December 2011 were enrolled. We included a comorbidity code only if the diagnosis appeared in at least 2 separate claims in a patient’s record. Treatment modalities (code included extracorporeal shock-wave lithotripsy (SWL; 98.51, ureteroscopic lithotripsy (URSL; 56.31, percutaneous nephrolithotripsy (PNL; 55.04, (open ureterolithotomy (56.20, and laparoscopy (ie, laparoscopic ureterolithotomy; 54.21. There were 28 513 patients with ureteral stones (13 848 men and 14 665 women in the randomized sample of 1 million patients. The mean cost was 526.4 ± 724.1 United States Dollar (USD. The costs of treatment were significantly increased in patients with comorbidities. The costs of treatment among each primary treatment modalities were 1212.2 ± 627.3, 1146.7 ± 816.8, 2507.4 ± 1333.5, 1533.3 ± 1137.1, 2566.4 ± 2594.3, and 209.8 ± 473.2 USD in the SWL, URSL, PNL, (open ureterolithotomy, laparoscopy (laparoscopic ureterolithotomy, and conservative treatment group, respectively. In conclusion, URSL was more cost-effective than SWL and PNL as a primary treatment modality for ureteral stone(s when the possible additional costs within 45 days after the initial operation were included in the calculation.

  19. Low cost submarine robot

    Directory of Open Access Journals (Sweden)

    Ponlachart Chotikarn

    2010-10-01

    Full Text Available A submarine robot is a semi-autonomous submarine robot used mainly for marine environmental research. We aim todevelop a low cost, semi-autonomous submarine robot which is able to travel underwater. The robot’s structure was designedand patented using a novel idea of the diving system employing a volume adjustment mechanism to vary the robot’s density.A light weight, flexibility and small structure provided by PVC can be used to construct the torpedo-liked shape robot.Hydraulic seal and O-ring rubbers are used to prevent water leaking. This robot is controlled by a wired communicationsystem.

  20. Cost Minimization Analysis of Different Strategies of Management of Clinically Significant Scorpion Envenomation Among Pediatric Patients.

    Science.gov (United States)

    Sinha, Madhumita; Quan, Dan; McDonald, Fred W; Valdez, André

    2016-12-01

    Scorpion antivenom was recently approved for use in patients with clinically significant scorpion envenomation in the United States; no formal economic analysis on its impact on cost of management has been performed. Three different strategies of management of scorpion envenomation with systemic neurotoxic symptoms in children were compared for cost minimization from a societal perspective. In strategy I, patients were managed with supportive care only without antivenom. In strategy II, an aggressive strategy of full-dose antivenom (initial dose of 3 vials with the use of additional vials administered 1 vial at a time) was considered. In strategy III, a single-vial serial antivenom dosing strategy titrated to clinical response was considered. Clinical probabilities for the different strategies were obtained from retrospective review of medical records of patients with scorpion envenomation over a 10-year period at our institution. Baseline cost values were obtained from patient reimbursement data from our institution. In baseline analysis, strategy I of supportive care only with no antivenom was least costly at US $3466.50/patient. Strategy III of single-vial serial dosing was intermediate but less expensive than strategy II of full-dose antivenom, with an incremental cost of US $3171.08 per patient. In a 1-way sensitivity analysis, at a threshold antivenom cost of US $1577.87, strategy III of single-vial serial dosing became the least costly strategy. For children with scorpion envenomation, use of a management strategy based on serial dosing of antivenom titrated to clinical response is less costly than a strategy of initial use of full-dose antivenom.

  1. Cost of providing injectable contraceptives through a community-based social marketing program in Tigray, Ethiopia.

    Science.gov (United States)

    Prata, Ndola; Downing, Janelle; Bell, Suzanne; Weidert, Karen; Godefay, Hagos; Gessessew, Amanuel

    2016-06-01

    To provide a cost analysis of an injectable contraceptive program combining community-based distribution and social marketing in Tigray, Ethiopia. We conducted a cost analysis, modeling the costs and programmatic outcomes of the program's initial implementation in 3 districts of Tigray, Ethiopia. Costs were estimated from a review of program expense records, invoices, and interviews with health workers. Programmatic outcomes include number of injections and couple-year of protection (CYP) provided. We performed a sensitivity analysis on the average number of injections provided per month by community health workers (CHWs), the cost of the commodity, and the number of CHWs trained. The average programmatic CYP was US $17.91 for all districts with a substantial range from US $15.48-38.09 per CYP across districts. Direct service cost was estimated at US $2.96 per CYP. The cost per CYP was slightly sensitive to the commodity cost of the injectable contraceptives and the number of CHWs. The capacity of each CHW, measured by the number of injections sold, was a key input that drove the cost per CYP of this model. With a direct service cost of US $2.96 per CYP, this study demonstrates the potential cost of community-based social marketing programs of injectable contraceptives. The findings suggest that the cost of social marketing of contraceptives in rural communities is comparable to other delivery mechanisms with regards to CYP, but further research is needed to determine the full impact and cost-effectiveness for women and communities beyond what is measured in CYP. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. The Opportunity Cost of Capital

    Directory of Open Access Journals (Sweden)

    Ayman Chit PhD

    2015-04-01

    Full Text Available The opportunity cost of the capital invested in pharmaceutical research and development (R&D to bring a new drug to market makes up as much as half the total cost. However, the literature on the cost of pharmaceutical R&D is mixed on how, exactly, one should calculate this “hidden” cost. Some authors attempt to adopt models from the field of finance, whereas other prominent authors dismiss this practice as biased, arguing that it artificially inflates the R&D cost to justify higher prices for pharmaceuticals. In this article, we examine the arguments made by both sides of the debate and then explain the cost of capital concept and describe in detail how this value is calculated. Given the significant contribution of the cost of capital to the overall cost of new drug R&D, a clear understanding of the concept is critical for policy makers, investors, and those involved directly in the R&D.

  3. Analysis and modeling of rail maintenance costs

    Directory of Open Access Journals (Sweden)

    Amir Ali Bakhshi

    2012-01-01

    Full Text Available Railroad maintenance engineering plays an important role on availability of roads and reducing the cost of railroad incidents. Rail is of the most important parts of railroad industry, which needs regular maintenance since it covers a significant part of total maintenance cost. Any attempt on optimizing total cost of maintenance could substantially reduce the cost of railroad system and it can reduce total cost of the industry. The paper presents a new method to estimate the cost of rail failure using different cost components such as cost of inspection and cost of risk associated with possible accidents. The proposed model of this paper is used for a real-world case study of railroad transportation of Tehran region and the results have been analyzed.

  4. Cost reduction in the production process using the ABC and Lean tools: Case Study in the refrigeration components industry

    Directory of Open Access Journals (Sweden)

    Levi da Silva Guimarães

    2015-03-01

    Full Text Available This paper focuses on production management with respect to operating costs that relate directly to the value of the product. For this study, three methods were used, ABC - Activity Based Costing, which provides accurate information about the knowledge of the real costs, VSM - Value Stream Mapping and Lean Manufacturing. The method adopted for this research was the case study. The study was conducted at a refrigeration components company in the Industrial Center of Manaus. The analyses and observations initially went through the process of mapping the value stream, measuring the current state of activities (cycle time, setup, etc.. After analysis it was possible to map the cost for each activity and finally calculate the cost of the product before and after the improvements resulting from the lean methodology. The results obtained in this study showed a 20% reduction in product costs resulting from operational improvements. The activity-based cost led to a discovery of the real costs of waste. The steps for this study include process mapping through the value stream, measuring the current state of activities (cycle time, setup, etc., establishing the cost driver for each activity, and finally calculating the cost of the product before and after the application of lean improvements. The paper was conducted through literature and descriptive review, and used a case study method. It describes the model that has been tested in a production line for a refrigeration components company from the Manaus Industrial Center, achieving a 20% reduction in product cost.

  5. Low-cost carriers fare competition effect

    NARCIS (Netherlands)

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

    2010-01-01

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

  6. Documenting costs and yield of crops of organic origin

    Directory of Open Access Journals (Sweden)

    J.P. Melnychuk

    2016-06-01

    Full Text Available The article focuses on the study of primary cost accounting and output of organic crop production. The article has also agreed the key issues that ensure in the primary accounting of organic crop production. For the survey we have used such general scientific methods as induction and deduction, dialectic, historical and systematic methods and some specific methods of accounting which include documentation, inventory, assessment, calculation, accounting records, double entry, balance sheet and financial statements. . As for the documentation of costs and yield of crops of organic origin, it should be noted that documentation is an important method of accounting as it’s the basis of initial observation of commercial operations and it’s a prerequisite for their reflection in accounting. The article has highlighted the features of documenting the posting of production costs and crop production of organic origin, and has also studied the order of registration of land in the operating lease for the production of organic products. The author submits the suggestions for improvement of documenting costs and yields of organic crop production in order to develop reliable information about the costs of production and the grown crop of organic origin for management decision-making.

  7. Estimating the costs of human space exploration

    Science.gov (United States)

    Mandell, Humboldt C., Jr.

    1994-01-01

    The plan for NASA's new exploration initiative has the following strategic themes: (1) incremental, logical evolutionary development; (2) economic viability; and (3) excellence in management. The cost estimation process is involved with all of these themes and they are completely dependent upon the engineering cost estimator for success. The purpose is to articulate the issues associated with beginning this major new government initiative, to show how NASA intends to resolve them, and finally to demonstrate the vital importance of a leadership role by the cost estimation community.

  8. Performance analysis of a full-field and full-range swept-source OCT system

    Science.gov (United States)

    Krauter, J.; Boettcher, T.; Körner, K.; Gronle, M.; Osten, W.; Passilly, N.; Froehly, L.; Perrin, S.; Gorecki, C.

    2015-09-01

    In recent years, optical coherence tomography (OCT) became gained importance in medical disciplines like ophthalmology, due to its noninvasive optical imaging technique with micrometer resolution and short measurement time. It enables e. g. the measurement and visualization of the depth structure of the retina. In other medical disciplines like dermatology, histopathological analysis is still the gold standard for skin cancer diagnosis. The EU-funded project VIAMOS (Vertically Integrated Array-type Mirau-based OCT System) proposes a new type of OCT system combined with micro-technologies to provide a hand-held, low-cost and miniaturized OCT system. The concept is a combination of full-field and full-range swept-source OCT (SS-OCT) detection in a multi-channel sensor based on a micro-optical Mirau-interferometer array, which is fabricated by means of wafer fabrication. This paper presents the study of an experimental proof-of-concept OCT system as a one-channel sensor with bulk optics. This sensor is a Linnik-interferometer type with similar optical parameters as the Mirau-interferometer array. A commercial wavelength tunable light source with a center wavelength at 845nm and 50nm spectral bandwidth is used with a camera for parallel OCT A-Scan detection. In addition, the reference microscope objective lens of the Linnik-interferometer is mounted on a piezo-actuated phase-shifter. Phase-shifting interferometry (PSI) techniques are applied for resolving the conjugate complex artifact and consequently contribute to an increase of image quality and depth range. A suppression ratio of the complex conjugate term of 36 dB is shown and a system sensitivity greater than 96 dB could be measured.

  9. Recovering full repair costs of INDOT infrastructure damaged by motor vehicle crashes.

    Science.gov (United States)

    2011-01-01

    There are approximately 4,000 instances per year where state property located along Indiana Department of Transportation : (INDOT) maintained right-of-way needs to be replaced or repaired due to motor vehicle crashes. INDOT incurs significant financi...

  10. Recovering full repair costs of INDOT infrastructure damaged by motor vehicle crashes : [technical summary].

    Science.gov (United States)

    2011-09-01

    There are approximately 4,000 instances per year that require infrastructure located along right-of-way maintained by the Indiana Department of Transportation (INDOT) to be replaced or repaired due to motor vehicle crashes. This infrastructure includ...

  11. A Full Overhead Cost Model for the U.S. Coast Guard Yard, Curtis Bay, Maryland.

    Science.gov (United States)

    1982-06-01

    80.0 STORAGE SHED B 43 A 35000.50 700.00 B 50 I IMPROVE SHINGLES 1750.43 40.70 B 75 I RELOCTE FLAMB STOR 22432.18 1246.23 81.0 FLAMABLE STORAGE B 43 A...35000.50 700.00 B 45 I UNKWN IMPRVMNT 50.48 1.04 B 50 I IMPROVE SHINGLES 1750.43 40.70 B 75 I RELOCTE FLAMB STOR 22432.18 1246.22 85.0 STORAGE SHED B

  12. Cost-Effectiveness Evaluation of Etoricoxib versus Celecoxib and Nonselective NSAIDs in the Treatment of Ankylosing Spondylitis in Norway

    Directory of Open Access Journals (Sweden)

    Jeroen P. Jansen

    2011-01-01

    Full Text Available Objectives. To evaluate the cost-effectiveness of etoricoxib (90 mg relative to celecoxib (200/400 mg, and the nonselective NSAIDs naproxen (1000 mg and diclofenac (150 mg in the initial treatment of ankylosing spondylitis in Norway. Methods. A previously developed Markov state-transition model was used to estimate costs and benefits associated with initiating treatment with the different competing NSAIDs. Efficacy, gastrointestinal and cardiovascular safety, and resource use data were obtained from the literature. Data from different studies were synthesized and translated into direct costs and quality adjusted life years by means of a Bayesian comprehensive decision modeling approach. Results. Over a 30-year time horizon, etoricoxib is associated with about 0.4 more quality adjusted life years than the other interventions. At 1 year, naproxen is the most cost-saving strategy. However, etoricoxib is cost and quality adjusted life year saving relative to celecoxib, as well as diclofenac and naproxen after 5 years of follow-up. For a willingness-to-pay ceiling ratio of 200,000 Norwegian krones per quality adjusted life year, there is a >95% probability that etoricoxib is the most-cost-effective treatment when a time horizon of 5 or more years is considered. Conclusions. Etoricoxib is the most cost-effective NSAID for initiating treatment of ankylosing spondylitis in Norway.

  13. Dream recall and the full moon.

    Science.gov (United States)

    Schredl, Michael; Fulda, Stephany; Reinhard, Iris

    2006-02-01

    There is ongoing debate on whether the full moon is associated with sleep and dreaming. The analysis of diaries kept by the participants (N = 196) over 28 to 111 nights showed no association of a full moon and dream recall. Psychological factors might explain why some persons associate a full moon with increased dream recall.

  14. Academic Journal Embargoes and Full Text Databases.

    Science.gov (United States)

    Brooks, Sam

    2003-01-01

    Documents the reasons for embargoes of academic journals in full text databases (i.e., publisher-imposed delays on the availability of full text content) and provides insight regarding common misconceptions. Tables present data on selected journals covering a cross-section of subjects and publishers and comparing two full text business databases.…

  15. Skin cancer full-grown from scar

    International Nuclear Information System (INIS)

    Zikiryakhodjaev, D.Z.; Sanginov, D.R.

    2001-01-01

    In this chapter authors investigate the peculiarities of skin cancer full-grown from scar, the theory of it's descent, quote some statistical data on skin cancer full-grown from scar and variety clinical forms of skin cancer full-grown from scar was shown, quote some methods of treatment

  16. Emerging Pathogens Initiative (EPI)

    Data.gov (United States)

    Department of Veterans Affairs — The Emerging Pathogens Initiative (EPI) database contains emerging pathogens information from the local Veterans Affairs Medical Centers (VAMCs). The EPI software...

  17. Life cycle cost analysis rehabilitation costs.

    Science.gov (United States)

    2015-07-01

    This study evaluates data from CDOTs Cost Data books and Pavement Management Program. Cost : indices were used to normalize project data to year 2014. Data analyzed in the study was obtained from : the CDOTs Cost Data books and the Pavement Man...

  18. Process-based costing.

    Science.gov (United States)

    Lee, Robert H; Bott, Marjorie J; Forbes, Sarah; Redford, Linda; Swagerty, Daniel L; Taunton, Roma Lee

    2003-01-01

    Understanding how quality improvement affects costs is important. Unfortunately, low-cost, reliable ways of measuring direct costs are scarce. This article builds on the principles of process improvement to develop a costing strategy that meets both criteria. Process-based costing has 4 steps: developing a flowchart, estimating resource use, valuing resources, and calculating direct costs. To illustrate the technique, this article uses it to cost the care planning process in 3 long-term care facilities. We conclude that process-based costing is easy to implement; generates reliable, valid data; and allows nursing managers to assess the costs of new or modified processes.

  19. The costs of turnover in nursing homes

    Science.gov (United States)

    Mukamel, Dana B.; Spector, William D.; Limcangco, Rhona; Wang, Ying; Feng, Zhanlian; Mor, Vincent

    2009-01-01

    Background Turnover rates in nursing homes have been persistently high for decades, ranging upwards of 100%. Objectives To estimate the net costs associated with turnover of direct care staff in nursing homes. Data and sample 902 nursing homes in California in 2005. Data included Medicaid cost reports, the Minimum Data Set (MDS), Medicare enrollment files, Census and Area Resource File (ARF). Research Design We estimated total cost functions, which included in addition to exogenous outputs and wages, the facility turnover rate. Instrumental variable (IV) limited information maximum likelihood techniques were used for estimation to deal with the endogeneity of turnover and costs. Results The cost functions exhibited the expected behavior, with initially increasing and then decreasing returns to scale. The ordinary least square estimate did not show a significant association between costs and turnover. The IV estimate of turnover costs was negative and significant (p=0.039). The marginal cost savings associated with a 10 percentage point increase in turnover for an average facility was $167,063 or 2.9% of annual total costs. Conclusion The net savings associated with turnover offer an explanation for the persistence of this phenomenon over the last decades, despite the many policy initiatives to reduce it. Future policy efforts need to recognize the complex relationship between turnover and costs. PMID:19648834

  20. Thoracic surgical resident education: a costly endeavor.

    Science.gov (United States)

    Calhoon, John H; Baisden, Clint; Holler, Ben; Hicks, George L; Bove, Ed L; Wright, Cameron D; Merrill, Walter H; Fullerton, Dave A

    2014-12-01

    We sought to define an accurate measure of thoracic surgical education costs. Program directors from six distinct and differently sized and geographically located thoracic surgical training programs used a common template to provide estimates of resident educational costs. These data were reviewed, clarifying questions or discrepancies when noted and using best estimates when exact data were unavailable. Subsequently, a composite of previously published cost-estimation products was used to capture accurate cost data. Data were then compiled and averaged to provide an accurate picture of all costs associated with thoracic surgical education. Before formal accounting was performed, the estimated average for all programs was approximately $250,000 per year per resident. However, when formal evaluations by the six programs were performed, the annual cost of resident education ranged from $330,000 to $667,000 per year per resident. The average cost of $483,000 per year was almost double the initial estimates. Variability was noted by region and size of program. Faculty teaching costs varied from $208,000 to $346,000 per year. Simulation costs ranged from $0 to $80,000 per year. Resident savings to program ranged from $0 to $135,000 per year and averaged $37,000 per year per resident. Thoracic surgical education costs are considerably higher than initial estimates from program directors and probably represent an unappreciated source of financial burden for cardiothoracic surgical educational programs. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  1. The costs of turnover in nursing homes.

    Science.gov (United States)

    Mukamel, Dana B; Spector, William D; Limcangco, Rhona; Wang, Ying; Feng, Zhanlian; Mor, Vincent

    2009-10-01

    Turnover rates in nursing homes have been persistently high for decades, ranging upwards of 100%. To estimate the net costs associated with turnover of direct care staff in nursing homes. DATA AND SAMPLE: Nine hundred two nursing homes in California in 2005. Data included Medicaid cost reports, the Minimum Data Set, Medicare enrollment files, Census, and Area Resource File. We estimated total cost functions, which included in addition to exogenous outputs and wages, the facility turnover rate. Instrumental variable limited information maximum likelihood techniques were used for estimation to deal with the endogeneity of turnover and costs. The cost functions exhibited the expected behavior, with initially increasing and then decreasing returns to scale. The ordinary least square estimate did not show a significant association between costs and turnover. The instrumental variable estimate of turnover costs was negative and significant (P = 0.039). The marginal cost savings associated with a 10% point increase in turnover for an average facility was $167,063 or 2.9% of annual total costs. The net savings associated with turnover offer an explanation for the persistence of this phenomenon over the last decades, despite the many policy initiatives to reduce it. Future policy efforts need to recognize the complex relationship between turnover and costs.

  2. Treatments for Metastatic Prostate Cancer (mPC): A Review of Costing Evidence.

    Science.gov (United States)

    Norum, Jan; Nieder, Carsten

    2017-12-01

    Prostate cancer (PC) is the most common cancer in Western countries. More than one third of PC patients develop metastatic disease, and the 5-year expected survival in distant disease is about 35%. During the last few years, new treatments have been launched for metastatic castrate-resistant prostate cancer (mCRPC). We aimed to review the current literature on health economic analysis on the treatment of metastatic prostate cancer (mPC), compare the studies, summarize the findings and make the results available to administrators and decision makers. A systematic literature search was done for economic evaluations (cost-minimization, cost-effectiveness, cost-utility, cost-of-illness, cost-of-drug, and cost-benefit analyses). We employed the PubMed ® search engine and searched for publications published between 2012 and 2016. The terms used were "prostate cancer", "metastatic" and "cost". An initial screening of all headlines was performed, selected abstracts were analysed, and finally the full papers investigated. Study characteristics, treatment and comparator, country, type of evaluation, perspective, year of value, time horizon, efficacy data, discount rate, total costs and sensitivity analysis were analysed. The quality was assessed using the Quality of Health Economic Studies (QHES) instrument. A total of 227 publications were detected and screened, 58 selected for full-text assessment and 31 included in the final analyses. Despite the significant international literature on the treatment of mCRPC, there were only 15 studies focusing on cost-effectiveness analysis (CEA). Medical treatment constituted two thirds of the selected studies. Significant costs in the treatment of mCRPC were disclosed. In the pre-docetaxel setting, both abiraterone acetate (AA) and enzalutamide were concluded beyond accepted cost/quality-adjusted life year limits. In the docetaxel refractory setting, most studies concluded that enzalutamide was cost-effective and superior to AA. In

  3. Cost-minimization analysis of subcutaneous abatacept in the treatment of rheumatoid arthritis in Spain

    Directory of Open Access Journals (Sweden)

    R. Ariza

    2014-07-01

    Full Text Available Objective: To compare the cost of treating rheumatoid arthritis patients that have failed an initial treatment with methotrexate, with subcutaneous aba - tacept versus other first-line biologic disease-modifying antirheumatic drugs. Method: Subcutaneous abatacept was considered comparable to intravenous abatacept, adalimumab, certolizumab pegol, etanercept, golimumab, infliximab and tocilizumab, based on indirect comparison using mixed treatment analysis. A cost-minimization analysis was therefore considered appropriate. The Spanish Health System perspective and a 3 year time horizon were selected. Pharmaceutical and administration costs (, 2013 of all available first-line biological disease-modifying antirheumatic drugs were considered. Administration costs were obtained from a local costs database. Patients were considered to have a weight of 70 kg. A 3% annual discount rate was applied. Deterministic and probabilistic sensitivity analyses were performed. Results: Subcutaneous abatacept proved in the base case to be less costly than all other biologic antirrheumatic drugs (ranging from -831.42 to -9,741.69 versus infliximab and tocilizumab, respectively. Subcutaneous abatacept was associated with a cost of 10,760.41 per patient during the first year of treatment and 10,261.29 in subsequent years. The total 3-year cost of subcutaneous abatacept was 29,953.89 per patient. Sensitivity analyses proved the model to be robust. Subcutaneous abatacept remained cost-saving in 100% of probabilistic sensitivity analysis simulations versus adalimumab, certolizumab, etanercept and golimumab, in more than 99.6% versus intravenous abatacept and tocilizumab and in 62.3% versus infliximab. Conclusions: Treatment with subcutaneous abatacept is cost-saving versus intravenous abatacept, adalimumab, certolizumab, etanercept, golimumab, infliximab and tocilizumab in the management of rheumatoid arthritis patients initiating

  4. OPTIMIZATION OF TIMES AND COSTS OF PROJECT OF HORIZONTAL LAMINATOR PRODUCTION USING PERT/CPM TECHNICAL

    Directory of Open Access Journals (Sweden)

    Fernando Henrique Lermen

    2016-09-01

    Full Text Available The PERT/CPM is a technique widely used in both the scheduling and in the project feasibility in terms of cost control and time.  In order to optimize time and costs involved in production, the work presented here aims to apply the PERT/CPM technique in the production project of the Horizontal Laminator, a machine used to cut polyurethane foam blocks in the mattresses industries. For the application of PERT/CPM technique in the project of Horizontal Laminator production were identified the activities that compose the project, the dependence between them, the normal and accelerated durations and the normal and accelerated costs. In this study, deterministic estimates for the duration of the activities were considered. The results show that the project can be completed in 520 hours at a total cost of R$7,042.50, when all activities are performed in their normal durations.  When all the activities that compose the critical path are accelerated, the project can be completed in 333.3 hours at a total cost of R$9,263.01. If the activities slacks have been exploited, it can obtain a final total cost of R$6,157.8, without changing the new duration of the project. It is noteworthy that the final total cost of the project if the slacks are used, will be lower than the initial cost. Regarding the initial cost of the project, after the application of the PERT/CPM technique, it presents a decrease of 12.56% of the total project cost.

  5. Targeted Radiation Therapy for Cancer Initiative

    Science.gov (United States)

    2017-11-01

    AWARD NUMBER: W81XWH-08-2-0174 TITLE: Targeted Radiation Therapy for Cancer Initiative PRINCIPAL INVESTIGATOR: Dusten Macdonald, MD...for Cancer Initiative 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Dusten Macdonald, MD 5d. PROJECT NUMBER...Cancer Initiative Final Report INTRODUCTION: The full potential of radiation therapy has not been realized due to the inability to locate and

  6. Achieving single channel, full duplex wireless communication

    KAUST Repository

    Choi, Jung Il; Jain, Mayank; Srinivasan, Kannan; Levis, Phil; Katti, Sachin

    2010-01-01

    This paper discusses the design of a single channel full-duplex wireless transceiver. The design uses a combination of RF and baseband techniques to achieve full-duplexing with minimal effect on link reliability. Experiments on real nodes show the full-duplex prototype achieves median performance that is within 8% of an ideal full-duplexing system. This paper presents Antenna Cancellation, a novel technique for self-interference cancellation. In conjunction with existing RF interference cancellation and digital baseband interference cancellation, antenna cancellation achieves the amount of self-interference cancellation required for full-duplex operation. The paper also discusses potential MAC and network gains with full-duplexing. It suggests ways in which a full-duplex system can solve some important problems with existing wireless systems including hidden terminals, loss of throughput due to congestion, and large end-to-end delays. Copyright 2010 ACM.

  7. Applying activity-based costing to healthcare settings.

    Science.gov (United States)

    Canby, J B

    1995-02-01

    Activity-based costing (ABC) focuses on processes that drive cost. By tracing healthcare activities back to events that generate cost, a more accurate measurement of financial performance is possible. This article uses ABC principles and techniques to determine costs associated with the x-ray process in a midsized outpatient clinic. The article also provides several tips for initiating an ABC cost system for an entire healthcare organization.

  8. Review of the cost of venous thromboembolism

    Science.gov (United States)

    Fernandez, Maria M; Hogue, Susan; Preblick, Ronald; Kwong, Winghan Jacqueline

    2015-01-01

    Background Venous thromboembolism (VTE) is the second most common medical complication and a cause of excess length of hospital stay. Its incidence and economic burden are expected to increase as the population ages. We reviewed the recent literature to provide updated cost estimates on VTE management. Methods Literature search strategies were performed in PubMed, Embase, Cochrane Collaboration, Health Economic Evaluations Database, EconLit, and International Pharmaceutical Abstracts from 2003–2014. Additional studies were identified through searching bibliographies of related publications. Results Eighteen studies were identified and are summarized in this review; of these, 13 reported data from the USA, four from Europe, and one from Canada. Three main cost estimations were identified: cost per VTE hospitalization or per VTE readmission; cost for VTE management, usually reported annually or during a specific period; and annual all-cause costs in patients with VTE, which included the treatment of complications and comorbidities. Cost estimates per VTE hospitalization were generally similar across the US studies, with a trend toward an increase over time. Cost per pulmonary embolism hospitalization increased from $5,198–$6,928 in 2000 to $8,764 in 2010. Readmission for recurrent VTE was generally more costly than the initial index event admission. Annual health plan payments for services related to VTE also increased from $10,804–$16,644 during the 1998–2004 period to an estimated average of $15,123 for a VTE event from 2008 to 2011. Lower costs for VTE hospitalizations and annualized all-cause costs were estimated in European countries and Canada. Conclusion Costs for VTE treatment are considerable and increasing faster than general inflation for medical care services, with hospitalization costs being the primary cost driver. Readmissions for VTE are generally more costly than the initial VTE admission. Further studies evaluating the economic impact of new

  9. Materials Genome Initiative

    Data.gov (United States)

    National Aeronautics and Space Administration — Develop computational tools to assist in the manufacture, design and certification of new materials and processes. These tools will reduce the time and costs to...

  10. Nonfasting Versus Initial Fasting Ketogenic Diet

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2005-02-01

    Full Text Available A retrospective evaluation of the ketogenic diet (KD was conducted comparing efficacy and tolerability of the diet with or without initial fasting and fluid restriction and involving university centers in Seoul, Korea.

  11. Current Editorial Initiatives: A Progress Report

    Directory of Open Access Journals (Sweden)

    Werner Ulrich

    2013-01-01

    Full Text Available This editorial article reports on the progress that the Journal of Research Practice (JRP has achieved in its ongoing development since November 2011, when a number of editorial initiatives were announced. Several new initiatives are also proposed. In addition, there are some current announcements, including a number of recent awards, distinctions, and nominations.

  12. Comparative dynamic analysis of the full Grossman model.

    Science.gov (United States)

    Ried, W

    1998-08-01

    The paper applies the method of comparative dynamic analysis to the full Grossman model. For a particular class of solutions, it derives the equations implicitly defining the complete trajectories of the endogenous variables. Relying on the concept of Frisch decision functions, the impact of any parametric change on an endogenous variable can be decomposed into a direct and an indirect effect. The focus of the paper is on marginal changes in the rate of health capital depreciation. It also analyses the impact of either initial financial wealth or the initial stock of health capital. While the direction of most effects remains ambiguous in the full model, the assumption of a zero consumption benefit of health is sufficient to obtain a definite for any direct or indirect effect.

  13. Materials Genome Initiative Element

    Science.gov (United States)

    Vickers, John

    2015-01-01

    NASA is committed to developing new materials and manufacturing methods that can enable new missions with ever increasing mission demands. Typically, the development and certification of new materials and manufacturing methods in the aerospace industry has required more than 20 years of development time with a costly testing and certification program. To reduce the cost and time to mature these emerging technologies, NASA is developing computational materials tools to improve understanding of the material and guide the certification process.

  14. AC Initiation System.

    Science.gov (United States)

    An ac initiation system is described which uses three ac transmission signals interlocked for safety by frequency, phase, and power discrimination...The ac initiation system is pre-armed by the application of two ac signals have the proper phases, and activates a load when an ac power signal of the proper frequency and power level is applied. (Author)

  15. Misinterpretation of the strategic significance of cost driver analysis: evidence from management accounting theory and practice

    Directory of Open Access Journals (Sweden)

    Henry T Palowski

    2011-06-01

    Full Text Available This paper traces the development of cost driver theory in the Strategy literature and reflects on misinterpretations of the strategic significance of the theory in related academic disciplines, notably Management Accounting. Management Accounting has largely been responsible for informing costing practice in a wide range of organizational settings. The paper considers one such application- i.e. the case of the Higher Education Funding Council’s (HEFC costing and pricing initiative for UK universities. The project was completed just under five years ago, although details of implementation are still ongoing, to a degree. The systems in place incorporate most of the theoretical flaws outlined in this paper. Rather than providing cost driver analysis to aid the strategic management process in universities, the system appears to represent little more than a compliance and reporting framework between university central administrations and the funding provider, HEFC.

  16. Appling a Novel Cost Function to Hopfield Neural Network for Defects Boundaries Detection of Wood Image

    Directory of Open Access Journals (Sweden)

    Qi Dawei

    2010-01-01

    Full Text Available A modified Hopfield neural network with a novel cost function was presented for detecting wood defects boundary in the image. Different from traditional methods, the boundary detection problem in this paper was formulated as an optimization process that sought the boundary points to minimize a cost function. An initial boundary was estimated by Canny algorithm first. The pixel gray value was described as a neuron state of Hopfield neural network. The state updated till the cost function touches the minimum value. The designed cost function ensured that few neurons were activated except the neurons corresponding to actual boundary points and ensured that the activated neurons are positioned in the points which had greatest change in gray value. The tools of Matlab were used to implement the experiment. The results show that the noises of the image are effectively removed, and our method obtains more noiseless and vivid boundary than those of the traditional methods.

  17. Methodology of social and environmental external costs estimation in the Ukraine’s energy sector

    Directory of Open Access Journals (Sweden)

    Karaieva Nataliia Veniaminivna

    2016-09-01

    Full Text Available Paper objective is analysis of the external costs assessment model for the eco-social damage, and/or human capital losses caused by environmental pollution from the energy enterprises in Ukraine. Using the given method, necessary initial socio-economic parameters were defined and used for calculating the social costs of capital health losses in Ukraine due to deterioration of the environment, and due to the negative impact of energy sector on the air quality for the period 2002-2013. On the proposed technique determines the range value of social losses due to the negative impact of energy on air quality in Ukraine excluding future external costs for years 2002 – 2013 ranges from 1.6 – 4.5% of GDP, and the range of values of taking into account future costs is 2.0 – 6.2% of GDP.

  18. Do randomized controlled trials discuss healthcare costs?

    Directory of Open Access Journals (Sweden)

    G Michael Allan

    Full Text Available BACKGROUND: Healthcare costs, particularly pharmaceutical costs, are a dominant issue for most healthcare organizations, but it is unclear if randomized controlled trials (RCTs routinely discuss costs. Our objective was to assess the frequency and factors associated with the inclusion of costs in RCTs. METHODS AND FINDINGS: We randomly sampled 188 RCTs spanning three years (2003-2005 from six high impact journals. The sample size for RCTs was based on a calculation to estimate the inclusion of actual drug costs with a precision of +/-3%. Two reviewers independently extracted cost data and study characteristics. Frequencies were calculated and potential characteristics associated with the inclusion of costs were explored. Actual drug costs were included in 4.7% (9/188 of RCTs; any actual costs were included in 7.4% (14/188 of RCTs; and any mention of costs was included in 27.7% (52/188 of RCTs. As the amount of industry funding increased across RCTs, from non-profit to mixed to fully industry funded RCTs, there was a statistically significant reduction in the number of RCTs with any actual costs (Cochran-Armitage test, p = 0.005 and any mention of costs (Cochran-Armitage test, p = 0.02. Logistic regression analysis also indicated funding was associated with the inclusion of any actual cost (OR = 0.34, p = 0.009 or any mention of costs (OR = 0.63, p = 0.02. Journal, study conclusions, study location, primary author's country and product age were not associated with inclusion of cost information. CONCLUSION: While physicians are encouraged to consider costs when prescribing drugs for their patients, actual drug costs were provided in only 5% of RCTs and were not mentioned at all in 72% of RCTs. Industry funded trials were less likely to include cost information. No other factors were associated with the inclusion of cost information.

  19. CT colonography and cost-effectiveness

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-11-15

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

  20. CT colonography and cost-effectiveness

    International Nuclear Information System (INIS)

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

    2008-01-01

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